Journal of Ardabil University of Medical Sciences
Year:2007 | Volume:6 | Issue:4 (22)|Papers Count:16

Background and Objectives: Perception and Feeling are two parts of each sensory experience. Sensory reception of information proceeding about internal or external environment is conducted by sensory root. Humans inform themselves of their surrounding by receiving and organizing sensory stimulants. This conception and stimulant organization is called sensory reception. When a help seeker is admitted to a health care organization, he/she encounters stimulants which are different in quality and quantity from past stimulants and this causes sensory changes in him. The patient who is admitted to ICD ward is exposed to overburden or sensory deprivation due to some critical situations and complex methods of therapy.Methods: This was a descriptive study performed on 45 cases using simple random sampling method. A three-part questionnaire was used to collect the data which were analyzed using descriptive statistics.Results: The findings showed that the subjects experienced no, very little or occasional unpleasant sensory reception in more than 80% of the cases (without sensory overburden). But the assessment of emotional reactions indicated 39.8% had experienced pain, 18.5% anxiety, 12% fear, 7.4% anger and 0.9% hating, which probably happened because of sensory deprivation arising from less family visiting and lack of knowledge about disease.Conclusion: Since patients in ICD experience some unpleasant emotional reactions, in order to decrease this experience, it is recommended to educate the patients and increase the duration of visiting time.

Background & Objectives: Most of the people who need blood and blood products transfusion, are the critic cases under transfusional therapy for their bleeding, chronic disease anemia, clotting disorders, platlet problems and so on. Considering the problems and high costs of providing safe blood and due to the transfusional complications, it is necessary for the blood products to be used based on scientific standards and only in the time of emergency.This study examined the cases of transfusion in a surgery and burning hospital to determine the unnecessary cases of transfusion in a period of six months.Methods: This descriptive study was performed on 150 patients under blood and blood products transfusion in Ardabil Dr Fatemi hospital during 2003. Necessary and unnecessary cases of transfusion were categorized according to the patients clinical situations, laboratory criteria, the evidence existing in their records and on the basis of standards documented in the literature. The data were analyzed by SPSS software.Results: Among 150 cases transfused, 46 (25.7%) received whole blood, 92 (51.4%) packed cell, 36 (20.1%) FFP and 5 (2.3%) platlet. The ward of transfusion was ICD in 60 cases (40%), surgery ward in 31 (20.7%), operation room in 28 (18.7%), orthopedic ward in 11 (7.3%), burning ward in 10 (6.7%) and emergency ward in 9 (6%). Highest rate belonged to 20 to 40 age-group (32.7%). 67.3% of the cases were male. With regard to the necessity of transfusion, based on documented criteria, 26.08% of the cases in whole-blood group, 30.44 in packed cell group, 47.22 in FFP group and 80% in platlet group received unnecessary transfusion.Conclusions: Considering the high cost of preparation of safe blood and blood products and regarding the problems which can affect the patients after transfusion, these products should be used carefully and on the basis of the documented criteria. The high rate of unnecessary transfusion of blood and its products at the present research demands more attention in this regard.

