JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2012 | Volume:22 | Issue:88|Papers Count:16

Background and purpose: Bordetella pertussis is a gram negative and obligate aerobic bacteria that is cause of whooping cough and is exclusively a human pathogen. In the last decade increasing rate of pertussis was observed. Despite the importance of pertussis as a contagious disease enough information does not exist regarding its incidence rate in Iran. In this research pertussis suspicious specimens were collected from different provinces of Iran in 2009-2010 and then were studied.Materials and methods: A total of 1084 sample from nasopharyngeal secretion or nasal of patients with coughing more than two weeks were collected from different provinces of Iran and were sent to microbiology unit of pertussis reference laboratory in Pasteur institute of Iran. The isolation was done through culturing method. All samples were inoculated through swab on pertussis charcoal agar and Bordet-Gengou plates containing (40 mg/ml) cephalexin antibiotic and once without it. Then the suspected colonies were gram stained and complementary tests was done if colonies were identified as B. pertussis, B. parapertussis.Results: From the total of 1084 samples 12 inoculated samples were positive (1.1%) of which 11 samples were B. pertussis and one sample was B. parapertussis. Among positive cultures, three cases were the patients who were below 2 months, six cases related to individuals from two months to two years of age, two cases related to those aged between two and 10 years old and one patient was over 10 years of age. Nine cases of positive culture specimens were vaccinated and seven cases were the patients who used antibiotics.Conclusion: Results of this study indicated that most isolated strains in Iran were related to those aged between two months to two years old. According to clinical and paraclinical problems regarding whooping cough in Iran and also low sensitivity of culturing method to diagnose Bordotella, complementary methods such as Real-Time PCR should be used.

Background and purpose: Kawasaki disease (KD) is an acute vasculitis in children. Studies indicated different relationships between eosinophilia and coronary artery disease (CAD). This study was done to assess the possible relationship between eosinophilia and coronary artery disease.Materials and methods: This descriptive study was carried out during 13 years on 61 children with Kawasaki disease who were admitted to Sina Referral Hospital. They were assessed regarding eosinophilia and coronary artery diseases. Data was evaluated by Fisher exact and t-test.Results: The research population included 61 patients of whom 33 (54%) were male and 28 (46%) were female with the mean age of 36.56±23 months. Among the patients 85% were>5 years of age and eosinophilia was found in 28 cases (45.9%) and five patients (14.8%) were diagnosed with coronary artery disease. This disease was observed in 25% suffering from eosinophilia and in 6% of the cases without eosinophilia. However, there was no association among gender, eosinophilia and coronary artery disease. Also, no significant difference was found between age groups.Conclusion: Eosinophilia was not a risk factor or protective factor for CAD. However, the exact relationship could be determined if further multicentre studies are carried out.

Background and purpose: Workers’ exposure to respirable silica particles and in particular free crystalline silica in the workplace causes some disorders such as silicosis or lung fibrosis. This study was carried out to evaluate the workers’ exposure to free crystalline silica particles using the infrared spectrophotometery method in some industries.Materials and methods: In this cross sectional study respirable silica dust was collected from workers’ breathing zone using a personal sampling device and a cyclone separator with a PVC filter. Silica samples then were analyzed using a infrared spectrophotometery recommended by NIOSH in method number 7602.Results: Mean personal exposure to respirable silica particles within the workers’ breathing zone in 4 industries were considerably higher than the threshold limit value recommended by ACGIH. Workers’ exposure to crystalline silica particles ranged from 0.03 mgm-3 to 0.57 mgm-3 and there was a significant difference between mean respirable particle concentrations within the workers’ breathing zone in these industries.Conclusion: Individuals who are working in asphalt production, foundry work, and sand and gravel mining and brick manufacturing are exposed to crystalline silica particle concentration higher than the standard level. Therefore, engineering and hygiene methods of dust control should be applied for the reduction of exposure and prevention of silica related disorders.

