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A Survey of Multiple Births in Mashad
AK Hamedi,F Akhlaghi
Iranian Journal of Pediatrics , 2002,
Abstract: Ovulation induction drugs in the recent years and modern technologies in treatment of infertility resulted in remarkable increase of multiple births. The goal of the present study was to determine the frequency of multiple births and maternal-fetal as well as neonatal complications of multiple pregnancies in Mashhad during a period of 5 years. Out of 19959 deliveries, 99.3% were singletons, 0.67% twins and 0.015% triples. The incidence of twins’ delivery was 6.7 per 1000 (1 in 150 cases). For triplets this was 0.15 per 1000 (1 in 6666). The majority of mothers aged 20-29 years; the youngest were 15-20 years old. The incidence of multiple births decreased with increasing parity and age over 29 years. Maternal complications included premature delivery (41.6%), preeclampsia (11%), hemorrhage (10.2%), infection (4.3%), and placental detachment (1.4%). Fetal and neonatal complications were observed in 70% and consisted of prematurity, fetal malformations (7.9%), stillbirth (6.1%) and multiple births mortality (13%). A direct relation was noticed between mother’s age and neonate’s weight. Thus, multiple pregnancies must be seen as a high risk for mother and her newborn and should be managed carefully during pregnancy and in labor.
"COMPARISON OF MATERNAL AND FETAL/NEONATAL COMPLICATIONS IN GESTATIONAL AND PRE-GESTATIONAL DIABETES MELLITUS "
F. Akhlaghi A. B. Hamedi
Acta Medica Iranica , 2005,
Abstract: Presence of maternal diabetes mellitus (DM) during pregnancy has important consequences for both mother and child. To determine maternal and fetal/neonatal complications of gestational DM and compare them with pre-gestational DM, a prospective study was performed in 100 diabetic women delivered in our hospital from January 2001 to April 2002. Pregnancy outcome in 27 women with gestational DM and 73 women with pre-gestational DM and their offspring were studied and analyzed. The mean age of women was 28 years, women with gestational DM being slightly older than women with pre-gestational DM. Mothers with gestational DM were at increased risk of presenting with pre-eclampsia and preterm labor compared to pre-gestational DM. Frequency of Cesarean section was higher in mothers with pre-gestational DM. Frequencies of abortion and hypoglycemic episodes were similar in gestational DM and pre-gestational DM. Infants born to mothers with pre-gestational DM were at increased risk of suffering from respiratory distress syndrome and congenital malformations but rates of unexplained intrauterine fetal death and large for gestational age were higher in infant of mothers with gestational DM. Gestational and pre-gestational DM are associated with increased risk of maternal and neonatal morbidity. Pregnant women with gestational and pre-gestational DM and their offsprings should be monitored and managed carefully.
Visual Estimation of Post Partum Hemorrhage and its Treatment
F Akhlaghi,V Taghipour Bazargani,J Jamali
Tehran University Medical Journal , 2012,
Abstract: Background: Postpartum hemorrhage is a leading cause of maternal morbidity and mortality that is preventive by appropriate estimation of blood loss and its treatment. This study was undertaken to evaluate the accuracy of visual estimation of postpartum hemorrhage by clinicians and co worker who work in the obstetrics department. Methods: In this descriptive observational study, 199 educational/clinical personnel participated who worked in the obstetrics department of 3 training hospital in Mashhad in 2010. First characteristic of their occupation, educational and period of work experience recorded. Then scenes similar of postpartum hemorrhage were rebuilt by using of expired whole blood in five different volume (500, 1000, 1500, 2000, 2500, 3000 cc). Participants looked each scenes and estimated volume and necessary treatment and record in forms. Data were analyzed by SPSS software version 12 and fisher and student tests and relation between accurate volume of hemorrhage and estimated volume and treatment, occupation and experience of participants were determined. Results: Accuracy visual estimation of blood loss in different volume of postpartum hemorrhage was between 14.3% to 52%. There was no significant association between the position of the participants and accuracy of their estimation and proposed treatments. There was no association between the staffs work experience and accuracy of their estimation. Conclusion: Visual estimation of blood loss was not accurate in the majority of participants. For prevention of maternal morbidity and mortality education is necessary that to be skilled for accurate estimation of blood loss.
All- Ceramic Crown Preparation and the Remained wall Thickness of the Pulp Chamber
Mohammadzadeh Akhlaghi N.,Jalalian E.,Hadaegh F.
