@article{ author = {Falah, S.H and Mehdinia, S.M and Hydarieh, M and Abasi, A}, title = {Survey the Level of Nitrite and Nitrate in Semnan Drinking Water Resources}, abstract ={Abstract Introduction: Nitrite (NO2) and Nitrate (NO3) compounds are the pollutants in ground water and due to developing of agriculture and man's activities, their average rate is increasing: These materials are absorbed rapidly in the first parts of small intestine and then enter the blood. In blood, NO2 is changed into NO3 and through a process, Hb is changed into methemoglobin and Hb is unable to join with O2 and CO2, as a result O2 can not be transferred into tissues and lungs. Objective: This study aimed to survey the level of Nitrite and Nitrate in Semnan drinking water resources in 2002. Materials and Methods: In this research, the rate of NO2 and NO3 in Semnan drinking water was measured in all seasons using Spectrophotometer DR 2000has. Sampling was performed in all drinking resources in Semnan city (120 samples). Results: Nitrite concentration measurement in spring was higher than the WHO’S standards (0.2 ppm) in all resources. This variable was also higher in well NO.1 in the east north and also the Seda-o- Sima’s well which was more than the WHO’S instructions. In autumn, the NO2 concentration rate in Seda-o-Sima’s well was higher than the WHO’S standard. In winter, it was less than WHO’S standard. Nitrate concentration in Seda-o-Sima’s well in spring was in the classification of the polluted waters (26 ppm), and the rest of sources were considered as little polluted (less than 20 ppm). In summer all resources had little polluted water. In fall, the Seda-o-Sima’s well was polluted (22 ppm). In winter, all of them were little polluted. Conclusion: In attention to the categorization of little polluted water with nitrate less than 20ppm, all drinking water resources in Semnan except Seda-o-Sima’s well, in all seasons were considered polluted. While Seda-o-Sima’s well, all categorized as polluted water in spring and autumn, but in summer and winter Seda-o-Sima’s wells categorized as little polluted. Also Seda-o-Sima’s well is more polluted with nitrite and nitrate in comparison with the other Semnan drinking water resources.}, Keywords = {Methemoglobina, Nitrates, Nitrites,Water Pollution}, volume = {15}, Number = {60}, pages = {1-6}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-407-en.html}, eprint = {http://journal.gums.ac.ir/article-1-407-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {BaghabanEslamiNezhad, M.R and RezazadehValojerdi, M and Ashtiani, S and EftekharYazdi, P}, title = {Ultra Structure of Human Uterine and Oviduct Epithelial Cells Cultivated Under the Same Culture Condition}, abstract ={Abstract Introduction: Extra cellular matrix (ECM) as an important component of cellular microenvironment has a key role in maintaining the differentiated state of cells. Effects of ECM on morphologic differentiation of epithelial cells including those from uterus and oviduct has been shown in past studies in which cellular and hormonal factors have been used in addition to ECM to maintain epithelial cell differentiation. Not much attention has been paid, in these studies about the ultra structure of cultured cells specially those from oviduct. Objective: The purpose of present study is to cultivate the human uterine and oviduct epithelial cells under the same microenvironment (ECM Gel and DMEM/Ham's F12 medium) and to observe and compare ultra structural characteristics of the cultured cells by transmission electron microscopy (TEM). Materials and Methods: For this purpose, uterine and oviduct tissue were obtained from patients undergoing total hysterectomy in Emam Khomeini Hospital. Epithelial cells, after being isolated, were cultured on plastic surfaces and the epithelial nature of the cells was confirmed using immunocytochemistry. Cells with epithelial nature were trypsinized and cultured on ECM gel. At the end ultra structure of cells in parallel with tissue were prepared for TEM. Results: Our results showed that the plastic cultured cells have no signs of differentiation and appeared as elongated spindle cell in sections, whereas those cultured on ECM gel had highly differentiated structure and observed as columnar in shape. In this term they were very similar to epithelial cells from tissue fragment. Epithelial cells of oviduct, cultured on ECM gel, were noticed ultra structurally very similar to that from uterus. The main structural difference existed in vivo state (the presence of abundance cilia on apical surface of oviduct epithelial cells) were not observed in vitro. Conclusion: As a conclusion, it seems that ECM gel by itself is enough to induce morphologic differentiation and structural polarization of epithelial cells.Uultra structurally different cells grows and acquires the same structure when being cultured under the same microenvironment.}, Keywords = {Epithelial cells, Exracellular matrix}, volume = {15}, Number = {60}, pages = {7-17}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-408-en.html}, eprint = {http://journal.gums.ac.ir/article-1-408-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {Modabernia, M.J and ShojaeeTehrani, H and Jalaly, H}, title = {The Study of Mean Changes in Fasting Glucose Level and BMI in Psychotic Patients Treated with Olanzapine in Shafa Hospital and Private Clinics of Rasht in 2005-2006}, abstract ={Abstract Introduction: New anti psychotic drugs (atypical) have fewer extra pyramidal adverse effects and more therapeutic effects in comparison with the old ones. There is no agreement on the effects of new antipsychotics on the BMI and rising blood glucose. Objective: This study was done to investigate above adverse effects (raising blood glucose and BMI) in the psychotic patients who were treated with Olanzapine in Shafa hospital and private clinic during 2005-2006. Materials and Methods: In this descriptive- analytic (study a population in two periods of time) 150 individuals who referred to previous mentioned centers were chosen. Inclusion Criteria were: diagnosis of psychosis according to DSMIV, using Olanzapine as treatment and having FBS less than 110 mg/dlit. Exclusion criteria included: those who had inadequate response or had no tolerance to Olanzapine, users of other psychothropic and substance and those who had received long term Antipsychotics during the last month. Their BMI and fasting blood glucose were measured before and after the study. More over, some variables such as the history of Diabetes Mellitus in the family, type of psychosis, gender and age were asked through an specific questionnaire which had been designed for this purpose. Then we collected the data in two periods. These data were analyzed through SPSS 11/5 while using the appropriate statistical tool and α=0.05 was accepted. Results: From total 150 individuals, 79(52/7%) were female and 71(47/3%) were male. 16 of them had a FBS more than 110 mg/d lit. 11(7/33%) individuals showed Diabetes and 5(3/33%) individuals showed some disturbance in FBS. There were significant difference between the mean changes of blood glucose (paired t p<0.0001) and also average body mass index changes (paired t p<0/0001) before and after treatment was statistically significant. There were no significant correlation between changes of body mass index and fasting blood glucose in base and end point (p=0/218,0/249). Among studied variables, the most significant relationship statistically was with changes of FBS and Olanzapine 10 mg a day (p<0.006) and ages over 45 (p<0.006). Changes of fasting blood glucose had a marginal relationship with schizophrenia (p=0.55), and the other variables (such as gender, family history of Diabetes) had no statistically significant relationship with the changes of glucose level. There was also no relationship between the gender and the incidence of diabetes (p=0.68) There are significant difference between changes of FBS and using more than 10 mg daily Olanzapine(p<0/006) and also between changes of FBS and ages over 45(p<0.006) and schizophrenic patients (p=0.055). Conclusion: This study demonstrated that mean changes of fasting blood glucose and BMI after using Olanzapine in psychotic patients is statistically significant. Prescription of Olanzapine in schizophrenic patients who are over 45 and those who use more than 10mg a day of Olanzapine should be done more cautiously. Additional investigation by using clinical trial would offer more precise results.}, Keywords = {Anti psychotic Agents, Blood Glucose, Body Mass Index, Olanzapine, Psychotic Disorders}, volume = {15}, Number = {60}, pages = {17-25}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-409-en.html}, eprint = {http://journal.gums.ac.ir/article-1-409-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {Soori, H and Rahimi, M and Mohseni, H}, title = {Epidemiological Pattern of Job Stress Among Managers of Car Manufacture Companies in Iran}, abstract ={Abstract Introduction: Management is one of high stress occupations but little attention has been paid to occupational stresses among manufacturing managers. Objective: The goal of this study is to determine the epidemiological pattern of occupational stress among 70 SIPA industrial companies. Materials and Methods: Stress was assessed according to different criteria’s with a self- completed questionnaire in-group meetings. Results: Mean age of samples (440 managers) was 43.6 years (SD= 7.3) and their mean job experience was 12.1 years (SD=7.7) the level of occupational stress was 49.5%. The top four stressors were stress due to decision making at work (99.1%), time pressure (97.3%), and time- table and scheduling (73.5%). There was a significant difference between overall occupational stress of managers and age (P=0.001) and younger managers were more at risk of occupational stresses. Conclusion: Occupational stresses have undesirable effect on people and it is necessary to control and prevent stress among young managers by proper interventional programs on personal and institutional level.}, Keywords = {Administrative Personnel, Industry, Stress }, volume = {15}, Number = {60}, pages = {26-35}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-410-en.html}, eprint = {http://journal.gums.ac.ir/article-1-410-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {Golestan, M and AkhavaneKarbbasi, S and SadreBafghi, M and BehjatiArdakani, M and ModareseMosadegH, M and Eslami, Z and Falah, R}, title = {Comparing the Antipyretic Effectiveness of Oral and Rectal Acetaminophen in Children}, abstract ={Abstract Introduction: Acetaminophen is the most commonly used drug for temperature reduction in febrile children, which is used orally or rectally. The effectiveness of rectal versus oral Acetaminophen is not well established. Objective: This study is designed to compare the antipyretic effectiveness of rectal acetaminophen dose 15mg/kg to the standard oral dose of 15mg/kg. Materials and Methods: A randomized clinical trial was performed on 60 patients aged 6 months to 6 years with fever≥39° rectally. The patients were randomly assigned in one of two groups. First 39°c group received 15mg/kg Acetaminophen rectally and the second group received same dose orally and their body temperature was measured one and three hours after Acetaminophen administration. Results: The mean temperature reduction, 60 and 180 minutes after use of acetaminophen were 1.07± .0.16 and 1.74±0.25. Conclusion: Effectiveness of oral and rectal Acetaminophen with 15mg/kg dose is similar in decreasing children’s fever. Standard (15mg/kg) oral and (15mg/kg) rectal acetaminophen has similar antipyretic effectiveness.}, Keywords = {Acetaminophen, Fever }, volume = {15}, Number = {60}, pages = {36-41}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-411-en.html}, eprint = {http://journal.gums.ac.ir/article-1-411-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {Darvishpour, A and Lotfi, M and Salehi, F and Aghazadeh, A and hasani, A and Aali, N}, title = {Comparing Dressing with Silver Sulfadiazine and Nitrofurazone on Burn Wound Infection Among the Patients Admitted to the Pediatric Burn Ward in Tabriz, 2005}, abstract ={Abstract Introduction: Burns are among the main public health problems throughout the world especially in the developing countries. In Iran burn injuries causes significant morbidity and mortality, especially among the pediatric population. Infection remains the most common cause of death in the severely burned patients. The proper use of topical antimicrobial agents decreases the occurrence of bacterial resistance and sepsis. Objective: The purpose of this study was to compare two topical antimicrobial agents, Silver Sulfadiazine and Nitrofurazone, with respect to the rate of healing, infection and their treatment. Materials and Methods: This study was a quasi-experimental study that used convenience sampling for 5 months on 60 cases that were admitted in the pediatric burn ward at the burn center of the Sina hospital, Tabriz, East Azarbijan, in 2005. Research population consisted of children who were admitted in this center and from among them the patients who met the characteristics of research samples were selected after explaining the study to their parents and receiving their permission. They were allocated in random into two groups (control and experimental). The tools were a questionnaire and a checklist. In this research one group was dressed with Silver Sulfadiazine cream and another group with Nitrofurazone and they were replaced once per day. For burn status assessment, in dressing change time, the wounds were considered regarding to the infection criteria and presence of epithelialization and granulation tissue. Also for each patient, bacterial cultures were taken three times by a swab. Descriptive and analytical statistics were performed using the χ2-test and T-test by means of SPSS software (version 11.5). Results: Statistical analysis didn’t show any significant difference between the two groups with regard to clinical signs of infection (P= 1.000) and microbiological study (P= 0.739). Also there wasn’t any significant difference between two groups with regard to re-epithelialization time (P= 0.763), hospitalization days (P=0.818) and cost of confinement (P= 0.969). Conclusion: In this study, our hypothesis based on a difference between two topical antibacterial agents was rejected and it was seen that the efficacy of two drugs (Silver Sulfadiazine 1% cream and Nitrofurazone) were parallel. It indicated that over use of one drug can’t be a reason for its efficacy. It seems that more attention should be paid on selecting the drug for burned patient treatment.}, Keywords = {Burns, infection, Silver Sulfadiazine, Nitrofurazone}, volume = {15}, Number = {60}, pages = {42-49}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-429-en.html}, eprint = {http://journal.gums.ac.ir/article-1-429-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {Aghajanzadeh, M and Kohsary, M.R and Safarpoor, F and Ghanbari, A and Riazi, H and Hemati, H and Tuzandehjany, H}, title = {Evaluation of Transhiatal Esophagectomy for Esophageal Cancer}, abstract ={Abstract Introduction: Esophageal cancer is an invasive tumor with a poor prognosis. Unfortunately, this malignant tumor has a considerable prevalence in north part of Iran, especially near the Caspian Sea. It is also an important cause of cancer-related mortality. Surgery is the most effective approach for cure and also is used for palliation. Transhiatal esophagectomy is a popular method of resection with a low morbidity and mortality. Objective: We designed this study to document the clinic pathologic characteristics of patients undergoing this procedure for esophageal cancer and to determine the contributing factors survival of patients. Materials and Methods: This descriptive study was performed between 1993 and first half of 2003 on 162 patients in Rasht Razi hospital. Patients’ medical records were surveyed regarding their age, sex, stage of dysphagia, complications of surgery, mortality, stage of cancer and level of survival. Data were analyzed by EPI-6 software. Results: There were 102 male and 60 female patients. The mean age of patients was 57 years. 29.1% of them were urban versus 70.9% who were rural. The most frequent presenting symptoms were dysphagia (100%). The most common site of tumor was lower third of esophagus (56%) and cardia) 22%). 47.1% of patients required tube thoracostomy after surgery.9.8% of patients were splenectomized because of splenic injury. Recurrent nerve damage was observed in 4% of patients.18.4% of patient's required mechanical ventilation. Pneumonia, Mediastinitis and Chylothorax was observed in 10, 2 and 2% of patients respectively. 