JOURNAL OF RESEARCH IN MEDICAL SCIENCES (JRMS)
Year:2002 | Volume:6 | Issue:4|Papers Count:30

Introduction. Sludge production from municipal wastewater treatment plants should have quality standards before disposal in to the environment. Environmental specialists classified sewage sludge as a hazardous waste because of high organic compounds and pathogenic microorganisms. They belive that sewage should be stabilized before disposal and so composting of sewage sludge is an effective and economical method to stabilize. Sewage sludge compost could be used to improve soil structure and enrich the soil with nutrients. Methods. To evaluate the optimum conditions of aerobic compost, the mixture of dewatered sewage sludge from Isfahan municipal waste water treatment plant and sawdust as bulking agent were used. Pilot scale study were performed in Isfahan municipal waste water treatment plant. To perform this research project, the dewatered sewage sludge with humidity between 78 to 82 percent were mixed with sawdust. Turning over method of the piles with one week interval were applied to aerate the mixture. Temperature of the piles were monitored at different depths daily. Other parameters such as N, G, organic matters and pH were determined weekly. Total and fecal coli form, and salmonella were determined at the beginning and end of the composting process, also heavy metals were measured at the same time. Results. The results of this study showed that after days, temperature of the mixture reached up to 55 G, and were stabled for 15 days. Humidity, organic matter, organic carbon and GIN ratio of the mixture decreased over the period of the study, due to increasing the temperature. Also organic matter and humidity mainly decreased in thermofilic phase. The number of total and fecal coliform and also salmonella decreased to A class standards of US.EPA at the end of the operation. Discussion. The results of the study also showed that, this type of composting method is reliable, and simple to schedule, with high flexibility and low odor production. Organic compounds and pathogenic microorganisms reduced and EPA standards were reached during this project.

Introduction. Sandflies are vectors of at least three kind of diseases to man amoung which the most important one is leishmaniosis. In this study fauna and seasonal activity of different species of sandflies in Lordegan county, Chaharmahal - Bakhtiari province, an endemic area of visceral leishmaniosis is elucidated. Methods. During April to October 1995, sandflies were collected by sticky traps from Barz and Shovartz regions located in the west of Lordegan twice a month. The collected sandflies fixed and cleared in Puris medium and idendified morphologically. Results. Totally 3497 sandflies were collected and identified. Eight species of genus Phlebotomus and ten species of genus sergentomyia. Discussion. P. alexandri and P. sergenti from genus Phlebotomus and S. dentata, S. theodori, S. sintoni and S. tiberiadis from genus sergentomyia were predominant species. Also seasonal activity of P. major and P. keshishiani, the probable species of visceral leishmaniosis was confirmed.

Introduction. Adolescence is one of the most critical periods in human life which impairs calmness and leads to imbalance. Healthy character of an adolescent is based on parents approach. Usually in this period, children will be separate from parents because of some psychological characters. Determination of ralation between family function and psychological characters provide good information for management this important subject. Methods. Random samples from high school students (438 boys and 454 girls) were studied. To assess family function, they filled out questionaire asking about responsibility affinity to religion, self concept and future expectancy. Results. Function of family related to boys in the vast majority was desired and in cases of girls was relatively desired. Family function related positively to psychological characters (responsibility self concept, affinity to religion and future expectancy) (P<0.001). All of the above psychological characters except for affinity to religion were different between boys and girls (P<0.05). Discussion. This study confirmes positive relationship between family function and psychological characters of adolescents. The more desired family function, the more desired will be reponsibility self concept, future expectancy and affinity. to religion. The above finding are compatible with other, finding in setting like this to have healthy children we advise parents to consider their expectations.

Introduction. Chronic renal failure and dialysis are complicated situations that affect on somatic and mental status of patients. In this study, relation between stress, renal diseas, dialysis and mental disorders was determined. Methods. In a case control study in Noor hospital"s dialysis ward (affiliated to Isfahan University of Medical Sciences and Health Services) the mental status of 30 end stage renal disease (ESRD) patients were compaired with well matched control group by MMPI. Results. Hypochondriasis (Hs), depression (D), hysteria (Hy) psychastenia (Pt) and schizophrenia (Sc) were observed in ESRD patients more than controls (P<0.05). Means of sociopathy (Pd), paranoia (Pa) and hypomania (Ma) had no difference between groups (P>0.05). Realy sadness and dysphoria, rumintion with illness, obsession, anxiety, compulsion, impaired process of thinking, isolation tendency and odd sensation in patients were more than control group (P<0.05). Discussion. Chronic diseases have psychological complication and as a stress must cope and adjust with it. So, these patients and their families must be educated about coping mechanism. When the patients and their families have good coping mechanism, they would be able tolerate these streses.

