Zahedan Journal of Research in Medical Sciences
Year:2007 | Volume:9 | Issue:3|Papers Count:13

Background: Post-operation shivering is very common and followed by many problems such as increased oxygen consumption, blood pressure, intracranial and intraocular pressure, and postoperation pain. Therefore, prevention of shivering is important especially in elderly and ischemic heart disease patients. The goal of this study was comparing the effect of Pethedine (Meperidin), Dexamethasone and Placebo on prevention of shivering.Material and Methods: This double blind clinical trial study was carried out on 114 patients of ASA class I and II who were candidates for elective abdominal surgery under general anesthesia.The patients were randomly divided into three groups including those who received Pethedine (P), Dexamethasone (D) and Placebo (N). Induction and maintenance of anesthesia for all patients were similar. Temperature of patients was measured in 4 steps: before induction, before extubation, in the beginning of recovery and the end of recovery. Five minutes before the ending of the surgery 0.3mg/kg of Pethedine, 0.1mg/kg of Dexamethasone and 3ml of saline 0.9% were injected to groups P, D and N respectively. IN recovery all patients were controlled for visible shivering. 25mg of Pethedine was injected intra venously while shivering. All data were statistically analyzed by SPSS software and ANOVA and chi square tests.Results: There were no significant differences among three mentioned groups regarding of gender, age and duration of surgery. 18 cases (47.4%) in group N had post-op shivering. Whereas, in group D only 7 cases (18.4%) had shivering and the difference was significant (P value= 0.0001). Also in group P just 3 cases (7.9%) had shivering that the difference from Placebo group was significant (P value= 0.0001). But the difference between groups P and D was not significant too (P value= 0.155).Conclusion: The present study showed that Pethedine and Dexamethasone are effective drugs for preventing the post-op shivering in elective abdominal surgery.

Background: The widespread use of electric power results in exposure of humans to low level 50/60 Hz electric and magnetic fields. There are some controversial reports about the impact of electromagnetic field (EMF) on biological systems. Alanine transaminase (ALT) and aspartate transaminase (AST) are nonspecific enzymes of plasma whose elevations are an indicator of cellular damage. The aim of this investigation was to study the effect of low frequency EMF exposure on activities of serum ALT and AST of mice.Materials and Methods: In this experimental study twenty four male mice weighting 30 ± 5 g were divided into four groups each of six animals. The treatment groups were exposed to electromagnetic field (EMF) tensity of 250 microtesla and with frequency of 25, 50 and 100 Hz for one hour per day for thirty days. The control group was in the similar situation without exposure to EMF. The blood samples were taken after thirty days. ALT and AST activities were determined at 37oC by kinetic method. The data were analyzed by SPSS (version 11.5) computer software.Results: Mice serum ALT activity was 84.3 ± 6.2 , 89.8 ± 14.3 and 84.8 ± 10.8 IU/L and AST activity was 183.8 ± 9.1 , 185.5 ± 10.5 and 163.5 ± 15.7 IU/L in groups exposed to 25, 50 and 100 Hz electromagnetic fields respectively. Significant differences were detected in ALT and AST activities between exposed groups and control group (P< 0.05).Conclusion: In this study, 250 microTesla intensity EMF with 25, 50 and 100 Hz frequency increased the mice serum ALT and AST activities. Serum ALT and AST activities enhancement can be due the electromagnetic fields effect on liver.

Background: An increase more than definite limit in sound pressure level is harmful for health, mean while, organic solvents like toluene are used in industrial processes with noise widely. So, this study was going to investigate the relationship between toluene (1000 ppm), noise and toluene along with noise (frequencies 4000 and 8000 Hz) per auditory Brain Stem response (ABR) on rabbits being exposed to these contaminants.Materials and Methods: This survey was done in experimental method on 48 three months old, male adult white New Zealand rabbits (1800±200 g body weight), in nine groups which were exposed to toluene(1000 ppm), noise (4000Hz), 100 dB SPL, combination of toluene and noise (4000Hz), noise (8000Hz) and combination toluene and noise (8000Hz). ABR test measurement was conducted using click and tone burst stimuli in 110dB sound pressure level. Then the results of ABR test of groups exposed were analyzed by SPSS software. One-way variance (ANOVA) analysis was used to compare the groups and Tukey test was applied as a post hoc test for comparison among the groups. P values were obtained by Tukey test. t-test was conducted for comparison of ABR test results after and before exposing groups. Differences at the level of P<0.05 were considered statistically significant.Results: The results of the study showed that Exposing rabbit's to combination of toluene and noise caused hearing impairment in all of frequencies auditory especially in frequencies 250, 500 and 1000Hz. So that, wave five in ABR test (tone burst stimuli) didn’t formed in 250-1000Hz frequencies. The mean of latency time of V wave (5 wave) were as follows; In control group 4.84±0.07ms, group exposed to toluene 5.18±0.07ms, noise group (4000Hz) 5.5±0.07ms and in combination noise and toluene group (4000Hz) 5.79±0.07 ms. The mean of latency time of V wave in control was compared to that of group noise group P=0.01, toluene group P=0.07 and combination noise and toluene group P=0.0001.Conclusion: According to the result of this study, Both toluene and noise exposure caused the rabbits in hearing impairment but combination of toluene and noise exposure in frequencies of 4000 Hz and 8000Hz was much worse than hearing impairment. So that, the ABR test on rabbits didn't formed V wave in low frequency.

