2024-03-29T00:18:20+04:30 http://rjms.iums.ac.ir/browse.php?mag_id=112&slc_lang=en&sid=1
112-2762 2024-03-29 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2013 20 112 Searching group A streptococcal polysaccharide antigens in synovial fluid of patients with arthritis Samileh Noorbakhsh Vida Zarabi Mahshid Talebitaher Azardokht Tabatabaee Nazanin Ali Beig  Background: Diagnosing the etiologic causes for septic arthritis is very important. The main goal of study was to determine the group A streptococcal polysaccharide antigens in synovial fluid of patients with arthritis. Methods: A cross sectional study was performed upon 52 cases with acute mono arthritis in Hazrat-e-Rasool hospital in Tehran Iran (2010-2012). Techniques used were: Gram stain/culture and rapid antigen tests (LPA) for H. influenza, S. pneumonia, group B streptococci, N. meningitidis, and E. coli and for Group A streptococcal polysaccharide antigens (Cusabio company Austria license, China, ELISA) were searched in synovial samples (negative smear and culture). P value <0.05 was considered valuable. Results: Septic arthitis was diagnosed in 34.5% (including positive culture or gram staining in 15%, rapid antigen test (LPA) in 5.7%), and positive group A streptococcal polysaccharide antigens was observed in 3.8% of cases with negative results for other tests. Conclusions: Septic arthitis was diagnosed in 34.6% of cases. Also 15% of cases had positive culture or gram stain (mainly S. aureus, S. pneumonis), 5.7% were diagnosed by rapid antigenic tests (LPA). Group A streptococcal polysaccharide antigens (ELISA) test was positive in 3.8% of remaining cases (negative smear and culture). By adding the new methods of searching for the common bacterial antigens (especially streptococcus) to the conventional culture tests, the role of infectious organisms in evolution of acute arthitis would be elucidated more clearly. Streptococcal polysaccharide antigen in synovial fluid is not defined by immune system. The irreversible cardiac, renal, neurologic complications are probable. Optimal treatment of the proved streptococcal cases is recommended.  Group A streptococcal polysaccharide antigens (ASP Ag) Arthritis Septic arthritis. 2013 10 01 1 8 http://rjms.iums.ac.ir/article-1-2762-en.pdf
112-2763 2024-03-29 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2013 20 112 The effect of chewing sugar-free gum on the anxiety level of active phase of labor in nulliparous women Somaye Makvandi Shirin Zargar Shoshtari Simin Montazeri Akram Ahangarpour  Background: Nulliparous women often are extremely anxious because of fear of labor pain and this anxiety will decrease their chances of normal vaginal delivery. The aim of this study was to investigate the effects of chewing sugar-free gum on labor anxiety in nulliparous women. Methods: This study was a randomized clinical trial and performed on 66 nulliparous pregnant women with spontaneous labor pains in Ahvaz Razi hospital in 2011. Samples were randomized to case group (n=34) and control group (n=32) based on the inclusion and exclusion criteria. Maternal anxiety was measured at baseline using Spielberger anxiety scale. Then an Orbit sugar-free chewing gum was given to case group. The women in the control group did not receive any intervention. After 30 minutes of chewing gum anxiety was measured in all subjects again. Also labor stages duration, type of birth and the need for oxytocin in both groups were recorded. Data were analyzed using descriptive statistics, t-tests and chi-square in SPSS version 15. A p-value less than 0.05 was considered statistically significant. Results: Findings of this study showed that after 30 minutes of chewing gum, mean and standard deviation of active phase anxiety of women in case group (42.85±5.46) was significantly lower than control group (49.82±7.68). In the case group, active phase duration were significantly less than control group (177±89.03 min in case group VS. 229.03±59.68 min in control group p=0.001). Also second stage of labor duration in the case group (43.91±10.96) was less than control group (52.65±18.27) with p-value of 0.021. Type of delivery and the need for oxytocin were not significantly different between the two groups. Conclusions: Based on the findings of this study it seems that chewing a gum can be used to reduce anxiety of labor as a non-invasive and effective method.   Chewing gum Anxiety Labor anxiety Active phase of labor. 2013 10 01 9 15 http://rjms.iums.ac.ir/article-1-2763-en.pdf
