Journal of Shahrekord University of Medical Sciences
Year:2006 | Volume:8 | Issue:3|Papers Count:16

Background and aim: The micronutrient deficiency is an important health problem around the world. Among the micronutrients, iron and zinc deficiencies are the most common. The aim of this study was to find the effects of iron and zinc supplementation, alone or combined, on iron and zinc status of the primary school children.Methods: The study was a randomized double-blind clinical trial in which 81 primary schoolchildren of 11 years old were divided into 3 groups. Group 1 were supplemented with iron (20 mg/d), group 2 with zinc (20 mg/d) and group 3 with iron plus zinc (20 mg/d of each) for 4 months. At the beginning and at the end of this intervention, using cell counter, radioimmunoassay, and atomic absorption, hemoglobin plasma ferritin and serum zinc, the children, were measured. Data was analyzed using ANOVA, paired t test, Wilcoxon and Kruskal-Wallis tests.Results: Our results showed that using either iron or zinc alone and using both of them together significantly increased the serum zinc level to 4.5±2.1, 4.5±2.7 and 3.6± micromole per liter, respectively. Among the 3 groups studied, zinc supplementation had the most benefit for the children who suffered from zinc deficiency (p<0.01). Using iron complementation alone, resulted in an increase in serum ferritin, while using zinc alone, led to a decrease in plasma ferritin (p<0.01). Both iron and zinc supplementation and the combination of them had no significant impact on blood hemoglobin. Conclusion: Supplementation with either iron or zinc, would improve serum zinc and plasma ferritin.

Background and aim: Economic analysis should be applied to hospitals for optimization. Therefore, this study was conducted to evaluate the economic behavior (production-cost) of general hospitals of Iran University of Medical Sciences from 1997 to 2004.Methods: Data was collected using appropriate questionnaire and analyzed by t-test. In this research, Cobb-Douglas function and its T form was used for evaluation of production and cost, respectively.Results: The marginal production of hospital labor for physician was 57, for nurse was 24, and for other personal was 0.04 of the patient admission. The marginal product of capital agent was 18 patient admissions. The personnel and non-personnel costs were 62 and 38 percent of the overall operatic costs respectively. Cost elasticity of overall expense to labor price, capital rate and production was 0.69, 0.48 and 0.32, respectively.Conclusion: The hospitals can be on the decreasing part of LRAC (Long Run Average Cust) care and can decrease the unit cost of production with increasing economic agents.

Background and aim: Wastewater treatment is carried out with various techniques. The conventional techniques are used for treatment of wastewater containing biologically active materials. The limitations of active-sludge method are production of sludge and failure of removal of carbohydrate and organic containing pollutants. Combination techniques are used successfully for treatment of industrial effluents including petrochemical, textural and similar wastewater. The aim of this study was to perform a combined biological system including fixed media reactor (Biofilm system) and ozonation and to compare the results with those of the conventional techniques. Methods: This experimental-applicable study was performed to construct an experimental model using an aerated fixed film biological reactor with ozonation. At first, the imported and exported parameters of treatment plant of Shahrekord were tested. Then, following the set up of a pilot plant, the effluents of the plant using biological treatment with and without ozonation were measured. Results: Our results showed that the mean of chemical oxygen demand (COD) in the pilot input was 541.2±171.3 mg/lit and in its output at the first and the second step was 226.6±194.4 and 64.1±26.6 mg/lit, respectively (p<0.05). The mean of biological oxygen demand (BOD) in the pilot input was 227.9±78.2 mg/lit and in its output at the first and second step was 106.6±64.5 and 55.8±30.4 mg/lit, respectively (p>0.05). The percentage of decolonization was 80 to 90 percent. The efficiency of ozone transfer to wastewater was 35 to 45 % and ozone consumption for each gram of COD removal was 0.35 to 0.75 milligram. Conclusion: The results indicated that the combination of ozonation and fixed media biological reactors are strong tools for treatment of pollutants in wastewater. Removal of organic pollutants was considerably higher than that of the conventional methods and the sludge production was the lowest.