Introduction. Renovascular disease is the commonset form of surgically curable hypertension Estimates of the prevalence in general population range from 0.2 percent to 4 percent. It is the most common secondary form of hypertension that is not easily recognizable but curable. We studied the frequency of bilateral renal artery stenosis in patients who had been candidated for coronary artery angiography. Methods. Angiography of oronary and renal artery were done in three hundred patients (56.5 percent female and 43.5 percent male), simultaneously. The procedure was done by digital substraction angiography tract in chamran hospital (affiliated ti IUMSHS). Results. Fifthy patients had renal artery stenosis. Fourthy six patients had unilateral and four patients had bilateral renal artery stenosis. Only 8 percent of renal stenosis was bilateral. Discussion. Atherosclerosis is the most frequent cause of renal artery stenosis. It is often bilateral and progressive, but in this study only 8 percent of patients (1.3 percent of all patients that undergo angiography) had bilateral renal artery stenosis. Therefore in our study bilateral renal artery stenosis was much lower from previous study in other country.

Introduction. One of the characteristic signs of uremic syndrome is anemia. One of major factors that affects on severity of anemia in ESRD is underlying diseas. The porpuse of this study is to compaire anemia between diabetic and non diabetic ESRD patients. Methods. In a case control study we compared the mean valuse of Hb, Het, MCV, MCH, MCHC, BUN, Cr and duration of dialysis between diabetic and nondiabetic patients on chronic hemodialyis. some variables (such as age, sex, use of erythropoietin, nonderolone decaonats, folic acid, ferrous sulfate, transfusion and blood loss in recent three months and acquired kidney cysts) were matched between cases and controls. Results. Means of Hb were 9±1.3 and 8±1.7 in diabetic and non diabetic patients (P<0.05). Mean corposcular volume in diabetic patients (91±3.1 fl) was more higher than non diabetic ones (87.1±8.9) (P<0.05). Other indices had no differences between two groups (P>0.05). Discussion. Severity of anemia in patients with diabetic nephropathy is milder that other patients with ESRD. So, Anemia as an indicator of chronocity of renal disease in diabetics is missleading.

Introduction. Expresssion of tardive dyskinesia as one of the side effects of antipsychotic drugs causes various problems in psychotic patients. It is the main cause of patient"s drug incompliance.Vitamine E with it"s antioxidants properties might be an effective treatment for tardive dyskinesia. Methods. In a randomized double blind clinical trial, thirty inpatients of the psychiatric hospital in Isfahan were studied. Patients were stratified according to their age, psychiatric disorder and duration, intensity of tardive dyskinesia and antipsychotic dosage. Then they were asssigned randomly into two groups. Vitamine E (600 mg/day) was administered to interventional group (15 patients). Another group received placebo (15 patients). Treatment durated for 6 weeks. Abnormal Involuntary Movment Scale (AIMS) was used to measure tardive dyskinesia intensity. Results. Average of disorder intensity in those who received vit. E, dropped down from 8.33/10 (befor treatment) to 6.13/10 (after treatment). It means 26.3 percent reduction of tardive dyskinesia intensity. This difference was only 7.3 percent in control group. There were no statistical diffrence between two groups after treatment (P>0.05). Discussion. There is no statistical efficacy for vitamine E in the management of tardive dyskinesia. But it is recommended to make another study with more samples.

Introduction. There are increasing interests about pharmacotherapy in depressed children and adolescents. Althought TCAs (such as imipramine) are approved for use in enuresis and ADHD, but controlled studies have failed to demonstrate efficacy of them over placebo in the treatment of depressive disorders in both children or adolescents. On the other hand, a relatively more amount of studies address SSRls (such as fluoxetine), as the drug of choice for treatment of depressed children and adolescents, because of theire effectiveness and safety. Methods. In this retrospective study, 306 depressed child and adolescent (7-18 year old) who admitted to a psychiatric out patient clinic were studied (196 male and 110 female). Imipramine and fluoxetin were administered for 47 percent and 43 percent of cases, respectively. Results. In imipramin geoup and fluoxetine group the symptoms of 126 (87 percent) and 102 (77 percent) patient was improved, respectively. The frequency of side effects was 21 percent for imipramin (specialy sedation, dizziness and palpitation) and 22 percent for fluoxatine (specially headache, insomnia and agitation). Discussion. This study suggests that both imipramin and fluoxetine are efficient for tratment of children and adolescents depression. However, because of high theraputic index of fluoxetine, this drug may be a better choice.

