نشریه دانشگاه علوم پزشکی بیرجند
سال هفدهم شماره 3 (پیاپی 44، پاییز 1389)

Anemia is one of the major risk factors for cardiovascular disease (CVD) in hemodialyzed patients. Therefore, the present study was designed to investigate the effects of ω3 fatty acid supplement on anemia and hematologic factors in hemodialysis patients. The study was a double-blind randomized clinical trial on 34 hemodialysis patients. The patients in the ω3 fatty acid supplement group received 2080 mg ω3 fatty acid daily for 10 weeks, while the placebo group received placebo for the same period. At baseline and the end of 10th week of the study, blood hemoglobin, hematocrit, red blood cells, MCV, MCH, MCHC and serum CRP were measured. Statistical analysis of the data was performed using chi-square, t-test, paired t-test and ANOVA. The mean age and duration of dialysis were 50 ± 18 years and 23 ± 25 months in the ω3 fatty acid group and 50 ± 17 years and 28 ± 18 months in the placebo group, respectively. During this study, no significant difference was observed between the two groups in mean changes of blood hemoglobin, hematocrit, red blood cells, MCV, MCH, MCHC and serum CRP. The results of the present study indicate that ω3 fatty acid supplement has no effect on hematologic factors and anemia in hemodialysis patient.

Hot flashes are the commonest complaint of postmenopausal women. Because of the side effects of hormone therapy, alternatives treatment methods, such as acupuncture, are used to control hot flashes. Therefore, the present study aimed to evaluate the effects of electro-acupuncture on hot flashes in postmenopausal women. In this randomized, placebo-controlled trial, 41 postmenopausal women with hot flashes were divided to experimental and control groups. For experimental group, the electro-acupuncture was carried out; but in control group, needles taped to the skin in the same of acupoint and did not pass any electricity. The treatment period was 10 weeks; then patients were followed up for 3 months after the last treatment. Number of hot flashes was registered daily during 10 weeks and 3 months after the last treatment. The severity hot flashes were measured by visual analogue scale (VAS) after 2, 6 and 10 weeks of treatment and 3 months follow-up. Hormone levels (E2 and FSH) were measured at the end of treatment and 3 months after the last treatment. Then chi-square, t-test, Mann-Whitney and Wilcoxon tests were used for data analysis. A significant difference was found in severity and number of hot flashes (except 2nd week) between two groups (P < 0.001). There were significant differences in the mean levels of FSH and E2 between groups at the end of treatment and 3 months after the last treatment (P < 0.001). The findings of this study suggest that electro-acupunture is a suitable method of treatment for relief of hot flashes in postmenopausal women.

Physical activity is considered to be effective in prevention and modification of diabetes mellitus. This research aimed at identifying the effects of an educational program of walking training on outlook knowledge, attitude and performance of women with diabetes type II. In this intervention and quasi-experimental study, 88 women suffering from diabetes type II were enrolled. The tools for gathering data were a questionnaire and checklist completed via interview before and 3 months after training interference. Finally, data were analyzed using chi-square, t-test and paired t-test. Before interfering, the mean score of knowledge and view in each two groups, case and control, was in average level and mean performance score regarding correct walking was less than average. After interference and 3 months of perseverance, the mean score of a wariness, view, and performance regarding the correct way of walking increased (P < 0.05); also the minutes spent on hiking with average and heavy extents in the case group increased significantly (P < 0.05); average blood sugar level before breakfast and glycoside hemoglobin was significantly reduced too (P < 0.05). The finding of this study show the importance of walking training toward increasing of knowledge, outlook, and correct performance concerning walking and better control of blood sugar of women suffering from diabetes type II. We recommend regular walking in these patients.

It is believed that cortical spreading depression (CSD) is underlying mechanism of aura and subsequent pain in migraine. This study was designed to investigate the effect of Pimpinella Anisum on CSD specifications in rat neocortical slices. In this experimental study, CSD was induced in rat somatosensory cortical slices using two methods. At the first method, after KCl microinjection, the slices were washed out for 60 minutes with Pimpinella Anisum oil extract in different concentrations (0.01-50 μM/L). At the second method, slices were washed at artificial cerebrospinal fluid (ACSF) with low concentration of NaCl. Then, slices were washed with 50 μM/L Pimpinella Anisum oil extract for 60 minutes. In both methods, control cortical slices were washed in low alcohol containing CSF. Using extracellular potentials recording, the frequency, amplitude, duration, and propagation velocity of CSD was measured. All data were statistically analyzed. In KCl induced CSF model, the amplitude (P < 0.001) and duration (P < 0.02) of CSD was significantly decreased after superfusion of Pimpinella Anisum at higher concentrations with dose-dependent route. Nonetheless, adding Pimpinella Anisum insignificantly reduced the propagation velocity of CSD (P = 0.3). In CSD induction with low NaCl concentration ACSF model, adding Pimpinella Anisum to washing solution caused reduction of frequency (P = 0.03) and amplitude (P = 0.048) of CSD. However, the duration of CSD in this model showed no significant difference after using Pimpinella Anisum. Regarding to our results, theoretically, Pimpinella Anisum is able to suppress CSD phenomenon as underlying mechanism of migraine with aura.

