Iranian Red Crescent Medical Journal
Year:2001 | Volume:4 | Issue:1|Papers Count:15

Cardiac siderosis form transfused iron remains the main cause of death n thalassemia major, despite iron chelation therapy with deferoxamine (DFO). Our aim was to determine the nature and extent of cardiac involvement and its relationship to DFO use in a group of children with thalassemia major. We reviewed 67 patients with thalassmeia major and alalyzed factors affecting their cardiac status. Factors studied included: age, serum ferritin, starting age of iron-binding therapy, compliance with DFO treatment, electrocardiograms, chest X-rays and echocardiograms.16 (24%) patients showed some kind of cardiac involvement. They were order (p<0.001), began DFO later (p<0.001), and had lower shortening fraction (p<0.05). We conclude that older age, late commencement of DFO, and lower shortening fraction are associated with increased risk of heart disease in major thalassemia patients.

Background/Purpose: Genitourinary anomalies in patients with imperforate anus are a frequent souree of significant morbidity. Variability of reports on the incidence of associated anomalies with imperforate anus mandates further investigation on this issue.Material and Methods: The case records and imaging studies of 63 patients who underwent reparative surgery for imperforate anus over a 9-year period were retrospectively reviewed.Results: Genitourinary anomalies were seen in 29 patients (16.03%). A voiding cystourethrogram was performed in 36 patients, 11 of whom were shown to have vesicoureteric reflux and 3 of whom required surgical correction. Vesicoureteral reflux was the most prominent urologic anomaly observed. Uretropelvic junction (UPJ) stenosis, hydronephrosis, hypospadiasis, renal agenesis and undescended tests were also common in these patients.Conclusions: Patients with anorectal malformations should be evaluated for urinary tract and spinal problems.

Anitinociceptive effect of the aqueous decoction and ethanolic maceration extracts of Perovskia abrotanoides aerial parte were studied using hot-plate and writhing tests. The intraperitoneal injection of aqueous and ethanolic extracts of P. abrotanoides practically showed no antinociceptive activity in hot-plate test. In writhing test, both extracts exerted significant antinociceptive activity that was not inhibited by naloxone. This showed that the extracts of P.abrotanoides had peripheral antinociceptive activities which not mediated by opioid receptors.

Background: Thalassemic patients are one of the high-risk groups of hepatitis C virus (HCV) and human Immunodeficiency virus (HIV) infection. The study of HCV and HIV seroprevalence and some qualitative risk factors in this target group can be valuable for prevention of the infection. Methods & Material: This study was undertaken in the year 1999 to determine the prevalence of HCV and HIV infection among thalassemic patients in Shiraz, Southern Iran. A total of 147 patients (55.1% males, and 44.9% females with mean age of 13.62%±4.82 year) who received multiple blood transfusions were screened for HCV and HIV by ELISA-II method in Dastgheib Hospital in Shiraz, Southern Iran. Results: Forty of 147 subjects (27.2%) were positive for antibody to hepatitis C virus (anti-HCV). No antibody to HIV virus was detected in any of the subjects. Jaundice was observed in 13.6% of HCV seropositive patients. The duration and interval of blood transfusion did not reach the level of statistical significance when HCV seropositive subjects were compared with seronegative ones. Serum protein, albumin, SGOT and SGPT were significantly higher in HCV positive patients but this difference was not significant for alkaline phosphates and bilirubin. Conclusion: Routine screening of blood donors with markedly decreases the incidence of transfusion infections due to HCV and HIV among recipients.

Mashhad University of medical sciences Mashhad Iran CD23, the low affinity receptor for IgE (FCε R II), functions as a multifunctional regulator of immune system and IgE synthesis, in part, by producing an IgE binding factor (soluble CD23). Objectives: To evaluate the serum levels of total IgE and soluble CD23 (sCD23) in the atopic patients and to determine whether there is any correlation between these markers. Method: Forty-five adult atopic subjects (allergic rhinitis 17, allergic asthma 17 and atopi dermatitis 11) with positive skin prick test to common allergens and positive family history of atopy were entrolled in a case-control study. Serum levels of total IgE and sCd23 of these subjects were measured by ELISA controls. Results: Mean age and sex ratio were similar among study groups. Mean serum levels of sCD23 in atopic groups (5.12±3.9ng/ml) were significantly higher than control group (0.2ng/ml) (P<0.01). Mean total IgE level in atopic groups and control group were 388±204 IU/ml, 43±40 IU/ml respectively. Atopic subjects had significantly higher IgE level (P<0.01). There were no correlations between serum levels of total IgE and sCD23. Conclusion: sCD23 maybe a good atopy prediction marker. 

Objectives: To determine relationship between the levels of serum total homocysteine and folate in patients with myocardial infarction.Design and methods: The serum total homocysteine level was measured using gas chromatography. Serum folate was determined by competitive immunoassay using direct chemiluminescence on the ACS 180 Analyzer.Results and conclusions: Serum total homocysteine levels were significantly and negatively correlated with fotale in the patinets with myocardial infarction.

