MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES
Year:2016 | Volume:59 | Issue:5|Papers Count:13

Introduction: Mediterranean visceral Leishmaniasis (VL), so called kala-azar, is an endemic parasitic disease at Northeastern provinces of Iran. Several techniques are used for diagnosis of VL, but serology is less invasive. This study aimed to obtain the frequency of asymptomatic carriers of VL in endemic areas of North and Central Khorasan province, during 2015-2016.Methods: This descriptive cross-sectional study was performed on 442 children residing in rural areas of North and Central Khorasan province. The data were collected including demographic information and field observation. Direct Agglutination Test (DAT) and rK39 test were performed to identify antibodies against Leishmania infantum. The obtained data were analyzed using SPSS version 16.Results: DAT was positive in 23 (5.22%) of the children. The result of rK39 test showed that none of the participants suffering from acute stage of kala-azar. DAT test showed that there was a significant difference between the rate of Leishmania infection in two provinces (P<0.005).Conclusion: According to the results obtained by DAT, the prevalence rate of asymptomatic VL is estimated to be 5%. The rate of VL infection is higher in the Northeast of Iran in comparison with other regions. The rate of asymptomatic VL is higher in the North Khorasan than Central Khorasan provinces. Despite the high sensitivity of rK39 test in diagnosis of VL, it is not appropriate for identifying asymptomatic VL, therefore, using DAT is recommended for diagnosis of asymptomatic VL.

Introduction: Headache is one of the most common medical complaints. The treatment types of headaches require the diagnosis of these types. The aim of this study was to distinguish and diagnose common headaches by fuzzy logic and fuzzy system.Methods: A fuzzy expert system for the distinguish types of common headaches is presented, the Mamdani modeL was used in fuzzy inference engine using Max-Min as OR-AND operators and Centroid method was used as defuzzification technique.Results: The fuzzy system was evaluated using data obtained from 150 patients and showed 82% good agreement and high ability in terms of correct diagnosis. Accuracy, Precision, sensitivity, specificity of the system were 86%, 93%, 85%, 88% for migraine, 93%, 91%, 55%, 99% for tension, 97%, 86%, 66%, 99% for headaches resulting from infection and 95%, 85%, 88%, 97% for headaches resulting from increase of ICP, respectively. The Binomial and Chi-Square Test evaluated that between correct and incorrect diagnosis was meaningful difference and the proportion of correct diagnosis (82%) was more than the incorrect diagnosis (18%) (P<0.001).To measure agreement of system results with the physician diagnosis, Kappa statistics was employed and showed a high relation, 71%, 65%, 74% and 84% for migraine, tension, headaches resulting from infection and headaches resulting from increase of ICP, respectively.Conclusion: According to proximity of common headaches symptoms, and importance of early diagnosis of headache, and favorable results of the implementation and evaluation of the suggested expert system, therefore this system can be very useful for diagnosis of common headaches with similar symptoms.

Introduction: Community Acquired Pneumonia (CAP) is known as the Captain's death Platelets are inflammatory cells with an important antimicrobial role in host defense. Our hypothesis is that abnormal platelet count can be an indicator of the CAP intensity. The aim of this study was to investigate the relationship between blood platelets and complications in hospitalized CAP patients of Mashhad Islamic Azad University teaching hospitals.Methods: A total of 60 CAP patients were selected for this study Complete Blood Count was routinely performed for all patients. Patients with platelet count less than 100000/microliter considered thrombocytopenic, count more than 400000 /micro liter considered thrombocytosis. The relationship between CAP of complications, included pleural effusion, respiratory insufficiency, septic shock, empyema, and platelet count were evaluated.Results: Mean age of patients was 62.6±10.4 years, 46 patients hade normal platelets, 11 patients hade thrombocytosis and 3 patients hade thrombocytopenia.Age, sex and leukocyte count showed no meaningful difference between three groups. Respiratory insufficiency was not different between three groups, but pleural effusion and empyema were more prevalent in thrombocytosis group, and septic shock was more prevalent in thrombocytopenic group.Conclusion: In CAP platelet count should be considered, because of the impressive clinical results, and further studies may be necessary to achieve more accurate results.

