مجله دانشگاه علوم پزشکی قم
پیاپی 1 (فروردین 1386)

Background and objectives Haemophilus influenza can lead to several infections in humans. For example it can lead to meningitis epiglottitis pneumonia cellulitis bacteremia septic arthritis and conjunctivitis. H. influenza can be classified into seven biotypes independent of their serotypes. Biotypes are determined by three tests including indol production urease and ornithine decarboxylase. As specific biotypes are associated with different types of infections sources and antimicrobial resistance patterns this study was designed to evaluate biotyping in H.influenza and its relationship with the type of infection. Methods In an 18 month period from April 2005 to September 2006 all clinical specimens that were candidate for Haemophilus isolation were cultured on standard chocolate agar and blood agar with staphylococcal streak technique. Those isolates that showed the phenomenon of satellitism were biotyped by indol production urease and ornithine decarboxylation tests. Results From 24 samples positive for Haemophilus influenza 11 were isolated from eyes 11 from paranasal sinuses one from cerebrospinal fluid (CSF) and one from blood. The isolates from sinuses belonged to the biotype III the biotype of 6 of the eye isolates was II and that of the other 5 biotypes were III and the isolates from blood were type I. Another biotype was not isolated from these samples. Conclusion In other studies biotype I was the most frequently isolated biotype from CSF and blood. Biotypes II and III have been isolated from the eyes and sputum. The relationship between biotypes II and III in conjunctivitis is well documented. In this study the most frequently isolated biotypes from conjunctivitis samples were II and III type III was also common in sinusitis. Biotype IV has been isolated from genital tracts. Due to correlation of biotype and antimicrobial resistance biotyping is recommended in Haemophilus isolates.

Background and objectives Iodine deficiency was a public health problem in Iran before the start of iodine supplementation program in 1989. This study has been conducted in the framework of the national monitoring survey in 2001 to find the prevalence of goiter and urinary iodine levels in order to evaluate the effect of national supplementation program on the iodine status of school-aged children in the city of Qom. Methods In a deh1ive cross-sectional study 1200 schoolchildren aged 7-10 years were selected randomly from all regions of Qom and the grade of goiter was determined in 600 boys and 600 girls according to WHO classification. Urinary iodine content was estimated using the digestion method in one tenth of the schoolchildren. Results Goiter was observed in 26% of children (24.3% of girls and 27.7% of boys). The average urinary iodine level was 15.2 µg/dl. Urinary iodine levels higher than 10 μg/dl was measured in 71.7% and less than 5 µg/dl in 8.1% of children. Urinary iodine levels less than 2 μg/dl has not been observed in any of the cases. No significant difference was observed in prevalence of goiter and the urinary iodine level between males and females and students in living in urban or rural areas. Conclusion Comparison of these results with those of the year 1996 shows that prevalence of goiter has significantly decreased in these students. Also it shows that in the city of Qom the urinary iodine levels of schoolchildren fall in the standard range determined by WHO. This indicates that the iodine intake is adequate in the province of Qom. Therefore this province can be considered as an “iodine deficiency-free” zone.

Background and objectives Provision of standard childbirth facilities has been considered as an important healthcare issue for a long time. The physical and psychological states of mothers are important factors determining the fate of delivery. Therefore several programs have been established to decrease the mother-child mortality rates and the complications of delivery. One of the most common approaches for controlling the pain of delivery is application of local anesthesia such as epidural spinal or a combination of these methods. It has been shown that complications of epidural anesthesia are less than other methods of local anesthesia employed for the painless delivery. In this study a comparison is made between two groups of 80 neonates delivered by either NVD or EU. Methods A form was designed for collection of data including Apgar score at first minute need for CPR NICU admission FHR variability breast feeding time duration of hospital stay and neonatal reflexes. The data were analyzed by chi-square and fisher tests using SPSS software. Results There was no significant difference between the neonates born by EA or NVD at the 95% confidence level. Conclusion Based on these findings it could be concluded that epidural anesthesia for delivery does not lead to neonatal complications more than that of NVD without pain control. Therefore this method could be recommended to mothers who choose elective cesarean section to avoid the pain of childbirth.

Background and objectives Rheumatoid arthritis is one of the most common chronic diseases of unknown cause leading to significant disabilities especially in the adult patients. The physical signs and symptoms of this chronic disease can considerably affect the patients’ quality of life. Methods In this relationship survey 190 randomly selected patients with rheumatoid arthritis. The data were collected through self-reports interview and observation by questionnaire and using the pain and fatigue severity scales which consisted of eight items. Statistical analyses using deh1ive and inferential methods were performed by SPSS software (version 11.5). Results The results showed that the quality of life was high to moderate in half of the subjects (%50) and low in the other 50%. The status of physical dimensions socio-economic mental sleep and rest and general health was high to moderate in 50% and low in the other 50% of patients. The intensities of pain fatigue anxiety and depression were severe in most cases but the disability in mobility was mild. There was a significant relationship between intensity of pain intensity of fatigue disability in mobility intensity of anxiety intensity of depression and the quality of life. Conclusion The results showed that the quality of life in half of the subjects (50%) was low. There was a significant relationship between pain fatigue disability in mobility anxiety and depression and the quality of life.

