Yafteh

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Introduction: Suicide with plaster is a new and strange way of suicide which has been only committed in Lorestan province and its vicincy out skirts which have been occurred in recent years. Concerning the points of unclear border of this issue charactristics of victims patient's sign and symptoms, management, suitablecuring way, a study case has been done. Materials & Methods: This study considers the patients who had eaten plaster and been rushed to the Shohaday-e Ashaer Hospital of khorramabad from 1997_2000. The research method was cross_ sectional and performed on 40 patients by using a questionaire cantaining a variety of questions about demographic situation of sick person, signs & symptoms, remedy techniques, and outcome. 37.5% of patients were women and 42.5% were men, the most people who had attempted to suicide with plaster were teenagers (45%). This suiciding still has spread in summer time. And the majority of patient were students (%37.5). Half of victims have been treated to gastric washing by normal salin and among 20 patients only one person needed a surgery. The number of patients who (that) needed operation were 7, totally. (laparatomy, gastrotomy, excision of plaster mass- gastroraphy) Half of the patients were any signs & symptoms, but in symptomstic patients abdominal pain was the most common symptom and abdominal mass was the commonest sign (17.005), and just one case was death, that intoxincated with organophosphate poisoning at the same time. Conclusion: It seems gastric washing by 2 lit of normal salin immediately at the bigining of treatment ,then applying conservative management and following up by daily examinations and taking plain abdominal X-RAY consecutivly, is a suitable cure method to save such patients, and surgery is just used for patients who have signs of intestinal and gastric obstruction or mass- abdomen

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Background: Vasectomy is a safe and effective method to prevent fertility. This method is practical in most regions, because it does not require complex technology. In spite of this, in some regions of Iran, It has not been approved because of the general believe that vasectomy causes impotence. Materials and Methods: In this cross-sectional research, 110 persons who were underwent vasectomy in Khorram Abad during 1999-2002 time period were studied. Variable parameters including libido, impotence, granuloma, ejaculation problems, joint pain, sleep disorder, chronic pain, surgery regret and surgical failure were considered. The required data were collected by questionnaire and physical exam. Findings: After necessary evaluation of the cases, it was found that 60% of individuals had not any libido variation and 30% had increased libido, 85.5% of them did not have impotence, 85.5% of them did not have granuloma, 90.9% of them did not have joint pain, 89.1% of them did not have ejaculation problems, 90% of them did not have mood disorder, 95.5% of them did not have sleep disorder and 80% of them did not have chronic pain in the site of surgery. 97.3% of them did not regret of vasectomy. Surgical failure was not seen in any cases. Conclusion: It was found that vasectomy is an effective and successful method to prevent fertility. In most cases it has not side effects such as libido reduction, impotence, granuloma formation, etc. A few cases of side effects may be due to other factors. For better evaluation of long-term effects of vasectomy, a case- control study is necessary.

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Background: Nurses have a major role in continued care and health promotion. Thus, their productivity is very important. Although many factors affect productivity, but evaluating the personnel's perception about it has a pivotal role in productivity improvement. Moreover, evaluation is a factor that can facilitate or impede productivity. Materials and Methods: This study was done in qualitative mode. Purposive sampling and open interviews were done to gather data. Content analysis approach with constant comparative analysis was used to analysis data. Findings: Nurses consider productivity both quantitatively (efficiency) and qualitatively (effectiveness). But most of them think about productivity from qualitative view. They consider the effective care which they provide to patients. One of the factors facilitating or impeding productivity is evaluation. Effective evaluation can increase productivity, and current barriers impede nursing team productivity from their viewpoint. Conclusion: Effective evaluation can improve productivity. Thus, it is suggested that current evaluation process be revised extensively.

