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Showing 25 results for Fever

Shahnam Arshi , Homayoun Sadeghi , Mahdi Mohebali , Seyedhashem Sezavar, Arman Javanrozegar , Darioush Emdadi , Vahid Sepehram , Nayereh Aminisani ,
Volume 2, Issue 3 (9-2002)

 Backgrond & Objective: In recent years, malaria has been a serious problem in Parsabad (a north-western town in Iran). A lot of health-care funding has been allocated to malaria campaign program in this area. The objective of this study was to investigate clinical epidemiology of malaria during 1999-2000.

 Methods: The data collected through epidemiology forms filled for 509 malaria positive cases during 1999- 2000 was analyzed by EPI2000 software. Frequency tables, X2 test and one way ANOVA were used in this analysis.

 Results: All 509 Malaria cases diagnosed were P vivax. They belonged to the first seven-month of the year. 69.4% of malaria cases were related to the year 2000 and the others were related to 1999. The most frequent symptoms were chills in 488 cases (95.9%) and fever in 481 of them (94.5%). Sweating was found only in 3.9% of the reported cases. Mean age and standard deviation of patients was 22.9 + 15.6. There was no significant difference between men and women in terms of the distribution of fever and chills.

 Conclusions: The high prevalence of fever and chills was compatible with the findings of previous studies. If one of the two symptoms is positive in the residents of this area or those people traveling there, malaria should be suspected.

Zhinoos Bayatmakoo , Roshanak Bayatmakoo ,
Volume 4, Issue 1 (4-2004)

 Background & Objective: The emergence of multi-drug resistant salmonella strains h ave made t h e treatment of typhoid fever difficult all over the world. It is even more complicated w h en t h e hi g h cost of newly marketed antibiotics, their side effects and arising bacterial resistance to them are considered. Knowledge of antibiotic sensitivity and resistance of salmonella can make prevention of side-effects and emergence of resistance as well as the treatment measures more effective in this region.

  Methods : This descriptive study was performed in a 6-year period between 1992-97 on 397 patients who were culture positive (blood and stool) in terms of typhoid. The drug resistance was determined based on the anti-biogram of salmonella separated from blood and stool culture of the patients.

  Results: The total number of patients was 397 (237 males, 160 females). All of the subjects were above 12 years old. The resistance of strains of salmonella separated from the blood and stool culture to an antibiotic was 76.9 and 79.6 percent respectively. Resistance to ampicillin, amoxicillin, co-trimoxazole and chloramphenicol was highest among others. There were 60 strains with multi-drug resistance 34 of which (8.57% of all patients) were separated from blood culture and 26 (6.55% of all patients) from stool-culture. The amount of microorganisms multi-drug resistance separated from blood and stool was 6.55% and 8.57% respectively (15.12% in total).

  Conclusions : Using antibiotics without the knowledge of bacterial resistance and sensitivity can complicate the issue.

Shahnam Arshi , Ali Majidpoor , Homayoun Sadeghi , Seyedhashem Sezavar , Reza Gasemi Bargi , Darioush Emdadi , Nategh Abbasgholizadeh , Parvaneh Naftchi ,
Volume 4, Issue 1 (4-2004)

 Background & Objective: Ardabil province is the main area of Iran affected by relapsing fever (RF) for which Borrelia Persica is the most common cause. The aim of this study was to determine the epidemiologic characteristics of the disease, and the frequency of infection among ticks in this region in order to take necessary measures to decrease it is incidence and increase awareness about the characteristics of this disease.

 Method: In this study a total of 391 patients who were diagnosed to have been effected by tick borne relapsing fever were investigatated in terms of clinical epidemiology between 1998 and 2001. The kind of Borrelia as well as the clinical characteristics of the disease were observed. The kind and prevalence of Borrelia infection was determined in 1,421 ticks collected from 130 indoor and 14 outdoor sites. The ticks were crushed and the suspension obtained was injected into the peritoneum of two mice and two guinea pigs to determine the frequency of infection among the ticks living in this region. Data including the tick species determination were collected through a questionnaire and analyzed using Chi-square and ANOVA tests.

 Results: The most prevalent clinical manifestations were fever, chills and headache. Other findings included nausea, vomiting, sweating, abdominal pain, arthralgia, cough, photophobia, eosinophilia, hematuria, jaundice, petechiae and sclera congestion. Laboratory tests performed on 60 patients showed leukocytosis, high erythrocyte sedimentation rate (ESR) and anemia. Of the 1,421 ticks collected, 45.9%, 40.3% and 13.8% were infected by Ornithodoros lahorensis Ornithodoros tholozani and Argas persicus species, respectively. The prevalence of ticks was highest in Khanadabil village. The ticks collected from three villages were found to be infected with Borrelia.

