Tehran University Medical Journal

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Sixty pregnant women with the gestational age of 6-14 weeks who met the following criteria were selected: 1) Presence of nausea and vomiting. 2) Absence of other medical conditions that cause nausea and vomiting. 3) Negative history of medical treatment for at last three days prior to admission. 4) Negative for threatened abortion, molar and twin pregnancy. Cases were randomly divided into two groups. Mean age of the cases was 25.16 y (range: 16-37 y) and not significantly different in the two groups. The two groups were also similar in gestational age, severity of nausea and vomiting, number of previous pregnancies and abortions, profession, working inside or outside the house, family income and education of patients and their spouses. In one group, Pe6 point of acupuncture was stimulated by TENS (once every 2 hours, 10 minutes each time, from the time of awakening). The other group received placebo. Both groups were hospitalized for 48 hours, and were evaluated for severity of nausea and vomiting, apetite, frequency of vomiting and VAS at their worst day, 24 hours prior to admission and 24 and 48 hours after admission. The two groups were similar in frequency of vomiting, VAS, appetite, and severity of nausea 24 hours prior to admission, and the worst degree of nausea and vomiting. However, a significant difference was observed in the severity of nausea and vomiting 24 and 48 hours after the adminission between TENS and placebo (P=0.000). In the group who received TENS, 24 cases (86.7%) reported improvement (compared to 23.3% in the control group). Of all the cases, 81.6% had received prior medication, only 18.3% of the latter reported improvement with medication. Level of VAS in the groups with severe and mild to moderate nausea and vomiting was not significantly different in the first and second days of admission. Fifteen percent of the cases reported a transient cutaneous rash. Five cases were hospitalized more than once. Of the cases who reported improvement with TENS, 5% had improved after two stimulations, and 47% reported a relapse of symptoms in less than 24 hours after cessation of TENS. In one of the cases who were re-admitted, TENS did not result in alleviation of nausea and vomiting, and 56.6% of all the cases suggested to use TENS at home, 45% were attracted to TENS by commercial advertisements. Disscusion: Stimulation of Pe6 (Neiguan) point alleviates the nausea and vomiting of pregnancy.

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As fever is a sign of infection and also an unpleasant and unfavorable feeling for patients it is urgent to be treated as soon as possible. The treatment can be difficult because of critical situation. This paper is intended to propose a management program according to 6 months follow up in our (ICU). Results were considerable in decreasing about 60% mortality and morbidity.

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In a cross-sectional epidemiological study of headache disorders in neurology clinic of Fatemieh hospital of Semnan (August 22-November 20.1996), information on types of headaches, quality, severity, location, duration, frequency, precipitating factors, age of onset, influence of menstruation and pregnancy, positive familial history, use of oral contraceptive pills and other epidemiological factors including socioeconomic and age/sex composition was collected. The presence of any types of headaches was ascertained by a clinical interview and examination using the operational diagnostic criteria of the International Headaches Society. The prevalence of migraine and tension type headache was also analysed in relation to variables of life style (physical activity and sleep pattern) and associated signs and symptoms (nausea, vomiting, photophobia and phonophobia). In this study migraine and tension headache were also compared in variable aspects with each other. 1) Headache was more prevalent in women than men (F/M=3/1). 2) The most common types of headache included: tension type headache (41.4%), migraine (31.2%) and unclassified headaches (17.2%). 3) Migraine and T.T.H were more prevalent in early adult life and middle ages. 4) In both migraine and tension type headache the time profiles (duration, frequency, age of onset), quality and location were like that noted in textbook and previous studies. 5) In both migraine and tension type headache the most conspicuous precipitating factor was stress and mental tension and frequent headaches were accompanied with psychiatric problems (e.g depression and or anxiety). 6) Nausea, vomiting, phonophobia and photophobia were the most common associated symptoms in both of them. 7) Positive familial history and aggravation of headache in perimenstual period were more commonly seen in patients with migraine than tension type headache. In conclusion using the operational diagnostic criteria of International Headache Society in clinical practice, treating, teaching, clinical and epidemiological research is very useful and must also be applied for Iranian patients.

