1 2008-6164 Babol University of Medical Sciences 30 Infectious Diseases Relation between EDSS and monosymptomatic or polysymptomatic onset in clinical manifestations of multiple sclerosis in Babol, northern Iran Hojjati Seyed Mohammad Masood b Hojjati Seyyed Ali c Baes Mobina d Bijani Ali e b Department of Neurology, Babol University of Medical Sciences, Babol, Iran c Shahid Beheshti University of Medical Sciences, Tehran, Iran d Babol University of Medical Sciences, Babol, Iran. e None- Communicable Pediatric Disease Research Center, Babol University of Medical Sciences, Babol, Iran 1 1 2014 5 1 5 8 19 10 2013 25 11 2013 Background: Polysymptomatic or monosymptomatic patients of multiple sclerosis (MS) at the onset of the disease may influence the natural course of the disease. The purpose of this study was to determine the prognostic effect of the expanded disability status scale (EDSS) of patients with MS with polysymptomatic or monosymptomatic onset of the disease. Methods: From 2001 to 2011, 263 patients with definitive diagnosis of MS were investigated in Shahid Beheshti Teaching Hospital in Babol, Iran. These patients were assessed regarding mono-or poly symptoms at the beginning of their disease. MRI of brain and spinal cord was done for all cases. These cases were evaluated every three months interval. EDSS of each patient at the beginning of their disease and then yearly were evaluated and registered. Results: One hundred sixty-one subjects (61.2%) were monosymptomatic and 102 (38.8%) were polysymptomatic at the onset of their disease. The mean age of patients with monosymptomatic onset was 26.81+84 while in polysymptomatic was 26.35+7.7 years (P=0.656). Sex, place of residence and marriage statusbetween these two groups were equal. The mean EDSS in monosymptomatic and polysymptomatic patients were 1.37±0.64 and 2.16±0.714, respectively (P=0.0001). After the initiation of treatment, reduction of EDSS was seen in both groups but after the reduction in the first year, an increase of EDSS was seen in both groups. But there was no significant difference in the increase of EDSS in both groups. Conclusion: The results showed that the mean EDSS in monosymptomatic was lower than the polysymptomatic patients before treatment, but after treatment, this value does not differ in the increase of EDSS.
31 Infectious Diseases Silymarin in treatment of non-alcoholic steatohepatitis: A randomized clinical trial Solhi Hassan f Ghahremani Ramin g Kazemifar Amir Mohammad h Hoseini Yazdi Zahra i f Department of Toxicology, Arak University of Medical Sciences, Arak, Iran g Department of Gastroentrology, Arak University of Medical Sciences, Arak, Iran h Department of Toxicology, Qazvin University of Medical Sciences, Qazvin, Iran i Arak University of Medical Sciences, Arak, Iran 1 1 2014 5 1 9 12 16 12 2013 16 12 2013 Abstract Background: No pharmacologic agents have been approved for the treatment of non-alcoholic steatohepatitis (NASH) that is common in our region. The present study was designed to evaluate the efficacy of silymarin, a known herbal drug, in the treatment of NASH. Methods: This clinical-trial study was conducted on 64 patients with NASH who were randomly divided as case group (33) and control group (31). Abdominal sonography and persistent elevation in levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) more than 1.2 times of the upper normal limit within the last six months were selected as inclusion criteria. They were advised to take low-fat, low carbohydrate diet, do regular sport activity to lose weight up to 4 Kg. Patients in the case group received 210 mg/day silymarin orally for 8 weeks and those in the control group received placebo. After 8 weeks, the patients were reevaluated and their AST and ALT levels were measured. This study was registered in the Iranian Registry of Clinical Trial (www.irct.ir) with registration number ID: IRCT201202159018N1. Results: The mean age of patients in case and control groups was 43.6±8.3 and 39.4±10.5 years, respectively. Their BMI were 27.4±1.7 and 27.5±1.9, respectively. Their weights were also 79±9.2 and 76.9±9.5 kg, respectively. Serum concentrations of ALT were 91.3±21.3 and 38.4±11.8 in case group before and after the study respectively, whiles the figures were 84.6±23.3 and 52.3±29 in the control group (P=0.026). The same trend was seen for AST (P=0.038). Conclusion: The patients who had taken silymarin experienced more notable fall in hepatic enzymes. 