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Volume 5, Issue 21 (12-1997)
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Volume 6, Issue 23 (6-1998)
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Volume 10, Issue 40 (9-2002)
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Background: Most of cesarean deliveries are performed with regional anesthesia especially spinal anesthesia (SA). Disadvantages of SA include maternal hypotension and fetal asphyxia. This study was conducted to find prophylactic strategies for prevention of maternal hypotension in the women who were candidate for cesarean in Rasht Azzahra Hospital in 2001. Materials and Methods: This study was a double blind randomized clinical trial that was done on 96 women who were candidate for elective cesarean section. The patients were randomly divided into four groups (24 patients in each group). They received either Saline (control), intramuscular Ephedrine 30 mg [IME] 15 minutes before SA, intravenous Ephedrine 30 mg [IVE] one minute after SA and intravenous Atropine 0.5 mg [IVA] one minute after SA. Blood pressure, pulse rate (PR) and SaO2 were determined before SA and then with 3 – 5- minute intervals until 40 minutes after SA. Severe hypotension was defined as more than 30% decrease in systolic blood pressure or less than 90 mmHg in patients with normal blood pressure. SA was done with 5% Lidocaine. Statistical analysis was done using Chi-square test and variance analysis. Results: The prevalence of severe hypotension was 21% in IME, 17% in IVE and 37.5% in IVA and 42% in control group. Their difference was statistically significant only in IVE (P<0.05). IME group had more tachycardia than other groups probably due to higher prevalence of mild hypotension. Ephedrine IV had not any adverse effect on maternal PR, neonatal PR and APGAR score. Conclusion: Prophylactic administration of Ephedrine 30 mg IV during one minute after SA is useful for the prevention of severe hypotension in cesarean deliveries and these patients had more hemodynamic stability. Administration of this drug had not any adverse effect on maternal PR, neonatal PR and APGAR score.


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Volume 10, Issue 40 (9-2002)
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Background: Lupus nephritis, especially diffuse proliferative type is one of the potentially life threatening disabling consequences of SLE that needs intensive and invasive treatment. As there is not enough information available about the results of Intravenous Cyclophamide (IVC) therapy on these patients in our country, this study was performed from 1997 to 2002 in Esfahan Azzahra Hospital. Materials and Methods: In this semi-experimental study 14 hospitalized patients with Diffuse Proliferative Glomerulonephritis (DPGN) were treated with IVC, and the efficacy of IVC was investigated by evaluation of urine sediment, serum urea, creatinin, and urinary excretion of creatinin and protein. The results were evaluated after 6,12 and 24 months of IVC therapy again. All of the data were analyzed by paired t-test and Chi - square test. Results: 3 patients were excluded and 14 patients were studied. Partial remission was seen in 5 patients (33.4%) after 6 months, and in one patient (7.1%) after 12 months of IVC therapy. There was not any cases of partial remission after 24 months of treatment. The rate of complete remission in 6th, 12th and 24th months of study were 14.3%, 28.6% and 28.6%. The cumulative frequency of complete remission cases in 6th, 12th and 24th months of study were 14.3%, 42.9% and 71.4%. In general, only 3 (21.4%) cases continued to have proteinuria in the range of nephrotic syndrome after 24 months of treatment. The average interval to achieve partial remission was 7.7 2.9 months and for complete remission was 15.6 7.59 months. Conclusion: Most cases with diffuse proliferative lupus nephritis achieved complete remission after 2 years (71.4%) of IVC therapy. So we recommend this treatment for all patients with lupus induced diffuse proliferative glumerolonephritis.


