مجله دانشگاه علوم پزشکی مازندران
پیاپی 73 (آذر و دی 1388)

Background and

There is growing interest in employing screening procedures to identify critical infants at the beginning of hospitalization at NICU and adjusting death rate with severity of early disease. Most of studies were carried out on preterm infants born in the same center. The aim of this study was to compare the diagnostic power of SNAP-PE, SNAP, and CRIB indices in determining the severity of disease and predict the mortality of neonates referred from other centers to NICU of Bou-Ali Sina Hospital, Sari, and compare them regardless of age at birth.

All newborns admitted the NICU with whatever age and birth weight less than 1500 grams compared with infants weighing 1500 grams or more during the first 24 hours of hospitalization by disease severity were evaluated by questionnaires SNAP-PE, SNAP, CRIB from January 2005 to April 2007. Patients due to death or early discharge in less than 24 hours or with lethal congenital anomalies were excluded from the study. The median score obtained in discharged or expired patients compared by Mann-Whitney U Test and the diagnostic power and differentiation of the three tools were compared using ROC curves. Cut point (cut off) of each tool was calculated and sensitivity, specificity, NPV, PPV were obtained respectively.

Out of 200 studied neonates, 60 patients (30%) expired. Median SNAP-PE, SNAP, CRIB was higher in the died patients. Appropriate cut-off point based on the ROC curve for the CRIB was 6 and 10 for SNAP and was 12 for SNAP-PE. The area under the curve was 0.918 for the CRIB, 0.886 for SNAP, and 0.89 for SNAP-PE and all three tools were statistically significant (P<0.000). Sensitivity and specificity SNAP-PE, SNAP, CRIB for predicting neonatal death in infants weighing less than 1500 grams was lower than infants weighing 1500 grams and more.

SNAP-PE, SNAP, and CRIB are suitable methods for predicting death and determine the severity of the disease in neonates. Therefore using these methods is recommended even for patients who referred to the NICU.

Background and Leptospirosis (also known as Weil's disease, 7-day fever and many more) is a bacterial zoonotic disease caused by spirochetes of the genus Leptospira that affects humans and a wide range of animals, including mammals, birds, amphibians, and reptiles. It was first described by Adolf Weil in 1886 when he reported an "acute infectious disease with enlargement of spleen, jaundice and nephritis". Leptospira was first observed in 1907 from a post mortem renal tissue slice. It is recognized as the world's most common zoonoses. This disease continues to have a major impact on people living in urban and rural areas of developing countries with inestimable morbidity and mortality. The disease is an occupational hazard.People in Mazandaran province in the North of Iran, are mostly involved in agricultural fields or animal husbandry and leptospirosis is common in this area. In this study we tried to find seroepidemiology of leptospirosis in workers that were involved in 5 group of high risk jobs (farmers, mine workers, abattoir workers, animal farm workers, anglers).This is a descriptive case- series study. Our target population was 500 people that were involved in one of fore-mentioned high risk occupations for leptospirosis, 100 of each one, selected them by cluster sampling. They were screened for the presence of serum Leptospira immunoglobulin G. IgG was tested with a commercially available immuno florescent assay (IFA) method.Serologic study showed that 29.5% of farmers, 18% of fishers, 12.5% of mine workers, 6% of animal farm workers and 4% of abattoir workers were positive (IFA ≥ 1/10).Our data emphasize the importance of occupational exposure to leptospirosis among people who have exposure with infected water or soil in Northern Province Mazandaran-Iran. Thus, it is clear that contact with water and soil are risk factors of getting infected with Leptospira.

Background and Paraoxon is the active form of parathion, which is an organophosphate pesticide (OP). The toxic effects of some OPs are not limited to inhibition of cholinesterase, they are capable to produce free radicals and induce disturbance in body antioxidant systems. The purpose of this study was to evaluate the effect of paraoxon on oxidative stress indexin the kidney of rat.Wistar male rats were randomly divided in four groups including: control (corn oil as paraoxon solvent) and three paraoxon groups receiving different doses (0.3, 0.7 and 1mg/kg) by intraperitoneal injection. 24 hours after injection, animal was given anesthesia and kidney tissue removed. After kidney tissue hemogenation, superoxidedismutase (SOD) and catalase (CAT), lactate dehydrogenase (LDH) and glutathione S- transferase (GST) activities, glutathione (GSH) and malondialdehyde (MDA) levels were determined by biochemical methods.At doses higher than 0.3 mg/kg paraoxon, kidney SOD and CAT activities were significantly increased, comparing with the control, while GSH level was significantly decreased. There were no significant changes observed in GST, LDH activities and MDA levels.The results suggest that paraoxon induces the production of free radicals and oxidative stress. The enhanced activity of antioxidant enzymes in kidney of rats probably wasa function of the increased detoxification capacity. Depletion of tissue GSH is a prime factor, which can impair the cell’s defense against the toxic actions of free radicals.

