29 1029-7855 Kashan University of Medical Sciences 210 General Designing and testing the outcome based management model in diabetics Masoudi Alavi Negin Ghofranipour Fazlollah Ahmadi Fazlollah Rajab Asadollah Babeie Gholam Reza 1 1 2004 7 4 1 10 03 11 2008 Background: Diabetes mellitus is a common and dangerous disease. Current methods in our country are not effective in the management of diabetes mellitus. The main object of our study is to design and test an effective model in the management of diabetes mellitus.Materials and methods : Grounded theory research used for designing the heory, 30 adults patients with their families, physicians, nurses, and dietitians were interviewed. The data were analyzed according to the Straus and Corbin method. The effect of designed theory on glycemic control was assessed during a randomized clinical trial on 104 diabetics referring to the Iranian Diabetes Association in 1382. Results : In qualitative part, 395 open codes were clustered in 27 subcategories and 9 main categories. Later on, the model shaped with defining the process and relationships between the categories. Personal system cure, care, and support system as well as social system are the main 3 systems that their interaction will determine the outcomes like glycemic control which is the most important indicator of diabetics. 3 months followed by model-based interventions, the mean of HbA1c was reduced form 8.22±2 to 6.7±1.6 in the intervention group. (p<0.02) Conclusion : Outcome based management revealed to control effectively the blood glucose level.
207 General Differential parameters of male and female Odontobuthus doriae Dehghani Rouhollah Tirgari Siavash 1 1 2004 7 4 11 16 03 11 2008 Background: With respect to the importance of morphological parameters in zoology and their application to differentiate male from female specimens, the present study was conducted to identify the differential parameters of male and female Odontobuthus doriae. Materials and methods : It was a descriptive study. 91 Odontobuthus doriae that their sex was previously determined according to their fertilization parameters were selected. Having put them in alcohol, the number of ventral serration, length of shoulder, and length of scorpion were determined using a ruler and t-test was used for data analysis. Results : The study population included 39 male and 51 female Odontobuthus doriae. One male Odontobuthus doriae was omitted due to abnormality in its shoulder. The mean number of ventral serratio in each side was 31±3 in male and 22±2 in female Odontobuthus doriae, respectively (p<0.001). The mean length of shoulder was 6.5±1.65 in female and 8±2mm in male Odontobuthus doriae, respectively (p<0.001) and the mean length of male and female Odontobuthus doriae was 5.35±1.65 and 5.35±2.15, respectively (NS). Conclusion : The number of ventral serratio, and length of the shoulder can be used to differentiate male and female Odontobuthus doriae. 205 General Association between the multiple sclerosis and relaxation time of MR in brain tissue Anvari Sayed Saeid Oghabian Mohamamd Ali Riahi Alam Nader Ghanaati Hossein 1 1 2004 7 4 17 26 03 11 2008 Background: Contrast of conventional MRI images is influenced by different parameters such as T1, T2, and proton density that may lead to invisibility and undetectibility of some small lesions in the normal appearing white matter (NAWM) in patients with multiple sclerosis (MS). Each brain tissue has specific values for T1 and T2 that usually changes in different pathologic lesions, thus, these differences may help clinician to differentiate different pathologies by measurement of these relaxation times. The present study was conducted to determine the association between the multiple sclerosis and relaxation time of MR in brain tissue. Materials and methods : For this case-control study, 15 patients with MS and 15 normal subjects were selected. MRI was performed in Imam hospital on 1.5 Tesla   Picker MRI system. First, T1 and T2 maps were computed from two images using spin echo (SE) and inversion recovery (IR) pulse sequences with optimization of interpulse time intervals TE, and TR to minimize errors. Then, T1 and T2 values of brain tissues were measured. Results : Results have revealed that not only T1 and T2 values in MS plaques increase significantly (P<0.0077), but also these values in NAWM increase accordingly T1 of NAWM changes between 2.99% and 10.23% (p<0.01) and T2 changes between 5.06% and 16.21% (p<0.037), whereas T2 in normal appearing gray matter (NAGM) decrease to a value between 2.07% and 5.07%, p<0.038). Conclusion : Increasing of T1 and T2 in NAWM and decreasing of T2 value in NAGM can be considered as a fdiagnostic parameter of MS diseases. 