[Effect aerobic exercises on fatigue and quality of life in women with multiple sclerosis]

Introduction: Multiple Sclerosis Multiple Sclerosis is a chronic and autoimmune disease. Muscle weakness and fatigue leads to decreased functional capacities and diminished quality of life in Multiple Sclerosis patients

Objective: The purpose of this study was to determine the effect of aerobic exercises on fatigue and quality of life in women with Multiple Sclerosis

Methods: Fifteen women with Multiple Sclerosis [aged 33.68 +/- 8.22 years] and Expanded Disability StatusScale < 4 participated in this study. Subjects were randomly divided to experimental [8 patients] and control group [7 patients]. The experiment group went through Modified Fatigue Impact Scale-5 aerobic activity for 8 weeks, 3 days/week, 20-40 min/day, with 60-80% of maximum Heart Rate on treadmill. Modified Fatigue Impact Scale-5 questionnaire on fatigue and quality of life [SF-36] and additionally, walking endurance of subjects were measured before and after program in both experimental and control groups

Results: Data analysis showed that the aerobic exercise led to improvement of quality of life in MS patients [P=0.001]. Therefore, the exercise program led to a significant decrease in fatigue in experimental group [P=0.001]; while fatigue increased in control group. Additionally, after the 8-week aerobic activity, walking endurance increased significantly in experimental group [P=0.000]; and decreased significantly in control group [P=0.04]

Conclusion: Considering study results, it can be stated that aerobic exercises may increase walking endurance and improvement of quality of life of Multiple Sclerosis patients and decrease fatigue

[Assessment of the prevalence rate of status epilepticus and its underlying factors among adults and children]

Status epilepticus is a medical emergency condition which has various causes among adults and children. Timely treatment and elimination of the underlying factors are important. Identification of its underlying factors in different societies can be helpful for diagnosis and treatment of this disorder. This study was conducted to investigate the underlying factors of status epilepticus and compare them between adults and children. This was a cross sectional study and included all adult patients with diagnosis of epilepsy who had been hospitalized in the internal medicine and neurology wards of Tohid Hospital and also all hospitalized children with epilepsy in the pediatric ward of Be'sat Hospital, in Sanandaj. According to the patients' records and documents the main cause of status epilepticus in every patient was extracted and recorded by a neurologist. Data were revised and chi-square and Fisher's test were used for data analysis and comparison of the qualitative variables between the two groups [adults and children]. This study included 504 patients. 212 patients [63.1%] in the children group and 87 patients [51.8%] in the adult group were male [p=0.01]. The prevalence rate of status epilepticus in the children and adults were 28.3% and 17.3% respectively. 29 children [26.3%] and 10 adults [34.5%] had previous history of epilepsy [p=0.39]. Moreover, 32 children [33.7%] and 4 adults [13.8%] had previous records of epilepsy within their family [p=0.04]. The most common causes of status epilepticus among adults were misuse or discontinuance of medications [34.5%], head trauma [20.7%], cerebrovascular problems [20.7%]. Among children febrile diseases [60%], misuse or discontinuance of antiepileptic medications [20%] and metabolic disorders [7.4%] were the most common causes of status epilepticus. It seems that epilepsy is not controlled properly in the patients and it is likely that patients do not use antiepileptic medications correctly. It is necessary to design plans to prevent head trauma. Also it seems the parents do not have enough knowledge of controlling fever in their children. Therefore, proper instructions should be given to the parents about the disease of their children.

[Comparison of the effects of propofol versus thiopental induced anesthesia on postoperative nausea and vomiting]

Postoperative nausea and vomiting [PONV] are common and unpleasant complications. Various drugs are used for prevention and treatment of PONV. But it stands to reason to overcome this problem by the anesthetic drug itself. In this study, the effects of propofol versus thiopental on PONV were evaluated. This was a double blind clinical trial. In a period of 8 months, ninety patients [aged between 18-50 years] who had been scheduled for elective surgery [ASA physical status I] were entered into this study and randomly divided into two comparable groups; group A received 2 mg/kg propofol IV and group B received 5 mg/kg thiopental sodium for induction of anesthesia. Each group included 45 patients. The patients were observed for 12 hours for PONV [2 hours after operation in the recovery room and 10 hours in the surgery ward. The results were processed with SPSS soft ware and analyzed by means of student t-test. The results of this study showed that in propofol group the number of episodes of nausea and vomiting was less than that of thiopental group which revealed a significant difference [p < 0.05]. The mean age of the patients was 29.4 +/- 9. 51.12% of the patients were female and 48.86% were male which revealed no significant difference between the two groups. Propofol is more beneficial than thiopental for the prevention of PONV and it is recommended to be used for induction of anesthesia, when PONV may be life threatening

