Jundishapur Scientific Medical Journal
Year:2011 | Volume:9 | Issue:6 (69)|Papers Count:16

Background and Objective: The prevalence rates of symptoms of asthma, allergic rhinitis and eczema which are common disorders of children vary widely in different areas. The aim of the study was to estimate the prevalence and severity of allergic disorders among Ahvazian children by ISAAC protocol in 2006-7.Subjects and Methods: The descriptive study was conducted on primary (6-7 years) and guidance (13-14 years) schoolchildren who were randomly selected among Ahvaz schools by cluster sampling method. Data were collected using phase I standardized International study of asthma and Allergy in child hoos (ISAAC) questionnaire which was completed by schoolchildren itself or by the parent of each child. Data were analyzed by SPSS-15 and using Chi-square test.Results: The prevalence of symptoms of asthma, allergic rhinitis and eczema were 14.1%, 18.2% and 8.4% respectively. Sex difference was not significant, while by educational level guidance students showed significant higher prevalence for asthma and allergies (11.8% vs 16.4% P<0.01). The Prevalence of “physician diagnosed” asthma, allergic rhinitis and eczema" were 8.4%, 12.3% and 5.7% respectively; guidance school children in compare to elementary school children showed higher rate in the each 3 conditions (P<0.01).Conclusion: Allergic disorders are common in Ahvaz and its prevalence is similar to those reported from other parts of Iran. The prevalence of physician diagnosed asthma was higher than that reported from other regions of Iran, but lower than those obtained from neighboring Arab countries.

Background and Objective: Evaluation of medical records departments in hospitals of Iran shows that these departments have not achieved desirable standards and high quality services. The major aim of this survey is to evaluate the performance of the Medical Records Departments of hospitals of Ahvaz for awareness of their status.Materials and Methods: This is an applied research, conducted in descriptive cross-sectional. Research population includes medical records departments of hospitals Imam Khomeini, Golestan, Razi, Aboozar, Shafa, Taleghani, Salamat and Sina. In this study the required data has been collected by the use of a questionnaire and four types of check-lists in each of Admission, Filing, Coding and statistics units. To analyze of data, each four checklists of units was assigned 100 score and then the performance average of each unit was calculated and compared.Results: The best performance was for statistics units (71.97%) and lowest it was for coding units (56.79%) Conclusion: Functional status standards were partially observed. Auditing results show that the functional status in medical records departments of university hospitals in Ahvaz lack standard instructions that should be followed on all the functional processes and require appropriate attention by trustees of these hospitals.

Background and Objective: Gastrointestinal bleeding can arise following various stressing conditions such as burns. Gastrointestinal bleeding has serious effect on the treatment process of burn patients. The aim of the present study was to investigate the incidence of gastrointestinal bleeding and to identify factors contributing to its occurrence in burn patientsSubjects and Methods: In this descriptive and retrospective research study, the population of the study included all patients admitted in the Ahvaz Taleghani burn center from the year 2008 to 2010 and 3901 medical records were reviewed. Data were collected by a checklist and analyzed using descriptive and analytical statistical methods. Results: From a total of 3901 patients admitted during the three years period of study, 45 patients had gastrointestinal bleeding (1.15%). The average of burned surface area in these patients was 61%. Seventy seven percent of gastrointestinal bleeding had occurred in patients with burn over 50 percent, and there was direct correlation between the incidence of gastrointestinal bleeding and the extent of burn. The age group of 15-30 years comprised 40.1% of our cases. The mortality among patients suffered from gastrointestinal bleeding was 71%. A significant relationship was found between burn in face and incidence of gastrointestinal bleeding (P<0.001). However, the risk of gastrointestinal bleeding among different sexes was not statistically significant.Conclusion: The results of this study show that the importance of timely diagnosis and treatment of gastrointestinal bleeding in burn patients. Therefore, doing preventive procedures such as medication and psychiatric interventions to reduce stress can decrease the incidence of gastrointestinal bleeding in burn patients.

Background and Objective: Cylindrical ionization chamber is used for measurements of patient dose in radiation therapy. By determination the effective point of measurement we can determine the dose distribution and the parameters of treatment. Therefore in this research we introduce an analytical approach for determination this point in CC13 cylindrical ionization chamber that used for dosimetry of linear accelerator.Subjects and Methods: In this study a CC13 ionization chamber was used for dose measurement of 6 and 18 photon beams of Variant accelerator in different field sizes, 5*5 cm2 up to 35*35cm2. Measurements were performed in blue phantom, up to 5cm depth and data fit software was used for evaluation of experimental data.Results: with our formalism the Pdis quantity in 6MV for 5x5 thought 35x35cm2 were measured 3.088 to 2.88 mm and in 18 MV are measured 4.62 to 4.20 mm.Conclusion: The first critical point of each curve is caused by changing environment from air to water during measuring of ionization. In fact it can be considered critical point as effective point of measurement of ionization chamber. Investigation shows that any increasing in field size, decrease and increasing of energy increase the depth of this critical point.

