Journal of Sabzevar University of Medical Sciences
Year:2013 | Volume:20 | Issue:1 (67)|Papers Count:15

Background: Post stroke depression is a common state after stroke causing disability and affects cognitive status in patients.Present study tried to show the effect of citalopram on post stroke depression as well as cognitive state.Method & Materials: in clinical trial study all patients with acute ischemic stroke who had been consecutively admitted to the Ghaem Hospital (from 1388-1389), in Mashhad were evaluated for inclusion in the study. (218 person).in first visit neurological tests and hamilton rating test for depression were taken. At last 89 patients admitted az sample of study. Cognitive impairment was assessed with the Dementia Rating Scale (DRS). The severity of the depressive symptoms was measured by Hamilton Rating Scale for Depression (HAM-D).Then they were classified into those with severe depressive symptoms (HAM-D>20; N=18), with mild depressive symptoms (HAM-D scores 12-19; N=39) and non-depressed patients (HAM-D scores<12; N=32). Patients with severe depressive symptoms were treated with citalopram. Statistical analysis was performed using spss version 11.Results: HRDS, MMSE and DRS scores had significant change at the baseline and the end of study in group treated by citalopram. There were significant differences between DRS scores in attention domain at the baseline and the end of study in both citalopram group and without depression.Conclusion: These data suggest that treatment of depressive symptoms in the acute phase of stroke improves both mood and cognition and would be a reasonable treatment for patients suffering post stroke depression and cognitive change after stroke.

Background: To determine the familial aggregation, Coaggregation and within person association of myopia and four phenotypes of astigmatism by a conditional model in Tehran Eye Study.Materials and Methods: Myopia, Total, ATR, WTR and oblique astigmatism were studied through a population based, cross sectional study in 1326 siblings older than 5 years from 531 families with 2-4 siblings using stratified cluster random sampling from August to December 2002 in Tehran Eye Study.Results: Based on the conditional model and via Proc GENMOD SAS 9.1, the conditional odds ratios (95% confidence interval) , that indicates conditional familial aggregation, for the total, WTR, ATR and oblique astigmatism and myopia were 1.16 (1.01-1.33), 1.59 (1.17-2.16), 1.77 (1.39-2.26), 2.12 (1.41-3.19) and 1.96 (1.72-2.24), respectively. On the other hand, conditional odds ratios that indicates within person association of two disease, for myopia and WTR, myopia and ATR, myopia and Oblique and at last myopia and total astigmatism were 5.74 (3.99- 8.17), 3.41 (2.01-5.82), 4.6 (2.15-9.86) and 6.10 (4.76-7.82), respectively. Although no significant familial co-aggregation has been identified.Conclusion: Based on conditional model and after controlling for the confounders, this analysis yielded, a significant aggregation of four phenotypes of astigmatism and myopia, a large within person association and moderate but non-significant coaggregation of these disorders.

Background: Intravenous regional anesthesia (IVRA) is a easy and reliable method for extremity injuries. To improve block quality, decrease tourniquet pain and postoperative analgesia different drugs has been used as an adjuvant in IVRA. In this study, we evaluated the effect of nitroglycerin (NTG) in quality improvement when added to lidocaine and Meperidine as an adjuvant in IVRA.Material and Methods: Fifthly patient with upper extremity injury under IVRA were randomly and blindly to two groups. Under identical condition, control group received total dose of 200 mg lidocaine and 20 mg Meperidine diluted with saline (40cc) and study group received 200 mg lidocaine and 20 mg Meperidine plus 200mg Nitroglycerine. Onset time, anesthesia quality, tourniquet pain and analgesic use were assessed during surgeryAfter tourniquet deflation, the tim. e to first analgesic requirement and side effect were noted.Results: The sensory block onset time were shortened in study groups (3.7±1.1 vs 5.1±1.3) (P=0.004).Intraoperative pain score and quality of analgesic were not different between two groups and fentanyl requirement was similar. The onset of postoperative pain were similar in study and control groups. [78.79 (61.28- 92.23) vs 52.28 (35.07-73.448)]. (P=0.29) Conclusion: Addition of Nitroglycerine to lidocaine and Meperidine in intravenous regional anesthesia shortens onset times of sensory block but is not improved the quality of intraoperative analgesia and postoperative pain in patients undergoing hand surgery.

