Feyz Medical Sciences Journal
Year:2002 | Volume:6 | Issue:22|Papers Count:16

Background: Cadmium is an essential component of industrial and non-industrial materials including foods, water, drinks, and cigarettes. Reports have shown the Teratogenic effects of cadmium, thus the present study was carried out with the aim of determining the effects cadmium chloride on cochlear development in male mouse fetus.Materials and methods: In this experimental study 30 male mouse fetuses of balb/ c race were included Samples were divided in-three groups of control. Experiment I, and Experiment II. Experiment groups have received cadmium chloride with the dosage of 3mg/kg and 5mg/kg intraperitonealy at the 9th day pregnancy, respectively. The control group received distilled water. Six days later, mice were killed ether and their fetuses were removed and kept fixative. Finally, specimens were prepared and stained by H&E. Results were analyzed using ANOVA and sche.ffe tests.Results: Cochleal surface was significantly reduced in Experiments groups comparing to the control (p<0.05), meanwhile, the spiral ganglion surface was significantly reduced, top (p<0.01 and p<0.003). The ecochleal diameter has not differed among the groups (NS). The organ of corti in Experiment II group was smaller than that of control group (p<0.02).Conclusion: Cadmium chloride can cause degenerative changes on cochlear development al mouse fetus. Further studies regarding the effects of cadmium chloride on neural the deformity and hearing dysfunction are strongly recommended.

Background: Electroconvulsive therapy (ECT) is a useful non-pharmacologic Tool for Treating major depression and other neurologic disorders, however, it may lead of bradycardia and consequently To tachycardia and hypertension. Atropine is considered as premedication of choice. We have studied the cardiovascular response following the ECT procedure.Materials and methods: 80 patients had entered this double-blinded clinical Trial. Patients were randomly assigned in either case or control. The case group was intravenously given 0.5mg atropine before the anesthesia induction; however, the control group received 1ml normal saline. Blood pressure and heart rate were monitored after the induction, and at minutes 1,3; and 5 after ECT.Results: The case and control groups were composed of 31 males and 9 females. The mean age of case and control group was 35.3±7.8, and 33±7.6 years, respectively (NS). AT minute 3, the mean blood pressure was higher in the case group (p=-0.43). At minutes 1 after induction and 5 after ECT the mean heart rate was faster in the case group (p<0.05).Conclusion: Administration of atropine as a premedication agent may lead To Transient hyper Tension, meanwhile, those who haven't received atropine (control), had no hradycardia. We don't suggest atropine as the routine premedication agent before ECT, especially ill whom hypodynamic heart, usage of sympathetic inhibitor, and previous history of bradycardia following the ECT procedure exist.

Background: Cataract is one of the common senile diseases. Globally, it is estimated that 20 million subjects are blind due to cataract. Anesthesia modality in cataract surgery is a challenge. The present study was carried out to compare the complications of local anesthesia plus intracameral lidocaine 2% with general anesthesia during cataract surgery.Material and methods: 55 patients undergoing cataract surgery were enrolled in this clinical trial. Patients were randomly divided in two groups. Receiving either focal anesthesia plus intracameral lidocaine 2% (n=28) or general anesthesia (n=27). We evaluated corneal edema, anterior chamber inflammation and intraocular pressure, and followed them up for 2 months. Independent t-test and Fisher's exact Test were applied for statistical analysis. Results: There was no significant difference in corneal edema anterior chamber inflammation and intraocular pressure between two groups in 1,2,15.30 and 60 days after cataract surgery. These complications were more common du-ring the first day following the surgery.Conclusions: Local anesthesia supplemented with intracameral lidocaine 2% was an effective and safe alternative to general anesthesia in cataract surgery. These two methods have similar ocular complications, however systemic complication of general anesthesia limit its usage for senile patients.

