Avicenna Journal of Clinical Medicine
Year:2002 | Volume:9 | Issue:1 (SN 23)|Papers Count:14

This study was performed to evaluate the efficacy of anterior keratoplasty with microkeratome in the improvement of visual acuity (V.A) in superficial corneal disorders in patients admitted to Labbfi Nezhad hospital and Tehran Bassir Clinic.This clinical trial was done on 14 eyes of 14 patients with superficial corneal disorders involving less than 70% of the corneal thickness. Including criteria were patients with good functional endothelium and corneal thickness not less than 350 um. Using the chiron automated corneal shaper (A.C.S) 240-400 um resection of the diseased cornea was done and the same thickness donor cornea was cut and sutured to the recipient bed. "Post op VA", graft interface and bed clarity and refractive error were evaluated. Of 14 eyes; 3 belonged to females and 11to males ranging from 22-71 years of age mean F/U time was 7.2 months, mean "pre-op VA" was 20/400 improving to 20/30 with a mean astigmatism of 4.2 D. Graft was clear in 11 cases but the bed opacity was mild in 3 cases and moderate in 2 cases. Corneal opacity in 3 of our cases were secondary to lasik and the remaining were due to corneal dystrophies, gelatinous drop - like dystrophy and trachoma keratopathy. ALK with microkeratome improves V.A in superficial corneal disorders and may be a promising thechnique in future.

Beta- lactoglobulin (BLG) is a major whey protein in the milk of ruminants, e.g. cows, and such non-ruminants as horses. This protein is resistant under various conditions of pH and temperature. There is some evidence of absorption of some intact BLG in humans. Infants being fed with cow's milk- based formulas are especially prone to develop adverse reactions against proteins, including BLG, absorbed intact through their intestinal wall that is more permeable than that of adults. Regarding its importance, purification of BLG for immunological and serological studies and for setting up such diagnostic tests as ELISA and RAST is undoubtedly necessary. The aim of this study was to introduce a simple, reproducible, fast and less expensive method for BLG purification while saving its antigenicity, as well. Whey (lactoserum) was prepared by isolating casein from defatted milk using HCl. Globulins were then precipitated in whey by half-saturated ammonium sulfate. The whey and precipitated globulins were used for Sephadex G-50 gel filtration and diethyl aminoethyl cellulose anion exchange chromatography. Using enzyme-linked immunosorbent assay (ELISA), Western blotting and ELISA inhibition assay, antigenicity of the purified protein was then evaluated. In gel filtration, BLG was eluted with the second peak. In anion exchange chromatography of ammonium sulfate precipitated proteins and of whey proteins, it was eluted with the second peak. Our results showed high purity and well-preserved antigenicity of BLG thus purified.

To determine the incidence of pericardial effusion at the 9th gestational age in normal pregnant women, we performed echocardiography in 50 normal pregnant women at the end of pregnancy and then 6 weeks after delivery. The results showed that 22% of pregnant women had mild to moderate pericardial effusion ,that were resolved completely in all cases 6 weeks after delivery. Pericardial effusion was significantly more prevalent in primigravids and there was no relationship between maternal age and it's occurance. In view of this study, we recommend that in case of larger than moderate pericardial effusion or effusions that persist 6 weeks or more after delivery, a complete workup for pericardial effusion must be done.

Storke is a disabling neurological disorder and is the third cause of death in the U.S. The various risk factors have been investigated for stroke; the most important of which are age, sex, hypercholesterolemia, smoking, alcoholic dirnks, records of cordiac diseases(specially a trial fibrilation), taking oral contraceptives, takibg some kinds of drugs, etc. On obesity- which measured against a criterion called Body Mass Index (BMI) and its relevance to stroke, different kinds of studies have been done, only to reach no certain results. In this research, it has been attempted to evaluate the effect of BMI in the two kinds of ischemic and hemorrahgic strokes, regardless of any other risk factors. This study was preformed on 200 individuals, of whom 80 were selected from stroke patients hospitalized in the neurology ward of Sina hospital of Hamadan in 2000 and the other 120, the control group from people with no records of stroke. Both groups were investigated in terms of BMI and other risk factors, and then the results were compared with each other , using t-student and mantel haenszel test. The BMI mean in ischemic stroke and control groups was not significant(p=0.69)and neither was the mean hemorrhagic and control groups (p=0.83). comparing the odds ratio in ischemic stroke with the other risk factors it was indicated that none of these risk factors had any adverse effects as invalidator in this study. It is concluded that there is no significant relationship between obesity or BMI with any types of stroke (ischemic or hemorrhagic). Therefore more efforts must be undertaken to prevent the other kinds of risk factors mentioned.