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Background: Mucocele of the appendix is a clinical term for a pseudocyst that is associated with mucus extravasation into the surrounding medium. This may be the result of neoplastic causes. Case Presentation: Two cases of the mucocele of the appendix at Golestan hospital of Ahwaz were found. The first case was a 70 years lady who complained of the pain in lower part of her abdomen since 1 year ago. The patient suffered from constipation. In physical examination, there was fullness in RLQ and right flank. In complementary investigation, sonography showed a cystic mass with solid component in lower pole of right kidney with the diagnosis of mesenteric and hydatic cyst. In Abdominal CT scanning, there was duplication cyst and mesenteric cyst. The Second case was a 38 years man with chief compliant of abdominal pain since 5 days ago that was localized in RLQ with anorexia. In complementary investigation there was leukocytosis (11000 cells/µl). In sonographic examination, there was a cystic mass in RLQ with the diagnosis of appendiceal abscess. The patients were underwent operation. In both cases we observed mucocele of appendix. The pathologic report was also indicative of benign mucocele of appendix. Conclusion: appendiceal malignancies are extremely rare. The two above-mentioned new cases presented with abdominal cystic mass and abdominal pain. A mucocele of benign etiology is adequately treated by a simple appendectomy.

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Abstract Background: Medical errors are among the main problems of health and treatment in the world which are responsible for mortality and psychophysical complications in patients, families, and even in the society each year. Medical errors have been increasingly taken into consideration in different countries. Different strategies have been explored to prevent medical errors, one of which is undergraduates education. The aime of this research is to study the current status and the necessity of medical errors education as one of the curricula from viewpoint of general practitioners in Lorestan province graduated from different universities. Materials and methods: A questionnaire was designed and distributed among 200 GPs in Lorestan province to be completed, then data were analyzed using SPSS software. Results: The results of the survey indicated that 90% of the GPs have not been taught any courses entitled medical error prevention. Moreover, 64% had committed medical errors before graduation, out of which 47.5% had been diagnostic errors. Additionally, 60% has committed medical errors after graduation, out of which 51% has been errors in disease diagnosis. 72.5% of them stated that have not taken any education about medical errors after graduation, 88.5% considered medical error prevention education as essential, and 40% believed that the education have to be restricted to diagnostic errors. Conclusion: Regarding the results of the present study and the importance of the topic, teaching medical error prevention as separate credits is highly recommended for medical students, as well as GPs need to be taught related education.

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Tabatabai SA1, Hashemi SM2, Ahmadinejad M3 1. Associate Professor, Department of Thoracic Surgery, Esfahan University of Medical Sciences, Al –Zahra Hospital 2. Assistant Professor, Department of Thoracic surgery, Esfahan University of Medical Sciences, Al –Zahra Hospital 3. Assistant Professor, Lorestan University of Medical Sciences, and Resident of Thoracic Surgery, Esfahan University of Medical Sciences, Al –Zahra Hospital Abstract Background: The primary ectopic goiters of mediastinum, specially of posterior mediastinum is rare and estimated on 1% of the goiters of retro sternal and mediastinum and their blood supplies is from intra thoracic vessels. Case presentation: We introduce a patient who referred with the complain of a huge mass in the anterior medistinum. His complain presented by dyspnea breathlessness and chronic cough at first. This mass was removed easily through collar incision and partial strernotomy. Throught surgery we found that blood supply of mass arised from thoracic vessels and inominate artery, with drainage to inominate vien. Following mass removal, all the symptoms of the patient were resolved. Conclusion: we presented an uncommon true primary ectopic mediastinal goiter resected through a median strnotomy with complete excision and relief of all symptoms.

