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Showing 20 results for Diarrhea

Manoochehr Barak , Leila Azari-Namin , Ali Nemati , Nategh Abbasgholizadeh , Mehrdad Mirzarahimi , Anooshirvan Sedigh ,
Volume 3, Issue 4 (12-2003)

  Background & Objective : Failure To Thrive (FTT) refers to the insufficient physical growth or inability in keeping the desired growth rate in a period to time.

  It is a problem in Iran as far as hygienic nutrition is concerned. FTT is a multifactor problem which is caused by various organic and nonorganic agents. This study was conducted to pinpoint the major risk factors involved in the growth of children under 2 years of age who are the most vulnerable age-group in terms of growth disorders.

  Methods: This case-control study was conducted in 2002-2003 on 120 infants (60 cases with FTT and 60 controls) in Namin health centers. The case group was under the third percentage of their growth chart or they had -2SD in growth chart at least in three months. The control group was composed of infants with normal growth chart.

  The demographic characteristics of parents, and the nutritional and antropometric (height/weight, head circumference) characteristics of the subjects were measured. The collected data were analyzed by SPSS software, using chi-square and ANOVA.

  Results: The findings indicated higher frequency of respiratory infections, diarrhea and vomiting in case group (p<0.05). The control group, on the other hand, outnumbered the case group in terms of the number of infants under 6 months who were exclusively breast-fed (p<0.05). Most of the infants with FTT had a lower birth weight than control group (p<0.05). The number of mothers with lower level of education and those who were housewives and also the number of family members were significantly higher in case group than control group (p< 0.05). However, no significant difference was observed between two groups in terms of frequency of breast feeding and birth rank.

  Conclusions : The results indicated that some risk factors such as respiratory infections, birth weight, education, mother ُ s knowledge, exclusive breast feeding and the frequency of diarrhea and vomiting have far more important role in growth disturbances in children compared to factors such as frequency of breasr feeding and birth rank.

Manoochehr Barak , Nayereh Aminisani , Nategh Abbasgholizadeh , Mehrdad Mirzarahimi ,
Volume 4, Issue 2 (6-2004)

 Background & Objective: Each year thousands of children under five years old die due to acute respiratory infection and diarrheal diseases. A huge number of infants and children are hospitalized and visited by the physicians whereas most of these diseases can be prevented with timely treatment. Child health maintenance and improvement is one of the most important considerations in each society. Moreover, identifying child morbidity patterns should be a matter of concern in order to improve the health services. This study provides an overview of the leading causes of hospitalization among children with the aim of determining the most important causes of hospitalization and offering appropriate strategies to decrease them.

 Methods: This cross-sectional study was conducted in 2001 in Ardabil Ali-Asghar hospital. The subjects were randomly selected from the admission list on a daily basis. A questionnaire including demographic characteristics such as age, sex, time of admission and primary diagnosis was completed for each subject. The data were analyzed by SPSS software using descriptive statistics.

 Results: A total of 1945 patients were admitted almost half of which were studied. Febrile convulsion was found to be the most common cause of hospitalization (26%) while gastroenteritis (22.1%) and pneumonia (20%) were in the second and third order. Other causes included epilepsy, drug poisoning, meningitis, mumps, drug encephalitis, asthma, etc.

 Conclusion: According to the findings of this study, standard case management is necessary especially about febrile convulsion which is the most common cause of hospitalization. Since the present pattern is different from similar studies, further investigations are required to identify its causes.

Nader Pashapour, Mohamaad Hosein Hosseinianzakaria,
Volume 5, Issue 1 (4-2005)

 Background & Objectives: Yogurt is recommended as a treatment for acute diarrhea. This study was conducted to determine the effect of pasteurized yogurt consumption on acute non-bloody and non-mucoid diarrhea in hospitalized 6-24 month old infants as compared with that of routine treatment.

 Methods: In a clinical trial study 80 children with 6 to 24 months of age with diarrhea for less than four days and were hospitalized in Urmia Imam Hospital, were assigned into two groups. The first group consumed yogurt containing streptococcus thermophilus and lactobacillus bullgaris 5 ml/kg per day while the second group received the routine treatment. Those suffering from malnutrition, bloody stool and diarrhea without GI source were excluded. Reduction of diarrhea frequency to half compared to admission time was regarded as response to treatment. Weight gaining, duration of admission and reduction of diarrhea frequency were compared in two groups.

