Feyz Medical Sciences Journal
Year:2002 | Volume:6 | Issue:21|Papers Count:20

Background: Bacterial corneal ulcer is a common ophthalmic problem. Still controversies are exist for the treatment of bacterial corneal ulcer, thus, the present study was carried out in Namazi Hospital in Shiraz to determine the efficacy and side effects of ciprofloxacin ophthalmic solution 0.3% and compare this with fortified cephazolin-gentamicin.Materials and methods: It was a clinical trial. Having the physical examination and patient's history completed, two samples were obtained for culture and smear. Patients were randomly distributed in two groups. One received the standard protocol (Cephazolin 5% and Gentamicin 9% ophthalmic solutions) and the other was given ciprofloxacin ophthalmic solution 03%.Efficacy was evaluated according to the days of treatment and side effects were surveyedby eye burning and white deposit.Results: Of 45 cases, 6 were excluded due to the altered regimen. Of 39 studied cases, 20 received ciprofloxacin ophthalmic solution 0.3% and the remaining 19 were - given standard regimen. Success rate was 90% and 89.5% for the ciprofloxacin and Standard regimen, respectively (NS). Eye burning was reported 5% and 36.8%, respectively, meanwhile, white deposits were reported in 36.8% of patients who have received standard regimen (p<0.02). Of cultured bacteria, one had shown intermediate resistance to ciprofloxacin, however, resistance was noted to cephalexin and gentamicin.Conclusion: Ciprotloxacin can be a suitable alternative for fortified cephazolin-gentamicin sine it has better outcome, and less side effects. Further studies are highly recommended.

Background: Non-ulcer dyspepsia is a prevalent problem that made patients visiting the doctor. Different medications are used, such as: cimetidine, ranitidin, metoclopramide, and omeprazol. The present study was conducted in Kashan in 1995-96 to determine the effects of cimetidineon non-ulcer dyspepsia.Materials and methods: It was a double-blinded clinical trial with concurrent controls. Patients who had at leas one of the following signs or symptoms for 3 months were included: bloating, nausea, vomiting, reflux, belching, heartburn. Physical examination and necessary tests were used to rule out any underlying disease and endoscopy was applied to exclude any organic GI problem. Patients were randomly distributed in two groups of case and control. Case group received cimetidine 200 mg/qid for 2 weeks and the control group received placebo.Results: Of 70 patients, 40 were males and 30 were females. The mean age (±SD) of case and control group was 30.1±8.1 and 29.1±9.1 years, respectively (NS). Partial or complete improvement of signs and symptoms were shown in 86.6% of patients in the case group and 82.9% of control subjects.Conclusion: Results have revealed that cimetidine is an effective agent for non-ulcer dyspepsia. Surveying the efficacy of other drugs is highly recommended.

Background: Extra embryos developed during IVF have led to different freezing methods with variety of antifreezes. The present study was conducted with the aim of determining the effects of ethylene glycol on mouse ova development and existence following the freezing procedure.Materials and methods: It was an experimental study. Oocyte was obtained and fertilized by sperm. 16-17 hours later zygotic cells were distributed randomly in three groups of control, toxicity and freezing. In freezing group, embryos were frozen slowly by two antifreezes, ethylene glycol and propandiol, according to the standard procedure. Lived embryos were cultured for 120 hours. Then their development was compared with that of control group.Results: Toxicity test results have shown no significant difference considering zygotes viability and development between the control and freezing groups. Following the procedure, viability of cells in propandiol group was significantly higher than that of ethylene glycol (94.1% vs. 58.2%), meanwhile, the rate of cell development till blastocyte was significantly higher in the pre-prandial. group (68.2% vs. 39.1%, p<0.001).Conclusion: Ethylene glycol is not a suitable alternative for propandiol in slow feezing. Results of cell viability and development revealed that propandiol could be an appropriate substance for freezing human zygotes.

Background: Asthma is a prevalent chronic pulmonary disease presented in 20% of population. Steroids have been shown to be effective in asthma treatment, however. controversies are arisen in the route of administration. The present study was conducted in a private clinic in Kashan to determine the effects of different routes of corticosteroid administration (oral injection, and inhalation) on asthma attack. Materials and methods: 120 patients had entered this clinical trial. Patients were distributed in three groups; oral, injection and inhalation group. All subjects received salbutamol, Spirometery was performed before and after the therapy, then results were analyzed. Results: The study population included 63 males (52%) and 57 females (48%) with. the mean age of 39.9 years. Comparison of FEF25-75, FEV1, and FVC results showed non-significant differences between the oral and injection groups, however, they were more effective than inhalation corticosteroids.Conclusion: Administration of corticosteroids either orally or by injection can be easily used to control asthma attack. Inhalation therapy is less effective and is not recommended.

