مجله سازمان نظام پزشکی جمهوری اسلامی ایران
سال سی‌ام شماره 1 (پیاپی 117، بهار 1391)

health care providers are among those groups with greatest risk of blood born infections as Hepatitis C. This affects their practice toward patients with this type of infection. We conducted this survey to study health care provider's knowledge and attitude toward patients with hepatitis C in Razi Hospital in Rasht to increase our knowledge about this issue as well as to improveprofessional health level and health care service toward these patients. 239 health care professionals of Razi hospital in Rasht (the central of Guilan province) entered an analytical cross-sectional study. Inclusion criteria were working in Razi hospital as doctors,nurses and operation room technicians. Questionnaires consisted of questions on demographic characteristics, knowledge and attitude toward hepatitis C documented by a pilot study and validated by Cronbach's alpha (alpha= 0.7) which were distributed among participants. Data were collected and analyzed by SPSS16 software.P<0.05 was considered significant. The mean knowledge score was 17.43 ± 2.65 (from the total of 22), 51.9% of participants achieved upper scores while 48.1% got scores than this limit lower. There was a significant relationship between knowledge score and age, sex, occupation and Level of education of study group. Also there was a significant relationship between attitude level and age, sex, working and educational Background of population under study. Physicians were significantly more knowledgeable and showed more positive attitudes than the other occupational groups. There was a positive correlation between knowledge scores and attitude scores that means better knowledge correlates with better attitude. Present data show that discriminatory attitude is common among health care providers toward hepatitis C patients. Increasing health care provider's knowledge toward this disease is necessary to provide optimal health services for hepatitis C patients.

Chronic tension type headache is one of the most common types of headaches, which in half of the patients leads to decreased functional output and irregular analgesic consumption.Amitriptyline(a tricyclic antidepressant) is the most commonly used medicine in control of chronic tension type headache, but its adverse effects can cause a poor compliance in patients. With consideration of the lower side effects of the selective serotonin reuptake inhibitors such as fluvoxamine, this study compared the efficacy of fluvoxamine and amitriptyline in control of chronic tension type headache. 110 eligible patients enrolled in the study and were divided into two groups: amitriptyline group (AG) and fluvoxamine group (FG).During 3 months of follow up, 81 patients completed the study, 38 patients in control(AG) and 43 ones in the case(FG) group. Self structured check lists comprised weekly headache indices (number, Intensity and duration of headache episodes), analgesic consumption and drug adverse effects. Data related to the week preceding the study, collected and regarded as basal data.Paired and independent sample T tests were used to compare the results related to each group and both groups, respectively. Headache indices in two groups during the first and second months of follow up improved significantly, in comparison with the basal data, in such a way that at the end of the follow up, there was no significant difference in headache indices between the two groups. Fluvoxamine can be used in treatment of chronic tension type headache (as an alternative for amitriptyline) with equal clinical efficacy, after a month of consumption.

Hydroxyapatite (Ca10(PO4)6(OH)2) is the major inorganic component of hard tissues, the best bio-active materials, which is compatible with the bone tissue. In addition, hydroxyapatite nanoparticles (Nano-HA) have received enormous national attention in medical and dental applications recently; but the ultimate fate of the Nano-HA within the body is still unknown. Degradation products of nanomaterials are potentially cytotoxic. Thus, it is essential to assess biocompatibility before their usage in clinical applications.

Purpose of this research is to evaluate toxicity of hydroxyapatite nano particles on the human peripheral blood mononuclear cells.

In this experimental study, nano sized, rod-like hydroxyapatite particles sterilizalied then HPBMCs were cultured on 96-well plate. Cells were exposed to Nano-HA at the following concentrations: 15.5, 32, 65, 125, 250, 500, 1000, 2000, 4000, 8000 ppm. Later, For measuring the cell vitality, MTT method was utilized. Measuring the photo absorption was done by ELISA READER system at 570 nm, which evaluated the vitality of cell by the value of MTT absorption cells. The statistical ANOVA test was used in this study

All of drug concentration were effective in Loweriy eellular biologic ectivity but none of them were statis fically significant.

Therefore as a conclusion we can adjudicate that "Nano-HA" biomaterial is the material which is compatibility with the human blood mononuclear cells.

Obstructive sleep disorders and their effects on dental and maxillofacial growth has long been debated. Adenotonsillar hypertrophy as the most common cause of Obstructive sleep disorders with its consequent impact on dental growth has recently gained greater attention and its treatment may help prevent or reverse these effects. In this corss-sectional study 120 children were enrolled.60 patients assigned to undergo adenotonsillectomy for obstructive sleep disorders were compared with 60 children without obstructive sleep disorders. Both groups were matched in terms of gender and age. Dental casts and measurements with caliper were used.Crowding of upper and lower teeth, anterior open bite, posterior cross bite, overjet, class II malocclusion, width of upper and lower dental arches were documented and compared. Differences were found in crowding of upper and lowerteeth, anterior open bite, posterior cross bite, overjet, class II malocclusion and width of upper and lower dental arches. This study suggests the effects of obstructive sleep disorders on dental growth, probably due to the long term impact of the position of the head, mandible and tongue to keep the airway open in oral breathing.

