Journal of Mazandaran University of Medical Sciences
Year:2009 | Volume:19 | Issue:72|Papers Count:18

Background and purpose: Chronic idiopathic urticaria (CIU) is a recurrent disorder that is characterized by itching wheels lasting more than 6 weeks. Etiology of CIU is unknown. The aim of this study is to assess the efficacy of Helicobacter pylori (Hp) infection eradication in improvement of CIU.Materials and methods: In this double blind placebo-controlled clinical trial, 60 CIU patients were enrolled in the study. Urea breath test (UBT) was performed for indicating the Hp infection. Hp positive patients were divided in 2 groups: cases that were treated with quadruple therapy for eradication of Hp (Amoxicillin, Omeprazole, Bismuth and Metronidazole) and controls (placebo). The gastrointestinal (GI) and dermatologic symptoms and signs were recorded and compared in the beginning of the study, and 1 and 3 months after the treatment.Results: From 60 CIU patients, 32 (53%) were UBT positive. 15 cases and 13 controls completed the study. There were no significant statistical differences between the two groups for their GI and dermatologic complaints before intervention, and 1 and 3 months after eradication, except for pyrosis that was improved in cases after 3 months (P=0.029) Conclusion: Eradication of Hp does not have any effect on improving CIU symptoms or signs.

Background and purpose: Squatting test and heart rate variability (HRV) are currently being used to evaluate cardiovascular autonomic nervous function. HRV indexes are able to measure vagal function, while squatting test is able to measure both sympathetic and vagal functions. Our objective in this research is to evaluate the influence of injective dicyclomine hydrochloride (DCH)-an M1 receptor selective antagonist- on autonomic nervous system function regarding HRV indexes and squatting test.Materials and methods: Fifteen healthy males 19-24 year-old volunteers were involved in this single blind research. Each volunteer was referred two times every week and in each session the DCH (20 mg / 2ml) or placebo (2 ml) is injected to the muscle and between 30 to 40 minutes after injection, the uncontrolled normal breathing test and squatting test were conducted. After that, those parameters which show cardiac vagus and sympatic activity were measured in these tests.Results: Administration of single dose of DCH didn’t cause any side effects; only one case of dry mouth is monitored. An increase in HRV indexes in uncontrolled normal breathing test, increase in vagal ratio, and decrease in sympathetic ratio in squatting test all caused by DCH.Conclusion: Although DCH is an anticholinergic agent, in muscular administration with 20 mg dose, regarding HRV parameters and squatting test, it shows cholinergic effects.

Background and purpose: Intradialytic hypotension (IDH) is the most frequent complication in patients receiving haemodialysis (HD) that poses most problems for patient and treatment team. The use of sodium profile and ultra filtration (UF) profile is one of the preventive methods that have been recently introduced. However, increased intradialytic weight gain (IDWG) has been described as the side effect of this method. The aim of this study was to evaluate the effects of linear and stepwise sodium and UF profile on Intradialytic hypotension and IDWG.Materials and methods: This was a clinical trial study and crossover design. Twenty- six stable HD patients from two dialysis centers (Ali Asghar and Alzahra Hospitals) of Esfahan University underwent three treatments: (1) control, constant dialysate sodium concentration of 138 mmol/l with constant UF; (2) linear sodium profile + UF profile (type 1), a linearly decrease dialysate sodium concentration (146-138 mmol/l) combination with a linearly decrease UF rate. (3) Stepwise sodium profile + UF profile (type 2), a stepwise decrease dialysate sodium concentration (146-138 mmol/l) combination with a stepwise decrease UF rate. Data were analyzed using c2 and independent t-test in SPSS software.Results: In this study, a total of 26 patients (14 men, and 12 females) participated. The mean age was 46.8±19 years. In each group, 78 dialysis sessions and a total of 234 dialysis sessions were analyzed.The incidence of intradialytic hypotension, while receiving an intervention, was significantly reduced during linear and stepwise profiles, as compared with control (P<0.05, respectively). However, there was no significant difference between profiles. IDWG did not show any changes during three groups.Conclusion: Sodium profile and UF profile modulates the dialysate sodium concentration and ultra filtration rate and also, prevents the incidence of IDH while reducing nursing intervention, without increasing IDWG. Thus, using sodium profile and UF profile groups (linear and stepwise) is recommended for the prevention of hypotension, as compared to routine method.

Background and purpose: Protein quality of cereal/legume mixtures results in nutrient profiles.Regarding to the importance of food protein quality, this study was conducted to compare protein value of two samples of home made food (based on semolina spaghetti + soybean and nole spaghetti + soybean mixed) with Cerelac - based on wheat (commercial baby food) in Rats.Materials and methods: Experimental study was conducted on 80 male rats (wistar) aged 21 days in 8 groups, under 10 diets inclusive of: 3 test diets (Cerelac and two samples of home made food), 1 diet standard (casein+Methionine) and 1 diet basal (protein free) for True protein Digestibility (TPD) and Apparent Digestibility (AD) study and 3 test diets, 1 diet standard and 1 diet basal for Net Protein Ratio (NPR), Protein Efficiency Ratio (PER) and Food Efficiency Ratio (FER) study. The value of TPD, NPR and PER between groups were analyzed by ANOVA and then with Bonferroni post test.Results: The value of TD 92.8, 87, 89 and 85.4, NPR 4.3, 4.3, 3.6 and 3.6, PER 3, 2.5, 1.8 and 1.7, were for casein+Methionine, Cerelac and home made foods based on semolina spaghetti+soybean and nole spaghetti+soybean mixed. So there are significant difference between groups in compare to TD and PER (p<0.05), but in compare to NPR is not significant.Conclusion: The findings showed that TD and NPR of home made food in comparison with Cerelac are acceptable, but in compare to PER is lower.