Background: Noise pollution is a environmental problem of big cities that cause hearing loss, sliep disorder, hypertension, and GI problems. Determining the noise pollution is of utmost importance to access suggested standards. The present study was carried out in different districts of Kashan in 2000 to determine the noise pollution.Materials and methods: During this descriptive study four different settings of Kashan were included; districts of heavy traffic, hospital setting, residential areas, and residential-industrial areas. Noise Dosimeter and Sound Level Meter were used in 24 stations for 8 hours (8AM-]2 and 16PM-20PM) during a 9-month period. Leq was determined in each station.Results: Leq of districts of heavy traffic, hospital setting, residential areas, and residential-industrial areas was 76.6, 65.6, 56.7, and 54.8db, respectively. There was no significant difference between morning and afternoon periods.Conclusion: Noise pollution was obvious in districts of heavy traffic, hospital setting, and residential areas. Further studies are highly recommended.

Background: Fluor is an anion found in water and soil, however, its concentration is greatly varied in different sources of drinking water. Since our body requirement to Flour is mainly achieved through drinking water, determination of its concentration is of utmost importance. The present study was conducted to determine the Fluor concentration of drinking water of Kashanin 1999.Materials and methods: It was a descriptive study. All sources of drinking water in Kashan were examined. With respect to its seasonal changes, sampling was performed twice (in two different seasons). Sampling and the related examinations were performed according to the standard methods.Results: 201 sources were sampled twice. The maximum and minimum concentration of Flour were revealed 1.2 and 0.25 mg/dl, respectively, mean while the mean concentration of Fluor in spring and fall were 0.65 and 0.64 mg/dl, respectively. 50.6% of sources had standard Fluor concentration. Fluor concentration was higher in plateau areas.Conclusion: Some water sources in Kashan have not met standard Fluor concentration, thus, we suggest addition of Fluor to their food cycle. Fluor-enriched mouthwashes are highly recommended for their children.

Background: Despite recent progresses in renal transplantation, acute rejection during the first year is the most common cause of kidney loss. Recently, Mycophenolate mofetil (MMF) was used as an effective agent. We have compared the effects of Mycophenolate mofetil and Azathioperine (AZA) in prevention of acute rejection of renal transplantation in patients referring to Hashemi Nejad hospital in 1997-2000.Materials and methods: 60 patients had entered this clinical trial and divided in two groups. One received MMF (2g/d) as well cyclosporine A and prednisone and the other received AZA-i-cyclosporine A-t-prednisone. Groups were matched according to the times of transplantation, underlying disease, and other confounding factors. Patients were followed up for 6 months regajding the acute rejection, hematological GI, liver and infectious complications.Results: MMF group included 16 females and 14 males with the mean (±SD) age of 37±12 years. however AZA group included 17 females and 13 males with the mean age of 35±11 years. Acute rejection was reported in 10% and 27% of MMF and AZA groups, respectively (p<0.09). Creatine was reported 1.3±0.4 and 1.3±0.3 mg/dl, respectively (NS). Leukopenia was found in 20% and 23% of patients, respectively, however, thrombocytopenia was reported in 3.3% and 6.7%. Elevated liver enzymes were noted in 26.7% and 30%, respectively. Icter was found in 2 patients of the AZA group. GI bleeding was noted in one patient who received MMF that was recovered after the drug cessation Cytomegalovirus was shown in 2 patients of the AZA group. Conclusion: Results have revealed that MMF could effectively decrease the acute rejection of renal transplantation Side effects were not significantly differed, however, further studies with greater sample size are required.

