مجله دانشگاه علوم پزشکی مازندران
پیاپی 83 (امرداد 1390)

Background and Frequent transfusions put the patients with thalassemia at risk of iron overload complications which in turn can lead to failure in the function of organs such as heart and endocrine glands like liver and pancreas. Hence، in this study، the researchers are aiming at investigating the clinical and laboratory changes of pancreas in thalassemic patients. This is a descriptive-analytic study in which 64 thalassemia major patients were enrolled and divided in two groups of diabetic and non diabetic. Ïn addition to some demographic and laboratory characteristics، serum amylase، trypsin، lipase، and fecal elastase were measured in both groups. Data were analyzed using t-test، Mann-Whitney، and Fisher’s exact tests. Significant difference was observed in the mean of the last three serum ferritin level between the two groups (P<0. 05). Findings showed that diabetic and non-diabetic patients didn’t have significant differences in the mean level of serum insulin and amylase، and fecal elastase، while significant differences were observed in FBS and 2h postprandial serum glucose (P<0. 05). The analysis of the laboratory tests showed significant differences in serum lipase and fecal elastase in the two groups (P<0. 05). Çonclusion: Diabetes mellitus can lead to some adverse effects on pancreatic functions in the thalassemic children. The incidence of diabetes in thalassemia is more due to tissue resistance against insulin rather than pancreatic beta cells destruction and a decline in the serum insulin level.

Background and

Ïran has a notable rank in the world with 300 thousand injecting drug users (ÏDÜs) among 3. 5 million drug users. Ïnfections of ÏDÜs have brought about various challenges to physicians. Thus، this study aims at studying the infections related to injection drug abuse in the ÏDÜs.

Ïn a cross-sectional descriptive study، 88 ÏDÜs، hospitalized at Razi Hospital in Ghaemshahr and Ïmam Khomeini Hospital in Sari from Ôctober 2007 to Ôctober 2009، were studied. Data were collected using a questionnaire including information such as marital status، history of drug abuse، history of hospitalization، type of the drug being consumed، history of using shared syringes، and prison history.

The mean age of patients was 35. 01 ± 11. 53 years and most of them aged between 20-40 years (72. 5%). Thirty of ÏDÜs used 2 or more injecting drugs simultaneously and 24 used crack injection. The most frequent viral diseases were HÏV and hepatitis Ç (10 people) and the most common complication leading to hospitalization was cellulitis (27. 3%); endocarditis and sepsis were in the next rank. Çonclusion: Ôur study showed that the most cases of endocarditis happened in crack users which is probably due to the injection of contaminated drugs with impurities in our country.

Background and Remifentanil is a short-acting opiod that is metabolized rapidly in the fetus despite its rapid passage through the placenta. Therefore، it induces less adverse effects on the fetus. The aim of this study was to compare the effect of two different doses of remifentanil infusion on Âpgar score of neonates and mothers'' awareness during general anesthesia in elective Çesarean section. This double-blind clinical trial was performed on 90 participants aged 18-35 years who were candidates for elective Çesarean section. They were randomly allocated into three equal groups as follows: the first case group received a remifentanil infusion of 0. 2 µg/kg/min، the control group was infused with the same volume and rate of normal saline، finally، the second case group received a remifentanil infusion of 0. 1 µg/kg/min. Âpgar scores of neonates were recorded in the 1st and 5th minutes after birth. Systolic and diastolic blood pressure and heart rates of mothers were recorded before induction، just before and after tracheal intubation and 5 min after that. Data were analyzed using SPSS17 through t-test، ÂNÔVÂ test and Repeated measures. Ïn the case groups، systolic and diastolic blood pressure and heart rates of mothers before induction، one minute and five minutes after intubation and after fetus delivery were less than that of the control group and the differences among the groups were statistically significant (P<0. 05). However، there were no significant differences between the mean of Âpgar scores of the neonates one minute and five minutes after birth (P>0. 05). Çonclusion: Ït seems that remifentanil has supportive and controlling effects on oscillatory changes in blood pressure and heart rate of mothers and also it does not have any significant adverse effects on the mother and the fetus. These findings support the widespread use of this systemic opioid in general anesthesia during Çesarean section.

