Internal Medicine Today
Year:2007 | Volume:13 | Issue:2|Papers Count:13

Background and Aim: The convergence insufficiency is an inability to converge or to maintain convergence for prolonged near work or in the other hand an inability to obtain or to maintain sufficient comfortable binocular vision at near. The symptoms associated with convergence insufficiency are asthenopia, headache, intermittent diplopia, perceived moving of print when reading etc. These symptoms can be worse with prolonged near work, sleepness, stress, anxiety and illhealth. The clinical signs of this problem are remote near point of convergence, reduced positive fusional vergence and increase of exophoria at near. The stages of treatment are elimination of decompensating factors, correction of any refractive errors, vision training, prism prescription and surgery if required. The purpose of this study is the determination of mean and range of convergence insufficiency diagnostic tests in patients with convergence insufficiency.Materials and Methods: In this cross sectional study 74 patients aged 12-25 year with convergence insufficiency who refer to Alzahra eye center and had inclusion criteria selected randomly. After the determination of refractive errors by retinoscopy (with cyclopentolate %1 if needed)and best correction with subjective refraction, near point of convergence with millimeter rule, exophoria with alternate prism cover test and positive fusional vergence with prism bar was measured. One vertical row of reduced snellen chart with equivalent size approximately 20/30 used as a accommodative target.After collection of desired information, data were analyzed by SPSS.14.Results: From 74 subjects, 41 patients (%55/4) were females and 33 patient (%44/6) males. In this study the mean of near point of convergence, exophoria at near, positive fusional vergence were 11/97 ± 3/24 centimeter, 9/66 ± 4/36 prism diopter and 19/63±8/26 prism diopter respectively. There was not statistically significant relationship between sex and convergence insufficiency diagnostic tests (P>0.05).Conclusion: This study showed that the mean and standard deviation of near point of convergence, near exophoria and positive fusional vergence in most patients with convergence insufficiency were abnormal compared with patient without convergence insufficiency. Also in spite of normality of one diagnostic test, patient may have convergence insufficiency.

Background and Aim: Ventilated_associated pneumonia is the most common acquired infection in ICU. The prevalence of pneumonia in intubated patients is 21 times more than other patients. Tracheal tube colonization is considered as a risk factor and affected with duration of intubation and decreased gastric acid. This study is conducted to determine the epidemiology and microbiology status in the patients admitted at loqman hospital poisoning ICU.Materials and Methods: The research method was descriptive and its technique was an observation-interview. Patients with positive endotracheal tube culture was entered the study, the sampling method was endotracheal aspiration. Qualitative culture and resistance pattern evaluation with Kirby-bauer method was used. We surveyed 180 intubated patients with mean age of 31.63 ±13.9 years old .83.3 precent of the patients had received antibiotic therapy before sampling.Results: Staph. coag. Positive. (45.6%) was the most commonly isolated pathogen and followed by Klebsiella, Acintobacter and E.coli. Isolation of one organism was seen in 62.8% and multiorganisms in 37.2%. Temp³38 was seen in one_third of the patients and WBC³12000 was detected in 44 precents of the patients. There was a significant relationship between antibiotic therapy with fever. 11.1 precent of the patients died. There was a significant relationship between the kind of organism and survival, but there was a significant relationship between antibiotic therapy before sampling and patient's survival.Conclusion: Detection of Acintobacter with Klebsiella, E.coli and Staph. aureuse increases the probability of nosocomial pneumonia caused by AST III group. Lack of relationship between kind of organism and prior antibiotic therapy is considered as an alarm for resistant infections.

