Feyz Medical Sciences Journal
Year:2000 | Volume:4 | Issue:15|Papers Count:19

History and Objectives: Due to descrepencies on the role of cholecystokinin receptors in pain, and Oil the role of surgical processes and nerve ligation as a pain inducer and hyperalegesic agent, the present experimental study was carried. Materials and methods: An experimental study was performed on groups of nine mice. The unilateral nerve ligation was made on the light hind limb, according to the Seltzer's method. The pain sensitivity was measured by the hot-plate test based on Eddy and Leimbach's method. Antinociception was measured in a 60min period of time (15, 30, 45, 60min) after injection. Control group in all of the experiments were received vehicle or saline solution. Experimental  group were compared with the control group.Results: Different doses of morphine (3, 6 and 9mg/Kg) induced a dose dependent antinociception in the intact and nerve ligated animals but nerve ligation did not decrease caerulein response. In another experiment, carulein, proglumide and the combination of two rugs induced antinociception but there was no interaction between the two drugs. Conclusions: CCK agonists or their combination with morphine can be used for the treatment of neuropathic pain. The mechanism of action of CCK agonist has not been elucidated and further research is needed to unravel its action.

History and Objectives: Due to the prevalence of Behcet's disease and the importance of ocular complications and lack of information the present epidemiologic of ocular complication of Behcet's disease was studied in 1998. Materials and Methods: A descriptive study was carried on 200patients with Behcet's disease. Personal records and ocular complications were recorded. Results: From a total of 200 patients, 58.5% were male and 41.5% were female. The mean age was 31.5 years (range 5-58 years). Uveitis was the most common ocular complication in both sexes (87%), follwoed by retinal vasculitis (58.7%), cataract (38%), optic atrophy (24.5%) and episcleritis (7.7%) in patients under age of 30 years, macular edema, between 30-39, uvitis and over 40 years of age. Cataract was the most prevalent complication (P<0.001). Conclusions: Ocular Behcet's disease is usually associated with bilateral vision impairment, and is a major problem Behcet's disease which require specific diagnosis and treatment.

History and Objectives: Due to importance of learing and long-term memory and recent reports emphasizing requirements for learning and due to the impotance of anatomy courses on the clinical learning process, the present study was carried out on medical students of Kashan Medical University accepted in 1996 academic year and taking abdominal and thoraxic anatomy courses.Material and Methods: An experimental study was performed on 56 medical students.Students taking abdominal anatomy was taken as an experimental group and control group was consisted of student taking the anatomy of thorax. Laboratory sessions were held before and after the lecture classes for the experimental and control groups respectively. Mean score for mid-term and final exam and student's evaluation of the courses were analyzed by Fisher exact, and Mann- Whittney test.Results: Mean score of lecture classes of control group (13.2±3.11 from 20) in comparison to experimental group (15 ±2.93) was decreased (P<).005). In addition, total score for the course (lecture and laboratory, ...) for control group (12.8±2.53) in comparison with experimental group (14.3±2.67)are decreased (P<0.004). 67% of students accepted the new educational method  and 69% were more comfortable with the new method.Conclusions: Offering the laboratory(practical) anatomy sessions before the corresponding lecture classes will fascilitate the learning process. Further investigation of the present method with other courses and its long term effect on learning and cognition is recommended.

History and Objectives: Strongyloides stercoralis infection has adverse effect on hemodialysis and renal transplanted patients. Since strongyloides stercoralis infection does not have apparent clinical signs, the present study was carned out to address the diagnostic power of ELISA and indirect immunofluoresence on pateints referred to the hospitals for renal transplantation and hemodialysis in 1996.Materials and Methods: A diagnostic clinical trial was performed on 110 renal transplant and hemodialysis patients. ELISA, indirect immunofluoresence, direct microscopic fecal examination and formalin-ether examination of fecal samples were compared. Sensitivity, specificity and predictive value of each method were determined.Results: From 10 samples, 14 showed infection whereas 96 samples did not show any infection. Diagnostic value was 100% for ELISA and indirect immunofluoresent methods. There were close coorelation between the two mwthods. Both method of direct fecal examination formalin ether method were unable to detect all the positive samples and all negative samples were reported as such by two fecal examination methods. There were no significant difference on the detection of positive samples of hemodialysis patients of Gilan and Tehran province and between emodialysis and renal transplant patients of Gilan province. No significant difference between postive sample and sex was recorded.Conclusions: Immunosuppressant chemotherapy of rena l transplant patients causes reduction of inmmune response and low antibody titer and poor diognostic value of immunologic tests. ELISA and indirect immunofluoresent detection of strongyloides stercoralis infection is very simple and rapid test to perform and has an high degree of sensitivity and specificity.

