مجله دانشگاه علوم پزشکی بابل
سال شانزدهم شماره 7 (پیاپی 82، تیر 1393)

Distal radius fractures are one of the most common fractures and ulnar sided wrist pain is one of the most common complications of these fractures. The simplest treatment for this complication is corticosteroid injection. The present study was designed to assess the effect of corticosteroid injection in prevention of ulnar sided wrist pain.

In this clinical trial study, 82 patients with distal radius fracture scheduled for closed reduction and percutaneous pin fixation were randomly divided into control and corticosteroid groups. In the cortcosteroid group the patient received a single betamethasone injection in the dorsoulnar side of the wrist before reduction, while the control group received placebo. The patients were followed for 6 months. The pain was assessed by visual analogue score and compared. (IRCT 201104062115N1)

Finally 82 patients were followed for 6 months, 39 in control (placebo) and 43 in corticosteroid group. The mean age of the patients was 39±13.62 in control and 42±13.23 in steroid group. At the end of the 3 month follow up the difference between the two groups with regard to the number of individuals without ulnar sided wrist pain was statistically significant (12 individuals in the control and 23 in steroid groups, p=0.038), while this was not the case in the 6 months follow up (18 individuals in the control and 23 in steroid groups, p=0.507), but in the both time frames the mean visual analogue pain score was higher in the control group (2.39±1.89 vs 1.09±1.41 at 3 months and 1.92±1.88 vs 0.95±1.21 at 6 months follow up (p<0.05).

Based on the findings of the present study it seems that prophylactic corticosteroid injection will be associated with a decrease in the severity of wrist pain in patients with acute distal radius fractures. With regard to the decrease in the number of painless individuals.

Osteoporosis and obesity are a world major problem that their prevalence is increasing. Obesity is a risk factor for cardiovascular and metabolic diseases although it is said that it has protective effect on bone loss. The aim of this study was to evaluate the relationship between body mass index and bone mineral density in older people.

This cross sectional study came from "Amirkola Health and Aging Project (AHAP)" that has been done on 1000 people aged 60 and over in Amirkola city, Iran. Demographic data collected by questionnaire. Weight, height, waist circumference and hip circumference were measured. Waist to hip ratio (WHR) and body mass index (BMI) were calculated and bone mineral density (BMD) was measured by DEXA scan in lumbar spine and femoral neck.

In this study, 554 (55.4%) of the participants were men and 446 (44.6%) were women. The mean of bone mineral density in femur (0.90±0.1) and spine (0.94±0.2) in men were higher than women (0.80±0.1 versus 0.79±0.1 respectively) (p=0.001). BMI has significant positive relationship with BMD (p=0.001) that in both men and women this relationship was strongest in femoral neck (p=0.001). Central obesity in men had a positive association with bone mineral density in both areas (p=0.000). In overall the strongest relationship of femoral neck BMD was with BMI (r=0.38, p=0.001) and in lumbar spine was with WHR (r=0.21, p=0.001). Regression analyses showed that by control of age, WHR and waist circumference, BMI is effective on femoral neck BMD but in lumbar spine the effect of BMI has covered with those factors.

Due to high prevalence of osteoporosis in older people with lower BMI, having normal weight in older people is recommended to prevent decreasing bone mineral density.

Various drugs used as maintenance therapy following transplantation have been assessed. Therefore the use of maintenance therapy to eliminate residual malignant cells is controversial yet. So, the aim of this study was to evaluate the efficacy and side effects of maintenance therapy with thalidomide following stem cell transplantation in patients with multiple myeloma. The open label trial was randomly performed on 73 patients with multiple myeloma who underwent Autologous Hematopoietic Stem Cell Transplantation (ASCT) with acceptable marrow recovery. Thirty-five patients assigned to thalidomide group and received 100 mg/day thalidomide after ASCT and 37 patients assigned to non-thalidomide group. All patients received acyclovir and cotrimoxazole for prophylaxis. Survival rate and complications were compared in two groups. Median age in thalidomide group was 52 years and in non-thalidomide group was 55 years. Twenty three (66%) patients in thalidomide group and 36(95%) patients in non-thalidomide group continued initial treatment. The median duration of thalidomide consumption was 13.2 months. The 2-year progression free survival rate was 63.4%±0.10 for thalidomide group and 42.1%±0.19 for non-thalidomide group (p=0.91). The 2-year overall survival rate was 82.1%±0.09 for thalidomide group and 90.2%±0.07 for non-thalidomide group (p=0.22). Totally 40 percent of patients developed thalidomide related complication. So most common complications include sensory and motor neuropathy and deep vein thrombosis (DVT). The results showed that there is no benefit to use thalidomide after SCT. With attention to thalidomide complications, it is recommended to reserve post-ASCT thalidomide maintenance primarily for patients with high-risk disease

