مجله دانشگاه علوم پزشکی اردبیل
پیاپی 29 (پاییز 1387)

Since the students majoring in different Fields of medicine are going to play key roles regarding Community health in the future, it seams necessary to characterize problems threatening their mental health. This study was performed in order to evaluate students’ mental health status in Ardabil University of Medical Sciences In this descriptive-analytical study, 352 students were selected through census and were requested to fill out general health questionnaire (GHQ) with 28 questions as well as personal information questionnaire. The data were analyzed using descriptive statistics and chi- square. The findings indicate that students have problems in physical (1.7%), and social function (4.3%), anxiety and insomnia (2.3%) of them suffer from severe depression (2%). Also according to cut point (23) 22.7% students were suspected of mental disorders. In this research, there was no significant difference in mental disorders between male and female students, but there was a meaningful relationship between status with paternal educational degree and family size and mother's job (p< 0.05). according to the findings, student's psychological evaluation and counseling service in different fields to promote student mental health, is recommended

hyperphosphatemia and hyperkalemia have major roles of mortality and morbidity in hemodialysis patients. In this study we evaluated the effectiveness of increase in blood flow rate on blood potassium and phosphate of hemodialysis patients. This is a clinical trial study 42 patients were assessed during the hemodialysis. A questionnaire and laboratory tests were used for gathering data. At first questionnaire of demographic data was completed and then the weight of patients was connected to each session of dialysis. Then the patient was connected to dialysis machine and blood sample was gathered before dialyzer. After taking blood sample, flow rate was regulated on 200 ml/min in the first session and on 250 ml/min in the next session. During hemodialysis, hemodynamic status and clinical status of patients was controlled. At the end of hemodialysis and before disconnection patient from dialysis machine, a blood sample was taken from arterial set before dialyzer (4 blood samples for each patient). Blood sample was sent to laboratory and all of them were analyzed by one technician and with one set. Average phosphorus changed significantly from 3.35 to 2.94 with increasing Qb from 200 to 250 similar to the increase in Qb in potassium removal (from 3.43 to 3.52) meq/lit. Paired t-test (p0.005). It can be concluded so that increase in blood flow rate from 200ml/min to 250ml/min, can affect removal phosphorus but can not affect removal of potassium

Carcinoid tumor is the most common appendix tumor and its origin in from neuroendocrine cells. 80% of tumors are located in GI tract and the most common site of the tumor is appendix. This neoplasm is found in 0.3-0.5 percent of appendectomized samples. The mean age in diagnosis time is 30 years old and the neoplasm is more common in women. The aim of this study was to investigate the age and sex prevalence of carcinoid tumor in appendectomized patients. This descriptive study was done on 5644 specimens in the Fatemi Hospital of Ardabil for surveying of carcinoid tumor prevalence, on the basis of age & sex, from 2003-2007. In this study, the prevalence of carcinoid tumor was 0.19%, average involvement mean 33.6 years old (ST= 23.1) & the men diameter of tumor was 0.74 cm (ST= 0.37). The prevalence in women was 3 in 1000 and in men was 1.36 in 1000.All of the tumor located in the tail portion of appendix. The tumor can cause acute appendicitis by duct obstruction but mostly is discovered during pathologic examination accidentally, conclusion pathologic examination of appendix with sagital incision in all appendectomy cases is recommended.

Even though there are different treatments for patients with pityriasis versicolor, there are not enough information about using new topical systemic treatments. In this study, the effect of clotrimazole VS topical fluconazole in treating patients with pityriasis was investigated. A double blind randomized controlled trial was designed in dermatologic clinic of 5th Azar hospital Gorgan North of Iran, from April 2006 to May 2007. 120 patients were randomly divided into two groups: In the first group (G1), patients underwent treatment with single - dose of fluconazole capsule (400mg) and placebo cream. In the second group (G2), patients underwent treatment with clotrimazole cream (twice daily) and placebo capsule. The course of treatment was 2 weeks. All subjects were re-evaluated 2, 4 and 12 weeks after the end of the therapeutic course. In group one there were 50 patients and in group two 55. After 2 weeks, the rate of complete resolution of disease was significantly higher in G2 group than G1 (49.1% vs. 30%). After 4 weeks, 41 patients (81.2%) of G1 and 52 patients (94.9%) of G2 showed complete resolution. After 12 weeks 46 patients (92%) in G1 group and 45 patients (81.8%) in G2 group showed complete resolution. Recurrence rate in G1 and G2 groups were 6% and 18.2%, respectively. No complications were seen in the two groups. In this study, clinical response at 4th week, in clotrimazole group was greater than fluconazole group. Recurrence at 12th week after treatment with oral fluconazole was less than clotrimazole cream.