Background and aim: Listeria monocytogenes is a food borne pathogen capable of causing outbreak or sporadic episodes in human. Most of the outbreak or sporadic episodes were in the last two decades and due to high rate of mortality, caused a great concern in food industries. There are various medicinal plants with the high performance of antibacterial activity in Iran. The present study investigated the anti-listerial activity of some of these palnts against two serotypes of foodborne L. monocytogenes.Methods: The plants were used included: Thymus vulgaris L., Eucalyptus globulus Labill. Matricaria recutita L, Rosmarinus officinalis L and Saliva officinalis L. The plants were selected and identified by Pharmacognosy Department of Isfahan Faculty of Pharmacy. Extracts of the selected plants were prepared. Then antibacterial activity of these extracts was determined by disc diffusion method. The Minimal Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) were also determined by the serial dilution method. Ampicillin (10 µg/disc) used in the test as standard.Results: Only ethanolic extract of Eucalyptus showed antibacterial effects against L. monocytogenes in both disc diffusion and serial dilution method. MIC and MBC of this extract were 31. 25 µg/ml and 500 µg/ml, respectively. There was no significant difference between the sensitivity of the two serotypes. Extract of other plants did not show any antibacterial effects against L. monocytogenes.Conclusion: Based on our results, only the extract of Eucalyptus showed antibacterial effects on both serotypes. Using other extraction methods and higher concentration of extracts may cause stronger antibacterial effect on L. monocytogenes.

Background and aim: Despite the rapid diagnosis and treatment of diarrhea, it is still a health problem among infants and children. It has been shown that zinc deficiency, which is common in Iran, is one of the important causes of the diarrhea. Therefore, the aim of this study was to find the effects of zinc supplement on treatment period of acute diarrhea in 6 to 36 month old children.Methods: This double-blind clinical trail study was performed on 200 children with non-invasive acute diarrhea hospitalized in Amir Kabir hospital, Arak. They were divided into two groups of the case and control by simple random assignment. The case and the control group had 3 mg/kg/day zinc and placebo, respectively. Independent t-test was used for analysis. Results: The mean age of the children was 14.07±8.18 months. The average of hospital admission days for the case and control group was 3.14±0.125 and 3.59±1.83 days, respectively (p<0.05). Also, the mean of admission days for children with moderate dehydration in the case and control groups was 2.69±0.73 and 3.11±1.29 days, respectively (p<0.05). In the children with severe dehydration in the case and control group, it was 4.65±1.46 and 5.22±2.7 days, respectively (p<0.05). The duration of admission of the case group was 3.29±1.41days for children with 6-12 months, 3±0.98 days for children with 13-24 months, and 2.9±1.25 days for children with 35-36 months old (p<0.05).Conclusion: Based on the results, zinc supplement reduces duration of diarrhea in the children with acute diarrhea. Therefore, it is recommended for treatment of this syndrome in these children.

Background and aim: Nosocomial infection is an important health problem. The operation rooms of the hospitals are potentially favorite places for distribution of these diseases. It is now known that using standard control methods could prevent the infections. The aim of this study was to find the application level of these methods in Shahrekord university hospitals and to compare them with the present standards methods.Method: This descriptive analytical study was performed in three operation wards including 7 operation rooms. Data was collected using a questionnaire consisted of 54 questions about facilities and equipments, 8 questions about personnel practice related to infection control, 12 questions about individual hygiene and scrub methods, 8 questions about disinfection and sterilization and 7 questions about using preventive measures. The data was analyzed using t test.Results: The findings showed that application of disinfecting and sterilizing methods (93.75%), individual health, scrub methods (79.2%), and the patient admission process (84%) were poor.Conclusion: In conclusion, the operation wards have to be reviewed and supervised regularly for personnel, equipments, buildings, and training of the personnel to use disinfection control methods.

Background and aim: Many people still use plant-derived medicines for their basic health requirements. Zingiber officinal Roscoe (Ginger) is a spice that has been used since two thousand years ago as a medicine in several Asian countries. Increase of creatinine and blood urea nitrogen (BUN) level is representative of renal failure. Therefore, the aim of this study was to investigate the effect of hydroalcoholic Zingiber extract on creatinine and BUN in order to estimate the renal function.Methods: In an experimental study, 10, 20, 40 mg/kg of a hydroalcoholic extract of Ginger was administered intraperitoneally (IP) to male mice every other day for 20 days. Subsequently, using ophthalmic puncture method, their blood was used to measure BUN and creatinine levels.Results: The mean of BUN concentration in the control group was 37.68±3.89 and in the case groups received 10, 20, and 40 mg/kg of hydroalcholic extract of Ginger during 48 h were 21.54±11.38 (p<0.05), 25.3±3.42 (p<0.01), and 20.79±6.61 (p<0.01), respectively. There was significant difference between the case and the control group for BUN level (p<0.01), but not for the creatinine level. BUN/creatinine ratio was significantly (p<0.05) different between the two groups.Conclusion: Ginger may be useful to change BUN and creatinine level of blood to achieve normal body balance.

