[ relationship of febrile convulsion with serum magnesium level in children between 6 months and 5 years of age]

Seizure is the most common neurological disorder among children that not only is known as a diagnosis but also as a clinical manifestation of several underlying diseases. Its pathogenesis is not yet known, but the genetic background and alterations in neurotransmitters and the rare elements such as magnesium may be involved. This study was conducted to evaluate the relationship between magnesium levels in children and seizure. This study was a case - control study and included 78 children aged between 6 months and 5 years with febrile convulsion and 74 children hospitalized for reasons other than febrile seizure in Besat Hospital from 2011 to 2012. Demographic characteristics, history and duration of disease were obtained from their parents and if the patients met the inclusion criteria, blood samples were taken for serum preparation. After preparation of serum using Hitachi 902 automated analyzer and Pars Azmoon kits, magnesium levels were measured in milligrams per liter by spectrophotometeric method. Normal range of magnesium level was considered 15-23 mg/ liter. Using SPSS version 18, descriptive statistic tests and t-test, the data were used to compare magnesium levels in both sexes and groups. We used chi-square and OR calculation to calculate the odds ratio for seizures. The highest frequency belonged to seizures with duration of 5 minutes [24%] and tonic-clonic seizures [74/4%]. Mean levels of magnesium in the boys and girls were 22/87 +/- 3/18 and 24/77 +/- 5/89 respectively, which showed a statistically significant difference [p = 0.018]. The mean magnesium level was 24/09 +/- 3/87 in children with seizure and 23/40 +/- 5/50 in healthy children which had no differences [p = 0.37]. The odds ratio for the risk of seizure in children with magnesium deficiency was 1.38.s. In general we can say that magnesium levels in children with seizure and healthy children do not differ and deficiency of this element alone cannot cause seizure, although we found higher than normal levels of magnesium in most children in our study

[ relationship between fetal gender and outcome of pregnancy in the term pregnant women]

Identification of fetus health risk factors can be helpful in the diagnosis, immediate treatment, and prevention of irreversible damages on the fetus. Fetal sex is considered as a risk factor in fetal and neonatal conditions. The aim of this study was to evaluate the relationship between fetal gender and adverse fetal outcomes in the term pregnant women. This cross-sectional study was performed in Besat Hospital in Sanandaj, in 2011 and included 2389 pregnant women. Gestational diabetes and presence of any underlying chronic disease such as hypertension, asthma, diabetes, and cardiac diseases were considered as our exclusion criteria. Data about stages and conditions of delivery and demographic variables were recorded in a questionnaire for every subject. Data about the neonates including Apgar score, fetal distress, and macrosomia were collected and recorded. Using SPSS 16 software, data were analyzed by descriptive and inferential statistics including chi-square, Fisher's exact test, and t-test. There were no statistically significant differences between male and female neonates in relation to maternal age, gestational age, duration of the first and second stages of labor, and average time of rupture of membrane [p>0.05]. However, male neonates had higher birth weights [p=0.0001]. In addition, there were no statistically significant relationship between boys and girls in regard to preeclampsia, mode of delivery, Apgar score, meconium, detachment of placenta, IUGR, umbilical cord prolapse, and stillbirths [p>0.05]. However, prevalence of fetal distress syndrome was higher in boys [OR=1.83]. Apart from respiratory distress syndrome, fetal sex is not associated with any other adverse fetal outcome. Even though, frequencies of cesarean delivery and Apgar scores of less than 7 were more in the boys compared to the girls

[Removal of acid black 1 dye by carbon nanotube-dendrimer composite: operation parameters, isotherms and kinetic]

Organic dyes are the major pollutants produced in many industries and have different adverse effects on water resources. The aim of this study was to synthesize a novel adsorbent with high adsorption capacity and evaluate its efficiency in removing organic dyes from aqueous solutions in a batch system. This study was an applied research in which carbon nanotube composite-dendrimer was synthesized and its chemical properties was evaluated by fourier transform infrared spectroscopy. Acid blue 1 dye was selected as a model to evaluate the decolorization capacity of the adsorbent. The effects of the parameters influencing the adsorption process such as initial dye concentration, adsorbent dose, pH and the effect of inorganic salts were also studied. Longmuir and Freundlich isotherm models and pseudo first order and pseudo-second-order kinetic models were used for data evaluation. In this study removal of acid black 1 dye by carbon nanotube-dendrimer composite followed the Longmuir and Freundlich isotherm and pseudo-second-order kinetic models. We also found that the synthesized adsorbent had a maximum adsorbent capacity equal to 690 mg/g, when the concentration of dye was 100 mg/l. We concluded that carbon nanotube composites - dendrimer can be used as an effective adsorbent for removal of dyes form colored effluents

