@article{ author = {Kavalci, Cemil and Narci, Huseyi}, title = {ISOLATED TRANSVERSE SACRUM FRACTURE}, abstract ={Sacral fractures are usually occurs following high-energy trauma. Most fractures of the sacrum are occur in women after age 70 years. Fractures of the sacrum are rare and generally combined with a concomitant pelvic fracture. Transverse sacral fractures are even less frequent which constitute only 3–5% of all sacral fractures. This type of fractures provide a diagnostic challenge. We report an isolated transverse fracture of sacrum in a young man sustained low-energy trauma. The patient presented to our emergency department after several hours of injury, and diagnosed by clinical features and radiography findings}, Keywords = {Emergency, sacrum fracture, trauma}, volume = {2}, Number = {3}, pages = {0-0}, publisher = { International Journal of Medical Investigation}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://intjmi.com/article-1-41-en.html}, eprint = {http://intjmi.com/article-1-41-en.pdf}, journal = {International Journal of Medical Investigation}, issn = {2322-2913}, eissn = {2345-640x}, year = {2013} } @article{ author = {Taghipour, Mehrdad and Ahmadi, Alireza and Fereydouni, Mohammad Amin and Shams, Moghadaseh and Nobari, Niusha and Davoudi, Lotfollah and MalekiGorji, Rez}, title = {LATE ONSET MALIGNANT PERIPHERAL NERVE SHEATH TUMOR IN A PATIENT WITH NEUROFIBROMATOSIS TYPE Ι AND LUNG METASTASIS}, abstract ={Malignant peripheral nerve sheath tumors are one of the rare soft tissue sarcomas, which have not good prognosis despite of treatments. In this paper we tend to report a malignant peripheral nerve sheath tumor in the legs of a 44-year-old patient with neurofibromatosis type Ι. The patient underwent surgical operation and chemotherapy, but unfortunately died due to lung metastatic involvement several years later. Despite the poor prognosis of the disease, early diagnosis can reduce mortalityand morbidity}, Keywords = {Malignant, Neurofibromatosis, Peripheral nerve sheath tumor}, volume = {2}, Number = {3}, pages = {0-0}, publisher = { International Journal of Medical Investigation}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://intjmi.com/article-1-42-en.html}, eprint = {http://intjmi.com/article-1-42-en.pdf}, journal = {International Journal of Medical Investigation}, issn = {2322-2913}, eissn = {2345-640x}, year = {2013} } @article{ author = {Yenibertiz, Derya and Demir, Melike and Kanmaz, Dilek and Tuncay, Esi}, title = {THE COMPARISON OF TUBERCULIN SKIN TEST AND QUANTIFERON-TB GOLD TEST FOR THE DETERMINATION OF LATENT TUBERCULOSIS INFECTION IN HEALTHCARE WORKERS IN A PULMONARY DISEASES HOSPITAL}, abstract ={To evaluate the positivity rate and effectiveness of tuberculin skin test (TST) and Quantiferon-TB Gold test (QFT) in the diagnosis of latent tuberculosis infection in healthcare workers (HCWs) and the parameters that affect the the results of those tests. Healthcare workers from tertiary care pulmonary diseases hospital were enrolled into the study. BCG scars were evaluated and chest roentgenograms were obtained. TST was applied by the Mantoux method to the participants and the diameters of induration above 15 mm with BCG scars and above 10 mm without BCG scars were considered as positive. On the day of TST, blood sample was taken for QFT which measures interferon gama levels associated with specific antigens such as ESAT-6, CFP-10, and antigen 7.7. The tuberculosis specific antigen-Nil value of 0.35≥IU/ml was accepted as positive QFT and <0.35 IU/ml was recorded as negative QFT. Ninety-four HCWs were included. The mean age of the participants was 32.6±9.4 years. Fifty-nine of them were women (62.8%) and 35 were men (37.2%). Thirty (31.9%) of HCWs were doctors, 27 (28.7%) were nurses, and 37 (39.4%) were allied health personal. The positivity of TST and QFT increased significantly with aging (p:0.026 and 0.002, respectively). It was found by univariate analysis that the positivity of QFT was affected from age and working duration but multivariate analysis revealed that the working duration was the only independent risk factor affecting the positivity of QFT (p:0.018). A statistically