Journal of Gorgan University of Medical Sciences
Year:2009 | Volume:10 | Issue:4 (28)|Papers Count:22

Background and Objective: Treatment of Cutaneous leishmaniasis (CL) with oral therapeutic drugs, ideally cheap, with good tolerance and safe are highly desirable. The aim of this study was to assess the efficacy of azithromycin (AZ) for treatment of patients with CL in Ahvaz – Iran.Materials and Methods: In a randomized controlled clinical trial study, 28 patients with CL as cases (AZ group) and 26 patients as control (C group) were studied. Cases were treated orally 500 mg/day of azithromycin in single dose for 28 days. Patients in control group did not receive any treatment. Both groups were followed up in days 14, 28 and month 2 and 5. Data were analyzed in SPSS-11.5 by using chi square and exact Fisher's tests.Results: Means ± SD age of subjects was 20.26±8.45 years. Male to female ratio was 1.5:1. The half of the patients resided in rural area. At the end of study treatment; 46.4% of patients in AZ group and 15.4% of patients in control group were cured (P<0.02). One relapse of CL was observed in AZ group, no serious drug side effects were observed.Conclusion: This study showed that azithromycin has an acceptable effect on the treatment of cutaneous leishmaniasis in Iranian patients and can be used alternatively in treatment of cutaneous leishmaniasis.

Background and Objective: Treatment of the femural shaft fracture is improving. The aim of this study was to compare the outcome of Dynamic Compression Plating (DCP) and intramedullary nailing in the femural shaft fracture.Materials and Methods: This clinical trial study was done in orthopedic department of Shahid Kamyab Hospital in Mashhad – Iran during 2002-03. 40 patients with open fracture of femur divided into two groups. One group was treated by dynamic compression plate and the other group by intramedullay nailing. Follow-up time was 9-14 months.Results: Out of 40 patients, 75% were male. The time of clinical and radiological bone union was the same in both groups. There was 4 implant failure in the plate group (P<0.05). There was one deep infection in the intramedullary nailing group.Conclusion: This study showed that there is no difference between plate and intramedullary nailing group according time of bone union. But because of 4 implant failure in DCP group intramedullary nailing is recommended for femural shaft fracture.

Background and Objective: In clinical situation, pain occurs during intravenous Catheterization (IVC). Finding methods to reduce pain related with insertion of Angiocut. This study was performed to evaluate the effect of types of Transcutaneous Electrical Nerve Stimulation (TENS) on the pain severity regarding to insertion of Angiocut is very important. This study was performed to evaluate the effect of types of transcutaneous nerve stimulation (TENS) on the pain severity regarding to insertion of Angiocut.Materials and Methods: This clinical trial study was performed on the 80 patients of Internal and CCU wards of Fatemieh Hospital in Semnan, Iran during 2001. In this study, severity of pain related with insertion Angiocut assessed and compared in four conditions; No TENS, low TENS (5 Hz), high TENS (100 Hz) and burst TENS (with frequence 100 Hz And burst frequency 2 Hz). The severity of pain measured by testes visual analogue scale (VAS), One-way ANOVA, Tukey, and Dunnett tests were used for comparing means of pain severity in different conditions.Results: Findings showed significant difference between severity of pain during Angiocut insertion in four conditions (P<0.05), so that the lower intensity of pain was in the high-TENS group, while higher pain was in the No TENS group. Significant difference was between intensity of pain in the No TENS group with high TENS and burst TENS group (P<0.05), but no significant difference was between low TENS and No TENS groups.Conclusion: This study showed that TENS was a effective method to reduce pain during Angiocut insertion. The lowest severity of pain was obtained in high TENS method. therefore, high TENS method can suggest as a effective method to reduce pain during Angiocut insertion.

