Journal of Shahrekord University of Medical Sciences
Year:2005 | Volume:7 | Issue:3|Papers Count:16

Background and aim: Polymerase chain reaction (PCR) coupled with Restriction Fragment Length Polymorphism analysis (RFLP) has been used for genotyping of Mycobacteria in recent years. While detailed differentiation of non tuberculosis Mycobacteria has been described by this technique, even in some species ability of this technique for molecular epidemiology has been proven, only a small number of Mycobacterium tuberculosis (MTB) strains have been studied. The present study was conducted to apply this method to an expanded population of MTB isolates. Methods: A total of 150 clinical isolates were collected from patients referred to TB reference unit, PHLS, Ahvaz, Iran. Acid fast staining was performed for the isolates and they were identified as MTB by using conventional culture and biochemical tests. The PCR-RFLP method uses a simple DNA extraction followed by a PCR step based on amplification of a 439 bp fragment of hsp65 gene involving genus specific primers. The restriction enzyme analysis was then performed by digestion of products with HaeIII and BstEII enzymes. Results: Our results showed that 145 clinical isolates (96.6%) showed the identical restriction patterns similar to M. tuberculosis reference strains equal to 165/140/72 bp fragments for HaeIII and 250/120/82 bp fragments for BstEII digests. Three different patterns were observed for five clinical strains in HaeIII digest as 165/145 bp (three isolates), 180/100/80 bp (one isolate) and 194/72 bp (one isolate), while their BstEII digestion patterns showed no variation and were similar to other isolates. Conclusion: Our results showed that in clinical strains of mycobacterium tuberculosis, few polymorphisms in hsp65 fragment might be present.  

Background and aim: Intravenous (IV) insertion is a common painful procedure in pediatric care and it is a source of distress in children. Many children especially those suffering from chronic diseases such as thalassemia experince treatment procedures without any pain relief. This study was performed to compare the effect of distraction and eutectic mixture of local anesthetic (EMLA) cream on pain intensity of IV catheterizing in children with thalasemia. Methods: In this study a clinical trial was performed on 32 thalassemic children aged 5-12 years selected by convenient sampling method. The methods of distraction, EMLA cream and control (routine intervention) were used for each case in three stages with 14 days intervals. Data was collected by Ocher scales and CMFS questionnaire and was analyzed using t- and Wilcoxon test. Results: There was a significant difference between mean pain intensity (numeral and photographic) of distraction and EMLA cream methods compared to the control, but not between distraction and EMLA cream methods. Conclusion: Our findings showed that both distraction and EMLA cream procedures decreased pain of IV catheter with the same level of efficacy. However, since distraction method is more economical than EMLA ointment, it is recommended.   

Background and aim: With increased popularity of laser surgeries as a treatment for refractory errors and importance of pre-operative pachymetry for decreasing the complications of refractive surgery, correct measurement of corneal thickness is an important refractive procedure. There are two methods of corneal thickness measurement (phachymetry), optical method with orbscan system and ultrasonic method. This study was performed to compare the efficacy of these two methods in phachymetry. Methods: Corneal thicknesses of 324 eyes were measured with both orbscan and ultrasound phachymetry. Statistical analysis was performed using t-, ANOVA and correlation tests. Results: Corneal thickness was 504.28±26.23 µ using ultrasound pachymetry and 484.4±35.94 µ using orbscan system. The difference between the two methods was statistically significant (p<0.001). Conclusion: Corneal thickness measurement with orbscan and ultrasound systems might reveal different results and refractive surgeons should pay attention to this point. 

Background and aims: Scoliosis is referred to abnormal curvature of spinal column beyond 10 degrees. The most common type of it, is adolescent idiopathic scoliosis. Scoliosis screening test is the most economic and simplest method for diagnosis of the disease. Preferred age of scoliosis screening is 10-14 years old when growth spurt is occurring. Methods: This study was performed on 936 students between 10-14 years old in Shahrekord. Diagnosis was based on observation of asymmetric anatomical landmarks (such as spinout process، pelvic and shoulders), Adam’s forward bending test and radiographic measurement of Cobb’s angle. Results: Eighty-six persons out of 936 were referred to orthopedic clinic. Seven cases had idiopathic scoliosis, 5 females and 2 males. Two persons had thoracic, 4 had thoracolumbar and 1 had lumbar congenital curvature. Two patients had family history of scoliosis and overall prevalence of idiopathic scoliosis was 0.7%. During exercise all 7 patients got tired sooner than their classmates and had higher incidence of back pain. Two girls and one boy needed surgery. Also 3 girls and 1 boy needed Brace treatment. Conclusion: Using this method, the patients can be recognized easier and more rapidly. Therefore, both the curve progression and dysfunction of limb are inhibited leads to decrease need for surgery.  

