مجله دانشگاه علوم پزشکی مازندران
پیاپی 88 (اردیبهشت 1391)

Background and Bordetella pertussis is a gram negative and obligate aerobic bacteria that is cause of Whooping cough. It is exclusively human pathogen. In the last decade increasing rate of pertussis was observed especially in those under 6 months old and also over 10 years. Despite importance of pertussis as a contagious disease, we have not enough information about it our country. In this research pertussis suspicious specimens collected from different provinces of Iran in 2009-2010 were studied. Totally 1084 samples from nasopharyngeal secretion or nasal of patients with coughing more than 2 weeks were collected from different provinces of Iran and sent to pertussis reference laboratory in Pasteur institute of Iran. In this research the specimens were studied by culture. On receipt, all swab specimens were inoculated on pertussis charcoal agar and Bordet Jengou plates containing (40 µg/ml) cephalexin and without cephalexin. The plates were incubated at 36 0c. Colonies were identified as B. pertussis, B. parapertussis by gram staining and complementary tests. B. pertussis and B. parapertussis was found in 11 and 1 patients, respectively. Three cases of culture positive specimens was from the patients with the age of under 2 years of old and 6 was from the patients with the age of 2 month-2 years, 2 was from the patients with the age of 2-10 years, and 1 isolate was from a patient over 10 years. Eight patients of culture positive specimens were vaccinated and 7 cases were from patients after initiation of antibiotic therapy. Results of this study indicated that this illness is associated with the age group of 2 month-2 years of old in Iran. Culture is highly specific method but its sensitivity is low. According to clinical and paraclinical problems of this illness in Iran, for diagnosis of infection with B. pertussis other molecular methods such as Real-Time PCR should be done.

Background and Worker's exposure to respirable silica particles and in particular free crystalline silica in the workplace causes some disorders such as silicosis or lung fibrosis. This study was carried out to evaluate the worker's exposure to free crystalline silica particles using the infrared spectrophotometery method in some industries. In this cross sectional study respirable silica dust was collected from worker's breathing zone using a personal sampling device and a cyclone separator with a PVC filter. Silica samples then were analyzed using a infrared spectrophotometery recommended by NIOSH in method number 7602. Mean personal exposure to respirable silica particles within the worker's breathing zone in 4 industries were considerably higher than the threshold limit value recommended by ACGIH. Worker's exposure to crystalline silica particles ranged from 0.03 mgm-3 to 0.57 mgm-3 and there was a significant difference between mean respirable particle concentrations within the worker's breathing zone in these industries. Individuals who are working in asphalt production, foundry work, and sand and gravel mining and brick manufacturing are exposed to crystalline silica particle concentration higher than the standard level. Therefore, engineering and hygiene methods of dust control should be applied for the reduction of exposure and prevention of silica related disorders.

Background and

To determine the effect of intrasphincteric botulinum toxin injection to treat internal anal sphincter achalasia.

Twenty patients (11 boys, average age 4.95± 2.47 years) with definite diagnosis of internal anal sphincter achalasia received 20 units of botulinum toxin injection in 4 points of the internal anal sphincter (totally 80 units). Then during 8 months of follow up visits, profile and response to treatment and bowel movements criteria of the patients were recorded in a questionnaire

All patients except one had treatment response. On 1-month follow-up, response to treatment was excellent in 35% of patients, and average in 60%. Response to treatment after 8 months follow-up was excellent in 50% and average in 40% and 10% was poor. The effect of botulinum toxin in 14 patients continued by the end of follow-up, and in 5 patients lasted between 7 to 20 weeks. The therapeutic response of these people, except one, remained moderate. Transient fecal incontinency was the only complication observed in 3 patients that was resolved after 1 to 3 weeks.

Injection of botulinum toxin into the internal anal sphincter is an effective and safe method of treatment for achalasia, with long lasting results and few transient complications.

