[Changes in pulmonary function and peak oxygen consumption in response to interval aerobic training in sedentary girls]

There is a significant relationship between pulmonary function and general health and mortality. The matching between ventilation and perfusion is an effective factor in pulmonary function. This study investigated the effect of 24 sessions of interval aerobic training on pulmonary volumes and capacities and maximal oxygen consumption in sedentary girl students. In this experimental study with pre- and post-test design, 30 healthy sedentary girl students were selected and randomly allocated to experimental [N = 15] or control [N = 15] groups. The experimental group performed 24 sessions of 45 minute interval aerobic running while the control group had no training program. Before and after the training program, pulmonary volumes and capacities and peak oxygen consumption were evaluated via spirometry tests and Bruce treadmill protocol, respectively. Exercise training resulted in 62% increase in ERV [p = 0.004], 65% increase in PEV [p = 0.03], 35% increase in MVV [p = 0.03], and 23% increase in VO2max [p = 0.001]. Also, training had no significant effect on TV, IRV, FVC, PIV, and FEV1/FVC. In spite of increase in TV, IRV, and FEV1, FVC, PIV, MEF-25%FVC, FMEF-25%-75%FVC, and FEV1/FVC, training had no significant effect on these variables. However, the effect of training on the increase of ERV, PEF, MEF-50%FVC, MEF-75%FVC, MVV and VO2peak was significant [p < 0.05]. Aerobic training in young girls improves capability and coordination of respiratory muscles, especially expiratory muscles, and causes improvement in lung function via increasing some lung volumes and capacities

[Polyethylene glycol versus lactulose in chronic pediatric constipation]

Introduction: Constipation is one of the most prevalent causes of abdominal pain in pediatrics, with no underlying pathology. It is defined as functional constipation in 95% of cases evaluated. This study was designed to compare the therapeutic effect of polyethylene glycol [PEG] and lactulose in treating chronic functional constipation in children

Materials and Methods: In this randomized, double blind clinical trial, patients were classified into two groups: lactulose [n=65] and PEG [n=63]. During an eight week period, patients were either treated with an average of 3.5 g/day [PEG] or 7 g/day [lactulose]. Successful treatment was defined as defecation [painless and soft, or normal] three times or more per week. Analysis was performed by calculation and comparison of the success rate in both groups, followed by reporting the relative risk and number needed to treat [NNT]

Results: Response to treatment in the second week was significantly higher in the PEG group when compared with the lactulose group [P<0.0001]. There was a significant difference in the response rate between both groups in the 4th and 6th weeks [P<0.0001]. In the 8th week all patients in the PEG group were treated successfully, whereas there were five [7.7%] cases who did not respond in the lactulose group

Conclusion: These results have shown that a four week treatment period with PEG [3 g/day] lead to a response rate of 87% in children, in comparison with lactulose [7 g/day] which needed at least eight weeks of treatment

[Scorpions fauna of Kerman province-Iran]

Considering wide distribution of scorpions in various parts of the country and their importance in biological and medical Sciences, the current study was performed during 2005 to 2006 in order to determine scorpions species in Kerman/Iran. In this descriptive research, 13 cities in Kerman province were investigated. All collected scorpion specimens in%75 ethyl alcohol were sent to the entomology laboratory of Kerman university of Medical Sciences for identification of their species by the use of stereo microscope and morphologic identification key. A total of 8 species belonged to three families of Buthidae, Hemiscorpiidae or Liochelidae and Scorpionidae were identified. The identified species were as follows: A: Family Buthidae: Mesobuthus eupeus [44%], Androctonus crassicauda [28.5%], Odontobuthus doriae [22.6%], Orthochirus scrobiculosus [3%], Androctonu. Amorcuxi [0.35%], Buthotus saulcyi [0.35%], B: Family Liochelidae: Hetmiscorpious lept urus [0.9%], C: Family Scorpionidae: Nebo sp [0.3%] Kerman province with 8 scorpion species has a high bidogical founa. This is the second report of the Nebo Genus from Iran after the report in 1980 from Hengam island located in south of Iran in Persian Golf Planning prevention, control and treatment programs based on the identified species is suggested

short term results of complete revascularization in diabetic patients by off- pump coronary artery bypass graft [OPCAG]

