مجله دانشگاه علوم پزشکی مازندران
پیاپی 27 (تابستان 1379)

Background and

Çollection of blood for the measurement of PT and ÂPTT time in routine diagnostic laboratory work, and even for the anemic patients in Ïran is done as 9 parts for blood and 1 part for sodium citrate (3.6%). While in some diagnostic lab kits and reference books, adjusted citrate volume with the value hematocrits (Hct) is recommended. Ïn this study a comparison between the results of PT and ÂPTT test in anemic patients without adjusting citrate volume was done.

This research was Basic- applied, and done on 80 anemic patients, PT and ÂPTT tests were done in two tubes for each patients. Ïn one tubes the routine citrate ratio was 9 to 1 and in the second with Âdjusted citrate according to the value of HÇT by using biomerive kit and coaggulometer instrument. The result of each tube reported separately. The results were analysed by T- student test.

The mean difference of PT between two tubes was 0.3 second and for ÂPTT was 1.15 seconds. Çonclusion: Âdjustment of citrate volume according to the value of HÇT has no significant difference in the rate of PT and ÂPTT with the time when nonadjusted condition aie using the name routine concentration of citrate (9 to 1) clinically as well as statistically

Background and

Ïnfertility means, couple not having a child for a year after married life, is one of the most important socio-health problems of different societies. Â lot of variations in it’s prevalence rate has been reported some reports state that the prevalence rate is 0.5% to more than 3%. Therefore, since the determination of infertility rate is important in futhur planning of health and treatment programmes and also since it has never been done in Mazandaran province, this study was conducted to determine the prevalence rate of infertility in central region of the province.

Sampling was done randomly from 15 regions of sari, Ghaemshahr and Neka cities and also 50 villages affiliated to these cities. The reproduction history was obtained by home interviewers with the women, coducted by two groups of medical and midwifery students.

The prevalence of infertility in this study was 13.2% out of which 4% were unresolved infertility. There was no statistical correlation between familial marriage and infertility, but the correlation between familial history and infertility was significant. 29.4% of infertility women had at least one experience of spontaneous abortion, while it was significantly lower in fertile women (16.3%). Çonclusion: The high prevalence of infertility necessitates a programme of assisted reproduction in health service centers and can be used for setting up such centers for the trearment of infertility.

Background and

Helicobacter pylori is the most prevalent infection in the world, particularly in the developing countries, which usually leads to gastritis, gastric ulcer, deoudenal ulcer, even gastric cancer and lymphoma. Çonsidering the importance of this infection and its different prevalence rate in various provinces of the country, this study was conducted to determine the prevalence of helicobacter pylori among the persons of 7-18 years of age in Sari township during 1999.

Some 400 students were selected randomly from the primary, secondary and high school. Primarily, personal characteristics like the age, sex, civil region, Socio-economic status i.e. father’s-occupation, parent’s education, dwelling situation, foundation area, the number of family members, address, the amount of used water and the type of management in school were recorded in the forms. Serum samples were examined for the existence of Âb ÏgG by ËLÏSÂ method and kit of HPG screen made by Genesis diagnostic company of Ëngland. Statistical analysis of the results was done by SPSS and X2 test.

Âccording to the results, the prevalence rate of H.P. was 19.2% (accuracy 95%, 17.2-21.2)therefore, there is a statistically significant relationship between the prevalence of H.P. infection and the age or educational status (P<0.002), Socio-economic status (P<0.04), father’s education (P<0.02), mother’s education (P<0.006), foundation area (P<0.0005), number of family members (P<0.002) and the type of management in school (P<0.05). But the other variables like Sex, father’s occupation, residential place, history of digestive problems in the subject, his parents, dwelling situation and the type of water used, had statistically no significant relationship. Çonclusion: The prevalence rate of H.P. infection in children of 7-18 years of age is high in Sari township and an extensive study on its clinical importance is recommended.

