مجله طب جنوب
سال دهم شماره 2 (اسفند 1386)

Recently, ingestion of shark cartilage has been increased among patients with cancer on the basis of this claim that sharks rarely develop cancer because of their high proportion of cartilage and antiangiogenesis compounds. The goal of this study was to evaluate the antitumor effect of shark cartilage and growth of induced mammary tumors in rat using dimethylbenzanthracene (DMBA) and to assess the improvement in some Quality-of-Life markers. Tumors were induced by 7, 12 Dimethylbenzanthracene (DMBA) 20mg/2ml corn oil for each rat using gavage method. Cartilage powder was prepared from neural cord of white snout shark (Persian Gulf, Iran).A total of 60 Sprague Dawley rats were divided in two groups (30 rats in each group): pretumor establishment treatment (PRTE) and post tumor establishment treatment (PSTE). Each group was divided in two control (n=15) and treatment (n=15) subgroups. Animals in treatment PRTE (30 days after tumor induction) and PSTE (after palpable tumors were established) groups were treated with 10mg/day /rat shark cartilage for 30 days. Animal weight gaining, tumor induction time, tumor number and size were recorded on induction and 30, 60, 120 and 200 days after induction. There was no significant difference in number and size of tumors between PSTE treatment and PRTE control, two months after treatment (P>0.05), but this difference was significant between PSTE treatment and PSTE control groups (P<0.05). Weight gaining, in treatment period, was higher in PRTE treatment than PRTE control (P<0.05), but this difference was not significant at the end of the treatment (P>0.05). Two months after treatment tumors significantly regressed in PSTE group. At the end of the study, significant difference was shown between PSTE treatment and other groups in weight gaining, number and size of tumors (P<0.05). Mammary tumor induced with DMBA in rat was regressed when shark cartilage was administrated orally and weight gaining mean, as a marker of improvement of quality of life, was better two months after treatment. But shark cartilage did not prevent tumorigenesis. Further studies about proper dosage, clinical complications, efficient prescription methods and level of availability of biological protein products derived from shark cartilage are recommended.

Usage of equipments producing electromagnetic radiations are increasing in daily life of most societies. The probable effects of these waves, even with low intensity, on different organs are focused by many researchers. The present research was designed to study the effects of electromagnetic field (EMF) on heart muscular walls and cavities, for the first time. A total of 24 wistar male rats were divided into one control group, one sham group and 2 experimental groups (4 animals in each group). The experimental groups were exposed continually to 2.1 and 4.3 mT of electromagnetic fields for 6 and 15 days, respectively. The sham group was maintained in similar conditions in the off fields and for the control group no operation was done. At the end of the experiment, animals were sacrificed and their hearts were extracted. Serial sections with 7µm thickness were prepared and stained by hematoxylin & eosin. Total volume of heart, volume of right and left ventricular wall and cavity and interventricular septum were measured by Cavalier’s method and stereological coefficient error were calculated for all groups. There were no significant differences between 15 days exposure groups compared to control and sham groups. In the 6 day exposure with intensity of 2.1 mT group, the volume of left and right ventricular walls were decreased significantly. There was significant increase in interventricular septum of the 6 day exposure group with intensity of 4.3 mT. Short time exposure of low intensity EMF probably will affect growth or blood supply of heart muscles by producing free radicals but animals that exposed to same condition for longer time will adapt to EMF and show the normal state. This adaptive phenomenon may be due to coordination of CNS and circulatory system.

