Journal of Advances in Medical and Biomedical Research
Year:2009 | Volume:17 | Issue:66|Papers Count:11

Background and Objective: COPD is a common disease with well-known complications. Pulmonary rehabilitation techniques have been reported to be effective in clinical status of these patients. The purpose of the present study was to determine the effects of pulmonary rehabilitation techniques on the clinical status in moderate severity COPD patients in university hospitals of Isfahan city in 2006-7.Materials and Methods: This quasi experimental research was carried out on 80 patients with moderate severity COPD. Patients were randomly divided into two groups (fifty patients in case group and 30 patients in control group). The severity of the disease was determined by the result of spirometry test. All the data was collected by demographic questionnaire and clinical status assessment form. Initially, clinical status of two groups was evaluated by clinical status assessment forms. After that chest physiotherapy and exciting Spirometry programs were carried out on case group through 20 minutes at morning and evening for two months. After the intervention, clinical status of patients in both groups was evaluated again.Results: The findings showed that dyspnea, orthopnea, cough, sputum, breathing pattern, Peripheral cyanosis, chest pain, breathing sounds and FEV1/FVC were improved in test group after intervention (p<0.05).Conclusion: With regard to these findings, we that suggest using the demographic data and rehabilitation techniques in care programs of patients with COPD will improve the clinical status.

Background and Objective: Tuberculosis (TB) is the most common infectious disease. It causes more than 2 millions deaths annually around the world. The aim of this study was to investigate the effectiveness of designed health education package on healthy behaviors of patients with tuberculosis at Pasteur Institute of Iran.Materials and Methods: This research was a quasi-experimental study that was carried out on 31 smear positive patients who referred to Pasteur Institute in 2004. Questionnaire and self report checklist were used to collect the required data. The educational needs were recognized and then the health educational package was designed. After that, the questionnaire and checklist filled out and educational package was performed for 8 weeks. The effect of training was evaluated by post-test after two months and the obtained results compared with the results of pretest. The main data was analyzed by analysis of variance, paired T-test and Pearson correlation coefficient tests in order to evaluate the effectiveness of intervention on knowledge, attitude and behavior of the patients before and after the intervention.Results: The average age in study group was 33.71 years old (SD=13.68) and the sex frequency was 54.8 for males and 45.2% for females. There was a significant correlation between the change of attitude and the previous family history of TB (P<0.001). However, there was no significant correlation among the past jail and the previous tobacco use with the patient.s knowledge, attitude and practice. Analysis of the data, before and after the educational package intervention showed a significant difference among knowledge, attitude and practice before and after education (p<0.001).Conclusion: Health education has an important role in improving knowledge, positive attitude and adopting healthy behaviors in the patients with Tuberculosis.

Background and Objective: Obsessive-Compulsive Disorder (OCD) is the fourth prevalent psychiatric disorder. Despite the known first line therapies including Clomipramin and Specified Serotonin Reuptake Inhibitors (SSRI), 40% to 50% of the patients are either resistant to treatment or do not show enough response. On the other hand, some of the previous studies have shown a positive effect of Olanzapine augmentation therapy in the OCD patients but, some studies have not confirmed such effects. Therefore, we added the Olanzapine to the medical regimen of the OCD patients and studied the effectiveness of this intervention.Materials and Methods: Forty two patients with OCD according to DSM-IV-TR who were resistant to treatment with SSRI were entered to the study. 20 patients in the study group were taken 5-10 mg Olanzapine in addition to their previous drug regimen for six weeks. 22 patients in the control group received the above mentioned drug regimen without Olanzapine. Then, in order to evaluate the severity of disorder, the Yale-Brown test was done at the first, third and the sixth weeks after the study. 6 patients were withdrawn from the study because of the complications of the Olanzapine.Results: YBOCS score in the treatment group was 33.6±5 and in the control group was 34.8±3.3. After Olanzapine augmentation therapy the score decreased to a mean of 7.2±6.1 in the treatment group and 7.1±5.9 in the control group. However, there was no significant statistical difference between the two groups (P>0.001).Conclusion: The findings of this study showed that Olanzapine as augmentation, supplemental and strengthening therapy has a neutral effect in OCD patients.

