Journal of Mazandaran University of Medical Sciences
Year:2003 | Volume:13 | Issue:38|Papers Count:15

Background and purpose: Considering different reports on hazardous of commercial antioxidant, In the recent years, researches have been focused on preparation of more effective and safer antioxidant from natural resources. Hydroquinone is a brightener compound which is used for brightening hyperpigmented region and used in cosmetic preparations. This chemical compound has poor stability, and quickly turned to brown colour in oxidation. In this study, antioxidative metanolic effect of licorice extract in comparison with commercial anti oxidants was evaluated.Materials and methods: Extraction of dried root powder of licorice was performed in methanol. Antioxidative property of the extract was compared with commercial antioxidants hydroxytoluene BHT. 0.1% hydroquinone cream compounds containing antioxidant, and our extracted material were incubated in dark at 25°c±0.5 and 45°c±0.5 for three mooths. Physical stability and percentage of hydoguinone remaining after 2 weeks and 1, 2 and 3 months were determined by UV spectrophotomerty at 294 nm wave length.Results: Results of this study indicated acceleration in deterioration of hydroquinone, by increase in temperature. Increasing in concentration of antioxidant caused increase in percentage of remaining hydroquinone, but increase in concentration of commercial antioxidant, particulary sodium metabisulfite by 1% and BUT by 2% caused decline in physical stability of the compound. In the third month, at 25oc and 45oc, the extracted material in all of the above mentioned concentrations, had more antioxidative property as compared with commercial antioxidants (P<0.001). In the third month, the preparation contaning 0.1% 0.5%, 1% and 2% had good physical stability Compared with 72%, 76%, 78% and 81% hydroquinone kept at 25°c and 51%, 55%, 60% and 63% hydroquinone kept at 45°c respectively.Conclusion: referring to the findings of this study, it is proposed that, using of the licorice extract with concentrations of 0.5% and 1% as natural antioxidant be used in compounds sensitive to oxidation.

Background and purpose: Rheumatiod arthritis (RA) is one of systemic autoimmune disease. In this disease, autoimmune antibodies are discovered, which have diagnostic and prognostic properties. One of them is APF, that can react with keratohyalin granules of buccal mucosal cell. Therefore, at first APF-IFA kit was designed and then antibody titer (Ab) was evaluated in RA patients.Materials and methods: Designing of kit was as follow: 1- Identification of satisfactory donors. 2- Antigenic substrate preparation. 3- Improvement of method and quality control.The method is based on the binding of APF to Perinuclear Keratohyaline line granules of buccal mocusal cells and its detection with total Anti Human Globulin (AHG) conjugated to FITC. After calibration of AHG, APF assayed in sera dilution of 1/5 , 1/10 to 1/1280 in three RA patients (52 RA patients mean age 48.0 ± 15.8), 23 sera of patient control groups (Mean age 32.5 ± 16.4) and 30 sera of healthy control group (mean age 32.1 ± 16.9).Results: From total of 52 RA patients (71.2%) were APF positive, in 2(8.7%) cases and in healthy control group 1(3.3%) case were APF positive.The designed APF kit had 98% accuracy by inter and intra assay methods. Sensitivity and specificity of APF in serum dilution was 71.2% and 94.3% respectively.Conclusion: According to the results of this study, 1/5 serum dilution has best diagnostic value for RA for best sensitivity and specificity, that means, 1/5 as a cut off, or significant minimum dilution in diagnosis and approving of RA, and considering 98% accuracy of designed kit, APF-IFA assay has medium diagnosis and high approving property for RA patients. Also Comparison between different groups under investigation showed that there is significant relationship between concentration of APF and Severity of disease.