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Brucellosis is a multisystem disease with diverse clinical presentations and involvement of the nervous system is considered to 5 to be 10% in adult patients and 1% in children. The presentations of neurobrucellosis includes meningoencephalitis, subarachnoid haemorrhage, myelitis, radiculoneuritis, intracerebral and epidural abscess, psychosis and vascular syndrome. Twenty-two patients with neurobrucellosis are described. Ten patients had meningoencephalitis, seven patients had meningitis, three patients had polyradiculopathy and one patient presented with spinal epidural abscess and one patient had brain abscess. Results of an agglutination test for Brucella in serum were positive for all patients (>1:160) eight of 15 patients had positive agglutination test in CSF. Five patients had positive blood cultures, 3 patients had positive bone marrow cultures and 2 of 15 patients had positive CSF cultures. All of cultures were Brucella Mellitensis. Antimicrobial treatment included concurrent administration of Doxycycline, Rifampin and Trimethoprim-Sulfametoxazole. Four patients received Dexamethason concurrently. In conclusion, nervous system involvement is a serious manifestation of brucellosis. As brucellosis is an endemic disease in Iran we suggest that brucellosis be investigated with neurological symptoms and signs.

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The aim of this investigation is to compare the effect of applying two transcutaneous electrical nerve stimulation (TENS) current with different frequencies (2 Hz & 100 Hz) on Hoffmann reflex recorded from gastrosoleus muscle of healthy people. Forty female subjects between 20 to 30 years of age were participated in this quasi-experimental design. Twenty of them were exposed to the 100 Hz current and the remaining 20 to 2 Hz current on dermatome S1 root. The excitability of the alpha motoneurone was measured by H-reflex amplitude (peak to peak max/2) before and after the application of the TENS current for 30 minutes. The reflex was recorded and at measured before (TO) and after the application of TENS at different times (T1, T% and T10) up to 10 minutes. The mean values were compared by multiple paired T test (alpha=0.00825). The results indicate a considerable decrement in Hoffmann reflex amplitude after application of 100 Hz current in comarison with that of before the application. The effect last for 10 minutes after the TENS application, whereas the application of 2 Hz current results in increment of the Hoffmann reflex amplitude. The 5 and 10 minutes interval test dose not show any significance and the results were attenuated befor 5 minutes. As a conclusion high frequency of TENS (100 Hz) has an inhibitory effect on excitability of alpha motor neurone reflex lasting for 10 minutes, while low frequency of TENS (2 Hz) has an facilatory effect on the same motoneurone with short lasting effect.

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The aim of this investigation is to compare the effect of applying two transcutaneous electrical nerve stimulation (TENS) current with different frequencies (2 Hz & 100 Hz) on Hoffmann reflex recorded from gastrosoleus muscle of healthy people. Forty female subjects between 20 to 30 years of age were participated in this quasi-experimental design. Twenty of them were exposed to the 100 Hz current and the remaining 20 to 2 Hz current on dermatome S1 root. The excitability of the alpha motoneurone was measured by H-reflex amplitude (peak to peak max/2) before and after the application of the TENS current for 30 minutes. The reflex was recorded and at measured before (TO) and after the application of TENS at different times (T1, T% and T10) up to 10 minutes. The mean values were compared by multiple paired T test (alpha=0.00825). The results indicate a considerable decrement in Hoffmann reflex amplitude after application of 100 Hz current in comarison with that of before the application. The effect last for 10 minutes after the TENS application, whereas the application of 2 Hz current results in increment of the Hoffmann reflex amplitude. The 5 and 10 minutes interval test dose not show any significance and the results were attenuated befor 5 minutes. As a conclusion high frequency of TENS (100 Hz) has an inhibitory effect on excitability of alpha motor neurone reflex lasting for 10 minutes, while low frequency of TENS (2 Hz) has an facilatory effect on the same motoneurone with short lasting effect.