13% had anastomosis leak in neck, which was managed conservatively.83.1% of patients, were discharged from hospital in two weeks. The mean duration of hospital stay was 9.94±4.14 days.14% of patients expired during first month of hospitalization. Survival in 1,2,3,4 and 5 years were 80%, 50%, 40%, 30% and 20% respectively. Conclusion: In this study mortality and morbidity were comparable with previous studies. On the other hand there wasn't any significant difference between results of this procedure and transthoracic approach that is used in other centers. Therefore it is recommended that transhiatal esophagectomy with appropriate selection of patients is the procedure of choice for curative and palliative means}, Keywords = {Esophageactomy, Esophageal Neoplasm’s, Postoperative Complications}, volume = {15}, Number = {60}, pages = {50-57}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-430-en.html}, eprint = {http://journal.gums.ac.ir/article-1-430-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {OmidiKashani, F and Hotekani, A.R}, title = {Distal Soft Tissue Surgery and Proximal Open Wedge Metatarsal Osteotomy in Hallux Valgus}, abstract ={Abstract Introduction: In the moderate and severe cases of hallux valgus with metatarsus valgus, one of the most important parts of surgical technique is proximal metatarsal osteotomy. Objective: In this study, the results of a distal soft tissue procedure and a medial open wedge proximal metatarsal osteotomy were reviewed. Materials and Methods: In this study we operated 22 feet (16 patients) with moderate or severe hallux valgus . In all the patients distal soft tissue procedure were done then with the b::union:: part of the metatarsal head medial open wedge proximal metatarsal osteotomy were done and fixed. Average follow up period was 13 months. Results: 13 patients were female. At follow up 16 feet were free from pain at the first metatarsophalyngeal joint. In 6 feet the pain was improved but persisted. The mean hallux valgus and intermetatarsal angles were 38 and 18 before and 13 and 6 after surgery respectively. The postoperative hallux valgus and intermetatarsal angles in patients who had pain at the first metatarsophalyngeal joint after surgery were greater than those in patients without pain after surgery. Conclusion: This procedure corrects moderate and severe hallux valgus deformity and relieves the symptoms effectively, but careful attention should be paid to the surgical technique to obtain consistent and satisfactory results.}, Keywords = {Hallux Valgus, Metatarsal Bones, Metatarsus,Osteotomy, Tarsal Joints }, volume = {15}, Number = {60}, pages = {58-64}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-431-en.html}, eprint = {http://journal.gums.ac.ir/article-1-431-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {Mansouri, M and Bidabadi, E and Sobhani, A.R}, title = {Relation Of Iron Deficiency Anemia with First Febrile Convulsion In 6 month to 5 year old Children}, abstract ={Abstract Introduction: There are some studies about possible relation between iron deficiency anemia and febrile convulsion. But these results have not shown a definite and convincing answer yet. In attention to high prevalence of anemia and febrile convulsion in children population and its importance that has a preventable nature, this study aims to further survey its possible relation. Objective: This study was carried out to determine the relation of iron deficiency anemia with first febrile convulsion in 6 month to 5-year-old children admitted to Hefdah Shahrivar Hospital, in Rasht in 2006. Materials & Methods: Degree of iron sufficiency parameters including Hemoglobin (HB), Mean Cell Volume (MCV), Mean Cell Hemoglobin (MCH), Plasma Ferritin, Fe and Total Iron Binding Capacity (TIBC) were prospectively measured in 200 children with first FC (FFC) and compared with 200 controls matched regarding age and sex with febrile conditions without convulsion. Results: In our 400 participant febrile children, 233 were boys (58.2%) and 167 were girls (41.8%). Out of 200 children who had febrile convulsion, 118 were boys (59%), and 82 were girls (41%). In convulsion group mean HB (10.481.16), MCV (77.56.6), and MCH (25.32.78) were higher than control group but without any statistically significant differences. Mean Fe 58.5535.35 (P=0.003), Ferritin 100.23114.3 (P=0.005), TIBC 320.8949.4 (P=0.002), were higher in convulsive group with no statistically significant differences. From 184(46%) anemic children, 96(52.1%) were without convulsion and 88 children (47.9%) had convulsion, with no statistically significant differences regarding febrile convulsion and iron anemia and with odds ratio = 1.175 shows anemia doesn’t have any protection for FFC. Conclusion: We found that there was no relation between iron deficiency anemia and First Febrile Convulsion.}, Keywords = {Anemia, Iron Deficiency, Child, Seizures- Febrile}, volume = {15}, Number = {60}, pages = {65-73}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-432-en.html}, eprint = {http://journal.gums.ac.ir/article-1-432-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {Zahiri, Z and Sharami, S.H and Faraji, R and Asgharnia, M and Atrkarroshan, Z}, title = {Survey the Association Between Maternal Age and Pregnancy Outcome}, abstract ={Abstract Introduction: Age of mother at pregnancy can be one of the main risk factors for hazardous outcome of pregnancy. Objective: The aim of this study was to determine the association between the maternal age and the outcome of pregnancy. Materials and Methods: This is a descriptive, cross-sectional analytic study that pregnancy outcome in women presenting to Alzahra hospital for delivery was assessed. Variable studied included: enduced hypertension and diabetes in placental complication (placenta abruption, placental previa), preterm labor and premature rupture of membranes (PROM) was divided into 3 groups based on age 16 and 17-34 and 35.‍Pregnant women in two groups: 17-34 and 35 were matched according to parity. Data collection analysis was carried out with chi-square test by SPSS.9 software. Results: In this survey, 6045 pregnant women with gestational age over 20 weeks were studied. Frequency of delivered women according to age group showed that 52 cases (%0.8) were 16 years, 5406(89.4%) were 17-34 years and other 587(9.8%)were 35.Data showed that there were significant differences between the three age groups and the risk of pregnancy-induced hypertension, gestational diabetes, placental abruption, placental previa, PROM, mal presentation, preterm labor and cesarean section (P0/05). Conclusion: It appears that pregnancy in age 35 comparing with teenage pregnancy has special risk factors. Awareness of the risks and complications has an important role planning for appropriate prenatal services.}, Keywords = {Maternal Age, Pregnancy, Pregnancy- out come}, volume = {15}, Number = {60}, pages = {73-78}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-433-en.html}, eprint = {http://journal.gums.ac.ir/article-1-433-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {Ghafari, R and Dalili, Z}, title = {Frequency of Retention Cyst of Maxillary Sinus in Panoramic Radiography}, abstract ={Abstract Introduction: Diagnosis of sinus retention cysts indicates inflammatory reaction in sinuses and in attention to its reports in different geographic sites we decided to survey its frequency in panoramic radiography. Because it doesn’t have the limitation of waters’ view in detection of small lesion in antral floor due to superimposition of molar roots and petrous bone in this area and it can be used as a routine radiography in dentistry. Objective: This study was designed to determine the frequency of retention cyst in panoramic view in Rasht-Iran from the beginning of winter of 2003 to 2004. Materials and Methods: Two maxillofacial radiologists assessed 1422 panoramic radiographs, which were taken by Planmeca EC Proline machine together during one year. Absence or presence of this lesion, number of these cysts and location of antral wall involvement were defined. Data collections were organized on sex, age and months of radiography taking. SPSS analysis software, chi-square test and t-test were used for statistical analysis. Results: Frequency of retention cyst was 4% and it was more in males than females. Ninety percent of this antral lesion was single and 10% had multiple forms. The most common location involved was antral floor. June and January were the most common months of retention cyst presentation in Rasht in panoramic views. Conclusion: In our study, frequency of antral cyst was higher than previous studies. Temperature fluctuations, inflammatory and allergic factors in different months are effective factors in higher presentation of retention cyst in this geographic region. Antral floor involvement in single form and retention cyst presentation in male more than female are the most important notes of this study.}, Keywords = {Jaw Cysts-Maxillary Sinus, Radiography-Panoramic}, volume = {15}, Number = {60}, pages = {79-83}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-434-en.html}, eprint = {http://journal.gums.ac.ir/article-1-434-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {NeshandarAsli, H and Jahandideh, Y}, title = {Evaluation of the Transversel Strength of Acropars Heat Cure Acrylic Resin as Compared with Bayer and Meadway Heat Cure Acrylic Resins}, abstract ={Abstract Introduction: One of the numerous problems that clinicians and technicians are faced with is the phenomenon of breakage of Acrylic resin, the basic material in complete denture. Objective: The main aim of this research was to survey the quality of Acropars heat cure Acrylie resin and compare it with Bayer and Mead way heat cure acrylic resins in order to reduce the deficiency existing. Materials and Methods:‌ 10 samples of each acrylic resins were‌ build‌ in with dimensions of ‌‌65*10*2.5mm and then were divided in three groups: 1. Acropars 2-Meadway 3- Bayer Energy was exerted on samples through the Instron machine at speed of 5mm/min and their transversal strength (breakage strength) was measured. Results: The average transversal strength in first group was: 65.961.23 Mpa & the transversal strength in second group was 81/081.02 Mpa and in third group was 84/31.19 Mpa, and there was a significant difference in first group compared to the second and third groups. Conclusion: Regarding to the average transversal strength of samples it was shown that the Acropars heat cure Acrylic resin have significant difference when comparison with similar foreign samples. But it was approved regarding the ISO 1567 test, which states that mpa 65 is satisfactory.}, Keywords = {Acrylic Resins , Dentures- Complete, Polymers}, volume = {15}, Number = {60}, pages = {84-88}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-435-en.html}, eprint = {http://journal.gums.ac.ir/article-1-435-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {Kalantari, Z and Jafari, H}, title = {Survey of Extract of White Cabbage in Prevention and Treatment of Peptic Ulcer Caused by Aspirin in Rats}, abstract ={Abstract Introduction: Peptic ulcer is a multifactor trend caused by blood vessels alterations, mucus secretion, and gastric acid biochemistric condition of gastrointestinal tract. Aspirin (non-steroidal anti inflammation) with high curative effects can lead to mucus lesions in stomach. The lesion is caused by delay in stomach mucus rebuilding, increased free radicals and prostaglandin ( ) producing prohibition. There were different applications for white cabbage mentioned in traditional medicine, however the most important one was its use in digestive pains. Objective: The goal of this study was to examine the effect of extract of white cabbage in prevention and treatment of peptic ulcer caused by Aspirin in rats. Materials and Methods: In this research 48 rats were kept hungry for 48 hours and as a result ulcer peptide appeared with aspirin suspension in standard condition. For a group of rats an hour before prescribing aspirin, different amounts of edible extracts of white cabbage were used. For the other group of rats the same were used but this time after prescribing aspirin. In both conditions, animal's stomach were brought out and opened through the large curvature and lesion signs were assessed according to J. score criterion. Then statistical analyses were preformed using variation factor and T. student test by SPSS software. Results: Findings showed that white cabbage's extract in the amount of 100 mg/kg is most effective on prevention of peptic ulcer caused by aspirin (P<0.01) as compared with 200mg/kg dose used to cure peptic ulcer (P<0.05). Conclusion: As an overall conclusion, white cabbage can be used in prevention and treatment of peptic ulcer especially as prevention. Maybe the effect of this plant on peptic ulcer is like the prostaglandin that prohibits acid secretion, stimulates sodium bicarbonate and changes the PH of stomach and this can be further studied by researchers.}, Keywords = {Aspirin, Plants, Medicinal, Rats, Stomach Ulcer }, volume = {15}, Number = {60}, pages = {89-94}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-436-en.html}, eprint = {http://journal.gums.ac.ir/article-1-436-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {Asefzadeh, S and Rafati, M}, title = {How to Update Physicians and Dentists’ Education after Graduation}, abstract ={Abstract Introduction: Defining the use of Internet and other sources for professional updating among physicians and dentists are very essential for improving continuing medical education (CME). Objective: This investigation was undertaken to assess the extent of using Internet among physicians and dentists and to compare it with of other sources for professional updating information in Qazvin Medical University. Materials and Methods: This was a descriptive study and a questionnaire was randomly sent to half of all physicians and dentists (399) in Qazvin. Results: All 339 samples answered the questionnaire, which included 52.8% general physician, 2.1% residents, 8.26% specialist, 2.8% fellows, 11.9% general dentists, and 3.6% dental specialist. 69.7% stated reading books as the best source of CME, 24.6% use of internet and e-mail, 28.1% reading foreign journals and 26.8% stated participating, in seminars and work shops as the best sources CME. Comparing the two groups, physicians and dentists on average spend 14 hours and 19 hours of studying per month. From those who didn’t use Internet, 45.84% stated, “not being available” and 40% stated, “don’t know how to use it”. The time of samples were divided to 5hrs/ week for study, 9hrs to education, 2.5hrs to research, 4hrs participating in meetings and 35 hrs to medical visits. Conclusion: Since Internet plays an increasingly important role in physicians professional updating, it is suggested that training courses, more hardware and software facilities at hospital and libraries, and Internet program for continuing medical education be provided in university and electronic library with last edition of medical books be made available in university.}, Keywords = {Dentists, Education Professional, Information Technology, Internet, Physicians }, volume = {15}, Number = {60}, pages = {95-101}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-437-en.html}, eprint = {http://journal.gums.ac.ir/article-1-437-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {Azari-Hamidian, SH and Yaghoobi-Ershadi, M.R and Javadian, E and Mobedi, I and Abai, M.R}, title = {Review of Dirofilariasis in Iran}, abstract ={Abstract Introduction: Dirofilariasis or dirofilariosis is a mosquito (Diptera: Culicidae) borne metazoonotic disease, caused by different species of the nematod genus Dirofilaria (Spirurida: Onchocercidae). Its reservoirs are mostly canids and it is cosmopolitan. Human dirofilariasis is now classified as an emerging zoonosis. Objective: This article reviewed all previous records and investigations in Iran and the world in relation to dirofilariasis in order to provide a foundation for forthcoming studies. Materials and Methods: From the first report of dirofilariasis in Iran in 1969 up to 2005, all human and animal cases and important data such as: the pathogen and reservoir species, distribution, frequency, and human cases, as retrospective study, were investigated and analyzed. Also, the natural history of parasite, pathogenicity, the disease diagnosis, treatment, and control, and the last status of the disease in the world were briefly mentioned. Results: Two species of the genus Dirofilaria D. immitis (canine heartworm) and D. repens are found in Iran. By now, nine human cases have been formally reported including four subcutaneous and two ocular cases of D. repens, a rare case of D. immitis in testicular hydrocele, and two pulmonary cases (most probably D. immitis). As a whole, human and animal dirofilariasis has been recorded in eleven provinces of Iran. The species D. immitis has been reported in East Azerbaijan, West Azerbaijan, Ardebil, Tehran, Khorasan, Khuzistan, Fars, Golestan, Mazandaran, and Hormozgan Provinces and D. repens in Tehran, Khorasan, Guilan, and Mazandaran Provinces. Different investigators have reported D. immitis in dogs (with the frequency of 0.95 to 36.8%), jackals (7.5-57.1%), foxes (5.7-50%), wolves (20-50%), and cats (0.8%) and D. repens in dogs (1.4-60.8%) and jackals (10%) in the different areas of the country. Conclusion: Data on dirofilariasis in Iran are to some extent scattered as regard to distribution or other aspects of the disease. More studies need to be done on dirofilariasis in the country, especially in places where no investigation has been carried out. There is no information about the vectors of dirofilariasis in Iran.