80 2981-0086 Gonabad University of Medical Sciences 224 Internal Medicine The comparison of epinephrine, fentanyl and sufentanil effect on spinal anesthesia with lidocaine Abbasnejad AA. Moslem AR. Nazemi SH. 1 10 2007 13 3 5 12 23 06 2008 Background and Aim: Recent developments in anesthesia have brought human beings to realize analgesia as the main objectives of painlessness, so they try to find the simplest method and the most economical drug with less side effects for it. This research has been done to compare the effects of three drugs, epinephrine, fentanyl and sufentanil with lidocaine on spinal anesthesia to find the best drug. Materials and Methods: This is a clinical trial and the samples were 50-60 year men reffering to Gonabad 15 khordad hospital, for inguinal hernia operation 120 patients were divided into 3 groups randomly each group consists of 40 men. In one group (E) 0.2 mg epinephrine and in other group (F) 25 µg fentanyl and in the 3rd group (S) 2.5 µg sufentanil with 100 mg lidocaine 5% were used for spinal anesthesia. A check list and a questionaire were used for data collection, and then the data were analyzed by computer softwares and chi-square and ANOVA. The p value < 0.05 was considered significant. Results: The mean duration of analgesia in group E was 82.1±15.7 minutes and in group F was 99.37±18.61 minutes and in group S, it was 153.62±26.62 minutes. So, there was a significant difference between the three groups regarding the duration of analgesia (F=121.1, P<0.001). In group F the occurance of hypotention was %15, bradycardia was %10 and vomiting and nausea was %7.5 but in group F, it was %37.5, %27.5 and %10 and in group S, it was %40, %32.5 and %15, respectively that was not significant. Conclusion: The length of analgesia in spinal anesthesia with sufentanil was more than fentanyl and with fentanyl It was more than epinephrine and there was a significant difference, but it was not significant regarding to side effects like hypotention, bradycardia,vomiting and nausea.
225 Internal Medicine The use of oral ketamine in the management of posthemrroidectomy Taheri H. Behdad A. Kashefi P. 1 10 2007 13 3 13 19 23 06 2008 Background and Aim: Hemorrhoidectomy can be associated with severe pain in the immediate postoperative period. The aim of this study was to assess the efficacy of oral ketamine, in the reduction of pain and analgesic requirements after hemorrhoidectomy. Materials and Methods: 80 patients were suitable for an established day surgery hemorrhoidectomy protocol. Immediately before surgery patients were randomly assigned either to receive (Group 1) or not receive (Group 2) the oral ketamine. All other aspects of surgery and anesthesia were standardized. In the postoperative period, analgesia was maintained with IV pethedine. Pain was assessed by VAS (Visual analogue scale) at T0 (arousal), and T4, T12, T24 later. The interval time for the first request of analgesia and the total amount of analgesic consumption were reported. All statistical analyses were performed with SPSS. Results: There was a statistical difference between the 2 groups in the average mean values of pain intensity at T0 and T4, T12, T24 in the numerical scale. The interval time to request the first analgesic supplement was longer in the G1 than G2 (7.5 hr versus 1.5 hr p <0.05). There was a statistical difference between G1 and G2 in the total dose of pethedine consumption (p <0.05). Conclusion: In this study, the use of oral ketamine, is associated with a significant decrease in pain and analgesia requirements after hemorrhoidectomy. 226 Internal Medicine The study of ethanol effects on microscopic structure of the lung in adult mouse Mofidpoor H. Jafarpoor M. Ebrahimzadeh AR. 1 10 2007 13 3 20 24 23 06 2008 Background and Aim: Ethanol is a well-known substance with extensive medical and industrial applications. It is used also as a drinking and has dangerous side effects on several organs of the body. Effects of ethanol on some organs of the body have been studied but few experimental studies have been carried out on lung. The purpose of this research was to study the effects of ethanol on histological changes of lung structure after ethanol consumption in adult mouse. Materials and methods: Twenty adult Male and female, 3 month age mice, were selected and divided randomly into two experimental and control groups. Diluted ethanol was injected intraperitoneally, once daily, for 21 days in the experimental group. Control group received normal saline simultaneously. After 21 days ethanol consumption, mice were anesthetized and lungs were removed. Specimen were immediately washed in normal saline and fixed in formalin, dehydrated with an ascending ethanol series, cleared with xylene and then embedded in paraffin. The paraffin blocks were cut into sections of 5µm thickness. Sections were stained with H;E and were studied by light microscope. Results: Congestion in blood vessels of the septal alveolar, accompanied by bleeding, moderate and severe inflammatory cells infiltration, mainly polymorphonuclear neutrophill, were seen on septal alveolar tissues by light microscopy. Focal intraalveolar bleeding was seen in some areas of the lung as well. Conclusion: This study showed that ethanol may have destructive effects on lung tissues such as blood congestion, bleeding and inflammation. 