مجله دانشگاه علوم پزشکی شهرکرد
سال سیزدهم شماره 3 (پیاپی 51، امرداد و شهریور 1390)

Considering the iron supplementation during pregnancy and the problems due to over using of this supplementation, almostall women take iron supplementation during pregnancy. The aim of this study was to determine the effect of the iron supplementation prophylactic on outcome and the problems of pregnancies. In this double- blind randomized clinical trial study 129 women with Hb > 110 g/l, serum ferritin > 20 µg/l and gestational age less than 20 weeks were randomly divided to receive either of ferrous sulfate tablets (n=62), 1 table / day (60 mg) or placebo (n=67). Hemoglobin and ferritin were also measured in the 24-28th weeks and at the end of pregnancy. In addition, weight and length were recorded at the beginning and during the pregnancy in both groups. Data were analyzed using independent-t test, ANOVA, and Chi square tests. Iron deficiency prevalence in Fe and placebo groups was found 5.8 and 24.8 percent in the 24-28th weeks (P=0.002) and 9.5 and 28.2 percent at the end of the study respectively. No significant differences were found in hemoglobin and ferritin indices during the study in both groups. Average birth weight was 3.30±0.49 Kg and 3.27±0.47 Kg in Fe and placebo groups, respectively. Average length birth was 49.1±3.9 cm in Fe group versus 49.3±4.4 cm in placebo group. Duration of gestation in Fe and placebo groups were 38.9±1.7 weeks and 38.8±2.2 weeks, respectively (P>0.05). The results of this study showed that iron supplementation during pregnancy may have no effect on pregnancy outcome. It is obvious that because of more iron deficiency prevalence in placebo group, absolute conclusion about whether iron supplementation prophylactic during pregnancy is useful or not, more studies are needed in the future.

Extended-spectrum beta-lactamase of CTX-M-type is considered as an important mechanism resistant to cephalosporin in the gram-negative patogene and is wildly growing. Enterobacteriaceae species are able to produce extended-spectrum beta-lactamases (ESBLs). The aim of this study was to detect the prevalence of CTX-M genes in ESBLs producing enteric bacteria isolated in Shahrekord educational hospitals using Polymerase Chain Reaction method. In this analytical-descriptive study, antibacterial susceptibility patterns of 325 gram negative bacteria to Cefotaxim, Ceftazidim, Cefterixon and Azteronam tested using disk diffusion (Kirby-Buer) method. In addition, confirmatory tests for detecting ESBLs phenotypes were performed using Ceftazidim-clavulanic acid and Cefotaxim- clavulanic acid combination disks (MAST). The presence of CTX-M gene was assessed using PCR. Bacteria strains isolated in this study were Escherichia coli (59.4%), Klebsiella pneumoniae (30.4%), Enterobacter spp. (15.4%) and Proteus spp. (2.2%). Confirmatory phenotypic test showed that 28% of the strains were ESBL positive. The prevalence of CTX-M gene in isolated Enterobacteriaceae was 50.5 %. High frequency of CTX-M gene in ESBL producing isolates indicates that this enzyme plays an important role in resistance to betalactam containing antibiotics.

The migraine headache is usually one sided, vary in intensity and duration, lasting from several hours to three days. It is often accompanied by nausea, vomiting, and sensitivity to light and sound. Its diagnoseis is based on IHS criteria and there is several methods for the treatment: drugs such as triptans and sedatives, relaxation method and compression on superficial scalp arteries. The aim of this study was to determine the effect of intravenous Dexamethasone with and without superficial scalp arteries compression in acute migraine attack. In this clinical-trial study, 200 ambulatory volunteer patients affected with migraine were randomly divided into two groups. Control group were injected Dexamethasone (8 mg, i.v.) only and case group received Dexamethasone (8 mg, i.v.) as well as superficial scalp arteries compression. Pain scores were measured in both groups before and after intervention according to HIS criteria. Data were analyzed using Mann-Whitney, Chi-square, Wilcoxon and one way ANOVA tests. The average age of patients was 31.4±11 years and 74% of patients were female. The ratio of migraine without aura to migraine with aura was 10 to 1. Pain score was decreased in both groups after the intervention (P<0.01) and pain relieve in case group was significantly more than control group (P<0.05). A brief superficial scalp arteries compression along with Dexamethasone injection can relieve migraine pain better than Dexamethasine alone.

