مجله فیض
سال هشتم شماره 4 (پیاپی 32، زمستان 1383)

According to high incidence of fever and its side effects in children and also because of different effects of drug regimens on reducing fever, we decided to investigate three kinds of adminstration of acetaminophen (aral with regular dosages, Rectal with regular and high dosages) on children whom were admitted in shaheed Beheshti Hospital in kashan in 2004. This randomized clinical trial was performed among 120 patients aged 6 months to 6 years with fever (axillary temperature ³ 38 ° c). Patients divided in 3 groups. Group A (40 patients) received oral acetaminophen with dose of 10-15 mg/kg acetaminophen. Group B and C received acetaminophen rectally with dose of 10-15 mg/kg and 30-60 mg/kg,respectively. Recovery was defined as reducing axillary temperature at least 1 ° c.Data analysis was performed using Chi Square test. The frequency of recovery in groups A, B and C after 1 hour of adminstration of acetaminophen was 34 (85%), 32 (80%) and 36 (90%), respectively (p<0.05). It was 37 (92.5%), 38 (95%) and 39 (97/5%) after 3 hours (p<0.001) and 10 (25%), 14 (35%) and 22 (55%) after 6 hours (NS) of administration of acetaminophen in groups A, B and C, respectively High dose rectal acetaminophen is much more effective in reducing fever of children in comparison of regular dose of acetaminophen, orally or rectally.

Co-culture techniques have important role in the study of cellular interactions. The ability of distinguishng co-cultured cells facilitates evaluation of these cultures. P388D1 cells are macrophage like cells but morphologic appearance of these cells is like lymphoblasts. In evaluation of P388D1 and bone marrow cells co-culture, Different antigens on P388D1 cells surface could help to distinguish these cells from bone marrow cells. In order to prepare the antibody against P388D1 cells, rabbits were immunized by intraperitoneal and intravenous injections of these cells. After getting blood, serum immunoglobulins were precipitated in ammonium sulfate solution. Before and after each precipitation, serum protein electrophoresis was performed and protein was assayed by Bradford method. Antibodies, which had a cross reactivity with bone marrow cells were removed by several absorptions with bone marrow cells. The presence of antibodies on cell surface was detected by indirect immunoflurescence labeling technique. Complement mediated cytotoxicity of antibodies was also assayed. The results indicate that this antibody solution has no detectable cross reaction with bone marrow cells, using indirect immunflurescence labeling technique, while it has positive reaction against P388D1 cells. By means of these antibodies we would be able to recognize or remove P388D1 cells from bone marrow cell population.

Aquatic insects are able to transit the pathogens and disturb human beings. So, this study was performed to determine the type and distribution of insects in Kashan during 2001-2002. This is a descriptive study, in which 2222 larva and mature insects were collected from pools and stream habitats. After transporting to laboratory, they were diagnosed using morphologic diagnostic clues. The frequency of different types of insects was as following: Diptera 55%, Trichoptera 24%, Heteroptera 8%, Ephemeroptera 7%, Coleoptera 3% and Odonata 3%. Considering the role of insects in transmitting pathogens and their disturbance for human beings, it is recommended further specific studies using molecular methods.

Considering the high secretion of gastric acid in peptic ulcer, its known complications and failure to previous therapeutic regimens, and also regarding history of prescribing peppermint essential oil in the treatment of gastric disorders and lack of information about interactions between peppermint essential oil and secretion of acid by parietal cells, this study was performed. This experimental study was conducted on 60 male rats, species Sprague Dawley. Rats were divided in 6 equal groups. Each group received normal saline (0.9%) and menthol with doses of 0.9, 2.7, 9, 27 and 90 mg/kg by plastic cannula, respectively. Gastric secretion was extracted from pylorus. Gastric acidity was evaluated using titration by NaOH. Data analysis was performed by t-test, paired t-test, one way ANOVA and tukey's test. Rate of gastric acid secretion was constant in rats received normal saline, while it increased in rats received peppermint essential oil. Peppermint essential oil with dose of 9 mg/kg decreased acid secretion from 100 to 61.1±3.8 percent at the beginning of prescribing. Increasing dose aggravated the efficacy of peppermint essential oil on inhibiting acid secretion. The maximum of effect was seen in dose of 27 mg/kg. The effect of peppermint essential oil was reversible and after washing stomach with normal saline, this inhibitory effect was disappeared. It seems that peppermint essential oil has dose-dependent and reversible inhibitory effect on gastric acid secretion. So, it is recommended to patients with gastritis to decrease prescribing anti-secretory drugs.

