JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2006 | Volume:8 | Issue:2 (30)|Papers Count:19

BACKGROUND AND OBJECTIVE: Considering the antidiabetic and anti-inflammatory effect of marrubium vulgare (MV), this study was designed to investigate the analgesic effect of MV on formalin-induced nociceptive response (standard formalin test) in diabetic rats. METHODS:  Forty-eight rats were randomly divided into control, MV-treated control, diabetic, sodium salicylate (SS)-treated diabetic, sodium salicylate (SS)-treated control and MV-treated diabetic groups. For induction of diabetes, streptozotocin was used at a single dose. The treatment groups received oral administration of MV-mixed pelleted food (6.25%) for two months. FINDINGS: In this study, administration of sodium salicylate to control and diabetic groups caused a significant reduction in pain score in the second phase of formalin test (p<0.05 and p<0.01, respectively). On the other hand, administration of marrubium vulgare for two months to control and diabetic groups caused a significant reduction in pain score at both phases of the formalin test (21.3% (p<0.05) and 18.4% reductions (p<0.05)) in control and diabetic groups (17.6% (p<0.05) and 17.9% reductions (p< 0.05)) as compared to untreated control and diabetic groups. CONCLUSION: The results indicate that administration of marrubium vulgare could attenuate nociceptive score in an experimental model of diabetes mellitus and this may be considered as a potential treatment for painful diabetic neuropathy.

BACKGROUND AND OBJECTIVE: Varicocele is one of the causes of male infertility. It changes with temperature and drainage of testicular veins that due to spermatogenesis disturbance and decrease of fertility in these patients. However varicocelectomy is a treatment for varicocele, but there are other methods of treating this disease including assisted reproductive technology (ART), Sperm processing and swim up. METHODS: This interventional study was performed on 155 cases in fertility and infertility Center of Babol University of medical sciences in 2004. Sperm parameters in varicocele patients was assessed before and after sperm processing. FINDINGS: The mean age of patients was 31.8 years. Sperm motility before sperm processing in grade III and IV was 53.9% and 12.9%, respectively but after sperm processing in grade III and IV changed to 78.7% and 56.8%, respectively. Total motility before sperm processing was 40 % and changed after processing to 80%. CONCLUSION: The results show that with sperm processing and collection of appropriate sperms, we are able to increase fertility.

BACKGROUND AND OBJECTIVE: Nowadays, besides the ordinary staining, a variety of cell markers and immunohistochemistry methods are incorporated for distinction between neoplasms. But in the current situation, due to the high cost of most of these methods, cheaper and simpler way like silver nitrate staining should be sought for analyzing the nucleolar organizer dots. Therefore, this study was conducted to evaluate the distinction capability of silver nitrate within the benign and malignant neoplasms of the salivary glands. METHODS: Silver nitrate staining was carried out for nucleolar organizer regions in 22 cases of the most common benign neoplasms of the salivary glands, namely pleomorphic adenoma, and 22 cases of common malignant neoplasms of salivary glands, consisting of 11 adenoid cystic carcinoma and 11 mucoepidermoid carcinoma cases. Twenty-two cases of normal salivary glands of the peripheral regions of the same samples were analyzed. FINDINGS: The mean dots occurrences for normal salivary glands, pleomorphic adenoma, adenoid cystic carcinoma and mucoepidermoid carcinoma were 1.67±0.2, 2.32±0.39, 3.92±1.11 and 3.25±0.78 (for malignancies was 3.58±1), respectively.  There were significant differences among benign and malignant, malignant and normal, and benign and normal groups (p<0.05). CONCLUSION: This study purposed that the use of silver nitrate staining method is suitable for distinction of the benign and malignant neoplasms of salivary glands.