215 General Role of acetaminophen on the complications of DTP vaccine Talebian Ahmad Taghavi Ardakani Abbas Moosavi Sayed Gholam Abbas 1 1 2004 7 4 27 32 03 11 2008 Background: Parents worry about the complications of DTP vaccine. However, there are some reports demonstrating the positive effect of acetaminophen on DTP vaccine complications. The present study was conducted on children referring to Kashan health care centers to determine the role of acetaminophen on the complications of DTP vaccine. Materials and methods : For this clinical trial, 324 children aged 1.5month-6 years who had received DTP vaccine produced by Razi institute in 1378 were selected. They were assigned randomly in two groups of case and control. The case group have received acetaminophen at the dosage of 15mg/kg/dose at the time of vaccine injection and then each 6 hours for 48 hours. Then, complications were recorded after 48 hours and analyzed by chi square. Results : Groups were matched according to the sex and age. Of 324 children, 281 (86.7%) developed complications. This was 88.9% for the control and 84.6% for the case group, respectively (NS). Fever was the most common complication (66.1% for the control vs. 46.9% for the case group, p<0.0007). On the other hand, pain at the site of injection was the most common local complication occurred in 58% of controls and 35.21% of cases (p<0.0001). Conclusion : Acetaminophen may reduce some complications of DTP vaccine, thus, it is recommended following the vaccine injection. 219 General Comparison of determination of Iodine value in edible oils by Hanus titration and FTNIR Sadeghi Aliabadi Hojjat Ghafari Farahnaz 1 1 2004 7 4 33 41 03 11 2008 Background: Determination of Iodine value (IV) along with factors like acid value, peroxide value, saponification value, solid fat index, refraction value, and trans fatty acid content is an important factor in controlling edible oils and fats. In unsaturated fatty acids, IV is a measure of the degree of unsaturation. The range of figures for IV of the various groups of oils and fats are therefore different. The Iv is usually determined by wijs or Hanus titration method, but recently for quick determination FT-NIR has been introduced. In this study, we compare the IV figures of Hanus and FT-NIR methods. Materials and methods: For this project, 20 samples (7 solid and 13 liquid) were obtained from domestic oil factories. 100-200mg of liquid oil (250mg of solid sample) were dissolved in 10ml of chloroform and 25ml of Hanus solution was added and kept in dark place for 30 minutes. 10ml of KI solution and 100ml of distilled water were then added and titrated with sodium thio sulfate (0.1N). After the color of solution turned yellow, 2-3 drops of starch solution was added and titration was continued until the blue color disappeared. IV was then calculated using Hanus equation. For FT-NIR all liquid samples were put into sample holding directly and solid samples first melted and then poured into sample holding and IV was determined using special software. Results: IV figures showed 0.5 to 4.5% (65% < 3% and only 35% showed 3 to 4.5%) difference between the two methods (NS). 90% of samples showed higher IV with FT-NIR as compared to Hanus method. Determining IV by Hanus required 45-60 minutes, whereas for FT-NIR it will take 2-3 minutes. Conclusion: Results have revealed the feasibility of using FT-NIR to measure IV in oils and fats. There are major advantages of using FT-NIR as follows: provide faster analysis method, no sample preparation is required, eliminating the usage of solvents, reagents and glassware in control laboratories and finally very low level of operator error may occur. 206 General Role of oral codeine to prevent coughing following the cataract surgery Atarod Sirus Soltani Hasan Ali Montazeri Kamran 1 1 2004 7 4 42 47 03 11 2008 Background: Coughing is quite common after surgery. However, it is believed that codeine may reduce coughing, thus, the present study was conducted to determine the effects of codeine on coughing. Materials and methods: It was a double blind clinical trial performed on 150 subjects in the form of two groups. Induction and maintenance of anesthesia was similar in both groups. The case group had received 30mg of codeine phosphate one hour before the surgery, but the control group received placebo. Heart rate, and systolic and diastolic blood pressure were determined 3 minutes following the intubations and 3 minutes after the extubation. Meanwhile, number of coughs was determined right after extubation, 3 and 10 minutes later. Results: Groups were similar according to the age. Of placebo group, 23 (30.7%) and of the case group 19 (25.3%) had experienced severe cough (NS). The mean number of cough in the case and placebo group was 9.05±8.65 and 5.65±4.56, respectively (NS). There was no significant difference in systolic and diastolic blood pressures measured before intubation, 3 minutes after intubation and 3 minutes after extubation. Conclusion : Oral codeine failed to prevent coughing after cataract surgery. Thus, other techniques are strongly recommended 208 General Effect of coronary artery bypass graft on exercise test and ejection fraction in patients with coronary artery disease Esmaili Nadimi Ali Nough Hossein Ahmadi kohanali Jafar 1 1 2004 7 4 48 51 03 11 2008 Background: Coronary artery disease is one the most common and fatal disease worldwide. The primary management of CAD is medical however, coronary artery bypass graft (CABG) is a reliable method of treatment. The present study was vonducted with the aim of determining the effect of coronary artery bypass graft on exercise test and ejection fraction in patients with coronary artery disease. Materials and methods: This clinical trial was performed on 40 patients candidated for CABG. All patients had undertaken exercise test and echocardiography before and 3-6 months after the surgery. McNemar and paired t-test were used for data analysis. Results: The study population included 28 males and 12 females with the mean age of 59.2 years. The mean ejection fraction of the left ventricle (LVEF) was about 50% before and after the surgery that did not show any significant difference. Mean time of exercise test was 6.79±1.7 and 8.3±1.7 minutes before and after the surgery, respectively (p<0.0001). The prevalence of dyspnea, angina pectoris and positive ET were 62.5, 82.5, and 92.5% before and 17.5, 17.5, and 37.5% after the surgery that revealed a significant difference (P<0.01). Conclusion: CABG shows positive changes on dyspnea, pectoris angina, and ET tolerance improvement, however, could not change ejection fraction. Further studies are strongly suggested. 