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Most cancer patients complain from pain in final part of their disease. One of the aims of health center, in the country is how to relieve pain from such patients. Therefore we tried to carry on a semi-experimental research to find out the effectiveness of Morphine by either continuous infusion or intermittence injection in such patients. We used non-random sampling, the total number of samples were 11 female and 9 male. These patients were on their final phase of disease. The process that we collected the information was based on the check-list which consist of two sections, in first part the demographic characterization of patients was recorded, using observation and interview with patients and in second part of these check-list the level of pain was assessed using visual analogue scale, which marked every two hours and finally the average of this scale in 24 hours is evaluated using as index in our study. Our results indicate that continuous infusion is more effective in relieving pain than intermittence injection (P<0.03). The results of this investigation showed that, age, sex and different type of cancer has got no meaningful variation in changing the main findings of this semi-experimental research.

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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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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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Background and objective: Nosocomial infections are the important problems in health care centers in the world. Incidence rate in different countries is very variable and has been reported about 5% to 15%. This research was done for ascertainment of level of knowledge, attitude and practice of employed nurses to nosocomial infection in teaching hospitals of Golestan University of Medical Sciences. Materials and methods: This is a descriptive and analytical study, total number of employed nurses (518), 189 male and 328 female. The research carried out using a questionnaire. The data was used to analyze the data SPSS software. Results: Results of research showed that 26.5% of nurses had very low knowledge, 63.9% medium knowledge and 9.6% good knowledge. About attitude 52.4% had negative attitude, 36.4% medium and 11.2% positive attitude. About practice 37.1% had poor practice, 49% medium and 15.9% good practice. In this research between attitude and knowledge, knowledge and practice there was not any meaningful correlation but difference between attitude and practice was statistically significant. Conclusions: The nurses are playing important role in prevention and control of nosocomial infection. So, it is necessary for nurses to have enough knowledge about how to control the infection and to have positive attitude, if they want to do their job property.

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Background & Objective: In all of world, a portion of household income expends on health care cost. Amount and distribution of the proportion indicate financial burden of health care in the societies. WHO believes that one of the main determinants in health system efficiency is fairness of financial contribution. This study aimed distribution pattern of urban households’ income, health expenditure by cost types and measuring of equality on health care costs in the Gorgan district. Materials & Methods: In order to establish the population laboratory, this cross-sectional study assessed 1014 household in the Gorgan health posts (No 4 and 8) on January 2003. health insurance status, monthly household income and monthly health care cost gathered through interviewing with the husbandmans. Results: Health insurance coverage was 67% in highest and 44% in lowest income deciles (P<0.05). Median and mean of assessed households’ income and household health care cost were 1200000 Rls, (1669669±187300 Rls) and 80000 Rls, (281530±95124 Rls) respectively. Mean of median of out of pocket proportion health care cost per households’ income was 0.57±0.03 and 0.66 respectively. 13% of total income expended health care cost through out of pocket. This proportion in highest and lowest income decile was 7% and 28% (P<0.05). Gini coefficient of health care cost and out of pocket cost per total household income were 0.22 and 0.18 respectively. Conclusion: Low income households expended almost 40% of their income in order to purchasing of health care, in comparison to richest households, they spent 9% of total income. Instead of, additive development of health insurance systems and complementary insurance mechanisms, a half of health care cost in the population spend by out of pocket. According to WHO standards of health system performance, revising health insurance system and payment mechanisms are mandatory.

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Background & Objective: About 1.3 billions people are infected with Tuberculosis (TB) all over the world. There is a close relationship between the quality of TB treatment and the rate of drug resistance. The recurrence epidemy of TB and increased resistance to some drugs was the basis for the WHO to suggest the directly observed short course treatment strategy or (DOTS) strategy, for the TB patients. Materials & Methods: This research was a cohort study and aimed to evaluate the epidemiological finding, the clinical basis and strategy of DOTS on improving, and prevention from failure of treatment and was compared with non-DOTS procedure. Sample population were total of 260 smear positive patients that had been under study for a period of 2 years (1999-2000). All of the patients were new cases. SPSS software and Fisher exact test was used to analyzed the data. Results: The rate of treatment failure in DOTS strategy in the beginning of 5th month was 1.7%, but in the control group the failure in the same period was 7.3% (P<0.05). Conclusion: This study indicated that the DOTS strategy is substantially increasing the success rate of TB treatment.

