HAKIM RESEARCH JOURNAL
Year:2000 | Volume:3 | Issue:3|Papers Count:15

The National Health Survey (NHS) in Iran is conducted for second time in 1999. This survey has been designed to collect information about the health, public facilities utilization and risk factors exposure (e.g. cigarette smoking and hypercholestrolemia) of people in Iran. It combines home interview and health examinations which are performed by trained personnel This study was performed by cluster sampling were the sample proportion was 1/1000 and the clusters were chosen in a systematic manner: The data of this study were gathered by interview, physical exam and lab tests (stool and blood). 61140 persons were studied and the selected results are illustrated in 16 comprehensive tables. These results are compatible with the objectives of the study. NHS data can be used to influence policy and improve the health of the Iranian population in many ways.

Catecholamines, especially the three main ones, Dopamin (DA), Epinephrine and Norepinephrine (NE) that are metabolized from 3,4- dihydroxyphenylalanine (DOPA) perform a number of important neuronal and hormonal functions in human systems. These catecholamines are mainly excreted in urine. Therefore, the exact determination of catecholamines in urine is important in clinical analysis. Recently measurement of these compounds is available by High Performance Liquid Chromatography (HPLC) with high sensitivity and accuracy. Since this technique was not used in Iran (1994), we decided to measure the catecholamines level in urine by HPLC. Our procedure uses a selective Liquid - Liquid extraction and based on Tsuchyia.H* procedure. We employed this technique to study the level of urinary catecholamines in 17 patients suffering from Post Traumatic Stress Diwrder (PTSD) as a result of Iraqi imposed war against Iran. These victims were present in battle field between 3-98 months and study was carried out regarding 16 soldiers as control who stayed in battle field at least 6 months. The final results showed that urinary NE levels were sisl1ificantly higher in patients (120.6 micromoles) than healthy subjects (99.187 micromoles). In addition urinary epinephrine levels were significantly lower in patients (27.7 micromoles) than normal subjects (53.6 micromoles), and urinary DA levels were significantly higher in patients (1746.3 micromoles) than normal subjects (1474.2 micromoles).

Principle focus of medical ethics is relationship between physician and patient. A cross - sectional study in the field of health system research was conducted in teaching Hospitals affiliated to Universities of Medical Science in Tehran in 1998-99.After interview with 2000patients during discharge from Hospitals, questionnaires were filled out. Results of this study showed that although 79% of patients ascertained that physician paied attention to them and listened to their complaints but physician -patient dialogue is disappointed in 50% of cases. Patients dignity is supported respectively in 85.6%. In conclusion, we suppose that physicianpatient relationship in teaching Hospitals can be developed by patients centered approach.

Infertility has many causes and results in high levels of anxiety and psychological problems in infertile couples. Anxiety correlates with culture, religious beliefs, personality and individual differences. In this retrospective study the levels of anxiety and other psychological problems were compared in spinal cord injured (SCI) of imposed Iraq-Iran war with those persons who were naturaly infertile (NI). Sixty - one male subjects who were-applying for I.V.F. in Kowsar Assisted Reproductive Center of Tehran and Shariati Hospital were randomly selected and tested.Subjects completed the symptoms checklist 90 (SCL-90) and Cattel's anxiety test.In terms of measures other psychological problems such as depression, hypochondriasis, obsession-compulsion, aggression, paranoia and psychotism were evaluated as well as anxiety. The results showed that there was a significantly lower level of anxiety in SCI subjects than NI (p<0. 05). The other findings are discussed in terms of the relationship between infertility and psychological problems which were lower in SCI group comparatively but not significantly, and may be related to personality of war injured and awareness of infertility before marriage and strong religious beliefs between them.Our results showed that the level of aggression in SCI was higher than NI by SCL-90. The levels of paranoia and psychotism in NI group were higher than SCI, but were not significant.On the basis of the results it is recommend that psychological therapies such as psychotherapy, cognitive behavioral therapies and social supports imply before scheduling the patients come to I.V.F treatment.

In this survey the data from medical records of 7930 stinged patients who refered and treated in Abozar Hospital Center during 1989-1990, were analyzed, respectively. Among them 47 persons have been died, so fatality rate was 5.9/1000.In descending order of frequency three species of scorpion: 1- Mesopeus eupeus (M.e), 2- Androctonus crassicauda (A.c) from Bothidea family and 3- Hemiscorpius lepturus (H.I) from Hemiscorpionidea family were introduced for total scorpion stings. M.e scorpion with the highest rate of stings had no death and H.I type with the least sting rate had the highest fatalities. Most of stings were seen in active persons (20-29 and 10-19 years old) and the highest rate of fatalities in infants with 0-9 years old.There are no significant differences between women and men in sting and fatality rate. Although scorpion sting occurs in all months of the year, most of stings are appeared in summer and the least in winter. Scorpions are usually active during night, and most of stings and fatalities occurred from 7 PM to 6 AM at night rather than 7 AM to 6 PM per day.According to the mind of activity, scorpion type and geographical location, different parts of the body stinged and the highest cases of stings occurred in the foot and the least in the head and body of victim. The highest risk of fatality observed when head and body stinged by Scorpion.

