Payavard Salamat

The Effect of Dexamethasone on Side Effects after Coronary Revascularization Procedures

Z Hosainkhan

Introduction: Corticosteroids decrease side effects after noncardiac elective surgery. The aim of this study was to determine the prophylactic effects of IV dexamethasone (6mg×2) in preventing side effects after cardiac surgery.

Methods and Materials: In a randomized, double blinded, placebo-controlled study 184 ASA physical status I or Il patients ranging 40-82 undergoing coronary revascularization surgery were enrolled in Imam Khomeini Hospital, medial sciences university of Tehran.
Dexamethasone (6mg/mL) or saline (1mL) was administered after the just before surgery and a second dose of the same study drug was given on the morning after surgery. The patients were assessed at 24 and 48h intervals after surgery as well as at the time of hospital discharge, to determine the incidence and severity of postoperative side effects.

Results: Dexamethasone significantly reduced the incidences of nausea (P=0.034) and vomiting on the first postoperative day (P=0.005). In addition, dexamethasone significantly improves appetite on the first postoperative day (P=0.005). The corticosteroid decreased the incidences of atrial fibrillation AF (P=0.018) in the postoperative period. However, the corticosteroid failed to decrease the incidences postoperative pain.

Conclusion: dexamethasone (12 mg in divided doses) is suggested in reducing nausea and vomiting, decreases of atrial fibrillation and improving appetite after cardiac surgery.

The effect of repeated transfusions on active cytomegalovirus infection, in the presence of IgM, in patients with thalassemia major in Iran

H Choobineh

Background: With due attention to the prevalence of thalassemia in Iran and patients' importunate needs for blood intake, this study aimed to inspect contaminations due to repeated blood transfusion which does not sift in blood donation. One such contamination is cytomegalovirus infection, which is an important pathogen in immunosuppressive patients or receivers of transplanted organs.

Methods: This cross sectional study was conducted on 311 thalassemia patients under age of 15 yr who was receiving blood from Hospitals in Tehran and Noorabad Mamasani repeatedly. To determine active infection (presence of IgM antibodies) of cytomegalovirus, ELISA method was used. In addition, 225 healthy people under age of 15 yr were studied as testified group and finally all data were analyzed using SPSS ver. 11.5.

Results: 12.9 % of patients were positive from the view point of active infection. Regional separation of patients showed that the patients resided in Tehran are more contaminated to this virus than patients of other cities.

Conclusion: The range of cytomegalovirus active infection in thalassemia patients is high. One reason might be the infected blood intake or immunosuppressant (weakness of immune system) in patients, therefore immunity care of these patients and negative serologic blood intake with respect to and also hematic parents (parents with the same blood) are important.

Evaluation of Antibiotic Susceptibility of Enterobacteriacea Isolates from Blood Cultures

Y Erfani

Background: Septicemia is a life threatening status and needs rapid antibiotic treatment. Enterobacteriacea are one of the most important causes of septicemia. So this study is therefore aimed to evaluate antibiotic susceptibility of enterobacteriacea isolates in blood cultures in Shariati Hospital, Tehran, Iran.

Methods: This retrospective study was performed on 138 patients with positive blood culture in Shariati Hospital, Tehran, Iran in 2004, using disk diffusion and Macfarland standard.

Results: Prevalence of isolated enterobacteriacea was respectively E. coli (n=74, 53.6%), Klebsiella (n=37, 26.8%), Enterobacter (n=21, 15.2%), Citrobacter (n=4, 2.9%), Salmonella paratyphi (n=1, 0.7%) and Proteus mirabilis (n=1, 0.7%). The most antibiotic susceptibility among enterobacteriaceaes was ciprofloxacin (60.4%), cloramphenicol (56.8 %) and gentamycin (49.3%). The most antibiotic resistance were seen among cephalotine (78%), cotrimoxazole (62.3 %) and ceftriaxon (57.5 %).

Conclusions: Due to dissimilarity between antibiotic consumption in laboratories and hospitals, it seems that to reach more proper conclusions and choosing better strategy for antibiotic consumption, cooperation should be between laboratories and physicians, plus synergism between drug prescription and antibiotic discs in laboratories.

Evaluating the effects of cooking on the decrease microbial contamination of kebabs and hamburgers supplied for selling in southern areas of Tehran

MM Soltan Dallal

Introduction and objectives: Despite the advances in the control of food-borne diseases, still one of the dilemmas in the health of most societies and a matter of concern for health authorities is food poisoning and food-borne diseases by unsafe foods.

Materials and methods: In total 390 samples, including 195 samples of raw kebabs and hamburgers and 195 samples of the cooked ones were gathered from shops, sampling raw and cooked meat at the same time, and they were sent to the laboratory for testing, over a period of one year. The methods used for the tests were based on the Iranian National Standard procedures, numbers 356 and 2394.

