Jundishapur Scientific Medical Journal
Year:2010 | Volume:9 | Issue:2 (65)|Papers Count:12

Background and Objective: Chronic infection with Helicobacter pylori (H-pylori) that is associated with chronic atrophic gastritis increase susceptibility to typhoid fever. There are conflicting reports on this association in different parts of the world. The aim of this study was to estimate the association between H-pylori infection and typhoid fever.Subjects and Methods: In this case-control study, 50 hospitalized patients with typhoid fever diagnosed based on clinical features and positive  blood or bone marrow culture and admitted to Razi and Abuzar hospitals in Ahvaz were investigated. For each patient one age- and sex- matched control (among classmates or hospital visitors) based on healthy appearance and lack of fever was chosen. All of the cases and controles were tested for IgG-anti H-pylori by ELISA. Data were analyzed by Chi squared test in SPSS software.Results: Positive seroprevalence for H-pylori in case group was 66% which was significantly higher than those of control (44%) (P=0.02). H-pylori positive seroprevalence in subjects younger than 20 years of age in cases and control groups was 60.6 and 54.5% respectively (P>0.05). on the other hand, in subjects older than 20 years, was 39.4 and 45.5%, respectively (P=0.43). There was a significant difference between patients and controls among males (P=0.03), but not among females (P>0.05).Conclusion: This study suggests that there is an association between H-pylori infection and typhoid fever. So prevention and control of H-pylori infection may also decrease the occurrence of typhoid fever

Background and Objective: Acute pancreatitis is an inflammatory disease of the pancreas that can be associated with mild abdominal pain to severe disease and even death. In several studies various drugs have been used, with various results, to control the symptoms and to prevent its complications. The aim of this study was to assess the effectiveness of octreotide in two groups of patients suffering from this disease. Subjects and Methods: This research was carried out from March 2002 until September 2004 in Emam Khomeini (group A: 19 patients) and Golestan hospitals (group B: 6 patients) of Ahvaz Jundishapur University of Medical Sciences. Group A was treated with octreotide (0.05 mg q 12 hr sc) and group B was treated with conventional method. Follow up period was at least 6 months. Results: According to Ranson’s criteria, severity of disease was greater in group A and octreotide therapy had no benefit in the healing time and relieving of fever and leukocytosis, but incidence of complications and mortality in group A was non-significantly lower than group B.Conclusions: Although administration of octreotide had not significant effects on course of the disease (p>0.5), and the relapse rate was equal in both groups, it seems that this drug, at the prescribed dose of 0.05mg q12 hrs sc, could be partially effective in lowering morbidity and mortality.

Background and Objective: Menopausal estrogen-deprivation is an important cause of memory impairment. Exercise is known to improve learning and memory, while ovariectomy causes memory impairment. The present study was designed to evaluate the effect of forced treadmill running on learning and on spatial memory in ovariectomized rats.Materials and Methods: Sixty female Wistar rats (between 240-270 g) were randomly divided in to six groups: Intact and sham exercised control; Intact and exercised (Exe); Sham ovariectomized and sham exercised (Sh-Ovx-Sh-Exe); Sham ovariectomized and exercised (Sh-Ovx-Exe); Ovariectomized and sham exercised (Ovx-Sh-Exe); Ovariectomized and exercised (Ovx-Exe). Animals in all groups were exposed to 10 days treadmill forced running after ovariectomy or sham ovariectomy operation and recovery period. Then spatial learning and memory were tested for 21 days using T maze.Results: Latency and errors to goal box were not changed in control group comparing to Sh-Ovx group during learning and memory test. Latency and errors to goal box were reduced in control group comparing to Ovx-Sh-Exe during learning and during memory test. Latency and errors to goal box were reduced in Exe group comparing to Ovx-Sh-Exe and Ovx-Exe in both learning and memory test. These factors were reduced in Ovx-Exe group comparing to Ovx-Sh-Exe during learning and memory test.Conclusion: Sham ovariectomization did not affect spatial learning and memory, while ovariectomy causes spatial learning and memory impairment in rats. This reduction effect of ovariectomy can be compensated by exercise. Furthermore, exercise causes memory improvement in both intact and Ovx rats.

Objective: The aim of this study was to investigate the prevalence of these factors in knee osteoarthritis (OA).Subjects and Methods: This prospective cross-sectional descriptive study was performed during a period of 12 months. Inclusion criteria consisted of symptomatic or radiologic OA in patients of more than 40 years of age without previous disease or trauma to the knee joint. The patient's age, sex, BMI, living style, any kind of knee deformity as well as questionnaire-based Modified Oxford Knee Score was recorded for each patient.Results: Four hundred patients with knee OA were observed. Sixty nine and half percent were 60 years or older. 63% were women and 37% were men. Seventy five percent of women were postmenopausal. There was a direct relationship between increase in BMI and genuvarum deformity there was increased occurrence of more severe OA in other joints (e.g. spine) in 8.7% of the patients.Conclusion: The most common risk factors associated with knee osteoarthritis were obesity, aging, female gender, post menopause, genuvarum and traditional habits such as kneeling, and squatting. By correcting and modifying some of these factors, such as correction osteotomy for genovarum before 40 years old age, the rate or symptoms of the knee OA can be decreased or minimized. Additional research is required to determine the other risk factors such as the effects of genetics, metabolism and nutrition in this disease.

