مجله دانشگاه علوم پزشکی اردبیل
پیاپی 27 (بهار 1387)

one of the most common causes of Epiphora or lacrimation or recurrent infection is Dacryocystitis. The Dacryocystorhinostomy operation, which involves fistulization of the lacrimal sac into the nasal cavity may alleviate the symptoms. Since the routine usage of silicon tube in DCR operation for reducing the replapse has been a controversial issue, This study was done to investigate the rate of success of DCR operationwith silicone tube. This study was a cross-sectional descriptive study in which all of the patients (189) who had history of DCR at Sina and Alavi hospitals were asked to continue the treatment after the operation through contact or follow up from home. So the results of their records were analyzed statistically. 102 out of 189 patients had history of operation who had referred for follow up, in terms of most prevalent symptoms, epiphora and purulent discharge was the highest 55.6% and the second one was epiphora alone 29.1%. The operation prevalence was more in women 74.1%. than in men 25.9% and unilateral involvement 97.3% was more than bilateral one. The highest age prevalence in DCR operation was 30-60 years. The surgery was successful in 82.3%. It was a little more successful in men (85.7%) than in women and the mean age of patients with successful DCR surgery was more than that of patients with unsuccessful DCR surgery. The results showed that the rate of recovery in unilateral involvement is more than that of bilateral involvement. Also, success after the operation in patients whose primary complain was only purulent discharge was significantly more than those whose primary complain was epiphora and purulent discharge, It also seems that routine application of silicon tuby in DCR surgery has no effect in the increase of recovery and decrease of diseaserecurrency which of course more prospective studies are required to prove this.

one of the most important challenges during the recent century will be to decrease the global burden of accidents. In Iran although respiratory infections and diarrhea were major reasons of mortality rates, Accidents have come to be one of the main causes of child mortality. In rural areas of ardebil province burns constituted 75% of homeinjuries in preschool aged children. The study was conducted as a case-control study which included rural children of Ardabil under 6. Number of cases were 145 & controls were 289. Data analysis was done using SPSS 11 ver. 6.8% of case group mothers and 12% of control group mothers had academic education. Difference of mean for sill of kitchen and the ratio of sill of kitchen on sill of house and also difference of mean for sill of house per person were not statistically significant between case and control groups. No statistically significant difference was found in fuel type used cooking or heating between case and control group. No statistically significantdifference was found in heating device between Them. only in one third of houses in both groups separate place was available for cooking purpose and cooking was done in rooms.Child presence in kitchen while cooking was 76.7% in case and 70.9% in control group. Child access to flamers like lighters and matches was 80% in case compared to 69% in control group. The difference was shown to be statistically significant. No statistically significant difference was found in using Valor's and picnic gas for cooking between case and control group.chance of burn injury in preschool aged children in those houses that keepmatches and the lighters out of children reach was 1.8 times lower.

Brucellosis is one of the most common zoonotic diseases in Iran and is endemic in all parts of the country. Patients recorded in 1988 were 71,051(132. 4 per 100,000). Brucella species are facultative intracellular bacteria, and therefore a limited number of antibiotics are effective against these organisms. The aim of this study was theevaluation of in vitro sensitivity of various antimicrobial agents against 47 brucella melitensis strains isolated from blood culture. The susceptibility of 47 Brucella melitensis isolates derived from clinical samples were tested in vitro. The minimum inhibitory concentrations (MICs) of the tested antimicrobials were measured by the agar dilution method.MIC90 and MIC50 values were defined as the lowest concentration of the antibiotic at which 90 and 50 percent of the isolateswere inhibited, respectively. The NCCLS criteria for slow growing bacteria were considered to interpret the results. Tetracycline (MIC50: 0.13μg/ml, MIC90: 0.25 μg/ml) and streptomycin (MIC50:0.003 μg/ml, MIC90:0.25 μg/ml) had the lowest MICs in vitro against the B. melitensis strains. Norfloxacin had the highest (8 μg/ml) MIC90 value. More than halfisolates presented reduced susceptibility to rifampin (MIC value: 2μg/ml). Brucella isolates remain susceptible in vitro to most antibiotics used for treatment of brucellosis. There is no significantly important resistance problem for antibiotics targeted against Brucella species in Iran. However, since rifampin is commonly used for prevalent diseases such as tuberculosis, the regional susceptibility pattern of rifampin should be assessed periodically.

