مجله فیض
سال پنجم شماره 1 (پیاپی 17، بهار 1380)

History and Considering the incremental trend for using the stimulatory drugs for ovulation and the new techniques for the treatment of infertility, therefore there is a higher incidence for the syndrome of polycystic ovaries. In this research study mannitol serum was used as a preventive agent in patients with such a syndrome referred to Sarem medical center from 1999 to 2000. The clinical trial of this study was carried out on 228 patients with polycystic ovaries. They have been treated by stimulatory agents of ovulation (Human chorionic gonadotropin and human menopausal gonadotropin) and were divided into case and control groups. The former received daily injection of mannitol serum (0.5 g/kg of body weight) and the control group received no treatment. For evaluation of the efficacy of mannitol, the parameters blood pressure, hemoglobin, hematocrit and WBC were measured and statistical t-test was used. Out of the total 228, 132 patients were included in the control group and the remainder (96 patients) comprised the case group. Both group were similar regarding age, weight, blood pressure, hemoglobin, Hct and WBC before using mannitol serum. The results showed that 100% and 25% of patients in control and case groups respectively had OHSS. The systolic and diastolic blood pressures were 87±10.7 and 54±10 in control group and were 112±5.6 and 63±14 mmHg in case group respectively. The level of hemoglobin, Hct and number of WBC were 15.7±1.5, 45.3±7 and 13548±6165 in control group and were 12.6±0.7, 38.3±3.8 and 77525±1523 in case group respectively. The difference between case and control groups was significant statistically (P<0.001). It is concluded that the administration of mannitol serum can prevent the severe form of OHSS and can attenuate the mild and severe forms of OHSS. Therefore it is recommended to perform more intensive researches to find the beneficial effects of mannitol serum.

History and Considering the significance of newborn growth, its prognosis, the absence of enough information and the controversies regarding the effect of feeding intervals on the growth process, this comparative study was carried out to evaluate the effect of demand-based and multiple feeding on the newborn growth in Shabihkhani hospital in Kashan from 1996 to 1997. The clinical trial, sequential sampling and quasi-experimental strategy of this research was carried out on 45 newborns in demand-based feeding group (Control) and 40 newborns in multiple-feeding group (Case). The groups were similar regarding age, occupation, education, multiparous state, number of children, kind of pregnancy, interval between labors, father’s age, education and occupation, number of children, home area, home status, monthly income, gender, time of first feeding and birth-time weight, height and head perimeter. Birth-time weight, height and head perimeter and the same parameters at days 14 and 28 postpartum were measured and statistical t-test was used for data analysis. Eight cases of the demand-based group and 14 cases from the multiple-feeding group were excluded from the study for illnesses, incomplete information, supplementary nutrition, not on time refers, inappropriate follow-up and/or mismatch of nutritional style with considered criteria. In total, the research was carried out on 63 cases (Control (n=32) and case (n=31) groups). During the first 14 days, the weight changes were 399.7±113 and 613.9±194.1 in control group and case group respectively. In other words, case group showed a 53% increase in comparison with control group (P<0.001). In addition, changes of head perimeter and height were also greater in case group, but did not reach to significant level. Multiple-feeding method can clearly affect the physical growth of newborns. It is recommended to perform a research study to evaluate the long-term effect of this feeding pattern on growth and other related parameters.

History and It is of high importance to use intact and normal bones in training of anatomy courses. Considering the relative deficiency and the low quality of the present materials, this study was designed to find out a new method of preparation of normal bones from fixed cadavers in 1999. In this study the bones from cadavers fixed with formalin, phenol, alcohol and glycerin were used in anatomy department of Tehran university of medical sciences. For this purpose, the soft tissues were removed from the bones by surgical scissors and scalpel and for complete removal of these tissues, the bones were immersed in sodium hypochloride solution for 24h and then after rinsing and drying in oven at 50°C, they were placed in cerosene-ethanol solution for fat removal. In the next stage, they were dried in the open environment and were bleached by 5% hydrogen peroxide solution. Finally, a layer of oil was painted on the bones. The prepared bones by this method were compared with the existing bones regarding quality and anatomic structure. The prepared bones by this method showed no fracture and decay and their normal integrity was maintained and they were more healthy to use and it is more easier to clean them and more cheaper to prepare them in large scale. The above-mentioned method is recommended to prepare bones with higher quality and it is better to use them in teaching of anatomy courses. Furthermore, it is recommended to perform more studies using other materials for preparation of intact bones.

