Journal of Gorgan University of Medical Sciences

The effect of Middel Broke 7H9 Broth medium in the application of heat labile anti-Tuberculosis drug

A.A.Eimani –E-Fooladi (M.Sc)

The appearance of the Tuberculosis drug resistance caused to expand the research about the new drugs. LSJ medium used as a main base for culturing the Mycobacterium Tuberculosis in most place of the world. A group of the anti-microbial substance which are used to treat the Tuberculosis are sensitive to heat and they can not be used in LSJ medium. In the performed research by considering the primary possibilities in each Tuberculosis research laboratory a method designed used for the drug resistance. In this method the using of the drugs for treatment of Tuberculosis examined and it was compared with the standard method. The primary contact in the 48 hours of the Mycobacterium in middle broke 7H9 broth showed the same results as the middle broke 7H10 Agar culture.

Prevalence of Staphylococci Aureus nasal carrier in healthy school students in Gorgan

A.Tabbarai (M.Sc)

Golden Staphylococci is one of the most common factors in skin and systemic infection. About 30% of people are carrying this bacterium in their skin and nose. Increased drug resistance in this microorganism and consequent infection, has gained the attention of scientific organization. Therefore we decided to determine the prevalence of nose carrier of this bacterium in healthy children in Gorgan schools. During the winter 1998 to March 1999 the sample has been taken from 1193 student’s nose with sterile cotton swab. These results showed that in 194 samples (16.3%) Staphylococci Aureus has been isolated, from these samples 114 cases belong to girls (16.1%) and 80 cases were boys (16.4%) that there is not a meaningful variation between them. The number of bacteria isolated from the villages children was 109 cases (17.6%) and in town’s children were 85 cases (14.8%), also this difference didn’t show significant difference. The prevalence of carrier among the 6-12 years old was 12-25.3%, which has got a significant meaning (P<0.001). Antibiotic resistance in the isolated S.aureus were tested and result showed that 34.8% of samples are resistant to Methicilin and 1.7% were resistant to Vancomycin, only 4% were sensitive to Penicillin. Therefore with regard to the results of this investigation, further researches are recommended in relation between strain’s of S.aureus that isolated from carrier’s and strain’s that isolated from patients and to determine their drug resistance in this region.

Establishment of IFA technique for detecting ANCA

M.Saeedi (M.Sc)

ANCA are classes of antibodies or in reality autoantibodies usually produce in conditions that degradation of neutrophiles occurs. This is led to vascular damage. They are more common in rheumatic diseases such as Rheumatoid Arthritis (RA), systemic Lupus Erythematus (SLE) and vasculitic diseases especially Wegners’ granulomatosis (With specificity and sensitivity as high as 95%). We decided to design IFA-ANCA because this assay has high sensitivity and in with comparison other techniques such as ELISA & RIA is more economic and simple. On the other hand, screening test for determining ANCA is immunofluorescent assay. ANCA test establishment contains: Isolation of neutrophiles, fixation with Ethanol and Formalin, improvement of method and quality control by using of indirect immunofluorescence assay (IFA), 2 staining pattern are observed. Cytoplasmic (C-ANCA) or classic and prinuclear (P-ANCA) pattern. Established ANCA test by inter assay method had 95% reproducibility and 91% precision.

Mutation detection in exons 3, 10, 12 of BRCA1 gene in 30 patients affected with familial breast cancer

H.Teimori (M.Sc)

Breast cancer is one of the most common causes of death due to cancer in women. More than half of hereditary breast/ovarian cancer families could be attributed to mutation in breast cancer susceptibility gene BRCA1. This study was performed on blood samples of 30 women who affected with familial breast cancer. Non-radioactive PCR-SSCP technique was utilized mutation screening in exons 3, 10, 12 of BRCA1 gene. Two shifts in exon 3 and also two in exon 12 was detected, but no shift in exon 10 was found. Due to low number of recognized mutations, the statistical analysis didn’t show a meaningful correlation between mutations and pathological characteristics. Results from this study showed that there was a low possibility of germline mutation in these three exons. Low rate of mutation in this report was concordance with the others.

