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Evaluating the Correlation of Systemic Inflammatory Response Syndrome with Mortality and Morbidity in Critically Ill Obstetric Patients in ICU
M Jabalameli
Qom University of Medical Sciences Journal , 2012,
Abstract: Background and Objectives: Systemic inflammatory response syndrome (SIRS) is a relatively accurate predictor of outcome in critically ill patients treated in medical/surgical ICU. However, there are few data on the incidence of SIRS and its effect on outcome in obstetric patients. The aim of this study was to assess the incidence of SIRS and its relationships with mortality and morbidity in obstetric patients admitted to ICU. Methods: Routine Data Base study was conducted on documents of all obstetric patients admitted to ICUs of two medical teaching centers of Isfahan University of Medical Sciences from Oct 2005 to Feb 2006. Information including SIRS criteria factors, complications, length of ICU stay and mortality were gathered from patients medical records. According to SIRS criteria, patients were categorized into SIRS positive and SIRS negative with comparing the morbidity and mortality rates between the two groups. X2 test was used for comparing mortality rate and complications between SIRS positive and negative, and Mann-whitney test was used for comparing the length of stay. Correlation coefficient of Spiermann was applied for assessing SIRS score with mortality rate and complications. In all tests, P<0.05 was considered statistically significant. Results: In this study, out of 102 available medical records, the data of 82 were complete, and hence were included in the study. Based on the criteria, 68(83%) had SIRS. The difference in mortality rate was not statistically significant, but the two groups were significantly different in complications especially cardiovascular and coagulation complications which were more frequent in SIRS positive patients (P<0.05). The length of stay in SIRS positive patients was statistically more than SIRS negative cases (P<0.05). There was a positive correlation between SIRS score and mortality rate but it was not statistically significant (r=0.189, P=0.089). Conclusion: Based on the results of this study, the incidence of SIRS in obstetric patients admitted to ICU is remarkable and associated with increasing morbidity. So, it can be used as a predictive factor for outcomes in obstetric patients treated in ICU.
Bone and joint tuberculosis, Review of the patients treated in the Shafa Yahiaian Hospital, 1350-74
Jabalameli M,Ameri E
Tehran University Medical Journal , 1998,
Abstract: This paper represents a retrospective study of 142 patients with skeletal tuberculosis during the years 1350 to 1357 at Shafa Yahiaian Hospital. Confirmation of diagnosis is made by positive culture or pathology. The mean age of the patients was 27.5 years (range from 1.5 to 72 years). Most of the patients were in the second, first and third decade respectively. 45.3% of the patients were female. The spine was the most common site and was affected in 40.88% of the patients. The next sites were knee, hip and elbow, in order of frequency. The commonest site in spine was thoracic. The mean of sedimentation rate in the first visit was 48. Tuberculin skin test was negative in 23% of the patients. Evidence of pulmonary tuberculosis in chest radiography was present in 48.61% of the patients. Five patients had tuberculosis osteomylitis without involvement of the joint.
