فهرست مطالب مجتبی تیموری

 The ureteral stent is one of the most useful devices in urology to remove obstructions that can cause problems for the patient. This study was conducted to determine the effects of lettuce on improving symptoms caused by stents.

 The clinical trial included 60 male participants with ureteral stones who were treated with ureteroscopy and stone fragmentation through the urethra. Urinary symptoms were evaluated using the USSQ questionnaire initially and again two weeks after the intervention. The participants were divided into two groups: the intervention group, which received tamsulosin and lettuce extract, and the control group, which received tamsulosin and a placebo. Statistical analysis was performed using SPSS software, utilizing appropriate statistical tests with a significance level set at 0.05.

 The average age of the patients studied was 44.6±14.5 years. For the control group, the initial mean score for urinary symptoms was 26.64±3.13, which decreased to 16.58±2.84 two weeks after the intervention. In the intervention group, the initial score was 28.27±5.05, reducing to 15.68±2.42 post-intervention. There was a statistically significant difference noted within each group (P=0.001). However, between the two groups, no statistically significant difference was observed either before (P=0.136) or after the intervention (P=0.198).

 In the comparison of the two groups, lettuce did not demonstrate a significant effect on reducing urinary symptoms in the study subjects after the intervention. This issue can be due to the small sample size, the short duration of the study, the underlying disease of the patients and the type of lettuce planted. Future studies with longer duration are recommended.

In the recent few years endometriosis has been identified as the third common gynecologic disease among the women aged 15 to 44 years old having been discharged from the hospitals. Not only does this disease cause pains, dysmenorrheal, abnormal bleeding and infertility, but also it reduces the quality of life and produces depression leading to expending much more on thetreatment. In this study we tend to evaluate the common complaints about the disease and find out about the most engaged sites through reviewing our laparoscopic findings. Our descriptive cross-sectional study was conducted prospectively. The study group were selected among the patients of Najmieh Hospital from March, 1996 to March, 2006. Those patients with the chief complaints about chronic pelvic pains, dysparonia, dysmenorrheal and infertility, as diagnosed by a surgeon, underwent the laparoscopy surgery. Then, a pathologist confirmed the diagnoses through biopsy. Those patients with only clinical diagnosis or without any pathology results recorded were excluded from the study. For each one of the subjects, data on surgical and demographical findings were collected using a questionnaire that contained questions about demographical background, the chief complaints, the engaged site and the surgeon’s findings. The average age of the participating patients was 28.7±6.2 with a minimum of 17 and a maximum of 49 years old. The chief complaints were recorded about: 43% primary infertility, 24% chronic pelvic pains, 14% having a cyst resistant to the treatment, 8% secondary infertility, 7% dysmenorrheal, 4% recurrent abortion and vaginal hemorrhage. The incidence of endometriosis was found to be 28% in this study. The most affected sites by endometriosis were anterior and posterior choledosac in 12 and 16 cases, respectively; the right ovary and the left one in 7 and 11 cases, respectively; and the left and right tubes were respectively affected in 10 and 6 cases. According to the findings of this study, pelvic pains are the most prevalent incident of the clinical complications related to endometriosis. So, it is recommended here that those women complaining about pelvic pains undertake laparoscopic surgery to avoid the negative consequences on their married life as well as on the quality of their social life. Also, further studies are needed to confirm the unlikelihood of the effect of endometriosis on infertility.

Although the prognosis of advanced ischemic heart disease is poor, coronary artery bypass grafting in patients with severe left ventricle dysfunction remains controversial. This study was performed with the aim of evaluation and comparison of the surgery results and survival in these patients, regarding left ventricular function and the dysfunction degree. This retrograde cohort study was performed on 1024 patients who underwent coronary artery bypass graft in one of Tehran's hospitals from February of 2003 to February of 2007. Patients were divided into two groups with or without left ventricular ejection fraction lower than or equal to 35%. Data were analyzed using descriptive statistical indices and Kaplan-Meier and Cox regression analysis SPSS 17 software. One year survival rate was 90.1% for group who suffered from severe left ventricle dysfunction and 99% for the group without left ventricle dysfunction and there was no significant difference between two groups. The hospital mortality rate was 1.4%. Age, left ventricle dysfunction, renal failure, hypertension and NYHA III & IV functional classes had great impact on patient survival but effects were not significantly different between two groups. Coronary artery bypass grafting can be performed safely on patients who suffer from severe left ventricular dysfunction, with a good short-term survival. Although adverse cardiac outcome and mortality rate is higher, it seems to have potential treatment benefits for patients.

Patients who continue smoking after coronary artery bypass graft experience more risk. Smoking results in decrease in quality of life and increase depression furthermore of Somatic problem. Unfortunately 50 to 75 percent of patient continues smoking. Smoking cessation is the best way for preventing sudden death and investigating effective way is important، so we decide to evaluate this problem. Level and quality of smoking confirmed by DSM IV- TR. Patient who undergone CABG 2010 enrolled. Fagrshtrom smoking cessation questionnaires completed by patient before and one month after surgery. Patient randomized in two groups. First group used nicotine patch and second group were in control group. Nicotine patch administered in 3 doses 15 milligrams in first week، 10 milligram in 2nd week and 5 milligram for next 2 weeks. Smoking cessation in nicotine group significantly were higher than control group after one month after trial. (35. 71 percent versus 16. 66 percent، P=0. 001) It seems nicotine replacement therapy is valuable way in short term especially in patient with non favorable clinical status. We see some weight gain in some patient and seem it be a valuable way by educating technique.

