Internal Medicine Today
Year:2008 | Volume:14 | Issue:2|Papers Count:13

Background and Aim: Several studies have shown that some neurotransmitters such as opioid and nitric oxide (NO) influence animals' nutritional behavior and their central or peripheral administration can alter some behaviors. These two transmitters occasionally have interactions. This study examined the interaction of L-arginine, a nitric oxide precursor and N (G)-nitro-L-arginine methyl-ester(L-NAME)a nitric oxide synthesis inhibitor, on the food intake of male rats following morphine injection.Materials and Methods: 48 male rats with 250- 300g weight were randomly used in 6 difference equlal groups. Drugs were injected 12 h after fasting and during light phase. Then the animals were put in the test cages indusial, and allowed to intake ad lib food while the amount of food consumption was measured at each 15min interval up to 1hand this measurement continued at 4h later.Results: Our study showed that the administration of morphine (5 mg/ kg/ s.c.) suppressed rat's food intake during the early 60 first minutes, but increased their consumption during 4 h late period of the test. Administration of L-arginine (50 mg/ kg/ i.p) and morphine increased food consumption in compared with morphine administration individually. L-NAME (50 mgl kg/ i.p) reduced the amount of food intake and attenuate the hyperphagic effect of morphine, especially for 4 hof late time of the test.Conclusion: This result supports the idea that the nitric oxide and opiates systems have strong synergic interactions on animal's nutritional behavior, The mechanism of these interactions may be triggered through the effect of the nitric oxide and opiates on dopaminergic, glutaminergic and serotonergic neural pathways. More studies are necessary for accepting or declining of these mechanisms.

Background and Aim: To study the effect of an Iranian herbal drug in the treatment of primary dysmenorrhoea a randomized, double-blind, placebo-controlled pilot trial among 180 female students settled at Isfahan University dormitory aged 18-27 years who suffered from primary dysmenorrhoea was conducted.Materials and Methods: Participants were divided into three groups randomly (Herbal drug, Mefenamic acid and Placebo).The herbal drug (SCA) group were given 500 mg of SCA (Saffron, Anise and Celery Seed extracts highly purified) three times a day for three days, starting from the onset of bleeding or pain was administered. Participants were followed with three cycles from beginning of menstruation and continued through the whole three days of bleeding. Main outcome measures the severity and duration of pain at two and three months. A visual analogue scale (VAS) was used to record pain. Overall-pain was the average pain intensity among days in pain.Results: There were statistically significant reductions in pain score and pain duration in SCA (p<0.01) and Mefenamic acid (p<0.01) groups. The decrease in pain score was reflected by a significant reduction in another drug used among the treatment groups compared with placebo. The magnitude of the reduction was significantly greater in the SCA group than in Mefenamic acid and placebo.Conclusion: Both of the drugs relieved menstrual pain effectively in compare with placebo. So more clinical trials needed for efficacy of this herbal drug.

Background and Aim: Inadequacy of dialysis is one of the main reason of mortality of dialysis patient and it is completely effective on forewarning. The aim of this study was to determine the adequacy of dialysis and its relationship with the kind of filter in patient referred to 22-Bahman hospital of Gonabad.Materials and Methods: This crossover study was done on all patients underlying dialysis that enrolled in the study in 22-Bahman Hospital. They were divided into two groups in simple random sampling. Each group involved 15 patients. In one group High flux filters and in another group low flux filters were used. The filters were changed after one month. Dialysis was done 3 times a week and lasted 4 hours .KTN > 1.2 was considered as dialysis adequacy.Results: The result showed 60% of the patients had dialysis adequacy> 1.2. The means of KTN was 1.34±0.42 in Low flux group. 80% of the patients had dialysis adequacy>1.2 and the means of kt/v was 1.44±0.32 in High flux group. There wasn't a significant relationship between dialysis adequacy and the kind of filter (p=0.29). The means of Haemoglobin was 11.49±2.03 in Low flux group and 12.58±2.01 in High flux group. There was a significant relationship between Haemoglobin and the kind of filter. (p=0.04). Conclusion: In this study dialysis adequacy with High flux filter was desired in comparison with other studies. Although there wasn't a difference between Low flux and High flux filter in dialysis adequacy, but the means of KTN in High flux filter was more than Low flux filter and also the most patients that used High flux filter had enough dialysis adequacy (80% against 60%). The means of Haemoglobin in High flux was more than Low flux filter. So it is recommended to use High flux filter if there is any contradiction.