Avian influenza virus (AIV) subtype (H9N2), not only causes great economic losses in poultry industry of the Middle East countries, but also has some public health significance as well. The aim of this study was to assess the pathological effects of AIV subtype (H9N2) on different organs of broiler chickens and to detect the virus antigen in these organs. A number of fifty 1-day-old broiler chicks (Ross breed) were randomly divided into two equal (experiment and control) groups and at days 1, 2, 4, 6, 8 and 11 after inoculating virus, antibody titer against H9N2 subtype of AIV was detected in experiment group and tissue samples from trachea, lung, kidney, spleen, thymus, bursa of fabricius, duodenum, pancreas, liver and brain were collected for histopathology and immunofluorescence studies. The antibody titer against H9N2 AIV at days 1, 2, 4, 6, 8 and 11, post-inoculation, in experiment group was 3, 2.4, 1.7, 3.3, 4.2 and 5.6 and in control group, 3, 2.7, 2.34, 1.8, 1.24 and 0, respectively. Histologic lesions in treatment group were observed as follow: lymphoid and reticuloendothelial cell hyperplasia in the spleen and duodenum, lymphoid depletion in the thymus, lymphoid atrophy in bursa of fabricius, lymphocyte infiltration and mild vacuolation of cells in pancreas. Histologic lesions were absent in the liver and brain of inoculated chickens. The H9N2 AIV antigen was detected in the trachea, lung and kidney of inoculated chickens using indirect immunofluorescence technique. H9N2 avian influenza virus is low pathogenic subtype and has epitheliotropic effect in chickens. In intranasal inoculation, it has tissue tropism and pathogenicity for trachea, lung (pneumotropic) and kidney (nephrotropic)

Sea fish oils are rich in n-3 fatty acids, these oils are useful in treatment of diseases. The majority of clinical health benefits of n-3 fatty acids belongs to Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA). These two compounds are found only in fish tissue. The aim of this study was to use flaxseed oil as a precursor in the production of DHA and EPA in the Oncorhynchus mykiss tissues. Rainbow trout fishes with average weight of 6.150 ± 0.240 gr were stoked in polyethylene tanks with the capacity of 250 liters and reared in a randomly 3 repeats form. A diet containing 25, 50, 75 and 100 % flaxseed oil were prepared and given to the fishes bond on their biomass which was determined every 20 days. During the period of investigation, different parameters were measured as follows: water temperature 15 2˚C, pH=7.500-7.850, dissolved oxygen (saturated level), electrical conductivity=2800qm/cm and salinity 1.4 g/l. By increasing the amount of flaxseed oil in the foods given to the fishes, the percentage of crude fat, the body protein and total fatty acids of n-3 type were significantly increased. The maximum change was in EPA type. There was no significant change in the final weight and growth rate of the fishes (p<0.05). We conclude that a diet containing 75% flaxseed oil and 25% fish oil will provide the biological need of the fishes and better protein absorption, and will increase the percentages of the fatty acids of DHA and EPA up to two times in the tissues.

Helicobacter pylori (HP) is the cause of the most common infection in the world. It has been recognized as the major cause of peptic ulcer and an important risk factor for gastric malignancy. A variety of reliable methods are available for detecting HP during upper gastrointestinal endoscopy. Rapid urease test (RUT) is the cheapest method and histology is the most expensive; brush cytology is faster and cheaper than histology. The brushing cytology materials were obtained from the antrum of the stomach in 109 patients who suffered from dyspepsia and were candidates for endoscopy. The RUT and histology with hematoxylin-eosin staining were also performed on each patient separately. The infection status for each patient was established by a concordance of two test results. Seventy-eight of 100 patients (78%) were diagnosed as positive for Helicobacter pylori organisms using brushing cytology. The sensitivity and specificity of brushing cytology were 96% and 72% respectively. Sensitivity of brush cytology (96%) was higher than RUT (77.4%), and RUT was more specific than histology (100% vs 90%). Gastric brushing cytology provides an accurate, inexpensive and easy technique in the rapid detection of Helicobacter pylori infection. When additional information about the severity of mucosal damage or the presence of cell atypias is not necessary, histologic examination can be omitted, and a cost effective strategy for assessing HP status might consist of taking antral biopsies, the former for RUT and performing brush cytology slide, which should be stained and examined only when the RUT result is negative.

Endoscopic gastrostomy provides a secure route for the provision of permanent enteral feeding. We performed this study to determine the incidence of endoscopic gastrostomy complications. Our secondary aim was to determine the efficacy of prophylactic antibiotic at the time of Percutaneous Endoscopic Gastrostomy (PEG) for reducing peristomal wound infection. The complications of endoscopic gastrostomy in 136 consecutive patients who had been referred to department of gastroenterology diseases of Fatemeh-Zahra hospital were recorded. Also in a randomized clinical trial the efficacy of a single dose of 1 g intravenous ceftriaxone or 5 g tetracycline cream 30 min before PEG insertion for prevention of gastrostomy wound infection was compared to those who received no prophylactic antibiotic. A number of 77 male and 59 female patients were enrolled in this study. The mean age of the subjects was 49 ± 8 years. The most common indications for placement of the gastrostomy tube were cerebrovascular accident and brain trauma, respectively. Peristomal leakage was seen in 3.7%; and gastrostomy wound infection after the first week, gastric ulceration and inadvertent PEG tube removal were detected each in 2.2% of subjects. Gastrostomy wound infection in the first 48 hours and one week follow-up after PEG insertion were not seen in the subjects. Percutaneous endoscopic gastrostomy is an easy, secure, and safe way to provide enteral feeding and the risk of major complications is negligible. The benefit of prophylactic antibiotics for prevention of gastrostomy wound infection is questionable.

