Zahedan Journal of Research in Medical Sciences
Year:2007 | Volume:9 | Issue:2|Papers Count:11

Background: Spinal anesthesia for elective cesarean section using drugs such as lidocaine has long been used with reports of various complications. To reduce these complications, many methods such as administration of sympathetic stimulating drugs like ephedrine, and using other drugs including pethidine have been recommended. The present study was aimed to evaluate comparatively the effects of separate and combined administration of pethidine and lidocaine on spinal anesthesia in candidates for cesarean surgery.Material and Methods: In this double blind clinical trial study, 150 cases with ASA I-II and full term neonatal, candidate for elective cesarean surgery from Zahedan Ghods Hospital and Ali- Ebene-Abitaleb Hospital, were subjected to the study during 2001-2004. They were randomly divided into three groups of 50, for using 5% lidocaine, 5% lidocaine plus 5% pethidine and 5% pethidine, respectively. A number of variables, including duration of postoperative analgesia, variation of homodynamic, heart rate, hypotension, nausea and vomiting were assessed. Statistical descriptive methods, one way ANOVA and X2 were used for the data analysis.Results: Breath depression was not seen in the neonates. The Apgar score was ³8. Duration of post operating analgesia was 453 minutes in pethidine group, 344.3 minutes in lidocaine plus pethidine group and 141.4 minutes in lidocaine group with significant differences (P<0.05). Differences of nausea and vomiting between groups were not significant.Conclusion: The longest duration of analgesia was seen with pethidine usage. The combination of pethidine and lidocaine was intermediately effective and seems to be suitable choice in anesthesia comparing to lidocaine alone.

Background: Despite the progress in the technology of endoscopy and cholangio pancreatography (ERCP), acute pancreatitis is still the common as a consequent complain. In the present study, the prevalence of panceratitis after endoscopic retrograde cholangio-pancreatography was surveyed.Methods and Materials: In this descriptive study, 112 patients referred for ERCP, aged 21 to 83 years, were studied. After collection of some information about age, gender and ERCP indications, ERCP was performed. The serum amylase levels were consequently measured at 4 and 24 hours after pancreatography.Post ERCP pancreatitis was diagnosed when serum amylase level was normal before ERCP but increased in for times in 24 hours post ERCP.Results: In 112 patients, the prevalence of panceratitis according to the post ERCP serum amylase level and abdomen pain was 12%. A higher prevalence was seen in females comparing to males. The west common diagnostic outcome of ERCP was stone in common bile duct and operation was sphancterotomy.Conclusion: The result of this study further confirmed that the progress in the technology of ERCP could not decrease the prevalence of post ERCP pancreatitis. The higher prevalence of post ERCP pancreatitis in females, the requirement of further notice to this group.

Background: Premedication is used for preparing patients before operation in order to induce sedation, homodynamic stability, analgesia, and prevention of nausea and vomiting. The side effects of the drugs and amnesia also need consideration. The purpose of this study was to compare the effect of Lorazpam and Chlordiazpoxide as premedication in prevention of recall perioperative events, following general anesthesia.Materials and Methods: This clinical trial was carried out during October 1997 to March 1999 on 128 adult patients who had inclusion criteria and were randomly assigned to two groups. The patients in group 1 each received 2mg lorazpam and in group 2 each received 10mg chlordiazpoxide at night before operation and again at the morning of operation. Twenty-four hours after operation, all patients were asked about perioperative events and then scores of amnesia were specified for all patients of the two groups. The data were analyzed by U-Mann Whitney and chi-square tests.Results: The patients ranged between 20 to 50 years of age. The mean age in group 1 (Lorazpam) and group 2 (chlordiazpoxide) were 38±3.9 and 39.3±2.8, respectively (P>0.05). The results showed that Lorazpam group recalled perioperative events were less than those of chlordiazpoxide group (P<0.05).Conclusion: It was found that induced amnesia with Lorazpam was significantly more than that of chlordiazpoxide, suggesting that Lorazpam may be preferable as a premedication before operation.

