نشریه پژوهش در پزشکی
سال سی و دوم شماره 1 (پیاپی 125، بهار 1387)

Cryptosporidiosis is prevalent in animals and human beings, both immuno-competent and immuno-compromised persons, worldwide. Epidemiologically, it is important to differentiate between human and animal species. The aim of this study is to define the utility of a 1055 bp fragment of 18s rRNA for differentiation of Human and Cattle Cryptosporidiosis.

1020 human fecal samples and 940 bovine fecal samples were collected and tested for Cryptosporidium by modified acid fast staining. DNA of positive samples was extracted and a 1055bp fragment of 18s rRNA was amplified by Nested-PCR technique using 4 designed primers. The second PCR product was digested by Ssp1&Vsp1 restriction enzymes to determine the Cryptosporidium species and the results were analyzed by 2.5% agarose gel electrophoresis and visualized after ethidium bromide staining.

12 human samples and 23 cattle samples were detected as being positive for Cryptospridium by modified acid fast method. These results were confirmed by molecular technique. All cattle samples and 10 human samples presented similar bands on 2.5% agarose gel which confirmed Cryptosporidium parvum except two human samples which had different patterns. On sequencing these 2 samples these two new isolates were found to be different from the rest. The sequences of 2 new human isolates were different from others in Gene Bank so they were deposited in Gene Bank at accession No: EU311203

In this study we detected both cryptosporidium parvum & cryptosporidium hominis in human samples but cryptosporidium parvum was more prevalent.

Iodine deficiency disorder, (IDD), is a worldwide health problem. Parts of Iran, such as Semnan, are known as endemic areas for goiter. IDD was accepted as a priority health problem in our country and a National IDD Council was formed in 1989. This study was performed to evaluate the implementation of the National IDD Council program in 2001 among 7-10-year-old children in Semnan province.

In this cross sectional study, 1200 children, (M/F ratio=1), aged 7-10 years, were selected and grading of goiter was performed in accordance to the WHO criteria. Urinary samples were obtained from 120 children and urinary iodine was measured using digestion method.

Total prevalence of goiter was 17% (16.3% in girls and 17.7% in boys). The median urinary iodine was 13.7µg/dl. 73.2% had a urinary iodine of more than 10µg/dl, while 10.8% had urinary iodine levels of <5µg/dl. None of the candidates had urinary iodine levels less the 2µg/dl. There was no significant difference between the two sexes and urban or rural areas.

There has been a significant decline in the prevalence of goiter among children in Semnan province. In addition, urinary iodine concentration of children has reached rates approved by the WHO. Semnan province can now be classified as one of the "iodine-deficiency-free" areas in Iran.

The main result of hearing impairment is reduction of speech perception. Patient with auditory neuropathy can hear but they can not understand. Their difficulties have been traced to timing related deficits, revealing the importance of the neural encoding of timing cues for understanding speech.

In the present study psychoacoustic perception (minimal noticeable difference in intensity, frequency and time), and word discrimination ability of young patients with auditory neuropathy was compared with normal controls.

This cross-sectional analytical study was performed on 16 young right-handed people with auditory neuropathy, (mean age 20±5.30 years), and on 28 subjects with normal hearing, (mean age 22±3.80 years). The minimal noticeable difference in sound intensity, frequency and time were measured by conducting "intensity discrimination'' and "gap detection" tests at supra-threshold levels and "frequency discrimination" test at different octave band frequencies in both groups. The word discrimination score was measured in silence and in three different signals to noise. Results of tests were compared between two groups.

Significant difference was shown between patients with auditory neuropathy and control subjects in gap detection (at all intensity levels), frequency discrimination (in all octave band frequencies) and intensity discrimination tests at all intensity levels, (p<0/003). The word discrimination score was decreased in the presence of noise in three different signals to noise ratios of zero, +5 and +10 dB in both groups, and there was a significant difference between results of word discrimination test in patients and controls in both silence and different levels of noise.

The results showed that people with auditory neuropathy have a deficit in temporal processing and poor frequency discrimination. Severe impairment in temporal processing is probably the major factor contributing to poor speech recognition in people with this disorder. This data not only demonstrates the importance of neural synchrony for auditory perception, but also provides guidance for better diagnosis and treatment of auditory neuropathy.

The relationship between coping styles and mental health was investigated in a sample of Multiple Sclerosis (MS) patients. A correlational analysis was performed to assess the kind of association that exists between stress-coping styles, including problem-focused, positive emotion-focused, and negative emotion-focused coping styles, and mental health, (psychological well-being and psychological distress).

