JOURNAL OF GUILAN UNIVERSITY OF MEDICAL SCIENCES
Year:2004 | Volume:13 | Issue:51|Papers Count:16

Introduction: Transmission of malaria, different filariasis, arboviruses and biting nuisance place mosquitoes as the most important arthropods in medicine and health not only in Guilan province and Iran but also in the world. Objective: To study mosquito (Diptera: Culicidae) fauna in Guilan province (Caspian Sea littoral areas, North of Iran), an investigation was carried out during April to December 2000. Materials and Methods: Mosquito larvae were collected from different larval breeding places by means of ladle or dropper. Adult mosquitoes were collected from different habitats by means of aspirator or captorator or reared from pupae. Results: The whole set of 2478 adult spceimens from 64 habitats and 6656 larvae from 127 larval breeding places were collected. During this study, Coquillettidia (Coquillettidia) richiardii (Ficalbi, 1889) and Uranotaenia (Pseudoficalbia) unguiculata Edwards, 1913 were collected and identified. In this investigation,the second species was recorded for the first time in Guilan province (Loshan, Roodbar district) as larva. New data were provided about the distribution of Cq.richiardii in Guilan province and the second species was collected from Rezvanshahr and Lahijan districts for the first time and Some-e-Sara as female adults (in forest parts).Conclusion: The distribution, biology and ecology of the two species need more studies in Guilan province and Iran. The possible transmission of some arboviruses by Cq.richiardii can be taken into consideration.

Introduction: The main clinical application of the H-reflex is: evaluation of S1 nerve root such as radiculopathy. An attempt has been made to reduce the pathway over which H-reflex can be obtained in the hope for localizing a lesion to the S1 nerve root; So S1 central loop has been suggested. Objective: The main goal of this investigation is to estimate H-reflex number of synapses. Materials and Methods: 40 healthy adult volunteers (26 males, 14 females) with mean age of (37.7) years participated in this study. They were positioned comfortably in the prone, with the feet off the edge of the plinth. Recording electrodes were positioned at mid point of a line connecting the mid popliteal crease to the proximal flare of the medial malleolus. Stimulation was applied at tibial nerve in popliteal fossa and H& F& M waves were recorded. Without any change in location of recording electrodes, a monopolar needle was inserted as cathode at a point 1cm medial to the posterior superior iliac spine, perpendicular to the frontal plane. The anode electrode was placed over the anterior superior iliac spine, then M & H waves of central loop were recorded. After processing the data, sacral cord conduction delay was determined by this formula:Sacral cord conduction delay = central loop of H-reflex - delays of the proximal motor & sensory fibers in central loop. Results: Central loop of H- reflex was: (6.77±0.28) ms and sacral cord conduction delay was: (1/09±0.06) ms. Conclusion: This study is in accord with previous investigations indicative of 1 synapse at S1 cord level for H-reflex.

Introduction: Cryptosporidiosis is one of the problems in patients receiving immunosuppressive drugs. Objectives: Considering the presence of broad range of clinical manifestations in such patients, following secondary infections, longevity of patients, the new methods of treatment and prevention, are continually changing. Hence, the aim of this study was to determine Cryptosporidium parvum in 100 patients receiving immunosuppressive drugs considered as the test group and another 100 patients with gastroenteritis but non-immunosuppressive drugs users as the control. Materials and Methods: In this case-control survey in Babol Amircola Children Hospital in Babol, 100 patients as test and 100 patients as control after being matched for sex, age, geographic conditions of the residing places (rural and urban areas) were studied. All the data concerning the patients such as age, sex, the kind of disease, the kind of drug used, the doses being used, contact with animals, the kind of drinking water, duration of chemotherapy and other clinical symptoms were obtained by questionnaire. From the test and control groups, stool samples were collected three times, and were stained by Ziehl- Neelsen and modified Ziehl- Neelsen methods. The results were analyzed statistically.Results: The results of the study indicated that the rates of infection in test and control groups were 5 % and 6% respectively. The average infection rate was (5.5 %). There was no statistically significant difference in the rate of infection between test and control groups (Z= 0.3). The highest rate of infection was observed in the age groups of 4-6 years and 6-8 years in the test and control groups, respectively. There was no significant difference between sex and the rate of infection. The highest rate of infection was observed in patients with acute lymphatic leukemia. The number of drugs used had no effect on the rate of infection. Conclusion: The results of this study indicate that more accurate laboratory diagnostic methods for this parasite and more individuals with normal and suppressed immune system are required.

