29 1029-7855 Kashan University of Medical Sciences 311 General Effects of Cadmium chloride on cochlear development in mouse fetus Roozbehi Amrollah Atlasi Mohammad Ali 1 7 2002 6 2 1 6 09 11 2008 Background: Cadmium is an essential component of industrial and non-industrial materials including foods, water, drinks and cigarettes. Reports have shown the teratogenic effects of cadmium, thus the present study was carried out with the aim of determining the effects of cadmium chloride on cochlear development in male mouse fetus.Materials and Methods: In this experimental study 30 male mouse fetuses of Balb/c race were included. Samples were divided in three groups of control, Experiment I and Experiment II. Experiment groups have received cadmium chloride with the dosage of 3 mg/kg and 5 mg/kg intra-peritonealy at the 9th day of pregnancy, respectively. The control group received distilled water. Six days later, mice were killed by ether and their fetuses were removed and kept in fixative. Finally, specimens were prepared and stained by H;E. Results were analyzed using ANOVA and scheffe tests.Results: Cochlear surface was significantly reduced in Experiments groups comparing to the control (P<0.05), meanwhile the spiral ganglion surface was significantly reduced, too (P<0.01 and P<0.003). The cochlear diameter has not differed among the groups (NS). The organ of corti in Experiment II group was smaller than that of control group (P<0.02).Conclusion: Cadmium chloride can cause degenerative changes on cochlear development of mouse fetus. Further studies regarding the effects of cadmium chloride on neural tube deformity and hearing dysfunction are strongly recommended.
310 General Atropine premedication and the cardiovascular response following electroconvulsive therapy Mahdian Mehrdad Nourizadeh Samad mosavi Sayed Gholam Abbas 1 7 2002 6 2 7 12 09 11 2008 Background: Electroconvulsive therapy (ECT) is a useful non-pharmacologic tool for treating major depression and other neurologic disorders. However, it may lead to bradycardia and consequently to tachycardia and hypertension. Atropine is considered as premedication of choice. We have studied the cardiovascular response following the ECT procedure.Materials and Methods: 80 patients had entered this double-blinded clinical trial. Patients were randomly assigned in either case or control. The case group was intravenously given 0.5mg atropine before the anesthesia induction, however, the control group received 1ml normal saline. Blood pressure and heart rate were monitored 1 minute after the induction and at minutes 1, 3 and 5 after ECT.Results: The case and control groups were composed of 31 males and 9 females. The mean age of case and control group was 35.3±7.8 and 33±7.6 years, respectively (NS). At minute 3, the mean blood pressure was higher in the case group (P=-0.43). At minutes 1 after induction and 5 after ETC the mean heart rate was faster in the case group (P<0.05).Conclusion: Administration of atropine as a premedication agent may lead to transient hypertension, meanwhile those who haven’t received atropine (Control), had no bradycardia. We don’t suggest atropine as the routine premedication agent before ECT, especially in whom hypodynamic heart, usage of sympathetic inhibitor and previous history of bradycardia following the ECT procedure exist. 312 General A comparison of Cataract surgery complications under local anesthesia plus intracameral Lidocaine with general anesthesia Soleimani Mohammad Reza 1 7 2002 6 2 13 17 09 11 2008 Background: Cataract is one of the common senile diseases. Globally, it is estimated that 20 million subjects are blind due to cataract. Anesthesia modality in cataract surgery is a challenge. The present study was carried out to compare the complications of local anesthesia plus intracameral lidocaine 2% with general anesthesia during cataract surgery.Materials and Methods: 55 patients undergoing cataract surgery were enrolled in this clinical trial. Patients were randomly divided into two groups, receiving either local anesthesia plus intracameral lidocaine 2% (n=28) or general anesthesia (n=27). We evaluated corneal edema, anterior chamber inflammation and intraocular pressure and followed them up for 2 months. Independent t-test and Fisher’s exact test were applied for statistical analysis.Results: There was no significant difference in corneal edema, anterior chamber inflammation and intraocular pressure between two groups in 1, 2, 15, 30 and 60 days after cataract surgery. These complications were more common during the first day following the surgery.Conclusion: Local anesthesia supplemented with intracameral lidocaine 2% was an effective and safe alternative to general anesthesia in cataract surgery. This two methods have similar ocular complications, however, systemic complications of general anesthesia limit its usage for senile patients. 