Jundishapur Scientific Medical Journal
Year:2002 | Volume:- | Issue:32 |Papers Count:17

Rubella is an acute exanthematous viral infection in both children and adults. The disease may cause severe congenital anomalies in newborn if exposed to this virus during early pregnancy. The objective of this study was to determine seroprevalence of rubella among pre-marriage females living in Ahwaz city. Rubella IgG antibody was measured using ELIZA method. The results showed that among the 400 randomly selected women who were referred for routine per - marriage tests; 366 cases (93%) were seropositive, 28 cases seronegative and the remaining 6 cases were suspicious and therefore were omitted from the study. Based on the result obtained from the worldwide vaccination shows a rate of 95% immunity against rubella. Furthermore, considering that there were insignificant differences in the level of protection between the vaccinated and development of natural immunity; and if the results from similar studies in other parts of the country show same level of protection, it may be concluded that vaccination programme against rubella, at the present time, is not an urgent priority in Iran.

Using of epidemiological findings on injuries has been shown as an important step on accident prevention program . This study aimed to describe the occurrence of childhood injuries in Ahwaz and to show the distribution of these injuries by time, place, and person. This study was cross- sectional in design and data was collected from children aged under 15 years attended to one of the 17 A & E depts. of Ahwaz in 1378(1998-9). Information gathering was carried out within 24 days of the year that were randomly selected by months. In each seclected day, data from all injured children attented to A & E depts, were collected within 24 hours. Overall 9738 children attended, of them 1558 (16.0%) were injured . Boys compared to girls were more likely to be injured (68% vs. 32% , P<0.001) , and 14.7% of injured children were accident repeaters. The most important places that accidents were taken place were at home (58.7%) , streets (33.0%), schools, (5.0%), parkes/ public places (2.8%), and other places (0.5%). Most accidents occurred in Aban (November) (11.3%) . Stroke by objects (37.2%), falls (22.8%), and traffic accidents (10.6%), were more common than other causes. Differences in distribution of childhood injuries by time, place and person in this study may help the policy makers to improve the injury prevention programs. The high incidence of childhood injuries in Ahwaz point out the importance of the problem and reinforce the childrens injury prevention programs as a priority in health programs. More studies on circumstances of accident occurrence in children is recommended.

Lung cancer is one of the most common causes of human mortality and the majority of patients are referred at late inoperable stage of the disease. Understanding the causes of inoperability is a challenging question which can open new horizones of early cancer diagnosis and treatment. In this study prospective study sampling of cases was easily performed. All patients with suspected clinical findings and doubtful imagine study, after ruling out of other diseases and without consideration to age and gender, were considered for further diagnosis of lung cancer. Sputum cytology, bronchoscopy, pulmonary tissue biopsy, biopsy of pleura or lymph nodes (whenever indicated) were used as confirming procedures. After histopathological documentation of cancer, the patients were classified as operable or inoperable. .Oat cell carcinoma and all patients with concurrent active insufficiency of cardiovascular, renal, CNS and pulmonary system were considered as inoperable malignancy. Anatomical staging (based on TNM system), the patients in the stages I and II were considered as operable. Of 69 patients (F:20 M:49) with histopathologically confirmed lung cancer only 13 patients were operable, although only 5 of them consented to operation. Most operable cancer suffered from squamous cell carcinoma. The remaining 56 patients were inoperable, of which 15 cases had oat cell carcinoma and 41 cases had progressed non-oat cell carcinoma. Most of bronchogenic cancer patients present at an inoperable stage of the disease and the main cause of inoperability was local invasion and metastasis.

Relapsing polychondritis is a rare multisystem disease of unknown ethiology The disease is characterized by episodic inflammation of cartilaginous structures resulting in tissue destruction. The role of immune system in the pathogenesis of relapsing polychondritis is well documented. There are standard clinical criteria for its diagnosis and if not there is ambiguity biopsy becomes necessary. The case reported is a young female patient aged 32 years, who was admitted to Golestan hospital. She had cartilage deformity including cauliflower ear and saddle - nose. In addition she suffered from intercostal cartilage deformity and severe respiratory problems. On examination she had dyspnea and tachypnea and wheezing. The duration the disease perior to diagnosis was approximately two years. The treatment was carried out with aggressive high dose steroid and cyclophosphamide pulse therapy. After a few days of treatment, the respiratory manifestation was suppressed and she was discharged with good general condition, although cartilage deformities persisted. She is now under observation and tapering of the dosage of steroid therapy.

In attempting to achieve a definitive lung cure by radical radiotherapy, there is a need for accurate planning of radiotherapy treatment. The basic data for this purpose is obtained from measurements made in water phantom. The human body differs from water phantom in size, shape and composition. Therefore, correction factors are necessary for such an inhomogeneitic environment. In this study, three methods: Tissue-Air Ratio, Power Law Tissue - Air Ratio and Isodose Shift have been subjected to comprehensive experimental tests to ascertain their suitability for lung tissue correction. Cobalt 60 - Gamma rays photons was used for these experiments. The measured inhomogeneity correction factors were compared with the calculated results. The results showed that as the source-surface distance from the field size increased the depth of the tumors and the correction factors were decreased. For practical purposes the calculated results for isodose shift method was closer than the other methods