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Background & Objective: Black pepper is frequently used in Iranian traditional medicine as an analgesic (E.g, for toothache). This investigation was conducted to evaluate the response of mice to pain induced by hot-plate and Formalin test either with or without Piperine (One of the active substances of the pepper). Materials & Methods: This randomized experimental study was performed on mice. Hot-plate and Formalin tests were planned to pain measurement. The mice were divided into 2 groups in each arm of study (Hot-plate and Formalin test group). The data of control (Saline) and drug (Piperine) groups were separately compared in each arm of study with student t-test and ANOVA. The difference between each point of data was considered significant at P-value under 0.05. Results: There was not a significant difference in tolerance time of subjects between hot-plate and saline groups. Piperine (25, 50 and 75 mg/kg) along with Morphine (10 mg/kg) causes significant increase to saline group in tolerance time and also significant increase to Morphine group, but in Formalin test Piperine could have significant effect in decreasing the pain induced by of Formalin on mice. These effects are comparable with Morphine. In Formalin test, pain has 2 phases. The first phase is acute and the 2nd one is chronic that begins from 15-20 minutes. Acute pain has central effect and chronic pain has peripheral pathway and Piperine causes decreasing response to Formalin test at the first phase of pain. Naloxone can prevent these effects in all groups. In Formalin test and hot-plate, the effect of Piperine were dose dependent. Conclusion: Piperine can centrally act on the nociception pathway and its effect on Opioid system exhibits as an enhancement Opioid effect. The effects are dose dependent and will be inhibited by Opioid antagonist.

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Background&Objective: Bisphenol A (BPA) is a xenobiotic estrogenic compound that are a monomer of some plastics (poly carbonate and epoxy resin) that are widely used in dental sealant, dishes and tableware. This compound has suspected to have estrogenic effects on reproductive system and related to endocrine disrupting chemicals. In this present study we investigated possible low dose effects of BPA on testis weight and structure and prostate weight. Materials&Methods: Male wistar rats (12-13 week old) were administrated a daily intra peritoneal 10µg/kgbw/day, 50µg/kgbw/day, 100µg/kgbw/day dose of BPA for6 and 12 days and one day after last injection testis and prostate weighted and histological section of testes prepared( 5 micrometer ) and stained by H&E and weigert hematoxilin . All data were expressed as means±SE. two-way ANOVA and chi- quire was performed. Results: in compare with control group, testis and prostate weight of dose groups were decreased. Disruptions of epithelial layer cells of semniferous tubules were detected. Conclusion: The present study showed that BPA at low doses affects histological structure and weight of testis and prostate, in the adult wistar rat.

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Background&Objective: Surgery is an important stressor which makes some harmful physiological reactions shuch as high blood pressure, tachycardia, and repiratory distress. The aim of this study was to investigate the effects of music on the anxiety and some of physiological responses of patients before abdominal surgery, as assessed by objective parameters and a subjective validated questionnaire. Materials&Methods: This study is a semi-experimental study. Total of 134 subjects was randomly assigned to undergo either 20 minutes of music intervention or a rest period. The level of anxiety was measured using Spilberger questionnaire and physiological responses, arterial blood presure, heart rate and respiratory rate. Subjects in intervention group listened to 20 minutes music by Johann Sebastian Bach. The control group listened to no music. The anxiety level and physiological responses were measured before and after intervention. Results: There was no significant difference between the anxiety level and physiological responses in two groups of subjects before intervention. The findings indicate a significant statistical difference in the level of anxiety and mean of arterial blood pressure in the intervention group (P<0.05). There was no significant difference in heart and respiratory rate in two groups of subjects. Conclusion: As indicated by the results of this study, music can provide an effective method of reducing potentailly harmful physiological responses arising from abdominal surgery, therefore it is suggested to use it before surgery.

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Background&Objective: Genital mycoplasmas can cause infection of the genitourinary tract. Thses organisms are associated with bacterial vaginosis, pelvic inflammatory disease, endometritis, cervicitis, Nongonococcal urethritis. Spontaneous abortion, premature birth, neonatal pneumonia and meningitis, and infertility. The aim of this study was to determine the ability of PCR method for diagnosis and identification of genital mycoplasma in culture negative samples taken from women suffering from bacterial vaginosis. Materials&Methods: 174 genital samples were taken from women suffering from bacterial vaginosis during January until December 2005. Two genital swabs were taken from each patient. One of them was cultured on the mycoplasma specific media for isolation of mycoplasma. The other swab was immersed in PBS buffer and frozen until DNA extraction. To detect the presence of mycoplasma and ureaplasma in genital DNA Samples: a 520-bp fragment of the 16S rRNA was amplified. The specific primers used for this purpose were: MGSO, UGSO, MY- ins. Results: From 174 samples, 71 samples (40.8%) were positive by culture for mycoplasma & ureaplasma. From 103 culture negative samples. According to PCR results, 14 samples (13.6%) were positive and 89 Samples (86.4%) were negative for mycoplasma and ureaplasma. Conclusion: This study showed that PCR method is more sensitive than culture for detection genital mycoplasma, Therefore PCR is a rapid, sensitive and easy method to detect genital mycoplasmas in urogenital swabs.

