2024-03-28T19:32:56+04:30 http://rjms.iums.ac.ir/browse.php?mag_id=46&slc_lang=en&sid=1
46-1504 2024-03-28 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2010 16 دی Evaluation of Gabapentine Effects on Anxiety and Pain after Ocular Surgery under Local Anesthesia by Tetracaine S.R Entezari S Salarian      Background & Aim: Pain is a significant aspect of post-operative patient morbidity. In this study, we evaluated the efficacy of oral gabapentin administration as premedication in the management of postoperative pain in patients undergone local anesthesia for cataract surgery.   Patients and Method: The study was a randomized, double–blind, controlled trial. Sixty-one patients who were candidates for eye surgery under local tetracaine anesthesia were enrolled in this study and divided into two gabapentin (n=32) and placebo (n=29) groups. In gabapentin group, the patients received oral gabapentin (300 mg) the night before surgery and the morning of surgery before operation. The pain and sedation scores were evaluated 20, 40, 60 and 120 minutes after surgery by visual analogue scale (VAS) and Ramsay score, respectively.   Results: In gabapentin group,the pain score (VAS) during follow-up period was significantly lower than the patients who received placebo (p<0.001). Ramsay score increased significantly in gabapentin group during the follow-up period (p<0.001).   Conclusion: Our study showed that gabapentin could reduce postoperative pain. In addition, total amount of opioid consumption for relieving pain in patients undergone local anesthesia for eye surgery was reduced. Key Words: 1)Gabapentin 2)Local Anesthesia by Tetracaine 3)Post Operative Sedation 2010 1 01 7 13 http://rjms.iums.ac.ir/article-1-1504-en.pdf
46-1373 2024-03-28 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2010 16 دی Application of MAGIC Normoxic Polymer Gel to Electron Beam Dosimetry in Homogeneous Phantom R Ghahraman Asl B Bolouri H Nedaee A Arbabi   Background & Aim: Nowadays, radiosensitive polymer gels are used as a reliable dosimetry tool for verification of 3D dose distributions. Polymer gel dosimeters consist of an aqueous mixture of monomers and a gelling agent, which after irradiation, 3D dose distribution is acquired by using imaging techniques. The aim of this study is to evaluate the application and capability of normoxic polymer gel to determine electron 3D dose distributions at depths of 1 and 4cm beneath the homogenous phantom at 8 and 15 MeV energies.   Material and Method: In this descriptive study, we used MAGIC-type gel dosimeter to measure dose distribution at depths of 1 and 4cm underneath homogeneous slab phantoms by using MRI. The homogenous phantoms were irradiated by 8MeV and 15MeV electron beams. Paired sample t-test and Pearson correlation coefficient were used to analyze the results.   Results: Dose resolution at the range of 0 to 10Gy was 0.23 to 1.55Gy. The mean dose differences and the maximum distance to agreement (DTA) of dose profiles for two diode and gel measurements were 2.5% and less than 2mm, respectively. In addition, 3D dose distribution was obtained at two orientations: transverse and axial.   Conclusion: This study shows the feasibility of using gel dosimeters to evaluate dose distribution for different electron beams. Key Words: 1) Polymer Gel Dosimetry 2) Electron Beam 3) Homogeneous Slab Phantom 4) MRI Method 2010 1 01 14 22 http://rjms.iums.ac.ir/article-1-1373-en.pdf
46-1374 2024-03-28 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2010 16 دی Comparative Study of the Frequency of Paraoxonase1 Gln/Arg192 Polymorphism in Patients with Coronary Artery Stenosis and Control Subjects A Ghasemi S Fallah M Firoozrai L Hosseini Gohari   Background & Aim: Serum paraoxonase (PON1) is an HDL (high density lipoprotein) associated esterase that prevents the oxidation of LDL (low density lipoprotein). A common polymorphism in coding region of the paraoxonase gene involving a Gln (Q) to Arg (R) interchange at position 192 has been demonstrated to affect PON1 activity. It has been shown that R alloenzyme is less efficient at preventing LDL from oxidation and this finding may explain why in some studies the paraoxonase RR genotype has been found at an increased frequency in coronary artery disease (CAD) therefore, to investigate the significance of this polymorphism in pathogenesis of CAD, we performed a comparative study of the frequency of this polymorphism in patients with stenosis and control subjects.   