Journal of Arak University of Medical Sciences

An Investigation of the Predisposing Factors Pertaining to ADHD in Arak Public Primary School

Akram Bayati

ADHD is the most observed Behavoural disorder in primary school students, This research is adiscreptive analytic (Case-Control) research in order to determine the predisposing factors (Socio-Economical, Familial and individual) pertaining to ADHD in primary schools children. This study has done with muiti-stage sampling method on the 82 students with ADHD (case) and 80 normal students (control), that completely accidental has chosen between Arak Primary schools students. The research tools have been the special teachers questionaies. Forms prepared by researchet, After collecting the data, results were analyzed by statistical methods such as X2, Fisher and T-test with p<0.05. The result shows that: the age most of chidren suffering from ADHD are between 10-12 years old and percentage of the boys is more than girls and most of them living in poorer part of the city. There was statistical meaningful difference between two examined groups (with P<0.05) in some factors students. Birth weight, Birth order(first child), the fathers educational level, living environment atmosphere, punishment by parents, past history of long term separation of parents or family members, past history of parents high illness, past history of ADHD in family members, family member or parent involved with low, fathers occupation, changing job, fathers prolonged absence from home for occupation. Therefore it seems that above factors are predisposing factors in the disorder and the most important of them were family history of behavioural disorder and inimical familial environment.

Investigation on the Effects of ACE Inhabotor Drugs in Treatment of b Hypertension in Dialysis Patients who Refer to Vali-Asr Hospital

When chronic renal failure with chronic and progressive course produce uremic syndrome. It can be treated in two ways: dialysis or kidney transplanatation. In CRF one of the complications is hypertension which is modified after dialysis, but in some patients hypertension is resistant and the BP doesn’t decreases after dialysis and even increases after that. The reason for this, is known as reduction of intravascular load after dialysis and high level of plasma renin. So it is advised to use the ACE inhibitor drugs to minimize this complication.
1-From 80 dialysis patients, 18 ones had resistant hypertension to dialysis or elevated BP after dialysis.
2-By using 5 mg enalapril (ACE inhibitor) 0.5 hour before dialysis and systolic and diastolic blood pressure were reduced after dialysis(PV<0.01)

Assessment of Relationship Between Orthostatic Hypotention with Duration and Type of Diabetes Mellitus in Diabetic Patients Admitted Shaheed Beheshti Hospital of Kashan in 1997

Mohammad Reza Rezvanfar

Orthostatic Hypertension is one of nervous system (Autonomic) complications of diabetes mellitus (D.M) that is the most common cause of morbidity in autonomic neuropathy , This study is a case control study for assessment of relationship between frequency of orthostatic hypotension with duration and type of D.M in Kashan Dr, Beheshti hospital in 1379. From 300 diabetes patients in this study, 100 patients have orthostatic hypotension in case group and 200 patients, have not this complication(control group). From case group, 14 had IDDM and 89 had NIDDM average duration of diabetes in case group was 8.44 years and in control group was 7.65 years by T test analysis this difference has no means and so there is not correlation between diabetes duration and frequency of orthostatic hypotension (p=0.05) By K2, test analysis, however there was not correlation between diabetes type and orthostatic hypotension frequency (p=0.05). In contrast with some other diabetes complications orthostatic hypotension has not correlation with diabetes type and duration.

Prevalence and Background Risk Factors of Acute Renal Failure (ARF) in Intensive Care Unit (ICU) Patients of Vali-Asr Hospital Since JAN 21, 1997 TO AUG 22 1999

Ali Fani

Acute renal failure (ARF) is common complication in ICU patients(Patients), which causes disturbance of homostasis of, electrolytes, acid-base balance with high mortality Rate, The principle cause of ARF especially in ICU ward are hypotension and Renal hypoperfusion and sepsis complications. This survey was performed with history taking, clinical and Paraclinical evaluation on 952 ICU patients from 21 Jan 1997 to 22 AGu 1999 Vali-Asr Hospital of Arak. From these pts 203 had different degree of ARF, 362 patients were female, 590 male, 5 patients had/chronic renal failure which omitted from study. From 198 patients with ARF 77 (38.9%) were female and 121 (61.1%) were male. Prevalence of ARF in male was 20.6% and in female was 21.4% sex difference is meaningless. The rate of ARF N in this study was 20.9% which there is no meaningful difference with report of western country (20-30). 110(55.5%) patients with ARF were being treated with one aminoglycoside and 66(33.3%) patients were taken aminoglycoside and cephalosporins concomitant compar 40(4.2%) patients with normal renal function. It seems that such nephrotoxic. Total mortality rate in ICU patients was 30.8% and in patients with ARF 116(50.6%) with meaningful difference with PV<0.0001, so ARf intensified most olity rate in ICU patients.

Determination of Frequency, Etiology and Prognisis of b Menengitis in Patients of FIROOZABADI HOSPITAL From 1996 to 1998

