HAKIM RESEARCH JOURNAL
Year:2002 | Volume:5 | Issue:2|Papers Count:13

Car accident is the most common cause of morbidity and disability among children in developed countries. This study was carried out to evaluate the epidemiological aspects of pediatric traffic related injuries (TRIs) in Tehran.The data of this article was adopted from the information of the National Trauma Project (DTP & ETC) which was a comprehensive study of civilian Trauma that lasted one year and ended at August 2000.All the data of Trauma patients admitted to the emergency departments of six teaching hospitals had been gathered by educated observers.Out of 7815 hospitalized trauma cases, 2226 were children and adolescents below 19 years old, of whom, 901 cases (40%) had suffered from car accident injuries. Most of the car accidents happened in the 16-18 years age group (34.2%) and boys were affected 3.5 times more than girls. Pedestrian injuries with 52.3% (471 cases) and motorcycle related accidents with 25.4% (229 cases) were the most common kinds of accidents. Thirty percent of the patients (269 cases) were injured in summer and the accidents had happened most frequently between 12a.m-6p.m.Head injuries was the most common mechanism of trauma (79%) followed by lower and upper extremity injuries with 322 and 308 cases, respectively.As most pedestrian related injuries had occurred in 5-9 years old children and the most vulnerable group to motorcycle related injuries was 16-18 years old teenagers, it seems that physical separation for pedestrians and helmet use in motorcyclists could be a suitable strategy for decreasing TRIs-related injuries and establishing comprehensive public education programs and law enforcement strategies could alleviate the magnitude of the problem.

In this article, the results of the research related to design and implementation of an experimental prototype of a spectrophotometer, similar to the one which is used routinely in clinical laboratories, are presented. In this research, after the designing, implementation and testing different optical, mechanical and electronic modules of the system and developing operating software for control and signal processing, a complete system capable of selecting the desired wavelength automatically was implemented. A series of experiments on selected samples were carried out using the implemented system with the objective of testing, calibration and compensation for the errors of the system. The results of the experiments have been presented in this paper.  

Congenital toxoplasmosis is one of the most serious infectious diseases peresented in children and newborns as a result of mother affliction with Toxoplasma gondii parasite during pregnancy.To determine the infection level in pregnant women, blood samples from 4120 mothers (6-12 weeks of pregnancy) were collected and examined by Indirect Florescence Antibody Test (I.F.A.T). Out of 4120 individuals, 2804 were positive (68%) and 1316 were negative (32%).Among seropositive women, those who had antibody titer lower or equal to 1/400, were eliminated from the study, and those had antibody titer more or equal to 1/800 were followed up. In the next visit, these women (antibody titer>1/800) were sampled and tested. Some of them that had constant or decreasing antibody assay which is the evidence of infection before pregnancy were eliminated from the study. Pregnant women that had increasing antibody titer which was the evidence of new infection were put under observation for antibody titer.Altogether, in this part of the study, there was only one toxoplasmic child and two cases of abortion. Sampling and testing were carried out regularly (16-24 weeks and 28-36 weeks of pregnancy) from the seronegative women (32%) during the pregnancy period, and those who became seropositive during the pregnancy period, (seroconverted=18 cases) were put on research. In addition in this part, 8 children were observed with congenital toxoplasmosis and one case of abortion.Based on the results obtained from this study, risk of affliction of seronegative mothers during pregnancy is about 14 in 1000 and the probability of being toxoplasmic among the children with high risk mothers is 7 per 1000.

It is about 20 years that Helicobacter pylori have been discovered as an etiologic factor for peptic ulcer and gastric adenocarcinoma and lymphoma. The bacterium has a spiral form, but under stress conditions can transform to coccoid form. Coccoids are not culturable (by routine methods) therefore it is believed that, they are the morphologic manifestations of cell death. Some investigators successfully showed that coccoids are alive cells. In this research, using flow cytometry, we were able to discriminate between dead and alive cells.The results of this study showed that all of the reserved bacteria in water converted to the coccoid form after 24 hours, also after conversion to the coccoid form, the bacteri can live until 11 months under low temperature conditions.The technique is reliable, fast and convenient to investigate the effect of different environmental factors on H. pylori viability.  

