فصلنامه کومش
سال یازدهم شماره 1 (پیاپی 33، پاییز 1388)

Inadequate weight gaining is common cause of prolong hospitalization, increased costs and complications in preterm and low birth weight infants. For these reasons, the present study was undertaken to investigate the effect of oil massage on weight gaining in hospitalized preterm infants in NICU of Ghaem hospital. This clinical trial was performed in neonatal intensive care unit of Ghaem hospital between April 2007 and April 2008. Sampling was nonrandom and samples were divided randomly to three groups: 1) massage with oil 2) massage without oil and 3) control group. Finally, daily weight gaining was compared between three groups. In this study, 121 preterm neonates (age < 28 days) were selected and randomly divided to three groups: 1) oil massage group 2) massage without oil group 3) control group. In three groups, weight gaining was recorded daily and compared together. There was no significant differences in mean gestational age, height and head circumference (p>0.05) between three groups. The Mean of weight gaining on day seven was respectively 105±1.3g, 52± 0.1g and 54 ± 1.3g in the MCT oil massage group, the group with massage without oil and the control group. These differences were statistically significant only between the MCT oil massage group and massage group (P=0.002) and also between the MCT oil massage group and the control group (p=0.000). In preterm neonates, MCT oil massage can promote weight gaining, probably by transcutaneous absorption.

Beijing strains constitute more than 1/4 of Mycobacterium tuberculosis (MT) genotypes. Beijing genotype is considered an important genotype because of its reasonable characteristics such as association with multi-drugs resistance TB. The aim of this study was to identify the genetic pattern of MT Beijing genotype using spoligotyping, variable number tandem repeat (VNTR) typing and RFLP-IS6110 methods. Materials ands 238 MT culture positive specimens (2007-2008) were genotyped by spoligotyping. Thereafter, the isolated Beijing genotype was subjected to VNTR typing and RFLP analysis. The results of Spoligotyping were analyzed using SPOLDB4 database. VNTR typing was used to identify alleles diversity in 9 locus (MPTR-A, ETR-A, ETR-B, ETR-C, ETR-D, ETR-E, ETR-F, QUB11B, QUB3232) of the isolated Beijing strains. The allelic diversity of VNTR was measured using Hunter Gaston Index (HGI). The spoligotyping of MT isolates revealed the following 8 patterns: Haarlem (27.7%), CAS1 (25.2%), EAI3 (21.8%), CAS2 (6.7%), T1 (6.3%), Beijing (5.5%), U (5%), T (0.4), EAI2 (1.2%). By VNTR typing, the QUB3232 locus was identified as the most distinctive (HGI≥0.6); ETR-F, ETR-E and QUB11b loci; as median distinctive loci (HGI≥0.4-0.6) and other loci as the weakest distinctive locus for Beijing families.The Beijing strains demonstrated diverse patterns in RFLP, 13/13(100%) and VNTR 10/13(77%). The ariety of genetic patterns revealed the reactivation in the studied population. As RFLP method is a time consuming and costly effective method, VNTR and spoligotyping method can be used as alternative methods for molecular epidemiology of MT.

Taguchi method is an experimental design approach based on, we can predicate the effect of factors and optimum levels of operational factors with a minimum number of experiments. Propylene glycol is a synthetic organic which can release to the environment and cause health and environmental effects. The objective of this study was to determine the optimum conditions of propylene glycol removal in a fixed bed activated sludge bioreactor by Taguchi method. Following the adaptation of microorganisms, which were obtained from a municipal wastewater treatment plant to different concentrations of propylene glycol in a fixed bed activated sludge reactor, optimum conditions of operational parameters of bioreactor such as hydraulic retention time, influent COD, source of nitrogen and volume of fixed bed of aeration basin with packing were determined in three levels by Taguchi method. COD removal efficiency of synthetic wastewater containing N and P based on C:N:P ratio of 100:5:1 in the fixed bed activated sludge reactor with HRT of 14 h and influent COD of 500, 700, 900, 1100, 1300 and 1500 mg/L was 95%, 92%, 91%, 86%, 81 and 77% respectively. Optimization of the process by Taguchi method showed that HRT of 6 hours, influent COD of 1000 mg/L, fixed bed volume of 30% and NH4Cl as the source of nitrogen with importance priority of 47.96%, 29.927%, 13.25% and 8.857% were determined as optimum conditions of operational parameters of the fixed bed activated sludge rector for propylene glycol biodegradation respectively. Results of this study indicate that by the use of Taguchi method, optimum operational conditions of fixed bed activated sludge reactor for propylene glycol can be predicted