34 Infectious Diseases Clinical manifestations of right ventricle involvement in inferior myocardial infarction Khosoosi Niaki Mohammadreza j Abbaszade Marzbali Narges k Salehiomran Mohammadtaghi l j Department of cardiology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran. k Student Research Committee, Babol University of Medical Sciences, Babol, Iran. l Department of cardiology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran. 1 1 2014 5 1 13 16 17 12 2013 17 12 2013 Abstract Background: Early diagnosis of right ventricle (RV) involvement in inferior myocardial infarction (Inf MI) is very critical. This study was performed to evaluate the clinical findings of Inf MI with or without RV infarction. Methods: From September 2010 to September 2012, 195 patients with definite diagnosis of Inf MI were evaluated in the Department of Cardiology, in Babol, north of Iran. The presence or absence of right ventricular infarction was evaluated by ST elevation in preicordial V3R-V4R leads. Chest pain (CP), changes in electrocardiography (ECG), serum level of Troponin T (TnT), decreased level of consciousness, hypotension, and jugular vein prominence (JVP) in patients with and without RV involvement were noted. Results: One hundred forty eight (95 males and 53 females) and 47 (31 males and 16 females) cases developed Inf MI without and with RV infarction, respectively. The mean age of the patients with and without RV infarction were 60.59±12.9 and 60.9±12.2 years, respectively (P=0.883). CP, decreased consciousness, hypotension, and JVP were seen in 147 (99.3%), 1 (0.7%), 1 (0.7%) and 1 (0.7%) patients without RV involvement and in 44 (93.6%), 9 (19.1%), 27 (54.4%) and 9 (19.1) in RV involvement, respectively (p<0.05). No significant differences were seen in ThT enzymes and ECG changes. Conclusion: The results show that chest pain, decrease of consciousness, hypotension, JVP prominence are more frequent in inferior MI with RV involvement patients 35 Infectious Diseases Association between serum uric acid level and diabetic peripheral neuropathy (A case control study) Kiani Javad m Habibi Zahra n Tajziehchi Ali o Moghimbeigi Abbas p Dehghan Arash Azizkhani Homeyra m Department of Endocrinology, Department of Internal Medicine, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran n Department of Internal Medicine, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran. o Shahid Beheshti Hospital, Hamedan University of Medical Sciences, Hamedan, Iran. p Department of Biostatistics and Epidemiology, School of Public Health and Center of Health Research, Hamedan University of Medical Sciences, Hamedan, Iran Department of Pathology, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran. School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran 1 1 2014 5 1 17 21 17 12 2013 17 12 2013 Abstract Background: The role of uric acid is well known for the development of nephropathy and retinopathy in diabetic patients. The aim of this study was to evaluate the serum uric acid levels in patients with or without diabetic neuropathy (DPN). Methods: Forty-two patients with DPN (case group) and 42 patients without DPN (control group) matched with regard to age, gender, body mass index (BMI) and duration of their disease were entered into the study. The diagnosis of DPN was based on the nerve conduction studies on sural, peroneal and tibial nerves in lower limbs. Serum uric acid was measured in these two groups. Results: The mean age of the patients in the case group was 54.6±6.9 and in the control group was 55.8±5.8 years (p=0.389). The demographic characteristics of the patients in these two groups were equal, but only the history of diabetic foot ulcer was higher in patients with DPN (p<0.05). The mean serum uric acid was 4.70±0.96 in diabetic patients with DPN and 4.36±0.89 mg/dl in patients without DPN (p=0.019). Conclusion: The results show the higher level of serum uric acid level in diabetic patients with diabetic neuropathy. Further studies are required to determine the role of uric acid in the development and progression of DPN. 36 Infectious Diseases Frequency of odontogenic periradicular lesions in diabetic patients Mesgarani Abbas Haghanifar Sina Eshkevari Narges Ehsani Maryam Khafri Soraya Nafarzade Shima Damankesh Zahra Department of Endodontic, faculty of Dentistry, Babol University of medical Sciences, Babol, Iran. - Department of Oral & Maxillofacial Radiology, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran. Dental Material Research Cneter, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran Department of Social Medicine and health, Babol University of Medical Sciences, Babol, Iran. Department of Oral Pathology, Faculaty of Dentistry, Babol University of Medical Sciences, Babol, Iran Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran 1 1 2014 5 1 22 25 17 12 2013 17 12 2013 Abstract Background: Diabetic patients are more prone to oral infections and periradicular lesions due to changes in their immune system and qualitative and quantitative changes in normal flora of their mouth. The aim of this study was to evaluate the frequency of periradicular lesions in diabetic patients in Babol, North of Iran. Methods: From October 2011 to March 2012, 135 diabetic patients who referred to the Iranian Diabetes Society - Babol Branch and Endocrinology Clinic of Babol University of Medical Sciences were studied. The demographic features as well as the duration of the diagnosis of diabetes (> 48 months was called long term and < 48 months short term) is the quality of control of their diabetes. For all the patients, panoramic and periapical radiography were performed for the presence of any radicular radiolucent lesions. Vitality test has been done for the recorded teeth except for the root treated ones and periodontal involvement necrotic teeth. The data were collected and analyzed. Results: Periradicular lesions were seen on 90.37% of the patients. The frequency of periradicular lesions in long term patients was 85 (94.4%) and in short term was 37 (82.2%) (p=0.023). The mean of teeth with periradicular lesions in long and short term diabetic patients was 2.63±2.23 and 2.11±1.79, respectively (p=0.174). Conclusion: The results show that the frequency of periradicular lesions in diabetic patients is higher in long-term diabetic patients than the short-term diabetic patients. 37 Infectious Diseases The effect of fennel (Foeniculum vulgare) gel 3% in decreasing hair thickness in idiopathic mild to moderate hirsutism, A randomized placebo controlled clinical trial Akha Ozra Rabiei Khadijeh Kashi Zahra Bahar Adele Zaeif-Khorasani Elham Kosaryan Mehrnoush Saeedi Majid Ebrahimzadeh Mohammad Ali Emadian Omid Diabetes research Center, Mazandaran University of Medical Sciences, Sari, Iran. Traditional and Complementary Medicine Research Center, Mazandaran University of Medical Sciences, Sari, Iran. Diabetes research Center, Mazandaran University of Medical Sciences, Sari, Iran. Diabetes research Center, Mazandaran University of Medical Sciences, Sari, Iran Diabetes research Center, Mazandaran University of Medical Sciences, Sari, Iran Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, Iran. Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran Department of Medicinal Chemistry, Faculty of Pharmacy, Mazandaran University of Medical Sciences, sari, Iran. Department of Pathology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. 