significant correlation was determined between the positivities of TST or QFT and induration diameter (p<0.001). TST and QFT were determined positive in 59 (62.8%) and 51 (54.3%) of the participants, respectively. Low level of agreement was detected between two tests (69.8%, k:0.391). Quantiferon-TB Gold test was found to be more effective and sensitive in relation to TST for the diagnosis of latent infection in the BCG-vaccinated people. We think that Int j med invest.2(3):166-175 October 2013 167 International journal of medical investigation www.intjmi.com QFT should be used instead of TST for screening latent infection in the HCWs, in the populations with high prevalence of tuberculosis and routine BCG vaccination alike our country.}, Keywords = {Tuberculin skin test, QuantiFERON-TB Gold test, Latent tuberculosis infection, Healthcare workers}, volume = {2}, Number = {3}, pages = {0-0}, publisher = { International Journal of Medical Investigation}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://intjmi.com/article-1-43-en.html}, eprint = {http://intjmi.com/article-1-43-en.pdf}, journal = {International Journal of Medical Investigation}, issn = {2322-2913}, eissn = {2345-640x}, year = {2013} } @article{ author = {almajali, Zahi and batarseh, Emil and masadeh, Ahmad and Mustafarafeeqkhalil, Pharm and Alkhaldi, RN Hazem}, title = {IMPACT OF INTRAOPERATIVE INTRAVENOUS ADMINISTRATION OF KETAMINE, FENTANYL OR PROPOFOL IN DECREASING PEDIATRIC POST-TONSILLECTOMY EMERGENCE AGITATION}, abstract ={To evaluate the frequency of emergence agitation after tonsillectomy in children administered ketamine, fentanyl or propofol during surgery. Our prospective and double-blind investigation included 273 children patients, of both sexes, aged 3-11 years, classed I by the American society of anesthesiologists and scheduled for tonsillectomy under general endotracheal anesthesia at Queen Rania hospital for children, KHMC, Amman, Jordan during the period April 2012-April 2013. Children patients received intravenous induction of anesthesia using fentanyl 2 mcg/kg,propofol 2 mg/kg and tracurium 0.5mg/kg ,after which a proper endotracheal tube size was secured through which a mixture of nitrous oxide/oxygen with 1 MAC of isoflurane was delivered.At the end of surgical procedure, patients received in a random fashion an intravenous dose of either ketamine 1mg/kg(GI,n=93), fentanyl 1 mcg/kg(GII,n=89) or propofol 1mg/kg(GIII,n=91).Incidence and intensity of postoperative emergence agitation was assessed using the five-step emergence agitation scale where 1 meant obtunded with no response to stimulation, 2 meant asleep but responsive to movement or stimulation, 3 meant awake and responsive, 4 meant crying and 5 meant thrashing behavior that requires restraint. The patient scale of more or equal to 4 was considered as having emergence agitation. The frequency of emergence agitation was analyzed statistically using Chi-square test .Significant P –value was considered significant if it was 0.05) and 13.97% in ketamine group (P<0.05). The incidence of postoperative emergence agitation was significantly less in groups using intraoperative fentanyl or propofol compared to group using ketamine . Int j med invest.2(3):151-158 October 2013 152 International journal of medical investigation www.intjmi.com}, Keywords = {Intra:operative,venous:fentanyl,ketamine,propofol,isoflurane,paediatric,post-tonsillectomy:emergence agitation}, volume = {2}, Number = {3}, pages = {0-0}, publisher = { International Journal of Medical Investigation}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://intjmi.com/article-1-44-en.html}, eprint = {http://intjmi.com/article-1-44-en.pdf}, journal = {International Journal of Medical Investigation}, issn = {2322-2913}, eissn = {2345-640x}, year = {2013} } @article{ author = {Bouzari, Zinatossadat and Zeinalzadeh, Mahtab and Yosofniyapasha, Yousofreza and Cherati, Shahla Yazdani}, title = {PREGNANCY OUTCOMES UNDER 20 YEARS IN COMPARISON WITH NORMAL REPRODUCTIVE AGE WOMEN}, abstract ={Teenagers age is a transient mental and physical period between adolesence and childhood. Pregnancies that occur in women under 20 years of age are more high