Journal of Guilan University of Medical Sciences
Year:2003 | Volume:11 | Issue:44|Papers Count:13

Introduction: Silent myocardial infarction is a kind of infarction that could not be diagnose at onset except casually. Objective: The aim of this study was comparing the prevalence of opium addiction in silent with non-silent myocardial infarction.Materials and Methods: A consecutive series of 676 patients (male 495, female 181) with diagnosis of Q-wave myocardial infarction (MI) by resting ECG (with or without previous history of MI) in a cardiovascular private clinic in Rasht were selected.Results: Silent MI (SMI) was observed in 231 (34.2%) of patients. The prevalence of opium smoking in non-silent MI (NSMI) was higher than SMI (17.5% vs. 6.5%, P<0.001).The prevalence of opium users (smoking and oral) in NSMI was higher than SMI (20.4% vs. 10.8%, P<0.005). The prevalence of oral users in SMI (4.3%) was not significantly (NS) higher than NSMI (2.9%), P=NS. Mean age (P<0.0001), sex (female) (P<0.0001), Hypertension (just in males) (P<0.0001) diabetes mellitus (P<0.05), and stroke (Just in male)(P<0.005) were higher in SMI than NSMI.Conclusion: The results of this study suggest that: 1-Opium addiction is not an associated factor with SMI. 2-the associated factors of SMI are: Older age, sex (female), Diabetes Mellitus, hypertension, and stroke (in male patients).

Introduction: Living in close and crowd conditions can cause increase in many diseases including contagious skin diseases. Objective: The aim of this study was to determine the prevalence of contagious skin diseases (Scabies, Pediculosis, Wart, Dermatophytosis and Molluscum) in Rasht Lakan prison in 2001-2002.Materials and Methods: We selected all prisoners with more careful clinical exams for suspected cases.Results: In this survey 2100 prisoner evaluated (2055 were male and 45 were female). We picked up 356 prisoners with various skin problems.Dermatophytic infections with 6.28% were more prevalent than Pediculosis (5.1%), Scabies (4.5%) and Wart (1%). There was not any patient with Molluscum Virus. Age range was 18-70 years with mean age 36.38±11.84 years. Conclusion: This study showed the situation of main skin problems in Rasht Lakan prison.

Introduction: 400000 new cases of cutaneous Leishmaniasis are reported each year and unresponsiveness to treatment of choice (Glucantim) is increasing. In cases of drug resistance, Allopurinol is prescribed as alternative therapy. Objective: In this in vitro study Allopurinol effects were assessed on L. Tropica resistant Types.Materials and Methods: The L. Tropica Promastigote species were cultured in increasing concentrations of Glucantim to obtain the resistant type to 250 mg/ml. After cytological evaluation of all resistant types, Allopurinol effects were measured by count and by growth percentage of both wild and resistant types. The differences of these variables were then compared in and between species.Results: Promastigotes of resistant type were decreased in dimension, their tails got thicker and shorter or even disappeared, and cytoplasm got dentate while kinetoplast moved next to nucleus. Allopurinol decreased growth percentage and the number of both resistant and wild Promastigotes. But growth percentage of resistant type was significantly less than Wild type for all Allopurinol concentrations.Conclusion: Mechanisms of Glucantim resistance lead to morphological and growth rate changes. In agreement to precedent clinical studies the in vitro resistant type of L. Tropica Promastigotes was more sensitive to Allopurinol, although Allopurinol is effective on both wild and resistant species.

Introduction: Electrolyte imbalance usually happens in I.C.U patients. Magnesium is one of the most important ions disturbance of this ion, causes hemodynamic instability, Cardiovascular dysfunction, Seizure, muscle weakness, Failure of weaning and influence other ions concentration. Objective: The onset time of magnesium imbalance after trauma and how does trauma mechanism interfere it, is the aim of this observational study. The aim of our study was survey the influence of kind of injury on magnesiume imbalance.Materials and Methods: In this Analytical study serum Magnesium (Mg) in patients with head trauma compared with patients with extremities trauma at admission time in ICU.We studied 30 head injury and 30 patients with extremities trauma during 1380. Two groups were same in age and sex and had no medical history. (PS I, II) 24 hour after trauma patients was admitted in I.C.U and blood sample was taken for evaluating serum Mg. [with calorimetric spectrophotometry (Reagent: Xylidylblue)]. Our Statistical Analysis was Chi- square. Results: Results showed that mean serum Mg of head trauma patients was 1.84 0.19 meq / L which was significantly lower than extremities trauma (2.23 ±‏ 0.29meq/ L, P < 0.02).Conclusion: This study showed that serum Mg in patients with head trauma decreases sooner and more sever than extremities trauma and concerning this on the first course of treatment in ICU and proper correction should be in mind.

