JOURNAL OF GORGAN UNIVERSITY OF MEDICAL SCIENCES
Year:2010 | Volume:12 | Issue:3 (35)|Papers Count:21

Background and Objective: Carbamazepine (CBZ) is an antiepileptic drug that causes significant malformations such as neural tube defects (NTDs), cardiac, skeletal and craniofacial defects if it is consumed during pregnancy. The aim of this study was to evaluate the protective effect of folic acid on prevention of birth defect due to Carbamazepine in Balb/c mice.Materials and Methods: In this experimental study, Sixty Balb/c timed-pregnant mice were divided into 4 experimental and 2 control groups. Two experimental groups received daily intraperitoneal injections of 30 mg/kg (group I) and 60 mg/kg/body weight (group II) of CBZ on gestational days (GD) 6 to 15. Two other experimental groups (group III and IV) received similar doses of CBZ with folic acid supplement (3 mg/kg/day) by gavages route for 10 days before pregnancy and 15 days after GD0 (gestational day 0). Two control groups received normal saline or Tween 20 (polysorbate 20). Dams underwent cesarean section on GD18 and embryos were collected. External examination was done and data concerning malformations, weight and crown- rump of fetuses were collected and analyzed by using SPSS-11.5 software and ANOVA and chi-square tests.Results: The mean weight and crown-rump of the fetuses in both experimental groups I and II were significantly reduced. Also in both experimental groups I and II various malformations were detected such as open eyes, limb defects, scoliosis, facial deformity and NTDs. The mean weight and crown-rump of fetuses in the folic acid treated groups did not show any meaningful differences in comparison with fetuses in experimental groups I and II. Also, meaningful reductions in eye, vertebral, limb and facial defects were seen in fetuses of group III. In experimental group IV, reduction of vertebral and limb defects were observed.Conclusion: This study showed that consumption of folic acid (3 mg/kg/body weight) before and during pregnancy can reduce birth defects due to CBZ in Balb/c mice fetus.

Background and Objective: Laser is a source of electromagnetic radiation. Laser therapy has a kind of natural and biological effect on tissue which acts via energy and light power. Today’s the use of infrared and red rays from low-power lasers have been established as a routine way for the treatment of diseases. Considering the important role of laser in biological sciences this study was done to compare the effect of red and infrared spectrum low level of laser rays on Rat Seminiferous tubules.Materials and Methods: This experimental study was done on 40 male Rat which divided in four groups including one control and three experimental. In the first experimental group, the right testis of the rats was exposed to a mixture of 300 Hz infra-red ray for 7 minutes and 300 Hz red spectrum for 1 minute daily. In the second experimental group, the right testes were exposed to the 300 Hz infra-red ray for 8 minutes for 40 seconds daily. In the third experimental group, the right testes were exposed to 80 Hz infra-red for 5 minutes and 80 Hz red ray for one minute daily. The controls did not receive any rays. After 15 days, testes were dissected, fixed and stained for histological processing. Thickness of seminiferous tubules and lumen as well as the thickness and area of seminiferous epithelium were measured. The concentration of testosterone was determined with radioimmunoassay. Data was analyzed with SPSS-13 software and ANOVA test.Results: There was a significant difference in the thickness of seminiferous tubules, thickness of lumen space and thickness of epithelium between first (i.e., the mixture of 300 Hz red and infra-red lasers), second (300 Hz infra-red laser) and the third experimental groups (80 Hz red and infra-red lasers) (P<0.05). But no difference was found between the first group and control. The serum testosterone concentration did not show any differences between experimental and control.Conclusion: This study showed that morphologic and morphometric alterations have direct relation with laser energy density.

