Journal of Mazandaran University of Medical Sciences
Year:2001 | Volume:11 | Issue:32|Papers Count:10

Background and purpose: Ear infection in one of the common problem of ENT specialists and the general physicians. External otitis is a painful inflammation of external auditory metus and earlob. Otitis can be of infectious and noninfectious type, or both. The infection is caused by bacteria and fungi. Prevalence of external otitis is quite more in summer than in winter season. Due to climatic condition of Mazandaran province and its closure to Caspian Sea, tourist spots of beaches and using of swimming pools, we decided to study the etiological agents of external otitis in summer of 1999.Materials and methods: The samples were collected from the patients who were diagnosed clinically as external otitis. Collection of the sample was performed by two sterile swabs wetted in sterile saline and kept in sterile plugged tube, transferred to laboratory as soon as possible to culture in proper media.The patients were visited by a consulted physician also the questionnaires were filled and wet mount with 10% KOH and one smear for staining were prepared from the samples to identify fungi and bacteri respectively. Also the sample was inoculated on blood agar and McConky agar incubated for 24 hours and was followed by the biochemical tests to identify the species of bacteria. Meanwhile the same sample was inoculated on saborauds dextrose agar incubated for 48 houres to identify fungi and finally the identification of the species was done by macroscopic characteristics.Results: In this study out of 101 (59 females and 42 males) cases suspected to have external otitis, 39(38.6%) and 23(22.8%) cases were of bacterial and fungal infections respectively and 16(15.2%) cases were of both bacterial and fungal infections.Most of the patients were in the third and fourth decade. X2 test showed significant relationship between the occurrence of otomycosis and gender of the patients (p<00.5) while there was not significant relationship between bacterial otitis and gender of patients. In 22.7% of cases no organism was isolated, but in same patients the normal flora of skin (Staph epidermidis Corynebacteria and non hemolytic Streptococci) were isolated. The most common isolated bacteria was Pseudomonas aeroginosa in 37(36.6%) cases and the most common isolated fungi were as following: Aspergilus niger in 10(9.9%) cases, yeast species in 9(8.9%) cases and Aspergilus fumigatus in 5(5%)cases.Conclusion: In this study it was found that the clinical symptoms of otomycosis were same as of bacterial otitis but with less severity, but pruritis and stuffiness was more marked in otomycosis than bacterial otitis. So due to similarity of clinical symptoms, it is recommended that the laboratory investigations be carried out to identify the causative agent before treatment begins.

Background and purpose: Determination of hight and weight and processes of puberty in students could be one of the best indices for evaluation of nutritional and growth status of the population of a society.Taking in to account that the information available at present is from western societies, we decided to perform the same in our society.Materials and methods: On the basis of a trial study with cartain sample size, random sampling of 1266 boy students in the age group of 7-17 in sari township were done.The materials used for the research were strap scale, ruler, spring weighing device and orchiometer for measurment of testis.Results: Maximum increase in hight and weight was observed at the age of 13 years.Increase in hight and weight continued till 14 years of age and then the rate slowed down. The first sign of puperty was the growth of pubic hair.Conclusion: Considering the difference between the percentage of hight and weight with the available standard percentage, preparation of a new standard percetage for our society is recommended.

Background and purpose: Infection remains the major problem of the burned patients. Factors such as disruption of the integrity of the skin, vast antibiotic treatment which causes loss of the normal flora of the body and impairment of phagocytotic system, contribute to the increased susceptibility to mycotic infections. Among the fungi, Candida albicans which is an opportunistic microorganism and one of the normal flora of the body, causes the most dreaded septic complications in thermal injured patients. Neutrophils with their phagocytotic activities are effectors cells especially essential for protection against fungal infections.Post burn impairment of PNL cells activity as a result of intrinsic defect or alternation in opsonic activity of serum has been reported.Materials and methods: In this study the Candidiacidal activity of neutrophils in 30 patients with second and third degree burns and 30 aged matched normal persons were compared using MTT assay for determination of fungal viability. Candida specimens were prepared by serial passage of a standard species on sabouard dectrose agar (SDA). Yeast were grown overnight in yeast-nitrogen base broth (YNBA). In using them for experiment the viability of all specimens were more than 90%. Neutrophils were obtained from whole blood by dextran sedimentation followed by ficoll separation. The neutophil of patient and normal controls were cultured and normal and patient serum was added as opsonins after an hour of incubation with candida samples. Neutrophils were lysed by addition of dexycholic acid and the viability of remaining yeasts was measured using MTT assay. Statistical analysis was done using student t-test and variance analysis.Results: Our results indicated an increase in neutrophil abundance in patients blood as compare to healthy individuals. But the candidiacidal activity of patients neutrophils was significantly decreased. The observed decrease of activity was not only related to intrinsic defect of cells, but also to serum changes. So that when adding patients serum to normal neutrophils the killing activity was also significantly reduced.Conclusion: Considering the above results if we can increase the neutrophil activity of burned patients using cell stimulator drugs or cytokines which is the scope of another study we can hope to reduce the infectious problems of thermaly injured patients. Specially the fungal infections.

