[Evaluation of tuberculosis prevalence and delivered care among close contacts of smear positive tuberculosis patients in Sanandaj from 2009 to 2012]

Background and Aim: based on TB control program, evaluation of persons in close contact with pulmonary TB patients is very important. Evaluation of assessment process and services provided to close contacts and also evaluation of defects in this process can be helpful for proper planning. In this study we evaluated the prevalence of tuberculosis among close contacts of TB patients and the services provided for them in Sanandaj during 2009-2011

Materials and Methods: this cross-sectional study [descriptive-analytical] included all persons in close contact with smear positive TB patients, who had been registered in TB control center of Sanandaj according to TB Country Guide, from 2009 towards the end of 2011 [three years]. Data of all close contacts of the smear positive tuberculosis patients were obtained from the medical records. The close contacts were evaluated based on history and physical examination. Using SPSS software, data were analyzed by chi-square test and Fisher's exact tests

Results: in this study, 298 close contacts of TB patients were assessed. According to the records, 248 contacts [83.1%] had been evaluated at the time of diagnosis of tuberculosis in the patients. Also, after completion of TB patient's treatment, only 111 [37.2%] members of the families had been followed. There were no statistically significant differences between male and female in regard to the services provided to the close contacts [p>0.05]. 137 [57.3%] subjects had long term contact and 102 [47.2%] had limited contact [p=0.022]. Among those who had been referred to specialist, 4 [23.5%] and 13 [76.5%] subjects had long term and limited contact respectively which showed a significant difference [p=0.012]. In this study one new smear positive TB patient was diagnosed

Conclusion: the results of this study showed that about one fifth of close contacts have not been evaluated at the time of diagnosis of TB in the patients and more than half of the contacts had not been followed. Although the percent of services for those with long term contact was higher, essential measures such as medical history and physical examination had not been implemented

[Evaluation of pneumothorax risk factors in mechanically ventilated neonates admitted to neonatal intensive care unit]

Pneumothorax is the most common pulmonary air leak syndrome which occurs more frequently in the neonatal period than any other time of life. Mechanical ventilation with positive pressure is one of the most common causes of this condition. The aim of this study was to evaluate pneumothorax risk factors in mechanically ventilated neonates admitted to neonatal intensive care unit [NICU] of Besat Hospital in Sanandaj This was a nested case-control study. Case group were neonates under ventilation with pneumothorax admitted to NICU between April 2012 and March 2013. Control group included neonates under ventilation without pneumothorax whose admission times followed in the immediate chronology to the case group. 31 cases and 62 controls were selected. Data collection was performed by use of medical records and ventilator memory in the last 24 hours. The data were introduced into SPSS software. Analysis of qualitative variables was performed by chi-squared and Fisher test. We used Mann Whitney U test for analysis of quantitative variables and logistic regression in order to control confounders. 61.3% of newborns with pneumothorax were male and 38.7% female. 61.3% of these neonates were born by Cesarean section and 38.7% by vaginal delivery. Their mean gestational age was 32 weeks and the mean birth weight was 1819 g. 74% of cases had pneumothorax in the right side, 13% left side and 13% bilaterally. Hyaline membrane disease [HMD] was the most common underlying disease [74.2%] in the newborns with pneumothorax. 38% of neonates under pressure controlled ventilation developed pneumothorax compared to 7.1% of neonates under synchronized intermittent mandatory ventilation [SIMV], which showed a significant difference [p=0.03]. Ventilator parameters associated with higher risk of pneumothorax were more episodes of ventilator adjustments [P<0.001], high peak inspiratory pressure [p<0.001], high positive end expiratory pressure [p=0.029] and high mean airway pressure [p<0.001]. In general pneumothorax risk factors in mechanically ventilated neonates in our investigation were similar to those of other studies. Our findings indicated that pressure controlled ventilation more episodes of ventilator adjustments, increased peak inspiratory pressure, positive end expiratory pressure and mean airway pressure are major pneumothorax risk factors in the mechanically ventilated newborns. To prevent pneumothorax, it is necessary to avoid frequent changes of ventilator adjustments and decrease in the above mentioned parameters to the levels enough to supply lung oxygenation