The effect of different Sellick's maneuver on laryngoscopic view and intubation time
M Jabalameli,J Hashemi,M Mazoochi
Journal of Research in Medical Sciences , 2005,
Abstract: Background: Sellick's maneuver (cricoid pressure) may make laryngoscopic view and tracheal intubation more difficult. This study compared the different techniques of cricoid pressure (CP) regarding to the laryngoscopic view and time to intubation. Methods: In142 anesthetized patients, 4 types of CP was randomly applied; A) one-handed CP using thumb, index and middle fingers, B) one-handed CP using index and middle fingers, and the heel on the sternum, C) technique A with another hand below the neck, D) technique C with a pillow below the neck. Results: There was significant difference in the laryngoscopic view changes. The view was better in group A, C, D and B, respectively. Mean intubation time did not show significant difference. Conclusion: One-handed CP using thumb, index and middle fingers can provide the best views at laryngoscopy without significant effect on time to intubation. Key Words: Sellick's maneuver, Laryngoscopic view, Intubation time, Tracheal
SENSITIVITY AND SPECIFICITY OF URINARY BLADDER CANCER ANTIGEN FOR DIAGNOSIS OF BLADDER TUMOR;A COMPARATIVE STUDY WITH URINARY CYTOLOGY
K. Radkhah,M. R. Nowroozi P. Jabalameli
Acta Medica Iranica , 2005,
Abstract: Cystoscopy and urinary cytology are currently the basis for diagnosis and follow-up of bladder tumors. Research to find a sensitive and specific tumor marker for diagnosis of bladder tumor is actively underway, however, due to low sensitivity and high cost of cytology. This cross-sectional study was performed in 65 patients to evaluate whether urinary bladder cancer (UBC) antigen level can predict the presence of active bladder tumor. In patients with inactive tumor, UBC antigen level was determined in addition to standard cystoscopy and cytology for follow-up. Patients with active tumor were subjected to standard treatment and UBC antigen level determination. UBC antigen levels were measured by ELISA, using monoclonal antibodies specific for UBC antigen. As a control group, UBC antigen level was also determined in 65 persons who had been referred for urinalysis for other reasons. UBC antigen level more than 1 μg/L which was regarded as positive was found in 49.4% of the patients. In control group, 96.9% had UBC antigen < 1μg/L . Mean UBC antigen level in patients was 3.77 μg/L while it was 0.508 μg/L in controls (P < 0.0001). Sensitivity of UBC antigen was 53.3% and its specificity was 40%. Sensitivity and specificity of urinary cytology was 17.3% and 88.2%, respectively. This difference was statistically significant (P < 0.001). UBC antigen is more sensitive than urinary cytology, although cytology still retains its priority in specificity. It is not yet recommended to replace UBC antigen for cytology due to its low specificity and not favorable sensitivity.
Congenital Dislocation of Knee: Results of the Treatment in 29 Cases Between 1970 and 2010 Years at Shafa Yahyaian Hospital in Tehran
M Rahbar,M Jabalameli,N Aqajani,R Shafipour
Tehran University Medical Journal , 2012,
Abstract: Background: There are not many reports regarding the treatment approaches of congenital dislocation of the knee in the literature. Therefore, the preferred method of treatment of this rare congenital disease is still controversial. Hereby, we report the treatment outcome of 29 patients admitted in Shafa Yahyaian Hospital during 40 years. Methods: In this retrospective study done in Shafa Yahyaian Hospital in Tehran, Iran during 2010, we retrospectively reviewed the medical records of 29 patients treated conservatively or surgically for congenital dislocation of the knee. Patients had been evaluated for an average follow-up of 8.5 years. Results: Overall, 54 knee dislocations had been treated surgically (58%) or conservatively (42%). Range of knee motion, persistent recurvatum, instability, valgus deformity after treatment and limping were the more important factors reported in the two surgically or conservatively treated groups. Knee function was satisfactory in patients with conservative treatment. Despite 80% of instability in the operated knees, patients could ambulate with or without braces and had a range of motion equal to 80 degrees. Knee function was also good after quadricepsplasty with transarticular pins in selected cases. Conclusion: We recommend a conservative approach to the disease, regardless of the patients age at the time of treatment and subsequent surgery in patients with dissatisfactory recovery. Quadricepsplasty with transarticular fixation is recommended as a good option in treating these patients. Posterior capsulorrhaphy for patients with CDK and ligamentous laxity is also recommended.