Candida Albicans is a fungus that frequently infects diabetic patients. Because it is very common infection in diabetics, we tried to determine the prevalence of infection and the asymptomatic carriers and show factors like age, sex, duration of diabetes and quality of disease control that probably have effect on infection. In this study 200 diabetic patients were chosen randomly and blood samples were taken for FBS and HbA1C and then skin smears were performed from body folds (Axillaries groin interdigital folds) and probable lesions. The skin samples were cultured in Chrom-Agar medium. Then the gathered data were analyzed. Overall, from 200 patients, there were 180 (90%) negative culture and 20 (10%) positive cultures. Candidial infection in men and older patients were relatively higher than others. Candida infection in poor controlled diabetes was considerably higher. Infection in type-1 diabetes was more than type-2 diabetes. There was no correlation between duration of diabetes and prevalence of infection. Candida infection is more common in diabetic patients with poor control, male and older ones.

Venous thromboembolism is a common disorder that is difficult to diagnose clinically but carries significant mortality if untreated. Many diagnostic imaging algorithms for the detection of PTE, including ventilation perfusion lung scan, Doppler ultrasonography of lower extremity and pulmonary CT angiography. This study's aim was the comparison of Doppler ultrasonography of lower extremity with perfusion -ventilation lung scan in patients suspected for pulmonary emboli and finding the best approach for diagnosis of the suspected pulmonary emboli. One hundred twenty patients of suspected pulmonary embolism referred by internists to Doppler ultrasonography of lower limbs Department of Imam's Khomeini Hospital were studied. The patients were studied within 48 hour post suspected pulmonary emboli and evaluated with V/Q scan and Doppler ultrasonography. The prevalence of DVT in lower limbs of patients suspected of pulmonary emboli was %37.5. Results of lung scan in patients suspected pulmonary emboli are as below: High probability in %17.5, intermediate probability in %27.5, low probability in %41.5 and normal in %13.5 Results of lung scan in patients suspected for pulmonary embolism with DVT are as follow: High probability in %24.4, Intermediate probability in %33.3, low probability in %26.7 and normal in %15.6. Mean age in patients with and without DVT Was 52.53 14.13 and 56.22 17.63 year respectively. Patients suspected for pulmonary emboli with normal lung scan needs more assessment for DVT in lower extremity with Doppler ultrasonography. Normal Doppler ultrasonography of lower extremity doesnt exclude performing lung scan for approving pulmonary emboli. Doppler ultrasonography and lung scan both need evaluating patients suspected for pulmonary embolism.

Mental Health is a phenomenon which has been considered by psychologists, medical doctors and religious scholars and it is a combination of physical, social and cognitive factors. Due to the effectiveness of teaching coping skills in increasing mental health, this study was done to achieve the effect of teaching coping skills in providing mental health in students of Ardabil University of Medical Sciences. Due to the nature and aims of the study, the study method was experimental research method. The samples of the present study comprised all male and female students (n=112) at Ardabil University of medical Sciences in 2006-2007 and gained 23 or more in GHQ-28 questionnaire (which evaluates four subscales of anxiety, depression, physical symptoms, and disorder of social functioning). At the next stage the samples (i.e. 80 female and male students) were selected randomly and divided in to two groups. Then, coping skills were taught to the experimental group for 4 weeks (two sessions in a week) and no variable was exposed to the control group during this period. At the end, the data from 62 (Dropt=18 case) individuals were analyzed by independent t test. the results showed that teaching coping skills affects on decreasing mental disorders symptoms especially somatization of symptoms and anxiety of students suspected to the mental disorder (R< 0.001). But the teaching coping skills do not affect on decreasing depression and disorder of social functioning of students. This study showed that teaching coping skills is a good method in decreasing mental disorders symptoms among the students suspected to the mental disorder. Therefore it is suggested that in order to prevent and decrease mental disorders symptoms, the coping skills should be taught to students.