Background and Objective: Ovarian endometriosis is a condition affecting women in the reproductive age. The correlation between ovarian endometriosis and both infertility and pain is well documented, but several aspects of this disease, including most effective treatment are not well established. So the best management of ovarian endometriosis is controversial. In this study we want to assess the efficacy of two laparoscopic methods for the management of ovarian endometriosis: cystectomy and cauterization, in terms of pain relief, pregnancy rate, and disease recurrence.Subjects and Methods: This is a retrospective study which was performed from 2006 to 2009. In this period, 85 patients with ovarian endometrioma operated with laparoscopy, were entered the study. One group underwent cauterization (group A) and cystectomy was performed for another group (group B). Thirty patients were studied in group A and 55 in group B. Then we compared the recurrence of signs and symptoms of endometrioma, especially pain and pregnancy rate in these two groups. Results: The recurrence of symptoms, especially pelvic pain was 83.3% in group A and 76.4% in group B after 1 year. There was no significant difference statistically. The pregnancy rate was significantly higher in group A (73.3%) than in group B (36.4%) at 1 year follow up (P<0.001). Recurrence rate was lower in group A (23.3%) than in group B (34.5%), but this difference was not significant. Conclusion: Cauterization was a better choice than cystectomy because it leads to higher pregnancy rate, and cystectomy could cause reduced follicular response in controlled ovarian hyper stimulation cycles.

Background and Objective: Several studies have shown that non-surgical periodontal treatment can improve periodontal condition and diabetes metabolic control. Doxycycline seems to be useful in periodontics and control of diabetes, but its effect on periodontal tissue of diabetic patients is not well established. The aim of this study was to compare clinical effects of scaling and root planning with systemic application of doxycycline in type II diabetic patients with chronic periodontitis.Subjects and Methods: 120 patients with type 2 diabetes mellitus and moderate to severe periodontitis participated in this single blind controlled clinical trial and randomly divided in 2 groups. The baseline periodontal parameters consisted of bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL) and glycemic parameters consisted of measurement of Fasting blood sugar (FBS) and glycosylated haemoglobin A1C (HbA1C) recorded for both groups. Group 1 was treated with oral hygiene instruction, scaling, root planning and doxycycline. Group 2 had the same treatment but without doxycycline. After 4 months their periodontal and glycemic control status were evaluated. Recorded data were analyzed with independent and paired T-test. Results: After treatment, both groups had a significant improvement in all periodontal and glycemic control parameters: BOP, PD, CAL, FBS, HbA1C were significantly reduced. However, the reduction in all parameters except of FBS was more significant in doxycycline-treated group.Conclusion: Although both periodontal treatment regimens are effective in type II diabetics, the use of doxycycline as an adjunct provided more significant improvement in periodontal and glycemic control.

Background and Objective: The most recognized symptom during menopause is experiences of hot flashes that affect career, social activities, sleep and quality of life. The common treatment of this symptom is administration of hormone replacement therapy (HRT) that has some adverse effects and is sometimes contraindicated. The aim of this research was to compare licorice (Glycyrrhiza glabra) and HRT on hot flash in menopausal women.Subjects and Methods: This clinical trial was performed on 60 women, who passed their last menstruation 1 to 5 years ago, suffering from hot flashes and being referred for treatment to the boarding clinics of Ahvaz. The samples were randomly divided in 2 groups: the first group was given licorice (D-Reglice) containing Glycyrrhiza glabra, 3 times daily, and the second group was given HRT (0.312 mg conjugated estrogen and 2.5 mg medroxy progesterone daily). All the patients were interviewed and a questionnaire considering demographic and hot flash characteristics (using Kupperman index) was filled out for each case. Hot flash was assessed a week before and 1, 2, 3, 4, 6, 8, 10 and 12 weeks after starting treatment.Results: The results showed that no significant differences were seen in the mean of reduced severity, time and number of hot flashes between 2 groups during the period of the study (P >0.05).Conclusion: Licorice has the same preventive effects as HRT on the hot flashes among menopausal women. Therefore, it can be considered as an alternative therapy.

Background and Objective: Nasopharyngeal angiofibroma is a rare, highly vascular, benign, locally aggressive tumor, affecting boys of adolescent age. Classically it accounts for 0.05% of all head and neck tumors. The aim of this study was to determine the frequency of signs and symptoms, age, sex and its frequency of recurrence in ENT department of Imam Khomeini hospital, Ahvaz, Iran.Subjects and Methods: In this retrospective-descriptive study, all of patients admitted with nasopharyngeal angiofibroma between 1996 -2005 in Ahvaz Imam Khomeini hospital, were analyzed statistically.Results: Of 24 cases found, 23 patients (95.7%) were males. The mean age of patients was 17 years. Nasal bleeding (88.9%) and subsequently nasal obstruction (83.3%) were the most common and important initial presenting symptoms. The most common clinical findings were nasal mass (88.9%), otitis media and proptosis (11.1%). Tumor recurrence was 30.04% which occurred within 3 to 12 months (mean 8.5 months) after operation.Conclusion: Angiofibroma was mainly seen in males (95.7%), Obtaining a detailed history and observation of important symptoms such as nasal bleeding and nasal obstruction in young male adolescents are essential for early diagnosis, prevention of extension and its complication of this tumor.

