Iranian South Medical Journal
Year:2006 | Volume:8 | Issue:2|Papers Count:16

Background: Recent studies showed a possible relationship between infections caused by some of Helicobacter members and gallstones formation. The aim of this study was identification of Helicobacter members in gallstones from patients with biliary diseases. Methods: Gallstones and bile samples from 33 patients were subjected to rapid urease test, culture and Multiplex-PCR using primers based on 16srRNA and isocitrate dehydrogenase genes to identify Helicobacter genus and H. pylori species genes, respectively. This PCR was also done on bile samples from 40 autopsied gallbladders with normal pathology (as a control group). Results: In 18.1% of stones and 12.1% of bile samples, H. pylori DNA was detected using PCR. Rapid urease and cultures tests were negative for all samples. The genome of H. pylori was not detected in control group using PCR. Conclusion: H. pylori DNA was detected in gallstone, however, we are not sure of H. pylori viability in these samples. To clarify the clinical role of Helicobacter in gallbladder diseases, more investigations are needed to ascertain whether this microorganism is innocent bystander or active participant in gallstone formation.

Background: Ciprofloxacin is a synthetic antibacterial agent from the fluoroquinolones family with a very broad spectrum against microbial pathogens, especially Gram-negative infectious diseases, which has been approved in more than 100 countries world-wide. This study was planed to identify the histopathological effects of ciprofloxacin on rat Sertoli cells. Methods: Twenty male Wistar rats were selected and randomly divided into two groups; control (n=10) and experimental (n=10). The experimental group received 12.5 mg/kg oral ciprofloxacin daily for sixty days. On sixtieth day the testis tissues in both groups were removed and weighted, then prepared for light microscopy and electron microscopy studies. Results: There was a marked decrease in testicular weight, marked accumulation and atrophy of seminiferous tubules of Sertoli cells in experimental group as compared with control group (P<0.05). Conclusion: Ciprofloxacin can induce marked histological alteration in testicular tissue of rat, therefore these histological effects and possibility of producing infertility should be investigated in human subjects.

Background: The excito-repellency effect due to the application of some insecticides is important in interrupting the malaria transmission cycle. The repellency effect of some insecticides also inhibits the entry of mosquitoes into sprayed houses, which in long-term causes alteration in endophilic and exophilic rates. Methods: In this study, a modified excito-repellency (E-R) test box was used. In order to standardize this system, a number of methods and techniques were considered to evaluate the mosquitoes' reaction to pyrethroid-impregnated nets. A cylindrical guinea- pig holder made up of aluminum mesh was placed within the exposure chamber. Treated and untreated nets covered this holder so that the guinea pig was available to mosquito for bloodfeeding. An exit trap was devised on the rear side of the exposure chamber. Nets were impregnated with lambdacyhalothrin insecticide at the concentrations of 12.5,25 and 50 mg/m2, deltarnethrin at 12.5, 25 and 50 mg/m2 and cyfluthrin at 40, 80 and 100 mg/m2 or unimpregnated in laboratory by standard dipping procedure. The blood feeding rate, exit rate, survival rate, mortality rate and recovery rate of mosquitoes were considered. Results: The results obtained using one-way analysis of variance (ANOVA) reflects a significant difference in excito-repellency of tested insecticides (p<0.05). The blood feeding rate of exposed mosquitoes to nets treated with lambdacyhalothrin, deltamethrin and cyfluthrin at standard dose of 25 mg/m2 were 15%, 5.3%and 9.3% respectively; the exit rates were also 18.2%, 11.2% and 19.7%, and it was 98.9 % in the control group. The survival rate of mosquitoes was 63.2%, 34.9% and 67%, respectively. The bloodfeeding and exit rates for control group were 41.3% and 1.4%, respectively. Conclusion: The excito-repellency evaluation revealed that the deltarnethrin-impregnated net was more effective on An. stephensi than lambdacyhalothrin and cyfluthrin insecticides, under laboratory conditions.

