Journal of Advances in Medical and Biomedical Research
Year:2001 | Volume:9 | Issue:35|Papers Count:14

The purpose of this research is to study the effects of streptokinase on complications and mortality in patients suffering from inferior wall infarction associated with right ventricular infarction. To this end, all the patiens with inferior wall infarction who referred to Zanjan Shahid Beheshti Hospital from April 1994 to February 1998 were studied.This research included the patients whose ST segment elevation was more or equal to one mm in V3R and V3R leads. One hundred thirty of them had right ventricular infarction and 37 people of them (28.5%) were treated with streptokinase and 93 (71.5%) of them did not take this drug. Treatment with streptokinase decreased the prevalence of right ventricular and atrial dilatation. After using this drug the rate of prevalence of right bundle branch block shifted from 2.2% to Zero and that of arrhythmias also reduced so that the prevalence of atrioventricular changed from 22.6% to 5.4%.In consequence of taking streptokinase, the prevalence of cardiogenic shock decreased from 7.5% to 2.7%. However, this drug resulted in the increase of cardiogenic shock in the patients with hypertension history after right ventricular infarction. Treatment with streptokinase led to the decrease in the prevalence of post infaction complications in patients with right ventricular infarction. In consequence of taking this drug, the prevalence of only reinfarction and post MI angina as well as intracranial and gastrointestinal hemorrhage increased. Treatment with streptokinase decreased the prevalence of left and right ventricular systolic dysfunction and it increased the prevalence of EF≥55 from 42% to 56.7%. Therefore, taking this drug led to a greater percentage of patients with EF≥55.Treatment with this drug resulted in the decrease of mortality in patients with right ventricular infarction and had no effect on the length of hospitalization.

Ophtalmic diseases in patients suffering from chronic renal failure have a fairly high incidence. In this study, ophtalmic findings regarding dialysised patients have been analyzed statistically in order to determine the importance of optalmic examinations, and that of finding significant parameters in prognosis as well as the follow-up of the patients. The study was carried out on 40 patients suffering from renal failure who were under dialysis in the hemodialysis ward in Zanjan shahid Beheshti hospital from 2001 to July 2002.Method of study: All of the patients completed questionnairs and were examined ophtalmically. The mean of visual acuity of the patients was 6/10 in this study. 60% of the patients' vision recovered after correction and the ability to see decreased in 20% of them after dialysis. The results of optalmoic examinations in 70% of the patients reported to be abnormal. The most common complications are: Hypertensive Retinopathy, Cataract, Opticneuro- pathy respectively.

Bacterial meningitis is a medical emergency which requires rapid diagnosis, and appropriate therapy, to minimize the consideable risk of associated morbidity and mortality. As presenting signs and symptoms might be inclusive, laboratory tests are essential in establishing a definite diagnosis. Rapid diagnosis of bacterial meningitis is an important task of most laboratories and is usually based on microbilog, cytology and biochemical assays. Measurement of serum and CSF, C-reactive protein by slide latex agglutination is a simple accurate laboratory test and is of great value specially for the countries lacking sophisticated laboratory services. Sixty patients with meningitis were hospitalized after first symptoms had occurred. The patients were divided into two groups. Group I comprised B.M (n=30) and group 2 comprised V.M (n=30).In our study CFS routine tests (WBC count, protein) and CRP increased in bacterial meningitis as compared to viral meningitis (P<0.0001). Glucose decreased significantly in B.M while it was normal in V.M. Duration of illness, age and sex of the patients, and body temperature had no signicant effect on the CRP values.CRP latex test does not require expensive equipment or technical expertise and can be performed in rudimentary laboratories. The simplicity, and specificity (CRP in CSF is 100%, sensitivity of CRP in CSF is 93.33% and in serum is 100%) of this test would encourage its use as a rapid diagnostic test for bacterial meningitis specially in areas lacking adequate laboratory facilities.

Nacl is one of the requirements of the body whose different concentration in food and water could affect the quantity of water consumption. In this research the effect of 1%,3%,5%,7% and 9% of Nacl in drinking water in the amount of water consumption has been investigated .The control group was drinking tap water and the other seven experimental groups (five approximately 200 gr rats in each group) were drinking distilled water and water with previously mentioned Nacl concentrations, respectively. The water consumption in the group which used distilled water decreased by 11% comparing with control group. Compared to control group, in 1% Nacl group the water consumption increased by 81% and in 3% Nacl group increased by 44%, but for higher Nacl concentrations including 5%, 7% and 9% Nacl, the water consumption was decreased by 56% , 73% and 85% and was compared to control group. This decreae could be due to mental intolerance of high salty taste which predominates the thirst mechanism.

