1 1728-6506 Yasuj University Of Medical Sciences 683 Special The Effect of Low Flow Inhalation Anesthesia on Operative Hemodynamic Condition in Comparison with High Flow Anesthesia Eidi M Hoseinzade H Kolahdozan KH Aghamohammadi D 1 7 2007 12 2 1 9 02 06 2015 02 06 2015 Introduction & Objective: Low flow anesthesia technique in which the flow fresh gas is lower than minute volume of the patient results in improvement in the patient’s care such as reduction of operative hypothermia, reduction of postoperative shivering and leads to an increase in economical and enviornmental interests. The goal of the study was to investigate the patients’ operative hemodynamic variations using the high and low flow anesthesia techniques. Materials & Methods: This prospective, clincal and single blind study was carried out in Tbriz Emam Khomeini Hospital in 1384. In this study 97 patients in ASA class I or II after routine induction of G.A, during maintenance of anesthesia were randomly divided in two groups group I (high flow anesthesia) and group II (low flow anesthesia). For all patients ECG, HR, SPO2, BP, B.T, ETCO2 and inspiratory, expiratory percentage of O2, N2O, halothane, postoprative shievring and duration of oprations were recorded. 46 patients underwent high flow anesthesia and 51 patients underwent low flow anesthesia. Results: The average blood pressure in group I was as follow: preoperative, systol=13820 mmHg and diastol=7815 mmHg, intraoperative, systol=10531 mmHg and diastol=6410 mmHg and in recovery systol=11615 mmHg and diastol=7013 mmHg. In group II who had low flow anesthesia the blood pressure was found to be systol=13922 mmHg and diastol=7922 mmHg preoperative, systol=12221 mmHg and diastol=7517 mmHg intraoperative and systol=11815 mmHg and diastol=7717 mmHg in recovery. The differences in blood pressure in both group were statiscally significant (p=0.01). The average heart rate in group I was 9018 beat/min preoperative, 7014 intraoperative and 126 in recovery. The avrage heart rate in group II was 87.921 preoperative, 8616 intraoperative and 10417 in recovery. The differences were statiscally significant but there was no significant difference between the two groups with regard to sex, age and weight. Conclusion: Maintenance of anesthesia with low flow anesthesia gasses maintains more hemodynamic condition during operation.
684 Special Response to Hepatitis B Vaccine in HIV-Infected Patients Afrasiabian SH Hajibageri K Esmaeil Nasab V Esmaeil Nasab N Sayfi SH 1 7 2007 12 2 11 18 02 06 2015 02 06 2015 Introduction & Objective: The risk of developing chronic hepatitis B virus (HBV) is 5% in general population but can reach up to 20% in HIV patients. The response rate to HBV vaccine in HIV infected patients is 23.8-56 percent. The aim of this study was to evaluate response of HIV-infected patients to 20 µg dose of recombinant HBV vaccine. Materials & Methods: In this quasi experimental study, 51 subjects, sampled through census, were HIV patients who had HBsAg negative test in HIV/AIDS counseling and care center. Patients were vaccinated with 20 µg of recombinant HBV vaccine, IM at intervals of 0, 1 and 6 months. Response to the vaccine was checked 2 months after the last injection. Data were analyzed with SPSS software, using descriptive statistics and nonparametric tests. Results: The mean age of the patients was 33.68±8.37 years. Two patients were female (3.9%) and 49 patients were male (96.1%). Mean of hepatitis B antibody level was 47.55±71.58 mIU/ml. The levels of antibody in different patients were as follow: 31 patients (60.8%) 10 mIU/ml. There was no significant correlation between antibody levels and CD4+ cell count (correlation coefficient = -0.191). Conclusion: Response to hepatitis B vaccination is low in HIV infected patients. Conventional dose of HBV vaccine is not enough to get protective immunity. Therefore, two-fold dose of vaccine dose, repeat of conventional dose or increasing of interval administration of hepatitis B vaccine should be considered in future studies. 