In addition to making policies, taking decisions and designing activities that ensure availability and accessibility of drugs for the whole population, rationalizing prescription and usage of medicines is another important duty of health authorities. In this regard assessing the rationality of the usage of medicine is of great importance. One of the illustrious methods of such assessment is the WHO guidelines. In this study prescription and drug usage was evaluated in 55 randomly chosen daily and 24 hour service pharmacies in Tehran.The main indicators such as, number of items per prescription, difference between prescribed, dispensed drugs, percentage of antibiotics, injections prescribed, drugs without prescription, existense of essential drugs, dispensing time, over the counter drugs and etc were investigated for five regions of the city of Tehran (north, south, east, west and center) and compared to each other.It was found that the average number of drug items per prescription was 3.60 In daily pharmacies fifty nine percent of patients knew about recommended dosage and number for 24 hour service pharmacies was only 20% about 43% of prescriptions contained at least one antibiotics and 39% at least one injectable item In daily pharmacies, 43% of patients who requested drugs without prescription, received their drugs. The average dispensing time (time of consultation allocated to each patients by pharmacists) was only 35 seconds. Nearly 28% of essential drugs were not available in pharmacies at the time of study.These results show that prescription and drug usage in Tehran do not follow academic practice.

Vulvovaginal candidiasis is, most commonly caused by Candida albicans. Due to the high incidence of this fungal infection and the antifungal activities of Allium sativum and Zataria multiflora, the preparation of vaginal suppositories containing their volatile oils, has been considered as the main goal of this investigation. The constituents of the volatile oils of Allium sativum (A.S. oil) and Zataria multiflora (Z.Moil) were identified by Gas Chromatography with mass spectrometry. Then the minimum inhibitory concentration of each volatile oil and their combinations were determined by the disk plate and cup plate methods. Vaginal suppositories containing 30 µl Z.M. oil and 15 pi mixture of A.S. oil-Z.M. oil per ml of base (polyethylene glycol) were prepared and their appearance, mass uniformity, hardness, disintegration time, content and unifonnity were evaluated. The stability of suppositories containing Z.M. oil, stored at 4, 25 and 40°C was investigated after 1, 2, and 6 months, while the stability of those containing both A.S. oil and Z.M. oil was studied after a 3 month-storage at 4°C 1rwas found that storage at higher temperatures (25 and 40° C) can cause a decrease in the voatile oil concentration. Since both A.S. and Z.M. oils have relevant in vitro antifungal activities against Candida albicans with low amounts, and due to the high quality of the formulated suppositories, these could be suggested as a successful replacement in the treatment of vaginitis caused by Candida albicans, following the clinical studies.

In order to determine the required number of general dentists regarding the effective factors in the Islamic Republic of Iran, a model for estimating dental manpower was designed.Using the model, and performing two relating projects, the population which could be covered by each dentist on the basis of their utilization and/or demand was calculated.All over the country, 23481 persons were questioned. In urban communities, the rate of utilization and demand for dental services were 46.19% and 72.12%, respectively.Calculations pointed out that each dentist has delivered services to 9800 people in 1999. It can be estimated that if all people suffering from dental and oral problems had been referred for treatment, each dentist could manage 8200 of them.

Electrodiagnostic evaluation of radicular LBP is one of the valuable measures in detecting lumbosacral root lesion and it is comparable to CT-Myelography. This study were carried out on over 151 patients including 114 male and 37 female between 16 to 60 year old of age from August 1996 to August 1997 in Military Hospital No: 501 of Medical 5cience University for the Army of Islamic Republic of Iran. The study included nerve conduction studies and needle electromyography and following results obtained all sensory NC5 were Normal Amplitude of tibial and deep peroneal nerves were decreased in 4 and 9 cases, respectively. H-reflex was impaired in 33 patients. Needle electromyography studies recorded from L1 to 53 myotomes revealed33% involvement and involved roots in order of increasing frequency which were S3,S4<L3,L2<L4<51 <L5. Finally according to this study we recommend that increased insertional activities and early polyphasic motor units action potentia Is be regarded as root irritation and fibrillation potentials, positive sharp waves, long duration high amplitude and polyphasic motor unit action potentials as roots lesion.

The purpose of this study was to quantify the mouse behaviors, caused by botulinum toxin type A. Acid precipitation of the whole culture was prepared at pH=3.5 by addition of 3 M of H2S04 and then centrifuged at 10,000 rpm for 20 min, at 4°C. The pellet washed three times with distilled water and was homogenized in 100 ml of 0.1 M Sodium titrate buffer with pH=5.5 for one hour at 25°C. The sample was recentrifuged at 10,000 rpm for 20 min to obtain the supernatant which was considered to contain the toxin. Partial purified toxin was prepared by addition of 70% saturated ammonium sulphate to the sample solution. The precipitation was redissolved in 0.1 M Phosphate buffer with pH=6.5 and the solution were dialysed against the same buffer at 4°C. Protein concentration was examined by Bradfored method and then determined 1-2 µ.g/ ml. Parallel to concentration, the toxicity test was performed by intraperitoneal injection of 0.1, 0.2, 0.3 and 0.5 ml of toxin solution. In order to change the qualitative parameters to quantitative ones, movement responses of animal to different toxin concentrations was graded from one to five and the results were analysed. Therefore, with changing the qualitative parameters to quantitative ones, it could be possible to define the biological activity of Botulinum Toxin type A.

Protein digestibility is one of the most important determinants of protein quality, which can be precisely determined by fat balance methods, using Sprague-Dawley strain; but inadequate breeding of this strain in Iran makes the routine evaluations difficult. Instead, Razi's NMRI strain is mass-breeded and easily available. This study conducted [0 determine and compare true digestibility of casein protein in two strains, Sprague-Dawley vs Razi's NMRI. Eight male rats from each strain at the same age were divided, into two groups of four, and each group was randomly allocated to one of the experimental diets, i.e. Non-protein and Casein. The feeding period was 9 days, during its last five days, food intake and fecal nitrogen excretion were determined for each rat. According to the results, protein intake and excretion through feces are the same among two strains, suggesting that Sprague-Dawley rats could successfully be substituted by Razi's NMRI in protein digestibility evaluations; however, further studies are recommended to confirm these findings.