HAKIM RESEARCH JOURNAL
Year:2004 | Volume:7 | Issue:3|Papers Count:9

Introduction: Nowadays with improvement of screening tests for blood donors, recombinant methods, intervention of molecular methods and virvcidal techniques, the risk of infection transmission by coagulation factor concentrates has been diminished. Whereas formation of factor VIII inhibitor is a new concern for the patients with hemophilia A. Patients with hemophilia who have inhibitor are capable for severe hemorrhage; their treatments are more difficult and expensive with long- time hospitalization and sometimes cause death. The aim of this study was to show existence of inhibitor in Northeastern Iran and to determine necessity of screening of patients with hemophilia A for factor VIII inhibitor all over the country. Method: About 140 registered patients with hemophilia A exist in Khorasan that with the help of Khorasan Hemophilia Center they were invited to Ghaem Hospital to answer a questionnaire. Among them, 102 patients with hemophilia refered to the hospital so that information and sampling were done. Their venous blood were mixed with 3.2 g/dl citrated sodium (0.109 M) and after preparation plasma, APTT Mix was done for all samples and then Bethesda test and dilution for determination titer of inhibitor were done. Results: Out of 102 patients with hemophilia A under survey, 20 (19.6%) had inhibitor and 82 patients (80.4%) were without inhibitor. Minimum and maximum titers of inhibitors were 0.8 and 6 B.U., respectively. None of patients with hemophilia A were assayed for inhibitor already. There was no significant relation between factor VIII inhibitor and age of patients (P=0.712). Conclusion: As patients with hemophilia A in other countries, a number of patients with hemaphilia A in Khorasan have inhibitor too (19.6%). Hence, screening of all patients and doing test every 6 months to follow up patients with inhibitor and detection new inhibitor in patients without ancient history of inhibitor are recommended.

Introduction: Joint hypermobility(JHM) represents an increased range of movement in the joints of normal population in the absence of underlying connective tissue disorder. To determine the prevalence and features of JHM among school children in Tehran, we conducted a cross-sectional study between January 2002 and Februa 2003. Methods: Using a multi-stage random sampling, we screened 1005 school children (501 girls and 504boys) with the mean age of 12.39± 3.25 year (range 6-19) from 5 different educational area of Tehran for the presence of JHM by a 0 to 9 scoring method; Carter-Wilkinson & Beighton system. Results: Generalized JHM (defined as a score ≥5) was found in 23.9% of the children, 14.1% of boys and 33.7% of girls (p<0.0005). The prevalence of JHM was significantly greater in lower age group (6-12 year olds) in comparison with higher age group (13-19 year olds); 27.2% and 20.5%, respectively (p=0.012). The most common hypermobile joint was the thumb (97.9%), followed by elbow(87.5%), knee (78.3%), hand fingers (60.4%), and ultimately, trunk(23.3%). With the exception of US/LS ratio, we didn't find any noticeable differences in body measures and proportions between hypermobile and non-hypermobile students. Conclusion: We showed that the JHM is a common trait among Tehrani school children. This finding notifies more clinical attention to JHM among rheumatologists, pediatrics, and other concerned physicians. We believe, this high prevalence of JHM and its features seen in this study, probably are specific for Iranian populations.

Introduction: Patient waiting time, visit time and satisfaction are the most important indexes of hospital services effectiveness. This research is performed with the aim of improving the outpatient's waiting time, visit time and satisfaction of services in outpatient department of the hospital using quality circles (participative management). Methods: This descriptive and interventional research was accomplished from Feb 20, to June 21, 2001 in outpatient department of Razi hospital, Qazvin, Iran. In the beginning, 1336 patients who were admitted in outpatient department were enrolled to the study. The data was collected by a questionnaire designed to indicate patient's waiting time, visit time and satisfaction. After determining the above indexes and applying the quality assurance and promotion interventions, in the end of this research, 1270 outpatients via the same questionnaire were studied for determining the efficiency of research. Results: The average of outpatient's waiting time and visit time for received services and their satisfaction improved from 162.18 minutes and 4.34 minutes and 3.37 of 5 credit (weak scale), to 128.43 minutes, 5.06 minutes and 3.84 of5 credit (medium scale), respectively. Conclusion: Based on the results, applying the total quality management and participative management can improve the hospital effectiveness and efficiency and patients' satisfaction.

Introduction: The aim of this study was to identify infectivity of Anopheles species with malaria parasites. Infectivity of malaria vector mosquitoes and infected bloods were tested by nested polymerase chain reaction (nested-PCR) assay in Chabahar and Iranshahr districts of Sistan-Baluchestan province, southeast of Iran. Mehtods: Investigation was carried out on 14 infected blood samples and 1294 female anopheline mosquitoes (head+thoarax) which were collected during 2 malaria transmission peaks, April-May and September-October 2002. The genus- and species-specific primers corresponding to small subunit ribosomal DNA (ssrDNA) of malaria parasites were used for specific amplification by a nested amplification and then the amplified DNA products were detected in stained gels. Results: The results revealed that Plasmodium vivax is the common malaria parasite species in the region, however, a proportion of blood samples were mixed infected by both P. falciparum and P. vivax. Among different anopheline species tested, only mosquitoes of Anopheles stephensi, with 0.22% infectivity, were infected by P.vivax. Conclusion: The Nested-PCR assay for detection and identification of malaria parasites in mosquitoes is used for the first time in Iran and has proven to be more sensitive, accurate, and friendly than other diagnostic methods and recommended for epidemiological studies in different malarious regions of Iran.