Background: Vernal keratoconjunctivitis is a recurrent seasonal bilateral disease, poorly respond 10 conventional therapies. Present study reveals our experience with the low dose topical mitomycine-c in the treatment of severe vernal keratoconjunctivitis refractory to conventional therapy in Shiraz in 2000.Materials and methods: In this placeho-controlled randomized clinical trial 58 patients were randomly assigned to treatment with topical 0.01% mitomycin-c eye drops (n=31) and placebo (n=27) three times daily for 2 weeks, symptoms (including itching photophobia. Tearing, mucous discharge, foreign body sensation) and signs (conjunctival hyperemia, epithelial conjunctival giant papillae) of vernal keratoconjunctivitis recorded at the day of enrollment and at the end of the treatment period.Results: There was a statistically significant decrease in the signs and symptoms 2 weeks following the mitomycin-c administration. In addition one of the treated patient and 26 of the subjects of the placebo group required medication during the first 4 weeks following the Treatment (p<0.001). Therapy was discontinued in tow patients because of drug side effects.Conclusions: Short term low dose topical mitomycine-c may he considered in the acute exacerbation period of patients with severe vernal keratoconjunctivitis refractory to conventional Treatment.

Background: There are various pathologies causing abnormal uterine bleeding (AUB) of which some are predisposing for cancer, thus, we studied frequency of different pathologies in patients referring to Shahihkhani hospital in Kashan, 2000-01. Material and methods: It was a descriptive study. Initial data including method of contraception, parity, age, severity of dysmellorrhea, and bleeding pattern were all recorded Samples were obtained by D&C procedure. Results: The study population included 200 patients with the mean age of 46.2±6.2 years. Endometrial tissues were insufficient in 11. Proliferative endometrium was by far the most frequent pathology. Adenomatous hyperplasia was more commonly seen in para-8 women (0.6%), however, atrophic endometrium was frequently observed in para-9-and-higher females (0.6%). Cystic and- adenomatous hyperpiasia were commonly found in obese females. There was relationship between the results of pathology and the presence and severity of dysmenorrheal. Conclusion: Cystic and adenoma thou hyperplasia (predisposing to endometrial cancer) were more commonly seen in obese patients.

Background: Toxoplasmosis is a disease with various prevalence among different society groups. The present study was conducted with the aim determining the prevalence of acute and chronic infections as was toxoplasma Gondi antibody in pregnant women and those who are involved in the meat indusl1y in Kashan in 2001.Materials and methods: The study population included 300 males and 340 females aged 14-70 years selecting through a simple random sampling. Initial data including age, sex, occupation, place of living, previous history of compact with cat, deity habits, gestational age, previous history of abortion, and clinical manifestations were all recorded. 5cc venous blood was obtained and antibodies 1veredetermined in dilutions of 1:20 and 1:100 by IFA. Positive samples were evaluated by ELISA at titer of 1:200. Meanwhile ANA evaluation was conducted for positive samples. Titer of 1:20 was considered as positive, however titer of 1:-100 was valuable.Results: Toxoplasmagondii was found in 54.2% of whom, 15% had IgM antibody and the others the IgG antibody. Subjects aged 60-70 years have shown greater infection (75%). Males and female infection rate were 16.7% and 61%. respectively. Titer of £200 was reported in -10.2%. Infected males working in the meat industry were 200- fold more susceptible than normal subjects 10 the usage of mm-completely cooked meats. (p <0.0001)Conclusion: The prevalence of toxoplsma Gondi is high in Kashan with respect 10 its complications and the high costs of serologic screening method. educational programs are high suggested, especially for those at risk.

Background: Kawasaki disease is the most common children vacuities and one of the most common acquired heart diseases with serious complications. Although infectious agents are supposed to be involved in the pathogenesis, it is still largely unknown. The present study was performed 10 surveys the related factors in Kawasaki disease in children hospitalized in Shaheed Beheshti Hospital (Kashan) and Tehran Childreh's Center, 1995-2000. Materials and methods: It was an existing data type study: Having reviewed the files of Kavasaki disease. Initial data including age, sex, clinical manifestations, Laboratory results and primal and infection were recorded.Results: Study population included 40 hoys and 23 girls, aged 1-8 years. Clinical manifestations were fever and oral changes (100%), conjunctivitis (85.7%), rash (79.3%), arthritis desquamation (79.3%), arthritis and swelling of extremities (53.9%), cervical lymphadenopathy (50%), and diarrhea (38%). Laboratory findings were: raised ESR (100%), thrombocytosis (90%). leucocyiosis (82.5%), pyoria and proteinuria (53.9%). Primary infections were noted as below pneumonia (9.5%). UST (14.2%), osteomielitis (7.9%), meningitis (12.6%) and 12.6% of patients had previous history of contact with detergents. Conclusion: Results have revealed that Kavasaki is accompanied by an infectious cause in more than 50% of the cases.