Background: Gonadal dysfunction is one of the short and long-term side effects following bone marrow transplantation (BMT). We assessed hypophyseal-gonadal axis after BMT by low dose busulfan- cyclophosphamide conditioning regimen (120 mg/kg). Methods: In this cohort study, we evaluated gonadal function in 48 patients (25 pubert males and 23 pubert females). Data were obtained by history, physical examination, LH, FSH, prolactin, estradiol (E2), progesterone, testosterone and semen analysis before BMT and in 6 and 12 months of post-BMT. Results: Gonadal axis in 16 male subjects (64%) was normal before BMT and remained normal in 6 subjects (37%) 12 months post BMT. In another 10 patients (63%), hypogonadism was started in 6 months post BMT. Spermatogenesis failure (31%), low level of testosterone (25%) and spermatogenesis failure plus low level of testosterone in 12.5% were found. Gonadal axis in 20 female subjects (87%) was normal before BMT, but remained normal only in 10% of subject until the end of the study. Other patients (90%) had primary hypogonadism in 6 months of post BMT. Conclusion: There is a high prevalence of gonadal dysfunction following BMT in both adult sexes (especially in female patients). Therefore, regular gonadal assessment is recommended following BMT.

Background: Subcutaneous deferoxamine is the first line for management of iron overload in Thalassemia major. There is a wide deferoxamine adherence variation in patients with thalassemia major. In order to assess the effect of education on patients and their parents, a cognitive approach was used. Methods: In a randomized control trial, 78 consecutive patients with thalassemia major were randomly divided into educational (38 cases, 50% male and 50% female) and control (40 cases, 65% male and 35% female) groups. Oral and practical education sessions for deferoxamine injection were planned. Deferoxamine usage, pump function, side effects, knowledge levels of the patients and their parents, and ferritin serum levels were assessed before and after the trail. The knowledge was also evaluated promptly after educational sessions. Results: the mean age of experimental and control groups were 14.6 and 13.0 years, respectively. There was no significant difference in age, sex and weight (P>0.05) at the end of the study, there was no significant change in the level of knowledge in both groups; however, the patients who used deferoxamine at least 5 times a week were increased in the experimental group (P<0.05).Pain, irritation, redness and edema at local injection sites were reported lesser by experimental subjects after education (P<0.01), but the ftequency of these local complications did not change in the control group (P>0.05). Both groups reported improvement in pump function (P>0.001). Conclusion: A cognitive approach had relatively significant effect on deferoxamine adherence. However, educational sessions had not dramatic change in knowledge levels of the patients and their parents, but oral and practical education produced a significant change in decreasing local side effects of subcutaneous deferoxamine in thalassemia major.

Background: Family history of premature myocardial infarction (PMI) is an important risk factor; thus diagnosis and therapeutic intervention of cardiovascular risk factors in the first degree relatives of the patients with PMI is the most effective measure for preventing myocardial infarction and its mortality rate. Methods: Cardiovascular risk factors were assessed in the relatives of 49 patients with PMI in Fatemeh- Zahra University Hospital using MONICA-WHO project and Behavioral Risk Factor Surveillance System (BRFSS) criteria. A control group with the age of over 25 years old was randomly selected among the subjects of the Persian Gulf Healthy Heart Study (PGHHS). Lipid and lipoprotein abnormalities were defined according to National Cholesterol Education Program Adult Treatment Panel HI (NCEP ATP III). Results: A total of 148 (88 females and 60 males) first degree relatives of 49 patients with PMI were evaluated. The frequency of hypercholesterolemia, high LDL-cholesterol, low HDL cholesterol and hypertriglyceridemia in subjects with less than 20 years old (42 first degree relatives) were 33.3%, 28.5%, 71% and 16.6%. No significant difference in frequency of hyperlipidemia and the other cardiovascular risk factors was found between the first degree relatives of patients with PMI and their age - and sex - matched control subjects (P>0.05). We also found no significant difference in frequency of lipid abnormalities between the patients with PMI and their age - and sex - matched control subjects; however these patients had a higher frequency of diabetes mellitus (28.1% versus 6.5%) and hypertension (56.3% versus 22.6%), in comparison to the control group. Conclusion: Lipid and lipoprotein abnormalities in the first degree relatives (≥25 years old) of patients with PMI are the same as normal general population; therefore investigation of novel cardiovascular risk factors should be considered for further evaluation.