Introduction: Usage of diagnostic curratage in clinical practice is very common. The aim of this study was to compare the efficacy of bacteriostatic saline and buffered lidocaine in cervical aneasthesia. Methods: In this double-blind randomized clinical trial sixty patients who referred to gynecology ward of Shariati hospital, Tehran during 2001 - 2002 were randomly a Hocated into two groups. The severity of pain during dilatation and curratage (D&C) operation and 30 minutes after operation was assessed by 21-point Box Scale. Statistics analysis was performed by SPSS 11 software. Results: Severity of pain during D&C operation and 30 minutes after that was significantly much more in saline group than lidocaine group (respectively, P=0.007, P=0. 001). Four patients in lidocaine group and15 patients in saline group were excluded from the study because of confounding factors (such as complications or low efficiency). Conclusion: It seems that in Iran, bacteriostatic saline in cervical aneasthesia for the purpose of diagnostic curratage was not efficient.

Introduction: The present study was carried out to assess the prevalence of overweight and obesity in secondary school students. Methods: This descriptive study was conducted in Tehran city, 2000-2001. Using multistage sampling method, 2321 students (1068 males and 1253 females) aged 11-16 years from 51 secondary schools of all the 20 departments of education and training were assessed. Body weight and height were measured and body mass index (BMI) values were calculated. Overweight and obesity were defined as ≥ 85th and ≥ 95th percentile of age-sex-specific NCHS/CDC 2000 BMI values, respectively. Results: The overall prevalence of overweight and obesity were 21.1 and 7.8%, respectively. The prevalence of overweight in girl students (23.1%; 95%CI: 20.8-25.4) was significantly higher than boys (18.8%; 95%CI: 16.5-21.1) (P=0.01). This difference remained significant after adjustment for age (OR=1.26, Cl: 1.03-1.55, P=0.02). The observed difference between boys and girls was not significant for obesity even after adjustment for age. No significant risk of obesity associated with age was found in girls and boys. Wilcoxon signed-rank test showed that in both sexes, median values of age-specific BMI in this study were statistically higher than corresponding values collected 10 years ago for adolescents in Tehran (P=0.03). Similarly, a significant difference was seen in girl students between this study and the reference values (P=0.03). The difference in boys was insignificant. Conclusion: According to this study, overweight, especially in girls, should be considered as an increasing epidemic health problem in adolescent students in Tehran.

Introduction: The yolk of eggs laid by immunized chicken has been recognized as an important source of polyclonal antibodies. Specific antibodies produced in chicken offer several important advantages over producing antibodies in mammals. This antibody can be considered as a real alternative to the traditional antibody production in laboratory animals. The purpose of this study was to explore the influence of passive oral administration of antibody to botulinum neurotoxin type A in mouse model for therapeutic usage. Methods: Chicken antibodies were obtained from the yolk eggs of chickens immunized with botulinum neurotoxin. Immunization was done with 20 µg of toxoid in incomplete ferunds adjuvant per chicken injected into breast muscle of lay. Antibody extracted from egg yolks by biochemical methods in two steps and ultracentrfugation methods. Preimmune chicken egg yolk cantaining immunoglobulin Y (IgY antibody) to C.botulinum neurotoxin was supplied in drinking water of mice one day before experiment. Then, all animals were challenged with C. botulinum neurotoxin. Mice were controlled during 120 hrs. Results: Each yolk, after extraction contains about 40 mg /ml of Ig Y and specific antibodies was 20 mg/ml after purification. Our results indicated that antibody could protect mice against botulinum neurotoxin. Conclusion: This is the first demonstration that IgY raised against C. botulinum neurotoxin can have a protective effect against C. botulinum toxin.

Introduction: An annual increase in per capita consumption of water in societies, particularly in the dry, semi - dry countries and frequent droughts during the recent years have accelerated demand for application of effluents resulting from industrial activities. Transfer of heavy metal ions into the soil is a function of mass transfer related factors including velocity of water flow and rate of chemical reaction. These compounds infiltrate underground waters, and respect to the potential of these substances to accumulate in different tissues of the body and their cancerogen characteristics as proved through various researches a, strong need is felt to render a careful control on these sources. Methods: In this research, with pH controllers of batch system, calcium hydroxide and sodium hydroxide were studied both in separate and simultaneous forms. First, 96 water samples with a given amount of chrome and nickel contents were prepared and divided into four different groups with 6 concentrations and environmental conditions. The experimental and non-probable sampling were applied. Sample taking and the counter effects of calcium hydroxide and sodium hydroxide were studied both in separate and simultaneous forms. The amount of remaining concentration was determined by flame application at the Atomic Absorption device. Results: Among the measured specimen, 50 mg/lit of concentration of calcium hydroxide and 50 mg/lit of concentration of sodium hydroxide along with 80 to 100 percent output proved to render best condition in omitting chrome (+6), chrome (+3), nickel and cadmium from reaction environment. The results also revealed non significant relations of sodium hydroxide (10, 20mg/l) chrome (+6), (50, 100mg/l)with chrome (+3), (10, 20, 50, 100mg/l) Nickel, (1, 5, 50, 100 mg/l) cadmium and significant relations of sodium hydroxide (1, 5, 50, 100mg/l) with chrome (+6), (1,5, 10, 20mg/l) chrome (+3), (1mg/l) Nickel, (10,20 mg/l) and cadmium (P<0.001). The same status was non-significant for calcium hydroxide (5, 10mg/l) with chrome (+6), (upper 10 mg/l) with chrome (+3), (20, 100 mg/l) with Nickel (1, 20 mg/l) with cadmium and significant for calcium hydroxide (1, 20, 50, 100 mg/l) with chrome (+6), (lower 10 mg/l) with chrome (+3), (1,5, 10, 50 mg/l) Nickel, (5, 10,50, 100 mg/l) and cadmium (P<0.001). Conclusion: The finak conclusion is that all location in the industrial wastewater treatment with control PH is the best way for wastewater treatment.