risk than 20-34 years. This study was conducted to comparison of pregnancy outcome in the age groups below and above 20 years. This cross-sectional study was conducted of 100 cases in two groups, age group <20 and 20-34 age groupin pregnant women refferd to Ayatolah Rohani Hospital in Babol from September of 2006 to March of 2012. Sociodemographic and clinical data were extracted from patient records and were analyzed. Results of the study showed that pre-eclampsia and the cesarean rate in pregnant women under 20 years and 34 to 20 had significant statistical difference (0.003, 0.015). Neonatal outcomes in pregnant women in two groups did not have any significant difference. Regression analysis to determine the number of visits during pregnancy reduces the risk of cesarean delivery (OR=0.52, p=0.041). This study showed that maternal outcomes in a group of mothers under 20 years of age compared to a group of mothers above 20 years of age were more clinical but did not have any significant statistical difference except pre-eclampsia that had significant statistical difference too.}, Keywords = {High Risk Pregnancy, age ,cesarean delivery, pre-eclampsia}, volume = {2}, Number = {3}, pages = {0-0}, publisher = { International Journal of Medical Investigation}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://intjmi.com/article-1-45-en.html}, eprint = {http://intjmi.com/article-1-45-en.pdf}, journal = {International Journal of Medical Investigation}, issn = {2322-2913}, eissn = {2345-640x}, year = {2013} } @article{ author = {Davoudi, Alireza and Najafi, Narges and Soleymani, Aria and Davoodi, lotfollah and Asghari, Hassan and Ehsani, Raziye}, title = {EVALUATION OF ANTIBIOTIC PRESCRIPTION PATTERN IN FATIMAH ZAHRA HEART HOSPITAL OF SARI, AT NORTH OF IRAN ONE YEAR SURVEY}, abstract ={Background: Given the widespread use of antibiotics, antibiotic resistant organisms that cause nosocomial infection is increasing rapidly. To modify the pattern of antibiotic consumption requires accurate information about their current prescription. Material & method: This study aimed to investigate the pattern of antibiotic use in Sari Fatima Zahra hospital from April 2011 to March 2012. This study was a retrospective drug utilization evaluation based on ATC / DDD system. Results: Sari Fatima Zahra hospital had an occupancy index 0/91 with an 8564 Admission. In total 355 patients received antibiotics that 55.25% were male ;44.8% female. The most common illnesses were including pneumonia (45.6%), surgical wound infection (16.3%), endocarditis (15.2%), urinary tract infection (6.8%), sepsis (6.5%) ;mediastinitis (9 / 3%), respectively. The antibiotic cost was 15.14% of all drug costs. Antibiotics were administered intravenously in 93.34% of cases. The most commonly used drugs were ceftriaxone (in 65.6%) that the most common indication for its use was pneumonia (59.7%) & endocarditis (16.7%), respectively. The second was vancomycin (54.6%) that the most common causes for its use were pneumonia (29.8%), surgical wound (26.8%) and endocarditis (21.8%), respectively. Clindamycin was prescribed in 35.3% and imipenem in 21.4% of patients. The use of antibiotics using the defined daily dose was calculated 423 for total drugs and 140.32 ;111.3 for ceftriaxone & vancomycin, respectively. Conclusion: Despite the relatively good use of antibiotics in our hospital, the use of essential drugs, vancomycin and imipenem was high. This is partly due to type of our Int j med invest.2(3):143-150 October 2013 144 International journal of medical investigation www.intjmi.com patient’s disease (heart surgery) and party due to lack of sufficient knowledge about common objects antibiotic resistance in hospitals. Thus, scientific, accurate and acceptable studies in this context would be helpful.