Koomesh
Year:2007 | Volume:8 | Issue:3 (23)|Papers Count:16

Introduction: Tonsillectomy, with or without adenoidectomy, is the most common surgical operations which is performing in the field of ear, pharynx and nose. The most common serious complication following tonsillectomy is postoprative hemorrhage that it could threat patient’s life and occurs intraoperatively, immediate postoperatively (within 24 hours post-operation) or delayed (24 hours after operation). Materials and Methods: The current survey was a cross- sectional study, which performed according to the records of patients who had an adenotonsillectomy and involved with hemorrhage after the surgery in Tabriz children hospital from April 1999 to June 2002. In addition, the patients were needed for a surgery with general anesthesia to control the hemorrhage. Results: Postoperative hemorrhage was observed in 17 out of total 1107 patients (1.53%) and the most common indication of surgery was both infective and obstructive causes.  94.1% of these  patients involved with primary hemorrhage and the cause of hemorrhage was disorder in hemostasis in 70.6 % of patients. The most common ages of hemorrhage was  8 and 12. Conclusion: By establishment of exact hemostasis following surgery and the control of tansillar fossa and nasopharynx for remaining tissues, hemorrhage could be decreased. In addition, the rate of mortalily after surgery could be significantly decreased by the control of patients for the first 24  hours after surgery, that it says, the control of vital signs and tonsillar fossa for probability of hemorrhage and its treatment.

Introduction: Despite of success in treatment of cardiovascular diseases by drugs and other methods, cardiovascular diseases and myocardial infarction are the most common causes of death in the developing countries.  Many reports have been published about correlation between free radicals and increase of homocysteine with atherosclerosis pathogenesis. The aim of this research was to study the correlation between the heaelevation of homocysteine with changes of superoxide dismutase (GPx) activity after myocardial infarction. Materials and Methods: This research was a descriptive cross-sectional study that performed in 2006. In fasting condition, blood was taken from 48 patients and 48 normal healthy people under 76 years old. Serum homocysteine was determined by ELISA method, erythrocyte GPx (rGPx) activity assayed by Randox company kit and serum GPX (sGPx) activity assayed by Cayman chemical company kit. Results: 36 men and 12 women were in the patien group, while the control group included 29 men and 19 women. The mean of homocysteine in patients were 30.3±5.3 mmol/L and in controls were 11.1±3.1 mmol/L, that it showed a significant difference between two groups (p<0.001). The mean activity of sGPx in patients and controls were 2705±2078 U/g Hb and 2509±2450 U/g Hb, respectively. The mean activity of rGPx in patients and controls were 47.8±25.6 U/ml, 44.8±24.6 U/ml, respectively. Conclusion: In this study, an increase in homocysteine, sGPx and rGPx was observed in patients in compared with controls; however the increase of GPX was not significant. It seems that the elevation of GPX is due to cellular damages. This enzyme inhibits free radicals.

Introduction: Tens of milion people undergoing surgery each year in the world. Surgery is a stress that creates physiological responses (endocrine) and psychologic stress (fear, anxiety). Prolonged anxiety, if unrecognized, creates stress which may subsequently harm the patient and delay recovery. This study was intended to assess factors affecting peroprative anxiey of the patients. Materials and Methods: This descriptive-analytical study involved 100 patients who admited on the general surgery wards in the hospitals of Mashhad. The patients were selected by objective-bused sampling method and a state - trait Anxiety inventory questionnaire was filled for each patient in the evening and morning (immediatelly pre-oprative) prior to surgery. Data analysis was performed using SPSS software.Results: Our result indicated that a significant difference between the mean evening anxiety (40.6) and mean morning anxiety (43.2) (P<0.001).In addition, the following factors were found to be affecting preoprative morning anxiety: sex, asleep night prior surgery, waiting more than 2 hours, financial problems, occupation and companion (R=0.456).Conclusion: Given the factors that have influence on preoprative anxiety, and some these factors are preventable, it is suggested that a systematic planning for recognition these factors in order to minimize their effects are prepared in surgery wards.

