Hormozgan Medical Journal
Year:2008 | Volume:12 | Issue:2|Papers Count:12

Introduction: Unripe cervix is the most important factor in failure of labor induction. This study is conducted to compare the efficacy and side effects of Dinoproston and high dose Oxytocin as ripening agents in labor induction. Methods: In this double blinded randomized clinical trial, 120 women with unfavorable cervix who underwent labor induction were randomly assigned to vaginal Dinoproston (9 mg) or intravenous high dose Oxytocin (6 miu/min) groups. Initial 12 hours Bishop-Score, labor induction to labor duration, delivery type, 1 and 5 minute APGAR, side effects on mother or neonate, hospitalization duration and hospitalization costs were recorded. Data were analysed using t and Chi-square tests by means of Minitab statistical software. Results: The results showed that vaginal Dinoproston was effective in shortening latent phase of labor (P<0.01).But, mean Bishop-Score over the initial 12 hours, the interval between labor induction to delivery, and side effects for mother or neonate were not different between the two groups. Based on the results, although hospitalization duration was not different between the groups, hospitalization costs for Dinoproston group was significantly higher (P<0.05).Conclusion: It seems that in spite of shortening the latent phase of labor in vaginal Dinoproston group, it is not more effective than high dose Osytocin as an adjuvant to labor induction in women with unfavorable cervix.

Introduction: Kidney transplantation from a live donor has many advantages, but the donor should undergo a major surgery and accept potential morbidity and mortality. In this study, we evaluated the long term effects of nephrectomy on renal function and blood pressure of kidney donors.Methods: In this cross-sectional study, we assessed 195 kidney donors. The controls were 100 healthy individuals with two kidneys. The variables were age, sex, systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine, creatinine clearance and proteinuria (all before and after kidney donation) and time interval between donation and study. Data analysis was accomplished using SPSS software, and paired t-test and Pearson correlation coefficient were used for data analysis.Results: Although serum creatinine was elevated at the time of study, but this rise was not significant. SBP at the time of study was significantly greater than the time of donation (P<0.001). Creatinine clearance at the time of study was significantly lower than the time of donation (P<0.001). There was no correlation between serum creatinine, creatinine clearance, SBP, DBP and age at the time of kidney donation in men. Age at the time of kidney donation was correlated with SBP and DBP and creatinine changes in women (P=0.001 and P=0.002, respectively).Conclusion: This study showed that nephrectomy does not impair renal function in donor and does not lead to a progressive rise in blood pressure or urine protein excretion up to 6.5 years after nephrectomy. Nevertheless, we suggest that kidney donors should be selected after exact screening for potential risk factors of renal disease.

Introduction: Migraine as the most popular vascular headache has always been the topic of discussion in the medical literatures. Regarding the theories underlying pathophysiology of migraine, various methods for treatment of this disorder have been proposed. Menthol is the most important active agent in peppermint and various mechanisms of action for it have been proposed till now, many of them focused on its analgesic effect through TRPMs, a group of the transient receptor protein TRP. In previous interventional studies also, a solution of peppermint extract in ethanol significantly reduced the clinical tension type headache intensity. Regarding numerous therapeutic effects of menthol, we performed this study to evaluate the effect of cutaneous application of menthol on reducing headache intensity in migraine acute attacks.Methods: Twenty five female patients enrolled in this interventional uncontrolled study. They all used the 10% menthol solution the way they were informed. During the consumption, they filled out some questionnaires containing information about intensity of headache and associated symptoms.Results: Within 33 well recorded attacks of migraine, 50% relief of pain occurred after 1.85 hours and sustained pain-free efficacy was achieved after 6.76 hours. Seventy one percent of migraine patients who had nausea/vomiting and 43% of those who were suffering from photophobia and phonophobia associated with headache became symptom-free after 2 hours.Conclusion: This study demonstrates that cutaneous consumption of 10% menthol in ethanol solution is well tolerated by the patients and relieves the pain and associated symptoms. However, further controlled studies are needed to confirm these observations.