Background and purpose: Tinnitis is one of the most common cause of complaints among patients, who referred to otolaryngology clinics. This study has been performed to analyze the characteristics of patients referred to ENT Clinics of Boo Ali Sina hospital in Sari in 1998.Materials and methods: This descriplive study was done in about a year. The demographic characteristics of the patients were documented and disgnostic tests with audiometer (OB-822) were done. Patients were given a symptomatic or a specific treatment.Results: Total number of patients was 2052. out of which 143 of them (7%) had a main complaint of tinnitis and were taken under consideration.Among the patients with tinnitis 61% were males and 39% were females, 74% were city dwellers and the rest were villagers.The age of the patients varied from 19 to 80 years and most of them were between 25-45 (63%). All patients had a subjective tinnitis.49% of them had pure tone tinnitis and 21% of them had noise tinnitis, 2% had both kinds of tinnitis and another 2% had pulsing tinnitis. 6% of patients could not adjust themselves to any kind of sound waves.In 65% of the patients the frequency of tinnitis was higher than 2000 hertz and in 16% lower than 2000 hertz. 2% of Cases had white noise and 1.4% Speech noise tinnitis and in the rest of the cases tinnitis frequency was variable or unadjustable with the presented frequencies. The loudness of tinnitis in 51% was more than 5 decibel and in 2.8% was variable. Most of the cases had tinnitis in their both ears (38%). In 78% of cases, the impairment of hearing was sensory-neural type, in which 36% had impairment in low frequency, 2% in high frequency and the rest in all frequencies.8% of the impairments were transitional and 6% were interactive. The impairment of hearing in 69% of the cases was mild and in 2% was severe. The occupation of the patients, in women were house wives and in men 29% clerks and 13% farmers. 10% of the men were veterans of Iran-Iraq war and 8% of them had an experience of working in factories. 10% of the cases were smokers and all were males.Conclusion: In this study, it was determined that gender has no effect on loudness of tinnitis, kind of tinnitis and direction of tinnitis. Kind of tinnitis is related to the frequency of tinnitis because tonal tinnitis is lower as compare to noise tinnitis.The prevalence of tinnitis is related to occupation and sex of individual, thereby it is wise to avoid unnecessary sounds and noises.Also workers and people who are exposed to noise, should be educated and learn the necessary safety precautions.

Background and purpose: Renal osteodystrophy (ROD) is the skeletal response to long-standing chronic renal disease. Nowadays with improved dialysis techniques and renal transplants. Survival rates in chronic renal failure (CRF) atients have increased and ROD is more freguent. In this study we evaluated the incidence of ROD in CRF patients who were under dialysis in Fateme-Zahra hospital in sari in 1998.Materials and methods: A descriptive study performed on all patients who were dialysed regularly (three times weekly, 4 hours at each session) and accepted to be evaluated were chosen. In every patient radiographic films from thorax, pelvis, vertebra, skull, hands and knees were taken and evaluated for positive findings by a radiologist.Results: 41 patients, 22 (54%) males and 19 (46%) females with mean age of 49 years (16-70 years) were evaluated. 23 (56%) patients showed radiographic abnormalities of ROD (61% males and 39% females).Conclusion: Incidence if ROD in our patients at Fateme-Zahra hospital is relatively high. We recommend, screening programs for chronic renal disease in high risk propulation, because with early diagnosis we can protect them from CRF and ROD

Background and purpose: Drug interactions occur when two or more drugs are administered at a time. This will Cause a varying theraputic effect of a drug poisoning by other drugs of factors.In this research, the prevalence of different degrees of interactions by Cardio-vascular drugs prescribed in insured prescriptions during the fist six months of the year 2000 in sari drug stores were evaluated.Materials and methods: This descriptive study was conducted on 11280 regular, randomly sampled insured prescriptions issued by general physicians and specialists during the fist six months of the year 2000 in eight drug stores of Sari Township.Drug interactions were studied on the basis of the rating by Drug Interaction Facts book.Results: 9.31% of the prescriptions had at least one cardiovascular drug (57.43% in females and 42.57% males.)40.2% of the cardiovascular drugs were prescribed by cardiologists, 18.4% by other specialists and 41.4% by general physicians.Drug interaction was observed in 50% of the prescriptions and type of interaction from first degree to fifth degree was 10.82, 14.53, 7.85, 46.01 and 20.78 percent respectively.High prevalence of prescribed drugs and also drug interactions belonged to beta blocker group of drugs.The mean of number of drugs prescribed was 3.68±1.21 and mean of number of Cardio vascular drugs prescribed was 1.87±1.12.An increase in the number of prescribed drugs in a prescription is directely proportional to the rate of drug interaction.Conclusion: High prevalence of cardio vascular drug interactions in these prescriptions emphasizes a proper attention to be paied to practical pharmacology by practicioners and pharmacologists.

