JOURNAL OF GUILAN UNIVERSITY OF MEDICAL SCIENCES
Year:2009 | Volume:18 | Issue:70|Papers Count:18

Introduction: Occult Hepatitis B Infection (OBI) is a form of hepatitis in which despite of absence of detectable HBsAg, HBV-DNA is presented in patient’s peripheral blood. Responsible mechanisms of progression of OBI are unknown yet, but some investigators believed that the genetic and immunological parameters may be different. Cytokine network system could be leading alteration in viral immune response. IL-4 as an anti-inflammatory cytokines causes decreased immune function. Thus, regulatory factors which influence expression and function of IL-4 can be effective on immune system functions. As polymorphic variation in cytokine genes has regulatory effects on their expression and functions, this study investigates the association of -590 region polymorphisms of IL-4 with OBI.Objective: Determination of association between IL-4 polymorphisms with OBI.Materials and Methods: In this study, the plasma samples (FFP) of 3700 blood donors were tested for HBsAg and anti-HBs by ELISA. The HBsAg negative and anti-HBc positive samples were selected and screened for HBV-DNA by PCR. HBV-DNA positive samples assigned as OBI cases while HBV-DNA negative samples were used as control and PCR-RFLP was performed to examine the presence of polymorphisms in -590 regions of IL-4 genes of patients with OBI.Results: 352 (9.51%) Out of 3700 blood samples were negative for HBsAg and positive for anti-HBc antibody. HBV-DNA was detected in 57(16.1%) of HBsAg negative and anti-HBc positive samples. Our results showed that none of the alleles had significant difference between patients and control group.Conclusion: Our results demonstrated that there is no significant difference between patients with OBI and control cases. Therefore, it seems that there is not any relation between these alleles and OBI and more study should be done on polymorphisms in other to cytokine genes in patients with OBI.

Introduction: Abuse of drug is a chronic phenomenon which brings about a plenty of physical, mental, social, family, and economic harm in a way that the addicted person’s individual and social functions are severely reduced.Objective: Comparison of emotional intelligence and mental health in addicted and normal individuals.Materials and Methods: Samples consisted of 80 addicted and 80 normal individuals. Sample group were selected by accessible sampling from governmental and non governmental rehabilitation and remedial centers from Rashat. Both groups matched according to age, marital status, number of family members, educational level and economic condition. Then participants answered to the Petridis and Furnhum’s (2002) emotional intelligence questionnaire and 28 Item Gold berg’s (1979) general health questionnaire (GHQ28). Data were analyzed through statistic analysis.Result: Data analysis shows significant relation between emotional intelligence and mental health in two groups. The addicted person had low or levels of emotional intelligence and mental health than the normal individuals. Furthermore, person coefficient correlation showed relation between emotional intelligence and mental health of the addicted and normal individuals which were (0.403 and -0.445) respectively.Conclusion: The addicted person had lower level of emotional intelligence and mental health than normal individuals. There was significant relation between emotional intelligence mental health in addicted and normal individuals (P<0.05).

Introduction: Access to exclusive Breast feeding up to 75% is one of the objectives to healthy people until 2010, Breast feeding advised as the best milk for suckling neonatal and there were expanded documents about protective effects of Breast feeding against different diseases. Objective: Determination of pattern of exclusive breast feeding and its associated factors in Arak.Materials and Methods: An analytical cross sectional study conducted on 352 mothers that have 6-12 month suckling neonatal. Data collection fulfilled by structured questionnaire and interview. The prevalence of exclusive Breast feeding calculated and association between dependent and independent variables analyzed by t-test, chi square and regression statistical tests in univariate and multivariate methods.Results: Prevalence of exclusive breast feeding was 41.5%. nonuse and the most important factors of exclusive breast feeding indicated of solution of sugar and water, and mammalia nipple nonuse, breastfed base of neonatal appeal, wanted pregnancy, vaginal labor and multi parity identified as the related factors in exclusive breast feeding (P<0.05). There was not any significant relationship with family income, use of colostrums, age, job, education and breastfed education during pregnancy period in mothers (P>0.05).Conclusion: So initiation of Breast feeding after labor and of mothers with unwanted pregnancy and cesarean delivery advice. Also educational programs about disadvantage of solution of sugar and water and Mammalia nipple in pregnancy period and after discharge may be useful in exclusive breast feeding.