Seizure caused by fever is frequently observed in children as the most prevalent neurologic emergency, and lumbar puncture is carried out for most of the patients. In order to study the cerebrospinal fluid we investigated the results of CSF in a subgroup of patients suffering from fever and seizure namely complex febrile seizure. The number of the in-bed patientts with complex febrile seizure in the ward of newly – born children located in Valli-e-Asr Hospital during a year (from 1/7/1999 to 1/7/2000) was 50 including 33 males (66%) , 17 females (34%), 14 people (28%) under 12 months old, 21 people (42%) between 12 to 18 months old and the rest including 15 children (30%) were over 18-months old. In all the 50 in bed cases the result of the study of cerebrospinal was normal. In all the patients generalized seizure was observed. But there was no trace of focal seizure. The previous history of fever and seizure in 9 patients (18%) has been positive. 3 patients (6%) had family history of fever and seizure. However, none of them (100%) had a history of neonatal- seizure. The most prevalent reason for fever proved to be upper respiratory tract infections (64%).According to this research, it can be maintained that LP can be avoided if the other experiments and clinical judgments are made meticulously, and conducting LP can be limited to cases with high suspicion and with a reason to prove the existence of CNS infections. It goes without saying that, to prove the obtained result absolutely, a wider and more complete research is necessary.

One of the first clinical symptoms III long-term diabetic patients is nephropathy with the subsquent micro albuminuria. In this study 24 urine samples were collected from 63 long-term (more than 10 years) diabetic patients attending Zanjan diabetic clinic. Sampling was repeated three times over 6 months with two-month intervals to confirm the observation. Meanwhile a questionnaire was prepared for each patient with respect to his/her identification and background. Bromo phenol blue method was used for albuminuria measurement, which is a simple, rapid and low-cost method.The results revealed that an outstanding number of patients (60.4%) had unstable microalbuminuria (30 to 300 mg in 24h urine) while 39.6% of them had stable microlbuminuria (2 out of 3 stages of 24 urine samples in 6 month period included more than 300 mg albumin). Using k square method, it was found that there was no significant difference between IDDM and NIDDM patients whose urine samples included over 300 mg albumin in 2 stages out of three. There were significant differences (P<0.01) between patients with over and under 15 years of diabetes who had at least 2 stages out of three of 24h urine samples over 300 mg albumin. This presents that patients with 15 years of diabetes are more nephropathic. There was no significant difference between males and females in albuminuria stability. This estimate might be of value in predicting nephropathy prevalence in Zanjan city.

Wound infection is one the complications of cesarian section. Pre-operation care like the prep of the site of operation, use of prophylactic antibiotics, careful washing of hands, removal of the hair of the site of operation, ect reduce wound infections. This study is semi-experimental and comparative. The aim of this research is to stady the effect of irremoval of the hair in the site of opreation on cesarian wound infection. Some 256 mothers served as subjects in this study who were selected non- randomly. In 122 cases, the hair of the site of operation was shaved and in 134 cases the hair of the site of operation was not shaved.The number of the infections was 4 cases in each group and 8 cases totally. In this study, 110 significant relationship was observed between the two groups with respect to wound infection. This study indicates that we can take the patient to the operating – room without shaving the hair of the site of operation and consequently a lot of time is saved.This point proves to be much more important about emergency cesarian cases.

