Journal of Babol University of Medical Sciences
Year:2003 | Volume:5 | Issue:1 (17)|Papers Count:12

BACKGROUND AND OBJECTIVE: Polycystic ovary syndrome (PCOs) has been studied for years but the most intriguing issue of PCOs that is causal factors affecting on ovarian function are still unknown. Neuroendocrine drug therapies which affect on ovarian and adrenal function are currently used for treating patients with PCOs. METHODS: This controlled clinical trial was done on 60 patients with PCOs referred to Mirza Koochak Khan hospital in Tehran during 2000-2001. Hormonal tests and the degree of hirsutism (Freeman- Galloway score) and medium diameter of ovaries were monitored by abdominal sonography at third day of the first menstruation during 6 month treatment. Patients were randomly divided into two groups (each group 30 persons). First and second groups were treated with OCPLD and OCPLD with GnRH agonist, respectively.FINDINGS: Both therapeutical regimens were effective in reducing androgen levels, Freeman Galloway score and medium ovarian diameters during 6 month treatment. However, this reduction in second group in comparison to first group was significantly more. This reduction of plasma testosterone, androstenedione, LH/FSH, medium diameters of overies and hirsutism in second group was significantly more than first group.CONCLUSION: According to the obtained data, it could be concluded that efficacy of the combined regimen (GnRHagonist+ OCPLD) is higher than OCPLD alone in treatment of patients with PCOs.

BACKGROUND AND OBJECTIVE: On the basis of etiology of aphthous ulcer, there are many factors which cause this problem such as immunologic and hematologic disorders and emotional stress. For treating this disorder, it is recommended using a steroid drug. This study was performed to investigate one of the natural bases as a bioadhesive dosage form in the management of aphthous ulcer.METHODS: In this experimental study, there were two groups. The first twenty persons received bioadhesive without triamcinolone acetonide (as pilot study) for determining the rate of adherence and possibly side effects of the bioadhesive. The second twenty persons as case and control, with history of minor aphthous ulcer were selected and treated in two courses of disease, once with bioadhesive containing drug (case) and once again without drug (control). The data were statistically analysed by using student t-test. FINDINGS: In the pilot study group, duration of adherence on the oral cavity was more than 20 minutes and there were not side effects or undesirable reactions such as bad smell or taste. There was not significant difference in analgesia and healing time course between case and control groups. Healing time in case and control groups after treatment were shorter than before treatment (p<0.000).CONCLUSION: Using bioadhesive as coating and protective agent may cause reduction of pain and healing time course. Also, triamcinolone in bioadhesive dont affect on reduction of pain and healing time.

BACKGROUND AND OBJECTIVE: Most of patients with cancer are treated with a combination of therapies on the basis of the kind of tumor, extent of illness and physical condition. Therefore, it is important that patients to know about complications and prevention of any changes in their life; in other words about their self- care. This study was done to determine educational needs regarding self-care in patients with cancer referred to private and public clinical centers in Rasht in 2001.METHODS: This study was performed on patients with cancer referred to chemotherapy clinics in Rasht. Data was gathered by questionnaires with forty questions related to the care during chemotherapy and radiotherapy. FINDINGS: The knowledge of the patients were 62% and 54% about care during their chemotherapy and radiotherapy, respectively. There was not a significant relationship between educational needs and their age, job and education. CONCLUSION: The results showed that the patients in any age and job need to education regarding their self-care.

BACKGROUND AND OBJECTIVE: Skeletal complications are common in brucellosis. Early diagnosis of these complications may prevent surgical procedures. The aim of this study was to evaluate the skeletal complications of brucellosis in Babol twon.METHODS: This study was conducted on patients with skeletal complications of brucellosis referred to infectious diseases and orthopedic departments during 1998-2001. Skeletal complications and laboratory test results were recorded in questionnaire. Proportions were compared with X2 and Fisher exact tests. FINDINGS: From 431 cases, 161 (37.6%) were with skeletal complications (94 [58.4%] were male and 67 [41.6%] were female). Mean age±SD of adults and children were 34 ±17.6 and 9.5± 4.2 years, respectively. Among 127 adult cases, 79(62%) had peripheral arthritis which in 48 (37.8%) cases was as monoarthritis. Peripheral arthritis was seen in 32 (94%) of 34 cases of children, which in 26 (76.5%) was as monoarthritis. Peripheral arthritis and hip involvement in children were more common than adults (p<0.05) but, spondylitis was more common in adult cases (p<0.05). In 14 (8.7%) cases, brucellosis was diagnosed after surgery. Normal erythrocyte sedimentation rate (ESR) and positive rheumatoid factor were seen in 80.7% and 15.5% cases, respectively.CONCLUSION: Since, skeletal complications of brucellosis is similar to septic arthritis and also rheumatologic disorders and monoarthritis are the most common form of these complications; therefore, it is recommended that in endemic regions, brucellosis should be considered in differential diagnosis of all cases with monoarthritis.