Introduction: Spinal stenosis of the lumbar area is the most common problem of this area in older patients and surgery is needed in refractory cases.Objective: The purpose of this study was to assess the surgical outcome of the less invasive decompressive surgery in the patients with lumbar spinal stenosis.Materials and Methods: In a retrospective study, we reviewed 50 cases with lumbar spinal stenosis that carried out this type of surgery and followed regularly. For assessing the results, we used anatomical economical functional rating system of Prolo, visual analogue scale and White and Panjabi instability criteria.Results: The patients were followed-up for a mean of 3.5 years (2 to 8) after surgery. Good or excellent results were obtained in 82% of the patients. A significant reduction of the low back pain intensity and disability was seen.  Claudication and radicular pain was disappeared in 100% and 94% of them, respectively.Conclusion: Less invasive decompressive surgery by limited laminotomy, undercutting of the facet joints and not doing extensive laminectomy is a safe and reliable surgery for the treatment of the refractory patients with lumbar spinal stenosis.

Introduction: An important part of one's information from surrounding environment comes through olfactory system. So its disorders regardless of the reason can lead to a lot of problems.An appropriate diagnostic smell test is needed for determination to the normal range of olfactory sense, and evaluation of patient's complain of hyposmia or anosmia and determination the severity of the problem. It is helpful for follow up and choosing the most effective surgical or medical treatment too. Unfortunately Current used tested for diagnose of factory system disorders are not modified for Iranian population and are difficult to run and interpret.Objective: Development of a standard smell test for Iranians and determination of the normal range of olfactory sense in this region.Materials and Methods: In order to find popular odorous items in the region, 56 well known materials were presented to two hundred, 15-60 years old, normal relatives of patients who came to university based Amir-Al-Momenin hospital. Then 16 materials with the highest scores were selected (based on this consensus) as the test materials. These were: petrol, alcohol, tea, rice, soap, cinnamon, origan, and garlic, onion, washing powder, mint, rose water, lemon juice, olive oil, Vinegar and Vix. Then, these 16 selected materials were presented to 150 people of study group (77 women, 73 men). All materials were presented in identical containers. Participants were requested to smell material at 2 centimeter distance for 3 seconds, without being able to see the material. Then they would choose an answer in a multiple choice questionnaire. Each nostril was tested separately, therefore the total score for two nostril and 16 materials was 32 for each person.Results: Considering 97 percentile, the normal range of olfactory score for 15-60 years old residents of Rasht was 28–32.Conclusion: This study is helpful to evaluate the patients who complain of hyposmia or anosmia and could be use for future studies.

Introduction: Neural Tube Defects (N.T.Ds) are the most common anomalies of the central nervous system which cause due to the defect of the closing of neural tube during the third and forth week of intra uterine life. It is estimated that 300/000 children born with these anomalies each year. Recent studies show the role of both environmental and genetic factors in the occurrence of N.T.Ds.Objective: Evaluation of relation between maternal age, job, smoking, use of folic acid and other drugs during pregnancy and N.T.Ds.Materials and methods: In a case-control and retrospective study, we studied the data from 51 N.T.Ds infant and the same number of normal babies. Chi- square test was used for statistical analysis and P<0.05 was significant.Results: There was significant relation between maternal smoking, agricultural and animal husbandry job and not use of folic acid with occurrence of N.T.Ds.Conclusion: neural Tube Defects can cause by smoking of mother, her agricultural and animal husbandry activities and not using of folic acid tablet during pregnancy. Most of these children were born from mothers less than 35 years old.

Introduction: Hydatid cysts caused by the Echinococcus Granulosus and Multilocularis. Liver and them lungs are the most common sites of lodgment of it. Because the clinical symptoms, diagnosis and outcome of treatment are not well discussed, we want to discussion this problem.Objective: Survey of the clinical signs, symptoms, diagnosis and outcomes of patients with complicated lung hydatid cysts.Materials and Methods: We retrospectively examined 54 records of patients with ruptured lung hydatid cyst in 152 patients who were hospitalized in Rasht hospitals, since 1993 to 2005, and were surgically treated. Data collection tools were a predetermined review form; and findings are presented in relative frequencies tables.Results: 54 cases 38(70.3%) were male. Age rang of patients was 4-63 years. Chief complaints of the patients were cough in 47 cases (87%), dyspnea in 42(77.8%), sputum in 37(68.5%), chest pain in 31(57.5%), and hemoptysis in 13(24%). Most common lodgment of cysts in the lungs was right lower lobe in 38(57.5%). Ruptures occurred in tracheobronchial tree in 39(73%), and in pleural space in 10(23%). Complication after surgery occurred in 15 patients. Three patients (5.5%) were needed reoperation for treatment: bronchopleural fistula treatment in two cases and bilio-pleural fistula in one case. After surgical treatment, 53 patients (98.1%) were completely cured; recurrence occurred in one patient (1.9%) who treated with Albendazol. There was no hospital mortality.Conclusion: In endemic area all cystic lesions of lung must be ruled out for hydatid cysts; because some patients with lung hydatid cysts present complications: the cause of complication are, lately referring to physician and delay in diagnosis..Early treatment with medical and surgical approach recommended.

