Internal Medicine Today
Year:2005 | Volume:11 | Issue:1|Papers Count:10

Background and Aim: Unfortunately, a little attention was paid to importance of newborn pain problem but presently, according to identification of several complications, which is followed after painful procedures; its importance has been revealed and considered more seriously by scientists. In addition, nursing and medical painful interventions in newborn wards is very common and advising non-drug treatments in order to decrease and control pain during painful interventions will be important. This study aim was to determine oral glucose effect on newborn pain intensity.Materials and Methods: This study as an applied research was done on 93 newborns that were divided in three groups equally consisting of two experimental groups and one control group randomly. This study was a double-blind clinical trial and to collect data, a sample selection form and newborn pain measurement scale (NIPS) were used. One experimental group (Group 1) took 2 ml glucose 25% solution orally and the experimental group (group 2) was given 2 ml sterile distillated water orally (placebo) during 30 seconds, and 2 minutes after glucose solution and distillated water taking, B- hepatitis vaccine was injected. After injection, behavioral newborns pain scale was surveyed. No interventional treatment was performed in control group (group 3). SPSS software chi-square and statistical tests (LSD, ANOVA) were used to analyse data. Results: The findings showed that the score of pain in the newborns that took glucose 25%  was significantly lower than the other groups. The average of pain scores for group1, group 2 and group 3 were calculated 2.90, 5.29 and 5.45 respectively. The Comparison of pain intensity in these groups showed that the difference between group1 with group2 and group3 was significant (P=0.0001) but there was no significant difference between group 2 and group 3 was not significant (P=0.664).Conclusion: Prescription of glucose 25% solution orally during injection could induce a considerable analgesic effect. By noting that the glucose solution is safe, cheap, and available, it can be used as an analgesic solution when performing painful procedure on newborn such as vaccination.

Background and Aim: During organogenesis two different type of adipose tissue developed which are different in morphology، vascularity and distribution. White adipose has very diffuse distribution but brown adipose has very restricted distribution. Human embryo has also this type of fat، but amount of brown adipose is decreased during the fetal period and after birth so that all type of fat change into white type in adult. In this investigation the pattern of brown adipose tissue in mouse embryo was studiedMaterials and Methods: In this exprimental study 20 Balb/c mice were used. Vaginal plug was recognized as day 0 of pregnancy. Embryos from day 10 to 18 and pops among 5th، 10th، 15th as well as adults were collected and fixed in Paraformaldehyde or FAA (formaline، alcohol، acetic acid)، serial frozen section and histochemical staining by using Nile blue sulphate and Sudan IV were carried out. Results: The first sign of brown adipose tissue was observed at day 14th of gestation around the scapula and after that it can be detected in other sites such as around the abdominal aorta from day of 16th and in hilus of the kidney and great vessels of the neck after day 17th of gestation، but the most amount of brown adipose were concentrated around the scapula. That at day 18th of gestation two symmetrical mass of brown fat are located between two scapula bones. These data also revealed that the composition of lipid in brown adipose tissue at day 16th of gestation، consist of 55% triglyceride in the form of neutral fat، and about 45% in the form of phospholipid and fatty acids but in new born animal from P1 to P15 there is a shift away from phospholipid and fatty acids to neutral fat. Conclusion: It seems that during fetal life some of the indifferent cells form a lobule of epitheloid cells through symmetrical mass and the fat elements are developed in the form of brown adipose tissue ,however it may changed to white adipose directly by fat storage.

Background and Aim: Most of copper present in blood is incorporated in the structure of a protein called ceruloplasmin and only a small fraction of it is present as free copper. Undoubtedly, the separate determination of each of these forms needs a convenient, reliable, and accurate method of measurement. Therefore, an investigation on the precision and the accuracy of the method for determination of ceruloplasmin and the relationship between its concentration and the total copper level was studiedMaterials and Methods: In the present study, 90 serum samples from which 43 accessions belonged to men and 47 accessions belonged to women were collected from the laboratory of Kerman General Hospital, and their ceruloplosmin and total copper level were determined. Total copper levels were measured by flame atomic absorption spectroscopy (AAS), while the concentration of ceruloplasmin was determined by enzymatic oxidation of p-phenylenediamine method.Results: The results obtained indicate that the average levels of copper in the serum for men and women were 119±40 µg/dl and 129±39 µg/dl, and ceruloplasmin for them 36±11mg/dl and 37±11 mg/dl, respectively. It should be mentioned that, the data, disregarding their sex, were found to be 124±38 µg/dl and 36±11 mg/dl respectively. The effect of temperature and storage on the level of ceruloplasmin was also studied. The results showed that keeping serum at room temperature for a long period does not significantly affect the ceruloplasmin level. The linear relationship between the concentration of ceruloplasmin and level of total copper was obtained as:   Copper (µg/dl)=2.73+3.34 (mg/dl of ceruloplasmin).Conclusion: It seems that one could easily determine the ceruloplasmin concentration and then by referring to the above relationship calculate the otherwise hard to measure concentration of copper present in the serum. Also long time storage of the serum does not affect the Enzyme activity.

