Journal of Shahrekord University of Medical Sciences
Year:2003 | Volume:5 | Issue:3|Papers Count:13

At present Campylobacters are the main cause of the bacterial diarrhea worldwide. In human beings the disease is transmitted by consumption of contaminated water and foodstuff, especially poultry products. Diagnosis of this bacterium is difficult by the bacteriological tests due to the long incubation period and unavailability of suitable differential tests. Hence, other diagnostic procedures, other than culture, are very demanding. Rectal swabs of 116 chickens from the poultry farms of Isfahan were enriched for 12 to 18 hours in Campy-Thio medium, and cultured in the Campylobacter selective agar medium. Gram staining, oxidase, catalase and hypurate hydrolysis tests and evaluation of sensitivity to nalidixic acid and cephalothin were employed for diagnosis and typing of the samples. For molecular evaluation of the samples, after DNA extraction, PCR was performed using two sets of type specific primers for C.coli and C.jejuni. Using culture, 11 samples (9.5%) were found positive from which 8 were jejuni and 3 were coli. Using PCR, 27 samples (23.2%) were positive, from which 18 were jejuni and 9 were coli. Sensitivity and specificity of PCR procedure in comparison to the culture were 100 and 84.7 percent, respectively. According to the results, all the culture positive samples were diagnosed and genotyped correctly using the PCR procedure. Therefore in view of its considerable sensitivity and speed, PCR could be a very reliable substitute for the culture method in Campylobacter detection in poultry samples.

Cardiac output (CO) is the most important factor to be taken into consideration in relation to the circulation because it is a determining index of cardiac function, clinical management, therapeutic protocols and the prognosis of many patients with congenital and acquired cardiac disease. The aim of this clinical study was to compare the results of CO measurements by echo–doppler and Fick method. This prospective research was performed on 56 children, 3-15 years of age, afflicted by various congenital heart defects from august 2000 to August 2002. All patients needed hemodynamic assessment regardless of their participation in the study. CO was measured by Fick method and echocardiography, then compared by paired t-test. Mean cardiac index (CI) by the Fick method was 7.18±2.18 Lit./min/m2 and by echo was 7.58±1.94 Lit. /min/m2. There was a significant correlation between them (P<0.001). By regression analysis the following formula was obtained showing the relation (r=0.919, P<0.0001, r2 =0.85): Cardiac index by Fick method =-0.63+1.03 (cardiac index by echo). Although the mean CO by echocardiography was not the same as that by the Fick method, it is possible to predict the CO by the Fick method based on the CO by echocardiography.

Pain control after abdominal surgery significantly decreases surgical morbidity. Because of beneficial effect of regional pain relief and controversy about bupivacaine effect on pain relief, this study was performed to determine the efficacy of ilioinguinal-iliohypogastiric block (IHB) in inguinal hernia surgery. In this double blind study, 60 patients with inguinal herniorrhaphy were randomly divided into case and control groups. In the case group, bupivacaine, and in the control group normal saline was used. The amount of used narcotic analgesics, surgical complications and severity of pain were monitored every 4 hours for 24 hours. Our results showed that the scores of postoperative pain were significantly lower during the first 8 hours after surgery in the case group (2.7±1.2 at the first visit and 4.1±1.1 at the second visit) compared to those of the control group (6.7±1.6 and 7.1±1.5). The complications and amount of analgesics used were not significantly different between two groups. Since IHB decreases pain and morbidity, its usage is recommended for relief of postoperative pain.

Stress is a major problem of the modern world, causing psychological and physiological diseases. Object of this study was to evaluate the effects of cognitive behavioral therapy on coping styles of non-medical students of Shahrekord university of medical sciences.This two phases experimental study was performed on 60 students, having non-effective coping styles. They were randomly divided into the control (n=30) and case (n=30) groups. Billingz & Mouse coping questionnaire was used to assess coping styles. The case group was treated with 8 weeks of group cognitive behavioral therapy. Quantitative analysis of data was undertaken by using dependent and paired t-tests. The results showed that cognitive behavioral therapy had significant effects on improvement and effectiveness of the coping strategies (P<0.001).

