Journal of Kerman University of Medical Sciences
Volume:20 Issue: 4, 2013

Irritable bowel syndrome (IBS) is the most prevalent gastrointestinal functional disorder، characterized by non-specific symptoms such as abdominal pain and discomfort، altered bowel habit، and bloating. Its prevalence varies between 3. 5% and 30% in the world. This study was conducted in order to determine the prevalence of IBS in the adult population of Kerman، Iran، which is a representative of the population living in Southeast of Iran. This population-based، cross-sectional study was conducted in a one stage randomized clustered sample of the adult population of Kerman in 2010-11. 2259 persons were recruited and interviewed in a specialty clinic. The questionnaire for collecting data was based on ROME III criteria and demographic characteristics. Data were analyzed with chi-square and logistic regression tests. P values of less than 0. 05 were considered significant. The study consisted of 1088 (48. 2%) males and 1171 (51. 8%) females with mean age of 43 ± 16 years and IBS prevalence of 4. 38%. The regression analysis showed that there is a significant inverse relationship between IBS and age (P < 0. 001). The most common symptoms of IBS were the need to strain during bowel movement (59. 6%) and bloating (55. 6%). The most common subgroup of IBS was IBS-D (diarrhea-predominant IBS) (49. 5%). The result of this study showed that the prevalence of IBS in Kerman was less than that which has been obtained in Western Countries. IBS is common among the young population، and the population of Kerman is mainly young; therefore، educational and health measures for the prevention of IBS can have important personal and economic outcomes.

Conventional radiography is used for the diagnosis of problems such as dental caries and failure in root canal therapy. The diagnosis accuracy of conventional radiography is acceptable in the evaluation of anatomical and pathological structures. However، it seems that by using digital radiography we can obtain more information in this field. The aim of this study is to compare the diagnosis accuracy of bitewing radiography and digital panoramic imaging (filtered and unfiltered) in detection of proximal caries. This was a descriptive-analytical study which has evaluated 56 files of patients who were referred to a private office in Qazvin، Iran. These patients had digital panoramic (with CD) and bitewing radiographies in their records. The presence of decay and depth of decay were evaluated at the basis of 5-scale and 4-scale measurements، respectively. After collecting the data، data were entered into SPSS and ANOVA and Kappa coefficient were used. Values of P < 0. 05 were considered significant. The highest agreement in terms of presence or absence of caries based on location was obtained for bitewing (Kappa > 0. 76)، unfiltered panoramic، and filtered panoramic، respectively. General agreement between the two observers in terms of depth of caries was higher for panoramic views than bitewing radiography. According to the results of this study digital panoramic imaging، in spite of its digital imaging which the manufacturer claims can increase diagnostic accuracy، cannot be as accurate as bitewing radiography in detection of proximal caries. Thus، bitewing radiography is always the best option for evaluation of proximal surfaces.

Due to the importance of a suitable treatment for nausea and vomiting during pregnancy and reducing maternal and fetal complications، and the beneficial effect of Ondansetron in the treatment of nausea and vomiting compared with promethazine، this study was performed. In this case-control study، 60 pregnant women under 20 weeks of gestation with hyperemesis gravidarum were compared. The subjects were randomly assigned to two groups after excluding patients with a multiple pregnancy، non-viable pregnancy، and underlying diseases that cause nausea. One group received Ondansetron and another received promethazine. After 48 hours، responses and side effects were assessed using 2 questionnaires. Finally، response to treatment and side effects of the two drugs were compared. Although the response to treatment with Ondansetron was obviously better than promethazine، this was not statistically significant. The only clear side effect of promethazine was drowsiness. The response to Ondansetron was good، and there are no reports، in the literature، of it having any adverse effects on the fetus. Moreover، untreated conditions may be followed by many maternal and fetal complications. Therefore، it is better to use Ondansetron in the first course of hospitalization. Although، due to the limited sample size in this study، more studies with larger sample sizes are recommended in order to obtain more accurate results.

Utility of antibiotics، such as third and fourth generation of cephalosporins and carbapenems، and resistance to these antibiotics in hospital acquired infections are increased. There are scientific data that support the application of Tazocin (piperacillin-tazobactam) as an empirical treatment of moderate to severe bacterial infections. In our area there is not much information available on this topic. Therefore، we decided to determine the susceptibility pattern of bacterial species isolated in patients with infection to piperacillin-tazobactam at Alzahra Hospital (a tertiary care center)، Isfahan، Iran. This cross-sectional study was conducted at Alzahra Hospital (referral and educational hospital) from 2009 to 2010. 90 clinical specimens of bacterial cultures isolated from blood، urine، and respiratory tract of patients with nosocomial infections in different parts of the hospital were included in this study. Standard methods for the detection of microbiological bacterial species were used، and the antibiogram pattern of bacterial samples was performed by using E-test method. Among the 90 studied specimens in this study، 73 samples were gram-negative bacteria and the remainder was gram-positive. More than 78% of gram-negative bacteria and more than 88% of gram-positive bacteria، grown in cultures of patients with nosocomial infections at Alzahra Hospital، were sensitive to piperacillin-tazobactam. The information obtained from this research may be a guide for physicians that work in our region for the use of empiric therapy with piperacillin-tazobactam in cases of moderate to severe bacterial infections.

The accuracy of dental implants has increased in recent years. An accurate radiography from the region is needed for precise treatment planning in implants and for determining prognosis of treatment. Because this technique can demonstrate the buccolingual aspect، and due to its lower radiation dose، lower cost، and availability، in comparison with computed tomography، lineartomography could be the most suitable technique in cases with restricted implant sites. In this study we evaluated the accuracy of this technique in determining the quantity of maxillary bone.

