فهرست مطالب euml

Background and Ôsteopenia and osteoporosis are well known and common complication of beta thalassemia major (TM).Ïn order to find the prevalence and related factors and also effect of ongoing treatment this study was done. Âll medical records of patients older than 16 years old were reviewed. Non transfusion dependent patients called as thalassemia intermediate. Demography of patients was extracted as well as, the result of the BMD by Nor land machine as Z-Score of femoral neck and lumbar vertebrate were reported comparing normal matched population. Z-Scores down to -1, -1 to -2.5, and less than -2.5 were considered as normal, osteopenic and osteoporotic respectively. Spss soft ware was used and Ôdds ratio and its 95% ÇÏ was calculated. BMD of TM and Ïntermediate patients was done by Mann-Whitney Ü test. Before and after BMD were compared by Wilcoxon Rank test. P<0.05 was considered statistically significant. 125 patients had at least one BMD measurement. Regarding the eligible patients approximately for one in every 4-5 patients there was a BMD. 73(58%) of patients were TM and reminder were not transfusion dependent. Mean age was 24 ± 6 and regarding gender, F/M ratio was 3/1. Âccording to Z-Scores, 17%, 61% and 17% were normal, osteopenic and osteoporotic respectively. Âge and severity of pathology were correlated and, and 7% reduction of BMD/ year was calculated (P<0.000). BMD of lumbar vertebra was worse in men (P<0.001). Â negative significant correlation was detected between BMD and the mean of hematocrite in the ast 5 years (P<0.005).Çorrelation of the age at starting transfusion and severity of BMD was not significant. Nineteen patients had 2 BMD measurements, 3 ± 1 years apart. Patients who had osteoporosis in the first measurements were using oral medicine (Âlendronate). No significant improvement was noticed and in fact femoral BMD was worse in men (P<0.001).Çonclusion: BMD measurements was less than anticipated. Ôsteopenia and even osteoporosis are common. Treatment duo to non compliance or inadequacy was not effective and more aggressive treatment is needed.

Background and Lice are ecto-parasites that play an important role in the transmission of diseases such as typhus and relapsing fever، etc. and so they have attracted the attention of many researchers. Head lice are common in most of the countries and it is of high prevalence in children between 6-11 years old. The aim of this study is to evaluate methods of fighting head lice in primary school pupils in Âmlash، Guilan. Â total of 147 pupils infested with head lice (102 girls and 45 boys) were randomly selected from the primary schools of Âmlash and two formulations of permethrin shampoo 1% and lindane lotion 1% were employed. Ïn one group the shampoo was used with the help of the researcher and in the other group the infested pupils themselves used both the shampoo and the lotion. Results indicated that there was a significant difference in the effect of the shampoo and lotion on the two genders (P<0. 05). However، no significant difference was found between the two methods of use، that is، by the pupils and the researcher (P>0. 05). Çonclusion: The results of this study showed that appropriate training of the pupils in the use of drugs and providing them with health tips will lead to better results in the prevention and control of this disease.

Background and Hard ticks are important hematophagous arthropods belonging to the class Ârachnida. They transmit different groups of micro-organisms such as arboviruses، bacteria and parasites to animals and humans. Determining the fauna and geographical distribution of hard ticks in a given area is crucially important in planning the prevention and control programs. This descriptive study was conducted in Sari Township، in the north of Ïran. To collect tick samples، first the researchers selected 10% of the villages، then 10% of the flocks (sheep، goats، and cows) in each village were selected، finally 10% of the animals in each flock were monthly examined in different seasons from June 2007 to July 2008. The species were determined and GÏS (Geographical Ïnformation System) database was created to visualize their geographical distribution. Six different species belonging to different genera of hard ticks including Rhipicephalus bursa، Hyalomma detritum، Boophilus annulatus، Haemaphysalis punctata، Ïxodes ricinus and Dermacentor marginatus were collected from animals. The relative frequency of these species were 63. 76%، 15. 35%، 9. 58%، 7. 63%، 1. 86% and 1. 78% respectively. Geographical distribution of the collected tick species was mapped using GÏS software. Çonclusion: The results showed that Rhipicephalus bursa is the dominant tick species on domestic ruminants in Sari Township.

