فصلنامه علوم پزشکی دانشگاه آزاد اسلامی مشهد
پیاپی 2 (تابستان 1384)

Allergic Rhinitis-chlorpheniramine-loratadineclavitin is one of the most important disease that occure commonly in east IRAN specially northeast, Khorasan. Approximately 10-15% of general population suffers from it´ s signs and symtpms. One of the best methods of allergic rhinitis treatments, that most is the most usual, is the of classic antihistaminic drugs such as: Chlorpheniramine, Pyrilamine and Diphenhydramine.These are common in the consumption of classic antihistaminics. There is more than a decade that is showed the Non Sedating Anti Histaminic Drugs are free from these side effects and do not show the CNS and anticholinergic disorders. In this clinical study, the efficacy and adverse reactions of the Loratadine and it´ s registated product calles Claritin are compared with Chlorpheniramine on 90 patients. It has been performed in northeast IRAN and the study is a kind ofdouble blind, prospective studies. 30 patients have recieved Chlorpheniramine, as the same for Loratadine and Claritin. Then the results are compared together. The results suggest than in the geographic condition of IRAN likewise, Lorataddine & specially Claritin can use as the powerful and effective nonsedating antihistamines that do not cross the blood brain barrier to show advers disorders and will be successful treatment of Allergic Rhinitis in the first line, specially in patients whom are sensitive to other antihistaminic dregs. Between them Claritin by it´ s acceptable clinical efficacy & lower side effects is preferable than Loratadine.

this research is about nasometer efficcacy in evaluation of patients who suffer of speech disorders specially hypernasality. hypernasality is a quantitative problem and computerized instruments could convert it to qualitative parameters. This study is about the patients with cleft lip and cleft palate. Hearing disorders and hypernasality who were referred to speech therapy centers and ENT clinics. At first, specialists referred these patients to the rehabilitation and health university where the patients speech factors were evaluated with nasometer. The results were interpretataed as tables and curves. Our cases Were treated for two months and then they were evaluated with nasometer again. In this case control study we have compared 11 patients (5 female and 6 male) as case group with 11 patients (5 female and 6 male) as control group to determine speed therapy efficacy in evaluation of speech disorders specially hypernasality and the role of treatment methods when we could guess the speech disorder severity only with hearing. These instruments help us to evaluate the cases before and after treatment methods exactly. We evaluated both case and control group With four standard test and then we compared Mean (nasality criterion) which is the main factor of hypernasality between different groups. In the first test (Pa-Khoda-33), mean average in case group Was %25.98 (p= 0.001) above the normal range befor treatment and Was %19.89 (p= 0.143) above the normal range after treatment. In the second test (asb alafhaye sabzra Khord), Mean average in case group Was %24.11 (p< 0.000) above the normal range befor treatment and Was %9.52 (p= 0.100) above the normal range after treatment. In tht third test (Maman-99). Mean average incase group Was %9.47 (p= 0.165) above the normal range befor treatment and Was %1.97 (p= 0.895) above the normal range after treatment. In the fourth test (Maman Amin amad), Mean average in case group Was %15.47 (p= 0.028) above the normal range befor treatment and Was %7.70 (p=0.060) above the normal range after treatment. we analyzed the differences With paired T test and results showed a significant efficacy for our treatment intervenentions. (p< 0.000 in all case).

Despite progression of contraceptive methods and governmental policies for control of population growth, we can see alot of unwanted pregnancies every day. In unwanted pregnanies we see in correct behavier like induced abortion. Soin this stady we estimated the prevalence of unwanted preynany and induced abortion and their causes. It was a cross- sectional study. 1000 pregnant women who went to 22 Bahman and Aria hospital, interviewed and questionnaire were completed. the relationship between unintended pregnany and age, education, the number of childern, economicd status, cause of unwanted pregnany, job, contraception method and tendency for induced abcrtion was eraluated. 43% of prengnancies were unwanted and 66.5% of them were uneducated and 57.8% had low economicd status. and 23% had high economicd status. Bygrowing children number and age the rate of unwanted pregnancy becamehigher. 37.2% of them used OCP for contracotion and 31.1% had rythumic contraception 80% ctthem were not aware of the morning after pill. 45.7% of them pravided contraception method fram heath center. the most impertant causes of unwanted pregnancy were economical problems (40.6%) and pregnancy in engagement (23.7%). 37 women were willing to terminate and 34 of them did induced abartion indifferent wags. unintended pregnany and induced abortion are very prevalant in our society and ourwerks haven’t been enough, so we showld plan correcty and edacate people for reducing wnwanted pregnancies.