Abdominal wall Hernias is one of the most prevalent ailments of human being. Both men and women are affected by this disorder. It is common in all age groups, the incidence is different in men and women and in different ages. It comprises of 7% of all attendances at surgical out- door clinics and 12% of total operating time of the hospital is allocated for managing abdominal wall hernias.The aim of this study is to determine the relative Incidence of different types of abdominal wall hernias and their complications. In this descriptive study hospital files of the patients operated for abdominal wall hernias in Zanjan Shafieh Hospital for a period of 15 months (from 1999/1/1 to 2000/4/1) were studied. A questionnaire for each patient was filled out individually and all the data were extracted and analyzed statistically.In this descriptive study a total of 933 patients were studied. Inguinal Hernia was the most comnon (81.5%) and femoral Hernia was the rarest Hernia (1.4%). Amongst them 80.8% were simple abdominal wall Hernias and 19.2% were complicated hernias. Regarding gender distribution, 82.9% were men and 17% were women. 14.4% of the patients had incarcirated hernia, 2.2% had stranglated Hernia, and 43% had intestinal obstruction. The prevalence of abdominal wall Hernias was Inguinal Hernia (81.5%), (Right Inguinal Hernia 51.4%, left Inguinal Hernia 25.5% , Bilateral Inguinal Hernia 7.29%), omblical Hernia 4.9%, epigastria Hernia 3.5% femoral Hernia 1/4%. It is suggested that all the people involved and also the physicians provide every one with sufficient information regarding the symptoms of Hernial disorders and their complications. Consequently, this will result in their in-time attendance and treatment.

Iodine dificiency disorders (IDD) is a worldwide health problem. Many parts of the Islamic Republic of Iran have been known as areas of endemic goiter. IDD was accepted as a health problem priority in the country, and a National IDD council was formed in 1989, under the supervision of the Ministry of Health and Medical Education. One of the main strategies of National council for IDD control was to provide at least 150 µg of iodine per day for the entire population through making available iodized salt. This study was performed to evaluate the national IDD council program in 1996, in rural and urban areas of Zanjan province. 1400 schoolchildren, aged 8 to 10, including 50% girls and 50% boys, were selected through randomly sampling. Grading of goiter was performed according to WHO's classification. Serum T3 and T4 were measured by RIA and urinary iodine by digestion method. The mean serum T4 and T3 were: 9.0±1.3 g/dl, 136±24 g/dl respectively. There were no differences between males and females and school children of rural or urban areas.One person had serum T4 more than 12.5 g/dl. The mean urinary iodine was 94 g/dl in entire population, 94% had urinary iodine more than 10 g/dl. Only 3% had urinary iodine less than 5 g/dl. Total prevalence of goiter was 51% (57% in girls and 45% in boys). Based on the available data, seven years after generalized use of iodized salt and 2 years after that more than 50% of population used iodized salt. Currently iodine excretion is within acceptable range. However, goiter is still endemic in Zanjan province.

Aim: The purpose of this study was to determin the incidence of the traditional (non pasteurized) cheese and milk contamination with Brucella and Esherchia coli.Method: 140 cheese and 159 milk samples were obtained from all the city dairystores for a couple of months using randomly sampling method. All cheese and positive milk samples (Using ring test method) were cultured on Brucella agar with polymixin. After a 72 hour incubation period positive samples were isolated and biotyped to diagnose the type of Brucella.Results:1) 108 cheese (77.1%) and 134 milk samples (84.3%) tested positive for E.coli  contamination.2) Five of 2999 samples were contaminated with Brucella and the other one with Brucella abortus.3) There was no relationship between severity of total bacteria contamination and incidence of Brucella.Conclusion: It was found that most of traditional cheese and milk were contaminated with E.coli. Brucella contamination was observed in some of both samples. Therefore it is recommended not to use dairy products before their pasteurization.

For examining psychological health condition in students of Zanjan University of medical sciences, we preformed a research. Among 1265 students, 395 of them randomly selected to fill demography in formative questionnaire and General health questionnaire (H.Q). The summary of this reassure resulted that 4.6% of the students felt distress and depression, 218% suffered from average depression and according to these test summaries 62% of the students had disorders in average function, 4.1% percent had disorders in acute function, 34.9% had average physical symptoms and 3.3% had acute physical symptoms.The hypothesis of these tests resulted that there weren't any significant differences among these students, whether girl or boy, single or married and regarding their entrance year, educational level, parents job, economical condition and different admission advantages.But from psychological health point of view, there were significant differences among native and nonnative students and employed and unemployed ones. The research resulted that 43% of students suspected to have average psychological symptoms and furthermore, 5.4% suspected to suffer from acute psychological symptoms.

This research was conducted to evaluate the performance of health houses and health centers in Ghorveh city. The research was a cross - sectional study in nature. The study population was 257 women who have at least one child under 24 months old and inhabited in the selected villages. A questionnaire and a checklist were used as research instruments.The findings of the study reveal that about 54% were satisfied with the performance of health houses and 35% were satisfied with the performance of rural health centers.