Background and aim: Awareness of postpartum physico-sexual problems and its related factors could help better postpartum care. The aim of this study was to determine postpartum physico-sexual problems and its related factors. Methods: This cross-sectional study was performed on 384 women referred to 12 health centers in Isfahan for the first time after delivery. For each person a questionnaire was filled by interview. Data was analyzed by t-test and chi square test. Results: The results showed that most of the women (77.6%) suffered from physico-sexual problems: 2% complained of vaginal dryness during coitus, 3.7% of perineal pain (in the place of episiotomy or laceration), 14.5% of decline or lack of sexual desire, 24.9% of tiredness and 54.9% of a combination of these problems. There was significant statistical relation between number of delivery, number of children, marriage duration and physico-sexual problems. Conclusion: Regarding the high prevalence of women suffering from physico-sexual problems during postpartum period, health authorities should plan to deal with such problems. Therefore, health personnel can get familiar with these problems and know how to manage and deal with the primipara women.

Background and aim: Serous otitis media is one of the main causes of hearing disorder in human and its serious complication is permanent hearing loss. The aim of this study was to find the prevalence of serous otitis media in primary school students of Shahre-kord and to determine its relationship with allergy, family infancy feeding, birth weight, sinusitis, adenoid hypertrophy, gender, sex, age and the family size in these children. Methods: In this descriptive-analytical study, 1017 students (416 females and 518 males) were selected randomly and a questionnaire was filled for each one by the parents. Ear, nose and trout of each one were examined and suspected cases were referred to ENT specialist for further examinations. Results: The prevalence of this disease was 1.5%. There was a significant relationship between the frequency of serous otitis media and allergy (p<0.05). A significant relationship was also found between this disease and largeness of adenoid, family history of allergy as well as recent ear infection. Conclusion: Regarding the fact that, the history of allergy, as the most important predisposing factor for serous otitis media, has been found in 80% of the cases in this study, we suggest that tympanometry should be performed as a screening test, at least in patients with a history of allergy. 

Background and aim: Psychological complaints are common after motor vehicle accidents (MVA) and might be strong predictors for long term complications and problems of the accidents. This study was performed to compare the acute and delayed psychological complications of MVA in Shahroud.Methods: The sample consisted of 42 MVA victims selected by unrandomized sampling from those referred to Imam Hossein hospital. The general health questionnaire (GHQ) and symptom checklist-90-revised (SCL-90-R) were used for evaluating psychological symptoms and screening psychological patients. The mean scores of each psychological dimension in 4 phases: reception time, one, three and six months after the accident were obtained and were compared with statistical tests (t-test, repeated measures ANOVA and one-way ANOVA). Results: The average age of the sample was 24.4±8.5 years. The mean score of all psychological dimensions, except summarization and obsessive compulsive dimensions, increased from reception time to one month and 3 months later (p<0.05). Then the scores decreased to 6 months after the accident time (p<0.05). Three months after the accident time, unmarried patients had a higher score of depression compared to the married ones (p<0.05). The mean scores of depression, phobic, paranoid and psychoticism were higher (p<0.05) in unemployed versus employed persons. Conclusion: Based on our results, the psychological problems started from accident time until 3 month later. Therefore, the fast and early diagnoses of the complications, use of appropriate pharmacological and psychological interventions, also effective planning for their rehabilitation are both essential and important.

Background and aim: Treatment of inattention and impulsivity in attention deficit hyperactivity disorder (ADHD) is challenging. The aim of this study was to compare the effect of computer games versus computer assisted type instruction on inattention and impulsivity of primary school children with ADHD. Conclusion: With respect to the life time complications of ADHD children, and decrease in impulsivity by the computerized type learning in this study, we hope that with future studies, computer assisted instruction can play a role in the treatment of ADHD. Results: In the group I commission errors did not change significantly by the intervention. Commission errors decreased significantly in the group II (11.64±20.44 versus 14.10±10.18) (p<0.05). Omission errors and reaction time showed no significant changes in both groups. Methods: In this single blind clinical trial, 37 primary school children with attention deficit hyperactivity disorder were divided into two groups. Group I (n=17) and group II (n=20) underwent one month intervention by computer game and computer assisted type instruction, respectively. Intervention was consisted of eight one-hour sessions. The two groups were matched for age, sex, school grade, drug, school performance, parents and teacher Conners' scale, having computer at home and history of work with computer. Inattention (commissions) and impulsivity (omission) was tested with continuous performance test, pre- and post-intervention.