Introduction. Valuable effects of oral clonidine hemodynamic instability during general anesthesia and prolongation of spinal anesthesia were approved in previous studies. In this study, the effects of clonidine as an oral premedication on the duration of block, hemodynamic status and ephedirine requirements in patients undergoing spinal anesthesia, has been evaluated. Methods. In a double blind controlled clinical trial, sixty patients of ASA class I and II, who were candidates for spinal anesthesia for lower abdominal and lower extremity surgical procedures of less than 90 minutes duration, were randomly divided into two equal groups. In interventional group, clonidine and in another control group placebo, was taken orally, 90 minutes before begining of operation. Blood pressure and pulse rate in predetermined times, the amounts of ephedrine being used, duration of sensory and motor blocks and the block level were compaired. Results. Mean changes in MAP and pulse rate at 10 minutes before and 10 minutes after induction of spinal anesthesia from basic values in the study group was more than control group (P<0.05). Mean duration of sensory and motor block in the study group was more than the control group (P<0.001). Mean of the ephedrine requirements in the study group (5.47±7.5rng) was more than the control group (1.9±4.97mg) (P<0.05). Block levels was the same (P>0.05). Discussion. It is implicated that the effect of oral clonidine premedication in prolongation the block time in spinal anesthesia is almost conclusive. But regarding more hemodynamic flactuations in the study group, the results of this study was different from studies that performed with general anesthesia. This may be due to additive effects of spinal anesthesia or inappropriate dose of clonidine. More ephedrine requirements in the study group was due to more hemodynamic instability in this group which may be decreased by modifying the clonidine dose. It is suggested that for the routine use of oral clonidine in spinal anesthesia, further evalutions with greater number of patients and various doses of clonidine is necessary.

Introduction. Depression as a cause of stress increase free radicals in serum. It can oxidize lipids and result in atherosclerosis. Kinds of these products are malondialdhyde (MAD), conjugated diene (CD) and antioxidants capacity. Methods. Two groups of patients with major deppressive disorder (MDD) were studied. Group one consisted of fifthy patients with unipolar MDD, second group was bipolar MDD and third one was control healthy ones. Diagnosis was cofirmed by DSM-IV. Beck test was used to follow up patients. Before and after three month of treatment, MAD, CO and antioxidants capacity were compaired in three groups. Results. MAO and antioxidant capacity were decreased after treatment in unipolar and bipolar MDD (P<0.001). But, there was no significant difference between CD serum levels before from after study. Discussion. Stress oxidants have a rcognized effect on coronary artery disease by lipid peroxidation. So, by findings in this study, it is believed that antideppressive therapy can reduce coronary artery events in patients suffered from deppressive disorders, by reducing these agents in serum.

Introduction. Despite of vital role of blood and it"s components as an only curable treatment, it"s transfusion is accompanied by many complications. In the other way, the most important adverse effects of anemia is decrease in oxygen supply to the tissues. Therefore, it is essential to determine those patients need to blood transfusion and exact hemoglobine and hematocrite level which transfusion become necessary. Recent studies show that during general anesthesia due to vasodilation in the level of microcirculation and passage of many red blood cells from microcirculation there is a decreasing in hemoglobine level measured in peripheral veins which named plasma skimming. So, during sampling of hemoglobine and hematocrite from peripheral veins, there is a pseudodecrease in Hb and HCT levels. In this study we want to determine this decrease in Hb and HeT. Methods. Study was done in 182 patients with ASA 1 and 2 undergoing general or local anesthesia for cataract surgery. Duration of nill per os (NPO), preoperotive and intraoperative intravenous fluid administration were simillar in two groups. A sample of blood for preoperative evaluation and another one immediately after operation achevied and compared with each other. Results. There was not significant differences between mean Hb and HCT in two groups preoperotive. But postoperative, there was a significant differences between mean Hb and HCT in general anesthesia vs local anesthesia (P<0.01). This decrease in Hb and HCT was orderly 0.91±1.14 gr/dl for Hb and 2.862±3.6 percent for Hct. Discussion. In determining of Hb and HCT immediately after general anesthesia, there is some pseudo decrease due to plasma skimming that must be appreciated.

