مجله دانشگاه علوم پزشکی شهید صدوقی یزد
سال دوازدهم شماره 3 (پیاپی 47، پاییز 1383)

Coronary artery bypass graft can Improve myocardial contractility and functional class in Ischemic heart disease. 

Materials & Methods:

This study was done on 200 patient’s with CABG operation during 6 months. 142 patients were men and 56 patients were women with mean age 57.7  9.2 years (36-83). EF was measured by echocardiography before & 1 week after CABG, CCSFC evaluated before and 3 months after surgery by questioner. Data was analyzed statistically SPSS software.

Mean EF was 48.1  5.9 before surgery, and 48.3  8.5 after surgery. CCSFC was 2.9 0.9 before surgery and 1.10.3 after surgery (P Value = 0.0001).

CABG can improve EF and reduce CCSFC in ischemic heart disease especially in patient’s with EF<35% and history of myocardial infarction.

Previous studies have shown that various factors such as emotional stress can trigger of MI in susceptible persons. More studies are needed to evaluate the characteristics of patients regarding to emotional stress, heavy work, routine activity, infection or rest before occurrence of MI.

We studied 608 consecutive hospitalized in CCUs from May 2000 to October 2001. For patients, questionnaires including demographic, clinical and paraclinical characteristics were completed and data analyzed.

In this study rest (33.4%) and ordinary activity (32.4%) were more prevalent among the MI situations and infection had the lowest prevalence (0.7%). In patients higher than 45 years we had similar results, but in age group younger than 45 year ordinary activity (30.6%) and after heavy work (20.8%) had the highest prevalence before occurring of MI. In Diabetic patients, MI developed in sleep situation more frequently.(17.8%),(P=0.03) 52.5% of MI mortality occurred in rest situation.(P=0.009)

Rest had the highest prevalence of MI compared to other situations but in age group younger than 45 years MI after heavy work had the highest prevalence. Autonomic neuropathy may be one of the reason of higher prevalence of MI in sleep situation.

Fat body mass and body mass index (BMI) are important determinants of bone mineral density (BMD). Although the mechanism involved in this relation is uncertain, it seems that aromatization of androgens to esteradiol in adipose tissue is the most important explanatory mechanism.

The purpose of this study is to evaluate the correlation between BMI and BMD among 63 women aged 45 to 55 36(57.1%) postmenopausal and 27(42.9%) premenopausal referred to Imam Khomeini hospital. We measured BMD at the lumbar spine (L1-L4), hip (femoral neck, trochanter, and intertrochanter), and Ward's triangle by dual energy X-ray absorptiometry (DEXA). Additionally, body composition was measured in this group.

Using WHO BMD T-score criteria, 28.8% of these women had osteoporosis in the lumbar spine and/or the femoral neck. As expected, relative positive linear correlations were found between BMI and BMD at L1-L4 (r=0.315 p = 0.026) and femoral neck (r=0.297 p=0.036), but these correlations were not significant in premenstrual women. Between the age, postmenopausal duration and BMI in relation with BMD, using multiple regression analyses, only BMI remained significant predictor for BMD. The correlation between BMI and BMD was improved after adjustment for age and postmenopausal period (R=0.402, p=0.034 for L1-L4 R=0.376, p=0.049 for femoral neck).

The present results, confirming the results of other studies, have revealed a significant correlation between BMD and BMI in perimenopausal women. Our findings suggest that maintenance of adequate body mass (prevention for leanness) is important for prevention of postmenopausal bone loss.

Zinc deficiency is a health problem in many communities, especially among children because of growth spurt. Zinc deficiency can causegrowth limitation, delay in sexuel maturity, behavior disorders and abnormalities of immune system,susceptibility to respiratory and gasterointestinal infections and impairment of taste and smell perception.