History and Objectives: Food toxicity is an acute disease arising from the lack of attention to the health related food regulations. One of the indices for determination of bacterial food contamination is total baterial counting, examination for existence of Escherichia coli (E. coli) and other pathogenic agents. Since E.coli induce diahrea by different mechanisms, the present search was performed in order to determine the distribution and prevalence of there mechanisms of E. coli contamination isolated from different food sources referred to the microbial laboratory of Iran University of Medical Sciences and Health Service in 1998-1999.Materials and Methods: A descriptive study was performed on 2119 samples from food sources within one year and 300 isolated E. coli samples were examined in order to observe how they cause diease. E. coli diagnostic entropathogen antiserum was used to detect entropathogenic E. coli (EPEC). SMA biologic techniques and new born mice were used to detect heat-stable entrotoxin producing E. coli (ETEC). Sereny biologic test and entrohemorrhagic E. coli antiserum 0157:H7were used for detection of invasive type E. coli and entrohemorrhagic E coli (EHEC) respectively.Results: 23 cases (2.7%) of E. coli isolated from various food sources, showed EPEC whereas 13 cases (1.5%) were ETEC and 1 case was EHEC. Conclusions: The rate of E. coli isolation in spring and summer compared to other seasons were higher. Milk, other diary products, juices traditional ice-cream and candies were the most frequent food sources with E. coli contamination. These findings strongly recommend monitoring and surveillance of food industries for microlial contamination.

History and Objectives: Delivery is associated with severe pain and it is one of the most severe type of pain. Regardless of recent progress in medical-surgical operations, management of delivery with reduced pain is one of the challenges of medicine. The present study was conducted to address the effect of childbirth preparation in order to reduce pain and duration of delivery without therapeutic use in the Imam Khomeini Hospital in the city of Semiroom in Iran in 1999-2000.Materials and Methods: A clinical trial was carried out on 100 primigravida mothers. They were selected by random-sequential sampling into two groups (50 experimental and 50 control groups). The two groups were matched for age, weight/hight percentage, educational status, condition of cervix before delivery, and history of dysmenorrheal. Experimental group (32±2 weeks of pregnancy) participated in the childbirth preparation classes held weekly for 2 hours for 4 to 6 weeks prior to delivery. Mothers recieved information about pregnancy, delivery and related techniques. Members of experimental group were accompanied by research team during labor and delivery. The control group recieved routine care. The intensity of pain was measured by MacGill ruler. Ki-square and t-test statistical analysis were carried out. Results: In the first stage of delivery, the ocurance of moderate and severe pain in the experimental group were 46% and 48% respectively and] 8% and 70% in the control group. Here was a significant difference in the two groups (P<0.0001). There were no mild and moderate pain in the second stage of delivery. Severe and more severe pain in the experimental group were] 2% and 88% respectively and 4% and 96% in the control group. Average duration of the first and second stage and total duration of delivery in the control group were 336.5±54.5, 50.6±12.3 and 405±56.5 and in the experimental group were 243.2±72.5, 30.7±12.2 and 284±77.7 min respectively. There was a significant difference between the two groups (P<0.0001).Conclusions: Childbirth preparation reduced intensity of pain in the first stage of delivery and duration of first, second and total duration of delivery. It seems that childbirth preparation should be included in the prenatal instuctions for mothers. Further research is needed to study other methods of childbirth preparation.

History and Objectives: Due to the prevalence of breast cancer and its complications and the necessity or cancer screening by health workers including midwives and lack of accurate data on the knowledge, altitude and practice of midwives, the present study was carried out on midwives working in the health clinics of Tehran in 1994. Materials and Methods: A descriptive study was performed on 100 midwives working in the health treatment anters in Tehran. Data were collected by multi-stage cluster and then by simple randomized sampling method. Information regarding age, educational level, marital status, work history, family history for breast cancer, breast self-examination, breast examination of patient  and questions regarding midwives attitude and knowledge via separate questionnaire were collected. The peifol7nance of midwives were evaluated with a corresponding check list. Results: Most midwives have a fair knowledge (41 %), strong positive attitude (58%) and moderate practical skills (50%) on breast examination. A direct statistical correlation was found between knowledge and type of attitude and between knowledge and practical skills of midwives on breast examination. In addition, a close relationship was found between educational level and family history of breast cancer with midwive's knowledge. A stitistically significant coorelation was found between breast examination of patients with midwive's attitude. However, there were no relationship between other characteristics and midwive's knowledge, attitude and practical skills. Conclusions: Since midwives have fairly moderate knowledge and practical skills on breast examination, and due to the importance of breast examination in early detection of cancer further studies are needed to determine the effect of continuing education on the level of midwive's knowledge and practical skills and their performance of breast examination.