Background: Rectal route is a gold standard method of measuring fever, but it is invasive and stressful for parents and children. A recently used method is tympanic that has the advantages of safety, speed and compatibility but its accuracy is under question. Methods: In order to assess the accuracy of tympanic thermometry, 220 children within 3 months to 6 years old were selected and temperature was checked by rectal, axillary and tympanic methods. Results: The mean rectal temperature, compared with tympanic and axillary, was higher (0.3oc and 0.1oc, respectively). There was a good correlation between right and left tympanic measurements (r=0.87, P<0.001), rectal and right tympanic (r=0.76, P<0.005), axillary and right tympanic (r=0.80, P<0.001), and axillary and rectal methods (r=0.74, P<0.001). The sensitivity, specificity and accuracy of tympanic method (with 38°Cascut off point) were 46.4%, 97.2 % and 90.9%. ROC curve analysis showed that the best cut off point for fever was 37°c; the sensitivity, specificity and accuracy were increased 92.9%, 90.1% and 90.4%, respectively, using this cut off point. Kappa coefficient showed a good correlation between rectal and tympanic methods. Conclusion: Tympanic thermometry, in comparison to axillary and rectal thermometry is an accurate, rapid, safe and comfortable method and the best cut off point for defining fever is 37°c.

Background: Juvenile myoclonic epilepsy (JME) is one of the most common idiopathic generalized seizures that include about 5-11% of epilepsies. According to clinical features of JME, this disease could not be diagnosed correctly in clinics which results in inappropriate treatment. However, the clinical response of JME to treatment is excellent and the patients need longlife treatment. Methods: In a prospective observational study, JME subjects were selected among epileptic patients referred to neurological clinic of Isfahan University of Medical Sciences, using clinical and electroencephalographical criteria. The clinical, demographic and therapeutic treatment characteristics were written in special questionnaires. Patients were followed every 3 months for one year. Results: Among 985 epileptic patients, 50 (5%) subjects with JME were found. Female to male ratio was 3.5. The mean onset age of the seizure was 13 years. Familial history was positive in 38% of them and the precipitating factors were found in 66%. Stress, flashing lights, somnolence, and fatigability were the precipitating factors in 79% of occasions. All of patients were treated. Finally, 84% of patients responded to treatment completely and 14% of subjects responded partially and only 2% of them were refractory to treatment. Conclusion: JME is more prevalent in female subjects in Iran; however the other clinical features of this form of epilepsy are compatible with the previous international studies. More evaluations including genetic investigation is recommended for JME in Iran.

Background: Fluoride increases tooth resistance to dental caries, but mild toxicity due to excessive ingestion of fluoride can cause dental fluorosis. Drinking water naturally contains fluoride and is a major source of fluoride. In Bushehr port, drinking water is supplied from limestone springs with normal fluoride levels but dental fluorosis is observed. Methods: A total of 95 native school children (between the ages of 10-12 years old) were randomly selected from four Bushehr port regions. Dental fluorosis, height and weight were examined. Probable attributing factors of dental fluorosis were also questioned. A 16 to 18 hours urinary fluoride concentration was measured with a fluoride ion selective electrode. Results: Dental fluorosis in four upper incisors was apparent in 52.6 % of the subjects. The urinary fluoride concentration was 2.18 mg/lit. Fluoride concentration in drinking water of schools ranged from 0.41 to 0.58 mg/lit. Forty percent of subjects were caries tree. Conclusion: In spite of the normal range of fluoride concentration in the drinking water of Bushehr, dental fluorosis and urinary fluoride concentration are higher than the recommended ranges. Therefore, it is necessary to further investigate the amount and effects of fluoride ingestion in residents of Bushehr province.