Cockroaches have important role in transmission and distribution of pathogen agents. So, this study was carried out to determine the cockroache's species and their bacterial agents in Kashan hospitals in 2001. This description study was performed on 88 cockroaches of three major medical centers. Species of cockroaches, their bacterial infection, and isolated bacteria species from internal and external surface were determined. The frequency of infection in cockroaches was determined and their prevalence in cockroache's population was estimated. From 88, 83% were German cockroaches and remaining were American cockroaches. The rate of infection was 44.3%. 61.5% of German cockroaches and 100% of American cockroaches were infected with at least one species of bacteria. Internal and external infections of cockroaches were 71.8% and 28.2%, respectively. The most prevalent bacterium was Enthracoccus (36%) and Streptococcus (31%) respectively. Naghavi hospital had more infection (76%) compare to others. Bacteria isolated form internal and external levels were Streptococcus, Escherichia coli, Bacillus, Enterococcus, Micrococcus, Coagulase-Negative Staphylococci, Coagulase-Positive Staphylococci, Pseudomonas. Cockroaches bacterial infection is a noteworthy problem in Kashan hospitals. Therefore it is considered the ways to reduce abundant cockroaches and their bacterial infection..

Nurses have the major role in care continuity and health promotion. They frequently affect total factor productivity in organization. But there is not adequate information about nursing productivity. Therefore objectives of this research are assessing nurses’ view about productivity and its effecting factors. The study conducted between the years 2003-2005 in the hospitals of Tehran university of medical sciences. We chose the grounded-theory approach for analysis of the participant's experiences and their viewpoints regarding the nurses’ productivity. Semi-structured interviews were used to gather the data. Purposeful sampling was used 26 participants were interviewed and the constant comparative analysis method was used. 26 participants were consisted samples from nurses, head nurses, supervisors, matrons and nurseducators. 23% of participants were male and 77% were female with mean age of 39.8 ± 7.6 and 17 ± 7.9 years of service. Nurses defined productivity as being useful for the clients and delivering effective and high qualitative nursing care. However, they believed that their productivity is low becaues of obstacles such as staff shortness, high level of non-nursing duties, and inefficient management strategies such as dictatorial and selfish behaviors of managers. They emphasized that the manegers performance and behavior can facilitate or hinder the nurses productivity. Qualitative studies are apropriate for recognising the variables and the process of organizational and social conditions like productivity. nurses defined productivity as being usful for the clients and delivering effective and high qualitative nursing care. Effective management can improve productivity and enhance quality of care – essntial mission of health care organization. Qualitative studies are suggested for recognising the process behind the organizational behaviors.

Interlocking nailing is a surgical technique in the treatment of patients with humeral shaft fractures that can not be treated by non surgical procedures. There are controversies about benefits of this technique. So we evaluated this technique in patients with humeral shaft fracture during 2000-2004. This case series study was performed on 34 patients who operated by antigrade or retrograde nailing. They are followed up till union formation. Decreasing range of motion in the shoulder and elbow joints was classified as good (less than 10o), intermediate (10o-30o) and bad (more than 30o) scale. Data analysis was performed by sign test. 34 patient (56% male, 44% female) aged between 17 and 68 years were studied. 71% and 29% of patients were operated by antigrade or retrograde nailing, respectively. In the 44.1% of patients, duration of union was less than 3 months. Good scale in the function of shoulder and elbow joints occurred in 88.2% and 85/3% of cases (P<0.01). The frequency of non union was 5.9%. It seems that Interlocking nailing is a safe and reliable technique in the treatment of patients with humeral shaft fractures

