مجله دانشگاه علوم پزشکی گیلان
پیاپی 37-38 (بهار و تابستان 1380)

Much researches has focused on the theory that antioxidant nutrients act as scavengers of oxygen derived free radicals, thereby helping to prevent cell and tissue damage that otherwise would give rise to degenerative diseases such as atherosclerosis caused by LDL oxidation. Findings from extensive studies suggested that the determination of lag objective procedure for determining the susceptibility of LDL towards oxidation as well as of pro and antioxidants, particularly fat soluble vitamines. In this study, the Lag-time or oxidation resistance for LDL samples, obtained from 8 healthy male adult subjects was found to be between 40-50 minutes. It is evident that the intake of dietary antioxidants or supplements can increase the resistance or Lag-time and the measurement of Lag- phase could be a highly promising routine method for measuring the total antioxidant status of LDL and its susceptibility towards oxidative conditions.

Cancer of the cervix is a common malignancy in females' genital tract. This is the third most common malignancy in females. The main object of this study was to determine the risk factors associated with cervical cancer. In this case-control study, from 282 cases, 87 patients with progressive disease were in the case group and 195 healthy women in the control group. Sampling method in the case group was a simple one and in the control group a randomized one. These two groups had the same age characteristics. This research was performed in "Sayed-Al-Shohada" and "Amin" hospitals. The data were analyzed by SPSS. The results showed that cervical cancer is related to age of first marriage (P= 0.0008, OR=5), number of delivery (P=0.0001, OR= 3.2) and contraceptive method used (oc pills). Results showed that in the group who used oral contraceptive pills for more than 6 years, O.R was 3.3 (P = 0.008). The weekly mean intercourse rate at the first, second, third, and fourth decades of marriage life in the case group was more than control (P = 0.001). Socioeconomical status differences were not significant in rural VS urban areas (P>0.05). There was a significant relationship between education in two groups (P=0.018). Pap smear test results were flales negative in about 15.5 percent of cases. Some of the above mentioned risk factors probably increase the cervical cancer incidence. We wish by performing more interventional programs designed to omit as much risk factors as possible, this incidence rate would be reduced.

This is a descriptive-analytic survey to evaluation the knowledge of women and men over 15 years old about prophylaxis and transferring of AIDS and hepatitis B in sanandaj in 1998. The purpose of this study was to determine knowledge of people over 15 years old about prophylaxis of AIDS and hepatitis B based on their age, job, and education. In this study 852 men and Women over 15 yr. were selected by cluster-randomized sampling, the method of data collection was questionnaire with 23 questions. Most of cases was women, married, graduated from high school, housewife and 15-24 years old. The most of them belived that the best way for prophylaxis is training the people. The most of them don't know the way of hepatitis B transfer and prophylaxis. Based on results there was significant relationship (P<0.0001) between knowledge about transfer and prophylaxis of AIDS and education, job and age also there was significant relationship (P<0.0001) between knowledge about transfer and prophylaxis of hepatitis B and education, job and age. It appears that partitioners individuals' knowledge about prophylaxis and transferring of AIDS and hepatitis B was low, therefore the health workers needs special attention to the training the of people.

Breath holding (B.H) attacks is one of the most common problem in children that disturbs their parents. With respect to the presence of discrepancies between anemia and iron therapy in this condition, this study designed for evaluation the relation of C.B.C findings and B.H attacks. This analytical case-control study was done on 86 patients under 6 years old who referred to outpatient clinic of Shahid Beheshti Hospital and Private Clinic in Kashan in 1999. Patient group includes 43 child with B.H attacks and control group includes 43 child with other disease which had no effect on C.B.C findings. Demographic characteristics and C.B.C Findings recorded and evaluated by Chi-square and exact Fisher Tests. Study showed that rate of B.H attacks in boys was 65.1% and in girls 34.9%, most common rate was in age 1-2 years(58.1%). In 74.4% of patients B.H attacks was of cyanotic type and 46.5% of patients had at least one attack daily. C.B.C findings such as R.B.C number, M.C.V and M.C.H in compare with normal values, in patients was lower than control groups and this difference statistically was significant. Study showed that decreased number of R.B.C and magnitude of M.C.V and M.C.H in patient with B.H attack were more than control group. It is suggested that more analytical and experimental studies are needed for evaluation of iron compound effects on C.B.C findings and B.H attacks.

