Yafteh
Year:2007 | Volume:9 | Issue:1 (31)|Papers Count:15

Background: Environmental exposures usually occur to chemical, physical and microbiological factors. WHO has evaluated related loading of 25 risk factors that 7 of these are environmental factors. With regard to the lack of comprehensive studies, this survey was carried out in Tehran to investigate the knowledge of the citizens on environmental pollutions, related health effects and their information sources.Materials and methods: Present survey was carried out on 1596 individual upper than 18 years old. Samples were taken randomly. Data was collected by phone interview. In order to determine correlation between qualitative variables, Chi -square test was used. In necessary condition OR index was used. Reliability of questions in any part was tested by principal component analysis.Results: Results of this survey showed that in general 54.2% of people have a good knowledge about environmental pollution and health effects. The knowledge of women, youths (18 - 20years old), university educated people (PhD), westerns and northern, and those who had got their information from radio / TV is more than others. The knowledge of people about the environmental pollution and their health effects with education level and source of information had a significant difference. After elimination the effect of variables that probably interfere with knowledge of people, logistic regression was done. In this case, there was a correlation between education level and information sources. More than 80% of people got their information from radio and TV. Newspaper and social conversation were the next important sources, respectively.Conclusion: Although Tehran citizen knowledge about some environmental problems and related institutions was low, in general, Tehran citizen's knowledge about the problem and special health issues resulted from air pollution was good. With regard to importance of environmental factors in public health because of machinery life especially in large cities of our country, more research should be accomplished to identify and how to control them.

Background: Postoperative nausea, vomiting (PONV) and pain are common causes of postoperative morbidity. Menstrual cycle may be one of the several factors that influence the incidence of them. This study was done to evaluate the effect of menstrual cycle phase on the on the Meperidine and Metoclopramide consumption rate for controlling postoperative pain, nausea and vomiting.Materials and methods: On the basis of the menstrual cycle {pre ± menstrual (PD 25-6) follicular phase (PD 8-12) ovulatory phase (PD 13-15) and luteal (PD 20-24)}, 63 patients enrolled in this blinded, prospective study. All patients underwent a standardized surgery. Meperidine 1mg/kg was given to patients who had pain intensity more than 5 on Visual Analog Scale (VAS) intravascularly in recovery, and intramuscularly in the ward. Metoclopramide 0.3mg/kg was administered intravascularly to patients who had vomiting. A blinded person recorded PONV and pain score as well as required amount of Meperidine and Metoclopramide in the recovery and ward arrival time, 6, 12, 18 and 24 hours postoperatively. Results: At the first 24 h post gynecological operation, PONV score was higher in luteal and follicular phase and lowest in pre±menstrual phase (P<0.001, X²= 41.64). The need for Metoclopramide in luteal phase was more than other phases (P<0.001, X² =32.9). The highest pain score was in luteal phase (P< 0.001, X²=4.6) and the required dose of Meperidine was higher in luteal and follicular phase (P< 0.001, X²=22.2).Conclusion: We suggest that scheduling of surgery according to the menstrual phase may reduce the incidence of PONV and postoperative pain intensity as well as the required dose of Meperidine and Metoclopramide and hospitalization costs.

Background: Iodin (I) 125 is one of the radioactive materials that is used in medical laboratories for hormonal evaluation in radioimmunoassay (RIA) method. In many laboratories sume of personnel are exposed to I125. When one of the staff is exposed to I125, especially internal exposure, there is concern about ionizing radiation effects. Therefore preventive measures against these hazards are required.Materials and methods: The present study was carried out in 13 medical laboratories in Qazvin city and 51 employees in autumn 2004.We used a safety checklist that filled by researcher at the field of laboratory.Fitness for work (FFW) assessment was done through paraclinic history (CBC, TSH); familial history of malignancy (first and secoundry family) and eventually physical examination.Results: From all personel 82% used appropriate gloves and 61% avoided drinking, eating, smoking and cosmetic use in work place. 90% decontaminated working surfaces immediately and 94% washed hands at the end of tests. All of them were exposed to open vials that can potentially generate aerosols. Absorbent coverages on working surfaces were used only by 2% of employees and 54% used appropriate local ventilation (hood). Preemployment examinations (for FFW) and periodic medical surveillance weren't done at all.Conclusion: In the laboratories which we studied personnel protective measures was better than administrative controls, and it is expected that the conditions will be better by training of personnel and managers, and seriously auditing laboratories.