[Sublicnial symptoms of intoxication associated with exposure to low levels of mercury by dentists]

Dentists are occupationally exposed to elemental mercury from placements of mercury-containing amalgam. Although many studies have been conducted on mercury intoxication, there is still widespread concern about possible ill effects of chronic low-level mercury exposure on dentists. The present study examined the effects of occupational exposure to low levels of mercury by a group of dentists. In this historical cohort study, subjects consisted of 106 dentists and 94 general practitioners [referent group], from private and public clinics in Shiraz city. Subjects were requested to complete a questionnaire on demographic variables, symptoms experienced and work practices. Additionally, using standard' methods, atmospheric and urinary concentrations of mercury were measured. The data were analyzed by appropriate statistical tests. In univariate analysis, Chi-Square test was used to compare the prevalence of symptoms among both groups. Independent sample t-test and Mann- Whitney's U-test were used to compare the mean and median of quantitative data of both groups. Multivariate logistic regression analysis was used to adjust for potential confounders. Both groups were similar as far as most demographic and socioeconomics variables, but age and number of personal amalgam fillings, were concerned. Median of atmospheric concentration of mercury was found to be 3.35 micro g/m[3]. Likewise, the urinary concentration of mercury in dentists was estimated to be 3.22 micro g. creatinine. This value was significantly higher than that of the referent group. Additionally, analysis of the data revealed that subclinical symptoms of intoxication were more prevalent in dentists. Our findings indicate that occupational exposure to mercury by dentists, even at low levels, is associated with a significant increase in the prevalence of subclinical symptoms of intoxication

[Comparison of the therapeutic efficacy of Azithromycin vs Tetracycline in Acne Vulgaris]

Acne vulgaris is a common skin disease which affects a large number of adolescents and adults at some time in their life. Several drugs have been used for the treatment of acne vulgaris and recently systemic azithromycin has been tried for its treatment. The aim of this study was to compare the therapeutic efficacy of azithromycin vs. tetracycline in acne vulgaris. The present study was a randomized investigator-blind clinical trial, carried out at the outpatient department of Besat Hospital of Sanandaj in 2008. 82 patients were allocated randomly into two groups. Azithromycin 500 mg for 3 consecutive days per week for the first month, then 250 mg/ every other day was prescribed for the first group The second group received tetracycline 250 mg/6h. The treatments continued for 12 weeks. The therapeutic efficacy of these drugs was assessed on the basis of lesion counting. Data were introduced into SPSS 11.5 software and analyzed by means of independent t- test, Mann-Whitney and chi-square test. The mean number of lesions was not statistically different before treatment in the two groups. There was statistically a significant difference in the mean number of inflammatory papular lesions on the face and back after treatment [p<0.05]. However no significant difference was found in comedons lesions in both groups. The percentages of improvement of inflammatory papular lesions on the face and back were 82.3, 63.6 and 80.14 and 58.56 respectively [p<0.05]. This study suggested that azithromycin was more effective than tetracycline in treating inflammatory papular lesions of acne vulgaris on the face and back. Azithromycin can be used as an alternative in the treatment of resistant inflammatory papular lesions to tetracycline

[Comparative efficacy of 10% sodium sulfacetamide lotion and 1% clotrimazole lotion in treatment of tinea versicolor]

