[Clinical manifestation of patients with acquired pneumonia admitted in the respiratory ward of Imam Khomeini hospital in Ahvaz]

Introduction: Pneumonia is an infection in the gas exchange units of the lung. This disease is one of the most common causes of admission in the hospital. Regarding the pneumonia, we aimed to evaluate the mean age, sex and incidence of some important clinical manifestation and the duration of the admission in the hospital

Methodology: In this cross sectional cases were selected from patients referring to Imam Khomeini hospital in Ahvaz during 2007-2004 with the diagnosis of the Community Acquired Pneumonia. During this study 365 patients were evaluated. Patients› data such as age, sex, and clinical manifestation were collected using a questionnaire and analyzed by statistical software

Results: Mean age of the 365 patients was 60.6 years. Out of them 47.4% were <65 years old and 52.6% were > 65 years old. 51.2% were male and 48.8% were female. Most common manifestations were cough [87.9%], dyspnea [81.4%], sputum [72.9%] and fever [55.6%] respectively, and hemoptysis with 24.1% was the least common manifestation

Conclusion: This study showed high prevalence of community acquired pneumonia in the studied population. It also showed that age and sex are effective factors in the presentation of the clinical manifestations of this disease

[Using the service quality Gap's model [SERVQUAL] in Imam Khomeini teaching hospital: 2012]

Introduction: Patients can determine the quality of services provided by hospitals which are regarded as large and complex service organizations within the health system. This study aimed to assess service quality gaps in Imam Khomeini teaching hospital in Tehran with respect to the differences between patients' perceptions of and expectations from health services

Methods: In this cross-sectional study, the six-dimensional SERVQUAL model questionnaire - the validity and reliability of which were confirmed by the researchers - was used to collect the viewpoints of 116 patients admitted to Imam Khomeini teaching hospital. Samples were estimated using the Cochrane statistical formula and the data were analyzed by means of independent t-test as well as correlation and ANOVA tests

Results: There was a negative gap in all dimensions of the quality of services. The highest and the lowest gaps [-2.55 and -0.697] were observed in the access and assurance dimensions, respectively. However, there was no significant relationship between the variables of quality gap of services and gender, marital status, insurance, visit frequency, age, and education [p value>0.05]. It was also found that in none of the dimensions were the expectations of the patients satisfied

Conclusion: The results indicated that except for the access dimension, expectations can be affected if any of the other variables is changed. Generally, there are lots of opportunities to work on to improve the quality of services provided by health care system

Rhazes' prescriptions in treatment of Gout

Among the diseases that clinicians deal with, few do have a documented medical history that can be traced back to several centuries ago. A careful study of Rhazes' Treatments on Gout reveals a lot about the nature and therapy of gout. We managed to study the perceptions about pathogenesis, symptomatology, diagnosis, and treatment of gout that have changed over time. We also discussed some of the past and present fallacies regarding this disease. Rhazes provided a detailed description on the vital role of genetics and the relationship between the development of gout, an indulgent way of living, and tophi at a period of time between 1st and 6th centuries AD. This study showed that the findings of Rhazes about treatments of gout were consonant with modern medical theories

Enhancement of 4-nitrophenol ozonation in water by nano ZnO catalyst

The removal of 4-nitrophenol [4NP] from aqueous solution by ozone combined with nano-ZnO was investigated in a laboratory-scale reactor in which pH of solution, ZnO dosage and initial 4-nitrophenol concentration were considered as variables. The degradation of 4-nitrophenol was determined using UV-Vis and HPLC methods. Interestingly, the degradation of 4-nitrophenol was high under acidic condition where the degradation was about 93% at initial phenol solution pH=3. It was due to aggregation of nano-ZnO particles above pH=6.5. This result was different from the case of ozonation alone, in which higher pH had positive effect on the degradation of 4-nitrophenol due to the formation of hydroxyl radical. As expected, degradation efficiency increased by increasing the nano ZnO dosage and initial 4-nitrophenol concentration. It was found that the nanosized ZnO enhanced the degradation of ozone and the catalytic ozonation enhanced the degradation of 4-nitrophenol on the surface of the nanosized ZnO. In addition, the degree of degradation was also determined indirectly through Total Organic Carbon [TOC] of the samples. Carbon mineralization of 4-nitrophenol was obtained as 13.68% and 60.34% during ozonation and nano-ZnO catalytic ozonation, respectively, after 30 min reaction, proving that combined ozonator and nano-ZnO for reduction of TOC is more efficient. Also a high degree of nitrogen mineralization during catalytic ozonation was achieved at pH= 3 [7.61mg/L]

Surgical outcome of posterior fossa epidermoid tumors [1980-2008]

