Changes in Body Fluid Composition Before and Early after Renal Transplantation and comparing it with Normal Persons
Farzaneh
Sharifipour
Associate professor of Nephrology, Mashhad University of Medical Sciences, Mashhad, Iran
author
Masih
Naghibi
Professor of Endocrinology,
Mashhad University of Medical Sciences, Mashhad, Iran
author
Masoud
Mohebi
Resident of Internal Medicine,Mashhad University of Medical Sciences, Mashhad, Iran
author
Abbassali
Zeraati
Associate professor of Nephrology, Mashhad University of Medical Sciences, Mashhad, Iran
author
Maryam
Hami
Associate professor of Nephrology, Mashhad University of Medical Sciences, Mashhad, Iran
author
Boshra
Hasanzamani
Nephrologist,Mashhad University of Medical Sciences, Mashhad, Iran
author
Farnaz
Kalani Mogaddam
General MD, Mashhad, Iran
author
text
article
2011
per
Introduction In this study we evaluated the body composition before and two weeks after kidney transplantation and compared it with the healthy people by BIA. Materials and Methods A total of 23 progressive renal failure patients who attended the transplantation were recruited for this study. The control group included 27 graft donors .Patients were checked one day before hemodialysis and a day before transplantation, by BIA. After transplantation, body composition was assessed between days 1-7 and on the 14th day of post transplantation. The control group included 27 graft donors. Result The comparison of body composition between two groups (donors and recipients) showed significant changes before hemodialysis and after transplantation, and TBW% decreased from the 7th day post transplantation. The Main cause of low level of TBW% was the decrease in ECW% and ECW/ICW from the beginning of 2nd week after transplantation. Just TBW% in normal males was different from that it normal females but in recipients there was no difference between males and females. Conclusion The body composition takes a long time to reach to the normal level and two weeks after transplantation some agents are probably responsible for intense changes of body composition including drugs and mild prerenal azotemia specially on the 2nd week after transplantation.
medical journal of mashhad university of medical sciences
1735-4013
54
v.
3
no.
2011
131
136
https://mjms.mums.ac.ir/article_5321_552add65f88330af12023f178dda79cf.pdf
dx.doi.org/10.22038/mjms.2011.5321
Mousa
Ahmadpour-kacho
Associate professor of Pediatrics, Babol University of Medical Sciences, Babol, Iran
author
Yadollah
Zahedpasha
Professor of Pediatrics, Babol University of Medical Sciences, Babol, Iran
author
Siamak
Peydayesh
Resident of Pediatrics, Babol University of Medical Sciences, Babol, Iran
author
Aazamossat
Mazloomi
BSc in nurse, Babol University of Medical Sciences, Babol, Iran
author
text
article
2011
per
Introduction Total Serum Bilirubin level (TSB) has been the gold standard indicator for exchange transfusion (ET) in the neonates for many years. This study was designed to assess the bilirubin/albumin (B/A) ratio as an indicator for ET in comparison with TSB. Materials and Methods In the NICU and newborn services at Amirkola Children's Hospital (ACH) in the north of Iran, 90 neonates in 3 groups were selected. The first group was 30 neonates who required exchange transfusion (ET), because of severe hyperbilirubinemia (HB) based on the TSB according to the ACH protocol .The second group was 30 neonates, treated with phototherapy due to pathologic HB and the Other 30 neonates had only physiologic neonatal jaundice. Blood samples were checked for serum bilirubin, albumin and B/A ratio in addition to the routine lab tests for HB. Sensitivity, specificity, negative predictive value, positive predictive value, and relative risk were assessed for B/A ratio as a determinant to do ET. Results The mean±SD of B/A ratio was 6.0847±0.9870 in blood exchange group, 4.1680±0.5480 in phototherapy group and 1.7677±0.5061 in healthy neonate group. “Cut off level” of B/A ratio calculated to do ET was 4.50.The B/A ratio of 4.5 has a “positive predictive value” of 75% and a “negative predictive value” of 100%. Conclusion A B/A ratio equal to 4.5 among newborns Who required exchange transfusion has a high value as a criterion to do ET, although further study is required to recommend it alone in clinical practice. So we recommend doing B/A ratio in accompaniment with TSB as an adjunctive test.
medical journal of mashhad university of medical sciences
1735-4013
54
v.
