Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Comparison of Manitol and Albumin Treatment in Diuretic Resistant Edema in Children with Nephrotic Syndrome Referred to Ali Asghar Children Hospital in 2002
343
349
FA
H
Otukesh
Y
R
Hosseini Shams Abadi
N
Nephrotic syndrome is an important disease in children and the diagnosis and treatment of its complications is important. Edema is one of these complications which is more common and severe in children and has different treatment in comparison with adults. Treatment of edema in children contains protocols that increase intravascular volume and decrease sodium reabsorption in all parts of nephron especially proximal tubule and aldostrone inhibitors, whereas sodium channel blockers in distal nephron(like amiloride) are used in adults. Albumin is an appropriate drug for the treatment of edema in children, although it has a few side effects such as expensiveness, intensifying interestitium nephritis and reducing furosmide effect. Therefore, nowadays, it has been tried to use drugs that have albumin advantages but no side effects(like manitol) for the treatment of edema. Thus, it was decided to use manitol and compare its effects with albumin on weight loss and reducing edema. The patients of the present study took albumin and manitol patient by patient. Weight loss(first and last weight) which was important for us was remarkable in both groups(Pv0.005). Also, this weight difference did not have any relation with the amount of serum albumin in these two groups. Complications did not show any remarkable difference in both groups. Complications were evident in 16% of patients with manitol and 17% of other patients with albumin protocol. Complications in manitol protocol were hypokalemia and hypertension whereas they were hypertension and dehydration in albumin protocol. 15.8% of patients treated with manitol did not respond to this drug. This absence of response was seen in 30% of patients with albumin protocol. All the patients who were under manitol treatment and did not respond to it had MCD.
Key Words: 1) Manitol 2) Albumin 3) Edema 4) Nephrotic Syndrome
http://rjms.iums.ac.ir/article-1-21-en.html
http://rjms.iums.ac.ir/article-1-21-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Study and Comparison of Sensitivity Rates among Current Chemical Methods for Detecting Occult Blood in Stool
351
358
FA
L
Akhlaghi
Y
H
Ourmazdi
N
M
Firooz Rai
N
P
Sadr
N
Any abnormality in stool compounds can be an indication of colon disfunction or diseases. Occult bleeding which is determined by means of occult blood test(peroxidase activity) is the most valuable diagnostic test for primary stage of colorectal neoplasia which can be fully prevented. Considering dietary precautions, foods such as red meat, fish, vegetables, vitamin C and iron containing anti-inflammatory non-sterodial drugs should not be consumed at least three days prior to doing the test. Common techniques for conducting the occult blood test are the Meyer, Guaiac, O-Tolidine, Pyramidine alcohol methods and a few commercial kits such as Hematape. The principle behind all of these methods are the oxidation of the chromogen reagents, by O2 released of H2O2 due to the peroxidase activity present in RBC hemoglobin with the subsequent induction of color. In order to determine the sensitivity of each of these methods, blood was added in different amounts to human stool samples. The Meyer method was found to be the most sensitive way of conducting the occult blood test and it can detect pathologic bleeding of GI tract within the range of 5-10ml of bleeding per day. The other methods, in terms of their relative sensitivity were: the Guaiac method, O-Tolidine method, Pyramidine alcohol and Hematape, respectively.Hematape kit showed the least sensitivity and it can detect bleeding less than 81.5ml per day. The main purpose of conducting this study was to determine conventional occult blood tests(OB tests) and choose the best one in order to be presented and introduced to clinical pathology laboratories in all over the country.
