Hormozgan Medical Journal
Year:2006 | Volume:9 | Issue:4|Papers Count:14

Introduction: Aspiration of foreign body can cause partial obstruction, secondary inflammation or complete obstruction of tracheobronchial tree and sometimes may lead to death. This study was aimed to investigate the main causes of foreign body aspiration in patients referred to Bandar Abbas medical centers. Methods: In this cross-sectional and analytic study, 134 patients with foreign body aspiration, who referred to Bandar Abbas medical centers during 2000 to 2004, were investigated. After history taking, physical examination and radiography, foreign body was removed and the information about foreign body, personal characteristics of the patient, and etiology related to aspiration were collected. Using SPSS statistical software, Chi-Square test as well as Hest was used for statistical comparisons. P<0.05 was considered significant.Results: Rigid bronchoscope for removal of foreign body in 131 of 134 patients was successful. 53% of the patients were in 1-5 years age group. Findings showed a significant relationship between age, sex, number of family member, job and education of the parents (P<0.05) Conclusion: Identification of high risk groups and conducting training programs are effective methods for preventing foreign body aspiration. Its diagnosis depends on history taking, physical examination and radiography. In the case of foreign body aspiration suspicious, the best way of diagnosis and treatment seems to be rigid bronchoscope as soon as possible.

Introduction: Dermatophytes are fungi that require keratin for growth. These fungi can cause skin, hair, and nail infections. Dermatophytes are spread by direct contact from other people (anthropophilic organisms), animals (zoophilic organisms), and soil (geophilic organisms), as well as indirectly from fomites.Dermatophyte infections can be readily diagnosed based on the history, physical examination, and potassium hydroxide (KOH) preparation. Variable clinical forms require different therapeutic approaches. The aim of this study was to analysis different clinical types of dermatophytosis and their etiologic agents as well.Methods: In this epidemiological study, a total of 402 clinically suspected cases of dermatomycoses, from three different dermatology clinics in Bandar Abbas were examined for causative fungi during September 2003 to March 2005. The patients were clinically examined by dermatologist. The causative organisms were identified by potassium hydroxide preparation and cultured in Sabouraud dextrose agar slants. Macroscopic appearances of colonies, microscopic examination through slide culture and biochemical tests were used to identify the fungi. The results were presented using descriptive statistics.Results: From total 402 suspected cases, 299 were culture positive. The most frequent clinical form of dermatophytosis, were Tinea cruris (37.5%), tinea capitis (22.5%), tinea corporis (20.7%). Male patients were infected mainly with tinea cruris, tinea capitis and tinea pedis, while female patients were infected mainly with tinea unguium. Nevertheless, the incidence of tinea manuum in males was the same as those in females. The non-inflammatory 'gray patch' variety was the most common clinical type. The most frequent isolated agents, were Trichophyton mentagrophytes (35.8%), T. rubrum (25.1 %), and Epidermophyton fluccosum (22.4%). Conclusion: Dermatophyte infections are still a major health issue in the region.To plan strategies for infection control, epidemiological surveys are essential.This study revealed that the main etiologic fungi were anthropophilic. In order to diminish dermatophytosis, sanitary conditions should be improved.

Introduction: Cerebral palsy is defined as a movement disorder in the first years of life which is not progressive and is due to permanent cerebral damages. Most of these movement disorders are preventable. The aim of this study is investigation on the probable etiology of cerebral palsy of children in Mashhad, Iran.Methods: In this descriptive study, 5 rehabilitation centers in Mashhad city were selected randomly. All children under the age of 13 years old with cerebral palsy were investigated. 54 children with complete prenatal and postnatal history were physically examined. The results were presented by descriptive statistics. Results: Of 54 cases of cerebral palsy, 29 (54%) cases were male and 25 (46%) cases were female. 30 (55.6%) cases were spastic, 7 (13%) cases were extrapyramidal, 12 (22.2%) cases were flaccid and 5 (9.3%) cases with mixed type of cerebral palsy were observed. In 35 cases of spastic cerebral palsy, 18 (33.3%) cases were diplegic, 6 (11.1%) cases were quadriplegic, 9 (16.7%) cases were hemiplegic, 1 (1.9%) case was paraplegic, and 1 (1.9%) case was monoplegic cerebral palsy. 19 (35%) cases were flaccid or extrapyramidal types. Conclusion: This study showed that most causes of cerebral palsy in children are preventable.

