مجله دانشگاه علوم پزشکی اردبیل
پیاپی 20 (تابستان 1385)

The cognitive processes such as attention, thinking, memory and recall have effective role on the child’s confrontation with daily life problems. The psychological disorders are among those impairments which may severely affect these processes. Researches have shown that schizophrenia can impair children’s cognitive processes to a great extent. The aim of this research was to compare the comprehension, lexical Knowledge, memory and recall in children with schizophrenia, conduct disorder and brain damage. The sample of this causal-comparative research consisted of 80 children (8-13 years old) suffering from schizophrenia, brain damage and conduct disorder as well as a group of healthy ones who were selected from among in and out-patients referring to psychology and neurology wards of Emam Hossein health care center in 2004 (20 subjects in each group). The instruments employed in this research were WISC-R (comprehension, vocabulary, digit span) and Recall Test of Babcoch. The one way analysis of variance showed significant differences between the children with schizophrenia, conduct disorder, brain damage and non-patient in comprehension, lexical knowledge, memory and recall (p<0.01). The LSD test showed that comperhension, lexical knowledge, memory and recall in children with schizophrenia were more impaired compared to children with conduct disorder and brain damage. Moreover, comprehension, lexical knowledge and memory in children with conduct disorder were more severely impaired than children with brain damage. However, the recall was better in children with conduct disorder than those with brain damage (p<0.01). The results showed that schizophrenic children have comprehension, lexical knowledge, memory and recall more impaired than those suffering from conduct disorder and brain damage. The timely recognition of the cognitive abnormalities seems necessary to have a better diagnosis and choose effective treatment and remedial strategies to cope with them.

Urinary tract infections (UTI) are among the most common bacterial infections in humans. One of the most frequent form of UTI is asymptomatic bacteriuria. The aim of this study is to determine the prevalence of asymptomatic bacteriuria in female students of Babol Islamic Azad University. This research was carried out on 207 female students from Babol Islamic Azad University in 2002. The age ranges of the students were between 18-29 years. Mid-stream urine (MSU) was collected from students. Urinalysis and bacteriological identification culture of MSU were done twice on all specimens. The prevalence of asymptomatic bacteriuria was determined by dividing the total number of observed bacteriuria by the total number of samples. Bacteriological tests of MSU revealed that 19 (9.2%) cases were positive for asymptomatic bacteriuria. The microbe most frequently causing asymptomatic bacteriuria was staphylococcus saprophyticus in 7 (36.8%) cases Escherichia coli in 6 (31.6%) cases and Klebsiella in 3 (15.8%) cases. Asymptomatic bacteriuria was highly prevalent in our study. Therefore, young women must consider general health rules about genitourinary system to avoid asymptomatic bacteriuria.

According to a recent report published by the ministry of health, Esophageal cancer is the second most common fatal cancer in Ardabil. This study investigated the relationship between anatomical sites and pathological features of Esophagus cancer with related risk factors. This descriptive-cross-secional and prospective study was conducted on patients referring to GI clinic of Ardabil (Aras) between 2000-2003. Patients with suspicious upper GI symptoms underwent upper GI vide-endoscopy. At least five to six endoscopic punch biopsies were obtained from all the lesions and sent for pathology. Diagnosis was confirmed by pathology. Anatomical sites, demographic information of the patients (age, sex, educational state, residential area) smoking habit, alcohol and opium consumption were entered into the questionnaire. Statistical analyses were performed using the EPI 2000 statistical software. The mean age of the patients with cancer was 59 ± 11.64 years and the male to female ratio was 1:1. Villagers constituted 117 (77%) of the patients. 93.4% of these patients were illiterate. The cancers were of the following types: 126 (82.9%) SCC, 25 (16.4%) adenocarcinoma and 1(0.7%) in situ carcinoma. The most common site of esophageal SCC cancer was middle third of esophagus with 73 (48%) patients. In contrast the most common site of adenocarcinoma in 31 (20%) patients was lower third of esophagus. No meaningful relationship was found between esophageal cancer and smoking drinking or opium consumption. The findings indicated that unlikewestern countries esophagus cancer had no relationship with smoking or alcohol consumption in Ardabil. Other studies are recommended to be performed to find out more about relationship between known esophageal risk factors including nutritional habits, nitrosamines, soil contents, agricultural products and genetic background.

