JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2001 | Volume:3 | Issue:1 (9)|Papers Count:10

OBJECTIVE: It is important to pay attention to poisoning conditions that have special role in our life. This study was done to investigate the mortality rate induced by acute chemical and drug poisoning in Loghman Hakim hospital (Tehran) during 1997-1998. METHODS: During this interval, 35580 Patients who were over 12 years old, were admitted and their information were registered on questionnaires and then analyzed. FINDINGS: 53% of cases were outpatients and 47% were hospitalized. From all of 35580 patients, 346 patients (0.97%) that 71% of them were male died and the causes of their poisoning were intentional, incorrect use, accidental, unknown and occupational in 57.5%, 35%, 5%, 2% and 0.5% of cases respectively. The most common causes of death induced by poisoning were as follows: opiate compounds (39.5%), drugs (21.7%), pesticides (17.3%), unknown (7.8%), depilatory compounds (6.6%), alcohol (3%), cyanide and carbon monoxide (2.6%), bites (0.6%), corrosive agents (0.6%) and poisonous plants (0.3%). About 16.5% of dead cases were in emergency or before reaching to the hospital. The main cause of mortality was delay in referring to hospital and respiratory insufficiency so that 51% of cases were referred to the hospital 6 hours after development of poisoning. CONCLUSION: Providing the necessary facilities for transfer of patients to emergency centers, providing equipment and antidotes, gathering suitable information and medical personnel can be effective in reducing of mortality rate.  

OBJECTIVE: Nitric oxide (NO) is produced by different cells such as monocytes and plays an important role in non specific immunity. In addition to its numerous physiological and pathophysiological effects, (NO) has tumoricidal activity. It seems patients with acute lymphoblastic leukemia (ALL) have an imbalance and a defect in their immune system, especially in (NO) production. Therefore, in this study (NO) production by monocytes in children with (ALL) was evaluated before and after treatment and the results were compared to an age -matched reference population. METHODS: Peripheral blood samples from 30 patients with (ALL) were collected before treatment and after induction of remission. Samples were also taken from 30 healthy children. Mononuclear cells and then monocytes were separated from blood samples and cultured in the presence of activators and inhibitors of (NO) pathway. For evaluation of (NO) production, nitrite level, which is a determinant of (NO) output, was measured in supernatants of culture media by the Griess method. FINDINGS: The results show that the level of (NO) production before treatment in comparison to control group is significantly increased. CONCLUSION: Although there are cellular immunity defects in patients with (ALL), it seems (NO) production in a non specific pathway by monocytes is not altered and may have anti - tumoral activity in these patients.  

OBJECTIVE: Excitatory amino acids (EAA) and noradrenaline are known as a neurotransmitter which stimulates gonadotropin secretion in female and male animals. This study was designed to evaluate the involvement of central noradrenergic system on FSH secretion induced by EAA in adult rats. METHODS: Rats were implanted with monolateral cannula through the LC -SC (Locus Coeruleus –Sub coeruleus) by stereotaxy. Then saline or glutamate (2mg/ml) was injected into the cannula. Blood samples were drawn just 10 min. After injection and were prepared for IRMA (Immunoradiometric Assay). For investigating the involvement of LC -SC in nor adrenergic system, DSP-4 was used as an injection bilaterally one week before glutamate. FINDINGS: Microinjection of glutamate significantly increased the plasma level of FSH in comparison to saline in control group. Pretreatment with DSP-4 significantly decreased the plasma level of FSH before glutamate injection. CONCLUSION: The results indicate that LC-SC in adult rats is one of the major sites affected by EAAs on FSH secretion by noradrenergic neurons.    

OBJECTIVE: Esophageal cancer is a very common disease in north of Iran. There is no information regarding the survival rates in this area. This study determined 5 year survival rate in patients with esophageal cancer referred to Shahid Rajaii radiotherapy center in Babolsar. METHODS: A descriptive- analytical (historical cohort) study has been conducted on the basis of information that presented in medical files of 230 patients with esophageal cancer at this center (1992-1997), using nonrandom convenient sampling method. The survival analysis was performed by nonparametric Kaplan - Meier method. FINDINGS: The results show that 59.1% of patients were male. The mean age of patients was 62.2 years. In both sexes, the frequency of esophageal cancer in the age range of 60-69 years has been more than other age groups. The survival rate at 1 and 5 year has been 42% and 8% respectively. There was a significant difference in survival rates in terms of the age and sex (P=0.02, P<0.01 respectively); females and patients under 50 years had better survival rate. There was no significant difference on the basis of the histologic findings, anatomical location and the type of treatment of tumor in the survival rate. CONCLUSION: The results indicated that esophageal cancer has poor prognosis. In this study, 5 year survival rates in patients with esophageal cancer are consistent with the remarked statistical information that was studied in European countries and north America, but it has poorer survival rates in comparison to remarked statistical information that was studied in China and Japan.  