211 General Clinical, paraclinical and pathologic findings of irritable bowel syndrome Matini Sayed Mohamma Khamechian Tahere 1 1 2004 7 4 52 57 03 11 2008 Background: Irritable bowel syndrome(IBS) is a common GI complaint. Since there exist some controversies with reference books regarding the clinical and pathological findings, the present study was conducted to determine the clinical, paraclinical and pathologic findings of irritable bowel syndrome in a group of patients. Materials and methods : For this descriptive study, 80 patients who had been diagnosed as IBS according to the ROME criteria were selected. Other diseases were excluded by complementary studies. Colonoscopy and barium enema was performed and multiple biopsies were obtained. Results : The study population included 42 males and 38 females with the mean age of 26.5±7 years. The most common chief complaints were flatulence, abdominal pain, and diarrhea. Pathologic findings were revealed in 77 cases (96.3%). Conclusion : High prevalence of pathologic changes is a unique finding in our patients. Further studies regarding the diagnostic modalities and proper treatment are suggested. 216 General Incidence of septicemia and urinary tract infection in newborns with jaundice hospitalized in Mofid hospital Hajebrahim Tehrani Fateme Valaie Naser 1 1 2004 7 4 58 63 03 11 2008 Background: Jaundice is of the most important signs of septicemia, meanwhile, it could be one the presenting signs of neonatal urinary tract infection (UTI). Physicians may request blood and urine culture for jaundiced but otherwise healthy neonates, thus the present study was conducted to determine the incidence of septicemia and UTI in newborns with jaundice hospitalized in Mofid hospital. Materials and methods : For this descriptive study, 750 jaundiced but otherwise healthy neonates were selected. Urine (by suprapubic approach) and blood samples were obtained for culture. Results : The mean weight, age, and billirubin level of the subjects were 3228±408gr, 4.95±3.87 days, and 20.7±3.6mg/dl, respectively. We have founf no positive blood culture, but 4 positive urine culture. They were discharged following a successful treatment. Conclusion : Blood and urine cultures are not necessary for jaundiced neonates and may lose our time and energy. 214 General Frequency of protozoal and bacterial microorganisms in patients referring due to gastroenteritis in Kashan, 1380-81 Talari Safar Ali Arbabi Mohsen 1 1 2004 7 4 64 70 03 11 2008 Background: With respect to the importance of microbial organisms as the cause of gastroenteritis, prompt diagnosis, proper treatment and follow up is of utmost importance. The present study was conducted on patients referring to Kashan Central Lab with the diagnosis of gastroenteritis to determine the frequency of protozoal and bacterial microorganisms. Materials and methods : For this descriptive study, 500 consecutive cases of gastroenteritis were enrolled. Initial data were gathered and 3 separate stool samples (with 3-day interval) were obtained and examined by direct observation and ether-formalin method to detect possible microorganisms. Meanwhile, specific media and cultures were used. Results : Of 500 cases, 50 were excluded due to weak cooperation. Of the remaining, the infection rate of protozoal, bacterial and other microorganisms were 50.9%, 13.5%, and 35.6%, respectively. Among protozoa, giardia was the most common (21.8%), however among bacteria, shigella was more frequently cultured (6.4%). Most of the infection did occur in summer among 7-11 year-old subjects. Conclusion : Infection with shigella, giardia and salmonella is quite common. Necessary health care activities are strongly recommended. 218 General Level of lead and cadmium in peanut Rahbar Nader Nazari Zahra 1 1 2004 7 4 71 77 03 11 2008 Background: With respect to the natural, industrial, and environmental origin of lead and cadmium, and also with respect to the known side effects of these two elements, during the present study we have attempted to determine the level of lead and cadmium in peanut. Materials and methods : 27 samples of peanut were randomly selected from different shops in Ahwaz. Level of lead and cadmium was determined by atomic absorption technique. Results : The mean level of cadmium was 83μg/kg, ranged 15-160, where 92.6% had levels of >40μg/kg. The mean level of lead was 384μg/kg, ranged 12-1043, where 81.5% had levels of >200μg/kg. Conclusion : The level of lead and cadmium was quite high in our studied samples. Determining the etiologic factors in this regard will be helpful. 