Internal Medicine Today
Year:2011 | Volume:17 | Issue:2 (51)|Papers Count:14

Background and Aim: One of the most common causes of post-operative morbidity is nausea and vomiting which are followed by aspiration pneumonia, dehydration, patients' delayed discharge, or electrolyte and acid-base imbalances. Even though different protocols have been reported for the prevention of nausea and vomiting, it has remained as one of the post-operative problems.Materials and Methods: In this study, we evaluated the effects of two medications (Ondansetron and the combination of Dexametasone-Metocholopromide) on prevention of the post-operative nausea and vomiting. They were prescribed with a specific dosage, half an hour prior to the patients' appendectomy procedure. The patients were evaluated 24 and 48 hours after the operation in the recovery room for any related signs and symptoms.Results: The Ondansetron effect on reducing the patient's nausea and vomiting has been about 30% more than the effect of Dexametasone-metocholopromide combination.Conclusion: As no specific complication has been reported for Ondansetron, its favorable effects on decreasing of post-operative nausea and vomiting, cost-effectiveness, and easily availability, it may be recommended to be used as an effective medication for prevention of post-operative nausea and vomiting.

Background and Aim: The application of herbal plants instead of synthetic drugs is increasing in recent years because of their lower side-effects and high varieties of efficient components. The study of anti-inflammatory and antinociceptive effects of hydroalcoholic extract of Securigera securidaca L. seems to be necessary due to the existence of its anti-inflammatory and antinociceptive components.Materials and Methods: This study has been done on 156 NMRI male mice of 20-25 g in weight. After determining Lethal dose (LD50) of the extract, we used Xylene-induced ear edema and Formalin Test for demonstrating its anti-inflammatory and antinociceptive effects. In each of these two tests, the animals were divided into 6 groups (each group consisting of 8 mice): Sham, Positive Control (receiving dexamethasone at dose of 15 mg/kg in inflammatory test, and receiving morphine at dose of 10 mg/kg in formalin test), experimental groups receiving hydroalchoholic extract at doses of 42, 85, 170 and 340 mg/kg.Results: LD50 was obtained 1.7 gr/kg. This study shows that the seed of Securigera securidaca L. has anti-inflammatory effect at all doses, particularly at dose of 340 mg/kg. In addition, the extract decreased nociception meaningfully in both acute and chronic phases. Dose of 340 mg/kg had the most antinociceptive effect especially in chronic phase.Conclusion: The hydroalcoholic extract of Securigera securidaca L. has antinociceptive and anti-inflammatory effect in both phases (especially inflammatory phase) which is caused by formalin, and this effect may be flavonoid and tannin components in plants, which have anti-inflammation and antinociceptive properties. Flavonoid and tannin components in this plant may be the reason of these effects.

Background and Aim: Visceral leishmaniasis is endemic at least in three provinces of our country, Iran, including Ardabil, Fars and East Azarbayejan. The disease is of Mediterranean type in Iran and affects mainly children. Therefore, the early diagnosis and treatment of this disease can prevent its high mortality (95%). Because of the invasion of bone marrow aspiration or biopsy and limitations in the others methods, several studies have been done to use simple tests for the diagnosis of Leishmania infantum in children that KAtex test to detect the urinary antigens is one of them. The aim of this study was to evaluate the efficiency of KAtex test in the diagnosis of visceral leishmaniasis and possible replacement with serological methods (IFA, DAT, Elisa IgG & IgM) in endemic areas.Materials and Methods: This was a cross-sectional, descriptive and epidemiologic study, which was conducted in Ahar and Kalybar villages of East Azarbayejan as endemic areas. KAtex kit was used for diagnosis in 72 confirmed and historic Kala-azar patients and for case finding among 313 children in the endemic area of Kalibar & Ahar, East Azerbaijan province, the northwest of Iran. The results were also compared with serologic tests (DAT, IFA, and Elisa- IgG & IgM) to determine any possible agreement and validity & reliability indexes. Kappa and McNemar were used for data analysis.Results: From 385 of urinary samples, 38 (9.8%) were positive by KAtex test. The rapid KAtex test had sensitivity of 77.7% and quite specificity (98.2%) in the diagnosis of human visceral leishmaniasis. Highest and lowest agreements of KAtex test were with Elisa- IgM (kappa = 0.834, P= 0.549) and DAT (kappa=0.400, P< 0.001), respectively. Also, this test did not have any cross reaction with tuberculosis, toxoplasmosis and brucellosis patients' urine samples.Conclusion: The KAtex test is rapid, non-invasive and simple. It does not require much expertise or elaborate equipment; and it can be used for the diagnosis of visceral leishmaniasis in remote endemic areas.Also, because KAtex discriminates between active diseases, sub-clinical and past infection, its results can complete DAT for the diagnosis of unconfirmed visceral leishmaniasis cases.

