JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2008 | Volume:17 | Issue:61|Papers Count:24

Background and Purpose: Early detection of Candida species in body site could improve the survival of the immunosuppressed patients by allowing the initiation of specific treatment while the fungal biomass is still low. The aim of this study was the identification of Candida albicans isolated from the oncology patients by molecular methods.Materials and Methods: Sixty two of Candida albicans isolated identified by phenotypic methods (color of colony on CHRO Magar medium, germ-tube formation in horse serum, chlamydospore formation on Cornmeal agar with 1% Tween 80). DNA was extracted by using a glass bead/phenolchloro form method. The oligonucleotide primer pairs (NL1/NL4) were used to amplify a 620-bp fragment of D1/D2 region of large submit (26s) ribosomal DNA gene. PCR-products were electrophoresed in a 1.5% agarose gel. Eighteen PCR-amplified products sequenced and results were evaluated by online BLAST software. Multiple sequence alignment was performed by using online CLUSTAL-W (version 1.83) software.Results: The BLAST search revealed that all of products were Candidaal bicans. All sequences showed >99% similarity when compared with known reference sequences at the Gene-Bank. Four different strains were obtained of albicans species, including: AA 1622b (13 samples), 24698 (3 samples), TA 62 (1samples) and 551 FC (1 sample). A total of 131 nucleotide exchange sites were revealed. Conclusion: The dominant species by phenotypic approaches was Candida albicans. In addition, identification of Candida albicans by (26S) rDNA sequencing was 100% concordant to the results obtained by the phenotypic methods.

Background and Purpose: Cardiac complications in major thalassernia are the most debilitating problem among them. Iron chelating with desferrioxamine, may be difficult or inadequate. The aim of this research is to evaluate the effect of combination therapy with the two drugs "deferiprone & desferrioxamine" on cardiac complications in major thalassernia.Materials and Methods: In a clinical trial study (before & after), 47(24men and 23 women) patients with major thalassemia referred to Booali research center, 10 to 35 years old, all of whom were undertaken combination therapy with deferiprone & desferrioxamine, enrolled in this study.Echocardiography was performed for all patients before & after at least 6 months of combination therapy. Echocardiographic systolic & diastolic function indices including LVEF, EPSS, CI&E/A, EF slope & MPI, as well as presence of arrhythmia were obtained. The data were analyzed by paired T Test & Pearson correlation.Results: There were significant changes in ferritin, systolic function& MPI, indicating statistically significant improvement. Ferritin decreased to 3306±1347 ng/ml from 4489±1607 ng/ml (p=0.0001). VEF increased to 69.7±2.6% from 67.6±3.9% (p=0.04). EPSS decreased to 2.9±1.3mm from 3.9±2.lmm (p=0.004). Cardiac Index increased to 3.6±0.18 from 3.5±0.3 (p=0.02). MPI decreased to 0.33±0.05 from 0.37±0.06 (p=0.03). Arrhythmia & diastolic function were also slightly improved which were statistically no significant.Conclusion: The results showed that combination therapy with the two drugs deferiprone & desferrioxamine led to decrease ferritin level and improve systolic function in patients with major thalassemia.

Background and Purpose: Previous studies have demonstrated the cardiovascular effects of Urtica dioica (Nettle) such as anti-hypertensive, and negative inotropic effects on heart. The effects of plant on atrioventricular node have not been explored yet. Inhibitory Na+-K+-ATPas pump has been shown ny U. dioica. The aims of the present study were:1) to determine concentration-dependent effects of ethanolic extract of nettle on the nodal basic and functional properties.2) to compare mechanism of action nettel with ouabaine and verapamil. Materials and Methods: This was an experimental study. Male New Zealand rabbits (1-1.3 kg) were used in  all of the experiments; Various experimental stimulating protocols (Wbc1; Recovery, Facilitation, Fatigue) were applied to assess electrophysiological properties of Node. We used isolated perfused AV-nodal preparation (n=18). All protocols were repeated in the presence and absence (control) of different concentration (0.2-0.4 g/l) of Nettle, verapamil (0.1 mM) and ouabaine (0.25 mM). Results were shown as Mean±SE and a probability of 5% was used to indicate statistical significance.Results: In the presence of Nettel, significant increases in WBCL (150.7±4.3 to 180±15.2 msec), AVCT (44±2.5 to 54±1.7msec), ERP (125±13 to 149±20.6msec) and magnitude of fatigue (D.AH) 6±0.9 msec were observed. The nettel has less inhibitory activity than verapamil, such as ERP of Nettel was 40% ofverapamil. Also, Nettel had similar electrophysiological effects in regard to ouabain.Conclusion: In the present study, negative donnotropic effect of extract, Citrus bigaradia of Nettel, was observed on the isolated AV-nodal preparation. The same electrophysiological trend of ouabain and Nettel, may indicate the role of Na+-K+-ATPas pump in the depressant effect of Nettel.