A Simulated Annealing method to solve a generalized maximal covering location problem
M. Saeed Jabalameli,Behzad Bankian Tabrizi,Mohammad Moshref Javadi
International Journal of Industrial Engineering Computations , 2011,
Abstract: The maximal covering location problem (MCLP) seeks to locate a predefined number of facilities in order to maximize the number of covered demand points. In a classical sense, MCLP has three main implicit assumptions: all or nothing coverage, individual coverage, and fixed coverage radius. By relaxing these assumptions, three classes of modelling formulations are extended: the gradual cover models, the cooperative cover models, and the variable radius models. In this paper, we develop a special form of MCLP which combines the characteristics of gradual cover models, cooperative cover models, and variable radius models. The proposed problem has many applications such as locating cell phone towers. The model is formulated as a mixed integer non-linear programming (MINLP). In addition, a simulated annealing algorithm is used to solve the resulted problem and the performance of the proposed method is evaluated with a set of randomly generated problems.
A location-inventory model for distribution centers in a three-level supply chain under uncertainty
Sara Gharegozloo Hamedani,M. Saeed Jabalameli,Ali Bozorgi-Amiri
International Journal of Industrial Engineering Computations , 2013,
Abstract: We study a location-inventory problem in a three level supply chain network under uncertainty, which leads to risk. The (r,Q) inventory control policy is applied for this problem. Besides, uncertainty exists in different parameters such as procurement, transportation costs, supply, demand and the capacity of different facilities (due to disaster, man-made events and etc). We present a robust optimization model, which concurrently specifies: locations of distribution centers to be opened, inventory control parameters (r,Q), and allocation of supply chain components. The model is formulated as a multi-objective mixed-integer nonlinear programming in order to minimize the expected total cost of such a supply chain network comprising location, procurement, transportation, holding, ordering, and shortage costs. Moreover, we develop an effective solution approach on the basis of multi-objective particle swarm optimization for solving the proposed model. Eventually, computational results of different examples of the problem and sensitivity analysis are exhibited to show the model and algorithm's feasibility and efficiency.
Evaluation of Lidocaine and Bupivacaine in post operationpain after abdominal hysterectomy
J.Bahrami,S.Aram,M.Jabalameli
Journal of Mazandaran University of Medical Sciences , 2006,
Abstract: Background and purpose: Post operation pain is seen in 30-70 percent of patients. Using local anesthetic is a safe, easy and cheap method for post opration pain management. In this study, the effects of lidocaine and bupivacaine lavage on post operation pain are assessed.Materials and Methods: In this double blind randomized control clinical trial, 90 healty women between 15-60 years old randomly allocated in 3 groups, lidocaine, bupivacaine and normal salin. After abdominal hysterectomy the medicine or placebo (in uniform package) is Administered in peritoneal cavity by surgeon and, 0, 2,6,12,24 and 48 hours after the surgery, the rate of pain was checked. Consumption of morphin and frequency of vomiting were measured and compared between groups using SPSS 12 software.Results: Post operational pain relief was significantly lower in lidocaine group compared with bupivacaine and normal saline, however, morphin consumption and frequency of vomiting were the same in three groups.Conclusion: Based on the results, it can be concluded that intraperitoneal lidocaine provides significant pain relief for 12 hours after abdominal hysterectomy.