[Evaluation of imprinting pattern in patients with obsessive- compulsive disorder [OCD] in Sanandaj]

Obsessive-compulsive disorder is [OCD] one of the serious problems which imposes high economic and social expenses on the society. The aim of this study was to identify a probable transmission pattern in the families of the patients with OCD. This cross sectional study included 150 patients in the psychiatric centers in Sanandaj. Diagnosis of the disorder was confirmed by a psychiatrist. History of signs and symptoms of OCD in the maternal and paternal relatives of the patients, including the type, severity and duration of the signs and symptoms were recorded in a questionnaire for every patient. We used descriptive statistics to determine relative and absolute frequencies, and chi-square test to analyze the relationship among the nominal variables. The results of this study showed that contamination and pathological doubt were the most frequent patterns. Washing was the most frequent pattern of obsession which was observed in 42% of the patients. The family history of OCD were18% in paternal and 44.7% in maternal relatives. 35.3% of the patients had no family history of OCD. The results indicated that family history of OCD, especially maternal, is important and OCD is more likely to occur in the subjects with family history of this disorder. However more studies are needed to identify the exact genetic pattern

[Assessment of performance of the hospitals of Kurdistan University of Medical Sciences by use of Pabon Lasso Model [2007-2011]]

One of the useful methods to assess hospital performance is Pabon Lasso Model. The aim of this study was to assess performance of the hospitals of Kurdistan University of Medical Sciences by Pabon Lasso Model from 2007 to 2011. In this cross sectional study we used turnover rate, bed occupancy rate and the average duration of hospitalization as our indicators to assess the performance of 12 hospitals of Kurdistan University of Medical Sciences by Pabon Lasso Model from 2007 to 2011. We used Excel software for data analysis. In this study we found a bed occupancy rate of 62.5% and a bed turnover rate of 79.2 times. The average duration of hospitalization was 3.4 days. One [8%] hospital was located in zone 1, four [33%] hospitals in zone 2, five [42%] hospitals in zone 3 and two [17%] hospitals in zone 4. According to the results of this study it can be suggested that the development of outpatient services, transmission of beds between the hospitals and prevention of development and extension of medical center scan be considered as the main strategies for increasing the efficiency of the hospitals

[Percentage of out-of-pocket payment for health services by people of Kurdistan in 2010]

In all countries a part of household income is spent on health-related costs. The amount and distribution of this financial contribution impose a significant burden of health problems to communities. The aim of this study was to determine the percentage of household's direct payments for health care services and health equipment in Kurdistan. This descriptive cross-sectional study included 1518 households living in urban and rural areas of Kurdistan, in winter of 1388, and they were divided into 150 clusters. Every cluster included 10 households. Data were collected by using a questionnaire consisted of two parts: household characteristics and household health expenses including; outpatient costs, the costs of hospitalization, medicines, medical equipment, nursing care, paramedical and medical diagnostic measures. The costs of outpatient health care services [visits, diagnosis, drug prescription and medical devices] and hospitalization were determined during four weeks for each member of the family or the total costs and expenses paid by the household were recorded in the questionnaire. Collected data were analyzed by using spss.16 software and mean, standard deviation and median were calculated. People contribution for prescription drugs was 43/3% and for other non-prescription drugs and consumer goods was 100%, for durable medical equipment 95/4%, for diagnostic measures especially in private offices, clinics or home 75/5%.Household contributions to the cost of medical services by GP, medical specialists, psychiatrists and dentists were 62/3%, 76/5%, 75/5% and 80/9 % respectively. 13/8% of the inpatient fees were paid by the patients. The mean cost of family health services in our study was 85380 +/-252012 with a median of 41050 Toman .The out-of-pocket payment by people was 55%. In general, considering the high percentage of people's contribution to health service costs, expansion of the roles of the insurance organizations to achieve the objectives of coverage of over 90% of population and increasing public and private sector contribution to more than 70 % in health services, is essential