Background and purpose: Acupuncture is a treatment useful in reducing and eliminating pain.This study was undertaken to present a simple and fast method of treatment in acute radicular low back pain by injection of acupoints.Materials and methods: Fifty patients with acute low back pain with positive Straight Leg Raising (SLR) test were enrolled in the study. The patients were randomly divided into two equal groups.Physical examination in the pilot study showed that patients have five tender acupoints including BL-57, BL-40, BL-36 or 37, BL-23 and GB-30. The subjects in the first group were injected in at least 3 acupoints of these 5 points. Injection was done only once by mixing 2cc of lidocaine 2% and 1ml of methylprednisolone acetate (40 mg). The subjects of the second group took medication such as piroxicam 20 mg orally, methocarbamol 1500 mg and diazepam 10 mg daily for one week. Dependent variables were measured including; pain intensity was measured by Numerical Pain Rating Scale (NPRS), balance and weight bearing ability was measured by Standard Hopping Scale (SHS), sciatic nerve stretch was measured by SLR, patients’ function was measured by Back Pain Functional Scale (BPFS) questioner.Results: Both groups were equal statistically before starting treatment, but there was a significant difference between them in variables BPFS and SHS 10 days after treatment. The mean of decreased pain intensity in NPRS and SLR were equal but effective in both group on the 10th day.Conclusion: It seems that effect of injection with acupuncture points in acute low back pain not only is as good as medical treatment but it is also better than that. In this treatment, there was no report of secondary complication to treatment. So, in patients with acute radicular LBP, injection of tender acupoints is an effective, safe, economical, and time saving method of treatment.

Background and purpose: Weight-based dosing of medication is used in the emergency and anesthesia departments. Ideally each patient should be weighed prior to dosing. However, this may not always occur, especially in the anesthesia department. The purpose of this study was to assess the prediction formula for actual patient weight by the sum of head weight and estimated Anesthetic personnel.Materials and methods: Diagnostic descriptive study was used for patient’s body weight, which had been estimated by anesthetic personnel's, while head patient weight was measured by instrument during anesthesia. Data was analyzed by descriptive statistics and regression linear and compared with ANOVA test. The significance level in this study was.Results: The mean total weight of patients that were estimated by the personnel of anesthesia was 65.7±11.7 kg. The mean actual weight was 65.2±13.7 kg. The correlation coefficient between estimated actual weights is not significant.Conclusion: This study showed that adding head weight to the estimation weight by anesthetic personnel, results in a more accurate weight estimation than head Wight alone.

Background and purpose: Homocysteine is a new cardiovascular risk factor that its enhancement can cause increase in cardiovascular diseases. Because of physical activity importance in cardiovascular diseases prevention (specially in older people) this study intend to investigate the effect of 8-week low impact rhythmic aerobic (LIA) exercise on total plasma homocysteine concentration in non athlete Iranian older women for first time.Materials and methods: Twenty five healthy women of (60-85) in Taravat retirement home at Shahrekord were the statistical sample of this study. They were purposefully divided in to two groups: (including) experimental and control. The Control group was also able to do the physical activity. At first, anthropometric characteristics including height, weight, Body Mass index (BMI) and Waist-to-Hip Ratio (WHR) were measured and recorded. Then resting blood sampling was taken from anterior vein in 5cc amount, while they did not eat any breakfast for 8-hours. Experimental group were directed to the LIA exercise program such as musical aerobic exercise with 40 percent of maximum heart rate for 15 minutes in first week and with 65 percent maximum heart rate for 40 minutes in the final week. Then WHR, BMI, resting blood sampling and total plasma homocysteine were measured again.Results: For pre-test and post-test data comparison in two groups paired t-test and between groups in dependent t-test and Pearson correlation coefficient for assessment of relationship between homocysteine with WHR and BMI were applied. According to these results, there was a significant difference between total plasma homocysteine, BMI and WHR before and after the training in experimental group while nonsignificant difference was observed in control group. In investigating the relationship among these factors in experimental group, although there was not a meaningful relationship between BMI & homocysteine, a direct but incomplete relationship was observed (p=0.372, r=0.27) and also, between homocysteine and WHR in this group has been obtained similar results to previous one was obtained. In control group no significant relationship was observed among the variables.Conclusion: Observations from this study, reveals that an 8-week low impact rhythmic aerobic training had useful effects on older women’s total plasma homocysteine concentration BMI & WHR reduction.