Oral Clonidine Premedication Decreases Intraoperative Bleeding in Patients Undergoing Endoscopic Sinus Surgery
M Jabalameli,SM Hashemi,HA Soltani,SJ Hashemi
Journal of Research in Medical Sciences , 2005,
Abstract: Background: The antihypertensive drug, clonidine, is a centrally acting alpha 2 agonist, useful as a premedication because of its sedative and analgesic properties. We examined the effect of clonidine given as an oral premedication in producing a bloodless surgical field in patients undergoing endoscopic sinus surgery. We also evaluated the relation between bleeding volume and consumption of fentanyl and hydralazine to control hypotension. Methods: This prospective double - blinded clinical trial was performed on 113 patients (ASA I, ASA II). Fifty-two patients received oral clonidine (5 μg/kg) while the other 61 patients received placebo. During general anesthesia, the hemodynamic endpoint of the anesthetic management was maintenance of hypotension (MAP) at 70 mmHg for producing a bloodless surgical field. The direct control of MAP was attained with inspired concentration increments of halothane up to maximum of 1.5 vol % as needed. When it was unsuccessful, an intravenous fentanyl bolus of 2 μg/kg was also added. When both drugs failed, hydralazine , was given intravenously as a bolus and intermittently, 0.1mg/kg up to a maximum dose of 40 mg. Intraoperative bleeding was assessed on a six – point scale from 0 (= no bleeding) to 5 (= severe bleeding). Data were compared with chisquare test, fisher's exact test and Student t-test. Results: There was less bleeding volume in the clonidine group (mean ± SD) than in the placebo group (144 ± 75 Vs 225 ± 72 ml, P<0.05). Frequency of bleeding severity scores 3 and 4 (troublesome with repeated suction) were lower in the clonidine group than in the placebo group (12% Vs 35%, P< 0.05). Fentanyl requirement was significantly lower (112 ± 18 Vs 142 ± 21 μg, P < 0.05) in the clonidine group. Hydralazine requirement was significantly lower (0.45 ± 1.68 Vs 2.67 ± 4.33 Conclusion: Premedication with oral clonidine reduces bleeding in endoscopic sinus surgery and also decreases fentanyl, and hydralazine consumption for controlling hypotension. Keywords: Sinus surgery, Endoscopy, Clonidine, Hydralazine, Fentanyl, Bleeding
Effect of Culture Conditions on the Production of an Extracellular Protease by Bacillus sp. Isolated from Soil Sample of Lavizan Jungle Park
Abbas Akhavan Sepahy,Leila Jabalameli
Enzyme Research , 2011, DOI: 10.4061/2011/219628
Abstract: Soil samples of Tehran jungle parks were screened for proteolytic Bacilli. Among eighteen protease producers one of the isolates obtained from Lavizan park, in north east of Tehran, was selected for further experimental studies. This isolate was identified as Bacillus sp. strain CR-179 based on partial sequencing of 16S rRNA. Various nutritional and environmental parameters affected protease production by Bacillus sp. strain CR-179. Protease production by this Bacillus cultivated in liquid cultures reached a maximum at 24?h, with levels of 340.908?U/mL. Starch and maltose were the best substrates for enzyme production while some pure sugars such as fructose, glucose, and sucrose could not influence production of protease. Among various organic nitrogen sources corn steep liquor, which is commercial, was found as the best substrate followed by yeast extract, whey protein, and beef extract. The optimal pH and optimal temperature of enzyme production were 8.0 and 45°C, respectively. Studies on enzymatic characterization revealed that crude protease showed maximum activity at pH 9.0 and 60°C, which is indicating the enzyme to be thermoalkaline protease. 1. Introduction Proteases are one of the most important industrial enzymes and are used in a variety of industrial applications, such as laundry detergents, pharmaceutical industry, leather industry in dehairing and bating of hides, manufacture of protein hydrolyzates,food industry like meat tenderizing, cheese flavour development, treatment of flour in the manufacture of baked goods, improvement of dough texture, flavour and colour in cookies, and so forth [1–6], silver recovery from X-ray films [7], and even in waste processing industry [8, 9]. These enzymes account for about 60% of the total enzyme market [10–12]. Microbial proteases are preferred to enzymes from plant and animal sources, since they possess almost all the characteristics desired for biotechnological applications [13]. Commercial proteases are mostly produced from various bacteria, and it was reported that about 35% of the total microbial enzymes used in detergent industry are the proteases from bacteria sources [14]. Among bacteria Bacillus sp. are specific producers of extracellularly proteases [15] and can be cultivated under extreme temperature and pH conditions to give rise to products that are, in turn, stable in a wide range of harsh environments [16]. Furthermore, many Bacillus sp. secrete large amounts of proteases than that required for their physiological activities [17]. The cost of enzyme production is a major obstacle in its
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