مجله دانشگاه علوم پزشکی ایلام
سال نوزدهم شماره 4 (پیاپی 73، زمستان 1390)

Post dural puncture headache (PDPH) is an important complication of spinal anesthesia, especially in young parturient women after cesarean section. The usage of glucocorticoids such as dexamethasone is a drug suggested to treat PDPH. The aim of this study was to determine the effect, of intravenous dexamethasone in prevention of PDPH after spinal anesthesia in cesarean section. This is a doubleblind randomized clinical trial in which 246 cases of parturients candidated for cesarean section. Patients were divided randomly in 6 equal groups(n=41) according to the number of punctures (1, 2 or > 2 punctures) and administration of 8 mg intravenous dexamethasone. All the patients received spinal anesthesia using 75 mg of 5% lidocaine with a 25G quincke needle. Then, the
patientqs age,history of surgery,previous spinal anesthesia and headache,new onset and duration of PDPH and vital signes of patients were recorded. Finally the obtained data were analyzied by SPSS software. 44(17.9%) patients out of the 246 ones were affected by headache. 12.2% of patients who had received dexamethasone and 23.6% of patients who had not received it suffered from headache,(p-v= 0.030)/ The frequency of hypotension during surgery in patients who had received dexamethasone and those who had not received it were 63.4% and 76.4%, respectedly, (P-v=0.037). Discussion & Administration of intravenous prophylactic dexamethasone caused a significantly decrease in the incidence of PDPH & intraoperative hypotension.So, we suggest the use of 8mg intravenous dexamethasone in susceptive patients for prevention of PDPH.

If the fluoride concentration in drinking water is lower than the standard level, it causes dental caries and if it be more than standard level it causes dental fluorosis. The aim of this study was to determine whether a relationship exists between the groundwater fluoride(F) concentration and dental caries in children living in 7 areas of Nourabade Mamasani town in Iran. F level of the town drinking water was measured by the SPADNS method. All the children of the 4 age groups of 6, 9, 10, and 12 were sampled for a total of 3349 in seven districts of the town. All the 28 teeth of the children were subject to this test. The drinking water in the region is totally of groundwater supply. The residents have essentially the same socio-economic living standards and nutritional conditions. In these 7 areas, the F level in the drinking water was from 0.53 to 1 mg/L., While the number of decayed permanent(Dt) teeth per child ranged from 0.13and 0.34 to the number of decayed deciduous(dt) teeth ranged from 0.5 to 3.9 Although the F level in the drinking water was below the national level, the dental caries were below the national level. Over this narrow concentration range, there appeared to be a weak association between the F level in the drinking water and Dt and dt. Linear regression analyses showed very weak decreases of the Dt and dt scores with increasing water F level is not significant. Discussion & This study shows that in low concentrations of F ranging 0.1 to 0.53mg/L, there is a negligible effect on prevention of dental caries.

Intravenous opioid injection as premedication is one of the most common methods for preventing and controlling hemodynamic changes due to laryngoscopy and tracheal intubation. Using such drugs is not suggestsd in pregnant women who candidate for cesarean section, because of respiratory depression in the newborn, but in special conditions such as preeclampsia, anesthetists can inject low doses of fentanyl(as a synthetic opioid). Because of rapid metabolism of remifentanil and no respiratory effects in the newborn, it can be introduced as a perfect alternative for longer acting opioids in such conditions. This study was done as a randomized clinical trial on preeclamptic pregnant women who were candidate for cesarean section under general anesthesia. They were divided into two groups: in one group 1ml. fentanyl was injected before induction of anesthesia(n1=18), and in the other group 0.05
g/kg/min remifentanil was infused for 3 minutes before induction (n2=20). Afterwars, of heart rate, systolic and diastolic blood pressures before and after intubation and also the newborn's apgar were measured and assessed. All hemodynamic indices increased after intubation in the fentanyl group, and increase in diastolic pressure an heart rate was significant. Mild increase in heart rate and decreasing in systolic and diastolic blood pressure after intubation in remifentanil group was achieved that the decrease in systolic blood pressure was significantly different(R1=154.35, R2=148.35). Comparison of changes between the two groups also demonstrated significant difference (Pval.<0.05). The newborns mean apgar score showed no signifant difference between the two groups(AP.remi=0.88, AP.fent=0.86). Discussion and Considering no difference between the newborns apgar in both the groups and results of assessment of hemodynamic indices, it can be suggested to use remifentanyl in pregnant women who are candidate for cesarean section under general anesthesia to prevent severe increase in blood pressure and heart rate during tracheal intubation.

