Journal of Shahrekord University of Medical Sciences
Year:2004 | Volume:5 | Issue:4|Papers Count:13

Sensorineural hearing loss is a relatively common disorder that causes different degrees of reduction in voice perception and speech recognition. Its incidence is 1 in a 1000 neonate of which 50% is the result of genetic factors. About 80% of the hereditary deafness cases are non-syndromic and are inherited in an autosomal recessive mode. Recent studies show that mutation in the connexin 26 gene (GJB2) on chromosome 13 is associated with autosomal recessive non-syndromic hearing loss (ARNSHL) in many populations. So study of pedigree patterns of families having at least one member affected with hearing loss will hand a valuable information about its etiology and also its mode of inheritance. The results will make us able to help such families in genetic counseling procedure and in determining the high-risk cases. Also it will be a good point for starting molecular study to identify the related mutant gene/s.This descriptive and analytical study was performed on all families (N=30) that had at least one member with ARNSHL studying in Baghcheban Center, Hamadan, Iran. Data was obtained from files of the affected cases, then the suitable questionnaires were filled after face to face interviews with their parents. The cases were indicated as deaf if they had hearing loss more than 40db. Then based on the results of the interviews, their pedigrees were drawn and based on the standard criteria, the pattern of inheritance was determined. By employing the descriptive statistics, the results were evaluated and analyzed. Finally the results were compared with others and the role of consanguinity and genetic isolation in occurrence of hearing loss was studied.The results showed that pedigree patterns in all families interviewed were autosomal recessive. 90% of parents had consanguineous marriages and half of the families were related to the isolate groups.

Keloid and hypertrophic scars are abnormal healing responses to injury due to overgrowth of dense fibrous tissue developing after healing of skin injury. Several treatments for keloids and hypertrophic have been suggested, from which cryotherapy followed by intralesional corticosteroid injection is the most common. The aim of this study was to compare the therapeutic responses of bleomycin tattoo and cryotherapy followed by intralesional triamcinolone injection methods for treatment of keloids and hypertrophic scars.The study was performed on 45 patients divided into two groups. Group A (23 patients) treated with bleomycin tatto and group B (22 patients) treated with cryotherapy and intralesional injection of triamcinolone. Each group received one treatment per month for a period of four months, and was followed up for three months after the treatment. Therapeutic response was defined as the percentage of scar height reduction. Patients treated with bleomycin showed 88.3%±14 and the next group showed 67.3%±22.5 reduction of scar height, that were significantly different. Also 69% of group A and 49% of group B became symptom free. It is concluded that bleomycin tattoo showed a better therapeutic response for Keloid and hypertrophic scars.

Diagnostic radiology is one of the most useful applications of radiation in the world. To reduce unnecessary exposure in this imaging modality, implementation of a quality control (QC) program is vital. In this study, to reduce absorbed dose and to increase the image quality, various QC parameters were evaluated for x-ray machines consisting of kilo volt peak (KVp), milli-ampere (mA), exposure time (ms), focal film distance (FFD), inherent filters, additional filters, half value layer (HVL) and processor condition. To apply these parameters seven x-ray machines in six diagnostic radiological centers were selected and were kept under QC program. To compare the doses before and after implementation of QC programs chest x-ray examination was done on 10 randomly selected patients for each machine. The dosimetry showed that the average entrance skin dose (ESD) for each chest x-ray examination was 0.7 mGy before application of QC program. The average absorbed dose for chest examination was %40 after application of the program. Number of patients under radiological examination is about 500,000 persons. If a similar QC program was exactly performed in all diagnostic centers of this province, the collective dose will be reduced to (500000×0.28 mGy) =140 Man-Sievert. Therefore, by implementation of a QC program, the absorbed dose and cancer risk resulted from diagnostic radiology will be effectively reduced.

ECT is a process in which a generalized seizure is induced by passing electrical current for 25 to 150 seconds through the brain under general anesthesia. It is a highly effective treatment for major depression, mania and schizophrenia. Seizure is terminated by active inhibitory processes. The inhibition of seizure is due to the production of endogenous opioids. Naloxone, as an opioid antagonist, may lessen the effect of endogenous opioids. This clinical trial study was conducted to determine the effect of naloxone on length of the seizure.Sixty patients (30 male and 30 female), who met the diagnostic criteria were included in this study. The control group comprised of 30 patients, received ECT without naloxone, and the experimental group comprised of 30 patients, received ECT and 2 mg naloxone (i.v.). Duration of seizure was compared between two groups by t-test.The mean of seizure length was 21.3s in the control and 27.8s in the experimental group. Therefore naloxone can be used for lengthening of seizure and consequently for improving its treatment benefit.

Head trauma can result in severe disabilities and problems for patient, families and society. Trauma is the third most common cause of mortality and disability, and more than 50% to 70% of the mortality is due to head trauma. The aim of this survey was to search for epidemiological, etiological and radiological findings in 1510 patients admitted to Kashani General Hospital from June 2000 to May 2001. The patients consisted of 74.1% males and 25.9% females, and 25% of them were 11-20 years old. The main reasons for admission was falling (33%), car accident (29%) and assault injury (15%). With respect to the consciousness level, according to Glasgow Coma Scale (GCS), the patients were divided to severe (4.5%), moderate (6.9%) and mild (88.6%). 58% of the patients had multiple traumas. High percentage of trauma in the second decade of life, trauma with contact mechanism (e.g. compound depress fracture) and assaults injury (15%) were peculiar to this survey. Overuse of X-ray (in more than 78%, with less than 5% positive findings) and CTS (with 84% normal report) in these patients highlight the need for revising of the use of these techniques. Since there was a high percentage (53%) of mortality among patients referred from other centers, the diagnostic and treatment facilities of the referring centers should be improved