Background and Purpose: The most common complication of pregnancy is abortion. The etiology of recurrent pregnancy loss is not completely known. There are few therapeutics and diagnostic strategies in recurrent abortion. The aim of this study was to compare the use of heparin with aspirin vs prednisolone with aspirin in patients with recurrent pregnancy loss (RPL).Materials and Methods: This randomized clinical trial study comprised of 50 patients with RPL referred to Faternieh Hospital, Hamadan. These patients were selected when b-HCG test was positive and were divided into two groups (n=25 for each group). Patients in the first group received subcutaneous heparin (5000 U twice a day) and oral microcoated aspirin (80 mg once a day) up to 20th week of pregnancy. Ultrasonography was repeated 3 times for these patients. Ca tablet was administrated in order to prevent osteoporosis. Antiphospholipid and anticardiolipin antibodies were checked for all patients. Neonates were visited by a neonatologist and followed up for one month. Finally, the data were analyzed by t-test and Fisher's exact test.Results: The mean age of prednisolone with 'aspirin group were 31.8±3.3 years while, it was 30.7±3.2 years in heparin with aspirin group and, this difference was not significant (P>0.05). The mean pregnancy loss number was 2.8±1.1 while 2.4±1 in prednisolone with aspirin and heparin with aspirin groups respectively, which was not statistically significant (P>0.05). Anticardiolipin antibody was positive in 4 (8%) patients, and antiphospholipid antibody was also positive in 4(8%) patients. Pregnancy loss with heparin+aspirin was significantly higher than prednisolone+aspirin (P<0.05). There was not any case of complications in two groups.Conclusion: The results of this study showed that prednisolone with aspirin are more effective than heparin with aspirin in the management of recurrent pregnancy loss and are preferred to use in these patients.

Background and Purpose: Succinylcholine isn't used in Emergency Department intubations routinely, that, this study was performed to compare success and complications of tracheal intubation with and without succinylcholine administration.Materials and Methods: This interventional study was done on 150 patients admitted in Emergency Department of Hazrat Rasoul Akram Hospital who underwent intratracheal intubation.Demographic data were evaluated. The Cases were entered in protocol A (rapid sequence intubation with succinylcholine) or B (modified RSI without succinylcholine) randomly and then intubated. During and after intubations, results and complications were recorded in checklists and analyzed via SPSS11 software.Results: The mean age in group A was 34.1±5.1 yrs while in group B was 35.1±5.3 yrs. In group A, 35 cases (46.6%) were female and 40 cases (53.4%) were male and in group B 37 cases (49.3%) were female and 38 cases (50.7%) were male. The differences between groups were not significant. In group A, 74 cases (98%) were intubated in first attempt and 1 case (2%) in second attempt. Bradicardia was seen in 3 cases (4%), hypotension in 8 cases (10.6 %), vomiting in 8 cases (2.6 %), hypertension in 2 cases (2.6 %) and hypoxia (O2 sat<90%) in 9 cases (12%). In group B, 64 cases (88%) were incubated in first attempt and 9 cases (12%) in second attempt. Bradicardia occurred in 2 cases (2.6%), hypotension in 9 cases (12%), vomiting in 3 cases (4%), hypoxia in 11 cases (14%) and hypertension in no case. In this study, the success rate of intubation in RSI with succynilcholine was higher significantly. There are no significant differences regarding in complications between two groups. Conclusion: Our study showed that in emergency patients intubation the which there is no coritraindication for succynilcholine, it is better to try RSI.

