Armaghane Danesh
Year:2006 | Volume:11 | Issue:1 (41)|Papers Count:16

Introduction & Objective: Post operative pain is usually treated by opioids, which is expensive and may induce various side effects. Non steroidal anti-inflammatory drugs have been considered recently for controlling pain due to their cheapness, fewer side effects and availability. This study compares the analgesic efficacy of preoperative administration of single dose of rectally diclofenac and acetaminophen for post operative analgesia in septorhinoplasty, one of the most common head and neck surgeries.Materials & Methods: Sixty adult patients with ASA =1 underwent septorhinoplasty were randomly divided into two equal groups. Thirty minutes before induction of anesthesia, 100 mg diclofenac suppository and 325 mg of rectal acetaminophen were given to group I and group II respectively. Induction and maintenance of anesthesia were similar in all patients. Then the severity of pain was graded 1, 2 and 4 hours after operation according to Visual Analogue Scale. Also the first time of analgesic request and: total administered dose of analgesics were assessed by another person in all patients.Results: Results revealed that severity of pain in diclofenac group in all three defined times was significantly less than that in the other group (p<0.05). Also the average of first time analgesic request in group 1 and 2 was 205 and 97 minutes respectively and the average dose of administered pehtidine was 12.25 mg in diclofenac and 37.15mg in acetaminophen group. Conclusion: The pre-operative administration of rectal diclofenac was more effective for post septorhioplasty analgesia than the rectal acetaminophen and thus it could be used and recommended as a safe, compensive and effective method for post operative pain relief in this common surgery.

Introduction & Objective: Cardiovascular disease is the main cause of death in the most countries. Its development is determined by genetic and environmental factors. The major known risk factors are elevated LDL and reduced HDL. There is a direct correlation between these factors and dietary intake. Fructose intake has increased during the past years. The purpose of this study is to investigate the consequences of short-term fructose consumption on plasma lipids in male rats. Materials & Methods: This experimental study was performed in pharmacology department of Hamadan University of Medical Sciences in 2005. Thirty male Wister rats weighing 250-300 g were recruited, divided into two groups of 15, and were fed either 10% fructose in drinking water for 2 weeks or drinking water. Serum triglyceride, cholesterol, LDL and HDL was measured on the first and fifteenth days. All the data were compared with T student test and analyzed with SPSS software. Results: The concentration of serum triglycerides, cholesterol on  the fifteenth day were not significantly different as compared with  the first day; whereas the concentration of LDL and HDL were  significantly different between day 15 and day 1 (p<0.05). The ratio of LDL/HDL, Cholesterol/HDL and triglyceride/HDL on day 15 wee significantly different as compared with day 1 (p<0.05).Conclusion: On the basis of these findings, it can be suggested that fructose intake for short period increases the CHD risk factors.

Introduction & Objective: Cisplatin is a potent antineoplasic  drug. The beneficial effects of the drug are limited by its nephrotoxicity. The purpose of this study IS to Introduce stereological methods (Estimation of mean glomerular volume) to determine the toxicity of drug & examine the Gahum apanne (a traditional herbal plant) as a protective agent. Materials & Methods: This experimental study was done in histology department in Ahwaz University of medical sciences in 1380. 70 Spraque-Dawally male rats Were iselected randomly and divided into 7 groups as below: two control groups (one for drug &  one for plant), five experimental groups; one treated by acute dose  of drug (7.5 mg/kg, IP) and other groups treated with 4 doses of  hydroalcholic extract of plants (4, 8, 16, 32 mg/kg) half an hour  before receiving drug orally. Animals were scarified 96 hour after receiving the drugs and their right kidneys were processed for stereological assessment based on cavalier method. Statistical analysis of data from calculation of mean glomerular volume was done by ANOVA and two sided-dunet test, using SPSS software.Results: The results based on cavalier method, showed an increase in mean glomerular volume in all the groups that were treated with drug, whereas lower grade of glomerulomegaly was  seen in those groups which received higher doses (16 & 32 mg/kg) of plant's extract (p<0.05). Conclusion: Nephrotoxicity induced by cisplatin was even observed in quantitative parameters of kidney (e.g. increasing the mean glomerular volume) but by using Galim apain's extract this side effect can be reduced significantly. Moreover stereological techniques are valuable tools for studying the drug effects in all organs of the body.

