2024-03-29T16:12:10+04:30 http://rjms.iums.ac.ir/browse.php?mag_id=1&slc_lang=en&sid=1
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Comparison of the Exfoliative Cytology and Histopathology in Cancer Diagnosis M Oskooei Far M Kadivar Considering the progressive frequency of malignancies and the importance of rapid and non-invasive diagnosis of neoplasms, this study was conducted to compare the exfoliative cytology and histopathology in neoplasms diagnosis. In this process-evaluation study, all of the 92 samples that were sent to pathology laboratory were selected sequentially. Diagnosis was determined using two methods of exfoliative cytology and histopathology. Sensitivity, specificity, positive and negative predictive values and accuracy were calculated. 9 samples showed false negative, 0 showed false positive, 0 true negative and 83 samples showed true positive. Therefore sensitivity, specificity, positive and negative predictive values and accuracy of exfoliative cytology method were 90%, 0%, 100%, 0% and 90%, respectively. Considering the results of this study and comparing them with that of other studies, it seems that exfoliative cytology method has high sensitivity proportional to its specificity, and it can be a suitable method when we encounter with undesired artifactual or degenerative changes in biopsy specimen. Key Words: 1) Cancer 2) Exfoliative cytology diagnosis 3) Accuracy 2004 6 01 5 11 http://rjms.iums.ac.ir/article-1-111-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Association Between Helicobacter Pylori Infection and Coronary Heart Disease M.A Bahar A.H Faghihi Kashani P Haghighat A Kabir M Poor Eslami Cardiovascular diseases are one of the most causes of morbidity and mortality in industrial and developing countries such as Iran. Different studies have been done to find out whether or not Helicobacter Pylori(HP) is a risk factor for cardiovascular diseases, but different results have been obtained. HP infection is common in our country too. In this analytic cross-sectional study, which was conducted on 261 patients, 131 hospitalized patients were selected from CCU ward as cases and 130 hospitalized patients from surgery and orthopedic wards of Iran University of Medical Sciences hospitals as controls. HP infection was determined according to IgG titer using ELIZA method. T-test, chi-square and general linear model were used for the analysis of the data. Sex and job were the same in both groups. Cases had higher age and weight(P<0.001) and lower knowledge(P=0.002) than controls. Smoking and hypertension was more in cases too(P<0.001). Patients with HP infection were 56.3% in cases and 43.8% in controls. These differences were not significant even after controlling age, weight and coronary heart diseases(CHD). Risk factors of CHD had significant correlation with HP infection(P=0.022, r=0.171). In conclusion, previous infection with HP is not a major risk factor for CHD. Key Words: 1) Helicobacter Pylori 2) Coronary Heart Disease(CHD) 2004 6 01 13 21 http://rjms.iums.ac.ir/article-1-112-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Elderly Grip Strength in Nursing Homes in Tehran A Hassani Mehraban F Hosseini This study was aimed to assess grip strength of elderly people in nursing homes in Tehran. These elderly people were 60 years old or above, with no orthopedic and neurologic problem in upper extrimity and they were able to perform basic activities of daily living. 109 elderly people(56 women, 53 men) were selected with stratified sampling design from four areas(North, South, East, West) of Tehran and evaluated by using standard method of hand grip strength assessment which was accepted by American Society of Hand Therapist. Average grip strength in right hand was 16.55 Kg/cm2 and in left hand 15.21 kg/cm2. Also right and left grip strength of men were greater than women(P<0.0001) and this difference was between 49.95-51.27%. In all the elderly, there was a significiant difference between right and left hands(P<0.0001) and grip strength of right hand was greater than left(difference = 8.1%). In conclusion, with age increase, grip strength decreased in both hands and with increase in length and circumference of hands, grip strength increased. Key Words: 1) Hand strength 2) Grip 3) The