[Assessment of the quality of educational services by the SERVQUAL model: viewpoints of the students at Kurdistan University of Medical Sciences]

Students as the main stakeholders of educational system evaluate the quality of educational services according to their expectations and conceptions. Therefore the viewpoints of students on the quality of educational services are regarded essential in all scientific centers in the world. This study was conducted to determine the gap between expectations and conceptions of the students at Kurdistan University of Medical Sciences'. This was a descriptive-analytical study. The study population included students of Kurdistan University of Medical Sciences studying in four faculties including; Medicine, Paramedical, Health and Nursing in the first semester of 90-91 academic year. 200 students were selected on the basis of systematic random sampling. Data gathering tool was standard ServQual questionnaire .198 students completed the questionnaires. Using SPSS software, data analysis was performed by descriptive statistics as well as Mann Whitney U and Kruscal Wallis tests. Although there was negative gaps in all five dimensions of quality including; assurance, responsiveness, empathy, reliability and tangibility, maximum and minimum quality gaps belonged to responsiveness [-2/02] and assurance [-0/32] respectively. There was no statistically significant differences between male and female students in regard to the gap in the five dimensions of service quality [p>0.05]. Also there was no statistically significant relationship in the five dimensions of service quality and education levels of the students [p>0.05]. In all five dimensions of service quality, There was a statistically significant difference in expectation scope between male and female students [p=0/0001]. There are negative gaps in all five dimensions of educational service quality between expectations and conceptions of the students at Kurdistan University of Medical Sciences. To reduce this gap, it is necessary to revise educational methods and management.

[Comparison of the effect of tetracycline 1% and erythromycin 0.5% ophthalmic ointments for prophylaxis of ophthalmia neonatorum]

Ophthalmia neonatorum is a kind of conjunctivitis occurring in infants younger than 4 weeks of age and is the most common eye disease of the newborns. This study compares the effect of tetracycline 1% eye ointment with that of erythromycin 0.5% ophthalmic ointment on decreasing the incidence rate or prevention of neonatal conjunctivitis. This study was a controlled randomized single blind clinical trial without placebo. The study included 330 term neonates born by normal delivery or cesarean section in the post-delivery ward of Besat Hospital in Sanandaj City from the spring of 2010 to the spring of 2011. The neonates were assigned to three equal groups, A, B and C, every group consisted of 110 neonates. Before intervention, written consent from the parents was obtained. One hour after birth one cm of tetracycline 1% ophthalmic ointment and one cm of erythromycin 0.5% ophthalmic ointment was used for group A and group B respectively. Group C [control group] did not receive any medication. All the infants were examined at the end of the first, second and fourth weeks. Data were introduced into SPSS software and analyzed by chi-square and t-test. Conjunctivitis occurred in 22 [20%], 16 [14.5%] and 25 [22.7%] neonates in tetracycline, erythromycin and control groups respectively. Considering the high prevalence of conjunctivitis in the control group and considering the complications that can result from neonatal conjunctivitis [especially gonococcal conjunctivitis], prevention of neonatal conjunctivitis seems quite logical. Since use of tetracycline and erythromycin did not led to a significant decrease in the incidence of conjunctivitis, more comprehensive studies on the effect of other drugs such as povidone iodine or silver nitrate to find an appropriate medication for prevention of neonatal conjunctivitis, seems necessary

[ frequency of microscopic colitis in the patients with chronic diarrhea in Kurdistan province in 2009]

