فصلنامه یافته
سال نهم شماره 2 (پیاپی 27، تابستان 1386)

The most common microorganism in blood cultures is Coagulase Negative Staphylococci (CNSt). Exact diagnosis of bacterial agents in blood and their antibiograms are an important value in septicemia therapy. The purpose of the present study is to identify and determine antibiotic susceptibility of CNSt isolated from blood in children. Samples were collected from 270 patients with CNSt positive blood cultures during 2 years (2003-2004) in pediatric center of Tabriz by routine microbiological methods. The disc agar diffusion technique (kriby-Bauer) was used to evaluate the susceptibility test of CNSt. In our study mean age of patients was 10 month. 54.4% and 45.6% were male and female repectively. In 270 CNSt, the resistance to Penicillin, Ampicilline, Cephalexin, Ceftizoxime, Ceftriaxon and Vancomycin were respectively 98.1%, 95.9%, 62.3%, 55.9%, 53.7% and 2.6%. Antibiotic susceptibility of CNSt is not predictable and multiresistant strains are common. Vancomycin is the drug of choice, since only 2.6% resistant CNSt were noticed.

In this study we evaluate the outcome of pregnancy in the patient that received M. MR vaccine during M.MR vaccination program on Lorestan of fall 2003. This is a descriptive epidemiologic study, we evaluated all of women that vaccinated with M.MR vaccine during pre and post conception. We collected and analyzed all of information like prognosis of pregnancy, congenital rubella syndrome, gestational age weigh of newborn. In 92 pregnancy women infected with MMR vaccine, the prognosis of pregnancy clearly seen 88 pregnant women (96%) 73 (83%) had normal and healthy newborn infant and 5 (6%) had spontaneot abortion and 10 pregnant women (11%) had legal abortion. Mean gestational age at birth was 39.5 ± 2.1 and weigh of newborn was 3257 ± 535 grams. None of the live born infants had not congenital rubella syndrome. In this study we showed M.MR vaccination during pregnancy had not any complication pregnancy. But pregnancy yet is an contraindication for M.MR vaccibnation, vecause this patient theories have risk of congenital rubella syndrome.

Some studies show the depression، stress، low self-esteem، sexual dissatisfaction may be psychological outcomes of infertility. Depression and sexual satisfaction play a significant role in the life of infertile couples، their infertility treatment follow- up and in their hopefulness for the future. The present study was carried out to determine and comparing the depression and sexual satisfaction among infertile and fertile couples referring to Alzahra educational center in Tabriz. This is a comparative- descriptive study in which depression and sexual satisfaction rate were studied and analyzed in 150 infertile versus 150 fertile couples. Sample selection was randomized. Data gathering was done by using questionnaire including 3 parts (Demographic characteristics of couples، Beck Depression Inventory and Larson standard questionnaire for determining sexual satisfaction). All data gathered for this study was analyzed by using descriptive statistically methods، mean difference tests and also relation test. The BDI mean difference between infertile and fertile men and between infertile and fertile women was significant (p=0. 011،t=2. 54in men & p<0. 005، t=3. 68in women). But the difference between sexual satisfaction mean difference in infertile and fertile men and between infertile and fertile women was not statically significant (p=0. 707، t=0. 377 in men & p=0. 370، t=0. 898 in women). Mean difference in infertile women was higher than their husbands but sexual satisfaction score in men and women was not statistically significant. Also there was a negative correlation between sexual satisfaction and depression. Infertile couples are indigent to exact care and treatment about their psychological problems. Presence of expert counselors in infertility treatment teams for diagnosing and treating these patients before any delay، is quite necessary.

Intraoperative bleeding accounts one of the most disturbing complications during various surgeries including vertebral column surgery, head and neck surgery, plastic surgery especially rhinoplasty. To decline this problem, some techniques and drugs are used. We examined the effect of clonidine given as an oral preanesthetic medication in producing a bloodless surgical field in patients undergoing rhinoplasty. A prospective, randomized, double-blind clinical trial was performed in 40 patients scheduled for elective rhinoplasty under general anesthesia. Patients had been divided randomly in two groups. 20 patients received only diazepam 0.1 mg/kg and 20 patients received both diazepam 0.1 mg/kg and clonidine 3 µg/kg orally 90 minute prior to arrival at the operating room. Method of anesthesia were simillar in two groups. Intraoperative bleeding was assessed on a four-scale from 1=no bleeding to 4= abundant bleeding and also amount of blood in suction and number of gauze that total bloody. These data were recorded in data collecting sheets. There were no significant statistical difference in sex and means of age between two groups (p<0.05). Mean age was 24.9±6 years. The mean of gauze number in group that recieved clonidine was 1.9±0.9 and in other group 3.6±1.1. The mean blood volume in suction was 65± 28cc and 125±30cc (clonidine recieved and other group, respectively). Statistical analysis using independent sample T-test shows significant difference between two groups (p<0.001). Premedication with oral clonidine 3 µg/kg reduce bleeding in rhinoplasty and improve surgeon’s satisfaction.