Elderly 2004 6 01 23 29 http://rjms.iums.ac.ir/article-1-113-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 The Effect of Age at Onset on the Prognosis of Childhood Steroid-Sensitive Nephrotic Syndrome A Derakhshan GH Hosseini Al-Hashemi M.H Fallahzadeh GH.R Bardestani Minimal change nephrotic syndrome(MCNS) is the most common form of Idiopathic Nephrotic Syndrome(INS) in childhood. Although most of the children with INS respond to steroid, a majority of them have subsequent relapses. In this study the effect of age at onset on the outcome of steroid-responsive nephrotic syndrome(NS) was evaluated. Medical records of all children with INS(1-10 years old) and initial response to steroid were reviewed. They had been followed for at least 7 years, and age of onset, sex, number of relapses, pathology report and other immunosupressive therapy were considered. They were studied in 3 age groups: 1-3 years, 4-6 years and 7-10 years at the onset of NS. Sixty-one children(46 boys and 15 girls) were included in this study. There were 23, 24 and 14 children in the above-mentioned age groups respectively. Kidney biopsy had been done for 46 children 76.5% of whom had MCNS. Cyclophosphamide, chlorambucil and cyclospurin had been used for 18.4 and 1 of them respectively. Children with onset of NS at 1-3, 4-6 and 7-10 years of age had(mean±SD) 7±5.92, 4.54±3.74 and 1.57±1.81 of relapses respectively. The duration of disease was also 5.52±4.15, 5.37±3.57 and 1.92±1.54 years respectively. Regarding the number of relapses and duration of disease, the differences between the 7-10 years age group and the other 2 groups were statistically significant(P<0.05). It can be concluded that age at onset is a reliable predictor of the course and prognosis of childhood steroid-responsive NS. Key Words: 1) Nephrotic syndrome 2) Children 3) Age at onset 2004 6 01 31 37 http://rjms.iums.ac.ir/article-1-114-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Evaluation of the Relationship Between Serum Zinc and Peripheral Neuropahty in Chronic Hemodialysis Patients F Rashid Farrokhi A.R Asadi V Moazed Zinc deficiency is a common finding in hemodialysis patients. This element is an essential constituent of some intracellular enzymatic systems, so zinc deficiency is associated with several disorders. Some neurologic distrubances as peripheral neuropathy associated with zinc deficiency have been described in human. At present there is no sufficient data to recommend the measurement of zinc level or routine use of its supplements in all hemodialysis patients. This study was done to evaluate the relationship between zinc deficiency and peripheral neuropathy. If this relationship can be confirmed, the improvement of plasma zinc by zinc supplementation may provide an effective therapy for uremic neuropathy. In this cross-sectional study, the electrophysiologic evaluation of sensory and motor nerves, were done in 67 nondiabetic chronic hemodialysis patients in Kerman, Rafsanjan, Sirjan and Jiroft. All cooperative patients with stable catabolic states were included in this study. At first, zinc level of these 67 patients was compared with its level in 72 healthy control persons. Then, for each nerve in lower limbs, the relationship between serum zinc and nerve conduction velocity(NCV) and distal latency(DL) was evaluated. The intervention effect of dialysis adequacy(KT/V), protein catabolic rate(PCR), serum PTH, dialysis interval and dialysis treatment duration was eliminated in this analysis. Serum zinc concentration was significantly low in 67 hemodialysis patients compared to 72 healthy controls(94.13±30.05 versus 104.53±42.8) (P<0.05). Fifty-seven percent of cases had electrophysiologic findings of peripheral neuropathy and 33% of them had clinical findings of it. Superficial peroneal nerve was the most common involved nerve in these patients. In 38 cases sup peroneal NCV was lower than normal. Zinc level of these patients was significantly lower than other 29 cases(88.9±25.1 versus 105.99±34.9) (P<0.03). On the other hand the relationship between serum zinc and NCV was significant for sural(P<0.01) and sup peroneal(P<0.05). The relationship between serum zinc and DL was also significant for sup peroneal(P<0.01). In conclusion, zinc deficiency and peripheral