Purpose: To determine the effect of anterior capsulotomy methods on posterior capsule opacification (PCO) after cataract surgery.Settings: Department of Ophthalmology, Iran Medical Sciences University, Tehran, Iran.Patients and methods: 314 eyes were examined retrospectively following intraocular lens implantation within the capsular bag between February 1991 and December 1999. Patients were divided into 2 groups according to anterior capsulotomy techniques. Envelop capsulotomy and continous curvilinear capsulorhexis (CCC) patients were followed for 6-94 (mean 42) months.Results: Posterior capsule opacification developed in 57 of 34 eyes. The distributions of PCO were 40 of 168 eyes (23.8%) in envelope capsulotomy and 17 of 146 eyes (11.6%) in CCC. Posteroir capsule opacification occurred significantly less (X2-P<0.005) in the patients who had an anterior capsulotomy with CCC compared to envelope capsulotomy. Hazard of occurring PCO was significantly greater in envelope than CCC group (log, rank, p=0.004).Conclusion: CCC decreases the incidence of PCO compared to envelope capsulotomy.

When developing countries adopt and industrialized style of living an increase in asthma prevalence can be expected. A cross-sectional study was undertaken to evaluate the prevalence of asthma, related symptoms and clinical findings in high school adolescents of Isfahan, Iran.A randomly selected population of Isfahan high-school pupils, consisting of 3,930 adolescents aged 15 to 18 was enrolled in this study. The students completed a Persian questionnaire as a modified form from ISAAC and ECRHS questionnaires. The returned 3,668 (93.3%) questionnaires were reviewed and 623 pupils suffering asthma or any history of intermittent dyspnea and/ or wheezy breathing were invited for further evaluations. In this stage, 519 pupils (82.9%) underwent medical interview and physical examination. In this study, 289 students (45%) underwent post-exercise spirometry.A previous diagnosis of asthma was recorded in 1.2% of the population. The prevalence rates for confirmed history of dyspnea and wheezing attacks (actual asthma) ever in life, asthma attacks in the last 12 months, and frequently recurring asthmatic attacks were 14.8%, 3.5% and 2.2% respectively. Wheezing was heard on auscultation of the chests of 53 students (10.2%). FEV1<80% of prediction was recorded in 6.2% of the stage two participants, other findings included reduced PEF, FEF 25-75, FEF75 in 21.8%, 8.6%, 31.1 of the pupils respectively. We conclude that asthma screening programs employing clinical methods should be encouraged to compensate for frequently encountered biases observed in the studies based on self-administered questionnaires.

A cohort of 329 lactating mothers who delivered in the 14 maternity clinics of Shiraz during two random consecutive weeks was selected randomly in 1996 and followed at their homes at 11 occasions for a two-year postpartum period. A semi-structured questionnaire was used to record the mothers knowledge and attitude in a face to face interview and their practice examined by two trained female members of the research team. Mothers knowledge toward family planning was significantly associated with the level of education (P<0.001). their friends were the main source of knowledge in using contraceptive measures (64.2%), while health workers (17.0%), mass media (8.2%) and miscellaneous sources (10.6%) played less efficient roles in this respect. Ideal number of children in general (80% said £2 and 20% ³3) and sons in particular were significantly associated with the duration of marriage and number of living children (P<0.01). The first two pregnancies with the age at marriage and duration of marriage. However, it was reversed for third and above pregnancy order. The number of living children decreased with the age at marriage (P<0.001), which was significantly associated with duration of marriage (P<0.001). Of duration of marriage affected the number miscarriages and still births (P<0.01). Use of contraceptive measures among mothers increased enormously 3 months postpartum and continued rather uniformly later on until the end of the study period. Mothers used natural and hormonal device (IUD) more frequently than other kinds of contraceptives. The reasons for not using contraceptives or changing birth control measures were unknown to most of the mothers. The paper concludes that mothers attitude towards family planning was perhaps due to the cultural causes or economic problems which increased the willingness of mothers to use contraceptives. It seems, that health centers were inefficient in furnishing information to and providing mothers safe contraceptives which may be the reason why most mothers used natural birth control measures which may not be safe enough.