Background and Aim: Modern anesthesia relying on new techniques and methods is trying to fulfill the patient's satisfaction and, however there is some problems sometimes for the patients. This research is to determine the Diazepam impact on muscular pains after injecting succinychline in the patients. Materials and Methods: This research is an experimental research that was done in Ghaem hospital of Mashhad University.Totally 100 patients that tolerated ortheopedic surgery were selected by simple sampling The patients who had Diazepam were in case and the other patients in control group. To approve the research variables on intensity and prevalence of muscular pains chi-square and to certify the correlation intensity between the said variables Chuprows coefficient were used. The data were analyzed in a meaningful level (p≤%5).Results: The findings showed that there was no important difference between the two said groups give Diazepam and not given it in muscular pains rate.Conclusion: The data analysis showed that Diazepam is not useful in removing the pains.

Background and Aim: Tuberculosis in some cases involves spinal column and spinal cord so this disease can cause spine distortion, para paresis or paraplegia and in some cases incontinence. In rare instances, upper limb paresis or plegia may be seen. In overall the incidence of neurological deficit in spinal tuberculosis is high. It is clear that in time diagnosis and appropriate treatment can decrease these complications.This research aim is the comparative surgical modalities in spine tuberclulosis treatment.Materials and Methods: 24 patients with diagnosis of spinal tuberculosis were studied from January 1996 to august 2002. They divided into three groups: first group were patients that they were treated with anti- tuberculosis drugs. The second group was treated surgically with posterior approach, and the third group was treated surgically with combine posterior and anterior approaches.To analyse the data descriptive statistic methods were used. Since the samples were small in each group the data were analysed manually.Results: From 24 patients 6 were males and 18 females and their ages were between 4-78 years. The neurological status of 66.6% improved and 16.6% got worse. In anterior combine, posterior surgical approach 72% improved and 9.8% got worse. In patients who diagnosed in appropriate time and treated with anti tuberculosis drugs all except one case cured completely without complication.Conclusion: In time diagnosis of spinal tuberculosis can facilitate the treatment is simple and prevent of surgical procedures and complications. Therefore, we must consider spinal tuberculosis in any suspicious spine lesions.In surgical approach, combine posterior and anterior approach spinal alignment can be much better and these combine procedures have better neurological result.

Background and Aim: Hypertension is a common and endangering disease in Diabetes, which affects 20% to 60% of diabetics. It seems that different nutrients affect blood pressure. This study is intended to examine the status of micro- and macronutrients intake and its effect on blood pressure in type II diabetics. Materials and Methods: 92 type II diabetic patients were randomly sampled from those who referred to Diabetes Clinical in Sabzevar, Iran. Their blood pressures were measured using Hg sphygmomanometer in sitting position, their nutritional intake were also recorded in a 24-hour questionnaire and Food recall. Data analyzed in food processor for each patient. The obtained data were statistically analyzed in SPSS using descriptive statistics and Pearson correlation coefficientResults:The patients mean age was 53±13 years; their BMI was 26.98±4.82; mean systolic BP was 131.03±19.28 and diastolic BP 77.01±6.67 mm/hg. Hypertension prevalence was 29.3% in subjects. Significant positive correlation was observed to exist between systolic BP and the intake of cholesterol, sodium, B3 and B5 and folic acid. However a significant negative correlation existed between diastolic BP and the intake of selenium; zinc and copper.Conclusion: The findings indicated that negative effect of hypertention on diabetes must be reduced by the enhancement of public knowledge of diabetics and their families as well as inducing proper eating habits through permanent educational programs.