112-2764 2024-03-29 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2013 20 112 Frequency of multidrug-resistant Pseudomonas aeruginosa in patients with ventilator associated pneumonia Narges Nooritalab Maryam Latifnia Alireza Samarbaf zadeh Najmeh Shams pour Mahshid Talebi Taher Ehsan Mostafavi Mojtba Fattahi Abdizadeh  Background: Ventilator associated pneumonia (VAP) is one of the most common nosocomial infections among patients in Intensive Care Unit (ICU), which has high mortality rate. Among the common agents, Pseudomonas aeruginosa (P. aeruginosa) is the most common causative agents of VAP incidence and resistance to a wide range of antibiotics is increasing. The aim of this study was to assess the prevalence of P. aeruginosa and its drug susceptibility pattern. Methods: This sectional survey has carried out for a year on ICU patients of Ayatollah Kashani hospital who received mechanical ventilation during Oct 2010 to Oct 2011. Sixty eight samples of endotracheal tubes were collected from the patients with signs of pulmonary infection which included fever, purulent secretions, and leucocytosis. Samples were cultured and strains isolated were identified by microbiological standard methods. Antibiotic susceptibility testing was performed on isolates using disc diffusion method and results were interpreted using Clinical and Laboratory Standards Institute guidelines. Antibiotics were grouped into the 4 following categories: 1) Cephalosporins (Ceftazidime, Cefepime), 2) Fluroquinolones (Ciprofloxacin), 3) Aminoglycosides (Gentamycin, Tobramycin, and Amikacin) and 4) Carbapenems (Imipenem). Results: Out of 68 endotracheal samples, VAP was confirmed in 46 cases (67.7%) of these patients. The most common microorganism recovered was P. aeruginosa (15 cases, 32.6%), others were included: Methicillin-resistannt Staphylococcus aureus or MRSA (8 cases, 17/4%), Klebsiella pneumonia (10 cases, 21/7%), Escherichia coli (7 cases, 15.2%), Enterobacter (3 cases, 6.5%), Acinetobacter (2 cases, 4.3%) and 1 case of Citobacter (2.3%). 75% of P. aeruginosa isolated were MDR (resistant to ≥3 classes of antibiotics) and 50% of isolates were resistant to all classes of antibiotics. Conclusions: Due to the increasing prevalence of Pseudomonas MDR, developing strict protocols to prevent increase in drug resistance bacteria appears to be necessary.  Ventilator associated pneumonia Pseudomonas aeruginosa Multidrug resistance. 2013 10 01 16 23 http://rjms.iums.ac.ir/article-1-2764-en.pdf
112-2765 2024-03-29 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2013 20 112 A review on absence epilepsy with focus on basic sciences Maryam Jafarian gorjial@uni-muenster.de Fariba Karimzadeh Hadi Kazemi Ashkan Divanbeigi Ali Gorji Abstract Background: Epilepsy is one of the most common neurological disorders. Seizures could be presented as general or focal attacks. Absence epilepsy is one of the main forms of the general epilepsy and associated with sudden impairment of consciousness and non/convulsive generalized attacks. The prevalence of absence epilepsy was estimated about 10% of all types of seizures and seizures onset usually started between 3-8 years old. The genetic factors play a crucial role in the absence epilepsy. Dysfunction in the thalamocortical network seems to be a main factor in the pathogenesis of the absence epilepsy. Due to abnormal interaction between the reticular neurons, thalamocortical neurons and pyramidal neurons absence epilepsy can be occurred. Extra release of GABA from the reticular neurons leads to suppress the relay neurons in the thalamus. Hyperpolarization of these neurons can open T-type-Ca+2 channels. The burst activity of relay neurons causes extra release of glutamate. These hyperactivities of relay neurons trigger spike-wave discharges in the neocortex. Methods: In this manuscript the epidemiology, etiology, epidemiology, animal models, pathophysiology and the treatment of absence epilepsy were collected by studying the original and review articles. Conclusions: It seems that we should notice this disorder because of its prevalence and side effects. The results of many studies indicated that there are several types of reasons for the onset of this disease. Thus for treatment of these patients we should consider all of the involved elements. Keywords: Absence epilepsy, EEG, Pathophysiology. Absence epilepsy EEG Pathophysiology 2013 10 01 24 35 http://rjms.iums.ac.ir/article-1-2765-en.pdf
112-2766 2024-03-29 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2013 20 112 Assessment of effect of awkward seating postures on attention test performance while working with computer Hamid Reza Mokhtarinia Hamid Shiri Mahnaz Saremi Porya Reza-Soltani Ali Asghar Dadkhah  Background: Undesirable work situations (such as awkward postures) can result in health issues such as musculoskeletal disorders in addition to reduced productivity and efficiency. The main purpose of this study was to determine the effect of these awkward postures on attention task performance. Methods: Hence by designing two different simulated work stations, subjects were asked to complete a relatively complicated cognitive task on a 1 hour experimental session. RULA analytical method was used to evaluate the working postures. A series of mathematical tests was used as a fatigue manipulation tool. Moreover a subjective assessment was conducted by questionnaire. Results: RULA score showed a significant difference between groups (p< 0.001). This difference showed that subjects in awkward posture reported more mental (p= 0.002) and physical fatigue (p= 0.023) than the standard posture group. The results also showed that awkward posture is related to impaired selective attention (p= 0.028) and a poor difference in the simple reaction time (p=0.050) was observed between the groups. Conclusions: This study supports the theory that physical workload can interfere with cognitive performance in a concomitant mental activity.  Cognitive load Awkward posture Mental fatigue. 2013 10 01 36 44 http://rjms.iums.ac.ir/article-1-2766-en.pdf