Epidermoid tumors comprise 5% of posterior fossa tumors and are the third among tumors of the cerebellopontine region in frequency. In the review of recent literature, there are several case reports but few case series. In this retrospective study, we evaluated the surgical results of our patients, reviewed the existing literature and compared our results with other series. Surgical results of 8 patients with epidermoid tumor that originated mostly in the posterior fossa from 1980-2008 in Mehrad Hospital, in Tehran, are presented. The age, sex, duration, signs and symptoms, topographical location, surgical approach, the extent of resection and outcome are analyzed and compared with other series. This study is based on the clinical data of 8 patients operated from 1980-2008 in Mehrad Hospital, in Tehran, due to posterior fossa epidermoid tumors. 62.5% of the patients were female. The average age of our patients were 34.1 years [range: 2453 years]. The most common symptom was headache [87.5%]. The most common tumor location was cerebellopontine angle. Supratentorial extension was observed in half of our patients. In 37.5% of the cases, the tumor was resected totally. The mean followup period was 31.5 months [range: 1-115 months]. In the post operative period, 37.5% of our patients suffered from complicating events, but we had no mortality in our series. In contrast with other posterior fossa benign tumors, in which the cure is obtained by overcoming surgical technical difficulties, the main problems in the management of epidermoids remain misdiagnosis, incomplete removal at the first operation, and delayed detection of recurrences. With the use of modern microneurosurgical techniques, our surgical results are comparable with other series. Extended multicentric prospective studies are recommended for more definitive results

Pediatric head injury

Minor trauma to the head is common in childhood and does not require any medical or surgical treatment. Nevertheless, head injury in infancy and childhood is the single most common cause of death and permanent disability. Measurable deficits occur even after mild to moderate head injury but are markedly greater after severe injury. They include impaired cognition, motor impairments, disruption of attention and information processing, and psychiatric disturbances. Despite the frequency of the sequelae of head injury in childhood, there is relatively little information about the structural basis of the clinical deficits. Classical literature suggests that the immature brain and its coverings, at a time when it is rapidly acquiring new information, respond differently from the adult brain when subjected to an equivalent amount of mechanical force, whether mediated by contact or inertial loading. Identification of different patterns of injury in different age groups has resonance in clinical practice and now provides a reference point for future clinical and neuropathological studies. This work not only provides the basis for the future management of patients, but also serves to remind us of the continuing value of the autopsy and the proper examination of retained organs using modern standardized techniques

[ survey on missing values in osteoporosis using a weighted estimating equation]

In different statistical studies, a subset of data maybe missing for some study subjects either by design or happenstance, such data are called missing variables. Ignoring such data causes bias in the results; therefore presenting statistical methods for analyzing such data are necessary. One of the most common techniques used in linear regression analysis with missing covariates is a Weighted Estimating Equation [WEE]. In this method, the observe probability of missing data are computed using the logistic regression, then the inverse probability of these data are input into the score statistics equation and finally the equation is solved using the EM algorithm and the regression parameters are estimated. The advantage of this method is that the distributions of the missing data need not to be correctly specified. In the present study, the above method was compared to Maximum Likelihood [ML] by using an applied example. Considering the covariates missing at random [MAR], the WEE method is more efficient than the other statistical methods. Regarding the advantages of WEE, this method is applicable when the distributions of covariates are not normal

prospective study on rapid prenatal diagnosis of trisomy 21 in uncultured amniocytes using interphase fluorescence in situ hybridisation and an Alu-PCRamplified YAC clone

Herein we report the result of a prospective study directly comparing aneuploidy detection of chromosome 21 by fluorescence in situ hybridisation in interphase nuclei with the results obtained by cytogenetic analysis.The inter-Alu sequences in chromosome 21 specific YAC clone were amplified by polymerase chain reaction [PCR]. The resulting DNA probe was used for fluorescence in situ suppression hybridisation to detect the copy numbers of chromosome 21 in interphase nuclei.A total of 214 independent amniotic fluid samples were analysed in a blind fashion. The combination of specific probe and optimized hybridisation and detection conditions allowed accurate enumeration of chromosome 21 in uncultured amniotic fluid cells consistent with the results obtained by traditional cytogenetic analysis

[Report of 54 cases of diastematomyelia treated in Shohadaye Tajrish, Mehrad and Mofid Hospitals]

Diastematomyelia is a congenital anomaly of the spinal cord which is usually associated with other CNS, skeletal and skin abnormalities. In this study, 54 cases treated with surgical or medical routes have been surveyed. Average age was 35 months and female/male ratio was 1811. Two thirds of the patients were found to have neurological deficit, with gait problem being the most predominant whereas skin and orthopedic anomalies ranked next. Tethered cord was detected in about half of them and spurs found in two third. Two thirds of cases underwent surgery out of which 114 had transient postoperative complications with complication rate of 25%. There was no postoperative mortality. Post-operative improvement of neurological deficit occurred in 14% of cases and same percentage had deterioration, while others had no change in their neurological status

efficacy of vaginal misoprostol in treatment of missed abortions

Missed Abortion is a important obstetric and gynecology complication because of its serious outcomes such as DIG, infection, shock, hemorrhage and death. There are various medical and surgical methods for treatment of missed abortion. Medical treatment of missed abortion is safe, effective, acceptable and an inexpensive alternative. Misoprostal is a synthetic prostaglandin [El] and recommended by PDA for treatment of missed abortion. There are different views about its safety, dosage and effectiveness. This study was designed in order to determine the efficacy of vaginal misoprostol for termination of pregnancy in women with missed abortions admitted in Shahid Sadoughi, Madar and Mojibian hospitals of Yazd from 2003 to 2004. The method of study was semi-experimental. [Clinical trial without control group] 50 women with missed abortion and the required criteria [age 15-45 years, gestational age