Background and purpose: Hospitals are one of the most important solids sources in cities, in which large parts of the solids are hazardous. If proper attention is not paid to the control of hospital solids, it will not only affect the patients and personal health in the hospitals but also will affect the human health and environmental pollution. Therefore collection, transfer and disposal of private and government hospital solids in Mazamdaran state were evaluated.Materials and methods: A descriptive study carried out in all hospitals of mazandaran province during the year 2001; the study included 20 government and 7 private hospitals.The equipments used in this research were researchers observation and a questioners (data Collection forms) filled by researcher.Results: The results obtained in this research showed that inspite of solids seperation in almost all the hospitals of the province, the complete seperation is not done in about 85% of the hospitals, and sometimes the infected solids are collected in non-infected solids buckets.X2 test was 3.84 which show a significant relationship between the government hospitals and solids separation.In 45% of government hospitals, transfer of solids form wards to their temporary sites are done by hands and in 55% by wheel porters, butin 72% of private hospitals this procedure was 58% by hands and the rest by wheel porters. 60% of the hospitals and an incinerator.The obtained X2 test of 2.25 showed a significant relationship between an active and intact incinerator and government hospitals.Conclusion: Asregard to the results obtained in this research, we conclude that a legislation and establishment of hospital solids waste law and also a development of hospital indection control committee and employment of skilled. Environmental health staff and also a continous education of hospital staff could be an unavoidable measures to be taken in collection, transfer and healthy disposal of hospital solids.

Background and purpose: Meconium stained amniotic fluid (MSAF) is one of the most important indicators of fetal distress and meconium aspiration syndrome.Meconium stained neonates are high risk of seizure, mental retardation and cerebral palsy.The aim of this study is to detemine the prevalence of meconium stained amniotic fluid in neonates and some of its risk factors in Babol and Ramsar towns.Materials and methods: This is a Cross-Sectional study which was carried out on 4014 neonates born in Babol and Ramsar labour wards during 1997-98.The information was obtained by an interview, observation and examination of the mother and the neonate. Statistical analysis was done using X2 test and Odd ratio (OR) of risk factors by liner Regression module.Results: Out of 4014 cases 10.36% were MSAF. FHR abnormalities had a direct relation with development of MSAF (OR=4.2, CL=3.5, 4.8, and P=0.000);Conclusion: According to the high incidence of MSAF and its relation with FHR depression, nasopharynx and oropharynx suction before delivery of the head in all MSAF neonates and direct endotracheal suction in any depressed neonate are recommended.

Background and purpose: Hepatitis B infection (HBV) is a world wide health problem, and about 2-10% of the infected persons will be prone to permanent liver conditions, of which, one third will have chronic liver disease and get cirrhosis, liver Carcinoma. Some people such as permanent blood products receivers, health services staff, addicts, neonates from chronic carrier mothers etc more in risk of being infected.Hepatitis B vaccine is one of the safest and effective vaccine which can prevent hepatitis B infection. The question is that, the acquired immunity due to a complete series of vaccination, lasts for how long and whether booster doses are required.The purpose of this study was to determine the immunity status of vaccinated above mentioned cases, six years after vaccination.Materials and Methods: This research was a descriptive- analytical study done in the above mentioned high risk groups individuals who received a complete series of HBV vaccination six years ahead. Antibody against HBV was essayed by ELISA method quantitatively.Results: Total of 81 health services staff and 98 thalassemic patients were undertaken for the study. Six (7.4%) persons of the health staff and 22 (22%) of the thalassemic patients had infection. There was statistically a significant difference by X2 method. P<0.01, DF=1, Xz=7.58.Conclusion: On the basis of the results of this study and determination of previous studies, the methods of prevention of hepatitis B infection in the previously vaccinated individuals, varies in different high risk groups. In the health services staff due to long lasting of absolute immunity in more than 90%, there is no need of routine assay of antibody after complete vaccination of HBV or administration of booster dose each five year interval. In the thalassemic patient inspite of reduction in the number of persons with absolute immunity, but due to its presence in more than three- fourth of the patients and partial immunity in the others, screening of transfused blood products for HBV and reduction of the HB infection cases due to transfusion, assay of antibody or booster dose in less than 10 years is not recommended in this group. Vaccination of above mentioned high risk group is compulsory infection.