Molluscum contagiosum is a disease caused by a poxvirus of the Molluscipox virus genus that produces discrete, hemispherical umbilicated papules covered by a pearly surface. The infection is found worldwide and has a higher incidence in children, sexually active adults and those who are immunodficient. There are severalmeans of therapeutic destruction method to help speed resolution. Most of the common theratments consist of various means to traumatize the lesions. For example cryotherapy is effective but need to be repeated at 3-4 weekly individual, special instruments and a dermatologist or skillful individual. Other possible topical preparations include tretinoin, cantharidin and podophyllotoxin cream. TCA is caustic and astringent. It’s easily available and it’s a cheap therapeutic method. In this research we compared the effect of TCA and Cryotherapy on mlluscum contagiosum. In statistical consideration, there was not significant relation betweenresponse to treatment by cryotherapy and topical TCA. Also there was not significant relation between tiems referring for treatment in cryotherapy and topical TCA. According to findings existed in refernces and taking into consideration statistical results; topical TCA has suitable therapeutic effects and it can substitute as a suitable therapeutic method instead of other methods.

This study is performed in oder to consider effect of Hypertonic Glucose (%50) in treatment of Rectal prolapse of children. In addition, relation of some factors such as constipation, anatomic and family problems, malnutrition and cystic fibrosis with rectal prolapcehave been searched. In this Original study 12 children from their birth to 5.5 years old who had having Rectal Prolapse, have refered to children Medicial Center of Tehran University during from 23 september 2002 to 23 september 2003 and they were treated with submucosal injection of Hypertonic Glucose (%50). All information have been analyzed statisically by SPSS-9software. 1. 58.3 percent of patients were boys and 47.7 percent of them were girls. 2. 83.3 percent of patients have previous domain of rectal prolapse such as constipation, anatomic and family problems and malnutrition. 3. 66.7 percent of patients have been improved with one injection and 33.3 percent of them need to be injection again. 4. Average period of follow up of the pationts 7.16 months during which symptoms completly disappeared. 5. Regarding the excellent therapy- results, prirectal injection of hypertonic glucose (%50) is simple, cheap and safe for treatment of Ractal prolapse.

nutrition is very important in pregnant women it’s effects on growth and development of fetus is controversial. As pregnancy is not a disease in islamic culture so it doesn’t limit fasting. In this research we evaluated the effects of starvation on different fetomaternal factors. this is a prospective study on pregnant woman who Game to maternity unit of 17 -sharivar, 22- Bahman and Aria hospitals between 2003 and 2004. in this research we evaluated 3 groups of 100 pregnant woman that some of them were fasting for more than 15 days. grouping was acording to the time of fasting in trimesters of pregnancy. then we compared fasting and nonfasting pregnant women in each groups. In the Three groups, there were not any sigificant difference between mean age, stature and weight of fasting and non fasting prgnant woman also there were not any significant difference between job, education, insurance, delivery method and perinatal care in these cases. mean pariety and gravidity in fasting group were more than nonfasting groups signifcantly. mean weight gain in nonfasting pergnant women was significantly more than other group and hypoglycemic attacks were more common infasting group. the rasults showed that fasting for more than 15 days reduces weight gaining in pregnant woman and cause more hypoglyecmic attacks but it hasn’t any effect on eftus growth and development.