Comparison of analgesic effects of intramuscular Pethedine to Diclofenac Na suppository among postoperative inguinal hernioplasty patients

AA Abdollahi (MSc)

Pain is a symptom of disease and most diseases accompanied with pain, specially among hospitalized post-operative patients. Several drugs and routes of administrations have used for post operative pain control. We compared post op analgesic effects of Diclofenac suppository to intramuscular Pethedine in post op inguinal herniorrhaphy patients. This study is a clinical trial on 40 patients who were operated due to unilateral inguinal herniorrhaphy. They divided into two groups incidentally. In Diclofenac Na group each patient received 100 mg Diclofenac Na supp every 8 hours. In Pethedine group each patient received 0.5 mg/kg Pethedine, intramuscularly. Pain severity of the patients controlled for 24 hours with visual comparation method and mean pain severity compared among 2 groups in the first 24 hours. Mean pain severity difference of Pethedine groups patients compared to Diclofenac Na group was 6.10 with standard error of 3.57 with (P<0.212) had no meaningful difference during first post operative phase. We concluded that Diclofenac Na is a suitable substitute of 24 hours intramuscular Pethedine for post op pain relief.

The incidence of cardiovascular complications in Kawasaki disease

B.Nikyar (M.D)

Kawasaki disease is a systemic vasculitis of unknown etiology. The most significant sequela of acute Kawasaki disease are related to information of small to medium sized arteries and, in particular, the development of coronary artery dilation and aneurysms (CAA). The aim of this study was to assess the cardiovascular complications of Kawasaki disease in Iran. The studied population consisted of 54 patients who were diagnosed to have Kawasaki disease and referred for cardiac evaluation. There were 30 boys and 24 girls, aged between 5 months and 13 years (Mean 3.9 years). All patients except 3 had received standard treatment with high-dose Aspirin and intravenous ? Globulin (IVGG). All patients were evaluated by physical exam, chest X-ray, ECG and echocardiography (ECHO). Abnormal cardiac findings included: Cardiomegaly in 4 (7.6%), ECG changes in 4 (7.6%), Mitral regurgitation in 3 (5.5%) LV dysfunction in 2 (3.7%), pericardial effusion in 4 (7.6%) and coronary artery dilatation in 5 (9.2%). Conclusion: 1) Kawasaki disease and its cardiovascular complications are not uncommon in Iran. 2) Coronary artery involvement is a major problem. 3) IVGG therapy reduces the risk of cardiac complications. 4) ECHO is a valuable tool in acute phase and follow-up period.

The study of anemia among the women residing in the villages around Gorgan (North-East of Iran)

G.R.Vaghari (M.Sc)

Anemia especially those due to Iron deficiency is one of the nutritional problems. Women are more susceptible to anemia during the age of fertility. The main purpose of this study is to determine the prevalence of anemia among 18-35 years old women in the villages around Gorgan. It was carried out in the 20 villages on 415 women. They were chosen by compound sampling. The mean age of the cases was 24.92 years old. Blood sampling and filling the questionnaire were carried out. On the chosen samples ferum Iron, TIBC, was determined using spectrophotometer hematolog tests was carried out using electronic cell counter. The prevalence of Iron deficiency, anemia, and the anemia due to Iron depletion were 37.78%, 25.1% and 13.45% respectively. There was not a meaningful relationship between marital status age with Iron depletion anemia and anemia due to Iron depletion. The conclusion out of this research showed that the anemia and especially anemia due to Iron depletion is one of the main nutritional problems among the women living in the villages around Gorgan.

Prevalence of HIV infection among intravenous drug addicts in Shiraz, 1998

A.R.Mirahmaizadeh (M.D)

Drug addicts, especially those practicing injection, are regarded as a major high-risk group for HIV infection. This study was performed to determine the burden of infection in 1061 drug addicts residing in the rehabilitational camp of Shiraz. In 1998, a survey in 1061 randomly selected drug abuse residing in the rehabilitational camp of Shiraz were performed in which demographic and other required data were collected using a questionnaire and samples from each subject were tested for anti-HIV by ELISA-II and then western blot. Overall, 0.76% of subjects were positive for anti-HIV detected by ELISA-II, 1.2% among intravenous and 0.33% among non-intravenous drug abusers, which, being several hundred times more than the prevalence in the general population. Points to the fact that drug addicts must be regarded very high-risk irrespective of their principle method of drug use. The high prevalence among non-intravenous addicts also may be indicative of the possibility that they have practiced high-risk injection sometimes during the period of addiction or imprisonment. Due to the low number of positive cases, no relation could be established between the age, duration and method of drug abuse, history of imprisonment, job, tattooing, marital status and HIV infection. Authors recommend widespread education of the community and drug abuser population in order to reduce the prevalence and spread of infection in addicts an the society, active case-finding among drug abusers, particularly before their referral to rehabilitational centers and developing control measures along with educational program to prevent the residents of these centers from access to drugs and practice of high-risk methods such as needle-sharing.