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Yarahmadi B1, Mahdavi HR2, Moaydinezhad A4 1. Research Instructor, Department of Animal Products, Lorstan Research Center of Agriculture and Natural Resources, Khorramabad, Iran 2. Research Assistant Professor, Department of Animal Products, Karaj Animal Science Research Institue, Karaj, Iran 3. MSc in Biotechnology, Department of Agricultural Biotechnology, Hamadan Bou Ali University, Hamadan, Iran Abstract Background: The primary quality of raw milk is affected by several factors including animal nutrition, animal health, milk components, and its bacterial activity and these factors are effective on the final products. Therefore, the quality of raw milk depends on time and milk condition from production to delivery. In Lorestan, 97% of the milk production is obtained from rural and small units. This study was carried out to determine the factors affecting the bacteriological quality of raw milk from letdown phase till delivery to factory and to find out the critical points of bacterial contamination in the years 2003 and 2004. Materials and methods: In this study, the collecting centers of raw milk with a capacity of more than 3 tons, between 1.5 to 3 tons, and fewer than 1.5 tons were included as the centers with high, moderate, and low capacity respectively. The sampling stages consisted of cow milk letdown, milk collecting equipment, milk collecting tankers, milk cooling tanks, and milk delivery to factory. Microbial experiments consisted of standard plate count (SPC), E. coli, and coliforms. All the collected samples were 45 ones in each month and 540 samples in a year. Being converted to Log10, the data were analyzed by the SPSS software (version 11.5) and GLM procedure was used to determine the effects of month, capacity of centers, and sampling stages. Results: Based on the results of the study, the average total count (TC) in all seasons in Lorestan province was 6.43 0.37cfu/m. The effects of month, capacity of centers, and the sampling stages on TC, E. coli, and coliforms were statistically significant (p<0.01). Additionally, the lowest TC (6.31 0.38cfu/m) was in January while the highest (6.57 0.31cfu/m) was in August. Moreover, the decreasing trend of TC started from September and was the lowest in January and February. Correlation coefficients showed that there was a significant positive correlation between TC and E. coli (r=0.79) and TC and coliforms (r=0.90, p<0.01). Conclusion: The major problems of milk collecting in Lorestan province are the long distances of some milk collecting centers from the milk factories as well as the long milk delivery time which play important roles in increasing TC from letdown stage till delivery to factory in addition to the insufficient road facilities in some of the villages in Lorestan province.

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Background: Borderline Personality disorder is a disabling disease affecting 2% of general population. Various drugs have been suggested for treatment of borderline Personality disorder. If a drug could alleviate a wide range of symptoms, it would be more suitable. In these disorders drug addiction is very common. This fact makes the symptoms complicated and the treatment more difficult. This study is designed to evaluate the effect of Olanzapine and Sertraline in patients suffering from personality disorders who are on methadone maintenance therapy.

Materials and Methods: This clinical trial study was carried out on 120 male and female cases chosen for methadone maintenance therapy through interview by a psychiatrist based on DSM-IV-TR diagnostic criteria for BPD. Afterwards they were randomly divided into two groups. These groups separately received Olanzapine (5-10 mg daily) and Sertraline (50-100 mg daily) therapy. The SCL-90 questionnaire was filled out by the participants before treatment and at the 4^th, 8^th and 12^th weeks of the treatment.

Results: According to this clinical trial, Olanzapine and Sertraline were effective in ameliorating symptoms of depression, anxiety and aggression, reducing sensitivity in interpersonal relationship and alleviating obsessive symptoms, pessimistic behaviors and somatization disorders in patients with personality disorders on methadone maintenance therapy.

Conclusion: As results of this study stated that Olanzapine and Sertraline are definitely effective in alleviating symptoms of patients with personality disorder, prescribing theses drugs are highly recommended for these patients.

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Background: Theophylline is one of the oldest drugs that is used to treat asthma and COPD. Theophylline metabolism can alter by some of the drugs and diseases. Severe theophylline side effects are usually related to plasma concentration higher than 20 mg/L. The present study was done to determine aminophylline clearance and the drug use evaluation in Afzalipour hospital.

Materials and Methods: In this cross-sectional study 21 asthmatic or COPD patients were enrolled. 2 blood samples were drawn at 15 minutes and 24 hrs after completing aminophylline loading dose and starting maintenance dose infusion. Serum theophylline concentration were determined using HPLC and drug clearance was calculated by Chiou methods and compared with theophylline clearance based on population pharmacokinetic study.

Results: Mean patients age were 57±18 years. Mean theophylline concentration in the two samples were 9.1±4 and 5.1 ±3.3 mg/L respectively. Our patients clearance was 4.2±2.2 L/hr and there was no statistically significant difference with theophylline clearance (3.1±1) based on population pharmacokinetic study (P=0.075).

Conclusion: Based on our study there was not rational and logical usage of aminophylline in the our patiens. In 62% of the patients’ serum, theophylline level were less than 5 mg/L. It is suggested that Therapeutic Drug Monitoring must be used in patients who receive intravenous aminophylline specifically in the critically ill patients, to prevent drug toxicity and to ensure about drug efficacy.