Jundishapur Scientific Medical Journal
Year:2004 | Volume:- | Issue:40|Papers Count:14

Infantile colic is a common problem characterized by excessive crying and restlessness. Twenty nine percent of infants cry more than 3 hours a day during the first 3 to 4 months of life. Infantile colic has been reported in both breast-fed and formula-fed infants. There are several hypotheses for infantile colic. One of these hypothesis suggests that cows milk proteins may be responsible for infantile colic. In the present study, we examined the effect of elimination of cows milk and its products from the maternal diet on the exclusively breast fed infant with colic symptoms. Fifty infants with colic symptoms were studied for 7 days baseline period followed by 8 days of intervention period of strict elimination of milk and dairy products from maternal diets. Forty-eight and forty four percent of infants showed an improvement in crying and restlessness respectively. Therefore, the strict elimination of milk and dairy products from the maternal diet may be an effective way to control colic symptoms in approximately 50% of exclusively breast fed infants.

Induction of labor for safety purposes of mother or fetus is a prevalent beneficial obstetrics measure. One of the important groups who has benefited from induction of labor is the patient with post-date pregnancy. For termination of pregnancy in these patients, both methods of labor induction or cesarean operation have been used. The condition of cervix is clearly related to the successful induction of labor, the length of delivery and probably vaginal delivery.Therefore the physicians use a preparatory agent for ripening of cervix before labor induction that can be a medical agent or mechanical device. The aim of this study was to review the result of induction of labor using foley catheter for ripening the cervix in post term pregnancy. For this purpose, 60 patients were chosen non - randomly based on target, meaning exclusion-inclusion criterion, in two groups of case and control before insertion of foley catheter. Ripening of cervix was determined based on bishop system. After the placement of foley catheter the following parameters were determined: change of Bishop number, duration of foley insertion to self extraction, duration of oxytocin usage to uterine contraction, the active and second stage of labor, the type of delivery and induction success rate. The results of this study showed that the use of foley catheter leads to the increase in rate of vaginal delivery compared with control group. Since the use of foley catheter is a safe, non-invasive and reversible method for preparation of cervix in-patient with undesired bishop score is highly recommended.

Corneal epithelial defect is one of the earlier complications after keratoplasty. Therapeutic methods for enhancement of epithelial healing rate are of paramount importance for maintaining corneal graft clarity and for prevention of development of graft ulcer.In this prospective clinical the efficacy of pressure patch, tarsorrhaphy and non patch eye methods on the corneal epithelial healing rate after keratoplasty were compared.For this purpose, 69 eyes from 69 patients with average-age of 56.6 yrs, without considering causes of keratoplasty, were assigned randomly into three treatment groups. In order to evaluate corneal healing rate, all patients were examined daily with slit lamp biomicroscope for measurement of maximum and minimum dimension of the corneal epithelial defect following staining with sterile flureosien stripe. The results showed the rate of reduction in diameter of corneal epithelial defect in pressure patch group to be 3.292 ± 0.82 mm/ day compared with 2.221 ± 1.129 mm/day in tarsorrhaphy and 2.370 ± 1.105 mm /day in nonpatch eye groups.These findings suggest a faster corneal epithelial healing rate in pressure patch group after keratoplasty (P<0.01). However, there was no significant difference between tarsorrhaphy with non-patch eye on the epithelial healing rate (P>0.1).

High blood pressure (HBP) is the commonest referred reason for visiting clinics from which 25% of all population suffer at some stage of their lives. The white coat hypertension has been implicated as one of the difficulties in diagnosis and treatment of HBP and can predispose the patients to unnecessary drug treatments. On the other hand, the incidence rate of this phenomenon among different societies varies. This study attempts to clarify its incidence among Iranian population.One hundred subjects, having the allocated criteria (29 male, 71 females, age range 32-81 years old) were randomly selected for this quasi-experimental study. The patients were selected from those visiting the internal clinic of Shiraz University and who suffered from HBP or those diagnosed for the first time. The blood pressure was measured twice by the attending physician and then by a nurse (a member of the research team), who made the home visit measurements, using the same mercury gauged instrument. Fifteen percent of the patients were those who were diagnosed to have HBP for the first time and the remaining were already on drug treatment. The results showed that there was significant difference between in the measurement of both systolic and diastolic blood pressures in the clinic and at home among the patient who were already under drug treatment for their HBP (P<0.001 and <0.01 respectively). While there was a significant difference only in the systolic blood pressure among the first-time diagnosed patients (P<0.001). Overall result showed there was an increase of 20 mmHg in the systolic blood pressure among 36 % of the patients (systolic white coat effect). While the corresponding increase in the diastolic blood pressure was 10 mmHg in 43 % of the patients (diastolic white coat effect).This study demonstrated that there was a significant white coat effect on a high percentage of the patients who visit the clinics for blood pressure assessment, and these findings need to be considered when attempting to prescribe or change drugs regiments. The visiting nurse can ameliorate these discrepancies.