Introduction: F-wave latency is one of the most sensitive parameters which is used for diagnosis of radiculopathy and neuropathy in electrodiagnostic medicine. Electrodianosis professionals mostly use reference values published in major textbooks mostly written in USA based on anthropomorphic characteristics of American people. Also there is considerable difference between heights of males and females in each country, which is not considered in reference tables. We performed this study to determine any difference between F-wave latencies in both genders and also between our population and mainly used reference values. Methods: This cross-sectional study was performed on 60 healthy volunteers (30 males and 30 females). Minimum F-wave latencies of median and ulnar nerves at wrist, and also tibial and peroneal nerves at ankle were recoded after ten supramaximal stimulation of each nerve.Results: The average heights were 156.05±4.80 and 171.58±6.05 centimeters in females and males, respectively. Mean of minimum F-wave latencies in males were 24.93±1.55, 25.73±1.48, 46.86±2.94 and 46.91±3.04 and in females were 22.66±1.23, 22.97±1.33, 42.61±3.20 and 42.33±3.17 milliseconds for median, ulnar, tibial and peroneal nerves, respectively. These values were significantly higher in males than females. There was correlation between height and mean of F-wave latencies in median, ulnar, tibial and peroneal nerves. There were significant differences between males and females in all tested nerves. Also there were significant differences between our measured latencies and the reference values published in major electrodiagnostic textbooks.Conclusion: Regarding the significant height difference between two genders, we recommend defining separate reference values for each group. On the other hand, each population should have its own reference values correspondingto average height of its own people; otherwise the sensitivity of this parameter (F-wave latency) will be significantly low.

Introduction: Staphylococcus aureus is one of the most important pathogens in nosocomial infections. About 30-50% of people harbor this organism in their nose. Since carrier status in hospital staff is a major source of S. aureus infections in hospitalized patients, it is of great importance to detect carriers for preventive strategies.Methods: In this cross-sectional study, nasal carriage of S. aureus was studied in 200 hospital staff, working in teaching hospitals, in Bandar Abbas. The nasal swabs of the subjects were cultured on blood agar and manitol salt agar media. Identification of isolates was performed by catalase, coagulase and DNase tests. Antibiogram pattern and beta-Iactamase activity of isolates were assessed according to Kirby-Bauer and acidometric methods, respectively. Results: Nasal carriage state was found in 33 individuals (16%). The maximal carrier rate was observed in internal ward (40%). The strains were quite resistant to penicillins and cephalosporins. All of the isolates were sensitive to methicillin and 94.5% of them were sensitve to imipenem. High degree of sensitivity (>95%) was also observed to netilin, rifampin and vancomycin. The isolates were completely resistant to colistin, lincomycin, neomycin and streptomycin. Penicillinase activity was observed in 27.3% of isolates. Conclusion: Regarding high frequency of nasal carriage states, more attention should be paid on screening and treatment of carriers.

Introduction: Using standard guidelines of occupational safety and health administration (OSHA) is necessary for handling cytotoxic drugs at chemotherapy centers and nurses should learn them carefully. This experimental study was performed to evaluate the effect of educating standard OSHA guidelines on the quality of drug administration in chemotherapy centers affiliated to Shiraz University of Medical Science.Methods: This interventional study was performed for nurses (N=46) who have worked in chemotherapeutic centers affiliated to Shiraz University of Medical Sciences. Two questionnaires and four observational checklists were used for evaluating and comparing the nurses' knowledge and performance in two stages: before and three months after attending in an educational workshop: "The standard principals of working with antineoplastic drugs". Data analysis has done by SPSS software.Results: The comparison of the mean of personnel knowledge scores showed a significant difference between them before and after training (P<0.001). The comparison of the mean of personnel performance scores for standard drug administration showed that the mean of performance score increased after training from 28.79±8.5 to 55.44±5.3 (out of 86) and the difference was statistically significant (P<0.001). Conclusion: Educating the principles of standard drug administration to personnel of chemotherapy centers can improve the quality of drug administration and also will decrease the environmental pollution and professional hazards during working with cytotoxic drugs.

Introduction: Chronic suppurative otitis meida (CSOM) is a common ear disease with potential intra and extracranial complications. The control of infection is very important for prevention of its consequences. The aim of this study was to compare three topical treatment modalities in patients with this disease.Methods: A randomized clinical trial was performed on three groups of CSOM patients with active otorrhea but without cholesteatoma, otomycosis or ear polyps. They were treated with three different topical drug regimens: group I (combined therapy, 61 patients) with acetic acid 1.5% solution and ciprofloxacin 0.3%; group II (acid therapy, 30 patients), with acetic acid 1.5% solution; and group III (antibiotic therapy, 30 patients) with ciprofloxacin 0.3%. All patients were followed weekly for 4 weeks and results compared with chi-square and fisher tests.Results: At the end of second week, the infection was controlled in 95.1% of patients in group I, which was statistically greater than other two groups 50%, 73.3% respectively (p<0.0001). The response rate to topical therapy was also more than other groups in group I patients, after one week of treatment (p<0.001). In accordance with the ethical principles, 15 patients of group II and 8 patients of group III, with treatment failure, were also underwent combined therapy, which 100% of these patients in the group II and 87.5% of them in the group III, responded to treatment after two weeks.Conclusion: According to our findings, the combined topical therapy with acetic acid and ciprofloxacin is an effective and quick treatment method for control of infection and otorrhea in patients with CSOM.

