Journal of Guilan University of Medical Sciences
Year:2005 | Volume:14 | Issue:53|Papers Count:13

Introduction: Yersinia is a gram negative bacteria and member of the family enterobactericeae. Pathogenic Y.enterocoliticace is significant cause of human disease in many parts of the world.Objective: Three objectives were followed in this study: 1) determined ability of different media in pure growth of yersinia strains, 2) determine the ability of different media in suppression of fecal flora and 3) assessing the ability of these medias in recovery of yersinia from experimentally inoculated stool specimens.Materials and methods: This study contains three phases that at the first phase 42 suspensions of pure yersinia strains inoculated to CIN agar, Mac conkey agar (MAc). Cellobiose, Arginia, lysine Agar (CAl), yersinia selective Agar (YSA), Hekton Entric Agar (HEk) and blood Agar (BA), then recovery rate was compared with BA. At the second phase 20 suspensions of stool specimens without diarrhea was inoculated on above medias and its suppression rate was compared with BA. At the third phase suspension of mixed stool from phase two was diluted with 10-2 and 10-7 and 31 yersinia stains and two dilution rate of 103 and 104 Cfu/ml was added and rate of yersinia was compared with CIN agar.Results: At the first phase, maximum mean growth of pure culture yersinia strains belonged to CIN (89.5%) & minimum growth was on Hek (45.7%). At the second phase, maximum suppression rate belonged to CIN (88.2%) & minimum was MAC (9%) and at the third phase maximum recovery rate was on CAL (47.2%) and minimum was on HEk(20.2% & 24.1%) and MAC(17.7% & 21.4%). Conclusion: Statistical calculation and Bonferroni test indicated that CIN agar compared with other four medias is a highly selective and differential medium with high sensitivity.  Our results indicated that fecal flora decreases recovery of enteric pathogens from stool specially Y. enterocalitica and use of high selective medium in laboratory significantly increases isolation of Y.enterocolifica and Y.enterocolitica -like species from multibacteria specimens like stool.

Introduction:  Proper intervention of family planning needs informed, active and volunteered cooperation of all people and families. Such cooperation can only be insured through education.Objective: The aim of this study was to assess the educational needs of women referring for birth delivery to Al-zahra Educational center regarding family planning methods in 2002.Materials and Methods: The sample consisted of 285 pregnant women who were randomly chosen on even days in postpartum unit. Data was collected through a questionnaire, which was used to determine its validity and reliability. Results: The mean age was 26.7 years, with 2.2 pregnancies, 2.1 deliveries, and 6.9 years of married life. From all samples 55.1% lived in cities and 57.7% were illiterates or had elementary schooling and only 3.2% had education higher than high school. 61.8% of samples had information about contraceptives and 56.1% of them received this information from health centers and only 1.4% mentioned TV as their source of information.  And 27.7% of samples had low level of information about natural methods of contraception and 10.2% had efficient level of information which indicated that 89.8% need information at a moderate to high level. In regard to hormonal contraceptives, 41.8% had needed information and only 9.8% had little information that needs more education. In relation to their knowledge level about surgical methods, 18.2% had low-level Knowledge who needs more education and 62.8% had moderate to high level of knowledge regarding barriers.The findings also showed that there is a significant correlation between education level, knowledge, number of pregnancy and delivery, years of marriage and knowledge needs (P<0.02). Conclusion: Increasing the knowledge level of people about family planning is essential and can play an important role in preventing and decreasing economic and social problems.

Introduction: Previous studies indicated that vasopressin as a neurotransmitter can have a role in modulation of anxiety reactions. Objective: The present study was designed to evaluate the role of vasopressin as a neurotransmitter on the fear and anxiety in plus maze model. Materials and Methods: Male albino mice (mean weight of 25-30 g) were used for these experiments. First animals were randomly divided into three control and experimental groups. Then 5-10 μg/kg vasopressin was administered to experimental group and same amount of normal saline was given to control group ten minutes before the experiment.  And in order to increase their movement and curiosity, they were put inside the black wall box for 5 min. Then animals were transferred to the Plus Maze and evaluated their anxiety reaction through observing the standard index of anxiety assessment.Results: Results indicated that injection of vasopressin in both doses reduced anxiety reaction as compared to saline group and in the test group animals have more number of entrances and spent more time in open arm (P<0.01).Conclusion: The above results show that vasopressin plays an important role in reduction of anxiety in Plus Maze model.  