212 General Surveying the knowledge, attitude and practice of Kashan faculty member towards educational media Rasoulinejad Sayed Asghar Behnia Hamid Davoodabadi Abdolhossein Rasoulinejad Sayed Vahid 1 1 2004 7 4 78 83 03 11 2008 Background: Educational media have utmost importance however, their proper application is not clarified for faculty members. The present study was performed to determine the role of educational media on knowledge, attitude and practice of Kashan faculty members. Materials and methods : All Kashan faculty members have enrolled. Their knowledge was assessed based on subjects' knowledge towards educational media, while their attitude was evaluated by Likert test. Meanwhile, their practice was evaluated by direct observation of their usage of media. Finally, subjects were assigned in 3 groups of poor, moderate, and good. Results : The study population included 38 clinicians and 59 basic scientists. Good knowledge, attitude, and practice was reported in 12, 11.3, and 25.3% of faculty members, respectively. However, 34, 40.2, and 44.3% revealed to have poor knowledge, attitude and practice, respectively. Conclusion : Results have revealed that Kashan faculty members have poor knowledge, attitude and practice of educational media. Thus, they are strongly candidated for educational programs 213 General Measuring the duct concentration and its free silica at Emarat lead and zinc surface mine Samadi Sadegh Jonaid Badri Sadat 1 1 2004 7 4 84 89 03 11 2008 Background: Silica is the most common minerals on earth. Exposure to dusts containing free silica is associated with pulmonary diseases that finally may lead to silicosis. The present study was conducted to measure the duct concentration and its free silica at Emarat lead and zinc surface mine. Materials and methods : For this descriptive study sampling was achieved according to the standard No. 7500 of NIOSH. The level of total exposure and respirable dust were measured by personal sampling. Then the level of dust was quantified by gravimetric method. The dust samples have been analyzed for free silica content by X-ray diffraction method. Results : The mean exposure to respirable dust in the units of drilling and damping were 2.81±0.46 and 2.69±0.5 mg/m3. Meanwhile, the mean exposure to free silica respirable dust in these units were 0.51±0.12 and 0.47±0.9mg/m3. These averages are 5.1 and 4.7 times of standard of Iran (OEL) and 10.2 and 9.4 times of standard of ACGIH (TLV), respectively. Conclusion : Unfortunately, the mean concentration of free silica in respirable dust of different units of the Emarat mine exceeds the allowed levels. This should be controlled. 209 General Frequency of positive family history of breast cancer in 100 breast cancer sufferers in Kashan Khamechian Tahere Mazouchi Tahere 1 1 2004 7 4 90 94 03 11 2008 Background: Bear in mind the prevalence of breast cancer and the importance of identifying its risk factors and also with respect to the controversies regarding the positive family history of breast cancer, the present study was carried out to determine the frequency of positive family history of breast cancer in 100 breast cancer sufferers in Kashan, during a 7-year period, 1372-79. Materials and methods: For this descriptive study, all patients with breast cancer who had biopsies referred to pathology department of Kashan University were enrolled. Patients were interviewed and initial data gathered. Results: 100 female patients were enrolled. The mean age of subjects was 51±14.3 years (24-82 years). The frequency of breast cancer did not obey a regular pattern during the studied period. Of these, 51% had left-side, 46% had right-side, and 3% had bilateral tumor. Frequency of positive family history of breast cancer was 8% in first degree relatives, 13% in second degree relatives and 21% in total. Invasive ductal carcinoma (IDC) was the most common pathologic findings (88%). Conclusion: With respect to the high frequency of positive family history, better follow up, and more precise examination are highly recommended in subjects with positive family history of breast cancer. 217 General Goiter and hypothyroidism in children with insulin dependent diabetes mellitus Karamifar Hamdollah Amirhakimi Gholam Hossein 1 1 2004 7 4 95 100 03 11 2008 Background: Diabetes mellitus is the most common endocrine disorder in children. Chronic lymphocytic thyroiditis is frequently associated with type I diabetes in children. With respect to the unknown prevalence of goiter and hypothyroidism in the region, the present study was performed to determine the prevalence of goiter and hypothyroidism in children with insulin dependent diabetes mellitus. Materials and methods : For this cross sectional study, 72 children with insulin dependent diabetes mellitus were enrolled. A complete history was obtained and physical examination was performed. They had no other systemic disease and all of them were on NPH insulin. Goiter was evaluated according to the EHO criteria, meanwhile, T4 and TSH were checked by radioimmunoassay. Results : Goiter was reported in 69.4%, among whom 7% had hypothyroidism. Hyperthyroidism was also reported in 1.3%. Of 5 children with hypothyroidism, 4 had height below the 5th percentile (p<0.05). Conclusion : Goiter and hypothyroidism may be found in diabetics, on the other hand, deceleration of growth may also be associated with thyroid failure, thus, we recommend routine screening of hypothyroidism in diabetic children annually.