Journal of Dentistry , 2012,
Abstract: tatement of Problem: A minimally invasive method of preparation is essential to prevent tooth structure weakening and pulp irritation; especially for mandibular anterior single-tooth all-ceramic crowns. According to many investigations, one of the most important reasons of pulp injury caused by tooth preparation for different restorative procedures is reduced “remained wall thickness” (RWT). In order to protect the pulp from irritation, it is necessary to maintain a 0.5 mm of RWT.Purpose: The purpose of the present study was to evaluate the effect of all-ceramic crown preparation on pulp chamber RWT of mandibular incisors.Materials and Method: Mesiodistal and buccolingual initial images of 24 ex-tracted mandibular incisors were provided. The pulp chamber initial wall thick-nesses of buccal, lingual and proximal surfaces of cervical, 1and 2 mm above the cervical areas and also the incisal surfaces of incisal sections were measured using digital radiography and Photoshop software. After all-ceramic crown preparation, images were provided at the same initial positions. The initial and remained pulp chamber wall thicknesses were statistically evaluated and analyzed by ANOVA, paired t-test and a post hoc Tukey test.Results: Repeated measures ANOVA showed that the mean of pre- or post-preparation wall thicknesses were not significantly different for each surface at the three horizontal levels (p> 0.05). However, there were significant differences between the surfaces for each section. Comparison of pre- and post-preparation wall thicknesses revealed significant differences (p< 0.05). Proximal surfaces of cervical sections had the least RWT (0.42±0.12).Conclusion: According to the results of the present study, the least amount of initial and remained wall thicknesses of pulp chamber were related to the proximal surfaces, particularly in cervical areas. Therefore a reduction of preparation to 0.7 mm is suggested to prevent future pulp injury for mandibular incisors of 35 to 40- year- old patients and younger who require all-ceramic crown preparations.
Effect of Gum Chewing on Prevention of Post
F Akhlaghi,M Pourjavad,A Mansouri,F Tara
Hayat Journal of Faculty of Nursing & Midwifery , 2008,
Abstract: Background & Aim: Post cesarean ileus is a common complication that induces abdominal distention, delays feeding, and increases hospitalization. Multiple studies showed that false nutrition increases the bowel movement. This study aimed to investigate the effect of gum chewing as false nutrition on the bowel movement and prevention of post cesarean ileus. Methods & Materials: In this randomized controlled trial, a total of 400 patients who were hospitalized in Mashhad Zeinab hospital were divided into two 200-patient groups. The groups were matched for age, gravity and duration of surgery. In the intervention group, gum chewing was started after surgery, 3 times/day until the regular diet was initiated. In the control group, patients underwent routine care by restricting oral intake until the bowel function was returned. The outcomes were time of the first bowel sound, flatus passage, defecation, ambulation of patients post cesarean, initiation regular diet, and hospitalization. Statistical analysis was performed using unpaired t-test and fisher's exact probability test. Results: The mean age, parity and operation time were similar in the two groups. All patients in the intervention group tolerated gum chewing immediately after surgery. The results showed the followings among the intervention group vs. control group, respectively: post operative time intervals to bowel sounds (14.7 hours vs. 16.6 hours; P=0.569), time intervals between surgery and abdominal distention (16.59 hours vs. 14.21 hours; P=0.01), first post operative defecation (28.16 hours vs. 32.21 hours ; P=0.000), post operative time interval to onset diet (19.3 hours vs. 16.54 hours; P=0.000), post operative time interval to ambulation (20.14 hours vs.17.58 hours; P=0.000), post operative lengths of ileus (31.13 hours vs. 30.35 hours; P=0.5), hospitalization (1.84 days vs. 1.92 days; P=0.02). Conclusion: Gum chewing after cesarean section is safe and well tolerated and reduces post operative ileus, shortens mean duration of first defecation, decreases the time of returning to regular oral diet, shortens the time of patient ambulation and hospital discharge. Gum chewing is offered as a physiologic and inexpensive method to prevent or reduce post cesarean ileus.
The Correlation between endothelin-1 antibody plasma concentrations in patients with scleroderma and different manifestations of the disease
Aghaei M,Gharibdost F,Zayeni H,Akhlaghi M
Tehran University Medical Journal , 2011,
Abstract: "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Systemic scleroderma (SSc) is a generalized connective tissue disorder of unknown origin which most notably is characterized by skin thickening and organ damage. Endothelin-1 (ET-1) antibody plays a role in skin fibrosis. The aim of this study was to determine the prevalence and correlation of different manifestations of SSc with ET-1 plasma levels."n"nMethods: This cross-sectional analytical study was conducted on 95 patients (91 women and four men) with scleroderma in 2006. The patients had been referred to the Rheumatology Clinic of Shariati Hospital in Tehran, Iran. The demographic data and signs and symptoms were entered in a questionnaire and endothelin-1 concentrations were measured. "n"nResults: The mean age of the patients was 38±12.29 years. Diffuse cutaneous SSc (dcSSc) was diagnosed in 52 and limited cutaneous SSc (lcSSc) in 43 patients. Raynaud's phenomenon (91%) was the most common manifestation in the patients. The relationship between the resorption of terminal phalanges due to fibrosis with the plasma concentration of Endothelin-1 was statistically significant (p=0.001). Pitting ulcers had significant relationships with endothelin-1 concentrations too (p<0.05). No other significant relationships were found between the other manifestation of the disease and Endothelin-1 concentration. "n"nConclusion: In this study, Reynaud's phenomenon was the most frequent sign in patients with scleroderma. Thus, it could serve as a tool for the diagnosis of scleroderma. As there were no significant relationships between the other manifestations of scleroderma with endothelin-1, a cohort study with a larger sample size is suggested.