Introduction: Breast Feeding is known as the best way of nutrition for newborns in the world wide according to many studies about the best way of nutrition for children. Objective: The aim of this investigation is to consider the knowledge and attitude of mothers who attended Lahijan Urban Health Centers (UHC) during one year after delivery about breast feedings benefits for infants.Materials and Methods: This research is a descriptive study which has been done with quantitative and qualitative method in between 2001- 2002. Data were collected through direct interview and aquestionaires. The research community consisted of all mothers presenting to Lahijan urban health centers during one year after delivery. Of these, 120 mothers were selected by classified randomized sampling method.Results: According to present study, most of the samples were in the range of 21-30 years old (57.5%). The majority of them were under diploma (48.3%) and with diploma (40.0%). Housewives (90.8%), had 1-2 children (84.2%). Method of nutrition for present infants was mother's breast milk alone in the most of samples (86.7%). Most of them were informed about breast feeding (87.5%). Resource of information was collection of different resources. (62.9%) Actually, most of the samples had low knowledge (50.8%) and negative attitudes (57.5%) about the subject in question. Statistically significant difference was observed between the level of knowledge and attitudes of samples (p<0/0001).Conclusion: Analysis results of present investigation showed that generally most of the mothers had knowledge and attitude about the topic of study. Therefore, our suggestions are to increase the mother's knowledge and attitudes through mass media and to hold training classes in Urban Health Centers.

Introduction: Zinc has important effects on structural and functional activities of many proteins and enzymes, especially in regulation of immune system. Objective: This study was carried out to examine the in vitro effects of different concentrations of Zinc on viability and morphology of T-Lymphoid (Molt-4) and B-Lymphoid (Raji) cell line. Materials and Methods: In this study, the cell line was exposed to different concentrations of Zinc (100 µM to 500 µM) followed by incubation (37°C, 5%Co2) at various time points (12 to 72 hrs). The cells were then evaluated with trypan blue exclusion dye ، and Wright-Gimsa staining.Results: The results of this study showed almost different responses to different amounts of Zinc by the T and B cell line. Concentrations less than 100 µM of Zinc at different incubation time points had little to no effects on cell line when compared to the controls. Higher concentrations of Zinc (>100 µM) diminished cell viability to 70% at 12 hrs and less than 50% at 24 to 72 hrs of incubation times.Conclusion: We concluded that Zinc shows cytotoxic effects (Raji & Molt-4) depending on the concentrations used. At higher concentrations, it exerts cytotoxic effects.

Introduction: Legionella species are ubiquitous in both natural and man - made water systems. These organisms spread by the inhalation or aspiration of aerosolized organisms arising from water sources such as: rivers, hot springs, air conditioning systems, cooling towers and pools. Objective: In order to isolate and identify Legionella in therapeutic equipments and the other water sources, in Ahwaz city (Iran). Materials and Methods: 210 samples collected from different sources, such as neonatal incubators, dental units, water bathes, cooling towers, drinking water reservoirs, hot water taps or showers and little pools in parks , were examined. Sediment of water samples were inoculated onto selective and non-selective media such as BCYE, BMPA and MWY, before and after acidic treatment with Kcl- Hcl buffer. Isolated colonies which were suspicious of Legionella, were examined by different biochemical tests. Results: This study resulted in isolation of 14 strains (6.6%) of Legionella, which 9 strains (64.3%) were identified as Legionella pneumophila and 5 strains (35.7%) as Legionella Spp by biochemical tests. The greatest contaminated sources were dental units (with 19 %) and the lowest ones (2.9%) were hot water taps and showers. 2 strains of Legionella were isolated from each of examined sources, such as water bathes, hospital cooling towers and neonatal incubators. Conclusion: The results of this study showed that therapeutic equipments and different water sources such as drinking water reservoirs, were contaminated by Legionella and so, for recognition of the patients with Legionnaires disease and determination of different serogroups of Legionella, further epidemiological investigations in this regard are recommended.