History and Hyperactivity, inattention and absent-mindedness syndrome is a common problem among children and has clear-cut complications. Since piracetam is used for the treatment of developmental retardation and the existing controversies regarding its role in the pathogenesis of ADHA, this study was carried out to determine the effect of piracetam in development of hyperactivity and inattention in children with developmental retardation referred to Imam Reza hospital in Mashhad during the years 1997-1998. The clinical trial, two-blinded and cross-sectional strategy of this research was carried out on 30 children over 4 years old. Half of them received piracetam syrup and the remainder received placebo at a dose of 50 mg/kg the and after a 2-week period of washout, they received the treatment inversely and finally the ADHD condition was evaluated and analyzed statistically. Five of the cases did not cooperate to the end of experiment and the remaining 25 cases had an average age of 6 years consisting of 7 girls and 8 boys. The ADHD rate was 0.16±0.07 in control group and 0.44±0.09 in case group (P<0.001). In addition, incidence rate for ADHD was 14.3% in control group and 53.3% in case group (P<0.03). It was also found out that incidence rate of ADHD was greater in boys and occurs at a lower age. Piracetam consumption can lead to inattention disturbances, hyperactivity and absent-mindedness in children. Therefore, much precaution should be considered in administration of piracetam in children with developmental retardation or similar conditions.

History and Considering the incremental trend for the incidence of trauma and the existence of little information and much controversies in this field, the present study was carried out on referrals of Farabi hospital in 1999. The descriptive and sequential sampling strategy was carried out on hospitalized patients with definitive diagnosis of trauma. For this purpose the personal characteristics and condition were evaluated regarding the cause of trauma, its kind, the ensuing lesion and post-traumatic vision. A total of 150 patients were studied and the incidence rate for post-traumatic hospitalization was 3.2%, that is in the ages 16.3 respectively 14.5 from a minimum 3 months to a maximum 70 years and with a ratio of 2.7/1 for males to females. The most common causes of trauma were stone (14%), wood (13.3%) and knife (8.7%) and the most prevalent lesion was corneal rupture (77.3%), scleral rupture (30%), traumatic cataract (25.3%) and iris prolapse (25.3%). Since the patient’s characteristics, the causative agent and condition of trauma is different from other countries or in comparison with references, therefore it is recommended to perform more intense research in this field by other universities and their affiliated hospitals and to find the most appropriate method to involve in a general training program.

History and Considering the role of triple vaccine in reduction of mortality as a result of three disastrous diseases diphtheria, tetanus and pertusis and its known side-effects and little information on the incidence of these complications in Kashan, this study was performed to determine the complications of triple vaccine in referrals of the health centers of Kashan in 1999. The descriptive strategy of this study was carried out on 383 cases from 1.5 month to 6 years old. All of them were carefully examined by a pediatrician up to 48h for the occurrence of complications and the observed symptoms were collected in questionnaire and the data were analyzed. In this study, pain in the injection area, swelling, erythema, non-humorous behavior, fever, somnolence, loss of appetite, vomiting and crying were 44.7%, 31.4%, 27.7%, 37.8%, 54.5%, 9.4%, 16.2%, 7.5% and 5.3% in a total of 344 cases (89.9%). The incidence rate of complications after injection of triple vaccine was rather high in Kashan and it is recommended to recognize the causative factors and its reduction.