313 General Surveying the low dose topical Mitomycine-C in the treatment of severe vernal keratoconjunctivitis refractory to conventional therapy Roozitalab Mohammad Hossein Masouri Feizollah 1 7 2002 6 2 18 22 09 11 2008 Background: Vernal keratoconjunctivitis is a recurrent seasonal bilateral disease and poorly respond to conventional therapies. Present study reveal our experience with the low dose topical mitomycine-c in the treatment of sever vernal keratoconjunctivitis refractory to conventional therapy in Shiraz in 2000.Materials and Methods: In this placebo-controlled randomized clinical trial 58 patients were randomly assigned to treatment with topical 0.01% mitomycine-c eye drops (n=31) and placebo (n=27) three times daily for 2 weeks. Symptoms (Including itching photophobia tearing mucous discharge, foreign body sensation) and signs (Conjunctival hyperemia, epithelial conjunctival giant papillae) of vernal keratoconjunctivitis recorded at the day of enrollment and at the end of the treatment period. Results: There was a statistically significant decrease in the signs and symptoms 2 weeks following the mitomycine-c administration. In addition one of the treated patient and 26 of the subjects of the placebo group required medication during the first 4 weeks following the treatment (P<0.001). Therapy was discontinued in two patients because of drug side effects.Conclusion: Short term low dose topical mitomycine-c may considered in the acute exacerbation periods of patients with severe vernal keratoconjunctivitis refractory to conventional treatment. 314 General Etiology of abnormal uterine bleeding in patients referring to Shabihkhani Hospital in Kashan, 2000-01 Behnamfar Fariba Khamechian Tahere Fahiminejad Tahere Mazochi Tahere Mosavi Sayed Gholam Abbas 1 7 2002 6 2 23 27 09 11 2008 Background: There are various pathologies causing abnormal uterine bleeding (AUB), of which, some are predisposing for cancer, thus, we studied frequency of different pathologies in patients referring to Shabihkhani hospital in Kashan, 2000-01.Materials and Methods: It was a descriptive study. Initial data including method of contraception, parity, age, severity of dysmenorrhea and bleeding pattern were all recorded. Samples were obtained by D;C procedure.Results: The study population included 200 patients with the mean age of 46.2±6.2 years. Endometrial tissues were insufficient in 11. Proliferative endometrium was by far the most frequent pathology. Adenomatous hyperplasia was more commonly seen in para-8 women (0.6%), however, atrophic endometrium was frequently observed in para-9 and higher females (0.6%). Cystic and adenomatous hyperplasia was commonly found on obese females. There was no relationship between the results of pathology and the presence and severity of dysmenorrhea.Conclusion: Cystic and adenomatous hyperplasia (Predisposing to endometrial cancer) was more commonly seen in obese patients. 315 General The prevalence of Toxoplasmosis in subjects involved in meat industry and pregnant women in Kashan Arbabi Mohsen Talari Safar Ali 1 7 2002 6 2 28 38 09 11 2008 Background: Toxoplasmosis is a disease with various prevalence among different society groups. The present study was conducted with the aim determining the prevalence of acute and chronic infections as well as toxoplasma gondii antibody in pregnant women and those who are involved in the meat industry in Kashan in 2001.Materials and Methods: The study population included 300 males and 340 females aged 14-70 years selecting through a simple random sampling. Initial data including age, sex, occupation, place of living, previous history of contact with cat, dietary habits, gestational age, previous history of abortion and clinical manifestations were all recorded. 5cc venous blood was obtained and antibodies were determined in dilutions of 1:20 and 1:100 by IFA. Positive samples were evaluated by ELISA at titer of 1:200. Meanwhile, ANA evaluation was conducted for positive samples. Titer of 1:20 was considered as positive, however, titer of 1:400 was valuable. Results: Toxoplasma gondii was found in 54.2% of whom, 15% had IgM antibody and the others the IgG antibody. Subjects aged 60-70 years have shown greater infection (75%). Males’ and females’ infection rate were 46.7% and 61%, respectively. Titer of ?1:200 was reported in 40.2%. Infected males working in the meat industry were 200-fold more susceptible than normal subjects to the usage of non-completely cooked meats (P<0.0001).Conclusion: The prevalence of toxoplasma gondii is high in Kashan. With respect to its complications and the high costs of serologic screening methods, educational programs are highly suggested, especially for those at risk. 316 General Surveying the related factors in Kawasaki disease in children hospitalized in Shaheed Beheshti Hospital (Kashan) and Tehran Children's Center, 1995-2000 Sharif Mohamamd Reza Iranfar Mahdi 1 7 2002 6 2 39 44 09 11 2008 Background: Kawasaki disease is the most common children vasculitis and one of the most common acquired heart diseases with serious complications. Although infectious agents are supposed to be involved in the pathogenesis, it is still largely unknown. The present study was performed to survey the related factors in Kawasaki disease in children hospitalized in Shaheed Beheshti hospital (Kashan) and Tehran Children's Center, 1995-2000.Materials and Methods: It was an existing data type study. Having reviewed the files of Kawasaki disease initial data including age, sex, clinical manifestations, laboratory results and primary infection were recorded.Results: Study population included 40 boys and 23 girls, aged 1-8 years. Clinical manifestations were fever and oral changes (100%), conjunctivitis (85.7%), rash (79.3%), acral desquamation (79.3%), arthritis and swelling of extremities (53.9%), cervical lymphadenopathy (50%) and diarrhea (38%). Laboratory findings were: raised ESR (100%), thrombocytosis (90%), leucocytosis (82.5%), pyoria and proteinuria (53.9%). Primary infections were noted as below: Pneumonia (9.5%), UTS (14.2%), osteomielitis (7.9%), meningitis (12.6%) and 12.6% of patients had previous history of contact with detergents.Conclusion: Results have revealed that Kawasaki is accompanied by an infectious cause in more than 50% of the cases. 317 General Self-medication in Zahedan city in 1999 Rakhshani Malek Rakhshani Fateme Mirshahi Afsae 1 7 2002 6 2 45 52 09 11 2008 Background: The expansion of medical sciences, pharmacy and health coverage in large scale have increased accessibility of people to all sorts of medicines. Hence the latter has created enormous problems in terms of over and under dose and duration of medication: Therefore investigation of this phenomenon seems very crucial. Materials and Methods: A cross-sectional study was designed in order to investigate self-prescription in Zahedan in 1999. The questionnaire consisted of demographic criteria, self-medication and knowledge of its side effects.Results: Of 245 cases, 49.8% were males and 50.2% were females with the mean age of 31.2±12.1 years. 67.3% had used drugs after appearance of common cold symptoms without visiting physician. Another common cause of self-medication was headache (55.9%). However, the least percentage of drug intake was noticed in case of subjects suffering from dysuria as a result of urinary tract infection (UTI) that was 7.3%. In addition this study showed that 77% of people believed drugs were harmless and 51.8% took drugs till he symptoms disappeared and only 20% completed the course of treatment. The largest amount of available drugs at homes were painkillers and antibiotics, subsequently the largest amount of medicines taken as a result of self-medications were painkillers, anti pyretics and then antibiotics. Conclusion: With respect to the above mentioned facts. It is concluded that Self-medication and self-prescription are very common among people regardless of their socio-economic level hence it is strongly recommended that educational measures should be employed in order to increase their knowledge of drugs proper usage. 318 General Venous catheter infection of patients admitted to ICU and its related factors sharif Ali Reza Emami Amir Hossein Mazouchi Tahere Mosavi Sayed Gholam Abbas Sharif Mohammad Reza Verdi Javad Yarandi Mostafa 1 7 2002 6 2 53 58 09 11 2008 Background: Nosocomial infections is a common source of infection in hospitalized patients. Prior reports have shown the possibility of venous catheter infection, too. The present study was carried out to determine the venous catheter infection of patients admitted to ICU and its related factors in Shaheed Beheshti hospital in Kashan in 2000.Materials and Methods: It was descriptive study. Patients for whom IV catheters were removed were included. Then the 3cm of the catheters were cut aseptically and put in Thayer-glycolate. In case of growth within the next 7 days, the sample would be passage on agar. Finally the type of cultured bacteria as well as its antibiogram was determined. Infectious related factors were considered as: Age, sex, duration of catheter usage, duration of ICU hospitalization, catheter-induced phlebitis and the location of catheter.Results: Of 100 cultured catheter removed from 36 patients, 29% revealed to have infection, among which, staphylococcus coagulase-negative was the most prevalent (18%). Age, duration of catheter usage, duration of ICU hospitalization, catheter-induced phlebitis and the location of catheter had no effects on infection rate (NS). Conclusion: Staphylococcus coagulase-negative is the skin normal flora and do not cause severe infection, thus the true rate of infection is less. Needless to say, the venous catheter infection is a critical problem seeks further attention in hospitalized patients. 