Journal of Shahrekord University of Medical Sciences
Year:2005 | Volume:7 | Issue:2|Papers Count:12

Background and Aim: Combined anterolateral and posterolateral rotary instability are treated by correcting knee alignment, Anterior Cruciate Ligament (ACL) reconstruction and repair or reconstruction of the Posterolateral Complex (PLC). Because of technical difficulties encountered in these operations and the need for more than tow stages, and considering the controversy among the importance of Posterolateral Complex (PLC) in valgue knee, this study was performed to treat this instability by ACL reconstruction alone, after correction of varus, without reconstruction of the posterolateral complex and further extra-articular manipulation. Methods: This clinical trial was performed on 29 patients (29 knees) with combined anterolateral and posterolateral rotary instability. Subjective and objective instability signs were recorded. Arthroscopy was then performed. To correct alignment, a valgus osteotomy was done and then an ACL reconstruction carried out. Results after a mean of 23 months follow-up, were compared to the ones of before surgery. Fisher Exact test, 2 and Wilcoxon tests were used to analyze data. Results: Pain was relieved in more than half and locking disappeared in all of the patients. giving way diminished from 79.3% to 6.9%. Special instability tests showed a significant improvement after surgery (P<0.001). Most of the patients returned to the preinjury level of work or sports. Conclusion: Based on the results of this study, after correcting varus, ACL-reconstruction alone, without further invasive procedures on extra-articular structures and posterolateral complex, is sufficient to cure this instability, avoiding unneeded complications and longer rehabilitation.

Background and Aim: Among the man-made radiation sources, X-ray machines cause most of the patient exposures. The aim of this study was to measure the radiation doses received by patients in diagnostic radiology departments in Chaharmahal and Bakhtiari province. Methods: Seven X-ray machines from six hospitals were studied. Entrance surface dose (ESD) was measured for twenty randomly selected patients for each X-ray machine. The amoluminescence, LiF (Litium floride) and Geiger-Muller dosimeters were used to measure patient"s exposure in four common radiographic views. Results: The ESD for the PA and lateral chest x-ray examinations were found to be in the range of 0.22-1.45 and 0.34-4.90 mGy respectively. The ESD values for the AP (Anteroposterior) or PA (Posteroanterior) skull and LAT (Lateral) skull were in the rage of 2.55-8.45 and 2.85-9.12 mGy respectively. Conclusion: The results indicated that quality assurance (QA) programs should be taken seriously to reduce high patient doses. Also it is recommended to avoid unnecessary radiation exposure.

Background and Aim: Saghand area is located at 190 Km north-east of the Yazd city. The presence of radioactive materials and the possibility of radiation caused concern among people. This study was performed to measure radioactive materials in the soil, plant, and water of the Saghand area. Methods: In a cross sectional and analytical study the amounts of Ra226,Tu232, K40 and Cs137 in each 5Km as far as 50Km of Saghand mines were measured. Samples of plants were washed, dried and grinded. Samples of soil were picked up from 30cm deep and the water samples were picked up from the springs of that area. The samples were analyzed by spectrometry by the pure germanium (H.P.Ge) detectors in the lab of Iran Atomic Energy Organization. Results: The results showed that the value of Ra in the soil was 21-45, Tu was 21-43, K was 303-505, Cs was 0.1-12 Bq/Kg, and the amounts in the both axes were similar. The amount of Ra in the plant of that area was 0.6-2.8, Tu was 1.7-3.3, K was 86-157, and Cs was 0.4-3.4 Bq/Kg. The value of Ra226 of water was between 2 to 8 mBq/liter in the water sources of that area. Conclusion: According to the radiation law, by increasing the distance, the value of radiation from radioactive materials do not decrease. The value of radiation in water was much less than the standard level (110 mBq/liter). Therefore, we can confie to all of the people in the district that the life is not dangerous for water, food and soil pollution with radioactive materials in this region.

Background and Aim: Due to importance of the emergency wards the ministry of health and medial education introduced a plan for the improvement of emergency wards. This plan has been executed since 2002 in Kashani and Hajar hospitals of Shahrekord. The aim of this study was to find the effects, pros and cons of the plan. Methods: This descriptive and analytical study was performed on 264 patients before and after the execution of the plan. According to the ward of service donor 35-60 cases were selected for evaluation of the services. Data was collected by observation and three types of questionnaires during the first six months of the years 2002 and 2003. Results: Execution of the plan caused a structural advancement of 13.98% and 16.67% in Kashani and Hajar hospitals respectively. Likewise, the educational condition for the emergency wards have a good improvement towards average condition of 14.29% in Kashani and 10.72% in Hajar hospital. The mean interval between the time of entrance and the first visit of the patients suffering from cerebral ischemia and stroke was 9 minutes. The mean interval between the time of entrance for the patients suffering from stroke to CT scan was 56 minutes. The mean interval between the time of entrance for the patients with neurosurgery and first visit was 9 minutes that decreased significantly (P<0.01). The results showed that the mean interval between the time of entrance for the patients with acute myocardial infarction and first visit to the patients was 6 minutes and 48 seconds that decreased significantly (P<0.01). Conclusions: The results showed that the performance of improvement plan on the emergency services has improved these services but still is far from the ideal.