Background: The expansion of medical sciences, pharmacy and health coverage in large scale have increased accessibility of people to all sorts of medicines. Hence the latter has created enormous problems in terms of over and under dose and duration of medication: therefore investigation of this phenomenon seems very crucial.Materials and methods: A cross-sectional study was designed in order to investigate self-prescription in Zahedan in 1999. The questionnaire reconvicted of; demographic criteria, self-medication and knowledge of its side effects.Results: Of 2-15cases, 49.8% were males and 50.2% were females with the mean age of 31.2±12.1 years. 67.3% had used drugs after appearance of common cold symptoms without visiting physician. Another common cause of self-medication was headache (55.9%). However, the least percentage of drug intake was noticed in case of subjects suffering from dysuria as c result of urinary tract infection (UTI) that was 7.3% In addition this study showed/hat 77% of people believed drugs were harmless and 51.8% took drugs till the symptoms disappeared and only 20% completed the course of treatment. The largest amount of available drugs at homes was painkillers and antibiotics, subsequently the largest amount of medicines taken as a result of self-medications were painkillers, anti pyretics and then antibiotics. Conclusion: With respect to the above mentioned facts, it is concluded that self-medication and self-prescription are very common among people regardless of their socio-economic level, hence it is strongly recommended that educational measures should he employed in order to increase their knowledge of drugs proper usage.

Background: Nosocominal infectious is a common source of infection in hospitalized patients. Prior reports have shown the possibility of venous catheter infection, too. The present study was carried out to determine the venous catheter infection of patients admitted to ICU and its related factors in Shaheed Beheshti Hospital in Kashan in 2000.Materials and methods: It was descriptive study. Patients for whom IV catheters were removed were included. Then the 3cm of the catheter were cut aseptically and put in Thayer-glycolate. In case of growth within the next 7 days, the sample would he passaged on agar. Finally the type of cultured bacteria as well as its antibiogram was determined Infectious related factors were considered as age, sex, duration of catheter usage, duration of ICU hospitalization, catheter-induced phlebitis, and the location of catheter.Results: Of 100 cultured catheter removed from 36 patients, 29% revealed to have infection, among which, staphylococcus couagulase-negative was the most prevalent (18%). Age, duration of catheter usage, duration of ICU hospitalization, catheter induced phlebitis, and the location of catheter had no effects on infection rate. (NS).Conclusion: Staphylococcal coagulate-negative is the skin normal flora and do not cause severe infection, thus the true rate of infection is less. Needless to say, the venous catheter infections a critical problem seeks further attention in hospitalized patients.

Background: With respect to the ascending rate of urban wastes and its environmental effects, the present study was conducted with the aim of determining the wastes and its recovery rates as Well as the cost-effectiveness of the procedure in Kashan in 1999- 2000.Materials and methods: It was a descriptive study. We have divided Kashan to 7 districts and determine the amount of wastes in each district monthly wastes density was calculated and its components including paper, glass, metals, plastic and so on were weighted.Results: During the study period (one year; 1999-2000) 29865000kg of wastes were collected in Kashan. The daily and per capita waste rate was 82900kg and 0.412kg, respectively. The amount of waste was higher in spring and lower in summer. The urban waste density was 264kg/m3 55.5% of the wastes were recoverable. This would save 2094500 Rails.Conclusion: With respect to the per capita rate of waste in Kashan and the possibility of recovering these wastes, it would be worth investigating in the project of waste recovery in Kashan.

Background: Maternal and fetal complications following the macrosomia are of utmost importance. The present study was carried out with the aim of determining the prevalence of fetal macrosomia and post-term delivery and multi parity as ifs risk factors in Kashan in 1999-2000.Materials and methods: It was an analytical study. During the first phase the prevalence of macrosomia was determined during a two-year period (1999-2001), then, the second phase was conducted on 110 without macrosomia (case group) and 110 without macrosomia (control). Groups were matched according to the sex, BMI. Level of education, prenatal care, mother's nationality and age. A questionnaire was used for data collection, then the role of post-term delivery (>40 weeks) and multiparity was determinedResults: Macrosomia was found in 3.04% of the infants. Post-term delivery was reported in 45.5% and 61.8% of the control and case group, respectively (p<0.02). The mean parity was 2.39±1.34 and 2.54±1.37 in the control and case group, respectively (NS).Conclusion: the prevalence of macrosomia is not high in Kashan. Post-term delivery has increased the rate of macrosomia, however. multiparity has no statistically significant association. Further studies are highly recommended.

