مجله دانشگاه علوم پزشکی رفسنجان
سال دوم شماره 2 (پیاپی 6، بهار 1382)

Conventional dissection suturing technique and Plastibell circumcision are the two most widely used methods of circumcision in Iran. We conducted a clinical trial to assess the complication, cosmetic results, and duration of the procedure using the two techniques. 2185 infants under the age of one were circumcised at two hospital centers, from April 2000 to March 2003. The infants were randomized to one of two groups group A, using the plastibell device (n=1085), and group B, using the conventional technique (n= 1100). All infants received dorsal nerve block with Lidocaine 2%. The two groups were evaluated for complications and cosmetic results immediately follwing the operation and 4-10 days later. The parents were told to notify the surgeon if meatal stenosis occurs. Comparisons were made regarding the complications, cosmetic results, and duration of the procedure. The incidence of bleeding in the plastibell group (A) was 3 infants (0.3%), significantly less than the convention group (B) which was 11 infants (1.0%)(p=0.030). In group A, local infection resulting in further surgery did not occur, but 3 infants (0.3%) in group B needed further surgery due to local infection (p=0.127). The Plastibell circumcision resulted in poor cosmetic results for 3 infants (0.3%) compared to 9 infants (0.8%) in the conventional group (p=0.076). The mean operation time (± SD) was shorter for Plastibell circumcision (4.08± 0.81 vs 18.13± 1.87 minutes). We recommend circumcision for infants using the Plastibell technique, because of the results of this study which indicated less complications and shorter duratrion.

The evaluation of blood lipids and lipoproteins especially the ratio of them is one of the initial action in assessment of the vascular performance. In recent years, the evaluation of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subgroups have become important to determine the vascular efficiency. Therefore regional research to evaluate these subgroups is essential. HDLs reduce the risk of cardiovascular diseases thus, they are the main anti-risk factor for the coronary heart disease (CHD) especially atherosclerosis and myocardial infarction. HDLs grossly consist of two subgroups, HDL2-C and HDL3-C. Many studies have shown that reporting HDL2-C subgroup is more useful than total HDL-C. The aim of this study was to determine the concentration of HDL-C, HDL2-C, and HDL3-C and relating them to coronary heart disease, in a number of patients hospitalised in Dr. Heshmat,s Hospital of Rasht. The relationship of plasma level of lipid status such as total cholesterol (TC), total HDL, HDL subfractions (HDL2, HDL3), TAG, LDL, VLDL, to the incidence of coronary heart disease (CHD) was measured by enzymatic and precipitation methods, in 191 sera from 125 men and 66 women (15-73 years old), who were referred for coronary angiography, in angiography department of specialized Dr. Heshmat hospital in Rasht. From the 191 patients, 58 (37 men & 21 women 15-70 years old) were found to have no CHD and 133 (88 men & 45 women 31-73 years old) had CHD assessed by coronary angiography. Statistical analysis (student's t-test) Showed a significant correlations between the concentration of TC, TAG, LDL-C, VLDL-C, HDL-C, HDL2-C, LDL-C/HDL-C, HDL2-C/HDL3-C, TC/HDL-C and CHD (p<0.05). There was no significant difference between HDL3-C, TC/LDL, and HDL2-C/HDL. The findings of this study suggest that factors that influence CHD risk do so in part through modifying HDL2-C levels. Moreover in many cases the ratio of HDL2/HDL3,TC/HDL and LDL/HDL can be used instead of measurment of these factors individually.

Listeria monocytogenes is frequently transmitted from contaminated food such as cheese, raw vegetables, prepacked salad and etc, to humans. This bacteria can grow inter and extracellular. The aim of this study was to present a simple practical method for isolation of this bacteria from cheese, and detection of it in Hela cell culture by light microscopy In this experimental study, the sample of fresh local cheese was suspended in selective enrichment medium with yeast extract and kept at 4ºC for one week. Then, the sample was diluted with potassium hydroxide and cultured on Palkam and Listeria Selective agar. After colonies appeared, they were examined for the existance of L. monocytogenes and then were inoculated in Hela cell culture. Samples were taken intervally (12, 24, 36, 48 hrs), stained with Gimsa, detected by light microscopy and photographed. This study showed that 9% of fresh local cheese was contaminated by L. monocytogenes. Pictures, taken by microscope, indicated that this bacteria in concentration more than 5x105 after 12 hours can enter into hella cells and after 48 hours lysed the host cells. The results of this study showed that L. monocytogenes exist in some contaminated local cheese. Contamination of dairy products by Listeria monocytogenes can occur during preparation, transport and distribution. So, because of the high consumption of these products in our country, it is necessary to specific surveillance of the production and distribution of dairy products to prevent the incidence of listeriosis in susceptible people.

�psychiatric disorders are common and they have adverse effects on social activities of affected individuals. Special groups such as orphans are more vulnerable to these disorders. The aim of this study was to identify psychiatric problems in orphaned girls living in foster care institutions of kerman �In this cross – sectional study 150 orphaned girls over 15 years old were living in Kerman foster care institutions were randomly selected. They were matched for age and level of education with 150 non orphaned high school girls. The two groups were assessed by means of SCL-9-R test. SCL-90-R test containing 90 items is a diagnostic instrument for evaluating psychiatric disorders. The cut off point of 0.4 has been reported for Iranian society. The scores and point prevalences of all scales of SCL 90-R were higher in orphans compared to the control group. The highest and lowest scores in both groups belonged to paranoid thoughts and phobia scales respectively. The highest and lowest point prevalences in both groups belonged to somatic complaints and phobia scales respectively. Point prevalence for all scales was 90.33% in the case group. �High point prevalence for all scales in orphans showed high vulnerability of orphans to psychiatric disorders. Regular psychiatric evaluation and on time referral for treatment could improve their mental health status.

