Safety of Percutaneous Endoscopic Gastrostomy Tubes in Centenarian Patients

BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is a relatively safe procedure; however, no study has evaluated the safety of PEG tube placement in patients over the age of 100 years. METHODS: We conducted a retrospective review of patient records for patients who underwent PEG tube placement. Thirty patients aged 100 years and older were identified and a random sample of 275 patients was selected for comparison. RESULTS: The mean age of the patients was 80.6±16.2 years. No procedure-related deaths or major complications were identified; the overall inpatient mortality rate was 7.6%. Minor complications were noted in 4% (n=12) of the patients. Centenarian patients were predominantly female (80% [n=24] vs. 54% [n=147], p=0.006), with a mean age of 100.5±0.9 years. There was no significant difference in procedural success rates (93.3% vs. 97.4%, p=0.222) or inpatient mortality (6.7% [n=2] vs. 7.7% [n=21], p=1.000) between the two groups. However, a higher minor complication rate was noted in the older patients (13.3% [n=4] vs. 2.9% [n=8], p=0.022). CONCLUSIONS: Success rates, major complications and inpatient mortality associated with PEG tubes in patients aged over 100 years are comparable to those observed in relatively younger patients at our center; however minor complication rates are relatively higher. These findings lead us to believe that PEG tubes may be safely attempted in carefully selected patients in this subset of the population.

Measurement of radium-226 concentration and dose calculation of drinking water samples in Guilan province of Iran

Background: radium-226 [[226]Ra] is a product of the [238]U radionuclide decay series that significantly incorporated into the human body through water intake. It can also potentially cause a series of health problems including cancers of the digestive system. Radium-226 [[226]Ra] is a product of the [238]U radionuclide decay series that significantly incorporated into the human body through water intake. It can also potentially cause a series of health problems including cancers of the digestive system

Materials and Methods: [226]Ra has been determined in drinking water samples collected from various locations of Guilan province of Iran. The water samples are taken from public water and urban tap water sources. For evolution of gross a and b exposure precipitation method and proportional scintillator system was used. The radon emanation method was used to measure the radium concentration in drinking water

Results: the measurements showed the gross alpha and beta concentration ranges were between <38 mBql[-1] to 92 mBql[-1] and <41 mBql[-1] to 328 mBql[-1], respectively. The radium concentration range was between 2 mBq l[-1] to 38.2 mBq l[-1]. The resulting contribution to the annual effective dose due to the digestion of [226]R in water was calculated to be between <0.4 microSv y[-1] to 7.8 microSv y[-1], respectively

Conclusion: the average concentration of [226]Ra was found [7.6 mBq l[-1]] in drinking water samples and the average annual effective dose, from the digestion of [226]Ra in water samples was calculated to be 1.5 microSv y[-1]. According to UNSCEAR, the annual effective dose value by ingestion is report to be 0.12 mSv y[-1]

[Complications leading to hospitalization due to consumption of anti-TB drugs in patients with tuberculosis in Gorgan, Iran [2007-12]]

Anti tuberculosis drugs therapy is the most effective method for controling the tuberculosis [TB]. Early detection and appropriate treatment can prevent the TB-drug resistance. This study was carried out to determine the complications leading to hospitalization due to consumption of anti-TB drugs in patients with tuberculosis. In this descriptive-analytic study, 1550 records of patients with TB in urban and rural health centers of Gorgan, north of Iran were assessed during 2007-12. Checklist consists of demographic and clinical data for each patient was recorded in a questionare. 44 cases experienced the complications of anti-TB drugs. 27 [61.4%] of cases with complications were women. 77.3% and 22.7% of patients affected with pulmonary and extra pulmonary tuberculosis,respectively. 38.6% of patients were diabetic. The hepatic complication was seen in 37 cases [84.1%]. Skin and other complications were seen in 5 and 2 cases, respectively. There was not any relationship between drug complications and other disases. Hepatic damage is the most common complication leading to hospitalization in tuberculosis patients using anti-TB drugs

