Journal of Inflammatory Diseases (The Journal of Qazvin University of Medical Science)
Year:2003 | Volume:- | Issue:24|Papers Count:24

Background: Cesarean is one of the major operations in obstetric ward and evaluation of discharge time and its complications is important. Objective: To compare complications (wound-infection and metritis) and satisfaction of cesarean patients discharged 24 & 72 hours after operation. Method: In this clinical trial study, 120 cesarean patients were randomly divided into 2 groups: 59 & 61 patients were discharged 24 & 72 hours after operation respectively. The complications & satisfaction of the samples were compared. Findings: Metritis was observed in neither groups. There were 5 cases of wound infection in 72- hours group & 2 cases in the other one (P≈0.233). All patients in 24- hours group were completely satisfied whereas in 72- hours group, 51 had complete satisfaction, 5 had relative satisfaction and 5 were not satisfred (P≈0.00078). Conclusion: Patients discharged after 24 hours were satisfied more than the other ones. Considering complications, no significant difference was seen.

Background: The Coronary Artery Disease (CAD) is one of the most common causes of mortality worldwide. The awareness of the risk factors and symptoms can result in prevention and timely diagnosis along with appropriate therapeutic measures. Objective: To determine the awareness rate of the symptoms and risk factors of coronary artery disease in over 20- year- old urban population in Zanjan. Methods: This random sampling study was implemented on 1000 urban people through interview and questionnaire in 1997-1998. Findings: Chest pain and smoking are respectively the most notable symptoms and risk factors of which 70.9% of the subjects were unaware, 27% were a little aware, arid only 1.2% was aware. Regarding risk factors, 72.6% proved to be unaware, 23.2% with little awareness, and solely 4.2% aware. Conclusion: The findings indicate that utilizing practical and effective methods to increase the public awareness of the symptoms and risk factors of the disease seems essential.

Background: Experimental studies have showed that dietetic protein consumption can decrease glomerulal pressure, prevent progressive glomerular sclerosis and postpone the progression of the chronic renal failure. Objective: To determine the effects of a designed dietetic regimen on the control of chronic renal failure in early stages (renal insufficiency). Methods: 65 randomly selected patients were divided into two groups: test group and control group including 35 and 30 patients respectively. After assessing Wt., BP, Ht., lab data, and dietary condition of patients for several times, a nutrition regimen consisting of protein 0.6-0.7 gr/kg, phosphrus 10-12 mg/ gr protein, energy 35-40 kcal/kg, calcium 1-1.5 gr/day, and sodium 2-4 gr/day was designed for test group for 6 months. Lab data, protein catabolism rate, the rate of phosphorus excretion were assessed. Assessing renal function from creatinine clearance rate and performing the lab tests, pars azemoon kits for creatinine measurement, zist shimi kits for urea, kitman for phosphorus, and trichloroacetic acid 3%for measurement of urine protein were used. The groups were followed up every1.5 months for six months. Findings: The results showed that, after the intervention there was a significant difference in mean creatinin clearance rates of two groups (p<0.01), while there was not any before intervention. Conclusion: The designed nutrition regimen may delay the progression of chronic renal failure in the early stages, decrease the clinical signs of the disease, and postpone the necessity of dialysis.

Background: Membranoproliferative glomerulonephritis (MPGN) is the most common type of chronic glomerulonephritis in children. Objective: To determine clinical manifestations of MPGN in Iranian children and to compare their responsiveness to drug regimens (steroids & immunosurppressives). Methods: The medical records of the patients from June 1972 to January 1996 were reviewed. Age of onset of disease, sex, creatinine clearance, initial clinical presentation, presence or absence of pathologic proteinuria, hematuria, hypertension and low serurm C3 level in each patient & also the responsiveness of those who had follow-up drug treatment were examined. Using T test & x2 test the means were compared (P≤0.05). Findings: 66 cases were reported: type I 55 patients, type II 7 patients and type III 4 patients. 31 patients were male. There was no significant correlation between sex, pathologic proteinuria and hematuria and progression to CRF but more patients who had hypertension progressed to CRF (P<0.05). Patients with initial clinical presentations of rapidly progressive glomerulonephritis and chronic glomerulonephritis had worse prognosis and more progress to CRF (P<0.05). Patients who had received specific treatment had better prognosis (P<0.05). Conclusion: MPGN has the potential for progressing to CKF. Long-term treatment with steroids and immunosurppresiive drugs may prohibit this progression.  

