Journal of Arak University Medical Sciences
Year:2002 | Volume:5 | Issue:3 (20)|Papers Count:13

Introduction: Regarding the extensive use of IUD, as contraception. The present study was conducted to evaluate the complications resulting from multiload 375 & T cu 380 A IUD inserted in women referred to the Health & Treatment settings of Kermanshah Medical Sciences University in the year 2002.Materials and Methods: The study was descriptive-analytic, on 122 women using M.L 375 IUD and 245 others using T 380A IUD were fully assessed. The tools used to collect data were questionnaires evaluating the following variables: pregnancy, bleeding, ectopic pregnancy, uterine perforation, and expulsion, Pelvic Inflammation disease (PID). To analyze the data, descriptive statistic and X2 , student-t and Fisher tests were used.Results: Severe bleeding during menstrual cycle was the most common complication in the two study groups, especially in the multiload 375 IUD group (%75 vs, %41.6; p<0.001). The multiload 375 IUD had a significantly higher dysmenorrhea rate compared to the T cu 380A (%70.8 vs, %40.8; p<0.001). The rate of interauterine pregnancy was low for the two device (% 1.7 vc, %2), and occurrence of ectopic pregnancy in multiload 375 lUD was 0.8% and in Tcu 380A group was not reported. There were no uterine perforation observed for either device.Conclusion: According to the results gained, the common complications in each group were not dangerous and their severe and threatening complications were uncommon. The most frequent complications were severe bleeding during menstrual period, dysmenorrheal and spotting which were not life threatening and could be controlled by supporting and training their users, although these complications were seen more among those using M.L 375 lUD. These two devices were effective enough to prevent pregnancy. It seems that using T Cu 380A IUD is more suitable for those who want to have a long-term contraception.

Introduction: Glucose Six Phosphate Dehydrogenase (G6PD) catalyses the first step in pantose phosphate pathway to produce NADPH. NADPH plays an important role in oxidation and reduction of hemoglobine and reduces H202 level. However, in absence of G6PD, NADPH also will be decreased, as a result of severe defect in function of red blood cells occurred. So we decided to survey is prevalence in our region by studying on the umbilical cord blood.Material and Methods: Our study were descriptive-analytic and samples were gathered by Simple Sampling Method. EDTA was used as an anticoagulant. Enzyme activity was measured with the method of Fluorescent spot Test. (FST). Chi-Square and logestic regression were used to analyses the data and P<0.05 was considered as significant.Result: From a total of 2160 neonates, 1103 case (51.1%) were male and 1057 case (48.9%) were female. 3.5% of the males and 0.8% of females and over all 2.2% of the neonates were G6PD deficient. Due to chi-square analyses and logestic regression, positive RH increases the risk by 1.6 as compare to negative RH. However we could not find any significant relationship between blood groups and prevalence of G6PD.Conclusion: As our results showed, the G6PD deficiency is more common in male than female. Relation between positive RH and G6PD deficiency were significantly increased. Prevalence of G6PD in Arak City showed 2.2% which is lower than that of north our country (8.7%) as well as lower than other part of the world (10-14.9%). We suggest using the screening umbilical cord blood test on the neonates to diagnose the G6PD deficiency and to promote the primary health care quality and public as well as reduction the social and economical problem of the society.

Introduction: Considering the high incidence of hip fractures in the elderly, anesthetists and orthopedic surgeons are frequently encountered with these fractures. Timely fixation of hip fractures decreases morbidity and mortality. Surgical bleeding and the resulting homodynamic compromise, decrease in vital organ perfusion and complications of blood transfusion are important problems in this age group. The ability to decrease Surgical rise; in these patients.Material and Methods: In a semi-experimental and prospective study 40 victims of hip fracture (50-90 y/o) were selected. The goal was to clarify the relation between anesthesia technique and surgical bleeding. 22 patients received spinal (group A) and 18 patients received general (group B) anesthesia.Results: According to recorded data surgical bleeding was greater in group B (general anesthesia) Than group A, and these data was statistically significant.Conclusion: In this study %60 of group A and %61.2 of group B were males and %40 of group A and %38.8 of group B were females. During the operation, blood loss was measured and recorded for each patient.

Introduction: Osteoporosis is an important health problem and the most common metabolic bone disease, that according data statistic, more than 6000000 Iranian have this disease.Material and Methods: This research is a descriptive analytical study which has been conducted in order to evaluate application prevention behaviors of osteoporosis in health caregivers and how them educating for women referred to the health care centers of Arak City in 2002. The research units were composed of 24 health caregivers 110 women referred to these centers that had been selected by convenience.Results: The results of the research show medium age of caregivers were 33.7 years and in women were 29.3 years. (%58). Caregivers and (%80.9) women had adequate education intake daily and (%80.2) caregivers and (%16.4) women had regular exercise. (%62.5) caregivers and (%63.5) women exposed to the sunlight. Also the results show (%49.1) units research in the day gave discussion of caregivers about osteoporosis. (%79) intake calcium, (%90) exercise, (%85.5) exposing to the sunlight, but (%80.9) women did not discuss about taking hormonal drugs.Conclusion: The result show significant relation between age, educational, level and family history of osteoporosis in health caregivers with before education, but relation between adequate calcium intake in women and education was non-significant and relation between doing exercise and education was significant.

