[Evaluation of completeness and legal aspects' compliance of emergency's medical records in teaching hospitals of Zabol university of medical sciences]

Emergency departments have a basic role in saving the human life in any accidents. Developing an information system with an accurate documentation facilitates evaluating emergencies activities and providing quality care. The main objective of this study was to determine the rate of complete documentation and compliance of legal aspects in documentation of Emergency's Medical Records in teaching hospitals of Zabol University of Medical Sciences. In this descriptive-analytical research, 500 Emergency's Medical Records were selected by random sampling method. Two checklists were applied to gather all the information. First checklist measured completion of data element in Emergency's Medical Records forms and second checklist analyzed the legal aspect Compliance. Since the first checklist used the standard medical record's data item of Ministry of health, it was validated. Reliability and validity of second checklist were verified by of medical records experts' opinions. The statistical significance was set to 0.05. The statistical package SPSS were used for the analysis [Chi-square test]. The amount of data recorded by physician, nurses, and reception staffs were 25.4, 52.6 and 67.1 percent, respectively. In general, legal aspect Compliance was 44.7 percent. Comparing hospitals' legal aspect Compliance ratio showed a statistically significant difference [P=0.0001]. Our study showed that Emergency's Medical Records were incomplete and legal aspects were not complied in medical record documentation. These deficiencies lead to loss of patients' information. Therefore authorities, doctors, and medical experts should pay more attention to completeness of documentation of emergency's patient records in teaching hospitals of Zabol University of Medical Sciences

[Comparison of four different types of carriers for the growth of vero cells and propagating rabies virus for production of human rabies vaccine]

In this study, capability of Vero cells for growth on FibraCel disks were compared on 3 kinds of microcarriers including Cytodex-1, Cutodex-3, and Sigma Solohill in 500 ml Spinner flasks in both serum contained medium [DMEM+10% Fetal Calf Serum, FCS] and serum-free medium [VP-SFM]. The propagation of fixed PV [Pasteur Virus] strain of rabies in Vero cells, for production of rabies vaccine, grown under the above conditions were studied and compared. Stepwise perfusion mode in growth phase and batch mode were applied in the virus production step by the use of M199 +0.2% Bovine Serum Albumin [BSA] and VP-SFM as serum containing and serum-free media, respectively. The available surface area provided by the carriers, and primary cell density in the experiments were assumed the same [about 12,000 cm[2] and 12,500 cells/cm[2], respectively]. The highest cell density was achieved on FibraCel disks in DMEM equal to 7.1 +/- 0.7_10[6] cells /ml on day 9, while the lowest cell density was obtianed on Cytodex-3 in VP-SFM equal to 2.91 +/- 0.2_10[6] cells/ml. The highest virus titer [55.18 +/- 4.4_10[6] Fluorescent Focus Unit, FFU/ml] was gained in VP-SFM containing FibraCel disks, and the lowest titer [3.66 +/- 0.4 _10[6] FFU/ml] was resulted on Cytodex-3 in M199. In these experiments, FibraCel disks supported the growth of Vero cells better than the microcarriers, and the use of DMEM for propagation of Vero cells and VP-SFM for proliferation of rabies virus showed better results. The experimental vaccine prepared by collected virus from VP-SFM has an acceptable potency of 2.75 IU. Based on these results and to the relative ease for making FibraCel disks, we recommend the use of this carrier for propagation of Vero cells and production of rabies virus

Effects of carrot juice enriched with beta carotene on serum levels of inflammatory indicators in type 2 diabetics

Background and Purpose: Variation and increase in the levels of inflammatory factors and glycemia are among the major problems of type 2 diabetics. Therefore, the present study was designed to investigate the effect of beta carotene-enriched carrot juice on CRP inflammatory indexes, IL-6 and FBS glucose in diabetics

Methods and Materials: This randomized double blind clinical trial was conducted on 44 type 2 diabetics. Participants based on gender and BMI were assigned into two groups [Group A receiving 200 ml carrot juice enriched with 10 mg beta carotene and Group B receiving normal carrot juice] by randomized stratified sampling. Both groups received 200 ml carrot juice for 8 weeks for lunch [instead of cereals]. A 24-hour recall was obtained for 3 consecutive and 6 concomitant days at the beginning and end of the study duration. Also, CRP, IL-6, FBS glucose and serum beta carotene levels were measured in FBS blood sample at the beginning and end of the study duration. The consumption data were fed into Nutritionist IV, and analyzed in SPSS 11.5