One hundred and twenty patients, (41 men, 79 women), from Iranian MS Society were included in this study. All participants were asked to complete Tehran Coping Styles Scale (TCSS) and Mental Health Inventory (MHI). Analysis of the data involved both descriptive and inferential statistics including means, standard deviations, multivariate analysis of variance, Pearson's correlation coefficients and regression analysis.

The results revealed that positive emotion-focused coping style was positively associated with psychological well-being and negatively associated with psychological distress.

It can be concluded that psychological well-being and psychological distress of MS patients are influenced by emotion-focused coping styles.

Hypothyroidism may cause symptoms and disorders in different parts of the body which can lead to speech disorders. This research was done to recognize and identify speech disorders in patients with Hypothyroidism.

This descriptive study was done on 120 subjects with hypothyroidism, with T4 <4.5 μg/dL and TSH >4mU/L. Members of the study team interviewed all subjects, performed a complete physical examination and documented the data on a pre-designed questionnaire. Voice parameters analysis was completed by MDVP soft ware. All data was statistically analyzed. Spearman correlation coefficient was used for quantitative variables and Mann Whitney and chi square tests for qualitative variables.

One-hundred and six patients were females. The prevalence of different speech disorders was as follows: Voice disorders 81 %, Stuttering 11%, Articulation disorders 6%, Hyper nasality 6%. There was a significant decrease in basal frequency, (P<0/001), and a low voices, (bass), was present in 60% of these patients. There was also abnormal increase in most parameters of voice in studied subjects. Dryness of the laryngopharyngeal region was a common complaint, (53%). Prevalence of sensory and auditory signs was more common in women, (P<0.001). Globus sensation was reported only in women and stuttering was more common in men. Voice disorder was the only speech disorder that was directly related to the elevation of TSH level, (p < 0.003).

Voice disorder is the most common speech disorder in hypothyroid patients and may be helpful in the diagnosis of hypothyroidism. Voice disorders are more common in women. Stuttering is prevalent in hypothyroidism and hypothyroidism is an important cause of speech disorders.

Multiple Sclerosis (MS) is one of the most common chronic diseases of the Central Nervous System. Psychological disorders i.e depression, anxiety and stress are common in these patients. Muscle Relaxation Technique (PMRT) is a form of complementary therapy to combat psychological symptoms. The aim of this study was to assess the effect of applying Progressive Muscle Relaxation on depression, anxiety and stress in patients with Multiple Sclerosis.

This is a quasi-experimental study. 66 multiple sclerosis patients were selected with no probability sampling according to specific criteria and assigned to experimental and control groups, (33 patients in each group), by random allocation. Data collector tools included: demographic questionnaire, DASS-21 for assessing depression, anxiety and stress, Self-reported checklists. PMR was performed for 63 sessions in the experimental group for a period of two months but no intervention was done in the control group. Scores for depression, anxiety and stress were checked before the treatment and at one month intervals for two months. Statistical analysis was done by SPSS software.

Student t-test showed that there was no significant difference between two groups in the mean scores of depression, anxiety and stress before the study but a significant difference was found in mean scores of anxiety and stress between two groups, one month and two months after intervention (P<0.05). ANOVA revealed no significant difference as regards to mean scores of depression and anxiety between two groups on all 3 repeated measurements,(P>0.05), but a significant difference in mean score of stress was shown between the two groups, (P<0.008).

PMR is practically feasible and is associated with decrease of depression, anxiety and stress in patients with MS as this technique can promote wellbeing in these patients it should be offered to all patients with multiple sclerosis.

Although postoperative pain has been suitably controlled by new analgetic agents, it is still a major health concern following the operation. The present study was designed to compare the analgetic effect of indomethacin suppository and intramuscular pethidine in post cesarean section period.

For this randomized controlled clinical trial, 204 women subjected for elective or emergency cesarean section were enrolled. They were randomly assigned in 3 groups indomethacin suppository 200mg (68 subjects), intramuscular pethidine 50mg (68 subjects), and placebo (68 subjects). Response to therapy was assessed by Visual Analog Scale (VAS) during the first hour and 8 hours following the second and third dose.

Results revealed a significant pain relief following the first and second dose of indomethacin when compared with placebo and pethidine groups (p<0.05). Meanwhile, pain was significantly relieved 4 hours following the first and second dose of pethidine when compared with placebo, however, the effect was even greater 8 hours later.

Indomethacin suppository could effectively relieve pain during the first day following the cesarean section.

Cervical carcinoma is the second most common cancer among women worldwide. In the Middle East it is the most common malignancy in women. Prognostic utility of squamous cell carcinoma antigen (SCCAg) for cervical cancer, and its correlation with pathologic grading has been demonstrated in several studies. However, no such study has been performed in Iran. The aim of the present study was to investigate the frequency of SCCAg and its correlation with histological stage and grade of tumor in blood samples from cervical cancer patients.

