Journal of Advances in Medical and Biomedical Research
Year:2006 | Volume:14 | Issue:56|Papers Count:9

Background & Objective: Outpatient surgery can be performed by general or spinal anesthesia. Spinal anesthetic drugs have side effects. Many anesthesiologists choose general anesthesia, because of its relative predictability and to avoid undesirable side effects associated with spinal anesthesia. For example; lidocaine is frequently associated with Transient Neuroligic Symptoms (TNS). Bupivacaine may cause urinary retention, prolonged discharge time and unpredictable level of anesthesia dependent on dose. Reducing bupivacaine dose will shorten the duration of action and its anesthesia level will be predictable in saddle block technique. This study was designed to assess the effects of hyperbaric, low dose bupivacaine in level of sensory block, duration of anesthesia and selective sensory block in an rectal surgery and its comparison with lidocaine.Materials & Methods: In a clinical trial study, 64 patients who were the candidates for anorectal surgery were divided in two groups randomly. In one group, hyperbaric bupivacaine 0.5% was injected in sitting position. The other group received hyperbaric lidocaine 5% in the same position. The patients were laid in lithotomy position after 5 minute. Blood pressure, pulse rate, severity of sensory & motor block, duration of anesthesia and tonicity of anal sphincter were recorded in two groups. The results were analyzed through Ttest, chi square and variance analysis.Results: Sensory level and anesthesia duration in bupivacaine group were higher than lidocaine group. Motor block degree and anal sphincter tonicity loss in lidocaine group were greater than the other one. Blood pressure decreasing in lidocaine group was significantly higher to bupivacaine group.Conclusion: The proper sensory level and short anesthetic duration of low-dose hyperbaric bupivacaine are comparable with lidocaine in saddle block position; and selective sensory block may be useful for anorectal surgery in lithotomy position.

Background & Objective: Several studies have shown that Soya oil has analgesic effects when it administered orally or injected. Oral administration of Soya oil has antinociceptive effect on bone dysplasia induced pain. Based on previous reports concerning analgesic effect of peripheral administration of Soya oil and the usage of the oil as a solvent or the oil part of emulsions to prepare water insoluble drugs, we investigated the analgesic effect of intracerebroventricular (i.c.v.) injection of Soya oil.Materials & Methods: The antinociceptive effects of i.c.v. administration of Soya oil using formalin test have been studied in stereotaxed mice after one week of surgery and insertion of a stainless steel canulla in the right cerebroventricle.Results: Administration of pure Soya oil induced an antinociceptive effect in mice but the oil did not show any analgesic effects in 10 percent concentration.Conclusion: The results of this study are in agreement with previous data on analgesic effect of peripheral administration of Soya oil. Therefore, we suggest that minimum concentrations should be used to prepare emulsions with Soya oil for water insoluble drugs in antinociception studies.

Backgrounds & Objective: Mycoplasmas pneumoniae is responsible for more than 20% of community acquired pneumonia cases and also implicated in acute respiratory infections, such as sore throat, pharyngitis, rhinitis, and tracheobronchitis. Conventional assays for the detection of M. pneumoniae have their limitations, resulting in the need for more accurate diagnostic methods. Molecular methods, for example Polymerase Chain Reaction (PCR), have the potential to produce rapid, sensitive, and specific results, allowing early appropriate antibiotic therapy. In this study, we aimed to compare PCR and culture results and to develop a rapid and more practical PCR technique for detection of M. pneumoniae.Materials & Methods: Clinical samples from 100 patients with respiratory complaints were subjected to culture and PCR. A highly sensitive, PCR protocol using P4A and P4B primers targeting the PI cytadhesin gene was designed and applied to nasopharyngeal swab samples collected from patients. Amplicon (345 bp) cloned by PCR-cloning and then sequenced by dideoxy chain termination.Results: The results of positive cultures (10 out of 100) well correlated with the results of PCR. Samples from 33 additional patients which showed a negative result in culture were positive by PCR. The detection limit for this assay was found to be 10 M. pneumoniae organisms in clinical samples. There was no amplification of DNA from 11 other species of human and animal mycoplasmas and 17 other bacterial species.Conclusion: This study indicates that PCR is a sensitive, specific and reliable method for rapid diagnosis of M pneumoniae in respiratory tract samples.

Background & Objective: Regarding the high prevalence of epileptic seizures, its complications and the necessity to control them, this study was carried out in order to assess the role of progesterone administration in newborn rats on Pentylenetetrazol (PTZ) kindling susceptibility after maturity.Materials & Methods: This experimental study was carried out on 32 newborn Wistar rats. Rats were randomly divided into four groups, which are as follows: progesterone-injected females, progesteroneinjected males, sesamoid-injected females and sesamoid-injected males. Progesterone and sesamoid groups were injected with progesterone (100 mg/Kg) and sesamoid (100 mg/Kg) respectively. Sixty days after injection chemical kindling in the rats was analyzed by PTZ administration.Results: Progesterone significantly increased the susceptibility for PTZ kindling in female rats however; it did not have a significant effect on seizure parameters in male rats.Conclusion: The results of this study suggest that chronic administration of progesterone can only increase susceptibility for chemical kindling in female rats and not in the males.