Key Words: 1) Occult Blood 2) Sensitivity 3) Chemical Methods
http://rjms.iums.ac.ir/article-1-22-en.html
http://rjms.iums.ac.ir/article-1-22-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Study of Cardial Involvement Prevalence in 61 Pediatric Cases of Kawasaki Disease
361
365
FA
M.Y
A’rabi Moghadam
Y
S.M
Meraji
N
K
Sayadpour
N
Kawasaki syndrome is an inflammatory multiorgan disease of unknown etiology. The most dramatic organ involved is the heart. There were a few studies about cardiac involvement in Iranian pediatric cases of Kawasaki disease. The aims of this study were determination of cardiac involvement prevalence in Iranian children with Kawasaki disease and its comparison with other studies. 61 pediatric cases of Kawasaki disease referred to pediatric clinic of Shahid Rajayee Heart Hospital during 7.5 years were studied for cardiac involvement retrospectively and prospectively. 41 cases(69%) did not have any sign of cardiac involvement. Coronary artery aneurism was detected in 8 cases(13%). Pericardial effusion was seen in 11%. There were EKG changes and cardiomegaly each in 8% of patients. Mild mitral regurgitation was seen in 10%. Combined treatment with aspirin and intravenous immunoglobulin led to less aneurisms than treatment with aspirin alone. Our study showed that Kawasaki patients need traditional treatment(aspirin and intravenous immunoglobulin) for decreasing the probability of cardiac involvement. Pericardial effusion was less prevalent in our study which may be due to less frequent echocardiographic examinations and evanescent nature of those effusions. We recommend that our colleagues refer Kawasaki patients to pediatric cardiologist for better assessment of their cardiovascular status.
Key Words: 1) Kawasaki Disease 2) Coronary Aneurism 3) Aspirin
http://rjms.iums.ac.ir/article-1-23-en.html
http://rjms.iums.ac.ir/article-1-23-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Patients’ Expectations and Satisfaction with their Treating Physician
367
375
FA
A
Afkham Ebrahimi
N
M
Nasr Esfahani
Y
N
Saghafi
N
N
The aim of this study was to determine the expectations of the patients and their satisfaction with their treating physician and health services. 375 outpatients from different day clinics of Hazrat Rasoul Akram Hospital were sampled by proportional sampling and the “Patients’ Request Form” which measured three different expecations(explantion, emotional support and investigation and treatment)was administered. A satisfaction questionnaire which addressed patients’ compliance to medical advices and their general level of satisfaction was also administered. The findings were then transferred to SPSS for further analysis. The results which were upon four hypothesis showed a significant difference among the expectations(emotional support and the investigation and treatment) of the patients of the different clinics. Moreover, there was a significant correlation between patients’ satisfaction and the fulfillment of “explanation” request. Also, a positive and significant relationship was found between satisfaction and adherence to medical prescriptions and change of the physician. In conclusion, physicians’ knowledge of the patients’ expectations and the factors affecting their satisfaction improve the patient-doctor relationship and the quality of health care which is the end goal of health system.
Key Words: 1) Expectations 2) Patients’ Satisfaction
http://rjms.iums.ac.ir/article-1-24-en.html
http://rjms.iums.ac.ir/article-1-24-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Comparison of Functional Ankle Brace and Short-leg Casting effect on Gait Variables in Treatment of Grade II, III Lateral Ankle Sprains
377
383
FA
M
Akbari
Y
I
Ebrahimi Takamjani
N
E
Sadeghi
N
People with acute ankle sprains walk slowly and take smaller steps because of having pain, swelling and limited range of motion. While inversion ankle sprains are one of the most frequently occurring injuries among athletes and physically active people, the optimal method of treatment is still controversial. Various treatment plans for the management of acute ankle injuries have been categorized in two main methods, early mobilization and immobilization. The present study was designed to clinically investigate the effects of early mobilization by using ankle brace versus immobilization by applying short-leg casting, through measuring 3 gait variables: stride speed(gait-speed), contra lateral step length, and single leg support time. It was also conducted to investigate whether treatment method decreases pain and improves range of motion. 30 subjects suffering from unilateral ankle sprain selected by convenience sampling were recruited in the study and randomly allocated into two groups of 15. The first group received ankle brace and the second one received cast immobilization. After 3 weeks, motion controlling methods finished and the first test from cases was taken. Then, cases were referred to the physiotherapy service to receive 10-session treatment. After physiotherapy, both groups were tested for the second time and measurements of two groups were compared. Results of student’s t-test showed no significant difference between groups in both pre-test and post-test however, results of paired t-test showed a significant difference between pre-test and post-test in casting group. In brace group this difference was not significant. The results indicated that brace group members reached better gait variables before physiotherapy and, therefore, goals of rehabilitation was reached earlier.