Patients referred to the oncology center of Qhaem hospital in Mashad, during a three-year period, from 1382-1385, were included in the study. Previously untreated patients, and subjects in whom no other parts of body were involved with squamous cell carcinomas, were selected. Pretreatment serum SCCAg levels were measured by RIA.

52 patients qualified for the study. The average age of patients was 52.9 years. The most common presenting sign was bleeding (94.1%). 35 patients (64.8%) were in stage II 26 patients (48%) had grade 1 tumor. 29 patients (55.7%) had positive levels for SCCAg with the average of 15.37 ng/ml and median of 10 ng/ml. According to primary evaluations, there was a significant difference in the level of serum SCCAg with size, stage, grade of tumor and lymph node metastases.

SCCAg was positive in a high percentage of patients with cervical squamos cell carcinoma. It may be regarded as a tumor marker in this cancer.

Handicapped subjects have special social and clinical needs that should be observed. The present study was designed to survey the incidence of congenital anomalies in a rural population aged 5- 19 years in Rafsanjan.

In a descriptive study, we included 1356 subjects who were randomly selected through rural population of Rafsanjan. The incidence of congenital anomaly was calculated for each age group. Parametric and non-parametric tests were applied for data analysis.

Totally, 87 had at least one congenital anomaly that makes an overall prevalence of 63.2 per 1000 person-year. Although the incidence of congenital anomalies had dropped significantly during 1987- 1988, it was increased during 1999-2001. The following factors may be associated with the increased incidence of congenital anomalies: maternal smoking, X-ray, and residing near pistachio gardens.

The incidence of congenital anomalies is quite high in the region. Thus, the responsible authorities should pay further attention to the problem and attempt to recognize the possible predisposing factors besides managing the rehabilitation aspects of the sufferers.

The presence of lead in the industrial fumes, sewage, and also in industrial paints, ceramic, and printing materials, make this element as one of the most common environmental contaminant. Lead can enter the body through respiratory and digestive tracts as well as through the skin and with progressive accumulation can have a destructive effect on several organs in the human body. Blood lead level is used as an index of lead contamination. Since Arak is an industrial city there is a danger of lead poisoning in its residents.

In this cross-sectional research, 1140 individuals >10 years old were selected randomly from 20 population clones by the use of family codes. After face-to-face interview and a complete physical examination, blood samples were taken for laboratory tests: CBC, BUN, uric acid, creatine, and blood lead level. Collected data were analyzed by SPSS and Excel software and the association between blood lead levels and clinical symptoms was evaluated by logistic regression and one way ANOVA. A p-value less than 0.05 was considered significant.

From 1140 investigated residents, 463 individuals, (40.5%), had blood lead levels more than 10 micgr/dl, (range 10-66 μg/dl, mean 13.42 μg /dl). There was no significant difference between males and females, (P>0.05). The difference between age groups was significant, school-age children had the highest and housewives the lowest blood lead levels. We found a significant association between high blood lead levels, anemia and hypertension, (P<0.001).

Lead contamination is present in all age groups in the residents of Arak city. Young people are the most susceptible group for lead poisoning. High blood lead levels count as risk factors for hypertension and anemia. We recommend that the sources of lead contamination must be eliminated from the environment in all industrial cities like Arak.

Acute poisoning is a significant mental health problem all over the world. Poisonings are a well-known cause of morbidity and mortality in adolescents in Iran. The main aim of this study was to determine the pattern of poisoning in adolescents admitted in Loghman-Hakim hospital, the only referral center for poisoning in Tehran.

In a six- month cross-sectional study (23 Mar to 23 Sep 2003), all 12-18 years cases of poisoning admitted to Loghman-Hakim hospital were reviewed. Demographic data were reviewed for each case. SPSS Version 11.5 was used for analysis the data, α=0.05 was considered as the level of significance.

A total of 12548 poisoning cases were admitted during this period, of which 2485(19.8%) had occurred in the adolescents, mostly students. Most cases 1674, (67.4%), were treated as outpatients. The majority of cases occurred in youths aged 17- 18 years, mean age 16.7 (±1.3) years. Most incidents of poisoning occurred in females (1529 cases, 61.5%), singles (2254 cases, 90.7%), and high school students, (1258 cases, 50.6%). The majority of events happened at home, (2223 cases, 89.5%), by oral ingestion, (2392 cases, 96.3%), and as an act of deliberate self harm, (2038 cases, 82%). Psychotropics were the most common agents, used in 1504(49.5%) cases. 324(13%) cases had a previous history of deliberate self poisoning. The mortality rate was 0.44%.

Most poisonings were intentional. Young girls are at risk for deliberate self-poisoning.