3
no.
2011
137
142
https://mjms.mums.ac.ir/article_5322_9d32ea60b6e5f4ed86fe147ecc4b6dd3.pdf
dx.doi.org/10.22038/mjms.2011.5322
Assessment of Relation of Hospital and Short and Term (30 days) Mortality of STEMI Patients with Angiographic Parameters and its Contributing Factors
Ali Asghar
Dadgar
Professor of cardiology, Mashhad University of Medical Sciences, Mashhad, Iran
author
Mohammad
Tayeby
Assistant Professor of
Cardiology, Mashhad University of Medical Sciences, Mashhad, Iran
author
Amirhossein
Shakiba Herfeh
Cardiologist, Mashhad Iran
author
Mahsa
Hassanzadeh Bashtian
MSc in Statistics, Mashhad Iran
author
text
article
2011
per
Introduction Myocardial infarction is one of the most common causes of hospitalization and mortality in human societies. Several researches have performed to identify various risk factors for cardiovascular disease progression and improve treatment methods, medications and therapeutic interventions to minimize mortality. In this study, we have assessed the relation between angiographic findings of patients having myocardial infarction with ST segment elevation and mortality during the hospital course and one month follow up. Materials and Methods A total of 156 patients with STEMI Who referred to Imam Reza hospital with the definition of more than 2mm elevation of ST segment in precordial leads and more than 1mm in limb leads also with elevation in cardiac biomarkers were enrolled in this study. Patients’ history obtained and the angiography was carefully reviewed by a cardiologist and variables were recorded. Death of patients during hospitalization and a month after discharge was also recorded. Results There was a significant relationship between angiography performance and the presence of thrombus and location of involved vessel, hypotension at presentation, killip class, and tachycardia, hypertension with hospital mortality. Age and calcification were independent factors for one month mortality. In-hospital mortality was 10.3% and one month mortality was 4.3%. Conclusion Age and some angiographic factors including the existence of thrombus and anterior wall involvement were significantly correlated with mortality after myocardial infarction.
medical journal of mashhad university of medical sciences
1735-4013
54
v.
3
no.
2011
143
149
https://mjms.mums.ac.ir/article_5323_eb1a24cb1327abf52dbd47ae8a6e2ddf.pdf
dx.doi.org/10.22038/mjms.2011.5323
Effect of Thoracic Epidural Anesthesia on Oxygen Saturation During one-lung Ventilation in Pulmonary Resection Surgery
Hamzeh
Hosseinzadeh
Associate Professor of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
author
Davoud
Aghamohamadi
Assistant Professor of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
author
Khosro
Kolahdouzan
Instructor of Anesthesiology,Tabriz University of Para Medical Sciences,Tabriz ,Iran
author
Parisa
Hosseinzadeh
Student of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
author
Rasool
Azarfarin
Associate Professor of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
author
Afshin
Iranpor
Anesthesiologyst, Tabriz, Iran
author
Samad
Golzari
Resident of anesthesiology, Tabriz, Iran
author
text
article
2011
per
Introduction The perfusion in the nonventilated, operative lung during one-lung ventilation (OLV) in patients undergoing thoracic surgery increases intrapulmonary shunt and decreases systemic arterial oxygenation. The anesthesia with OLV may affect oxygenation. The aim of this study was comparing the effect of total intravenous anesthesia (TIVA) and thoracic epidural anesthesia (TEA) combined with TIVA on saturation of oxygen during OLV in patients undergoing pulmonary resection. Materials and Methods In a randomized double-blind clinical trial, 60 patients undergoing elective pulmonary resection were Divided in to two groups .The intervention group received TEA (bupivacaine 0.25%) plus TIVA (propofol+remifentanil) while the control group received TEA (saline) plus TIVA.The hemodynamic parameters, Aldrete score and possible complications were compared between the two groups, within the study period . Results The change of hemodynamic parameters, as well as SaO2, PaO2 and ETCO2 within the study period was not significantly different between the two groups. The mean Aldrete score was comparable between the two groups upon entering recovery and after getting discharged from there. During the recovery stay, frequency of patients with pain and shivering was significantly higher in the group with sole TIVA. There was no significant difference in nausea and hypotension between the two groups. Conclusion TEA plus TIVA does not have a significant effect on O2 saturation in OLV in patients comparing with sole TIVA. However, this combination significantly decreases the post-operative pain and shivering and so may be recommended.
