medical journal of mashhad university of medical sciences
1735-4013
2008-2673
55
4
2012
12
21
Preventable Medication Errors in High Risk Cardiac Patients; A call for Systematic Reconsideration for Social Health
201
205
FA
Mahmoud
Ebrahimi
Associate professor of Cardiology, Mashhad University of Medical Sciences, Mashhad, Iran
ebrahimi_cardiology@yahoo.com
Alireza
Abdollahi
Assistant professor of Cardiology, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/mjms.2012.130
<em>Introduction</em>
Active and informed role of patients in their medications could prevent many following errors and their overall costs. Due to vast amount of prescriptions in cardiac patients and their higher vulnerability, we set up to study their information around medications.
<em>Materials and Methods </em>
This descriptive, Cross- sectional study was performed during March 2004 to Feb. 2005 by direct interview with patients having the history of admission at least once in emergency wards of ghaem or Imamreza hospitals, asking name, dosage, frequency usage of their drugs besides questions to distinguish between cardiac and none cardiac drugs, their source of information and the causes of patients' delay (if there) to get their drugs from Pharmacy.
<em>Results </em>
From 300 studied cases, with mean admission rate of 4.3±2.6 in cardiology departments, 76% of patients did not even know the name of their prescribed drugs and 31 % of them could not basically distinguish between their cardiac and non cardiac drugs, 20.3 % of patients did not know the time, dosage and frequency of drug administration. The patients believed that only 13.3 % of their drug information and education are from pharmacies. 19.3% of patients had delay to get their prescribed drugs.
<em>Conclusion</em>
Our patients' level of awareness about their medication is very low. This weakness could easily lead to medication errors, and its related morbidity and mortality. Prevention seeks for immediate systematic solution.
Cardiac patients,Medication error,Social health
https://mjms.mums.ac.ir/article_130.html
https://mjms.mums.ac.ir/article_130_84172bc081a31fe17dc530c5c3a8510b.pdf
medical journal of mashhad university of medical sciences
1735-4013
2008-2673
55
4
2012
12
21
Effects of Routine and Intermittent Protocols, on Rising TSH level and Clinical
Manifestations of Hypothyroidism in Patients with Differentiated Thyroid
Carcinoma, Preparing for I-131 Whole Body Scan
206
210
FA
Zohreh
Mousavi
- Associated Professor of Endocrinology, Mashhad University of Medical Sciences, Mashhad, Iran
Seyed Rasoul
Zakavi
- Associated Professor of Nuclear Medicine Research Center, Faculty of Medicine, Mashhad University of Medical
Haleh
Rokni
- Assistant Professor of Endocrinology, Mashhad University of Medical Sciences, Mashhad, Iran
Parvin
Layegh
- Assistant Professor of Endocrinology, Mashhad University of Medical Sciences, Mashhad, Iran
layeghpa@mums.ac.ir
10.22038/mjms.2012.141
<em>Introduction</em>
It is favorable to obtain an optimal level of TSH with a minimum of clinical manifestations of hypothyroidism in patients with differentiated thyroid carcinoma, preparing for whole body scan.
<em>Materials and Methods</em>
In this randomized clinical trial that was performed in Ghaem Hospital during a 2 years period, we compared routine and intermittent protocols .In routine protocol, 4-6 weeks after surgery, levothyroxin discontinued and liothyronin prescribed for two weeks, then liothyronin discontinued for 2 weeks and TSH measured. In intermittent protocol, levothyroxin prescribed every other day and after 30 days discontinued and TSH was measured.
<em>Results</em>
Fifty patients were female and 10 cases were male. Fifty-three patients had papillary and 7 cases had follicular carcinoma. Twenty-two patients performed intermittent and 38 patients were on routine protocols. There was no significant difference between two groups in pulse rate, skin dryness, constipation, paresthesia, puffiness and change in weight. There was no significant difference in TSH level between two groups at the end of two protocols. (p=0.08). We used chi-square, independent and paired t tests for analysis of data and p-value less than 0.05 was considered as significant.