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Essential hypertension is one of the risk factors of cardiovascular diseases. Hypertension etiology is not completely known, it seems that rennin-Angiotensin system has an important role in its etiology, Thus better recognition of this system and its activity changes or vascular reaction changes to different parts of this system during progressive hypertension can be more effective in better recognition of the disease progress and treatment.
Materials and Methods: In this study responsiveness of mesenteric vessels of Goldblatt two kidney- one clip (2k-lc) renovascular hypertensive rats to angiotensin / and II with and with out captopril during a time of two , four , six and eight weeks after hypertension induction was investigated and compared with control and surgical sham groups.
Results: This study shows that vascular responsiveness to angiotensin // in animals that passed four weeks of their hypertension , (p< 0.05) and in the sixth and eight week of post induction hypertension (p< 0.01 and p< 0.001) has a significant different with both sham and control groups. Also it has been observed that an increased reaction to angiotensin II with an increased significant rate of arterial hypertension in hypertensive group. In the other hand in spite of inhibition of angiotensin converting enzyme by captopril in animals that have been eight weeks hypertension , on the contrary to other groups reactive to angiotensin /.
Conclusion: Results of this study show that vessels reaction to angiotensin /and II increased due to six to eight weeks post induction renal hypertension. Captopril does not inhibite mesenteric vessels reaction to Angiotensin / in hypertensive Rats after eight weeks. Try to completely inhibit production of angiotensin II maybe a hopful way in controlling essential hypertension.

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Background: One of the disturbing complications of propofol is pain on venous injection. Some investigators had reported that corticosteroids effectively induce and prolong the duration of local anesthetics. The aim of this study was to assess and comparing the efficacy of propofol pretreatment with dexamethasone in prevalence and severity of its pain on injection.

Materials and Methods: In a randomized, double-blinded, placebo-controlled prospective study, 90ASA I and II, 20 to 60 years-old patients scheduled for elective surgery under general anesthesia were enrolled. In all patients, one of the veins of both hands was catheterized with a 20 G catheter. Then randomly, and simultaneously 2 ml dexamethasone (8 mg) was injected to one of them and 2 ml of normal saline was injected to other. After 30 seconds, 2 ml propofol (20 mg) was injected to both hands, at the same time in 30 seconds. Pain intensity was measured using VAS system.

Results: The age mean was 32.87±5.61. Twenty nine patients were male (32.2%). The mean of pain during propofol injection was significantly lower in dexamethasone group than normal saline group (1.61 vs.4.21 respectively, p< 0.05). Also the pain incidence was significantly lower in dexamethasone group compared to normal saline group (20% vs. 57.78% respectively, p> 0.05).

Conclusion: Intravenous administration of 8 mg dexamethasone before propofol IV injection significantly decreases the pain on injection of propofol.

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Background and Aim: This study was conducted to evaluate the safety and efficacy of Tension-free Tape for the surgical treatment of female stress urinary incontinence.

Materials and Methods: In a prospective open study for pre and post operative, we followed 36 patients at least 1.5 years after surgery (18-28 months) all patients underwent the operation under local anesthesia, allowing the surgeon to check intra-operatively that continence has been obtained.

Results: Mean operation time was 36 minutes (range 20-45 minutes). 32(89%) of the patients was cured according to the protocol, another 3(8.3%) were significantly improved and there was 1(2.7%) failure. Mast of patients (about 91%) were operated on a one day-care basis, which implies that they were released from the hospital the day after the procedure, and no post operative catheterization, defect healing and tape rejection occurred. Pain free recovery time without any analgesic was another benefit. Five patients needed an indwelling catheter for 3 days and two uncomplicated hematoma occurred.

Conclusion: Based on the results, we conclude that Tension-free Vaginal Tape is a safe and effective ambulatory procedure for surgical treatment of genuine stress urinary incontinence, which allows the majority of the women to be discharged from the clinic the day after the procedure and start their works in the second week.

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Background: Hypertention and diabetes are important risk factors for cardiovascular disease. studies have shown that microalbuminuria is a strong predictor of cardiov-ascular disease in different population.In this study the relation of microalbuminuria with diabetes and hypertention as risk factors of atherosclerosis disease were investi-gated.