Febrile convulsion is a disease with good prognosis but its mismanagement leads patients to serious complications. T his study was conducted to compare practice guidelines with current practices in the management of children with first febrile convulsion. This descriptive-analytical study was conducted on patients hospitalized with the diagnosis of first febrile convulsion in Imam-Khomeni hospital of Urmia in 2004. The data were collected from their hospital records. Practice guidelines of the American Academy of Pediatrics (AAP) were employed as reference. Current practices were compared with AAP recommended practice parameter about simple febrile seizure. Investigations performed included lumbar puncture, complete blood count, CRP, ESR, blood glucose, serum calcium, serum electrolytes, renal function tests, urinalysis, urine, and blood culture, chest X-ray, EEG and CT scan. T wo hundred fifty one cases aged 6-60 months were studied. Complete blood count, ESR, CPR, blood glucose, serum calcium, serum electrolytes, renal function tests, urinalysis, urine culture, and blood culture in all cases (100%), lumbar puncture in 10%, chest X-ray in 24%, EEG in 1.4% and CT scan in 0.65% of cases were the measurements conducted. The present study showed that the use of unnecessary investigations was common. Investigations, though costly, proved to be of little diagnostic value. This problem can be alleviated through a well-organized national program or observing AAP practical guidelines.

Coronary artery diseases and acute myocardial infarction are among the most common causes of death worldwide. Revascularization techiques have a major role in the management of this disease. Thrombolytics especially stereptokinase have been widely used because they do not require any expertise. Stereptokinase therapy may cause reperfusion of infarct area which in turn can result in arrhythmia. This study was performed to determine the sensitivity and specificity of developing reperfusion arrhythmias in predicting left ventricle function in patients with anterior myocardial infarction. This descriptive and cross-sectionel study was conducted on 100 patiens with acute anterior myocardial infarction who were admitted to CCU ward of Buali hospital and received stereptokinase. The patients with history of heart failure and contraindication to stereptokinase therapy and patients who had died in the first 6 hours of myocardial infarction were excluded from the study. During the first 24 hours after admission echocardiography was performed for obtaining left ventricle ejection fraction. The data were gathered and analyzed with SPSS saftware using descriptive and inferential statistics. 52% of the patients encountered arrhythmia during receiving stereptokinase, 33% of whom had normal left ventricle function and 19% encountered significant dysfunction of left ventricle. From remaining 48% who didn’t encounter arrhythmia, 21% had normal function of left ventricle and in the rest of them it was impaired. This study showed that the creation of arrhythmia due to reperfusion can predict the consistency of LV functioning with a sensitivity of 61% and a specificity of 58%. Moreover, there is a meaningful relationship between reperfusion arrhythmia and continuation of left ventricle functioning after treatment with streptokinase.

Infertility affects approximately 10-15% of reproductive age couples. Intra Uterin Insemination (IUI) is a primary, simple and effective method of infertility treatment in ovulatory disorders, unexplained infertility, cervical factors and some cases of male factor. In this research, the success rate of IUI with regard to different causes of infertility was studied in Kowsar IVF centre. In this retrospective study, 404 infertile couples were studied using a questionnaire that included the demographic data, duration of infertility, sperm count and mobility, follicular diameter and count, situation of uterus and fallopian tubes and pregnancy results. The data were analyzed with SPSS. Pregnancy rate was 11.1% for patients with ovulatory factors and 7.1% for male factors. There were no significant differences in sperm count and diameter of follicles in pregnant and nonpregnant women. With regard to different causes of infertility the best treatment results were achieved by IUI in ovarian factor. Patients over 35-40 did not have a good prognosis in COH-IUI cycles. Other methods of ART are recommended in such cases.

Lipid peroxidation has recently attracted considerable attention. It has been linked to carcinogenesis, aging and variety of other diseases including atherosclerosis. Atherogenesis involves the complicated interaction between cells of the arterial wall and lipoproteins (mainly oxidized LDL). The aim of this study was to investigate the relationship between serum malodialdehyde (MDA), the important indicator of lipid peroxidation and alteration in serum lipids and lipoproteins concentrations in male patients with coronary artery disease (CAD). The subjects of this study were 51 male patients under 55 with angiographically comfirmed CAD admitted to Shahid Madani Hospital and 60 age and sex matched apparently healthy individuals as the control group. The serum level of MDA was measured by colorimetric method using thiobarbituric acid reaction and lipid and lipoproteins concentrations were determined by standard enzymatic methods. Significant elevation in the level of MDA was noticed compared to the controls (P=0.03). Serum concentrations of cholesterol, triglyceride, LDL-C and LDL - C /HDL - C ratio in cases were higher than those of the controls (P=0.03). There was a positive and significant relationship between serum MDA and biochemical risk factors including Triglyceride, Cholesterol, LDL-C and LDL - C/HDL - C ratio (p=0.03). The correlation between serum MDA and serum HDL-C was negative and meaningful (P=0.03). No relationship was observed between serum MDA with BMI and age in cases. Simultaneous control and monitoring of both dyslipoproteinemia and lipid peroxidation may be of equal importance in prevention of occurrence and progression of CAD.