neuropathy are two common findings in hemodialysis patients. This study can confirm the relation between zinc deficiency and peripheral neuropathy in sensory nerves. Absence of this relation for motor nerves may be due to less severe involvement of them during uremic neuropathy. Key Words: 1) Peripheral neuropathy 2) Nerve conduction velocity 2004 6 01 39 47 http://rjms.iums.ac.ir/article-1-115-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Determination of the Effect of Teaching Skills Workshop on the Quality of Residents’ Teaching S.K Soltani Arabshahi A Ajami C Siabani Studies show that residents play an important role in teaching medical students and as there is a large number of contact hours among them, they are assumed as the leaders of educational team. So developing teaching skills, being familiar with innovative teaching methods, knowing how to increase the educational efficacy, providing teaching objectives and educational spiral are the necessities of residency programs. The purpose of the present study was to determine the effect of teaching skills workshop on the teaching role of residents at Iran and Kermanshah Universities of Medical Sciences to promote residents’ teaching skills. In this quasi-experimental study a self-administered Likert type scale questionnaire was given to target population in pediatrics and internal medicine wards. After the pilot study, the questionnaire was distributed among interns of these two clinical wards in both universities. Then, the randomized selected residents of these two clinical settings participated in an 8-hour workshop, and then 2-3 months after the workshop, the interns again completed the questionnaire and the data were gathered. In the first stage, 164/67 interns of Iran/Kermanshah University of Medical Sciences completed the questionnaire. Then 37/16 of second and third year residents of Pediatrics and Internal medicine of Iran/Kermanshah University of Medical Sciences attended the workshop. In the second stage, 56/44 interns of Iran/Kermanshah University of Medical Sciences completed the questionnaire. There was a significant difference between the mean group ratings for all of the teaching skills characteristics in both universities(P=0.001). The overall teaching skills in Iran University of Medical Sciences significantly increased and 5 categories of teaching skills in Kermanshah University of Medical Sciences except “Giving Feedback” and “Professional Characteristics” also increased after the workshop. Overall teaching effectiveness of residents increased after the workshop. Increasing scores of interns about residents’ teaching skills after the workshop revealed that training programs and teaching skills courses for residents should be performed as formal instructional residency programs. Also, a need assessment should be done to develop such a course to improve residents’ teaching skills. Key Words: 1) Teaching skills 2) Clinical teaching 3) Resident 2004 6 01 49 57 http://rjms.iums.ac.ir/article-1-116-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 The Effects of Vitamin C on Lipoproteins, Apo A-I, Apo B, Malondialdehyde(MDA) and the Assessment of its Interaction with Copper in Hyperlipidemic Patients F Shidfar S.A Keshavarz A Ameri R Miri M Jalali Epidemiological studies showed protective effect of vitamin C on improvement of serum lipoproteins and decrease of coronary heart disease(CHD), but its interaction with copper absorption and metabolism is also reported. The aim of the present study was to determine the effects of vitamin C on lipoproteins and its interaction with copper in hyperlipidemic patients. In a double blind placebo trial of parallel design study, 36 hyperlipidemic patients(total cholesterol(TC) and triglyceride(TG) greater than 200 mg/dl) were randomly assigned into two groups to receive daily 500mg vitamin C (study group) or placebo(control group) for 10 weeks. Fasting blood samples were collected at the beginning and at the end of the period. TG, TC, LDL-C, HDL-C were measured enzymatically, apo B and apo A-I immunoturbidometerically, MDA and vitamin C colorimetrically, serum copper via atomic absorption spectroscopy and plasma ceruloplasmin(CP) enzymatically. The obtained data which were analyzed by t-test, paired t-test, chi square