JOURNAL OF GUILAN UNIVERSITY OF MEDICAL SCIENCES
Year:2008 | Volume:17 | Issue:66|Papers Count:16

Introduction: Antifungal drugs have been successfully used in treatment of fungal infections. Recently, immunomodulatory effects of some of these agents have been reported. Base on immune system role in the treatment of various infection, alteration in cytokine pattern would be influenced the immune responsiveness.Objective: Study the expression and secretion of the inflammatory cytokines in human keratinocyte.Materials and Methods: In this invitro study, cultured keratinocytes were treated with different concentrations of Fluconazole, Ketoconazole and Griseofulvin. The level of IL-1 and TNF-a by keratinocytes in cultured supernatant were measured by Quantitative Enzyme Immunoassay technique and their expression were evaluated by using real time PCR. Data was analysed with one way ANOVA test (Varyance).Results: Treatment of keratinocytes with different concentrations of Fluconazole (3.3,10,30 m/ml) and low concentration of ketoconazole caused to decrease of IL-1 secretion (P<0.001), but Griseofulvin did not show this effect at the same concentrations. In addition, the examined drugs had no effect on TNF-a secretion. Quantitative analysis of IL-1 encoding genes revealed that transcription on these genes might be suppressed following treatment with Fluconazole or ketoconazole.Conclusion: Antifungal azoles might be modulated cytokines expression and secretion as well as affect the direction of immune response induced by keratinocytes.

Introduction: Participatory research as performing research by involving all people, need to public participation, so determining the attitude of people toward this topic is important.Objective: Determine the attitude about Community Based Participatory Research in People Residing in Ali Abad.Materials and Methods: This descriptive cross sectional study was performed on 178 people residing in Aliabad with a convenient sampling method. A structured questionnaire comprised of attitude statement and demographic characteristics was used for data collection and completed self administered by participants. The validity of attitude statements was determined by faculty members and reliability was measured by Cronbach's alpha greater than 0.7. T-test was applied for data analysis using SPSS program.Results: The mean attitude score was 45.56 (95% CI: 44.74-46.38). Furthermore the mean attitude in empowering category with 20 maximum score was 10.77 (95% CI: 10.77-11.48), removing community problem with 15 maximum score was 9.11 (95% CI; 8.84-9.38), community participation with 25 maximum score was 16.12 (95% CI; 15.74-14.49) and community confidence with 15 maximum score was 9.0(8.64-9.37). Participant attitude toward community based participatory research was statistical significantly associated with respondents membership in population research center (P<0.05).Conclusion: The most important factor in successfully administrating community base programs is the community participation. The findings of this study indicate the importance of community based participatory research for community.

Introduction: Dental ankylosis is one of the local factors that can influence tooth eruption. It always was observed in primary molars. Dental ankylosis might be leads to delay of eruption of successors tooth, ectopic eruption, arch length deficiency and peril the periodontal health of successors and neighboring permanent teeth. Timely diagnosis is imperative in prevention and control of occlusal disturbances.Objective: Investigate the prevalence of dental ankylosis in primary schools children in Rasht.Materials and Methods: This is a descriptive cross sectional study witch was performed on 1023 children in grade two and three. Exist of 1mm infraocclusion in compare to intact marginal ridge of neighboring tooth was consider as diagnostic criteria of ankylosis. In case of difficult diagnosis, occlusion of antagonist teeth and immobility were considered. Data was analyzed according to qui-square test.Results: Prevalence of dental ankylosis was 15%. There was no significant difference between two sexes. Ankylosis was significantly more in mandible (p=0.001).The most affected teeth were observed first primary molars and the least involved teeth were upper second primary molars. More than 60% of subjects had more than one Ankylosed tooth. 9 aged children had the highest frequency of Ankylosed molars, but not significant between groups. In 2% of subjects, dental ankylosis was in upper larger than normal upper central incisors were observed.Conclusion: According to high prevalence of dental ankylosis in this population during and the importance stage of alveolar growth and clinician’s knowledge about the problems is necessary intervention during routine dental examinations to reduce its complications and treatment costs.

