Razi Journal of Medical Sciences
Year:2001 | Volume:7 | Issue:22|Papers Count:20

In spite of the common concept that all types of cholelithiasis have fairly similar clinical signs and symptoms, we noticed quite a difference in their clinical presentation and prognosis between the two groups of patients that had multiple stones (group I) or single stone (group II) cholelithiasis.To varfiy this clinical assumption, we reviewed 125 patients which underwent cholecystectomy with the diagnosis of gall –stones in a two – year periode in Firoozgar Hospital and extracted the following results. The patients with choledocholithiasis and other biliary tract pathology excluded from the study.The incidence of multiple stones (group I) was higher than the single stones (group II) patients, (69%Vs. 31%).The overall incidence of cholelithiasis was seven times higher in women (106 women and 16 men); which is twice higher than the international statistics. The group II patients were mostly over weight and the incidence was twice higher than group I patients. The pain in group II patients was mostly constant and located in epigastrium; but the pain in group I patients was mostly located in right upper quadrant and was colicky in nature. The number of patients in group II in our study was twice higher than the international statistics.The group II patients were 10 years younger than the group I patients, and had less associated diseases.The prognosis was also must worse in group II patients. So it should not be assumed that the patients with a single gall stone have less symptoms and better prognosis; and is advised to give them priority in surgery.

This study was designed to investigate the relationship between Body Mass Index (BMI), hirsutism and menstrual pattern. It was performed on 617 women, during one year period. The followings are the results of this investigation:1- The frequency of obesity in women with hirsutism and abnormal menstrual pattern is higher than those that do not have hirsutism and abnormal menstrual pattern. (P=0.000)2- The average weight of women with hirsutism is higher (P.0.000) and the average menarche age is less than those of nonhirsute women (P=0.04).3- The average weight of women with abnormal menstrual pattern is higher than those women with normal menstrual pattern (P=0.000).The results of this investigation indicate that there is a relationship between Body Mass Index (BMI) with hirsutism and menstrual pattern.

The Purposes of this study were to:1- Determine the effects of infra-red (I-R) Laser radiation on Sensory and motor electroneurographic parameters of nerve including latency, amplitude, and duration of Action Potential.2- Determine the effects of I-R Laser radiation on skin temperature changes.Forty healthy male subjects ranging from 20 to 30 years of age without any history of pathological condition of no dominant upper extremity were studied. It was a single blind study in which subjects randomly received laser radiation in both ways of real (power output=10 mw) and placebo (power output =0).The parameters of I-R laser were wavelength= 780 mm, power output= 10 mw and continues mode. An orthodromic sensory and motor conduction study was performed on the median nerve for each subject.Four 1 cm2 blocks were plotted on the skin along the superficial median nerve, where laser was radiated at 60 sec/cm2 per block. Latency, amplitude, duration and skin temperature measurements were recorded pre test, immediately post test, and post intervals of 10 and 20 minutes. To examine the data, paired t-test with repeated measures were performed.Results:- No significant changes were noted in the placebo method.For real laser radiation method:- Significant increase was noted in distal sensory latency.(p1 =2.54 x 10-6) (p2=1.91 x 10-3),(p3=1.57 x 10-3)- Significant increase was noted in distal motor latency.(P1 =2.49 x 10-4) (p2 = 1.06 x 10-3) (p3=4.3 x 10-3)- Significant decrease was noted in sensory amplitude. (P1=1.75 x 10-4 (p2 = 9.35 x 10-3), (p3=8.7 x 104)- No significant changes were noted in motor amplitude. sensory and motor duration and skin temperature. Discussion:This study showed that low power I-R laser radiation would cause latency in median nerve conduction.

