Designing an expert system for prediction of heart attack using fuzzy systems

Background and Aim: Nowadays, there are increasing amounts of data in various fields, which calls for special methods for management and extraction of information. Therefore, use of expert systems in different fields in particular medicine has attracted the attention of many investigators. Prediction of diseases such as heart attack is also a complex issue for which selection of major risk fectors and obtaining correct results have been considered essential

Material and Methods: In this study, using fuzzy system, a model was designed which works based on medical knowledge and discerning comparison. In this system the criteria used for the diagnosis heart attack are introduced into the system. Then theses criteria will be used for the risk fectors in order to predict presence or absence of heart attack. In order to increase efficiency and accuracy of the system, the influence of the more important risk fectors have received higher values. The proposed algorithm was used for the data collected from 1000 heart attack cases and patients without heart disease by using fuzzy systems in Tohid Hospital in Sanandaj

Results: The proposed algorithm could predict heart disease with 98% accuracy in the subjects predisposed to heart attack. Another advantage of this method is its high efficiency in the absence of important diagnostic methods, such as exercise testing

Conclusion: The proposed algorithm can accurately identify patients with heart disease

Risk fectors such as age, blood pressure, unhealthy fet, smoking, family history and gender have significant impacts on the development of heart disease, Therefore, designing interventional programs by medical centers and providing information by mass media can be useful for prevention of heart attack

Investigation of enterotoxins of Staphylococcus aureus in processed meat products sausage and ham, in Isfahan Province in summer of 2015

Background and Aim: Contamination of food with enterotoxins of Staphylococcus aureus is a risk factor for public health. Because of lack of information on the contamination of the processed meat products including sausage and hams with the enterotoxins of Staphylococcus aureus, the present study was conducted to assess the presence of these toxins in the aforementioned products in Iran

Material and Methods: In this cross sectional study, 72 samples of sausage and ham were obtained from product storages of four active meat processing plants with different qualitative grades; including A, B, C and D in summer of 2015 in Isfahan Province, Iran. The qualitative grading of the meat processing plants was performed on the basis of the [pre requisite programs: PRPs] form approved by Food and Drug Administration of Ministry of Health in Iran. The scores of hygienic factors including [hygiene of workers], [production and processing], [washing, disinfection, cleaning] and [hazard identification and verification] of the aforementioned meat processing plants were determined according to the PRPs form

The meat processing plant with qualitative grades of A, B, C and D had the scores of 924, 825, 754 and 614, respectively. The hygienic grades of meat processing plants were [desirable], based on the PRPs form. The ELISA kite was used to detect the enterotoxins of Staphylococcus aureus

Results: The results showed lack of contamination of the processed meat products with enterotoxins of Staphylococcus aureus in all samp Is obtained from all of the factories with different qualitative grades

Conclusion: The result of the current study showed that the implementation of suitable designs in relation to the hygienic principles and the continuous surveillance of food inspectors of the Department of Food and Drug of Isfahan University of medical sciences could have a positive role in prevention of contamination of sausage and hams with enterotoxins of Staphylococcus aureus

[VacA and cagA genotypes status and antimicrobial resistance properties of Helicobacter pylori strains isolated from meat products in Isfahan province, Iran]

Although Helicobacter pylori has a significant impact on the occurrence of severe clinical syndromes, its exact ways of transmission and origin have not been identified. According to the results of some previously published articles, foods with animal origins play a substantial role in the transmission of H. pylori to humans. The present investigation was carried out to study the vacuolating cytotoxin A [vacA] and cytotoxin associated gene A [cagA] genotypes status and antibiotic resistance properties of H. pylori strains recovered from minced-meat and hamburger samples. A total of 150 meat product samples were collected from supermarkets. All samples were cultured and the susceptive colonies were then subjected to nested-PCR, PCR-based genotyping and disk diffusion methods. 11 out of 150 samples [7.33%] were positive for H. pylori. All the isolates were further identified using the nested-PCR assay. Prevalence of H. pylori in hamburger and minced-meat samples was 1.42% and 12.5%, respectively. S1a, m1a and cagA were the most commonly detected genotypes. The most commonly detected combined genotypes in the H. pylori strains of minced-meat were s1am1a [10%], s1am1b [10%] and s2m1a [10%]. Helicobacter pylori strains of meat products harbored the highest levels of resistance against ampicillin [90.90%], erythromycin [72.72%], amoxicillin [72.72%], trimethoprim [63.63%], tetracycline [63.63%], and clarithromycin [63.63%]. Hamburger and minced-meat samples may be the sources of virulent and resistant strains of H. pylori. Meat products are possible sources of resistant and virulent strains of H. pylori similar to those vacA and cagA genotypes. Using healthy raw materials and observation of personal hygiene can reduce the risk of H. pylori in meat products