Background: Depressive disorder is one of the most prevalent mental disorders and causes disability and early death. This disorder leads to increased economic burden for people and society. Mental disorders are the cause of 15 percent of disability and early death in developing countries. According to the joint report of W.H.O and the word Bank, depressive disorder is the first one among the ten most important causes of disability and disablement all over the world. Thus the diagnosis and treatment of this abnormality is very important for patients, families and society.Materials and methods: The aim of this cross–sectional study was to screen the depressive disorder in people aged 20-64 in Khorramabad city. Data were collected by Beck Depression Questionnaire that detects depression. Khorramabad city has tow region and each region has three areas. The sample (2740 persons) was selected from all areas by a clustered and systematic sampling method. Data were analyzed by statistical software.Results: 33.4 percent had symptoms of depression. 25% of the affected patients had minor depression, 7.4% had moderate and 1% had sever depression. The prevalence of depression was highest in age group 50-64 years and lowest in age group 30-46 years. Depression was higher in women (34.3%) than men (32.4%). The highest rate of depression was in widowed (43.3%) and the lowest rate of prevalence was in married (29%). The rate of depression in non-specialists workers was higher (43.2%) than officers (16.2). The rate of depression in primary school and diploma person (17.4%) was higher than less educated or illiterates (7.1%) and university educated (8.6%) people. The lowest prevalence of depression was in persons with more than two million Rials salary (3.5%) and highest prevalence of depression was in persons with salary lower than two million Rials. the prevalence of depression was related to factors including age, marital status, educational status, occupation, family, salary and house status (p<0.001). But, there were not statistically significant related to sex, geographic area.Conclusion: Mental health is usually neglected but, its prevalence and disability is not lower than infectious diseases according to the physician’s experiences and epidemiologic studies. Thus, appropriate diagnosis, management and treatment of it is very important for patinas, family and society and decreases economic and mental problems.

Background: Family environment is the first place in which child may recognize his potentialities and talents and tries to raise those potentialities. If family fails to provide the child with an appropriate situation to grow and evolve his character, he may develop the basis of social delinquencies. All kinds of crimes may form in the family. Studies show family as a social factor and character as an inner factor can create the grounds for the criminal behavior. The present study tries to investigate the psychological and personality factors learning people to run away from their homes.Materials and methods: The present survey is a descriptive- analytical study. The cases were selected by census method. All the women and girls who were kept in the intervening centers were studied during one year. A two-section questionnaire containing demographic, family characteristics as well as the standard questionnaire named SCL 90 was used for data collection. The questionnaire was completed using clinical interview. The data was analyzed using SPSS software.Results: Among 73 cases participated in the study, 37.5% was under 20 years, 91.7% was housewife and 58.3% had elementary education, 58 % was of those who migrated from villages to towns. Most of them were among the mid born of the families. 36% had imprisonment, 30.6% had substance abuse, and 63.9% was among those who had previous crime records. 46.3% of the married ones mentioned compulsory marriage as the cause of leaving their homes. 41.7% had a bad economic situation. 25% of the children were criminal. 54.2% had challenges and disputes with parents which they mentioned this as the cause of leaving their homes. 46.3% of the participants had Phobia, 64.3% had psychotism, 83.5% had hypochondrias is, 90.4% had obsessive compulsive, and 82.8% had depression, 84.9 % anxiety, 68.6% was aggressive, 41% paranoid and 56.2% had supportive problems.Conclusion: There is a significant relationship between leaving homes and variables such as challenges with parents, compulsory marriages, parents’ education and unemployment. Also there is a significant relationship between personal and emotional characteristics and running away from home.

Background: Recognition of Clinical factors associated with disability of stroke patients is important, because they can affect the prognosis and future recovery following rehabilitation.Materials and methods: Consecutive stroke patients admitted in Valie-Asr hospital of Khorasan enrolled in a prospective study in 2005. Hemihyposthesia, hemianesthesia, hemineglect and homonymous hemianopsia were evaluated in the patients. Disability score was determined based on the Rankin scale at 72 hours post stroke. Mean of Rankin Disability Score (MRDS) was analysed by T and Fisher tests and p<0.05 regarded as significant.Results: 329 stroke patients were investigated. Hemihyposthesia, hemianesthesia, hemineglect and homonymous hemianopsia were found in 37.4%, 13.8%, 7.9% and 7.3% respectively. MRDS was significantly higher in patients with hemianesthesia than other stroke patients, p<0.001. MRDS of patients with each of hemihypoestheisa, hemineglect and homonyous hemianopsia was not significantly different than patients without these abnormalities, p=0.44, p=023 and p=0.83 respectively. Patients with triad of hemianesthesia, hemineglect and homonymous hemianopsia had significantly higher MRDS than others, p<0.001.Conclusion: Hemianesthesia is the most important clinical causative factor of MRDS of the stroke patients. Presence of above triad predicts the highest MRDS in these patients.

