Shiraz Emedical Journal
Volume:11 Issue: 4, Oct 2010

The measurement of Arterio-Venous (A-V) Fistula Recirculation has important diagnostic implications because the efficiency of haemodialysis (HD) may be limited, resulting in dialysis delivery being less than that prescribed. The purpose of the study is to determine its prevalence and causes in our HD patients. Methods and Materials: We randomly selected 100 end stage renal disease patients with A-V fistula that they were on HD more than 3 months. The degree of recirculation was also measured with Urea based two needle technique method. For each patient distances between arterial and venous and distances of needles from fistula and its directions was recorded. Echocardiography and A-V fistula Color Doppler Ultrasound were also performed. Blood flow rate and dialysate flow rate were 300 mL/min and 500 mL/min respectively. The prevalence of A-V fistula recirculation was 17% (17patients).Average degree of recirculation between these patients was 9.56±2.32 %. The most common cause was misplacement and or misdirection of needles (17 patients). The second cause was heart failure with Ejection Fraction > 40% (8 patients). No difference was seen between diabetic versus non diabetic (P =0.28) and hypertensive versus normotensive (P =0.21%) HD patients. A-V fistula recirculation is common occurrence in HD patients and the most common cause of recirculation is misplacement and or misdirection of needles so we should have more emphasis on education and training of HD staffs.

The subject of adequacy in cervical smears has an essential role in the prevention of cervical cancer deaths. The predicament of establishing exactly what constitutes an adequate sample has received increasing attention in recent years. In this study, we tried to compare specimen adequacy and cytomorphological changes between conventional cervical and liquid based cytology “Liqui-PREP TM”. A total of 170 asymptomatic women who undergo annual screening, were examined in cytopathology and gynecology departments (Al-Zahra Hospital of Isfahan University, Iran) during August 2008 to December 2008. Among which 153 cases, 93 cases: pre-menopause and 60 cases: post menopause women were subsequently selected. The conventional smears (CS) and Liquid-Based slides (LBS) using Liqui-PREP TM technique taken from each patient were evaluated carefully by a professional cytopathologist. The number of endocervical and transional zone's cells per slide, covering diagnostic squamous cells (%) and degenerated cells per high power microscopic field (HPF) were also counted. Other cytomorphological changes evaluated for postmenopausal women were included: number of eosinophilic pyknotic cells and spindled cells, basophilic globules (per HPF) and the presences of basophilic filaments (+/-).SPSS software was used for data analysis using indices of frequency percent, mean, and standard deviation for descriptive analysis. Mean of the patient's age was 42.28 which ranged from 20 to 67 years. The numbers of satisfactory cases with CS were 30 (31.9%) compared to 58 (62.4%) with the LBC (P<0.0001). Data for menopausal women included respectively: 11 (18.30%) and 39 (65%) and the P<0.0001. A significant difference was observed two methods in the number of degenerated cells and the amount of slide coverage by squamous cells in both age groups (P=0.0001) but bet the quantitative amount of endocervical cells was more in CS method rather than LBC method (P=0.0001). Other morphologic changes (variations) assessed in menopause age group included:eosinophilic pyknotic cells, basophilic globules, spindled cells, and basophilic filaments which demonstrated a significant difference between two methods.The basophilic filaments were evaluated qualitatively as positive and negative. In CS 13 cases (21.7%) were negative and 47 ones (78.3%) were positive for filaments. All 13 negative cases in CS method were negative in LBC method also. But out of the 47 positive cases in LBC method, 13 cases (21.7%) were positive and 47 cases (78.7%) were negative (P value = 0.0001). 1. Liquid-PREP TM is a straight-forward cytological procedure, relying on classic cell handling procedures. 2. Cellular material is encapsulated in a matrix material that assures quantitative, robust adherence to the slide. 3. The number of cells transferred to the slide is controlled by the cytologist. 4. Liquid-PREP TM is not expensive.

Concerns on the safety of polio vaccine in some parts of northern Nigeria that led to the suspension of the immunization efforts in those parts of the country, informed our design of this prospective study. To determine polio-specific Immunoglobulin G antibodies among children (seven months - seven years) in Jos. Within the months of March and April 2007, One hundred and eighty two blood samples were collected from children in the Emergency Peadiatric Unit of the Jos University Teaching Hospital and tested for the presence of polio-specific IgG antibodies using Poliomyelitis IgG ELISA Test Kit produced and described by DEMEDITEC Diagnostic GmbH Germany. One hundred and seventy eight percent (97.8%) of the tested children had detectable antibodies against poliovirus. The study population had appreciable levels of protection against poliovirus. There was no significant association between the detection of the IgG in children in relation to gender, age, religion, and number of doses. Only educational status of fathers had statistically significant relationship with the detection of the antibodies. This study demonstrated that progress has been made towards the eradication of poliomyelitis in Nigeria. To further strengthen the gains made and weaken the barriers to immunization, there is an increasing need for more funding to increase awareness and intensify the final efforts targeted at ‘kicking polio’ out of Nigeria.

