Hormozgan Medical Journal
Year:2002 | Volume:6 | Issue:2|Papers Count:12

Endocrine gland dysfunction in the background of iron retention is major problem in thalassemic patients. In order to assess the prevalence of thyroid dysfunction, calcium and phosphate metabolism in thalassemic patients, a total number of 104randomlyselected, 7 to 21 years old thalassemic patients, were compared with 107age matched healthy individuals. The results revealed that 86% of thalassemic patients had ferritin level of greater than 1500 mg/ml. Prevalence of goiter in girls of both patient and healthy groups were 74%and 42%, respectively(P< .05), but this figure was not significantly different in boys. T4 and Ff41 level averages in patients were significantly less than those in healthy individuals (P< .05), while T3 and TSH levels were not significantly different. The results show that of 47% of thalassemic patients (3 girls and 2 boys) suffered from sub-clinical hypothyroid (TSH>5 and normal T4 and F T4I) and 9.1% of patients (6 girls and 4 boys) had normal TSH and deficiency in FT4I, which may be due to central hypothyroidism or Sick Euthyroid Syndrome (SES). 13.8% of thalassemic patients had abnormalities of pituitary-thyroid axis, while there was no Relationship between ferritin level and thyroid indexes. Calcium averages in boys of both case and control groups were significantly different (8.7 mg/dl vs. 9.2 mg/dl), but it was not different in girls. Phosphor level in boys and girls of case group was significantly higher than in control group (p< .0001). Calcium level of less than 8.1 mg/dl was detected in 27.6% of patients and it was shown also that risk of hypocalcaemia increases as age increases (r = -0.33, P<0.05). The results of this study shows that, in Hormozgan province (with sufficient iodine intake), the prevalence of hypo-thyroidism in thalassemic patients are relatively low, but prevalence of hypo-calceumia needs more investigations.    

Accurate, standardized intrauterine growth curves are important for monitoring fetal growth. The available anthropometric standards vary mainly due to the differences in the populations. There are no adequate standard intrauterine fetal growth curves suitable for Iranian infants. The purpose of this study was developing inter uterine growth curves in an Iranian population living at 1490 meters above sea level and comparing them with available intrauterine growth curves. In this prospective study weight, length, head and chest circumferences of 115 fetuses with birth weight lower than 1500 gr and 885 infants with birth weight of above 1500 gr which were born from mothers with normal vaginal or cesarean section delivery, were investigated with respect to their gestational age. Published intrauterine growth curves and data are different from those of this study. Weight and length curves in this study are lower compared to American curves (p<0.0001). There is no difference between head circumferences, but chest circumference is wider than the American standards (P<0.000). This study reveals that, due to differences between socio-economic criteria in different communities, this study was not able to estimate the effect of this factor in different aspects of neonatal growth.  

Nowadays suicide is the main public heath problem in all communities. This study was conducted to determine the risk factors for suicidal behavior in Bandar Abbas. Subjects were 360 persons who committed suicide and referred to Shahid Mohammadi Emergency ward in Bandar Abbas. Mean age was 23.85 years with standard deviation of 6.35 Years. Married women including housewives living in the city with high school education from middleclass tried to commit suicide more often. 324 subjects stated emotional and family problems as the main cause of suicide attempt. The most frequent method was overdose. Results also showed significant relation between suicide method with sex, emotional and family problems and place of residence (p < 0.05). Since committing suicide has special features and risk factors, it is suggested that the results of this study to be used for primary and secondary prevention of suicide by health care planners and providers.    

Treatment of trichiasis, using argon laser with local anesthesia is an effective and safe method. In this study treatment of focal trachomatous trichiasis with argon green laser is investigated. A total number of 90 eyelashes in 20 patients with 90% success were randomly selected for treatment. In this study the required energy for photo epilation in constant time and spot size of the laser modality was evaluated. The minimum energy of the laser for photoepilation was 500 mw and maximum one was 900 mw (the average of power 68.7 mw). On average total energy consumption for one eyelash epilation was 92.22 mw. All patients were examined at three month interval for one year. At the end of follow up four of them had recurrence and there was no complication.    

