Studies in Medical Sciences
Year:2004 | Volume:15 | Issue:1|Papers Count:10

Background & Aim: Bone infection after internal fixation of closed fractures is still one of the orthopedic complications. With new and modern sterility techniques, the duration of prophylactic antibiotic therapy has been shortened. The purpose of this study is to compare the occurrence of in1ection between 24 hours and 48 hours prophylactic antibiotic protocols in closed fractures. Materials & Methods: In a prospective double blind study, 210 patients with closed fractures and internal fixation took 24 hours or 48 hours prophylactic antibiotic therapy and the results compared between them. Results: There were 2 infection cases. One of them had a superficial infection in a hip nailing surgery that finally treated with a 2 week antibiotic therapy. She was in 24 hours antibiotic therapy protocol. The other one had a deep infection which happened in a 6"dth bone fracture of forearm fixation. He was under a 48 hours prophylactic antibiotic regimen. Discussion: The occurrence of infection in this study was 1%. There was not a meaningful difference between 24 hours and 48 hours antibiotic prophylaxis. It can be concluded that in our operating room conditions and sterility techniques, one may use 24 hours antibiotic prophylaxis instead of 48 hours.

Background & Aim: Trichomonas vaginalis is a flagellate protozoa which can be found in urinary canal, cervix and vagina of contaminated persons. The disease affected by this parasite is called trichomoniasis. The common way to diagnose the disease is applying wet mount method with 60% sensitivity; this study tries to compare two different ways of wet mount and Diamond culture to diagnose Trichomonas Vaginalis. Materials & Methods: In this study, vaginaldis charges of 420 women referred to Health Care Center No 15 of Urmia Medical Sciences University were collected and examinated by two different methods; wet mount and Diamond Culture. Finally they were compared. Results: From all of cases, 11 (2.6%) of them had parasite in their sample, but the results of parasite culture showed contamination in 10 cases (2.4%). In this study, sensivity of two methods (wet mount and Diamond Culture) was 100% and 90.9%. Statistical data showed that there is a significant relationship between rate of contamination and clinical findings (p<0.05). Discussion: AS Diamond culture has got a high sensitivity comparing to the other methods, the difference between different ways of wet mount and Diamond culture can be explained by the factor that in transmitting the test tubes, most probably the parasites are lysed. It can be justified by inappropriate parasites culture conditions, too.

Background & Aim: General anesthesia remains the most widely used anesthetic technique for managing ambulatoy surgery. The ability to deliver a safe and cost effective general anesthetic with minimal side effects and rapid recovery is critical in outpatient surgery unit. Questions regarding the optimal anesthetic technique, remain to be answered. This study was designed to compare the difference between the effects of propofol-ketamine and propofol-fentanyl total intravenous anesthesia (TIVA); on hemodyamic, respiratory and recovery profiles. Materials & Methods: Sixty patients, ASA class I-II undergoing outpatient surgery were randomly assigned to one of two groups (n=30 each). After premeditation with midazolam (0/02 mg/kg), the first group received 1 µg/kg fentanyl followed by 1mgjkg propofol; while 0/3 mg/kg ketamin replaced fentanyl in the second group. Anesthesia was maintained with propofol infusion (50 µg/kg/min) both groups. Results: Incidence of hypotension (k: 3/3%, F: 70%), bradycardia (K: 4/3%, F: 43/3%) and mean apnea duration (k: 37/7 s, F: 184/5s) was significantly lower in the ketamine-propofol group (p<0.0001). Recovery, time was similar in two groups. Psychomimetic side effect was not seen in each of the groups. Discussion: TIVA with ketamine (as analgesic with subhypnotic dose) and propofol is comparable to the most commonly used combination of propofol-fentanyl, and may be an appropriate choice when hemodynamic stability is of great importance.