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Background & Objective: WHO estimated almost 27% of under 5 years children suffered from under-weight. This study aimed are assessing anthropometric indicators (underweight, wasting and stunting) in 0-24 months children at Golestan province and the relationship with the background variables of households. Materials & Methods: This cross-sectional study was done on 1473 children (under 2 years old) whom resided in urban and rural area. Samplimg method was single stage cluster sampling. Constitutional variables in child’s mothers, age, educational level, job and child’s weight and height are measured by structured questionnair. The data were analysed with chi square, chi square for trend and logistic regression. Results: The under-weight, wasting and stunting (mild to severe) prevalence were 21.4% (CI 95%: 19.3-23.6), 16.5% (CI 95%: 14.7-18.5) and 31.4% (CI 95%: 29.1-33.8) respectively. Maximum sex difference in the malnutrition indicators were seen stunting (boys 14.3%, girls 7.2%) (p<0.05). The prevalence of under-weight, wasting and stunting are positively correlated with increasing the children’s age. The under-weight and stunting linear trend was significant (p<0.05). The risk of under-weight children were 2.8 fold in illitraced mothers relative to mothers with high school diploma (CI 95% for adjusted odds ratio: 1.1-7). The risk was 1.5 fold in stunting (CI 95% for adjusted odds ratio: 0.5-4.3). Conclusion: The under-weight and wasting (moderate to severe) prevalence are increased relatively ANIS study (1998), but stunting prevalence are not increased. The mothers’ illitracy and very low educational level can be suspected risk factors for under-weight and stunting.

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Background & Objective: Despite advances in medical sciences, preeclampsia and eclampsia are still among chief causes of maternal mortality worldwide. In this study, we used classification and regression trees to investigate the role of certain inherent and maternity care factors in severe preeclampsia. Materials & Methods: This study was done on 1643 pregnant women admitted at 4 hospitals in Iran with one of the 53 maternity complaints were enrolled in this study during 2005. Variables of socioeconomic status, history of pregnancy and diseases, health care visits numbers awareness of warning signs, and the body mass index before pregnancy were recorded in the analysis model as predictors, and preeclampsia severity was entered as the dependent variable. A non-parametric method, known as the classification and regression tree was used to predict the studied consequence. Model validation was done using subsets of the study sample. The results were compared with logistic regression analysis. Results: The incidence of preeclampsia among the studied patients was 5.2%. In model 1, variables of frequent headaches and epigastric pain during pregnancy, the number of previous pregnancies, and the amount of maternal care received were predictive of severe preeclampsia. In model 2, only frequent headaches and the number of previous pregnancies were found predictive. Sensitivity for model 1 and 2 was 47.8% and 39.1%, respectively, and specificity was 96.8% and 93.6%, respectively. In logistic regression analysis, only frequent headache was related to severe preeclampsia (OR=2.5, CI 95%: 1.3-5.0). Conclusion: This study showed that using of variables that can be measured during maternity care visits to predict severe preeclampsia. Regarding the simple interpretation of tree models and their application in clinical decision making, which can be used in different levels of the health care system.

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Background & Objective: Dyslipidemia and smoking are among the most important medical problems in human society. Their share in the mortality of coronary heart disease (CHD) has led to multiple investigations about them. This study was done to determine the prevalence of dyslipidemia and the effect of cigarette usage on it. Materials & Methods: This epidemiological cross-sectional study was carried out on 9632 persons selected randomly in Tehran urban with a minimum age of 20 years and over. We measured fasting blood sugar, blood sugar 2 hours after 75 grams oral glucose, triglyceride, total cholesterol, LDL cholesterol, HDL cholesterol. Degree of physical activity was registered according to Lipid Research Clinics classification. Anthropometrics data, social condition, family history and smoking exactly delineated. Our patients were divided into: those having normal lipid profile and primary dyslipidemia (without any risk factor for dyslipidemia) and secondary dyslipidemia (having one or more risk factors such as diabetes mellitus). ANOVA, t.test, and logistic were used to analyze the level of significance. Results: Our population sample consisted of 5619 female and 4013 male. 68.5% of our cases had dyslipidemia. 65.8% of females and 72.3% of males had at least one type of dyslipidemia. There were 1085 smokers (11.4%) that 73.2% of them were dyslipidemic. With comparing smokers to nonsmokers shows that in smokers HDL.cholesterol, LDL.cholesterol and total cholesterol had decreased and triglyceride increased (p<0.05). Conclusion: Tehran population suffers from dyslipidemia. Large number of secondary dyslipidemia and smoking highlighted the importance of education to overcome to these preventable and modifiable factors.