Background: Prevalence of mandibular wisdom teeth impaction is high (20% -30%) which sometimes is accompanied by some complications. Because of fear, anxiety and post-operation complications (swelling, pain and movement limitation) the patients avoid surgery. Corticosteroids have important role in decreasing the complications. Objective: To determine corticosteroids (prednisolone pill) effects on decreasing pain and movement limitation after surgical removal of the impacted wisdom teeth of mandible. Methods: 16 patients (2 women, 14 men) with symmetric impacted wisdom teeth of mandible were selected. In one side, the surgery was done using prednisolone 50 mg 12 hours before and after surgery and in the other side, using multivitamin 50 mg as placebo under the same conditions and then considering pain and movement limitation (trismus) the findings were compared and analyzed statistically. Findings: Results indicated that prednisolone in this dose obviously decreases trismus and pain after surgery. Decrease in trismus on the first day was 43.7% and pain reduction was seen on 1st, 3rd, 7th days after surgery using prednisolone. The most effect of prednisolone on decreasing of trismus was on the first day after surgery. In both sides, a direct and significant correlation existed between time of surgery and pain intensity. Conclusion: Using prednisolone decreases pain and trismus evidently and in general the patients were more satisfied with corticosteroid therapy.

Background: Excessive hemorrhage during cesarean section increases mothers' morbidity & even mortality if they are not given transfusion timely. Objective: To assess the incidence of blood transfusion in cesarean section and to determine whether it is necessary to reserve two units of cross- matched blood for cesarean section. Methods: This prospective study was implemented at Qazvin kosar hospital (October 2000 to October 2001). The researchers recorded the name and specifications of the patients who had received blood during surgery or recovery or 3 days after operation, afterwards through a retrospective study the accuracy of recorded statistics were verified through comparing laboratory notebook with bloods delivered to operating room and surgical ward and reviewing the notebook of operating room and patient's files. Findings: Transfusion incidence at Qazvin Kosar hospital until 72 hours after operation was recorded 0.86% & 0.41% in the operating room. The hemoglobin average of both pre-operation & post- operation (8 hours after transfusion) was 10.9 & 8.61 respectively. Conclusion: Regarding the low incidence of blood transfusion in CS, reserving 2 units of cross- matched blood does not seem necessary and reserving the blood in the form of type & screen and having a ready and orderly laboratory with experienced personnel seems adequate.

Background: Post- operation shivering should be treated because it causes harmful side effects such as increased need for oxygen, tension on suture line, lops and so on. Objective: To compare IV pethidine with IV clonidine for treatment of post- operation shivering. Methods: This study was implemented on 60 patients (aged 20-40 years) who belonged to ASA I class. They had a general anesthesia with halothane after a 2-3 hour operation & also severe shivering not treated by rewarming or 02 administration. IV pethidine (25 mg) & IV clonidine (75 mg) were injected to 2 groups of 30 patients (groups A & B) randomly. Findings: In pethidine group (A) and in clonidine group (B) recovery times were 2.4 & 4.4 minutes respectively (P<0.005).In pethidine group HR & BP was usually stable whereas in clonidine group a drop in HR & BP was sometimes observed. The difference was statistically meaningful. Conclusion: Because of the fast effect & few side effects of IV pethidine it is recommended as an appropriate method to treat post- operation shivering.

Background: Pregnancy is associated with substantial but reversible variations in thyroid function and some studies reveal the appearance of hypothyroidism in pre-eclamptic patients. Objective: To survey the relation between thyroid hormones & TSH and the process of pre-eclampsia. Methods: In this case- control study 40 proteinuric, 40 pre-eclamptic patients and 40 normotensive ones were studied. The samples were matched based on age & gestational age none of them had previous history of hypertensive or thyroid disorders or took medication that might affect thyroid function. Their venous blood samples were collected using RIA method and thyroid hormones and TSH were measured. Findings: Pre-eclamptic patients had significant lower T4 and higher TSH concentrations compared with normotensive ones (T4: 7.8±1.7 mIu/ml 10.2±1.4 mIu/ml), (TSH:5.3±1.5 mlu/ml, 3.6±0.4 mIu/ml) (P<0.05). T3 concentration correlated with severity of pre-eclampsia. Severe pre-eclamptic patients had lower T3 than the mild pre- eclamptic ones (P<0.05). Conclusion: The results suggest that mild biochemical hypothyroidism is found in proteinuric pre-eclompsia and the concentrations of T3 seem to reflect the severity of pre-eclampsia.

Background: Ascorbic acid with low & high density has agonistic & antiagonistic effects on both dopaminergic & glutamatergic systems respectively. These two systems directly affect learning & memory.Objective: To determine the effect of ascorbic acid on spatial learning.Methods: Through an experimental study (Qazvin 1998) male rats (220-280 gr) were trained in- an 8-arms radial maze apparatus. Ascorbate (100, 500, 1000 mg/kg, I.P) was injected to the subjects & some rats received ascorbate (4,8 ug/ul) that were injected into Ventral Tegmental Area (VTA).Findings: The injection of Ascorbate (100-500 mg/kg LP) facilitates spatial learning dose-dependently but 1000 mg/kg of Ascorbate impairs it. The injection of 4ug/ul of Ascorbate into VTA facilitates spatial learning whereas injection of 8ug/ul of Ascorbate impairs it.Conclusion: Ascorbate facilitates spatial learning when used with low or average dose and conversely impairs it when used with high dose.