Introduction: Due to importance of duration of labor, this study investigates the effects of acupuncture on duration of labor. Prolonged labor causes of maternal and neonatal complications, prenatal mortality & high CS. By inserting specific needles into particular spots of the body, acupuncture cases reduction duration of labor. By instigating Oxytocine, labor duration is shorter.Objective: Evaluation of influence of acupuncture on duration of labor. Materials and Methods: The present study was accomplished on 60 pregnant women who had referred to some of Tehran hospitals for their childbirth. First of all, the qualified pregnant women were entered into the study by the answers that had given to questionnaire No.1. Then these 60 women were divided into two groups of 30, a true acupuncture (group A) a false acupuncture group (group B). In the group A, 12 spots acupuncture in the active phase of labor were used and in the group B, 6 hypothetical spots were used to reduce duration. Results: The mean time of first phase of delivery in  group A was 169.6 minutes and in group B was 165.3 minutes indicating no statistically significant difference between the two groups (p=0.297). The mean time of second phase of delivery in group A was 33 minutes and in group B was 31.67 minutes which indication no significant difference between the two groups too (p=0.167). On the other hand, as for the rate of oxytocine reception during the delivery time, there was a statistically significant difference between the two groups, that is, 15 women out of the group A and 23 women out of group B had used oxytocine (p=0.03).Conclusion: The results of research indicate that acupuncture does not influence on delivery and neonatal. Acupuncture has no influence on labor duration in both group A and group B. It reduces need to Oxytocine in labor.

Introduction: This research has been done with awareness of positive effects of green tea, and because of the importance of treatment of opened skin wound.Objective: The effect of different doses of water green tea extract on the development of open wounds in mice.Materials and Methods: There were 32 male mice in 4 different groups. First group was control and the others were experimental. Different dose of watery such as 50, 150 and 300 mL were injected them. After anaesthetizing the mice, Skin wound is created on the back of the Mice by a 6mm punch. While the Mice in control group were treated by serum physiology, around the wound of the back of other Mice watery of green tea were injected. The researchers measured the dimension and also the recovery percent of the wound in the 1st, 3rd, 7th and 15th days of study. Furthermore they evaluated the duration of recovery. Some histology studies have been done. On 2 Specimen of wound in 3rd/ 7th / 15th days for study.In this way fibroblasts macrophages, Neutrophils and endothelial cell of blood vessels from the wounds were accounted. Data were analyzed using analysis of variance method.Results: Evaluation of recovery processes showed there were no significant differences between groups on 4th day of study. The degree of recovery on 7th day for observer group was (19.2±10.2) for 2nd group were (38.8±17.9), for 3rd groups were (48.3±17.7), for 4th were (60±17.8) (P<0.04).The degree of recovery on 15th day of study for observer group was (25±8.2)/ for 2nd group were (47.8±17.5) 3rd group (66.5±18.1) and for 4th group were (76.5±18.4) (P<0.01). The degree of fibroblasts in different groups are alternatively as follow in the 1st group (observer) (106±13.8, 185.8±12.1, 90±10.5), 2nd group (89.1±20.2, 152±15.5, 101.6±13.5), 3rd group (97.1±22.5, 162.9±16.8. 110.2±10.4) and 4th group (100.2±21.2, 174.9±14.5, 121.5±11.5).Conclusion: according to the findings, watery of green tea extract speed up the wound healing. We recommend more researches in the field of content enrichment, different methods of use and the effect of them. Examine the water and alcohol of green tea extract on different animals (chronic wounds and burnt) and finally on sick persons.