Background and purpose: Formaldehyde is colorless gaseous material with strong and irritant odour. It is mainly used as a disinfectant agent in medical and health Service centers, and according to reported data, there is high rate of exposure to this material. Its acute and chronic effects such as, irritation on skin, eyes and respiratory system has been reported. There are data indicating its pulmonary carcinogenic properties in laboratory animals. Long term inhalation of formaldehyde is efficiently threathening and causes reduction in repiratory capacity. Considering the sensitivity and hygienic aspects of exposure in hospital wards, this study was performed.Materials and methods: NIOSH-3500 method was selected for this study. With the help of personal sampler pump connected to impenger, containing absorbant solution sample. Collection was done. Assay was done with the help of DR-2000 spectrophotometer. Also questionnaire containing question about response of individuals exposed to gas was prepared and given to the individuals under study.Results: The mean concentration of formaldehyde in governmental pathologic laboratories and operation room was 0.62±o.44 and 0.40±0.05 ppm respectively which are higher compared to the private hospitals 0.44±0.26 and 0.29±0.12 ppm. The highest rate of pollutant was observed in governmental pathologic laboratories and the less in private hospitals pediatrics ward, CCU and ICU of governmental hospitals.Conclusion: Results of this study indicated that, the mean concentration of formaldehyde in the pathalogic laboratory and operation room is higher than the recommended standard level of 0.3 ppm. The obtained results from analysing of the data indicated that, those exposed to formaldehyde have problems of caughing and burning, itching of throat and nose. There is significant statistical differance between private and governmental hospitals. In order to improve the health of working staff and prevent formaldehyde hazardous, dicisions to improve the hygienic condition, specially in pathologic laboratories which are exposed to pollutant air is recommended.

Background and purpose: DCM is the major cause of heart failure. No definite treatment has been found so for. Aim of this research is to evaluate the effect of atenolol on clinical and cardiographic improvement as an alternative in patients suffering from DCM, so, to provide an appropriate method of treatment for those patients cardiac transplantation is indicated as main treatment transplantation. Cardiac transplantation is less possible in Iran, because of being expensive, advanced technique and non availability of proper donor.Materials and methods: In this double-blind clinical trial, 23 patients with DCM (both ischemic and idiopatic), referring to Imam khomeini hospital in sari were selected randomly and divided in to two groups (12 for case and 11 for control), matched for age, sex, FC (NYHA), LVEF, and lack of presence of associated diseases. At first FC (based on NYHA) and echocardiographic parameters such as Left ventricular ejection fraction (LVEF), Left ventricular end diastolic dimention (LVEDD), Left ventricular end systollic dimention (LVESD), Left ventricular posterior wall dimention (LVPWD), Intra ventricular septal dimention (IVSD), E point septal separation (EPSS) were measured. Then previouse drugs like digoxin, ACEIs, diuretics, aspirin, and nitrates were administered to both groups. In addition atenolol, 25-50 mg daily, was administered to the case group. Each patient was followed for 3 months and at the end, the above mentioned parameters were measured again. Howerer, 4 patients (one of case group and three of control), were excluded from the study.Results: Analysis of the collected data showed that, EPSS and LVEF were changed significantly in the case group, as Compared to the control group (EPSS from 22 mm to 17.7 mm and LVEF from 27.7% to 32.9%), (P<0.02 and P<0.05), but there was no significant changes in the other parameters. Conclusion: Using atenolol in treatment of DCM for 3 months will improve some echocardiographic parameters (LVEF, EPSS) and cardic function, but will not improve significantly FC and functional capacity of the patients.

Background and purpose: Though burn wound infections have been extensively studied, but other nosocomial infections in burn patients have received less attention. Invasive diagnostic procedures (vascular and bladder catheterization) make the burn patients more susceptible to different nosocomial infections. The aim of this study was to determine the incidence rates of blood stream and urinary tract infections associated with IV line and urinary catheter in Ghotbeddin burn center and also to compare these rates with those of the National Nosocomial Infections Surveillance System (NNIS) in the U.S.A.Materials and methods: This study was conducted for 11 months, from 21st December 2000 to 21st November 2001. All the patients admitted for more than 48 hours without evidence of infection at the time of admission were included in this study. For diagnosis of urinary tract and blood stream infections, the standard definitions of the Center for Diseases Control (CDC) were used.Results: Of 106 eligible patients under study, 91 acquired different nosocomial infections (85.85%). Urinary catheter-associated urinary tract infection (UC-UTI) rate was 30 per 1000 urinary catheter days and IV line associated blood stream infection (IV line-BSI) rate was 17 per 1000 IV line days.Conclusion: Comparison of incidence rates of UC-UTI and IV line-BSI in Ghotbeddin hospital and NNIS showed that, rate of infection is more in Ghotbeddin hospital (P<0.001) while device utilization ratio (urinary catheter and central line) was more in the NNIS hospitals (P<0.001). In order to reduce the rate of infection, education, development of standardized guidelines for the use of invasive devices and introduction of a nosocomial infections surveillance system are necessary.