 Conclusions: The clinical manifestations were similar to those reported in other studies. Petechiae occurred less frequently in our study compared to louse-borne RF. The high frequency of anemia in this region, which was not stated in other reference articles, requires further investigation.

Khalil Rostami,
Volume 4, Issue 3 (9-2004)

  Serious vascular complications of IV drug abuse are being encountered with increasing frequency. These patients often present with cellulitis, abscess and endocarditic. Due to having viral infections these people can be a hazard to health care workers. Medical intervention is usually conducted after the emergence of one of the dreadful complications of IV drug abuse. The subject is a 40-year old male prisoner who referred to Emergency Department with 24 hours history of chill and fever, intermittent bleeding from a painful ulcerated lump in right groin along with hypotension and severe edema of right lower extremity necessitating packing and initial resuscitative measures. It was clinically diagnosed as ruptured infected pseudo aneurysm and urgent exploration was undertaken. Excision of common femoral artery was conducted by interpositioning of saphenous graft between external iliac and superficial femoral artery along with ligation of deep femoral artery drainage of abscess and debridment of necrotic tissue. The patient recovered with limb salvage except seroma on original site of vein graft.

Ahmad Hashemzadeh, Farhad Heidarian,
Volume 5, Issue 4 (12-2005)

  Background & Objectives: Juvenile Immune Arthritis (JIA), which is a disorder with unkuown etiology, occurs in children under 16 and is one of the most common collagen vascular diseases in pediatrics and among the important causes of permanent deformity of joints and blindness in children. With regard to its importance, we studied the incidence, different types as well as clinical and laboratory features of this disorder.

  Methods: This descriptive and cross-sectional study was performed on 24 patients (age range: 6 months-12 years) admitted to pediatric wards of Ghaem and Imam Reza hospitals in Mashhad during 1998-2001. The data were collected from the patients’ records using a questionnaire and analyzed by SPSS software.

  Results: Polyarticular type was the most common form of the disease. Peak age of involvment was 11 years old. Boys were more frequently affected than girls. Knees, ankles and wrists were the most commonly involved joints. Most of the patients suffered from loss of appetite and irritability. Fever was detected in 100% of the patients with systemic type and 2/3 of the cases with polyarticular form. The most important laboratory findings were elevated ESR, positive CRP and anemia. There was an excellent response to aspirin or glucocorticoids.

  Conclusion: In comparison to similar studies the onset of disease in our patients was a little later. Fever was seen in all patients with sytemic disorder and skin rash was observed in most of the cases. So, it would be quite wise to suspect JIA in such cases. Aspirin or prednisolone are suitable drugs to treat most of these patients.

Farhad Salehzadeh,
Volume 5, Issue 4 (12-2005)


 The term periodic fever and diseases classified under periodic fever, have particular situation in pediatrics. Periodicity and fever are the hallmark of these syndromes, though there could be other symptoms and signs in each syndrome. On the other hand, most of these syndromes have familial pattern. Since some of these syndromes are common in north-west Iran, the understanding and recognition of these diseases seems to be necessary. Nowadays at least seven periodic fever syndromes have been explained in pediatrics: The first one is FMF and the last and new one is PFAPA. The rest of them are: Hyper IgD, FCAS, Muckel- Wells, CINCA, and TRAPS.


Nader Pashapour, Ali Macooei , Vahid Sheikhi ,
Volume 6, Issue 2 (6-2006)

  Background&Objectives: Febrile convulsion is a disease with good prognosis but its mismanagement leads patients to serious complications. T his study was conducted to compare practice guidelines with current practices in the management of children with first febrile convulsion.

  Methods: This descriptive-analytical study was conducted on patients hospitalized with the diagnosis of first febrile convulsion in Imam-Khomeni hospital of Urmia in 2004. The data were collected from their hospital records. Practice guidelines of the American Academy of Pediatrics (AAP) were employed as reference. Current practices were compared with AAP recommended practice parameter about simple febrile seizure. Investigations performed included lumbar puncture, complete blood count, CRP, ESR, blood glucose, serum calcium, serum electrolytes, renal function tests, urinalysis, urine, and blood culture, chest X-ray, EEG and CT scan.