Background and Objective: Kawasaki disease is an acute febrile multisystem vasculitis syndrome. This study designed to assess clinical and laboratory findings of children diagnosed as Kawasaki disease hospitalized in two major pediatrics departments of Abuzar and Golestan hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences.Subjects and Methods: According to the criteria of Centers for Disease Control (CDC) for Kawasaki disease, all children who were diagnosed as Kawasaki from Oct 2001 to Apr 2004 were enrolled. History taking, physical examination and laboratory assessment were performed and standard treatment was carried out. Echocardiography was performed for all patients at the time of diagnosis and two weeks later.Results: Twenty five subjects had the definite diagnosis of Kawasaki. The mean age was 30±19.55 month; male/female ratio was 1.77: 1. Hospitalization was more frequent in winter season, especially in January. The most common presenting symptom (except fever) was maculopapular rash and the most common diagnostic criteria was bilateral non-purulent conjunctivitis. Leukocytosis with polymorphoneuclear predominance, high erythrocyte sedimentation rate and positive CRP were present in patients in acute phase of the disease. The mean serum hemoglobin level was 10.4 g/dl before treatment. The mean platelet count rose from 418000/mm2 in acute phase to 621000/mm2 in convalescence period (P<0.05). Six of 25 patients (24%) showed coronary involvement all mild coronary artery ectasia-in echocardiography. Laboratory findings were not differed statistically between the groups with and without coronary artery involvement (P>0.05).Conclusion: Clinical and laboratory findings of Kawasaki in this area is similar to other centers and were not affected with coronary artery involvement.

Background and Objective: Accuracy and efficiency in screening program for congenital hypothyroidism (CH) in each geographical area requires regional studies and updating protocols. This study performed to assess factors possibly interactive with the result of screening test for CH in Ahvaz.Subjects and Methods: During 19 months (Nov 2006-May 2008) all newborns in Ahvaz enrolled in screening by heel prick sampling for TSH then were referred for confirmation if it was ³5mIU/L. In next step, second assays considered as hypothyroid if TSH remained ³10 mIU/L. The factors were studied including: age, history of hypothyroidism in mother, sex, birth weight (BW), birth number, feeding, parental consanguinity, TSH levels and duration of normalization of TSH.Results: In totally of 35655 neonates were screened. 1162 cases (55.8%M, 44.2% F with p<0.001) recalled (3.25%). Our study showed sex difference that was not significant in confirmed CH (82) cases (52.4% M, 47.6% F with P=0.6), and also for TSH levels in both suspicious and confirmed individuals (P=0.55 and p=0.49 respectively). The 90% of registered suspicious neonates were healthy, ad consequently discharged without treatment. Our study was shown hypothyroid neonates (3.7±1.8 kg) had no correlation with TSH (P=0.6 and p=0.3). Also there were no correlation between TSH levels and the above-mentioned studied factors. If TSH level was high in screening test a longer time was needed for its normalization (P=0.03).Conclusion: This study showed that suspicious and hypothyroid dominancy was mainly in boys with no relation to TSH. This suggests that healthy newborns suspicious to CH with elevated TSH need to be followed longer without treatment.

Background and Objective: Osteoporosis is a major health problem for postmenopausal women and use of dual x-ray absorptiometry (DXA) is standard diagnostic method. But due to the cost, it is not economical to use for screening of all postmenopausal women. thus, the aim of this study was to evaluate performance of Osteoporosis Risk Assessment Instrument (ORAI) as a tool for screening of osteoporosis among Iranian postmenopausal women.Subjects and Methods: In this study data was collected from a bone densitometry centre. The osteoporosis risk was evaluated for 341 postmenopausal women (age³45 years) without consider secondary cause of osteoporosis. The results were compared with their bone mineral density.Results: From 341 postmenopausal women, 20.8% were showed osteoporotic and 39.6% had low bone mineral density in one or both studied area by DXA. To assess osteoporosis of low bone mass, ORAI was shown a sensitivity of 70.9% and specificity of 66.9% respectively.Conclusion: The ORAI was adequate sensitivity to evaluate Iranian postmenopausal women. This test could be used as screen test to determinate low bone mineral density to referral of women.

Background and Objective: Anal fistula is a tract between anorectal canal and perianal skin. It usually develops after perianal abscess and it is one of the most common surgical diseases that presents with persistent drainage from the tract. Recurrence of fistula and gas or fecal incontinence are important problems after surgical management of fistula particularly in recurrent fistula. The aim of this study is to evaluate the rate of recurrence and incontinency after open fistulectomy with repair of sphincter muscles.Subjects and Methods: In a prospective interventional semi-empirical study 98 patients with recurrent fistula were evaluated for recurrence and incontinency during 10 years (1999-2008) follow up after treatment by fistulectomy and primary sphincter muscles repair.Results: From 98 patients (96 male and 2 female) of recurrent anal fistula, 27 patients have high anal fistula and 71 have low (common) fistula-in-ano. Ninety six patients were developed prolonged neither gas incontinence nor recurrence. One patient who was considered as type 2 diabetes, presented with wound infection postoperatively. In this patient fistulectomy and sphincter repair was performed after control of wound infection. One male patient was developed long life gas incontinence.Conclusion: In compare with other surgical methods, fistulectomy and sphincter repair was shown the lowest rate of recurrence. One case of permanent gas incontinence and no case of fecal incontinence was found.