Background and aim: Brucellosis is a common zoonotic disease with different clinical pictures such as chronic brucellosis. The aim of this study was to determine the incidence rate of chronic brucellosis after one-year of antibiotic therapy in tribal patients of Koohrang district of Chaharmahal and Bakhtyari province from 2003 to 2004. Methods: The patients with acute brucellosis were recognized using both standard tube agglutination (STA) (Wright) and 2-mercaptoethanol (2ME) tests. Also a questionnaire about demographic variables of the patients, their signs and symptoms and how they were infected was filled in by the patients. Subsequently, they were treated using conventional regimen. After one year, the patients were reviewed for the signs and symptoms of the disease and their sample sera were tested for related antibodies. The patients with specific antibody (>1/160 for both tests) regarded as positive. The data was analyzed by t, Chi square, and regression tests. Results: During the peak of brucellosis in 2003, 119 persons were infected, 63.9% male and 36.1% female. Arthritis (88.7%) and fever (78.54%) were the most common signs and symptoms. In the second visit 97 new patients were recognized. rifampin with cotrimoxazole (57.7%) and doxycycline with rifampin (15.5%) were used for treatment of the patients. 17.5% of the patients had final titer of STA test titer and 15.5% of them had a 2ME titer higher than 1.160. 16.5% of the patients had recurrence signs and symptoms and 11.3% of them had mild symptoms. There was significant statistical relationship between antimicrobial drugs regimen and final titer of STA and 2ME tests and clinical course in the following year (p<0.001). Using both rifampin and cotrimoxazole resulted in a higher chance of chronic brucellosis (p<0.001). Conclusion: The incidence rate of chronic brucellosis in this area was higher than that in the other regions of Iran and other countries. This was mainly due to lack of standard antimicrobial regimen, using single drug regimen, short-course antimicrobial therapy, low level of training of the patients and low access to health facilities in the region.

Background and aim: The most effective therapy for patients with chronic hepatitis C and B is combined therapy with interferon. These treatments, however, cause varying degrees of adverse effects; which may negatively affect the patients’ vitality, social activity, and ability to work. Therefore, the aim of this study was to assess the effect of an educational program about using interferon, properly, self-management of side effects and follow up on the quality of life of the patients with hepatitis B and C. Methods: This semi-experimental study was performed on patients with chronic hepatitis B and C subjected to interferon therapy, in Tehran hepatitis center. Sixty patients selected by available sampling method were divided randomly into two equal groups of control and case. Data was gathered using demographic information questionnaire (DIQ) and the specific chronic liver disease questionnaire (CLDQ). The educational program consisted of four 45-minute sessions. Then the patients were followed up for 28 weeks. Quality of life of the patients was assessed before and 28 weeks after the educational program and interferon therapy. Quality of life of the two groups was compared using Chi- Square, Manwitny and Wilkakson tests. Result: There was no statistically significant difference in demographic characteristics between the two groups. The quality of life of the case group was increased (p<0.001) but did not change in the control group. After 28 weeks, all the checked aspects of the life, except activity, were significantly different between the two groups. Also, the rate of treatment stopping in the control group was 4 times more than that in the control one. Conclusion: The results showed that educational programs improve the quality of life of the interferon-therapy patients.