  Results: T wo hundred fifty one cases aged 6-60 months were studied. Complete blood count, ESR, CPR, blood glucose, serum calcium, serum electrolytes, renal function tests, urinalysis, urine culture, and blood culture in all cases (100%), lumbar puncture in 10%, chest X-ray in 24%, EEG in 1.4% and CT scan in 0.65% of cases were the measurements conducted.

  Conclusions: The present study showed that the use of unnecessary investigations was common. Investigations, though costly, proved to be of little diagnostic value. This problem can be alleviated through a well-organized national program or observing AAP practical guidelines.

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.

Farhad Salehzadeh , Dina Emami , Aliasghar Zolfeghari , Abbas Yazdanbod , Shahram Habibzadeh , Bahman Bashardoost , Manoochehr Barak , Eiraj Feizy , Hormoz Azimi , Marina Jastan , Jafar Khalafi ,
Volume 6, Issue 3 (9-2006)

 Background and Objectives: Familial Mediterranean fever which is the prototype of the hereditary periodic fever syndromes is common in the countries around the Mediterranean Sea. Regarding the geographical position of the northwest of Iran, having Turkish originality and its vicinity to the Mediterranean Sea , the incidence of this disease is significant in Ardabil. The goal of this study was to introduce Familial Mediterranean Fever as a disease with significant outbreak in this area.

 Methods: This research is a descriptive study which has been done during one year from October 2004 to October 2005. According to the Tel-Hashomer criteria, the patients suffering from Familial Mediterranean Fever were collected from private clinics and pediatric rheumatology clinics records. Then from 112 patients only 74 ones were studied. All of the patients were interviewed and filled out a questionnaire.

 Results: Familial Mediterranean fever is common among children under 18 (76%) and more common in male than female. Abdominal pain has been the most common complaint (74%) and abdominal pain and fever (95% and 84% respectively) were the main clinical symptoms. The most common period of pain was 12-72 hours and the common recovery (attack free) period was from 1 week to 1 month (63/5%). Majority of the patients had hospital admission for diagnostic work up (85%) and some of them (32%) had been under surgical operation mistakenly. On the whole 92% of the patients had taken medications as a result of wrong diagnosis and 20% had positive familial history. 50% of the patients' parents were first degree relatives and in 59.5% delay in diagnosis was more than 3 years.

 Conclusion: Results of this study and introduction of this group of patients in a one-year research indicate that: Familial Mediterranean Fever is more common in the Northwest of Iran although physicians are not familiar with that. The common age for manifestation of this disease is under 18 and its presentation after the age of 40 is very rare.

Afshar Tamook , Fereidoon Ashenaie, Joobin Yeganeh Moghadam , Mahdi Chiniforush , Nayereh Amini Sani, Shahram Habibzadeh ,
Volume 7, Issue 1 (4-2007)

 Background & Objective: Visceral leishmaniasis is a reticulo endothelia system and it is known as 'black fever' by Indians. According to WHO every year there are 500 thousand new cases of it in the world. The province of Ardabil, with 25-40% from all the country's leishmaniasis has a major part in the country and is considered as one of the main focuses in Iran. Due to its importance, this study was done to identify clinical signs and demographic characteristics of the patients.

 Methods: This was a descriptive cross-sectional study which was done retrospectively 110 children who were hospitalized in three different active hospitals between 1375-1382 entered in this study. Disease definition include parasite detection in bone marrow aspivation or special clinical signs (fever, spleenomegal, pansytopenia and weight loss) in addition direct agglutination test was positive. The samples were investigated in terms of demographic information. Place of living, clinical signs and the length of time between the symptoms of the disease and its diagnosis. To get to the results, simple descriptive statistics was used. 37.8% of the patients were diagnosed from the beginning of symptoms with in a month.

 Results: There were 56.4% boys and 43.6% girls of all the 110 children. DAT test was done in 97 patients which was positive in 91 cases (minimum positive titer 1/400). In 42 patients biopsy and bone marrow aspiration was done which was positive in 26 cases (lishman body detection). The age of the patients was 4 months -14 years. The most common findings were fever 97.3% and anorexia 97.1%. There was anemia in 90% thrombocytopenia in 60.8% and leukopenia in 24.8%. There was death in 6 patients (5.5%) and unresponsiveness to the treatment in 3 cases (2.7%).

