Journal of Guilan University of Medical Sciences
Year:2001 | Volume:9 | Issue:35-36|Papers Count:22

Human fascioliasis is an endemic disease in the Guillan province and it has became a public health problem in the port of Anzali. Thousands of people in this area were infected during the two outbreaks in 1987 and 1998. If the mature worm settles in the liver, finding the ova in the 8tool is the most reliable diagnosis of the infection. Therefore selecting the most sensitive parasitological method is of value in prompt diagnosis and treatment of the disease. The Formalin-Ether method which is a routine procedure in the clinical laboratories is compared to Katz-Kato which is usually used for quantitative parasitological assessments, but is also reported as being useful in the diagnosis of human fascioliasis. Stool samples of 184 suspected patients, referred to the parasitology lab of the Guillan university of medical sciences, were consecutively collected. Patients had liver-free diets at least 3 days prior to specimen collection. Each sample was examined by both the formalin-ether and the Katz-Kato methods, performed separately by two technologists neither of whom knew the results of the other one (blinding). In order to see the outcomes of the tests on the repeated samples, 3 stool samples were collected at 2-3 days intervals from 69 patients and examined as before. For the first part, 44 samples were positive and 124 were negative with both methods. 9 samples were only positive with the formalin-ether and 7 samples were exclusively positive with the Katz-Kato. For the second part (3 samples for each patient) 22 patients were diagnosed as positive and 46 patients as negative with both methods. Only one patient was exclusively positive with Katz-Kato. Comparing the results of 184 samples with Kappa statistics an agreement of 0.78 (very good) was found. This agreement increased to 0.98 (excellent) for repeated samples of 69 patients.

Lumbar puncture (LP) is performed frequently in Pediatric departments to diagnose meningitis in infants and young children with fever. Children selected to have LP who do not have meningitis may, however, have other bacterial infections. During a 2-year desciptive study, we investigated lumbar punctures performed in pediatric departments of Bou-Ali, Emam-Hossein and Loghmane-Hakim hospitals and monitored the incidence of meningitis and other bacterial infections. Meningitis was diagnosed in 8% of children who underwents LP.An additional 10.5% of children who underwent L.P and had normal amount of cerebrospinal fluid had positive cultures of blood (3.1%), Urine (4.1%) and stool(3/3%). The decision to perform lumbar puncture identifies children at risk of having not only meningitis but also other bacterial infections. 2 years old and younger children with normal cerebrospinal fluid should be considered for cultures of blood, urine and possibly stool.

The object of this study is determination of normative values of nerve conduction studies (NCS) among the population of Guilan Province.We selected 216 at the ages of 20-59yr on the basis of their medical histories and examination, and on condition that they had no factors or diseases interfering with nerve conduction by convenience sampling method. In this cross-sectional study, the motor amplitude (AMP), nerve conduction velocity (NCV), distal latency (DL) and sensory amplitude, and peak latency (PL) of Median, Ulnar, and Radial in nondominant hand were determined.%95 was recognized as cut-off and normal values; and mann-whiteney test (a=0.05) was used to compare means.5% of Median, Ulnar, and Radial sensory AMP in nondominant hand were 37.2, 33, and 18.9/-lV, respectively. 5% of motor AMP Were 5.2, 4.5, and 2.5 MV, respectively. The 5th percentile of motor NCV were 54, 52.3, and 51.8 M/S, respectively. 95% of sensory PL were 3.8, 3.9, and 3.1 ms, respectively. 95% of motor DL were 4.2, 3.9, and 3.3 ms, respectively. There has been no significant difference in sex about in nerve conduction, but there has been a significant difference in motor AMP and NCV, and sensory AMP study results between age groups of under and over 60 (P<0.00l). As regards to functional conditions of this center, we present the above-mentioned values as the normal values for use in conduction nerve studies in Poursina Electrodiagnostic center; Rasht.

