فصلنامه علوم پزشکی دانشگاه آزاد اسلامی مشهد
سال سوم شماره 3 (پیاپی 11، پاییز 1386)

Cabergoline (CAB) is a new oral dopaminergic compound showing a very long-lastingPRL-lowering activity. The Purpose of this study is to evaluate the efficacy, side effectand tolerability of the treatment with CAB in female hyperprolactinemic patients.We conducted a cross-sectional study on hyperprolactinemic women. The patients underwent the treatment with either Bromocriptine or Cabergoline over a period of 6 months.The initial dose of Cabergoline to be taken by the patients was 0.5 mg once a week andsubsequently increased to 1-2 mg. per week. The initial prescribed dose of Bromocriptinewas 1.25 mg/d, which was subsequently increased to 7.5 mg/d. Then, throughoutthe study, the effectiveness and tolerability of the treatment with both Bromocriptine andCabergoline were evaluated in the patients with hyperprolactinemia.Treatment with Bromocriptine normalized the serum PRL level (< 20 mcg/L) in 48% ofthe patients while in the Cabergoline group, the serum PRL level declined to normal in77.7% of the patients. The comparison of the two groups showed that Cabergoline wassignificantly more effective than Bromocriptine in suppressing PRL secretion (P<0.001).The clinical efficacy of the drugs was clearly demonstrated by the resumption of mensesin 68% and 83.3% of the patients in the Bromocriptine and Cabergoline groups, respectively(P<0.01).Six months after the therapy, a computed tomographic scan was performed on 15 patientswith either microadenoma or macroadenoma. The results showed reduced size of the adenomain 33.3% and 55.5% of the patients in the Bromocriptine and Cabergoline groups,respectively (P<0.01). In the Cabergoline group, side effects were noted in 44.4% of thepatients, but only 11.1% of them discontinued the therapy because of side effects. Thecomparison of the two groups showed that the number of patients requiringdiscontinuation of Bromocriptine was significantly higher (36% vs. 11.1%, P< 0.001).We conclude that CAB is an effective treatment for hyperprolactinemia and often bettertolerated than Bromocriptine. Its efficacy, tolerability, and long duration of action makeit the drug of choice for patients with hyperprolactinemia.

Syphilis and AIDS both are sexual transmitted diseases that can be assumed as predisposing factor for each other. Immune deficiency in AIDS facilitates other infections and genital ulcers in syphilis increase the risk of HIV transmission. The aim of this study is to evaluate the prevalence of HIV infection in VDRL positive patients.Serologic studies were done on 100 seropositive cases using VDRL and confirmed by RPRtest (25males-75females). HIV infection was also evaluated by ELIZA test in a private laboratory in Mashhad. Most of the cases (72%) were received from gynecology and obstetrics clinics for screening before pregnancy.The subjects’ average age was 31.5±12.45 years (21-46). 75% were females and 93% were married. 72% had low level of education and 89% were either housewives or didn›t have any job. A history of previous STD was reported in more than half of them and 2 cases were IV drug abuser. HIV infection was seen in 3 cases (3%). Two of the cases had IV drug abuser partners while the other one was a single IV drug abuser.3% of RPR positive cases were identified with positive anti HIV antibody. Thus, we suggest informing high risk cases such as young criminals, sex workers and IV drug abusersabout STD as well as having supportive plans for the wives of IV addicted cases.

One of the common complaints made by patients with psychiatric disorders ispseudoneurologic symptoms. To find the causes of these symptoms, standard neurologicalexamination and its analysis are very important.This is a descriptive-analytic study with simple sampling among 100 patients withpsychiatric disorders (According to DSM IV criteria). Standard neurological examinationwas performed for all of them. Grasping, palmomontal and glabellar reflexeswere also evaluated.83/8% of the patients were identified with hyperreflexia and 42.4% of them withHoffman sign complete or incomplete sign. In all the cases, these findings were symmetric.None of them had babinski sign. Achill clonus was detected in 3%. PalmomentalReflex was also detected in 28.8% of the patients which was more commonamong psychotic patients that were statistically meaningful.The prevalence of hyperreflexia is a very common among different psychiatricdisorders and should be cautiously interpreted by physicians. Hoffman sign was notas acute as babinski sign in our observation and may be symmetrically detected inpsychiatric disorders. Palmomental reflex could be regarded as a sign of psychoticdisorders and we think that the presence of it should guide the physician toward thepossibility of occurrence of psychotic symptoms.

