Jundishapur Scientific Medical Journal
Year:2006 | Volume:5 | Issue:2 (49)|Papers Count:18

Objective: Sunscreen preparations are applied to protect the skin against harmful effects of sunshine. The most determining index for evaluation of these preparations is sun-protection factor (SPF), which reflects the degree of protection against UV light. Numerous in vivo and in vitro methods are employed for assessment. Despite the accuracy of in vivo methods, their expensiveness and time consuming have restricted their routine application at the stage of screening formulations. Therefore, in vitro methods are employed. In the present study, the efficacy of two in vitro methods (transpore and the diluted solutions methods) was compared using four trade preparations (Arden, Rasen, Onagrin and Rexol).Subjects and Methods: The first method was performed using a suitable, cheap and widely available substrate called transpore tape. In this method 2 mg/cm2 of each product was uniformly dispersed on the surface of the substrate, and the spectrophotometer transmittance values in the range of 290 – 400 nm, at 5nm intervals, of prepared films were determined and values SPF were calculated. In the second method, different concentrations of test products were made in methanol and UV transmittance values were measured at the range of 292.5–337.5nm and values SPF were calculated. By plotting the amount of SPF versus each concentration the efficiency of the products SPF were compared. The SPF of 2 mg/ml concentration of each product was calculated.Results: In the first method results indicated a good, although incomplete, linear correlation between the measured and labeled (r = 0.975). In the second method all result were considerably larger than the labeled values and showed poor correlation (r = 0.35).Conclusion: Based on the results, because of the ease of process, availableness and also offering closer result with the in vivo methods. The transpore method, in contrast to the diluted solutions method, is a more efficient method for determination of SPF values. Therefore this method can be applied as an in–process control test to ensure lot-to-lot uniformity.

Objectives: Tonsillectomy is performed when there is obstruction in the upper respiratory tract or following recurrent chronic infections of the tonsils. It can be performed under local or general anaesthesia. The aim of the present study was to compare the complications that develop following these two methods.Subjects and Methods: In this prospective clinical study, the side effects associated with both methods were evaluated among 300 co-operative teenagers and adult patients (150 patients in local tonsillectomy and the same number of patients for tonsillectomy under general anaesthesia). Post operative pain, amount of bleeding both during and after the operation and patient satisfaction were assessed and compared. Local tonsillectomies were performed in the operating room using local anaesthesia with intravenous sedation.Results: The average blood loss during the operation was 68 ml in local tonsillectomy group with two cases of postoperative hemorrhage, while the average blood loss was 180 ml with four cases of postoperative hemorrhage in the general anaesthesia group. No significant differences in the post-operative bleeding were noted between the two groups. In local tonsillectomy group all patients but one stated that if given the choice, they would select local anaesthesia again. We conclude that local tonsillectomies have high patient acceptance and are associated with minimal morbidity and complications.Conclusions: The safety and effectiveness of local tonsillectomy in comparison with tonsillectomy under general anaesthesia was demonstrated.

Objectives: Dental caries is an infectious and communicable disease and multiple factors influence its initiation and progression. Establishing health care procedures are effective factors in prevention of dental caries. One of the causes of early caries of first permanent molar is unawareness of parents of the time of its eruption and the importance of this tooth in oral health. The purpose of this study was to compare the level of Decayed, Missed and Filled (DMF) and oral hygiene among male and female 6-year old students in Ahwaz in year 2000.Subjects and Methods: For this purposes 264 six-year old male and female students were evaluated via a descriptive study by direct observation and interview. The results were analyzed by use of descriptive statistics, frequency and percentage distribution tables. Student t-test was used for statistical comparisons.Results: The overall average of DT was 0.22 (0.25 in girls and 0.2 in boys) which was not significant. Average of DMF was 3.36 (3.40 in girls versus 3.30 in boys). The oral hygiene score index (OHI-S index) was good among 32.5 and 42.4 % of girls and boys respectively (p>0.5).Conclusions: The results of this study showed that dental caries were mainly related to the total amount of DMF. Furthermore the mean percentage of good level of OHI-S index among this population group was 33.3% suggesting that education of oral hygiene for parents is an important parameter in the control of developing dental caries.