Background: Left ventricular hypertrophy (L VH) is an important risk factor in determining cardiovascular disease prognosis. Echocardiography (ECHO) is a sensitive and specific tool for detection of L VH but cost and operational consideration tend to limit its utility; in contrast, the Electrocardiography (ECG) is widely available, expensive and less operator dependent. Since the comparison of diagnostic validity between ECG and ECHO for evaluating of L VH has not been well studied, this survey was carried out on a number of major b-thlassemia patients.Materials and Methods: This descriptive-analytical study was performed on 135 patients (including male and female) with major b- thalassemia over 8 years old. Patients with heart failure, valvular or structural heart disease, renal and endocrine disease and Hb<10g/dl were excluded.ECG and ECHO were performed 48 h after blood transfusion. ECG criteria of L VH and myocardial performance index (MPI) in ECHO were measured. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of ECG indexes were calculated separately for both sexes and compared with ECHO findings.Results: The patients included 64 (47/4 %) males and 71 (52/6 %) females. ECG indexes were found as follows: 70% sensitivity of the Sokolow-Lyon index, 14.3%; specificity, 90.3% PPV, 40% NPVand.Sensitivity of the Sokolow-Lyon-Rappaport, specificity, PPV, and NPV were 61.9%, 25/8%, 27/4%, 60%, respectively. Sensitivity of the Comell index was 66.6%. specificity13.3%, PPV 86% and NPV 4.7%, Sensitivity of the White-Bock index was 0%, specificity 100%, PPVO% and NPV was 68.9%. There was significant relationship between E{:G indexes and some ECHO parameters. In this study there was a reverse and significant relationship between left acceleration time (AT) and the Sokolow-Lyon-Rappaport index statistically (r = 0.181,p = 0.035). There was a significant direct relationship between left deceleration time (DT) and the Sokolow-Lyon- Rappaport index (r = 0.181, p = 0.036). A reverse significant relationship between right AT and the Sokolow-Lyon index was seen (r = 0.173, P = 0.044). A direct and significant relationship between diastolic inter ventricular septum diameter (IVSd) and the Sokolow-Lyon-Rappaport index was also observed (r = 0.186,P = 0.031).Conclusion: Thefindings of this study showed that ECG, compared with ECHO, has verylow diagnostic validity for L VH but ECG indexes has statistically significant relationship with some ECHO parameters (AT, DT, /VSd, LV/Dd) of left ventricular mass.

Background: Helicobacter pylori is a gram negative curved bacterium, inhabited in gastric mucosa where it remains for years. It causes several diseases such as gastritis and peptic ulcer. Its c conventional treatment is antibiotics therapy; however there are other methods under investigation by probiotic micro organisms like Lactobacilli. It is reported that Lactobacilli supernatant inhibits H. pylori growth. In the present study, inhibitory effects of a subspecies of Lactobacillus genus, L. casei casei, on H. pylori growth in a mix culture was investigated.Materials &Methods: The study was performed in 2002, using a gel stabilized system. This system consisted of two layers including a solid PYS (peptone yeast extract salt solution) medium containing 1.5% agar plus 2% glucose at the bottom and a semi-solid PYS medium (0.75% agar without glucose but certain number of washed bacterial cells) on the top, all in a 30 ml tubes. In this system, L. casei casei and H. pylori were cultivated alone and in mix cultures. Samples from cultures were taken by sterile cork borers, each core was sectioned into smaller size, on which viable counts, pH, glucose concentration and optical density were determined and compared to each other.Results: The investigating organism in this system produced growth band in the semi-solid layer. The growth position (growth bands), number of viable cells, optical density and pH in the mix culture of H. pylori plus L. casei casei were similar to those in the culture of H. Pylori alone.Conclusions: The results indicated that, L. casei casei can not prevent H. pylori growth in the mix culture and is not a good candidate as a probiotic against H. Pylori.

