مجله پزشکی بالینی ابن سینا
سال هفدهم شماره 1 (پیاپی 55، بهار 1389)

Introduction & Biological treatment is a new established technology for the air pollutants. This technology can be an alternative for physical and chemical treatment methods. Among bioreators, the Bioactive Foamed Emulsion Reactor (BFER) is a new alternative that has not the problems of the conventional ones. In this reactor bed clogging in the conventional bioreactor was resolved by bioactive foam as a substitute of packing bed. The pollutant absorption has been increased using biocompatible organic phase in liquid. This reactor can be used for higher inlet toluene concentration. The objective of this study was designing and optimizing the operational parameters of BFER for toluene treatment. In the first step of this experimental-analytic study, the toluene degradation microorganisms were identified, extracted and concentrated for injection to bioreactor. Then the effect of several parameters such as Kind and concentration of organic phase,and residence time oxygen content on bioreactor performance were studied and the optimum conditions were selected for continuous operation. The continuous operation of bioreactor was monitored at the optimum conditions. Experimental results showed that the residence time of 15s, oxygen content of 40%, and the 4 % (v/v) n-hexadecane as organic phase were the optimum conditions. The average elimination capacity (EC) and removal efficiency of bioreactor were 231.68 g/m3h and 88.44% respectively for the inlet concentration about of 1 g/m3. The statistical developed model predicted that the maximum EC of this reactor could reach to 426.21 g/m3h. Since the elimination capacity of this reactor is several times more than the other bioreactors, it has the potential to be applied instead of biofilters and biotrickling filters

Introduction & Urinary Tract Infection (UTI) is one of the most common infections during childhood and E-Coli is the more predominant pathogen recovered in UTI. Disk Diffusion agar test is a method of choice because it is cost effective, simple, and now routinely used for detection of antibiotic susceptibility. A rapid increase in antibiotic resistance in our region made the authors to design a study to compare this traditional method with two different disk diffusion agar tests. Our study was conducted between 2009 and 2010 in Be’sat teaching hospital on 100 pediatric patients ranged 15 days to 13 years old with positive urine culture for E-coli. Antibiogram detection was performed by disk diffusion agar test with two different kits as Padtan-Teb (made in Iran) and Mast (made in the U.K.) for Co-trimoxazol, Amikacin, Ceftriaxone, Nalidixic Acid, Cefixime, and Nitrofurantoin. At last the data was analyzed by McNemar test. Co-trimoxazol obtained the lowest (23% Padtan-Teb and 26% Mast) and Nitrofurantoin had the highest (86% Padtan-Teb and 97% Mast) sensitivity in the two methods which were used in our study. The results were statistically significant for Amikacin, Ceftriaxone, Cefixime, and Nitrofurantoin. The data was analyzed by Mc Memar test. According to our study the results of antibiotic susceptibility were more compatible with other non national Disk diffusion agar test and thus we recommend that our manufactures in Iran should increase the quality of their products.

Introduction & Second trimester labor induction is a major problem in obstetrics and is the cause of two-thirds of all abortion related complications and more than half of the maternal deaths associated with abortion. The goal of this study was to compare the effectiveness of vaginal misoprostol and intravenous oxytocin for termination of second trimester pregnancy. One hundred women were allocated in a randomized controlled way to one of the two induction groups: oxytocin group patients initially received an infusion of 50 units of oxytocin in 500 ml of ringer over 3 hours, 1 hour of no oxytocin followed by alternating 3 hours of oxytocin with 1 hour of rest. Oxytocin was increased by 50 units in each successive period until a final concentration of 300 units per 500 ml has been reached. Another group received 200 µg misoprostol tablets in posterior fornix vagina and was repeated after 12 hours if needed. The two groups were compared for induction to delivery intervals and their safety during induction. The success rate within 24 hours of induction was 94% in the misoprostol group and 86% in oxytocin group (p= 0.182). The mean induction to delivery time was significantly longer in the oxytocin group compared with the misoprostol group.(13.5 versus 9.93 hours; P=0.0057). Retained placenta requiring curettage was lower in the misoprostol group than the oxytocin group. Intravaginal misoprostol is more effective than high dose intravenous oxytocin in women with second trimester termination