[Relationship between platelet indices and severity of rheumatoid arthritis according to DAS28 criteria]

There are few studies about the relationship between platelet indices and the activity of rheumatoid disease and it is still a controversial issue. Therefore we decided to study the relationship between platelet indices and severity of rheumatoid arthritis according to DAS28 criteria. In this Historical cohort study, 250 patients with rheumatoid arthritis and 250 people who accompanied the patients were selected via convenient sampling method. After written consent; 2cc of blood was taken from each patient and was sent to our laboratory. All patients were examined by a rheumatologist for diagnosis of disease activity. DAS28 formula was used to evaluate the severity of disease activity. Data were entered into SPSS 16 software and analyzed by independent t-test, Pearson correlation and multiple regression analysis. The mean values of hemoglobin [p<0.001], hematocrit [p<0.001], MCH [p<0.001], and PLcr [p=0.002] were lower in the patient group compared to the control group. The mean values of platelet [p<0.001], RDW [p=0.001], and PDW [p= 0.03] were higher in the patient group in comparison to the control group. There was no statistically significant differences between the two groups in relation to the mean values of MCV [p= 0.22] and MPV [p= 0.21]. A significant negative correlation was observed between DAS28 scores of hemoglobin [p=0.005] and hematocrit [p=0.02]. Increased severity of the rheumatoid arthritis led to decreased hemoglobin and hematocrit and increased platelet count. Therefore, these blood parameters can be used as a primary prognostic factor. Also ESR can be regarded as a good prognostic factor. However, MCV and MPV are not suitable prognostic factors for the patients with rheumatoid arthritis

[Survival rate estimation and its associated factors in patients with stomach cancer in Tohid Hospital in Sanandaj]

Estimation of the survival rate after diagnosis is an important indicator of treatment process in cancer patients. The aim of the present study was to determine 5-yearsurvival rate and its associated factors in the patients with stomach cancer. This was a descriptive analytical study. We reviewed records of 239 patients with confirmed diagnosis of stomach cancer who had been hospitalized at Tohid Hospital in Sanandaj city, during a five-year interval from 2006 onwards. Survival rate was calculated according to the Kaplan-Meier and by using Log rank statistical methods. Our study included 178 male [74.5%] and 61 female [25.5%] patients with a mean age of 68.8 +/- 11.97 years. The mean maximum survival rate was 19.85 months [CI 95%: 16.46-23.24] which belonged to the patients with intestinal type of tumors [60.6%, n=145], followed by the patients who had surgical therapy [10.3%, n=21] with a mean survival rate of 15.67 months [CI95%: 8.78-22.58]. Variables such as gender, residential areas, and history of stomach cancer in first degree relatives, history of symptoms of gastric diseases, cigarette smoking and psychiatric disorders during treatment course showed no significant association with mean survival rate. The mean survival rate in the patients which their cancer had been diagnosed at early stages was 14.86 months [CI 95%, 12.77-16.94] which was significantly higher as compared to those with late diagnosis of the disease[P=0.049]. One to five year survival rates were 41%, 17%, 13%, 10% and 5.4% respectively. Early diagnosis of stomach cancer increases 5 years survival rate in the patients significantly

[Comparing the effects of Hatha yoga and physical fitness on anxiety and depression in women]