Patients and Method: In the present case-control study, PON1 genotypes were determined in 174 subjects who underwent coronary angiography. CAD (>50% stenosis) was detected in 99 subjects (patients) and 75 subjects with <10% stenosis served as controls. PON1 genotypes were determined by PCR and AlwI restriction enzyme digestion. Students’ t-test was used to compare age, BMI, and lipid profile in control and patient groups. Genotype frequencies were compared by Chi-square test. The relationship between PON1 genotypes and the severity of disease in patient group was evaluated by Chi-square test.   Results: The frequencies of the QQ, QR and RR genotypes were found as 28.3%,50.5% and 21.2% in patient group and 45.3% , 42,7% and 12% in control subjects respectively ( c 2=6.12 p=0.046). The association of this polymorphism with the severity of stenosis was also evaluated,but according to the results of the distribution of PON1 genotypes and compared with the severity of stenosis,it was not statistically significant ( c 2=2.67 p=0.27). Conclusion: These results suggest that Gln/Arg 192 genotype is a risk factor for stenosis but does not have any effects on the severity of this disease. Key Words: 1) CAD (coronary artery disease) 2) PON1 (paraoxonase1) 3) Polymorphism 2010 1 01 23 31 http://rjms.iums.ac.ir/article-1-1374-en.pdf
46-1505 2024-03-28 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2010 16 دی Evaluation of Immune Response to Hepatitis B Vaccination and Effects of Booster Dose in Chronic Transfusion Patients A Azarkeivan M Eslami SH Ghazizadeh H Afradi B Haji Beigi M Nasiri Toosi   Background & Aim: Hepatitis B vaccine is in national vaccination programs. In healthy individuals the immune response is complete d by three-dose injections in 95% of cases and remains complete with time. However, in patients with chronic transfusion this immune response may be incomplete . In such patients, it is advised to check HBs antibody periodically, and use booster dose in cases with low titer of HBs antibody. In the present study we studied the immune status of thalassemic patients for Hepatitis B Virus (HBV) and the booster effects of vaccine.   Patients and Method: Our cross-sectional study was conducted in Adult Thalassemia Clinic in Tehran.We checked Hepatitis B surface antigen (HBsAg), Hepatitis B surface antibody (HBsAb),and Hepatitis B core antibody (HBcAb). We classified the immune status of patients into four categories: 1) immune to HBV via the vaccination (positively vaccinated) if HBsAg:negative, HBsAb:positive, HBcAb:negative2) immune to HBV via the natural disease (past infection) if HBsAg:negative, HBsAb:positive, HBcAb:positive3) non-immune to HBV (negative) if all three parameters were negative4) carrier of HBV (carrier state) if HBsAg was positive and HBsAb and HBcAb were both negative.   We had grading of immunity to HBV vaccine through antibody (HBsAb) titration as below: positive if antibody level was more than 100 IU/mL,negative if antibody level was less than 10 IU/mL, and weakly positive if antibody level was 10-100 IU/mL. SPSS statistical software (version 10) was used for the analysis. We analyzed and compared variables using Pearson and Chi-square tests and p-value for meaningful correlations.   Results: We studied 416 patients including 302 (72.5 %) thalassemia major , 104 (25 %) thalassemia intermediate, 7 sickle thalassemia, and 3 Hb H disease. There were 247 (58.4 %) males and 169 (40.6 %) females with a mean age of 25.6. According to our classification, 289 (69.4%) were positively vaccinated, 80 (19.2 %) were immune to HBV from past infection, 40 (10.5 %) were negative and 3 (0.7 %) were carrier state of HBV. We had 319 (76.6%) cases of HBsAb level more than 100 IU/ml (positive), 77 (18.5 %) between 10-100 IU/mL (weakly positive) and 20 (4.8 %) less than 10 IU/mL (negative).   