Hormozgan Medical Journal
Year:2012 | Volume:16 | Issue:4|Papers Count:14

Introduction: Bladder Exstrophy (BE) is a congenital anomaly in which the bladder and abdominal wall and external genitalia are pathologically open. Incidence of this anomaly is one in 50000. Treatment of this anomaly is complicated and, the old method of treatment was pelvic osteotomy. The aim of this study was offering a new surgical approach, which is closure of the bladder in bladder exstrophy-epispadiasis complex using rectus muscle flap without pelvic osteotomy.Methods: From Nov 2008 to Nov 2011 15 cases of BE containing 10 boys (70%) and 5 girls (30%) were under 3 steps of surgical operation. Patients were followed up in this period and outcomes and complications of this new surgical approach were recorded.Results: Mean volume of bladder after first operation was 58.2±3.71 milliliter (ml). There were 4 cases of wound infection (26.6%), 3 wound dehiscence (20%) and 2 bladder dehiscence (13.3%). After the second step of surgery there were 3 cases of wound infections (20%), 4 cases of uretero-vesical fistulas (26.6%). After third step of surgery there were 2 cases of wound infections (13.3%) and 4 cases of bladder dehiscence's (26.6%). The shape and size of external genitalia in 60% of boys and in 80% of girls were acceptable. The mean time of the urinary continency was 25 min.Conclusion: Outcomes of the new surgical technique, based on our study, were acceptable and complications with little and controllable complications. So we recommend the new surgical technique for bladder exstrophy repair.

Introduction: Anopheles mosquitoes are the sole biologic vectors of mlaria. Up to now, more than 480 species of Anopheles have been identified. The present study was achieved to identify the Anopheles mosquitoes of malaria high risk foci in Hormozgan province (Bashagard and Syahoo districts) and detect their main biologic characteristics in 2007-2008.Methods: Larvae, pupae and adult mosquitoes were captured in a descriptive- cross sectional study from selected villages. Adults were captured using total catch, aspiration and shelter pit methods. 4th instar larvae and adults were identified microscopically using identification keys.Anthropophilic tendency of 184 adult fed females were chequed by ELISA. Some females of dominant species were dissected to cheque for oocyst ans sporozoite of Plasmodium. Night activity of adults was assessed in a night catch operation using volunteer human bait.Results: Totally 5496 larvae and 1986 adults of Anopheles mosquitoes were identified.Eight species were identified as the Anopheles fauna in malaria high risk foci consisting of Anopheles stephensi (34.63%), An. moghulensis (22.28%), An. dthali (13.84%), An. fluviatilis (10.34%), An. culicifacies (9.51%), An. turkhudi (6.95%), An. sergenti (1.63%) and An. superpictus (0.8%).Conclusion: An. moghulensis could be a suspected vector in the Bashagard district because of very high population. Because of endophilic tendency and relative high anthropophilic index (20.58%). It is recommended that infants and pregnant women use the impregnated bed nets because the mosquito's blood feeding activity starts from the early night.

Introduction: Population movement and immigration from malarious areas to non endemic will increase the risk of malaria transmission. Immigration could be lead to role back malaria and changing clear up to potential even residual active foci. The purpose of this study is the effect of foreign immigrant on the malaria incidence and focal malaria classification in Konarak County, Iran.Methods: In this descriptive- analytic study, the number of malaria patients in the villages of Jahliyan region during the 2005 to 2009 were classified. The region located on the route of foreign immigration of the east country and borderline of Pakistan. Descriptive statistics and t-test was used for analysis.Results: The presence of foreign immigrants lead to increasing Annual Parasite Incidence (API) in 2008 than 2005 – 2007 and changes the focal malaria classification in the villages. So that some clear up foci changed to residual active. A significant difference between the number of malaria cases in the villages in 2006 and 2008 and also between 2007 and 2008 was observed.Conclusion: According to this research, the major cause of malaria cases increase and change in malaria focal classification in the villages was presence of foreign immigrants. The national malaria elimination program emphasizes on development and keeping of clear up foci. So the presence of foreign immigrants is critical point in this program.

