مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
سال پنجاه و هفتم شماره 5 (پیاپی 129، آبان 1393)

Multiple sclerosis (MS) is a chronic neurologic disease. At the present time، Rebif، which is the most effective drug in treatment of MS after Avonex، is used to prevent relapses. Recigen is Iranian generation of Rebif. It is almost a year since the entry of Recigen into our pharmaceutical market and it is virtually superseding American Rebif، but no study has been performed on efficacy and hepatic side effects of this drug. The aim of this study is to compare the efficacy and side effects of Betafron and Recigen in medical university of mashhad in 1389-1390. This was a single blind study conducted in neurology department of Qaem hospital on MS patients who fulfil criretia for pharmacotherapy indications. EDSS، complications and symptoms were compared in Betafron and Recigen group. Demographic data were analyzed using SPSS software. Demographic characteristics (like age and sex) were similar in both groups with no significant differences. There were no significant differences in EDSS and hepatic side effects in both Betafron and Recigen groups (p=0. 134). Relapse rate was significantly lower in Betafron group (p=0. 03). It seems both drugs has the same rate of side effects and EDSS scores. Recigen has similar efficacy in comparison with Betafron، though it cannot prevent relapses in short time.

Group B Streptococcous (GBS) is a leading cause of neonatal infection. It also plays a significant role in maternal infections. Pregnant women colonization is notably related to infections in newborns. Penicillin is usually the drug of choice for treatment of GBS infections. The purpose of this study was to assess epidemiology of Group B Streptococcous، colonized in pregnant women vagina، as well as Antibiotic susceptibility and Colonization risk factors. This study was performed asa cross-sectional on 382 pregnant women in Kashan during 2011-2012، sampeling method was performe by sterile swab from vagina، swabs were inoculated in LIM broth. GBS isolates were identified by laboratory methods. Antibiotic susceptibility was determined using disk-diffusion method. Data were analyzed by SPSS software، Chi square and Fisher exact tests. The prevalence of vaginal GBS was9. 4%. All isolates were sensitive to penicillin and cefazolin، 97. 2% to ampicilin، 80. 5% to erythromycin and 83. 4% to clindamycin. A significant correlation was found between GBS colonization and parity while no correlation were found with other variables. Our study confirms the high rate of beta-lactam sensitivity of GBS.

The balance between oxidative stress and antioxidant activity is critical to the pathogenesis of many disorders including Lupus nephropathy. The relation between prooxidant – antioxidant in lupus patients with nephritis is unknown in detail. The aim of this study was to determine the Correlation between prooxidant – antioxidant balance (PAB) with lupus activity in patients with nephritis and without nephritis.

In this cross- sectional study that was conducted in 2013 in ImamRezaHospital (Mashhad،Iran)، Twenty-one lupus patients with nephritis and Twenty-two lupus patients without nephritis were enrolled in this study. Twenty-three healthy volunteer selected as a control group. PAB، C3، C4، ANA، and Anti ds DNA were measured and SLEDAI Score were calculated.

The values of PAB in lupus patients were significantly higher than that in control group. However، there was no significant difference between PAB values among the two groups of lupus patients with and without nephritis. There was a significant direct correlation between the PAB values and SLEDAI in lupus patients with nephritis but not in lupus patients without nephritis. In lupus patients، an inverse correlation between PAB and C4 was observed. There was no indicative correlation between PAB values and AntidsDNA and C3 in lupus patients. Moreover، there was a significant direct correlation between the PAB values and proteinuria in lupus patients with nephritis

The results of this study indicated that oxidative stress processes were significantly higher in lupus patients in comparison with controls. There was correlation between PAB values and nephritis activity in lupus patients.

Vesicoureteral reflux (VUR) is a backward flow of urine from bladder to ureter or kidney. Potential reflux is harmful because of kidney being faced with the hemodynamic high -pressure during urination. This project was carried out for high prevalence of VUR and delay in growth of children with chronic diseases. In case of growth disorder in children with this disease and its difference with healthy person، treatment can be tried by treating the growth disorder. All patients who performed VCUG because of UTI، divided into two groups، healthy and sick. History and checklist filled، patient’s height and weight measured in a standard way and ASQ questionnaires adjusted to age used for the studying development effect. Children’s height and weight measured by standard meter and scale and used the curves adjusted to age and sex. Control group entered the study with the same characteristics of case group without VUR، however، their height and weight were recorded. The way of evolution studied according to Nelsons evolution table and ASQ questionnaire. The total of 150 studied children in the two axes: The both groups in the area of ​​ development of fine motor، gross motor and indicators of mean and percentile of height and weight and parents'' literacy، had a significant difference، it can be known as a sign of parents better assessment and follow، higher education levels and better socioeconomic situation. Children with VURhad better growth and development than the normal children.

Urinary lithiasis is the third most common disease of urinary system. Nowadays، Extra Corporeal Shockwave Lithotripsy (ESWL) is the treatment of choice for urinary lithiasis. Majority of patients experience pain during ESWL. Recently، The topical analgesic methods is more common than invasive procedures such as general anesthesia is more. Regarding the trivial complications of EMLA cream، we decided to evaluate its therapeutic effect on diminishing the pain during ESWL. Patients were randomly divided into two groups. In the intervention group، EMLA cream and for the control group، ultrasound gel was used. EMLA cream was applied 45 minutes before ESWL to the patient''s flank. Supplemental doses of Fentanyl to control pain during lithotripsy were administered to patients. A rater، blind to the allocated groups، recorded pain scores based on the standard VAS scale. Data were analyzed using SPSS software and independent samples T-test. 80 patients were examined. Our findings show that pain scores and medication dose of Fentanyl، received during ESWL، in EMLA group is less than the ultrasound gel group Age، sex، weight، BMI، size and location of stone has no effect on the pain scores. Applying EMLA cream in patients، under ESWL، will reduce the pain scores and supplementary dose of Fentanyl during ESWL.