Background and

Çyproheptadine (ÇYP) is an antihistaminic and antiserotonine agent with specific property which differentiates it from the other antihistaminics and antiserotonic agent. The appetite stimulating effect of (ÇYP) is well documented in man but its effects on the blood glucose and liver glycogen are not the same. Hence this study was conducted to determine the effects of different doses of (ÇYP) on the level of blood glucose and liver glycogen.

Ïn this study a group of 28 rats with weight of 95 grams were selected, in order to determine the effect of different doses of (ÇYP) on the blood glucose and liver glycogen, the animals were divided into five groups as a control and four experimental groups. Ëach groups was kept in separate animal cages. The rats of experimental groups were fed 2.5, 5, 10, 20 mg of (ÇYP) per Kg of body weight daily for 14 days and the effect was determined on the level of blood glucose and liver glycogen. Statistical analysis was done with the help of Ânova test.

the level of glucose in control group and the experimental groups Ï,e 2,3,4 and 5 were 82.39, 110.32, 109.4, 120.54 and 121.54 mg per 100 ml respectivley which showes a significant difference between the groups F=4.43, P=0.008. The level of liver glycogen in control group and the experimental groups Ï,e 2,3,4 and 5 were 142.86, 83.06, 7.92, 9.13 and 26.1 mg per gram of liver tissue. There was significant difference between the groups F=26.88, P=0.000 Çonclusion: The results of this study showed that the effect of (ÇYP) on glucose and liver glycogen level is hyperglycemia with a reduction in the level of glycogen in liver tissue.

Background and

Basically, The muscle spindle is innervated by γ – fibers, γ – fibers are divided into phasic and tonic groups on the basis of their function. Ït is believed that phasic one γ innervate all the muscle spindle fibers where as tonic one innervate only tonic muscle spindle fibers and phasic of type two. The purpose of this study was to observe the fiber activity during phasic and tonic stretches in muscle spindle of rat tail and their effect on the sensory afferent fibers. Ând more knowing about physiologic mechanisms of γ-fibers, afferents and the way of controlling them will provide significant help in control of patients with rigidity and distonic move ments.

Ïn this study, 15 normal male Sprague-Dawely rats with mean 500 gram weight were selected. General anaesthesia urethane (30 g/100 ml) with the dose of 170 mg/100g body weight and laminectomy was done in part of lumbosacral.

During severe stimulation of external ear of anaesthetized rat, γ fibers activity increases and affect afferent spindle fibers, so that, La fiber showed more activity compare to group ÏÏ afferent fibers. Stretches in muscle spindle first inhibits the activity of γ neuron fibers, after releasing of stretches physic and tonin γ fiber will be active. Ïn phasic stretches activity of la afferents of muscle spindle will be more and more while than group ÏÏ afferent fibers while the tonic of amplitude of Depolarized la decreases. However two sensory fibers are active. Çonclusion: Following γ-mononeuron activity, muscle afferent fibers shown the depolarized amplitude in the same spindle segment or even one or two segments upper. Ïn a way, always muscle spindle activity had stimulfaneous fluctuation with time. Âny way both the afferent fibers are controlled by γ ring. γ is under control of nuclear activity of central nerve. Ând in continual resting position La activity was not clear.

Background and

Tuberculosis (TB) is a chronic infectious disease, and its epidemiologic study in risk group people plays important role in controlling of this disease. This study was conducted to determine the purified protein Derivatives (PPD) reaction in Municipality street cleaners which is a T.B. diagnostic method.

Ïn this descriptive study municipality street cleaners were under studying, because of being high risk group on the basis of their job status, awareness of T.B spreading, economic condition and the high number of households. The clinical trials and laboratory test including PPD was done. Ând appearance of induration more than 10 mm diameter was considered positive.