Ear wax is the combination of different producing gland secretions. According to controversial ideas about the antifungal effects of ear cerumen and lack of any research around this matter in Iran, the present study performed on antifungal activity of cerumen from healthy people referred to Beheshti Hospital, Babol on some fungi. This experimental study was carried out on the 30 ear cerumen samples of healthy people referred to the Shahid Beheshti Hospital of Babol, Iran. The experiment was conducted on 4 type of fungi; Aspergillus fumigatus, Aspergillus niger, Candida albicans (clinical isolate) and standard Candida albicans (PTCC5027) by using of 10% cerumen solution in glycerol buffer, in sterile ELISA micro plate accompanying positive and negative controls (as duplicates); then the antifungal activities of cerumen as minimum fungicidal concentration and minimum inhibitory concentration 90% and 50% on fungi, were obtained. The average ages of the subjects were between 2-85 years. Minimum inhibitory concentration (MIC50) observed in 70.83%. The most antifungal effect (MIC50) observed on Aspergillus fumigatus and Aspergillus niger (each 26 samples) and least effect observed on the species of Candida albicans (16 samples) (P = 0.003). The Aspergillus niger was more sensitive to cerumen than others. Regarding to the results, cerumen has antifungal effect on tested fungi.

N-Acetyl cysteine (NAC) is an effective antidote for acetaminophen poisoning. Now, in some poisoning centers the prescription of NAC is related to the dose of drug through medical history of patients, because of mines equipments and high load of patients. We evaluate the patient’s history more closely and compare it with the plasma acetaminophen to find the effective factors of history on severity of poisoning. This prospective cross sectional study was carried out over 170 patients who were consumed more than 7.5 grams of acetaminophen. Some variables like age, sex, number of suicides, the amount of drug, and the duration between drug consumption and hospital admission were evaluated and the data were analyzed using SPSS software. In total 170 patients, the mean age was 21.81 ± 6.05 years. Out of the total number of samples, 44.7% were men and 55.3% were women. The mean plasma level of acetaminophen was 18.7 µg/ml. The prevalence of poisoning was more in third decade of life. Number of suicides, amount of drug, and duration of consumption and emergency admissions were three variables which positively affect severity of poisoning. In conditions which quick plasma tittering of acetaminophen is impossible for determining the indication of NAC prescription, some factors through patients’ history help the physician for better decision. Positive history of suicide, high dose drug consumption, and long duration between drug poisoning and hospital admission are some risk factors for poisoned patients.

In present more than one million people in world doing hemodialysis, This study do to determine adequacy of dialysis in hemodialysis patients Vali-Asr Hospital in Birjand. Descriptive cross- sectional and 50 dialysis patients six months after they started dialysis were selected. The questionnaire measured individual data and recorded the weight before and after dialysis and blood urea before and after dialysis within a minute of slow blood to 50 ml of blood from the patient's body and back venus. Then, measured URR and Kt/V, the distribution of patients in three part low, moderate and high adequacy of dialysis. Statistical analysis were used by descriptive statistics and SPSS software. The mean age were 47.70 ± 16.72 years, weight before dialysis 58.2 ± 12.36 and after hemodialysis 56.2 ± 12.22 kg, mean BMI 21.40, urea before dialysis was 140.42 ± 37.92, urea after dialysis was 52.32 ± 16.75 mg dl. 70 percent of patients was Kt/V 0.9-1.2 and 66 percent URR between 61 and 70 percent that had a relatively good level of adequacy of dialysis. mean total Kt/V of patients were 1.17 and URR 62.8 percent. Between BMI, the average pump blood, sex patients and the number of time of dialysis at week with dialysis adequacy were significant relationship (P < 0.05). Prevention of ESRD at the community level and attention to details such as the choise strategy to increase hours of dialysis, filter type and time of dialysis at week is important in dialysis wards.

In CABG, during lima harvesting, usuall branches of lima are ligated, but almost always the left thoracic cavity for an aberrant lima side- branch, which is usualy named Lateral costal artery, is not explored. In case, this unusual branch exists and is not excluded, it could cause the Coronary Steal Phenomenon. The aim of this study was evaluating the incidence of LCA in Iranian patients. In the cross sectional study, 909 coronary patients operated in cardiac surgery department of Ghaem hospital in Mashhad from 2004 to 2009. All lima patients were harvested and the left pleura was opened widely. the presence of LCA was cotrolled and also its traversed length was recorded, based on the number of intercostal space, then it was ligated and excluded We analyzed the length of that branch between males and females by X2 test at the significant level (P ≤ 0.05). Fiftyfive out of 909 patients had Lateral Costal Artery (6%). It extended to the second intercostal in 18 patients (1.6%) (12 males-6 females); fourth space in 26 patients (2.8%) (18 males-8 females); sixth space in 11 patients (1.2%) (8 males-3 females). This variation in 37 patients (4%) (4th, 6th costal space) was long and large enough and there was no meaningful difference in length between men and women by χ2 test (P = 0.7). During CABG, after the pleura is widely opened, the exploration of left thoracic cavity is prudent to exclude the presence of this variation. This will avoid the coronary steal phenomenon, which is a controvertial issue in future. The incidence of LCA was 6% in Iranian patients.

Elective tracheotomy is a common operation in hospitals in associations with intensive care unit. According to the high incidence of this operation and its importance, we designed our study by gathering information about patient including the most common and post operation complications. In our retrospective study, all patients need tracheotomy in both Imam Reza and Vali-Asr hospitals in Birjand during 2000-2007 were studied. The most common indications of tracheotomy were coma, laryngeal cancer, thyroid cancer, sub glottis stenosis, respectively. In this study, 176 patients during 7 years were analyzed. 65.9% of cases were male, the most common indication for tracheotomy were long intubations (54%). Laryngeal cancer (26%). 39 patients (22.1%) were complicated. The most common post operative complications were hemorrhage of the site of operation (5.1%), Tube difficulties (4.5%), tracheal stenosis (2.85%), and the difficulties in deconolation (2.3%), sub cotaneous emphysema (1.7%), infection (1.7%), granulation tissues (1.1%) and others (2.85%). According to prevalence of tracheotomy and its complications, more post-operative care of patients in ICU and emergency wards can be effective in reducing complications and having a better prognosis.