JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2004 | Volume:6 | Issue:3 (23)|Papers Count:19

BACKGROUND AND OBJECTIVE: MCNP is a general-purpose Monte Carlo code that is used for simulating of neutrons, photons and electrons transport in different media. Recently this code has been used for radiotherapy dosimetry and treatment planning. In recent investigations, the reasonable run-time was not acquired for clinical use of Monte Carlo method. In this research, the speeds of the computers available in Iran were compared in running a percent depth dose calculation (PDD) for CO60 teletherapy machine. METHODS: Geometry of a typical CO60 teletherapy machine and a water phantom were simulated. Both version of MCNP code was installed on Pentium 233, 866, 1500 MHz, 700 MHz Duran and Athelon 1333 MHz personal computers. Percent depth dose of CO60 gamma rays in water phantom for 10 × 10 cm was calculated by each computer. FINDINGS: The time required to compute the PDD by F6 tally was 60 times greater than the F8 tally. In all the cases, the 4A version was approximately %5 faster than 4B version. This suggests that in radiotherapy application like our test problem there is not considerable computing time difference between 4A and 4B version. CONCLUSION: The results recommend the use of F6 tally in radiotherapy application by CO60 gamma rays where the point of interest is not situated in electronic disequilibrium regions and when the time of calculation is important.

BACKGROUND AND OBJECTIVE: The control of postoperative pain that is one of the main goals of anesthesia care can lead to patients satisfaction and reduce time and expense of hospitalization. This study was done to compare the postoperative analgesia indices of free lidocaine spinal anesthesia with lidocaine plus buprenorphine. METHODS: This clinical trial study was performed on 100 patients aged 17-80 years in ASA Class I. They were randomly divided into two groups (each group=50). In group 1 (control), 75-100 mg lidocaine (5%) with 0.5 ml distilled water and in group 2 (study), 75-100 mg lidocaine (5%) plus 50 µg buprenorphine were injected intrathecally equal volumes. Patients were followed up for 24 hrs because of vital sign, severity of pain and respiratory rate and then compared to each other. FINDINGS: The mean duration of postoperative analgesia in group 1and 2 were 2.1 and 22.7 hours, respectively (p=0.000). The difference of range of hemodynamic changes was not statistically significant. CONCLUSION: According to the results, the mean duration of postoperative analgesia in study group (Buprenorphine+lidocaine) was longer than the control group and there were no hemodynamic changes between two groups.

BACKGROUND AND OBJECTIVE: Nausea and vomiting are common symptoms in pregnancy that occur during the first 14 weeks of pregnancy. A way for relief is consumption of natural products. The purpose of this study was to determine the effect of ginger powder as capsule on nausea and vomiting during pregnancy. METHODS: Forty four selected women were entered in a double - blind randomized cross-over trial. Each woman swallowed capsules containing either 250 mg powder of ginger root or starch T.I.D during the first 3 days of the treatment period. After a 3 days wash-out, the alternate medication was given in the second 3 days period.FINDINGS: Findings showed that median change in nausea (duration, severity, frequency) and vomiting (severity, frequency) after consumption of ginger capsule was significantly greater than placebo (p<0.001).CONCLUSION: Powdered root of ginger in daily doses of 750 mg during 3 days is better than placebo in reducing the nausea and vomiting.

BACKGROUND AND OBJECTIVE: Pap smear is the first diagnostic step of preinvasive lesion. Its sensitivity is 85%. Colposcopic and histologic evaluation for diagnosis is recommended. The aim of this study was to compare abnormal cytologic and histologic findings.METHODS: This cross-sectional study was done on the patients who referred to obstetrics and gynecologic clinic of Babol Yahyanejad hospital. In patients with abnormal cytology, cervical biopsy with colposcopic examination was performed. FINDINGS: Among 7050 patients, 74 (1.04%) cases had shown abnormal Pap smear that 58 (79%) were with reactive atypia and 21% were with cancerous and invasive lesions. Prevalence of cancerous lesion was 0.22%. Abnormal histologic results were in 9 (12.2%) cases (LSIL 5.4%, HSIL 1.4%, carcinoma 5.4%). There was a significant correlation between cytologic and histologic findings (p<0.05).CONCLUSION: It is necessary to evaluate completely with colposcopy and cervical biopsy, when Pap smear is abnormal.

BACKGROUND AND OBJECTIVE: Hirsch sprung s disease (H.D) is the most common cause of lower gastrointestinal tract obstruction in newborns. Diagnosis of H.D was established by a full-thickness rectal biopsy, then it was replaced by rectal suction biopsy, that is easier and has less complications. This study was done to compare the sub mucosa and muscular coat of rectal wall for ganglion cells. METHODS: In this descriptive, analytical and cross-sectional study, data were obtained from 239 pathological reports in archive of Shahid Beheshti hospital, department of pathology from 1991 to 2001. Serial sections (up to 60 sections) were tested microscopically.FINDINGS: Sixty-one from 239 specimens were diagnosed as H.D (19.3%) and in 172 cases ganglion cells were present in both muscular and sub mucosal layers (54.43%). Sensitivity of sub mucosa for presence of ganglion cells was 96.6% and correlation between sub mucosal and muscular layers for absence of ganglion cell was 100% (p<0.05). CONCLUSION: The results showed a good correlation between advantages of serial sections of muscular and sub mucosal layers for presence of ganglion cells. Probability of coincident presence of ganglion cells in both layers was confirmed.

