Journal of Shahid Sadoughi University of Medical Sciences
Year:2005 | Volume:13 | Issue:3|Papers Count:15

Biotin is a water-soluble vitamin and co-factor for activation of carboxylases apoenzymes. Biotinidase enzyme is essential for release of biotin from apoenzymes. Absence of biotinidase is an autosomal recessive trait with a prevalence of 1 in 60000. Clinical manifestations of biotinidase deficiency include dermatitis, alopecia, seizures, hypotonia, developmental delay, hearing loss, visual impairment and immunodeficiency. With early diagnosis and treatment with biotin supplements, it is possible to prevent clinical manifestations and neurological deficits. We report a case of biotinidase deficiency with seizures, developmental delay, acrodermatitis enthropathica manifestations and mild compensated acidosis.

Introduction: Hyperhomocysteinemia is associated with an increased risk of cardiovascular disease in diabetic patients. The aim of this study was to determine plasma homocysteine levels in diabetics and compare with control persons and also evaluation of correlation between plasma homocysteine concentration and diabetic related variables. Methods: This study was done on 39 type II diabetic patients, 27 subjects with impaired glucose tolerance and 23 normal persons referring to Endocrine and Metabolism Research Center of Medical university of Isfahan. Physical characteristics were recorded. After an overnight fast, a blood sample was drawn for determination of FPG, HbA1c – homocysteine, Cr. Cholesterol – Triglyceride and HDL- Cholesterol. Mean plasma homocysteine levels in the groups were compared by one way ANOVA. The Correlation of different parameters was tested by Pearson’s correlation. Results: There was no statistically significant difference in the plasma homocysteine levels of all the groups.(P=0.71). Correlation between homocysteine levels and HbA1c was not significant (P=0.42) in diabetic patients. Conclusions: The findings suggest that diabetes does not influence plasma homocysteine levels. Also, there is no correlation between plasma homocysteine levels and HbA1c in diabetic patients

Introduction: Fever is the most common symptom of patients referring to pediatrics clinics.. The first choice for antipyretic medication is acetaminophen with dosage of 10-15 mg/kg every 4-6 hours. We compared the efficacy of oral (10 &15 mg/kg) and rectal (15 mg/kg) acetaminophen in fever reduction in children Methods: A randomized, controlled trial was performed in 90 patients aged between 6months and 6 years with fever > 39o Celsius. The patients were divided into three groups; Group 1 administerd rectal acetaminophen 15mg/kg, Group2 oral Acetaminophen 15mg/kg and Group3 oral acetaminophen 10mg/kg. The results at the end of the first and third hour were assessed. Results: The rate of temperature reduction at the end of the first and third hour in the group receiving rectal acetaminophen (15mg/kg) was 1.07 +0.16 and 1/74 + 0.25, respectively. The rate of temperature at the end of the first and third hour in the group receiving oral acetaminophen (15mg/kg) was 0.98 + 0.19 and 1.25 and 1.7+0.14, respectively The rate of temperature reduction at the end of the first and third hour in the group receiving oral acetaminophen (10mg/kg) was 0.63 +0.18 and 1.25+ 0.22, respectively Conclusion: There was no significant difference in temperature reduction between the groups receiving oral (15mg/kg) and rectal acetaminophen, but oral acetaminophen (10 mg/kg) was less effective in temperature reduction.

Introduction: Aphasia is a common manifestation of stroke and evaluation of relationships of aphasia and brain topography could lead to better understanding of cognitive neurophysiology. Methods: 100 stroke patients with aphasia admitted in Valie-Asr hospital, Khorasan since April 2003 were enrolled in this prospective cross-sectional study. Diagnosis of stroke and aphasia was made by a neurologist and topography of involved cerebrovascular territories confirmed by topographic maps of brain in CT scan. Results: Global, Broca and Wernicke subtypes of aphasia constituted 52%, 40% and 6% of the cases, respectively. Based on the usual nourishment of Broca and Wernicke areas by anterior and posterior cortical branches of the middle cerebral artery, 79% of Global, 47% of Broca and 50% of Wernicke aphasias had compatible infarct topography. The infarct topography in other cases was not congruent with the involved linguistic areas of their brain. Conclusion: Specific cerebrovascular topography for subtypes of aphasia in stroke patients was not found. The effects of cerebrovascular lesions on linguistic functions are not predictable by their topography in CT scan.

