HAKIM RESEARCH JOURNAL
Year:2007 | Volume:9 | Issue:4|Papers Count:13

Increase in the rate of elderly population in developing countries can cause emotional, social and health problems. Awareness of real needs in this group can assist policymakers in implementing effective interventions. This study has been proposed to assess the needs among elderly people in Ekbatan and design interventional programs according to community participatory method to promote health among the elderly.Methods: Using a descriptive research, 100 old men and 100 old women were selected by random sampling. Instrument used in this study was questionnaire and then according to the results of data analysis of need assessment questionnaire, interventional programs were designed.Results: In Ekbatan, 89% of old people are educated. Based on their opinions, 92% of women and 70% of men suffer from at least one disease and receive treatment. Different diseases such as hypertension, arthritis and diabetes mellitus were more common in women. Psychologically, 70% of old people were satisfied with their lives, 30% expressed that their lives were meaningless, 66.5 % were worried about some bad event in the future. More than 90% of them had enough free time which was spent on watching TV in 97%. 67% said they did exercises. 88% - 98% of them used all five major food groups, 82% used red meat and 77% ate sweets.Conclusion: According to the results of the need assessment, appropriate interventions are needed to be planned in four fields as follows: Common diseases and their preventive methods, mental health, physical activities/leisure, and healthy nutrition.

The hepatitis D virus (HDV) is a 36-nm virus, which needs hepatitis B virus for replication. Infection by the Delta agent can occur as a co-infection with hepatitis B, which usually causes acute hepatitis, or as a super- infection of hepatitis B infection. The present study was conducted to estimate the prevalence of super infection or co-infection in HBsAg positive patients.Methods: Anti-HDV (IgM) and HDV Ag by EIA method were tested in 79 HBsAg-positive sera and the liver function tests including SGOT and SGPT were done. All anti-HDV IgM positive samples were tested for anti-HBc IgM by EIA method. The prevalence of super infection was determined.Results: Delta Ag was not detected in any of the 79 sera. 7 out of 79 (8.8%) samples were positive for anti-HDV (IgM) but they were all negative for anti-HBc IgM. The liver enzyme function tests were elevated in 5 out of 6 samples.Conclusion: 7 samples were positive for anti-HDV (IgM) and indicated recent infection with HDV in these patients, but anti-HBc (IgM) was not detected, so these serologic data suggest super-infection with Delta agent in HBV-infected patients. In HBsAg-positive patients with liver enzyme elevation, investigating possible HDV infection is strongly recommended.

One of the important causes of the high mortality and morbidity during surgery is transfusion. Important factors which change during transfusion are coagulation system, blood pH, and tissue oxygenation. There are two types of transfusion: homologous (traditional) and autologous.Autologous transfusion, one type of which called ANH was evaluated in this study, have several differences which are important especially during surgery. The purpose of this study was to evaluate these differences.Methods: 60 patients in 2 groups were studied. Before beginning of the surgery these tests were done: PT, PTT, arterial blood gases (A.B.G.), bleeding time (BT), C.B.C and platelet count. Then one type of transfusion that had been chosen by random allocation was used. At the end of transfusion and within 6 hours, the same tests were repeated. Using the information from C.B.C. and A.B.G., arterial oxygen partial pressure ratio to alveolar oxygen partial pressure (PaO2/PAO2) was calculated.Results: Reduction of hemoglobin after both types of transfusion was seen, but it was more prominent after ANH type compared with the other type. BT and PTT increase and PT% decrease were more prominent in homologous group.Conclusion: The amount of hemoglobin reduction after transfusion in both groups showed that ANH is an acceptable alternative method of transfusion in some cases. More BT and PTT increase and PT% decrease in homologous group show more damaging effect homologous transfusion on coagulation system.

Many countries have set programs for suicide prevention. Knowledge about behavioral patterns of suicidal persons before suicide attempt is needed for suicide prevention programs. Many studies have shown that suicide attempters had contacts with physicians before suicide attempt. Thus it is suggested that general practitioners and other specialists play a key role in suicide programs. The aim of this study was to survey contact with physicians before suicide attempt in suicide attempters in Razi hospital in Rasht.Methods: This cross-sectional study was performed on 206 suicide attempters. Clinical interviews with suicide attempters who were selected by convenience sampling were performed by two trained general practitioners. Chi-square test was used for analysis of data.Results: 94 (45.7%) of suicide attempters contacted with physicians during the month prior to suicide attempt. 65 (31.6%) of them contacted general practitioners or specialists (except psychiatrists). 29 (14.1%) of them contacted psychiatrists. General practitioners (39.4%), psychiatrists (30.8 %), internists (8.5%) and neurologists (8.5%) had the most contacts. Significant statistical relationships were found between contact with health care system and sex (p=0.012), educational status (p=0.018), type of chronic disease (p=0.001), and history of admission in non-psychiatric hospitals (p=0.001). Also, significant relationships were found between contact with mental health system and age (p=0.017), number of previous suicide attempts (p<0.0001), history of admission in psychiatric hospital (p=0.002) and type of chronic disease (p=0.015).Conclusion: Among suicide attempters, contact with physicians was seen with high frequency and had significant statistical relationship with some risk factors. It is suggested that involvement of all physicians is necessary in suicide prevention programs and more works are needed to determine risk factors and persons with greater risk for suicide.