Conclusion: HBV is one of transfusion transmmitted infections with a high rate of infectivity via tear ,saliva, urine , semen, in addition to blood transfusion. HBV vaccination is obligatory for thalassemics and has been in national vaccination program since 1993. Response rate with vaccination is complete and it is not needed to use booster in healthy people, but for thalassemics it is advised to check the antibody level and administer booster dose for patients with low titer of HbsAb.This protocol can maintain immunity and prevent the decrease in antibody titer in the patients. Key Words : 1) Thalassemia 2) Hepatitis B 3) Immune Response 4) Vaccination 5) Booster Dose 2010 1 01 32 39 http://rjms.iums.ac.ir/article-1-1505-en.pdf
46-1376 2024-03-28 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2010 16 دی A Case Report of Cerebral Nocardiosis in a Patient with Crohn\'s Disease N Khalesi R Taghipour M Aflatoonian   Introduction : Cerebral nocardiosis is a rare complication in patients who receive immunosuppressants, those with malignancy , AIDS, and transplant recipients.   Case Report : Herein we present a case of Crohn’s disease who was being treated with prednisolone, salazine and azathioprine but suddenly faced a decrease in the level of consciousness and presented with the signs of focal neurologic deficit. Imaging studies revealed brain abscess and the patient underwent a surgery. Bacterial cultivation and histologic examination indicated cerebral nocardiosis and the patient was successfully treated with antibiotics.   Conclusion :As far as we know, this was the first case of cerebral nocardiosis in a patient with Crohn’s disease who was receiving salazine, prednisolone and azathioprine. So far no similar case has been reported in English articles. Key Words: 1) Nocardiosis 2) Crohn’s Disease 3) Brain Abscess 2010 1 01 40 63 http://rjms.iums.ac.ir/article-1-1376-en.pdf
46-1377 2024-03-28 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2010 16 دی Incidence Rate of Physical and Verbal Violence Inflicted by Patients and Their Companions on the Emergency Department Staff of Hazrate-e-Rasoul Hospital in the Fourth Trimester of the year 1385 A Hasani M.M Zaheri M Abbasi H Saeedi M Hosseini M Fathi   Background & Aim: The stressful environment of the emergency department exposes the staff to the hazards posed by physical and verbal violence.This can affect not only the job security and satisfaction among the personnel but also the service and care offered to the patients. This study has been designed to determine the incidence rate of physical and verbal violence inflicted by patients and their companions on the emergency department personnel of Hazrate-e-Rasoul Hospital in the fourth trimester of the year 1385.   Patients and Method: In this cross-sectional descriptive study, all the emergency department staff of Hazrat-e-Rasoul Hospital were asked to fill in a questionnaire about experiencing physical and verbal violence in the last trimester of the year 1385. 166 respondents included 17 attending physicians, 33 residents, 15 interns, 32 nurses, 15 ancillary staff, 20 laboratory technicians, 10 radiology technicians, 18 security guards and 6 orderlies. Data were collected and analyzed using SPSS software version 15 , t-test and Chi-square.   Results: The mean age of the staff was 32.20‌±7.67 years. 39% of the subjects were female and 61% were male. 77.5% had experienced verbal or physical violence at least once.The mean rate of verbal violence in the fourth trimester of the year 1385 was 31.1 times. 74% of verbal assaults were committed by men and 26% by women. 15.93% of the emergency department staff had experiences of physical violence in this trimester, and in 78% of the cases the violent person was a man and in 22% of the cases a woman. 13% of the emergency staff felt a high degree of security during their shift work, 52% felt a moderate degree of security, 27% felt a low grade of security and 8% felt no security during their shift work. 96.15% of the staff had received no education in this regard, and 87.4% reported that they think security measures provided to decrease violence in emergency department are insufficient.   Conclusion: This study shows that the incidence of violence in emergency department is high and this is a concern for the emergency department staff. Most of the violent behaviors which were displayed by patients’ companions can be controled by considering a good waiting area for them and avoiding their crowding in the ward. Key Words: 1) Verbal Violence 2) Physical Violence 3) Emergency Department Staff 2010 1 01 46 51 http://rjms.iums.ac.ir/article-1-1377-en.pdf