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Volume 10, Issue 40 (9-2002)
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Background: Considering high prevalence of hypertension and its increasing trend in urban areas, insufficient awareness of its prevalence in rural areas, and also in order to determine its prevalence and some related factors in rural population, the present research was performed on the population affiliated to health centers in Tarom in 2001. Materials and Methods: This cross-sectional study was carried out on 1500 people over 15 years of age who had been selected through multi-stage randomization. The information required was gathered using questionnaire, interview, and observation by 10 trained Behvarzes. Blood pressure, height, and weight were measured using standard scales, cloth meter and the same sphygmomanometer. Then, the subjects who had systolic blood pressure more than 140 mmHg in two repeated visits were labeled as hypertensive people. After the determination of prevalence of hypertension, the relationship between hypertension on one hand and sex, age, and Body Mass Index (BMI) on the other hand was determined as well. Then, confidence interval was estimated. In order to analyze the data descriptive statistics and Chi-square were utilized. Results: Among 1500 people studied, 42% were male and 58% were female. The prevalence of hypertension was determined to be 12/3% in the samples and by increasing the age and BMI the proportion of hypertensive people was found to be on rise (P<0.0001). Conclusion: Hypertension rate was found to be higher in Tarom rural areas with different lifestyle in comparison with areas with civil lifestyle. More studies to determine the factors related to the increase in hypertension prevalence and observational studies to relieve this problem are highly recommended.


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Volume 10, Issue 40 (9-2002)
Abstract

Background: Endoscopic procedures are performed for diagnosis and treatment of GI disturbances and require adequate, short-time anesthesia. Propofol is a rather recently introduced IV drug used for its conscious sedation effects. This study has compared the effects and complications of propofol versus midazolam in endoscopic procedures in Hamedan in 2001. Materials and Methods: This double blind randomized clinical trial was performed on 70 patients at ASA class I- II who underwent endoscopy or colonoscopy at Ekbatan Hospital in Hamedan. After randomization of the patients into 2 study groups: test (propofol) and control (midazolam), phentanil (5mg/kg) was administered as a sedative and after 3 minutes contents of syringe A (propofol) or B (midazolam) were injected by an anesthesiologist. Then, the 2 groups were compared regarding such points as injection pain, conscious sedation, operation satisfaction (by the patient), duration of recovery, nausea and vomiting, hypotension and decrease in O2 saturation. Results: Average score of conscious sedation in midazolam group (4.1) was slightly higher than propofol group (4). Mean duration of recovery was 15.3 in midazolam and 14.8 in propofol groups. A total of 14 patients (40%) in midazolam group and 7 patients (20%) in propofol group experienced complications whose difference was not statistically significant. Mean pain score in midazolam group (2.7) was slightly higher than propofol group (2.6). Mean satisfaction score was also slightly higher in midazolam group (3.23) vs propofol group (3.2). Conclusion: There was no statistically significant difference between propofol and midazolam from the point of view of conscious sedation, patient satisfaction, duration of recovery, injection pain and other complications.


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Volume 10, Issue 41 (12-2002)
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Volume 10, Issue 41 (12-2002)
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Volume 11, Issue 42 (3-2003)
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Background: Infection with human immune deficiency virus (HIV) or hepatitis B virus (HBV) is one of the health problems in blood transfusion science. This study was conducted in shiraz for determination of the rate of HIV positivity in blood donors during the years 1998-2002. Materials and Methods: This cross-sectional descriptive study was conducted on 615790 blood donors. All samples were screened by ELISA for HIV and all positive samples were analysed by western-blot for final confirmation. All positive samples in western-blot were considered true positive for HIV. Epidemiological data such as age, sex, marriage and number of blood donation were studied and the rate of hepatitis B and C in HIV positive and HIV negative blood donors were compared. Results: The rate of HIV positivity in blood donors was 5.5 in 100,000. The mean age of HIV positive persons was 33.4±4.2 y. 94.2% of HIV positive cases were male and 79.4% of them were married. 32.4% of HIV positive cases were first blood donors. HIV positivity was more common in first blood donors and in male donors (P<0.005), but there was not any significant differences between married and single persons regarding the HIV infection rate. HCV Ab was positive in 10.4% of HIV positive blood donors and HBS Ag was positive in 5.2% of them. Conclusion: Frequency of HIV infection in blood donors in iran is lower than many other countries. Regarding the prevalence of the infection in young age, educational programs in these age groups were recommended.