Anxiety and depression have increasingly affected many people within the last two decades and therefore researchers are trying to find non-invasive and non-drug methods for these disorders. In this respect, Hatha yoga practice, as an alternative medical system, seems to have attracted considerable attention. The purpose of this study was to compare the effects of Hatha yoga and physical fitness training on anxiety and depression in women. This was a quasi-experimental study with pre-test and post-test performed on 42 women who visited the sport clubs of yoga and physical fitness in the city of Shiraz [Iran] in 2009. Women diagnosed as having anxiety and depression but declined to take medications were invited to fill out the questionnaire designed by the researchers if they were willing to do so. The study population was randomly divided in two groups as Hatha yoga and physical fitness of 21 members each. Exercise protocol included 24 sessions of Hatha yoga and physical fitness over eight weeks and performed as three training sessions of 90 min duration a week. Depression, anxiety, and stress scales were used to evaluate the degree of anxiety and depression. There was a significant difference in degree of anxiety and depression between the pretest and post-test findings in Hatha yoga group [p=0.017] but not in the physical fitness group [p=0.664]. Also, a significant difference in post-test results for anxiety and depression between the Hatha yoga and physical fitness groups was demonstrated [p=0.001]. Consistent with other similar studies, our study showed that the Hatha yoga and physical fitness practices have beneficial effects on management of anxiety and depression symptoms and could lead to appearance of a balance in physical, emotional, mental, and spiritual capacities of an individual. Hence the Hatha yoga and physical fitness practices can be used as an alternative medical system for these disorders

[Isolation of Escherichia coli O[157]: H[7] in sheep meats using cultural and PCR method]

Background and aim: Escherichia coli O[157]:H[7] is now recognized as an important cause of diarrhea, hemorrhagia colitis and hemolytic-uremic syndrome worldwide. Meat contaminated with animal feces is probably the major source of the E. coli O[157]:H[7]. In this study, we investigated the prevalence of E. coli O[157]:H[7] in meat samples of sheep in Isfahan from August 2008 to January 2010

Methods: A total of 148 sheep carcasses in Isfahan slaughterhouse were assessed for E. coli O[157]:H[7] using the standard cultural and polymerase chain reaction [PCR] methods. Bacteriological examinations were performed by using Triptone Soya Broth containing Novobiocin [TSB-n] as an enrichment media and then sorbitol MacConkey agar plates supplemented with Cefixime and Tellurite [CT-SMAC] a selective plating media. Suspected colonies of E. coli O[157]:H[7], identified by bacteriological methods, were tested by PCR

Results: Using cultural method, 43 [29.1%] and 10 [6.8%] samples were positive for E. coli and E. coli O[157]:H[7], respectively. Only 5 sorobitol negative E. coli strains were identified as E. coli O[157]:H[7], using polymerase chain reaction. The seasonal prevalence of E. coli O[157]:H[7] in samples were 0-9.7% and it was at its highest level in Spring and Summer

Conclusion: These results indicate that sheep can be a reservoir for E. coli O[157]:H[7] and sheep meat may serve as a vehicle for the pathogen transmission to human

Isolation of enterotoxigenic and enteroaggregative straines of Escherichia coli from chicken carcasses by PCR

The aim of this study was to determine the frequency of enterotoxigenic and enteroaggregative strains of Escherichia coli in chicken carcasses by polymerase chain reaction [PCR]. In this study 63 strains of E. coli were isolated from 110 samples of chicken carcasses during processing after chilling in the poultry slaughter house of Shahrekord. Polymerase chain reaction assays were used to detect the presence of the genes encoding heat-stable enterotoxin a [STa], heat-stable enterotoxin b [STb], heat labile toxin [LT] and Enteroaggregative heat-stable toxin 1 [EAST1]. Sixty three out of 110 [57.27%] carcasses were contaminated with E. coli. Six out of 63 [9.52%] harbored the gene for LT, 1 [1.58%] STb, 21 [33.3%] EAST1 and 8 [12.69%] contain both LT and EAST1 genes. None of the strains contain the STa gene. The results indicated that contamination of the chicken carcasses with E. coli in such a level could be a potential hazard for consumers