Results: Each group consisted of 22 [11 male and 11 female diabetics] participants. There was a significant increase in the levels of beta carotene in group A [111.9 +/- 64.9 at the beginning and 72 +/- 43.9 at the end] [p=0.02]. However, the reduction of CRP in Group A [-996.9 +/- 2172.6 at the beginning and -537.3 +/- 1412.4 at the end] was not significant [p=0.098]. Also, IL-6 reduction in Group A [-0.8 +/- 2.1 at the beginning and -0.6 +/- 2.4 at the end] was not significant [p=0.085]. FBS glucose was also not examined in the present study

Conclusion: Daily consumption of carrot juice enriched with 10 mg beta carotene for eight weeks caused an improvement in the levels of serum antioxidants including beta carotene in type 2 diabetics, with no significant effects on serum glucose and inflammatory indexes

[ evaluation of anxiety, depression and global assessment of functioning in bipolar patients at manic and mixed episodes]

This research is carried out with the aim of comparing anxiety, depression and global assessment of functioning between two groups of bipolar patients at mixed and manic episodes. Using an analytical cross-sectional approach, a sample of 94 patients with mean age of 32 years old [Standard Deviation: 11.3], who had been categorically diagnosed with bipolar disorder using DSM-IV criteria and admitted in Shahid Beheshti Mental Hospital of Kerman /Iran from autumn 2007 to summer 2008 were analysed. These patients were grouped under two categories of Manic episode [n=48] and Mixed episode [n=46]. Hamilton's Rating Scale for Depression [HRSD] and Hamilton's Anxiety Rating scale [HARS] tests were performed. Patients' functionality were rated during their illness and for the period of 6 months before their infirmity using "Global Assessment of Functioning" [GAF] scoring system. Multiple logistic regression analysis, t-test, ANCOVA, MANOVA and Pearson Correlation coefficient were used for data analysis. Mean Hamilton's depression scores in mixed and mania groups had a significant difference [P<0.001] and mean Hamilton's Anxiety score of Mania group was significantly higher than that of mixed group. Patients' functionality rate at the time of admission was reduced considerably comparing to the 6 months prior to the admission in both groups but at admission the functionality of the tow groups did not have a significant difference. Both anxiety and depression in bipolar patients at mixed episode are higher than those in Patients at mania episode. Although the functionality of both of these groups reduces at the time of episode, there is no significant difference between these two groups in their functionality rate

Effects of beta-carotene-fortified carrot juice on the lipid profile in type-2 diabetes patients

Hyperlipedemia is a health problem in type-2 diabetes patients. This study was designed to investigate the effects of carrot juice fortified with beta-carotene on the blood lipids in these patients. This controlled randomized double-blind clinical trial was performed on 44 patients with type 2 diabetes. They were randomly divided into two groups receiving, daily for 8 weeks, either 200 ml carrot juice fortified with 10 mg beta-carotene [group A] or 200 ml ordinary carrot juice [group B]. All the subjects would drink the juice [exchanged for one serving of bread] at lunch. Twenty-four hour dietary recalls were done on 3 consecutive days and 6 alternate days by a nutritionist at the beginning and the end of the period. Initial and final fasting blood glucose, beta-carotene, and lipids were also measured. The dietary data were analyzed using Nutritionist IV and statistical analysis was done using SPSS[11.5]. The serum level of beta-carotene increased and that of total cholesterol and triglyceride, as well as the LDL-C/HDL-C and TC/HDL-C ratios, decreased significantly in group A as compared to group B. The treatments did not affect HDL-C or glucose concentrations in either group. Daily consumption of both 200 ml carrot juice fortified with 10 mg beta-carotene and ordinary carrot juice for 8 weeks brings about desirable changes in some of the blood lipids in type-2 diabetic subjects without any change in the serum glucose level, although fortified carrot juice is more effective. Such an intervention may prevent hyperlipedemia in these patients

Comparison of lipid changes in chicken frankfurters made by soybean and canola oils during storage

