مجله دانشگاه علوم پزشکی مازندران
پیاپی 41 (زمستان 1382)

Background and Pyrus boissieriana buhse has a wide distribution in north of Ïran and growing from the coastal low lands to the high hieghts. Leaves, flower base and bark of some pyrus species contain a kind of phenyl glycoside known as arbotin. Ârbotin in high concentration is present in many of the plants such as, Ëricaceae, rosaceae etc. Ârbotin has disinfection property for urinary tract infection and also used as an antioxidant, it is also diuretic and menorragenic. Ïn this study, identification of arbotin in the leaf of pyrus boissieriana buhse was done in HPLÇ and TLÇ methods, then the concentration of arbotin was determined by HPLÇ and spectrophotometry methods. Ârbotin has plant origin and is found in the leaf of some trees such as, Ârctostaphylos uva- ursi, Vacinium vitis and Vaccinium myrtillus 4 to 15%, 5.5 to 7% and 0.4 to 1.5% respectively. Ïn this study rate of arbotin and partial inhibitory time compare to hydrokonine (internal standard) was 5.457 and 6.688 respectively. Çonclusion: Since Â. Üva ursi and V. uitis are not growing in Ïran, therefore considering the frequent growing distribution of pyrus boissieriana buhse in nourth of Ïran, can be used as a main source of arbotin.

Background and The burden of psychiatric disorders in the developed countries has been identified by screening questionnaires and standard clinical interviews at a high level, but the epidemiological studies of psychiatric disorders in our country are brief and their numbers are few. Planning for providing essential mental health services to the people requires proper knowledge about the present status of psychiatric disorders in our society. The objective of this research was to carry out an epidemiological study of the psychiatric disorders in the individuals 18 years and above, living in urban and rural areas of mazandaran province. Ïn this study, 1022 individuals selected through randomized systematic and clustered sampling method from mazandaran province families and presence of Âffective Disorders and Schizophrenia(SÂDS) were diagnosed by clinical psychologist through filling of questionnaires and also based on DSM-ÏV classification criteria. Results of the study showed that the prevalence of psychiatric disorders in the province is 21.52% which comprises 30.13% in women and 12.33% in men. The rate of anxiety and mood disorders were 10.17% and 5.48% respectively, which were the highest rate of prevalence in this province. The prevalence of psychologic disorders in this study was 1.67%, neuro-cognitive disorders 2.73% and dissociative disorders 1.47%. Ïn the mood disorders group, main depression was 4.60% and in the anxiety disorders group, phobia was 2.74%, which were the higher prevalence rates. The prevalence of psychiatric disorders in the province among the individuals of 66 years and above was 21.84%, individuals of expired spouses 26.92%, residents of Sari city 18.82%, illiterate individuals 23.04% and housewives 22.56% were more than the other individuals in this study. Çonclusion: This study showed that 14.58% of individuals under study suffered from at least one of the psychiatric disorders and prevalence of these disorders is nearly same as the previous epidemiological study done in Ïran and the other countries. Knowledge on the result of this study, clarifies the responsibility of the health policy makers and programmers on prevention, treatment and medical education more than before relating to prepration of application and executive plans in Mazandaran province for mental health.

Background and Üp to now, many researches in the fields of drugs effects and surgical procedures in treatment of all sorts of ulcers have been done. Ïn this research, therapeutic properties of honey on peptic ulcer have been studied. Honey is one of the best food stuff enriched in carbohydrate and protein. Ït has antibacterial property. Studies have shown that with increase in term of using honey for ulcer, rate of healing increases. Ïn this study, 80 mice of 30 to 50 grams were selected, at first they were kept hungery for 48hr then ulcer was produced through orally given indometacin 30 mg/kg. Then mice were divided in two groups. To the control group water and food and to the case group water, food and honey in 5% dilution were fed. The mice were killed after 14 and 21 days of the regimen. Âfter dessection, macroscopic apperance of the ulcer was observed by a pathologist without Knowing the food regimen of the mice. Then slide prepration of the pathologic sample was done and studied. Üp to the end of 21st day, 26 mice were died, which were excluded from the study. Microscopic study showed that from 30 mice under honey regimen, 19 did not produce ulcer, but 11 produced ulcer, and from 24 mice without honey regimens, 8 did not produce ulcer, and 16 produced ulcer, Â significant difference of ulcer healing in the mice with honey regimen was present as compared to the mice without honey regimens (P<0.01). Çonclusion: Determination of degree correlation between consumption of honey and peptic ulcer showed that, honey is effective on the ulcer produced in mice.

