Medical Journal of Mashhad University of Medical Sciences
Year:2013 | Volume:56 | Issue:4|Papers Count:10

Introduction: Regarding the severity of central nervous system infections and their considerable mortality and morbidity, it seemed necessary to re-assess the accuracy of the management of patients with CNS infection, whether the requested action and the prescribed drugs, as if they were timely and correctly sequenced.Materials and Methods: In this prospective study, patients with suspected central nervous system infection admitted to Imam Reza Hospital, from October 2011 until October 2012, went to the regular and systematic review. Sample size calculations were based on an estimated 108 people, and the information required was completed on the designed questionnaire. Finally, the results were analyzed statistically.Results: Data analysis in this study showed that the average time from admission to the initial visit by a physician was about 9 minutes, and requesting an infectious diseases specialist visit took on average 55 minutes. It took 154 minutes to actual specialist visit and 15.6 hours up to perform lumbar puncture (LP). The average time between performing LP and obtaining the results of CSF analysis was 5.5 hours.Conclusion: The data indicated that the average length of time in this study was longer than the other studies, thus it implied either empirical antibiotic therapy should be started immediately for all patients with suspected CNS infection before any diagnostic approach, which does not seem much logical and scientific, or should it be based on a protocol agreement accepted by both the Departments of Emergency Medicine and Infectious Diseases.

Introduction: Medication errors are considered as the most common medical errors. Some of these errors are related to the mistake in dosage prescription and number and duration of drug usage. The purpose of this study was to evaluate the efficacy of the educational intervention-pamphlets of common medication on the accuracy of medical intern students in prescription.Materials and Methods: In this interventional study, 94 interns from pediatrics, surgery, and internal sections entered to the study and were randomly divided in to two groups; without pamphlet (control group) and with pamphlet (case group). The test was obtained using the questionnaire before and after the intervention. The accuracy of prescription was determined by paired t test, before and after the test and by independent t test between the groups.Results: Educational intervention as pamphlet had positive effects in all studied sections of internal, surgery and pediatrics. The final mean scores of interns after the intervention in groups of without and with pamphlets were 37.64±15.21 Vs 50.52±15.80 (P=0.018), 69.37±9.46 Vs 85±8.66 (P<0.001) and 34.61±12.15 Vs 35.83±7.63 (P=0.76) in internal, pediatric and surgery sections, respectively.Conclusion: Use of the educational pamphlets have effective role in accuracy of interns prescription.

Introduction: The purpose of this study was to determine the effect of eight weeks aerobic training and green tea supplementation on body fat percentage and serum lipid profiles in obese and overweight women.Materials and Methods: A total of twenty obese & overweight females volunteered and were randomly divided in to two groups: experimental group (11 subjects with means of age 38.54±9.44 years, weight 70.68±7.30 kg) and control group (9 subjects with means of age 40±7.51 years, weight 76.22±5.78 kg). Experimental group performed aerobic training and used green tea supplementation for eight weeks. Aerobic training was three sessions in the week and each session was 45 min with 65%-80% intensity of maximal heart rate. A total of 9 grams Green tea supplementation was used for three times per day. Before and after the exercise period, total data was gathered concerning questionnaire completion of physical activity and diet and taking blood sample. The data were analyzed, using the Kulomograf-smirnof, paired sample T-test, and independent sample T-test.Results: Combination of aerobic training and green tea supplementation, caused a significant decrease in weight and body fat percentage (P<0.05), but there was no significant effect on indices of total cholesterol, triglyceride, LDL-C, HDL-C.Conclusion: Obese and overweight women can loss body weight and body fat percentage by using aerobic training and green tea supplementation. However, dertermining positive effect of aerobic training and green tea supplementation on serum lipid profiles needs further investigation.

Introduction: Attention Deficit-Hyperactivity Disorder (ADHD) and epilepsy are both among common childhood disorders. Children with epilepsy are at a high risk for symptoms of ADHD. The purpose of the current study was to explore the prevalence of ADHD and its subtypes in children suffering from idiopathic epilepsy.Materials and Methods: The participants were 55 voluntary children with idiopathic epilepsy (29 boys and 26 girls) who went to Semnan Amir al’momenin hospital and Mashhad Ghaem hospital from December 2011 to June 2012. Criteria for entering this study included having age of 7 to 16 years old, diagnosis of epilepsy by neurology specialist and considering his/her dossier, seizures began at least 1 year ago and, outgoing criteria included to have one of psychiatric disorders (brain paralysis, autism,..), mental retardation (IQ<85). Parents of participants have completed the SNAP-IV questionnaire - Parent versions.Results: The findings showed that the prevalence of ADHD was 21.8% in epilepsy children. Prevalence of subtypes was 9.1%, 7.3% and 5.5% for inattentive, the hyperactive and combined types, respectively. The hyperactive type was more prevalent in generalized epilepsy and the combined type in partial epilepsy. In addition, the combined type was accompanied by various drugs in order to control the epilepsy. Sex and educational level didn’t have a moderating role.Conclusion: High prevalence of ADHD in children suffered from epilepsy necessitates the attention to medical interventions and prevention programs.

