Studies in Medical Sciences
Year:2000 | Volume:11 | Issue:3|Papers Count:13

Bipolar mood disorder is one of the most important psychiatric disorders, which has multiple recurrencesin it's course and impairs the function of the patient in it's active phase. It seems that, the most admissions of manic patients occur during especial seasons. To study seasonality of admissions of these patients, this study was done. All of patient's charts who were admitted in Kerman psychiatric center (Beheshti hospital) during 3 years period were reviewed. 600 of them who fullfilled criteria for bipolar mood disorder (manic phase) based on diagnostic and statistical manual of mental disorders (DSM-W) criteria were selected. The mean of patient's age was 30.84 years with SD=12.94 years. Patients who were admitted during their third decade of life were higher than other age groups. Male to female ratio was 1.17. 19.6% of patient's have more than one admission in this 3 years period. Mean of each episode was 2.2 years and mean of each periods length was 9 mounths and 8 days. Most admissions for maniac patients occured during winter and spring. These findings were similar to some previous findings. It seems that increase in temperature and sun-shine are related to manic relapse in specific seasons.

Introduction: cleft palate is one of the commonest congenital obnormalities and requires to repair at early ages. These patients often suffer from co-abnormalities, swallowing disorders, aspiration and upper respiratory infections, so anesthesia and surgeryare more sensitive. Frequent cases of upper abway obstruction caused by lingual swelling following the use of mouth gag has been reported after palatoplasty. This study compare two methods, continuosly applied and intermittently relieved, mouth gag, in prevention of macroglossia and airway obstruction. Methods: During this clinical trial, two groups of patients compared with each other. In group A, gag has been applied continuously all over the operation and in group B, gag has been relieved for 1 minutes to let circulation and venous drainage.Results: Twenty patients were studied in group A and upper airway obstruction was observed in 5 cases (4 relative and 1 complete obstruction), whereas in group B, included 40 patients, there was no obstruction and Macroglossia.Conclusion: With due attention to the necessity of careful and gentle manner in such cases, it seemes that intermittently gag relief method is more effective intervention of lingual edema and prevention of upper airway obstruction.

We report and analysed 20 patients with blepharospasm and hemifacialspasm who had been treated with botulinum A toxin (BTA) injection between 1996 and 1998. The 20 patients comprised 13 females and 7 males. Their mean age was 50 years (SD:±12). 16 patients had idiopathic blepharospasm and 4 patients were diagnosed with hemifacialspasm. The mean duration of suffering was 20 months. Each patient recieved 120 IU of BTA. The results of BTA injection were classified as: excellent result (an improvement of more than 75%) in 45%; a good response (an improvement of 50-75%) in 35%; a moderate response (an improvement of 25%-50%) in 15% and a minimal or no response in 5%.The efficacy of BTA injection lasted 2-3 months and more often needed to repeat the injections (12 patients). These patients followed for 1 year ajier last injection and there were no recurrence of symptoms in most of them. Conclusion: BTA injection is a simple and effective out-patient treatment for patients with blepharospasm, causing no side effects and minor transient local complications.

We reviewed 19 patients who underwent the modified Raz bladder neck suspension for stress urinary incontinence between september 1994 and March 1999. Mean follow up time was 14 months. Overall, our results demonstrated a successful outcome in 18 of 19 patients (94%). When the results were classified by degree of incontinence preoperatively, 16 with moderate and 2 patients with severe incontinence had a successful outcome.No statistical correlation was found with patients age, number of prior operations, hysterectomy, urgency incontinence or menopause. The only patient who failed, the interval to recurrent SUI was 2 months. Significant urgency incontinence was present preoperatively in 8 patients (42%), but postoperative resolution was obtained in 87%. De novo urgency incontinence occurred in 9%. Complications were enterocele (10%), permanent retention (5%), suprapubic pain (5%).In summary, the modified Raz Bladder neck suspension for correction of stress urinary incontinence was successful in more than 90% of our patients.

Duodenal and gastric ulcers account for about 50% of upper CI bleeding episodes. although several effective therapies have been developed for peptic ulcer disease during the past decades, this advances have had little or no impact on hospitalization rates for bleeding ulcers, so, risk factors of bleeding may differ from risk factors of ulceration. In this Case-Control study, bleeding peptic ulcer patients (85 cases) compared with no complicated ulcer patients (26 controls-I) and individuals with no history of peptic ulcer symptoms (170 controls-2). This comparison was on the subject of nutrition, smoking, physical activity, psychial condition, economic condition, family history of peptic ulcer and its bleeding, history of hypertension and NSAID consumption. according to Multi-Regression analysis, the difference between case and control groups was on more consumption of rice in control-1 (p<0.01) and the difference between case and control-2 groups was on more consumption of candy (p=0.02) and white meat (p=0.06) in controls-2, more anorexia (p <0.001), consumption of Pickles (p=0.06), NSAIDs (p=0.06), family history of peptic ulcer and its bleeding (p<0.01) in cases. Totally it seems that carbohydrats and fibers may be protective agents againts bleeding of peptic ulcers and the other risk-factors may be due to peptic ulcer or its bleeding.

