مجله طب جنوب
سال نهم شماره 1 (شهریور 1385)

By considering the daily increase in drug resistance of various viruses, novel antiviral compounds extracted from natural resources – due to their fewer side effects, had always been important to researchers. In the present study, we investigated antiviral activity of the hot water extract of a green seaweed, Caulerpa sertularioides, collected from coastal water of Bushehr in the Persian Gulf, against Herpes Simplex Virus Type 1 (HSV-1).

The hot water extract of a green seaweed, Caulerpa sertularioides was sterilized by autoclave and filtration methods. After determining its cytotoxic concentration 50 (CC50) value, the effect of the extract on the inhibition of HSV-1 replication was examined in Vero cell culture.

The extract showed antiviral activity against HSV-1 in both attachment and entry of virus to the Vero cells and also on post attachment stages of virus replication. Inhibitory concentration 50 (IC50) values of the autoclaved extract were 81µg/ml and 126 µg/ml for attachment and post attachment stages, respectively. IC50 values of the filtered extract were 73 µg/ml and 104 µg/ml for attachment and post attachment stages, respectively. CC50 values for autoclaved and filtered extracts were 3140 µg/ml and 3095 µg/ml, respectively.

The hot water extract of Caulerpa sertularioides of the Persian Gulf had antiviral effect against HSV-1.

Mesobuthus eupeus of the buthidae scorpion family is a native species in Iran (especially in Khuzestan region). The venom of scorpions, particularly buthidae family, is mainly composed of various bioactive components including various toxins. These toxins affect different ionic channels in excitable membranes of insects or mammals. In this study, the toxic fractions of Mesobuthus eupeus crude venom were isolated and those with higher toxicity were purified.

Six toxic fractions from the crude venom of Mesobuthus eupeus were separated by gel filtration chromatography on sephadex G-50 in the equilibration with 20 mM ammonium acetate buffer, pH 4.7. Then the most toxic fractions were separated by cation exchange column chromatography and their purity was confirmed by electrophoresis.

The amount of 816 mg protein of soluble crude venom was applied on sephadex G-50 column chromatography, and 815 mg protein was yielded from the 6 separated fractions. From these fractions, fractions III and IV were toxic to mice. The LD50 values (Lethal Dose 50) of them were 0.40 and 0.46 mg/kg in mice, respectively. Fraction III was separated into 20 distinct subfractions. Through examining the toxicity of those subfractions to the mice, the toxic effect of subfractions III.14 to III.19 on mice was detected. From 250 mg protein of fraction III, applied on CM-sephadexC-25, 242.75 mg (97%) protein was attained in the separated subfractions.

Three distinct toxins were obtained in pure form from the venom of Mesobuthus eupeus. The subfraction III.14.4 with an LD50 of 0.11 mg/kg in mice had the highest toxicity. The structural characteristics, physiological and pathological effects of these three purified toxin subfractions can be studied in the future studies.

In some countries, though wild poliovirus isolation from clinical specimens has not been done, evidences of silent circulation of wild virus in sewage system have been reported. On the other hand, based on WHO recommendations, if there is any probability of wild virus entrance from endemic countries, environmental surveillance is advised as a completion to Acute Flaccid Paralysis (AFP) surveillance.

AFP and environmental surveillance were performed simultaneously in Sistan and Balouchestan province to confirm wild poliovirus eradication. To perform AFP surveillance, 21 stool specimens of AFP suspected cases were collected in a one year period and evaluated using L20B, RD and Hep-2 cell lines. To perform environmental surveillance, 86 samples from urban and hospital sewage disposal systems were collected. Using direct, Pellet and Two-phase methods for virus concentration, Enterovirus existence was investigated in above-mentioned cell lines.

Non-polio enteroviruses and polioviruses were isolated from 53.49% and 20.93% of sewage specimens, respectively. Sabin-Like polioviruses were isolated from 9.52% of AFP cases, and non-polio enteroviruses from 14.28% of them. Poliovirus type 2 was not isolated form stool specimens and there was no Poliovirus type 1 isolation from sewage specimens, either.

The environmental surveillance as a completion to AFP in Sistan and Balouchestan Province in Iran confirms poliovirus eradication.

The presence of C-reactive protein (CRP) during different stages of stroke had been shown in several studies. There is still no definite document about the correlation of CRP level and size of infarct in stroke. We studied the correlation of the acute level of CRP with size of infarct in stroke.

A total of 90 consecutive patients with acute stroke admitted in Fatemeh Zahra University Hospital in Bushehr city were studied. Levels of CRP were measured at admission time and 48 hours later. Sizes of infarct and types of stroke were determined with Computerized Tomography scanning. The excluded patients were those with infection, stroke in brain stem, a delay more than 24 hours after attack of stroke and Transient Ischemic Attacks. CRP level was measured quantitatively using ELISA method.

No correlation between the first CRP levels and variables of age, size of infarct and type of stroke was detected. Size of infarct was correlated with the second CRP (r=0.41, P<0.001) and the difference in CRP levels (r=0.45, P<0.001). The CRP difference was significant in ischemic, hemorrhagic and territory infarcts (P<0.01). But there was no difference between the first and the second CRP in lacunar infarcts.