Methods: Two hundered twenty eight patients with angiographically confirmed coronary atherosclerotic lesions, (mean age 60 ± 0.5 SD) referred to Madani Hospital, Tabriz, Iran were studied .This patients according to the number of diseased vessels were classified in two groups. The levels of glucose and creatinine and that of post parandial glucose were determined in venous blood samples by standard methods. Immunoturbidimetric method was employed in the measurement of microalbuminuria. The results were analysed by statistical tests.

Results: The increased albumin/creatinine ratio was markedly correlated with fasting blood sugar, systolic and diastolic blood pressure (P < 0.05 in all cases). Significant correlation was noticed between microalbuminuria, diabetes according to the extension of the disease lesions (P < 0.05). No relationship was observed between microalbumin-uria, high levels of blood pressure according to the number of diseased vessels (P > 0.05).  Conclusion: The relationship between diabetes and microalbuminuria was meaningful. According to atherosclerotic lesions a marked correlation was also noticed between microalbuminuria and diabetes. These facts may contribute to the higher cardiovascular risk in diabetic patients. An associated between hypertension and microalbuminuria was noticed. The result suggests that although risk factors such as hypertension and diabetes are known to cause cardiovascular disease, microalbuminuria may in fact be a better indicator of established microvascular damage and better predictor of cardiov-ascular events.

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Background: Microalbuminuria (MA) is associated with increased cardiovascular risk in hypertensive patients, but not many studies have specifically examined the effects of MA-lowering on regression of left ventricular hypertrophy (LVH) among pediatric patients with hypertension.
Methods: Fifty-five patients with essential hypertension, 11 to 19 years old were prospectively studied. All patients received concomitant therapy of hydrochlorothiazide and angiotensin-converting-enzyme inhibitor. Five patients also required angiotensin-receptor blocker to achieve the blood pressure goal. Baseline and 12-month follow-up measures of left ventricular mass index (LVMI) determined by echocardiography and urine microalbumin/creatinine ratio (MA/Cr) were collected. MA was defined as MA/Cr>30. LVH was defined as LVMI>38.6 g/m2. The primary end points were 25% or more reductions in MA and the LVMI.
Results: Weight (r=0.83), body surface area (r=0.85), body mass index (BMI) (r=0.86), systolic blood pressure (SBP) (r=0.57), diastolic blood pressure (DBP) (r=0.49), mean arterial pressure (r=0.53) and MA (r=0.87) were all univariate correlates of LVMI. In a multiple regression analysis, MA, BMI and SBP were significant correlates of LVMI. MA alone explained 76% of the variance of LVMI, whereas BMI and SBP explained only 1.6% and 0.4% of the variance, respectively. MA was the most significant correlate of follow-up LVMI after BMI and SBP were included in the overall multiple regression models.
Conclusion: MA is a strong predictor of LVH in hypertensive children and adolescents. MA-lowering halts the progression of LVH or induces its regression.

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Background: Abdominal compartment syndrome (ACS) is a clinical entity that develops from progressive, acute increases in intra-abdominal pressure (IAP) and adversely affects all vital organ systems In this study, the development of intra-abdominal hypertension (IAH) and ACS in a surgical ICU population is described and examined.
Methods: Over a one-year period (2004), urinary bladder pressure (UBP) was measured prospectively in all surgical patients with abdominal problems admitted to the ICU of the Imam Hospital complex. UBP of >20 cm H2O indicated IAH. ACS was defined as the development of multiple organ dysfunction including peak airway pressure (PAP) >50 cm H2O, Horowitz quotient <150 torr or urine output <0.5 ml/kg/hr in the setting of IAH. Data were gathered on all patients with IAH and ACS.
Results: We evaluated some 353 patients, consisting of 165 elective laparatomies and 188 emergency cases, including 28 trauma patients. The incidence of IAH and ACS was 2 and 1 per cent (7 and 3 patients, respectively). The mean IAP of these seven patients was 29.8 cm H2O. No elevated IAP was observed after elective laparotomy (165 patients), nor in emergency cases with temporary abdominal wall closure (29 patients). APACHE II score, PAP and worst base deficit were significantly higher in patients with elevated IAP. None of the three patients with ACS underwent decompressive laparotomy. The mortality rate for patients with elevated IAP was 85%, significantly higher than the total study population.
Conclusion: IAH is a rare disease of the rarity of IAH, routine measurement of IAP is necessary only in high-risk patients. Prophylactic temporary abdominal wall closure may prevent IAH and ACS in high-risk patients. Patients with elevated IAP have dismal outcomes. Critical care practitioners should become familiar with different aspects of IAH and ACS, including decompressive laparotomy.

