JOURNAL OF RAFSANJAN UNIVERSITY OF MEDICAL SCIENCES AND HEALTH SERVICES
Year:2009 | Volume:8 | Issue:2 (31)|Papers Count:12

Background and Objectives: In order to measure the economic cost of accidents as well as their effect on human health, information about incidence trend, the risk of accidents and the severity of resulting injuries is needed. This study aims to assess one-year incidence rate of job-related accidents' among workers of Sarcheshmeh Copper Factories Complex, Kerman, Iran. Furthermore, a new method for measuring job-related accidents severity is also introduced.Material and Methods: In this longitudinal study all workers in Sarcheshmeh Copper Factories Complex were followed for two years. Demographic characteristics as well as specific Information such as the number of lost days were collected using a checklist. Injured people or their co-workers were interviewed in face to face sessions. Data were analyzed in SPSS and parametric (t-test, ANOVA) or non-parametric (Chi-Square) tests were used where appropriate. Relative risk (RR) was calculated to compare incidence rates. The new method for measuring the severity of job-related accidents is also presented.Results: Mean age of injuired people was 37.4±7.3 years (n=170). One-year incidence rate of accidents (in 1000 person-year at risk) in 2004 and 2005 was 21.52 and 14.41 respectively. Carelessness was the most common cause of accidents. Mean lost days for injured workers was 29.8±29.7.Conclusion: Reduction of the risk of accidents in the second year shows the success of educational and protection programs. However, more attempts should be made to reduce this risk. The method for calculation of the severity of job-related accidents in this research is more accurate than the method that is being used.

Background and Objectives: This investigation was performed to examine hemodynamic stability for the period of anesthesia induction and intubation, employing thiopental added to fentanyl, thiopental added to ketamine, and thiopental added to fentanyl and ketamine.Materials and Methods: Sixty adult patients were randomly allocated in this randomized clinical trial to one of the three groups according to the drugs used for the induction: thiopental (4 mg/kg) plus to fentanyl (3µg/kg) (TF, n=20), thiopantal plus ketamine (0.1mg/kg) (TK, n=20), or fentanyl (3µg/kg) and ketamine (0.1mg/kg) (TFK, n=20). Hemodynamic responses were evaluated by determining changes in blood pressure (BP) and heart rate (HR) just before laryngoscopy and at 1, 3, 5, and 10 min after that.Results: Throughout the induction of anesthesia BP and HR variations were more in the TK group than that in the TF and TFK groups (p = 0.009). After laryngoscopy, BP significantly increased in the TF and TK groups compared with the TFK group (p=0.027), the rank sequence was TK > TF > TFK. Heart rate was also significantly increased in TK group compared with TF and TFK groups after laryngoscopy (p= 0.013), the rank sequence was TK > TF > TFK. After intubation, BP and HR remained unchanged compared with their preintubation levels in the TFK group.Conclusion: Thiopental added to fentanyl and ketamine caused greater reduction of instabilities in hemodynamic variables throughout the induction of anesthesia and tracheal intubation than thiopental added to fentanyl or thiopental added to ketamine

Background and Objectives: Muscles are known as organs which can generate pain in human body. Muscle tissues more than other organs are predisposed minor tearing during activities of daily living and cause pain. Among different types of muscle pain, myofascial trigger points (MTPs) are very common. The aim of this study was to evaluate the effect of the low power laser in the treatment of the MTPs of trapezius muscles.Material and Methods: A double blinded clinical trial conducted on a consecutively selected sample of 60 patients between 4 may 2007 and 5 August 2008, in the Fattemieh physiotherapy clinic of Rafsanjan. Respondents who were all suffering from MTPs of trapezius muscles, were divided into two groups, randomly (30 in each group). Treatment methods were included low power laser and placcbo. Intensity of the pain, improvement of movement, the tense band, reduction of the redicular pain and the sensitivity of the tense band were assessed in 1st, 5th, 10th sessions and also 10 days after the treatment. Pain intensity was evaluated by visual Analogue scale (VAS).Results: T he results of this study showed that low power laser can be more effective than placcebo in relief of the local pain of the MTPs (p<0.0001). In 10th session, chi-squire test showed that low power laser in comparison with placcebo, can be effective in removing the tense band of the muscle, reducation of redicular pain, improvement of the movements and reduction of the sensitivity of tense band (p<0.0001).Conclusion: T his study can be concluded that in the 10th session, low power laser can be effective on the relief of local pain, redicular pain, removing of muscle tense band, improving of movement and reducion of the sensitivity along tense bend of the MTPs in the trapezius muscles.

Background and Objectives: Sensory – neural hearing loss following mastoid surgery has been reported with different severities. In the mastoid surgery, different factors can affect hearing. The aim of this study was to introduce the most common frequency that was affected during mastoid surgery and also to determine the correlation between duration of drilling and suction irrigation with the severity of sensory – neural hearing loss.Materials and Methods: This Longitudinal Study was performed in the E.N.T department of khalili Hopistal-Shiraz University of Medical Sciences. Thirty consecutive patients with chronic otitis media were selected. Audiometry was done (250Hz–8kHz) in two occassions, one day before the operation and 2 months after the operation. The results were analyzed using paired T- test and Pearson Correlation.Results: There was not any significant change in threshold of bone conduction in all frequencies (250HZ-8KHZ) after 2 months. The average time of drilling, was 46.6 minutes (SD 8.77). There was a significant correlation between the time of drilling, suction, irrigation and change in bone conduction threshold in the 4KHZ, (p<0.05) but this correlation relation was not found in the other frequencies. We did not find persistent changes in the bone conduction thresholds after tympanomastoid surgery in the operated ear and the other ear.Conclusion: We did not find persistent changes in the bone conduction thresholds after tympanomastoid surgery in the operated ear and the other ear after two months. So in case of SNHL Consequence of surgery we should consider other factors.