Background and Multiple Sclerosis is one of the neurological common disease. This disease is caused to injurey the materials called “Myelin”. And causes different symptoms. The main aim of searching is comparing Big five factors of personality in people with multiple Sclerosis and in healthy people in the east of Mazandaran. In this search that was done on case-control Way, 191 patients with Multiple Sclerosis and 191 healthy people were studies in east of Mazandaran that with a view of age, sex marriage situation and educational level were a like to each other. Individual specification questionaires, Five Neo- Personality Inventory Revised, were used as a tool. The things were given with using of statistical test of Indespendent-t were analyzed. The reasons of search showed that the patients with Multiple Sclerosis in two personality inventories such as Neuroticism and conscientiousness with healtly people have mailnful differences.

Background and Guilan province, with unique environmental values of the Caspian Sea is located in the southwest.Disposal of untreated domestic sewage, industrial and agricultural surface water and cause pollution of the Caspian Sea region and the remarkable waters and beaches, especially due to having different pollution could endanger the health of swimmers. The purpose of this study microbial contamination of water in the Caspian province of Gilan is. In this case 21 point plan in the Caspian Sea littoral provinces of Guilan and identify points of microbial contamination by microbial indicators of fecal and total coliform with pH and temperature and turbidity during the year were assessed with standard methods. Each station during the sampling period a total of six samples and 122 samples were taken. The data using statistical software were analyzed. The results show that the average coliform Total 234.8 and coliform Grmapay equal to 60 MPN per 100 ml sample, while the mean coliform total stations 1 and 2 respectively in 1445 and 600 MPN per 100 ml sample and fecal coliform in stations 1, 2, 6, 8, 9 and 11, respectively, 195, 163.3, 131.5, 111.5, 127.7, 118.8 MPN per 100 ml sample is. Also significant relationship between temperature, turbidity and microbial contamination was observed (P< 0.05). The results show that the average total coliform in the two stations and the average fecal coliform standard six stations too and according to local standards relating to swimming as a microbial threat to swimmers is considered.

Background and The deep cervical flexor muscles have a major role in neck stabilization and evidence suggests that these muscles especially longus colli muscle (LCM) becomes dysfunctional in panitents suffering from cervicogenic headache. Therefore, measurement of these muscles in healthy subjects and patients may be of great value to understand the stabilization function of the muscles and also to fallow the effect of interventions. The purpose of this study was to assess within and between days reliability of LCM anterior-posterior dimension(APD) and lateral dimension (LD) measurement using ultrasonography (US) in a group of healthy subjects and a group of patients with cervicogenic headache. This methodological research was performed on 19 subjects including 10patients with cervicogenic headache and 9 healthy subjects. Neck LCM dimensions was measured at the level of thyroid cartilage using a real time US device. Two images of LCM dimensions were taken on the same day with an hour interval to assess the within- day reliability and the third image was taken tow days later to determine between- days reliability. Then data were compared using statistical analysis. Healthy subjects were aged between 20-35 and patients between 20- 25 The ICC measurements for within day and between days reliability in healthy subjects were varied ranging from 0.80 to 0.92 for APD, 0.68-0.89 for LD. In patients group it was also ranged between 0.90- 0.92 and 0.81-0.90 respectively. The highest reliability score were performed for APD measurement in healthy subjects and patients with cervicogenic headache (ICC= 0.92). The results indicated that US could be a reliable tool to measure the LCM dimensions in healthy subjects and patients with cervicogenic headache. Therefore, this non invasive method can be used to follow up the effect of exercise therapy interventions.