and ANOVA, showed that in vitamin C group there was a significant decrease at the end of study in TC, apo B and MDA compared to initial value(P=0.004, P=0.005, P<0.01 respectively). There was a significant increase in blood vitamin C compared to initial value(P=0.001) and compared to control group(P=0.01). There was no significant change in TG, apoA-I, LDL-C and HDL-C, copper and CP during the study. It seemed that LDL particle size became greater due to apo B decrease but LDL-C did not change during the study. Therefore, it can be concluded that 500 mg vitamin C for 10 weeks in hyperlipidemic patients have desirable effects on TC, apo B and possibly LDL size and can decrease the risk of CHD without any interaction with body copper status. Key Words: 1) Vitamin C 2) Lipoproteins 3) Copper 4) Hyperlipidemic 2004 6 01 59 67 http://rjms.iums.ac.ir/article-1-117-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Assessment of NO Synthase Activity in Endothelial Cells of Healthy and Diabetic Rat Aorta Using NADPH Diaphorase Staining M Shafiei M Nobakht M Fattahi L Kohneh-Shahri M Mahmoudian Impaired endothelium-dependent relaxation of blood vessels is a common feature in diabetes but the exact underlying mechanisms have not yet been clarified. In the present study, endothelium-dependent vasorelaxation of aortic rings were evaluated in vitro in streptozocin-induced diabetic and age-matched control rats. Moreover, NO synthase activity of aortic endothelial cells was assessed in both diabetic and healthy rats using histochemical staining for NADPH diaphorase activity. The results showed a significant decrease of endothelium dependent relaxation in response to ACh in diabetic rings compared with control. A remarkable attenuation of eNOS activity was also observed in sections of diabetic rat aorta using NADPH diaphorase staining. Furthermore, many endothelial cell membranes were disrupted in diabetic cessations. It can be concluded that a decrease in NOS activity together with a disruption of endothelial cell membranes play a major role in endothelial dysfunction observed in diabetes. Key Words: 1) Diabetes mellitus 2) Nitric oxide synthase 3) Rat aorta 2004 6 01 69 75 http://rjms.iums.ac.ir/article-1-118-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Assessment of Diabetic Foot Ulcer’s Predisposing Factors and its Outcomes in Patients with Diabetic Foot Syndrome Hospitalized in Hazrat Rasoul-e-Akram Hospital in Tehran During 1996-2001 H Shahrad Bejestani A.R Motabar Prophylactic efforts can be helpful for the incidence of diabetes mellitus and its disabling complications and may cause noticeable decline in imposed economical costs on health systems. Epidemiological studies have revealed that Iranian diabetic population is more than 1.5 million and it is estimated that 14.5% to 22.5% of people older than 30 have Impaired Glucose Tolerant test. Foot problems are one of the late complications and main cause of disability, morbidity and hospitalization in diabetic patients. Moreover, 50% to 58% of nontraumatic lower extremity amputation is allocated to diabetic foot problems. Meanwhile the main goals of this research have been focused on assessment of predisposing factors due to diabetic foot ulcer syndrome and frequency of different outcomes that might happen during hospital stay. For this reason, 130 patients who had been hospitalized in one of the central university hospitals in Tehran during 5-year period with diagnosis of diabetic foot syndrome were selected. This study showed that majority of patients were male(72.3%) and 74.6% were suffering from NIDDM. The mean age of getting affacted was 62 years old. History of wearing tight shoes before ulcer was present in 11.5%. Furthermore, 40% had history of prior foot ulcer which led to hospitalization. The average diabetic duration was 13.7 years and the average length of hospital stay was 19 days. Moreover, lower extremity amputation occured in 41.5% of patients. Meanwhile there was a correlation between hospital stay and amputation (Pvalue=0.03) and history of smoking and amputation(Pvalue=0.01). Diabetic foot is a common health problem in Iranian diabetic men. Old age, male sex, poor glycemic control, smoking, history of prior amputation or foot ulcer and diabetic duration can be