Hormozgan Medical Journal
Year:2008 | Volume:12 | Issue:1|Papers Count:15

Introduction: Fever and consequent convulsion are among major concerns for parents of febrile children. Many antipyretic drugs are applied excessively to decrease fever in children. This research is designed to study the efficacy and stability effects of cetaminophen and Ibuprofen in febrile children aged 6 months to 10 years old.Methods: This single-blind clinical trial study was performed on 360 children (aged 6 months to IO years) referring to pediatric emergency department. The cases were divided equally and randomly into two groups, allocated to receive either 15mg/kg Acetaminophen or 10 mg/kg Ibuprofen. Including criteria was oral temperature of 38- 40C or rectal temperature of 38.5-40.50C;. Temperatures were recorded at the time of admission, 2, 4 and 6 hours after receiving antipyretic drug. Data was analyzed by SPSS software. T-tests and chi-square test were used for statistical comparisons. Results: Findings revealed that mean temperatures on admission were 39.01±0.70C; and 39.03±0.690C; in the Acetaminophen and Ibuprofen groups, respectively, showing no significant difference. Mean temperatures at 2 hours after initiation of treatment in Acetaminophen and Ibuprofen groups were 38.78±0.920C; and 37.25±0.780C;, respectively (P<0.0001). After 6 hours, the temperatures were 37.36±0.920C; and 36.99±0.050C; (P<0.002). Overall, stability of antipyretic effect of Ibuprofen was more than Acetaminophen.Conclusion: Results indicate that Ibuprofen is more effective than Acetaminophen in maximum decline in temperature and its stability in lowering temperature is better than Acetaminophen. It is suggested that Ibuprofen be used as an antipyretic in children older than 6 months when Acetaminophen cannot control fever or more stable antipyretic is expected.

Introduction: Chronic renal failure causes impairment of all body organs including heart and lungs. Main problem in these patients are pulmonary edema due to increased permeability of capillaries, intravascular and interstitial volume overload, hypertension and heart failure. These changes cause altered physiologic and mechanical function of lungs. The objective of this study is evaluating the effect of dialysates and other intervening factors on spirometry parameters.Methods: This cross-sectional study was performed on 41 patients with chronic renal failure in September and October 2006 in Labbafi Nejad Hospital, Tehran. Patients were randomly divided to bicarbonate and acetate groups. Prior to and after hemodialysis, patients were meticulously weighed and spirometry parameters (FVC, FEV1, FEV1/FVC%, FEF 25-75) were measured. Biochemical indices were checked.Spirometry parameters were analyzed using t-test, and p-value less than 0.05 was considered statistically significant.Results: We compared 29 patients undergoing dialysis with bicarbonate and 21 patients on dialysis with acetate. Respiratory function improvement in spirometry parameters was only significant in patients undergoing dialysis with bicarbonate dialysate, and when results were compared according to gender, they were statistically significant only in men. This improvement was meaningful in FEF (25- 75%), FEV1, FVC. Post dialysis weight loss and serum chemistry had no significant correlation with improvement of sprirometry parameters. Conclusion: Dialysis with bicarbonate dialysate causes significant improvement in spirometry parameters and respiratory function in men.

Introduction: Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal system characterized by special gastrointestinal symptoms without organic cause. The etiology of IDS is not clearly known but individuals with IDS mainly report symptoms compatible with psychopathologic disorders, abnormal personality traits and psychological distress. Objective of this study was to evaluate relationship between life event stress and IBS. Methods: This is a case-control survey performed on 76 patients with gastrointestinal disturbances with a diagnosis of IDS and were compared with the control group. The control group were randomly selected from all individuals without previous history of gastrointestinal disorder or referral to an internist and matched with the case group. Research tools included Paykel life event stressor test (with some modification), diagnostic criteria checklist foe IBS (Rome II), a checklist for demographic informationand clinical interview. Data analysis was done by SPSS software. Results: There was a significant correlation between stress and IDS (P=0.002). In other words, the rate and severity of stress in IDS group was higher than control group. Other findings showed that among 65 life event stressors in IDS patients, the most severe' stressor was related to consort death and the least severe was mild physical disorder. The most frequent stress in this group was increasing of life expenses which were reported by 50% of patients as one of the most prevalent life stressor, whereas it was 42 % in the control group. Conclusion: Psychological distress and life event stressors are important components of IDS patients' life, which should be considered in designing therapeutic strategies.

