JOURNAL OF RESEARCH IN MEDICAL SCIENCES (JRMS)
Year:2003 | Volume:8 | Issue:1|Papers Count:28

Introduction: The most common psychiatric disorder of new communities are the anxiety disorders. In this survey Isfahans' high school students' social phobia were assessed as an important part of anxiety disorders.Methods & Materials: In this cross sectional study, 500 high school students (250 male, 250 female) whom selected by multi-stage cluster and simple random sampling, were enrolled into study. Data collection performed by multiple choice question are and analysis were done by SPSS software with 0.05 significance level.Results: 11 percents of selected students with mean age about 16 Yrs, have had Social Phobia (male=56.4%, female=43.6%). Parents' education of affected group were higher than non-affected, and birth rank had significant relation with Social Phobia (P=0.043).Conclusions: Unfortunately in spite of high prevalence of social phobia, It's remain unknown and affected students would have numerous educational and communicational problems because of this disorder, therefore for complications' prevention and on time treatment, its need to inform people and physicians about this disorder and its' diagnose.

Introduction: Severe Psychiatricillness is accompanied by gross disturbances in patient's occupational role. This study presents a comparative picture of work performance before and after psychiatric hospitalization.Method: Subjects comprised 440 psychiatric admitters from Noor Medical center - Isfahan - Iran, who were followed from November 1999 to November 2000. Their work adjustment was measured by means of Weiss man's index. Data were computer analyzed using SPSS by running paired t- student and ANOVA.Results: Majority of the patients (53%) were without permanent sources of income before psychiatric hospitalization, about 12 percent of those who were working prior to hospitalization lost their job after being discharged from hospital. Better work adjustment before hospitalization was positively correlated with better work adjustment after discharge for working patients (r=0/66). Working ability of the patients after discharge was lesser than before the attack f9r patients with regular and irregular job (P<001).Discussion: Job loss or poor working ability after psychiatric admission reported by several researchers and has bean confirmed in this study as well. These observatoins have been discussed in view of the current socio economic problems in the society and nature of psychiatric disturbances.

Introduction: High plasma cholesterol levels, mainly LDL are a widely recognized major risk factor for Coronary Heart Disease (CHD). According to the epidemiologic studies findings, people from the Mediterranean countries, have lower CHD rats than other countries, in these countries usual diet is high in olive oil. The present study compares the effects of cholesterol enriched diet with or without adding olive oil on serum Lipoproteins, lipid per oxidation, and atherosclerosis development.Method: Twenty Dutch male rabbits were Categorized to four groups (one group as Control, and others as Experimental). They received one of standard, cholesterol - rich, olive oil rich and combined (cholesterol + olive oil) diet for Twelve weeks. Fasting blood samples from heart were collected at the beginning, and the end of Experimental period. Means of total cholesterol, HDL-Ctriglycerides, MDA and antioxidant caperimental period, significant differences were showed in total cholesterol, HDL-C, triglyceride and MDA between groups.Results: The comparison of cholesterol rich diet with cholesterol + olive oil showed a higher mean of MDA in cholesterol rich group (P<0.001). Biochemical factors and aortic lesion degree showed no significant difference between standard and olive oil group. Aortic lesions in cholesterol + olive oil showed nonsignificant lower degree than cholesterol group.Discussion: This findings showed preventive effect of olive oil against atherosclerosis which is independent of plasma lipoprotein effect, and suggested that probably olive oil acts on arteries directly.