Background and Purpose: Simvastatin is an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme, a reductase and widely used as cholesterol-lowering agent. It is a promising candidate for future treatment in multiple sclerosis (MS), as it has been shown to exhibit immunomodulatory and anti-inflammatory effects. This study examined the effect of simvastatin on the evolution of experimental autoimmune encephalomyelitis (EAE), as an animal model forms.Materials and Methods: EAE was induced by immunization of 8 week old C57BL/6 mice with MOG35-55 peptide with complete Freunds adjuvant. Therapy with simvastatin (1mg/kg/every day given as oral) was started on day 3 before the immunization until 25 day after immunization. Total antioxidant capacity (TAC) was assessed by ferric reducing-antioxidant power (FRAP) method. Nitric oxide (NO) production was also estimated by Griess reaction.Results: The results show that simvastatin-treated mice had significantly less incidence and clinical score of EAE than non-treated (control) EAE induced mice (p=0.001 and p=0.0001, respectively).Moreover, treated mice displayed a significantly delayed disease onset compared with control mice. Simvastatin significantly increased TAC and level serum uric acid (p=0.001), but had no effect on serum nitrite production.Conclusion: Our results suggest that simvastatin therapy may be effective in the prevention of symptomatic EAE. This resistance to encephalomyelitis may be associated with the inhibition of oxidative stress and the increase of antioxidant capacity

Background and Purpose: Dysmenorrhea is one the most common disorders in Gynecology, which occurs in 50% of women with regular menstrual cycls. There have been various treatment methods regarding this, among which the drugs with less side effects are preferred. The porpuse of the present study is to compare the effect of Fennelin and Mefenamic Acid on primary dysmenorrhea.Materials and Methods: This research is the result of an experimental study at the level of a double-blind clinical trial in 2006. In this study, 104 students with moderate to severe primary dysmenorrhea were randomly selected and assigned into 3 drug-taking groups, including Fennelin (36), Mefenamic Acid (36) and Placebo (32). They were assigned to receive the relevant drugs in two successive menstrual cycles at the beginning of the pain. The selected subjects were asked to fill out the questionnaires regarding the severity of pain, hemorrhage and clinical problems in the first visit, during the first five hours, 48 hours and the first three days in two successive cycles.Results: There were no significant differences between the 3 selected groups regarding the age and the characteristics of menstruation. The average age of the subjects was 20.7±0.16 and the average age of the beginning of primary dysmenorrhea was 15.11±0.26. 71.2 % of subjects had moderate while 28.8 % with severe dysmenorrhea. The pain severity highly decreased in Fennelin takers compared with the Placebo takers, and as the time of treatment continued, this difference increased. However, there was no significant difference between the Fennelin and Mefenamic Acid takers. The effect of Fennelin was also more than Mefenamic Acid in reducing the severity of hemorrhage. There was no significant difference between the 3 groups regarding the clinical symptoms, but there was considerable reduction in the severity of clinical problems in Fennelin takers compared with the two other groups. According to the drug-takers, Fennelin was more effective in reducing the complaints compared with Placebo; however, it had no significant difference from Mefenamic Acid.Conclusion: The effect of Fennelin in relieving primary dysmenorrhea is not less than Mefenamic Acid, and it can be useful in reducing the severity of pain, hemorrhage and clinical symptoms. Therefore, due to the safety of herbal drugs, it can replace the chemical drugs.