Introduction: Electroconvulsive therapy (ECT) is an effective treatment for many psychological disorders, mainly major depression and schizophrenia which is often associated with some complications such as hypertension, tachycardia arrhythmia and even myocardial infarction.Various methods have been used for prevention or control of these cardiovascular side effects. The aim of this study was evaluating the effect of oral clonidine as premedication on hemodynamic response after ECT.Methods: This double-blind clinical trial was performed on 100 patients aged 15-50 years with ASA I and II who were candidates for ECT.Prior to ECT, patients were randomly divided to 2 equal groups. The first group (N =50) received oral clonidine and the second group (N =50) received placebo as premedication. After baseline measurement of heart rate, systolic and diastolic blood pressures, similar induction of anesthesia was done in both groups. Then ECT was induced. The patient’s heart rate, systolic and diastolic blood pressures were measured again 2 minutes after termination of convulsion. Data was analyzed by t-test p<0.05 was considered statistically significant. Results: Regarding age, sex and baseline hemodynamic parameters, the patients were similar in both groups. Mean systolic and diastolic blood pressures after ECT were significantly lower in clonidine group (p < 0.05), but there was no significant difference between heart rate after ECT in the two groups.Conclusion: According to these results, we recommend usage of clonidine as premedication before ECT.

Introduction: TCU -380 A IUD is one of the safest and widely used methods reversible of contraception. The purposes of this study were to determine continuation rate and its determinants and also the reasons for discontinuation of the TCU-380A IUD in women who referred to health centers of Bandar Abbas.Methods: The population studied in this retrospective survey was women who had started using TCU-380A IUD from early 2003 to late 2005 by referring to Bandar Abbas health centers. A total of 400 subjects were selected randomly by multistage sampling method. Data were collected from documents in health centers and interview with subjects. Life tables, Kaplan-Meier, and cox regression model used for data analysis by SPSS 13 statistical software.Results: The continuation rate of using TCU-380A IUD between 6 month, 1, 1.5,2, 2.5, 3, 3.5 and 4 years were 92%, 87%, 81 %, 75%, 69%, 62, 56% and 50%, respectively. Counseling and desire for having child in the future were significantly associated with continuation of TCU-380A IUD (P<0.03). The main reasons for discontinuations were bleeding (23.6%), side effects (21.1 %), planning pregnancy (16.3%), pain (11.4%), health concerns (8.9%), spontaneous (6.5%) and dissatisfaction with the method (5.7%). Conclusion: Holding educational workshops for health workers about counseling on family planning and empowering them, counseling before TCU-380A IUD insertion, informing women about side effects and regular check-up visits is recommended to increase the IUD continuation rate.

Introduction: Nowadays implementing educational models for identifying reasons of rejecting health issues in the treatment process is increasingly concerned. One of the models which has been a matter of concern in recent years is health belief model. The objective of this study is assessing the structures of this model along with HbA1C in diabetic patients.Methods: In this cross-sectional study 76 (insuline dependent and non-insulin dependent) diabetic patients who referred to diabetes clinic of Hormozgan University of Medical Sciences during July and August 2006 and had been detected as diabetic at least one year prior to recruitment, entered the study after filling consent form. Data collection was performed via 3 questionnaire including demographic information, health belief model and self-efficacy questionnaires. HbA1C was calculated by calorimetry and body mass index (BMI) was calculated. Data by SPSS software, using t-test and pearson's correlation coefficient.Results: 46 women (60.5%) and 30 men were studied. Data analysis revealed that there is no significant difference between HbA1C and the following factors: amount of perceived barriers according to sugar control, amount of perceived self-efficacy based on sex, rate of perceived self-efficacy on the basis of literacy and sensitivity rate perceived by the number of years inflicted with diabetes.Conclusion: Diabetes control is not satisfactory in patients despite long term medication and prejudiced diets. The level of health belief model structures in patients with unfavorable diabetes control is lower than those with optimum control. Hence, a precise educational program based on health belief model is necessity for excelling severity and sensitivity perceived by patients, increasing the perceived benefits and removing perceived barriers.

