ARAK MEDICAL UNIVERSITY JOURNAL (AMUJ)
Year:2006 | Volume:8 | Issue:4 (33)|Papers Count:10

Introduction: The presence of necrotic tissue is an important problem in patients with deep burns. In this study the effectiveness of Sesame oil plus calcium hydroxide on debridment of third degree burns is investigated in rats.Materials and Methods: This experimental study is performed on 40 Wistar rats. After anesthesia, both flanks of rats were shaved, then third degree burns with 3cm diameter were produced using boiling water. Rats were divided into 4 groups randomly. One side of the first three groups was treated by fibrinolysin pomade and the other side in group one to third was treated using 1, 2.5 and 5% Kenhide pomade. In the forth group wounds were healed without treatment and spontaneously. In each group and wound, the time of necrotic tissue detachment and then formation of granulation tissue was documented in a checklist. Data was analyzed using paired T and ANOVA tests.Results: Results showed that comparing the three different concentrations of Kenhide the lowest debridment time with 16.6 days was related to 5% Kenhide (p=0.001). On the other hand there was relatively no significant difference between debridment time in case group and the first control group (p=0.053), but this difference was significant in case and the second control groups (p<0.001). There was also a significant difference between the time of granulation tissue formation in using 5% Kenhide and first control groups (p<0.01).Conclusion: Using Kenhide 5% pomade not only causes no injury to healthy tissues but also can be compared to fibrinolysin pomade in necrotic tissue debridment. More investigation is recommended in this field.

Introduction: Hepatitis B is a disseminated liver inflammation from HBV, that causes diseases and a large number of deaths. Regarding the fact that some of the vaccinated people are non responder (NR), evaluation of immunity in vaccinated ones and identification of NR especially in high risk group is necessary.Materials and Methods: In this descriptive study blood samples of all medical students of Borujerd Azad university at the age of 18-25 and vaccinated personnel of Borujerd Shariaty hospital were tested for Anti HBS-Ab level by ELISA method with Radim kit (cat.KHB31). Results were analyzed according to the number of received vaccines, the duration of vaccination and demographic criteria using descriptive statistics.Results: About 90% of samples had protective immunity and 10% were NR. 8% of immune group had more than 1000, 17.2 % between 500-1000 and 74.8 % between 10-500 miu/ml of Ab titer. About 75% of immune samples had received two vaccines. In NR group 53% had received three vaccines and 47% had two.  4% of samples were immune with the duration less than one month after vaccination which 85 % of them had  two vaccines.Conclusion: Herd immunity was 90% which is accordant to most studies. In some studies with different results the effective criteria were not differentiated. So regarding these differences, vaccinated people are recommended to evaluate their HBS.Ab level.

Introduction: It is showed that the activity of paragiganocellularis (PGi) nucleus is diminished in addict animals, but in contrast this activity was augmented during withdrawal period. Also, regarding interrelation of opiate and adenosine systems, it was obvious that in each system not only the specific antagonists but also the contrast antagonists system could produce withdrawal signs. In this study the role of PGi nucleus in precipitation of withdrawal signs induced by opiate and adenosine antagonists was investigated. Materials and Methods: In this experimental study, dependency was induced by escalating doses of morphine via drinking water which were prescribed to the animals during a 21 days period. Then addicted rats were subjected to four groups: 1-Intact 2-Sham 3-unilateral PGi destruction and 4-bilateral PGi destruction. Withdrawal signs were induced by 1-Naloxone (2 mg/kg sc.) and 2-Caffeine (50 mg/kg ip.) administration in each group. Data was gathered and then analyzed using one way ANOVA, Tukey and  Chi square tests. P<0.05 was considered significant.Results: Naloxone withdrawal signs were consisted of diarrhea, ejaculation, teeth chattering, ptosis, irritability, wet dog shake, strop tail, jumping and weight loss. Following bilateral PGi destruction there was a marked attenuation in three signs of irritability, teeth chattering and jumping signs. The number of withdrawal signs which were produced by Caffeine administration were less than Naloxone (diarrhea, ejaculation, teeth chattering, chewing, irritability and jumping). However, destruction of PGi nucleus (bilateral) diminished four sgins including: diarrhea, ejaculation, teeth chattering, and irritability. Conclusion: The present study showed that the withdrawal signs precipitated with Caffeine are less different than Naloxone, and the bilateral PGi destruction could markedly attenuate these sings in Caffeine group more than Naloxone ones.

