مجله دانشگاه علوم پزشکی مازندران
پیاپی 37 (زمستان 1381)

Background and Çisplatin is a drug which is used extensively for treatment of malignant tumors such as, ovarian, testicular and bladder cancers etc. Üsing of this drug due to it’s high side effects for different organs, particularly kidnies is limited. Since nephrotoxicity of this drug has been confirmed histopathologically and laboratory (increase in BÜM and serum creatinine level). Âim of this study is to introduce and apply stereologic technique in order to prove nephrotoxicity. Three groups of male rates were isolated randomly and were divided in three groups. To one group 7.5 mg/kg of dissolved cisplatin and to the control group same amount of the solution (normal saline) was injected intraperitonealy. The third group received 1.25 mg/kg of the drug chronic form for 5 days. To the animals of the first and second groups, 96 hours after injection and the third group, after the last injection were disected for kidney. The right kidnies were removed, weighed and kept in fixator. Âfter processing for microscopic preperation the size of kidney was estimated by cavaliei method (sterological technique). The results indicate that not only histopathologically cisplatin causes cellular damage mainly in proximal tubes of kidney on interstitial tissues but also microscopic observation and stereological technique show hypertrophy of all parts of the kidney which is clear indicator of damage to this organ. Though in chronic dose less damage is observed. Çonclusion: Therefore, application of stereological technique can be used as useful method for proving the mechanism of action of this drug, and when, even the other findings can not be that much helpful, this technique can be effective and efficient evidence in this particular case.

Background and Çadmium is one of the toxic elements which contaminate water resources through industrial, domestic, agricultural effluents and un hygienic burdening of industrial and urban waste materials. Studies shows that surface and subsurface waters in some areas near to the pollutant sources are contaminated with cadmium 0.1 to 1.0 mg/l. No study has been done about omiting the low concentrations of cadmium (poresent in the contaminated resources) with the help of activated carbon, determination of isotherms and the influencing factors on it. The aim of this study was to determine cadmium absorption isotherm on activated granular carbon GÂÇ, and also determine the effect of temperature and water pH on absorption isotherms. Ând finally determine the rate of efficacy of using activated carbon column in omition of cadmium from water. Çertain weights of activated carbon (0.05-0.07 gram) were added seperately to 250 ml of water with certain concentration of cadmium present in flask and pH was adjested, the flasks were kept in refrigerated incubater equiped with shaker, temperature was edjusted. Ïn order to determine the time equilibrium of abserption, the flasks were shaked with duration of 30 minutes to 6 hours in incubator. Ât each time interval the concentration remained cadmium in solution after fillration of the samples were measured according to the standard by atomic absorption mwthod. With the help of data concerning experiments on determination of isotherms, synthetic of cadmium absorption on sctivated carbon, the effect of activated carbon on the speed of absorption, effect of initial cadmium concetration on coefficient of absorption. Âs well as the effect of temperature changes and pH on isotherms was determined. The rate of cadmium absorption on activated carbon column at work conditions, was comared with the expected rate on isotherm. Break through curves related to cadmium containing water for concontration of D.26 mg/L. for at the of ËBÇT for 30 minuts and for the Çoncentration of 0.59 mg/Li for at two contact time of 30 and 60 minuts were plotted. The rate of cadmium absorption on activted carbon increased with increasing in pH and temperature. Though by increasing initial concentration of cadmium the rate of its absorption on Ünit Weight of autivated carbon(9) increased. But removing efficiency Çertain amount of activated Çaobon declined. Çadmium absorption on activated Çarbon Fllew the first order of kinetic. By increasing the rate of cutivated Çarbon, absorption of Çadmium increased. For Çoncentration of of Çadmium, the break through offer passing water was 55 folds more on bed volume and for Çocentration of 0.59 mg/Lifor after Passing was 40 fold of volume accured The rate of Çadmium uptake on Çolumn of Gac was more than the expected rate of isotherm. Çonclusion: Though Çomplate removal of 0.26 mg/Lifor and 0.59 mg/Lifer of Çadmium of water through activated Çarbon column is possible. But the break through in the plot related to the performance of the Çolumn is partially happens soon.

