@article{ author = {Haghpanah, Parya and Moghadamnia, Aliakbar and Zarghami, Amin and Motallebnejad, Mi}, title = {Muco-bioadhesive containing Ginger officinale extract in the management of recurrent aphthous stomatitis a double blind clinical study}, abstract ={Background and objectives: Recurrent aphthous stomatitis (RAS) is the most common oral mucosal lesions in the general population. Various treatment modalities have been used but no specific therapy proved to be definitive. Ginger Officinale (ginger) indicated to have anti-inflammatory properties in herbal medicine. Thus, this study aimed to evaluate the efficacy of Gingerginger containing bioadhesive in treatment of aphthous ulcers. Material and Methods: This was a double-blinded placebo randomized controlled trial. Fifteen patients enrolled in this study. The clinical efficacy of the mucoadhessive on pain, inflammatory zone and ulcer's diameter in the test period was compared with that of the base treatment and no treatment periodss during 10 days of study. Results: Significant reduction in pain as observed on day 5 between placebo (using base bioadhesives) and no-treatment periods at the first phase of the study (4.53 vs. 3.27 p=0.038.( Reduction in inflamed halo diameters was significant on day 1 between no-treatment and ginger containing bioadhesives )46.73 vs 28.67 p=0.044). Other variables such as ulcer's diameter did not indicate any significant differences in both periods. Conclusion: This study indicated that ginger bioadhesive is capable to relieving pain of RAS. However, its efficacy on ulcer diameter, inflamed halo and healing time was not significantly different compared to the results of the placeb received period.}, Keywords = {Recurrent Aphthous Stomatitis, Ginger Officinale, Muco-bioadhesive, Herbal remedies}, volume = {6}, Number = {1}, pages = {3-8}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-269-en.html}, eprint = {http://caspjim.com/article-1-269-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Mostafalou, Narges and Yahyapour, Yousef and Sedaghat, Sadegh and ShokriShirvani, Javad and Haji-Ahmadi, Mahmoud and Seyadati, Sepideh and Shefaee, Shahreyar}, title = {Human papilloma virus infection in non-cancerous versus normal esophageal tissue samples by endoscopy}, abstract ={Abstract Background: Cancers are the second most common cause of non-accidental deaths in Iran, after cardiovascular mortality. Although most cases of esophageal squamous cell carcinoma (ESCC) in the USA and western populations have been attributed to high levels of exposure to tobacco and alcohol, but in Iranian populations the other risk factors especially infectious agents have been postulated as possible causes, particularly human papillomavirus (HPV). This study aimed to determine the prevalence and the types of HPV infection in biopsy samples taken from non-cancerous esophageal lesions during upper endoscopy. Methods: A total of 80 non-cancerous esophageal samples were collected in parafinnated blocks of tissue archives in pathology. After DNA extraction, qualitative PCR (qPCR) was performed using the HPV L1 primer pairs MY09/MY11 and then genotyping was performed in HPV DNA positive by Real time PCR. Results: From 80 cases, 29 (36.3%) were qPCR positive. Using the Real-time PCR method, a total of 14 HPV genotypes were assessed. We detected HPV-11 as a dominant type in this study and we did not find any type of HPV-16 and 18. Conclusion: In this study, HPV-II was the most common type in esophageal samples, in contrast we have found no oncogenic HPV like HPV 16 and 18 which are the most known responsible factors of ESCC in other countries}, Keywords = {HPV (Human Papilloma virus), esophagitis, normal tissue, non-cancer, Real-Time PCR. }, volume = {6}, Number = {1}, pages = {9-14}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-316-en.html}, eprint = {http://caspjim.com/article-1-316-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Banihashem, Nadia and Alijanpour, Ebrahim and Basirat, Majid and Shokri, Javad and Kashifard, Mehrdad and Taheri, Seyed Hasan and Savadkohi, Shahryar and Hosseini, Vahid and solimanian, seyed sedigheh}, title = {Sedation with etomidate-fentanyl versus propofol-fentanyl in colonoscopies: A prospective randomized study}, abstract ={Abstract Background: The combination of propofol-fentanyl for sedation during colonoscopy is characterized by the frequent incidence of side effects. Etomidate-fentanyl provides fewer hemodynamic and respiratory complications. The aim of our study was to compare the safety and efficacy of propofol-fentanyl and etomidate-fentanyl for conscious sedation in elective colonoscopy. Methods: This double-blind clinical trial was conducted on 90 patients aged between 18 and 55 years old who were candidates for elective colonoscopy. Patients were randomized to receive sedation with fentanyl plus propofol or etomidate. Two minutes after injecting 1 micro/kg of fentanyl, the patients received propofol (0.5 mg/kg followed 25 micro/kg/min) or etomidate (0.1 mg/kg followed 15 micro/kg/min). Pulse rate, mean arterial blood pressure, respiratory rate, and saturation of peripheral oxygen (SPO2) were monitored. Indeed, the patient and colonoscopist satisfaction, the recovery time, sedation and pain score in both groups were assessed. Results: Sedation score in propofol group was higher. Pain score as well as the physician and patient satisfaction showed no significant difference in two study groups. Hemodynamic changes and arterial saturation were the same in both groups. The duration of recovery was 1.27±0.82 minutes in the etomidate group whereas, it was 2.57±2.46 minutes in the propofol group (P=0.001). Hospital discharge in the propofol group was 5.53±4.67 minutes and in the etomidate group was 2.68±3.14 minutes (p=0.001). Conclusion: The combination of fentanyl and etomidate provides an acceptable alternative to sedation with fentanyl and propofol with the advantage of significantly faster recovery time, which are of relevance in the outpatient setting.}, Keywords = {propofol, etomidate, colonoscopy, sedation}, volume = {6}, Number = {1}, pages = {15-19}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-53-en.html}, eprint = {http://caspjim.com/article-1-53-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Maleki, Iradj and Taghvaei, Tarang and Barzin, Maryam and Amin, Kamyar and Khalilian, Alirez}, title = {Validation of the Persian version of the inflammatory bowel disease questionnaire (IBDQ) in ulcerative colitis patients}, abstract ={Abstract Background: Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine that may have critical consequences on patient’s quality of life (QOL). Many disease-specific QOL tools have been developed recently. The McMaster Inflammatory Bowel Disease Questionnaire (IBDQ) is one of them. The aim of this study was to translate into Persian and evaluate the validity and reliability of this version of the McMaster IBDQ. Methods: 68 subjects with ulcerative colitis were recruited in this study. The original IBDQ was translated into Persian using back- translation method. The reliability of the subscales and the summary score of the Persian IBDQ was demonstrated by intraclass correlation coefficients, their validity was evaluated by their correlations with SF-36, visual analogue scale and colitis activity index. Results: All dimensions of IBDQ met the standards of construct validity and were correlated well with SF-36, visual analog scale and colitis activity index. IBDQ was able to discriminate between different groups of patients. The intraclass correlation coefficient was very high and its value was close to one (P<0.05). All dimensional scores differed significantly between the baseline and the follow-up measurement. Conclusion: The findings of this study conclude that the Persian translation of IBDQ has satisfactory psychometric and cultural properties when applied to a sample of Iranian population with inflammatory bowel disease. This questionnaire is recommended for use in clinical trials and in the assessment of efficacy of interventions and therapy.}, Keywords = {Inflammatory Bowel Disease, Quality of life, Ulcerative Colitis, Persian, Linguistic validation }, volume = {6}, Number = {1}, pages = {20-24}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-51-en.html}, eprint = {http://caspjim.com/article-1-51-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Alizadeh, Maryam and Mahjoub, Soleiman and Esmaelzadeh, Seddigheh and Hajian, karimollah and Basirat, Zahra and Ghasemy, Maryam}, title = {Evaluation of oxidative stress in endometriosis:A case-control study}, abstract ={Abstract Background: Recent studies have suggested that oxidative stress (OS) may have a contribution in the pathogenesis of endometriosis. However, the results of previous studies regarding OS in endometriosis are controversial. The objective of this study was to compare the serum levels of OS markers in endometriosis versus the control group. Methods: This case-control study was carried out on 30 women with endometriosis aged 20-38 from March 2011 to November 2013. These patients were admitted in Fatemeh Zahra Infertility and Reproductive Health Research Center, Babol, Iran. The serum samples of 40 women with same age were collected as the control group. The serum levels of malondialdehyde (MDA), carbonyl and iron were measured by photometric methods and compared between the patient and control groups using t-test. Also, we used ROC curve analysis to determine the discrimination ability of these markers. Results: Serum iron in endometriosis patients was significantly higher than control (p<0.0001). Area under ROC curve (AUC) for iron, MDA and carbonyl were 0.899, 0.648 and 0.530, respectively. Serum iron at cutoff value of 173.3 µg/dl exhibited high discrimination ability to recognize endometriosis from control. Conclusion: These findings indicate that the high level of serum iron may promote OS in patients with endometriosis. Also based on the ROC curve results, iron showed high discrimination ability to distinguish the patients with endometriosis from healthy subjects}, Keywords = {Endometrioma, Oxidative stress, Iron, Malondialdehyde, Carbonyl}, volume = {6}, Number = {1}, pages = {25-29}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-24-en.html}, eprint = {http://caspjim.com/article-1-24-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Darzi, Aliasghar and Kamali, Sakineh and Khakzad, Mohamm}, title = {Influence of splenectomy on immunoglobulins and complement components in major thalassemia}, abstract ={Abstract Introduction: Thalassemia is the most common hereditary anemia in Iran. The aim of this study was to evaluate the humoral immune system and assess the effect of splenectomy on the serum level of immunoglobulins IgG, IgM, and IgA and complement components in patients with major thalassemia. Materials and Methods: This interventional semi-experimental study (before-after) was performed on 40 patients with major thalassemia that referred to the treatment centers of Babol for splenectomy from March 2011 to March 2013. Results: The mean age of patients under study was 25.38±6.89 years. The results of this study showed that the rate of IgA and IgM had a significant decrease after splenectomy. While the increase of serum level in IgG in this study was not significant. The serum levels of C3 and CH50 were evaluated in all patients that its reduction was statistically significant, but the decrease of serum levels in C4 was not significant. Conclusion: The spleen plays role in releasing immunoglobulins and starter proteins of complement activation pathways and splenectomy causes reduction in serum levels of immunoglobulins and complement components.