Introduction: Contact eczema is a common inflammatory skin disease; different materials with irritant and allergic mechanisms can produce this disease. Although history and physical examination are important in diagnosis of allergen, because of extent of several factors, environmental allergens, were not simply recognized. Patch test is an important diagnostic tool to confirm allergic contact dermatitis and can reduce mistake of clinical diagnoses.Objective: Determine frequency of dermatic allergens in patients with contact or atopic dermatitis who were referred to Razi hospital in Rasht.Materials and Methods: In a descriptive cross sectional study during 22 months, 100 patients with clinical diagnoses of contact and atopic dermatitis who referred to Razi hospital patch tested with European standard series containing 24 allergens. Their reactions were evaluated after 24, 48 and 72 hours after application of patch test. Data was collected and were analyzed by SPSS. (P<0.05 was considered significant.Results: Among 100 patients, positive patch test was seen in 36% which mean age of them was (30.67) years (SD=10.85 The most common involved location was hand (86%) and most common allergens were Nickel sulfate (20%) and potassium dichromate (9%). In this study 6 (25%) of all allergens showed positive reaction.Conclusion: Nickel Sulfate and Potassium Dichromate were the most common contact allergens in our study.

Introduction: The objective of prenatal care is to reduce the rates of maternal and neonatal mortality and morbidity by early diagnosis, treatment and prevention. Satisfaction of the clients is a valuable means for performance assessment of the planners and executive authorities of health and treatment systems can lead to planning for promotion of the ways for providing the care services. Objective: Determine the satisfaction rate of prenatal care in two public hospitals in Rasht.Materials and Methods: In this descriptive cross- sectional study 600 pregnant women who were referred to two public hospitals of Rasht (Alzahra and Rasool-Akram) were selected with simple-randomized sampling. The data collection instrument consisted of two-part questionnaire including demographic variable and criteria of satisfaction. Score were measured according to likert scale. Data were analyzed SPSS 10 software and chi-square t- tests. P<0.05 was determined as statistical significance.Results: The mean age of women was 25.7±5.4. The majority of them were primipara, low literate, housewife, city-dweller and covered by the insurance .In general, the satisfaction rate among the majority of them was moderate (%62.7); %37 were satisfied and only %0.3 dissatisfied. Satisfaction dimensions were as follows: %49.3 satisfied with the communication method of the care providers, %55.5 with the professional skills, %30.8 with the facilities for easy access to the drug and information, %24 with the welfare facilities, %9.2 with the available equipments, %40.3 with the organization, and %40.5 with the environmental accommodations. Also, in viewpoint of the costs, %23.1 was satisfied and the rest were either satisfied at a moderate level or dissatisfied. In a comparison between these two hospitals, a statistically significant relation was found among the communication manner of the service providers, easy access to the facilities, welfare facilities, devices and costs (p<0.05).Conclusion: According to the results, the satisfaction rate among the majority of the clients with the prenatal services was moderate. By comparison between two hospitals, it appears that the Rasoole Akram hospital is in relatively better condition in meeting the satisfaction of the clients compared to Alzahra hospital. With regrinding to the existing weaknesses, could be designed appropriate planning for improving the satisfaction rate in prenatal services.

Introduction: Trauma is ranked four as being a lethal disease. Spinal trauma and the spinal cord injuries arising from the trauma are the cause of 3%death rate. Concomitant spinal cord injuries may lead to neurological deficit and socio-economic problems.Objective: Determining the relative frequency of spinal cord fractures, types and some related factors as recorded in the emergency ward of Poursina hospital in Rasht from 2001 to 2003.Materials and Methods: In a descriptive cross-sectional survey performed on the hospital archive, the patients confined to be suffering from the fracture based on imaging studies from 2001-2003 were included in the study. Exclusion criteria were: mismatch between the report of imaging studies and physician diagnosis, absence of the report in the patients' records and leaving the hospital before making a diagnosis. Variables such as age, sex, trauma mechanism, and place of lesion were extracted and registered in a special form designed for this purpose.Results: After dully studying the bulk of files, 215 in number, 41 cases were omitted from the study. About 71.8% were male. The mean age was 40.75±15.55 and 23% of them were in the age group of 21-30 years. Burst fracture was the most common fracture type. The majority of accidents were due to falling from height (63.3%). The most common fractures occurred in the lumbar area at the l1 level (60%), thoracic area at the level of T12 (64%) and cervical at the level of C7 (40%).Conclusion: Regarding to the high frequency of spinal injuries followed by falling, we can decline these injuries by paying attention to safety issues.

