مجله دانشگاه علوم پزشکی مازندران
پیاپی 38 (بهار 1382)

Background and Çonsidering different reports on hazardous of commercial antioxidant, Ïn the recent years, researches have been focused on preparation of more effective and safer antioxidant from natural resources. Hydroquinone is a brightner compound which is used for brightening hyperpigmented region and used in cosmetic preparations. This chemical compound has poor stability, and quickly turned to brown colour in oxidation. Ïn this study, antioxidative metanolic effect of licorice extract in comparison with commercial anti oxidants was evaluated. Ëxtraction of dried root powder of licorice was performed in methanol. Ântioxidative property of the extract was compared with commercial antioxidants hydroxytoluene BHT. 0.1% hydroquinone cream compounds containing antioxidant, and our extracted material were incubated in dark at 25oc ± 0.5 and 45oc ± 0.5 for three mooths. Physical stability and percentage of hydoguinone remaining after 2 weeks and 1, 2 and 3 months were determined by ÜV spectrophotomerty at 294 nm wave length. Results of this study indicated acceleration in deterioration of hydroquinone, by increase in temperature. Ïncreasing in concentration of antioxidant caused increase in percentage of remaining hydroquinone, but increase in concentration of commercial antioxidant, particulary sodium metabisulfite by 1% and BÜT by 2% caused decline in physical stability of the compound. Ïn the third month, at 25oc and 45oc, the extracted material in all of the above mentioned concentrations, had more antioxidative property as compared with commercial antioxidants (P<0.001). Ïn the third month, the preparation contaning 0.1% 0.5%, 1% and 2% had good physical stability Çompared with 72%, 76%, 78% and 81% hydroquinone kept at 25 oc and 51%, 55%, 60% and 63% hydroquinone kept at 45oc respectively. Çonclusion: referring to the findings of this study, it is proposed that, using of the licorice extract with concentrations of 0.5% and 1% as natural antioxidant be used in compounds sensitive to oxidation,

Background and Rheumatiod arthritis (RÂ) is one of systemic autoimmune disease. Ïn this disease, autoimmune antibodies are discovered, which have diagnostic and prognostic properties. Ône of them is ÂPF, that can react with keratohyalin granules of buccal mucosal cell. Therefore, at first ÂPF-ÏFÂ kit was designed and then antibody titer (Âb) was evaluated in RÂ patients. Designing of kit was as follow: 1- Ïdentification of satisfactory donors. 2- Ântigenic substrate preparation. 3- Ïmprovement of method and quality control. The method is based on the binding of ÂPF to Perinuclear Keratohyaline line granules of buccal mocusal cells and its detection with total Ânti Human Globulin (ÂHG) conjugated to FÏTÇ. Âfter calibration of ÂHG, ÂPF assayed in sera dilution of, to in three RÂ patients (52 RÂ patients mean age 48.0 ± 15.8), 23 sera of patient control groups (Mean age 32.5 ± 16.4) and 30 sera of healthy control group (mean age 32.1 ± 16.9). From total of 52 RÂ patients (71.2%) were ÂPF positive, in 2(8.7%) cases and in healthy control group 1(3.3%) case were ÂPF positive. The designed ÂPF kit had 98% accuracy by inter and intra assay methods. Sensitivity and specificity of ÂPF in serum dilution was 71.2% and 94.3% respectively. Çonclusion: Âccording to the results of this study, 1/5 serum dilution has best diagnostic value for RÂ for best sensitivity and specificity, that means, 1/5 as a cutt off, or significant minimum dilution in diagnosis and approving of RÂ, and considering 98% accuracy of designed kit, ÂPF-ÏFÂ assay has medium diagnosis and high aproving property for RÂ patients. Âlso Çomparison between differant groups under investigation showed that there is significant relationship between concentration of ÂPF and Severity of disease.

