Zahedan Journal of Research in Medical Sciences
Year:2008 | Volume:9 | Issue:4|Papers Count:14

Background: Eradication of H. Pylori has an important role in curing peptic ulcer and dyspepsia. Several therapeutic regimens have been offered for eradication of H. Pylori. There are several reports of resistance of H. Pylori to metronidazole in Iran, so other therapeutic regimens have been offered. We compared Furazolidone versus Tetracycline, in quadruple regimen [Omeprazole-Amoxicillin-Bismuth subcitrate-Tetracycline (OAB-T) vs. [Omeprazole-Amoxicillin- Bismuth subcitrate-Furazolidone (OAB-F)].Materials and Methods: In a clinical trial study we treated 109 H. Pylori infected patients with dyspepsia in Zahedan Khatam-ol-Anbia Hospital in two therapeutic groups. The first group received Omeprazole 20 mg BID, Bismuth subcitrate 200 mg Q6h, Amoxicillin 1 gr Q12h, Furazolidone 100 mg Q12h. The second group received Omeprazole 20 mg BID, Bismuth subcitrate 200 mg Q6h, Amoxicillin 1 gr Q12h, Tetracycline 500 mg Q12h.Results: There were 49 patients in OAB-F group and 51 patients in OAB-T group. H. Pylori eradication rate based on H. Pylori fecal Ag Test negativity was 85.7% and 80.4% in OAB-F & OAB-T groups respectively.Conclusion: Furazolidone-based regimen is effective in H. Pylori eradication. With respect to low price and availability of Furazolidone, Furazolidone- based Quadruple therapy is an acceptable regimen in communities with high metronidazole resistance.

Background: Lactation failing is one of the leads to infants weight loss and illness. Vary degree of success have been reported with many strategies to increase milk production when it is failed. This study was investigated the effect of Domperidone in augmentation milk production Methods and Material: In a double blind placebo controlled trial 48 mothers that their infants were under grow square and it was due to mothers milk not enough, randomly divided to two groups: 24 received Domperidone 10mg TDS orally for 14 days and 24 received placebo (the same shape) TDS orally for 14 days. Milk volume was measured the day before study on day 7, 14 and one week after study; and serum prolactin level was measured the day before study, day 14 and one week after the study. SPSS 11.5 software was used to analyze the results with Q square test and T student test; and P<0.05 was significantly difference.Results: Data obtained from two group of study indicated treatment with Domperidone increased the volume of milk amount 48.5 ml compared 8 ml in treatment with placebo.(P=0.008) a+lso serum prolactin was raised 116.4 ng/ml in Domperidone group compared with 4ng/ml in placebo group (P=0.001).Conclusion: Domperidone is an effective drug in milk production increasing and serum prolactin.

Background: Although there is a great concern regarding rational use of drugs, the available evidence for the appropriate strategies to improve prescribing is scarce in Iran. The goal of the this study was to assess the prescribing pattern of general practitioners (GPs) in Fars province (Shiraz) and evaluate the effectiveness of the combination of feedback of individualized prescribing and workshop training programs.Materials and Methods: A quasi experimental intervention study was conducted in which prescription copies of 119 GPs before and after intervention was compared. Physicians received individual instruction with specific recommendations or participated in a training workshop for improvement according to their baseline prescribing quality levels. The paired t-test was used to compare before and after results.Results: The most frequently prescribed drugs were injectable drugs (58.8%) and antibiotics (47.3%). A trend toward increasing rational drug prescriptions was observed in most pharmacological components of prescriptions. Over-prescription of injectable and non-steroidal anti-inflammatory (NSAIDs) drugs showed statistically significant decrease, but the antibiotics showed no significant change. Unusual dose of antibiotic, concurrent prescribing of H2-blocker and Omeprazol and first degree drug-interaction also decreased significantly.Conclusion: The intervention showed that improving the quality of prescribing was feasible, particularly in over-prescribing.