Background: Many evidence showed that exercise training has beneficial effects on skin blood flow in the health and diabetic condition. On the other hand some finding showed that C-peptide has protective and therapeutic effect on vascular dysfunctioninduced by diabetes. Therefore the purpose of this study is effects of resistance exercise on vascular function of C-peptide.Material and method: In this experimental study, Male wistar rats (220±10g, N=30) were used in two diabetic (control and trained) and one age-matched healthy control groups. After 1 week of diabetes induction, animals were submitted to resistance exercise training for 9 Weeks on ladder. To characterize cutaneous micro vascular responses by Laser Doppler flowmetery, animals were deeply anesthetized by intraperitoneal injection of pentobarbital sodium (50 mg/kg). For data analysis, one-way ANOVA test was used to compare the groups. Statistically significant difference between the minimum acceptable levels is p<0.05.Results: Local microinjection of c-peptide increased coetaneous blood flow in trained and control diabetic rats, however this effect in trained group is higher than control diabetic group rats. Administration of Nw-nitro-L-arginine (nitric oxide synthase inhibitor) before C-peptide reduced significantly C-peptide vascular effects in trained and control diabetic rats.Conclusions: Chronic resistance exercise potentiate C-peptide vascular function, possibly by nitric oxide pathway.

Background: To identify the prevalence of polypharmacy (concurrent use of 5 or more medications) and the most frequent medications and medication groups used by the elderly residents of Kahrizak Charity Foundation (KCF).Materials and Methods: This is a descriptive cross-sectional study of 237 elderly residents of KCF (134 female), aged 60 or more, who have been taking care since the spring of 2010. A randomized cluster sampling was done. Polypharmacy was defined as concurrent use of 5 or more medications, prescribed or non-prescribed, excluding locally effective and “PRN” drugs. Classification of medication groups was based on the Anatomical Therapeutic Chemical (ATC) system. The SPSS software was applied for descriptive analysis.Results: Mean number of drugs used for any resident was 5.10 (±3.22). Prevalence of polypharmacy was 52.3%. The most frequent used medications among attendants were Calcium-Vit.D, Nitrocantin (Glyceryl Trinitrate), and Atenolol, and in polypharmacy group were Calcium-Vit.D, Nitrocantin, and Aspirin. The most frequent medication groups used by both, the attendants and polypharmacy groups, were Cardiovascular drugs, Nervous system drugs, and Alimentary/Metabolism drugs.Results: The mean number of drugs used for any resident and prevalence of polypharmacy was high among the elderly residents of KCF.Conclusion: More pharmaco-epidemiological studies should be conducted to assess drug use status in Iranian elderly people, specially nursing homes residents, and guidelines should be presented for decreasing the incidence and prevalence of polypharmacy in this population.

Background: Furfural is a toxic chemical, so, to avoid its effects on humans and the environment, furfural-containing wastewater must be treated with an appropriate method prior to dispose in the environment. In this study, advanced oxidation methods based on ozone was used to removal of various concentrations of furfural in laboratory scale.Material and Methods: This study is an applied research and the required samples was taken in desired times. The effects of single ozonation process (SOP), catalytic ozonation process (COP), and single adsorption on activated carbon (SAP) on furfural removal efficiency in different conditions were studied.Results: In this study, the influence of some important parameters such as pH, activated carbon dosage and reaction time on the efficiency of SOP, SAP and COP was studied. In the case of pH, the results showed that the efficiency of all three processes in very acidic and very alkaline conditions were higher than the other pH. By increasing activated carbon dosages, the removal efficiency was also increased. Finally, the removal efficiency for the processes studied, increased by increasing reaction time.Conclusion: The higher removal efficiency of furfural in acidic conditions can be due to direct and catalytic oxidation of furfural by ozone. Higher efficiency in the alkaline pH may be due to indirect oxidation because of hydroxyl radicals generation. About the effect of reaction time, the removal efficiency of COP indicates that there was a synergistic effect in catalytic ozonation processes. The increase of reaction surfaces available for ozoneactivated carbon-furfural reactions could be the reason of increased efficiency with increasing dosages of activated carbon.