Complete revascularization in diabetic patients due to small size and diffuse involvement of vessels is a problem in cardiac surgery. Due to known complications of on-pump CABG, the off-pump CABG has been suggested in these patients. This study was carried out to assess the short term results of complete revascularization in diabetic patients. This retrospective study was done during 2002 to 2006 at Imam Reza Cardiac Surgery Ward on 500 patients who were operated by off-pump CABG. The patients were divided into two groups, a: diabetic [235 pts] and b: non diabetic [265 pts]. The preoperative comorbidity, intraoperative measurement of the size of the artery at the site of anastomosis with different gauged probes, and the number of grafts per patient were recorded. Intraoperative and postoperative variables between two groups compared. The observed number of grafts [O] after surgery compared with the number of grafts predicted [P] before surgery. The O/P ratio or [completion index] of >/= 1 signifies complete revascularization. Logistic regression analysis used to test possibility that diabetes was a predictor of poor outcomes. Diabetic patients were older, with more comorbidity [congestive heart failure, peripheral vascular diseases, dialysis-dependent]. The number of grafts per patient was 4.2 +/- 1.3 [DM] and 4.2 +/- 1.3 [non-DM]. The size of 875 DM and 1068 non-DM arteries were gauged. There was no statistical difference in size between DM and non-DM [in millimeters] at each artery. All ratios ranged from 0.9 to 1.2, indicating similarity between DM and non-DM. The only significant risk factor for operative death was low left ventricular ejection fraction [P=0.001]. patients with DM were sicker, but tolerated off-pump coronary artery bypass grafting as well as non-DM patients. The number of grafts per patient and O/P ratio signified the ability to perform complete revascularization. We were able to bypass the small target vessels, as anticipated. Diabetes is not a predictor of the outcomes

[Clinical and paraclinical characteristics of hospitalized pa talents with congestive heart failure in Yazd [a survey of 258 patients]]

The Clinical and Paraclinical Characteristics of patients with congestive heart failure [CUF] have been described by a number of previous studies, but very little information is available on this issue in Iran. This study aimed to delineate the clinical and paraclinical characteristics of Iranian patients hospitalized with CHF. During an observational, analytical, descriptive, cross-sectional study, 258 consecutive patients were interviewed and examined at S hospitals in Yazd, Iran from January to December 1999.Questionnaire comprised of information regarding etiology, signs, symptoms, paraclinical data, etc. Results were analyzed by SPSS9.01 and EP16 programs using ANOVA, Chi-Square and f-TEST and reported as Mean +/- SD. The study population had a high mean age [67.59 +/- 0.73], 0.8% were less than 35 years old and 70.80% were older than 65 years. Mortality rate due to heart failure was 7.5%. Major causes of CHF were ischemia [65.1%]. valvular lesions [5.8%], cardiomyopathy [5%] and hypertensive heart diseases [4.6%]. Mean number of hospitalizations per year was 2.2 +/- 0.1, while mean hospitalization time was 7.25 +/- 3.8 days and mean cost was 1122439 +/- 89874.8 rials. Even though many background and aggravating factors of heart failure are preventable, this disease incurs a lot of expenditure on our country's health system. Therefore, there is a requirement for programming and research in the fields of education, treatment and prevention of this disease for all members of the community

Effect of laryngoscope blade cover on bacterial contamination of pharynx and post-operative sore-throat