Suicide is one of the social problem which brings about death of active characters in the society and it is considered as a remarkable problem for health. Suicide is the number 9 factor of death in America. Nearly 85 cases of suicide happen per day within 20 minutes each. Drug abuse is of psychiatric urgency and it is regarded as an important variable related to suicide. All clients who committed suicide and were hospitalized in Shohadaye Ashayer hospital were included in this study (from July 83 to January 83). The results showed that there is a significant relationship between drug abuse and chronic organic disease among patients with suicide intention. Among 67 suicide cases, 55.2% were male and 44.8% were female. The highest frequency (55.2%) covered the age group (19–26). Most of the cases were unmarried. 47.8% were unemployed. 79.1 % were city residents and 21.9 % were living in the country. 53.7% of the participants had elementary school and junior high school education. The study was to determine the frequency of personal, familial psychological characteristics and drug abuse among clients with suicide. The results emphasize on the preventive effect of the level of education in this Province. The results also showed that the more the number of people in the family, the more suicide cases in the family. Further more among married ones, cases with one or two children were prominent.

Intestinal parasites are the most common enteric pathogens in patients with HIV infection. These intestinal pathogens are the main cause of morbidity and mortality in HIV positive patients. There have been very few reports on the prevalence of intestinal parasites in HIV positive and AIDS patients in Iran. To investigate the prevalence of opportunistic intestinal parasites in this population, a cross-sectional study was carried out on 306 HIV positive and AIDS patients in Khorramabad city. Demographic data were collected by a questionnaire. Three stool samples were collected from every patient. Direct smear, Formalin-ether concentration techniques and Modified acid fast (Kinione) and modified trichorome staining method carried out on all samples. Data was analyzed by T-test and Chi square method. After examination’s it detect that, Prevalence of the intestinal parasite in HIV positive and AIDS patients in Khorramabad city was 22.5% and This rate was higher in AIDS patients. Moreover, we demonstrated that there is a significant relationship between age group, level of education, occupation, type of intestinal signs, variants and infection to intestinal parasites. It’s noticeable that between status of HIV/AIDS variant and infection to intestinal parasite there was a significant relationship High prevalence of intestinal parasites in HIV positive and AIDS patients in Khorramabad city reflects the necessity of prevention, screening, diagnosis and treatment programs for these patients.

High risk behaviors are the most prevalent factors that endanger the health of a community. Nowadays the prevalence of high risk behaviors, especially among adolescents and young adults has created a lot of worries for human societies and despite the preventive measures of the last three decades, high risk behaviors have grown tremendousely in the world and have imposed heavy medical bills.Since prevention has been recognized to be the only way of controlling such behaviors, medical professionals should change people’s health behaviors by promoting the knowledge of the society. Among these professionals, health trainers can have an important role in increasing community knowledge for the prevention and control of high risk behaviors. Therefore, the level of their knowledge is important. This study was carried out to evaluate the effect of high - risk - behavior prevetion educational program on the knowledge and atittude of school health trainers in Khoramabad in 1384. The study was a quasi-experimental one. The sample of the study was all school health trainers (n=50) in Khoramabad. The data collection tool was a three-section questionnaire including questions on demographic data, knowledge, and atittude toward high risk behaviors which was prepared based on reliable information, books and papers and was used after confirming its reliability and validity. In this study the intervening variable was the high - risk - behavior prevetion educational program. The educational method in this study was a two-session workshop. The educational content emphasized on the promotion of knowledge, positive attitude toward prevetion to implement healthy behaviors which was performed by university instructors in the field. After two months of education, the post test was performed on the sample. After collecting the data, the score of each question was obtained and the likert scale was used to obtain the sample’s level of knowledge and attitude. The level of knowledge was determined to be weak if their score was between 0 to 18, moderate in the range of 19-35, and good from 35 to 55. Then data was analyzed by statistical tests (t-test). The results of the study showed that 78.7% of the sample had some information about high risk behaviors before education, and only 3.4% could define high risk behaviors correctly. The majority of the sample had received their information on high risk behaviors through variouse sources including radio, TV, books and other publications. Paired T-test statistic showed a significant difference (p=0/0001) between the pre and post experimental average score of the sample knowledge and atittude. The results of the study indicated that health education program has caused an increase in the knowledge and atittude of the sample.Therefore, regarding the trainers’ respansibility in the protection of cimmunity and children’s health, it is imperative to promote their knowledge through continued education on the control and prevention by including them in school books and formating a health consulting committee in schools.