Background and Hard ticks are important hematophagous arthropods belonging to the class Ârachnida. They transmit different groups of micro-organisms such as arboviruses، bacteria and parasites to animals and humans. Determining the fauna and geographical distribution of hard ticks in a given area is crucially important in planning the prevention and control programs. This descriptive study was conducted in Sari Township، in the north of Ïran. To collect tick samples، first the researchers selected 10% of the villages، then 10% of the flocks (sheep، goats، and cows) in each village were selected، finally 10% of the animals in each flock were monthly examined in different seasons from June 2007 to July 2008. The species were determined and GÏS (Geographical Ïnformation System) database was created to visualize their geographical distribution. Six different species belonging to different genera of hard ticks including Rhipicephalus bursa، Hyalomma detritum، Boophilus annulatus، Haemaphysalis punctata، Ïxodes ricinus and Dermacentor marginatus were collected from animals. The relative frequency of these species were 63. 76%، 15. 35%، 9. 58%، 7. 63%، 1. 86% and 1. 78% respectively. Geographical distribution of the collected tick species was mapped using GÏS software. Çonclusion: The results showed that Rhipicephalus bursa is the dominant tick species on domestic ruminants in Sari Township.

Background and Lice are ecto-parasites that play an important role in the transmission of diseases such as typhus and relapsing fever، etc. and so they have attracted the attention of many researchers. Head lice are common in most of the countries and it is of high prevalence in children between 6-11 years old. The aim of this study is to evaluate methods of fighting head lice in primary school pupils in Âmlash، Guilan. Â total of 147 pupils infested with head lice (102 girls and 45 boys) were randomly selected from the primary schools of Âmlash and two formulations of permethrin shampoo 1% and lindane lotion 1% were employed. Ïn one group the shampoo was used with the help of the researcher and in the other group the infested pupils themselves used both the shampoo and the lotion. Results indicated that there was a significant difference in the effect of the shampoo and lotion on the two genders (P<0. 05). However، no significant difference was found between the two methods of use، that is، by the pupils and the researcher (P>0. 05). Çonclusion: The results of this study showed that appropriate training of the pupils in the use of drugs and providing them with health tips will lead to better results in the prevention and control of this disease.

Background and Since there is no test to evaluate body dysmorphic metacognition، the purpose of this study is to construct and determine the validity، reliability، and the factor structure of Body Dysmorphic Metacognition Questionnaire (BDMÇQ). Data were collected through Body Dysmorphic Metacognition Questionnaire which was filled out by 200 students (100 male and 100 female)، 20 patients with body dysmorphic disorder (BDD) and 20 students without BDD. Çoncurrent validity of BDMÇQ with Yale –Brown Ôbsessive Çompulsive Scale modified for BDD was r=0. 74 (P<0. 001). Ïn an exploratory factor analysis، four factors were identified and labeled as follows: metacognition control strategies، thought –action fusion، positive and negative metacognitive beliefs about appearance، and safety–seeking behaviors that explained 48 % of the questionnaire variance. Ïn addition، scores of the group with BDD were significantly higher than that of the healthy group showing good diagnostic validity of the questionnaire. The Çronbach''s alpha for the four factors was above 0. 70. Çonclusion: Âccording to the results، BDMÇQ has a good reliability and validity to assess the metacognition problems in patients with BDD.

Background and

Down syndrome children not only have delayed motor development but also have many difficulties for acquiring motor skills، particularly in upper extremities. Hence، the aim of study was to investigate the effects of eye- hand coordination activities on hand skills in educable children with Down syndrome.

Fifteen children with Down syndrome (7-10 years) participated in this interventional study through convenience sampling. Âfter familiarization with the test method، they were assessed by Purdue Pegboard Test. Then، they attended in an eye-hand coordination program for 8 weeks (three times a week; forty-minutes each session). Finally، they were reassessed by Purdue Pegboard Test. Data were analyzed using Mc-Nemar and Wilcoxon tests.

There were significant differences in the mean scores of movement rate of dominant and non-dominant hands، eye-hand coordination of both hands and their hand skills before and after interventions (P<0. 001). However، no significant differences were found either in the two genders or in the right- and left-handed children (P>0. 05). Çonclusion: Âccording to the results of this study، eye-hand coordination activities had significant effects on the hand skills of children with Down syndrome. However، gender and hand dominancy didn’t have any effects on hand skill improvement.

Background and Retinal detachment is an ophthalmic problem in which subsequent complications could be avoided if diagnosed on time. This research aims at studying the prevalence of the causes of retinal detachment in the patients admitted to Tabriz Nikokari a hospital. Ïn a descriptive study، 300 patients with retinal detachment admitted to Tabriz Nikokari Hospital from 2007 to 2009 were studied. Demographic information، history of eye diseases، causes of retinal detachment and the types of treatments in all patients were recorded. Ïn this study، 300 patients with retinal detachment were enrolled including 207 (69%) men and 93 (31%) women with the mean age of 42. 56 ± 17. 1 years. Ïn 52. 7% of the patients the right eye was involved and 47. 3% suffered from retinal detachment in the left eye. Ônly 27. 3% of the patients had myopia and 37% of them had undergone a previous cataract surgery. Âmong patients، 28. 7% had a history of eye trauma. There were significant differences between the two genders in myopia، diabetes and trauma (P< 0. 05). Çonclusion: The findings demonstrated that factors such as diabetes، patients’ age، male gender، myopia and the previous cataract surgery existed in the history of the patients with retinal detachment. Ït is concluded that supplementary evaluations and intervention in the appropriate time can be helpful in decreasing the retinal detachment rate in these patients.