Introduction: The effectiveness of fluorided toothpastes in reducing dental caries is well-documented, However not all fluorided toothpastes are equally effective. The objective of this study was to compare some essential criteria of six different toothpastes manufactured in Iran with one brand of ADA approved toothpaste (Crest).Methods. Six commercial toothpastes produced in Iran named as Paveh, Puneh, Nasim, Darugar, golpasand and saviz were compared with Crest in three subjects as follows: 1. Amount of fluoride concentration 2. Amount of releasing fluoride 3. Cleaning efficiency. Two first criteria were tested using the potentiometric method with F- Ion specific electrode, and Cleaning efficiency was done by O'Leary index on 60 volunteers (10 for each toothpaste).Results: Fluoride Concentration in Paveh, Puneh, Nasim toothpastes were nearly700PPM,while in three others were much lower. The highest amount of fluoride was seen in Crest (1450 PPM). Cleaning efficiency of Darugar was better than Crest, Paveh, Puneh. Cleaning efficiency of Nasim was the same as Crest and Golpasand and Saviz were weaker than Crest.Discussion: Since at the present time, the most effective, Cost-benefit method for preventive aspects of fluoride, especially in developing countries is obtained by fluoride toothpastes. Manufactures should improve quality of fluoride toothpastes, ensure that all pates maximize Fluoride bioavailability, develop active agents to help better cleaning efficiency and label products clearly with containig fluoride in PPM.

Introduction: Attention deficit hyperactivity disorder (ADHD)is the most common psychiatric disorder among school age children. It consists of hyperactivity, inattention and impulsive behavior. The onset of the disorder is before the age of 7 years and it happens at least in two situations. It causes significant impairment in social and academic functioning. A determination of factors that influences the therapeutic response in ADHD is the aim of this study.Methods: This study is designed as an analytic descriptive on hyperactive children. The tools that were used was the interview with parents and it provided CSI-4 checklist.Results: Methylphenidate was completely effective in ADHD and oppositional defiant disorder and was effective in majority sign of conduct disorder. There wasn't any relation between therapeutic response and demographic characteristics.Discussion: Methylphenidate is effective not only in ADHD but also in mixed ADHD and disruptive behavior.

Introduction: The prevalence of urinary stones is 2-3"10.Therefore well treatment of the stones is vwre important PCNL is the new method sor excluding the stones from kidney with minimal pain, convalescence, convalescence, complications and cost. The flexible nephroscope role is evaluated in this study.Methods: All 60 patients that PCNL was done on them in Al-Zahra hospital 0 Esfahan From Farvardin to Dei 1378 are evaluated in this study. At firt pyelocalyceal system is checked with rigid nephroscope and stones are excluded. Then pyelocalyceal system is checked with flexible nephroscope and if the residual stone presents, it will be excluded.Results: With flexible nephroscope stone excluded from kidney in 45% in PCNL patients. Stone free rate was 75%. The mean of the stone surface was 668±415mm2. The stones were staghorn or multiple in 90% of patients. Complications were 6.7% of case containing: fever and late hematuria. The hospitalization time was 2.7±1 day. Sequence percentage of upper, middle, lower calyces that been seen by rigid nephroscope were in srder: 31.7%, 8.8%, 86.7% and by flexible nephroscope were in order: 95%, 70.2%, 95%.Discussion: Flexible nephroscope considerably increases stone free rate in PCNL patients and to see the upper and middle calyces significantly helps the surgen. The use of flexible nephroscope is recommended for all PCNL patients all over the country.

Introduction: cataract surgery is .one of the most common operation in ophthalmology. Post operative caught can lead to anterior chamber hemmorage and dehiscence of suture so we were going to finding a way to overcome to this problem.Method: This study is a clinical trial one which was done on 150 ASA 1, 2 patient that were over 45 years old age. These patient have cataract surgery under GA in Farabi Hospital of Esfahan medical university. All of the patient were intubated under direct laryngoscopy. Patients that have more of one laryngoscope, difficult intubation, thraceal intubation prolonged more than 15 seconds and those which have opiate addiction. We divided the patients into two 75 patient group by randomized selection.This study is double blind and 30mg codeine phosphate and placebo has given to the patient one hour preoperatively. Heart rate and systolic and diastolic, blood pressure has been recorded preoperatively, three minutes after intubation and three minutes after extubation respectively. Caught has been counted and recorded immediately. Five minutes and 30 minutes after extubation and results in contorol group are compared with the results in another group.Discussion: According to the statistical analysis t-student test, chi-square and non parametric test and Pvalue only changes in heart rate after extubation has been different in two groups and other findings make no difference in two groups. There was not any significant difference between two groups about age, sex, duration of surgery, preoperative mean heart rate and blood pressure. There was not any difference about mean number of coughs between two groups and according to this study oral codeine phosphate has administered preoperatively has not any effect on reducing postoperative caught in patients who have GA and tracheal incubation for cataract surgery.

