29 1029-7855 Kashan University of Medical Sciences 189 General Prevalence of sick building syndrome (SBS) in employees of Ministry of Housing and Urban Development, summer 2002 Sadeghniat Khosrow PourYaghoub Gholam Reza Saberi Hamid Reza Hanachi Pirouz 1 7 2004 8 2 1 6 02 11 2008 Background: Our knowledge of diseases and maladies has been increased during the recent decades. These diseases are related to the presence of people in the buildings which may cause due to varieties of physical, biologic, and chemical (organic or inorgicic) factors. We decided to investigate one of these problems, namely sick building syndrome (SBS) in one of high administrative buildings in Tehran in summer 2002. Materials and methods: It was a descriptive study. All employees working in the Ministry of Housing and Urban Development were included. Personal complaints of mental and irritative symptoms were assessed using a combined questionnaire (Questionnaires of CCOHS-2001 and London Center Hazards-1990). The prevalence of SBS of determined and the association between human, environmental and building factors with the occurrence of this phenomenon was clarified. Results: Of 312 employees, 171 were randomly selected. There were 96 males (56.1%) and 75 females (43.9%). The prevalence of SBS was 58.7%. The most prevalent symptoms were fatigue (57.3%) during the past 3 months. The most prevalent irritative symptoms were burning sensation in the eyes and tearing (25.7%). The prevalence of SBS was 46.3% in males and 72% in females (p<0.001). Feeling of low air movement (68.4%), and feeling of airless environment (59.1%, always) were the most common complaints. There was no significant association between SBS and smoking, age, different stages, and duration of employment. Conclusion: The prevalence of SBS is quite high. Disorders of ventilation system are the probable cause.
175 General The study of cell surface glycoconjugate of polyp and adenocarcinoma of colon by lectin histochemistry Arab Mohammad Reza Sarani Shir Ahmad Karimi Mehrbod Khamari Mohammad Reza 1 7 2004 8 2 7 14 02 11 2008 Background : Because of bad prognosis, nonspecific signs and high incidence, carcinoma of the colon is one of the leading cause of cancer-related mortality. Recent studies have proposed the role of cell surface glycoconjugate in the course of neoplasia changes. These compounds are used to clarify early diagnosis, prognosis, biologic behaviour of neoplastic cells, and of course, an appropriate therapeutic approach. The aim of the present study was to identify the Gal/GalNac in cell surface glycoconjugate of polyp and adencocarcinoma of colon. Materials and methods : It was a descriptive study. Pathologic blocks of 47 patients with polyp and adenocarcinom of colon admitted to Khatam-Al-Anbia hospital in Zahedan were reviewed. Having confirmed the diagnosis, 5-7 m m sections were prepared form suitable paraffin blocks of 10 patients (5 polyp & 5 adenocarcinoma) and lectin histochemistry using PNA staining was achieved (lectin dilute 10 m g/ml in PBS 0.1 M, pH = 6.8 and alcian blue pH=2.5). Results : Results showed existence of Gal/GalNac in entrocytes of polyp cells in region of nuclei and supranuclear portion of the cytoplasm. However, cancerous cells showed the presence of this terminal sugar principally in luminal surface and intraluminal secretion of glandular components. The cell-reaction to lectin was higher in neoplastic cells than entrocytes of polyp. Therefore the existence of Gal/GalNac was confirmed in cytoplasm of entrocytes of polyp and luminal surface of neoplastic cells in adenocarcinoma of colon. Conclusion : Results have revealed that the degree and location of reactivity of cells to lectins were changed in neoplasia. 187 General The effects of glucose, breast milk and lidocaine cream on acute pain of arteriopuncture in term neonates Malekan Rad Elahe Momtazmanesh Nader Barkatin Reihane 1 7 2004 8 2 15 19 02 11 2008 Background: Prior studies have proposed that neonates do feel pain. Venepuncture is one the most painful procedures for neonates. There are several ways to eliminate this pain. The present study was conducted to compare the effects of glucose 33%, breast milk and lidocaine cream on acute pain of arteriopuncture in term neonates hospitalized in Shabih Khani and Shaheed Beheshti hospitals in Kashan. Materials and methods: A clinical trial was performed on 120 term neonates. They were assigned in four groups (each 30). First group underwent blood sampling without any particular treatment. Blood sampling was performed after 2cc of breast milk in the second, 2cc of glucose 33% solution in the third and application of a thin layer of 2% lidocaine cream in the fourth group, respectively. During the blood sampling process DAN score and crying period were determined. Results: The mean crying period were 65.33±45.97, 48.83±35.78, 18.60±16.65, and 24.67±23.19 in the control, breast milk, Lidocaine cream and glucose groups , respectively (p<0.0001). DAN score showed a significant difference between groups according to the Kruskal-Wallis analysis (p<0.0001). Conclusion : Both glucose solution and lidocaine cream decreased pain severity and crying period, however, due to safer state of glucose solution, it is more strongly recommended. 