Key Words: 1) Ankle 2) Sprain 3) Functional Brace
http://rjms.iums.ac.ir/article-1-25-en.html
http://rjms.iums.ac.ir/article-1-25-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Detection of Chloroquine Retinal Toxicity on Perimetric Findings in 52 Rheumatoid Arthritis Patients with Normal Findoscopic Findings Referred to Rasoul-e-Akram Hospital
385
391
FA
A
Bidari
N
M
Soltan Sanjari
N
M.A
Saba
Y
F
Ahmadi
N
Chloroquine and its congeners are antimalarial agents which have anti rheumatic properties. One of the most important side effects of these drugs is retinal toxicity. Different methods have been used for early detection of this complication but there is no firm consensus about the best one. The purpose of this study was to assess the value of central 2-10 perimetry in early detection of retinal toxicity. This prospective cross-sectional study was performed on 63 rheumatoid arthritis patients, who had been receiving chloroquine for at least 6 months and still were continuing this medication. All of the patients were examined by an ophthalmologist through direct and indirect ophthalmoscopy as well as central 2-10 perimetry. 21 of the cases were subjected to another perimetry, 3 to 12 months after the first perimetry. All the perimetric studies were interpreted by the same ophthalmologist. 2 out of 63 patients had macular pigmentary changes, 6 patients had cataract, 6 had corneal pigmentation and 3 ones were affected by both cataract and corneal pigmentation. Of 42 patients who were assessed by perimetry, 30 patients(71.4%) had normal results and 12 patients(28.6%) showed abnormal results. Out of 21 patients who were subjected to repeat perimetry, 11(52.4%) and 10(47.6%) patients had normal and abnormal results, respectively. In the latter group, in 8 patients(80%), despite continuing chloroquine, the second perimetric examination was normal unexpectedly. In 2 patients the second perimetric exam was worse and both of them had sustained cataract and corneal pigmentation. In 3 out of 11 patients(27.3%), who had normal result, the second perimetric examination showed some progression therefore, chloroquine was stopped in those patients. In this study the prevalence of chloroquine retinal toxicity was 5.9%. No correlation was found between accumulative and daily chloroquine dosages and perimetric results(P>0.7, P>0.8). Cataract as an underlying occular disease affected significantly the results of perimetric examinations(P0.13, P>0.9). Central 2-10 perimetry is a useful method for early detection of chloroquine retinal toxicity, but concordant ophthalmologic examinations and regular periodic perimetric examinations is mandatory to confirm chloroquine retinal toxicity.
Key Words: 1) Rheumatoid Arthritis 2) Chloroquine
http://rjms.iums.ac.ir/article-1-26-en.html
http://rjms.iums.ac.ir/article-1-26-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Savodjbolagh High School Students’ Knowledge and Attitude to HIV & AIDS in Spring 2002
393
399
FA
N
Hajian Motlaq
N
S
Farshi
N
E
Abdollahi
Y
A
Arvantaj
N
A
Kordestani
N
S
Ahmadi Yazdi
N
A
Khorami Banaraki
N
A
Asadi
N
M
Kianpisheh
N
R
Bayat
N
M.R
Narmani
N
The objective of the present study was to determine Savodjbolagh high school students’ knowledge and attitude to HIV and AIDS. In this descriptive cross-sectional study 1224 student were selected from 58 urban and rural high schools in Savojbolagh with the random numbers table. A questionnaire was administered by the researchers which contained some questions about HIV transmission ways, attitudes to HIV, questions on preventive methods and information sources of HIV. The analysis of the data was achieved by SPSS software. 29.7% of students believed that AIDS is a great threat to health while 19.5% of them believed environmental pollution is the main cause of it and 11.9% of them believed addiction is an important threat. 84.3% of the students were informed via television and only 15.5% of them got the information from their books. In their opinion, the majority of patients were infected by HIV through sexual misbehaviours(34.9%) and IV drugs abusing(33.1%). They believed that one of the main ways of transmission was using a common shaving blade(43%). About 58% of students believed that the infected patients had to be isolated. 39% and 81% of the students believed that condom and vaccination are effective ways for preventing AIDS, respectively. 64% of students preferred to be informed by the medical experts. 91% of students, agreed about, the compulsory HIV screening before marriage. This study revealed that television has an important role in improving students’ knowledge towards AIDS while their courses do not have enough information to aware them. Most of the students preferred to get information from the medical experts. The students have limited knowledge about AIDS transmission ways, its preventive and contraception methods. It seems that training of reproductive health is definitely required.