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Background&Objective: 15-20% of TB cases are extra pulmonary tuberculosis (EPTB). Abdominal TB is the most common type of extra intestinal TB. Signs and symptoms of abdominal TB are unspecific. In this study, we identified all GITB cases in Golestan province (Iran) between 1999 and 2003 and determined their demographic characteristics. Materials&Methods: We reviewed all new cases of TB reported during 1999-2003 from TB centers of Golestan province .Then EPTB and especially GI and abdominal TB cases were selected. We completed a questionnaire containing demographic information for each of them. The information entered the computer in SPSS-13 was used to analyze the data. Results: 30 patients had been treated for GI and abdominal TB, most of them were females (22 cases, 73.3%). Mean age of the patients was 32.03±13.73 with higher incidence in age before 40 years old (70%). Most common complaints of the patients were fatigue, weight loss, anorexia, fever and abdominal pain, respectively. In 66.7% of patients the diagnosis was pathologically documented. Conclusion: Our data suggest that 38.46% of all TB cases in Golestan province were EPTB, and this scale is higher than other studies. In this study, 5.27% of EPTB cases were GI and abdominal TB, higher than the world reports (3%).

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Background&Objective: Silis (SiO2) is an oxide of silicon that its existence in food products is known as a contamination, classified as a human carcinogen. Some suggest it as an etiology of esophageal cancer. Golestan province has a high incidence and prevalence of esophageal cancer and is on the world belt of this disease. This study was designed to determine the concentration of silis in flour produced in Golestan province, north of Iran Materials&Methods: This descriptive study was done in spring 2005. Census method was used to gather flour samples from flour manufactures. Samples were transported to laboratory. Base-melting method in nickel cruise was used in 550°c and the extract was reduced with acid. The complex was evaluated with spectrophotometer. Data entered into SPSS-12, and the differences between silis concentration in various regions were compared with non-parametric Kruskul Walis test. Results: Median silis concentration was 0.0030 grams, mean concentration was 0.008760 with 0.004265 standard deviation, minimum was 0.003 and maximum was .018 grams in each 100 grams flour produced in province's factories. Mean silis concentrations were 0.012, 0.01 and 0.003 in Gorgan and the central part of the province, western and eastern part, respectively. The differences were not significant. Conclusion: Although in earlier reports it was shown that silis level in the flour is high, but the findings of this study indicated that the above element is in normal range.

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Background&Objective: High blood pressure (BP) is one of the most important health problem world-wide (2005), and risk factor of cardiovascular diseases. This study was determine the prevalence of high blood pressure (BP) among urban subjects in Golestan of province, during 2005. Materials&Methods: This cross sectional study was done on 5000 subjects of 17-70 years old in different towns of Golestan province during 2005. Two equal ratios of both sexes were selected on random clustering sampling in the morning and afternoon. A questionnaire consisting of demographic data and clinical information such as electronic presser gauge filled by trained persons. All of the data analyzed using spss-11.5 and descriptive statistics. Results: The result showed that 2500 male (50%) and 2500 (50%) female, ethenicity were (4.6%) Torkaman, (18.9%), and Sistani (76.4%) Fars group from age of 17 to 70 years old. This study on this basis criterion JNC-5 (46.4%) all of studied subjects had blood pressure normal, (22.6%) blood pressure high normal (21.4%), blood pressure light (7.4%), blood pressure medium and (2.2%) blood pressure severe. Conclusion: The prevalence high blood pressure among the urban population in this province in this province was 31%. Which is slightly higher than other regions in Iran and other part of the world. This issue can be considered in the health planing and theraputic programs in the region.

