Studies in Medical Sciences
Year:2007 | Volume:18 | Issue:1|Papers Count:22

Background & Aims: Combined oral contraceptive pills (OCP) provide highly effective birth control. Studies have indicated that the risk for dysplasia and carcinoma insitu of the uterine cervix increases with the use of oral contraception for more than 1 year. Invasive cervical cancer may increase after 5 years of us reaching a 2- fold increase after 10 years. But conclusions regarding cervical cancer are not definitive. The aim of this study is to assess the frequency of cervical squamous intraepithelial lesions in users of OCP for more than 5 years versus nonusers.Materials & Methods: This cross- sectional study was performed on 500 women between 30-50 years old. The Study population were selected from a population lab; 250 woman using OCP for more than 5 years (exposoure) and 250 nonusers (non exposure) were selected. After filling the questionnaires out and obtaining pap smear test, the results were reported based on Bethesda system. The results were statistically analyzed by chi- square and logistic regression tests.Results: OCP users had ASCUS in 2.8% and LSIL in 0.8% of cases. The non-exposures had also 2.8% ASCUS. There was no statistically significant relationship (P>0.05). The only significant relations were between long- term OCP use with increasing age and current use. Conclusion: Regarding no significant relation between long- term OCP use with cervical squamous intraepithelial lesions, we recommend OCP use because of its high effectiveness without fear of increased risk of cervical neoplasia. However, there is a need for further case – control studies to evaluate the relation between long-term use of OCP and intraepithelial cervical lesions especially in current users.

Backgrounds & Aims: The incidence of diabetes type I and II is increasing in all over the world. Gastrointestinal symptoms are the most common complaints of these patients. This study was done to find the frequency of GI symptoms and determine their relationship with diabetic complications and blood glucose controlling in diabetic patients.Materials & methods: These studies were done prospectively on 638 in and out patients with diabetes mellitus. They were evaluated with a validated questionnaire, then HBA1c was checked in their blood. These cases were 214 males and 424 females. Eighty-one of cases were type II of DM and 557 of cases were type II (of DM). Frequency of diarrhea, constipation, fecal incontinence, episodic abdominal pain in well-controlled diabetics were 4%, 4.9%, 0%, 2.9% respectively' but in uncontrolled diabetics they were 41.9% (OR=1.47), 51.4% (OR=0), 10% (OR=1.03), 51.42% (OR=1.10)Conclusion: In this study increasing of glucose levels resulted in increasing the number of lower gastrointestinal symptoms.

Background & Aims: Intrapleural analgesia using local anesthetics is one of the means for postoperative pain control, and is mostly used in surgeries performed on upper abdomen, chest and kidneies. We evaluated the effects of adding morphine to local anesthetic to improve postoperative analgesia.Materials & Methods: Thirty patients (ASAI , 20–50 years old) admitted for elective kidney surgery were randomly classified into two groups (control & study) to receive either bupivacaine 0.5% plus normal saline or bupivacaine plus morphine, respectively. The degree of postoperative pain was estimated by verbal pain score (VPS), the 24 hr parenteral morphine requirement between two groups was compared.Results: The average VPS during 6h postoperatively in control and study groups was 2.26 and 1.53 respectively, which was statistically significant (P<0.05). The results of 12 and 24 hr postoperative time were also similar. The average systemic consumption of morphine (mg/kg of body weight) during 24 hr after surgery in control and study groups were respectively, 0.117±0.033vs 0.096± 0.024 (P>0/05).Conclusion: In 24 hr postoperative time, intrapleural bupivacaine plus morphine compared with bupivacaine plus normal saline, caused improved quality of pain control. Although at the same period, intravenous morphine consumption in the study group reduced compared to the control group, the difference wasn’t statistically significant.

