فصلنامه علوم پزشکی دانشگاه آزاد اسلامی مشهد
سال پنجم شماره 2 (پیاپی 18، تابستان 1388)

The purpose of this study is to quantify the voice disorders in children with cochlear implantation and hearing aids. Until now, quantifying voice disorders has been done subjectively by speech experts and it is for the first time that the preset study tends to run an objective experiment using signal processing features. Introduction 4 levels were considered to be qualify speech. Linear and nonlinear features were extracted from 5 Farsi words: “mashin”, “mar”, “moosh”, “gav” and “mowz” uttered by 30 subjects and then put into hidden Markov classifiers. Classifier outputs then were fused together to have better accuracy. The main hypothesis of the study is to answer this question: Can we separate children into 4 levels based on their voice features? Voice features including “fundamental frequency, first formant, second formant, third formant, first to second formant ratio, third to second formant ratio, Rational Intensity, nasality, approximate entropy and fractal dimension were extracted from speech segments and then are were given to artificial decision making systems (classifiers). Materials and Methods The results show that classifiers can separate 4 levels of voice disorders with the accuracy of 93.1%. Among the introduced features, first to second formant ratio and third to second formant ratio can be used directly to track voice recovery after using cochlear implantation or hearing aid. Results The output of this research study can act as a speaker independent system to help speech specialists with evaluating voice disorder recovery in children who fall in the same range of age.

Due to the worldwide prevalence of diabetes, the disease has become a pandemic giving much more weight to its side effects. One of the chronic complications related to diabetes is Diabetic Nephropathy that leads to notable rate of death. Microalbuminuria is one of the determinants that predicts the onset of diabetic nephropathy. Introduction This study was carried out on 369 type 2 diabetic patients who referred to a diabetes clinic in karaj. A questionnaire inquiring the participants’ age, gender, duration of diabetes and family history of diabetes was filled out. Body Mass Index (BMI) and Blood Urea Nitrogen (BUN), the levels of Creatinin, Cholesterol, Triglyceride as well as HbA1C measurements were examined. Then, the twelve-hour urine samples collected from the patients with standard method s were examined for urine culture, urine analysis and urine albumin. Materials and Methods Out of 369 patients, 309 (83.7%) were diagnosed as normoalbuminuric (Albumin excretion less than 20 mcg/min), 57 (15.5%) were microalbuminuric (Albumin excretion between 20- 200 mcg/min) and 3 (0.8%) were macroalbuminuric (Albumin excretion more than 200 mcg/min). Statistically, there was a significant difference between blood creatinin, BMI and HbA1C of patients in two groups of microalbuminuria and normoalbuminuria, but there were no significant differences in age, sex, duration of diabetes, family history of diabetes, blood pressure, and hyperlipidemia between the two groups of the study. Because of the small sample size of macroalbuminuric patients, statistical analyses on this group are not considered valid. Results In the mentioned population, the prevalence rate of microalbuminuria is 15.5 percentage and the increase of blood creatinin, BMI as well as the indication of poor blood Glucose control are among the risk factors that cause microalbuminuria.

Crystal is one the pernicious addictive drugs which has unfortunately been imported to Iran in the recent years. As Crystal is the purified form of Heroin, its adverse effects are much more serious than those of Heroin. Apart from psychological effects, addiction to Crystal may have adverse effects on organs and tissues. So, the evaluation of enzymatic changes could be helpful in identifying the origin of damages. Alkaline phosphatase is present in most tissues and the most prevalent cause of its elevation is liver and bone diseases. Since liver damages may be caused by Heroin consumption, assaying ALP levels could be useful for investigating the adverse effects of this drug. Introduction This study is a case control study which was carried out on 50 control persons and 108 crystal addicts who referred to Salehabad Center of Drug Addiction Treatment (Torbat jam) for the first time during 2008-2010. The activity level of Alkaline phosphatase in the serum was measured with Calorimetry-Spectrophotometry Using computer software SPSS-16, t-test was used to analyze the data. Materials and Methods The results of this study indicate that there is a significant relationship between Crystal consumption and the serum level of ALP in both groups (P= 0.001). Besides, the relationships between the duration of Crystal consumption with Alkaline phosphatase level and cigarette smoking were significant. Results Our results revealed that Crystal consumption is an important factor for elevating the ALP serum level in Crystal addicts.