Background and One of the most common complications of depression and treatment with ECT as one of the most effective treatments for depression is problem related to memory. This study was performed with aim of determination of the effects of Ginkgo pill on depression and cognition disturbance in this patients. In this clinical trial study, 81 major depressed inpatients who was admitted in Hajar hospital allocated randomly in two groups (case and control). patients had indications of bilateral ECT. Before and at the end of treatment period with ECT, cognition status of patients was evaluated by Mini Mental State Exam questionnaire and depression severity was evaluated with Hamilton depression questionnaire. In case group, patients was treated with Ginkgo pill 40 mg each 8 hours and control group was treated with placebo for ECT treatment period (2weeks). Data analyzed by software SPSS 11 / 5 t-test, mean and ANOVA. Between the two groups there was no statistically significant differences between age, gender, marital status, employment, duration of disease, depression and cognition score (P>0.05). The average scores in the field of cognitive problems and depression status of patients before and after ECT in both groups had significant difference (P<0.001) and case groups was better in both condition. Result of this study revealed the effectiveness of Ginkgo biloba in, cognition and depression status of major depress patients who treated with ECT, probably related to flavenoids and antioxidant component of this plant.

Background and Assessment of neck extensor strength and measurement of neck muscles dimensions utilizing ultrasonography are reliable and valid methods. Cervical muscles strength and dimensions may change in different ranges of cervical spine motions. The aim of this study was to compare the strength of cervical extensor muscles and dimensions of semispinalis capitis muscle in three different neck positions in healthy subjects Thirty female students (18-24 years) participated. An ultrasonography device was used to scan the right semispinalis capitis muscle at the level of third cervical vertebrae. A measurement device was used to assess the isometric strength of neck extensor muscles at three positions: neutral, flexion and extension. The lateral dimension and anterior posterior dimension were measured and the size of the muscle was calculated by multiplying the anterior-posterior dimension at lateral dimension of the muscle. The semi spinalis capitis muscle SECM size was significantly larger in extension than that of neutral and flexion positions (P<0.001). The strength of extensor muscles in neutral position was more than that of flexion and extension positions. There was no significant relationship between size and strength of the muscle in all three positions. The result of this study indicated that the size of SECM and the strength of head and neck extensor muscles were reversely increased from neck flexion to extension. The maximum performance of cervical extensor muscles appeared in neutral position of cervical spine, when the muscles were not maximally lengthened of shortened.

Background and Stachys lavandulifolia is used for many diseases. In this study the toxic effect of alcoholic extract of this plant was investigated, in rats. In present experimental study, 100 Wistar rats (about 250gr, 8-12 weeks old) were divided into 10 groups randomly (8 groups as case and 2 groups as control groups). Alcoholic extract of Stachys lavandulifolia was prepared by maceration method. Normal saline was injected to control groups and doses of 50, 100, 150 and 200mg/kg of the extracts were injected to others groups, intraperitoneally, daily, for 28 days. In 29th day, and one month later, the serum parameters level (ALP, AST, ALT) and pathological samples were evaluated in different groups. On the first month there was significant increase of AST level at dose of 200mg/kg and ALP level at all doses; compared to the control group (P<0.05). But there was no significant difference in the toxic effect of different concentrations of extract (P>0.05). On the second month, the liver enzymes changes was almost the same as first month, exception for dose of 150mg/kg that was increased significantly in AST level compared to control group and in ALP level compared to dose of 100mg/kg (P<0.05). The main histological finding was necroinflammatory and fibrotic reactions in liver at all doses, compared to control group (P<0.001). On the first month this hepatic damages significantly increased at the higher doses (150 and 200mg/kg) compared to lower doses (50 and 100mg/kg) of the extract (P<0.05). Extract of Stachys lavandulifolia caused toxicity effect in rate's liver, and therefore it should be use with caution.