BACKGROUND AND OBJECTIVE: Nausea and vomiting are complications of cesarean section (C/S) during spinal anesthesia and different methods have been suggested to prevent it. The aim of this study was to compare incidence of intraoperative nausea and vomiting (IONV) during cesarean section (C/S) under spinal anesthesia. METHODS: This double- blind and placebo- controlled study was performed on 150 ASA 1&2 women submitted for spinal anesthesia scheduled C/S. They were divided into three groups: 4mg ondansetron, 10mg metoclopramide or saline were administered I.V after clamping of umbilical cord, depending on their treatment group. After that treatment, if INOV appeared or the patients had no subside completely after 5 minutes, the subjects were treated with droperidol.FINDINGS: Nausea and vomiting were not seen in 91.8% of the ondansetron group, 91.6% of the metoclopramide group and 60% of the placebo group (p<0.001). There was no significant difference between the first and second groups. Emetic symptoms were more frequent after clamping the umbilical cord (25.9%) than prior to it (16.3%) (p<0.05).CONCLUSION: According to the results, there was no significant difference between ondansetron and metoclopramide. For reducing IONV, it is recommended to use metoclopramide for preventing intraoperative nausea and vomiting during spinal anesthesia for C/S.

BACKGROUND AND OBJECTIVE: The curves of vertebral column have an important role to shock absorption and stability of the spine. The goal of this study was to evaluate the correlation between total and segmental lumbar lordosis with sex and obesity. METHODS: One hundred volunteers (54 males and 46 females) aged between 20-70 years and without a history of low back pain were selected. A standing lateral radiograph of the lumbar spine was taken for each volunteer. Then by using Cobb methods, the total and segmental lumbar lordosis was measured from radiographic film. The age, sex, height and weight of each participant were recorded and also B.M.I for each participant were calculated. Data were statistically analyzed and the difference between points were considered significant at p<0.05.FINDINGS: The mean total lumbar lordosis for women was 57o and for men were 52.5o and the segmental lordosis for the two groups, women versus men was as follows: L1-L2: 5o VS. 4o; L2-L3: 9o VS. 8o; L3-L4: 10o.5 VS. 9o; L4-L5: 15o VS. 13o; L5-S1: 19.5o VS. 22o. Women being overweight had significantly greater total lumbar lordosis and segmental lordosis at L1-L2 and L2-L3. CONCLUSION: In comparison to men, women had significantly greater total lumbar lordosis and segmental lordosis at L3-L4. The overweight among female influence on amount of total lumbar lordosis and segmental lordosis at L1-L2 and L2-L3.

BACKGROUND AND OBJECTIVE: The incorrect and unsuitable use of antibiotics affects on the transfer of antibiotic resistance. Since, pseudomonas aeruginosa is one of the most serious pathogenic bacteria in hospitals and it is resistant to different antibiotics and it has created therapeutic problems for physicians, this study was done to determine the multiple resistance in pseudomonas aeruginosa against antibiotics, arsenate and metals. METHODS: In this study, 23 strains of P. aeruginosa isolated from clinical samples. They were tested against the antibiotics penicillin groups by Kirby-Bauer test. M.I.C and M.B.C of antibiotics and heavy metals (cadmium, mercury) and arsenate were measured respectively by broth and agar dilution and grown on agar plate methods. FINDINGS: In this method, the most and less M.I.C against heavy metals were cadmium (0.6, 4.9 µg/ml), mercury (<0.12, 4 µg/ml) and arsenate (8×103, 256×103 µg/ml). Of 23 strains of P. aeruginosa, 84% were resistant against antibiotics carbenicillin, 63% to piperacillin and 100% to metals cadmium and arsenate. 82.6% of these strains were resistant to mercury.CONCLUSION: So our results showed that these strains are generally multi-resistant to antibiotics carbenicillin, piperacillin, arsenate and metals.

