Journal of Medical Council of Iran
Year:2010 | Volume:28 | Issue:2|Papers Count:11

Background: Cough, bucking and laryngospasm during emergence from anesthesia are side effects of endotracheal intubation and associate with increased in intracranial pressure and ischemia of myocardium. We compared effects of Lidocaine 2% and Bupivacaine 0/25% infiltrating into endotracheal tube’s cuff in order to reduce in occurance of cough, bucking and laryngospasm during emergence from anesthesia.Methods: 95 adult patients (49 in lidocaine group and 46 in bupivacaine group) undergoing elective surgery under general anesthesia inTabriz Zakarya hospital in 2009-2010 enrolled in a double blind randomized clinical trial. Occurance of cough, bucking and laryngospasm during emergence from anesthesia noted and analyzed with SPSS16 with independent-t test.Results: There was no significant difference between lidocaine 2% and bupivacaine 0/25% in reducing occurance of cough, bucking and laryngospasm (appending on duration of surgery) during emergence from anesthesia.Conclusion: Considering important side effects of bupivacaine, such as neurologic and cardiovascular side effects, we do not recommend using bupivacaine 0.25% instead of lidocaine 2% to infiltrate into endotracheal tube’s cuff in order to reduce occurance of cough, bucking and laryngospasm during emergence from anesthesia.

Background: Compatibility between hospitals manager's career and their personality could assured job performance improvement. Personality tests are used to determine management hospital's manager's type of personality compatible with their career. This research is aimed to study hospital managers personality types with their management career at one of the largest University of Medical Sciences in Iran.Methods: A cross-sectional, descriptive study was conducted among 210 of the hospital departments managers by James Barrett's personality type questionnaire compatible with their management career. Before the beginning of the main survey, the face and coincidental validity and reliability of questionnaire and also test-retest technic was performed and reliability coefficient was high. The data was collected by SPSS software and analyzed by Chi-Square and Kruskal-Wallis test.Results: Most of the paraclinical managers were retired and emotional, and most of the hospital administrators were realistic and cautions.Discussion: We demonstrated that hospital administrators were more compatible with their career. But, it seems, most of the studied manager's type of personality were not compatible with their careers.Conclusion: Although, compatibility testing is not the only procedure to select the candidates of management career, but we suggest this test and other recruitment tests are conducted to select the candidates for management career in all hospitals of Iran.

Background: Chronic rhinosinusitis is one of the most common chronic diseases which can adversely affect patients’ quality of life with a considerable economical burden. Bacteriology of chronic rhino sinusitis is not well defined. Recently, Helicobacter pylori gained a considerable concern in respect to its probable association with upper respiratory tract diseases. This study aimed to evaluate the relationship between H. pylori colonization in sinonasal mucosa and chronic rhinosinusitis.Methods: This case-control study was conducted in Ayatollah Taleghani General Hospital – Tehran in 2007-2008. All patients with chronic rhinosinusitis who failed to respond to the medical therapy (32 patients), enrolled as case group and samples were taken from involved sinonasal mucosa during endoscopic surgery. Patients with nasal septum deviation (65 cases) recruited as control group and samples were evaluated for Helicobacter colonization by using polymerase chain reaction (PCR) technique and results in two groups were compared.Results: 97 patients (61% male and 39% female) were studied ranging in age from 12 to 53 years, with an average of 29.6 years. Out of 32 patients in the case group, 56% were male and 44% female, aging from 12 to 53 years (averagely 32.16 years).65 cases of the control group (63% male and 37% female) were 16-50 years old with an average age of 28.34 years. After the evaluation of samples from 97 patients in both study groups, 16 patients out of 32 in chronic rhino sinusitis group (50%) and 7 out of 65 patients in control group (10.7%) had positive results for helicobacter colonization in their sinonasal and bulla ethmoidalis mucosa which was statistically significant (p<0.001, and Odds Ratio=8.28, 95% CI=2.9-23.59). There was no statistically significant relation between H. pylori colonization and site of involved sinus or typical symptoms of gastro-esophageal reflux.Conclusion: According to the results of current study, there was a significantly higher rate of Helicobacter pylori colonization in chronic rhinosinusitis patients compared to the control group. This finding suggests that Helicobacter pylori may play an etiologic role in pathogenesis of chronic rhinosinusitis.

Background: The lack of resources and optimum utilization of available resources is the main challenge for the management at all hospital. one of the suggested solutions for this problem is to reduce average length of stay of hospital. The main goal of this study was to determine the effect of the presence of full time gynecologist on the patients length of stay in gynecology ward in yazd social security hospital.Methods: This study started with intervention of the presence of full time gynecologist in hospital and analysis of its effect on the reduction length of stay of patient in gynecology ward in yazd social security hospital. This study was performed at 3 months before (2007) and 3 months after (2008) intervention. This analysis was carried out with calculation and comparison of average length of stay index of 3 physician before and after intervention.Results: The average length of stay index in cesarean section before intervention was 2.55 days and after that 2.22 days. The average length of stay index in patient with Social Security insurance before intervention was 1.98 days and after that 1.77 days. The Presence of Full Time Gynecologist had significant effect on Length of Stay among Inpatient of Gynecology Ward (p=0.001).Conclusion: The finding showed that the presence of full time professional physician has reduced the length of stay in hospital. by using this method, the efficiency of hospital beds will increase and so lake of hospital beds in Iran can be solved.