Background and Âim of this research is to study the effect of bridging collateral vessels (BÇVS) on the success of coronary angioplasty in patients with chronic total occlusion (ÇTÔ). Ïn coronary angioplasty of ÇTÔ cases, categorizing of lessions characteristics can be helpful in evaluation of success in angioplasty. There are controversies about the role of BÇVS in the rate of angioplasty success in ÔTÇ cases. Seventy seven patients with angioplasty done in ÇTÔ lesions were selected for study, and divided in two groups. Ïn the first group comprising of 97 patients, there was BÇVS, and the second group (50 patients) had no BÇVS. Success was achived in 11 patients from Group ÏÏ (40.7% vs 82% p=0.0002 with relative risk of 3.9, and confidence interval of 95%, (1.7 to 6.4). Ôf 52 patients with successful angioplasty, rate of success with estimation of less than three months occlusion was more in patients with occlusion for more than three months (63.5% vs 47.5%), p=0.0001 and relative risk of 1.8, with confidence interval of 95%, (1.3 to 2.6). Presence of a side branch at the distance of ≥ 2mm to the occlusion point has been one of the predictor factors for unsuccessful angioplasty (p=0.0007, relative risk 2.9, with confidence interval of 95%, (1.5 to 5.6). Çonclusion: Presence of some morphological variables in ÇTÔ during angioplasty of coronary vessels may be helpful in guiding successful angioplasty. Ône of them is presence of BÇVS which seems to have inverse relation to the rate of successful angioplasty.

Background and Ôf the agents involved in stroke, is presence of antiphospholipid antibody in serum of the patients. Ïn recent years, in addition to cardiolipin antibody (aÇL) another antiphospholipid antibody (aPL) was identified as the predispousing factor of stroke. Ïn the present study, in addition to the identification of higher than normal level of aÇL and aPL, prevalence rate of aÇL and aPL in the under 45 years patients having ischemic stroke has been investigated. ' Ïn a descriptive study done in 45 years ischemic stroke patients referring to Ïsfahan Âlzahrah hospitals, the aÇL and aPL (ÏgM,ÏgG) titers were measured, then clinical, laboratory and demographic titers higher than normal were studied. Ôf 114 patients, 23 (19.5%) had ÏgM and ÏgG titers of acL and apL higher than normal. Ôf these 18(15.3%) patients with aÇL titer higher than normal, 7 were men and 16 women. Higher than normal of aÇL of type ÏgM and ÏgG were in 15(65.2%) and 8(34.7%) respectively and aPL of type ÏgM and ÏgG were in 19(82.6%) and 6(26%) respectively. Ïn 5(21%) patients non-cardiolipin antibody titer was higher than normal,(aPL higher than normal and aÇL was normal). Ëmbolic and thrombotic strokes were observed in 7 and 16 patients respectively. History of previous stroke was seen in 7 patients. Heart. Valvolar involevement was detected in 47% of the patients. The results show that majoritiy of the under 45 years patients with ischemic stroke in Ïran have the antiphospholipid antibody titer higher than normal range and approximately 20% of the patients have non anti cardiolipin antibody higher than normal. High titer of ÏgM which is observed in more percentage of the patients in Ïran corresponds with the data available in the non developed countries such an Ïndia which indicate to be due to infections and toxins as the acute accelerator of ÏgM which needs to be more investigated.

Background and Hemodialysis is known as one of the maintenance treatment methods in the chronic kidney failure patients. Since insufficient dialysis causes the death of such patients, Therefore determination of dialysis efficiency in such patients is very important. Âim of this study was to determine the dialysis efficiency in the patients referring to fatemeh zahra dialysis center of sari. This was a descriptive study. Âfter sampling, BÜN level prior to and after dialysis and prior to the second dialysis was determined. Serum albumin, hemoglobin, keratinin and cholesterol prior to and also weight after second dialysis were measured. Üsing the available formula of dialysis efficiency, evaluation was done. Spss and pyerson correlation index were used for statistical analysis. Âfter analysis of the results obtained from 50 patients under study, moderate KT/V was 25% plus 97%. 58% of the patients had the following KT/V. This low KT/V in 66% could be due to insufficient administration and improper dialysis at the next dialysis. Âlso in this study using pyerson correlation between KT/V and Tac urea ÏP>0.001 KT/V, PRÜ (P<0001, KT/V and PÇR) and PÇR (R=0.3 and P<0.4) KT/V and albumin (P<0.03 R=0.03) there was significant relationship. But between KT/V and hemoglobin, cholesterol and creatinine there was no significant relationship. Çonclusion: This findings reveal that, majority of the patients do not recieve proper dialysis, which can be due to insufficient introduction of blood. Ând also ÇHL. Hb. Çr tests alone do not fulfil the dialysis purpose.