Helicobacter pylori as a protective factor for esophageal squamous cell carcinoma

A wide variety of epidemiological studies suggest the increase in incidence of esophageal adenocarcinoma which, in turn, might be related to decrease in Helicobacter pylori prevalence, but very few studies have examined this association .The aim of this study was therefore to evaluate the relationship between H.pylori and esophageal squamous-cell carcinoma in Urmia in a period of 30 months. In this case-control study 161 patients with pathologically proven esophageal squamous-cell carcinoma were enrolled. Subjects were cancer cases, pathologically proven to have esophageal squamous-cell carcinoma, in medical centers in Urmia in the west of Iran during a 30-months period in 2006 -2007 .Control cases [168 patients] were selected from the patients who were admitted to the ophthalmology department and were matched for sex, age and history of smoking. H .pylori seropositivity was determined by ELISA, using Trinity Biptech capita measuring IgG .Data were analyzed using Chi square and Mantel Hanzel tests. The mean age of patients with esophageal cancer was 61.8[SD=13.4] years. Sixty eight[42.2%] of patients were male and 93[57.8%]were female. In 31[19.2%] cases tumor ware located in the upper, 73 [45.3%] cases in middle and in remaining 57[35.4%] cases in the lower portion of the esophagus. A total of 69 [42.8%] and 105[62.5%] out of 161 cases and 168 controls, respectively, had positive H. pylori infection. Subjects with positive H .pylori infections had a significantly reduced risk [OR= 0.45; 95% CI= 0.28-0.72; P=0.0001] of developing esophageal SCC than those without SCC. Our findings suggest that H .pylori infection may have a protective role against development of esophageal SCC in our area .Additional studies are needed to confirm these findings

[Epidemiology of helicobacter pylori infection in Kurdistan Province, 2006]

It is estimated that more than half of the world population are infected with H-pylori. Therefore, this infection maybe regarded the most common infection in human being. The organism may be unique among bacterial pathogens in provoking a wide range of sequelae. The aim of this study was to determine the prevalence rate of H-pylori infection in Kurdistan Province in the west of Iran, in 2006. In this cross sectional study, the sample size included 1503 people, older than 10 years of age, who were selected randomly out of Kurdistan resident population. Samples were tested by use of ELISA method for detection of H-pylori IgG antibody using kits of Trinity Biptech capita H.pylori IgG. Data were introduced into SPSS software and analyzed by means of Correlation analysis, t-test, and X[2] test. Blood specimens from 1503 subjects were collected. 866 [57.6%] patients were female and 637 [42.4%] were male. 802 [53.35] patients were living in urban and 70 [46.64%] patients in rural areas. The mean age of subjects was 32.15 [SD=14.91] years, with age range of 10 to 100 years. The prevalence of H-pylori infection was 36.5 percent. According to the results of this study the prevalence of Helicobacter pylori infection in our subjects is relatively low which must be considered in clinical evaluation

Determination of cadmium and lead in human milk

The objectives of this study were to determine cadmium and lead concentrations in the breast milk of healthy lactating women who were living in Zarrinshahr, an industrial area of Iran and to investigate the effect of mother's age, parity and smoking habits in families living in the vicinity of areas contaminated with heavy metals. Cadmium and lead concentrations were determined by graphite furnace atomic absorption spectrometry in 44 milk samples from healthy lactating women collected on first to sixth postpartum week. Accuracy of the analysis was checked by various methods including the use of reference material. The mean + standard deviation of cadmium and lead concentrations in human milk were 2.44 +/- 1.47 micro g/L [range 0.62 -6.32 micro g/L] and 10.39 +/- 4.72 micro g/L [range 3.18-24.67 micro g/L], respectively. There was a positive correlation between the concentrations of lead in milk samples and mother's age and parity [P < 0.05]. Also the concentration of cadmium in breast milk significantly increased [P < 0.05] in mothers who were actively and/or passively exposed to smoking. The results of this study showed that lead and cadmium concentrations in milk samples from lactating women in Zarrinshahr were high. This can be a major public health hazard for the inhabitants living in this industrial region of Iran

