[Bayesian model for work-related accidents in Iran: 2009]

Introduction: It is of prime importance to consider the pattern and geographical changes of a disease, in each community independently, to determine high and low risk areas. Mapping diseases is a set of statistical methods which attempt to provide precise maps by which the geographical distribution of a disease is estimated. In this study, Bayesian methods were applied to estimate the relative death rate of work-related accidents in Iran

Methods: For the purpose of this study, the data of work-related accidents of Iran in 2009 were analyzed. To estimate the parameters of the map, empirical Bayes method [Poisson-Gamma method] was applied using Winbugs 1.4 software. Moreover, the Arc GIs 9.2 software was used to set relative incidence of death and accident related maps

Results: Regarding the estimates achieved by empirical Bayes method and applying Poisson-Gamma for the incidence of work related accidents in 2009, the maximum and minimum prevalence risk rate among men was 2.991 in Markazi province and 0.457 in Khorasan Razavi province, while they were 3.848 in Semnan province and 0.243 in Hormozgan province for women

Conclusion: Overall, the incidence of work-related accidents follows no specific geographical distribution pattern and in most provinces the pattern was different for men and women in Iran. By and large, the incidence of these events in the neighboring provinces of Tehran is more than the other parts of the country

[Evaluation of Ocimum basilicum effects on uterus apoptosis in rats exposures in electromagnetic fields]

In the industrial world, almost everyone is unavoidably exposed to ambient electromagnetic field [EMF] generated from various technical and household appliances. Controversy exists about the effects of EMF on various tissues of the living bodies. Uterus play an important role in reproductive and the effects of EMF on its tissue is worthy of investigation. In order to examine this, 40 rat were selected and kept for one weeks in quarantine and 20 rats subdivided to two groups were exposed to 50 Hz [non-ionizing radiation] for 6 weeks, one of this exposed group received 0.7 g/kg Ocimum basilicum, other experimental group just received 0.7 g/kg Ocimum basilicum, The materials were processed and observed apoptosis under a light microscope. In the experimental rats apoptotic cells showed significantly increased in emf groups, but in exposed group that received Ocimum basilicum, apoptotic cells were decreased [p<0.05]. As exposure to EMF may result in pathological changes then lead to sub fertility and infertility, Since in our study 0.7 g/kg Ocimum basilicum have significantly Preventive effect on uterus cells damages by reducing number of Apoptotic cells, so it seems that using it can be effective for treatment in emf exposed Rat

Compartments of Quercetin and Allium cepa [onion] on blood glucose in diabetic rats

The major concern in diabetes is increased oxidative stress. Maintaining a balance between reactive oxygen species [ROS] and antioxidants is a major mechanism in preventing damage from oxidative stress. Quercetin [QR] is a well-known flavonoid and a strong antioxidant derived from the onion, Allium cepa, and it has been shown to reduce oxidative stress in the long-term treatment of streptozotocin [STZ]-induced diabetes in animals. We aimed to study on beneficial effects of QR and Allium cepa on regulation of blood glucose in diabetic model. Methods: Seventy male 8-week-old Wistar albino rats weighing 250 +/- 10 g were obtained, the rats were divided into seven groups comprising ten animals in each group. Diabetes induced with single intraperitoneal injection of STZ. Diabetic rats treated with quercetin [15mg/kg/day, started 48 hours after STZ injection] and Allium cepa juice [2cc/rat/day, started 48 hours after STZ injection]. After 28 days treatment, analysis on blood glucose and insulin was done. The mean TAC showed a significant increase [p < 0.05] in the QR compared to the control, STZ and STZ + QR groups. Both QR and onion Juice had significant effect in lowering blood glucose [355.3 +/- 104 mg/dl and 353.4 +/- 103 mg/dl respectively] [p<0.05] in STZ induced diabetic animals. Both QR and onion juice had lowering effect in Serum insulin in healthy animals and significant increasing effect on serum insulin level in diabetic animals. Both QR and onion juice had good effect in modifying diabetes related biochemical parameters and they are recommended to be studied more in order to being used in the therapy

[Protective effect of Captopril and Allopunnol against renal warm ischemia reperfusion injury in dogs]