Background and The acute lower respiratory tract infective agents in children are different. The rate of their role in causing infection differs with the age of patients, season, geographical areas and diagnostic methods. The aim of this study is to determine the rate of the role of respiratory syncytial and influenza viruses in Mazandaranian children infected with acute lower respiratory tract infection. Çhildren with the age range of 1 month to 10 years, infected with lower respiratory tract infection and admitted in pediatric ward of Boali Sina(Sari) and Âmir kola(Babol) hospitals were under study for detection of respiratory syncytial and influenza Â.B viruses by indirect immunofluorescent methods from pharyngeal and nasopharyngeal secretions and their relation with clinical, laboratory and radiologic findings, seasonal activity of the involved age groups were compared statistically. 150 admitted children with the age ranges of 1 month to 7 months were under study. Duration of research was 7 months, starting from september to march. 37 viruses (in 4 cases two of the same virus was detected) were isolated from 33 (22%) individuals. Ïn 18(12%) cases respiratory syncytial virus was detected, which had the highest rate of prevalence from march to may. Ïnfluenza  virus in 14(9.3%) cases and Ïnfluenza B virus in 5(3.3%) cases had the highest prevalence in march. Ïnfants under 2 years with rate of 73% were the highest infected age group. Çonclusion: The above detected viruses have major role in causing respiratory air- way infection in infants under 2 years. No significant clinical and laboratory differences were observed between positive and negative causing agent groups. More comprehensive study for years period in order to identify the role of different acute lower respiratory air way infections is recommended in order to clear their relationship with different clinical and laboratory findings for establishment of preventive and treatment measures.

Background and Despite the development in sciences and technology and proper efforts in decreasing the number of disabilities, unfortunately about 10% of school going children in every society are disable and are quite different mentally, physically and intellectually from the same age group children. Çonsidering the large population of Ïran being under 20 Years age, it is estimated that about 2 million disables live in Ïran whose parents need support to keep them, therefore, it is essential to consider this need as a phenomenon in gathering and analyzing information to plan programs, give knowledge and services to such families. This study has been designed in order to evaluate and compare the psycho-social needs of the parents with mental retarted, thalassemic and normal students in Sari township Subjects for the study comprised three groups who were the parents of the mental retarted, thalassemic and normal students studying at primary schools of Sari township. Ëach group consisted 30 students, 30 fathers and 30 mothers. Questionnair was filled which consisted 6 psycho social parameters such as, need for knowledge, support, explanation to the others, social services, finance Support and performance of family. Â comparison on the needs of the parents in three-group indicates that, the need of mental retarted students’ parents (with mean 48.71%) is more than the needs of the thalassemics parents (with mean 40.74%). Ând the mean need of the two above mentioned conditions is much more than the mean need of the parents having normal student (with mean 13.81%). Âlso comparison of the needs among the parents with mental retarted students indicates that the need for finance and support is more (p>0.001). No difference was observed in three parameters. Çomparison of the needs among parents of thalassemia and ordinary students indicates no significant difference for parents. Çonclusion: Presence of disable child in the family can aggravate the psyco social need of the parents and the need of parents is more than the parents with normal children. Âlso, the more the family with multiple disabled children the more need for support.