Epidemiologic study of clinical and paraclinical manifestations of Choleraic patients and report of uncommon manifestations of it during the epidemic episode in Gorgan (1998)

B.Khodabakhshi (M.D)

Gastro-enteritis due to Vibrio Cholera was increased suddenly in summer of 1998 in our country. In this research we studied epidemiological and clinical features of Cholerae patients. Vibrio Cholera isolated from 189 (3.3%) patients from 56II stool samples. 182 (96.2%) Vibrio Cholera O1 isolated. 46 (24%) patients with positive stool cultures for Vibrio Cholera were hospitalized. 50% patients were 15-45 yrs. No sex predominency was seen. The important observations in this study including: Fever in 28.1% (13) of patients, sever leukocytosis in 15% (7) of patients, RBC in stool in 33% (15) of patients. Fever and neutrophilia and RBC in stool probably shows co-infection with order intestinal pathogens or different serotypes of Vibrio Cholera with new characteristics. So we are recommending extensive research to be done on serotyping of all of the isolates of Vibrio cholera and other intestinal pathogens simultaneously.

The effects of racial factor on the head and face shapes of normal female newborns in north of Iran (Gorgan)

M.J.Golalipour (Ph.D)

Anthropometric dimensions are basis for evaluation of newborns’ health. In respect of importance of anthropometric indices of head and face in forensic medicine, surgery, pediatrics, medical imaging, … . We achieved this study. Determining range of head and face dimensions in normal one-day old female newborns on Fars and Turkman races. This descriptive and cross-sectional study is achieved on 423 normal one-day old newborns (Turkman group: N=211, Fars group: N=212) by classic cephalometry method. Mean and standard deviation of cephalic and prosopic indices in Fars group were 78.63±4.7, 74.3±11.5 and in Turkman group were 77.85±8.7, 81.6±9.8 respectively. Dominant and rare types of heads in Fars group were mesocephalic (42%) and hyperbrachycephalic (9%) and in Turkman group were mesocephalic (39%) and hyperbrachycephalic (8%) respectively. Dominant and rare types of face in Fars group was hypereuriprosopic (71%) and hyperleptoprosopic (4.24%) and in Turkman group were mesoprosopic (39%) and hyperleptoprosopic (1.89%) respectively. This study determines the types of head and face in normal female newborns in Fars and Turkman groups and determines the effects of racial factor on the diversity of head and face shapes in normal newborns.

Immediate effects of a five minutes back massage on patients’ physiological parameters in critical care unit

H.Rahmani . Anaraki (M.Sc)

Recent publications have questioned the efficacy of massage. It is acknowledged that critical care environment are stressful for patients in term of invasive medical, and nursing procedures. Continuous brighting and excessive noise prohibits the potential relaxation and sleep. In this article, which is a research study, the physiologic response during and following a five minutes administration of back massage are described. This study is a semi-experimental research in which a 5 minutes back massage was offered to 25 patients as stress reduction intervention. Physiological data (Heart rate, mean arterial blood pressure, respiration and peripheral oxygen saturation) were obtained from the patient bedside monitoring system. Results indicated there was significant effect from the intervention on peripheral oxygen saturation (P<0.002). However, a significant decrease in heart rate (P<0.001), blood pressure (P<0.001) and respiration rate (P<0.001) was observed during the back massage intervention. Results indicated back massage had the potential effect of increasing relaxation as evidenced by physiological change during the intervention administration to critically ill patient in intensive care unit massage was found to be a useful therapy to enhance relaxation and sleep in critically ill patient.