Background: Cutaneous leishmainasis (CL) is highly prevalent in several provinces of Iran, having increased during the recent decades. The diagnosis of CL in most of clinical laboratories is usually performed using routine microscopy. However, this method is not sensitive enough, and the assessment and utilization of other methods, including a variety of PCR techniques, have been taken to consideration. In the present study, a direct PCR, based on kDNA primers, in comparison with the microscopic examination and in vitro NNN culture was evaluated for the detection of CL.Materials & Methods: The scrapings were taken from 73 patients from Mirjaveh, Sistan & Baluchestan province, and subjected to the comparative diagnoses.Results: The results showed that 38.4%, 55.5% and 63.2% of the specimens were positive by microscopy, PCR and NNN culture, respectively. The parasite species were also characterized by the current PCR. Separate comparisons of both microscopy and PCR methods with NNN culture, showed that the sensitivity of the PCR (76%) is higher than that of microscopy (61%). The calculated specificity, however, was 100% for microscopy and 73% for PCR.Conclusion: In addition to the higher sensitivity, this particular PCR, which uses species-specific primers, has a major advantage of identification of Leishmania species at the same time. It is, therefore, concluded that this PCR technique can be a suitable complement to the routine microscopic examination for diagnosis and identification of the parasite species from suspected leishmaniasis.

Background: Treatment of the immature pulpless tooth presents both an endodontic and restorative challenge. A more favorable long–term prognosis may be achieved with a mineral trioxide aggregate (MTA) apexification procedure followed by an internal bonding technique. We investigated the efficacy of this treatment option by evaluation the sealing ability of restorative materials used to strengthen the weakened root in this new treatment concept.Materials and Methods: Forty – nine single rooted bicuspid extracted human teeth were used in this study. After preparation in a standardized in- vitro open apex model, MTA (proroot-Angelus) was placed as orthograde apical barrier at a thickness of 4 mm (except 2 teeth saved as positive control). Then samples were divided into three groups (n=15). Group 1 was filled with a flowable dual cure composite (Luxa Core-Dual; DMG) from MTA barrier to 2 mm below the orifices. Group 2 was filled with a self cure glass ionomer (ChemFil; Dentsply) and group 3, was filled with AH26 sealer and thermoplastisized gutta percha. Four teeth were used as positive and negative controls.The teeth were immersed in 1 % basic fuchsin for 7 days. The roots were split and examined with steromicroscope (x20) for dye leakage.Results: 100 % of the MTA barriers showed leakage and 86.6 % of them showed complete dye penetration through the barriers. We found a significant difference in dye leakage between groups filled with restoration material (composite resin or glass ionomer) and group that filled with sealer and gutta percha (P<0.01).Conclusion: Based on these results it appears that restoration materials may not adequately seal obliterate entire remaining canal.

Background: Adolescence is an important stage of life marked by changes and rapid development. These changes are associated with health-related behaviors and influence. The purpose of this research was to determine the prevalence of health–related risk behaviors leading to unintentional and intentional injuries among adolescent high school students of Sistan & Balouchestan province.Materials and Methods: In this cross-sectional study, a multistage cluster sampling method was used to select a representative sample of high school students of Sistan & Balouchestan province. A total of 1855 students (925 males and 930 females) were selected and asked for completion of the questionnaire of risk behaviors.Results: During 12 months preceding the survey, 42.6% of students had ridden motorcycle; 78% of the riders never, 14.5% rarely and 7.5% always used safety helmet. In response to the question of using seat belt while driving a car, they stated never, rarely and always with 39.2%, 35.7% and 24.9%, respectively. They showed that 39% had ridden with a driver who had used drug (opiate or alcohol) and 49.3% stated to have driven a car one or more times without license during lifetime.About 22.1% of high school students had some time carried a weapon (a gun, knife) and 6.7% had carried a gun during the 12 months preceding the study. In that period of time, 53.3% of students were involved in a physical fight and 41.8% reported injury due to their fights, 19.6% had attempted or designed a suicide and 69% reported sadness for several days. About 14.2% had been absent from school one or more times because of unsafe feeling at school or on the way to or from school. In the year prior to the survey, 40.9% had left school without permission. Also, 4% of students had left their home for one day or more.Conclusion: The findings indicated that many high school students of Sistan & Balouchestan were engaged in behaviors that place them at risk of serious health problems. Planning and improving health policies and programs, particularly focusing on adolescents, are recommended to reduce risk associated behaviors.