Introduction: Cardiovascular diseases are the leading cause of death around the world. Diet and nutrition play an important role in health and preventing from these diseases. Because dietary patterns have an important role in progression of CVD risk factors, we decided to explore dietary patterns and cardiovascular diseases risk factors of Mashhad city’s people.Materials and Methods: With the use of food-frequency questionnaire data from MASHAD Study, dietary patterns of healthy Mashhad’s adults (35-65 y old; n=1500) were identified by factor analysis and cardiovascular disease risk factors were investigated across the quintiles of dietary patterns.Results: Two major dietary patterns were extracted: mixed and westernized. The mixed pattern was characterized by high intakes of vegetables, fruits, chicken, seafoods, legumes and dairy products. The westernized pattern was characterized by high intakes of fast foods, soft drinks, red meat, coffee, french fries, tea, snacks and nuts. Weight, BMI and WC increased across the quintiles of both patterns while total cholesterol and LDL-c increased across the quintiles of westernized dietary pattern. HEI score was greater across the quintiles of mixed dietary pattern.Conclusion: These dietary patterns were weakly associated with cardiovascular diseases’s risk factors. On the other hand these dietary patterns identified were based on the real food intakes of healthy people and they were not representative of ideal dietary patterns, we need to assess different passes that mediated the relation between dietary patterns and cardiovascular diseases’s risk factors other than traditional risk factors.

Introduction: Beside assessment by physical examination a device also should be used to confirm the correct position of endotracheal tube immediately after intubation. Recent studies have shown that ultrasound can be a used to detect diaphragmatic motion as an indirect sign of endotracheal intubation.Our objective was to assess the sensitivity and specificity of ultrasound for verification of tube position after intubation and to evaluate whether ultrasound could be used as a usefull method for secondary confirmation of tube position.Materials and Methods: Ultrasound imaging was performed immediately after intubation for each patient. Scanning window was in right lower chest where the right lateral part of diaphragm could be imaged just on top of the liver. Then a second laryngoscopy was performed by the means of a glydoscope and tube position was assessed under direct visualization. Sensitivity, specificity and agreement between 2 methods were calculated.Results: Overall 100 patients with a mean age of 67.1±16.6 [SD] years were included in the study. The sensitivity and specificity of ultrasound for correct tracheal intubation was 97% and 100% respectively. Agreement between ultrasound and glydoscope in assessment of tube position was 0.713 which indicated that there was an acceptable agreement between the 2 methods. We successfully identified all 4 esophageal intubations and 9 tracheal intubations which had been positioned down in to the right main bronchus.Conclusion: Diaphragmatic ultrasound is a rapid, noninvasive and useful method for assessment of endotracheal tube position.

Introduction: Adult stature represents fundamental biological characteristics of individuals and populations. Stature estimation from skeletal dimensions is one of the essential parameters in the establishment of an individual identity. In this study, Relative parameters of ulna and tibia bones were measured with radiography and used to establish the mathematical models for stature estimation of Iranian adults (from 20 to 40 years old) in Tehran Province.Materials and Methods: The radiography of ulna and tibia bones of 49 male and 52 female adult individuals were taken on normal position and the lengths between relative landmarks were measured. The body height of each subject was recorded. Linear regression equations for stature estimation between body height and the lengths of ulna and tibia bones were established.Results: The mean stature of men and women estimated 171±3.6 and160±3.6 the mean length of tibia and ulna in menwere 43.6±0.4 and 27.3±0.6 and in women 40±1.8 and 25±0.74 single linear regression equations and 2 multiple regression equations were obtained.Conclusion: These equations could be used to estimate the body height of Tehranian population aged from 20 to 40. The lengths of the ulna and tibia bones measured on the Radiography films could be useful to stature estimation of the personal forensic identification.

Introduction: Cutaneous Leshmaniasis (CL) is a parasitic disease which is caused by different flagellated protozoan species of leishmania. The objective of this study was to evaluate the effect of electroporation on leishmania major promastigotes using different pulse durations in the presence of silver nanoparticles (SNP).Materials and Methods: Promastigotes of L. major were cultured in RPMI-1640 medium supplemented with 10% FCS at 27oC. The promastigote suspension with a concentration of 40 106 parasite/ml was prepared. It was incubated in the presence of SNP of 6 nm in two various concentrations. By an ECM 830 electroporator device 8 electrical pulses were applied in four duration widths of 50, 100, 150 and 200 microseconds with an electrical field magnitude of 2500 V/cm and a frequency of 1 Hz. Then 24 hrs later the percentage of promatigote survival was measured in each sample by the MTS method in order to determine the IC50 of SNPs and also the effect of certain electrical pulses in the presence and absence of SNPs.Results: It seems that in the presence of SNPs at 24 micromolar concentration, the contribution of electrical pulses with a duration of 150 microseconds and an electrical field magnitude of 2500 V/cm was successful in reducing the proliferation rate of promastigotes (p<0.004).Conclusion: Electrical pulses in the presence of SNPs can lead to a significant decrease in parasite survival rate.