Background and Purpose: Cholelithiasis is a common problem among patients with homozygous major and intermediate b-thalassemia due to chronic hemolysis, ineffective erythropoesis and other factors that causes variety of side effects. Hydroxyurea (HU) decreases hemolysis by increasing HbF production in homozygous b-thalassemia patients. Up to now, there have not been evidences about relationship between use of Hydroxyurea and cholelithiasis in the patients. The aim of this study was to determine the relationship between use of HU and incidence of cholelithiasis in patients with major and intermediate p-thalassemia referred to thalassemia research center of Mazandaran University of medical sciences at Boo-Ali Sina hospital of Sari, IRAN.Materials and Methods: This historical cohort study was performed in 2006. Study population was major and intermediate b-thalassemia patients referred to Boo-Ali Sina Hospital of Sari, IRAN. The patients were divided to two groups: case and control groups. The case group (36 patients) was consisted of major or intennediate b-thalassemia patients using hydroxyurea at least for one year, and the control group were: non-hydroxyurea user patients or beginning to use the drug less than 3 months. The groups were matched on order to age, gender and severity of the disease. Severity of the disease was determined according to grading, clinical and laboratory characteristics of the patients. Data about demographic information severity of the disease and results of hepatobiliary ultrasound were recorded in a questionnaire. The data was analyzed using SPSS (11) software and t-test, Chi-square test and fisher exact test. Results: Thirty-six [20 women (55.6%)] patients in case group and 36 [19 women (52.8%)] patients in control group were studied. The mean duration of use of hydroxyurea was 67.9±25.5 months with maximum 108 months (9 year). The mean dosage of the drug was 14.9±5.9 mg/kg with maximum dosage 34 mg/kg.Thirteen (48.1%) patients in control group (12 cholelithiasis, 1 sludge) and 6 (19.4%) patients in case group (5 cholelithiasis, 1 sludge) had abnormal hepatobiliary sonography. The difference between two groups was significant statistically (P<0.02). Among the different variables, a significant relationship was detected between gender of the patients and effect of HU on cholelithiasis.Conclusion: This study showed that the incidence of cholelithiasis in major and intermediate b-thalassemia patients using hydroxyurea was less than non-hydroxyurea user patients did. As a result, it seems that there was a preventive effect of hydroxyurea in incidence of cholelithiasis in major and intermediate b-thalassemia patients.

Background and Purpose: Oral administrations have been used for many years as a main method comparing to other methods. Sustained release techniques have been a great interest recently. Matrix polymers are one of the ways used to prepare a sustained-release drug and are most widely used to prepare the controlled-release drugs. Cellulose derivatives are the most common ones. Solubilities of some drugs are pH-dependent due to their acidic or basic nature. Diltiazem Hydrochloride due to having pH-dependent solubility is a suitable model to investigate the effect of pH and also to prepare pH independent formulations.Materials and Methods: In the present study, an attempt was made to form pH-independent formulations using HPMC, lactose, CAP and organic acids in different ratios. The physicochemical properties of tablets prepared (including weight uniformity, hardness, tensile strength, friability and assay) were investigated. Rate of drug release was studied using USP I at pH 1.2 and 7.2, and sampling was done in the time of 0.5, 1, 1.5, 2, 3, 4, 5, 6, 7, 8. The drug release data were analyzed according to four kinetics models.Results: Drug release profile in acid free formulations showed that it was higher in the acidic medium. 50% replacement of HPMC with CAP and 1:1 ratio with drug release was pH-independent. Studying the formulations containing organic acids; citric acid and polymer with 1:1 and 2:1 ratios; ascorbic acid and polymer with 1:1 and 2: 1 ratios and tartaric acid with 1:1 and 2:1 ratios showed their pH independent release characteristics.Conclusion: These results showed the effect of combination of polymers and organic acids on drug release and its kinetic. Thus, the micro-environmental conditions for the dissolution and diffusion of diltiazem HCl were almost kept constant. The release of diltiazem HCl from tablets composed of HPMC and organic acids was found to be pH-independent.

