Armaghane Danesh
Year:2005 | Volume:10 | Issue:4 (40)|Papers Count:14

Introduction & Objective: Rhinoplasty is the most common surgery in the facial plastic surgery. We suspect to have a lot of personality disorder in the rhino plastic patients, so we design this study for finding the relationship between rhino plasty and personality disorders. Material & Methods: This study were done on a group of 60 patients had referred to Amir ـ Aalam hospital in Tehran for rhinoplasty and a group of 60 persons in were in Amir ـ Aalam hospital for other purposes as a control group. Two groups were same age, gender, economy and educations. We have done this study with Minnesota personality test (MMPI). Results: We find out Iranian rhino plastic patients have three personality disorders, compare to control group. Immature personality were found 21.6% in rhino plastic patients compare 1.6% in control group (p<0.01). Seclusion 18.3% in rhino plastic patients compare to 3.3% in control group (p<0.05). Hypochondrias is 20% in rhino plastic patients compare to 6.6% in control group (p<0.01). Conclusion: Personality disorders are very common in rhino plastic patients and knowledge about personality of patients before operation is very important. We recommend study about personality of patients before every rhino plastic surgery.

Materials & Methods: In this study 3749 individuals (1911 male and 1839 female) were selected by cluster sampling and were interviewed using a questionnaire. Results: Results of this study showed that 40.7% of the studied people were familiar with drugs (20% familiar and 20.7% fairly familiar), and 1.7% of them have been using drugs. The most common types of drugs among drug users was opium (85.9) which was used in a traditional form (using opiumsmoker's pipe). It was found that the drugs have been introduced to drug users by their friends for the first time and their friends have provided the drugs for them. Our findings showed that the highest rate of drug using was in Gachsaran (2.8%) and the lowest rate was in Boyerahmad (1.3%). Also it was found that drug using among adolescents was more than in the other age groups (2.6%). These results indicated that the most useful method for families to prevent the youth and adolescents from drug addiction were: parent knowledge, parent–child relationship (27.3%) parent control of child behaviours (34.6%) and providing a peaceful and quite place at home (24.4%). The most appropriate educational method for preventing drug abuse was found to be media (33.6%) and among media, TV education (45.4%) was stated to be the best. Changing the rules about drug abuse campaign was emphasized (46.2%) for drug abuse prevention. The subjects in this study stated that the most appropriate method for punishing drug abusers and drug suppliers were imprisonment (39.3% and 37.5%), and execution (21.4% and 32.9%), respectively, and the most important method for punishment of drug smugglers were execution (53.2%) and imprisonment (27.1 %). In this study the most effective social method for drug-abuse prevention was stated to be providing the entertainment, cultural and educational facilities for leisure  time (39.7%), providing the sports facilities (33.4%).The most effective economical method for preventing drug-abuse was mentioned to be providing jobs for unemployed people (41.9%), campaigning against robbery and corruption and discrimination (33.6%).  Conclusion: The recommended measurements for preventing drug addiction were as fallows: employment of young adults, closure of boundaries to prevent drug imports. Considering the result of this study, it would be difficult to point out the most effective and important method for preventing drug addiction. Differences in personal profiles, problems, attitudes, behaviors and beliefs about drug-abuse seek a multidimensional approach for this problem. Contribution of families, society and authorities are needed to tackle this problem. Public and family education is a social vaccine which improves the immunity of society. Appropriate punishment of drug-users, drug suppliers, and drug smugglers make it difficult to find the drug easily. Employment of young adults, providing entertainment and sports centers would be effective in prevention of drug addiction.