Background: Unsaturated fatty acids decrease serum leptin level and wild pistachio oil is rich of them. With attention to this effect and reciprocal effects between leptin and thyroid hormones, the aim of the present study was to investigate the impact of dietary wild pistachio oil on serum leptin concentration and its relationship with thyroid hormones.Materials and Methods: 28 healthy adult female rats were selected and divided randomly to four equal groups. Group 1 as the control group and other three groups received normal diet with, 5, 10 and 20% of wild pistachio oil, respectively. RIA for thyroid hormones assay (T3 and T4) and ELISA for leptin, fT3 and fT4 measurement were used.Results: Serum leptin level reduced with increasing wild pistachio oil concentration in the diet after 60 days. In the control group with normal diet important alterations weren't observe. The differences between groups were significant. Pearson correlation coefficients were calculated between leptin and thyroid hormones in the different sampling times. Control group had not any significant correlation. In group 2 (feeding with 5% wild pistachio oil), leptin concentration had a positive significant correlation with fT4(r=0.87; P<0.05). There was no significant correlation between leptin and thyroid hormones at the third stage of sampling. A positive significant correlation between leptin concentration and T4 at the third stage of bleeding was observed in group 4 (feeding with 20% wild pistachio oil) (r=0.95; P<0.05).Conclusions: Wild pistachio oil has a high content of unsaturated fatty acids; therefore reducing serum leptin level in the studied rats can be related to unsaturated fatty acids effect on serum leptin level. Taken together oral consuming of wild pistachio oil has a positive effect on reducing leptin and cholesterol of serum, Its association with thyroid hormones and prevention of cardiovascular diseases.

Background: Social support is known as a health behavior facilitator which is correlated with adherence of self care behaviors among diabetic patients. The aim of this study was determining the status of this construct and its correlated factors and also its association with self care behaviors in diabetic patients.Materials and Methods: This analytical and cross-sectional study was carried out on 120 patients who referred to Yazd diabetes research center. A questionnaire was used for data collection which measured perceived social support and self care behaviors constructs.Questionnaire was completed with a private interview of subjects. Subjects' demographic variables were also enquired. Validity and reliability of the questionnaire was assessed and approved.Results: Subjects earned 58.1% of earnable score of social support which was due to 56.4% of earnable score of supportive family behaviors and 39.4% of earnable score of nonsupportive family behaviors. Among self care dimensions, correct taking of drugs was at the lowest rate of perceived support and general cares of diabetes was at the highest level. Perceived nonsupportive family behaviors, was significantly more common among women. Perceived social support was positively associated with self care behaviors (r=0.253). Perceived supportive family behaviors also was correlated with self care behaviors but the correlation of perceived nonsupportive family behaviors and self care behaviors was not statistically significant. Perceived social support predicted only 6.4% of variance in self care behaviors while perceived supportive family behaviors predicted 9.1% of variance in self care behaviors.Discussion: Perceived family support level was not at a favorite level and some dimensions of self care behaviors such as correct taking of drugs was at a worse situation. Attention to family support in educational programs for increasing self care behaviors among diabetic patients is highly recommended.

Background: Left ventricular hypertrophy (LVH) is reported to be common in chronic hemodialysis patients and also increases risk for mortality and morbidity in such patients. Effects of PTH on LVH are approved by clinical and experimental studies. Therefore, PTH control is important in LVH prevention. In some centers PTH can be measured, so we conducted a descriptive study about the relationship between Ca, P, alkaline phosphatase and LVH in chronic hemodialysis patients.Material and Methods: 56 chronic hemodialysis patients included in this descriptive-analytical study and followed for one year. The patients were divided into LVH group and non- LVH group by echocardiographic findings. The mean Ca, P, Alkaline Phosphatase (Alk),Ca×P product, Hb, HCT ,serum Albumin were checked monthly and moreover HTN frequency, hemodialysis duration, cardiac calcification and ACE in, EPO use were compared in two groups. Relationship between these factors and LVH was evaluated using Chi-Square T.test and fisher-Exact test.Results: Results showed that 32 patients (57.1%) had LVH, among them 19 patients (59.4%) were male and 13 patients were (40.6%) female (P<0.05). Mean age of patients with LVH was 53.5+- 13.3 which had not statistically significant difference with patients without LVH (P>0.05).The mean serum levels of Ca, P, Alk P, Hb were not significantly different in both groups but mean of Ca×P product was significantly higher in the LVH group (P<0.05) (58.7±16.6 versus 47.6±18.2).Conclusion: HTN control, ACE inhibitor and EPO use are important in prevention of LVH in chronic hemodialysis patients but maintenance of Ca×P product in acceptable level is another important factor for this prevention.

Background: Respect to psychological needs and health of students that are high ratio of country population is highly important. Because of some stressful factors and impact of circumstances, this group is at high risk. The purpose of the present study is assessment of GH and some related factors among students of ZUMS.Materials and Methods: This cross-sectional study was carried out on 240 students of ZUMS in 2007. The subjects were selected using stratified random sampling. The data were collected using GHQ-28. The cutoff point of total score was set as 28 and in each item was set as 6. In addition to demographic information, we asked all subjects about history of use taking drugs, type of drugs, and history of illness. The data were analyzed by SPSS version 13 soft ware using descriptive and analytical (Chi-square test and principal component analysis) statistics. Significant level was set as 0.05.Results: This study showed that 38.8% of students are suspected to have physical or psychological disorders. These disorders among males and females were 22.7% and 44.8%, respectively (P<0.05) which were highlighted in anxiety item. GH status of students was related to marital and socio-economic status (SES) of students (P<0.05) that this relationship was more obvious in depression and social function items. Single students and students with low level SES had more problems. GH status of students was not related to graduate level, semester, field, age, physical activity, average, residential status and household size (P>0.05).Conclusion: Socio economic status, especially monthly income is a good predictor of psychological disorders among students, so respect to Socio economic status of students, especially students with low monthly income is too important.