}, Keywords = {Dirofilaria, Dirofilariasis, Dirofilariosis, Nematoda}, volume = {15}, Number = {60}, pages = {102-114}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-438-en.html}, eprint = {http://journal.gums.ac.ir/article-1-438-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2007} } @article{ author = {Amiri, I and Nasiri, E and Mahmodi, R}, title = {The effect of Vitamin E in Prevention of Developmental Defects of Diabetic Rats Embryos}, abstract ={Abstract Introduction: Now days it is proven that maternal hyperglycemia increases production of free radicals and decreases antioxidants in the embryonic cells and through this it injures the embryos of diabetic mothers. Therefore it seems that use of antioxidants can decrease deleterious effects of hyperglycemia on embryos. Objective: This study aims to investigate the effect of vitamin E in control of embryonic developmental disorders in diabetic rats. Materials and Methods: In this experimental study, diabetes was induced by intraperitoneal injection of 65-mg/kg streptozotocin in Wister female rats with 250-300g weights and was placed with healthy male rats in the same cage for mating. Then they were divided into two groups. One group received 150mg/kg Vitamin E per day from the first day of pregnancy. Animals were killed on day 13 of gestation and embryos were collected and examined for number, size and incidence of malformations in cerebral hemispheres, cranial and caudal neuropors, upper and lower limb buds, otic and lens placodes using an stereomicroscope. Then, One Way ANOVA compared the means of length, number of reabsorbed and achieved embryos in three groups. The incidences of malformations in the groups were compared by Chi-Square test. Results: Findings show a significant difference between control group and experimental diabetic group when achieved and reabsorbed embryos counted. Frequencies of malformed embryos (at least one diagnosed malformation) in control group were 1% and in diabetic and treated diabetic groups were 46.3% and 11.6% respectively. Result showed that the incidence of embryonic malformation significantly decreased in diabetic rates, that received vitamin E and there was a significant difference in diabetes and treated diabetic groups (P<0.001). Conclusion: ‏The results shows that Vitamin E supplementation in early stages of pregnancy in diabetic mothers can prevent deleterious effects of diabetes.}, Keywords = {Diabetes Mellitus, Embryo, Fetal Development, Fetus, Rats, Vitamin E}, volume = {15}, Number = {59}, pages = {1-7}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-440-en.html}, eprint = {http://journal.gums.ac.ir/article-1-440-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Mehraban, D and Samadzadeh, S and Moosavi, M}, title = {Sensitivity and Characteristic of Urinary Bladder Cancer in Comparison with Cytology in Transitional Bladder Carcinoma Cell}, abstract ={Abstract Introduction: Bladder Cancer is one of the most common urologic malignancies. The risk of recurrence in the same place or a new growth elsewhere in the urothelium, with the same stage or higher, is always with the bladder cancer patient. Therefore, a close follow-up and surveillance is of fundamental importance. Cystoscopy is limited in its ability to discover early urothelial changes. Urine cytology does not have enough sensitivity. Objective: The aim of our study is to compare the sensitivity and specificity of urinary tumor marker Urinary Bladder Cancer- Linked Immunosorbent Assay (UBC-ELISA) with urine cytology in the diagnosis of transitional cell cancer of the bladder. Materials and Methods: Voided urine samples were collected from 73 patients with active or history of bladder cancer, prior to cystoscopy at Urmia and Tehran universities urology sections, from March 2004 until March 2005. Ninety-eight volunteers were sampled as controls. Fresh samples were processed and frozen. UBC-ELISA and urine cytology were done during next 3 months period. Results: UBC and cytology sensitivity and specificity were 70%, 97% and 30%, 98% respectively. Positive and negative predictive values were 93%, 86% and 87%, 74% respectively. Accuracy of UBC was 87% as compared with urine cytology, which was 75%. There was no statistically significant relationship between UBC and grade or stage of the tumors (p= 0.11/ p= 0.28). A statistically significant relationship was demonstrated between urine cytology and grade or stage of the tumors (p= 0.01/ p= 0.001). Both tests had a statistically significant relationship to the size of the tumor if the cut-off was at 3 centimeters (p= 0.003/ p= 0.006). Conclusion: Our study shows that the UBC test is much more sensitive than urinary cytology, but the specificity is not very different. Since UBC is less expensive and is an objective test, it can be used instead of urine cytology in the diagnosis and follow-up of transitional cell cancers of the bladder}, Keywords = {Bladder Neoplasms, Carcinoma- Transitional Cell, Cytology, Tumor Markers, Biological }, volume = {15}, Number = {59}, pages = {8-14}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-441-en.html}, eprint = {http://journal.gums.ac.ir/article-1-441-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Hatamian, H.R and Roudbari, S.A and Emamhadi, M.R}, title = {Assessment of Mean Value of H-reflex Latency of Tibial Nerve among Persons 20 Year Old}, abstract ={Abstract Introduction: Nerve conduction studies and needle electromyography (EMG) play a central role in the evaluation of patients with neuromuscular disorders. The tibia nerve H-reflex is one of the most common parameters in clinical electro diagnosis, especially in the diagnosis of S1 radiculopathy. H- reflex is important because involvement of S1 root most common in disc hernia causes rapid changes. Objective: The purpose of this study was to determine the mean values of tibia H-reflex in healthy individuals aged 20 years and older. Materials and Methods: In this cross-sectional study 110 asymptomatic volunteers were controlled. All of them were placed in prone position with flexed knee by 20 degree tibia H-reflex latency was recorded by Medelec machine from midcalf on each side. Stimuli were applied at the midpopliteal crease. Data were analyzed by EpiInfo software and by using ANOVA tests to compare means of different groups. The results were reported as mean (CI 95% of mean). Results: 55.5% were male and 44.5% were female. Mean age of subjects was 41.6 years and mean height was 165.26 cm. The mean H-reflex latency for 220-tibia nerve (110 of right & 110 of left) was 26.46 m/sec (CI 95%=26.62-26.28 m/sec). The maximum mean H-reflex latency was 28.23 m/sec in over 60 years old age group and the least mean H-reflex latency was 25.93 m/sec in 40-60 years old age group (P<0.0001). Mean of H-reflex latency were 25.92 m/sec in less than 150 cm height group and was 29.78 m/sec in more than 180 cm height group (P<0.0001). Conclusion: Since from references, age and height have major effect on normal value of H-reflex latency and this is also evident in this study, and on the side, there is a significant difference in H-reflex values measured in different studies so we recommend the use of normal values according to standardized measurement in each region or clinic.}, Keywords = {Electrodiagnosis, Electromyography, H-reflex, Neural Condition, Tibial nerve.}, volume = {15}, Number = {59}, pages = {15-19}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-442-en.html}, eprint = {http://journal.gums.ac.ir/article-1-442-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Roudbary, S.A and Aini, A}, title = {Survey Homocysteine Serum Level in CVA Ischemic Infarct Patients}, abstract ={Abstract Introduction: Ischemic stroke has a high prevalence and is accompanied with high mortality, severe complication and high expenditure and cost. Increase awareness of risk factors can improve the prevention of stroke. Although several studies have proposed hyperhomocysteinemia as a risk factor for ischemic strike but some investigations have not confirmed this association. Objective: The aim of this study is to determine Homocysteine serum level in ischemic infarct patients in Poorsina Hospital, Rasht, from 2005 to 2006. Materials and Methods: In this descriptive study on hospitalized ischemic stroke patients according to clinical findings, imaging and R/O of exclusion criteria 200 patients were selected and their plasma homocysteine level measured at the base of paraclinical findings. History and manner of smoking have been considered. Smoking defined as ≥ 8 pack per year. Results: From total patients, 24.5% serum homosysteine level was normal ( 100 µ mol/lit). 8.5% of patients were smokers. No significant statistical relationship was found between smoking & homocysteine level. ( p=0.053) Conclusion: Hyperhomocysteinemia is a risk factor for ischemic stroke and its effect is independent from smoking. Thus prescription of vitamin B groups and folat that decrease serum Hcy level may play a roll in decreasing of this risk factor.}, Keywords = {Cerebrovascular Accident, Homocysteine , Risk factors}, volume = {15}, Number = {59}, pages = {20-25}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-443-en.html}, eprint = {http://journal.gums.ac.ir/article-1-443-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Honarmand, H.R and Eshraghi, S and Khoramizadeh, M.R and Ghanaei, M}, title = {Evaluation of Two Commercial Qualitative and Semi Quantitative ELISA Methods for Diagnosis of Acute Human Leptospirosis}, abstract ={Abstract Introduction: Leptospirosis is most widespread Zoonosis in the world, especially in Tropical and temperate regions with moist climate. Diagnosis of Leptospirosis according to clinical symptoms is difficult and uncertain due to lack of specific sign (s). Leptospira is a fastidious bacterium. Isolation of these bacteria by culture is difficult, time consuming and hence doses not contribute to an early diagnosis. Specific antibodies against Leptospira appear from 6th day of disease onset. The Microscopic Agglutination Test (MAT) is most reliable assay but generally requires paired sera for detection of seroconversion and is considered too complex for routine use. Objective: We performed this study to final a simple and reliable method for diagnosis of acute human leptospirosis. ELISA is another common method for diagnosis of Leptospirosis . Materials and Methods: In summer of 2004, we examined 282single sera of patients who were suspected of Leptospirosis by a commercial none quantities and an in-house semi quantative ELISA assays and compared their results with MAT. Results: Mean time of first taking blood samples were 6:36 after onset of symptoms. All specimens with titers ≥640 against a pathogenic serovar in MAT were regarded as confirmed leptospirosis(104 from 282). All specimens which were positive in any IgM-ELISA assays were compared with the results of MAT. In our study, sensitivity , specifity, positive and negative predictive values of in house ELISA were 89.4%, 87%,80.2% and 93.4% consequently but were 87.5%, 41.5%, 44.6% and 85% for comerical IgM-ELISA assay consequently. Conclusion: .The results of our study show that IgM- ELISA assay is a reliable and sensitive method for diagnosis of acute leptospirosis and also show that in house semi quantative IgM ELISA was more specific and commercial qualitative IgM- ELISA was more sensitive.}, Keywords = {Enzyme – Linked Immunosorbent Assay, Leptospirosis}, volume = {15}, Number = {59}, pages = {26-31}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-444-en.html}, eprint = {http://journal.gums.ac.ir/article-1-444-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Roohafza, H.R and Akochakian, SH and Sadeghi, M and Fardmoosavi, A and Khairabadi, GH.R and Ghasemi, H}, title = {Investigating the Relation between Lifestyle and Chronic Obstructive Pulmonary Disease}, abstract ={Abstract Introduction: In studies or lifestyle of patients with (Chronic Obstructive Pulmonary Disease COPD), physical and, social activities, nutrition and smoking are the behavioral patterns, which aggravate this disorder and cause a dysfunctional circle, which prevents healing. Objectives: This study aimed to compare the lifestyle of patients with COPD and control group and then the two groups according to severity and length of disease. Materials and Methods: This descriptive-analytical study was done on 70 patients with COPD as the case group, which was selected, based on American Thoracic Society and also on 70 healthy persons as the control group. Patients with any psychiatric or chronic disorder or those who didn’t cooperate were excluded from this study. The questionnaire included demographic information such as age, sex, education level, duration of affliction to this disease and FEV1 and Miller-Smith lifestyle questionnaire were filled for all patients. All data were statistically analyzed by t-student and ANOVA tests. Results: The mean age of case and control groups were 66.3±9.2 and 64.2±11.6 respectively. Thirty-six persons (51%) in case group and 35 persons (50%) in control group were male. The means of education level in case and control groups were 8.3±4.1 and 9.2±3.4 respectively. The mean score of lifestyle in case group was 66.64±18.6 and in control group was 32.01±6.49, which was statistically significant (P<0.013). The mean score of Miller-Smith questionnaire was significantly increased as the severity of the disease (based on FEV1) and the duration of the disease increased (P<0.003). Conclusion: Lifestyle is an important factor in patients with COPD. Suitable management and effective pulmonary rehabilitation can be effective in the treatment of patients with COPD. So it is necessary to consider lifestyle change as a part of patients’ treatment.}, Keywords = {Lifestyle, Lung Diseases- Obstructive}, volume = {15}, Number = {59}, pages = {32-37}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-445-en.html}, eprint = {http://journal.gums.ac.ir/article-1-445-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {RahimiBashar, M}, title = {Study Educational Needs of Mothers on Prevention of Rheumatic Fever and Its Complications}, abstract ={Abstract Introduction: Rheumatic fever and rheumatic heart diseases are among the chronic diseases. Rheumatic fever is the most common heart disease in children and young adults especially in the developing countries. Objective: The purpose of this study was to investigate the educational needs of mothers referring to the Health and Treatment Centers of Lahijan-City for prevention of rheumatic fever and its complications and to prepare an educational pamphlet on the basis of research findings. Materials and Methods: This research is a descriptive study performed in 2001.Required data were gathered by a questionnaire. Research population were mothers presenting to the Health and Treatment Centers of Lahijan-City who were selected by a convenient randomized sampling. Thus, all of the mothers who had the determined criteria for the samples (such as true mother of child, married and having at least 1 child between 5-15 years of age, having minimum literacy for reading and writing, lack of history of rheumatic fever or rheumatic heart disease and absence of formal education regarding the subject under study) were given a code. Then, from these given codes, drawing was performed and from each health and treatment center, 56 mothers were selected in a convenient random sampling .On the whole, 280 mothers were studied from 5 health centers. Results: The majority of mothers needed high education regarding all research objectives (cause and predisposing factors, symptoms and signs, complications of rheumatic fever and its prevention) 56.0%, 51.8%, 53.2%, and 43.9% respectively. Conclusion: Research results indicated a low level of knowledge (high educational need) of mothers concerning the disease of rheumatic fever and complications.