among precipitating factors. Most of the patients needed aggressive debridment and amputation in order to save their lives. In regard to high prevalence of diabetes in Iran, preparation of an appropriate field for training the patients’ family and health system staff and treatment methods for reducing one of the significant complications of diabetes mellitus is very necessary. Key Words: 1) Diabetes mellitus 2) Diabetic foot syndrome 2004 6 01 77 83 http://rjms.iums.ac.ir/article-1-119-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Angiosarcoma of the Right Atrium A Sadeghpour Tabaee GH Omrani M Gholampour Dehaki GH Mollasadeghi Angiosarcoma is the most frequent primary malignant tumor of the heart. The symptoms of this tumor is nonspecific and has aggressive course and fatal evolution. The patient of the present study was a 51-year-old man who referred to the emergency service with dyspnea, chest pain and history of recurrent pleural effusion. He complained of night sweating, exertional dyspnea and drowsiness. In transthoracic echocardiography, pleural effusion and pretamponade was evident. Surgical exploration was performed and histopathology showed Angiosarcoma. Key Words: 1) Cardiac Tumors 2) Cardiac Tamponade 2004 6 01 85 90 http://rjms.iums.ac.ir/article-1-120-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Assessment of the Role of Dexamethasone on Modulation of Acute and Chronic Pain and its Comparison with Stress Analgesic Effect in Formalin Test in Mice A.A Taherian A.A Vafaei A Rashidi Pour H Miladi Gorji M Jarrahi A few studies have shown that stress and glucocorticoids probably interfere in pain control. The aim of this study was to investigate the role of dexamethasone(Dex) as a glucocorticoid receptor agonist on acute and chronic pain in formalin test in mice. In this study male albino mice(n=60) in 6 groups(25-30gr) were used. Dex ( 0.5, 1 and 2mg/kg) was injected 30 min before test and stress (St) was caused by 1-min swimming in cold water(18–22˚). Also, formalin test was performed 3 min after inducing St in St groups and 30 min after injection of Dex in Dex+St groups. Indices of signs were licking and foot elevation for assessment of acute pain(5 min) and chronic pain(15-40 min) after injection of formalin 5%(25µl) in right paw. Findings indicated that Dex had analgesia effect in duration of acute and chronic phases compared with control group and St was more effective than Dex effect. The present data provide further evidence for important role of glucocorticoids on relief of acute and chronic pain(P<0.01). Also, the effect of St was higher than Dex. The present data show that St and Dex receptors induce acute and chronic pain in formalin test. More investigation is needed to find antinociception effects of St and Dex. Key Words: 1) Acute and chronic Pain 2) Dexamethasone 2004 6 01 91 96 http://rjms.iums.ac.ir/article-1-121-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Attitudes of Physicians and Nurses of Intensive Care Units to Organ Transplantation with Brain Dead in the Hospitals Affiliated with Iran University of Medical Sciences(Tehran-2003) A.R Zohoor Z Piri Studies have indicated that brain dead is one of the most important factors of death in accidents. In our country more than 15000 brain dead occur in each year, about 10% of which are in donor group. The number of transplants is low compared to those in Europe and the United States. One of the most important causes of limitation in transplantation is a shortage of donor organs. Physicians and nurses of Intensive Care Units play an essential role in the process of organ donation in brain dead cases. The object of the present study was to determine attitudes towards organ donation in brain dead among physicians and nurses of Intensive Care Units in hospitals affiliated with Iran University of Medical Sciences in 2003. In this cross-sectional study a total number of 84 (28 physicians and 54 nurses) were surveyed without sampling. Data which was collected via using a self-made questionnaire was then analysed by SPSS software, Chi square and T-tests. While 95% of physicians and nurses agreed with organ donation in brain dead, only 79% were interested in signing the donation consent. Reasons for agreement were: to save the life of recipient, to