Thalassemic patients need recurrent transfusion due to the RBC hemolysis resulted from hereditary defect in beta globin chain synthesis. This might lead to transfusion complications such as hemochromotosis; splenomegaly and others associated complications. Most cases might need splenectomy for avoiding recurrent transfusion and splenomegaly complications. In this study, we tried to evaluate the outcomes of splenectomy in 45 patients. This descriptive and retrospective study was done on 45 thalassemic patients who under went splenectomy during the last 10 years. Twenty-eight patients (62.2%) suffered from major thalassemia and the remaining 17 (37.8%) had thalassemia intermediate. Most patients were over 15 years old. 27 (60%) patients had huge splenomegaly up to or over umbilicus, 5 (14.5%) simultaneous gallbladder stone removal and 11 (24.5%) LUQ pain with early satiety. Forty three of the patients (95.5%) received 20 CC packed blood cell for each five kg of body weight. After splenectomy 23 (57.5%) of the patients did not need any blood transfusion from a month to a year; 6 (15%) did not require transfusion after a year. Overall, the amount of transfusion decreased in all patients. All of the patients felt healthier after splenectomy. Operative complications occurred in 3 (6.66%) of patient, despite pre-opretion vaccination with Pneumovax polyvalent various infections occurred in 9 (20%) on long term.Therefore, the finding of this study suggest that splenectomy is recommended only in thalacemic patients in whom there is a need for high level of blood transfusion and in those who suffer from symptomatic splenomegaly.

Previous investigations suggest that the limibic corical region is involved in the pathophysiology of schizophrenia. On the other hand reduced inhibitory GABAergic tone in these areas may contribute to the appearance of schizophrenic symptoms. Super infusion of 25-OH cholesterol increases the peak amplitude of the GABAA IPSP and that cholesterol partly mimics the effect of 25-OH cholesterol. The aim of present investigation was to elucidate whether serum concentrations of total cholesterol, LDL-, HDL-cholesterol and triglycerides differ in schizophrenic from normal subjects. Forty-nine male schizophrenic patients admitted to the Ebne Sina Hospital in Shiraz were examined based on DSM-IV and clinical criteria before treatment, during treatment and after recovery. Serum concentration of total cholesterol, LDL-, HDL-cholesterol and triglycerides were assayed by RA1000 method. The results showed that the serum concentrations of total and LDL-cholesterol were significantly (p<0.05) lower than the control values in the corresponding stages of the study. However, the serum concentrations of HDL-cholesterol and triglycerides at all stages of treatment were shown not significantly (p>0.05) different from normal subjects. It is deduced that changes in the levels of cholesterol and triglycerides may be altered in schizophrenia and remained so even after recovery.

Urinary tract infection (UTI) is one of the most common bacterial infections in children. UTI may be a presentation of urinary tract abnormality including vesicoureteral reflux (VUR) in about 29-50% of children with symptomatic UTI. The long-term complications of UTI with this condition is renal scarring, hypertension and chronic renal failure. During a two year period, 158 patients admitted with symptomatic UTI aged 1 month up to 15 years, VUR was diagnosed by voiding cystourethrography (VCUG) and the patients were followed up for 6 to 24 months. Among the 158 cases, 126 patients were selected for this study (100 girls and 26 boys). There were 77% under 5 years. The most common symptoms were fever without localizing sign and dysuria. VUR was detected in 39.6% of patients (39% of girls, 42.3% of boys). There were 25.39% unilateral and 14.2% bilateral. Symptomatic UTIs were more common in girls (88%) and younger children (77% < 5 years). Forty percent of these patients had VUR in which 14% were bilateral. Symptomatic UTI may be a presentation of an underlying problem particularly VUR that maybe severe and bilateral. For this reason, VCUG should be performed in any patient in every age and sex. Furthermore, ultrasonographic studies of kidney and the urinary tract (for detection of underlying abnormality) and renal cortical scan (3-6 months later) for evaluation of renal scarring are required.

The objective of this research was to study prevalence and severity of depression among parents of children suffering from malignant diseases. This study has been preformed over a four-month period at Shafa Hospital of Ahwaz Medical Sciences University on 66 parents (32 fathers and 34 mothers). Depression was diagnosed in accordance with DSM-IV criteria through clinical interview and MMPI test. For severity measurement Beck test was used. The results show that prevalence rate of depression in the target population was almost four times more than in the general population. The finding of this study demonstrated that the parents of children suffering from malignancy need specific psychiatric support and attention.