Introduction & Objective: Propofol is an ultra short acting non barbiturate I.V. anesthetic used for induction and maintenance of anesthesia. It can also be used for sedation purposes out of the operating rooms but its usage is limited because of pain feeling at the time of IV injection. The etiology of pain is unknown but the phenol may cause pain from a local irritated vein. Pain maybe resulted from indirect action kininogens released from endothelium which trigger painful stimuli in the nerve endings ought to also be considered. The aim of the present study was to evaluate the effect of ephedrine on reducing pain in order to extend its usage as a useful and safe anesthetic at the time of anesthesia induction. Material & Methods: This is a placebo controlled double blind study performed in educational and the therapeutical centers of Tabriz University of Medical Sciences. One-hundred patients with ASA class I (classification of physical status by American Society of Anesthesiologists) were randomly selected. All the patients were monitored with an ECG, pulse oximeter and an automatic NIBP and a 20-gauge canula inserted in to a vein on the dorsum of the hand. Patients were divided into two groups. Group one (control group) received 2 ml normal saline and group two received 50 µg/kg ephedrine diluted with normal saline to 2 ml, 30 seconds before propofol administration (2mg / kg) by a person who was aware of the contents of the labeled syringes. During administration, the intensity of pain was assessed using VRS (Verbal Rating Scale). Vital signs were recorded one and three minutes after induction. Collected data were analyzed by Man Whitney, t-test and chi-square. Results: Mean age of the patients was 29.74±7.69 years. From the point of pain intensity, 30 of patients in control group suffered from moderate pain and 19 from mild pain. Only one of patients in case group did not experience pain. These parameters in study group were 0, 10 and 40 respectively (p<0.001). There was no correlation between sex and pain feeling. Differences in duration of pain sensation were statistically significant in two groups (9.49±2.34 versus 6.20±20.9). Changes in blood pressure and heart rate one and three minutes after induction of anesthesia, except for systolic BP one minute after induction, were also statistically significant in studied groups (p<0.001). Tachycardia in case group, 3 minutes after,   was significant compared to control group (p<0.001). Conclusion: Use of ephedrine before propofol administration can decrease or prevent feeling of pain. It also can prevent blood pressure and bradycardia after its administration. Considering these findings and needs for development of outpatient surgeries, and also decreasing the exposure of anesthesia team to anesthetic gases, propofol which is a relatively safe and useful anesthetic can be used, with more satisfaction and confidence, for anesthesia induction.

Introduction & Objective: Brachial plexus block is the most popular peripheral neural blockade that can take action in many anatomic locations. Surgical procedure can be performed on this block upon elbow, hand and forearm. Serveral studies noted that adding chemiclas such as epinephrine and narcotics to local anesthetics enhance the quality and duration of anesthesia. The aim of this study was to compare the effects of fentanyl added to lidocaine for axillary block on duration of anesthesia. Material & Methods: This is a double-blinded clinical trail, which performed on 60 patients with ASA class I and II that scheduled for elective hand and forearm surgery. This study was performed in Tabriz Shohada hospital in 2004. All patients received 400 mg of 1% lidocaine injected into the brachial plexus sheath. Patients were randomly assigned into two groups. The patients in control group were given lidocaine and patients in study group received lidocaine containing 1 ml fentanyl (50 μg). Sensory and motor blockade were evaluated by using apinpriek, pinch and by measuring pushing and pulling force, respectively. Date were collected by a questionnaire and analyzed with SPSS software using, chi-square test and independent sample analysis. Results: Differences in age and gender of patients in both groups were not statistically significant. The duration of the sensory blockade increased in study group (176.20 ±13.63) compared with control group and these changes were statistically significant (121.17 ± 9.36, p<0.001). However, onset time of analgesia was prolonged by adding fentanyl to blachial plexus block (14.73 ± 2.50 in control group versus 21.24 ± 2.76 in study group, p<0.001). Conclusion: Addition of fentanyl to lidocaine significantly increases the duration of brachial plexus blockade, but delays the onset of analgesia.

Introduction & Objective: Cardiovascular diseases represent the number one of causes of death in the United States. In addition to traditional medical treatment, alternative pharmacotherapy, such as the use of vitamins, has been studied or tried by patients suffering from cardiovascular diseases. Antioxidant vitamins are the most frequently used medications in this regard. The aim of this study was to investigate the effect of vitamin E or combination of vitamin E and vitamin C on blood cholesterol, triglyceride, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) of patients undergoing lovestatin treatment. Materials & Methods: In a clinical trial, 93 hyperlipidemic patients were chosen and assigned in one of three drug groups. Group one received lovastatin plus placebo tablets. Group two received lovastatin plus vitamin E (400 IU), and group three lovastatin plus vitamin E and vitamin C (1000 mg) per day. Blood cholesterol, triglycerid, LDL, and HDL were measured before and following 10 weeks of medication. Results: Following 10 weeks of drug use, blood cholesterol, triglycerid and LDL were less and HDL was higher than these parameters at the beginning of the study. Comparison of results between three groups showed that the studied parameters were not different in group three compared with group two, except for LDL. Conclusion: Adding antioxidant vitamins, particularly vitamin E, to medications of hyperlipidemic patients might be beneficial to these patients.

