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In this case-control study, 58 transfusion-dependent Thalassemic patients compared with 46 normal healthy persons on study of their thyroid size & function. In this study, thalassemia patients divided in two groups: Group one 31 patients with (Ferritin<1500) and group two 27 patients with (Ferritin>1500) and 3rd one was named control group (46 healthy persons). These groups were compared to achieve the best possible results and conclusion out of 31 patients. From first group 26 people had normal thyroid function test only 5 patients (16%) had goiter. From 27 patients in second group, 5 people (19%) had normal thyroid and 22 patients had goiter, in 3rd group 29% had normal thyroid, the difference between second and third groups were significant (P<0.01). In second group T4 level were lower than control, instead the TSH level were more than control group. The difference in second and third group were significant. The mean of T3 and T4 in group one and three don’t have significant differences. Conclusion: The goiter incidence and hypothyroidism in major Thalassemia with poor control (Ferritin>1500) are high.

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The term Noonan syndrome has been applied to phenotypic male and female who have certain anomalies that occur also in female with Turner’s syndrome. These patients have normal karyotype. The disorder is very rare. The most common abnormality are short stature, webbing of the neck, Pectus Carinatum or Pectus excavatum, congenital heart disease. This particular case is a 8-year-old girl-patient who referred to pediatric clinic with short stature. Another abnormality in these patients is abnormal facies (Hypertelorism, hypogonadism, piqure chest and webbing of the neck). The patient had moderate mental retardation. Chromosomal analysis revealed 46xx cytogenetic distinguished Noonan syndrome.

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In this study 32 patients whom had only one superficial bladder tumor (T?-T1 stage) were selected to investigate the effectiveness of either BCG of Alfa-Interferon in preventing the recurrence of tumor. The other aim of this study was to compare the ideal regiment for the patient. These patients previously had neither tumor nor immunotherapy. The patients were divided randomly into two groups, each consisting of 16 people, and they were given the chosen medicine two weeks after surgery of tumor, which is usually superficial tumor (TCC type). 10 million unit of Alfa-Interferon in amount of 7 dose was injected weekly in those patients in group 1 and 120 mg BCG in group 2 respectively. Tumor recurrence in those patients, which receive interferon, was 50% and those that receive BCG was 18.5% respectively (P=0.07). The average recurrence of tumor in group 1 was 0.046 for one person per month (Patient/month) and the same index for group 2 was 0.015 recurrence for each person per month. Relative risk in equal to 3 (Relative risk=3) with accuracy of 95% between (0.87-10.38) but in those patients that were under ?-Interferon treatment only 4, and in BCG group 13 patients got the side effects of medicines.

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Stress responses have been excited by the painful stimuli, after induction of anesthesia and during the operation. In order to reduce these responses, it will be useful to select the type of anesthesia. Based on this fact, two groups of patients (Every group had 50 patients) were selected randomly. All patients are older than 18 years old and were chosen according to America Society of Anesthesiologist, class I, II, and were candidated for cataract surgery. Propofol were used for induction and maintenance of anesthesia In group 1 (TIVA group). In group 2 (Balance anesthesia), Sodium Thiopental induced anesthesia and the combination of N2O and Halothane were used for maintenance of anesthesia, respectively. Blood Glucose in two groups was measured before induction of anesthesia that all were in normal range (80-120 mg/d). Then after induction, incision and 30 minutes after start of surgery, blood Glucose was measured again and deviation from basal level were classified in three categories as: <10%, 10-20%, >20%. The results demonstrated meaningful difference between two groups, statistically (Chi-square, P<0.001). Increasing the blood Glucose in group 2, in three stages, was more than group 1. Blood Glucose level was increased about 20% from its basal level, in the majority of group 2 (32% after induction, 64% after incision, 62% 30 minutes after start of surgery). But, this amount of increasing in group 1 was detected as follow. 16% after induction, 16% after incision, 12% 30 minutes after start of surgery. It is possible that in TIVA group’s, control of blood Glucose and stress responses better than balance anesthesia group’s. The comparative measurements of catecholamine level in both groups would be the next investigations.

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Breast cancer is the most common cancer in women. Histologic grading is one of the prognostic factors in breast cancer. The present study performed in analytic descriptive method and based on the slide review of beast biopsies received in the pathology department of 5th Azar Hospital from 1976 to 1978, and on the basis of Bloom-Richardson criteria (Mitoses, tubule formation and nuclear pleomorphism). The results are consist of: 1) Infiltrating duct carcinoma is the most common histopathologic form, and tubular carcinoma is the least common 2) The most common age is 36-45 years 3) There is meaningful relationship between mitoses and tubule formation and between pleomorphism and tubule formation. But there is no relation between nuclear pleomorphism and tubule formation in the tumor. Histologic grading of breast carcinoma should be reported by pathologist for clear determination of prognosis and also the best choice for management of the tumors.

