ABSTRACT
Background: Rheumatoid arthritis is one of the most common autoimmune diseases. Early diagnosis can prevent side effects and disability. Anti-cyclic citrullinated peptide antibody is a specific marker to diagnose rheumatoid arthritis. This study was carried out to evaluate the efficacy of anti-cyclic citrullinated peptide in comparison with rheumatoid factor in rheumatoid arthritis patients referred to Behshti Hospital of Kashan city during 2006-7
Materials and Methods: This diagnostic value study was done on 98 randomly selected rheumatoid arthritis patients and 75 patients with other rheumatic diseases. In this study rheumatoid factor titer>35 IU/ml and anti-cyclic citrullinated peptide>6.25 IU/ml were considered positive
Results: Anti-cyclic citrullinated peptide compared to rheumatoid factor had a higher sensitivity [73.5% vs. 69.4%], specificity [88% vs. 84%], positive predictive value [88.9% vs. 85%], and negative predictive value [71.7% vs. 67.7%] for rheumatoid arthritis. The use of rheumatoid factor and anti-cyclic citrullinated peptide test together increased the specificity and positive predictive value for diagnosis of rheumatoid arthritis to 93.3% and 92.4%, respectively. The mean anti-cyclic citrullinated peptide showed a significant difference in Rheumatoid arthritis [46.8 IU/ml] in comparison to non rheumatoid arthritis patients [5.3 IU/ml]
Conclusion: Anti-cyclic citrullinated peptide had a better diagnostic value when compared to rheumatoid factor for detection of rheumatoid arthritis. Also combined use of rheumatoid factor and anti-cyclic citrullinated peptide had a higher specificity and positive predictive value than each alone for the diagnosis of rheumatoid arthritis
ABSTRACT
Background: Preliminary clinical studies have suggested that gabapentin may produce analgesia and reduce the need for opioids in postoperative patients. The aim of the present study was to investigate the opioid-sparing and analgesic effects of gabapentin administered during the first 24h after surgery
Materials and Methods: In a randomized, single-blind study 196 patients assigned to two groups receiving gabapentin [n=102] or placebo [n=94]. Oral gabapentin 1200 mg or placebo, 2h before surgery, followed by oral gabapentin 600 mg or placebo 8, 16 and 24 h after the initial dose. Patients requesting analgesia received it with pethidine at dose of 25 mg [iv]. Total pethidine consumption for each patient was recorded from zero to 24h postoperatively. Pain was assessed on a visual analogue scale [VAS], and vomiting, dizziness and somnolence were assessed
Results: Gabapentin reduced total pethidine consumption [P<0.001] and postoperative pain as well [P<0.001]. It was associated with a significant increase in somnolence [P=0.007] and dizziness [P=0.019], however, no significant difference in vomiting [P=0.075] was observed
Conclusion: A total dose of 3000 mg gabapentin before and during the first 24h after surgery, reduces pain score and pethidine consumption, and increases the incidence of somnolence and dizziness
ABSTRACT
Background: Insomnia is a distressing and disabling condition affecting not only many people's quality of life and work but also their psychosocial conditions. Therefore, this research has done to survey insomnia prevalence among 18 years old people and over in Kashan city in 2008
Materials and Methods: This cross-sectional research has performed done in Kashan using randomized sampling [N=1155]. The research tools contain demographic characteristics questionnaire and insomnia questionnaire based on DSM-IV criteria including difficult falling asleep, staying asleep and daytime sleepiness. Its validity was confirmed by five psychiatrists; the reliability of this questionnaire with test-retest method was 99%. The data were analyzed via Chi square, Fisher exact test and OR, CI
Results: Of 1155 persons, 684 [59.2] had insomnia problem. Insomnia problem is extremely prevalent among those who were between 41 to 65 years old [266 of persons 67.9] and women [387 of persons 56.5]. This study showed that there was a significant relationship between insomnia problem and mental disorder history [P<0/0001, OR=2.24], sleep disorder in family history [P<0/0001, OR=4.67] and drinking caffeine before sleep [P<0/001, OR=1.64]
Conclusion: According to this study, most people studied suffer from insomnia problem, particularly women and middle aged people. Since insomnia can be a risk factor for onset of depression and anxiety disorders, and increases direct and indirect medical costs among other consequences it is necessary to prepare an exact schedule for resolving this problem and improving sleep quality
