مجله دانشگاه علوم پزشکی بابل
سال بیستم شماره 8 (پیاپی 131، امرداد 1397)

Risk of Mortality Pediatric (PRISM) is one of the indicators used by pediatricians in order to predict the mortality risk the intensive care units (ICUs). The purpose of this study was to evaluate the effectiveness of PRISM system in predicting mortality rates in the intensive care unit of Namazi Hospital in Shiraz. In this cross-sectional study that, 204 patients aged between 1 month and 4 years were studied for a six month period from June to November 2015. The PRISM numerical value and the mortality rate were calculated and the results were considered as either death or discharge. FINDINGS: The respondents included 123 (60.29%) male and 117 (39.70%) female patients. The average age was 30.543 and the standard deviation was 41.987 months. 44 patients died during the study. PRISM scores ranged from 0 to 10 in 73.5% of the patients, 11 to 20 in 24.9% patients, and 20 to 30 in 1.6% of the patients. The increase in PRISM score was found to be associated with an increase in the mortality rate of patients. Besides, 11.3% of deaths were observed in patients with PRISM score between 0 and 1, and 100% in patients with PRISM score between 21 and 30. The PRISM index is an appropriate measure for predicting mortality rates in patients admitted to intensive care units.

In patients with beta – thalassemia major, iron overload and oxidative stress cause metabolic disorders, especially in the liver. Green tea may be beneficial in reducing the complications of this disease due to the iron chelation and antioxidant properties. Therefore, this study was conducted to evaluate the effect of green tea on liver enzymes and serum lipid profiles in these patients. This randomized clinical trial was performed on 52 patients with beta – thalassemia major in two groups of controls and intervention (26 people in each group). Patients in the intervention group received 3 cups of green tea for 8 weeks and the control group consumed the same amount of boiled water each day for the same period. The assessment of dietary intake, AST and ALT, total cholesterol, triglyceride, LDL-C and HDL-C, and height and weight measurements were performed at the beginning and the end of the study. FINDINGS: Significant decrease in the levels of ALT enzymes (p<0.0001, 38.8±4.8 U/L) and AST (p<0.007, 39.53±11.01 U/L) and serum triglyceride (p<0.0001, 135.03±31.82 mg/dl) compared to baseline values (42.53±5.26 U/L, 43.46±9.7 U/L, 150.35±33.34 mg/dl) was observed in the green tea group. The consumption of green tea resulted in a significant reduction in total serum cholesterol levels at the end of the study in the intervention group compared with the control group (p=0.006). The results of this study showed that green tea consumption reduced levels of liver enzymes, triglycerides and especially total serum cholesterol in patients with beta – thalassemia major.

Calcification of media layer of peripheral arteries (Monkeburg sclerosis) often occurs with age and in diabetic patients with chronic renal failure. The appearance of this mark in hemodialysis patients can help predict cardiovascular events. Therefore, this study was conducted to compare the Abdominal Aortic Calcification Index (ACI) in hemodialysis and non-renal patients. In this cross sectional study, 84 hemodialysis patients who had the inclusion criteria were enrolled. 157 traumatic patients who had no chronic diseases like diabetes or hypertension were enrolled as the control group. The evaluation of CT scan sections, put the patients in three ACI groups (0-40), (41-80) and (81-120).
FINDINGS: A sum of 241 patients were enrolled in the study [ 84 (34.9%) in the case and 157 (65.1%) in the control group]. There was a significant difference in ACI between the two groups (P< 0.001). Comparing the chance of ACI in two groups, dialysis patients have a 22.67 times more chance to have severe ACI than mild ACI {CI 95% (4.987-103.062) (p=0.001)}, and also dialysis patients have a 7.32 times more chance to have severe ACI than moderate one {CI 95%(1.486-34.891) (p=0.001)}. According to more severe ACI in dialysis patients in comparison to healthy people, renal disease and dialysis may have an essential role in vascular calcification and its complications.

