IRANIAN SOUTH MEDICAL JOURNAL (ISMJ)
Year:2001 | Volume:4 | Issue:1|Papers Count:14

Those involved in the culture of shrimp in the warmer and moister area are more prone to superficial epidermal infections. In order to evaluate the prevalence of superficial fungal infections of the skin in workers of shrimp industry, 176 workers were examined in a cross-sectional study. Eleven workers had superficial mycosis (8 cases of Tinea versicolor and 3 cases of erythrasma) and 4 cases had cutaneous mycosis (2 cases of Tinea cruris, 11 cases of Tinea pedis and 1 case of Tinea barbae). Therefore, the prevalence of superficial fungal infection among the workers of shrimp industry in Bushehr Port was 8.52%. So, these workers should be considered a high risk group for superficial mycoses and periodic skin examination by industrial health team is suggested.

Hemorrhoidectomy may be associated with severe pain in the first 24-48 hours of operation. In order to access the analgesic effect of ischiorectal fossa block in hemorrhoidectomy, 24 patients (12 cases underwent ischiorectal fossa block and 12 cases in control group) were evaluated after the hemorrhoidectomy. The surgical and anesthetic technique were the same for two groups. The pain was scored by McGill Vzsual Analog Scale in 2,4,12 and 24 hours after operation by expert nurses, who were blinded to the technique of analgesia. The mean of pain scores of patients who underwent ischiorectal block were 1.25,1.41,2.66,2.83 and the scores in control group also were 2.83,3.83,4.08 and 3.91 (P<0.001). During the first 24 hours of operation, parenteral analgesics were used for 6 cases of group one, however all of patients of control group needed the analgesics. Therefore, ischiorectal block apparently decreases the pain of post hemorrhoidectomy and the need of parenteral analgesic administration.

In this single-blind clinical trial, 68 patients with criteria of International Society of Headache suffered from at least two headache attacks per month were divided into two groups who were similar in sex, age, severity and number of headahe attacks per month. Fluoxetine (20 mg per day) for experimental group and imipramine (50 mg per day), for the other group were prescribed for 12 weeks. During study, 8 patients in control group and 10 patients in fluoxetine group discontinued the trial due to adverse drug effects (P>0.05). There was no significant headache attacks between fluoxetine group [6.94±2.85headache attacks per month before treatment which changed to 3.48±3.11 attacks per month; p<0.05] and imipramine group [Z30±3.11 attacks per month to 3.08±2.84 attacks per month; p<0.05] (p>0.05). The severity of headache attacks were decreased in both groups, however, there was no difference between groups. Fluoxetine has no contraindication in pregnancy, it could be prescribed in single dose. Therefore, it is recommended as a prophylactic choice measure for migraine headache.

Major orthopedic surgery is associated with large blood loss. Acute normovolemic hemodilution is recommended as a technique for reducing allogenic blood transfusion requirements during surgery. In order to evaluate the acute hemodilution in reducing allogenic blood transfusion in internal fixation of femur; we randomized 63 cases (range of 15-45 years) who had not history of cardiovascular, respiratory, hepatic and renal diseases in two groups (38 cases and 25 controls). In addition to half of NPO fluid, we administrated 40 to 50 ml/kg normal saline or ringer intravenously before active intraoperative bleeding. Three ml of fluid was also administrated for each ml of blood loss. Blood transfusion was done for all the control subjects; however, blood transfusion was only necessary for one of the experiment subject. The mean difference of hemoglobin and hematocrit before and after operation in the experiment group(2.17 gr/dl and 6.24%; respectively) and control group (4.56 gr/dl and 13.24% respectively) was significant (P<0.001). Therefore, acute hemodilution technique is recommended for prevention of need for blood transfusion in patients who undergo hemorrhagic orthopedic surgery.

Cerebrospinal fluid (CSF) analysis is one of useful way to detect cerebral venus thrombosis. We evaluated 39 (30 females and 9 males) patients with cerebral venous thrombosis (mean age of 32 years) who admitted in 3 university hospitals in Tehran. In 32 (82%) cases, the CSF pressure was high (mean=320 mmH20) and in 7 patients (18%), the pressure was normal (mean=130 mmH20). CSF analysis for protein, sugar and cell count was normal in 23 cases (59%) and low protein (less than 15mg/dl) was the single abnormally in 5(13%) cases. In 10 cases (25%), CSF analysis showed one or several abnormalities including; high protein(3 cases), high WBC count with lymphocyte predominant (7 cases) and increased RBC count (5 cases). No cases showed decreased sugar in CSF. Therefore, CSF analysis and its pressure recording are useful measures for evaluation of cerebral venous thrombosis. An increased CSF pressure was noted, however, its normalities never rule out sinus venous thrombosis.

The extranodal lymphoma is different from nodal lymphoma in several aspects; including sites of involvement, histopathology, molecular pathology, epidemiology, prognosis and treatment. Awareness of dominant organ involvement, histopathology, clinical presentation and epidemiology leads to the rapid diagnosis and also provides an appropriate background for further research. In this retrospective case series study, of 336 recorded lymphomas in pathologic department of Shariati University Hospital in Tehran during 10 years, 47 cases (26 males & 21 females) had the criteria for extranodal lymphoma. The most common organ of involvement was gastrointestinal system (22 cases of small intestine and 14 cases of stomach); central nervous system, skin and parotid glands had the following frequencies. The most common histopathologic form according to Working Formulation was diffuse large cell type (28 of 47 cases). In small intestine, the frequency of lymphoma with diffuse cell type was equal to IPSID (11 cases for each one). Dyspepsia and malabsorption were the common clinical findings in gastric lymphoma and IPSID; respectively. In conclusion, extranodal lymphoma (especially in gastrointestinal tract) should be considered in differential diagnosis and in prolonged diarrhea, IPSID should be ruled out.

