Hormozgan Medical Journal
Year:2005 | Volume:9 | Issue:3|Papers Count:17

Introduction: Febrile seizure is the most common seizure disorder during childhood, with an excellent prognosis regardless of the treatment. Therefore a serious underlying disease such as sepsis or bacterial meningitis each with a seizure associated with fever must be carefully examined and ruled out. Several subsequent studies have shown an incidence of febrile seizure of 3% to 9%. This study is designed to reveal the etiology and epidemiology of febrile seizure in Bandar Abbas pediatric hospital. Methods: All of the patients with febrile seizure admitted in Bandar Abbas pediatric hospital during March - Feb 2001 were enrolled in this descriptive study. Relation between etiology and other factors such as gender, age, type of seizure was examined using Epinfo software. Results: 181 patients laid in our study which was 2.6% of all 6768 hospital admission during the study period. The patients age ranged from 4 to 96 months (mean age 27 months). 61.3% of patients were males and 38.7% females. 83.4% had simple febrile seizure and 16.6% had complex febrile seizure. The most frequently identified cause of febrile seizure was gastroenteritis 34%, upper respiratory tract infection 28.7%, the other causes included fever without focus 13.8%, pneumonia 9.4% and acute otitis media 8.3%. Conclusion: The etiology of febrile seizure can be variable in different parts of the world and in various races. The most frequent cause of febrile seizure in our study was gastroenteritis. High prevalence of gastroenteritis as a cause of febrile seizure emphasizes the need for more cooperation between the city education authorities and health centers.

Introduction: Osteopenia of trabecular-rich bone tissues in patients with urolithiasis has been suggested. We performed a study to evaluate the prevalence of osteopenia and osteoporosis in Iranian patients with recurrent urinary tract stones. Methods: In this case control study 24 male patients, aged 30-50 years old, who had recurrent urolithiasis (more than once per year) and were referred to extracorporeal shock wave lithotripsy (ESWL) unit, entered our study. We also valuated 24 healthy male controls of a comparable age group. Both groups had similar diets. Ages, body mass index (weight/height2), stone disease duration and BMD of two ports, Lumbar spine (L2-L4) and femur region were evaluated and compared in both groups. Linear, regression and t-test were used to analyze the data.Results: Excluding confounding factors, BMD difference in both lumbar and femur region between patients and controls were statistically significant (P<0.01). BMD results were quite independent of age and body mass index. According to regression analysis, there was a significant correlation between BMD of lumbar and duration of urolithiasis (P<0.001, r=-0.73). The same significant correlation existed between BMD of femur and duration of disease, although not as the previous one (P<0.01, r=-0.52). Conclusion: BMD decrease in patients with urolithiasis may herald a primary defect of bone metabolism. As 30% of patients were osteopenic, calcium intake and its restriction should be monitored in these patients.

Introduction: CRP (C-Reactive protein), an acute phase reactant, is considered as an indicator of inflammation and its measurement has been used as an early indicator of infection. This study was performed in order to examine the natural changes in CRP in orthopedic surgical operations related to long bone fractures in Shahid Mohammadi Hospital, Bandar Abbas, Iran.  Methods: 54 patients were enrolled in this descriptional study, of which ultimately 39 completed the study period. In all of the patients, CRP was checked serially until it became negative. T-test and analysis of variance was used for statistical analysis and P<0.05 was considered significant. Results: In all of the patients, the peak CRP elevation was observed on the second postoperative day (48 Hours) and in all of the uncomplicated cases, CRP returned to normal within 3 weeks. The difference between CRP rise in upper and lower limbs was statistically significant (P<0.002). Conclusion: It seems that a high CRP titer after 3 weeks, in a patient who has undergone surgery for a single long bone fracture, is good evidence of complication occurrence, especially an infection.