History and Objectives: Rodents are living in different climates with dispered and highly populatied colonies. Some species share common living space with human beings. Due to hygienic and economic burden of rodent clean up, comprehensive knowledge of their living habits in a given geographic region is of prime importance. The present study was designed to determine the type of rodents and their biological activities in the desert region of Kashan, in 1996. Materials and Methods: A descriptive study was carried out on wild rodents caught alive in the region. Rodents were hunted by setting live-catching metal traps. Forty traps were employed fifteen day of a month during different seasons of the year. The traps were placed at the entrance of the active holes to hunt rodents. The fauna and their biological avtivities were studied. In order to determine the type of rodent, biometric measures and key characteristics of rodents were recorded. Results: From 825 traps, 167 small rodents in 9 species were caught. The majority of the species were classified as Rhombomys opimus (53.3%) and Meriones libcus (31.3%). These two groups of rodents were gregarious. R. opimus were active during the day whereas M. libycus were active during night. R. opimus had two peaks of activities. Most of thier activity was devoted to summer time with a less peak of activity in the end of fall season. The mean body length for the R. opimus and M. libycus were 307 and 292mm respectively. Conclusions: Due to the high incidence of, and variation of species and their role in the transmission of diseases, recognition of different species of rodents and their biological activity are importa nt in the control of rodents. Therefore further research is required.

History and Objectives: Many investigations have evaluated the effects of serum androgen changes on pituitary hormones. In this article, the effects of androgenic therapy on thyroid function test in hypogonadal men were examined.Materials and Methods: Subjects were chosen among the male patients with clinical signs of hypogonadism. Blood samples were taked for testosterone, throxine, triiodothyronine and thyrotrophic measurements before and after androgenic therapy. Therapy was carried out for two months. Results: The mean thyroxine, triiodothyronine, thyrotropin were 8.5±2.09 ug/dL, 137±3 8.71 ng/dL and 1.7±1.5 uU/mL respectively. After the treatment, the means were 7.9±1.9 ug/dL, for thyroxine, 133±43 ng/dL for triiodothyronine and 1.5±1.3 uU/mL for thyrotropin. The means of thyrotropin showed significant difference (P< 0.05). Conclusions: This study shows that androgen therapy can suppress thyrotropin production.

History and Objectives: Gynecomasty and ectopic breast are disorders of breast. Due to difficulties in the biopsy diagnosis and different reports on sensitivity of FNA test for diagnosis of gynecomasty and ectopic breast and in order to identify the sensitivity of FNA test, the present study was carried out on patients referred to surgical clinic of Kashan Shahid Beheshti Hospital for clinical diagnosis of gynecomasty and ectopic breast. Materials and Methods: A descriptive study was conducted on patients with clinical diagnosis of gynecomasty and ectopic breast. FNA test was performed before the surgical operation to remove the mass (biopsy). The outcome of the two test were compared and the positive cases of FNA in gynecomaty and ectopic breast were identified. Results: From total of 20 patients, 9 with the mean age of 27.1±11 years had axillary mass with ectopic breast and 11 cases (mean age of 28.9±9.5 years) had gynecomaty. The rate of positive FNA test was 33.3% for ectopic breast and 54.5% for gynecomasty. Conclusions: It seems that FNA test for the positive diagnosis of gynecomasty and ectopic breast is less sensitive therefore further research is need.

History and Objectives: Foreign body a sipiration may be life threatening among children due to complications associated with bronchoscope. The present study was carried out on patients undergoing foreign body aspiration who were admitted to Matini Hospital of Kashan during the period of 1991- J 999. Materials and Methods: A descriptive study was carried on existing data which included 121 patients who have undegone bronchoscope aspiration of foreign body. Patient's personal records including, age, sex, symptoms and signs on admission, type and location of foreign body, radiologic findings and complications of bronchoscope were recorded and the results were analyzed. Results: From total of 121 patients enrolled into the study, 73 cases (60%) were male and 48 cases (40%) were female. Foreign body aspiration was most commonly observed at 1-3 years of age (42.9%). Cough, as the most common clinical finding was present in 62 cases (51%). Seed of watermelon was the most frequent foreign body(72%). Obstructive emphysema was observed in 37 patietns (39%) by X-ray examination and atelectasis was evident in 16 patients (17%). Thirty two patients (34%) had normal chest X-ray. Nine patients (7.3%) experienced complications of dunng bronchoscopy. Conclusions: Although foreign body aspiratiori is more commonly observed in children, it can occur at any age and without any underlaying factor. A normal chest X-my does not rule out the presence offoreign body. An experienced physician can reduce the complications of foreign body removal by bronchoscope.