Background: Urinary tract infection and resistant organisms are the most serious problems for hospitalization and mortality in spinal cord injured patients. Empirical administration of various antibiotics in hospitals has caused increased resistant organisms involved in UTI in these patients. In this study, the antibiotic sensitivity of organisms isolated from urine samples of spinal cord injured patients with UTI was investigated.Material and methods: It was a cross sectional study which was done on 145 male patients with spinal cord injury and UTI referring to Al-Zahra hospital, Isfahan, from 1384 to 1385. Urine sample was obtained from them on the basis of bladder drainage method (catheter, condom bag or cred maneuver) and was sent for analysis and culture. MIC of various antibiotics on organisms was determined using E test.Results: Mean age of patients was 44.1±2.According to culture results of patient´s urine samples, Ecoli (53.3%), klebsiella (20%), Enterococcus (9.1%), pseudomonas aeroginosa (8.3%), proteus (0.8%), serratia (2.5%), staphylococcus aureus (4.1%) and staphylococcus epidermidis (1.6%) were isolated. Highest rate of positive cultures were seen in patients with permanent catheter.The most percentage of sensitivity of organisms to antibiotics amikacin, ciprofloxacin, gentamicin, trimethoprim/sulfamethoxazol, ceftriaxone and ceftazidim was respectively: in Ecoli %94.1 and Klebciella 100%to Amikacin, in pseudomonas 80% to Amikacin and Ceftazidim, in Enterococcus, Staphylococcus aureus and epidermidis 80% to Vancomycin. The sensitivity of Proteus and Seratia to Ciprofloxacin, Ceftriaxone, Ceftazidim and Amikacin was100%.Sensitivity of gram negative organims to Ciprofloxacin was more than Ceftriaxone and sensitivity of all of them to Imipenem was 100%. The most resistancy of gram negative organisms was to Trimethoprim/Sulfametoxazol and about Enterococcus and Staphylococcus was to Amikacin.Conclusion: With regard to increased risk of urinary tract infection with resistant organisms in spinal cord injury, determination of antibiotic sensitivity has an important role in proper treatment of these patients and prevention of inadvertent use of broad spectrum antibiotics with unknown effect on organisms causing urinary tract infection. Consequently it is useful in prevention of increasing microbial resistance and in reduction of patient's costs.

Background: Incorrect diagnosis in internal anatomy and morphology of the pulp increases failure probability in endodontics treatments. Thus, being familiared with possible anatomic forms of tooth root canals is necessary. The aim of this study was prevalence assessment of C-shaped canals in mandibular second molars of patients attending to the surgery department of Zahedan dentistry school and dentistry centers in Zahedan 2006-2007.Materials and Methods: In this study, a total number of 368 mandibular second molars of the patients attending to surgery department of Zahedan dentistry school and city dentistry centers were collected. Then access cavities were performed on the teeth with fused roots by high speed handpiece with water spray and fissure bur. Teeth which had C-shaped orifices were separated under direct dental unit light and 3x magnification . After that teeth were marked on three points: CEJ, midroot, and 2mm to apex and were mounted in translucent acryl. Radiographic images were taken from each tooth in faciolingual and mesiodistal aspects. Then 0.2mm thickness cross sections were made by hand piece and diamond disc (D&Z). These sections were assessed under stereomicroscope by 40 magnifications. C-shaped canal forms were categorized according to Melton classification and their radiographic views were classified according to Fan classification.Results: This research was performed on 368 mandibular second molars, out of which 312 teeth (84.8%) had two separate mesial and distal roots. 56 teeth (15.2%) had fused roots 11 of which (3%) had C-shaped canals. The number of teeth in each category and type was as following: 5 (1.35%) category I , 4 (1.08%) category II , 2 (0.57%) category III. Based on radiographic views the number of teeth in each type was as following: 4 (0.36.4%) type I. 2 (18.2%) type II and 5 (44.4%) type III.Discussion: Clinical significance of c-shaped canal is due to cleaning and obturation problems of the canal. %3 prevalence of c-shaped canal in studied group of this survey showed the necessity of clinician care for better diagnosis and treatment and higher success rate of root canals treatments.