مجله علمی دانشگاه علوم پزشکی کردستان
سال هشتم شماره 1 (پیاپی 29، پاییز 1382)

Pelvic Inflammatory Disease, which occurs in female upper genital tract, is a common problem which women face the gynecologists in their outpatient department because of it. The objective of this study was to compare the efficacy of ceftriaxone with doxycycline versus ofloxacine in the outpatient treatment of those women came to gynecologic clinic in Sanandaj in 2003. For prevention of PID, treatment of upper genital tract is necessary. Early diagnosis and treatment of PID prevents from complications. Forty women with clinical symptoms & signs of pelvic inflammatory disease were randomized (Block Randomization) in two equal groups getting ceftriaxone and doxycycline (group A) and ofloxacine (group B). These women were in fertility age, married and nobody had systemic disease or history of antibiotic medication. This study was single blind randomized clinical trial. Checklist and physical examination made the collection of data. Analysis of data has been done in SPSS.win software and were demonstrated with 2 test and paired t-test. There was significant reduction in severity of disease in these two groups. But there was not statistically significant difference in these groups. The results indicated that the efficacy of these two regimens was equal in management of pelvic inflammatory disease.

Valproic acid (VPA) with good anticonvulsant activity has become accepted as one of the most important antiepileptic drugs. The potential teratogenicity of valproic acid on neural tube in infants born to mothers who have taken this drug has been described. The incidence of neural tube defect following exposure to VPA during the first weeks of pregnancy can increase to 1-2%. For this reason and for a relationship between zinc deficiency and neural tube defects and highest incidences of these abnormalities in areas of the world where human zinc deficiency exists we investigated the effect of VPA on plasma zinc concentration. In this experimental study we selected 12 rats (Albino) randomizely in 2 groups. The rats were in equal environmental and nutritional states. In Control group normal saline 4ml/kg and in experimental group VPA 350mg/kg is injected intra abdominal. All the rats were sacrificed with cervical cutting and plasma prepared. Plasma zinc concentration was measured with flameless atomic absorption method. Quantitative data were presented as a Mean±SD were analyzed by t-test. Mean plasma zinc in the case group was 27.96±2.23, and in the control group was 42.2±0.579 (p=0.000). These results indicate that injection of VPA to rats decrease plasma zinc levels, that may be one of the mechanisms in neural tube defect following exposure to VPA.

Reconstruction of traumatic soft tissue defects at calf middle third after a trauma or open fracture is very important esthetically and psychologically for patients. There are few methods for this. One of them is hemisoleus flap. Cases: In this study 6 patients who experienced fractures after trauma, one case with chronic secretary osteomyelitis and one with exposed plate were reconstructed with hemisoleus flap technique. After surgery and follow up, flap cover was complete in 7 cases. In one patient (with exposed plate), one half of flap was necrotized, which in second stage was covered by gastrocnemius flap. Functions and wrist flexion were not decreased after surgery in 7 cases. One case had movement defect, but after 3 months it was disappeared. Design and application of muscular hemisoleus flap (medial belly) for this goal with preservation of muscle function for flexion, instead of scarification of total soleus muscle function is usefulness of this procedure.

Similar to some other country prevalence of Hepatitis B, Hepatitis C, in Iran is considerable. Health care personnel, especially members of surgical teams are at risk for occupational transmission. In this survey we studied prevalence of seropositivity for all those three viruses in admitted patients in hand trauma unit at 15 Khordad hospital. In Tehran and compared the results with other domestic and international reports. From March 2001 to March 2003, 3714 patients who were 15 year and older were operated in this unit and ELISA serologic test were done for all of them. In 126 cases, (3.4%) at least one of the three serologic tests were positive. HBS-Ag in 2%, Anti HCV-Ab in 1.5%, and Anti HIV-Ab in 0.13% of cases were reported as positive. Compared with other studies in many countries which have been performed in emergency or trauma patients, blood donators, or general population prevalence of seropositivity to these viruses were different in our study in 15 Khordad Hospital.

