JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2005 | Volume:7 | Issue:2 (26)|Papers Count:19

BACKGROUND AND OBJECTIVE: In radiobiology, the most important physical radiation quantity to predict the effect of irradiation of a biological specimen is the absorbed dose to the tissue of interest. In this project an irradiation set up was designed and verification of set up and dosimetry procedure was performed to deliver a precise X-ray dose to the small field of rat cervical spinal cord.METHODS: AAPM-TG61 (American association & physician in medicine radiation therapy committee task group 61) protocol was used for dose measurement and we tailored a rat like phantom from polyethylene for dosimetry verification. The ionization chamber in this study was a farmer type and the X-ray generator was an orthovoltage Siemens machine working at 200 KVp potential. Dosimetry was done in air and phantom. An special jig was also built to fix the animals during irradiation which could help the treatments to be reproducible. Simulation and portal films were obtained to verify the irradiation field.FINDINGS: The average value of dose rate in specified geometries by measurement was 146.54 cGy/min (SD= 0.109). While the dose determined by calculation was 95.145 cGy/min (SD= 0.105), the comparison between these two methods shown a small discrepancy of 0.50% (p<0.001), which lies within the error limit of ± 5.3% as mentioned by ICRU.CONCLUSION: Using protocol of AAPM TG-61 can provide an accurate dosimetry with minimum ambiguity. Application of appropriate correction factors and protocols can increase the accuracy and decrease the irradiation errors in radiobiological studies

BACKGROUND AND OBJECTIVE: Hemodynamic changes following laryngoscopy and intubation of trachea is one of the main problems in anesthesia. Different methods and drugs are used to lower this problem. The aim of this study was to survey the effect of alfentanil, which is a short acting opioid on hemodynamic changes. METHODS: Hundred patients with ASA class I were divided into two groups of 50 patients. Both groups received diazepam 0.1 mg/kg, morphine 0.1 mg/kg and faxedil 20 mg/kg as premedication. Three minutes before induction, alfentanil group received 10 mg/kg alfentanil and control group received normal saline as placebo. Both groups received sodium thiopental and succinyl choline for induction. Blood pressure and heart rate were recorded before and after premedication, 1, 3 and 5 minutes after intubation of trachea. The data were compared together.FINDINGS: Changes in heart rate and blood pressure (systolic and diastolic) before and after premedication had no meaningful difference in both groups, but average of changes in heart rate and blood pressure in the patients in the alfentanil group after laryngoscopy and intubations were less and there was statistically significant difference. Homodynamic features in both groups after 5 minutes were stable.CONCLUSION: According to the results, alfentanil is effective in reducing heart rate and blood pressure (systolic and diastolic) after laryngoscopy and intubations of trachea. So, using alfentanil before laryngoscopy in general anesthesia is recommended.

BACKGROUND AND OBJECTIVE: Homocysteine is an amino acid with a free thiol (sulphydryl) group and is an intermediate formed during the metabolism of methionine to cysteine. Measurement of total plasma homocysteine may be of value in several clinical conditions including homocysteinuria, atherosclerosis, thrombophilia and folate/vitamin B12 deficiency. The purpose of this study was to measure total plasma homocysteine using RP- HPLC with fluorescence detection method.METHODS: Total plasma homocysteine was measured with reversed-phase HPLC with fluorescence detection after reduction of homocysteine with tris (2- carboxyetile) phosphine (TCEP) and derivatization of plasma thiols with ammonium 7- fluorobenzo-2- oxa 1,3- diazole-4- sulfonate (SBD-F). FINDINGS: The limit of detection for homocysteine was 0.2 µmol/l. The within day coefficient of variation (CV) was 2.67% to 4.56% and the between day coefficient of variation was 5.43% to 8.17%. The mean recovery of homocysteine was 93% to 103.4%.CONCLUSION: The results show that the HPLC method with fluorescence detection for measurement of total plasma homocysteine, is sensitive (the limit of detection 0.2 µ mol/l), accurate (CV between 2.67% and 8.17%) and it has acceptable recovery (93% to 103.4%). Therefore, it is confident method especially for investigate application.

