JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2000 | Volume:2 | Issue:4 (8)|Papers Count:11

OBJECTIVE: For several surgical procedures spinal anesthesia is preferred to general anesthesia. However some of its most important effects are reducing blood pressure (hypotension) and heart rate. In this study, we evaluated the effect of prophylactic intramuscular ephedrine before spinal anesthesia. METHODS: This study was conducted on 100 cases in A.S.A class, I (American society of anesthesiologists) between 20-60 years old who had no co-existing disease. They were randomly divided into two groups (each with 50 cases). The test group received 2Smg (%5ml) intramuscular ephedrine 10-15 minutes before spinal anesthesia & the subjects in control group received 5ml normal saline (0.9% ) as placebo. After receiving 500ml Ringer's solution, spinal anesthesia with 2cc lidocaine %5 was done. Heart rate, systolic & diastolic blood pressure have been measured seven times before ephedrine or placebo injection, before spinal anesthesia & during the procedure at the 2nd, 5th, 15th, 30th & 4Sth minutes. Then data were recorded & compared. FINDINGS: In this study, those who received prophylactic ephedrine had a raised heart rate & blood pressure before spinal anesthesia, but this rise was not more than %10 of the baseline & there was no need to treat their hypotention or reduced heart rate during anesthesia or the operation. But %28 of control group has received ephedrine for treatment of hypotention & %36 of them received atropine to manage bradycardia. After statistical analysis & comparing of these two groups, we have seen that the range of fall of heart rate, systolic & diastolic blood pressure in the study group was narrower than that in control group & their differences were meaningful (p=0.000). CONCLUSION: The results show that the patients who have received intramuscular ephedrine before spinal anesthesia, have a rather higher level of hemodynamic stability. Therefore, in patients for whom hemodynamic changes, specially a reduced blood pressure is dangerous such as those with a heart disease, old patients or those undergoing caesarean section using of this method could be useful.          

OBJECTIVE: Caffeine consumption may reinforce and/or deteriorate memory and learning; this is related to the dose of caffeine. The effect of caffeine on retention and retrieval of memory in mice, by using of passive avoidance learning was investigated. METHODS: For this purpose after weighing, coding and grouping, the mice were examined as follows: a) Test group that received electric shock and caffeine (5mg/kg). b) Control group that received electric shock and saline (IP). c) Sham group that only received electric shock. The latency period for both retention and retrieval tests of memory in all three groups of mice were measured. Caffeine was injected immediately after an electric shock in the retention test of memory and 23, 30' hours after electric shock in the retrieval test of memory. FINDINGS: Obtained results indicate that caffeine (5mg/kg) reinforced retention of memory, but in comparison with control group, there was no significant difference and also it caused to reinforce retrieval of memory, but in comparison with control group, there was a significant difference. CONCLUSION: The results indicate that caffeine (5mg/kg) has no effect on retention of memory, but it reinforces the retrieval of memory.  

OBJECTIVE: Brucellosis is a common infectious disease in our country and it is frequently seen in children. Since different therapeutic methods for childhood brucellosis are suggested, this study was performed to evaluate the efficacy of co-trimoxazol and rifampine in the treatment of children with brucellosis. METHODS: This study was conducted on % cases of childhood brucellosis without any control group in Babol during 1995 to 1998. After diagnosis of brucellosis all patients were treated by co-trimoxazol and rifampine for six weeks, and then all patients were followed for 12 months. FINDINGS: From a total of 96 cases, 53 (55%) were male and 43 (45%) were female. Mean age was 10.3±3.4 year. The mean interval between presentation of the disease and the final diagnosis was 27±17 days. 82 cases completed the treatment and followed up for 12 month, and 2 cases (2.4%) had relapses. CONCLUSION: Combination therapy with co-trimoxazol and rifampin for six weeks is a good regimen with a low relapse rate, however further controlled trials must confirm these results.  

OBJECTIVE: Intrauterine insemination is one of the treatment methods for infertility. This study assesses the results of IUI in two groups which include of male factor infertility and infertility that is unexplained. METHODS: This study was done in the form of census on the bases of data in 223 files of infertile patients who referred to Fatheme Zahra fertility and infertility center of Babol. These data showed that clomiphene alone or clomiphene with HMG was used to induce ovulation for every patient. Then they were followed by vaginal sonography and after having at least one follicle (18 mm or more) they received HCG and finally after two weeks BHCG was done for pregnancy test. Then the analysis of obtained results were done by chi-square and T-tests. FINDINGS: 223 patients undergone with a total of 419 times of IUI. Of these, 134 had a male factor and underwent 234 IUIs , as a results 15 women were successfully conceived ( 11/2%for every patient and 6/4%for every menstrual cycle).89 patients in unexplained infertile group underwent 185 IUIs resulting in 4 cases of pregnancy and pregnancy rate for every patient was 4.2% and for every mentural cycle 2.1% . In 50 infertile patients with male factor whose sperm counts were under 10millions/ml. (severe oligospermia) there was only one pregnancy (0.7%). CONCLUSION: In treatment of infertile patients with male factor, specially those who without a severe oligospermia compared with unexplained infertile patinets, IUI and COH (controlled ovarian hyperstimulation) was more successful.    