Introduction . Tonsillectomy performed by a variety of techniques such as laser bipolor and monopolar electrodissetion and blunt dissection (classic method). Serious and lethal post operative complications secondary to tonsillectomy are related to bleeding and anesthesia. For this reason we have introduced a modified form of electrodissection tonsillectomy using bipolor scissor diathermy to compare the morbidities with classic method. Methods. One hundered patients (2 to 30 years old) candidate for tonsillectomy, were entered in a randomized controlled clinical trial to compare the post tonsillectomy morbidities. Fifty patients were operated with bipolar electrosurgical scissor and fifty patients with classic method. This study was performed in Kashani and Alzahra medical centers of Isfahan University. Patients with a positive history of bleeding tendency and tonsillectomy performed because of tonsillar cancer or uppp. uvulopalato pharyngoplasty) were excluded. Re suits. Bipolar electrosurgical scissor tonsillectomy significantly reduce intraoperative bleeding (3.1±4.5 mL) in comparison to classic method (70±30.61 mL) (P<0.001). No bleeding Dccurs in 24 hours and 10 day after operation in both methods. Mean of pain intensity in both methods, was similar. Mean time of ability for fluid Swallawing after bipolar method was lesser than classic method (3/4±1/47 h VS 4±1/69 h) (P>0.05). Bipolar tonsillectomy siqnificantly reduces the time of operation and anesthesia (7.3±2.76 min VS 11.5±3.29 min) (P<0.001). Only 4 percent of electrodissection qroup and 70 percent of classic group was required to suturing in tonsillar bed (P<0.001). Delayed otalgia in electrosurgical grbup was greater than classic group. Discussion. The most common cause of death in tonsillectomy is bleeding and anesthetic complication. We believe the bipolar electrosurgical tonsillectomy result in significantly reduce intraoperative blood loss and time of operation and .lesser need to sutring of tonsillor bed. Thus if we can reduce the post operotive otalgia in electrodissection method, this method will be the best technique of tonsillectomy in future.

Introduction. It is very important to know the resistant bacteria to common used antibiotics in our community. Staphylococcus coagulase positive was the main cause of infection in infectious disease. This study was done to demonstrate the pattern of resistance to batalactamase antibiotics among staphiococci. Methods. During a period of five month, 38 coagulase positive staphylococcus isolates were identified from various clinical specimens from 600 patients at the AI-Zahra university hospital (affiliated to IUMSHS). Results. Betalactamase production assays using rapid acidometric and iodometric tests showed that 78.9 percent and 73.6 percent of isolates were positive, respectively. The differnce in determination rate between acidometric and iodometric tests was not statistically significant. Moreover the acidometric test was cheaper and more easy to perform than iodometric test. In vitro sensitivity testing using the disc diffusion method showed that all of isolates were resistant to carbenicillin, ampicillin and amoxicillin, while 7.9 percent and 13.2 percent were resistant to cefazolin and cephalexin, respectively. Discussion. We recommend use of cefazolin, cephalexin and oxacillin for treatment of patients with staphylococcus infections.

Introduction. The yeasts are a large group of fungi. In addition to their different uses in food industries and pharmacology they can also cause human and animal infections under predisposing factors. For investigating the yeast"s growth phases and diagnosis of the species, they should culture in media from natural sources like the seeds on the commercial media. According to yeast"s nutritinal requierments and considering the various nutritional materials of seeds like wheat, rice, barney and better use of these seed"s compounds during sprouting, this research was done with the aim of measurment of growth rate and yeasts characterization in such media. Methods. For making seeds media, a fixed quantity of seed"s flour or sprout"s flour was added to a certain amount of agar in acidotic condition (pH=5.8). The germination of seeds was done by Hus method and for colony counting Mc, Farland tubes were used and microscopic and macroscopic characteristics were investigated and compared in both synthetic and seed media Results. The results showed that the rate of yeasts growth in all germinated seeds was more than the seeds themeselves. Statistical analysis showed no significal difference between the growth rate of yeasts in both wheat and barney sprout compared to the commercial media. In the microscopic studies, the species of Candida albicans in wheat flour has produced more chlamydoconidia than the synthetic medium of corn meal agar. Also production of the capsule in C.neoformans in the seed"s media has been better than the synthetic media. Discussion. According to the promising results obtained from the present study regard to the growth rate and differentiation of the fungal species in such media, standardization and mass production of them in our country would seem to be an productive step towards self sufficiency.