Effect of Vitamin E on Primary Dysmenorrhea
F Akhlaghi(MD),N Zyrak(MD),Sh Nazemian(MD)
Hayat Journal of Faculty of Nursing & Midwifery , 2009,
Abstract: Background & Aim: Dysmenorrhea is a common problem in young women. Although dysmenorrhea is not life threatening, it can have adverse effects on quality of life. Various treatments are offered for dysmenorrhea including vitamin E supplements. This study investigated the effect of vitamin E on primary dysmenorrhea. Methods & Materials: In this before-after clinical trial, 200 female students who suffered from primary dysmenorrhea were recruited to the study at Mashhad University of Medical Sciences. First, they filled a questionnaire including demographic characteristics and the pain measurement chart (duration and severity). Then, they were divided into three groups: low, moderate and severe dysmenorrhea groups. Vitamin E (200 mg) tablets were administered to them and they were requested to have them once/day for five days (two days before and three days after the beginning of the menstruation). They filled the pain measurement chart (duration and severity) after two treatment periods. Data were analyzed using t-student, chi-square, and variance analysis tests in SPSS software. Results: The age of the students ranged 19-26 years old. The severity of dysmenorrhea was mild, moderate, and severe respectively in 28%, 60%, and 14% of the students. The mean of painful menstrual days was 2.05 in the first month, and 2.08 in the second month before using vitamin E. After using vitamin E, painful menstrual days were 1.63 in the first month and 1.64 in the second month. Regarding duration of painful days, all of the participants felt pain in the first day of menstruation. After using vitamin E, about one sixth of the participants in the first month and one fifth of them in the second month had no pain at first day. The severity of pain was 5.18 before using vitamin E that decreased to 3.40 after the intervention. Conclusion: Vitamin E administration in women, who suffer from primary dysmenorrhea, significantly reduces the severity and duration of pain. It can be used as an alternative treatment method in affected women. Key words: primary dysmenorrhea, vitamin E, menstrual period, treatment of dysmenorrhea
Experimental production and preliminary imaging of [18F]-6-thia-14-fluoro-heptadecanoic acid ([18F]FTHA) for myocardium evaluation
A. R. Jalilian,M. Akhlaghi,F. Saddadi,M. Mirzaii
Iranian Journal of Nuclear Medicine , 2006,
Abstract: [18F]-6-thia-14-fluoro-heptadecanoic acid 3b, a free fatty acid, has been used in mycardial PET imaging. In order to establish an automated synthesis module for routine production in the country, a study performed for optimization of the production conditions as well as making modifications. [18F]Benzyl-14-Fluoro-6-thia-heptadecanoate 2b was prepared in no-carrier-added (n.c.a) form from Benzyl-14-tosyloxy-6-thia-heptadecanoate 1 in 2 step. The fluorination was achieved at 85-90 C in Kryptofix2.2.2/[18F] and acetonitrile as the solvent followed by Silica column chromatography. The compound 2 was then hydrolysed using 0.2M KOH for 5 min at 90 C and acidification. The radiolabeled compound was finally went through quality control and formulated in 5% albumin and passed through 0.22 micron filter. The final preparation was injected to tail vein of normal rats followed by co-incidence imaging up to 3 hours as well as biodistribution studies. The best imaging time was shown to be 140-160 post-injection.
Experimental Production and Initial Imaging of [18F]-14-Fluoro-6-thia-heptadecanoic acid ([18F]-FTHA) for Myocardial Performance
"A.R. Jalilian,M. Akhlaghi,F. Saddadi,M. Mirzaii
Iranian Journal of Nuclear Medicine , 2006,
Abstract: Introduction: [18F]-6-thia-14-fluoro-heptadecanoic acid 3b, a free fatty acid, has been used in myocardial PET imaging. In order to establish an automated synthesis module for routine production in the country, a study performed for optimization of the production conditions as well as making modifications. Methods: [18F] Benzyl-14-Fluoro-6-thia-heptadecanoate 2b was prepared in no-carrier-added (n.c.a) form from Benzyl-14-tosyloxy-6-thia-heptadecanoate 1 in one step at 90 C in Kryptofix2.2.2/[18F] and acetonitrile as the solvent followed by Silica column chromatography. The radiolabeled ester 2 was then hydrolyzed to yield [18F]-6-thia-14-fluoro-heptadecanoic 3b. The final solution was concentrated using C18 SPE system and administered to normal rats for biodistribution as well as co-incidence imaging studies. Results: The synthesis took 15 min with overall radiochemical yield of 15-25% (EOS) and chemical-radiochemical purity more than 94%. Automation was performed using a two-pot synthesis. The best imaging time was shown to be 140-180 minutes post injection. Conclusions: Using this procedure a fast, reliable, automated synthesis for the cordial PET tracer, i.e. [18F]-FTHA can be obtained without HPLC purification step.
The Prevalence of Human T-Cell lymphotropic Virus Type 1 in Pregnant Women and Their Newborns
A. Hamedi,F. Akhlaghi,Z. Meshkat,M. Sezavar
ISRN Obstetrics and Gynecology , 2012, DOI: 10.5402/2012/975135
Abstract:
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