Background: Waiting time is one of the factors affected patient satisfaction of service quality wich is offered. Assessing the Main Factors Affecting Waiting Times Referred to Specialized Clinics on One of the Public Hospitals of Tehran.Materials and Methods: This study was applied research that has been done in three stages. Outpatient Clinic of a total of 21 clinics (2661 patients) and 10 percent of the population as the sample size (N:266) and using non-probability sampling method was selected. Data analysis software was used to 11.5 SPSS.Results: The average waiting time of patients was 121 minutes with standard deviation 33.73. Many patients simultaneously, the presence and absence of timely medical charts for scheduling and planning, respectively, with a mean score of 3.9, 3.5 and 3.3 to and from the perspective of service providers, lack of timely medical shortage of doctors and many patients simultaneously with the mean scores were 4.3, 4.1 and 4 were selected as the first three priorities.Conclusion: The admissions process can be studied identify factors affecting waiting time of patient. Whit the proper management and utilization of useful strategies to reduce time and increase client satisfaction and ultimately helped to improved the quality of sevices provided.

Background: The effluent of textile industries is high dyefully and this is one of most problems for environmental health engineers. Two Azo dyes biosorption, direct black 19 and direct red 23, on Cystoseira indica, an invasive macroalga in Iran, has been investigated using visible absorption spectroscopy.Material and methods: Pre-treatment and chemical cross-linking with CaCl2, have been conducted in order to improve the stability as well as the biosorption capacity of the algal biomass. All measurements were conducted by UV-Visible Spectrophotometer. The effects of operating parameters such as contact time, pH, initial dye concentration and amount of biosorbent on the dye removal efficiency were investigated. The biosorption has been described in terms of isotherm and kinetic models; from the maximum adsorption capacity values, an estimation of the algal specific surface area was made.Results: It has been found that biosorption kinetics can be described according to the pseudo second order model and biosorption equilibrated for 120 min (89.3% of direct red 23 and 69.02% of direct black 19 removed). Maximum biosorption found at pH 5 (2.4mg/g). It also observed increasing initial dye concentration and decreasing biomass dosage would reduce dye removal. Isotherm studies also revealed the dye biosorption on algal biomass followed from Freundlich model.Conclusion: Biosorption of selected Azo dyes onto algal biomass, Cystoseira indica was fast and more dye is eliminated in the first hour. So, by determining the optimum conditions of contact time, pH, initial dye concentration and biosorbent dosage, Cystoseira indica can be used as an inexpensive sorbent for removal of Azo dyes from aqueous solutions.

Background and objective: Breast cancer has high incidence among Iranian women and their long term survival lead to have more challenges with cancer complication. This qualitative study aimed to identify psychological responses following breast cancer.Materials and methods: A qualitative phenomenological method has been designed for the study. A sample of 11 women with breast cancer by purposive sampling selected and semistructured in-depth interviews were conducted. The interviews were transcribed verbatim, then Information have been analyzed during 5 steps using smith’s method.Results: Two main themes emerged from the interviews included basic reactions and residual reactions and The following six sub themes of despair of life, trying to find a guilty, social isolation, irritability-sensitivity, feeling incompetence and fear of disease recurrence has been determined.Conclusions: Although breast cancer is a physical disease but it has great impact on a person's mental health. Also So many psychological problems caused by breast cancer and its treatment, remains until many years after completion of therapies.