Captopril and Allopurinol have protective effect against renal warm ischemia with different mechanisms. The aime of this study was to evaluate this protective effect against induced 1 hour warm ischemia in dog's kidneys. This experimental study was done in the year 2006. We performed the operation on 15 healthy dogs. During these procedures both kidneys were clamped for 1 hour, then left kidney was removed for pathologic evaluation and right kidney remained insitue for functional assessment. Five random dogs received 1 [mg/kg]d[day] Captopril orally before and after surgery [captopril group]; another five dogs received 10 [mg/kg]/day Allopurinol orally before and after surgery [allopurinol group]. Five dogs of control group received no drugs. Serum urea and creatinine were measured preoperatively and on postoperative days of 1, 3, 5, 10 and 16 in all groups. Serum levels of urea and creatinine elevated in all groups but in Captopril group maximum levels of urea and creatinine were significantly lower than control [P<0.05]. In Allopurinol group the maximum rise of creatinine was significantly lower in comparison to control group [p< 0.05], but the maximum levels of urea in this group had no significant difference when compared with control values [p< 0.05]. There was no significant difference in pathologic changes in the three groups. One hour warm ischemia results in ATN so it is not safe for dog's kidneys. Althogh Captopril and Allopurinol do not prevent ATN after one hour warm ischemia; they can reduce its severity and improve renal function after warm ischemia

[ evaluation of 41 panoramic radiographic cases of dentigerous cysts and odontogenic keratocysts]

Dentigerous cyst [DC] is the most common pathologic pericoronal radiolucency and the odontogenic keratocyst [OKC] radiographic features appear as unilocular, multilocular or pericoronal radiolucency. Since OKC is very invasive and has a high recurrence rate and its radiographic features are like dentigerous cyst and bone important lesions such as amelobastoma and mural ameloblastoma, it seems necessary to recognize radiographic features of these two cysts.The aim of this study was to compare panoramic radiographic findings in DC and OKC. In this descriptive [case series] study, 41 panoramic radiographs of 26 patients with DC and 15 patients with OKC, were evaluated by one maxillofacial radiologist as an observer.The radiographic information included persent pericoronal radiolucency, unilocular or multilocular radiolucency, smooth or scalloped periphery, impacted tooth, size and area of cyst, age and sex. Finally, the data were analyzed using Chi-square and T tests statistically. One case of DC had multiolocular radiolucency, 4 cases of OKC had unilocular pericoronal, 2 cases had multilocular pericoronal, 2 cases had unilocular non-pericoronal radiolucency and 7 cases had non-pericoronal multilocular radiolucency. A significant relationship was detected among the mean age of patients, and mean area of cysts [P<0.05]. Based on the present study, DC was more common in maxillary canine appearing mainly as a pericoronal unilocular pattern, while OKC was more common in mandible appearing mainly as a multilocular pattern

[Accuracy rate of clinical diagnosis of disc displacement without reduction in temporomandibular joint using MRI]

Internal derangement [ID] of TMJ is the most common type of temporomandibular disorders after muscle disorders and includes all disorders related to incoordination and dislocation of disc and condyle. Anterior disc displacement without reduction or closed lock will happen if the disc or condyle displaces severely or if the disc traps in the space in front of the condyle accompanied with reduction in maximum mouth Opening. The purpose of this study was to evaluate reliability of clinical diagnosis of disc displacement without reduction [closed lock] by using magnetic resonance imaging as the Gold standard. This cross-sectional study was carried out on 10 patients who had referred to Dental school of Mashhad University with the symptoms of ID and were assigned a clinical diagnosis of disc displacement without reduction. Sagital and coronal MR images were obtained with 0.5 Tesla magnetic resonance system, with the jaw in closed and maximum opening position subsequently to establish the corresponding diagnosis of disc-condyle relationship. The data analysis included kappa statistic and calculation of positive predictive values and sensitivity. The overall diagnostic agreement for disc displacement without reduction was 0.22 with a corresponding kappa value. The predictive value for clinical diagnosis of disc displacement without reduction was 20% and the sensitivity was 100%. According to the results, clinical diagnostic criteria for disc displacement without reduction is not reliable and patients assigned clinical TMJ-related diagnosis of disc displacement without redaction may need to be supplemented by evidence from MRI to determine the functional disc - condyle relationship

[ one year epidemiologic study on radiolucent lesions in patients referred to radiology department of Mashhad Dental School]

Radiolucent lesions are common bony lesions and can be seen in the forms of periapical, pericoronal, interradicular and lesions not necessarily related to teeth. The purpose of this study was to determine the epidemiology of radiolucent lesions in patients who were referred to radiology department of Mashhad Dental School. In this prevalence descriptive study, panoramic radiographs of 256 patients referred to the radiology department were evaluated for one year and the frequency of their lesions were determined according to age, sex, number of lesions, site of occurrence, shape, border and effects on surrounding structures. The data were statistically analyzed using chi-square test. From 51 radiolucent lesions, the periapical granuloma was the most common lesion [45.1%] followed by periodontal disease [19.6%], radicular cyst [13.7%] dentigerous cyst [3.9%], cherubism, traumatic bone cyst, squamous cell carcinoma and central giant cell granuloma [2%]. These lesions occured predominantly at the second decade of life and most frequently in men. Three common radiolucent lesions were periapical granuloma, periodontal disease and radicular cyst. Periapical granuloma occurs predominantly in mandible while periodontal disease and radicular cyst occur in maxilla more frequently