get reward in the judgement day, to cause life continuation in others and to cause happiness in organ recipients, respectively. Physicians and nurses of Intensive Care Units have an important role in the process of organ donation, therefore educational programmes are recommended to increase their knowledge, motivation and self-confidence in order to have more effective communication with relatives of patients with brain dead. Key Words: 1) Organ donation 2) Brain dead 2004 6 01 97 105 http://rjms.iums.ac.ir/article-1-122-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Evaluation of Diagnostic Value of AgNOR Technique in Differentation Between Non-Neoplastic(Benign) and Malignant Lesions in Urine Cytology M Asgari A.A Omidi M.H Sadeghian H.R Hashemian This cross-sectional study was carried out to evaluate the usefulness of AgNOR technique in differentiation between benign and malignant cells in urine cytology and to determine the expression of Argyrophilic Nucleolar Organizer Region(AgNOR) proteins as a marker of proliferative activity in benign and malignant urothelial cells. Quantification of AgNORs which was stained by the silver colloid method in urothelial cells was carried out on voided urine from 75 cases composed of 43 Non-Urothelial Neoplastic(NUN) cases and 32 Transitional Cell Carcinoma(TCC) with varied degree of tumoral grade (grade I: 6 cases, Grade II: 16 cases, Grade III: 6 cases, Grade IV: 4 cases) which had been proved by gold standard method of bladder biopsy. The Mean AgNOR Count(MAC) showed stepwise increase in NUN cases(mean=3.19) through Grade I of TCC(mean=3.86), Grade II of TCC(mean=4.20), Grade III of TCC(mean=7.44) and Grade IV of TCC(mean=8.34). Oneway ANOVA Test and Post Hoc(Scheffe method) were used to compare the results between the groups. The mean differences were significant between low grade TCC(Grade I, II) and high grade TCC(Grade III, IV), and also between NUN group and high grade TCC(Grade III, IV). On the other hand, there were no significant statistical differences between the NUN group and Grade I TCC and also between Grade III and Grade IV. The mean maximum number of AgNOR in each group showed the same results. Key Words: 1) Urine cytology 2) Transitional Cell Carcinoma(TCC) 2004 6 01 107 113 http://rjms.iums.ac.ir/article-1-123-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Comparison of Inotropic Requirement of Patients Under CABG with Two Different Anesthetic Drugs N Aghdaii R Farasatkish E Heidarpour GH.A Mollasadeghi Inotropic requirement of patients under CABG(Coronary Artery Bypass Graft) for CPB(Cardiopulmonary Bypass) weaning depends on multiple factors including: type of heart disease and its severity, co-existing diseases, technical success in surgical operation and the type of anesthetic drugs. Among the above-mentioned factors the effects of anesthetic drugs on inotropic requirement of patients under CABG were studied.The present study was performed as a prospective randomized clinical-trial analysis on 60 patients under CABG in Shahid Rajaii Heart Hospital. Inclusion criteria were: patients aged between 40-60 years, ejection fraction>40% and exclusion criteria were: Patients with underlying and co-existing diseases(exept CAD), pump time more than 2 hours, hypothermia more than 30 degree and cross clamp of aorta more than 45 minutes. Type and dose of premedication drugs, intraoperative opioid and muscle relaxant in two groups were the same and based on the standard of the reference book. The patients were divided into two groups of 30. Induction of anesthesia in the first group was by propofol and in the second group by midazolam. Maintenance of anesthesia in two groups was by infusion of standard doses of anesthetic drugs. All of these patients were studied based on monitoring of hemodynamic changes (heart rate and blood pressure). Results showed that inotropic requirement of patients in group 1(propofol group) was 16.7%, while 30% of patients in group 2(midazolam group) needed inotropic drugs. There was not statistically significant difference between two groups(P>0.05). Key Words: 1) Propofol 2) Midazolam 2004 6 01 115 121 http://rjms.iums.ac.ir/article-1-124-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Hearing Assessment in Neonates and Children Suffering