Background & Aims: Amblyopia (lazy eye) is one of the most common pediatrics eye diseases and important because of its potential risk of vision threatening condition. Its diagnosis is an occasion and infact screening includes the only effective method to diagnose it in populations. Snellen chart that has been applied in amblyopia screening program of 6-10 year-old children is one of the most efficient and cost-benefit methods. As other screening programs, it is necessary to determine the efficiency of screening test by estimating sensitivity and specificity.Materials & Methods: Two random groups were selected among screen test positive and negative cases and were assessed by gold standard vision test and were separated into two true amblyope and true normal groups to determine sensitivity and specificity of the screen test in a 2×2 table. Results: A total of 55551 cases were screened and 2955 subjects (5.3%) had positive result in screen test, and the rest were negative. Among 300 randomly selected cases from test positives, 126 cases were truly positive and 174 cases were normal. And also among 263 randomly selected cases from test negatives, 6 cases were amblyope and 257 cases were truly negative. So sensitivity and specificity of the screen test were calculated 95.45% and 54.63%, respectively. conclusion: So it seems that Snellen chart has a proper sensitivity for screening amblyopia among 6-10 year-old children but it must be considered that when the test is negative, it does not signify the absence of amblyopia.

In this descriptive study in 100 patient with ASA class I, II with age range between 18-65 years that were candidates for elective surgery on abdomen and lower limb to study the pressure transmitted by the laryngoscope blade on the base of the tongue and the relation between the laryngoscipic pressures and post-operative sore throat laryngoscopy was performed with a modified size 3 macintosh blade and a small ballon was attached to the tip of the blade that was connected with a narrow pipe to the pressure sensore of the monitor and calibrated before each measurement.In this study four different laryngoscopic parameters were determind:1) The duration of laryngoscopy; 2) The maximally applied pressure; 3) The mean pressure; 4) The surface area under the pressure time curve. Twenty four hours after the surgery, the intensity and frequency of sore thorat were measured by visual analyze scale (VAS). The data were analyzed by SPSS soft-ware and ANOVA; the discriminant was analyzed, the result was presented by Mean±SD. The result of this study demonstrates: 1) The duration of Laryngoscopy is 10.57±1.66 seconds; 2) The maximally applied pressure is 259.73±21.17 mmHg 3) The mean pressure is 156.30±19.00 mmHg 4) The surface area under the pressure-time curve is 2939.97±413.00 mm2.There was a positive correlation between maximum pressure and sore throat (P=0.001) and mean pressure and sore throat (P=0.006). Between post operative sorethroat and other factors such as age, sex, duration of laryngoscopy, duration of operation, and surface area under the pressure-time curve. There is no positive correlation. The findings show that post-operative sorethroat is related to maximum and mean laryngoscopic pressure. This fact has not been evaluated in previous researches.

Background & Aims: Mosques are considered as public places, so it is necessary to apply sanitation rules in such places. In case, the mentioned rules are not taken into consideration seriously, they may become a center to spread various kinds of pathogenic agents. As mosques are managed by public contribution, so this study tries to attract mosque managers' participation by proposing educational and surveillance programs.Materials & Methods: In this study, 24 mosques were considered to undertake the educational and surveillance programs. The educational programs include lectures, group discussions, individual training and using posters. The surveillance programs included hygienic inspections and giving feedbacks in two times. Data collection was done in two stages before and after performing the plan by filling up a checklist. Results: Comparing the means of checklist items showed that personal hygien and hygienic application of tools increased siginificantly (P<0.05). Considering the hygienic situation of structure of mosques, there was no signigicant changes (P=0.12). Conclusion: As a remarkable number of population attend mosques, any improving hygienic situation of these places can play an important role in controlling pathogenic agents and promoting community health.