Background and Aim: Accidents, which are prevalent in our country, are responsible for different kinds of injuries like fractures that lead to physical and psychological complications. Psychological factors play an important role in the quality of life. Mental distress can interfere with economical, cultural and social aspects of life, which lead to impaired quality of life. Since there has not been any research about quality of life in patients with fractures, we assessed the quality of life in these patients and compared with that of the healthy people. Methods: This cross-sectional and analytical study was performed on two groups (patients and healthy subjects) each consisted of 60 persons of 20-50 years old. The patients have underwent a surgery for the fracture of femoral shaft and had no other fractures or trauma of other organs. Also none of them had a history of fracture complications during 1-2 years after surgery and they had all the criteria indicating good clinical and radiological outcomes. Two groups had comparable economical and social status. A Short Form-36 (SF-36, Farsi translation) questionnaire was filled for each person to assess the quality of life [Physical Function, Emotional Health, Pain, Vitality, Role Limitation due to Physical Health, Role Limitation Due to Psychological Health, Social Function, General Health] and the data was compared between two groups using t-test. Results: The mean age of the patients was 34.18 years. Compared to the control group all 8 aspects of the quality of life were lower in the patients. There was no difference between males and females. Conclusion: The low quality of life could be due to poor follow up of the patients, payment for the surgery or lack of social support. Lack of enough rehabilitation programs after the surgery may also influence the quality of life. This shows the importance of good follow up and participation of the patients in the treatment and rehabilitation programs.

Background and Aim: Stress provokes unspecial responses and render necessary changes in life. Universities have many stressful conditions for newly arrived students such as being away from home, economical and communicational problems, etc. This study was performed to find the efficacy of consoling guidelines to decrease psychological problems in newly arrived students of Shahrekord university of medical sciences. Methods: The sample consisted of 40 persons out of 148 newly arrived students with a GHQ-28 questionnaire score of equal or more than 23. The sample was randomly divided into two groups of case and control. After 3 months (without any intervention) and 7 months (education of consoling guidelines) the psychological health was assessed by GHQ-28 questionnaire. The data was analyzed by ANOVA, t-test and Dunkan test. Results: There was no significant relation between elapsed time, adaptation with university or being far away from family and psychological problems. But there was a significant correlation between education of life skills, relaxation or psychoanalysis and reduction of psychological problems. There was no reduction of disorders scale in the control group but there was a reduction in summarization scale, anxiety and social dysfunction in the case group. Conclusion: Consoling guidelines and psychological intervention such as education of life skills, psychoanalysis and relaxation could improve the life quality and reduce psychological problems of the students.

Background and Aim: Satureja khuzestanica is a native plant of Iran that is widely distributed in the southern part of the country. In traditional medicine, it is used as analgesic and antiseptic. The previous studies showed that Satureja khuzestanica caused weight loss. Then the present study was designed to find the effect of Satureja khuzestanica on food intake, glucose, lipid factors, protein and electrolytes. Methods: In three groups, 75, 150 and 250 mg/kg/day of extract of Satureja khuzestanica were orally administered for three weeks. In the fourth group essential oil of Satureja khuzestanica (1000 ppm) was administered in drinking water for three week. The control group received tap water. Animals were weighted and food intake was recorded. After three weeks, plasma cholesterol, triglyceride, fasting blood sugar (FBS), creatinine, potassium, BUN (Blood Urea Nitrogen), urea and alkaline phosphatase (ALP) were measured. Results: Serum triglyceride level (43.15±3.92 mg/dl) in essential oil group was significantly (P<0.001) lower compared to that (89.99±8.03mg/dl) of the control group. FBS (117.86±8.5 mg/dl) of group 3 and essential oil group (97.22±7.1 mg/dl) were significantly (P<0.001) different from that (165.97±15.91 mg/dl) of the control group. Food intake in 3 weeks decreased in the group 3 (80.87±3.5 gr) and increased in the essential oil group (101.45±7.9 gr) when compared to that (88.91±3.9 gr, P<0.001) of the control group. Satureja khuzestanica induced a decrease in serum creatinine level in the extract and essential oil groups (P<0.001). ALP in the essential oil group was significantly (P<0.001) decreased compared to the control group. No significant changes were observed for other factors. Conclusion: The aqueous extract and essential oil of Satureja khuzestanica induced a reduction in the serum glucose and triglyceride levels and improved renal function with lowering serum creatinine. They also improved the liver function via decreasing liver enzyme activity in rat.

Background and Aim: There are controversy about the advantages and disadvantages of new psychiatric drugs, particularly about clozapine in comparison to other drugs. The aim of this study was to compare the effects of clozapine and haloperidol on positive and negative symptoms of chronic schizophrenic patients hospitalized in Sina Psychiatric Center, Chahrmahal and Bakhtiary province, Iran. Methods: Sixty schizophrenic patients were divided into two equal groups. One group received clozapine (200 mg/day) and the second group received haloperidol (15 mg /day) for 6 weeks. Symptoms were measured using Positive and Negative Symptoms Scale (PANSS). Results: Clozapine was better than haloperidol in decreasing positive and negative symptoms (P<0.05) and clozapine was better than haloperidol in treating positive symptoms in females (P<0.05). There was no evidence of any superior efficacy of clozapine or haloperidol in treating negative symptoms in females. Conclusion: Clozapine was better than haloperidol in decreasing positive and negative symptoms and should be considered more for the treatment of chronic schizophrenia.