Exchange transfusion is a therapeutic method for immediate treatment of hyperbillirubinemia to prevent kernicterus, but it has some complications including hypoglycemia and hypocalcemia. This study was performed to find the changes of blood sugar and calcium after blood exchange and their possible correlation with weight, blood incompatibility and bilirubin decrease rate. Thirty-six neonates with blood exchange were evaluated over a period of 6 months. Blood samples were collected from umbilical vein catheter, before and 6 hours after the exchange transfusion, and their total calcium, bilirubin and blood sugar were measured. Following every 100 ml of blood exchange, 1 ml of calcium gluconate (10%) was infused slowly.Our results showed that, 6 hours after exchange transfusion, the total calcium level was decreased. There was no significant correlation between calcium decrement and weight. Also, no significant correlation was found between blood incompatibility and bilirubin decrement. There was no significant alteration of blood sugar 6 hours after exchange transfusion. We recommend using of calcium gluconate during exchange transfusion and serial measurement of calcium level until its level is stable.

Narcotic drugs are usually used for post operative pain control, which could cause several complications such as respiratory depression and apnea. Therefore, replacement of these drugs with safer analgesics is recommended. The aim of this study was to compare the analgesic effects of voltarene (Diclofenac Na) and pethidine (a narcotic drug) on post appendectomy pain. Seventy-two patients (more than 15 years old), were randomly divided into two groups. The first group (p) received pethidine, 1 mg/kg intramuscularly, at three stages; immediately after complete consciousness, 6 and 12 hours later. The second group received diclofenac Na (D) 50-75 mg intramuscularly at similar stages.Comparison of severity of pain between the second stage and the first stage in group p was 42/40 and in group D was 30/60 (P<0.05). Severity of pain at the third stage compared to the first stage in group P was 42/31 and in D was 30/69 (P<0.05). Severity of pain at the fourth stage in comparison with the first stage in group p was 43/37 and in group D was 29/67 (P<0.05).Therefore, it can be concluded that diclofenac Na is better than pethidine for post operative pain.

Kienbock's disease refers to lunate bone avasular necrosis and if untreated in stage I or II will lead to collapse and cause deformity of bone. If it progress to stage III or IV, the salvage of radio carpal bone will be impossible and patients may need a problematic surgery. The goal of this study is to compare the surgical treatment results of radial shortening or ulnar lengthening method in stage II. Sampling was done in simple sampling method (20 patients) that had wrist pain and referred to clinic. The patients divided into two groups. In first group radial shortening and osteotomy and in second group ulnar lengthening and oseotomy were done. The cure of disease was evaluated as 1) no pain in rest, 2) in normal activity, 3) in severe activity, 4) signs of union in radiography. The results showed that radial shortening method 10 patients and in ulnar lengthening group patients had recovered that (P<0.05). Our findings show radial shortening method is preferred to ulnar lengthening in stage II and therefore this method is suggested.

Menopause signals the cessation of fertility and accompanies changes in health status. To find the mean age and factors affecting menopause, a retrospective study was conducted on a community sample of women with cessation of menstruation for at least 12 months at the end of reproductive years (>40 years). A sample of 810 women was selected with cluster sampling. Data was collected using a structured questionnaire and interview. The mean age of menopause was 47.19±5.31 years and prevalence of premature menopause was 13.8%. The mean age of menopause was higher in women with last pregnancy at an age more than 35 years, with higher age of first pregnancy, with history of using oral contraceptives and in women with type II diabetes mellitus, and with multiparty (P<0.05). There was an unexplained high prevalence of premature menopause, which needs more attention.

Cytological examination for diagnosis of cervical cancer (one of female genital malignancies) is very important. This experimental study was performed on two groups of 131 women referred to Kashani clinic of Kerman, and the sufficiency of spatula sampling (first group) and combined cytobrush-spatula sampling (second group) for diagnosis of cervical cancer was compared. A questionnaire with three parts was used. The first part consisted of demographic data (age, marriage age, number of previous childbirth, previous gravidity, contraception methods, and previous cervical operations) that was completed by interview. The second part was about the rate of patient’s inconvenience during sampling that was completed by observation. The third part consisted of the indicators of sufficient cervical smear that was completed by the cytologist. Data of the first and second parts were similar between two groups. There was no significant difference between two groups with respect to observing 25 or more cervical canal cells in the smear. But the amount of blood in the smears was significantly different between two groups (P<0.05). Epithelial cells were observed in all smears. Due to less tissue damage and less smear’s blood, preparation of cervical smear with combined method is recommended.