<em>Conclusion</em>
In this study there was no significant difference in hypothyroid manifestations in intermittent and routine protocols. But exposure to high levels of TSH and its outcomes are less in intermittent protocol.
Differentiated,Hypothyroidism,Scan,thyroid carcinoma
https://mjms.mums.ac.ir/article_141.html
https://mjms.mums.ac.ir/article_141_ebde656532913fd4557297628af89965.pdf
medical journal of mashhad university of medical sciences
1735-4013
2008-2673
55
4
2012
12
21
Effect of Phototherapy on Platelet, Reticulocyte and White Blood Cells in Full Term Neonates with Hyperbilirubinemia
211
217
FA
Mousa
Ahmadpour-kacho
Associate professor of Pediatrics, Babol University of Medical Sciences, Babol, Iran
Yadollah
Zahedpasha
Associate professor of Pediatrics, Babol University of Medical Sciences, Babol, Iran
Mehdi
Taghavi
Resident of Pediatrics, Babol University of Medical Sciences, Babol, Iran
Ali
Bijani
Vital statistics, Babol University of Medical Sciences, Babol, Iran
10.22038/mjms.2012.146
<em>Introduction</em>
Some adverse effects has been attributed to phototherapy in the treatment of neonatal indirect hyperbilirubinemia, but less known about its effect on Platelet, Reticulocyte and White Blood Cells (WBC) counts. This study was done to assess the effect of phototherapy on Platelet, Reticulocyte and White Blood Cells in neonatal hyperbilirubinemia.
<em>Materials and Methods</em>
In a cohort study at Amirkola Children Hospital (ACH) in Babol, the north of Iran, 50 full term healthy babies with a total serum bilirubin ≥ 15 mg/dl who were admitted for phototherapy considered as case and another group of the same neonates with a total serum bilirubin 10- 15 mg/dl who were visited but not admitted for phototherapy considered as control group. In both groups a blood samples were taken for Platelet, Reticulocyte, WBC and other routine tests needed to assess hyperbilirubinemic neonate, at the time of enrolment and after 48 hours. Matching was done for sex, birth weight and postnatal age. The differences in the Platelet, Reticulocyte and WBC counts analyzed by SPSS-18 and a P-value less than the 0.05 considered being significant.
<em>Results</em>
The mean±SD of Platelet, Reticulocyte and WBC did not differ at the time of enrollment but after 48 hours the Platelet was increased in the phototherapy group significantly (P-value=0.040.The difference in the change in neutrophil (p value=0.112, lymphocyte (p value=0.178) and Reticulocyte count (P-value=0.705) were not significant between two groups<em>.</em>
<em>Conclusion</em>
Phototherapy increases the platelet count but has no a significant effect on the WBC and reticulocyte counts.
<em> </em>
Hyperbilirubinemia,neonate,Phototherapy,Platelet count
https://mjms.mums.ac.ir/article_146.html
https://mjms.mums.ac.ir/article_146_c140e4e83f2f86af43b261b460e0e61d.pdf
medical journal of mashhad university of medical sciences
1735-4013
2008-2673
55
4
2012
12
21
Relational Study of Clinical Findings and Renal Pathology in Systemic Lupus Erythematosus Patients
218
224
FA
Nayyereh
Saadati
Associate Professor of Rheumatology, Mashhad University of Medical Sciences, Mashhad, Iran
saadatin@mums.ac.ir
Maryam
Hami
Assistant Professor of Nephrology, Mashhad University of Medical Sciences, Mashhad, Iran
Ataollah
Behroz Aghdam
- Professor of Nephrology, Mashhad University of Medical Sciences, Mashhad, Iran
Baharam
Naghibzadeh
General Practitioner, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/mjms.2012.157
<em>Introduction</em>
Renal biopsy plays a very important role in diagnosis, and treatment of patients with systemic lupus erythematosus (SLE). The purpose of our study was to assess the role of renal biopsy in determining the prognosis of SLE.
