مجله پزشکی بالینی ابن سینا
سال هفدهم شماره 4 (پیاپی 58، زمستان 1389)

Introduction & Leishmaniasis is one of the most important infectious diseases in the world. This disease is reported from more than 15 provinces of Iran as a health problem. Identification of reservoirs and characterization of parasite species in patients is very important for identifying the epidemiological aspects of disease and planning for control program This survey was performed as a descriptive study by PCR-RFLP method in Damghan district. Study was carried out on giemsa-stained smears from cases of leishmaniasis and rodents which collected in infected villages that leishmanal infection was confirmed by microscopic observations. DNA of giemsa-stained slides was extracted and followed by conventional PCR technique using specific primers of ITS1. PCR products were digested with a restriction enzyme (HaeIII). Totally 25 smears from human skin lesions and 8 rodent ear scrapings were examined by PCR. Electrophoresis results showed that leishmania major was present in patients and rodents giemsa-stained slides. PCR-RFLP is an effective method to identify leishmania species from giemsa-stained smears which have been collected from humans and animal reservoirs. Using this method identification of causative species of leishmaniasis is possible without sequencing.

Oral health problems of chronic renal failure patients can compromise systemic health. The purpose of this study was to investigate the dental and periodontal status of patients on regular hemodialysis (HD) maintenance therapy and the effect of duration of HD on oral health. Methods & Materials: In this historical cohort study 65 HD patients and 65 healthy people were collected as case and control groups. Decayed (D), Missed (M) and Filled (F) teeth, DMFT Index, Plaque Index (PI), Gingival Index (GI), and Probing depth (PD) were examined and compared between case and control groups. Also, HD patients were divided into two subgroups based on duration of hemodialysis: 1: three and less than three years and 2: more than three years). In this study all variables were examined and compared between these subgroups. T-test and chi-square and SPSS software were used for statistical analysis.

Except M and DMFT index, significant differences were found in other indices between case and control groups (P<0.05). D, M, F, DMFT values showed no significant differences between the two HD subgroups, whereas, PD, GI and PD values had significant increase in two groups based on the duration of hemodialysis.

The dental and periodontal health is poor in HD patients and periodontal status becomes worse specially during the time of dialysis.

Cytokines are immune system factors known to play a key role in both HCV clearance and the development of infection; the impact of host genetic factors on the clinical outcome of HCV infection has not been elucidated. On the other hand, the impact of Genetic changes like Single nucleotide polymorphisms on expression rate and function of Cytokine is under study. The aim of the present study was to compare TGF-B cytokine gene polymorphisms associated with the susceptibility to HCV infection. In this case-control study population composed of 125 individuals infected with HCV and 125 healthy controls. Genotyping was carried out by PCR-RFLP and the distribution of the TGF-B1 Gene 915 G>C polymorphism was compared in these groups. For confirmation of RFLP results, 10% of samples were genotyped by direct sequencing. The frequency of the TGF-β1 gene polymorphisms at position 915 in the HCV patients was GG (92%), GC(8%), CC(0%) and in the healthy controls was GG (89.6%), GC(8.8%),CC(1.6%), respectively. Allele frequency in the patients was G(96%),C(4%) and in the controls was G(94%)and C(6%).Statistically, there was no significant difference in genotype or allele frequency between the HCV patients and the control group. Distribution of genotypes in the HCV patients was similar to the results of some other studies, but the frequency of genotypes in the healthy controls of this study was different from the results in studies carried out in populations out of Iran. In conclusion, we can not consider TGF-B1 Gene 915 G>C polymorphism as an increasing or decreasing factor for susceptibility to HCV infection in our studied population.

