Shiraz Emedical Journal
Volume:13 Issue: 4, Oct 2012

Dengue Fever (DF) is an emergent disease in India. It is endemic in some parts of country and contributes annual outbreaks of dengue. To study the knowledge regarding dengue and the preventive measures practiced by the rural population attending a hospital.Setting: The Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha is the rural medical college located in Maharashtra. Study Design: The study design was a descriptive cross-sectional study concerning Knowledge, Attitudes, and Practices of DF prevention among the people in Rural Hospital of Central India. Study population: The population in this study was residents of Wardha Districts, Maharashtra State, India, who were living there for at least one year. A 410 adults (aged 18 years and above) were interviewed using a pre-tested questionnaire regarding their knowledge, attitude and practices about DF. 43.91 % respondents belonged to the age group of 30 – 44 years, 84.15 % respondents were married and 31.21 % respondents were high school certificate (31.21 %). 76.58 % respondent knew that the vector for dengue is a mosquito. Whereas 47.8 % respondents knew that human to human spread occurs in dengue and mainly transmitted by mosquito bites. Around 60.48 % of them were aware of fever as the presenting symptom. With regards to the knowledge of the preventive measures, respondents were generally aware of mosquito coils/liquid (57.08 %) and spraying (35.12 %). 74.14 % respondents knew about breeding places of mosquitoes. 94.64 % respondents strongly agreed and agreed that dengue is a serious illness. Only 17.06 % respondents strongly agreed and agreed that they are at risk of getting dengue whereas 62.92 % was not sure about the risk. Common preventive practices that were prevalent in the respondents were use of mosquito coils/liquid (45.12 %); cleaning the house (28.30 %) and mosquito spray (23.42 %). Important sources of information about DF were from television (59.75 %) followed by Friends/relatives (47.80 %). The DF remains a public health problem in this area and the people need more understanding of the disease. Our findings highlight the need for further information, education and communication programs. Preventive strategies are the only means of controlling the DF.

Although triple therapy with one proton pump inhibitor (PPI) and two antibiotics for one week has been introduced as the treatment of choice, quadruple therapy in Iran is the standard treatment due to the organism’s high resistance is related to Helicobacter pylori (H. pylori) organism. Comparison of three different PPIs; esomeprazole, lansoprazole and omeprazole with a longer duration (10 days) for eradication of H. pylori in the Iranian population.Methods and Materials: Two-hundred ninety-four patients with endoscopic evidence of peptic ulcer, non-ulcer dyspepsia, gastritis or acid reflux and confirmed H. pylori, either by histology or a positive urea test were randomly divided into three groups; namely, group I (98 patients) received omeprazole, clarithromycin and amoxicillin (OCA); group II (97 patients) received lansoprazole (LCA) and group III (98 patients) received esomeprazole (NCA) instead of omeprazole.Response to treatment was defined as eradication of H. pylori confirmed by negative C14 urea breath test 40 days after treatment course completion. Per protocol (PP) eradication rate of H. pylori was 91.9 % for group I, 80.4 % for group II and 91.8 % for group III (P = 0.017). Intention to treat (ITT) eradication rate for groups I, II and III were 91 %, 78 % and 90 %, respectively (P = 0.012). The patients’ compliance was 99 %, 97 % and 98 % and the adverse events were 36 %, 35 % and 14 % in these three groups, respectively (P = 0.614) (P = 0.001). Based on age and sex, eradication rate showed significant difference without considering various treatment protocols (P = 0.017 and 0.031, respectively). There was no difference in eradication rate between PUD and NUD patients (P = 0.166). Both PP and ITT eradication rates were higher in the OCA and NCA treatment groups. Group III had the least adverse effects. Eradication by NCA regimen had less side effects but more cost compared to OCA regimen.

There is a substantial amount of evidence suggesting that alteration in some hormones is associated with depression. The aim of the study was to assess the serum level of thyroid hormones and leptin in patients with depression. Subjects and In this case-control study, 63 patients with different degrees of depression and 69 healthy, age and sex matched control subjects were selected. The Beck Depression Inventory was used to classify the degree of depression into mild, moderate, and severe. The level of Leptin, thyrotropin (TSH), thyroxine (T4), tri-iodothyronine (T3) were estimated using commercially available kits and Free T4 index was calculated. Leptin and T3 levels were significantly decreased and T4 rose in the depressed women as compared to the healthy controls (P < 0.05, P < 0.001, and P < 0.001 respectively). Furthermore, the serum level of leptin was significantly lower and T4 was significantly higher in sever depressed women compared to moderately or mildly depressed women (P < 0.001 and P < 0.01, respectively). This study showed that thyroid and leptin hormones malfunction in depressed women. Thus, inclusion of thyroid and leptin screening test in the case of deessed patients might be required in proper management schedules.