Background and Aim: Skin cancer is the most prevalent type of cancers in Yazd city. Childhood and adolescence are important times for preventing the skin cancers. The aim of this study is to survey the effect of education based on protection–motivation theory on skin cancer preventive practices among female high school students in Yazd.Materials and Methods: This was an experimental study. The participants were 360 female students from four high schools in Yazd city, Iran. They were divided into two groups (180 in case group and 180 in control group). A self–report questionnaire was used to assess the variables, threat appraisal at pretest and follow-up. The questionnaire was distributed before the intervention (pre-test) and following at a two-month interval. T-test, ANOVA, Chi-square, paired t-test, Pearson’s correlation coefficients were used to analyze the data.Results: There was a significant difference between the mean grade score of all of the variables in case group, in pre-test and follow up phases (p<0.05). No significant difference was seen between mean grade scores of variables in control group in pre-test and follow up phases (p>0.05). A significant difference was found between all the variables mentioned in the case and control groups in follow-up (p<0.05). Conclusion: The findings support the effectiveness of a PMT-based intervention to change the attitude and behavior associated with skin cancer risk.

Background and Aim: One of the social problems of communities is the currently increasing rate of divorce and family disintegration host building. The aim of this research is to understand the condition and factors influencing divorce and to identify some practical solutions to reduce it in Gonabad.Materials and Methods: This is a descriptive-analytic research. 123 divorced couples who got divorced in 1387-88 in Gonabad city were selected and completed a researcher-made questionnaire including demographic information.Results: In this study, 81 divorced woman and 42 divorced men were surveyed, 50% of the divorces were in affiance time, 60.7% in the early years of marriage or being together as couple, 63.3% in urban areas and 36.7% in rural areas. 54.1% of the divorces were through women's request and 14.2% on the part of men, 31.7% with the couples' agreement. 76.9% of the couples had a diploma or degree below. The marriage age of 45.2% of the couples was under 20 years. 65.4% of the couples had a familiarity with their spouse during marriage. 75.2% of them had not conducted enough investigation and surreys on their spouse and his/her family. To study different social, economical, cultural and personal factors, the most important related factors to divorce were: men's addiction, low familiarity of couples with each other, lack of life skills, low age of marriage, urbanization, misunderstanding, mental or physical diseases of the spouse, unemployment, family or other interference from the spouse's family or other people, mandatory marriage, shortage of relationship and sexual skills and hypocrisy There was also a significant difference in the rate of divorce from location (p=0.0019), the history of familiarity with the spouse (p=0.0013), education (p=0.0000), research and evaluation conducted on a spouse (p=0.0012), physical and mental abuse (p=0.0000), and misunderstanding (p=0.0001) points of view.Conclusion: Because of the role of different factors in divorce, preventive strategies and reduction of divorce should be much considered before marriage.

Background and Aim: Health providers and patient's knowledge and awareness of patient's rights bill require respect. Therefore, this study was performed to determine the awareness of patients and health providers about patient bill of rights and its observance rate in one of the hospitals in Gonabad.Materials and Methods: This descriptive-analytic study used a questionnaire to assess awareness and observance rate of patient's rights bill in 2010. The awareness was ranked in three categories (good, moderate and weak) and respecting the patient's rights Bill in three floors (ideal, average and poor). Sampling for patients was based on the objectives and for health providers was random classification. The obtained data were analyzed by SPSS software version 14 using descriptive statistics, Chi-square, Tindependent, ANOVA and Pearson correlation coefficient at %5.Results: The results showed that 189 patients (60.8%) were females, 122 patients (39.2%) were males and 20 health providers (60.6%) were females and 13 (39.4%) were males. Health providers and patient awareness of patient's rights bill was sufficient and patient's bill of rights in the study population is observed in 69.1% of the cases. There was a significant relationship between awareness and observance rates of patient's rights bill so that as patient awareness increased, observance patient's rights bill increased, too (p=0.007). The results also showed that despite optimal health provider's awareness of patient's rights bill, observance rates aren't satisfactory in comparison with those in other studies.Conclusion: Patients and staff awareness in the medical group level is good, but the observing rate isn't satisfactory. This study recommends that the managers of hospital develop a practical strategy to provide written information for patients about the rights when they are admitted. In order to preserve the patients' sanctity, students and health providers should be taught to get permission from patients before attending the bedside.