As life expectancy increases health promotion behaviours are even more important, particularly with regard to maintaining functional independence and improving quality of life (QoL). The purpose of this study was to explore the relationshipbetween health promotion behaviours and quality of life among elderly people in west region of Tehran. This was a descriptive-correlational study. Through multi-stage sampling method, 410 participants over 60 years old and cognitively intact were selected to contribute in the study. The data-gathering tool consisted of a 2-part questionnaire; Health Promotion Behaviour Checklist and Short Form Health Survey (SF12) that were used to measure QoL. The results of the study showed that there were statistically significant differences in QoL of the elderly related to 'exercise or walking and consumption of milk, dairy products, meat, vegetables and fruits and 'low salt diet', 'low fat diet', 'health check up', 'blood pressure (BP) (p< 0.05). The Elderly with high quality of life had more exercise or walking and consumption of milk, dairy products, meat, and fresh fruit and vegetables and the elderly with low quality of life, had better observed low salt diet, low fat diet, health condition control and blood pressure control. Regarding the results we found that health promotion behaviours and the quality of life are related meaningfully, so, considering old people as a vulnerable group by health authorities, it is recommended to provide this group with programs and facilities to promote their health behaviours, social participation and to improve health care and provide consultation services.

Emphasiz to the research in any country leads to develop and progress of it, and it presents the self- sufficiency and real independence for that country. The first step to optimize the research in society is to obtain the correct understandding fromcapabilities, possibilities and to find the weakness and strength aspects of investigations. This study aspeet's of has been done regarding the above-mentioned aims. This was a descriptive-cross-sectional study, that has been done to determine the view of Ardabil province Universities scientific member's about research and its limitations by simple sampling. Data collection tools were questionnaire including two parts: the first part, consisted of personal-social specifications and the second part, consisted of five parts (personal, intra- organizational, extra-organizational limitations, characteristics and their attitudes to research. the results showed that in related to the personal limitation overworking with mean 2/75±2/48, in the intra-organizational limitations, to be low the investigation payment in relation to the passed time with mean 3102±1/14, in the extra-organizational ones, ineffectiveness of the investigation results in managers decision 2/81±/44, in the characteristics, sensitivity of the scientific research 2/8±1/17 and in to promote and progress of the society, with mean 4/72 ± /53 had the highest scores. many factors such as parsonaling, intra-and extra-organizational and characteristic factors, attitude to research on the view of scientific members of the restriction factors

Many factors interfere in liver fibrosis one of which is hepatitis B.The aim of our study was to determine the parameters serum iron, TIBC and ferritin of patients with hepatitis B and fibrosis of the liver Study involved 50 cases with liver fibrosis and viral hepatitis type B (2002-2004)and 26 controls. Iron concentration, Total iron-binding capacity and Ferritin concentration were measured by standard biochemical methods. To compare the results of the two groyps a student t-test was used and considering p< 0.05 the difference between two groups was significant. The results showed that serum ferritin increase 243.7±16.7 micro gr/L and 238.7±13.9 micro gr/L in man and women patients with chronic hepatitis B virus infection compared to the control group, 198.5±14.3 and 182.7 ±14.3 mg/L in man and women, respectively. No significant difference was found between serum Iron and TIBC in both groups. there was a significant relationship between them. Increased serum ferritin concentration and liver fibrosis induced by hepatitis B virus infection. Also, determination of serum ferritin could help in diagnosis of liver fibrosis.

Ingrowing toe nail disease is caused by excessive lateral nail growth in to the nail fold. Because of high incidence of this disease and high percentage of recurrence after routine treatments, we decided to compare the matricectomy with phenol %88 with electrocoagulation. This research was an clinical trial study that have been done on 30 patients with bilateral ingrowing toe nail disease who referred to the Dermatology clinic in the Ardabil Imam Khomeini Hospital, from October 2005 to September 2006. In each case, phenol %88matricectomy used on one side of affected zone and lectrocoagulation used on the other side.The data was collected with questionnaire and the time for follow up patients was six months. Collected data analyzed by SPSS, chi square and fisher exact test. Average age of patients was 24.56±5.40 years old, ratio of female to male was 3 to 2 and in all patients affected site was the big toe. Most of the patients were in primary level of education (%33.3), 18 (60%) patients had secondary infection, 8 (26.7%) patients hadabscess, 13 (43.3%) patients have granulation tissue and no cases of onychomycosis were detected. Recovery period with phenol was 2-4 weeks and recurrence or side effect were not seen. Regarding the recovery duration these two therapeutic methods had significantstatistical differences only during the second fortnight (p=0.001). But there was no significant statistical difference in recurrence period and side effects. Matricectomy with phenol %88 had less recovery time than electrocoagulation.