177 General Diagnostic value of colposcopy for identifying precancerous lesions of cervix in patients with abnormal pap smear Behnamfar Fariba Khamechian Tahere Shishehgar Monire 1 7 2004 8 2 20 24 02 11 2008 Background: Cervical carcinoma was among the most common neoplasm of females. Screening and diagnostics tests are widely used to identify the precancerous lesions. The present study was conducted to determine the diagnostic value of colposcopy for identifying precancerous lesions of cervix in patients with abnormal pap smear referring to ShabihKhani hospital in Kashan during an academic year. Materials and methods: This clinical trail was performed on 100 females with abnormal pap smear. They all underwent colposcopy and punch biopsy. They were assigned in two groups of positive negative according to the findings of colposcopy and biopsy. Results : The mean age of the candidates was 44.6±13.3 years. Colposcopy has a sensitivity of 79.2% and specificity of 63.8%. Positive and negative predictive values were 71.2% and 73.2%, respectively the total accuracy of the colposcopy was 72%. Colposcopy has shown higher sensitivity for high grade lesions. Conclusion : Results have revealed that colposcopy could not identify precancerous lesions regardless of punch biopsy and cytology. With respect to the adequate sensitivity of colposcopy in high grade lesions, one could only rely on colposcopy findings when it reveals a high grade lesion. This screening technique is valuable for patient follow up in low grade lesions and diagnose of high grade lesion before the therapeutic approach 185 General Diagnostic value of cold agglutinin test in tuberculosis Khalifeh Soltani Sayed Ahmad Talari Safar Ali Valaie Naser Shahsenaei Vahid Farmani Mahdi Jafarpour Mohsen 1 7 2004 8 2 25 30 02 11 2008 Background: Tuberculosis (TB) is a common disease in our society for which acute diagnosis is rather a time-consuming process. Early diagnosis is of utmost importance. Cold agglutinin could serve as a diagnostic modality in patients with TB, thus, the present study was conducted to determine the efficacy of this test in patients with TB and their control group hospitalized in Shaheed Beheshti hospital in Kshan. Materials and methods: The study population included 36 cases of TB and 65 non-TB patients. Blood sample (1ml) was obtained and cold agglutinin test was achieved on bed side. Positive agglutinin test was defined as clumping of RBCs in test tube walls and graded as +1 to +4. Absence of RBC agglutinin was considered as negative test result. Finally, sensitivity, specificity, positive and negative predictive values (PPV, NPV) of cold agglutinin was determined in accordance to the definite diagnosis of TB. Results: The TB group included 18 males and 18 females with the mean age of 50.8 years (13-86 years), of whom, 69.5% had pulmonary TB and 30.5% had extra pulmonary TB. If strongly positive cold agglutinin test results are considered, it may have sensitivity of 44.4%, specificity of 98.5%, PPV of 94.1%, NPV of 76.2% and total accuracy of 79.2%. However, if relatively positive results (grade <+3) are considered the sensitivity and specificity may change, improving sensitivity up to 89%. Conclusion: Cold agglutinin test has an acceptable PPV for TB diagnosis. Thus, it could be used as a screening test or as a diagnostic modality in early stage of the disease or even to evaluate the success of treatment. 