Medical ethics is an important component of professional ethics and it consists of principles: respect for patient's autonomy, beneficence, non-maleficence, justice, veracity, confidentiality. This paper attempts to assess student's attitudes toward principles of medical ethics and match them with Islamic ethics in Kerman University of Medical Sciences and fundamental principles of modern medical ethics be argued with some of the verses of the Holy Quran and Islamic ethics. In this cross sectional study, by using 18-item self administered questionnaire that each items were scored from 1 to 5, the attitude of 385 students from Kerman University of Medical Sciences that were selected by Quota sampling were evaluated. The overall attitude of students was positive (4.07±0.45) and the attitude of students over 20 years (4.21±0.29) was more than the rest (3.95±0.33) (p=0.00), marrieds (4.27±0.16) more than singles (3.98±0.27) (p=0.00), medical students (4.34±0.42) more than the rest (p=0.00) and males (4.30±0.24) more than females (4.06±0.35) (p=0.011) and the participating students in the workshop (4.15±0.22) more than the rest (4.06±0.46) with (p=0.081). The results showed that students had positive attitudes towards ethical principles and knew those principles in accordance with Islamic beliefs and values

The use of an appropriate stimulus to speed up in vitro and in vivo stem cell proliferation and growth is the one of the most important issues in cell therapy. The aim of this study was in vitro evaluation of hydroethanolic extraction of citrus aurantium on proliferation and growth rates of neonate rat neural stem cells. Neural stem cells were isolated using enzymatic digestion from hippocampus region of 3 day old neonatal rat brain. To determine optimal concentration of citrus aurantium extraction, isolated neural stem cells were treated at 200, 400, 600, 800 and 1000 µg/ml for 48 h. Then cells proliferation rate were evaluated using MTT assay method. Citrus aurantium promoted neural stem cells proliferation compared to untreated cells. As well as the effect of aurantium extract is dose dependent. The result of this study showed that proliferative rate in treated cells with 600 µg/ml of Citrus aurantium extraction (0.81±0.06) significantly is higher than control (untreated neural stem cells) group (0.59±0.02). (p<0.05) Regarding the effect of Citrus aurantium extract on the proliferation rate of neural stem cells, the use of hydroethanolic extraction of Citrus aurantium can be useful for clinical purposes to cell replacement therapy of various neurodegenerative disorders such as spinal cord injury.

Coffee plants can alter the activity of liver enzymes and reduce liver enzymes. Considering vital role of liver in the detoxification and the role of dietary factors in enhancing the body's ability to detoxify the chemicals and drugs, the present study was performed to determine the protective effect of boiled coffee on liver enzymes aspartate transaminase)AST(, alanine transaminase)ALT), alkaline phosphatase)ALP(, and total bilirubin in rats treated with thioacetamide.

In this experimental study, 32 male rats were divided into four groups of eight. Animals in the first group (control) received water and normal food for rats, group II (control) received water and normal food associated with the injection of 1 ml of normal saline as a solvent, and the third group received both normal food and water. For injecting thioacetamide (100mg/kg) the treated group received no intervention and the fourth group received boiled coffee (4mg/kg) orally in the diet of rats during 68 days (pretreatment). The average length of treatment time for pretreatment was considered from 8 to 10 weeks. Blood samples were taken at two stages: pretreatment and post injection of thioacetamide intraperitoneally at the dose of 100mg/kg. AST, ALT, ALP and total bilirubin were measured 48 hours after last injection.

The results showed a significant increase of the rate of serum AST in treated group with thioacetamide (321±26) in compared to control group (162±3). Boiled coffee as pretreatment has protective effect on liver tissue. The rate of ALP in this group was 384±39 that significantly decreased (p<0.05).

In this study, boiled coffee has protective effect on liver enzymes.