Depression is a debilitating disorder with high prevalence especially in child-bearing women. This study was done to determine relationship between postpartum depression and its various risk factors. This was a descriptive-analytic study on 600 women referring to health centers in Tabriz. Data were gathered using a questionnaire including 5 parts: demographic characteristics, mother-newborn characteristics, Rosenberg self-esteem scale, Holms stress scale, Edinburgh Postnatal Depression Scale. These data were analyzed by descriptive and inferential statistical methods in SPSS 14/win software. In this study 34.7% of mothers were depressed (scores>12). Significant risk factors for postpartum depression were: Marital dissatisfaction, relationship with mother, mother-in law and husband's family, job dissatisfaction, house condition, having an unpleasantpregnancy experience, unplanned pregnancy, baby care stressors, infant feeding method, nursing problems, mother's self-esteem and stress level. Concerning high prevalence of postpartum depression in this study and other similar studies and effects of some factors in this disorder, it seems to be necessary to improve the knowledge of mothers and health care staff about this risk factors for reducing effects of this disorder on physical and psychological health of newborns, mothers andcommunity.

Labor pain is one of the most severe pains that mothers experience. Intense pain leads to stress and has unfavorable effects on the mother and fetus. This research was done to determine the effect of using Entonox (N2O) self administration on reducing labor pain in the active phase of labor& delivery, Mode of delivery, and newborn's Apgar score. One hundred and twenty primiparous women in 29 Bahman Hospital in Tabriz were included it this randomly single-blind research. In the active phase of delivery, Entonox and Oxygen gases were used. The severity of the mother's pain was asked and was scored according to analogue criterion. There was a significant difference in frequency of pain intensity in two groups of Entonox and Oxygen. The Mean score of pain intensity in Entonex user, in the first & second stage of labor was 5.93% and 5.82% respectively, while for the oxygen users it was 6.99% and 6.74% which was significant. 41.7% of the mothers in the Entonox group had a severe pain and 11.7% had a very severe pain, whereas in the Oxygen group 58.3% of the mothers had a severe pain and 25% of them had very severe pain (p< 0.001). Meanwhile we found no significant difference between modes of delivery; progress of labor and newborn's Apgarscore. According to research results, Entonox reduces the intensity of labor pain more than oxygen and is effective during the first and second phase of delivery.

Hydatid cyst disease is a zoonosis disease that is common in both humans and animals. Humans acquire echinococcosis by ingesting viable parasite eggs with their food. The hydatid cyst tend to be in the liver (50-70% of patients) or lung (20-30% patients) but may be found in any other organs of the body, including brain, heart, and bones (less than 10%). Symptoms are often absent, and in many cases infection is detected only incidentally by imaging studies.This paper presents a case of hydatid cyst who admitted with non specific symptoms such as blotting, recurrent constipation and abdominal distention. Abdominal CT of the patient found low density mass in the right side of abdomen (in small bowel mesentery), without involvementof the liver, kidney, spleen, and pancreas. The patient candidated for resolution of cyst with lapratomic style. And in operative laparatomy a typical hydatid cyst was found and confirmed by pathology and similar reports were not found by the author regarding the literature.

Iodine deficiency is one of the most important life-threatening factors from the beginning and encounter irreversible damage to human. This study aimed to investigate stability of Iodine in iodized salt in different situations such as light and humidity and comparing it with standard amounts. In this cross-sectional descriptive-analytical study, 12 samples of iodized salts which have been distributed in Damghan, were accidentally selected. Samples were examined in the chemistry laboratory of Faculty of Health (Damghan University of Medical Sciences) using titration method recommended by British pharmacopeh. 10 mg of each iodized salts were kept at presence of light, darkness, humidity, and non- humidity situation and then titration method was performed. The samples were kept for two weeks and examined weekly. Data were analyzed with T paired and ANOVA tests using SPSS software. Findings of this study showed that reduction of Iodine was seen for all samples. The amount of reduction were 2.2, 1.5, 4.1 and 2.1 mg/l for purified salts at light, darkness, humidity, and non- humidity situation, respectively. The amount of reduction were 3.4, 2.1, 5.35 and 2.6 mg/l for non-purified salts at light, darkness, humidity, and non- humidity situation, respectively. In spite of reduction in Iodine, concentration of it was at standard amount (30-50 PPM). Results showed that stability of iodine was more when salt was exposed to darkness in comparison with light situation (p< 0.09). Meanwhile, the stability of purified salts was more than the non- purified salts (p< 0.28). Also, stability of iodine was less at humidity in comparison with non- humid situation (p< 0.006). The purified salts which was exposed to humidity was much stable compared to the non- purified salts (p< 0.28). It also, demonstrated that the amount of iodine stability was more for salts which was exposed to light in comparison with humidity (p< 0.05).