 Conclusion: The results of the present study nearly corresponds to those of other studies. The main vulnerable community of visceral lieshmaniasis are mainly children. In order to decrease the mortality and morbidity its early diagnosis is essential. It is necessary that the physicians working in endemic regions be familiar enough with the disease.

Mohammad Narimani , Malahat Amani ,
Volume 7, Issue 2 (6-2007)

 Background & Objectives: Mental retardation is a critical deficiency in cognitive functions, social skills, and adjustment behaviors. About 1 to 2 percent of people are mentally retarded because of various factors. The purpose of this research was to study the prevalence of mental retardation in Ardebil city and determining the role of environmental and Heredity factors on mental retardation. In other words, which of pre-, on-, and post-birth factors as well as environmental factors are related to mental retardation of 7-11 aged children.

 Methods: In order to find out the prevalence of mental retardation, a sample of 500 families were selected by simple random sampling method and were studied by causal-comparative method. Also percentage, frequency, and comparing of two independent groups were used to analyze the data and study the extent of prevalence.

 Results:The results showed that the rate of prevalence of mental retardation is 3.6%, which is higher than the extent of prevalence of the world. Also the results of comparing two groups normal and mentally retarded revealed that familial marriages, in-birth events, fever and convulsion diseases during post-birth period are higher in mentally retarded group. Furthermore, the results showed that the level of mothers’ educations in normal group is significantly higher than that of mentally retarded group. And among the other factors, environmental factors were the most important factors of mental retardation of children in Ardabil city.

 Conclusion:The high rate of prevalence of mental retardation and the role of environmental factors in mental retardation of children in Ardabil city require environmental intervention such as training of families and improving health level of society.

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.

Parsa Yousefi, Ali Cyrus, Fatemeh Dorreh,
Volume 8, Issue 3 (9-2008)

Background & Objectives:Urinary tract infection (UTI) ranges from asymptomatic bacteriuria to severe renal infection with sepsis. Urinary tract infection can cause many complications as abscess, hypertension, renal failure, renal scar, reflux and so on. Since there is no general agreement on the administration of additional fluid (1.5 times maintenance) on the early treatment of UTI on this study was conducted to see the effect of additional fluid. 

Methods:206 children with UTI who were admitted in Amir Kabir Hospital of Arak from March 2005 to March 2006, were divided into two groups of 103. One group received the usual amount of maintenance fluid and the other 1.5 times of maintenance. The course of resolution of dysuria, frequency, malodorous urine, abdominal pain and fever were compared in the two groups. Patients' urine culture was performed on the second day, 7-10 days, and 90 days after admission. Patients were matched according to their age and sex. Those who presented with azotemia were excluded from the study.

Results: Receiving additional fluid had a significant effect on the malodorous urine dysuria. However, it had an inverse effect on the treatment of fever and urinary frequency and it made them even last longer. In other areas like abdominal pain and urine culture in 3 stages there was no difference.

Conclusion: It seems that intake of excessive amounts of water has no significant effect on the results of the UTI treatment.

Parsa Yousefi, Abolhasan Faraz , Fatemeh Dorreh , Mahmoodreza Nakhaie , Zahra Moghaddasi, Sahar ,
Volume 10, Issue 2 (6-2010)

  Background and objectives: Common cold is the most common disease in children. Young children have an average of 6 to 7 colds each year. Some complications of common cold include: secondary bacterial infections, school absence and excessive cost for treatment. The management of the common cold consists primarily of symptomatic treatment. An effective and safe drug is needed to reduce the duration of common cold ۥ s symptoms in children and reduce subsequent complications. In some studies zinc sulfate has showed an antiviral effect and immune enhancing activity. Therefore this study designed to evaluate the efficacy of zinc sulfate in duration of cold ۥ s symptoms in children.

  Methods: This was a clinical trial study. The subjects were children between 1 - 7 years old with common cold that attended to pediatrics clinic of Arak Amir Kabir Hospital. The study included 112 patients randomized in two groups. One group received zinc sulfate within 10 days and other group didn’t receive this drug. Using a researcher made questionnaire duration of symptoms: rhinorhea and nasal obstruction, cough, sneezing, fever and duration of illness, in both groups were evaluated.

  Results: Consumption of zinc sulfate significantly reduced the mean duration of rhinorhea and nasal obstruction in children with common cold (p < 0.05). Also the mean duration of cough in zinc group was lower than the control group (p < 0.05). Compared to the group that didn’t receive zinc sulfate, the zinc group had shorter mean duration of sneezing (p < 0.05). Also the mean duration of fever in zinc group was shorter than the other group (p < 0.05). The mean duration of illness in patients who had received the zinc sulfate was significantly less than the other group (p <0.05). No side effect was observed in subjects received zinc sulfate.

