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 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.

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 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.

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 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.

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 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.

 

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  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.

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 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.

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  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.

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  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.

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  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.

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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

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Background & objectives: In recent years, regarding the side effects of chemical drugs, the use of medicinal plants has increased due to their low side effects, low costs and effective compounds. The aim of this study was to investigate the anti-inflammatory, anti-nociceptive, and anti-pyretic effects of hydroalcoholic extract of Rosa canina L. fruit in male mice.
Methods: In this experimental study, 120 male BALB/c mice weighing 23-30 g were used. In each test, the mice were divided into 5 groups (in each group, n=6), including control group, positive control and three experimental groups treated intraperitoneally with hydroalcoholic extract of Rosa canina L. fruit at doses of 100, 200 and 400 mg/kg respectively. The anti-inflammatory and antipyretic activities were measured using xylene-induced ear edema and brewer’s yeast-induced pyrexia tests, respectively. In addition, the antinociceptive activity was measured using the abdominal constrictions induced by acetic acid and formalin tests. The data were analyzed by SPSS statistical software and One Way ANOVA test. The level of significance was set at   p<0.05.
Results: 200 (p<0.05) and 400 mg/kg (p<0.001) doses of extract reduced significantly inflammation. Doses of 100 (p<0.05), 200 (p<0.01) and 400 (p<0.001 significantly reduced pain in the abdominal constriction test and dose of 400 mg/kg (p<0.05) decreased the chronic pain in formalin test. Extract treatment did not reduce fever in any of the existing doses.
Conclusions: The findings of this study suggest that Rosa canina L. fruit has anti-inflammatory and visceral analgesic activity, which may be due to its antioxidant potential.