1 1 2014 5 1 26 29 17 12 2013 17 12 2013 Abstract Background: Hirsutism is a common symptom presenting to primary care endocrinologists, gynecologists, and dermatologists. Management is usually a long and troublesome process. This study was designed to evaluate the effect of fennel topical gel on mild to moderate idiopathic hirsutism. Methods: The randomized, double-blind, placebo-controlled clinical trial was carried out from 2009 to 2011, in Sari, Iran. Forty four women with mild to moderate idiopathic hirsutism were randomly divided to case and control groups, each group included 22 cases. The case group received fennel gel 3% and the control group received placebo. The effect of fennel gel 3% was defined as reduction of thickness of facial hair in micrometer by microscope in comparison with placebo. Measurements were performed at zero time and 24 weeks after treatment. This study was registered in the Iranian Registry of Clinical Trial (www.irct.ir) with registration number 138901213672N1. Results: The mean age of patients was 26.9±6.7 and 25.6±4.3 years in case and control groups, respectively. Hair thickness was similar between the two groups before intervention. The hair thickness reduced from 97.9±31.5 to 75.6±26.7 micron in patients receiving fennel gel after 24 weeks (P<0.001). Four patients complained of itching (3 in case group) and 4 patients complained of irritation and itching (3 in case group). However, this difference was not statistically significant. Conclusion: The study indicated that fennel gel 3% is effective in decreasing hair thickness in women with idiopathic mild to moderate hirsutism. 39 Infectious Diseases Bacterial entropathogens and antimicrobial susceptibility in children with acute diarrhea in Babol, Iran Esmaeili Dooki Mohammad Reza Rajabnia Ramazan Barari Sawadkohi Rahim Mosaiebnia Gatabi Zahra Poornasrollah Mohammad Mirzapour Mohaddeseh Non-Communicable pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, Iran Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sceinces, Babol, Iran Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sceinces, Babol, Iran Babol University of Medical Sciences, Babol, Iran. Non-Communicable pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, Iran Non-Communicable pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, Iran. 1 1 2014 5 1 30 34 18 12 2013 18 12 2013 Abstract Background: Infectious diarrhea is one of common cause of children diarrhea causing mortality and morbidity worldwide. This study was performed to identify the common bacteria and their antimicrobial susceptibility in children with diarrhea. Methods: Children under 14 years old with acute diarrhea who referred to Amirkola Children’s Hospital, Mazandaran, North of Iran, were enrolled during the summer and fall of 2009. From each patient, two fecal specimens were collected. Samples were cultured and bacterial isolation was done by conventional methods. Antimicrobial susceptibility was identified by disk diffusion and micro dilution methods. Results: One hundred-seventy two patients with the mean age of 41.8±37.6 months were evaluated. The bacteria were isolated in 48 (27.9%) cases. The most common isolated bacteria was E.coli and then shigella in both bloody and nonbloody diarrheal patients. There was a significant difference between bacteria positive specimens and WBC in stool smear (p=0.003). All isolated shigella were susceptible to Ceftizoxime and ciprofloxacin and were resistant to Cefixime. Resistant to Nalidixic acid was seen in 14% of them. Conclusion: The results show that E.coli was the most frequently isolated pathogen in children with bloody and nonbloody diarrhea. Ceftizoxime is a good antibiotic for shigellosis in children in our area but Cefixime is not appropriate. 40 Infectious Diseases Clinical profile of classical Fever of unknows origin (FUO) Mir Tanveer Dhobi Gulam Nabi Koul Ajaz Nabi Saleh Tajamul - Department of Medicine, Division of Infectious Diseases, sheri-Kashmir Institute of Medical Sciences, India. Department of Medicine, Division of Infectious Diseases, sheri-Kashmir Institute of Medical Sciences, India Department of Medicine, Division of Infectious Diseases, sheri-Kashmir Institute of Medical Sciences, India. Department of Medicine, Division of Infectious Diseases, sheri-Kashmir Institute of Medical Sciences, India. 