Background and aim: Atopic dermatitis is one of the common skin diseases of childhood that creates considerable side effects on patients, their families and the health care system. This study was carried out to identify both prevalence rate and risk factors of the disease in Shahrekord schoolchildren in 2003.Methods: In a cross-sectional study from all Shahrekord schoolchildren, 1500 students (750 female, 750 male) were randomly selected and the questionnaires of atopic dermatitis were distributed among the selected students and then collected after being filled by their parents then all selected students were examined by a general physician. Suspected students were examined by a dermatologist and an ophthalmologist. The serum IgE of students with any evidence of AD was then serologically tested and the collected data were analyzed with both X2 and student-t test.Results: The mean ages of students participated in the survey were 9.2±1.4 years. According to AD criteria, the prevalence rate was 2.1 percent (32 students). There was no significant statistical relationship between sex and age with a topic dermatitis prevalence rate, but there was significant statistical relationship between AD prevalence rate and signs and symptoms of asthma, allergic renitis, family history of the atopic dermatitis and atopy (p<0.05).Conclusion: Our results showed that atopic dermitis was more frequently seen in those individual with asthema, allergic renitis, familial history for atopic eczema or familial history for atopic dermitis. But no relationship between atopic dermitis and age as well as sex was observed.

Background and aim: Problem base learning results in the clarification of the words and concepts, the definition of the concepts, problem analysis, providing a systematic method to describe the situation during analysis process, the determination of learning objectives, getting more knowledge according to learning requirements and merging of the new knowledge with solutions. Regarding the progress of nursing science across the world and the importance of promotion in nursing education using new educational methods, the aim of this research was to determine the effect of teaching using both problem base learning and lecture on behavior, attitude and learning of nursing (BSc) students at Shahre-Kord University of medical science.Methods: This research was a semi-experimental study involved 40 of nursing (at 4th semester) students at Shahre-Kord University of medical sciences who were learning the internal course (surgery 2). They were selected using conventional sampling method and divided into two equal groups of case and control, using random sampling method. The problem base learning and lecture methods were used to teach individuals of case and control groups, respectively. At the end of the course, using a questionnaire, behavior, attitude, and learning of the students were assessed. Using T and Manvitni tests, the data was analyzed.Results: The students were 95% female and single. The mean of age in both groups was 22/04±1 years. There was no significant difference between the two groups in terms of the three former semester average scores, using t-test. The mean of learning in the case and control was 68.24±6.8 and 44.98±9.8, respectively. The mean of attitude in the case and control was 123.3±21 and 96.8±8 and the mean of behavior in the two groups was 69.5±2.5 and 63±3.1, respectively (p<0.001). There was significant statistical difference (p<0.05) in the two categories of evaluation and application between the two groups studied (p<0.05). There was also slight difference in the level of understanding between these two groups. Conclusion: Based on the results, teaching by problem base learning is more useful than lecture in modification and improvement of learning and attitude of the students studied. The results of this research is offered and recommended to the educational officials to substitute this method for the traditional ones.

Background and aim: Shoulder pain and hand edema associated with hemiparesia and hemiplegia is common complications after the stroke and restricts the patient’s daily activities. Therefore, this study was conducted to evaluate the effect of manual lymph drainage (MLD) massage on hand edema and shoulder pain in hemiplegic-paretic patients post stroke.Methods: In this randomized clinical trial study, 62 stroke patients with age ranging of 35-70 years and having shoulder pain and hand edema associated with hemiparesia or hemiplegia were selected and randomly divided into two groups of case and control. Then, manual lymph drainage massage (MLD) was performed in the case group for five sessions and each session last 20 minutes. The MLD was not performed for the control group. Sensory, affective, intensity and general condition of shoulder pain and also circle size of wrist and middle part of the arm were assessed using of McGill Pain Questionnaire-Short Form: (MPQ-SF) and tape gauge, before and 24 hours after last session of MLD in both  the case and control group. The acquired data were analyzed using independent t and paired t-tests. Results: The means of sensory components of shoulder pain before and after massage was 2.3±0.9 and 1.3±0.4, respectively (p<0.05). Based on the Visual Analogue Scale (VAS), the mean of shoulder pain intensity, after massage, in the case and control group was 3.3±1.2 and 4.8±1.5, respectively. The mean of arm circle size before and after massage in the case group was 29±4.6 and 28.1±3.9 centimeter, and in the control group was 29.4±4.1 and 29.7±3.9 centimeter, respectively (p<0.05). Also, the mean of wrist circle size, before and after massage in case group was 17.2±1.1 and 16.4±0.9 centimeter, while in the control group, it was 16.9±0.8 and 17.1±1.1 centimeter, respectively (p<0.05).Conclusion: Based on the results of this study application of MLD by the health care personnel would be effective in prevention or decrease of shoulder pain and hand edema.