Background and OBJECTIVE: The side effects of antinociception chemical drugs caused notice to medical plants. This study was performed to investigate the effects of hydro alcoholic extract of thymus vulgaris (TV) on neurogenic and inflammatory pain in formalin test in mice. METHODS: Forty male albino mice (20-30 gr) were used. TV (100, 500 mg/kg) as extract and saline were injected 30 min before formalin test. Indexes for evaluation were duration of licking and foot elevation for assessment of acute pain (5 min) and chronic pain (15-40 min) after injection of formalin 5% (25µl) in paw. FINDINGS: Results indicated that TV has analgesic effect in both doses (p<0.01), and higher dose (500 mg) was more effective. CONCLUSION: Findings showed that hydro alcoholic extract of TV can modulate acute and chronic pain. Further research is required to determine the mechanisms by which TV has an inhibitory effect on pain sensation

BACKGROUND AND OBJECTIVE: Hinosan and diazinon are organophosphorate pesticides with contacting and penetrating effect that are used in agriculture against rice blast. Therefore, with regard to high use of these pesticides in the north of Iran, their harmful effects and high rates of infertility that are increasing every year in Mazandaran province. This study was performed to determine the effects of hinosan and diazinon on sperm parameters.METHODS: This experimental study was performed on sperm samples of subjects who referred for semen fluid analysis (SFA). The sperms were affected by hinosan and diazinon (0.001&0.0001 concentration). The sperm number, motility and grading at the times of 0, 1, 2 & 4 were recorded. Data were analyzed by repeated measurement and compared with normal condition.FINDINGS: Hinosan and diazinon can reduce sperm motility by time (p< 0.05), but the increase of dose had not significant effect on sperm motility decreasing. During the study, changes in increasing of grade I & grade II was statistically significant (p< 0.05), but these changes were not significant in grade III.CONCLUSION: According to the findings, diazinon and hinosan can exert their reducing effects on number and motility of sperm as a time dependent profile. These effects are not dependent to the dose of the materials

BACKGROUND AND OBJECTIVE: Among all occupations, the highest rate of musculoskeletal injuries especially back pain is seen in nurses. The purpose of this study was to determine the prevalence of back injuries in nursing personnel and to study how individual and occupational characteristics affect it.METHODS: Following ethical approval, 1226 nurses were randomly selected from 13 hospitals in Mazandaran province in the north of Iran. Data were gathered by questionnaires included individual and occupational characteristics, prevalence of back pain, probable causes and its effects on nursing activities. FINDINGS: Point, one month, six month, one year and lifetime prevalence of LBP (low back pain) in nurses reported 51.5%, 56.3%, 58.9%, 59.6% and 62%, respectively. Lifting heavy things was the most common cause of back injury (30.4%). Prolonged standing and rest were found to be the significant aggravating and relieving factors, respectively (57.6% and 59.2%). Absence from work because of LBP during the last month was reported 33.7% of the sample. There was a significant correlation between the type of ward and LBP (p<0.001), the highest prevalence of LBP was in emergency ward and the lowest one was in NICU and urology ward. There was also a reverse correlation between job satisfaction and prevalence of LBP in nurses (p<0.001).CONCLUSION: The results demonstrate that the magnitude of LBP amongst nursing personnel appears to be high and associated with some occupational and individual characteristics. Therefore, more resources should be allocated to prevent such an injury in nursing profession.