Visceral leishmaniasis (kala-azar) is an infectious-parasitic disease occurring sporadically in various parts of Iran. The disease is endemic in Ardabil, East Azarbaijan, Bushehr and Fars provinces. This study was performed with the aim of evaluation and comparison of direct agglutination test (DAT), indirect immunofluorescent antibody (IFAT) and ELISA in sero-diagnosis of visceral leishmaniasis that is following a seroepidemiological survey in Germi district of Ardabil province. Cluster sampling has been performed from ≤12 years old and 10% of the adult population in Germi district. Altogether 1155 blood specimens were collected to detect anti- Leishmania antibodies. The samples were tested by direct agglutination test (DAT), indirect immunofluorescent antibody (IFAT) and ELISA methods. 32 (2.8%) of the collected specimens have anti-Leishmania antibodies with titers ≥1:800 and from total specimens 7 (0.6%) were positive with ≥1:3200 titers. In IFA test 32 (2.8%) have titers ≥1:40 and from total specimens 6 (0.52%) were positive with ≥1:320 titers. In ELISA test 8 specimens were positive and other specimens were negative. According to the results of this study, IFAT and ELISA are specific and high sensitive tests for sero-diagnosis of visceral leishmaniasis but these methods are expensive and require the complicated tools. Whereas, DAT is a simple method, not expensive and require a simple local laboratory with one or two trained technicians. Therefore DAT could be used for seroepidemiological studies and sero-diagnosis of visceral leishmaniasis in endemic areas instead of IFA and ELISA methods.

Hemorrhage is one of the most common complications of the tonsillectomy that needs accurate intraoperative control. Different techniques are used for its control. The present study was carried out to compare the hemostasis efficiency of electro coagulation with that of suture legation following tonsillectomy operations under identical conditions. The prospective study from 2004-2006 was done on 100 patients. Homeostasis was done by suture legations on one side and bipolar diathermy electro coagulation on the other, in the same patients. Then we compared the length of operation, volume of intra-operative hemorrhage, post-operative pain, immediate and late post operative hemorrhage. All of operations were done by the same surgery team and all of data were analyzed in SPSS 14 by paired T-test and Macnemar. In our series of 100 patients, the mean length of operative time was 8.6 minutes for hemostasis by bipolar electrocoagulation procedure, and 11.3 minutes for suture legation (P< 0.005). Intraoperative blood loss volume by electro coagulation were 9.6cc and by suture legation 12.7 cc (P< 0.005). In 88 patients no difference was in post operative pain but in 7 patients suture legation site had more pain and in 5 patients bipolar caused more pain. With CI 95% there was no significant difference between them. Electrocoagulation was found to be more effective, easier, and faster than suture legation. Therefore, we recommend this type of hemostasis for children whose length of operation and volume of blood loss is important for them.

Some studies have shown the protective effects of Etomoxir and Ranolazine in the hypoxic and ischemic condition of the heart. However, at present, there has not been any comparative study between the effects of Etomoxir and Ranolazine onischemia/reperfusion injuries (esp. infarct size), So their effects on infarct size in the ischemic isolated rat heart were studied and compared. Isolated rat hearts were divided into 3 groups randomly (n=6 in each group) and mounted on a Langendorff apparatus then perfused by a modified Krebs-Henseleit solution. In control group, the hearts were perfused by the solution at stabilization, 30min regional ischemia and 120min reperfusion while in the test groups they were perfused by enriched Krebs solution with 1μM of Etomoxir or 20μM of Ranolazine during ischemia/reperfusion. At the end of reperfusion, Evans Blue solution was infused to stain the non-ischemic area. Then the heart was incubated in 1% thriphenyl tetrazolium chloride solution and fixed by formalin. The infarct size was determined by a computerized planimetry package. The results showed that Etomoxir results in the significant decrease in the size of infracted area. In the control group, infarct size was 6.3±2.9%, while Etomoxir reduced infarct size to 20.9±5% (p< 0.01). Perfusion of the hearts by Ranolazine enriched Krebs solution produced greater reduction in infarct size (16.4±3.6%, p< 0.001). The effect was not statistically significant between the test groups. It seems that Etomoxir (an inhibitor of fatty acid uptake by mitochondria) and Ranolazine (an inhibitor of fatty acid oxidation by mitochondria) probably, by indirect increasing of glucose oxidation, duning ischemia and reperfusion, may improve reperfusion recovery of ischemic heart and reduce infarct size. The results showed protective effects of Etomoxir and Ranolazine on infarct size without any significant difference between them.