Introduction & Objective: Visceral leishmaniasis (VL) is a disease commonly known as Kala-azar caused by protozoan parasites of the genus Leishmania including L. donovani, L. infantum and L. chagasi. VL is sporadic in manyareas of Iran and is endemic in a few provinces such as Fars, Azarbayjan, Bushehr, Ardabil and Qom. VL has been reported from some areas of Kohgiloyeh and Boyerahmad and this study aimed to characterize the causative agent of VL in this region.  Materials & Methods: Bone marrow sample was obtained from 6 VL patients from children department in Imam Sajad hospital in Yasuj. DNA was extracted from the obtained samples and was checked by semi-nested PCR to determine the species of the parasite. To do that, a segment of minicircle kinetoplast DNA was amplified, using LINR4 and LIN17 primers. Products of PCR were evaluated by electrophoresis, using 1.5% agarose and stained with ethidium bromide. Results: Parasitologically examination of bone marrow smears demonstrated amastigotes form of the parasite in the samples. For mass cultivation, isolated parasites were cultured in diphasic NNN followed by RPMI 1640 media. All the samples produced a 720 bp band in PCR assay. The isolates were compared with referent strains and it was revealed that all the isolates were L. infantum. Conclusion: Findings of this study demonstrated that the causative agent of VL in Kohgiloyeh and Boyerahmad was L. infantum. Further study is needed to explore other aspects of VL in this region.

Introduction & Objective: Eczema is one of the most common pruritic skin disorders for which various treatments are used to relieve the symptoms. There are several reports about the efficacy and in part safety of topical doxepin in the treatment of pruritic dermal diseases. However, lack of a suitable topical preparation from this drug in our country persuaded us to design the present trial.Materials & Methods: A randomized, double blind, placebo controlled and multi- central clinical trial was carried out in Isfahan during the years of 1383-84 by using 60 volunteers and both the drug and placebo were given QID for 8 days. The efficacy, side effects and their relevance to sex and age of subjects were assessed before, during and after the treatment. The data were analyzed using non-parametric tests including Mann-Whitney, Wilcoxon, and Kendall Tau where appropriate.Results: Results indicated that doxepin cream effectively reduced disease symptoms including pruritus (75.5%), inflammation (43.8%) skin dryness (37.5%) exudates (59.5%), lichenification (41.5%), and eczema (41.5%) after the course of treatment (the day of 8). Same results were obtained by using placebo. Stinging as an adverse effect was occurred in both the drug (30 %) and placebo (27%) groups.Conclusion: Although there was no significant difference between the two groups, it can be concluded that doxepin cream (5 %) is effective in depressing the signs and symptoms of pruritic skin disorders. A larger clinical trial is needed to evaluate the efficacy and safety of the product more precisely.  

introduction & Objective: Talc powder is extensively used as a lubricant in rubber industry. However the nature of its respiratory effects, if any, has not been thoroughly investigated. The purpose of this study was to assess the pulmonary reactions associated with occupational exposure to talc dust.Materials & Methods: This is a analytical study in which 97 talc- exposed workers and 110 unexposed employees as the reference group were randomly selected from a local rubber industry. Standardized respiratory questionnaires were administered to the subjects. They underwent chest X-ray and were examined by a specialist for any possible respiratory abnormality to be diagnosed.Furthermore, Pulmonary Function Tests (PFTs) were performed just before and after the work shift. Moreover, to assess the extent of exposure to talc dust, using standard methods, inhale able and reparable dust concentrations were measured in different dusty worksites. The data were analyzed by standard statistical tests using SPSS software.Results: The average (mean±SD) age (years), weight (kg), height (cm) and duration of exposure to talc dust (years) for the exposed group were 35.8±6.75, 73.1±9.2, 173.2±5.9 and 11.79±5.3 respectively. The corresponding values for the non- exposed group were 36.1±6.87, 73.36±8.1, 172.2±5.7 and 0±0, respectively. Atmospheric concentrations of inhaleable and respirable talc dust were found to be 41.8±23.52 and 19.8±8.04 mg/m3, (mean±SD), respectively. Talc exposed subjects had a significantly higher prevalence of respiratory symptoms. Similarly, PFTs revealed that exposure to this lubricating agent was associated with significant decreases in the mean percentage predicted of vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1). Moreover, there was a sharp reduction in some parameters of pulmonary function such as VC, FVC and FEV1, over the work shift. Chest radiographs of exposed workers showed evidence of chronic inflammatory process. Conclusion: These results which are in full agreement with the preliminary observations support the notion that occupational; exposure to talc is associated with both acute and chronic respiratory disorders and induces bronchitis and interstitial lung disease.