Introduction: The control of postoperative pain after cesarean section is one of the problems which is always in physicians mind. Unsuccessfulness in the pain management is not only psychologically unpleasant but also in causes post operative complications. Also due to the need of early ambulation of these patients, enough analgesia is needed post operatively. The most common pain relieving method postoperatively is the use of systemic narcotics and/or NSAlD's, which have their own side effects. In the field of postoperative analgesia many researches by using one dose infiltration of Bupivacaine in operation field is done. But as far as there is contra version in the effectiveness of this method.Methods: we decided to research the effect of repeated infiltration of Bupivacaine in incisional side via catheter in cesarean section from 77/7/1 till 77/12/31 in Isfahan Beheshti Hospital. And the analgesic effect of Bupivacaine infiltration on horizontal incision of cesarean section is studied, and compared with the control group which give a intramuscular declofenac as an analgesic. The amount of the severity of pain is measured via VAS method every 6 hours post operatively, and the consumption amount of narcotics and the average percentage of vital signs variations were measured and recorded. The analysis of the data was done by using Hest and Chi-square test.Results: the pain severity in 12, 18 & 24 hours post operatively was lower in studied group than control group. These differences were statistically meaningful. The mean percentage of the changes of systolic blood pressure for 24 hours in comparison with its base was also lower in studied group, this difference was also statistically meaningful, too.Discussion: The results show that the local infiltration of Bupivacain is effective in reducing post operative pain and the analgesic requirement. So using this method can be a suitable replacement of systemic analgesic drugs with less side effects.

Objective: In order to primary prevention in cardiovascurlar diseases to establish the relationship lipid peroxidation (Malon De Aldehide) and antioxidation capacity with posttraumatic stress disorder (PTSD).Method: MalonDeAldehide and antioxidation capacity in 30 case of PTSD were compared with 30 normals in ISFHAN Cardiovascular Research Center, using Symptoms check List 90 revised (SCL 90 R) to determine Global Symptom Index and using laboratory tests to measure MDA and antioxidation capacity. Results: The mean of GSI for cases was 2.13 and for controls was 0.41 (p<0.05).MDA level was higher for cases (0.822 microgramg/DL in cases, 0.634 micorgramg/DL in normals, p<0.05) while peroxidation capacity was higher for control group group (20.04% glubular hemolysis in controls, 13.16% in cases, p<0.05).Conclusion: Lipid peroxidation and antioxication capacity as an index for primary prevention in cardiovascular and metabolic diseases, and aging process have relation with PTSD, and may be viewed as risk factor for PTSD. Imipermain and other antioxidatants were recommended for PTSD to reduce lipid peroxidation.

Background: Recurrent or facial herpes simplex infection is a troublesome condition. In addition, it can cause some complication as recurrent erythema multiform and eczema herpeticum. Effectiveness in the prevention of recurrence of or facial herpes infection with acyclovir has been shown, but acyclovir is costy and not completely safe over years of treatment. Some studies have been shown the effectiveness of low dose of aspirin in prevention of recurrent herpes simplex infection. The purpose of this study was to assess the effectiveness of low dose of aspirin in reducing the duration and recurrent attacks of or facial herpes simplex infection.Method: In a double blind randomized controlled clinical trial with cross over method, 50 patients with recurrent or facial herpes simplex infection that refer to dermatologic clinics of Isfahan university & medical sciences during the year of 1999-2000 that had inclusion criteria have been selected by using a convenience sampling method and put in 2 groups as follows:Group one received one tablet of drug A and group B one tablet of drug B per day for three months. In the next step, these two groups changed places, and monthly follow ups were performed for 3 months.At the end of the study, we found that drug A was aspirin and the other was placebo. The data were evaluated by using chi, square test and SPSS program.Results: Among 22 patients in each group which completed the course of study during the first three months: In the first group (aspirin group), recurrences was occurred in six patients (22.27%) and in the second group (placebo group), 18 cases (81.81%) had recurrences (P<0.05). In this period, decrease in duration of disease was seen in 19 patients (36.36%) in aspirin group and in 8 patients (36.36%) in placebo group (P<0.05). In the second three months: recurrences was occurred in 19 patients (86.36%). In placebo group and in 5 cases (32.27%) in aspirin group (P<0.05). In this period decrease in duration of disease was seen in 8 patients (36036%) in placebo group and in 20 casses (90.90%) in aspirin group (p<0.05).Discussion: Results of this study showed that aspirin decreases recurrence instances and the duration of recurrent or facial herpes simplex infection.