Objective: Color blindness is an important hidden problem that may cause secondary complications in daily lives of some professions. In addition, due to differences in the prevalence of color blindness in many populations, as well as its unknown level in our population, the aim of this study was to find out the prevalence rate of this condition in our region.Subjects and Methods: In this descriptive study 2500 high school students in Ahwaz (1250 males, 1250 females) were randomly selected. Color blindness test of Ishihara was performed.Results: 94 students (3.7%) were found to be color blind (68 males and 26 females). From the total cases identified, 46 cases (49) deutanopia, 14 cases (33%) with deuteranomaly, 6 cases (6.3%) were protanopia and 11 cases (11.7 %) protanomaly. No case with complete color blindness was found.Conclusion: We suggest checking of color vision in the school age groups, in order to detect early color- blindness and hence guide them for more suitable job selection.

Objective: Multiple mandibular fractures are fractures that occur in more than one line in the same bone. The aim of this study was to find the most common pattern of multiple mandibular fractures among patients referred to Taleghani hospital (Tehran) and educational hospitals of Ahwaz Jundishapur University.Subjects and Methods: In this retrospective study, 305 files of patients with multiple mandibular fractures during years 1998–2005 were selected and the data such as age, pattern and the cause of fractures were collected.Results: This study showed that in 85.6 percent of patients suffered from two fracture lines in the lower jaw and the rest had more than two fracture lines. The most common pattern of fracture was parasymphysis and opposite condoyle (19.5%). The second most common type was body and in opposite angle (15.3%). The most common cause was car accidents and it occurred predominantly among men aged between 16-25 years old.Conclusions: The most common pattern of multiple mandibular fractures depends on cultural and social characteristics of each society. In our population young aged men are more prone to this type of fractures, which is mainly due not paying enough attention to traffic provisions.

Objectives: Hepatitis B virus (HBV) is the underlying cause for chronic and acute hepatitis. Chronic hepatic can progress toward cirrhosis and hepatocellular carcinoma. Vaccination against HBV is one of the important ways in the prevention of these conditions. Because of suppressed immune system, dialysis patients are less responsive to vaccination. However, there are several ways for increasing the immune response in these patients; one of them is intradermal injection of HBV vaccine. The aim of this study was, therefore to evaluate the degree of immune response and determining efficacy of intradermal injection of HBV vaccine in these patients.Subjects and Methods: One hundred and nine hemodialysis patients who fitted the conditions for entry in this study were evaluated. Necessary information including age, sex, number of vaccine injections, time of last vaccine injection, frequency of dialysis, dialysis product, duration of dialysis, serum albumin level, HCVAb and HBCAb was collected. From these data, immunity level as well as the immunity against HBV was estimated by monitoring of HBSAb. The selected groups were those patients with negative Ab, who were divided into two groups: the first group received 20mg intradermal HBV vaccine and the second group the vaccine was administered intramuscularly.Results: The results showed that 45% of patients were antibody positive and 55% had no appropriate response to vaccine. There was no relation between age, sex, serum albumin level and dialysis product and the degree of immune response. However, there was a significant relationship between the duration of dialysis and the time last vaccine injection with the degree of immune response. Immune response in patients who were injected intradermaly was statistically different from those who had intramuscular injections Conclusions: It recommended that the protocol for the national HB vaccination should change from injections to 4 times and with a double dose. Furthermore, in patients who can not achieve appropriate response, vaccination should be given intradermaly.

