[Correlation of extracorporeal shock wave lithotripsy with mean arterial blood pressure and heart rate in patients with kidney stones]

Background: At present, although more than 90% of renal stones are treated at a success rate of 68-86% with extracorporeal shock wave lithotripsy [ESWL], complications such as the possible occurrence of hypertension are attributed to application of this technique

Objective: The purpose of this study was to determine the correlation of ESWL with the mean arterial blood pressure and heart rate

Methods: This analytical study was performed on 75 patients with kidney stones in Mashhad using non-probability and purposeful sampling. Blood pressure was measured at three stages before, during, and after lithotripsy in the supine position. The relationship between ESWL- related hypertension and autonomic neural activity was also evaluated by heart rate spectral analysis. Data was analyzed with t-test and one-way analysis of variance

Findings: The mean arterial blood pressure increased from 93.30 +/- 9.73 to 98.30 +/- 12.63 in men and from 87.82 +/- 11.08 to 96.08 +/- 14.51 mmHg in women during lithotripsy and the difference was found to significant, statistically [P<0.001]. The incidence of diastolic pressure >/= 100 mmHg in patients with diastolic pressure less than 90 mmHg prior to lithotripsy was 7.5%

Conclusion: These results indicate the risk of hypertension during lithotripsy however, the possible occurrence of hypertension following lithotripsy needs more prospective studies

Effects of extracorporeal shock wave lithotripsy on electrocardiogram changes in patients with renal stone

Background and Purpose: Extracorporeal shock wave lithotripsy [ESWL] is initial treatment of choice for most calculi in the kidney. Although ESWL has many side effects one of which is cardiac arrhythmia, occurring mostly in non-synchronized mode. The aim of this research was to determine the effect of extracorporeal shock wave lithotripsy on electrocardiogram changes in patients with renal stone

Methods: This quasi-experimental study was carried out on 75 patients with renal stone who were selected by non-probability and convenience sampling. Then electrocardiograph was obtained from participants before, during and after lithotripsy. The relationship between ESWL-associated arrhythmia and autonomic neural activity was evaluated by heart rate spectral analysis. Electrocardiogram changes were interpreted and the data were analyzed in SPSS and SAS using chi-square, independent t-test, paired t-test, McNemar, Cochrane, One-way ANOVA and general linear model

Results: ESWL was found to elicit new or worsened electrocardiogram changes in 66.7 percent patients with no previous cardiac disease. A statistically significant correlation was demonstrated between the presence of ventricular premature contractions and analgesic drugs [p<0.001] and between the presence of ventricular tachycardia and treatment duration [p<0.001]

Conclusion: Shock waves delivered by lithotripsy cause cardiac arrhythmia

[Comparative efficacy of Iranian and foreign methylphenidate in children with attention deficit hyperactive disorder]

Methylphenidate is one of the basic drugs in treating ADHD. According to many clinical studies, the foreign form of methylphenidate [ritalin] is more efficient than the Iranian form of the drug [stimidate]. This study aimed to compare the efficacy of stimidate and Ritalin in the treatment of attention deficit hyperactive disorder. In this double blind, randomized clinical trial, 200 children with attention deficit hyperactive disorder who referred to Isfahan psychiatric clinics were studied. For 100 of these patients ritalin was prescribed while others received stimidate. After 4 weeks, changes in severity of symptoms were evaluated with parental form of Conner's questionnaire. After 4 weeks of treatment, the mean decrease of Conner's number in Ritalin group was 19.63 +/- 13.5 and in Stimidate group was 3.29 +/- 7.2. Ritalin had effectiveness in treatment of 83.3 percent of the patients [>/= 6 reduction in Conner's number], but Stimidate was only effective in treating 37.5 percent of the patients. This study showed that foreign methylphenidate [Ritalin] is more effective than the Iranian form of the medicine [stimidate]

Comparison of the effect of food and non-food ingestion during hemodialysis on early acute side effects of hemodialysis

Background and purpose: Food ingestion during hemodialysis may aggravate early side effects of hemodialysis due to hemodynamic changes. Therefore, this study was carried out to investigate the effect of food and non-food ingestion during hemodialysis on its early symptoms