Pediculosis Capitis is one of the important health problems in students which cause physical, mental and social complications. The aim of this study was to determine the effect of designed health education program on knowledge, attitude, practice and Pediculosis Capitis rate among female elementary students in Chabahar city during 2008 and 2009.

This research was a quasi-experimental (case –control) study. Data gathering tools were questionnaire, check list and head examination. Two schools were randomly selected among female primary schools in Chabhar and 153 students were divided into case and control groups. After collecting the data, an educational program was designed and performed in case group and was evaluated after 2 months. Data were analyzed using Chi-square, Wilcoxon-Mann Whitney, and McNemar tests.

Results showed a significant difference in knowledge, attitude and practice of the students in the case group before and after the educational program (P<0.001), however, it was not significant in the control group (P>0.05). The infestation rate was 69.3% in the case group before education and 82.1% in the control group which decreased to 26.7% in the case group after the education (P<0.001). However, it was not significant in the control group (P<0.05). Significant relationship was observed between infection and the variables such as father’s level of education, number of bedrooms, number of individuals per room, existence of continuous water at home, type of hair, history of infection in students and infected cases in the family (P<0.05).

The health education program had a positive effect on the reduction of Pediculosis Capitis among students. Therefore, performing and evaluating educational programs for students and their parents is suggested.

Nowadays writing an essay is very important to represent scientific achievements providing that the principles of rhetorical patterns would be considered. The present study aimed to compare the structural variations in English abstracts of Persian and English journals in the area of medical sciences. In this analytical-descriptive study, 64 medical article abstracts (32 in Iranian journals, 32 in international journals) were analyzed and compared on the basis of Swales’ model. Furthermore detailed analysis was done on the Introduction section regarding CARS (Create- a- Research- Space) model proposed by Swales. The IMRC (Introduction, Methods, Results, Conclusion) sequence was considered as the structural conventions for the analysis. Data were analyzed using Chi square and Fisher tests. The results showed that while all translated abstracts considered IMRC sequence, the original ones did not considered it completely. In the introduction section, there was a significant difference, in writing the aim of the study and it was found more in translated abstracts compared to the original ones (P<0.001). In addition, there was a significant difference in using the Material and Methods section between the two groups of abstracts but pro translated abstracts (P<0.01). Both groups of abstracts were identical in the Results and Conclusion sections. The results showed that the translated abstracts from Persian to English in medical articles more closely reflected the criteria of scientific writing structure than the abstracts excerpted from the original English articles.

Candida albicans is the most common etiologic agent of diseases caused by yeasts of Candida genus. The treatment of these infections is necessary because they may spread in neutropenic and immunosuppressed patients. Fungi resistance to some antifungal drugs is being increased. In addition, many of these drugs are toxic and expensive. Therefore, the study of natural plant products which can be effective against these fungi is necessary. Among the plants which have shown in vitro efficient biologic activity, is Thymus vulgaris. Thus the aim of this research was to study the inhibitory effect of Thymus vulgaris essence on of Candida albicans growth. In this research, fifty patients with oral candidiasis were studied. The obtained swab samples were cultured on Sabouraud Dextrose Agar supplemented with cycloheximide and chloramphenicol (SCC) medium, finally with performance of supplementary tests. 32 isolates were recognized as Candida albicans. Then we added Thymus vulgaris essence to SCC medium in different concentrations and the Minimum Inhibitory Concentration (MIC) of the essence was accounted for different suspension dilutions of Candida albicans. The MIC of the Thymus vulgaris essence for the dilutions of 100, 10-1 and 10-2 of Candida albicans was 0.390µl/ medium and for dilutions of 10-3 and 10-4 were 0.195 and 0.0975 µl/ medium. The Thymus vulgaris essence has a very good antifungal effect against Candida albicans so that low amounts it can inhibit Candida albicans growth.