Objective: Resistance to heavy metal ions has been reported in many bacteria. Since any change in the bacterial activity can have important consequence both from scientific and clinical aspects, this study was performed for the determination of potassium tellurite resistance in the clinical isolates of Escherichia coli.Subjects and Methods: The minimum inhibitory concentration (MIC) of potassium tellurite was determined for 449 isolates of Escherichia coli, isolated from infected urinary tract or normal fecal flora, using standard agar dilution method.Results: Approximately half (48.7%) of the isolates had MIC of ≤1mg/ml after 24 hours of incubation at 35 ºC. Many of the bacteria that were cultured with low concentrations of potassium tellurite, ≤ 5 mg/ml, overcame the toxicity of this heavy metal when they were re-incubated for the additional 24 hours. The MIC for these isolates was increased, so that the difference between the MIC after 24 and 48 hours of incubation became significant (P ≤ 0.001). In medium containing ≥10 mg/ml of potassium tellurite, the bacteria formed typical black colonies. No statistically significant difference was found between the MIC of bacteria that where isolated from urinary tract infection or normal fecal flora.Conclusion: Since resistance to heavy metals can be simultaneous with resistance to antibacterial agents, determination of simultaneous resistance to antibacterial agents and other heavy metals in this bacterium and other bacterial genus is necessary in this region.

Objective: Six to10 % of the population in Sistan and Baloochestan (S&B) province are minor beta thalassemic. On the other hand, in1379, the General Fertility Rate (GFR) in S&B was the highest in Iran (113 births per1000) and this index was even higher among the major thalassemics' family (155.6 births per 1000). Therefore, it is estimated that annually there would be 35 additional new cases of thalassemia in this region, which would lead to uncontrollable health and socioeconomic problems in the near future. Consultation can be used as a mean by which information can be dissipated and has an influence on knowledge, attitude and practice (KAP) of people. However, the extent of this in this society has not been studied before. Therefore, we decided to project a standard family planning program with well trained consultants in thalassemia ward in Zahedan and evaluate its effectiveness to improve KAP among thalassemics' parents about birth control.Subjects and Methods: We scheduled at least 7 consultations for one or both of the parents in each family, during a period of one year (1379-1380). Parents of 167 families were studied and responded to pre- and post-test questionnaires.Results: There was a significant decline in GFR, relative to the previous year, from 155.68 to 47.9 in 1000. In the previous year there were 43.3 % unplanned pregnancies versus non during the year of our study. In addition, there was reduction in the influence of cultural aspects (religion and education) on KAP related to birth control (p<0.01). However, there were eight planned pregnancies.Conclusions: The findings from this study showed that implementation of continuous standard family planning program throughout the country; especially in poor regions is an important factor in the control of thalassemia in our country. However, persistence on planned pregnancies, dictate that prenatal diagnosis is mandatory to control thalassemia as a complementary optional measure in this region.

Primary pulmonary hypertension (PPH) a rare condition that is more common among pregnant females. It can have a high mortality rate during delivery and caesarean section. In PPH cardiac out put is highly dependent on venous return and pulmonary artery pressure. Pain during delivery may lead to decrease in venous return or increase pulmonary vascular resistance which can seriously decrease cardiac out put. Spinal anaesthesia is often quoted as unsuitable for such patients due to possible disadvantage of venodilation and decrease systemic vascular resistance. We present a 25-year old pregnant female who needed emergency caesarean sections at 36th week of gestation. We choose spinal anaesthesia by 50mg of 5% lidocain + 0.5 ml of hypertonic dextrose (20%) in a total volume of 1.5 ml injected at L3-L4 lumbar space in the sitting position.  She delivered a newborn with apgar scores 8 and 10 at 1 and 5 minutes respectively. Before spinal anaesthesia her PH was 7.40, BE=, SaO2=90, PCO2= 60 mmHg, PaO2= 60 mmHg and HCO3 =15mEq/l which was corrected by administration of 25 mEq of HCO3. During surgery SaO2 was acceptable (92%- 98%). She was transferred to ICU and discharged in good condition on 4th post-operative day.We suggest that properly conducted spinal anaesthesia with correction of maternal acidosis and fluid therapy can be a safe anaesthesia in PPH.