[Radiographic evaluation of idiopathic osteosclerosis in patients referring to Mashhad dental school from November 2002 to May 2004]

Idiopathic osteosclerosis is a common radiopaque lesion in the jaw bones, which is asymptomatic and usually detected accidentally in various radiographs. The purpose of this study was to determine the radiographic features of idiopathic osteosclerosis in the jawbones of patients referring to the maxillofacial radiology center of Mashhad Dental Faculty. In this descriptive study, panoramic radiographs of 300 patients [ 125 males, 175 females ] who had referred to the maxillofacial radiology department were evaluated for the presence of idiopathic osteosclerosis. The radiographic information included location, number, shape, size, relationship with teeth, pattern of density [ trabecular-cortical ] and demographic data [ age, sex ] and evidence of disease in the gastrointestinal tract and kidneys were also recorded . Then data was analyzed using chi-square and t-student test. A total of 27 patients [9%], exhibited 40 foci of idiopathic osteosclerosis with different shapes and sizes [4 cm[2] to 1/09 cm[2] ], most of which had well defined borders [65%] and trabecular density [62/5%] . The most common region for these lesions was in the mandible, especially in the second premolar [47/5%] and first molar [42/5%] regions and the majority had no connection to the teeth [57/5%]. The lesions were most prevalent in the second decade of life [29/6%] followed by third and fourth decades. [25/9%]. The results of this study were the same as that of previous similar studies. In addition, chronic renal failure was seen in 1/3 of patients with idiopathic osteosclerosis

Evaluation of the effect of four current Iranian processing solutions on the image quality of two dental X-ray films

The combination of different processing solutions and dental film types can affect sensitometric properties [density and contrast]. The aim of this study was to determine the effect of 4 currently used Iranian processing solutions on the image quality of 2 types of dental films. In this experimental-laboratory study, a casted mandibular 2nd premolar along with a step wedge was used, to obtain 248 periapical radiographs during 10 working-days. All films were processed in four Iranian processing solutions: Teifsaz, Jahan, Farhan and Champion. Endodontic files were used to assess the diagnostic accuracy, Densitometric evaluation of the lead wedge radiographs was done at the Atomic Energy Organization of Iran using an Iranian digital software densitometry. Data were analyzed using the ANOVA test. The mean density and contrast of the Kodak images was significantly higher than the Agfa images [P=0.001], Films processed with Champion solution revealed the highest radiographic contrast [P=0.001]. No significant difference was found between the Agfa and Kodak films in determining the position of the endodontic file [P>0.05]. This study showed that the type of processing solution and film can significantly affect radiographic density and, contrast. Kodak films processed in Champion solution revealed the highest radiographic density among the studied materials

Initiation and continuation of breastfeeding and its associated factors in children

Advantages of breastfeeding are widely known and in general undisputed. This study shows different breastfeeding patterns and continuation in the country. This study was conducted to estimate breastfeeding continuation and its associated factors. An existing data study was carried out to estimate the duration of breastfeeding and its associated factors in zahedan. 2007 children 2 to 6 years in zahedan health centers were studied using health records from 1998 to 2002. Breastfeeding duration and some of it's associated factors such as parents' age, education, and job, child's sex, birth rank, birth weight, and the time of the onset of supplementary feeding were collected. The mean duration of breastfeeding was 18.09 +/- 6.2 months. Ninety-nine percent of women initiated feeding of babies with breastfeeding. It was 91.6%, 81.7%, 54.5%, and 2% in the months of 6, 12, 18, and 24 respectively. Breastfeeding was related to maternal age, birth rank, birth weight and the timing of the onset of supplementary feeding. There was no relation between breastfeeding and parent's education and job, child sex, and delivery type. Children born in 2000 had been breastfed significantly less than those born in 1997-1999. it is necessary to have planning for maintaining and promoting breastfeeding based on modifiable factor

Is OSCE successful in pediatrics?