Febrile Convulsion is the most common reason of seizures of epilepsy during child hood from 9 mo to 5 years of age. That is classified in to two groups, as simple and complex based on it's Clinical Features. One of the factors in this dividing is repetition of convulsion for several hours or days. In some studies sex, age, family history, temperature at the time of convulsion and duration between starting fever and convulsion attack are effective in the recurrence. With observation of repetition of convulsions in a large group of patients in 17 Shahrivar Hospital and their development from simple to complex. In this study main object was determination the factors that may be effective in repetition of convulsions in patients during bedridding in hospital. In this cross sectional study 693 record of children with fever and convulsion which are admitted in 17-Shahrivar Hospital of Rasht in 1999-2000 reviewed. Information's were produced with use of SPSS hardware and statistical t- test and chi- 2. 269 Cases (39%) had recurrence, including 197 Cases (73%) with one new attak ,62 Cases (23%) with two attaks and 9 Cases (4%) With 3 attaks. In Overall, 374 Cases 54% were males and 319 Cases (46%) were Females. There were no any Significant difference between age and sex with the recurrence, but about the family and personal history of convulsion differences were significant (P<0.001). Recurrence was higher when seizure occur in temperature below 380C and when duration between starting fever and first convulsion was lesser than two dayes. 70% of patients who had recurrence were admitted in the hospital with simple febrile convulsion and 98.5% of patients with recurrence discharge with phenobarbital of and 94% of them With EEG request.Recurrent of attack in children with convulsion and fever admitted in hospital was higher.

Congenital genitourinary tract abnormalities occur in 0.1% to 1% of all neonates and are a major cause of perinatal mortality and morbidity. Nowadays, prenatal ultrasonography can detect most malformations and anomalies. In this study the genitourinary tract abnormalities of the Fetuses of the pregnant women by prenatal ultrasonography and causes of these abnormalities were evaluated.7,200 pregnant women in 3rd trimester who need specific ultras no graphic evaluation was selected. The fetuses of these pregnant women evaluated for geritourinary abnormalities and causes of these anomalies.66 (0.9%) of cases had genitourinary anomalies. The male to female ratio was 1.5/1. Hydronephrosis was the most common abnormality detected and accounts for 59 (89.3%) of all parentally detected lesions. 21 (35.5%) of these had bilateral hydronephrosis. In postnatal evaluation, 42 (63.7%) of parentally detected hydronephrosi was caused by ureteropelvic Junction obstruction then vesicoureteral reflux 9 (10.6%), posterior urethral valve 4 (6%), ureterovesical Junction obstruction 4 (6%). Oligohydroaminous was detected in 5 of patients (7.6%). Upper urinary tract dilatation was the most common genitourinary tract abnormalities and also ureteropelvic junction obstruction was the most common causes of Hydronephrosis. The male to female ratio of UPJO was almost equal (1/1/1).

Many factors affect decision-making by patients who seek surgical management and choose hospital for admission.They include: The quality of health and medical services, the cost of them, social, physical, financial and cultural factors.This study was carried out to make clear, which of the above mentioned factors are more effective than the others. In this study, during summer of 2000, 385 patients attending 4 governmental and 2 private hospitals were questioned about the relevant factors of choosing the hospital for surgery. The majority of the patients from private hospitals (47%) were working in private sectors and those from the governmental hospitals were housekeeper (42.1%). In governmental hospitals, 25% of patients were high-school graduates and postgraduates.In private hospitals this figure was about 60.2%.The results in descending order of frequency were: Financial factors were effective in 89.3%, Hospital facilities and equipments in 82%, Insurance coverage in 80.3%, The quality of care given by Nurses in 79.6%, Hospital sanitation in 78.8%, Hospital reputation in 57.5%, The history of good service received by family members or friends in 44.7%, The possibility of visit by family members in 43%, Attending residents and students in 58.4%, Waiting period on 31.3%, To give a reduction by the hospital in 13.6%, Employed family members in 7.3%, In governmental hospitals, 65.4% and 100% of patients in private hospitals preferred private hospitals for surgery.The results of this study revealed that governmental hospitals have' lost their prestige. The findings showed that with improvement of' financial situation, all patients will choose private hospital for management. Governmental hospital have to increase the quality of their services with changing the trends.