The aim of the present study was to describe the clinical and laboratory findings among a series of patients with non-alcoholic steatohepatitis (NASH). The clinical, biochemical features of 26 patients with non-alcoholic steatohepatitis, observed for 4 to 44 mo (mean 15.2 mo) were analyzed. Eleven of the patients (42.3%) were women and the rest were men (57.7%). Mean age was 40.12 ± 11.4 (range 17-67). Two of the 4 obese patients (BMI ≥30) were men (15.4%) and the only morbid obese patient (BMI ≥ 40) was a women. Totally thirteen patients were over weight (40≤ BMI<30) 6 of whom were women. Thirteen patients (6 men and 7 women) had BMI within the range of 25 to 30. Eight patients (6 men and 2 women) had normal weight. Twelve patients (46.2%) had hyperlipidemia, while only 2 had the past consumption history of drug-induced NASH (7.7%). Initially 10 patients were asymptomatic, another 10 had non-specific symptoms (totally 80.8%) and 5 patients had the symptoms related to NASH. Only 1 patient progressed to cirrhosis and 5-showed fibrosis in their liver biopsy. The finding of this study suggests that non-alcoholic steatohepatitis can be a progressive liver disease. Furthermore, it suggests that this disease should not be considered a disease predominantly seen in obese women with diabetes mellitus.

Coronary artery disease is one of the most common causes of death in the world. The disease have multifactorial nature but four important potential risk factors for atherosclerotic coronary artery disease include: hypertension, hyperlipidemia, smoking and diabetes mellitus. Aortic valve diseases also have multiple etiology but two of the common forms of aortic valve diseases include rheumatic and degenerative involvement. Degenerative lesion of aortic valve is associated with traditional risk factors for atherosclerosis. Echocardiography is the most important laboratory technique for evaluation and following patients with aortic valve diseases and selection for operation. Preoperative coronary angiography indicated in patients with high probability of coronary disease. If coronary disease is present, aortic valve replacement and coronary bypass graft should be performed simultaneously, because surgical risk increases when coronary disease is left untreated.Because of the differences in the reported literature on the prevalence and the factors involved in the development of coronary diseases in different areas of the world, this retrospective study was performed in Glostan Hospital Ahwaz University of Medical Sciences, between Mar. 1996 to Mar. 2001, to determine the prevalence and predicting factors of coronary disease in all aortic valve patients that undergone preoperative coronary angiography. Ninety four patients had the criteria of this study:58 patients were men and 36 patients were women. The results showed that only 13 patients had significant coronary disease. The patients were divided in two age groups of less or above 45 yrs old, 45 patients, and 49 patients respectively. In both groups the relation of coronary disease with four important atherosclerotic risk factors (hypertension, hyperlipidemia, smoking and diabetes mellitus) and chest pain were studied by Chi Square and Fisher Exact, test. The results also showed that in younger than 45 years old, the coronary disease had significant relationship with the atherosclerotic risk factors (P<0.001) and history of chest pain (P<0.01) but these relationship was not obtained among patients 45 years age or older. The results of this study revealed low prevalence of coronary disease in aortic valve patients (13.8%) as compared with other studies (about 50%). However, similar to the previous studies, old age, major atherosclerotic risk factors and chest pain were associated with high probability of coronary disease in aortic valve patients.

Group A β-hemolytic streptococci is the most important etiology of bacterial pharyngitis. Since rheumatic fever and glomerolonephritis which are both serious diseases of man, are the sequelae of streptococcal pharyngitis, so rapid laboratory diagnosis of the infection is an important for rapid treatment and prevention of post-streptococcal diseases. Conventional bacteriological methods take at least 48 hours to identify these bacteria. The aim of this project was to detect group A β- streptococci by direct Immunofluorescence within 8-10 hours. For this purpose, group A β-hemolytic streptococcus strain ATCC 1447 was cultured into 300 ml of Todd-Hewitt broth and was incubated with shaking at 37° C with overnight shaking. Following centrifugation, the bacteria were collected and after treatment, whole bacteria were used as antigens for immunization of rabbits. After the titer of anti-streptococci in rabbit sera reached to a sufficient level, the immune sera were collected; its immunoglobulins were sedimented and conjugated with FITC. Serial dilution of conjugated immune sera was prepared and smears of various bacteria (S. aureus, Streptococcus pyogen, group B, C, and α-streptococci) were stained with conjugated serum and observed under UV microscope. The result showed that the reagent could detect Streptococcus pyogen reliably. Of the strains examined by this method, only Streptococcus pyogen showed 4+ in compare with S. aureus which showed 2+ positivity (brightness). The specificity and sensitivity of the method was determined 96.1% and 94.4% respectively.