Background and purpose: Internal anal sphincter achalasia is one of the causes of refractory constipation in children. These patients are treated with internal anal sphincter myomectomy which results in complications such as permanent fecal incontinence due to permanent damage in sphincter. This study evaluates the impacts of botulinum toxin sphincteric injections in the treatment of these patients.Materials and methods: In a clinical trial 20 patients enrolled with the mean age of 4.95±2.47 years, of whom 11 were males. When the internal anal sphincter achalasia diagnosis was confirmed the patients received 20 units of sphincteric injection of botulinum toxin in four parts of the sphincter (in total 80 units). Then patients’ responses to treatment and bowel movements were recorded during 6 months follow-up visits. The responses were classified as excellent (at least one bowel movement every other day without laxatives), average (minimum of one bowel movement every other day with laxatives) and poor (one bowel movement over two days while taking laxative).Results: All patients except one responded to treatment. In one-month follow up, excellent response to treatment was seen in 35% of the patients while 60% showed average responses to treatment. However, six-month follow up responses to treatment was observed as 50% excellent, 40% average and 10% poor. The impacts of botulinum toxin in 14 patients remained until the end of the follow-up period, in five patients between seven to 20 weeks and in other patients except one remained on average. The only observed complication was fecal incontinence in three patients, which resolved after one to three weeks.Conclusion: Botulinum toxin sphincteric injection is an effective treatment in the treatment of internal anal sphincter achalasia induced constipation with few and transient complications.

Background and purpose: Multiple sclerosis (MS) is a chronic diseases of the nervous system in which the myelin nerve fiber in the brain and spinal cord is destroyed and the causes are still unclear. MS could result in progressive disabilities in young adults with different symptoms and incidence rate. This research aimed at comparing the big five personality factor in MS patients and healthy individuals.Materials and methods: This research was a case-control study which was conducted in east of Mazandaran. The research population included 191 patients with multiple sclerosis and 191 healthy individuals who were the patients’ companions with similar age, sex, marital status and education level with the first group. Personal questionnaire and NEO Personality Inventory-Revised were used and the data was analyzed by independent t-test.Results: The mean of neuroticism personality factor in patients and healthy subjects was 30.81 and 24.12, respectively (P=0.001). Their means in conscientiousness were 30.9 and 35.93, respectively (P=0.001).Conclusion: This study revealed that patients suffering from MS had a higher score in neuroticism personality factor and a lower score in conscientiousness compared with healthy subjects.

Background and purpose: Guilan province, with unique environmental values is located in southwest of the Caspian Sea. Disposal of untreated domestic, industrial and agricultural sewage to the surface of water pollutes the coastal waters of the Caspian Sea. Due to many pollutants in these swages they could endanger the health of swimmers. The purpose of this study was to evaluate the microbial contamination of water in the Caspian shores of Guilan province.Materials and methods: In this study 21 littoral swimming areas in Guilan were studied regarding microbial contamination by microbial indicators of fecal and total coliform with pH, temperature and turbidity during 2009-2010. In each swimming area six samples were taken during the study period. The data from the total of 122 samples were analyzed using statistical software.Results: The results showed that the mean of total coliform and fecal coliform was 234.8 and 60 MPN per 100 ml, respectively. The mean of total coliform in swimming areas 1 and 2 were 1445 and 600 MPN per 100 ml, respectively. Fecal coliform in swimming areas 1, 2, 6, 8, 9 and 10, was 195.3, 163.5, 131.5, 111.7, 127.8, 118.8 MPN per 100 ml, respectively. Significant correlation was found among temperature, turbidity, and microbial contamination (P<0.05).Conclusion: The results indicated that the mean of total coliform in two swimming areas and the mean of fecal coliform in six swimming areas were more than the standard level. Therefore, these swimming areas are considered as a microbial threat to swimmers.

Background and purpose: The deep cervical flexor muscles have a major role in neck stabilization and evidence suggests that these muscles especially longus colli muscle (LCM) becomes dysfunctional in panitents suffering from cervicogenic headache. Therefore, measurement of these muscles in healthy subjects and patients may be of great value to understand the stabilization function of the muscles and also to fallow the effect of interventions. The purpose of this study was to assess within and between days reliability of LCM anterior-posterior dimension (APD) and lateral dimension (LD) measurement using ultrasonography (US) in a group of healthy subjects and a group of patients with cervicogenic headache.Materials and methods: This methodological research was performed on 19 subjects including 10patients with cervicogenic headache and 9 healthy subjects. Neck LCM dimensions was measured at the level of thyroid cartilage using a real time US device. Two images of LCM dimensions were taken on the same day with an hour interval to assess the within- day reliability and the third image was taken tow days later to determine between- days reliability. Then data were compared using statistical analysis.Results: Healthy subjects were aged between 20-35 and patients between 20-25 The ICC measurements for within day and between days reliability in healthy subjects were varied ranging from 0.80 to 0.92 for APD, 0.68-0.89 for LD. In patients group it was also ranged between 0.90-0.92 and 0.81-0.90 respectively. The highest reliability score were performed for APD measurement in healthy subjects and patients with cervicogenic headache (ICC=0.92).Conclusion: The results indicated that US could be a reliable tool to measure the LCM dimensions in healthy subjects and patients with cervicogenic headache. Therefore, this non invasive method can be used to follow up the effect of exercise therapy interventions.