112-2767 2024-03-29 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2013 20 112 Comparison between entonox and oxygen on lowering labor pain and the progress of labor Shayesteh Parashi Maryam Kashanian Ommelaily Rabbani  Background: Labor is a painful event and its pain is one of the most severe one. Reducing this pain, for lowering the negative effects on pregnant women and also labor progress, has always been under serious concern. The purpose of the present study was to compare the effect of entonox and oxygen for lowering labor pain and also its effect on the progress of labor. Methods: A randomized clinical trial was performed on 120 nulliparas pregnant women who had been admitted in the labor ward of Akbarabadi Teaching Hospital for termination of pregnancy, They had labor pain and were in the active phase of labor, thus enterd the study and randomly were assigned into the two groups of entonox (case group) and oxygen group (control group) (each group with 60 women). Pain was evaluated using Visual Analogue Scale (VAS). Duratin of the active phase and second stage of labor and also the total duration of labor and pain and adverse effects were compared between the two groups. Results: The women of the two groups did not have significant differences according to age (p= 0.6), gestational age (p= 0.4), BMI (p= 0.9), neonatal weight (p- 0.6), Apgar score of 1 and 5 minutes and cesarean deliveries (p= 0.2). Mean pain score at different times (hours 1, 2, and 3) (p< 0.05) was lower in entonox group. Mean duration of labor (p= 0.003), active phase of labor (p= 0.02), and second stage of labor (p=0.02) were lower in entonox group. Side effects were more in the entonox group (p= 0.001).  Conclusions: Entonox is effective for pain relief. It also reduces the duration of labor, however, its side effects are more than oxygen.  Entonox Oxygen Pain Labor Pregnancy Process of labor Pain reduction. 2013 10 01 45 52 http://rjms.iums.ac.ir/article-1-2767-en.pdf
112-2768 2024-03-29 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2013 20 112 Identifying and documenting work processes promoting efficiency in emergency department ofShahid Mohammad Montazeri Hospital in 2012 Hojatolah Askari Ali Samandari Zahra Rastegari Nahid Nadipour  Background: With due regard to the current health care system situation and problems in our organizations and the loss of efficiency, improvement of work processes seems to be essential. Identification and documentation of work procedures are needed in this regard. In this study, the situation in Montazeri hospital has been evaluated in 1390.  Methods: This study is a cross-sectional analytic study. All procedures performed in the emergency department of Shahid Mohammad Montazeri hospital is Najaf-Abad were evaluated. Data were analyzed and guidelines were designed. Results: Six processes within the emergency department were identified including: work flow, patient discharge, transferring patient to other hospitals, transferring patients to wards, outpatient process, and transferring patients to diagnostic units. Conclusions: Application of analytic methods are essential for usage of process-oriented and customer-oriented approach and new concepts such as systems management, quality management, reengineering processes, utilization and development of information technology to access electronic government administration that leads to the modernization of administrative systems.  process assessment identification documentation efficiency emergency service. 2013 10 01 53 66 http://rjms.iums.ac.ir/article-1-2768-en.pdf
112-2769 2024-03-29 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2013 20 112 Effectiveness of educational intervention based on theory of planned behavior for promoting breakfast and healthy snack eating among elementary school students Isa Mohammadi Zeidi Amir Pakpour  Background: Fasting school and increasing consumption of low-value meals among children is associated with adverse health consequences and chronic diseases in adulthood. Since most bad hygienic behaviors are rooted in childhood experiences, the present study examined the effectiveness of educational interventions based on application of the theory of planned behavior (TPB) in improving the breakfast and healthy snacks in elementary school students in the second half of 2011 in Qazvin. Methods: Randomly, 150 students, in case and control group, from six schools participated in a quasi randomized controlled experimental study. Variables were evaluated before and 3 months after intervention. In treatment group, the educational program was conducted with targeted educational pamphlets. The program included five 30-minute sessions that developed regarding the beliefs and structures extracted from the qualitative study and constructs of theory of planned behavior. Data regarding TPB were collected using valid and reliable questionnaire with 40 items by self report method. The food frequency checklist was used to assess students' nutritional habits. Finally, the data were entered into SPSS 17.0 software and statistical tests