Background and Objective: Respiratory distress syndrome is the most important lung problem during the neonatal period. Although the benefits of antenatal corticosteroids in neonates with a gestational age of less than 34 weeks have been demonstrated, the benefit of this treatment in neonates with higher gestational age is dubious. This study investigated the effect of Betamethasone on respiratory distress syndrome among neonates with gestational age of 35-36 weeks.Materials and Methods: This double blind randomized controlled trial study was done on 200 pregnant women who were of high risk for preterm labor in 35-36 weeks of gestation in Sanandaj city-Iran during 2007. 200 pregnant women randomly divided into treatment and placebo groups were received intramuscularly Betamethasone (12 mg/kg/BW twice) and normal saline, respectively. Data including age of mother, sex, weight, respiratory distress syndrome and newborns admission in hospital were recorded for each subject. Data was analyzed by using two-tailed T, Mann-Whitney, chi-square and Fisher exact tests.Results: There were no difference among two groups about age of mother, sex and weight of newborns. There were 8 (8%) and 20 (20%) newborns with respiratory distress syndrome in case and controls, respectively (P<0.01). Admission in hospital was 16% in Betamethasone group vs 28% in normal saline group (P<0.04).Conclusion: The study demonstrated that exposure to antenatal Betamethasone with 12mg/kg/BW twice between 35 and 36 weeks of gestation is associated with a significant reduction in the rate of respiratory distress syndrome.

Background and Objective: Post dural puncture headache (PDPH) is a relatively common complication in spinal anesthesia. Several regimens had explained for treatment of this problem. The aim of this study was to determine the effect of intravenous single dose of Aminophylline (1.5mg/kg/body weight) on the incidence of PDPH in cesarean section under spinal anesthesia.Materials and Methods: In a double blind randomized trial study, 120 patients undergone spinal anesthesia for the elective cesarean section in Motahhari hospital of Marvdasht in Fars province in south of Iran during 2008. After umbilical cord clamping 1.5mg/kg/body weight of Aminophylline injected slowly and intravenously in 60 patients. In placebo group (n=60) normal saline injected intravenously. At the 1st, 4th, 24th and 48th hour after surgery, PDPH in patients were evaluated.Results: The incidence of PDPH was significantly lower in cases compared with controls during the first 24 hours post operation (5% vs. 31.7%, P<0.001). Incidence of PDPH in case and control groups after 48 hours was 5% and 23.3% respectively (P<0.004).Conclusion: This study revealed that the intravenous single dose of Aminophylline (1.5mg/kg/body weight) significantly reduced PDPH after spinal anesthesia in cesarean section.

Background and Objective: Multiple sclerosis (MS) is a chronic, progressive and degenerative myelin sheath of the central nervous system. Manifestation and side effect of this disease drastically impress patient’s body image and destruct self concept. The objective of the implementation of this study was to evaluate the effect of Orem self- care program on multiple sclerosis patients’ self concept.Materials and Methods: This quesi-experimental study was done on 34 MS patients referred to Ayatollah Kashani hospital in Shahrekord – Iran, during 2008. The patients were selected by convenience sampling. 8 sessions educational program based on patients needs and Orem self care frame work during 3 months were carried out and with self reporting sheets program was pursued. After 3 months self concept questionnaire completed and data were analyzed by using SPSS-11.5 software and paired T, will kakson and kruskal wallis tests.Results: Mean of self concept, prior and post intervention was 60.67±4.20, 118.26±3.53, respectively (P<0.05). No significant correlation was found between age, gender, educational level, marriage status, number of children, occupation, level of income, duration of outbreak, times of hospitalized with self esteem.Conclusion: This study showed that self care program based on the Orem frame work has positive effects on self esteem in multiple sclerosis patients. Therefore this program is recommended in MS patients.