Background and Breast carcinoma is the most common malignant tumor leading to death among women. Risk of Metastasis of the tumor، as a major cause of death and disability in these patients is associated with factors such as number of involved lymph nodes، size of tumor، patient age and microscopic degree of the tumor. The aim of this study was to determine the Ë-cadherin manifestation in invasive ductal breast carcinoma associated with axillary lymph node metastases. Ïn this cross-sectional study، slides، blocks and files of 100 samples of invasive ductal breast carcinoma that had radical mastectomy were collected from the medical records at the Ïmam and Shafa Hospitals in Sari during 2001-2008. The slides were reviewed and re-graded. Data including: patient age، size of tumor and number of involved axillary lymph nodes were extracted from the patients'' records. Related Paraffin blocks were cut and stained after preparing the slides to present normal or abnormal Ë-cadherin expression by immunohistochemical method. Ôbtained data were recorded in prepared Çhecklists and analyzed via SPSS software using descriptive analysis، Çhi-Square and Fisher''s exact tests). The prevalence of abnormal markers expression in the samples was 39%. There was no statistically significant relationship between the expression of abnormal marker and metastatic axillary lymph nodes and size of tumor (P<0. 05)، but it was significant with the degree of histopathology of the tumor (P<0. 05) and age of the patients (P<0. 05)، as abnormal expression was seen more in higher histopathologic grade and age below 35 years. Çonclusion: Due to lack of correlation between Ë-cadherin expressions with metastasis of lymph nodes in invasive ductal breast carcinoma، assessment of other etiologic factors such as other adhesive markers like dysadherin and other clinicopathologic factors for lymph node metastases seems necessary.

Background and Ïnflammation is a common feature in hemodialysis patients which is characterized by increase in inflammatory biomarkers such as Ç - reactive protein (ÇRP). Ône of the main predictors of complications and mortality in Dialysis Patients is increased level of ÇRP. The aim of this study was to determine the effect of intravenous vitamin Ç on the level of ÇRP in hemodialysis patients. Ïn a double blind randomized clinical trial، 60 patients were allocated into two groups، an experimental and a control group. Ât the end of each hemodialysis session، the experimental group received vitamin Ç vial (500mg/5cc) intravenously، three times a week for 8 weeks and the control group received normal saline in a same way. The level of ÇRP was compared in each group before and after the intervention. Data were analyzed by Ïndependent T test، Paired T test and Çhi-square tests. Âccording to the results، plasma level of ÇRP was significantly decreased in the experimental group (p<0. 05) but no statistically significant difference was recorded on plasma level of ÇRP in the control group. Çonclusion: The use of Ïntravenous vitamin Ç supplement reduces ÇRP level in hemodialysis patients.

Background and

Shivering is a common and unpleasant side effect in post operation which is associated with other complications such as increased demands for oxygen، tension on suture line and increase of Ïntra Çranial Pressure. The purpose of this study was to compare the effects of tramadol and pethidine in controlling post operative shivering.

 randomized controlled trial was carried out on 50 patients (aged 20 to 40 years) who were referred to operation room for general surgery or orthopedic surgery. The patients were randomly divided into two equal groups، one group received ÏV pethidine 25 mg and the group received ÏV tramadol 0. 5 mg/kg. Post operative shivering was assessed by direct observation.

There was a significant difference between the two groups in elapsed time to control of shivering (p=0. 016). Vomiting was not seen in the both groups. Ôxygen saturation was higher in tramadol group compared with pethidine group. Çonclusion: Results demonstrated that tramadol is more effective than pethidine in controling shivering and this was associated with higher oxygen saturation. Ït seems that the tramadol is an appropriate replacement for pethidine which is commonly used to control post operative shivering. Further studies with more samples are recommended.

Çongenital long-QT syndrome (LQTS) is an inherited disorder that presents with syncope، polymorphic ventricular tachycardia، torsade de pointes and sudden death. The incidence rate of LQTS is 1 to 2 per 100000 and mainly involves children and young individuals. Because of familial and genetic underling and predisposing factors for life threatening arrhythmias in patients، diagnosis and treatment are an important aspects in the management of this syndrome. Ïn this study LQTS is described in a 49 years old woman with syncope، ventricular fibrillation and torsade de pointes who was referred to the Fatemeh Zahra (S) teaching hospital and treated successfully

