Journal of Medical Council of Iran
Year:2008 | Volume:26 | Issue:3|Papers Count:14

Objective: The aim of this study was to examine the effects of "Designed Back School Program" on quality of life in women with chronic low back pain.Methods: 102 eligible women were randomly allocated into two groups. The two groups including back school group who received the 'Designed Back School Program' plus medication (n=50) and clinic group who received just medication (n=52) were compared at four points in time. Data were collected at baseline and at three, six and 12 months follow-up using the SF-36 questionnaire. Repeated measures analysis was performed to compare quality of life scores in two groups.Results: Quality of life scores were significantly different between two groups (P<0.0001) indicating a better quality of life among intervention group.Conclusion: 'Designed Back School Program' could improve the quality of life in women with chronic low back pain.

Background: Maior thalassemia in a common disease in Iran. One of the most common endocrine disorders in such patient in pubertal disorders that can be due to iron overload because of repeated transfusions. The objective of this study was the assessment of the relationship between mean serum ferritin level and indices of sexual puberty among thalassemic adolescent boys. In the case of such association, beginning treatment in appropriate age, the pubertal delay can be prevented in such patients.Methods: In this cross- sectional descriptive study, 100 boys aged more than 12 with major thalassemia were assessed in Seyedolshohada hospital, Isfahan.The correlation between pubertal indices and serum LH, FSH, testostrene and ferritin were assessed.Data were analyzed by SPSS/win software at P<0.05. The correlation between variables was assessed by Pearson correlation test.Results: According to the findings of the present study, an inverse significant association was found between serum mean ferritin and sexual hormones LH, FSH and testosterone (r=-0.5,-0.6, P<0.05) In addition a significant difference was shown between testis size and mean serum ferritin level (P=0.02). Overall 69% of subjects studied hold pubertal delay.Discussion & Conclusion: Considering the inverse relationship between serum ferritin and sexual hormones, as well as testicular size as the onset of puberty, the necessity of assessment of pubertal stage and controlling serum ferritin level is suggested for prevention of pubertal delay as one of other complication of iron overload in thalassemic patients.

Background: This study was designed to compare the in-hospital clinical outcomes and 9-month follow-up of percutanous coronary intervention (PCI) in patients with and without history of coronary artery bypass grafting (CABG).Materials and Methods: 1979 patients who had undergone coronary angioplasty with 9-month follow-up were enrolled into this study. Patients were divided into two groups, with a history of CABG (54 patients) and no history of CABG (1929 patients). Baseline, clinical, and technical characteristics, and short- and long-term outcomes of PCI were compared between groups. Results: Patients with a history of CABG had lower ejection fraction (p=0.001). These patients were older (p=0.05) and had higher frequency of prior PCI (p=0.007), positive family history of coronary artery disease (p=0.05), and multivessel disease (p<0.001). Moreover, the percentage of diabetics and men was higher in this group (p=0.02 and p=0.04, respectively). The lesions in patients with history of CABG were more type B2/C (p=0.01). In this group, PCI had been done more on left circumflex territory (p=0.001). However, procedural and clinical success were not significantly different in patients with history of CABG vs. those without prior CABG (94.4% versus 97%, p=0.7 and 92.6% versus 96.1%, p=0.16), respectively. In follow-up, no difference was noted in target vessel revascularization (TVR) and major adverse cardiac events (MACE) in patients with and without history of CABG (4.2% vs. 3.3%, p=0.67 and 4.5% versus 4.7%, p=0.999). Multivariate analysis also did not show prior CABG to be associated with increased TVR (p=0.98, OR=0.99; 95% CI=0.21-4.70).The predictors of TYR, however were PCI on left anterior descending artery (p=0.03, OR=2.06, 95% CI=1.06-3.99) and previous PCI (p<0.001, OR=5.78, 95% CI=2.92-11.44).Conclusions and Recommendations: PCI outcomes are similar in patients with and without history of CABG. However, the outcomes should be studied more precisely in larger patient populations in prospective studies.

Background: Nurses' role in the cadaveric organ and tissue donation and transplantation is very important. This study assessed nurses' knowledge and attitude toward organ and tissue donation and transplantation. Methods: The survey consisted of 66 nurses who completed a confidential questionnaire that aimed to assess their existing knowledge and attitude toward organ and tissue transplantation. This assessment was done with 39 questions about attitude and knowledge.Results: We didn't find significant correlation between attitude and knowledge (Pvalue>0.05). The mean of attitude was higher than knowledge. Attitude in nurses who had donor card significantly was higher than the others.Conclusion: Nurses have significant gaps in knowledge regarding the organ and tissue donation and transplantation. The education of nurses is important as legislation efforts and establishment of transplantation procurement coordination and network. We need to special training for all health care professionals such as nurses, because they play an important role in guiding public attitudes and behavior in organ and tissue donation and transplantation. Trained health care professionals working in Emergency and intensive care units or other units can serve to promote positive attitude while dispelling negative attitude and beliefs.