Relationship between Helicobacter pylori infection and cardiac syndrome X

There is no obvious etiology for cardiac syndrome X [CSX]. Some mechanisms, such as endothelial dysfunction and estrogen deficiency have been involved. In this study, we tried to find the association between Helicobacter pylori [HP] infection and cardiac syndrome X. In this case control study in year 2007, 54 cardiac syndrome X-affected patients and 168 referred patients to the Taleghani hospital for elective surgery were included. Data were collected by interview physical examination, laboratory and angiographic findings. Then, Serum anti-Helicobacter pylori antibody [IgG] was determined by enzyme-linked immunosorbent assay [ELISA]. Statistical analysis was performed using Chi-square, and Mantel- Hanzel tests with SPSS software. According to the results of this study, 54 patients were considered as case group and meeting diagnostic criteria for cardiac syndrome X. The mean age of subjects was 54.54 +/- 8.99 years [range=38 to 72 years]. From the total 54 case group patients, 44 patients [81.5%] were positive for helicobacter pylori and from 168 control patients, 95 patients [56.5%] were positive [P < 0.001]. There was no significant difference between history of diabetes and blood pressure in H.pylori-positive cardiac syndrome X-affected patients. According to the results of this study, a probable role for HP infection seems to be involved in the pathogenesis of CSX

[ effects of expiratory rib cage compression before endotracheal suctioning on airway-secretion removal in mechanically ventilated patients]

Endotracheal suctioning is one of the most frequently used methods for airway clearance in patients receiving mechanical ventilation. Chest physiotherapy techniques before endotracheal suctioning can be used to facilitate mobilizing and removing airway secretions. The study was conducted to determine the effects of expiratory rib cage compression before endotracheal suctioning on airway-secretion removal in patients receiving mechanical ventilation. A clinical trial study design was undertaken with a sample of 70 mechanically ventilated patients drawn from intensive care units and emergency department of Hazrat-e Rasool Hospital in Tehran. They were selected through purposive convenience sampling. All participants received two endotracheal suctioning with and without rib cage compression. There was at least three hours interval between the two interventions. Expiratory rib cage compression was performed for five minutes before endotracheal suctioning. Sputum was collected in a pre-weighed sputum trap attached to the suction catheter. Data were collected using data recording sheet. All statistics were computed by the SPSS software data [version 11.5], using Paired T-test. Mean of removed airway-secretions by rib cage compression was 3.66 compare to 3.21 without rib cage compression. Significant differences in airway-secretion removal between the two methods [P<0.0001] were demonstrated. Findings indicated that expiratory rib cage compression before endotracheal suctioning improves airway-secretion removal, compare to performing only endotracheal suctioning. The study recommends performing expiratory rib cage compression before endotracheal suctioning in patients receiving mechanical ventilation

[ effect of sexual cognitive-behavioral therapy on females' sexual knowledge, sexual attitude, and sexual self-confidence. A case study in Shiraz, Iran]

Knowledge and attitude about sex are very important elements in sexual dysfunction. The aim of the present study was to study the effectiveness of sexual cognitive-behavioral therapy on improvement of sexual knowledge, sexual attitude, and sexual self-confidence in women. This was a quasi-experimental study with pre- and post test and a control group. Thirty married women were selected through simple random sampling method and assigned into experimental and control groups. The Sexual knowledge questionnaire [Ann Hooper]; the Sexual Self-Confidence Questionnaire [Ann Hooper] and the Sexual Attitude Questionnaire [Khushabi and Valaie] were used for data collecting. The experimental group received sexual cognitive-behavioral therapy while the control group was in the waiting list. The results showed that interventions were effective in women sexual knowledge [p<0.0001], sexual attitude [P<0.0001], and sexual self-confidence [P<0.0001]. It was concluded that sexual cognitive-behavioral therapy could improve female sexual knowledge, sexual attitude and sexual self-confidence

Relationship between violence exposure pregnancy and neonatal low birth weight: a case-control study