Background & Aim: Approximately 30% of all deaths in women are related to coronary artery diseases. In contrast to dramatic decrease in cardiovascular mortality achieved for men because of improvement of diagnostic and therapeutic procedures in the past years, there has been a little- improvement for women. It seems that anatomic variations, or differences in coronary risk factors influences of gender on coronary artery disease presentation. The aim of this study was to evaluate coronary risk factors in women with established coronary artery disease. Materials & Methods: In this study, we selected 250 women with coronary artery disease randomly and evaluated magnitude of various risk factors and their weight and heigh for coronary artery disease and 114 patients with abnormal coronary angiography were assessed too. Results: Diagnosis of patient at presentation was included myocardial infarction (11.5%) and unstable angina (88.5%) All patients had risk factors of coronary artery disease. Diabetes mellitus 38.5%, hypertention 78%, cigarette smoking 27%, cholesterol >150 mg/dl in 98%, oral contraceptive 57%, family history for coronary artery disease in 28% and BMI >27 KG/M2 in 59.5% were distinguished. Discussion: In this study unstable angina was the most common presentation of coronary artery disease in women. There were three or more risk factors in most of patients. Factors associated. With higher cardiac risk were as follow respectively: dyslipidemia, hypertention, oral contraceptive, diabetes mellitus, and smoking.

Background & Aim: The aim of this study is reduction of hemodynamic changes during induction of general anesthesia by co-administration of intravenouse ketamine and propofol. Materials & Methods: In this clinical trial, we studied sixty, 20-40 yrs old patients, which randomly divided in two equal groups, control and study. At first, under equal conditions, prior to any drug administration, the patient's systolic, diastolic and mean arterial pressures and heart rate were detected (basal parameters). In the control group, intavenous ketamine (2 mg/kg) and in study group, intravenous ketamine plus propofol (each 1 mg/kg) administered for induction of general anesthesia. Then, the mentioned hemodynamic parameters were measured in both groups, at the times of 1 minute after induction and 1, 3, 5, 10 and 15 minute after intubation. The changes of measured indexes were analyzed. Results: In all cases (except for changes in heart rate), in study group, cardiovascular indexes reduced from basal parameters to less than 20%, and in control group, these indexes increased from basal parameters to greater than 30% (p<0.05). Discussion: If there are no contraindications for ketamine and propofol administration, and the a little hemodynamic change be desirable (e.g. ischemic heart disease), we can use the combination of ketamine and propofol for induction of general anesthesia.

Background& Aim: The factors that cause patients to be hospitalized, usually increase the chances of acquired infections in hospitals. The most important of them that disturb host immune system and some hospital related methods that can be the abnormal ways for microorganisms to enter up our body. For example, we can point to put a tracheal tube in trachea or mechanical ventilation in respiratory system of patients. Also nosocomial infection factors can colonize on the surfaces of materials and instruments in wards and transferred to patients. The aim of this study is a careful consideration of bacteria and fungi contaminating instruments, materials and surfaces in the operation rooms. Materials & Methods: This study is a descriptive one and at first, we gathered samples from instruments, materials and surfaces of operating rooms with sterile swabs. Then we transported the samples to the bacterial and fungal culture mediums and after incubation time, identification of bacteria and fungi were carried out. Results: As the result of this study, bacteria and fungi contamination of operation rooms in order are 31.5% and 24.6%. Pseudomonas, coagulase negative staphylococcus and staphylococcus aureus in order with 28.6% 26.8% and 14.3% and candida sp, penicillum, cladosporidium in order with 24.5%, 22.4% and 16.3% are the most prevalent of isolated organisms. Discussion: This study reveals the incidence of hospital contaminants in operating rooms are high and caution should be considered.