medical journal of mashhad university of medical sciences
1735-4013
54
v.
3
no.
2011
150
158
https://mjms.mums.ac.ir/article_5324_6b0557a7eb13aad192d2f1764b502ce5.pdf
dx.doi.org/10.22038/mjms.2011.5324
Diagnostic Value of Standard 12 Lead Electrocardiography in Acute RV Myocardial Infarction
Research Center of Cardiology- Birjand University of Medical Science
Toba
kazemi
Associated professor of cardiology, Birjand university of Medical science, Birjand, Iran
author
Homa
Falsoleiman
Associated professor of cardiology, Mashhad University of Medical science Mashhad, Iran
author
Sara
Rozmina
Eneral practitioner, Birjand, Iran
author
text
article
2011
per
Introduction Right ventricular infarction (RVMI) is associated with increased morbidity and mortality in patients with acute inferior myocardial infarction (MI). Although, electrocardiography is probably the most useful, simple, and objective tool for the diagnosis of acute MI, there are no well-defined criteria in the standard 12-lead electrocardiogram to properly identify RVMI in patients with acute inferior MI. The aim of this study was to evaluate the value of ST-segment changes in 12-lead in diagnosing RVMI in patients with acute inferior MI. Materials and Methods A total of One hundred sixty seven patients, hospitalized with acute inferior MI, were included in this study. The diagnosis of acute inferior MI was based on the clinical history and the appearance of ST-segment elevation (STE) ³1 mm in at least two of the leads (leads II, III, aVF). RVMI was defined by STE³1 mm in lead V4R during the first 12 hours after the beginning of the symptoms. Then the patients were divided into two groups (RVMI + and -) and ST-segment changes were compared between the two groups. Results The Ninety patients (51.1%) had RVMI according to lead V4R. ST-segment change ³1mm was seen in I, III, aVL, and in aVF; also ST-segment depression ³2mm in I+aVL and STE³1 mm in lead III greater than lead II (III>II) was significantly different between the two groups. The high sensitivity-specificity was seen in lead I: 86%-72%; lead aVL: 96%-26%; I+aVL: 84%-71%; and III>II: 82%-74%. Conclusion More than 1 mm ST-segment depression in lead I, STE in III>II and ST-segment depression³2 mm in I+aVL are possible to identify RVMI in patients with acute inferior MI.
medical journal of mashhad university of medical sciences
1735-4013
54
v.
3
no.