Birth weight is one of the most important indices of health status in communities. Exposure with violence during pregnancy may influence birth weight. The aim of this study was to assess the relationship between exposure with violence during pregnancy and low birth weight. [LBW]. This case-control study was conducted on 318 cases [Mothers with neonates weight less than 2500 grams] and [Mothers with neonates wigheied more than 2500 grams] 318 controls matched by sex of neonate and pregnancy age. The cases were selected using convenience sampling method and the controls were selected using quota sampling method in 2006-2007. The data were collected using a structured questionnaire and interview method. The data were analyzed by descriptive and analytical [chi. square and independent T-test' odds ratio and logistic multiple regression model] statistics' using SPSS 13 software. The mean birth weight among the cases and controls was 2217 +/- 334 and 3390 +/- 392 grams, respectively. This study showed that 13.7% of women were not exposed to any violence during the pregnancy [10% of cases and 17% of controls]. Multiple analysis using logistic regression showed that the chances of LBW among neonates whose mothers were exposed to behavioral, sexual and physical violence were 1.5 [P> 0.05], 2 [P> 0.05] and 4.9 [P=0.01] times that of the unexposed group respectively. The results showed that physical violence during pregnancy influences the birth weight. It is recommended that some programs be plan need to reduce violence, especially physician violence, and the families be justified about the consequences of such violence

[ effects of endotracheal suctioning on arterial blood gases in patients receiving mechanical ventilation: a before-after open clinical trial]

Endotracheal suctioning is one of the most frequently used methods for airway clearance in patients receiving mechanical ventilation but there are controversial findings regarding its effects on arterial blood gases in mechanically ventilated patients. This study was carried out to determine the effects of endotracheal suctioning on arterial blood gases in patients receiving mechanical ventilation. This research was a before-after open clinical trial study. The subjects consisted of 70 mechanically ventilated patients who were admitted to intensive care units and emergency department of Hazrat-Rasool Hospital in Tehran. Subjects were selected with purposive convenience sampling. The patients received endotracheal suctioning. Arterial blood gases were measured 5 minutes before and 25 minutes after endotracheal suctioning. Data were recorded on the data-recording sheet. Data were analyzed utilizing Wilcoxon and paired t-tests. There were significant differences in the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen [Pao2/Fio2], Paco2, and arterial oxygen saturation [Sao2] between before and after endotracheal suctioning [p=0.000]. As findings showed that endotracheal suctioning improves arterial blood gases exchanges in patients receiving mechanical ventilation, so performing endotracheal suctioning in mechanically ventilated patients is recommended

prevalence of Escherichia coli O157:H7, Listeria monocytogenes and Campylobacter spp. on bovine carcasses in Isfahan, Iran

This study was carried out to determine the prevalence of foodborne pathogens, Escherichia coli, E. coli O157:H7, Listeria monocytogenes and Campylobacter spp. on slaughtered cattle in Isfahan, Iran. A total of 203 cattle carcasses were sampled by surface section of neck meat taken immediately after slaughter and analyzed using microbiological examinations. Suspected colonies to E. coli O157:H7 were confirmed by a specific polymerase chain reaction method [PCR]. The results showed that the contamination rate of samples to E. coli and E. coil O157:H7 were 42.4 and 6.4%, respectively. Seasonal distribution showed that the highest prevalence of E. coli and E. coli O157:H7 occurred in summer samples. Six carcasses carried L. monocytogenes whereas Campylobacter spp. were not detected on any carcasses. The results indicated that prevalence of E. coil and E. coli O157:H7 was high on bovine carcasses in lsfahan. This condition should be considered as a probable hazard for human health

[Prognostic value of serum T-lymhocyte cytokines for prediction of early acute rejection of renal transplants]