Synthesis of brominated 2-phenitidine derivatives as valuable inhibitors of cholinesterases for the treatment of alzheimer's disease

The present study reports the synthesis of a series N-substituted derivatives of brominated 2-phenitidine. First, the reaction of 2-phenitidine [1] with benzenesulfonyl chloride [2] in aqueous media yielded N-[2-ethoxyphenyl] benzenesulfonamide [3], which was then subjected to bromination with bromine in the presence of glacial acetic acid to give N-[4,5-dibromo-2-ethoxyphenyl]benzenesulfonamide [4]. Secondly, the product [4] on further treatment with alkyl/aryl halides [5a-l] in the presence of lithium hydride [LiH] produced twelve new derivatives of N-substituted sulfonamides [6a-l]. These were characterized by 1H-NMR spectrum and screened against acetylcholinesterase [AChE], butyrylcholinesterase [BChE] and lipoxygenase [LOX] and were found to be valuable inhibitors of butyrylcholinesterase [BChE] and acetylcholinesterase [AChE]. Few of these synthesized derivatives were also active against lipoxygenase [LOX]. It was concluded from this investigation that these derivatives were moderate inhibitors of cholinesterases and are also ideally suited for further structural modification to obtain more potent and less cytotoxic therapeutic agents for the treatment of Alzheimer's disease

Diagnostic value of high resolution computed tomographic scan in active pulmonary tuberculosis

Since accurate and quick clinical and paraclinical diagnostic methods are not available, in some cases diagnosis of active pulmonary tuberculosis occurs after considerable time from the onset of disease. This study was designed to determine the diagnostic value of High Resolution Computed Tomographic [HRCT] scan in active pulmonary tuberculosis, in Gorgan, Golestan province, North of Iran. This diagnostic screening study was carried out on 135 [79 male and 56 female] hospitalized patients suspected with active pulmonary tuberculosis, and HRCT was used in their course of treatment as recommendation of their clinician. The patients were chosen from 5[th] Azar hosptial during 2009-10. Also it should be mentioned that patients were selected on avaliabity bases, and they were examined by smear, and sputum culture. The patients with negative smear and culture were set up as true healthy group [64 subjects]. The lung or small nuddles in HRCT was considered as proper position of lung involvument in active lung pulmonary. The HRCT findings between the case group [71 subjects] and healthy group were compared. According to HRCT findings, the sensitivity and specifity were determined for each patient. Data were analyzed using SPSS-16 and Chi-Square test. In this study, sensitivity, specificity, positive predictive value and negative predictive value of HRCT in active pulmonary tuberculosis were equal to 97.2%, 71.9%, 79.3% and 95.8% respectively. Involvement of upper and middle lobe of the right lung and upper lobe of the left lung were significantly higher than the control group [P<0.05]. This study showed that HRCT has high sensitivity and specificity in diagnosis of active pulmonary tuberculosis and can be used as a quick diagnostic way in active pulmonary tuberculosis, especially in patients with strong clinical suspicion and negative smear

[ relationship between caregiver burden with coping strategies in Family caregivers of cancer patients]

Cancer is one of the most common chronic diseases whose caregivers are confronted with related problems to caring and treating the cancer patients. Caregiver burden, which is resulted from the negative impact of living with the cancer patient along with inappropriate use of coping strategies, which could lead to rejection diagnosis, can be accounted as the reasons of why the treatment and health would be impaired. The present study was aimed to determine the relationship between caregiver burden and coping strategies of caregivers of cancer patients. In this cross-sectional study, 133 caregivers of cancer patients who referred to Gorgon's 5[th] Azar Educative and Therapeutic Center were selected via Census sampling method. Data were gathered by three-part questionnaire, including demographics checklist, caregiver burden and coping strategies questionnaire. In order to analyze the collected data, SPSS V. 16 software with descriptive statistics was applied; also, the analysis of variance and logistic regression were conducted. In addition, statistical significance was defined as p< 0.05. Findings showed that mean and standard deviation of caregivers' age was 35.73 +/- 14.31. And, 50.4% of all the participants were male. Based on the results taken from multivariate model of logistic regression, high care demand [OR=0.403,%95 CI: 0.227 - 0.714] and higher rate of emotional coping strategies use [OR=1.09,%95CI: 1.04 - 1.15] have significant correlation with caregiver burden. Based on our findings, the using of emotion-focused coping strategies among caregivers and caring needs of patient, lead to increase care burden, therefore beside of patient empowerment, could be educated efficient coping strategies for caregiver's burden reduction

