JOURNAL OF ARDABIL UNIVERSITY OF MEDICAL SCIENCES (JAUMS)
Year:2007 | Volume:7 | Issue:2 (24)|Papers Count:19

Kikuchi is a benign inflammatory and self-limited disease which was first and reported in Japan.Females are more commonly affected, in their third decades usually presents itself as a single lymph adenopathy, in the cervical region. The recurrence occurs approxjmate1y in 3% of the cases. The subject is a 22 year old female presented with skin rashes and multiple adenopathy one month before admission .The peripheral blood smear shows moderate leukocytosis, with atypical lymphocytes. The ESR show moderate elevation. Finally after lymph node biopsy, the diagnosis of KFD was confirmed.

Background & Objectives: The high incidence of low birth weight (LBW) occurs in developing countries, and diarrhea and respiratory infections are the main causes of infant mortality and morbidity. This study was done to find out whether there was a growth or morbidity response to zinc supplementation, among LBW infants during the first 6 mo of life.Methods: The study was a randomized, placebo-controlled, and double-blind trial study.LBW infants were given daily for 6mo 5mg zn, or a placebo. Questionnaires were filled out during the study by a pediatrician and a GP. Anthropometric measurements were made at 0, 4, 8, 12, 16, 20 and 24 wk via home visits by trained interviewers.Results: Baseline characteristics were similar in zinc and placebo groups. Weight gain in zinc group was significantly higher that of placebo group between 1 to 6 months (p=0.036).Length and head circumference gain were also greater in zinc group than in placebo groups, (p=0.04, p<0.001). The episodes of upper respiratory infections was greater in placebo group than zinc group (mean Episodes in zinc groups= 1.7 and in placebo group was 3) and there was significant difference between two groups (p=0.005). 8 Cases of lower respiratory infections in placebo group and 5 cases in zinc group were observed, but it was not significant diarrheal episodes were observed only in placebo groups.Conclusion: It was found that low birth weight infants had better growth and lower morbidity during the first 6 months of life by receiving zinc supplementation.

Background & Objectives: Mitral valve prolapse (MVP) syndrome is one of the most prevalent abnormalities of mitral valve that arises from pathologic changes of the various parts of mitral valve. MVP may lead to ECG changes, like T wave inversion in inferior leads and atrial and ventricular arrhythmias, in some people that may be misdiagnosed as myocardial ischemia.Methods: This was an analytical (case-control) study in 50 cases with MVP with age below 30 years who had referred to the Ardabil Bouali Hospital and some private cardiology clinics.The diagnosis of MVP was based on clinical and echocardiographic findings, and after taking history and physical examination, an ECG and an echocardiogram were taken from each person in case and control groups and the acquired information was analyzed via statistical methods of SPSS software.Results: From 50 studied cases with MVP, 60% (30 cases) were female and 40% (20 cases) were male, and the most commonage range was 21 - 25 years. From these cases, 68%(34 persons) had changes in their ECGs while %32 (16 subjects) did not. In control group, from 50 persons, 44% (22 persons) had ECG changes and 56% (28 persons) did not.Conclusion: In general this study showed that increase in ECG changes in MVP group in comparison with control group (p=0.01). In cases with MVP, there was not significant relationship between gender and ECG changes. In comparing case and control groups, there was not significant difference in ECG changes in females, while there was a significant difference in males (14 of 20 versus 6 of 20) with considering that ECG changes in persons with MVP may be misdiagnosed as ischemic heart disease it is recommended that cases (especially men) with MVP always keep a record of their ECGs.

Background & Objectives: Resistance Strains of propionibacterium acnes is one of the most growing problems in acne treatment. Azelaic acid, due to the lack of bacterial resistance, could be a useful alternative in topical treatment of acne. The purpose of this study was to investigate the therapeutic effects and side effects of azelaic acid and its comparison with topical clindamycin in the treatment of acne.Methods: This randomized clinical trial study was performed on 100 patients with mild acne.The patients were divided in to two groups. One group was treated with azelaic acid 20% cream and the other one was treated with Dalacin 1% gel twice daily for 4 weeks.Results: Both drugs Produced significant reduction in inflammatory Lesions (for azelaiCacid p=0.000 and for clindamycin p=0.000) and noninflammatory lesions (for azelaic acid P=0.001 for clindamycin p=0.033). Comparing the mean of decrease in inflammatory and noninflammatory lesions, there was not a significant difference between two groups (of Papule and Pustule P=0.864 of comedons P=0.239). So the efficacy of these two drugs was same. In comparing the sideffects, erythem was more common in azelaic acid users significantly (p=0.031) and skin dryness was more Common in clindamycin users significantly (p=0.000).Conclusion: Azelaic acid 20% cream as effective as clindamycin gel 1% in the treatment of mild acne.