Introduction: Different conventional markers for prediction of the presence of spermatozoa in azoospermic men have been investigated.Objective: A reliable marker for prediction of the presence of germinal epithelium in testes from azoospermic patients is of utmost importance in planning treatment in the ARTs era. The objective of this study has been the assessment of sensitivity and specificity of serum inhibin B levels as an indicator of the presence of testicular spermatozoa in azoospermic infertile men and the comparison of its sensitivity and specificity with the traditional serum FSH marker.Materials and Methods: This study was performed between 11 October 2002 and 9 October 2003 in the urology clinic of Razi University Hospital in Rasht. 45 infertile men including 33 azoospermic patients and 12 men with previous history of vasectomy were studied.After history taking and physical examination, hormonal evaluation including FSH, LH, inhibin B, and scrotal ultrasonography for the assessment of the size of testes, and then bilateral testicular biopsies were performed in azoospermic men. Statistical comparisons between groups were made with one-way ANOVA by SPSS 9 software.Results: The results of our study showed that patients with nonobstructive azoospermia have significantly higher levels of serum FSH (16.14±14.09 IU/ml vs. 5.04±6.49 IU/ml) and significantly lower levels of inhibin B (80.2±23.9 pg/ml vs. 225.42±86.3 pg/ml). This difference was more significant for inhibin B (p<0.001 vs. P=0.01). Mean serum inhibin B levels were significantly higher in patients with nonobstructive azoospermia (high serum FSH & small size testes) who had spermatozoa on TESE than in those in whom no spermatozoa were found (215.53±55.19 pg/ml vs. 79.54 ± 26.68 pg/ml), but mean serum FSH levels did not have similar predictive power (26.4±13.9 IU/ml vs. 17.8±8.2 IU/ml).The cut-off level of inhibin B separating both groups, as determined by ROC curves, was > 133.4 pg/ml (sensitivity=100% & specificity=94.4%).Conclusion: Serum inhibin B level seems to be more accurate than serum FSH level in prediction of the presence of testicular spermatozoa in patients with nonobstructive azoospermia.

Introduction: The burden of psychiatric disorders in the developed countries has been identified by the screening questionnaires and standard clinical interviews at a high level, but the epidemiological studies on psychiatric disorders in our country are limited and their numbers are few. Planning for providing essential mental health services for people requires us to be knowledgeable about the present status of psychiatric disorders in the society. Objective: The objective of this research was to carry out the epidemiological study of the psychiatric disorders in the individuals 18 years and above in urban and rural areas of Guilan province. Materials and Methods: 925 individuals were selected through randomized cluster and systematic sampling methods from the existing families of Guilan province and questionnaires of Schedule for Affective Disorders and Schizophrenia (SADS) were completed by the clinical psychologists. The diagnosis of the disorders was based on DSM-IV classification criteria.Results: The results of the study showed that the prevalence of psychiatric disorders in the province is 15.78 percent which was 22.77 percent in the women and 8.57 percent in the men. The anxiety and mood disorders respectively with 8.32 and 4.12 percent had the higher prevalence in the province. The prevalence of psychotic disorders in this study was 0.32 percent, neuro-cognitive disorders 2.59 percent and dissociative disorders 0.43 percent. In the group of mood disorders, major depression with 3.03 percent and in the group of anxiety disorders, obsessive-compulsive disorder with 2.81 percent had the higher prevalence. The prevalence rates of psychiatric disorders in the province among the individuals in the age group of 41-55 years with 12.50 percent, divorced or separated individuals 25 percent, residents of province 13.39 percent, individuals with primary school education 16.23 percent and housewives 16.40 percent were more than other individuals in the sample.Conclusion: This study showed that at least 10 percent of individuals older than 18 years that were studied suffered from minimum one of the psychiatric disorders. Being aware of this matter reveals the responsibility of the health policy makers and programmers for prevention, treatment and medical education more than before in relation to preparing applied and executive plans in Guilan province for mental health. Although the validity and reliability of SADS for screening and diagnosis were shown in the pilot study, we suggest that another study should be conducted with a greater sample size for the assessment of validity and reliability of SADS for the diagnosis of psychiatric disorders.