Background and Purpose: IV Acetaminophen (Propacetamol) is one the drugs which has recently been discussed in pain management. The purpose of this study is the comparison of analgesic effect of Propacetamol and Tramadol in pain relief of renal colic patients. Materials and Methods: This double blinded randomized clinical trial was performed on 80 patients who came to ED of Hazrat Rasool Akram Hospital (HRAH) due to renal colic. Demographic data and pain scores were evaluated prior to injection (through numeric rating scale). Then, patients received one of the drugs, drug A (1 gr Propacetamol) or B (100 mg Tramadol) randomly. Pain relief and adverse effects of the drugs were evaluated 30 minutes after injection. After I hour, satisfaction and the need to administer a narcotic were evaluated. Data was gathered and analyzed by T-test via SPSS software. The Pvalue less than 0/05 was determined to be significant.Results: The mean age in group A, was 33±8.6 yrs and in group B, was 34.2±8.2yrs. Mean of pain score in group A, was 7.6±1.6 and in group B, was 7.5±1.5.Pain relief in group A, was 4.4±1.6 and in group B, was 2.6±1.2. Differences between the groups were significant. 12 cases (%30) in group A, and in 25 cases (%62/5) in group B, recieced additional analgesic for pain relief, thus, difference between groups was significant.Conclusion: According this study, IV Propacetamol is a safe and effective drug for pain relief in renal colic patients, without any significant adverse effects. Our survey showed that IV Propacetamol is more efficient and has less side effects in comparison with Tramadol in the pain relief of renal colic patients.

Background and Purpose: Thalassemia is a hereditary quantitative hemoglubinopathy which is common in mediteranian area including IRAN. Homos zygotic/3 thalassemia patients suffer from severe anemia and complication of the disease in many organs. Studies have shown different results about renal complication and disease. Thus, in this study we investigated renal function of thalassemia Major (TM) patients in comparison with control group.Materials and Methods: This was a historical cohort Study. The population who TM patients were was admitted to Boalisina hospital, Sari, and control group were brothers and sisters of the patients who were matched in gender and age. Serum and urine markers of renal function were measured and demographic and therapeutic data were gathered from medical records. Analysis of the data was performed using SPSS 11 with statistical test (t, chi square).Results: the Total of 84 (42 patients and, 42 controls) patients were studied. The Mean age of the patients was 21.3±5.2 years. Dose of Deferral was 70±19 mg/kg. The results showed no significant statistical differences in levels of b2 macroglobulin, 24 urine protein, Excretion Fraction of Na and K between case and control group. There were significant differences in levels of serum BUN, creatinin, Potassium and urine potassium and creatinin between case and control group. Gender, level of Hb and serum Ferritin significantly affected the differences between two groups.Conclusion: In this study, evidences of renal tubular damage were not detected in TM patients. There was increase in levels of Bun, serum potassium, uric Acid, specially with sever anemia, high dose desferal and Iron over load.

Background and Purpose: UTI is one of the most common bactctrial infections in pediatrics. Febrile urinary tract infection can produce severe renal complications when unrecognized or untreated. Acute pyelonephritis (APN) and reflux are two synergistic factors in the destruction of kidneys of children. There are no certain specific diagnostic laboratory tests and clinical symptoms for diagnosis of UTI. There are several diagnostic methods for APN and reflex in pediatrics, including ultrasonography. IVP, VCUG, CT, Doppler and DMSA scintigraphy. Most of these methods are associated with the danger of exposure to radiation. In this study, we assessed and compared the accuracy of renal artery resistive index (RI) in doppler ultrasonography with DMSA scan and vcug to the diagnosis of APN and reflux in pediatrics patients.Materials and Methods: In this diagnostic study, we assessed 72 kidneys from 36 children (28 girls and 8 boys, age 19 days to 27/19 months) with febrile UTI admitted in Booalisina Hospital of Sari in 2005 to 2006. All patients underwent cysto-renal ultrasonography and Doppler ultrasonography. They Also underwent VCUG and DMSA scan to rule out vesicoureteral reflux and APN respectively. The data recorded in separate questionnaires and were analyzed using spss- statistical software.Results: The results concluded that DMSA was positive in 34.7% of children with febrile and confirmed clinical impression, while Doppler sonography was positive in 33.3% of cases. The specificity and sensitivity of Doppler sonography were 64% and 83%, while the positive predictive value and negative predictive value were 66.7% and 81.3% respectively.Conclusion: According to the results of this study, Doppler RI>0.7 in pediatrics with febrile UTI and clinically suspected APN are in need of careful antibiothic therapy and must be controlled by DMSA scan. DMSA is not necessary in children with Doppler RI <0.7 and they must be treated for possible cyst urethral infection. Thus, there is a significant relationship between increased RI and the severity of renal involvement. Considering, that 83% sensitivity and 81.3% predictive value of Dpppler RI measurement to diagnosis of APN and scaring, it is concluded that Doppler index (RI) measurement to rule out of APN is valuable.

