Ardabil University of Medical Sciences
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Health Literacy and its Relationship with the medical, dietary Adherence and exercise in Patients with Type II Diabetes mellitus
Get PDFBackground and objective: Medical, dietary adherence and exercise plays a key role in the control of diabetes, and health literacy is a decisive factor in patient's adherence. The aim of this study was to determine the health literacy and its relation with medical, dietary Adherence and exercise in Patients with Type II Diabetes mellitus.
Methods: This analytical- descriptive study was conducted on 241 patients with type II diabetes referred to Imam Khomeini Hospital of Ardabil city in 2017 who were selected by simple sampling method. Tools for data collection was demographic Test of functional health literacy of adults (TOFHLA), Morisky 8-Item Medication Adherence (MMAS-8) and dietary Adherence and exercise, questionnaires. For data analysis, descriptive statistics (mean, standard deviation and frequency distribution) and analytical statistics (one-way variance, independent t test and Pearson correlation) by SPSS were used.
Results: The mean(SD) age of patients was 55.17 (10.15). The overall score of health literacy, medical adherence and adherence to diet and exercise were 52.51 (17.60), 2.96 (1.89) and 57.15 (14.35), respectively. 128 patients (53.1%) had inadequate health literacy. Health literacy was significantly correlated with medical, dietary Adherence and exercise(p< 0.05).
Conclusion: Health literacy is effective on medical, dietary Adherence and exercise of patients. Therefore, it seems to be essential to pay attention to education and promotion of health literacy by Mass media and healthcare custodians
Unilateral shortening of third metacarpal bone in a patient with tuberous sclerosis
Get PDFA 33-year-old woman with a history of hypothyroidism and celiac disease presented with symmetric in- flammatory polyarthritis. She had no history of seizure. She presented with multiple angiofibroma on the
left side of the face and in the back (Figure 1a, b) with bone cysts in phalanxes, which were indicative of tuberous sclerosis with normal neurologic findings. Kidney ultrasonography showed cortical nephrocalci- nosis. We observed shortening of the third metacarpal of the left hand during physical examination and radiography (Figure 2a, b). Inflammatory tests showed positive ANA=39.1 IU/mL (using ELISA with normal range <20), CRP: 3+, and ESR: 52. She had no history of hand trauma or surgery. After full evaluations and treatment of arthritis, the patient was discharged symptom free with normal nflammatory marker
The Role of Fluconazole Prophylaxis Regimen and the Regimes Chosen by the Patient’s Risk of Fungal Infection in Reducing the Infection Rate after Bone Marrow Transplantation
Get PDFObjective: Invasive fungal infections (IFI) in bone marrow transplant (BMT) recipients are common and lethal. Fluconazole was the choice prophylaxis previously, but recent strategy utilization antifungal drugs according to the risk of IFI in patients undergoing transplantation. In this study we aim to evaluate the efficacy of fluconazole prophylaxis regimen and the regimes chosen by the patient’s risk of IFI. Materials and Methods: We evaluated 376 patients with BMT. Patients were divided into those treated before 2012 with fluconazole prophylaxis (group I, n=206) or those undergone transplantation after 2012 and received fluconazole, voriconazole and posaconazole prophylaxis according their risk of fungal infection (group II, n=170). Results: Group I was significantly younger (p=0.007), less smoker (p=0.01), received more autologus transplant (p=0.001) and mostly high risk patient for infection (p<0.001). Group I had significantly higher duration of fever (p=0.004) and increased WBC (p=0.02), longer length of stay (p=0.001), more proven and less probable fungal infections (p=0.008) and higher hepatic complications (p=0.003). There was no significant difference in fungal related and overall mortality rate between groups. Conclusion: The use of prophylaxis
based on risk of fungal infection in patients undergoing BMT results in reduce fungal infections, duration of fever and accelerate the engraftment and patient discharge
An unusual presentation of a papillary thyroid carcinoma in thestruma ovarii in a 10 year-old girl: A case report
No full textIntroduction
Struma ovarii is an ovarian tumor with thyroid tissue as its predominant component. It usually occurs in older women and presents with abdominal mass, pain and abnormal bleeding. Most patients are euthyroid, but some reports have noted thyrotoxicosis originating from the malignant struma ovarii.
Presentation of case
A 10 year-old girl presented with tachycardia, normal thyroid exam and thyrotoxicosis. Thyroid scan showed no uptake with increased uptake in right ovary indicative of struma ovarii. The patient underwent oophorectomy and thyroidectomy, Pathology showed papillary thyroid carcinoma limited to the struma ovarii. Following TSH suppressive therapy and treatment with I131, she is totally symptom free.