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Background&Objective: Teacher’s mental health, due to its effect on the formation of attitude and mental health of students, play more important role than any other social-class. This research focuses on the extend of teacher’s mental health with various levels of education as its main objective. Materials&Methods: This is a descriptive cross-sectional research. Statistical population is comprised of all teachers in Golestan province who involved teaching at schools in the educational year of 1383-84. a sample of 535 teachers was obtained through multi-phase random cluster sampling. Symptom checklist questionnaire with a cut-point of 2.5 on each dimension and 1.3 cut-point for global symptom index (GSI) were considered in determining teacher’s mental disorder. Results: Finding showed %81.1 of teachers are of sound mental health and %18.9 of them (%21.8 in female and %14.9 in mal) seem to suffer at least from one of the symptoms of mental disorder. The sequence of disorder symptom prevalence was as follow: somatization %7.3, paranoid ideation %5.8 and depression % 4.9. the highest mental disorder was seen among elementary school teachers(%21.6) and the lowest among senior high school teachers(%14.9). a significant correlation coefficient between teacher’s level of education and overtime work with global symptom index(GSI) was seen(P<0.05). Conclusion: Result of study showed that the prevalence of mental disorders among Golstan teachers are medium and this finding are indicative of lower mental disorder among the teachers in Golestan province in comparison to the finding of similar researches done in other provinces.

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Background & Objective: Bombesin (BBS) is a tetra-decapeptide amino acid neuropeptide in central nervous system within a variety of mammalian species. Also it has many biological effects that may be effective in modulation of anxiety. The aim of present study was to determine the effect of BBS on modulation anxiety reaction in elevated plus maze (EPM) in mice.

 

Materials & Methods: 60 male mice (25-30 g) were used in this study. Bombesin in doses of 1.25, 2.5, 5, 10 and 20 µg/kg IP or saline was injected in different groups 10 min before of evaluation. Five minutes later for increase of activity, animal was put in black box for 5 min. Then each animal in regulated time transferred to standard elevated plus-maze and the time spent in the open arms and the ratio of open arm entries during 5 min, were measured. The data analyzed by using ANOVA and Tukey test.

 

Results: BBS in dose dependently manner increase which the anxiety reaction in mice. Animals had spent lower time and ratio of open arm entries in compare with control group significantly (P<0.05) and BBS only in dose of 1.25 µg/kg did not showed significantly effect.

 

Conclusion: This study indicated that Bombesin in dose dependently manner have important role in modulate anxiety reaction in EPM in mice.

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Background & Objective: Addiction to opiates such as morphine is one of major public health problems. It has been shown that in addicted animals, administration of antioxidant agents such as vitamin C can reduce the withdrawal symptoms (WDS). The aim of this study was to evaluate the preventional effect of grapefruit juice (Citrus Paradisi Macf.) on withdrawal symptoms in rats. Materials & Methods: In this experimental study, Sixteen male Wistar rats (250-300g) randomly divided into two groups (n=8). All animals were addicted by intraperitoneal (i.p) injection of morphine (the 1-3 days: 10 mg/kg, the 4-6 days: 20 mg/kg and the 7-9 days 40 mg/kg daily) for 9 days. The first group received 2 ml Citrus Paradisi Macf. orally 1 hour before morphine administration. The sham group received 2 ml of normal saline. Naloxone (10mg/kg, s.c) was administrated 45 minutes after of an additional dose of morphine (40 mg/kg) in the tenth day for withdrawal symptoms inducing. Then withdrawal symptoms such as frequency of wet-dog shaking, teeth chattering, defecation and penis licking were evaluated for 30 minutes. Results: All withdrawal symptoms including frequency of wet-dog shaking, teeth chattering, defecation and penis licking were reduced in the Citrus Paradisi Macf. group in comparison with the sham group significantly (p<0.05). Conclusion: Our results showed that presumably antioxidant activity of Citrus Paradisi Macf. can reduce withdrawal symptoms. Although the exact mechanisms of its effect in brain need to be elucidate.

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Background and Objective: Genital herpes is increasing in Asia and the world. Based on other studies, knowledge has an important role in reducing high risk sexual behavior. In this study we evaluated knowledge among Shahid Beheshti University students as a sample of young and educated population of Iran. Materials and Methods: This cross-sectional study carried out on 409 of Shahid Beheshti University students in Tehran - Iran at Autumn 2004. Research material was questionnaire and data analyzed by SPSS-13, T-student, Chi-square, Mann-Whitney, Kruskal-Wallis Tests. Results: Mean±SD of level of knowledge, nature and transmission of genital herpes was 26.5±26%, 23.7±24.2% and 30.56±36.8%, respectively. The level of knowledge about signs, treatment and prevention of disease was 18.8%, 16.4% and 46.2%, respectively. There was a significant relation between age, marital status and education with knowledge (P<0.05). The level of knowledge among engineering students was higher than humman sciences students (P<0.05). Conclusion: Based on our study, most of participants had no enough knowledge about genital herpes. Most of participants were willing to know more about it as they obviously welcomed to our pamphlets. It seems that educations about genital herpes should be added to educational programs.