Polyneuropathy is defined as a diffused peripheral nerve disorder that presents with sensory, motor or autonomic dysfunctions. This study aims at determining the causes of polyneuropathy among patients who referred to Bahman 22nd Hospital in Mashhad. This is a descriptive study that was carried out on 31 patients suspected to polyneuropathy referring to Bahman 22nd Hospital in Mashhad during the years of 2007-2008. The study collected data on the patients’ past medical history, drug history and family history of manifesting similar symptoms. Also, the research undertook neurological examinations and neurophysiologic studies on all the participating patients. Polyneuropathy was confirmed using electrophysiologic studies. Supplementary laboratory exams were conducted with patients’ consent to diagnose polyneuropathy. Statistical analysis was then done on the collected data using SPSS software. The most frequent ca use of polyneuropathy was found to be CIDP. The other causes were determined as diabetes mellitus in 16.5% of the participants, GBS in 16.5% as well as leprosy, toxic and hereditary causes each in 9.7% of the participants. Also Vitamine B12 deficiency was determined to be the cause in 6.5% of the cases. We didn\\\'t find any determinative cause of the disease in 9.7% of the cases; so, they were classified as cryptogenic. Among the predominating clinical manifestation was sensory complains (66.7%). Pain and temperature disorders were the most common presentations (87.1%). It was also found that muscle tonicity affected mostly the distal area of lower extremities. Muscle strength was found to be diminished in the distal areas of both lower and upper extremities. Moreover, Achilles Reflex function was reduced in 87.1% of the patients in this study. The most frequent causes of polyneuropathy were inflammation and metabolic disorders. Muscle tonicity, muscle strength and deep tendon reflexes were reduced in the distal areas of extremities. Therefore, in neurological examinations, detailed evaluation of distal areas is essential.

The development and empowerment of any society depend on the sound health conditions of the individuals living in that society. In fact, the two factors of health and development are interrelated in a sense that the existence of one gives rise to the other. That is why the present study aims at assessing some physical health indexes among secondary-school male students ranging from twelve to fourteen years old in Gachsaran, Iran. The study was carried out during the academic year of 2009-2010. This is a descriptive research study. The variables assessed in this study include: physical growth like height and weight, health status of vision, hearing, mouth and tooth, as well as that of the vertebral column. For the purpose of this study, 1000 boys with the age range of twelve to fourteen years old, i.e. from the first to the third grade of secondary high school, were randomly selected for the assessment. The selection was based on multistage sampling. The instruments used for data collection include a questionnaire and observation record sheets. As for the physical examinations, several instruments were utilized as follows: measuring tape, weighing scale, Snellen chart, tuning fork, flashlight, spatulas and disposable gloves. Regarding the assessment of physical growth, the median values for weights and heights of the subjects in all age groups were lower than the median point of NCHS. Generally, the weight of 4.6% of the students was below the third percentile of the NCHS chart, 29.2%, fell between the third and the fiftieth percentiles, 54.3% between the fiftieth and the ninety seventh percentiles and 11.9% of their weight was found to be higher than the ninety seventh percentile of the NCHS chart. As for the findings related to the height, 3.2% of the students were shorter than the third percentile of the NCHS charts, 32.6%, fell between the third and fiftieth percentiles, 52.3% between the fiftieth and ninety seventh percentiles and 11.9% were taller than the ninety seventh percentile of the NCHS chart. The results of assessing visual conditions show that 25.8% of the students with glasses had at least one eye with less than 0.9 visual acuity.Regarding the hearing status, the findings show that 8.4% of the students subjected to whisper test were found to have hearing loss in either one or both ears. In relation to health status of teeth, the findings indicated that 72% of the students participating in the present study had decayed permanent teeth.Concerning the vertebral column, the results indicate that 6.8%, 2.4% and 3.9% of the students in this research had scoliosis, lordosis and kiphosis, respectively. As for demographic specifications, it was found that there was a significant correlation between DMFT index and the fathers’ education as well as the number of children in the family The results of the present study show the importance of paying more attention to students’ dental health, nutrition, physical education and health status of visual, hearing and skeletal systems.

