نشریه یافته
سال پنجم شماره 17 (پیاپی 12، تابستان 1382)

In age group of 5-12 no significant difference was observed between the two kinds of wheat. Iron deficiency anemia is one of the most common problems in the world. This study was carried out to determine the effect of consumption of whole bread baked from cultivated wheat with microfertilizers on blood indices of iron. In this field trial and double blind research two villages (Tajaragh as case and Khaneghah as control) in East Azarbaijan province of Iran were studied. Three hundred and fifty persons of each village were selected based on random sampling. In beginning of the study 5cc blood was taken of each participant. The number of participants were 257 and 268 in Tajaragh and Khaneghah, respectively. Hemoglobin (Hb), Iron, TIBC (Total iron binding capacity), and serum ferritincopper were determined. Transferrin saturation (TS) was calculated. Food consumption was carried out using 24 hours recall (one day) and foodstuff record (two days). Bread was provided in bakeries of the villages. Case village consumed whole bread cultivated with micro fertilizers while the control village has taken regular whole bread for 4 months. At the end of the study the same mentioned above indices were measured. The number of participants in this stage decreased to 160 and 152 persons in case and control, respectively. Independent t test and paired t test, Wilcoxson and Mann whitney’s tests were used for comparing. Results in different groups were as follow: Consumption of bread and intake of micronutrients were similar in the two villages. Hb concentration in 5-<12 age group was increased in both case and control groups (P<0.05). But in other age groups it was not significant. In all age groups of the case village, TS was increased (p<0.05).Serum ferritin in both villages was decreased (p<0.01).

Blink reflex (BR) is a new electro diagnostic test mediated through a reflex arch with fifth cranial nerve in its afferent and seventh cranial nerve in its efferent side. BR responses are designed R1, R2 and R2c responses. Anatomic locations of this reflex arch in central nervous system are still undefined and various results have been reported in different studies, for example in hemispheric strokes, exclusive abnormalities of R2 responses or abnormalities in both R1 and R2 (unilateral or bilateral) have been reported. Twenty patients with hemispheric strokes were evaluated during 1.5 year period and were compared with age and sex matched normal volunteers. BR was performed in similar circumstances in both groups and results were compared with each other. BR was abnormal in 19 patients and was normal in only one patient. R1 response was normal in 18 patients and was prolonged in two patients. R2 response was absent or prolonged in 18 patients (in 15 patients bilaterally) and was normal in two patients. The most prevalent observed risk factors in the study population were Hypertension and Diabetes mellitus respectively. BR was abnormal in 95% of the patients and R2 response abnormalities were detected in 90% of the patients (Bilateral in 75%). The most common observes pattern of BR abnormalities in hemispheric strokes was bilateral absence or prolongation of R2 responses.

Hematopoiesis is an on going process mammalian marrow system. A few cells from the nucleated cells of bone marrow are hematopoietic cells which include primary stem cells, precursor cells and progenitor cells. Primary stem cells and progenitor cells are able to produce colonies in culture medium (CFU-C) and irradiated mouse spleen (CFU-S). A hematopoietic cell is alive and active when it can produce colonies and proliferate otherwise it is practically a dead cell. These cells are subject to damage from chemical or physical agents such as chemothrapeutic drugs or ionizing radiation. In the present research 150 balb/c mice were bought from Razi institute, as well as daunorubicin, which is an important drug for treatment of acute myeloid leukemia, was used as a destructive agent for bone marrow and cimetidine was used as a protective agent for bone marrow against daunorubicin. In this research one of the methods of in vivo stem cell assay. Which is called spleen colony assay, is used. The basis of this method is injection of bone marrow hematopietic cells into irradiated mouse (Supralethal irradiation). 8 to 10 days after injecting bone marrow cells stem cells produce colonies in spleen of irradiated mouse each colony represents one primary hematopoietic cell. By the method of spleen colony assay it was shown that daunorubicin at doses of 5 to 20 mg/kg will decrease the number of colonies formed in spleen. On the other hand it was shown that cimetidine in concentration of 15 mg/kg will decrease the toxic effects of these drugs and will cause an increase in spleen colonies and relative survival of mouse bone marrow cells. Cimetidine will possibly cause its relieving effects by neutralizing histamine free radicals through decreasing the activity of cytochrome P450 and increasing glutathione and increasing glutathione activity. Cimetidine is able to reduce the cytolytic and cytotoxic effect of daunorubicin on nucleated cells of mouse bone marrow.