[ co- infection of crime Congo hemorrhagic fever and brucellosis: a case report]

Crimean-Congo Hemorrhagic fever [CCHF] is a viral disease transmitted to ruminants or human by the bite of mature tick vectors. It can be transmitted through contact with the infectious blood or viraemic tissues during slaughter and hospital contacts. 80% of the cases are sub clinical and the rest of them are presenting with an acute febrile and occasionally hemorrhagic disease. The mortality rate of the fulminate form of the disease is equal to 20% to 50%. The hemorrhage is usually in the form of hematoma, melena, nose, conjunctiva, uterine or subcutaneous bleeding. CCHF complications are: encephalitis, optic neuropathy, hepatitis, renal failure and myocardial necrosis. In this article, we've discussed a CCHF patient who presented with high fever, myalgia, headache, nausea, vomiting, abdominal pain, diffuse cutaneous and gingival hemorrhage during the course of the disease while the patient was hospitalized. Profound jaundice, petechia and global ecchymosis were considerable. Lab data showed at the beginning of hospitalization that the number of liver enzymes was increased up to 8-10 times. The number of placates were lower than 150000 ml. Moreover, during the first three days there was a decrease in the number of white blood cells and PTT was abnormal. [AST] was higher than 100 units per litre. The results of serologic examination of IgM- ELISA virus for CCHF on day 5 and IgG-ELISA on day 10-which were carried out in pasture Institute-were reported to be positive. According to the patient's history and clinical symptoms, he was also suspicious for Brucellosis and the lab data demonstrated that he is also infected with Brucella. [Wright=1.320, 2ME=1.160] The patient was a 22 year old man, sheep farmer, residing in the GhalehKamkar area of Qom City

[Ultrastructural changes of epididymal spermatozoa in alcohol consuming rats]

The evaluation of epididymal sperm infrastructure in chronic alcohol-consuming rats. 16 male mature Wistar rats with the same age of 10 weeks were categorized into two different groups. Control group included 8 rats allowed free access to rat chow and water. Experimental group included 8 rats with free access to rat chow and 5% ethanol in the same volume [50 cc daily] as controls that received water. After 30 days, epididymal spermatozoa from two groups were aspirated for sperm electron microscopic study. No ultrastructural changes were observed in control group. In experimental animals, most of spermatozoa showed several alternations in their ultrastructures. Anomalies such as abnormal nuclear chromatin density, swollen area, rupture and lysis of plasmalemma, persistence of numerous cytoplasmic droplets, mitochondrial swelling and vaculization, absence of axonemal microtubules, complete degeneration of axoneme, deletion of one or more outer dense fibers as well as absence of tail plasmalemma were seen in majority of the alcohol-treated spermatozoa. Spermatozoa from alcohol consuming rats show spectrum of anomalies in their head, middle and principle piece of tail. These may be one of the possible causes of subfertility or infertility due to alcohol consumption

Modified Hodge test: a simple and effective test for detection of carbapenemase production