Introduction & Objective: Coronary artery disease is the main cause of mortality in developing countries like Iran. Due to failure of classic risk factors to completely explain epidemiologic variability of the disease, other risk factors, for example infection diseases are under investigation. One of these infectious agents is Helicobacter pylor which have been investigated in numerous studies. This study was designed to assess the controversies about Helicobacter pylor prevalence in acute coronary syndrome.Materials & Methods: All the patients with ACS including unstable angina and myocardial infarction who referred to Fatemie Hospital between 20 Feb 2003 to 9 Feb 2004 and were admitted in CCU ward were included in this cross-sectional study. A total of 411 patients with ACS were evaluated for prevalence of Helicobacter pylor antibody.Results: Mean age of patients was 59.97and 56% of them were male. The serological test for Helicobacter pylor infection was positive in 45.6%of cases, negative in 43.8% and borderline in 10.6% of patients. 191 patients had unstable angina and 220 patients had myocardial infarction. Conclusion: This study showed that prevalence of Helicobacter pylorinfection in patients with acute coronary syndrome was not high. Thus acute or chronic infection with Helicobacter pylor could not be a risk factor for ACS.

Introduction & Objective: Nerve conduction study is the most sensitive test for diagnosis of carpal tunnel syndrome (CTS). This test is normal in some patients with mild CTS. Median nerve conduction study evaluation after a provocative test (e.g. wrist flexion) maybe helpful for diagnosis of mild CTS. This study aimed to determine the effect of wrist flexion on median nerve conduction in patients suspected to CTS and in healthy subjects. Materials & Methods: In this case-controlled study, 20 patients (20 hands) with clinical signs of CTS and normal routine electro diagnosis test results and 20 healthy subjects were investigated. Measured parameters included median nerve distal sensory latency (DSL), nerve conduction velocity (NCV), compound nerve action potential (CNAP), distal motor latency (DML) and compound muscle action potential amplitude (CMAP AMP). The above noted parameters were measured before and after 5 minutes of full wrist flexion. Data were collected by filling out a questionnaire and were analyzed using Paired T-test.Results: Distal Sensory Latency increment and NCV decrement after 5 minutes wrist flexion in the patients group were statistically significant (p<0.05). The same parameters did not show a significant incremental or decremental change in the control group.Conclusion: Median nerve DSL and NCV measurement after 5 minutes wrist flexion may be helpful in determining more sensitive parameters in the electro diagnosis of CTS.

Introduction & Objective: Diabetes mellitus is the most common endocrine disease of human with prevalence of 1 to 4 percent. Peripheral neuropathy is one of the chronic complications of diabetes and its prevalence is not properly known, but worldwide is from 5 to 66 percent. The prevalence of this complication is not known in Iran. The aim of this study was to evaluate the prevalence of peripheral neuropathy in definite cases of diabetes type 2 and related factors in Dena town-ship in fall 2004.Materials & Methods: This was a cross sectional descriptive study that 40 definite cases of type 2 diabetes (28 females and 12 males) whose duration of disease were between 5 to 25 years were selected randomly.After informing and taking history and physical examination of the subjects, the nerve conduction study and electromyography were performed for them. Then the data were analyzed by SPSS software and X2 and Fischer exact tests.Results: Results of this study showed that prevalence of diabetes in urban and rural areas of Dena township were 1 and 0.8 percent respectively. Prevalence of neuropathy was 52.5% which comprised of 17.5% peripheral neuropathy, 22.5% carpal tunnel syndrome (CTS) and 12.5% combined form. The distal symmetrical sensorimotor peripheral polyneuropathy and carpal tunnel syndrome were the most common peripheral neuropathy and entrapment mononeuropathy, respectively. In this study, there were no significant statistical correlation between peripheral neuropathy and sex, age, duration of diabetes, fasting blood sugar, underlying disease, retinopathy and nephropathy, but significant correlation was found between mononeuropaty (CTS) and fasting blood sugar.Conclusion: Type 2 diabetes mellitus causes high prevalence of neuropathy (peripheral neuropathy & mono neuropathy) which is not related to duration of diabetes, retinopathy, nephropathy, age and underlying disease. We concluded that early diagnosis of disease could be done by educating of people and this can lead to a decrease in complications of diabetes.