}, Keywords = {Antibiotic use, Antibiotic resistance, Antibiotic stewardship}, volume = {2}, Number = {3}, pages = {0-0}, publisher = { International Journal of Medical Investigation}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://intjmi.com/article-1-46-en.html}, eprint = {http://intjmi.com/article-1-46-en.pdf}, journal = {International Journal of Medical Investigation}, issn = {2322-2913}, eissn = {2345-640x}, year = {2013} } @article{ author = {UNCU, Fatoş and OĞUZÖNCÜL, Ferdane}, title = {HEALTH CARE WORKERS WHO WORK IN THE PROVINCE OF ELAZIG LEVELS OF AWARENESS ABOUT CHILD ABUSE AND NEGLECT, AND THE FACTORS AFFECTING THIS SITUATION}, abstract ={Child abuse and neglect is one of the major health problems seen in all societies that can have a permanent negative impact on one’s life. This research is made to determine the awereness of the health care professionals about child abuse and neglect who work in the Elazig city center as well as the factors that affect this situation. The subjects of this study consists of the health care professionals who work in Elazığ and with the formula n=Nt²pq/d²(N-1)t²pq 906 people were selected (t=2.59,d=0.03, p=0.30) and 899(%99.2) of these people were reached. Data for the study was collected with the help of a questionnaire consisting of multiple-choice questions in general and “Scale for Identifying Signs and Risks of Child Abuse and Neglect” . 46.4% of health care workers included in the study were physicians and 53.6% were nurses and midwives. Age average of the health care workers were 33.6 ± 7.7 and 61.6% of them were female. The total scale points for identifying signs and risks of child abuse and neglect for physicians (3.67±0.29) was found to be significantly higher than those recorded for nurse and midwives (3.55±0.30) (p=0001). The average score for the sub-groups of physicians of ” Scale For Identifying Signs And Risks Of Child Abuse And Neglect” were found to be statistically meaningful compared to the nurses and midwives. Both physicians (3.83±0.53) and nurses and midwives (3.74±0.65) scored highest in the subgroup “Neglect indications upon chid” of the “Identification of child abuse and neglect indications and risks” scale group. Physicians (3.41±0.49) and nurses and midwives (3.21±0.50) scored the lowest in the subgroup “Properties of a child prone to abuse and neglect” of the “Identification of child abuse and neglect indications and risks” scale group. As a result, health care workers who work in Elazig were inspected in terms of their level of their child abuse and neglect awareness and it’s been determined that the health care staff needs to be informed about this subject. Int j med invest.2(3):129-142 October 2013 130 International journal of medical investigation www.intjmi.com}, Keywords = {Child, Physician, Nurse, Midwife, Neglect, Abuse}, volume = {2}, Number = {3}, pages = {0-0}, publisher = { International Journal of Medical Investigation}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://intjmi.com/article-1-47-en.html}, eprint = {http://intjmi.com/article-1-47-en.pdf}, journal = {International Journal of Medical Investigation}, issn = {2322-2913}, eissn = {2345-640x}, year = {2013} } @article{ author = {Aliasgharpour, Mehri and RahnamayeFarzami, Marj}, title = {Trace Elements in Human Nutrition: A Review}, abstract ={Trace elements also known as trace minerals, are the chemical components that naturally occur in soil, plant, and wildlife in minute concentrations. They are necessary for the optimal development and metabolic functioning such as proper cell metabolism, effective immune function, and healthy reproduction of humans . Their role and homeostasis in living organisms varies. There are 19 known trace elements that are categorized in three groups (WHO classification) essential elements ,probably essential elements, and potentially toxic elements .This review provides some detailed information and criteria for assessing the probable trace element status in human physiology . In addition, for some elements it may offer additional effective ways of diagnosis to physicians as well as interested peoples.}, Keywords = {Trace Elements -Essential-Immune Function-Homeostasis-Organisms}, volume = {2}, Number = {3}, pages = {0-0}, publisher = { International Journal of Medical Investigation}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://intjmi.com/article-1-141-en.html}, eprint = {http://intjmi.com/article-1-141-en.pdf}, journal = {International Journal of Medical Investigation}, issn = {2322-2913}, eissn = {2345-640x}, year = {2013} }