Postoperative nausea and vomiting (PONV) is a major unpleasant symptom in the postoperative period that has many causes, including the choice of anaesthetic drugs and induction. The prevention of PONV is considered as equally important as the prevention of postoperative pain. Thus, this study was performed to evaluate and compare the prevalence of PONV after abdominal hysterectomy using general anesthesia. To this end, the roles of two different drugs regimens, Propofol and Tiopental Sodium, were studied. This single-blinded clinical research study was carried out in Ariya Hospital during the years of 1387 and 1388 (H.S.). For this study, 104 ASA class I or II women, aged 30-60 years, were scheduled for abdominal hysterectomy by the same surgeon The operations lasted about 25 to30 minutes. The samples of the study were randomized into one of two groups: Group P (n=52) who received the induction of 2 mg/kg Propofol with the maintenance of 5 mg/kg/hr of Propofol. On the other hand, group T (n=52) were given the indution of 5 mg/kg Tiopental Sodium with the maintenance of 0.5 MAC Halothane. All the patients received 4 µg/kg Fentanyl, 0.6 mg/kg Atracurium and the ventilation was controled at O2/N2O 50/50. The number of patients suffering from nausea and/or vomiting at the recovery room was recorded within 6 and 24 hours after the operation. The data were then statistically analyzed using Chi-square and Fisher‘s exact test. After the operations, the number of patients experiencing nausea at the recovery room was %5.8 (n=3) for group P and %59.6 (n=31) for group T (P=0.001). %5.8 (n=3) of the patients in group P were vomiting while %28.8 (n=15) in group T (P=0.003) had that experience. The number of patients experiencing nausea within 6 hours after the operation was %55.8 (n=29) for group P and %67.3 (n=35) for group T (P=0.314). In terms of vomiting in 6 hours of postoperation, %21.2 (n=11) of the patients in group P and %38.5 (n=20) in group T were having the experience (P=0.085). Also, the results indicate that the number of patients experiencing nausea within 24 hours of postoperation was %3.8 (n=2) for group P and %32.7 (n=17) for group T (P=0.001). However, %1.9 (n=1) of the patients in group P and %5.8 (n=3) in group T (P=0.618) were suffering from vomiting within the same duration of time. As a whole, the findings indicate that the incidences of nausea and vomiting at the recovery room were significantly lower in group P than in group T, but the difference in 6 hours after operation was insignificant. Also, the prevelance of nausea in 24 hours after operation was significantly lower in group P than in group T, but the difference in terms of vomiting within the same period was insignificant. For women undergoing abdominal hysterectomy, the choice of induction and maintenance of general anesthesia with Propofol provides a better prophylaxis against PONV than the induction with Thiopental Sodium with the maintenance of Halothane. `` This single-blinded clinical research study was carried out in Ariya Hospital during the years of 1387 and 1388 (H.S.). For this study, 104 ASA class I or II women, aged 30-60 years, were scheduled for abdominal hysterectomy by the same surgeon The operations lasted about 25 to30 minutes. The samples of the study were randomized into one of two groups: Group P (n=52) who received the induction of 2 mg/kg Propofol with the maintenance of 5 mg/kg/hr of Propofol. On the other hand, group T (n=52) were given the indution of 5 mg/kg Tiopental Sodium with the maintenance of 0.5 MAC Halothane. All the patients received 4 µg/kg Fentanyl, 0.6 mg/kg Atracurium and the ventilation was controled at O2/N2O 50/50. The number of patients suffering from nausea and/or vomiting at the recovery room was recorded within 6 and 24 hours after the operation. The data were then statistically analyzed using Chi-square and Fisher‘s exact test. Materials and Methods After the operations, the number of patients experiencing nausea at the recovery room was %5.8 (n=3) for group P and %59.6 (n=31) for group T (P=0.001). %5.8 (n=3) of the patients in group P were vomiting while %28.8 (n=15) in group T (P=0.003) had that experience. The number of patients experiencing nausea within 6 hours after the operation was %55.8 (n=29) for group P and %67.3 (n=35) for group T (P=0.314). In terms of vomiting in 6 hours of postoperation, %21.2 (n=11) of the patients in group P and %38.5 (n=20) in group T were having the experience (P=0.085). Also, the results indicate that the number of patients experiencing nausea within 24 hours of postoperation was %3.8 (n=2) for group P and %32.7 (n=17) for group T (P=0.001). However, %1.9 (n=1) of the patients in group P and %5.8 (n=3) in group T (P=0.618) were suffering from vomiting within the same duration of time. As a whole, the findings indicate that the incidences of nausea and vomiting at the recovery room were significantly lower in group P than in group T, but the difference in 6 hours after operation was insignificant. Also, the prevelance of nausea in 24 hours after operation was significantly lower in group P than in group T, but the difference in terms of vomiting within the same period was insignificant. Results For women undergoing abdominal hysterectomy, the choice of induction and maintenance of general anesthesia with Propofol provides a better prophylaxis against PONV than the induction with Thiopental Sodium with the maintenance of Halothane.