Introduction: The incidence of tuberculosis among patients with chronic renal disorders and under hemodialysis is sixteen times more as compared to other individuals of the society and the findings of tuberculin skin test in this group were negative in 30-40% of cases. To ascertain the immunity status of the above patients is helpful in analyzing the status of tuberculosis infection.Objective: This research has been undertaken to evaluate the status of tuberculin test and the phenomenon of remembering as well as to evaluate the skin anergy among the patients of chronic hemodialysis.Materials and Methods: The method of research is descriptive and its data collection tool was interview and observation. Forty-three hemodialysis patients from Taleghani and Modares hospitals were subjected to tuberculin skin test and anergy. Skin test with the use of tetanus and diphtheria toxoid solution was carried out on the hand without fistula within a 10 CM distance. The result was announced after 48-72 hours. Those patients whose tuberculin skin test was less than 10 mm were subjected once again to PPD. Results: The average age of the patients under study was 56.6± 5.7. The time of dialysis was 54.2 ± 67.1 months and the instances of dialysis were 2.9 ± 0.3 times per week. First PPD induration was 7.1 ± 4 and 16.3 % of test findings were negative (<5 mm) and 53.5 % had induration measurement of 5- 10 mm and 30.2 % had positive result of more than 10 mm. There was a weak correlation between the findings of first PPD and age, which was statistically insignificant.There was not significant correlation between the findings of first PPD and tuberculosis precedence. There was a weak correlation between the time of dialysis and the first time PPD measurement, which was statistically insignificant. Induration measurement of anergy test was 3.9 ± 2.8; the result of this test was negative (<2 mm) in 18.6% of the patients. 83.3% of the patients with the result of less than 10 mm on the first PPD test were positive on anergy test, 28.6 % of patients had negative results for both tests of anergy and first PPD. The indurations balance of second PPD was 7.4 ± 2.8 mm and 2 patients (4.6 %) out of the total patients had result of less than 5 mm on first and second tuberculin test and showed the result of less than 2 mm on the anergy test.Conclusion: In attention to 14% of cases with negative results on anergy test who showed positive result on tuberculin test, it’s suggested that PPD and Booster tests in combination with anergy tests can be better than using tuberculosis screening in hemodialysis patients.

Introduction: 2, 4, 6 trichlorophenol (TCP) is one of the most toxic Chlorophenols and is very difficult to biodegradation. Advanced oxidation processes (AOPs) are the most effective processes for the degradation of persistent compounds, since the mineralization of recalcitrant compound by AOPs often requires long reaction time and strong dose of oxidant, the combination of this process with biological one considered as one efficient and economic method.Objective: Integration of Fenton oxidation with activated sludge as an efficient and economic method for removal of 2, 4, 6 trichlorophenol and on kinetics of activated sludge in this integrated system was studied.Materials and Methods: This study performed in pilot scale of Fenton oxidation / Activated sludge Integration for treatment of 2-4-6 TCP wastewater and all analytical methods were according to 19Th edition of standard methods. Results: The study results showed that intermediates in effluent from Fenton reactor [H2O2] /[Fe2+] =3 , [H2O2] / [TCP] =3  Oxidation Time = 1hr  and   pH= 3  [TCP] 0 = 120 mg/  equal COD=150 mg/L), was degraded by activated sludge process and COD reduction was ~%75.  Increasing aeration time from 6 hr to 18 hr has no significant effect on removal efficiency (α =0.01). ML VSS increasing from 200 mg/L to 800 mg/L after 21 days indicated that TCP concentration in Fenton reactor effluent didn’t have inhibitory effect on microbial growth. Increasing of TCP concentration from 120mg/L to 240mg/L has no significant effect on removal efficiency, however removal efficiency decreases to %71. Activated sludge kinetics were studied and y= 0.66 mg/mg   Kd =0.088 day-1 Ks = 109 mg/ L, K = 2.04 day-1 determined.Conclusion: As results this integrated system was an efficient method for removal of 2,4, 6TCP and result from increasing aeration time and TCP concentration, as sole substrate source for Activated sludge combined with Fenton oxidation was not adopted with Monod equation.

