مجله دانشگاه علوم پزشکی بابل
سال هفدهم شماره 9 (پیاپی 96، شهریور 1394)

Hyperbilirubinemia is one of the most common problems during the neonatal period. Despite the severe complications of jaundice, no reliable data is available regarding the prevalence of acute and chronic complications of jaundice and the predisposing factors in our community. Therefore, this study aimed to determine the complications of neonatal jaundice and the predisposing factors in neonates. This cross-sectional study was performed on icteric, term newborns with bilirubin level higher than 20 mg/dl, referring to Ghaem Hospital during 2003-2013. After history taking and physical examinations, developmental status of infants was followed within six and twelve months after birth, using Denver Developmental Screening Test-II. The newborns were divided into two groups, based on the occurrence or non-occurrence of complications (e.g., acute or chronic kernicterus, auditory disorders and developmental disorders). Afterwards, predisposing factors for these complications were evaluated. Complications of jaundice were reported in 143 (13.37%) out of 1069 neonates. The two groups were not significantly different in terms of variables such as neonatal age and gender or maternal age. However, there was a significant difference between the children with and withod complication regarding treatment modality and mean total serum bilirubin level (27 mg/dl vs. 32 mg/dl) (p<0.05). The predisposing factors for neonatal complications were as follows: idiopathic jaundice (30%), ABO incompatibility (18%), Rh incompatibility (14.8%), G6PD deficiency (12.6%) and sepsis (3.3%). Our findings showed that ABO incompatibility, Rh incompatibility and G6PD deficiency were the most common risk factors for jaundice, followed by idiopathic jaundice.

Neonatal jaundice is a major problem among infants in the first weeks of life. Research on several indicators of severe neonatal jaundice including alpha-fetoprotein and umbilical cord bilirubin level has indicated contradictory results. Therefore, the aim of the present study was to evaluate the significance of umbilical cord bilirubin level as a predictive indicator of severe neonatal jaundice.

This prospective, cross-sectional study was performed on 102 healthy infants, born to healthy mothers at Babol Clinic Hospital, Babol, Iran. After birth, 2 cc blood samples were obtained from the umbilical cord and the bilirubin level was measured in the hospital laboratory. The infants were followed-up after hospital discharge in terms of jaundice presentations. In case jaundice was diagnosed in infants, they were compared in treated and untreated groups.

Clinical jaundice was not detected in 54 cases (52.94%). Overall, 48 neonates (47.05%) suffered from clinical jaundice and 10 cases (8.9%) presented with severe jaundice, requiring treatment based on the criteria proposed by the American Academy of Pediatrics (AAP). The mean umbilical cord bilirubin level was 1.82±0.42 mg/dl in the untreated group and 2.36±0.56 mg/dl in the treated group (P=0.000). The area under the ROC curve for umbilical cord bilirubin level was 0.722 in the treated group, based on the AAP criteria. The cut-off point of 2 mg/dl showed 80% sensitivity and 73% specificity in predicting severe jaundice (requiring treatment), based on the AAP criteria.

As the results indicated, measurement of umbilical cord bilirubin level and determination of a suitable cut-off point could be valuable in predicting severe jaundice in newborns.

Frozen shoulder is a common condition, characterized by pain and restrictions in shoulder movements. Different non-surgical and surgical methods are used to overcome this condition. Given the high prevalence of frozen shoulder among the working class in communities, re-empowerment is essential for individuals’ return to daily activities. Considering the contradictory results reported by previous research, further investigations are required in this area. Therefore, this study aimed to evaluate the clinical findings of arthroscopic release in treatment of primary frozen shoulder. This cross-sectional study was performed on all patients with primary frozen shoulder, referring to Bahonar and Shafa Hospitals of Kerman, Iran. These patients were candidates for surgery due to unsuccessful supportive treatment. First, American Shoulder and Elbow Surgeons (ASES) assessment form (score: 0-100) and Simple Shoulder Test (a 12-item questionnaire) were completed before surgery. Then, all patients underwent arthroscopic release and examinations. The assessment forms were completed again within 3 and 12 months after surgery. Overall, 15 patients with the mean age of 50.57±12.01 years were included in this study. There was a significant difference in the mean score of SST before (10.21±0.98) and after (10.98±1.05) surgery (p=0.034). Also, patients’ performance at 12-month follow-up significantly improved, compared to the three-month follow-up (p=0.014). There was a significant difference in the mean scores of ASES test before and after surgery (p=0.007). Also, the mean score of ASES test was higher at 12-month follow-up, compared to the three-month follow-up (p=0.019). Overall, arthroscopic release could help relieve pain and improve the range of shoulder movements in patients. Moreover, it could help patients return to their daily activities and regain their productivity. In fact, this technique facilitates simultaneous diagnosis and treatment of shoulder joint problems.

The risk of high blood pressure increases to a great extend with increasing age which, in turn, raises the risk of retinopathy. Given the high prevalence of ophthalmic complications in the advanced ages, there is a growing need for public health and medical services. This study aims to determine the frequency of hypertensive retinopathy in the elderly, in Amirkola town. This cross-sectional study was performed on all patients aged 60 or above, residing in Amirkola town, Iran. All the patients were referred to the eye clinic of Ayatollah Rouhani Hospital during 2011-2012. Comprehensive ophthalmic examinations were performed by an ophthalmologist. Based on the obtained definitive evidence and photographic findings, various degrees of hypertensive retinopathy in one or both eyes were detected and assessed. Among the 505 studied patients, 65 patients (12.9%) were suffering from hypertensive retinopathy. About 10 (15.4%) patients were suffering from high blood pressure for more than ten years. Moreover, 55 patients (84.6%) had hypertension for less than 10 years (p<0.0001). A total of 18 patients (27.7%) had history of hyperlipidemia, while 47 patients (72.3%) had no history of it (p=0.005). The obtained results of our study indicated that the frequency of hypertensive retinopathy in the elderly patients was high. Therefore, monitoring blood pressure and serum lipids on a regular basis in the elderly is highly recommended.

