Journal of Kerman University of Medical Sciences
Year:2000 | Volume:7 | Issue:2|Papers Count:11

It has been shown that many types of physical - environmental stresses during fetal life alter behavioral responses to stimuli. Sex hormones have been shown to be evolved in these behaviors. Nociception can also be affected by stress, but the mechanism (s) are not fully investigated. In this study NMRI pregnant rats (220-250 gr) were exposed to repetitive one hour intermittent noise stress (90-120 db, low frequency, white noise) during night dark cycle. Intensity and frequency of noise varied each 2-3 minutes between minimum and maximum levels. Pain thershold was measured after after subcutaneous injection of 50 ul  formalin (2.5%) in right paw. The experimentmsubcutaneous injection of 50 considered to have two stages: 1) phasic pain, minutes 0-15 and 2) tonic pain minutes 20-50. Pain score was marked every 15 seconds. The results showed that exposing to noise stress during fetal life has mostly affected tonic pain threshold. Pain threshold in stressed female offspring was increased significantly compared to stressed male offspring or compared to control male and female offspring. In conclusion it is suggested that noise stress during fetal life may increase pain threshold (hypoalgesia). Increase in endogenouse opioid release may be considered as the mechanism.

β- thalassemia major is a hereditary disorder which is relatively common in our country. One of its complications is scoliosis. In this study one hundred thalassemic children from Kerman and its districts were studied for scoliosis. The variables such as age, sex, sexual maturation, splenectomy, early administration of deferoxamin and its dosage, osteopenia, time of first transfusion, location of scoliosis and its severity were studied. Ninety-three (93%) had some degree of scoliosis; 35 (36%) mild (less than5), 43 (42.6%) moderate (5-9), and 15 (16.1%) had severe scoliosis (above 10 degree). It was shown that prevalence of scoliosis was not related to inadequate transfusion however its severity was related to inadequate transfusion. Previous studies have also shown that hyper transfusion and higher levels of hemoglobin have resulted in better quality of life and lesser physical complications in these patients. Therefore it is recommended that improvement should be made in blood transfusion for these kind of patients.

To ascertain the cost - effectiveness of current screening strategies for syphilis, a review of one year period from April 1998 to March 1999, was made at district health office and two women's hospitals in Shiraz, Iran. In total 20716 patients were screened by means of three different screening programmes (14854 by mandatory premarital screening, 3250 by preemploymet screening and 2612 by antenatal screening programme). Six (0.03%) cases were confirmed, serologically (VDRL, FTA-ABS) to be treponemal infection. To evaluate the cost-effectiveness of such a screening system we developed a decision analysis model. When considering direct medical cost, antenatal screening programme is the most cost-effective. Altogether routine screening programmes for syphilis would be cost-effective even at a lower prevalence (0.022%) and it should be continued because of the fact that the present notification system, due to nonparticipation of a great majority of private physicians, is unreliable.  

The aim of this study was to find a practical screening test to detect breast tumors for those who cannot attend a specialist due to geographical locations, economical reasons and many other problems. Therefore, this research is designed to determine the sensitivity and specificity of diagnosis of breast tumor made by health care providers (Behvarz) to that made by the specialist. Among 2000 women who were referred to health care centers of Kerman and Zarand cities, a total of 170 were found to have pathological signs when examined by the Behvarz. Among 169 cases in whom a pathological condition was detected by a obstetrician, 162 cases were also detected by the Behvarz. Seven women were detected by the physician to have pathological signs, and these were missed by the Behvarz, and eight women were reported to be positive by the Behvarz which were reported to be negative by the obstetrician. In conclusion the sensitivity of diagnosis of breast tumors made by the Behvarz compared to specialist was99.2% and the specificity was 95.8%. There fore screening of breast tumors by the Behvarz is recommended.