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Background: The incidence of ESBL producing species have been steadily increased in recent years, resulting in limitation of infection control issues and therapeutic options.The purpose of this study was to evaluate prevalence of Enterobacteriaceae and also assess epidemiology ESBL producing strains isolated from patients admitted in ICUs.
Methods: A total of one hundred fifty isolates were collected from urine, sputum, blood, wound and other clinical samples from patient admitted in ICU and then were identified by biochemical tests .All of the samples were screened by DAD method according to The NCCLS Guideline. The species that met NCCLS screening criteria was further tested for Clavulanic Acid effect by confirmatory method.
Results: A total of one hundred fifty isolates,133(89.3%) were found to be resistant at least on of the indicators cephalosporin tested according to NCCLS Guideline. 121(80.6%) of the isolates were resistant to all the indicators tested .89(59.3) isolateds were confirmed as ESBL producers. The number of isolates ESBL producing was as follow: Klebsiella pneumoniae 33 (76.74%), E.coli 20 (60.60%), Enterobacter cloacae 8 (47.05%), Citrobacter diversus 6 (54.54%), Enterobacter aerogenes 7 (53.84%), Citrobacter freundii 4 (40%), Klebsiella oxytoca 6 (62.5%), Proteus mirabilis 4 (50%), Serratia marcescens 2 (40%), Proteus Volgaris 0%.All of the isolates sensitive to imipenem.
Conclusion: The present study shows high prevalence of ESBL producing Enterobacteriaceae from patients admitted in ICU .The increased rate of these species in most cases due to the administration of inadequate and irrational antimicrobial therapy .To overcome this problem, it needs to develop new antimicrobial agents, limiting the Unnecessary Use of antimicrobial and increasing compliance with infection control issues.

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Background: Exposure to low levels of lead increases blood pressure in humans and animals. Although there are controversial reports about the exact mechanisms of lead-induced hypertension, many factors such as alteration in the cardiovascular responsiveness to endogenous substances including catecholamines could be one of the mechanisms involved. In the present study, the effect of lead acetate on the systolic blood pressure and responsiveness to β-adrenergics was investigated in rats.

Methods: Through their drinking water, three groups of rats were exposed to 100 ppm lead acetate for periods of 4, 8 or 12 weeks. The blood pressures of the rats were monitored throughout the study. The rat hearts were isolated and perfused with Krebs-Henseleit solution (pH=7.4) at 37˚C and gassed with 95% O₂ + 5% CO₂. The heart rate (chronotropic) and contractile (inotropic) responses were recorded before and after adding isoproterenol at multiple concentrations to the perfusion solution.

Results: The mean blood pressures in the 8 and 12-week lead-treated groups were significantly higher than that of the control group (P<0.01). The chronotropic response to many doses of isoproterenol was significantly increased in the 12-week lead-treated group compared to that of the control group (P<0.05). The inotropic response to this drug was significantly increased in both the 8- and 12-week lead-treated rats (P<0.05 and P<0.01, respectively).

Conclusions: Our results indicate that low-levels of lead increase systolic blood pressure as well as both chronotropic and inotropic effects of β-adrenergics, which could imply an important role in the pathogenesis of lead-induced hypertension.

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Background: Hypertension is a very common and important disease. There are conflicting reports about mercury, a trace element, in the genesis of hypertension.

Methods: In this study we examined the relationship between blood mercury levels and hypertension prevalence in a population-based sample of hypertensive and normotensive patients at the Shariati Hospital and the Tehran Heart Center in Tehran, Iran. A cross sectional sampling of 224 patients, aged 40-80 years, who participated in physical examinations conducted in 2006 were included in this study. The population that participated in this study were sample of hypertensive (n=112) which had essential hypertension and normotensive (n=112) patients which had no history of essential hypertension at the Shariati Hospital and the Tehran Heart Center in Tehran. The consent of all the patients were taken in the written form before the experiments. After selecting the patients the range of blood mercury levels were measured with Flame atomic absorption.