Introduction: During the history of internal medicine Goiter has always been at the center of attention as one of the most important endemic disorder. It has estimated that about one billion people around the globe are affected with Goiter. Iran is recognized as an endemic area for Goiter. The aim of this study was to reveal the pattern of distribution of different thryroid disorders in-patient with Goiter in Markazi Province.Material and Methods: It was a descriptive-cross-sectional study that enrolled 2138 patients with Goiter who were selected randomly and by categorized sampling(F=1542, M=596)TSH serum titers were checked for screening and if abnormal, detailed thyroid function tests were done. We used Randon ELISA Kits previously checked with RIA in our study. Patients were first examined for Goiter and graded if Goiter was found, and if it was nodular, the patient was referred for sonography, thyroid scan and FNA. Then the patients were further evaluated based on clinical findings and laboratory results for various thyroid disorders. Results: In this study we evaluated 2138 pts with Goiter (72%(1542)=F. 28%(596)=M) from which 83.1% had a simple Goiter, 6.94% were hypothyroid, 3.36% had subclinical hypothyroidism. 13 pts (0.7%) had nodular Goiter that in one case it was diagnosed as papillary carcinoma. Three Patients had cold nodules and the rest had multiple warm nodular or diffuse Goiter. In 44.3% of cases Goiter was in grade IA and in 34% cases it was graded as IB. Goiter was the most prevalence (32.5%) in 10-19 age group and it was least prevalence (2.1%) in pts over 70.Conclusion: Goiter is endemic in Markazi Province, but its prevalence in the children of recent decade is declining and in previous decades, clinical and subclinical forms of hypothyroidism and hypothyroidism are more prevalent.

Introduction: The relation between Helicobacter pylori with iron deficiency is being studied in recent years. The aim of this study is finding the relation between Helicobacter pylori with the rate of hemoglobin and serum ferritin.Material and Methods: This study is an observational study and a cross - sectional type which is done analytical-descriptive against 262 patients suffering from anemia and for each patient the amounts of Hemoglobin, MCV, serum ferritine and Helicobacter IgG titre is calculated and then the relation between these amounts and Helicobacter is evaluated.Results: In 147 patients (56%), Helicobacter IgG antibody was negative. In 78 cases (29.8%) the serum ferritin was less than 120 µgr./dlit .Using statistical analysis (Logistic regression) revealed that there was a statistical relation between the amount of ferrittin and the chance of strickened with Helicobacter in individuals whom their ferrittin rate was less than 12, 1.93% of patients whom their ferrittin is more than 12 and the enhance is significant. By the way it was cleared that there is not any significant statistical relation between MCV reduction and the chance of being stricken with Helicobacter.Conclusion: Serum ferrittine rate in-patients with Helicobacter pilory infection reduced and this reduce was significance. Previous studies in other countries indicated to this issue.

Introduction: Wilms' tumor is the most common malignant and primary renal tumor  in children. Studies, which have been done in some countries, have introduced numerous factors such as age of incidence, stage, lymphadenopathy, histopathology and etc. Effective in the survival rate of this tumor according to the importance of this tumor in children, we decided to perform a study about the survival rate of Wilms' tumor and the effective 'factors on it.Materials and methods: This is an analytic study on 128 patients affected with Wilms' tumor whom referred to the oncology ward of Hazrat-e-Ali Asghar Hospital between 1977 and 2001. In addition to the current status of the patients, demographic characteristics, signs and symptoms, laboratory studies at the time of diagnosis and the stage of the disease were recorded and ultimately survival analysis was performed using the Kaplan-Meier procedure and life table. Cox Regression was used to determine the effective factors.Results: The mean survival rate was 82.99 months. The number of patients was equal in both genders (64 patients in each gender) and the survival average did not have any significant statistical relationship with gender (power = %92.4). Most of the tumors were in stage 3 at the time of diagnosis. The survival of the patients was reducing significantly, with the progression of the stage of tumor (P = 0,002). The existence of metastasis (P=0.000, odds ratio 0.207), splenomegaly (P = 0.018, odds ratio = 0.336), and recurrent (P= 0,037, odds ratio = 0.184), were significantly reducing the survival of the patient. To determine the severity of effective factors on the survival rate of the patients Cox Regression Method was used in with, absence of metastasis and positive blood group were from well-prognosis predictive factors in these patients.Conclusion: 5-year survival rate of the patients was 63.28% in this study which was lower in comparison with the results of other studies in other countries. This can be the result of delay in consulting with medical centers, the diagnosis method and or the Referral State of this center. Recent studies have shown that age and tumor size has minimal values in the prognosis or the patients due to improvement in the quality of treatment and our study support this idea. Genetic factors will probably be used in determining the survival of these patients and also in their treatment.

Material and methods: This is Double blind Randomized clinical trial study which was  performed on 66 children of  2-7 years of age who had been referred for first time, for nonbrain non-liver elective surgery (class 1 Anesthesia). This study was designed to define the efficacy of oral Ketamine on Anxiety and Agitation  and crying of children after separation from these parents, toleration of Anesthesia mask and IV needle. Sleeping before Anesthesia and entry into the operating room samples were divided in to two groups, cases and control. 5mg/kg of ketamine plus 0.2/kg of fruit juice was given to the case group while only 0.2ce/kg of fruit was given to the control group 30 minutes before the operation.Results: Our results showed that 78.8% of children in the ease group did not cry when they were separated from their parents and 78.8% of them did not show any resistance. 34.4% of children in the case group showed no response and 59.4% also had low response. Only 6.1% of children in the control group had no response while 78.8% of them had responses such as intense body movements and pulling of hand. 69.7% of the case group were cooperative when putting on the anesthesia mask while 75.8% of the control group refused to wear the mask, 81.8% of the children in the case group were asleep before Anesthesia while all of the children in the control group were awake and uneasy.Conclusion: These findings indicate that ketamine can be used as a pre-anesthetic drug to decrease the anxiety and fear of children and to calm them before their transfer to the operating room.