BACKGROUND AND OBJECTIVE: About 25-50% of women with infertility and 3-10% in reproductive age are with endometriosis. The objective of this study was to determine the prevalence of endometriosis, stage of endometriosis and planning for treatment base on the stage of endometriosis.METHODS: This study carried out on 221 infertile patients after laparoscopy in Babol Fatemeh Zahra center during 1998-2001. FINDINGS: Of these patients, 30 (13.6%) had endometriosis. From these, 63%, 20% and 16.7% were with mild, moderate and severe endometriosis, respectively. The mean age±SD was 5.74±5.13 years. The pregnancy rate with expectant treatment was 23.3%. From these, 16.7%, 3.3% and 3.3% were with mild, moderate and severe endometriosis, respectively. CONCLUSION: Prevalence of endometriosis is related to marital age, parity and genetic factors. Patients with mild endometriosis can be first managed expectantly.

BACKGROUND AND OBJECTIVE: In using IUD as an intrauterine device, an important problem is earlier extraction which reduces the rate of its efficacy. The objective of this study was to explain the determinants of earlier extraction of IUD. METHODS: This study was done depending on existing data of 385 files of women who were inserted IUD at 11 rural health care centers in Babol from 1991 to 1997; all studied subjects were followed until the end of 1999. The data about causes of IUD extraction were gathered from the file of family planning and then analysed statistically by SPSS soft ware.FINDINGS: The results showed that the Mean ± SD of duration of IUD using was 36±24 months. Out of 385 women, IUD was extracted earlier than regular time in 263 (62%) subjects. The most common causes of extraction were vaginal bleeding (28.9%), propensity to be pregnant (19.8%) and infection (10.6%). The most discontinuation (26%) and expulsion rates were occurred in the first year of insertion of IUD.CONCLUSION: According to the results, the rate of discontinuation of IUD was relatively high. Although, the vaginal bleeding and PID are the most causes of its discontinuation, a numerous IUD discontinuation had not any indication of IUD extraction. It indicated that the IUD using candidates should be carefully selected. Thus, it is necessary to provide more educational program for health exprerts of family planning.

OBJECTIVE: Long life in patients with thalassemia major has increased considerablely. In spite of this fact, long term complications such as liver and heart complications that caused by hemosiderosis make some problems for these patients. This study was done to evaluate long term effects of this disease on lung tissue by pulmonary function test.METHODS: This analytical study was performed on 91 normal persons and 100 patients with thalassemia (over 5 years old) who referred to thalassemia research center. Both groups were matched according to their gender and age. After physical examination, ferritin was measured and chest X-ray and spirometry were done on all persons in both groups. Parameters of pulmonary function test between two groups were compared and p<0.05 was considered as a significant level in test. FINDINGS: Patients with thalassemia had regular transfusion and 94% of cases received desferral . Spirometry results in 63% of persons in case group and 75.8% in control group were normal. Spirometeric dysfunction in case group was as a restrictive pattern (37%) and obstructive pattern was not seen. In control group 15.4% and 8.8% of persons had restrictive and obstructive patterns respectively. Also desferioxamine use caused less limitation in pulmonary fuction test. Meanwhile pulmonary function abnormality in females was more severe than males (p<0.0001).CONCLUSION: Restrictive pattern was the most common spirometric dysfunction in patients with thalassemia . There was not a relationship between the intensity of this dysfunction and ferritin whereas pulmonary complications of this disease can be reduced by using desferral.

BACKGROUND AND OBJECTIVE: Otalgia is a common compliant of patients at ENT clinic. ‏The main problem in referred otalgia may be in head and neck that is referred to ear because of nervous connections. This study was done to determine the varieties of referred otalgia and its early diagnosis and treatment. METHODS: This study was performed on patients with complaint of otalgia who referred to clinic of ENT. The parameters included age, duration of pain onset, quality of pain, result of physical examination, laboratory findings and some useless investigation by previous medical consultants were registered in questionnaire for 143 patients during 1999. FINDINGS: Among 143 patients, 46% were with referred otalgia that 40% were male and 60% were female. The causes of referred otalgia were cervical osteoarthritis (15%), unerupted wisdom teeth (21.2%), carious molar teeth (13.6%) and temporomandibular syndrom (13.6%). Six percent of cases suffered from referred otalgia due to pharyngeal malignancy. CONCLUSION: The most common cause of referred otalgia was unerupted wisdom teeth. About 45% patients with referred otalgia had dental problems, therefore attention to dental condition is important in physical examination. Since hypopharynx, nasopharynx and or pharynx cancers are one of the etiological factors for referred otalgia, so it is necessary to be more careful in finding the cause of this disease in cases which there is n't any pathological otic finding.