Background: Injury is a major public health problem in Iran. The essential part of an injury control program is injury surveillance. This study was conducted to clarify the type of injuries and to explore the demographic characteristics of injured individuals in Kerman. Methods: This cross sectional study was conducted in emergency wards of three major hospitals of Kerman from August 2002 through July 2003. Data were collected by trained interviewers on arrival of patients attending the emergency wards every fourth day via a questionnaire. The questionnaire had three parts: demographic characteristics, type of injury, and baseline characteristics of accidents. Results: The age range of the injured patients (61%) was 15 - 39 years; male to female ratio was 2/3. The educational level of the majority was less than high school (70%). Traffic accident was the most common cause of injury (36.6%, CI= 35.1% - 38.1%). Falling down (9.83%, CI= 8.9% - 10.7%) and physical fighting were the second and third causes of injury, respectively. Friday and Thursday had the highest proportion of accidents (15. 5% and 15. 1%; respectively). A total of 27% of subjects admitted in hospitals, after initial evaluation in emergency wards. Conclusion: Adolescence is a major risk factor for injuries in Kerman. Road accident is also the most common cause of injury; therefore more educational emphasis should be paid to prevention measures of traffic accident.

Background: More than one fourth of diseases around the world are caused by environmental threats. These threats have multifactorial effects on children's health. So, it needs collaboration between teachers, parents, students, and public health authorities to decrease them and improve health. Methods: A total of 18 primary schools were selected using random cluster sampling. After a need assessment analysis about environmental threads, the 3rdand 4th degree students of selected primary schools were invited to draw posters about air pollution, water sanitation, food contamination, natural disaster, solid waste pollution, and sea and beach pollution. Then, a booklet based on the initial need assessment about environmental threads was designed and used for a six weeks educational course. The students drew a second poster after the educational course taught by their teachers. The posters were scored for technical aspects and health concepts by independent examiners. Results: The mean score of students' knowledge about environmental threads increased after intervention (P<0.05). There was no difference between 4th graders and 5th graders, but girls showed a higher score than boys. Conclusion: In primary schools, booklet-based education was effective in promotion of the students knowledge about environmental threads on health. Therefore, a booklet-based education, designed according to local need assessments, is recommended as a complementary education in primary schools.

Background: Iran, the same as other developing countries, is in a nutritional tradition in socio-economical status. The aim of this study was to assess nutritional status of rural communities in Hamadan city.Methods: A total of 614 subjects from 15 rural regions were selected using random cluster sampling. The anthropometric parameters including age, weight and height were recorded and body mass index (BMI) was calculated for all subjects. All of 2 to 20 years old subjects whose weight and height for age, and weight for height were <-2SD of NCHS (National Centre for Health Statistics) standard, were classified to underweight, stunting and wasting groups accordingly. Overweight and obesity in all subjects and underweight in adults were defined according to Body Mass Index (BMI). Results: In 2-20 years old group, underweight, wasting or stunting were found in 12.5%, 12.3% and 26.8%; respectively.Over nutrition was observed in 11.9% (6.7% were overweight and 5.2% were obese) of the subjects. In >20 years old group, 5.5% (mostly males) had BMI <18.5 and 34.9% had BMI> 25. Based on BMI in all subjects, 24.76% had overweight and obesity, and 9.2% had underweight. Conclusion: The observed under nutrition in 2 out of 20 and over nutrition in 5 out of 20 subjects, indicate an imbalance between the need and intake of food. Education of nutrition may control most of these disorders and their consequent complications.