Background and Objective: Constraint induced movement therapy is an approach that with limitation of the healthy upper limb movement of a person with hemiplegia obligate to use the affected limb. This study was done to determine the modified constraint induced movement therapy on quality of upper extremity skills in affected limb in children with hemiplegic cerebral palsy.Materials and Methods: This single blind randomized clinical trial was carried out on 21 children with hemiplegic cerebral palsy referred to rehabilitation centers in Tehran-Iran during 2008. Samples randomly were divided into experimental (n=11) and control (n=10). Common therapeutic physical practice was carried out for 6 weeks in both groups equally. In treatment group intervention was practiced by constrain induced movement therapy methods for 3 hours daily. Quality of upper extremity skills pre and post intervention based on the quality of upper extremity skills test (QUEST) was evaluated. Data were analyzed by SPSS-16 software, Kolmogrov-Smirnoff, chi-square, T student and repeated measurement tests.Results: Mean age of children in the experimental group (7 girls, 4 boys) and control group children (5 female, 5 male) were 46.55±17.5 and 48.10±19.2 months respectively. Internal analysis of all items in interventional group were significant after 6 weeks of treatment (P<0.05). but in control group only grasp item was significant (P<0.05). Analysis between two groups did not show any significant difference in total and subtitle score including dissociated movement, weight bearing and protective extension. But only grasp subtitle showed significant difference between two groups (P<0.05).Conclusion: This study showed that modified constraint induced movement therapy only affect in quality of grasp.

Background and Objective: There are some factors including socio-demographic, maternal and nutritional variables reported to influence the growth of children in the first two years of life. The aim of this study was to determine some factors related to undesirable growth of 6 months-2 years old children in Tabriz-Iran.Materials and Methods: In this case-control study 233 children with undesirable growth as cases, and 412 children with desirable growth as controls selected in five primary health care centers in Tabriz city in North-West of Iran during 2007. A questionnaire which included some questions regarding demographic characteristics, fertility history, and nutritional status was filled by using face-to-face interview with selected children’s mother. The influence of different factors on undesirable growth was evaluated with a logistic regression model by using SPSS-14 and EPI-2000 software.Results: Having any disease during two monitoring (OR=4.23, 95% CI: 2.95-6.07, P<0.001), type of pregnancy (unwanted) (OR=1.87, 95% CI: 1.20-2.93, P<0.006), gender (girl) (OR=1.51, 95%CI: 1.05-2.17, P<0.025), low birth weight (OR=1.0, 95% CI: 0.99-1.01, P<0.097) and having conflict in the family (OR=1.22, 95% CI: 1.01-1.47, P<0.045) associated with undesirable growth.Conclusion: This study determined having any disease, type of pregnancy, sex of child and low birth weight related with undesirable growth of 6 months -2 years old children. Using safe family planning methods and help to reduce unwanted pregnancy, parental training about the nutritional requirements of children particularly during period of disease, is recommended in order to enhance the health of children.

Background and Objective: Golestan province, located in north of Iran has been known as a high risk area for esophageal cancer. The relationship between esophageal cancer and Selenium (Se) has been assessed in previous studies. This study was conducted to assess the relationship between Soil selenium levels and development of esophageal cancer in Golestan province of Iran.Materials and Methods: In this ecologic study, Golestan province in northern Iran was divided into 135 blocks based on geographical altitude and longitude on the map. One Soil sample was collected from the center of each block. Selenium level in Soil samples was determined by flame atomic absorption spectrometry. Statistical analysis was performed by Pearson correlation and T-Student tests.Results: The mean±SD of Soil Selenium level in Golestan province was 3.7±1.61 mg/kg. There was a positive correlation between Soil level of Selenium and esophageal cancer rates in this area (P=0.03), (Pearson correlation coefficient=0.19). The Soil Selenium level for high risk and low risk area for esophageal cancer were (4.13 mg/kg) and (3.39 mg/kg) respectively (P=0.01).Conclusion: This study showed that there is high Soil Selenium level in Golestan province in north of Iran. Also it is found to be a significant positive relationship between Soil Selenium level and esophageal cancer rate in this area.