Background and Homesickness is a complex cognitive, exciting and stimulating condition that comes into existence because of the individual’s transition into a new environment and it seems to present the reduction of coping strategies. This research aims to study the effectiveness of the method of assertiveness training on homesickness of female university students. This was an interventional study pre and post test study. Among 249 female freshmen, 96 students were found to be suffering from homesickness among which 60 students were randomly selected and put in the intervention and control group. The information was gathered by Archer et al., homesickness questionnaire which involves 30 expressions, from 1 to 5 likert scale, and also by the researcher’s own questionnaire which involves demographic information. The pre test data were gathered within the first 2 weeks of their arrival to the dormitory. The experimental group took part in 12 90-minute training sessions followed by evaluation 3 weeks after the initial testing. The data were analyzed according to Mann-Whihtney test. The pre- test data from the two groups showed no significant difference, however, with the presentation assertiveness training, the experimental group grades were significantly higher than control the group. Also, two factors of homesickness i.e., not-likening the university and strong attachment to their home did not show a difference in pre test, however, differences in post test were shown to be significant. The results of the study show that assertiveness training can be effective in alleviating problems that come up after the transition of the individual into the university and their new environment.

Background and Chemical fertilizers which contain nitrite and nitrate ions contaminate water, soil and plants. The livestock are exposed to the ions through grazing in these areas. This study was designed to evaluate the levels of ions in raw sheep and cow¢s meat in Mazandaran and also, to estimate the dietary intake of the ions from fresh meat consumed in a regular diet.A total of 36 samples of beef and 36 samples of mutton meat were collected from different cities of Mazandaran province (Sari, Babol and Qaemshahr) and their nitrite and nitrate contents were measured by colorimetric Griess Ilosvay method. Data were statistically analyzed by using Mann Whitney.The mean of nitrate and nitrite in mutton was 4/9 and 0/36 and beef was 6/3 and 0/38 mg/kg. Nitrite and nitrate content in beef and mutton had no significant difference.Considering the recommended consumption of meat groups and their substitutes in the food pyramid, which is 6.5 ounce/daily for those who use 2,500 Kcal/day, it is estimated that the amount of nitrate and nitrite consumed by an adult in all meat groups from red meat, the nitrate intake is higher than in some countries such as the UK, although lower than CONTAM Panel is recommended.

Background and Many athletes adopt nutritional manipulations to improve their performance. Among the substances generally consumed is carnitine (L-trimethyl-3-hydroxy-ammoniobutanoate) which has been used by athletes as an ergogenic aid, due to its role in the transport of long-chain fatty acids across mitochondrial membranes. Nutritional supplements containing carbohydrates, proteins, vitamins, and minerals have been widely used in various sporting fields to provide a boost to the recommended daily allowance. The aim of this study is to investigate the effects of acute L-carnitine administration on ventilatory breakpoint, an exercise performance during incremental exercise. This study was double-blind, randomized and crossover in design. The subjects were 12 randomly selected active male physical education students, 21.75±0.64 years old, with a mean body mass index (BMI) of 23.7±0.94kg/m2, divided into 2 groups. They received orally either 2g of L-carnitine dissolved in 200 ml of water, plus 6 drops of lemon juice or a placebo (6 ml lemon juice dissolved in 200 ml of water) 90 minutes before they began to exercise on a treadmill. They performed a modified protocol of Conconi test to exhaustion. One-way analysis of variance with repeated measurements was used for data analysis.The results showed that exercise performance improved in LC group (2980±155 meter) compared with placebo group (2331±51 meter). Furthermore, no significant difference was found in ventilatory breakpoint between the two groups.This finding indicates that administration of L- Carnitine, 90 minutes prior to exercise may improve performance; despite the ventilatory breakpoint as one of the anaerobicsystem indices that had no effect.