BACKGROUND AND OBJECTIVE: H. pylori eradication has been known as an effective measure in the treatment of peptic ulcer disease (PUD), chronic gastritis and gastric malt lymphoma. Furazolidone has recently shown promising efficacy in H. Pylori eradication and has replaced metronidazole in different eradication regimens. The aim of this study was to investigate the efficacy of two quadruple therapies based on furazolidone or metronidazole in the eradication of H. Pylori in Babol. METHODS: This interventional study was performed on 103 patients with dyspepsia and endoscopic diagnosis of H. pylori infection. H. pylori status was assessed by histologic examination of biopsy specimens and rapid urease test (RUT). Patients were randomly assigned to one of the two treatment groups: ABRM (amoxicillin 500 mg tid, bismuth subcitrate 120 mg tid, ranitidine 150 mg bid and metronidazole 250 mg tid) and ABRF (with the same regimens but furazolidone 100 mg tid was administered in stead of metronidazole 250 mg tid). All antibiotics were taken for 10 days, but BR for 20 days. The endoscopy was repeated 4 weeks after the cessation of antibiotics. The efficacy of eradication was assessed by the histologic examinations and RUT. FINDINGS: Of 103 patients, 96 (%96.1) completed treatment. Forty-six patients with mean age of 42 years (range: 20-75 years) and 50 with mean age of 40 years (range: 18-71 years) were treated with ABRM and ABRF, respectively. Clinical manifestations were the same in both groups. The per-protocol eradication rates were 54.3% and 60% for the ABRM and ABRF groups, respectively (p= 0.362).CONCLUSION: This study show that both quadruple metronidazole and furazolidone have equal effect on the eradication of H. pylori.

BACKGROUND AND OBJECTIVE: IVIG is used in patients incapable of producing antibodies and in autoimmune disorders. IVIG infusion rarely causes undesirable reactions due to the speed of infusion. So, this study was performed to determine the indications and complications of IVIG infusion. METHODS: This descriptive study was performed on 265 patients, hospitalized in Amirkola pediatric hospital, needing IVIG infusions, from October 1999 to June 2004. Data was analyzed by SPSS. T-test, chi square and fisher exact test were used to compare drug complications based on age and speed of infusion in two genders. FINDINGS: In this research, 265 patients with 871 infusions were studied. One hundred and thirty one patients (49.4%) were male and 134 (50.6%) were female. Two patients (0.7%) had autoimmune hemolytic anemia, one patient (0.3%) had ataxia telangectasia, 9 patients (3.4%) had refractory seizure, 2 patients (0.7%) had guillain-barre syndrome, 83 patients (31.3%) had immune thrombocytopenic purpura, 46 patients (17.3%) had kawasaki, 51 patients (19.2%) had immunodeficiency and 72 patients (27.1%) were premature neonates. Among the studied patients, 17 infusions (1.95%) had complications, which were mild in 14 patients (82.5%), moderate in 2 patients (11.7%) and severe in 1 patient (5.8%). Complication was the same in both genders, and it had a significant difference with the speed of drug infusion (p<0.05). CONCLUSION: The most common cause of IVIG infusion is immune thrombocytopenic purpura. Complications are usually mild and had relationship with the speed of drug infusion.

BACKGROUND AND OBJECTIVE: Bell's palsy is the most common disorder of the facial nerve, developing some acute changes in the face. Considering its probable viral etiology, antiviral therapy is recently added to the classic regimen. This study has been conducted to compare the effectiveness of two regimens of prednisolone versus prednisolone plus acyclovir in the treatment of Bell’s palsy. METHODS: This clinical trial study was performed on 496 patients with Bell’s palsy who divided into two groups; the first group was treated with oral prednisolone and the second group with oral prednisolone and acyclovir. The patients were evaluated at the end of the second week, first, third and sixth months after treatment. The outcome of therapy in two treated groups were compared. FINDINGS: Two hundred and forty eight patients (108 males and 140 females) with average age of 20-39 and 248 patients (135 males and 113 females) with the same mean age were treated with prednisolone and prednisolone plus acyclovir, respectively. At the end of the study, the recovery rate in the combined regimen group was 95.06% (237 patients) and in the prednisolone regimen group was 91.2% (226 patients) (p= 0.035). CONCLUSION: The result of this study shows that combination of prednisolone plus acyclovir is the preferred regimen of therapy in Bell’s palsy.