46-1378 2024-03-28 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2010 16 دی Using Dot-ELISA Method to Study the Prevalence of Human Hydatidosis in People Referred to Blood Transfusion Center in Tehran, 2005-2006 M Tavalla L Akhlaghi H Ourmazdi SH Sarvi E Razmjoo M Shokrabi M.R Siavoshi M Beiromvand   Background & Aim: Hydatidosis, which is seen in human and other hosts, is caused by the infective larval stage of Echinococcus granulosus. In most cases, diagnosis of hydatid cyst is not easy due to a long term incubation period and lack of specific clinical symptoms, and remains asymptomatic for years in some patients. The aim of this study was using the easy and sensitive serologic technique of Dot-ELISA to determine the prevalence of hydatid cyst in individuals referred to Blood Transfusion Center in Tehran between 2005 and 2006.   Patients and Method: This cross-sectional study was done on 1100 people who were referred to Blood Transfusion Center and the results were analyzed by running t-test and Chi-square test. B antigen is one of the principal specific and heat resistant compounds of hydatid cyst. To perform Dot-ELISA test,this antigen was purified from the sheep hydatid fluid. In addition, by using SDS-PAGE method, the 8-12 kDa molecular weight proteins of this antigen were determined. 1gµ of purified B antigen was dotted on the nitrocellulose disk and 1/250 diluted serum samples were added. Then, the incubation was performed against the HRP conjugated antihuman. In the final step, DAB stain was added as an indicator. Brown sediment indicated a positive result.   Results: From 1100 tested blood samples, 18 (1.63%) were hydatid positive, which can indicate the cryptic hydatid cyst infection in the ordinary people of Tehran. The observed rate of hydatid infected individuals is statistically significant, considering the studied population as a representative of Tehran's population. Owing to the long incubation period of the disease, the cyst is usually diagnosed in old patients at the stage when surgical treatment is necessary. The surgery complications might be unendurable in old age patients. Consequently, it is suggested that screening programs be run to detect and treat the patients at the primary stage of the infection.   Conclusion: This study shows 1.63% of people referred to Blood Transfusion Center in Tehran have positive serum for hydatid cyst. Key Words: 1) Hydatidosis 2) Dot-ELISA 3) Echinococcus granulosus 2010 1 01 52 58 http://rjms.iums.ac.ir/article-1-1378-en.pdf
46-1379 2024-03-28 10.1002
Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2010 16 دی A Case Report of Cerebral Nocardiosis in a Patient with Crohn\'s Disease A Zare Mirzaee N Shayanfar A Ostadali Makhmalbaf   Introduction : Cerebral nocardiosis is a rare complication in patients who receive immunosuppressants, those with malignancy , AIDS, and transplant recipients.   Case Report : Herein we present a case of Crohn’s disease who was being treated with prednisolone, salazine and azathioprine but suddenly faced a decrease in the level of consciousness and presented with the signs of focal neurologic deficit. Imaging studies revealed brain abscess and the patient underwent a surgery. Bacterial cultivation and histologic examination indicated cerebral nocardiosis and the patient was successfully treated with antibiotics.   Conclusion :As far as we know, this was the first case of cerebral nocardiosis in a patient with Crohn’s disease who was receiving salazine, prednisolone and azathioprine. So far no similar case has been reported in English articles. Key Words: 1) Nocardiosis 2) Crohn’s Disease 3) Brain Abscess 2010 1 01 59 63 http://rjms.iums.ac.ir/article-1-1379-en.pdf