Video-assisted thoracoscopic surgery is preferred over conventional methods, such as pleural biopsy, in the diagnosis and treatment of patients with pleural effusion. Considering that Imam Khomeini Hospital is facing a large volume of patients with pleural effusion of unknown origin referred from other centers, the present study was conducted to investigate the role of thoracoscopy in the diagnosis of pleural effusion of unknown origin. In this prospective study, 31 patients with pleural effusion of unknown origin, whose disease was not diagnosed using conventional methods such as imaging, thoracentesis or pleural biopsy, were treated with video-assisted thoracoscopic surgery (VATS) at Imam Khomeini Hospital in Urmia. FINDINGS: The most common symptoms were dyspnea in 18 patients followed by chest pain in 8 patients and cough in 5 patients. Histological findings reported cancer in 19 patients, pleuritic in 10 patients and tuberculosis in 2 patients. Among the patients with malignant pleural effusion, the most common causes were metastatic carcinoma (42.1%) adenocarcinoma (26.3%) and mesothelioma (7.5%). In general, VATS was unable to definitively diagnose the disease in 5 patients. The diagnostic function of VATS was 83.9% in patients with pleural effusion of unknown origin (CI-95%= 71–96.8). The results showed that thoracoscopy along with imaging can be helpful in detecting pleural effusion with unknown origin.

Background and purpose: The rate of surgical site infection (SSI), as one of the most common post-operative complications in the orthopedic surgeries, has not been assessed in Babol, northern Iran. The present study aimed to determine the prevalence rate of SSI and the associated factors in traumatic patients in this city. Material and Methods: This cross-sectional study was conducted on 516 patients with hip and knee trauma and femoral fracture who underwent orthopedic sutgeries in Shahid Beheshti Hospital in Babol during a five-year period. SSI was defined as an infection occuerd within 30 days of surgery. The demographic and surgical information were collected and then analyzed. SSI was observed in 88 patients (17.1%). The mean age in the infected and non-infected patients was 43.11±19.08 and 39.22±9.54 years old, respectively (p=0.014). The duration of hospitalization was 17.59±6.23 days in the infected group and 13.08±5.77 days in the non-infected group (p<0.001). Duration of surgery in the infected and non-infected subjects was 2.42±1.62 and 2.11±1.23 hours (p=0.043). According to Chi-Square test, the patients underwent general anesthesia were infected more than those underwent spinal anesthesia (23% vs. 12.9%, p=0.003). Also, patients with diabetes had more infection rate (22.4%) than non-diabetic patients (14.3%) (p=0.021). The prevalence rate of SSI was considerable in this study. According to the results, age, durations of hospitalization and surgery, type of anesthesia (general), history of diabetes and smoking were determined as risk factors for SSI.

Regarding the toxic and oxidative effects of cadmium on male reproductive system and controlling importan, the aim of this study was to compare the effect of Origanum vulgar aqueous extract and vitamin C on cadmium chloride damage in testicular tissue. In experimental interventional study used 30 wistar male rat. The control received Cadmium 2 mg/kg of single dose intraperitoneal, T1 group received cadmium with vitamin C 250 mg/kg. T2, T3 and T4 groups received cadmium and aqueous extract of Marjoram at 125, 250 and 500 mg/kg, respectively for 10 days intraperotonealy. At the end of the period, the animals were weighed. Serum antioxidant level and malondialdehyde in testis tissue were measured. In addition, after staining were counted calls in testicular tissue. Findings: The highest concentration of MDA was observed in the control group at 1.4 ± 0.018 and the lowest in the T4 at 93.03 ± 0.30 μmol/ml. In association with TCA, the lowest in control was 796.41 ± 40.76 and the highest in T4 group was 1198.91 ± 51.45 μmol/ml. There was no statistically significant difference in the concentration of MDA and TCA between T1 and T3 groups (P=0.076). However, the mean of testicular tissue cells (sertoli, spermatogonia, spermatocytes and laydic) in T3 was the highest and lowest mean in control group and the difference was significant (P=0.048). Marjoram aqueous extract in controlling oxidative stress damage in the same dose 250 mg/kg has a better performance than vitamin C.

