JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2002 | Volume:4 | Issue:3 (15)|Papers Count:15

BACKGROUND AND OBJECTIVE: Midazolam is the only drug of benzodiazepine category that because of its fast effect and least cardiovascular complications is used for induction and maintenance of anesthesia. Also, halothane is the most common drug for maintenance of anesthesia with some complications that causes a tendency to use IV anesthesia. This study was done to determine the effect of midazolam and halothane on hemodynamic changes in maintenance of anesthesia. METHODS: This study was conducted on 100 cases (16-60 years old) in ASA class I (American society of anesthesiologists). They were randomly divided into two groups (each group 50 persons). Subjects in both groups were administered with premedication and induction of anesthesia with an equal dose according to their weight and then tracheal intubation was done. For the maintenance of anesthesia, control and case group received halothane (0.5-1%) and midazolam (1µg/kg/min), respectively and both groups received N2O and oxygen (50%) equally. Heart rate, systolic and diastolic blood pressure were measured and recorded after premedication, 1 min after induction and every 10 min during 90 minutes and then data was compared.FINDINGS: According to the obtained results, the changes of heart rate and systolic and diastolic blood pressure in midazolam group was less than halothane group and there was not a statistically significant difference. The range of systolic and diastolic blood pressure changes in midazolam group in comparison to halothane group was less and it was statistically considered significant ( p< 0.05). Emergence from general anesthesia in midazolam group was less than halothane that this difference was meaningful (p= 0.01). CONCLUSION: Hemodynamic changes in maintenance of anesthesia with infusion of midazolam in comparison to halothane were similar or less. If it is necessary, continuous infusion of midazolam can be used instead of halothane with regard to its some complications.

BACKGROUND AND OBJECTIVE: Human- derived antibodies, which are prepared by expensive methods are used in diagnosis, prophylaxis, and treatment of diseases. The aim of this study was to develop an effective and inexpensive method for purification of human serum immunoglobulins. METHODS: Human serum immunoglobulins were precipitated by ammonium sulfate (50% saturation) and then purification was done by thiophilic chromatography (T-gel). Purification of antibodies was evaluated by cellulose acetate electrophoresis. Concentration of antibodies (IgG, IgM, IgA) in serum and the resulting pooled fractions were estimated by single radial immunodiffusion (SRID) and percentage of recovery was calculated. FINDINGS: Analysis of products by electrophoresis showed only one band in γ-region. Recovery of the purified IgG was 75% while that for IgM was considerably low (about 17%). CONCLUSION: The purified immunoglobulins were eluated by a low salt buffer closely neutral pH, thus post treatment of product was not necessary. Thiophilic chromatography causes the purification of immunoglobulins at a stage after ammonium sulfate precipitation. The purified immunoglobulins in this study could be suitable for immunochemistry methods.

BACKGROUND AND OBJECTIVE: Parkinson is a common disease that caused by degeneration of nigrostriatal dopaminergic pathways. Drug therapy can prevent movement disorders in patients and so they can do independently their daily activities. Many drugs are used for treatment of this disease. This study was done to compare the effect of bromocriptine and selegiline in parkinson s disease.METHODS: 77 outpatients (50 were male and 27 were female) with the mean age of 65 years were selected and followed for a three year period. The patients were divided into three groups: levodopa and trihexyphenidyl were administered to all groups but in second and third groups they were given selegiline and bromocriptine, respectively. The patients were evaluated on the basis of United Parkinsons Disease Rate Scale (UPDRS) and consequent visits. FINDINGS: In this study by considering motor scale, third group in comparison to first group was in a better condition. At first, second group (selegiline) in comparison to first group was in a better condition but by passing a period of time this difference was statistically non- significant. The rate of side effects especially dyskinesia in third group was low. CONCLUSION: According to the results, bromocriptine as an adjunctive drug is used for treatment of parkinsons disease with levodopa and in comparison to selegiline is more effective.

BACKGROUND AND OBJECTIVE: The control of pain in dentistry is one of the important aims. Up to now, some drugs such as non- steroidal anti inflamatory drugs (NSAIDs), acetaminophen with or without codeine have been used for this purpose. With regard to the effect of caffeine in increasing of the stomach acid secretion and intestinal movements, it seems that caffeine can increase the absorption of acetaminophen with and without codeine.METHODS: This experimental study was performed by simple sampling method and as double blind on 60 patients with acute apical periodentitis due to disease and necrosis of pulp. Drugs and groups were as follows: 1- Acetaminophen (325 mg) + placebo powder2- Acetaminophen (325 mg) + caffeine (1mg)3- Acetaminophen codeine (325.15 mg)+ placebo powder4- Acetaminophen codeine (325.15 mg) + Caffeine (1mg)Only a single dose of drugs was randomly administered to each patient. The rate of the pain was recorded on the form by using visual analogue scale method (numerical 0-10) every 10 minutes for 120 minutes. FINDINGS: The process of decreasing pain intensity was different in four groups but this difference was not statistically significant. In the analysis of two combined drugs, the group with caffeine showed better responses in decreasing the pain. Although, there was not a statistically significant difference. CONCLUSION: According to the obtained results, it seems that adding caffeine to acetaminophen can induce similar effectiveness with acetaminophen with codeine in control of the pain due to apical periodentitis.