Two batches of frankfurters containing about 55% chicken meat with two different oils [including canola and soybean] were manufactured. Batch 1 included canola oil and Batch 2 included soybean oil in the products. Various analyses were performed to detect the lipid changes of both batches during storage. Fatty acid composition analysis using gas chromatography showed little change in the fatty acids of either batch over time. From a nutritional viewpoint, Batch 1 was more acceptable over time than Batch 2. Chemical analysis included oxidation reactions, such as peroxide and TBA [Thiobarbituric acid] value and free fatty acid analysis. Each chemical experiment had different trends at each time, but both batches had values lower than the maximum levels at all times. With regard to microbial analysis, psychrotrophic bacteria in both batches showed a decreasing order until day 30, and then growth increased. In Batch 1, a significant difference was observed only on day 1, but the differences were more significant in Batch 2, and there were significant differences on days 15, 30 and 45. Also, Lactobacillus counts were not significant after the cooking process until the end of storage [growth was not detectable after the cooking process]. At the end of storage, we concluded that Batch 1 had a higher quality and storage stability than Batch 2 and canola oil could be a good substitution for soybean oil in meat products. The data were analyzed with GLM [repeated measures]. Differences were reported as significant at P<0.05. Also, the statistical software was SPSS ver. 11.5

[Association between anti- beta 2GP1 autoantibody with Acute Coronary Syndrome]

Atherosclerosis is a chronic autoimmune inflammatory disease that remains the most common cause of death in the globe. This affects the vascular wall and leads to coronary artery diseases. Several studies have evaluated the association between auto-antibodies and cardiovascular disease. One of the candidate autoantigens is the Beta 2-glycoprotein I [beta 2GPI]. Determining risk factor of the coronary heart diseases is of huge significance, so we carried out the comparative study of Anti- beta 2GP1 autoantibody level in patients with Acute Coronary Syndrome and healthy controls in Gorgan, Iran. A case-control, study was conducted on 179 subjects in 2007 in whom 79 subjects were healthy [Control group] and 100 subjects had coronary artery disease [Case group]. A questionnaire was filled by all subjects. Blood and serum samples were assessed by commercial ELISA tests measuring IgM and IgG auto-antibodies to beta 2GP1 antigen. Data were analyzed using student t-test and Fisher test. The positivity of IgG and IgM isotypes for anti- beta 2-GPI antibodies in serum of the cases were%68.6 and%43, respectively. Our results also indicated that frequency of IgG and IgM autoanti-beta2-GPI isotypes in serum of the controls were%48.1 and%2.5, respectively. The results from the serum of the subjects showed that IgG-antibody against beta 2GPI was found in%50 of the female cases and%73.2 of the male cases [P<0.01]. On the other hand, this values were%48.5 of females and%47.8 of males in control group [P<0.05]. Our finding shows that there is a relation between serum levels of IgG-antibodies against beta 2GP and coronary artery diseases

[ survey of oral-dental health of grade 3 students of Gonabad primary schools in 2007]

Health fulfillment is based on all effective factors that fulfill it. One of the 11 slogans of 21st century is oral-dental health and it was one of the PHC items before. DMFT is a very simple, fast and reliable index in determining oral-dental health. Grade 3 students of primary school are between deciduous and permanent form dental growth point of view that mixed teeth are observed in this period that make DMFT possible. This study was done to determine oral-dental health status of students with the help of DMFT index in Gonabad city. In this descriptive-cross sectional study, all grade 3 students of primary schools [529 students] were checked for oral-dental health statues and interviewed by a dentist. The used instruments were a checklist, DMFT index, questionnaire, once used mirror a special catather. Data were analyzed by SPSS with T-test, correlative coefficient and variation analyses were analyzed. 51.2% of the samples were male and 49.8% female. 77.3% used tooth-brush and 8.32% used from dental floss. DMFT of students in research was 3.86 +/- 1.11 and DMFT was 1.04 +/- 0.22 that showed no meaningful difference in two semis [p=0.18, p=0.12]. The students that had no caries free tooth were 8.3%. One sided variation analysis showed a meaningful relationship between brushing frequencies with the index. Family size and education had a meaningful relationship with DMFT. The results showed that oral-dental health statues of grade 3 students of Gonabad primary school follow the country model and it is fairly well and CF has no meaningful difference with national index but it is average in accordance with WHO goal. Programmed efforts for KAP improvement and using need resources, administration evaluation, costs efficacy of some measures such as fluoride therapy, etc seems necessary