Medical students are less happy compared to other students in University because of specific education and work conditions. As happy and healthy personality people are responsible ones, we evaluated the happiness of Medical students and its relationship with age, gender, marital status and life style.Methods and Material: This study was performed by using Oxford happiness questionnaire to evaluate happiness in 210 medical students of Shiraz Medical Sciences University. In various studies carried out in different countries, Cronbach’s alpha of the questionnaire was ranging 0.87 to 0.92 and the re-test reliability was ranging 0.78 to 0.81. The data were analyzed after collection by SPSS software and variance analysis test. The average happiness score was 52.7 ± 8.9. There was a significant difference between happiness level of the students and gender (girls are happier than boys), marriage (married students are happier than single students) and living status (the students who live with their families at their home are happier than the students living in dormitory). The lowest happiness level was observed among age group of 21. It was due to the start of clinical part of medical period and hard work in the hospital. But marital status can decrease the pressure of life by increasing the happiness level and increases the life happiness. Living with the family and receiving their support an increase the happiness compared to living in dormitory.

Hepatitis B virus infection is a worldwide health problem. Vertical transmission is a route of Hepatitis B virus infection that is regarded as a considerable factor in Hepatitis B virus prevention program all over the world. This study was conducted to screen the hepatitis B surface antigen, hepatitis B surface antibody and hepatitis B e antigen in pregnant women. From September to October 2009, two hundred fifty pregnant women in Zeynabieh hospital in Shiraz, Iran, were recruited consecutively to this study at the time of their delivery. Their sera were examined for detection of hepatitis B surface antigen, hepatitis B e antigen and hepatitis B surface antibody, using enzyme-linked immunosorbent assay. Different demographic data (i.e. age, nationality, vaccination and family history of Hepatitis B virus infection) were investigated to determine the presence or absence of hepatitis B surface antigen, hepatitis B e antigen and hepatitis B surface antibody. Among 250 subjects, the prevalence of hepatitis B surface antigen and hepatitis B surface antibody was 1.2 % and 50%, respectively. Demographic data that showed significant association with prevalence of hepatitis B surface antigen were family history of Hepatitis B virus infection (X2 = 7.735, P = 0.05), age (X2 = 3.762, P = 0.05) and nationality (X2 = 5.41, P = 0.02). The findings of this study recommended the necessity of hepatitis B surface antigen screening test for pregnant women especially for those younger than 25 years of age and with the family history of Hepatitis B virus infection and also for Afghani residents.

The abdominal wall is an uncommon site of extra pelvic endometriosis, which usually develops in a previous surgical scar and it should be considered in the differential diag-nosis of any abdominal swelling. Endometriosis involving the rectus abdominis muscle is a very rare event and its rarity explains the incomplete nature of the reports in the literature. The true incidence of endometriosis is unknown, but it is estimated that 15 percent of females have some degree of the disease. It is second only to dysmenorrhea as the etiology for cyclic pain in females of reproductive age.(1) We report the case of which came to our observation, a woman with endometriosis of the abdominal wall. The diagnosis was made by the histopathological analysis of the specimens.

Leishmaniasis is a well recognized opportunistic infection, which caused by an intracellular protozoan parasite belonging to genus Leishmania. Although, in healthy subjects the mortality and morbidity from this infection is not significant, however in immunosuppressed patients it can cause an overwhelming visceral disease.We report a case of cutaneous leishmaniasis in a 54 years old diabetic man after kidney transplantation. He had successful unrelated kidney transplantation 14 months before presentation of skin lesions. In physical examination, the patient had multiple itchy and erythematous nodules and ulcers in diameter of 1×2 cm with central ulceration over his arms and hands compatible with a diagnosis of cutaneous leishmaniasis. The patient was given intramuscular Glucantime 20 mg/kg but he didn’t tolerate it. In finally he was treated with fluconazole and after two weeks the ulcers healed. Cutaneous leishmaniasis should be considered as a differential diagnosis of each nodule or chronic skin lesion in kidney transplant patients. Although, antimonials are the first line drug, fluconazole can also used in the treatment of cutaneous leishmaniasis.