Background and The duration of post operative intestinal Motility disorder and pain Following abdominal Surgery are quite Variable and They are iatrogenic phenomena With Important influence on Patient Morbidity, hospital Cost and Length of Stay in hospital. The aim of the present Study Was to determine The effect of interaperitoneal bupivacaine on Postoperative bowel Motility and Pain. This Study Was a double blind randomized Clinical Trial. One hundred and twenty Patient Candidates For abdominal Surgery (appendectomy, cholecystectomy and laparatomy) Were enrolled and divided in two groups randomly. In case group, the Patients received (1mg/kg) bupivacaine Plus 20 cc normal salin and in Control group they received only 30 cc Normal Salin interaperitoneal. Anorexia, nausea, vomiting, distension, bowel sound, defecation, pain (VAS) in 6,12,18,24 and 48 hours after surgery were evaluated and compared in the two group. Spss V 16, Chi2 and T-Test were used for data Analysis. P< 0.05 was Considered as statistically significant According to the results of this study, Anorexia, vomiting and nausea decreased post operative (P=0.002) and intestinal Motility increased (Fishers P<0.001) and post operative pain decreased (P<0.001) in the case group. The Use of interaperitoneal Bupivacaine was reduced post operative pain, vomiting, nausea, anorexia and increased intestinal motility

Background and Preeclampsia is a pregnancy-specific condition characterized by hypertension and proteinuria. According to many predisposing factors in pathophysiology of preeclampsia, the role of lipid preoxides, is recently important. The aim of this study was to evaluate association of preeclampsia with maternal plasma and umbilical cord Lipid concentration. This case-control study was done on pregnant women referring to Babol Yahyanejad Hospital, during 2008 - 2009. Case group include 31 term preeclamptic pregnant women and for control group 31 term normal pregnant women were recruited. All women had 20-30 years old and were in gravid 1 and 2. Total TG, cholesterol, HDL and LDL for plasma and umbilical cord were measured by enzymatic and calorimetric methods. The mean level of triglyceride (291.1 102.8 VS 309.4 114.4) cholesterol (226.3 48.8 VS 234.9 40.6), LDL (119 38.3 VS 123 33.1), HDL (50.1 10.6 VS 51.5 8.1) and VLDL (59.2 20.8 VS 61.5 22.6) in women with preeclampsia and normal subjects had not significant difference (p>0.05). About level of Lipids in umblical cord, only one case in control group had abnormal Triglycerid level. The mean level of umbilical cord triglyceride (56.3 32 VS 50.1 54) umbilical cord cholesterol (70.9 22.8 VS 64.4 20.8), umbilical cord LDL (30.9 12.7 VS 26.1 10), umbilical cord HDL (28.7 10.7 VS 30.7 8.6) and umbilical cord VLDL (11.6 6.8 VS 9.9 10.7) in preeclampsia and normal groups had not significant difference (p>0.05). Result show that there was no significant association between levels of plasma and umbilical cord lipids with preeclampsia.

Background and primary dysmenorrhea is described as pelvic pain around the time menstrual bleeding in the absence of an identifiable pathologic lesion. It is a common gynecologic problem among women in reproductive age groups. Our objective was to compare the effect of vitamin E and Fennel extract on intensity of primary dysmenorrhea A randomized single blind, Placebo-controlled trial among 65 single female students who suffered from primary dysmenorrhea that divided into 3 groups: Fennel extract, vitamin E and placebo. Groups used treatment four times a day from the onset of bleeding and continued through three days for two consecutive menstrual periods. In the Fenalgin group, pain severity was lower in compare to before treatment (P<0.000) and vitamin E group either cycle (P<0.02). Comparison 3 groups showed that there was significant difference in pain severity in second cycle and reduction was greater in Fenalgin group (P<0.019). Painkiller using was lower in compare to before treatment in Fenalgin and vitamin E vitamin E groups but reduction in both drugs was not significant in compare to placebo. Fenalgin, which has few side effects, can be taken for treatment of primary dysmenorrhea. More clinical trial needed to establish the efficacy of this herbal drug.

Myxoma is the most common type of primary tumor of heart. Recurrence of nonfamilial myxoma is unusual and recurrence in left atrial appendage was not reported. We present a case of sporadic myxoma, which after successful resection from the left atrium, recurred in the left atrial appendage, create the most confusion and difficulty in the diagnosis. Echocardiography is the modality of choice for non invasive diagnosis and localization. Operative resection of this tumor is Recommended as the most appropriate treatment option.