One of the most common causes of fear from the surgery in patients is post operative pain. Opioid analgesic and NSAIDs are commonly used to relieve pain in patients. Both groups have some side effects. In this study we evaluated the local anesthetic effect of bupivacain in pain relieving after cesarean section. This clinical-trial study was performed on 100 pregnant women who were referred to the Najmiyeh hospital in Tehran, Iran, for cesarean delivery. Pregnant women were randomly divided into two equal groups. Case group was injected bupivacaine 0.5% (10 ml subcutaneously) after the cesarean delivery. Pain Intensity was evaluated in 1st, 2nd, 4th, 6th, 9th and 12th hours after caesarean operation using Visual Analogue Scaling (VAS). Sedative (Petedin) consumption was measured and was compared in both groups. Results were analyzed using student t-test and Mann- whiney test. The results of this study demonstrated that mean analgesic consumption in case group was 25.63±16 (mg) and it was 35.05±13.6 (mg) in control group (P<0.05). Mann- Whitney test demonstrated that pain intensity is significantly lower in case group in 4th, 6th and 9th hours after cesarean operation compared to the control group. The data of this study shows that bupivacaine 0.5% can have a good sedative effect after cesarean operation.

The prevalence of cesarean section in our country is growing. Our aim was to investigate the education and attitudes of obstetrics team toward the preferable delivery method in some selected educational hospitals in Tehran. The population under investigation in this descriptive cross-sectional study was a group of interns, gynecology residents, obstetricians, midwifery students, and midwives working in delivery wards of Baqiatollah, Najimeh, Shariati, Imam Khomeini, and Bouali hospitals in Tehran. The questionnaire included patient's demographic data, individuals’ attitudes toward delivery methods and their willingness to cesarean section, their knowledge about delivery methods, and their satisfaction with the education they received during academic years. Data was analyzed by SPSS software using Chi², Fisher exact test, ANOVA, and Mann Whitney. Fifty two cases of cesarean out of total 103 deliveries, provides an approximate rate of 50.5% cesarean among the medical population. The amount of education received during academic period was reported as perfect and comprehensive by 17.7% of them and 26.4% mentioned normal delivery as a better method for delivery. The increase in the willingness of medical society toward cesarean section compared to other countries in an unbelievable manner, counts for their poor level of knowledge about benefits and deficiencies of cesarean as well as the dissatisfaction of students and graduates of medical disciplines with received educations. Medical and midwifery education administrators should regard this matter seriously.

many factors such as a diabetes, hypertension, hyper lipidemia, smoking and occupational stress are in association with atherosclerosis. Up to now there isnt and study about risk factor differences between military occupation and non millenarian. Therefore we designed this study to investigate these differences.

in this cross-sectional study all patient had angiography, angioplasty or CABG in year of may 2006 to may 2008 in Baqiyatallah or Shahid rajaee hospital were investigated. We collect data by face to face questionnaire based material. Our variable include age, sex, smoking, hyper lipidemia, diabetes, psychological history, chemical weapons exposure, first line standing.Results. form 196 patient referred to Baqiyatallah and Shahid rejaee 2 patient were excluded, from 194 left, 132 (68%) were non military and 62 (32%) had military occupation. average age of CABG was 51.5 in miltaries and 57.5 in non militaries hypertension and diabetes were more common in non military occupation and smoking and psychological histories were more common in military occupation. All patent undergo CABG were male.Conclusion. in patient undergo CABG and who had chemical weapons exposure hand less average age that maybe because of military occupation and its occupational life style or because of exposure with chemical weapons that result in cardiovascular disease in lower age.

AIDS has been regarded as a great health problem in many countries in the recent years.By the end of year 2003 about 44 million people were reported to be infected by HIV. There are about 14000 patients in Iran who have been identified with the virus and it is estimated that there might be about …… more who haven’t been identified, yet. Regarding a change of the population being infected by the disease from IV drug abuser to those involved in high risk sexual relations, this study tends to pay attention to the population of women who are at risk. Furthermore, there are not many studies that have examined women‘s knowledge about the disease; therefore, we decided to carry out this study because of the important role of women as mothers in Iranian sociality who play an educating role in their families. We conducted a cross sectional study on 500 women who came to the hospital for gynecologic/ obstetrics periodic checkups. A questionnaire was developed after pre-testing and standardization, which asked the participants about their gender, age and occupation as well as whether they knew someone close to them with HIV/AIDS. A five-ranking scale was used to score the answers. Using SPSS software version 14, the data were analyzed and a test of logistic regression revealed significant results in terms of their age, education and knowledge about AIDS (p<0.01). The average age of the participants 500 was 33.4±5/6 with Confidence Interval of 95%, ranging from 14 to 62 years old. Most of the participants were married (80.1%; N=407). In terms of their knowledge about AIDS on a 5-level scale, the results ranked as: excellent (12.2%), good (24.6%), moderate (43.4%), weak (43,2%) and bad (5,6%). There were significant relations between the level of knowledge and education level (p=0,000) as well as that and age (p=0.00). There was not any relation between the participants’ job and their level of knowledge about AIDS (p>0.1). In our study, juvenile showed to have more knowledge about AIDS that can attribute to the education they have received. With a special attention to this age group, their knowledge about sexual relations and using the same needle as the most frequent ways of spreading the infection was good. With respect to the Participants’ ideas, it seems TV is the best way of education. Thus, it is recommended that a medical team, including physicians educate women in occasions such as a pre-natal care period and pregnancy visits.