Introduction & Helicobacter pylori (H. pylori) is a major gastroduodenal pathogen that is etiologically linked with duodenal and gastric diseases. We aimed to determine the prevalence of H. pylori infection in patients with diabetes mellitus (DM), and to assess the association between H. pylori infection and upper gastrointestinal (GI) symptoms in DM. In a case-control study from November 2004 to May 2007 in Hamadan a total of 79 DM patients with upper GI symptoms and 84 aged-matched, non- diabetic patients with upper GI symptoms were included. All patients underwent upper GI endoscopy with biopsy specimens being collected from gastric mucosa. H. pylori was evaluated in each patient by rapid urease test and histology. A serum sample was obtained from each subject for evaluation of antibody against H. pylori using a validated ELISA kit. HbA1C was tested for DM patients. The rates of H. pylori infection in the diabetic and non-diabetic patients were 73.4% and 63.1% respectively (non significant). No association was found between H. pylori infection and upper GI symptoms in the both groups(P> 0.05). The serology test for H. pylori was positive in54.4% of diabetics and 60.7% of controls (p=0.417, non significant). There was significant difference in rapid urease test between DM patients and non- diabetes controls (70.9% versus 45.2%, p=0.001). H. pylori infection appears not to be associated with DM or upper GI symptoms in DM

Introduction & Methyl methacrylate (MMA), as a monomer of acrylic resin that has a wide variety of usages in denture fabrication, is considered as an air pollution indicator in the laboratories. Occupational exposure to these compound vapors can cause respiratory hypersensitivity, occupational asthma, eye and skin irritation and Allergic Contact Dermatitis (ACD). Therefore control of MMA exposure may promote the personnel’s health. The aim of this study was to determine the relationship between spirometric disorders and methyl methacrylate in dental laboratories personnel.. In this case control study, exposure of time-weighted average (TWA) and short-term exposure level (STEL) were measured with MMA vapors in 39 randomly selected male employee (case group) in 25 denture fabrication laboratories in Hamadan city. The air samples were collected by sorbent tubes containing chromosorb (XAD2(and analyzed by gas chromatograph equipped with FID detector based on NIOSH method. In addition 30 men whitout occupational exposure to air pollutants (control group) were selected to compare the variation of spirometric parameters. Spirometric parameters of the case and control groups such as FVC, FEV1, FEV1/FVC and FEF25-75 were measured by Vitalograph spirometer (model: 2120) on ATS method, after the standard questionnaire of respiratory diseases had been completed during an interview and medical examination.. The mean of MMA concentration was 132.87 ± 220.67 ppm for STEL and 1.95 ± 3.59 ppm for TWA.The relationship between MMA concentration in the STEL and TWA exposures was significant (P<0.05) and the relationship between MMA concentration and ventilation was significant just for STEL. In this study no relationship between MMA concentration and spirometric parameters in both STEL and TWA exposures was found. Also there was no significant difference between spirometric parameters of the case group and normal values of the control group. Only two cases of obstructive lung function decrease (5.13%) one case of macula (2.56%) and five cases of xerodermatitis (12.8%) were observed among the dental laboratory personnel. The results showed that spirometeric tests are not enough to screen respiratory diseases in dental laboratory personnel as a measurement in prevention and health monitoring program. In order to control the exposures, specially in case of STEL, this study emphasizes, like the other studies, on biological monitoring, installing local ventilation systems in the laboratories and educating the personnel to correctly use suitable personal protective equipments

Introduction & Understanding the determinants of physical activity in patients with inflammatory bowel diseases is effective in controlling or reducing the complications of these diseases. The purpose of this study is to determine the effect of educational program based on transtheoretical model(TTM) on physical activity in patients with inflammatory bowel diseases. This study is a semi experimental research. 60 patients with inflammatory bowel diseases referring to Emam khomeini hospital in Ahvaz in 2008 were selected through purposeful method and then randomly divided into 2 groups.They completed questionnaires about demographics and physical activity before and after 1 month of intervention. The intervention program included tailored counseling and focus group based on transtheoretical model. d The data was analyzed with T-test and X2 using spss software. Our findings showed a significant difference for the effect of health educational program based on transtheoretical model on increasing change stages of self-efficacy, decisional balance and physical activity behavior in the case group(P<0/05)but showed no difference in the control group Also educational intervention caused significant difference between the 2 groups in self-efficacy, decisional balance and physical activity behavior and finally the hypothesis of the study was confirmed. . Educational programs based on transtheoretical model have positive effects on observing the constituents of the TTM, thus nurses can play an effective role in promoting the health level of the society through counseling and educating