In the recent years, effect of hypertonic solution in resuscitation of shock has been shown by clinical and laboratory studies. On the other hand ATP-MgCl2 is used for better tissue perfusion and cardiac output in shock. The aim of this study is evaluation of ATP-MgCl2 with hypertonic solution in resuscitation of hemorrhagic shock. In this experimental study 21 rats were divided into three groups. After anaesthesia, induced hemorrhagic shock with bleeding and shock was for 30 minutes then the solutions were infused.Group1 received hypertonic solution NaCl 5%, group2 ATP-MgCl2 and group3 both solutions and then systolic, diastolic, mean arterial blood pressure, serum electrolytes (Na+, K+), serum albumin, protein, and serum and urine osmolality before, and after one hour of shock were measured. Results showed that systolic BP in the first 15 minutes after resuscitation in group 1 and 3 was greater than group 2(p<0.05) and between groups 1 and 3, group3 that received both solutions, showed greater elevation in systolic BP but it was not significant. 60 minutes after resuscitation, mean arterial pressure in group 1 showed significant increase than other groups. Increasing in Na+ concentration in groups 1 and 3 had significant differences than group2. Albumin concentration in-group 2 was significantly greater than the other groups. There was no significant difference in other factors. It seems that ATP-MgCl2 alone or with hypertonic solution have no additional beneficial effect, than hypertonic solution, on hemodynamic and laboratory parameters in hemorrhagic shock.

Bacterial meningitis is still one of the most dangerous infectious diseases and causes serious complications and mortalities in children. The aim of this study was to identify the most common of bacterial agents causing meningitis in children under 10 years old and to detect their resistance to antibiotics in patients who referred to the educational hospital of Hamadan. Overall 582 children suspected to meningitis were investigated for CSF cultures, frequency of age groups, sex and seasons and antibiogram patterns from 1998 to 2000. Data were gathered through a questionnaire and analyzed using Epi6 software. The species were identified by biochemical and serological methods. Antibiogram tests were also performed by Gel- diffusion method of Kirby- Bauer. Out of 582 children suspected to meningitis, 46 cases (7.9%) had positive bacterial culture that 58.9% were gram positive and 41.1% were also gram negative bacteria. The most common species were S. pneumonia 23.9%, S. aureus 13.1%, E. coli 10.9%, N. meningitis and P. aeroginosa each 6.5% respectively. The most positive cases were observed in children 0-2 age group (28.3%), male (54.4%) and during Autumn (43.7%). The results of antibiogram showed that the most effective antibiotics were ceftizoxime, kanamycin and gentamycin for both gram positive and gram negative bacteria, but they showed high resistance to amoxicilin, ampicillin and chloramphenicol. The present study showed that gram positive bacteria in particular, Streptococcus pneumonia and Staphilococcus aureus are predominant causes of bacterial meningitis in children under 10 years old in these regions. Most species showed high resistance to routine antibiotics such as amoxicillin, ampicillin and choramphenicol.

Urinary tract infection is a common bacterial infection in childhood. Approximately 3-5% of girls and 1% of boys acquire a urinary tract infection (UTI). The management of UTI is complicated by the increasing prevalence of antibiotic- resistant strains and over the - counter antibiotics empiric therapy with antibiotics such as ampicillin, amoxicillin and cotrimoxazole world cost more and lead to widespread antibiotic resistance. In this study we aimed at assessment of prevalence of antibiotic resistance in 127 patients with positive urine culture based on antibiogram results. This cross- sectional study was performed in Khorramabad Madani hospital during 2001-2002. 62/2% of the patients were female and 37.8% were male. Culture results were: Ecoli (73.3%), proteus (12.6%), klebsiela(9/4%), Entrobacter(3.1%), Citerobacter (0.8%), Yersinia (0.8%). Overall antibiotic resistance was 96.9% and resistance to antibiotics, were: Ampicillin(88.2%), Amoxicillin (86.6%), Cotrimoxazole (75.6%), Nitrofurantoin (18.9%), Nalidixic acid (10.2%), Cefixim (4.7%), Ceftriaxon (3.1%) Gentamicin (11.8%), Amikacin (3.1%). Results showed that antibiotic resistance for over- the counter antibiotics was significant.

Since long time ago parasitic problems have been taken into consideration by people and physicians in our country and at present, parasitic diseases are among important healthy problems of our community. This study aims at determination of intestinal parasites prevalence in Khorramabad bakeries’ workers. In this study all the bakeries of the city (270 bakeries) were studied. By using formalin- detergent method all of 993 workers of these bakeries were examined. Results showed that total frequency of intestinal parasites was 13.2%. Among them 12.4% infected with one parasite and 0.8% infected with two parasites. The most frequent infection, related to Giardia lamblia (7.9%). Results also showed that intestinal parasitic infection was less in people with higher education, as well as to be familiar with transmission ways of infection results in reduction of infection prevalence. Compairing between two groups of workers with and without Healthy Card, shows no significant difference from view point of infection rate. stool examination and test in every three month intervals using better methods of concentration, exact supervision and exertion of healthy rules by health responsible and also direct education about individual and social health, and. ....