Resistance among bacterial isolates is the leading cause of increased mortality and morbidity worldwide. Carbapenems once thought to be effective are becoming ineffective mostly due to the emergence of carbapenemase. This study was designed to determine in vitro efficacy of Modified Hodge test for detection of carbapenemase production in Gram negative rods. The study was done in the Department of Microbiology, Armed Forces Institute of Pathology Rawalpindi Pakistan from January 2010 to December 2010. A total of 200 Gram negative rods from different clinical samples were taken. Those isolates which showed intermediate or susceptible zones i.e 16mm-21mm on disc diffusion were included in the study. These isolates were then subjected to Modified Hodge test. Out of 200 isolates, 138 [69%] were positive for carbapenemase production by Modified Hodge test. Out of 138 MHT positive organisms, the frequency of E. coli was 38%, followed by Pseudomonas aeruginosa [30%], Klebsiella pneumoniae [17%], Acinetobacter baumannii [12%], Citrobacter diversus [2%] and Enterobacter agglomerans [1.4%]. Modified Hodge test is a simple test which can be performed in the routine lab for detection of carbapenemases in isolates showing intermediate or sensitive zone diameter on disc diffusion

[Comparison of the effects of oral charcoal capsule with aluminum hydroxide syrup on pruritus in hemodialysis patients]

Uremic pruritus is one of the most common and interruptive symptoms in patient with hemodialysis. Approximately, 60% of these patients suffering from this condition. There are several causes for pruritus, thus, various treatments are applied in order to control it. Comparison the effects of Oral charcoal capsule with Aluminum Hydroxide Syrup on pruritus in hemodialysis patients in 5 Azar hospital, Gorgan. Using a cross-over clinical study, we examined 30 patients with moderate and severe pruritus [two groups; n= 15 per group]. Subjects received oral charcoal capsule [6g daily in three doses] for two weeks as well as hydroxide aluminum syrup [30 cc; three times per day before each meal] for the same time. Wash out period was considered 48 hours. Pruritus severity was determined by visual analog scale [VAS] and measurement of pruritus scale [MPS]. Data were analyzed by SPSS using Wilcoxon, Mann-Whitney, unpaired and paired t-test. P=0.05 was considered as statistic significant level. Based on VAS and MPS, patients in the first group showed 40% moderate pruritus and 60% severe pruritus. However, patients in the second group showed 46.7% moderate pruritus and 53.3% severe pruritus at the beginning of the clinical trials. The results also showed that oral charcoal significantly decreased the severity of pruritus in both groups [alpha<0.05]. However, this effect was not the case for hydroxide aluminum syrup. This study showed that oral charcoal capsule was an effective drug to decrease pruritus in hemodialysis patients to compare with hydroxide aluminum syrup

The effect of training maternal-fetal attachment behavior on primipara maternal mental health in the third trimester of pregnancy

Background and purpose: Mental health of mothers during pregnancy has considerable effects on fetal growth and consequently on baby's future health. Therefore, using various methods to enhance the mental health of mothers will have an important role in minimizing baby's and mother's problems. The present study was conducted to determine the effect of training maternal-fetal attachment on mother's mental health

Methods and materials: This interventional study was conducted on 83 pregnant women selected through purposive sampling from among the population of pregnant women admitted to health centers, and were divided randomly into case and control groups. Data collection instruments included interview checklist, MFAS, GHQ- 28. Cases received training on maternal-Fetal attachment behavior, but controls received only the routine pregnancy care. Scores of mental health and maternal-Fetal attachment before and after training were compared across the two groups. Chi- squre, Fisher's exact test, Mann Whitney U and t-test were used for data analysis

Results: The results indicated that differences in the mean score of mental health before training across the two groups were not statistically significant [p=0.51]. However, the difference came up to be significant after training [p<0.001]. Also, differences in the mean score of maternal-Fetal attachment behavior after training were significant across the two groups [p <0.001]

Conclusion: The results indicated that training mothers on maternal-Fetal attachment behavior can enhance mother's mental-health and their attachment with the fetus

[ comparative study of kojic acid cream and hydroquinone in treatment of melasma]