One of the methods of assessment the zinc defeciency is “ Zinc taste test” using zinc sulfate solution 0.1% , this test performed used to assess the zinc deficiency among preshool childeren in Yazd. The results were evaluated with measurments of weight,height and demographic data. 400 preschool children were selected by multi stage random sampling.Having good taste perception of zinc sulfate 0.1% was used as impaired taste test ( zinc deficiency) and having bad taste perception as normal zinc level.

Regarding to zinc taste test 73.9% of study group had zinc deficiency (77.6%femal, 69.7% male) There were no significant relation between zinc deficiency and measurment of weight and height,but there was higher prevalence of zinc deficiency in children who were below the 5th percentile in height and weight by age.

70% of preschool children in yazd had zinc deficiency assessed by “ zinc taste test”,31% of adolecents in Tehran have had zinc deficiency based on plasma , erythrocyte and hairindex. There is no significant relation between zinc deficiency and antropometric and demographic data, in this study and the study that had been done on adolescents in Tehran.Considering the prevalnce of zinc deficiency with “ Zinc taste test” it seems more accurate studies need to be done like zinc measurment in WBC,RBC and Platelets and zinc taste test at the same time,if correlation coefficients between zinc taste test and other tests were very strong , we can used zinc tase test in the different age for assessment of zinc body.

Hot flashes can be prominent problem in menopausal women. The treatment of hot flashes is hormonal thrapies but in some patients that are unable to use estrogen other treating hot flashes are required. Based on anecdotal information reqarding the efficacy of fluoxtin for treating hot flashes , the present trial was developed .

This trial used a double Blinded randomized to study the effecacy of fluoxetin (20mg/day) and comparing with placebo in treating hot flash in 4 week treatment.

310 women began protocol thrapy. in two group: A (flouxetine) and B-( placebo ) By the end of protocol hot flashes frequeney decreased 77.5 % with floxetin versus 13.7 % whith placebo( p=.0001)The flouxetin was well tolerated .

Flouxetin resulted well improvent in hot flashes.

Vitis vinifera (grape) is from Vitaceae family and many researches have performed on its seed but not on leaf. It has been reported that Vitis vinifera leaf extract induces relaxation in rat uterus, aorta, trachea and vas deferens precontracted by KCl. According to these reports, the inhibitory effects have been evoked through the voltage dependent calcium channels blockade. The aim of present study was to investigate the effect of Vitis vinifera leaf hydroalcoholic extract (VHLE) on rat ileum contractions induced by KCl, acetylcholine (ACh) and barium chloride.

Vitis vinifera leaf powder was extracted using manerated method by 70% alcohol for 72 h at ambient temperature and then solvent was evaporated. From Sprague Dawley rats (male and female) pieces of ileum (2cm) were isolated and placed in an organ bath (10ml) containing Tyrode’s solution gassed with oxygen. An isotonic transducer recorded contractions under 0.5g initial tension. The mean±SEM of changes in length (mm) or the percentages of length changes were calculated.

The results indicate that VHLE (0.25, 0.5, 1, 2 and 4mg/ml) reduces the ileum contractions induced by KCl (60mM) dose dependently (P<0.001). This inhibitory effect was unaffected by propranolol (1μM). VHLE (1mg/ml) also inhibited the ileum contractions induced by ACh (0.05 and 0.5μg/ml) P<0.001 and P<0.05 respectively. Ileum contraction induced by BaCl2 (4mM) was unaffected by VHLE (2mg/ml).

In conclusion, it seems that VHLE inhibits ileum contractions via blocking the voltage dependent calcium channels. Ineffectiveness of propranolol on inhibitory effect of extract indicates that the adrenoceptors are not involved in this inhibitory effect. VHLE failed to relax ileum precontracted by BaCl2 probably because, BaCl2 increases intracellular calcium concentration via releasing calcium ions from intracellular pools that was not affected by VHLE.

In order to study the effects of turpentine oil on the concentration of lipids and lipoproteins of rabbit ( as an animal model for human studies )35 healthy female rabbits were chosen and then randomly allocated into 13 groups. Different percents of turpentine oil and other oil compounds like vegetable oil, cholesterol and animal oil were given to each group ( 5 rabbits ) separately or in combination.