Gastroesophageal reflux (GER) is one of the most frequent clinical disorders affecting the gastrointestinal tract of infants and children. In older children, complications of GER are chronic and more severe. The aim of this study is to present GER in 36 children more than 2 years of age and the symptoms that led to diagnosis. During the period of January 1999 to October 2000, 199 esophagogastro duodenoscopies (EGD) were performed in 106 boys and 93 girls aged 2.5 to 14 years old in Aboozar children,s Hospital, Ahwaz University of Medical Sciences. The symptoms led to perform EGD in these 199 patients were: 84 (42.5%) chronic abdominal pain, 48 (24%) hematemesis, 34 (17%) chronic vomiting, 11 (5.5%) melena, 7 (3.5%) failure to thrive, 3 (1.5%) recurrent pneumonia, and 12 (6%) other miscellaneous symptoms. The results showed that 36 (18%) patients (20 male) had obliteration of the Z-line in the esophagus during EGD and the biopsies results from the esophagus confirmed esophagitis due to GER in these patients. The causes led to do EGD in these 36 patients were: 15 (41.5%) chronic vomiting 13 (36%) chronic abdominal pain, 3 (8.5%) failure to thrive, 3 (8.5%) recurrent pneumonia and 2 (5.5%) hematemesis. There were 16 (44%) severe esophagitis including 1 barrett,s esophagus all aged more than 6 years old. Treatment with cisapride and H2 receptor blocker (cimetidine) or omeprazole was undertaken. Surgical antireflux procedure was performed on two patients who showed no resolution of symptoms after 4 months therapy. In conclusion, GER beyond infancy is not rare and tends to be chronic and severe and such patients are at high risk of developing serious complications.

Torsion of kidney pedicle is a very rare phenomena that not previously mentioned in textbooks. We report three cases which occurred during operation. The cause is due to complete mobilization of the kidney which predominantly occurs in lean patients who have low retroperitoneal adipose tissue. The sign of torsion of the kidney is discoloration which is due to obstruction of the arterial blood flow. Treatment is by detorsing and fixation of the involved kidney to the psoas muscle in order to prevent its reoccurrence. We advise not to free the kidney completely form its attached connective tissues. Furthermore, in order to insure good renal function, it is recommended that excretory urograph should be performed before discharging the patients who developed torsion during surgery.

From a total of 2000 food samples sent to the food control laboratory, 521 different bacteria belonging to the family Enterobacteriacae were isolated. The routine IMVIC series of test, as well as the decarboxylation of different amino acids and sugars fermentation methods were used for bacterial identification. Escherichia coli alone comprised 300 of these isolates and the remaining bacteria included, 110 Enterobacter spp (40 E.cloacae, 30 E. taylorae, 21 E. aerogenes and, 19 E. sakazakii), 44 Klebsiella spp. (24 K. oxytoca, 15 K. pnenmoniae, and 5 K. terrigena), 41 Serratia spp. (32 S. marcescens, and 9 S. fonticola), 11 Buttiauxella spp, 6 Hafnia alvei, 6 Pantoea spp, and 3 Citrobacter freundii. The kinds of food samples, in the order of their extent of contamination were dairy products, sweets, and ice creams. Due to the fact that these foods items are ready-to-eat and many different enterotoxins and cytotoxins are known to be contaminated by E.coli, Enterobacter, Klebsiella, and Hafnia; food contamination with these bacteria should be considered as potential health hazard.

One of the most expressed complaints following coronary artery bypass grafting (CABG) is chest pain originating from the operation site. Pain relief during the early days after operation is an important effective action which facilitates adequate ventilation. In this research we evaluated the effects of transdermal electrical nerve stimulation (TENS) in post operative pain management in CABG patients. 60 males patients were selected and divided into two equal groups. For pain management we used TENS + analgesic drugs in test group and only of analgesic drugs in control group. In order to evaluate the TENS effects on pain, four common different scales were used: subjective (numerical scale), physiologic, behavioral responess and the amount of medication used during the hospitalization time in cv ICU. The results showed significant differences between the means of the test and control groups in respect of all the four parameters considered in the present study, and the use of TENS was effective in relief of pain. Furthermore, due to the inherent side effects associated with the use narcotic analgesics, such as respiratory depression, nausea and vomiting, utilization of TENS is recommended in pain management after all CABG operations.

The goal of the present investigation was to detect the prevalence of intestinal parasites in mentally disabled students in Hamadan, west of Iran, in 2000. 191 samples were randomly collected from out of total 650 mentally disabled students in Hamadan city and examined using formal ether method. Results of the study showed among the 191 student studied 141 (73.8%) were infected by at least one parasite, 115 (60.2%) were infected by pathogenic parasites, 80 (41.8%) were infected with helminths and 100 (52.3%) were infected with intestinal protozoa. The most important parasites found in this study were: Ascaris lumbricoides (39.2%), Giardia lambllia (21.4%) Hymenolepis nana (3.1%) Entamoba histolytica. (1%) and Trichuris thichiura (1%). Regarding different school regions classification, the highest percentage of infection was among north area of Hamadan city. Concerning age and sex groups the statistical analysis determined no significant differences. In conclusion, the results showed a relatively high rate of prevalence of intestinal parasitic infection in mentally disabled student in Hamadan city.

Stress ulcer is an important clinical entity and its two major complications (bleeding & perforation) are the most difficult problems in clinical practice. Although perforation is less common than bleeding, it is perhaps the most formidable aspect t manage when it occurs in a very sick infant. This study we report of a case involving an eleven-month-old boy infant with bacterial meningitis and perforated duodenal stress ulcer. The main therapeutic efforts needed to be undertaken in such a patient are early sufficient shock therapy and prophylaxis to prevent development of stress ulcer and its complications