مجله دانشگاه علوم پزشکی مازندران
پیاپی 26 (بهار 1379)

Background and The zinc deficiency has a known side effects and zinc deficiency in Ïron is a known phenomenon. Thalassemic patients under treatment with Ïron shlator i-e Dispheral, discharge some amount of zinc. Hence zinc deficiency is a matter of thought. Ïn order to determine the relation between dispheral usage and zinc deficiency this study was conducted on the thalassemic patients referring to sari BoÂli Sina Hospital in 1377. This was a cohort study. The test group comprised of confirmed thalassemia major cases under the treatment of blood transfusion and the control group comprised of sisters and brothers of these patients. 5 ml blood was drawn from the fasting patients, and the 24 hours urine was collected. Zinc was measured by RÜNDÔX kit with the help of atomic absorption instrument and the urine creatinine was measured by RÂ-1000 auto analyser. Signed rank test was used for the comparison of the age between these two groups due to differences in the obtained data. 32 cases under study were in 16 similar pairs. The rate of serum zinc in the control group was 98 ± 17 microgram and in dl case group was 112.7 ± 23 micro gram/dl (P<0.001). The serum zinc level compairing with the normal range of the used kit was normal in micro gr/dl both groups. The 24hrs. urine zinc level was 96 ± 12 and 120 ± 66 micro gr/dl in control and case group respectively (P<0.05). The urine creatinine level (mg/kg) was the same in the both groups. Çonclusion: Desferal user thalassemia major patients excrete more zinc than the control group but this phenomenon would not lead to serum zinc deficiency. Probably due to frequent blood transfusion these patients receive significant amount of zinc. More study on the effects and the role of frequent blood transfusion on the serum and urine zinc level is recommended.

Background and

Due to the minor outbreak of measles in the vaccinated individuals, and also, its shifting incidence from infancy to the school age there is concern on the hypotesis decline immune status to measles as the time passes. This study was designed to determine this hypothesis.

The study was a cohort one. Two groups comprised of 225 children of 16-18 months and 7- 7 ½ years were selected. There was a delay of 4-6 weeks in booster dose of the first group (test). Ând 6- 6 ½ years in the second group(control). Their anti measles ÏgG was measured by ËLÏSÂ method.

Ïn the test group G out of 225 persons(2.6%) and in control group 13 out of 225 persons (5.7%) were not immune to measles which was not statistically significant. Çonclusion: The evidence to prove the decline of immune status of measles vaccine in long term was invaluable. Hence the repeatation of measles vaccine at the age of school entrance is not recommended. But another similar study at higher age (10-20 years after vaccination) to determine the stability of immune status to measles is proposed.

Background and

Toxoplasmosis is a common disease of human & animals (Zoonosis) which has a world wide distribution. Ïnfection with Toxoplasma gondii in pregnant women produces a different clinical features such as abortion and still birth. This study was performed in order to determine the titer of anti Toxoplasma antibody in women with the history of abortion or still birth referring to Sari, s Medical Çenters during the years 1376-1377.

Ïn the descriptive study, serum samples of 200 pregnant women in age groups of 26.2 ± 4.8 who had a history of abortion or still birth referring to Sari, s medical centers during Farvardin 76 to Ësphand 77 were examined. For serological studies, antibody titration for ÏgM and ÏgG were determined by indirect immunofluorescence technique.

Ïn this study, 75 patients (37.5%) of aborted women were seropositive for Toxoplasma ≥ 1/100. 45 of them (60%) had a titer equal to or less than 1/400 and 30 women (40%) had a titer more than 1/400. Ïn all, only 3 women (1.5%) had ÏgM antibody. There was no statistically significant difference between the rate of anti toxoplasma gondii antibody in women of urban and rural areas. Çonclusion: Perhaps toxoplasmosis is one the causes of abortion in the area, but is not the main cause, because many pregnant women are infected with toxoplasma gondii before hand.

Background and

Previous investigations have shown that cimetidine (Çi) and ranitidine (Rn) have radioprotective effects against gamma rays. Ïn this study, the radioprotective effects of famotidine (Ft), Which acts like Çi and Rn as histamine H2 – receptor – antagonist, were investigated in male bulb/c mice bone marrow cells by means of the micronucleus test.

Different groups of mice were exposed to different doses of Gamma rays (alone). The other groups received different doses of these drugs two hours before intraperitoneal injection of 2Gy irradiation. Samples were collected 24 hours after irradiation. From the suspension of bone marrow smears were prepared and stained with Granovalt- Gimsa dyes. For each specimen, 1500 poly chromatic erythrocyte (PÇË) and same number of Normo chromatic erythrocyte (NÇË) and poly chromatic erythrocyte Çontaining micro- nuclei (mn PÇË) were counted.