Background: Oxidative damage is considered as a major factor involved in senile cataract. Objective: To determine the relation between plasma vitamin C level & nutritional behaviour and age- related cataract. Methods: This case - control study was implemented on 102 patients with cataract and 102 healthy volunteers attending the ophthalmology clinics of Tabriz University of medical sciences both over 45 years old. The anthropometric measurement was carried out and a food frequency questionnaire was used. Personal information was also collected and capillary blood was drowning to determine plasma vitamin C with 2, 4- dinitrophenylhydrazine method by the UV detection spectrophotometry. Findings: Plasma vitamin C level and BMI in the patients were found to be significantly lower than the control (0.43±0.03 mg/dl, 23.18±0.9 kg/m2 vs. 0.69±0.03 mg/dl, 26.10±0.8 kg/m2 respectively) (PV< 0.05). Conclusion: The findings indicated that the inadequacy of plasma vitamin C level can lead to cataract & the lack of enough information about nutritional value may play an important role in this matter.

Background: Recurrent aphthous stomatitis (RAS) is one of the most common diseases of oral cavity which affects 10-20 % of normal population. It vastly affects the patient's nutrition, oral hygiene and social communication. Objective: To determine the effect of sucralfate suspension on RAS treatment. Methods: In this double blind clihical trial, 78 patients with RAS (aged 15-57 years old) were studied: group A received sucralfate suspension and group B received a similar suspension without sucralfate as a mouthwash to use it for one minute three times a day each. Findings: There was no difference in the time of pain reduction in both groups (P>0.05). On 7th day of treatment, 24 patients of group A and 15 patients of group B(P<=0.05-P=0.035) & after 14 days 38 patients of group A and 31 of group B had complete remission (P= 0.014). It was a significant difference. Rebound of lesion after 3 months was 5 in group A and 8 in group B which was not significant. Conclusion: The sucralfate suspension is more effective in treating aphthous stomatitis.

Background: Treatment of a single seizure is so complicated and has received much discussion and debate. Objective: To determine the risk rate of recurrence of seizure after the first unprovoked generalized tonic clonic seizure, and ascertain the effectiveness of treatment. Methods: In this prospective study in the neurological ward of Mofid children hospital in 1992, 50 children (from 9 months to 17 years of age) were followed up for one year. Children were randomly divided into two groups, phenobarbital was administered for one group and placebo to the other one. Findings: In the year after the first unprovoked attack, second seizure occurred in 20 children (the recurrence rate was 40%), of which 14 (56%) belonged to placebo group and Six (24%) were in phenobarbital group. The majority of attacks happened in the first 6 months of the year. Conclusion: This study revealed that the use of antiepileptic drugs (phenobarbital) considerably reduces the risk of seizure recurrence.

Background: Admission of neonates kads to the emotional stress of the parents. In recent years it is emphasized that the environment of the pediatric wards should be less stressful for both the neonate & the family. Objective: To identify the stressors which mothers of hospitalized neoliates experience during their stay in the ward? Methods: This descriptive study was implemented on 40 mothers in the neonatal ward of Qods hospital in Qazvin in 2001. The questionnaires were of 2 parts: the 1st part included the information about the mother & her neonate & the 2nd part included stressors. Findings: Mothers experienced the most stress from the neonate's appearance & illness, alteration to their parental role, neonate treatment and relation with the staff. Conclusion:  Mothers of hospitalized neonates experience extreme stress. Appropriate planning should be made so as to reduce the mothers' stressors caused by the above mentioned reasons.

Undoubtedly one of the bad traces of the industrial life in contemporary world is mental disorder which is growing on and on. Mental health is a science for the social comfort, the health of life and living in better situation than before and relates to the whole periods of life, (from birth to death), from the environment of home to the environments of college, work and society. It is believed that human has moral emotional religious, educational and guidance needs in addition to the physiological needs. The healthy life is achieved through satisfying the needs and, making a balance between them. For making the balance, Self-respect is the main factor in mental health and it stands at the front of the contempt and self-disrespect which is followed by some diseases such as, selfishness, personification violence, greedy of honours, hypocrisy, lying, sensuality, fault finding, fear, jealousy, greedy and revenge. In Islam these serious diseased are treated through recognizing and removing one's faults, belief in God, praying, good entertainment, benevolence, being happy and appreciation in God's blessing.