Background & Aims: Thyroid hormones have important effects on growth and differentiation of body organs specially the central nervous system; It also has a role in metabolism of carbohydrates, lipids and vitamins. Certain studies showed that low level of thyroid hormones is a risk factor for complication of prematurity, and they suggested administration of thyroxin for premature infants. So this study was done to evaluate FT4 and TSH levels in preterm infants. Materials & Methods: This cross-sectional descriptive study was done on 99 premature 2-7 day-old infants whose gestational age was between 26 to 36 weeks in NICU and a neonatal ward with random sampling from 21 March 2004 to 28 May 2005. One millilier of venous blood was taken, and serum FT4 and TSH level were measured by radio immunoassay.Results: This study showed that with increase of infants' weight, FT4 level rises (P=0.4, R=0.05) and TSH level decreases (P=0.2, R=0.12). With the increase of infants height FT4 level rises (P=0.8, R=0.02) and TSH level decreases (P=0.13 R=0.15). While increase of head circumference did not have a meaningful correlation statistically with FT4 level in both sexes (P=0.08) but there was a meaningful correlation in boys (P=0.04), TSH level decreases with increasing head circumferences but it was not meaningful statistically (P=0.2 R=0.12); The mean value of FT4 level between infants born with high and low apgar score (P<0.01) and between high and moderate (P<0.03) was statistically meaningful, so the FT4 levels decreases when apgar score is reduced. But apgar changes have no correlation with the mean value of TSH level (P=0.13). With increase of gestational age, FT4 level rises (P=0.1 R=0.17) but TSH level decreases (P=0.56 R=0.05). In this study, there was no meaningful difference in mean FT4 (P=0.37) and TSH levels (P=0.16) between LBW and VLBW infants.Conclusion: The results of the present study show the possiblity of hypothyroxinemia increases in infants with lower weight, height, head circumference, apgar score, and gestational age. But this correlation is meaningful only in lower apgar score and in boys with low head circumferences. Regarding the availability of facilities for preventing the mortality and morbidity of VLBW and LBW infants in our country, short period administration of thyroxin especially in infants with lower apgar score seems to be necessary.

Introduction: The goal of this study is to determine the prevalence of ocular herpes simplex manifestations between September 2004-March 2005. The importance of this study is in reducing symptoms and complications of herpes simplex keratitis (Such as iritis, blindness, and decreased visual acuity due to corneal scarring, perforated corneal ulcer, secondary infection with bacteria or fungi, secondary glaucoma) and reducing the risk of recurrence and improving corneal graft survival after penetrating keratoplasty.Materials & Methods: Sampling procedure was sequential. Forty nine patients were selected from the ophthalmic clinics who had ocular herpes simplex manifestation and were examined by completing questionnaires.Results: The results of this study showed that the prevalence rate of epithelial keratitits was 65.3%, stromal keratitis %48, conjunctivitis 4.1%, uveitis 4.1%. The most trigger factors were as follow: Psychological stress 34.7%; sunlight 8.2%; fever 4.1%, local trauma 4.1%; systemic disease 2.05%. The prevalence rate of primary infection was 22.4% and the recurrent infection was 77.6%. Forty seven percent of these patients had visual acuity less than 4.10.Conclusion: Because the rate of corneal scorring increases with any episodic disease recurrence, the necessity of prevention of disease recurrence increases. It is necessary to educate people to recognize the disease manifestations, provocation factors, and preventing methods.

Background & Aims: Osteoarthritis is the most common joint disorder in the world. The knee joint is frequently involved by primary osteoarthritis. The influence of various risk factors has been identified. The aim of this study is to determine the effect of anatomical parameters on knee osteoarthritis.Materials & Methods: Tibial plateau tilt, cam effect, and tibial plateau coverage by femoral condyles were measured in grade>2 X-rays of 50 osteoarthritis cases and compared with 50 normal 50-65 year old cases. Results: All parameters were significantly more in osteoarthritis group pv=0.005, pv=0.001, pv=0.003.Conclusion: Anatomic parameters should be attended in occupations with knee bending and high physical demand.

Background & Aims: Professional atheletes are more prone to upper respiratory tract infections during strenuous exercise. Alterations in saliva IgA concentrations are thought to be involved in the development of oral and upper respiratory tract infections. This study was designed to evaluate the impact of intensive exercise on saliva IgA in wrestlers.Material & Methods: Professional young wrestlers and sedentary controls (n=15; each) were recruited. Height, age, body mass, and fitness grade were recorded. Athletes were tested in stages including, the first and second five weeks of being trained and the recovery period. Controls did not engage in any type of formal exercise. Saliva IgA levels were measured by ELISA. Results: In a rested condition no differences were seen in IgA levels between athletes and control subjects. After 5 weeks of wrestling, IgA concentrations were markedly decreased in athletes than in the controls (P=0.087). In the test group IgA levels were even lower after 10 weeks of exercise compared to those at rest but it was not significant (P value=0.632). Conclusion: This study suggests that intensive wrestling alters saliva IgA production. It was revealed that there is a marked reduction in saliva IgA levels after 5 weeks of intensive activity. Although in second and recovery stages there was a difference in IgA level between two groups, it was not significant (P=0.632). As a result athletes were more prone to upper respiratory infections. It seems heavy training which may reflect a chronic suppression of lymphocyte antibody production.

