JOURNAL OF GORGAN UNIVERSITY OF MEDICAL SCIENCES
Year:2003 | Volume:4 | Issue:10|Papers Count:17

High prevalence of acute psychotic agitation in psychiatric emergency centers, necessiates finding an medication with less side effects and more efficacy. Concerning the reports about the efficacy of atypical antipsychotics (even in oral route) in shch cases. We decided to examine the efficacy of these drugs in comparisson with older ones (oral resperidon plus lorazepam and haloperidol (IM) plus lorazepams. The sample population included 60 acute psychotic agitaed patients admitted to emergency room of Ebne-Sina psychiatric center. The exclusion criteria were seizure disorder – pregnancy – substance abuse, developmental disorders and other major medical problems. These patients were randomly divided in two groups. The first group was given haloperidol (5mg/Im) plus lorazepam (2mg/po) and in the second group, risperidon (2mg/po) plus lorazepam (2mg/po) were administered remission was assesed based on the total score and scores of subclasses of PANSS incuding: hostility – incooperativeness hallucinatory behaviors – implus dyscontrol and excitement on time zero, 30 and 60 munutes. The results were analyzed using the proper test analyzer. Significant decrease in PANSS scores were observed in each group (P<0.001). There was no significatn differences in total score and scores of subclasses between two groups. 3 patients of each group needed aditional dose 1 hour after the first one. The mean time to induce sleep in haloperidol group was 60 minutes (SD: 33m) and in the resperidon group 55 minutes (SD: 34m). The present study similar to previous ones showed that the efficacy risperidon plus lorazepam (po) in the control psychotic agitaton was equal to that of intramuscular haloperidol plus oral lorazepam.

A great number of drugs have been used to inhibit preterm labor but none has been completely effective. This study has compared .The efficacy of indomethacin and Mg-sulfate for delaying delivery in preterm labor. In this randomized controlled trial study 120 pregnant women with intact membrane and preterm labor, cervical dilatation at least 2 cm were studied and if they had premature rupture of membranes, gestational age less than 24 or more than 32 weeks, complete cervical dilatation, severe hemorrhage, chorioamnionitis and triple or higher order gestation excluded from study. Subjects are randomely managed with indomethacin 25 mg every 6 hours for 4 doses or Mg- sulfate initially 4 gr/IV followed by 2 gr/h IU infusion until uterine activity diminished or decrease. The success of management was considered as either reduce or stopping the uterine contractions, and no increase in cervical dilatation or effacement. Statistical analysis were performed with chi-square and t test. The two groups understudy had the same inducer maternal matched maternal age, gestational age, parity, dilatation and effacement at initiation of study, frequency of uterine contractions. Delivery was delayed 24 hr in 66.6% and 48 hr in 58.3% by Mg-sulfate, also delayed 24hr in 40% and 48hr in 35% by indomethacin (p<0.0001). No complications were reported in each group. Mg-sulfate is more effective than indomethacin in delaying preterm labor.

Increase blood level of thyriod hormones due to hyperthyriodism can change the balance between resorption and bone formation and result in hypercalcemia, increase alkaline phosphatase and increase in urinary calcium excretion. Due to these finding and the nutritional conditions of our country in calcium containing food, we dicided to evaluate some of bone indexes in hyperthyriod patients. 30 women, 6 men between 17-40 years (23 patients) and more than 40 years (13 patients) were the sample papulations. The control subjects were 35 healthy people 17-40 years (25 persons) and more than 40 years (10 persons). The serum calcium, phosphorus and alkaline phosphatase were determined in these hyperthyriod patients. There were a meaningful correlation between the alkaline phosphatase of hyperthyriod patients compared to normal subject (P<0.05) in the patients more than 40 years old, and P<0.01 in the 17-40 years patients. There were no differences between serum calcium of hyperthyroid patients and normal subjects. The results from this investigation indicat that in hyperthyroid patients the avarage alkaline phosphatase level is higher than normal subjects. On the other hand the reason for not having a meaningful differences n calcium level between the hyperparathyriod patients and normal population may be due to low dietry intake of dairy product and proteins in daily diet which results in low amount of calcium in nutrition.

