[Evaluation of different Sellick's maneuvers on laryngoscopic view in cesarean section]

Cricoid pressure [Sellick's maneuver] may alter the laryngoscopic view during tracheal intubation in parturients. This study was performed to compare the different techniques of Sellick's maneuver on laryngoscopic view in cesarean section. This was a clinical-trial performed on 142 parturients, aged 18-45 years of ASA I, and II undergoing elective cesarean section. Patients were randomly divided into 4 groups based on type of CP.1] In this group the cricoid pressure was performed using the index finger over the cricoid cartilage while the thumb and middle finger either side, in group 2] with the index and middle fingers over the cricoid cartilage while the palm of hand over sternum, in group3] with one hand behind the neck while the index finger over the cricoid cartilage and the thumb and middle fingers either side, and in group4] similar to the technique used for group C as well as using a pillow behind the head. Laryngoscopic view was determined following induction, laryngoscopy and CP. Data was analysed with spirmann, ANOVA, krusskal wallis, and X2 tests. A better laryngoscopic view was found in group 1 followed by 3, 4, and 2, respectively. There was significant differences between 4 groups based on laryngoscopic view changes [p=0.02]. No intubation failure in patients was observed during Sellicks's maneuver. The view at laryngoscopy during cricoid pressure was better than the view without cricoid pressure. The Sellick's maneuver in which downward pressure was applied with the left index finger over the cricoid cartilage and the thumb and middle fingers either side could produce the best laryngoscopic view in parturients undergoing cesarean section

[ evaluation of Papanicolaou [Pap] smear processing in the health centers of Shahrekord in 2005]

Papanicolaou [Pap] smear screening is an effective method of detecting cytological changes in cervix before they lead to cervical cancer. To determine the quality of process of Pap smear and comparison of pathologist and cytologist reports about quality of obtained samples and accuracy of diagnosis, this study was performed. In this cross sectional study which performed during spring and summer 2005, the processing of a total of 160 Pap smears were observed randomly by standard checklist. Also a total of 360 Pap smear samples reported by a cytologist were examined by a pathologist and the Kappa correlation coefficient was compared between the two reports. The function of midwifes in patient recording was 96.15% good and 3.85% poor. The function for Pap sampling was 88.72% good and 11.28% poor. In the pathologist report, the quantity of specimen, infection cellular changes, inflammation reactive changes, cell abnormality were reported were 308[85.5%], 12[3.3%], 232[64.4%] and 3[0.83%], respectively. There was significant relationship between pathologist and cytologist reports [p<0.05]. According to the result, the quality of processing of Pap smear, the quality of obtained samples and accuracy of diagnosis were acceptable. However, we suggest more supervision and attention about midwifes and cytologists practices

Response rate to hepatitis B vaccination in patients with chronic renal failure and End-stage-renal-disease: Influence of diabetes mellitus

Hepatitis B vaccination is recommended for all individuals with renal failure. Nevertheless, the response rate for this vaccine in hemodialysis patients is low. This study was designed to determine the response rate to hepatitis B vaccination in chronic renal failure [CRF] and end stage renal disease [ESRD] patients and those factors that influence it. We evaluated antiHBs level after primary vaccination in 32 predialysis and 93 dialysis patients. HBsAg positive patients were excluded. AntiHBs titers were determined in the period of 1 to 6 months after completion of vaccination. Seroconversion [antiHBs >/= 10mIU/ml] was found in 100 patients [80%], but an excellent response [titer>100 mIU/ml] was observed only in 74 [59.2%]. Response rate were 71.9 and 82.8 in predialysis CRF and ESRD patients, respectively, but this difference was not significant [