Introduction: In recent years, different studies have considered a possible association between immunologic factors such as anticardiolipin antibody (Ac/a) and the risk of premature myocardial infarction (MI). In the present study, Acla is compared in patient with premature MI and their children with controls.Method: In this case-control study, three paired groups (parent-child) of 25 each, were selected by simple random sampling and their Acla levels measured by ELISA method. A comparison was made between parents who had premature MI (<55 years of age) and one of their 12-19 year children as the case group, and the parents with MI >55 years and one of their children, as well as those with no heart attacks and one of their children as the first and second control groups. Data have been analyzed by SPSS/win using the Chi square test.Result: In this study, the number of positive and or relatively positive titers of Acla was higher in those with premature MI and their children. Also, the percentage of concomitant elevated Acla in parents and their children of the case group was significantly higher than the two control groups (40%vs. 12% and 8% respectively, P<0.05).Discussion: The findings of this study point to the probable role of Acla as a risk factor in predicting premature MI. More research is recommended in this regard.

Introduction: Hyperthrophic scar and keloid is a big problem after many operation. Hypertrophic scar depended on many factor one of them is Incision.Method: This is a randomized clinical trial and sequential sampling in Alzahra hospital and Kashani hospital. we selected two groups, one group we used S shape incision and observed group linear incision. Age was between 10-30 years and dermatological problems and cigaret smoking was Negative in two groups perforated and secondly skin closure was excluded in our study. patient divided in two group each group was twenty and fllowed for one year. Patients satisfaction and skin collor normality and itchiny was evaluated in two groups.Results: Appearance of scar was different in collor much and shape. Normality for collor of incision in s shape groups were 68.4% but in linar incision was 31.6% (Pvalue= 0.026) with statically meaningful. Mean of scar width: In 5-shape =1.33+0.49mm in Linear shape=2.23+0.92. P=0.001. Prevalence of itching was same in both groups.Discussion: patients overall satisfaction and itching were the same for both groups. skin color normality was 68.4% in 5 shape incision groups versus 31.6% in linear incision groups which has been shown to be statistically meaningful using chi-square test so it seems reasonable to conclude that calor mathing is more favorable in 5 shape incisions rather than linear incision. Mean of scare width in licear incision group was 2.23+0.92 mm versus 1.32+0.49 mm in 5 shape incision group. this difference is also statistically meaningful using T test. 50 it can be concluded that using 5 shape incision is better because post operative scar is smaller and exposure is like linear incision.

Background: Nonunions with large defect is a problem, especially in large defects with infection this problem is more serious. Due to war and grave accidents in our country, we have encountered with these difficulties and in future time will also.Methods: We modified D.O.B.G by using plate in one side of large defect and metal plate on another side, and fixed these plates using screws anchoring the distal and proximal segments of nonunion sites rigidly. The technique is very simple, reliable, less morbidity in donor site, short operation time and needn's especial instruments and equipments. We use this technique in 146 patients and follow one hundred of thems for 2.5 yrs (mean time) clinically and radiological.Results: Union rate was ninety percent. Due to rigid fixation and early R.O.M of joints the final limbs function were excellent (comparison with others technique).Discussion: Modified D.O.B.G is the choice technique for nonunion with lange defect especially in metaphysis. because of rigid fixation results early R.O.M and good limb function, high union rate, short operation time, simple technique and less morbidity in donor site.