Functional ankle instability is a common musculoskeletal injury. Patients with impaired proprioception and permanent impairment in postural stability. The aim of this study is to investigate the short-term effect of kinesio tape on joint position sense, proprioception and postural control in patients with functional ankle instability. This quasi-experimental study was performed on 20 non-athlete women aged 18 to 45 years with functional ankle instability. The joint position sense test was performed by Motion Analyzer, sense of force was examined by Load Cell, and balance strength test was done by Force Plate before and after kinesio taping. Kinesio tape was used with a tendon correction technique for the anterior tibialis, peroneus and gastrosoleus muscles.
FINDINGS: The absolute error of the joint position sense (0.98 ± 0.79 degrees), the sense of force (5.43±2.89 n) and postural control (5.73±1.37 ms) decreased to (p<0.001, 2.49±1.49 degrees), (p = 0.004, 10.18±6.09 n) and (p = 0.01, 6.91±1.75 ms), respectively, after using kinesio tape in the affected patients. The results of the study showed that immediately after kinesio taping in patients with functional ankle instability, the absolute error of the joint position sense, the sense of force and postural control decreased and joint proprioception improved.

Considering the presence of important organs in head
and neck area, treatment of tumors which are existing in this area is very important. The existence of dental implants will effect on dose distribution in radiotherapy. The aim of the present research was to study the effect of dimensions and materials dental implants on radiotherapy dose distribution in using the Monte Carlo method. In this research study a Varian 2100 C/D linear accelerator with energy of 6MV was simulated using the Monte Carlo Code (MCNP). In order to assess the simulation correctness and accuracy, the results of Percentage Depth Dose and the dose profiles obtained from the simulation were compared with the experimental dosimetry. Then, dental implants with length 1.5 cm and diameter 0.4 cm dimensions and length 1.3 cm and diameter 0.7 cm dimensions made of tantalum, steel stainless 3161, zirconium oxid, titanium alloy, oxide aluminum and polytetrafluoroethylene were added to the simulation program. FINDUNGS: The larger dental implants have shown the increase of more dose 5.82%, 5.03%, 4.83%, 4.42%, 3.81% and 3.54% regading the above-mentioned materials.The tantalum dental implant caused the greatest heterogeneity. The research results indicated the effect of dental implants on dose distribution in cancer patients under radiotherapy depends on its gender and cross section.

Oral habits are risk factors for the incidence of malocclusion in deciduous teeth. Investigating the factors associated with malocclusion is essential for the policies of public health. The present study was conducted to determine the prevalence of malocclusion and oral habits in children aged 3 – 5 years old in kindergartens of Ramsar, Iran. In this cross-sectional study, 180 children with complete primary dentition and without previous orthodontic treatment were randomly examined in kindergartens of Ramsar. After filling out questionnaires about the oral health of the child by the parents, the intraoral examination was performed using mirror, catheter and periodontal probe in terms of occlusion. FINDINGS: Malocclusion was observed in 138 children (76.7%), while 80 children (44.4%) had oral habits. There was no significant relationship between total habits and malocclusion. Children with bruxism had a higher incidence of edge to edge overjet, and overbite. There was a significant relationship between bruxism and the condition of overjet and overbite (p < 0.0001). Of 54 children with bruxism, abnormal overjet in 31.5% of them was edge to edge, in 20.4% of them was increased and in 1.9% of them was reverse, and abnormal overbite in 35.2% of them was edge to edge and in 27.8% of them was deep. There was a significant relationship between finger-sucking habit and open bite dental occlusion (p < 0.004) and of 16 children with finger-sucking habit, 37.5% were open bite. The results of this study showed that there is no relationship between total oral habits and malocclusion in children.

Since in patients with herpes zoster ophthalmicus (HZO), intraocular involvement is common and sometimes leads to eye-threatening complications, the aim of this study was to determine the symptoms and complications of herpes zoster ophthalmicus in patients. This cross-sectional study was performed through convenience sampling among 26 patients with herpes zoster ophthalmicus admitted to Ayatollah Rouhani Hospital in Babol during 2009-2016. Variables such as age, gender, involved eye, associated disease, and associated symptoms were evaluated in patients diagnosed with herpes zoster ophthalmicus. FINDING: The mean age of the patients was 61.6±16.3 years. Half of patients (50%) were male and the left eye was involved in 15 cases (57.7%). Hypertension was observed in 11 cases (42.3%) and diabetes was observed in 9 cases (34.6%). Pain was observed in 23 cases (88.5%), and erythema and skin lesions were the most commonly observed symptoms in the patients, each with a frequency of 15 (57.7%). Six patients (23.1%) were normal in the ophthalmologic examination and complications were observed in 20 cases (76.9%). The results of this study showed that pain is the most common symptom of herpes zoster ophthalmicus and eye involvement is associated with complications in most cases.