 Results: The two groups were not significantly different in terms of age, weight and frequency of diarrhea at the time of admission. Mean hospitalization days, weight gaining, reduction of diarrhea frequency were 2.7±0.91 days, 435± 89.30 grams, and 4.30±1.74 times respectively for case group and, 3.1± 0.74 days, 383 ± 98.96 grams, and 3.60±1.23 times for control group respectively. No significant differences were observed between two groups regarding mean hospitalization days (P=0.035), reduction of diarrhea frequency (P=0.049) and weight gain (P= 0.017).

 Conclusion: Consuming pasteurized yogurt as a probiotic agent has a positive effect in treatment of acute nonbloody and nonmucoid diarrhea. Public use of yogurt is recommended.

Behnam Mohammadi Ghalehbin, Esmaeil Falah , Mohammad Asghar Zadeg, Abdol Hasan Kazemi, Ahmad Daryani, Firooz Amani, Saeide Amani, Mina Agazade, Rasool Abdollahi, Rouhollah Arab,
Volume 6, Issue 2 (6-2006)

 Background & Objectives: Cryptosporidium is an intracellular – extracytoplasmic parasite that has taken much attention in last 20 years as a clinically important human pathogen. Cryptosporidial infection can be transmitted from fecally contaminated food or water and from animal-human or human-human contact. In immunocompromised persons, the illness is much more severe such as debilitation, fatigue, cholera-like diarrhea, severe abdominal cramps, low-grade fever, severe weight loss and Anorexia. Because there was no regional study about cryptosporidiosis in Ardabil, we carried out this survey to determine the prevalence of cryptosporidiosis among the children hospitalized in Ardabil.

 Methods: This descriptive and analytical study was carried out on 371 patients in Sabalab and Aliasghar hospitals of Ardabil between 2004 and 2005. A questionnaire was filled for each patient. Stool samples were examined by concentrated formal - ether method and stained with modified Ziehl-Neelson method. The data were analyzed with SPSS (ver 11) using Chi-square test.

  Results: We analyzed 371 stool samples from children with diarrhea. Cryptosporidium oocysts were detected microscopically in 15 samples. Its prevalence was 4.04% in infected patients. 66.7% of the infected ones were at the age of 6 to 24 months, 20% 25-48 months, and 13.3% 49-72 months.

 Condusion: Because cryptosporidiosis was more prevalent at the age of 6-24 months, health education is more necessary for their mothers.

Maryam Zakeri Hamidi , Saeideh Zeiyaei , Anooshirvan Kazem Negad ,
Volume 6, Issue 4 (12-2006)

 Background & Objectives: Dysmenorrhea is a common complaint among women, which is occasionally accompanied by gastro-intestinal problems. This study was designed to consider the therapeutical effects of vitamin E on gastro-intestinal symptoms such as nausea, vomiting and diarrhea due to primary dysmenorrhea.

 Methods: This was an experimental randomized study. A questionnaire was given to three hundred girl students suffering from primary dysmenorrhea. Then 128 girls who had gastro- intestinal symptoms accompyning dysmenorrhea entered the study. 69 subjects were assigned to case group and 59 to control group. From two days before the period until three days after it, four pills of vitamin E (400IU) daily were given to the case group and four chewing placebo were given to the control group as well, for four months. The data were analyzed by SPSS using Chi-square test.

 Results: The findings showed no significant difference between the two groups in terms of gastro-intestinal symptoms after two months of treatment. But after four months of treatment there was a significant difference in the gastro-intestinal symptoms between the two groups (p=0.001).

 Conclusions: Vitamin E is effective to be used after the second month of treatment to treat the gastro-intestinal symptoms in girls with primary dysmenorrhea.

Nayereh Amini Sani , Manoochehr Barak , Seyedmorteza Shamshirgaran , Firooz Amani , Saadollah Mohammadi , Benyamin Fazli ,
Volume 7, Issue 2 (6-2007)

  Background & Objectives: The high incidence of low birth weight (LBW) occurs in developing countries, and diarrhea and respiratory infections are the main causes of infant mortality and morbidity. This study was done to find out whether there was a growth or morbidity response to zinc supplememttion, among LBW infants during the first 6 mo of life.

  Methods: The study was a randomized, placebo-controlled, and double-blind trial study. LBW infants were given daily for 6mo 5mg zn, or a placebo. Questionnairs were filled out during the study by a pediatrician and a GP. Anthropometric measurements were made at 0, 4, 8, 12, 16, 20 and 24 wk via home visits by trained interviewers.