Background and Aim: Thalassemia is the name of a group of genetic blood disorders. Thalassemia is an inherited disease of the red blood cells, classified as a hemoglobinopathy. In the research patients were selected major thalassemia for aldolase, hexokinase enzymes activity level, Serum Ferritin arterial blood oxygen were measured.Materials and Methods: In the experimental research, 50 patients were selected among 700 patients with major thalassemia who were treated in Sayedolshohada hospital in Isfahan. Serum Ferritin, arterial blood oxygen and Aldolase – Hexokinase enzymes activity level were measured in these patients.Results: A comparison was performed between mean level of serum ferritin, mean level of arterial blood oxygen, and activity level of Aldolase- Hexokinase enzymes.Conclusion: Mean level of Serum Ferrtin in 50 patients with major Thalasemia 237 µg/ml was made. According to the findings the increase of Aldolase- Hexokinase is increase with the increase of Serum Ferritin level.

Background and Aim: Recently the pedicle screw has become increasingly popular because of good purchase in spinal instrumentation. The most feared complications in pedicle screw insertion are nerve root, cord, dura and vascular injuries. The aim of this study was reduction of the incidence of complications by making use of a simple and safe method.Materials and Methods: 92 patients with 332 pedicle screws insertion were treated between 1999 and 2002 by our technique. In this technique after identification and perforation of entry point, a 4.5 cortical screw (or 4N.schanse) is inserted in pedicle, image is used to verify correct position and finally the cortical screw (or schanse) is replaced by pedicle screw.The collected data were analyzed by T-student statisticaltes (P≤5%)Results: From 332 Inserted pedicale screws only four (1.2%) screws had incorrect position that were corrected after image control. 2 screws from the 4 ones were from spondylolisthesis Grade III and 2 were related to idiopathic scoliosis . No complications were shown  such as pedicle fracture, dura rupture or neural, spiral  cord and vascular injuries. Conclusion: This method is simple and safe because of easy application and low or zero rate of complications.

Background and Aim: Coronary heart disease (CHD) is one of the most common health problems in the world’s with high mortality and morbidity. Awareness to its risk factors is very important. There are some evidences about contribution of iron as a risk factor for CHD in recent years. There are few studies in this subject at the present. This study was done to determine serum ferritin and acute myocardial infarction and it's impossible role on early coronary vessels. Materials and Methods: In this cross-sectional study, 104 patients with myocardial infarction (MI), admitted to Shahid Beheshti hospital in Babol during 18 months as case group compared with 138 matched controls subjects (men 45, women 93) from regarding to serum ferritin levels.5 ml Serum were collected from each patient and ferritin level was determined by using standard biochemical and Elisa method. In last day of the second week after acute MI in the laboratory. To diagnose acute MI was based on two positive parameters such as typical chest pain, electrocardiographic changes and enzyme rising. Ferritin mean level of the two groups was compared by T and chi-square tests. Case and control group ferritin were compared in less and higher then 50 years old.Results: The mean age of patients, were 60.23±12 years old and in controls were 55.72±25 years old. Mean ferritin levels in men with acute MI were 209.2±178.6 μg/l and in controls were 75.4±53.2 which was significant (P<0.0001). In the women with acute MI mean serum ferritin were 145.1±15.2 μg/l which was meaningful compared with controls, 72.5±61.3 μg/l (P<0.004).Conclusion: Our findings showed, the relationship between ferritin levels and MI in patients with acute MI. therefore evaluation of ferritin in patients with acute myocardial infarction is important.

Background and Aim: The recent strategies of research in education is based on usinglearning strategies for education development and facilating learning process. The strategies importance as a way and method of improving education level is known for all today. Since a few researches has been done on this subject , we did a research called,The survey of using learning strategies rate on Gonabad medical sciences students in 2002-3.Materials and Methods: This is a pilot survey that its samples were all Gonabad medical students ,121 students were selected through random quota. Data were collected by a questionnaire containing demographic features and learning strategies questions of Weinstein. The data were analysed by T-test, and correlation coefficient.Results: The most frequency was related to nursing students with 35.5%, Midwifery students, 28.1%, health students 14.0%, controlling disease students 8.3%, operation room students 7.4% and anesthesia students 5.8%.  The average students marks of attitude, motivation, time control, anxiety and concentration showed a meaning full statistical difference between different students (p<0.05). Exam strategies had a meaningful relationship with education development (p<0.05). The average marks of motivation had a meaningfull statistical difference with duration of studying in the library (p<0.05). The average marks of the student’s were 20 to 30 centile of normal marks of American students.Conclusion: It is recommended to teach these strategies to students to use them in learning and improve their abilities for improving education quality.