Bloody nipple discharge is among the most common problem in breast surgery. This is because the benign intraducatal papilloma is the leading cause of bloody nipple discharge, although in malignant carcinoma of the breast any discharge is bloody.This survey was carried in order to determine ranking rate of causes and coincidence of intraductal papilloma, bloody nipple discharge and breast mass, for avoidance of exaggerated or insufficiently appreciated treatment (unnecessary mastectomy versus insufficient local operation) in these patients. This study performed retrospectively by chart review of 1218 patients with any impression of breast problems, who enconsecutively and admitted in Hazrat Rasul and Imam Khomeini University Hospitals during 10 years (1986-1995). Among these patients 28 cases with benign papilloma lesions were determined and classified to solitary intraductal papilloma (SIP, 15 cases), multiple intraductal papilloma (MIP, 9 cases) and papillomatosis (4 cases).The mean age of patients with SIP were 40.2 years and in MIP were 39.5 years. Nipple discharges were detected in 80% and palpable mass was also detected in 73.3% of patients with SIP. In patients with SIP 88.3% of discharges were bloody. In 53.3% of patients with SIP discharges and breast mass were detected coincidentally. In patients with MIP palpable mass was determined in 88.9% and discharge 66.7%. Carcinoma of the breast was not found in these patients.There were no significant relation between the rate of palpable breast mass, malignancy of lesions and nipple discharges in these patients.

Contact dermatitis is seen n two forms of allergic contact dermatitis (ACD) with 20% and irritant contact dermatitis (ICD)with 80% frequency.This disease is manifested in three forms of acute, sub-acute and chronic, characterizes by pain, itching, vesicle, swelling, papul, lichenification and oozing.ACD or contact hypersensitivity (CHS) in an eczematous dermatitis which is regarded as T-cell mediated delayed-type hypersensitivity (DTH) reaction, caused by exposure to some substances act as haptenic allergens.The role of T- Lymphocyte subsets has been clearly shown in the pathogenesis of this disease, However, results from different studies on blood samples are controversial in this regard. This project aimed at a broader study on distribution of different lymphocyte subsets in peripheral blood of patients with CHS compared with other types of dermatitis and normal individuals.Patch - Test is generally required to identify the specific allergen(s). In this study, we used Europen Srand Mdpatch test kit (Trolab) with 23 allergens, tested 46 patients and 36 control healthy individuals. Forty - Eight hours later, 5 ml peripheral blood sample was obtained from the patient and control groups.Serum total IgE of patient and control groups with ELISA were assessed.Peripheral blood samples were stained with Abs (IMK-Plus Kit) Conjugated with FITC and PE, such as; CD 14/45, (CD3+, CD4+,CD8+)T, (CD 16+/ CD56+) NK, (HLA- DR+) T and (CD19+) B, and analyzedon FACS-Caliber (Becton Dickinson Company) Flowcytometry.The results of patch-Test revealed that the most frequent positive reactions were due to nickel - sulphate, cobalt choride, potassium dichromat and formaldehyde.The results of serum total IgE in ACD and ICD showed non significant difference from control group. In Patients with atopic dermatitis total IgE was 8 to 10 times greater than serum IgE in control group (P<0.001).Mean percent, total T-cells (CD3+) and (CD4+) T-cell subset showed non significant change compared to control group (CD8l T-cell subsets showed some increase and total B-cells (CD19+) some decrease which were no significant.CD4/CD8 ratio significantly decreased in ACD patients, but showed significant increase in AD patients with Pvalue of < 0.05.As opposed to total T-Lymphocytes, NK cells (CD 16+/56+) and (HLA-DR+) T-Cells increased significantly (P<0.05).Total number of WBC significantly increased in ACD group compared to control group (P<0.05). In addition, mean percent eosinophil in AD group showed significant increase (P<0.05), comparing with control Individuals. The results of this study indicate the involvement of cell -mediated immunity, specially activated T-cells and increased NK cells in this disease.

