مجله دانشگاه علوم پزشکی اردبیل
پیاپی 31 (بهار 1388)

Psychosis is a psychiatric disorder in which reality testing and interpersonal relationships in several important functional areas are impaired. Some biochemical disturbances occur during psychotic period. Due to the vital role of serum potassium level on psychotic patients and its effect on cardiovascular system, this study was conducted to investigate serum potassium changes. A prospective non- Randomized pre/post test study (Quasi-experimental) was conducted on 103 prepared samples obtained from 103 patients hospitalized in Imam Hossein and Taleghani Hospital during 2005-2006 in Tehran. All subjects were initially interviewed in the first day then considering inclusion / exclusion criteria, blood samples were drawn and Brief Psychiatric Rating scales (BPRS) were completed by the researcher. The same process was repeated in the day before release. Data were analyzed through Spearman- multiple regression, Paired test, chi-square and Kolmogorov- Smirnov tests. BPRS were significantly different in the first and last days of hospitalization (P< 0.019) Serum Potassium levels of the first and last days were meaningfully different (P< 0.005) there was a negative correlation between the severity of psychosis in the first day and serum potassium level.

Trauma is one of the major causes of morbidity and mortality in the world and it puts a great deal of financial pressure on the health systems. Due to the abundance of the mechanism of trauma and identification of most prevalent mechanism this study was done to survey specifications of traumatized patients referring Fatemi Hospital in Ardabil city. This was a cross-sectional study carried out on traumatized patients between Jan and June 2008. Data collection method was a questionnaire including demographic data, mechanism of trauma, location of accident, way of transportation and some other data that have been obtained by face to face interview. Data were analyzed in SPSS program using descriptive and analytical statistical methods. In 955 patients with trauma, the ratio of male to female was 2.3. The mean age of patients was 28.7±18.7. About %50 of patients were < 25 years old. The most common causes of injuries were falling (38.5%) then cutting and accidents each with 22.1%, 10.8%, respectively. Satisfaction with the emergency care was relatively high and only 9% were carried by an ambulance to the emergency unit. The most prevalent trauma mechanism was falling from height and then cutting injury and car accidents. Satisfaction with emergency care was relatively high.

Postpartum depression is one of the most important problems during post partum. Several new medications have been introduced for treatment, but considering their side effects and also breast feeding women's desire for dietary complements rather than chemical drugs, this research was done to determine comparison of effectiveness of Omega-3 fatty acids with placebo in treatment of mild to moderate postpartum depression. This double-blind randomized placebo controlled trial study was done on 120 women with postpartum depression, who had the required criteria. First by using Edinburgh Postnatal Depression Scale (EPDS) in women who gave birth 2 weeks to 3 months before, postpartum depression approved; for determining the severity of depression, Beck Depression Inventory scale (BDI) was used. Women with mild to moderate depression who had a score 46 on the (BDI) and did not have any tendency to use anti-depressant drugs under the supervision of the psychiatrist, enrolled in the study and randomly assigned to receive either 1gr of Omega-3 capsules or placebo for 8 weeks. Severity of depression was measured before treatment and weekly during treatment in both groups. The data were analyzed through T-Test, repeated measurements of one way ANOVA and chi square test in SPSS 14/Win. There were no significant differences between two groups with respect to demographic characteristics. Results show that Mean Depression Scores before treatment in Omega-3 group (35.4±9.2) decreased after treatment (17.7±7.0), which was significant (p< 0.0005). Mean Depression Scores before treatment in placebo group (34.2±3.4) decreased after treatment (33.6±9.3) which wasnt significant (p=0.57). There was a significant difference between reductions of Depression Scores in two groups (P< 0.001). According to research results, use of Omega-3 1gr/day for 8 weeks improves postpartum depression.