Iodine deficiency disorders (IDD) is a worldwide health problem. Many parts of the Islamic Republic of Iran had been known as areas of endemic goiter. IDD was accepted as a priority  health problem in the country, and a national IDD council was formed in 1989. One of the main strategies of National Council for IDD control was to provide at least 150p.g of iodine per day to the entire population through making available iodized salt. This study was performed to evaluate the national IDD council program in 1996, in rural and urban areas of Bushehr Province. 1400 school children, years 8 to 10 years, including 50% girls and 50% boys, were selected through random sampling. Grading of goiter was performed according to classification of WHO. Serum T3, T4 and TSH were measured by RIA and urinary iodine by digestion method. The mean of serum T4, T3 and TSH were: 10.0±2 µg/dl, 160±30 ng/dl and 3.0±1.4 µIu/ml; respectively. There were no differences between males and females and school children of rural and urban areas. Eight person had serum T4 more than 12.5 µg/dl and only five person had TSH more than 5 µIu/ml. The mean urinary iodine was 17 µg/dl in entire population, 89% had urinary iodine more than 10 µg/dl. Only 3.6% had urinary iodine less than 5 µg/dl. Total prevalence of goiter was 53% (56% in girls and 54% in boys). Based on the available data, seven years after distribution of iodized salt and 2 years after that more than 50% of population used iodized salt, urinary iodine of school children in Bushehr Province is in "adequate" range. However, goiter is still hyperendemic in Bushehr Province.

To determine the relationship between hypertension and ischemic heart disease in 30-64 years old population in Bushehr Port, 1036 person was studied. Ischemic heart disease end points defined electrocardiograms (EKG) according to the Minnesota code and angina pectoris was defined by Rose questionnaire. Hypertension was defined as systolic blood pressure ≥ = 140 mmHg and for diastolic blood pressure ≥ =90 mmHg and for current use of antihypertensive medication. This study was cross-sectional. The crude prevalence of hypertension was 19.4% (with age - adjusted prevalence of 18.3 for women and 14.5 for men). The age – adjusted prevalence of coronary heart disease was 2.5% in men and 1.3% in women by (P< 0.05). Possible myocardial infarction was significantly associated with hypertension in men [in men (odds ratio: 3.63 {95% CI: 1.59-6.76} P<0.001), in women (odds ratio: 1.87 {95%CI:1.22-2.87} P<0.001)]. The results introduced hypertension as a major risk factor for myocardial infarction in Bushehr Port, and considering high prevalence of hypertension in this port, prevention for decreasing hypertension should be a priority in health programs of this area.

Pediculosis and scabies are two contagious dermatitis which are seen all around the world and their association with the other diseases are common. In order to reveal the prevalence of these two dermatosis in Bushehr Port, in a cross-sectional study, 3913 students (1951 girls & 1962 boys) of primary schools of Bushehr Port were examined. Of the examined students, 469 (12%) and 84 (2.1%) had pediculosis and scabies; respectively. Girls had pediculosis more than boys [22% versus 2%; p<0.05], however, there was no difference for scabies between the girls and boys. In conclusion, scabies and pediculosis are common contagious dermatosis among students of primary school of Bushehr Port, thus preventive measures should be considered.

The most important complication of the allowed ionization rays are genetical and carcinogenic effects. For rays protection, some safety rules and regulations have been designed. In order to evaluate the protective principles of the rays in radiological centers in Bushehr Province using questionnaire, based on the Iranian Atomic Energy suggestions, 25 radiological centers in the province were studied. Out of 25 radiological centers, 22 and 5 centers had not gonadal shield and lead apron, respectively and also 30 radiographic rooms, at different centers, were not using lead apron for the patient's accompanied persons. Seven centers were using expired date films and 10 centers were not using film badge for their personnel. Almost 29 radiographic rooms were not having proper ventilation systems and also 22 radiographic rooms were without entry signal and 21 rooms were without any" Radiation Area" signal. The doors of six radiographic rooms were not closed properly while operation was going on inside. And almost non of the centers were using lead sheet for the protection of other patients in the same room while using portable radiographic system. So, we can notice that non of the centers follow the safety principles completely. But with regular checking and more observations by the concerned authorities, and' conducting more training classes for the personnel, we can improve the quality of work done regarding the protective principles in radiographic centers in the province.

To assess the satisfaction of the patients for hospital services, we evaluated the level of satisfaction of 440 cases who admitted in hospitals of Bushehr University of Medical Sciences by using questionnaire. The best scores was obtained for nursing services (89 of 100 scores) and the least one for hospital obtained (65 of 100 scores). Overall 88% of The patients had acceptable level of satisfaction for the hospital services. The women and the patients from rural areas had more satisfaction level. Those with higher education level had the higher level of satisfaction (P<0.01). More than 80% of patients believed that the physicians and nurses of the hospitals were well-mannered. Programs for improvement of physical facilities of the hospitals should be designed to gain the highest satisfaction level of the patients for the hospital services.