Background and Aim: Aerodynamic data can be used in diagnosis, evaluation on and treatment of complex problems, including vocal nodules, hypernasality, articulation errors, voice, disorders, laryngeal disease, respiratory disease and pulmonary conditions. The purpose of the study was to determine the average phonation time, phonation volume and airflow rate, as well as, the relationship between each of these parameters during two conditions (normal and deep breaths). Materials and Methods: The method used in this research is a cross-sectional, descriptive-analytical and was done by 103 subjects including 67 males and 36 females. A tape recorder with a VUmeter and a microphone was used to record phonation and control loudness. A stopwatch was used during the experimental session to measure phonation time. A 9 litter respirometer was used to produce a permanent record of the phonation and lung volume of each subject Finally, data were analyzed with descriptive and analytical (t-test, Pearson Correlation) statistic. Results: According to the effect of different conditions-normal breath and deep breath-the results showed that the phonation time, phonation volume and air flow during deep breath are significantly greater than those during normal breath(P<0/05). With respect to sex differences, most of findings showed statistically significant differences in phonation time, phonation volume and mean air flow rate between males and females during normal breath as well as deep breath(p<0/05).The mean phonation times of vowels /u/ and /i/ were statistically significant longer than that of vowel /a/ during normal and deep  breathes (P<0/05).The mean phonation volume of vowel  /a/ was statistically significant greater than those of vowels /u/ and /i/ during normal breath. There was a positive relationship between phonation time and phonation volume and so, there was a high positive relationship between mean phonation volume and mean air flow rate. In other hand, there was a negative relationship between mean phonation time and mean air flow rate both normal and deep breathes. Conclusions: The results showed that the values of air flow rate mean, phonation volume and airflow rate during deep breath were significantly greater than those during normal breath and results indicated that the parameters for males were significantly greater than those for females. The phonation time was inversely related to the air flow rate, however, there was a positive relationship between phonation time and phonation volume, as well as, between phonation volume and airflow rate

Background and Aim: Hematologic values are extensively used for health evaluation. These values can be used for diagnosis and management of hematologic and nonhematologic diseases. Some factors affect these values, including age, sex, race, diet, and environment. Since these factors vary in various populations, they can cause differences in reference hematologic values.Materials and methods: In this study 1040 healthy individuals were randomly selected in various locations of Mashhad from different age groups: 11-13, 14-18, and 19-55 years. Standard specimens were collected. Analysis of WBC, RBC, Hb, Hct, RBC indices, PLT and leukocyte differential counts were performed and reference values were calculated.Results: Reference ranges for RBC, Hb and hemtocrit were higher in adult male participants. Platelet counts were higher in females. Hematologic reference values in adult males were: WBC (´103ml)= 6.45(3.3-9.6), RBC(´106ml )= 5.43±0.9, Hb (gr/dl)=15.9±1.96, Hct (%)= 47.2±7.2, PLT(´103ml)=231(133-329).Conclusion: Determination of hematologic reference values in this study showed obvious differences with previous studies. In particular MCV, MCH, MCHC, WBC, and platelet counts were lower.

Background and Aim: schizophrenia is a kind of disease which decreases intelligent capacity and the ability of mind .In addition the symptoms that present in schizophrenia directly or indirectly are associated with intellectuality. Some researchers have shown such sort of association between the ability of mind and educational level with the grade of insight as well as clinical feature. The present study tries to show whether any association between insight and level of education is as well as positive and negative symptoms of schizophrenia.Materials and methods: One hundred and twenty five schizophrenic patients aged 18-45 years old referred to Avicenna hospital in Mashad were included. The duration was since Ordibehesht of 1384 until Ordibehesht of  1386.The positive and negative symptoms of schizophrenia scale (PANSS) and Schedule for assessing the three components of insight (ASTCI) were used to assess the clinical features and the level of insight.SPSS-11 was used to statistical analysis and the method was Pearson co-efficiency analysis.Results: There was a significant association between educational grades and insight (p<0.05) and negative association between mean scores of PANSS in three dimensions (negative, positive and global scores with total score of SATCI (P<0.05).Conclusion: There is positive association between educational and insight levels. Furthermore the negative relationship between the severity of disease and the insight level has presented the importance of focusing on this issue to predict the prognosis as well as acceptance of medication account of the important role of insight and compliance of the treatment.