BACKGROUND AND OBJECTIVE: Zinc is an essential trace element for humans that has important role in the immune system. Zinc deficiency contributes to the incidence, prevalence, severity and duration of infectious diarrhea and FTT ( Failure to Thrive). This study was done to determine the zinc level in hospitalized diarrhea children. METHODS: This study was conducted on 100 diarrhea children who were hospitalized in Amirkola pediatric hospital during June and July 2001. Characteristics such as age, gender, duration of diarrhea, serum zinc level and FTT were studied. Data were analyzed by X2 test, Fishers exact tests and spearman correlation coefficient. FINDINGS: From 100 patients, 42 were female and 58 were male that their range of ages was from 2 months to 12 years and the mean age was 45.9 months. The mean serum zinc level was 105.8 µg/dl. It was seen a significant difference between growth percentile and serum zinc level (p=0.012, Spearman correlation coefficient= 0.25). Children with low serum zinc levels (<63.8 µg/dl) spent a significantly greater number of days with diarrhea. In addition, incidence of diarrhea and zinc deficiency in the children bellow 6 years was greater than other groups ages.CONCLUSION: According to the results of this study, patients with zinc deficiency had longer duration of diarrhea and the children with FTT had low serum zinc level.

BACKGROUND AND OBJECTIVE: Low back pain is one of the problems that involves many of people during their life, especially in old ages. It is estimated 80% of individuals experience low back pain. According to high prevalence of this problem, it is necessary to evaluate its epidemiologic characteristics. The aim of this study was to evaluate the radiographic findings in chronic low back pain. METHODS: This study was performed on 547 patients with chronic low back pain referred to Yahyanejad hospital in 2001. Plain anterior -posterior radiographies were taken and if there was any doubt about spondylolysis, right and left oblique radiographies were requested. All findings were detected from these graphs.FINDINGS: 408 women (74.6%) and 139 men (25.4%) were participated in this study. In 286 of cases, there was not any radiologic finding. The most frequent radiographic findings were: spondylolysis (21.6%), narrowing L4-L5 (7.9%). There was a significant relation between spondylolisthesis, narrowing>L4, flat back and narrowing L4-L5 and age (p<0.05). Also spondylolisthesis L4-L5 and narrowing L5-S1 were more frequent in female (p=0.005 and p=0.041, respectively)CONCLUSION: More than half of patients have positive radiographic findings. So, it is advisable to take lumbosacral radiography before any treatment of chronic low back pain.

BACKGROUND AND OBJECTIVE: In patients with unilateral or bilateral loss with high length (more than 10cm) and with different etiologies, ileal substitution is good alternative when other procedures are not suitable. The objective of this study was to survey the effects and complications of ileal substitution for urethral loss. CASES: Sixteen patients were operated in urologic ward of Shahid Labbafinejad hospital with ileal substitution for urethral loss during 1994-1999. Twelve patients were male and four were female with mean age 28 years (3-47 years). Etiology was complications of surgery and ureterscopy in 11 and T.B in 2 and ureteral avulsion in one due to trauma. Follow up was 9-60 months and 3 patients missed follow up. Pre. op sonography, I.V.P. and D.T.P.A isotope scan in all patients revealed severe hydronephrosis in 11 patients. Post.op sonography and scan showed much improvement of kidney function. In 2 patients, hydronephrosis persisted that nephrectomy was performed. CONCLUSION: In cases with high ureteral loss which other procedures like uretero-ureterostomy or transuretero ureterostomy or autotransplant or kidney descending or Boari-Flap cannot be done, ileal substitution is good alternative with low complication

BACKGROUND AND OBJECTIVE: VIN (Vulval Intraepithelial Neoplasia) is a rare disease that can be observed in young females. In this study, four VIN cases referred to the gynecologic oncology clinic of Ghaem and Omid hospitals (Mashhad) during a year are going to be introduced. CASES: Four patients (mean age 30 years) suffering from mass and itching vulva referred to our center. All had multifocal lesions. Risk factors such as HIV, STD and smoking showed negative results. Despite not having the possibility of examining HPV infection, two patients had koilocytosis pattern in pathologic examination. No patients had CIN and other related genital cancers. Surgery treatment in the form of local exision during the usage of acetic acid was performed in the operating ward. In two patients, the removed marginal tissue showed positive malignancy results had gone through orthovotage radiotherapy. The recurrence was observed in one patient after one year who was reoperated in the form of skinning vulvectomy. CONCLUSION: According to this fact that the major cause of VIN is STD and in more than 80% of patients is HPV infection; the decrease in incidence of STD can especially lead to VIN decrease and vulva cancer naturally

BACKGROUND AND OBJECTIVE: Some of the brachial plexus and radial nerve variations have been reported. In many cases, variations could be important in clinical aspect. As anatomical situation of brachial plexus and radial nerve has an important role in explaining of their injuries and the neurological signs of those, paying attention to major variations of this nerve plexus seems necessary.CASE: This report is a rare variation in order to posterior cord of brachial plexus is double and radial nerve originates in lower than of sub scapular artery where two posterior cords conjoined together. CONCLUSION: As a result of posterior cord and radial nerve injuries in situations such as Saturday night syndrome and improper use of a cruch pressing on the nerve in the axillary fossa are related to their anatomical position, any changes in this situation can be make new expectancy in the etiology of injury and its neurological signs.