Hepatitis A , like any other intestinal diseases, is common across the world. But its prevalence and epidemiological feature vary according to sanitation and crowded of people. This study which was conducted in the spring of 1377 (1998) aims at the evaluation of epidemiologic pattern of hepatitis A in Zabol. 229 people from rural area of Zabol were randomly selecteted and investigated for IgG AntiHAV. 202 people (88.6%) had antibody against HAV (95% confidence interval =84.4%-92.8%). Prevalence of the infection were 85.6% for men and 91.4% for women. But this difference was not significant. The results indicated that the infection occurred in the first year of life and its proportion incresed rapidly in such away that 79.6% of the children who were under 5 year old and 100% of 15-19 years olds were infected by hepatitis A. So hepatitis A infection in Zabol is hyperendemic and in most cases there is no need to prescribe immunoglobolin to the patient's family or relatives.

Stevens-Johnson syndrome (SJS) is a serious acute self limited emergency in dermatology with considerable morbidity and mortality, Its specific therapy with systemic steroids has been the matter of challenge and controversy in the past 4 decades. The purpose of this study was comparing of complications and the length of hospitalization between those treated with steroids and supportive care versus only supportive care measures. This is a cross-sectional study of 40 cases of SJS admitted to dermatology department of Razi Medical Center in Rasht in a 6 year period (1995-2001), evaluated with diagnostic criteria of: 1- Moderate to severe involvement of at least one issues. 2- Widespread involvement of the skin (mean 50% of skin surface) by lesions compatible with Erythema Multi form (EM), in two group of 20 patients, either on supportive care or supportive care with moderate doses of systemic steroids (0.5-1 mg/kg/day) (mean: 33mg prednisolone) The mean duration of hospitalization in supportive care group was 13.25 days while this period for systemic steroids group was 9.05 days (P<0.05) In steroid group,5patients and but in other group 8 patients were developed complication. It was not statistically significant. If systemic steroids begin soon (mean:3 day after appearance of rashes) with a moderate dose and short period, not only does not cause further complication but also reduce the length of hospitalization; in comparison to those on supportive care only. It is apparent that these data needs further prospective study for confirmation with regard to ethical limitation of prospective study in a rare emergency problem such as SJS.

I.M.R is one of the most important Indexes in health system that used for in assessment of health service and appllicated determine of developing society. If we'll diagnose the case of mortality in developing countries we can dissolve this problem with simple Actions. this study was carried out for determine of correlation between demographic factors of mother and child and I.M.R in village of Zabool that covered by home health . This investigation was a cased-control and society study on the died children that had less than one years old from January 99 to January of 2000 control group was one years children that was matched with case group for age and sex. Totally 200 children was participant in this study. Data gathering instrument was questionnaire that completed by interview with mothers and read children health record. Descriptive and analytical statistic was used for data analysis . Results indicated that there was significant relation between weight of birth (P=0.002), maturation (P=0.005), time of breast feeding (P=0.000), nutrition status of children (P=0/001) Number of child's cares (P=0.001), process of infant growth (P=0.000), mother's education (P=0.02), parents' relationship (P=0.001), and number of mother's cares (P=0.04), with I.M.R. On the whole, considering the factors related to I.M.R , it is possible to decrease it through accurate planning and increasing the general knowledge of mothers and health staffs.