Laryngoscope blades are in contact with mucous membrance and can pissiblily contaminated with transmissible microgranisms. The cover for the blade of the laryngoscope may be can prevent the cross infection. The aim of this study was to evaluate the effect of use of disposable nylon sheath over laryngoscope blade on bacterial contamination of pharynx and post operative sore throat. 66 patients undergoing general anesthesia were included in this study. In case group [n=32] a translucid nylon cover enclosing the blade of laryngoscope. In control group [n=34] the blade used without cover. Before induction of anesthesia, in both groups the samples from blade, and before induction of anesthesia and 24hr after operation the sample from patients pharynx were obtained and sent for aerobic and anaerobic bacterial culture. Frequency of positive culture and post operative sore throat were determined. The intensity of post operative sore throat was assessed at 24hr after operation using visual analogue scale [VAS]. Data were ananlyzed using chi-square, Fisher exact, McNemar and t-tests. The frequency of positive culture of pharynx before induction of anesthesia in case and control groups was 89.3% and 94.1% respectively [P > 0.05]. This frequency was 43.7% and 61.8% at 24 hr after operation [P > 0.05]. In 6 samples of laryngoscope blade, bacterial culture was positive. The occurence of post operative sore throat in both groups was 62.5% and 52.9% respectively [P > 0.05]. There were no correlation between pharyngeal cultures and post operative sore throat. The bacteriological study of laryngoscope blades showed that the routine cleaning and sterilization of blades in our hospital is effective. Laryngoscope blade cover has no effects on bacterial contamination of pharynx and post operative sore throat

[Relation between admission blood glucose levels and in-hospital and one year mortality in non-diabetic acute myocardial infarction patients]

Several studies have evaluated the association of admission blood glucose levels and short and long term mortality after myocardial infarction and have had different results. The aim of this study was evaluation of association between admission blood glucose levels and in-hospital and one year mortality in non-diabetic patients with AMI. In this study, demographic, clinical and Para clinical data of 120 non-diabetic patients with AMI on admission was collected and analyzed. The patients were followed for one year. Blood glucose level >/= 140 mg/dl was defined as hyperglycemia. 78% of patients were men. The mean age and admission blood glucose level was 63 +/- 13 years and 146 +/- 76mg/dl, respectively. Death due to cardio vascular causes was seen in 20% of patients in hospital and 9.8% during the one year follow up. The mean admission blood glucose level in patients who died in hospital was significantly more than live patients and also had an influence on the in-hospital outcome. Every 100mg/dl increase in blood glucose level was associated with 11% increase in in-hospital mortality risk in non-diabetic patients. Our results demonstrate that admission blood glucose level is a good marker for diagnosing patients with worse prognosis after AMI. We suggest that later studies should focus on optimal control of hyperglycemia with insulin in patients with AMI

[Frequency of cardiac dysrythmia, blood pressure changes and level of arterial oxygen saturation during endotracheal suctioning in intensive care unit patients]

Introduction: Tracheobronchial suctioning has some complications for the patient. One of these complications is cardiac dysrythmia. Some articles mention ventricular extra systole to be common after suctioning but some other articles indicate bradycardia or premature arterial contraction [PAC] as the most common dysrythmia during endotracheol suctioning

Objective: In attention to the danger of cardiac dysrythmia during suctioning and also different existing opinions among researchers, the present study is conducted to determine the frequency of cardiac dysrythmia during tracheobranchial suctioning

Materials and Methods: Four hundred patients aging 18-65 under mechanical ventilation from intensive care units of Ayetoloh Kashani Center were selected. EKG, systolic and diastolic arterial pressure [SAP, DAP], heart rate [HR] and arterial hemoglobin saturation were recorded before the endotracheal suctioning. Then standard endotracheal suctioning was done and these parameters were determined during the suctioning. At the end of suctioning another EKG was taken and shown to the cardiologist. Data were analyzed using descriptive statistics, ratios and also analysis variance

Results: Mean age of the patients and M/F ratio were 33 +/- 14 yrs. and 17.2 respectively. The most common abnormal rhythm during the suctioning was sinus tachycardia [33%]. No other arrhythmias were seen in this study. The greater increase in HR occurred 2 minutes after endotracheal suctioning [114 +/- 20 vs. 102 +/- 16 pre suctioning][P<0.05]. Patients' systolic blood pressure significantly rose after suctioning [P<0.05]. There was insignificant difference in diastolic BP and saturated arterial hemoglobin

Conclusion: These findings suggested that endotracheal suctioning can induce sinus tachycardia but other dysrythmias, which may be dangerous in the patients under mechanical ventilation, did not occur in this study. Perhaps suctioning tracheal and bronchial secretions under correct medical conditions causes no dangerous arrythmias

Oral clonidine premedication decreases intraoperative bleeding in patients undergoing endoscopic sinus surgery