Introduction: Exposure to systemic corticosteroids is known to be associated with a risk of cataract. This study was undertaken to determine the risk of cataract associated with the use of inhaled corticosteroids in old age. Methods: A case-control study consisting of 160 people with cataract (case) and 160 controls matched for age and sex was conducted at Shaheed Sadoughi and Shaheed Rahnemoon hospitals of Yazd. Data gathered via a questionnaire and interview and analyzed by SPSS, Chi Square and ANOVA tests. Results: There was no difference in age and sex between the two groups of case and control. In case group, 22(13.8%) and in control group 11(6.9%) persons (total of 33 patients) used inhaled corticosteroids that was statistically significant (P-Value=0.042). The odds ratio for the association between inhaled corticosteroids and cataract was 2.16 (95% CI 1.01 to 4.61). After adjustment for systemic corticosteroid exposure, the Odds ratio rose to 4.73 (95% CI 1.51 to 14.82). The association was stronger with increase in duration of use. Conclusion: This case-control study showed an association between use of inhaled corticosteroids and increased risk of cataract, especially the posterior sub capsular type. But, in order to confirm these findings, other studies including experimental ones and similar groups in respect to other risk factors of cataract are needed.

Introduction: Regarding the numerous problems of solderers in electronic industries because of their exposure to Acids, bases and fumes of soldering ,a study was carried out on107 solderers and administrative personels of a factory producing electronic appliances in Tehran to inspect the long term effects of soldering on lung functions Inspection. Methods: At first ,47 solderers and 66 controls (totally 107 persons )were selected randomly. All the solderers were working in the manual soldering section and used the soldering wire made of an alloy (composed of plumbum, Stannum and special oil of soldering called flux ). The persons controls worked in the administrative sections of the same factory and for the same hours as the solderers , but they did not have any soldering experience. After they filled the standard respiratory questionnaire , spirometry was done at least 3 times on each of them under the same conditions and according to the ACT criteria (No smokers included in the study) Results:The spirometry parameters of the two groups were compared . There was a significant difference in the average FEF 25 : 75% (P=0.03).Also ,there was a significant difference in the average FEV1/FVC P=0.026 and PEFR (P=0.04)between two groups .After controling the altering age factor . ameaningful relation between the years of work in soldering section and decrease in the spirometry parameters related to FED 25-75% and FEV1/FVC was seem . Also . the frequency of the signs of nasal and eyes initation in the solderer group was more than the other group (p=0.007) Cough and Asthma related to ork had no meaningful difference in the two groups . Conclsion :It seem that in the above study , soldering is a factor decreasing the spirometry parameters with a blocking pattern , especilly in smal airways . This study was done in the direction of the former studies done in other countries and emphasizes on the need for necessary preventive action in this profession , uch as effective local ventilation and use of alternative substances .

Introduction: Missed Abortion is a important obstetric and gynecology complication because of its serious outcomes such as DIC, infection, shock, hemorrhage & death. There are various medical and surgical methods for treatment of missed abortion. Medical treatment of missed abortion is safe, effective, acceptable and an inexpensive alternative. Misoprostal is a synthetic prostaglandin (E1) and recommended by FDA for treatment of missed abortion. There are different views about its safety, dosage and effectiveness. Methods: This study was designed in order to determine the efficacy of vaginal misoprostol for termination of pregnancy in women with missed abortions admitted in Shahid Sadoughi, Madar and Mojibian hospitals of Yazd from 2003 to 2004. The method of study was semi-experimental. (Clinical trial without control group) 50 women with missed abortion and the required criteria (age 15 – 45 years, gestational age ≤ 25 weeks, no previous medical or surgical complication and confirmation of missed abortion on sonography) were selected. The data was collected by a questionnaire filled at the onset of study and after treatment (Misoprostol, (200 micrograms/dose) repeated every 4 hours till expulsion of pregnancy products for maximum of 4 doses).The data analysis was done by statistical tests such as x2 and ANOVA. Results: The mean duration of medical treatment in the group with complete expulsion (44%) and incomplete expulsion (56%) was 12.63± 9.13 hours and 8.81± 2.9 hours, respectively, which was significantly different. (P value = 0.037). Of the total, 29 women had received two tablets of misoprostol, but the highest rate of complete expulsion was observed in women who had received four tablets. This difference in result was statistically significant. (p ≈ 0.000 ). Observed side effects included headache (26%), nausea (16%), uterine cramps (12%) and diarrhea. (6%) There was no serious complication such as uterine rupture, excessive vaginal bleeding, DIC, prolonged PT or PTT. Conclusion: This study confirmed that medical evacuation of missed abortion with vaginal misoprostol is an effective, safe and cost efficient method without any serious complications and can be a suitable alternative to surgery.

Introduction: Women are likely to be involved in anxiety two times more than men. One of the reasons for this increase is that stressors like pregnancy and labor are specific for women. 70 percent of primigravidas and 75 percent of multigravidas experience anxiety during their pregnancy. So, this research was done with the aim of evaluating the effect of education module “Preparing for childbirth” on the level of anxiety during pregnancy and labor in primigravidas referring to the Social Security Insurance clinic in Mashad. Material & Methods: This study was a kind of semi-experimental clinical research that was done on 110 primigavidas. The method was goal-center sampling on three occasions; beginning of research, pregnancy period and labor by using the Cattells anxiety test. After determination of primary anxiety, experimental group was educated for “preparation for childbirth” in 3 meetings for 3 weeks, and about four weeks after the determination of primary anxiety. During labor, (dilation 3-5 cm) anxiety in two groups was measured. Results: Findings showed that education significantly decreases the anxiety during pregnancy (p<0.0001) and labor (p<0.0001) , while in the control group, the level of anxiety during pregnancy and labor as compared to the initial stage was significantly higher. There was a straight correlation between hidden anxiety and the acquired scores during education.(P=0.018, r=0.28) Conclusion: “Preparation for labor” education declines the anxiety of pregnant females during their pregnant period and as soon as the education is stopped, its effect gradually decreases and anxiety again increases. The researcher therefore proposes that for reduction of anxiety in pregnant females, continuous education should be imparted to pregnant women.

