Shiraz Emedical Journal
Volume:14 Issue: 2, Apr 2013

Postpartum hemorrhage is an important cause of maternal morbidity and mortality. There are some active and physiologic methods for management of third stage of labor. This study is aimed to evaluate and compare the efficacy of intraumbilical vein injection of oxytocin and placental cord drainage in the management of third stage of labor. In this prospective clinical trial, 152 women received 20 ml of a 0.9% saline solution with either 20 units of oxytocin injected in the umbilical vein after clamping (Group A, n = 51), placental cord drainage (Group B, n = 50) or no intervention (Group C, n = 51). The primary outcome was mean duration of third stage of labor. The third stage of labor was significantly shorter in group A and B as compared to group C (3.50, 3.54 vs. 5.16min, P = 0.001). There were no reports of need for manual removal of placenta or retained placenta. The use of intraumbilical injection of oxytocin and placental cord drainage in the third stage of labor significantly reduced the duration of the third stage.

Attention-deficit/hyperactivity disorder (ADHD) is a fairly common disorder. Given the high prevalence of this disorder in children worldwide and its adverse effects on the quality of life of themselves and also their parents (especially their mothers we decided to study the quality of life these mothers. 100 cases were selected from the mothers of the children with ADHD referring to Hafez psychiatric clinic in Shiraz. The control group was randomly selected from the mothers of healthy 4th grade primary school students and matched with the case group. Quality of life was evaluated in both groups by use of “the short from health survey” (SF-36). In comparison of health-related quality of life in mothers of children with ADHD and the control group based on the number of children, in the case group the Physical functioning (PF), Role limitation Physical problems (RP), Bodily pain (BP) and General health (GH) dimensions and Physical Component Summary (PCS), had a higher mean score with the higher number of children; but the relationship was significant only in the PF dimension.In the Vitality (VT), Social functioning (SF), Role limitation Emotional problems (RE) and Mental health (MH) dimensions and Mental Component Summary (MCS), the mean score were lower with the higher number of children. The relationship was significant in the VT, SF and RE dimensions and MCS. This study shows that the quality of life in mothers of children with ADHD is significantly lower than the control groups. Also, age of the mother and the number of affected children had a significant effect on further diminishing their quality of life. However, higher education can be considered as a protective factor in these mothers. Employment, although increases the quality of life in some dimensions (e.g. physical functioning), decreases it in some others (e.g. body pain).

Patient satisfaction is an important indicator of quality of care and health facilities. It is a predictor of patient willingness to follow treatment regimen. The major predictor of patient satisfaction with hospital care is patient satisfaction with nursing. The main purpose of this study was to determine efficacy of transactional analysis training on inpatient`s satisfaction of nurses. At first, hospitalized real patients and standardized patients completed satisfaction questionnaire about nurses. The mean of scores for all nurses was calculated. Nurses were divided to two groups: 1-nurses with scores higher than mean 2-nurses with scores lower than mean. Then in each group nurses were divided to two subgroup randomly: case and control group. Participants in the intervention group received a brief training about Transactional Analysis (TA). Inpatients real patients and standardized patients `satisfaction was followed up after one week, one month and three month. Application of the education intervention program provided a desirable effect by improving inpatients` satisfaction. There was a significant difference between case and control groups’ scores, one week after TA education. Although one or three months after TA education, the mean of scores were higher in case group than control group, these differences were not significant. Although brief education intervention program improved inpatients` satisfaction in short term, this positive effect was not continued after one and three months later. It is likely for earning long term positive effect of TA training on inpatients’ satisfaction; this educational program must be more extended or repeated in reasonable intervals.

We assessed the dimensions of health related quality of life (HRQOL) in our area, Shiraz, Iran. In this cross sectional study 300 diabetic patients of both types (I, II) in two specified diabetic healthcare centers and two hundred concomitants of the patients as healthy individuals were enrolled conveniently. Reliable and valid Persian SF-36 questionnaire were used for assessing HRQOL. Data were entered in SPSS 15 and p value less than 0.05 was considered to be significant. Difference of scores between patient and control group in scales of physical functioning, physical problems, body pain, general health perception, social functioning, emotional problems, p-value were less than 0.001 while for vitality p-value was 0.102 and 0.200 for mental health. HRQoL scores of two genders did not differ significantly in patients. There were significant linear correlation between age, educational state, duration of disease and some aspects of QOL. Difference of mean score of HRQOL in different marital status was statistically significant in some scales. Diabetic patients in our study had lower scores in all scales of HRQOL when compared with control group. Worst score in patient group was attributed to general health perception. Mental status was influenced in patients group in this study. Some patients indicated they feel downhearted and blue and some mentioned they felt so down in the dumps that nothing could cheer them up. lower HRQOL in diabetic patients needs to be addressed by special appropriate actions and interventions. These actions should be first studied regarding efficacy and cost effectiveness and if these interventions addressing individuals, requires mention to health literacy of population.