Key Words: 1) Knowledge and Attitude 2) Information Access
http://rjms.iums.ac.ir/article-1-27-en.html
http://rjms.iums.ac.ir/article-1-27-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Determining the Relationship between Blood Glucose Level in Patients with Diabetes Mellitus and Cholecystectomy Complications During and After Cholecystectomy
401
409
FA
M
Khavaninzadeh
Y
L
Modarress Enshaee
N
Diabetes mellitus is the most common endocrine disease in the world, the prevalence of which is perhaps one to two percent of the world population. Most findings show that hyperglycemia is the most important cause of diabetic complications although genetic factors may also play a role. In this observational analytical historical cohort survey, data were gathered from all diabetic patients who underwent cholecystectomy surgery in Hazrat Rasoul-e-Akram Hospital from 1992-2001. The data were then analyzed via x2 test and SPSS software. There was no significant statistical relationship between controlled glucose level and cholecystectomy complications during the surgery. However, there was a significant statistical relationship between controlled blood glucose levels both before and after surgery and cardiovascular complications after the surgery(P<0.05). Moreover, there was also a significant statistical relationship between the length of the disease and cardiovascular complications(P<0.05). There was no relationship between other complications and the life of the disease. Perhaps the duration of the disease is a destructive factor. In reference to the above findings, other journal articles and texts, controlling glucose levels before surgery will decrease surgical complications therefore, blood glucose levels must be brought to an acceptable and ideal level. This will prevent short and long-term complications such as cardiovascular complications, blood pressure hypertention, incisional hernia and adhesional bands.
Key Words: 1) Blood Sugar Control
http://rjms.iums.ac.ir/article-1-28-en.html
http://rjms.iums.ac.ir/article-1-28-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Assessment of the Effect of Self Care Program on Quality of Life in Patients with Cirrhosis referred to Tehran Hepatitis Center in 2003
411
420
FA
M
Zandi
N
S.M
Alavian
Y
R
Memarian
N
A
Kazem Nejad
N
Liver cirrhosis is one of the most essential problems of health care system in our country, because of its high prevalence and its disabling or deathly complications. According to literatures, chronic liver disease substantially reduces HROL which does not differ markedly by the type of the disease. In this regard, designing a self care program according to client’s needs in different aspects of quality of life, can maintain their independence, promote their sense of well-being and improve their quality of life. Using non-probability sampeling(convenience), a number of 44 patients(21 experimental & 23 control) concerning their charactristics(20-65 old, etc) were studied. Patients and their fellows’ demographic questionnaire, chronic liver disease questionnaire(CLDQ), educational needs checklist and self-reported checklist were the data collecting tools. For experimental group and their fellows, a self care program was performed in 4 sessions with 45 minutes. The quality of life in both groups was assessed by CLDQ questionnaire before performance of the self care program and three months after the self care program. The quality of life in both groups was compared and then data were analyzed using SPSS software. Chi-squared test and t-test revealed that the experimental and control group were the same concerning the effective factors on the quality of life, such as age, sex, etc(P>0.05). Mann-whitney test showed that the quality of life total score before intervention did not show a significant difference between the two groups(P=0.75). While after intervention the same test indicated a significant difference between the two groups(P=0.001). Wilcoxon test revealed that the quality of life total score before and after self care program in the experimental group had a significant difference(P=0.001), and the same test showed a significant difference in the control group too (has a decrease)(P=0.001). Consequently, the hypothesis of this study “the quality of life in patients with cirrhosis increases after the performance of self care program compared to the control group” was confirmed.