Warts are common dermatological disorder which are difficult to treat and usually relapse. In this study the efficacy of topical %5 5- fluorouracil was compared with conventional cryotherapy in treatment of plantar Warts. In a clinical trial study, 50 patients clinically diagnosed as warts were divided in to two groups. 25 patients were treated with topical 5% 5- fluorouracil while the other 25 were treated with cryotherapy. After treatment, patients were followed for 6 months from the viewpoints of treatment complication, efficacy and relapse rate. It was observed that treating period in cryotherapy was short but 5F-U therapy needed longer time. Initially in 5-FU group 52% of patient had good response, 36%moderate response and in 12% no response was observed there is no significant difference in view of sex in this group (p=51%) and in cryotherapy group 60% of patients had good response, 28% moderate response and in 12% no response was observed like wise there was no significant difference in terms of gender (p=0.08). In response to therapy there was no difference between two groups (p=0.09%) after 6 months follow up relapse rate was 18% in cryotherapy patients and only 8%in 5-FU group which wasnt statistically meaningful and no difference was observed between two groups (p=0.27). The results indicated that course of treatment was shorter in cryotherapy than the topical 5- FU but the relapse rate didnt have any difference between two groups. The only significant difference was pain in which 5- FU was painless but cryotherapy was painful.

Identifying urinary tract infection, especially in infants and young children is very important from the viewpoint of start of treatment, and if it is delayed probably the children are affected by risk of failure to thrive, sepsis and chronic problems such as renal scars, increase of arterial blood pressure and renal failure. Increasing usage of antibiotics, result in AB resistance microorganism. This study was done because of bacterial differences in resistance in different regions and the change in the rate of resistance in UTI. This research is a descriptive-prospective study 510 children under the age of 12 as the study samples were chosen. These children were referred to clinics of Ardabil Aliasghar and Sabalan Hospitals in 2006. Their urine culture colony was above 100000. Data gathering was accomplished by their parents through questionnaire and interview's then gathered Data were analyzed by computer software programs of the SPSS and Excel. Findings of research showed that symptoms of malodorous urine (54.7%) in children under 12 months, dysuria (58.9%) in 1-3 years age groups, frequency (54.8%) in 3-6 years old groups dysuria (49.2%) in 6 years old groups and above were most prevalent symptoms which were reported. From the viewpoint of gender differences UTI in girls was 4 times more than that of boys that this difference in 1-3 years old groups was highest range (4.8 to 1). About antibiotical resistancy of microorganisms, Ampicillin with 78.9% resistance, Co-trimoxazole with 66%, Cephalexin with 62.8% and cephazoline with 33.3% were most resistant antibiotics respectively. E-coli resistance against gentamicine was 15.8%, that compared with other microorganisms is very high and its resistance against ceftriaxon was 8%, which is low compared with other microorganisms. Findings of research showed the variety of UTI symptoms in children and also showed that drug resistancy against Ampicillin, Co-trimoxazole, Cephalexin and cephazoline is high.

