HAKIM RESEARCH JOURNAL
Year:2003 | Volume:6 | Issue:3|Papers Count:18

Introduction: Vitamin A deficiency (VAD) is one of the most prevalent nutritional deficiencies in less developed areas and has a key role in increasing the burden of infectious diseases, especially among vulnerable groups. In this study, we aimed to determine the nutritional status of vitamin A in urban and rural areas of Hormozgan province, southern Iran. Methods: In March 2000 breast-milk and conjunctival (in pair) samples were taken from 239 lactating mothers (1-9 months after delivery) and 687 children (24-71 months), respectively. Weight, height, prevalence of respiratory and gastrointestinal infections during two weeks before the study in children, and the practice of colostrums feeding were determined. Breast milk retinol was measured by high performance liquid chromatography (HPLC). Conjunctival impression cytology (CIC) was done by microscopic investigation of conjunctiva samples. EPI6.0 software was used to analyze data. Results: Prevalence of retinol-deficient milk samples (retinol< 1.05 mM) was 16.8% (12.0-21.6%) with no significant difference between urban (18.5%) and rural (15.7%) areas. Abnormal CIC was found in 25.2 and 28.7% of urban and rural children, respectively, with no statistically significant difference. Total proportion was 27.3% (24.0-30.6%) in the province. The overall importance of vitamin A deficiency seemed to be at "moderate sub-clinical" level.Conclusion: Considering the time of study, it seems that problem of VAD should be more serious during other months, especially in remote rural areas. Nutritional education with special emphasis on local potentials in cultivating vitamin A rich foods, continuation of vitamin A supplementation in children and integration of a vitamin A supplementation program into the maternity care services are highly suggested.

Introduction: Mortality statistics and cause of death is one of the main components in health planning in any community. This study has been conducted to determine and analyze the epidemiological trends for all leading causes of deaths in the last 23 years.Methods: In this study data related to 2, 598, 891 deaths for the period of 1979 to 2001 were analyzed. The data related to the number and causes of deaths were collected from 11 to 24 selected cities for the period of 1979-1994, and from 1995 onwards from throughout the country. These data were collected by the Office of Development and Coordination of Statistical System of the Ministry of Health and Medical Education. The sources of the data are: records at the organization for vital records, cemeteries, death certificates, hospitals and health houses. The causes of death were coded and classified based on the International Classification of Diseases (ICD). To assess time trends in mortality over time, the proportional mortality ratio (PMR) was calculated for each year and also for five-year intervals.Results: The results showed that the PMR due to disease of the circulatory system, and injuries and poisonings has been ranked the first and second highest groups, respectively, during the period of study. These two causes of death plus neoplasms, diseases of the respiratory system, congenital anomalies, diseases of the digestive system, infectious and parasitic diseases, neonatal diseases, and diseases of the genitourinary system are responsible for 80 percents of all deaths. The PMR for neoplasms ranked the 5th place of the causes of death in the study population during 1979-81, and then promoted to the 4th place in 1982-86, then was the 3rd place in 1987-90 and has tended to be stabilized since then. The PMR for infectious and parasitic diseases which ranked the 7th in 1979-81, reached to the 6th place in 1981-91, then again held the 7th place in 1992-96 and dropped to the 9th position in 1997-2001. In addition, PMR for diseases of the respiratory system ranked the third place during 1979-81 periods, and then reached to 5th in 1997-2001.Conclusion: In conclusion, in the past 23 years, the PMR for infectious diseases has been decreasing and PMR for non-infectious diseases especially cancers and injuries and poisoning have been increasing.  Therefore, rise of PMR for neoplasms requires special attention in the control and prevention programs.

Introduction: This study was designed for preparation and evaluation of standard Leishmania suspension against small-white mice (out-bred(.Methods: Leishmania suspension was prepared from Leishmania major (MRHO/IR/75/ER). The Leishmania parasites were cultured in Schneider and RPMI1640 culture media. We then, subcultured them for each 72 hours interval. The promastigotes were harvested 120 hours post the fourth subculture and washed with isotonic normal saline. The parasite suspension was mixed with phosphate buffer saline (PBS, pH=7.2) or isotonic glucose- Nacl and glycerole 10% and counted by Neobar procedure (2X107 parasite /ml) and then were gradually freezed in liquid nitrogen. Viability test showed that from 5 to 25% of promastigotes were alive after this process. Two hundred and thirty seven mice (outbred-souri) were divided to two groups. Group 1 (135) were inoculated by 0.1 ml of Leishmania suspension subcutaneously in their base of tail. The mice of control group (102) were injected by isotonic normal saline with the same procedure. Results: Lesions were manifested from one to 6 months post inoculation. Fifty eight (63%) of the rest mice from interventional group, were infected versus none of the mice from control group showed any lesion. Leishmanin skin test (LST) conversion rate was significant higher in interventional group compare, to control group after 72 hours. (54.1% VS 4.3%, P>0.05).Conclusion: In conclusion, this study showed the standard Leismania suspension can produce lesion and provoke the CMI in the small-white mice.