Introduction: Surgical site infection (SSI) is one of the common complications in postoperative period. SSI is induced with microorganisms that spread by surgeon, assistant and etc. Surgical scrub could reduce colony count of hands. This reduction can reduce the potential of SSI. Disinfection solutions are one of most important in scrub efficacy. These solutions have specific advantage and disadvantage. It seems that compound solutions have more efficacy in compared with each of these solutions alone. This study was designed to survey the effect of betaine and alcohol compound in surgical scrub. Materials and Methods: With approval of the ethics committee of the medical university, 40 volunteers including surgeons, operating room technicians, nurses, resident and operating room students were selected. Scrub with each of these solution was performed in one, three and five minutes. Each volunteers scrubbed with povidone iodine 7.5% alone or a compound solution of povidone iodine and alcohol in a duration of 1, 3 and 5 minutes. They selected one of the 6 methods randomly. In first day, scrub sampling were taken on blood agar nutrient plates using the finger impression (dominant hand) technique before, immediately after and 30 minutes after scrub. The plates were then labeled and transported to a separate laboratory. The sample plates were incubated for 24-48 hours at 37Oc temperature. Colony forming units and the type of bacteria on sample plates were then recorded.Results: Results showed that most of bacteria were Staph. Saprophyticus, Staph. Epidermis, Micrococcus spp., Bacilus spp. Scrub with betadine or betadine and alcohol compound in each of 1, 3 and 5 minute duration, could reduce hand colony counts effectively. This reduction was continued until 30 minutes after scrub. Conclusion: Both applied methods in this study, betadine alone and betadine and alcohol compound, had equal effects on scrub. Given the drying and irritation effecst of alcohols on skin, we recommend to use of betadin alone for scrub.

Introduction: Incidence of early wound related complications was assessed in laparoscopic versus open abdominal surgeries. Complications of surgical wounds (esp. wound infections) are considered as a major problem in surgery wards. Complications of surgical wounds are classified as early and late. Common and early complications are hematoma, seruma and wound in fection. Materials and Methods: Medical records of 104 elective laparoscopic (A) and 106 diagnosis matched open surgeries (B) including appendectomy, cholecystectomy, ventral hernia repair, and bariatric surgery were prospectively reviewed. Study data included patients`sex, age, wound class, type of operation, and occurrence of early wound related complications. Surgical wounds were evaluated for presence of early complications during the post-op period and 10 to 15 days after the operation.Result: The two groups were not different with respect to age, sex and wound classes. No patients in group A and 7 patients in group B developed wound infection (P<0.05).Incidence of Hematoma was similar in the two groups; one case in each. No patient in the two groups experienced seruma and wound dehiscence. Gender, age and wound classes were not associated with higher rates of wound complications. Conclusion: Laparoscopic surgery significantly reduced the incidence of early wound complications, specially wound infection, and is a safe and effective alternative to conventional open procedures.

Introduction: Usage of medicinal plants for treatment of pathogenic diseases is one of the most promising methods, which have minimum side effects. The strains of E.coli 0157 are the most dangerous gastrointestinal tracts pathogens causing death worldwide. Therefore, a medicinal plant extract with potential for treatment of this disease would be quite effective medics. Materials and Methods: In the present study, the effect of plant extracts on the different phases of bacterial growth was precisely determined using spectrophotometery, besides routine methods such as MIC, drop plate and disc plate. To peforming this study, E.coli 0157 (NCTC1290) was obtained from the university of Aberdeen, and following the initial characterization of the bacterium, the different phases of bacterial growth were investigated in the presence of the plant extracts of Eucalyptus globulus, Juglans regia and Vitex angus castus.Results: The results showed that the alcoholic plant extracts of E.globulus and J. regia had no significant influence on the growth of above strain of E.coli. However, the extract of V. angus custus had an inhibitory effect on bacterial growth 4-11h after inoculation, while such effect was not observed at the early stages of bacterial growth. Conclusion: These results could provide a better understanding and perception of the antimicrobial effects of plant medicines on bacterial growth phases, which facilitates their applications.

Introduction: The role of ryanodine canal/receptor current on the pacemaker activity of heart cells is controversial. This study was performed to characterize the effects of ryanodine receptor (RyR), on the cycle length (CL) of action potential of the sinoatrial node (SAN) and the atrioventricular node (AVN) of rabbit heart.Materials and Methods: As a specific blocker of the RyR, the effects of 0.2 and 2 micromolar of Ryanodine on action potential CL was investigated. The action potential was recorded and measured from endothelial surface of intact SAN and AVN by two separated metal microelectrode before and after using ryanodine. The experimental method used, was intervention. Data analysis was performed using independent and paired T test.Results: Inhibition of RyR by 0.2 and 2 mM of Ryanodine prolonged CL by 11.6±4.3 and 30±6.75 % in SAN preparations and by 18.5±6.3 and 65±11% in AVN preparations. This effect was significantly (p<0.05) longer on AVN than SAN.Conclusion: Rabbit SAN and AVN showed distinct different responses to the inhibition of RyR, which reflects the variation in contribution of this current to the pacemaker function of the cardiac nodes in the rabbit. As ryanodine did not cease pacemaker activity of any tissue  preparation for two nodes; therefore, it is possible to say that ryanodine receptor has no absolute role in generating action potential of nodes.