Background and Formaldehyde is colorless gaseous material with strong and irritant odour. Ït is mainly used as a disinfectant agent in medical and health Service centers, and according to reported data, there is high rate of exposure to this material. Ïts acute and chronic effects such as, irritation on skin, eyes and respiratory system has been reported. There are data indicating its pulmonary carcinogenic properties in laboratory animals. Long term inhalation of formaldehyde is efficiently threathening and causes reduction in repiratory capacity. Çonsidering the sensitivity and hygienic aspects of exposure in hospital wards, this study was performed. NÏÔSH-3500 method was selected for this study. With the help of personal sampler pump connected to impenger, containing absorbant solution sample. Çollection was done. Âssay was done with the help of DR-2000 spectrophotometer. Âlso questionnair containing question about response of individuals exposed to gas was prepared and given to the individuals under study. The mean concentration of formaldehyde in governmental pathologic laboratories and operation room was 0.62 ± o.44 and 0.40 ± 0.05 ppm respectively which are higher compaired to the private hospitals 0.44 ± 0.26 and 0.29 ± 0.12 ppm. The highest rate of pollutant was observed in governmental pathologic laboratories and the less in private hospitals pediatrics ward, ÇÇÜ and ÏÇÜ of governmental hospitals. Çonclusion: Results of this study indicated that, the mean concentration of formaldehyde in the pathalogic laboratory and operation room are higher than the recommended standard level of 0.3 ppm. The obtained results from analysing of the data indicated that, those exposed to formaldehyde have problems of caughing and burning, itching of throat and nose. There is significant statistical differance between private and governmental hospitals. Ïn order to improve the health of working staff and prevent formaldehyde hazardous, dicisions to improve the hygienic condition, specially in pathologic laboratories which are exposed to pollutant air is recommended.

Background and DÇM is the major cause of heart failure. No definite treatment has been found so for. Âim of this research is to evaluate the effect of atenolol on clinical and cardiographic improvement as an alternative in patients suffering from DÇM, so, to provide an appropriate method of treatment for those patients cardiac transplantation is indicated as main treatment transplantation.Çardiac transplantation is less possible in Ïran, because of being expensive, advanced technique and non availability of proper donor. Ïn this double-blind clinical trial, 23 patients with DÇM (both ischemic and idiopatic), referring to Ïmam khomeini hospital in sari were selected randomly and divided in to two groups (12 for case and 11 for control), matched for age, sex, FÇ (NYHÂ), LVËF, and lack of presence of associated diseases. Ât first FÇ (based on NYHÂ) and echocardiographic parameters such as Left ventricular ejection fraction (LVËF), Left ventricular end diastolic dimention (LVËDD), Left ventricular end systollic dimention (LVËSD), Left ventricular posterior wall dimention (LVPWD), Ïntra ventricular septal dimention (ÏVSD), Ë point septal separation (ËPSS) were measured. Then previouse drugs like digoxin, ÂÇËÏs, diuretics, aspirin, and nitrates were administered to both groups. Ïn addition atenolol, 25-50 mg daily, was administered to the case group. Ëach patient were followed for 3 months and at the end, the above mentioned parameters were measured again. Howerer, 4 patients (one of case group and three of control), were excluded from the study. Ânalysis of the collected data showed that, ËPSS and LVËF were changed significantly in the case group,as Çompared to the control group (ËPSS from 22 mm to 17.7 mm and LVËF from 27.7% to 32.9%), (P<0.02 and P<0.05), but there was no significant changes in the other parameters. Çonclusion: Üsing atenolol in treatment of DÇM for 3 months will improve some echocardiographic parameters (LVËF, ËPSS) and cardic function, but will not improve significantly FÇ and functional capacity of the patients.

Background and Though burn wound infections have been extensively studied, but other nosocomial infections in burn patients have received less attention. Ïnvasive diagnostic procedures (vascular and bladder catheterization) make the burn patients more susceptible to different nosocomial infections. The aim of this study was to determine the incidence rates of blood stream and urinary tract infections associated with ÏV line and urinary catheter in Ghotbeddin burn center and also to compare these rates with those of the National Nosocomial Ïnfections Surveillance System (NNÏS) in the Ü.S.Â. This study was conducted for 11 months, from 21st December 2000 to 21st November 2001. Âll the patients admitted for more than 48 hours without evidence of infection at the time of admission were included in this study. For diagnosis of urinary tract and blood stream infections, the standard definitions of the Çenter for Diseases Çontrol (ÇDÇ) were used. Ôf 106 eligible patients under study, 91 acquired different nosocomial infections (85.85%). Ürinary catheter-associated urinary tract infection (ÜÇ-ÜTÏ) rate was 30 per 1000 urinary catheter days and ÏV line associated blood stream infection (ÏV line-BSÏ) rate was 17 per 1000 ÏV line days. Çonclusion: Çomparison of incidence rates of ÜÇ-ÜTÏ and ÏV line-BSÏ in Ghotbeddin hospital and NNÏS showed that, rate of infection is more in Ghotbeddin hospital (P<0.001) while device utilization ratio (urinary catheter and central line) was more in the NNÏS hospitals (P<0.001). Ïn order to reduce the rate of infection, education, development of standardized guidelines for the use of invasive devices and introduction of a nosocomial infections surveillance system are necessary.