Quality of life measures have assumed increasing importance in the medical literature.This is a cross-sectional study to examine quality of life and factors related to it among psychiatric nurses in the university teaching hospital in Tehran.Methods: The research population consisted of all the nurses in the psychiatric ward at 6 university hospitals. Quality of life was measured by a self-administered questionnaire and for reliability and validity. Data frm a sample of 100 psychiatric nurses were analyzed with SPSS software by descriptive and analytical tests.Results: A total of 21% of nurses perceived their quality of life as moderate, 67% of them explained it as good 11% of nurses were quite satisfied with their quality of life. There was a significant relationship between number people living with nurse, status of dwelling house, positive idea others on psychiatric nursing, job security, job satisfaction, satisfaction with relationship with other employees, satisfaction with working in a psychiatric ward, satisfaction with relationship with psychiatric patients, satisfaction with relationship with managers, and all 7 domains of quality of life. Gender, material status, organizational position, and over-time work had a relationship with at least one domain of quality of life.Conclusion: It seems that having this information will allow nurses and hospital administrators to focus on ways to improve quality of life in nurses and increase their quality of nursing care.

Conventional risk factors like serum cholesterol, smoking, and hypertension do not explain all the mortality and morbidity due to coronary artery disease. Novel risk factors like plasma homocystein have been currently recognized as independent risk factor for coronary artery disease.Methods: A case-control study was carried out to examine the role of plasma homocystein in angiographically established coronary artery disease patients. Plasma homocystein level was measured by HPLC method.Results: Mean plasma homocystein after matching for other major risk factors was significantly different in two groups. (p = 0.003) But sex as a minor risk factor was effective in homocystein level and after matching of groups according to sex, the homocystein level was not significantly different in case and control groups. However, homocystein level in sex matched study groups was higher than control groups but due to wide variation in homocystein levels in study groups it was not statistically significant.Conclusion: current study showed high homocystein level is a risk factor for coronary artery disease in less than 50 year-old patients and according to current knowledge, high level of homocystein in this study is clinically important regardless of lack of statistical significance. According to current study, it is recommended that in coronary artery disease patients younger than 50 and without any other major risk factor, homocystein level should be measured.

While the advanced abdominal and thoracic surgical retractors seem superior to traditional systems in providing a precise and stable traction, they have not gained much appreciation due to their long and complicated installation procedure. The purpose of the present study was to design, fabricate and test a new self-retaining, standing, adjustable surgical retractor which could simultaneously provide a desirable functional performance and an easy and fast installation.Methods: At first, the common varieties of surgical retractors were studied and their application and performance analyzed. Then considering the desired functional characteristics, the design specifications were defined and the overall mechanism was designed. Following detailed design of the system components, they were fabricated using investment casting, forging, deep drawing and machining methods, as well as finishing processes. Then the standard chemical composition, corrosion resistance and surface condition tests were performed on the components. The systems were then subjected to preliminary and final clinical tests.Results: Design evaluation of the invented retractor indicated its superiority over the existing systems in the number of the components and blind corners, stable adjustment of the position and orientation, and control of the traction force. The results of the standard tests were all in the acceptable range. Some operational complications were observed in the preliminary clinical test; and appropriate modifications were applied to the system based on the observations. The final clinical test indicated no tissue release and necessity for readjustment.Conclusion: The results indicated that the new retractor has a good performance and can perfectly satisfy the surgical needs, ensuring simultaneously several degrees of freedom for safe, precise and stable traction of the surrounding soft tissues, and an easy and fast installation procedure.