Introduction: Hypertensive disorders in are common pregnancy. Combination of hypertension and proteinuria such as preeclampsia during pregnancy markedly increases the risk of prenatal mortality and morbidity. Inspire of numerous studies to find a faster test for assessment of proteinuria, 24-hour urine collection is the gold standard. The purpose of this study was to determine whether a 2-hour protein estimation and random urine sample correlated with that of a formal 24-hour collection. Methods: In this the study population included 32 pregnant women over 20 weeks gestations who were admitted for assessment of proteinuria and ruling out of preeclampsia in Dr Ali Shariati Hospital, Bandar Abbas.Patient’s urine was collected with the first random urine sample, next 2 hour sample and 24 hour sample. Urinary estimation of proteinuria was made on these samples. 2-hour value was multiplied by 12 and compared with 24-hour protein. Correlation coefficient between 2-hour and 24-hour samples, sensitivity, Specificity, Positive predictive value and negative predictive value of random and 2-hour samples were calculated.esults: Pearson’s correlation coefficient between 2 and 24 sample was 0.59 (P<0.0001). 2-hour sample predicted significant proteinuria with a sensitivity of 78%, specificity of 66%, and positive value of 64% and negative predictive value of 80%. Random sample predicted significant proteinuria with a sensitivity of 78%, specificity of 77%, and positive predictive value of 73% and negative predictive value of 82%. All patients with proteinuria in random and 2-hour samples had significant proteinuria in 24-hour sample. Only one patient without proteinuria in random and 2-hour samples had significant proteinuria in 24-hour sample. Conclusion: There was a moderate correlation between the 2-hour and the 24-hour urine protein levels. When the results of 2-hour and random urine samples are either positive or negative for proteinuria, It is highly valuable for documentation or ruling out of significant proteinuria.

Introduction: It is important to measure background radiation, because human beings are always exposed to environmental radiation. These ionizing radiations leave energy when striking human body and this energy when imparted is harmful for body tissues. In this study, environmental gamma radiation (outdoor measurements) of Kerman towns and indoor gamma dose rate in Kerman by thermoluminescent dosimeter (TLD) and RDS-110 surveymeter were measured. Methods: Equipments used in this study Experimental include: 1. A survey meter (RDS-110). 2. TLD-100 H (Lif:Mg,Cu,P) dosimeters. 3. TLD-Reader 3500 made by Harshaw, USA. In order to determine outdoor dose rate, four stations along with four main geographical directions and one station in town centers were selected. Indoor measurements in Kerman were carried out inside 20 dwellings by both TLD and RDS-110. Results: Our results indicate that on average, Bardsir has the highest outdoor background radiation in the province (1.03±0.32mSv/y) and Kahnooj has the lowest outdoor background radiation (0.61±0.30mSv/y). The average indoor dose rate measured by TLD and RDS-110 in Kerman dwellings were not equal and the difference of averages is equal to 12%. Conclusion: According to the above results, the annual dose rate of Kerman, Zarand, Baft, Shahrbabak, Sirjan, Bardsir, Rafsanjan, Bam and Jiroft are higher than the corresponding values for a normal area.

Introduction: There are multiple factors in failure of arteriovenous fistula (AVF) in patients with chronic renal failure (CRF) who require periodic hemodialysis. Out of technical errors, hypertension, site of insertion, size of vessels, diabetes and atherosclerosis are the common causes of failure in AVFs. This study is designed to evaluate failure of AVF in patients. Methods: In this descriptive study, 100 fistulas from 75 cases of CRF patients who were referred for AVF during 1996-2000 were selected and operated upon AVF by a given surgeon with the same technique (end-to-side) and followed 2 years relatively. In addition to underlying disease such as diabetes mellitus, atherosclerosis and inappropriate vessels, other factors as hypotension and bleeding of aneurismal vessels were recorded when AVF failed. The results were reported using descriptive statistics. Results: 100 AVFs were inserted in 70 patients, 53 in snuff box of left hand, 26 in distal of left forearm, 17 cases in left arm and 4 ones in snuff box of right hand. 30% failed primarily (before dialysis) commonly due to drop in blood pressure and among next 70%, 47 patients had functional AVF for at least 20 months and 23 of them had 7.5 months function who then failed commonly due to hypotension  during hemodialysis Conclusion: According to this study, hypotension was the cardinal cause of failure of AVFs in CRF patients. So we can reduce failure rate of AVFs by monitoring and controlling the blood pressure during hemodialysis and prevent hypotension by salted regimen intake.