To compare the laryngeal and gastro-intestinal complications of using ETT and LMA after elective orthopedic operations. Eighty patients who were candidate for elective orthopedic operation and were in class 1 and 2 of ASA, participated in this study and. Patients randomized into two groups. Laryngeal Mask Airway(LMA) was used in one group and Endo Tracheal Tube(ETT)in the other one. Postoperative complications including nausea, vomiting, coughing and sore throat were assessed in all patients during the first 24 hours. Cases of nausea, vomiting and sore throat in LMA group were less than ETT group. However, this difference wasn’t statistically significant. But cough incidence in ETT group was significantly further than the LMA group. There was no significant difference between the LMA and ETT regarding mentioned complications in the first 24 hours after the surgery. Of course more research is recommended in this area, considering the limitations and contrasting evidence.

Substance abuse is a serious problem. Incidence of substance abuse in Iranian students is high. The current study surveys of substance abuse in medical students in southern Iran. Patients and From April 2008 to June 2009 in Iran, prevalence of substance use among 1000 Shiraz University medical students were assessed by a questionnaire based on DSM-IV. Overall 971 medical students completed the questionnaire. (54.8 %were males).. 22% of the male and 8% of the female students had a history of at least one episode substance abuse. The rate of substance abuse among the male students was significantly higher than females. (P value<0.05) The most important substance which was used was cigarette followed by water pipe. Overall prevalence of substance use among the medical students in Iran is lower than west. In this study prevalence of substance use was significantly higher among the males and such as the other studies in Iran cigarette, water pipe, Alcohol and opium, were the most prevalent substances which used

Cytomegalovirus (CMV) has been recognized as one of the most important opportunistic pathogens in kidney transplant patients.The aim of this study was to determine the prevalence of CMV antibody in donors and recipients before transplantation. In a cross sectional study from March 2008 to August 2009 we prospectively studied donors and recipients who referred to our kidney transplant center.All of routine pretransplante laboratory studies including liver function tests and CMV IgG and IgM antibody were performed for them. A total of 148 patients (79 donors and 69 recipients) were included in the study. Mean age of donors and recipients were 30 ± 8 years and 40 ± 18 years respectively.Liver Function tests (SGOT and SGPT) were at normal range and marker of HBV infection was negative in both groups but HCV antibody was positive in 2.89 percent of recipients (n=2) and negative in all of donors.CMV IgG antibody was positive in 100 percent of recipients and 98.73 percent of donors (n=78). CMV IgM antibody was negative in 98.55 percent of recipients (n=68) and 100 percent of donors (n=79). CVM infection is very common in donors and recipients candidate for kidney transplantation in Khuzestan province and almost all of them in this study have CMV IgG antibody.

This manuscript provides a literature review of prevalence and routes of hepatitis C virus transmission, and prevention methods regarding its prevalence in different populations. There is a great difference in the frequency of hepatitis C virus infection of general population versus injection drug users. Even in developing countries with unsafe therapeutic injections and contaminated blood, the rate of disease is higher in injecting drug usere. A literature review of published scientific reports on HCV epidemiology, prevalence, and its relation to addiction in some countries was performed. While different epidemiologic patterns of HCV infection exist with seroprevalence of 0.4% to 1.1% and 9.6% to 20% in general population in North America and some countries of North Africa; respectively, the frequency of HCV infection in injection drug users is 48% to 90%. Injection drug use seems the most important worldwide risk factor for hepatitis C virus infection. Substance abuse, HCV infection and mental illness frequently coexist and complicate HCV treatment. Implementing effective measures for preventing injecting drug use by effective drug education programs in school, research in behavioral/environmental addiction predispositions, implement strict drug abuse policy, regular estimation of addiction patterns, and to model prevention approaches according to every certain situation is necessary.

To identify medical coding software requirements.Design: To identify medical coding software requirements, 15 medical coding software products used in Iran and 6 medical coding software products used in other countries, were surveyed. Based on a literature review, a checklist containing general and specific features of medical coding software was developed.Measurement: The criteria used for this comparison are as follows: operating system type; connected to other departments or stand alone; and general and specific requirements of medical coding software. DOS and Windows operating systems were used in 4_(29%) and 11_(71%) software products, respectively. Just 3 software products were networked products, the others being stand alone. Flexibility and improvement were 42.8% and 41%, respectively. Numerical and alphabetic lists of diseases and surgeries enjoyed the highest and the lowest frequency with 93.3% and 6.6%, respectively. In general, there are lots of weaknesses in medical coding software products in Iran. Some specific features should be included in medical coding software, such as: flexibility; user-friendliness; back up ability; satisfaction of health care needs; software support, data recovery: data sharing; parallel searching; data security, integrity, validity, and accessibility; databank coding; death information recording; and researcher identification.