Background & objectives: Hypertension is a disease with high prevalence and complications and unfortunately the treatment of which is not desirable in many communities including ours. The aim of this study is to assess the therapeutic diet giving and level control of HTN in patients with Hypertension who referred to Ardabil Boali Hospital emergency room and out patient Clinic room.Methods: This study was performed on 200 patients who referred to the emergency room and out patient Clinic in Ardabil Boali Hospital from 2003 to 2004 due to high blood pressure. In this study, blood pressure and other factors such as sex, age and the therapeutic modality including compliance to therapy and kind and quality of drugs were determined, then the data was analyzed by using descriptive statistics.Results: Of 200 patients only 1% did not take drug 59.5% of patients were on monotherapy and 39.5% took two or more drugs 33.5% were on Beta blocker (Atenolol) and 11% on ACE inhibitor (Enalapril). Among patients on combination therapy the highest prevalence was B.bloche and ACE.I 40%, and the least one prevalence was diuretic and CCB (2%). All patients on diuretic were pre hypertensive whereas the majority of patients on CCB had stage II hypertension. In patients on multi drug therapy all patients on diuretics + CCB were pre hypertensive but 57% of patients on ACEI + CCB or ACE.I + diuretic had stage II hypertension.Conclusion: In this study for combination therapy Diuretic and CCB had the best result in controlling hypertension.

Background & Objectives: Pools and Saunas are one of the most public areas that may cause superficial and cutaneous mycoses in humans. So investigating the fungal flora in the mineral swimming pools like Sarein area can remove or reduce the contamination or prevent the probablity of fungal infection.Methods: A total of 284 samples from 11 mineral swimming pools were taken of which 214 were from pools, sauna Jacuzzis, tubs and showers which were covered by sterile moquette and 70 were from water in saunas, jacuzzis, tubs and showers which were collected in sterile test tubes. All of the samples were cultured in standard method on sabouraud dextrose agar (SDA), sabouraud dextrose agar+oleic acid (S+O) and sabouraud dextrose agar + chloramphenicho1+cyclohexamide (SCC) medias, then identified macroscopically (colony morphology )and microscopically.Results: From 284 samples, 193 were contaminated with fungi. The most frequently isolated species in 11 pools were Aspergillus fumigatus (22/79%), Aspergillus flavus (15/54%), Aspergillus niger (15/54%) and Penicillium (14/5%) respectively. On the other hand, Ulocladium, Sepedonium, Acremonium, Pscilomyces, Stemphylium and Streptomyces with 0.51 %were the least frequently isolated species. In this study, no dermatophytes or other true dimorphic pathogenic fungi were isolated from samples.Conclusion: So it can be concluded that routine hygiene inspections such as disinfection of pools, personnel training and following hygienic rules were much effective in lowering the comtamination. Also mineral waters of these pools can be growth inhibitors of pathogenic and dermatophytic fungi.

Background & Objectives: Septicemia is one of the serious infections of neonatal period that its microbial etiologies bacterial causes are different in various parts of the world. Incidence of sepsis in developing countries is much more than that of developed countries and it is one of the important causes of mortality and morbidity in neonatal period. This study was done to determine the microbial etiology, mortality and resistance pattern of septicemia.Methods: This study was a retrospective cross-sectional study for three years on blood cultures of 210 neonates admitted in pediatric hospital in Tabriz. Demographic information, clinical findings, types of bacteria in blood culture and antibiogram were analyzed.Results: Mean age of patients was 8±2 days in which sixty percent were male and the rest were female. Among 12 isolated bacteria, negative staphylococcus coagulase was the most common. 68.6% of isolated bacteria were positive gram. 31.4% of negative gram was in which klebsiella pneumoniae the most frequent incidence had. 22.9% of neonates died, in which 9% of them weighed less than 1500 grams. Among 8 antibiotics used by disc diffusion method, ampicillin showed the highest (97.4%) and vancomycin the lowest (6.7%) resistance.Conclusion: septicemia is still the main problem in neonatal ward and neonatal intensive care unit. The etiologic agents and resistance pattern of each area should be considered in starting empirical treatment.