Background: Asthma is an inflammatory and chronic disorder of trachobronchial tree that is associated with increased response to allergens. Treatment of acute attack of asthma is short acting b 2 agonist such as Albuterol that is used via a nebulizer or Metered-dose inhaler (MDI) with and attached spacer. Object of this study was evaluation of therapeutic effects of Albuterol via a nebulizer or MDI with an attached holding chamber in patients that had been referred to Emergency departement of Mobasher Hospital in Hamadan.Materials and methods: The present study was a clinical trial (before and after) in 60 patients that were suffered from acute attack asthma. Inclusion criterias were 16-65 years old age patients, FEV1, below 60% of predicted value, and cooperation for spirometry performance. Exclusion criterias were COPD, cardiovascular disorders, pneumonia, preumothorex, or their systemic or pulmonary disorders,severe respiratory failure with cyanosis or confusion, pregnancy and smoking. On arrival to the ED, all patients underwent spirometery and all of patients received oxygen and a single dose of 8 mg intravenous dexamethasone. Immediately thereafter patients were randomized to two groups.The study was designed as double blind trial. The first group patients received four puffs Albuterol attached to spacer and immediately distilled water via nebulizer. The second group patientts received 5 mg Albuterol solution via nebulizer after administration of placebo inhaler attached to holding chamber. All of the patients received a total of four treatment. The first dose was administered immediately after spirometry and then every 30 minutes. Spirometry was performed at entry between to the study and then 15 minutes after each treatment.Results: Analysis of comparison of bronchodilating effects of salbutamol via nebulizer or MDI with attached to spacer showed similar effects in two methods (P>0.05). FEV1, FVC, FEV1/FVC changes were significant among four treatments in every group (P<0.05) but there was no difference between two methods among four treatments (P<0.05).Conclusion: A short acting b 2-agonist such as Albuterol can be administer in patients with acute attack asthma with every two methods (nebulizer or MDI with attached spacer) and have similar bronchodilating effect.

Background: IUD is a useful and effective tool for family planning. Different kinds of this equipment are available at the market, but currently the most commonly used one in our country is CU T380A. Previous studies have shown that CU safe 300 is more effective and associated with less complications than CU t380A, thus it is more acceptable by users. The aim of this study was to determine and compare failure rate of CU T380A and CU safe 300 IUDS, four years after insertionMaterials and methods: The present research is a cohort study carried out on 246 women who referred to health clinics of Khorramabad four years ago. These women divided into two equal groups. One group used CU T380A and the other group used CU safe 300. The rate of unwanted delayed complications such as spontaneous bleeding, pregnancy and spontaneous repelling of the IUDs were assessed by a questionnaire. Data were analyzed by Chi square and paired T test.Results: Failure rate of CU T380A was more than CU safe 300. Statistical tests showed significant differences between these two groups.Conclusion: This study shows that new IUD (CU safe 300 ) which are smaller in size have less Failure rate and more acceptable by women, so their use is suggested in health clinics.

Background: The discovery of the X-ray in November 1895 by the W. C. Roentgen caused the increasing use of x-ray, because of the benefits that patients get from the resultant the diagnosis. Since medical radiation exposure are mainly in artificial radiation sources, immediately after the x- ray discovery, progressive dermatitis and ophthalmic diseases were occurred in the early physicians and physicists. But delay effects were observed approximately 20 years after the x-ray discovery.History: Based on the studies, ionizing radiation is a potential hazard to the developing fetus, avoiding unnecessary radiation exposure to pregnant women is a standard practice in radiology, unless there are important clinical indications. Due to difference in stages of fetus development, using of the current radiation protection standards includes: justification of a practice, optimization of radiation protection procedures and dose limitation to prevent of serious radiation induced conditions is necessary.Conclusion: Conversely the somatic and genetic effects of x-rays, since the X-ray has the benefit effects, special in diagnostic and treatment procedures, there is increasing use of x-ray, so using of the latest radiation protection procedures is necessary. Radiation protection not only is a scientific subject but also is a philosophy, Moral and reasonable. since the ionizing radiation is a potential hazard to the developing fetus, avoiding unnecessary radiation exposure to the pregnant women is recommended, unless in important clinical conditions.

Background: Acute appendicitis is a completely known disease but for many physicians chronic appendicitis is unknown and some of them don't believe in it. Although the number of people suffer from chronic appendicitis is much fewer than those who suffer from acute appendicitis, we shouldn't ignore it. Clinical symptoms for these patients are chronic, longtime and recurrent abdominal pain, which is usually in the right lower quadrant of the abdomen. In the Para clinical examinations there isn't any considerable pathological problem (in urine, stool, and sonography of the abdomen and pelvis.) By recognizing appendicitis and appendectomy, the symptoms will be vanished and the patients will recover.Case presentation: The case was a 57-year-old man who has complained from chronic abdominal pain in the RLQ area since 15years ago. No pathological problem had been found in all diagnostic process.Conclusion: The problem was diagnosed as the chronic appendicitis and he underwent the appendectomy by laparoscopic procedure and was completely recovered.