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Background: The present study was conducted to examine adverse pulmonary effects of exposure to cotton dust in Isfahan Materials and Methods: All employed workers of Bafnaz textile factory were studied by medical interview, physical examinations, and spirometry in symptomatic subjects. Frequency tables were used to extract major symptoms and pulmonary illnesses. Logistic regression analysis was used to evaluate relationships between illnesses and possible risk factors. Results: All workers had some potential exposure to cotton dust; mean employment duration was 18.20±5.34 years. Prevalence of chronic cough, chronic bronchitis, asthma, and byssinosis was 2.4%, 30.8%, 9.2%, and 3.9% respectively. Odds ratios (OD)and 95% confidence interval (CI)for prevalence of chronic bronchitis and byssinosis in those working in most dusty jobs, after adjustment for age, smoking habit and duration of employment were; 1.77 ( 1.10-3.04), and 1.41 (1.33-2.63) respectively. In these textile workers, chronic respiratory symptoms and disorders were associated with job category after correction for age and smoking habits. Conclusion: These data support the evidence for an increased prevalence of respiratory disease in populations exposed to cotton dust. (Tanaffos 2003; 2(6): 25-30)
Background: Deep Vein Thrombosis (DVT) and Pulmonary Thromboembolism (PTE) are one of the frequently missed and lethal complications in admitted patients. Unfortunately, in spite of the presence of consensus about prevention of DVT, these guidelines are not applied in most hospitals. Death rates from DVT and PTE are more than those of road accidents and breast cancer. Our study aimed to analyze the situation of DVT/PTE prevention in hospitals of Tabriz. Materials and Methods: Based on 75000/ year admission, we studied the records of 17 teaching wards in 7 hospitals systematically. At least 50 records from each ward were reviewed. Records with insufficient data; admissions of less than 3 days; heparin treated cases; uremic and cirrhotic patients; those with bleeding tendencies, and ENT, ophthalmology, pediatric wards were excluded. 1557 records were collected, and risk of DVT (low-moderate-high-very high) along with appropriate prevention method was stratified according to ACCP 1998 guideline for surgical ward. For stratification of risk factors in medical wards, comparable rate of prevalence of DVT/PTE was used for every medical condition. Results: Highest rate of DVT prevention was related to cardiology unit (63.4%) and lowest rate to thoracic surgery unit(2.7%). Appropriate prevention methods were related to cardiology (73.1%), pulmonary ICU (51.4%), and gynecology (42.3%). Inappropriate methods were related to neurology ICU, neurosurgery, and orthopedic wards (0%). Conclusion: This study shows that in spite of the presence of guidelines for prevention of DVT, and the importance of this in decreasing costs and mortalities, application of appropriate method in most wards is far from reality, and continuous learning of physicians about prevention of DVT and regular control of medical records by medicare is strongly recommended in order to reach a good endpoint. (Tanaffos 2003; 2(6): 31-37)
Background: Cigarette smoking is considered as the commonest preventable cause of morbidity and mortality. Materials and Methods: The present study shows that over a 2- year period, a total of 743smokers have been registered in monthly therapeutic and training courses of Smoking Cessation Clinic. They have received audio-visual training and behavioral therapy. For Nicotine Replacement Therapy (NRT), nicotine dependence of the patients was assessed by Fagrostrom Tolerance Test in the beginning of each course. Results: The test scores of 170 people (31.2%) were less than 7 (low nicotine dependence), and 376 individuals (68.8%) had scores of 7 or more (high nicotine dependence). At the end of the course, 90% from the first group and 87.5% from the second group had successfully quitted smoking. In the above-mentioned groups, 23.5% from the first group and 48.9% from the second one received not only behavioral therapy but also NRT. However, it is noteworthy that all the smokers with respect to the training provided during the course were prescribed NRT while its usage was up to the patient. This means that half of the second group (51.1%) had succeeded to quit smoking only by means of education and behavioral therapy without any NRT. Conclusion: The role of this kind of training in implementing smoking cessation program is essential. (Tanaffos 2003; 2(6): 39-44)