BACKGROUND AND OBJECTIVE: The end stage of many severe renal diseases is chronic renal failure (CRF). These patients have many problems in various organs especially in cardiovascular system. Since, more than one half patients die due to cardiac complications, therefore, these complications must be known and treated by physicians for improving these patients. METHODS: This cross- sectional, descriptive and analytical study was performed on all 103 patients with CRF who were under hemodialysis about two years in Babol Shahid Beheshti hospital during 1999-2000. Information related to age, gender, duration of hemodialysis, frequency of hemodialysis in a week, clinical manifestations, lab finging, cardiac examination, electrocardiography and color dopler echocardiography were recorded and then analyzed by using SPSS soft ware and Chi- Square and t- tests. FINDINGS: Relative frequency of cardiac complications were as follows: Aortic regurgitation (AR) (19.4%), aortic stenosis (AS) (6.79%), aortic calcification (1.94%), mitral regurgitation ( MR) (55.33%), tricuspid regurgitation (12.61%), mitral calcification (3.88%), pericardial effusion (18.44%), left ventricular hypertrophy (LVH) (30.01%), left ventricular systolic dysfunction (LVSD) (18.44%). Eighty- four percent of patients with pericardial effusion had severe anemia (Hb< 8mg/dl). Ninety- five percent of patients with pericardial effusion had serum creatinine less than 8 mg/dl.CONCLUSION: In this study, it was found a high prevalence of many cardiac problems such as mirtal and aortic regurgitation, LVH, LVSD and pericardial effusion in patients with CRF on hemodialysis. The prevalence of MR, AR and AS in cases over 50 years was higher.

BACKGROUND AND OBJECTIVE: Skin cancer is one of the most common malignancy in human. Early diagnosis and appropriate treatment can decrease the mortality and complications of these cancers. The aim of this study was to evaluate the frequency of skin cancers in Babol. METHODS: This study was performed on all cases with skin cancers referred to surgery department in Babol medical university. Biopsy of skin lesions were done and sent to pathology department. Data were analysed by SPSS and the proportions were compared by using X2 and Fisher exact tests. FINDINGS: From all of 132 cases, frequency of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) were relatively high and the most common sites of involvement were head and face. Eighty- eight (66.6%) of cases were more than 50 years and there was not a significant relationship between the time of the onset of the lesions and diagnosis in all kinds of these cancers. The mean duration of time from the onset of tumor to diagnosis in BCC, SCC and melanoma were 3.7±1.2, 2.96±1.3 and 3.2±1.3 years, respectively. There was not any significant differences between the types of these cancers according to gender (p=0.04), and also between these cancers and relapse (p=0.0001). CONCLUSION: Since, most of the patients refer with a delay after onset of lesions and with regard to metastasis of some kinds of these cancers, it is necessary to increase the knowledge of people about skin cancers for early diagnosis and appropriate treatment.

ABSTRACT: The extensive and indiscriminate use of antimicrobial agents (antibiotics and biocides) in hospitals and environments lead to the emergence of new antimicrobial resistance. Selective pressure has an important role in the evolution and and acquisition of resistance. The resistant determinants are transferred by various genetic exchange mechanisms, including transduction, transformation, conjugation and phage-mediated conjugation between clinical isolates (Bacilli, Staphylococci, etc) and other sources such as soil, plants and humans. In bacteria, the multi- resistance occurs in one strain and then is transferred to others. It was suggested that the origin of some resistance determinants is older than their clinical introduction. The exchange mechanisms have an important role in the survivals of bacterial spps. The various exchanges and factors played an important individual or combined role between staphylococci and other clinical isolates in the evolution and spread of novel antimicrobial resistance that originated from sources such as soil, plants, animals and humans. The genetic exchange mechanisms, the effective factors, the genetic basis of antibiotic resistance and cause of antimicrobial resistance appearance will be discussed.

BACKGROUND AND OBJECTIVE: Choroidal osteoma is a rare and benign osseous tumor that begins in adolescence age especially in young females and causes to decrease vision permanently in involved eye. CASE: A 16 year old female referred with decreased vision in her right eye. Visual acuity was count finger=3 m in her right eye. Examination with indirect ophthalmoscopy revealed a yellow mass with distinct margins in macular area beneath the retina. Echography and fluorescein angiography revealed choroidal osteoma and treatment was not done. CONCLUSION: Choroidal osteoma should be considered in differential diagnosis of yellow- white macular lesions.