}, Keywords = {Mothers , Need Assessment, Rheumatic Fever }, volume = {15}, Number = {59}, pages = {38-46}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-446-en.html}, eprint = {http://journal.gums.ac.ir/article-1-446-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Zare, M and Shamszadeh, P and Najari, A}, title = {Application of GIS in the Promotion of Management Decision Making in Health Sector}, abstract ={Abstract Introduction: Information system and its main effect in empowering the management decision-making results in highest quality of a system. Therefore if information is given to managers rapidly and correctly it helps them in correct and useful decision-making. Not receiving the information can create problems especially in Health and treatment centers. Objective: The goal of using Geographic Information system (GIS) in Health management is to help in prevention of incidence and prevalence of different diseases via their analysis with attention to geographic situation and environmental conditions. In such a way useful approaches for proper management for control of health and treatment problems can be achieved. Materials and Methods: After necessary assessment and meetings, three cities (Farsan from Chahar mahal Bakhtiary, Dashti from Boshehr and Bam from Kerman) which have different race and related environ mental diseases, were chosen for this study. This study was done under agreement with private sector and with the cooperation of Health centers of above-mentioned cities. Results: In intervention of this project based on the descriptive information of Health and treatment centers and need assessment, the data model was designed and provided in a geographic information bank (place). Conclusion: Finally system was able to answer many information needs of health system and the possibility of development was provided.}, Keywords = {Decision Making- Organizational, Geographic Information, Health Services Administration, Organization and Administration, Safety Management }, volume = {15}, Number = {59}, pages = {47-54}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-447-en.html}, eprint = {http://journal.gums.ac.ir/article-1-447-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Dalili, Z and Bavagharian, F}, title = {In Vitro Survey of the Role of Spiral Tomography in Measurement of Distance from Crest to Mandibular Canal}, abstract ={Abstract Introduction: Following the teeth loss, the changes in the shape and angulations of alveolar ridge happens Tomographic images can be helpful for providing the sufficient details about vertical and horizontal dimension of alveolar bone, situation of vital and anatomic structures, and deduction of surgical injuries. Objective: Considering the importance of spiral tomography in determination of mandibular canal and vertical height of alveolar ridge, we decided to use this advanced method in evaluation of the alveolar bone height from crest to mandibular canal. Materials and Methods: Three dry human mandibles were selected in this analytical study for comparison of tomography and real measurements. Cross-sectional tomographic slices with 2 mm thickness ware taken at three or four different locations distal to the mental foramen by means of Cronex Tome unit (Sordex, Helsinki Finland) in each side. These sites marked by gutta-percha filled pits. On tomographic image, a line was drawn from crest to the inferior border of mandible (MC) and the distance from crest to mandibular canal was measured on MC line. Meanwhile the distance from the crest to mandibular canal was measured. Subsequently, vertical sections were provided at the sites marked by gutta- percha, perpendicular to the lower border of the mandible by special disk .The real anatomical bone height, after estimation of magnification factor 1.5 were compared. SPSS software ( version No 11.5) and sign test analysis were used in order to evaluate the statistical details. Results: In measurement of the distance between crest to mandibular canal, showed no significant difference between tomographic measurements and real dimensions. Measuring height in tomography indicated an underestimation ranging 3.7 to 0.07. Conclusion: This point that there is an underestimation in measurement of height justifies the safety of spiral tomography in estimation of distance from crest to mandibular canal. Which itself prevents serious injuries to neurovascular bundle.}, Keywords = {Dental Implantation , Mandible , Tomography}, volume = {15}, Number = {59}, pages = {54-60}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-448-en.html}, eprint = {http://journal.gums.ac.ir/article-1-448-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Sadeghi, SH and Mirzazadeh, H}, title = {The Effect of Three Temporary Restorative Material Thickness on Coronal Micro Leakage in Endodontics – An In – vitro Study}, abstract ={Abstract Introduction: Maintaining an adequate coronal access seal is an integral part of multiple-visit endodontic therapy or after root canal treatment until crown reconstruction. This is provided by filling the access cavity with temporary restorative materials. The thickness of the temporary restorative materials is one of the important factors in preventing of coronal microleakage. Objective: This research was conducted to determine the effect of the thickness of three temporary restorative materials of Cavizol, Cavtemp and Coltosol on coronal micro leakage of extracted human teeth. Materials and Methods: In this Invitro study, 100 multi rooted posterior human teeth, were randomly divided into nine experimental groups (n=10) and two negative and positive control group (n=5). According to manufacture’s instruction, the access cavities in experimental groups were filled with three temporary materials, Cavizol, Cavtemp, Coltozol in 2, 3, 4 mm thickness each. Linear dye penetration and clearing technique were used to evaluate coronal leakage of temporary filling materials. Data was analyzed with one way ANOVA test. Results:Comparison of experimental groups in different thicknesses (2, 3, 4 mm) showed no statistical difference (p<0.05) of coronal leakage between different groups as regard as to level . Conclusion: There was no preference between the materials were put for preventing coronal micro leakage. There was no limitation for their essential thickness in access cavity. So they may be suited for clinical situations in access cavities which have the depth of 2mm or more.}, Keywords = {Dental leakage, Root Canal Filling Materials, Root Canal Therapy ,Tooth Crown}, volume = {15}, Number = {59}, pages = {63-68}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-450-en.html}, eprint = {http://journal.gums.ac.ir/article-1-450-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Shahsavari, F}, title = {Dental Caries in Patients with Beta-Thalassemia Major}, abstract ={Abstract Introduction: Beta-thalassemia patients require regular iron chelation therapy based on the severity of disease, treatment and its complications. Then these patients should receive regular medical care. The relation between dental caries and some diseases are identified. But unfortunately dental and oral problems in these patients received less attention and present information is little. Researchers also stated different opinions. The prevalence and severity of dental caries have been documented to be associated with a number of diseases. Little data are available on the association of dental caries with beta- thalassemia major. While some studies reported increase dental caries in these patients, other studies showed no differences between thalassemia patients and healthy controls. Objective: This study aimed to examine the levels of dental caries in beta-thalassemia patients and to compare it with matched nonthalassemic healthy controls. Materials and Methods: This study is cross sectional with control group. 60 thalassemia patients in health center of Iran Institute thalasemia and 60 healthy controls (referrals to college and patients healthy accompanies) were assessed by DMF Index. The two groups were matched in age sex, socio-economic condition, oral hygiene, eating carious material and its frequency. Results: Mean DMF were 7.3 (SD=3.80) and 7.26 (SD=3.73) in patients and healthy controls respectively. There was no significant difference between patients & healthy controls in DMF index. Mean D and F were 5.55 and 1.33 in patients and controls respectively. There were significant differences between two groups in D and F indexes. There was not significant difference between DMF index in males and females in both groups. Conclusion: There was no significant difference in the two groups regarding DMF and it seems that there is no relation between Beta – thalasemia major and dental caries. As advanced treatment has greatly increased the probability for a thalassemic child to reach adult age, regular dental visits are recommended. Since decay was seen in patients more than controls, it's necessary to examine and fill them.}, Keywords = {Beta – Thalassemia , Decayed- missing and filled Teeth, Dental Caries}, volume = {15}, Number = {59}, pages = {69-74}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-451-en.html}, eprint = {http://journal.gums.ac.ir/article-1-451-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {SeyedNoori, T and JamshidiAranaki, F}, title = {Survey the Relationship Between Knowledge and Attitude Of Pregnant Women Requesting Cesarean Section Referred to Rasht health Centers and Their Choice Reasons}, abstract ={Abstract Introduction: Cesarean Section (CS) is more dangerous than normal delivery for mothers and neonates. Rate of Cesarean in our country (total 35%) especially in Guilan province (57.6%in urban areas) is very high. A major reason for this high rate is maternal request. Objective: This survey is done to detect the relationship between knowledge and attitude has pregnant women requesting Cesarean Section and their choice reasons. Materials and Methods: This is a descriptive- analytic study. A total of 210 pregnant women in Rasht who were at 36-40 weeks of pregnancy and had chosen CS as their delivery method without previous history of CS or any medical indications. Cluster sampling was performed at health- treatment centers of Rasht. Data were collected by interview and a questionnaire that was completed by investigators in 2003-2004. Statistical analyze was performed by descriptive and analytic methods (Chi-square and Fisher exact test). Results: The majority of participants (68.6%) had moderate knowledge about benefits and harms of CS and most received their information from their relatives and friends. The majority of women (71.4%) had abstained attitude to CS. More than (50%)of the mothers had chosen CS for following reasons in decreasing order of frequency: child's health, fear of pain, stress and anxiety, prevention of genital tears, fear of vaginal exams, prevention of deformity and relaxation of genital system and shortening of labor duration. There was a significant relation between knowledge level and following reasons: fear of pain, psychotic stress and anxiety, shortening of labor duration. Conclusion: Findings of this study gives attention to the need for instruction deployment by midwives and other health staff. High rates of negative and abstain attitude (84.2%) in spite of choosing it shows that pregnant mothers demand cesarean subsequent to flighting of classic painful vaginal delivery. Thus we can utilize new obstetric and complementary methods, counsel with target mothers and support them by giving information, emotionally and socially in order to decrease cesarean section.}, Keywords = {Attitude , Cesarean Section , Knowledge ,Pregnancy, Women}, volume = {15}, Number = {59}, pages = {75-84}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-452-en.html}, eprint = {http://journal.gums.ac.ir/article-1-452-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Mohammadi, H and Haghighi, M}, title = {Survey Relationship of Mortality Rate of Hospitalized Patients in ICU with Different Degrees of APACHE II}, abstract ={Abstract Introduction: In Attention to the importance of caring for patients referring to treatment centers specially ICU, the care prided should be in concordance with the severity of disease so that it give satisfactory result and patients with more sever disease receive intensive care. It is necessary to use standard scoring of APACHE II to determine the severity of disease and compare it with other standard treatment centers. Objective: This survey is carried out to determine relationship between APACHEII scoring system and mortality rate of patient in ICU. Materials and Methods: This descriptive and retrospective study was performed in one-year period from mid Agust 2004 to 2005 in ICU ward of Poorsina Hospital. Overall admitted patients were 600 and data were collected from 200 patients and recorded in special data sheet of APACHEII Scoring system. In APACH II system there are two criteria that together make the acute physiology and two other criteria including chronic disease and age were included and the maximum score was 710. Data sheet were prepared for all patient and at the end of sheet, total scoring was recorded. This scoring system had relationship with mortality. In the scoring: 0-12, 16-19, 20-30 and >30, probability of mortality were: % 10, %15, %35 and> %75 respectively. Results: In the assessment of 200 patients, men group were 66.5% (133) and women group 33.5% (67). Mortality and viability in these two group was 22% (44) and 78% (156) respectively. All of 117 (%58.5) patients with scoring below 15 were alive and scoring above 30 died. (2.5%). In 50(%25) patients with scoring between 20-30, 37(%84.59) died and 13 patients were lived. In the patients with scoring number between 16-19, mortality rate was % 4.54(2) and viability was 16.6% (26). In comparison with standard scoring system, mortality rate in scores below 19 in Poorsina center was lower than standard, but with scores above 20, mortality rate was greater than standard system. So scoring between 20-30, mortality rate was %39 and with scoring above 30 , mortality rate was % 25 greater than standard system. Conclusion: With increasing the scoring number, mortality was increased. In greater scoring numbers, severe intensive care must be considered for ICU patient.}, Keywords = {APACHI E, Hospital Mortality, Inpatients, Intensive Care Units }, volume = {15}, Number = {59}, pages = {85-90}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-453-en.html}, eprint = {http://journal.gums.ac.ir/article-1-453-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Amirmozafari, N and MansourGhanaei, M and SadrNouri, B and FarhadiTooli, L}, title = {Survey Prevalence of Group B Streptococci in Genital Tract Women in 28-37 Weeks Pregnancy}, abstract ={Abstract In‌troduction: Group B streptococci (GBS) have a tendency to colonize female genital tract and is a causing factor of premature delivery. In addition, they can also induce serious life – threa‌tening in‌fections such as meningitis and septe‌cemia in the newborn. GBS in‌fection are generally higher in pre-mature infants in relation to full-term born neorates. Objective: The purpose of this research was to determine the prevalence of Group B streptococci in genital tract 28-37 weeks of pregnant women. Materials and Methods: In this study specimens were obtained from 100 pregnant women (28 – 37 pregnancy weeks) who had not taken any antibiotics with‌in one-month period prior to sample collection and referred to prenatal ward and special clinic of Alzahra Hospital during summer 2005 in Rasht. Three vaginal swabs were taken from each woman. The first swab was used for direct lamb from vaginal secretions.The second swab was in‌oculated in 3ml of Todd – Hewitt broth (without antibiotic) and the third swab was inoculated into 3ml of selective Todd – Hewitt broth, supplemented gentamicin and Nalidixic acid. After 24h of in‌cubation at 37°C in 5% CO2 results of cultures were compared. For identification of isolated strains, the following tests were done, He‌molytic reaction, susceptibility to baci‌tracin, optochin and SXT discs, CAMP test, bile esculin, Hydrolysis of hippurate. Results: Based on various bio‌chemical and microbiologi‌cal tests, 15 GBS strains were isolated from the vaginal secretions of 100 pregnant women (28 – 37 pregnancy weeks). Fifteen strains of Streptococcus Viridans, One case of group A streptococcus Pnenmonea , 5 isolated belonging to the group C,G,F Streptococci, and 30 group D streptococci strains were isolated. Beside streptococci, other micro‌organisms were also isolated based on Gram staining and growth charac‌‌teristics on blood agar , and eosin methylene blue agar plates. One hundred Gram positive bacilli, 45 Gram negative bacilli, 60 staphylococci spp., and 40 yeast isolates were also detected. Conclusion: In attention to %15 of 28-37 weeks pregnancy women who were carriers, it is possible that it can cause premature delivery and also infections neonates.