[Frequency of work injuries of needle stick among personnel in Sina Hospital in 2011]

Introduction and Aims: since the needle stick is one of the hospital-based infections and taking immediate precautions is vital in staff's health and safety. In order to identify causes and frequency of injuries, this cross-sectional study was conducted among Sina hospital staff in 2011

Materials and Methods: among 295 medical workers of Sina hospital that were selected using census method, 191 persons filled the questionnaires. Data was analyzed by SPSS v.15, descriptive analysis and regression logistic

Results: more needle stick occurred about nurses in the morning shift with a bachelor's degree with 15-10 years of experience and 20-30 years old. There was a significant relation between demographic criteria and the frequency of needle stick. The most accident was needle stick injury in 25% of cases and the most reaction was wound washing with water and soap [66%]. High level of load work and lack of protection instruments were recommended as 44% and 9% of the reasons of needle stick respectively

Conclusion: in order to reduction needle stick, promoting education, safe work practices for staff and using devices with safety features seems to be necessary. Considering the importance of health personnel, the employee should expect to have tests by the hospital for baseline results of Hepatitis B surface antibody, Hepatitis C antibody, HIV antibody and possibly other liver necessary tests

The Effect of Acupuncture on Relieving Pain after Inguinal Surgeries

BACKGROUND: Postoperative pain is one of the most prevalent and bothersome issues found in the surgical department. Nowadays, there are various methods of acupuncture used for relieving pain without the complications found in some routine postoperative analgesics. These methods could be especially useful for high risk patients prone to complications from analgesics, such as transplantation recipients. The aim of this study was to evaluate the efficacy of electro-acupuncture on postoperative pain control after inguinal surgeries. METHODS: Ninety male patients, who were referred to our department with indications of inguinal surgery, were included in the study and randomly divided into two groups, such as acupuncture and control. We used electro-acupuncture for the acupuncture group and no actual acupuncture (but placed needle electrodes similar to the acupuncture group) for the control group. Postoperative pain was quantified by a blind observer in both groups using a visual analogue scale (VAS) standard score before being compared. RESULTS: Pain intensity and analgesic use were significantly higher in the control group (P < 0.05). In the acupuncture group, the VAS pain scores were significantly lower than the control group at 0.5, 1 and 2 hours post operation. When the opioid related side effects were compared for each group, the results showed that the number of subjects who experienced dizziness in the acupuncture group was significantly lower than the control group (P < 0.05). CONCLUSIONS: Acupuncture in patients, after inguinal surgery, can reduce the need of analgesics, which also directly reduces the complications that may occur when analgesics are used in relieving pain postoperatively.

[Evaluating Y chromosome microdeletions in infertile men with severe oligozoospermia or azoospermia at Imam Reza Hospital In Meshad]

Male factors account for nearly 50% of infertilities, among which genetic defects constitute some of the major ones. Microdeletion of the long arm of Y chromosome has been seen in about 7% of infertile men. The importance of these microdeletions lies in the possibility of their occurrence in the off-springs in ART and their de novo appearance. This cross-sectional descriptive-analytical study was performed on 47 individuals with azoospermia or severe oligozoospermia. The cases were recruited when they attended Imam Reza Hospital in Mashad during 2006-2008. Hormone profile, including FSH, was measured and karyotyping, testicular biopsy and Y chromosome microdeletion detection, using 11 pairs of sequence-tagged site [STS method] sets which were specific for AZF and SRY loci, were performed. Three out of four patients with azoospermia had Y chromosome microdeletion [8.5%]. Klinefelter's syndrome and deletion of SRY region were each seen in two patients [4.3%]. Multiple AZF region deletions were seen in 75% of Y chromosome microdeletions and deletions in AZFa, AZFb and AZFc regions were seen in 25%, 75% and 100% of the cases, respectively. The prevalence of AZF deletion in patients with and without FSH abnormality were 17.6% and 3.3%, respectively, however, the differences were not statistically significant [p = 0.125]. In patients with azoospermia and severe oligozoospermia, AZF deletion were 11.1% and 5%, respectively [p = 0.628]. In addition, there were no significant differences in AZF deletion between patients suffering from varicocele or other related disease [p = 1.0]. Family history had no significant effect on AZF deletion [p = 0.239]. Testicular biopsy showed Sertoli-cell-only syndrome in three out of four patients with AZF microdeletions. Male factor infertility is associated with a high incidence of Y chromosome microdeletions and transmission of these defects to the off-springs in ART, aside from their de novo occurrence, seems probable. Therefore, it would be wise to look for microdeletions in cases with severe oligozoospermia or cases with non-obstructive azoospermia. There seems to be a correlation between the prevalence of AZF regional deletions and the degree of spermatogenesis disruption but this finding needs further scientific evidence