One of the effective technologies to remove heavy metals is to use bio-absorbents which are economical, easy to access, and conformed to environmental standards. The aim of this research was to study the biosorption level of copper, zinc, lead, and cadmium using Ulothrix Zonata Algae from industrial wastewater.  Materials &
was a cross sectional investigation. Sampling was done from wastewater of battery-making, electroplating and copper industries of Kerman City. Initial levels of Copper, Zinc, Lead and Cadmium were measured by atomic absorption spectrometry. To determine the absorption level of such metals by Ulothrix Zonata absorbent, various amounts of absorbent (0.2, 0.4, 0.5, 1, 1.5 g) were exposed to the mentioned wastewater under different pHs (3, 4, 5, 6, 7), various temperatures (10, 15, 20, 25, 30 °C) and different exposure times (15, 30, 45, 60 and 80 min). Then, the absorption isotherms and kinetic modeling of metallic ions were determined on the absorbent based on testing Longmuir, Freundlich, and first and second grade kinetics isotherm models.  Findingsq Level of removing metals by Ulothrix Zonata absorbent was different. In optimum temperature 25 °C, optimum pH 4 for copper and lead metals, optimum pH 5 for zinc and cadmium metals, balanced contact time of 60 min and absorbent level of 1.5 g/L, removal level of copper, zinc, lead and cadmium was 98.2%, 96%, 98.4% and 94.7% respectively. The removal rate of lead was more than the other metals.  Discussion & Isotherm parameters showed that absorbent capacity for absorbing lead was higher, but absorption of copper and cadmium metals with energy height occurred. Concerning high absorption efficiency, Ulothrix Zonata algae can effectively be used to biosorption of heavy metals from industrial wastewater.

Excessive sun exposure in childhood has been associated with the development of skin cancer. The aim of this study was the promotion of sun protection behaviors in 1-8 years old children through mother education based on Social Cognitive Theory (SCT). One hundred and sixty five mothers with 1-8 years old children referring to Emamshahr health care center of Yazd city participated in this study. The study subjects were randomized to either an intervention (70 subjects) or control (90subjects) group. Data was collected using Persian version of Parental Sun Protection Scale (PSPS), before and two months after performing the educational intervention program and then analyzed using SPSS 11.5 software, descriptive statistics, chi square test, t test and paired t test. Results of this study showed significant differences in mean scores of self efficacy (P
0.001), norms (P
0.001), impediments (P
0.01), and expectancies (P
0.001), in intervention group two months after performing the educational intervention program. Significant increases were also found in behaviors of using the sun protection strategies such as sun screen usage (P
0.001), protective clothing (P
0.01), and sun avoidance (P
0.007) in intervention group. There was no significant difference in mean scores of variables among control group. Discussion & The results of this study showed the applicability of educational intervention based on Social Cognitive Theory to promote sun protection behaviors in children via education of their mothers.

Introductioni Glycation is a non enzymatic reaction initiated by the primary addition of sugar to the amino groups of proteins.In the early stage of glycation, the synthesis of intermediates leading to formation of Amadori compounds occurs. In the late stage, advanced glycation end product (AGE)is irrevesibly formed after a complex cascade of reactions. Glycation also affect diabetes-related complications physiological aging and neurodegenerative diseases such as alzeimers. Materials & Methodsi In this study, HSA incubation with glucose and different concentration of papaverine for 42 days at 37°C. as well as HSA incubation alone (control sample), with glucose(glycated sample)were treated respectively under the same conditions. After 42 days, the samples by use of circular dichroism, fluorescence and UV spectroscopy were investigated. Findingsi HSA glycation increases alon with rising of papaverine concentration. Samples containing papaverine showed more changes in secondary structure free amino groups and AGE fluorescence in relation to glycated and control samples.
Discussion & In glycated  helix and  sheet a 5.7% decrease and 3.1% increase were seen in comparison to the control respectively. Glycated showed 14.2% fluorescence more than the control. Free lys number in glycated showed 8% less in relation to the control. All this cases showed more changes in samples which contained papaverine. HSA absorb in presence of papaverine showed that papaverine cause more lys contact with sugar and an increase in glycation.

Family planning is the most effective strategy in reducing the world population. Family planning was replaced by reproductive health since 1994 and the role of men is one of the most important aspects of this program. Therefore, determination of men's knowledge in family planning and the role of education in enhancing the awareness are important. This study has been performed to determine the impact of education on knowledge and performance of the married men's contribution to family planning. During the investigation, 500 married men working at hospitals and health centers of Ilam were studied by use of easy sampling method. A questionnaire was used to collect data. Analyzing the data was performed by SPSS software and Paired t-test, x2 and Fisher. It was shown that mean of score about men's knowledge of family planning before the education was statistically different from that of after the education. A signficant difference was seen between the men's age, education, job and their wives. Before the education, the most frequent method of contraception was pills usage, (53.9%) and the lowest frequencies were IUD and DMPA (0%). After the education, pills continued to be the most frequent method of contraception (28/4%) and DMPA (0/8 %) as the rarest.

Nowadays, electronic learning is not a choice but a necessity for higher education. This study aims at investigating readiness of faculty members of Iranian west medical universities in application of e-learning in learning processes. Running a stratified sampling technique, 140 faculty members of Iranian west medical universities were selected and their readiness for electronic learning application was assessed by a researcher-developed questionnaire. The reliability of the instrument turned out as acceptable using Cronbach’s Alpha coefficient. Hypotheses were tested utilizing t-test and one-way analysis of variance (ANOVA). Results of the study revealed that the respondents mostly believed in the effectiveness of e-learning environments in learning process. Further, those who had had abroad studies opportunities believed in the effectiveness of such environments, had knowledge and skill on these areas and used the environments more than others. Discussion & Providing opportunities for academic staff to experience learning and teaching process abroad and attending the e-learning conferences and workshops, especially for those who have been graduated more than ten years ago, would persuade them to utilize e-learning environments.