History and Mitral valve prolapse is the most common of the valvular diseases, especially its posterior cusp as cited in references. In this respect, there is little information for its incidence in Iranian children. This study was carried out to determine its incidence in 50 neonates referred to echocardiography ward to Shaheed Beheshti hospital in Kashan. The descriptive strategy of this study was performed on 50 neonates and children with mitral prolapse and with auscultation it was as non-ejection click or without end-systolic murmur. The echocardiography was performed in M-mode, two-dimensional and color Doppler and data were analyzed statistically. Out of 50 studied children and neonates, 29 cases (58%) were female and 21 cases (40%) were male and their age was from 2 months to 13 years. In 48 cases (96%) only the anterior cusp was involved. In one case (2%) there was prolapse of posterior cusp and in 1 other case (2%), both cusps were involved. In 4 patients (8%) there existed mild mitral failure and in 46 of them (92%), there was no valvular failure. Out of 4 patients with mitral failure, 3 cases were male and one of them was female. In contrast to existing information in available references, the most common involvement of patients with mitral prolapse is anterior cusp failure. This difference can be attributed to regional, racial and genetic factors.

History and Considering the significance of occupational satisfaction and its influence on personal performance and mental health and the existence of little information in this field, this study was carried out to evaluate the occupational satisfaction among official staff in Kashan during the years 1998-1999. The descriptive strategy of this study was performed on 1250 cases and data were collected in especially designed questionnaire from 44 public organizations. The questionnaire consisted of two divisions one containing issues about age, gender, record of service, level of education, working field and income and the other one contains 37 questions and issues on occupational satisfaction and related subjects. A total of 829 qualified questionnaires were filled in the study. The average age of cases was 35.79±8.32 years and 66% of them were male and 90% of them were married. In addition, most of them had diploma of high school (30.1%) and 26.3% had bachelor degree. satisfaction was 26.1% for maintaining needs and 16.6% for developmental needs. Furthermore, 60.7% of them satisfied with their occupation. Despite a low income and the existence of different problems encountered, official staff in total satisfied with their occupation.

History and Considering the goal of WHO to eradicate the polio viruses type I, II and III and it is also executed by our health authorities, it is very important to immunize well the children. Therefore, this study was carried out to determine the degree of immunization following Polio vaccination in children at an age range of 7-10 years in Ahwaz. The descriptive strategy of this study was performed on 324 samples of serum. At first, the polio viruses type I, II and III were cultured in Hela Medium and then the viruses were isolated by ultracentrifuge (40000 RPM) for one h. for determination of antibody titer of polio viruses, the ELISA method was used for which 30?g of related antigen was added. The immunization rate was determined in samples and then it was extrapolated to society. The study was performed on 324 cases consisting of male and female ones in equal ratio at an age of 8.4±3 years. It was found out that 281 cases (86.7%) had antibodies against viruses type I, II and III. Furthermore, there was no significant difference among groups with different degrees of immunization. A high level of immunization was observed in immunized children. Therefore, it is recommended to perform similar studies in other sects of society including rural areas.

History and Hypertension is one of the common diseases with complications that lead to death. Some researches has argued that in patients with hypertension, the level of C3 in serum is elevated. This study was carried out to determine the level of C3 in patients with hypertension and to compare it with control group in Isfahan province in 1998. The analytical strategy of this study was randomly performed on 60 patients with hypertension and on 60 normal persons. The SRID method was used to determine the level of C3 in serum. Both groups were similar regarding age and gender. For statistical analysis t-test was used. C3 level was 85±13 in normal persons and 131±32 mg/dl in patients with hypertension with a 54% difference (P<0.0001). In addition, its level showed no relationship with gender. In patients with hypertension, there was a lower increase in the level of C3 with age. Hypertension can increase the level of C3 in serum. It is recommended to carry out a cohort research study for finding a relationship between an increase in the level of C3 in patients with hypertension and incidence of atherosclerosis.

