فهرست مطالب

Razavi International Journal of Medicine - Volume:7 Issue:1, 2019
  • Volume:7 Issue:1, 2019
  • تاریخ انتشار: 1398/07/01
  • تعداد عناوین: 8
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  • Comparing The Efficacy Of NCPAP And NIPPV In Infants With RDS After Extubation; A Randomized Clinical Trial Article In Published
    Bita Najafian , Iman Ansari Benam , Mohammad Torkaman , Mohammad Hossein Khosravi * Page 0
    Background

    Respiratory distress syndrome (RDS) is the most common respiratory disorder of premature infants and leading cause of mortality. The main progress in RDS management is attributable to prescription of surfactant for fastening pulmonary maturation.

    Objectives

    In this study we aimed to compare nasal continuous positive airway pressure (NCPAP) with nasal intermittent positive pressure ventilation (NIPPV) in infants with RDS lower than 1800 gr of birthweight.

    Methods

    In this randomized clinical trial, infants with confirmed diagnosis of RDS who underwent treatment with surfactant and mechanical ventilation were randomly allocated to two NCPAP and NIPPV groups. Duration of hospitalization, oxygen therapy, respiratory protection, need for re-intubation and complications were recorded in a pre-designed checklist.

    Results

    Eventually 60 (37 males and 23 females) infants with mean gestational ages of 31.73±1.72 weeks in NCPAP and 32.6±1.92 weeks in NIPPV group underwent analysis (p=0.096). Infants in NCPAP group underwent mechanical ventilation for a mean duration of 3.3±1.7 days; while it was 2.4±0.96 days for infants in NIPPV group (p=0.026). The mean received doses of surfactant was 2.36±0.66 in NCPAP and 1.9±0.25 in NIPPV group (p=0.005). After intervention, infants in NCPAP group had a mean arterial oxygen saturation of 91.36±3.03%; while it was 91.3±4.03% for those in NIPPV group (p=0.669). Mean arterial oxygen pressure was 67.6±6.91 mmHg in NCPAP group and 75.2±7.2 mmHg in NIPPV group after intervention (p=0.045).

    Conclusion

    We found that NIPPV is more effective than NCPAP in decreasing need for reintubation and invasive mechanical ventilation in premature infants with respiratory distress syndrome and it also shortens the duration of hospitalization.

    Keywords: Mechanical ventilation, NCPAP, NIPPV, Respiratory distress syndrome
  • Young Man With Spontaneous Pneumomediastinum With Atypical Presentation
    Behrang Rezvani Kakhki , Azadeh Mahmoudi Gharaee , Hamid Namjoo * Page 0
    Introduction

    Spontaneous pneumomediastinum (SPM) is a rare condition that is defined as the presence of free air in the mediastinal structures without underlying cause. It commonly happens after coughing, vomiting or intensive physical exercise. Most patients present to emergency department (ED) with dyspnea and chest pain. Young healthy adults are the most population that involve with this problem. Chest X-ray and Chest CT are modalities that can be used for approving the diagnosis. Although SPM seldom accompany with life threatening complications, it is usually a benign and self-limiting disorder. Here we introduce a patient with spontaneous pneumomediastinum with atypical presentation.

    Case Presentation

    A 19-year-old man presented to ED with chief complaint of dyspnea without chest trauma. He denied any drugs consumption and his past medical history did not have noticeable problems. Patient’s vital signs were normal and in physical examination, except mild emphysema of neck, other system inspection did not have any pathologic findings correspond with his complication. Chest X-ray and chest CT scan exhibited air in mediastinum without any other pathology like rib fracture. After three days his symptoms was resolved with no requiring to specific treatment.

    Conclusion

    It is a rare condition and if it present with rare symptoms the diagnosis would be very difficult. More, physical examination and chest x-ray as the first diagnostic imaging in respiratory complaints may detect no obvious findings. SPM should be considered as differential diagnosis in young adults, with any respiratory complaint.

