Avicenna Journal of Clinical Medicine
Year:2001 | Volume:8 | Issue:2 (SN 20)|Papers Count:11

Patients with sick sinus syndrome (SSS) and implantation of permanent pace maker (PPM) have complications that prevalence of them are depended to type of PPM. Evaluation of these complications is the goal of this study. File of 83 patients with SSS who experinced implantation of VVI mode PPM during 17 years in Tehran's Shahid Rejaei heart hospital have been considered for these complications. Cardiomegaly 37.75%, congestive heart failure 10.84%, chronic atrial fibrilation 30.12%, atrial flutter 3.61%, systemic emboli 4.81% and atrioventricular block (31.32%) have been observed. The results showed more complications in VVI mode PPM.

Social phobia is one of phobias which is the least studied. Clinical characteristics of the disorder include, phobic avoidance of social situations somatic and cognitive symptoms of anxiety and impairment in functioning. No comprehensive research in Iran is available. The aim was study on prevalence of social phobia and some related factors among high school students in Kerman in 1998. In this cross - sectional study 2944 students were evaluated by DSM IV criteria for social phobia via semi structured interview. 14.6% fulfilled criteria for social phobia, female to male ratio was 1.8. There was meaningful statistical relationship between history of shyness during childhood and physical abuse with social phobia. Prevalence of this disorder was higher than same western researches. Complementary researches is recommended.

The emergence of Staphylococcus strains resistant to methicillin occurred shortly after the introduction of methicillin into clinical use. Resistance to methicillin in clinical isolates of Staphylococci has been explained by the production of a characteristic penicillin-binding protein (PBP), designated PBP2a, that has a decreased binding affinity for - lactam antibiotics, the gene mec-A encoding PBP2a was cloned and is distributed among methicillin- resistant but not methicillin-susceptible populations of S. aureus. Recently, high prevalence of methicillin resistance has been noticed in the clinical isolates of coagulase-negative Staphylococci (CNS) which, besides MRSA (Methicillin- Resistant -Staphylococcus aureus), also have been recognized as important nosocomial pathogens. Detection of the mec-A using PCR may provide a sensitive method for identifying methicillin resistant Staphylococci. In this study, overall 268 wound swabs in which 107 cases (40%) were Staphylococcus aureus and 10 cases (3.7%) were coagulase negative Staphylococcus and the rest of them were other microorganisms were examined . After the extraction of DNA, PCR was carried out using specific primers. The results indicated that the mec-A was present in 24 cases (9%). In 8 cases (34%) Staphylococcus aureus,3 cases (12%) coagulase negative Staphylococci, the others were related to another microorgamisms that probably were contaminated by Staphylococcus species.

  Nose and paranasal sinuses tumors are rare but their clinical signs and symptom's are nonspecific and their diagnosis usually established with delay. The purpose of this study was determination of epidemiological status of these tumors in Hamadan. Patients' records in Hamadan hospitals' file were reviewed from 1991 to 1998 retrospectively. Over all, 44 patients with these tumors were evaluated. In 81.4% nasal cavity and in 15.9% maxillary sinus were original site of tumor. Chief complaints in decreasing order of frequency were epistaxis, unilateral nasal obstruction, pain in the region of face and nose and rhinorrhea. The most common malignant and benign tumors were S.C.C and hemangioma respectively. The results indicated that physicians must be more careful regarding the clinical sign and symptoms of these tumors and in the case of clinical suspicion refer them for complete evaluation.

Pemphigus describe a group of autoimmune disease characterized by blisters and erosions of the skin and mucous membrane, acantholysis and autoantibodies against epidermal cell surface components. The aim of this study was assessment of pemphigus patients hospitalized in the dermatology ward of Sina hospital Hamadan. The research was descriptive 'retrospective study and was done on the base of information that obtained from 37 pemphigus patients' file hospitalized in Sina hospital during 1992-1995. In this study 23(62.2%) patients were female and 14(37.8%) patients were male and most of the patients were in the age of 41-50 years. Oral lesion was seen in the 83% patients that in one third of the patients (32.4%) was the initial presentation. Relapse in this study was (29.7%). Death occurred in four patients (3 women and 1 man) and septicemia was the most common cause of death. The most common from of pathology was pemphigus vulgaris. The average time between beginning of the disease and admission time was 103 days. This study showed that pemphigus was more common in women than men, also relapse of pemphigus in this study was more than the other studies which was done in other countries.