Discussion
Struma ovarii should be a possible diagnosis in any female patient with thyrotoxicosis manifestations with normal thyroid scan and examination
wsp-based analysis of Wolbachia strains associated with Phlebotomus papatasi and P. sergenti (Diptera: Psychodidae) main cutaneous leishmaniasis vectors, introduction of a new subgroup wSerg
No full textSand flies of Phlebotomus papatasi and P. sergenti are the main vectors of cutaneous leishmanisis (CL) in the old world. We aimed to screen Iranian P. papatasi and P. sergenti for their natural infections with Wolbachia and to determine their phylogenetic association with other species. Wolbachia surface protein (wsp) gene was PCR amplified from DNA extracted from Phlebotomus species, sequenced, and were analysed in combination with wsp sequences related to Phelebtominae and other insects. All Wolbachia-infecting Iranian sand flies of P. papatasi and P. sergenti were classified in the Supergroup A., Wolbachia isolated from P. sergenti were clustered in a new subgroup within Supergroup A so-called wSreg. The Wolbachia strains identified from the P. papatasi clustered mainly in the subgroup wPap and partly in wSerg. Multiple Wholbachia infection within a single population of P.papatasi warrants investigation on existence and intensity of cytoplasmic incompatibility between the wPap and wSerg subgroup
Incidence of thrombocytopenia following phototherapy in hyperbilirubinemic neonates in Ardabil City
Get PDFBackground: Jaundice is one of the most common problems in neonatal period. In 60% of term and 80% of preterm neonates are seen during the first week of birth and most cases are physiologic. Hyperbilirubinemia is the most common cause of jaundice in newborns. Phototherapy is used to treat it, which seems to be safe. Some studies showed that thrombocytopenia is one of the side effects of phototherapy. The aim of this study was to investigate the relationship between thrombocytopenia and phototherapy in newborns.
Methods: This is a descriptive study that has been done on 100 neonates with jaundice which requiring phototherapy. A blood sample was taken at the admission time, 24 hours late, end of the phototherapy and 48 hours after the end of phototherapy to measure the bilirubin and the number of platelets along with other necessary tests for the study of hyperbilirubinemia. Data collected by a checklist and analyzed by statistical methods in SPSS version 19.
Results: Of all neonates, 55% were boy and 45% were girl with mean age of 8.86 days. The mean platelet count before phototherapy, 24 hours late, at the end of phototherapy, and 48 hours after phototherapy were 298170, 288540, 282620 and 266310, respectively which was statistically significant during time.
Conclusions: The results of this study showed that phototherapy can lead to a significant reduction in platelet count in newborns. Also, there wasn’t seen any case of thrombocytopenia following phototherapy in the present study
Measurement of blood lactate levels during cardiopulmonary bypass pomp in patients undergoing Coronary Artry Bypass Graft opration with Mean Artial Pressure between 50-70 mmhg
Get PDFBackground and objective : Continuous blood flow during CPB causes low blood circulation and tissue hypoperfusion. Blood lactate is a good indicator of the adequacy of oxygen supply. For this purpose, lactate level monitoring during cardiopulmonary bypass should be provided with accurate information on tissue perfusion during cardiopulmonary bypass. The purpose of this study was to measure the level of lactate in the blood during cardiopulmonary bypass to determine the adequacy of the pump and the cardiac output.
Methods: In this cross-sectional, analytical and randomized study, 30 patients underwent CABG. The demographic data were collected from patients including age and sex. Then, for each patient, the data were recorded and during the operation, a blood sample of 3 ml At the beginning and the end of the pump and then the pump when entering the ICU was prepared to measure blood lactate levels. The time of pump and Map, pH, Pao2 and Paco2 was measured during the pump.
Results: 18 patients (60%) were female and 12 patients (40%) were male. The mean age of the patients was 60/73+/-12/08 years with a range of 34-83 years. Blood lactate levels increased during CPB and had a significant relationship with cardiac output, pump time and mean artrial pressure, but no significant correlation was found between pH, Pao2 and Paco2.
Conclusion: Blood lactate monitoring in patients undergoing CABG during Cpb has high sensitivity and specificity to determine the adequacy of the pump and the rate of cardiac output. Further studies are proposed in a wider range of sample sizes and a wider range of patients in operations Follow up of different surgeries
Comparison the Effect of Vaginal Isosorbaid Mononitrat and Estradiol on Cervix Ripening in Term Pregnancy: A controlled clinical trial
Get PDFBackground and objectives: Cervical ripening usually starts before the onset of labor contractions and it is necessary for dilatation and embryo passage. Considering the importance of vaginal delivery and risk reduction of cesarean, cervical ripening in pregnant women is a priority for Gynecology.
Methods: This double-blind randomized clinical trial was performed on 99 pregnant women over 40 week’s gestation who admitted to Alavi hospital in Ardabil. Participants were randomly allocated in to three groups of isosorbide mononitrate, estradiol and placebo, tablet were placed in the posterior fornix, out-patiently. All three groups were hospitalized after 12 hours. Because of Bishop scores (BS) less than 6, the previous doses were repeated in all groups. Examination of the cervix every 2 hours and blood pressure and the heart rate of the mother were performed every 4 hours. Data were analyzed using SPSS software (version 16), one way ANOVA, Chi-square and Kruskal-Wallis tests. (P <0.05) was considered meaningful.
Results: There were no significant differences in demographic characteristics of the three groups. The results showed that the time of cervix preparation in Isosorbide and Estradiol groups was similar (p=0.381), but it was significantly shorter in both than placebo (p=0.016). Isosorbide and Estradiol also increased cervical Bishop Score. There was no significant difference in duration of active phase of delivery among the groups (p=0.860). Despite of higher cesarean frequency in the placebo group, no significant difference was observed in the method of delivery between three study groups (p=0.484). The drugs side effects were higher in Isosorbide and Estradiol groups compared to placebo. The most common side effect of Isosorbide was hypotension and headache, and the Estradiol was headache.
Conclusion: Isosorbide mononitrate and Estradiol changed Bishop Score, and reduced preparation time to delivery. Both drugs reduced the hospitalization time to delivery, cost of delivery induction, and improved delivery experience; without need to any aid instruments or surgery