Acute rejection is one of the most important complications after renal transplantation which influences transplant prognosis and survival. This study was conducted to determine the prognostic value of Th1/ Th2 cytokines in acute renal rejection [AR]. This was a cross-sectional study and included 60 kidney transplant recipients [40 male, mean age 38.82], who had received their transplants from live donors. Serum levels of Th-1 dependent cytokines [interleukin- [IL] 2 and interferon-gamma] and Th-2 dependent cytokines [IL-4, IL-10] were measured on the day before, 7th and 14th days post transplantation using ELISA. All the patients received Immunosupressive agents including cyclosporine, mychofenolate mofetile and prednisolon. Acute rejection was defined as a more than 50 percent rise in serum creatinin in the first 20 days after transplantation. Data were introduced into SPSS soft ware and analyzed by means of independent T-test. Among 60 patients, 40 were male. The mean age of the patients were 38.82 years. In our study we diagnosed twelve cases of AR [20% of the cases]. There was no significant relation between the serum levels of IL2, IL4, IL10 and IFN zeta in the patients with acute rejection of the transplant and those without. These data showed that there is no correlation between Th1/ Th2 serum cytokines profile and early AR episodes in kidney transplantation and these cytokines can not be used as prognostic factors in acute renal rejection

effect of addition of intravenous nitroglycerin to lidocaine for improvement of quality of intravenous regional anesthesia

Disadvantages of intravenous regional anesthesia [IVRA] include slow onset, poor muscle relaxation, tourniquet pain, and rapid onset of pain after tourniquet deflation. In this randomized, double-blind study, we evaluated the effect of addition of nitroglycerine [NTG] to lidocaine for improvement of IVRA. Forty six patients [20-50 yrs] were randomly assigned into 2 equal groups. Under identical conditions, the control group received 3 mg/kg of lidocaine 0.5% diluted with saline, and the study group received an additional 200 microgram NTG. Vital signs and tourniquet pain were measured on the basis of VAS score and recorded before applying tourniquet and 5, 10, 15, 20, and 30 min after administration of anesthetic solution. The onset of sensory and motor block was measured and recorded for all patients. Severity of pain was measured at 5 min, 2, 4, 6, 12, 24, hours after deflation of tourniquet and the total dosage of pethidin injected in the first 24 hours after operation was calculated. Sensory and motor block began more rapidly in study group than control group [2.61 vs. 5.09 and 4.22 vs. 7.04 min., respectively] [p<0.05]. Recovery from sensory and motor block and onset of tourniquet pain were delayed [7.26 vs. 3.43, 9.70 vs. 3.74 and 25 vs. 16.65min., respectively] [p<0.05]. Duration of analgesia after tourniquet deflation was more prolonged and tourniquet pain intensity was lower in study group [p<0.05]. Fentanyl requirement during operation and meperidine used during first postoperative day and pain intensity at 4, 6, 12 and 24hr postoperatively were lower in study group p<0.05. No significant side effect was noted in the patients of both groups. Addition of NTG to lidocaine in intravenous regional anesthesia accelerates the onset of anesthesia and decreases the tourniquet and postoperative pain, without any side effect

Prevalence and symptoms of idiopathic hypercalciuria in primary school students in Sanandaj

Determination of prevalence rate of idiopathic hypercalciuria [IH] in primary school students in Sanandaj. This was a descriptive-analytic study and included 506 primary school students. First we measured the ratio of urine calcium to urine creatinine [UCa/UCr] as screening test then 24 hour urine calcium of the patients who had UCa/UCr ratio more than 0.2 mg/mg [31 patients] was measured. Those with 24 hours urine calcium of more than 4 mg/kg were regarded hypercalciuric, [3 boys and 12 girls]. Data were introduced into SPSS win soft ware, represented in the form of frequency distribution table and analyzed by means of Chi square and T-tests. 248 patients were female and 258 were male. 32 patients [6.32%], 11 boys and 21 girls had UCa/UCr ratio more than 0.2 mg/mg, but 15 patients [3 boys and 12 girls] had excretion of more than 4mg/kg/day calcium in urine which encompassed 3% of the students [1.2% boys, 4.8% girls]. The results of this study indicated the Incidence of hypercalciuria among student girls was more than that of boys. 95th percentile for urine Ca/Cr is 0.198 for boys and 0.253 for girls. Considering the effect of hypercalciuria on bone density and growth which has more importance in girls, it is recommended to evaluate such effect in a more comprehensive study