Background: Irritable Bowel Syndrome (IBS) is the most common cause of GI-man visits. Recem trend was seen towards neurotransmitters; however, these drugs are expensive. We have determined the effects of fluoxetine, nortriptyline, and amitriptyline in IBS patients referred to a private GI clinic in Tehran in 2000. Materials and methods: 173 patients had entered this clinical trial. Diagnosis was made according to the Rome criteria. Patients were concurrently allocated in three groups. Flouxetine 20mg/d, amitriptyline 25mg/d, and nortriptyline 25 mg/d were given to individuals of each group, respectively. Pre- and post-test data were collected and recorded in a checklist.Results: The study population included 53 cases as the "Constipa Jion group", 57 as the Diarrhea group and 63 as the "Abdominal Pain group" 50 patients received fluoxetine, 69 nortriptyline and 54 received amitriptyline. Fiuoxetine has effectively increased the defecation times of constipated individuals (from 2.56/week to 12/week, p<0.02). out was ineffective for diarrheal individuals (NS). Amitriptyline has improved the defecation pattern of constipated and diarrheal individuals (2.31/week to 6.54/week and 17.26/week to 1L79/ week, respectively, p<0.02). Nortriptyline had the same effect as amitriptyline (2.67/week to 6.33/week anci 20 64/week to 12.23/week. respectively, p<0.01). Fluoxetine and TCAs were significantly improved the abdominal pain, bloating, and general performance of affected patients. Amitriptylinehas shown more side effects than nortriptyline and fluoxetine (p<0.01).Conclusion: Fluoxetine was shown to be more effective than TCAs in constipated patients, however in patients with diarrhea it seems to be less effective.

Background: With respect to the prevalence of diabetes mellitus, its known complications, the impact of epidemiological features on prognosis, and in order to determine the acute complications of diabetes mellitus and its related mortality and morbidity, the present study was conducted in Shahid Beheshti University Hospital in Kashan, during an 8-year period (1991-99).Materials and methods: It was an existing data type study. Demographic characteristics as well disease profile were all recorded. Then descriptive statistics, was used.Results: 114 patients with 144 acute complications were included. Diabetic ketoacidosis, hyperosmolar syndrome, and hypoglycemia were reported in 54(37.5%), 9(6.3%) and 81(56.2%). respectively. Diabetic keroacidosis was more obvious in 12-20-year -old individuals (21 cases). The mortality rate was 11.1%. 66.6%, and 6.2%, respectively.Conclusion: Hypogiycemia was by far the most common complication. Diabetic ketoacidosis was found more common among 12-20-year-old individuals, whereas hyperosmolar syndrome and hypoglycemia were more prevalent after 60. Mortality had occurred among these patients. thus an experimental study is strongly recommended.

Background: Depression is a prevalent finding in offender adolescents. The present study was conducted in a prison in Yazd to determine the frequency of depression and its associated factors in adolescent prison population.Materials and methods: It was a' descriptive study. 58 male adolescent criminals were included. They were selected through simple sampling. Demographic data including age, level of education, family size, having private house, drug addiction, type of criminal, and the possibility of any somatic disability were all recorded. Beck standard test (including 21 questions) was performed for all candidates. Chi-square was used for data analysis. Results: Results have revealed that all candidates have depression with different severity. Severe depression was noted in 58.6%, however, moderate and mild depression was present in 24.1% and 17.3%, respectively. Significant association was found between depression and: not having private house, criminals of stealing type, family size greater than 8, drug addiction and suicide intentions (p<0.05). Illiterate individuals as well as those who have somatic disability or belong to low econ9mic class were more depressed.Conclusion: Results have revealed the high prevalence of depression among offender adolescents. Thus, further studies are strongly recommended to determine the associated factors, so that incase of prompt diagnosis and prevention better results will be achieved.

Background: Mood disorders are of utmost importance during pregnancy, thus the present study was conducted to determine the prevalence of depression in parturients referring university hospitals in Tehran in 1999.Materials and methods: It was a cross sectional study Parturients aged 15-49 years were included. Our exclusion criteria were history of psychiatric disorders, drug usage, chronic disease, infectious disease, pregnancy-induced complications.Demographic data including age, level of education, occupation, economic status, gestational age, gravidity, abortion, preterm delivery, family size, infertility, history of PMS, social support, and unpleasant happens were all recorded. Beck test was used to determine the depression and its severity, Pikayl test was used for determination of unpleasant happens and Winfield and Triggerman had assessed social support. Beck score of 0-15 was considered as normal, however; higher than that was cohsideredas depression.Results: Of 580 parturients, 45.7% were depressed. Depression has shown significant association with level of education (p<0.002), economic status (p<0.000), family size (p<0.000) gravidity (p<0.000) gestational age (p<0.000) unintentional pregnancy (p<0.000), history of PMS (p<0.001), social support (p<0.000) and unpleasant happens (p<0.02).Conclusion: Depression is frequent during pregnancy, thus screening tests are highly recommended.