Background and aim: Gastric disorders especially nausea and vomiting are the most common complaint during pregnancy. Previous studies have shown that nearly 20% of pregnant women visited physician for these problems. The aim of this study was to compare the effect of acupressure and Vit. B6 (pyridoxine) on reduction of nausea and vomiting in primigravida women. Methods: In a clinical trial study, 100 women with gestational age of 10-16 weeks and single fetus were randomly selected from primigravida women who referred to antenatal care centers of Ahvaz for nausea and vomiting. Then they were allocated to acupressure (n=50) or pyridoxine group (n=50). Treatment with acupressure or pyridoxine was carried out for four days. In acupressure group sea band was placed on the neiguan (p6) point of hand and in pyridoxine group, each patient had 40 mg of Vit. B6 every day. Severity of nausea and vomiting was recorded by each subjects. Data was analyzed by Chi-square, Manwithney, Wilcoxon and t-tests. Results: Our results showed that nausea score and frequency of vomiting were decreased significantly by both treatments (p<0.001). Also acupressure was significantly more effective in reduction of vomiting frequency (p<0.001). The severity of nausea was not different in two groups. Conclusion: Our results showed that acupressure was more effective than Vitamin. B6 in treatment of pregnancy vomiting. Regarding the fact that sea band is cheap, comfortable, available and easily use, it is recommended to reduce vomiting in pregnancy.  

Background and aim: Diabetes is a major endocrine disorder and is characterized by metabolic abnormalities, retinopathy, neuropathy, nephropathy and atherosclerosis. In this disease, the patients play important role in their treatment. Therefore, this study was performed to show the importance of self-care on foot healing of diabetic patients. Methods: In this quasi-experimental study, 54 diabetic patients with foot wound were randomly divided into two groups of case (n=30) and control (n=24). The case group was followed up for 3 months after 3 or 4 self-care educational sessions about insulin ejection, drug administration, diet and wound care. In order to evaluate the outcome of educational program, a checklist was filled every other week. Also wound condition was checked 1, 2 and 3 months after the intervention. HbA1c was measured before and after the intervention as self-care criteria. Results: The amount of HbA1c was not different between two groups before intervention but it decreased in the case group 3 months after the intervention (p<0.05). Also the wound recovery grade increased (p<0.05) in the case group 3 months after the intervention. Conclusion: Findings of this study showed that self-care in the diabetic patients has a great influence on treatment and prevention of complications of the disease.  

Background and aim: In human body, there are a number of special systems to defend the damages caused by antioxidant. In some diseases the defense system against antioxidant activity alters and this alteration may be used in recognizing and the processing of different diseases. Diabetes is one of the most common and important chronic illnesses in which the antioxidant capacity is altered. The aim of this research was to determine and compare the antioxidant capacity of both serum and saliva of diabetics compare to the control group. Method: This is a cross - sectional research in which those under studying are 42 people of with type II diabetes mellitus coming and going to the Arak diabetes center as the case group with 42 people of control group which were in the same age and sex with the people in the case group from the point of total antioxidant capacity in serum and saliva were compared. The capacity of antioxidant in serum and saliva was measured by FRAP method. Results: The average and standard deviation (mean±SD) of the total antioxidant capacity of serum and saliva in case group were in range: 2.51±0.088, 1.90±0.110  µm/ml and in control group were: 2.90±0.107, 1.97±0.098 µm/ml .(P=0.001, 0.74) From the statistical viewpoint, the increase in the total antioxidant capacity of serum in case group was meaningful, but the decrease in the total antioxidant capacity in saliva was not meaningful. Conclusion: Our results showed that the antioxidant capacity in the patients, s serum was higher than that in the control group. However, this difference was not observed in the saliva of these two groups. Conclusively, if this capacity of antioxidant is used in recognizing and processing of the disease, this difference should be taken into account.

Background and aim: Migraine headache is a common familial disorder and its prevalence varies base on sex, age and races. There are two types of treatments for migraine: acute headache treatment (abortive) and preventive treatment. There are a number of drugs such as betablockers are used to prevent migraine attacks. Propranolonl is the most common betablockers used. Also, non-pharmacological treatments such as Transcutaneous Electrical Nerve Stimulation (TENS) are used for prevention of migraine. The aim of this study was to compare the effects of propranolol and TENS in prevention of migraine attacks. Methods: This clinical trial study was performed on 60 patients diagnosed as having migraine headache based on international headache society (HIS) criteria by a neurologist. They were divided randomly into two groups of 30. One group was treated with TENS for 10 sessions and the next with propranolol (40 mg/day) for 6 months. Frequency, duration and intensity of headache were evaluated 3 and 6 months after the treatments. Data was analyzed by c2 test. Results: Three months after treatment, 90% of TENS patients had no headache while 40% of propranolol patients were headache free. Mean intensity of headache changed from 6.8±1.2 to 0.65±2.06 in TENS group while it changed from 6.7±1.2 to 3.2±3 in propranolol group. Conclusion: The results of this study showed that TENS is an effective treatment for prevention of recurrence headache in migraine patients.