Introduction: The recent studies have shown that breastfeeding is beneficial for both physical and mental health of baby. In addition, it is very important with respect to the socio-economical status of family life and the society. The aim of this study is to identify the influence of some factors on duration of breastfeeding in Mazandaran province with survival analysis.Material and methods: This cross-sectional study was performed on 480 mothers who had at least one baby aged 2-3 years. A questioner was completed for all mothers by interview. Data analysis was carried out using the Cox Proportional Hazard Regression model.Results: The results of study showed that the breastfeeding median was 22 month and mean (SD) was 21 (4.6) months. In addition, the results showed that 1.9% of babies who had breastfeeding were less than 6 months old, 5.6% between 6 and 12, 17.9% between 12 and 18, 65.1% between 18 and 24 and 9.5% more than 24 months old. To detect effective factors on the duration of breastfeeding, the Cox regression was used and then significant factors were entered in a multiple Cox regression to remove the potential confounders. It was found that residencey place (urban or rural), having twin babies, mother jobs, the type of pregnancy, using other milk, drinking tea or water to babies before the age of 4 months, number of breastfeeding per day, and finally  supporting and promoting by husband were among the significant effective factors on the breastfeeding duration.Conclusion: On the basis of the final model the probability of continues breastfeeding at 6, 12, 18, 22 and 24 months were 99.2, 95.0, 79.5, 50.0 and 8.2 percent respectively.

Introduction: Central motor conduction time (CMCT) includes time for excitation of the corticospinal pathways and transmission along those tracts. Data obtained by cortical magnetic stimulation are helpful in some clinical situations such as multiple sclerosis, cervical spondylosis, motor neuron disease, and etc. However, using different methods for peripheral motor conduction time (PMCT) demonsrates two different results. In this study, we used two methods to compare CMCT from F- wave latency and spinal root magnetic stimulation. Also, this study was performed to determine normal values, effects of sex, age and upper limb length.Materials and Methods: Magnetic stimulation of the cortex and cervical spinal roots was performed on 39 healthy subjects. Responces were recorded from the abductor pollicis brevis (APB) muscle. F-wave study was performed in the median nerve. Subtraction of total motor conduction time (TMCT: cortical response) and PMCT by F-wave and cervical root stimulation, shows CMCT.Results: The results showed 19.7 ms for TMCT, 7.3 ms for CMCT of root stimulation and 4.8 for F-wave based CMCT. CMCT to the APB correlates with upper limb length but no with age or sex.Conclusions: The CMCT calculated by subtracting F-wave latencies measured to APB after transcranial stimulation was shorter than the one obtained after magnetic root stimulation.

Introduction: Menopause, cessation of menstruation, is a public event for all women that occur between the ages of 45-55 (or even sooner). A variety of researches done in Iran and the rest of the world show age at menopause can depend on numerous factors such as race and genetics, socio-economics, history of fertility, physical activity, nutrition, sexual behaviors, diseases and etc. However, there are inconsistencies between results from different researches which can be related to methodology and methods of analysis. Present research has been done to analyze methodologies which estimate age at natural menopause and its associated factors by considering their power and weakness points.  Methods: The cohort and cross-sectional methodologies to estimate age at natural menopause are introduced as well as appropriate statistical techniques to determine effective factors.Results: Iranian and the some foreign papers, which their main object or one of the principle objects was estimating age at menopause, are introduced and analyzed.Discussion: The results show that prediction and estimation of age at menopause are more complicated than it seems. Nearly all Iranian and some foreign surveys are poor in methodology and methods of analysis which decreases the efficacy and correctness of their findings.

Bacterial abscesses involving the spinal canal are associated with a high morbidity and mortality. Most frequently, these lesions are found in the epidural, rarely in the subdural spaces. Spinal subdural abscess is rare. The exact incidence of the spinal subdural abscess(SSA) is unknown and the most affected region is the thoraco-lumbar spine. The timing for MRI is very important when the clinician notices these symptoms in the patient.Early diagnosis and emergent treatment is vital to prevent the formation or progression of neurologic deficits. Although the most common bacterial source is Staphylococcus aureus, bacterial sources were proteus and E.coli in the patients .In this report, we presented four patients with SSA in the thoraco lumbar region. Over the last 10 years, four cases of spinal subdural abscess were admitted and treated at Tehran Children Medical Center. All of four cases were under 3 years old and surgically and medical treated. All four patients were received  antibiotics for a period of 4-6 weeks and showed remarkable recovery.

A case of sever bullous irritant contact dermatitis in uncommon site in a 50 year-old woman secondary to contact with angustifolia fruit is reported. She developed multiple bullous lesions on anterior of her trunk. We found no prior clinical report of contact dermatitis due to Elaeagnus angustifolia.In a broad sense,  Irritant contact dermatitis represents the cutaneous response to the physical and toxic effects of a wide range of environmental exposure. Irritant contact dermatitis has a spectrum of clinical features, ranging from a little dryness, redness or chapping through various type of eczematous to an acute caustic burn.