}, Keywords = {Major thalassemia, Splenectomy, Immunoglobulin, Complement}, volume = {6}, Number = {1}, pages = {30-33}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-247-en.html}, eprint = {http://caspjim.com/article-1-247-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Alikhani, Ahmad and Babamahmoodi, Farhang and ForoutanAlizadegan, Laleh and Shojaeefar, Arman and Babamahmoodi, Abdolrez}, title = {Minimal inhibitory concentration of microorganisms causing surgical site infection in referral hospitals in North of Iran, 2011-2012}, abstract ={Abstract Background: A surgical site infection (SSI) is the most common nosocomial infection after surgery and is the third most common infection in hospitalized patients. The aim of this study was to asses minimum inhibitory concentration (MIC) of the causing agents of SSI and antimicrobial susceptibility patterns. Methods: This cross-sectional study was done in three referral hospitals in North of Iran during 2011-2012. The samples were taken one month after orthopedic, abdominal, cesarean section surgery and coronary artery bypass graft (CABG) in patients with scores compatible to SSIs criteria. The sample was sent for bacteriologic culture and MIC determination for positive cases by broth microdilution method. The data were collected and analyzed. Results: From 103 positive cases S. aureus, E.coli and coagulase negative staphylococci were the most common isolated agents as 29.12%, 23.3% and 21.3%, respectively. S. aureus was sensitive to vancomycin (70%), amikacin (70%) and teicoplanin (76.6%) and cogulase negative staphylococci was sensitive to vancomycin (68.1%) and teicoplanin (72.6%) and E.coli to amikacin (95.83%) and imipenem and meropenem (66.66%). P.aeroginosa showed no sensitivity to cefepime and was sensitive to imipenem (93.75%) and meropenem (81.25%). Conclusion: The most important point is worrisome problem of the increased MIC of S. aureus to vancomycin that causes difficult use in the treatment of staphylococcal SSIs. In spite of resistance of micro-organisms to cephalosporins, gram negative organisms had low MIC to carbapenemes especially P.aeroginosa although the rate of its MIC is increasing.}, Keywords = {Minimal Inhibitory Concentration, Surgical site infection, Resistance, Antibiotics}, volume = {6}, Number = {1}, pages = {34-39}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-446-en.html}, eprint = {http://caspjim.com/article-1-446-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Shahandeh, Zahra and Shafi, Hamid and Sadighian, Farahnaz}, title = {Association of staphylococcus cohnii subspecies urealyticum infection with recurrence of renal staghorn stone}, abstract ={Abstract Background: Stphylococcus cohnii is an organism of coagulase negative species which is considered as normal flora. However, it has been isolated from urinary tract infections and surgical prostheses but its relation with staghorn stones has not been reported, yet. Case Presentation: A 50-years-old woman presented with left renal staghorn stone in June 2014. She had bilateral staghorn stones 7 years ago. Staphylococcus cohnii subspecies urealyticum were detected from a removed stone. After 7 years, recurrence staghorn stone in her left kidney was diagnosed and patient underwent another surgery. The patient had several attacks of cystitis during these 7 years. The results of stone and urine cultures revealed staphylococcus cohnii subspecies urealyticum. Conclusion: This case report emphasizes a possible association between staphylococcus cohnii subspecies urealyticum infection and recurrence renal staghhorn stone.}, Keywords = {staphylococcus cohnii subspecies urealyticum , renal staghhorn stone, }, volume = {6}, Number = {1}, pages = {40-42}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-354-en.html}, eprint = {http://caspjim.com/article-1-354-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Rijal, Jharendra and Giri, Smith and Khanal, Sumesh and Dahal, Khagendr}, title = {A case of Brugada Syndrome unmasked by a postoperative febrile state}, abstract ={Abstract Background: Brugada Syndrome (BS) is an inherited ion channelopathy characterized by an electrocardiographic (ECG) pattern of a coved type ST segment elevation in right precordial leads with or without right bundle branch block. Case Presentation: A 23-year old male presented with right lower quadrant abdominal pain. Further evaluation revealed a diagnosis of acute appendicitis. The patient developed a febrile episode on second post-operative day of laparoscopic appendectomy. ECG revealed features consistent with BS. Prompt control of temperature in the patient resolved the ST-segment elevation and prevented potentially life-threatening arrhythmias. Conclusion: Febrile episodes in susceptible patients may unmask a concealed BS. Prompt control of temperature is advocated to reduce the risk of life-threatening arrythmias}, Keywords = {Arrythmias, Brugada Syndrome, fever, Electrocardiogram, appendectomy.}, volume = {6}, Number = {1}, pages = {43-45}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-251-en.html}, eprint = {http://caspjim.com/article-1-251-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {HasanjaniRoushan, Mohammad Reza and Ebrahimpour, Soheil}, title = {Human brucellosis: An overview}, abstract ={}, Keywords = {}, volume = {6}, Number = {1}, pages = {46-47}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-447-en.html}, eprint = {http://caspjim.com/article-1-447-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Heidari, Behz}, title = {Helicobacter pylori infection and osteoporosis in elderly patients}, abstract ={changes (BMD) and osteoporosis .Helico bacter pylori which is a known cause of gastritis and peptic ulcer Osteopprosis is one major cause of bone fracture and subsequent morbidity and mortality in the elderly population. Several clinical and demographic parameters including aging, menopause, parity , inflammatory disease, hormonal, gastrointestinal, renal and metabolic disorders like vitamin D deficiency, obesity, weigh loss may affect bone mass and result in bone mineral density disease is associated with systemic inflammation. It has been also linked to many other disorders like autoimmune thyroid diseases, diabetes mellitus, dyslipidemia, obesity, osteoporosis and primary hyperparathyroidism.}, Keywords = {Helicobacter pylori ,osteoporosis}, volume = {6}, Number = {2}, pages = {48-50}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-467-en.html}, eprint = {http://caspjim.com/article-1-467-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Hajian-Tilaki, Karimollah}, title = {Metabolic syndrome and the associated risk factors in Iranian adults: A systematic review}, abstract ={Background: Metabolic syndrome (MetS) is a complex clustering cardiovascular risk factors such as abdominal obesity, hypertension, diabetes and dyslipidemia. It has been a growing health problem in Iranian adults in recent decade. The objective of this article was to review the prevalence of MetS and the corresponding risk factors among Iranian adults.Methods: We conducted a systematic review to extract the published articles regarding metabolic syndrome and its risk factors among Iranian adults aged >19 years by searching in PubMed, Google Scholar, SID, Magiran and Iranmedex databases. The forty-three published articles were selected regarding MetS among Iranian adults in this review during 2005-2014.Results: From the 43 studies, the rate of MetS varied from 10% to 60% depending on sex, age and region. The highest rate reported among postmenopausal women in Shiraz was over 60%. There was almost a consistent finding that the rate of MetS was higher among women compared with men across national level except in one study. A very sharp difference (43.3% vs. 17.1%) was observed in western Iran (Kordestan province) between sexes. MetS was significantly more prevalent among older adults, postmenopausal women, less-educated people, those living in urban areas and those with low physical activity and unhealthy eating habits across national level consistently.Conclusion: An emerging high rate of MetS across national level highlights the lifestyle modification as preventive measures in Iranian population by focusing primarily on high risk profiles such as low socioeconomic background, low level of education, older age and postmenopausal women.    }, Keywords = {Metabolic Syndrome, Cardio metabolic risk factors, Adults, Iran}, volume = {6}, Number = {2}, pages = {51-61}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-471-en.html}, eprint = {http://caspjim.com/article-1-471-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Fotouk-kiai, Mahdiye and Hoseini, Seyed Reza and Meftah, Neda and Ghadimi, Reza and Bijani, Ali and Noreddini, Hajighorban and Nematollahi, Hamidreza and shokri-shirvani, Jav}, title = {Relationship between Helicobacter pylori infection (HP) and bone mineral density (BMD) in elderly people}, abstract ={  Background: Low bone mass is a frequent complication of chronic inflammatory disease. The pathogenesis of osteoporosis in chronic inflammatory disease may be secondary to releases of cytokines such as TNF-a and IL6. Chronic gastritis due to helicobacter pylori (HP) infection may lead to decreased bone mineral density (BMD) and predispose patients to osteoporosis. The objective of this study was to determine the BMD status in HP positive patients with gastritis versus HP negative cases. Methods: In this cross-sectional study, we enrolled 967 participants aged 60 years old and more from Amirkola Health Study Ageing Project. Seven-hundred and fifty eight HP positive and 209 HP negative patients were analyzed. BMD was measured by dual-energy x-ray absorptiometry (DXA) method in the spine and femoral neck in all participants. Results: The mean age in HP+ and HP- negative patients was 68.3±6.8 and 69.3±7.4 years, respectively. BMD g/cm2 in the spine and femoral neck did not differ between the two groups (P=0.19 and 0.22 respectively). The prevalence of osteoporosis did not also differ across the two groups as well. There was no relationship between the level of antibodies against HP and BMD.Conclusion: According to the findings of this study, H. pylori infection is not associated with BMD changes in the elderly population.  }, Keywords = {Helicobacter pylori, Osteoprosis, Bone mineral density, Elderly patients }, volume = {6}, Number = {2}, pages = {62-66}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-375-en.html}, eprint = {http://caspjim.com/article-1-375-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Barat, Shahnaz and Esmaeilzadeh, Sedigheh and Golsorkhtabaramiri, Masoumeh and Khafri, Soraya and MoradiRecabdarkolaee, Maryam}, title = {Women’s satisfaction in early versus delayed postcaesarean feeding: A one-blind randomized controlled trial study}, abstract ={ Background: The early postoperative feeding after caesarean section (C- section) has remained controversial. This study was designed to evaluate the safety and efficacy of early versus delayed postcaesarean section oral feeding regarding gastrointestinal complications and patients postoperative satisfaction after C- section. Methods: This clinical trial study was conducted on 200 pregnant women undergoing planned C-section under spinal anesthesia (Registration Number: IRCT: 138712211760N1). Women were randomly divided in two groups group A (early feeding group) comprised of 101 patients who were encouraged to take oral fluid. If they tolerated, they continue semi-solid and solid foods starting 2 h after caesarean section. Group B (delayed feeding group) comprised of 99 patients who were given oral fluid 8 h after surgery. After beginning of feeding the patients’ tolerance, first flatus, first defecation, beginning of regular diet, the length of hospital stay and also patient satisfaction level were evaluated in each group by visual scale analog (VAS). Results: The mean time of the first passage of flatus was 10.2±1.7 hours for the early oral feeding group versus 10.7±1.6 hours for the delayed feeding group and the difference was significant (P=0.03). Duration to first defecation and length of hospital stay as well as patient satisfaction level did not differ significantly between the two groups.  