}, Keywords = {Infection, Infant Mortality, Pregnancy, Streptococcus, Group B, Urinary Tract}, volume = {15}, Number = {59}, pages = {91-96}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-454-en.html}, eprint = {http://journal.gums.ac.ir/article-1-454-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Najafi, K and Avakh, F and Nazifi, F and Sabrkonandeh, S}, title = {Prevalence of Postpartum Depression in Alzahra Hospital in Rasht in 2004}, abstract ={Abstract Introduction: Postpartum depression is a prevalent disorder that has undesirable effects on mother and child’s health. Its prevalence is reported different in various studies. Objective: The aim of this study was to determine the prevalence of postpartum depression in mothers who delivered at Alzahra hospital in Rasht in 2004. Materials and Methods: In this cross sectional study 335 women who delivered at Alzahra hospital after signing informed consent were assessed with a demographic questionnaire including variables (age, live child number, home living, delivery type, wanted or unwanted pregnancy, history of abortion or dead child, delivery number, educational level, employment status after delivery). Samples were screened with Beck depression inventory (a standard self questionnaire and independent of any cultural bias) 2-3 weeks after delivery. For mothers who scored 16 or higher, a structural clinical interview for major depressive disease was done. The interview results were evaluated according to DSMIV-TR criteria and the results were analyzed and statistically significant difference was determined (α=0/05) Results: According to the screening examination, 61 patients had mild depression (scoring 16-230) and 6 patients suffered moderate depression (scoring 31-46). From 59 patients who referred for clinical interview, 48 had essential depression disorder based on DSMIV-TR and 43 had mild depression. There was a significant relationship between mothers’ occupation and depression (P=0.02) and between history of still birth and infant death in past with depression (P=0.02) Conclusion: The prevalence of mild depression in our study was notable. In addition to the limitations of this study, more studies with more specific screening assessment and more subjects are recommended}, Keywords = {postpartum depression, Beck depression inventory, structured clinical interview}, volume = {15}, Number = {59}, pages = {97-105}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-455-en.html}, eprint = {http://journal.gums.ac.ir/article-1-455-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Kalantri, S}, title = {The Prevalence of Autoimmune Thyroid Disease in Diabetic Patients}, abstract ={Abstract Introduction: The prevalence of autoimmune thyroid disease (AITD) had been shown to be markedly increased Diabetes Mellitus Type I (DM1). Some report have indicated that AITD is ten times more commonl in DM1 than in the general population, as might be expected due to the autoimmune nature of the two diseases. However it is difficult to find report regarding the incidence of AITD in type2 DM2, although this condition accounts for the majority of the population with hyperglycemia. Objective: This study aimed to determine the prevalence of AITD in diabetic patients. Materials and Methods: This cross sectional study was on 62 performed patients with DM1, and 601 DM2, for a total of 633. The subjects were selected randomly from diabetic out patients of an endocrine clinic. There were 467 women and 196 men with both types of diabetes with an age range of 8-84 years.one screening basis all patients had thyroid function testing (at least a sensitive TSH). Results: Overall 39 patients (5.8%) had AITD (Graves disease and Hashimototos thyroiditis). The incidence of AITD was 8% and 5.6% in DM1 and DM2 respectively. However the prevalence of AITD in DM1 was more striking. Because these patients were younger, and at age when generally AITD is more unusual, the incidence of AITD in DM2 was surprisingly high, but may be accounted for by the older ages of these patients. Conclusion: There is definitely an increased prevalence of AITD in patients with DM2 as well as DM1. While in contrast with latter this may not represent a true disease association, the merit of screening for thyroid function in type 2 diabetes is questionable.}, Keywords = {Dibetes Mellitus-Insulin–Dependent, Diabetes Mellitus- Non–Insulin–Dependent, Thyroidits- Autoimmune. }, volume = {15}, Number = {59}, pages = {106-111}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-456-en.html}, eprint = {http://journal.gums.ac.ir/article-1-456-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Fakheri, T and Najafi, B and FadakarSoogheh, GH}, title = {Correlation Of P53 Protein Expression with Clinicopathologic Parameters and Hormonal Receptor Status in Breast Cancer Patients}, abstract ={Abstract Introduction: Mutation of the P53 gene is thought to stimulate cell growth and to be involved in the development and progression of tumors. Objective: The aim of this study was to survey the relationship of P53with other clinic pathological parameters such as size of tumor, grade of malignancy, lymph vascular attacks, and also its correlation with the condition of steroid receptors in breast cancer patients (BCP). Materials and Methods: The study samples were chosen from 465 BCPs who had breast surgery or excistonal biopsy. Immunohistochemistery method was applied for the detection of estrogen and progesterone receptor and HER2 and P53.According to hormone receptor status, cases were either hormone receptor positive (ER+ or PR+) or hormone receptor negative (ER- and PR-). We divided patients into two groups:low grade instead of grade1,and high grade instead of grade2 and3. Results: 29.7% of our 465 cases were P53 positive. The mean age of P53negative cases was significantly more than P53positive ones. (49.2 y/o vs. 46.7 y/o) P53protein Expression correlated positively with HER2 protein expression. (P=0.000). P53 negativity and hormone receptor positivity had a positive correlation with low-grade tumor (P=0.007). There were no significant correlation between P53 and lymphovascular invasion and relapse and tumor size. Conclusion: Our results show that tumors of low malignant potential (grade1) have an immunophenotype of P53-, ER+, PR+, while high grade tumors (grade3) frequently express a P53+ and ER- ,PR- phenotype. Negativity of P53has a significant correlation with good prognostic factors like hormone receptor positive and low gradity, so evaluation of biologic marker of P53is helpful to select the protocol of treatment in patients with equal stages.}, Keywords = {}, volume = {15}, Number = {58}, pages = {1-6}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-457-en.html}, eprint = {http://journal.gums.ac.ir/article-1-457-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {SilanianToosi, M and Salehi, M.H and SaidiSaedi, H}, title = {Clinical Evaluation of Serum CEA and CA15-3 in Patients with Breast Cancer}, abstract ={Abstract Introduction: Tumor markers are useful means for obtaining information about some malignant tumors whilst causing minimal inconvenience and cost. Objective: The purpose of this study was to evaluate the value of CA 15-3 and CEA in patients with breast carcinoma. Materials and Methods: This retrospective study was performed on 604 patients (mean age= 47 years) who were referred for treatment to oncology departments of Ghaem and Omid hospitals of (Mashhad Iran) from 1999 to 2004. CEA (cut off, 5 ng/ml) and CA 15-3 (cut off, 40 U/ml) had been measured with radioimmunoassay method for every patient (1- 10 times). Results: Stage I to IV were found in 25, 370, 165 and 44 patients respectively at the time of referral. With a mean follow up time of 18 months, from 560 nonmetastatic patients, 76 (13.6%) cases experienced recurrence. The sensitivity of CEA and CA 15-3 measurements in patients with overt metastasis or up to one month before the detection of recurrence were 56.4% and 90% respectively. CEA and CA 15-3 were measured 2 to 8 months before the detection of metastasis in 44 patients from which raising the levels of these markers were found in 7 (15.9%) and 23 (52.2%) cases respectively. Among 249 disease free patients who had been followed for more than 18 months, false positive levels of CEA and CA15-3 were found in 7 (2.8%) and 4 (1.7%) cases respectively. Conclusion: Considering the low number of false positive results in recurrent free patients, both CEA and CA15-3 showed good specificity. The sensitivity of CA15-3 is good for the detection of overt metastasis. However CA15-3 has a modest sensitivity in patients with minimal disease. CEA has a much lower sensitivity compared to CA15-3. However, the positive test can confirm the result of CA15-3 in metastatic setting.}, Keywords = {Breast Neoplasms, Sensitivity and Specificity, Tumor Markers Biological }, volume = {15}, Number = {58}, pages = {7-14}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-458-en.html}, eprint = {http://journal.gums.ac.ir/article-1-458-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Najafi, M and Ebrahimi, M and Hashemi, E and Kaviani, A}, title = {Evaluation of General Surgeons’ Practice Regarding Different Types of Breast Cancer Surgery: Breast Conserving Surgery or Mastectomy}, abstract ={Abstract Introduction: Nowadays breast-conserving surgery (BCS) where only a part of breast tissue is extracted is a standard and accepted method of treating breast cancer under certain condition. BCS use in Iran is very limited. Objective: This study aims to evaluate general surgeons’ practice regarding BCS and its related factors. Materials and Methods: Structured questionnaires were sent by mail to 300 general surgeons whose addresses were extracted from address list of general surgeons in Iranian Medical Council. The questionnaire included general surgeons’ characteristics such as age, sex, work experience, practicing in a university hospital, number of breast cancer patients treated per year, preference of surgeons about performing mastectomy versus breast conserving surgery (BCS) and the reasons for avoiding breast conserving surgery. Results: In all, 83 surgeons returned back the completed questionnaires. The response rate was 27%. Results showed that only 19% of surgeons were performing BCS in their routine practice. Of all evaluated factors, only surgeon’s experience that was defined as “the number of patients treated annually” had a statistically significant correlation with performing BCS (P= 0.01). There was no association between other mentioned variables and the use of BCS. The most frequent reasons noted for avoiding BCS were uncertainty about conservative therapy results (46%), uncertainty about quality of available radiotherapy services (32%) and probability of patients’ incompliance for radiotherapy (32%). Conclusion: These findings indicated that BCS is not routinely selected by Iranian surgeons as the first and the best treatment modality. Further research to evaluate patients’ outcome treated by BCS in Iran, with regard to available medical facilities and cultural factors (patients’ compliance) is recommended.}, Keywords = {Breast Neoplasms, Mastectomy- Segmental}, volume = {15}, Number = {58}, pages = {15-20}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-459-en.html}, eprint = {http://journal.gums.ac.ir/article-1-459-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Mansoorian, A.R and Golalipoor, M.J and Mobasheri, E and Vakili, M.A}, title = {Determine Serum Zinc Level of Mothers in Neural Tube Defects in Gorgan}, abstract ={Abstract Introduction: Neural tube defects (NTD) comprise a group of congenital malformation that includes spina bifida, anencephaly and encephalocele. Pervious study has shown that the rate of NTDs is 3.12 per 1000 in Gorgan. Some studies have indicated that Zinc deficiency is one of the causative factors of NTDs. Objective: This study carried out to compare the serum Zinc level in maternal affected NTDs with healthy controls. Materials and methods: This case- control study carried out to compare the serum Zinc level in 23 mothers with affected NTDs newborns and 36 healthy controls in Dezyani Hospital in Gorgan during 2003 by spectrophotometery technique. Results: Zinc deficiency was found in 13(36.5%) of the cases and 7(19.4 %) of the controls. The logistic regression analytic showed the relation between the presence of NTDs with Zinc deficiency (OR=5.06, 95%CI: 1.51-16.99) and drug exposure during 1st trimester in mothers (OR=13.12, 95%CI: 1.31-130.97). Conclusion: Our findings indicated that maternal Zinc deficiency was thought to be one of the important factors in the NTD etiology.}, Keywords = {Encephalitis, Mothers, Neural Tube Defects, Spinal Dysraphism, Zinc }, volume = {15}, Number = {58}, pages = {21-26}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-460-en.html}, eprint = {http://journal.gums.ac.ir/article-1-460-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {JafariShakib, R and Ajdari, S and Khamesipour, and Shokrgozar, M.A and Mortazavi, H and Malakafzali, B and Nikbin, B}, title = {Soluble CD26 and CD30 Concentration in Cutaneous Leishmaniasis}, abstract ={Abstract Introduction: Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis that usually heals spontaneously with unsightly scar but rarely non-healing lesion of CL develops which is refractory to all types of therapy. It is shown that Th1 and Th2 response is associated with healing and non-healing form of the diseases, respectively. On the other hand, it is reported that CD26 and CD30 are associated with Th1 and Th2 types of response, respectively. In some diseases, there is a relationship found between level of CD26 and CD30 and Th1 and Th2 responses. Objective: The goal of this study was to determine the concentration of soluble CD26 and soluble CD30 (sCD26 and sCD30) as a possible marker for Th1/Th2 response in CL Materials and Methods: The blood samples were taken from 36 patients with healing form of the lesion and 10 patients with non-healing form of CL who were referred to Razi hospital or Center for Research and Training in Skin Diseases and Leprosy in Tehran during 2003-2004. As a control blood samples were taken from 23 volunteers with no history of CL. In this study, the concentration of sCD26 and sCD30 were measured in plasma by ELISA method. Results: The results showed that the plasma levels of sCD26 and sCD30 were significantly higher in non-healing form of the disease than healing form of CL or control group (p<0.05). The level of sCD30 was more prominent than sCD26. There was no significant difference in the level of sCD26 or sCD30 markers in healing form of CL compared to normal control group. Conclusion: Overall it seems that the level of sCD30 might be a useful marker to study the immune response in CL, which needs to be studied further.}, Keywords = {Antigens, CD 30, Antigens, CD 26, Leishmaniasis- Cutaneous}, volume = {15}, Number = {58}, pages = {27-32}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-461-en.html}, eprint = {http://journal.gums.ac.ir/article-1-461-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Lotfi, R and Goshtasbi, A}, title = {Quality Assessment of Prenatal Care Using LQAS in Urban Health Centers and Health Houses of Astara, 2004}, abstract ={Abstract Introduction: Prenatal care is very important in community health promotion,and inadequate prenatal care can result preterm labor,low birth weight neonate and maternal and neonatal mortality. LQAS is a cheap and also fast approach to assess the quality of care given in prenatal phase. This method helps us to compare all care providers with standards and also with each other and therefore work on their problems. Objective: The aim of this study is to surgery prenatal care quality in urban health centers and health houses of Astara. And also LQAS Method is introduced for local managers’ use. Materials and Methods: This is a descriptive study which was done in 2004 and 18 centers including three urban centers and 15 health centers in Astara were surveyed sampling method was random stratified and six samples were chosen from each center. A questionnaire and a checklist were chosen for data collection. First questioner completed the checklist, which covered utilities needed for prenatal care in each center and health house and then observed the care provided to six pregnant women by one health care worker. Also mothers’ demographic characteristics were studied. Questionnaire and checklist validity and reliability were established. Results: Findings showed that 18 center had shortage of utilities and 8 center had shartage of ferrous sulfate. Regarding quality of prenatal care, history taking and abdominal examination were undesirable in six and eight centers respectively. Conclusion: The quality of prenatal care was very poor in only one center and desirable in all other centers. Overall quality of prenatal care was satisfactory in Astara.