The antihypertensive drug, clonidine, is a centrally acting alpha 2 agonist, useful as a premedication because of its sedative and analgesic properties. We examined the effect of clonidine given as an oral premedication in producing a bloodless surgical field in patients undergoing endoscopic sinus surgery. We also evaluated the relation between bleeding volume and consumption of fentanyl and hydralazine to control hypotension. This prospective double - blinded clinical trial was performed on 113 patients [ASA I, ASA II]. Fifty-two patients received oral clonidine [5 micro g/kg] while the other 61 patients received placebo. During general anesthesia, the hemodynamic endpoint of the anesthetic management was maintenance of hypotension [MAP] at 70 mmHg for producing a bloodless surgical field. The direct control of MAP was attained with inspired concentration increments of halothane up to maximum of 1.5 vol% as needed. When it was unsuccessful, an intravenous fentanyl bolus of 2 micro g/kg was also added. When both drugs failed, hydralazine, was given intravenously as a bolus and intermittently, 0.1mg/kg up to a maximum dose of 40 mg. Intraoperative bleeding was assessed on a six - point scale from 0 [= no bleeding] to 5 [= severe bleeding]. Data were compared with chisquare test, fisher's exact test and Student t-test. There was less bleeding volume in the clonidine group [mean +/- SD] than in the placebo group [144 +/- 75 Vs 225 +/- 72 ml, P<0.05]. Frequency of bleeding severity scores 3 and 4 [troublesome with repeated suction] were lower in the clonidine group than in the placebo group [12% Vs 35%, P< 0.05]. Fentanyl requirement was significantly lower [112 +/- 18 Vs 142 +/- 21 micro g, P < 0.05] in the clonidine group. Hydralazine requirement was significantly lower [0.45 +/- 1.68 Vs 2.67 +/- 4.33 mg, P<0.05] as well. Premedication with oral clonidine reduces bleeding in endoscopic sinus surgery and also decreases fentanyl, and hydralazine consumption for controlling hypotension

[Diagnosis and treatment of penetrating cardiac injury one year after thoracic stab wound]

In any patient with a history of penetrating thoracic trauma, cardiac injury must be kept in mind. Here, we describe a 36 years-old female referred to this hospital with severe chest pain and hypotension. After primary evaluation and suggestion of AMI, streptokinase was started for the patient and because of deterioration of vital signs, cardiac surgery consultation was requested. After performing urgent echocardiography, massive pericardial tamponade was detected. Visualization of a knife blade on C.X.R and past medical history of thoracic stab injury led to a diagnosis of delayed cardiac tamponade and urgent sternotomy was performed. The blade that had penetrated the right ventricular chamber was extracted. Six days after operation, patient was discharged without any problem. This case study suggests the importance of high suspicion to cardiac injury in any patient with chest pain and a history of chest trauma

Early outcome of acute myocardial infarction

Introduction: Previos studies indicated that generally after acute myocardial infarction women have a poorer outcome thane men. Further studies with complete adjustements for coexisting condition are needed to determin whether the older age of the women who studied or the presence of other unfavorable prognostic factors or both explains this difference

Material and Method: We studied 817 consecutive patients [556 men and 261 women] hospitalized in all CCUs in city of Yazd due to acute myocardial infarction from May 2000 to October 2001

Results: In this survey, women were older than men [67.50 +/- 11 Vs 60 +/- 13] and had higher prevalence of hypertension, diabetes, dyslipidemia and in-hospital mortalities. The unadjusted odds ratio for death among women compared to men was 2.7[95 percent confidence interval, 1.79 to 4.28]. After adjustment for age the odd ratio reduced to 2.03 [95 percent confidence interval, 1.3 to 3.1]. Adjustmen for other differences in the base line characteristics reduced the odds ratio to 1.91 [95 percent confidece interval, 1.03 to 3.5]. These differences were significat, but after adjustment for treatment the odds ratio reduced to 1.51 [95 percent confidence interval, 0.6 to 3.7], and it wasn't Statistically significant

Conclusin: Women have worse prognosis after acute myocardial infarction and on the treatment may be contributing to this, and for correct judgement the difference of mortality after acute myocardial infarction, both sexes should under go the same approach for treatment