Melasma is an acquired hyper pigmentation on the face which generally happens in women between the ages of 30 to 35. If there is no timely treatment, it can cause a lot of cosmetic problems. The aim of this study was to compare the effect of kojic acid cream and hydroquinone 2% in treatment of melasma. This clinical trial was done on 100 women who had epidermis melasma and were referred to the dermatology department of the 22 Bahman Hospital in mashhad, Iran. Each patient had at least two melasma scars with similar severity and size on both sides of the face. For each of the patient, kojic acid cream on one side of the face and hydroquinone 2% cream on the other side of the face was prescribed. The researchers assessed the rate of improvement during a three month period. Data were analyzed using Wilcoxon test. One month after the start of treatment there was a positive response of both applications, 7% from Koji acid treatment and 10% from hydroquinone treatment. Two months after the treatment there was a positive response of 24% from kojic acid and 22% from hydroquinone. In both treatments, there was no statistical significance but there was a statistical significance after 3 months of treatment which was 58% in kojic acid and 30% in hydroquinone, group. Based on the length of the treatment during the trial, kojic acid was found to be more suitable in the treatment of melasma. Therefore, it should be considered in the protocol of treatment for this pigmentation disorder

Accuracy of spiral CT in non-traumatic acute abdominal pain in Sina University Hospital

Acute abdominal pain is a common complaint in an emergency setting. An immediate and precise diagnosis is necessary for reducing morbidity and mortality. Several studies have reported that CT scan increases diagnostic accuracy for patients with acute abdominal pain. This study was designed to evaluate the sensitivity, specificity and accuracy of spiral CT scan compared to that of abdominal ultrasound and plain radiography. We assessed the data of 91 consecutive patients, including 45 males and 46 females, ranging in age from 8 to 84 years [mean age 52.38 years] presenting to the emergency department of Sina Hospital, Tehran, Iran, with acute non-traumatic abdominal pain during the years 2003-2005. All patients underwent spiral CT scanning; in addition, sonography and plain radiography were performed for 66 and 64 of the patients, respectively. The sensitivity, specificity and accuracy were calculated and compared, based on the final diagnosis, which was established with surgical, pathologic, and clinical follow-up. The data was analyzed by SPSS 13.0 software. Among the 91 patients examined, CT scan was reported to be normal in 15 patients [16.5%]. The most common CT findings were aortic aneurysm [12.1%], pancreatitis [9.9%], ovarian cyst [7.7%], intestinal distension [7.7%], and hepatic cyst [7.7%]. The overall sensitivity, specificity, and accuracy of unenhanced spiral CT were 92.2%, 92.86%, and 92.3%, respectively, whereas those of plain radiography were 13.2%, 72.7%, and 23.4%, respectively, and ultrasound 73.2%, 90%, and 75.7%, respectively. This study suggests that plain radiography is an insensitive technique in the evaluation of nontraumatic acute abdominal pain presenting in the emergency department. Unenhanced spiral CT is accurate for adult patients with nontraumatic acute adominal pain and should be considered as an alternative to radiography as the initial imaging modality

[ efficacy of home walking exercise program on functional performance and quality of life in patients with heart failure]

Dyspnoea and fatigue caused considerable impairment in the functional performance and quality of life in HF patients. The purpose of this study were to determine efficacy of home walking exercise program on functional performance and quality of life in patients with heart failure. This study was qusiexperimental trial that assessed efficacy of home-based exercise program on the functional performance and quality of life in patients with HF in the Ahvaz city [2005]. In this study 60 patients with New York Heart Association [NYHA] class II and III heart failure divided two groups training [n=30] and control [n=30]. Material or measurements was demographic characteristics form, Minnesota quality of life check list and timed exercise program form. Exercise training in the patients would be performed three day per week for 8 weeks. Determination quality of life measures by Minnesota check list would be performed in both the training and control groups at entry and after 8 weeks. Also 6 minute walking tests for determination functional performance would be performed in both groups at entry and after 8 weeks. Ultimately data analysis by SPSS softward. results showed that significant difference existed between mean walking distance on the 6MWT at entry and after 8 weeks in the training group [373.86 to 412.30 m, P<0.05], that no significance was seen between control group [376.79 to 377.63 m]. Also significant difference exists between mean quality of life scores at entry and after 8 weeks in the training group [52.32 to 43.80], that no significance was seen between control group [52.43 to 52.50]. This study showed that home-based exercise program affected on functional performance and quality of life in HF patients. Its accepted. Therefore exercise training can be used as a therapeutic approach in these patients, because not only promotes quality of life but also improve the functional performance