The purpose of this descriptive study is determining knowledge, attitude and practice of mothers about Jaundice . The mothers who delivered into midwifery wards of Kerman and has a maximum of 20 days newborn baby responded to questions in their homes . Data collection performed by investigator-made questionnaire that its validity and reliability determined before gathering data . Statistical testes including chi-square, t, one way Anova, Kruskal-Wallis, Fisher and Pearson coefficient were used. The age of most subjects were 26-30 years (36.4%). In regard to education levels, the majority of mothers (33.2%) educated 9-12 school years and 76.8% cases were housekeepers. In general, studied mothers acquired 75.05% total knowledge scores and 75.5% total attitude scores. 72% of subjects done Jaundice prevention practices before and 42% after delivery. Among the mothers who had children with jaundice the majority (82%) refere to physician that in the most cases (51%) this practice was in primary priority and after referral. 71% mothers were used plant drugs which in 48% cases were in primary priority. There was a moderate correlation between total score of knowledge and attitude(r=0.46).

Erythroderma is a severe skin disease that can be associated with serious metabolic disorders and so it requires immediate care. The difficulty with erythroderma lies in finding the underlying cause. Several studies in other countries, that reported a different incidence of each etiologic group. The aim of this study was to evaluate various causes of erythroderma in Gilan and compare the findings with previous studies. This descriptive study was done retrospectively by reviewing the existing records of 64 erythrodermic patients admitted in skin diseases ward of Razi Hospital in Rasht in 1995-2000. The mean age of onset was 51 years, and majority of patients were older than 40 years, with a male female ratio of 3/1. The most frequent causes of erythroderma were psoriasis (46.8%), drug reactions (14.1%), dermatitis, (9.3%) and lymphoma (6.2%) followed by PRP (3.1%) and lichen planus, Pemphigus foliaceus, Ichthyosis, actinic reticuloid each in 1.6%. No cause could be found in 14.1%. With regard to the possibility of recognizing the etiology in 85.9% of patients and consideration of this point that the most common etiologies of erythroderma are the underlying dermatitis, especially psoriasis, early recognition and appropriate treatment of these underlying causes is recommended in order to prevent erythroderma.

Hirsutism is a difficult problem for both to the patients and the physicians. Its definition is subjective and the severity of hirsutism and the degree of acceptance are dependent on racial, cultural and social factors. The hair growth pattern, under the influences of genetic and ethnic factors, has significant variations among normal females. In order to determine the prevalence of hirsutism and the hair growth pattern in normal female students, this study is conducted. We studied 256 randomly selected normal female students of Guilan University of Medical Sciences. All students with menstrual abnormality, thyroid disease, galactorrhea and history of medication affecting hair growth were excluded. The "Ferriman-Gallwey scoring system" and the "modified Ferriman-Gallwey scoring system" for body hair were used. The age (mean ± 1 STD) of the students was 22 ± 2.5 years; age range was 18 -31 years. ninety percent of them were single. Age at menarche (mean ± 1 STD) was 13.3 ± 3/6 years. Their menstrual period (mean ±1 STD) was 29.4±4.6 and bleeding period (mean ± 1 STD) was 5.6 ± 1.4 days. Only in nine students the score of hair growth in any of the nine areas was zero. On the basis of the "Ferriman-Gallwey scoring system" all the students were considered hirsute, and on basis of the "modified Fcrriman-Gallwey scoring system", only in 52 (20%) of students the hair growth score of all the four areas was less than 2. On the basis of the "modified Ferriman-Gallwey scoring system" for body hair, near 80% of the students were considered hirsute, too. In conclusion, in a sample of normal Iranian females, hirsutism is common and on the basis of both the "Ferriman-Gallwey scoring system" and the "modified Ferriman-Gallwey scoring system" for body hair, most of them were hirsute.