Background: The quality of teacher’s voice has an important role in understanding lessons by the students. The roughness of the Noice is the most importantsign of darynx disease and one of the reasons of the spasm of Noice is the improper usage of the of the noice the object of this study is inverstigating rateof knowledge and prophydaxis behaviors from dissphoie and the rate of it’s outbreak in female teachers of Yazd’s elementary school.Materials and Methods: This study is descriptive–analytie, and is done obout 280 teachers that were chosen from education areas casually. It used of questionnaire and interviewing for callectingdata.Results: The rate of dissphonie’s outbreak between the teacherswas 55.4% and the most epidemic form was stiffness of larynx. The rate of teachers’ knowledge was in average. There was a meaning full relationship between education and the rate of knowledge. Everyone that had a course of studies for associate of arts diplona and higher than it, had the higher rate of knowledge. There was a statical relationship between the age and the signs of spasm of noice also, it was seen a meaningful relationship between the employment background and prophydaxis behaviors from dissphorue. There was a direct meaningful relationship between the rate of knowledge and praphydoxis behaviors, and the teachers who had the higher rate of knowledge, choose further praphydoxis behaviors between the teachers of Yazd’s elementary schools oven though the outbreak of this farm is high and it’s suggested by holding the educating classes, the rate of knowledge and performance of the teachers have been increased for preventing and controlling this problem.

Background: Although all the advances of medical science has come to achieve, parasitic infections including intestinal parasites in many countries especially in developing countries, is a health problem; according to the annual fees paid by that the World Health Organization and governments to eliminate, prevent and treat them, their existence is still visible. In this study the prevalence of intestinal parasite in mental disability community in Ardabil city will be studied.Material and methods: This descriptive cross-sectional study with was design to detect the prevalence of intestinal parasites on the 216 cases of mental disability under the Social Welfare Organization in Ardabil city, with methods of direct smear, formalin ether concentration method and Modified ziehl-neelsen staining.Results: From 216 patients 95 samples (44%) were infected with at least one parasite including Blastocystis hominis 41 cases (19%), Entamoeba coli cyst 25 cases (11.6%), Giardia cyst 18 cases (8.3%), Trichuris trichura egg 2 cases (0.9%) and contemporary infection with two parasite Entamoeba coli/Blastocystis hominis cysts and Entamoeba coli/Iodamoeba butschili cysts 4 (1.9%) and 3 (1.4%) cases respectively. In 0.5% of cases we found Entamoeba coli cyst with 4 nuclei cysts.Conclusion: According to the results, levels of intestinal parasitic infections in mental disability community in the Ardabil city in compare to other communities was higher that need to pay more attention of the authorities.

Objective: The aim of this study was to estimate the frequency of preterm birth (PTB) and premature rapture of membranes (PROM) and their associations with maternal factors.Material and methods: This cross sectional study was carried out at Akbar–Abadi hospital in Tehran during January 2009–Aprile 2010. Nine hundred and ninety primiparous women with gestational age more than 20 weeks and singleton pregnancy were enrolled in the study. Data were analyzed using SPSS–16. P<0.05 was considered as being significant. maternal age, maternal height ,maternal education, pre–pregnancy maternal weight, occupation and smoking during pregnancy were compared between two groups (with or without PT PROM).Results: This study shows the incidence of PTB and PROM was 30.4 ,36%. The result showed a significant relation between maternal weight gain during pregnancy and PTB (p=0.001). Although there was a significant relation between mothers age , gestational age and PROM ( P=0.0028, P=0.00) but between other social determinants and PTB, PROM didn’t find correlation.Conclusion: Findings highlighted the importance of maternal age as a cause of adverse pregnancy outcomes. Since this study showed PROM and PTB to be two common adverse pregnancy outcomes in Iran assembling appropriate services can lead mothers to improved pregnancy outcomes especially among older pregnant women.

This is a descriptive-analytic study which was carried out on 45 samples of influent water to dialysis machines in hospitals of Qom. Then results comparised with related standards. The results showed that means of anions in this study were below AAMI and EPH standards. It should also be mentioned that in few samples, these amounts were above the standard levels. Then it should be analysed influent water to dialysis machine continually.