Methods and materials: This clinical trial was conducted on the research population of ESRD Patients; 31 cases were selected through convenient and purposeful sampling. They were NPO during hemodialysis first, and received one meal [containing 325 Kcal] one hour after the second hemodialysis started. Their blood pressure, intensity of nausea and vomiting immediately before and after hemodialysis, and every 30 minutes during hemodialysis were measured and recorded. The obtained data were analyzed in SPSS using paired and independent t-test, Pearson and Spearman correlation coefficients, Wilcoxon and McNemar tests

Results: Blood pressure reduced 6.1 +/- 4.1 mmHg 60 minutes after hemodialysis started but in non-food hemodialysis, the reduction was 1067 +/- 2.57 mmHg, and the difference was significant. Also nausea intensity after food ingestion increase in 11 patients [35.5%], but it increased in 5 cases [16.1%] after non- food hemodialysis, and the difference was significant. Vomiting intensity after food ingestion increased in 8 cases [25.8%] and in 1 patient [302%] upon non-food hemodialysis, the difference of which was significant

Conclusion: Food ingestion during hemodialysis causes a decline in blood pressure, and increases the intensity of nausea and vomiting. Therefore, food ingestion during hemodialysis should be avoided

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

[ comparison between results of topical nitroglycerin ointment and sphincterotomy in chronic idiopathic anal fissure]

Chronic anal fissure is a common problem, and there are different ways for treatment. The goal of this study was to compare the effectiveness and complications of topical nitroglycerin with internal sphicterotomy in the treatment of chronic anal fissure. This randomized clinical trial study was performed from 2002 to 2005 at Imam Reza Hospital, Mashhad, Iran on 200 patients with symptomatic anal fissure, who randomly categorized into two groups of case [n=100] and control [n=100]. The case group [A] treated with nitroglycerin ointment%0.2 twice a day for 6 weeks and the control group [B] recieved sphincterotomy. Individual, surgical and medical results data were recorded in the questionnaire. Data analyzed using descriptive statistics, frequency distribution tables, and Fisher test. after 6 weeks of treatment, results showed that healing was not significantly different between the two groups, but after 6 months, difference was significant [p=0/11]. Surgical group healed 100%. Headache in medical group was more noticable than the other group [p<0/001]. But hypotension attack, palpitation, dizziness, and vomiting were not considerably different between the two groups. Internal sphincterotomy is superior to topical nitroglycerin in treatment of chronic anal fissure, with a high rate of healing, few side effects, and low risk of early incontinence

[Effect of tanacetum parthenium in treatment of migraine headache comparing to placebo]

Migraine is secondary common cause of headache. Headache is the most common clinical syndrome of pain. There are several methods in treatment of migraine including herbal medicine. Tancetum parthenium, a kind of chrysanthemum from kacny race is traditionally used for treatment of headache. The aim of this research was to assess the effect powder of Tanacetum parthenium in treatment of migraine. This is a double blinded clinical trial that lengthened for 8 months from 2004 to 2005. Patients were selected from Imam Reza hospital neurology clinic, Mashhad University of medical science. We had two groups: drug and placebo group. 45 people were introduced in each group. In our research, 4 patients in drug group and 11 patients in placebo group were missed. Patients with migraine that their headache frequency was more than 3 times in a month were included in our research. Severity and frequency of headache and kind of prescribed drug were variables that investigated in this study. After 15 days, 29 people [70.7%] in drug group and 21 people [61.8%] in placebo group were good or better than before treatment [p=0.49]. There was a significant improvement in severity and frequency of headache in drug group compared to placebo group only 105 days after treatment [P=0.01]. This research shows that Tanacetum parthenium is significantly more effective than placebo [p<0.05]. So use of this drug is suggested in treatment of migraine

Assessment the several types of pain in the first stage of labor: the effect of mother's selected positions

