مجله دانشکده پزشکی اصفهان
پیاپی 242 (هفته چهارم امرداد 1392)

Employees in night shift experience sleep deprivation continuously. Stress-induced insomnia affects on fatigue and reduces maximum activity. During the shifts، hormonal changes affect on immunoglobulin M (IgM) operation. Individual differences in encounterring and adaptation with shift-induced stress can be effective to determine vulnerability. The aim of this research was to assess the relationship of personality traits، chronic fatigue and serum IgM level in patients with sleep deprivation. The study population was the shift employees in steel factories in Isfahan، Iran. A total number of 221 male employees were selected with random cluster sampling. Personality traits، (Eysnek and Freidman)، and chronic fatigue (Barton et al.) questionnaires were used to assess research variables. IgM was determined with nephelometric method. Data were analyzed using Pearson''s correlation coefficient and structure equation modeling. Neurosis، introversion and A type personality correlated significantly with chronic fatigue (P < 0. 01). Type A personality and neurosis correlated with serum IgM level، too (P < 0. 01). Indirect effect of neurosis، introversion and A type personality on serum IgM level was significant (P < 0. 01). This research argued employees with neurosis، A type personality، and introversion traits are talented for reducing serum IgM level.

Sore throat and hoarseness are the most frequent subjective complaints after tracheal intubation for general anesthesia. We conducted a prospective، randomized، double-blind، placebo controlled study to evaluate the efficacy of intravenous dexamethasone plus ketamine gargle for reducing the incidence and severity of post-operative sore throat (POST) and hoarseness. 140 patients (aged 16-65 years) scheduled for elective surgery were enrolled. Patients were randomly allocated into four groups of 35 subjects: group K gargled 40 mg ketamine in 30 ml saline; group D were infused 0. 2 mg/kg intravenous (IV) dexamethasone; group KD gargled 40 mg ketamine in 30 ml saline plus 0. 2 mg/kg intravenous dexamethasone; and group P (placebo) received saline (gargle and IV). POST was graded at 0، 2، 4، 8، 16 and 24 hours after operation on a four-point scale (0–3). The incidence and severity of POST were significantly lower in group KD، compared with the other groups at all times after tracheal extubation for up to 24 hours (P < 0. 05). Also، the incidence and severity of hoarseness were significantly lower in groups of KD، K and D compared with group P (P < 0. 05). The prophylactic use of 0. 2 mg/kg of intravenous dexamethasone plus ketamine gargle significantly reduced the incidence and severity of POST compared with using each of these drugs alone or using placebo.

People، who can identify، understand and express their inner feelings well، cope with negative experiences and adapt with environment and other people successfully. Alexithymia is a personality trait characterized by difficulty in identifying، describing and regulating feelings. Patients with alexithymia، who cannot cope with stress، somatize their emotional disturbance in a variety of medical disorders، particularly dermatologic diseases.

In this prospective case-control study، 63 eligible subjects referring to dermatology clinics of Isfahan University of Medical sciences (Isfahan، Iran) were selected by convenience sampling method and implied case group. Control group was selected from normal population without any skin problem. The General health questionnaire (GHQ)، Toronto alexithymia scale (TAS-20) and Coping response index (CRI) were used to compare the variables between the groups.

Alexithymia had association with dermatologic diseases while CRI and GHQ scores showed no significant difference between the groups of case and control.

Present research suggests that in the treatment of dermatologic diseases، psychological problems should be considered. Dermatologist should be aware of alexithymia association with an underlying dermatologic disease.

The health of subjects is not affected by the nutrients ingested in a particular day; it actually is influenced by the dietary habits over a long time. In the most commonly used methods، usual food components intakes would be estimated along with bias. Considering the initiating and developing of many chronic diseases in the middle-age and elderly، majority of them affected by nutrition، the aim of current research was to evaluate the distribution of usual intake of selected nutrients using a powerful statistical method i. e. NCI (National Cancer Institute) method in a general above 40-years-old population of central region of Iran.

In this cross-sectional study، based on information obtained from the Isfahan Cohort Study in 2007، 1922 people aged 40 and over، were investigated. Subjects’s dietary intakes were assessed with a 24-hour recalls and two food records. Distribution of usual nutrient intake was estimated using NCI method. The proportion of subjects at risk of nutrient intake deficiency or excess was estimated by comparing the estimated values with recommended standards، for men and women، separately.

The prevalence of vitamin A inadequacy for men in different age groups was more substantial than women (58. 3-96. 7 percent for men vs 23. 3-57. 2 percent for women). The usual calcium and dietary fiber intakes for a low percentage of studied subjects were more than recommended standards (Maximum of 7 and 28 percent for dietary fiber and calcium، respectively). There was a significant difference between men and women، at the age of 40-70 years، in terms of compliance of recommended cholesterol level (P < 0. 0001).

The results of current research showed that intake of vitamin A، calcium and dietary fiber was not adequate، and somewhat there was excess intake of cholesterol in the studied population. Thus consuming of dairies، vegetables and fruits، as the main sources of micronutrients، should be increased in this population. Interventional population-based programs such as enriching food and training in order to adjusting the pattern of diet should be designed.

Currently، endoscopic retrograde cholangiopancreatography (ERCP) is one of the most practical measures in the diagnosis and management of various pancreatobiliary diseases. Difficult cannulation which contributes to developing side effects of ERCP، is influenced by many factors، one of which is anatomic variants such as periampullary diverticulum (PAD). The purpose of current systematic review study was the investigation of the effect of periampullary diverticulum on technical success rate of endoscopic cholangiopancreatography. The general conclusion would be presented based on statistical analysis. In the current study، MEDLINE، PubMed and EMBASE databases were searched in February 30th، 2012 using a sensitive search strategy to retrieve relevant studies in English language. The data met the inclusion criteria were selected for the study. Statistical analysis was carried out using CMA. 2 software. Eleven articles with a total sample size of 12243 and an average consensus of 88% among researchers entered into the survey and all of the necessary data were obtained. The results of statistical analysis indicated low success rate of cannulatoin in patients with PAD in comparison with those without it (OR = 0. 502؛ CI 95% (0. 262-0. 961); P < 0. 038). Performing ERCP cannulation in patients with and without PAD carries a lower success rate respectively. Nevertheless، the recent studies which employ new methodology does not demonstrate this low success rate.