}, Keywords = {Community Health Centers, Pregnancy, Quality of Health Care}, volume = {15}, Number = {58}, pages = {33-40}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-462-en.html}, eprint = {http://journal.gums.ac.ir/article-1-462-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Asgharnia, M and Heidarzadeh, A and Akbari, E and Oudi, M}, title = {Effect of Cervical Cleaning with Cotton on Quality of Pap smear}, abstract ={Abstract Introduction: Today, cancer of the cervix has been considered a preventable cancer due to its long pre- invasive state, availability of cervical cytology screening programs, and effectiveness of the treatment of preinvasive lesions. Due to slow progression of cervical cancer lesions, Pap smear is an efficient procedure for cancer detection and decreases mortality. Objective: The objective of this study is to compare the quality of Papsmear before and after cervical cleaning in females referred to Alzahra Hospital. Materials and Methods: This is a before – after clinical trial. Subjects were sampled by nonprobability convenience method. Inclusion criteria were absence of vaginal bleeding, infection, pregnancy, coitus and vaginal douching during past 48 hrs. After obtaining informed consent, two cytologic smears were taken by cytobrush (Cervex-Brush) before and after cervical cleaning by sterile cotton. Both smears were fixed, Coded and send to a special laboratory immediately. They were taken by a resident and were reported by a pathologist. After data collection analysis carried out with 2 , 2 Mantel Hanszell, statistical software SPSS.10 was used. Results: In this study, 152 patients had met inclusion criteria .The mean age of women was 39.611.2yrs (range 17-65 yr). Before cleaning, there were 39(25.7%) satisfactory versus 101 (66.4%) after cleaning (P<0.0001). There were 22 (14.5%) unsatisfactory smears before cleaning versus 10 (6.6%) after it (P=0.0025). Before cleaning 15 (9.9%) of smears were poor cellular although 4 (2.6%) of smears was poor cellular after procedure (P= 0.009). Before cleaning, we had 1 (0.7%) smear with epithelial abnormality, which were increased by 7 (4.6%) after (5 ASCUS-1 AGUS-1 CIN-I) (P=0.032). Conclusion: Pap smear sampling after cervical cleaning increases the quality of smear and is recommended. Due to similar standard results in other sites of the world, we advocate this procedure for accuracy improvement.}, Keywords = {Cervix Mucus, Cervix Neoplasms , Cervix Uter, Vaginal Smears}, volume = {15}, Number = {58}, pages = {41-47}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-463-en.html}, eprint = {http://journal.gums.ac.ir/article-1-463-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Joafshani, M.A and Falahatkar, S and Asgari, S.A and MahdaviRoshan, M}, title = {The Study of Testis Agenesia in Patients with Undescended Testis}, abstract ={Abstract Introduction: Cryptorchidism is one of the most common disorders of childhood. This anomaly occurs when the descent of testis inhibited anywhere along it’s normal pathway between kidney and scrotum. There isn’t any study about testis agenesia in our region and the picture of the disease may be different in this region. The aim of this study ,is to determine more clear picture of this disease in our region and to consider that whether not to use diagnostic laparoscopy in this area can be lead to increased false diagnosis of testis agenesia or not. Material and Methods: This study is descriptive and basis of our study is to refer to hospital archive files, from all patients that admitted during 1996-2003,we found those who had UDT ,then all of required data including patient’s age ,unilateral or bilateral UDT ,associated disease ,site of UDT, diagnostic procedures, and first symptoms were extracted and then we analyzed this data. Results: Out of 7200 patients that admitted during 1996-2003 yrs, 235 patients had UDT ,according to this data the relative frequency of UDT is 3.26% . Regarding to age of patients most patients were in 5-14 y/o (41.3%). According to associated disease 14% had contralateral UDT, 8.1%had inguinal hernia, 1.7% had hypospadiasis , 6% had hydrocele, 0.9% had torsion of testis and 3% had infertility. Regarding to anatomic site of descent cessation, intracanalicular in 61.4% pts. Superficial inguinal pouch in 16.1% pts , intraabdominal in 14% pts, suprapubic region in 0.9% pts and agenesis of testis in 7.6% pts was found. Conclusion: According to this survey, the relative frequency of UDT was relative common and the most of operated patients are in higher range of age group(5-14yo).Which shows necessity of public education and also high incidence of testis agenesia(7.6%) suggests using of preoperative diagnostic laparoscopy in patients with nonpalpable testis.}, Keywords = {Cryptorchidism, Hydrocele, Laparoscopy}, volume = {15}, Number = {58}, pages = {48-53}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-464-en.html}, eprint = {http://journal.gums.ac.ir/article-1-464-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Kermansaravi, F and Rakhshani, F and Sharakhipoor, M}, title = {Applying Pender\'s Educational Model in Promotion of Health Behavior of Workers}, abstract ={Abstract Introduction: Conceptual models are important because they are used in education and research. Several models are discussed in health education. One of them is panders educational model, which has been applied in some research, and led to positive outcome too. Objective: This research was performed to study the application of panders model in improving workers health behavior in Zahedan faculty of Nan Razawi. Materials and Methods: In this quasi- experimental study, 200 workers were selected randomly from population of workers and they were studied in two groups of case and control. Data gathering tool was a question pair. Date obtained before education and one month after education. For data analysis descriptive and analytical statistics were used. Results: Based on findings, the marks of cognitive – conceptual concepts such as health models, perception of health control and health importance increased after education and there was a statistically significant difference in case group after education (P=0.000). There was a significant relation between health models and perception of health importance with health behavior too (P=0.02). Also, there was a significant relation between income and health concept, perception of health control, and health behaviors (P=0.01). ANOVA indicated effect of education on promotion of health behaviors and there was significant difference (P=0.005). Findings revealed that there was a significant relation between cognitive – perceptual factors such as clinical models (P=0.04), adoption model (P=0.01) and demographic factors such as sex (P=0.03) and race (P=0.02) with health behaviors. Conclusion: Pender’s educational model is effective in promotion of workers health behaviors.}, Keywords = {Health behavior, Health Education, Models- Educational }, volume = {15}, Number = {58}, pages = {54-60}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-465-en.html}, eprint = {http://journal.gums.ac.ir/article-1-465-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Navidian, A and ArbabiSarjou, A and Kikhai, A}, title = {Frequency of Mental Disturbances in Hemodialysis Patients Referred to Hemodialysis Ward of Khatam- Al- Anbia Hospital in Zahedan}, abstract ={Abstract Introduction: Hemodialysis as a treatment in chronic renal failure is a stressful process and has several psycho-cognitive and social complications. The latter can cause mental disorders in such patients. Objective: As a result of high prevalence of psychosis, this investigation was done to determine mental health status in hemodialysis patients and then compare it with normal population group. Materials and Methods: This cross sectional research was carried out on (40dialysis patients in Khatam hospital of Zahedan and 40 healthy persons who were matched in variables such as age, sex, marital statue and education in 2002. In this study, the mental health status of experiment and control group were assessed and compared using the standard questionnaire of general health from consisting of 28 questions by descriptive and analytical statistics. Results: Finding showed that dialysis patients (mean =11/65) have lower mental health state than control or healthy group (mean = 6/20). The result of T test shows a significant relation between these two group (p<0/001). Also there are statistical significant relation between mental health status of dialysis patients and dialysis times in a week (p<0/009) and sex (p<0/03). Conclusion: Considering lower mental health status of dialysis patients in this investigation, It is recommended that the psychological team apply therapeutic interventions by assessing them before and during dialysis period which can be effective in patient adjustment , coping and health promotion.}, Keywords = {Kidney- Failure- Chronic, Mental Health, Renal Dialysis}, volume = {15}, Number = {58}, pages = {61-67}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-466-en.html}, eprint = {http://journal.gums.ac.ir/article-1-466-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Ebrahimi, M and Bostani, T and Nikdoust, M and Hosseini-Nezhad, J}, title = {Compare the Cost- effectiveness of Standard Heparin and Low Molecular Weight Heparin in Treatment of Deep Vein Thrombosis}, abstract ={Abstract Introduction: Deep Vein thrombosis (DVT) is one of the most common vascular diseases, which affects millions of people around the world annually. The important complication of DVT, pulmonary emboli, can cause various dangers as well as mortality. Therefore correct and on time treatment helps patient’s life greatly. From time ago, standard or unfractionated heparin (UFH) has been the chosen treatment, but in recent years with the production of low molecular weight heparin (LMWH) and its specific advantages as compared to UFH, treating patients with LMWH instead of UFH has been presented. Objective: This study aims to compare the cost of LMWH and UFH in treatment of DVT. Materials and Methods: This cross- sectional study was conducted on 125 DVT hospitalized patients with DVT admitted to cardiac ward of Imam Reza Hospital in Mashhad between 2002 to 2004. Mean hospitalization days and hospital costs, nursing care, venous heparin prescription, routine tests and PTT test and also other costs such as serum therapy and … were extracted from patients’ medical files along with LMWH. Data was analyzed with SPSS software. Results: Mean hospital stay was 8.48±2.57 days. The average occupied bed was nearly 500 nights annually. Treatment cost with intravenous UFH and LMWH for each patient was 942080 Rials and 760000 Rials respectively. Conclusion: In attention to advantages of LMWH including economic benefits, decreased bed occupation, better personal and social function of patient, decreased complication and simple use, LMWH can be used in low risk patients instead of hospitalizing and treating with intravenous heparin.}, Keywords = {Health Care Costs, Heparin, Venous Thrombosis }, volume = {15}, Number = {58}, pages = {68-72}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-467-en.html}, eprint = {http://journal.gums.ac.ir/article-1-467-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Khori, V and Semnani, SH and Dadjoo, M and Besharat, S}, title = {Effects of an Active Multifaceted Educational Intervention on Dispensing Time in the Pharmacies of Gorgan}, abstract ={Abstract Introduction: The pharmaceutical care framework requires an active client-pharmacist partnership, particulary with respect to consultation about medication (dispensing process). The educational intervention can imply to improve rational use of drugs. Objecti ves: In this study the effect of active group discussion and dispenser feedback in increasing the patient care indicator (dispensing time) in the pharmacies of Gorgan were examined. Materials and Methods: An interventional, semi-experimental study was designed. The study was conducted in Gorgan,thirty pharmacies and 750 pharmacy client, were randomly selected in each step (before and after intervention). A structural questionnaire was used to interview clients. Data were collected from patients and by interviewing immediately after patient-dispenser encounter. Focused group discussion, audit feedback and distribution of educational bucklet were designed and conducted, after two months. All data were collected and analyzed with SPSS-11.5 software and were shown as mean±SE. Results: Data from 750 prescriptions before intervention showed that the average drug dispensing time was 19.43 ± 5.83 seconds and the average waiting time was 4.91 ± 1.2 minutes. In the post-intervention period, we had significant increase in the aformention indicators. Patients’ satisfaction and knowledge of adverse effects and dosage information significantly increased after intervention. Conclusion: The study shows the impact of active educational intervention in improving WHO patient care indicator (dispensing time).}, Keywords = {Pharmacies, Prescription- Drug, Product Surveillance- Post marketing }, volume = {15}, Number = {58}, pages = {73-80}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-469-en.html}, eprint = {http://journal.gums.ac.ir/article-1-469-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Afkar, A}, title = {System of Provision, Distribution, Maintenance, Control and Drug Consumption in Teaching Hospitals of Rasht}, abstract ={Abstract Introduction: The issue of drug management and its different aspects are considered as important and sensitive affairs of Ministry of health, treatment and medical education and even for all over the country. Objective: The purpose of this study is to assess the system of provision, distribution, maintenance, control and drug consumption in teaching hospitals of Rasht in 2002. Materials and Methods: In this descriptive cross sectional study, 22 wards from four teaching hospitals of Rasht were surveyed. Questionnaire consisted of 3 parts: part one is related to the general information regarding the study hospitals. Part two, general information concerning the wards under study and Part three, the information relevant to the pharmacies of these hospitals Results: Finding of this research indicated that 36.4% of study wards were standard in term of drug use system and 50% of study wards have acted according to the standard in view of drug distribution system and also 31.8% of the hospital wards had standard performance regarding the registration of drug interaction. Conclusion: Finding indicates that due to the lack of appropriate conditions for a drug expert of hospital in order investigate the drug situation of hospitals to conduct the super vision and admission affairs the necessary monitoring measures are not carried out on the process of drug provision and its distribution by pharmacy.}, Keywords = {Hospitals-Teaching, Pharmaceutical Preparations, Pharmacies }, volume = {15}, Number = {58}, pages = {81-86}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-470-en.html}, eprint = {http://journal.gums.ac.ir/article-1-470-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Vejdani., J and MohammadAlizadeh, N}, title = {The Prevalence and Etiology of Anterior Crown Fracture of Anterior Permanent Teeth}, abstract ={Abstract Introduction: Treatment and follow up of traumatized teeth has ever been the concern of many dentists throughout the world. The matter sounds more concerning when the traumatized tooth is a permanent anterior tooth. Regarding to the importance of anterior permanent teeth in mastication, speaking and esthetic, and high prevalence of crown fracture in traumatic injuries of the permanent teeth, we decided to do this study. Objective: The aim of this study is to survey the etiology and prevalence of crown fracture of anterior permanent teeth in 2nd-5th grade children of primary school in Rudsar. Materials and Methods: The study was done by a descriptive and cross-sectional method. The sample consisted of 700 students of 2nd - 5th grade of primary school were randomly selected from 21 schools in Rudsar. Examination was done in natural light and the information about types of crown fracture, number of traumatized tooth, rate of over jet and over bite, lip seal, etiology of trauma and if treatment, registered in a questionnaire. The data were analyzed with SPSS software and Chi-Square test. Results: The prevalence of crown fracture among anterior teeth was 10.3%. The ratio of male to female patients was 1.1/1 Maxillary central incisors were most affected (83.5%) and the most common type of crown injury was enamel fracture (76.4%). Most injuries occurred at home (50%) and in summer (37.4%). Falls were the most frequent cause of dental trauma (37.5%). There was a tendency for children with an increased over jet, deep bite, open bite and lip incompetency to have experienced dental injuries. Conclusion: Considering the importance of anterior teeth and more frequency of trauma in summer, preventive education programs should be instituted in the region, directed at parents and schoolteachers, to inform them about the problems of dental trauma and to obtain cooperative attitude in treatment and good motivation.