Background & Objectives: Patients with esophageal SCC and GEJ adenocarcinoma have a poor prognosis. The advanced stage tumor is not amenable to cure and requires palliation, specially to relieve dysphagia and to improve quality of life. Esophageal stenting has been shown to be faster, and longer lasting method of palliation. Esophageal expandable stents have been available recently in IRAN. The aim of this study was to report the results of our experience to relieve dysphagia by means of stents, specially plastic removable types.Methods: This was a prospective trial in 60 patients with strictures due to malignant esophageal and for GEJ cancers and those who had undergone anastomotic procedure during 2001 to 2005. These patients referred to endoscopy clinic of Tabriz Immam hospital for stenting. Dysphagia was scored according to a 5-point scale before stenting, 3 days after, and later during follow-up period of a mean of 7.6±6.6 months. Barium study and endoscopy were done for evaluation of site and length of stricture and its etiology. Strictures were dilated up to 15mm before stenting. The data were analyzed using correlation test, Chi-sqare and T- tests.Results: Covered metallic Wallstent was used in 12 patients, removable covered polyflex stents in 47 and double lumen metal stent in only one case. Stents were successfully deployed in all cases. Dysphagia improved significantly by all stent types compared with the presenting status, after 3 days (p<0001) and during follow up period (p<0.05). Distal displacement of stents was seen in 16 (32%) patients, all of which happened during 1-3 months after insertion.In polyflex stents, the way restored by endoscopic intervention. Tumor overgrowth at the end of stent was seen in 4 (8%) of the cases. Mean period of survival was 7.6±6.6 months. In no case was the death directly attributable to the procedure.Conclusions: Self-expandable plastic stents (SEPS), have favorable efficacy in palliating dysphagia. Their insertion is easy, with low risk and successful and associated with a lower rate of complications, morbidity and mortality in majority of the patients.

Background & Objectives: Piracetam is a nootropic compound, which acts as a nervous system enhancer. Different processes are involved in memory formation and various parameters are able to disturb it. Due to increase of exposure possibility to electromagnetic fields in recent years and the effects of theses fields on memory consolidation, this investigation designed to clear the relation between these parameters and memory consolidation.Methods: In this research eleven groups of male wistar rats (ten rats in each group) with a mean weight of 275±25 gr aging 3-4 months were studied. To evaluate the effects of electromagnetic field, four groups of rats were exposed to 5mT/50HZ electromagnetic field for 1,4,6 and 8 hours respectively immediately after training. In other six groups 250 mg/kg or 500 mg/kg piracetam were administered orally one hour before training. They were also exposed to electromagnetic field for 4, 6, 8 hours respectively immediately after training.Retrieval test was performed 24 hours later in all groups.Results: 1 hour exposure on EMF had no meaningful effect on memory consolidation, however, in other three groups the electromagnetic fields impaired memory consolidation significantly compared to the control group (p<0.05). Piracetam administration with two mentioned doses significantly improved memory consolidation (p<0.05).Conclusions: Acute exposure to low intensity magnetic field can disturb memory consolidation and piracetam administration can prevent it.

Background & Objectives: Stroke is the third cause of mortality after cardiovascular diseases and cancer. It is also the most common debilitating neurologic disorder. Considering the high prevalence of intracerebral hemorrhage (ICH) and its mortality, it seems quite necessary to study the frequency of ICH risk factors and its mortality related to size and region of hemorrhage.Methods: 157ICH patient units were studied to determine hemorrhage size and region via CT Scan reports. Patients were followed to record the mortality and a questionnaire was filled out for them. The data were analysed by SPSS version 13.Results: Females constituted 57.9% of the 157 patients and the rest were males. Mortality rate was 37.6%. Most of the patients were in 70-79 years age group. Hemorrhage had the highest frequency found in putamen (39.4%). Hemorrhage size less than 20 cm3 had the highest frequency among living patients and hemorrhage size in a range of 20-100 cm3 was most common among expired patients. There was a statistically significant relationship between mortality and hemorrhage size (P<0.05). Intraventricular hemorrhage was more frequent among expired patients (p<0.05). There was also a statistically significant relationship between a history of cardiovascular disease and mortality rate (P<0.05).Conclusions: Intraventricular hemorrhage and hemorrhage size were significantly related to mortality rate.