Background and Objective: some studies shown that position of fetus in uterus could be some lower limb deformities. Up to now, no research has been done about relationship between type of delivery and tibiofemoral developing. We were investigated to consider of this relationship in people between 3-16 years old in Ahvaz city.Subjects and Methods: This cross-sectional study was carried out on 853 people (455 girls and 398 boys). Tibiofemoral (TF) angle, Intercondylar and intermalleolar distances were measured in standing position with knees and hip in full extension. Information about a kind of delivery (caesarian or vaginal) were taken by questionnaires in which was completed by their parents.Results: TF angle in cesarean sections was more than in vaginal deliveries and the difference was statistically significant (p=0.02). Intercondylar and intermalleolar distances in cesarean sections were more than in vaginal deliveries but the differences were not statistically sign-ificant.Conclusion: There is significant relationship between tibiofemoral and type of delivery, but for the future work need to evaluate the effect of fetal position and adaptathions(mechanism of laber) in the development of tibiofemoral angle after birth.

Background and Objective: Major depression disorder (MDD) is most common psychiatric disorder in community. MDD is one of the important disorders because of  its prevalence and serious complication such as suicide, substance abuse, loss of well being and function, this study was investigated to determine the efficacy of vitamin B-complex add on citalopram,(its cofactor role in serotonin synthesis) in treatment of MDD.Subjects and Methods: This study is a double-blinded placebo-control cinical trial on 40 MDD patients (18-45 years old) referred to psychiatric clinic in 2009. Duration of study was 6 weeks. Depressive symptoms were assessed with Beck Depression Inventory at 0, 3 and 6 weeks after intervention. Data was analized by using SPSS, ANOVA, Chi-square and Fisher tests.Results: In both groups (B-complex and placebo), symptoms were significantly improved at the end of study respectively (P=0.002, P=0.04). Beck's rating scale score between two groups was not significantly different (P=0.99).Conclusion: The main finding of this study was that efficacy of either vitamin B-complex on citalopram or citalopram alone was not differed in reduction of depression symptoms. Because of low sample size, short duration of study and basic effect of vitamins in behavior, further future works to be considered.

Background and Objective Breast cancer is the second most common malignancy disorder in the word. Chemotherapy as an effective measure decrease quality of life (QOL) in these patients. Side effects of chemotherapy can be effective on physical, emotional and social aspects. Complementary medicine can be effective on QOL. The purpose of this study was survey the effect of Benson relaxation intervention on QOL in breast cancer who was undergoing chemotherapy.Subjects and Methods: This study was designed on quasi-experiment in which 25 subjects who have breast cancer without metastasis and receiving chemotherapy with TAC (Taxotere Adriamycin and Cyclophosphamide,) regimen. Subjects completed demographic data, C-30 and BR23 QOL questioners in first day of treatment and 3 week after it. Then the Benson relaxation to subjects were considered. The individuals received audiotape of relaxation to do the technique daily 15-20 min. for 3 weeks. At the end questioners were completed by subjects. Information analyzed by SPSS soft ware.Results: There was statistically significant improvement in QOL (P=0.02) and Physical functioning (P=0.001), ole functioning (P=0.001), emotional functioning (P=0.001), cognitive functioning (P=0.001), social functioning (P=0.001), body image (P=0.001), sexual enjoyment (P=0.01), future perspective (P=0.001) and there was no statistically significant improvement in sexual functioning (P=0.7) after Benson relaxation intervention.Conclusion: Benson Relaxation intervention could be an effective approach for improving QOL in breast cancer patients undergoing chemotherapy.

Background and Objective: Understanding all the causes and addiction fundamental factors leads to plan systematically preventing, identifying, treating and persisting. Trend this study was conducted with the aim of considering comparison of effectiveness of cognitive- behavioral therapy (CBT) in community therapy and narcotic anonymus groups compared with those addicts who just received therapeutic methadone consideringSubjects and Methods: The study society included Khuzestan province addicts in centers of community therapy and narcotic anonymus groups and those who received methadone in the physician's offices. The study sample consisted of 75 subjects selected in the three 25 people that 2 temperamental groups (unknown addicts and society-center groups) who received (CBT) therapy and a control (medicine therapy) who were not treated by CBT. Samples were selected in cluster random form and using identification method. Instruments used in this study were constituted of abusing questionnaire (Gol–parvar), and tent to abuse narcotics questionnaire. Covariance analyzing test was used to analyze data.Results: Average differences indicated more cognitive-behavioral therapy effectiveness than methadone therapy on reducing tend to abuse drugs. Cognitive-behavioral therapy effective-ness on society-center groups on reducing tend to abuse narcotics was more than unknown group (p<0.05).Conclusions: cognitive-behavioral therapy effectiveness in community therapy group, narcotic anonymus group on decreasing tend to abuse narcotics is more than methadone therapy. Cognitive-Behavioral Therapy effectiveness in community therapy group is higher than in unknown addicts.