Background: The cesarean section rate is very high and is increasing in most countries including Iran. Being a major surgery, the cesarean section may have dangerous side effects and even can be rarely fetal. During recent years, in most developed countries there have been many attempts to reduce the cesarean rate using education and other interfering methods. In our country it seems that the efforts with this regard have not been significant. The goal of the present study was to evaluate the effects of Behavioral Intention Model (BIM) education on reducing the cesarean rate among pregnant women.Methods and Materials: In this interventional study, 140 women at their first-time pregnancy and in 3rd trimester, where chosen in the winter of 2005, using simple random sampling method; they were divided into case and control groups. After pretest using a questionnaire in both groups, BIM was employed for the test group, followed by a post test performance in both groups. The collected data were analyzed by T-paired, independent T & chi-square methods.Results: The results showed significant differences between case and control groups in the level of knowledge, evaluation of results, attitude & behaviors (p<0.001).Conclusion: According to the results, it can be concluded that BIM is effective on increasing or improving the knowledge, evaluation of results, attitude, strengthening the intention and behavior of the pregnant women. It is, therefore, suggested to use this method and other systematic education for pregnant women to decrease the rate of unnecessary cesarean.

Background: Obesity is becoming a world wide health problem, affecting all groups of age, sex and economy. This important problem is a major risk factor for some diseases. The prevalence of obesity not has been well studies in the rural areas. The purpose of this study was to determine the prevalence of obesity and some of the relevant risk factors in women of Zarrindasht rural areas using the odds ratio estimated from the regression approach.Methods and Materials: In a cross-sectional study in 2005, a number of920 women infertility age from rural areas of Zarrin-Dasht, at eastern part of Fars province were selected by random multi stage sampling. Correlation ship between BMI and some variables including age, education level, number of children, socio-economic status and mean duration of breast feeding were evaluate. The age and education level of their husbands were also considered. Odds ratio (OR) was using both logistic regression approach and the linear regression procedure (without dichotomizing). BMI of 25 or higher was considered as over weight or obesity. Results: The studied women aged between 17 to 47 years old and the prevalence of over weight (25<BMI<30) and obesity (BMI³30) was 30% and 14% respectively. In both statistical models, significant associations were found among husbands education, number of children, socioeconomic status and increasing risk of obesity. Precision of linear regression approach in estimating OR was higher than that of logistic regression.Conclusions: It is concluded that, similar to the urban areas, the obesity is highly prevalent in the rural population. This can potentially affect the health of rural community and needs consideration.Prevention and control of obesity are recommended to be as of health program priorities.

Background: The ionizing radiation can affect the human health and the life of other organizes living things in short time, especially when the dose of radiation exceeds the ICRP standard. The amount and type of radioactive matter were not known in water, soil and food products of Zahedan.Therefore this study was aimed to survey the safety of such materials for the human being. Materials & Method: Five different places in Zahedan city were chosen for sampling from water, soil and food materials and concentration and type of radionuclide were determined.Sieving, drying and mix Turing were amongst the method utilized for suitable preparation of the materials.Results: The results show no existence of any artificial radio nuclides. However there were some natural radionuclide’s such as K-40, U238, Th232 and Ra226 in different dosages in the examined samples.Conclusion: The study corifirmed that there is no risk of radio nuclides exposure with regard to the soil, water and food materials in Zahedan.

The axillary artery, a continuation of the subclavian artery, begins at the outer border of first rib, and ends nominally at the inferior border of teres major muscle where it becomes the brachial artery. During the dissection of a 30-35-year-old man cadaver, according to classical anatomy method (Grant's method), we found an unusual branching in the second part of the axillary artery on the right side. The second part of axillary artery had a common branch, from which a lateral thoracic and subscapular artery was originated. This is an infrequent variation that has not been reported in the anatomy references, as yet.The increasing use of invasive diagnostic and interventional procedures in cardiovascular diseases, as well use of branches of upper limb arteries for coronary bypass and flaps in reconstructive surgery. Therefore, accurate knowledge of normal and variant arterial pattern of the upper extremities, for example axillary artery, is very important for medical specialists particularly anatomists and surgeons. Awareness of such variations can help surgeons to reduce the postoperative complications.