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The assessment to bacterial epidemiology in large hospitals help the management of the febrile patients and prescribing the correct kind of antibiotics, before receiving the laboratory results. In a descriptive study during (1996-97) in different hospital departments. The samples were transferred to the laboratory and common bacterias were isolated. In this study, cultural mediums of stool, blood, wound, were used as source the samples the results indicate that, the most common bacteria was E.coli with 30.6%, Staphylococci 14.2% and common infection sites were, urinary 33.3%, blood 21.7% respiratory tracts 14% respectively. The results from this investigation shows that frequency and distribution pattern agrees with those reported by other researchers. The susceptibility of isolated bacteria to Ciprofloxaxin and amino glycosides were quiet high.

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Diabetes commonly is associated with CAD risk factors, in addition sub-optimal metabolic control of diabetes is associated with increased incidence of thyroid function disorders. In this study patients with diabetes type II who were referred to 5th Azar Hospital in Gorgan were assessed to find out the relationship between thyroid dysfunction and NIDDM in such patients in Gorgan. We studied 210 diabetic patients in hospital outpatient department. The blood pressure, height, weight, serum total Cholesterol, Triglycerides, fasting blood sugar, and glycosylated hemoglobin (HbA1c) were determined. The obesity (BMI>30) were seen in 35% of the subjects. Hypertension and hyperlipidemia were seen in 38 and 65 of our patients respectively. The observed disorders included goiter (30%), sub-clinical hypothyroidism (13%), clinical hypothyroidism (4%), and clinical hyperthyroidism (0.5%). The patients were divided into two groups according to HbA1c: Group 1 with HbA1c<8 and group II with HbA1c?8. A significant difference was observed in TSH serum concentration between group I and II (1.5±1.2 vs. 3.7±11.3 mu/l, P<0.05), whereas the concentration of T4 (10±11 vs. 11±8) and T3 (2.4±3.7 vs. 1.9±3.2) were not significantly different between the two groups. The mean concentration of HbA1c in patients with hypothyroidism was significantly higher than those that of non-hypothyroid subjects (11±2.5 vs. 9±2.5, P<0.005). A significant positive correlation was observed between HbA1c concentration and TSH levels (R=0.2, P<0.01). Our results confirm the association between thyroid dysfunction and uncontrolled diabetes mellitus. It has been recommended that the final diagnosis of thyroid function disorder in diabetic patients should be made after optimal metabolic status has been archived.

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Diabetes mellitus is a common metabolic disorder that is associated with long-term complications of various organs, such as cardiovascular system. This study is about evaluation of myocardial function and determination of related cardiovascular factor in type 2 diabetic patients who referred to diabetes clinic of 5th Azar Hospital from 200 patients who referred to the clinic, 48.5% had diastolic and 29.5% had systolic dysfunction. Related factors with both diastolic and systolic dysfunction of diabetic patients are: HbA1c level (Control of diabetes), duration of diabetes and hypertension. This investigation shows that: Incidence and severity of systolic and diastolic dysfunction in type 2 diabetic patients are related to metabolic state and quality of diabetic control. Incidence of hypertension increase in diabetic patients, and hypertension is an important risk factor in diastolic and systolic dysfunction. Diastolic dysfunction is more common than systolic dysfunction in diabetic patients. Intensive control of blood Glucose level lead to decreasing the incidence of coronary artery disease in diabetic patients. We suggest, intensive control of blood Glucose level, treatment of hypertension, regular cardiovascular evaluation in diabetic patients and screening test for early diagnosis of diabetes in high-risk population should be taken under consideration.

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Sialoprotein is one of the most abundant non-collageneous and phosphorylated glycoproteins in human. This protein plays an important role in the structure of human teeth. The aim of this project is to measure the amount of dentin Sialoprotein in the healthy and decay teeth to evaluate the variation in the teeth structure. In this investigation 50 decay teeth has been collected from patients referred to the clinic. The dentin was separated and placed in liquid Nitrogen. One gram of each dentin was washed with distilled water for 30 mins and subsequently the dentin was powdered, and relocated to the gaunidin-Hcl tris buffer, and incubated at 4°C for 48 hrs. The dentin powder was centrifuged at 3000 g for 20 mine. The supernatant was discarded, and the samples again was centrifuged at 10000 g. Finally one ml of this supernatant transferred to the sepharose column and washed with gaunidin-Hcl tris at 1 ml/min. The fractions obtained by chromatography was monitored by electrophoresis. The amount of decay teeth Sialoprotein was 17.23±1.45 ng/l and in the healthy teeth was 26.39±4.27 ng/l. The results from this study indicate that the Sialoprotein content in patient dentin decreased by about 1.5 time compared normal subjects.