2011
159
165
https://mjms.mums.ac.ir/article_5325_953e66f8f8a3cb1a98d5c07771b3bd30.pdf
dx.doi.org/10.22038/mjms.2011.5325
A Survey of Early Oral Feeding in Intestinal Anastomosis in Children Admitted in Tabriz Children Hospital
Child Health Research Center- Tabriz University of Medical Sciences
Saeed
Aslan Abadi
Professor of pediatrics Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
author
Davud
Badbarin
Assistant professor ofpediatrics Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
author
Asghar
Esmailzadeh
Assistant of General Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
author
Navid
Elmdust salimi
General M.D, Tabriz, Iran
author
text
article
2011
per
Introduction Early feeding improves the outcome of patients with trauma and burns, although, few studies have examined its use after gastrointestinal (GI) anastomosis. A randomized controlled trail that compared an early regular diet with the conventional postoperative dietary management to determine GI complications and mortality after major GI anastomosis was conducted. The secondary purpose of this trial was to evaluate the incidence of postoperative ileus after major GI anastomosis with early feeding in comparison with the conventional diet. The purpose of this study was to compare early feeding with traditional postoperative dietary management for improvment of postoperative gastrointestinal (GI) symptoms. Materials and Methods We conducted a prospective randomized controlled study. This was a study of 80 patients who were randomly allocated to early feeding beginning with liquid diet, 3 days postoperative, whereas those in the traditional feeding group were given a regular diet with normal bowel sounds. Results The incidence of postoperative ileus did not differ between the two groups. However, there was no significant difference in the rate of intraoperative complications such as, leakage of anastomosis, mesenteric embolus, wound infection, and wound dehiscence between the groups. Also, there were no Considerable Variation in mortality between the two groups. There was noticeable contracst in time of bedridden between the two groups (p<0.001). Conclusion Early feeding in GI anastomosis seems to be safe, well tolerated, and was not associated with increased postoperative GI complaints including ileus and postoperative complications such as wound dehiscence, infection, leakage, anastomosis, and mortality.
medical journal of mashhad university of medical sciences
1735-4013
54
v.
3
no.
2011
166
171
https://mjms.mums.ac.ir/article_5326_88f13f09bad2f08c1e5b1d396d256bff.pdf
dx.doi.org/10.22038/mjms.2011.5326
The Result of Transrectal Ultrasound Guided 10-14 Cores Biopsies of the Prostate
Reza
Mahdavi
Professor of Urology,
Mashhad University of medical Science Mashhad, Iran
author
Keyvan
Aghamohammadpour
Resident of Urology,Mashhad University of Medical Sciences,Mashhad, Iran
author
Mohammad Hadi
Shakibi
Urologist, Mashhad, Iran
author
text
article
2011
per
Introduction The diagnostic tool in prostate cancer is prostate biopsy but recently classic biopsy has low efficacy. In recent years, trans-rectal ultrasound guided prostate biopsy is a standard method in prostate cancer diagnosis. In the present study, we report our experience about ultrasound guided 10-14 core prostate biopsies at a hospital in Mashhad. Materials and Methods The study included 196 men with PSA values of ≥10 ng/ml or 10 ng/ml ≥PSA level ≥4 ng/ml and Free PSA/ Total PSA ratio was less than 20%. These patients underwent transrectal ultrasound (TRUS)-guided 10-14 core prostate biopsy. Results Of the 196 patients, cancer in 73 patients (37.2%), intraepithelial neoplasia in 14 patients (7.1%) and benign prostatic hyperplasia in 108 patients (55.1%) were diagnosed. Transrectal ultrasound guided 10-14 core prostate biopsy diagnosed prostatic cancer in 25% of 14 patients who had no prostatic cancer with traditional biopsy. There were non significant associations between age and total and free PSA. There was a non significant correlation between the free PSA and Gleason score, but there was a significant correlation between the Gleason score and total PSA. Conclusion This study shows that the TRUS-guided 10-14 core biopsies yield a better prostate cancer detection rate than the classic biopsy.
medical journal of mashhad university of medical sciences
1735-4013
54
v.
3
no.