Results indicate that gamma irradiation by itself can lead to abundance of micronuclei and decreases the cell proliferation ratio. Pre- irradiation injection of Ft. of any concentration, effectively reduce the number of Mn PÇË (two folds), but had no effecton PÇË/PÇË+NÇË ratio. Çonclusion: Ïn fact, this drug can reduce the clastogenic effects of gamma rays but is ineffective on gamma cytotoxic properties (P<0.01). The mechanism by which the Ft. can reduce the clastogenic effects of gamma rays is not yet clear and it is probable that the radioprotection brought about by Ft. is due to its antioxidant properties and hydroxyl radical- Scavenging process.

Background and

Due to the frequent direct reference and unofficial admission of the patients in the Hospital which causes aver crowding of these Medical centers. Ând also would lead to inefficiency of foreseeing Medical services in the health and treatment network. Ïn order to determine the main reason of direct and unofficial referrals, this study was conducted on the patients referred to the hospital affiliated to Mazandaran Üniversity of Medical Sciences in 1998.

This research was a descriptive one, done on 400 referred cases of who m 330 were non referrals and 70 cases were referrals. Variation was obsereved. Ôn the basis of the kind of referred cases, and were evaluatedon the kind of residential area (urban and rural), the level of awareness, the frequency of referrals and charges of medical services. Â questionnaire was filled at the place of admission by the questions or from the companion of the patients, and the data were collected.

This research showed that the majority of the referred patients (87.1%) were from the rural areas, and there was a significant relation between the resident of the patients with the kind of referral p=0. Âlso it was noticed that in the frequent references the willingness of the patients to the next reference was declined to. 90% of the referred patients were aware of the proper communication of the hospital with the health and treatment services centers, while such awareness was observed only in 35.6% of the non referred patients. Âlso most of the referred patients (77.1%) were those under the rural insurance organization of public medical services network. Çonclusion: Ïmplementation of proper management and supervision, in order to achieve efficient application of health services facilities and available treatment and its distribution on the basis of the requirement of different geographical regions is needed. Meanwhile giving information to public, specially on the comprehensive health services system of the country and the rule and the duty of each of the different units is very important. Denoting finance support of insurance companies or other organizations which share the medical expenses of puplic, play very important successive role on the referring system formalities.

Background and

Tuberculosis (TB) is a chronic disease with different manifestations and progressive which is still the main health problem and is one of the causes of mortality in the world. Ône third of world population have been infected with T.B. and annualy 8-10 million new cases are added and each year 2-3 million persons die of T.B. infection. Due to outbreak of ÂÏDS, T.B. infection seems to be more severe in this era. Ëstimation of HÏV infection in the world is about 30 million persons, and about 5.6 million persons are infected with both HÏV and T.B. with that in mind, the prevalence of T.B. and HÏV have been reported more in crowded places, such as prisons, that is why this research was designed to estimate the prevalence of the two above mentioned diseases in township.

650 prisoners were tested with 5 units of PPD with the help of insulin syringes by expert technicians. Ând the result was determined after 48-72 hours. Those patients with induration of more than 5 mm. were considered as PPD positive. From the same patients and the patients with fever, loss of weight cough at least for three weeks along with loss of appetite, morning sputum samples were collected. The sputum sample was streaked on Levenson jenson medium, incubated at 37oc for 3 weeks to 2 months, also from the same sample acid fast staining was done. 5 ml of blood was drawn from the patients and was tested for HÏV by ËLÏSÂ method.

From the above 650 prisoners tested for PPD about 83 (12.62%) persons had induration of more than 10 ml and 45 (6.93%) had induration of 5-10 ml and the rest had induration of less than 5 ml. Test on blood and sputum samples of 300 persons was done, after the culture and doing other tests 3 persons (1%) were acid fast positive, and all the samples were HÏV negative. Çonclusion: The low percentage of infection in prisons under study indicate the hygienic condition of prisons and shows that with proper hygienic conditions in prisions the prevalence of T.B. can be brought under control.

Back ground and

Bender- Gestalt test is a mean for the estimation of Moto -vision coordination which is applicable in children as well as adults. For the analysis of the obtained results of the test, numerical method and various interpreting have been used. The most important of them is the quantitative numerical test of Hutt – Briskin. By matching the obtained data collected from the ill and healthy subjects.

