مجله دانشگاه علوم پزشکی اراک
سال هشتم شماره 4 (پیاپی 33، زمستان 1384)

Hepatitis B is a disseminated liver inflammation from HBV, that causes diseases and a large number of deaths. Regarding the fact that some of the vaccinated people are non responder (NR), evaluation of immunity in vaccinated ones and identification of NR especially in high risk group is necessary. In this descriptive study blood samples of all medical students of Borujerd Azad university at the age of 18-25 and vaccinated personnel of Borujerd Shariaty hospital were tested for Anti.HBS-Ab level by ELISA method with Radim kit (cat.KHB31). Results were analyzed according to the number of received vaccines, the duration of vaccination and demographic criteria using descriptive statistics. About 90% of samples had protective immunity and 10% were NR. 8% of immune group had more than 1000, 17.2 % between 500-1000 and 74.8 % between 10-500 miu/ml of Ab titer. About 75% of immune samples had received two vaccines. In NR group 53% had received three vaccines and 47% had two. 4% of samples were immune with the duration less than one month after vaccination which 85 % of them had two vaccines. Herd immunity was 90% which is accordant to most studies. In some studies with different results the effective criteria were not differentiated. So regarding these differences, vaccinated people are recommended to evaluate their HBS.Ab level.

Treatment of urinary tract infections(UTIs), as one of the most common nosocomial and community acquired infections, has remained an important medical problem. Differentiation between susceptibility patterns of nosocomial and community acquired pathogens is important epidemiologically and helps the administration of appropriate antimicrobial drugs. The goal of this study was isolation of the most common causative bacteria, in two groups of 13-35 years old women in Shahrekord city within 6 months period(April-September 2004). Also, the resistance patterns of common isolated organisms in these two groups were compared. This is an analythical-cross sectional study. 100 urine samples from women aged 13-35 years old hospitalized in different wards of Hajar and Kashani hospitals(group one) with positive urine cultures were obtained performing clean-catch midstream method. Also 100 urine samples from 13-35 years old women with positive urine culture and acute UTI symptoms from Shahrekord private laboratory (group two) were obtained. The most common causative bacteria in the two groups and the antibacterial sensitivity patterns of isolated organisms were evaluated. Data was analysed using T test. Totally, the most common nosocomial UTI pathogens were E.coli, Klebsiella spp., Staphylococcus saprophyticus, Pseudomonas and Enterobacter spp. In group two, E.coli, Klebsiella spp., Enterobacter spp., Proteus, Staphylococcus saprophyticus and Citrobacter spp. were isolated predominantly. The highest bacterial resistance rate belonged to Ampicillin and Co-trimoxazole. Antibiotics useful in treatment of nosocomial UTI were Ceftizoxim, Nitrofurantoin, Nalidixic acid, Cephalothin and Gentamicin respectively. Nitrofurantoin, Nalidixic acid, Ceftazidim, Gentamicin and Cephalothin were the most effective antibiotics in community acquired UTIs. The emergence of pathogens with alarming rates of resistance, highlights the need for a more rationalized and restricted use of antibiotics in order to minimize the spread of resistant bacterial strains.

Cystic hygroma is a disorder in lymphatic vessel formation that involves the adjacent organs and can affect them due to its fast growing nature. The main treatment for cystic hygroma is surgical intervention that can have many complications after surgery. Treatments other than surgical interventions is the use of sclerosing agents. The goal of this study is to analyze the effect of Beliomycin in treating cystic hygroma. This quasi experimental study was carried out clinically at st-al Zahra and Kashanie hospitals of Isfahan from 1372 to 1383. A checklist including age, sex, cyst location, cystic hygroma volume before and after Beliomycin injection and/or surgery, was completed for each patient. Data was analyzed by T and paired T-Tests. p<0.05 was considered meaningful. The study was carried out on 72 patients. 24 patients were treated with Beliomycin and 48 patient by surgery. Patients age was below 1 month up to 18 years old. Cystic hygroma was mainly located at neck region(46.8%). The average size of cystic hygroma was 103.9±29.66cm3 before Beliomycin injection and 34.91 16.19cm3 after that (p=0.004). and 43.511±7.81cm3 before surgery and 1.39±1.39 cm3 after that(p=0.006). The rate of recurrence of lymphingoma in the surgery treated group was 25.1% and in the group treated with Beliomycin was 29.2% with no significant difference. Regarding the considerable decrease in cyst volume after Beliomycin injection and it,s low complication compared to surgery, this method can be used as a primary treatment or supplementary to surgery.

Markazi province was one of the regions with endemic goiter in Iran. Following initiation of iodine deficiency control program in 1989, production, distribution and consumption of iodized salt begun. This survey was conducted in the frame work of national monitoring survey in 2001 to find the prevalence of goiter and urinary iodine level in order to evaluate the iodine status of school age children in Markazi province. 1200 school children (600 boys and 600 girls), aged 7-10 years, were selected randomly from all regions of Markazi province. The grade of Goiter was determined according to WHO classification and urinary iodine content was estimated using the digestion method in one tenth of the these children. Data was analyzed using T, Chi square and Pearson tests. Total Goiter rate was 4.4% (4.4% in girls and 4.4% in boys). Urinary iodine median was 16.7 µg/dl. Urinary iodine was above 10 µg/dl in 81.2% and less than 5 µg/dl in 9.2% of samples. No one had urinary iodine below 2 µg/dl. It is concluded that the rate of Goiter in Markazi province has decreased significantly since 1986 and urinary iodine levels in school children are indicative of adequate iodine intake. Therefore Markazi province can be considered as an “iodine deficiency free” zone.

Postoperative nausea and vomiting is one of the most common problems in postoperative period. Patient's who are at high risk of PONV, may receive anti-nausea and vomiting drugs. The most common drug is Metoclopramide, but it,s extrapiramidal signs and side effects such as lethargy, dizziness and headache especially in children lead us to perform this study, in order to compare Dexamethasone and Metoclopramide effects in PONV prevention. This study was a double-blind randomized controlled clinical trial. 262 patients (2-25 years) in ASA class I,II which were candidates for ENT, eye and laparatomy surgeries, divided into two groups randomly. One group received 0.1 mg/kg Dexamethasone IV and the other group received 0.1mg/kg Metoclopramide IV, 10-15 minuets before operation ending time. During recovery, the frequency of PONV was assessed. Data was analyzed by Pearson test. PONV frequency in the two groups had no significant difference. Also PONV rate in the two groups had no significant difference in male and female. In prevention and treatment of PONV, Dexamethasone effect was same as Metoclopramide. Considering low expense, avalibility and low side effects, Dexamethasone is a proper substitute for Metoclopramide in surgeries with high risk of PONV.