Introduction: Attention deficit/ hyperactivity disorder is a common childhood disorder which finding an effective treatment to decrease its symptoms is very important. This research aimed to investigate the effect of computer games on sustains attention and working memory in elementary boy students with attention deficit/ hyperactivity disorder.Methods: This research was a queasy-experimental with a pre-test and post-test design. The statistical population included all elementary boy students with attention deficit/ hyperactivity disorder that referred to counseling centers of Pakdasht city in 2015. Totally 30 students were selected through available sampling method and randomly assigned to two groups. The experimental group educated 12 sessions of 60 minutes by computer games method. To assess sustain attention and working memory, CPT and N-back computerized tests were used respectively. Data were analyzed by analysis of covariance method and with using the SPSS-19 software.Results: The results showed the mean and standard deviation of sustain attention and working memory before the intervention in the computer games group were 121.86±12.73 and 33.43±6.86 respectively. But after the intervention, the mean and standard deviation of them become 148.23±11.18 and 43.62±7.29 respectively. Also, the other result showed that the computer games method significantly led to increase sustain attention and working memory in elementary boy students with attention deficit/ hyperactivity disorder (P<0.01).Conclusion: The results of this research suggest that therapists and clinical psychologists use from computer games method to increase sustain attention and working memory in students with attention deficit/ hyperactivity disorder.

Introduction: Varied dressings are studied for the donor site of split-thickness skin graft. Some are expensive and not easily available. Fine gauze and vaseline gauze are not expensive and are easily available. In this study, we compare these dressings.Materials and Methods: In a cohort study, 30 candidates of partial-thickness skin grafts from thigh in Ghaem Hospital, Mashhad are studied from 1389 to 1391. Every patient was compared with itself: half of the donor site was dressed with fine gauze and half with vaseline gauze. Pain was assessed with verbal pain scale from 0 to 10. Healing time was assessed as the time to complete epithelialization and detachment of dressing without trauma. Infection was diagnosed clinically by a plastic surgeon based on symptoms such as redor or purulent discharge.Results: The mean healing time with vaseline gauze was less than fine gauze. The mean score of pain with fine gauze was less than vaseline gauze. There was only one case of infection in fine gauze dressing.Conclusion: Dressing with vaseline gauze is advantageous regarding healing time, but disadvantageous regarding pain.

Introduction: Postpartum women for low rates of physical activity are at risk for increase weight and obesity. The aim of this study was to examine self-efficacy as a moderator on changes in postpartum physical activity.Methods: This study was a randomized controlled trial conducted on 80 postpartum (intervention (n=40) and control (n=40) groups) referred to health centers in Mashhad, Iran which were randomly selected by multistage cluster. The data collection instruments were the standard Exercise self-efficacy Scale (ESS) and International physical activity questionnaire (IPAQ). The educational intervention was designed based on self-efficacy strategies’ and was performed in two educational sessions lasting 80 minutes and practical sessions. Before and Two months after the intervention, questionnaires were repeated again. Data were analyzed and compared in SPSS 16 software by Independent Paired T and one way ANOVA.Results: This study indicated that only 15% of mothers had high exercise self-efficacy and 35% of them had moderate-to-vigorous physical activity (MVPA), before education intervention. In addition, there was no significant difference between the mean of self-efficacy and physical activity scores. However, two months after intervention, a significant increase was observed in the mean of scores in the intervention group compared to those of control group (P<0.001).Conclusion: According to the effect of self-efficacy on physical activity, it is suggested that workshops should be held in health centers based on self-efficacy physical activity strategies for postpartum women.

