Journal of Kerman University of Medical Sciences
Year:2001 | Volume:8 | Issue:1|Papers Count:9

BCG vaccination has an important role in preventing the serious forms of tuberculosis in children. Adverse effects of BCG vaccination are uncommon in immunocompetent children. One of the side effects of BCG vaccine is its potential for producing hypersensitivity to tuberculin and difficulties in interpretation of PPD test results. Knowledge of the normal variations in the in duration of Mantoux (PPD) test with age is of utmost importance in the interpretation of this test. Since no comprehensive study has been performed on this subject in our country, we undertook this investigation on 247 children with ages from three months to 8 years who had been admitted to pediatric ward of Kerman university hospital No. 1 and in whom all confounding variables had been omitted. Of all children hospitalized in our pediatric wards, those cases entered this study who were three months to 8 years of age and who had received BCG vaccine in the neonatal period. The result of PPD test was negative (induraation of 0-4 mm) in 78 cases (31.6%), doubtful (5-9 mm) in 138 cases (55.9%), and positive in 31 cases (12.6%). There was no statistically significant correlation between the degree of induration in the PPD test and age of the children (r=0.0262; p=0.341). However, when the study group was divided into two age groups of below one year and above one year of age, we found two different trends; In the former age group the amount of induration decreased significantly with age (r=-0.2857, p=0.002), while in the latter group induration increased significantly with age increase (r=0.1812; p=0.014). This investigation demonstrated that in the first few months of life and in the period after 24 months of age, there is a higher probability for finding positive results (≥10 mm). We can attribute these results to the effect of vaccination-in infants younger than six months of age and environmental factors such as increased contact of children with atypical Mycobacteria for children above 24 months of age, though it is necessary to investigate these cases for the presence of tuberculosis. In infants from 6 to 36 months of age, who have the highest rate of negative ersults, a more cautious approach must be taken in case of the PPD induration diameter of 10 mm or above.

In the present study 220 diarrhea samples of children aged between 3-12 months and 100 samples from healthy individuals of the same age group reffered to Shiraz University hospitals were investigated for bacterial and viral agents. Electron microscopy methods were used for the viral investigations, while conventional techniques of bacteriology were used for isolation of bacterial agents. The prevalence of rotavirus examined by electron microscopy was 25 cases (11.4%). Other pathogenic organisms were E. Coli 66 cases (30%), Kelbsiella 21 cases (9.5%), proteus 5 cases (2.2%), Shigella 4 cases (1.8%), Salmonella 31 cases (14%), mixed bacterial agents 34 cases (15.45%) and non bacterial viral agents 32cases (14.6%). The highest rate of rotavirus infection was seen in children aged between 7-9 months in Aban (October) and Ordibehesht (May), but the highest rate of bacterial infection was seen in children aged between 4-7 months.

The aim of this study was to determine the microleakage at the cervical margin of the class II composite resin syntac with and without a cervical amalgam base and to compare microleakage restoration at the occlusal margins of restorations and interface of amalgam and composite. 68 extracted sound permanent premolar were used. 68 class II slot cavities were prepared in these teeth. The teeth were randomly divided into four groups, and restored as follows; Group A: Amalgam (Cinalux) + Syntac (bonding agent) + composite (Tetric) (sandwich technique) Group B: Amalgam (Luxalloy) + syntac +composite (tetric) (Sandwich technique). Group C: Syntac + composite (Control 1). Group D: Amalgam (Cinalux) (Control 2). Then the teeth were thermocycled, and immersed in the fuchsion. Marginal leakage was assessed by the degree of dye penetration on sections of the restored teeth, under stereomicroscope at 7.5 maginification. For analysis of data non parametric statistic tests (Kruskal-wallis and Mann withney-u) were used. Although marginal leakage was not completely eliminated, Sandwich technique exhibited significantly less leakage at the cervical margins than conventional method (Syntac / Tetric composite) and also there was no significant difference between Cinallux and Luxalloy amalgams, at the cervical and occlusal margins.

Heart murmurs are a common finding during physical examination of children, but most of them are innocent or normal. Recognizing the etiology of heart murmurs can help us in differential diagnosis of them. The present study was undertaken to determine the prevalence and etiology of heart murmurs in 4761 school children. The sex ratio was nearly 1:1. Murmurs were heard in 459 students (9.64%) with no statistical difference between boys and girls (P>0.05). Innocent murmurs found in 298 (64.92%) and pathologic murmurs in 161 ones (35.08%). Most (91.93%) pathologic murmurs were valvular in origin and the rest (8.07%) were a sign of intracardiac shunts. Mitral valve prolapsus (MVP) was the most common valvular abnormality (77.03%). MVP was 1.71 times more prevalent in girls than in boys (P<0.05). Next common forms of valvular lesions were pulmonic stenosis (0.46%) and aortic valve stenosis (0.19%). Pulmonic stenosis was 2.67 times more prevalent in boys than in girls (p<0.05), andaortic stenosis was seen only in boys (P=0.002). Atrial septal defect (ASD) was the most prevalent form of intracardiac shunts (0.19%), and was 8 times more common in girls than in boys (P=0.018). The present study confirms previous investigations that murmurs are frequently found in school children and most of them are innocent requiring no diagnostic or therapeutic modality other than history taking and careful physical examination. On the other hand, children with pathological murmurs ought to be referred to a pediatric cardiologist for evaluation and treatment if needed.