Background and Aim: Meat and meat products have a very special importance in food diet as a rich source of proteins. Therefore, the need to create an accurate method for quality control of this essential nutrient seems necessary. The aim of this research is to distinguish and recognize the illegal tissues in sausages available in Kermanshah supply centers from 2009 to 2010.Materials and Methods: The method of this study is descriptive and cross-sectional one. 720 samples of sausages were obtained from Kermanshah supply centers. After sampling, preparation and staining of tissue sections were performed. Identifying the tissue was performed through light microscopy by an expert in histology.Results: There was skeletal muscle in 96.2% of the samples; fatty tissue was observed in 30.8% of the samples, and heart muscles were found in 19.2% of the samples. Adult cartilage and bone were observed in 96.2% of samples. Immature bone was observed in 57.6 of samples. The frequency of each of spleen, aorta, esophagus, salivary glands, alimentary glands, lymphatic node, hair, lung and tongue tissues was 3.8%. The frequency of each of the breast, skin and nerve tissues was 7.7%. The frequency of connective tissue and smooth muscles was 27% each one. The frequency of empty holes and blood vessel was 46.1% each one. Herbal tissues were recognized in 100% of samples.Conclusion: The presence of illegal tissues in meat products manufactured in Kermanshah raise health concern associated with these products and makes a more rigid regulatory monitoring of them necessary. 

Background and Aim: In biomedical research, we are concerned with exploring the risk factors of disease and classifying the patients based on similarity of their responses. However, traditional methods need to consider the related assumptions that are difficult to establish in biomedical studies. In this study, an alternative analytical method was used for determining the risk factors of breast cancer and classifying patients into groups based on the similarity of their features. Advances in the practical and theoretical aspects of tree-based methods were developed by Breiman et al. (1984) in their monograph on classification and regression trees. Tree-based methods have become one of the most flexible, intuitive, and powerful data analytic tools for exploring complex data structures.Materials and Methods: In this article, we used the data from a case-control study. The two groups included 628 women who were under 40 years old. The case group included women with positive breast cancer diagnosis, and the control group included the patients who referred to Emam Khomeiny hospital with non-hormone and non-neoplastic disease.Results: Of covariate selected to build the classification tree methods, the following variables were determined as the risk factors for breast cancer: Family history breast cancer, and ovarian cancer, irregular menstruation, lack of physical activity, and low age of menarche.Conclusion: The simplicity of result interaction in terms of clinical or other relevant patient characteristics made trees an appealing approach in clinical and epidemiologic investigation. 

Background and Aim: Available evidence shows that religious attitudes have noticeable effects on all aspects of human life. During the last decades, empirical examining of happiness has increased by the attempts made by the sociologists and psychologists. The purpose of this study was to examine the relationship between religious attitude and happiness in medical students in Shiraz university of medical sciences.Materials and Methods: The research is a cross-sectional and descriptive study which was done in 2008- 2010. Our subjects were selected randomly. The data were collected through Khodayarifard religious attitude scale and Oxford happiness inventory. The sample consisted of 271 medical students (164 males and 107 females). The obtained data were analyzed via Pearson correlation and t-test (for independent groups). Results: The mean age of students was 20.4 years and the standard deviation was 3. The mean score of happiness, religious attitude in males and females was 47.54, 46.77 and 96.83, 103.16, respectively. There was a significant relationship between happiness and religious attitude (P=0.0001, r=0.256), age and happiness (P=0.004, r=-0.241), age and religious attitude (P=0.018, r=-0.198).Conclusion: The results show that in addition to the significant relationship between religious attitude and happiness, the relationship between age and religious attitude and happiness is significant, too.