Background and Purpose: Auto graft is the best bone graft substitute, however, it has some limitations, so allograft with synthetic or natural materials has been advised to use for bone graft. In this study, Iranian Caspian seashell was used as a biocompatible natural material for radiological evaluation. lodgment of seashell in drilled defects of femur was compared in the treatment group (rabbit models) with natural healing process of cancelluos bone in the control group. Handling characteristics, osteoconductivity, resisting against bone forces and absorption, were evaluated by radiological study.Materials and Methods: The study was performed in faculty of Veterinary Medicine, Islamic Azad University of Karaj. Twelve New Zealand rabbits were divided into two equal groups of six (treatment and control groups). In the treatment group unilateral drilled defect was induced in the greater trochanter of femur. Each defect was implanted by the pieces of seashell. In the control group, similar bone defects were also produced to study natural bone healing process. Radiographs were taken from rabbits in 0, 10, 20, 30, 40, 50, 63 days post-operation.Results: After 9 weeks, radiographic findings in the treatment group were .included; a range of 10-15% reduction of bone density and progressive new bone formation in the presented bone defects. Results of radiographic evaluation in the control group, indicated more than 50 % of bone healing was developed in the cylindrical defects of femoral greater trochanter.(...) Due to high structural density of seashell, which makes it tolerable against local biomechanical bone stress, there was no post-surgical complication (such as trochanteric fracture) in the treatment group.Conclusion: Seashell is a natural source of calcium which is a valuable substitute for bone grafts in medical and veterinary orthopedic surgeries.

Background and Purpose: Intravenous immunoglobulin is used for primary immunodeficiency disorders. There have been some reports that intravenous immunoglobulin causes side effects. The aim of this study was to investigate intravenous immunoglobulin side effects in immunodeficiency patients.Materials and Methods: The study utilized the data of 29 primary immunodeficiency patients that were referred to allergy and immunology department in Medical Children Center in Tehran. 29 patients having completed record data files in the hospital were the subjects of this study.Results: Of 29 immune deficiency patients (aged 15 months to 55 years), they were 19 Males (65/51%) and 10(34/48%) Females Prevalence of disorders include common variable immunodeficiency 16(55/17%), Bruton disease 8(27/58%), hyper IgM 4 (13/79%) and severe combined immunodeficiency (3/44%). Based on the recorded data, the duration of infusion has been 5 months to 15 years. 15 patients had reported side effects (51/72%). 34 infusions from the total of 1,626 infusions accompanied with side effects (2/09%) Most side effects were occurred during 30 minutes onset of infusion and most were caused by rapid infusion. Most side effects were mild reactions (fever, chills and ...). Conclusion: Intravenous immunoglobulin is a rather safe drug with mild side effects. With an appropriate technique and proper infusion, these side effects can be reduced.

Background and Purpose: It has been reported that the cause of burn is an important factor in the determination of prognosis and outcome. Due to different results of various centers, we conducted this study to determine the relationship between cause of bum and outcomes including rate of infection, costs and mortality in Zare Hospital.Materials and Methods: This prospective study has been performed on 113 patients from September 2006 to April 2007. The inclusion criteria were ages more than 10 years old and partial thickness or full thickness burn. Based on the clinical situation of patients, appropriate samples, such as swab, tissue biopsy, urine, blood and sputum were obtained. The relationship between cause of burns and different variables, including demographic data, infections, costs and mortality has been assessed by Chi-square test.Results: Flame injury was the most common type of burn (53.2% cases). Burn percent and days stayed in the hospital were 30.6±21.2% and 21.6±11.9 days, respectively. These variables were significantly higher in the patients with flame injury. The mean antibiotics and total cost of patients were 9834102±11818945 and 24301863±18872089 Rials. Electricity was the cause of burns in 11.5% of patients. The overall mortality was 29.3%. However, it was significantly different in patients with various causes of burns.Conclusion: Inappropriate outcomes in patients with flame injury were much severe and more common than other causes. There was a relationship between the cause of burn and demographic and psychosocial variables such as sex, marital status, residency, educational state, suicide intent and past medical history of patients.

