مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
سال شصتم شماره 1 (پیاپی 150، فروردین و اردیبهشت 1396)

Anaphylaxis is a potential life threatening condition which may control by proper diagnosis and efficacious management. The aim of this study was to determine the level of knowledge of anaphylaxis diagnosis and management in pediatric residents.
Subjects & This study was conducted in teaching hospitals of Tehran University of Medical Sciences. A total of 192 pediatrician and general and subspecialty pediatric residents during Sep. 2013 to Feb 2014 were included. They were asked to complete a 19 item questionnaire. Collected data analyzed using SPSS (version19) software. p Almost all respondents knew anaphylaxis as a life threathening event, however 23.4% didn’t answer correctly to the questions about signs and symptoms of anaphylaxis. None could determine therapeutic steps of anaphylaxis correctly, however, 94.7% agreed to administer epinephrine as the drug of choice for treatment (P=0.014). Only 78.1% correctly identified intramuscular route of epinephrine administration as the route of choice (0.000) and 71.4% used the proper dose. About half of participants knew about in-hospital observation time.
the present study indicated that, pediatricians and pediatric residentsoften are not very familiarwith the proper dosage of epinephrine, administration route and the optimaltime for hospitaldischarge in anaphylaxis. herefore, it seems that theoretical education about anaphylaxis is not sufficient to provide pediatric residents for clinical practice.

Multiple sclerosis is the most common chronic neurological disorders, disabling young and active people in society and is determined by frequency and unpredictability of recurrence and improvement over time, MRI is the modality of choice in patients with suspected multiple sclerosis. The aim of this study was comparison of subcalosal striation and Dawson fingers in MRI of multiple sclerosis patients.
Subjects & This study was cross-sectional, 61 patients with MS who referred to radiology department of Imam Reza Hospital were tested with brain MRI. Signs of subcalosal striation and Dawson fingers in MRI Were assessed. The software of SPSS 21 was used for statistical analysis.
The prevalences of subcalosal striation and fingers Dawson in MS patients are significantly different, respectively 100% and 91.8% (P subcalosal striation as a criterium in the radiological diagnosis of MS can be helpful in making more accurate diagnosis of MS.

Leishmaniasis is one of the six important diseases in the tropics which the World Health Organization has recommended that to be under research. This study was conducted to assess cutaneous leishmaniasis in Lamerd city.
This study was conducted as Cross-sectional, the information including age, sex, number of lesions, tumor location, location and type of building were collected and eventually analyzed by using SPSS version 22 .
from 907 cases studied , 437 men (48.1 %) and 470 were women (51.8 %). The highest number of disease cases were amongage group of 0-9 years and the lowest in age group of persons above 60 years. A total of 60.9 % of the patients were in rural and 39.1 % were urban, 51.8% of patients in new homes and the rest lived in the old houses. 62.6 % of patients had more than one ulcer and the most members are involved parts were hands.
This study showed that under ten years age group are most at risk and the pattern of gender is different from other regions of the country. Also the disease was seen more commonly in rural areas Therefore, to prevent the disease, it is necessary to train the groups considered at risk.

Although the main problem for children with hearing impairment is linguistic and communication shortcomings, in various studies, the balance impairment is discussed in comparison with normal people. The aim of this study was to investigate the effect of a course of selected training program on the balance of children with hearing impairment.
Subjects & overall 20 hearing impaired boys from the age of 8 to 14 years old entered the study and were randomly divided into intervention and control groups after a static and dynamic balance test as a pre-test. The intervention group participated in a selected training program, which included10 to 12 training sessions. During this period, the control group performed their daily activities. In both pretest and posttest stages, Stork Stand Static Test was used to evaluate static balance and to assess dynamic balance and balance performance of individuals, Bruininks – Oseretsky test of motor proficiency was used, and the results were compared in two groups. To test the natural distribution of data, Shapiro Wilco test was used and independent t-test and t-correlation with Spss Version 21.0 software were used to test the research hypothesis.
The mean age of patients in the control group was 10.9 ± 1.66 years and in the intervention group was 10.2 ± 1.55 years. The test scores in the post test were significantly higher than in the pretest in the control group (9.03 ± 11.03) and in the intervention group (26.66 ± 29), respectively (P = 0.137). The score of the Bruininks – Oseretsky test of motor proficiency was decreased 8.65 ± 11.20 units in control group and was increased 94.23 ± 99.13 units in intervention group (P = 0.034).
This study showed that a course of selective training program can enhance the dynamic and static balance performance in deaf children. Therefore, it is suggested that these training programs be included in the rehabilitation program for these children.