Male participation in family planning has a crucial effect on birth control. This study was conducted to show the frequency of using condom or withdrawal methods in Bandar Abbas. Data was collected using a questionnaire which was completed by a male interviewer. 460 subjects were randomly selected. Results show that 30.6% of subjects use one of these two methods. 54.4% of them were relatively satisfied with the method that they were using and 50.4% thought about changing their methods. There was a significant correlation between the type of method and satisfaction rate (P < 0.05). There was not any significant correlation between variables such as age, education, and job and type of method. All of the subjects were familiar with at least one method of contraception. 35.5% of subjects stated the probability of pregnancy with these methods is moderate to strong. The most common reason for selecting these methods was its safety or low risk of complication. 88.3% of subjects stated that they will never decide for vasectomy in the future.'7.6% and 10.2% of subjects experienced unwanted pregnancy and unsuitable spacing by condom and withdrawal, respectively. There was no significant correlation between type of method and previous experiences. Development promotion of family planning consultant services for men is an important step in increasing male participation in family planning.    

Internet is efficient in coping with the ever-increasing volume of medical knowledge. Connecting to internet allows physicians to improve their decision making and clinical effectiveness. This descriptive investigation was undertaken to assess the extent to which Internet is used among physicians in Dr. Shariati, Shahid Mohammadi, and Pediatric hospitals, and to compares it with the use of more traditional information seeking ways such as referring to the library, consulting colleagues, searching CD - ROMS and so on. The total number of physicians was 65. Data was gathered using a questionnaire. Results showed that about half of the physicians (43.3 %) had Internet access at home and 21. 8% had access both at home and at work. The latter group used the Internet significantly (p < 0.05) more often than the former group. Only 14.3% of respondents, who used Internet more frequently, reported better computing skills. More than half of the respondents (53.3%) used Internet three times or more per week. Web-based search and e-mail were the dominant activities among physicians( 48.3 %). 11.1% of respondents reported using Internet, for coping with the ever-increasing medical information and 42.9% of them in addition to Internet consulted their colleagues, referred to the library and searched CD-ROMS. For the largest proportion of respondents (45.3%) time limitation and lack of training were typical barriers to effective use, and for 37.4% of physician's lack of hardware facilities and technical problems were the major barriers. Since Internet plays an increasingly important role in physicians professional updating, it is suggested that training courses, more hardware facilities at hospitals and libraries, and interactive Internet training programs should be provided for physicians.    

Cardiovascular reactions due to laryngoscopy and endothracheal intubation are transient and nondangerous in healthy persons but it is significantly dangerous in patients with a history of cardiovascular diseases. This study was carried out to clarify the level of these changes and the effect of fentanyl on these changes in patients under elective abdominal surgeries in Shahid Beheshti Hospital of Kashan during a six month period (1996-97). This study performed with clinical trial strategy on 100 patients (class I, II ASA) who were admitted to operation theatre for elective abdominal surgery. The patients were randomly divided in two groups. One group did not received fentanyl (group A) and the other one (group B) received fentanyl before induction of anesthesia. The heart rate and cardiac rhythm parameters were estimated in both groups before induction of anesthesia, endothracheal intubation and 1,2 and 3 minutes after endothracheal intubation. Chi-square test was used for data analysis and p < 0.05 was treated as significant. The mean of heart rate in 1, 2 and 3 minutes after endothrachcal in group A and B were 9.2±5.58 and 2.4 ±6.92, respectively (P < 0.05). Results of statistical analysis showed that changes of heart rate according to age and sex were not significant but changes in heart rate and cardiac rhythm between two groups were significant. This study showed that injection of fentanyl (2micro/kg) 2 minutes before induction of anesthesia can be effective in reducing heart rate and cardiac rhythm changes. Future analytic studies are recommend for estimating effect of fentanyl in decreasing cardiovascular reactions due to endothracheal intubation in patients with ischemic heart disease and hypertension and comparison of fentanyl with other opioid drugs.    

Reflex Sympathetic Dystrophy Syndrome (RSDS) is one of the musculoskeletal problems which is encountered in organ transplantation patients receiving cyclosporine-A. We herein report a patient treated with cyclosporine-A following kidney transplantation that developed RSDS. A 40-year-old man received a kidney allograft and treated with cyclosporine-A. Five months later, the patient came back with severe pain in the lower limbs, especially knees and ankles. Plain radiograph and bone scintigraphy findings were consistent with reflex sympathic dystrophy syndrome. Laboratory tests including calcium, phosphate, orate, alkaline phosphates and parathormone were within normal range. Cyclosporine level was 120 ng/ml. Clinical improvement appeared slowly over the following months after the institution of RSDS treatment, without any change in the cyclosporine dosage. It is conceivable that in kidney transplant patients, cyclosporine-A could be a risk factor for the development of a RSDS.