685 Special Comparison of the Efficacy and Duration of Three Different Methods of Digital Block Dehghani M Mahmoodian A 1 7 2007 12 2 19 26 02 06 2015 02 06 2015 Introduction & Objective: Finger injuries are very common and majority of them can be treated under digital block anesthesia. Traditional digital block is one of the most commonly performed blocks performed by care providers in several medical fields. There are two other less known methods, transthecal (pulley) block, in which local anesthesia is injected into the flexor tendon sheat that needs less volume of anesthesia and hasnot neurovascular complications and subcutaneous block in which local anesthesia is injected subcutaneously at the level of A1 pulley. This study aimed to compare the results of the three methods of digital block. Materials & Methods: A prospective randomized clinical trial was performed at Kashani hospital to compare the less known transthecal (pulley) and subcutaneous methods with traditional digital block with regard to the length of anesthesia and need to another anesthetic method (due to insufficient anesthesia) as a supplement. We divided 150 patients that were admitted to kashani hospital operating room due to finger injury, randomly, into three groups. In each group the patients were anesthetized by one of the three different methods. All blocks were performed by the same investigator. Data were analyzed by SPSS software using T test. Results: Mean length of anesthesia was 34.2 min’s in the transthecal digital block method and 34 min’s in the subcutaneous method and 33.8 min’s in the traditional digital block method. A repeat injection or local infiltration as a supplement was necessary in 5 instances (7 blocks) in the traditional digital block method and 9 instances (11blocks) in the subcutaneous method (p<0.05). Conclusion: Regarding fewer injections and less amount of lidocaine and no risk of damaging the neurovascular bundles and comparable length of anesthesia and no need to supplemental anesthesia, transthecal digital block is an appropriate alternative to traditional digital block and subcutaneous injection. 686 Special Effects of Ginger (Zingiberaceae) on Diabetes Mellitus Induced Changes in the Small Intestine of Rat Karimipour M Shirpour AR Roozbehi A 1 7 2007 12 2 27 35 02 06 2015 02 06 2015 Introduction & Objective: Diabetes mellitus is the most common endocrine disorder and causes gastrointestinal complications .The aim of this study was to investigate the effects of ginger on the small intestine of diabetic rats. Materials & Methods: This experimental study was done in the anatomy department of Uremia Medical University in 1385. 24 adult male rats, weighing 250±20 gr were randomly selected and divided into 3 following groups: control, diabetic (induced by 60mg/kg STZ) and treatment groups. The treatment group was given ginger powder (5% of their consumed food weight during day/night period). After 8 weeks, all rats were anaesthetized and their small intestines were removed and measured for their weight and length. For histological assessment, samples from each part of duodenum, jejunum and ileum was fixed in 10% formalin and slides with hematoxilin & eosin staining were prepared. Villi length, crypt depth and muscular layer thickness were assessed by graticule eye piece of light microscope. Statistical analysis, one- way analysis of variance and Tukey’s SPSS software was used for data analysis. Results: The results showed that mean of intestinal length and weight, villi length and muscular layer thickness in all three parts and crypts depth in duodenum and jejunum in diabetic group increased significantly in comparison with control and treatment groups, but there was no significant difference between control and treatment groups. Conclusion: The results of this study demonstrate that ginger as an antioxidant, through decreasing oxidative stress, can prevent pathologic alterations induced by diabetes in small intestine. 687 Special Comparison of Protein Digestibility of a Commercial Food Sample with a Sample of Home Made Food in Rats Taghizade M Asemi Z 1 7 2007 12 2 37 45 02 06 2015 02 06 2015 Introduction & Objective: Evaluation of the quality of food proteins have a great importance because of biological and economical impacts. Different biological, microbiological, chemical and combined methods have been used and introduced for determining quality of proteins. Considering the importance of protein quality in foods especially in downscale families, this study was conducted to compare protein digestibility of a commercial food sample (Homana based on rice) with a sample of home made food (based on mixed rice -bean) in rats. Materialas & Methods: This experimental study was conducted on 32 male Wistar rats, aged 21 days under 4 diets in 8 groups including: 2 cases diet (Homana and mixed rice -bean), 1 standard diet (casein plus methionine) and 1 basal diet (protein free) with a weight mean of 65.4 gr/groups. The study was conducted in biochemistry department of Kashan University of Medical Sciences in 2007. The duration of follow up for true protein digestibility and apparent digestibility was 9 days.True protein digestibility and apparent digestibility were analyzed by ANOVA and Tukey methods through SPSS software. Results: True protein digestibility was 92.8±4, 87±8 and 79.7±1.6 while apparent digestibility was 89.8±4.3, 80.6±4.2 and 76.8±1.6 for casein plus methionine, commercial food and home made food groups, respectively. The differences between three groups were significant (p<0.0001). Conclusion: The findings showed that protein digestibility of home made food based on rice and bean mixture is nearly almost equal to the industrial food of Homana. 688 Special Effects of a School-Based Intervention on the Basis of Pender’s Health Promotion Model to Improve Physical Activity among High School Girls Teymouri P Niknami SH Ghofranipour F 1 7 2007 12 2 47 59 02 06 2015 02 06 2015 Introduction & Objective: Participation in regular physical activity is associated with a variety of positive outcomes for young people. Physical activity (PA) rates decline precipitously during the high school years and are consistently lower among adolescent girls than among adolescent boys. In order to stop or diverse this negative trend, there are necessary interventions based on various theories and models to promote physical activity in girls. Materials & Methods: This randomized control study evaluated the effectiveness of a 24-week exercise education program based on Pender’s Health Promotion model to improve cognitive and psychosocial factors associated with physical activity and to promote physical activity in adolescent girls (n =106). The program included educational sessions and tailored counseling. Results: There was an increase of 45 minutes for daily physical activity in the experimental group compared to their baseline. After intervention, the training group had a positive significant progression in stages along with significant improvements in self efficacy, enjoyment of physical activity, interpersonal influences, planning for physical activity, and also a decrease in perceived barriers to physical activity and competing preferences (p ≤ .0001-0.04). Conclusion: Findings of this study showed the positive effect of program on stage of change and potential determinants of the behavior of physical activity. The high proportion of the people in action and maintenance in experimental group compared to the baseline and the attainment of recommend criteria for physical activity are promising findings of school-based intervention based on Pender’s health promotion model. 689 Special Prevalence of Allergy to Natural Rubber Latex and Potential Cross Reacting Food in Operation Room Staff in Shiraz Hospitals -2006 Nabavizade H Amin R 1 7 2007 12 2 61 68 02 06 2015 02 06 2015 Introduction & Objective: Allergic reactions to natural rubber latex have increased during past 10 years especially among health care workers and patients with high exposure to latex allergens. Allergic reaction to latex is related to many diseases like occupational asthma. This study was performed to determine the prevalence of allergy to natural rubber latex and potential cross reacting food in operation room staff in Shiraz hospitals. Materials & Methods: In this cross-sectional descriptive study five hundred eighty operation room staff of ten private and state hospitals in Shiraz completed latex allergy questionnaire. They were questioned about personal history and previous history of latex sensitivity, symptoms of latex reactivity and about other allergies particularly to foods that may cross react with latex. Informed consent was obtained and skin prick testing was performed with natural rubber latex. Skin prick tests were done with three potentially cross reacting food (banana, Kiwi, and potato). The obtained data were analyzed with SPSS software and Chi-square test. Results: Among the 580 operation room workers 104 (17.9 %) of participants were positive to latex skin test. We found a significant association between positive skin test to latex in operation room staff and atopy, urticaria and food allergy. Positive skin test to latex related to positive kiwi skin test (p<0.05). The prevalence did not vary by