Introduction: Stroke is an acute neurologic deficit which lasts for more than 24 hours. Recurrence of stroke increases the probability of the death rate and disabilities. This study was conducted in Farshchian Hospital in Hamadan from 2004 to 2009 to investigate the recurrence of stroke in the hospitalized patients.Methods: In a cross sectional study, all stroke patients hospitalized in neurology ward of Farshchian hospital surveyed from 2004 to 2009. The information gathered was based on research questions and an intended check list obtained from the patients the data were analyzed using descriptive statistics and Chi-Square test.Results: In this study, frequency of stroke recurrence was 939 from 5413 patients (17.35%). 864 cases (92.01%) were ischemic type and 75 cases (7.99%) were hemorrhagic type. Risk factors of recurrence stroke were hypertension, Diabetes mellitus, heart disease, smoking cigarette, hyperlipidemia, coagulopathy respectively. In this study, frequency of stroke recurrence death rate was 34.6%.Conclusion: Controlling the risk factors through medical treatments and changing people’s life style is recommended. This can reduce stroke recurrence and its mortality rute.

Introduction: In recent years, cardiovascular risk factors and the role of knowledge was so important in new researches.Unfortunately, ascending trend of these diseases in developing countries as well as Iran is disquieting. This study is aimed to determine the knowledge of truck and bus drivers about coronary heart disease risk factors.Methods: In this descriptive-analytic study, 300 bus and truck drivers who had come to passenger terminal and terminal trucks at Bandar Abbas city in south of Iran were selected randomly. A questionnaire containing demographic characteristics and questions about their knowledge about coronary heart disease risk factors was completed for each driver. Data were analyzed using SPSS software; t and Chi-square tests were used for statistical analysis with significance level of 0.05.Results: In total, 75 truck drivers', 149 trailers drivers and 76 inter-city bus drivers were studied. All drivers were male with mean (±Sd) age of 316.8±810.40 years. The drivers’ knowledge about coronary heart disease for 97 (33.32%) was moderate or good. In this study a significant relationship between education and level of awareness about the risk was observed (P<0.05). Moreover, statistically significant relationship between age and previous history of heart disease was observed (P<0.05).Conclusion: It seems that intervention measures should be carried out to escalate the drivers' knowledge about coronary heart diseases risk factors.

Introduction: Childbirth qualifies as an extreme traumatic stressor that can result in posttraumatic stress disorders. The current study aimed to determine the prevalence and precipitating factors of post traumatic stress disorder (PTSD) after childbirth.Methods: In this is cross sectional study, 572 women who were in 6-8 weeks after childbirth, were selected by convenience sampling method. The study was carried out in medical centers in 5 cities in west Azerbaijan province, Iran. Demographic, obstetrical, neonatal and mental variables, social support survey, life events scale and post traumatic symptoms scale-I (PSS-I) were collected. Data were analyzed by SPSS using Chi-Square and logistic regression methods.Results: Result of this study showed that 39% women reported PTSD after childbirth. The strongest risk factors were: parity, duration of lab our in hours, mode of delivery, sex of baby, income sufficiency and low social support (P<0/05).Conclusion: The prevalence of PTSD after childbirth in this research is higher than those found in other countries. So, interventions aimed at reducing the incidence of PTSD after childbirth are necessary.

Introduction: Lecture is the most applied method for teaching theory courses to medical students. This method is not accountable for the high current needs of students and leads to boring classes. This study was designed to assess the teaching effectiveness of active learning in small group sessions, compared with passive learning in didactic lectures.Methods: This study was carried out on Hormozgan University of medical sciences medical students.45 students of respiratory physiology course were divided into 5 equal groups. Participant’s scores and their perceptions of effective small group teaching in the Physiology of Respiratory System component of the undergraduate curriculum were assessed. During this process 3 topics were selected to be instructed in lecture- based and 3 topics for small group discussion. The course began with oral lecture sessions and was continued with inductive teaching. For inductive teaching, the students became familiar with the topics, references and lesson plans of sessions and in every session were exposed to 10 questions. Following every 3 sessions, students competency were assessed by a written examination composed of long answer and multiple choice questions and students satisfaction toward used learning methods were measured using a structured questionnaire.Results: The results show that the students prefer small-group learning method over lecturing and achieved scores in small-group discussion sessions were significantly higher than lecture sessions.Conclusion: This study highlighted that small-group learning is a practical and effective method in teaching basic science to medical students. Further studies and working on tailormade methods for our country is suggested.