BACKGROUND AND OBJECTIVE: Terbinfine a member of allylamines group is a new class of antimycotic agents that blocks sterol biosynthesis in the fungi through inhibition of sequlene epoxidase and with consequent sequalene accumulation due to a primarily fungicidal process. Terbinafine is very effective on various fungi as an oral and topical antifungal agent. The aim of this study was to compare the antifungal efficacy of terbinafine 1% cream with clotrimazole 1% in patients with pityriasis versicolor. METHODS: This clinical trial study was performed on 50 patients (30 males and 20 females) with mean age of 20 years (aged between 15-55 years) who randomly treated with terbinafine and clotrimazole for 4 weeks. The efficacy of drug and improving process evaluated mycologically and clinically before starting the study and at the end of each week. A patient was considered mycologically cured when direct microscopy was negative and clinically cured when all clinical parameters were considered negative. FINDINGS: Negativizations of all clinical parameters were observed within 2 weeks in 60% of terbinofine and 35% clotrimazole recipients. At the end of four weeks, disappear of lesions were seen in 90% and 80%, respectively (p<0.05). The percentage of negativization of direct microscopy in terbinafine group was 1.4 fold higher than that clotrimazole group after 2 weeks of treatment. At the end of therapy, 95% of terbinafine and 90% of clotrimazole treated subjects were clinically cured (p>0.05). Both drug eruptions and intolerance in two treated groups were similar. CONCLUSION: Although the efficacy of the both drugs is similar, but considering the expense of therapy, clotrimazole is preferred regimen for therapy of tinea versicolor.

BACKGROUND AND OBJECTIVE: Reflecting the wide variability of assisted reproduction technologies, the incidence of twin and higher order multiple gestation is increased which associated with complications and prenatal and maternal morbidity and mortality. The purpose of this study was to compare fetal and maternal complication in twin and singleton pregnancies. METHODS: This prospective study was performed on 108 twin pregnant women (case group) and 201 singleton pregnant women who referred to Babol Yahyanejad hospital during 2001-2003. Data related to patients were recorded in a questionnaire and the complication rate in both groups was compared. T-test and fishers exact test were used when appropriated. FINDINGS: Frequency of twin pregnancy was 1.4%. Preterm delivery was 60.2% in twin and 2.7% in singleton (p<0.05). Low birth weight and growth retardation was in 45.8% and 38.4% of twin and 7.5% and 10% of singleton, respectively. It was statistically significant (p<0.05). Frequency of placental abruption, previa, preeclampsia, fetal anomaly and death were not statistically significant. CONCLUSION: Results show that fetal complications such as preterm delivery, growth retardation and low birth weight were seen with higher frequency in twin pregnancies compared to singleton pregnancies. Since, this may cause high prenatal morbidity and mortality, therefore more attention is required to reduce complication.

BACKGROUND AND OBJECTIVE: Active pushing in second stage labor is acceptable, despite its complications for fetus and it has been noticed by midwifes and obstetricians. Recent studies have shown that spontaneous pushing decreases fetal acidosis. So, the objective of this study was to assess the effect of spontaneous and active pushing in second stage labor on fetal outcome in primiparous women. METHODS: This clinical trial study was done on 108 primiparous women with uncomplicated labor that based on fliess table randomly assigned to spontaneous and active groups. In spontaneous group used her own urge to push and in active groups encouraged to take a deep breath, hold it and push for ten numbers. After delivery, cord arterial blood PH value and Apgar score (1min & 5min) were measured. FINDINGS: The results of this study showed that arterial cord PH was higher in the spontaneous pushing versus active pushing (p<0.001). Apgar score (1min & 5min) had no significant difference between two groups. There was significant correlation between Apgar score (1min & 5min) and arterial umbilical PH (p=0.028, p=0.019). CONCLUSION: Spontaneous pushing decreases fetal acidosis so it can be effective, healthy, and cheap method for improving neonatal outcome.