sex, age, education, surgical and non surgical glove users, history of contact dermatitis or smoking status. Conclusion: Latex allergy has a high prevalence in personnel of operation room. Evaluation of present symptom and prediction of future disease necessitate screening test in individuals at risk. 690 Special Serological Study of Visceral Leishmaniasis in Boyer Ahmad Township in 2005 Sarkari B Moshfe AA Pedram N Zargar MA Yazdanpanah B Akhondi B Hasani Z Mohebali M 1 7 2007 12 2 69 77 02 06 2015 02 06 2015 Introduction & Objective: Visceral leishmaniasis (Kala-azar) is a disease caused by intracellular protozoa parasites of the genus Leishmania. Kala–azar in Iran is usually seen in children below 10 years old. Kala-azar is endemic in some areas of Iran including Ardebil, Fars, and East Azerbaijan. The present study was designed to assess the situation of Kala–azar in children of ten and below ten years in Boyer Ahmad township in Kohgiloyeh and Boyer Ahmad province in 1384. Materials & Methods: Blood samples were collected from all the children of 10 and less than 10 years old. In this survey 1628 blood samples were collected from finger tip of children on filter paper. Collected samples were evaluated by direct agglutination test (DAT). Collected data were analyzed by SPSS software. Results: Result of this study showed that from 1628 samples collected, 50 cases (3.07 percent) were become positive with DAT test. Infection in females was less than male. No significant correlation was found between antibody titer and sex. The highest prevalence rate of the infection was seen in age 10 (14.82%). Leishmania Infection was not found in any of the studied reservoirs (dogs). Conclusion: Results of this study indicate that Kala–azar is an endemic disease in the studied region. Considering the obtained data, more study is needed to find out the prevalence of the disease in other regions of the province and also to find out more about the possible animal reservoir of the diseases in the region. 691 Special Reliability and Validity of the QLQ-C30 Questionnaire in Cancer Patients Safaee A Dehkordi Moghimi B Tabatabaie SHR 1 7 2007 12 2 79 88 02 06 2015 02 06 2015 Introduction & Objective: Recently, it has been recognized that a more comprehensive assessment of the cancer patient is necessary and that the evaluation of outcomes must move beyond traditional biomedical endpoints to include assessments of the impact of disease and its treatment on patients' quality of life. European Organization for Research and Treatment of Cancer has developed a 30-item quality of life questionnaire to obtain information about the impact of disease and treatment on the daily living of cancer patients. This questionnaire was translated into many languages and used in various countries. But, validity and reliability of version 3.0 has not yet been checked for use with Iranian patients. The aims of the present study are to evaluate the reliability and validity of the QLQ-C30 (version 3.0) questionnaire. Materials & Methods: We conducted an analytical cross-sectional study on 132 random samples of breast cancer patients for determination of validity and reliability of QLQ-C30 (version 3.0) questionnaire. The questionnaire was completed for all patients that referred to chemotherapy ward in Namazi Hospital, Shiraz, during 19 Dec 2005 -19 Feb 2006. Reliability was evaluated through the internal consistency of multi-item subscales. Pearson’s correlations of an item with its own scale (corrected for overlap) and other scales were calculated to evaluate convergent and discriminate validity. Clinical validity was evaluated by known-group comparisons using ANOVA and Kruskal Wallis tests. Data were then analyzed with SPSS software. Results: In the reliability analysis, most scales fitted the criteria (Alpha>0.70) except the fatigue, pain, nausea and vomiting scales. Convergent validity was evidenced by item own subscale correlation above 0.40 for all multi-item subscales. Item discriminate validity was successful in all analyses except for item 4 of the physical functioning scale. Results of the known group based analysis show significant differences in QLQ-C30 functioning and symptom scores, where patients with higher grade have the worst (p<0.05). Conclusion: Iranian version of EORTC QLQC30 is a reliable and valid QOL measure for cancer patients which indicate that it can be used in clinical and epidemiological cancer studies. 