Journal of Shahrekord University of Medical Sciences
Year:2002 | Volume:3 | Issue:4|Papers Count:13

Retirement is a transition from one social role to another and it requires change of living pattern and adaptation with the new situation. Some of the retirees will experience preventable health care problems. There are about 6 millions old people that 2 to 3 millions of them are retirees and they need some special attention. This descriptive and analytical study was performed on a sample of 364 cases selected by simple sampling from retirees referring to the retirement center. The data was collected using retirement assessment questionnaire (R.A.Q). Our results showed that daily living situation of 54.9% of the retired people was relatively suitable, 41.4% suitable and 3.7% unsuitable. Some factors such as gender, health condition and planning a pre-retirement program were found to have a significant relationship with situation of daily living. Therefore, in spite of lack of prepared programs, living situation of most of the retirees was suitable and a minority of them suffered from some problems that more attention must be paid to them and pre-retirement programs should be planned for adapting with changes after retirement.

Natural cytotoxic cells (NC) are considered as one of the arms of the innate immune system against cancer. NC-1.1 has been reported as a marker on these cells, but the origin and the role of the receptor(s) are unknown. This experiment was carried out to address these questions. Spleen cells of the CBA mouse were cultured in an interleukine-3 (IL-3) rich medium, and natural cytotoxicity of the cells were evaluated at different development stages using cytotoxic assay method. By using Wright giemsa and Alcian blue staining techniques and the mouse mast cells proteinase, the characteristics of cells were identified. Furthermore, surface receptors of the cells were recognized using flow cytometric analysis at different times in the culture. The cells that were cultured in IL-3 rich medium were named mouse mast cell line (MCL). They were large and granular with abundant cytoplasm and 90% of them were stained with Alcian blue, a mast cell- specific stain. Probing the total RNA with cDNA, which encodes a mast cell specific proteinase (mPCP-5) identified the mMPC-5 transcript, which was confirmed at protein level. These cells lack receptors specific for macrophages B, T and NK, but express CD3 2/CD 16 receptor for FC portion of antibody and NC-1.1 receptor which mediates NC against WEHI-164 fibrosarcoma. The NC activity of MCL cells increased with time in the culture. Thus long-term culture of murine spleen cells in IL-3 induces mast cells line which express NC- 1.1 receptor meJiating NC against W6HI-164 fibrosarcoma and have no receptor for macrophages B, T, and NK cells.

Based on the gate theory of pain, an apparatus was manufactured for transcutaneous electrical nerve stimulation (TENS) that relieves some pains. Since this method inflicts no harm to the patients and due to cultural and environmental effects on the intensity and tolerance of pain, this study was performed to determine the effectiveness of the method on alleviating of labor pain in the province of Chahar Mahal & Bakhtiary. TENS was used in 50 nulliparous patients and reduction of pain intensity, duration of delivery as well as patients' inclination for future use of TENS, were compared to those of a control group that used placebo. Our results showed that there was a marked reduction in the duration of active phase of labor and a higher tolerance of labor pain and a higher inclination for reuse of the method in the case group compared to those of the control group. 52% of the case group inclined to reuse TENS for future labor. Also there was no significant reduction of labor pain in the case group. It can be concluded that due to the effectiveness of this method, its usage is advisable.

Nosocomial infections are of particular concern to the medical and nursing professions. These infections are caused by pathogenic organisms that are transmitted to patients by hospital personnel, medical instruments, etc. This study was carried out in Shahrekord Kashani hospital to identify these pathogenic bacterial strains and also their sensitivity to some antibacterial agents. 140 swab samples were collected from nursing station tables, food dishes, staff hands, tracheal tubes and other parts of seven wards of the hospital and were cultured for the identification of pathogenic bacteria. Antibacterial sensitivity tests were also performed using povidone iodine 10%, ethylic alcohol 70% and cetrimide-C 1.3%. 28% of the collected samples were positive for pathogenic bacteria. 49 bacterial strains were isolated from the samples, from which Staphylococcus aureus was the most prevalent one. Besides, Esherchia coli, Staphylococcus epidermidis, Pseudomonas aeroginosa and klebciella species were isolated. Approximately all of the pseudomonas species were .resistant to the most concentrations of antibacterial agents. However, povidone idodine 10% and cetrimide-C 3% had the best antibacterial effect on the gram (+) and gram (-) bacterial strains. Cetrimide-C was more effective on gram (+) strains. As a result, the control procedures and using the proper antibacterial agent in disinfection of hospital and medical instruments should be repeatedly notified to the medical staff.