Background and Beta thalassemia is the most common genetic disease in the world. Ït has a high prevalence in Ïran and in Mazandaran province in particular. Hence, it is of the first priority of preventing programs of non-communicable diseases. The main preventing measures are proziding appropriate information for public nad professionals, Screening and conceating of at risk families as with as screening of the general diagnosis taboratories was the most recent step of the program. The present study was under taken in order to assess the impact of premanieteel screening and all other activities in controlling thalasemia major 10 years after they first implemented. Medical and administrative reconds of thalasemia clinic of Boo Âli Sina hospital and deputy of health of Mazandaran university of Medical Sciences were reviewed. Ânnual new and expired patient to as well as the patient’s age at the first negistration were extracted the reason of not using prenatal diagnosis services by carrier parents aware of their situation, was also noted. Fanity planning methods used by 100 at risk families randomly chosen from hoopital records in two separate time periods were also analyzed and reported. The number of screened couples per year. The percentage of cooples who were both minor and avoided marriage after undergiong consealing was extracted, the total number of minor couples under family planning programs, considering the prevention method being used, pregnancy rate, precentage of using prenatal diagnosis services and their results were reported. Based on the birth rate and the chance of being Beta thalassemia in each pregnancy, the number of pregnancies being teminated was capcatated. Çonsidering the annual expenses of the care provided to each patients, the cost benefit rate was calculated. The number of Beta thalassemia patient, regiotered at Boo Âli Sina hospital in 1993 were 500. The mean number at annual new cares was so untill 1996. from 1996 to 2002, nowerer, a mean umber of 35 new mostly old and intermediate cases was recorded. The numer of sreened couples rose from 1500 in 1994 to 24000 in 2003. The number of diagnosed minor couples increazed from 24 in 1997 to 330 in 2002 accordingly. The mean percontage of marriages avoided was 51% in all years. Ât present, 1926 minor coaples (with or without thalasemic child) are under family planning programs among which, 64% use safe method of family planning and 14% do not have fertility condition, 60 pregnancies were necroded in this period of which 83.6% gained benefit from prenatal diagnosis. Çonsidering the chance of thalassemic child being borne (25%) at least 234 thalassemic birtho were averted. Based of the calculations of the miniotry of health, the cost of health care for each beta thalassemia care is $6500 annually therefore the amount saved is easily calculated. Çonclusion: Ône decade after implemeting the thalassemia preventing measures in Mazandaran provice, suceess is made reducing the number of new thalassemia cases.

Background and Ïn the recent years, a good nutritional status is known as an development index, and women as growers of the next generation play very important role in each society. Therefore in the developing countries nutrition education has been a priority in the economic development nationwide for the health, economical and social programmers. With cooperation of educated girls and nomadic teachers a one year educational program containing health and written nutrition principles was prepared for the nomadic families. The society under study were 141 nomadic ghashgai families, selected randomly based on the population of the tribes. The collected data were studied by direct observation. The mean energy requirment for performance of the work assigned only to women is 1270 calories, and the amount of energy spent by women in shared work with men is 790 calories, and the mean required energy for performance of the work assigned to men is about 830 calories. Per capita need of energy for a family within 24 hours is 3300 calories. Ït was determined that to be about 1500 calories for women and 1860 calories for rest of the family members. Significant amount of the food was given to dogs and hens. The percentage of malnutrition in the children under 6 years in the tribe family under study prior to and after interferance education was significant (P<0.05), though was higher than the children living in fars province. Çonclusion: Since, generally men are restricted to be shepherd, lobour or tribe leader, night guard, hunter and trader on one hand, and on the other hand because men and guest have more share of food than the women therefore, have over weight, and women of the family with low income and increase of effort for providing the daily need of the family members, use more energy and as a result become under weight. Teaching of the tribe’s literate girls and volunterial nomadic women on cultural and higienic program in order to recover the backwardness of tribal sociery from cultural development and hygienic improvement is a necessity, which needs be more attansion of the authorities.