Background and Objective: Carpal Tunnel Syndrome is the most common compression neuropathy which can cause mild, moderate and sever disability in patiens hands. The first standard treatment is to use Cock-up splint. This study was done to compare therapeutic effects of long (With MP Joint restriction) and short (without mp Joint restriction) Cock-up splint patients with Carpal Tunnel Syndrome.Materials and Methods: In this clinical trail study was done on 23 patients with mild and moderate Carpal Tunnel Syndrome in Shafa Yahyayian Hospital, Tehran, Iran. The diagnosis of Carpal Tunnel Syndrome in patients confirmed with electrodiagnostic method. In this study 23 Patients was treated with long & short cock-up splint in two groups. Group A (12 Patients) was treated by long Splint and group B (11) Patients was treated by short Splint for 4 weeks. Patients were evaluated by Semmes–Wein stein monofilaments, Two Point discrimination, Visual analog Scale (VAS), pinch and Grip Strength.Results: Both types of splints appear to be effective in decreasing CTS symptoms but long Splint more beneficial than Short splint. The results of SWMS, 2PD, Pinch & grip Strength in group A had higher significant difference than group B. (P<0.05). Two groups did not have significant difference in results of severity of pain according to VAS.Conclusion: This study revealed that long Cock-up Splint in comparison with short Cock-up splint demonstrate high efficacy in improving the signs of Carpal Tunnel Syndrome.

Background and Objective: Weight bearing position is considered as a functional condition. However, available data about it and also knee position sense is little. This study aimed to compare knee joint position sense in weight bearing and non weight bearing positions in men and women, and to determine the effect of target angle on knee joint position sense.Materials and Methods: This interventional study was performed in Zahedan University of medical sciences, Zahedan, Iran in 2006. Forty-four healthy subjects (22 women, 22 men) participated in this study through simple non-probability sampling. Subjects were asked to flex their knees in prone or in standing position, while their eyes closed. Three target angles (45, 60, 90 degrees of knee flexion) were reproduced by each subject. Angle matching errors were measured using an electrogoniometer. Outcomes were collected in form of relative, absolute and variable errors. Data were analyzed using MANOVA test.Results: There was significant difference between weight bearing and non weight bearing positions in terms of angle matching error (P<0.05), while no significant difference was seen between women and men, and also in three target positions.Conclusion: This study showed that subjects are more capable of recognition and identification of the angles during weight bearing position. A larger amount of proprioceptive afferent data may result from sources other than examined knee and lower extremity.

Background and Objective: The thalassemic syndromes are geneticaly structural disturbance of a and b globin chains. In major b-thalassemia the life expectancy depended on frequent blood transfusions that lead to over storage and deposition of Iron in different body-organs (Hemochromatosis) including parathyroid glands, which may cause hupoparathyroidism. This study was done to evaluate the frequency of hypoparathyroidism in thalassemic patients referred to teaching hospitals in Hamedan – Iran.Materials and Methods: This descriptive, cross-sectional study was done on 56 thalassemic patients, which received blood transfusion. Serum Ca, P, PTH, total protein, albumin, Ferritin and BUN cratinine were checked two weeks after last transfusion. The hypoparathyroidism was defined when calcium was less than 8mg/dl and phosphorus more than 5.5mg/dl and PTH less than 10ng/dl.Results: In this study, 14.2% of patients had hypoparathyroidism. 37.5% of hypoparathyroid ones had clinical manifestation of hypocalcemia. There were statistically meaningful association (P<0.05) between The hypoparathyroidism with desferal administration, splenectomy and diabetes.Conclusion: This study showed that the frequency of hypoparathyroidism in Beta-thalassemic patients receiving blood transfusion was relatively high, so clinical and labratory evaluation for endocrine glands specially parathyroid is recommended since early second decay of life.

Background and Objective: One of the problems in urban areas is nitrate contamination of ground waters. High nitrate concentration can cause methemoglobinemia, appearing as a risk factor is provided by ground waters. More than 80% of drinking water of Gorgan, Iran. So this investigation was done to determine of nitrate level in ground waters in Gorgan. This study has been carried out for investigation of nitrate rate in drinking water supply networks and not drinking water ground water wells of Gorgan city.Materials and Methods: This discriptive study was done on 43 ground waters and surface water samples which collected in spring and winter, in Gorgan during 2005. K+, Cl-, NO21-, NO31- of samples were analyzed by spectrophotometery method.Results: The chemical analysis of ground waters of drinking water resources of Gorgan city showed significant variation of nitrate between 3.52 to 69.52 mg/l. The rates of nitrate in certain ground waters wells in vicinity of landfills were between 84.48 to 145.2 mg/l which is more than drinking water standards. Nitrate concentration in agricultural lands such as Shast-kula and Garmabdasht aquifers is lower than Ziarate aquifer in vicinity of urban area.Conclusion: Nitrate contamination in aquifers in vicinity of urban area and unsanitary disposal of solid waste substance may result from house sewage effluents and infiltration of landfillleachs to ground water wells.