<em>Materials and Methods</em>
In this prospective review, which was pereformed in the Department of Internal Medicine of Gheam Medical Center, we studied 34 SLE patients for 5 years. After acquiring medical history and a routine general physical examination, clinical and serological characteristics of all patients were consecutively collected in questionnaires.
<em>Results</em>
Of 34 patients, 32 were female and 2 were male. The median age of patients was 25.12±12.05 years. All of them had lupus nephritis. The most common type of renal pathology was class IV lupus nephritis. Patients with class IV lupus nephritis had the worst prognosis.
<em>Conclusion</em>
Age, sex and renal pathology prevalence in the present study is similar to other studies. Lupus nephritis remains a strong predictor for development of end-stage renal disease (ESRD) and death in patients with SLE.
Lupus nephritis,Renal,systemic lupus erythematosus
https://mjms.mums.ac.ir/article_157.html
https://mjms.mums.ac.ir/article_157_67ecec19e89d5a5b73012556d62b8be1.pdf
medical journal of mashhad university of medical sciences
1735-4013
2008-2673
55
4
2012
12
21
The Evaluation of Shoulder Distention Technique in the Treatment of Frozen Shoulder
225
230
FA
Seyed Reza
Saeidian
Assistant Professor of Physical Medicine and Rehabilitation, Jundishapur University of Medical. Sciences, Ahvaz, Iran
seyedrezasaeidian@yahoo.com
Seyed Abdolhosein
Mehdi Nasab
Associate Professor of Orthopedic, Jundishapur University of Medical. Sciences, Ahvaz, Iran
Morteza
Tahmasebi
Assistant Professor of Radiology, Jundishapur University of Medical. Sciences, Ahvaz, Iran
Seyed Mahmoud
Latifi
MSc in Epidemiology and Statistics, Jundishapur University of Medical. Sciences, Ahvaz, Iran
10.22038/mjms.2012.158
<em>Introduction</em>
Painful-stiff-shoulder is a common complain among patients who referred to the musculoskeletal clinics. This study aimed to compare the impact of shoulder distension with the routine conservative treatments of frozen shoulder<em>.</em>
<em>Materials and Methods</em>
This clinical trial performed on 70 patients suffering from frozen shoulder who referred to the musculoskeletal clinic of Imam Khomeini hospital during 2005-2010. The patients were divided in to two sex and age matched groups consisting of 35 persons. One group received physio therapy along with Diclofenac Sodium 100 mg daily for two weeks. For the second group shoulder distension was performed in addition to the treatment of the first group. The amount of improvement in shoulder ranges of motions and pain reported by the patients were calculated in the both groups. The results of the two groups were compared using independent T. test.
<em>Results</em>
There were higher improvements in shoulder range of motion in the second group at p=0.001. The mean pain reduction in the first group was 2.6 ± 0.4 and for the second group was 5.5 ± 0.4 degrees. It was significant atp=0.001.
<em>Conclusion</em>
This study revealed that shoulder distension can improve the treatment of frozen shoulder significantly.
<em> </em>
Frozen shoulder,Pain- Range of motion,Shoulder distension
https://mjms.mums.ac.ir/article_158.html
https://mjms.mums.ac.ir/article_158_3f56cf79e928ee0ca8f902cabfe59bee.pdf
medical journal of mashhad university of medical sciences
1735-4013
2008-2673
55
4
2012
12
21
Comparison of Effect and Complication of Unilateral Spinal Anesthesia versus Standard Spinal Anesthesia in Orthopedic Surgery of Lower Limb
231
236
FA
Seyyed-Mostafa
Moosavi Tekye
Associate professor of Anesthesiology, Mashhad Universitiy of Medical Sciences, Mashhad, Iran
moosavim@mums.ac.ir
Mohamad
Alipour
Assistant professor of Anesthesiology, Mashhad Universitiy of Medical Sciences, Mashhad, Iran
alipourm@mums.ac.ir
Ehsanolah
Ghorbanian
Resident of Anesthesiology, Mashhad Universitiy of Medical Sciences, Mashhad, Iran
ghorbaniane891@mums.ac.ir
10.22038/mjms.2012.159
<em>Introduction</em>
Restricted sympathetic block during spinal anesthesia may minimize hemodynamic change. This prospective randomized study compared unilateral and bilateral spinal anesthesia with respect to intra and postoperative advantage and complication of each technique.