Background: Due to the relatively high prevalence of cervisitis and its complications such as pelvic inflammatory diseases that may lead to fertility, the present study was designed in order 10 determine the prevalence of gonococcal cervisitis and drug resistance of those in Kashan in 2001.Materials and methods: A descriptive study was carried on patients with cervisitis referring 10 Kynecologic clinics. After physical examination and diagnosis of cervisitis the sample collected from endocervix. The specimens were cultured on Thayer- Martin agar plates. after identification of isolated gonococci by standard methods, antibiogram Test were performed to determine the sensitivity or resistance of gonococci to common antibiotic. The data were presented using descriptive statistical analysis. Results: Of 315 women patients with cervisitis. 2 (0.63%) had gonococcal cervisitis, both of whom were under 25 years old. The age at which their sexual activity started was £20 years and they have both frequency and dysuria. One of them had revealed resistance to vancomycin and the other had resistance to ceftriaxon.Conclusions: Due 10 the relatively high prevalence of gonococcal cervisitis in western country, the prevalence of 0.63% in this study is not hazardous. Meanwhile, gonococci in/his area are sensitive to common antibiotics.

Background: Burger's disease has various presentations. During the present study we have determined the clinical manifestations of Burger's disease in a group of patients referring to Taleghani Hospital in 2000-01.Materials and methods: It was a descriptive study. Diagnosis was confirmed in accordance with clinical manifestations and angiography. Patients' clinical signs and symptoms as well as other demographic data were recorded.Results: 42 patients with definite diagnosis of Burger's disease and the mean age of 35.9±1.2 years were included. All were male and smoker. 71% had addiction and 54.8% had previous history of smoking for more than 10-20 years. Poor health status was reported in 69%. Clinical manifestations were: resting pain (81%), ischemic ulcer, intermittent claudication, thrombophlebetitis, and upper limb's pain. Conclusion: Our patients' clinical signs and symptoms have differed with reports of western societies. Poor socioeconomic and health status are the major risk factors. Further studies are highly recommended.

Background: Appropriate utilization of primary physician and specialty care. Hs stimulated substantial debate, but the portion of discussion focused on policies that restrict or discourage direct access to specialist. We examined the self-referral incidence rate and the association of health care delivery system structure with utilization of primary physician and specialist.Materials and method: Office visit for patients in private sector and outpatients in public clinic care, stratified by insurance status (Rural Health Insurance, Imam Khomeini Welfare Committee, private insured patients and non insured patients or self-pay patients). 1306 subjects were randomly selected for the study purposes. 39.9% were covered by Imam Khomeini Welfare Committee, 14% Rural Health Insurance. While 46.1%were open for direct referral to specialty services.Results: In Imam Khomeini Welfare Committee closed loop referral system, 6.8% of patients were direct self- referral. In rural health insurance 29.7% of patients were direct self-referral, while in open referral system 75.5% of the patients were direct self-referral to specialist. Significant association was detected between the structure of health care delivery system and patient self- referral to specialty care. The incidence rate of self- referral in public sector was 60.5 and in private sector was 36.4%.Significant association was detected between public and private sector self- referral (P<0.001). Patients' reasons for skipping the general practitioner was high specialist competency as those problems were specific for the specialist, waste of time, friends recommendations and weakness information about referral system.Conclusion: The results suggest greater utilization of specialist in open referral system. Closed loop referral system like Imam Khomeini Welfare Committee may reduce some of these disparities.

Background: Accident-induced trauma is a common problem with short- and long-Term complications. The present study was conducted in Naghavi Hospital in Kashan in 2000 to determine the external factors influencing the incidence (of accident-induced Trauma.Materials and methods: It was an existing data type study. Medical records of patients hospitalized in 2000 in Naghavi Hospital were reviewed and initial data including sex. age, type of accident and site injury were all determined.Results: The study population included 1543 males and 498females. 35.5% of females referred to the hospital because of falling down Males aged 10-30 and females aged ³50 years were more commonly affected Vehicles were the cause of accident in 49.2% of the cases of which morcycle was more common (56%). Head and neck regions were injured in 32% of the cases.Conclusion: Trauma has affected young adults more frequently. This seeks further attention since this age group are more actively involved in society activities.Results have revealed that in Kashan, motorcycle required more precise observations.