Awareness, treatment and control of hypertension, dyslipidaemia and diabetes mellitus in an Iranian population: the IHHP study

We used data from the baseline survey from the Isfahan Healthy Heart Programme to determine the prevalence of hypertension, dyslipidaemia and diabetes among a representative samples of 12 514 adults living in 3 cities in the Islamic Republic of Iran. The prevalence of hypertension, dyslipidaemia and diabetes was 17.3%, 66.3% and 5.6% respectively. Awareness, treatment and control of hypertension were 40.3%, 35.3%, and 9.1% respectively. The rates for dyslipidaemia were 14.4%, 7.1% and 6.5% respectively, and 54.6% of diabetics were aware of their disease and 46.2% were under treatment

[Intravitreal bevacizumab [avastin] injection alone or combined with triamcinolone versus macular photocoagulation as primary treatment for diabetic macular edema; an interim analysis]

To report the efficacy of a single intravitreal injection of bevacizumab [IVB] alone or in combination with intravitreal triamcinolone acetonide [IVT] versus macular laser photocoagulation [MPC] as primary treatment for diabetic macular edema [DME]. This randomized three-arm clinical trial included 103 eyes of 97 patients with clinically significant DME and no previous treatment. The eyes were randomly assigned to one of the three study arms: the IVB group received 1.25 mg IVB [37 eyes], the IVB/IVT group received 1.25 mg IVB together with 2 mg IVT [33 eyes], and the MPC group underwent focal or modified grid laser photocoagulation [33 eyes]. Primary outcome measure was change in best-corrected visual acuity [BCVA]. Changes in BCVA [logMAR] at 12 weeks were -0.22 +/- 0.23, -0.13 +/- 0.31 and +0.08 +/- 0.31 in the IVB, IVB/IVT and MPC groups, respectively. The marginal regression model based on generalized estimating equation analysis demonstrated that changes in visual acuity was statistically significant in the IVB group at both 6 [P<0.001] and 12 [P=0.024] weeks but only at 6 weeks in the IVB/IVT group. Significant decrease in central macular thickness [CMT] was observed in the IVB and IVB/IVT groups at 6 weeks. Up to 12 weeks, IVB treatment in eyes with DME yielded better visual outcome than laser photocoagulation, although it was not associated with a significant decrease in CMT. IVT seemed to have no further beneficial effect in combination with IVB

[Causes of visual impairment among patients referred to rehabilitation clinics of Shahid Beheshti medical university]

To describe causes of low vision and blindness in patients referred for low vision aids to rehabilitation clinics at Shahid Beheshti Medical University during 2005. Visual acuity was classified to five groups based on best-corrected visual acuity [BCVA] in the better eye according to World Health Organization [WHO] criteria and by using standard Snellen chart which included mild, moderate, severe and profound low vision and blindness. The causes of blindness and low vision were determined using the 10[th] version of International Classification of Diseases [ICD-10] based on the main cause in both eyes. The study was performed on 432 patients including 275 [65%] male and 148 [35%] female subjects with mean age of 43.6 +/- 25.5 [range 3-92] years. Mild to moderate and severe low vision and blindness were present in 28.8%, 46.4% and 24.8% of cases, respectively. The main causes of visual impairment were diseases of the retina and choroid [74.5%], optic nerve and optic tract diseases [9.8%], vitreous and globe disorders [3.5%], congenital cataract [3.1%] and glaucoma [2.6%]. The pattern of distribution of the causes was almost similar in all age subgroups. Diseases of the retina and choroid are the main cause of visual impairment among patients referred to eye rehabilitation clinics

[Intravitreal injection of bevacizumab versus triamcinolone acetonide in patients with refractory CME]