  Results: Baseline characteristics were similar in zinc and placebo groups. Weight gain in zinc group was significantly higher that of placebo group between 1 to 6 months (p=0.036). Length and head circumference gain were also greater in zinc group than in placebo groups, (p=0.04, p<0.001). The episodes of upper respiratory infections was greater in placebo group than zinc group (mean Episodes in zinc groups= 1.7 and in placebo group was 3) and there was significant difference between two groups (p=0.005). 8 Cases of lower respiratory infections in placebo group and 5 cases in zinc group were observed, but it was not significan diarrheal episods were observed only in placebo groups.

  Conclusion: It was found that low birth weight infants had better growth and lower morbidity during the first 6 months of life by receiving zinc supplementation.

Behnam Mohammadi Ghaleh Bin , Esmaeil Fallah, Mohammad Asgharzadeh, Abdolhasan Kazemi ,
Volume 7, Issue 2 (6-2007)

  Background & Objectives: Cryptosporidium is a coccidian protozoan parasite. This organism is one of the main causes of severe, long-time and life-threatening diarrhea in immunocompromised persons. It is also among the most prevalent diarrheal agents in children. Cryptosporidial epidemics occur after consumption of water which is contaminated by oosit species of cryptosporidium. Water is usually contaminated by animal feces or by drainage of waste water into drinking water resources.

  Methods: In this study, from ten regions 200 water samples were collected, filtered by 1.2 micron papers and then positive samples were identified in terms of cryptosporidium using PCR method. Finally the related species were detected by RFLP method.

  Results: Nested-PCR showed 8 samples were positive for cryptosporidium that according to RFLP of PCR products 5 samples belonged to cryptosporidium andersony, 2 samples belonged to cryptosporidium parvum bovine genotype and 1 sample belonged to cryptosporidium pig genotype.

  Conclusion: Since Cryptoridium andersony and cryptosporidium parvum bovine genotype are the common species in animals and cryptospovidium swiss is seen in wild animals (pigs and boars), it so we conclude that animal reservoirs have the main role in the contamination of related water resources in this region.

Ehya Garveriani , Mohammad Mahdi Aslani , Shahram Habibzadeh , Afshin Fathi ,
Volume 7, Issue 4 (12-2007)

  Background & Objective: Yersinia spp is from Enterobacteriacea family. The members of this group are all gram negative bacilli or cocobacili and non-spore and negative heme-oxidase which casuses a vast spectrum of diseases in humans the commonest one of which is gastroenteritis. Other diseases and clinical syndromes are septicemia, mesenteric lymphadenitis, Appendicitis, pharyngitis and rarely Reiter's syndrome. Due to frequent reports of febrile gastro-enteritis from Health centers of Ardebil, the probability of gastroenteritis resulted from Yersinia in this cold province is predictable. Thus this study was done to determine the role of Yersinia spp in the diarrhea of children under 5 in the cold seasons of the year in Ardebil.

  Methods: Stool samples from 490 children under 5 with diarrhea in a 7-month period were collected, and transferred in carry-Blair to the laboratory. Stool samples were cultured on Mac-Conkey agar and Salmonella-Shigella agar and Yersinia selective agar, TCBS agar and selenate agar. After adequate incubation, the growing colonies were identified according to the standard biochemical methods.

  Results: of 490 samples, only 405 were suitable to be cultured of which 9.38% pathogenic bacteria were isolated. The frequency distribution of the separated bacteria were as follows Y.enterocolitica, 13 species vibrio, 11 species Enteropathogenic E.coli, 6 species Salmonella, 5 species Shigella, 2 species and plesiomonas, one species.

  Conclusion: The findings of this study are the indicator of the role of Yersinia spp in diarrhea in the cold seasons of the year in the cold and mountainous province of Ardebil. On the other hand, the frequency of isolated vibria was due to simultaneous cholera epidemy in this area.