[How postintubation tracheal stenosis could be prevented?]

Although it is assumed that appropriate care of endotracheal tubes and airway might prevent postintubation airway stenosis [PIAS], but this concept has not been investigated adequately. The purpose of the study was to investigate practical ways for prevention of PIAS in intubated patients. The study was implemented in 3 phases. First we collected information about methods of caring for airways and tubes in intensive care units in Tehran and other cities [control group] and data collection based on filling 10-20 questionnaires in each intensive care unit. Then we assessed patients who had PIAS and had been treated by us during a 6 year period [1994-2000] [study group]. In the final phase, collected data were analyzed and we looked for important pitfalls in caring for airways in intensive care units in our country and also looked for the practical measures to prevent PIAS. In phase I, 341 questionnaires were filled out in 18 intensive care units [12 in Tehran, 6 in other cities]. There were 133 females and 208 males aged 3 month to 98 years [mean 46.1]. Head injury was the commonest cause of intubations in 24%. of patients. Out of 356 tracheal tubes which had been used in these patients, 318 were high volume low pressure types [new tubes], and 32 were high pressure low volume types [old tubes]. In 179 patients [52.4%], there was not any type of care for tubes and airways by attending physicians, in 140 patients [41%] there was some kind of care although not organized or sufficient and in only 21 patients [6.1%] the care was organized and sufficient. Mean time of intubation was 8 days [1-45 days]. Tracheotomy had been undertaken without any established criteria and mostly by junior staff with low experience [usually junior residents]. In phase II, 120 patients were treated for PIAS [36 females, 84 males aging 1-83 years, mean 25.9 years]. Head injury was the cause of intubation in 78 [65%] patients, the site of stenosis was tracheal in 88 and laryngotracheal in 32 patients. More than half of the patients were intubated by inappropriate old tubes. Direct cause of stenosis was the cuff in 92, tip of the tubes in 15 and stoma in 10 patients. In 3 patients more than one factor were the causes. Mean time of intubation was 14.9 days [1-90] and mean length of stenosis was 3.2 cm [1-7]. Caring of tubes and airways was inappropriate and inorganized in all patients. Factors which were statistically different in study and control group were: time of intubation [14.9 day vs 8 days, P=0.000], suicide attempts [12 vs 5, P=0.000], head injuries [65% vs 24% P=0.000], Age [25.9y Vs 46y, P=0.05], using old tubes [50% vs 9% P=0.000], organized caring of tubes and airways [0.0%vs6.1%P=0.000]. The following measures are effective in decreasing the PIAS: decreasing time of intubation, using appropriate tubes, [including PVC tubes], continuous care of airway and tube, cuff monitoring and daily recording of information about tubes and cuff pressure, and special care for intubated young patients who had sustained head injury or had attempted suicide

[ hypertension rate and it's risk factors in elders of Yasouj 2005]

