Journal of Medical Council of Iran
Year:2010 | Volume:27 | Issue:4|Papers Count:11

Background: Creating smoke-free public places is essential to protect non-smokers and it also motivates smokers to quit. Considering the smoking ban law in public places of Iran and weakly enforcement of this law, we decided to study the circumstances in Tehran.Methods: It was a cross-sectional study which has been done during 2009. Firstly, Tehran's geographic map was divided into 3 areas of north, center and south and secondly 10 spots in each area were selected randomly. By reaching to that addresses easy sampling was done and going straightly toward the right side to collect enough cases. The indicators including "the existence of smoking ban signs, ashtrays and smoking areas and also the way of showing objection against smoking" were questioned and observed.Results: 458 restaurants and food courts were studied. In 60 places (13%) there were no smoking ban signs. In 140 places (30%) there were ash trays and in 54 places (12%) there were smoking areas. In 132 places (29%) the in-charge people had no objection against smoking in restaurants. All the cases were aware of smoking ban law in public places. More than 50% considered it as a useful law and 106 restaurants (23%) believed that the law enforcement would increase the number of customers. There was no statistically relationship between the place and working year of restaurants and law enforcement but it was shown a statistically relationship between smoking ban signs and showing objection against smoking and increasing the number of customers (p=0.000).Conclusion: In spite of the fact that it has been a long time since the law adaptation, but it has not been fully implemented, so it is necessary to reinforce the law.

Background: Preeclampsia is a disorder of pregnancy with increased maternal and fetal morbidity and mortality. Endothelial cell dysfunction is important in the pathogenesis of preeclampsia. An imbalance between free radical induced lipid preoxidation and antioxidant system such as ceruloplasmin has been suggested as a possible pathogenic factor in preeclampsia and disturbing endothelial function. The aim of this study is to compare serum ceruloplasmin level in preeclampsia and normal pregnancy.Methods: This is a cross-sectional study that was performed on 39 preeclamptic patients (21 mild and 18 severe preeclampsia as case group) and 30 women with normal pregnancy (control group). Five cc of blood was obtained from each patient and serum ceruloplasmin level was measured with special kit. Data were analyzed by one-way ANOVA Kruskal-wallis tests and ROC curve. P<0.05 was considered statistically significant.Results: Maternal serum ceroloplasmin level was significantly different between the studied groups (P=0.47).Conclusion: increased serum ceroloplasmin level can be used as a predictive factor to diagnose severe preeclampsia.

Background: Concern about medical errors in all patients has been elevated recently. Understanding of how patients conceptualize medical error would help health care providers to diminish safety concerns and increase patient satisfaction. This study was performed to evaluate patients worrisome from medical errors and relationship with patient concern, characteristic and satisfaction.Methods: This descriptive cross-sectional study was done in Tehran on October 2008. A questionnaire was performed to assess patients feeling about medical errors and their satisfactions according to Likert Scale. During 1 week period, all of the patients who came to the emergency department of Hazrat Rasool Akram hospital were included in the study. Patients who had altered level of consciousness or intoxication or were less than 18 years old were excluded.  Telephone interviews were conducted 7 days later. Patients were asked about medical safety, concerns about medical errors and satisfaction with care. Data were gathered and analyzed by c2 and T Test via SPSS 14 software.Results: Of 638 patients, 48.3% of patients reported experiencing at least one specific error related concern; that most commonly were consuming too much time in emergency ward and medical stadents faalts. Their concerns were associated with age, educational level, length of stay and disposition (P<0.001). 62% of patients showed high satisfaction regarding medical care service. Patient satisfaction was highly related to their concern.Conclusion: Although many patients have a good sense of security medical care services, but due to stressful situation in emergency departments, understanding of patient concerns, education and good communication with patients could decrease their concerns and increase satisfaction.

Background: Parkinson could be regards the most prevalent degenerative disorder in the central nervous system. In addition to neuromuscular disorders, some degree of oculomotor dysfunction may be observed in these patients.  The assessment of oculomotor system function may provide a viewpoint about the balance status of Parkinsonian patients and cold be regard as an appropriate tool for the extent of movement disorders. The purpose of this study was the evaluation of oculomotor system in patients with idiopathic Parkinson’s disease. Certainly, better understanding of mechanisms involved in this disorder, may help in designing rehabilitation programs and quality of life increment in these patients.Methods: In an analytic cross-sectional study, 30 patients (M: 18, F: 12) with idiopathic Parkinson’s disease and 30 (M: 20, F: 10) normal subjects, aged 35-70 years, were evaluated. Gain and phase of smooth pursuit eye movements (during horizontal and vertical situations) were recorded in 0.2 Hz velocity for all participants. Independent T and Man-Whitney U tests (when the data distributions were not normal) were used for the comparison of mean gain and phase of responses between groups. Data analysis was carried out by SPSS 15.Results: The average of gain, except for horizontal right eye condition, in normal subjects was significantly higher than patients with Parkinson’s disease (P<0.05). Additionally, the average of phase, except for horizontal right eye condition, in patients with Parkinson’s disease was significantly increased compared to normal subjects (P<0.01).Conclusion: Serious oculomotor system dysfunction, both in horizontal and vertical situations, in idiopathic Parkinsonian patients may representative of dopaminergic control decrement in these patients.