Background and purpose: There are different etiological agents of lower respiratory tract infections in children. Rate of their role is based on the age of patients, season, geographical areas and the used diagnostic methods. Aim of this study is to determine rate of infections causecl by these viruses in the patients admitted for lower respiratory tract infection Materials and methods: Children of 1 month to 10 years of age, infected with lower respiratory tract infection, admitted in Boali sina and Amir kola hospitals were studied for the presence of adenovirus and parainfluenza viruses. Indirect Immunofluorescent method was used to study the pharyngeal and nasopharyngeal discharges. Then their relationship with clinical, laboratory and radiological findings were analyzed.Results: During 7 months period of this study (March to September), 150 children with age ranges of 1 month to 8 years were admitted. 60 viruses were isolated from 56 patients (in 4 cases, two viruses together). The rates of isolated viruses were as follow: parainfluenza virus type 3 18%, type 1 and 2 8% and 7.3% respectively, and adenovirus 6.7%. Children under 2 years had the highest rate of infection and consisted 70% of all patients. Conclusion: The above mentioned viruses, play very important role in respiratory tract infection in children. The role of viruses, bacterial agents and their relation with different clinical, laboratory and radioloagical findings be studied for years to come is recommended, in order to clear the relation between various agents and clinical syndromes, so, to be able to have proper treatment program for the area.

Background and purpose: Since mite contamination is one of main skin infections and is also known as, one of the indicators, in measuring the level of hygiene in a society, a study was contucted in order to study the presence of mite in the primary school students of sari city.Materials and methods: After necessary coordination with the education and training office, from total number of 90 primary schools, seperated as girls and boys. 35 schools were selected randomly after cluster grouping. Considering the results obtained from variables test, it was shown that, presence of trainer, parent's level of education, father's profession, common usage of personal belongings and observation of personal hygiene has important role in the rate of contamination in the school students. After brief explanation about mite disease for them, the students with itching problem were identified, and sampling was done from them. After observation of ovum, nanf or matured mite and/or mite skin, the students were considered as positive case and questionnair contaning variables such as, parents profession and education, using of private belongings and observing of personal hygiene, was filled with the help of school authorities and the students themselves. The collected data were analyzed statistically after coding, and the obtained results were compared by X2 and Z tests methods. Results: In this study, 10737 students were under investigation, of which 225(2.09%) were mite Contaminated and, showing relatively the same rate of infection in the girl and boy schools. From statisticad point of view, there was significant difference between infection and variables such as, having health trainer, father's profession, parent's level of education, common usage of belongings and, personal hygiene observation.Conclusion: Considering the obtained results, it was clear that the prevalence of mite contamination in the students under study is 2.09%.

Background and purpose: Considering the role of mite in causing severe allergic reactions in sensitive individuals, particularly women, a study was done to determine the effects of mites in residents of sari township in 1999-2000Materials and methods: This was a desciptive study done on the residens in sari. Sampling was done randomly in 80 residential places. Samples were collected from mattresses, pillows and carpets by vacume cleaner collected material was kept in a plastic bag and sent to the laboratory. 200 mgs of dust particles were placed in a petridish and observed under minocular considering the anti light property of mites, they remained under the layer of dust and were picked up by an entomology needle and kept in 70% alcohol. Lighting of sample, neutraliztion and finally assembling were done in hoyer solution for identification after mounting. All the data about the mites were recorded in a questionnair and analyzed statistically. Results: In this study, 3400 mites were hunted and 5 species could be identified as follows: D. Pteronyssinus, D. farinae, Glycyphagus domesticus, E. moynei and Cheylatus malayensis. Considering the identified species, it was cleared that, 30 houses (37.5%) were infected by one or more species of mites, also it was noticed that, 15% of houses had more than 300 mites.Conclusion: The result of this study showed that contamination rate of house with mites contaning dust was 37.5%. Considering the fact that E. mayei, D. pteronyssinus and D. farinae play an important role in severe allergies, and 15% of these houses had the density of more than 300 mites, this could have a complete correlation with symptoms of bronchial asthma.

Background and purpose: Since Panic attack is associated with some sotamic symptoms such as, tachycardia, heart beat, dyspenea etc. Generally panic attack makes patients refer to hospital. On this basis, in this Study, prevalence rate of panic disorder, rate of anxiety in the patients under pulmonary performance test referring to Imam khomeini hospital of sari were studied in 2000.Materials and methods: This was a descriptive cross- sectional study, done on the Patients referring to spirometry center. Questionnaires of demographic spilbergers anxiety and panic attack were of SADS series.Results: Obtained results of this study show that, 58(50.42%) of the referring patients have experienced panic attack from the view point of pulmonary disease. There was no significant difference between the patients with and without panic attack experience. But the result of spirometry in 67.3% of the patients had concordant with chronic obstructive pulmonary disease (copd) of which 48.98% had obstructive view. On the basis of severity of anxiety and individual self assessment on anxiety, there was statically significant difference between patients with and without attack panic attack. It was clear that patients referring for spirometry have high rate of anxiety.Conclusion: Results of this study showed high prevalence of panic attack in the patients referring for spirometry, particulary those patients with COPD. Also it was clear that the rate of anxiety is high. Therefore, it is recommended that, patients with pulmonary symptoms referring to medical centers be considered for panic attack, in order to be diagnosed in the early stages and undergo for proper treatment.