To compare intravitreal bevacizumab [IVB] with intravitreal triamcinolone acetonide [IVT] for treatment of refractory uveitic cystoid macular edema [CME]. In this randomized clinical trial, 31 eyes with uveitic CME were allocated into 2 groups: the IVB group, received one to three injections of 1.25 mg bevacizumab [15 eyes]; the IVT group received one to three injections of 2mg triamcinolone [16 eyes]. The primary outcome measure was change in best-corrected visual acuity [BCVA] at 36 weeks. Visual acuity improvement as compared to baseline values was meaningful in the IVB group at 12, 24, and 36 weeks and in the IVT group at 24 and 36 weeks. A significant reduction in central macular thickness [CMT] was observed only in the IVT group at week 36 [74.6?108.0 microm [P=0.049]]. Intergroup analysis however, disclosed no significant difference in any of the outcome measures. By removing the effect of cataracts, IVT had a better improving effect on VA [P=0.007]. No significant systemic side effect was observed during the study period. IVB was as effective as IVT in refractory uveitic CME regarding VA improvement. Irrespective of triamcinolone-induced cataract, the effect of IVT may be superior to IVB

[Evaluation of the impact vaccination program among children and mothers during in southern khorasan province in 2005 year]

Vaccination is one of the most important index for disease prevention program. Therefore this study conducted to assess the coverage of vaccination program to identify the delay or disruption of program in 2005 year. Health profiles [vaccination card] of children between 15-26 months assessed. We did interview with their mothers as well. This survey was conducted in rural and urban area in southern Khorasan province in Iran during 2005. The coverage of children and mother's vaccination were 96.7% and 71.1% respectively. The study findings showed that inadequate information about the arrangement of dosage, distance to health centre and feeling the necessity of vaccination were most factors for incomplete converge of vaccination program. Based on study findings educational program to increase mothers awareness is recommended

[ burden of traffic accidents in south Khorasan province, Iran in 2005]

Burden of disease studies have been implemented in many countries using the disability adjusted life year [DALY] to assess major health problems. This study was designed to assess the burden of transport accident in South Khorasan [SK] province of Iran for 2005. Years of life lost [YLLs], Years lived with Disability [YLDs] and DALYs were calculated by using methodology developed for the global burden of disease study [GBD] in 2003. The total population of SK was included in this study. In the 2005 year, the DALYs from transport accident in the south Khorasan province were 7456. DALYs for males and females were 5775[77%], 1 691 [23%] years respectively. The total rate of DALYs was 13.28 [per 1000] and with higher rates in age groups 30-44 years [20/86 per 1000], 15-29 years [16/96 per 1000] and 45-59 years [13/28 per 1000]. The age group 15- 44 years was more at risk of transport accidents and injuries than others. The findings suggest that adequate interventional programs for transport accidents prevention and control should be taken to minimize at different levels

Utilization pattern of antibiotics in different wards of Sari Imam Khomeini teaching hospital

Due to an increase in cases of irrational drug prescription and it's health and economic consequences, evaluation of the rational use of drugs seemed necessary. Among drug groups antibiotics are greatly significant. Utilization pattern of antibiotics in different wards of Sari Imam Khomeini teaching hospital in the first half of 2000 and 2005 were reviewed. ATC/DDD [Anatomic, Therapeutic, Chemical/ Defined Daily Dose] methodology was used. Data showed, use of antibiotics jumped from 95.4 DBDs [DDD per patient's bed-days] to 124 DBDs. Distribution of different class of anti-microbial, showed the highest increase in use of vancomycin and clindamycin. Use of cotrimoxazole and aminoglycosides remained fairly unchanged, howerrs consumption of Penicillin G dropped. In year 2005, ICU ward followed by gynecology, were among the University Hospital departments with the highest consumption of antibiotics. Cefazolin was the most prescribed antibiotics during this study. It appears that there is a need for more national drug policities and drug education program for health care professionals. Evaluation of drug distribution in hospitals seems to be necessary

multicomponent intervention to prevent postoperative delirium after open-heart surgery

To assess a multi-component intervention to prevent post operative delirium after open-heart surgery. This is an experimental-analytic study which assessed 32 patients 45 to 70 years of age after open-heart surgery in to 16 member groups [case and control]. From second days after operation until three days later, by 6 risk factors: cognitive visual and auditory impairment immobility, dehydration and sleep deprivation were assessed and a standard protocol was used for case group. Incidence of delirium was determined by clinical interview; based on DSM-IV-TR; twice a day [morning and evening]. Result were analyzed by t-test and S- plus. The median of total number of risk factors and immobility in case group had a significant reduction in comparison to control group. There were trends towards reduction in other risk factors and incidence of delirium. Primary prevention of delirium is probably the most effective treatment strategy