Introduction: In different countries, different etiologic factors are considered to be responsible for acute pancreatitis. Objective: In this study we tried to determine the relative frequency of etiologic factors of acute pancreatitis in our patients.Materials and Methods: This study is a retrospective one and we studied all patients with documented acute Pancreatitis in Poursina and Razi Hospital. 185 patients were studied from1994-1999. Data were processed.Results: From 185 pt, 97(61%) were female and 61 were male (39%). The ratio of female to male was 1.59. Most patients were 41-50 years old. For 78pts (49%), the etiologic cause was unknown, (Idiopathic).Known causes included: Biliary stone (41%), Alcohol (3.3%), previous surgery (1.9%, and trauma (0.63%). Mortality rate was 13.3% (21pts) with highest rate in 61-70 year old age group. Diagnoses of 17 cases were revealed after explorative laparatomy.Conclusion: In this study in 49% of Pancreatitis, the etiologic causes weren’t known; in other studies 7-21% of Pancreatitis was idiopathic. It may be due to missing of other causes; the biliary stones were the most were the most cause of acute pancreatitis. This is different from other studies in American & European countries.

Introduction: Immobility refers to limitation of physical activity. If immobility continues for a long term can cause serious complications such as skin injuries that form pressure sore. A study conducted in USA reported the morbidity rate due to pressure sore in patients was 19% and an another study showed this rate in patients in orthopedic ward in Tehran was 25%.Objective: Since promoting the quality of care can prevent many immobility complications, therefore this descriptive study was performed. The purpose of this study was to determine quality of care in prevention of pressure sore. Materials and Methods: The tool of data collection had three sections including: predicting Braden Scale, demographic data form, check list for determining quality of care in prevention of pressure sore and quality of structures.Results: The results of study showed that in the majority of cases (87.1%) the performed care process for prevention of pressure sore was almost satisfactory. Findings also showed that quality of structure in this educational-therapeutic center, in the majority of cases (72.9%) was undesirable. Other findings indicated a statistically significant relationship between performed quality of care process and quality of structure (P<0.004, r=0.341)Conclusion: Quality of structure in the majority of cases was undesirable, this can affect on quality of care in prevention of pressure and it seems the managers’ knowledge can arise quality of care in that cent.

Introduction: The HSG is a noninvasive method for tubal assessment in infertile couple and is used as screening test, but laparoscopy is the “gold standard” of tubal disease diagnosis, but it is not used as screening test due to its invasiveness and it’s only used in special circumstances. Due to different results about concordance between these two methods, this study was undertaken.Objective: The aim of this study was to assess concordance between HSG and laparoscopy for tubal disease.Material and Methods: This is a prospective study and laparoscopy was done on 200 patients who underwent HSG for assessment of tubal disease from 1999-2002 in Alzahra hospital and then the sensitivity, specificity, positive predictive value and negative predictive value of HSG in tubal obstructive, hydrosalpinx and peritoneal adhesion was assessed. At last the concordance between two procedures was calculated.Results: The mean age was 28.5±5.1.The mean duration of infertility was 3.8±3.1 years. The results showed that the sensitivity and specificity of HSG in tubal obstruction and concordance with laparoscopy are 60%, 81% and 36% respectively. The sensitivity and specificity of HSG in hydrosalpinx and concordance with laparoscopy are 23%, 95% and 23% respectively. The sensitivity and specificity of HSG in peritoneal adhesions, endometriosis and concordance with laparoscopy are 37%, 79% and 17% respectively.Conclusion: Our results showed the HSG isn’t an accurate procedure for diagnosis of tubo-peritoneal pathology, It seems that not doing HSG by only one radiologist can intervene with the result because of different radiologist’s experience in taking film and reports of graphy, therefore it can lead to false interpretation. It’s suggested that another study for completing these results be carried out.