Ïn this study 160 street cleaners of mean 44 ± 8 age group were under studying, out of which 43(39%) had positive PPD response and 41(91%) of them showed induration of 10-15 mm, 4(9%) showed induration of more than 15 mm. The smear preparation of sputum of all the street cleaners was negative for tubercle bacilli. Ând chest X-ray of them did not show any lesion of the lungs. Çonclusion: This bacterium is persistant in the region due to geological condition and bacterial characteristics. Â proper health education program me for prevention of the spread of the disease can be important for the health improvement of the society.

Background and

There are many cases of Thalassemia major in mazandaran province, and cholelithiasis is a known complication of all hemolytic anemias. Ïn order to evaluate the incidence of this complication in Thalassemia patients of Sari city, a descriptive study was designed and performed in two hundred thalassemia patients referred to Thalassemia control center.

The assessments were done by Ültrasonography by two radiologists. GË machine RT 2800 model of Ültrasound was used. The patients were such as kept in 14 hours fasting condition. Ïn sonography the informations such as liver size and Ëchogenecity, the shape and size of gall bladder wall, portal system, bile ducts spleen and portal system, as well as, sex and age were registered. The patients with previous history of stone formation along with cholelilithiasis were considered as positive.

The total incidence of stone formation was 14% (15.4% in females and 11.5% in males) in these patients. There was a correlation between the incidence of cholelithiasis with increase in age of the patient. Çonclusion: Due to the high incidence of this complication in thalassemic patients, it is recommended to include Ültrasonography in routine examinations of these patients, in order to prevent such complications in the thalassemic patients.

Background and

The prevalence of Hepatitis B in ÜSÂ was reported 0.5- 0.1 % while in Ïran is 1.6- 6.5 %. Ït was reported that the titer of antibody three days after vaccination was 79-90 %. The titer of antibody decreases with the pass of time, and age has a significant role in the respones to vaccination. This study was performed in order to evaluate the HBS titer after vaccination against hepatitis and the rate of its decline as time passes in the nursing staff of Gaemshahr Razi Hospital.

This was a Çross- sectional study, done on 183 nursing staff. 4cc blood was collected from each person at the same time vaccination was repeated. The history of vaccination was reported in a questionnaire paper by the same candidate. HBSÂg and HBSÂb were measured quantitatively with using Ëuro kit by ËLÏSÂ method.

1.6 % of staff were HBSÂg positive. 54.1%, 13.1% and 10.9% staff received vaccine three times, two times and once and 86%, 71% and, 55% of them had antibody titer more than 10 mu/ml respectively. 21.9% of them were not vaccinated, but 12.5% of them had antibody titer more than 10 mu/ml as time pass there was a decline in antibody titer. So that 94.1% of them in the first year declined to 67.8% in the next fifth year and the age above 40 years had a negative effect on antibody formation. Çonclusion: Ôld age and numbers of vaccinations has a significant role in the responses to vaccine, and with time the titer of HBS antibody declines, so a booster dose should be considered.

Background and

Neonatal conjunctivitis which mostly occurs after birth, has a high prevalence rate according to the world statistics (0.4-18.9%). But its statistical value in our country is not known. Standard prevention methods are costly and not accessible. This disease can lead to corneal ulceration, blindness and infection. Ïn this study, Povidone Ïodine 2.5% was used for treatment of conjunctivitis regardless of its ethiology to determine, whether this drug which effectiveness and safety has already been proved in previous studies, could prevent or reduce neonatal conjunctivitis or notω

1130 neonates born in nursury of Razi hospital in Ghaemshahr were studied during 1997-98. The study was double blind in which Betadine drops 2.5% was used in one eye of the neonate immediately after birth and the other eye of the same neonate was treated as control. Then during two visits in two consecutive weeks, the positiveness of conjunctivitis was noted by visiting preformer.

The preventive effect of the drug was desirable during the first week of treatment because the eye which was not received the drug developed conjunctivitis 1037 times more than the eye which received the drug. But during the second week the difference was not significant in two eyes. Ôther important findings include, higher conjunctivitis rate in neonates born by normal delivery as compare to cesarean section (P<0.001). Çonjunctivitis was more prevalent in boys as compare to girls during the first and second week (P<0.001). There was no significant difference between premature and full term and also belween intact membrane and premature rupture of membrane. Çonclusion: Âs regard to the low cost of the drug and its availability and also the positive effects of this drug during its use in first and second week of birth, its extensive use is recommended for prevention of neonatal conjunctivitis.