Tinea versicolor is a common superficial fungal infection caused by normal skin flora and many topical and oral anti-fungal medications have been used for its treatment. The aim of this study was to compare the therapeutic effects of 10% sodium Sulfacetamide lotion with 1% Clotrimazole lotion in treatment of tinea versicolor. In this single-blind clinical trial 67 patients were divided into two groups using block randomization method. The first group consisted of 33 patients who were treated with 1% clotrimazole lotion. The second group included 34 patients who received 10% sodium sulfacetamide lotion. After 2 weeks of treatment, both groups were evaluated for clinical and paraclinical responses. The collected data were recorded in a data sheet and analyzed by X[2] and independent T tests, using SPSS software. After 2 weeks of treatment, clinical and paraclinical responses were seen in 22 patients [66.7%] and 28 patients [84.8%] in the first group [clotrimazole lotion] and in 7 [20.6%] and 8 [23.5%] patients of the second group [sodium sulfacetamide lotion], respectively. Statistical analysis showed that the differences are significant. The therapeutic effect of 10% sodium sulfacetamide lotion is much less than that of 1% clotrimazole lotion in treatment of tinea versicolor

[Comparison of sputum induction and bronchoalveolar lavage methods in diagnosis of pulmonary TB in patients with negative smear or without spontaneous sputum]

Sputum smear is recommended for microbiological confirmation of diagnosis of pulmonary tuberculosis. It has been reported that sputum induction is a safe and non-invasive method for confirmation of microbiological diagnosis of tuberculosis in smear negative patients. This study deals with the comparison of the value of sputum induction with that of bronchoalveolar lavage [BAL] in the diagnosis of TB. 56 patients suspected to have tuberculosis were admitted in the infectious ward of Tohid Hospital and entered into this study. Sputum induction and BAL were performed for two consecutive days according to a standard procedure. Smears obtained from induced sputum and BAL contents were stained for acid fast bacilli. Exclusion criteria were severe asthma or severe chronic obstructive pulmonary disease and pregnancy. Of 56 tuberculosis suspects with negative or absent sputum production, sputum induction led to positives smears in 8 [14.3%] patients [5 previously smear-negative, 3 unproductive] and BAL had positive results in 7 [12.5%] patients which revealed a significant difference [p = 0.000]. Sputum induction is safer, easier to accomplish and more sensitive than BAL technique for diagnosis of pulmonary TB. Our study suggests that sputum induction with aerosolized hypertonic saline is a useful technique for better detection of cases of tuberculosis in patients with negative smears or non-productive cough

Survey of epidemilogic status and incidence rates of cancers in the patients above 15 years old in Kurdistan province

At the present time, cancer is among the first three causes of death in developed countries and also in Iran. Considering different distribution of different types of cancers in the world and their significance in regard to morbidity and mortality, diagnosis of different kinds of cancers will be the first step in controlling these disorders. By proper planning, we can reduce the incidence rate of all types of cancers. This survey deals with epidemiological study of cancers in Kurdistan province. This was a descriptive study. Data were obtained from cancer registration system, which is a national program. In this system the data of all types of cancers, diagnosed in pathological centers, were collected and entered into the national soft ware program. Different types of cancers were encoded on the basis of ICD"O2. In this study 1294 cases of different types of cancers were collected from pathologic diagnostic centers in Kurdistan province in a period of 2 years [2003-2004]. In this survey the overall incidence rate of all types of cancer in 2003 and 2004, was 60 and 66.9 in 100000 people. 62% of cases were male and 38% female. Generally, the most common cancers in both sexes, were those of skin [22.8%], stomach [20.5%], esophagus [12.8%], urinary bladder [7.5%] and lung and bronchus [4.9%]. The most common cancers in male patients, belonged to stomach, skin, esophagus, bladder, lung, prostate, colorectal; and in female patients, cancers of skin, esophagus, stomach, breast and colorectal carcinoma were the most frequent types, respectively. The highest incidence rate of cancers had occurred in the patients who were older than 75 years. Histopathologically the most common cancers of skin, stomach and esophagus were basal cell carcinoma, adenocarcinoma and squamous cell carcinoma respectively. skin cancers were the most common cancers in Kurdistan province. But the total number of cases of cancers of all parts of Gastrointestinal tract, exceeded those of all other systems. In Females, opposed to males, esophageal cancer was more common than stomach cancer. Histopathologically, there was no significant difference in the prevalence of different cancers in Kurdistan province, in comparison to other parts of the country. The epidemiologic profile of cancers in Kurdistan province is different from other parts of our country, which requires more investigation