Background & Aims: Human papillomaviruses (HPVs) are associated with cervical intraepithelial neoplasia and invasive carcinoma. Epidemiological data show that about 90% of all cervical cancer patients are HPV positive and HPV-16 is the most prevalent in cervical cancer, followed by HPV-18. As HPV subtypes has not been assessed in the West Azerbaijan province, therefore; the main focus of this study was to determine the prevalence of HPV 16 and 18 in cases of cervical cancer.Materials & Methods: Thirty six pathological blocks with uterine cervical carcinomas (SCC, CIN, CIS, Adenocarcinoma, etc.) who referred between 2000-2005 to a pathology unit were collected and their DNA was extracted. DNA was amplified using PCR method and subtypes of the virus were determined.Results: From 36 amplified samples with general primers, 30 samples (83.3%) were HPV positive and 6 samples were HPV negative (16.7%). Thirteen cases were HPV16 positive (36.1%). Neither of the cases were HPV 18 positive. The majority of tumors were squamous cell carcinomas (62.2%), and the rest were CIN I and LSIL (23.1%). There was a significant correlation between the presence of HPV and type of pathological findings since all SCC samples were HPV positive (P=0.007). Conclusion: Obtained results showed that HPV screening by PCR method especially screening subtype 16 in all cervical carcinoma samples is advisable in West Azerbaijan province.

Background & Aims: In patients with nephrotic syndrome, the natriuretic effect of furosemide (FU) is diminished. The effect of co administration of FU and human albumin (HA) has remained controversial.Material & Methods: In a cross-over clinical trial study, ten nephrotic patients (seven females, 33.57years) on standardized sodium chloride intake, in random order on three separate days, received by intravenous administration for 60 minutes either (a) 1 mg/kg FU plus a sham infusion, (b) 1mg/kg FU plus 200 ml of a 20% solution of HA, or (c) sham infusion plus 200 ml of a 20% solution of HA. Urinary volume and sodium excretion and glomerular filtration rate were assessed. Results: Mean 24h urine volume after infusion of HA, FU, and HA plus FU was 724ml (SD= 528), 1707ml (SD=745), 2175ml (SD=971), respectively (Pv=0.015). Mean FENa was 1.96% (SD=0.251), 3.18% (SD=0.25), 4.77% (SD=0.21) respectively, (Pv=0.015). Mean 24h urine Na was 118.3 (SD=6.86), 208.4 (SD=5.27), 206 (SD=8.45) respectively, (Pv=0.005). Mean GFR was 104.5, 96.6, 106.6 respectively, (Pv=0.021).Conclusion: Coadministration of HA potentates the action of FU in patients with nephrotic syndrome by increasing effects on GFR and diuretic potency of FU.

Background & Aims: In the few thousand years history of medicine, there is no infection like HIV/AIDS to be such a terrible chaos for humanity. According to estimations of UNAIDS, 70 million infected people and 28 million deaths has been reported. Considering the routs of transmission, medical and dentistry personnel based on their occupational conditions are at the risk of acquisition of infection from infected patients, and on the other hand they can transmit and propagate the infection to other patients. So we decided to survey the knowledge and attitude of Urmia dentists about HIV/AIDS.Materials & Methods: This cross-sectional study was carried out on those dentists that were volunteer to cooperate in the study with completion of a presented standard questionnaire. The collected data were analyzed by statistical software SPSS. Results: Findings of this study showed that the studied population had moderate knowledge about HIV/AIDS. This study showed no meaningful statistical relationship between dentists knowledge and their sex and age. (X2=1.07; df=2; P-Value=0.504). Approximately 30.8% of the studied population had positive attitude about treatment of HIV/AIDS patients in their offices; there was on statistically meaningful relationship between dentists, attitudes, their sex, or age. (X2=1.07; df=4; P-Value=0.899) Conclusion: With attention to moderate knowledge of dentists about HIV/AIDS, it is recommended to perform the compiled educational and re-educational programs, in order to upgrade the knowledge level of dentists. So permanent education and considering universal precautions help not to banish the infected patients from dentistry clinics.