234 Internal Medicine The survey of physical and chemical quality of Gonabad drinking water in spring and summer of 1386 Keramati H. Mahvi AH. Abdulnezhad L. 1 10 2007 13 3 25 32 23 06 2008 Background and Aim: Enough water with proper quality is necessary for life. Health promotion and environment guarding is dependent on providing fresh water. Human civilization has been started near the rivers, seaside or natural fountains. Fresh and healthy water is very important in preventing most of diseases such as: Diarrhea, Cholera, Typhoid, Paratyphoid, Infectious hepatitis, Ameba and bacillus diarrhea. The people of old times evaluate the water quality only through physical senses such as: vision, taste and smelling. Because no methods and techniques were found for determination of water quality and its effects on human health biological, chemical and medical sciences were developed. We entered to determining chemical and physical parameters of Gonabad drinking water to be compared finally with national and world standards. Materials and Methods: To evaluate the strategic parameter in the study, the standard methods were used. for Turbidity , EC and pH measuring turbidity meter , EC meter and PH meter sets were used, Oven was used for TDS (Total Dissolved Solids) ,Hardness was measured by titration method and residual Chlorine was also measured by DPD method. Results: The measured parameters average were such as the followings: residual Chlorine =0.57 ppm, EC= 1840.36 µmho/cm, PH= 7.56, Hardness=268.6 mg/lit, Turbidity= 0.33 NTU and TDS= 901.65 mg/l Conclusion: Statistical analysis doesn't show a meaningful difference between the parameters with standard parameters. There is a significant difference between Chlore parameter in spring and summer time. It seems that this difference is due to Gonabad hot climate in the summer (desert area). There was a significant difference between PH in spring and summer time, too. 228 Internal Medicine Survey of vessels colorability rate via coloured polymer in S10 plastination technique Moeen AA. Ghafari HR. Dashti GhR. Zareban I. Moudi M. 1 10 2007 13 3 33 38 23 06 2008 Background and Aim: Teaching human anatomy, at any level, relies not only on the expertise of a tutor but also on the availability and use of good teaching aid. Plastination specimens have unique position as a teaching aid to exhibit accurate anatomical structures and easy to be stored and handled by students. The aim of this study was to prepare plastinated specimen of trunk, by Survey of vessels color ability rate via colored polymer in S10 plastination technique. Materials and Methods: This study performed on a human body after fixation of the cadaver .The colored polymer was prepared by mixing red colored paste with polyester and the cobalt (accelerator) and peroxide (hardening material) was added to it. The prepared colored material was injected into the body through femoral artery by the naso-gastric catheter with the help of the hydraulic pump. After a few days when the colored polymer dried up, dissection (Posterior trunk, spinal cord and medulla oblongata), dehydration, defatization and impregnation of the body was carried out. Finally the prepared plastinated specimen was compared with the standard plastinated model. Results: The prepared plastinated specimen was dried, in toxic and without noxious fumes also spinal cord and medulla oblongata have showed a normal anatomical position of structure and flexibility, elasticity and traction was compared with a similar one of standard specimen. The obtained result showed that the P-value was 0.05 and the standard error was (0.382±-0.4600). Colored polymer into the arteries and colored vein was easy for detection. Conclusion: According to this study, the P-value was greater than 0.05, which shows no significant difference statistically. The plastinated specimen prepared by injecting colored polymer into the arteries, provided an excellent opportunity to demonstrate and reduction in toxic and noxious fumes of formalin, durability and safety. 229 Internal Medicine The comparison of baby industry food with home-made food in male rats Asemi Z. Taghizade M. 1 10 2007 13 3 39 46 23 06 2008 Background and Aim: Evaluation of the quality of food proteins has a great importance because of biological and economical impacts. Among existing methods, true Protein digestibility, net protein ratio and protein efficiency ratio have been suggested as appropriate methods to determine the quality of proteins. Considering the importance of protein quality in foods, this study has been conducted to compare the value protein Cerelac (food industry baby) with home made food (Rice -Bean mixed) in male rats. Materials and Methods: This experimental study was performed on 64 male rats (wistar), aged 21days under 8 diets in 8 groups including of: 2 case diets (home made food and Cerelac), 1 diet standard (casein + Methionine) and 1 basal diet (protein free) in order to determine TPD, AD and 2 case diets, 1 standard diet and 1 basal diet in order to determine NPR, PER and FER. Comparison of TPD, AD, NPR, PER and FER between the groups was analyzed by ANOVA and Tukey methods. Results: TPD were 92.8±4, 87±8 and 79.7±1.6, NPR were 4.3±0.4, 4.3±0.9 and 3.8±0.6 and PER were 3±0.2, 2.5±0.4 and 2.9±0.2 for Casein + Methionine, Cerelac and home made food groups respectively. So difference TPD ANOVA between three groups was significant (p<0.0001) but NPR and PER were not significant. Conclusion: TPD and NPR are home made food based on Rice -Bean mixed in comparison with cereal in protein was higher and it is acceptable. 