Mehrdad Biriya, Shahnam Arshi, Homayoun Sadeghi, Niloofar Malekpoor,
Volume 8, Issue 1 (4-2008)

Background & Objective: one of the most important challenges during the recent century will be to decrease the global burden of accidents. In Iran although respiratory infections and diarrhea were major reasons of mortality rates, Accidents have come to be one of the main causes of child mortality. In rural areas of ardebil province burns constituted 75% of home
injuries in preschool aged children.
Methods: The study was conducted as a case-control study which included rural children of Ardabil under 6. Number of cases were 145 & controls were 289. Data analysis was done using SPSS 11 ver.
Results: 6.8% of case group mothers and 12% of control group mothers had academic education. Difference of mean for sill of kitchen and the ratio of sill of kitchen on sill of house and also difference of mean for sill of house per person were not statistically significant between case and control groups. No statistically significant difference was found in fuel type used cooking or heating between case and control group. No statistically significant
difference was found in heating device between Them. only in one third of houses in both groups separate place was available for cooking purpose and cooking was done in rooms.
Child presence in kitchen while cooking was 76.7% in case and 70.9% in control group. Child access to flamers like lighters and matches was 80% in case compared to 69% in control group. The difference was shown to be statistically significant. No statistically significant difference was found in using Valor's and picnic gas for cooking between case and control group.
Conclusion:chance of burn injury in preschool aged children in those houses that keepmatches and the lighters out of children reach was 1.8 times lower.
Mitra Barati , Samileh Noor Bakhsh, Azardokht Tabatabee , Farideh Ebrahimi Taj , Mahshid Talebi Taher ,
Volume 8, Issue 2 (6-2008)

  Background & Objective: Respiratory tract infections causes 4.5 million children death in the world annually that occur mostly in developing countries like Iran. Bacterial and viral pathogens are responsible for this event and Adenovirus is one of the major responsible agents. According to multiple survey, incidence of viral pathogens in different world region is different so local survey is needed to describe regional incidence of different viral pathogens. Rapid test for detection of respiratory pathogens help us to select appropriate treatment and avoidence of antibiotic overusage. So abuse the aim of this study was to evaluate incidence and clinical presentation of Adenovirus infection in children in Tehran with rapid test.

 Methods:This study is a descriptive-cross sectional analysis. All 3 month to 15 year old children with upper respiratory tract infection that come to OPD of Rasol-e-Acram Hospital in one year(1385) are included.

  Direct smear of patient’s throat was evaluated by rapid chromatography test for adenovirus infection. SPSS software was used to analyse the data.

  Results: 160 children with upper respiratory tract infection with a mean age of 61.5 months were evaluated. 57.5% were boys and 42.5% were girls. 77.4% had fever, 66% had sore throat, 37.4% had cough, 27% pharyngeal exudate, 16.4% had abdominal pain, 15.7% had vomiting, 13.8% had cervical lymphadenopathy, 10% had diarrhea, 5.7% had petechea in palate and 1.9% had conjectivitis. They admitted 24% in spring, 14.1% in summer, 23.1% in fall and 38.5% in winter.

  Adenovirus infection was detected in 10(6.3%) cases, 4(40%) boys and 6(60%) girls with mean age of 83.7(SD=58.5). they were detcted 20% in spring, 30% in summer, 30% in fall and 20% in winter.

  Conclusion: Adenoviruses are responsible in 6.3% of upper respiratory infections in children. They become less prevalent with increasing age. Its prevalence did not obey seasonal pattern. Fever and sore throat are most common clinical signs and cervical lymphadenopathy is more prevalent in adenovirus infection than others.

Hosein Hatami, Feizollah Mansoori,
Volume 9, Issue 2 (6-2009)

  Gastrointestinal (GI) anthrax is a rare disease that occurs 2 to 5 days after the ingestion of undercooked meat contaminated with anthrax spores. The signs and symptoms of classic form include severe abdominal pain, hematemesis, melena, sudden and progressive ascites and severe diarrhea. The disease usually progresses to toxemia, shock, and eventually death in more than 50% of patients. Treatment-failure with penicillin is common.

  We report two cases of GI anthrax with review of literature. During 1988-1994 a total of 38 cases of human anthrax had been admitted in Sina hospital of Kermanshah (west of Iran). There were two cases of GI anthrax (5.3%) with positive culture of ascitic fluid. One of patients unexpectedly was diagnosed with vomiting and ascites and the other had only ascites. There were not any other signs and symptoms including abdominal pain or tenderness, diarrhea, hematemesis and melena. In contrast to available reports, these cases had atypical presentations. Both of them died although they had received sufficient dose of penicillin.