Introduction: Knee arthroscopy causes painful signals and if untreated, it will cause intensive and prolonged pain that may prevent rehabilitation of the patients for 2 weeks. The analgesic activities of some analgesics, following intra-articular injection, have been studied before. This study was designed to compare the analgesic effects of three narcotic analgesics in comparison with the control group.Methods: In a double blind randomized clinical trial, 110 patients were designated into four groups. All of them received an intraarticular injection containing 95ml bupivacaine with: 1:200000 epinephrines at the end of arthroscopic procedure in a 10ml syringe. The remainder of syringe was filled with one of the following solutions:Methadone (5mg) for 28 patients, Morphine (5mg) for 23 patients, Normal saline (5cc) for 28 patients, and Meperidine (50mg) for 27 patients. The patients then received analgesic based on their needs. The equivalents of analgesics to morphine were calculated. Other variables including patients need to analgesics during hospitalization, number of visits from discharge to 7 days later, and pain scores were also recorded. Data were analyzed by SPSS-12 statistical software and using Chi-Square and analysis of variance tests.Results: In morphine group the analgesic usage was significantly low in hospitalized (P<0.05) and outpatients (P<0.05) compared with the other groups. There was no complication during the study.Conclusion: Morphine in comparison with meperidine or methadone is more beneficial in reducing pain when added to bupivacaine following arthroscopic meniscectomy.

Introduction: Pterygium, one of the degenerative and prevalent ophthalmic diseases, is more prevalent in equatorial and tropical areas. This study was conducted in order to compare recurrence rate and surgical complications of pterygium treatment with four different transplantation methods of conjunctival autograft, conjunctival flap, using mitomycin-C with conjunctival autograft and using mitomycin-C with bare sclera.Methods: In this experimental study, pterygium treatment on 80 eyes from 68 patients was investigated. The transplantation methods were randomly allocated to the patients and all operations were implemented by one surgeon. Pterygium size of all patients was> 2 mm. 21 eyes were treated with conjunctival autograft method, 18 eyes with conjunctival flap method, 18 eyes with mitomycin-C with conjunctival autograft method and 23 eyes were treated with mitomycin-C with bare sclera method. Follow-up duration of the patients was between 6 to 24 months. The results were analyzed using Hest, Chi-Square and Analysis of variance statistical tests.Results: Recurrence rate for autograft transplantation method was 4.67%, for conjunctival flap method was 16.67%, for conjunctiva auto graft with mitomycin-C was 5.55% and of bare sclera with mitomycin-C was 8.70%. All recurrences occurred within 2 months from operation and there was no surgical complication. The relationship between recurrent pterygium and recurrence rates were statistically significant (P<0.05).Conclusion: Pterygium treatment with conjunctival autograft transplantation method is simple and safe with minimum recurrence rate. Using mitomycin-C with conjunctival autograft method has not any effect on recurrence rate and surgical complications for suitable and selected patients.

Introduction: Asymptomatic renal disorders my have a variety of different clinical presentations. Many of these patients in their routine laboratory examinations show elevated serum creatinine or abnormal urine analysis. This study is designed to evaluate the prevalence of asymptomatic urinary abnormalities in school age children in Bandar Abbas.Methods: This cross sectional and descriptive study was performed to evaluate the prevalence of asymptomatic urinary abnormalities in school age children in Bandar Abbas, Iran. 1010 school age children were randomly selected. Morning urine samples were examined for hemoglobinuria, glucose, proteinuria, bilirubinuria, white and red blood cells, hematuria, ketonuria, bacteriuria, parasites, and urine PH, by dipstick and also microscopic clinical tests. Data were analyzed using T and Chi-Square statistical tests.Results: 1010 children were examined. 53.5% of which were male and 46.5% female. The findings revealed that, 6% (30 male, 30 female) had proteinuria and 13.5% (60 male, 136 female) hematuria (P<0.05). The prevalence of bacteriuria was higher in females (24.7%) than in males (5.2%). The difference was statistically significant (P<0.001).Conclusion: Considering high prevalence of asymptomatic urinary abnormalities such as proteinuria, hematuria and bacteriuria, it seems that setting routine urinalysis can reveal significant urine abnormalities which may pave the way for early diagnosis and management of renal diseases.