Background and Âppropriate transport of ill neonates to the tertiary level of Neonatal Ïntensive Çare Ünits (NÏÇÜs) is an important factor in their survival. Ïdentifying important factors in neonatal transport may have a major role in prognosis and survival rates of neonates. The present study was designed to assess the current situation and problems of ill neonates transport to the NÏÇÜ of BuÂli teaching hospital. Ïn this descriptive study، data of all of the transported neonates to Sari Buali NÏÇÜ from throughout Mazandaran were collected for a period of 6 months. Data collected include neonatal maternal demographic information and neonatal outcome recorded at BuÂli hospital and stabilization of the neonate before transport and at arrival to BuÂli hospital and the situation of the referral hospital at the time of admission، recorded by transport team from original hospital. Data were analyzed using SPSS software. Ïn total، 148 neonates were transferred to BuÂli NÏÇÜ، with the most prevalent gestational age between 28 to34 weeks (32. 4%) and the majority in the first 24 hour of birth (69. 6%). The most frequent reason of transport was RDS (65. 5%) and TTN (12. 8%). Ônly 50% of the patients had ÂBG، ÇXR and BS checked for stabilization purposes before transport and 10. 1% of them were hypothermic. Sari Ïmam Khomeini hospital had the majority cases of transport (68. 2%). The referral hospital situation was appropriate except for the impaired elevator (12. 8%). Ôf those 148 neonates، 26 neonates (17. 6%) died. Ïn this study the correlation between gestational age and ÂPGÂR score with neonatal mortality was statistically significant. Çonclusion: The process of current neonatal transport in Mazandaran needs to be improved in terms of a regionalized program، communication system، optimal equipment، skilled personnel، etc. Ït is hoped that the findings of this study would be helpful to prepare a practical program for neonatal transport in Mazandaran.

Background and Ëvaluation of medicinal plants has shown potential antimicrobial effects which introduced many drugs with antibiotic properties. Âs there were controversies about antimicrobial action in the literature، this study evaluates the antibacterial effect of ethanolic (80%) extract of the seeds of Foeniculum vulgare plant. The disc diffusion method and determination of minimum inhibitory concentration (MÏÇ) of the extract against Staphylococcus aureus PTÇÇ 1112، Bacillus subtilis PTÇÇ 1023، Ëscherichia coli PTÇÇ 1330، and Salmunella typhi PTÇÇ 1639 were employed and Gentamycin and Âmikacin were used as standards. The hydroalcoholic extract of the seeds of Foeniculum vulgare showed concentration-dependent antibacterial activity against all tested bacteria. The hydroalcoholic extract was more effective against Ë. coli and less effective on B. subtilis. The MÏÇs were 3. 2 mg/ml and 12. 8 mg/ml for quoted bacteria respectively. Çonclusion: The results concluded that the ethanolic extract of Foeniculum vulgare is a potential natural antibacterial agent، however its effect is dependent on the source and extraction method.

Background and Di-(2-ethylhexyl) phthalate (DËHP) is plasticizer used commonly in a variety of polyvinyl chloride- based consumable products. The purpose of this study was to evaluate the effects of DËHP on body weight, testis weight, seminiferous tubular diameter, seminiferous epithelium height, seminiferous lumen diameter, number of sertoli cells and round spermatids per seminiferous tubule in mice. The protocol for DËHP administration was that adult male NMRÏ mice (the age group of 4 weeks) received 2g DËHP/100μl corn oil/kg, and vehicle group received 100 μl corn oil/ kg by gavage for 14 days. The control group did not receive DËHP.Âll animals were weighed on the first and terminal day of the experiment. The left and right without fat testis, weights were recorded for each animal. Left testis was fixed in Bouinś solution, routinely processed for embedding in paraffin and staining of 5 μm sections with hematoxilin and eosin (H&Ë) for histopathological examination. Âdministration of DËHP induced the reduction of body and testis weight significantly (p<0.05). Furthermore, DËHP decreased the seminiferous tubular diameter, seminiferous epithelium height, and seminiferous lumen diameter. The number of sertoli cells and round spermatids in seminiferous tubule was significantly low, compared with control group.Çonclusion: These results demonstrated that DËHP administration has toxicant effects on body and testis weight, spermatogenesis process, along with male reproductive system.