Introduction & Objective: The subcutaneous mycoses are infections involving the dermis, subcutaneous tissues and adjacent bones. These infections are usually acquired as a result of the traumatic implantation of organisms that grow as saprobes in the soil and plants. These infections developed most frequently among the rural populations of the tropical and subtropical regions of the world. The aim of this study was to determine the prevalence of subcutaneous mycoses and their causative agents in Fars province. Materials & Methods: Samples were taken from the patients suspected of subcutaneous mycoses with sever, chronic, suppurative and non healing lesions who referred to dermatology clinic of shiraz. Samples were cultivated on Sabouraud dextrose agar, Mycosel agar, BHI agar and blood agar supplemented with Chloramphenicole 200 mg/L, Penicillin 200000 IU/L and Streptomycin 0.3 gr/L. The cultures incubated at 25 and 37°C for at least six weeks. Fungal species were identified by traditional methods and chromagar candida media. Results: During three years, 93 patients suspected of subcutaneous mycoses were enrolled and no cases of deep mycoses were identified. Other fungal infections such as spergillosis (one case), candidiasis (one case) and nocardiasis (2 cases) were detected. The etiological agents of phaeohyphomycosis and hyalohyphomycosis were isolated by culture in five cases but their infections were not confirmed by direct or histopathological method. Conclusion: Fars province belongs to the tropical areas of Iran and the occupations of most of the people gardening, agriculture and animal breeding, which make them prone to subcutaneous mycoses. Scarcity of these diseases is the major cause of hidden cases.

Introduction & Objective: There are several indicators for determination of health status and one of the most important one is birth weight of newborns which is connected to nutrition quality, care during pregnancy, maternal health quality, growth trend, and natural development. The aim of this study was to find out the effect of maternal risk factors, especially domestic violence, on birth weight of infants in Kohgiloyeh and Boyerahmad during 2004-2005. Material & Methods: This is a prospective case control study. The case group consisted of 318 mothers having infants with birth weight less than 2500 and the control group consisted of 318 mothers having normal weight at birth. This study curried on the regions urban and rural Kohgiloyeh and Boyerahmad province from March to September 2005.  Data were collected using a questionnaire and via interview. Statistical analysis was performed using T test, ، binary logistic regression, especially multiple logistic regression models. Results: The mean of birth weight was 2217±324g in case group and 3390 ±392g in control group and the mean of birth height was 46.7±4cm in case group and 49.7 ±3 cm in control group. In multiple regression model, five variables showed significant correlation with birth weight which were include: multiparus [OR = 50,( CI (6.5 – 84.3)], gestational age (weeks)   [OR = 5.9, CI (2.69 – 12.92)], interval between pregnancy (year) [OR = 0.46, CI (0.29 – 0.72)], birth order [OR = 0.38, CI (0.25 – 0.57)], physical violence [OR = 3, CI (2 – 4.21)]. Conclusion: A strong correlation was found between gestational ages of pregnancy with LOW. The mean of birth weight rise with increasing of birth order. Considering the type of violence, only physical violence in multiple logistic regression models had a statically significant relationship with low birth weight.

Introduction & Objective: Identification of Lieshmania is based not only on external characteristics, but also on some internal characteristics including molecular structure of the organism. It is necessary to perform these tests with 1010 organisms. In vitro mass cultivation of Leishmania needs different rich liquid culture media with FCS (Fetal Calf Serum) at 22-26°. Thus, introduction of cheap media which can guarantee the growth of parasites seems necessary. This study aimed at introducing of a cheap, simple, and modified blood agar media for mass cultivation of Lesihmania. Materials & Methods: In this experimental study, at first the growth rate of of Leishmania major, Leishmania infantum and Leishmania tropica, on blood agar and BHI (Brian Heart Infusion) broth with 20% FCS were compared.  Then the schisodeme pattern of RFLP (Restriction Fragment Length Polymorphism) for Leishmania major cultivated in two cultures was compared. Finally, 40 samples taken from patients suspicious of cutaneous leishmaniasis, referred to Shiraz university in 1380-1381, were cultured in the new introduced media to determine its usefulness for mass cultivation of Leishmania Spp. Results: The promastigote growing ratio in blood agar media and BHI broth for Leishmania major, Leishmania infantum and Leishmania tropica were 5.1, 9.4, and 5.7, respectively after one week for L. major and L.infantum and two weeks for L. tropica. Similarity of leishmania major RFLP schisodeme pattern cultivated on both media revealed unchanged natural characters of the mass cultivated parasites. Ten samples isolated from patients were mass cultivated on NNN and blood agar successfully and all reached 1010 parasite. Conclusion: Use of blood agar media for mass cultivation of Leishmania is a cost-effective method which increases the growth rate of parasite and decreases the risk of contamination.