Introduction: There is a relationship between stress and the onset of Multiple Sclerosis (MS). So, controlling stress is necessary in patients with MS. We aimed to investigate the effect of educational intervention base on BASNEF model to promote behaviors in patients with multiple sclerosis in stress management.Methods: This is a quazi-experimental intervention study. This study was performed on 100 multiple sclerosis patients of 15-50 years old from Sina and Shariati hospitals Tehran. They were randomly divided into, experimental and control groups. The instrument for data collecting was a questionnaire established based on the BASNEF model. Both groups completed the questionnaires before intervention, and the patients of the experimental group participated in educational classes for 8 weeks. The collected data were analyzed using t, Chi-Square and Man Whitney statistical tests.Results: Both groups did not have any significant differences based on demographic characteristics. Before intervention, there was no significant difference between the grades of behaviors of patients with multiple sclerosis. After intervention, a significant difference was seen in experimental group’s grades (P<0.001), but there was no significant difference in time management behavior.Conclusion: The finding of current study confirmed the effect of educational intervention, based on BASNEF model, on promoting behaviors of patients with multiple sclerosis.

Introduction: The quality of service has an important role in the success of health care organizations. Service quality has been an important research topic in view of its significant relationship to costs, profitability, customer satisfaction, customer retention and service guarantee. This study attempts to use SERVQUAL instrument to analysis the gap between qualities of services in Shahid Sadoghi hospital, Yazd, Iran.Methods: This descriptive study was carried out through in 2010. The research population comprised patients admitted to Shahid Sadoghi hospital wards. Sample size, included 78 patients, and obtained randomly. The data was collected by 22-item SERVQUAL questionnaire that was designed according to gap model. Data analysis was carried out by SPSS 14, using Kolmogror – smirnore and t-tests.Results: The results demonstrated that there was a quality gap in Shahid Saddoghi hospital. In the other hand, the results showed that there were significant differences between expectations and perceptions of patients in SERVQUAL dimensions. Also, the study identified some critical and problematic items that have main role in constructing observed quality gap.Conclusion: The existing quality gap means patient's expectations exceed their perceptions.Thus, improvement is needed across SERVQUAL dimensions.

Introduction: Microwaves are a part of the electromagnetic radiation spectrum that has high frequency and short wavelength. The purpose of this study is to determine electromagnetic radiation emitted from household and restaurant microwave ovens.Methods: The survey was carried out for 45 ovens used in households and restaurants.Electromagnetic radiations from different brands of microwave ovens available in Iranian market were investigated by microwave leakage detector model HI-1501.Results: The total average measured leakage was 1.11±1.3 mw/cm2 with water load test, while average measured leakage for household and restaurant user type were 1.1±1.7 and 1.1±1.2 mW/cm2, respectively. In 86.66% of the household ovens, only 25.2% emitted radiation was more than 1 mW/cm2. Ovens surveyed in households were elder than restaurant user type (2.3 ±1.3 vs. 2.1±1.5). The maximum leakage was found at the door key (8.1 mW/cm2) of the ovens. Three-way ANOVA to evaluate oven age, type of user and place of measuring on the leakage rate showed that there was not relationship between the quantity of radiation leakage and type of user but oven age and place of measuring were effective on the microwave leakage. 70.4% of the ovens emitted radiation was less than the public exposure limit (1 mw/cm2) and none of them emitted more than the occupational exposure limit of 5 mw/cm.Conclusion: Based on the findings in this study, no detrimental health effects are expected from microwave ovens.