We conclud that the GI anthrax is not as rare as reported but it may be misdiagnosed due to atypical presentation . Therefore, GI anthrax should be considered as a differential diagnosis in the case of progressive ascites and other GI presentations in endemic areas. This could help to diagnose more patients particularly in an early stage which may lead to better management of disease.
Marjan Akhavan Amjadi , Faraz Mojab, Samira Shagbazzadegan,
Volume 9, Issue 3 (9-2009)

 Background & Objectives:Primary Dysmenorrhea (PD) is common gynecology problem in women. It is defined as a menstrual pain that occur in absence of pelvic pathology. PD is common reason of women and girls’ absence from schoole. Pain is main complain of PD but other systemic symptoms like headache, nausea and vomiting, diarrhea, fatigue, irritability and dizziness are common. Many chemical drugs have been used to cure dysmenorrheal, but each has its own side effects.

  Cinnamomum zeylanicum has been used as an anti-spasmodic agent in traditional medicine .

  Methods : This study was a placebo-control, triple blind and randomize clinical trial. We research. The efficacy of C. zeylanicum on severity of symptoms with PD Severity of symptoms were assessed. Data were collected by question validated questionnaires. The subjects of study were 47 single women, who sufrred from primay dysmenorrhes, They were randomly selected and their age use between 18-30 years old. We divided them two group, 26 case women in (treatment group) whom needed capsules contain C. zeylanicum and control group whom revided placebo capsules. administered as soon as onset of pain feeling or bleeding, five capsule a day and continued for minimum three days. Severity of systematic symptoms was assessed with Andersch & Milsom verbal multidimensional scoring system. Data were analyzed through by SPSS software.

  Results: The mean age of women in case and control groups were 20.69 ± 1.93 and 21.7+4.6. There was a significant differences (p<0.001) in the Severity of pain between two groups. The severity of all the systematic symptoms decreased in both groups, but this reduction was not significant between two groups. No significant difference was seen for systematic symptoms between twogroups. In this study, had not been observed any side effects by using of C. zeylanicum .

  Conclusion: The results our study should that C. zeylanicumcan be effective in reducing the severity of dysmenorrheal, but C. zeylanicum has no sufficient effect on relief of systematic symptoms accompanying with dysmenorrhea.

Maryam Chavoshi Frooshani , Abbasali Imani Fooladi , Sara Saadatmand,
Volume 11, Issue 3 (9-2011)

  Background & Objectives: Escherishia coli O157:H7 is one of the most important diarrhea causing agents in developing countries . Using antibiotics cause adverse effects as promoting emergence of antibiotic resistance, fading the microflora of intestine and enhancement of verotoxin (VTEC) production by this bacterium. So, a modern treatment protocol is needed for treatment of infections caused by this bacterium. In this study, Lactobacillus casei (L. casei) was isolated from yogurt and antibacterial effects of bacterial cell debris and its culture supernatant were tested against E.coli O157:H7.

  Methods: Several different samples of yoghurt were cultured in MRS agar in anaerobic conditions at 37 ºC. L. casei was identified by common microbiological and molecular methods. Antimicrobial effects of bacterial cell debris and its culture supernatant were tested against E. coli O157:H7 by using Agar Well Diffusion (AWD) and Broth macrodilution methods. In addition, standard growth curves of pathogenic bacterium and L. casei were obtained by turbidometery and colony count procedures. The MIC (Minimum Inhibitory Concentration) and MBC (Minimum Bactericidal Concentration) of supernatant originated from culture of L. casei were determinded. The stability of antimicrobial effects of the supernatant in different conditions of pH and temperature were studied.

  Results: Lactobacillus casei was isolated from two different samples of yoghurts, and confirmed by phenotypic and genotypic methods. The results showed that antimicrobial effects of culture supernatant were stable at 56, 70, 80and 100 ºC for 30 and 60 minutes. Furthermore, they were stable in pH of 3, 7 and 10. The MIC and MBC of supernatants were 1:16 and 1:8 respectively.

  Conclusion: According to the results of this study, culture supernatant of L. casei can be used as a biological preservative in food industries. Also due to antimicrobial effect of L. casei, it can be used in treatment of diseases associated with E. coli O157:H7.