Most common cause of cesarean in U.S.A and Fatemieh hospital in Hamadan is repeat cesarean section. The most effective way to reduce cesarean rate is vaginal delivery after previous cesarean section. The aim of this survey was to confirm the safety and less cost and morbidity in vaginal delivery after previous cesarean section. Full term pregnant women with history of once previous section with a singleton, cephalic, less than 3.5 kg fetus who selected vaginal delivery, were studied. From the 201 selected cases, 109 patients had vaginal delivery and 81 patients of the delivered successfully (74.3%). No maternal morbidity happened. Morbidity reduced to 3.7% in comparison to 7% in cesarean after cesarean. Vaginal delivery after cesarean reduced cost to half. 81 vaginal delivery after previous c/s saved 20 million rials. Mean hospital stay in vaginal delivery group was 1.1 day and in cesarean group was 2.8 day. Cause of cesarean - selection in 36.9% of patients was pain and fear of pain. This survey reduced c/s rate from 25.1% to 21.2% and changed the most common cause of cesarean from repeat to meconium. Vaginal delivery after cesarean was safe and reduced the cost and morbidity. Main cause of cesarean selection was pain and fear.

Headache is one of the causes of calling many patients to clinics. This disease sometime becomes so persecutor that one is not able to perform the daily activities. Hence, if the kinds of headache and their causes are identified, these people can probably be helped in order to have a comfortable life. The aim if this study was determination of headache causes in the patients that had referred to Sina hospital in 1998, with regard to headache specifications and by means of complement tests to confirm or refuse the diagnosis. After designation a questionnaire, the necessary information was collected by interview and recorded in the question. All of the patients, are visited in neurologic ward of Sina hospital. For all of the patients a brain CT-Scan and EEG were perform. This study was a descriptive study. The results showed that the most common headache was tension headache (33%) and then migraine type. The proportion of female was 37% and male was 27%. The mean age of population was 36 years and standard deviation was 16 years. Approximately 14% were due to organic causes. The most common was hypertension (21%) and then is cervical osteoarthrosis (15%). In this study, we begun to change headache algorithm by means of complement tests to refuse other diagnosis. To consider headache specifications in group of ETC and comparison with the diagnosis type, it is possible to help physicians to change and improve the post headache approach.

The aim of this study was to determine the arterial blood pressure changes in adult patients under operated through general anesthesia one of the training hospitals in Iran University of Medical Sciences. This study was a comparative analytic descriptive study, and was performed in one of the related hospitals in Iran University of Medical Sciences in 1991. In this research, arterial blood pressure of forty patients was recorded using the mercurial sphygmomanometer, stethoscope and direct observation. The mentioned data were analyzed through paired t.test. The results indicated that the means of the differences in the mentioned patient systolic blood pressure prior to induction of anesthesia, during anesthesia, and immediately after extubation were 10, 18.62 and 11 mmHg respectively. Also the means of the differences in the same patients diastolic B.P in these stage in comparison with their B.P in the ward were 3.25, 5.67, 8.87 and 6.62, respectively and the paired t.test showed the meaningful differences. The results obtained from the statistical analysis showed the patients blood pressure change in all stages; prior to and after induction of anesthesia, during operation and immediately after the extubation.

Brucellosis is relatively prevalent in undeveloped countries. Meningitis is one of the most common complications of neurobrucelloss but mylopathy is very rare. We report here two cases of brucellosis mylopathy that they referred to department of neurology in Hamadan Sina hospital in 1999 with weakness of lower extremity, difficulty in gait and urine incontinancy. Although various differential diagnosis were suspected for them but the diagnosis of brucellosis mylopathy for both was established by accompanying signs and symptoms and paraclinic examination.

Upper respiratory tract is an unusual site for tuberculous (T.B.) infection. Primary nasopharyngeal tuberculosis without pulmonary involvement is rare. Review of the articles has shown only 39 cases of secondary and primary nasopharyngeal T.B. from 1968. This report described a 26 years old woman with nasopharyngeal T.B. who referred with hearing loss and bilateral serous otitis media who was treated with anti tuberculous drug for 6 months with good results.