Journal of Birjand University of Medical Sciences
Year:2006 | Volume:12 | Issue:3-4 (24-25)|Papers Count:32

The widespread use of sulphur mustard (SM) as an incapacitating warfare agent in the past century has proved its highly long lasting toxic effects. It exerts direct toxic effects on the eyes, skin, and respiratory tissue, with subsequent systemic action on the nervous, immunologic, haematologic, digestive and reproductive systems. SM is an alkylating agent that affects DNA synthesis and thus its delayed complications has been considered since the World War One and cases of malignancies in the target organs particularly in haematopoietic, respiratory and digestive systems were reported. Important delayed respiratory complications include chronic bronchitis, bronchiectasis, frequent bronchopneumonia, and pulmonary fibrosis, all of which tend to deteriorate in time. Severe dry skin, delayed keratitis, and decreased number of natural killer cells with subsequent increased risk of infections and malignancies are also among the most distressing long-term consequences of SM intoxication. However, there are still major gaps in SM literature. Immunological and neurological dysfunctions, as well as SM relationship to mutagenicities, carcinogenesis and teratogenesis are important fields which require further studies, particularly on human subjects following single exposure.

Background and Aim: Diabetes mellitus is a common disease, which accompanied by adverse effects on different tissues. Retinopathy, nephropathy and neuropathy are some known complications in diabetes.Because there are only few studies about diabetes effects on skeletal muscles, such effects were investigated in the present study.Materials and Methods: In this experimental study, we used 24 male mice. For half of them alloxan were used for diabetes induction (case group), and the rest was named as control group. Diabetic group included mice whose blood glucose level after 72 hours of alloxan injection was more than 180 m/dL. After eight weeks, biopsy from extensor digitorum muscle in the experimental and control groups under anesthesia was done. The specimens were fixed and assessed by using optical microscope and serological counting methods.Results: Our study showed that there are myofibril irregularity, reduction in fiber's diameter, and their number nuclei decrease, and also connective tissue increase in diabetic mice.Conclusion: The obtained data from diabetic mice could account for atrophy and necrosis which caused functional motor abnormalities. It is concluded that diabetes has an adverse effect on the number and diameter of fibers in skeletal muscles which can end up in myopathy due to neuropathy in diabetic mice.

Background and Aim: Invasive cervical carcinoma is one of the most common malignancies in women. The risk factors are old age, low socioeconomic status; multiparity, first intercourse in low age, multipart, history of infection and sexual transmitted disease (STD), smoking, long term use of oral contraceptive (OCP), malnutrition, and so on. There has been a possible relationship between invasive cervical carcinoma and OCP or any other methods of contraceptive. The contraceptive methods are commonly used in I.R. Iran.It was thus aimed to study the relationship between the methods of contraceptive use and cervical carcinoma. Materials and Methods: In this case- control study, 109 Iranian Moslem patients with cervical carcinoma were selected. The control group (218 individuals) was Iranian Moslem patients that referred to hospital with any reason except gynecology diseases, and had a normal pap- smear in the last year and had no history of colposcopy, cryotherapy, electro cauterization and conization.Results: Almost all (99%) of the cases and 87% of the control group had a history of contraceptive use (P=0.004). Of which, 71% of the cases and 67% of control group had a history of use of oral contraceptive (P=0.52), 15% and 13.5% of the respective groups had positive history of use of IUD (P=0.75) and 43% of the cases and 31% of the control group had a history of use of condom (P=0.028).Conclusion: There was no statistically significant correlation between OCP or IUD and cervical carcinoma, but there was a significant correlation between the use of condom and cervical carcinoma. Protective effect of condom has relationship with continuously and long term use, but patients in this study had no these characteristics.