Background and purpose: ECT is one of the most effective ways to treat depression. One of the most common complications of this treatment is patients’ cognitive impairments. This study aimed at determining the effects of ginkgo biloba pill on depression and cognitive disorders of patients treated with ECT who referred to psychiatry ward of Hajar Referral Hospital in Shahrekord.Materials and methods: In this clinical trial, 81 major depression patients who were admitted to Hajar hospital with indications of bilateral ECT were randomly allocated in two groups (case and control). Both groups received routine medication for ECT but one group received ginko biloba while the other group was given placebo. Before and at the end of treatment period with ECT, depression and cognition status of patients were evaluated by Mini Mental State Exam questionnaire and Hamilton depression questionnaire.Results: There were no significant differences between the two groups according to age, gender, marital status, employment status, duration of disease, cognition and depression status (P>0.05). The mean scores in cognitive and depression tests before and after ECT revealed significant difference in both groups. The group receiving ginkgo biloba had better cognitive status and milder depression (P<0.001).Conclusion: Results of this study showed that ginkgo biloba could improve the patients cognitive and depression status probably due to flavenoids and antioxidant components.

Background and purpose: Ultrasonography is a reliable and valid method to assess the strength of neck extensors and measuring the neck muscles dimensions. Cervical muscles strength and dimensions may change in different positions. The aim of this study was to compare the strength of cervical extensor muscles and dimensions of semi-spinalis capitis muscle (SECM) in three different neck positions in healthy female individuals.Materials and methods: The research population included 30 female students, 18-24 years of age. Right SECM at the level of third cervical vertebrae was measured by ultrasonography in order to assess the isometric strength of neck extensor muscles in neutral, flexion and extension positions. The size of muscle was calculated by multiplying the anterior-posterior and lateral dimension of the muscle. Afterwards, the muscle strength was measured by a measuring device. One way-ANOVA was used to analyze the data.Results: The SECM size was significantly bigger in extension than that of the neutral and flexion positions (P<0.001). The strength of extensor muscles in neutral position was more than that of the flexion and extension positions. However, there was not a significant correlation between size and strength of the muscle in all three positions.Conclusion: The result of this study indicated that the size of SECM increased in extension position while the strength of neck extensor muscles decreased. The maximum performance of cervical extensor muscles appeared in neutral position of cervical spine, when the muscles were not maximally lengthened or shortened.

Background and purpose: Stachys lavandulifolia is a plant commonly used for many diseases. But so far there is no report indicating its toxicity. The aim of this study was to investigate the probable hepatoxicity of S. lavandulifolia extract on Wistar rats.Materials and methods: In this experimental study, 100 Wistar rats (about 250 gr, 8-12 weeks old) were randomly divided into 10 groups (8 groups as case and 2 groups as control). They were intraperitoneally injected with S. lavandulifolia extract with doses of 50, 100, 150 and 200 mg/kg per day for 28 days. Afterwards, the serum parameters level (ALP, AST, ALT) and pathological samples were evaluated and compared in four case group and one control group after 28 days and other groups after one month.Results: On the first month there was significant increase on AST level only in 200 mg/kg dose while ALP level significantly increased in all doses (P<0.05). There was no significant difference among all doses regarding their effects on the increase of liver enzymes (P>0.05). On the second month, the changes in liver enzymes were almost the same as first month, except 150 mg/kg dose that significantly increased the AST level compared to control group and also this dose significantly increased the ALP level compared to 100mg/kg dose (P<0.05). In examining liver samples obtained from rats in the first and second months, necrotic inflammatory reactions and fibrotic lesions significantly increased compared to control group (P<0.001). In the first month we also found that there was significant difference between higher doses (150 and 200 mg/kg) and lower doses (50 and 100 mg/kg) regarding their effects on hepatic lesion (P<0.05).Conclusion: Since the extract of S. lavandulifolia causes toxicity it should be consumed with caution in people with underlying cholestatic diseases.