Controlling diet to regulate blood pressure in hypertensive patients has always been a challenging issue. On the other hand, insufficient supporting systems, non efficient follow-up programs, patients inability to do treatment measures in relapsing period, insufficient following of diet and drug taking, unplanned discharge and poor knowledge of risk factors are among controllable factor that lead to the readmission of the patients. The aim of this study is determining the effect of follow up on blood pressure control in hypertentive patients. In this interventional study, hypertensive patients referring to emergency ward were randomly divided into two case groups (100 patients) and two control groups (100 patients). After collecting data, case group patients were trained in their homes about the role of nutrition, mobility and regular drug use in blood pressure control for 3 months. Then, blood pressure in case and control groups was controlled and mean blood pressure in two groups was compared. The collected data were analyzed by SPSS software using descriptive and analytical statistics. 55.4 % of the case and 54.3% controls had family history of blood pressure. Before intervention mean BMI in case and control group was 26.8±5.56 and 28.04±14.66 and after intervention it was 25.96±5.38 and 27.61±14.29 respectively. Before follow up program was implemented, 39.13% of the cases and 35.87% of the controls had regular drug use history. After follow-up this rose to 44.6% and 42.4% respectively. After follow-up program 22.83% of the cases and 17.39% of the controls had referred to emergency ward or a physician once in 3 months. After intervention program, mean systolic blood pressure in cases and controls were 133 and 153 mmHg respectively and this difference was statistically meaningful (P<0.001). After follow-up, systolic blood pressure control in case and control groups was 59.8% and 35.9% respectively and this difference was meaningful (P<0.001). Results showed that after training program and home follow-up, blood pressure and weight control were more in case group, than control group, Therefore, we suggest that patient training programs and follow up and home follow-up be used as an effective way in hypertensive patient's health care and their treatment.

Cerebrovascular diseases are the most common disabiling neurologic disorders and the third cause of death in the population over 45 years of age. Most of the strokes in adults are ischemic and almost one-fifth of them are due to intra- or extracranial internal carotid artery stenosis. Ultrasonography is a noninvasive, cost-effective and safe technique for evaluation of intra or extracranial vessels that is available in two TCD and carotid Duplex. The present research is an attempt to investigate the appropriatens and comprehensiveness of TCD in diagnosing symptomatic significant carotid stenosis. This descriptive-analytical study was conducted on fifty patients admitted to the neurology ward of Imam Hospital who underwent both carotid duplex and TCD examination. Variables of blood flow velocities, collateral flow evidences and degree of carotid stenosis were assessed with both methods. The data were analyzed by SPSS (ver.11.5) using T.test, Chi-square and Fisher test. 34 patieuts were. Male mean age of the patients was 66.70% of the subjects were above 65 and 68% of them had a history of hypertension. No statistically significant difference was seen between systolic and diatolic blood flow velocity in internal carotid artery and pulsatile index obtnined from reported by TCD and carotid Duplex. There was no statistically significant difference between the percentage of stenosis TCD finding of the patients with carotid stenosis showed collateral flow in 78.57% of the cases. Acceptable correlation of the flow velocity parameters and the percentage of carotid stenosis between TCD and Carotid Duplex results showed that the primary performance of TCD to diagnose significant carotid stenosis (that causes hemodynamic disorder) and screen ischemic cerebrovascular accident is a reliable and effective method, but for precise determination of stenosis, plaque typing and for diagnosing stenisis below 50% the performance of carotid duplex study is also necessary and to complemantory TCD.

Diabetes mellitus (DM) is a clinically and genitically heterogeneous group of disorders characterized by abnormally high levels of glucose in blood. The skin is involved both in the effects of acute metabolic changes and in the chronic degenerative compilications of diabetes. Skin lesions are frequently observed in diabetic patients and it is generally stated that about 30% of these patients have cutaneous disorders. The aim of this study was to assess the prevalence of skin lesion in patients with diabetes mellitus referring to dermatology and diabetes clinic of Sina hospital in Tabriz. This descriptive-analytical study was conducted on diabetic patients with skin lesion who referr e d to diabetic and dermatology clinic of Sina hospital of Tabriz during 2003. Data collecting instrument was a questionnaire which included some variables such as age, sex, job, type of diabetes, its duration, control of blood glucose, receiving regular treatment, type of lesion. The questionnaire was filled out for each patient with skin lesion individally. Skin lesions due to burn were excluded from our study. The data were analyzed by SPSS using Chi-aquare and Fisher test. From a total of 500 patients, 80 patients (16%) had skin lesions. 57.5% of these patients was male and 91.2% had type II DM. Mean age of the patients with skin lesion was 56.86±1.54 years and mean diabetes duration was 10.87±0.82 years. Patients over 50 years had the most skin lesion. The most common type of skin lesion in the diabetic patients were 30 cases of necrotic ulcer (6%) and 22 cases of diabetic dermopathy (4.4%) respectively. Other skin lesions such as infection, sclerodermoid, punched out lesions, neuropathic ulcer, diabetic bulla, dermatitis and lichen planus were not common. 97.5% of diabetic patients with skin lesion had poor control of blood glucose. Twelve percent of the patients had some kind of diabetic foot ulcer (Neuropathic Necrotic, punched out and cellulitis ulcer altogether) of which 21.6% underwent amputation. The results showed that rate of skin lesions in diabetic patients is decreased. compared to the past. This may be due to increase of knowledge and attitude of patients regarding diabetes and its complications.