  Conclusion: According to the results zinc sulfate can be administered with other supportive treatments of common cold, for reduction of symptoms duration and complications in children.

Manoochehr Barak , Setareh Mamishi , Seiyed Ahmad Siadati , Peyman Salamati , Ghamartaj Khotaii, Mehrdad Mirzarahimi ,
Volume 11, Issue 2 (6-2011)

  Background & objectives: Nosocomial infections increase patient’s mortality and are considered as a health problem. The aim of this study was to assess the risk factors for nosocomial infections and antimicrobial resistance pattern of isolated bacteria in NICU and PICU, in Bahrami and Children’s Medical Center hospitals, Tehran .

  Methods: In a prospective cross-sectional study from October 2008 to September 2009, risk factors and etiology of nosocomial infections were evaluated in all patients who showed infectious signs upon 48h admission. Infectious agents were diagnosed by the standard microbiological tests and antibiotic sensitivity of isolates was determined using dick diffusion method. The data for location of the hospital, admission history, presence of immunodeficiency, fever and using venous and urine catheters, suction, venous injection as well as cerebral shunt and surgery have been collected by a questionnaire and analyzed, statistically .

  Results: About 9.3% (70 individuals) of cases encountered with nosocomial infections. From whom, 24.3% were infected by Pseudomonas aeroginosa and 18.6% and 3.14% by Klebsiella pneumonia and Enterobacter spp, respectively. The location of the hospital, using of suction and surgery were the most common risk factors related to nosocomial infections (p<0.05).

  Conclusion: Our findings showed that the hospital location, suction and surgery were the most common risk factors and Pseudomonas aeroginosa, Klebsiella pneumonia and Enterobacter spp were the common infectious threats. So, we need to design the special program to improve nosocomial infection control in hospitals .

Hormoz Azimi, Sholeh Khademabbasi,
Volume 11, Issue 3 (9-2011)

  Background & Objectives: The first Laparoscopic Cholecystectomy surgery was performed by Erich Muhe in 1985.Nowadays in developed countries, more than 90% of cholecystectomy surgeries are done by Laparoscopic method and it is one of the most common elective surgeries. The aim of this study is to evaluate the frequency and side effects of this method and the rate of conversion to open surgery patients undergoing laparoscopic cholecystectomy surgery in Sabalan and Arta hospitals in Ardabil province.

  Methods: This descriptive analytical study was performed between October 2006 and January 2009. We have studied 200 patients (24 male, 176 female) with cholecystitis (symptomatic gallstones) treated by Laparoscopic Cholecystectomy surgery. Data were collected through questionnaires and telephone calls (at least 6 months after surgery). Data analysis was done by SPSS statistical software and chi-square test. p<0.05 was considered as significant.

  Results: The average age of patients was 44.6 years. In the final diagnosis, 168 patients (84%) had chronic cholecystitis and 32 patients (16%) had acute cholecystitis. The rate of conversion to open surgery was 8 patients (4%). Eight cases (4%) were suffered organic side effects including: four cases (2%) jaundice after surgery, 1 case (0.5%) postoperative fever, 1 case (0.5%) leakage of bile, 1 case (0.5%) slight leaking of serum from the surgical site and 1 case (0.5%) associated with increased liver enzymes that had no other symptoms. About the risk factors for conversion to open surgery, there was significant correlation between acute cholecystitis and male gender. Information about the satisfaction of patients after surgery showed that, 89.5% were completely satisfied, 2.5% were completely dissatisfied and 8% were relatively dissatisfied. No deaths were seen.

  Conclusion: Laparoscopic Cholecystectomy is a standard selective treatment method for gallbladder stones. It has many advantages including reduced duration of hospitalization, less pain, reduced morbidity and less side effects than open surgery, lower recovery period and faster return to normal life.

Abbas Karimi , Morteza Jabbarpour Bonyadi, Mohsen Esmaeili, Saeid Dastgiri ,
Volume 12, Issue 3 (9-2012)

  Background and Objectives : Familial Mediterranean Fever, an autosomal recessive disorder, is the most common and well known periodical fevers syndrome. Disease is mainly prevalent among non-Ashkenazi Jews, Arabs, Turks and Armenia. According to the geographical location of North-West of Iran, neighboring with two high risk FMF population (Turkey and Armenia), the prevalence of FMF in this region of Iran is not unlikely. The aim of this study was to estimate the carriers rate of FMF common mutations in healthy control people. Results can be potentially useful to estimate prevalence of disease.