Environmental control of allergens and irritants is the essential part of allergy control and management. Molds are among important aeroallergens which can proliferate enormously in both indoor and outdoor environments, especially in poor ventilated humid milieus. The prevalence of mold sensitization and some related factors in allergic rhinitis patients were investigated in the current study. In this cross sectional study, 300 patients with the signs and symptoms of allergic rhinitis who referred to Semnan (Iran) allergy clinic during 2006-7 were selected and underwent skin prick test with standard extracts of allergens. "Wheal and Flare” reaction of each of the allergens were compared with negative control and wheals of 3 mm larger than wheal of negative control and flares of 10 mm larger than flare of the negative control were considered as positive and the patient were regarded as sensitized to that allergen. 26.7 %(95% Confidence Interval: 21/7-31/7%) of patients demonstrated to have been sensitized to one or more allergenic molds. Aspergillus (12.3%) and Penicillium (8.3%) were shown to be the most and the least commons allergenic molds, respectively. Cladosporium (11%) and Alternaria (10.7%) were among the important allergenic molds. There was no relationship between the prevalence of mold allergy with urban and rural environments, and also patients’ gender. A significant association was only observed between age and Alternaria sensitization (P=0.036), but not found with other molds (P>0.05). Mold sensitization is a relatively common finding among patients with allergic rhinitis. Elimination or reduction of mold exposure in allergic patients is of special consideration and measures to reduce environmental factors which facilitate mold growth and proliferation is very important.

Obesity results in some diseases such as of atherosclerosis diabetic and therefore influence on the immune system, greatly. Given the undeniable role of sport in general health, the aim of this present study was to assay the effects of regular exercise on serum levels of immunoregulators factors (leptin, tumor necrosis factor- α (TNF- α) and interleukin-6) in obese and lean men. 37 male subjects divided two groups of obese and lean with body composition analyzer. Blood samples were taken 48 h before starting the aerobic training program. Then, both groups performed the aerobic training program included running with 65-85% of individual maximum heart rate on treadmill for 3 sessions per week, 30 minutes per session and 2 consecutive months. Then another blood sample was taken following the training period. Serum levels of leptin, TNF- α and interleukin-6 of all subjects before and after the training period were measured using standard biochemical methods from all the subjects and all the parameters were measured in both groups again. Our results showed that the aerobic training resulted in a significant decrease in leptin levels in obese (p=0.000) and non obese (p=0.004) peoples and also a significant decrease in TNF- α (p=0.042) in lean people. However, the aerobic training had no significant influence in the levels of interleukin-6 in both groups. The results showed that regular and light aerobic exercises could decrase leptin levels in both obese and lean men, but have differential effects on levels of TNF- α in both groups. These effects may influence functions of immune system and metabolism in obese and lean men in a different way

Releasing crude oil in environment tends to some problems such as toxic effects، preventing oxygen exchange with aquatic environment، killing lived creatures in water and etc. Due to these problems، the biodegradation of floating crude oil by isolated microorganisms from environment contaminated by crude oil was studied. in the first step of this study، by liner culture، microorganisms isolated from soil and waste water contaminated by oil. After isolation of microorganisms، the optimization of biodegradation process was performed by using Tagochi method. The tests were performed twice. Five factors in three various levels used in this optimization. These experiments perform duplicate and finally process by tagochi method for determination of optimum condition. In this study 14 strains of microorganisms were isolated and purified form environment. All microorganisms were identified as bacteria. Among of those، the microorganism called A-14 had the best removal percentage of floating crude oil (about 89%). The emulsification test (E24) indicated that all isolated microorganisms in this study could produce biosurfactant. The optimum condition was obtained for pH equal 7، the volume percentage of crude oil in water equal 3، nitrogen concentration equal 1 mg/l and hydraulic retention time (HRT) equal 5 days. In the optimum condition the removal percent of crude oil was 93%. In this study crude oil with higher concentration was degraded in the time less than other similar previous researches