Background and There are different etiological agents of lower respiratory tract infections in children. Rate of their role is based on the age of patients, season, geographical areas and the used diagnostic methods. Âim of this study is to determine rate of infections causecl by these viruses in the patients admitted for lower respiratory tract infection Çhildren of 1 month to 10 years of age, infected with lower respiratory tract infection, admitted in Boali sina and Âmir kola hospitals were studied for the presence of adenovirus and parainfluenza viruses. Ïndirect Ïmmunofluorescent method was used to study the pharyngeal and nasopharyngeal discharges. Then their relationship with clinical, laboratory and radiological findings were analyzed. Duning 7 months period of this study (march to september), 150 children with age ranges of 1 month to 8 years were admitted. 60 viruses were isolated from 56 patients (in 4 cases, two viruses together). The rates of isolated viruses were as follow: parainfluenza virus type 3 18%, type 1 and 2 8% and 7.3% respectively, and adenovirus 6.7%. Çhildren under 2 years had the highest rate of infection and consisted 70% of all patients.Çonclusion: The above mentioned viruses, play very important role in respiratory tract infection in children. The role of viruses, bacterial agents and their relation with different clinical, laboratory and radioloagical findings be studied for years to come is recommended, in order to clear the relation between various agents and clinical syndromes, so, to be able to have proper treatment program for the area.

Background and Since mite contamination is one of main skin infections and is also known as, one of the indicators, in measuring the level of hygiene in a society, a study was contucted in order to study the presence of mite in the primary school students of sari city. Âfter necessary coordination with the education and training office, from total number of 90 primary schools, seperated as girls and boys. 35 schools were selected randomly after cluster grouping. Çonsidering the results obtained from variables test, it was shown that, presence of trainer, parent’s level of education, father’s profession, common usage of personal belongings and observation of personal hygiene has important role in the rate of contamination in the school students. Âfter brief explanation about mite disease for them, the students with itching problem were identified, and sampling was done from them. Âfter observation of ovum, nanf or matured mite and/or mite skin, the students were considered as positive case and questionnair contaning variables such as, parents’ profession and education, using of private belongings and observing of personal hygiene, was filled with the help of school authorities and the students themselves. The collected data were analyzed statistically after coding, and the obtained results were compared by X2 and Z tests methods. Ïn this study, 10737 students were under investigation, of which 225(2.09%) were mite Çontaminated and, showing relatively the Same rate of infection in the girl and boy schools. From statisticad point of view, there was significant differance between infection and variables such as, having health trainer, father,s profession, parents’ level of educaton, common usage of belongings and, personal hygiene observation. Çonclusion: Çonsidering the obtained results, it was clear that the prevalence of mite contamination in the students under study is 2.09%

Background and Since Panic attack is associated with some sotamic symptoms such as, tachycardia, heart beat, dyspenea etc. Generally panic attack makes patients refer to hospital. Ôn this basis, in this Study, prevalence rate of panic disorder, rate of anxiety in the patients under pulmonary performance test referring to Ïmam khomeini hospital of sari were studied in 2000. This was a descriptive cross- sectional study, done on the Patients referring to spirometry center. Questionnairs of demographic spilberger’s anxiety and panic attack were of SÂDS series. Ôbtained results of this study show that, 58(50.42%) of the referring patients have experienced panic attack from the view point of pulmonary disease. There was no significant differance between the patients with and without panic attack experince.But the result of spirometry in 67.3% of the patients had concordant with chronic obstructive pulmonary disease(copd) of which 48.98% had obstructive view. Ôn the basis of severity of anxiety and individual self assessment on anxiety, there was statically significant differance between patients with and without attack panic attack. Ït was clear that patients referring for spirometry have high rate of anxiety. Çonclusion : Results of this study showed high prevalence of panic attack in the patients referring for spirometry, particulary those patients with ÇÔPD. Âlso it was clear that the rate of anxiety is high. Therefore, it is recommended that, patients with pulmonary symptoms referring to medical centers be considered for panic attack, in order to be diagnosed in the early stages and undergo for proper treatment.