Visceral leishmaniasis (VL) or Kala-azar is a parasitic disease caused by a protozoan of Leishmania genus and in Iran by Leishmania infantum. Cytokines have a major role in determining progression and severity of clinical manifestations in VL. The role of TGF-β1 in VL has been recognized since 1992. We investigated polymorphism in the TGF-β1 gene, which is a cytokine known to have a role in onset and severity of the disease. This descriptive and cross-sectional study was done on 85 pateints with confirmed VL, 106 healthy seronegative controls and 99 seropositive controls. Salting out method was used to extract DNA and the amplification refractory mutation system (AR1MS)-PCR procedure was used for detecting polymorphism at TGFβ1 (-509) C/T. The frequency of TGF-β1 CC, CT and TT genotypes among all subjects were 21.4%, 71% and 7.6% respectively. Statistical analysis of distribution of genotypes was performed using Chi-Square test and reveal a significant difference among groups (P = 0.00). To our knowledge this study demonstrates for the first time the association of the cytokine transforming growth factor-β1 gene polymorphism in Iranian patients with VL. Individuals with the transforming growth factor-β1 (-509) CT genotype may have increased susceptibility to Visceral leishmaniasis.

The quality of reporting Randomized Controlled Trials (RCTs) in the most prestigious scientific medical journals was investigated to show that what extent the items in the Consolidated Standard of Reporting Trials (CONSORT) 2010 checklist are addressed. In this cross-sectional study five the most prestigious scientific medical journals that they had high impact factor (IF) were selected including: Lancet, New England Journal of Medicine, British Medical Journal, Journal of the American Medical Association, and Canadian Medical Association Journal. Ten randomized controlled trials in 2011 and 2012 were selected randomly from each journal. The percentage of items in the CONSORT checklist for each study was investigated. The total percentage of items addressed by these studies was 74.06 (95%CI: 71.21, 76.90). We concluded that reporting of RCTs published in the top and the most prestigious scientific medical journals are not desirable and not enough yet.

Back ground: Rupture is a fatal complication of abdominal aortic aneurysm. An aneurysm is defined as ruptured when bleeding is present outside of the wall of the aneurysm.AAA is usually the result of degeneration in the media of the arterial wall, resulting in a slow dilatation of the lumen of the vessel. AAA is usually asymptomatic until they expand or rupture. Whether aortic rupture is due to AAA can only be ascertained though aortic imaging. Patients at risk for AAA are those who are male, old, have atherosclerotic vascular disease, collagen vascular disease or mycotic aneurysm. Chronic inflammations play an important role on AAA formation. Recently identified risk factor for aortic aneurysm in the pregnant woman is the use of crack cocaine. AAA is very rare in young females Crack cocaine users and pregnant woman are at increased risk of suffering from AAA. Cardiovascular complications related with cocaine abuse are adrenergic mediated, vasoconstriction, Include myocardial ischemia, infarction, myocarditis, thrombosis and aortic dissection. A 32 year old woman crack user, in 40 weeks pregnancy came to labor department. An emergency cesarean section was performed. She expired 13 hours after surgery. Autopsy detects dissection of abdominal aortic aneurysm. Sympathetic agonist and vasoconstriction effect of crack resulting increased blood pressure, heart rate, myocardial contractility would increase the risk of aortic dissection.

Primary hyperparathyroidism is a rare endocrine disease characterized by hypersecretion of parathormone. Giant cell tumor (GCT) of bone arising from a finger phalanx is an extremely rare phenomenon. We introduced patients with tumoral mass in the fifth proximal phalanx of their right hand. Although pathology findings indicated to giant cell tumor, she had hyperparathyroid adenoma and treated by parathyroidectomy. Neoplastic lesions gradually disappeared without further surgical interventions.