Armaghane Danesh
Year:2005 | Volume:10 | Issue:37|Papers Count:13

Introduction & Objective: Zinc is one of the important elements necessary for human growth. CNS utilizes zinc for its biological functions. Zinc is one of the important cofactors of many enzymes in the body and about 200 enzymes contain zinc as their integral part of their structure. If for any reason zinc is omitted from the enzyme structure, those enzymes can not catalyze any biological functions. The fluctuation of this trace element in the body is clinically important. The concentration change of this trace element can lead to some overt and unrecognized manifestations in haemodialysis patients. This study is to determine the possible fluctuation of serum level of zinc in haemodialysis patients before and after dialysis, to explain the differences in concentration of such trace element in these patients. Materials & Methods: This study is a comparative and nonexperimental study which was carried out on 50 haemodialysis patients chosen randomly from the patients referred to the department of haemodialysis in 5th Azar hospital in Gorgan university of medical sciences. The concentration of urea, creatinine, zinc of these patients were determined using laboratory kits and spectrophotometry technique before and after the dialysis. The findings were analyzed by wilkacson non parameter - analytical method. Results: Results of this study indicated that the average concentration of zinc in haemodialysis patients after dialysis was 135.32±59.32 microgram / deciliter which markedly increased in comparison to the serum  concentration of this trace element before the dialysis which was 78.38±37.46microgram/ deciliter (p < 0.05).Conclusion: Uremia, dialysis membrane, contaminations, heavy metals, and the quality of consumed water in the dialysis procedure, all can pave the way for the abnormality of trace element and clinical manifestation in haemodialysis patients. The trace element variation concentrations in human body clinically are very important because the decrease and increase in level of each trace element has its own clinical manifestation. The increased concentration of this trace element leads to toxification accompanied with clinical syndromes such as diarrhea and vomiting. Therefore, it is suggested that before the process of dialysis the level of released zinc from the different part of dialysis machine (such as pipeline, consumed water and dialysis membrane) be determined and on the basis of such information the level of zinc in haemodialysis patients can be replaced by proper nutrition.    

Introduction & Objective: Refractive errors play important role in the etiology and treatment of strabismus and amblyopia. As screening is one of the common techniques in diagnosing visual disorders, children are, therefore, to be examined for the health of their vision at least once a year. This study is intended to compare the accuracy of Snellen chart and retinoscopy in diagnosis of refractive errors. Materials &Methods: The target population included guidance-school children in grade one from Sabzevar (2008 female and 2085 male subjects). Relevant data were collected through interview and clinical examination. Visual acuity of the subjects was examined from a distance of 6m by Snellen chart and those with VA<10/10 was examined with retinoscopy by an ophthalmologist. Results: The mean visual acuity of both eyes in girls and boys obtained by the Snellen chart turned out to be 0.95±0.12 and 0.97±0.09 respectively. Also, 294 subjects appeared to be suffering from refractive errors. In 65% of the cases a significant difference was found between Snellen chart and retinoscopy in diagnosis of refractive errors (p<0.05). Conclusion: Further research is suggested to reveal the possibility of Differences of VA between girls and boys.    

Introduction & Objective: Caesarian section is the most common operation in gynecology field. Selection of anesthetic drugs for this operation needs so many considerations. Anesthetic drugs for this operation must prevent server homodynamic changes to tracheal intubations in mother and without side effects on neonate. This study was conducted to determine the effect of alfentanil given before induction of anesthesia on cardiovascular response to tracheal intubation in mother and Apgar score of neonate in Yasuj Emam Sajad hospital. Materials & Methods: In this clinical trial 60 patient who was Yasuj candidates for elective c/s delivery under general anesthesia, in ASA1, without fetal distress, after taking knowledgably satisfaction for participant Yasuj in study were allocated to 2 groups randomly. In both groups anesthesia  induced by sodium thiopental, scholin and atracorium but in trial group  alfentanil5 µg/kg was given intravenouslyone minute before induction of anesthesia. Results: Attenuated systolic blood pressure right after tracheal intubation and 5 minutes after tracheal intubation when compared with control group. Also in study group pulse rate of mothers had a smaller increase in comparison with control group. In this study systolic and diastolic blood pressure decreased 10 minutes after tracheal intubationbut this decrease was less in comparison with control group. Apgar score of neonate in study grouphad not a meaningfuldifferencein comparisonwith control group. Conclusion: According to this study mothers who received alfentanil before induction of anesthesia had less increase in their systolic blood pressure and heart rates after tracheal  intubation but systolic and : diastolic blood pressure had decreased more in control group in comparison to trial group ten minutes after tracheal intubation. This phenomenon is due to more narcotic administration after delivery of neonate in control  