Diagnosis and localization of offending glands in hyperparathyroid patients is a subject that has always concerned surgeons. Until two decades ago this could only be achieved through complete neck exploration by the surgeon. In recent decades, with introduction of better imaging techniques such as advanced sonography and isotopic scans, remarkable progress has been made in this field. To evaluate these techniques a study was designed and performed. This is a retrospective descriptive study in a group of patients with primary hyperparathyroidism who underwent parathyroidectomy in Imam Khomeini General hospital and Dr. Shariati General hospital, Tehran university of medical sciences, during the years 1989 to 1998. The purpose of this study is to evaluate the sensitivity and accuracy of the available imaging facilities in diagnosis and localization of the offending gland(s), compared to intraoperative findings. 61 patients were studied. 11 men (18%) and 50 women (82%) 47 single adenoma (77%), 2 multiple adenoma (3%) and 12 hyperplasias (20%) were reported. 24 patients with single adenoma had MIbI scan with a sensitivity and accuracy of 70% and 100%, respectively. In all cases of multiple adenoma and hyperplasia who had MIbI scan, the results was false negative. Sensitivity of Th-Tc scan for single sadenoma was 33.3%. Sonography had a sensitivity of 71.5% for adenoma and 40% for hyperplasa with 100% accuracy for both of them. Sensitivity and accuracy of intraoperative diagnosis and localization for adenoma was 100% and 96.7%, respectively. For hyperplasia these figures were 83.3% sensitivity and 100% accuracy. According to the results in diagnosis and localization of offending gland(s) in primary hyperparathyroidism, intraoperative judgment of experienced surgeon has a higher sensitivity and accuracy than available imaging facilities. This is specially true for multiple adenoma and hyperplasia. Therefore, we suggest that still during surgery for hyperparathyroidism all parathyroid glands should be explored, and limited dissection directed by imaging findings should be avoided. However, with increasing experience and introduction of new technologies such as radiotracing, one may expect better results from imaging day by day.

Coronary artery disease (CAD) is among the most common, serious, chronic and life- threatening illnesses in the world. CAD represents a spectrum of conditions, with acute myocardial infarction at one end of it and silent ischemia at the other. There is growing evidence on importance of prognosis of C- reactive protein (CPR) in unstable angina and this protein is a maker of an adverse prognosis. In this cross- sectional research. We study all of the patients that admitted in the coronary care unit of the Shahid Rahimi hospital with unstable angina (n=32) and acute myocardial infarction (n=32), but exclude the patients with exclusion criteria. Complete clinical data and blood samples for laboratory measurements were collected on admission. A baseline ECG were obtained at entry and 12 hours later. A CFM echocardiogram was performed within initial 24 hours. Serum CPR levels were measured on admission and at time of hospital discharge. All patients were followed up for 14 days after discharge. Patients with MI showed a striking higher CPR during the duty period than with UA. The occurrence of cardiac events at 14 day follow up was related to CPR level at 48 hours and hospital discharge (p=0.02). CPR levels correlated inversely with ejection fraction (r=-0.44). Our data demonstrated that the CPR were significantly higher in patients with acute myocardial infraction than patients with unstable angina. Elevated levels of CPR were associated with cardiac events out of hospital during a 14- day follow up.

Trauma is the 3rd major cause of death in urban areas, and cardiac penetrating injury is one of the most important causes of it. Vital signs, mechanism of injury and cardiac tamponad are the important prognostic factors in this patients. At about 70% of alive injured patients have not any clinical symptoms related to cardiac injury, for this reason early diagnosis according to clinical setting with proper use of diagnostic procedure influence on the patients, survival. Early thoracotomy and cardiography is the management of choice in this patients. Cases Report: This study considered five patients who were referred to Shohada hospital in Khorramabad during 8 months. All of them were evaluated in 3 stages (pre operative, intra operative and post operative) One patient (an 8- year old girl) injured with small shot accidentally and the other 4 patients were injured due to stab wound. Sites of injury include left parasternal border (3 patients) right parasternal border (1 patient) and subxyphoid area (1 patient). Sites of laceration include left ventricle (2 patients) right ventricle (2 patients) and right atrium (1 patient). Two patients showed post operative complications including Rt.B.B.B and weakness in right brachial plexus due to thoracotomy position.