Urinary tract infection (UTI) is one of the most common infectious diseases in inpatients and outpatients, thus recognition of the pathogen and a proper treatment can prevent related complications. The aim of this study was to identify various microorganisms causing community acquired UTI and their relative prevalence and antibiotic susceptibilities in outpatients of Bushehr port in 2006. In this retrospective study, urine samples of 2000 outpatients with community acquired UTI who referred to standard clinical laboratories of Bushehr in the year of 2006 were collected. The results of urine cultures were adjusted to the results of Urine analysis. The microbial susceptibilities of urinary tract infection pathogens were evaluated using disc diffusion method. UTI in women was more prevalent (85.8%). The most common UTI pathogen was Escherichia coli (40.2%) and staphylococci (23.7%), respectively. Other organisms were Klebsialla and Entrobacter (20.8% and 12%, respectively). In 3.4% of patients, Serratia, Pseudomonas, citrobacter, Proteus mirabilis and Acinetobacter were isolated, as miscellaneous group. Escherichia coli (88.1%), which is the most common cause of UTI had the highest antibiotic sensivity to the third generation of cephalosporins. and the highest antibiotic resistance to vancomycin (97.1%). Staphylococci showed a high susceptibility to Aminoglycosides (94.3%) and the most resistance to the third generation of cephalosporins (67.4%). The most common cause of UTI in Bushehr port was Escherichia coli with a high susceptibility to the third generation of cephalosporins. The second common organisms were staphylococci with a high antimicrobial susceptibility to aminoglycosides.

Due to presence of confounding factors in contemporary studies, there are controversial data on correlation between hypertension and chronic H. pylori infection. In our study which was conducted for the first time in the Western Asia, we tried to find any correlation between hypertension and positive H. pylori seropositivity after correction for the confounding factors. To evaluate any correlation between H. pylori infection and hypertension, the randomized multistage stratified cluster sampling method was used to select 1752 subjects from Northern Persian Gulf (Bushehr, Genaveh and Dailam). Hypertension was defined according to WHO criteria. ELISA method was used for seropositivity of H. pylori infection. The prevalence of hypertension and positive H. pylori seropositivity were 26.3% and 61.6%, respectively. According to multivariate logistic regression analysis, we observed correlation between hypertension and positive H. pylori seropositivity, independent of type II diabetes, high LDL cholesterol, smoking, and high BMI [OR=1.49; CI (1.18-1.89); P= 0.001]. There is an association between H. pylori infection and hypertension in the residents of the Northern Persian Gulf after adjustment of demographic and metabolic factors.

Occupation trauma is a social and economic problem which industrialization in developing countries has increased its prevalence. This study was designed to assess the distribution of occupation – related ocular trauma in Esfahan. In this descriptive cross-sectional study, all first time referrals to eye emergency department in Feiz Hospital who suffered from occupation-related trauma were evaluated using questionnaire designed according to United State Eye Injury Registry. A total of 450 (27.9%) out of 1610 patients, consisting 447 male (99.3%) and 3 female (0.7%) who referred to Feiz Hospital had occupational-related trauma and their mean age was 30.4 (15-62) years old. A total of 202 patients (44.9%) were 21-30 years old. The level of education in 162 (36%) subjects was junior high-school and 110 of them (24.4%) were arc-welders. Metallic foreign body injured 70.2% of patients and in 62.2% of subjects, corneal foreign body was the most common injury. Only 19.6% of the patients used protective goggles and 15.1% (68) of them had been receiving educational instructions for eye healthcare and safety strategies. At the end of the treatment, visual acuity of 12 (2.8%) subjects was significantly decreased. Occupation–related ocular trauma was a very prevalent eye injury in Esfahan. Metallic foreign body was the most common causative agent and corneal injury was also the most common form of ocular injury. Thus convincing workers to use protective goggles and giving education about correct way of using them is an effective step to prevent ocular injuries.