BACKGROUND AND OBJECTIVE: Occupational burnout is a common problem among nurses that can have negative effects on patient care and physical and mental health status of nurses. It imposes some treatment and personnel expenses. The purpose of this study was to evaluate the prevalence and causes of occupational burnout in practicing nurses in hospitals of  Babol University of medical sciences. METHODS: Research resourses in this study was nursing staff who working in hospitals of Babol University of Medical Sciences. Data were collected by a questionnaire that included 11 questions about personal characteristics, 40 questions about Galdard occupational burnout and 20 questions about causes of occupational burnout. Score classification of Galdard occupational burnout were as follows: occupational burnout level in scores (40-80), (81-120), (121-200) and (201-280) was very low, low, high and very high, respectively. FINDINGS: In this study, 30.7% of cases had low level of occupational burnout, 68.6% had high level of occupational burnout and 0.7% had very high level of occupational burnout. Also, the staff of Pediatric hospital (82.9%) had the highest level of occupational burnout. There was a significant relationship between occupational burnout and the age of staff (p=0.01) and their years of working (p=0.03). The most important causes of occupational burnout were: low amount of salary and perks (93.9%), lack of social support (85.5%), lack of management support (85%), lack of job security (84%) and high working hours (83.3%). CONCLUSION: Occupational burnout is a common problem among helping professions. In such a situation, the nursing managers should provide conditions to reduce the staff psychological stress such as increasing their salary, decreasing the working hours, setting recreational plans, group working, participating in meetings to solve the problems, holding sports classes and educational workshops to cope with stress.

BACKGROUND AND OBJECTIVE: The urinary tract infection (UTI) is a common problem in pregnant women. Since, UTI is caused by bacteria in the stool, hygienic behavior may affect the risk of contracting UTI. The purpose of this study was to determine the relationship between hygienic behavior and incidence of UTI in pregnant women. METHODS: This case-control study was performed on 250 pregnant women from 2002-2004. One hundred pregnant women from five health centers of Babol University of Medical Sciences for prenatal care, with a diagnosis of UTI by means of positive urine culture (as case group) were compared with one hundred fifty pregnant women (as control group). Both groups were matched according to age and social, economic, educational status and parity. Patients with recurrent UTI, chronic diseases like diabet and sickle cell anemia and consumption of immuno suppressive and antibiotic drugs were excluded from this study. Data was analyzed by SPSS. P<0.05 was considered significant. FINDINGS: Escherichia coli was the etiologic agent in 83% of cases. Odd ratio for any of the above variables were determined and risk factor for UTI were as follows: for sexual intercourse ≥ 3 times per week (OR=5.62), recent urinary tract infection (OR= 3.27), washing of genital pre coitus (OR= 2.16), washing of genital post coitus (OR= 3.89), voiding post coitus (OR= 8.62), washing of genital from back to front (OR= 2.69). Mean scoring hygienic behaviors in case and control group were 19.9±3.65 and 23.44±3.43, respectively. CONCLUSION: Hygienic habits and sexual behavior may play a significant role in the pregnant women with UTIs, with a positive bacterial urine culture, but evacuating of bladder after coitus was the most strongly associated variable.