Attention to labor pain and its sedation are important parts of maternity care. Mother positioning seems to be effective in pain intensity and positions that women choose in order to become more comfortable are often those that tend to promote the baby's progress through the birth canal. Women often describe less pain when the fetus and pelvis are better aligned. This study investigated the effects of mother's selected positions on the intensity of several types of pain in the first stage of labor. This is a clinical trial on 68 pregnant women with singleton fetus in vertex presentation, 38-42 weeks gestational age and normal labor progress at Zeinab hospital in Mashad in 2004-5. They were randomly allocated to selective positions group and routine positions group. Mothers in selective positions group changed position as they wished while mothers in routine positions group were cared in bed. Pain intensity of low back and abdomen were measured hourly by visual analog scale. Data were gathered by using forms of interview and observation, and visual analog scale and analyzed in SPSS using Student t-test, Chi-square, Mann-whitney and Fisher's exact test. Scores of total pain [average of low back pain and abdominal pain] arid low back pain were significantly lower for the selective positions group than those for the routine positions group [p=0.007 and p<0.001 respectively]. Score of abdominal pain was the same in both groups. In accordance with time and location, the mean score of low back pain between contractions was significantly lower for the selective positions group than that for the routine positions group [p<0.001]. This study showed that in the active phase of the first stage of labor, mother's selective positions reduce intensity of low back pain between contractions. Therefore using alternative positions are simple and cost effective methods that reduce labor pain

relationship between sleep patterns and the quality of life in coronary artery bypass graft patients

Rest and sleep have restorative and protective roles in the restoration of our mental and physical abilities which are two important dimensions in the quality of life. Non-rapid eye movement sleep is important in protecting the cardiac function in CABG patients, who return to normal life after 8-12 weeks while sleep disorders prevail for one year after surgery. Therefore, this study was conducted to investigate the relationship between sleep patterns and the quality of life in CABG patients. This longitudinal, descriptive and correlational study was conducted on 91 patients admitted to Imam Reza Hospital in Mashad, Iran in 2005 [1384]. Subjects were selected in three phases: 24 hours before surgery, as well as 6 and 10 weeks after surgery. Interview checklists were used for data collection. Three scales were used to measure sleep patterns: Pittsburgh sleep quality index, Epworth sleepiness scale and sleep log. Quality of life was measured with 36 short form. The first two interviews were done at the hospital clinic and the last via telephone. Relevant data were analyzed in SPSS using student t-test and pearson correlation coefficient. Mean score of nocturnal sleep quality and efficiency in all three stages were undesirable. Also, mean score of sleepiness in all three stages were normal and mean score of quality of life was in the mid one-third of 0-100 scale. No significant differences were found between on-pump and off-pump groups in their sleep patterns and quality of life. In all three stages, sleep quality positively and significantly correlated with quality of life [p<0.001, p<0.002 and p=0.004 respectively]. Moreover, significant positive correlation existed between sleep efficiency and quality of life [p<0.001, p=0.002 and p=0.005 respectively]. However, no significant correlation was found to exist between sleepiness and quality of life. The findings of the present study indicated a significant and positive correlation between sleep pattern and quality of life in CABG patients. Therefore, it is necessary to restore their physical and mental health as soon as possible

[An investigation on cranial and facial anthropometric parameters in parents of children with cleft lip and palate]

Cleft lip and palate is one of the most common congenital abnormalities in the head and neck area. Disturbance in primary sutures fusion can cause this problem in different parts of head and neck. So our goal to fulfill this research is to find some special facial anthropometric indices in parents that may have correlation with cleft lip and palate in children in order to separate families with genetic aptitude for cleft lip and palate. In this case - control study 57 couples of healthy parents with a child with unilateral or bilateral cleft lip and palate were chosen in the epithet of case group and 57 couples of healthy parents with at least two healthy child, without a child with cleft were introduced as control group. 16 craniofacial anthropometric indices were measured by a digital caliper with 0.01 mm accuracy and a soft measuring tape and the findings were compared in two group by using t- test and mann-withney test. This research indicates that head width, minimal frontal width, head length and face width in fathers with a child with cleft are significantly less than the fathers in control group and face height, ear width and maxillary arch length are significantly more than fathers in control group. It also illustrates that minimal frontal width and facial width in mothers have a child with cleft are significantly less than the mothers in control group and face height, ear width, inner canthal width, outer canthal width, maxillary and mandibular arch length and head circumference are significantly more than the mothers in control group. We can conclude with attention to this research that craniofacial complex is under the heavy control of genetic factors thus the future investigations on the controlling genes concerning this index seem to be necessary

[ relationship between diet and oral hygiene and gingival status in private preschool children in the city of Mashhad]