One of the main areas of research in hot springs is to investigate the probability of the presence of gamma radiation resulting from the natural radioactivity substances in geologic combinations in volcanic regions. Meshkinshahr with a beautiful landscape is located in the northwest of Iran. Sabalan volcanic mountain has created many hot springs in its vicinity. One of the major ones is hot spring of Qotursui with PH= 2.5 n the north east, chainarja with an average temperature of 80 0c and Ilando and moillsui in the northwest of sabalan. This study was done to determine the environmental gamma and the annual absorption dose for the above hot springs and to compare it with that of world standard in Meshkinshahr in 2007-2008. In this descriptive cross sectional study, a Geiger Muller dose meter (Model: Smart Ion) was used to measure the amount of environmental gamma. Placing the dose meter in two different heights of 1 meter and 5 centimeter respectively, the mean of environmental gamma was obtained. The number of dosemetry in each season was at least 30 in the morning and in the afternoon. In each dosemetry, 3 points in the source of the dosemetry was repeated in the deposits. The dose meter in each height was kept on a stool for 10 minutes and it registered the information momentarily. The findings were analyzed through a T-test. Results during one year study show total average level of dose of environmental radiation for Hot springs of Ghainarjeh 26.3, Ilando 21.6, and Moill 22.04 msv.y -1. Average dose of gamma rays in Hot springs is high in proportion to world standard which is more than 8-10 times and this region can be considered as high natural radioactive.

In addition to the socio-economics costs, Diabetes is a major cause of illness and death at all groups. Diabetes affects over %10 of adults in the world. Despite promising trend in improving many aspects of health Care and treatment in the last decade in our country, little attention has been paid to the subject of registering Diabetes on an international standard. Quality improvement of treatment, identifying high risk groups, controlling, preventing and evaluating of diabetes, would materialize only when the national Diabetes Registry System is established and its data are collected and completed on time. The aim of this study was to suggest Diabetes registry system in Iran, to meet the health and medical needs. This Comparative Cross-sectional study was conducted to evaluate the developed national diabetes registry systems in 2003. In this study national diabetes registry system in Britain and USA was evaluated by library resources, Websites and Email communication with internal and external specialist. Suggestions were made on the basis of economic cultural and geographic situations. These axes included aims, structures, data elements, registration, data collection processing, and classification and control of quality of system. The results show that in order to optimize the diabetes registry system, structure, data elements, information gathering process, main goals, registration criteria, Classification systems and quality control mechanism of the current national diabetes registry system should be reevaluated. Considering the results and international diabetes institutes recommendation, the decrease in poor registry and increase in quality can be the advantages of model suggestion in comparison with the country's current system.

Serious reactions which normally is delayed and occur against serious stressor factors like natural disasters (for example: earth quake, flood and etc) and human made disasters (for example war, murder and etc) calls post traumatic stress disorder (PTSD). The aim of this study was Assessing the effectiveness of teaching problem solving skills in decreasing the symptoms of PTSD. The type of this research is experimental. After clinical assessment and selecting with clinical assessment these individuals showed PTSD symptoms through the results of both Mississippi scale and clinical appointment, in which there were 160 cases. The cases were separated to two groups of experimental and control. Through an experimental method, we studied and measured changes of their status before and after examination and only case group had been chosen for problem solving skills teaching. In order to analyze the results of the study, a T test and Variance analysis (ANOVA) were used. The results showed that 61.6 percent of population showed PTSD symptoms and there was no significant difference between male and female in level of PTSD symptoms. There was a significant difference between, means level of PTSD in pre-test and post-test conditions, in addition there was no significant difference between levels of PTSD symptoms-decreasing, in female group after intervention, and male group. By comparing mean numbers of samples, in pre-test and post-test results of control and experiment groups in using problem-focused coping skills and decreasing emotion-focused coping skills, there was a significant differences. Also there was not any difference in using levels of coping methods, but indeed in amount of using emotion-focused coping method there was significant difference between male and female. Presence of significant differences between pre-test and post-test results showed that training problem-solving-skills in decreasing PTSD symptoms is effective.

Clock drawing test is a neuropsychological test and has simple scoring and administration. It is a visual-spatial task and therefore can be useful for assessment of the right parietal lobe, constructional apraxia and executive function in schizophrenia. this research was a descriptive-analytical study. The samples of this research were 80 inpatient male persons with schizophrenia in Razi Hospital of Tabriz in the fall of 2007. The sample size was 28 patients that were randomly selected. 28 normal persons that have been matched in age and educational level as comparison group were assessed with the test. The raw data were analyzed by independent t-test and the analyses were done by SPSS13. The results indicated that there is a significant difference in two groups on two phases of research (p=0.01). In particular, the error scores in group with schizophrenia on two phases were higher than normal group. Furthermore, error scores of group with schizophrenia did not show any difference in the second phase. On the basis of the results it can be concluded that the clock drawing test can diagnose differentially between persons with schizophrenia and normal population. On the other hand most frequent errors on drawing the test in persons with schizophrenia was the place assignment of numbers in clock face. This failure is due to visual-spatial disorder. Visual-spatial ability is affected by the object centered system and the viewer centered system.