Introduction: Hypertensive disorders are common during pregnancy. Combination of hypertension and proteinuria markedly increase prenatal morbidity and mortality. The gold standard method for proteinuria assessment is 24-hour urine collection. This survey is designed to determine the correlation between protein content of 8-hour and 24-hour urine collections.Methods: This cross-sectional study was conducted on 65 pregnant women with gestational age of over-20 weeks who were admitted for assessment of proteinuria in obstetrics section of Shariati hospital, Bandar Abbas. Four urine samples were collected from each patients including random sample, 8, 12 and 24-hour samples. Randoms sample was examined qualitatively while other samples were assessed quantitatively. Data was analyzed by Minitab software. Person's correlation coefficient of 8-hour and 12-hour samples with 24-hour was calculated. Sensitivity, specificity, negative and positive predictive values of random, 8-hour and 12-hour samples was also determined.Results: Pearson's correlation coefficients of 8-hour with 24-hour and 12-hour with 24-hour were 0.873 (P<0.01) and 0.89 (P<0.01), respectively. 8-hour sample had a sensitivity of 63% and negative predictive value of 82 %. The 12-hour and random samples predicted significant proteinuria with a sensitivity of 82% and 75 %, specificity of 88% and 63 %, positive predictive values of 85% and 62 %, and negative predictive values of 86% and 76%, respectively. All patients with proteinuria in 8-hour and 12-hour samples had significant proteinuria in 24-hour sample. Conclusion: There is a strong correlation between 8-hour and 12-hour with 24-hour urine protein levels. Either the simultaneous positive or negative result for proteinuria in 8-hour, 12-hour and random samples is of great significance in documentation or ruling out of proteinuria in 24-hour sample collection.

Introduction: Psoralen plus ultraviolet A (PUVA), regardless of its hazards to physician and patients, is consi1ered to be treatment of choice for subtotal vitiligo. This study attempts to evaluate the efficacy of PUVA in treatment of patients with vitiligo. Methods: We have performed a descriptive-analytic study on 30 patients with vitiligo who received PUVA therapy during 2004-2005 in phototherapy center of Doctor Faghihi hospital, Shiraz and evaluated their response to treatment. Data was analyzed by Mann-Witney statistical test and spearman correlation coefficient. Results: Overall, 22 patients (73.4%) showed some improvement; 18 patients experienced a repigmentation of 51-75% and 4 patients achieved greater than 75% regimentation. Trunk, face and neck lesions showed better 1epigmentation than other areas, whereas hands and feet were generally refractory to treatment. Sex of the patients and disease duration had no influence on PUVA-included regimentation, but age at onset of the disease had negative correlation with degree of repigmentation and dose of PUVA had positive correlation with degree of regimentation.Conclusion: Distribution of vitiliginous lesions must be taken into consideration before the initiation of PUVA therapy, as the response to treatment varies greatly at different body sites; Hands and feet lesions are refractory to PUVA. Trunk, face and neck lesions show the best responsiveness.

Introduction: Erroneous nutritional behavior is one of the most important factors related to malnutrition and nutrients deficiency in human being. Obesity is probably the most prevalent type of malnutrition among adolescents and adults mainly in developing countries. Recent studies in our country have demonstrated that overweight and obesity have high prevalence in urban and rural societies. This survey was carried out to evaluate some nutritional behavior among obese (BMI³30) adolescents (age = 10-20) and adults (age=50-60) who referred to Jenah health center, Hormozgan province.Methods: This is a cross-sectional study which recruited 82 obese referrers (40 adults and 42 adolescents) by convenience non-probability sampling as research cases. Data was gathered by questionnaire of nutritional behavior determination and interview. Data was analyzed by SPSS statistical software, using descriptive statistics. Results: Findings showed that approximately 20% of obese adolescents and 10% of obese adults consume sandwiches and fast foods more than 3 times a week. 44% of adolescents and 20% of adults drink soft beverages more than 3 times a week. 52% of adolescents did not eat breakfast at all. 60% of each group received less than 2 servings of dairy products per day. 44% of adolescents and 55% of adults had less than 3 servings of fruits daily.Conclusion: The results indicate that obese participants in this study have multiple unhealthy nutritional behaviors. Attempts for educating people about importance of healthy diet and improvement of government strategies for availability of healthy foodstuff can ameliorate nutrition status of society.

Introduction: Home birth has beneficial effects on labor and delivery. This study is aimed to compare home and hospital births in primigravid women.Methods: In this analytic descriptive study the participants consisted of all women aged 18-30 years, with term pregnancy, single fetus, cephalic presentation, spontaneous onset of labor and without antenatal complications. 50 women were in home birth group and another 50 were in hospital birth group. In this study length of delivery, first and fifth minute APGAR scores, rate of episiotomy, satisfaction from delivery experience and initiation of breastfeeding were measured T-test, Chi-square and Fisher exact tests were used for data analysis.Results: Findings revealed that home birth appears to be associated with shorter overall delivery time (P < 0.01), lower rate of episiotomy (P < 0.01), earlier initiation of breastfeeding (P<0.01) and increased satisfaction from delivery experience (P<0.01). No significant difference was observed in duration of second stage of delivery, and also first and fifth minutes APGAR scores in two group. Conclusion: Considering the above findings, it can be concluded that home birth is not only devoid of adverse effect on delivery, but also improves many factors related to delivery. Planned home birth can be applied in normal uncomplicated deliveries in our country by providing optimum conditions.