Conclusion: The results of this study suggest early postcaesarean feeding. It is well tolerated and helps return normal feeding habits. }, Keywords = {Caesarean section, Satisfaction, Gastrointestinal, Feeding}, volume = {6}, Number = {2}, pages = {67-71}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-501-en.html}, eprint = {http://caspjim.com/article-1-501-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Godazandeh, Gholamali and Kashi, Zahra and Godazandeh, Farnaz and Tayebi, Pouya and Bijani, Ali}, title = {Influence of thyroidectomy on postoperative serum calcium level regarding serum vitamin D status. A prospective study}, abstract ={ Background: Hypocalcemia is a well-recognized complication after total thyroidectomy. Hypovitaminosis D may have additional effect in the development of hypocalcemia. This study aimed to determine the effect of total thyroidectomy on postoperative serum calcium in patients with and without hypovitaminosis D. Methods: This prospective study was performed on patients who underwent total thyroidectomy from 2011 to 2014 in Imam Khomeini General Hospital of Mazandaran University of Medical Sciences. Serum calcium and vitamin D values were recorded before and after surgery. The patients were classified according to serum vitamin D concentrations as less 10 ng/ml (vitamin D deficiency) or higher (control group). The mean values of postoperative calcium level for each class of serum vitamin D were determined and compared. Hypocalcemia was defined as a postoperative calcium level <8 mg/dl. Results: 125 patients due to thyroid disease underwent total thyroidectomy. The incidence of symptomatic and asymptomatic hypocalcemia after surgery was 12% (n=15) and 3.2% (n=4) respectively. 82 (65.6%) patients had vitamin D deficiency and 43 (34.4%) patients had sufficient vitamin D level. There was not any significant difference in calcium level (8.67±0.58 mg/dl vs. 8.70±0.59 mg/dl) between two vitamin D studied groups after thyroid surgery (p>0.05). Conclusion: The findings of this study indicated that vitamin D deficiency had no significant effect on post-thyroidectomy serum calcium level.  }, Keywords = {Hypocalcemia, Transient hypocalcemia, Vitamin D deficiency, Thyroidectomy, Hypoparathyroidism }, volume = {6}, Number = {2}, pages = {72-76}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-412-en.html}, eprint = {http://caspjim.com/article-1-412-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Rasoulinejad, Seyed Ahmad and Iri, Habib-ollah}, title = {Determination of serum lipid profile in patients with diabetic macular edema that referred to Shahid Beheshti and Ayatollah Rouhani Hospitals, Babol during 2011-2012}, abstract ={ Background: Diabetes is a common metabolic disorder leading to the development of many complications, among which diabetic retinopathy and macular edema are the most significant. These complications can contribute to blindness if not diagnosed or treated properly, and several studies have been conducted to evaluate the methods for the prevention or slowing down their progression. Therefore, serum lipids, apparently play an effective role in the creation and acceleration of macular edema, we therefore determined the relationship of serum lipid level in patients with diabetic macular edema in the present study. Methods: 180 participants were selected from patients with the definite diagnosis of diabetes referred to the eye clinic of Shahid Beheshti and Ayatollah Rouhani Hospitals of Babol during 2011-2012, the patients with a history of taking lipid –lowering drugs and hypertension were excluded from the study. The study data were provided from the medical records of each patients. SPSS Version 18 was used for analyses. Results: In the present investigation, the mean age of participants was 53.22±with the age range of 18-77 years. Ninety patients with diabetic retinopathy and macular edema were compared with ninety patients with diabetic retinopathy without macular edema (control group) were compared. There was a significant difference in serum cholesterol and LDL-cholesterol between patients and groups (p<0.000). Conclusion: The results of this study indicate that high serum cholesterol and LDL-cholesterol is associated with severity of diabetic retinopathy particularly with macular edema }, Keywords = {Diabetes, Diabetic retinopathy, Macular edema, Lipid profile, Cholesterol}, volume = {6}, Number = {2}, pages = {77-81}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-443-en.html}, eprint = {http://caspjim.com/article-1-443-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Aliramaji, Arsalan and Kasaeean, Aliakbar and Yousefniapasha, Yousefreza and Shafi, Hamid and Kamali, Sekineh and Safari, Mohsen and Moudi, Em}, title = {Age distribution types of bladder cancers and their relationship with opium consumption and smoking}, abstract ={ Background: Recognition of the predisposing factors of bladder cancer is very important and provides possible prevention measures. The aim of this study was to investigate the types, distribution of bladder tumors and their relationship with opium consumption and smoking in patients who referred to Shahid Beheshti Hospital, Babol, Iran. Methods: In this case-control study, all patients diagnosed with bladder cancer who underwent surgery during 2001-2012 were enrolled. The subjects of the control group were selected among the patients who underwent ERCP (endoscopic retrograde cholangiopancreatography) for gallstone and had no tumors and genitourinary problems. Data regarding demographic, pathology reports and tumor type, smoking status, history of opium consumption and its duration were collected. Patients and controls were compared using t-test and chi-square test. SPSS software Version 20 was used for analysis. Results: In this study, 175 patients with an average age of 63.30±15.29 years and 175 age- matched controls were studied. A significant association was observed between smoking and opium consumption with bladder cancer (P=0.001 for both). Conclusion: The results of this study showed that opium consumption and smoking are associated with bladder cancer }, Keywords = {Bladder cancer, Smoking, Opium}, volume = {6}, Number = {2}, pages = {82-86}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-432-en.html}, eprint = {http://caspjim.com/article-1-432-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Ahmadi, Abbasali and Amri, Parviz and Shokri-Shirvani, Javad and Hajian, Karimollah}, title = {Comparison of the analgesic effect of intravenous paracetamol/midazolam and fentanyl in preparation}, abstract ={ Background: Although some patients can tolerate colonoscopy procedure using fentanyl/ midazolam without any sedation and analgesic requirements but some patients may require additional sedation with benzodiazepines. We performed the present study to compare the effect of paracetamol/midazolam with fentanyl/ midazolam. Methods: In a clinical trial, 96 patients aged 18 to 75 years old, who were candidate for elective colonoscopy assigned consecutively into two groups as paracetamol/midazolam and fentanyl/midazolam. The first group received 1 gr paracetamol 45 minutes before colonoscopy and 0.5 mg/kg midazolam 5 minutes before colonoscopy whereas the second group received 04- 0.5-1 mcg/kg fentanyl 3 minutes before colonoscopy and similar dose of midazolam. The two groups were compared in regard to patient intensity, discomfort, a colonoscopist and, patient satisfaction and rescue dose of propofol during colonoscopy and vital signs. Results: There was no significant difference between the two groups for patient pain score, colonoscopist satisfaction, patient satisfaction and rescue dose of propofol (P=0.817, 0.978, 0.460, and 0.104, respectively). The incidence of apnea was greater in fentanyl group (P=0.045). After adjusting for age and education, there was also no significant difference between the two groups. Conclusion: This study indicates that paracetamol can be considered as an alternative drug regimen in preparation of colonoscopy. }, Keywords = {Paracetamol, Fentanyl, Colonoscopy, Analgesia}, volume = {6}, Number = {2}, pages = {87-92}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-389-en.html}, eprint = {http://caspjim.com/article-1-389-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Heidari, Behzad and Javadian, Yahya and Monadi, Mahmoud and Dankoub, Yahya and Firouzjahi, Alirez}, title = {Vitamin D status and distribution in patients with chronic obstructive pulmonary disease versus healthy controls}, abstract ={ Background: Vitamin D has a potential to modulate inflammatory response against noxious particles in patients with chronic obstructive pulmonary disease (COPD). The present study was conducted to determine the status of serum vitamin D in COPD versus healthy group. Methods: The patients presented to the outpatient pulmonary clinic of Ayatollah Rouhani Hospital, Babol Iran. Diagnosis of COPD was confirmed based on airflow limitation defined as FEV1/FVC ratio <70% and FEV1< 80% of predicted. All eligible patients aged ≥ 40 years old entered the study. Pulmonary infection, tuberculosis, pleural effusion, congestive heart failure, pulmonary hypertension and embolism, restrictive airway disease, conditions leading changes in vitamin D metabolism and absorption were excluded. Serum 25-hydroxyvitamin D (25-OHD) was determined by electrocheminluminescence method and levels 50 years old. All patients were males and age and sex-matched controls were selected among healthy subjects accompanied COPD patients. Results: Ninety patients and 100 controls with respective mean (±SD) age of 64.8±11.7 and 62.6±11.7 years old (P=0.19) were studied. Compared with control, proportions of serum 25-OHD deficiency and insufficiency in patients >50 years were higher and deficiency was lower (61.5% vs 87.5%, P=0.11). Conclusion: These findings indicate that a significant proportion of young COPD patients have insufficient serum 25-OHD. Regarding a positive relationship between 25-OHD and FEV1 in COPD, these findings highlight serum 25-OHD assessment in COPD for recognizing high risk patients. }, Keywords = {vitamin D, COPD, Deficiency, insufficiency}, volume = {6}, Number = {2}, pages = {93-97}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-420-en.html}, eprint = {http://caspjim.com/article-1-420-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Javadian, Yahya and Akbari, Mohammad and Talebi, Ghadamali and Taghipour-Darzi, Mohammad and Janmohammadi, Naser}, title = {Influence of core stability exercise on lumbar vertebral instability in patients presented with chronic low back pain: A randomized clinical trial}, abstract ={ Background: Excessive lumbar vertebrae translation and rotation in sagittal plane has been attributed as an associated factor of lumbar segmental instability (LSI) and low back pain (LBP). Reduction of these abnormalities improves back pain. The aim of this study was to investigate the effect of core stability exercise on the translation and rotation of lumbar vertebrae in sagittal plane in patients with nonspecific chronic LBP (NSCLBP). Methods: In this randomized clinical trial, 30 patients with NSCLBP due to LSI were included. The participants were randomly divided into two groups of treatment and control. The treatment group received general exercises plus core stability exercise for 8 weeks whereas the control group received only general exercises.  