Shahin Ghasemi

Introduction: Meningitis is the inflamination of leptomeninges caused by the infectious and non infectious agents. The most common kinds of infectious meningitis include bacterial. Viral, fungal and mycobacterial meningitis. The three types of infectious meningitis are acute bacterial meningitis, aseptic meningitis and subacute to chronic meningitis which can be differentiated on the basis of CSF findings. Three fourth of the acute bacterial meningitis involve the persons below 15 years old. The etiologist cause of acute bacterial meningitis differs in various age groups. The most reliable criteria in diagnosis are laboratory and clinical findings. The permanent neurologic damages are the main complications that remain forever. Prognosis and mortality rate of meningitis depends on various factors , among which the main factors is the early diagnosis.
Methods and Cases: This is a cross-sectional study performed on 240 patients with meningitis in FIROOZABADi HOSPITAL from 1996 to 1998. Demographic information, about clinical and laboratorial findings have been collected.
Results: The male to female preponderance was 1:3. 81.3% patients had a previous history of headache, 94.4% had fever and 27.1% have defferent states of reduced alertness. 56.2% persons were diagnosed as having viral meningitis, 37% as bacterial meningitis and 6.8% as T.B. meningitis. The cases diagnosed with bacterial meningitis were influenced by the following bacteria in order: Pneumococus (44.9%), Meningococcus(26.5%), Staphylococcus aureus (12.2%), gram negative bacilli (10.3%) and Haemophilus influenza (6.1%). In 2.4% of cases CSF smear and culture were negative. The mortality rate among the patients was 8% and 8% of them developed consequences. The means of ESR duration had significant difference among various groups with different etiologies.
Discussion: In attention rate of similar studies in England and French were 24.2% and 56%. In attention to high prevalence of meningitis in our country, further greater complementary studies see to be necessary.

Evaluation of Ploidy Status in Patients with Lymphoma (Non-Hodgkin and Hodkgin) by flow Cytometry with Paraffin-Embedded Tissue

Farideh Karymi

DNA analysis by flow cytometry is one of novel techniques recently introduce of utilize in routine clinical diagnosis laboratories , generally, there is an wverall agreement between DNA status and chromosomal content of cells, so with DNA analysis especially in neoplastic diseases, one coukd find the ploidy feature and number of cells which are in synthetic phase (S-phase fraction) and also cellular kinetics in select neoplasia, which are charactristics findings and factors that could be used as prognostic markers for predicting clinical behaviour and monitoring response to treatment protocol. In this study, we measured DNA content in eighty eight (88_ malignant lymphopreliferation diseases including 58 NHL and 30 HD diagnosed histopathologycally, by flow cytometry using Hedley method, Also immunohistochemical staining for proper immunophenotyping done in selected cases with ABC method with MoAb,s. Aneuploidy were 38% in NHL and 47% in HD patients. This occurance was unrelated to other parameters used as Age, tumor location and histologic subtypes. (P>0.05) S-phase fraction (SPF) measurement calculated as percentage of cellw in active phase and proligeration index determinations reveral higher frequency of SPF (PI) within Iranian patients rather than reported Western patients. This finding can account for lower survival rate and poor response to chemotherapy and (or radiotherapeutic regimen used in Iranian patients, but also other parameters in this regard also should be considered simultaneously.

The Study of Burn Wound Infections and Determine Sensitivity Patterns of Antimicrobial Drugs of Isolates in Hamadan

Rasoul Yousefi Mashouf

Burn wound is one of the most common causes which damaged skin, followed by different bacteria infections. The aim of this study is to identify causetive agents of burn wound infections and also to determine sensitivity of isolated to current antibiotics. In a cross-sectional descriptive study a total of 465 burned patients who hospitalized in Imam Khomeini hospital of Hamadan were investigated during 1996-1998. The samples were also collected from different parts of burns section and identified by standard methods. The drugs sensitivity of isolates were detected by agar disk diffusion of Kirby Bauer method. In this study causes and rate of burning were studied in burn patients 538 bacterial strains were isolated and frequency of Pseudomonas was 32.7%. This was followed by Klebsiella 24.8% and Staphilococus aureus 21.2%. The most effective antibiotic were ciprpfloxacin, ceftazidime and amikacin. The most cause of burning was because of boiled water 32.8% and lowest cause was vecause of cooler, 73.6% burns was unintentional and 26.4% intentional. The results of present study indicated that the burn wound infection still is a major problem in hospitals. Bacterial drugs resistance is also other problem for burned patients, S0, prevention and control of hospital acquired infections is necessary for burn section of hospitals.

The Study of Results of Ueine Cultures and Antibiograms in Children with Urinary tract Infection referred to laboratory of Amir-Kabir hospital of Arak

Sousan Marefati

Urinary tract infection(UTI) is the most genitourinary disease of childhood. UTI include a wide range of clinical signs. That all of them have a common finding: positive urine culture. We study the results of urine cultures and antibiograms of 101 child aged 0 to 10 years who were referred to laboratory of Amir Kabir hospital. The presence of more than 100.000 colonies /ml of a single organism is considered as positive culture. 25 patients were boys and 76 were girls. The most microganism that grows is Ecoli in 87 ones and then 86.1% klebsiella in 4 cases, stophylocococi in 4 cases enterobacter in 3 cases, proteus in 1 case streptococos in 1 and mixed growth in 1 case, In girls the most pathogen is Ecoli (69n.09%) then staphylococci. In boys, Ecoli is the most common pathogen, then klebsiella and enterobacter. Antibiotic resistance in Ecoli were 72% resistance to cotrimazol, 76% resistance to Ampicilin. Sensitivity to coentamy Nalidikic acid and Nitrofurantom were 90,95.96%. The study show that in treatment of out patient cause that urine culture is not available, use of Nitrofortion. Nalid and preferred to use of cotrimazol.

Study on Preventive Effect of Mitomycin on Relapsing of Pterygium after Surgery in Amir Kabir Hospital

In this study we studied the efficacy of mitomycin in prevention of relapsing of in pterygium in 80 patients in Amir Kabir hospital of Arak. This research was a case-control analytic- experimental study that was performed prospectivity. We observed pastoperative patients was performed prospectivity. We observed postoperative patients (because of pterygium) during 6 months after surgery, Small size was about 80 ones. Case group received mitomycin. The sex, age and local residency were matched carefully in both groups. Due to Pv<0.0001, there is a significant relation between prescribing of mitomycin and decreased relapses of pterygium in patients. In case group relapsed was observed in 5% of patients but in another group it was about 86%.