Key Words: 1) Liver Cirrhosis 2) Quality of Life 3) Self Care
http://rjms.iums.ac.ir/article-1-29-en.html
http://rjms.iums.ac.ir/article-1-29-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Investigation of Doctor-Patient Communication Skills Teaching: Medical Learners’ Perception(Stager-Intern) and Staffs of Iran University of Medical Sciences & Kermanshah University of Medical Sciences
423
431
FA
S.K
Soltani Arabshahi
Y
A
Ajami
N
S
Siabani
N
During last 20 years, the importance of communication skills in medicine has been increasingly stressed. Medical schools around the world have implemented instructional programs in this context. Since these skills are complex behavior, teaching has been of great importance. The objective of this study was to investigate communication skills teaching at IUMS and KUMS. In this descriptive-analytical study a self-administered questionnaire containing demographic data and 25 ordinal questions based on Likert scale was designed. A pilot study on stager/intern/staff in 4 main wards(internal medicine, surgery, pediatrics, OB & Gyn was performed. Face validity was sufficient. Content validity and coefficient reliability were determined(α of crohnbach 45% P=0.015). The number of stager/intern/staff at IUMS were 185/127/14 and those of KUMS were 63/61/30 which comprised a total of 446 medical learners and 45 medical clinical staffs who returned the questionnaires. Opinions of medical learners staffs at both universities were gathered and analyzed. The results obtained from each university were then compared. The main results were based on the following issues: formulating educational objectives and strategies for communicating with patients, drilling and giving feedback about patient’s history, receiving feedback from staffs and residents, the extent of communication skills teaching in different clinical enterprises and hospital settings, teaching and assessing the skill, and teaching basic and advanced skills. There were no definite formal educational programs and written objectives for communication skills at both universities. Teachings are unintentional, with no instructional design and plan in terms of teaching strategies(knowledge content and assessment in teaching basic and inter personal skills). It seems that KUMS medical staffs are more engaged in teaching and training the students.
Key Words: 1) Communication Skills 2) Doctor-Patient Relationship
http://rjms.iums.ac.ir/article-1-30-en.html
http://rjms.iums.ac.ir/article-1-30-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
A Prospective Study of the Diagnostic Value of Core Needle Biopsy and Fine Needle Aspiration in Bone and Soft Tissue Lesions
433
439
FA
T
Shooshtarizadeh
Y
M
Mehrazma
N
S
Haji Aliloo Sami
N
A
Kabir
N
Fine needle aspiration biopsy(FNAB) and core needle biopsy(CNBx) have proved to be accurate and cost-effective techniques for diagnosis of inflammatory and neoplastic lesions at different body sites. However, their applicability in bone and soft tissue pathology is still controversial. In this study, our experience with FNAB and CNBx of musculoskeletal lesions was prospectively investigated to determine the diagnostic values of different closed biopsy techniques in these lesions in contrast to open biopsy. 49 consecutive FNAB and CNBx were reviewed and the results were then compared with conventional biopsy results of bone and soft tissue lesions. FNAB precision was about 61.9% while CNBx distiguished 80% of bone and tissue lesions correctly. Accuracy of both FNAB and CNBx was more than 7% for diagnosing malignant from benign lesions. FNA sensitivity and CNBx specificity for differentiation of malignant from benign lesions was 100%. Although CNBx is an accurate and reliable method for diagnosis of most musculoskeletal lesions, specifically if the site of biopsy is properly chosen, the accuracy and reliability of FNAB is limited to the differential diagnosis of benign and malignant lesions. FNA is a suitable screening test for differentiating malignant from benign musculoskeletal lesions.