Pulmonary Tuberculosis (TB), usually is a chronic disease that caused by Mycobacterium Tuberculosis. Identification of the cases of TB is the key to control of it and radiology still plays a major role in both active and passive TB diagnosis. To assess the radiological patterns of presentation of active postprimary pulmonary TB, in this review and retrospective analysis, we studied CXRs, and medical records of 101 cases with positive sputum smear for AFB seen over a period of 2 years (1997-1999) in Razi referral center in, Rasht. The most common chest radiographical findings were as follows: consolidation, with different patterns such as reticulonodular appearance air space, fibrosis and calcification (46.5%) mostly at both apexes and upper lobes with right side dominancy (23.7%) 3 of them had healed process appearances. Cavities with air-fluid levels (mostly upper lung zones) (35.6%) and isolated pleural effusions (12.6%) and Milliary pattern (0.9%). 4 cases had normal CXRs, .Haemoptysis and high sputum bacillary burden were related in proper order to the presence of CXR consolidations and then the cavities. There were no significant differences found between sex and radiological and clinical patterns. Consisting with other reports and findings, we may consider CXR appearances in patients with AFB+ sputum as "highly suggestive" for "active disease in pulmonary TB", in endemic areas.

By restoration of pulpally exposed teeth with root canal therapy edentulous areas and neighbouring teeth displacement can be avoided. Prefabricated posts may be used for crown restoration of these teeth. For the preparation of root canal for post placement, Gutta percha should be removed by means of mechanical, thermal and chemical agents. To study the amount of apical leakage in vitro, three methods have been compared: 1. not plugger. 2. gates glidolen and 3- peeso reamer, in 60 human single extrated root teeth, (earning at least 5mm gutta-percha at apical third). Result showed significant difference between 3 methods. Highest leakage observed in peeso remer group (4.669mm), and least leakage seen in hot plugger group (1.945mm), and in gates glidden group (3.843mm). The result of this investigation shows that hot plugger is appropriate instrument for removal of gutta-percha from tooth root canal system.

Cholesterol and particularly LDL-c is one of the most important risk factors of cordiovascular disease. The most important environmental factor that influence this anomaly is nutritional status. The aim of this Cross-Sectional study was determination of the level of serum cholesterol and its association with fats and cholesterol intake. we selected 628 men and women aged 35-65 years old in Tehran. The results indicated that, the level of total cholesterol and LDL-c in 59% of the population was less than 200 and 130 mg/dl respectively. The level of HDL-c in 63.6% of women and 81.9% of men was below 40 mg/dl, so that the LDL-c/HDL-c ratio which is a predictor of cardiovascular disease increased. The nutritional status indicated that more than 50% of the population consumed daily, more than 75 gr of total fats, which 2/3 of this fat constituted from saturated fats. the cholesterol intake in 90% of the population was less than 300 mg/day. We observed no significant association between serum lipids and fats and cholesterol intake. We concluded that less than 10% of the population suffer from hypercholesterolemia, but the decrease of HDL-c is remarkable and can be considered as an important risk factor for cardiovascular disease in Iranian population.

We evaluated 229 cases of children who were born in the first half of the year. These cases refered to the ten health centers in Rasht in 1995. There were 116 (50.66%) boys and 113 (49.34%) girls in this research. We saw that 96 boys were feed through the breast milk in the first four months, and 20 boys were feed through the formula and we saw 102 girls out of 113 were feed through the breast milk and 11 girls were feed through the formula. According our growth chart we understood that: 1) New separate chart is needed for breast fed Infants. 2) Breast fed infants were leaner than their counterparts, the slower growth and lower energy intake of the breast fed infants were associated with normal accelerated development and they were less morbidity from infectious illness. We had shown that breast feeding has increased about fifth fold. It is due to promotion of breast milk feeding with the university and health centers. The rule of Islamic religion was an important factor in the promotion of breast feeding. Finally the most important factor which was effective in the loss of breast milk, is insufficient breast milk that it is misapprehension.