This work was a descriptive-Analytical cross sectional study which was directed to investigate the dairy producers' knowledge about brucellosis. The sample size was included 202 workers. The data was collected by a developed questionnaire. The results of study indicated that, 3.5% of producers had good knowledge, 52% intermediate and 44.5% weak. The level of education was 3.5% illiterate, 47.5% level of primary school 3% level of high school and 6% higher than diploma. There was significant difference between the level of education and knowledge, regarding to brucellosis (P<2%). This study also showed that, with increasing age and duration of working, the knowledge of procures is increased. There was no significant difference between knowledge and brucellosis according to the living in roral area or cities (P>5%). 14.5% of workers who were working in a diary factory have trained about brucellosis and remainder (85%) have not trained. The final results showed that the knowledge to brucellosis have increased by training of workers.

1600 stool samples were collected from children under 5 years old with diarrhea and fever referred to health center in islamshahr in a period of one year.After recording the history and physical examinations the samples were delivered to the microbiology laboratory. 235 children were infected with intestinal pathogens. The highest isolations were related to Shigella with 54 strains or 3.4%, Salmonella with 46 strains or 2.9% and Campylobacter with 15 strains or 0.9%. The highest serotypes and species isolations were Sh. flexneri, Sal. typhi and Campylobacter jejune. These results show that, the importance of campylobacter was lowest among other intestinals pathogens.

In a prospective study we evaluated the effect of wearing lab coat on the reliance of patients.In an obstetric department, all mothers were guided about their baby care after childbirth by a pediatrician. The pediatrician attended in the mothers room with or without lab coat and guided them about feeding, jaundice, immunization and care of umbilical cord each week alternatively with or without lab coat. The mothers also were recommended to bring their babies to the clinic again after 4-5 days to be rechecked for hyperbilirubinemia and other problems. The acceptance of the physicians advice and coming back again was the index of the mothers reliance to the doctor. The study continued for 12 months during the year 1990. After exclusion of patients with stillbirth, premature babies, and newborns with congenital diseases and malformations and mothers from cities other than Urmia, 275 mothers were included in the study. 143 mothers were visited with lab coat (group 1) and 132 mothers were visited without wearing lab coat (group 2). 93 newborns from group 1 (65%), and 63 babies from group 2 (47%) were brought for second visit after 4-5 days after the first visit, (p<0.0005).As the study showed, there was an obvious relation between doctors disciplinary on wearing lab coat and the patients reliance.

Manganese is an essential trace element which is taken part in the structure of some metaloenzymes. There is a little evidence for deficiency of manganese in human, whereas its toxicity has been reported in several cases.There are a number of stages by which iron metabolism being achieved. First stage is the uptake of iron from lumen by intestinal mucosal cells. In mucosal cells the exact mechanism by which iron transportation occurs is stilla matter of speculation.Previously, it has been reported that manganese may inteifere with iron metabolism either through intestinal absorption or via blood transportation sites which might be due to chemical similarities between these metals.In this project the interrelationship between iron (Fe) and manganese (Mn) absorptions by rat everted gut sac (EGS) has been investigated. Incubation of freshly prepared EGS in Krebs ringer phosphate (KRP) medium PH 7.4 containing either Fe++ or Fe+++ showed that iron absorption completed within 60 min of incubation time, whereas maximum manganese absorption occurred after 30 min. The absorption of metal ions is a dose dependent process and maximum absorption carried out in the presence of 1.78 or 1.85 mM of iron or manganese respectively.Addition of iron to reaction mixture reduced manganese absorption significantly by 40% Identical level of manganese decreased iron absorption by approximately 15 percent. The effect of other factors on intestinal absorption of iron and manganese have been investigated here.

Chest tube drainage of phase Il Empyema is a way of treatment in some patients but thoracostomy is - needed in some situations. Thoracoscopic inte11Jentionis a new approach for above mentioned patients with low mortality and morbidity, although it is obvious that the chest tube drainage for phase one Empyema and thoracostomy for phase III is strictly indicated. Twenty patients with average age of 40 (18-60) were undergone thoracostomy and Thirty patients with average age of 48 (20-65) thoracoscopic intervention with phase II Empyema. Post operation complication was more in 1st group that was performed thoracostomy.Post-operation bleeding in one case, airleakage in are and wound infection in three patients were obse11Jedin group I, but in 2nd group only one post-op bleeding and one Airleakage were seen.There was no difference in operation lime, but difference was obvious in hospital stay (11 versus 6 duys). Therefore the thoracoscopy is recommended as a choice treatment for phase II Empyema Because of low post operation complications, hospital stay, pain and cosmetic reasons.

Bladder cancer is the second most common cancer of the genito –urinary tract. Transurethral resection allows accurate estimate of tumor stagehand grade and need for additional treatment.This case report is pertaining to a rare form of bladder tumor invasion and T U R syndrome due to this complication. A 67 years old male was candidated for palliative TUR because of tumor relapse.During the procedure, he showed signs of TUR syndrome and follow up provided fertilization of bllader tumor into the ileum and dilutional hyponatremia because of excessive absorption of inigation fluid.Vesicoenteric fistulas are most commonly associated with diverticulitis, crohn's disease, and the carcinoma of the colon.