The Faculty of Medical Sciences, University of Zahedan implemented the Objective Structured Clinical Examination [OSCE] in the final Examination during the 2003-2004 academic year. Simultaneously, the pediatric department initiated faculty and student training, and instituted the OSCE as an assessment instrument during the pediatric clerkship in year 5. The study set out to explore student acceptance of the OSCE as part of an evaluation of the Pediatric clerkship. This study implemented to evaluate a new method of assessment in medical education in pediatrics. A self-administered questionnaire was completed by successive groups of students immediately after the OSCE at the end of each clerkship rotation. Main outcome measures were student perception of examination attributes', which included the quality of instructions and organization, the quality of performance, authenticity and transparency of the process, and usefulness of the OSCE as an assessment instrument compared to other methods. There was overwhelming acceptance of the OSCE in Pediatric with respect to the comprehensiveness [90%], transparency [87%], fairness [57%] and authenticity of the required tasks [58-78%]. However, students felt that it was' a strong anxiety-producing experience. And concerns were expressed regarding the ambiguity of some questions and inadequacy of time for expected tasks. Student feedback was invaluable in influencing faculty teaching, curriculum direction and appreciation of student opinion. Further psychometric evaluation will strengthen the development of the OSCE

Attitudes of clinical faculty members of Zahedan University of Medical Sciences on teaching in ambulatory care setting

Although it will be one of the most critical duties and skills of a general practitioner to manage outpatients in his office or at ambulatory care centers, our present medical education is based upon ward-based teaching and ambulatory care, as one important part of medical education, has been overlooked. We evaluate attitudes of faculty members of Zahedan University of Medical Sciences on teaching in ambulatory care setting. This descriptive study was carried out through collecting data from questionnaires.75 faculty members, 66 persons [88%] answered the questionnaire. About 75.7% of faculty members believe that ward based teaching, alone is not sufficient for preparing students for their future occupation. 51.5% of them say there is no proportion between the problems observed by the students during their study and the diseases prevalent in the society which they will be encountered with later. 75.7% of faculty members chose clinics of educational hospitals as the best place for teaching ambulatory care and the same percent believed the space, facilities and time devoted to examining patients were insufficient. 51.5% of them recommended 3 students for every faculty member in teaching ambulatory care. 33% of the faculty members viewed their not having enough time, patients' dissatisfaction from students being present, lack of incentives of faculty members and shortage of facilities as obstacles to teaching ambulatory care. 33% of the faculty members viewed their not having enough time, patients' dissatisfaction from students being present, lack of incentives of faculty members and shortage of facilities as obstacles to teaching ambulatory care. This study emphasizes on extending the field of teaching medicine to the level of the society. For this purpose appropriate physical space and well equipped ambulatory care teaching centers should be provided. Also the problems of faculty members should be intentioned and educational programes be altered so that medical education creates a holistic and community oriented view for medical students

[ impact of Gluconate calcium on hypocalcaemia after blood exchange in hyperbilirubinemia newborns]

Background: blood exchange is one of therapeutic methods for neonatal hyperbilirubinemia. But this method has some complications. One of these complications is hypocalcemia. In some studies, for avoiding from this problem, calcium gluconate injection is recomm ended. But in some studies there was any important difference between calcium treated group and the group without calcium prescription. Due to lack of documented evidences about prevalence of this complication, this study was conducted to compare the result of using calcium gluconate injection in the incidence of hypocalcemia and hyper calcemia

Methods and materials: for this purpose in a randomized controlled clinical trial in Ali_ Asghar pediatric hospital in Zahedan, 40 hyper bilirubin neonates that were hospitalized for blood exchange came into this study. These patients were randomized in two groups so that they were adjusted in terms and preterm delivery. For 22 patients, I ml of calcium glucdnate%10 was injected in each I 00 ml exchanged blood and for 18 patients [control group], calcium injection wasn't been done. Calcium serum level was tested before, immediately after and 6 hours after blood exchange in all patients. Data analysis was been done by means of fisher's exact test, Chi_ Square and Binomial test

Results: in calcium treated patients, hypocalcaemia wasn't being present after blood exchange. But in no calcium treated patients hypo calcemia was seen in 4 cases [%22.4] after blood exchange [P < 0.013]. All of these 4 cases were preterm. In calcium treated patients hypocalcaemia had a significant increase after exchange especially in term neonates [P < 0.028]

Conclusions: on the base of these results, in preterm neonates, calcium gluconate injection after blood transfusion exchange is recommended. But this procedure isn't necessary in term newborns because may result in hyper calcemia

[ study of general practitioners' views on the content of composed programs in Zahedan]