Nowadays one of the most important methods for evaluation of treatment and care is to assess the quality of life (QOL).chronic patient like diabetics are face with many disorder in dimensions of QOL.The important question is what factors effect it? In this regard, the researcher wishes to assess the relational pattern between demographic characteristic and dimensions of QOL.So to achieve a pattern which describes the effects of such factors on QOL are of interest. The sample consisted of 117 patients with type 2 diabetes who referred to Sina Hospital of Tabriz. From the total number, 85.5% were female and 14.5% were male. Subjects answered two sets of questionnaires :(1)standard instrument of QOL related to health, (2) specific instrument of diabetes which included nine dimensions:physical function, pain, daily activities, feelings ,sleep, relation with relatives ,overall health , problems and satisfaction with treatment methods The data were analyzed by inferential statistics, Variance Analysis , Pearson Correlation Coefficient, Multi-stage Regression and Linear Regression. The results showed that independent variables (age, presence of medically educated people in family ,bread winner of family, employment and complication ) were 0.52 simultaneously related to dependent variable (physical function) and 0.27 of physical function variance of above variables were determined. Also it was shown that was an inverse and significant correlation between age and physical function (R=0.31,P<0.01).

Simultaneous use of multiple drugs (Polypharmacy, PP) is associated with adverse drug reactions, medication errors, increased risk of hospitalisation and increased curative costs, specially when the number of drugs exceeds four items. This cross-sectional study was conducted to determine prevalence of PP and its some associated factors. Data were derived from health insurance prescriptions practitioners in Social Security Organization and Employees Services insurance: Rasht 2000-2001(n=4750). Data collection tool was a questionnaire including: drug items, graduation year specially and sex of practitioners and patient. Data analysis was performed by SPSS, NOS-3 softwares and for hypothesis test chi-square and t-test was used and statistically significant difference was determined (α=0/05). Poly pharmacy was observed in 88% of prescriptions, which consisted of 62% minor PP(2-4 Drug) and 26% Major PP (Drug>=5). Drug prescriptions were 60% more prevalent among women than men, but prevalence of PP was 89% in men and 87% in women (non significant). The prevalence of PP was 91% in prescriptions of general practitioners and 83.5% in prescriptions of specialists (non significant). There was a significant difference between general practitioners and specialists in major PP(P<0.01). Cardiologistes had the most of major PP(29.3%). The prevalence of PP was 89% in male practitioners and 82% in female practitioners. PP were seen in prescriptions of practitioners graduated between 1995-2000 and the least of major PP (13%) in prescriptions of 1981- 84 graduates . Drug interaction occurred in 8.5% of prescriptions and 59% of server drug interaction were associated with major PP. The most prescribed drugs were central nervous system medications with 45% and the predominant drug in this group were analgesics (24%) and cardiovascular drugs with 20.5% were the second degree. In conclusion PP is widespread in this sample; not related to prescribers' sex, but related to graduation year. Responsible authorities should make priority in supervising and planning for rational drug use.

Cesarean section is an emergency operation and in many cases it is vital for mother and newborn to do it fast. If spinal Anesthesia, be chosen, because of emergency condition, anesthesiologist always haven't enough time to be sure of skin sterility at the site of needle puncture with skin preparation in the required time by proper detergents. In this situation there is danger of infection in: skin, subcutaneus and subarachnoial infection. The main goal of this study is comparing the efficacy of two skin preparation methods for spinal anesthesia. Samples include 100 Candidates of emergency cesarean section under spinal anesthesia who randomly selected and divided into two Group, each conclude 50 patients. for each group we used one of the methods for skin preparation : A or B Group A : 10% Bethadin For 60 seconds Group B : 10% Bethadin For 50 seconds and then Washing with Alcohol 96° Before and after skin Preparation, Skin samples was taken with sterile swab and cultured on EMB and N. A Growth media, cultures were studied 24 hours later. Results were analyzed with SPSS software. culture study showed growth of bacterial colony in all samples before skin preparation in both Group after 24 hours. Positive culture after skin preparation was seen in 15 (30%) Group A and 3(6%) Group B. Difference between two groups was significant(P < 0.001) Results showed that Bethadin 10% is not fully effective in shorter than 60 seconds period, for skin sterility. Washing the skin with 96° Alcohol reduce positive cultures From 15 (30%) in Group A to 3 (6%) in Group B Therefore we recommend if you want to prepare the skin with Bethadin in shorter than 60 seconds wash it with Alcohole 96° finally to reduce the risk of infection.