Introduction: Treatment of urinary tract infections(UTIs), as one of the most common nosocomial and community acquired infections, has remained an important medical problem. Differentiation between susceptibility patterns of nosocomial and community acquired pathogens is important pidemiologically and helps the administration of appropriate antimicrobial  drugs. The goal of this study was isolation of the most common causative bacteria, in two groups of 13-35 years old women in Shahrekord city within 6 months period(April-September 2004). Also, the resistance patterns of common isolated organisms in these two groups were compared.Materials and Methods: This is an analythical-cross sectional study. 100 urine samples from women aged 13-35 years old hospitalized in different wards of Hajar and Kashani hospitals(group one) with positive urine cultures were obtained performing clean-catch midstream method.  Also 100  urine samples from 13-35 years old women  with positive urine culture and acute UTI symptoms from Shahrekord private laboratory (group two) were obtained. The most common causative bacteria in the two groups and the antibacterial sensitivity patterns of isolated organisms were evaluated. Data was analysed using T test.Results: Totally, the most common nosocomial UTI  pathogens were E.coli, Klebsiella spp., Staphylococcus saprophyticus, Pseudomonas and Enterobacter spp. In group two, E.coli, Klebsiella spp., Enterobacter spp., Proteus, Staphylococcus saprophyticus and Citrobacter spp. were isolated predominantly. The highest bacterial resistance rate belonged to Ampicillin and Co-trimoxazole.Antibiotics useful in treatment of nosocomial UTI were Ceftizoxim, Nitrofurantoin, Nalidixic acid, Cephalothin and Gentamicin respectively. Nitrofurantoin, Nalidixic acid, Ceftazidim, Gentamicin and Cephalothin were the most effective antibiotics in community acquired UTIs.Conclusion: The emergence of pathogens with alarming rates of  resistance, highlights the need for a more rationalized and restricted use of antibiotics in order to minimize the spread of resistant bacterial strains.

Introduction: Brucellosis is a matter of problem in an endemic area, since it involves not only human and animals but also causes socioeconomic difficulties. The disease is rare in developed countries, so there are little informations about this disease in medical reference books. Therefore, it is necessary to study it in Iran as an endemic area.Materials and Methods: This is a case-control study, done in Arak in 2005. At first by assistance of the health center of Arak city patients were recognized, and  if the presence  of Brucellosis was proved by the physician according to epidemiology, clinical manifestations and serology, the patients were considered as the samples of this study. Members of control group were selected among neighbors with the same age and sex, considering negative Wright and 2ME. Sample size of this study were 300 subjects (150 patients, 150 control). They were asked to complete a questionnaire containing demographic informations, animal conditions and subjects' knowledge about Brucellosis. To determine the degree of significant effects of studied variables, a conditional logestic regression model was used.Results: According to the result of this study, the presence of an involved person among  members of the family can increase the chance of Brucellosis, (about 7.55 times), as the most important factor of the disease. The next risk factor is the use of non pasteurized diaries which can increase the chance of the disease about 3.7 times. Among the information variables, lack of knowledge about transmission of the disease through fresh cheese was more important than the other factors (OR=0.44). The involved persons had more animals (about 2 times) than the members of control group. Considering educational level and source of information there was no significant difference.Conclusion:Since it is not possible to eliminate Brucellosis at present time, it seems necessary to increase the knowledge of people about transmission routes specially the fresh cheese. This can greatly decrease the disease within an endemic area. Considering the high level of disease risk among members of a family having an infected person, it is suggested to do a study for cost-effectiveness of Wrigh test in family members of patients.