Background: Gastroesophageal reflux disease (GERD) is a common gastrointestinal disease. Although, the prevalence of GERD is high, has an adverse impact on the quality of life and there was a relationship between GERD and peptic stricture, Barrett's esophagus and esophageal adenocarcinoma, that is increasing recently, there is limited information and conflicting data for risk factors of GERD. The aim of this study was to investigate prevalence and the potential risk factors of GERD in Gonbad city (Northern Iran).Methods: A total of 1016 randomly selected subjects aged 18-40 years, were invited to the study. face to face interview was performed for 1000 participants. Cardinal symptoms of GERD (heartburn and /or regurgitation), frequency and severity asked. Subjects who reported heartburn and/or regurgitation, at least once a week, during the last 12 months were defined as GERD patients and controls were persons without any compliant of those symptoms. Dietary intake was assessed using a local validated Block 116 food frequency questionnaire.Results: The prevalence for weekly GERD was 12.3%.increasing Age [OR: 1.04, 95% CI: (1.00-1.07)], BMI£30 [OR: 1.14, 95% CI: (1.34-4.35)] had association for GERD. Further risk factors included consumption of high amount of tomato sauce. consumption of some drug such as NSAIDS and OCP was associated with reflux. Gender, smoking, alcohol and opium consumption, physical activity, speed of eating, Eating -to-bed time did not affect the risk of GERD. No association was found between total calori and total intake of; tea, spicy foods, fiber, fat, protein, and carbohydrate with GERD.Conclusion: the prevalence of GERD in Gonbad was more than most Asian counties and comparable to western countries. increasing Age and obesity are risk factors for GERD. Tomato sauce was the most potent dietary risk for GERD symptoms.

Background: cardiovascular diseases are the first cause of death in the world and Iran. Physicians are a social health symbol and they are decision makers in health system. Therefore determining of risk factors of cardiovascular diseases in this group is very important.Methods: In a cross sectional study, 592 physicians were selected according to list of medical council with simple random sampling. The participants filled in an anonymous self reported questionnaire consist of family, personal and occupational history, their blood pressure, height, weight, blood glucose and lipids level. Collected data also included cigarette smoking, physical activity. Data analysis was done with SPSS 11.5 software.Results: From 592 selected physician 476 (80.4%) responded.218 subjects (66.8%) were male, mean ages of physicians was 47.8±8.3 (from 26 to 71 years).37.4% males and 1.2 % females were smokers. Hypertension was reported in 16.5% males and 1.3% females.14.6% males and 10.3% females had dyslipidemia, 2.6% males and 0.7% females were diabetic. Only 26.1% males and 22.7% females were normal weight and others were overweight or obese. Mean of sport index was 2.69±0.45 and mean of leisure index was 2.47±0.48.13.4% had not any risk factors but 30.7% had two or more risk factors.Conclusion: These findings revealed that risk factors of cardiovascular diseases among physicians are more prevalent in comparison to normal population and calls for future intensive prevention in this group.

Calcium is an essential element for living cells and plays an important role in muscle contraction, neurotransmitter secretion and blood coagulation. It has been cleared that deficiency in daily calcium intake can increase the probability of osteoporosis, hypertension, colon cancer, post partum depression and premenstrual syndrome. Dairy products are the most important sources for calcium. Calcium requirement is increased during years of growing to reach peak bone mass. It is increased in puberty and also during years after menopause and elderly to prevent osteoporosis and resultant fractures. Nowadays, peoples in the society are consuming synthetic drinks increasingly while liquids like milk and yogurt have been replaced by this type of drinks. With attention to great consumption of this type of drinks, it seems that placing some foods which have been fortified by calcium in daily regimen, could supply daily calcium requirements. The aim of this review article is to insist on calcium importance and food fortification with calcium and also to describe methods of fortification.

In modern medicine fever is considered as a symptom and result of temperature change in hypothalamus. Fever was known as hommi and hommeat in traditional medicine. Hommi and hommeat are important subjects in CANON of Avicenna. Various aspects of hommi and hommeat have been studied in this book by Ave-sina. New diagnostic and therapeutic point of view of traditional medicine and physician like Ave-sina may help to solve problems and open new windows for research about fever. Fever is a stranger heat that triggering in heart and spread throughout the body. Avesina classified fever to three type based on involved organ, time and etiology. Fever is caused by changes in hypothalamus set point. This is influenced by bacterial exotoxins or lipopolysaccharides.We investigated fever in our study in view of traditional and modern medicine. In a comparative study we evaluated Ave-cina's theories about fever and compare it with principle of modern medicine.Paying attention to Ave-cina's theories might be helpful to find the cause of fever. It can also open windows toward new research and studies and represent new therapeutic methods.

Introduction: Incomplete of information recorded in the form of anesthesia, can result in the need for health measures to clinical decision making is weak and thus the delay in providing search services is timely. Considering the importance of anesthesia information form, design and offer new form is action.Methods: The study by the World Wide Web ASA, AHIMA, ONS, CMS, records anesthesia in Iran, the new form was designed.Conclusion: Recording information in new form with its details can prevent problems during anesthesia and also improve patient care, improve legal judge and improve procedures coding system.