from Meningitis in Mofid Hospital Using ABR Test L Faraji M Akbari A Mousavi O Khojasteh The object of the present study was to assess hearing in neonates and children suffering from meningitis using ABR test. There were 40 neonates and children (from birth to 12 years of age). Hearing of these cases was evaluated in two phases: 27-72 hours following the diagnosis and repeated 24-72 hours before discharge. During 24-72 hours following the diagnosis, ABR test revealed normal hearing in 35 patients(87.5%) and severe to profound sensorineural hearing loss(unilateral: 1, bilateral: 4) in 5 patients(12.5%)(girl=4 & boy=1, from 5-15 months). The same results were obtained in re-evaluation which was 24 hours before discharge. Therefore, it is concluded that hearing loss caused by meningitis (if present) is detectable in critical period. This problem which affected 12.5% of the patients in this study can be detected by using ABR test. Key Words: 1) Auditory Brain stem Response test(ABR) 2) Meningitis 2004 6 01 123 131 http://rjms.iums.ac.ir/article-1-125-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Comparison of the Success Rate of Extra Amniotic Saline Infusion with Traction on the Cervix with Folly Catheter for Termination of Second Trimester Pregnancies M Kashanian A Parvin Karami The objective of the present study was to compare the success rate of extra-amniotic saline with traction on the cervix with folly catheter for termination of second trimester pregnancies. A randomized trial of extra-amniotic saline infusion versus traction on the cervix with folly catheter was performed on 200 patients with gestational age of 14-28 weeks who required induction of labor for either maternal or fetal indications. One hundred patients(extra-amniotic saline infusion) and 100 patients(traction on the cervix with folly catheter) who were similar in age, gestational age, parity, past vaginal delivery, and live or dead fetus were assigned randomly and alternately. The success rate was not statistically significant but the duration of induction was significantly shorter for extra-amniotic saline infusion(P=0.02). Maternal complicaions were minimal and not significantly different. In conclusion, extra-amniotic saline infusion is as effective as traction on the cervix but faster than it. Both methods are safe, and cheap which are tolerated by the patients very well. Extra-amniotic saline infusion should be seriously considered as a first priority in case other methods are not accessible. Key Words: 1) Second trimester Pregnancy Termination 2004 6 01 133 141 http://rjms.iums.ac.ir/article-1-126-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Pancreas Pathology in Hyperinsulinemia Hypoglycemia of Infancy M Mehrazma SH Yoosefi Hyperinsulinism is responsible for about 55% of hypoglycemia in children less than 1 year old. In this study pancreas from 8 children with idiopathic hyperinsulinemic hypoglycemia of infancy(HHI) who underwent pancreatectomy in Ali-Asghar Hospital from 10 years ago were examined, using histochemical method and morphometric measurements. The children ranged from 3 to 13 months, and were presented with seizure. They all had positive glucagon test and high serum ins/glu ratio and were unresponsive to medical therapy(Diazoxide, Somatostatin or Hidrocortisone). Sections were studied with particular reference to islet cell distribution in patients and controls. Quantitative assessments were made of islet size and total surface area of pancreas occupied by endocrine tissue. Four patients had diffuse islet cell hyperplasia and others showed multifocal islet cell hyperplasia, islet cell dysplasia, adenoma and normal pancreas, respectively. Immunostaining can show any recapitulation of islet structure or increase of B cells. Furthermore, frozen section study during surgery can help to distinguish different pathologies of HHI. Key Words: 1) Hyperinsulinemia 2) Hypoglycemia 3) Pancreas 2004 6 01 143 149 http://rjms.iums.ac.ir/article-1-127-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 The Effect of Iron(Oral or IV) and Erythropoietin(EPO) Prescription on Levels of Hematocrit and Transferrin Saturation Percentage in Hemodialysis Patients M Nobahar A.A Vafaei F Davachi Iron deficiency anemia is one of the essential problems