Background and purpose: Nowadays, using emergency contraception with using high dose oral contraceptive pills method is recommended as one of the most reliable methods to avoid unwanted pregnancy resulting from an unprotected sexual intercourse. In this regard, pharmacists can play a major role in offering correct information and advice to the patients/customers. This study was designed to investigate the knowledge and behavior of the pharmacists regarding emergency contraception method in Tehran. Concurrently, possible covariates related to the pharmacists' knowledge were evaluated.Methods: Firstly, a straightforward structured questionnaire containing information about demography of pharmacists and questions assessing pharmacists’ knowledge on emergency contraception method was organized. 100 pharmacies were evaluated in this study. Researcher (standard patient) attended in the pharmacies in 2 stages. In the first stage, she went to the pharmacies as a simulated customer and had a direct face-to-face interview with the pharmacist, asking questions about the method. Answers were entered the forms as soon as after leaving the pharmacies. In the second stage, the researcher attended in pharmacies to gather some demographic data". Findings: Overall, 100 pharmacists including 64 males and 36 females with the mean±SD age of 42.98±13.05 years selected. 71 pharmacists were informed about existence of emergency contraception method with using HD tablet but only 28 pharmacists correctly answered all of the questions. Multivariate regression analysis revealed that female pharmacists have a higher level of knowledge about the emergency contraception method (r=-0.35, p<0.0001). Interestingly, attendance (or not attendance) of pharmacists in continuous educational programs containing lectures on OCP had no relationship with their knowledge about emergency contraception method.Conclusion: Findings of this study exposed that knowledge of pharmacists about the emergency contraception is disappointingly very limited and unsatisfactory. Considering the unique position and role of pharmacists in delivering drug information to the public, improving their knowledge about emergency contraception method especially male pharmacists is crucial.

Background: Today Narcotic abuse has a high incidence among people and many of young go to hospital because of adverse effects of this abuse everyday. Crack is a narcotic that accompany with many complications like gastrointestinal perforation who has high mortality but it is not due to acid. The goal of this study was the evaluation of the effect of Omental patch closure.Methods: An interventional without control study that was done on 35 patients in Loqman Hakim Hospital on 1385-1386.0mental patch closure was done for all the patients who inter the study. Datas was analyzed by SPSS soft ware.Findings: The average age was 32.3.two of them has a history of peptic ulcer. About 80%of them had Air under diaphragm.2 patients died that was in ASA class 5 at arrival time. Two of them referred due to Dyspepsia that controlled by Omeprazole. 31 patients had good result without any serious complications.Conclusion: The Crack induced peri pyloric perforation is seen in many patients that are 10-12 years younger than expected age. Omental patch closure is a good surgical procedure for them whit acceptable results. But more studies control group is valuable in further decision.

Background & purpose: Umbilical granuloma (U G) is a common lesion in the first few weeks of life. Traditional therapy is topical application of Silver nitrate stick by a physician. In this study the curative effect of common salt of UG is reported. Materials &Methods: The parents of 50 infant with UG were given instruction to treat their infant at home. The treatment consisted of application of common salt on the lesion 3- times a day and repeated for 5 day course. The cure and relapse and complication were under follow up for 6 month.Results: 100% case had perfect cure and relapse or complication was not funded.Conclusion: It is concluded that treatment of UG with common salt is simple, cost effective, curative and safe without complication and need let a physician.

Background: It has been well established in the Literature that environment and activity of daily living (A.D.L) are associated with ulnar nerve injures. Problem in the work place setup and tools design , excessive force and accident are among the most common causes of the injuries.The purpose of this study was to investigate the relationship between environment and activity of daily living Leading to ulnar nerve injures.Methods: In this retrospective study 96 patients were selected from among patients. The questionnaires were completed using the appropriate information extracted from the patients. The data were analyzed using special Statistical programs. Findings: The results indicated that there was a correlation between the jobs of house wife and construction worker Leading to ulnar nerve injuries. The causes of the injuries were similar to those reported in the literature.Conclusion: It is, therefore, concluded that most of the ulnar nerve injuries can be easily prevented by taking the safety measures in to consideration when designing the tools and appropriate training of the work - force. In addition, ergonomic principle should be observed while setting up the work places.