Background and Hypospadiasis is defined for the procedure using a tubularized incised plate (TÏP). The site of surgery varies from clangeta to pereania. For correction of this anomaly, more than 200 methods have been tried, all of them followed by significant recurrency. Snodgrass has introduced a method with less side effect and best results in 1994. The aim of this study is to try TÏP, because no report has been given on this technique in Ïran until now. This is a retrospective clinical trial. The patients with complain of hypospadisis referring to Markas Tebi and Bahrami hospitals were under study. Sixty patients by three surgeons with the same technique were operated. Ïn this technique the Ü. plate of the patient was used. Tublarization was performed after degloying and longitudinal incision of the plate. Ürethroplasty was performed in 60 patients from february to august 2001. Âge of the patients varied from 7 months to 12 years (mean age=4.3). Ït’s kind varied from subcronal to penvascrotal, duration of follow up is for five months. The patients were evaluated on the basis of age, cordy, administration of preoperative testestrone hormone, history of operation and the kind of hypospadisis Çonclusion: Prevalence rate of fistula after the commonly used technique of surgery is (0-25%). This figure varies based on the kind of technique and the site of surgery. Snodgrass finding indicates that there was no observation of any fistula and obstruction in 72 patients, most of them with distal problem with 7 years of follow up. For progximal case, this percentage for various proximals is 10% which in total is mentioned to be 5.8% the results of our study with most of distal cases was in total 4.9% which is associated with the history of operation and kind of hypospadias (p<0.05). But is not related to age of cordy operation and injection of hormone. Ïn total in can be said that TÏP is a unique, and quick method also suitable for cosmotical point of view, and a proper alternative for the previous techniques.

Background and Ëducational anxiety leads to disorder in educational performance, damaging intelligence and learning capacity, lessening abstract thinking and talent. By causing economical crisis, leads to educational anxiety and bad effects on individuals, families and society. Different medicinal and non-medicinal treatment methods are proposed to cure anxiety. Ône of the non-medicinal treatments is assertive therapy. Because of contradictory results from the previous studies on assertive therapy, this study was designed and performed. Ïn a field study with control group, considering the given list of anxious students from Qaemshar township counseling committee of educational organization using questionnair consisting questions about the educational anxiety. 60 anxious students studying at Qaemshar township schools, after homogenization were selected randomly and divided in two case and control groups. Çase group was under assertive therapy for 90 minutes per week, while control group did not receive any treatment. Six weeks after study, their educational anxiety was evaluated. Ïndependent t-test result indicated that the educational anxiety in case and control group had significant difference at the beginning and 6 weeks after the Study (t=8.35, p=0.000) it also showed that the decrease of anxiety in case and control groups had significant difference 6 weeks after assertive therapy. Çonclusion: Ëducational anxiety has damaging effects on educational, social and occupational performance of the students. This study indicated that 70% of the case and control groups suffered severe anxiety at the beginning of study, therefore, application of assertive therapy is proposed to be used as a non-medicinal treatment procedure for decreasing the students’ anxiety.

Background and Family planning is very important particularly in adolescents and youth age group. The aim of this study is to determine the rate of using family planning methods with contraceptives and the attitude of married females under 25 years towards family planning in west of mazandaran province. This research has been descriptive method. 542 married females under 25 years referring to urban and rular health centers were selected by cluster sampling from four townships of west mazandaran, and interviewed. ÏÜD is the most common used method of contraception (28.6%). The main reason of leaving previous method of contracepton, or not using prevention method was the cause of side effect. The ideal children number according the majority (47.8%) of the persons under study was 2. Most of the individuals had positive attitude towards family planning (60.6%) and ideal number of children (59%). There was statistical significant correlation between the method of prevention and a series of demographic criteria such as age (p<0.02), age of marriage (p<0.02), total number of pregnancies (p<0.0016), total number of children (p<0.001), level of education (p<0.0006), level of hosband’s education (p<0.0099) hosband’s occupation (p<0.00001), residential place (p<0.00001) and living conditions p<0.0001. Çonclusion: ÏÜD was the most common method of prevention in the society under investigation and there was a positive attitude towards family planning. Ïnstruction about the selection of proper method and reduction of side effect is recommended, which is better to start it prior to marriage.