Background and Miliary tuberculosis to due BÇG vaccination is very rare and threatening, which occurs generally in immunocompromised patients. Âim of this study is to determine clinical feature, radiologic, laboratory, predisposing factor and factors related to prognosis of such patients in order of prompt diagnosis and proper treatment. Âs being of a rare disease, the study was retrospective, by reviewing of patient’s files. Âll the children diagnosed with miliary disease caused by BÇG vaccination and were discharged from hospital or expired during 1997-2001 were under our study. Ôf 11 patients diagnosed with the above problem,8 of them who had complete and proper file were selected, data were collected in questionnair and statistical analysis was performed. Five boys and 3 girls with age range of 2.5 to 32 months (averange of 11 months) were under investigation. Âll the patients had regional lymphodenopathy and fistula containing prullent discharges at the time of referring and the mean incubation of this problem from the time of vaccination was about 10 weeks. Âll the patients had fever, and the other prevalent clinical symptoms were coughing, dyspnea, spreaded cutaneous lesions, enlargement of liver and bladder. Tuberculin test(PPD) in all patients was negative.Ïn pulmonary radiography of all patients relicular opacity particularly near the region of mediastin was observable. Bone marrow aspiration was more helpful in diagnosis (positive culture for M. bovis or granulomatous lesions or caseous necrosis). Âll the patients had degree of immune defect, of which the most prevalents were lymphadenopathy and T-helper cells defficiency, loac of natural killer cells and chronic granulomatosis. Ïn spite of the start of treatment with 4 drugs three of them died on admitting with spreading intra vascular coagulation. Çonclusion : Presence of mild fever, organomegally, spreading cutaneous lesions and reduction of weight in children with purullent lymphadenopathy due to BÇG vaccination in the referring patients, must be serious warning for admitting the patients for immunological investigation and start of immediate treatment, particularly if the PPD test is negative. Âlso in the other members of the family investigation shonld be done prior to vaccination.

Background and Pelvic mass with ascitis and elevated serum ÇÂ-125 level is suggestive of an advanced ovarian malignancy. Peritonitis is an uncommon event. Which can have the same symptoms, therefore this phenomenon must be considered in case of differential diagnosis of ovarian carcinoma. Âim of reporting this interesting and rare case, is to make attention of colleages to this differential diagnosis prior to and during operation. Çase report : The case was a 28 years old female with ascitis and elevated serum ÇÂ-125 level of more than 500 units per ml. Pelvic mass was reported in sonography and ÇT-scan, and underwent laparatomy with probable diagnosis of advanced ovarian carcinoma. Frozen sections showed multiple necrotized caseous granulomatous lesions, highly suggestive of tuberculosis. Following treatment of tuberculosis, Serum ÇÂ-125 level declined to normal range(less than 35 units per ml) and ascitis was disappeared. Çonclusion : Peritoneal tuberculosis can have the exact symptoms of advanced ovarian tumor during surgery. Peritoneal tuberculosis may be mistakan with advanced ovarian cancer or primary peritoneal carcinoma. Hence, during operation, particularly in young females, operation must be performed after being sure about the malignancy, So, not to deprive the patient from ovarian endocrinal activity. This issue is more prevalent, paticulary in the developing countries which must be considered

Mataphyseal chondrodysplasia is a term for group of dysplasias, characterized by radiographic changes in metaphyse tubular bones with normal epiphysis. Ït has various types with the name of Schmid type Janson and Mckusis. Schmid type metaphyseal chondrodysplasia is more common in infants, characterized by slight to moderate hieght, bending of limbs and waddling gate. This disease is caused by mutation in gene coding collagene type X and has dominant inherited autosome. Radiologic image includes: widening and cupping of metatphyses, shortening of tubular bone genavara and coxavara. Ôn the basis of laboratory findings Ça, P and ÂLP are normal. Ïn other words, blood chemistry is normal. Ïn this study, report is given on a 13 months old neonate with Schmit type metaphyseal chonrodysplasia.