BACKGROUNG AND OBJECTIVE: Cleft lip and palate is one of the most common human congenital craniofacial abnormalities with the side effects of middle-ear infections, hard of hearing, nutritional problems, speaking, and other societal burdens. The objective of this study was to assess the frequency of cleft lip and palate and its relation with sex, ethnic group, paternal and maternal age, consanguineous marriage and season in Gorgan during 6 years.METHODS: This cross-sectional study was done on 37951 births in Gorgans Dezyani hospital during 1998-2003. Sex, type of abnormalities, ethnic group, paternal and maternal age, consanguineous marriage, season and date of birth were recorded in questionnaires and data were analyzed by SPSS.FINDINGS: The prevalence of cleft lip and cleft palate was 0.97 per 1000 birth and it was more common in males (1.08 per 1000) than in females (0.86 per 1000). The rate of cleft was 0.86, 0.89 and 1.47 per 1000 in native Fars, Turkman and Sistani ethnic group, respectively. 29.7 percent of parents had consanguineous marriage. 29.7 percent of mothers with affected newborns consumed different drugs during pregnancy. The commonest rate was in winter and autumn. Maternal and paternal age was 35.5 and 28.5 years, respectively. Cleft was more common in 1998.CONCLUSION: This study reveals that incidence of cleft in Gorgan is much closer to European and East Asian countries. Consanguineous marriages and the toxicity of pregnant women with drugs or chemicals can induce cleft palate.

BACKGROUND AND OBJECTIVE: Atherosclerosis and its complications are a major cause of ischemic heart diseases. Platelets play an important role in initiation of atherosclerosis and coronary thrombus formation. Large platelets are shown to be hemostatically more active. Evaluation of platelet volume parameters could be useful and significant in prediction and differentiation of coronary events. METHODS: In this study, 100 patients with chest pain were divided into three groups according to clinical manifestation and standard diagnostic criteria. Twenty-five patients were with unstable angina, twenty-five patients with chronic stable angina and fifty patients with non-cardiac chest pain as normal population. Platelet indices and count were assayed within 1 to 3 hours, after sampling from venous blood and collection in K3 EDTA, by a Sysmex KX21 analyzer. Data were provided for each group and surveyed by ANOVA & Tukey tests with Pearson correlation and P- value less than 0.05.FINDINGS: Patients with unstable angina had a significant higher MPV (mean platelet volume) (l0.7±0.23fl), PDW (platelet distribution width) and PLCR (platelet- lerge cell ratio) than those in chronic stable angina and normal group (p<0.05). MPV in chronic stable angina patients (10.1 ± 0.2 fl) was higher than normal population (9.5± 0.1 fl), but platelet count and other indices were not statistically significant difference. There were no sex or age differences in MPV amounts in population group.CONCLUSION: Platelet volume indices are increased in unstable angina probably because of platelet activation and a compensatory volume enhancement. Platelets count reduction in this condition results from platelets consumption. These changes in platelet count and volume could differentiate unstable angina patients from chronic stable patients and normal individuals.

BACKGROUND AND OBJECTIVE: There are many causes in acute gastroenteritis that result convulsion such as fever, electrolyte imbalances, meningitis and sometimes toxins. The aim of this study was to evaluate the convulsion causes in these patients.METHODS: This prospective and descriptive study was performed on 34 patients with acute gastroenteritis and convulsion admitted in Amirkola children hospital during may 2002 to November 2002 on the basis of questionable titles. The patients were assessed according to fever, electrolyte imbalances, stool smear and culture.FINDINGS: In this study, 34 patients between 7 months to 10 years were assessed that 22 cases were male and 12 were female. Ninety seven percent of the ‍patients were febrile and the most of them had temperature below 39oc (70.5%). 11.7% had hyponatremic electrolyte imbalances that were equal in both sexes. The convulsion was more common in males than females (1.83 fold), exclusively generalized form and frequently in 2-3 years old (26.4%). 56% had lethargic decreasing level of consciousness, 79.4% of them hadn’t past history and 70% hadn’t familial history of convulsion. 53% had positive stool smear and 11.76% had positive stool culture (stool culture was exclusively shigellosis) and one case had positive blood culture (G+ Bacillus). CONCLUSION: The findings show that fever and electrolyte imbalances are two important factors of causing convulsion in the patients with acute gastroenteritis. Thus, management of these noting factors is important in prevention of convulsion.