2011
172
176
https://mjms.mums.ac.ir/article_5327_a43b76f4180f97d25e0ec7994601a740.pdf
dx.doi.org/10.22038/mjms.2011.5327
The Study on Fungal Colonization of Respiratory Tract in Patients Admitted to Intensive Care Units of Sari and Babol hospitals
Sadegh
Khodavaisy
MSc inMedical mycology, Sanndaj University of Medical Science,Sanndaj, Iran
author
Masoud
Alialy
Assistant Professor of Pulmonary, Sari University of Medical Science,Sari, Iran
author
Saeed
Mahdavi Omran
Assistant Professor of Medical mycology,Babol University of Medical sciences,Babol, Iran
author
Mohammad Reza
Habibi
Assistant Professor of Anesthesiologyt, Sari University of Medical Science,Sari, Iran
author
Parviz
Amri
Assistant Professor of Anesthesiology, Babol University of Medical sciences,Babol, Iran
author
Mahmoud
Monadi
Assistant Professor of Pulmonary, Babol University of Medical sciences,Babol, Iran
author
Mohammad Taghi
Hedayati
Professor of Medical mycology, Sari University of Medical Science,Sari, Iran
author
text
article
2011
per
Introduction Fungi are considered as a life threatening in immunocompromised patients and respiratory tract is the main involvement location. Critically ill patients who are admitted to intensive care units (ICU) may also be susceptible to these infections, because of their conditions. Fungal colonization in respiratory tract maybe consider as a probable source for infection. Therefore, in the present study we evaluatedfungal flora of respiratory tract in patients admitted to ICU. Materials and Methods Bronchoalveolar lavage samples were collected by bronchoscope from 45 patients with underlying predisposing conditions for invasive fungal infection twice a week. Samples were homogenated by pancreatin for performance of direct microscopic examination and cultured on Sabouraud’s dextrose agar. The grown fungi on culture media were identified by standard mycological procedures. Results The main underlying predisposing conditions were COPD (22.2%), hematologic malignancy (20.3%) and prolonged stay in the ICU (16.9%). The mean length of ICU stay was 19.6 days. Overall, 80 samples had positive result in direct examination (76.2%) and culture (71.2%), respectively. The most frequent isolated fungi were Candida (64.7%), Aspergillus (19.3%) and Penicillium (7.9%). Among Candida and Aspergillus species, C. albicans and A. flavus were most common. In 48.4% of patients, similar fungal species were isolated in both sampling times. Conclusion The results of our study showed that the ICU patients were susceptible to fungal resistant colonization especially Candida and Aspergillus as two life threatening fungal agents. So we emphasize the control procedures to reduce the fungal infection possibility among ICU patients.
medical journal of mashhad university of medical sciences
1735-4013
54
v.
3
no.
2011
177
184
https://mjms.mums.ac.ir/article_5328_2a00f168634626cee224e756a9f969ed.pdf
dx.doi.org/10.22038/mjms.2011.5328
A Case Report of Nodular Regenerative Hyperplasia of the Liver and Coeliac Disease
Azita
Ganji
Gastroenrologist and Hepatologist,Mashhad University of Medical Sciences, Mashhad, Iran
author
Abbas
Esmaeilzadeh
Assistant ProfessorofGastroenrology and Hepatology,Mashhad University of Medical Sciences, Mashhad, Iran
author
Kamran
Ghafarzadegan
APCP-Pathologist,Mashhad, Iran
author
Ali
Mokhtarifar
Assistant ProfessorofGastroenrology and Hepatology,Mashhad University of Medical Sciences, Mashhad, Iran
author
text
article
2011
per
Introduction Coeliac disease (CD) is an autoimmune enteropathy triggered by gluten. Several hepatic disorders have been described in association with coeliac disease. Nodular regenerative hyperplasia (NRH) of the liver is a rare disorder and is a cause of non-cirrhotic portal hypertension. [ Case report A 22 y/o lady presented with portal hypertension, after all causes of chronic liver disease ruled out we checked for coeliac and it was positive. Liver biopsy was done and was compatible with nodular regenerative hyperplasia (NRH) of the liver. Conclusion As far as we know this is one of the rare cases of nodular regenerative hyperplasia of the liver in a patient with coeliac. Only three cases have been reported until now and seems we should think about coeliac in any patient suffering from chronic liver disease with unknown cause.
medical journal of mashhad university of medical sciences
1735-4013
54
v.
3
no.
2011
185
188
https://mjms.mums.ac.ir/article_5329_a72f8bac27dbb1642c10c685aac1acb8.pdf
dx.doi.org/10.22038/mjms.2011.5329