Background and Objective: To evaluate the effectiveness of Neonatal Intensive Cares Many different data banks have been developed. Furthermore, various scoring systems such as SNAP and CRIB have been validated to designate and compared differences among hospitalized patients in NICU. This study was done to determine mortality rate and prevalence of complications in neonates admitted to Taleghani and Dezyani NICU centers in Gorgan - Iran.Materials and Methods: In this descriptive study a questionnaire including sex, birth weight, gestational age, duration of hospitalization, age at the time of discharge or death, complications and other information needed for CRIB scoring system, was completed for 46 neonates with gestational age of less than 37-week old and birth weight of less than 1500 grams.Results: Mortality rate was 37% (17 neonates) with the most common cause being respiratory failure. RDS was associated with a 101-fold increase for the chance of death (OR=1.1, CI=12.9 793.6). This probability was 4.7 fold for delivery-time asphyxia. The mean of birth weight, gestational age and CRIB in living and dead infants were 1201 and 934 grams, 30 and 28 weeks and 3.76 and 11.7, respectively. Using a ROC curve, a cut off point of 7 was reached to predict neonatal outcome for CRIB scoring.Conclusion: This study showed that the mortality rate was higher than the rate in most centers of the world. The mortality rate was directly related with the increase of CRIB score, especially for scores more than 11.

Background & Objective: Rubella vaccine is prepared with live virus thus if it injects during abstinence period, it can cause fetal risks. The aim of study was to evaluate rubella IGM among infants of women who were vaccinated against rubella during 3 months pre-or post-conception (abstinence period).Materials & Methods: This cohort study was done on 253 mothers, including 116 mothers as cases and 137 mothers as controls. The case group inadvertently had received MR vaccine (RA27/3) during abstinence period. The control group selected randomly from similar delivery center that admitted for delivery. The background and confounding factors was matched between the control and case groups. In both groups after delivery, cord rubella IGM was measured by ELISA for serological diagnosis of infant infection. Data was analyzed by Chi-square and T-student tests.Results: The findings showed that the number of positive IGM infant was similar in both groups (One positive IGM in each group). In spite of no significant difference between the case and the control groups, the maximum theoretical risk in this study was 4.392% (RR=1.091; 95% CI=0.271-4.392).Conclusion: Although no significant difference was found from the point of infants with an IgM+ serology in two groups, according to the risk ratio obtained in this study, we still recommend vaccination should be avoided during abstinence period.

Background & Objective: Glucose Amino Glycans (GAG) are unbranched polysacharides, major components of the basement membrane and play a key role in their molecular organization and function, also have an important role in the pathogenesis of some diseases such as hypertension. Hypertention is probably the most important health problem in several countries. But there is not yet a reliable indicator for early diagnosis of hypertension. The goal of this study was the measurement of serum and 24-h urinary GAG as an exact and early diagnostic marker.Materials & Methods: In this case – control study, 24-h urine and serum samples collected from the 53 patients and 38 persons as matched control normotensive group. Then amount of GAG was measured with spectrophotometery method.Results: Our findings showed that there is a direct relation between 24-h urinary GAG excretion and systolic blood pressure and it increases with increase of systolic blood pressure. Also amount of serum GAG increases in hypertensive patients in comparison with control group.Conclusion: This study showed that the concentration of GAG in sera and 24-h of urine samples increase in systolic hypertention.