such as chi square, independent and pooled t test, McNemar and one-way ANOVA with Scheffe post hoc test were used for data analysis. Results: Student’s average age was 8.43 ± 0.83 years old and their sex ratio was equal. Before educational intervention, 57.3 % in the intervention group and 53.3 % in the control group did not use the breakfast. After educational intervention, significant improvement of about 12.6% was seen regarding breakfast eating (p < 0.001). However, significant changes weren’t seen in the control group. There were no significant differences between two group regarding constructs of TPB in the pretest period, however after intervention significant changes in attitude (from 53.26±25.7 to 74.72±28.18) (p<0.001), subjective norms (from 56.97±26.6 to 68.07±26.28) (p<0.001), perceived behavioral control (from 32.57±19.6 to 57.66±35.7) (p<0.001) and intention (from 8.5±3.3 to 11.37±3.11) (p<0.001) was seen in case group. Moreover, results showed that consumption of soft drinks and junk food such as chips, etc. decreased from 74.6 % to 58.3% in case group after education (p<0.05). Conclusions: The finding of this study demonstrates the high prevalence of inappropriate eating behavior in this sensitive period. Educational intervention with the appropriate application of psychological theory correct behaviors associated with a healthy breakfast and snacks at the elementary school. According to appropriate educational field and cost-effective educational intervention in schools, generalization of such training programs in other areas seems critical.  Educational intervention Theory of planned behavior Snack Elementary schools. 2013 10 01 67 78 http://rjms.iums.ac.ir/article-1-2769-en.pdf
112-2770 2024-03-29 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2013 20 112 Detection of rare beta globin gene mutation [+22 5UTR (G>A)] in an infant despite prenatal screening Mohammadreza Mehrnoosh Mehrnoosh Kowsarian Payam Roshan Hossein Jalili Atefeh Khosh Aein  Background: Beta thalassemia is one of the most common hereditary disorders worldwide. In Iran, it is frequently reported from northern and southern provinces. In order to prevent child birth affected by this complication, prenatal screening and diagnosis is carried out nationwide. However in some instances, this program is unable to identify rare mutations leading to thalassemia. Case presentation: A married couple, who took part in prenatal screening and diagnosis, gave birth to a child who is affected by thalassemia major. After several molecular examination, a rare mutation [+22 5UTR (G>A)] in compound heterozygote state with a common mutation [codon 8 (-AA)] was found.  Conclusions: This case study suggests that more advanced molecular evaluations must be integrated in prenatal screening programs to identify rare mutations and antenatal diagnosis of thalassemia cases.  Beta thalassemia Rare mutation Beta globin gene Prenatal screening. 2013 10 01 79 83 http://rjms.iums.ac.ir/article-1-2770-en.pdf
112-2771 2024-03-29 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2013 20 112 Effect of noise exposure on auditory system of industrial workers using pure tone audiometry (PTA), transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) Mohammad Farhadi Saeid Mahmoudian Azardokht Tabatabaei Ahmad Naghavi Morteza Hamidi Tehrani Shima Javadinia  Background: Different studies have shown that Otoacoustic Emission (OAEs) is generated by Outer Hair Cells (OHCs) and these sensory cells are first structures exposed to damage of high level noise. Therefore minor impairment in OHCs can lead to lack of response of OAE. The purpose of the current study is to compare the pure tone thresholds, Transient Evoked Otoacoustic Emission (TEOAE) and Distortion Product Otoacoustic Emission (DPOAE) amplitude in industrial workers experiencing non-permissible noises and official staffs. Methods: This study was conducted as a case control paradigm. The cases included 134 workers exposed to non-permissible noise and control group that constituted 89 official staff. The threshold of pure tone, TEOAE and DPOAE amplitudes were recorded and compared among the subjects. Results: Pure tone thresholds at frequencies of 1- 4 KHz among industrial workers were higher (worse) than the control group and these differences were significant within frequencies of 3 and 4 KHz (p< 0.01). TEOAE amplitudes within 4 frequencies (1-4 KHz) indicated significant decrease among workers group in comparison with control group (p<0.05). Although DPOAE amplitudes indicated decrease within 4 frequencies in the workers group, these differences were statistically significant only in 4.4 KHz (p< 0.01). Conclusions: The decrease of OAE amplitudes and increase in audiometric thresholds in workers may indicate damage to cochlea due to noise exposure. In the current study, the sensitivity and specificity of DPOAE frequency responses was estimated higher than the TEOAE. It seems that DPOAE responses may have been more homogeneic to audiometric results.  Noise-induced hearing loss Transient evoked otoacoustic emission Distortion product otoacoustic emission Pure tone audiometry Noise pollution. 2013 10 01 84 92 http://rjms.iums.ac.ir/article-1-2771-en.pdf