Urticaria is a common skin disorder which arrects 15% of population in their life time. Pruritus is also a vexing symptom which sometimes occurs without relationship to dermatologic or systemic diseases.Aim: This study was done for comparing the therapeutic effect of ketotifen against hydroxyzine in the treatment of the patients with pruritus and chronic idiopathic urticaria who to the dermatology department of Hamadan Sina Hospital between 1998-1999.Patients and Methods: The study was a randomized double blind clinical trial. The patients were divided into two groups, each groups had 75 patients. Ketotifen was prescribed in the maximum dose of 4mg daily to one group and for other group hydroxyzine between 10-75mg daily was started and after one weeks. Patients were examined and rate of effectiveness, frequency and the type of side effects were evaluated in each group.Results: From 150 patients having pruritus or chronic urticaria 51.3% were female and 48.7% were male. The majority of patients were in the third and fourth decades. Duration of affection was from 6 weeks to 2 years. There were history of association with background systemic disease (4.6%), history of skin disorders (4.6%), history of food sensitivity (2%) and history of drug sensitivity in 3.3%, 88% of the patients who took ketotifen and 92% of patients who received hydroxyzine, reported the positive therapeutic effects in the form of resolution of pruritus and urticarial lesions and lack of new lesions. Side effects were seen in 46% of the patients of whom 8.7% were with ketotifen and 91.3% were with hydroxyzine.Drowsiness occurred in 91% of the patients using hydroxyzine and in 9% due to ketotifen. Dizziness, giddiness, blurred vision and sleep disorder were due to hydroxyzine.92% of reported dryness of month was due to hydroxyzine and 8% due to ketotifen.Conclusion: In spite of effectiveness of both hydroxyzine and ketotifen in the treatment of pruritus and chronic urticaria, with regard to fewer side effects seen with ketotifen, utilization of ketotifen in patients suffering from pruritus and chronic urticaria is a suitable treatment and was more accented by the patients.

The pediatric nursing test was held in 1995-1996 academic year for 55 nursing students. Having 89 multiple choice questions (MCQs), the examination was based on a sound content, nursing plan and thorough behavioural objectives. To find the validity and reliability of this and also to examine its predictive validity, it was compared to a test based on the same content held in 1997-1998 academic year.Item analysis of the test showed only three items having correct construction, proper difficulty and discrimination indices.Mode, mean, median and variance of the test marks were 62, 65.13, 63.66 and 63.84 respectively. Its standard deviation was 7.99.Content-related validity of the test was 98.6 percent. The validity was complete in 71 percent of the items and it was incomplete in 29 percent.All items were constructed in the cognitive domain. 83 percent belonged to the knowledge, 14 percent to the comprehension and 3 percent to the application levels. No item was framed in affective of psychomotor domains.Predictive validity of the test was 0.97. Reliability of the test was 0.77.The test had a 3.83 standard error of measurement.Direction of the test was clear item orders were proper.

As was in the past, nowadays the physicians and health professionals need new information to manage their patients with best quality. Obviously, this is not attainable without good access to recent literature. The up-to-date sources are produced by the research results and they are published in journals to distribute scientific knowledge among medical experts.Sharing the results of a study in a sound medical journal is both a demanding and exciting process. In other words, writing a medical paper is a form of mental exercise. This mental exercise requires the learning of certain basic skills and it has to be practiced to be successful. It means that ideas can be conveyed well, only when they are written in an organized manner.A well-written scientific paper should be in such a way to build a logical flow for the reader. It should respect accepted principles according to international standards. Otherwise the paper rejection rate will increase by the editors. So it is possible to say that preparing a valuable manuscript for a prestigious medical journal is not an easy job. The writing process includes prewriting (selecting a subject and collecting details), writing the first draft, revising, editing, proofreading and publishing. So there are many important points to take into account to come to a paper that is suitable for publication.The present article is going to give some suggestions and practical guidelines on medical paper preparation (report of a research results). Ti will also review the organization, content and function of each component of medical papers...

A case of gall bladder polyp with heterotopic gastric mucosa in a gastric mucosa in a 35-year-old man who presented with recurrent right upper quadrant abdominal pain is reported. Ulrtasonography demonstrated a highly echogenic polypoid mass in the body of gallbladder. All other investigation results were normal. His symptoms resolved after laparoscopic cholecystectomy. Histologically, the polyp was consisted of both fundic and pyloric type gastric glands located in the mucosa of polyp. Up to knowledge of authors so far, 43 cases of heterotopic and gastric mucosa of gallbladder have been reported, only two cases, including the present case were found as a gall bladder polyp.

The development of germ cell carcinoma of the ovary during pregnancy is a rare occurrence. The use of chemotherapeutic drugs in pregnancy is also rare. Recent advances in chemotherapy have improved significantly the prognosis. We describe a pregnant patient who found to have endodermal sinus tumor (EST) of the ovary stage IIIc at 14 weeks of gestational age. She received five courses of post-operative adjuvant multiagent bleomycin, etoposide and platinum chemotherapy and delivered a normal infant, at 35 weeks of gestation by cesarean section. No residual tumor was found at cesarean section. After delivery, she received an additional course of chemotherapy. The infant is developmentally normal at 1-year follow-up. 

An 11-year old girl presented with acute thrombocytopenic purpura and a painful right hip. The findings of the bone marrow aspiration were compalible with idiopathic thrombocytopenic purpura. She was treated with oral steroids and all her symptoms disappeared, she returned with recurrence of hip pain and serum agglutination test performed at the time of initial hospitalization were strongly positive for brucellosis. She was successfully treated with doxycycline and gentamicin. Review of literature revealed only 2 cases of childhood brucellosis presenting with acute thrombocytopenic purpura.This case highlights one of the many unusual presentations of brucellosis and emphasizes the need for a high index of suspicion in endemic areas.