Hypertension is one of the most prevalent diseases that, causes lots of complications, it is not controlled. Sufferers should change their life style and avoid the risk factors. The aim of this research is to determine the hypertension rate and it's risk factors in elders of Yasouj in 2005. This is a descriptive analytical and cross-sectional study. Convenient sampling was done which was consisting of all elders above 60 referred to the health centers during the first six months of the year. Data collection instrument was questionnaire and also scale, meter and sphygmomanometer was used to determine weight, height and blood pressure. Collected data were analyzed using SPSS software and descriptive and inferential statistics such as ; analysis of variance and x2 tests. 286[47 .4%] of elders were suffering from HTN out of which 233[38.6%] had HTN history and 53[8.8%], did not have any knowledge of their HTN. The BMI mean in elders with high blood pressure was 94.1 +/- 3.3 and in others, it was 23.1 +/- 2.3. The average weekly use of meat, eggs and smoking of patients with high blood pressure as compare to those with normal blood pressure did not show significant difference. Considering the risk factors of hypertension the necessity of screening and educating elders by health personnels to improve their life style is felt

[Role of surgery for diagnosis and treatment of tuberculosis]

There are few recent prospective studies regarding role of surgery for the treatment and diagnosis of tuberculosis [TB]. We conducted this study in our department and the results are presented. From 20 February 2003 to 21 September 2003, patients who underwent surgery for diagnosis or treatment of TB at the Department of Surgery, Masih Daneshvary Hospital were enrolled in the study. We designed a data form and details of history, radiology, laboratory, bacteriology, operation, complications, histologic studies, as well as results of surgery were recorded. Clinical follow up was scheduled prospectively. Statistical analysis of the data forms were done at the end of the study. During the study period, [7 month] 18 patients enrolled in the study. There were 7 females and 11 males with mean age of 34.16 [range: 12-76 years]. Twenty six operations were performed on 18 patients which are listed below: Thoracotomy 6, surgical bronchoscopy 6, lymph node biopsy 4, laparatomy 2, video assisted thoracoscopy [VATS] 2, chest tube insertion 2, chest wall resection 1, insertion of stent in the right main bronchus 1. Goals of surgery were: diagnosis in 8, diagnosis and treatment in 6, and treatment alone in 4. In all patients goals of surgery were successfully achieved. There was no mortality, but 3 major complications occurred [persistent air leakage in one patient, severe bleeding after right pneumectomy in one patient and occlusion of the stent by granulation tissue in one. All complications resolved with appropriate treatment. Diagnosis of TB was based on histological findings of surgical specimens or isolation of Mycobacterium TB or both. Whenever indicated, surgery has a definite role in the treatment and diagnosis of TB. Results of surgery are good with few complications

Imaging in 100 patients of thoracic hydatid disease including unusual imaging appearances

To evaluate the chest radiography and CT scan characteristics of pulmonary hydatid disease [PHD]. One hundred patients [59 males and 41 females, age ranged from 9 to 80 years] with surgically proven pulmonary hydatid cysts were studied. We reviewed clinical and imaging findings including PA and LAT chest roentgenograms and conventional CT of the chest. Only 82 patients had CT scan in their files, but all had CXR. The radiological features [localization, diameter, architecture, density and other radiological signs and appearances] were determined. On CXR, 124 cysts were determined. In evaluation of 82 available CT scans, a total of 112 cysts were detected. No cysts was detected on 5 CT scans. No discrete cyst was detected on 10 CXRs: 4 patients. only consolidation; and 6 patients, only hydropneumothorax. The most frequent site of involvement was RLL [29.6%]. Fifteen hydatid cysts appeared as solid masses on CT. Fifty-seven cysts were ruptured cysts and 25 patients with ruptured cysts had hemoptysis [43.9%]. Thirty-eight percent of cysts had thin walls and 62% had thick walls. Sixty-four cysts were round in shape [55.7%]. Single cysts were seen in 63 patients while multiple cysts were seen in 37. Median CT density of the cysts was 24 Hounsfeild Units [HU] [-18 to 84]. There were 16 giant cysts [diameter >/= 10 cm] on CT. Mean maximum and minimum dimensions of cysts were 5 cm and 4 cm on CT and 6.8 cm and 5.7 cm on CXR, respectively. On CT and CXR, "water lily sign" was seen in 18 and 22 patients, 'air-fluid level" in 12 and 17 patients, and "crescent sign" in 11 and 5 of patients, respectively. Inverse crescent sign and calcification were not observed on CXRs, but each was reported on 4 CT scans. On CT' 90% of cysts were smooth, 74 cysts were uniloculated and 9 were multiloculated. Nineteen percent of cysts were infected. Other imaging findings included mediastinal shift, atelectasis, infiltration. pericystic lung reaction, chest wall involvement, and rib destruction. CXR is helpful with diagnosis of intact cysts but fails to define entire morphology of complicated cysts. CT imaging recognizes certain details not visible on radiography. In endemic regions like Iran, atypical imaging presentations of complicated pulmonary hydatid disease, such as solid masses, should be considered in differential diagnosis of pulmonary lesions