Relationship between depressive’s symptoms and diabetes

S.A.Taziki (M.D)

Depression is a common disorder in the world. Depression may due to general medical condition disorder such as diabetes mellitus. This study explains the relationship between diabetes M and depression (Prevalence, age, duration, sex, type, control of disease) among diabetic patients. This is a analytical and cross-sectional study. Sampling has been done by random among out-patients diabetics in Gorgan 5th Azar Hospital, diabet clinic, during year 2000. About 100 NIDDM diabetic patients type and 50 IDDM type selected by randomization. They were assessed according to age, sex, FBS, HbA1c, duration, type and beck inventory standard test. The findings showed: 40.6% have moderate and sever depression with beck test over 21 points. There are a significant relationship between age of diabetic patients and depression (P<0.14). There are a significant relationship between duration and depression. There aren’t any relationship between sex and depression (P>0.81). There aren’t any relationship between type of diabet and depression (P<0.236). There aren’t any relationship between HbA1c and depression (P>0.85). Depression is more common among diabetic patients than general population and incidence have a direct relation with age and duration of disease.

Effectiveness of continual education on quality of nursing records

H.Khoddam (M.Sc)

Documentation is one of the most important nursing functions that one third of their time are spent for them. Since documentation is recording all of cares delivered to patient, the result of the care and patient response to treatment, and all that has been done does show in documentation. The present research is the semi-experimental study with purpose of determining effect of continuing education on quality of nursing records. The samples consist of nursing personnels of medical-surgical units that responsible for documenting of nursing records Gorgan teaching hospital. Prior to and after education, the content and structure of records were evaluated, scored and mean of scores were comparated by a check-list analysis of findings indicated significant differences between mean of scores prior to and after education (P<0.001). The results showed that we can use continual education for promotion of nursing record quality.

Assessment of nutritional knowledge, attitude and practices in pregnant women in university hospitals of Tehran

K.Khajavishojaii (M.Sc)

Pregnancy is the great physiological stress during of women’s life and cause the most importance change in their biological state. This physiological stress arising from fetus needs and thus increase pregnant women requirement to energy and nutrients in comparison with non-pregnant women. Nutritional continuous training caused increase of women knowledge by additional foods side, for poor mother, provide maternal and child health, so this survey has been done to determine knowledge rate, attitude and practices of pregnant women in Tehran, nutritional knowledge, attitude and practices in 315 pregnant women were assessed in 10 hospitals of Tehran. A structured questionnaire was used for this purpose. This research showed, 60% of women had low-level nutritional knowledge. In the attitude part of this research data showed 71.4% of women had positive attitude toward changes to improve the quality of their diet, and 87.6% of women had positive attitude toward dairy consumption eating during pregnancy. But 69.8% of women had negative attitude about Iron supplement. There was significant relation between level of education and attitude toward Iron supplement. Nutritional knowledge of pregnant women is weak so that the effects in their practice. Therefore nutritional training is necessary during pregnancy by physician.

A statistical study on the role of high-risk factors in the incidence of CVA

S.A.Hosaini (M.Sc )

Cerebrovascular accident has been defined as some neurologic changes due to lack of cerebral blood supply. CVA is the most common CNS disorder and the third factor resulting in death in western countries. Unfortunately, the exact statistic data of the risk factors causing this disorder, in Iran isn’t available. In order to show these factors, this descriptive study has been done on CVA patients in one year. Data gathering was performed by a questionnaire including 17 questions. The questionnaires were filled by the patient’s bedside via using patient’s records, patient’s relatives and patient himself. Data analysis indicated the results such as: Average age of 66, the greatest frequency of Fars race (86%), pre-existing hypertensive disorder (64%), FBS=152 and the highest incidence of sensory and motor disorder. Consequently, applying some educational program can be useful in decreasing the intensity of the agents causing CVA, reducing stroke and its harmful effects and performing rehabilitation program.

The reasons for failure of exclusive breast-feeding in health centers in Gorgan (1378-79)

K.Jalaly Aria (B.Sc)

The present research is a descriptive and analytical study, which is done in order to investigate the reasons of failure in exclusive breast-feeding in Gorgan. 322 women with children between six to 12 months who referred to health center in Gorgan were chosen as convenience sampling. The instruments for collecting information were some questionnaires included open-ended or closed questions, which was related to individual, social and familial characteristics of parents and children. The findings showed that only 44.4% had exclusive breast-feeding. The most current additional liquid in 59.9% was Glucose water. The most important reason for beginning the additional nutrition was colic which most of the time was advised by grandmother (32.6%). Chi-square has shown maternal age, mother’s conception of her ability in breast feeding, feeling that she would not have enough milk to adequately nourish her baby child, acute diseases, the low birth weight and among the reason for failure to have exclusive breast feeding (P<0.05).