Background and Aim: Human serum paraoxonase (PON) / aryl esterase (ARE) is synthesized by the liver and its roles are hydrolysis of organophosphate compounds in mammals and resistance against atherosclerosis. This enzyme has tree model phenotypes-distribution, including AA (homozygous with low activity), AB (heterozygous with Average activity), or BB (homozygous with high activity). This study was aimed to measure the level of PON/ARE activity and determine the relationship between activity of this enzymeand serum lipid levels& non-lipid indices in 25-50 year-old healthy men.Materials and Methods: Our research was a sectional and observational study. Fifty healthy men from Tarbiat Moddares University were volunteered for this research. PNO activity was measured by a spectrophotometric method using 1 ml serum; adding Immol TrislHCL buffer including 2 mmol/L calcium chloride and 5.5 mmol/L HCL. Paranitrophenol production was measured at 405 nm wave length. ARE was determined by adding serum to 20 ml buffer including 1 mmol/L calcium chloride and 1 mmol/L phenyl acetate. Phenotype distribution was estimated by two substrates method. The correlation between PON/ARE activities and lipid & non-lipid indices were evaluated by Pearson correlation analysis. We used 2-tailed Pvalues. The P<0.05 was accepted as the level of significance.Results: The average activities of PON and ARE were 89.14±40.62 and 100.15±36.16UIL, respectively.This means that our participants had lower enzyme activity and all of them classified as AA phenotype. There were no significant correlations between PON/ARE activity and demographic characteristics (age, body mass index, waist to hip ratio or blood pressure). In addition, there were no significant correlations between PON/ARE activity and lipid indices (triglyceride, total cholesterol, LDL & HDL). However, LDL /PON ratio had a significant relationship with HDL/LDL ratio(r=-0.45, P<0.002), HDL/total cholesterol ratio (r=-0.37, P<0.01), total cholesterol concentration(r=0.34, P<0.02), and LDL concentration (r=0.46, P<0.001).Conclusion: Existence of weak correlation between serum PON/ARE activities and lipid indices along with low PON activity in studied group suggest that PON/ARE enzyme activities are under influence of genetic and racial factors.

Background and Aim: Cataract is one of the public health problems worldwide and it is the most important cause of blindness. The aim of this study was to evaluate some risk factors of cataract including history of hypertension, body mass index (BMI), smoking, literacy, and type of job in the patients.Materials and Methods: This case-control study was implemented on 176 patients with cataract (case group) and 176 healthy volunteers (control group) of referrals to Birjand Valiassr hospital. A general questionnaire was used to collect the information about history of hypertension, smoking, type of job and education level. Case and control groups were matched by age and sex. Blood pressure, length and weight of patients were determined. Then data entered to SPSS software and analyzed with chi-square and regression logistic at a=0.05.Results: History of hypertension was recorded in 29.5% of the cases and in 19.3% of the control group (P=0.026). In terms of education, 88.1% were illiterate in the case group and 64.2% in the control group (P<0.001). Job title with significant difference included only farmers (35.2% in the case group and 22.2% in the control group; P<0.001). Smoking was observed in 18.8% of the cases and in 10.8% of the controls (P<0.001), were higher in case groups then control group; But body mass index (BMI) was higher in control group (6.8% in the case group and 16.5% in the control group) (P<0.001).Conclusion: The results of this study showed that hypertension; smoking and low literacy are the risk factors for Cataract. These findings indicate a need for health promotion activities to control these risk factors.

Background and Aim: Different methods for appendectomy operation wound repairs have been applied. The two common methods of the wound repair in suppurative phase of appendicitis are subcuticular and interrupted wound repair. There have been controversies on the benefit of each method. This Study was designed to compare the two methods of appendectomy wound repair on wound infection after suppurative appendectomy.Materials and Methods: Two hundred patients who had necessary conditions for participating in survey were divided randomly into 2 groups in 2003. In the first group, operational wounds were repaired by subcuticular method and in the second by interrupted transdermal technique. Then the patients in the two groups were visited by another surgeon unaware of the type of suturation at intervals of one week and one month after operation. The results on the rate and kind of wound infection, pus secretion, wound opening and systemic infections were compared by SPSS software using Chi-Square and fisher exact tests. P<0.05 was considered as the significant level.Results: The mean age of patients in interrupted transdermal and subcuticular groups were 20.85±6.7 and 20.61±6.58 yrs (P=0.8), respectively. Sexes of the two groups were also similar with male dominating of 54% and 53% in transdermal and subcuticular groups, respectively (P=0.89). Local infection rates in subcuticular and transdermal group one week after surgeries were 9% and 6%, respectively (P=0.421). Rates of pus secretion and wound opening one week after surgery in subcuticular and transdermal group, were 5% and 4% respectively (P=0.99). No Systemic infection was found one week and one month after operation in both groups.Conclusion: Sine there were no statistical significant differences between the two methods of subcuticular and interrupted transdermal wound repair in supportive appendectomy either of them could be used.