In this study, a new sign for clinical diagnosis of acute appendicitis is introduced. The study was performed on a sample of 250 cases simply selected from the patients with acute appendicitis admitted to Al-Zahra Hospital of Isfahan. Before operation, the patients were evaluated for this sign in order to. assess its predictive value in diagnosis of acute appendicitis. Following the intervention, the appendix was sent to the department of pathology to confirm the diagnosis. Abdominal examinations prior to operation included checking the superficial and deep tenderness, rebound tenderness, Rovsing and the new sign. To check the new sign, while the patient was lying in a supine position, then the physician places his left hand below the right costovertebral angle and inflicts a few short thrusts on the flank. In case, the patient feels pain in front of the lower abdomen, and with his/her hand locates the pain, it will be considered as a positive sign. Then predictive value, sensitivity and specificity of the new sign in diagnosing acute appendicitis were assessed. For comparison of the qualitative variables chi-test and for the quantitative variables Hest were employed. The results showed that sensitivity of the new sign is 67%, its specificity is 35%, its negative predictive value is 32% and its positive predictive value is 72%. This new sign here after named (BEHDAD SIGN) can, along with other signs, helps to diagnose acute appendicitis.

Bacterial vaginosis is common, and involves, bacterial as well as fungal and protozoal agents. Gardenella vaginalis is an organism often suggested as playing a major role in bacterial vaginosis. The current cross-sectional study was carried out on 227 women with vaginal discharge referred to the women"s outpatient clinic in Borujen from Apr. to Oct. 2000 in order to determine the frequency of cases and to evaluate the diagnostic criteria for the infection. A questionnaire including some general and clinical information was completed for all cases. The minimum diagnostic criteria sufficient for the identification of bacterial vaginosis included the clinical symptoms, presence of clue cells in the "Gram staining of vaginal discharge, homogeneity of secretions with a pH > 4.5 and a positive reaction to amin (Whiff) test. Bacterial culture and isolation of G. vaginalis were implemented using conventional differential tests on a selective bacterial medium as recommended by Ison et al. 43 out of a total of 227 cases (18.9%) were found to have bacterial vaginosis. All the women with bacterial vaginosis were married and the majority of (69.9%) belonged to 20-39 age group. G. vaginalis was successfully isolated from 76.7% of bacterial cultures. All positive samples revealed clue cells, 90.7% had a pH>4.5, 81.4% were positive for amin test and 67.4% had a homogenous secretion. We did not find a significant relation between IUD application and incidence of Gardenella associated vaginosis. Since all women with vaginosis due to G. vaginalis were married, a conclusion can be made on a relation between sexual activity and occurrence of the infection.

Refractory ceramic breaks are non-crystalline or amorphous made from melted kaolin clay or a combination of AlI02 and Si02, and they can produce obstructive airway diseases. This descriptive and cross sectional study was performed on 145 workers of a refractory ceramic break factory in Isfahan. Respiratory symptoms and pulmonary function were evaluated using spirometry, physical examination and a questionnaire. Mean age of the participants was 39.5±7.62 (26-61) year, and 33 workers (22.8%) were smokers. Noisy breathing was detected in 38 cases (26.2%) and noisy breathing along with dyspnea was detected in 33 cases (22.8%) of the sample. Pulmonary function tests revealed evidence of obstructive airway disease in 63 workers (43.3%) and small airway disease in 81 cases (55.9%). The prevalence of airway diseases in this factory was higher than that of the western countries' refractory workers. Therefore it is import to promote the safety measures as well as workers' knowledge for implementing them.