Background & Objective: Patients with ischemic heart disease classified to two major groups: patients with stable angina and patients with Acute Coronary Syndrome (ACS). Previous studies showed that posterior segment of left ventricle is a silent segment on ECG, and routine 12 leads electrocardiognlm (ECG) is not sensitive for evaluation of posterior infarction. This study designed for evaluation of ST segment deviation on posterior leads of ECG in patients with ACS at Beheshti hospital in 2002.Materials & Methods: This is a descriptive-analytical and prospective study. In 347 patients with diagnosis of ACS who were admitted in the emergency department, 12 leads ECG with additional three leads (V7-V8- V9) were carried out. For statistical analysis, calculation of percentages for sensitivity, odds ratios, and %95 confidence intervals was performed.Results: Major abnormalities (ST elevation ³1mm and ST depression 2³1mm) were found on the extra three leads in %21.6 (75 out of 347). Sensitivity of ST segment elevation for acute myocardial infarction on 12 versus 15 leads increased from %68.5 to %90.7 (P=0.0005). Sensitivity of ST segment depression for acute myocardial infarction on 12 versus 15 leads increased from %31.5 to %40.7 (p=0.157). Sensitivity of ST segment elevation for unstable angina (239 cases) on 12 versus 15 leads from zero to %5 and sensitivity of ST segment depression for unstable angina on 12 versus 15 leads increased from %31.8 to %36.8 (P=0.25 ).Conclusion: The 15-leads ECG provides increased sensitivity of detecting ST-segment deviation in acute myocardial infarction and unstable angina.

Background & Objective: Nurses form the most significant sector of the health care provision and play a fundamental role in providing on-going quality care for patients. To attain clinical competency, it is essential to understand the factors influencing it. Due to the fact that clinical competency is directly affected by specific features of the educational and health care system and the medical training within each country, it is necessary to assess the factors influencing clinical competency. Materials & Methods: This study was based on the Grounded Theory method. The sample of 36 comprised of clinical nurses, as well as trainers and managers within the Ministry of Health and Medical Training, Nursing and Midwifery faculties, hospitals and members of the Nursing Council in Tehran. Data was obtained through semi-structured interviews, which were recorded and subsequently transcribed. The analysis was carried out by the Straus and Corbin method.Results: In this study, personal factors were identified as one of the contextual factors affecting clinical competency. The respondents branded this category as "the internal and personal factors". This included a significant number of sub-categories such as education and skill, moral values, consciousness responsibility and accountability. Another category was identified as "the external and organizational factors" which included categories such as educational and clinical environments, work license, control and supervision and effective educational system.Conclusion: The clinical competency process resulted from the interaction between three factors; ethics, effective experience and environmental factors.

Background & Objective: Iodine deficiency was a public health problem in Iran before iodine supplementation. In order to evaluate the iodine status of school aged children in Zanjan, this survey was conducted in the frame work of national monitoring survey in 2001 to find the prevalence of goiter and urinary iodine level. Materials & Methods: 1200 schoolchildren, aged 7-10 years, were selected randomly from all regions of Zanjan, and the grade of goiter, in 600 boys and 600 girls, was determined according to WHO classification. Urinary iodine content was measured using the digestion method in one tenth of the schoolchildren.Results: Total goiter rate was 19.7%, 225% in girls and 16.8% in boys. Median urinary iodine was 18.1 mg/dl. Urinary iodine was above 10 mg/dl in 85.1% and less than 5 mg/dl in 1.6%, no one had urinary iodine below 2 mg/dl. There was no difference in goiter prevalence and urinary iodine between gender and rural or urban school children. Conclusion: It is concluded that urinary iodine levels in school children of Zanjan province are indicative of adequate iodine intake. There is considerable decrease; in goiter rate as compared to survey of 1986. Zanjan province therefore can be considered an "iodine deficiency free" zone.

Background & Objective: The prevalence of obesity, one of the greatest public health problems in the world has tripled in many countries since three decades ago; this increase is often faster in developing countries than in the developed world. Gathering information on the main factors involved in the occurrence of obesity in different geographical areas plays a key role in the prevention of it. Therefore, the aim of this study is to evaluate the prevalence of overweight and obesity in relation to various factors in the Zanjan population.Materials & Methods: This cross-sectional study was conducted on 2500 Zanjan residents aged between 15 and 64 years who were randomly selected through cluster sampling via their postal codes, using the protocol of the WHO STEP wise approach. Information on demographic characteristics was collected using questionnaires. Weight and height were measured according to standard protocols. Those with a BMI within the range of 25-29.9 Kg/m2 and 30 Kg/m2 or above were classified as overweigh and obese, respectively.Overweight and obesity were defined based on the WHO classification. Data was analyzed using Chi-Square tests and Logistic regression models to estimate odds ratios.Results: The prevalence of being overweight and obese in this population were 30.7% and 15% respectively. The proportion of obesity was 21.3% in women and 8.9% in men. The prevalence of obesity increased with increasing age and in both sexes was the highest in 45-54 year olds. Both prevalence of overweight and obesity were greater in urban residents and married participants. The prevalence of obesity was also decreased with increasing educational level.Conclusion: High prevalence of overweight and obesity in this population, specifically within high-risk groups, highlights the need to implement interventions for reducing this epidemic.