[Evaluation of lidocaine ointment in treatment of chronic anal fissure]

Surgical procedures including open and close lateral sphincterotomy were the main treatment of chronic anal fissure in past years. Nowadays, medical treatments are the standard therapy for this disease, but there are some limitations for this method of treatment. This study aimed to compare the efficacy and complication of surgical and medical treatments by lidocaine ointment for patients with chronic anal fissure. A clinical trial study was conducted on 180 patients with chronic anal fissure who had symptoms for more than 6 weeks. The main symptoms of patients were pain during defecation, anal bleeding and skin tag. After history taking and physical examination, method of treatment was explained for patients to choose one group: Group 1 [surgery] or group 2 [medical treatment with lidocaine H]. Surgery was performed by closed method. Medical treatment was consisted of high fiber regimen, sits baths, C-lax tablet nightly, Naproxen tablet 250 mg twice daily and 5% lidocaine anal application before defecation and anal washing during defecation. Patients were followed for 8 weeks. Data were analyzed using chi-square, Fisher and Mann-Whitney tests. One hundred of patients in group 1 and 80 patients in group 2 completed the study. Duration of symptoms was 8.1 +/- 2.5 weeks in group 1 and 7.9 +/- 3.1 weeks in group 2. Post operative complications in group 1 were skin ecchymosis [10%], large hematoma [2%] and 10 cases [10%] complained from mild incontinency to flatus. There was no complication in group 2. Healing rate was 93% in group 1 and 75% in group 2 [P<0.05]. Medical treatment with lidocaine is a safe and effective treatment for chronic anal fissure

Dosimetric characteristics of 137Cs sources used in after loading selectron system by Monte Carlo method

For an effective treatment planning in brachytherapy, it is necessary to know the accurate source dosimetric information such as air kerma strength, exposure rate constant, dose rate constant and redial dose distribution. The usual method to determine these factors is thermo luminescent dosimeter [TLD] dosimetry. Nowadays, another more accurate method is known to be the Monte Carlo simulation, and it is widely used in determining of brachytherapy sources dosimetric factors. The aim of the present study has been determine to dose distribution of 137Cs sources configuration used in interacavitary low dose rate [LDR] Selectron brachytherapy by Monte Carlo simulation method. Simulation has been performed for 137Cs stainless-steel encapsulated source in 2.5 mm in diameter of Selectron system. Six different combinations of 137Cs sources were simulated and each combination was put into different applicator. The Monte Carlo MCNP4C code was used for simulation. The number of history was taken 1 million for the calculation of air kerma strength and exposure rate constant and 0.1 million for calculating dose rate constant and redials dose distribution. Maximum air kerma strength was obtained for the combination with fourteen active sources and found to be 919.3 microGym2h-1 while its minimum value was 133.9 microGym2h-1 for the case with two active sources. Maximum and minimum dose rate constant of 4.3 cGyh-1mCi-1 and 2.1 cGyh-1mCi-1 were obtained for the combination with eight and fourteen active sources, respectively. The results indicated that the Monte Carlo simulation method may be useful to determine dosimetric characteristics of brachytherapy sources

[ evaluation of base deficit as the predictive agent of mortality in geriatric trauma]

Base deficit is a well-characterized feature of occult tissue hypo-perfusion. However, its cut off point value for mortality in geriatric trauma has not been determined. In this study, the prediction value of base deficit and its cut off point were evaluated in old aged patients. In a prospective study, 300 old age [>=65 year] patients with trauma referred to All-Zahra hospital of Isfahan were studied. In each patient, arterial blood gas was taken and base deficit was checked. Risk factors of base deficit changes were determined. Patients were followed until death or discharge. The predictive probability of significant variables of mortality was tested by regression analysis. P value less than 0.05 was considered significant. Our results showed that in stable old aged traumatic patients base deficit was the only significant predictor of death [p<0.01]. A cut off value of 2.55 mmol/L had the best accuracy. Pelvis-AIS, GCS and cardiac disease were significant coefficient of base deficit changes [p<0.05]. Base deficit changes in range of 2.55-3 in old aged traumatic patients indicates occult tissue hypo-perfusion and increased mortality

[Knowledge, attitude and practice [KAP] of people living in Babol about clinical symptoms and risk factors of coronary artery diseases [CAD]]

Background and Objective: Determination and modification of cardiac risk factors with early detection of coronary artery disease [CAD] have important role in control of mortality and morbidity in the world. It is necessary to increase the knowledge and attitude of people for better practice and decrease in morbidity and mortality of cardiac disease. This investigation was done to determine the KAP study of people living in Babol [As one of the large cities in North of Iran] for CAD

Methods: This cross-sectional, descriptive and analytical study was performed on 1500 persons aged 20-70 years old in Babol. Data were gathered by a questionnaire with 32 questions in five different regions of the city and then the results were statistically analyzed

Findings: From all cases, 58.6% were male and 41.4% were female. About symptoms of CAD: 62.7% and 4.2% had poor and good knowledge, respectively. 27.9% and 36% had poor and good attitude, 37.7% and 14.6% had poor and good practice, respectively. About risk factors of CAD: 65.3% and 0.9% had poor and good knowledge, 43.5% and 6.5% had poor and good attitude, 53.7% and 0.9% had poor and good practice, respectively

Conclusion: In conclusion, people of Babol city have poor knowledge, moderate attitude and poor to moderate practice about symptoms of coronary artery disease and its risk factors. Planning for increasing KAP for prevention of CAD is necessary