692 Special Particulate Air Pollution Concentration in the City of Gachsaran, 2005-2006 Jamshidi A Karimzadeh Shirazi K Raygan Shirazi AR 1 7 2007 12 2 89 97 02 06 2015 02 06 2015 Introduction & Objective: Air pollution is a major environmental problem in urban areas. PM10 (Particulate Matters with a diameter less than 10 micrometer) is one of the most important pollutants in air, and an increase of 10 μgr/m3 in concentration may cause an increase of 1-3 percent in the mortality rate. The aim of this study was to determine the concentration of the PM10 air pollution in the city of Gachsaran. Materials & Methods: This is an analytic-longitudinal study. 6936 air samples were collected during 334 days from April 2005 to March 2006 using a SM200 dust monitor sampler machine. The data were analyzed conducting oneway ANOVA, Tukey and t-student tests and then compared with the WHO standard rates. Results: The results revealed a direct linear correlation between air temperature and concentration of PM10 (p<0.001). There was a significant difference between the mean value of PM10 concentration (μgr/m3) in the seasons of summer (226.3), spring (167.8), autumn (111.6), and winter (85.7). In addition, the mean concentrations of PM10 in warmer months exceeded to the maximum permissible concentration. Conclusion: It can be concluded that some important variables such as air dryness, low rate of humidity and rainfall, high temperature along with the huge local oil industries are the potential factors of air pollution in Gachsaran. 693 Special A Study on Mental Health Status and Personality Traits of Pet Owners Choobineh H Rostami R Mohamadi A Bahonar AR Shirani D Safdari R Ghalyanchi A Nosratabadi M 1 7 2007 12 2 99 107 02 06 2015 02 06 2015 Introduction & Objective: Many Iranian families manage to keep pets at home. Examining psychological consequences and personality traits of pet owners is important. The aim of this study was to examine mental health status and personality traits of pet owners. Materials & Methods: In this descriptive study, 612 pet owners (143 cat owners, 162 dog owners, 155 bird owners and 152 other pet owners) were asked to complete General Health Questionnaire (GHQ) and IPIP Personality Scale from January to December 2006. Results: Bird owners had the highest (234 cases (38.3%)) and other pet owners had the lowest (129 cases (42.3%)) mental health problems. In general, 188 cases (30.7%) of all groups had mental health problems. 122 cases (20%) of them had somatic compliance, 182 cases (29.7%) had anxiety, 149 cases (24.3%) had social dysfunction and 84 cases (13.7%) had depression. Bird owners had significant high level of social dysfunction than other pet owners. With respect to personality traits, dog owners had low level of agreeableness and openness to experience than other groups. Other pet owners had high level of emotional stability than other groups. Conclusion: Contrary to other countries, it seems that having a pet in home enhances the probability of mental disorders in Iran. It is possible that lower mental health persons were keeping pets in Iran. In personality perspectives, dog owners are more disagreeable people and other pet owners are more emotionally stable ones. 694 Special Rostami Nejad A Khosravi A Ashrafi S 1 7 2007 12 2 109 117 02 06 2015 02 06 2015 696 Special A Case of Re-Expansion Pulmonary Edema after Rapid Pleural Evacuation Shahbazi SH Savaei M 1 7 2007 12 2 119 125 02 06 2015 02 06 2015 Introduction & Objective: Pulmonary edema after chest tube insertion is a rare complication and is associated with high mortality. The cause of this phenomenon is not clear, although causes such as decrease in surfactant and inflammatory process have been defined. Early diagnosis and treatment decrease the mortality. This study introduces a case of re-expansion pulmonary edema after rapid pleural evacuation. Case: The case is a 4.5 y/o boy, a case of Tetralogy of Fallot, who developed respiratory distress after surgery (Total Correction) in ICU of Namazi Hospital in 1385. Chest X ray showed pneumothorax of left lung. For the patient, chest tube was inserted and the symptoms improved. After few hours the patient developed tachypnea, tachycardia, and CXR showed pulmonary edema of left lung. Appropriate treatment was done for the patient and his condition improved. Conclusion: Pulmonary edema after sudden evacuation of pleura is a rare phenomenon and early diagnosis decreases the mortality.