Introduction: Many studies in children and adolescents have shown that high blood pressure in adults is closely associated with high blood pressure during juvenile ages. This study was conducted to determine distribution of blood pressure among Tehranian adolescents. Methods: Data of 2575 participants aged 10-17 years (1254 boys and 1321 girls) in the cross-sectional phase of Tehran Lipid and Glucose Study (February 1999 to September 2001) were collected. The study used mean of two separate standardized blood pressure measurements in each individuals.Results: The mean Systolic blood pressure ranged from 100.2 ± 10.9 mmHg (12 years old) to 112.0 ± 11.7 mmHg 17 years old for boys and from 99.0 ± 11.4 mmHg (11 years old) to 106.4 ± 11.0 mmHg (17 years old) for girls. The corresponding values for mean diastolic blood pressure were 70.4 ± 9.9 mmHg (11 years old) to 73.1 ± 8.9 mmHg (17 years old) in boys and 67.0 ± 9.5 mmHg (12 years old) to 73.7 ± 8.2 mmHg (17 years old) in girls. The mean SBP showed a rather steady increase with age in both genders while mean DBP showed a less increase with age. The SBP and DBP of boys and SBP of girls were predominantly correlated by height rather than age. Compared to girls, boys had higher SBP levels. The overall prevalences of significant hypertension and high normal state were 10.6% and 12.3% in boys and 12.3% and 12.9% in girls, respectively.Conclusion: Significant hypertension during adolescence is prevalent in Tehran. This finding requires further evaluation for causes and preventive measures.  

Introduction: Measles virus has a wide spread distribution around the world and human is the only natural host of this virus. In Iran from 1987 the vaccination schedule was: one dosage at 9 months old and the second dose in 15 months old. Measles vaccine dose not give 100% immunity, as a result, the number of people who are sensitive to measles are increasing and this leads to sporadic and epidemics cases in the society.World health organization (WHO) is held responsible to eliminate measles in the eastern Mediterranean countries up to year 2010. Hence, study on the epidemiology of measles is important.Methods: This research was a descriptive cross-sectional study. All suspected cases which had been reported from the year 1995 to the year 2000 enrolled to the study. This was achieved by referring to the health center of Yazd city and information was gathered by answering question sheets. Three hundred and sixty nine cases (confirmed and suspected) had been reported to the center.Results: In the past four years most of the suspected cases of measles (64%) in Yazd city had been confirmed by the laboratory examinations. The majority of reported cases were the group 15-19 years old (30.6%). The second age group was 10-14 years old (24.4%), while the least number of cases (3%) was found in the less than one year old age group. The majority individuals were vaccinated only once (47.7%). In the age group 15-19 years old most of the individuals had unknown vaccination history (41.5%). Seasonal paten of disease occurrence, indicates measles to have the most prevalence in spring (65.6%), and the least in autumn (2.7%).Conclusion: Overall the majority of measles cases have been observed in the males (64.2%). The frequency rate of the disease under 15 years old was not different among males and females. However, in the cases above 15 years old, was significantly higher in males than females. It could be possible since most reported cases were soldiers. The prevalence of reported cases of measles in the urban (cities) areas (65%) was higher than the rural areas (35%).

Introduction: The present study was designed to investigate the types and severity of stresses that the patients were experienced a year before onset of panic disorder.  The co-morbidity of any other associated diagnosis with panic disorder and general health condition were also studied and reported in this article.Method: Fifty-one patients with diagnosis of panic disorder and 51 healthy subjects were examined using semi-structured clinical interview, Paykel life event inventory, and the short form of general health survey.Results: Findings showed that patients experienced higher rate of stressors before onset of the illness in contrast to control subjects (P<0.0001). They reported to have a higher distress with the stressful events when compared to control group (P<0.0001). When the list of stressful events grouped according to the concept of lost and non-lost classes, the patients and controls did not differed in experiencing in the number of the two types of stressors. The major depressive disorder was the most prevalent type of illness associated with panic disorder. The level of general health in patients with panic disorder was severely lower than control subjects.Conclusion: Clinicians working with panic disorder patients need to consider the effect of life events stressors, low stress tolerance, depressive mood in their treatment protocol for these patients.