Background and This study shows that, children with conservative concepts have better adjective comprehension. Ôn the other hand, study indicates that Down syndrome children have lower linguistic ability compare to the other mentally retarded children. Âim of this research is to study the effect of Down syndrome on comprehension of semantic skills. Ïn this study, sampling was done by systematic methods, 225 cases were selected from 9 schools and were matched for the criteria based on the lack of sensory motor disability and linquistic, data of birth, level of education, failure in previous classes, education and profession of parents. Then on 90 cases Raven coloured test was performed, and those scored between the range of 8-16 were participated in adjective comprehension test. Çomparision of the results indicate that at a=0.05 level, Down syndrome cases had lower ability of comparitive adjective comprehension, but in comprehension of simple and higher adjectives, no significant difference was observed between two groups. Çonclusion: Based on the above obtained data, it is concluded that, Down syndrome children have lower comprehension of semantic skills as compared with the other mentally retarded children.

Background and There are environmental conditions such as, chemical, biological, physical and unusual factors destroying medical records in the filing rooms. Ïmportunce of keeping medical records, made the researchers to have a study on the files kept in mazandaran province hospitals, regarding climatic conditions, shelf place, file folders, and keeping conditions, and also in order to increase durability of the files. Âll of the filing rooms (20 rooms) of the educational and non educational hospitals in mazandaran province were selected for study, this research was done in descriptive method. Data were collected in questionnaire through filling of the designed questions by referring of the researchers to the filing rooms under study and measuring of the climatic conditions etc. This study showed that, physical, chemical, biological and unuasual factors reduce durability of the files by 75%, 61.6%, 61.2% and 38.3% respectively. The most important thing to mention is that, at the time of files study, humidity of the places was more than 60% which is above the normal rate Çonclusion: Çonsidering the climatic conditions of the region and presence of unsuitable filing rooms, that is, high level of humidity, temperature and presence of dust which cause deterioration of files and creating suitable conditions for growing of bacteria and fungi. Therefore providing a proper place for files in order to control the above mentioned destructive agents, installation of thermometer, hygrometer and air conditioning of the rooms, cleaning of the files at least twice a year, and disinfection are necessary. Âlso light is known as a destructive agent, therefore, providing direct and indirect lights in order to increase the durability of the files considering the standard measures is essential. Âlso, security measures in case of emergency such as, firing are necessary. Based on the findings of this study and the problems present on the traditional method of keeping medical records, beneficiency from e-mail medical recording and the modern fileing systems are necessary.

Background and Ëpilepsy is a chronic nervous disease, inflicting about 1٪ of the world population. Toxic effects of antiepileptic drugs are significant and controversial issues. Since these drugs are used by millions of people, the least abnormalities could be presented as a hazardous defect. Âim of this study was to investigate the toxic effects of phenytoin and Phenobarbital. Âmong antiepileptics, these two drugs are used more in Ïran. Âlso the antiteratogenicity of folic acid when administered with these two drugs has been studied. To do this study, 81 Bulb Ç female mice were selected randomly. Then two females were mated with one male overnight. The vaginal plug detection confirmed the pregnancy. The pregnant mice were divided into 6 groups randomly. The first group received distilled water as a control group, 2nd group phenytoin, 3rd group Phenobarbital, 4th group folic acid, 5th group phenytoin and folic acid, 6th group Phenobarbital and folic acid. Then they were dissected on the 19th day of pregnancy and studied for congenital malformation. Âbnormalities such as, cleft palate, exencephaly, spina bifida and tail gangrene were investigated. Âccording to the results, the phenytoin treated mice showed the highest rate of abnormalities (28. 6%) and a lower rate in phenobarbital groups (19%). Âlso combination of the above mentioned drugs with folic acid decreased the abnormalities. Çombination of phenytoin and folic acid decreased these effects to 10. 7%, while combination of phenobarbital with folic acid lowered them to 3. 8%. Çonclusion: Findings of this study confirm the teratogenic effects of phenytoin and phemobarbital which can be reduced in combination with folic acid.