The magnitude of translation (mm) and rotation (deg) of lumbar vertebrae in the sagittal plane was determined by radiography in flexion and extension at baseline and after intervention. The primary outcome measures were to determine the mean changes from baseline in translation and rotation of the lumbar vertebrae in the sagittal plane after 8 weeks of intervention in each group. The secondary outcome was to compare the two groups in regard to translation and rotation of the lumbar vertebrae at the end of the study period. Data were analyzed using paired t-test and independent t-test. Results: Thirty patients aged 18-40 years old with clinical diagnosis of NSCLBP entered the study. Compared with baseline values, mean value of translation and rotation of the lumbar vertebra reduced significantly in both groups (P<0.05), except L3 translation in the control group. At the endpoint, mean translation value of L4 (P=0.04) and L5 (P=0.001) and rotation of the L5 (P=0.01) in the treatment group was significantly lower than the control group.Conclusion: These findings indicate that in patients presented with NSCLBP due to lumbar segmental instability, core stability exercises plus general exercises are more efficient than general exercises alone in the improvement of excessive lumbar vertebrae translation and rotation. }, Keywords = {Chronic low back pain, Stabilization exercises, Segmental instability}, volume = {6}, Number = {2}, pages = {98-102}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-317-en.html}, eprint = {http://caspjim.com/article-1-317-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {shafaei, shahryar and sharifian, mahnaz and hajian, karimolah}, title = {Immunohistochemical expression of CD10 in cutaneous basal and squamous cell carcinomas}, abstract ={ Background: Non-melanoma skin cancer is the most common malignant tumor in humans. The role of ultraviolet radiation is well-known in the pathogenesis of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). CD10 is a zinc-dependent metallopeptidase known as common acute lymphoblastic leukemia antigen (CALLA). Although CD10 expression has been investigated in some cutaneous tumors, to our knowledge, data regarding its expression in cutaneous epithelial neoplasms are very limited. In this study, we aimed to determine the immunohistochemical expression of CD10 in BCC and SCC and to find whether it could distinguish between these two skin malignancies. Methods: Twenty SCC and 42 BCC cases were retrieved randomly from Ayatollah Rouhani Hospital pathology archive and CD10 expression was determined in tumoral and stromal cells of each case based on immunohistochemical method. Positive CD10 staining was identified as brown cytoplasmic, with or without cell membrane staining. Results: In all the 20 SCC cases, tumor cells failed to stain with CD10 in contrast to the stromal cells that showed CD10 expression in 18 cases (90%). In BCC cases, the expression of CD10 was noted in tumor cells in 25 cases (59.5%) and in stromal cells of 32 cases (76.2%). There was no relation between CD10 expression in aggressive and non- aggressive BCC. Conclusion: Our findings suggest that CD10 is a useful immunohistochemical marker to differentiate between BCC and SCC. At least, if tumor cells were CD10 positive, this would favor BCC over SCC. Due to small number of aggressive BCC in contrast to non- aggressive types, more studies need to be done to prove or rule out this finding.  }, Keywords = {CD 10, Immunostaining, BCC, SCC}, volume = {6}, Number = {2}, pages = {103-107}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-56-en.html}, eprint = {http://caspjim.com/article-1-56-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {zamani, Hassan and Meraji, Mahmoud and ArabiMoghadam, Mohammad Yousef and Alizadeh, Behzad and Babazadeh, Kazem and Mokhtari-Esbuie, Farz}, title = {Clinical presentation of coronary arteriovenous fistula according to age and anatomic orientation}, abstract ={ Background: Coronary arteriovenous fistulas (CAVFs) are direct connections from one or more coronary arteries to cardiac chambers or a large vessel. They are mostly of congenital origin. The aim of this study was to describe clinical presentation and also delineate the course and management of CAVF. Methods: Clinical data, chest x-rays, echocardiographic and angiographic evaluation of 40 patients with congenital CAVF during 1990 to 2008 were reviewed retrospectively. Results: Seventeen patients were ≤ 20 years old (42.5%) were mostly asymptomatic, and twenty tree cases were older than 20 years old (57.5%), mostly symptomatic (P<0.05). Twenty one (52.5%) patients had pure CAVF and nineteen (47.5%) patients with associated intarcardiac congenital heart disease (15%) or acquired valvular and coronary arteries diseases (32.5%). CAVFs mostly originated from left anterior descending artery (LAD) (42.5%) and mostly drained into the main pulmonary artery (MPA) (35 %). Twenty-four patients underwent CAVF surgical ligation. From twenty-one patients with pure CAVF, eight (38%) patients were complicated by congestive heart failure and aneurism formation of fistula.Conclusion: Unlike some previous reports, in our study, the most prevalent origin site for CAVFs was the left anterior descending (LAD). Most patients with CAVFs especially those who went first diagnosed before 20 years old were asymptomatic. On the other hand, as the continuous murmur is not always detected in children or infants, consequently, cases of spontaneous closure may remain undetected. All symptomatic and asymptomatic patients with moderate to severe shunting should be operated on and minimal morbidity and good surgical results could be expected. }, Keywords = {Congenital heart disease, Coronary arteriovenous fistula, CAVF}, volume = {6}, Number = {2}, pages = {108-112}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-58-en.html}, eprint = {http://caspjim.com/article-1-58-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Hoseinpoorfeyzi, Abbasali and Farshdoustihagh, Majid and Ebadi, Tohid and Shams-Asanjan, Karim and Movasaghpoor-Akbari, Aliakbar and Talebi, Mehdi and Ebadi, Behz}, title = {The effect of resveratrol on the expression of MDR1 gene in leukemic lymphoblast’s of acute lymphoblastic leukemia patients}, abstract ={ Background: Chemotherapy plays a very important role in the treatment of leukemia but the resistance properties of the lymphoblasts limit the effect of chemotherapy. One of the main mechanisms of resistance to chemotherapy is the increased expression of MDR1 gene. The aim of this study was to explore the effect of resveratrol on the expression of MDR1 gene in leukemic lymphoblast of new cases of acute lymphoblastic leukemia (ALL) patients in vitro. Methods: Separation of lymphoblasts of 5 new case ALL patients from peripheral blood was performed by ficoll density gradient centrifugation. Lymphoblasts were cultured in RPMI 1640 medium. Lymphoblasts were treated with 50µmol/L resveratrol for 48 h. Total RNA was extracted with guanidine isothiocyanate. RNA was converted to cDNA. Real time PCR was used to detect mRNA expression of MDR1. Results: The results of gene detection showed that the expression of MDR1 did not change significantly in the patients however, in one patient expression of MDR1 increased upon treatment with resveratrol. Conclusion: The results of this study did not support resveratrol as a compound to reverse multidrug resistance in leukemic lymphoblasts. }, Keywords = {Resveratrol, Multi drug resistance gene, Leukemic lymphoblast, ALL}, volume = {6}, Number = {2}, pages = {113-115}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-427-en.html}, eprint = {http://caspjim.com/article-1-427-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Haghshenas, Mohammadreza and Jafarian, Elham and Babamahmoodi, Farhang and Tabrizi, Ahmad and Nandoost, Sharbano and Alizadeh-Navaei, Rez}, title = {Prevalence of influenza A/H3N2 virus in northern Iran from 2011 to 2013}, abstract ={ Background: Influenza A virus is the most virulent human pathogen and causes the most serious problem. Having epidemiological knowledge about this disease is important. The aim of this study was to determine the prevalence of influenza A/H3N2 virus infection in northern Iran from 2011 to 2013 using the real-time polymerase chain reaction (RT-PCR). Methods: In this cross-sectional study 57 samples were collected from patients with influenza-like illness (T≥ 38 °C and cough or sore throat. Influenza-RNA was extracted from the samples using PureLinkTM Viral RNA/DNA Kit. RT-PCR was one using SuperScript III Platinum, Quantitive Real Time PCR system from invitrogen with a specific type of primers and probs. All samples were examined in the Influenza laboratory of Mazandaran University of Medical Sciences. Results: The mean age of patients was 38.2±14.5 year, 278 (48.69%) were males and 293 (51.31%) females. A total number of 201 patients (35.2%) were diagnosed as influenza A1 H3 N2 infection. Conclusion: The results show that the prevalence of A/H3N2 in the North of Iran is considerable and needs more attention for preventive measures}, Keywords = {Influenza A, Influenza A/H3N2, Swine flu, Season flu}, volume = {6}, Number = {2}, pages = {116-119}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-505-en.html}, eprint = {http://caspjim.com/article-1-505-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {pourghasem, Mohsen and Shafi, Hamid and Babazadeh, Zahr}, title = {Histological changes of kidney in diabetic nephropathy}, abstract ={  Diabetes mellitus is the most common cause of chronic renal disorders and end-stage kidney disease in developed countries. It is the major cause of dialysis and transplantation. Failure in renal function causes wide disorders in the body. Diabetes results in wide range of alterations in the renal tissue. It is believed that early histological changes in diabetic nephropathy are detectable 2 years after diabetes is diagnosed. The glumerular alterations are the most important lesions in the diabetic nephropathy (DN). The Renal Pathology Society provides a new pathological classification for the detection of histopathology of DN. It divides diabetic nephropathy into four hierarchical glomerular lesions. Alloxan or streptozotocin induced diabetic rat is the one most widely used specie to study DN. Histological changes in the rat DN closely resemble the human disease and the most information of this review was obtained through the study of rat DN. All cell types of the kidney such as mesangial cells, podocytes and tubulointerstitial cells are liable to be affected in the event of DN. Severity of renal lesions is associated to the clinical aspect of renal outcome, but the aim of this article was only to review the histological changes of kidney in diabetes mellitus. }, Keywords = {Diabetic mellitus, nephropathy, histological changes}, volume = {6}, Number = {3}, pages = {120-127}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-523-en.html}, eprint = {http://caspjim.com/article-1-523-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Hajian-Tilaki, Karimollah and Heidari, Behz}, title = {Sex difference of biological variation of BMI and waist circumference with age in Iranian adults: A predictive regression model}, abstract ={ Background: Background and Objectives: The biological variation of body mass index (BMI) and waist circumference (WC) with age may vary by gender. The objective of this study was to investigate the functional relationship of anthropometric measures with age and sex.Methods: The data were collected from a population-based cross-sectional study of 1800 men and 1800 women aged 20-70 years in northern Iran. The linear and quadratic pattern of age on weight, height, BMI and WC and WHR were tested statistically and the interaction effect of age and gender was also formally tested. Results: The quadratic model (age2) provided a significantly better fit than simple linear model for weight, BMI and WC. BMI, WC and weight explained a greater variance using quadratic form for women compared with men (for BMI, R2=0.18, p<0.001 vs R2=0.059, p<0.001 and for WC, R2=0.17, p<0.001 vs R2=0.047, p<0.001). For height, there is an inverse linear relationship while for WHR, a positive linear association was apparent by aging, the quadratic form did not add to better fit. Conclusion: These findings indicate the different patterns of weight gain, fat accumulation for visceral adiposity and loss of muscle mass between men and women in the early and middle adulthood. }, Keywords = {Body mass index, Waist circumference, Waist to hip ratio, Quadratic form, Adults}, volume = {6}, Number = {3}, pages = {128-133}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-442-en.html}, eprint = {http://caspjim.com/article-1-442-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Ala, Shahram and Akha, Ozra and Kashi, Zahra and Asgarirad, Hosein and Bahar, Adeleh and Sasanpoor, Ne}, title = {Dose levotyroxine consumption in hypothyroid patients before dinner change the levels of TSH and T4?