Study of occlusion and its relation with masticatory system is an important subject in dentistry. As the teeth are one part of this system and have close relation to muscles and temporomandibular joint they can cause change in some parts of masticatory system. In this study temporomandibular joint of 125 partial edentulous patients were examined in oral diagnosis department of dental school of Rafsanjan, during 7 interrupted months in 1998. Frequency of patient who had temporomandibular joint disorders was 76.8% and only 35.4% of patients were aware of these problems. The most pathologic finding of temporomandibular joint was clicking and most incidence of disorders were seen in angle class 2 and group function occlusion. With increase in the duration of edentulous periode the temporomandibularjoint disorder were increased. The most temporomandibular joint disorders were in free end edentulous patients and the most premature contacts were seen in protrusive movements. The result of this study showed partial edentulous can cause temporomandibular joint disorders therefore it is recommended to advise patients for replacement of teeth to prevent irreversible temporomandibular joint problemes.

Exchange transfusion is the standard mode of therapy for immediate treatment of hyperbilirubinemia to prevent kernicterus, but it has some complications. Potassium and acid-base variations are frequent in neonates who had exchange transfusion. These are directly related to factors such as type of blood, age of utilized blood, gestational age of the neonate, etc. In this study 47 neonates (42.6% boys and 57.3% girls) with blood exchange transfusion were evaluated over a period of 13 months in the University HospitalNo.1, Kerman Medical Sciences and Health Services. Blood samples of the neonates was collected from umbilical vein catheter, before and after exchange transfusion for K+ and blood gas measurement. Also one sample from blood bag was used for K+ measurement. The relationship between blood gas and factors such as gestational age, preservation time and volume of utilized blood and duration of exchange transfusion procedure were studied. In this study, like other studies, increasing in blood K+ concentration was found. This changes was obviously related to the preservation time of utilized blood and its K+ concentration. The potassium concentrations of utilized blood was often more than standard K+ concentrations for exchange blood (lower than 6 mEq/l) and was directly related to the preservation time of utilized blood. Sodium bicarbonate concentration of the neonates was obviously reduced after exchange transfusion and had a significant relation to the preservation time and sodium bicarbonate concentrations of utilized blood. Despite reduction in sodium bicarbonate, neonatal blood pH did not vary after exchange transfusion. After exchange transfusion the average PO2 and SO2 of venous blood was significantly increased. This increment was not related to the neonate's age, volume and preservation time of utilized blood, and its PO2 and SO 2. It is recommended that the preservation time of blood to be considered before transfusion.

Various cutaneous lesions have been described previously at the sites of herpes zoster scars such as: lymphomas, pseudo lymphoma, granuloma annulare, sarcoidosis, tuberculid granuloma, granulomatous vasculitis, keloid, kaposi's sarcoma and lichen planus. Isotopic response describes the occurrence of anew disorder at the site of another unrelated, and already healed skin disease. A 55 year-old woman was seen with a localized zoster form papulonodular eruption in L3 and S2 dermatomal distribution. Simultaneously, she developed erythematous butterfly rash on her face and non specific erythematous rashs on the upper extermities. In addition, she complained of malaise and weight loss. Light microscopic examination of skin biopsies from erythematous. lesion of the face was in favour of lupus erythematosus. Histopathological examination of papulonodular lesion on the trunk showed marked mucin deposition through out the papillary dermis with extension into reticular dermis without usual inflammatory or epidermal changes of lupus. Sections of papulonodular lesion were stained with periodic-acid Schiff and alcian blue stains which both were positive. It is uncommon and unique in lupus erythematosus with dermal mucin deposition in a sufficient quantity to produce papulonodular eruption without typical epidermal changes on the sites of hrepes zoster scars.

In this paper a case of missed abortion in a cervical pregnancy is presented. A 38 year old women G2P1001 referred with vaginal bleeding following a curretage which had been performed 14 days ago in another hospital. The pathological report was indicative of missed abortion. Based on the sonographic evidences which were indicative of retained products of pregnancy, it was decided to perform curettage again. During curettage a sever and uncontrollable haemorrhage ended up to hysterectomy with the preservation of adnexa. The enlarged cervix was indicative of cervical pregnancy. The patient was discharged after 4 days in a healthy condition and histopathologic examination revealed endocervical implantation of trophoblasts and degenerated product of conception which were suggestive of missed abortion.