Electroconvulsive therapy (ECT) has been used widely to treat psychiatric disease. ECT under anesthesia is associated with hypertension and tachycardia. The cardiovascular effects of ECT were studied after per-treatment of 100 patients with lidocaine 1.5 mg/Kg (experimental group) and saline solution (control), using a double-blind, randomized clinical trial study.There were no significant difference between two groups with respect to demographic data. Although, arterial blood pressure, heart rate and respiratory rate increased significantly in all patients after ECT (P<0.05). Pre-treatment with lidocaine significantly reduced the hemodynamic response to ECT compared with saline solution (P<0.05).There wasn't significant difference between two groups in seizure duration.This study indicated that 1/5 mg/kg of lidocaine LV. was an effective pre-treatment regimen for preventing the acute hyperdynamic response to ECT.

Trauma is the most common reason of death in 1-44 years olds. In patients with multiple trauma, the head is the most common involved part. Car accident is the most common cause of head injury in adults.The importance of computed tomography (CT) in diagnosis of brain trauma is well established and CT of the brain is a choice method. A descriptive study was carried out in 880 patient with car accident injuries admitted in Poorsina Hospital in Rasht. Data was collected prospectively during 6 months in 2000. CT scan was performed on 3rd generation sct 3000TR, indication of CT scan was basis on clinical assessment and Glasgow Coma Score (GCS).In this study we evaluated computed tomograms of traumatic patients, of 880 patients 630 case (70%) have normal brain CT scan and 250 case (30%) have positive finding that of these 250 patients, 25 case (20.7%) had brain contusion, 50 case (20%) epidural hematoma, 62 case (24%) subdural hematoma, 90 case (36%) sub arachnoid hemorrhage, 76 case (30.4%) brain edema. Skull fracture was detected in 249 patient (20.7%). An overall male to female ratio was (3.2:1), with peak at age of 25 years.Our findings was similar to those of other large studies in: dominacy male to female ratio, age group (most patient are Adolescent and young Adult), Location of Brain Lesion and fracture type. This study shows men are not only more likely to receive head trauma, but also more to recieve sever head injuries.

Wart is one of the most common contagious dermatologic diseases throughout the world, which allocate high funds for therapeutic, cosmetic and hygienic works in a society. It seems that school children are more susceptible to infection due to the closely extensive contacts with each other. Thus, with the aim of detecting the prevalence of wart in the exposed areas in school children in Rasht in 2000, we examined 3600 prepuberal students on the basis of clinical examination in a descriptive cross-sectional multistages random sampling study.The general prevalence was 1u.1% with the highest rate among 10-13 years old (11.5%), and the lowest one among 6-9 years-old students (7.9%). The highest prevalence was observed among the 13-years old students in both sexes (17.1%). Common warts were the most common type (38.7%) of all cases, and the highest rate of infection was seen in feet (49.4%), while face had the lowest rate. There was no significant difference between involvement by warts with students' sex, public or private baths, parent's literacy level and job apart from number of family off springs. These data confirm that this infection is common amongt the school population. It seems logical to families and school health staff participating in the programmers to be familiar with preventive measures.