BACKGROUND AND OBJECTIVE: Female suicide is an important indicator of cultural, social and legal improvement of women in different societies. Incidence of female suicide rate is low in societies in which women have proper individual, familial and social rights. This study was done to determine the incidence and causes of women suicide in Babol town.METHODS: This study was performed on 136 women attempt to suicide who referred to teaching hospitals of Babol University of Medical Sciences and burn center of Mazanderan province from Jan 2001 to Jan 2002. Data were collected by trained personnel and then analyzed by SPSS and X2 test.FINDINGS: Incidence of women suicide was estimated 60 per 100000 women population during one year. Rate of suicide under 20 years of age was more than other age groups (15.5%). Suicide was more in autumn and winter. Suicide rate of single women was as same as married ones. Acute crisis and familial problems were two main causes of suicide. Suicide was more in the afternoon and nights. Methods of female suicide were drugs (87.5%), poisons (6.6%) and self- burning (5.9%).CONCLUSION: High incidence of women and adolescents suicide, equality of suicide among singles and married and acute crisis and familial problems as main causes of suicide are indicated that preventive programs should be directed for young adults as target group and role of marriage as protection of suicide has been decreased.

Background and OBJECTIVE: Considering, the great importance of nasal morphology, it is important to define morphology and age changes of the nose objectively, instead of usual subjective definitions. Objective description of morphology and age changes of the nose (and other facial structures), support diagnosis and clinical practice of nasal morphologic abnormalities (and other facial dysmorphic signs). In addition, it enables to define standard sizes of nose and other facial structures in some syndromes (medicine) as well as in some human races (anthropology). Methods: In this study, four parameters including distance and angular measurements were done on frontal and profile photos of 100 normal Tehranian children aged 4-14. The indices have been shown by a scatterplot for each parameter separately to indicate dispersion of values and the age changes. Data were analyzed by Excel and scatter plot was plotted and regression line and correlation coefficient was determined for each of them. FINDINGS: The results, present clinical and objective description of morphology and age changes of the nose of Tehranian normal children. Normal range and abnormal sizes for each parameter is presented. With increasing age, nasal root gets more prominent (r =-0.54), length of the back of the nose increases (r = 0.60), nasal base gets more inverted (r = 0.45), and interalar distance increases (r = 0.23).Conclusion: Based on the results, using this method enable to define normal (standard) and abnormal sizes of facial structures in population of some human races as well as some facial dysmorphic syndromes, and support the diagnosis

BACKGROUND AND OBJCTIVE: Homebirth leads to reducing medical interventions, inducing parent-neonate attachment and breast-feeding encouragement. This study was performed to assess the knowledge, attitude and propensity of pregnant women regarding homebirth.METHODS: In this study, five therapeutic and health centers were selected. Sampling was randomly done on 220 pregnant women by questionnaire. FINDINGS: In this study, most pregnant women (58%) had average knowledge toward homebirth. There was a statistically significant relationship between knowledge with educational level but did not show a significant relationship with other individual characteristics. 76% had neutral attitude and only 4% had positive attitude to homebirth and also most of them did not show any attitude to homebirth (79.1%). Attitude and propensity had not relationship with any individual characteristics of subjects. However, there was a statistically significant relationship between knowledge with attitude and propensity and between attitude and propensity. CONCLUSION: According to the results, improvement of knowledge and more correction of attitude to homebirth should be planned by educational programs and inducing motivation to increase knowledge that will be due to improvement in practice

BACKGROUND AND OBJECTIVE: Pathology of hirschsprung’s disease is a ganglionic colon, and the most common symptom is chronic constipation. Surgical intervention started with stages pull-through from last decades, but since 1980, many pediatric surgeons have performed one stage pull-through with excellent results. METHODS: From 1992 to 1998, 40 patients with hirschsprung ’s disease who were divided into two patient groups (20 patients in each group) operated with different stages (Swenson) and one-stage pull through procedures in Mofid children’s hospital and the results of these two procedures were compared with each other. FINDINGS: Six years evaluation reveals one stage pull-through takes less time, has less cost, short staying in hospital, less complications and earlier recovery than stages procedures. CONCLUSION: One stage pull-through in HD is a safe and effective procedure, but most important point is patient selection.