Background and purpose: The duration and intensity of intestinal motility disorder and pain following abdominal surgery varj among patients. Ileus and postportative pain are iatrogenic phenomena influencing the patients’ morbidity, hospital cost and length of stay in hospital. The aim of the present study was to determine the effect of intraperitoneal bupivacaine on postoperative bowel motility and pain.Materials and methods: A double-blind, randomized clinical trial was carried out on 120 candidates of abdominal surgery (appendectomy, cholecystectomy and laparatomy) aged between 15 and 80 years who referred to an educational hospital. The patients were randomly divided into two groups. Patients in case group, the patients received (1 mg/kg) bupivacaine 0.5% in 20 cc normal salin while the control group received only 30 cc normal salin interaperitoneal. Afterwards, some information including nausea, vomiting, anorexia, distension, bowel sound, flatulence and defecation was recorded in six, 12, 18, 24 and 48 hours after surgery.Results: According to the results of this study the group receiving intraperitoneal bupivacaine intestinal motility happened 12-18 hours earlier (P=0.001) and severity of postoperative pain was reported less (P=0.001). Anorexia, vomiting and nausea also decreased in case group (P=0.002).Conclusion: This research indicates that intraperitoneal bupivacaine could reduce postoperative pain, vomiting, nausea, anorexia and may increase intestinal motility.

Background and purpose: Preeclampsia is a medical condition in pregnancy that is determined by hypertension and proteinuria. Among many predisposing factors in pathophysiology of preeclampsia, the role of lipid peroxides is recently emphasized. The aim of this study was to evaluate the association of preeclampsia with maternal plasma and umbilical cord lipid concentration.Materials and methods: A case-control study was done on pregnant women referring to Babol Yahyanejad Hospital, during 2008-2009. Case group included 31 term preeclamptic pregnant women and for control group 31 term normal pregnant women were recruited. All women were 20-30 years of age and were gravida 1 or 2. Total TG, cholesterol, HDL and LDL for plasma and umbilical cord were measured by enzymatic and calorimetric methods.Results: No significant differences were found between women with preeclampsia and normal subjects according to the mean level of triglyceride (291.1±102.8 VS 309.4±114.4), cholesterol (226.3±48.8 VS 234.9±40.6), LDL (119±38.3 VS 123±33.1), HDL (50.1±10.6 VS 51.5±8.1) and VLDL (59.2±20.8 VS 61.5±22.6). Level of lipids in umbilical cord showed abnormal triglyceride level in only one case in the control group. Moreover, the mean level of umbilical cord triglyceride (56.3±32 VS 50.1±54), umbilical cord cholesterol (70.9±22.8 VS 64.4±20.8), umbilical cord LDL (30.9±12.7 VS 26.1±10), umbilical cord HDL (28.7±10.7 VS 30.7±8.6) and umbilical cord VLDL (11.6±6.8 VS 9.9±10.7) were not significantly different between preeclampsia and normal groups (P>0.05).Conclusion: Results showed that there was no association between lipid concentration of mothers and umbilical cord lipids with preeclampsia.

Background and purpose: Primary dysmenorrhea is a common gynecologic problem among women. This study aimed at comparing the impacts of vitamin E and Fennel extract on intensity of primary dysmenorrhea.Materials and methods: A randomized single blind, placebo-controlled trial was carried out on 75 single female students who suffered from primary dysmenorrhea. They were divided into three groups receiving Fennel extract, vitamin E and placebo. Groups received treatment for two consecutive menstrual periods using the drugs four times a day from the onset of bleeding until three days.Results: Pain severity decreased in the Fennel extract (P<0.000) and vitamin E groups (P=0.02). Significant difference was found in pain severity during second cycle and reduction was greater in the group receiving Fennel extract (P=0.019). Sedatives were used less compared with before treatment in Fennel extract and vitamin E groups, however, this was not significant in comparison with the group receiving placebo (P>0.05).Conclusion: Fennel extract which has few side effects could be used to treat primary dysmenorrhea.

Myxoma is the most common type of primary tumors of heart. Recurrence of nonfamilial myxoma is unusual and recurrence in left atrial appendage is not reported.We present a case of sporadic myxoma in the left atrium who had a successful resection. However, the patient’s constitutional symptoms caused confusion and difficulty in diagnosis. Final diagnosis was recurrent Myxoma in the left atrial appendage which was made through echocardiography. Echocardiography is a standard choice for noninvasive diagnosis and localization of heart tumors. Operative resection of tumors is the most appropriate treatment for myxoma.