Introduction: Pulmonary Nocardiosis is a dangerous chronic infection, which is caused by implantation of aerobic Actinomycetes called Nocardia in respiratory system. The disease is more commonly found in patients with chronic infectious disorders, which may be treated with prolonged antibiotics or Corticosteroids, and also in immunosuppressed patients. Objective: Our aim was study of Nocardiosis in pulmonary patients being confined or referred to Imam Khomeini and Dr. Shariati hospitals as well as Medical Mycology Department in public Health School of Tehran University of Medical Sciences.Materials and Methods: 150 reliable samples of BAL (Bronchoalveolar lavage) specimens were collected during a period of 12 month from patients, being confined or referred to above centers.Results: Fifty nine percent of patients were male and the rest were female. The results obtained by using direct smears (KOH, BM, Kynion), culture and diagnostical - identical methods were revealed two positive cases of Nocardia asteroides. Conclusion: Therefore, Paying attention to Nocardiosis in the patient suffering from pulmonary diseases is highly recommended.

Introduction: Cesarean sections delivery is the most common surgical procedures performed in Guilan, and postoperative pain is a common complain in this patients. Objectives: To determine leaving peritoneum opened after Cesarean sections deliveries on postoperative pain in patients.Materials and Methods: In a double blind clinical trial, with a non- randomized sampling 150 patients randomly assigned in two groups: experiment group with leaving peritoneum opened and control group with postoperative closed peritoneum as routine procedures. All information about patients (including background variables and experimental variables) recorded on forms. Pain assessment performed by visual analog scale two times with 12 hours interval. Statistical analysis carried out using t- test, Manwithney test, and chi- squared tests. Type 1 (alpha) error considered 5%.Results: There was no difference on background variables, type of abdominal incisions, and anesthetic methods between two groups. The means of pain numbers had statistically significant differences in two groups (P<0.01) the mean of administering injection analgesics had statistically significant differences (in experiment group less than control group).Conclusion: As leaving peritoneum opened have a lot of advantages such as decrease postoperative adhesion in peritoneum. Based on the findings of this study decreasing postoperative pain is another advantage of that.

Introduction: The genus Brucella consists of six species, four of which are associated with human Brucellosis, B. Abortus, B. Melitensis, B. Suis and B. Canis. Brucella are small, no motile, none capsulated gram negative and coccobacilli. It is an intracellular parasite of the Reticuloendotnlial system. Brucella infection has a worldwide distribution. Objective: In this research, serologic test data results from 500 patients were evaluated.Materials and Methods: Method of tests consisted slide and tube agglutination test, Rose Bengal, 2ME and Immunofluorescent test, that were compared.Results: Relative frequency of Antibody titers was consisted:Rose Bengal 24.4%, Rapid Wright 21.2%, Coomb'sw 23.8% and IFA 21.4%.GMRT (Geometric mean of reciprocal titers) of Anti - Brucella Antibody titers was consisted: Tube Wright: 284.5, c.w: 294.39, IFA: 326.3.Relative frequency of Anti- Brucella Antibody titers by sex and age groups was explained that percent of disease in made (38.3%) was more than female (15.6%) and relative frequency of Anti - Brucella Antibody by seasons of the year was not significant.The specificity of the IFA was higher than of tube test.The sensibility of the IFA was higher than 2ME test.Conclusion: As a general rule, IFA test has less false positive and negative results.

Introduction: Antibiotic resistance of Salmonella Typhi has been increased since several decades ago. Resistance pattern is different in different areas and is dependent on many factors so knowledge of this pattern is necessary for physicians in order of treatment of typhoid fever patients. Objective: Our aim was to study antibiotic Resistance of Salmonella Typhi Isolated from typhoid fever patients who admitted in Razi Educational and Medical Center. Materials and Methods: In this descriptive study, 86 positive blood cultures for salmonella Typhi and their antibiograms in Razi during 3 years (1377-1380) and distribution of cases during this time were studied. Results: The results showed that Multi drug resistant (MDR) Salmonella Typhi was rare (1 case resistant to Ceftizoxime, Trimetoprim Sulfamethoxazol and Amoxicillin) and distribution of disease was sporadic. The most percentage of resistance were to Ampicillin and Amoxicillin (19% and 22% respectively) Resistance to Trimetoprim Sulfamethoxzaol and Ceftizoxime were (5/8%) and (4/8%) respectively. Resistance to Chloramphenicol and Ciprofloxacin were not seen.Conclusion: MDR Salmonella Typhi in this area is rare and physicians can use first line Antibiotics such as Trimethoprim Sulfamethxazol, Chloramphenicol and if being sensitive, Ampicillin and Amoxicillin for treatment of typhoid fever patients.