BACKGROUND AND OBJECTIVE: A lot of organisms including parasites cause damages to the fishes. Ligulosis is one of the most common parasitic infections and is economically the most important fish diseases in sweet water. This study was performed to introduce the cases of river whitefishes infected by ligula intestinalis parasite. CASES: Fifty river whitefishes (Rutilus rutilus), which had been hunted from Aras dam prepared from Babol fish market and transferred to parasitology department of Babol medical school. For more investigation, the samples were kept in 10 percent formalin. On average most of these fishes had 4 to 5 numbers of plerocercoid larvae that their size was on average 30 ± 5 centimeters. CONCLUSION: This parasite has been known to infect aquatic animals especially breeding fishes that many scholars in the world reported it and there are some reports from Iran. The important point is the toxin produced by this parasite, which causes special physiologic side effects in fishes such as infertility, reduction of body weight, pale and etc and this toxin can be harmful for human health.

BACKGROUND AND OBJECTIVE: Ventricular septal defect (VSD) is one of the mechanical complications after acute myocardial infarction (AMI). VSD was recognized by color Doppler echocardiography. The aim of this report was early diagnosis of this complication after AMI with echocardiography and its relation with thrombolytic therapy.CASES: The first patient was a 54 year old man who presented to emergency ward with chest pain and he was admitted to CCU with diagnosis of acute anterior AMI and received streptokinase therapy (SK), he had a systolic murmur with thrill in LSB (left sternal border) and had moderate size muscular VSD with echocardiography. Second patient was 66 year old woman who presented with chest pain and she was admitted to CCU with diagnosis of inferior MI and anterior Ischemia at distance. She had pan systolic murmur with thrill at LSB and had muscular type VSD with echocardiography. Third and forth and fifth patients who were 75, 80 and 52 years old, respectively were referred with chest pain and with diagnosis of AMI, they had systolic murmur with thrill at LSB, diagnosis of VSD after AMI was confirmed with echocardiography and fifth patient received SK. Selective coronary angiography, cardiac catheterization and oxymetry were done. CONCLUSION: VSD is one of important complication of AMI. They were recognized with physical examination and echocardiography. Thrombolytic therapy accelerates the time from AMI to VSD formation.

by tracheal stenos is, tracheoesophageal–fistula and tracheo-innominate fistula. This report presents a 22-year-old man with post intubation tracheal stenosis and tracheoesophageal fistula, following long term intubations and simultaneous repair of tracheoesophageal fistula with a good result.CASE: The patient after car accident in comatose state was incubated and connected to ventilator for 3 weeks. Ten days after intubations, tracheotomy was performed on him. During this time, his nutrition was done by nasogastric tube. With beginning oral route nutrition, there was cough with each swallowing. In bronchoscopy there was mucosal inflammation and tracheal rings destruction in 3 cm below the vocal cords, with 2.5-3 cm in length that was accompanied by tracheoesophageal–fistula in the tracheal membranous wall. Because of dyspnea and tracheal stenosis, it was decided to resect the destructed part of the trachea and end- to- end anastomosis with fistula repair.CONCLUSION: In the presence of tracheoesophageal–fistula, correct judgment, pre- and postoperative cares are the key factors in the outcome of patients. Proper calorie calculation for the patient (enteral route) and simultaneous repair of tracheal stenos is are the secret of the success in the surgery of these patients.