Introduction: Based on World Health Organization (WHO) studies health education is the best possible way for HIV prevention. To Fulfit the matter high risk population is the priority. Injecting drug user is heavily affected and accounts for near 66% of all cases.Objective: This study goal is to affect of health education program based on HBM model on the AIDS preventive behaviors of addict in zarandieh.Materials and Methods: This is a quasi-experimental before and after study, on 48 male addicted Tavoloddobareh association of Zarandieh selected as research units. Data collection tool was a questionnaire design based on Health Belief Model (HBM), knowledge and behavior. The training content was designed, edited, and executed after the analysis of the results of the first test. Two months after the intervention, the secondary test was performed using the same questionnaire. Function collected data was analyzed statically tests like t-test, chi-square.Results: 42% of addicted had good knowledge, 31% of them, had risky sexual and 45% had drugs injection. There were significant different, better mean scores of all parts before and after educational intervention.Conclusion: The results of the study indicated, designed health education program, on the basic of HBM was effective in AIDS preventive behaviors: this research suggest intervention study by using other methods a model for behaviors change.

Introduction: Iron Deficiency Anemia is the most common cause of anemia in children and one of the health threatening problems in all of the world.  The high prevalence of Iron Deficiency Anemia and its effect on the growth retardation suggests more prophylactic methods.Objective: This study was designed to evaluate the effect of early iron supplementation on incidence of Iron Deficiency Anemia in term infants.Materials and Methods: This experimental study was done on 4-months-old term breast-fed infants referred to the primary health care services for vaccination, without any underline disease or growth retardation or history of hospitalization. 60 infants selected and were divided randomly to two groups (n=30 in each) and a questionnaire was completed for each case. Two groups were matched for gender (c2(1)=1.714; P-value=0.19).Iron drop (2mg/kg) was given in the interventional group. Iron deficiency anemia was assessed in all 6-months-old infants. T-student test and chi-square were used to analyze the independent variables and comparing the hematologic indices, after entering in SPSS-13 software and testing the normal distribution with komologrof-smearnoff test. Relative risk index (RR) was used to compare the two groups. A p-value less than 0/05 were considered as Significant.Results: The relative risk of iron deficiency anemia in the interventional group was 0.34 folds [RR=0.333, CI %95 for RR=(0.179, 0.620)]. Significant difference was seen between the two groups (p<0.001).Conclusion: According to the effectiveness of earlier iron supplementation for prophylaxis of iron deficiency anemia in term infants; we suggest it in all cases.

Introduction: Bibliometrics as a method of annual evaluation of research performance in Iranian Universities of Medical Sciences involves determination of scientific activities of faculty members. A wide range of scientific performances are evaluated in this way and determination of number of publications is an important indicator of this evaluation.Objective: Determination of number of article published by Guilan University of Medical Sciences (GUMS) faculty members.Materials and Methods: Using a descriptive design based on biblometrics methods, four eminent scientific databases including Scientific Information Database (SID), Iranmedex, Web of Knowledge (WOK); and Scopus has been searched and the number of articles published by GUMS faculty members has been determined.Results: Data obtained in this research indicates the number of Persian and Latin articles published by GUMS faculty members shows a rapid increase in recent five years as the number of Latin articles increased from 9 in 2003 to 41 in 2008. Of 879 articles published by GUMS members in this period, the medical faculty members contributed the highest percentage (77.47%), with Internal group as rank one with 69 articles.Conclusion: The current trend of article publication by GUMS members is favorably increasing, although this tendency has no equality in all faculties. Conducting more researches to discover the potential causes of this situation and providing sophisticated resolutions seems be necessary.

Renal artery stenosis now is one of the well recognized causes of Ischemic nephropathy and arterial Hypertension. It is one of the most challenging fields in medicine. Like other vascular anomalies, renal artery stenosis does not always have clinical outcomes. Renal artery stenosis can be seen with accompanying of other vascular abnormalities like arterial duplication, but stenosis of all supplying arteries together is rare.Case Reportation: Patient is a 65 years old man, known case of poor control hypertension, chronic renal insufficiency and CVA, presented with diarrhea, repeated vomiting and deterioration of renal function. After clinical evaluation, patient underwent renal angiography and with bilateral duplication and renal arteries stenosis in all four arteries, and then angioplasty was per formed. Renal function returned to normal and blood pressure controlled.