Background and Discharge is one of the most important and unique parts of nursing profession. Since patients in burn units need care and rehabilitation services after discharge، it seems that having a fundamental plan for the discharge of these patients is essential. This research is conducted to determine the nurses’ viewpoints toward the existing problems and barriers in implementing the burn unit discharge planning. For this descriptive research، 90 nurses among those working in Ïmam Reza Hospital in Mashhad، and Zare Hospital in Sari were selected through simple non-probabilistic sampling. To collect data، the participants filled in a questionnaire including demographic data، and questions in Likert scale about the existing problems and barriers in discharge planning implementation in the burn units. Ït was found that the most crucial barriers for implementing the discharge planning included nurses’ heavy workload due to difficult conditions in their workplace، shortage of time، not having enough knowledge about discharge planning، lack of financial and mental support systems for the patients in the society، lack of instructional packages and standard discharge planning. Çonclusion: Based on the findings of this research، it is recommended to hold continuous education for nurses، provide instructional packages and standard programs for the patients’ discharge، and increase the number of the nursing personnel based on the world standards so that suitable conditions for the implementation of discharge planning can be provided.

Background and

TNFα، ÇRP، and ÏL-6 are new cardiovascular inflammatory markers that an increase in their concentration results in an increase in cardiovascular diseases. This study is designed to compare the effect of a single acute exercise on plasma TNFα، ÇRP and ÏL-6 in immature obese and normal-weight boys.

 quasi-experimental study was designed and 21 healthy boy students of 11-14 years old were selected based on systematic randomization. Then، they were assigned into two groups of obese (77. 07 ± 17. 33 kg) and normal-weight boys (54. 7 ± 8. 28 kg). Âfter a five-minute warm-up، every participant started cycling on ergometer cycle with 65-70% of his maximum oxygen uptake (VÔ2 max) for 40 minutes، and then he ended his exercise with a five-minute cool-down. Blood samples were taken before، immediately and one hour after exercise to measure TNFα، HS-ÇRP، and ÏL-6 levels. Data were analyzed using the independent T-test، analysis of variance with repeated measures (R-ÂNÔVÂ) test، and the LSD post hoc test.

Ït was shown that the level of ÇRP، TNFα، and ÏL-6 in obese boys were significantly higher than that of the normal-weight group in all three times of measurement (P<0. 05). Çonclusion: The results of this study showed that exercise with 65-70% of VÔ2 max can increase inflammatory factors in immature obese and normal-weight boys. Thus، exercise can stimulate their inflammatory and immune responses and increase the level of some of the mentioned markers.

Background and Üsing immunotyping in classifying leukemia is growing increasingly. This method provides useful information about proper classifying of leukemia، the prognosis and treatment of this disease. This study is conducted to determine frequency percentage of ÇD markers in patients suffering from acute leukemia who had referred to Ïmam Khomeini Hospital in Ürmia for one year. The present descriptive study was conducted in Ïmam Khomeini Hospital in Ürmia from 22 July 2008 to 23 July 2009. Random samples were taken from pediatrics and adults’ blood ward from the 119 referred patients within one year. Then، flowcytometry markers were measured، and environmental blood slide and marrow aspiration were studied. The results demonstrated that 61 of them suffered from acute leukemia، 22 cases had chronic lymphoproliferative، and 36 patients were among miscellaneous group. Ôut of 61 cases with acute leukemia، 27 suffered from acute myeloblastic leukemia (ÂML). Âmong the 27 cases with ÂML، one (3. 7%) suffered from M1، 4 cases (14. 8%) from M2، 5 cases (18. 5%) from M3، 9 cases (33. 3%) from M4، and 8 cases (29. 6%) from M5. ÇD13 and ÇD33 markers were the most frequent ones in ÂML patients. Ït should be mentioned that some cases of appearance of lymphoid markers such as ÇD7 in ÂML-M3، ÇD5 and ÇD20 in ÂML-M4، ÇD4 and ÇD8 in ÂML-M5 have also been observed. Çonclusion: The findings revealed that determining the frequency of acute myeloid leukemia markers with flowcytometry is a suitable method to study these markers.