Factor XI is a glycoprotein that important role in blood coagulation. The aim of this study is determine correlation of thrombotic factor and bleeding severity with factor XI deficiency. 24 patients with factor XI deficiency were included in this study. Following physical examination and interview, a questionnaire was filled for all the patients. A blood sample was collected for measurement of coagulation factors (II, V, VII, and VIII, IX, X, XI, XII, and XIII), fibrinogen, protein C, protein S, antithrombin III, PG20210A, factor V Leiden, MTHFR gene and Homocystein. 54.2% and 45.8% of patients were male and female, respectively. Mean (±SD) age of patients was 27.2±13.6 (3-49) years. 45.8%, 29.2%, 25% of the patients showed mild, moderate and severe bleeding, respectively. Although, a significant positive correlation was observed between factor V and bleeding severity (P=0.033, r =0.491), there was no correlation between bleeding severity and other thrombotic factors. The findings showed that a positive correlation between factor XI deficiency and factor V. We need more studies as multicenter studies to detecting the relation of other thrombotic factors with bleeding severity in patients with factor XI deficiency

Fine needle aspiration (FNA) is one of important diagnostic procedures in evaluation of masses of salivary glands which is noteworthy due to its simplicity and cost-effectiveness. This study aimed at comparing the results of FNA in masses of salivary glands with results of post-excisional histological examinations. In an analytic-descriptive setting، 51 patients with masses of salivary glands were recruited during a 30-months period (April 2005- September 2007) in ear، nose and throat and pathology wards of Tabriz Imam Khomeini Hospital (Iran). Firstly، all the patients evaluated with FNA and then، post-excisional histopathological studies were carried out، considering as the final diagnosis. Fifty one patients، 30 females and 21 males with the mean age of 32. 87±16. 41 (17-80) years were enrolled. Forty six masses located in parotid gland، 4 masses in submandibular gland and a mass in sublingual gland. Results of FNA were consistent with definite diagnosis in 42 (82. 4%) cases. This consistency was 85. 2% and 60% for benign and malignant masses، respectively. Sensitivity، specificity، positive predictive value، negative predictive value and accuracy of FNA for diagnosis and discrimination of benign masses from malignant ones were 85. 4، 30، 83. 3، 33. 3 and 74. 5 percent، respectively. There is a high consistency between the results of FNA and final histopathological diagnosis in masses of salivary glands. Sensitivity of this procedure is high for diagnosis and discrimination of benign masses from malignant ones and the related specificity is low.

Anaphylaxis is an acute life-threatening allergic reaction, which occurs in genetically susceptible individuals following exposure to allergens via contact, inhalational, and/or oral routes. Food anaphylaxis is now the leading known cause of anaphylactic reactions treated in emergency departments, and wheat is one of the most common causes of anaphylaxis. Here, we reported a case of anaphylaxis to wheat in an infant (10 months old). The infant experienced two episodes of anaphylaxis following ingestion of food containing wheat at ages of 6 and 7 months and referred to us for further diagnostic procedures. Skin prick tests were severely positive for wheat and mildly positive for peanut, onion, curry, fish, potato and formula. There was no history of asthma and eczema in patients and her relatives. No drug was administered and because of lack of vaccine for prophylaxy of disease, strict abstinence of wheat consumption was advised.

Wandering spleen is a rare disorder in which the spleen is not located in the left upper quadrant but is found lower in the abdomen or in the pelvic region. Wandering spleen is usually demonstrated as asymptomatic abdominal mass, intermittent abdominal pain or acute abdomen. Here, we reported one case of acute torsion of wandering spleen. A 20 years old virgin woman with acute hypogastric, right and left lower abdominal pain, nausea and vomiting was referred to Amir Al Momenin hospital in Semnan (Iran). Physical examination revealed a generalized tenderness with preference in right lower abdomen, rebound tenderness and guarding. With diagnosis of acute abdomen, laparatomy was performed that it confirmed the presence of a pelvic spleen twisted several rounds on its long vascular pedicle, with congestion, partial infarction, and gangrene. Then, splenectomy was carried out for the patient. Clinical presentation of wandering spleen is varied and the diagnosis is often elusive. Complications of wandering spleen include infarction, gangrene, splenic abscess, variceal hemorrhage and pancreating necrosis. The usual treatment is fixation of the spleen (spleopexy) except in cases of complications where splenectomy is preferred.