Afrouz Mardi, Mahnaz Azari , Manoochehr Barak , Mehrnaz Mashoufi , Parvaneh Naftchi , Nasrin Foladi ,
Volume 11, Issue 4 (12-2011)

  Background & Objectives: Diarrhea is one the important causes of mortality among children in developing countries. The effect of zinc supplementation in reduction the rate of diarrhea is controversial. The aim of this study was to evaluate the effect of zinc supplementation on the severity and duration of diarrhea in children less than 5 years old hospitalized in Ali-Asghar hospital in Ardabil, 2005.

  Methods: This study was a double-blind, randomized, placebo-controlled trial including 228 children with acute diarrhea. The subjects randomly assigned into two placebo and experimental groups (114 patients in each group). The placebo group received glucose (5%), while the experimental group received 20 mg/day Zn sulfate. The severity and duration of diarrhea were assessed during the study. Data were analyzed using Chi-square, Pearson correlation coefficient tests and Students t-test by SPSS software.

  Results: Our findings showed that most of the patients in both groups were male (age range 1-12 months, weight range 3-11 kg, weight percentile 3-50). These children had breast feeding and complete vaccination. They were the first baby in their family and the majority of them were from urban area (Ardabil city). The severity of diarrhea in zinc supplemented children (74.6%) was less than placebo group (89.5 % ) (p=0.037). There was no significant difference between two groups in the duration of diarrhea (p=0.737). There also was no relationship between the severity of diarrhea and weight percentile (p= 0.085).

  Conclusion: Our data indicate that zinc supplementation reduces the severity of acute diarrhea and could be advised in children with acute diarrhea.

Ali Nemati, Reza Mahdavi , Eiraj Faizi, Abbas Nagizadeh Baghi,
Volume 12, Issue 3 (9-2012)

  Background & Objectives: Chemotherapeutics induce side effects in patients with cancer . In animal models the intake of ω3 fatty acids during chemotherapy can increase the impact of chemotherapy drugs and reduce their side effects . This study was aimed to determine the fish oilintake on side effects of chemotherapy drugs in patients with gastric cancer.

  Methods: A double blind clinical trial study on 30 adult volunteer patients (15 experiments and 15 controls) with gastric cancer was conducted during chemotherapy in Ardabil, Iran, during 2010-2011 . Experimental and control groups were selected by randomized allocation. About 3 grams ω-3 fatty acid supplementation (1.8 g Eicosapentaenoic acid & 1.2 g Docosapentaenoic acid ) and placebo were given to experimental and control groups for 6 weeks, respectively . Then, the results of data were collected at the beginning, 4 and 6 weeks after intervention of ω3/placebo in both groups and analyzed by using descriptive statistics , Chi -Square , Independent sample t-test and Cochran,s Q test.

  Results: The results of this study showed that there were significant differences of nausea in both group of patients at the end of 6 weeks (p<0.05). A bdominal cramp and nausea significant ly decreased in experimental group during the study (p<0.05). Hair loss , vomiting and diarrhea were reduced in experimental group during the study, but these differences were not statistically significant . There were no significant differences in vomiting , diarrhea and hair loss between two groups at the end of intervention.

  Conclusion: The present study showed that the intakes of fish oil strongly reduce side effects of chemotherapy drugs such as nausea and abdominal cramp. So, this oil supplementation appears to be harmless and useful in patients with gastric cancer during chemotherapy .

Shahram Habibzadeh , Ahmad Ghasemi , Moharram Aghabalaii, Jafar Mohammad Shahi, Bita Shahbazzadegan, Naser Mahmoodi , Jafar Hoseini , Younes Sheshgelani , Nahid Pourmohammadjan,
Volume 13, Issue 2 (6-2013)

  Background & Objectives: Considering new pandemic attack with new emerging (H1N1) influenza virus, the study was designed for evaluating clinical and epidemiologic characteristics of patients in Imam Khomeini hospital, admitted with presumptive diagnosis of H1N1 influenza . In all of the patients clinical and paraclinical findings and outcome (including mortality rate and definitive diagnosis) were evaluated. Bed occupancy rate in infectious disease ward and ICU and also mean days of admission were calculated.

  Methods: This is a cross sectional study . All 118 patients with acute respiratory symptoms and possible diagnosis of emerging H1N1 influenza that had been admitted at least 24 hours in hospital from 20 October to 1 February 2009 were enrolled in the study. Data collection was done based on questionnaires, with a team other than researchers. The questionnaire included demographic data , clinical symptoms , laboratory findings , radiographic manifestations and outcome of patients. Data analysis was performed with SPSS software version16.