Introduction & Objective: It has been verified that androgene concentration in epileptic men who were treated with antiepileptic drugs is decreased and this results in a decrease in sexual activities in such patients. Although there are many investigations regarding the effects of antileptic drugs on the rate of serum androgenes and particularly testosteron, little is known about the probable effects of androgenes on epileptic seizures. In this study the effects of plasma level of testosteron on epileptiform seizures in three cases (normal, increased and decreased) induced with Pentylentetrazole (PTZ) in Wistar male rats were investigated. Materials & Methods: Wistar male rats with similar response and sensitivity to PTZ and epileptiform seizures were randomly assigned to the five following: groups (n=8 for each group). 1st exprimental group: Intramuscular injection of testosteron (5 mg/Kg BW) and after 2 hours intraperitoneal injection of PTZ (25mg/Kg BW/for max. 3 times); 2nd experimental group: treatment with testosteron (0.5 mg/Kg BW) for 10 days and injections of PTZ thereafter; control group for 1st & 2nd experimental rats where they received sesame oil and then PTZ in a protocol precisely similar to the 1st and 2nd groups; 3rd exprimental group PTZ injections and recording of epileptiform convulsions before gonadectomy (as control) and repeat of PTZ injections after 10 days. The last protocol was performed in two groups: gonadectomized, without any testosteron injections, and gonadectomized but with one dose of testoteron. Results:The results show that increase in serum testosteron level does not affect epileptiform convulsions, whereas the reduction of testosteron level increasesthe partial seizures (p<0.001) and duration of tonic-clonic seizures (p<0.05). Conclusion: Results of this study show that testosteron has an anticonvulsant effect and this effect might be through neurosteroid metabolites, where these metabolites affect on GASA A receptor complex.    

Introduction & Objective: Growth and development are basic subjects in pediatric health Deviation in growth patterns are nonspecific but important indicators of serious medical disorders. Anthropometric survey in any region and for any child group is Essential for the evaluation of growth pattern and factors that affect it Materials & Methods: In this descriptive, cross-sectional study, 1822 children aged 64-82 months in Yasuj, Iran were evaluated for body weight, height, sex, birth grade, parents' education and job and number of sibling. Results: Analysis of data showed wasting in 6.5 % (118 children), stunting in 6% (106 children) and underweight in 10.3 % (187 children). Boys had lower anthropometric measures than girls when compared with NCHS' standard particularly for weight for age (p=0.0001) and height for age (p=0.0003). Results also showed that, a few factors were more important for stunting including fathers education (p=0.0001), mother's education (p=0.0001), birth grade (p=0.02) and numbers of sibling (p=0.0009). Also factors which affected underweight were fathers education (p=0.05), mothers education (p=0.013) and birth grade (p=0.04). These factors did not have any meaningful effect on wasting. Conclusion: In general, weight for age, height for age and weight for height in 64-82 month children in Yasuj are below 50% of NCHS' standards. Further study is needed to detect other factors that might deteriorate child growth pattern. Accordingly, those factors need to be changed actively.    

Introduction & Objective: Median nerve entrapment in the wrist is the most common entrapment neuropathy and is called carpal tunnel syndrome (CTS). Conventional electrophysiologic studies evaluate only the myelinated fibers. Sympathetic skin response (SSR) is a well- established test for evaluation of the unmyelinated sympathetic fibers. This study was designed to evaluate the sympathetic fibers in CTS. Materials & Methods: Fifty four patients with carpal tunnel syndrome and 78 healthy subjects were enrolled in this study. Conventional electrodiangostic studies and SSR were performed in all the subjects with standard method. Results: Latency of the SSR in healthy subjects was 1520.21±87.25 ms and 1637.11 ± 281.13 ms in patients. Conclusion: Unmyelinated sympathetic fibers are involved in CTS and SSR which may, along with other conventional electrophysiologic tests, help in diagnosis of CTS.    