Introduction: The tonic-colonic attacks are the commonest from of epileptic seizures. Diagnosis of generalized tonic-colonic seizures (TCS) by inspection of seizures, history and paraclinic findings (electroencephalogram) are easy, but diagnosis of pseudo seizures, syncope and TIA from TCS are occasionally differentiated. Determination of serum level of prolaction after attack can help in some of the cases. Determination of serum level of creatine kinase (CK) after attack can help to differential diagnosis of generalized tonic-colonic seizures. To determine the utility of serum CK measurement for diagnosing TCS and the best time of measurement this study was designed. Methods: In this descriptive study, serum CK was detected in 50 patients admitted following an episode of TCS in 1,6,24 and 72 hours after attack. T-test and analysis of variance was used for statistical analysis. Results: Enzyme level was elevated in all of measured time. There wasn’t any significant difference between time 1,6,24 and 72 h. In all times, except 72 h enzyme level was significantly higher than maximum normal level (P<0.05).Conclusion: Determination of serum level of CK is a useful test for evaluating patients with TCS and it’s measurement to 24 hours after episode of seizure is more accurately.

Introduction: Congenital lobar emphysema (CLE) is rare a rate anomaly of lung development that usually presents in the neonatal period with respiratory distress and pulmonary lobar hyper inflation and may present as a diagnostic and therapeutic dilemma. Methods: In this descriptive study, we reviewed the clinical features and management of 6 patients with (CLE) treated in our department over a period of 13 years, from 1990 to 1993. Blood gas analysis, CX ray, CT of chest and bronchoscopy; if indicated was done. Lobectomy was performed in 5 patients. All information about the patients, diagnosis, treatment and 1 year follow up were collected. Results: Physical examination in all patients showed. Mediastinal shift, decreased breathing sound in the involved lung and also resonance in percussion. The involved lobes were: left upper lobe in 3 patients, R middle lobe in 2 patients and right lower lobe in 1 patient. In all patients, CX ray showed hyperinflation of the involved lobe and herniation to the opposite side and atelectasis of the adjacent lobes. In 2 patients with thachypnea, CT of chest confirmed the diagnosis. Conclusion: Congenital lobar emphysema should be suspected in any infant presenting with breathlessness and a simple CX ray is sufficient to establish the diagnosis in the vast majority of patients. Pneumothorax, tension pneumothorax, hyperinflation of lung due to foreign body aspiration should be in the list of differential diagnosis. In patients presented very early in life and those with severe respiratory symptoms surgery is more indicated.

Introduction: Short or long inter pregnancy intervals increase fetal and maternal risks. Suitable interval between children increase mothers health level and enable her to get ready for the next pregnancy. This study is conducted in order to investigate the pregnancy intervals and the pregnancy issues in Shariati hospital, Bandar Abbas, Iran. Methods: In this cross-sectional study, the relationship between interpregnancy interval the interval of the last pregnancy whether term or preterm till present pregnancy) and of the prenatal cares, abortion, pre-eclampsia and eclapmsia, third trimester bleeding, preterm birth, kind of delivery, still birth and low birth weight were studied. The population under study were 1093 singleton pregnant having prior delivery that refer to the maternal hospitals during a year. The results were analyzed using Chi-Square and analysis of variance statistical tests. Results: This study shows that short (<12 month) and long (>60 month) inter pregnancy intervals were respectively observed 13.8% and 32.1%. The greatest amounts of samples in the pregnancy interval less than 12 months (34-7%) were observed in 21-25 years old women. The greatest amount of samples in the pregnancy interval more than 60 month was 36.8% in 26-30 years old women. There was significant relationship between mother’s age and pregnancy interval (P<0.05). This rate in the women who had not prenatal cares and did not refer to the health centers (30.77%), the most amounts related in pregnancy interval of 37-48 months. Conclusion: Women with short interpregnancy interval (<12 month) had the highest rates of placenta previa, still birth, preterm birth and low birth weight, and the rates of pre-eclampsia and eclampsia were highest in the women with interval>60 month. This interval is associated with increased risk for mothers and fetus.