Objectives: It is estimated that as many as 75% of women experience at least one episode of vulvovaginal candidacies during their lifetime. Candida albicans is responsible for 85 to 90% of vaginal yeast infections. Topically applied azoles are the most commonly available treatment for vulvovaginal candidacies. In 80 to 90% of patients the symptoms usually take 2 to 3 day to resolve. Treatment with an oral antifungal agent, fluconazol, used in a single 150 mg dose has been approved for the treatment of vulvovaginal candidacies, but symptoms do not disappear within 2 to 3 days. Due to fewer side effects and the ease of use of oral fluconazol the aim of this research was to compare the efficacy of oral fluconazol vaginal clotrimazol in the treatment of vulvovaginal candidacies.Subjects and Methods: In this study 192 patients 97 patients were in vaginal clotrimazol group and 95 patients in fluconazol group with vulvovaginal candidacies were divided randomly in two groups. Diagnosis of vulvovaginal candidacies in these patients was based on typical clinical signs and symptoms, normal PH of vaginal discharge and microscopic findings including observation of budding-yeast forms or mycelia in 10 % KOH. The first group was treated by oral fluconazol (150 mg single dose) and the second group treated with vaginal clotrimazol for 1 week. The efficacy of drugs compared by chi-square test The Mean age of patients was 30 years.Results: Response to treatment in vaginal clotrimazol group was 97% with 72% of patients responded in 1 to 3 days and 28% after 3 days. Response to treatment in fluconazol group was 86% with 94% of patients responded in 3 days and 6% after 3 days.Conclusions: This study reveals that therapeutic response in clotrimazol group was higher than fluconazol groups (P <0.05). However, contrary to other studies, the time of response in fluconazol group was faster (P <0.01). Therefore, according to these results, fluconazole produced efficacy in 86% of patient with faster rate of recovery. In addition, the ease of administration of fluconazol together with some disadvantages associated with use of vaginal clotrimazol, it is advised that the patients suffering from vulvovaginal candidacies to be treated initially with oral fluconazol and in non-responders with vaginal clotrimazol.

Objectives: Since thalassemia patients receive continuously blood and its products, they are in high risk to acquiring various transfusion-transmitted infections, such as hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV). Nowadays, one of the major hygienic problems in thalassemia patients is to reduce and control these viral infections effectively.  The aim of this study was to determine the prevalence of HBV, HCV, and HIV antigenic markers among major and inter media thalassemia patients.Subjects and Methods: A retrospective cross-sectional study was conducted on 122 thalassemia patients (102 major; 20 inter media) referred to the Hemoglubinopathi and Thalassemia Center of Ahwaz Shafa hospital during October 1999 to October 2004. Demography data and serological laboratory results obtained from the patients, files at hospital. HBsAg, HCVAb and HIVAb had been tested in their serums by using ELIZA technique and then confirmed by RIBA technique. The results were analyzed using SPSS and chi-square test.Results: Out of 122 patients 73 (59.8%) and 49 (40.2%) were men and women respectively, with age mean of 14.96 years. 3 individuals of whole patients were positive for HBsAg, 32 for HCVAb and nothing for HIVAb. Therefore, the overall seroprevalence rate was for hepatitis B 2.5%, HCV 26.2% and HIV zero. There was significant positive relation between age and blood transfusion duration with prevalence of HCVAb (p value= 0.008 and <0.001 respectively).There was also significant difference between vaccination against hepatit B virus and lack of HBV infection among patients (p value<0.03).Conclusion: It can be concluded the incidence of HCV is rather high in thalassemia patients of Khozestan prozon. Although it seems blood donor screening project reduced HCV infection, using more accurate technique is necessary in order to find viral infection and treat thalassemia patients with HCV infection more carefully.