Introduction & Objective: Thyroid nodules are very common and of course the most important point to approach thyroid nodules is to find out whether the nodule is benign or malignant. Biopsy is the most definite way to differentiate malignant nodules from benign ones and this is, at least, equal with a labectomy. FNA is a method which was first introduced in 1930 and led to a decrease in the number of thyroidectomy. Nowadays this is the best way to approach the thyroid nodules. Materials & Methods: This study was performed on 100 cases of thyroidectomy to find out the sensitivity, specificity and accuracy of FNA in diagnosis of malignant thyroid nodules. Candidates for thyroidectomy who referred to Mofateh clinic in Yasuj were evaluated by FNA and also open biopsy. Results: FNA results showed 78% ±15% sensitivity, 91% ±13% specificity, and 89% ±13% accuracy. Positive predictive value of FNA was 75%±35% and negative predictive value was found to be 93% ±20%. Conclusion: Considering the results of this study, FNA can be used instead of biopsy in approach to thyroid nodules and this will help to prevent unnecessary operations and high dose of radiation to neck.    

Introduction &Objective: Cardiovascular diseases have been known as the first cause of morbidity and mortality in Iran and many other countries. The noise of workplace and the shift work are among the risk factors of these diseases. This study was conducted to assess the relationship between different occupations and risk factors of heart diseases. Materials & Methods: This study was done on 4872 men and women, agreed over 19, in Isfahan. For each subject a questionnaire was filled in order to collect necessary information about the anthropometric characteristics and some cardiovascular risk factors and clinical tests were: done in order to determine the status of participants' blood factors. Men were divided according to the noise of workplace and the shift work non- shift work, and women were divided based on whether they were housekeepers or not. Results: Results of this study showed that in men with high-noise workplace, the prevalence of hypertriglyceridemia (p=0.02) and hypertension (p=0.01) was more than others but there was not any significant difference in other risk factors. Also in subjects with shift work, the prevalence of hypertriglyceridemia (p=0.03) and obesity (p=0.001) was high whereas there was not any significant difference in other risk factors. In housekeeping women mean value of waist circumference (p=0.001), body mass index BMI (p=0.000) serum triglyceride (p=0.000), cholesterol (p=0.001), LDL cholesterol (p=0.001), 2hpp (p=0.001), diastole blood pressure (p=0.001), systole blood pressure (p=0.01) and also the prevalence of obesity (p=0.0001),high LDL cholesterol (p=0.001), hypertriglyceridemia (p=0.001), hypercholesterolemia (p=0.0001) and hypertension (p=0.003)were significantly higher than those in employed  women. Conclusion: Considering the result of this study, the noise of workplace causes increase in the prevalence of hypertriglyceridemia and hypertension and the prevalence of hypertriglyceridemia and obesity increased because of the shift work. It seems that two factors of noise and 1 shift work cause these changes by inducing stress. Housekeepers had a high level of most of the CVD risk factors in comparison with employed women. It seems that two factors of noise and shift work by producing stress and reduction of physical activity in housekeepers can prone the subject to CVD.    

Introduction & Objective: Opiates include natural alkaloids and synthetic derivates. Their pharmacologic effects are based on bounding opiate receptors. Peak toxic and therapeutic effect of opiate is 90 minutes after oral administration. Acute presentations of opiate poisoning are CNS, respiratory and GI involvements. In long term, opiate can change numbers and sensitivity of their receptors, and result in tolerance or withdrawal syndrome. In opiate over dosage, morbidity and mortality decrease with careful therapeutic and supportive managements. Study of frequency distribution of opiate poisoning according to individual characteristics and clinical manifestations are the main objectives of recent investigation. Materials & Methods: In this retrospective descriptive study, 2520 patients were enrolled in 2001-2002. Information including demographic and clinical characteristics of the subjects was collected. Results: 263 cases of 2520 (10.4%) were poisoned with opiates. The most frequent age group was 21-30 years old (38.3%) and the most common hospital stay was 1-7 days (55.8%). The males were more poisoned than female (71.4%) and respiratory support was used for 29 patients (18%). Poisoning route was often (68.8%) by ingestion (181 cases). The most common clinical presentation was CNS involvement (74.1%). The most common type of used narcotic substances was opium (60.4%). Mortality rate was 4.5% (12 cases). Conclusion: Opiate poisoning can result in morbidity and mortality. Complications were more among those who referred to hospital with delay or used high dose or potent agents. The main cause of mortality in opiate overdose was hypoxia with respiratory depression.    