Stroke is the third most common cause of death after heart disease &cancer and the most common disabling neurological disorder. The incidence increases with age, and is somewhat higher in male than in female. The main risk factor of stroke is hypertension. In last years incidence of stroke has decreased due to improvement of hypertension treatment but due to occurrence of cerebrovascular accident with normal blood pressure, in many patients with stroke. This study aimed to evaluate the frequency of mortality and morbidity in stroke patients with hypertension & normal blood pressure. This descriptive retrospective study, evaluated 8121 patients with stroke who were admitted at hospital (1997-2006). The inclusion and exclusion criteria were defined. Data was gathered through check list and analyzed by SPSS soft ware 10 edition and the results were compared with each other. The total mortality and morbidity rate of stroke was 13.59% who 19.3% of patients with high mean blood pressure and 10.2% of patients with normal mean blood pressure were expired due to stroke. The mortality based on age in two groups was similar and more frequent in 65 to 74 year olds. The rate of mortality and morbidity in patients with high mean blood pressure in male and female were similar but in normal mean blood pressure cases were more frequent in male than in female. Hemorrhagic stroke was the most common type of stroke in hypertensive patients (59.55%) and in normotensive patients, ischemic stroke was more frequent (37.7%). The duration from admission to death was similar in two groups and the death was highest within 72 hrs after admission. Since mortality and morbidity according to age had no significant difference in both groups. It seems other risk factors are effective in evaluating cerebrovascular accidents (prognosis).

Schizophrenia is a chronic disease with frequent periods of exacerbation & remission which influences all aspects of the patient's life, in a way that the patient never returns to his premorbid life. The goal of this survey is Study of main signs in Schizophrenia patients in Ardabil City. This study was a descriptive-analytic one which was done on all of the patients with schizophrenia admitted in Fatemi & Issar hospitals in 2006. A sample of 100 was selected. To study the main signs of schizophrenia in these patients, a questionnaire was used. To screen the patients with schizophrenia, MMPI test was used. The findings were analyzed by descriptive statistics & through the computer software SPSS. Also a PCA method of factor analysis was used for the hypotheses. 79 patients were male and the rest female. The most frequent main sign in these patients was attention deficit, & social withdrawal was at the second place. Also, the most frequent type of schizophrenia was paranoid schizophrenia (44%=44 patients). The most widely used was clozapine. The findings of this study have a concordance with the results of the last studies about the main signs of schizophrenia & also with DSM-IV & Bluerian & Kreaplian symptoms (except from the perception disorders).

Urinary tract infection (UTI) ranges from asymptomatic bacteriuria to severe renal infection with sepsis. Urinary tract infection can cause many complications as abscess, hypertension, renal failure, renal scar, reflux and so on. Since there is no general agreement on the administration of additional fluid (1.5 times maintenance) on the early treatment of UTI on this study was conducted to see the effect of additional fluid. 206 children with UTI who were admitted in Amir Kabir Hospital of Arak from March 2005 to March 2006, were divided into two groups of 103. One group received the usual amount of maintenance fluid and the other 1.5 times of maintenance. The course of resolution of dysuria, frequency, malodorous urine, abdominal pain and fever were compared in the two groups. Patient's urine culture was performed on the second day, 7-10 days, and 90 days after admission. Patients were matched according to their age and sex. Those who presented with azotemia were excluded from the study. Receiving additional fluid had a significant effect on the malodorous urine dysuria. However, it had an inverse effect on the treatment of fever and urinary frequency and it made them even last longer. In other areas like abdominal pain and urine culture in 3 stages there was no difference. It seems that intake of excessive amounts of water has no significant effect on the results of the UTI treatment.