Pain is one of the most common postoperative complaints in any type of surgery and has negative effects on all aspects of patients' functions, including psychiatric and somatic functions.Post-thoracotomy pain is commonly very severe and induces complications such as atelectasia. It affects pulmonary function. Different ways of pain control have been studied before and mutually compared. In the present study we compare four methods of post-thoracotomy pain control with emphasis on pulmonary function tests.Methods: 100 ASA physical status I & II patients scheduled for posterolateral thoracotomy were included in this study. The patients were randomized into one of the four groups (25 patients in each group): every 6 hours group A received fentanyl via epidural catheter every, group B received 0.25% bupiavacain via epidural catheter, group C were administered 0.25% bupivacain via inter-costal catheter, and group D received intravenous meperidine. Pain was assessed every 6 hours (15 minutes before medication injection) using visual analogue five-grade scale. Pulmonary function indexes were measured before and 72 hours after surgery.Results: The mean of pain were different among the four groups (p» 0.00). In group C mean of pain was less than group A by 0.77(p= 0.001) & in group D was less than group A by 0.54 score (p= 0.04).There were no significant differences in pain score among other groups. In group D the petedine requsted were less than A, B & C groups by 61.9mg, 46.6mg & 46.6mg (p» 0.00). There was less FEV1/ FVC reduction in group B, but this reduction is not statistically significant. Also FEV1/ FVC ratio are significantly different among groups (p= 0.001).Conclusion: The study shows that intercostal injection of 0.5 ml/kg 0.25% Bupivacain or intravenous injection of 0.5 mg/kg Meperidine every 6 hours has better efficacy for post-thoracotomy pain relief in comparison with the other studied methods.

Introduction: TT virus (TTV) is an undeveloped single-stranded circular DNA virus. Sensitive PCR (Polymerase Chain Reaction) methods with primers designed for very conserved regions of the viral genome (UTR) indicate high prevalence (> 90%) of TTV infection in general population of many countries world-wide. Although there has been no evidence of its relation to any liver or other specific disease to date, it is speculated that certain genotype (s) may be capable of causing hepatitis. A relationship between viral load and immune status of host is also suggested. This study was done to determine the prevalence of TTV infection in general population of Isfahan, Iran. Methods: Serum samples were collected from 132 voluntary blood donors in Blood Transfusion Organization, Isfahan. Among them, four were positive for HBs-Ag and six for Anti-HCV antibody. DNA was extracted and subjected to PCR using consensus primers. The amplified PCR products were sequenced. Results: TTV DNA was detected in 105 out of 132 examined samples (95% confidence interval: 73% to 86% with) these included ninety-five out of 122 healthy and 10 out of 10 hepatitis-positive sera.Conclusion: The results showed high prevalence of TTV in general population of Isfahan which is the same as other areas studied. Determining the genotypes present in Isfahan population is suggested.

Introduction: Echinacea purpurea belongs to the family Asteraceae. Preparations from Echinacea purpurea are among the most widely used herbal medicines. Most uses of E. purpurea are based on its reported immunological properties. The aim of this study was to evaluate antiviral activity of aerial parts of Echinacea purpurea extract against herpes simplex virus type 1 (HSV-1). Methods: Aerial extract was' obtained with 70% ethanol by maceration. Vero cell was grown in DMEM medium containing 5 % fetal bovine serum, in 96-well micro titer plates. Serial dilutions of extracted suspension were exposed by the 100 TCID50 HSV and monitored daily for antiviral activity of the extract. Results: The results showed that Echinacea purpurea has activity against HSV-1 and most antiviral activity is seen with 1/10 concentration.Conclusion: This study indicates that aerial parts of Echinacea purpurea have antiviral activity against HSV-1.

Since interaction between sperm and ovum results in fertilization, determination of molecular events and glycoprotein involved in this interaction may clear the cause of infertility due to molecular defects or immunologic reasons. Thus we studied the properties of mentioned antigens in views of antigenic site and determination of its molecular weight and cross reactivity with other antigens by anti sperm monoclonal antibody (HS80).Methods: Surface sperm antigens were extracted by NaCl and Lithium diiodosalicylate (LIS) separately. At the next stage, the location of mentioned antigen was determined by indirect immunofluorescence using HS80 monoclonal antibody. Meanwhile, molecular weight of mentioned antigen was measured by immunoblotting. Finally, ELISA was used to study the cross reactivity of monoclonal antibody with human peripheral blood leukocytes, semen proteins and other mammalian sperms (from rat and mouse).Results: Sub-equatorial and collar regions of all sperms had shiny fluorescence after immunofluorescence staining. Likewise, molecular weight range of the antigen was 80±4. Meanwhile, there was not any cross-reactivity among the antibody and other antigens except a 80 kD human leukocyte surface antigen.Conclusion: The presence of the antigen with 80 kD on sub-equatorial region may increase the possibility of its role in vital processes of sperm such as sperm/oocyte membrane fusion and fertilization.Thus, it is recommended to study the role of this antigen in fertilization, in the presence and absence of HS80 monoclonal antibody, sperm interaction with zona pellucida and Oolema using sperm functional studies.