Introduction: Cystic hygroma is a disorder in lymphatic vessel formation that involves the adjacent organs and can affect them due to its fast growing nature . The main treatment for cystic hygroma is surgical intervention that can have many complications after surgery. Treatments other than surgical interventions is the use of sclerosing agents. The goal of this study is to analyze the effect of Beliomycin in treating cystic hygroma.Materials and Methods: This quasi experimental study was carried out clinically at st-al Zahra and Kashanie hospitals of Isfahan from 1372 to 1383. A checklist including age, sex, cyst location, cystic hygroma volume before and after Beliomycin injection and/or surgery, was completed for each patient. Data was analyzed by T and paired T-Tests. p<0.05 was considered meaningful. Results:The study was carried out on 72 patients. 24 patients were treated with Beliomycin and 48 patient by surgery. Patients age was below 1 month up to 18 years old . Cystic hygroma was mainly located at neck region (46.8%). The average size of cystic hygroma was 103.9±29.66cm3 before Beliomycin injection and 34.91±16.19 cm3 after that (p=0.004). and 43.511±7.81cm3 before surgery and 1.39±1.39 cm3 after that(p=0.006). The rate of recurrence of lymphingoma in the surgery treated group was 25.1% and in the group treated with Beliomycin was 29.2% with no significant difference.Conclusion: Regarding the considerable decrease in cyst volume after Beliomycin injection and it,s low complication compared to surgery, this method can be used as a primary treatment or supplementary to surgery.

Introduction: Markazi province was one of the regions with endemic goiter in Iran. Following initiation of iodine deficiency control program in 1989, production, distribution and consumption of iodized salt begun. This survey was conducted in the frame work of national monitoring survey in 2001 to find the prevalence of goiter and urinary iodine level in order to evaluate the iodine status of school age children in Markazi province.Materials and Methods: 1200 school children (600 boys and 600 girls), aged 7-10 years, were selected randomly from all regions of Markazi province. The grade of Goiter was determined according to WHO classification and urinary iodine content was estimated using the digestion method in one tenth of the these children. Data was analyzed using T, Chi square and Pearson tests.Results: Total Goiter rate was 4.4% (4.4% in girls and 4.4% in boys). Urinary iodine median was 16.7 µg/dl. Urinary iodine was above 10 µg/dl in 81.2% and less than 5 µg/dl in 9.2% of samples. No one had urinary iodine below 2 µg/dl.Conclusion: It is concluded that the rate of Goiter in Markazi province has decreased significantly since 1986 and urinary iodine levels in school children are indicative of adequate iodine intake. Therefore Markazi province can be considered as an “iodine deficiency free” zone.

Introduction: Postoperative nausea and vomiting is one of the most common problems in postoperative period. Patients' who are at high risk of PONV, may receive anti-nausea and vomiting drugs. The most common drug is Metoclopramide, but it,s extrapiramidal signs and side effects such as lethargy, dizziness and headache  especially in children lead us to perform this study, in order to compare Dexamethasone and Metoclopramide  effects in PONV prevention.Materials and Methods: This study was a double-blind randomized controlled clinical trial. 262 patients (2-25 years) in ASA class I,II which were candidates for ENT, eye and laparatomy surgeries, divided into two groups randomly. One group received 0.1 mg/kg Dexamethasone IV and the other group received 0.1mg/kg Metoclopramide IV, 10-15 minuets before operation ending time. During recovery, the frequency of PONV was assessed. Data was analyzed by Pearson test.Results: PONV frequency in the two groups had no significant difference. Also PONV rate in the two groups had no significant difference in male and female. Conclusion: In prevention and treatment of PONV, Dexamethasone effect was same as Metoclopramide. Considering low expense, avalibility and low side effects, Dexamethasone is a proper substitute for Metoclopramide in surgeries with high risk of  PONV.