Major histocompatibility complex (MHC), which plays a major biological funciton in immune response, is generally associated with so many human diseases. During recent years a new clinical relevance of MHC diseases. On the other hand there is a strong correlation between some autoimmune diseases and MHC system such as in some alergic abnormalities and its relation with HLA antigens. In order to investigate this concept 30 atypic asthmatic patients and 100 healthy controls were selected. Human leukocyte antigen (HLA) typing was performed by standard N.I.H procedures and the results analysed. The frequency of HLA-A2, A11, Aw19 and HLA-B51 decreased in atypic asthmatic patients while no assocation recorded significantly between HLA-C and allergic asthma. The results of our study indicated that there was a significant relationship between allergic asthma and HLA-I antigens.

Liver is an important organ with major role in carbohydrates, proteins and lipids metabolism. In addition, secretion and excretion of toxic materials occur in this organ. Exposure to a variety of infectious agents such as parasitic, viral, bacterial or toxic materials may lead to liver damage. Today, one of the best way for investigation and diagnosis of liver damage is measurement of some liver enzyme such as alanine aminotransferase (GPT or ALT), aspartate aminotransferase (GOT or AST). Since, these enzymes exist in other tissues, measurement of other specific enzyme is required. In this study activity of ornithine carbamyl transferase (OCT), the second enzyme in urea cycle, in 56 patients with liver problem (cirrhosis and viral hepatitis) was determined. SGPT, SGOT, Alb, Bil, مGT and ALP tests were performed. To assess the health and unhealthy liver in both control and sample groups. Our data shows a correlation between activity of OCT with SGOT (r=0.782, p<0.001) and with SGPT (r=0.857, p<0.001). Since OCT enzyme is specific for liver, further investigation of activity of this enzyme in assessment of other liver problems is required.

Solvent exposure can effect human health. It can cause different effects in different part of the body. One of the most important side effects is neurobehavioral symptom including mood disorders, short memory, and tiredness. To determine the frequency of neurbehavioral effects in painters of a car producing plant in Tehran and compairing them with other workers in the same plant whom was not being exposed to such solvents. All of car painters (78 persons) as our case group and 83 non-painters as our control group were selected by simple random sampling and neurobehavioral abnormality was assessed by Q16 questionaire. Neurobehavioral disorders based on above questionnaire was observed in 46 percent of car painters vs.36 percent of nonpainters (p=0.10). The significant differences were observed in perspiration without any particular reason (Q8) and feeling irritated without any particular reason (Q4). There was not a significant difference in observed frequency of neurobehavioral abnormalities in painters vs. non-painters, however both of these frequencies were higher than expected frequency reported in other reports.

Diarrhea is one of the main reasons of mortality among children in the developed countries and half of all death is due to presisted diarrhea. This research is a cross-sectional and analytical study done on 708 children with acute diarrhea in villages around Gorgan, to find out the effective factors on having presisted diarrhea in children under five years old. Face to face interview and determining the variable factors and examining health center records on children with acute diarrhea were the basis for filling the corresponding questionarirs. 14 days after the start of acute diarrhea, which was the second part of this research, the above questionairs were fully completed by calling on the patient’s home. According to our investigation the risk factors related to the presisted diarrhea were as follow: age, ethenicity, children length of breast feeding, chlorinated water, children consumed food at the time of acute diarrhea. The results from this investigation indicate that with 95% absoult probability 10.7%-11.3% of patients with acute diarrhea end-up with presisted diarrhea, which means diarrhea, was continued for more than 14 days. Therefore by controlling the above risk factors the mortality rate due to acute diarrhea could be reduced.

It is reported that the rate of congenital malformations is about 2-3% at birth. They are one of the major causes of morbidity, mortality and disability in childhood and later in adulthood. The aim of this study was to determin the rate of gross congenital malformations that were present at birth. The other factors studied were anatomic locations of anomalies, neonatal sex, race, maternal age and race. This study was a cross – sectional descriptive study, and the sample population was 10000 briths. The rate of congenital malformations was 10.1/1000 in our sample; 11.8/1000 in male and 7.5/1000 in female neonates. The rate of malformtions in muscluskeletal system were 3.8; in CNS 2.8 and in urogenital system 2.5 per 1000 births. It was concluded that the most frequent malformations in CNS, muscluskletal and urogenital system were cystic spina bifida, clubfoot and hypospadias respectively. The rate of malformation newborns were 14.5 per 1000, 8.5 per 1000 and 17 per 1000 birth in Turkman, Native Fars and Sistani racial groups respectively. The results from this investigation showed that there were relations between rate of overt malformations, races and sexes of individuals.