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Volume 11, Issue 43 (6-2003)
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Volume 11, Issue 44 (9-2003)
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Volume 12, Issue 46 (3-2004)
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Volume 12, Issue 47 (6-2004)
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Background: Methoxsalon is considered as an effective drug in controlling skin diseases. Since there have been reports concerning cellular disorders following the intake of the drug, this study was undertaken to analyze the effects of methoxsalon treatment on liver in subjects in Tehran Medical university (2003-2004). Materials and Methods: In this experimental study 40 albino rabbits (32 females & 8 males) with approximate weight of 2.5-3 Kg and 5.5-6 months old were divided into 4 groups. One group served as control and 3 others as treatment groups to investigate the effects of the drug in three different stages of pregnancy (predifferentiation stage, embryonic stage and fetal stage) . Following the copulation and successful fertilization, an oral dose of 0.6 mg/kg drug was administered to treatment groups every other day for 8 days. Fourteen weeks after birth, prenatal treated rabbits were anesthetized and were submited to light microscopic tissue preparation. Results: Hypertrophic hepatocytes with highly vaceuolated cytoplasm and degenerated nuclei were found. Conclusion: Regarding the vital importance of proper functioning of hepatocytes either during fetal stage or adulthood and in the light of harmful effects of methaxosalon on fetus, it is recommended that administration of the drug be carefully carried out. More research is also recommended.
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Volume 12, Issue 47 (6-2004)
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Background: In the light of dysmenorrhea prevalence and its importance for women at reproductive age and lack of clinical research on the effects of fish oil on dysmenorrhea in our country, this study was conducted on university students over the period 2002-2003. Materials and Methods: This clinical trial (before & after treatment) was carried out on 80 single girls, who suffered from primary dysmenorrhea. Data were collected through a questionnaire including demographic factors, exercise, stress causing factors, use of pain reliever and the Mc Gill pain ruler for determination of pain. The subjects were classified into two groups based on their pain severity. The moderate group (4 grade 7) and also the severe one (8 grade 10) and the subjects with less than 4 grades were excluded from this study. All the subjects consumed fish oil capsule (1gr), b.i.d from the 15th day of menstrual cycle for 45 days continuously. The research data were collected before study, during the consumption of fish oil and two menstrual periods thereafter and were analyzed by employing Sign and McNemar statistical tests. Results: The subjects averaged 22.1 2.5 years of age. Factors affecting dysmenorrhea severity did not show significant difference before and after treatment. Severe dysmenorrhea decreased from 50 percent to 21.2 percent, (P= 0.0001). The consumption of pain reliever decreased after treatment with fish oil. Moreover, no serious side effects were observed as a result of fish oil intake. The effect of fish oil improved after 2 cycles followup, so that severe dysmenorrhea decreased from 21.2 percent to 16.8 percent. Conclusion: The consumption of fish oil (2gr daily) for 45 days decreases primary dysmenorrhea. The investigation of effects of long term consumption of fish oil (6 months) is recommended.
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Volume 12, Issue 47 (6-2004)
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Background: Approximately 90% of hospitalized clients receive some type of infusion therapy. Phlebitis is a common complication of i.v. therapy. In numerous studies, application of drugs such as antiseptics, heparin, steroids and filter administration have been tested to reduce phlebitis occurence. Subsequently, the present study was carried out with the aim of efficacy of topical nitroglycerin on severity and occurence of phlebitis in 2004. Materials and Methods: This study was a randomized double – blind controlled clinical trial. The investigated units consisted of 82 patients, who were prescribed intravenous catheter. In this research, the samples were randomly divided into two equal groups: control group and experimental group. These two groups were matched according to their age and medication received .After the placement of the catheter, nitroglycerine ointment (1.5 centimeter) or placebo ointment was applied to the distal section of the injection place and every 12 hours the site of cannulation was examind for signs and severity of phlebitis and ointmet was readministerd and bandaged. This was repeated at intervals of 24, 36, 48, 60 and 72 hours. The data were collected by using checklist. The results were analyzed using T-test and X2 and relative risk was plotted. Results: The results showed that occurrence and severity of phlebitis in experimental group was significantly lower than control group after applying the ointment. (P =0.001). Moreover, the results showed that longevity of catheter was higher in treatment group than in control group. Conclusion: According to the above findings, the hypothesis of this research was approved .The results can be applied to nursing service , nursing education and nursing research .