The objective of this study was to compile effective teaching criterion by using opinions of students and staffs of basic sciences center at Iran University of Medical Sciences and Health Services, about characteristics of teaching. Effective teaching is a set of teacher's behaviors which leads to educational objectives, achievement and better learning for student. Review of literature was done and by using proposed criterions, 2 separate self-administered questionnaires for students and staffs was designed in order to perform a analytical- descriptive that was given to 244 students and 38 staffs. With collecting the questionnaires, analysis was done and based on the degree of agreement of these 2 groups, priorities was extracted, subsequently final effective teaching criterion in 3 parts consisting of professional characteristics, personal characteristics and motivation for learning and independent study was compiled based on criterion effective teachers are those who have the following general characteristics:1- Logical and systematic sequences in teaching2- Appropriate organization of teaching time3- Successful creation and establishment of fair atmosphere for teaching and learning4- Motivation and promotion for learning5- Adequate feedback to studentsThe compiled criterion is substantially similar to those criterions mentioned in other world's researches. The criterion could be used for improving the quality of teaching, for evaluation of student's learning and for increasing student's academic achievement.

The development of radioligand - binding studies has greatly advanced our knowledge of the molecular pharmacology of beta - adrenoceptors. Using this technique it became possible for the first time to directly determine the tissue concentration of beta - adrenoceptors, and by this, the responsiveness of tissues to beta - adrenergic stimulation. One major insight into the molecular pharmacology of beta - adrenoceptors to come from radioligand - binding studies was that the tissue concentration of beta - adrenergic is not a fixed number, but is rather dynamically regulated by a variety of drugs, hormones, physiological and pathologic conditions.In addition to the changes that occur in receptor characteristics, post - receptor events may be influenced by different pathologic states which in turn affect beta -adrenoceptor responsiveness.

Acute head trauma is one of the most common causes of emergency hospital admissions and its two important complications are subdural haematomas and epidural haematomas, for which the CT scan is a main tool of diagnosis. Differentiation of this two haematoms is important and the ability of CT scan to differentiate them always been in question. This descriptive study aims to evaluate the ability of CT scan in diagnosing and differentiating SDH and EDH by reviewing 80 patients admitted Hospitals during the year 1999 and reports the results of CT scan in comparison with surgical findings.The results of study showed that the CT scan is highly sensitive in diagnosing and differentiating these two haematomas. Also the haematoma shape and extension are valuable in differentiating these haematomas, but associated skull fracture or brain injury is not sensitive factors.

Surface epithelial tumors constituted 65.7% of all the ovarian tumors. Brenner tumors are a type of surface epithelial tumors that constitute 1% to 3% of all ovarian neoplasms. The average age of presentation of Brenner tumors is about age 50 and 71% of the patients are over 40. Most patients are asymptomatic but abnormal uterine bleeding is the most common presenting symptom. Associated endometrial changes ranging from glandular hyperplasia to invasive adenocarcinoma were reported. Microscopically, they consist of solid and cystic nests of epithelial cells resembling transitional epithelium (urothelium) surrounded by an abundant stromal component of dense fibroblastic nature. Brenner tumors can be seen in association with mucinous cystadenoma and exceptionally, struma ovarii. They have also been found to coexist with transitional cell tumors of urinary bladder. We have found only one paper dealing with coexistence of Brenner tumor with adenocarcinoma of colon, has not been published previously.

Syphilis is the infectious disease that named "great imitator" because can imitate manifestations of other diseases and can involve any organ in body. Late manifestations of syphilis in cardiovascular system and central nervous system (CNS) are important. A case of huge syphilitic aortic aneurysm who visited in Shahid Rajai Hospital, is being reported. The Patient underwent surgery under general anesthesia, Anatomic repair of the thoracic aortic aneurysm was done without any graft. Immunofluorescence test and pathologic study were in favour of syphilitic aortitis, the late manifestation of Treponema Pallidum infection.

This study was about total intravenous anesthesia for coronary artery bypass graft. In this study Patient's. hemodynamic were stable. Hypothermia and rewarming during cardiopulmonary bypass were very smooth and ideal. Severe acid - base imbalance did not happened. It did not need excessive in0tropic and vasodilators. Generally, before, during and after cardiopulmonary bypass circulation, hemodynamic changes were not important. There was hypotension during anesthesic induction in some cases; we think it was due to rapid injection of 0.75 mg/kg sufentanil intravenously. If injection was slow and before that it 4-5 cc/kg Ringer solution infused, hypotension would not happen. Except of this complication, method of intravenous anesthesia with midazolam, sufentanil and atracrium is more suitable for coronary bypass graft.