Cryptosporidium is an intracellular – extracytoplasmic parasite that has taken much attention in last 20 years as a clinically important human pathogen. Cryptosporidial infection can be transmitted from fecally contaminated food or water and from animal-human or human-human contact. In immunocompromised persons, the illness is much more severe such as debilitation, fatigue, cholera-like diarrhea, severe abdominal cramps, low-grade fever, severe weight loss and Anorexia. Because there was no regional study about cryptosporidiosis in Ardabil, we carried out this survey to determine the prevalence of cryptosporidiosis among the children hospitalized in Ardabil. This descriptive and analytical study was carried out on 371 patients in Sabalab and Aliasghar hospitals of Ardabil between 2004 and 2005. A questionnaire was filled for each patient. Stool samples were examined by concentrated formal - ether method and stained with modified Ziehl-Neelson method. The data were analyzed with SPSS (ver 11) using Chi-square test. We analyzed 371 stool samples from children with diarrhea. Cryptosporidium oocysts were detected microscopically in 15 samples. Its prevalence was 4.04% in infected patients. 66.7% of the infected ones were at the age of 6 to 24 months, 20% 25-48 months, and 13.3% 49-72 months. Condusion: Because cryptosporidiosis was more prevalent at the age of 6-24 months, health education is more necessary for their mothers.

Diabetes mellitus may be associated with the imbalance between protective effect of antioxidants and increased free radical production with regard to discrepancies of the findings in previous researches the present study set out to determine the changes of plasma malondialdehyde and erythrocyte antioxidant superoxide dismutase activity in patients with type II diabetes mellitus. This case-control study was conducted in 2005 using random sampling. 38 patients with type II diabetes mellitus who referred to 5th Azar diabetes center and 19 age and sex matched healthy controls were selected for this study. Heparinated blood samples were taken from the cases. The separated plasma was tested for blood sugar, lipid peroxidation and blood cells (for glycolisated Hb and superoxide dismutase enzyme activity). The collected data were analyzed by SPSS (ver. 10) using t-test. The level of plasma malondialdehyde from type II diabetes mellitus patients (6.27±0.80 nmol/ml) was significantly different from that in control group (3.56±0.98 nmol/ml)(p<0.05). Erythrocyte superoxide dismutase activity from type II diabetes mellitus patients (678.78±59.36 U/gr Hb) was significantly lower than control group (1056.47±52.98 U/gr Hb) (p<0.05). The significant difference between the increase in malondialdehyde and decrease in the activity of antioxidant enzymes in patients with type II diabetes mellitus may predispose to the development of serious complications leading to cellular damage. This suggest that diabetic patients may need more antioxidants than normal. Supplementation with medical or non-medical free radical scavengers such as vitamins E and C or foods untaining vitamin C (sitrus fruits) have a potential role in reinforcing antioxidant defence and can be important in diabetic patients.

Clinical findings show that stress can gradually affect the activity of various systems of the body such as immune system and impair them. Different variables potentiate and modify this effect. This research aimed at studying the relationship of personality traits (self-respect, tenacity, type A personality), stress, and stress coping skills with immune system status in nurses. In this descriptive-analytical study, 246 individuals were selected by simple random sampling method. At the first stage, the subjects on the job completed the questionnaires of self-respect, tenacity, type A personality, stress, and stress coping skills. At the second stage to determine the amount of antibodies, 2-cc blood of the subjects was assessed. The data were analyzed using correlational methods. The findings indicated a significant, positive and meaningful relationship of immunoglobulin antibody with “self-respect”, and IgM antibody with “type A personality” in male nurses (p<0.05). But there was no significant relationship between the immune system variables and tenacity, stress, and stress coping skills. From among the predictive variables (self-respect, tenacity, type A personality, stress, and stress coping skills) only the stress variable had significant relationship with the criterion variable (IgA antibody)(p=0.05). Regarding the results it can be said that self-respect may adjust IgG variable in stress positions (especially in chronic stress). So in hard jobs such as nursing, psychological characteristics should be considered as an important job factor along with physical capabilities.