JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2001 | Volume:3 | Issue:3 (11)|Papers Count:14

OBJECTIVE: There is not any effective treatment for patients with asthma now. Physicians need drugs with minimal side effects for conservative treatment. This study was done to compare the effects of ipratropium bromide and beclomethasone for conservative treatment of asthma.METHODS: In this clinical trial 60 patients were randomly selected, divided into two groups and were treated during two weeks (group one with ipratropium bromide and group two with beclomethasone). After two weeks, the results were compared with original physical examination and spirometry.FINDINGS: Despite clinical improvement of asthma after administration of ipratropium bromide in 83% of cases and beclomethasone in 70% of cases, there was not a significant difference. On the basis of PFT, ipratropium bromide in 50% of cases and beclomethasone in 10% of cases caused an improvement in spirometry results (p<0.05). CONCLUSION: According to the results, it seems that ipratropium bromide is more effective than beclomethasone in improvement of pulmonary function. Of course, further investigation is necessary.

OBJECTIVE: Saddle block in anorectical, some urologic and gynecologic procedures provide suitable condition for surgeon due to sufficient analgesia and decreases side effects of spinal anesthesia. In this study, duration of painless period and hemodynamic changes in saddle block with lidocaine (intermediate acting) and bupivacaine (long acting) were compared.METHODS: This study was conducted on 51 cases in ASA class I (American society of anesthesiologists) 15-65 years old who had no co-existing disease. They were randomly divided into two groups. Before starting of saddle block, all patients received 500ml crystalloid solution. Saddle block was done in the first group (26 cases) with lidocaine 5% (1ml) and in the second group (25 cases) with bupivacaine 0.5% (1ml), with a 25- gauge spinal needle. Systolic and diastolic blood pressure were measured and recorded 5 minutes before the block (baseline) and at 5th, 15th and 60th minutes after the block and then data were compared. FINDINGS: After saddle block, systolic blood pressure in both groups decreased. This change in the first group was more intensive than the second group. The difference of systolic blood pressure between two groups only in the first 5 minutes was significant (p= 0.047). Variation of diastolic blood pressure after saddle block in both groups was more stable and there was not a significant difference between them. The mean of duration of painless period after block in the first group was 197.3 minutes and in the second group was 345.2 minutes, showing a significant difference (p<0.0001).CONCLUSION: The results showed that hemodynamic stability and painless period in patients who received bupivacaine were more than those who received lidocaine. Therefore, bupivacaine can be used instead of lidocaine in saddle block.

OBJECTIVE: Uterine activity in women with dysmenorrhea is abnormal. Vasopressin induces the contraction of myometrium and leads to dysmenorrhea. Water load is an important factor in lowering vasopressin level. This study was done to investigate about the effect of water load on intensity of primary dysmenorrhea. METHODS: In two groups, intensity of dysmenorrhea at 0, 45, 90 and 120 minutes after onset of dysmenorrhea and during the first 8 hours in 59 women (18-25 years old) were measured. FINDINGS: In the case group (cycle with water load) the intensity of dysmenorrhea at 90th minute after starting of dysmenorrhea was significantly less than that in control group (cycle without water load). The rate of discomfort at the 45th and 90th minutes and duration of pain in the first 8 hours after starting of dysmenorrhea in case group was less than those in control group. CONCLUSION: Physiologically water load decreases vasopressin followed by decreasing intensity of pain and discomfort. As a result, drinking more water is recommended to women with dysmenorrhea.

OBJECTIVE: This study was done to determine the role of maternal obesity on pregnancy outcome in pregnant women at Amol Imam Reza hospital.METHODS: This study was done on 240 pregnant women in the age range 18-35 and at full term pregnancy with cephalic presentation of fetus that were equally divided into two groups (women with normal weight (19.8≤ BMI≤ 26) and obese women (BMI>26)). Their age, education, employment, parity, birth interval and their weight gain during pregnancy were equal in both groups. Data were gathered by questionnaires and then analyzed by statistical method. FINDINGS: The mean duration of the first, third and the whole stages of delivery in obese group was more than other group. Also, the mean duration of second stage was equal in both groups. But, there was a significant difference between two groups in the mean of total duration of delivery stages relevant to their weight gain during pregnancy (equal or more than 12kg). Oxytocin was used in obese women (64.2%) more than women with normal weight (44.4%). The mean of neonatal weight in obese women (3670.8±456.4g) was significantly more than that of women with normal weight (3511.7±452.7g). CONCLUSION: Pregnancy in obese women was considered as a high risk. Obese women should be under the care of a specialist during their pregnancy and delivery. In this way, duration of delivery stages and neonatal weight will be controlled.