Introduction: The prevalence of allergic diseases has increased worldwide in last decades.Objective: This study is conducted to assess the severity and prevalence of the symptoms of allergic rhinitis among children of Rasht city from 2001-2002 and compare it with similar study conducted in 1993-1995.Materials and Methods:  Total of 6145 primary (6-7 years old) and guidance (13-14 years old) school students were randomly selected and studied. It was a descriptive study. The students responded to written questionnaire of Isaac (international study of asthma and allergy in childhood) protocol for 6-7 and 13-14 years olds. Data were collected and double entered and was analyzed with SPSS software.Result: A total 6060 questionnaires were collected and analyzed. In positive response to history of rhinitis 429 (14.3%) were 6-7 year olds and 822 (28.2%) were 12-13 year olds and the difference between two age groups was significant and also it was significantly higher in males. The prevalence of “recent rhinitis” and symptoms of). “Rhinoconjectivitis” was higher in guidance school children than elementary group (in all cases P<0.05). 191 elementary students (63% with rhinitis) and 316 guidance students (62% with rhinitis) stated limited daily activity due to rhinitis which was not statistically significant. Conclusion: Comparing the results obtained in this study with the similar study done in 1994-1995, the prevalence of symptoms of allergic rhinitis was higher in all students but its severity did not increase. It is suggested that further study to assess risk factors of this disease in this region to be conducted.

Introduction: Traumatic Brain Injury (TBI) is a major cause of morbidity and mortality. Each year 50000 deaths in the United States are associated with TBI, representing more than 33% of all injury –related deaths.Motor- Vehicle accidents are the major causes of TBI that its occurrence has been increasing in our country in recent years. Objective: We decided to study TBI in our region to evaluate the Epidemiological features of this health problem.Materials and Methods: In a six- month period in 2001, we reviewed TBI-patients records in Rasht Poorsina hospital and data such as age, sex, mechanisms of trauma and Radiological findings were collected. We staged the severity of trauma by Glasgow – Coma - Scale. Data were analyzed by SPSS software. We used Chi-Square test and P-Value less than 0.05 was considered significant.Results: From the total of 715 patients, 79.3% were males and 20.7% were females with a male to female ratio of 2.6 to 1. The most common age group was 15-24 years. Majority of patients were students. The most frequent mechanism of trauma was motor-vehicle accident. 89.7% of injuries were mild in severity. There was a significant relation between C.T Scan findings and severity of injuries. (P<0.0001) Isolated brain injury was seen in 71.6% of patients.Conclusion: This study showed that we should pay more attention to TBI in young patients who are the most active potential forces of our society.

Introduction: The success in parathyroid surgery depends on the preoperative localization of abnormal parathyroid glands. In primary hyperparathyroidism, Sestamibi scan successfully localizes the parathyroid adenoma.  By preoperative localization the duration of operation is reduced.Objective: The goal is to determine the impacts of preoperative sestamibi scan on the rate of success in the first exploration of neck and on the duration of operation in patients with primary hyperparathyroidism.Materials and Methods: In a retrospective study the medical records of 28 patients with primary hyperparathyroidism who underwent parathyroidectomy during last 5 years (2000-2004) are reviewed.Results: In 26 (92.8% of) patients the adenomas were at the same sites where were localized by the sestamibi scan. In one patient the adenoma was embedded in a thyroid nodul, and in another patient, the adenoma was ectopically located in the upper mediastinum. The duration of operation was 63±minutes. There was no serious complication.Conclusion: By preoperative localization of the abnormal parathyroid glands in first exploration for primary hyperparathyroidism, the abnormal gland can be resected successfully in shorter duration.

Lumbar hernia is one of the rare hernias. It occurs through parietal abdominal wall defect at the lumbar triangles. The most common site of herniation is inferior lumbar triangle (petit). Up to now only 300 lumbar hernias have been reported in the literature. In this article the author reports another rare interesting case of posttraumatic lumbar hernia following harvesting a bone graft from iliac crest.  In this case patient is a 60years old Farmer man who sustained cervical spine fracture due to blunt trauma. A colleague with iliac bone graft operated him. After 2 years he developed an abdominal mass associated with intermittent pain at the left flank region. Clinical investigation confirmed inferior Lumbar hernia (petit) that was repaired by prolen mash successfully. After one year follow up there was no complication or recurrence.