Stroke remains one of main causes of death and disability in human. Animal models of the brain ischemia provide important roles for studying of the pathophysiological mechanisms and evaluating of the efficacy of neuroprotective agents. The aim of this study is introducing a new model of the focal cerebral ischemia with increased success and low mortality rate. Fifteen six C57/BL6 male mice were anesthetized with isofolorane and mixture of O2/N2O divided in four groups. Focal cerebral ischemia was induced by intraluminal filament method. A silicon coated nylon filament was used for middle cerebral artery occlusion. Regional cerebral blood flow was monitored by laser Doppler flowmetery for leading of filament in vascular pathway. In the 24 hours following ischemia (60minutes), animals were assessed for neurological outcome, infarct volume and brain edema induction. A new and reformed neurological test was used for evaluation of neurological deficits. 10 µm coronal sections were collected from 12 levels of the brain and stained, digitized and quantified by using an image analysis system. Ischemic brain edema was investigated by brain water content detection. When sham operated mice had no motor deficit and infarction, induction of ischemia in ischemic group, seriously caused impairment of motor functions (neurological deficit score 3.36±0.25). Mean total infarct volume of left (ischemic) hemisphere was 85.2±4.9 mm3 and 47 percent of infarction occurred in subcortical regions of the brain. Induction of focal cerebral ischemia in the left (ischemic) hemisphere of the brain significantly increased water content (83.1±0.29 percent) compared to both hemispheres of sham group and right hemisphere of the same group. Success rate of ischemia induction was 97.6 percent and mortality rate was 4.21 percent. These findings indicate, this can be used for brain ischemia studies with high success rate, low mortality rate and narrow variety of the size and location of infarct volume. This model provides controlled and standard conditions to study ischemic brain injury and edema formation and introduce new therapeutic strategies.

The reason for attacks of wild canines are for hunting or defense or as rabies. Usually in the biting of rabid wolf there are so many victims and the wounds are deeper and more dangerous. The rabies probability in this wound is 15 times more than the other bites. This article is a report of 24 bites of a rabid wolf in a short period of time. It is considerable even after 3 years because of the large number of victims and the appropriate measures of health related systems, and lack of mortality. The report consists of 24 wounded patients from the health center of Meshkin Shahr. All of the victims were interviewed, examined and followed up for 3 years. In the summer of 2006 a rabid wolf, whose rabies later was confirmed by Pasteur Institute of Iran, attacked 7 contiguous villages in the southern part of Meshkinshahr and 24 of natives were wounded. Mean age of victims was 36.5 years old. The injured organs were as follow: head and face in 21 cases, hands in 12 cases, body and abdomen in 8 cases, neck in 3 cases, leg 3 cases, and buttock 1 case. In 14 cases the wound of claw and teeth were observed. In two cases the attack form was inability in bending fingers and in other cases there werent any complications. All of the patients were treated with vaccine and anti rabies serum and if necessary with tetabolin. There wasnt any mortality and morbidity reported during the 3-year follow-up. The manner of wolf attack was compatible with the rabid wolf's behavior. No death was reported due to sufficient support, health care center's awareness, vaccination and serum injection and tetabolin

Providing safe and rapid air way conduction, is very important in the anesthesia of emergency patients because it reduces many complications due to delay in the endotrachal intubation. In this group of patients, administration of succinylcholin is not necessary. But, in certain conditions, it can cause a sudden increase of serum potassium level, and could cause cardiac arrest. Therefore use of non blocker dosage of non depolarizant neuromuscular blocker (defasciculation), for reducing this side effect is suggested. The aim of this study, is determine the effect of pretreatment atracurium on serum potassium level associated with administration of succinylcholine. This study was a clinical trial on 82 patients aged between 15-70 years with ASAI-II (American society of anesthesiology of physical status class) After administering premedication drugs to all patients, blood samples were taken, and they considered as control group, then pretreatment atracurium injection (50mcg/kg) and after three minutes, induction was performed with thiopental sodium (5mg/kg) and succinylcholine (1.5 mg/kg), and after 5 minutes, second blood sample was taken, as case group. Blood samples, were collected in to the espicial tube of serum potassium and serums were separated immediately. Then, potasiom level of serums were measured with micro light. The data were analyzed and compared through T-test and wilcoxon. According to the results, the mean of serum potassium level after administration of succinylcholine associated with defasciculation atracurium and before the administration of pretreatment atracurium (base level) was not significantly different. Administration of pretreatment atracurium is not effective in prevention of hyperkalemia induced by succinylcholin with attention base level.