The purpose of this study was to evaluate the relationship between diet and oral and gingival hygiene stata in preschool children. In this corss-sectional study, 250 preschool children [105 boys and 145 girls] aged 4-6.5 years old, were randomly selected among private kindergartens in Mashhad. The data were collected through questionnaire and clinical examination, and diet, OHI-S and PMA indices were evaluated. The data were analyzed statistically by chi-square test and Kendell correlation coefficient using SPSS software.-The data revealed that nearly all of the children [96.8%] consumed snacks between the main meals.-No relationship was found between type of diet and either oral hygiene or gingival status.-The amount of dairy products, fruits, vegetables and snacks taken didn't affect oral hygiene and gingival status.-There was no relationship between the time of snacks and sweets consumption and oral hygiene and gingival status. Poor oral hygiene can lead to periodontal diseases. The effect of diet on dental caries is obvious, however its effect on oral hygiene and gingival status is not completely understood. In this study no relationship was detected between diet and oral or gingival hygiene stata

study on the effect of humidity on the surface hardness of plaster dies

Ditching plaster die is a very important part in fabricating fixed prosthetics. Some clinicians humidify the plaster die to simplify the procedure. The objective of this investigation was to assess the effect of humidity on the surface hardness of plaster die. In this experimental study, American-made type 4 gypsum was used according to the manufacturer's instructions. 70 dies were prepared and were divided into seven groups of 10, 24 hours after pouring the gypsum. The hardness of the control group [first group] was immediately cxamined. The second, third and forth groups were dipped into water for 10 seconds and the fifth, sixth and seventh groups for 10 minutes. The hardness of the second and fifth groups was assessed immediately, the third and sixth groups after 5 hours and the fourth and seventh groups after 24 hours of being removed from water. Statistical analysis was performed using one-way ANOVA, Duncan and t-tests. The duration of humidification and dehydration affected the surface hardness of plaster dies. Maximum hardness was observed in the control group [no humidification] [P<0.001]. Surface hardness after humidification for 10 seconds without dehydration revealed the second highest values, after the control group [P<0.001]. Hardness was minimal when the humanizing time was 10 minutes without dehydration [P<0.001]. Humidification of plaster dies can decrease the surface hardness which is irreversible

effect of kangaroo care method on the pain intensity of vaccination in newborns

Pain is a complicated phenomenon that has been ignored in newborn in the past. Researchers have demonstrated that newborns feel pain completely, so they should be considered more sensitive to pain. Recent researches demonstrated that non-pharmacological interventions such as Kangaroo Care could be useful in decreasing pain in newborn. The present research was conducted to determine the effects of kangaroo care on the pain intensity of vaccination in healthy newborns. This study was a randomized case-control clinical trial. The study subjects were 60 healthy full-term newborns delivered at 22 Aban hospital, Lahijan. 60 term newborns were randomly assigned into two groups of trial and control. The trial group received 30 minutes skin to skin contact, where as the control group were wrapped in their blanket, beside their mother bed. In two groups behavioral changes of newborns were evaluated and observed 2 minutes before, during and 3 minutes after the intervention. All procedures were filmed. A Researcher assistant who was blind to the research aim, scored behavior changes by NIPS. Heart rate and oxygen saturation levels as displayed on the pulse monitor and duration of crying were recorded by stop watch. Data was analyzed using chisquare, Fisher's Exact Test, paired t-test and independent t-test. Mean pain intensity during intervention period was significantly lower in the trial than the control group [p<0.006]. Mean pain intensity in 3 minutes after intervention was significantly lower in the trial than the control group, [pc<0.021]. Also, mean duration of crying was significantly lower in the trial than the control group [p<0.001]. Kangaroo care method is a useful and cost-effective procedure. Therefore; it is recommended as a caregiving which reduces pain while doing painful procedures on newborns, who are helpless creatures

effect of mother's selected positions on the duration of the active phase of the first stage in labor

Background and Purpose: Left to their own choice, parturients will usually select positions they find most comfortable and will frequently change their positions over the course of labor. Maternal changing the positions will adjust fetus alignment to pass through the birth canal. Therefore, maternal positioning choice will include those positions with maximum comfort and those which improve the descent of the fetus through birth canal and make the labor process progress normally. This study is therefore intended to study the effect of mother's selected positions on the duration of the active phase of the first stage of labor