  Methods : Randomly 200 samples from healthy people [non-FMF] from North-West of Iran selected. After taking consent, DNA was extracted from blood samples of these groups. Then mutations were evaluated using ARMS-PCR and RFLP-PCR techniques.

  Results : from 400 studied alleles, 44 and 7 mutant alleles were found for E148Q and V726A respectively. For 2 other mutations, no mutant alleles were found. The total allelic frequency for these four common mutations was 0.132. The carriers rate was 23.4%.

  Conclusion : This study showed that E148Q has high mutation frequency relative to other mutations in North-West of Iran.

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.

Farhad Salehzadeh, Morteza Eslami,
Volume 16, Issue 1 (4-2016)

Background & objectives: FMF is an auto-inflammatory and hereditary periodic disorder. The symptoms can occur in more than 80% during the first decade of life. With regard to high prevalence of FMF in northwest of Iran, this study was conducted to introduce especial features of FMF in this area.

Methods: This is a descriptive study performed on 403 patients with diagnosis of FMF according to the Tel-Hashomer criteria. Information obtained from patients' file and entered in the questionnaire. Data analyzed by SPSS v20 using simple descriptive statistical analysis.

Results: In this study 228 (56.6%) patients were male, and the mean age of patients was 21.03 years. The common symptoms were abdominal pain in 93.3% and fever in 88.1% of patients. Abdominal pain was the main complaint(49.6%), the average duration of pain was 43.3±34.5 hours and the average attack-free period was 36.5±29.6 days. 15.1% of patients had positive family history and 12.7% had history of appendectomy. Delayed diagnosis was more than three years in 52.3% of patients. Genetic analysis has been done in 239 patients in which 21.33% had no mutations, 39.7% were compound heterozygous genotype, 25.52% heterozygote and 13.38% had compound homozygous mutations. The most common mutations were M694V/V726A (10.46%) and the most common alleles were M694V (20.9%) and V726A (12.7%). The M694V-V726A genotype (12.7%) was the most common combined mutations in male and the common mutations in female was M694V/M694V (10.4%). Among the patients with abdominal pain M694V/V726A (12.5%) was more common. The genotypes of M680I/V726A (13.9%), M694/V726A and M694V/R761H (16.7%) and the M694V/M694V (33.3%) had the common mutations in patients with fever, chest pain and joint symptoms respectively.

Conclusion: First decade is usual age to presentation of FMF. M694V is the most common mutation and M694V-V726A is the common compound heterozygous mutation. MEFV mutations in this study are similar to Arabs results. It seems that clinical criteria still are the best way in diagnosis of FMF in spite of the fact that erysipelas like skin rash  is not common as a clinical criteria in this area

Yavar Mahmoodzadeh , Mohammad Mazani, Lotfollah Rezagholizadeh, Aliasghar Abbaspour, Eslam Zabihi, Pirooz Pourmohammad,
Volume 16, Issue 4 (1-2017)

Background & objectives: Some herbs contain compounds with antioxidant activity and can be used to protect or cure damages caused by chemical toxins. The aim of this study was to evaluate the effects of carbon tetrachloride (CCl4) on total antioxidants in various tissues and Tanacetum parthenium impacts on reducing devastating effects of carbon tetrachloride.

Methods: A total of 42 male Wistar rats were divided into seven groups of six animals in each group: normal control, damaged control, three groups that treated with 40, 80, and 120 mg/kg of Tanacetum parthenium extract 14 days before CCl4 injection and two groups served as post-treatment groups that received 80 and 120 mg/kg extract 2, 6, 24, and 48 h after CCl4 injection. At the end of study  the liver, kidney, testis, and heart were removed and then homogenized and then the antioxidant activity of the tissues assessed using FRAP method. Results were analyzed by one-way ANOVA test.

Results: The results showed that the injection of carbon tetrachloride significantly decreasestotal antioxidant in both liver (p<0.001) and kidney (p<0.05) tissues. Administration of extract significantly (p<0.05) increased the total antioxidant of liver and kidney.
Conclusion: Protective effect of Feverfew against CCl4 induced damages is more effective in liver and kidney than testis and heart..

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