Background and purpose: Miliary tuberculosis to due BCG vaccination is very rare and threatening, which occurs generally in immunocompromised patients. Aim of this study is to determine clinical feature, radiologic, laboratory, predisposing factor and factors related to prognosis of such patients in order of prompt diagnosis and proper treatment.Materials and methods: As being of a rare disease, the study was retrospective, by reviewing of patients files. All the children diagnosed with miliary disease caused by BCG vaccination and were discharged from hospital or expired during 1997-2001 were under our study. Of 11 patients diagnosed with the above problem, 8 of them who had complete and proper file were selected, data were collected in questionnaire and statistical analysis was performed.Results: Five boys and 3 girls with age range of 2.5 to 32 months (averange of 11 months) were under investigation. All the patients had regional lymphodenopathy and fistula containing prullent discharges at the time of referring and the mean incubation of this problem from the time of vaccination was about 10 weeks. All the patients had fever, and the other prevalent clinical symptoms were coughing, dyspnea, spreaded cutaneous lesions, enlargement of liver and bladder. Tuberculin test (PPD) in all patients was negative.In pulmonary radiography of all patients relicular opacity particularly near the region of mediastin was observable.Bone marrow aspiration was more helpful in diagnosis (positive culture for M. bovis or granulomatous lesions or caseous necrosis). All the patients had degree of immune defect, of which the most prevalents were lymphadenopathy and T-helper cells defficiency, loac of natural killer cells and chronic granulomatosis. In spite of the start of treatment with 4 drugs three of them died on admitting with spreading intra vascular coagulation.Conclusion: Presence of mild fever, organomegally, spreading cutaneous lesions and reduction of weight in children with purullent lymphadenopathy due to BCG vaccination in the referring patients, must be serious warning for admitting the patients for immunological investigation and start of immediate treatment, particularly if the PPD test is negative. Also in the other members of the family investigation should be done prior to vaccination.

Background and purpose: Pelvic mass with ascitis and elevated serum CA-125 level is suggestive of an advanced ovarian malignancy. Peritonitis is an uncommon event. Which can have the same symptoms, therefore this phenomenon must be considered in case of differential diagnosis of ovarian carcinoma. Aim of reporting this interesting and rare case, is to make attention of colleges to this differential diagnosis prior to and during operation. Case report: The case was a 28 years old female with ascitis and elevated serum CA-125 level of more than 500 units per ml. Pelvic mass was reported in sonography and CT-scan, and underwent laparatomy with probable diagnosis of advanced ovarian carcinoma. Frozen sections showed multiple necrotized caseous granulomatous lesions, highly suggestive of tuberculosis. Following treatment of tuberculosis, Serum CA-125 level declined to normal range (less than 35 units per ml) and ascitis was disappeared. Conclusion: Peritoneal tuberculosis can have the exact symptoms of advanced ovarian tumor during surgery. Peritoneal tuberculosis may be mistaken with advanced ovarian cancer or primary peritoneal carcinoma. Hence, during operation, particularly in young females, operation must be performed after being sure about the malignancy, so, not to deprive the patient from ovarian endocrinal activity. This issue is more prevalent, paticulary in the developing countries which must be considered.

Mataphyseal chondrodysplasia is a term for group of dysplasias, characterized by radiographic changes in metaphyse tubular bones with normal epiphysis. It has various types with the name of Schmid type Janson and Mckusis. Schmid type metaphyseal chondrodysplasia is more common in infants, characterized by slight to moderate hieght, bending of limbs and waddling gate. This disease is caused by mutation in gene coding collagene type X and has dominant inherited autosome. Radiologic image includes: widening and cupping of metatphyses, shortening of tubular bone genavara and coxavara. On the basis of laboratory findings Ca, P and ALP are normal. In other words, blood chemistry is normal. In this study, report is given on a 13 months old neonate with Schmit type metaphyseal chonrodysplasia.