Jundishapur Scientific Medical Journal
Year:2010 | Volume:9 | Issue:3 (66)|Papers Count:15

Background and Objective: Enucleation is surgical removal of the eye to enhance patients comfort and cosmetics, to protect vision in the fellow eye, or to safeguard life. In evisceration the eye content is removed. This procedure will affect the psychological and socioeconomic activity of the patients. The present study was undertaken to determine the incidence and causes of enucleation and evisceration in hospitals of Khuzestan province.Subjects and Methods: This retrospective study was carried out to determine the incidence and causes of enucleation and evisceration in Khuzestan from 2002 to 2007, based on patients’ medical records and additional information received by calling the patients.Results: This study included 283 eyes (265 enucleated and 18 eviscerated cases) with or without hydroxyl opatite. There were 162 males and 121 females (age range 1 to 98 years; mean 44 years). The mean incidence was 13 cases per 1,000,000 in the general population. The indications for enucleation were: trauma (n=85), infection (corneal ulcer, endophthalmitis) (n= 41), blind painful eye (n=35) phthisis bulbi (n=30), advanced glaucoma and high IOP (n=29), tumors (n=25), corneal opacity and vascularization (n=16), congenital dysgenics (n=11) and unknown causes (n=11).Conclusion: This study showed that the main causes of enucleation were trauma, infection and advanced glaucoma. Furthermore, the incidence of this procedure could be reduced by appropriate medical care, early diagnosis and treatment. Propaganda for prevention of eye trauma through the use of protective devices in industrial, educational and sports centers and use of safety belts and airbags in cars can be useful preventing measures.

Background and Objective: Acute renal failure (ARF) can be pre-renal, intrinsic renal or post-renal in etiology. The aim of the study was to assess the causes of ARF in patients admitted to Abuzar Children’s Hospital in Ahvaz, a referral center in the South Western of Iran.Subjects and Methods: The records of patients managed as ARF were reviewed in our center from 2003 to 2006. ARF was defined as doubling of baseline serum creatinine associated with oliguria. A patient with evidences of chronic kidney disease was excluded.  Based on the data, these causes were categorized in 3 groups as: pre-renal, intrinsic renal and post-renal.Results: Totally 113 admitted patients had the criteria for ARF. There were 77 (68%) males and 36 (32%) females (M/F: 2.2). The mean age was 6.8 years (ranging from 10 days to 15 years), but most of the patients (34.5%) were 5-10 years old. The underlying causes of ARF were 74.4% intrinsic, renal 18.6% pre-renal and 7% post- renal. Among 84 patients with intrinsic renal failure, 63 (55.7%) had acute glomerulonephritis (AGN). Conclusion: The underlying causes of ARF in our region were different from other parts of the world. The most common causes of ARF were AGN and ATN due to scorpion sting and severe dehydration secondary to acute gastroenteritis. Therefore, most of these cases can be preventable by improving primary health care and by early and prompt treatment of infection and dehydration.

Background and Objective: Familiarity with the epidemiological, clinical and laboratory features of bacterial meningitis (BM) is important for rapid diagnosis and initiation of antibacterial therapy. This study aimed at evaluating these patients based on their epidemiological, clinical and laboratory findings and comparing these variables with patients with aseptic meningitis (ASM).Subjects and Methods: Admitted patients aged 18 years or more who were hospitalized because of meningitis, were studied between 2003 and 2007. Cases were grouped as BM and ASM and compared for their epidemiological, clinical and cerebrospinal fluid (CSF) laboratory aspects.Results: Among 312 patients with meningitis, 215 (68.9%) had BM (42 definite, 156 probable and 17 partially treated) and 97 (31.1. %) had ASM. The mean age of patients with BM was 44.7±26.7 years and for ASM was 37.3±15.5 years (P>0.05). Twelve percent of cases had triad of fever, neck stiffness and low level of consciousness. The means for CSF-WBC, CSF- glucose and  CSF-protein in BM compared with ASM patients were 4021.6±1035.2 and 163.2±116.4 cell/ml of CSF; 27.5±17.3 and 68.7±16.1mg/dl and 689.8±476.8 and132.6±107.7mg/dl , respectively (P<0.05).Conclusion: The prevalence of BM was higher than that of ASM. Tuberculous meningitis had a considerable frequency among ASM patients. Confirmed BM based on CSF culture was lower than other studies. The number of performed LP procedures was not in accordance with the total meningitis cases. Similarly, WBC and glucose in CSF were helpful in differential diagnosis of BM vs. ASM.