Hypophosphatemia can be seen in renal transplant recipients. Hyperparathyroidism, glucocorticoid treatment, and impairment of renal tubular phosphate reabsorption are the most common causes of hypophosphatemia in these patients.
It is well-known that dipyridamole enhances renal tubular phosphate reabsorption in some clinical conditions. We did not find any information about the effect of dipyridamole in renal transplant recipients (RTRs) with hypophosphatemia. For this reason, we decided to give dipyridamole 28 RTRs with hypophosphatemia.
Subjects & A total of 28RTRs whose serum phosphate and creatinine levels were below 2.5 mg/dl and 2 mg/dl, respectively, were included in this study. None of the patients received drugs altering phosphate metabolism and they did not change their routine diets. Urinary phosphate excretion and tubular phosphate reabsorption (TPR) were calculated before 3 weeks after dipyridamole treatment.
The mean levels of serum and urine (daily) phosphate and TPR were 1.68±0.36 mg/dl, 725.32±544.25 mg/day and 999.44±0.4, respectively. After treatment, the mean levels of serum-urine phosphate and TPR were 2.47±0.72 mg/dl, 667.91±259.85 mg/day and 999.69±0.22, respectively.
Serum phosphate level and TPR were found to be significantly different before and after dipyridamole therapy.
No significant change was observed in phosphate level before and after dipyridamole therapy.
On Short-term dipyridamole treatment no negative effect was observed on renal functions in these cases. Although the number of cases included in this study is small, dipyridamole is an effective choice in management of hypophosphatemic RTRs.

Autistic spectrum disorders syndrome with continuous failure in communication, social interaction, limited interests and other behavioral symptoms and bad prognosis is associated with multiple complications and problems.Anthropometry is the science of linear and angular dimensions measurment on live skeletal system. Knowledge of quantitative and qualitative characteristics of the lips may provide useful information in various medical fields. Therefore, in order to identify individuls and develop anthropometric medical reserch anthropometric features of the lips can be used. In is research the main goal was to examine the possibility of the above-mentioned relationship.
Procedure:In this research, in a 6-month period from the end of 1394 to the beginning of 1395 , a number of 37 male children 3-18 years old with autistic spectrum disorders and 43 healthy male children 3-16, who were residing in Mashhad Persian ethnic groups, were studied.
These people did not have inflammation, herpes simplex, or congenital malformations such as cleft lip.. Anthropometric measurement of the width of the mouth (ch-ch), filtrum width (cph-cph), length filtrum (sn-ls), Vermilion height of the upper lip (ls-sto), lower lip Vermilion height (sto-li), total height (ls-li) and total area Vermilion lips on Computer-generated images and MIP software, were measured. Data were evaluated statistically using SPSS software, polynomial regression and ANOVA models (PInvestigation of lips dimensions in Persian males with autism compared between the two groups of patients and healthy subjects.
Mouth width variables, upper lip height, the height of the lips and lip area are more in the group of patients than in healthy group, while the height of lip to the nose of healthy people is more in patient groups. Lower lip height and filtrum width variables in two groups, are almost equal..

Quality of cardiopulmonary resuscitation affects its success and survival of patient. Several studies have shown that physicians’ knowledge about resuscitation is very low, but there is no detailed information in our country. Therefore, this study was designed to determine the level of basic knowledge of Mashhad University of Medical Sciences residents in the field of resuscitation.
Subjects & The newly arrived residents of Mashhad University of Medical Sciences participated in a resuscitation training course. Pre-test with 20 questions endorsed by the American Heart Association was performed and a score of 0 to 20 was considered as the level of basic knowledge. After a training course, post-test was performed.
Findings A total of: 136 people participated in the study, with an average age of31.24±4.82 years. Of these, 44.1% were male and 55.9% were female. Pre-test and post-test mean scores were 10.24±3.4 and 13.35±2.9, respectively. The difference was statistically significant (P = 0.000), and training improved the knowledge by 30%. Gender and specialty had no significant effect on pre-test and post-test scores.
This study showed that the level of knowledge of residents about cardiopulmonary resuscitation was not acceptable, and needed appropriate training courses with appropriate intervals to improve their knowledge and skills.

Low back pain is one of the most important causes of disability and accounts for a considerable portion of healthcare costs. One of its causes is Lumbar disc herniation, which sometimes may call for surgical treatment. One of the outcomes of lumbar disc surgery is return to work (RTW) which is studied with its determinants in this article.
In a prospective cohort, patients hospitalized to undergo discectomy were interviewed and examined. Follow up was accomplished 3 months later by telephone call.
overall 56 patients were included and analyzed, 48 subjects (85.7%) returned to work after 3 months. Influencing factors were satisfaction about the work organization/workplace, perception of being supported to return by employer and colleagues, and the surgeon’s comment. In contrast, Demographic factors, Occupational factors outside the control of subject (such as income or disability security or even physical demands of job), and factors pertaining to pain didn’t affect return to work, after 3momenths, statistically.
Patient’s perceptions of his illness and job are of utmost importance in returning to work. Appropriate interventions in this field- either pre or postoperatively- can improve Return To Work and reduce disability.