Introduction: The high prevalence of mental disorders in patients with skin diseases has been confirmed in several studies. Psoriasis is a chronic skin disease with psychosomatic element and various studies indicate the emergence or aggravation of disease symptoms with psychological factors. Studies also showed a higher incidence of anxiety and depression in patients with psoriasis relative to general population. Psoriasis can highly affect the quality of life of these patients. The aim of this study was to investigate the effectiveness of cognitive-behavioral stress management on anxiety, depression and quality of life in patients with psoriasis.Methods: This study is a quasi-experimental study conducted with pretest, posttest and control group. The sample consisted of 16 patients diagnosed with psoriasis which were randomly assigned to experimental (8 patients) and control (8 patients) groups, following diagnostic interview and confirmation of anxiety and depression. Hospital Anxiety and Depression Scale (HADS), Short Form (36) Health Survey (SF-36) and Dermatology Life Quality Index (DLQI) were used for data collection. The test group was subject to cognitive-behavioral stress management in 8 sessions. Data were analyzed using analysis of covariance.Results: The results showed that the average scores of quality of life in the experimental group were significantly increased (P<0.05) and average scores of anxiety and depression were decreased (P<0.05) compared to control group. The results of this study demonstrated the effectiveness of group intervention for stress management using cognitive-behavioral approach on anxiety, depression and quality of life of patients with psoriasis.Conclusion: The results of this study demonstrated the effectiveness of group intervention for stress management using cognitive-behavioral approach on anxiety, depression and quality of life of patients with psoriasis.

Introduction: The purpose of this study was to investigate the effect of eight weeks endurance training on platelet indices in women with type (II) diabetes.Methods: Atotal of, 20 women with type 2 diabetes voluntarily participated in this study and divided into training (N=10) and control (N=10) groups. Subjects were invited to the laboratory after an overnight fasting and blood samples were taken from antecubital (brachial) vein (5 mL), Pre and post training period. Thereafter, anthropometric characteristics and peak oxygen consumption were measured in the separate sessions. Endurance training protocol consisted of running on treadmill for 8 weeks (intensity: 60-75% peak of oxygen consumption, exercise duration: 35-50 min per day). Platelet indices, serum glucose and glycated hemoglobin, were measured by using cell counter system, enzymatic colorimetric and column chromatography methods, respectively. In order to analyze the within and between groups changes dependent and independent t-test were used, respectively.Results: Results showed that glucose and HbA1c levels were significantly decreased in training group (P<0.01) after 8 weeks period and also there was a significant difference between two groups (P<0.05). PCT and PLT did not change significantly between the two groups (P>0.05); but MPV and PDW significantly reduced in the training group and increased in control group, respectively (P<0.05). MPV and PDW changes between the two groups showed significant differences (P<0.01).Conclusion: Based on these findings it could be concluded that endurance training through glycemic control and improvement of platelet morphology can prevent the occurrence of thrombotic events in diabetic women.

Introduction: Renal artery stenosis (RAS) is the most common cause of secondary systemic hypertension. The efficacy of endovascular treatment of patients with RAS, who achieved antihypertensive optimal medical treatment (OMT), is unclear. But it may be useful in some selected clinical scenarios, including cardiac disturbance, resistant hypertension and ischemic nephropathy.Case Report: Our first patient suffered from resistant hypertension with end organ damages (EOD), due to significant bilateral RAS. In the second and third patients, the severe unilateral RAS was presented by resistant and malignant hypertension. In all three patients, hypertension had become under controll by medical treatment after renal artery stenting.Conclusion: It seems that renal artery stenting is an effective and safe adjuvant approach in addition to the medical treatment of patients with RAS, in whom their hypertension is not only unversponsive to the OMT, but also causes EOD.

Disease related to coronary artery is one of the important subgroups of cardiovascular diseases. Replacement of the blocked or narrowed arteries is an usual surgery for treatment of these diseases. Nowadays autografts are the best replacement for diseased vessels. Saphenous veins, radial arteries and internal mammary arteries are known as gold standards for transplants of damaged arteries in patients who suffer from cardiovascular diseases, but in many of them the autografts are not available because of different reasons such as age, small size, varicosities and previous removal. So due to the large number of requirements especially for small diameter vascular grafts, it is necessary to find a suitable replacements for diseased blood vessels. Nowadays tissue engineering attempts to design and fabricate artificial blood vessels which have the most accordance with native vessels. Also progresses in biomaterial and bioreactor technologies make it possible to fabricate synthetic vascular scaffolds which can optimal mimic the conditions of autografts. So in this paper we focused on common polymers in fabrication of artificial vascular scaffolds.