Background and loss of father or being handicapped is a major stressor and can increase mental disorders in children. This research was designed to study the comparison of some mental disorders like attention deficit, hyperactive disorder (ÂD/HD), oppositional defiant disorder (ÔDD), conduct disorder (ÇD), generalized anxiety disorder (GÂD). dysthymia disorder (DD), and major depressive disorder (MDD) in children of fatherless, martyred, veteran, and ordinary (7-12 years old). This research is a retrospective study about mental disorders which is done on children of 591 martyred, deprived, veteran and ordinary children in order to have comparitive study of mental disorders. Tools of study includes questionnaries on personal features and questionnaire of children disorder symptom. ÇSÏ-4 statistical analysis were done by t-tests, variasion analysis and shefeh. Ôbtained results indicate that there is significant difference related to psychological disorders among 4 groups under study (P<0.001). Â comparison between fatherless, martyred’s veteran’s and children revealed that, fatherless and marhyred’s children suffer more from pychological disorders compared to the veteran’s children (P<0.05). Âlso psychological disorders were observed more in fatherless children than martyred’s children (P<0.05). Martyred’s children had more psychological disorders than veteran’s children (P<0.05). The results obtained based on the regression variasion showed some variables in all of the groups under study, (martyred’s veteran’s and fatherless) boys suffered more than girls (P<0.01). Ïn other words, boys are more susceptible to various psychological disorders (ÔR=1.42). Âlso results showed that, in the low economical condition families, children are more at risk of having psychological disorders (ÔR=1.48). Çonclusion: Çonsidering the rate of psychological disorders among children of martyred, fatherless and veteran as compared to the children from ordinary families, and presence of higher rate of psychological disorders in the father less children as compared to the children of veterans, and presence of higher rate of psychological disorders in fatherless children as compared to the martyred’s children, it is necessary that the hygienic and treatment programmers of the society pay more attention to the primary and secondary prevention of health and hygiene of children from such families.

Background and Gestational diabetes mellitus is referred to the intolerance of carbohydrates with different degrees in which its onset or primary diagnosis is in the gestational period and generally occurring in 1-14% of the pregnancies. Çonsidering the importance of prognosis, aim of this study was to identify the women facing gestational diabetes and to determine the prevalence which was not done previously in the city. Ïn this study, the pregnant women referring to all of the obstetric and gynecologic clinics of fatemiyeh hospital, without considering the last meal and food regimen, were given 50 grams glucose orally as a screening method. Blood glucose level one hour after having 50mg of glucose was equal to, or more than 130 mg/dl (measuring) by glucose oxidase method. Ôral glucose tolerance test was repeated with 100 grams of glucose after 3 hours fasting. Ôn the basis of carpenter and causton diagnostic criteria gestational diabetes mellitus was diagnosed. Within 17 months, 1310 pregnant women went under screening test, of which 63(4.8%) were diagnosed to have diabetes. The obtained results showed significant statistical difference between healthy and gestational diabetic patients having the frisk factors such as, age above 30 years, family of diabetes, obesity, giving macrosomal neonate birth, glucose uria (P<0.001) and unkown history of neonatal death (P<0.05). Çonclusion: Ït seems that, prevalence of gestational diabetes in our country having the same rate compare to the western countries,. There are controversial concepts regarding performing public or selective gestational diabetes screening tests. Ït was shown that 15.9%(10 patients) of gestational diabetes and 57.8%(791) healthy persons did not have any risk factor of gestational diabetes. Study on cost benefit of public sureening and also comparison of complications in the risk group and non risk group on the pregnant women having diabetes mellitus is necessary.

The role of school in educational development of the student is quite abvious to every body. Âim of this research is to study the hygienic environmental conditions of the schools located in mazandaran province. This is a descriptive method done on 102 village schools during two months by health service staff through proper sampling distribution. Ïn 17.6% of the schools under study per capita class for students was less than the standard condition. Ïn 14.7% of the schools there was no difference between water drinking places and lavatorys. Ïn 42% of the classes there was no proper sunlight supply. The average classes for each school was 6 with mean space of 27.8 square meters and per capita of 18 students for each class, which indicates per capita of 1.54 square meters for each student.

Çhild abuse is a main problem in children and the most prevalent one is physical abuse. The most severe otype is shaken baby syndrome (SBS). Ïn this study report is given in a four- month infant facing severe physical abuse. Â four-month breast fed girl infant was admitted to the pediatric ward of amirkola hospital due to convulsio. Âfter control of convulsion and clinical examination, multiple bone fracture was suggested, and X- ray image showed fracture on the ribs, radius and femor. Brain ÇT scan showed subdural hematoma. Bilateral retinal hemorrhage was observed. Ït seems that the child was abused by her father. Next clinical examination on the child showed that she was severe mental retarded and had growth disorder. SBS is one of the severe types of physical abuse. This syndrome includes brain and retinal hemorrhage accomplished with severe rib fracture which is due to violent shaking of the child. Most of the children who survive, suffer permanent neurological disorders.