Background and Aim: In the recent years various reports indicate that gastric cancer is highly prevalent in our country, it is the second most common cancer in the general population. This study was designed and carried out to determine the five-year survival rate of gastric cancer patients using actuarial life-table method. Materials and Methods: All patients with stomach cancer that registered in Fars Cancer Registry Center were enrolled in this study. Information about patients was gathered from different resources. Also, to estimate the survival rates, patient's survival status were followed till March 20, 2006. 1 to 5-year survival rates were estimated by using actuarial life-table method and compared by Wilcoxon test.Results: 303 of 442 stomach patients were men (mean age 60.72±1:13.00 years) and 139 were women (mean age 53.29±14.48 years). 266 (60.2%) cases were dead during the term of investigation. The median survival time of cases was 12.6(CI: 10.76-14.44) months. The survival rates at 1 to 5-years after diagnosis were 53, 32, 25, 21 and 16 percent, respectively. Age at diagnosis, location, number of household, duration between first symptomatic date to diagnostic date, metastasis, histology grade and type of the first treatment had a significant association with patient survival.Conclusion: Our findings suggest that early detection of patients in lower ages, primary stages and grades of tumor are important to increase patient's life expectancy.

Background and Aim: Nowadays using modem technology in human life, such as mobile phones and necessities of life, has increased and unavoidably exposed to ambient electromagnetic fields (EMF) generated from various electrical devices and from power transmission lines. The aim of our study was to see the effect of (EMF) on Anatomical & Histopathological of Gingival-epithelial tissue in rat. Materials and Methods: In this study 30 rat pups (age: 15weeks), randomly allocated into test group (n=15) and control group (n=15). The test group was exposed to 50 Hz EMF(80G) (non-ionizing radiation) during postnatal life (5 weeks) and (n=15) rat pups were kept free of radiation in control group, at the end of the 5th week of experiment the samples were collected from Gingival-epithelial tissue in whole rats (pups) in the experiment group.Results: This study indicated that experimental rats Gingival-epithelial tissue was found disrupted at various layers and due to the loss of collagen fibrils and the rates of apoptotic cells are increased in the test group (33±0/074) in compared with control group (12±0/044), (P£ 0/01).Conclusion: These results suggest that EMF exposure may cause profound changes in the gingival tissue and decreasing in its integument layers. Therefore exposure to EMF may result in pathological changes that lead to dental and gingival disorders and diseases.

Background and Aim: Musculoskeletal disorders (MSDs) are major parts of the occupational diseases in workplaces. In hairdressing because of repetitive motions, prolonged practice in stand postures, wrong working conditions there is the probability of musculoskeletal disorders occurrence. Protection from such diseases is dependent on assessment and improvement of job postures by using job analysis methods in ergonomics. This study was aimed to evaluate ergonomic conditions in hairdressing by rapid entire body assessment (REBA) in Birjand city and also to assess the relation between MSDs in different parts of the body and work conditions. Materials and Methods: In a descriptive-analytical study ergonomic posture of 150 hairdressers was studied by using REBA method. The prevalence of MSDs was obtained by using Nordic Musculoskeletal Questionnaire (NMQ). The data were analyzed by independent t-test and chi-square tests with p£0.05 as the limit of significance.Results: 39% of hairdressers were males and 61% females. The prevalence of disorders for different parts of the body was as follows: 21% for neck, 31% for shoulders, 6% for wrist, 54% for back and 69% for legs. There were significant correlations between disorders of wrist and legs with sex, leg disorder and work time, disorders of wrist and legs with REBA score's. (p£0.05).Conclusion: It is concluded that the work conditions need to be improved. In addition the level of hairdressers' education regarding biomechanical hazardous effects as well as correct work conditions should be increased.