Objectives: Diabetes Mellitus, like any other chronic disease in children, can cause serious health problems among their family member. On the other hand psychological responses in family to their child disease, can effect the children's reactions. We therefore, conducted this study to determine relationship between the effect of type I diabetes in children, as a stress factor, and it relationship with general health among parents.Subjects and Methods: For this purpose, 66 parents with type1 diabetic children, who referred to diabetic clinic of Ahwaz Golestan hospital and diabetic center, were selected by simple sampling. The following data were collected: A general health questionnaire (GHQ), a questionnaire of stressors to parents due to diabetes in their child and demographic characteristic form.Results: The results showed, only 24/02% of parents with diabetic child had general normal health level. Probability of hospital admission of child, development of diabetic complication hypoglycemic shock, marriage of child and his\her having a child, were main stressing factors to the parents. The was a significant correlation (p<0/01) between these stress factors and the parents general health. Furthermore, there was significant relationship between stress factors and general health of the parents with the duration of children's disease, parent’s educations and positive family history of diabetes mellitus. However, there was no significant relationship with the sex of the child.Conclusion: these findings indicated that children with diabetes act as stress factors that can affect the general health of their parents and appropriate psychological attention and support is needed to be provided to these parents.

Objectives: The aim of the present study was to isolate the proteinous components of the venom electrically extracted from the scorpion Hemiscorpious lepturus and to test some of their toxic effects in mice.Materials and Methods: electroshock method was used to isolate the venom from ten thousand scorpions from the species Hemiscorpious lepturus. The extracted venom was dialyzed with distilled water for 24 h, and the water soluble components, containing the active ingredients, was separated by freeze drying method. The venom components were isolated by aid of chromatographic and spectroscopic, at 280 nm wavelength, methods using Cephadex G-50 jell column. The four isolated components were dissolved, at 200 mg/ml, in water and injected intravenously at the tail of mice. Two hours after administration blood samples were taken and the following parameters were measured: glucose, urea, creatinine, triglyceride, total protein as well as hematological parameters including, WBC, RBC, hemoglobin and hemtocrit. The results of these components were compared with those of control mice group, not envenomed, as well as those received the raw venom.Results: The result showed that the first fraction produced increase in urea, glucose, creatinine, triglycerides and lymphocytes, with a significant reduction in neutrophiles. While the second fraction produced a significant reduction in urea, critinine, cholesterol, total protein, and non-significant reduction in neutrophiles and increase in relative lymphocytes. Other parameters were not changed. The third fraction produced reduction in glucose, cholesterol and lymphocytes and increase in neutrophiles. Other parameters remained unchanged, while fraction four all biochemical parameters were reduced while those of hematological parameters did not change. The raw venom produced increase in neutrophiles and other, with exception of glucose, biochemical parameters. The number of lymphocytes was reduced.Conclusion: Since the forth fraction produced different responses relative to other parameters, it is possible that the forth fraction as well as other fractions can be used to produce more specific antivenom serum.

Objective: Soft tissue foreign body may cause some complication and problem in diagnose. In this case report, a 5-year old boy with ambiguous history of trama a year ago was visited in clinic with soft tissue mass and dirty discharge 10 days after the trauma. About 1 month later, the discharge stopped. One year later, a tumor-like mass appeared on the lateral side of right leg: On MRI with and without contrast media rhabdomiosarcoma was suspected. The following actions were undertaken: an incisional biopsy was done. A 32 mm wooden foreign body was found and removed. Foreign body on follow up, after one year he had no recurrent problem.

Objective: Splenic cyst is not a common disease. Robbins reported 32 primary splenic cysts from 42327 autopsies examined during 25 years. Splenic cysts are divided into two groups: parasitic and non-parasitic cysts. Splenic cysts are clinically divided to primary and secondary cyst. Ten % of and are primary or true splenic cysts. Because these cysts have non-specific symptoms like vague abdominal pain, abdominal distension and dyspnea, they may become huge by the time of diagnosis. Proliferation of epithelial cell and increased secretion of this cyst layer may be the cause of the growth. The traditional treatment is splenectomy.Subjects and Methods: In this case report, a 17-year male old patient with signs of weakness, abdominal distension, and mild dyspnea, which had begun 8 months ago, is presented. On Sonography we found a huge 217x 166 x 301 mm cyst in his spleen.Results: Laparatomy revealed splenic cyst 30x 20x20cm with the same the same pathology.Conclusion: After splenectomy patient was completely cured and left the hospital with a good general condition.