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One of the major determinative of the outcome of the ophthalmologic surgeries, is how efficiency the anesthesiologist can lower the intraocular pressure (IOP) and prevent it from rising in response to such maneuvers as laryngoscopy and tracheal intubation. In our study, we have chosen Midazolam and Propofol for comparing their effects on IOP during induction of anesthesia, laryngoscopy and tracheal intubation, with the purpose of identifying the drug which can more effectively decrease IOP and prevent it’s during laryngoscopy and tracheal intubation. 100 patients were selected randomly and received either Midazolam 0.2 mg/kg, Sufentanil 0.2 microgram/kg, Atracurium 0.5 mg/kg (Group 1) or Propofol 2.5 mg/kg, Sufentanil 0.2 microgram/kg, Atracurium 0.5 mg/kg (Group 2). The IOP was measured before and after induction and immediately after intubation. Both groups showed a meaningful decrease in IOP following induction of anesthesia (P?0.0001). Laryngoscopy and intubation, increased IOP in group 1, however not significantly and still lower than the base line IOP (P=0.09). Group 2 showed no such increase (P<0.0001). We concluded that Propofol in comparison to Midazolam is more effective in prevention of IOP rise in response to laryngoscopy and tracheal intubation.

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Meningitis is one of the urgent medical ceases, and in spit of tramendous efforts. There is a high prevalency in various part of the world, still has got a high mortality. Rapid diagnosis is one of the best way to control the disease, and the basis for the present study is to find out the rate of occurrence of meningitis in suspicious cases. During nine-month study (Sep 1999-June 2000), 100 children with suspicious sings of meningitis referring to Taleghani children hospital were taken under medical surveillance, and LP has been carried out by the pediatrician. The samples were transferred to the laboratory and various tests has been done on the samples. On the ground of clinical and paraclinical findings 15 meningitis patients (7 bacterial, and 8 viral were diagnosed). The most abundant isolated bacteria from the CSF was Pneumococci (42.8%) and the most significant clinical finding was fever, vomiting, stiffness of neck. In all bacterial meningitis the CSF’s appearance was deeply turbid, and the average WBC in CSF was about 3200, the rate of PMN was 92%, these results had significant meaning with comparison to the viral and non-meningitis sample (P<0.001). CFS’s protein level was much more higher in bacterial meningitis, than other cases (P<0.001), and this can be used as diagnostic tool, but in spit of reduction in CSF glucose concentration, and CSF/blood glucose ratio (48% in bacterial, 70% viral, and 74% in non-meningitis), these ratios didn’t have significant meaning (P<0.4). The results of this research indicate the clinical manifestation such as fever, convulsion, vomiting turbidity of CSF, WBC count more than 500, and positive CRP, could help effectively in the diagnosis of bacterial meningitis.

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One of the best products, which is the favorite of the families is Spaghetti. In various parts of the world, the demand of usage of spaghetti is increasing exceptionally. The most important element for consumer is to have no microbes. To have high quality of cooking. The primary foodstuffs, which are applied, must have suitable condition in order to have healthy product in terms of microbes. At the present surveys at five factories which are producing spaghetti in some areas in Iran such as Jajrood and Rudehen. There have been 160 sample of water, flour and spaghetti in order to determine microbial pollutions especially clostridium perfringens. The pollution of the water in terms of CL.perfringens includes 8 samples (5%), the pollution of flour includes 3 samples (1.87%) and the pollution of spaghetti includes 10 samples (6.25%), according to the result, we are able to relate the pollution of spaghetti to CL.perfringens on the basis of 85% to water and of the basis of 15% to flour. As the reducing of the total number of microbes from 11.87% to 1.25% in flour and from 9.37% to 0.62% in the mould of flour in spaghetti. The result shows that the optimal condition in the produce doesn’t increase not only by the microorganisms, but also it shows a decrease in the their intensity of its rate.