}, abstract ={ Background: Levothyroxine is commonly used in the treatment of patients with hypothyroidism. Levothyroxine is often administered in the morning, on an empty stomach, to increase its absorption. However, many patients have trouble for taking levothyroxine in the morning. The aim of this study was to evaluate the effect of changing administration time of levothyroxine from before breakfast to before dinner on serum levels of TSH and T4.  Methods: Fifty hypothyroidism patients aged 18-75 years old were included in the study and randomly divided into two groups. Each group received two tablets per day blindly (one levothyroxine tablet and one placebo tablet) before breakfast and before dinner. After two months, the administration time for the tablets was changed for each group, and the new schedule was continued for a further two-month period. The serum TSH and T4 levels were measured before and after treatment in each group.  Results: Changing the levothyroxine administration time, resulted in 1.47±0.51 µIU/mL increase in TSH level (P=0.001) and 0.35±1.05µg/dL decrease in T4 level (P=0.3). Conclusion: Changing the levothyroxine administration time from before breakfast to before dinner minimally reduced the therapeutic efficacy of levothyroxine.  }, Keywords = { Levothyroxine, T4, TSH, administration}, volume = {6}, Number = {3}, pages = {134-140}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-464-en.html}, eprint = {http://caspjim.com/article-1-464-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Rasoulinejad, Ahmad and Zarghami, Amin and Hosseini, Seyed Reza and Rajaee, Neda and Rasoulinejad, Seyed Elahe and Mikaniki, Ebrahim}, title = {Prevalence of age related macular degeneration among elderly smokers results from AHAP study}, abstract ={ Background: Age-related macular degeneration (AMD) is the leading cause of visual impairment and blindness in elderly population in the developing countries. Previous epidemiological studies revealed various potential modifiable risk factors for this disease. The purpose of this study was to evaluate the prevalence of AMD among elderly living in Babol, North of Iran.  Methods:  The study population of this cross-sectional study came from  the Amirkola Health and Ageing Project (AHAP), the first comprehensive cohort study of the health of people aged 60 years and over in Amirkola, North of Iran. The prevalence of AMD was estimated and its risk was determined using logistic regression analysis (LRA) with regard to variables such as smoking, hyperlipidemia, hypertension and diabetes. Results: Five hundred and five participants with mean age of 71.55±5.9 (ranged 60-89) years entered the study. The prevalence of AMD was 17.6%. There was a significant association between AMD and smoking (P<0.001) but no association was seen with AMD and age, level of education, history of hyperlipidemia, hypertension and diabetes. Multiple LRAs revealed that smoking increased AMD by odds ratio of 5.03 (95% confidence interval 2.47-10.23 p<0.001) as compared to nonsmokers Conclusion: According to our findings, the prevalence of AMD was relatively high and smoking increased the risk of AMD in the elderly population. }, Keywords = {Aged, Smoker, Macular Degeneration, Risk factors}, volume = {6}, Number = {3}, pages = {141-147}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-455-en.html}, eprint = {http://caspjim.com/article-1-455-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Ferdosi-Shahandashti, Elaheh and Javanian, Mostafa and Moradian-Kouchakssaraei, Masoomeh and Yeganeh, Babak and Bijani, Ali and Motevaseli, Elahe and Moradiyan-Kouchakssaraei, Fatemeh}, title = {Resistance patterns of Escherichia coli causing urinary tract infection}, abstract ={ Background: Urinary tract infection (UTI) is one of the most prevalent infectious diseases and Escherichia coli is its common cause. The aim of this study was to assess the resistance patterns of E.coli in urinary tract infections and to determine the susceptibility of E.coli to commonly used antimicrobials and also to evaluate the options for empirical treatment of UTI. Methods: This study was conducted in the Ayatollah Rouhani Teaching Hospital of Babol Medical Sciences University in North of Iran. Between January of 2013 to December 2013, antimicrobial susceptibility tests were done by disk diffusion and microdilution method. Growth of >=105 cfu/ml was considered as positive urine test. Ten commonly used antibiotics were examined for susceptibility test. Data and the results were collected and analyzed. Results: E.coli grew in 57 urine samples. Imipenem, ofloxacin, ciprofloxacin were the most sensitive antibiotics at 87.7%, 87.7% and 78.9% respectively. Whereas, cotrimoxazole, cefexime, cefotaxcime and ceftriaxone were the most resistant antibiotics. Antibiotic sensitivity of disk diffusion compared minimum inhibitory concentration (MIC) detected by microdilution had the sensitivity, specificity, positive predictive value and negative predictive value of 82%, 98%, 99% and 74%, respectively. Conclusion: Imipenem, ofloxacin and ciprofloxacin should be used in empirical therapy of UTI. }, Keywords = {Urinary Tract Infection, UTI, Escherichia coli , antibiotic susceptibility ,antibiotic resistance, disk diffusion , micro dilution}, volume = {6}, Number = {3}, pages = {148-151}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-331-en.html}, eprint = {http://caspjim.com/article-1-331-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Hojjati, Seyyed Mohammad Masoud and Zarghami, Amin and Hojjati, Seyyed Ali and Baes, Mobi}, title = {Optic neuritis as onset manifestation of multiple sclerosis A single center study in North of Iran}, abstract ={ Background: Multiple sclerosis (MS) is an inflammatory and demyelinating disease of central nervous system (CNS). The aim of the present study was to determine the type and the frequency of initial presenting symptoms in patients with MS and their relation with demographic characteristics in Babol, northern Iran. Methods: All patients of this study were recruited over a ten year period from 2002 to 2012 from single neurologic clinic. Diagnosis of MS was confirmed according to the McDonald criteria, demographic and clinical features Then, all the clinical findings and demographic variables including: age, sex, marital status, age at onset, education, place of residence, disease duration, initiation pattern of disease have been collected. Expanded Disability Status Scale (EDSS) was used for the evaluation of disability at the onset of disease. Data analysis was performed by chi-square test.  Results: A total of 263 consecutive MS patients with the age range of 17 to 61 yr were examined. Optic neuritis was the most prevalent initial presenting symptom in 123 (46.8%) patients followed by sensory disturbances as the second common presenting symptom of MS. Significant difference was found between patients with or without optic neuritis and the onset age of the disease and EDSS (p<0.001). The mean EDSS score at the time of initial presentation was 1.67±0.77. Conclusion: The findings of this study indicated that optic neuritis is the most prevalent initial presentation of MS in the geographic region of northern Iran. In patients less than 30 years, development of visual disturbances justifies neurologic examination. }, Keywords = {multiple sclerosis, epidemiology, Babol}, volume = {6}, Number = {3}, pages = {151-155}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-519-en.html}, eprint = {http://caspjim.com/article-1-519-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Ahmadi-Ahangar, Alijan and Bazouyar, Bahareh and Mortazavi, Roughayeh and Jalali, Moazzameh}, title = {Prevalence of headache at the initial stage of stroke and its relation with site of vascular involvement. a clinical study}, abstract ={ Background: Stroke is the most common neurologic disease and an important cause of morbidity and mortality. Headache is an initial presenting feature of ischemic stroke and sometimes preceedes the development of stroke and thus, provides an opportunity for offering preventive measures. The aim of the present study was to determine the association of new onset headache with stroke. Methods: A total of 263 consecutive patients with stroke entered the study. Development of headache 24 have prior to admission lasting <3 days was considered the new onset headache. The intensity of headache was graded as mild, moderate and severe. Stroke was classified with respect to the localization of brain damage using magnetic resonance image (MRI). Chi-square test was applied for comparison of proportions.  