BACKGROUND AND OBJECTIVE: With regard to increasing of the mean age of human being, elderly population makes an important group of society. In addition to dental problems and periodontal diseases that occur in the elderly, different diseases also affect on their oral mucosa. The purpose of this study was to evaluate the most common oral mucosal lesions which occur in institutionalised elderly population. METHODS: This descriptive and analytical study was done on 275 old people (over 65 years old) who lived in Kahrizak geriatric institute in 2000. Data was gathered by questionnaires and analysed by statistical chi-square test and SPSS soft ware. FINDINGS: 84% of studied subjects had at least one oral mucosal lesion. The most common lesions were as follows: varicosity (44.7%), denture stomatitis (18.2%), varices (17.8%), hyperplasia in the maxilla induced by denture suction (13.8%). Oral mucosal lesions and prevalence of varicosity in males were more than females. Prevalence of denture stomatitis, hyperplasia in the maxilla induced by denture suction, epulis fissuratum and traumatic ulcers in females were more than males. Oral mucosal lesions in removable denture wearers were more and traumatic ulcer have been seen in removable denture wearers more than non wearers. Oral mucosal lesions, varicosity and varices in tobacco users were more common than non tobacco users (p<0.05%). Most of lesions were found in tongue (36.1%) and then in palate (19.4%).CONCLUSION: Increasing of age, using tobacco for a long time and also poor oral hygiene which are related to inability of the elderly, cause some oral lesions to occur. It seems that pay attention to oral and dental problems of elderly people can decrease their oral lesions.

BACKGROUND AND OBJECTIVE: The aim of dental care is improvement of oral health. Although the radiography is useful in detection of diseases, but it can be harmful because of its Ionization ray. The objective of this study was to evaluate the knowledge and practices of general dentists and giving them further information about proper prescription of radiography. METHODS: This descriptive, cross- sectional and analytical study was done on all general dentists in Babol during 2001. A questionnaire was prepared on the basis of questions about prescription of different kinds of intra and extra oral radiography and also some questions about their occupational experiences and University where they were graduated. Data was analysed by SPSS soft ware, chi- square and T-test. FINDINGS: From 65 general dentists, 19 (29.2%) were female and 46 (70.8%) were male. The average score of their knowledge and practices in females (8.6 and 15) was higher than males (7.7 and 14.2) (p = 0.358 and p = 0.023, respectively). The knowledge scores of graduated dentists from famous Universities (Tehran, Shahid Beheshti, Mashhad, Isfahan and Shiraz Universities) in comparison to other Universities was lower ( p= 0.878) but the score of practices was equal in both groups (p= 0.99). The score of knowledge and practice of dentists with 10 years experience or more in comparison to those with less than 10 years experience was higher (p = 0.545, p =0.33, respectively).CONCLUSION: It seems that some dentists do not pay enough attention to correct principles of radiography prescription so with continuous instruction, they should be familiar with new guidelines.

BACKGROUND AND OBJECTIVE: Nephrotic syndrome (NS) is one of the kidney diseases in children that was with high mortality and morbidity before starting of management with corticosteroid (CS). Of course, some patients are resistant to CS and do not respond to CS. This study was done to evaluate the resistance and responsiveness to CS. METHODS: This analytical study was done on all patients with NS disease who admitted in Amirkola children hospital during 1994-2001.These patients were treated with 60 mg/m2 of prednisolon for 4 weeks and then response to CS was evaluated.FINDINGS: Among 73 patients, the ratio of female to male was 1.6 to 1 and most of patients were at the 2-8 age group and were involved in winter (p=0.012). 74% of patients responded to CS, but 26% were resistant to CS. The most responsiveness to CS was at the 2-8 age group (89%). There was not a difference between females and males for response to CS. CONCLUSION: In this study, response to CS in children with NS was the same with those in some areas and different to others but like other studies, children at the 2-8 age group were involved. Therefore, it is recommended that every patient in this age can be treated with CS without using other invasive diagnostic procedure.