    Keywords: Dyspnea, Emphysema, Spontaneous pneumomediastinum
  • Shokfeh Maleki, Mohammad Gholami Fesharaki*, MohsenRowzati Pages 6-9
    Background

    Sick leave is one of the important areas inHealth Professional. Since various unknown factors may be result in sick leave, shift work can be considered as one of the effective factors on the number of sick leave in occupational Medicine.

    Objectives

    This study aimed to consider the effect of shift work on the number of sick leave among steel industry staffs.

    Methods

    This cross-sectional study is carried out on Esfahan’s Mobarakeh Steel Company (EMSC) staffs in 2016 using census sampling method.

    Results

    A total number of 21168 staffs with mean age of 39.96years were entered in this study. 14248 staffs (67.3%) were shift workers. Our results revealed that shift working is significantly correlated with cardiovascular diseases (OR=1.891; p<0.001), leukemia (OR=2.29; p=0.039), respiratory problems (OR=1.29, p<0.001), infectious diseases (OR=1.55, p<0.001), mental disorders (OR=1.658, p<0.001), and poisonings (OR=0.724, p<0.001).

    Conclusion

    Shift workers are more susceptible to different diseases and subsequently they use higher number of sick leave. Therefore, preventive decisions are needed to reduce the negative effects of shift work.

    Keywords: Cardiovascular diseases, Leukemia, Mental disorders, Poisoning, Shift work, Sick leave
  • SaidehMasafi*, Mohammad EbrahimMaddahi, Adis KraskianMujembari, Shapour BadieeAval, Masoumeh Radfar Pages 10-15
    Background

    Depression is a common disorder that is often associated with other mental and physical disorders. One of the innovative approaches applied in depressed patients is Transcranial Direct Current Stimulation (tDCS).

    Objectives

    The study aimed to determine the effectiveness of transcranial direct electrical stimulations on reducing the severity of depression and negative automatic thoughts.

    Methods

    A quasi-experimental study wasconducted on 24 depressed women between 2015 and 2016 who were randomized via clinical interview in Tehran, district 2.The patients’ age range was from 20 to 55 years old.The process was done through the convenience sampling which was randomly assigned into test (n = 12) and control (n = 12) groups. The applied assessment tool in the clinical interview was Beck Depression Inventory (BDI- Form 21) and Automatic Thoughts Questionnaire (ATQ) respectively. All the patients underwent15-20 minutes anodal stimulation of T3 region, and Kathodal stimulation of FD1 with a current of 2-mAintensity along with a Transcranial Direct Current Stimulation (tDCS). The Data were analyzed using the independent t-test analysis.

    Results

    The results showed that there was a significant difference between tdcs and control groups in the rates of depression (P<0.05). There wasalso a significant differencebetween tdcs and control groups in terms of belief and frequency of automatic thoughts(P<0.05).

    Conclusion

    According to the results, it seems that Transcranial Direct Current Stimulation could reduce the severity of depression. Therefore, psychologists and psychotherapistscan use it as a method of intervention used to improve symptoms in patients with depression.

    Keywords: Automatic thoughts, Depression, Transcranial direct current stimulation
  • Hossein Talebzadeh, Shabnam Mohammadi*, Vahid Arabvazife, Maryam Mohammadi, Raheleh Baradaran, Mahbobeh Rahmani, Fatemeh Mohammad Zadeh, Ali Delshad Pages 16-20
    Background

    Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine and its efficacy is different from that of conventional medicine.

    Objectives

    Owing to the growing use of CAM in our country, the aim of this study was to evaluate the level of awareness, attitude, and performance of employees in Gonabad, 2014.

    Methods

    This was a cross-sectional study in 2014 conducted in Gonabad healthcare center with 237 workers (122 male and 115 female) and with a mean age of 31.57±8.34. A questionnaire was used for data collection. Data was analysed using SPSS software.