We found no correlation between the CRP levels of the 24 first hours after acute stroke with size of infarct in stroke. But the increase of CRP levels which were measured in 48 hours after the stroke had correlation with size of infarct irrespective of types of stroke. More studies could reveal the cause and effect of CRP in size of infarct in stroke.

Hypoxic Ischemic Encephalopathy (HIE) neonatorum is very important due to its high morbidity and mortality rates and long-term neuromotor outcomes.

In order to evaluate outcomes in moderate to severe HIE, in a historical cohort study, medical records of all neonates with HIE during 1999-2006 in a university hospital were reviewed. Of 134 neonates who had been admitted, 94 cases could be evaluated and were in reach of follow-up.

A total of 77 deaths (81.9%) were found due to sequel of asphyxia. The survival rate was 17% with a median of 5 days. Of 17 alive neonates, 5 cases (29.4%) had cerebral palsy. The most important risk factors related to survival were: heart massage more than one minute, low first minute APGAR score, low PH in arterial blood gas analysis and low birth weight (P<0.05). Also emergency cesarean section was a major risk factor for death.

HIE has high morbidity and mortality rates and needs urgent attention for implementation of prevention programs including more intensive intrapartum monitoring.

Using a valid system for assessing the severity of injuries in blunt trauma plays a great role in prognosis of the patients. The Injury Severity Score (ISS) is an anatomical scoring system that provides an overall score for patients with multiple injuries.

In a 2 months period, injury severity scores were obtained for 254 consecutive hospitalized patients with traffic accidents, after initial diagnostic evaluations. For its computation, the score squares of the 3 most severely injured body regions according to AIS (Abbreviated Injury Scale) are added together. The score of ISS ranges from 0 (no injuries) to 75 (not compatible with life).

A total of 254 patients (89% male) were studied. Ninety percent had lower than 50 years old age (the mean of age was 23 years). The score of ISS in %17 of patients was lower than 25. The mortality rate was %4/6 (12 cases) and their mean ISS was 37. The critical score of ISS for death was 25.

Increase of the ISS score to more than 25 is correlated with an increase in risk of mortality in patients with traffic accident. The Injury Severity Score is a significant prognostic predictor for patients with blunt trauma.

Brucellosis is the most important zoonotic disease. As Brucellosis is endemic in Iran, this study was designed to evaluate seroepidemiological prevalence of brucellosis in livestock breeders of the central rural area of Bushehr province in 2003-2004.

Sera of 397 livestock breeders from the central rural area of Bushehr province were collected and tested for anti-brucella IgG antibody using ELISA method.

The prevalence of brucellosis in livestock breeders was 10.8%. Brucella seropositively was found to have a significant association with sheep contact and abortion in domestic animals (p<0.05) but anti-brucella Ig antibody positivity had not a significant association with sex, age, contact with cattle, goats and camel, keeping livestock at home, consumption of milk products and raw milk, history of brucellosis in person and/or family and nonspecific signs such as fever, myalgia, low back pain and artheralgia.

The prevalence of brucellosis is high in the central rural area of Bushehr province. The prevalence was much higher among livestock breeders in contact with sheep and also in those who had abortion in their domestic animals.

Decreasing the time from onset to hospital arrival and improving of stroke risk factors depend on public knowledge about stroke warning signs and its risk factors. A variety of programs were conducted in different countries for public knowledge assessment of stroke and its promotion.

A total of 562 persons (66.4 female) aged over 25 years old were selected by random cluster sampling and their knowledge on stroke was evaluated using the revised 11 item questionnaire of NIH/NHLBI (National Institutes of Health/ National Heart Lung Blood Institute of USA). The complete score of the questionnaire was 54.

The mean stroke knowledge score of male and female participants were 23.45±9.0 and 24.14±7.8, respectively (P>5%). Meanwhile, the mean of stroke knowledge score was higher in those with hypertension and a history of stroke (P=0.001). Higher education had correlation with a higher score. At least one stroke warning sign was reported by 83.3 % of participants and 95.2 % of respondents mentioned at least one established stroke risk factor. The most recognized stroke risk factor was stress and the most identified warning sign for stroke was sudden weakness or numbness of the face, arm or leg on one side of the body.

Those aged over 25 years old in Bushehr port had a higher knowledge score on stroke warning signs and its risk factors than other countries, including USA.

By considering important role of nutrition in children and teenagers’ health, their nutritional status are determined as obesity and wasting using weight and height. The aim of this study is to evaluate the prevalence of obesity and wasting and their relationship to food intake in female students of junior schools in Zahedan.

In a descriptive analytical cross-sectional study, 687 female students from junior schools were selected by multiple stage sampling method. After recording the participants’ demographic data, their weight and height were measured for body mass index (BMI) calculation according to standard method. National Center for Health Statistics (NCHS) and National Health and Nutritional Examination Survey (NHANES II) data and a 48-hour recall questionnaire were used.