Background: Cigarette smoking affect on white blood cell (WBC) and Natural killer (NK) cells count in humans and animals.Natural killer (NK) cells are part of the innate immune system, and the first line  of  immune system defence and serve in surveillance of certain tumor and virus infected cells.The aim of this study was to investigate the effect of current cigarette smoking on CD16+ + CD56+ (NK cells) Peripheral blood in healthy Iranian volunteers, aged between 18-60 years. The study population consisted of male including 35 current smokers and 40 non-smokers.Methods: Anticoagulated peripheral blood samples were stained with monoclonal antibodies against CD16+ + CD56+ NK cells, and then samples were analysed by flowcytometry for the expression and count of the above markers. Data were analyzed by using SPSS software.Results: Cigarrette smokers had a significantly lower proportion of CD16+ + CD56+ (NK cells) than did subjects who had never smoked (P<0.001). NK cells were also decreased in the smoker subjects, aged 18-40 years as compared with the subjects aged 41-60 years (P<0.01).Conclusion: The data showed: 1-Smoking cigarette might have been more effective for younger than elder subjects in consideration  of NK activity.2-This quantitative NK cell deficit may contribute to the elevated risk of malignancy and viral infections in this population.

Background: Adenstonsilectomy is the most prevalent procedure in Earand nose and throat specialty, and unfortunately the main reason for delaying dischorging such patients is nausea and vomiting.Meanwhile, the most prevalent side effect of this surgery is recovery from anesthesia.Using medicines with minimum complication and price which can be effective in controlling this problem, and reducing side effects of patient‘s discharge and relevant problems, is a good option.Methods: In this study, 60 persons were candidates for Adenstonsilectomy, which have been introduced to operation room of Loghman Hospital. They have studied for a period of 6 months.These patients were divided in 2 growps each with 3. cases. In one group Dexamethasone and Metoclopramide was used and in second one Ondansetrone with sterile water at the same dosage.Immediately they received Induction, and stomach were evacuated by NG tube. For preserving the anesthesia they received propofol 150-200 µg/kg  with 50% (O2 +N2O), then they have been supervised between 0-3,3-12,12-24 hours after surgery for nausea and vomiting  in recovery room and at E.N.T. Ward.Results: No statistically significant difference in nausea and vomiting has been found in these two studied groups between 0-3, 3-12, and 12-24 hours after surgery.Conclusion: Our study indicated that the compound of Dexamethasone and metoclopramide  can be effective, the same as ondanstron, in controlling nausea and vomiting after surgery of Adenstonsilectomy during different hours, and there was no meaningful difference between these two drugs with Ondansetrone, in controlling nausea and vomiting after surgery, and in our study; Ondansetrone has no preference in using Dexamethasone and Metoclopramide simultaneously.

The causes of hepatitis or increased liver enzymes which follow liver cells (hepatocytes) are numerous. They vary from a temporary asymptomatic viral disease to a serious chronic liver disease that needs more attention and follow up.In a child with hepatitis, primary lab data including CBC, U/A, ALT, AST and PT are needed. According to the early clinical and paraclinical evaluation, hepatitis can be divided to cytotoxic and cholestatic types.In this paper, we suggest the appropriate approach for diagnosis and treatment of each type of hepatitis. Paying attention to this suggested approach will help physicians to do best in the management of their patients.

Abstract: Chronic Pancreatitis is a rare inflammatory Disease which can occur due to Different Causes such as:Alcohol consumption, Hyperparathyroidism, Hypertriglyceridemia Pancreatid divisum.Chronic Pancreatitis can be Sub grouped as:Lithogenic, obstructive, Inflammatory, Autoimmune, Idiopathic  pancreatic fibrosis, Tropical, Familial.We Report two cases of familial chronic pancreatitis in 5 and 16 years old girls which were cousin. Both girl referred with epigastric pain with radiation to the back and chronic nausea  and vomiting.With  primary diagnosis of chronic pancreatitis both patients went under ERCP and panceratography which revealed dilation and Irregularity of pancreatic duct with stone. Both cases operated by Fery procedure (Longitudinal Roux-en-y) Pancreaticojejunostomy.Postoperatively, both girls were symptom free and normal life.