Blood serum lipid and lipoprotein levels were analysed using routine laboratory methods.

According to the results, treatment with 10% and 20% turpentine oil had a significant decreasing effect on triglyceride, cholesterol, total lipid, VLDL- cholesterol and LDL- cholesterol ( P<0.05 ) and a significant increasing effect on HDL- cholesterol (P<0.05). On occasions which rabbits were fed a combination of different oils such as turpentine oil, animal oil and vegetable oil or cholesterol, varying results were obtained which showed significant differences with the control group in some instances and in some other occasions had no significant difference (P>0.05).

Conclusively, results showed that treatment with turpentine oil has a significant decreasing effect on the levels of serum lipids and lipoproteins (VLDL-cholesterol and LDL- cholesterol ).

Auto – immune disorders have been implicated as a cause for chronic uricaria and/ or angioedema and thyroid autoimmunity has been increasingly introduced to be associated with that. This study explores the association of thyroid autoimmunity with chronic urticaria and / or angioedema in Isfahani patients.

Anti – thyroperoxidase (Ani – TPO) and anti – thyroglobulin (Anti – Tg) antibodies, T4 and TSH were detected in 57 patients with chronic urticaria and / or angioedema and were compared with that of normal subjects without chronic urticaria or other autoimmune diseases.

Anti – TPO and Anti – Tg antibodies had been increased in 26 (45.6%) and 28 (49%) of patients in case group, as compared to 8 (13.2%) and 10 (16.7%) of subjects in control group, respectively. In total, raised titers of thyroid autoantibodies were found in 34 (60%) and 12 (20%) of subjects in case and control groups, respectively.

Considering the high prevalence of thyroid autoantibodies in patients with chronic urticaria and / or angioedema, these antibodies should be detected in affected patients, specially in young and middle– aged women.

The term of idiopatic osteosclerosis (I.O) have been used to describe a localised area of radiopacity of unknown origin. The condition is usually asymptomatic and discovered on a radiograph taken for other reason. The radiopacity is variable in size, shape, outline and density. The purpose of this investigation was to determine the frequncy, age and sex distribution and anatomic location of I.O and its relation to history of extraction of decidious teeth.

Standard panoramic radiographs of 917 patients(494 female & 423 male) were examined at the Department of oral and maxillofacial radiology, Yazd dental college and private clinic. The age, sex as well as the anatomic location of I.O is outlined I.O mass were observed in patients. The radiographs was studies carefully by oral radiologist and sclerosis mass place was marked then clinical examination was done.

In total 54 sclerosis mass in 52 mandibuls were observed According to the location of lesions premolars of lower jaws was higher than other (59.6% in female & 40.4% in male P=0.392). Most of cases were occurred in 3rd & forth decade of life (P=0.018). The most prevalence areas were premolar/ molar/ between firstmolar second premolar/ between canin & first premolar.

According to the our finding that the most prevalence was belogned to sclerotic mass that was not related to the root, the developing theory in a cause of mass that seems to be accepted.

Two main causes of nasal airway obstruction and mouth breathing Consist: 1- anterior nasal obstruction is caused by obstruction in nasal cavity, 2- posterior (nasopharyngeal) obstruction is caused by adenoid enlargement and decreased nasopharyngeal airway. The purpose of this study was the comparison of nasopharyngeal cephalometric measurements between two groups of mouth breathing with anterior (nasal cavity) and posterior (nasopharyngeal) obstructions.

In this descriptive study, a sample of 79 mouth breathers between the ages of 7 and 15 years old were selected in two anterior and posterior nasal obstruction groups. The sample had 39 patients with nasopharyngeal obstruction and mean of 10.87 years old in posterior obstruction group and 40 patients with nasal cavity obstruction without nasopharyngeal obstruction and mean of 10.97 years old in anterior obstruction group. After clinical examination by orthodontist, type of obstruction was diagnosed by ENT specialist .For each patient a lateral cephalogram was taken in centric occlusion. After tracing, 8 nasopharyngeal variables were measured and statistical t-test was conducted by calculating the mean, standard deviation and p-value of parameters.