Results: One hundred thirty-nine males and one hundred twenty-four females with mean age of 76.4±10 (40-89) years were analyzed. Ischemic stroke involving anterior circulation was diagnosed in 210 (79%) patients and vertebrobasilar ischemia in the remaining population. Diabetes, hypertension, hyperlipidemia and coronary artery disease were observed in 36%, 52%, 38% and 42%, respectively. New onset headache was found in 49 (18.9%) patients in who 81.6% was mentioned as new onset. Six out of 9 patients with severe headache had involvement of posterior circulation, whereas in the remaining population, anterior circulation was involved. Conclusion: The findings of this study indicate no association of new onset headache with stroke. There was only a trend for severe headache toward the involvement of vertebrobasilar ischemia. }, Keywords = {Ischemic stroke, Headache, Prevalence}, volume = {6}, Number = {3}, pages = {156-160}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-565-en.html}, eprint = {http://caspjim.com/article-1-565-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Heidari, Behzad and Taheri, Hasan and Hajian-Tilaki, Karimollah and Yolmeh, Mehdi and Akbari, Roghayeh}, title = {Low baseline serum albumin a predictor of anemia in patients on chronic hemodialysis}, abstract ={ Background: Inflammatory process has a substantial contribution in the development of anemia in chronic hemodialysis patients. Low serum albumin in hemodialysis patients is considered a marker of inflammation. The present longitudinal study aimed to determine the relationship between low baseline serum albumin and future development of anemia. Methods: The population of this study consisted of all patients on standard maintenance hemodialysis for at least three months or longer. Patients were classified as high or low serum albumin level (≥ or < 3.9 gr/dl). All patients received the standard treatment of anemia. The main objective of this study was to compare the prevalence of anemia defined as hemoglobin levels < 11 gr/dl between the two study groups at the end of the study period. Results: A total of 82 patients (50% females) with mean±SD age of 55±16.8 years and mean dialysis duration of 5.2±4 years were followed-up for an average period of 10±1 (range, 8-11) months, however 48 patients with high serum albumin and 24 patients with low serum albumin group completed the study. At baseline, the two groups were similar regarding hemoglobin (9.8±1.2 vs 9.16±1.6 gr/dl, P=0.95) levels. At endpoint, prevalence of anemia in high albumin group was significantly lower than the low albumin group (50% versus 83.3% P=0.005). Conclusion: The findings of this study indicate that low serum albumin in hemodialysis patients is a predictor of anemia indicating unresponsiveness to conventional treatment of anemia. }, Keywords = {Hemodialysis,Anemia,Serum Albumin}, volume = {6}, Number = {3}, pages = {161-164}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-559-en.html}, eprint = {http://caspjim.com/article-1-559-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Teheri, Hassan and Ghaemian, Naser and Taghavi, Yaser and Shokry-Shirvani, Jav}, title = {Biochemical profile of bile fluid in patients with malignant cholestasis in comparison with cholestasis due to biliary stone}, abstract ={Background: Cholangiocarcinoma is an invasive biliary malignancy with poor prognosis. Diagnostic accuracy of conventional methods is low which is mainly due to the specific anatomy of the disease. The aim of this study was to evaluate the diagnostic value of biochemical profile and tumor marker of the bile in patients with malignant cholestasis compared to that of choledocholithiasis. Methods: In this cross-sectional study, 46 patients with extrahepatic cholestasis were enrolled (20 patients with malignant cholestasis and 26 patients with choledocolithiasis) A definitive diagnosis of cholangiocarcinoma was made by imaging, cytology and biopsy. Bile fluid was obtained by aspiration through endoscopic retrograde cholagiopantreatography (ERCP) catheter or percutaneous drainage in patients with choledocolithiasis and cholangiocarcinoma respectively. Sex and age were matched in two groups. Data regarding the biochemical profile (triglyceride, (TG), cholesterol, billirubin and HDL) and CA19.9 level of the bile fluid were collected, then using the SPSS software, the data were analyzed. Results: Bile fluid level of TG, cholesterol, high – density lipoprotein (HDL), direct bilirubin and CA19.9 were significantly higher in patients with benign cholestasis in comparison with malignant cholestasis (P<0.001, P<0.001, P<0.001, P=0.012 and P= 0.03, respectively). Conclusion: Our study showed that the CA19.9 level of bile fluid in extrahepatic cholestasis due to biliary stone was significantly higher than those with cholangiocarcinoma, as is the biliary level of TG, cholesterol, high-density lipoprotein (HDL) and direct bilirubin. Thus they may help in the differentiation of benign versus malignant extra hepatic cholestasis.  }, Keywords = {Cholangiocarcinoma, Tumor marker, Biochemical profile}, volume = {6}, Number = {3}, pages = {165-169}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-566-en.html}, eprint = {http://caspjim.com/article-1-566-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {heidarian, alireza and Jafari-Kelarijani, seyed Ebrahim and jamshidi, reza and khorshidi, mohamm}, title = {The relationship between demographic characteristics and motivational factors in employees\' social security hospitals of Mazandaran}, abstract ={ Background: Health worker motivation has the potential to have a large impact on health system performance, and this depends on some factors. The purpose of this study was to determine the factors affecting this motivation. Methods: From Winter 2013 to Spring 2014, 1046 employees and physicians (439 males and 607 females) with a mean age of 36 and 37.2 years in men and women, respectively were chosen in selected hospitals of Social Security Organization (SSO). They were randomly categorized into six different classes of service record, age education class of hiring (permanent and contractual), marital status, and gender. The variables assessed via the classification groups were as follows: interpersonal relations, working conditions, equity, pay, job security, supervision, advancement, recognition, responsibility, and attractiveness of job, educational and organizational policies. Results: Bachelor’s degree (65%) or higher were the education degrees of most participants. Significant relations were observed regarding age, marital status, hiring, gender and years of service with promotion, recognition, responsibility, attractiveness of job, education, relations, working condition, equity, salary, job security, supervision and organizational policies. There were significant relations with hire status and degree with advancement and other variables. There were significant relations between marital status, gender, years of service and age with the above variables. Conclusion: The results show that the important variables that influence motivational factors are academic degree, hire status, marital status, gender, age and years of service. }, Keywords = { Motivation, hospital, motivational factors, social security }, volume = {6}, Number = {3}, pages = {170-174}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-483-en.html}, eprint = {http://caspjim.com/article-1-483-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Tamaddoni, Ahmad and Yousefghahari, Behnaz and Khani, Afshin and Esmaeilidooki, Mohammadreza and BarariSawadkouhi, Rahim and Mohammadzadeh, Iraj}, title = {Isolated thrombocytopenia report of a rare presentation of childhood Systemic Lupus Erythematosus}, abstract ={ Background: Systemic lupus erythematosus (SLE) has various presentations in children. Hematologic abnormalities is common in childhood onset of SLE, however, isolated thrombocytopenia is relatively rare. Thus, we present a child with isolated thrombocytopenia as a rare presentation of SLE. Case presentation: A 12-year-old boy with chief complaints of loss of appetite, weight loss, decreased platelet count (8000/µL) and lymph node enlargement was referred to our hospital. Biopsy of lymph node showed reactive lymphadenopathy. Investigations regarding infectious disease was negative. Platelet count remained low after low dose steroidned therapy. Antinuclear antibody (ANA) and anti-double stranded DNA antibody screening tests were positive with titer of 1/62 and 1/54, respectively. Therefore, juvenile SLE was considered as the final diagnosis and raising the dose of prednisolone to 2mg/kg/day was associated with increasing platelet count to 40000/µL and a week later to 96000/µL. Conclusion: The findings of this study indicate that in cases with isolated thrombocytopenia refractory to conventional dose of steroids, SLE should be considered. This study justifies serum ANA and anti DNA assessment in children with thrombocytopenia }, Keywords = {Systemic Lupus Erythematosus, Thrombocytopenia, Pediatrics}, volume = {6}, Number = {3}, pages = {174-176}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-59-en.html}, eprint = {http://caspjim.com/article-1-59-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Jguirim, Mahbouba and Golli, Mondher and Mhenni, Amira and Mnari, Walid and Bergaoui, Naceur}, title = {Osteopoikilosis: a rare cause of bone pain}, abstract ={ Background: Osteopoikilosis (OPK) is a rare inherited condition of the bones, transmitted as an autosomal dominant trait characterized by numerous hyperostotic areas that tend to localize in periarticular osseous regions. It is usually asymptomatic and is often diagnosed incidentally during x-rays made by other reasons. We present a case of 34-year-old man suffering from polyarthralgia and low back pain. Case presentation: A 34-year-old male patient, smoking 40 packs yearly and alcoholic was referred to our department of rheumatology, complaining of polyarthralgia which started 3 years ago and involving large and small joints. He reported the presence of pelvic pain mostly located at both hip joints and in the two ankles. On radiologic examination, numerous, symmetric, well defined, sclerotic lesions were identified on shoulder, wrist, ankles, pelvis, and on spine. The size of the lesions varied from 2 to 9 millimeters. These spots were located on spongious bone tissue, and in the inner bone cortex located bilaterally in the epiphyses and metaphyses. We concluded the diagnosis of OPK. His mother was found to have the same lesions without any symptoms. Conclusion: OPK may be an isolated finding or associated with other pathologies, e.g. skin manifestations, rheumatic and/or skeletal disorders. The main differential diagnosis is osteoblastic metastasis. }, Keywords = {Osteopoikilosis, Diagnosis, Osteoblastic metastasis, Treatment.}, volume = {6}, Number = {3}, pages = {177-179}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-411-en.html}, eprint = {http://caspjim.com/article-1-411-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Manuchehri, Aliasghar and Alijanpour, Ebrahim and Daghmechi, Mohsen and Ghaeminan, Naser and Abedi, Seyed Hasan and Nikbakhsh, Novin and GhaziMirSaeed, Seyed AliMohammad and Amani, Ne}, title = {A Case of Methanol Poisoning leading to prolonged respirator dependency with conseqent blindness and irreversible brain damages}, abstract ={ Background: Methanol is a colorless and poisonous liquid that is commonly used as an industrial and household solvent. Methanol poisoning is a rare but extremely hazardous form of in toxication that affects the central nervous system and causes visual disorder, drowsiness, seizures and coma.  Case Presentation: A 29-years-old man with methanol intoxication presented with drowsiness and acidosis with subsequent brain hemorrhage requiring prolong mechanical ventilation resulted in persistent visual impairment and disequilibrium. Conclusion: Prolonged mechanical ventilation in patients with methanol intoxication may be assouated with irreversible brain damage.  }, Keywords = {Methanol Poisoning, Computed Tomography, Ventilation}, volume = {6}, Number = {3}, pages = {180-183}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-567-en.html}, eprint = {http://caspjim.com/article-1-567-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Heidari, Behz}, title = {Obesity and diabetic retinopathy: What is the association?}, abstract ={}, Keywords = {Obesity, Diabetic retinopathy, }, volume = {6}, Number = {4}, pages = {184-186}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-621-en.html}, eprint = {http://caspjim.com/article-1-621-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Ahmadi, Elaheh and Alizadeh-Navaei, Reza and Rezai, Mohammad Sadegh}, title = {Efficacy of probiotic use in acute rotavirus diarrhea in children: A systematic review and meta-analysis}, abstract ={ Background: Probiotic therapies with different strains demonstrated some beneficial effects, although some studies did not show any significant effects. This study assessed systematically the current knowledge on the effect of probiotic bacteria on duration of in acute rotavirus diarrhea in children compared with control. Methods: The PubMed, Cochrane Controlled Trial Register (CCTR) and Ovid (Wolters Kluwer Health) were searched between 1980 to June 15, 2013. Randomized controlled trials including the administration of probiotics for treatment of rotavirus diarrhea in infants and children were reviewed. Results: A total number of 1244 articles were found through the aforementioned search. 