Microscopic colitis is a cause of chronic watery diarrhea which may be accompanied with abdominal pain and weight loss. The purpose of this study was to determine the frequency of microscopic colitis in the patients with chronic diarrhea in the subspecialty center in Sanandaj in 2009. This was a cross sectional study and included 115 patients with non-bloody chronic diarrhea in Sanandaj in 2009. Sampling method was census. Demographic data were recorded in a checklist for every patient. Then colonoscopy was performed and biopsy samples were obtained for pathological examination and determination of the type of colitis. Fifty patients [%43.4] had microscopic colitis [4.3 collagenous and%39.1 lymphocytic] and 65 patients [%56.6] had not this disease. Female to male ratio was 2 to 3. The majority of the patients were under 40 years of age and the mean values of the age of the patients with collagenous and lymphocytic colitis were 29 and 35.4 years respectively. The frequency of microscopic colitis [lymphocytic and collagenous] in the patients with non-bloody chronic diarrhea was high and the age of onset of this disease in Kurdistan was low, while in other parts of the world the disease occurs in the individuals over 50 years of age

[Comparison of the therapeutic effects of fluoxetine, citalopram, estrogen and progesterone and placebo in the treatment of hot flushes in perimenopausal women]

Frequency and morbidity of hot flushes has led to development of multiple hormonal and non hormonal treatments in the recent years. Fluoxetine and citalopram with limited side effects and high tolerability by most women with hot flushes have attracted the researchers' attention but there are plenty of rooms for disagreement on their effectiveness. In this study the effects of fluoxetine, citalopram, hormone therapy and placebo on perimenopausal flushes, were compared with one another. This study was a randomized clinical trial [RCT]. The study population included 46 to 55 year old women with hot flush who had lack of menstruation and reached menopause for at least 1 year. Sampling method was blocked randomization and the patients were divided into four groups including fluoxetine, citalopram, hormone therapy and placebo groups. The collected data were introduced into the SPSS software and analyzed by chi-square, ANOVA and Kruskal-Wallis tests. There were no significant differences between the groups in the mean duration of menopause, history of any chronic disease, drug use and frequency of hypertension before intervention [p<0.05]. But there was significant differences between the values of the mean age of the groups before intervention [P=0.03]. The mean frequency of hot flushes decreased by 57%, 74.7%, 81.8% and 80% after intervention in estrogen+progesterone, fluoxetine, citalopram and placebo groups respectively [P<0.001]. Considering the high rate of success of the treatment of the hot flushes with citalopram and fluoxetine and few side effects of these drugs, they can be regarded as good alternatives to hormone therapy and for thoese who are not willing to take estrogen

[Investigation of the causes of therapeutic abortion requests in Legal Medicine Organization in Sanandaj, from 2004 to 2008]

Passing the medical abortion law in 2006 brought about, a major change in dealing with cases of therapeutic abortion. This study was performed to investigate the causes of therapeutic abortion request made by pregnant women who had referred to the Legal Medicine Organization in Sanandaj, from July 2004 to July 2008. This was a descriptive cross sectional study and included all the files of therapeutic abortion [58 files] in the Forensic Medicine Organization in Sanandaj from 2004 to 2008. Sampling method was census. The collected data were analyzed by using SPSS statistical software and frequency tables were prepared. Most requests for therapeutic abortion were made in 2008 and included 18 cases [31%] and the least number of requests was in 2004 with six cases [10.3%]. 16 patients between 30 and 35 years of age had the highest rate of abortion [27.6%]. The lowest rate of abortion belonged to those with less than 18 years of age with one case [1.7%]. The mean gestational age was 11.8 +/- 4.1 [range 5-19 week]. The approved cases of therapeutic abortion included 34 patients [58.6%].The prevalence rates of requests for abortion license due to fetal and maternal causes were 22 [37.9%] and 36 [62.1%], respectively. Among the confirmed cases of therapeutic abortion 18 [52.9%] had fetal causes and 16 [47.1%] had maternal causes. The most common fetal causes for therapeutic abortion permit was anencephaly with 7 cases [20.6%] and thalassemia with 3 cases [8.8%] and the most common maternal cause was cardiovascular diseases with 10 cases [29.4%]. The results of this study indicated that after passing the medical abortion law, the numbers of requests for therapeutic abortion due to fetal causes are on the rise. Further interventions to promote knowledge in the field of therapeutic abortion among the medical staff and in the society and encourage use of certain methods of contraception by women with advanced cardiovascular disease are recommended

[Systematic survey of accreditation models for designing a national model]