Introduction. Memory and learning play an important role in human"s life that will become problematic in case disability is weak for any reason. There are many factors that facilitate process of mamory and learning of which accumbens nucleus plays an important role. Accumbens nucleus, which is a part of the limbic system, is one of many nuclei found of the septum in the mesencephalon. This study was performed to determine the effects of reversible Inactivation of a accumbens nuclei by lidocaein on memory storage in rat. Method s. Male wistar rats were surgically implancted with cannulae at the accumbens nuclei (Acb) bilaterally one weak later they recived one trial PAL (1 mA 1.S sec) and exactly at times zero, 60 and 120 minutes after posttraining, lidocaine was infused into the Acb. Retention was tested two days after training. Latency period before entering into the dark part of the shuttle box and duration of time in darkness were index for evaluation of retention. Results. A significant impaired retention performance was at zero and 60 minutes after posttrianing infusion of lidocaine into the Acb. Infusion administered 120 minutes after training had no effect. Discussion. This study has shown that Accumbens nucleus plays major role in praimary learning and memory and it is probable that by blocking this nucleus dopamine release is diminished which causes the learning process to be delayed consequently. 

Introduction. Despite the development of effective surgical treatment, abdominal aortic aneurysm remains a major cause of mortality throughout the world. In this study, demographic characteristics of patients with abdominal aortic aneurysm and post operative complications were evaluated. Methods. One hundred patients with abdominal aortic aneurysm in St-Zahra, Ayatollah Kashani, Feyz and Shahid Chamran Hospitals (affiliated to IUMSHS) were studied. Results. Patients commonly were in the range 60 to 70 years old. Disease was more common in males (77 percent). The most common site of aneurysm was infrarenal portion of aorta. The most common size of aneurysm (66.5 percent) was greater than 6 cm in diameter. The most common symptom was abdominal pain (66 percent). There was no positive family history in patients. Discussion. In comparison to findings about abdominal aneurysm in other countries, it seems that diagnosis of disease was delayed in our population.

Major aim of this study is evaluation teachers knowledge about health and treatment dentistry procedures. Data for this study have gotten of 1884 teacher by questionaire. Most of teachers have had low level knowledge, also relation between level knowledges and teacher sex and teaching area and grade stundents were not sighifcant. It is important to take optimum knowledge about health curative procedures. It is possible to furnish this knowledges by mass media and short time course in period of training and eduation to teachers.

Sometimes before signs of lung tumor, peripheral nerve involvement with sensory neuropathy tell us about lung cancer. This sensory neuropathy often accompany with oat cell carcinoma of lung. The initial symptoms are numbness or paresthesic in a limb and over a period of days or weeks symptoms became bilateral and spread to trunk. Areflexia and autonomic dysfunction as cardiac arrhythmia, gastric atonia, illeus and orthostatic hypotension accured. In CSF there is pleocytic Iyphmphocytes. Electra diagnostic test (NCV) compatible with loss of sensory potentials. In this survey in Alzahra hospitol (1999-2000) affiliated to IUMSHS, 64 patients with neuropathy, were investigated. Chest x-ray and lung CT scan was prepared for them. Bronchoscopy and biopsy of lung was done in indicated ones. On the other hand electrodiagnostic (NCV) and cerebrospinal fluid (CSF) study were done in then. Among 64 patients with neuropathy, six patients had lung tumors with sensory neuropathy. The commonest sign of diseas was limb paresthesia. In 84 percent of patients, tendon reflex in lower limbs was absent. The commonest tumor was out cell carcinoma of lung and 15 percent of patients had muscle pain in early phase of disease. CSF showed pleocytose of Iymphocytes. NCV showed absent of sensory potentials in 100 percent of patients.

Milk and its Products possess high nutritional value. It could be a desirable source for growing of pathogenic microorganisms. The objectives of this study was to obtain the frequency of pathogenic bacterial agents (i.e. brucella spp. and coliforms) in fresh cheese in Hamedan. A total of 210 cheese samples were collected randomly from Hamadan and its rural area for a period of six months. 50 to 100 gm of fresh cheese was purchesed in each time and one gram weighted to preparation of diluted concentration in selective media. The data were gathered through a questionnaire and analysed using IEPI6" system. Of 210 samples, only 5 cases (2.4 percent) of Brucella spp. Were isolated, however, all samples tested were positive for Coliforms contaminations (100 percent). E.coli type I was 143 (68.1 percent). E.coli type 11 42 (19.8 percent). The other major pathogenic bacteria isolated were as follows: Staph aureus 8.1 percent, Bacillus cereus 4.7 percent, psuedomonas 1.9 percent and Salmonella typhimurium 1.2 percent. Because of isolation of the pathogenic bacteria such as Brucella species, Pathogenic Cofiforms and Staph aures, from fresh cheese, and the role of them in transition of infectious disease, it is recommended that high health cares must be performed to preparation and distribution of fresh cheese.