In posterior nasal obstruction group, nasopharyngeal airway variables (PP, Ad.pmp and Air area) significantly decreased and nasopharyngeal bony variables (d and NP area) significantly increased. From bony nasopharyngeal measurements, mean of h, Ba.pmp and N.S.Ba variables insignificantly increased in posterior nasal obstruction group .

We conclude that in lateral cephalometric radiography, in posterior nasal obstruction group nasopharyngeal airway measurements decrease and bony nasopharyngeal measurements increase.

Secondry Prevention is Very important in breast cancer because when treatment is started,the breast mass will have smaler size. One of the most important way For Secondry Prevention of breast cancer is examination by Physician or health care provider.

In this Quasi experimental study that aimd to evaluating the effect of education about importance of CBE on attendance of kermanian teacher woman for examination, 501 subjects Participated. Schools were selected by multistage random sampling Method and divided in to experimental and control groups. An educational pamphelet were given to the experimental group and both groups were Informed about address and date of attendance. After two months an investigator-made questionnaire were responded by all of teachers.

The results showed there was not significant differences in two groups according to those variables Could be probably effective on attendance, with exception of mariage status and education level . The attendance rate for CBE in experimental grorp (17.3%) was Significantly (p<0.001) higher than control (6%). The relationships between attendance rate with Personal characteristics and variables related to breast Cancer revealed the significant difference with history of breast cancer in Family only in experimental group (p<0.05) ,so that the attendance rate in teachers with positive history were higher.

Although the attendanee rate is not stisfactory in two groups but using the educational pamphelet that is simple, Not expensive and needless to direct contact with educator, attendance rate in experimental group was three time higher than control group

modern knowledge could protect against cancer for individuals in community with early stage and premalignat state. Screening of cancer is best instrument for early detection of malignancy. Between women’s cancers breast and cervical cancer have more incidence and mortality than other cancers . But could be prevented by simple and cheep screening programs. Despite specific statistics in Iran evidence shows that women’s participation in screening program is poor , so cancers are diagnosed in advanced stage. The purpose of this study was to identify major barriers and motivators for breast and cervical screening .

This survey was a descriptive study in which 400 women participated in health and treatment centers in Yazd. Sampling method was done in two simple and random stages. Data was collected by inventory and questionnaire . Then data were analyzed by SPSS soft ware .

Findings showed that 80% of them never refereed to a health provider for clinical breast exam (C B E) and only 3% of them did regularly C B E . 46% of them had never done pap smear and only 14.5 % of them did regularly pap smear. The findings showed that major motivators were as follow: advice of health’s personnel , using of contraceptive methods , and awareness of media. Also the major barriers were as follow : Not having knowledge of these exams , not having knowledge of the existence of these centers of education and practice , not having precious health problems , fear of examination , Embarrassment of examination and health providers not to teach them . to consider the most important barriers were propounded which showed that health education role to eliminate barriers for referring women for screening .

Based on the results of this sample , screening was the least expected . considering barriers and motivators observed it was revealed that health education was required for prevention of common women’s cancers. Also considering the role of health providers in promoting health of community population and for health centers attracting them for participation in health program , It is appropriate to plan education health programs to eliminate barriers and to strengthen motivators of referring women for screening common centers in women.

Rickets by definition is a condition in which the bone mineralization is defective. Among the large cause of Rickets (Vitamin D deficiency, gastrointestinal disorders, acidosis, renal tubular abnormalities...), Wilson's disease is a relatively rare cause. There are few cases of Wilson's disease presenting first as rickets in the literature. ‎ Here we present an Afghan girl with Wilson's disease presenting with intractable Rickets.‎