Background and Purpose: Radiology unit has an important role in the diagnosis of many disorders, along with providing suitable and high quality pictures. A good picture is provided using a correct technical criteria and suitable circumstance of patient. Finally, operation and knowledge of radiology personnel’s directly has a primary role in the determination of radiography quality.Materials and Methods: This study was done in order to determine personnel operation in the units of hospitals radiologist, related to Universities of Mazandaran Medical Science. Data collection tools made a researcher a check list that was used after getting suitable letter and validity indices. All of the 73 personnels of the radiology unit related to Mazandaran Medical Science were studied. 35 operations (in technical, protective and technological fields), in any of personnel in three distinct shifts were observed and recorded. All of them were tested about these three fields with 40 questions.Results: The total obtained scores from personnel’s in technical part in the morning; evening and night shift were 66.4, 53.9 and 60.2 percents. Received scores from personnel’s in protective fields were 68.1, 59.5 and 60.2 percents, while received scores from personnel’s in Technological operation fields were 47.8, 39.95 and 43.65 percents. Comparison of these three scores in technical, protective and Technological operation fields showed a meaningful difference (p<0.05).Conclusion: The total quality of personnel’s operations were nearly desirable and in need of continuous education, supervision and evaluation. Emphasizing protection to beams, accessibility of necessary tools and continuous supervision regarding usage of these equipments and respecting other security points have important role in reducing patients absorbed doses.

Background and Purpose: Hirschsprung's disease (HD) as an organic cause of children constipation is only treated by surgical intervention. Regarding of variety of clinical manifestation of HD and lack of information about it in Sari, this study describes the prevalence of HD in constipated children referring to Boo Ali Hospital.Materials and Methods: this descriptive study was undertaken on children with protracted constipation and neonate suspicions for HD referring to Boo Ali Sina Hospital of Sari (1997-2006). Clinical and pathological data of patients were collected from their records and analyzed using SPSS 13 software.Results: 226 children were presented with constipation at a mean age of 30.6±34.8 months (range, 0.69-1.6 months). Rectal biopsy performed in 187 cases. HD was diagnosed in 59.4% of biopsied patients. The mean age of patients diagnosed was 24.8±33.2 months. 27.1% patients with HD were diagnosed in the first month, 44.1% in 1-12, 18% in 12-48 and 10.8% in over 48 months.Conclusion: This study revealed 59.4% of protected chronically constipated children had HD, indicating usefulness of rectal biopsy in these patients.

Background and Purpose: The aim of this study was to investigate the Iranian psychiatrist's knowledge, attitude and practice about compulsory admission and its related laws.Materials and Methods: The target group of this descriptive prospective study was the entire Iranian psychiatrists whose addresses were available in Iranian psychiatry association. Assessment was performed through a self-report questionnaire, which contained 52 evaluating questions. Questionnaires were mailed to psychiatrists and assessed after they returned the answers.Results: We obtained responses from 116 psychiatrists. Twelve and a half percent of them had been complained against due to compulsory admission. More than 50% of them had studied literature crowing psychiatric health laws, and 12.1% of them had a poor knowledge reyording this literature.About 70% of them believed that the present law is not befitting with current needs. Majority of them reported that they hospitalize their patients involuntarily and they prefer their opinion on compulsory admission rather than other resources in most situations.Conclusion: These findings suggest that the present law about compulsory admission of psychiatric patients is deficient and not befitting with current needs. Furthermore, lack of education in this view is obvious and prominent.