176 General Evaluation of cholesterol and lipoprotein of pleural fluid and their correlation with pleural permeability coefficient in patients with exudative or transudative pleural effusion Razi Ibrahim Abedi Samakosh Mohammad Moosavi Sayed Gholam Abbas 1 7 2004 8 2 31 40 02 11 2008 Background : Cholesterol and lipoprotein level of pleural fluid and their correlation with serum level is of utmost importance in differentiating exudative form transudative pleural fluid. The present study was conducted in patients with pleural fluid referring to Shaheed Beheshti hospital in Kashan during a two-year period. Materials and methods : It was a cross sectional study. Light's criteria were used to differentiate exudative and transudative pleural fluid. Cholesterol and lipoprotein levels of pleural fluid and serum were determined using the standard techniques and their correlation was calculated by Pearson method. T-test and Mann-Whitney were used for data analysis. Results : The study population included 52 males and 67 females with the mean age of 63.5±15 years. Pleural effusion was exudative in 70 (58.8%) patients and transudative in 49 (41.2%). Pleural fluid cholesterol level were 29±16 and 65±25 in transudative and exudative group, respectively (p<0.001). Pleural fluid cholesterol level (transudative and exudative) depends on their serum level as well as the ratio of pleural fluid to serum protein (for exudative r=0.61, p<0.001, and for transudative r=0.62, p<0.001). Correlation coefficient of LDL, HDL, VLDL, and triglyceride of exudative pleural fluid with the ratio of pleural fluid to serum protein were 0.53 (p<0.001), 0.40 (p=0.01), 0.29 (p=0.01), and 0.29 (p=0.02), respectively. These figures were 0.48 (p<0.001), 0.24 (p=0.09), 0.09 (p=0.52) and 0.04 (p=0.79) respectively for transudative pleural fluid. The percentage of cholesterol associated with LDL and HDL in exudative and transudative pleural fluid were 90 and 89, whereas their serum percentage were 83 and 86. Conclusion : Pleural fluid cholesterol level (transudative and exudative) depends on their serum level as well as the ratio of pleural fluid to serum protein. With respect to the unchanged level of pleural fluid lipoproteins, determination of pleural fluid cholesterol level may help us to differentiate exudative from transudative pleural fluid. In exudative pleural effusion the pleural fluid lipoprotein level depends mainly on the ratio of pleural fluid to serum protein, however, in transudative state LDL level depends on this ratio. 178 General Role of acetic acid in prevention of pathogens in suppurative chronic otitis media in Milad hospital in 2003 Fattahi Ali Fathololoumi Mohammad Reza 1 7 2004 8 2 41 44 02 11 2008 Background: Suppurative chronic otitis media (SCOM) is a disease associated with tympanic membrane perforation and pus secretion. Varieties of medications have been applied as oral, local, or even IV preparations to eradicate the infection. Some investigators have used acetic acid 1% or 2% alone or in combination with other drugs. In the present study we have compare the efficacy of acetic acid over the SCOM pathogens. Materials and methods: It was a clinical trial. Samples were collected from ear secretions of 96 patients with SCOM. Isolated microorganisms were cultured in the presence of acetic acid 1% and 2%. Results: Of 100 samples, 20 microorganisms (19 pathogens) were isolated among which 16 bacteria and 3 fungi were identified. Having exposed to acetic acid 1%, 10 microorganisms, including 8 bacteria and 2 fungi, failed to grow, however, none of the aforementioned microorganisms grow following the exposure to the acetic acid 2%. Conclusion: Results have revealed that acetic acid 2% have been applied as an appropriate bactericidal and fungicidal agent in SCOM patients. Further studies dealing with the side effects of acetic acid are highly recommended 183 General Prevalence of Iarge intestinal Nematodes of rumenant in Slaughterhouse of Kashan Talari Safar Ali Arbabi Mohsen 1 7 2004 8 2 45 50 02 11 2008 History and Objective: Considring the role to importance economic and helth of large intestinal nematodes in domestic animals and lack of information on its Condition in lran, this study was carried out to determine large intestinal nematodes of domestic animals slaughtered of Kashan. Materials and Methods: The descriptive and randomized strategy of this study was conducted on 195 digestive tract from 80 sheep, 78 goats and 37 caws from different agricultural regions of Iran, Animal’s characteristies and microscopic findings were recorded in special form. Data were calssified and statistically analyzed. Results: A total of 195 Iarge intestinal tracts, 80 sheep, 78 goats and 37 caws were examined. A nematodes infection rate was Chabertiidae (54%) Ttrichuridae (38.5%) and oxyuridae (7.5%).  The all case in female were more frequently infected than males. The contamination rate of intestinal infection with Trichuris discolor in sheep and goats 95%, 18%, Chbertia ovina 58.8%, 62.8% and in caws Trichuris ovis 1.8%, Oesophagostomum venulosum 10.8% respectively. The contamination rate of Skrjabinema ovis in sheep 25%, goats 39% and caws 8.2% respectively. Conclusians: Due to the relatively high prevalence of intestinal nematodes in rumenants. We suggest further studies to determine the causes and decrease contamination and the role of different factors. 