Introduction: AIDS is a pandemic nowadays. In 1991, the number of HIV infected people was estimated 33 million. This number increased to 40 million up to 2001. The first case of the disease in Iran, was reported in a hemophilia children in 1987. At first, this disease transmitted by blood products in Iran, however, it expanded from other routes so that the early 2002, about 23% of cases transmitted by sexual contact, and 9% were less than 19 years. Considering this change of transmission pattern, education of community, especially high risk groups can effect on prevention of this disease. This cross-sectional study was carried out to determine education level of high school students of Tehran from AIDS during the years 2001-2002. Method: Method of collecting data was a questionnaire consisted of 32 questions regarding transmission and prevention of AIDS. Students were selected by multistage random sampling. Sample size was 400 and data analysis was performed by SPSS version 10. Results: Out of 400 students, 196(49%) and 204 (51%) were boys and girls, respectively. Among them 77.5% had good and 22.3% had moderate knowledge about AIDS. Knowledge of AIDS transmission was 90% in good and 9.8% in moderate level. These proportions about AIDS prevention were 48.5% and 50.8%, respectively. Knowledge of girls significantly was more than boys. With elevation of education level, AIDS knowledge was significantly increasing and the forth years had the highest score (86.5% with good knowledge). Knowledge of experimental science students was significantly more than the others (87.3% with good knowledge). Level of students knowledge based on fathers and mothers’ occupation and mothers’ literacy had no differences. Conclusion: Considering the above results, it seems that education of students about the ways of prevention against AIDS is more important than that of transmission routes and education of boys is in priority.

Introduction: Admission Discharge System-9 (ADS-9) is software gathering information about patients and their diseases in a uniform method. This descriptive study was aimed to study the points of views of users about application of ADS-9 software in teaching hospitals of Iran and Shahid Beheshti universities of medical sciences in 2002.Method: In this research, study population was divided to two groups: 1) ADS-9 software users of mentioned hospitals and 2) ADS-9 software designers and executive practitioners of Statistics Departments of Iran and Shahid Beheshti universities of medical sciences (executive staff) and Research Department of Ministry of Health and Medical Education (central staff). Data were collected using two questionnaires and one verbal interview.Results: Finding indicated that, the points of views of the users concerning application of the software in teaching hospitals were different in many aspects. When relations between users' views and their education levels or their years of experience were compared, most of them with different years of experience (%68.19) and various education levels (%63.64) evaluated its efficiency in a moderate level. Software users in executive staff and central staff had different attitudes about its application in disease analysis and using its information in management. Also, in this group when relation between user’s views and their education levels, field of study and years of experience were investigated, 42.86% of them with associate and bachelor degrees, 57.14% of Medical Records graduates, and 42.86% with years of experience between 10-15 evaluated its efficiency in a high level.Conclusion: Considering the results, we can conclude that the most important way of promoting quality and quantity of ADS-9 software is to pay attention to users needs, especially in hospitals and health centers. Because, lack of some abilities not only will influence accuracy and validity of information, but also will prohibit fluency and velocity of users' performance.

Introduction: With regard to probable malaria epidemy and mosquito (Diptera: Culicidae) biting nuisance during their seasonal activity in Guilan province (North of Iran, Caspian littoral), and to study mosquito fauna and ecology, an investigation was carried out during April to December 2000 in the province.Methods: In 41 occasions, 1506 adult mosquitoes, resting or blood sucking, were collected from 64 habitats including: inner places like house, stable, hen shelter and wash closet and natural outer places including vegetation, tree hole, rock hole and artificial outer places like open well and discarded tire by means of aspirator and captorator. Wall surface material of resting-places was recorded for each inner place including wood, plaster, mud and cement. Also, a few occasions of collecting were carried out by means of CDC light trap.Results: In this study, 14 species, as adult, were totally collected as follow: An. claviger, An. hyrcanus, An.maculipennis s.l., An.pseudopictus, Ae.vexans, Cq.richiardii, Cx.hortensis, Cx.mimeticus, Cx.pipiens, Cx.theileri, Cx.tritaeniorhynchus, Cs.annulata, Oc.caspius s.l. and Oc.geniculatus.As a whole, 66.4% specimens were collected from inner places and 33.6% ones from outer places and 92.9% and 7.1% for the genus Anophele and 43.93% and 56.07% for the subfamily culicinae from inner places and outer places, respectively. Cx.hortensis, Cs.annulata and Oc.caspius s.l. were only collected from inner places, the two first species from stable and the third one from human house, with very little frequency. Also, An.claviger, Cq.richiardii and Oc.geniculatus were only collected from outer places with very little frequency.Conclusion: According to this study, stables are the most important inner places of malaria vectors for resting and blood sucking from their primary hosts, cows, in Guilan province. It is noteworthy during residual spraying.