230 Internal Medicine Use of alamar blue assay as a colorimetric method for detection of multidrug-resistant Mycobacterium tuberculosis Mohammadzadeh AR. Farnia P. Rashed T. Ghazvini K. Behdani M. Ghanaat J. 1 10 2007 13 3 47 51 23 06 2008 Background and Aim: In recent years, tuberculosis (TB) has acquired a growing importance in developed and developing countries. The spread of multidrug-resistant (MDR) strains of Mycobacterium tuberculosis is an increasing public health concern in many parts of the world, especially in low- income countries. Standard methods for drug susceptibility testing of M. tuberculosis are time-consuming. In this study, we have evaluated the possibility of using colorimetric method by means of Alamar Blue, to detect susceptibility of M. tuberculosis strains as less expensive and easier-to-read methods. Materials and Methods: For this study 23 isolates of Mycobacterium tuberculosis were obtained from Iranian National Research Institute of Tuberculosis and Long Diseases. 11 isolates were resistant to rifampin and isoniazid and 12 isolates were susceptible to rifampin and isoniazid. The colorimetric method in this study was performed with a critical concentration of 0.2 µg/ml for isoniazid and 2 µg/ml for rifampin in 7H9GC broth. The tubes were incubated at 37˚C for 4 weeks. Results: For both rifampin and isoniazid, the sensitivity and specificity of Alamar Blue method was %100 and %90 respectively. In this study, the results for Alamar Blue were available in average 6 days. Conclusion: Medical laboratories in developing countries have to adapt a simple method, which does not require expensive equipment materials. In conclusion, this colorimetric method is simple, reliable and inexpensive methods to evaluate drug susceptibility of Mycobacterium tuberculosis, especially in laboratories with low- income. In this regard, Alamar Blue culture tubes have the optional to become the method of choice for assessing drug susceptibility of M. tuberculosis in countries like Iran. 231 Internal Medicine The comparison of headache following general anesthesia with halothane or isoflurane in educational hospitals of Jahrom Ghanei M. Kazemi F. Sahraian R. Sahraian A. 1 10 2007 13 3 52 57 23 06 2008 Background and Aim: Halothane and isoflurane are the most common anesthetic drugs in general anesthesia. Headache is the most common complication of patients after operation and the factors which cause it is inhalational anesthetics. The aim of this Study is detection of prevalence of headache after general anesthesia with halothane in comparison of isoflurane in patients who referred to Jahrom training hospitals for elective surgery. Materials and Methods: This is a clinical trial study done by simple sampling among Patients Who referred to Jahrom training hospitals during two months for elective operation. 120 of them were randomly selected and divided into two equal groups. Method of anesthesia on two groups was general anesthesia one of them received Halothane and nitrous oxide and, the other one instead of Halothane, used Isoflurane. All the patients after operation in recovery room, 6, 12 and 24 hours later, were asked and monitored for headache by a question list and interview. Data were analyzed by SPSS software and statistic methods, such as t-test and chi-square. Results: The Prevalence of headache after general anesthesia with Isoflurane (68.3%) was more than Halothane (56.7%)(P=0.1). The highest prevalence of headache after Isoflurane , in recovery room was (68.3%) , with the highest mean of pain severity (3.02) , and the least prevalence of headache was observed , 24 hrs. after using Halothane as the anesthesia agent(18.3%) and with the least mean of pain severity (0.48) . Duration of headache after anesthesia with Isoflurane was too longer (1.05 hours) than Halothane (0.7 hours). Associate symptoms after anesthesia with Isoflurane were more prevalent and overall, in both groups, women are more effected (%64.8) by headache than men (%60.15). Conclusion: This study shows the high prevalence and duration of headache after anesthesia with isoflurane 232 Internal Medicine The comparison of visual acuity and induced astigmatism after phacoemulsification and extracapsular cataract extraction Momeni H. Ansari H. Yekta AA. Ghiasi F. Azizi N. Shahbeigi A. 1 10 2007 13 3 58 62 23 06 2008 Background and Aim: There are three methods for cataract extraction, extracapsular, intracapsular and phacoemulsification. The purpose of this study is determination of visual acuity and astigmatism before and after phaco and ECCE method and comparison of these two methods. Materials and Methods: In this cross-sectional study, the all of cataract surgery records investigated that were belong to one surgeon in 2006-2007. They were 100 phacoemulsification and 34 extra capsular cataract extraction. The data were analyzed in SPSS 14 using independent and paired t-test. Results: The mean of visual acuity before and after phaco and ECCE showed a considerable difference (P< 0.001). The mean of astigmatism before and after phaco did not show any difference (P=0.7), But for ECCE did (P<0.001). The comparison of astigmatism and visual acuity after phaco and ECCE showed a considerable statistical difference (P< 0.001). Conclusions: The result of this study showed that recovery rate of visual acuity was faster in phaco than ECCE and induced astigmatism after surgery had been lower for phaco than ECCE technique. 233 Internal Medicine Massive hematocele after transfemoral cardiac angiography (a case report) Ahmadnia H. Ahmadnia H. 1 10 2007 13 3 63 64 23 06 2008 Hematocele is a rare complication following percutaneous transluminal angiography or angioplasty. It carries significant morbidity and causes extreme discomfort to the patient. We describe the case of a 47 year-old man who developed this complication.