Introduction: Construction of vascular access using subcutaneously placed to join an artery to a vien is increasly necessary in patients with poor peripheral veins or previously failed arteriovenous fistulas. Interposition grafts in the lower extremity are used for patients who have no usable vessels available in the upper arms. Experience with groin hemodialysis prosthetic access has been discouraging because of high infection rate and associated limb amputation Objective: Determine infection rate, patancy rates, and possible predicative factors for prosthetic thigh angioaccess outcomes in our hemodialysis patient’s population.Materials and Methods: In this prospective study 41 patients who were underwent placement of thigh vascular access graft at Sina Hospital, Tehran University of Medical Sciences, were selected between Jan 2000 and July 2003. Data were recorded base on demographic and complications variables and analyzed by Kaplan-Meier & long rank tests.Results: In this study the primary of thigh prosthetic graft were, 76%, 70%, 67%, and 60% at 3, 6, 9, and 12 months after placement respectively.There were 14 (34%) access failures, related to infection in 2 case (4.8%), thrombosis in 10 cases (24.4%) and psuedoaneurysms in two cases (4.8%). There was no limb ischemia, no significant difference in infection or graft patancy rate which were found by patient age and gender.Conclusion: In this study, infection and thrombosis rate of thigh access was not more than other studies. Thigh vascular access with PTFE could be used for patients who have no usable vessels available in the upper arms.

Introduction: A lot of industrial products and consumer resources have important role in human exposure and receiving yearly radiation dose limit.Radioactive products have been used in denture teeth and Porcelain powders for flourescence properties for long time in dentistry. Because of the most of the people used Porcelain powder and denture, this became an emotion to survey the rate of relative reactivity of powders and inform the laboratory personals. Objective: Determine the relative radioactivity of artificial teeth used in dentures and in porcelain powders.Materials and Methods: In this laboratovary-experimental study six samples of porcelain powders (ceramco III opaque, ceramco III dentin, ceramco II opaque, ceramco II dentin, noritake dentin EX3 and noritake incisal) and two samples of anterior and posterior artificial teeth with polymer base (marjan and shanghy) were used and about 3gr of each sample was placed in front of the scintillator detector NaI (ti) s' window.The number of emission in one houre was measured during each stage. Back ground radiation was measured in several stages. Samples and background radiations ratio were measured by means of paired t test. Data were analyzed by SPSS soft ware.Results: Radioactive properties of different porcelain powders and mentioned denture teeth were significantly lower than back ground radiation.Ceramco III opaque porcelain powder showed the most radioactive properties and marjan denture teeth showed the least.Conclusion: This study confirmed previous studies about low rate of radioactivity properties of samples relative to back ground radiation and indicated if safety precautionse are observed no problem should rise for dental technicians.

Introduction: Depression is a common disorder and 1 of 5 women and 10 men are affected by depression during their life time. Depression in candidates of Coronary Artery Bypass Graft Surgery (CABG) may increase the rate of morbidity, re-hospitalization and death and it reduces quality of life after CABG.Objective: Determine the relative frequency of pre-operative depression in candidates of CABG in Heshmat Hospital in Rasht City, Iran.Materials and Methods: A descriptive cross-sectional study was performed on a representative sample of 250 candidates of CABG who admitted in Heshmat Hospital (from October 2006 to May 2007). Patients were assessed by Beck Depression Inventory and those who scored more than 16 were interviewed considering DSM IV criteria for depressive disorders.Results: Among 250 patients, 67 cases (26.8%) acquired score more than 16 and 39 cases (15.6%) were depressed in structured clinical interview. Among them 12 cases (31%) were male and 27 cases (69%) were female, this difference was statically (p<0.001). There was a significant relationship between educations and employment situation with depression (p<0.001) respectively. Depression was more in illiterates or primary schools education (p<0.008). Unemployed and housewife women were statistically higher depressed (p<0.001). There was a significant relationship between depression and co-morbid disorders while it was not associated with place of residence, marital status and diabetes mellitus.Conclusion: Regarding to The prevalence of pre-operative depression in candidates of CABG and its relationship with poor medical prognosis in these patients, it should be assessed before operation in order to reduce re-hospitalization and improve patients' quality of life