Introduction: Glycyrrhiza Glabra (Licorice) root, a member of the pea family has been used since ancient times as both food and medicine. Licorice has been used as an antioxidant, antimicrobial and anti inflammatory in researches .Extraction of this medical plant is used as the basis of anti-ulcer medicine for treatment of peptic ulcer. Patients and Methods: In the present study, licorice decoction (20gr/dl,33gr/dl) was prepared and anti microbial activity on helicobacter pylori growth was studied by disk diffusion method and cup plate method. Results: The results showed that licorice decoction 33gr/dl by disk diffusion method inhibited growth of helicobacter pylori in vitro the same as metronidazole.(P value=0.709) However, it does not have anti bacterial activity against helicobacter pylori like amoxicillin and clarythromycin (Pvalue~0.000). Conclusion: Decoction licorice (20gr/dl, 33gr/dl) can not be used as an alternative to choice antibiotics (amoxicillin, clarythromycin) in vitro.

Introduction: Antifertility effects of naturally occuring antisperm antibody (ASA) in infertile couples and studies on experimental immunization of various animals with sperm antigens represent ASA as an immunocontraceptive target. The effects of different factors on sperm immunogenecity and ASA production have been studied and different results have been reported. In this study, whole sperm immunization was evaluated. Methods: In this experimental study, whole mice sperm with different adjuvants i.e. complete Freund’s adjuvant (CFA), incomplete Freund’s adjuvant (ICFA), cholera toxin subunit-β (CTS-β) were administrated to mice by different routes; Intramuscular (IM), Subcutaneous (SC), Intranasal (IN), Intra peritoneal (IP), Intrarectal (IR), Intravaginal (IVA) and oral. Control groups were inoculated with phosphate buffer saline (PBS) plus corresponding adjuvant. Immunization was carried out on day 0,7,14,28 and ASA titers were detected by indirect immunofluorescence (IFA) technique. The results were compared between control and experimental groups by Mann Whitney and Fisher exact tests. Results: The number of positive mice for ASA in IM, IN and SC experimental and control groups were significantly different (P=0.01, P=0.01, P=0.04 respectively). However, there were no significant differences between the IR, IVA, and oral experimental and control groups. No differences were observed between ASA in vaginal washing of all groups. Due to high mortality, the IP group was excluded from the study. Conclusion: It can be concluded that whole sperm antigen can induce immune response in female mice by IM, SC and IN routes, but not through IAV, IR and oral administration routes.

Introduction: Clinical education in critical care units is very important and promotion of quality of clinical education can lead to higher qualification and professionalism of nursing students in this area of practice . So, this study was conducted to evaluate the clinical skills of nursing students in ICU , CCU and dialysis Units . Method & Materials : This research was a cross sectional descriptive one and the samples of this research were 72 final year nursing students of Yazd Shaheed Sadoughi Nursing School. The data was collected by a demographic and checklist questionnaire about clinical skills in ICU, CCU , and dialysis unit . Analysis and descriptive statistics were used for the research goals. Results : Results showed that clinical skills of nursing students in critical care units is ideal, but these skills in CCU are lower than ICU and dialysis unit . Results indicated that the levels of the clinical skills of nursing students were directly related to their examination scores and interest in nursing . Conclusion : Our findings indicate that special attention should be paid to clinical education in critical care units and selection of students in this field should be given special attention.

Introduction: Tetanus is a serious infectious disease and the most common cause of neonatal mortality in developing countries. Although neonatal tetanus (NT) can be prevented by immunization of expectant mothers, good hygiene and asepsis during delivery, total eradication of organism is not possible. Methods: The cross-sectional study was done on 480 pregnant women after delivery. Data was collected by a questionnaire and analysed using SPSS windows software program. Results: Prenatal immunization rate (complete and partial) was 65/2% and 34/8%, respectively. There was a significant relationship between the vaccination status and age, education of mother, parity and length of time between pregnancy and previous pregnancy. The reasons reported by non immunized mothers (not receiving the two dose vaccine) included complete tetanus vaccination coverage before pregnancy, lack of awareness about the needs for vaccination, improper counseling by persons responsible for antenatal care, e.t.c. Conclusion: Considering the results of the study, it is proposed that a complete history of the pregnant woman recorded at the first antenatal visit should be the basis of counseling and education of the woman and prenatal care staff should be also be fully educated.