203 articles were selected after the first screening of title and abstract. The intervention group included subjects who received probiotic strains and dosage in any conditions. Placebo or any similar vehicle without probiotic was used in the controlled trials. Finally, 14 articles were selected. The outcomes from each study were considered in the duration of diarrhea. Statistical analyses were performed with Stata software. The pooled estimate of efficacy of probiotics in prevention or treatment of disease yielded in all studies a mean difference of 0.41 (CI 95%: -0.56 to –0.25 p<0.001). The pooled estimate of efficacy of lactobacillus rhamnosus GG and other probiotics significantly reduced the duration of diarrhea. Among trials, the overall reduction of LGG was 0.47 (CI 95%: -0.80 to -0.14 P= 0.020). Conclusion: In conclusion, probiotics exert positive effect in reducing the duration of acute rotavirus diarrhea compared with control.  }, Keywords = {Probiotics, Rotavirus, Acute Diarrhea, Children}, volume = {6}, Number = {4}, pages = {187-195}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-348-en.html}, eprint = {http://caspjim.com/article-1-348-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Khadir, Fatemeh and Pouramir, Mahdi and Joorsaraie, Gholamali and Feizi, Farideh and Sorkhi, Hadi and Yousefi, Fatemeh}, title = {A Study of arbutin protective effect on cyclosporin A-induced oxidative damage}, abstract ={ Background: Cyclosporine A (CsA) is a potent immunosuppressant drug with therapeutic and toxic actions. The use of CsA is limited by its toxicity. Several researchers had proposed that oxidative stress could play an important role in CsA-induced toxicity. Arbutin has recently been shown to possess antioxidative and free radical scavenging abilities.The present study was designed to investigate the in vivo effects of arbutin on lipid peroxidation and antioxidant capacity in the serum of cyclosporine treated rats.  Methods: Adult male Wistar rats were divided into six groups (n=8/group): (I) control (no CsA and arbutin administration), (II and III) were treated subcutaneously (Sc) with arbutin (50,100 mg/kg/bw), respectively, (IV) administered CsA (25 mg/kg/bw) intraperitoneally (IP), (V and VI) received the combination of CsA (25 mg/kg/bw) i.p and arbutin (50,100 mg/kg/bw) Sc daily, respectively. At the end of the treatment (after3 weeks), serum lipid peroxidation was measured by thiobarbituric acid-reacting substances (TBARS) and serum total antioxidant capacity (ferric reducing ability of plasma [FRAP]) was assayed based on spectrophotometric method.  Results: TBARS had been significantly increased by CsA administration compared with control rats. Arbutin (50mg/kg/bw) completely prevented this effect, but arbutin (100 mg/kg/bw) alone or in combination with CsA significantly increased lipid peroxidation compared with controls.  Conclusion: Our data indicate that arbutin (50mg/kg/bw) had protective effect in the CsA-induced toxicity but high concentration of arbutin (100mg/kg/bw) showed meaningful oxidative and lipoperoxidative effects.  }, Keywords = {cyclosporin A, oxidative stress, arbutin, anti-oxidant}, volume = {6}, Number = {4}, pages = {196-200}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-429-en.html}, eprint = {http://caspjim.com/article-1-429-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Baghiani-Moghadam, Mohamad Hosein and Seyedi-Andi, Seyed Jalil and Shokri-Shirvani, Seyed Javad and Khafri, Sorayya and Ghadimi, Reza and Parsian, Hadi}, title = {Efficiency of two constructs called "fear of disease" and "perceived severity of disease" on the prevention of gastric cancer: Application of protection motivation theory}, abstract ={ Background: Among all cancers, malignancies of gastrointestinal tract are the most common cancer among Iranian population. Dietary behavior is thought to be the most important risk factor in gastric cancer. Fear and perceived severity are two important constructs of the protection motivation theory (PMT). Despite the evidence of the impact of these two constructs in modifying dietary habits against gastric cancer, their efficiency is not well established. Therefore, the present study was designed to determine the efficiency of the mentioned constructs. Methods: This cross-sectional study was performed on 360 participants (180 males and 180 females) aged over 30 years old who presented to health centers in Babol, Iran in 2014. They were selected by a cluster sampling method in a population covered by health centers in Babol. Data collection was done using a questionnaire with acceptable reliability and validity, designed by a researcher based on two constructs of protection motivation theory. The data were analyzed by SPSS Version 20 using descriptive and analytical statistics such as ANOVA, linear and logistic regression analysis. Results: The participants who entered in the study achieved 38.6 and 69.7% of the scores of fear and perceived severity, respectively. There was a significant difference between perceived severity with level of education (p<0.05). There was a significant inverse correlation between perceived severity with nutritional high risk behavior associated with gastric cancer in the significant level of 0.05 (r=-0.165). The constructs of perceived severity and fear predicted 38% of the variance of nutritional high risk behaviors associated with gastric cancer. Conclusion: Constructs of fear and perceived severity of protection motivation theory with predicting 38% of the variance of nutritional high risk behaviors had an effective role against gastric cancer and may help in the design and implementation of educational programs for the prevention of gastric cancer.}, Keywords = {Perceived Severity, Fear, Gastric Cancer, Protection Motivation Theory}, volume = {6}, Number = {4}, pages = {201-208}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-485-en.html}, eprint = {http://caspjim.com/article-1-485-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Biazar, Tahmineh and Yahyapour, Yousef and HasanjaniRoushan, Mohammad Reza and Rajabnia, Ramazan and Sadegi, Mahmoud and Ranaei, Mohammad and Bayani, Masomeh}, title = {Relationship between hepatitis B DNA Viral load in the liver and it\'s histology in patient with chronic hepatitis B}, abstract ={Background: Serial measurement of  hepatitis B virus (HBV) DNA levels in the liver and its relation with liver damage and serum HBV DNA levels are guide to begin and/or end a treatment course. This study evaluated the relationship between liver hepatitis B DNA viral load with liver histology in patients with chronic hepatitis B (HBV). Methods:  Thirty patients with chronic anti-Hbe positive hepatitis B, with liver enzymes ;ge 2 times of the upper limit of normal and positive HBV DNA of any amount were entered in the study. They underwent percutaneous liver biopsy. Liver and serum viral load were determined using real time polymerase chain reaction (RT-PCR) method. Liver function tests and liver histology for all cases were recorded. The amount of viral load in the liver and histological grading and staging were recorded. Data were collected and analyzed. Results: The mean age of the patients was 32.8±10 years and 24 (80%) patients were males. Ten (33.3%) patients had HBV viral load levels less than 20000 IU/mL. There was a significant correlation between liver viral load levels with staging or grading of liver damage. Conclusion: The results of the present study showed a strong correlation between liver viral load and liver damage in patients with chronic hepatitis B.  }, Keywords = {Chronic hepatitis B, liver, viral load, serum }, volume = {6}, Number = {4}, pages = {209-212}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-388-en.html}, eprint = {http://caspjim.com/article-1-388-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Alavi, Seyed Mohammad and Salmanzadeh, Shokrollah and Bakhtiarinia, Pejman and Albagi, Ali and Hemmatnia, Fatemeh and Alavi, Leil}, title = {Prevalence and treatment outcome of pulmonary and extra pulmonary pediatric tuberculosis in southwestern Iran}, abstract ={ Background: Knowledge about childhood tuberculosis (TB) in Iran is limited. This study aimed to determine the proportion of tuberculosis in children living in Khuzestan in southwest of Iran and its treatment outcomes.  Methods: In this retrospective study, the child’s medical records registered in national TB program (NTP) unit of Khuzestan Health Center (KHC) for TB treatment from 2005 to 2010 were studied. Data including demographic, clinical presentation, laboratory test results, and treatment outcomes were extracted from the files and were analyzed.  Results: Of total 4104 new TB cases registered in KHC, 203 (4.9%) were children. The mean age was 10.7±4.3 years, and 75.7% of them were females. More than 84% of TB children cases were 10 years or older, whereas, young children (< 5 years old) accounted for 5.6%. Of the total studied cases, 57.1% were pulmonary TB and 42.9% were extra pulmonary, 91.7% were successfully treated and 8.3% had poor treatment outcome. The main risk factors for poor treatment outcome were: age <5 years (OR: 0.17, 95% CI, 0.04-0.76), low body weight (OR: 0.08, 95% CI, 0.01-0.60), household contact with cases of TB treatment failure (OR: 0.13, 95% CI, 0.03-0.52), and exposure to cigarette smoke odor inside the home (OR: 0.17, 95% CI, 0.05-0.56).  Conclusion: The proportion of pediatric TB in the region was lower than expected. The treatment success rate was higher than the rate defined in NTP. Special attention should be given to children aged less than five years, low body weight, contact with TB treatment failure cases, and exposure to cigarette smoke.  }, Keywords = {Tuberculosis, Children, Treatment outcomes, Iran}, volume = {6}, Number = {4}, pages = {213-219}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-277-en.html}, eprint = {http://caspjim.com/article-1-277-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Sadeghian, Naser and Sadeghian, Irandokht and Mirshemirani, Alireza and KhaleghnejadTabari, Ahmad and AbdollahGorji, Fatemeh and Roushanzamir, Fatollah}, title = {Types and frequency of ovarian masses in children over a 10-year period}, abstract ={ Background: Ovarian masses represent a range of pathology from benign cyst to highly aggressive malignant tumors. It has been estimated that gynecologic malignancy account for approximately 2% of all types of cancer in children, 60-70% of these lesions arise in the ovary.  Methods: All ovarian masses which were resected or biopsied in Mofid Children;#39s Hospital from 2002 to 2012 were reviewed retrospectively. Patient’s age, presenting symptoms, surgical procedures, pathological diagnosis, postoperative treatment, and outcome were obtained from medical records.  Results: Fifty-seven girls (aged 40.2±57months with the range of 1 day to 15 years) underwent different types of ovarian operations (24 salpingo-oophorectomies, 10 oophorectomies, 21 ovarian cystectomies, and 2 ovarian biopsies). 50 children had unilateral ovarian mass (49.1% right and 38.6 left, respectively). The most common presenting symptoms were acute abdominal pain in 46%.Twenty one (37%) of our patients had ovarian torsion. Four (7%) patients had benign tumors, and 8 (14%) had malignant tumors. There were no age differences between those with benign type (8.2±2.6years) and malignant tumors (6.1±5.3years) (P=0.683).  