[Comparison of diagnostic value of fetal cerebellar hemisphere circumference measurement and routine ultrasonography parameters for determination of the gestational age]

Recently, ultrasonographic assessment of gestational age has assumed an integral role in prenatal care. The aim of this study was to compare the diagnostic value of fetal cerebellar hemisphere circumference measurement with those of other parameters of routine ultrasonography for estimation of gestational age. This was a descriptive and analytical study and included318 pregnant women with gestational ages of 14 to 41 weeks and distinct LMP in Imam Reza Hospital in Kermanshah. The parameters of BPD, HC, AC, FL, TCD and CHC were measured by Siemens G50 ultrasound system, and gestational age was estimated. Data were analyzed by Spearman correlation coefficient. SPSS 20 software was used for statistical analysis. Based on LMP, mean +/- SD of gestational age was 29.18 +/- 8.86.But considering the parameters of BPD, HC, AC, FL, TCD and CHC we found mean +/- SD of 28.94 +/- 8.96, 28.93 +/- 9.01, 28.76 +/- 8.96, 28.87 +/- 8.98, 28.88 +/- 9.01 and 28.76 +/- 8.99 weeks respectively. Spierman correlation coefficients between LMP and other parameters of routine ultrasonography were more than 0.99 and significantly were correlated with one another. Comparison of the diagnostic value of fetal cerebellar hemisphere circumference measurement with those of other parameters of routine ultrasonography for estimation of gestational age did not show any significant differences. We can use measurement of fetal cerebellar hemisphere circumference with other parameters of routine ultrasonography

[Comparing the healing effects of topical phenytoin, conjugated estrogen and silver sulfadiazine on skin wounds in male rats]

Accelerating of skin wounds healing process has been focused by researchers in recent years. The aim of the present study was to compare the effects of topical phenytoin, silver sulfadiazine and conjugated estrogen on skin wounds healing in male rats. Accessing a way to accelerate skin wounds healing is still one of the important goals in medical science. This experimental study was accomplished on 32 male rats [8 animals in each group] with approximately equal body mass. Skin wounds were made with an area of 40 mm[2] and a depth of 0.5 mm on the back of the necks. Three groups were administered daily by topical phenytoin [1%], silver sulfadiazine [1%] and conjugated estrogen [625%]. Control group received no drug. Wounds healing was evaluated daily and the study was continued until the wounds healing completed. Silver sulfadiazine demonstrated to be the best treatment for the wounds healing; compared with the other medicines, it required significant shorter time of treatment. Silver sulfadiazine accelerates skin wounds healing in male rats

[ epidemiology of hospitalized head injury in Arak]

Head injuries are the most sever kind of injuries in accidents. It is an important factor of disability in society. Having information about present situation and its determinant factors is the first step of programming for head injury reduction. This survey aimed to have an epidemiological aspect of head injury in Arak. Relevant informations about severity of the impact, causes, demographic information and treatment results were extracted from medical files between 2005-2006 years. Of total 1105 patients with head injury 25.8% were in their first decade of life and 11.8% were reported as sever head injury. The most common injuries [18.4%] caused by downfall from low height. Men had more head injured 64.7% compared with women. In the period of hospitalization 12.8% of moderate head injuries and 43.1of sever head injury caused to death. It is concluded that applying and administration of the safety rules in the society as a compulsory rules and educating by mass media, are necessary. It should also be taken into account more effective hospital care for sever head injuries to reach better outcomes

[Effect of closed endotracheal suction on incidence of ventilatorassociated pneumonia]

Ventilator-associated pneumonia [VAP] is one of the common nosocominal infections in intensive care units [ICU] which leads to high mortality rates. Endotracheal suctioning is routinely performed in mechanically ventilated patients to clear secretions. The aim of this study was to compare the effect of closed versus open endotracheal suction methods on development of ventilator-associated pneumonia. This randomized control trial included 156 hospitalized patients in intensive care units of the hospitals of Arak University of Medical Sciences. Patients who had required mechanical ventilation and been transferred to ICU in less than 24 hours after their admission and had endotracheal tubes for less than six hours were assigned randomly into two groups. Routine open suction and closed suction methods were used for control [n=74] and intervention [n=82] groups respectively. After 72 hours the patients were examined for signs and symptoms of pneumonia based on clinical pulmonary infection score [CPIS]. The results of this study showed the incidence of pneumonia in the intervention and control groups were 28% and 48.6% respectively. Considering the incidence of pneumonia, there was a significant difference between the two groups [P=0.01]. Patients with history of cigarette smoking had increased incidence of pneumonia but no difference was detected in the incidence of pneumonia between males and females. Considering the decreased risk of transfer of contamination via medical devices and personnel's hands, use of closed suction method can lead to a decrease in the incidence of ventilator associated pneumonia

[ investigation on quality of emergency care of head injury patients in emergency ward, Vali-e-Asr hospital, Arak 2005]

The third leading cause of mortality in developed countries is trauma which 50% of these is because of head injuries. Since the injury to the brain is not limited to the time of accident and it can be developed or exacerbated some times after the accident, therefore care and treatment of these patients especially during the emergency phase can prevent secondary injuries. So it is important to investigate the quality of these patients' care in emergency phase at hospitals. This is a descriptive study which is done during a 6 months period. It is done using a quality of care checklist which was developed for three groups of patients with mild, moderate and sever head injury .The checklist is developed based an standards of care. The quality of 693 patients' care by health care team [physicians and nurses] was evaluated during the first 24 hours of hospitalization. Four domains of care including general, neurologic, respiratory and homodynamic care were assessed by the checklist. The highest score in each domain was 10. 9 and more was considered excellent care, less than 9 to 7 good, less than 7 to 5 moderate and less than 5 poor. Data was introduced using descriptive statistics. Results showed that the health care team in the domain of general care had 7.39 [good care], in the domain of respiratory care 5.08 [moderate care] and in the domain of hemodynamic care had 7.48[good care], scores. Findings showed that although care of head injury patients was not poor but it was not excellent also, which shows some deficits in the management of these patients. It is necessary to improve the quality of care by educating health care professionals and providing enough equipment for care

[Investigation of Sesame oil and calcium hydroxide effectiveness on nonsurgical debridement of third degree burns in male rats]

The presence of necrotic tissue is an important problem in patients with deep burns. In this study the effectiveness of Sesame oil plus calcium hydroxide on debridment of third degree burns is investigated in rats. This experimental study is performed on 40 Wistar rats. After anesthesia, both flanks of rats were shaved, then third degree burns with 3cm diameters were produced using boiling water. Rats were divided into 4 groups randomly. One side of the first three groups was treated by fibrinolysin pomade and the other side in group one to third was treated using 1, 2.5 and 5% Kenhide pomade. In the forth group wounds were healed without treatment and spontaneously. In each group and wound, the time of necrotic tissue detachment and then formation of granulation tissue was documented in a checklist. Data was analyzed using paried T and ANOVA tests. Results showed that comparing the three different concentrations of Kenhide the lowest debridment time with 16.6 days was related to 5% Kenhide [p=0.001]. On the other hand there was relatively no significant difference between debridment time in case group and the first control grpoup [p=0.053], but this difference was significant in case and the second control groups [p< 0.001]. There was also a significant difference between the time of granulation tissue formation in using 5% Kenhide and first control groups [p< 0.01]. Using Kenhide 5% pomade not only causes no injury to healthy tissues but also can be compared to fibrinolysin pomade in necrotic tissue debridment. More investigation is recommended in this field