In a health system, after finding a sputum positive TB, the closed contacts of the patient are followed-up to detect new cases. The aim of this survey was to assess the effectiveness of the surveillance system in Shahrekord and Broojen. During a 5 year period, 56 files (16 from Broojen and 40 from Shahrekord) of sputum positive TB were selected, and detection of new cases during the next five years was checked. The registered follow-up items included gender, age, vaccination, scar of BCG, smear of sputum, culture of sputum and chest x ray.In Broojen there were 16 patients with 122 closed contacts, from whom 74 persons were close relatives and 23 of them were under 6 years old. In most of the closed contacts the follow-up items were registered. One out of 11 cases of TB patients of the second period was from the closed contacts of first period TB patients.In Shahrekord there were 40 TB and 212 closed contacts with 165 persons at risk. Follow-up items were registered in less than 10% of cases. Eight TB positive cases were reported in closed contacts 10 days to 3 years after the index cases, but there was no follow-up activity for them.Follow-up in Broojen was more regular than in Shahrekord. Unfortunately the follow-up activities in Shahrekord did not end up to case finding. Based on this survey, 9% to 21% of new cases of TB may be due to failure of health system. Performing similar surveys in other health care systems of the country may help to find the probable faults.

Obesity is the most common nutritional problem in the industrial countries, which has negative physical and emotional effects. The purpose of this study was to determine the 90th percentile of BMI and some risk factors of obesity in school-age children. The study had a cross sectional and a case-control part. In stage one weight and height of 2772 children were measured and 90th percentile of BMI was calculated. In stage two, 188 obese children as the case group and 282 non-obese children as the control group were selected and both groups completed a risk factors questionnaire. Our results showed that children with BMI<18.26 are nonobese. Prevalence of obesity was 9.97%. There was significant correlation between parental or close relatives' obesity, some kinds of foods, birth weight (only in girls) and children's obesity. There was no significant correlation between socioeconomic status, diseases such as asthma, education level of parents and children’s obesity.

There is controversy about the effects of fasting on prenatal care. Therefore this study was performed to assess prenatal care changes during Ramadan. Six hundred and twenty-three women were selected by simple sampling method. Three urine samples were collected for each case: One week before Ramadan in the morning; One hour before Eftar on the 14th and 28th of Ramadan. Blood pressure, weight, height of pelvis, fetal heart rate and fetal activity were examined at the same intervals.Four hundred and sixty-six cases that did not fast in the first half of Ramadan, were chosen as the control group. 152 cases had 7 days of fasting, 130 cases had 15 days of fasting and 488 cases did not fast. Fifty-five percent, 26% and 19% of the cases were in the third, in the second and in the first trimester, respectively.Body mass index was not significantly different between case (fasting) and control (non fasting) group. The heart activity and fetal heart rate hearing was 45.5% before and 75.6% at the end of Ramadan. At the middle and at the end of Ramadan, the positive ketone was higher in fasting women compared to that of the control group. Systolic and diastolic pressures were not significantly different between two groups. This study showed that fasting may not be a serious problem for pregnant women if they receive proper medical care.

Migraine headaches are of common kinds of headaches which cause significant changes in the patient's lives. A decline in individual, social and occupational functions can be mentioned so treatment and follow up may lead to a better life. We studied the incidence rate of migraine headaches and related fall in education in 550 girls in high schools in shahre-kord region in Ordibehesht 1381 (may 2002). Sampling was in different stages using HIS and MIDAS questionnaires to study the incidence of migraine headaches and related fall in education respectively.73 students out of 550 (13.3%) had common migraine headaches and the related symptoms were photophobia (100%), nausea or vomiting (86.3%) and paleness (72.6%), headache lasted 4-72 hours in 100%, pulsative headaches in 90.4% and unilateral headaches in 71.2%. There was a positive family history in 80.8% of cases. No relations were found between migraine headaches and different steps of education and also between severity of the headaches and the level of decline in education. But headaches worsening with activity in 98-6%, medium to sever headaches causing interruption in daily activities in 58.9%. Because of these great effects of migraine headaches in young people, it is necessary to find predisposing factors for the headaches by giving information to their parents and teachers and a good programming and in time treatment are useful in Quality of educational function.

Cryotherapy (cold therapy) is a physical therapeutic method that is used for treatment of acute injuries. The effect of cold on muscle strength has recently been studied. Power grip is flexion of all fingers of a hand to hold objects. The purpose of this study was to determine the effects of cold and cold plus exercise on the grip strength. Sixty male undergraduate students, between 18 to 26 years old, were randomly selected and divided into two groups: cold and cold+exercise. First, grip strength, pinch strength and muscle strength were measured using a dynamometer, and the cold+exercise group members exercised for 5 minutes. Then arm of each member of both groups was immersed in a cold bath at 10- 15 degree Celsius for 30 minutes. Immediately following cold bath, strength measurements were repeated every 20 minutes for a period of 80 minutes. The data was analyzed with ANOVA and paired t-test.There was no significant increase in the grip and muscle strength after application of cold or cold+exercise. Application of cold or cold+exercise caused an increase of grip and muscle strength but returned to approximately normal valve. A significant increase of pinch strength was observed in both groups, that was higher in the cold+exercise group.It was concluded that cold+exercise method is not a useful therapeutic physical method for long-term treatment.