Results: The range of blood mercury levels was 0 to 39.55 µg/dL. The mean blood mercury level of hypertensive patients (10.75 +1.23 µg/dL) was higher than that of normotensive patients (1.6 +1.02 µg/dL). There was a significant difference in the mean blood mercury level of normotensive men (1.74 +1.56 µg/dL) versus that of hypertensive men (11.9 +1.38 µg/dL). The mean blood mercury level of normotensive women (1.5 µg/dL) was also significantly different from that of hypertensive women (9.65 +0.53 µg/dL) (p<0.001).

Conclusions: In this population, there is a positive relationship between the concentration of blood mercury levels and the presence of hypertension.

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Background: Nosocomial infections increase patients' morbidity, mortality and length of hospital stay especially in neonatal intensive care units (NICUs) and have become a matter of major concern. Controlling and preventing nosocomial infections need enough information about epidemiology of these infections. This study aims at estimating the incidence rate and the most frequent bacteria which cause these infections in neonatal intensive care unit of Ghaem university hospital, Mashhad.
Methods: In this study which is performed during a twelve month period in 2004 and 2005 at neonatal intensive care unit of Ghaem hospital, 971 hospitalized neonates were studied. Data were collected considering the standard surveillance protocols. Early onset neonatal nosocomial infections and late onset neonatal infections were defined as illness appearing from birth to seven days and from eight to twenty-eight days postnatal age respectively. Statistical analysis was performed using the χ2 test.
Results: In this study 32 cases of nosocomial infections were identified so the incidence rate of nosocomial infection in this ward was 3.29%. Fifteen babies identified with early onset neonatal nosocomial infection and the rest have presented with late onset neonatal infections. In order of frequency, the sites of infection were: primary bloodstream (84.4%) and pneumonia (15.62%). Coagulase negative staphylococci were the most common bacteria (43.74%) isolated in these patients. Other isolated bacteria were Klebsiella pneumonia (31.42%) and other gram negative bacilli such as E.coli, Pseudomonas aeroginosa and Acintobacter spp. The mechanical ventilation and umbilical catheter were associated with nosocomial infections as risk factors in our study (p<0.01).
Conclusion: Our findings show that the neonatal intensive care unit of Ghaem hospital has low rate of nosocomial infections. However, as neonatal intensive care unit is an area of great concern in terms of nosocomial infection, preventive measures especially hand washing should be intensified.

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Background: Identification of the best screening measure for the risk of chronic disease is essential. This study aims to comparatively assess the ability of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) to predict hypertension among women in Tehran.

Methods: In this population-based cross-sectional study, a representative sample of 926 adult women aged 40-60 years were selected using a multi-stage cluster random sampling method. Demographic data were collected and anthropometric measures including weight, height, WC and hip circumference were assessed according to a standard protocol. BMI was calculated as weight in kilograms divided by the square of the height in meters. Cut-off points of 80 cm for waist circumference, 25kg/m² for BMI, 0.87 for WHpR and 0.5 for WHtR were used. Blood pressure was measured and hypertension defined according to the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 6).

Results: In this study, the mean age of women is 48.7±5.6 years. Mean WC, BMI, WHpR and WHtR are 85.1±9.9cm, 29.4±4.6kg/m², 0.82±0.06 and 0.55±0.06, respectively. Although all anthropometric indicators have a significant association to hypertension, WC has the highest sensitivity, specificity and accuracy in predicting hypertension in both age groups of 40-50 and 50-60 years. This measure also has the greatest area under the ROC curve compared to other anthropometric measures: 0.70(0.69-0.71) for WC, 0.65(0.62-0.67) for BMI, 0.62(0.60-0.64) for WHpR and 0.65(0.63-0.67) for WHtR.