Introduction & Pupils have efficient potential to increase community awareness and promoting community health through participating in the health education programs. Child to family health education program is one of the communicative strategies that was applied in this field trial study. Because of high prevalence of Brucellosis in Hamadan province, Iran, the aim of this study was promoting families’ knowledge and preventive behaviors about Brucellosis in the rural areas by using child to family health education method. In this nonequivalent control group design study three rural schools were chosen (one as intervention and two others as control). At first knowledge and behavior of families about Brucellosis were determined using a designed questionnaire. Then the families were educated through “child to family” procedure. At this stage the students gained information. Then they were instructed to teach their parents what they had learned. After 3 months following the last session of education, the level of knowledge and behavior changes of the families about Brucellosis were determined and analyzed by paired t-test The results showed significant improvement in the knowledge of the mothers. The knowledge of the mothers about the signs of Brucellosis disease in human increased from 1.81 to 3.79 (t:-21.64, sig:0.000), and also the knowledge on the signs of Brucellosis in animals increased from 1.48 to 2.82 (t:-10.60, sig:0.000). Child to family health education program is one of the effective and available methods, which would be useful and effective in most communities, and also Students potential would be effective for applying in the health promotion programs.

Introduction &

Substance abuse is believed to be one of the greatest social, economical, and cultural problems all over the world and it is commonly observed among all social classes especially among mental disorder patients. Substance abuse can influence on the receptive-mental states such as mood and on the external visible activities such as behaviors. The aim of this study is to survey the frequency of Substance abuse in hospitalized mental-psychic patients in psychiatric ward of Farshchian hospital in Hamadan.

In this descriptive and retrospective study, available sampling method was used along with examining filed records in which the records of 400 hospitalized patients (293 men and 107 women) from September 2000 to 2001 were checked and required data such as demographic information, infliction duration, substance abuse duration, psychiatric diagnosis were extracted and registered. The data were analyzed with descriptive statistical methods.

About half of the hospitalized patients in the psychiatric ward had simultaneous substance abuse. Men had substance abuse more than women and the youths aged 20-39 more than the other groups. The study showed that widowing had positive relationship and higher education negative relationship with substance abuse

Mood disorders with 90.53%, schizophrenia with 8.29%, and other diagnostics with 1.18% were observed in persons with substance abuse and these diagnostics in non substance abuse persons were 79.22%, 11.26% and 9.52% respectively

Introduction &

The previous studies investigating alexithymia in psychotic patients indicated that such patients have difficulty in identifying and expressing their feelings. The purpose of this study is to investigate the extent of alexithymia in patients with psychotic disorders, non psychotic disorders, and normal people.

In this causal-comparative study 60 psychotic, 60 non-psychotic patients and 140 students were selected via available sampling method (the results of Leven's test indicated the homogeneity of variance among the three groups). Using Torento Alexithymia Scale(TAS-20),we compared them with each others.

Results showed that the extent of alexithymia in psychotic and non-psychotic patients was higher than that of normal people(P<0.001). Also the extent of difficulty in identifying, describing feelings and externally-oriented thinking is more serious in psychotic patients than in the other groups and more severe in men than women.

Since the findings of the study showed that psychotic patients are more inflected with high level of alexithymia, it is essential to contrive a special treatment (such as Emotional- focused therapy) to decrease alexithymia in these patients

Introduction & Surgical procedures are the most stressful expreiences in life, specially in children. Different methods are used before operation to decrease the stress. Intranasal midazolam is an effective way of preparing before operation and to prevent the separation irritability. In a double blind experimental trial study, 60 patients aged 2-6 years with ASAI who had no elective surgery in the past were randomly chosen and divided into two groups.For the patients in group I intranasal midazolam 0.2 mg/kg was administerated and for the patients in group II the equal volume of normal saline was used. The patients’ crying was considered as mild, moderate, and severe. The irritability of their hands shaking during IV canula insertion,consciousness before the induction of anesthesia and cooperation during the mask ventilation were also evaluated. The result of our study determined that 93.3% of the children in group I didn’t cry or they did mildly when separated from their parents but 90% of the children of group II cried moderately and some severely and 90% of the patients in group I cooperated well when separated from their parents. The resistance in group II was moderate or severe in 76.6%. Before induction of anesthesia 73.4% of group I were asleep but woke up with stimulation. 93.3% of the patients in group II were awake and irritated.90% of group I shook their hands steadily during iv cannula insertion but their hands shaking increased in 83.3% of group II..100% of group I cooperated well during face mask ventilation but 76.6% of group II did not. The above mentioned experiences showed that the intranasal midazolam is an effective way of preinduction sedation in children.