Diagnosis of migraine in children may encounter with some difficulties due to their low ability to express the disease history, and some of the affected children with a diversity of symptoms may face with some invasive treatment measures like surgery. The present study was carried out to evaluate the diagnostic value of EEG for migraine in 5-15 years old children. The sample consisted of 70 children with symptoms such as headache, vertigo and abdominal pain, referred to the hospital or private clinics. A stimulating EEG was recorded from all of the patients. The diagnosis of migraine was based on the WHS and HIS codes. In 57% of the cases, headache, vertigo and abdominal pain attack lasted 1-6 hours, in 34% the duration was more than 6 hours with a maximum of 2 days and in 9% the duration was less than 1 hours for more than two days. The main complaints of the patients in 42.5% of the cases were nausea and vomiting. Light was the most important predisposing factor for the migraine attacks (32%). 57% of the patients had a common migraine and 10% a classic migraine. More than 34.2% of the patients complained of vertigo. Abnormal EEG changes were present in 31% of the cases, including, sharp waves observed in 18.6%, spike waves in 3.9%, and focal slowing in 8.5%. Eighty one percent of the patients with abnormal EEG had a common headache, 18% had a classic headache and the rest could not localize the pain. 58% of the patients with an abnormal EEG complained of vertigo as well. EEG changes were significantly different between children of 11-15 years old and those of under 11 years old. Also the probability of an abnormal EEG in patients with migraine and vertigo was significantly higher than those with migraine headache without vertigo. The EEG changes in bi-or unilateral headache were similar. The study showed no relation Ship between frequency or predisposing factors of recurring migraine attacks and EEG changes. Therefore while EEG is not a definitive method for diagnosis of migraine, but in suspected cases the EEG changes may be attributed to migraine headache and if the vertigo associates with headache the two symptoms will increase the chance of migraine diagnosis.

Rheumatic fever is a delayed and non-suppurative streptococcal infection of upper respiratory tracts. Its diagnosis relies on clinical findings and supportive evidence of a recent group A streptococcal infection. The latter may be provided by elevated or rising ASO titer. Since normal range of ASO titer depends on the test type, age and geographical area, it should be interpreted cautiously. Because a normal range has not been established for this area, we determined the median, mode and upper limit of normal ASO titer in healthy children, and adolescent's sera in this city. We also investigated the relation of ASO titer with some background variables. This cross sectional study was performed in the spring of 1998. 400 students (7-14 years old) were selected from 19 primary and guidance schools by a random-stratified method of sampling. The exclusion criteria were 1- history of recent streptococcal infection, 2- evidence of streptococcal infection by physical examination, 3- history of rheumatic fever in the student or a family member. The median, mode and upper limit of normal ASO titer was 166 T.U. (Todd unit) Using a Mann-Whitney-U test revealed no significant differences between ASO titers in different age and sex groups. Statistical analysis revealed a significant relation between ASO titers and family size and socioeconomic status. Although the upper limit of normal of titers in our study was different from other studies but the prevalence of high ASO titers in our study was similar to other findings. This confirms that a specific cut-off point level cannot be used as a standard level of normal ASO titer everywhere and it varies from site to site.

As a part of the national project for primary prevention of acute rheumatic fever, this study was performed to determine the prevalence of group A, Beta hemolytic streptococcal (SβHA) pharyngitis and the healthy carrier rate. This part of the study was a descriptive and cross-sectional survey accomplished on more than 1000 students and patients (5-15 years old) selected randomly from all over province. Another aim of this study was to determine the MIC (minimum inhibitory concentration) and MBC (minimum bactericidal concentration) of penicillin on SβHA. The results showed that the carrier rate was 4.7%. MIC was 0.03 to 31.85 and MBC was 0.06 to 125 units/ml, showing the presence of resistant and tolerant varieties of SβHA to penicillin.