Background: With respect to the lack of sufficient vitamin, calorie, minerals and proteins in junk foods, they have the ability of filling child's stomach and decreasing. their appetite, thus, he/she would miss the opportunity of a healthy nutrition. Unfortunately, the nutrition profile of under-3-year-old children is not determined in our country, so the present study was conducted over under-6-year-old children of urban and rural areas in 1998.Materials and methods: It was a descriptive study. The study population included 16418 under-3-year-old children of urban and rural areas. Nutrition pattern was determined through a questionnaire.Results: 47.1% of urban and 51.2% of nural children aged 6-12 months have used junk foods including coca, sweets, chocolate and so on. For children aged 12-24 months these figures were 90.3% and 87.7%, respectively. Main nutrients including meat, egg and dairy were used 3.times a week, however, these junk foods were used 9 times a week.Conclusion: With respect to the known complications of junk food consumption, further studies considering the traditional foods through educational programs should be kept in mind. Needless to say, promoting parents' knowledge could be helpful.

Background: Problems in recording, data collection and reporting are common in university hospitals. Thus, the present study was carried out to determine these problems and also facilitate the conditions of reporting statistical data in Kashan University in 2000.Materials and methods: All statistics units of Kashan University were included in this descriptive study. A questionnaire was considered for data collection in different wards, emergency room, admission unit, operation room, radiology department, laboratory, and different clinics. These questionnaires were completed by interview and direct observation. Calculation of different statistical indices were observed and matched with standard methods.Results: All study units have medical record system. Previously designed sheets were used for data collection and reporting in 83% of study units, however, clinics have not these sheets. 35% of hospital indices were calculated, of which 48% were correctly calculated. These indices were reported to 14% of hospital managers. Data were collected daily in 56% and monthlyin 44% of the hospitals.Conclusion: Despite the presence of facilities for data collection, the process of data collection and reporting was not appropriate. Further studies are highly recommended to determine the underlying factors.

Background: With respect to the known complications of malnutrition, especially in vulnerable group of children under 5, the present study was conducted in Shaheed Beheshti University of Medical Sciences in 1997 to determine the prevalence of m1hlUtritionand its association with economic indices.Materials and methods: 1028 under-5-year-old children referred to pediatric clinics in Tehran were included in a descriptive-analytical study. Patients were distributed in two groups of case and control, matched according to the confounding factors.Groups were determined following the recognition of malnourished children. Thus, malnourished children were included as the case group and 550 normal children were considered as control. Demographic data including sex, age, and family size were all recorded. Having 33 children excluded due to the secondary malnutrition, malnutrition severity was assessed according to the weight and height of age. Results: 161(16.2%) children including 77 boys and 84 girls were malnourished. Family size of 3 or 4 was found in 22.4% and 32.7% of the case and control group, respectively. These figures were 31.3% and 28.5% for family size of 7. Significant associations were found between children malnutrition and family monthly income (P<0.0001) family size (P<0.02), and maternal education (p<0.03). Conclusion: With respect to the effect of economic indices on malnutrition, this should be considered as a priority, thus, complications and expenses would be decreased.

Glucocorticoids are mainly used for inflammatory and non-inflammatory diseases as well as cancers. Unawareness of their function, indications and side effects may lead to patient's hazard, Thus, medical stall' should be completely familiar with these drugs. Objectives:Promoting medical staff knowledge about glucocorticoids' side effects, function, and indications.Promoting their knowledge about the signs and symptoms of withdrawal and approaches to drug tapering.

Background: Renal artery aneurysm is a visceral aneurysm. During the recent years number of the affected individuals has increased because of increase in angiographies. We present a case-with renal artery aneurysm referred to Taleghani hospital in 1999.Case: A 19-year-old single girl was referred to our clinic due to headache and hypertension. She had a 7-year history of hypotension for which received therapy. Left renal artery interposition graft with saphenous vein was performed. She was normotensive darning a 12-month follow-up- Conclusion: Etiology of hypertension should be carefully monitored in young adults so that in case of true diagnosis, appropriate therapy employed. For patients with renal artery aneurysm surgery is the treatment of choice.