Background and Aim: Organizational culture would be considered as an effective factor in organizational performance such as six sigma. So the purpose of this paper was to determine effective organization's cultural factors on the implication of six sigma in teaching hospitals affiliated with Kerman University of Medical Sciences (KUMS). Materials and Methods: This Study was done in the way of descriptive case study. The research society consisted of the employees of KUMS (N=1634). The sample size was 110 that were selected through a stratified random sampling. The data was collected via a self-report questionnaire. Data gathering Instrument was a questionnaire which had three parts (demographic information, organizational culture and six sigma). The five-point likert scale was used to score the questions. At the end, data was analyzed by multi-variable Regression test.Results: The paper finds that the highest mean of organizational culture indexes in the hospitals were related to organizational identity (mean 3.43) and the lowest index (2.47) was related to differences and contradictions. To imply six sigma in the hospital, the highest mean was related to focus on patients (2.42) and the lowest (2.34) to improve their religious ability and failure tolerance. Robbie's organizational culture model as independent variable predict 69 percentage of variance in implementation of six sigma as dependent variable (p£0.001, F(10,41)=9/23R82,=0.693) Management support (p=0/015, t=2/538, b=0/457) and risk taking (p=0/002,t=2/381, b=0/255) effected implementation of six sigma in the hospitals expensively. Conclusion: It is argued that Robbie's organizational culture model more importantly affected on the implementation of six sigma especially support management and risk taking; so researches suggest building productivity incubator in the hospitals.

Background and Aim: Ununited fracture of tibia complicated by infection is not only a complex surgical problem but also a chronic and debilitating condition for patient and time-consuming problem for physician. Although traditional management results with success at times, it seems with Ilizarove external ring fixator we could achieve excellent results.Materials and Methods: From 1997 to 2004 these authors managed 84 patients with infected tibial nonunion in three teaching hospitals in Mashhad. There were 68 males and 16 females, with an average age of 26±1:8 years (17 to 55 years). The average time of follow-up was 3.5 years (range 3-9 year).Results: In 81 (96.42%) patients we achieved union and eradication of infection. The average time in frame was 6.4 months. Three patients (3.42%) eventually underwent below knee amputation because of refractory and persistent infection or other problems. We faced pin tract infection and loosening in 18 patients for 41 pins. We had 10 patients (11.9%) with neuropraxia of the proneal never which improved simultaneously but no long standing neurologic deficit. Only one patient with false aneurysm of anterior tibial artery happened which underwent vascular surgery. The most common long standing morbidity following this treatment was foot and ankle stiffuess and deformity especially in distal third cases.Conclusion: The Ilizarove technique for complex infected nonunion of tibia has a high rate of success in achieving union and eradication of infection. It is the only way, which we can advice the patient to be treated successfully strongly and surely.

Background and Aim: Gynecologic exams are among the most difficult competencies that students must learn and therefore their competency is insufficient in this regard. This implied the need for applying the innovative training methods. In the recent two decades it is suggested that SBE is being used for teaching new skills. This study was conducted to determine and evaluate the effects of SBE and compare it with traditional training program on the midwifery students' skill in performing pelvic examination.Materials and Methods: In this randomized controlled trial, 56 midwifery students were randomly allocated in two educational programs about pelvic examinations. One group received the traditional education and the other SBE. All the students attended in a simulation-based assessment before and after the workshops. At the end of the exam, students also reported their perceived ability and their learning experience. Results: Both programs promoted students' skill and confidence, but SBE significantly resulted in better performance (p=.001). Students in SBE rated their perceived ability higher in compare with the traditional group (p=.002). Students reported that SBE led to better learning and faster recall of learned issues. Conclusion: The results suggest that SBE is highly effective in enhancement of students' skill and more confidence in pelvic examinations.

Background and Aim: Domestic violence especially from intimate partner is the most common type of violence against women that has many psychological, social and economic adverse effects. Domestic violence in pregnancy causes serious problems for the infant and mother. Considering the importance of this matter, the present study investigated the frequency and intensity of intimate partner violence against pregnant women.Materials and Methods: In this cross-sectional study, two hundred and ninety inpatient mothers in post delivery sections in educational hospitals were assessed using Iranian version of "Conflict Tactics Scale (CTS2)" after establishing the validity and reliability of this scale.Results: 92.4%, 6.9% and 0.7% of women experienced very mild, mild and moderate intimate partner violence during their pregnancy. Verbal violence was rated as 40.9% and 0.7%, emotional violence as 81.1% and 1.7%, physical violence as 93.1% and 0.3% and sexual violence as 95.2% and 0.3%, as very mild and severe, respectively. Findings showed that there was a significant correlation between the violence against pregnant women and their neonates' low birth weight. There was not a significant relationship between education of men and violence against their wives (P=0.614).Conclusion: This research shows that many pregnant women experience the very mild forms of violence. The rate of neonates' low birth weight has a significant relationship with the intimate partner's violence against Iranian pregnant women. These findings showed the importance of this problem and the necessity of considering preventive strategies for that.