Background and purpose: Cancer is the second most common cause of death in developed countries and third in less developed countries. The incidence of the different histological types of cancer varies greatly between various populations and is attributed to occupational, social, cultural, racial, and geographic influences. The objective of this study was to determine and register all cases of cancer among population of Mazandaran province, during the year of 2006.Materials and methods: Characteristics of all registered malignancies were obtained from records in histopathology and radiology clinical, hospitals and deaths certificated in Mazandaran using the International Classification of Disease (ICD), with data being analyzed using ASR, Excel and spss soft ware.Results: A total of 2.399 patients with cancers were found during this study. These, 1.321(55.06%) were males and 1.078 (44.94%) females. Age standardized rate (ASR) for all cancers in males and females were 112.91/100000 and 104.59/100000 Respectively. The most common malignancies among females were breast (23.38%), skin (11.78%), colon and rectum cancers (10.30%).In men, stomach (42.41%), skin (15.59%) and esophagus (9.08%) were the most common cancers respectively. Infiltrating duct carcinoma was the most common histopathological types of tumors (69.35%) in breast cancer. The most common morphology in stomach cancer was adenocarcinoma, (54.67%).Conclusion: Distribution of malignant disorders in our population is different from other regions.Therefore, it appears necessary to have a valid health policy for prevention. Consequently, it is necessary to have a valid health policy for prevention and control of this problem.

Background and purpose: Adverse drug reactions (ADRs) are one of the leading causes of morbidity and mortality, worldwide. Mortality rate due to ADRs are ahead of pulmonary disease, AIDS, pneumonia and automobile accidents. This study evaluated the admission rates in a University teaching hospital related to ADRs.Materials and methods: During this retrospective study between 2001 and 2007, all patients admitted due to adverse drug reaction in Sari Bo-Ali Sina Hospital were evaluated.Results: In these years, 31 patients out of 71,680 were admitted, due to ADRs. Most common ADRs were skin reaction (74%) and fever (22%). Phenobarbital and penicillin were the most common drugs causing ADRs.Conclusion: Only 0.04% of hospital admissions were drug related, while reported admission due to ADRs in other countries were 2.4 to 6.2%. It appears that less drug-depended hospital admissions in Iran rational drug administration, but is due to lack of enough detection, records and reporting procedures.

Background and purpose: Leptospirosis is an infrequent zoometric bacterial disease which is caused by pathogenic bacteria called Leptospira. The risk factors of the disease include living in tropical and rural areas, contact with contaminated water, living near sewers and sanitation work. The disease may cause symptoms such as chills and fever, severe headache and myalgia. Costal region of Caspian Lake has desirable conditions for occurrence of this disease. The aim of this research is to study this disease in the North of Iran, by using and analyzing a 6-year set of recorded cases in Mazandaran province between 2003 and 2008, that provides more completed information.Materials and methods: This study is a descriptive, retrospective (case series) study. All of the recorded information concerning to patients with leptospirosis in Mazandaran Health centre from 2003 to 2008 were collected and checklist forms were completed, followed by data related to three characteristics including patients, living conditions and then the disease was analyzed.Results: Of the 102 patients, 76.5% were males, 46.6% were farmers and the mean age was 48.8+15.5. The prevalence of the disease was at the highest in 2007 and in summer seasons. The most common symptoms were fever (74.5%), myalgia (68.6%) and icter (47.1%). The greatest number of the cases was from Ghaemshahr city (37.3%), the majority of the cases (88.2%) had history of working farm.Over-all, 97.1% of the patients were cured.Conclusion: According to the findings, leptospirsis affects farmers in their working season in Mazandaran province. It is necessary to provide information to the medical practitioners, especially general practitioners and also, to develop diagnostic and therapeutic facilities in the province.

Background and purpose: Waardenburg syndrome (WS) is a rare disease characterized by sensor neural deafness in association with pigmentary anomalies and defects of neural-crest-derived tissues. WS is caused by mutations in the microphthalmia-associated with transcription factor gene.Materials and methods: This case is a 10 month old infant girl in which during a routine physical examination found that she has hetetrochromia and unilateral hearing loss. Regard to waardenburg syndrome criteria Type 2, this case report was diagnosed as WS.Results: WS is classified into four types. WS 2 is characterized by sensorineural hearing loss, lateral displacement of medial canthi (dystopia canthorum), pigmentary disorders of eyes, hair, and skin.Conclusion: Waardenburg syndrome can be diagnosed easily in the first few months of life, due to prominent phenotypic features. Earlier diagnosis means a more successful rehabilitation of hearing.

In the present study, the usage pattern of Anti-inflammatory drugs-steroidal and non-steroidalin patients referred to 13 Aban Pharmacy in Sari was evaluated. The results show a high rate of anti-inflammatory drug prescriptions, mainly by general practitioners with ibuprofen, diclofenac and mefenamic acid being the most widely used NSAIDs and prednisolone, dexamethasone and betamethasone being the most prescribed corticosteroids respectively. Training physicians regarding the rational use of anti-inflammatory drug prescriptions may be effective in modifying the usage pattern of these drugs and avoiding the risks associated with their heavy usage.