Both prostaglandin E2 tablet and an intracervical balloon catheter have been shown to be effective of cervical ripening. The purpose of this study was to compare the efficacy of vaginal prostaglandin E2 tablet with an intracervical Foley catheter for preinductiom cervical ripening. A Randomized, prospective study was conducted in the Mirza Koochakkhan Hospital in Tehran. Patients with a Bishop ≤ 5 were randomly assigned to recieve either prostaglandin E2 tablet or a Foley bulb. Prostaglandin E2 tablet was used according to the manufacture’s recommendation. Immediately after bulb extrusion or 6 hours after prostaglandin E2 tablet course completion oxytocin was started if the patient was not in labor.The groups were comparable with respect to maternal age, gestational age and initial Bishop scores. Forty-Five women were entered into the Foley group and 45 were entered into the prostaglandin E2 tablet group. The Bishop score after preinduction ripening (6.64, vs 6.76, P=0.544) and the change in bishop score (3.62 vs 3.67 P=0.786) showed no difference between the groups. The preinduction time (3.44, vs 6.52 hr, P<0.001) and total time (8.47, vs 15.99 hr, P=0.006) were significantly shorter than the Foley group. Both patient’s hotelling days (2.000 vs 2.125, days P=0.034) and costs (58435.294 vs 63183.750 RL, P<0.001) were significantly shorter than the Foley group. There was no difference between the groups in mode of delivery, rate of hyperstimulation, oxytocin use fetal weight, Apgar score, nonreassuring fetal heart rate and spontaneous labor.Use of the Foley catheter resulted in a shorter pre induction time, hotelling days and costs than vaginal prostaglandin E2 tablet did.

With regard to the economic importance of shrimp export and report of cases of cholerae especially in south coasts of Iran, and because of the possibility of contamination of surface water which is used in farms with waste water, this study was conducted.In this study marine and farm shrimps from south coasts of Iran were evaluated for possible infection with Vibrio spp.specially Vibrio cholerae.In three stages, 770 samples of shrimps from marine and farms in provinces of Hormozgan, Boshehr and Khozestan were collected. After early preparation in the provincial food control laboratories the samples transferred to Tehran. Each sample included 25g shrimp in a strile ice-bag. Samples were tested for Vibrio spp.by enrichment and culture on selective media and biochemical tests.Although four spices of vibrio, which have little importance in food hygiene, including V.parahaemolyticus, V.damsella, V.alginolyticus and V.fluvialis were isolated from the samples, no V.cholerae was found. Although it is now very unpredictable to find any contamination of shirimps with V.cholerae in south coasts of Iran, it is recommended to prevent contamination of surface water with sewage.

By increasing the number of patients with infectious diseases such as AIDS, which can be transmitted by blood transfusion, volunteer blood donation and selecting donors with less risk  factors have become a very important matter in world strategies to provide safe blood. Investment on human and monetary resources for public training of motive creation of blood donor will bring a lot of long term benefits such as adequate and safe blood resources. In our research we have studied the causes and the prevalence of blood donors deferral.This is an observational study by reviewing the registration of rejected donors, in a six months period from autumn 1999 to winter 2000 we collected information about age, sex, job, marital status and the cause of rejection. The information was analysed by SPSS software.Out of the 163418 donors, 32226 (21.1%) could not donate their blood, 80.7% were male and 19.35%  female, 45.7% were single and 54.3% married.4.7% of donors after filling the forms and reading the blood transfusion brochure, refused to donate their  blood (self deferral). 98.65% of donors could not donate because of pathologic causes. 91.8% of them were deferred temporarily and 8.81% permanently, 15.5% had unsafe sexual contact, which was the most common causes of rejections, 12.4% had antibiotic consumption, 11.5% had hypotension and 7.8% had done Hejamat before. Most of the rejected donors were under 25 years old (40.7%) and business was the main job among them (33.1%). It seems that the rate of blood deferral in Tehran is very high and to decrease this rate we have to consider the main causes which are mostly temporary and then choose the best ways to remove them.

This study has been carried out on mononuclear cells of peripheral blood to identify that L.major and L.tropica parasites have life cycle inside macrophage similar to the host. The in-vitro dynamic proliferation of the obligate intracellular protozoan parasites of L.tropica and L.major on peripheral mononuclear cells of five groups was investigated as follows: 1- control group(ten individuals) 2- Infected with L.tropica and sensitive to the treatment(five individuals) 3- Infected with L.major and sensitive to the treatment(five individuals) 4- Infected with L.tropica and resistant to the treatment (five individuals) 5- Infected with L.major and resistant to treatment (five individuals). Separated mononuclear cells of peripheral blood were infected with L.major and L.tropica and they were cultivated for 14 days. In the days 1, 3, 5, 7, 10, 14 after infection, the number of infected macrophages and the number of amastigots/macrophage have been counted.Using statistical trials t.test and paired t.test, no significant differences observed between two healty groups. On the other hand, significant differences observed between resistant and control groups as well as sensitive and resistant groups (P<0.05). Severe infection with L.major and L.tropica in both resistant groups has been shown in this study.The identification of the dynamic of proliferative cycle of L.tropica and L.major in human macrophages can help us for successful treatment of cutaneous leismaniasis.