Introduction & Objective: Acute injuries of the spine and spinal cord are among the most common causes of severe post-traumatic disability and death. The sample population was defined with respect to gender, age, cause of injury and neurological impairment (based on Frankel Grading System) to see whether these properties are similar to those of other studies. Materials & Methods: This is a prospective study conducted in Shiraz Nemazi Hospital to evaluate 85 new patients (68 men & 17 women) with a traumatic vertebral column injury (VCI) admitted in 1381. Results: The mean age was 35 ± 12 (Min15day-old baby, Max70 year-old man). The highest frequency of injuries was observed between ages of 20-29 for adults. The male female ratio was 4 to1. Motor vehicle accidents were the leading cause of VCI (54.11%), followed by falls (42.35%).The most common site of injury was thoracolumbar region (40%) while the most common neurological impairments were found in thoracic fractures (75%). A total of 60% of our patients had different degrees of neurological deficits (Frankel B-D), however, 32.44% of them were complete      (Frankle A). Conclusion: Our focus on the traumatic VCI and its major etiology revealed that efforts should be made to prevent collisions on the road. It highlights the need for a national prevention strategy and a nation-wide epidemiological study in our country.

Introduction & Objective: Diabetes mellitus is the most common endocrine disorder of childhood which is caused by relative or absolute deficiency of insulin. Diabetes can cause alteration in some elements of the body such as magnesium. This study was conducted for further evaluation of this matter and also to find out any relationship between level of serum magnesium and duration of diabetes. Materials & Methods: In this study blood sample (2 ml) was taken from 27 diabetic and 27 healthy children. Blood samples were freezed till the end of sample collecting when they were checked for the level of magnesium. Results: Results of this study show that the level of magnesium in serum of diabetic children is lower than that in the healthy ones, but this difference is not statistically significant. In addition, no correlation was found between the duration of diabetes and the level of serum magnesium. Conclusion. Further study is needed to evaluate this matter in details by measuring the intracellular magnesium for example in blood cells by more sophisticated experiments.

ntroduction & Objective:  Application of antibiotics in prevention and treatment of infectious diseases is a double bladed razor. On one side, it spoils pathogens and on the other hand, it has numerous complications. The most serious among them is selection of resistant agents. Prescription of antibiotics is a complex and scientific process that requires accurate clinical judgment, awareness of the pharmacologic and microbiologic principles on diagnosis, treatment and consideration of the patient's condition and his illness. Materials & Methods: In this study, we assessed 441 prescriptions (prescribed for <14 y/o outpatients children) of 58 GP in Yasuj city in Kohgyloyeh and Boyerahmad province in 2004. Results: The average number of drugs in each prescription was 3.6 and 64.4% of the prescriptions included antibiotics that consisted of penicillin group (51.6%), macrolids (24.5%) and cephalosporins (11.2%). Overall 32.2% had diagnosis which included pneumonia (31.7%), URI (21.9%) and pharyngitis (19%). Conclusion: The average number of drug in each prescription was much higher than the world average. Antibiotics have been prescriped a little more than in most of the countries and cities which might be due to age of the patients, unawareness of disease nature and epidemiology of infectious diseases. This pattern of antibiotic prescription causes a decrease in rate of bacterial infections in comparison with the past. However, this form of management, where antibiotic was prescriped for prophylaxis because of fear of future bacterial infection, led to several major outcomes including resistance of microorganisms that itself causes appearance of new agents with serious infection and complication of antibiotic therapy and their side effects that can cause morbidity and mortality.

Introduction & Objective: Osteogenesis imperfecta (OI) is a generalized connective tissue disorder and it is mostly inherited as an autosomal dominant trait. It may present with fragile bones, blue sclerae and hearing loss. We present two cases of OI. Case presentation: First case is a 18 Y/O man referred with bilateral hearing loss, who had 40db hearing loss in left side (operated ear) and underwent stapedotomy and received a good hearing. Second case is a 13 Y/O boy referred with bilateral hearing loss, who had 45db hearing loss in left side (operated ear) and underwent stapedotomy and received a good hearing with SRT less than 15.  Conclusion: If the patient is selected properly, good result is achieved.