Key Words: 1) Fine Needle Aspiration Biopsy(FNAB)
http://rjms.iums.ac.ir/article-1-31-en.html
http://rjms.iums.ac.ir/article-1-31-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Evaluation of Oral Misoprostol Effect on the Treatment of Spontaneous First Trimester Incomplete Abortion
441
447
FA
M
Tale
N
M
Kashanian
Y
A
Dehghani Zadeh
N
The object of the present study was to evaluate oral misoprostol effect on the treatment of spontaneous first trimester incomplete abortion. An experimental study was performed on 97 women who were admitted to the hospital with the diagnosis of spontaneous incomplete abortion(diagnosed clinically(22.7%) or sonographically(77.3%)). At first, 600μg misoprostol (Cytotec in the form of 200 μg tablet) and then, if needed, two doses of 400μg, was prescribed, every two hours (total 1400μg). Drug effect was defined as complete evacuation of uterus without needing curetage. The next day after misoprostol prescription sonography was performed and with confirmation of empty uterus and completion of abortion, the patients were discharged. All of the patients were checked up at least once in the next three weeks and evaluated for probable complications.Of 97 patients, 69(71.1%) did not need surgical evacuation(8(11.59%) with two doses and 61 with three doses). Side effects of misoprostol were minimal and were tolerated by the patients well. Misoprostol use is a simple, safe and effective method for completion of incomplete abortion with no expense and surgical evacuation complications.
Key Words: 1) Misoprostol 2) Spontaneous Incomplete Abortion
http://rjms.iums.ac.ir/article-1-32-en.html
http://rjms.iums.ac.ir/article-1-32-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
A Case Report of Granulocytic Sarcoma of Eye(Chloroma)
449
452
FA
A.A
Abdi
Y
A
Mehrvar
N
SH
Ansari
N
The patient of the present report was a twelve-year-old girl who had an eye chloroma. She faced with edema, redness, probtosism and loss of sight in her right eye 40 days prior to referring to the hospital. The patient underwent treatment after she was diagnosed with eye infection but it did not have any effects on her. Surveys and experiments implied an eye chloroma resulting from AML. All the above-mentioned problems except loss of sight in her right eye disappeared by arranging chemotherapy.
Key Words: 1) Acute Myelogenic Leukemia(AML)
http://rjms.iums.ac.ir/article-1-33-en.html
http://rjms.iums.ac.ir/article-1-33-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
A Survey of Candiduria in Diabetic Patients of Zanjan, 2001-2002
453
461
FA
F
Fakour
N
M
Falahati
Y
F
Zaini
N
N
Mousavi Nasab
N
Diabetes mellitus is the most common endocrine disease. Because of defect in immunity system of diabetic patients, these patients often experienece frequent infections just related to increase in blood suger level. This study was conducted to study the candiduria level in diabetic patients of Zanjan, their colony count along with determining candida species as compared to healthy individuals. In this study, samples were taken from urine of 227 diabetic patients with strict sterile and standard techniques during an 8 month period. Then, direct microscopy and culture as well as colony count and complementary tests for identification of yeasts species was conducted on them and they were compared to those of healthy individuals. The data were analyzed by chi-squared test and t-test. Of 227 urine samples in target group, candiduria was observed in 31 cases(13.65%), and of 226 sampels in control group, it was observed in 11 cases(4/9%). In target patients, candida glabrata(62.5%), candida albicans(28.12%), candida krusei(6.25%) and cryptococcus albidus(3.12%) were the most common organisms extracted from the urine. In contrast, the isolated yeast organisms in control group included: candida albicans(54.54%), candida glabrata(27.3%), candida krusei(9.09%) and candida kefyr(9.09%). Frequency of candida glabrata was observered especially in urine including 150-500mg/dl levels of glucose(32.25%). Through this study it was found that candiduria in diabetic patients was closely related to the level of glucosuria(P=0.02). In addition, the yeast colony count in this study was not significantly different from normal controls(P=.11). It is concluded that in diabetic patients with good glucose control, the percentage of candiduria will be low and similar to healthy individuals.