Background and Objective: Suicide is among the first 10 causes of mortality and loss of life in Iran. Among the various methods of suicide, self –burning is a fatal injurious and painful problem imposing costs to the individual and society. The aim of this study was to assess the personal and social background and risk factors for self –burning attempts.Subjects and Methods: This study is an observational, descriptive and cross-sectional research. Subjects include all burned patients (126 people) admitted in winter 2008 and spring 2009 in Ahvaz Taleghani Burn Center. Data were collected by researcher-made questionnaires, after confirming their validity and reliability.Results: Results showed that 108 women and 18 men attempted for self –burning. Individual and social risk factors in women include: history of depression (64.8%), illiteracy (25%), being married (63%), age range of 15-35 years (88%), residence in rural communities (38%) and being household (89%). Unemployment (50%) and addiction(16.7%) were important risk factors in men.Conclusion: The findings showed that young, illiterate, married and depressed rural housewives who had a low economic status were more at risk for attempted for self –burnings. Therefore, planning on the identification of individuals at risk and preventive actions by competent authorities may reduce the self-inflicted burns.

Background and Objective: In this study the frequency of early term mortality (1 month) was evaluated among patients with early supraventricular tachyarrhythmia (<72 hours) during the first acute myocardial infarction (AMI). Subjects and Methods: In this prospective descriptive study, we studied 315 patients with the first S-T elevation AMI. Various factors including age, gender, risk factors and types of supraventricular tachyarrhythmias (within first 72 hours of CCU admission) were assessed based on medical records. Early cardiovascular mortality (30 days sudden cardiac death or acute coronary syndrome complicated with death) was probed through out-patient clinic.Results: Among 300 patients, 208 individuals (69.3%) had one tachyarrhythmia with 8.1% mortality, 78 patients (26%) had two tachyarrhythmia with 12.8% mortality and the rest 11 (3.7%) had three tachyarrhythmia with 45% mortality. Mortality among patients with and without atrial tachycardia (AT) was 36% and 9.4%, respectively (p<0.05), but in patients with and without atrial fibrillation (AF) was 20% and 9%, respectively. (p>0.05) Mortality among patients with and without atrial premature contraction (APCs) was 8% and 14%, respectively, (p>0.05) while among patients with and without sinus tachycardia (ST) was 15% and 5%, respectively. (p<0.05). Conclusion: Early mortality (within 30 days) was more frequent among patients with S-T el-evation myocardial infarction complicated with sinus tachycardia, atrial tachycardia and mul-tiple simultaneously supraventricular tachyarrhythmia.

Background and Objective: The aim of this survey was to assess the relationship of perfectionism and responsibility to obsessive-compulsion disorder (OCD) among physicians residing in Ahvaz. Subjective and Methods: Responsibility and perfectionism were established as predictive variables while OCD was planned as a dependent variable. The sample constituted of 100 Ahvaz-resident physicians selected randomly. For measuring perfectionism, Ahvaz perfectionism scale, for measuring responsibility, responsibility essay and for measuring obsessive-compulsion disorder, symptom checklist 90- Revised were used. Pearson simple correlation was employed to analysis data.Results: The results showed that both perfectionism and responsibility had significant positive correlations with obsessive-compulsion disorder among physicians residing in Ahvaz. (p<0.01) Conclusion: The finding of this study showed that high levels of perfectionism and responsibility predisposed physicians to develop obsessive-compulsive disorders.