Introduction: CD46 is a membrane cofactor protein (MCP) of complement system wich is present on the membrane of all somatic cells except RBC. It is also present on the inner acrosmal membrane of human sperm. Thus, the aim of this study was to compare the expression of this prote, in on the inner acrosmal membrane of sperms from normospermic and asthenospermic individuals.Method: Semen from 6 normospermic and 17 asthenospermic individuals were examined for CD46 expression. After solublization of sperms in solublizing detergent, the solublized sperm membrane was separated from the rest of cell organelles by centrifugation. Solublized sperm membrane were divide to equal parts and SOS-PAGE gel was canied out in paired on the same gel for each sample. Western blot was carried out on half of the gel and then the nitrocellose papers were stained by a monocolonal Ab and HRP conjugate Ab. The other half were stained by silver stain for identification of MW. Results: After scoring the stained nitrocellose papen in each groups, no statistical significant difference was observed for C046 expression between the two groups. However, a significant Spearmen correlation was observed between CD46 expression and sperm motility (r=0.597, P=0.003). The MW of C046 was between 36 to 45 KD. with a mean of 42 KD.Discussion: This is the first report of a positive Spearmen correlation between sperm CD46 expression and sperm motility which suggest that there might be relation between CD46 expression and sperm motility.

Introduction: Spinal Anesthesia is a successful method for most surgical procedures on lower extremities and lower abdomen. Occasionally the duration of sensory blockade is shorter than the duration of the surgical procedures resulting in painful stress and discomfort. In one research, inhalation of N2O during spinal anesthesia provided analgesic effects and enhanced the level of sensory blockade. Our study evaluated the effects of N2O on the duration of sensory blockade in spinal anesthesia.Methods: In this double blind randomized controlled clinical trial, 80 adult patients who were candidates for lower extremity or lower abdominal surgery were randomly divided into two group received 500k N2O plus 50% O2 by inhalation and control group received 02 without N2O. Block level and the duration of T6 and T10 blockade were determined mean, systolic and diastolic blood pressures and heart rate recorded. Statistical analysis was performed by t-test.Results: The duration of sensory blockade above T6 and T10 levels in patients receiving N2O plus O2 was significantly superior to that in the control group (P<0.05). The mean changes in the heart rate and systolic, diastolic, and mean arterial blood pressures, were not significantly different between two groups. Discussion: Our results, show that N2O inhalation during spinal anesthesia enhances the duration of sensory block making this technique more piratical and appropriate. It also provided move homodynamic stability any adverse effects.

Introduction: FMRI is a new approach in MRI to provide functional data of human brain activities. Some methods such as BOLD contrast, perfusion imaging, diffusion imaging, and spectroscopy in MRI have used to yield functional images.Material and Methods: This research was performed in imaging center of IMAM KHOMEINI hospital in TEHRAN in 1997. The experiments were performed on a conventional 1.5- T picker MR instrument, using a standard head coil. CE – FAST gradient echo images were obtained (TR=100, TE = 35, 128*256 matrix, 10 mm slice, FOV = 250 mm, F.A =25 Degree, NEX = 1, 13 s per image). Images were obtained during sensory - motor stimulation by pressing fingers to each other, coronal oblique images were acquired through central sulcus (precentral gyrus) where the related sensory cortex is. Then, the Images were transferred to personal computers in order to eliminate noise and highlight the functional differences. These images were processed by various mathematical methods such as subtraction and student T- test.Results: Although some changes were seen in functional area, there were not significant results by the conventional system protocols. Some new protocols were designed and implemented to increase the sensitivity of the system to functional changes.Discussion: However, more research needs to be done in the future to obtain faster and more efficient techniques and in regard to clinical applications of the method.