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The sleep is one of the important phenomen in biological rhythm. Sleep function are usually characterized as being physical and emotional protective and restorative. On the average people spend a third of their life in sleep, and people up to 30% of population suffer from sleep disorders. Sleep disorders are major psychiatric problems. This is a descriptive survey for studying sleep disorders (Insomnia, excessive somnolence, functional disorders) among nurses working at hospitals affiliated with Shahid Beheshti’s Medical Sciences University in this study 751 nurses aged between 20-45 years have participated by data collection using questionnaire and analysis by tests, the results indicated, the most of sleep disorders in insomnia (Initiating sleep 55.8%, maintaining sleep 72.4%, early awakefulness 52.7%, excessive somnolence 65.5% and parasomnia 26.9%). In additional, there has been significant correlation between the demographic factors such as age, sex, marriage, shiftwork, with sleep disorders. These results conclude that the presence of different kind of sleep disorders among the nurses is the indicator of relation between the nurse job with biological disorder of sleep ryteme.

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A variety of extracranial sites have been described for Meningiomas including the nose, various viscera, skin, eye and extraspinal tissue. Among them cutaneous Meningioma generally occur most frequently on the scalp, forehead or paravertebral areas. We are reporting in this article one case of cutaneous Meningioma in the forehead region with respect by reviewing the literatures is very rare tumor. Our patient is a middle age woman with right forehead mass from two years ago, in the skull X-ray and computerized tomography of our case intracranial lesion is not seen and also there is some thickening involving frontal bone. After the surgical excision of the mass and in the microscopic examination of specimens, histopathologic diagnosis is Meningioma (Meningotheliomatous type) and immunohistochemical study react for epithelial membrane antigen. In the clinical course, extracranial Meningiomas enlarge slowly and are usually cured by simple excision alone but incomplete excision may lead to recurrence, the things have been occurred in our patient.

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

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

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

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Compared with older children and adults, neonates are more sensitive to pain and more vulnerable to long-term effects. Despite the clinical importance of neonatal pain, current medical practices continue to expose infants to repetitive, acute, or prolonged pains. This specific intervention are necessary for reduced the neonatal pain experiences. This is an experimental study of determine the effectiveness of skin contact between mother and her healthy full-term newborn to reduce pain experience by the infant during intramuscular injection. The sample population was 30 healthy full-term newborns delivered at university hospital in Gorgan. The samples and controls were chosen randomly. During intramuscular injection case group was being helped by their mothers under cloth that directly were contact with their abdominal and chest skin and newborn in control group swaddled in crib on the bed before, after and during injection. Behavioral responses (Facial changes, crying, …) and physiologic responses (Heart rate and O2 saturation of arterial blood) of newborns were noted before, after and during intramuscular injection. The results show that there was no significant difference in behavioral and physiologic responses caused by pain between two groups, except crying time (38.2 second in control group and 35.5 second in case group). Finding from this study indicate that skin-to-skin contact has a clinically important effect on the pain of intramuscular injection, if we can prepare physically and emotionally a good situation.

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One of the methods for CTS diagnosis is to compare distal motor latencies between median and ulnar nerves. In the previous research distal motor latency (DML) of ulnar nerve was recorded from hypothenar area and the median nerve DML was recorded from thenar. In this research we recorded DML of ulnar nerve from thenar area and compared it with DML of median nerve. The aims of this research is to shorten the process of electro diagnosis by preserving the sensitivity. The type of the research is diagnostic clinical trial on 42 normal person and 64 patients with CTS that referred to department of physical medicine and rehabilitation of Shohada Tajrish Hospital in fall and winter of 2000-01 participated in this research. The result of the research is analyzed by student T-test method. The DML of ulnar nerve recorded from thenar in normal persons was 3.52±0.5 ms and the difference between median and ulnar nerve recorded from thenar was 1.23 ms. The P-value of the study were less than 0.0001 that is significant thus this method can be used for diagnosis of CTS.

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Urinary tract infection is common disease in pregnancy and most symptomatic infection with grate danger for fetus and mother’s. This study has been done to determine the prevalency of asymptomatic bacteriuria in pregnant women in Gorgan in 2000. Mid-stream urine from 900 pregnant women was obtained. Urine analysis and culture for all of them have been done and positive cultured (Isolated bacteria with 100000-colony count) was antibiogramed by Kerby Buer method. Out of 900 urine specimen 3.7% of samples had positive urinary tract infection. The common organism isolated was E.coli (33.3%), Coagulase negative, Staphylococci (30.3%) and Klebsiella (15.2%). There was not a significant correlation between age, pariety, pregnancy age, fresh urinary infection and asymptomatic bacteriuria but there was a significant and correlation kidney stone between bacteriuria. Anti-microbial sensitivity pattern demonstrates more sensitivity of strain with Amikacin and Gentamycin. Although prevalence of bacteriuria in this (3.7%) lower than other studies in this country but for their severe sequele. This phenomen should be taken into more consideration further investigation in other part of the country should be done to face the probable difficulties.