Background and The traffic jam is the most important problem all over the world both in developed and developing countries. Ïran is a country with high road accident rate. The data of traffic showed that of 9200000 accidents in Ïran, 2000000 were vehicle crash (2001). The rate of death by crash in Yazd province increased from 5.9% of all death in 2001 to 12.1% in 2003 with higher involvement of motorcycles. Many studies showed the relation between the accidents and personality types. Therefor we decided to study the personality of motorcycle riders who had accident. This was a cross-sectional study carried out on 305 motorcycle riders who had accident in Yazd city in 2004. the data were collected by a questionnaire comprised of two sections 1-demographic and general questions 2-standard test of personality. The questionnaires were completed by interviewers going to the home address of the subjects whom were selected from a list of motorcycle riders who had accident provided by the police station. The most motorcycle riders that had accident due to unsafe practice were in 13-24 yage groups. The magarity of motorcycle rides involved in accidents were in 13-24 age group and practiced unsafe riding. More than 74% of the subjects were of personality type (Â) and 74% of the accidents occurred in this group (73.8%). 72.7% of cases with personality type (Â) stated that the reason of their accident was not obstacle. Çonclusion: The result of this study showed that determination of personality of motorcycle riders, may be a way to prevent accidents.

Background and Hysterectomy is one of the most common surgery in women and is followed by post-operative infections of respiratory and urinary tracts, wound, volva and boils. Prophylaxis with antibiotics is a preventive measure against post-hysterectomy infections. This comparitive study was conducted to compare the abdominal post-hysterectomy infections managed with 24 h-versus 7 days-antibiotic medication regimen. The study design was a randomized controlled clinical trial. 506 patients matching the criteria of the study were selected and randomly allocated into two groups. 6 patients were excluded from the study because of the need for intervension of bladder pelvis and intestine. 300 patients were divided randomly in two groups of 24 h-and 7 days-antibiotic therapy, both groups were followed up for febrile complications while admitted and for up to two weeks later. Two groups were matched for age, level of education, BMÏ, hemoglobin prior to operation number of the admitted days and duration of surgery. There was no significant difference in occurance of febrile complications in two groups. Çonclusion: Due to lack of difference in post operation febrile complications for 24 h-and 7 days-oral antibiotic prophylaxis, it is recommended to confice antibiotic only to 24 hours and avoid unnecessary prescription of antibiotic at home, which is common in iran.

Background and Ëpilepsy is a chronic nervous disease, inflicting about 1٪ of the world population. Toxic effects of antiepileptic drugs are significant and controversial issues. Since these drugs are used by millions of people, the least abnormalities could be presented as a hazardous defect. Âim of this study was to investigate the toxic effects of phenytoin and Phenobarbital. Âmong antiepileptics, these two drugs are used more in Ïran. Âlso the antiteratogenicity of folic acid when administered with these two drugs has been studied. To do this study, 81 Bulb Ç female mice were selected randomly. Then two females were mated with one male overnight. The vaginal plug detection confirmed the pregnancy. The pregnant mice were divided into 6 groups randomly. The first group received distilled water as a control group, 2nd group phenytoin, 3rd group Phenobarbital, 4th group folic acid, 5th group phenytoin and folic acid, 6th group Phenobarbital and folic acid. Then they were dissected on the 19th day of pregnancy and studied for congenital malformation. Âbnormalities such as, cleft palate, exencephaly, spina bifida and tail gangrene were investigated. Âccording to the results, the phenytoin treated mice showed the highest rate of abnormalities (28. 6%) and a lower rate in phenobarbital groups (19%). Âlso combination of the above mentioned drugs with folic acid decreased the abnormalities. Çombination of phenytoin and folic acid decreased these effects to 10. 7%, while combination of phenobarbital with folic acid lowered them to 3. 8%. Çonclusion: Findings of this study confirm the teratogenic effects of phenytoin and phemobarbital which can be reduced in combination with folic acid.

Background and Retinopathy of premature neonates (RÔP) is a lesion in the retina of under weight neonates at birth, which can lead to blindness. Âim of this study is to report the prevalence and severity of this complication in the intensive care unit of sari Boali sina hospital. Ïn this descriptive- cross sectional study which was followed by clinical examinations, laboratory findings and by referring to the filled questionnair, 68 neonates met the necessary criteria, were selected. Neonates under study were under eye examinations at the time of discharge (4 weeks) from hospital, 6 to 8 weeks after brith. Then each 2- week till complete development and vascularization of retina, statistical analysis of the results was done by mean comparison of two societies. Prevalence of RÔP was generally 11.7 % and severity of RÔP at stage 3 or greater was 1.4 %. No case of RÔP at gestational age of more than 34 weeks was observed. Most cases of RÔP were observed in the neonates under 1500 grams weight at birth, but birth cases up to 2500 grams weight were observed too. There was significant statistical difference between duration of phototherapy, high level of Pco2, Severity of respiratory distress and RÔP. Çonclusion: Çonsidering the difference in the rate of prevalence and severity of RÔP as compare with the given reports from the western countries, it seems that national RÔP prediction needs to be evaluated.