Serveral different types of collagen have been identified invivo. Human placenta has been employed by a number of investigators over the past decade as a starting material for isolation and characterization of different genetic types of collagen including type I, III, IV and IV molecules. Proteases of the placenta participate in the degradation of intracellular and extracelluar matrix proteins. To extract collagen types IV and I+III, a healthy placenta at term (38 weeks) and a premature placenta (14 weeks) were placed under pepsin digestion using minimum quantity. The steps of extraction were controlled by the SDS-PAGE. The electrophoretical patterns of premature placental collagen indicated that the number of collagen chains types IV and I+III in premature placenta were less than that of the healthy placenta at term. According to electrophoretical pattern in the premature placenta , there were not 2 (IV) , 11 (I) , 12 (I) and 1 (III) chains. Thus, it is probable that in some of the repeating abortion the synthesis of collagen is decreased or degradation of collagen is increased. So it is suggested to measure the serum and cervix collagenase in women who had unexplained abortions.

Performing the bacteriological tests for potable water is based on research, counting and discrimination of water pollution index (Coliform). In these methods doing the tests needs some preparation before sampling, during sampling and during transporting the samples to laboratory as well as during preparation of cultivation environment. The above mentioned tasks require much equipment and different stages of cultivation. In this project, the Presence-Absence method (P-A ), which examines the presence or absence of pollution index in water is compared to the multiple fermentation technique , which is being used in laboratories all around the country at present, also the replacement of method is evaluated. This project was performed during 3 months and 263 samples were examined by both methods. The results demonstrate 7.01% more sensitivity for P-A method to the other. Comparing quality and quantity of the two methods confirms more benefits for P-A method.

Position changing with blood distribution to different portions of lung can produce V/Q mismatch, and finally extend to oxygenation disruption. Thus, if position changing is done' neglecting the patients' pulmonary problem types, not only does it fail to cause oxygenation improvement, but it also induces gas exchange impairment, and with provocation of hypoxemia and respiratory acidosis, serious problems result. The goals of this research are to determine the semi-fowler's position and its duration effect on the arterial blood gases (ABGs) results in patients under mechanical ventilation hospitalized in general ICU. In this study, 30 ICU patients (22 males and 8 females) under mechanical ventilation were chosen. Then using questionnaires, the patients' demographic data were collected. A sample of arterial blood from these patients lying in supine position, was taken. Again the patients immediately were placed in semi-fowler's position and after 15, 30, 45, and 60 minutes lying in this position, samples of arterial blood were taken and sent to laboratory. The findings showed that semi-fowler's position did not have any positive effects on oxygenation and gas exchange. Also, the findings indicated that the effect of lying duration (15, 30, 45, 60 minutes) in semi-fowler's position on oxygenation and gas exchange wasn't significant. It was concluded that without considering the lung pathology, semi fowler's position should not be used, because not only is this position unable to induce oxygenation-improvement, but actually it may causes gas exchange impairment.

Breast feeding is very effective on infants' good health both mentally and physically. It prevents children from dying of malnutrition, respiratory infection and diarrhea which are the main causes of death among them. Up to now, little attention has been paid to the relation between breast-feeding and the type of delivery. Regarding the increasing number of cesarean childbirth, the relation deserves special attention. So the aim of this research is to study it statistically. The present study is descriptive-analytic. First , 400 mothers out of those who did not have relative or absolute prohibition of breast-feeding and whose infants were 4 months old or even older and had no difficulty in their sucking reflection with explained or unexplained causes were randomly chosen from 10 health care centers out of 28 in Hamadan. (200 mothers with natural childbirth - 200 with cesarean childbirth). The data including age, parity, education, receiving appropriate instruction in breast-feeding, occupation, type of delivery and breast-feeding success were collected using the patients' files or through interview. The two groups had no significant difference in their ages, parity and education. Appropriate instruction of the group with natural childbirth was 95% and in caesarian group was 85%. Breast feeding success among mothers with natural child birth was 81% (163 persons) and in comparison with (64% 129 persons) cesarean group was quite significant. Moreover, the breast-feeding failure among mothers who had natural childbirth (11.5%, 23 persons) had been mainly occurred after exclusively breast-feeding for 3-4 months while the majority of mothers with cesarean delivery (75%, 50 persons) had failed to breast-feed their infants exclusively in less than 2 months. Natural childbirth and instruction of mothers had considerable effect on breast-feeding success for four or more months.