OBJECTIVE: Arthritis is a common sign which is almost one of the first manifestations of musculoskeletal diseases. With regard to a relationship between the prevalence of some rheumatic diseases with genetic and environmental factors, the causes of arthritis may be different among the racial and ethnic groups in any geographic area. The present study was conducted to determine the etiology of acute arthritis in Babol. METHODS: Arthritis was confirmed clinically and etiological diagnosis was made according to the usual criteria for rheumatic disease. This study was done on patients aged over 16 and their disease duration was less than four weeks. FINDINGS: From 133 patients under the study, 26%were referred with acute monoarthritis (AM), 56% with acute oligoarthritis (AO) and 18% with acute polyarthritis (AP). The most common cause of AM was gout, the most common causes of oligoarthritis were reactive arthritis (ReA) and rheumatic fever(RF). ReA, RF, rheumatoid arthritis (RA) and systemic lupus erythematous (SLE) were the common causes of AP. CONCLUSION: These findings show that gout, ReA, RA, RF and SLE are the common causes of acute arthritis in old, middle and young age in Babol.    

OBJECTIVE: A high mortality and morbidity rate is observed among low birth weight infants. This study was performed to determine frequency of low weight infants hospitalization and their hospital management (The mean value of hospitalization period, mortality rate, need to respirator, the average time of onset of breast - feeding) in neonatology ward and NICU of Amirkola children hospital. METHODS: This study was performed on 885 neonates during the year 1998. Sampling was done by census and the data were analyzed after filling out the questionnaires. FINDINGS: 284(32%) neonates had low weight and the mean value of their weight was  1933±308 gr.56% were male and 44% were female that 60.3%, 34.1% and 5.6% of them were premature, IUGR and with unknown etiology respectively. Also, 14.4% were twins and the second to first twin ratio was two to one. 15.8% of LBW neonates died and 15.5% needed respirator of whom 68.2% died. The mean value of hospitalization period (after omission of the died neonates) was 9.8±7 days. Breast feeding began 3 days (with a range of 1-19 days) after admission on the average. CONCLUSION: According to the high frequency of LBW neonates (32%) and the high mortality rate (53%) of these neonates less than 1000 gr, we suggest the establishment of NICU with perfect equipment, drugs and personnel in all centers of the provinces by the ministry of health, treatment and medical education.  

OBJECTIVE: The correct use of antimicrobial agents is one of the important current issues in medicine. Increased emergence and spread of resistant bacteria are reasons for rational antibiotic therapy. Since antibiotics are the most frequently used drugs in surgery, this study was done to evaluate the suitable administration of antibiotics at surgical wards of two university hospitals in Rasht. METHODS: This descriptive study was done on 1026 patients on the basis of the surgical infection society (SIS) directions during 1996-1998. FINDINGS: 491 cases were operated as elective and 535 as emergency. Seven types of antibiotics were used for prophylactic and therapeutic purposes. In one-third of patients, the administered antibiotics were unsuitable and also in one- third of cases, the drug did not involve the causative organisms of infections. In 50% of cases, the duration of treatment was not according to correct directions. CONCLUSION: The results show that it is necessary to revise the use of antimicrobial agents in surgical operations.      

OBJECTIVE: Correct and rational use of drugs is one of the main factors in successful treatment and the patient should be aware of his dispensed drugs. This study was carried out to evaluate the knowledge of patients referred to Kerman pharmacies about their dispensed' drugs. METHODS: Data collection was carried out by face to face, filling out questionnaires and was analyzed by chi-square test. FINDINGS: From all of 300 patients, 69.7% were male and 30.3% were female. Most of them didn't finish their school studies, were illiterate or only were able to read and write and didn't have complete awareness of the use of dispensed drugs. Their awareness of dispensed drugs were as follows: drug dosage 32.3%, time of drug use 22%, interval of drug use 26.7%, route of administration 93.3% and duration of treatment 58.7%. These data show that except the route of administration, the patients were not informed about their dispensed drugs. Patients with higher education had more complete awareness of drug use in comparison to illiterate patients (p<0.01). CONCLUSION: Patients have low knowledge of their dispensed drugs in Kerman. Therefore, measures must be taken to improve the knowledge of rational use of dispensed drugs.    

OBJECTIVE: Shigelloid meningitis is a rather rare disease in healthy children that occurs in patients with a history of malnutrition and immune deficiency. CASE: The case is a 25 month child referred to the hospital for fever, restlessness, convulsion, nausea and coughing. In physical examination, it has got positive neurological signs (neck rigidity, positive Kernig and Brudzinsky sign). In lumbar puncture analysis, there was leukocytosis with PMN dominancy and low glucose level. In gram staining and culture of CSF, gram negative bacilli grew. Then presence of Sh.Flexnery was confirmed by a reference laboratory. CONCLUSION: The patient improved after ceftriaxon administration in 10 days and no complication was observed during a follow up of 3 months.