Introduction: Nowadays many scientists and companies have focused on research and development of medicinal plants and herbal medications. In addition, Iran has a very rich flora due to its diverse climates. Such great potentials have drawn attention of scientists to investigate on the herbal medications However, the lack of a national scientific reference, being reliable, comprehensive and rich in content encouraged us to prepare the first herbal pharmacopoeia of Iran.Method: In 1996, academics of the Department of Pharmacognosy at Isfahan University of Medical Sciences started writing of Iranian Herbal Pharmacopoeia (IHP) with the aid of academics of most Iranian universities. The executive committee for preparation of IHP established the guidelines for writing monographs. All one hundred monographs presented in this pharmacopoeia were organized according to these guidelines for its scientific contents. Each monograph was evaluated and organized by a committee of referees.Results: After compiling the IHP monographs include: definition, scientific and common names, plant morphology and parts recommended for use, geographical distribution of the plant, microscopic characteristics, constituents, medicinal applications and pharmacology of the plant and/or active constituents, control methods and other properties (if any, e.g. toxicity, dosage forms, ete.(

Introduction: From many times ago, herbal extracts have been used for curing diseases especially infectious ones. In this study antimicrobial effects of ten herbal extracts were evaluated on three different oral pathogens including: Actinobacillus actinomycetem comitans (Aa), Streptococcus mutans and Candidia albican.Methods: The herbal extracts used were: Thymus vulgaris, Syzygium aromaticum, Lavandula angustifolia, Punica granatum, Rosmarinus officinalis, Herate umpersicum, Punica granatum (flower), Querques infectoria, Terminalia chebula, and Melissa officinalis. Extracts with concentration of oil for the whole technique and disks containing 2mg of extract were prepared and antimicrobial effectets were compared with chlohexidine. Bland disks containing methanol were used as control. Antimicrobial effects of each extract were determined according to the diameter of no growth area in the culture.Results: The results showed that Thymus vulgaris, Syzygium aromaticum, Querques infectoria, Punica granatum and Termialia chebula had great antibacterial and antifungal effects. The antimicrobial effects of Querques infectoria were shown for the first time in this study. Some of the extracts were even better than chlorhexidine and none of the control disk showed any effect in the culture.Conclusion: This study confirmed that, herbal extracts have appropriate effects on the microorganisms in comparison with chlorhexidine.

Introduction: The advance in survival of premature neonates has significantly increased the incidence of patent ductus arteriosus (PDA). The pharmacological closure of the duct by antiprostoglandins has changed the clinical course of PDA. Early diagnosis and management of PDA can prevent many foreseeable complications. The objectives of this study were to determine the incidence, clinical profile and outcome of PDA in premature infants. Methods: In this study, seventeen neonates admitted over a one year period from September 2000 to November 2001 to the NICU at Nemazee Hospital of Shiraz University of Medical Sciences, were diagnosed as cases with PDA. The epidemiologic and clinical profile, management and outcome of PDA were investigated by a cross-sectional design. Echocardiography was used to confirm the clinically suspected PDA and repeated to demonstrate the closure of PDA.Results: PDA occurred in 14.9% of the total 114 premature infants who were admitted to NICU. The analysis revealed that respiratory distress syndrome (RDS) and pneumonia were the most determinant factors in 12 cases (70.6%) and sepsis in 3 (17.6%). More than three-fourth of the neonates had an onset of PDA in the first week of life accompanied by an inverse relation to birth weight and gestational age. The major presenting features were systolic murmur (100%), bounding pulses (30%) and tachycardia (47%). About 82.3% of the neonates responded to oral ibuprofen with no complications. Conclusion: Detection of abnormal heart sounds can be the best guide for early diagnosis of PDA especially in premature infants with RDS. Using echocardiography for confirmation of diagnosis and initiation of antiprostaglandins is crucial in preventing any complications in these patients.