Leptin is produced by fat cells and is secreted into the blood stream. Serum leptin level is higher in continuous ambulatory peritoneal dialysis (CAPD) patients, compared to the healthy peoples. There are a few studies with controversial results about the relationship between serum leptin level and bone metabolism. The aim of this study was to evaluate the relation between serum leptin level and some bone metabolism factors. In a descriptive-analytical study, 75 CAPD patients in Alzahra Hospital in Isfahan were enrolled from October 2007 to February 2008. Serum levels of leptin, albumin, KT/V, PTH, Ca, P, alkaline phosphates and demographic findings were measured in all patients. Data were using analyzed t-test and the coefficient of correlation. Mean serum leptin level was higher in women compared to men. There was a significant correlation between serum leptin level with body mass index (BMI) (P<0.001). There was no significant correlation between serum leptin level and KT/V, duration of renal failure, serum Ca2+, serum phosphorus and alkaline phosphates. There was a reverse correlation between serum leptin level and serum PTH. Results of this study demonstrated that leptin may have a role in suppression of bone turn over.

Applying different educational plans, teaching methods, and assessments have certain effects on the students’ learning and their scores. The purpose of the present study was to evaluate the effect of formative assessments (multiple quizzes) on the students’ learning of the Physics courses of radiology. In this semi-experimental study, two Physics courses were selected: Physics of Radiology (course “A”) and Radiobiology (course “B”). The courses were offered for one group of paramedical B.Sc. students (15 people) in Shahrekord University of Medical Sciences in 2009. During the educational semester, 8 formative assessments (quizzes) were performed for the course A; while, no quiz was applied for the course “B”. All other teaching conditions, midterm and final exams, etc. were roughly similar for the two courses. The scores of two other physical courses, offered with the same conditions, were compared with the scores of the courses A and B. Data was analyzed using independent t-test. The mean of the formative scores was 2.7±0.05 (out of 4). There was a significant difference between the midterm exams’ scores of the courses A and B (P<0.001). Likewise, a significant difference was seen between the final exams’ scores of the courses A and B (P<0.001). Furthermore, all student's final scores for the course A were higher than those for the course B. Finally, the mean scores of the course A was 22% higher than those for the course B (15.9±1.1 vs. 13±1.9). This study reveals that applying formative assessments during the educational semester can help radiology students to increase their learning in Physics course.

Shock wave during extracorporeal lithotripsy causes pain for which analgesic drugs are prescribed most often. The aim of this study was to compare the efficacy and adverse effects of fentanyl and combination of pethedine and midazolam for pain control during extracorporeal shockwave lithotripsy (ESWL). In this single blind clinical trial study, 89 patients older than 18 years with renal or upper urethral stones who were candidates for ESWL were randomly allocated into Intervention (45 patients) and control groups (44 patients). First group (Intervention) was given I.V. fentanyl (1 mg/kg) and control group was given I.V. pethedine (0.7 mg/kg) and (0.02 mg/kg) midazolam before starting ESWL. Then ESWL was performed in two groups with guidance of fluoroscopy by standard technique. During operation every 20 minutes and 2 hours after operation severity of pain was checked according to visual analogue scale. Efficacy of operation was evaluated in two groups according to follow up KUB and ultrasonography. Data were analyzed by SPSS software using Chi square test. Frequency of painless operation and mild pain in fentanyl group were found 26.6 and 24.4 percents, respectively. Although severe pain was more observed in the control group (32.5%), but it was not significantly different (P>0.05). Efficacy of operation didn’t show significant difference between two groups of patients (P>0.05). Similar pethedine and midazolam lower dose of intravenous fentanyl provides adequate analgesia with minimal side effects and suitable efficacy for pain control during ESWL, which can be used in outpatients, without need to monitoring in adult patients.