Background and Aim: Flexibility or extensibility of soft tissues that cross or surround joints, such as muscles, tendons, fascia, joint capsules, and skin is necessary for unrestricted movements during functional tasks. In order to increase flexibility, muscles should be stretched. There are different stretching methods that increase hamstring group’s flexibility. Only a few studies were carried out for determining the most effective one. This study aimed to determine the most effective stretching method to restore hamstring flexibility in lesser time in 18-28 years old boy students of Zahedan University of medical sciences in 2006.Materials and Methods: Sixty boy students ranging 18-28 years old were recruited for this clinical trial through simple non-probability sampling. Subjects were randomly assigned to 1 of 4 groups, 15 in each group, including (1) static stretching group, (2) hold-relax stretching group (HR), (3) stretching after post isometric relaxation (PIR), and (4) stretching based on reciprocal inhibition principle (RI). Stretching was carried out for six weeks, 5 times per week, and lasting 2 min on each occasion. Active and passive knee extension and passive hip flexion (degrees), distance between the tips of fingers in long sitting (cm), lumbopelvic rhythm mobility (cm) and lumbar lordosis (degrees) were measured using goniometer, tape measure, Modified Schober’s test, and flexible ruler, respectively. The obtained data was analyzed using one-way ANOVA and repeated measures.Results: Active knee extension was increased from 155.5o ±6.6o to 168.5o±5.5o in static stretch group, from 158.5o±4.9o to 172.5o±5.4o in HR group, from 156.7o±6.8o to 169.7o±5.7o in PIR group, from 157.1o±6.4o to 168.1o±6.7o in RI group (P<0.0001). Passive knee extension was increased from 158.1o±6.8o to 171.8o±4.3o in static stretch group, from 160.6o±5.5o to 174.1o±5.2o in HR group, from 158.3o±6.4o to 172o±5.6o in PIR group, from 159.4o±6.5o to 172.5o±5.8o in RI group (P<0.0001).  There was no significant difference between the four groups in terms of study variables except for lumbar lordosis (P>0.05).Conclusion: The results showed that no specific method was found superior compared to others in improving hamstring flexibility.

Background and Aim: This study was prompted by reports suggesting a high prevalence of unrecognized obsessive-compulsive disorder (OCD) in the dermatology clinics.Materials and Methods: 140 consecutive dermatology referrals were screened for DSM-IV OCD using the Yale-Brown Obsessive Compulsive Scale (YBOCS). Illness severity was rated on the Y-BOCS, and symptom profiles and dermatologic symptom were established for all cases.Results: 31patients (22.1%) qualified for a DSM-IV diagnosis of OCD, all of them were previously undiagnosed. The range and type of OCD symptoms covered the normal clinical spectrum. 33(23.6%) 0f patients had more than 1 symptom, and among OCD symptoms over washing was the most common. 39.7% of the positive cases scored 16 or higher. Dermatologic symptoms were various and did not seem to bear a direct relationship with OCD.Conclusion: These results suggest that there is a high prevalence of clinically relevant OCD in the dermatology clinics. This is an area that merits attention with regard to better recognition and treatment for OCD sufferers.