Introduction & Objective: Self-inflicted burn is a violent method of suicide. Since our society faces lots of psychological, social, personal and economical problems due to self-inflicted burn, more survey for this event can assist us to know its causes and prevent from its occurrence. This research was carried out to compare general health, self- esteem and social support in patient's self- inflicted burn and non-self-inflicted burn of the Choromy accidental and burning hospital in Ganaveh. Materials & Methods: This is a descriptive - analytic study. The sample consisted of 60 inpatients burnt (males & females) of the Choromy accidental and burning hospital (Ganaveh). The method of sampling was simple random. Participants completed the General Health Questionnaire (G.H.Q- 28) of Goldberg, Cooper Smith's questionnaire of self-esteem and Philip's social support scale. Multivariate analysis of variance (MANOVA) and T-test were the major statistical analysis in this research.Results: The mean and standard deviation of the general health were 44.57±14.65 for self-inflicted burn persons and for non – self inflicted burn they were 10.83±6.27. In the self-esteem variable, the mean and the standard deviation were 57.90±4.94 for self- inflicted burn persons and 55.47±6.04 for non-self inflicted burn ones. Mean and standard deviation of whole social supporting were 20.40±4.94 for self-inflicted burn persons and 23.73±1.17 for non-self inflicted burn group. The findings showed significant differences between the two groups from viewpoint of general health and social supporting while there were no significant differences between two groups in case of self-esteem.Conclusion: There are a significant relationship between general health, social supporting and self-inflicted burn. There fore, in order to prevent self inflicted burn it is suggested that we make a relationship between persons and societies, families, groups and different institutes.

Introduction & Objective: It has been noted that the myocardial infarction is an increasing episode in Islamic Republic of Iran and there are many procedures and methods which can help to reduce the number of death from this ongoing event. The aim of this study was to determine the survival rate in those patients who have had acute myocardial infarction and its association with different variables.Materials & Methods: This descriptive analytic study evaluates 111 cases of acute myocardial infarction admitted in Yasuj Imam Sajjad hospital during the year 2004 and 2005. Data were collected using a questionnaire which was completed through direct interviewing by trained personnel. The data were analyzed by standard statistical tests using SPSS software.Results: The mean age of patients was 57±12 years. The mean time of having access to physician after MI was 4±2.2 hours. The mean time of reaching hospital after physician order was 5±4.9 hours. The mean time of hospitalization was 4±1.67 days.Considering the past history of these patients revealed that 31 percent were smokers, 16 percent had the history of previous ischemic heart disease, 63 percent had hypertension, 8 percent had diabetes mellitus, 95 percent had clip I, 95 percent had no previous block, 82 percent had Ml with Q wave. The survival rate in our study was found to be 0.91 in the first 10 hours, 0.847 in the first day, 0.829 in the first 28 days, 0.820 in the first third months, 0.792 in the first six months and 0.771 in the first 10 months of  disease.Conclusion: The mortality rate during the first month among the patients with heart failure turned out to be higher than that of the other similar studies performed in other parts of the country; however, the annual survival rate proved to be less. The most important causes of survival after the stroke are being single, smoking, fatness and angina pain.  

Introduction & Objective: Peripartum cardiomyopathy is a rare but sometimes fatal form of heart failure during the period of 1 month antepartum to 5 months postpartum. The aim of this report is to assess the clinical presentation, management and crucial role of echocardiography in women with peripartum cardiomyopathy.Case: A 22 year-old woman, with previously healthy primipara, was admitted to the emergency ward with sever dyspnea, cough, and bloody hemoptesis and a preliminary diagnosis of pulmonary embolism (PE) two weeks after cesarean section. Neither perfusion scintigaphy nor Doppler sonography test of lower extremities and pelvis showed any evidence of PE or deep venous thrombosis. Echocardiography revealed features of left ventricular failure. A diagnosis of peripartum cardiomyopathy was made, appropriate treatment was administered and the patient improved.Conclusion: It is possible to misdiagnose peripartum cardiomyopathy with PE. Echocardiography is a valuable tool in the differential diagnosis. As a noninvasive procedure, it should be performed at the bedside as soon as possible to introduce proper treatment and to avoid potentially fatal errors.

Introduction & Objective: Osteoid osteoma is rarely located in the carpal bones. The clinical presentation is pain exacerbated at night but there is some unusual presentation that makes the diagnosis difficult. The aim of this article is to present the rare manifestation of this tumor.Case: The case is a 27 year old lady with pain in thumb, index and middle finger which exacerbated at night. Pain was constant, progressive with exacerbation at night that awakes the patient at 3- 4 A.M. The patient's symptoms did not relieve after carpal tunnel decompression. Due to refractory pain, the patient was dependent on analgesics. There was pain on wrist motion when she was examined. The Phalen test was positive, but Tinel test was negative. Electrodiagnostic study showed decrease median nerve conduction velocity. Radiographic study showed tumor and C.T scan documented it.Conclusion: This is the first case of osteoid osteoma with carpal tunnel syndrome. It seems that radiography in patients with refractory carpal tunnel syndrome is necessary.