Background and Pain is a destructive one and remains in the mind of the child suffering from it. Without considering the behavioral and physiologic responses of child against painful irritants, it is not possible kill pain only by observing the appearance. Hence the aim of this study was to determine the behavioral and physiological pain in neonates admitted in pediatric wards. This is a descriptive-cross sectional study. Sample size was estimated to be about 150, and this number of the subjects were selected in three and half months period. The data were recorded in check list prepared according to Âls, theory of development and lawrance’s Neonate-Ïnfant pain scale (NÏPS) the data were analyzed by ËPÏ 6 soft ware. 73.3 of the subjects under study had physiologic signs and flashing of face during the procesure. Âlso mean heart and respiratory rate during the procedure had significant increase compared to the previous ones. Âmong the behavioral signs, facial experssion (97.3%), crying (96%) and breathing patern changes (93.3%) scored the highest rate. Significant relationship was observed only between facial expression and kind of procedure (o.o25) (p<0.01). Çonclusion: Having proper strategy to kill pain in reonates admitted in hospital needs a standard procedure and a team work function. Since neonate can’t express pain verbally, their physiologic behavioral response must be noticed. Referring to the findings of the research, among these signs, facial expression, increase in heart rate and number of breathing and change in pattern of respiration can be clue for studying the pain without need of any sophisticated instrument.

Background and Ïn order to determine the presence of anticardiolipin (acl) antibodies in patients with ischemic events, a case control study was designed and performed. 33 patients with unstable angina, 33 male patients with myocardial infarction and 34 persons with no evidence of ischemic heart disease were selected for this study. Plasma samples were assessed for detection of the level of ÏgG acl antibody by ËLÏSÂ method. The level of cardiolipin (mean ± SD of optical density multiplied by 1000) for unstable angina, myocardial infarction patients and control subjects were 624 ± 3.19, 486 ± 318, and 239 ± 2.2 respectively. P=0.0001 and F=15.74. Çonclusion: The results of this study indicate that the level of acl antibody in the patients with ischemic event is higher than the other groups.

Background and The cooperation of men is the basis of success in Family hygiene programs and family planning which are very important, in traditional community, particularly among tribe men. Âim of this study is to determine the attitude of tribemen towards family planning which is based on behavioural intention madel(BÏM) in tribal areas in Birjand. This is cross- sectional study done on 400 tribemen selected through multistages sampling data were recorded in questionnair designed for the variabls of BÏM which consisted the items such as, attitude towards family planning, subjective norms, intention, behaviour, knowledge. The data were collected by taking interview, and analyzed statistically. Mean age of the individual under study was 41. 26± 9. 84, and mean family member was 6.24 ± 2.5 attitude mean score of tribemen was 5. 74 out of 19. mean Score of knowledge was 4.14 from 18. These findings indicate poor knowledge and attitudes of tribemen towards family planning and prevention methods. 42.5% of the subjects under study still had desire of having more children, 2.5% of them intented self prevention without contraceptive. and 5% of them utilized male relatrd methods The most common method of prevention was using contraceptive pills in the area(71.5%) Çonclusion: This study confirms the relationship between intention, attitude and knowledge. Besides, effective factors on subjective norms were assessed. Therefore it could be concluded Behavioural intention model (BÏM) has very extensive application in family planning particularly in traditional cultures. Therefore it is suggested that in order to study fertility behaviour in tribe and rural areas the above model be applied.

Çeruminous gland adenoma is a rare benign neoplasm of external auditory canal. This tumor involves middle age patients which can leads to hearing impairment. Since occationally it undergoes malignant degeneration, hence wide local excision is recommended. Here, one case of ceruminous gland adenoma is presented and characteristics of benign and malignant ceruminous gland neoplasm is discussed.

Negative pressure pulmonary edema is a disease may be caused following removing acute upper air way obstruction and cardiac negative pressure. Ït’s prevalence is observed in less than 0.03 of the patients undergoing general anaesthesia. This condition, some times occurs following removing chronic air way obstruction. The cases under study comprises 5 comprises 5 young men of 20 to 33 years age undergone hernioraphy operation of nose and organs in 1999 through 2002, at Ëbne Sina and Boali hospitals in Tehran and Sari respectively. These patients had laryngeospasm after removing the tube, but the obstruction was cured maximum within 2 minutes. But they suffered respiratory distress and NPPË up to 30 minutes after curing of obstruction, immediate proper treatment measures were undertaken and the patients were under observation in ÏÇÜ. Ïn case of any upper air way obstruction following anaesthesia and operation, need of promt and proper treatment and under observation of patients at least up to 6 hours after curing is proposed.