Background and Purpose: Nitrate is considered as a major pollutant for groundwater resource. In recent years, the concentration of nitrate in subsurface water is increasing because due to utilization of the of using excessive amount of fertilizers and disposal of wastewater in soils. This research was carried out as descriptive study, in a rural area of Paeen Khiaban Litkooh in Amol City in 2005.Materials and Methods: In this cross-sectional descriptive study, 300 samples were collected from 50 well drinking water in different weather (wet and dry) the samples were taken from each well, 3 times in the wet air and 3 times in the dry air. Nitrate analysis method was Ultraviolet Spectrophotometer (Model Jesco 7800 U.V/Visible) at 220 and 275 nm according to "Standard methods for the examination of water and wastewater (20th edition)".Results: The results revealed that, nitrate maximum related to well number38 in a rural qrea with code 8 and with 20.66 mg/l Nitrate as N. Maximum of Nitrate average concerned in rural code 8 with 9.66 mg/l and minimum of nitrate average related to rural code 2 with 1.257mg/l nitrate as N. The results indicated that nitrate was reduced when the depth of water wells increased and ford ware, the value of nitrate in deep wells is more than surface wells.Conclusion: The statistical analysis showed, there is a significant difference between concentrations of nitrate in surface wells drinking water in wet and dry air conditions, but there is not a significant difference between deep well drinking water. The leakage of surface water to the low depth well and lack of sanitation, may be the cause of this difference.

Background and Purpose: Due to an increase in cases of irrational drug prescription and it's health and economic consequences, evaluation of the rational use of drugs seemed necessary. Among drug groups antibiotics are greatly significant.Materials and Methods: Utilization pattern of antibiotics in different wards of Sari Imam Khomeini teaching hospital in the first half of 2000 and 2005 were reviewed. ATC/DDD (Anatomic, Therapeutic, Chemical/ Defined Daily Dose) methodology was used.Results: Data showed, use of antibiotics jumped from 95.4 DBDs (DDD per patient's bed-days) to 124 DBDs. Distribution of different class of anti-microbial, showed the highest increase in use of vancomycin and clindamycin. Use of cotrimoxazole and amino glycosides remained fairly unchanged, how consumption of Penicillin G errs dropped. In year 2005, ICU ward followed by gynecology, were among the University Hospital departments with the highest consumption of antibiotics. Cefazolin was the most prescribed antibiotics during this study.Conclusion: It appears that there is a need for more national drug publicities and drug education program for health care professionals. Evaluation of drug distribution in hospitals seems to be necessary.

Background and Purpose: Improvement of the quality of life for patients must be considered as a main objective of treatment. Therefore, increased attention to coronary artery surgery, coupled with patients quality of life, is significant for patients after surgery.Materials and Methods: This descriptive study was performed on 172 patients, after a coronary artery grafting bypass. Data was collected by a SF-36 questionnaire, comprising of 36 questions divided in 8 domains. The score was designated as 0 to 100; with the higher score being indicative of a better quality of life. The obtained data was analyzed by descriptive statistics, t-test and analysis of variance methods.Results: Findings showed that 75% of subjects reported well quality of life, while the mean score regarding quality of life in men, were higher than women in all health related dimensions. Based on Hest difference, the of quality of life in men and women for physical health (p<0.014), mental limitation (p<0.033), somatic pain (p<0.032) and mental health (p<0.049) was observed.Conclusion: Considering a greater quality of life after coronary artery bypass grafting in patients, it is recommended to pay more attention to increase quality of life through treatment, care, follow- up in order to achieve the best quality of life for patients.

Since exposure to irradiation in radiotherapy or unwanted radiation, induces side effects to health, it is important to makear effort to protect humans against side effects induced by irradiation. In these cases, radioprotective drugs could be used to reduce or delay the side effects and the mortality induced by irradiation. Although, thiol compounds were early compounds in these categories, administration of these agents have induced serious side effects and is limited to use clinically. The search for less-toxic radiation protectors has spurred interest in the development of natural products. Natural products have mainly antioxidant and immunostimulant activity. Cytokines and androsetendiol have immunomudulatory effects in the prevention of mortality induced by gamma irradiation in animal model. Many studies have showed herbal medicine has good radioprotective effects. Flavonoids are one of the main chemical compositions in herbal medicine with antioxidant activity. Although, these natural products had low efficacy in comparison to thiol compounds, they have low toxicity. This review focused on recent radioprotective agents with natural origin that have more potential effects.