}, Keywords = {Child, Crowns, Incisor, Prevalence, Tooth Fractures }, volume = {15}, Number = {58}, pages = {87-93}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-471-en.html}, eprint = {http://journal.gums.ac.ir/article-1-471-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {‍Khaki, A and SohrabiHaghdoost, I and GhafariNovin, M and Bazi, P and Zahedi, A and Azarmi, Y}, title = {Survey the Effects of Ciprofloxacin on Rat Testis Tissue Considering Electron Microscopy}, abstract ={Abstract Introduction: Ciprofloxacin is a synthetic antibacterial agent belonging to the family of Fluoroquinolones with a very broad spectrum against of microbial pathogens, especially Gram-negative infectious diseases, that has been approved in more than 100 countries world-wide. Objective: The aim of this study was planed to see determine the histopathological effects of ciprofloxacin after inducement, in rat testis. Materials and Methods: The twenty male wistar rats were selected and randomly divided into two groups control (n=10) and test (n=10). The test group was received 12.5mg/kg (PO) ciprofloxacin daily for sixty day however the control group just received plate. In sixtieth day the testis tissue of rats in both groups were removed and prepared for electron microscopy. Results: Electron microscopic studies of testis tissue slices of test group showed many changes such as: nuclei of spermatocyt I and sertoli cells and myoid were hyperchromatined. The Mitochondria of spermatogonia and spermatocyts cells in test group were vacuolated when as compared with control group. Thickness of spermatid tail in test group was increased when as compared with control group. Conclusion: There was a marked decrease in fertility index, testicular weight in experimental group as compared with control group. Since in our study ciprofloxacin had side effects on testis tissue in rat. It was suggested that using ciprofloxacin can decreasing fertility rate in human.}, Keywords = {Ciprofloxacine, Rats, Spermatogenesis, Testis}, volume = {15}, Number = {57}, pages = {1-7}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-472-en.html}, eprint = {http://journal.gums.ac.ir/article-1-472-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Honarmand, H.R and Eshraghy, S and KhoramiZadeh, H.R and MansourGhanaie, F and Hartskeerk,}, title = {Identifying Serogroup and Servers of Acute Human Leptospirosis In Gillan Province by MAT Method}, abstract ={Abstract Introduction: Leptospirosis is a common Zoonosis, which is more prevalent in tropical and temperate regions. Rodents, wild and domestic animals are reservoir of Leptospirosis. Usually the infected animals are carriers for the rest of their lives and the bacteri is secreted from their urine. The secreted bacteria can enter a host (animal or human) and continue the circle of disease. Objective: Diagnosis of leptospirsis according to clinical symptoms is difficult due to lack of pathogenic sign(s) and the similarities of its clinical features to some common febrile diseases, so laboratory is important in diagnosis. Leptospira is fastidious and its isolation from other clinical specimens is difficult, time consuming and usually unsuccessful, so MAT is the gold standard for diagnosis and serotyping of leptospira and is usual in all reference laboratories. Materials and Methods: We performed this study in 1383 by taking blood sample from patients hospitalized in Emam Khomeini Hospital in Some- e-sara, Razi and 22 Aban Lahijan and had clinical symptoms and were suspected of leptospirosis. Sampling was done in spring and summer, which are prevalent seasons of leptospirosis in Gailan prorince. We stored all serums in- 200ºc until examination, and in summer of 1383 serum samples were screened by a Quantitative Elisa method to detect positive samples for doing MAT, and performed MAT to determine causative serogroups. Results: 282 serum sample were all tested by quantitative Elisa and 130 cases had IgM titer equal or greater than 1:60 which were considered for MAT test. Seventy serum samples had titer ≤160 in both tests and all were positive and highest serum titer in MAT test was the determining criteria for causing disease. Conclusion: Analyzing the results of MAT was hard and complex due to alternate reactions happening between different serogroups specially in clinical samples related to acute disease. According to CDC, a serum titer of ≥ 200 and if it correlates with clinical symptoms can present probable diagnosis. In this study, considering the samples were only taken from patients with clinical symptoms and suspected of leptospirosis and then after screening by Elisa, only positive samples with IgM titer equal or greater than 1:16 were assessed by MAT keeping in mind three criteria (Correlating clinical symptoms Elisa and MAT results) there is a high efficacy of diagnosis and determines servoirs and serogroups are prevalent in this area.}, Keywords = {Laboratory Techniques and Procedures, Leptospirosis}, volume = {15}, Number = {57}, pages = {8-14}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-473-en.html}, eprint = {http://journal.gums.ac.ir/article-1-473-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Panahandeh, Z and PourGhasemi, M and Asgharnia, M}, title = {Body Mass Index and Prenatal Weight Gain}, abstract ={Abstract Introduction: Weight gain during pregnancy is variable and depends on mother’s diet status before pregnancy. Based on medical resources, there is an inverse relationship between mother’s Body Mass Index(BMI) and prenatal weight gain. Objective: The aim of the study was to investigate mothers’ BMI before pregnancy and prenatal weight gain. Materials and Methods: In a cross – sectional study, we analyzed retrospectively prenatal and obstetrical reports of 480 women attended health centers of rural areas in Rasht, who delivered during year 2002. The selection of them was done by cluster and random selection in ten health centers. Maternal characteristics including age, job, education, pre pregnancy weight, height, body mass index, pregnancy weight gain, parity, and main outcome including birth weight were recorded. Student t-test, Chi-square, One-way Anova and correlation were used to analyze data. Results: On the basis of body mass index (BMI), 7.9% 0f women were thin, 45.4% of them had normal BMI and 46.7% were overweight. The mean of BMI was 26.2 ± 5.2. The mean of pregnancy weight gain was 9.2± 4.1 kg (min=0.5, max=21kg). An inverse relationship between BMI and pregnancy weight gain was showed (r=-0.26, p =0.01). Although the mean of pregnancy weight gain in thin women was higher than obese ones but, about most of them didn’t gain expected weight during pregnancy. Rate of low birth weight was about 11% Conclusion: This study shows an inverse relationship between BMI and pregnancy weight gain. Pregnancy weight gain is lower than recommendations and also rate of LBW is higher than expected in these rural regions. Use of appropriate nutritional model for pregnant women, could contribute to increased pregnancy weight gain and improved birth weight.}, Keywords = {Body Mass Index, Pregnancy, Weight Gain }, volume = {15}, Number = {57}, pages = {15-20}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-474-en.html}, eprint = {http://journal.gums.ac.ir/article-1-474-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Najafi, B and Fakheri, T and Fadakaresogheh, GH}, title = {Relationship of HER-2 With Other Clinical– Pathological Diagnostic Criteria in Breast Cancer Patients}, abstract ={Abstract Introduction: HER-2/neu is a membrane protein and it is one of the determining prognostic factors of breast cancer. Objective: The aim of the study was to investigate the relationship between the expression of the HER-2 membrane protein and clinical- pathological parameters such as size: degree of the tumor differentiation, presence or absence of lymphovascular invasion and its relation with steroid hormone and P53 status in breast cancer patients. Materials and Methods: This descriptive study was done on 465 cases of breast cancers referred to two cancer centers in Gilan from 1980-1985. Patients’ demographic data, pathological and type of clinical therapy were gathered from their medical charts. All membrane samples taken by biopsy were embedded in paraffin and stained by hematoxylin-eosin technique and were evaluation by a semi-quantitative method of immunohisto- chemistery for HER2 protein, P53 and steroidal receptor. Results: A total of 32% of breast cancer patients had positive HER2 protein. There was a positive correlation between HER2 protein and P53 protein expression (P=0.000). There was a positive relationship between presence of HER2 protein and absence of steroid receptor with high-grade tumor (grade 3)(P=0.3) and absence of HER2 and presence of steroid receptor with low-grade tumor (grade 1) (P=0.5). There was no correlation between HER2 and lymphovascular invasion and size of tumor. Conclusion: In breast cancer patients, there is a positive correlation between presence of HER2 protein and degree of tumor differentiation and it also correlates with poor prognostic factors such as hormone receptor negativity and P53 positivity.}, Keywords = {Breast Neoplasm, Membrane Proteins, Receptors- Steroid}, volume = {15}, Number = {57}, pages = {21-27}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-476-en.html}, eprint = {http://journal.gums.ac.ir/article-1-476-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Hashemi, E.S and Montazeri, A and Akbari, E and Najafi, M and Haghighat, SH and Kaviani, A}, title = {Role of Tumor Markers in Breast Cancer Recurrence}, abstract ={Abstract Introduction: The value of clinical use of tumor markers for prediction of breast cancer recurrence in follow-up or level of response to treatment is still controversial. Objective: In this study, the role of tumor markers in breast cancer recurrence was evaluated. Materials and Methods: One hundred and forty-one breast cancer patients were entered into the study and followed up for 132 months (mean= 34.0، SD= 28.0). The mean age of the patients at time of diagnosis was 47.1 (SD= 12.3) ranging from 23 to 81 years. Most patients (51%) were presented with stage II breast cancer. 81% of the patients underwent modified radical mastectomy and the remaining 19% had breast preservation surgery. The association between clinical recurrence with age, tumor size, nodal involvement, stage, type of surgery and pathology, CA15.3, CEA, P53, ER, PR, and HRE-2 status were examined by using the forward conditional logistic regression analysis. Results: Recurrence occurred in 22% of patients during the follow up time. The results indicated that recurrence was significantly predicted by the status of CA15.3 (odds ratio= 6.1، 95% CI= 1.62-23.1, P= 0.007). Conclusion: The findings showed that independent of age and other known prognostic factors CA 15.3 is an individual factor for prediction of recurrence in breast cancer patients.}, Keywords = {Breast Cancer, Recurrence, Tumor Markers-Biological }, volume = {15}, Number = {57}, pages = {28-32}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-477-en.html}, eprint = {http://journal.gums.ac.ir/article-1-477-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Asadi, K}, title = {Effect of Smoking on Healing Time of Tibia Fracture}, abstract ={Abstract Introduction: Smoking is proven to be a factor in development of osteoporosis and its related fractures and al so its role in delaying bone ::union:: in spinal fusion has been cited. In attention to popularity of smoking in patients with limb fracture in Guilan province, we studied the relation between smoking and bone healing time. Objectives: The aim was to study the effect of smoking on clinical and radiological ::union:: in closed and Type I Open fracture. Materials and Methods: From 195 consecutive tibia fractures in 190 patients, 146 patients of Poorsina hospital with closed or open type I fractures have been studied in a 4 years period. 76 of them were non-smoker and 70 patients were smoker. From these patients, 44 (58%) non-smokers and 59(84%) smokers were followed until complete ::union:: or up to one year. ::union:: has been confirmed clinically and radiologically. Results: Statistical differences in clinical and radiological healing rates between those who smoked and those who didn’t smoke were observed in patients receiving intramedullary fixation or external fixation. Statistical differences were not seen in the clinical and radiographic healing of tibias treated with cast immobilization. Conclusion: This study revealed that smoking dramatically delay the tibia fracture ::union::, especially when the surgical treatment has been used.}, Keywords = {Fracture Healing, Smoking , Tibial Fracture}, volume = {15}, Number = {57}, pages = {33-39}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-478-en.html}, eprint = {http://journal.gums.ac.ir/article-1-478-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Khalkhali, S.M.R and Najafi, K and Nazifi, F}, title = {The Frequency of Drugs and Substances Use in Opiate Dependenents}, abstract ={Abstract Introduction: Some of the opiate dependents use other drugs and substances that confront them with more economic, social and medical problems and poor therapeutic outcome. Objective: This study was performed to identify the frequency of drugs and other substances used in opiate dependents referring to the clinic of welfare organization in Rasht. Materials and Methods: In a descriptive study, 96 patients admitted to the clinic from January 2002, in a 4 months period, were studied by clinical interview. The screening methods were not used. They were questioned about their time and type of substances (Opiate, Cannabis, Alcohol) or drugs (Codeine, Benzodiazepins, Barbiturats, Dextrometorphan, . . .) used, withdrawal symptoms, pattern of obtaining drugs or substances and history of lapses and relapses. DSM IV criteria’s for dependency or abuse were used. Results: From 96 patients studied 93 were male and 3 female, 31/3% unemployed, 81% lived in urban area, 44% with academic education lower than elementary, and 64% married. 12.5% had at least one year abstience, 30.2% without complete detoxification, 38.5% at least one month abstience and 21.4% two times and 9.4% three times of at least one month abstience. Opium in 63.5%, Heroin in 30.2% and Codein in 3.1% of subjects were the main opiates used. The most frequency of co morbidity was seen between opiates and benzodiazepins and between opiates and Alcohol. 21.8% of patients had multi substance dependency, 26% had co morbidity of opiate dependency and drug dependency, and 16.6% had co morbidity of multi substance dependency and drug dependency. The most common way of obtaining drugs were by prescription and pharmacy without prescription. Conclusion: The frequency of drugs and substances use and significant co morbidity between opiate dependency and dependency to other substances or drugs despite different geographical, cultural and economic backgrounds were similar to other countries. Greater emphasis on organizing drug policy, physicians’ education and treatment of comorbide conditions and evaluation of the effects of these interventions on drugs and substance use patterns is recommended.