Many advances have taken place in the management and treatment of head injured patients in recent years. Despite this, there have been few studies about depressed skull fractures as a subgroup of head injured patients. The aim of this study was to evaluate surgical results of patients with depressed skull fractures. This cross-sectional study was conducted on 74 patients (50 males and 24 females) with the mean age of 20 years (5- 52 years) who were admitted in neurosurgery department of Urmia Imam Khomeini hospital during 4 years (2009-2012) with depressed skull fracture and treated surgically. Preoperatively, CT scan was done in all patients. Prophylactic antibiotics and antiepileptics were administered in all cases. Variables such as: type and cause of fractures, neurologic deficit, seizure, postoperative meningitis, skin defect, wound infection, CSF leak and mortality were evaluated. Patients were followed up during one year after surgery. From 74 cases, 60(81%) were compound and 14(19%) cases were simple fractures. In 8(11%) patients fracture were crossed the midline (over superior sagittal sinus). The cause of depressed fractures were road traffic accident in 38(51%) cases, fall from height in 23(31%) cases, physical violence in 5(7%) cases, sports related injury in 2(3%) cases and miscellaneous in 6(8%) cases. Level of consciousness before surgery was ranged from 5 to 15 based on Glasgow Coma Scale. Postoperatively complete recovery occurred in 50(67.5%) cases, hemiparesis in 10(13.5%) cases, seizure in 4(5.4%) cases, dysphasia in 2(3%) cases, meningitis in 2(3%) cases, and skin defect with wound infection in 2(3%) cases. No death and CSF leak was recorded. Surgical treatment of depressed skull fracture with prophylactic antibiotics and antiepileptics has good results and few complications.

Emotional dysregulation is often described as the central feature of borderline personality disorder (BPD). For determining relative role of this factor in symptoms of patients with borderline personality disorder, the current study was conducted to investigate the relation of emotion processing styles and alexithymia with symptoms of borderline personality disorder. This descriptive study was conducted in correlation and prediction method. One hundred and fifty students of Azad University of Ardabil in 2012-2013 were selected by simple random sampling, they were being asked to respond to borderline personality, emotion processing and alexithymia individually and at classrooms. Then data was analyzed. The results showed that borderline personality symptoms have positive relationship with intrusion (r=0.35; p<0.001), lack of attunement (r=0.21; p<0.009), dissociation (r=0.25; p<0.002), discordant (r=0.44; p<0.001), suppression (r=0.19; p<0.02), lack of control (r=0.42; p<0.001), difficulty in identifying feeling (r=0.37; p<0.001), difficulty in describing feeling (r=0.32; p<0.001), external orient thinking style (r=0.17; p<0.03) and alexithymia (r=0.36; p<0.001). Also the results showed that 32% of variance of borderline personality symptoms was explained by emotion processing styles (F=21.13; p<0.001) and 15% variance of it was explained by alexithymia (F=25.05; p<0.001). This result show that symptoms of borderline personality disorder in general population can be predicted partly on emotion processing styles and alexithymia.

Systematic evaluation of hospital information system (HIS) leads to its modification and development in accordance with user's need, increase of hospital efficiency and effectiveness. The aim of this study was to assess the effect of hospital information system on processes and personnel function from user's viewpoint in the hospital affiliated to Babol University of Medical Sciences, Babol, Iran. This cross sectional study was performed on 155 users of affiliated hospitals of Babol University of Medical Sciences who used software daily in 2013 and participated in the census. The data was collected by a questionnaire that its validity and reliability has been confirmed. The questionnaire included basic and specific questions on Likert. In this study 72.9% individuals were women. Hospital information system (HIS) was used the most by nurses. The most average was related to need to learning new skills in users (3.72±0.7), 45.8% of individuals in this study expressed that HIS implementation caused to reduce the personnel workload and 70.4% declared that HIS implementation caused to increase personnel accuracy. 54.2% expressed that HIS implementation caused to increase work facility and 43.2% expressed that HIS implementation caused to reduce total expenditure of work. The results of this study showed that hospital information system has effectiveness on processes of personnel function.

Breastfeeding is the best food for growth and development of newborns and infants. General physicians have an essential role in promoting breastfeeding. The purpose of this study was to assess the knowledge and attitude of general practitioner about breastfeeding. This cross sectional study was about the knowledge and attitude of general practitioner in Sari, northern Iran in 2012. A questionnaire including 30 different questions related to breastfeeding, time of starting the feeding and duration of breastfeeding and maintenance of feeding was completed by general practitioners. Three hundred general practitioners completed the questionnaires. One hundred and forty (46%) were female, 188(63%) were employed in urban area. There was no significant difference between private or governmental section as a view point of the results of answer to the questions. Urban physicians had more knowledge than the rural physicians. Overall knowledge of the participants was more than 50% in most of cases (96%) and in more than half of the cases was higher than 70%. Work experience of individuals had no effect on level of their knowledge. The level of knowledge of the physicians was at optimal level in most of cases, but there are inadequate acknowledge in some items of breastfeeding among them.