Carpal Tunnel syndrome is a commondesosder and median nerve is more involved than other nerves. The main aim of this study is to clarrifing correlation between clinical symptoms and signs with electsro physiological findings in one hand and detectetion of the most sensitive Electlophysiologic index in the other hand. 40 patients adimitted in 22 Bahman & Arya hospital during Year 2002 was enrolled in this study. our specific test was performed for them. this was a prospective study. Main cause of CTS was Diabetes Melitus. Although Most pationts discomfort unilaterally electcophsilogical a bnormalities Was present in both sides. The most sensitive test was Distal Sensory median latency and flatency has the same Value. Electromyography was abnormal in only 7% of patients. Detection of underdyiny disease before surgery is manadatory. It seems that F wave has the same value as distal median sensory nerve in in carpal tunnel syndrome.

CRP as the one of Acute Phase Reactants increases in serum & the other biologicai fluids during inflammations, infections and malignancy Currently, CRP value for distinguishing between Pyogenic & Aseptic meningitis has been explained that is not definitely diagnostic but can be helpfui in Serum & CSF evaluations. Among severai laboratory methods for evaiuating the CRP, Qualitative & Semiquantitative Latex Aggiutination tests are the most commonly performed assays that used in MASHAD. Our research attempts to evaiuate this iaboratory methods both in Serum & CSF. Methods & Materiais: In this prospective interventional study from December 2001 to Juiy 2003, 45 patients of ali kihds of meningitis (by random), who were proven their diseases by ciinical & iaboratory parameters, have been examined in infectious department of Imam Reza hospital ofMASHAD. There were 26 males & 19 femaies and for each patient 2 ml of CSF & 5 mi of serum was extracted and refered to the iaboratory in less than an hour. Both the quaiitative & semiquantitative Latex aggiutination tests for detecting of CRP were used for each sampie. For statistical anaiysis tlie Clii- Square test lias been used with standard deviation of 0.05% (According to SPSS). Tliere were 32 cases of Aseptic meningitis & 13 cases of Pyogenic meningitis from 45 patients. The serum CRP was positive in 40% of Aseptic meningitis & 84% in the other one. Ofcourse tliere is a meaningfui statisticai difference between this results (P. vaiue: 0.007). On the other hand, there were no positive CRP evaluation results in CSF of both Aseptic & Pyogeiiic meningitis (with or witliout positive Serum CRP). This resuit can not be analysed by SPSS & the P. value is notjudgmentable. The meaningfixlness of statistical anaiysis about Serum CRP in the meningitis indicates that the usual iaboratory methods for detecting of CRP are useful enough & reliabie. But tlie negative results for ali of tlie CSF C-Reactive Protein evaluations in comparison to CRP sensitivity of 18-100% & specificity of 75-100% by references indicates that qualitative & semiquantitative Latex agglutination tests for examination of CRP in the CSF are not reliabie. If tliere is an enforcement for evaluation of CRP in the CSF, other sensitive Quantitative Immunocliemical methods must be used.

Ptergyium is one of the common ocular diseases that usually causes corneal astigmatism Jn this study the result of surgery on astigmatisrn has been studied. The aims of this study were to evaluate the degree of astigmatism changes afier surgery and the evaluation of pterygium surgery in improvement of patient s visual condition. Methdos: this study was a self-testifier clinical trial of experimental study subgroups. ln this study / exicision ofpterygium was done for 70 and patients Variants such as age, sex, job and refractory errors were considered. In this study 70 patidnts were studied, 42 paticnts were male and 28 patients were female so the ptervgium was more common in male group than fernale group. 38 cases were in grade I, 26 cases were in grade II, and 6 cases were in grad III. The. statisticai analysis showed that there is a significant correlation between the grade of pterygium and increase of age. In studying of cylandric refractory errors, the severity of astigmatism errors. The severity of astigmatism is increased by increase of the grade of pteigyum, and their relation was statisti cally signifi cant. The predisposing factors were aerosols in 6 case sun rays in 17 cases and both of these factors in 9 cases. We found that pterygium surgerv had such a significant effect on improvement of astigmatism in all groups specilly in grade II. and this finding was proved by T test. Sun-rays exposure and the prevalence of pterygium in male group were statistically correlated.