    Results

    The results were considered significant when P value was less than 0.05. The level of staff knowledge was low (21.08 ± 6.61), but 94.1% of the staff had positive attitude and more than 60% of them had a good performance level. As many as 5.1% had experience of traditional medicine courses, while 53.2% had experience of using a CAM for treatment. As many as 56.11% said that traditional medicine had been useful in their treatment. The most used method was the use of herbal medicine (48.3%), while the least used methods were meditation, hypnosis, traditional bath, and aromatherapy. As many as 65% of employees would recommend to others different methods of traditional medicine, and 90.7% knew the necessity of allocating traditional medicine course.

    Conclusion

    According to the findings,Gonabadhealth carestaff have a low level of knowledge, but a good attitude and practice of CAM are necessary through workshops to raise awareness of the CAM.

    Keywords: Attitude, Complementary, alternative medicine, Knowledge, Practice, Staff
  • Zohreh Ahmadi, Masoud Rahmati*, Rahim Mirnasoori, Mohammad Fathi Pages 21-29
    Background

    The interaction between genetic and environmental factors has resulted in growing prevalence of obesity around the world. IL6-174 G/Cgene polymorphism is widely studied as the involved factor in developing obesity.

    Objectives

    The aim of the present study is to evaluate the relationship between Interleukin 6-174 G/C promoter gene polymorphism and obesity in a systematic review and meta-analysis study.

    Methods

    In the present study Science Direct,Medline, Embase, Google Scholar, PubMedand SID search engines have been searched until March 2016. Articles were evaluated using the key words IL6 plus polymorphism or mutation or variant and adiposity, BMI and obesity. Data was analyzed using STATA software (12th version). OR ratio was calculated with 95% confidence interval to evaluate the strength in link between IL6 gene and obesity. Heterogeneity was calculated using I2 test. Articles bias was evaluated using funnel plot versus standard error (SE). The asymmetrydegree of the funnel plot was tested using linear regression tests ofEgger's and Begg's.

    Results

    Generally, 12 articles entered systematic review and 6 articles entered final meta-analysis. After data was extracted, the total case group consisted of 5343 people and control group consisted of 3449 people. The odds ratio was estimated for additive model CC vs GC (OR= 1; CI: 95%: 0/9-1/12), recessive model CC + GC vs GG (OR= 1/04; CI: 95%: 0/95- 1/15) and for dominant model (OR= 1/10; CI: 95%: 1-1/21). Also the results showed that there is a statistically significant relationship between IL-61-74 G/C gene polymorphism and obesity (P <0/05).

    Conclusion

    Generally, the results of the present study show that the IL-6 -174 G/C gene polymorphism is related to the obesity.

    Keywords: IL6 gene, Meta-analysis, Obesity
  • Mahtab Salek, Roham Salek* Pages 30-32
    Context

    Iran has been known as one of the most common areas of esophageal cancer in the world. Actually, North of Iran is well known as a high-incidence endemic region located on the belt of esophagus cancer which is extended from the north of China to the south of Caspian Sea. Evidence Acquisition: This paper is going to have an overview on the esophageal cancer in Iran through reviewing the results of some new researches have been completed in recent years in Khorasan, Iran.

    Results

    Epidemiology of esophageal cancer has been changing in recent years in Khorasan, Iran and the incidence rate of the disease is declining. Although the exact reasons for the high incidence rate and yet for declining incidence of the disease are not known, there has been some points of view for this evolution. Still the great majority of esophageal cancers are squamous cell carcinoma and the females and males are almost equally involved in the disease. The most interesting aspect of the disease in this region is long survival of most of the patients.

    Conclusion

    It seems there are some differences in esophageal cancer disease between Iran and other countries especially western onesin terms of the etiologic risk factors of the disease, some of its epidemiologic aspects, as well as outcome of the disease which seems to be better in Iran.

    Keywords: Epidemiology, Esophageal cancer, Iran, Khorasan, Outcome
  • Masoud Keikha* Pages 33-34