[Phacoemulsification and intraocular lens implantation in patients with congenital iris coloboma]

To evaluate the outcomes and complications of phacoemulsification and posterior chamber intraocular lens implantation [PE+PCIOL] in patients with congenital iris coloboma. In a prospective noncomparative interventional case series, 13 eyes of 9 patients [six female and three male] with congenital iris coloboma and cataract underwent PE+PCIOL using clear corneal incision and in-the-bag foldable hydrophilic acrylic IOL implantation by one surgeon. Best corrected visual acuity [BCVA] and complications were evaluated six months postoperatively. Mean age was 46.5 +/- 5.7 years. BCVA was counting finger in six eyes and between 20/200-20/100 in seven eyes, preoperatively which increased to 20/50-20/20 in 11 eyes, postoperatively [P<0.001]. No serious complications occurred intraoperatively. Two eyes had concomitant ocular pathology causing no improvement in their visual acuity after surgery. Two patients developed postoperative monocular dioplopia. No case of retinal detachment occurred during the follow up period. PE+PCIOL seems to be safe and effective in terms of visual improvement in patients with typical congenital iris coloboma and cataract

[ case of tuberous sclerosis with ocular involvement]

To report multiple astrocytic hamartomas in a patient with tuberous sclerosis [TS]. A 16-year-old girl with TS without any ocular complaint was referred for ophthalmologic examination. She had popular rash on her face and other skin lesions elsewhere in the body which were specific for TS. Multiple well-circumscribed elevated lesions characteristic of astrocytic hamartoma were seen in the retina of both eyes. Two larger nodular and calcified masses, one in inferotemporal retina of the left eye and another in superotemporal retina of the right eye were also detected. One of these lesions was located in far periphery. One of the retinal masses in our patient was located in the far periphery of the retina which is in contrast to previous reports that mention a maximum of 2 disc diameter distance from the optic disc for such lesions. Because of high probability of eye involvement, all cases of TS should undergo a thorough ocular examination

[Quantitative and qualitative study of dermatoglyphic patterns of schizophrenia in Khorasan Province]

Finger and hand prints are formed during the late first and second trimester of fetal development, and then remain unchanged. Schizophrenia is a psychotic disease that coexists with structural and biochemical changes of CNS. It is probably under the influence of environmental and/or genetic factors. There are some suggestions that disturbance in the dermatoglyphic patterns are probably in relationship with the appearance of schizophrenia. It seems that this disturbance appears in the first and second trimesters of fetal development, which is a critical period for CNS growth. We have studied the dermatoglyphic changes in 91 schizophrenic patients [49M, 42F] in Ebne Sina Psychosis Hospital of Mashhad, and have compared them with those of 72 healthy controls [42M, 30F]. The x2 test was used for quantitative and T-test for qualitative data analysis. The results showed a significant reduction of TABRC between healthy and patient. The forms of Loop and Arch are heterogeneous and compared to the control group were significant [P=.0/04,P=0/036]. In conclusion, these results provide further evidence that abnormal dermatoglyphic patterns exist in some patients with schizophrenia, and that, the a-b ridge count can be used as a marker of this psychotic disease, and support the idea that the incidence of schizophrenia maybe due to the adverse intrauterine events. Because these events probably affect the brain, behavior and finger print patterns, dermatoglyphics would be a proper method for prognosis of some cases of schizophrenia

Antinociceptive effects of Melisa officinalis aerial parts extracts in Mice

Some labiatae family plants show antinociceptive activities. Melisa officinalis belongs to this family, thus, antinociceptive activity of the aqueous decoction and ethanolic maceration extracts of the aerial parts of this plant studied in mice. Antinociceptive activities were done using hotplate and writhing tests. In hot-plate and writhing tests, the intraperitoneal injection of both extracts showed significant antinociceptive activity in mice. Naloxone, an opioid antagonist, pre-treatment, inhibited the antinociceptive activity of the extracts in hot-plate test. The extracts exhibited antinociceptive activity against acetic acid induced writhing which was partially blocked by naloxone. It is concluded that the aqueous decoction and ethanolic maceration of the aerial parts of M. officinalis has antinociceptive effects and this may be mediated partially by opioid receptors