Introduction & Objective: Domestic violence is a serious public health problem for many women. The prevalence rate of domestic violence in couples is of different degrees. Effective factors of abuse for women are dependent on demographic and economic status of society. Types of violence include physical, sexual, emotional, and economical abuse. Material & Methods: This descriptive and analytical study was done on 517 women. Data were collected by a questionnaire and then analyzed by descriptive and analytical statistics. Results: Findings of this study showed that prevalence rate of Domestic violence was 77.4%, and during pregnancy it was 8%. Common types of abuse were verbal (69.5%), emotional (52.2%), physical (36.4%) and sexual (22.2%). A correlation was found between education, Job, income and addiction of husband and exerting violence. Correlation was also found between the type of abuse and woman's age, time of marriage, number of children(p<0.05). Conclusion: Results of this study showed that the most common types of abuse were verbal, emotional, physical and sexual. Results also showed that there was a significant difference between Job, income and educational level of couples and husband's addiction with violence. Also a significant difference was found between age, time of marriage, number of children and the type of violence. Results appear to justify the necessity for E family consultation and education of the girls at high school and before marriage in order to promote women's health.    

Introduction & Objective: Self-esteem is an important factor in mental health that affects human functions, especially job performance. The number of nurses with low self-esteem is increasing and this is mostly due to role conflict. Only few studies have been done on this issue. This study was done in order to evaluate the effects of a course of assertiveness on self- esteem of female nursing students in Bushehr (1380). Materials & Methods: A total of 80 students were recruited and were given preliminary questionnaires. The 22 students that got lower scores were then chosen as the samples. Using a simple random method, the samples were matched, and then divided into 2 equal groups, a case and a control group. A pretest and a course on assertiveness and a post test were given to the case group while the control group was only given a pretest and a post test. Tools used for this study were the Cooper Smith Self-esteem scale and the independent T and paired T test, respectively. Results: Pretest results on self-esteem for the case group showed a mean score of 59.45, (SD= 10.25). After training, post-test results improved to E 75.90, (SD=9.49, p<0.001). In the control group, no significant change was noted on the pretest and posttest scores. However, there was a significant correlation between financial status of the students' family and self-esteem in the case group.Conclusion: A course of assertiveness may have an important impact on E promotion of self-esteem of female nursing students. The researchers suggest more study to be done in this field especially on other group of nurses.    

Introduction & Objective: Horseshoe kidney is seen in about 1 in 400 persons. It is found more commonly in males by 2: 1 margin. It can be seen in all age groups but in autopsy series. It is more prevalent in children, that is related to the high incidence of multiple congenital anomalies associated with the horseshoe kidney, some of which are incompatible with long- term survival. Case: The patient was a 25 years old man who presented with RLQ pain from 2 months before admission. In physical Examination, there was tenderness in this area. All routine lab data were in normal range. Sonography showed normal left kidney, absence right kidney and a large cystic structure occupying the left and posterior aspect of the bladder. IVP showed non visualization of right kidney, malrotation of left kidney and a filling defect in the right side of the bladder. C.T. Scan with and without IV contrast confirmed above data. Cystoscopy revealed hemitrigone with a mass effect. Surgical exploration showed ectopic right ureter within ejaculatory ducts. All its abnormal course, deviating to left side and ending in a fibro vascular structure attached to an isthmus on vertebral column. 2 months later the patient were admitted in neurosurgical ward and underwent craniotomy due to brain aneurysm.