Fungi widely distributed in nature and the study of fungal toxins is important among the research topics. Due to importance of flour over the diet of Iranian people، the incidence of fungal contamination of flour was studied in Zahedan bakeries. In this descriptive study، 113 bakeries were randomly selected from different regions in Zahedan. The samples of flour were cultured in order to identify fungal species with specific medium. Overall، 34 out of 113 samples had fungal contamination. The most common mycotoxins – producing fungi were Acremonium and Aspergillus fumigatus with 17. 64% and 14. 7% respectively. According to the results of this study and since the bread is the staple of the Iranian people، health regulation and monitoring their implementation at all stages of production، distribution and storage of wheat and flour is recommended to the authorities in order to eliminate the fungal contamination and this seems to be imperative.

acute coronary syndrome (ACS) is a common cause of emergency visit. Early administration of aspirin is associated with decreased mortality rate. Thus، aspirin should be administrated immediately to the patient with suspected ACS. Emergency medical services (EMS) providers should be trained to respond to heart emergencies and become familiar with presentations and complications of ACS. In this study، the effect of two educational methods – lecture and demonstration – on EMS providers were compared. A total of 30 EMS providers were enrolled in this interventional study. One group attended the lecture and classroom training and the second group was trained with demonstration in skill lab center. Ten days after the course، they were evaluated in dealing with ACS patients. EMS evaluation was according to patients transfer official forms. Data analyzed by SPSS software with chi-square test. Overall 410 patients with possible acute coronary syndrome who were transferred to Medical Center by EMS divided into 2 groups (243 and 167 patients). In the first group، patients received 32. 1% aspirin، 75. 3% nitroglycerin and 90. 1% oxygen while the second group received 49. 7 % aspirin، 58. 7% nitroglycerin and 90. 1% oxygen. In the first group، 43. 1% of 183 patients who had received nitroglycerin، also received aspirin. In the second group 67. 3% of 98 nitroglycerin received patients، had also received aspirin. None of the patients received Morphine، cardiac monitoring and ECG. Findings showed 17. 6% increase in aspirin administration and other management practices (nitroglycerin and oxygen) in the second group. None of the patients received cardiac monitoring. EMS providers usually use less beneficial interventions such as IV line، nitroglycerin and oxygen.

Because of the importance of learning disorders، and neurofeedback which is a relatively new method of treatment، the present study examined the effect of this method on treatment of learning disorders.

In this study، 28 third grade of primary school children according to psychiatric interview and academic records، mathematic scale، diagnosed learning disability were studied. One group (N = 14) received neurofeedback treatment and the other group (N = 14) was conducted with non- real neurofeedback treatment (sham). A total of 20 sessions took place for each child، and each session lasted 30 minutes for 10-12 weeks. Neurofeedback condition was as same as the sham group، except in the EEG activity which was not from patient. Both groups were matched for age، education، IQ، gender and severity of mathematics disorder.

In comparison of the experimental and sham groups، the intervention effect was different between two groups and statistically significant (P<0. 05)، and in three times mesurment، the difference was significant (P<0. 01). Trend of changes in variable that was measured in three times، was linear (P<0. 05). The difference between pre-test and post-test was significant in boy´s group، but the difference was not significant for the girls.

The intervention effect in experimental group showed effective and it was maintained for one year after the treatment (P<0. 01). The difference was significant only in males.

Minimum Data Set (MDS) is an important first step in the development of health care information system، since it leads to improve the quality of perinatal health care، achieving to integrate information system and meet the information needs of Obstetricians and Gynecologists، and other health care providers to deliver accurate and timely data. The aim of this study was to understand the definition of perinatal MDS، history، necessity، importance، and the purpose of MDS. This study was a review article based on Google Scholar، PubMed، Science Direct، EBSCO، SID and Iran medex database، and also accredited institutions in Australia، Canada، New zealand، America and England were searched. Finally 58 articles were selected and evaluated between 1986 to 2012. The literature review showed that the MDS was necessary for moving toward Electronic Health Record (EHR)، and the information exchange between different health centers. In many countries، the main purpose of MDS is perinatal health data comparisons and analysis and also statistical reporting، reduction of inequalities among pregnant women and babies، guarantee quality assurance. Reduction of perinatal mortality، health care planning and evaluation، research، clinical audit، teaching، health policy and resource allocation at the national level. Iran is in lack of perinatal national minimum data set. Designing model for perinatal MDS has an important role in improving the quality of health information and community health indicators. Therefore، the implementation of a national MDS needs the experiences of the developed countries and customizing to the needs of the country، because it is an inevitable necessity.

Exfoliative dermatitis (ED) is an inflammatory skin disease characterized by generalized (> 90%) erythema and scaling. ED is similar to Kawasaki in fever، rash، desquamation and conjunctivitis and redness of lips (sometimes). The patients: In the present study we report five children with ED. The interesting point is that one of the children had ED as the clinical presentation of Kawasaki. History of medicine consumption، generalized lymphadenopathy، scaling at the first days of rash، generalized desquamation and normal ESR are in discriminating ED from Kawasaki.