Background and Parasitical diseases are a common problem in developing countries. Different shapes of parasite such as cyst, larva and egg are carried from vegetables. Leaves of Allbezia contain saponin constituents, which is effective on surface tension reduction, and is preferred to chemical washer.This research was designed to study the extracted effect of removal from vegetable and its comparison with disinfectant commercial detergent in Sari city. Leaves aqueous extract (5, 10, 15, and 20) was prepared from the Allbezia julibrissin by maceration method, then 100 gram of parsley vegetable sample was taken randomly from shopping center. The sample was placed in contact with aqueous extract for 0 and 15 minutes according to the WHO guidelines. Then, the effluent was centrifuged and evaluated qualitatively and quantitavely for parasite decontamination by Mac- Master counting slid, (0/3mm). In addition to parasite, the contamination by commercial detergent (10%) was performed with contact times 0 and 15 minutes and also pure water as blank.Maximum parasite decontamination by aqueous extract and commercial detergent 10 % at 0 minute contact time was obtained 2306 and 97 parasites eggs, respectively. Also, maximum parasite decontamination by watery extract and commercial detergent 10 % and blank water at 15 minute contact time was obtained 3022,11,64 parasite ova, respectively. In this research, the best parasites decontamination range by aqueous extract was obtained at all concentration with contact time of 15 minutes.Quantitatively, rate of parasite ova decontamination from vegetables sample by aqueous extract of Allbezia in all concentration and 15 contact times was more than the commercial washer.

Background and Coronary artery disease (CAD) particularly of the acute myocardial infraction (MI) is one of the main causes of mortality in the developing countries. Considering the complication of the disease, the aim of this study was to investigate risk and accelerating factors of heart attack and the reason of the patient's delay in referring to Mazandaran Cardiac Center in 2009. This cross-sectional study was preformed on 200 acute myocardial infarction (AMI) patients. The criteria of diagnosis for AMI in this study was ST elevation of ECG, increase of CKMB above 25 in three phases and increase of Troponin-1 above 1nd/ml and also LDH increase: The demographic information, history of having specific and related disease and the heart attack accelerating factors and the reason of delay in referring to cardiac center was recorded in questionnaire. The collected data were coded, then analyzed by X2 test and ANOVA test using u. SPSS soft wave.Of 200 patients under study, 57% were male. With mean age and BMI of 62.02 years and of 26.66 respectively. The major risk factor in incidence of heart attack in this study first was high blood pressure (24.7 %) and the second one was diabetes mellitus 15.5 %. The accelerating factors of heart attack were heavy physical activity (25.3 %), sudden wake ups (25.2 %), and mental work along with tension (12.6 %) respectively.Considering the risk factors and heart attack accelerating factors, providing proper education to the public, it is possible it reduce the number of heart attack cases and implement proper strategy to reduce the delay in referring of such patients to a cardiac center.

Background and Occult hepatitis B infection (OBI) is a form of hepatitis in which despite the absence of detectable HBsAg, HBV-DNA is present in peripheral blood of patients. Investigators believed that the genetics and immunological parameters may be different in resistant individuals and patients. Cytokines, such as IL-12, could be leading to alteration in viral immune response. The main aim of this study was to investigate the serum level of IL12 in OBI patients.In this study, the plasma samples of 3700 HBsAg negative blood donors were tested for anti-HBs by ELISA. The HBsAg negative and anti-HBc positive samples were selected and screened for HBV-DNA by PCR. HBV-DNA positive samples were assigned as OBI cases and ELISA technique were performed to examine the serum level of IL-12 in OBI and 100 healthy controls.Our results showed that there was no significant difference in serum level of IL-12 between OBI patients and controls.In order to be clear of viruses, L-12 is increased in viral infection. Based on the results of this study, it is concluded that OBI patients can not produce enough IL-12 to clear HBV.

Primary ciliary dyskinesia and Kartagener's syndrome are rare genetic disorders. There is a ciliary dysfunction in these disorders that cause recurrent infections in respiratory and sinus tracts associated with dextrocardia, chronic vasomotor rhinitis and dextrocardia. The aim of this paper is to report two rare cases of Primary ciliary dyskinesia, including one case of primary ciliary dyskinesia and Kartagener's syndrome for additional knowledge.