319 General Wastes and its recovery rate in Kashan Doroodgar Abbas Mostafaie Gholam Reza Arbabi Mohsen 1 7 2002 6 2 59 64 09 11 2008 Background: With respect to the ascending rate of urban wastes and its environmental effects, the present study was conducted with the aim of determining the wastes and its recovery rates as well as the cost-effectiveness of the procedure in Kashan in 1999-2000.Materials and Methods: It was a descriptive study. We have divided Kashan to 7 districts and determine the amount of wastes in each district monthly. The wastes’ density was calculated and its components including paper, glass, metals, plastic and so on were weighted.Results: During the study period (One year 1999-2000) 29865000kg of wastes were collected in Kashan. The daily and per capita waste rate were 82900kg and 0.412kg, respectively. The amount of waste was higher in spring and lower is summer. The urban waste density was 264 kg/m³. 55.5% of the wastes were recoverable. This would save 2094500 Rials.Conclusion: With respect to the per capita rate of waste in Kashan and the possibility of recovering these wastes, it would be worth investigating in the project of waste recovery in Kashan. 320 General The prevalence of fetal macrosomia and post-term delivery and multiparity as its risk factors Saberi Farzane Sadat Zohre Abedzade Masoume 1 7 2002 6 2 65 69 09 11 2008 Background: Maternal and fetal complications following the macrosomia are of utmost importance. The present study was carried out with the aim of determining the prevalence of fetal macrosomia and post-term delivery and multiparity as its risk factors in Kashan in 1999-2000.Materials and Methods: It was an analytical study. During the first phase the prevalence of macrosomia was determined during a two-year period (1999-2001), then, the second phase was conducted on 110 infants with macrosomia (Case group) and 110 without macrosomia (Control). Groups were matched according to the sex, BMI, level of education, prenatal care, mother’s nationality and age. A questionnaire was used for data collection, then the role of post-term delivery (>40 weeks) and multiparity was determined.Results: Macrosomia was found in 3.04% of the infants. Post-term delivery was reported in 45.5% and 61.8% of the control and case group, respectively (P<0.02). The mean parity was 2.39±1.34 and 2.54±1.37 in the control and case group, respectively (NS).Conclusion: The prevalence of macrosomia is not high in Kashan. Post-term delivery has increased the rate of macrosomia, however, multiparity has no statistically significant association. Further studies are highly recommended. 321 General Prevalence of Neisseria Gonorrhea in cervisitis and evaluation of drug resistance of N.Gonorrhoeae in Kashan Tabasi Zohre Khorshidi Ahmad Alinaghipour Maryam Sadat Zohre Akbari Hossein 1 7 2002 6 2 70 74 09 11 2008 Background: Due to the relatively high prevalence of cervisitis and its complications such as pelvic inflammatory diseases that may lead to infertility, the present study was designed in order to determine the prevalence of gonococcal cervisitis and drug resistance of those in Kashan in 2001.Materials and Methods: A descriptive study was carried on patients with cervisitis referring to gynecologic clinics. After physical examination and diagnosis of cervisitis, the sample collected from endocervix. The specimens were cultured on Thayer-Martin agar plates. After identification of isolated gonococci by standard methods. Antibiogram tests were performed to determine the sensitivity or resistance of gonococci to common antibiotics. The data were presented using descriptive statistical analysis.Results: Of 315 women patients with cervisitis, 2 (0.63%) had gonococcal cervisitis, both of whom were under 25 years old. The age at which their sexual activity started was ?20 years and they have both frequency and dysuria. One of them had revealed resistance to vancomycin and the other had resistance to ceftriaxon. Conclusion: Due to the relatively high prevalence of gonococcal cervisitis in