Road accidents are one of the major causes of mortality and severe injuries, which impose substantial financial and social costs on communities. This study was conducted to investigate the epidemiology of road traffic traumas to the upper and lower extremities.

In this cross-sectional study, victims, admitted to Shahid Beheshti Hospital of Babol, Iran, were evaluated during 2010-2012. Demographic data, accident location, day, season and time of accident, as well as admission time were investigated.

In total, 1049 victims with the mean age of 32.93±16.56 years were included in this study. Overall, 830 (79.1%) and 219 (20%) victims were male and female, respectively. The majority of accidents occurred on inter-urban roads (n=830, 35%) on week days (n=839, 72.5%). The highest frequency of accidents was reported in summer (n=311, 29.6%) between 13:30 pm and 19:30 pm. The longest interval between the accident and hospital admission was 1-2 hours following the accident.

The results of this study showed that road accidents were more frequent in certain hours and seasons of the year. Therefore, recognition of local effective factors in accidents could be a proper guide for authorities to promote accurate and effective health planning.

The use of dental radiography is inevitable in order for disease diagnosis, assessment and monitoring. Radiogeraphy is potentially harmful due to the use of ionizing radiation. This study was conducted to evaluate dentists’ knowledge about the principles of dental radiology.

This cross-sectional study was performed on 600 general dentists willing to cooperate with this study in Amol, Noor, Mahmoodabad and Sari cities located in Mazandaran province, Iran, in 2014. All the data were obtained by means of a questionnaire. The questionnaire included two parts; the first part surveyed demographic information, and the second part included 11 items about radiographic technique and equipments.

500 questionnaires were completed. Among the surveyed population, 335 (67%) and 165 (33%) dentists were male and female, respectively. The mean of practical experiences was 12.35±6.68 years. 469 dentists (93.8%) used the dental X-ray machine with digital timer and 404 dentist (80.8%) used the dental X-ray machine with long cone tube. Additionally, 470(94%) X-ray machine had round. Generally, 367 (73.4%) and 374 (74.8%) dentists used bisecting technique and E-speed films, respectively. Also, annual calibration of X-ray devices was suggested by 416 (83.2%) dentists.

According to our study, dentists’ knowledge about the dental radiography principles was fair.

Recently, the efficiency of thyroid fine needle aspiration (FNA) as a method of choice in evaluation and management of thyroid nodules has been questioned. The aim of this study was to determine the diagnostic value of FNA as compared to pathology results in diagnosis of thyroid nodules in Shahid Behashti Hospital of Babol, Iran, within 22 years. This cross-sectional study was performed on cytology samples of 225 patients who were undergoing thyroidectomy at Shahid Beheshti Hospital of Babol during 1990-2012. Patients’ age and gender, physician's experience in performing FNA, type and location of surgery, FNA samples and pathology results were recorded. According to the pathology reports, FNA results were divided into four groups i.e. inadequate, benign, malignant and suspicious. The pathology results were divided into benign and malignant groups. The results of both methods were compared with each other. The sensitivity and specificity of FNA in diagnosis of thyroid nodules were 60% and 96%, respectively. Also, its positive and negative predictive values and diagnostic accuracy were 65%, 95% and 81.8%, respectively. Among the 225 cytology samples, 127 (56.7%), 47 (20.9%), 27 (12%) and 24 (10.7%) were benign, suspicious, malignant, and inadequate, respectively. Additionally, pathology results were benign and malignant in 150 (66.7%) and 75 (33.3%) patients, respectively. FNA was comparatively effective in diagnosis of thyroid nodules.

Gastric cancer is the second most prevalent carcinogenic disease and surgery, chemotherapy and radiation are its principal treatment modalities. However, in most cases, poor response to treatment and adverse side effects are observed regarding these modalities. Given the lack of response to treatment and growing rates of gastric cancer, researchers are trying to come up with more efficient treatments with fewer side effects. In the traditional medicine, licorice has been suggested as a cancer treatment considering its high antioxidant properties and few side effects. This study aimed to evaluate the effect of licorice extract on gastric cancer cell lines. In this experimental study, adenocarcinoma gastric cell lines were prepared from cell bank and were cultured. After passage, the cells were transferred into a 96-well plate. In each well, approximately 2,000 cells in RPMI-1640 culture medium with FBS (10%) were placed. The cells were repeatedly exposed to different concentrations of Glycyrrhetinic acid (0, 1, 10 and100.1 μM) and Glycyrrhizic acid (10, 1, 100 and 0.1 μM) for 24 and 48 hours. Finally, the obtained results of the experimental and control groups were compared with each other. According to our results, the toxic effect of Glycyrrhetinic and Glycyrrhizic acids is dose and time dependent. In 24 hours, the mean optical density (MOD) in 100 μM concentration of Glycyrrhetinic acid was 0.41±0.02 and 0.79±0.04 in the experimental and control groups, respectively (p=0.0002). After 48 hours, MOD was 0.16±0.004 and 1.749±0.24 in the experimental and control groups, respectively (p=0.0003). Moreover, the MOD of 100 μM concentration of Glycyrrhizic acid was 0.78±0.53 and 2.09±0.49 in the experimental and control groups in 48 hours. There was a significant difference between the experimental and control groups (p=0.035). The results of this study demonstrated that the licorice compounds have a toxic effect on carcinogenic cells. Therefore, it is recommended to perform more study on both Glycyrrhizic and Glycyrrhizic acids as effective compounds on gastric cancer treatment.