Background and Objective: Drug resistance to tuberculosis is continuously increasing and is a significant threat to tuberculosis control programs because afew effective drugs are present against Mycobacterium tuberculosis. Although isoniazid (INH) is the most effective drug against tuberculosis, resistance to this drug also develops readily. Mutations in katG, specially the Ser315Thr substitution, are responsible for isoniazid resistance in a large proportion of patients with tuberculosis. However, the frequency of the katG Ser315Thr substitution varies among population samples. This study provided molecular characterization of isoniazid resistance of M. tuberculosis strains and extended our knowledge about molecular basis of M. tuberculosis drug resistance that is widely applicable for rapid drug resistance detection.Materials and Methods: Using 1% proportional method, the sensitivity of 126 strains isolated from patients in Isfahan and Tehran to isoniazid was determined. The katG mutations in codon 315 associated with isoniazid resistance among isoniazid resistant isolates was determined by PCR-RFLP. In this way, 355 bp PCR products were digested by MspI.Results: Out of 126 isolates of M. tuberculosis, 32 (25.4%) strains were determined as INH resistant. Resistance rate was 22.6% (19 strains) in Isfahan and 31% (13 strains) in Tehran. Overall, 72% of isoniazidresistant isolates could be identified by analysis of just katG 315 loci.Conclusion: The PCR-RFLP using MspI restriction enzyme that detects katG Ser315Thr substitution could be identified in 72% of isoniazid-resistant strains. Elucidation of the molecular characterization of isoniazid resistance in M. tuberculosis has led to the development of different genotypic approaches to the rapid detection of isoniazid resistant in clinical isolates.

Background and Objective: Cerebrovascular accidents are one of the most common causes of disability in human population all over the world. Regarding the incidence of post- CVA Seizures and its effect on morbidity and mortality in these patients and due to lack of enough similar studies in our country, we decided to carry out this study in Valiasr hospital, Zanjan.Materials and Methods: This descriptive study was conducted on 404 CVA patients who were admitted in Valiasr hospital from Mar to Oct 2007. The data such as gender, age, type of CVA, damaged brain zone, occurrence of seizure in the first week, type of seizure and the expiration date (if patient had expired), was collected through questionnaire the data were analyzed using appropriate softwares.Results: The total mean age was 70.3 years old. 227 (56.2%) were men and 177 (43.8%) were women. Out of 404 patients with CVA, 362 cases (89.6%) were admitted with ischemic and 42 cases (10.4%) with hemorrhagic CVA. 16 cases (4%) had at least one seizure attack at the first week after CVA. Fifteen patients (4.1%) with ischemic CVA and 1 case (2.4%) with hemorrhagic CVA had at least one episode of early seizure in the first week (P=0.579). The mortality rate was 7.5 and 31.3% in patients without and with seizure attack respectively.Conclusion: This study showed that early seizure following CVA was more common in ischemic type of CVA, especially in embolic form. The risk of early seizure was higher at the first day after CVA. In addition, early seizure was correlated with higher mortality rate in CVA patients. The incidence of early seizures was higher in men. So prescribing prophylactic anticonvulsant drugs may reduce the incidence of post CVA seizure and its complications in these patients.

Background and Objective: Foot orthoses are a common intervention for patients with patellofemoral pain syndrome but, limited information is available in the effects of foot orthoses on knee pain and function of athletes with patellofemoral pain syndrome. The aim of our study was to determinate the effects of foot orthoses on reducing pain and increasing function of athletes with patellofemoral pain syndrome who demonstrated excessive foot pronation.Materials and Methods: 418 female athletes between 15. 35 years old in running, soccer, volleyball, fencing and mountain climbing were examinated. Among these athletes 25 subjects with patellofemoral pain syndrome had excessive foot pronation. The severity of pain was measured by VAS (visual analog scale) and their function was measured by KOOS (knee injury and osteoarthritis outcome score). Full length firm foot orthoses were given to athletes which at least 8 hours during the day was used. After 2 weeks: pain by VAS and function by KOOS were evaluated. After 6 weeks these variables were measured again.Results: The results of analysis of variance in repeated measures indicated a statistically significant improvement in pain by VAS after 2 weeks (p value=0.001) and after 6 weeks (p value=0.001).Improvement of function on KOOS were statistically significant at 5 subscales : reduction of symptoms after 2 weeks was not prominent but after 6 weeks was significant (p value=0.001) and reduction of pain after 2 weeks (p value=0.001), reduction of pain after 6 weeks (p value=0.001) and improvement of ADL after 2 weeks (p value=0.004) and after 6 weeks (p value=0.001) and improvement of sport activities after 2 weeks (p value=0.012) and after 6 weeks (p value=0.001) and improvement in QOL after 6 weeks (p value=0.001).Conclusion: Our results confirmed a significant improvement in reducing pain and increasing function of female athletes with patellofemoral pain syndrome and excessive foot pronation after foot orthoses.