Methods and materials: This clinical trial was carried out in 1383-84 [2004-5] at the labor ward of the Hazrate Zeinab [S] hospital in Mashad, Iran. Subjects were 68 low risk pregnant women with gestational age of 38 to 42 weeks, who were randomly assigned into two groups: cases [selective positioning] and controls [routine positioning]. In the selective positioning group, mothers changed their positions at wish while mothers in the routine positioning group were given bedside care. Observation and interview checklists were used for data collection, and Student t-test, Chi-square, Mann-Whitney U and Fisher's exact test were used for data analysis in SPSS

Results: Mean duration of the active phase of the first stage of the labor was significantly lower for the selective positioning group [p= 0.002]. Mean +/- standard deviation were 156.75 +/- 66.48 and 207.25 +/- 61.04 minutes for the selective and routine positioning groups respectively

Conclusion: The study indicated that the duration of the active phase of the first stage of the labor was lower in the selective positioning group. Therefore, selective positioning can be advised for parturients to decrease the duration of staying mothers in maternity wards

[Study on Neisseria gonorrhoeae antibiogram and its resistance to Quinolones and third generation Cephalosporins in men with gonococcal urethritis]

Gonococcal urethritis is one of the most common STDs in men, which in spite of expanded antibiotic therapies, is widespread over the world, the incidence of cases resistant antibacterial components is among the causes for recurrence of gonococcal diseases. This study aims at determining sensitivity of gonococcus to common antimicrobial in its treatment such as Penicillin, Sephalesporins, felodokinolos. Therefore, in this study in vitro-evaluation resistance of this organism to different antibiotic especially 3[rd] generation which have been used as selected medicine for the treatment of gonococcal infections in recent years and cases resistant to the treatment have been report recently was conducted as a background for clinical trials. In this study, the in vitro resistance rates of Neisseria gonorrhoeae to various antibiotics by using disk diffusion methods have been assessed. The study is a cross sectional descriptive one, on 200 culture positive samples during 2 years [2003-2004] in medical laboratory. For analyzing of data, chi-square test was used. Resistance of Neisseria gonorrhoeae to antibiotics were as follows: Ampicillin: 96%, Amoxicillin: 92.5%, Co-timoxasole: 92%, Gentamycin: 89%, Amikacin: 88%, Erythromycin: 85%, Penicillin: 75.5, Tetracycline 59.5%, Ciprofloxacin: 46.5%, Cefixime 15%, and Ceftriaxone 2.5%. The result showed that ceftriaxone and probably other Sefalosparins of 3[rd] generation including oral and injections is, presently, the sole group that can be considered as a select drug. Felorokinolons which were regarded as an effective drug until very recently, have lost their importance. This result is in conformity with regional and international studies. Hence, conducting experimental test, particularly E. test E pisilometery test and determination of [minimal inhibitory MIC concentration] and later clinical experiences at fixed intervals can contribute to diagnosis of resistance of Neisseria to antimicrobial component ion oerliminary stages that can decrease irrational consumption of drug in the treatment of clinical syndrome of Nesseria gonorrhea

Job strain and blood pressure in nurses during work shifts

The purpose of this study was to determine the effect of job strain intensity on blood pressure [BP] during nurses' work shifts in the hospitals of Mashad University of Medical Sciences. For this descriptive cross-sectional study, 150 nurses who met the inclusion criteria were chosen by cluster sampling. A questionnaire was used to gather the data including personal characteristics, height, weight and intensity of job strain. Blood pressure was measured three times: in the beginning, middle and the end of the work shift. Women constituted 79% of the participants, and 80% were married. Eighty-nine percent of nurses had a Bachelor's Degree, and 31% had BMI>25. There was a significant relationship between job strain and age, marital status and the hospital unit where they worked. The results imply the significant effect of job strain on the difference in first-second, and second-third systolic BP, but not on differences between diastolic BPs. General linear models indicate a significant relationship between working in emergency unit and first-second systolic BP variations. Marriage and divorce have significant relationship with the first-third systolic BP variations. In this study job strain had a significant effect on nurses' systolic BP at shift work