Introduction: VEP is a diagnostic test, especially for multiple sclerosis and optic neuritis. Objective: This survey was carried out to determine the influence of age, sex, dominant eye and technical factor on the mean P100 latency values of VEP in Rasht Poorsina Hospital.Materials and Methods: 66 females (18-65 years old) and 66 males (18-65 years old) who had specific characteristics of normal subjects, were selected. Visual stimulation was given by Medelec monitor 25004, with visual angle 15 degree. After 118 stimuli to each eye separately, with frequency of 2 HZ,. the results were registered.The collected data were analysed with spss software and t-test and variance analysis and post Hoc method were used for evaluation of mean value differences. The significance level was 0.05.Results: Mean p100 latency was 100.75±6.99 msec in all, 99.64±6.56 msec in females and 101.86±7.24 msec in males (P=0.01)Mean P100 latency was 100.73±6.7 msec in right eyes and 100.77±7.2 msec in left eyes, and 100.75 msec in all (P=0.959).Intraocular P100 latency difference was 2.4±2.2 msec in all persons, 2.2±2.4 in females and 2.6 ±1.9 in males (P=0.041)Mean P100 latency was 97.96±10.1 in subjects less than 20 years old and 101.65 ±7.41 ms in 20-30 years old and 99.97±6.65 msec in 30-40 years old and 100.41±6.01 msec in 40-50 years old and 101.01± 6.76 msec in 50-60 years and 107.17±4.95 ms in >60 years old. (P=0.004)Conclusion: In spite of the maximum mean P100 latency in our study subjects which was in normal range, mean P100 latency in each sex and mean P100 latency difference between two eyes and mean P100 latency in 60-65 years old were significantly different from reference books. Thus, we recommend that for precise interpretation of electrophysiologic data, each laboratory should obtain and use its normal values separately.

Introduction: Over the past two decades, the routine use of maternal-fetal ultrasound has spawned the field of prenatal nephrology and urology. The most common entity studied is prenatal hydronephrosis. Which is diagnosed with an incidence of 1:100 to 1:500.Objectives: In this study, the postnatal diagnoses of 21 patients with prenatal hydronephrosis were investigated.Materials and Methods: In this study, postnatal results of the prenatal hydronephrosis that were reported in the second trimester of pregnancy were discussed. For the child with bilateral hydronephrosis, an ultrasound examination was performed immediately after birth and if the bilateral hydronephrosis suggestive of bladder outlet obstruction a VCUG was performed before discharge of hospital. The child with unilateral hydronephrosis was treated with prophylactic antibiotic and then an ultrasound examination was performed at 4 weeks of age. If the ultrasound at 4 week demonstrated moderate or severe hydronephrosis a VCUG and DTPA scan were performed.Results: Twenty-one neonates and infants were investigated. Boys were more commonly affected than girls (ratio2:1). In sixteen cases, hydronephrosis was unilateral and in five patients, hydronephrosis was unilateral. In patients with bilateral hydronephrosis, two patients had posterior urethral valve and in one case, multicystic displastic kidney with reflux of opposite kidney was seen. One patient had bilateral partial obstruction in urethropelvic junction. Other patient had ipsilateral UPJO with UVJO in opposite kidney. In patients with unilateral hydronephrosis, 11 patients had UPJ obstruction. Multicystic dysplastic kidney was seen in two patients and reflux in two other patients and UVJO was seen in one patient. At last, 5 patients underwent surgical procedure due to decline of renal function and thinning of renal cortex in serial scan and sonography.Conclusion: Neonates with prenatal hydronephrosis should be carefully evaluated and followed by a pediatric nephrologist and urologist. Although upj obstruction is the most common cause of hydronephrosis in children but voiding cystography in these patients is necessary. These patients require close follow up to ensure that renal function and development are not affected.

Introduction: Root canal preparation is one of the most important stages of endodontic treatment. It seems that rotary NiTi files are efficient instruments in root canal preparation. Objective: This in vitro study was designed to assess the degree of canal transportation, resulting from instrumentation by a new rotary system (protaper) and to compare it with rotary profile 0.04 taper series 29 system and hand K- flexofiles in a Step- back manner.Materials and Methods: Thirty six mesiobuccal canals of extracted human mandibular molars were instrumented in three groups by each of these methods respectively. Rotary systems were used in a crown- down manner according to the manufactures instruction, and stainless steel K- flexofiles were used in a conventional step- back method. Pre- and postoperative X- rays were taken, projected and degree of canal curvature was determined according to the schneider method. The difference of pre- and postoperative canal curvature was evaluated with ANOVA and student tests.Results: The results of statistical analysis indicated that the degree of canal transportion in protaper group was statistically less than that in K- flexofile group that this difference was statistically significant(P<0.0001). There was no significant difference between two rotary groups (P<0.05).Conclusion: On basis of the results obtained from this study, profile 0.04 taper and protaper systems were significantly less likely to change the canal curvature in comparison to stainless K- flexofiles, lie, the former methods compared to the latter one have better capabilities in maintaining the original shape of root canal.