Background and

Ôxyuris vermicularis is one of the main hygienic problems in the world specially in children under 2 years of age. Ôver 40 million Âmericans specially children are infected by oxyuris vermicularis. Ône of the complications of parasite is it’s role in causing vulvitis. Since the parasite is more prevalent in girls than boys, this study was conducted to show the rate of prevalence of oxyuris vermicularis and vulvutis in girls between 2-5 years of age in kindergarden’s of Sari.

Samples were collected by scotch tape method from all children of 2-5 years of age. Vulua of the children were examined by a midwife under the supervision of specialist. Ïnformations about itching, edema, erythema and vulva itching, vaginal excretion, pruritus and bed wetting were recorded in a questionnaire. Ôther informations like age, education, occupation of parents, Family members, the number of siblings, the number of children in each class and their baby sitters, cleanliness of nails, beds and their informal habbits, bathing, disinfection of fomities and bed sheets, the presence of physicians in kindergarten, hygienic card for baby sitters and the children infected with oxyuris vermicularis were recorded in a questionnaire and the children infected to oxyuris vermicularis were examined by scotch tape method.

From the total number of 217 children under study, 64 (29.5%) were infected to oxyuris vermicularis and 38 (17.5%) persons had vulvitis, and 13 (6%) persons had vulvitis along with oxyuris vermicularis, and there was no significant relationship between oxyuris vermicularis and vulvitis by X2 statistical analysis. 34.2% who had vulvitis, were infected to oxyuris vermicularis too. There was a significant relationship between the age and oxyuris vermicularis infection (P<0.001), between vulvitis and age group (P<0.05). between oxyuris vermicularis and using fomities (P<0.01) and between vulvitis and itching of anus (P<0.05). Çonclusion: Regarding the prevalence of oxyuris vermicularis infection and it’s role in vulvitis and the limitation in the studies in this field, it is necessary to have a proper planning for the improvement of health and the agents of causing vulvitis.

Background and

Ïn hospitals or the other health service centers which deal with the life of the human resources who are the main economical resources, the main required information for planning and effective decision making are provided to managers by Medical Record Department in format and chart. This study was designed and performed in order to determine the rate of Medical record knowledge of the Managers in hospitals and the other health service centers under studying.

This study was descriptive and done on 24 and 12 managers from Mazandaran and Golestan provinces respectively. The data were collected in closed and open questionnaires filled by the managers.

This study showed that 10.15 (66.6%) managers of educational- treatment centers and 12.9 (90.4%) managers of treatment centers had weak or very less knowledge of Medical record, but the rate of the knowledge of the managers in Ëducational-Treatment centers was more than in treatment centers. The data were analyzed by X2 test which showed statistically significant differences (P<0.05). 31.36 (86%) of the managers had non-management Üniversity degree. 5.36(13.8%) of managers had management Üniversity degree, but none of hospital management. The jop service of 26.36 (72.1%) and management experience of 29.39 (80.5) of the managers was one to two years. 5.36 (13.8%) of them were diploma or completed two-year university course and the rest had bachelor degree or higher. 19.34 (55.8%) of the administrators Medical record had diploma or under diploma. The main inefficiency of medical record was due to ignorance of the physicians and paramedical staff. Ând the main reson of unestablished medical record committee in these two stats was due to no request from the medical record administrators. Çonclusion: For inhancing the optimization of hospital it is better to appoint those who are qualified in general management or hospital management and also the selected managers attend different workshop, and the present managers abserne different short courses on medical record subject. Ïn order to increase the efficiency of medical record in order to receive proper records the medical record staff preferably be selected from the bachelor degreee or the higher.