Introduction: There is a significant co-action between psychiatric disorders and cardiac diseases. Management of psychiatric disorders in cardiac disease patients can lead to promotion of life quality and reduction in treatment costs. The aim of this study was investigating the frequency of anxiety and depression in cardiac disease patients and also the effect of treatment of these psychic disorders on cardiovascular patients after their admission in Taleghani hospital cardiac ward. Methods: In this cross sectional study, we evaluated 50 cardiac patients for depression and anxiety in three consecutive surveys by hospital anxiety and depression scale (HADS). The treatment status and psychiatric referral rate was also assessed. The results were presented using descriptive statistics.Results: The prevalence of depressive and anxiety symptoms were 72% and 90%, respectively. Trjcyclic antidepressants were prescribed for 14% and benzodiazepines for 30% of patients. While 14 patients were treated by anti depressant medications, only one psychiatric consultation was requested.Conclusion: This study confirms the high prevalence of depressive and anxiety symptoms among hospitalized cardiac patients. We need to develop collaboration and liaison activities for managing these comorbidities.

Introduction: Cerebrovascular accident (CVA) is the most important and prevalent disease of all neurological disorders in adults. It is also one of the most important causes of morbidity and mortality. The current study was conducted to evaluate some of the acute phase reactants in patients admitted for ischemic CVA in neurology ward.Methods: In this descriptive cross-sectional study, the data were collected through a questionnaire from the patients admitted in the neurology ward of Aliebn- abitaleb hospital in Rafsanjan, with primary clinical diagnosis of stroke and the net diagnosis of ischemic CVA according to their MRI reports, during the first 24 hours of their admission. Co-morbidities such as infectious diseases, inflammations and tumors were excluded from the study. The data were analyzed using EPI6 statistical software.Results: Some acute phase reactants including platelets (PLT), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell (WBC) were evaluated in 250 patients with ischemic CVA. 60.4% of the cases had a normal WBC count, while 39,6% showed abnormal WBC. CRP was negative in all the patients. Also PLT count was in a normal range for all the patients. 67.2% of the cases showed a normal ESR and 32.8% had abnormal ESR.Conclusion: In this study, the number of cases with abnormal WBC count and ESR was more than those reported in most previous researches. It could indicate the association of some acute phase reactants and thrombotic stroke. Lower ages of the patients with abnormal WBC in this study, may be due to the higher prevalence of vasculitic diseases at this range of age, or because of a delay in the inflammatory reactions at old ages.

Introduction: The occupational noise induced hearing loss is one of the wide spread problems and a long term complication of working in noisy environments. At the present, large groups of workers who are working in noisy environments are exposed to hearing loss. So, this study is aimed to determine the prevalence of hearing loss (more than, 25 dB) of the workers in coal mines and leaching factories in Kerman state.Methods: In this descriptive study, a sample of 150 workers from coal mines was selected using proportional stratified random sampling method. Based on results of first audiometry, individuals with hearing loss, history of diseases that cause hearing loss, more than 60 years old age and less than 5 years working history in a mine factory were excluded from the study. Data collection was performed using a check list including some personal and job characteristics and results of the first audiometry. In addition, audiometry was done for all of subjects. The results were presented using descriptive statistics.Results: Based on the audiometry results, maximum percent of hearing loss was related to 4000 Hz frequency and then 8000 and 2000 frequencies. Totally, in bone conduction 16% of workers were two-sided hearing handicapped. 16.7% of the workers had right ear hearing reduction, 19.3% left ear and 8% of them had air and bone conduction disability.Conclusion: According to this study, the workers are seriously exposed to risk of hearing problems due to insufficient education about hearing loss and lack of annual audiometry. So, designing some programs in order to reduce hearing loss should be considered.