A qualitative survey as a focus group discussion of effective factors on exclusive breastfeeding and continuation has been accomplished in urban and rural areas of Khorasan, Semnan, Kordestan and Gilan provinces for the first time in Iran. The study was carried out with the cooperation of health deputies of the related university of medical sciences and health services.The objective was obtaining the points of views of the three attendant groups (successful and unsuccessful mothers in breastfeeding and health workers) on the bases of the type and style of nutrition among children one year of age, factors influencing mothers’ success in exclusive and continuing breastfeeding; sick infants, sick mothers; working mothers, pregnancy and breastfeeding and the effects of services of physicians, health workers, mass media and advertisements on breastfeeding.In this regard representatives from each of 4 provinces were trained. In each province mothers who had one to two years-old children were interviewed in two groups of successful and unsuccessful in breastfeeding in two sub-groups (rural and urban). Also interviews with health workers in rural (behvarzes) and urban (officers with bachelors or post-diploma degree) groups were conducted. There was one interview for 8-10 participants everyday, which took 1.5 - 2 hours. After every interview, all notes were reviewed and summarized. Finally, 48 preliminary notes, 24 summaries and 12 general reports of the provinces were analyzed. The most outstanding outcomes are as following:Most of health workers and mothers had good and comprehensive information and right believes about the importance of breastfeeding; feeding infants on demand; not using pacifier and bottle; important role of mothers’ nutrition and health on her breastfeeding; husbands’ support; supporting the new, low experienced mothers; continuing breastfeeding for sick children (in diarrhea and etc). But some mothers had lots of wrong believes or incomplete information about: when and how to start the complementary food; type of complementary foods; breastfeeding during breast problems; mothers’ illness and using the drugs, preserving expressed mother milk, etc. In addition physicians in the private sector were not familiar with topics developed in governmental sector and educational subjects in governmental sector are miscellaneous. On the other hand health workers’ instructions have more effect on continuance of breastfeeding in comparison with mass media and finally some mothers were successful in breastfeeding even though their practice were inconsistent with their knowledge and believes, about exclusive breastfeeding.  

The aim of this research was to study tissue reaction following placement of titanium screws and two types of loading, delayed and immediate in femoral bone of rabbit .The sample consisted of 14 male New Zealand rabbits. As a control group, 2 rabbits had surgical procedure and right lateral surface of femoral bone was drilled and two holes were made with 1cm distance. In the second group (4 rabbits), two titanium screws (3mm diameter, 7mm length) were placed with 1cm distance. In the third group (4 rabbits) 4 oz traction force was applied on screws by S.S. Closed Coil Spring that covered with polyethylene tube and it was considered as immediate loading group. The last group (4 rabbits) had two steps surgical procedure. In the first step, screws were placed and after 8 weeks as healing period, screws were loaded as the mentioned third group. After two months samples were sacrificed and femur bones removed and fixed in 10% formalin. The results showed that there was not any displacement for all 24 screws and it was not statistically significant (P<0.001) which was tested with Paired t-test and Wilcoxon matched pairs. Similar histologic pattern included vital bone around the titanium screws and lack of inflammatory cells accumulation was seen using light microscope in all groups. Surrounding bone was of mature lamellar type. A thin layer of fibrous tissue (2-3 layers of cells) was seen between screws and interface. There was not any difference between histologic reaction of two immediate and delayed groups.According to the results of this study, an acceptable histologic compatibility exists between titanium screws and surrounding bone and immediate loading is an acceptable method of orthodontic anchorage preparation which can eliminate healing period of delayed loading.

In this article, the health research challenges are synthesized to emphasize that a new approach to health research is necessary. Thus, the main challenges of the world like 10/90 gap, globalization, increased healthcare cost, threatening chemical and biological weapons are discussed and then mentioned to the weakness of knowledge management and lack of health research culture as the main health research challenges in Iran. In many countries, health research is not well coordinated and often fragmented, resulting in inefficiency and duplication. Also, health Research is inadequately linked to the priorities and goals of the health system, research capacity development and the mobilization of resources are not applied and the goal of health is not accessible as the result of health inequity. In addition, health research has tended to be isolated from the broader development community and suffers from a lack of appreciation of the tangible benefits which can bring. If we expect that health research has a significant impact on health and development, it needs to be a part of a long-term strategic plan closely linked to the development agenda. So, launching a health research system in the national and regional level seems to be the best solution and should be funded.