Injuries account for 16% of global burden of diseases and causes a great deal of mortality and morbidity. Today, amputation is one of the biggest challenges facing us and may accompany serious functional, psychosocial and personality disorders in communities. Therefore, we decided to assess the causes and types of traumatic amputation in patients referring Ardabil's Fatemi Educational Hospital from 2005 through 2006. The present study was descriptively & analytically retrospective one in which the data were collected using a questionnaire. Our study population included 218 cases referring Ardabil's Fatima educational Hospital for amputation from the beginning of 2005 through the end of 2006. In this study, the mean age of injured cases is 28.9±19.1 and men were also injured three times more than women. Most of the cases attended in summer between 8:00 Am -8:00 Pm. The number of cases among city dwellers and residents of rural areas were almost equal and most of the cases (39.6%) were illiterate. Most of the cases were injured outdoors especially in their workplace. The most commonly seen cause of amputation was tools used in farming and husbandry especially mower. Most of the amputations (50.5%) were total and unintentional (99.5%). Most of the injuries were seen in upper extremities (94.5%), hands and especially fingers (97%) Based on the obtained results, male workers are at a higher risk. Most of the injuries occurred during the work hours and amputation caused by tools used in farming and husbandry has a high prevalence. This is probably due to the unsafe and old structure of these tools.

Every organization which is a provider of service or a product is always responsible for seeking clients, comments as feedbacks so to identify the shortcomings and on the basis of their comments, plans can go through the growth and improvement. The present study, from the view of client tendency, is aimed at measuring the rate of Ardabil University of Medical sciences student's satisfaction with the practices of faculties, educational management, student-cultural management and the counseling unit. In this descriptive study, 705 students from all faculties were questioned. The main instrument for data collection was a questionnaire in which, in order to assure the adequacy of the concept in, measurement, content validity was used and it was applied according to the comments of some instructors. To confirm the reliability of the questionnaire, 10 subjects were chosen and the questionnaires were distributed and then collected. After 15 days of interval from the first administration, the readministration on the same group was done and the reliability of the test became 0.86 using Alpha cronbach. The data in the first stage were investigated through descriptive statistical methods SPSS 13 and in the next stage in order to determine the difference between group comments, the independent T-Test and ANOVA were used. None of the units of the university got scores above average and the two units of education in the faculties and education management got an average score from student satisfaction and the mean of other units was below average. Native students of the university were more satisfied with the faculties and educational management whereas the mean of nonnative students, satisfaction was higher in student-cultural management and the counseling center. Student dissatisfaction with the functions of student-cultural management and the counseling unit is a shortcoming which requires the people in charge to take necessary measures to improve the quality of affairs.

Staphylococcus aureus is known as an important pathogen causing a variety of bacterial infections. Treatment of this bacterium with antibiotics has led to antibiotic-resistancy, especially against methicillin (MRSA) and more recently rare resistance against vancomycin. The aims of this study were to determine nasal carriage rates of S. aureus in Meshgin Shahr Valiasr hospital's personnel and to determine antibiotic-resistance patterns in the mentioned isolates. Staphylococcus aureus isolates were collected from the nose of 200 hospital personnel in Meshgin Shahr Valiasr hospital in a 2 month period in 2006. Antibiotic sensitivity of the collected strains were tested against antibiotics used in routine treatment of S. aureus infections. Oxacillin agar was also used to screen for MRSA according to NCCLS recommendation. Our results showed there were 45% and 16% nasal carrier for S. aureus and MRSA (methicillin resistant staphylococcus aureus) strains, respectively in hospital personnel. Thirty two isolates were able to grow in oxacillin agar media, indicating 35% MRSA strains. Antibiotic resistant pattern of strains in disk method were as follows: 35% to oxacillin, 97.8% to penicillin, 34% to erythromycin, 2.1% to chloramphenicol, 39.36% to tetracycline, 11.7% to gentamicin, 30.85% to trimetohoprim sulfamethoxazol and 19% to clindamycin. All of the isolates were sensitive to vancomycin and ciprofloxacin. In this study, nasal carriage rate of Staphylococcus aureus among hospital Personnel was more than community expected rate (%40) and lower than hospital expected rate (%50-80). All of the test strains were sensitive to Vancomycin.