spite of the recent improvements in prenatal and postnatal cares, there is an increase of respiratory distress in premature newborns that need to be put on ventilators. Due to intratracheal intubation and ventilation systems, there is an increase of ventilator-associated infection among such neonates; thus, calling for more attention and evaluation. Accurate diagnosis and immediate treatment of these infections may decrease the onset of respiratory complications, the cost due to prolonged hospitalization, drug consumption and neonatal mortality. In spite of the recent improvements in prenatal and postnatal cares, there is an increase of respiratory distress in premature newborns that need to be put on ventilators. Due to intratracheal intubation and ventilation systems, there is an increase of ventilator-associated infection among such neonates; thus, calling for more attention and evaluation. Accurate diagnosis and immediate treatment of these infections may decrease the onset of respiratory complications, the cost due to prolonged hospitalization, drug consumption and neonatal mortality. This is a cross-sectional study. The sampling technique used for the study was easy and based on goals. The population of the study were selected among intubated newborns in neonatal intensive care of Bahman 22nd Hospital in Mashhad. The subjects were diagnosed for Respiratory Distresses (RDS) during the years 2006 to 2007. Tracheal culture was done and antibiograms were created for all the cases while changing the tube. Also, the results of blood culture, the number of tubes being changed, the duration of intubation and the number of suctions were studied. Having completed the information forms, the data were evaluated with SPSS software running Fisher test and K2. Among 100 neonates who were studied, 34 cases had positive tracheal culture. The organisms identified included: Coagulase positive staph (30%), C. Negative staph (23%) and E. coli (23%). The results of blood culture were positive in 6% of the cases. 40% of the subjects were suctioned 10-12 times a day and 60% of them were put on intubators 3-5 days and 50% of them had their tracheal tubes changed 3 to 4 times during hospitalization period. Repeated sterile suctioning as well as reducing the time of intubation and the number of tube changing diminished the formation of organism colonization in trachea.

The risk of being affected by infectious diseases in dentistry directly depends upon the degree of contact with body liquids, such as blood and saliva, as well as the working tools. Different micro-organisms including the viruses causing AIDS and Hepatitis B as well as oral thrush are possible to be transferred in dentistry. According to the Dental intervention (FDI), it is suggested that all dental patients, in spite of the healthy look, are considered to be infective. Therefore, the health principles and protective and safety methods must be observed in all the sequences to prevent cross-infection. Thus, the present study seeks to investigate the degree to which the dentists in Isfahan respect and approach to such standards. Introduction This is a cross-sectional descriptive study. In order to answer the questions of the study (as found in tables 1&2), the data related to the participants’ attitudes and performance were collected by having them fill out a questionnaire and a checklist. A total of 140 dentists in Isfahan were selected through a random sampling in 1385 (HS). The data collected was then evaluated with SPSS. Materials and Methods The mean score obtained from the attitude-related questions was 5.36. Also, the mean score of performance-related questions was found to be 8.03. No significant relation was found between the dentists` attitudes and the years of service (P=0.092, r=0.17). No significant relation was found between the dentists` performance and the years of service (P=0.12, r=0.15). No significant relation was found between the dentists` attitudes and their performance (P=0.1, r=0.16).