Background and Aim: Although circumcision is commonly done in Iran and the Muslims have emphasis on doing it, there have been very few reports on this subject. It was thus aimed to obtain more information about the commonest age of doing it, the groups who do it, the prevalence of complications and some factors. Materials and Methods: This cross-sectional study was done in 2003- 2004 on 1000 boys of the first to third degree of primary schools who were chosen through cluster and systematic sampling. We gained information by questionnaires that were filled out by their parents.Results: 971 boys (91.7%) were circumcised, the mean age was 4.36±2.39 years. the commonest age was between 2-6 years old (60.8%), the most of them were done in summer (56.64%) and by experimental persons (48.8%). The rate of complications was 8.4% and the commonest was hemorrhage (51.2%). The higher circumcision age was related significantly with higher complication (P<0.001). The highest rates of complications were belonged to experimental persons (70.7%). Nearly half (48.9%) of the children were circumcised in house and 51.1% in medical centers. The rate of complication in child that was circumcised in house was 12.2% and in medical centers were 4.8%. There was a significant relationship between the parent's literacy, and the agents of circumcision (P<0.001). With the decreasing level of parent's literacy, we had more experimental persons who did circumcision.Conclusion: Since the complications of circumcision depend on the agent and place of doing it, we recommended that circumcision will be done by an expert medical group and in clean place like hospital and clinic, preferably in neonatal period.

Background and Aim: Measurement of weight and height is very important source of information in evaluation of growth, nutrition and health of children and adolescence. Since, the growth is affected by genetic, racial, geographical and environmental factors, the growth charts differ from one population to another. The aim of this study was Measurement of weight and height of girls' students in range of 11-14 years old in Birjand and comparing with National Center for Health Statistic (NCHS) and other studies, in Iran.Materials and Methods: This cross-sectional study was performed on 1020 girl students, which were selected through multi stage cluster sampling in Birjand city in 2004. The height and weight of the students were measured. The relevant percentiles of height and weight was established and compared with NCHS percentiles. Age and some of demographic factors of students were completed in questionnaire by interview with students and studding their educational files.Results: The height and weight percentiles of 11-14 years old girls in Birjand are significantly lower than NCHS. As age increase, deviation from NCHS increase and height decrease more than height.Conclusion: There is a difference between NCHS growth standard and this study. It is recommend that the regional growth standard should be developed by more comprehensive studies so that it could be used for evaluation of health and growth disorders for Iranian children. Regarding important role of nutrition in growth, improvement of nutritional state through family education specially mothers, and improvement of economical situation is also advised.

Background and Aim: In spite of proposed causes of fever of urological endoscopy such as increased caulis pressure, bacteraemia and preproduced endotoxins, urinary infection and fever have not been studied after endoscopy. This research was aimed to study the frequency of fever after percutaneous nephrolithotomy (PNL) and the contributing factors.Materials and Methods: In a cross- sectional study from September 2003 to March 2004 all consecutive patients (217) with nephrolithiasis treated with PNL in Labbaf negad Specialized Urology Center were studied. The patients were studied for fever and its contributory factors. Data were analyzed by SPSS using Chi-Square, t, Mann Whitney, logistic regression and multi & univariant analysis. P£0.05 was considered as the statistical significance.Results: The frequency of fever after PNL was 25.8% (n=56). In 62.2% of cases (n=135), no prophylactic antibiotics had been administered. Significant relationships were observed between fever and female sex (P=0.02), positive post-surgical urine culture (P=0.02), nephrostomy tube insertion at the end of operation (P=0.04). Other variables did not prove to have significant statistical relationships with fever. In logistic regression female sex, nephrostomy tube insertion and month of surgery were independently related to postoperative fever.Conclusion: Although considerable proportion of our patients had not received prophylactic antibiotics, the rate of post PNL fever was not higher than the prevailing literature. Female sex and nephrostomy tube had a much higher risk for post surgical fever probably due to harboring bacteria.

Background and Aim: Tuberculosis is one of the most important problems in the world, especially in developing countries. The variation and dispersion of genital tuberculosis observed both in developed countries and developing countries. In order to determine prevalence of infertility due to genital tuberculosis, this study was conducted.Materials and Methods: This study was a cross-sectional survey among 61 women with genital tuberculosis who were referred to tuberculosis center between 1994 and 2004.Results: Our study showed that among 973 cases with extra pulmonary tuberculosis, genital tuberculosis formed 7.7% of all extra pulmonary tuberculosis (76 cases) and female genital tuberculosis formed 80% of all genital tuberculosis (61 cases, 42 Iranian and 19 cases Afghans). Out of 61 cases with genital TB, 51 cases had infertility (38 Iranian and 13 cases Afghans). 92% of Iranian women with genital TB had infertility.Conclusion: Our study reflects the high prevalence rate of infertility due to genital tuberculosis in endemic area such as Zahedan.