All the different kind of mycobacterium speicies except tuberculosis leprae and bovis are considered as environmental mycobacterium which usually can be isolated from sand, water and dusts. In addition to the role of their pathogensis, they can stimulate the immune systems. The imune mechanisms following mycobacterium environmental contamination can be either protect or destroy the immune system when facing the disease related to the mycobacterium. The Golestan province has got two regions from the point of view of T.B epidemy, it is higher in the East. The aim of this project is determine the prevalancy of various types and strains of environmental mycobacterium in the East and West of the region. The sampes were collected from both regions from the wet sand, and muddes covered with grass and following their preparation they were cultured on the Lowen Stein Jenson. The total of samples were 220 from these 120 samples were from the region with epidemy of T.B out of these we had 25 samples with positive culture (20.8%) and 47 type of mycobacterium were isolated, the most common forms of them were mycobacterium fortuitum (34%), Mycobacterium flavesens (21.2%), mycobacterium chelonae (12.8%). From 100 samples taken from the region with low epidemy of T.B, 66 smples were with positive cultures (66%) which 114 strains of mycobacterium were diagnosed. The most common forms of these microorganisms were mycobacterium flavesens (20.1%), mycobacterium chelonae (18.4%) and mycobacterium (16.6%). In conclusion in all the Golestan province without taking notice the T.B epidemy form 220 samples 91% were positive culture (41.2%) which 161 different strains were diagnosed out of these the most common were ycobacterium foruitum (21.8%) mycobacterium flavesens (20.5%) and mycobacterium chelonae (16.8%). The epidemy and variousity of environmental mycobacterium in the region with low epidemy were much higher than the region with high epidemy and in regard to that these differences are due to the bioenvironmental factors. So therefore this can indicate that the possibility of higher contact between the immune systems and the environmental mycobacterium. These mycobacteriums can act as Booster of BCG vaccine which can continuosly stimulate the immune systems and this can help the body’s proper responses when facing with the T.B mycobacerium.

Stress is applied to the collection of somatic, emotional and mental reaction which can disturbed the equilibrium in human beings. One type of stress is work in dependent stress environment which can affects on personnel due to its internal stressful factor. The object of this research is to investigat the rate of stress in operationg room personnel and its relationship with some relevant factors. The present study has been done on 104 personnel of operationg room in hospitals belong to the Gorgan Medical Sciences University. The tools for collection data were questionnaire, which contained demographical variables, physical and mental environment stress factors in operationg room life stress scale. The results from this investigation indicated that 54.4% of all personales had a mild stress. The stress factor present in the operation room were incovenient smells the highest with 76% uncooperated team work was the other factor with 29.7% and personnel equipment was (42.6%) It become clear from this investigation that there is a reverse between stress and demographical variables, of stress has a meaningfull relationship with age (p=0.01) and years of service in the operation room which means as the age and working in the operation room increased the level of stress decreased. According to the results from this investigation it is suggested therefor to use the old and well – experienced staff to work in the operation room to avoid such problems.

Hydatidosis is a parasitic infection mostly is found in the liver and lung due to echinococus species. But occurrence in other locations is possible. Purpose of this report is to describe a case of bilateral hydatic cyst in ovaries. Clinical findings with this uncommon location are poorly specific and diagnosis required histologic examination after surgical removal. Imaging and serology is useful to differentiate hydatid cyst from benign and malignant tumors. This obligatory to examine lung and liver as the main sites of cyst wen you are being faced with unusual location of hydatid cyst especially in endemic area such as Iran. Our patient was a 35 years old voman with history of 4-month abdominal pain in left and right lower quadran. Sonography showed two cysts in adenexal lesions after surgical removal, they were sent to pathology lab. Hydatic cyst membrane was seen in hidtologic examiantion of two cystic masses.

Mycobacterial diseases are among the oldest disease known to human beings. There are a lot of bitter memories of mycobcterial invasion especially tuberculosis and leprosy in human mind, even now after discovery of etiology, diagnostic tool, prevention, and treatment, still the recalling the above diseases are frightening to human being. Although leprosy is not an seroius desease nowadays but the TB after a long period of quietness, is going to be an serious risk factor for mankind, especially in third world countries, after cooperating with HIV. Some atypica mycobacteria, which have weak pathogenicity now, adapt themselve to the new condition and present as a dangerous cause of disease. The researcher that have made themselves familiar with such mycobacterial features, trying hard to discuse carefully the specifities and weak points of these bacteria, to fight them back. The aim of this review article is to highlight one of mycobacterial characteristic, which is bacteruosis slow growth rate.