Pica is an eating disorder typically defined as the persistent eating of nonnutritive substances for a period of at least 1 month, without an association with an aversion to food. This behavior should be developmentally inappropriate, and not a culturally sanctioned practice. Pica is more prevalent in underdeveloped and low socioeconomic areas. In this study under 6-year old kindergarten children of Bushehr were evaluated. In a cross sectional study, 256 under 6-year old kindergarten children were evaluated in Bushehr in 2001. The necessary information regarding pica characteristics was given to the parents and teachers. The questionnaires were completed by the parents and teachers, and the suspects were assessed a second time. A more complete history and psychiatric examination was done to confirm the diagnosis of pica according to DSM IV (Diagnostic and Statistical Manual of Mental Disorders IV) in these children. A total of 256 children including 123 girls (48%) and 133 boys (52%) were evaluated. Pica was diagnosed in 67 of these children (26.2%). The most prevalent age for pica was 12-18 months (27 persons, 40.2%) and 18-24 months (20 persons, 29.8%). Pica was significantly associated with sex (being a girl) and positive family history. Pica is prevalent in kindergarten children in Bushehr. Educating parents and teachers seems to be necessary.

Nowadays, determining research priorities is one of the strategic approaches for research planning. Since there is no clear research policy in nursing in Iran, the present study was designed to find research priorities for nursing. In this descriptive-analytic study, the nurses in academic and clinical settings of Bushehr city participated and responded to a questionnaire in two round Delphi survey (208 persons in the first round and 174 persons in the second round). The questionnaire contained a list of research topics to be prioritized according to 9 criteria (importance of the topic, their role in changing health status of the society, availability of data, change in nursing profession, potentiality to collaborate with other research centers, focus on social needs, protective principles and instructions, economical justification, possibility of applying achieved results). Its scoring scale was based on three options (high, good, low) and an open question. The research topics which received the highest ranking scores were: 1) Nursing and education, 2) Nursing and client education, 3) Nursing status in health system, 4) Nursing and medication therapy, 5) Nursing management and quality promotion, 6) Nursing and care, 7) Nursing and crisis (disasters), 8) Nursing and research, 9) occupational hazards, 10) Role of nurse in society health promotion. Delphi technique is a useful method for determining nursing research priorities. Through this method, topics related to nursing education and nursing status in health system were found to be of the highest level of priority in nursing.

Hospital waste contains a large quantity of dangerous pathogenic agents, which are hazardous to the health of man, animal, plant and the environment. In Iran, like many other developing countries, not enough attention is paid to this matter and available information regarding the generation and disposal of medical wastes are low. The existing information about production and disposal of wastes in our hospitals is little and incomplete. In this study, a survey on hospital waste management system in Bushehr province hospitals was conducted. In this cross-sectional study, 8 hospitals in Bushehr province were investigated during a period of 6 months using a questionnaire, interviews and direct observations. The questionnaire had 93 questions (open and closed) about general information on the hospitals and about various systems of managing hospital waste according to the World Health Organization suggested survey questionnaire for hospital waste management in developing countries. In hospitals of bushehr province, waste generation rate was 2615 kg/day, including domestic waste (51.7%), infectious waste (20.8%), sharps (15.2%) and chemical and drugs wastes (12.3%). In almost all hospitals, segregation of infectious waste from domestic waste at the place of origin and putting them in special containers had been done but this segregation wasn’t complete and sometimes some hazardous waste were disposed of in domestic waste containers. All hospitals used a color coding system for waste containers, 75 % of hospitals had incinerators. In others, waste was carried out by municipal service daily. In all hospitals, all workers were trained about hospital waste management. In none of the surveyed hospitals, there was an obvious policy and plan for purchasing equipment and necessary facilities in order to dispose hospital waste correctly and also no clear budget was allocated for hospital waste management. In none of these hospitals regular reports on hospital waste management were prepared. Hospital waste in Bushehr province hospitals are depositing in a nonstandard fashion and against the relevant recommendations. Compiling necessary rules and establishing the proper standards should be considered as an urgent policy in Bushehr province health service