Introduction: Regarding to frequency of prevalence of (RA), Pulmonary involvement is a common and serious complication of rheumatoid arthritis this study was performed.Objectives: Determine the prevalence of pulmonary disease in onset of rheumatoid arthritis base on history, physical examination, radiographic and pulmonary function test. Material and Methods: 52 patients (43 women, 9 men) fulfilling the ACR (American college of Rheumatology) criteria for RA (Rheumatoid arthritis) were consecutively assessed in a cross sectional study. Detailed medical (including respiratory symptoms and the disease activity symptoms) and drug and occupational histories were obtained. All patients underwent a complete pulmonary and rheumatologic examination and conventional chest radiography. All patients underwent PFT that comprised spirometry and body plethsmography. Data were analyzed by SPSS software.Results: Their mean age was 45.8±11.1 years (range: 21-78) and the duration of the disease was less than 6 months. Rheumatoid factor was positive in 76.9%. All patients were nonsmoker. Base on history: cough in 7.7%, dyspnea in 17.3% and wheezing in 1.9% was detected. Physical examination findings showed expiration wheezing (5.8%) and decreasing breath sound (1.9%), Chest X-ray was abnormal in 51/9% (Interstitial opacities 50% & Air-space densities 1.9%) PFT was abnormal in 30.8% (obstructive 15.4%, restrictive 9.6%, mixed pattern 5.8%). Conclusion: This study showed a high prevalence of lung involvement in beginning of rheumatoid arthritis, so we recommend to perform diagnostic investigation of pulmonary involvement (PFT, Chest X-ray, …) in beginning of RA.

Introduction: Methyl tert-butyl ether (MTBE) has been incorporated in reformulated gasoline at concentrations up to 15% (vol) to replace lead tetraethyl in order to comply with the octane index and to reduce the polluting emissions in exhaust gases. This compound is water soluble (48,000 mg/L) and one of the most common pollutants of ground water and surface water. Because of its undesirable effects on drinking water and ecologically harmful effects, MTBE removal has become a public health and environmental concern.Objective: Evaluation of biodegradability of MTBE by isolated microorganisms from activated sludge.Materials and Methods: In this study a microbial consortium that efficiently degraded methyl tert-butyl ether was obtained by Isolated microorganisms of Activated Sludges in the Aqueous Solutions. Microorganisms were isolated from a variety of sources, generally from petroleum or chemical and urban wastewater treatment plants. All experiments were conducted at a constant temperature of 25oC. Vials of 50 ml and 125 ml volume sealed with Teflon-lined Mini-Nert caps were used for microcosm experiments. In all experiments 1% sodium azide were used as controls. Cultures were incubated at 25oC in the dark on an orbital shaker (rotation speed of 150 rpm). The mineral medium was used for batch cultures. Samples of bacterial cultures that metabolize MTBE have been analysed for both MTBE and its metabolite TBA by direct GC analysis using FID. Cultures able to metabolize MTBE have been found in activated sludge and soils. Microbial consortium were plated on agar with MTBE vapor as the carbon source. After three weeks growth to saturation, independent clones were diluted into fresh mineral medium. This microorganisms, was a gram-positive bacterium. An aerobic microbial consortium able to biodegrade methyl tert-butyl ether (MTBE) was enriched in laboratory for four months. Results: MTBE has been shown to biodegrade under aerobic conditions and cometabolic conditions. Clearly, aerobic biodegradation of MTBE is demonstrable. In our laboratory, a microbial consortium was isolated from activated sludges based on its ability to grow on MTBE and was identified as cocobacillus. The capacity of this microbial consortium to degrade and grow on MTBE as a sole carbon and energy source is described in this paper. No biomass aggregates were observed during all the batch cultures, but the attached biomass was observed (the concentration of the initial attached biomass was about 0.11g/L of dry weight). 500 mg of yeast extract per liter and 20 mg of Peat humic support growth of microbial consortium, it clearly had a stimulatory effect on consumption upper than 20%. Consortium was capable of degrading concentration as great as 1000 mg/l MTBE, whereas concentrations of 1000mg/l MTBE and higher was not degraded.Conclusion: MTBE in low concenteration is biodegradable and biodegradability of MTBE enhanced by stimulator substances.