Mc Hugh has reported that incidence of neonatal facial nerve Paralysis in 1969, has been 0.23%. Infantile facial nerve paralysis has been categorized to three groups: 1- Congenital (Developmental) facial nerve paralysis2- Prenatal acquired facial nerve paralysis.3- Postnatal acquired facial nerve paralysisThe Mobius syndrome may be the most famous among the causes of congenital facial nerve paralysis. Many suggest the vascular theory for Mobius syrdome. This syndrome has a wide range of clinic pathological signs and symptoms from unilateral facial nerve paralysis to bilateral Facial and Cranial nerve VI paralysis.The involvement of other cranial nerves (IX, X, XII) also has been reported. Few reports suggest the autosomal dominant inheritance of this syndrome and few families presented which several of their members in different generation were disabled with this syndrome. In our research of the literature, we did not found any report about two siblings who are affected by this syndrome. In our cases, family history was negative. Their mother has no history of thalidomide or misoprostol use or rubella during preganacy. The first case is an 18 - year - old male and his right facial nerve is paralyzed. His EMG and NCV show no response in right side. In his temporal bone CT scan, the mastoidian segment of right facial nerve is narrower than contralateral side. The second case is a 16.5 - year - old female and her left facial nerve is paretic. She has been operated for her strabismus when she was 9 - year - old. Her EMG and NCV shows decreased response in left side. In her temporal bone CT scan, the mastoidan segment of left facial nerve is narrower than right side.

In this research incidence of ectopic pregnancy (EP) was different from other countries (especially USA, 0.11% Versus 1%) Causes of this difference are non distinguish, abortion, unkonown abortion and the most important thing is problems of sexual contaminations that in Iran is less than other countries. In our research we found out interference of application of IUD, infection, history of previous surgery, EP, abortion and curretages. One third of EP cases were accompanied with IUD. Also females with history of previous EP have greatly chance for rehappening EP unless it's etiologic cause realy has been gone. Suitable ages are between 25-41 year - old with maximum prevalence is in 30-35 year - old and among G4 - G6 multipars, with maximum prevalence in G4.All our cases were tubal type pregnancy that confirms over 98-99% tubal EP has been happened. In this study, culdocentesis had an important diagnostic role among our patients. 92.8% of culdocentesis was reported positive that is good guid for diagnosis.Pregnancy test was positive in 88.23% of our cases. Also b-HCG was positive in more than 97% of cases that is good guide for diagnosis too. Sonography would help very much if sonographist is expert. The results show this fact that the rate of EP has increased in recent years in our country as well as other countries. The reasons are use of IUD, OCP, increase of pelvic infection and enterance of sonography, laparoscoy, bHCG and exact diagnosis methods.The way of prevention is group education for females in health and family planning units.

Choanal atresa is a congenital disorder that could be unilateral or bilateral and could also be bony or membranous. Choanal atresia is a medical emergency. Surgical intervention in different ways may be used after air way and feeding way stabilized. In this article we explain endiscopic surgery for choanal atresia on five patients with choanal atresia admitted to ENT ward of Hazrat Rasul-e Akram Hospital for endoscopic surgery during 1996-1998. We had no complication in these patients with good results.

Enuresis is one of the most problematic disease in pediatric Medicine. Prevalence of enuresis is 3 -20 percent according to different studies. It is more common in boys than girls. There is different report about relation of enuresis and chronic upper airway obstruction such as adenotonsillar hypertrophy.This is a prospective study about Relation of adentonsillar hypertrophy and nocturnal enuresis. We also searched the effects of adenotonsillectomy on enuresis. The results was statistically valuable with 90% success rate.