This study examines factors affecting weaning pattern of mothers residing in Shiraz (Iran). A cohort of 329 mothers who gave birth at the 14 maternity clinics of Shiraz during two consecutive weeks in 1996were selected randomly. Mothers were visited 11 times at home during 2 years post delivery and their breast feeding performance and its associated factors were examined closely. Mother's knowledge and attitude score and first menstruation period after delivery were significantly assoicated with the time of cessation of breast feeding (P<0.05, and P<0.01 respectively). The mean duration of breast feeding was 17.4 months. By applying Kaplan-Meier model, a conversely significant association was found between the mothers level of education and the breast feeding period (P<0.001). Also an association between rooming-in project of mother and neonates and the time of cessation of breast feeding was observed (P<0.01). Mother's menstrual cycle began on the average 5.5 months after giving birth. The results emphasized on necessity of fundamental planning on promotion of breast feeding in Iran and justifies economically any investment in this regard.

Hydatidosis or hydatide cyst, caused by the larvae of Echinoconccus granulosus, is one of the mostserious tapeworm cestodes infection occuring in man and in livestock in Iran. The persent study was carried out in order to determine the rate of infection in Shahriar area, in which no study has been conducted regarding this infection. 1052 human blood sample from different age groups were collected by random sampling and the serums were examined by indirect fleurosence analysis. 62 samples (5.9%) were found positive. The percentage of seropositive rate in females and males were 6.3% and 4.5% respectively. The highest percentage of infection was in age group of over 60 years old (8%). Concerning occupation, a higher rate of infection was in farmers and animal husbandry (16%). The rate of infection in rural and urban districts were 8.1% and 4.8% respectively. Concerning the education, a higher rate of infection was found in illiterate group. In conclusion, since the prevalence of hydatidosis is high in this area, it is recommended to take into account a prompt control measures.

Mucoadhesive drug delivery systems are among novel drug delivery systems that due to their ability to adhere and remain on the mucosal surfaces and a slow and sustained release of their drug content have attracted special attention in recent years. The aim of this study was to evaluate the effect of four different important factors on the mucoadhesive strength of a few mucoadhesive polymers. Among the polymers investigated, apart from the known polymers such as Carbopol 934P (C934) and sodium carboxymethyl cellulose (CMC) which have high mucoadhesive strengths, the effectiveness of a few other polymers were also studied. These were polyethylene oxide (PEO), Karaya (Kar), Carrageenan (Carr) and sodium alginate (Na alg). For this purpose polymer containing discs were prepared and their mucoadhesive strength in rat intestine (as a mucosa model) was assessed by using a home made apparatus. The mucoadhesive strength of prepared polymeric discs in the presence and absence of phosphate buffer pH=6.0 at 37 C and at various pH values from 2.2-8.0, and under the condition of hydrating the polymeric discs for 2 and 5 minutes in phosphate buffer pH=6.0 before placing them in contact with mucosa, was evaluated. Also, the effect of urea (as the hydrogen bond breaker) on the mucoadhesive strength of discs containing C934 and PEO was evaluated. The results showed that among the polymers studied, PEO and Carr like C934 and CMC have desirable mucoadhesive strengths, and could be used for the preparation of mucoadhesive drug delivery systems. It was also found that the extent of hydration of polymer containing discs has an important effect on their mucoadhesive strength. In case of insufficient polymer hydration or its overhydration, the mucoadhesive strength will be greatly reduced. Also, the environmental pH has an important effect on the mucoadhesive strength of discs and therefore in the design of a mucoadhesive system, a polymer with a high mucoadhesive strength in the specific area of the body should be used. Furthermore it was found that the formation of hydrogen bonds between the mucoadhesive polymer and mucosa, plays a very important role in the formation of a strong mucoadhesive bond.

Out-of-body experience is a rare experience reported in near death patients. It is also seen in healthy persons when falling asleep and in psychiatric and neuroligic patients. In this article nocturnal panic disorder in a patient with co-existence of, sleep paralysis episodes, out of body experience and hypnogogic hallucination is introduced. Such a case has not been reported yet. Along with his introduction, patient's symptoms are discussed.