Introduction: Increasing knowledge about nutrition and related educational methods can affect on a proper and balanced nutrition in vulnerable groups, especially students. It has an important role in achievement and promotion of students' health. The aim of this study is assessment of the effect of education on knowledge and attitude of health teachers and its impact on students' practice about good nutrition.Methods: In this semi-experimental study, 40 health teachers in Zahedan city and all of the students of two girl's secondary schools were divided to two case and control groups. The health teachers filled up a questionnaire which contained questions about their knowledge and attitude of proper nutrition before education. The case group was then educated by formal lectures, focus group discussions (FGD), and also question and answer methods. After education, the knowledge and attitude of all teachers was evaluated again by means of a post-test procedure.Then, the students' practice about good nutrition was evaluated by means of a questionnaire for the case students who were educated by their health teachers and the control group without any education. Data were analyzed by SPSS software and Chi-Square statistical test.Results: The findings revealed that there was a significant correlation between knowledge and attitude before and after education (P<0.001, P<0.04). Attitude was positive (82.8%) in older health teachers in comparison with the younger ones (33%). Age and job experience had significant impact on knowledge of health teachers. On the basis of our findings in case students, a significant difference in their practice, before and after education, was observed (P< 0.001), but this difference was not significant in the control group.Conclusion: The results of this study showed that intervention in education system has positive impact on pattern of nutrition and continuing education has significant effect on knowledge and attitude of teachers as well as students.

Introduction: Myopia is the most common eye disorder in the world. Multiple factors such as genetics, diet and near work activity have been cited as causative factors. In this study the effect of literacy on myopia is evaluated.Methods: In this cross sectional study, refractive error was checked by performing cycloplegic refraction on 212 persons of 21-24 years old in Shiraz, Iran. Ninety nine cases were illiterate (51 women and 48 men) and 113 were highly educated (60 women and 53 men). Spherical equivalent less than -0.50 diopter was considered as myopia. Data analysis was done by SPSS version 11.5 and use of Chi-Square test.Results: Age and sex differences were not significant in illiterate and educated groups. In the highly educated group 46.7% of women and 37.7% of men and in the illiterate group 21.6% of women and 0.5% of men had myopia in both eyes. Myopia was much more common in highly educated persons than in illiterate persons (P<0.001). No difference was seen in the prevalence of myopia between the highly educated men and women. In the illiterate group myopia was more prevalent in women than the men (P<0.001).Conclusion: Myopia is much more common in highly educated persons than illiterate ones. Higher prevalence of myopia in the illiterate women in comparison with the illiterate men may be related to near work activities of housekeeping.

Introduction: One third of all women's cancers are breast cancer. It is estimated that using screening methods causes 30% decrease in death rates due to breast cancer in over 50 years old women. The best method of screening at present is breasted self examination (BSE) and mammography. The aim of this study was to investigate knowledge and practice of 20-60 years old women in Babol about breast self examination.Methods: In this descriptive and analytic study, 160 females of 20-60 years old age were randomly selected. Data was collected using a pre-designed questionnaire and observations. For data analysis, descriptive statistics and Chi- Square statistical test were used.Results: The findings revealed a weak women's knowledge and practice on breast self examination (55.6% and 66.9%, respectively). Women's knowledge was significantly related to age (P<0.001), job (P<0.001), living place (P<0.025), and previous breast examinations (P<0.001), but there were not a significant relationships with education and information resources. Women's practice had significant relationship with previous breast examinations (P<0.001). There was also a significant linear relationship between women's knowledge and practice (P<0.005).Conclusion: The obtained results recommend teaching programs about breast self examination for all age groups to promote women's health.

Introduction: Systemic lupus erythematosus (SLE) is a chronic multi-system autoimmune disease that is uncommon in the pediatric population. The cardiovascular system may be affected during the course of systemic lupus erythematosus. Coronary artery disease and myocardial infarction are rare in young patients with systemic lupus erythematosus (SLE).Case report: We present a girl who was diagnosed with SLE at the age of 8 years and suffered an acute myocardial infarction at the age of 14. Risk factors for her coronary artery disease were hypertension, hypercholesterolemia, and relatively long duration of active disease with nephrotic syndrome and chronic use of steroid.Conclusion: Although myocardial infarction is rare in children with systemic lupus erythematosus, this complication should be considered in these cases.