Middle ear infections are the most widespread ENT disorders in children. The destructive effects of passive inhalation of cigarette smoke on intensifying these disorders have been being researched for many years. Moreover, the daily increase the population of the smokers in the society signifies the necessity of the current research. The main objective of this research is to analyze any relation between the occurrence of Otitis media in children and the presence of a smoker in their family. This cross-sectional study was done over a year and half in Islamic Azad University Hospitals in Mashhad. Among 70 patients, we chose 49 children aged 5-15 years, whose parents were smokers. The study was a questionnaire-based study. Variables such as clinical symptoms, site of involvement and parents’ level of education were evaluated. The obtained data was analyzed using SPSS software. Our study shows that in 70% of the patients, there was a meaningful relation between the occurrence of Otitis media and passive inhalation of cigarette smoke. In 89.7 % of the patients, the exposure time was less than 12 hours in a day. The parents’ literacy level was at high school diploma and the lower in 85% of the subjects. The most common problem was ear ache. This research shows that cigarette smoke has important effects on increasing the infection of the middle ear. So, it is strongly recommended that parents be prohibited from smoking in the presence of children.

Urinary tract infection (UTI) is the most common disease during pregnancy and usually symptomatic infections are due to asymptomatic bacteriuria (ASB). Untreated ASB has some serious consequences for both the mother and her fetus. Because of the importance of ASB screening in pregnant women, this study was conducted in order to determine the prevalence of ASB and its potential relation with some factors and with the pattern of drug. sensitivity, as well We conducted a cross sectional study in 900 pregnant women who attended the antenatal service at Hazrate Zeynab outpatient clinic, in association with Tehran University. All the participants were visited by obstetricians. A clean-voided urine specimen containing more than 100,000 organisms per ml. was considered as evidence for ASB. Then, an anti biogram. was made using Bauer Kirby method The prevalence of ASB was found to be 3.7% and the most common micro organisms detected were Escherchia coli (33.3%) as the most frequent one followed by negative coagulase Staphylococcus (30.3%) and klebsiella (15.2%). In pregnant women both with and without ASB, there were statistical differences according to the mean of age (p< 0.001), gravidity (p< 0.05) and parity(p< 0.05). There was no statistically meaningful relationship between group with and (the group) without ASB in (terms of a) history of urinary tract infection and/or Kidney stone. The highest sensitivity was determined to be related to Amikacin. The prevlence (level) of ASB was high in second trimester of pregnancy, elder and multiparous. women, as well In regard to the high Prevalence level of ASB in the Second trimester of pregnancyrepetition of urine analysis in the second trimester of pregnancy, specially in the old and multiparus women is recommended. Considering the pattern of anti microbial drug sensitivity, the use of suitable drugs is recommended. Other studies on both the treatment and. follow-up studies on pregnant women with ASB are necessary.

AIDS has been regarded as a great health problem in many countries in the recent years.By the end of year 2003 about 44 million people were reported to be infected by HIV. There are about 14000 patients in Iran who have been identified with the virus and it is estimated that there might be about …… more who haven’t been identified, yet. Regarding a change of the population being infected by the disease from IV drug abuser to those involved in high risk sexual relations, this study tends to pay attention to the population of women who are at risk. Furthermore, there are not many studies that have examined women‘s knowledge about the disease; therefore, we decided to carry out this study because of the important role of women as mothers in Iranian sociality who play an educating role in their families. We conducted a cross sectional study on 500 women who came to the hospital for gynecologic/ obstetrics periodic checkups. A questionnaire was developed after pre-testing and standardization, which asked the participants about their gender, age and occupation as well as whether they knew someone close to them with HIV/AIDS. A five-ranking scale was used to score the answers. Using SPSS software version 14, the data were analyzed and a test of logistic regression revealed significant results in terms of their age, education and knowledge about AIDS (p<0.01). The average age of the participants 500 was 33.4±5/6 with Confidence Interval of 95%, ranging from 14 to 62 years old. Most of the participants were married (80.1%; N=407). In terms of their knowledge about AIDS on a 5-level scale, the results ranked as: excellent (12.2%), good (24.6%), moderate (43.4%), weak (43,2%) and bad (5,6%). There were significant relations between the level of knowledge and education level (p=0,000) as well as that and age (p=0.00). There was not any relation between the participants’ job and their level of knowledge about AIDS (p>0.1). In our study, juvenile showed to have more knowledge about AIDS that can attribute to the education they have received. With a special attention to this age group, their knowledge about sexual relations and using the same needle as the most frequent ways of spreading the infection was good. With respect to the Participants’ ideas, it seems TV is the best way of education. Thus, it is recommended that a medical team, including physicians educate women in occasions such as a pre-natal care period and pregnancy visits.