This study was a kind of diagnostic test validity. 4 dry human skulls were selected and on each maxilla locations of teeth 7531 1357 were selected and marked with opaque markers (n = 32). On each site، 3 metal bullets، with the diameter of 3 mm، were placed on the alveolar crest to buccal cortex and lingual cortex in different distances from the alveolar crest. Conventional linear tomography was provided by Promax (Planmeca) radiographic unit. Then، the distances from the highest points of the bullets on the alveolar crests to similar points of bullets on the buccal and lingual cortices، and distances from the highest points on the buccal bullets to lingual bullets were measured. These distances were directly measured on maxillary bones in a similar way. The measurements obtained from tomograms and maxillary bones were analyzed by Wilcoxon test.

According to Wilcoxon test، measurements on tomograms in buccal height، lingual height، and thickness of the bone were significantly smaller than the gold standard. In 81. 3% of measurements distances on tomograms were underestimated; however، in all measurements، differences in results were in the range of ± 1 mm.

Regarding the observed results of linear tomography in determining the quantity of maxillary bone in this study، the gained measurements were smaller than the gold standard. However، considering the mean differences in preoperative treatment planning of implants، especially in placing a limited number of implants، and if it is not possible to use the cone beam computed tomography (CBCT) technique، linear tomography can be used.

In the western countries، bladder cancer is the fourth and eighth common cancer in males and females، respectively، and like other cancers it has been significantly increasing in last years. The aim of this study was to find out the epidemiology of bladder cancer in Fars province /Iran during 2003-2008 according to cancer registry data system. In this epidemiological study، using Fars province cancer registry data، the incidence rates were calculated per 100،000 people and age standardized incidence rate (ASR) was calculated by direct method using the world standard population. Data were analyzed by SPSS 16 and Microsoft Excel 2007 software. Over a 6-year period، 1828 new cases were recorded in Fars province. The highest incidence rate was observed in males and the age group of over 70 years. The ASR of bladder cancer in these six years were receptively 6. 9، 6. 5، 11. 1، 10. 02، 12. 6 and 10. 3، for 100،000 showing a significantly increasing trend. Despite the significantly increasing trend، the ASR of bladder cancer in Fars province is very lower in comparison with western countries.

Exposure to cigarette smoke affects the health of mothers and infants. The aim of this study was to examine the effects of second-hand smoke exposure on breast milk and infant urinary cotinine during breastfeeding. This cohort study was conducted on 45 breastfeeding mothers and infants exposed to second-hand cigarette smoke (exposed group)، and 40 breastfeeding mothers and their infants not exposed to second-hand cigarette smoke (non-exposed group). The participants were chosen from mothers and infants who referred to one of the health centers affiliated with Tehran University of Medical Sciences، Tehran، Iran. Mothers’ breast milk and infant urine samples were collected twice at baseline (5–7 days after delivery) and 4 months after delivery. The cotinine levels in milk and urine were measured. Maternal nutritional status was assessed by 24-hour recall. All data were analyzed in SPSS. There was a significant difference between the two groups regarding average level of cotinine in mothers’ breast milk، and urine of infants at baseline. This difference was also significant at 4 months postpartum (P < 0. 001). The results showed that exposure to second-hand cigarette smoke during breastfeeding increases the cotinine level of mother''s milk and infant urine at 4 months postpartum.

The purpose of the present study was to investigate the effects of Stress Inoculation Training [SIT] on patients with dysfunctional attitudes and primary hypertension. The study sample included 60 subjects with primary hypertension (32 females & 28 males) referred to special clinics in Ahwaz. Those who had primary hypertension and dysfunctional attitudes based on Beck & Wiszeman Dysfunctional Attitudes Scale (DAS) were selected and after being matched for age، socio-economic status and lack of other diseases، they were randomly divided into experimental and control groups. Experimental group underwent an 8-session Stress Inoculation Training (SIT) program. Finally، all subjects of the two groups were assessed for dysfunctional attitudes and primary hypertension in posttest and three months fallow- up. The results revealed a significant difference between the two groups in dysfunctional attitudes and primary hypertension at posttest and fallow- up. Moreover، experimental group in comparison to the control group showed significant improvement in dysfunctional attitudes and hypertension in posttest and three months follow up. Stress Inoculation Training (SIT) significantly decreased dysfunctional attitudes and primary hypertension; therefore، using SIT in hypertensive patients is recommended.

Pseudoainhum is a rare acquired or congenital disorder characterized by progressive development of a fibrotic band on a finger or toe until spontaneous autoamputation occurs. The various etiological hypotheses given for this disease include infectious (mycosis، mycobacteria)، traumatic (plants)، vascular (andysplasia)، neurological (polyneuritis)، and genetic (keratodermia) mechanisms. Ainhum predominantly affects black people living in west Africa، south America، and India. A 12 year old girl from Chahrigan Harirabad، a village near Kahnooj، Iran، with low socioeconomic status whose parents were not related، presented with autoamputated right foot toes. According to her mother she was in her usual state of good health until 1 year of age، when she developed a deep painless wound in the base of the fifth toe of the right foot. The depth of the wound progressed over time until it autoamputed. The same process happened to the 2nd، 3rd، and 4th toes of the same foot. On physical examination the pulse of the posterior tibialis artery was too weak and there was no detectable pulse of the dorsalis pedis artery. All examinations of toes of the left foot were normal. There was also a kyphoscoliosis toward the left side. The laboratory tests were normal; however، triphasic Doppler sonography showed a decreased velocity of blood flow in the distal part of the anterior tibialis artery. Due to the rarity of the disease and genetics being the most important contributing factor، we suggest a genetic study of this patient and her family members، regular follow up، and physical examination of the patient. We also suggest that with promotion of the level of hygiene and adequate education we can prevent further damage in this patient، as trauma and subsequent infection are the likely predisposing factors.