182 General Prevalence of manual removal of placenta and its complications in vaginal delivery Tabasi Zohre Ashrafi Zahra Sadat Zohre 1 7 2004 8 2 51 57 02 11 2008 Background : Manual removal of placenta is a major concern during delivery. Its prevalence and complications vary in our region, thus, the present study was conducted to determine the prevalence of manual removal of placenta and its complications in vaginal delivery in Shabih Khani hospital in Kashan in 2002 and 2003. Materials and methods : This cross sectional study was performed on all parturients referring during the study period. Prevalence of manual removal of placenta, demographic and midwifery factors as well as complications were all recorded. Results : Of 3633 vaginal deliveries with gestational age of greater than 20 weeks, 136 cases (3.7%) referred for evacuating corpus luteum. Manual removal of the placenta was performed due to incomplete placenta or decidua formation in 111 cases (81.6%) and massive bleeding in 6 cases (4.4%). Most of the studied subjects (64.7%) were 20-29 years old, and 8.8% had gestational age of less than 37 weeks. 62 were primigravida and gravidity of ³ 3 was reported in 3 cases (9.5%). Previous history of evacuating corpus luteum was found in 12.5%, uterine scar in 0.7% and manual removal of placenta in 5.4%. Postpartum bleeding was the most common complication (12.5%). Endometriosis was found in 4.4% and uterine rupture and hysterectomy in 0.07% of the cases. Conclusion : High prevalence of evacuating corpus luteum and its complications are matter of concerns. Therapeutic and preventive interventions are highly recommended 179 General Prevalence and risk factors of low birth weight infants in Mahdieh hospital, Tehran Mosayebi Ziba Fakhraee Sayed Hossein Movahedian Amir Hossein 1 7 2004 8 2 58 67 02 11 2008 Background : Low birth weight (LBW) is associated with high mortality and morbidity in neonates. The incidence of LBW varies between societies. The aim of this study was to determine the prevalence and risk factors of LBW infants in Mahdieh Maternity Hospital, in Tehran during an academic year. Materials and methods : In this study all the LBW infants who were delivered alive in Mahdieh Maternity Hospital in 1996 were investigated. Initial data including maternal age, gestational age, parity, prenatal care, mode of delivery, sex, apgar score, cause of admission and death were carefully recorded from medical records. Results : The incidence of LBW was 7.05%. More than half of the LBW babies were premature. The girls to boys LBW ratio was 1.3: 1. In the premature group the mother’s age range was 16-20 years whereas in the intra uterine growth retardation group (IUGR) was 21-25 followed by less than 20 years. Asphyxia and low to moderate apgar score was more common in prematures. The most common maternal risk factors were preclampsia and eclampsia, and urinary tract infection. Forty seven percent of LBW infants were hospitalized. The most common causes of admissions were sepsis and hyaline membrane disease (HMD). The mortality rate was 27.5% and the most important causes of mortality were HMD, asphyxia, and sepsis. Conclusion : The incidence of LBW was within acceptable range. Birth weight is one of the most important factors in neonatal mortality and morbidity. The most important approach to the problem of LBW is prevention. This could be achieved not only by identification of it’s incidence and risk factors but also by improving the living standards and medical care of pregnant women 181 General Traumatic hyphema in 195 cases hospitalized in Farabi hospital in Tehran Nili Ahmadabadi Mahdi Farehvash Mohamamd Sadegh Valaie Naser 1 7 2004 8 2 68 72 02 11 2008 Background: With respect to the prevalence of traumatic hyphema and its well-known complications, a thorough study should be accomplished to draw appropriate therapeutic approaches. The present study was conducted on patients with traumatic hyphema hospitalized in Farabi hospital during a four-year period (1995-99). Materials and methods: For this existing type data study, all medical files of patients with traumatic hyphema hospitalized in our center were reviewed. Initial data including sex, age, visual acuity, severity of hyphema, increased intraocular pressure, and secondary bleeding were recorded. Results: The study population included 195 patients (76.4% males and 23.6% females) with the mean age of 17.3 years. Total hyphema was reported in 61%, increased intraocular pressure (>25mmHg) was found in 44.1% and visible secondary bleeding were reported in 16.9%. Poor vision of less than 