Key Words: 1) Candiduria 2) Diabetic Patients 3) Candida Species
http://rjms.iums.ac.ir/article-1-34-en.html
http://rjms.iums.ac.ir/article-1-34-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Pregnancy Outcome Following One Previous Spontaneous Abortion
463
471
FA
M
Kashanian
Y
A.R
Akbarian
N
SH
Shabandoost
N
The objective of the present study was to determine the pregnancy outcome following one previous spontaneous abortion. A randomized prospective historical cohort study was done on 300 patients. 200 patients were gravida 2 and their previous pregnancy was spontaneous abortion and 100 patients(control group) were gravida 2 but their previous pregnancy was term pregnancy with a live fetus. Then, pregnancy outcomes including maternal complications such as(placenta praevia, placenta abruptio, PROM, preeclampsia and eclampsia, abortion, breech presentation, preterm labor, intra uterine fetal death and neonatal complications(low birth weight, visible congenital malformations, low Apgar Score minute 1) and delivery route such as cesarean section or instrumental delivery(forceps or vacuume) were determined. Statistical analysis showed that pregnancy complications following one previous spontaneous abortion were not different from that of control group except for abortion and intrauterine fetal death, which was more than control group. Also, the rate of cesarean section and curetage had been increased. Neonatal complications did not have significant statistical difference in comparison with control group. In conclusion, one prior spontaneous abortion is not a very significant risk for next pregnancy, but the risk of abortion and IUFD will increase. Therefore, careful prenatal care is mandatory.
Key Words: 1) Spontaneous Abortion 2) Pregnancy Outcome
http://rjms.iums.ac.ir/article-1-35-en.html
http://rjms.iums.ac.ir/article-1-35-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Negative Appendectomy and its Related Factors in 1211 Cases Undergoing Appendectomy
473
481
FA
H.A
Mohebbi
Y
SH
Mehrvarz
N
S.M
Toliat
N
A
Kabir
N
Acute appendicitis is still the most common acute surgical disease. The aim of this study was to evaluate the frequency of symptoms, signs, paraclinical findings and diagnostic value of these findings in prediction of acute appendicitis in patients suspicious of having this problem. In this study 1121 patients, suspicious of acute appendicitis, were operated and surveyed in the period of two years. One way ANOVA, kappa and odds ratio correlation coefficient and logistic regression model were used to analyse the data and to predict the occurrence of acute appendicitis. 92.4% of the patients were males, and the average age was 24.1 years. The rate of negative appendectomy in this study was 18.2%, which ranged between 4% and 27.7% based on diagnosis made by various physicians(P=0.001). The regression model revealed that among factors which showed significant difference between negative appendectomy patients and the rest, only older age(P=0.005), male gender(P=0.002), higher percenage of PMN(P=0.027) and higher heart rate(P=0.014) could be regarded as independent predictors of acute appendicitis(P<0.001). In conclusion, based on the results of this study, it is reasonable to be hesitant about operating a female patient suspicious of having acute appendicitis, if she has a PMN percentage of lower than 75%, white cells less than 10,000 in milliliter, urinary symptoms and no rebound tenderness or questionable rebound tenderness.
Key Words: 1) Acute Appendicitis 2) Negative Appendectomy
http://rjms.iums.ac.ir/article-1-36-en.html
http://rjms.iums.ac.ir/article-1-36-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
A Case Report of Hereditary Nephritis(Fechtner Syndrome)
483
488
FA
H
Nejad Gashty
Y
SH
Savoj
N
M.R
Mahdavi
N
F
Elahi
N
Fechtner syndrome is an autosomal dominant syndrome which is defined by cataract, sensory neural hearing loss, kidney involvement, macrothrombocytopenia and neutrophilic inclusion bodies. We report a 21-year-old man with a history of idiopathic thrombocytopenic purpura, cataract and hearing loss who was admitted for work up renal failure. His blood smear showed macrothrombocytopenia with neutrophilic inclusion bodies. His family history revealed the same organ involvement in his brother and sister who both died due to active bleeding. During family work up, his father’s blood smear showed macrothrombocytopenia and neutrophilic inclusion bodies without kidney involvement. Due to patient’s organ involvement and pattern of inheritance, our diagnosis was compatible with Fechtner syndrome. To the best our knowledge, there is no reported case of Fechtner syndrome in Iran. Since the hematologic abnormalities of our case were erroneously diagnosed as idiopathic thrombocytopenic purpura and the patient received unnecessary treatments(splenectomy), the familiarity with this syndrome will help in better understanding and management of these cases.
