Journal of Arak University of Medical Sciences

Examination of Six Patients with Tracheo Esophageal Fistula (TEF)

Mahmoud Amyni

The most prevalent anomaly of esophageal cutaneus atresia is TEF (Tracheo-Esophageal fistula). Prevalencec of this disease is 1 in 3000 to 1 in 4500 of births. Esophageal atresia probably is a distinctive a tresia. This disease is composed of: 1-Atresia with distal portion TEF(88.5%). 2-Atresia with proximal TEF(0.8%) 3-Atresia without TEF(7.7%) 4- TEF without atresia (4.2%) 5- Atresia with both proximal and distal TEF. About 50% of patients have anomalies together. Appearance of disease usually begins in birth. Apnea and cough when the neonatal feeding is occurring because of aspiration is appear in first hours of life. This study done as prospective and cross-sectional. All of the neonatals were studied from 1/3/2000 to 1/1/2000. Rate of survival was 83%. 83.3% percent of patients were mature and 16.6% were premature.

Reviewing Patients Satisfaction of Provided Services for Them Hospitals Subsidiary to the Arak Medical Sciences University

Akram Bayati

Patients satisfaction is a concept that in medical cares is very important today. Certainly, medical cares provided for patients aren’t in high quality in general. Present survey is an analytical- descriptive study with the purpose of determining satisfaction degree of hospitalized patients from provided services. The sampling was made by calssifies random method with appropriate allocation, 2400 hospitalized patients from all subsidiary hospitals which had been chosen by simple random method were subjected for this study. Study tools were some questionnaires consisting 87 questions in the field of provided services in different hospitals units that were completed by interviewing with patients. The data analyzed by T. test statistical method, variance analysis, multiple average , X2 and central indications. The results indicate that there is a meaningful difference between satisfaction over age hospital in Amir Kabir hospital, Taleghani -H hospital, Ashtians hospital, Imam Sajjad hospital and Tafresh Valfajr hospital. In compare with satisfaction average several hospitals. Subsidiary to the Arak Medical sciences University there is a statistical difference (p=0.04) and the more satisfaction is attributed to the Arak Amir Kabir Hospital. Between satisfaction average of training and treatment units there was no meaningful difference. Between the number of hospitalization times and the number satisfaction average there was a reverse relationship. By comparing between patients satisfaction average from similar units of several hospitals statistical tests show a difference between nursing and obstetrical units in hospitals (p<0.05). Also by comparing between of similar units in hospitals , satisfaction average of newborn units (p<-0.04) and infants units P<0.05 was shown a meaningful difference. Consequently, patients satisfaction degree of hospitals was different that due to high capacity of nursing and midwifery cares, the major reason for this difference is difference in degree of expressing satisfaction with those units

An Investigation about Prevalence of Moulluscum in Kindergartners in Arak City IRAN Winter 1377

Zabihollah Shahmoradi

Molluscum contagiosum (M.C) is one of the nearly prevalent dermatologic disease of childhood are skin-colored papule which have a central umbilication. The main objective of this study, was looking for M.C in kindergartners of Arak city. The total prevalence of M.C in this study was 1.96%. There is no significant relation between sex and M.C common involved age 2-3 years and no seen under the age of 1 year. The distribution of the lesions is more multiple and the most prevalent lesions in both sex are seen on the trunk and then neck and axillae.

Case report of Familian Meditranian Fever (FMF)

Masoume Soufian

Familian meditranian fever (FMF) is an inherited disorder and characterized by recurrent self limiting attacks of fever and polyserositis. Because of rarity of this disease and the difficulty of diagnosis, the physicians presence of mind is a necessary thing. The patient is a 16 years old boy who had recurrent attacks of abdominal pain, headache, fever, rash and arthritis. The interval of his attacks was variable between 1-2 years and 2 times in a week. He had an appendectomy about 8 years ago. Because of arthritis, with probable diagnosis of R.F, he received penicillin monthly. During the attacks, lab tests showed, leukocytosis elevated sedimentation rate and positive CPR.
The CT of abdomen and transient of small bowell were normal.
The use of colchicine 0.5mg two times in a day caused arrest of attacks.
This case is reported because of its rarity and for physicians presence of mind.