in hemodialysis patients and with presence of iron deficiency, EPO does not have any effect on hematocrit(HCT) level and transferrin saturation percentage(TSP). However, injection of IV iron together with EPO improves responses to anemia treatment. The aim of this study was to determine the effect of iron(oral or IV) prescription with or without EPO on HCT levels and TSP in hemodialysis patients in Semnan City. In this case-control study hemodialysis patients were assessed for three months during one year. At first, demographic data including age, sex, marriage situation and treatment time were collected and recorded. Then, drug prescription was investigated, HCT measurement was controlled monthly and TSP for three months. Investigation of data indicated that in patients who used three components(iron oral, IV and EPO) or used iron IV and EPO the levels of HCT and TSP increased significantly (P<0.05), whereas use of iron IV or iron IV and oral indicated a significant increase only in TSP(P0.05). The obtained results showed that oral iron is unlikely to keep iron level in response to EPO. Therefore, patients with anemia and iron deficiency will always require intravenous iron therapy and it is better that they use three components all together. Key Words: 1) Iron 2) Erythropoietin 3) Hemodialysis 2004 6 01 151 157 http://rjms.iums.ac.ir/article-1-128-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Columnar Cell Carcinoma of the Thyroid: A Case Report M Hourmazdi A Zare Mirzaee The present case report concerns a 42-year-old female who referred with an enlargement of right lobe of thyroid gland since 6 months ago. Subtotal thyroidectomy specimen grossly revealed white-colored and poorly-demarcated nodule with papillary growth pattern. Microscopic examination mostly exhibited papillae lined by tall columnar cells containing pseudostratified nuclei which resembled those of follicular carcinoma and was significantly different from conventional (ground glass) appearance of papillary carcinoma. Ultimately, histopathologic diagnosis was rare columnar cell carcinoma of the thyroid gland. Key Words: 1) Thyroid 2) Papillary carcinoma 2004 6 01 159 164 http://rjms.iums.ac.ir/article-1-129-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 11 39 Study of the Effects of Chemical Warfare(Mostly Sulfur Mustard) on Neutrophils in Chemical Injuries Ten Years After Exposed War E Hooshiar Z Mohammad Hassan A.R Salek Moghadam Z Shaker M Ebtekar The incidence of recurrent infections in chemical injuries made us guess that phagocytic system of these patients has been disordered. On the other hand, deficiency of phagocytic function in scalds has been proved and superficial burns seen in these subjects also encouraged us to study the condition of their neutrophils. Neutrophils are one of the main members of natural immunity and have an important role in host’s defense especially against bacterial infections. In this study, 75 chemical weapon victims of the war between Iran and Iraq were divided into three groups of 25 depending on the severity of the complications(mild, moderate and severe). In addition, 10 subjects who were not exposed to sulfur mustard were considered as the control group. 5ml of peripheral blood was collected from 85 subjects and analysed for complete blood count, cell morphology and flow cytometry. Cell morphology was analysed by blood smear preparation and light microscopic examination under 100X objective. Blood parameters including WBC, RBC, platelet counts and hemoglobin concentration were calculated using Sysmex K-1000. Besides, blood cells were analysed for CD45, CD15 and CD16 cell markers and the neutrophils were regarded as CD45+/CD15+/CD16+. The reduction of NBT and converting of clear and soluble nitrotetrazolium blue(NBT) to insoluble and precipitated furmazane in cell was regarded as function of neutrophils. Statistical analysis of data was performed using analysis of variance(ANOVA), and Scheffe test. There weren’t any significant differences in percentage and absolute numbers of expression of CD45+/CD15+ and CD45+/CD15+/CD16+ cells and mean of NBT percentage in patient and normal groups. Key Words: 1) Sulfur Mustard 2) Chemical victims 3) Neutrophils 2004 6 01 165 171 http://rjms.iums.ac.ir/article-1-130-en.pdf