Introduction: Implementing infection control programs in dental clinics is essential to prevent transmission of infectious agents among personnel and patients. The program usually starts by evaluation of risk factors and is completed by designing a suitable strategy to eliminate them. In this study, we have evaluated the infection control situation in private dental offices in Bandar Abbas, southern Iran, during year 2006. Methods: In a cross-sectional study, 60 dental offices were investigated in a period of 6 months. A standard questionnaire was used for. data gathering (response rate was 82%). The questionnaire contained 46 questions about demographic information, knowledge and practice of dentists related to infection control and hygienic condition of their clinics. Data was analyzed using t-test and pearson correlation coefficient by means of Excel and SPSS softwares.Results: The vaccination rate against hepatitis B was 43.5% among dentists, while 75% of them were not sure about antibody production in their body. The rate of using personal protection equipments and mouth washing solution among dentists were 80% and 15%, respectively. Correct answer to questions on instruments sterilization, proper hand washing and subcutaneous infection control were 74%, 56.7% and 34%, respectively. Special containers were used for infectious disposal in 82% of clinics which only 60% of them were labeled. Seventy four percent of dentists were confident about accurate sterilization of instruments, but 50% of them were not confident that instruments remained sterilized until operation. The average score of knowledge, practice, and hygienic clinics situation in female and male dentists were 10.1±1.73 and 11.1±1.79; 14.4±1.40 and 13.6±1.73; and 16.6±1.13 and 16±1.26, respectively.Conclusion: In our quality assessments, the knowledge and practice level of participated dentists were intermediate and environmental health situation of clinics was scored high. According to relationship between knowledge and practice, infection control rate will be promoted using appropriate educational programs.

Introduction: Acidosis-hypoxic phenomenon is a valid indicator to determine fetal distress and is defined by measuring the blood pH of umblical cord. None of the present screening tests for evaluation of pregnant mothers have acceptable clinical accuracy to assess fetal acidosis. We decided to evaluate the relationship between fetal well being tests Non-Stress Test (NST), Oxytocin Challenge Test (OCT) and Biophysical Profile (BPP) with APGAR score and the blood pH of umblical cord.Methods: In this case-control study, we enrolled 50 high-risk pregnant women (BPP test positive, OCT positive or non reactive NST) as cases and 50 pregnant women without fetal risk factors as control group. The umblical cord blood sample was taken immediately after delivery. Some variables such as maternal age, gestational age, parity, NST, OCT, BPP, blood pH of umblical cord, neonatal weight, sex and APGAR score were evaluated and the data was analyzed by SPSS software.Results: Discrimination between NST with acidosis (P<0.01) was significant in the case and control groups, but in case of OCT with acidosis it was not significant. NST and OCT had low sensitivity (58.3 and 46.5 respectively). Besides, the relationship between BPP and blood pH of umblical cord was significant in the case and control groups (P<0.02). APGAR score of the cases were lower than the control group (P<0.0001). Conclusion: In evaluation of fetal acidosis, the BPP test is the best screening test comparing to NST and OCT.

Introduction: Diabetes mellitus is one of the most common chronic diseases around the world with increasing prevalence in Iran. Weakening of the antioxidant defense system that accompanies this illness may lead to several complications. In this study, we evaluated the parameters of oxidative stress in patients with type 2 diabetes and compared them with healthy individuals. Methods: In this cross-sectional study, 30 patients with type 2 diabetes who referred to diabetes clinic in Arak city were included based on well-defined inclusion criteria. They were compared with 30 individuals as the control group who were matched by age and sex. The total antioxidant capacity of serum were measured by Ferric Reducing Ability of Plasma technique in all partcipants. The ThioBarbituric Acid method was used to estimate the amount of lipid peroxidation and finaly, HU method was used to estimate the protein oxidation (Thiol groups). The data were analyzed with SPSS software.Results: The mean±SD of total antioxidant capacity of serum in patient and control group were 2.743±0.08092 mm/ml and 1.927±0.04839 mm/ml respectively (P<0.001). The mean±SD of lipid peroxidation in patient and control group were 3.2596±2.0650 nm/ml and 3.9050±3.5354 nm/ml, respectively that it was not statistically significant. The mean±SD of protein oxidation (thiol) in patient and control group were 0.2038±0.1307 and 0.3768±0.1487 mm/ml respectively (P<0.001).Conclusion: Our findings showed that the increased amount of total antioxidant capacity of serum in diabetic patients was meaningful, but lipid peroxidation was not significantly different between two groups that can be caused by taking natural and medical antioxidants by patients. the production of free radicals in patients has been increased and therefore the antioxidant defense system has been weakened.