Background and Objectives: Perinatal mortality is used as an indicator for evaluation of adequate perinatal and care services. Awareness of the major causes and effective factors on perinatal mortality play an important role in botl strengthening of obstetric services and in perinatal care planning (from pregnancy to birth and to neonatal care). The purpose of this study was to identify the effective factors on perinatal mortality in Rafsanjan city population.Materials and methods: This descriptive study was done on 321 cases of perinatal death over 2 years period. For each case, one baby who was living up to the 28th day after brith and its age was the closest to the case, has chosen as the control group. Data was obtained from hospital records also by interview with the nurse, mother and obstetrician (or the person who delivered the baby). Data were analyzed by SPSS software and chi-square and t- tests, were used where approfreiate.Results: Perinatal mortality rate was 32.2 per 1000 (29.1 and 34.9 per 1000 for girls and boys, respectively). The most common causes of newborn mortality were prematurity (%53.8), respiratory distress syndrome (%20.5), septicemia (%6.4) and the common causes of stillbirth were premature rupture of amniotic membrane (%27.7), pregnancy induced hypertension (%8.9), placenta abruptio (%6.3) and congenital abnormality (%5.4). Statistical tests showed a significant relationship between the fetal weight, gestational age, history of stillbrith and birth rank with stillbirth. Twin births, maternal age, previous maternal disease, maternal weight gain during pregnancy and the number of pregnancies were among the risk factors that increased the newborn mortality rate.Conclusion: According to the findings, several reasons such as maternal age, birth grade, the average of gestational age, history of stillbirth, birth weight and primigravida play important role in occurrence of perinatal mortality. High priorities should be given to the strengthening and improvement of the obstetric services and initiating preventive efforts for above mentioned causes of prinatal mortality.

Background and Objectives: Learning is change of behavior based on experience, and memory is recalling the past events consciously or unconsciously. Learning and memory are of the higher functions in the brain that involve many regions in the central nervous system. Permanent synaptic morphological changes specially in hippocampus, are the basis of learning and memory that can be influence by many factors. In this study the effect of morphine injected in CA3 of hippocampus on spatial learning and memory in male rats was investigated.Material and Methods: In this experimental study 48 male rats were anaesthetized and cannula implanted bilaterally in CA3 area of hippocampus (AP =3.5 from bregma, LA=±3.8, DV=2.7 from dura) using stereotaxic method. After recovery period (one week), rats were divided into six groups, including: control (only cannulated), Sham (received saline) and four other groups that received doses of 1, 5, 10 or 25 milligram of morphine in 1 ml solation through cannula during 5 days. Each day, 30 minutes after injection, their spatial learning and memory in morris water maze were evaluated. Throughout the experiments, animals were treated according to the suggested international ethical guidelines for the care of laboratory animals.Results: Results showed that 5, 10 and 25 milligram cause of morphine can delay in time and distance toward the hidden platform in four days. However, in fifth day all doses of morphine caused animals to spend fewer time and distance in trigger region.Conclusion: This study indicates that morphine injection in CA3 of hippocampus caused impairment on spatial learning and memory.

Background and Objectives: Pyrus boissieriana, Diospyros lotus, Eryngium caucasicum, Froriepia subpinnata are native to Northern part of Iran and are widly used in local foods. Diospyros lotus fruits are used in prepration of jams. E.caucasicum and F.subpinnata also used as wild herbs in local foods.Materials and Methods: The antioxidant activity of methanolic extract of Pyrus boissieriana, Diospyros lotus, Eryngium caucasicum, Froriepia subpinnata were determined with 6 invitro assay include DPPH, nitric oxide, H2O2 radicals scavenging , linoleic acid, reucing power and iron ion chelating activity. A total phenolic and flavonoid compound of extract was measured by Folin Ciocalteu and AlCl3 assays.Results: IC50 in DPPH method was in order: E. caucasicum > F. subpinnata > D. lotus > and P. boissieriana mg ml-1, respectively. The extracts showed weak nitric oxide-scavenging activity. The E. caucasicum and F. subpinnata extracts were better than others respectively. The F. subpinnata and E. caucasicum had shown better reducing power than other extract that was comparable with Vit C (p> 0.05).Conclusion: F.subpinnata aeial parts and E. caucasicum leaves had higher total phenolic and flavonoid contents than others, which may be the result of higher total phenolic and flavonoid contents of them.

Background and Objectives: Mucormycosis is a rare but often fatal disease caused by a fungus from the group of Mucorales. It most commonly affects the nose and brain. The aim of this report is the quick recognition and treatment of some opportunistic infections in patients with diabetes or suppressed immune systems and emphasis on surgery with protection of vital organs functions and limitations of some endoscopes in the nasal surgery.Case Report: This report presents a 76-year old diabetic female with severe headache, facial pain and hearing loss and recognition of paranasal sinus mucormycosis who was hospitalized in Mordad Hospital with in Rafsanjan. After two successive surgeries, (endoscopic surgery and medial maxillectomy) and medical therapy with Amphotricin B after 45 days was recovered.Conclusion: In the patients who are referred with headache or facial pain, exact examination and history-taking about underlying disease and immunosuppressive drugs is necessary. Protection of vital organs in the surgery for removeal of necrotic and infected tissues and endoscopic surgery with Caldwell-Luc procedure for better access to anterior wall of maxillary sinus must be considered.