<em>Materials and Methods</em>
Spinal anesthesia with 0.5% hyperbaric bupivacaine and 25G Quincke needle was induced in two group of patients with physical status ASA I-II admitted to orthopedic surgeries. In group A dural puncture was performed with the patient in sitting position with 2.5cc hyperbaric bupivacaine and then in supine positon. In group B dural puncture was performed with the patient in lateral decubitus position with 1.5cc hyperbaric bupivacaine with the line operated down ward .The speed of injection was at 1ml/30s. duration of lateral decubitus positon was twenty minutes.
<em>Results</em>
Demographical data were similar. The onset time of sensory and motor block was significantly shorter in group A (p=0.00). Duration of motor and sensory block was shorter in group B (p< 5%). The success rate of unilateral spinal anesthesia in group B was 94.45%. Two patient's spinal block Spread to the nondependent side. The incidence of complication (Nusea, headache, hypotension) was lower in group B. (p=0.02).
<em>Conclusion</em>
Unilateral spinal anesthesia with low dose, low volume and low flow injection technique provides adequate sensory and motor block and stable hemodynamic parameters in orthopedic surgery of lower limb. Patients Satisfacation also was better and avoids unnecessary paralysis on the non operated side
Bupivacaine,Lower limb,Spinal anesthesia
https://mjms.mums.ac.ir/article_159.html
https://mjms.mums.ac.ir/article_159_47d76829a9d4d1a477c23a3b5256e1d4.pdf
medical journal of mashhad university of medical sciences
1735-4013
2008-2673
55
4
2012
12
21
The Incidence of Deep Wound Infection after Spinal Instrumentation
237
241
FA
Saeid
Karamouzian
Assistant professor of Neurosurgery,
Kerman university of Medical Sciences, Kerman, Iran
karamouzian@gmail.com
Ehsan
Keykhosravi
Resident Neurosurgery,
Kerman university of Medical Sciences, Kerman, Iran
ehsank2500@yahoo.com
Farhad
Sarraf
Assistant professor of Infectious disease, Kerman university of Medical Sciences, Kerman, Iran
Mehrdad
Noroozi
Assistant professor of Anesthesiology, Kerman university of Medical Sciences, Kerman, Iran
Hamid
Jangi Aghdam
Resident Neurosurgery,
Kerman university of Medical Sciences, Kerman, Iran
10.22038/mjms.2012.163
<em>Introduction</em>:
Infection is one of the most known complications in each surgery. Concerning the effects of this complication on the results of spinal column instrumentation we decided to assess the frequency of deep wound infection and it's related factors at Bahonar Hospital in city of Kerman.
<em>Materials and Methods</em>
In our study all 181 patients who had gone under spinal column instrumentation due to any causes except the infection were evaluated.
<em>Results</em>
The average of the patients' age was 34.8±13.5 years. And 74% of them were male. Diabetes mellitus was seen in 7.2 % of the patients. Deep wound infection was seen in 8.8 (4.4%) patients, and among them 6 persons had diabetes melittus.
<em>Conclusion</em>
Diabetes mellitus was the only factor that significantly influenced the infection. (P value: 0.007). It seems that we need great attention to avoid wound infection.