Background and Objective: Childhood obesity is a significant public health concern due to its impacts on childhood physical and psychological health with subsequent adulthood complication. The aim of this study was to determine some related factors of obesity and overweight in girls' secondary school.Materials and Methods: This cross-sectional study was performed in Gorgan Northern Iran, during 2005-06. The subjects selected by stratified random sampling. Age, height, weight, BMI, daily time of television watching, frequency of physical activity and snack consumption was recorded by parents in a questionnaire sheet during a week. Data were analyzed by using SPSS-11.5 software, chi-square and ANOVA tests.Results: In this study, 6.3% and 41.7% of subjects were obese and overweight, respectively. The mean of BMI of girls was 19.69±4.6 kg/m2. The prevalence of obesity and overweight in Fars ethnic group was more than others (P<0.05). Average spending time for television watching was 2.35±0.98 hours and the same index was higher among the obese and overweight girls but, this difference was not significant. Food consumption during watching television, frequency and duration of physical activity were significantly related with obesity and overweight (P<0.05).Conclusion: This study showed that low physical activity and imbalanced nutritional behavior are related to obesity and overweight among secondary school girls in Gorgan-Northern Iran.

Background and Objective: Lichen planus presents with chronic, inflammatory mucocutaneous lesions; with almost 1-2% prevalency without any relation to demographic variables. This study was done to describe the clinical pathologic features of lichen planus patients in Mashhad, Iran. Materials and Methods: In this descriptive study, demographic data (age and sex) and some factors such as histology, form and anatomical zone of lesions were recruited from patient’s medical records and pathological slides revised. Data analyzed by using SPSS-13 software and chi-square and T student tests. Results: 309 patients (177 male, 132 female) were enrolled. Mean age was 40.12±16.3 years-old and patients were categorized mostly in 41-50 years age group. Clinical presentation in 44% was plaque and 41.7% with papules, 23.9% hyper pigmented, 26.9% scaled, 4.9% annular form and 2.9% linear. 45.6% of patients had classic histo-morphology and 25.9% of them had hypertrophic form. There was not any relationship between lesion histopathology with either sex or age. Anatomical zone had a significant relation with histopathology of lesion (P<0.05).Conclusion: This study showed that the prevalence of genital and mucousal lesions was lower than reported in other studies in various parts of the world.

Background and Objective: Ageing is a bio-cognitive which can be described as a progressive and degenerating process in human. One of the major changes in the elderly is loss of teeth, which can affect on dietary intake and nutritional status. This study was designed to assess the dental health in elderly people in Gorgan, North of Iran.Materials and Methods: This descriptive and cross-sectional study was conducted on 400 subjects (211 female and 189 male) aged 60 years and above in two selected health centers in Gorgan-Iran. Data were collected by questionnaire and oral and dental examination. Data was analyzed by using SPSS-13 software and chi-square test.Results: The mean age of the subjects were 66.7±6.7 Sixty percent of the participants were without natural teeth and forty percent had natural teeth. only 10.5 percent of subjects had complete natural teeth. 19.7 participants had decayed teeth. The mean of decayed teeth was 9.2 (rang 1-28) and filled teeth was 4.8 (rang 1-16) in 12.5 percent of participants. Age, level of education and level of income were significantly associated with the number of existed teeth (P<0.05).Conclusion: In regard to high prevalence of without natural and decay teeth in the elderly population, this study, it is recommended the serial assessment of dental health to be screened on routine bases.

Background and Objective: Helicobacter pylori (H.pylori) with positive Cytotoxin associated Gene A (CagA) have higher potential for pathogenesis. Cytotoxin associated Gene A (CagA) accelerate the pathogene city of bacteria due to cytotoxin production stimulation. The aim of this study was to determine the prevalence of the anti-CagA antibody among H. pylori infected persons in Golestan province-North of Iran.Materials and Methods: This descriptive study was carried out on 676 H. pylori positive subjects in Golestan province, northern Iran during 2008. Anti CagA antibody were determined in H.pylori positive subjects. Data analyzed by SPSS-16 software and chi-square test.Results: Prevalence of anti CagA in Helicobacter pylori infected cases was 57.7% (390 cases: 179 males and 211 females) (95% CI: 53.9-61.4). According to age the highest and lowest cases of anti CagA antibody were seen in, 15-24 (63.4%) and under 5 years old (26.3%). The level of anti CagA antibody in Sistanian ethnicity group (67.2%) was more than other ethnic group. Anti CagA antibody in Rural area was more than urban regions. Sero prevalence of anti CagA antibody was highest in Minudasht twon (78%), located in East of province in comparison with Bandar Gaz (44%) in west of provinceConclusion: This study showed the prevalence of CagA positive Helicobacter pylori strains in this region is similar to other regions of Iran, Asia and Europe and higher than African population.