In spite of the importance of breast feeding, as an exclusive manner, continuing the breast feeding is ignored frequently. So identifying the factors related to non tendency for breast feeding could be effective in planning for progress of breast feeding. This study was performed to determine the causes of formula milk consumption in infants in Charmahal va Bakhtiari province. In a descriptive-analytical study, 411 under one year old infants in Chaharmahal va Bakhtiari, Iran were selected through cluster randomized sampling. In this study a self making questionnaire was used which was consisted of some demographic information about mother and infant, diseases related to breast feeding and evaluating some factors related to tendency for using formula milk. This study conducted in 2007. The data were analyzed using chi-square and t-test. In this study, %51.6 of mothers were from rural areas and most of them (%59.7) were between 20-30 years of age. Generally about %76.1 of infants were using formula milk after 6 months. Our Results showed that most of the mothers and infants did not demonstrate any disease related to breast feeding. There was a significant difference between rural and urban infants, educational level of mother, age, and the kind of feeding (P<0.05). Inadequacy of mother milk was the most (%43.1) important reason of using formula milk. This study showed the limited knowledge of the mothers and health care personnel about the breast feeding and it is needed to continue educating the mothers during their pregnancy period and afterward.

Rabies is a viral disease which occurs commonly through the bite of a rabid animal. Anti rabies vaccination is an important prophylaxis after having contact with the disease agent. The aim of this study was to evaluate the anti-rabies anti-body titer among individuals who have had received 3-5 times anti-rabies vaccine.

In this descriptive-analytical study, according to the data collected from Shahrekord health centers, the blood serums of 63 individual's encountered animal bites within 4 years were collected and their anti-rabies antibody titer was tested using Rapid Fluorescent Focus Inhibition Test (RFFIT). The anti-rabies titer more than 0.5 ul/ml was considered as protected against rabies. Data were analyzed using Spearman and the dependant t-test.

In this study, 30 individuals were vaccinated 3 times and other 33 individuals were vaccinated 5 times. In all cases, 5 individuals received rabies vaccine together with Human Rabies Immune Globulin (HRIG). The mean time since last vaccination was 23.3±9.6 months (range, 5-38 months) and the mean antibody titer against rabies was 2.5±1.9 IU/ml (range, 0.4-14 IU/ml) only 3 individuals (4.8%) had the anti rabies titer less than recommended titer (0.5 IU/ml). There was no significant relationship between the numbers of vaccinations, individual’s gender, mean time since last vaccination and the age of the individuals with antibody titer against rabies (P>0.05).

In the case of encountering to suspected human rabies, it is better to check their serum anti-rabies antibody titer. If their anti body value is below than the global standard, they should receive a secondary doze of anti-rabies vaccination.

Peroxide is the first compound which is produced after oxidation of fats and oils. When the peroxide level increases to specific amount, adverse taste and odor will be released due to volatile compounds. Peroxides may contribute in different diseases such as; atherosclerosis, progeria, allergic inflammation, cerebral and cardiac ischemia, respiratory distress syndrome and different liver dysfunctions. The main objective of this study was to determinate hydrogen peroxide index in both cooked and uncooked (raw) oils in fast food shops in Shahrekord during 2009 to 2010. This cross-sectional study was accomplished on 50% of Shahrekords’ sandwich shops. In this research, 160 samples were gathered from 40 sandwich shops (4 samples per shop, two samples from uncooked and two samples from cooked oils) in the beginning and the end of the week, respectively. Samples were analyzed for hydrogen peroxide based on Association of official analytical chemists (AOAC). Allowable standard levels of hydrogen peroxide for solid and liquid oils are 2 meq/kg and 5 meq/kg, respectively. Data were analyzed with application of Mann-Whitney U-test and Wilcoxon Signed Ranks Test using SPSS software. Results showed that peroxide value was more than standard level in all of samples. Peroxide increasing percentages for two kinds of oils were as below: 1- for uncooked oils 45% in the beginning and 25% at the end of the week; 2- for cooked oils 100% in the beginning and 97.5% at the end of week. According to the statistical analysis, there is significant relationship between uncooked and cooked oils in the beginning and at the end of the week both in edible and fried oils (P<0.001). However; no significant relationship was found between cooked oils in the beginning and at the end of the week both in edible and fried oils (P>0.05). Based on the results of this study, approximately 100% of solid and liquid cooked oils (both edible and non-edible oils) had a peroxide index higher than standard limit. It is highly recommended that health centers authorities try to manage a specific educational program for fast food shops owners and also they have to schedule time table for proper supervision