Conclusions: Among this group of women in Tehran, waist circumference is the best screening measure for hypertension. However, no data are available regarding similar patients who have emigrated thus similar studies on Iranian women who have emigrated are recommended.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Approximately 2-15% of the global population suffers from migraine headaches. Since acupuncture is one of the treatments for this disorder, the aim of the present study was to assess the effectiveness of this modality on patients with migraine.
Methods: In this experimental interventional study, we enrolled 180 patients with migraine headache attacks at a documented frequency of at least 2 attacks during last 6 months. For all patients, the number, duration and intensity of the headaches were recorded before treatment. To treat the patients, the point with maximal pain was first determined and the meridian was distinguished. Then, the related acupoints were found and stimulated by percutaneous electrical acupuncture for several minutes. The procedure was repeated once per week for six weeks. After completion of all treatment sessions, the patients were visited and questioned about the number, duration and the intensity of headaches.
Results: The mean of number of attacks (9.55±8.26 vs. 3.50±6.77, p=0.001), the mean duration of each attack (9.11±6.59 vs. 3.33±3.65, p=0.001) and the intensity of the attacks (1.83±0.38 vs. 0.61±0.78, p=0.001) were significantly lower after treatment.
Conclusion: Application of acupuncture in patients with migraine headaches is associated with a significant decrease in the mean number, duration and intensity of attacks. Thus, this method of treatment is strongly recommended for migraine headache.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Many studies have demonstrated that pre-term neonates gained more weight over the 10 days stimulation period. This research has been conducted to determine the effects of five days Tactile- Kinesthetic stimulation (TKS) on weight gaining of pre-term infants hospitalized in Fatemiye neonatal intensive care unit.
Methods: Fifty one babies who graduated from the NICU to the intermediate care nursery were randomly allocated into test and control groups (24 and 27 neonate respectively). TKS was provided for three 20 minute periods per day for five consecutive days to the test group, with the massages consisting of moderate pressure strokes in left and right lateral position and kinesthetic exercises consisting of flexion and extension of the limbs. They were observed for changes in physiologic parameters and weight gaining during five days stimulation in hospital.
Results: Over the five days TKS an increase in weight was seen in the test group (p=0.018, 43.1 vs 5.4). Infants in both the test and control groups were matched for mean weight before study and days in which they received antibiotics and photo therapy. Mean temperature and O² saturation had no meaningful difference, but an increase in respiratory rate (p=0.047, 32.9 vs 32.5) and heart rate (p<0.001, 148 vs 145.7) (within physiologic range) was seen in the test group during stimulation, so that no one excluded from study.
Conclusion: Tactile- Kinesthetic stimulation has no adverse effects on physiologic parameters, meanwhile has a beneficial effect on weight gaining in pre-term neonates, So touch and massage therapy which are both beneficial and cost effective could be placed in policy of care programs in nurseries in Iran.

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Background: The inguinal hernia is a common disorder in general surgery. Different methods have been described for repair of these hernias. In modern methods, synthetic mesh is used to cover the wall defect and the most known method is Lichtenstein surgical repair. The laparoscopic totally extra peritoneal procedure (TEP) is a newer technique of repairing hernia. The aim of this study is to compare the outcomes of totally extraperitoneal laparoscopic inguinal hernia repair versus Lichtenstein open repair in patients with inguinal hernia. Methods: Among 50 patients, 25 cases underwent Lichtenstein procedure and 25 patients underwent TEP technique for repairing primary unilateral inguinal hernia. Findings during the operation have been recorded and the 12-months follow-up of patients in different views was performed through a questionnaire and then the results were compared. Results: The operation duration, the rate of complications and frequency of recurrence were similar in two groups but the hospital stay, postoperative pain, chronic groin pain and the required time to return to normal activity were significantly lower in patients who underwent the TEP method compared to the patients who underwent the Lichtenstein technique (p<0.001, p<0.001, p=0.012, p<0.001, respectively). Conclusion: The TEP surgical technique can be recognized as a safe method with acceptable results for patients and has significant effects on improvement of patients’ quality of life after hernia repair. Suitable results of this surgical method are achieved when the surgeon goes through the learning curve.