[ prototype of drug mis.abused of opioids in the self-introduced addicts in Gorgan [North-East of Iran]]

Addiction is one of major problems of today's world population. The first step on combating a social issue or disease is the proper reorganization. This study was done to determine the demographic characteristic, prototype of drug consumption and its relation with some personal and social variation in Gorgan [North-East, Iran]. This study was a descriptive cross sectional research. The characteristics of 3005 addicts, was studied whom research voluntarily to the addiction clinic during 2001-2005 in the 5th Azar hospital of Golestan Medical Sciences University in Gorgan. The collected data was analyzed using the SPSS software. From a total 3005 files which were studied, 2786 [92.7%] were male and the remainder were females. The mean +/- SD of age was 36.91 +/- 11.41. 4.8% of samples had university education, 21.3% high school diploma, and 61.7% were either unemployed or without any certain job. Opium with 66.7% was the substance with highest rate of consumption. In 40.2% of the cases, inhaling was the main route of consumption and in 30.9% of addict subjects taking the drugs orally. From the point view of type of drug, smoking cigarette, alcohol consumption, using cannabis and pill consumption, there was a meaningful correlation [P<0.05]. The rate of addicted male subjects whom referred to the clinic to leave the addiction was 14.97% times of female subjects. 93.8% of the addicts persons had 20-50 years of age, which is an indicative of the real of age of addicted people in Gorgan. Unemployment can be considered as one of the main cause of high rate of addiction among the people in the society and in particular in this sample population. It seems that with education and creating employment in the region, to some extent the addiction can be controlled

[ effect of aqueous extract of Croucus Sativus on the basic and functional electrophysiological properties of isolated perfused rabbit AV-nodal preparation]

Herbal remedies are suitable alternatives for synthetic drugs due to their availability, minimal side effects and lower price. Biologically active substances of plant origin represent an essential branch of modern cardiovascular pharmacotherapy. The aim of the present study was to determine concentration-dependent effects of aqueous extract of Croucus sativus on the nodal basic and functional properties. This was an experimental study. Male Newsland rabbits [1-1.3 kg] were used in all of experiments; various experimental stimulating protocols [WBCL, Recovery, Facilitation, Fatigue] were applied to assessing electrophysiological properties of Node in two groups [first group n=10 and second group n=7]. We used isolated preparation including some post up AV-nodal tissue preparation. All protocols were repeated in the presence and absence [control] of different concentration [A=9x10[-2], B=19x10[-2], C=28x10[-2] mg/l] of Croucus sativus and verapamil [0.1 micro M]. Results were shown as Mean +/- SE and a probability of 5% was taken to indicate statistical significance. Our results showed concentratration dependent depressant effects of extract of Croucus.s on Wenchebach Cycle Length [WBCL], AV Conduction Time [AVCT], Functional Refractory Periods [FRP]. Rate-dependent properties such as Facilitation and fatigue significantly increased by 19x10[-2] mg/l of Croucus. The effect of extract was prominent on fast pathway. The above results indicated potential antiarrhythmic effect of Croucus in treating supraventricular tachyarrhythmia