1/10 was recorded in 88.2% of the patients. Conclusion: Traumatic hyphema is more common in young males presenting with poor vision. Most of the cases were total hyphema with increased intraocular pressure. Prevention of eye-related trauma should be concerned 188 General Effects of health training on teachers' knowledge of oxyuriasis and giardiasis prevention Rasti Sima Moosvai Sayed Gholam Abbas Ramezani Yadollah 1 7 2004 8 2 73 78 02 11 2008 Background : Oxyuriasis and giardiasis are common intestinal infections in students. Prior investigators have proposed the role of teachers in preventing these problems. The present study was conducted to determine the effects of health training on teachers' knowledge of oxyuriasis and giardiasis prevention in Kashan in 2000. Materials and methods : For this quasi-experimental study, knowledge of 256 teachers towards the nature, transmission and prevention of oxyuriasis and giardiasis was assessed before the training via a questionnaire, then, one month later, after the training, their knowledge was reassessed. Kolmogorov-Smirnov, Wilcoxon and Mann-Whitney tests were used for data analysis. Results : Knowledge score of teachers' towards the nature, transmission and prevention of oxyuriasis and giardiasis prior the training intervention were 3.6±1.1, 3.6±1.2, and 3.4±1.0 respectively. These figures have changed to 4.3±0.9, 1.1±0.1, and 3.9±4.0 following the training respectively (p<0.00001). Training has increased both male and female teachers' knowledge (p<0.00001). Conclusion : Health training has improved knowledge of Kashan teachers' towards the nature, transmission and prevention of oxyuriasis and giardiasis. We recommend continued medical and health education for teachers 184 General A review of surgical approach to pituitary tumors A new approach to sella turcica Vazirnezami Mohsen Shabehpour Masoud Moghadasi Habiballah 1 7 2004 8 2 79 87 02 11 2008 Background : Surgeries of pituitary tumor and sella turcica are among the most common practice of otolaryngologists and neurosurgeons. The present article reviews the historical evolution in endoscopic approach to sellar lesions and of course, introduce a new safer and less invasive approach to sella turcica. Materials and methods : We have searched the medical literature using several keywords regarding the surgical approaches to pituitary tumor and sella turcica since 1889. The weak and strong points of each technique are highlighted and our new approach is also explained. Conclusion : We believe the new approach could significantly reduce the complications and associate with further patient's convenience. 180 General Report of 6 cases with rhinocerebral mucormycosis Nateghian Ali Reza Karimi Abdollah 1 7 2004 8 2 88 96 02 11 2008 Background : With respect to low prevalence of immunocompromised infectious diseases and their related difficulties in diagnosis and treatment, in the present study we review our experience with 3 adult and 3 infant patients with rhinocerebral mucormycosis. Materials and methods : Initial data including demographic features, clinical, laboratory and radiologic manifestations, therapeutic approach and clinical course of 6 cases of rhinocerebral mucormycosis were reviewed. Three patients died and 3 improved. Conclusion : Diabetes mellitus and metabolic cirrhosis were the most common predisposing factors. Rhinocerebral manifestations were present in all patients. Biopsy was the gold standard for diagnosis and the most efficient therapeutic approach is appropriate usage of immunosuppressive agents 186 General Pancytopenia following vaccination against measles and rubella Mahram Manoocheher 1 7 2004 8 2 97 100 02 11 2008 Background: Based on the absence of previous case report of bone marrow aplasia following vaccination against measles and rubella, the observation of one case is hereby reported. Case presentation: The patient was a 9-year-old boy, from one of the rural areas of Zanjan province, who was vaccinated against measles and rubella during the National Program for MR Vaccination. The patient was hospitalized due to skin rash after 10 days. Laboratory studies indicated the decrease of all cellular rows in CBC and aplasia of bone marrow in all cellular precursors. There was no similar case in the patient's family and no history of contact with known risk factors related to bone marrow apalsia has been recorded. The patient undertook coma owing to cerebral hemorrhage and finally died after 3.5 months. Conclusion: The occurrence of bone marrow aplasia is taken into consideration following vaccination against measles and rubella. Similar case reporting and etiologic assessment is recommended.