ABSTRACT
Background: high lipid serum level was a risk factor for cardiovascular disease. This study was performed to evaluate the effects of Lovastatin and exercise on hyperlipidemic patients at Kashan Shahid Beheshti Hospital during 2005-6
Materials and Methods: this randomized clinical trial study was carried out on hyperlipidemic patients [age>30 years]. After registering the personal data of the patients the participants were selected based on the inclusion criteria [HDL<35 mg/dl, LDL >/= 160 mg/dl, TG >/= 200 mg/dl, Chol >/= 200 mg/dl]. The Lovastatin group [40 mg/daily] and the exercise group [waking 35 minutes/day, 3 times a week]. The clinical tests were repeated for six consecutive weeks. Data were analyzed using t-Test, Wilcoxon Signed Rample Test, Kolomogorou-Smirnov Test, Mann-Whitney Test, levens Test
Results: from Ninety-six out of 150 cases were hyperlipidemic signifying that only 80 [59 male, mean age 55.12 +/- 8.4 case and control 55.35 +/- 9.2 years] out of 150 hyperlipidemic patients were qualified for the study. The mean decrease in TG level between the Lovastatin and exercise groups were 21.4 [P=0.2] and 20.5 mg/dl [P=0.2], respectively. The mean decrease in cholesterol level between Lovastatin and exercise groups were 41.3 and 1.5 mg/dL [P=0.001]. The mean decrease in LDL level between Lovastatin and exercise groups were 35.8 and 8.5 mg/dl [P<0.001], respectively. Finally, the mean increase in HDL level between Lovastatin and exercise groups were 5.4 and 0.4 mg/dl
Conclusion: exercise may be effective for decreasing the LDL. While Lovastatin could decrease the total cholesterol TG and increase HDL levels, using a combination is recommended for hyperlipidemic patients
ABSTRACT
Background: considering the significance of early diagnosis of cervical cancer and low sensitivity of conventional pap smear tests, this study was carried out to evaluate the adequacy of papanicolaou smear taken by liquid-based thin layer method compared to the conventional methods for women referring to obs/gynecological clinics of Kashan [March to October 2008]
Materials and Methods: this cross-sectional descriptive study was done on pap smear specimens [n=400] of women referring to gynecological clinics. Randomly for half of samples, Pap smear was prepared by manual liquid-based thin layer [direct to vial] method and the conventional method for half of the samples. Samples were prepared using cytobrush and interpreted based on Bethesda [2001] criteria. In each of sampling methods both satisfactory and unsatisfactory cases were identified and analyzed using Chi-square test
Results: in both methods, the number of satisfactory and unsatisfactory smears were 191 [% 95.5] and 9 [% 4/5] respectively, signifying no difference between methods. The factors for unsatisfactory smear in conventional smear were exudates [8 cases [[88.9%]]; blood [1 case [11.1%]] and in liquid based samples the lower cellularity [9 cases [100%]]
Conclusion: the number of satisfactory cases in liquid-based thin layer method was the same as the conventional method
ABSTRACT
Background: many studies have shown that the extra-pulmonary tuberculosis is growing compared to the pulmonary one. This study was carried out on under-treatment TB patients in order to evaluate the comparison of pulmonary and extra pulmonary TBs in kashan
Materials and Methods: the study was carried out on available data and the medical documents of TB patients treated in "Kashan TB Center" during a five year-period [2002-7]. All relevant data regarding the treatment were collected based on the definition presented by "Iranian Defense Guidelines against TB"
Results: one-hundred and three [52.6%] female and 93 [47.4%] male TB patients were studied 89 [45.4%] of who were Iranian and 107 [54.6%] was Afghani. The prevalence of pulmonary and extra-pulmonary cases were 130 [66.3%] and 66 [33.7%], respectively. The highest number of pulmonary TB was 72[55.38%] cases in female and extra-pulmonary TB was 35[53.04%] cases in males. Forty-six [69.6%] of extra-pulmonary patients completed their treatment period and 71[54.6%] of pulmonary patients were recovered completely. The most common clinical signs in pulmonary TB and in extra pulmonary TB were coughing [90%], sputum [87.6%] and weight loss [59.1%], night sweating [40.9%], respectively. The highest prevalent foci for extra-pulmonary TB were lymph nodes [19 [28.7%] cases] and bone [12[18.18%] cases]
Conclusions: the study showed that the prevalence of extra-pulmonary TB is one third of all TB cases. Therefore in the evaluation of non-specific findings of patients, TB must be considered