History and Considering the concern for ways of application of WHO guidelines and the problems as a result of not executing these items and for determination of tendency of pediatricians for applying the suggested protocols for acute gastroenteritis, this study was carried out on pediatricians who participated in a yearly congress in 1999. The descriptive and cross-sectional strategy of this study was randomly performed on 95 pediatricians who had graduated more than 10 years. In this regard, a 19-item questionnaire was prepared containing questions on personal characteristics, knowledge, information on gastroenteritis, use of ORS and feeding pattern for acute gastroenteritis and their answers were analyzed according to WHO guidelines. Out of 95 selected cases, 87 ones answered all of the questions and their age was 44±17 years and a working record of 17±6. In addition, 73% of them had enough information, but only 60% of them applied WHO guidelines. Meanwhile, 69% of them had enough information regarding use of ORS and 83% had an appropriate tendency for using ORS. Theoretically, 31% of these specialists and practically, 37% of them showed controversial views regarding the continuous use of foodstuffs during the period of acute diarrhea as recommended by WHO. Application of WHO guidelines have not been executed for continuation of feeding during the acute phase of gastroenteritis. Therefore, it is recommended to explore the causative factors and to perform the necessary procedures for quality upgrading.

History and DMPA is one of the commonly used contraceptive methods because of its high rate of success, less complications, easily applicable and rapidity. The major complication of DMPA is the occurrence of irregularity in menses that is of high concern in Islamic culture. Therefore, the present study was carried out to determine the effect DMPA on the pattern of vaginal bleeding in referrals of Mahdieh hospital in Tehran in 1999. The clinical strategy of this study was performed on 50 women with a history of regular menstrual cycle. DMPA at a dose of 150mg was injected and for 90 days thereafter, the bleeding pattern was determined and classified. In addition, the role of BMI in this regard was determined. Out of 50 studied cases at an age range of 18-45 years, 20 cases showed bleeding itself or its signs. For the latter, it occurred for one time in 35% of them, for 2 times in 35% of them and for 3-6 times in 35% of cases. The average days of bleeding for all them were 41.8±26.6 days. It is also evident that BMI can not affect the vaginal bleeding. It is concluded that the bleeding pattern is not a problem of high concern in consumers of DMPA, but it is recommended to perform more studies in this field.

History and German beetles are the most common beetles in human dwellings. They show different sensitivity to insecticides according to the region. Therefore, for determination for their sensitivity, they were collected from Naghavi, Shaheed Beheshti hospitals and Shabihkhani maternity hospital and exposed to different insecticides during the years 1995-1996. Beetles were collected by hand or by putting trap. After 48h of their capture in laboratory according to standards of WHO, they were exposed to Ectelic (0.12 g/m² and 0.2 g/m²), Sulfak (0.2 g/m²), Kupex (0.125 g/m² and 0.25 g/m²) and Ficam (0.24 g/m²) and knock down experiments. In this study regression analysis and criteria KT50 and KT90 were calculated. For Ectelic insecticide (0.12 g/m²), a mortality of 45%, 53% and 65% was obtained in Naghavi, Shaheed Beheshti hospitals and Shabihkhani maternity hospital respectively. For Sulfak insecticide (0.2 g/m²), KT50 was 9.87. 6.72 and 5.51 min in Naghavi, Shaheed Beheshti hospitals and Shabihkhani maternity hospital respectively. For Kupex insecticide (0.12 g/m²), KT50 was 23.9, 9.93 and 7.89 min in Naghavi, Shaheed Beheshti hospital and Shabihkhani maternity hospital respectively. And for Ficam (0.24 g/m²). KT50 was 31.23, 14.98 and 16.20 min in Naghavi, Shaheed Beheshti hospitals and Shabihkhani maternity hospital respectively. For Ectelic and Kupex insecticides, there was not a 100% mortality rate after 24h and with a higher dose of Ectelic, mortality rate was 74%, 80% and 88% in Naghavi, Shaheed Beheshti hospitals and Shabihkhani maternity hospital respectively. For Kupex (0.25 g/m²), mortality was 100%. It is concluded that sensitivity of beetles is different to different insecticides and also according to the site of collection. Multiple and repetitive use of these insecticides can lead to increased resistance.