People, patients, governments and third party payers seek indepth accurate assessment of health care quality world wide. To meet this aim, countries have different approaches to improving quality and standards, which licensure, certification and accreditation are some of these systems developed for this purpose. Because of maximum and challenging standards, accreditation is distinguished as the most powerful method. The aim of this study was to perform a systematic review of advantages and disadvantages of accreditation models to select and use as the reference model to develop a national accreditation model. In this study, a systematic review was conducted in SID, Ovid Medline and PubMed databases using key words of accreditation, hospital, medical practice, clinic, accreditation models and health care in both English and Persian languages. Considering defined inclusion and exclusion criteria, 2379 articles were identified. After that, based on the advantages and disadvantages of accreditation models, titles, abstracts and content of selected articles were studied step by step and finally 83 articles were selected and analyzed. Then the findings were extracted and summarized in the summary tables. Finally, based on 25 selected items the best accreditation models in the world were compared with one another in order to develop a national model. The accreditation models which were of much debate were JCAHO from USA and CCHSA from Canada, and the accreditation models of UK, Australia and France were in the next places. The results of this study were compatible with those of previous studies. According to the comparative items the accreditation models of JCAHO and CCHSA had the most advantages and the least disadvantages respectively. Based on the defined items, the JCAHO accreditation model and then CCHSA model are the models which can be best applied and other important accreditation models such as ACHS of Australia, ANAES of France, QHNZ of New Zealand and UK accreditation models are almost as the same level as JCAHO and CCHSA models. Therefore it seems that the Joint Commission accreditation model [JCAHO] is the best model which can be used as a benchmark to design a national accreditation model

[Influence of different intensities of resistance exercise on inflammatory markers in young healthy men]

Previous studies showed that inflammation is an important factor in the pathogenesis of atherosclerosis. IL-1beta, IL-6, and HS-CRP are biomarkers with a predictive value in cardiovascular disease. Considering that the effects of resistance training at moderate and high intensity on inflammatory markers have not been studied, the purpose of this study was to investigate the effects of resistance exercise intensities on levels of IL-1beta, IL-6, HS-CRP and fibrinogen. Thirty healthy young male volunteer students were randomly divided into 3 groups of 10 participants each. Groups I and II performed moderate [45-55% 1RM] and high intensity [80-90% 1RM] resistance exercise for 6 consecutive weeks [3 days/week] respectively. Group III, was the control group. Seven exercise stations were employed per session. The rest intervals between the sets of the protocols and stations were 1-2min and 3min respectively. Serum levels of IL-1, IL-6, HS-CRP and plasma level of fibrinogen were assessed before and after resistance training periods. Statistical analysis of data was accomplished using analysis of variance with repeated-measures design. There were no significant differences in serum levels of IL-1 and IL-6 before and after the training period. HS-CRP was decreased in groups I and II, but this was not significant [p>0.05]. Post test, however, HS-CRP in the two exercising groups was significantly lowered [p=0.008], compared to the control group. Plasma levels of fibrinogen decreased significantly in the high intensity resistance exercise group. In conclusion, short term resistance training can have beneficial effects on serum levels of some proinflammatory markers in healthy young males. In addition high intensity resistance training decreases plasma level of fibrinogen

role of family physician in case finding, referral, and insurance coverage in the rural areas

WHO suggest that family physician is the core in the world efforts for quality improvement, cost effectiveness, and equity in the health care systems. This study evaluates the impact of the program on accessibility of the services, case finding, patient referral, feedback process and insurance coverage in the rural health units. This study was quasi experimental. It compared the function of four health centers and eight health houses in the last three months of year 2004 with 2008. Data extracted from the available documents in the health units. Descriptive and analytical analysis was performed by using SPSS software. The presence of physicians in health centers were 75 and 100 percent for 2004 and 2008 respectively, this rate for midwives were 50 and 100 percent for the same years respectively. The total referral cases to the hospitals were 2676, the feedback rate was recorded in 36% of the cases. In this case the follow up rate by physicians was 0% in 2004 and 3.17% in 2008. Insurance coverage rate was 27% and 97% for 2004 and 2008 respectively within a meaningful P value range at 95% CI. The findings of this study show that the family physician program has the positive impact on function of health units in terms of availability of physicians and midwives and also insurance coverage at health centers in rural area. No impact on patient follow up and case referral rate was detected