western country, the prevalence of 0.63% in this study is not hazardous. Meanwhile, gonococci in this area are sensitive to common antibiotics 322 General Clinical manifestations of Burger's disease and its related factors in Taleghani Hospital, Tehran, 2000-01 Salehian Mohammad Taghi Parsa Hossein Valaie Naser 1 7 2002 6 2 75 79 09 11 2008 Background: Burger's disease has various presentations. During the present study we have determined the clinical manifestations of Burger's disease in a group of patients referring to Taleghani hospital in 2000-01. Materials and Methods: It was a descriptive study. Diagnosis was confirmed in accordance with clinical manifestations and angiography. Patients’ clinical signs and symptoms as well as other demographic data were recorded.Results: 42 patients with definite diagnosis of Burger's disease and the mean age of 35.9±2 years were included. All were male and smoker. 71% had addiction and 54.8% had previous history of smoking for more than 10-20 years. Poor health status was reported in 69%. Clinical manifestations were: Resting pain (81%), ischemic ulcer, intermittent claudication, thrombophlebitis and upper limb’s pain.Conclusion: Our patients’ clinical signs and symptoms have differed with reports of western societies. Poor socioeconomic and health status are the major risk factors. Further studies are highly recommended. 323 General A study of self-referral in public and private health care delivery system, Kashan, 2000 Rasoulinejad Sayed Asghar Khaghani Parvin 1 7 2002 6 2 80 87 09 11 2008 Background: Appropriate utilization of primary physician and specially care has stimulated substantial debate, but the portion of discussion focused on policies that restrict or discourage direct access to specialist. We examined the self-referral incidence rate and the association of health care delivery system structure with utilization of primary physician and specialist. Materials and Methods: Office visit for patients in private sector and outpatients in public clinic care, stratified by insurance status (Rural Health Insurance, Imam Khomeini Welfare Committee, private insured patients and non insured patients or self-pay patients). 1306 subjects were randomly selected for the study purpose. 39.9% were covered by Imam Khomeini Welfare Committee, 14% Rural Health Insurance, while 46.1% were open for direct referral to specially services. Results: In Imam Khomeini Welfare Committee closed loop referral system, 6.8% of patients were direct self-referral. In rural health insurance 29.7% of patients were direct self-referral, while in open referral system 75.5% of the patients were direct self-referral to specialist. Significant association was detected between the structure of health care delivery system and patient self-referral of specially cares. The incidence rate of self-referral in public sector was 60.5 and in private sector was 36.4%. Significant association was detected between public and private sector self-referral (P<0.001). Patients’ reasons for skipping the general practitioner were high specialist competency as those problems were specific for the specialist waste of time, friends’ recommendation and weakness information about referral system. Conclusion: The results suggest greater utilization of specialist in open referral system. Closed loop referral system like Imam Khomeini Welfare Committee may reduce some of these disparities. 324 General Epidemiology of trauma in patients hospitalized in Naghavi Hospital, Kashan, 2000 Rangraz Jeddi Fateme Farzandipour Mehrdad 1 7 2002 6 2 88 93 09 11 2008 Background: Accident-induced trauma is a common problem with short- and long-term complications. The present study was conducted in Naghavi hospital in Kashan in 2000 to determine the external factors influencing the incidence of accident-induced trauma. Materials and Methods: It was an existing data type study. Medical records of patients hospitalized in 2000 in Naghavi hospital were reviewed and initial data including sex, age, type of accident and site of injury were all determined.Results: The study population included 1543 males and 498 females. 35.5% of females referred to the hospital because of falling down. Males aged 10-30 and females’ aged ?50 years were more commonly affected. Vehicles were the cause of accident in 49.2% of the cases, of which motorcycle was more common (56%). Head and neck regions were injured in 32% of the cases. Conclusion: Trauma has affected young adults more frequently. This seeks further attention since this age group are more actively involved in society activities. Results have revealed that in Kashan, motorcycle accidents required more precise observations.