Introduction: Although injection of opium or anti-inflammatory drugs (IV or IM) is common for reducing postoperative pain there is limitation in use of them because of their side effects. Objective: In this study the efficacy of intrathecal Midazolam in the management of acute postoperative pain in C/S has been examined. Materials and Methods: 151 patients scheduled for cesarean section (C/S) under spinal anesthesia was performed by 80 mg of Lidocain Hyperbaric Solution plus 2.5mg Midazolam as case group. In control group 76 patient spinal Anesthesia was performed with 80mg Lidocaine Hyperbaric. In postoperative period, Visual Analogue Score determined pain evaluation at one and three hours after C/S.Results: The mean of VAS in 1 and 3 hours after C/S in case and Control group was (2.5±1.2, 4.9±1.9), (5.9±1.7, 8.8±1.5) Respectively with (P<0.0001). Ketamine injection, Hypotension and shivering in case group is lower than control group (P<0.01) (1.3% versus 50%), (29.3% Versus 42.1%), (%4 Versus 57.9%) Respectively.Conclusion: Interatecal midazolam without side effect can reduce postoperative pain.

Introduction: During pregnancy 50 to 90 percent of women suffer from backache. This is more in them who had history of backache or in who endured it during the last pregnancy. Objective: In order to study the relative frequency of different kinds of backache in pregnancy this study performed.Materials and Methods: 200 cases who came to clinic and complained of backache from 1996-2001 (during 5 years) were selected, and divided into 4 group on the basis of outbreak of pain (0-12 wk), (13-24 wk), (25-30 wk) and (31-40wk), on the basis of the kind of pain, they were placed in 3 groups Sacroiliac pain, Low back pain (LBP) and high back pain (HBP).Results: In present study among 200 pregnant 162 were multipara (81%); 73 percent had history of backache and 38 (19%) had backache for the first time. In different weeks of the pregnancy relative frequency of different kinds of backache was as follow: (A) - In the first group (0-12 wk) the most backache was in Sacroiliac area, LBP and HBP were 40% and 14% respectively.(B)- In 2nd group (13-24 wk) Sacroiliac pain had been achieved 48% and the rate of LBP (34%) and HBP (18%) had been decreased.(C)- In 3 rd group (25-30 wk) backache had been observed in Sacroiliac area more commonly (50%). (D)-In 4th group (31-40 wk) the relative frequency had been increased in Sacroiliac area (54%) and the rate of LBP (24%) and HBP (20%) had been decreased.Conclusion: The best management of backache during pregnancy in different methods of prevention.

Introduction: BPH is a common cause of urinary disorders. It causes troubling symptoms, which necessitates early treatment and is a leading cause of hospitalization in urology ward. Therefore study of its relative frequency is mandatory. Objective: To evaluate patients with BPH in urology ward of Razi Hospital of Rasht This study performed.Materials and Methods: This was a descriptive study including 675 medical records of patients with BPH operated in urology ward of Razi hospital from 1994-1998. Of these records, 43 incomplete records were eliminated. 632 records reviewed regard to variant: age, cause of refers, technique of operation, pathologic exam, urine analysis and blood exam. Results: About 14.9% of patients who hospitalized and operated in urology ward, had BPH. The most common age group was 60-79 years old (82.9%). The most common technique was open surgery (55.9%). The most common cause of refer was urinary relation (42.4%). 29% had leukocytosis and 42.2% had anemia. Increase in BUN and Cr. was seen in 16.8% and 3% of patients respectively. Urine analysis was normal in 57.3%. In 25.9% bacteriuria was seen. In 82.4% of patients, pathologic records were nodular hyperplasia. 13.2% of patients had nodular hyperplasia with chronic prostatitis. In 26 patients (4.4%) cancer was reported.Conclusion: High frequency of urinary retention could be for late refer of patients. Relative frequency of Prostatic cancer was determinate. In this study we clarified BPH. We need more studies for determination of epidemiologic status of it more carefully.