Introduction: Chemical weapons, (mainly mustard gas-MG) were heavily used by Iraq against Iranian soldiers between 1984-1986. It has acute effects on respiratory tract in the form of tracheobronchitis and ARDS, whereas chronic respiratory complications include chronic bronchitis, bronchiectasis, asthma and pulmonary fibrosis. There are few reports about human victims. Some of them describe acute effects while our purpose is to define chronic sequelae and their microbiologic, radiologic and physiologic behavior. Materials and Methods: Fourty four chemical weapon injured patients with moderate to severe disability were selected by AMA criteria (1). All of them underwent history taking and physical examination, ABG, spirometry, CXR, HRCT, bronchoscopy and BAL for cytology and quantitative culture. Results: Of fourty four patients; 29(66%) had diagnosis of chronic bronchitis by ATS criteria (2), 8 (18%) and 7 (16%) had diagnosis of bronchiectasis and asthma respectively. The most common HRCT finding was ground glass appearance. In one-fourth of patients BAL culture was positive and revealed unusual organisms (S.aureus, S.coagulase negative, E.coli)., BAL neutrophils were increased in bronchiectatic group (258±136 hpf) vs. (96±49 hpf), (148±133 hpf) (p
Introduction: Tuberculous spondylitis is an uncommon form of extra-pulmonary TB. Delay in establishing diagnosis and management causes spinal cord compression and spinal deformity. We studied to determine clinical and radiological presentations of this dangerous form of TB diseases. Materials and Methods: During 2002-3 years, all patients over 14 years old who hospitalized with a probable diagnosis of TB spondylitis were evaluated. Everybody with mycobacteriologic or pathologic confirmation was enrolled in study. Results: fourteen patients met our inclusion criteria. The mean age (±SD) was 39(±16) year. 57% were male. Treatment delay was 8.3 months. Fever reported in 7(50%) patients. Local tenderness was reported in 92.6% of cases. PPD was positive in half of the patients. The most regions involved were T8-T12 (43%) and L1-L3 (36%) respectively. Sputum smear was surprisingly positive in 50% of cases. Most of the patients had received anti-TB drugs for 9-12 months. Conclusion: CT guided aspiration and biopsy of spine lead to correct diagnosis in 93% of patients. Simultaneous pulmonary involvement is evident in half of them. (Tanaffos 2003; 2(6): 59-65)
Background: At the present time among various infectious diseases, tuberculosis is considered as one of the leading causes of death in adult population. These death rates are even higher than those caused by AIDS and Malaria. The diagnostic and therapeutic failure of the physicians results in the emergence of Multi-Drug Resistance (MDR). On the other hand, the best approach for controlling this situation is by implementing Directly Observed Treatment Short Course (DOTS) strategy. The requisite for reaching DOTS aims and objectives is through the cooperation and participation of all sections that are involved in offering health and medical services including private physicians. This cooperation requires the physicians to have satisfactory knowledge and assenting attitude towards these programs. This research was conducted with the aim of studying the level of knowledge and attitude of private general physicians, in regard to the National TB Programs (based on DOTS strategy). Materials and Methods: This cross-sectional study was carried out on 340 general physicians working in the private sector of Karaj city. The cases were chosen by random sampling method. Results: Also 66% of the physicians believed that TB is still recognized as a major health problem and issue worldwide. More than 75% of them have considered TB a serious threat to Iran. Only 1.8% of the general physicians had satisfactory level of knowledge. Meanwhile, 89.1% of them had a positive attitude towards National TB programs. Only 27.1% of physicians knew the most important symptom of pulmonary TB and about 43% recalled the short course of four-drug treatment. Conclusion: Majority of the general physicians had a positive attitude towards the National TB Program. But only few percent had satisfactory level of knowledge in this regard. (Tanaffos 2003; 2(6): 67-73)
Eosinophilic pneumonia is a rare disease in children and should be considered in differential diagnosis of bilateral pulmonary infiltration associated with peripheral blood eosiniphilia. In this report, a 13- year-old boy is presented with pulmonary involvement. He had an 8- year history of dry cough with fever and had received anti tuberculosis treatment for four times with diagnosis of smear negative pulmonary tuberculosis, but showed no evidence of clinical and radiological improvement. Bacteriologic evaluation for tuberculosis, tuberculin test, and PCR for M. tuberculosis were all negative. Pulmonary function tests of the patients revealed a restrictive pattern. Complete blood count demonstrated eosinophilia several times. The patient underwent bronchoscopy, which showed eosinophilia in bronchial secretions and open lung biopsy was performed, which confirmed the diagnosis of chronic eosinophilic pneumonia. Oral prednisolone was administered for the patient for 4 weeks. His clinical condition improved, and control radiography was indicative of improvement in pulmonary lesions. (Tanaffos 2003; 2(6): 75-79)
Background: Diabetes mellitus is the most common endocrine disease. Most of the patients suffering from diabetes mellitus complain of hearing loss. Since the previous studies made in this regard were not complete, this study was further conducted in order to evaluate t