OBJECTIVE: Aluminium phosphide (ALP) causes cellular death by releasing of phosphorus. This material is also a household fumigant insecticide used in rice bags. It is known as" rice tablet" in Iran. We studied ALP poisoning intensity in mice and tried to obtain antidote against that poison. METHODS: We used 20-30 gr white male mice in this study. Acute and chronic (24-48 hr next) poisoning effects of the ALP (10, 20, 40 mg/kg) on the heart, lung, kidney and liver were studied by a pathologist. All of the drugs were injected IP. Then data were analyzed with statistical methods. Difference with p<0.05 between data from experimental groups at each point was considered statistically significant. FINDINGS: The dosage of 40 mg/kg was considered as LD50 of ALP. The mice were exposed to this dosage died during 35±15 min. The pathologic reports showed that the most common changes were in the liver. The pretreatment of sodium selenite has not affected the mortality time, but it decreased the pulmonary and hepatic complications (edema and fatty changes, p= 0.028). NAC (50-100mg/kg) also improved the hepatic complications and prevented the hepatic necrosis (p=0.0002). It also delayed the mortality latency time till 138±13 hrs (p<0.001). There was a significant delay in mortality latency time between the groups received vitamin C (500-1000 mg/kg) and the control group (250±70 min vs 46±12, p<0.0005). CONCLUSION: Pretreatment of sodium selenite dose not improve the mortality rate except the pathologic results, but NAC delays the mortality time and improves the hepatic complications completely. There was no considerable effect for magnesium sulfate in our study.    

OBJECTIVE: Bacterial septicemia is one of the most common causes of neonatal mortality and morbidity especially in developing countries. The objective of the present study was to identify the bacterial agents of septicemia, detection of their resistance and consideration of other septicemic factors. METHODS: In order to find out the causative agents in Hamadan, a cross-sectional study was carried out on 620 neonates suspected of contracting bacterial septicemia. Antibiotic resistance tests were done by gel-diffusion method of kirby-Bauer. FINDINGS: The results indicated that 104cases of 620 blood cultures (16.8%) were positive, the most common isolated bacteria included; pseudomonas 26.9% , Klebsiella 25% , Staph aureus 14.4%, E.coli 13.5% and Staph epidermitis 7.7%. There was a high risk of infection among neonates weighing 1000-1500gr. The results of antibiotic resistance showed that gram - positive and gram -negative bacteria were sensetive to Ciprofloxacine and Ceftizoxime. CONCLUSION: This study showed that septicemia is one of the major problems in neonatal in our country, thus more professional vigilance is required.  

OBJECTIVE: Glycolated Hb is a valuable marker for identification and treatment of diabetics. It shows the mean of blood glucose level during the last 2-3 months. There are different methods (electrophoresis, colorimetry,...) for evaluation of this indicator with advantages or disadvantages for each. METHODS: This is a descriptive - analytical study that was done on patients referred to Shahid Beheshti hospital in Babol with their fasting blood samples collected. Also 30 persons were selected for evaluation of two methods (electrophoresis and colorimetly) for measurement of glycolated Hb in fasting and nonfasting conditions. FINDINGS: Mean of GHb by electrophoresis in fasting was 10.01% and in nonfasting was 11.04%. This marker by colorimetric method in fasting and nonfasting was 362.4 and 361.5 nmol/gHb respectively. The difference of GHb by electrophoresis between fasting and nonfasting conditions was significant (p<0.001), but for colorimetry was significant. CONCLUSION: GHb is a good marker of the mean value of glucose level for the recent 2-3 months of the individuals. Electrophoresis is a simple method, but regarding the findings taking the samples infasting is strictly recommended. Calorimetric method had not been influenced by the level of glucose at the time of sampling. But this method must be calibrated well.      

OBJECTIVE: Kidneys are major sites of erythropoietin production and in chronic renal failure (CRF), erythropoietin production decreases and leads to anemia. This study was done in children with different degrees of CRF and with primary disease of tubules and glomeruli. METHODS: In this study 45 children with CRF and glomerular filtration rate, less than 50 ml per minute for 1.73 m2 of body surface were divided into moderate, severe and end stage renal disease (ESRD). Serum hemoglobin and erythropoietin levels were evaluated with severity of CRF. FINDINGS: The mean of serum erythropoietin level in normal group were 10.9 mlu/ml and in moderate, severe and ESRD were 13.5, 9.7 and 9.1 mlu/ml respectively. Erythropoietin level in primary tubular disease was 13.9, 13.6 and 10.5 mlu/ml and in glomerular disease were 12.75, 7 and 7.5 mlu/ml. CONCLUSION: The comparison of hemoglobin and erythropoietin in these groups shows that the less the renal function, the more severe the anemia and there was not a significant difference in the level of serum erythro poietin in tubular or glomerular disease.  

OBJECTWE: Ovarian cysts rarely develop in female fetuses and they may be accidentally detected in a routine ultrasonography performed for evaluation of the fetal health condition during pregnancy. The formation of ovarian cyst in fetus accompanies severe stimulation of maternal and placental hormones. CASE: A 25 years old women in her first pregnancy that had a fetus with two cysts in ovary detected by ultrasonography. 4.5 months after delivery, these cysts were resolved spontaneously without any complication. CONCLUSION: We can follow this patient with bilateral ovarian cysts with conservative treatment (without surgery) and we recommend surgical management in an emergency situation (i.e. rupture or torsion of the cysts).