}, Keywords = {Drugs, Narcotics, Opiate-Related Disorders, Substance-Related Disorders}, volume = {15}, Number = {57}, pages = {40-47}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-479-en.html}, eprint = {http://journal.gums.ac.ir/article-1-479-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Ravanshad, SH and Naserollahzadeh, J and Sovaid, M and Setoudehmaram, E}, title = {Effect of Sour Orange (Citrus Aurantium L.) Juice Consumption on Blood Glucose and Lipid Profile in Diabetic Patients with Dyslipidemia}, abstract ={Abstract Introduction: Sour orange is known as an herbal plant in folk medicine. Previous studies indicate a protective relationship between the consumption of citrus fruits or juices and risk of some chronic diseases. Objective: In this study, the effect of short-term consumption of sour orange juice on blood glucose and lipid profile of diabetic patients was evaluated. Materials and Methods: In a clinical trial study (before and after), thirty-five (10 men and 25 women) dyslipidemic diabetic patients without nephropathy with mean age 53.1 + 7.7 years and serum cholesterol level greater than 220 mg/dl were selected. Each patient consumed 240 ml of sour orange juice daily for 4 weeks. The patients were asked to maintain their usual diet, physical activity and consumption of their oral hypoglycemic agent during the entire experimental period. Body weight and height were measured at baseline and after consumption of 240 ml of sour orange juice daily for four weeks and BMI was calculated. Fasting blood glucose, lipids and ascorbic acid level were measured at the beginning and the wnd of the study. Plasma ascorbic acid concentrations were measured by the 2,4 dinitrophenyl hydrazine method with calorimetric analysis. FBS, TG, and total cholesterol were measured by enzymatic method. A 24 hr dietary recall and food frequency questionnaire were analyzed by Nutrition III soft ware. Data were compared with paired t- test and X2-test as appropriate. Results: there were no statistical significant change in body weight, energy and macronutrient intakes before and after 4 weeks consumption of sour orange juice, but Vitamin C intake significantly (p<0.05) (24%) increased. Fasting blood sugar level significantly decreased) p<0.05) after consumption of sour orange juice (9%). Plasma ascorbic acid level were significantly increased (p<0.001) by 12.7% glycosylated hemoglobin and lipid profile, did not affected after consumption of sour orange juice. Conclusion: Short-term incorporation of sour orange juice in diabetics diet had a lowering effect on fasting blood glucose.}, Keywords = {Biood Glucose, Citrus, Diabetes Mellitus- Type2, Dyslipidemia, Lipids}, volume = {15}, Number = {57}, pages = {48-53}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-480-en.html}, eprint = {http://journal.gums.ac.ir/article-1-480-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Baghi, I}, title = {Association Rate of Leukocytosis, Increased CRP and ESR With Acute Appendicitis}, abstract ={Abstract Introduction: Acute appendicitis is one of the most common problems requiring emergency surgery. Diagnosis is based on history, physical examination and laboratory findings. Rate of misdiagnosis of appendicitis especially in female is up to 23.2%. Some basic laboratory examinations such us white blood cell count, CRP and ESR have been suggested as aids in the diagnosis of acute appendicitis. But results are controversial. Objective: This study was designed to consideration of association rate of leukocytosis, increased CRP and ESR in acute appendicitis. Materials and Methods: In this prospective study, 158 patients were admitted with clinical diagnosis of acute appendicitis from September 2001 to March 2002 in Poursina hospital in Rasht. Blood samples for WBC, CPR and ESR were sent to the laboratory preoperatively. Then sensitivity, specificity, PPV and NPV of these tests were determined and analyzed. Results: There were 98 males (62%) and 60 females (38%). The mean age was 28.41 years (range 3 to 70 years). 146(92.4%) patients have histologically confirmed appendicitis and 12(7.6%) had normal appendix. Sensitivity, specificity, PPV and NPV for leukocytosis were in order: 84.2%, 33.3%, 93.9% and 14.8% for increased CRP were in order 79.4%, 25%, 92.8% and 9.09%, and for increased ESR were: 69.2%, 8.3%, 90.2%, 22% in orderly. When all tests are used for diagnosis, these criteria were 54.8%, 66.6%, 95.2% and 10.8% respectively. In attention to sensitivity and value of positive (PPV) and increased WBC, CRP and ESR, it can be resulted that positivity of these tests in suspected appendicitis can strengthen the clinical diagnosis but lowered value of negative (NPV) tests showed that the negativity of each test or all tests together can not verify acute appendicitis. Conclusion: In presence of Leukocytosis, increased CPR;ESR probability of appendicitis was increased in clinically acute appendicitis. But normal value of WBC, CRP; ESR don’t rule out acute appendicitis.}, Keywords = {Angiomyolipoma, Kidney Neoplasms, Nephroctomy}, volume = {15}, Number = {57}, pages = {54-58}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-481-en.html}, eprint = {http://journal.gums.ac.ir/article-1-481-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Imantalab, V and Haghighi, M}, title = {Effect of Hemodynamic Propofol and Thiopemtal Sodium and During Electeroconvulsive Therapy}, abstract ={Abstract Introduction: For safe conduct of electro convulsive therapy (ECT) and decreasing the tissue physiological complication general anesthesia is recommended to patients. Objective: In this study we compared thiopental sodium and propofol as induction agent for ECT. Materials and Methods: Twenty-five patients each undergoing at least 2 sessions of ECT at the psychiatry department were included in the study. Each patient either received thiopental sodium or propofol for induction in a randomized manner. They are in ASA class I, II and don’t have any contraindication for ECT. Patients with cardio- vascular problem and stroke were excluded from study. Patients were anesthetized in a randomized manner wit h 2.5mg/kg thiopental and 1mg/kg propofol in separate session. Muscle relaxant drug dose was the same for all patients. Amount of energy shock administration can lead to effective tonic-clonic seizure in-patient. Mean arterial pressure and heart rate in 1,5 and 10 minute after ECT were evaluated. Meanwhile duration of seizure and verbal eye opening, discharge from recovery room and breathing rhythm in two groups were also evaluated. Results: The mean arterial pressure in proopfol group in 1,5 and 10 minute after ECT was respectively: (88.26±13.03) mm Hg, (92.50±10.01) mm Hg, (87.56± 10.24) mm Hg. And in thiopental group in 1,5 and 10 minutes after ECT was respectively: (84.97±10.28) mm Hg, (104.13±7.85) mm Hg, (96.73±9.08) mm Hg, that was statistically significant (P< 0.00). In the assessment of mean heart rate in 1,5 and 10 minute after ECT in thiopental group was respectively:(82.2±9.07)min, (110.04±7.08) min, (101.65±10.08) min. And in propofol group was respectively: (85.77±12.04) min, (98.75±11.02) min, (81.46±12.01)min which was statistically significant (P<0.05). Duration of seizure in thiopental and propofol group was respectively: (31.08±4.13)min, (25.76±3.38) min. Time to verbal eye opening in thiopental and propofol group was respectively(5.04±1.36) min, (3.28±0.89)min. Discharging from recovery in thiopental and propofol group was respectively: (13.68±1.72) min, (10.28±1.05) min. Breathing rhythm time in thiopental and propofol group was respectively: (5.02±0.3)min (4.74±0.3)min which was statistically significant (P< 0.001). Conclusion: Propofol offered a superior-hemodynamic stability during the procedure and a quick recovery from sleep. Propofol was found to be a better induction agent for ECT as compared to thiopental sodium.}, Keywords = {Electroshock, Hemodynamics, Propofol, Thiopental }, volume = {15}, Number = {57}, pages = {59-64}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-482-en.html}, eprint = {http://journal.gums.ac.ir/article-1-482-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Pishva,}, title = {Electrocardiogram Changes in Term and Premature Healthy Newborns}, abstract ={Abstract Introduction: Since electrocardiography along with the other diagnostic procedures, is applied in seeking cardiac disease, so perceiving normal and abnormal electrocardiography patterns in newborns, accelerates the diagnosis of these diseases. On the other side some ECG parameters of term and premature newborns, which changes through life span, are different from each other. Objective: There was no study done in our center to compare the electrocardiogram of term and premature neonates so we decided to compare their EKGs and its differences with other centers in the world. Materials and Methods: During 2002, from 30 term newborns (gestational age of > 38 weeks) and 30 premature (GS< 38 weeks) who were born in hospitals of Shiraz University of medical sciences and age 24-96 ours were chosen. And a complete EKG (12 leads) was conducted on lying position when newborn was calm and alert. All neonates were assessed fully for underlying diseases that could affect their EKG. All EKGS were assessed and compared as regard to heart rate, axis of heart, voltage, P wave duration and R wave in QRS complex. Comparative statistics was done using SPSS soft ware with fisher exact method. Results: QRS axis in full term neonate is shifted to the right and to the left in premature neonates (P<0.05). Duration of P and QRS waves in term is longer than those in premature babies (P<0.05). Voltage of P wave in premature neonates is higher than that in the term babies. We didn't find significant difference between R wave voltages in these two groups. Conclusion: The electrocardiogram of premature infants is different from the term ones in axis, P voltage and QRS duration.}, Keywords = {Electrocardiography, Heart Defect, Congenital, Infant, Infant- Premature }, volume = {15}, Number = {57}, pages = {65-69}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-483-en.html}, eprint = {http://journal.gums.ac.ir/article-1-483-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Ayatollahi, S.M.T and Ghaem, H}, title = {Asthma and Its Correlates in Primary School Children in Shiraz}, abstract ={Abstracts Introduction: Asthma is one of the most common chronic conditions in children. Objective: The present study was based on target population. After the study of prevalence, determination of asthma was matched by case- control method to identify correlates in primary school children aged 6-12 years in Shiraz (Southern Iran). Materials and Methods: This study was conducted in 2228 primary school children. The children were selected using two-stage random sampling from the four educational districts of Shiraz. A screening questionnaire was completed for each child. The consultant physician examined the children with positive result. After diagnosis of asthma, control group was selected by using matching method (age-sex-school). Conditional Logestic Regression determined the correlates of asthma. Results: The most important results were as follows: Prevalence of diagnosed asthma in primary school children estimated as %102 (boys: 1.19% – girls: 1.13%) with no significant difference. There was no significant association between asthma and birth order, social class, parent’s education, mother’s occupation and duration of breast-feeding. An increased risk of childhood asthma was associated with familiar history of allergic rhinitis (P<0.04), familial history of asthma (P< 0.01), history of allergy in children, (P<0.007) and exposure to smoking ( P<0.016). Conclusion: Our study confirmed that familial atopic diseases and exposure to smoking were significant predictors of childhood asthma in Shiraz children.}, Keywords = {Asthma, Child, Prevalence}, volume = {15}, Number = {57}, pages = {70-75}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-484-en.html}, eprint = {http://journal.gums.ac.ir/article-1-484-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Ghaffari, R and Varshosaz, M}, title = {Evaluation of Central Depth of Dental Demineralization on Digital Subtraction Radiography (invitro)}, abstract ={Abstract Introduction: The majority of carious lesions are not well-defined radiolucencies. Approximately 40% demineralization is required for radiographic detection of a lesion. The actual depth of penetration of carious lesion is deeper than may be detected radio graphically. However, digital subtraction images permit to detect 1-5% decrease of mineral mass per unit volume. Objective: The aim of this study was to detect central depth of dental demineralization on digital subtraction radiography. Materials and Methods: This study was preformed on 15 extracted human teeth. In each tooth, one approximal enamel demineralization defect was induced using an acidified system (PH=4.8). Direct digital radiography were obtained under standardized condition over a period of 42 days. The images of the 7th , 14th , 21st , 28th , 35th and 42nd days were subtracted from the baseline radiograph (before creation of the lesion). Because all of images showed moderate proximal demineralization on 42nd days, all teeth sectioned for histological study. Then, the mean standard deviation of the extent demineralization was obtained with the radiographic and histological measurements. The test served as the statistical sampling unit for testing difference between the measurements. Results: After 42 days, the mean±SD of the extent of demineralization was underestimated by radiographic assessment (0.48±0.25 mm than histometric measurement 0.54±0.18 mm).However this difference wasn't significant (P=0.82). Conclusion: For monitoring the progression of carries clinically, central depth seems to be the proper parameter.}, Keywords = {Dental Caries,Radiography, Dental, Tooth Demineralization}, volume = {15}, Number = {57}, pages = {76-81}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-485-en.html}, eprint = {http://journal.gums.ac.ir/article-1-485-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {Mehrabian, F and NasiriPour, A.A and Tabibi, S.J}, title = {Client Tribute Plan in Rasht Teaching Hospitals}, abstract ={Abstract Introduction: One of the measurement indices for effectiveness and development such as in health and treatment sections is client satisfaction with governmental organizations services . In order to promote this plan, client tribute plan has been implemented. Objective: This study is done to evaluate the implementation method of client tribute plan in Rasht teaching hospitals in 2004. Materials and Methods: The research was performed in a cross- sectional descriptive method. Target population of the study consisted of Rasht six teaching hospitals. Measurment instrument used for the study was a check-list so that its validity and reliability has been approved by the quality promotion of Iranian Health and Medical Education Ministry. It was based on three methods of observation , use of documentations and registered data , and interview. In this research all activities related to 10 clients programs were studied. Results: Mean scores related to the education of staff in the study hospitals were 45.3%. They were as follows: 60% in the area of clarification and documentation of providing services for the clients, 68.3% in the area of giving information regarding the method of providing services for people 100% in the field of preparation of ethical charter of the organization in connection with people , 93.3% concerning the prediction for appropriate space and facilities, 73.4% in the area of improvement and amendment of ways for providing services to people , 76.6% survay program from clients, 60% in the area of supervision and inspection, 53.3% concerning the appreciation and encouragement for successful managers and staff and 55% in connection with how to behave with people. The mean total scores from the “ clients tribute plan “ in Rasht teaching hospitals were 68.34%. Of these , Dr. Heshmat hospital had the highest score by 83.49% and Alzahra madernity hospital had the lowest score by 52.66%. Conclusion: Implementation of clients tribute plan in Rasht teaching hospital was associated with relative success. Also, we will witness the increasing success of this plan by stablishing change and development program in managerial systems as one of the important necessities as well as by changing the punishment and encouragement criteria of managers and staff from the traditional method so that the views of clients can be taken into consideration in this regard.}, Keywords = {Consumer Satisfaction, Hospital- Teaching, Program Evalution}, volume = {15}, Number = {57}, pages = {82-91}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-486-en.html}, eprint = {http://journal.gums.ac.ir/article-1-486-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} } @article{ author = {}, title = {}, abstract ={}, Keywords = {}, volume = {15}, Number = {57}, pages = {92-95}, publisher = {}, url = {http://journal.gums.ac.ir/article-1-487-en.html}, eprint = {http://journal.gums.ac.ir/article-1-487-en.pdf}, journal = {Journal of Guilan University of Medical Sciences}, issn = {2383-4307}, eissn = {2423-4818}, year = {2006} }