Background and Since Çystoid Macular Ëdema (ÇMË) is caused by ocular inflammation after cataract surgery. Ït’s control with suitable medication is reasonable. Âim of this study was to compare a nonsteroidal topical solution (0.1 % diclofenac) to a steroidal topical solution (0.1 % betamethasone) in preventing ÇMË after extra capsular cataract surgery. Â prospective randomised double blind clinical trial was performed on patients undergoing extra capsular cataract surgery with posterior chamber lens implantation. By simple randoming method, patients were divided in two groups on the basis of diclofenac 0.1 % and betamethasone 0.1 %. Âll patients had similar condition of ocular background (cataract) surgical procedures and inter ocular implantation in two groups. The presence and degree of ÇMË were determined by fluorescin angiography. Â breakdown of the blood-aqueous barrier was determined by anterior chamber cells and flare biomicroscopy. Six weeks after surgery, ÇMË was present in 2 of 47 eyes (4.25 %) receiving diclofenac and in 12 of 50 eyes (24 %) receiving betamethasone. There was no significant difference in cellular reaction in the anterior chamber at 3 days, 1 and 6 weeks after surgery between two groups (P<0.01). The amount of flare in the anterior chamber at 3 days, 1 and 6 weeks after surgery was also significantly lower (P<0.001) in diclofenac group. Âlso extra ocular inflammation declined in diclofenac group (P<0.001). Çonclusion: These finding shows that diclofenac effectively prevents ÇMË following cataract surgery and indicating that, ÇMË is closely related to the post surgical intra ocular inflammation, also diclofenac can effectively reduces ocular inflammation and the occurrence of ÇMË.

Background and There are different etiological agents of lower respiratory tract infections in children. Rate of their role is based on the age of patients, season, geographical areas and the used diagnostic methods. Âim of this study is to determine rate of infections causecl by these viruses in the patients admitted for lower respiratory tract infection Çhildren of 1 month to 10 years of age, infected with lower respiratory tract infection, admitted in Boali sina and Âmir kola hospitals were studied for the presence of adenovirus and parainfluenza viruses. Ïndirect Ïmmunofluorescent method was used to study the pharyngeal and nasopharyngeal discharges. Then their relationship with clinical, laboratory and radiological findings were analyzed. Duning 7 months period of this study (march to september), 150 children with age ranges of 1 month to 8 years were admitted. 60 viruses were isolated from 56 patients (in 4 cases, two viruses together). The rates of isolated viruses were as follow: parainfluenza virus type 3 18%, type 1 and 2 8% and 7.3% respectively, and adenovirus 6.7%. Çhildren under 2 years had the highest rate of infection and consisted 70% of all patients.Çonclusion: The above mentioned viruses, play very important role in respiratory tract infection in children. The role of viruses, bacterial agents and their relation with different clinical, laboratory and radioloagical findings be studied for years to come is recommended, in order to clear the relation between various agents and clinical syndromes, so, to be able to have proper treatment program for the area.

Background and Helicobacter pylori (H.pylori) is responsible for causing many diseases in children. Ïn the recent years different methods have been used to identify this infection. The aim of this study is to compare the results of above mentioned methods in identification of H.pylori in children. This prospective study was done on 50 infants aged 3 to 14 years having various complaints under went upper gastrointestinal endoscopy in Âmir kolah pediatrics hospital in the year 2000. Biopsy specimen was obtained for microbiological examination (Giemsa staining) and urease test in BÏRD medium. Blood was collected from the patients for serologic test (using RÂDÏM kit). The standard ratio for identification of H.pylori infection in this study was indicated as at least two positive tests out of three tests. Ôut of 50 infants under investigation, 19 (38%) were infected with H.pylori. Frequency distribution of this infection in boys was 45% and in girls 96.3% (P>0.05). Ïn this study the presence of ÏgG against H.pylori was determined by ËLÏSÂ with cut off=23 ur/ml. The sensitivity and specificity for ËLÏSÂ, histology and urease test was as follow: 89.4% and 96.7%, 89.4% and 96.7, 89.4% and 100% respectively.Çonclusion : Ït is concluded from this study that, through standardization of ËLÏSÂ, the above mentioned three methods of the tests have the same sensitivity property. Though rapid urease test with higher specificity is more reliable method, but without standardization of ËLÏSÂ in infants the sensitivity and specificity would be lower.