Key Words: 1) Hereditary Nephritis
http://rjms.iums.ac.ir/article-1-37-en.html
http://rjms.iums.ac.ir/article-1-37-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Study of Predisposing Factors of Urinary Tract Infections Among Married Women Referred to Selected Hospitals in Tehran City(2003)
489
497
FA
S
Nikpour
Y
L
Tabrizian
N
D
Masroor Roodsari
N
H
Haghani
N
Although acute urinary tract infections(UTIs) are common in young women, the associations of predisposing factors have not been defined prospectively. The objective of this study was to determine predisposing factors of UTIs among married women who referred to selected hospitals of Tehran in 2003. In this case-control study, information was obtained through questionnaire, in which participants were asked about predisposing factors. Through a continuous sampling method 400 women(200 women in case group and the rest in control group), who were between 14-45 years of age, were selected. Control patients were matched based on their date of birth. According to logistic regression hypothesis tests, under pants material(P=0.008), wearing synthetic underwear(P=0.01), changing underwear once a week or less(P=0.042), intercourse not followed by cleanliness of genital in husband(P=0.018), and not taking yogurt(P=0.015) or sour solutoin(P=0.039) increased predisposing factors of UTIs. The data in this study supported the view that several factors are associated with UTI. Therefore, providing proper education in suitable sets for example in health services for women is recommended. Also, these factors have been identified primarily in case-control study. Prospective studies are needed to confirm these observations and to develop approaches for prevention.
Key Words: 1) Urinary Tract Infections(UTIs) 2) Predisposing Factors
http://rjms.iums.ac.ir/article-1-38-en.html
http://rjms.iums.ac.ir/article-1-38-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
A Case Report of Schwannoma Presenting as a Lingual Mass
499
504
FA
F
Hashemi
N
M
Dolati
Y
The patient of the present case report was a 45-year-old Afghan man presented with lingual mass. CT scan revealed intramuscular mass in the floor of the mouth. Exploratory surgery revealed a huge well-defined encapsulated intramuscular mass. Histopathologic examination showed schwannoma. Only a few cases of lingual schwannoma have been reported in the literature. The huge size of the mass was also a surprising and noticeable point in this case.
Key Words: 1) Lingual Mass 2) Schwannoma
http://rjms.iums.ac.ir/article-1-39-en.html
http://rjms.iums.ac.ir/article-1-39-en.pdf
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
11
41
2004
9
1
Malignant Paraganglioma: A Case Report
505
508
FA
M
Hourmozdi
N
M
Dolati
Y
Paraganglioma are tumors that arise within the sympathetic and parasympathetic nervous system. About 10% of paraganglioma spread to distant sites. Malignant potential has been difficult to be determined by histologic characteristic and it is defined after a metastatic lesion or direct invasion found in a site with no residual embryonic paraganglionic tissue. In this case report, a 51-year-old man is presented who had a neck mass from 15 years ago. After resection of the mass, diagnosis was paraganglioma. After 6 months, the patient was involved by tumor recurrence and she was then reoperated, but this time due to lymph node involvement, malignant paraganglioma was diagnosed.
Key Words: 1) Paraganglioma 2) Metastasis 3) Polymorphism
http://rjms.iums.ac.ir/article-1-40-en.html
http://rjms.iums.ac.ir/article-1-40-en.pdf