Introduction: Dysmenorrhea is one of the most common problems of young girls and women and cause of absent of work and school. Objective: Determine the prevalence, knowledge and practice of university students about dysmenorrhea.Materials and Methods: In this cross- sectional study 380 female university students were selected by random multistage cluster sampling method in 2005. Data were collected by a self-administered questionnaire. It consisted of demographic, knowledge and practice questions. Based  on  the scores  the  knowledge  was divided  into  weak,  intermediate  and  appropriate. Performance   questions were analyzed separately.Results: Prevalence of dysmenorrhea was 73.2% and 15.3% of them had appropriate information. Knowledge in married and older students and home that their mothers had high education was higher than others. There was statiscal relationship between knowledge and age. The first source of information and the first counselor for decreasing menstrual discomfort was their mothers (57%) and (21%) respectively. About 6% of students used appropriate food, 54.7% had good personal hygiene and 85% had appropriate daily physical activity during menstruation.Conclusion: Prevalence of dysmenorrhea was similar to the other studies, level of information about dysmenorrhea was low. Most of students didn't use appropriate food during menstruation.

Introduction: The etiology of exudative ascites cannot always be diagnosed accurately. Laparoscopy could be used as an appropriate diagnostic modality in these cases. Objective: Evaluate the laparoscopic, biochemical and clinical findings in patients with exudative ascites of unknown etiology.Materials and Methods: In a case-series study, we studied the data of 67 patients with exudative ascites of unknown etiology who under went diagnostic laparoscopy in endoscopy ward of Imam Khomeini Hospital from 2002 to 2005. Demographic data; complaints; clinical, laboratory and laparoscopic findings were evaluated and the accurate etiology of exudative ascites was determined. Man Whitney and Fischer’s exact test were used for statistical analysis. P values less than 0.05 was considered significant.Results: The most common cause of exudative ascites was carcinomatous peritonitis then tuberculosis and lymphoma. Tuberculosis peritonitis was the most common etiology of exudative ascites in afghan immigrants. Abdominal masses were only palpated in cases of malignancy. Uniform micronodules and fibrous bands were observed in tuberculous peritonitis. Icter was observed in half of the patients with Budd-chiari Syndrome and lymphoma. Hepatomegaly was mostly seen in Budd-chiari Syndrome and neoplasms.Conclusion: Carcinomatous peritonitis, tuberculosis and lymphoma were the most common causes of exudative ascites of unknown etiology.

Introduction: Now a days, the increased use of abdominal ultrasound and CT scanning has led to the frequent finding of unexpected adrenal masses, which named incideltaloma. Unsuspected adrenal masses have been detected in 0.6-1.3% of upper abdominal CT scan.Case report: The case was a 24 years old woman who had vauge pain in her right flank. In sonography one mass, 5 cm diameter, in retroperitoneoum and right kidney was observed which had shifted renal vein to anterior. In CT scan, one mass, sized 4.6 c 39 mm, in anatomic size of right adrenal with significant enhancement and central hypodensity was observed which had moved renal vein to anterior.The patient underwent transperitoneal laparoscopic adrenalectomy and in pathology, neurofibroma was reported.