مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
سال پنجاه و ششم شماره 1 (پیاپی 119، فروردین و اردیبهشت 1392)

Epilepsy is a chronic neural disorder which has impact on cognitive and behavioral abilities of children. Also،epilepsy-related factors may impaire the achievement of social competence. The aim of this study was to assess the cognitive-behavioral problems and the social competence in children. In this descriptive research 30 children 3 to 7 years old with epilepsy who referred to child neurology clinic in Ghaem hospital in 88-90 year and 30 healthy children 3 to 7 years old were selected. Social competence، behavioral characteristic، cognitive abilities and demographic information were evaluated via special questionnaires. Student''s T test was used to compare the mean values between test scores. Behavioral and cognitive problems in the children with epilepsy in subcategories of emotional symptom، Conduct problems، hyperactivity-inattention، total difficulties and impulsive-hyperactive، scores were significantly higher than the control group. No significant difference was found between 2 groups in subcategories of peer relationship problems، prosocial behavior، impact scores، learning problems، psychosomatic disorders and anxiety disorders. According to the vineland social maturity scale، children with epilepsy had lower scores than healthy children but this difference did not reach to the significant level. Our findings consistent with most of the previous studies، revealed that children with epilepsy had more behavior problems than the healthy children and these children were confronted with a higher risk of inapprppriate social maturity. Therefore، educational and psychological interventions were needed to support the appropriate psycho-social development of these children.

The Multiple sclerosis is chronic and progressive neurological disease. MS is a Leading to various symptoms such as imbalance. Focus af attention is one of the major components of learning skill motor that is divided into two parts internal focus and external focus. Identifying the best type of focus can be an improved Problem of imbalance and fall risk in MS patients significantly. This research is quasi-experimental. A total of 30 patients with MS participated in this study with (20-45) age range. Patients were divided into 3 groups: internal focus، near external focus and far external focus. Each group with specific instructions had to keep their balance on Biodex. Results showed that a significant level of acquisition for internal group was p=0/41، for near external group p= 0/01 and for far external group p=0/002 Significance level was considered as p ≤ 0/05. These results indicated that internal focus of attention on the acquisition and learning the balance task was not effective، While the instructions for far and near external focus on the acquisition and learning the balance task were effective and patients may lead to improved balance. For data collection، tool was used to measure balance. Balance of participants in both near and far external instructions were improved and progressed in both groups but the average performance of these two groups was almost better than the one with internal instructions.

Crimean Congo hemorrhagic fever is a severe and potentially fatal disease. In recent years، the highest incidence of this disease has occurred in the Sistan and Baluchestan. Surveillance system is the most important strategies for disease control in community. General Practitioners (GPs)، as the first level of contact with patients، have essential roll in the proper implementation of disease surveillance system. Therefore، we evaluated the knowledge about CCHF surveillance system of Zahedan general Practitioners.

We conducted a cross sectional study on all general Practitioners in Zahedan city (April 2012). Data collection tool was a questionnaire that its validity and reliability were confirmed.

A total of 112 physicians participated in our study. Their knowledges about CCHF surveillance system were as follows: weak; 49. 2%، intermediate; 49. 1%، good; 8% and excellent; 0%. No significant difference was found in the GPs knowledge status according to their university and their duration of clinical works. But GPs who were working in the governmental centers had significantly higher knowledge than physicians who working in the private centers. Also، the knowledge of GPs who participated in retraining program about CCHF was significantly more than others.

GPs knowledge about the CCHF surveillance system was undesirable. It seems necessary to integrate the topic of infectious diseases surveillance system in the infectious diseases curriculum and community medicine curriculum. Also، the retraining programs for GPs and specialists on the topic of infectious diseases surveillance system can be an effective step in better control of these diseases.

Defining the optimal prostate-specific antigen threshold to identify the patients at the highest risk of prostate cancer has always been controversial. This study aims to analyze the diagnostic value of PSA and also evaluate the relationship between PSA and BMI as well as PSA and prostate size in asymptomatic subjects referring to the Check- up Clinic of Razavi hospital. In this descriptive، cross- sectional and retrospective study; the demographic data as well as total PSA and also prostate size of 1149 subjects who had referred to the Check- up clinic of Razavi hospital during 2006 - 2011 were evaluated according to their Sonography reports. All the subjects were asymptomatic. Data were analyzed by SPSS as well as descriptive and statistical tests. The mean age of the subjects was 45 ± 12 and BMI was reported 27± 8. Very low and inverse correlation was determined between PSA and BMI. Non- significant correlation was reported (p ₌0. 08، r₌ 0. 054). It was also observed that the correlation between PSA and BMI was greater than the correlation between PSA and prostate size individually (p ₌0. 001، r₌ 0. 394). According to this study، although non- significant relationship was observed between PSA and BMI; but a significant relation had been reported in other studies which were carried out on the symptomatic subjects perviously. The mentioned significant relation may be the result of PSA> 10. So it can be doubted that in the high level of PSA these relationships could be validated.

