MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES
Year:2014 | Volume:56 | Issue:6|Papers Count:14

Introduction: Obstructive sleep apnea syndrome (OSAS) is a common breathing disorder characterized by repeated episodes of upper airway collapse during sleep. While loud snoring and daytime sleepiness are the main symptoms, a variety of complaints including headaches may constitute the clinical manifestations.Materials and Methods: We conducted this cross sectional study on 178 adult individuals diagnosed with OSAS at the sleep laboratory of Ebn-e-Sina hospital. Overnight polysomnography provided the diagnosis of OSAS and its severity. All participants were examined by neurologist.Results: Headache was the forth common chief complaint. This study showed no correlation between headache and the severity of OSAS, body mass index(BMI), Sleep efficiency and hypoxia in OSAS patients; however, all of the patients with headache had anxiety or depression.Conclusion: According to this study, chronic headache is a common presenting complaint in patients diagnosed with OSAS. Therefore, it is recommended that sleep apnea is a diagnostic consideration in individuals suffering from chronic headache accompanied by snoring and daytime sleepiness.

Introduction: Understanding of metabolic and hormonal responses is main principles in each training programs. The purpose of this study was to determine the effect of sprint training on response and adaptation of enzymes, metabolites and hormones of healthy men.Materials and Methods: This study was semi-experimental research with repeated measures design. In this study, 10 Sprinter in Mazandaran were selected and after it perform the Astrand protocol to speed of 7.1 mph and 2.5 degrees. Then, subjects perform sprint training for 6 weeks to intensity of 60 maximal HR. Finally, ten blood samples was taken at pre and post test.Results: Statistical analysis showed that HR of subjects was significantly decreased (p<0.05). Also, amounts of testosterone and growth hormone was increased that statistically wasn't significant (p>0.05). In addition, amount of Insulin was significantly decreased (p<0.05). Levels of T3 in serum was significantly decreased (p<0.05) but amount of T4 in during and after of test was significantly increased (p<0.05). Levels of LDH and CPK in serum was significantly increase during training bouts (p<0.05) but amounts of LDH and CPK was decreased after training period.Conclusion: Six weeks sprint training appear to able increase athletic performance due to changes in profile of hormonal (such as increase in testosteron, GH and T4 and dercreas in insulin) and metabolic adaptations.

Introduction: Hirsutism is defined as androgen- dependent excessive male- pattern hair growth. Hirsutism is often idiopathic or the consequence of the polycystic ovary syndrome (PCOS).Insulin resistance is common in PCOS (specially obese patients), and, this association has been proved.However, association between Insulin resistance and idiopathic hirsutism is not clear. The aim of this study was to investigate the assessment of insulin resistance in idiopathic hirsutism, compared with healthy women and patients with PCOS.Material and methods: This case-control study was performed among patients referring to the clinics of Imam Reza and Ghaem general hospital, in 2011-2012.Age adjusted healthy controls were selected voluntarily. The study included three groups, patients with idiopathic hirsutism, PCOS and healthy women. Each group included 30 non-obese women. Insulin resistance was detected by using basal insulin and homeostasis model assessment (HOMA-IR) in all the groups.Results: There were no significant difference in the level of serum Insulin (P=0.491), level of HOMA- IR score (P=0.470), prevalence of insulin resistance (P=0.140) and prevalence of severe insulin resistance (P = 0.696) among three groups. After classification by body mass index (BMI£25, BMI>25), there were also no significant difference in insulin resistance among three groups.Conclusion: The study showed that prevalence of insulin resistance has not significant difference in idiopathic hirsutism, PCOS and healthy groups.

Introduction: Tracheal intubation is an essential and critical technique in emergency and operating rooms, where the lack of proper treatment (esophageal intubation) can be catastrophic. In this study, we compared an esophageal detector device (EDD) with a capnograph (EtCo2) for verifying tracheal tube placement.Material and methods: After the approval and support of the Research Council of Mashhad University of Medical Sciences, In this single-subject prospective study, 114 patients who were candidates for general or orthopedic surgery were enrolled. After anesthesia and tracheal intubation, tube position was first assessed by EDD (suction bulb type), followed by evaluation using an EtCo2 monitor. Data was analyzed with SPSS v16, McNemar’s, chi-square, and t-tests. Sensitivity, specificity, and positive and negative predictive values were evaluated. P<0.05 was considered as the level of significace.Results: In total, 114 patients underwent 124 intubation attempts due to several difficult esophageal intubations. Sensitivity and positive predictive values for EtCo2 were 100% and for EDD was 98.2% and 95.6%, respectively. Therefore, capnography was a more reliable method for verifying endotracheal tube placement (P=0.016).Conclusion: Capnography is the gold standard for recognition of tube position. EDD was less successful (sensitivity=98.2% vs 100%) for elective situations, but it provides rapid recognition and high sensitivity for verifying the tracheal tube position, particularly in cases of emergency and cardiac arrest. Because of high sensitivity and positive predictive value, EDD can be used for tube position recognition if necessary, but EtCo2 monitor is more accurate and reliable.

Introduction: The purpose of the current study was determined the mental health among students at Kurdistan University of Medical Sciences and its related to age, gender and their academic courses.Material and Methods: The design of the current study is cross-sectional. The sample size was 1000 students (382 males and 618 females). The sampling method of the present study was Convenience sampling method. The instrument of the current study was GHQ-28.Results: The results of the present study show that 40.2 % of respondents had lack of mental health. Based on the results of the current study there was a significant difference (p≤0.01) between gender and respondents’ mental health.Conclusion: According to results of the present study many of students have lack of mental health, so prevention and counseling services for decrease the students’ problems are necessary and commented.