Results: All the cooked specimens had bacterial contamination in acceptable standard levels and therefore were considered consumable. From the 165 raw kebab samples, 90 samples (54.5%) were consumable but 75 samples (45.5%) were not fit for consumption, where from 30 raw hamburger samples, 22 samples (73.3%) were consumable and 8 (26.7%) were inconsumable. In serological evaluations, Thompson serotype had the highest prevalence in kebab and hamburger samples.

Conclusion: The results of present study show that there is no reason for concern in consuming cooked kebabs.

Mechanisms of Health Care Information Technology Development

H Dargahi

Background: Study of the attitudes of health information management experts in health systems could be regarded in order to maximize utilization of information. The research reported here aimed to study of attitudes of medical records departments in Iran about mechanisms of development of health care system information technology.

Material and method: A cross- sectional research was developed by a questionnaire to study the attitudes of medical records departments of 17 universities by mail in Iran. 49 of them completed the questionnaire and returned it to us. Therefore the response rate was 70 percent. The data were saved by SPSS software and analyzed by statistical method.

Results: Faculty members of universities of medical sciences believe that the must hindrances of development of electronic health records in Iran are low budget and lack of standards.

Conclusion: Utilization of health information management experts attitudes could be assured the improvement of health care information technology.

Evaluation of cell counter machines in medical laboratories

V Changizi

Background and aim:Blood cells have an important role in human healthy, so their shapes and numbers are defined as human healthy indexes. These factors are measured by cell counter machines. Presenting a high quality report according to cell counters output is dependant on their operational accuracy. Therefore it was necessary to do a study on quality control of blood cell counter machines in selective medical laboratories of Tehran.

Method of study:This study was an experimental type in selective medical laboratories of Tehran. "Brittin method" was used as a general method for 6 selective machines over WBC, RBC, Hb, HCT, MCV, MCH and MCHC. In this method red blood cells index stability with EDTA, in 4^oC for 24 hour is assessed. Data was collected before and after quality controls and finally data analysis was done by T- student (paired samples T test) method and SPSS software.

Results:Using Brittin method showed all selective machines had significant differences before and after quality control in one or more quality factors (P-value< 0.05).

Conclusion:Quality control can show inaccuracy in cell counter machines output and finally inaccuracy over patient blood tests. By this subject we can have high quality diagnosis. This study showed parameters producing errors are error in sample volume, biological factors, error in concentration and using bad solutions.

Study conducted in filling and medical record department of hospital Tehran University of Medical Sciences

R Sharifian

Background: In recent years lots have been done for hospital automation but this non harmonized actions leads to different software usage and entrance of different data into the system when partly is not useful . In this way, usage of soft wares in medical records specialty in the high loaded reception and recording will decrease defect in registration and storage of medical data. Using computerized system which cover applied soft wares could decrease many problems in medical data records. Any research in medical record area needs to be fed with data there fore it should be to use and evaluation of computerized systems.

Method: This cross sectional study was conducted in reception and recording department teaching hospitals of Tehran University of Medical Sciences (TUMS), Iran, using check list and direct collection of the data in the hospital. We used descriptive statistics tools to analysis the data.

Results: Specialized hospital and general hospital use computerized system for medical record with percents of 49.06% and 40.73% respectively .search of the input data and output data were considered as 66.7%.

Conclusion: The usage of automation in reception and recording departments of TUMS hospitals was low and even the operating system was not capable to register the patients data. Even though a few humble of systems in medical records awards were set which would be the source of some problems is saving and processing the data.

People Awareness on Diabetes Disease and Complications in Bushehr, Iran using Linears Models

QR Babaee

Backgound: Approximately half of the diabetics population type 2 are not aware of their disease .Lack of awareness can lead to development of diabetes and increase cost of treatment. The aim of this survey was to determine the level of population awareness in Bushehr port in south of Iran in Bushehr province.

Methods: In this cross-sectional study, 719 subjects (417 male and 302 female) aged over 18 years old, without diabetes and inhabitant in Bushehr port in 2005 were assessed. Multi-stage random simple sampling was used. A 39 question questionnaire was used with validity checked by researchers in Yazd Diabetes Research Center and reliability alpha-cronbach=75%.The data were analyzed with independent t-test, pearson correlation coefficient , ANOVA and Multiple Logistic Regression models by SPSS package ver. 10.05.

Results: Mean and SD of scores of subjects knowledge levels were 16.96 and 6.29, respectively. The levels of males' awareness rate was more than females' (P=0.001). There was indirect relation between subjects awareness and their age (r=-0.203, P=0.001) and direct relation between awareness and the level of education (P=0.01, r=0.07).The mean of awareness scores was not similar between singles and married (P=0.042). Awareness regarding fundamental diabetes disease, primary symptoms, early complications, delay complications, diet awareness was low and concerning controlling methods of diabetes was high.

Conclusion: Awareness in relation to fundamental and complications of diabetes disease was low, so the people need more education about diabetes.