OBJECTIVE: Pain is one of the most common signs of different diseases relief of which, is the primary aim of treatment. Use of cold is a simple and inexpensive technique. This study was done to investigate the effects of cold on sensory and pain threshold in 18-25 year old women. METHODS: This study was conducted on 35 normal females, none of whom had any sensory psychical problems. By using of electrical stimulator set (50 s, 100Hz), the pain and sensory threshold were measured at four stages from a point that was 5cm above the radial crease of wrist (Before using of cold , 15 and 30 minutes after using of cold). Ice- pack was used for using of cold. Data were analyzed by descriptive statistics and paired t-test. FINDINGS: The results showed that there is a significant difference between the mean of sensory and pain threshold before using of cold, 15 and 30 minutes after using of cold (p<0.001). CONCLUSION: Application of cold increases sensory and pain threshold significantly.

OBJECTIVE: Measurement of lipids and lipoproteins is important in screening, prognosis and treatment of myocardial infarction (MI). The purpose of this study was to determine the level of lipids and lipoproteins in normal subjects, acute phase and also two weeks after incidence of MI in stable phase.METHODS: This study was done on 130 normal subjects and 130 patients with MI. Triglyceride (TG), total cholesterol, HDL -C, VLDL-C and LDL-C were measured in normal subjects and in acute and stable phases. Systolic and diastolic blood pressure and frequency of risk factors such as smoking, familial hyperlipidemia, diabetes mellitus and familial history of MI were surveyed. T-test and chi - square test were done to analyze the results and p<0.05 was statistically considered significant.FINDINGS: Mean of total cholesterol, triglyceride, LDL-C, VLDL-C in stable phase in comparison to acute phase decreased but there was not a significant difference. Whereas, they were higher in acute and stable phases in comparison to control group (p<0.0001). Also, the mean of HDL-C in stable phase was higher than acute phase with no significant difference and it was lower in stable and acute phases in comparison to control group (p<0.001). The frequency of risk factors except smoking in females is more than in males (p<0.05). CONCLUSION: The results indicate that there is a decline in the plasma level of lipids and lipoproteins in stable phase. So, we suggest nutritional regimen and medication for patients with MI during and after hospitalization. Also, the role of sex should be considered in emergence of risk factors in stages of screening, prognosis and treatment.

OBJECTIVE: The coronary artery disease (CAD) is the most common cause of mortality and morbidity in developed countries. Since there is a relationship between dermatoglyphic pattern and some diseases, this study was done to investigate the relationship between dermatoglyphic pattern and myocardial infarction. METHODS: This study was done on 900 patients with myocardial infarction referred to hospitals in Babol, Sari and Gorgan. Biopsy was done on 900 persons without myocardial infarction as a control group. After diagnosing of type and location of myocardial infarction, fingerprints were taken and an expert explained samples in details. Then obtained results were statistically analyzed by Chi-square and Z- test. FINDINGS: The types of fingerprint were arch, loop and whorl in 7.2%, 46.8% and 46% of patients respectively. In contrast, in control group, they were 3.7%, 50.7% and 45.5% respectively. There was a significant difference between two groups in arch type. Also, there was an increase in arch type of fingerprint of left thumb, forefinger and ringfinger (p<0.0001).CONCLUSION: According to the results, there was a significant relationship between arch types of fingerprint and the incidence of MI, especially in left thumb, forefinger and ringfinger. Thus, a survey on dermatoglyphic pattern can be useful in early detection of persons who are susceptible to myocardial infarction particularly without risk factors of MI.