  Results: A total of 118 patients were studied: 71 patients ( 60.2%) were female and 47 patients ( 39.8%) were male. Mean ( ± SD) age of admitted patients was 33.81 ± 15.64 years old. The most of admitted patients were in age range of 15 to 30 years old. The most common findings in CXR were bilateral respiratory consolidations and the most common symptoms were fever, weakness and fatigue. About 12.7% of patients had diarrhea. Leukopenia (WBC < 4000) and leukocytosis (WBC > 10000) occurred respectively in 4.58% and 33.2% of cases . Nine patients (7%) were admitted in ICU. I n 21 patients (18%) RT-PCR test results were positive and three of these patients had been admitted in ICU. In patients admitted in ICU while their diagnosis was confirmed, mortality was 33%. 48.3% of patients had at least one predisposing medical condition . Total admission days were 577 days, consisting 519 days in infectious disease ward and 58 days in ICU. Average of hospitalization days per a patient was 4.88 days.

  Conclusion: Except epidemiologic clues, there was no pathognomonic sign or symptom to differentiate influenza H1N1 from other respiratory tract infections. High proportions of pregnant women, bilateral respiratory consolidations, and presence of diarrhea and leukopenia in considerable number of patients were the most important findings of the study.

Marjan Akhavan Amjadi , Samira Shahbazzadegan, Maryam Shakiba ,
Volume 15, Issue 1 (4-2015)

  Background & objectives : Primary dysmenorrhea (PD) is a common gynecological problem in women. It is defined as a menstrual pain that occurs in absence of pelvic pathology. PD causes school absence and job restriction for many women and girls. Pain is the main complain of PD but other systemic symptoms like headache, nausea and vomiting, diarrhea, fatigue, irritability and dizziness are common. Many chemical drugs have been used to manage dysmenorrhea, but most of them have side effects. Acupoint stimulation therapies, like acupressure, might be an effective intervention for primary dysmenorrhea. SP6 and Liv3 are two important acupoints to improve primary dysmenorrhea. The aim of this study was to compare the effect of acupressure in two points SP6 and Liv3 on primary dysmenorrhea.

  Methods: This is a single-blind, randomized clinical trial study. Severity of pain and symptoms were assessed at baseline and also after two menstrual cycles of the investigation using validated questionnaires. 94 non-married women between 18-30 years old, who suffered from primary dysmenorrhea, completed the study (n=50 Liv3, n=44 SP6). The SP6 group received 20 min of acupressure during the initial intervention session and educated to perform the technique twice a day, from 3-5 days before to third days of their menstrual cycle, for two cycles. In contrast, the Liv3 group, performed this method but on Liv3 acupoint. Severity of dysmenorrhea was assessed with Andersch and Milsom verbal multidimensional scoring system. In order to analysis of data, Friedman test and GEE statistics test were used.

  Results: In comparison with baseline, severity of pain in both treated groups decreased (p=0.001). But statistical significance was not observed between two groups.

  Conclusion: It seems that acupressure on SP6 and Liv3, without any preference, is effective to decrease of severity of pain of dysmenorrhea.

Shadi Shahsavan, Abdolaziz Rastegar Lari , Bita Bakhshi, Parviz Owlia, Maliheh Nobakht ,
Volume 16, Issue 3 (10-2016)

Background & objectives: Shigella spp. are gram negative bacteria that can cause shigellosis in human. It is important in young children as well as elderly and immunocompromised people. Threatening complications can occur in severe cases with multidrug resistance species. It has been observed that Shigella spp. have become resistant to antibiotics like other bacteria. Investigation of resistance to azithromycin, tetracycline and pattern of resistance are the objectives of this study.

Methods: Fifty isolates of Shigella spp. which have been collected from three hospitals in Tehran were studied. Isolates identified and confirmed as Shigella spp. by biochemical, serological and molecular methods (ipaH, wbgz, rfc genes). Antimicrobial susceptibility test was performed for ampicillin, azithromycin, ciprofloxacin, doxycycline, levofloxacin, minocycline, nalidixic acid, norfloxacin, streptomycin, trimethoprim-sulfamethoxazole and tetracycline by disc agar diffusion method. Minimal inhibition concentrations were performed for azithromycin and tetracycline.