Background: nowadays because of rapid advance in sciences, updating the knowledge of graduates is of great important. Due to the fact that continuous medical education programs have been started a decade ago, frequent research is necessary to identify the needs and priorities, create motivation, encourage participation, as well as enhancing learners utilization. The aim of study was to collect general practitioners' views about the content of composed programs in 2000 in the city of Zahedan

Methods and Materials: the present descriptive study was performed using questionnaires including 29 questions for three composed programs.156 general practitioners were selected to attend three composed continuous medical education programs [C-CME programs]. They all responded

Results: the results showed that 87/8% participants believed in applied topics to be presented and 78/2%like to be informed of materials and references in advance.76/3% of them demanded the presentation of' materials with concern to seasonal and local health problem, and the concerned opinions to be taken in account for selection of the program contents. The time did not correspond to the content of the composed programs for internal medicine and surgery, as was stated by 85/3% and 82/9% of the participants, respectively. 50% of the responders believe that the C-CME programs don't have any positive aspect

Conclusions: with regard to the results of' the present research, in order to improve continuous education programs, the following factors should be taken into consideration to select the subject with accuracy, to set aside appropriate time for each topic, the priority of indigenous and seasonal diseases, to take advantage of the needs assessment to select the subject, to keep the participants informed about the materials and resources in use

[Comparison of change pattern of serum and transcutaneous bilirubin in hyper bilirubinemic neonates]

Background: hyperbilirubinemia is one of common and important problems in neonatal period. Spectrophotometry is the common method for evaluating serum bilirubin level. In this study transcutaneous bilirubinometry which is a non-invasive newer method and seems to be more proper for diagnosis, screening and controlling of treatment process of hyperbilirubinemia were studied

Methods and Materials: in a cross-sectional study, 162 newborns [101 terms and 61 preterm neonates] who were been admitted because of ichter in Ali-Asghar hospital of Zahedan, came into this study. Bilirubinometry was been achieved by means of both bili test and spectrophotometry, before and after phototherapy in all cases, and then these measures were been compared. For statistical analysis X2, t-test, willcoxon sign rank, and mann-whiteny tests were used

Results: the test showed that the average of transcutaneous bilirubin before of phototherapy is in term newborns and pre term newborns consequently 20/0 +/-4/6 and 1712+/-6/5 6. Also, the average of serum bilirubin before of phototherapy is in term newborns and preterm newborns consequently 16/8 +/-4/5 and 14/6 +/- 5/96. On the other hand, the average of transcutaneous bilirubin after of photo therapy is in term newborns and preterm newborns consequently 1313 +/- 3/7 and 10/04 +/- 2/45. Also, the average of serum bilirubin after of phototherapy is in term newborns and preterm newborns consequently 9/8 +/-2/2 and 8/01+/-2/5. So, there was not significant difference between bilirubin levels in before mentioned two methods. There was a similar pattern of changes between serum and transcutaneous bilirubin before and after of phototherapy and there isn't significant difference between them

Conclusions: like some other studies, this study proposes bili test as a useful measure for screening and controlling of treatment process and recommend it as a substitute for serum method in Zahedan ' s new barns

[Knowledge about students' health needs among teachers of Zahedan primary schools]

Background: students are major part of population that their physical and mental health provides health and dynamic society. For achievement this criteria, teachers have essential and main role if' they possess required knowledge. Therefore study was conducted to determine teachers· knowledge about students' health needs

Methods and Materials: a cross- sectional study was designed in 2003 and 400 teachers of Zahedan primary school was selected randomly. A 30-item questionnaire was developed including questions about environmental health and students' physical and mental health. Data was analyzed using SPSS 11

Results: the teachers' knowledge about environmental health in three categories low, moderate, and high respectively was 71.5%. 28.5% and 0.0%. About students' physical health it was 19% low, 78.3% moderate, and 2.8%high. The knowledge about students' mental health was 22% low, 61% moderate, and 17% high. The teachers' knowledge had no relation with their education level

Conclusions: results showed teachers' knowledge about school health is not adequate. Therefore teaching teacher about school health specially students' mental health as an effective strategy is recommended

[Diagnostic criteria of brain death]

The diagnosis of brain death in medicine is very important because of such outcomes as organ transplantation. Therefore, its diagnostic criteria should be carefully defined and their existence should be determined through specific clinical and para clinical examinations. Although these examinations are performed at specific intervals by experienced physicians who are out of organ transplantation team. All medical team members, especially critical care nurses, should be familiar with brain death criteria, because successful organ and tissue donation depends on knowledge and commitment of nurses in determining brain death patients who are potential organ donors