Background & Objectives: Atherosclerotic stenosis of carotid territory is the most common cause of ischemic stroke. A higher frequency rate of intracranial arterial stenosis in African and Far East ra~es has been reported.Methods: This double center and prospective study was carried out in 304 geriatric ischemic stroke patients admitted in MackenZie Hospital, Canada and the same number of geriatric ischemic stroke patients with similar sex ratio'admitted in Valie-Asr Hospital, Birjand during 2003-2005. The cause of brain infarction in carotid territory was made by neurologists was vasular origin. All of the patients underwent transcranial and carotid doppler studies based on the standard method by a neurosonologist. Topography of arteriosclerotic stenosis in bilateral Internal Carotid Artery (ICA) territories was determined. Fisher exact test served for statistical analysis and p<0.05 declared as significant.Results: In Iranian group; 71 patients (23.3%) and in North American group 83 patients (27.3) had extracranial ICA stenosis without a significant difference; p=0.3, df=1, OR=0.81, 95%CI (0.56- 1.17). Sever ³70% extracranial ICA stenosis was found in 14 Iranian patients (4.6%) and 23 North American patients (7.5%) without a significant difference. p=0.17, df=1, OR=0.59, 95%CI (0.3-1.77). In Iranian group, 14 cases (4.6%) and in North American group 5 cases (1.6%) had intracranial ICA territory stenosis which had a significant difference p=0.038, df=1, OR=2.9, 95%CI (1-8.1). Mixed intracranial and extracranial ICA territory stenosis was found in 2 Iranian and 1North American patients.Conclusion: Atherosclerotic stenosis of intracranial ICA territory is more common in Iranian than in North American populations.

Background & Objectives: Oligohydramnios is a disorder which is followed by unpleasant outcomes for fetus that can lead to termination of pregnan9Y before term and preterm delivery. For these patients' increase in gestational period and prevention of preterm delivery is the most important act. In this study the effect of intravenous and oral hydration therapy in increasing duration of gestation in patient with oligohydramnios was evaluated.Methods: In this study, the population was divided into two case and control groups with 30 female individual who were found to have oligohydramnios in course of hospital admission according to on sonographic results. Patients were randomly put in case or control groups.Case group were given 3-4 liter normal salin for. 1 week and then were given oral hydration solution until the end of pregnancy, In each group whenever it was found that pregnancy was not possible the pregnancy continuance was stopped. Data-collection was through history, physical examination completing relevant questionnaire and findings of sonography and in order to see the relationship among finding s, kitest and t-test from SPSS software were used.Results: The age means of case and control groups were 25 and 24 respectively. The mean of pregnancy duration from the diagnosis time in case group was. 30.2 weeks and in control group 31.8 weeks. The mean of pregnancy terminatior in case group was 34.6 weeks and in control group 34.2. Increasing duration of pregnancy in case and control group. It was concluded that intravenous and oral Hydration therapy cause increase in duration of pregnancy in patients suffering from oligo Hydraminos. According to the results of this study and significance of the difference.

Background & Objectives: Goiter prevalence in school age children is an indicator of the severity of iodine deficiency disorders (IDDs) in the society and goiter prevalence ³5% in school age children indicates a public health problem. In area of mild to moderate IDDs, measurement of thyroid volume by ultrasonography through observation is preferable to population for grading goiter. Considering the importance of this issue, because of being mountainous and lack of this method's application for determining the incidence of goiter this study was designed.Methods: In this descriptive- analytical study, thyroid volumes of230 boys between 12 to 15 . years old were measured by portable ultrasonograph in Tabriz. Also urinary iodine concentrations were determined by method A (Sandell-kolthoff reaction).Results: Mean of subjects' thyroid volume was 8.12±2.21ml and with latest references of Iran and WHO/NHD, goiter prevalence was taken based age 51.7 % and based surface body 81.1%. Urinary iodine median of tested samples was 15.2mg/dl and iodine deficiency prevalence was 29.1%. There was no significant correlation between urinary iodine and thyroid volume.Conclusion: Large thyroid volume of middle school boys in Tabriz is probably due to iodine intake deficiency in the first years of their life. Also, the role of goitrogenic factors and effect of climate condition on thyroid volume and goiter prevalence of middle school boys in Tabriz shouldn't be ignored. Further studies are recommended for determination of a local reference for thyroid volume Also it is necessary to be sure from consumption of iodine salt and its standardization.