History and Objectives: Upper gastrointestinal (UGI) bleeding is acommon cause of admission in the medical and surgical wards. Due to its impotance and different causes of bleeding, the present study was carried out to investigate the causes of UGI bleeding and their relationship to the laboratory and clinical data.Materials and Methods: A descriptive study on existing data on 114 patients who were admitted to the ward with UGI bleeding was carried out.Results: The most common cause of UGI bleeding was peptic ulcer (46.5%) and other less frequent causes of bleeding were gastritis (33.3%), duodenitis (6.1%), gastroduodenitis (3.5%) esophageal varices (3.5%), esophagitis (1.8%) and esophageal ulcer (0.9%). Five cases had normal endoscopic finding(4.4%) from which 4 cases were due to NASAIDs application. 45.6% of patients used NSAID60 for different causes.Conclusions: UGI bleeding is one of the common causes of referral to emergency departments. NSAID plays an important role in UGI bleeding. Therefore correct usage of NSAID is recommended. The most common cause of UGI bleeding is peptic ulcer disease. Futher research are needed to evaluate the effect of H pylori treatment to prevent UGI bleeding.

History and Objectives: Urolithiasis is a disease that has been known to human beings from 7000 year B.C. It effects all human beings regardless of age, sex and ethnic population. A urinary tract stones are believed to be common in Yazd province and there is a little information of the disease in the region. Materials and Methods: A descriptive study was carried out on existing data on patient's file admitted to the hospital with primary diagnosis of urinary tract stone formation. Information concerning sex, age, place of residence, occupation, past history of stone formation, type of stone and bacterial characterization of urine were recorded. Results: From the total of 475 patients that were studied, 42 cases were omitted due to incomplete data. From 433 cases, 288 patients were male and 145 were female. Sex ratio was 2:1. Mean age of patients was 40.35±17.2 years. The mean age for male and female patients were 37.47±16.96 years and 46.13±17.69 years respectively.58.2% of patients lived in urban and 40.4% in rural areas. The rate of referral for various seasons was 23-27%. Acute cholic pain was the most prevalence clinical sign (96%). More that 75% of patients referred to the hospital between 12.00 am to 6.00am. Urinary infection was detected in 44% of cases and E. coli was the most prominent type of bacterial infection. In 58% of cases, the location of stone was in the urinary tract. Conclusions: Urinary stone formation start at earlierage in the Yazd province. The prevalence of urolithiasis is more pronounced in female. Urinarytract infection along with urolithiasis requires further attention and research.

History and Objectives: Due to the prevalence and complications associated with pregnancy in adolescents, the present research was carried out on the quality of contraception's among adolescent women referred to Gholabchi Medical Clinic.Materials and Methods: A descriptive study was performed on adolescent women referred to the Gholabchi Medical Clinic for prenatal educational courses. Personal records concerning age, educational level of women and her husband, duration of marriage, type of contraceptive methods and factor associated with the contraceptive methods were collected. If a combination of different pills are used, it is considered low risk contraception and other methods are considered high risk contraceptive method. Results: From total of 191 of adolescent women, 176 were qualified with mean age of 16.9±1.6 years with a minimum of 11 years and a maximum of 19 years of age. Mean lenght of marriage was 11±37 months with a minimum of 5 months and a maximum of 18 months. 42.6% of individuals did not use any contraceptive method, 40.3% used high risk method and 17.1% used low risk method. Owing to husband's inclination for pregnancy, 44% of women did not choose contraception. Desire for pregnancy was the most prevalent cause of discontinuation of contraception. 50.6% of contraceptive users had previous pregnancy. 46.6% and 2.8% of cases had one and two successful pregnancies respectively. Conclusions: Due to complications associated with pregnancy and delivery among adolescent women, further research is recommended to detect factors involved in the pregnancy and to reduce possible complications.

History and Objectives: Thalassemia carriership is fairly high in Iran and there is an increasing incidence of thalassemia major because of high rate marriage among thalassemic carriers. Due to complications associated with high concentration of Iron on the endocrine system, the present study was carried to investigate the pituitary-thyroid axis hormones among patients suffering from thalassemia major being treated at the Ali-Asghar Hospital of Tehran in 1995.Materials and Methods: The descriptive study was carried out on 47 patients suffering from thelassemia major (21 female and 26 male; age interval 6-21 years). Hematological tests as well as HbA2 chromatographic data was used to confirm the thalassemia major. Blood samples were taken to determine T3, T4, T3uptake, TSH and Ferritin. Distribution of hormonal changes were reported.Results: Mean value of pituitary - thyroid hormones (T3, TLf, T3uptake, TSH) among thalassemic patients was similar to normal value. However value of T3 among male patients (133ug/dL) was lower than female patients (142ug/dL). T4 level was also lower among male patients (8.9ug/dL) compared to female patients (10.1ug/dL).Ferretin levels were high among all patiets.Conclusions: In light of lower growth rate among children and adolescents suffering from thelassemia major, normal function of thyroid hormones were observed. Further research on other factors, such as growth hormone, growth hormone reserves and insulin like growth hormone-1 are recomdended.