Respecting patients ethics and attempts to establish a framework for it, research shows a continuous background in the history of the country’s concern for hygiene which could lead to the patients’ satisfaction. The goal of this study is to survey the level of doctors’ and paramedical personnel’s knowledge and attitude about the patients’ prism ethics in dependent hospitals of medical faculty of Shahrood in the year (2003; i.e.) 1385(H.S.) This research is a cross-sectional and applied study. Because of a limited research community on one hand and a need for accurate information on the other, half of the research community has been studied by systematic, non stratified and non probability sampling method. The questionnaire consists of 6 general questions and 32 professional questions in an attempt to survey doctors’ and paramedical personnel’s knowledge and attitude about patient right’s prism. The data were analyzed using Spss and INSTAT soft wares and the results have been showed in tables and figures. The results of the analyzed data showed that 24.2% of the interviewees were males and 75.8% of them were females. 77.5% of them worked in Imam Hossein hospital while another 22.5% worked in Fatemie hospital. 77.4% of the interviewees were holding a degree of Bachelor and upper and the other 22.6% were of a lower level in terms of educational background. 18.1% of them were nurse assistant; 60.4% were nurse; 10.4 were doctors and the rest were included in other fields. 53.3% of the participants were informed about patient’s prism rights. 18.1% of them had gained their knowledge by means of educational seminars and conferences and the rest in other ways during their course of study. The hospitals had offered education terms for 15.9% of the cases while another 84.1% hadn’t received any education, whatsoever. As for the participants’ knowledge, the average grade was 16.38 totals was 20. It showed good knowledge in terms of research samples. Regarding their attitude, the average grade was 17.09 of a total of 20. It showed the presence of positive attitudes among them. Pierson test showed ameaningful relation between the variables of knowledge and attitude. Speerman’s test confirmed it, too (P = 0.0001). As the research finding show, there is an acceptable level of knowledge and attitude among the doctors and personnel of the hospitals. Because of the meaningful relation between knowledge and attitude, we recommend that the hospitals have plans to further inform their personnel about patient›s rights prism.

This study aimed to evaluate intelligence quotient of 5-11 years old children with adenoid hypertrophy who had clinical manifestations of upper respiratory tract obstruction. This is a case-control study on 20 children with adenoid hypertrophy who also had upper respiratory tract obstruction manifestations such as snoring, hard breathing and/or breath shortage during sleep. A modified version of Wechsler intelligence test was demonstrated on these children and the results were compared with 20 healthy children as the control group. The data were then analyzed using chi square and T-test to calculate the P value. The comparative study of the total scores obtained by both groups of the study in the verbal Wechsler intelligence test didn›t show any significant difference between the two groups (P=0.6). However, the comparison of the total scores obtained in practical Wechsler intelligence showed a significant difference between these two groups (P=0.001). Finally, there was a significant difference between the measurement of control tendency in the total scores obtained by the case and control groups in Wechsler intelligence test (P=0.006 Adenoid hypertrophy cases that have upper respiratory tract obstruction manifestations are different from normal children in some aspects such as, visual accuracy, visual conception, ability of perception, awareness and concentration, visual- motor organization, programming or prediction, perception, organizing, coordination and rapid visual¬ motor functions, rapid functioning, suitable motor response to conceptive impulses and non verbal communications. There wasn›t any difference between these cases and healthy children in rapid speaking, verbal memory and ability to use abstract concepts.