[Assessment of the effect of addition of propofol to remifentanil on seizure duration, homodynamic change and recovery from anesthesia]

General anesthesia is required to perform ECT. The hypnotic drug used for induction of anesthesia in ECT may affect the duration of seizure and recovery from anesthesia and also homodynamic change. The aim of this study was to evaluate the effect of addition of remifentanil to propofol for induction of anesthesia in ECT on seizure duration, homodynamic change and recovery from anesthesia. Twenty ASA 1 and 2 patients scheduled for ECT underwent induction of anesthesia for two times randomly with remifentanil-propofol [study group] or saline-propofol [control group]. ECT induced via bilateral electrodes and after injection of 0.5 Mg atropine, 50 Microgram remifentanil [study group] or 3 ML saline and 1Mg propofol, 0.5 Mg/Kg succinylcoline [control group]. Then the patients were oxygenated with 100% oxygen via face mask. Systolic and diastolic blood pressures and heart rate were measured before induction of anesthesia and 1, 5 and 10 minutes after termination of seizure. Duration of seizure, time of opening of the eyes on command after anesthesia and time for sitting and walking 10 meters without help were also measured and recorded. Data were introduced into SPSS soft ware and analyzed by means of T test and ANOVA. P value of less than 0.05 was considered statistically significant. Systolic and diastolic pressures as well as heart rate increased after induction of seizure in both methods but this increase was significantly higher in control group. Duration of seizure was the same in two groups. The time for opening of the eyes on command and sitting without help after termination of seizure were similar in both groups. Our study shows addition of remifentanil to propofol for induction of anesthesia in ECT has no effect on duration of seizure and recovery from anesthesia but modifies the homodynamic response to ECT

evaluation of efficacy of Avonex in the treatment of Multiple sclerosis patients in Tohid Hospital in Sanandaj

The effect of beta INF on multiple sclerosis has been reviewed in some studies but it is partially effective and some of its complications are unknown. This study was performed to evaluate Avonex efficacy in reducing relaps and attacks in the patients with Multiple sclerosis in Sanandaj. This was a before-after study from 1380 to 1382, encompassing 42 patients with multiple sclerosis who had received Avonex for 3 years. Data collected, were analyzed by means of SPSS. Win, x[2] and paired T-tests. Mean age of the patients was 34.85 +/- 13.73 years and most patients [42.8%] were between 30-39 years of age. 83.4% of patients were female and 16.6% of them were male [ratio5/1]. The mean number of attacks in the patients before treatment with Avonex was 1.8 +/- 1.29, while after treatment it declined to 0.71 +/- 1.04. which is statistically significant [p<0.01]. Results of this study suggest that Avonex reduce recurrences and attacks of MS in the patients

Prevalence and Causes of stick injuries, in medical personnels of Kurdistan University's hospitals and dealing with such injuries due to contaminated sharp tools in 1383

Needle stick injuries can cause transmission of 3 important blood viruses [HCV-HBV-HIV] to health care personnel. Generally these injuries inflict loss of life and property on the health care personnel, so that the medical associations of different industrial countries have scheduled important plans in order to take care of patients, provide personnel education and guarantee the health of physicians and medical staff. Considering the prevalence rate of blood-borne diseases in African and Asian countries, as well as our country, it is important to scrutinize the reasons and prevalence rate of these injuries to take proper preventive measures. This study was conducted with the aim of determination of the prevalence rate of needle stick injuries in the personnel of health care centers of Kurdistan's medical university. This descriptive-Analytic study was conducted in the university's hospitals. A questionnaire including necessary information was designed and sent to the personnel of the hospitals. The sampling method was census. 847 individuals filled out the questionnaires. The collected data were analyzed by means of SPSS statistical software. The findings of this study showed that the majority [73.7%] of the subjects were female. The mean age was [36.1 +/- 7.07] years old. Most of the subjects had the bachelor degree [47.9%]; [74.5%] of them were nurses, 5.5% midwives, 3.3% anesthetists, 7.7% personnels of the laboratory and 9% were the radiology staff. About 57.5% of the subjects had experienced splashing of blood or secretions into their mouth or eyes. In most cases, needles and angiocatheters were responsible for injuries in 43.77% and 35.3% of the cases respectively. According to the staffs opinion the most important predisposing factors included haste and being inundated with work. There was a significant difference between professions and needle stick injuries [p<0.05]. Prevention of needle stick injuries should be regarded a priority. Providing safe medical equipments regardless of their costs, in addition to necessary education for health care staff, should be taken into consideration. Special centers for treatment and follow up of the injured personnel should be allocated