Backgraound: Regarding the growing rate of hyperglycemia in Iran and some of its known complications, we attempted to assess the effect of teaching this matter on diabetic patients at kashan in 1380. This experimental research was conducted on 60 patients suffering from diabetes mellitus for at least on year. A Checklist including demographic and disease-related data were filled out for each patient. Then FBS (Fasting Blood Sugar) and Bs (5 PM) were evaluated in three consecutive days. The characteristics and complications of diabetes and the ways of its control were taught via face to face interview during two weeks. After 3 months, again the checklist was filled out and FBS and BS (5 PM) were evaluated in three consecutive days. Data analysis was performed by McNemar's test. 60 patients including 41.6% male and 58.3% female, aged between 22 and 60 years were studied. Duration of disease was between 1 and 15 years. The frequency of abnormal FBS and BS decreased from 95% to 48.3% (P< 0.0001) and from 91% to 71.6% (P< 0.0001), respectively. It seems that teaching diabetic patients about their illness is useful in control of disease. Further studies are recommended to find out more detailed results

Guillian Barre Syndrome (GBS) is the most common cause of acute paralysis. It may occurs following infection, inflammation, vaccination, surgery, and malignancies or may be idiopathic. Acute symetrical flaccid ascending paralysis begins in distal part of lower exterimities and it extends toward upper exterimities during few hours to few days. Increased cerebrospinal fluid protein and decreased nerve conduction velocity helps for diagnosis. We studied children who were admitted for GBS in Shiraz during 20 years ago. It was an existing data type study. From medical files of patients, those who have diagnosed GBS were selected. Data including age, sex, season, month, duration of admission, infections, blood pressure and clinical manifestations were recorded. 78 patients were studied. Mean age of patients was 6.26 ranged between 4 months and 14 years. The most of patients were in 1-5 years old age group. male to female ratio was 1.6. There was no relatio between frequency of admission and seasons. 45% had positive history of upper respiratory tract infection during the last ten days before hospitalization. In an interesting case, the disease was occurred following kala azar. 31% had cranial nerve involvement, mostly in fascial nerve. 44% had respiratory problems and 23% need to mechanical ventilator. Swallowing and sphincter dysfunction were present in 30% and 17%, respectively. Blood pressure changes, mostly hypertenstion, were seen in 9% of patients,. Recurrence and death were occurred in 4.4% and 8%, respectively. Guillain Barre Syndrome is a multifactorial syndrome in which infections, diseases and enviormental factors have important role in its etiology. Due to disability and even death, Further studies is recommended to find the etiology, treatment and prevention of GBS.

Some fungi such as Sporothrix Schenckii may rarely cause arthritis. A 36-year old woman presented with complaining monoarthritis of right knee. Sporothrix Schenckii was revealed in the joint effusion for the first time in Iran. Case Report: She received ketoconazol, 400 mg daily in two divided doses. During the treatment functional liver test and other necessary laboratory tests were evaluated every month. After 8 weeks, effusion, pain and movement limitation decreased. After 2 months, some yeast was seen in microscopic evaluation of sinovial fluid. Six month after treatment, pain and swelling completely disappeared. Based on the result of this study, Ketoconazole is recommended as choice treatment of sporothrical arthritis.

There are some defects in classification of scorpions. This review is focusing on the diagnostic clue for classification and statement of defects. Classification of scorpions has been varied during 5 years ago, repeatedly. By searching the internet, Journal's data bank and specific references, we reviewed 37 articles to design a diagnostic clue for classification. This diagnostic clue can be used to classify scorpion's species.