Many pregnant women suffer from heart disease. This disease affect both mothers and fetus. In this study we evaluated the prevalence of cardiovascular disease, the complications during the pregnancy and its outcome come in pregnant women in Sanandaj. This study has been done in pregnant women in Sanandaj during 2002 to 2003. A descriptive-analytic method was used in this study. First the diagnosis of heart disease was established by a cardiac surgeon in pregnant women then the patients were followed during the pregnancy, labor, delivery and in post partum Period. The control group was 100 healthy pregnant women in same age. The data was analyzed by t-test, 2 and Fisher exact test using SPSS soft ware. 3125 pregnant women were considered in this study. The prevalence of heart disease was 1.6%. The cardiovascular diseases affect the outcome of pregnancy significantly. There were 4 cases of abortion, 2 cases of IUFD and 2 neonatal death. Weight gain during pregnancy in pregnant women with heart disease was less than pregnant women in control group. In addition, newborn weight in case group was 2300 gr comparison with 2730 gr in control group. The most common heart disease were mitral stenosis (22%) and mitral valve prolapse (20%). The elective method for delivery in pregnant women with cardiac heart disease is normal vaginal delivery (NVD) and in this study 64.4% of patients had vaginal delivery. According to the results of this study the prevalence of cardiac heart disease in pregnant women in Sanandaj is higher than some studies and causes complications for mothers and newborns.

Myocardial infarction (MI) with a 25-30% mortality rate is one of the most common causes of death in most country. MI has many complications such as heart failure, mitral regurgitation, interventricular septal defect and various arrhythmia. Management of this disease and treatment of complications require complete recognition of them. This study was designed to investigate these criteria. This descriptive study was done on 320 patients with acute MI. Demographic data and history of coronary risk factors that were selected by non randomized consecutive sampling were collected by questionnaire and MI complications were determined by physical examination, electrocardiogram and echocardiography. Patients were followed during hospital staying. The sample included 71% males, 29% females and the average age was 59.5 years. The least frequency was under 35-year age group and the highest frequency was between 65 to 75 years old. 78% of infarctions were Q wave and 13% were non-Q wave. The most frequent site of MI was inferior and the least was lateral MI.10.9 percent of patients died after admission. The most common cause of death was cardiogenic shock (65.7%). 286 patients who had echocardiography (89.37%) revealed left ventricular systolic dysfunction (in 83.57%), mitral regurgitation (29.7%) and 1.14% of them had VSD. In patients over 65 years, the severity of left ventricular systolic failure was higher (p<0.0001). In patients with non Q wave MI the ejection fraction was higher than who had developed Q wave MI (p<0.05). Although this study’s result is match with the results of studies those have been done in many countries the mortality rate and complications of myocardial infarction without aggressive therapeutic measure is still very high.

Laser iridotomy in treatment of chronic angle closure glaucoma has been increased during recent years and despite its preference, it has same complications. One of the important complications is intraocular pressure rising. To determine the relation between consumed total energy during Nd: YAG peripheral iridotomy and frequency of intraocular pressure rising this study has been done. In this descriptive study on results of Nd: YAG peripheral iridotomy in 275 eyes from 190 patients that was done in Labbafinejad medical center laser ward, effects of diagnosis (chronic angle closure glaucoma or narrow angle) and amount of total energy on intraocular pressure rise one and three hours following Nd: YAG peripheral iridotomy was evaluated. This study was shown no relation between diagnosis and intraocular pressure rise following Nd: YAG peripheral iridotomy but with increase in total energy greater than 400 m.j intraocular pressure rising (≥5 mm Hg) three hours after iridotomy was statistically significant (P<0.05). If total energy reached 700 m.j this meaningful intraocular pressure rising was detected one hour after iridotomy. For avoidance of intraocular pressure rise following Nd: YAG peripheral iridotomy we recommend total energy lesser than 400 m.j and especially lesser than 700 m.j.

Bone tumors are uncommon and have two groups, primary and secondary tumors. The later consists of metastatic tumors and it is more common than the primary tumors. Bone tumors are rare in body. This study is designed to determine the frequency of bone tumors in Kurdistan. This study was descriptive and documented data were collected from governmental and private centers from 1996 to 2000 in Kurdistan. There were 190 files and necessary data consist of histopathologic types of masses, age, sex and location of lesions were analyzed with descriptive analysis. From 190 primary bone tumors 8.4% were malignant, 69.5% were benign and 22.1% were tumor like lesions. Osteochondroma was the most frequent in benign tumors (57.6%) and its frequency among all of the bone tumors was 40%. In malignant tumors osteosarcoma and giant cell tumor have the most frequency (25%). Among all pathologic types consist of malignant, benign and tumor like lesions, the frequency for male was more than female. Most of bone masses that were been biopsy are benign and malignant tumors are rare.