Objective: The main goal of this research was to study the psychological characteristics of parents with low birth weight children as effective factors related to low birth weight and comparing with that of psychological features of parents with normal birth weight children.Method: Considering the nature of this subject, the research methodology is causal- comparison or ex post facto. All women who delivered in hospitals during 2004-2007, and their husbands, in cities of Fars province were involved in this study. From the aspect of ecological conditions, three different areas of cold, warm and moderate, were taken into consideration. Urban and rural factors were also observed in this study. So 632 couples in two groups with low and normal birth weights children were studied. These families were available samples who could be found at their residence addresses which were obtained from hospitals. The data was collected by our researcher.Result: Data was analyzed by the use of k-square and Fay-Cramer tests.Conclusion: The maternal marital satisfaction, maternal attitude toward weight gain and its importance, parental tendency in having a child, showed significant differences between two groups.Suggestion: It seems that training and educating parents, especially mothers, due to mental care during pregnancy, interaction between spouses, planning for bringing child can reduce the negative consequences, like giving birth to Low Birth Weight child.

Pregnancy has profound effects on the regulation of thyroid function in healthy women and patients with thyroid disorders. These effects need to be recognized, precisely assessed, clearly interpreted, and correctly managed. For healthy pregnant women who reside in areas with a restricted iodine intake, relative hypothyroxinemia & goitrogenesis occur frequently, indicating that pregnancy constitutes a challenge for the thyroidal economy.Overt thyroid dysfunction occurs in 2-3% of pregnancies, but subclinical thyroid dysfunction (both hyper- & hypothyroidism) is probably more prevalent and frequently remains undiagnosed, unless specific screening programs are initiated to disclose thyroid function abnormalities in early gestation. Maternal alterations of thyroid function due to iodine deficiency, hypothyroidism and hyperthyroidism have important implications for fetal/neonatal outcome. In recent years, particular attention has been focused on potential developmental risks for the fetuses of women with hypothyroxinemia during early gestation.Pregnancy increases the metabolic rate, blood flow, heart rate, and cardiac output, and various subjective sensations such as fatigue and heat intolerance that may suggest the possibility of coexistent thyrotoxicosis. Other metabolic changes which also impact the hypothalamic pituitary thyroid system are the potential direct stimulation of the maternal thyroid by hCG, as well as the accelerated metabolism of thyroxine, presumably due to increased placental deiodination enzymes.In patients with hypothyroidism, it is important to recognize that therapeutic requirements for exogenous thyroxine are increased by 50% on average during pregnancy. This should be taken into account in the management of such patients. Main causes of thyrotoxicosis in pregnancy include Graves' disease (uncommon, but potentially pregnancy-threatening) and gestational non autoimmune transient hyperthyroidism (more common, but remaining mild usually). This must be kept in mind when treating thyrotoxic patients, since all ATD cross the placenta and may affect fetal thyroid function.Fetal and neonatal hyperthyroidism is due to the transplacental transfer of maternal stimulating TSH-receptor antibodies (TRAb). The proper management of pregnant patients with Graves' disease remains a difficult challenge in clinical endocrinology.

Background: Tuberculous meningitis is a serious form of meningitis that affects the meninge covering the brain and spinal cord and is associated with high mortality and morbidity.Patient: A 20 year-old Afghan man with headache and vomiting for about one month was evaluated by lumbar puncture that showed meningitis. CSF TB-PCR was positive. In next step he was enrolled in anti-TB treatment. Barin MRI showed multiple small lesion infavor of tuberculoma. Opthalmologic evaluation showed choroidal tubercles. His general condition was gradually improved during next 15 days after beginning of treatment. Conclusion: TB meninigitis should consider in every patient with chronic meningitis and evaluation of CNS and eye is necessary for rule out of these two organ involvement.

Background: We report 2 cases of partial arhinia (hemiarhinia) with its complete manifestations, which is a very rare congenital abnormality. Reviewing the literature showed that there were only three cases was reported. This defect can be classified as Cleft no. 1, rare craniofacial clefts which were reported by Paul Tessier on 1976.Methods: The patient was treated continuously for past 9y. and different reconstructive procedure was carried out on him to get more symmetric and natural looking appearance.Results: In our opinion, we could not reach a favorable outcome due to complex and multi organ anomaly. Since these cases refer to physicians at early ages, reconstruction with complex flaps such as forehead is far from satisfactory due to a lack of available tissue.Conclusions: These patients suffer from their congenital anomalies, mean while reconstruction of absence of half of the nasal cavity could complicated by injuries on eyes and check bones. Multi specialty teams to cover all anomalies are mandatory and staged reconstruction to have more available tissue and better results are recommended.