Introduction: There are general guidelines for reconstruction of complex wounds of the Lower extremity. The goal in treatment of these wounds is to preserve a limb that will be more functional than an amputation.Material & Methods: In this study, we evaluate our results in 15 patients with extensive wounds in lower extremities (April - 1998 to march - 2001).Results: The average age of the patients was 31.20 with an age range between 9 to 61 years. Majority of the patients were victims of motor vehicle accident, except two, which developed wounds due to war injury. Distal third of leg was the most common site of trauma and 7 patients had bone fractures, mostly Gustillo III-B. Wound coverage was the most common indication for surgery and free tissue transplantation performed for majority of the patients. Transfer of latissimus dorsi muscle or myocutaneous flap was the most common procedure. One free flap and one fasciocutaneous flap necrosed due to infection and poor technique respectively.Discussion: Our results revealed that the options for reconstruction of significant soft tissue wounds of the upper and lower thigh are included skin graft, local flap and rarely free tissue transfer. The gastrocnemius muscle or myocutaneous flap serve well for supra-patellar, knee and proximal tibial wounds. The soleus muscle flape is probably the most useful flap in middle tibia However, frequently; wounds of this part are best satisfied by micro vascular tissue transplantation. Soft tissue reconstruction in distal tibia and foot is viewed by many as the most challenging of all lower extremity areas. The vast majority of these wounds are best satisfied by micro vascular tissue transfer. Meanwhile, in cases with a modest skin defect, there is the opportunity to utilize either proximally or distally based fasciocutaneous flaps.

The tubal pregnancy is one of the most emergency cases in Ob & Gyn. EP Forms the second etiology of maternal mortality in USA.So the early diagnosis of EP will save the life of mother and reserve her reproductive potential. Many cases of tubal pregnancy ended during the first trimester by intraperitoneal rupture since the oviduct is very narrow.We have hada rare case which the tubal pregnancy continued for six month while the oviduct was completely safe. this case can rise question about the previous tubal pathological theories.

Resistance of H.pylori against metronidazole is increasingly appeared in reports of investigators of gastric infections. So that, seeking to find more effective anti-helicobacter drugs is a necessity.In this study, inhibitory effect of the P. aeroginosa-produced substance on H. pylori growth was determined using two methods, Cross-streak and Well-diffusion Only two out of 37 P. aeroginosa isalates were able to inhibit H. pylori growth which one of them was chosen for further investigation. Its antibacterial activity was tested on 31 isolates of H. pylori consisting 27 metrondazole-sensitive and 4 metronidazole-resistant isolates. The inhibitory substance was enable to kill both metrondazole-sensitive and resistant isolates of H. pylori. The substance could also inhibit the of several other bacteria including E.coli, Salmonella sp., Klebsiella sp., S. aureus and a gram positive bacilli. While the inhibitory effect of the substance had no change at 40c for 30 days, its effect substantially reduced by treating at 600c for 15 minutes. Treatment of substance at 600c (30 min). 80˚c and 100˚c (15 & 30min), and freezing (-20˚c) and melting (37˚c) inactivated its inhibitory effect completely. Treatment with trips in also could inactivate it. Thus P. aeroginosa-produced substance, probably is a protein and may be classified in bacteriocin group.

Background: The purpose of this study was to examine relation between religious attitude and performance in aging. According to literature, religion in later life have great role in adaptation to aging consequences. Spiritual function leed to physical and psychological well being. In this research it was hypothesized that attitude and riligious performance is related to hope and lower depressive symptoms.Methods: Subjects were 70 adult age that selected randomly from two again sanatorium in Isfahan. Research tools were psychological interview, HRSD Questionnaire, Religious Attitude and performance Scale (RAPS). In order to examine this hypothesis, in first step scychilogical interview was done throughout interview and after rapport with them. Two questionnaire were completed. Recorded data entered to computer and were analysed by correlation test.Results: Analysis of data indicated that, there is negative significant correlation between depressive symptoms and religious attitude and performances in aging. Age, number of children and duration of life in sanatorium , were not related significantly with religiosity and depressive symptoms.Conclusion; It is seemed, according to Islamic education, prayer, rely on God ,resorting to aemah, Quran reading or positive regarding to these leed to psychological well- being especially in later life.

Study objective: To exam the effect of asthma on- coagulation pathway.Methods: Case control study with 73 asthmatic pagtients at different age.Results: We show that PIT in asthmatic patients is longer than in control group (P<0.0001). We found no associated between PIT and age or sex in case and control group.Conclusion: One explanation for PIT is prolongation in asthmatic patients is presented by the increase level of endogen or heparin like molecules.