[Mode of feeding milk at one year of age and its relationship with respiratory infections of infants referred to healthcare centers of Sanandaj city, 1386]

The advantages of breast feeding especially exclusive breast-feeding have been clearly demonstrated. It has also been emphasized in our religious instructions. Breastfeeding infants by mother as an inclusive food could empower immunology system of infants. Breastfeeding as the ideal method of feeding infants is well accepted around the world because of its protective effect against intestinal and respiratory infection. The present study therefore designed and conducted to determine modes of breast feeding at one year age and its relation to respiratory infections of infants referred to healthcare centers of Sanandaj during 1386. In this case-control study, 100 infants with acute respiratory infection were recruited conveniently. The samples were drawn from hospitals and health centers. 100 matched healthy infants were also recruited to the study from the health centers. The diagnosis of ARIs were made by physicians. Data were gathered through structured interviews based on a questionnaire contained demographic factors and modes of breastfeeding. The data was analyzed using Chi-square and t student tests. A significant correlation was demonstrated between breastfeeding modes in two groups of infants with Acute Respiratory Infection and healthy infants [P=0.000] OR-5.44 [2.15:13.76]. It was also found that there is a significant relationship between breastfeeding modes with starting time of complementary nutrition and exclusive breastfeeding in both groups. The study revealed the increased risk of respiratory infections among infants who don't receive breastfeeding. Breastfeeding during the first year have considerable protective effects against respiratory infections and could significantly reduce the disease duationa dn related mortality rate. Exclusive breastfeeding during first six months reduce the risk of respiratory and infectious diseases among infants because of its ingredients. Public education regarding the differences of breastfeeding compare to other milk sources could be effective

[Toxoplasmosis infection in the pregnant women in the first half of pregnancy, in Kamyaran in 2008]

Toxoplasmosis is an infectious disease caused by Toxoplasma gondii which is an obligate intracellular parasite. Toxoplasmosis in the first trimester of pregnancy can lead to dangerous fetal complications. After diagnosis of toxoplasmosis, proper treatment or curettage of the fetus should be attempted in order to prevent long term disabilities in the newborn. The aim of this study was to determine IgM and IgG anti toxoplasma antibodies in pregnant women in the first trimester. This was a discriptive analytic study. 201 blood samples were obtained from pregnant women in the first trimester. Anti toxoplasma IgG and IgM antibodies were measured by ELISA method and data were analyzed by use of descriptive statistics. In this study, 24 subjects [12%] were IgM positive, 54 [27%] IgG positive and 33 [16.5%] were positive for both IgM and IgG antibodies. In general 55% of pregnant women were seropositive for IgM, IgG or both. The results of this study showed a significant relation between education level and serum levels of anti toxopalsma antibodies [P?0.05], but no significant relationship was found between: occupation, contact with cats or other pets, consumption of unwashed fruits and vegetables, raw or underdone meat and raw milk with presence of toxoplasmosis. Considering the high prevalence of serum anti toxoplasma antibodies in pregnant women in the first trimester, screening of the pregnant women in the first trimester is necessary to prevent fetal complications or to take therapeutic measures for the affected newborns

[Assessment of thyroid dysfunction in patients with beta- thalassemia major]

The thalassemia is believed to be the most prevalent of all human genetic diseases and caused by mutations of the synthesis of hemoglobin.Regular blood transfusions are necessary in major thalassemia patients. The combination of transfusion and chelation therapy has dramatically extended the life expectancy of thalassemic patients but an important complication is iron overload in different organs of the body. Despite improved hematologic care in recent years, in these patients primary hypothyroidism and other endocrine disorders due to iron overload are still common complication and affect the patient's quality of life. The aim of this study was to identify the prevalence of thyroid dysfunction and to determine its correlation with ferritin plasma level, amount of blood transfused and liver function in thalassemic patients. In this cross sectional study, fourty patients with beta thalassemia [20 males and 20 females; mean age, 12.7 +/- 5.8 yrs] were evaluated. Serum ferritin levels, SGOT, SGPT were evaluated by ELISA method and TSH were evaluated byIRMA. Hypothyroid index was defined according to the criteria of Kronberg et al. Normal thyroid hormone values were found in 34 patients [85%] and 6 [15%] had subclinical hypothyroidism. Mean ferritin levels in hypothyroid and normal patients were2220 +/- 1056 mg/l and 2028 +/- 1548 mg/l respectively, [p = 0.2]. Thyroid dysfunction could not be correlated with amount of blood transfused, liver function or ferritin plasma level. The high rate of thyroid dysfunction may be the result of poor disease control and manegement in early life when irreversible tissue damage occurs due to iron overload and chronic hypoxia, and indicates the importance of regular follow-up of beta thalassemia patients for early detection and manegement of associated complications