Background and Objective: Breast cancer includes 32% of women's cancer is the most common malignancies in women and is the reason for 19% of cancer-dependent mortality. The aim of this study was comparison between some breast cancer risk factors in patients with breast cancer and leukemia in Ahvaz Shafa Hospital.  Subjects and Methods: In this retrospective and analytic study, 167 patients with breast cancer were compared with 317 patients with leukemia in a two- year period. The risk factors included age, OCP usage, smoking, positive familial history of breast cancer and positive history of benign breast disease. Odds ratio index was used for statistical data analysis.Results: Breast cancer was seen more in 41 to 50 years old women. Familial history of breast cancer and history of benign breast disease were effective risk factors and smoking and, OCP usage increased the risk of developing breast cancer in our study.Conclusion: The results showed that some of the breast cancer risk factors are preventable, such as changes in lifestyle, regular examinations, especially about persons with a familial history of breast cancer or benign breast diseases which in turn can influence early diagnosis. Screening tests such as mammography are also useful in early diagnosis and improved prognosis of breast cancer.

Background and Objective: There has been an increasing interest for antioxidant compounds use in preventive medicine and food industry, mainly due to several drawbacks of synthetic compounds. Traditional herbal medicine plays an important part in Iranian healthcare system. Astragalus brachycalyx (Gaz angabin) has been used in traditional medicine and its antioxidant effects have not been studied previously. The aim of this study was to determine and compare antioxidant activity of various extracts of aerial parts of this herb.Subjects and Methods: Four extracts (methanol, chloroform, and polyphenols, aqueous) were prepared from aerial parts of A.brachycalyx. DPPH and TEAC assays were used for the antioxidant activity. The results of DPPH and TEAC assays were expressed as IC50 and TEAC values at individual time points.Results: The IC50 values of methanolic, chloroformic, polyphenolic and aqueous extracts were 0.625, 0.827, 0.193, 0.279 mg/ml, respectively. The TEAC values of the extracts at 2, 4 and 6 min reaction were 22. 29, 11.20, 17.06, 49.42; 24.07, 12.33, 18.47, 51.56; 25.19, 12.76, 18.78, 52.61 mmol Trolox equivalents/100 g DW.Conclusion: All extracts had antioxidant activity as measured by both methods. The polyphenolic extract was found to have maximum activity in DPPH assay, while in TEAC assay, the aqueous extract showed maximum activity and chloroformic extract had minimum antioxidant effects. The results showed that polyphenolic and aqueous extracts had better activities in antioxidant assays.

Background and Objective: Bloody diarrhea (Shigellosis) is caused by different species of Shigella and is often seen in children before than less than 15 years old must be added. Less than 15 years of age. This disease is extremely contagious, epidemic and endemic in communities with low level hygiene and in majority of cases is accompanied with hemolytic uremia syndrome and decreased children's growth. As the rate of infection by Shigella soneii among different ranges of age is considered as an indicator of hygiene level, this study was designed to detect the rate of infection by Shigella sonei among different ranges of ages in Tehran by Random Amplified Polymorphic DNA (RAPD-PCR) 2002-2006. Subjects and Methods: In this study totally 60 isolates of Shigella soneii taken from 36 (60%) boys and 24 (40%) girls were studied. All isolates were primary confirmed as Shigella species by biochemical (Motility, MR, Citrate, H2S, Indole, Lysin decarboxylase, Ornitin decarboxylase, ONPG) and serologic tests; then all isolates were finally confirmed as Shigella soneii by Random Amplified Polymorphic DNA (RAPD-PCR) test. Among all 60 patients, the highest rate of infection with Shigella soneii belonged to 1-2 year-old group (36.7%). Furthermore, the lowest rate of infection belonged to group with more than 9 years of age (1.6%). Conclusion: This study showed that RAPD PCR method had a relative good discrimination power, and was a good method for typing of Shigella isolates in molecular epidemiological studies according to its high discrimination power, typing ability, reproducibility, low cost, rapidity and ease of use.