BACKGROUND AND OBJECTIVE: Trauma is a dynamic process and involves different systems of body according to its severity. Genitourinary system injury is seen in trauma process. This study was done to evaluate the major trauma of genitourinary system with special attention to multiple trauma patients. METHODS: This descriptive and cross-sectional study was performed on records of 293 patients with genitourinary system trauma who referred to emergency center of Shahid Beheshti hospital from 1998-2004. One hundred and two patients suffering from major trauma of genitourinary system who operated were included in this study. Then necessary information such as sex, age, pattern of trauma, type and mechanism of trauma, involved organ, clinical findings, associated lesions, surgical procedure, laboratory findings, duration of hospitalization and year of admission were obtained and studied. FINDINGS: From 102 patients, 92.2% were male and 7.8% were female with mean age of 29.4±13 years. 33.3% of patients had multiple trauma and 98% of them had blunt trauma. Mean duration of hospitalization was 6.2±4.4 days. From 13 patients (12.7%) with major kidney trauma, 5 cases had shattered kidney that went under nephrectomy. Only 1 patient (1%) had ureter trauma with final diagnosis of left middle ureter transection. Five patients (4.9%) had intraperitoneal rupture of bladder in which 3 cases had rupture in dome area. Five patients (49%) had urethral injury with clinical findings such as blood at meatus and inability to void. In 50 patients (49%) with penile trauma, 49 patients had penis Fx and 1 case had total amputation of penis and left testis. Fifteen patients (16.7%) had testis trauma in which clinical findings were pain, swelling and ecchymosis. Eleven patients (10.8%) had major trauma of scrotum. CONCLUSION: According to the results of this study, the most common organ involved in major trauma of genitourinary system was penis. Accurate history and complete physical examination should be considered in patients with multiple trauma.

BACKGROUND AND OBJECTIVE: Tinea versicolor is one of the most common skin infections in tropical area, which causes ugly appearance especially in young people. This study was performed to determine the frequency of this disease in male high school students in Babol. METHODS: This cross sectional and descriptive study was performed on 2064 students with randomly cluster method. Data was gathered by questionnaires and frequency of this disease was recorded. FINDINGS: From 2064 students, 91% lived in urban area and 9% in rural area. 8.2% had tinea versicolor infection, which 94% of populations were urban and 6% were rural. Clinical examination of students was performed in spring. Family history in 11.7% was positive and in 88.3% was negative. 29.5% patients took a bath one time per week and 70.5% two or more times. The prevalence of skin lesions was 40% in head and neck, 43.5% in chest and back and 16.5% in other parts of body. CONCLUSION: With regard to high frequency of this disease among male high school students (about 10%) in this area we recommend further epidemiologic studies in different areas and age groups and also educating others about disease prevention methods.

BACKGROUND AND OBJECTIVE: Tuberculosis is an important problem in the world and Iran. Tuberculosis is an ancient disease but because of different presentations is a mysterious disease too. CASE: A 20-year-old girl who complained of abdominal pain with peptic ulcer and weight loss was admitted in our hospital. Since 4 months ago before referring, she had been treated many times for peptic ulcer including treatment for helicobacter pylori. Then endoscopy and biopsy were done. In endoscopy one ulcer in antrum with malignant appearance was observed. At biopsy granulomatous inflammation compatible with tuberculosis reported. She was treated by anti-tuberculosis drug for six months. Endoscopy repeated after 2 months of therapy showed completely normal pattern and she had 5 kg weight gain and totally symptom free after completion of therapy. CONCLUSION: Gastric TB should be considered for differential diagnosis of patient with gastric symptoms in endemic regions.

BACKGROUND AND OBJECTIVE: Gallbladder torsion is a rare condition of acute abdomen that can lead to acute cholecystitis and gallbladder gangrene. Preoperative diagnosis of this condition is usually difficult and in the most cases, diagnosis achieved at the operation. The preferred treatment is emergent surgery. Considering this condition in the diagnosis of acute abdomen and acute cholecystitis, makes it possible to prevent its dangerous complications such as gallbladder perforation, peritonitis and mortality. CASE: A 82 year old man with symptoms of acute cholecystitis presented to Shahid Beheshti hospital, Babol, Iran in summer 2004. Sonography of gallbladder showed cholecystitis due to stone. The patient had fever and with clinical diagnosis of empyema, he was operated for cholecystectomy. Diagnosis of gallbladder torsion was made during operation. CONCLUSION: Gallbladder torsion must be considered in the differential diagnosis of acute abdomen and cholecystitis in  old patients in order to prevent from its complications and mortalily.