Background and Aim: Nurses have the most receivers of social- psychological stresses because of their sensitive profession. They are the most numbers of staff in health-care .who spend long time with patients.Due to their important caring roles, and in regard to the importance of preventing and controlling of stress for improving their efficiency of and in turn to reduce hospital expenditure, this research was aimed to study social-psychological stresses of nurses in Birjand teaching hospitals.Materials and Methods: In this descriptive-analytical study, we used a questionnaire with 85 questions that had been designed according to Likert Scale. The questionnaire was distributed between all nurses of Birjand teaching hospitals and was collected after they filled out. Data was Statistical tests; chi-square, Student-t, multifactor analysis of variance Tokay were applied using SPSS and SPLUS software's considering P=0.05 as the minimum statistical significance.Results: This study was completed on 247 nursing staff, of which 83% were female, 47% had a record of service less 7 years, 68% had rotation shifts, 59% were nurses and technician nurses, 70% were official employees, and 81% were married. The average rate of stresses due to personal factors was 2.91, family factors 2.86, work conditional factors 3.51 and the total average rate of stresses was 3.11. It was also indicated that sex, age, record of service, educational level, employment status and rotation shifts had meaningful statistics in relationship to all stressful factors; 14% of nurses had low stress, 65% had average and 21% had high stress.Conclusion: The results of our study indicated that the average rate of stress due to work conditional factors is more than personal and family factors. So managers and Correspondents should be regard to decreasing of stresses between nurse's cadres in hospitals.

Background and Aim: Accelerated population growth around the world is a critical barrier on the way of social, economical, and cultural development of countries. Regarding the importance of birth control programs for the Ministry of Health and Medical Education and the fact that employed women form a main stratum of the community with their own peculiar beliefs, the study of their fertility (productivity) pattern (based on Intent Behavior Model) seems quite necessary.Materials and Methods: In a descriptive analytical study, all lay female employees working in the Birjand University of Medical sciences, Birjand University, and Birjand Azad University (135 women) were surveyed. Data collecting tool in the present study was a structural questionnaire on variables of intent behavior model such as attitude, abstract norms, intent, behavior, etc. To analyze the data we used chi-square, independent test, Pearson correlation coefficient, logistic regression. P£0.05 was considered as the significant level.Results: There was a significant difference between women's awareness score and their level of education (P<0.007). Also, there was a significant correlation between the women's awareness and their number and age of children (P<0.007). Logistic regression result showed that number of children, level of education and age, were respectively considered by the women using contraceptive methods.Conclusion: Family planning educations focusing on variables of intent- behavior models, face to face methods, group trainings- group discussion, and providing health pamphlets play an effective role in women's and families fertility behavior.

Background and Aim: Inappropriate diet and patterns of consumption and inadequate intake of nutrients among young people, e.g students can cause different diseases. Regarding that the studies done on the youth are very few in Iran, the present study was performed with the aim of assessing nutritional status and zinc, iron and copper serum concentration in University students and the relationship of some dietic and anthropometric variables with serum level of these elements.Materials and Methods: One hundred and seventy five volunteers of Tabriz University of Medical Sciences students (112 females and 63 males) were studied. After measuring of height and weight, usual dietary intake was estimated by using recall and food frequency. Serum zinc concentration through atomic absorbs on spectroscopy and serum level of iron by means of iron measurement kit was measured. The gathered data was analyzed using SPSS statistical software and food processor software.Results: Body mass index was higher than 24.99 in 13.4% of males and 19.3% of females. The mean energy intake of females and males was 2024.53±662.36 and 2410.93±815.58 kcal, respectively, 12.5% of females and 9.4% of males received more than 30% of daily energyuom fat.The mean of received vitamins A, B2, B6, folacin, C and minerals such as magnesium and zinc were lower than recommended levels in both genders.The mean of serum iron, zinc and copper concentrations in females was around standard level. However, zinc serum level of 19.2% of males and 21.7% of females iron serum level of 13% of males and 14.5% of females, copper serum level of 10.9% of females and 10.1% of males were lower than normal. There was a reserved relationship between BMI and Zinc serum level in male students but this was not statistically significant. It was found that there was a significant relationship between zinc serum level and dietic zinc in male students (P< 0.01), while there was a significant relationship between males Iron serum level, received Iron level, copper serum level, received copper level, and those of females.Conclusion: deficiency of micronutrients not macronutrients in students is significant and they should receive more important food groups such as milk and milk products, vegetables and fruits. Because of the importance of diet and its effect on future health of society, it seems that more attention should be paid to training and providing the possibility for university students to have optimal nutritional behavior.