Of the surveyed girls, 16.9%, 31.7% and 13.2% were wasted, under weight and stunted, respectively 8.7% and 1.7% were over weight and obese, respectively. The mean of energy intake was 1502.1±415.7 kcal/d in the students which is less than the recommended dietary allowances (RDA) and there were no balances in daily intake of protein, carbohydrate and lipids. In respect to energy and protein intake, 94.1% and 26.6% of students had deficiency, respectively. On the other hand, findings showed iron (72.1%), calcium (99.8%), phosphorus (83.6%), zinc (84.3%), vitamin A (63.8%) and B12 (66.5%) intake deficiencies.

The female students of junior schools of Zahedan do not have a proper nutritional status according to physical state, energy, protein, and micronutrients intakes and they are at the risk of wasting and underweight. Therefore, we suggest implementation of programs for nutritional support and designing of proper patterns of food consumption to improve female junior students’ nutritional status.

Social Behavioral Disorders (SBD) is significantly widespread among teenagers in such a way that psychologists called it as “the new hidden morbidity”. Therefore, screening of teenagers, finding out the related demographic factors and introducing them to consultation centers are very important points for therapeutic interventions.

In this cross-sectional study, a total of 400 male teenagers aged 13-18 years old were randomly selected in two stages, from a population in Bushehr in November 2005. Pediatric Symptoms Checklist 35-items Questionnaire (PSC/35) was used for their parents or their close relatives. The PSC/35 has 93% and 71% sensitivity and specificity, respectively. The cut off point of 28 was considered as the state of having SBD using this Questionnaire.

Overall 148 (37%) male teenagers were recognized to have SBD. SBD was more prevalent in boys with an annual educational average score of 14 (out of 20) in comparison with those with 14-17 or >17. Father’s job (labor, farmer or multiple job), predisposed his teenager children to SBD more than when he was employee or businessman. These behavioral abnormalities were more common if they were living with a single parent (death or divorce). SBD was more prevalent in those with externalized personality than both inter-externalized and internalized personalities. Less social behavioral disorders had a positive correlation with leisure time activities. Increase of age in male teenagers, number or order of children, being single, parents’ level of education, mother's occupation and the total income rate of the family had no significant correlation with SBD.

The prevalence of social behavioral disorders in male teenagers of Bushehr port is more than industrial countries. Demographic factors such as father’s job (labor, farmer or multiple jobs), living with a single parent (death or divorce), no leisure time activity, and internalized personality were related to SBD in male teenagers.

Iran has received Afghan refugees for many years. Few studies have been done to assess psychiatric morbidity among Afghan refugees in Iran, especially those who are resettled in camps. This study has been designed to determine the prevalence of mental health problems and the associated demographic factors, in Afghan refugees resettled in Dalakee refugee camp of Bushehr Province, in 2005.

In this cross-sectional survey, a Persian version of the General Health Questionnaire (GHQ-28) was administered to 321 resettled Afghan refugees with the minimum age of 15 years old who were randomly selected among 2200 residents of Dalakee refugee camp in Bushehr Province.

Among mental health subscales, the prevalence of social dysfunction, psychosomatic problem, anxiety and depression in the studied population were 80.1%, 48.9%, 39.3% and 22.1%, respectively. The total prevalence of mental health disorders in this camp was 88.5%. Male gender, living with more than eight persons per house, and being age ten or under at migration time were associated with higher level of social dysfunction. Higher rate of psychosomatic problem was associated with unemployment, being born in Iran, being age ten or under at migration time, and having no entertaining programs. Having 1-3 children, living with more than eight persons per house, and positive history of chronic disease were associated with higher level of anxiety. Having no entertaining programs, and family member's death during migration were associated with higher level of depression.

Mental health problems related to immigration and living in camps, are common among Afghan refugees.

Understanding the potential impact of information technology on health system can be used as a basis for health promotion based on information technology (IT). Undoubtedly, faculty members of medical record departments in Iranian medical universities have a significant role in knowledge gain of college students about the effectiveness of information technology on health system.

In order to assess the impact of IT on health system in the viewpoint of faculty members of medical record departments in Iranian medical universities, a cross sectional survey was conducted and questionnaires were sent to 17 universities with medical records departments. The questionnaire had three sections: The effect of IT on health information management (including: quantitative and qualitative promotion of documentations, follow up and referral, demand management and income and cost system), medical research and medical education. To investigate the correlations between variables of the study, X2 and exact fisher tests were used.

From 64 distributed questionnaires, a total of 49 were completed. The majority of faculty members (%40.81) believed that the use of IT enhances the utilization of paper documents. %26.53 believed that the use of IT has high impact on increase of medical errors. The majority of members (%36.75) considered IT to have a medium impact on self-therapy. The impact of information technology on medical research and medical education was believed to be very high by 83.67% and 79.59% of respondents, respectively. We did not find any correlation between the impact of IT on the studied variables and demographic data of participants such as age, gender and the years of teaching.

Most of faculty members of medical record departments have a high knowledge about the impact of IT on promotion of the management of health, research and education in medical sciences, but their knowledge about effectiveness of IT on quality of health services and its adverse effect was not proper. Therefore, the knowledge of faculty members of medical record departments in Iranian medical universities about the impact of IT on the quality of health services should be increased by educational programs.