Introduction & In recent years, the use of alternative disinfectants and the control of natural organic matters are two approaches that are typically applied in water treatment utilities to reduce the formation of chlorinated disinfection by-products. Catalytic ozonation is a new technology used to promote the efficiency of ozonation. The goal of this study was to survey the feasibility application of activated carbon as a catalyst in ozonation process for removal of humic acids from aqueous solution. This experimental study has been done in laboratory of water and wastewater chemistry, Tarbiat Modarres University. The solid structure and chemical composition of activated carbon were analyzed by X-ray fluorescence (XRF). Ozonation and catalytic ozonation experiments were performed in a semi-batch reactor and the mass of ozone produced was measured by iodometric titration methods. Concentration changes of humic acid in samples with a concentration of 15 mg/l were determined by using spectrophotometer at an absorbance wavelength of 254 nm. To evaluate the performance of catalytic ozonation in humic acid removal, total organic carbon and trihalomethane formation potential were evaluated and the results were analyzed by Excel software. Catalytic ozone results showed that using activated carbon as a catalyst increased humic acid decomposition up to 11 times and removal efficiency increased with increasing pH (4-12) and catalyst dosage (0.25-1.5 g/250cc). The experimental results showed that catalytic ozonation was most effective in less time (10 min) with considerable efficiency (95%) compared to the sole ozonation process (SOP). The results indicated that the catalytic ozonation process, compared to SOP, was less affected by radical scavenger, and total organic carbon, and trihalomethane formation potential removal achieved were 30% and 83%, respectively.

Trauma is one of the main causes of mortality in young women, fetus and neonate throughout the world and is the main cause of non obstetrical death during pregnancy as well; the prevalence is 6%-8% during pregnancy. With an increase in the rate of blunt and penetrating traumas, the occurrence of such events has increased in pregnancy. With regard to the prevalence and importance of trauma and contradictions existing in the field of causes and complications. This study was done to determine the outcomes of trauma in pregnant women referring to Kerman educational hospitals.

In this cross-sectional study, the computerized patients’ records at Kerman educational hospital were used and a list was prepared. This list included all pregnant women suffering trauma from 2003 until 2009. They were studied based on the clinical examinations done according to individual properties of the traumas, the region of trauma and maternal and fetal complications. The above causes were determined and approved. The study was reported in the form of descriptive statistics and frequency distribution tables.

In this study 80 women who hospitalized because of trauma were evaluated. The mean age of the pregnant women was 26.6 years. From the point of view of gestational age (66.6%) women between 20-36 weeks. The average of gestational age was 26 weeks. Statistically, there is a meaningful relationship between maternal and fetal complications and gestational age (p<0.05). Type of trauma in 77 women (96.7%) was blunt and the cause of trauma in (61.7%) was driving accidents. All who suffered In addition, the region of injury in all these people was abdomen and there is a meaningful relationship between maternal and fetal complications and location of injury(p<0.05). 17 women (21.25%) suffered from maternal complications due to blunt trauma. The most complication was preterm labor (32.5%). With regard to the fetal and maternal complications, fetal heart deceleration in 3 cases (37.5%), was the major cause that lead to cesarean section.

Trauma in pregnancy is a challenge in emergency wards and it is one of the most frequent causes of maternal death as well.. In addition, because of the anatomic changes in pregnant women, pregnancy management is difficult, so with regard to the above mentioned points and in order to decrease the complications of trauma, women protection against trauma and injuries is highly recommended.

Sternal wound infection and dehiscence are feared complications observed in 0.4-5% of cardiac operations. Even nowadays the mortality remains as high as 20-40%. The aim of the current study was to determine the rate of sternal wound infection. The outcomes of 388 patients undergoing cardiac surgery during a 7 month follow up were analyzed and their risk factors such as obesity, diabetes, cigarette smoking, blood transfusion, renal failure, hypertension, COPD, preoperative ejection fraction, aortic clamping time, and time of cardio pulmonary bypass were evaluated. The data was analyzed by t-test & c2 statistical tests. The present study revealed that 3 patients developed wound infection and dehiscence and its incidence was 0.74% (P=0.042). There was not any significant relationship between wound infection and the other risk factors (P>0.05). Our results indicate that ejection fraction preoperatively is very important in sternal wound infection.