Background & Objectives: Different studies have emphasized the psycho-social aspects of delivery, so that these aspects are no less important than medical and midwifery factors. This is a quasi- experimental study, the main objective of which was to evaluate the effects of the continuous labor support from a supportive companiom on the process and outcome of labor in primigravida.Methods: 50 women in supported group (case) and 50 without supporative companion (control) were selected. All women were between 18-30 years, and had term pregnancy, single fetus, cephalic presentatation or spontaneous onset of labor without any complications. The supportive companions were students of midwifery. The support consisted of talking, touching, reassurance, soothing, giving encouragement and physical comfort (e.g, helping to change position, keeping lips wet and cooling). The data were analyzed using student t-test, chi-square and Fisher test.Results: The findings showed that the continuous labor support by a companion reduced length of active phase (p<0.01), cesarean section (p=0.026) and increased APGAR score in the first minute (p=0.015) and led to the early onset of breast feeding (p<0.01). Duration of second labor and fifth-minute Apgar were not significantly different in two groups.Conclusions: This study showed that the continuous labor support can result in better outcomes in deliveries.

Background & Objectives: Dysmenorrhea is a common complaint among women, which is occasionally accompanied by gastro-intestinal problems. This study was designed to consider the therapeutical effects of vitamin E on gastro-intestinal symptoms such as nausea, vomiting and diarrhea due to primary dysmenorrhea.Methods: This was an experimental randomized study. A questionnaire was given to three hundred girl students suffering from primary dysmenorrhea. Then 128 girls who had gastrointestinal symptoms accompyning dysmenorrhea entered the study. 69 subjects were assigned to case group and 59 to control group. From two days before the period until three days after it, four pills of vitamin E (400IU) daily were given to the case group and four chewing placebo were given to the control group as well, for four months. The data were analyzed by SPSS using Chi-square test. Results: The findings showed no significant difference between the two groups in terms of gastro-intestinal symptoms after two months of treatment. But after four months of treatment there was a significant difference in the gastro-intestinal symptoms between the two groups (p=0.001).Conclusions: Vitamin E is effective to be used after the second month of treatment to treat the gastro-intestinal symptoms in girls with primary dysmenorrhea.

Background & Objectives: Different studies have reported conflicting results on increased rate of early mortality after acute myocardial infarction (AMI) in females compared to males after adjustment for age and other confounding factors. The female gender plays a crucial role in early mortality after AMI. The aim of this study was to assess the role of gender as an important key factor in early mortality after acute myocardial infarction.Methods: In this research, patients (80 females and 174 males) with acute myocardial infarction were studies for six months (2003-2004) in terms of risk factors of coronary artery diseases, clinical conditions at admission, treatment modalities in the hospital and at the time of discharge, clinical accidents at the hospital and mortality and during one month after acute myocardial infarction and after being discharged.Results: Intrahospital mortality odds ratio for females compared to males was 2 (confidence interval 95%: 0.951-4.208). Mortality odds ratio during one month after acute myocardial infarction and discharge for females compared to males was 4.586 (confidence interval 95%: 1.294-16.252). This rate after adjustment for age was 3.15 (confidence interval 95%: 0.857- 11.579) and after adjustment for confounders was 5.387 (confidence interval 95%: 1.296- 22.393). In severe clinical conditions females referred to hospitals with more delay compared to men. Females were treated less than males with streptokinase, aspirin, betablockers and invasive diagnostic and treatment procedures. They received calcium channel blockers and nitrate much more than males.Conclusions: Females in comparison with males were at higher risk for early mortality (during one month after acute myocardial infarction and discharge). Age was not considered as the most important and potential factor for this higher rate.