Tuberculosis is a major health problem in the world, which causes considerable mortality and morbidity. In a prospective-descriptive study, a group of patients with diagnosis of bone and joint tuberculosis on the basis of the clinical symptoms, signs and preclinical data with positive PPD and negative Wright tests, were examined in Imam Khomeini Hospital (Infectious Disease and Orthopedic Departments) from the clinical, microbiologic and therapeutical points of view. From 481 patients who was treating for tuberculosis, 13% had the above conditions. The age of the most was between 10-27 (min. 12 and max. 87 years). Complains, were often vague and mild and less attracts attention of the patient or physician. Besides prolonged Low Back Pain, there were tolerable pain and joint's movement limitation (first knee, then thigh). There were systemic signs as night sweats, fever and weight loss, which seemed unimportant. There were 65% collapse between two vertebrae, %6 of cases had multiple involvement of the skeleton and %11 of them had local fistulas. The duration of the illness (as mentioned by the symptoms) was mostly about 6 months or less. 66% had granuloma, showing a central area of caseation, epitheliod cells, lymphocytes and multinucleate giant cells in synovial biopsies of the joints and only one case had positive biopsy culture of the synovium for Mycobacterium Tuberculosis. X-Rays revealed nonspecific findings with no paranchymal involvement in Chest X-Rays. None needed surgery. As tuberculosis is endemic in Iran and regarding 12 months prescriled chemotherapy for our patients, despite their irregular and consult (56% of patients had only one cosuit) and as a few patients who consult regularly feel better and their signs and X-Rays improved. We may consider bone and joint tuberculosis, when there is a strong evidence, as regards other possibilities and start the medical management.

Blood transmitted diseases are one of the most important problems in the science of blood transfusion that cause illness and its complication, and spending much money. Among them check on hepatitis Band C, AIDS and syphitis are routine in all blood transfusion services.Our goal of this retrospective study is determining the prevalence of this diseases in Blood Transfusion Service of Yasuj during 1999.For this purpose we collected data from the special forms that donors filled before donation and then analysed them.Among all 4980 case there was 48 cases (0/96%) with hepatitis B, one case (0.02%) hepatitis C. The Prevalence of AIDS and syphils was zero.The Prevalence of Hepatitis Band C indicated that knowledge of prevention of these diseases was not enough and we must spend more time on it.

We carried out a retrospective study in Specialized Clinic of Rasht. In this study 200 women who referred to the Specialized Clinic with mastalgia from september 1997 until september 1998 on the basis of age, parity, nistory of breast feeding, family history of breast cancer, consumption of oral contraceptive, unilateral or bilateral breast involvement, fearing of breast cancer, cyclic or noncylic breast pain and changes of mammography and sonography were studied.Report of causes of breast pain in women was the purpose of this study. The average age of women was 49.5 years.In this study, all of patients were suffered from mastalgia and did not have breast mass or discharge. In this study the most common cause of breast pain was fibrocytic disease [25 patients (12.5%)] Thoracic outlet syndrom in 4 patient (2%) and in 166 patients (83%), the result of studies was normal. In this study, only 2 patients (1%) had cyclic mastalgia. 75 patients (37.5%) feared of breast cancer and 125 patients (62.5%) did not afraid of breast cancer.In 17 patients (8.5%) family history of breast cancer was positive 32 patients (16%) used OCP. In this study 147 patients (73.5%) had positive history of breast feeding. 196 patients (98%) accomplished mammography. The most women had two delivery and in 53 patients (26.5%) right breast, in 96 patients (48%) left breast and in 51 patients (25.5%) both breast was affected. In all women there is no relation between mastalgia and breast cancer and it can be say that mastalgia is a benign disorder.

Otitis serous is a common disease in pediatrics and ENT which can be treated by various medical and surgical techniques. The traditional surgery treatment of this disease has been done by realation of middle ear cavity with myringotomy and insertion of ventilation tube in tympanic membrane. Since remaining time of ventilation tube in tympanic membrane has a direct effect on the tratment result, the present research has been done to compare the iranian ventilation tube with their imported semblable in aspect of time of extrusion after surgery.Diagnosing chronic otitis serous, 80 patients below 14 yr. who were simply selected and confirmed by examine and bilateral B- type tympanogram. 160 ventilation tubes were inserted totally. Among of them, four patients were omited, because of their absence. To compare remaining time of ventilation tubes we inserted imported V.T shepard, in right ear and iranian V.T. pariz, in left ear. This research was a clinical trial and T-Test was the statistics test which was used. The average time of tube extrusion of iranian V.T was 6.2±1.6 months and for the other was 7.3±1.5 (p<0.001). The results showed that imported V.T was more effective and the iranian one in case of short time ventilation for middle ear in about one or two seasons can be utilized. It is imagin that the lower remain time of iranian v.t. pariz, versus the shepard was because of its design and existence of irregularity in its structure, which can be hopefully used effectively by solving its faults.