Diuresis renography for differentiation of upper urinary tract dilatation from obstruction F+20 and F-15 methods

The aim of this study was to evaluate diuresis renography with an intravenous injection of furosemide 20 minutes after administering the radiopharmaceutical [F+20 protocol] or 15 minutes before [F-15 protocol] in patients with upper urinary tract dilatation. Twenty-one patients with pyelocaliceal system dilatation, but not ureteral dilatation, on ultrasonography were evaluated. The patients underwent diuresis renography using the F+20 and F-15 protocols. Renal scan findings and kidney split function were recorded. Then, the patients underwent surgical or conservative treatment according to their clinical conditions and imaging results. Follow-up was done 3 and 6 months postoperatively by physical examination, intravenous urography, and diuresis renography. Eleven patients [52.4%] had complete obstruction in both protocols of renography, and 5 [23.8%] had an equivocal result in the F+20 and an obstructive pattern in the F-15. These patients underwent surgical operation. In 3 patients [14.3%], both protocols demonstrated a normal urinary tract. In 2 patients [9.5%], a nonobstructive response in the F+20 and an equivocal result in the F-15 were seen. One of them underwent surgical operation because of impaired kidney function during the follow-up and 1 was treated conservatively. Overall, obstruction was found in 16 out of 21 patients [76.2%] by the F-15 protocol, while it was found in 11 [52.4%] by the F+20 protocol [P = .01]. The mean kidney split function was 55.15% +/- 7.82% and 54.81% +/- 6.87% in F+20 and F-15 protocols, respectively [P=.45]. Using the F-15 protocol may reduce the equivocal results of the F+20 for diuresis renography

En Bloc Kidney Transplantation from Pediatric Cadaveric Donors to Adult Recipients

The shortage of cadaveric donors for kidney transplantation has led to the expansion of the criteria used for donor selection, such as the use of pediatric cadaveric donors. In this study we reviewed our results of en bloc kidney transplantation of pediatric cadaveric donors to adults. From May 2001 to May 2005, 245 cadaveric kidney transplants have been performed in our hospitals. Seven of these were en bloc kidney transplantations in adult recipients from marginal pediatric donors [age < 5 years, donor weight < 15 kg, high creatinine clearance, or kidney length < 8 cm]. We reviewed their records. Follow-up [range, 3 to 24 months] included ultrasonography, dimercaptosuccinic acid renal scintigraphy, and magnetic resonance imaging. Serum levels of creatinine ranged between 0.8 m/dL to 1.9 mg/dL during the follow-up period. One patient died of myocardial infarction 3 months postoperatively. One-year graft and patient survivals were both 85.7%. Complications included acute tubular necrosis in 1 patient [managed by conservative therapy and dialysis for 2 weeks], renal vein thrombosis in 1 [treated by anticoagulation], and subcutaneous hematoma in 1. There were no urologic complications. Median size of the grafts was 7.2 cm preoperatively that reached 9.6 cm, 3 months postoperatively [P =.018]. Twelve months following operation, the median size of the grafts reached 11 cm [P =.045]. En bloc pediatric kidney transplantation is a safe and suitable alternative for adult recipients. One-year graft and patient survivals are acceptable and complication rate is low