Background & Objectives: A psychiatric disorder is an illness with psychogical or behavioral manifestations accompanied with impaired functioning. The prevalence of psychiatric disorders is reported up to 30% in some communities. Regarding the high prevalence of psychiatric disorders in the society especially the high number of people referring to psychiatric commissions where some cases malinger with the aim of getting some secondary advantages, it seems necessary to have comprehensive information about the prevalence of these disorders. This study was an attempt to determine the prevalence of psychiatric disorders among people to psychiatric commission of Fatemi hospital, Ardabil.Methods: This descriptive study was conducted on people referring to psychiatry commission of Fatemi hospital from 2001 until 2003. A questionnaire filled through interviewing the subjects was used to collect the data. These data were analyzed by SPSS using descriptive statistics.Results: In this research out of 315 patients, the highest frequency related to mental retards with 68 (25.3%) cases. 60 (22.3%) cases had behavioral disorder, 27 (10%) stammering 26 (9.7%) personality disorders, 25 (9.3%) anxity disorders, 20 (7.4% schizophrenia, 11 (4.1%) somatoform disorder, 10 (3.7%) borderline IQ, 8 (2.9%) nevrosis, 6 (2.2%) histertic disorder, 4 (1.4%) sleep disorders and 3 (1.1%) acute psychosis. Also, 28 (8%) people referred for getting exemption from military service only 6 (21%) of whom had the qualifications for exemption.Moreover, 17 (5.3%) of all the subjects were disabled.Conclusions: No significant relationship was found between age, sex, education, residence and job with psychiatric disorders. However, there was a significant relationship between marital status and disablement with psychiatric disorders. The most common causes of referring to the psychiatry commission were mental retardness and histery whereas sleep disorders and psychosis were the least important ones.

Background & Objectives: Delayd post-traumatic intracranial hemorrhage (DTICH) is a kind of brain hemorrhage which occurs after the first six hours of the head trauma, and is not detected in the initial CT Scan taken from the patient in the first 6 hours after the trauma. As DTICH is one of the most important factors in occurrence of secondary brain injuries in patients with head trauma, its early diagnosis and treatment could significantly decrease mortality and morbidity of these patients. This diagnosis is a contraindication to anticoagulant therapy. This study was conducted to determine the frequency of factors associated with DTICH incidence.Methods: This was a case-control study conducted in Semnan trauma center. In this research all the patients with head trauma who referred to Emdad hospital between 2002 and 2004 were studied and the data about the delayed post-traumatic intracranial hemorrhage (20 cases) were included. Then, besides determining the incidence of DTICH in the patients with hemorrhage, some risk factors such as headache, contusion, reduction level of consciousness, skull fracture and impact intensity to the head were compared with a control group (40 cases) who had head trauma without primary or delayed hemorrhage. The groups were age and sexmatched. The data were analyzed using Chi-aquare and computing odds ratio.Results: This study showed that the frequency of DTICH was 10.6%. There was a meaningful relationship between DTICH and skull fracture, reduction of consciousness level, contusion and impact intensity. But, there was no meaningful relationship between DTICH and intractable headache.Conclusions: The results indicated that cases such as skull fracture, contusion, impact intensity and findings such as the reduction of consciousness in patients with head trauma (with no hemorrhage in the first CT scan), can be the risk factors for DTICH.

Background & Objectives: Otosclerosis is one of the causes of conductive hearing loss in different ages, the diagnosis of which sometimes becomes difficult using clinical and audiological symptoms. The early diagnosis and surgical treatment of this disorder will give a normal hearing to the patient. The goal of this study was to determine the role of exploratory tympanotomy in revealing the patients with hearing loss as a result of otosclerosis which is impossible to be diagnosed based on clinical and audiological, symptoms.Methods: This prospective study was conducted on 33 patients (18 females and 15 males) with conductive hearing loss suspected to otosclerosis, who were admitted to oto-rhinolaryngology department of Imam Khomeini hospital from 1999 to 2003 and underwent exploratory tympanomy. In 30 patients (16 females) otosclerosis was revealed during operation; all of these patients underwent stapedectomy. During three weeks after surgery, the patients were examined in terms of facial paralysis, non-response to treatment, deterioration of hearing ability, dizziness, the probability of tympanic perforation and other complications.Audiological tests were also studied. The obtained data were recorded and compared with findings of other researches.Results: The prevalence of the disease in women was more than men, and the majority of the patients had referred to be treated in the third and fourth decade of their life, while they had a history of hearing loss from the second or third decade of their life. The positive family history was below compared to other studies, but conductive hearing loss was more prevalent. This treatment led to hearing improvement in majority of the patients.Conclusions: Considering the proper time for stapedectomy is very important since better results can be abtained if the patients are operated with lower degrees of hearing loss. Thus, exploratory tympanotomy leads to early diagnosis and treatment in patients with conductive hearing loss suspected to otosclerosis.