Background: Colorectal cancer (CRC) is one of the most common cancers worldwide. But information regarding CRC in Iran is limited; the aim of this study was to investigate the epidemiologic features of CRC in Iran, using 6-year data from cancer registry.Materials and Methods: This survey was a descriptive-analytic study conducted on 1138 colorectal cancer patients who registered in Cancer Registry Center of Research Center for Gastroenterology and Liver Disease, Tehran, Iran. These data were gathered through interview and pathology reports recorded in cancer registry forms. Data analysis was performed by descriptive and univariate methods.Results: Of 1138 patients, 696 cases were male. There was no significant difference between males and females regarding age at diagnosis. 400 patients (35.1%) had a family history of cancer.The most common histology type of tumor was adenocarcinoma, NOS. In most cases (39.1%) tumor grading was well differentiated and there was no significant difference between males and females.Conclusion: Colorectal cancer is a disease with nonspecific symptoms. Family history of cancer was evident in 35.1% of our cases and also 42.9% of patients were below the age of 50 years old, suggesting that genetic factors may play an important role in the development of this disease in our country.

Background: How to care for the patients has a principle role in the quality of the services provided, so patients' management is one of the major duties of doctors. However, in Iran there is not a comprehensive program to achieve this goal and medical training is based on diseases while it should be patient based. This study tries to provide a practical approach in training how to manage patients.Materials and Methods: In this research 60 general practitioners working in urban health centers in Isfahan were randomly selected and studied. 30 physicians from health center number 1 were put in case group and the other 30 from health center number 2 were placed in control group. In conducting the project 4 physicians who had received necessary training worked as instructors. In the beginning of the study, the case group attended in theory classes about integrated patient management, and at the end of this class a package of integrated patient management was given to them. Then the plan was performed practically in the field. Throughout the study both case and control group received the usual training of health centers. The performance of the physicians was evaluated through check list both in the beginning and end of the study.Results: Before the study the mean scores of physicians' performance in both groups was the same; however, after the intervention the mean score of the case group was significantly higher than that of the control group. In the end of the study the mean score of clinical performance in case group was 48.9 and in control group was 42.1 (P<0.05), mean score of management performance in case group was 38.6 and in control group 32 (P< 0.05), and mean score of training performance in case group was 26.4 and in control group 22.1 (P<0.05).Conclusion: Results indicated that integrated management training can enhance educational, clinical and management performances of physicians.

Background: Urinary tract infection is one of the most common cause of the admission patients to the hospital and clinics. Because the side effects of UTI emergency treatment is very important.The aim of this study was to determine antibiotic resistance pattern of E.coli isolated from urinary tract infections in Mashhad.Materials & Methods: We studied specimens collected from patients during 1 year period.Antibacterial susceptibility test was performed by Kirby-Bauer method against 9 common antibiotics and the data were analyzed by SPSS software.Results: During this period 6024 urine samples were examined of which 1472 had positive culture. Escherichia coli with the frequency of 33% were the leading uropathogen. About 97% of isolated E.coli was resistance to Ampicillin. Resistance rate against other antibiotics was also high.Conclusion: Considering antibiotic susceptibility pattern for E.coli which is the most common uropathogen, it seems that antibiotics like Ampicillin and Co-trimoxazol should be used cautiously for treatment of E.coli UTI; instead other antibiotics like Ciprofloxacin can be recommended.

Subtalar dislocation is the simultaneous dislocation of the distal articulations of the talus at both the talocalcaneal and talonavicular joints. It can occur in any direction and always produce significant deformity. Most common is the medial dislocation (80% of cases). Less common presentations are lateral (20% of cases), anterior and posterior dislocations. These dislocations are associated with osteochondral fractures. Closed reduction and immobilisation remains the mainstay of treatment. Proper radiographs and CT scan confirms the post reduction alignment stability of subtalar joints and intraarticular fracture fragments. We report a case of medial subtalar dislocation with no osteochondral fracture fragments in a 17-year-old young man.