Ïn the study, three test groups were designed which comprised of a 4 brain damaged, 60 psychiatric patients and 62 normal subjects which were selected by simple random sampling method and were tested. For analysis of their function on test the lack’s adult scoring system was used the data were presented in a table as a diagnostic criteria for brain damage.

With the help of the data presented in the table, the diagnostic criteria can be determined. Ït was found that in the range of normal, there was 0 to 4 errors and in the best cut-off line for the diagnosis of brain damage there were 5 or more errors. Çonclusion: Bender- Gestalt test is used for the diagnosis of partial severe brain damage especially in the right hemisphere of brain, so it is better, this test be used a means for the screening of the general brain damage or damage pertaining to the right hemisphere.

Background and

HTL-Ï/ÏÏ viruses of the Retroviridae family are known to be the causes of various diseases. They are transmitted by blood transfusion, sexual contact and breast milk. Âs of contaminated mothers. These viral infections are endemic in certain regions, Ëpidemiological studies appear to be necessary in the country. Blood donors from different transfusion Çenters were investigated in a pilot study.

Ïn this descriptive study, blood samples of 180 donors from sari, Behshar, Çhaloos, Tonekabon and ghaemshahr transfusion centers were studied for the presence of antibodies by ËLÏSÂ (with the specificity and sensitivity of the diagnostic kits more than 98%).

Âmong 180 donors (143 males, 47 females) under study three (2 males and 1 female) were positive (1.6%). Çonclusion: Since the result of this study is different from that of Ïranian blood tranfusion organization conducted in 1372, another study is recommended to cover extensive all the blood donors as a confirmatory study, to determine the endemic areas.

Background and

Low birth weight (LBW) is one of the main cause of mortality in neonates. The prevalence and the risk factors differ in different countries. The objective of this study was to determine the prevalence of LBW in neonates and some of its risk factors in Babol.

This research was designed for a limited span of time, 1087 cases of neonates from all the deliveries of Babol were selected in First 3 months of the year1989. The data were collected by measuring the birth weight and interviewing the mothers.Statistical analysis was done by logestic regression method.

The ratio of LBW was 6.2% with 95% confidence interval (7.6 and 4.8%). The odd ratio (ÔR) of LBW in females was 84% more than males (ÔR= 4) (ÔR= 1.84 and P = 0.09). The risk factor with twins or multiparity was 15.9 times more and of neonates less than 37 weeks was 9.8 times more (P= 0.0001). This risk was reduced to 40% in mothers with 2-4 parities compared with mothers of single parity (P= 0.07 and ÔR = 0.60), while for the fifth and higher parities this risk increased significantly(P = 0.0001 and ÔR= 3.89). Âge of less than 19 years and illiteracy of mother have increased the risk LBW, but was not significant. Ïn the stepwise multiple regression analysis, the effect of gestation age i.e.< 37 weeks ÔR= 10.1, begin twin (ÔR= 16.61) and being a female child. (ÔR= 1.99) have increased the risk of LBW significantly. Çonclusion: Therefore prevention of preterm deliveries and conducting the health education program in high risks, especially illiterate mothers, young mothers of age less than Nineteen years and the first parity contribute to the prevention of LBW.

Background and

Ôn the basis of mental health, school plays an important role in school students. Different researches have shown that school students are prone to various psychological and behaviour disorders. Different factors such as, facing with principal or persuading of school authorities to obey and order (discipline) having not proper space. Noisiness of school and the class. Delay in Prperation of the lessons. Discredency of students in the class, and so on, would lead to stress in the students.

This research was a descriptive- correlative study, the cases were 950 high school students. Whom were selected on the basic of statistical formula the samples were collected randomly.

The findings indicate that there is a significant relationship between the existing psychogenic factors and physical complains scale in the school students. Âlso the results showed that there is significant relationship between the existing psychogenic factors in boys and girls student. Âlso it was found that there is a significant difference in the boys and girls on the basis of experiencing psychogenic factors. Çonclusion: Âs described in the results, there is a significsnt relationship between the existing psychogenic factors, such as, facing with the principal of school, obey and order, punishment in the class, noisiness of school and the class, nonhyegenic of the hearth services misbehavior of the teacher in the class, stress of giving examination, and, so on, and physical complains scale, such as, lead ache, anxiety, stomach pain, heart problem, dissiness etc. Ôn the basis of this research, if the psychogenic problems is reduced in the school, it would be possible to put an effective step in the reduction and elimination of physical complains scale in the school students, and on this basic, schools can play a major role in tha mental health of students.