Background and objectives Oxymetholone is an orally-administered active anabolic-androgenic steroid. This drug was synthesized in 1959. It is a 17α-methylated 5α-saturated compound. It is used for the treatment of a variety of diseases including anemia growth delay in children myocardial damage in heart failure and treatment of HIV associated wasting. This is one of the drugs used in high doses by the doping athletes because of its anabolic effects and its influence on muscular mass. In this study the effect of oxymetholone in supraphysiologic doses was evaluated on oogenesis in NMRI mice. Methods In our experiments 12 mg/kg/day oxymetholone was injected intraperitoneally to 4- and 6-week old mice for 70 days. Results The results demonstrated a significant difference between treatment and control groups after both 35 and 70 days of treatment. This drug led to significant decrease in the number of corpus lutea decrease in the number of atretic follicles decrease in the weight and diameter of ovaries decrease in the diameter of granulosa layer increase in number of primordial follicles decrease in number of primary follicles decrease in number of growing follicles decrease in the number of graafian follicles and decrease in the progesterone level. Additionally disordered formation of granulosa layers and growing of oocytes in antra anomaly of the ovular medulla and formation of two oocytes in one folliculus were observed in some mice. Conclusion The results show that oxymetholone decreases the ovarian growth and the rate of ovulation.

Background and objectives Water is the basis of life and health. The health of food and water supply plays an important role in human health. One of the methods of water desalination is membrane filter reverse osmosis method. This method is used for desalination of drinking water supply in Qom. Methods This is a deh1ive cross-sectional study designed to determine the quality of treated water in Qom desalination plant in year 2002. Inlet and outlet water samples of this plant were examined by the standard examination methods and the collected data were compared with national and international standards. Excel software was used for statistical analysis. Results The results showed that the residual chlorine concentration total hardness and fluoride concentration were lower than the minimum standard limit set for drinking water. The pH was also lower than the minimum standard limit. Microbial contamination was detected in 6% of samples. Conclusion The results show that the acidity of water was lower than standard in whole plant. This gives corrosive properties to the water and increases the dissolution of materials which are in contact with this water. In order to eliminate the secondary contamination the concentration of residual chlorine should be 1 mg/l. But none of the measurements showed a concentration as high as this value. As fluoride is an important element for health and growth of bone and teeth especially in growing children fluoride should be added to the drinking water. As the relationship between hardness of water and cardiovascular diseases has been established it can be concluded that this drinking water supply can increase the risk of cardiovascular diseases in long time. Dilution of this water is recommended to adjust various factors to the standard limits and keep the total dissolved solids low.

objectives The effects of music on blood pressure pulse rate respiratory rate and other physiological functions have been proven for several years. The effects of the music on human system have also been studied in several populations. But this effect has not been studied in Iranians. So we have decided to research on this matter. Methods In this experimental interventional study 28 patients with allergic rhinitis (12-36 years old with the mean age of 25) were included after application of a set of inclusion and exclusion criteria. The patients were divided into four groups three interventional groups (traditional Persian western classic and pop music) and one control group. Seven subjects were allocated to each group based on their favorite music. Each group underwent a period of intervention for one month and blood samples were obtained before the start and after the end of intervention. Samples were examined immediately by flow cytometry according to the standards and six cellular parameters of CD3+ T cells (CD4+ and CD8+) Natural killer cells (CD16+) B cells (CD19+) and activated T cells (HLA-DR+) were measured. Results We found significant difference between interventional groups and the control group. The differences are as follows: CD3+ cells: atopic pop versus atopic control (Pvalue = 0.03 increase) atopic Persian classic versus atopic control (Pvalue =0.04 increase). CD4+ cells: atopic pop versus atopic control (Pvalue =0.03 increase) atopic Persian classic versus atopic control (Pvalue = 0.03 increase). Non-atopic allergic pop versus non-atopic control (Pvalue =0.01 decrease). CD8+ cells: atopic pop versus atopic control (Pvalue = 0.05 increase) non-atopic allergic pop versus non-atopic control (Pvalue =0.02 decrease) western classic non-atopic allergic versus non-atopic control (Pvalue = 0.02 decrease). CD16+ NK cells: atopic pop versus atopic control (Pvalue =0.014 increase) non-atopic allergic pop versus non-atopic control (Pvalue = 0.02 decrease) CD 19+ B cells (Pvalue = 0.07 noticeable increase). Conclusion Evaluation of immune cells in atopic patients who listened to pop music showed significant increase in CD3+ CD4+ CD8+ and NK cells and a noticeable decrease in B cells. Therefore it can be concluded that pop music had positive effects on atopic subjects. But apparently the effects of this music on non-atopic subjects are opposite i.e. CD4+ CD8+ and CD16+ cells were significantly decreased in these patients. In contrast humoral immunity was strengthened and B cells were significantly increased.

Background and objectives Takayasu s arteritis so-called pulseless disease is a syndrome mostly seen in young women. It is a chronic inflammatory arteritis affecting large vessels. It is associated with abnormal angiography of the upper aorta and its main branches resulting in vascular impairment in the upper extremities. This report presents a case of successful pregnancy in a patient with Takayasu s arteritis. Case The patient was a 36 years old G2P1 woman. Her first child was delivered by cesarean section. She was suffering from Takayasu s arteritis and was treated with prednisolone since 7 years ago. She had an unplanned pregnancy after expulsion of IUD. In her past medical history in addition to Takayasu s arteritis involving subclavian artery an iodine 131 ablation for treatment of hyperthyroidism was noticed. She was first sought medical attention at 8th week of pregnancy and as she had normal cardiopulmonary and renal functions the pregnancy was continued. Subtotal thyroidectomy was performed at 10th week of gestation following a suspicious FNA showing a cold thyroid nodule. She was then treated with thyroxine in addition to prednisolone to control the post-thyroidectomy hypothyroidism. At 37th week her pregnancy was terminated by cesarean section with epidural analgesia because of reduction of amniotic fluid index and a BPS of 8/10.