Background & Aims: Hydatid cyst due to echinococus granulosus is a very prevalent disease in most countries particularly in areas where animal husbandry is very frequent. Iran is not an exception, most studies in Iran showed that hydatid cyst can be seen in domestic animals specially in herbivorous ones. Man is considered as intermediate hosts of parasites. Man can be affected by the parasite by eating vegetable and salad contaminated by parasite eggs. After several weeks these parasite eggs are transformed into hydatid cyst in different tissues especially in the liver, lungs, kidneys spleen, brain and bone marrow, which is accompanied by some complications. Epidemiologically, those who have a very close relationship with dogs that are the main hosts of parasites can be affected more frequently. This study aims to investigate cases of the cerebral that underwent neurosurgery in 10 years.Materials & Methods: The methodology of the study is a retrospective and descriptive one. All the patients who had surgical operations in the neurosurgery department were about 500 people among whom 16 (3.2%) cases were affected by cerebral hydatid cyst which has a correlation with international statistics and valid scientific documents.Results: Of these 16 cases, 9 were under 15 years of age, 7 were about 15 years old. Ten patients (62.5%) were females and 6 (37.5%) were males. In general from the same 16 people, 14(87.5%) were in supratentorium status and only 2 patients (12.5%) were in infratentorium status. 12.5% had numerous cysts, 87.5% had a single cyst.Conclusion: It is worth to mention that numerous cysts are more susceptible to be broken down than single cysts. As the disease is a very dangerous one, academic and health centers must do their best to give teaching and instructions to people through mass media.

Backgrand & Aims: Brucellosis is zoonotic that is an infectious disease caused by brucella spp. It causes economic losses among domesticated animals used as major sources of meat and dairy products. Fever, chills, and weaknesses are manifestations of the infection. Cases occur among livestock producers, livestock markets employees, and veterinarians. The main goal of this study is to survey brucellosis in the sera of slaughterhouse and veterinary farm employees.Material and methods: Questionnaires were prepared and 205 blood samples were obtained from the employees randomly. Brucella antigen and anti human serum were purchased from Pastor Institute (Iran) and Dako (Denmark), and ELISA kit from IBL (Germany). Anti-brucella antibodies were measured from the sera by a standard agglutination test (Wright test). To determine the class of antibodies and for identification of false negative results (Blocking antibodies), Coomb’s Wright, 2ME Wright, and ELISA tests were carried out. Results: In 205 samples, Wright agglutination test was negative in 158 (77.1%), positive in 47 (23 %) and the titer was ³1/40. From the positive results, 13 (6.3%) samples had titer 1.40, 21 (10.2%) had titer 1.80, 10 (4.9%) with titer 1.160, 2 (1%) with titer 1.320 and 1 (0.5%) with titer 1.640. In Coomb’s Wright, the titer of 16 samples was ³1/640. Anti-brucella IgM antibodies were positive in 17 (8.3 %) of the samples and anti-brucella IgG antibodies were found in 27 (13.2 %) of the samples. Conclusion: The results indicated that 23% of the employees were potentially exposed to contaminated materials. The positive results indicated that at least 8.3% of the cases suffered from acute brucellosis and 13.2% suffered from sub-acute or chronic brucellosis. It is recommended to adhere biosafty and consider precautions in personal vaccine should be designed and used precautiously.

Backgrounds & Aims: Traumatic arteriovenous fistulus malformation are rare complications of head injury that usually are presented with bruit in the head. CT angiography of brain is a choise diagnostic tool. So the early diagnosis and suitable treatment will stop the complete and progressive complications.History: A case of a young man who developed a traumatic dural arteriovenous fistulus malformation between middle menegeal artery and petrosal sinus after road-traffic accident is described.Fortunately he managed successfully with an excellent outcame.Discussion: Brain CT angiography is recommended in head injured patients with a bruit in the head. It can be useful in early diagnosis and treatment of such patients.