Background and Aim: Diabetes mellitus is an important and global health problem and is the seventh leading cause of death in the United States. It causes a high mortality and produces many personal, familial, social and financial problems. This study was performed to evaluate quality of life in diabetic patients based on the complications. Methods: ‏‏‏‏This study was performed on 150 patients with diabetes mellitus selected by unrandomized sampling from patients referred to Shahroud Imam Hossein hospital. Based on the disease complications the sample was divided into 4 groups: without complication, microvascular complication, macrovascular complication and miro-macrovascular complication. Quality of life was assessed in physical, emotional and social aspects with audit of diabetes dependent qoL (ADDQoL) questionnaire. Results: Average age of the sample was 59 years. 79.3% of patients were married, 62.8% were uneducated, 78.7% of patients did not have any educational course about diabetes mellitus. The mean of the total score of the quality of life in without complication group was 60.4 11.6, in microvascular complication group was 56.4 10.4, in macrovascular complication group was 61 7.8 and in micro-macrovascular complication group was 50.1 11.7. The quality of life of 4 groups was significantly different (ANOVA, P<0.05). There was not a significant correlation between demographic variables and the quality of life score. Conclusion: The results showed that diabetes mellitus complications have significant and advert effects on the quality of this patient"s life. Therefore, rapid diagnosis of the disease and its complication and use of appropriate therapeutic strategies in prevention or decreasing the complication is essential.

Background and Aim: Postoperative pain causes various problems such as medical complications, excess cost and administration of opioid drugs. Although previous studies have shown the preventive effect of ketamine on postoperative pain, the administered dose was high (over 1mg/kg), which may cause adverse effects. The aim of this study was to assess the effect of low dose (0.5 mg/kg) of ketamin on postoperative pain. Methods: Sixty women that were candidate for elective cesarean section were recruited for our study and were divided randomly into two groups of case and control. Sixty seconds before operation, case and control groups received 0.5 mg/kg ketamine or placebo, respectively. Techniques of anesthesia and surgery were the same. Pain severity was assessed by McGill pain questionnaire, at 4 visits (the first at recovery then every 6 hours). Results: Case patients showed a lower mean pain score (P<0.05, t-test). Conclusion: This study suggests that low dose of ketamine is an effective drug for postoperative pain, which could be considered as an alternative of its high dose.

Background and Aim: In the past two decades, the relationship between family functioning and parenting style has been studied by many researchers. In the present study family functioning of three groups of families, irresponsible families, families with behavioral disorder children and normal families was investigated. Methods: The McMaster model of family functioning questionnaire and baumarind parenting style questionnaire have been filled for three groups of children: 36 children with behavioral disorders, 65 children of irresponsible families and 444 children of normal families. Results: Results of the study indicated that, family functioning among the irresponsible families and families with behavioral disorder children was statistically lower than that of the normal families. Low family functioning in irresponsible families and families with behavioral disorder children was positively related to authoritarian parenting style. Family functioning in normal families had positive relationship with uninvolved and authoritarian parenting styles and negative relationship with authoritative parenting style. Irresponsible families and families with behavioral disorder children had more authoritarian and uninvolved parenting styles than authoritative parenting style. Conclusion: Parenting styles play an important role in family functioning and family functioning plays an important role in children"s health.

Background and Aim: Despite the wide use of family planning programs, they have not reached their goals -the prevention of unwanted pregnancy- and this failure was mainly due to coitus interrupts. The aim of this study was to find the correlation between socio-demographic characteristics and contraceptive methods in 15-49 years old women of Shahrekord in 2003-2004. Methods: This descriptive and analytical study was performed on 668 women selected by simple sampling from those referred to 9 urban clinics. A questionnaire with 31 questions about demographic and social factors and about the reason that they did not select another contraceptive method, was filled for each woman. For data analysis, descriptive statistics and Chi square test were used. Results: Demographic factors such as age of husband, age of marriage, duration of marriage, age of the first pregnancy, number of pregnancies, delivery, number of children and desire to have another baby and ideal number of children had significant correlation with choosing coitus interrupts. Social factors such as wife and husband education, wife and husband occupation and the pattern of making decision had significant influence on choosing coitus interrupts. Results also indicated that the most common reason for refusing to use pills was psychological problems, for IUD was uterine bleeding, for TL was desire to have another baby, for vasectomy was husband"s unsatisfaction, and for condom and coitus interrupts was fear of pregnancy. Conclusion: According to the results, young men, couples with lower age of marriage, low age at first pregnancy 6 lower frequency of pregnancy delivery and childern 6, short duration from marriage and also higher educational degree and occupational level, choose coitus interruptus more than the others. Therefore, in familly planning the abovementioned factors should be considered.