Conclusion: Ovarian tumors are rare in children. Most are benign, in children presenting with acute abdominal pain, ovarian mass particularly neoplastic tumors should be suspected. An important proportion of these patients may require postoperative chemotherapy.  }, Keywords = {Ovarian tumors, Abdominal pain, Children, Postoperative outcome}, volume = {6}, Number = {4}, pages = {220-223}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-421-en.html}, eprint = {http://caspjim.com/article-1-421-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Rasoulinejad, Seyed Ahmad and Hajian, Karimollah and Mehdipour, Elnaz}, title = {Associated factors of diabetic retinopathy in patients that referred to teaching hospitals in Babol}, abstract ={ Background: Information regarding the frequency and severity of eye involvement in diabetic patients and its risk factors can be useful for prevention and treatment. This study aimed to determine the prevalence of diabetic retinopathy and its associated risk factors in diabetic patients who referred to teaching hospitals in Babol, Mazandaran.  Methods: In this study a total of 1562 patients with the definite diagnosis of diabetes mellitus were chosen and referred to the eye clinic of Shahid Beheshti and Ayatollah Rouhani Hospitals of Babol during 2006-2010. Information about age, duration of diabetes, hypertension family history of diabetes, history of other organs involvement, BMI and laboratory findings were recorded. Retinopathy was classified according to early treatment of diabetic retinopathy study. Data were collected and analyzed.  Results: Of the 1562 patients, 357 (22.9%) were males and 1205 (77.1%) were females. The mean age was 54.6±10.6 years, diabetic retinopathy was found in 990 (64.1%) patients, the frequency of non-proliferative diabetic retinopathy was 37.3% and proliferative was 26.8%.Age, duration of diabetes, FBS, HbA1C, BUN, Cr, Hb were  significantly different between the patient’s with diabetic retinopathy and no diabetic retinopathy (p<0.05). No relationship was found between smoking, gender, hypertension and serum lipid profile.  Conclusion: Poor diabetes control anemia and nephropathy were the most associated factors of diabetic retinopathy but hypertension BMI smoking, dyslipidemia and gender showed no association.  }, Keywords = {Diabetic retinopathy, Diabetes mellitus, Risk factors}, volume = {6}, Number = {4}, pages = {224-228}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-568-en.html}, eprint = {http://caspjim.com/article-1-568-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Jalalinadoushan, Mohammadreza and Siadati, Sepideh and Davati, Ali and Torabi-Parizi, Gholamreza and Ghasemi, Samir}, title = {Cytokeratin7 expression in gastric and colorectal adenocarcinoma: Correlation with prognostic factors}, abstract ={ Background: Gastric and colorectal adenocarcinoma are the second and the fifth most common cancers in Iran, respectively. Expression of cytokeratin 7 (CK7) is established in most malignancies including gastric and colorectal adenocarcinoma. Demonstration of Ck7 could be related to prognostic factors and help to the better management of the patients. The objective of our study was to evaluate the CK7 expression in gastric and colorectal adenocarcinoma and its correlation with other prognostic factors.  Methods: This cross-sectional study was performed on 99 tissue blocks from patients with gastric or colorectal adenocarcinoma undergoing surgery. Tumor grade, tumor size, depth of invasion and metastasis to lymph nodes were determined. Then, the expression of CK7 was studied using immunohistochemistry staining.  Results: Expression of CK7 was 50% and 33.8% in gastric and colorectal adenocarcinoma, respectively. There was not only a significant correlation between CK7 expression and tumor size (r=0.267, P=0.009) but also histologic grade (r=0.222, P=0.028).  Conclusion: CK7 could be more expressed with the increase in tumor size and was associated with poorly differentiated gastric and colorectal adenocarcinoma. However, with these results gathered, it is highly recommended that further studies will be conducted to reveal the exact prognostic role of this factor.  }, Keywords = {Cytokeratin 7, Colorectal Cancers, Gastric Cancers, Prognosis}, volume = {6}, Number = {4}, pages = {229-232}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-230-en.html}, eprint = {http://caspjim.com/article-1-230-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Saravi, Mehrdad and Ahmadi-Ahangar, Alijan and Hojjati, Mohammad-Masoud and Valinejad, Ebrahim and Sanaat, Ahmad and Sohrabnejad, Reza and Khosoosi-Niaki, Mohammadrez}, title = {Etiology of syncope in hospitalized patients}, abstract ={ Background: Syncope is a common clinical problem which can be remarkably debilitating and associated with high health care costs. Syncope is a clinical syndrome with many potential causes. The aim of the study was to determine the etiologies of patients with syncope in the emergency department (ED) of a referral and general university hospital.  Methods: One hundred sixty-five consecutive patients aged more than 18 years old with syncope were admitted to the emergency department of Ayatollah Rouhani Hospital. Initially organized, systematic approach included detailed medical history and structured questionnaires for history taking, physical examination, ECG and cardiac monitoring, cardiology and neurology were done. Advanced diagnostic tests were carried out if the etiology of syncope remained unexplained.  Results: Out of the 165 patients who presented to the ED between February 2012 and February 2013, 124 had definition of syncope. The mean age of male patients was 59.5±19.8, 58. The etiology of syncope was diagnosed in 104 (83%) patients. Neurocardiogenic syncope was found in 36 (29.03%) patients, cardiac arrhythmias in 40 (32.25%) patients, and acute coronary syndrome in 8 (6.45%) patients. There are some infrequent etiologies like intracranial hemorrhage in 5 patients, aortic stenosis in 4 patients, hypertrophic cardiomyopathy and aortic dissection in 3 patients, Brugada and pulmonary embolism in 2 patients and carotid hypersensitivity in one patient.  Conclusion: We found that cardiac arrhythmias and neurocardiogenic type are the frequent causes of syncope. In about one-sixth of the patients, no etiology was found. Approximately one-third of patients had traumatic syncope.  }, Keywords = {Etiology, syncope, head-up tilt test, electrophysiologic study}, volume = {6}, Number = {4}, pages = {233-237}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-619-en.html}, eprint = {http://caspjim.com/article-1-619-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Salehifar, Ebrahim and Eslami, Gohar and Ahangar, Nematollah and Rafati, Mohammad Reza and Eslami, Shafagh}, title = {How rational Aminoglycosides are being used in critically ill patients? Results from a teaching hospital in north of Iran}, abstract ={ Background: Resistance to antimicrobial agents including aminoglycosides (AGs) is a great concern that is mainly related to inappropriate use. Since there were not adequate data regarding how rationally AGs are being prescribed in our critically ill patients, this study was conducted to determine the main issues in the area of appropriate use of this antibiotic class.   Methods: One hundred patients who were in the intensive care units (ICUs) of Imam Khomeini Teaching Hospital from February 2012 to August 2012 were included. A data gathering form was prepared based upon the recommendations provided by Up-to-date (20.1) 2012 and Medscape 2013. All demographic characteristics and other information about time of beginning and duration of dosage, interval of administration of AGs and creatinine (Cr) level were collected. In statistical analysis, SPSS Version 16 software was used. Independent samples t-test was used to compare the quantitative and chi-square for qualitative variables.  Results: Sixty six (66%) of patients received gentamicin and 38% received amikacin. In 27% of patients, serum creatinine (Cr) had been checked before and after AGs administration and 4 patients had no renal function monitoring. Monitoring of serum concentration and Cr clearance estimation was not carried out for any patients. Culture and laboratory sensitivity tests were done on 17 patients and E-coli (57%) was the most common isolated organism.  Conclusion: The results of this study revealed that majority of the hospitalized patients in the ICU and the dosage of AGs had not been adjusted to renal function.  }, Keywords = {Rational use, Aminoglycosides, ICU, Antibiotics, DUE }, volume = {6}, Number = {4}, pages = {238-242}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-52-en.html}, eprint = {http://caspjim.com/article-1-52-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Mohammadi, Rasoul and Meidani, Mohsen and Mostafavizadeh, Kamyar and Iraj, Bijan and Hamedani, Pooria and Sayedain, Mohammad Amin and Mokhtari, Mojg}, title = {Case series of rhinocerebral mucormycosis occurring in diabetic patients}, abstract ={ Background: Rhinocerebral mucormycosis is a fatal infection typically affecting diabetic or immunosuppressed patients. In most cases, infection is caused by inhalation of fungal spores. Mortality rate of patients is very high (40-85%).  Case Presentation: In this study, three diabetic patients with rhinocerebral mucormycosis were presented. The etiologic agents of mucormycosis in two patients were isolated and identified by sequence analysis and data were registered in Gene bank database.  Conclusion: In patients with mucormeosis, early detection, surgical excision and appropriate debridement, suitable antifungal therapy, and control of risk factors like diabetes mellitus are the main parameters of successful management of this lethal infection.  }, Keywords = {Rhinocerebral mucormycosis, Diabetes Mellitus, Iran}, volume = {6}, Number = {4}, pages = {243-246}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-497-en.html}, eprint = {http://caspjim.com/article-1-497-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} } @article{ author = {Kiakojouri, Keivan and Dehghan, Mehdi and HasanjaniRoushan, Reza and Pourdadash, Bij}, title = {Candida laryngitis appearing as carcinoma}, abstract ={ Background: Focal laryngeal candidiasis is not reported widely and is very infrequently recognized clinically. This disease is rare and may occur after pulmonary, pharyngeal and esophageal candidiasis or as part of disseminated disease. It is also secondary to inhaled steroid therapy which is usually mild and has been reported in 10-15 percent of patients taking these medications.  Case Presentation: In this study, we introduced a rare case of laryngeal candidiasis in a 79-year-old immunocompromised male presented with 17 months of progressive hoarseness. In video laryngoscopy a white, vegetative mass on anterior one-third of right vocal cord mimicking laryngeal carcinoma. The histopathological examination showed laryngeal mucosal with keratosis, degenerating necrotic epithelial cell aggregates containing hyphea and candida albicans.  Conclusion: In immunocompromised patients, the diagnosis of laryngeal candidiasis should be considered in any patients with laryngeal symptoms}, Keywords = {Laryngeal Candidiasis, Hoarseness,}, volume = {6}, Number = {4}, pages = {248-250}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-390-en.html}, eprint = {http://caspjim.com/article-1-390-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2015} }