Background & Aim: Leishmaniasis is a general name given to disease caused by any member of protozoan genus Leishmania and. can be divided into visceral (kala-azar), cutaneous and mucosal syndromes. For epidemiologic studies, identification of strains & species of lesihmania protozoan in any endemic area is a necessity. The aim of this study characterization of leishmania isolate from patient with kala-azar based on isoenzymes electrophoretic patterns & determination of the main reservoir, deduction from comparison of isoenzyme pattern of reservoir& patients in northwest of Iran were undertaken. Materials & Methods: Twenty one bone marrow aspirated were obtained from patients and after inoculation in semisolid sloppy evane's N.N.N meida electrophoresed by a thin-layer starch gel method for twelve isoenzymes. Results: The isoenzyme profiles of all patients were indistinguishable from L. Infantam LON-49= [MON-1] zymodeme (MHOM/TN/80/IPT1) and are the same profiles which previously were identified in naturally infected dogs in northwest of Iran. So while the species of leishmania was proved. The main reservoir also was identified. Discussion: This study again proved that kala-azar northwest of Iran is a Mediterranean site of kala-azar.

Background & Aim: DSM-IV as a system for classification of psychiatric disorders, presently is used extensively by psychiatrics. Although reliability of this system is -being discussed in many studies; in majority of cases, assessment is carried out by structured or semistructured diagnostic interviews, which are generally incompatible with usual clinical work. Hence, this study was carried out to investigate agreement among psychiatric residents about diagnosing DSM-TV axis I by an unstructured interview. Materials & Methods: The study was a cross - sectional research. One hundred and seventeen psychiatric patients were interviewed in daily; morning reports in Razi psychiatric hospital in Tabriz. The patients were evaluated by each residents separately and diagnosis on axis (I) were made. Collected data were analysed regarding agreement rate among residents by use of ICC (Intraclass Correlation Coefficient); also for assessment of effects of other variables upon these diagnoses, analysis of variance was done. Results: Agreement rate among residents in diagnosing axis (I) was good to excellent (ICC: 0.71). Resident and patients personal characteristics were not -significantly- important in explaining diagnoses. Also, with the exception of "patient perception" mental status assessments were not significantly important in this regard. Diagnoses in axes (III) and (IV) were important in explaining some part of final diagnostic process in axis (I). Discussion: It seems that when same information about patients is available for researchers, psychiatric disorders can be diagnosed with a good reliability even without using structured interview.

Background & Aim: The aim of this study is to determine an association between lymphoblastic lymphoma and myasthenia gravis. A 23-year-old male patient with myasthenia gravis (MG) developed mediastinal precursor T-lymphoblastic lymphoma (LBL), 15 months after MG diagnosis and treatment, presented with classic symptoms and MG crisis as a sign of LBL. LBL subtype was determined by using an immunohistochemistry test for B or T cell differentiation. His LBL did not show any high risk factors. His reaction was very well to CHOP (Cyclophosphamide, Doxorubicin, Vincristine, Prednisolone) chemotherapy with significant reduction in his myasthenic symptoms. Discussion: Decrease in signs of disease can show a significant relation- ship between myasthenia gravis and mediastinal lymphoblastic lymphoma.

Background& Aim: Polycystic Ovarian Syndrome (PCOS) is the most common endocrine abnormality affecting female reproductive system, (10%) PCOS is the most common cause of infertility due to anovulation. There are long-term health consequences in patient of PCOS such as the increased risk of developing coronary artery diseases, hypertension, type n diabetes, carcinoma of endometrium, dislipidemia and hyperinsulinimia. Induction of ovulation in the patient with PCOS is done by using of clomiphene citrate and gonadotrophin and surgical inducted ovulation. One of the complications of induction after cauterization is premature ovarian failute. Cases of ovarian failure have been reported after both wedge resection and laparoscopic surgery. Case report: This case is a 34 years old women who addmited due to oligomenorreh and (PCOS) and has been under laparscopic operation and ovarian diathermy. After a year, she referred due to amenorreh the patient investigated for amenorreh. Laboratory finding determine ovarian failure. (FSH=58 mlu/ml). Other laboratory findings were normal. Discussion: For preventing from (PCOS), patient selection, cauterization 1- Assistant Professor of obstetrics and Gynecology, Urmia University of Medical Sciences sites and numbers and hormonal tests are very important.