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Volume 12, Issue 47 (6-2004)
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Background: Unstable angina is a critical phase of coronary heart disease with widely variable symptoms and prognosis. In recent years, the pathophysiological roles of platelet activation and inflammation in unstable angina have been elucidated. The main aim of this study was to evaluate the role of C-reactive protein (CRP) and neutrophil count as predictive factors for future events (in a six-month follow up) in unstable angina patients. Materials and Methods: In this cohort study subjects were 100 patients with unstable angina (class IIIB Braunwald) who were admitted to coronary care unit .At the time of admission blood sample was obtained for CRP and leukocyte count. Patients were followed up for 6 months and coronary events such as readmission, myocardial infarction, coronary angiography and coronary revascularization were investigated. To determine relation between exposure and outcome relative risk was used. Results: Fifty percent of patients were males and 50% were females. Twenty percent of the patients had readmission. Myocardial infarction occurred in 4%, coronary angiography was performed in 28%,coronary revascularization was carried out in 23% and 4% of patients died. There was a significant relation between positive CRP and coronary events (P=0.009, RR=1.8). Patients with neutrophil count higher than 70% also had significant cardiac events (P=0.007, RR= 1.95). Conclusion: This study revealed a positive relation between CRP and leukocyte count with coronary events in unstable angina patients. Thus, these factor had prognostic risk index importance. More research with higher sample number is recommended.
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Volume 12, Issue 47 (6-2004)
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Background: Precise information about diseases and injuries is becoming increasing vital for the process of policy making in public health system. In 1993 WHO assessed the global burden of diseases. Since then, WHO member states have been engaged in the study of the burden of early mortality. The aim of this study was determing the burden of early mortality in people living in Zanjan province in 2003. Materials and Methods: In this discriptive study data were taken from the vital statistical ward in Zanjan University of Medical Sciences. We used WHO guidelines and software for estimating burden of early mortality by calculating YLL (Years of life lost due to mortality) for each disease group. Results: A total of 4199 deaths were recorded in the death registry. Of these 4118 (98%) deaths were analyzed to calculate YLL. Communicable, maternal, prenatal and nutritional disorders accounted for 75 (1.8%), non-communicable diseases for 3289 (79.9%) and injuries for 754 (18.3%) deaths. Top 5 causes of early death in men were unintentional injuries, cardiovascular diseases, malignant neoplasms, intentional injuries and congenital anomalies respectively. In women the top 5 causes were cardiovascular diseases, unintentional injuries, congenital anomalies, malignant neoplasm and respiratory diseases respectively. Years of life lost due to men mortality were 1.8 times more than years of life lost due to women mortality. Conclusion: Since Unintentional injuries, cardiovascular diseases and malignant neoplasms in both sexes are responsible for 75% of years lost due to early death considered in health system policy-making. Male early death is higher than female. The discrepancy between the two sexes in mortality risk is much larger than that seen among children.
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Volume 12, Issue 47 (6-2004)
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Background: Vaccination against hepatitis B has lead to satisfactory production of anti-HBs in more than 90% of the cases. Nevertheless, numerous studies have revealed a gradual decline in anti-HBs level. This study was carried out with the aim of determining anti-HBs serum level in 7-9 year-old children in Zanjan, vaccinated through routine nationwide vaccination program. Materials and Methods: Two hundred and seventy three students were selected through random multiple staged method from 10 elementary schools in Zanjan. After getting the letter of satisfaction from parents and preparing 5 ml blood sample, serum level of anti-HBs was determined using ELISA with Radium kit. All serums were also tested for anti-HBc. Data were categorized into four groups. The first group contained no antibody (0) the second <10, the third 10-100 and the forth >100 unit/ml and serum level under 10 was considered as weak response and confidence interval was estimated. Results: In 29.5% of the samples no anti-HBs was observed. In 22.5% the amount was under 10, in 27.5% between 10 and 100 in 20.5% over 100 unit/ml anti-HBs was detected. As a matter of fact 52% of the samples were under 10 and 48% contained over 10 unit/ml anti-HBs. Level of antibody decline in boys and girls was equal. One percent of the studied children had anti HBc. Conclusions: Decline in anti-HBs serum level was obvious five years after vaccination. However, this finding dose not either recommend or reject the administration of booster dose of vaccine. This decrease dose not imply potential for infection and it is possible that the subject would be able to produce antibody against the virus in case of exposure. More research including higher sample number is recommended.
, اعظم امینی کمیجانی,
Volume 12, Issue 48 (9-2004)
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Volume 12, Issue 48 (9-2004)
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