Introduction: The newborns who encounter the increasing of ISB (indirect serum bilirubinemia) thickness are 60%. The aim of this stay is the determination of the range of indirect serum hyperbilirubinemia three days after birth of term newborn by using their nutrition indicator. Methods: This study is a cross-section with all term newborns as statistical population (after 37 weeks till 42) who were born in Ghods hospital. The samples were selected randomly. Data gathering was done by interview, observation, physical (newborn weight) and biochemical (ISB & cord hemoglobin measurement). Check list, newborn card nutrition, weighting instrument were the other research tools. The methods were done by questionnaire performed for 118 newborns. The mothers were given registered card of nutrition specification during 3 days after birth. On the day, 85 newborns were brought to Ghods treatment center to sampling and determining ISB thickness. t statistical test was used for analysis and P<0.05 was considered significant. Results: In this study (61.1%), (69%) newborns in order had IB (inclusive breastfeeding) nutrition with the medium range of 5, 5-7 in 24 hours. Their ISB was more than 11 mg/dl in 3 days after birth, while 60% newborn had bilirubin less than 6 mg/dl with the range of IB nutrition of 7 period (40.3%), (80%), (69.2%) newborns with medium range of less than more than 11 mg/dl in 3rd day. t test showed that there is an indirect relationship between SW in 24 hours and ISB thickness 3 days after birth (P<0.05).

Introduction: Medical Record Services are considered as one of the prominent services in health sciences. To make sure of the providing required services and to improve the services, the performance of the services must be evaluated. This study is conducted to investigate the condition of "Medical Record Sections" at Hormozgan University of Medical Sciences (HUMS) affiliated hospitals. Methods: In this the society of the study is the staff in charge at Medical Record Sections in 11 hospitals affiliated to HUMS. View points of the staff about apace, equipments, using technology and their activities were collected via a pre-designed questionnaire. The results were presented, using descriptive statistics. Results: 81.8% of the under study sections, do not have the required staff. 91% of them do not have required space and equipment. 81.8% of them do not have an active medical record committee and none of them have computer networks.Conclusion: Since some of the issues propounded at medical record committees help to improve the quality of medical record sections, not having such a committee not only results in issues like devoid of computer networks, not having required staff, lack of space and equipment but also the number of issues increase to not carrying out qualitative and quantitative studies. It is recommended that medical record committees to be established by the in charge staff at the sections to propound the issues at their hospitals concerning medical record.

Introduction: Substance abuse is a major problem in many societies as well as our country. This leads too many socioeconomic problems for societies, so it is important to achieve an effective program to improve this problem. Many treatment protocols such as therapeutic community (T.C) have been suggested for substance abusers. Psychological problem and co-morbidity in substance abuse leads to poor therapeutic response and high rate of recurrence. T.C can improve mental status of substance abusers. Therefore we studied the effect of residence in T.C on their mental status. Methods: In an experimental pretest – posttest survey, 30 substance abusers were evaluated for mental status, before and after residence in T.C using ScL-90-R scale. The results evaluated with SPSS program and T - paired Test. Results: In this study, there was a significant difference in mental status of addict patients before and after residence in T.C (P,0.005), except in phobia (P=0.018). Conclusion: Our results show that therapeutic community is an effective program and improve mental status of substance abuser and addict patients and probably can decrease the tendency of patients to come back to dependency.

To evaluate the efficacy of Mitomycin-C during lacrimal probing for adults with blocked nasolacrimal duct, this prospective, non-comparative, interventional case series was conducted on 19 eyes of 16 patients from October 2001 to November 2004 with epiphora caused by nasolacrimal duct obstruction. The probing was not successful in 2 of the eyes due to proximal bony obstruction of nasolacrimal duct, so data of 17 eyes of 16 patients were analyzed. Ten (71.5%) of the patients were female and 4 (28.5%) male. Mean age and standard deviation of age, duration of epiphora before operation and follow-up period were 42.1±17.4 years, 2.04±1.03 years and 13.8±8.3 months, respectively. Bilateral involvement was seen in 3 of the patients. In 6 (35.2%) eyes second probing with adjunctive Mitomycin-C was done and only in one of them (16.6%) relative success resulted. In 4 (23.5%) patients immediately after probing hemorrhage from punctum occurred and stopped spontaneously. No, mild, moderate and severe watering were seen at the final visit in 4 (23.6%), 2(11.7%), 3(17.7%) and 8(47%) eyes, respectively. Overall in 4 (23.6%) eyes watering was completely absent and in 9 (53%) eyes watering decreased. Dacryocystitis occurred in 1 (5.8%) eye after operation and 5 (29.5%) of them underwent dacryocystrohinostomy owing to sever ephiohora unresponsive to probing with adjunctive Mitomycin-C. Conclusion: Complete success after probing with adjunctive Mitomycin-C is not high, but this procedure is simple, safe and doesn’t need especial equipment. So it can be considered as an alternative operation in the patient for whom dacryocystorhinostomy cannot be done.