1 1 2014 5 1 35 39 18 12 2013 18 12 2013 Abstract Background: The etiology of fever of unknown origin (FUO) may differ from different countries. This study was conducted to evaluate the etiology of FUO in patients attending SKIMS, a tertiary care teaching hospital, at Srinagar, Kashmir, India. Methods: From July 2010 to September 2012, this study was done to examine the profile of patients with FUO. The classic FUO was defined as three outpatient visits or three days in the hospital without elucidation of cause of fever. Infectious agents, collagen vascular diseases and hematological malignancies as well as other etiologies were investigated when appropriate. The data were collected and analyzed. Results: A total of 91 cases (62 males and 29 females), with age ranging from 16 to 80 years were investigated. The mean duration of fever before hospitalization was 26±4 days. The etiology of FUO was delineated in (66%) of cases, whereas, (25%) remained undiagnosed. Most common group of FUO was that of infectious diseases (44%) followed by collagen vascular diseases and malignancies (12 % each). Amongst the infection group, brucellosis and salmonellosis comprised the majority of cases (25% each). Conclusion: Infections are the most common cause of FUO followed by collagen vascular diseases in our region. 41 Infectious Diseases Status of Vitamin-D in diabetic patients Bayani Mohammad Ali Ghadimi Reza Akbari Rogheyeh Saeedi Fayyaz Banasaz Bahar Department of Endocrinology, Babol University of Medical Sciences, Babol, Iran. Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran Department of Nephrology, Babol University of Medical Sciences, Babol, Iran. Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran. Babol University of Medical Sciences, Babol, Iran 1 1 2014 5 1 40 42 21 12 2013 21 12 2013 Abstract Background: Vitamin D (vit D) deficiency has been found to have an inverse relationship with the occurrence of type-2 diabetes mellitus (DM). The aim of this study was to assess the vit D level in type-2 diabetic patients. Methods: One hundred-twenty DM patients selected as case group and 120 healthy individuals as control group were investigated in this study from October 2011 to September 2012 in Shahid Beheshti and Ayatollah Rouhani teaching hospital in Babol, North of Iran. Both groups were matched regarding age and gender. Serum levels of 25(OH)-vitamin D were measured in both groups. The data were collected and analyzed. Results: The mean age of the case group was 51.2±7.98 and in control group was 50.6±7.73 years. The mean concentration of vit D in the case group was 18.7±10.2 and in the control group was 24.6±13.5 ng/dl (p=0.002). The mean concentration of vit D in male subjects in both groups were equal but in women with diabetes was lower than the healthy women (19.3±11.9 versus 27.03±10.28 ng/dl, respectively) (p=0.0001). In diabetic patient vit D level was deficient in 77 (64.2%), insufficient in 30 (25%) and sufficient in 13 (10.3%) patients. In the healthy group, these parameters were seen in 44 (36.6%), in 46 (38.4%) and in 30 (25%) patients. Conclusion: The results show that vit D concentration was significantly lower in diabetic patients than the healthy individuals. Although the mean concentration of vit D in males in both groups was equal but in the women with diabetes was lower than the healthy women. 42 Infectious Diseases Meigs' syndrome with elevated serum CA125 in a case of ovarian fibroma /thecoma Yazdani Shahla Alijanpoor Abolhasan Sharbatdaran Majid Bouzari Zinatossadat Abedisamakoosh Mohammad Lakaieandi Faranak Mohammadpour Mehdi - Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran Department of Surgery, Babol University of Medical Sciences, Babol, Iran - Department of Pathology, Babol University of Medical Sciences, Babol, Iran Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran. Department of Nephrology, Mazandaran University of Medical Sciences, Sari, Iran. Babol University of Medical Sciences, Babol, Iran. Babol University of Medical Sciences, Babol, Iran. 1 1 2014 5 1 43 45 21 12 2013 21 12 2013 Abstract Background: CA125 levels in Meig’s syndrome can increase or be normal which an unusual laboratory condition is. In this paper, we present a case of Meigs’ syndrome associated with increased CA125 level due to ovarian fibroma / thecoma. Case presentation: A 50-year old Iranian woman presented with fever, abdominal pain and distention and in imaging assessment, a 90×109 mm heterogeneous pelvic mass with free abdominopelvic fluid was reported. Pleural effusion was