Infection is the major cause of death in thermal injury patients. S evere suppression of the immune system is the major cause of infection following burn injury. The aim of this study was to modulate the cell-mediated immune response by the use of cimetidine and pyrimethamine in an animal burn model. Male Balb/c mice were anesthetized, and given a 10% total body surface area full-thickness burn. Then the delayed type hypersensitivity (DTH) to sheep red blood cell (SRBC) and the effects of different doses of immunomodulators (cimetidine 5,10 and 15 mg/kg and pyrimethamine 2.5,5,10 mg/kg) on this response were quantitated ten days after the burn. The marked suppression of DTH was observed ten days after burn,s trauma. Cimetidine (at doses of 10 and 15 mg/kg) and pyrimethamine (at doses of 5 and 10 mg/kg) significantly augmented DTH response after thermal injury. Cimetidine and pyrimethamine did not exhibit any effect on DTH response at doses of 5 mg/kg and 2.5 mg/kg respectively. These results indicated that severe suppression of DTH responses occured after burn injury. Cimetidine and pyrimethamine prevented inhibition of DTH response following thermal trauma.

prevalence of intestinal parasites is one of the important indices of health in any community and combating with these parasites is one of the important parts of national expanded programs in the tropical countries. This study was conducted to determine the intestinal parasites and related factors among Bam,s day care centers. In this analytical descriptive study 370 day care center children were selected randomly-stratifyial. Data were collected by means of questionnaire consisting of information such as age, sex, parents, educational level and job, place of living, type of Day Care Center, infant nutrition, weight at birth, and number of children. Two methods were used to detect the presence of intestinal parasites, direct exam and Formalin-ether concentration method at three consecutive times. The scotch tape method was used to examine the Enterobius verrmicularis. 47 percent of the subjects were infected by one or several intestinal parasites. The prevalence of intestinal helminths were 3.24% and intestinal protozoa were 43.76%. Contamination rate in boys was 43.1% and in girls it was 56.9% and among the day care centers located in urban and rural areas contamination rate was 51.7% and 48.3%, respectively. A significant relation was found between place of day care center, parent,s educational level and job, weight at birth time, number of children, number of family, and parasitic infections (p<0.05).The relationship between sex, age and parasitic infections was not significant. Most of the infected children were among 6-7 years old. It is recommended that continuous education for children and their families about personal health must be a criteria in health implementation in day care centers and at admittance to the day care centers, parasitological tests should be done three times in one week.

Acute Abdomen Syndrom is one of the most frequent referal cases to the emergencies of hospitals all over the world. At the present, it is one of the most important causes of high mortality of human beings in all of the societies. The ethiology of acute abdomen syndrom is different in various geogrophical regions. It is very important to know the actual cause in order to prevent the unnecessary operations as well as prevention of undesirable side effects of operations Statistical data was collected from 898 patients, who were referred to the emergency unit Ali Ibn Abitaleb hospital due to acute abdomen syndrome and which were hospitalized. The data were analyzed in this retrospective study. This study was carried out whithin five months of the starting date. The patients were followed up until the final diagnosis was performed. The suspected patients of sufering acute abdomenal disorders were repeatedlly examinated physically in the hospital ward during the hospitalization in order to differentiate them in acute abdomen syndrom. Statistical analysis by Chi-Square test (P value < 0.05) indicated the following Among the referral patients, 492 persons were female (55%) and 406 persons were male (45%). The most frequent age group of patients were between 10-20 years old. The most frequent clinical symptoms that was observed in physical examinations were severe abdomen pain, lack of appetite nausea and vomiting. The most frequent cause of acute abdomen syndrome in reffral patients was non-specific pain of abdomen due to appendicitis and renal colics in men and non-specific pain of abdomen due to appendicitis and ovarian cysts in women. 5) Out of 898 patients, 391 of them required surgery (43%) and 507 patients recovered without needing surgery (57%). Nonspecific pain of abdominal region was the most frequent reason for admission to the emergency unit of the Ali Ibn Abitaleb Hospital of Rafsanjan Medical University. The frequency rate of appendicitis reported in previous studies were less compared to this study (both in men and women). However, intestinal obstruction cases were the least frequent cases in this study. The most frequent misdiagnosis were was in for women. We found that the patient’s history and physical examinations are very important factors for acurate diagnosis and discovering the etiology of the acute abdominal syndrome especially in female patients.

Glucose galactose malabsorption is a rare genetic disorder caused by a defect in glucose and galactose transport across the intestinal brush border. It is characterized by the neonatal onset of sev+ere, watery, acidic diarrhea. In the past, it usually resulted in death within the first weeks of life. Nowadays the disease has been identified, and children recover if glucose and galactose are withdrawn from their diet. We report two interesting cases of disease in this article. Both of them presented with severe water diarrhea, severe FTT, and the sign and symptom of dehydration. According to our knowledge this is the first case report of this rare autosomal recessive disease in Iran.