[Comparative efficacy of deferrioxamin and combination of deferiprone and deferrioxamine on echocardiographic indices in beta thalassemic patients]

Regular blood transfusions in beta thalassemic patients can lead to accumulation of extra iron in the body which may result in cardiac complications and death. Deferrioxamin [DFO] is the standard treatment for this condition but 12-8 hours subcutaneous [SQ] injection of this drug per day can cause local pain which together with lack of patients' compliance, it is necessary to use another drug to improve the condition of the patients. Deferiprone [DFP], is an approved drug for this purpose and removes iron from cells including cardiac muscle cells. The aim of this study is to compare efficacy of deferrioxamin with that of combined deferiprone and deferrioxamin on echocardiographic indices in beta thalassemic patients. In this randomized clinical trial 40 thalassemic patients who met the inclusion criteria of this study were divided into two equal groups. Controls group received SQ deferrioxamin for six days/ week and intervention group received deferrioxamin for three days/week and deferiprone orally for four days/week. Cardiac indices were measured and compared before and after the study. Mean values of the age of the patients were 15.6 +/- 5.1 and 14.1 +/- 6 years in the intervention and control group respectively. Right ventricle diameter [RVD] indices in control group was 18.7 +/- 7.6 and 20.8 +/- 6.6 mm before and after treatment respectively [P<0.05]. In the intervention group RVD indices were 19.5 +/- 5.8 and 18.0 +/- 4.7 mm before and after treatment respectively [P>0.05]. Other indices such as LVEDD, LVESD, aortic root diameter, EF and Fs of left ventricle and also indices of the heart valves revealed no significant differences between the two groups. We didn't observe any side effect of the drugs in the patients. We concluded combined therapy with 4 days DFP and 3 days DFO per week did not lead to cardiac complications and deterioration of echocardiographic indices

[Evaluation of the pre-emptive effect of acetaminophen codeine on the pain after liver biopsy]

Liver biopsy is one of the most important diagnostic procedures for liver diseases. Pain is the most common complication of liver biopsy and it can lead to clear morbidity. Finding a way to reduce pain of liver biopsy its complication is very important for investigators. There are limited studies on evaluation of pre-emptive effect of acetaminophen on liver biopsy. The aim of this study was to investigate pre-emptive effect of Acetaminophen codeine on the pain of liver biopsy during the first 24 hours after biopsy. This was a double blind randomized clinical trail study from Oct 2007 to Oct 2008 in gastroenterology and liver disease unit of Tohid hospital in Sanandaj. Sample size included all the patients who were candidate for liver biopsy. Forty four patients [23 in experimental group and 21 in placebo group] were enrolled into the study on the basis of randomized blocking method. Exclusion criteria included any contraindication for liver biopsy or need of penetration of needle for two or more times for biopsy. Visual analogue scale [VAS] was used to assess pain after liver biopsy, 0,1,3,6 and 24 hours after biopsy. This study was conducted after approval of Ethical review Committee of Kurdistan University of medical Sciences and obtaining the informed written consent from the patients. The patients received acetaminophen codeine or placebo one hour before biopsy. Data were analyzed by means of Chi square, t-test, analysis of variances, and nonparametric tests. The mean value of the pains intensity in zero, one, three, six, and twenty four hours after biopsy in experimental group was higher than that of placebo group but there was no significant differences between two groups [P>0.05]. Intensity of the pain after liver biopsy in females was higher than in males in the two groups but there was no significant differences between two groups [P>0.05]. Comparison of the results of the present study with those of other studies shows that acetaminophen codeine is not effective in reducing the pain of biopsy. Further clinical trail studies for determination of the effect of other analgesics drugs are recommended in the future