Results: From a total of 50 Shigella spp. isolates, 16% of them were Shigella flexneri and 84% Shigella sonnei. The majority of isolates were multidrug resistant. The most resistance was seen to doxycycline, streptomycin, trimethoprim-sulfamethoxazole and tetracycline. Resistance to azithromycin was 6%  and all of the isolates were susceptible to norfloxacin and levofloxacin. Nine patterns of resistance were revealed to these isolates.

Conclusion: High resistance to tetracycline was observed and resistance to azithromycin as an alternative treatment choice was also considerable.

Jafar Mohammadshahi , Shahram Habibzadeh, Mohammad Hosseinzadeh, Bita Shahbazzadeghan,
Volume 17, Issue 2 (7-2017)

Background & objectives: Human immunodeficiency virus (HIV) is a globally widespread infection that spreads mainly through sexual contact, mother to child and intravenous drug use. The disease can vary from an asymptomatic state to advanced immune deficiency and AIDS-related opportunistic infections and complications. Patients may be diagnosed at different stages of the disease. In this study, we aimed to analyze the clinical and epidemiological characteristics of patients with HIV and its consequences during the past 10 years (2005-2014) in Ardabil city.
Methods: In this descriptive and case series study, patients with HIV (including live and dead patients) referring to the Ardabil behavioral counseling center were included during 2005-2014 years. The checklist containing demographic data, modes of transmission, time of diagnosis, clinical and therapeutic problems during this period, etc. was prepared for each patient. In dead patients, the causes of death as well as the interval between diagnosis and death were investigated.
Results: In this study, 60 patients with HIV were evaluated, the mean age was 42.96 years, 76.7% of patients were male and 48.2% were intravenous drug users. In 39.7% of cases, patients have probably been infected through intravenous injection and 33.3% by sexual contact. The mean CD4 + lymphocyte cell count of patients was 252 cells per ml. The most common early symptoms of the disease were fever (63.33%), aphthous stomatitis (35%) and diarrhea (28.33%). In 7 cases (50%), tuberculosis was the most common opportunistic infection. 6 patients (10%) had coinfection with hepatitis B or C. 28 patients (46.6%) died within the time of study. The median time from diagnosis to death was 44.84±39.65 months and cardiorespiratory failure was the most common cause of death among patients.
Conclusion: This study showed that most patients were middle-aged and intravenous drug use was the most common risk factors for HIV. The most common way of transmission was intravenous injection and hepatitis C and tuberculosis were the most important comorbidities, respectively. Raising community awareness about the disease, early diagnosis and appropriate care during illness are basic measures to deal with this global problem.
Maryam Tajoadini, Babak Kheyrkhah, Kuomars Amini,
Volume 18, Issue 1 (3-2018)

Background & objectives: Shigella species are one of the most common causes of dysentery and sometimes death, especially in children and those with immunodeficiency. The variety of causative agents (Shigella species) and the development of drug-resistant strains make it difficult to select an appropriate antibiotic for the treatment of shigellosis. One of the most important factors involved in the resistance of Shigella isolates is the presence of extended spectrum beta lactamases (ESBLs) genes. The aim of this study was to determine the frequency of blaPER, blaGES and blaVEB genes in Shigella sonnei isolated from patients with dysentery using multiplex-PCR method and to determine the antibiotic susceptibility patterns of these isolates.
Methods: A total of 60 isolates of Shigella sonnei were collected from different hospitals and medical ‎diagnostic laboratories in Kerman province. Specimens from different age groups were cultivated in special media ‎and confirmed by biochemical tests. The presence of blaPER, blaGES and blaVEB genes were ‎investigated using specific primers and multiplex-PCR method. Antibiotic susceptibility test was ‎performed by disc diffusion method based on CLSI standards. ‎
Results: Multiplex-PCR results showed three samples had blaPER gene, but none of them had blaVEB or blaGES ‎genes. Also, the results of antibiotic susceptibility test showed the highest resistance for amoxicillin- clavulanic ‎acid (53.3%) antibiotic and the highest sensitivity for tetracycline (85%) antibiotic.‎
Conclusions: The results of the experiments indicated the presence of blaPER gene in Shigella sonnei isolates. In ‎addition, the results showed high resistance of isolates to amoxicillin clavulanic acid and ceftriaxone ‎antibiotics. Therefore, careful medical care and proper and timely use of appropriate antibiotics are essential to ‎prevent the spread of resistant isolates. ‎

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مجله دانشگاه علوم پزشکی اردبیل Journal of Ardabil University of Medical Sciences
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