Background and Aim: An important disease in the middle-aged is cardiovascular disease, including is a forwarding disease that is started in childhood and clinical effect will appear in adults from middle-aged. From the other side on the other part, living without activity or motion cause to increase all of the main defect of mortality and risk of cardiovascular disease, become twice as much. WHO recommends: one of an important cases in preventing cardiovascular disease is doing activity for 30 minutes per day, at least this research study the relation between cardiovascular disease and background of physical activity in middle-aged period in old people membered in Isfahan retirement center.Materials and Methods: The sort of the study is a cross-sectional that its target population is old people membered in Isfahan retirement center. 255 persons were chosen by a simple random sampling. The method for gathering data was a questionnaire with 6 questions about characteristic of demography, 5 questions about cardiovascular diseases, 20 questions related to physical activity in the middle-aged period that was completed by organized interview.Results: The conclusion showed that the prevalence of cardiovascular disease and hypertension in old people under examination is %32/2 and %46/7. Also, the result showed that there are statistic significant between cigarette usage and disusage from morbidity of heart disease (p=0/04) and also between morbidity and unmorbidity of hypertension and morbidity of cardiovascular disease (p<0/001).Conclusion: This research showed that the prevalence of cardiovascular disease and hypertension in old people membered in Isfahan retirement center is over expectation. Also it cleared that rate of walking; playing tennis, body exercises, cycling and mounting are effective in prevalence of morbidity in cardiovascular diseases. The study showed that the rate of walking, body exercises, running in the middle-aged between men and women is approximately equal and there are direct association between physical activity and level of education, in the other hand, what ever the level of education is up, physical activity will be more, too. But out of walking, cycling, mounting and running are in the middle-aged is equal with all level of education.

Background and Aim: In today society, human life, in all dimensions, has been changed. Marriage married life, sexual behavior, also, have been changed. Sex education can provide opportunity to learn about sex awareness and sex roles .Sex education helps youth to clarify their values, avoid risky behaviors and improve negotiation skills. Research goals are the study of sex education effect on prevention of sexual problems, health behavior, sex appropriate behavior, mental health, family health, and gender identity.Materials and Methods: In this study the research method was experimental and research design was post-test with one group .Statistical sample were 92 (36 female, 56 male) university students. The sampling method was stratified. To collect data a questionnaire was used the questionnaire consists of 20 items with Likert type five –scale response option (with a score rang of one to five). The questionnaire face and content validity were established using a panel of experts. A Cronbach's aloha reliability of 0/84 was obtained of the questionnaire in a pilot study with 30 students.Results: In the present study to analyze data t-test have been used. Six hypotheses were tested. The results showed that:1) Sex education have effect on health behavior (t=13/006.p<0/0001).2) Sex education have effect on sex appropriate behavior (t= 10/017, p<0/0001).3) Sex education have effect on mental health and prevention of sexual problems (t=12/555, P<0/0001)4) Sex education have effect on family health (t=9/720, p<0/0001).5) Sex education have effect on appropriate gender identity (t=4/139, p<0/0001).6) Effect of sex education is different between male and female students (t=0/556, p>0/000).Conclusion: The results of this research are consistent with other studies. For example Gibson and Mitchell (1999), Cooney (1991), Bee (1998), Berryman et.al (2002), Franken (2002), Jaff (1998), Santrock (1997), Schickedanz et al. (2001), Kvalem et al (1996), Millan st al (1995), Russell et al (1992), and Bhuiya et al (2002).

Background and Aim: There exist wide variations among clinicians as to management of the child who presents with the first febrile convulsion. Most experts recommend lumbar puncture for infants with febrile seizure. However the risk of meningitis is very low in these patients. These indicate that a large number of “unnecessary” lumbar punctures would be done. Finding risk factors of meningitis in infants with febrile seizure can help physician to select patients for lumbar puncture.Materials and Methods: 45 patients with febrile convulsion and 15 with meningitis, 3 to 18 months of age between Jan. 2002 to Nov.2002 enrolled in a cross sectional study. Patients with electrolyte abnormality, a febrile seizure, history of neonatal seizure or developmental delay and CNS abnormality excluded. Clinical and laboratory data between the two groups were analyzed.Results: 16 of 60 had less than 6 months age which 8 of them had meningitis (p=.007). 28 patients had complex seizure but 11 of them had meningitis (p=.017). Positive CRP in meningitis group was significantly different with febrile convulsion group (7 of 15 and 3 of 45, respectively). WBC count in 10 patients with meningitis was greater than 10000/mm3 and in febrile convulsion group only 14 of 45 had leukocytosis (p=.015).Conclusion: Although there is some statistically differences between clinical and laboratory data in meningitis and febrile convulsion group, lumbar puncture is still necessary in FC. Studies with large number of cases are recommended.