Infection,Instrumentation,Spinal column
https://mjms.mums.ac.ir/article_163.html
https://mjms.mums.ac.ir/article_163_8f01533168a0017a654ba628206a23fc.pdf
medical journal of mashhad university of medical sciences
1735-4013
2008-2673
55
4
2012
12
21
Prevalence of Renal Artery Stenosis and Its Risk Factors in Non Diabetic Patients with Coronary Artery Disease
242
249
FA
Alireza
Abdollahi moghadam
0000-0002-7072-8190
Assistant professor of Cardiology, Mashhad University of Medical Sciences, Mashhad, Iran
abdollahiar@mums.ac.ir
Hoda
Raffiei Jelodar
Medical Student, Mashhad University of Medical Sciences, Mashhad, Iran
Arash
Kahrom
General Practitioner, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/mjms.2012.190
<em>Introduction</em>
<em> </em>
Ischemic nephropathy can cause end stage renal disease in uremic patients. Renal artery stenosis caused by atherosclerosis is a progressive disease which maybe presented by kidney dysfunction, renal failure and acute pulmonary edema. In this study we wanted to findout the prevalence of renal artery stenosis in non diabetic patients with CAD and its relation with cardiovascular risk factors for finding the necessity of concurrency of renal and coronary angiography.
<em>Materials and Methods</em>
In this descriptive study in 2009-2010 in Imam Reza Hospital , 204 non diabetic patients who had coronary stenosis with inclusion criteria :1- stenosis of more than one vessel or its equivalent(more than 50 percent ) 2-undertreatment hypertension and increased intra-arterial pressure more than 140/90mmhg3- serum creatinin over 1.5 mg/dl underwent nonselective renal angiography during coronary angiography, data analyzed with SPSS software and K2 test, independent sample t test and logistic regression with p value less than 0.05.
<em>Results</em>
Among multiple variables that had meaningful relation with RAS only increased diastolic intra -arterial pressure, number of involved coronary artery and undertreatment hypertension could predict renal artery stenosis.
<em>Conclusion</em>
In these 3 groups of patients such as: patients with more than one vessel stenosis (more than 50%), increased diastolic intra-arterial pressure and undertreatment hypertension, Concurrency of non selective renal artery angiography without non invasive test for assessment of renal artery stenosis during coronary artery angiography is recommended.
Coronary artery angiography,Renal artery angiography,Renal artery stenosis
https://mjms.mums.ac.ir/article_190.html
https://mjms.mums.ac.ir/article_190_206c1e5f7a89ec9f87f0d414400f74f2.pdf
medical journal of mashhad university of medical sciences
1735-4013
2008-2673
55
4
2012
12
21
A Case Report of Nodular Regenerative Hyperplasia
250
254
FA
Ahmad
Khosravi
Associate professor of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Tahereh
Fakharian
- Fellow of Gastroenterology, Mashhad University of Medical Sciences, Mashhad, Iran
fakhariant891@mums.ac.ir
Kamran
Ghafarzadegan
Clinical pathologist, Mashhad University of Medical Sciences, Mashhad, Iran
Masoud
Pezeshky Rad
- Associate professor of Interventional Radiology, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/mjms.2012.192
<em>Introduction</em> <br />Nodular regenerative hyperplasia is a rare cause of portal hypertension. Clinical findings are consist of complication of portal hypertension such as variceal bleeding. Histopathology is key of diagnosis. <br /><em>Case report</em> <br />Patient was a 44 years old woman with a chief complaint of flank pain and easy bruising. She had a history of hematemesis many years ago. In physical examination, she had huge splenomegaly and ecchymoses on lower extrimities. Lab data are normal except for pancytopenia. In upper endoscopy, esophageal varices and portal hypertensive gastropathy were seen. Subsequently, she was found to have nodular regenerative hyperplasia on liver biopsy. Esophageal varices banded successfully and she was asymptomatic on Beta blocker after wards. <br /><em>Conclusion</em> <br /> Nodular regenerative hyperplasia should be considered in the differential diagnosis of any patient with portal hypertension without cirrhosis.
Liver,Nodular regenerative hyperplasia,Portal Hypertension
https://mjms.mums.ac.ir/article_192.html
https://mjms.mums.ac.ir/article_192_83f9be87de7afe1154e64a6c575eff30.pdf