Among all deathful and destructive factors, the work related accidents are of special importance. The principles of accident prevention have been changed after the mid 20th century based on refusing and decreasing the human unsafe acts. The most important step in accident prevention is recognition of accident occurrence reasons, so, it is necessary to evaluate the labors' unsafe acts that are the main causes of accident. In this study, the workers' unsafe acts in Godazan factory were evaluated by safety behavior sampling method, observation and interview in 2000. After description of unsafe acts, the sample size was 573 cases based on results of pilot study and sampling accuracy to 5% and confidence level to 95%. Using questionnaires, variables related to the workers were collected. The results showed that 59.2% of workers acts are unsafe. The most important unsafe acts are not using personal protective equipment with 50% out of total unsafe acts. The results showed a significant difference between unsafe acts and age, number of family members (p 0.01) ,education and former accident(p 0.05). The findings of the study showed that most of workers' acts in Godazan foundry were unsafe. Since, unsafe acts are the main causes of accidents, the results emphasize on decreasing the unsafe acts and recommend behaving according to safety principles.

Iridium-192 is one of the radioactive materials used in Brachytherapy in the treatment of tongue, lip, skin, prostate, breast and brain cancers. Different forms of Iridium-192 are used in Brachytherapy. This study was performed in order to produce Iridium-192 for the above mentioned uses in Iran. This research was carried out on two kinds of Iridium-192 wire using facilities available at the Iranian Atomic Energy organization. Activation of wire was done based on standards for employing Brachytherapy in the atomic reactor of the Iranian Atomic Energy Organization. In this study Kerma scan system was used to examine the properties of the materials. Results of this study showed that thermal neutron flux, geometric position of wire model during thermal neutron flux and sample constancy when activating wires by neutron radiation play a fundamental role in the activity homogeneity of the sample wire lengh and its activities. Regarding the results, Iridium-192, can be produced for Brachytherapy uses in the Iran Atomic Energy Organization. At present this material is employed in Brachytherapy in the institute of cancer and Jorjani hospital (Tehran).

Tuberous Sclerosis (T.S), an autosomal dominant disorder is one of the major neurocutanous diseases with the involvement of many other organs. In this retrospective cross sectional study, 40 cases of T.S have been followed up in the department of pediatric neurology in Tehran Mofid children's hospital between, 1997 to 2000 (20 males and 20 females). All patients suffered from seizure disorder and upon admission had extensive paraclinical investigations including biochemical, electorgraphic and neuroimaging, studies. In view of ophthalmic and cardiac involvement in a remarkable portion of T.S patients, we consulted cardiologists and ophthalmologists. In this report, neurologic, ophthalmic, cardiac and skin manifestations of T.S mental retardation and seizure disorder which are the most common neuroclinical symptomatologies have been described. Also in the present article, the varieties of seizures and EEG patterns in these patients have been discussed. All T.S patients had hypopigmentation areas. Of these 37 had preventricular Calcification , 30 were diagnosed having subnormal mentation, 8 suffered from aterial rhabdomyoma, 7 adenoma sebaceus, 5 shagreen patch, 5 retinal hammartoma and 3 had brain tumor. The combination of depigmented areas of skin, siezure disorder and delayed development are diagnostic for T.S

left ventricular pseudoaneurysm is a rare complication of myocardial infarction. Since the risk of rupture is high, accurate diagnosis and if possible prompt surgical repair are of great importance. A 79 year old man was admitted because of dyspnea on exertion and congestive heart failure, two weeks after an acute inferoposterolateral myocardial infarction. B mode echocardiography and color doppler were done on the patients and left ventricular pseudoaneurysm was diagnosed. Because of high risk of his operation, he only received medical therapy. Fortunately after more than two years, his general condition is satisfactory.