Background & Objectives: Cryptosporidium is a coccidian protozoan parasite. This organism is one of the main causes of severe, long-time and life-threatening diarrhea in immunocompromised persons. It is also among the most prevalent diarrheal agents in children. Cryptosporidial epidemics occur after consumption of water which is contaminated by oosit species of cryptosporidium. Water is usually contaminated by animal feces or by drainage of waste water into drinking water resources.Methods: In this study, from ten regions 200 water samples were collected, filtered by 1.2 micron papers and then positive samples were identified in terms of cryptosporidium using PCR method. Finally the related species were detected by RFLP method.Results: Nested-PCR showed 8 samples were positive for cryptosporidium that according to RFLP of PCR products; 5 samples belonged to cryptosporidium andersony, 2 samples belonged to cryptosporidium parvum bovine genotype and 1 sample belonged to cryptosporidium pig genotype.Conclusion: Since Cryptoridium andersony and cryptosporidium parvum bovine genotype are the common species in animals and cryptospovidium swiss is seen in wild animals (pigs and boars), it so we conclude that animal reservoirs have the main role in the contamination of related water resources in this region.

Background & Objectives: Perioperartive shivering is a common complication which interferes with monitoring of patients and it increases oxygen consumption (up to 500%) which can be life-threating in patients with a low cardio pulmonary reserve. This study compared the efficiency and complications of two perioperative antishivering drugs. (Tramadol and Meperidine).Methods: All of the 70 patients under went cesarean section with spinal Anesthesia, were categorized in two groups of 35 persons, and treated as clinical trial, double blind with tramadol and meperidine. Then they were compared in terms of the interval between administration of drugs and stoping of shivering and their complications.Results: The mean ages in patient were 27 years, youngest one was 17 and the oldest was 39 years. The average interval of stopping of shivering during tramadol using (2.57 min) is less than meperidine (6.24 min). The frequency of nausea and vomiting in meperidine group was more than that of the tramadol group. Regarding the incidence of pruritus and sedation after using of drug in both groups, there was no considerable difference between them. Respiratory and pulse rate changes, and decreasing of arterial oxygen saturation in post injection period to preinjection period of meperidine, didn't show any significant changes. In systolic and diastolic blood pressure changes, there was no significant change in both groups.Conclusion: Perioperative shivering treatment by tramadol is better than meperidine because of its faster onset of stopping of shivering and its low complications in cesarean section with spinal anesthesia.

Background & Objectives: Mental retardation is a critical deficiency in cognitive functions, social skills, and adjustment behaviors. About 1 to 2 percent of people are mentally retarded because of various factors. The purpose of this research was to study the prevalence of mental retardation in Ardebil city and determining the role of environmental and Heredity factors on mental retardation. In other words, which of pre-, on-, and post-birth factors-as well as environmental factors are related to mental retardation of 7-11 aged children. Methods: In order to find out the prevalence of mental retardation, a sample of 500 families was selected by simple random sampling method and was studied by causal-comparative method. Also percentage, frequency, and comparing of two independent groups were used to analyze the data and study the extent of prevalence.Results: The results showed that the rate of prevalence of mental retardation is 3.6%, which is higher than the extent of prevalence of the world. Also the results of comparing two groups normal and mentally retarded revealed that familial marriages, in-birth events, fever and convulsion diseases during post-birth period are higher in mentally retarded group.Furthermore, the results showed that the level of mothers' educations in normal group is significantly higher than that of mentally retarded group. And among the other factors, environmental factors were the most important factors of mental retardation of children in Ardabil city.Conclusion: The high rate of prevalence of mental retardation and the role of environmental factors in mental retardation of children in Ardabil city require environmental intervention such as training of families and improving health level of society.

Background & Objectives: University is the center in al1 fields of scientific developments which heightens the knowledge in the society. Investigating the effective factors on the quality of research and education in the faculty of medicine from the students planning to increase the quality and quantity of research and education status.Methods: This was a descriptive-analytic study which was done during the period April 2005 -April 2006 in two faculties of medicine in the state and Azad University of Ardabil. The samples included all the medical students, faculty members and employees of faculties of Medicine at Ardabil University. Data were collected through a questionnaire. In total, 308 statuses, 44 faculty members filled out the questionnaire. Data were analyzed by SPSS version 11. Education and Research, educational Status, educational facilities and educational spaces of both faculties were compared and with the desirable standard of 80%.Results: There was a significant difference in is education and research in both faculties from the instructors point of view. However, in students, view this deference was not significant. In comparing the research status in both faculties with the desirable standard of 80%, the faculty of Medicine in Ardabil state University of Medical Sciences showed a significant difference with this difference in Azad University was not significant. In comparing the educational Apace. The faculties with the desirable standard of 80%, there was a significant difference in Azad University where as it was not significant in state University.Conclusion: In terms of Education the faculty of medicine in state University was more desirable and in terms of research. Azad University was more desirable.