detected in CXR. Aspiration of ascetic fluid showed no evidence of malignancy. CA125 level was greater than 600 IU/mL. The patient went under laparotomy in which a 120×100 mm mass was detected in her left adnexa attached to colon, bowels and bottom of pelvis. Histology reported ovarian fibro/ thecoma. The mass was resected and after that, the symptoms disappeared and CA125 level reached to 15 IU/mL. The patient had no problem after 18 months of follow up. Conclusion: Meigs’ syndrome should be considered at the differential diagnosis for a patient with pelvic mass, pleural effusion and ascites with normal cytology, increased CA125 levels. 43 Infectious Diseases Alendronate-Related Femoral Fracture in a premenopausal glucocorticoid treated patient Mobini Maryam Department of Rheumatology, Mazandaran University of Medical Sciences, Sari, Iran. 1 1 2014 5 1 46 48 21 12 2013 21 12 2013 Abstract Background: Alendronate is a bisphosphonate that is approved to reduce bone loss in glucocorticoid treated patients. In this paper, we present a case of femoral fracture following the use of Alendronate. Case presentation: A- 46 year old woman who was a known case of hemolytic anemia has been treated by prednisolone (with different doses from 7.5 to 75 mg/day), calcium-D 500 mg/day and alendronate 70 mg/week for 3 years. Despite improvement of bone density, she experienced a low truama femoral shaft fracture. Conclusion: This case shows a rare complication of treatment by alendronate. It may be needed to evaluate patients with long term usage of bisphosphonates for cortical thickness. 44 Infectious Diseases Nasal tuberculosis in a 56 year old woman Alavi Seyed Mohammad Nashibi Roohangiz Jundishapur Infectioous and Tropical Diseases Research Center, Jundishapur University of Medical Sciences, Ahvaz, Iran. Department of Infectious Diseases, Jundishapur University of Medical Sciences, Ahvaz, Iran. 1 1 2014 5 1 49 51 21 12 2013 21 12 2013 Abstract Background: Nasal tuberculosis (NTB) is rare, but it can be caused by either a pulmonary disease or a retrograde involvement of the nose by lupus vulgaris of the facial skin. In this study, we present a case of NTB with an ulcerative lesion in her left nasal cavity. Case presentation: A 56 years old woman presented with an ulcerative lesion in her left nasal cavity. The patient exhibited no clinical evidence of any systemic diseases. Peripheral leucocyte count (CBC) was normal but erythrocyte sedimentation rate was elevated. Mantoux' test elicited 25 mm reaction after 72 hr. Chest x-ray was normal. Pathological evaluation of the lesion revealed the caseating granulomas, epithelioid cells, lymphocytes, and a few giant cells. These findings suggested a diagnosis of tuberculosis. The patient was cured after 6 months treatment with standard regimen of tuberculosis. Conclusion: Although, nasal tuberculosis is rare, it should be considered in the differential diagnosis of patients with chronic nasal symptoms and ulcerative lesions of the nose. 45 Infectious Diseases Circadian variation in onset of stroke in a university Hospital in Babol, North of Iran Ahmadi-Ahangar Alijan Meskini Leila Rostami Ghadi Mehdi Zarghami Amin Department of Neurology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran. Babol University of Medical Sciences, Babol, Iran. Babol University of Medical Sciences, Babol, Iran Student Research Committee, Babol University of Medical Sciences, Babol, Iran 1 1 2014 5 1 52 53 21 12 2013 21 12 2013 . 46 Infectious Diseases Health Education still needs the Knowledge level and Attitude of Male Students about HIV/AIDS Mouodi Simin Seyedi Andi Seyed Jalil Javanian Mostafa Jahanian Iman Rezaei Rozita Shirkhani Kelagari Ziba Ghazinezhad Neda Education Development Center, Babol University of Medical Sciences, Babol, Iran Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran Education Development Center, Babol University of Medical Sciences, Babol, Iran Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran. Babol University of Medical Sciences, Babol, Iran Shahid Beheshti Hospital, Mazandaran University of Medical Sciences, Iran, Noshahr 1 1 2014 5 1 54 55 21 12 2013 21 12 2013 .