Introduction & Depression and anxiety are common after acute myocardial infarction and are associated with an increased risk of mortality and morbidity. Also acute coronary syndrome is the most frequent cause of hospitalization in everyday cardio logical practice. Because the frequency of depression and anxiety in patients with acute coronary syndrome has not been examined well in our institute, we conducted a study to make it clear. In a descriptive cross-sectional study, interviews were carried out in the hospital with 360 patients with acute coronary syndrome. Depression and anxiety were assessed using the 13 and 10 item symptom checklist-90 (SCL-90) and was defined as a score of 10.4 or higher for depression and a score of 8 or higher for anxiety. All the data were extracted by questionnaire and compared with c2, one way ANOVA test and Pearson coefficient by using SPSS 13 Software. The SCL-90 identified depression and anxiety in 66.6% and 47.5% of patients, respectively. There is no difference between the age of the patients with various degrees of depression and anxiety. For those subjects who were depressed, distinctly higher scores on anxiety variables were established. Also, depression and anxiety were significantly higher in females than males (P<0.001). Depression and anxiety were common following an acute coronary syndrome in our institute, with a strong correlation between anxiety and depression in this sample of patients.

Recently, treatment of industrial wastewaters has attracted much attention of many governments and also environmental experts. Basically, these wastewaters are polluted due to the different contaminants such as dyes, halogenated hydrocarbons, phenolic compounds etc. Among these pollutants, phenols are widely used in petroleum, petrochemical, coal production and pharmaceutical industries. There are several methods for removing phenol from water including adsorption, wet peroxide oxidation, wet air oxidation, ozonation etc. Each of these methods has advantages and disadvantages. Therefore, in this study the adsorption of phenol on Copper modified pumice as an adsorbent was investigated. In this experimental study, the pumice granules were collected from Qorveh region in Kordestan with mesh 20. The pumice granules were modified by CuSO4. Synthetic solution of phenol was prepared and different parameters including pH (3, 7, 12) initial concentration of phenol (25, 50, 75, 100, 150, 200, 300,400 mg/L), contact time (20, 40, 60, 80,100,120 min) and the adsorbent dose of modified pumice (0.25, 0.5, 0.75, 1) were examined in a batch reactor, respectively. The chemical composition and solid structure of pumice was analyzed using X-ray diffraction (XRD), XRF, and scanning electronic microscopy (SEM). Also, Langmuir and Freundlich models were studied in the sorption of phenol onto the pumice. To determine the optimum pH of adsorption process, pHPZC of pumice was measured. The results showed that phenol removal efficiency had been increased by increasing contact time, initial concentration of phenol and the amount of modified pumice. On the other hand, removal efficiency decreased with increasing pH. The sorption process showed a good agreement with the Freundlich model. Also, pHPZC of modified pumice was 7.7. The results show that modified pumice can be used effectively in removing phenol. Due to the low price of the pumice and its simple modification, it can be used for removing hazardous materials from water and wastewater.

Introduction & The breast cancer is the most common malignancy in women and in recent years it is seen in younger ages. Because of dense breast tissue in these ages, the mammography sensitivity for breast cancer detection is reduced, so high quality ultrasonography (US) as a combined screening method is effective. The aim of this study is the evaluation of the mammographic finding with the positive finding of ultrasonogarphy. In this cross-sectional study 300 cases were referred to the Mehr Medical Imaging Center for breast US and sonography of breast and axilla was performed. Mammography before or after US was also performed by another radiologist. All suspicious patients were referred for biopsy or surgery. Mean age of patients was 46 y/o with the range of 32-76 y/o. Pathologic specimens approved malignancy in 21 patients and abscess in 1 patient. The most frequent symptom was palpable breast mass with mean diameter of 29 mm. Mean diameter of lymph nodes was 17.3 mm. Positive mammographic findings were seen in 85.7%and negative findings or only an asymmetric density in 14.3%. According to dense breast tissue especially in young women sensitivity of single screening by mammography is reduced in breast cancer detection, so combined screening with sonography and mammography especially in younger women improves the detection rate of breast carcinoma.

Introduction & Myopia is the most rampant human refractive error. There are many questions about the effect of fasting during Ramadan on myopia among these patients. Due to lack of enough researches on this topic, we decided to do a study to answer this question. This cohort study was done on 102 patients at Ramadan month (2007) referred to Besat hospital of Hamadan city, half being starved the other half no starved. In both groups ophthalmic examinations before and after this month were performed and data were registered. The myopic changes in starved group were 0.078±0.16 & 0.049±0.16 in right & left eyes respectively. This amounts were 0.088±0.19& 0.110±0.21 for non starved patients. The differences were not statistically meaningful in two groups. A complete course of fasting in Ramadan doesnt influence myopia.