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Pseudoxantoma Elasticum is a hereditary disease with prevalency of 1 among 160000 people in which yellowish papules and plaques are symmetrically distributed in abnormally lax skin of the neck, axilla, groin, and cubital and popliteal spaces, other parts of the body are less frequently involved. Patient that has been presented is 30 years old Turkman woman referred to 5th Azar Hospital with skin problems contains skin folds at neck, yellowish papules at ant, abdomen, cubital area and neck. After skin biopsy, histopathological findings confirmed clinical diagnosis of Pseudoxantoma Elasticum.

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Amniotic band syndrome is a collection of congenital abnormalities caused by early amnion rupture. It occurs in approximately 1:1200 to 1:15000 live births. The infant we are reporting was as result of dizygotic twins pregnancy of 34-years old woman in first delivery than born by cesarean section. In clinical examination there were multiple defects such as: Anencephaly, anophthalmia, cleft lip-palate, nose malformation and limb anomalies. Involved infant died an hour after birth, because of severity of anomalies. This case was reported because of rarity and severity signs of this syndrome and its occurrence in one twin from dizygotic twins.

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Rubella can be a disastrous disease in early gestation, leading to fetal death, premature delivery, and an array of congenital defects. In this study we tried to determine the preset states of immunity against Rubella virus among high-school girl pupils in Gorgan city in the north east of Iran. A total of 484 blood samples collected randomly from 484 school girl pupils for the detection of antibody against Rubella virus. Rubella antibody determined by hemagglutination inhibition (HAI) test. From total of 484 high-school girl pupils 88 (18.2%) were found susceptible to Rubella infection and 396 (81.8%) were immune to this infection. Our results show significant relation between immunity, age and history of previous vaccination against Rubella.

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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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The cancer of breast is the most common malignancy among women and after cancer of the lung is the second cause of death in females. Thus, early diagnosis and treatment can have a effect significant in prognosis and clinical course of disease. One of the numerous controversial tissues to the clinical management of breast cancers is the role of fine-needle aspiration (FNA) to assess the accuracy and determine the role of FNA in breast cancer diagnosis, we performed both FNA and excisional biopsy in 86 unselected patients with palpable breast masses and correlated the cytologic and histopathologic findings. In our study, FNA had no false-negative and no false-positive results, and the sensitivity of diagnosis of malignant tumors was 88.8%, the specificity of diagnosis of benign lesions was 96.2% and the predictive values were 100%, respectively. On the basis of above study, breast FNA may add a measure of confidence in the diagnosis of benign lesions, provides a safeguard for preventing misdiagnosis of malignant lesion, and might expedite and reduce the cost of managing breast cancer. Also, breast FNA like any diagnostic method depends to individual techniques and continual practice.

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Streptococcal pharyngitis and rheumatic fever/rheumatic heart disease are among the major public health problems in children. In this study we assay the frequency of group A Beta hemolytic Streptococcus in nasopharynex of 1588 healthy 6-12 years children in Gorgan in north of Iran. The sample obtained during February to March 1998, using sterile soap. The prevalence of this bacteria were 11% (175 strains) the rate of colonization in girls and boys were 10.8 and 11.2% respectively. Our study shows that the carrier of this bacteria in Town’s school children are more than the villages.

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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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In a randomized study we compared postoperative pain and analgesic requirement in patients who underwent elective cesarean section under general anesthesia induced with Thiopental 4 mg/kg (N=25) or Ketamin 1 mg/kg (N=25). Anesthesia was maintained with N2O and Halothane. Postoperative pain was measured with OPS scale and analgesia was provided with Morphine. Median time to first need of analgesic was greater in Ketamine group compared with Thiopental group. Median Morphine consumption over 24 hour was less in Ketamine group compared with Thiopental group. No patient had recall of intraoperative events in Ketamine group however in Thiopental group 12% of patients had such recalls. Apgar score was similar between groups. Induction of anesthesia for cesarean section using Ketamine is associated with a lower postoperative analgesic requirement compared with Thiopental. Patients who had anesthesia for cesarean section induced with Ketamine required less analgesic drugs in the first 24 hours postoperative period compared with patients who received Thiopental. Ketamin unlike Thiopental has analgesic properties that may reduce sensitization of pain pathways and extend into post-operative period.

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Although trace elements such as Iron is an essential nutrient of organisms, it is a toxic substance at high concentration for their growth and also change their metabolic patterns. In order to find out the influence of Iron on gram negative and gram-positive bacteria cells growth, the present investigation has been undertaken. In the series of experiments, B.cereus and E.coli incubated in NB-medium with and without Iron for 5 hours at 37?C. the result showed that addition 5.6 and 11.2 mg/li Fe+² or Fe+³ in medium (Inhibit) growth of B.cereus, but 11.2 mg/li Fe (II) or Fe (III) Inhibits of E.coli growth (P<0.001). These finding suggested that Iron is one of the necessary elements for microorganisms growth, but on the other hand Iron at high concentration has an toxic effect on their growth. B.cereus is more sensitive to toxic dose than E.coli.

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Problem behaviors of adolescence have severe adverse effects on teen age’s family and the society as well. Adolescence delinquency has been correlated with a variety of individual social demographical and biological variables such as locus of control (LOC) and self-esteem (SE). This study was designed to investigate the relationship between SE and LOC and delinquency in male adolescence. This case-control study was carried out with three questionnaires included demographic characteristic, Cooper Smith’s self-esteem scale, Rotter’s locus of control scale. The sample consisted of 35 delinquent adolescence from juvenile detention center (Case group) and 70 students from state’s high school and colleges (Control group). The age of subjects ranged from 15-20 years. The 2 groups were significantly different with respect to SES and LOCS. Also examining the correlations between SE and LOC showed that significant relationship was found between the 2 different groups of students. But no significant relationship was found between these 2 variables in delinquents the results of this study show there is a correlation between adolescent delinquency and locus of control and self-esteem. Therefore nurses can help the parents and those instructors who are responsible for looking after children and adolescent to adjust self-esteem and locus of control of these teen-agers who have not got any problem behavior. Also the locus of control of adolescence with problem behaviors has to be diverted from external to the internal dimension, and increase the self-esteem, and adolescent’s delinquency has to be replace with honesty. It is suggested that the next investigation to be about the relationship between the self-esteem and locus of control severity and items of the adolescent problematical behaviors. The manner of the parents behaves their children in relation to selfsteem and locus of control. It is also suggested to study the effectiveness of possible ways to up grade the self-esteem and to change the routs of locus of control for the problematic behaviors and delinquency.

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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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Adenomas of the extrahepatic biliary tuce are rare and common bile duct adenomas are rare too. They may be pessile or pedunculated our patient was a 60 years old lady who presented with RUQ pain and jaundice so with impression of cholangitic under weat laparotomy, cholecystectomy, CBD explouation and choledochoduodestomy. During CBD exploration a 0.5×0.5 cm of CBD identified that excised. Histopathology confirmed the diagnosis of CBD adenoma and the patient discharged 6 days later with no complication.

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

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

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

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

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

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