Background and Objective: Gestational trophoblastic disease (GTD) is one of the rare neoplastic diseases that remains curable even with a lot of metastases, but if left untreated, it can be life threatening. We had an increase in number of GTD during recent years in Ahvaz. The aim of this study was to determine the prevalence and risk factors of trophoblastic diseases among women who were admitted in Imam Khomaini Hospital, Ahvaz, Iran. Subjects and Methods: In this cross-sectional study, all hospital records related to trophoblastic diseases (n=132) were reviewed from 1996 up to 2006. Demographic and histo-pathologic data were taken using a questionnaire containing 34 questions. The Chi-square, "t" and Exact -Fisher tests were used to analyze all data. P£0.05 was considered significant statistically. SPSS, version 11 was used for statistical analysis.Results: The prevalence of hydatidiform mole was 5.4 in 1000 deliveries including 81.8% complete and 18.1% incomplete moles. It was shown that 34.2% of complete moles turned to persistent forms out of which 6.4% changed into invasive moles and 2.7% into choriocarcinoma. There was a significant association between complete and persistent moles and more than 40 years of age (p<0.02), but there was not any association between incomplete moles and increased age. There was a significant correlation between blood group of women (A and O) and complete moles (p<0.05). Conclusion: Pregnancy in the older ages and lack of follow-up of molar patients after suction-curettage is an important factor in the prevalence of hydatidiform and persistent moles.

Background and Objective: Open and laparoscopic surgery are performed around the world to treat this condition. The aim of this study is to compare post operative complications of these two surgical methods.Subjects and Methods: In this randomized clinical trial 100 patients with inguinal hernia were evaluated in two groups (open group A and laparoscopic surgery group B). Patients were followed at 1 week and 3 months post-operatively to evaluate complications such as wound infection, edema, post-operative direct hernia, hydrocele, testicular atrophy and chronic pain. Data were statistically analyzed through chi square and t-tests.Results: In open hernioplasty group (A) there were 46 males and 4 females and in laparoscopy group (B) 44 males and 6 females (P>0.05). Mean age in hernioplasty group was 17.6 years and 16.3 years in laparoscopy group (P>0.05). There were 4 mild, 2 moderate and 1 severe inflammation in group A and 1 mild  and 1 moderate inflammation and none wound infections in group B (P>0.05), one week after surgery. There was no wound infection, testicular atrophy and post operative direct hernia in any of the groups. Three months after surgery 4 chronic pain cases were recorded in group A and 3 in group B. One patient with hydrocele was recorded in group B. (P>0.0).Conclusion: The findings of this study showed that there were no statistically significant differences in post-operative complications between either laparoscopic or open hernioplasty.

Background and Objective: Numerous animals’ models have shown the inhibitory effects of fish oil on tumor growth, due to its long-chain omega - 3 fatty acids. The association between fish intake and breast cancer was investigated in this case - control study.Subjects and Methods: This retrospective study involved 197 women with breast cancer and 197 healthy subjects as control. Data were collected by questionnaires concerning demographic data, reproductive as well as breast cancer - related risk factors and a food frequency questionnaire. Information about fish intake one year prior to the disease onset was collected through the questionnaire. Qualitative variables and age were tested through chi square and Mann- Whitney statistical tests, respectively. Logistic regression analysis was used for final data analysis.   Results: The mean and standard deviation of age in case and control groups were 46.03±9.03 and 43.47±7.9 years, respectively. According to the final data analysis, shrimp (p=0.01) and tuna fish (p= 0.002) intake were significantly influential in decreasing breast cancer risk. There was no significant association between breast cancer risk and total fish intake, its preparation and source (cultivated vs. marine).Conclusion: There was no association between total fish intake, its source and/or preparation method and breast cancer. However, different fish species, shrimp intake, and use of conserved fish were important in reducing breast cancer risk.