Adipose tissue has an important role through the production and secretion of abnormal proteins such as leptin، adiponectin and resistin in insulin resistance. The aim of this study was to investigate the effect of a periodof aerobic training on serum resistinlevel in obese men. Twenty obese men were selected voluntarily and were included randomly in the experimental (N=10) and control (N=10) groups. Aerobic training protocol consisted of 3 sessions per week for 10 weeks. Each training session consisted of one slow running with intensity of 65 to 75 percent of maximal heart rate for a period of 10 minutes. In accordance to principle of overload، half-a-minute was added to each session، so that، at the last session the running time reached to 25 minutes. Before and after the training period، blood sampling was performed. Data were analyzed using independent t-test. Results showed that there was no significant difference in serum level of resistin and insulin resistance index between the control and experimental groups. However، aerobic training reduced significantly body mass index، body weight، waist to hip ratio، body fat percentage، and increased significantly the maximum oxygen uptake. It can be said that 10 weeks of aerobic training had no effect on serum resistin levelin obese men. However، to achieve more conclusive results، further investigation was warranted

Contrast-induced nephropathy (CIN) is most commonly defined as acute renal failure due to radiographic contrast medium exposure in patients undergoing cardiac cathetrization. In this study we investigated the possible association between volume expansions with N/S in prevention of contrast induced nephropathy. In this clinical trial study 962 patients، allocated in two groups underwent cardiac catheterization، in the first group with 575 patients، we used Normal Saline (N/S) (1-2 cc/kg/hr) but in the second group 387 patients did not use normal saline. We measured serum creatinin before and after Intervention and used T test and Man-Whitney test to analyze data. Mean Age of patients in the first group was 57. 8±10. 5 and in the second group was 57±10. 2 years، (p: 0. 212). Before catheterization Cr in the first group was 0. 94±0. 26 mg/dl and in the second group was 0. 98±0. 26mg/dl (p: 0. 04) that was a meaningful difference. After catheterization in the second group Cr was 1. 07±0. 26 mg/dl and in the first group was 1. 03±0. 30 mg/dl (p: 017) that was not a meaningful difference. Before and after catheterization serum Cr level difference in the first group was 0. 043±0. 44 and in the second group was 0. 132±0. 22 (p≤0. 01) that was meaningful. Based on this study we suggested that hydration with normal saline did not have a significant protective effect in renal performance، and it depends on gender and risk factors.

There is no sufficient information about different effects of intensities of resistance exercise on pain relief. Therefore، the purpose of this project was to investigate the effect of different intensities of resistance exercise on the threshold، pain perception and cardiovascular responses. Twelve non-athlete male Students with body mass index 21. 42±2 kg/m2 and normal blood pressure (systolic blood pressure (SBP) ≤ 129 mmHg and diastolic blood pressure (DBP) 84 ≥) were randomly selected as target and 4 resistance exercises with intensities of 40، 60 and 80% 1RM were performed with same volumes. The pain threshold and blood pressure was measured by Algiometer and sphygmomanometer ALPK2، respectively. SBP and heart rate (HR) increased significantly (P<0. 05) immediately post exercise compared with pre exercise، in the exercise intensities of 40، 60 and 80% 1RM. Also، SBP and HR at minutes of 10، 15، 20 and 25 after the exercise were significantly reduced in comparison with immediately post exercise (P<0. 05). DBP didn''t have significant change after the mentioned intensities (P>0. 05). Significant increase in pain threshold with intensity of 40% 1RM was observed up to 5 minutes post exercise. But، intensities of 60% and 80% didn’t change pain threshold post exercise significantly (P>0. 05). Based on the findings of this study، blood pressure and pain threshold interaction were observed in the lower intensity of resistance exercise that could indicate the effect of more duration and repetitions spent for exercise.

Food insecurity is defined as the limited or uncertain availability of enough food for an always active and healthy life. Cancer as a debilitating and lifespan reductive disease causes many individual and social damages. The aim of this study was to assess food insecurity status and some associated socioeconomic factors in patients with upper gastrointestinal cancers. A cross-sectional study was performed on 120 patients (72 males and 48 females with the mean age of 62. 23 years) with upper gastrointestinal cancers including stomach and esophagus cancers who were hospitalized in the cancer institute of Iran in 2012. General and socioeconomic characteristics and food insecurity status assessed using socioeconomic and 18-item USDA household food security questionnaires. SPSS16. 0 and Stata11SE software were used for Statistical analyses. Prevalence of food insecurity was 69. 17%. Food insecurity was significantly associated with having children under 18 years of age and low economic level. Since food insecurity in patients with esophagus and stomach cancers was more prevalent than others، it is essential to pay more attention to the reduction of food insecurity in the society.

Cholelithiasis (gallstone disease) is not frequent in children. However، in recent years reported cases have been increased by the use of ultrasound examination. Nowadays، gold standard treatment، specially in children، is laparoscopic cholecystectomy. Although this method has been done in other countries as a routine since some years ago، but according to our knowledge، laparoscopic cholecystectomy has not been common in children in Iran until now. Case report: In period of 2 years (2007-2009) we had 20 cases of cholelithiasis and did laparascopic cholecystectomy on 5 of them، the results of operation on them were presented. Although these cases were our first experience، by the perfect results we think would not need to do open cholecystectomy in future، except in rare cases.