Usually the incidence rate of delirium after hip surgery in elders is high. It causes several complication,bad prognosis and even mortality. Due to several side effects of drugs, music can be a nonpharmacological unrisk method for prevention of delirium. The purpose of the present study was to determin the effect of music on post operative delirium in elder women who underwent hip surgery hospitalized in orthopaedic ward. The present study is a semi experimental research. The samples were including 100 old women over 65 years of age with hip fracture in khorramabad Shohada hospital during 4 month. They were allocated according to inclusion criteria and sampling method to 2 equal groups of intervention and control, each with 50 persons. The tools of gathering data were demographic questionnaire, screening questionnaire and mini-mental state examination(MMSE). First, patient`s cognitive state were assessed by MMSE. Music was played for persons in intervention group for 20 minute, three times daily from 1 day before surgery until 4 days after surgery,while participants in the control group received standard care. During the intervention, patient`s cognitive state was assessed by MMSE two times daily. Then patient`s were divided in 2 groups before and after scores in intervention group were compared. Findings showed that there is significant difference between before and after scores in intervention group(p=0/018). This difference even was significant with modification of before cognitive scores (p<0.001) and age (p<0.001)of intervention group. This study provides evidence that music listening is an effective and unrisk tool for prevention of post hip surgical delirium in elders.

Idiopathic Pulmonary Fibrosis (IPF) is a chronic rare disease with unknown etiology which is usually fatal and occurs mostly in adults. This disease is extremely rare in children and infants. Eight children with IPF who were examined in the pediatric department of Masih Daneshvari Hospital during 2001-2004 have been reported.There were 5 boys and 3 girls at the age range of 7 to 13 years (mean age 10.2 yrs). Clinical symptoms were cough and dyspnea in all patients which were progressive and exacerbated by recurrent respiratory infections. In clinical examination, crackles were found in both lungs of all patients while cyanosis and clubbing were detected in 5 subjects. Chest x ray showed reticulonodular and bullocystic patterns in 6 and 2 cases respectively. Pulmonary function tests in all patients were in concord with those of pulmonary restrictive diseases.To make a definite diagnosis, lung biopsy was performed in all patients which showed histologic changes in accord with IPF. Patients were mostly treated with steroids. In the present study, the prognosis of disease has been good in our patients and only one death occurred due to respiratory failure. To our knowledge, this study is the first report of P.I.P.F (Pediatric Idiopathic Pulmonary Fibrosis) in Iran. Other cases of this disease may be found in other medical centers which should be collected and evaluated by the researchers.

The Bardet Biedl syndrome is a heterogenous and autosomal recessive disorder. Primary features are: retinitis pigmentosa, obesity, polydactyly, mental retardation, renal abnormalities and hypogonadism. Renal failure is the major cause of death in homozygote patients, with chronic glomerolopathy that cause chronic renal disease. Secondary features are: speech disorder delay, developmental delay, polyuria, diabetes mellitus and hypertension. The diagnosis of Bardet- Biedl syndrome is established by clinical findings. Twelve genes are known to be associated with Bardet Biedl syndromes: BBS1, BBS2… BBS12. In this article we report a four and half year old boy that have Bardet Biedl syndrome as a result of a consanguine marriage (third degree). A monogenic syndrome such as Bardet Biedl has a lot of symptoms. These symptoms are out put of a mutation in locus of a recessive allel. Therefore people like to marry consanguinly have to do genetic counseling before marriage. Because analysis of family history will reduced the risk of such syndromes.