Background and Objective: The incidence of infections is one of the most disturbing problems in the management of patients with systemic lupus erythematosus (SLE). The aim of this study was to describe the role of tuberculosis (TB) as a cause of fever in SLE patients.Materials and Methods: In this descriptive study 103 SLE patients enrolled in Ahvaz, South-West of Iran during 2000 - 06. Patients were diagnosed according to American College of Rheumatology criteria (at least 4 of 11 criteria). Diagnosis of tuberculosis was based on Iranian National Program against TB criteria. The infection free patients were given corticosteroid therapy.Results: In this study 20 patients did not follow the complete cycle and finally 83 patients were established as sample population of this study. Mean age of patients was 22.2±10 years, female to male ratio was 9.2:1, mean duration of treatment was 12±3.2 months and mean of daily dose of prednisolone was 28.2±13 mg.From total of patients, 8 (9.6%) had active tuberculosis. five patients had pulmonary and three with other type of TB, respectively. One of the above eight patients eventually died due to SLE/TB.Conclusion: Tuberculosis is one of the important causes of fever among patients with SLE under treatment of corticosteroid. In approaching febrile SLE patient TB should always be considered as a treat.

Background and Objective: Adolescence is a critical period which has physical, sexual and psychosocial changes. Scientists believe that adolescent must aware from necessary knowledge at critical time, because unawareness causes more sexual deviation. Thus in this study parents and teacher's view had been assessed about the best time and appropriate method for reproductive health education for female adolescents.Materials and Methods: In this descriptive study 400 parents and 50 teachers from girls' high school were chosen by multiple sampling in Gorgan-Iran. Information collected by a questionnaire which consisted of two parts of demographic characteristics and polling which contains three parts: fertilization and pregnancy, family planning, HIV and STDs. Descriptive statistic was used for analysis the Data by SPSS-9 software.Results: 43.5% of mothers and 38.5% of fathers believed that the best time for fertilization and pregnancy education is at marriage time, and 46% of teachers believed grade III high school and pre- university is suitable time. Majority of teachers and parents believed that the best time to teach family planning is at marriage time. 32% of mothers believed that the most suitable time. for teaching HIV and STDs is grade 3 at high school and  pre- university  but about 30.7% of fathers and 38% of teachers noted the best time is grade I and II at high school. About the most suitable education method, 45% of mothers and 44% of teachers believed that attending a midwife at school is necessary.Conclusion: This study showed that majority of parents and teachers agree with reproductive health education during high school and marriage time and they mentioned that the best education method should be done at school with attending a midwife as a counselor.

Background and Objective: Life saving with high quality health care programs in the shortest duration is the mainstay of emergency department system. Frequent monitoring and quality control of this process and the satisfaction of patients are among the very important indices in hospital quality. This study was designed to evaluate the clients satisfaction in the hospitals affiliated to Golestan University of medical sciences.Materials and Methods: This descriptive cross-sectional study was done on 2400 referred patients in emergency departments of different hospitals in Golestan province, northern Iran during 2006. Data were gathered by questionnaire included demographic data and questions about satisfaction of outpatients and emergencies. The Data analyzed by SPSS-15 software and chi-square test.Results: Level of satisfaction in emergency department, was reported as follow: physician attention and behaviors (86%), nursing behaviors (85%) responsibility to patients (84.1%) status of the environmental temperature (83.9%) and cleaning (81.9%). The lowest satisfaction was related to behavior of guardsman (33.8%). In emergency ward, levels of patient's satisfaction were as following: Access to telephone (49.7%) quality of the meals (47.4%) quantity of meals (44.1%) and the lowest level of satisfaction of patient was neglecting the patient's right (8.2%).Conclusion: This study indicated that more educational programs, should be arranged for the emergency units employees to observe patients right.