Background and Aim: Swimming in non-standard and unhygienic pools is one of the important health problems, which results in transmission of disease in swimmers. In case of unhygienic pools, diseases such as conjunctivitis, swimmer foot itching, skill diseases, typhoid disease, trachoma and fungal diseases may occur. The present study was aimed to evaluate the microbial and physicochemical circumstances of five public swimming pools in Birjand.Materials and Methods: In this descriptive-analytical study, bacteriological and physicochemical parameters of five active public swimming pools (four outdoors and one indoor) were evaluated in summer. Five samples were collected from surface and deep parts of every pool every ten days for one month and sent under standard condition to a qualified laboratory for investigations. PH, temperature and free chlorine were examined in site, but alkalinity and turbidity as physico chemical parameters were evaluated in the laboratory. Bacteriological culture for coli forms; streptococcus and pseudomonas aeroginosa was performed. After recording the physicochemical and bacteriological in relevant forms, comparisons with the standards were undertaken and analyzed.Results: pH in 56.6% samples was favorable. Free residual chlorine in 75% of samples was not satisfactory.Alkalinity and turbidity were satisfactory in 60% and 46.6% of samples, respectively. Temperature was favorable in microbial parameters in terms of most probable number (MPN) was at the standard level in 60% of all samples from swimming pools. MPN was above the standard level in 25.5% of all samples. Pseudomonas aeroginosa was identified in 15.5% of the samples. No E.coli or entrococci were observed in samples.Conclusion: Physicochemical and microbial parameters of the swimming pools in Birjand are not satisfactory and thus the environmental health department of Birjand must urge the management of swimming pools to improve the hygienic standards of the pools.

Background and Aim: Pseudoexfoliation syndrome is the most common identifiable cause of open angle glaucoma's worldwide. Despite its prevalence and potential for ophthalmic morbidity, little is known about the etiology and the pathogenesis of pseudoexfoliation. The aim of this study was to investigate the risk factor of pseudoexfoliation in all admitted patients to eye clinic.Materials and Methods: In this descriptive study, during 6 months, a questionnaire check list was completed for 100 referrals to eye clinic that their ophthalmic examination revealed pseudoexfoliation residues in their eyes. The checklist consists of possible risk factors including demographic, ultraviolet-rays, trauma, cardiovascular disease, hypertension, and diabetes. The collected data was analyzed by descriptive statistical methods like chi-Square tests using SPSS version 9.0 with P=0.05 as the minimum statistical significance.Results: Forty six percent of patients were male and the rest were females. History of hypertension was present in 19 cases, 4 cases had cardiovascular disease and one had diabetes mellitus. A majority of them (66.07%) of them were from rural area and 27.9% were from urban who had a history of sunlight contact less than 2 hours per day. Of 46 farmer patients 72.09% had sunlight contact more than 4 hours per day.Conclusion: This study showed that pseudoexfoliationis more prevalent in females, and that the farmers had more exposure to ultraviolet radiation. Contact of farmers with animal viruses, poisons, chemical agents and hard physical work should be regarded as predisposing factors. Because of the limitation of this study, descriptive and case-control studies with more population must be undertaken in the future.

Background and Aim: Nurses with motive, high job satisfaction and commitment will utilize their ability and professional aptitude for higher productivity and quality of cares delivered to patients and community.Therefore, the present study was aimed to determine nurse's job satisfaction in two teaching hospitals of Birjand University of Medical Sciences.Materials and Method: This study is a descriptive-analysis of 190 nurses working in the two hospitals; Valiye-e-Asr and Imam Reza. The cases were selected by randomize systematic sampling. Data collecting tool was a two parts questionnaire. The first part included personal demographic data and the second part was on evaluation of job satisfaction by using Job Descriptive Index and Herzberg theory questionnaire. Job satisfaction in 5 nursing domains was ranked by Likert three-point scale and the total score were analyzed by descriptive statistical methods such as Chi square using SPSS software with significant level at P£0.05. Results: Most of nurses were female aged 25- 29 years with B.Sc. degree, married with less than 5 years of service having private house, permanent employment and alternating working shift in internal (18.9%) and surgical (19.5%) wards. Most of them (62.1%) had overtime works. Nurses' job satisfaction in order of low, moderate and high on different views was as follows: supervision; 41.6%, 46.8%, 11.6%; physical environment of the wards; 58.9%, 34.2% and 6.9%; teaching; 48.9%, 46.9%, and 4.2% and welfare-culture; 71.1%,25.3% and 3.7%. Totally, 58.9% of nurses had low, 37.9% moderate and 3.2% had high satisfaction with their job. There was a significant relationship between the job satisfaction and the variables of age (P=0.0158), education (P=0.0165), kind of employment (P=0.0169) working place (P=0.002).Conclusion: Job satisfaction is associated with wage, supervision, facilities and condition of the work environment and promotion. It is thus necessary for the managers and authorities of nursing to pay more attention to nurses in providing grounds their academic education as well as utilizing permanent employment for young nurses of the hospitals.