Cancer or neoplasia is recognized as abnormal,uncontrolled growth of cells. New cases of cancer reported everyday. Development of medical science led to diagnostic and treatment methods for cancer. Many drugs are used in cancer chemotherapy and can treat a wide range of cancers. These drugs work in different ways and can lead to deficiency of immune cells and humoral responses. So it is expected that people treating with these drugs show higher rates of parasitic infections. This study was done to compare intestinal parasitic infections in cancer patients undergoing chemotherapy with healthy ones and with cancer patients that were not undergoing chemotherapy. In this case-control study three groups of people were selected. First group were 250 cancer patients undergoing chemotherapy for at least 1 month. Second group were 250 healthy people with immunocompetency. Third group were 100 cancer patients not that undergoing chemotherapy and radiotherapy. We take a stool specimen from each person. Specimens examined by direct (for diarrheal ones) and formalin-ether (for all). In order to investigate the presence of Cryptosporidium parvum, we take a thin smear from each specimen and stained it by Zeil Nelson method. Frequency of intestinal parasitic infections in first, second and third group were 24.8%, 33.6% and 28%; respectively; but differences were not statistically significant (P=0.09%). In another investigation of intestinal parasites in three groups, infection rate of E.hartmani in second group and G.lamblia in first group was significantly higher. Infection rates of other parasites were not significantly different. Overally in three groups, most frequent parasites were B.hominis 12.8%, E.coli 11.7% and G.lamblia 4.3%,Cryptosporidium infection was not seen. Despite our hypothesis, prevalence of intestinal parasitic infections in three groups were not significantly different.Drugs used in cancer chemotherapy may have suppressive effects on parasites or kill them. In another hand, cancer patients despite their depressed immunity may show parasitic infection less than expectedbecause of less exposure to parasites due to special medical care.

An evaluation and economic analysis for one of decision criteria about prioritising services has been provided. this research was done to present a cost- benefit analysis on screening congenital hypothyroidism in Qazvin city live births born in 2007. This study was a cross-sectional descriptive type on treatment and health care system. the study population was all live births in Qazvin city. In order to calculate the costs, unit cost method was used and the resulting benefit was obtained by distracting total direct costs of screening in 3 parts and direct costs of treating identified patients from direct cost of caring patients in the statewelfare organization in case of non screening. For analysis of data statistical methods and software Excel 2007 were used. in this study 8456 people from Qazvin city live births were examined in order to screen and diagnose congenital hypothyroidism. Direct costs of screening in 3 parts were calculated as 266220000 rials. in this part of study, 18 patients were identified indicating an incidence of 2.8 per 1000 live births. direct costs of treating the identified patients. was calculated as 54571500 rials. By distracting cost of identified patient from total cost of caring affected children in pensions and welfare centres (316800000 rials) the resulted ratio of obtained to costs was 9.6 to 1. benefits obtained from screening congenital hypothyroidism are significant aespite the costs of this process.Continuation of this plan in various regions of Iran leads to decrease in economic, burden on society.

Upper limb dysfunction is a common and disabling consequence of cerebral palsy. Instrumental evaluations, based on electromyography or biomechanical techniques, may objectively quantify various clinical characteristics associated with spasticity and should be considered as an adjunct to clinical evaluation. The purpose of this study was to determine the effects of wrist orthosis on Hmax to Mmax ratio, spasticity, Grip and pinch strength and wrist and elbow range of motion of 7 to 12 years old spastic children. The design of this study was clinical trial and before_after. Twenty four 7 to 12 spastic cerebral palsy children that have the inclusion criteria of study were selected from rehabilitation clinics of Tehran. The patients used a wrist orthosis (10 degree of wrist extension, full extension of fingers and abduction and opposition of thumb) for 2 mounts (2 hours during day and 4 to 6 hours at night). In this study the H-reflex was recorded using an electromyography, by an experienced physiotherapist who was blind to the clinical examination results. Spasticity of the upper limb was clinically assessed using the Modified Ashworth Scale. MIE used to evaluate Grip and Pinch strength and Goniometric measurements of elbow and wrist extension were obtained in degrees to calculate the passive range of motion. The results of this study showed significant reduction in Hmax to Mmax ratio (P 0/002),wrist spasticity and elbow spasticity (P 0/001) and significant increase in Grip (P 0/002) and Pinch (P0/001) strength and wrist range of motion (P 0/003). The data did not show any significance in elbow range of motion (P 0/328). Our findings suggested that 2 months using of wrist orthosis in children with spastic cerebral palsy can reduce Hmax to Mmax ratio and wrist spasticity and increase Grip and Pinch strength and wrist range of motion.

Drugs have been estimated to the cause of 10-15% of adverse events in hospitalized patients. Drug fever as the only manifestation or the most prominent clinical characteristics of an adverse reaction occurs in 3-5% of patients. Considering drugs as a cause of fever of unknown origin is important from clinical viewpoint. Drug fever is a febrile response coinciding temporally with the administration of a drug, subsides once the causative drug is disvontinued, and other probable causes of fever such as infection, malignancy,thromboembolic disease, cerebrovascular accidents, collagen vascular diseases, acute gout, surgery, and trauma have been ruled out by physical examinations and paraclinical investigations. A wide range of agents could induce fever by different mechanisms. Antibiotics have been considered as the most common offending agents among different drug classes causing fever. Antibiotics are associated with about one-third of drug-related fever episodes.Among antibiotics, drug fever has been mostly reported with betalactams, sulfonamides, and nitrofurantion. The sole effective approach to manage drug fever is to discontinue the offending agents(S).