Background & Objective: Trauma is the second most common cause of death regardless of age in Iran and the health system annually defrays a vast cost for trauma patients. The majority of cases comprise abdominal trauma. This study was performed to determine individual and pathologic characteristics of patients with blunt abdominal trauma in Gorgan – Iran.Materials & Methods: This descriptive and retrospective study was done on 239 patients with blunt abdominal trauma in 5 Azar hospital, Gorgan - Iran from March 2001 to March 2005.Results: 197 (82.4%) of cases were male and 42 (17.6%) were female. The mean age of patients was 23.4 years. The mean of hospital stay was 8.8 days. The most common cause of blunt abdominal trauma was traffic injury. The most common damaged organs were spleen (49.4%) and liver (21.3%) respectively. Mortality rate was 16.3%. The hypovolumic shock was the major cause of mortality.Conclusion: This study showed that epidemiology of trauma is similar to those in other regions of our country. Therefore, programming and attempts of governmental organizations are needed to prevent and decrease traffic accidents.

Background and Objective: The compound of MDMA or 3,4methyl deoxy met amphetamine, so called ecstasy, is a new narcotice compound. Ecstasy tablets have a temporary exciting and deteriorating side effects. This study was done to determine the knowledge and attitude of University students about ecstasy tablets in Gorgan, Iran.Materials and Methods: This descriptive - analytic study was done on 300 university students in Gorgan during 2006. The tools of data collection were questionnaire. This questionnaire developed by authors, consists of demographic, knowledge and attitude questions respectively. The data were analized by SPSS software and Kruskal- Wallis and Mann- Whitney tests.Results: 3% of subjects had previous usage of ecstasy. The 27.3% of students had poor knowledge about ecstasy; also 52.3% and 12.7% of students had middle and high knowledge about ecstasy respectively. There was significant relation between knowledge and attitude with educational level, family income, parents occupation and previous usage of ecstasy (P<0.05). But there was not any relation between knowledge and attitude and age, gender, and filed of education and source of information enquiry. There was a positive correlation between knowledge and attitude of students (P<0.001, r=0.243).Conclusion: This study showed that knowledge and attitude of University students about ecstasy is low. Therefore an educational program about ecstasy is necessary to increase the knowledge and attitude of university students.

Background and Objective: Genital herpes is increasing in Asia and the world. Based on other studies, knowledge has an important role in reducing high risk sexual behavior. In this study we evaluated knowledge among Shahid Beheshti University students as a sample of young and educated population of Iran.Materials and Methods: This cross-sectional study carried out on 409 of Shahid Beheshti University students in Tehran - Iran at Autumn 2004. Research material was questionnaire and data analyzed by SPSS-13, T-student, Chi-square, Mann-Whitney, Kruskal-Wallis Tests.Results: Mean ± SD of level of knowledge, nature and transmission of genital herpes was 26.5±26%, 23.7±24.2% and 30.56±36.8%, respectively. The level of knowledge about signs, treatment and prevention of disease was 18.8%, 16.4% and 46.2%, respectively. There was a significant relation between age, marital status and education with knowledge (P<0.05). The level of knowledge among engineering students was higher than humman sciences students (P<0.05).Conclusion: Based on our study, most of participants had no enough knowledge about genital herpes. Most of participants were willing to know more about it as they obviously welcomed to our pamphlets. It seems that educations about genital herpes should be added to educational programs.

Adrenocarcinoma is a rare disease with a poor prognosis. As a practical classification, adrenal carcinomas divide to two categories: functional and nonfunctional. Adjurent radiotherapy and chemotherapy is useful for palliation. The aim of this report is to introduce one case of large nonfunctional adrenocarcinoma. A 46 years old-male with ambiguous abdomen pain and orchidoepididymitis reffered to clinic in 2006. Physical examination revealed grade III fixed varicocele with left orchidoepididymitis. Sonography and computed tomography scan showed a massive lesion on left adrenal. Adrenal function test was normal, therefore nonfunctional adrenocarcinoma is diagnosed. This patient underwent open adrenalectomy. Then the patient introduced to chemoradiotherapy in oncology center. After six months, the patient suffered from multiple liver metastases and one year later was expired.