This study examined the effect of partograph on the first stage of delivery in Pregnant women who came to the delivery section of AL-Zahra Educational hospital in 1999-2000. In this semi- experimental study 218 samples are collected and the data collection tool was Partagraph that used in labors.Data analysis indicated that using Partograph had decreased the number of cesarean. In order to examine relationship between the number of cesarean with using partograph and without it X2 statistical test was used. The results indicated that there was a significant relationship between these two variables (p<0.05).With using Partograph, the average length of the first stage of delivery was 3/89±2.8 H in experimental group and 3/85±3/6 H in control group. In order to compare the average length of the first stage of delivery in experimental and control groups, T-test was used. The result indicated that there is no significant difference between two groups.Based on the findings the researcher recommends that as using Partograph has decreased the number of Cesarcan, the people in charge of hospitals use partograph for all the mothers at the time of delivery.

The Purpose of this study was determination of prevalence of various findings in pathologic reports of D&C that were done for abnormal uterine bleeding (AUB) in pre/peri/postmenopausal women.Study population in this descriptive cross-sectional study was all of D&C operations that were done for AUB indication in Alzahra hospital from April 1997 until April 1998. Their pathologic reports were collected from various pathobiologic laboratories of Rasht. We determined the frequency of different histologic diagnosis in 15-40, 41-50, and after 50 years old women.502 pathologic reports were used in this study. The most common diagnosis was "normal" (54.6%). The most common diagnosises in pre and peri menopausal women were "normal" (55.1% and 61.5%) and "pregnancy contents" (37.7% and 20.7%). Histologic findings after age 50 were "hyperplasia" (48%), "polyp" (20%), "cancer" (16%), and "endometritis" (16%). Although AUB in postmenopusal women is associated with endometrial histologic abnormality but AUB in premenopausal women is not usually with this finding.

The aim of this study was comparison of priming and intubating dose of Atracurium on the onset of muscle relaxation time to testing an alternative method for urgent operation. one hundred, 20-30 years old men that were candidate for urgency surgery entered in this study and divided in two groups randomly. First group was relaxed with Priming dose of Atracurium. In this way, %5 mg (priming dose) and 0.8 mg/kg 2 muinute Later and Second group was relaxed with 0.5 mg/kg Atracurium (intubating dose). The time of onset for relaxation measured by Trian - of - four mode by nerve Stimulator. Mean of this times compared using t-Student test.The onset of relaxation was earlier with use of Priming dose 70±10 Second), in compairsion to intubaiting dose (300±31 Second).The priming dose of Atracurium could decrease the time for onset of intubating time.

With considering of high prevalence of sinusitis and variable imaging modalities in diagnosis of it , we decided to evaluate sensitivity and specify of plain x-ray in diagnosis of acute sinusitis. In this research, CT scan and plain x-ray findings of 83 patients with suspected acute sinusitis (by otorhinolayrngologist) - with considering of ethical and economic notices - were compared and descriptive studies were done. CT scan is considered as gold standadrd.Sensitivity and specify of plain x-ray (waters and caldwell views) in diagnosis of acute sinusitis for paranasal sinuses Were maxillary (0.85 - 0.85), sphenoid (0.55 - 0.95), ethmoid (0.79 - 0.94), and frontal (0.86 - 0.93) sinuses and positive predictive value and negative predictive value were: maxillary (0.83 - 0.87), sphenoid (0.73 - 0.89), ethmoid (0.87 - 0.90), and frontal (0.83 - 0.94) respectively.Waters and caldwell views are accurate methods in primary investigation and also in follow up of patients with acute sinusitis without complication.