Cutaneus Lupus (Case Report)

Afsaneh Talayee

This paper is a case report about a 17 years old boy, who came us to Vali-asr hospital clinic with loss of appetite and skin lesions, and arthritis. He felt well to one month ago, until he was taken an operation for appendicitis.Several days after that , skin lesions included erythematous, purpura lesions began to appear. Arthritis in MCP,PIP, anckles, wrists and knees was appeared. Biopsy of skin lesions cleared, vasculitis, edema, and PMN infiltrations. Biopsy findings strongly suggested lupus. The exams were normal except for reduction of C3, C4, CH50, ADNA was positive. Photosensitivity arthritis, skin lesions and biopsy findings and serologic findings were in favor of sub acute cutaneous lupus. This form of lupus is seen in 10% of lupus case. Usually CNS and renal lesions are rare. ANA also is negative up to 50%. History of this form of lupus is better than systemic lupus, but occasionally this form is converted to systemic lupus. This boy was taken medication with prednisolone and coloroquine. Finally, all of symptoms respond to treatment.

Prevalence of Refractive Error in Primary School of Arak

Jamal Fellahati

Refractive error is a disturbance that a picture from one object is not on retina, in this reason picture is not clear. A clear picture is very important for development of visual nervous system to 10 years- old in children. This study was performed in 7 boys school in Arak. Today 753 boys student in the range of 6-11 years-old by the screening test was examined for visual acuity. Prevalence for refractive error was 9.5%. The most prevalence refractive error was pure myopia (56.9%). Family History in 65.3% was positive.

The Study of Prevalence Rate of Phlebitis and Comparing the Risk of it Among Clients According to Inserting Time of Intravenous Equipments During 24,48,72 and 96 hours

Ahmad Ghadami

Background: Nowadays, inserting intravenous equipments is one of the common invasive methods in patient care and one of the most common related complications is phlebitis.
Objective: This study was accomplished to determine the prevalence rate of phlebitis and comparing the risk of it among clients according to duration of staying of the intravenous equipments during 24, 48, 72 and 96 hours.
Materials and Methods: 350 clients who hospitalized in ward orthopedic with goal achievement sampling method were studied. The tools of collecting data was a questionnaire. Data was analyzed by descriptive statistics methods and survival test.
Finding: The prevalence rate of phlebitis was 31% . It has been increased according to the duration of staying of intravenous equipments. The risk of phlebitis in 24, 48, 72 and 96 hours was 0.0034, 0.0046, 0.0154 and 0.0187 respectively and the survival test didn’t show any significant difference among above numbers.
Conclusion: Noticing to present protocol which is related to stay intravenous equipments up to 72 hours and the obtained results of this research (no significant difference between 72 hours vs. 96), it is necessary to do more studies in this fields. Similar findings can show a way for decreasing the cost for patient and community.

Diarrheal Diseases are Major Cause of Morbidity and Mortality in the World

Parviz Ghadam Li

Guidelines about the use of oral rehydration solutions (OSR) and dietary management of acute gastroenteritis (GE) were published and presented by World Health Organization (WHO). The aims of this study were to examine pediatricians knowledge and implementation of the WHO guidelines, the effect of medical schools (Tehran versus other cities graduates) on the physicians practice, and the effect of the type of practice of the management of gasteroenteritis (private clinic versus hospital-based). A multiple-choice, written questionnaire was distributed at Pediatrics annual meeting. A total of 87 pediatricians completed the questionnaire. They were aware of 73% of the current WHO guidelines and followed 60% of the guidelines. Most pediatricians (83%) yse ORS fir treatment of dehydration in GE, but 60% of pediatricians believe that full-strenght feeds are inappropriate in the presence of GE. In addition, 37% of the pediatricians stop feeding temporarily in the presence of GE. These findings suggest that steps for implementing the nutritional guidelines are needed.

The Effect of Breastfeeding on Mortality of HIV - Infected Mothers

Zohreh Majidi

This article has no abstract.