OBJECTIVE: Congestive heart failure and other cardiac complications are the most important causes of death in patients with beta thalassemia major. Iron overloads and chronic anemia are the major causes of cardiac involvement. The purpose of this study was to evaluate the ability of echocardiographic systolic function for diagnosis of cardiac involvement in patients with thalassemia major. METHODS: This descriptive study was done on patients with thalassemia major (over 12 years old) who referred to Booali Sina hospital in Sari. They were evaluated according to their ages, sex, age at beginning of transfusion of deferoxamine, the amount of deferoxamine, serum ferritin level, clinical manifestations, electrocardiogram, chest radiography and echocardiographic systolic function. Data was statistically analyzed by T-test.FINDINGS: 55% of patients were male and the average age was 18±6 years. 22% of patients had systolic dysfunction. The difference of ejection fraction and fractional shortening between patients with and without cardiac involvement was significant (p<0.0000). The age at beginning of deferoxamine and ferritin level in patients with cardiac complication was greater. The evaluation of cardiac function for determining cardiac involvement in patients with thalassemia major with respect to clicial manifestations had a specificity of 76%, sensitivity of 41% and efficacy of 68%. CONCLUSION: When the patient is clinically symptomatic, systolic functon will be impaired. Evaluation of echocardiographic systolic function is not enough for determining cardiac involvement in asymptomatic patients.

IgG that is produced by mammalian species can be replaced by obtained immunoglobulin Y from egg yolk. The egg yolk of immunized chickens is a rich and inexpensive source of specific polyclonal antibodies. Chickens respond to conserved mammalian antigens better, IgY doesn't react with rheumatoid factors, bacteria and mammalian FC receptors. It reduces false-positive cases. But, the major problem in isolation is removal of lipids, which are in high concentrations. Several methods could be used for isolation and purification of IgY from egg yolk such as water dilution and T-gel chromatography. IgY can be useful in immunodiagnosis and therapy.

OBJECTIVE: The cervical vertebrae are the most mobile segments of the vertebral spine. Since there are few supportive structures in our bodies, this part is more susceptible to traumatic injury. One of the most common injuries is facet fracture and dislocation that may be uni/bilateral. Primary treatment is a closed reduction with skull traction. In some cases the facets are locked and it is impossible to treat even with maximal closed traction. Open reduction by surgical intervention is a suitable way for treatment. METHODS: This retrospective study was done on patients with trauma of vertebral spine referred to emergency center during three years. This survey was done on 274 patients with trauma of cervical spine and 19 patients with locked facet syndrome. FINDINGS: From 19 patients, 12 were male and 7 were female. Falling from a high place was the most common cause of injury. It happened more in second and third decade of their life. The most common manifestation was neck pain. 12 patients had no neurological deficit, 4 patients had incomplete neurological deficit and 3 had completed neurological deficit. CONCLUSION: Different methods such as interspinous wiring, interfacet wiring and lateral mass plating were used for treatment.

OBJECTIVE: Histiocytosis - X (H-X) is more common in children who are under 12 years. It involves different organs such as bone, lung, liver, spleen and skin. The purpose of this study was to investigate about radiographic findings of patients with H- X that have been confirmed by pathology. METHODS: This descriptive study was done to survey radiographic findings on patients with H-X. We studied the files and graphs of 32 cases who were hospitalized in Mofid hospital (Tehran) during 1980-2000 with a confirmed pathological diagnosis after taking biopsy from different tissues such as skin, lymph node and bone. FINDINGS: From 32 patients, 29 cases had bone involvement with involvement of flat bones more common than long bones in which metaphyses of long bones were more commonly involved than diaphyses. Lytic lesion with a defined limit and without sclerotic margins was the most common radiologic finding. In 23 cases, among the flat bones, skull was the most commonly involved bone. Vertebral involvement as vertebra plana and bilateral destruction of mastoid were observed in 5 and 3 patients respectively. In 12 patients, pulmonary involvement was noted with reticulonodular involvement as the most common radiologic finding.CONCLUSION: In this disease, the bones especially flat bones were the most commonly involved. In long bones, the involvement of metaphysis was more than diaphysis.