Introduction: Chemical weapons induce various and long lasting physical complications which could be affected the mental health. In this study we assessed the symptoms of Past Traumatic Stress Disorder in chemical and non-chemical injured war veterans.Methods: After the approval and support of Zanjan University of Medical Sciences, This study was a cross-sectional which was conducted on chemical (80 cases) and non-chemical (89 cases) war injured veterans in Zanjan, Iran during 2009-10. Persian version of both The PTSD Checklist-Military and Impact of Event Scale-Revised were used for evaluation of psychiatric condition. Data were analyzed and compared with using SPSS 16th edition and P.value less than 0.05 was considered statistically significant.Result: Prevalence of PTSD symptoms was 40 % and 28.1% in chemical and non-chemical injured veterans, respectively. PTSD prevalence and scales did not show any significant difference between two groups of chemical and non-chemical war injured veterans (p <0.05). Moreover, there was a relationship between these variables and some factors like the kind of soldier dispatch by military organizations and their occupations (p<0.05), but there was not any correlation between these and the time of event, literacy, and types of chemical agents (p>0.05).Conclusion: Although there is no significant difference between chemical and non-chemical war injured veterans in terms of the frequency of PTSD symptoms, mental health of veterans who exposed to chemical agents because of long-term adverse consequences could be affected.

Introduction: Osteoporosis is the most common metabolic bone disease and its prominent feature includes loss of total bone matrix mineral. This phenomenon involves more than half of the women population over 50 years old. This study aims to determine the osteoporosis frequency in the first 5 –year period of time in healthy women after menopauses in Rheumatologic Outpatients Clinic in Imam Reza Hospital Medical Center.Material and methods: In this descriptive cross- sectional study in the year 2010-2012, two hundred and fifty healthy post- menopausal women were entered to this project with respect to the inclusion and exclusion criteria through target based sampling method. Bone Mineral Densitometry (BMD) was performed in two different regions, femur and lumbar spine (L2-L4). Data was coded and analyzed with Version 17 SPSS Software.Results: In this study, two hundred and fifty women were evaluated. Their age was between 44 and 62 years old with the average age of 77.3±9.52 years. The mean menopausal period of time and the mean body weight was 2.8±1.5 years and 70±11.55 Kg respectively. Femoral BMD results showed osteopenia in 40% and osteoporosis in 8% of women. However in Lumbar BMD, 44% of our population had osteopenia and 17% were affected with osteoporosis.Conclusion: Seventy percent of this study individual (healthy women during their first 5- year of menopauses) had been affected with osteopenia or osteoporosis at least in one region either femur or lumbar spine BMD, however, only 30% of them had normal BMD.

Introduction: Teaching approach has the main role in quality of education and there are different educational methods for upgrading the quality of Cardiopulmonary Resuscitation (CPR) teaching. The aim of this study was to compare the effect of practical education vs. multimedia methods of teaching CPR to medical student.Materials & Methods: In these semi-experimental study, 51 medical students was enrolled. The medical students are allocated in two different categories, practical education (N=25) and multimedia methods (N=26), randomly. Pre-test and post-test were done in both groups and data were collected by using questionnaire and checklist. Data were analyzed by using simple and paired t-test.Results: Comparison of the post test results showed that there is a significant difference in the knowledge of cardio-pulmonary arrest diagnosis and the skill of CPR approach, orotracheal intubation modality, and Laryngeal mask airway apply, except the section of electroshock performance. Participants in practical education group were better than multi media group (P-value<0.001). There is a significant difference in pretest and post test results of orotracheal intubation and Laryngeal mask airway applying subjects between participants in two group. Participants in practical education group acquire better marks (P-value<0.001).Conclusion: The study demonstrates when practical education accompanies theoretical subjects in CPR learning course of medical students, results would be improved in comparison with multimedia teaching approach.

Introduction: The most common cause of short delayed arousal is due to “overdose of a sedative-hypnotic” medication after general anesthesia and it is not of clinical importace. However, long term delayed arousal is due to several important conditions that can confuse anesthesiologists.Case report: The patient was a 28 years old woman with mucormycosis, candidate for sinuses drainage by endoscopic intervention .One months before surgery, while she was in 18-19 weeks of gestational age, she suddenly felt dyspnea and fatigue. In further investigations, severe anemia was diagnosed and in bone marrow biopsy AML-M5 was detected. Physicians decided to end her pregnancy by D&C. After one week of chemotherapy with Cytosar (Cytarabine) and Idarubicin, pneumonia and sepsis occured. Therapy with Vancomycin and Amphotericin B and Imipenem leads to epistaxis and rhinorrhea. CT Scan of sinuses demonstrated mucormycosis. She was alert and awake before general anesthesia with Fentanyl and Cisatracurium and Propofol for induction and maintenance. At the end of operation she could not be awake .Her delayed arousal had been continued for one day, then awakened spontaneously and discharged from hospital.Conclusion: Several factors such as chemotherapy drugs (affects on liver and brain),length of operation, imbalance in levels of electrolytes and low proteins due to malnutrition caused by cancers are the possible causes of the condition. Use of BIS maybe a good offer to decrease anesthetic drug doses during general anesthesia.