Background and Objective: In this research, we studied prevalence, type, size and behavior of persistent ovarian cysts.  Subjects and Methods: We studied women with persistent ovarian cysts referred to Imam Khomaini hospital in Ahvaz- Iran in 2006-2007. Important factors in this study were patient's age, pathological diagnosis, type and size of cysts. A total of 112 patients were divided into 3 age groups: Less than 20 years, between 20-40 years and more than 40 years old. Cysts were divided into 3 groups according to their size: Less than 5 cm, 5-9 cm and more than 9 cm. Data were analyzed with SPSS 13. Results: 93% were benign and 7%were malignant.11.6% of patient had less than 20 years old, 67.5% 20-40 and 20.6% more than 40 years old. Functional and adenoma were the most common in less than 20 years, functional, dermoid and adenoma were most common in 20-40 years, and functional were the most in more than 40 years. 39.2% of cysts were less than 5 cm and all of them were benign. 40.1% of cysts were 5-9 cm (84.4% were benign and 15.6% were malignant). 20.4% of cysts had more than 9cm (93% were benign and 7% were malignant).Conclusion: 92% of persistent ovarian cysts were benign, thus we can follow conservatively with sonography and tumor markers and invasive approach is not necessary for all patients.

Background and Objective: Diagnosis and treatment planning are the basic principles in orthodontics. Large volume of data for evaluation of patient's problem in three dimensional space, difficulty in preparation of problem list and dentist mental fatigue are factors which can bring obstacles for correct diagnosis in orthodontic malocclusions. Use of decision supporting system software can help early assessment and prevention of complications that need more expensive treatments. The aim of this study was preparation and evaluation of a decision support system with ability for processing information for diagnosis and treatment planning in orthodontic malocclusions. Such a system can also be used as an educational tool for dental students. Subject and Methods: In order to design this software, in this descriptive and analytic study, we used an algorithmic method which was based on flow chart system. Reference books were used for preparation of gold standards. The efficacy of the software was assessed by 3 orthodontists. Descriptive statistics were used for determination of sample size and software efficiency.Results: With the aid of the software, the first and second orthodontists came to correct diagnosis in 100% and the third in 98% of cases. Conclusions: Since most of errors in diagnosis are due to inadequate attention to details, decision support systems with large data storage capability and reminding details can be reliable tools to help user reach the correct diagnosis and treatment plan.  However, it is important that the efficiency of these systems have very close correlation with user's knowledge of orthodontics.

Background and Objective: Muscle weakness and fatigue in patients with multiple sclerosis, decrease daily activity and quality of life. However, exercise routinely for these patients is acceptable, but its impact has not been proven. This study aimed to assess effect of exercise on walking speed, fatigue and Quality Of Life (QOL) of patients with MS. Subjects and Methods: Fifteen subjects with mild to moderate disability to MS assigned to an exercise group in a clinical trial study. The degree of disability was determined with the usage of Expanded Disability Status Scale (EDSS). Also walking speed and fatigue measured by 8m walk test and Visual Analog Scale (VAS). MS QOL-54 Scale was used to assess QOL. Subjects underwent the three times weekly stretch and aerobic exercise programs during 6 weeks.Results: after exercise, the subjects walking speed were significantly increased (p=0.0001). Fatigue were significantly decreased (p=0.001). There were statistically significant increased only in 4 aspects of QOL after intervention.Conclusion: The results of this research showed the exercise would increase the walking speed and decreased fatigue. Also, results showed that, exercise may have partially affected health - related quality of life. Furthermore, the results confirm that exercise is safe for MS patients and can be recommended for those with mild to moderate disability.

Background and Objective: Ekiri syndrome or lethal toxic encephalopathy is a rare complication of the Shigella gastroenteritis in children. In a period of five years, three cases of this syndrome were reported to the Center for Communicable Disease Control.Case presentation: Three children aged 4, 8 and 9 years with dysentery were hospitalized due to high fever, headache, bloody diarrhea, lethargy and decreased level of consciousness. There were no dehydration and electrolyte abnormalities. Encephalopathy, rapid progression of disease and worsening of conditions resulted in intubation and intensive care in Pediatric Intensive Care Unit (PICU), but they died despite treatment. Stool examination showed red and white blood cells in all cases. Blood cultures were negative but three stool cultures were positive for Shigella and two of them identified as Shigella flexneri.Conclusion: In spite of high mortality, in older children with suspected or confirmed Shigella gastroenteritis, lethargy and headache are the first and predictive signs of lethal toxic encephalopathy. Early diagnosis and appropriate treatment of brain edema can decrease the mortality due to this syndrome