BACKGROUND AND OBJECTIVE: Making a suitable program for giving mental health services to mental patients needs a knowledge about the presenting problems in the society. The objective of this study was to determine the epidemiology of mental disorders in people over 15 years in rural and urban areas of Qom in 2000. METHODS: The cases were randomly selected by cluster sampling method among families who were under supervision of Qom health centers in 2000. The questionnaires of symptoms checklist - 90 - revised on 391 cases were completed by clinical interviewing and diagnosed on the basis of DSM IV criteria. The cut off point for SCL- 90- R was scored 64 which showed 87.9% of sensitivity, 90.4% of specificity and 9.1% of overall misclassification rate. FINDINGS: According to the results, 67 cases (17.1%) suffered from different kinds of mental disorders (37 (18.2%) were female and 30 (16%) were male). Prevalence of mood, anxious, adjustment, somatoform and paranoid disorders were 5.8%, 4.9%, 3.3%, 2.8% and 0.3% respectively. The most prevalent symptoms were related to mood, headache and incontinence towards others and the least symptoms were faint in front of others and tend to break the things.CONCLUSION: The results of this study showed that the prevalence of mental disorders in females were more than males and in urban people was more than rural ones. Also, prevalence of mental disorders in the people aged 25-44 years, singles, people with diploma degree and higher education, unemployed men, housewives and large families were more than others.

BACKGROUND AND OBJECTIVE: Cardiopulmonary resuscitation in emergency and cardiac care unit due to some problems for medical team including nurses. The objective of this study was to determine the individual problems of nurses working in cardiac care unit and thus with recognizing these problems, the manner of care will be done better. METHODS: Data regarding demographic characteristics and different parameters of all employed nurses (68 persons) in emergency and cardiac care units of Babol hospitals were gathered and surveyed by questionnaires and then compared by Fisher exact test, Chi square and Cochran tests.FINDINGS: In this study, over half of these nurses had problems. There was not a significant difference between individual problems of nurses in emergency and cardiac care units on the basis of questions related to knowledge, skills and experiences but this difference was meaningful about some questions related to motivation, attitude and supporting of persons who were responsible (p<0.05). Also, there was not relationship between individual characteristics of nurses who worked in two wards and their problems. Furthermore, with omitting all individual characteristics and problems, statistical test did not show any significant difference. CONCLUSION: According to this study, interruption between knowledge and application in some cases makes some problems. Also, some attitude and motivated problems during their duties in hospital are effective in efficiency, practice and decision of nurses in cardiopulmonary arrest.

BACKGROUND AND OBJECTIVE: Puberty is the most important stage of ones life. Physical and psychological changes occur in this period of time. It should be paid more attention to problems of the girls at the age of puberty, otherwise this changes in future may affect on their health, knowledge and self confidence. This study was done to determine the effect of education on the rate of knowledge and practices of female students about puberty health in Amirkola highschool in 1999. METHODS: This interventional study was performed on 250 female students who were randomly selected. Data was gathered by questionnaires at two stages before and after instruction. Educational program was as speech, using blackboard, asking and answering, and educational pamphlets.FINDINGS: According to the obtained results, the education of puberty health had positive effect on the rate of knowledge and practices of students (p=0.000). Also, there was not a significant relationship between the knowledge and practices of students about puberty health and their individual characteristics such as age, habitation, parents job and education. CONCLUSION: This research showed that giving hygienic instruction had a remarkable effect on their health knowledge and practices. Therefore, it is necessary all girls be informed about their puberty health by their mothers, school health manager and personnel of health centers.

BACKGROUND AND OBJECTIVE: Neonatal adrenal hemorrhage is frequently accompanied with large fetal size and fetal hypoxia. The incidence of this disease is 1.7-1.9 per 1000 births, with a variety of clinical manifestations such as abdominal mass, jaundice and hypotension. The aim of this report was to present a case with profound neonatal jaundice with bilateral adrenal hemorrhage which rarely occurs. CASE: A male newborn with a birth weight of 3900 gr and gestational age of 36-38 weeks was born by normal vaginal deliver (NVD). He was big for gestational age neonate and developed to profound jaundice and bilateral adrenal hemorrhage which required exchange transfusion for six times. CONCLUSION: Adrenal hemorrhage should be considered in profound neonatal jaundice with unknown etiology.

BACKGROUND AND OBJECTIVE: Cholinergic syndrome (cholinergic crisis) is an extremely dangerous complication of anticholinesterase drugs such as neostigmine. Isolated forearm technique (I.F.T) with IV injection of neostigmine is used for the evaluation of awareness which is an deliberate problem in narcotic based anesthesia. This method is used for evaluation of ischemia of the anterior spinal artery and weakness of upper extremity motor after operation of cervical spines.CASE: The case was a 43 year old woman with dislocated C1- C2 fracture who was candidated for cervical spines surgery. After I.F.T, induction of anesthesia and tracheal intubation (muscarinic and nicotinic) cholinergic symptoms of crisis were developed that the cause of this presentation was I.F.T with injection of neostigmine. CONCLUSION: Since, the evaluation of awareness is not so predictable by I.F.T procedure, it is recommended to use other modern techniques such as bispectral index, nerve stimulators and evoked potentials.