History and Considering the high incidence of mumps and its complications and mortality and for determination of the role of environmental factors, this study was carried out on children with complications of mumps in hospitals of Tehran university during the years 1993-1997. This study was performed on existing data of medical records with a diagnosis of mumps. Personal characteristics, time of hospitalization, medical costs, symptoms and clinical manifestations, complications and history of vaccination were evaluated and recorded. During the study, 305 qualified children were examined. Their average age was 8.4 year and 76% of them were male and 24% were female. Vomiting, headache, neck stiffness and Kerning symptom were recorded in 96%, 92%, 75% and 30% of cases. In CSF, an average of 295 WBC and 80% lymphocyte was obtained. In addition, 91.7% of them had a history of vaccination and they have hospitalized after an average of 4.5 days. There is a high incidence of complications for mumps and with no vaccination the incidence increases. Performing vaccination for two times at ages 14-18 months and 6th year is strongly recommended.

History and Patients at end-stage renal disease (ESRD) need dialysis for living and because of dialysis insufficiency a high mortality has been reported. Nowadays, more than 200000 patients with renal disease existed in USA and more than 1 million patients live through dialysis. Therefore, this study was performed for evaluation of dialysis sufficiency in hemodialysis patients in Kashan in 1998. The descriptive strategy of this study was carried out on patients with ESRD and under hemodialysis. The parameters age, height, gender, weight, dialysis duration, Pres KV, del KT, cPCR, … were collected in a questionnaire and were presented in frequency tables. This study was performed on 37 patients and those with other causes including poisoning were excluded. Out of 37 patients, 15 cases (40.5%) were female and 22 cases (59.9%) were male. For Pres KT/V and, an average of 10.4 was obtained (0.92 for males and 1.23 for females) and for del KT/V, it was 0.45 and 0.48 in males and females respectively. In addition, an average of 33.8 in males and 33.34 in females was obtained for Tacurea. For URR, an average of 0.3 was observed (0.31 for males and 0.29 for females). Finally, 7 patients (18.9%) had a sufficient dialysis, that is a KT/V higher than 1.2. Since hemodialysis is insufficient in nearly 80% of patients with renal diseases, it is needed to carry out more studies in other cities of the country.

History and Meggittina gerbilli is a parasite of African rodents. Until now, 4 species have been reported. In this article, it is attempted to introduce a case captured and observed in Kashan in 1996. The descriptive strategy of this study was performed to evaluate the gastrointestinal parasites of wild mice inhabited in Kashan and suburban region. The captured mice were dissected through ventral surface and their parasites were isolated and diagnosed. A cooperation existed on suspicious cases with Health School of Tehran university. Out of 120 mice, in only one of them 7 cases of Meggittina gerbilli was diagnosed with a length of 2mm, 4 suckers, a wide and small neck, 3 segments and with one genital apparatus in each one of them. The genital pore lies in anterior ¼ of the segments alternatively. In addition, 210 round testes existed in two sides of each ovary. In evaluation of animal parasites, rare species should be considered to upgrade parasitologic knowledge.

History and Sleep disorders are very common in children and with various manifestations and for the latter reason, their complications are less commonly recognized as behavioral, learning disturbances and/or neurobehavioral. Considering the high incidence of such disorders, this research study was carried out to find the ways for diagnosis and treatment of sleep disorders. This review article was prepared by carefully studying 35 articles from 1993 to 2000 and the reference developmental behavioral pediatrics. It was found out that sleep disorders are the most common complaints among children and can lead to inattention and memory and learning disturbances. The sleep disorders include somnolence, no sleep, associated respiratory problems, nightmare, consciousness disturbances and disorders of motor behaviors and nocturnal urination. Furthermore, it can lead ton to other systemic disturbances and/or psychological disorders. Although sleep disorders are very common in children, but they are often not diagnosed and can lead to neuro-psychological disturbances. It is recommended to consider the sleep disorders in differential diagnosis of behavioral and learning problems in children and to perform more studies in this field.