Background & Objective: Recommended illumination Engineering Society of North America (IESNA) methods were used to measure the illumination in regular geometric areas such as square or rectangular form areas. It seems that with using the GIS method which is used to save, manage and spatial data analysis and processing them by computer we would be able to examine the illumination in many situations and make new predictions.Materials & Methods: In this research the Testo 545 luxmeter sensor was put in height of 30 inches (76 cm) from the bottom of irregular geometric study saloon in libraries of Zanjan. Then total, natural and artificial illumination was measured in the center of each station in lux. These data were entered into Arcview software as input data for analyzing. Thus the illumination quantities, the area coverage percent and isolux curves were obtained for each station.Results: The results showed that illumination quantities in the libraries studied were not suitable because, total, natural and artificial illumination in 51%, 80% and 99% of the libraries were less than 300 lux (IESNA recommended) respectively. Therefore it is necessary to redesign the artificial lighting systems or optimize them in order to achieve the standard illumination.Conclusion: It seems that GIS method could show the distribution of the illumination in the irregular geometric library halls. These data can also be showed as isolux curves with use of interpolation technique by ArcView software.

Background and Objective: Attitude toward Gender egalitarianism that is submitted in gender role has an important role in interpersonal relations, personal, family and social mental health. Many factors including culture affect the gender role. The aim of the present study was to compare the gender role attitude in males and females with different levels of education.Materials and Methods: 245 individuals were selected through stratified and cluster sampling from different universities and offices. The data was collected by self structured questionnaire and the data analyzed with T.test and regression statistics tests.Results: The findings showed that education and gender could affect the gender egalitarianism attitude. The gender egalitarianism was significantly different between males and females (p<0.001). Results showed that females had higher gender egalitarianism. The results also showed a significant difference in attitude between people with different levels of education (p<0.01). Individuals with higher grade of education had higher gender egalitarianism. The sex of individuals was a stronger predictor of gender egalitarianism than other variants such as language, education and income.Conclusion: Attempt to decrease the gap between females and males attitudes could lead to decrease the conflicts and problems between females and males in gender egalitarianism attitude and could improve the mental health.

Background and Objective: Environmental pollutions that affect human health are one of the important worries related to heavy metals production. Our objective of this study was to investigate the blood lead levels in workers of Zinc melting factory of Dandi Zanjan and to compare its level with healthy men who were living around the factory.Materials and Methods: This study was carried out on 40 workers as case group and 40 healthy non-worker male individuals who where living around the mentioned factory in Dandi region of Zanjan as control group.Blood lead concentrations was measured by graphite furnace atomic absorption spectrophotometer (GFAAS). The data were analyzed using T-test and ANOVA.Results: The mean of blood lead levels in case and control groups were 16.06 and 10.47 mg/dL respectively (P=0.0001). There was also a significant difference between workers lead levels in different parts of the factory (P=0.04).Conclusion: Blood lead levels in factory workers were higher than in control group, although blood lead levels were in reference limit in workers on the basis of OSHA standards. Since the major way of lead pollution is respiratory tracts, therefore it is necessary to use appropriate air conditioner systems in such factories.

Intracranial Tuberculoma is a rare form of Tuberculosis (Tb) with presentation of multiple space occupying lesions. Clinical manifestations of intracranial Tuberculoma are dependent to the site of involvement. MRI, positive smear and the evidences of other organs infection can help us to diagnose intracranial Tb. We should consider tuberculosis in patients with unusual presentations even when presents with normal CXR. A 24 years old man was admitted to the infectious ward. He presented with a decreased consciousness level and weakness in four limbs during the past 7 days. He complained of a productive cough since 3 months ago and knee arthralgia from 5 months ago. He was febrile and ill appearance. Breathing sound was decreased at the base of the right lung among with Cracle sound. Patient was quadriplegic without deep tendon reflex. Laboratory tests showed the rise of liver transaminases and elevation in the serum ESR and CRP. Gastric fluid smear was positive for AFB. In brain MRI, multiple hyperdense heterogen lesions were reported. The patient was treated with anti tuberculosis drugs and prednisolon. He discharged from the hospital with good general appearance after 21 days.