Background & Objectives: Caesarean section (CS) has increased in rate during the past years. Due to postoperative complications, long recovery time and high costs of surgery, normal delivery is recommended as a routine method. Regarding the increase in the number of CS and its' acceptability on the part of the public, it seems that women's as well as health personnels' attitudes play an effective role in selecting the termination method. The aim of this study was to evaluate and compare pregnant women's and health personnels' attitude toward termination procedures.Methods: This was a descriptive and comparative study. 84 health personnels and 300 pregnant women who referred to Ardabil health centers in 2002 were selected. These subjects' attitudes were collected through Likert questionnaire and the collected data were analyzed by SPSS, using t-test.Results: The findings showed that 30.1% of women and 50% of health personnels had positive attitudes towards normal delivery. The findings also indicated that there was a significant difference between pregnant women and health personnels in their attitudes toward normal delivery and cesarean (p=0.001).Conclusions: Since health personnels had a more positive attitude towards normal delivery than pregnant women did, it seems that the young as well as the pregnant individuals in society need more education and awareness to be able to change their attitudes towards delivery methods. Health personnel, due to their high positive attitude towards normal delivery, can play a more beneficial role in this regard.

Background & Objectives: Salmonella is amongst the most important food-borne pathogens and S.typhimurium is the most common species causing food infection. L. casei, R bifidum and B. angulatum are among probiotics with siginificant benefical effects in consumers. The purpose of this study was to investigate the interaction of the mentioned probiotics with S.typhimurium in vitro and growth in synthetic peptone water medium to evaluate the provisional effects of probiotic consumption in prevention and treatment of S.typhimurium food infection in humans.Methods: In order to activate the lyophilized bacteria, they were inoculated in erlene meyer containing peptone water and incubated at 37 °C for 24 hours. The activated probiotics and S.typhimurium were then incubated separately and together in peptone water medium for 24 hours at 37 °c. Then, the number of their probiotic bacteria and S.typhimurium were counted in MRS and BGA media using surface plate method. This procedure was repeated 10 times for each experiment and a mean number of S.typhimurium in each ml of erlene meyer containing S.typhimurium alone and with probiotics and also the mean number of probiotic bacteria in each ml of erlene meyer containing probiotic alone and with salmonella were compared using independent t-test.Results: Co-cultural growth of L.casei and Rangulatum significantly inhibits S.typhimurium growth (P<0.05) but the inhibitory effect of Rbifidum was not meaningful and the co-culture of S.typhimurium had no meaningful effect on the growth of the above bacteria.Conclusions: Consumption of products containing L.casei and Rangulatum could have benefical effects in prevention and treatment of S.typhimurium infection although more in vivo researches should be carried out in this regard.

Background & Objectives: Pain acts as a defensive mechanism of body, which occurs following tissue damage. It is expected in surgical wounds. With regard to negative clinical outcomes resulting from surgery pain, this study was conducted to investigate the quality of pain control after appendectomy.Methods: In this descriptive, cross- sectional and prospective study, 200 patients undergoing appendectomy were randomly selected. Pain control in all of the patients was managed for 8 hours using narcotics injected intramuscularly. The patients were studied during 12hours after surgery. The rating scale of 0-10 grade was used to estimate pain severity. The collected data were analysed by SPSS.Results: From 200 patients experiencing appendectomy, 101 (50.5%) were female and 99 (49.5%) were male. Pain was controlled with pethidine, methad on and pentazocin in 123 (61.5%), 51 (25.5%) and 26 (13%) patients, respectively. In 98 (49%) patients there was severe pain following the surgery. The most severe pain belonged to 21 (80.7%) patients who received pentazocin.Conclusions: With regard to multiple complications and problems resulting from pain after appendectomy, careful control of pain and more attention is necessary.