Avicenna Journal of Clinical Medicine
Year:2003 | Volume:10 | Issue:3|Papers Count:13

Pregnancy in diabetic females causes delay in early stages of embryonic growth and development and higher incidence of congenital malformations and spontaneous miscarriage compared with those of non- diabetic conditions. High glucosis tratogenicity seems to be related to reduction of Nitric Oxide production (NO) in hyperglycemic condition. The goal of present work was study of nitric oxid role in control of mouse preimplantation embryonic defects in high glucosis media.In order to test above hypothesis, 2-cell stage embryos of normal mice were cultured with high concentration of glucose (30mM) and different concentrations of L-arginine (5,10,20 mM) or L-NAME (An antagonist of L- arginine). After 96h culture, the morphology of embryos was assessed by an inverted microscope then blastocysts were stained by TUNEL. After TUNEL the total cell number and apoptotic cells were counted by use a Fluorescence microscope. Finally the amount of nitrite in the media was assayed by Greiss method. The results indicated that high glucose decreases the blastocyst formation and Nitric Oxide production and increases their apoptotic index, but 10-20mM L-arginine significantly increases the developmental potential and nitric oxide production and significantly decreases apoptosis. On the contrary L-NAME significantly inhibits the development of pre-implantation embryos . It seems that during pregnancy supplementation of high glucose media with L-arginine increases Nitric Oxide production and prevents high glucosis embryotoxicity.

Considering the hazards of macrosomia and low birth weight, the estimation of birth weight before delivery is of paramount importance. This study was performed to estimate the fetal weight on the base of mother fundal height and abdominal girth in women referred to Fathemieh hospital in Hamadan for delivery in 2000. We conducted a descriptive study with 200 women (100 primipara and 100 multipara) who were selected through a random sampling. Inclusion criteria were single normal pregnancy, body weight less than 90 kg, empty bladder, negative station of presentation, intact amniotic bag. The variables included the uterine height and abdominal girth (in Cms). Estimated fetal weight obtained through multiplying the two values of above variables and then comparing with the weight of newborn immediately after delivery. The results showed that the mean of mother fundal height and abdominal girth were 33.92±2.85 cm and 97±6.2 cm respectively. The mean of estimated fetal weight and measured weight were 3088 382g and 3060 344g respectively. The coefficient of correlation between the estimated weight and measured weight was 0.61. Sensitivity and specifity of this multiplication in detecting of fetuses larger than normal were 83.3% and 86.5% respectively and in detecting of fetuses smaller than normal were 48.4% and 96.2% respectively. The uterine fundal height and abdominal girth can predict the neonatal birth weight.

Diabetes mellitus is a metabolic disorder that affect different systems in human. Wide range of musculoskeletal syndromes have been described in association with diabetes. To determine the prevalence of upper limb soft tissue rheumatism in diabetes patients.In a cross sectional study 300 diabetic patients was examined by COPCORD questionnaire. The examination was performed by internist and rheumatologist . Data was analyzed by logistic regression. 73.3% of patients were female. Average age of cases was 51.2±13.7 years and mean of duration of disease was 7±6.4 years. 152 cases (50.7%) had soft tissue rheumatism in upper limbs. 66 cases had carpal tunnel syndrome, 23 cases with Dupuytren's disease, 23 cases with Flexortenosynovitis, 91 cases with shoulder periarthritis, 4 cases had limited joint mobility and 12 had Elbow Epicandititis. Logistic regression analysis showed that type 2 diabetes, weak control of blood sugar and duration of disease>5years were risk factors for incidence of soft tissue rheumatism in upper limbs. Results have showed the high prevalence of soft tissue rheumatism in diabetic patients.

Determining reduction proportion of blood urea in patients under hemodialysis in dialysis department of Ekbatan hospital and comparison between obtained results and standard scales.This study was descriptive, cross - Sectional. In this study the number of 100 patient under dialysis in were evaluated and their blood samples were accumitated before and after dialysis and were transferred to the laboratory. Results were calculated by BUN formula, meanwhile the other parameters as, the time of dialysis, speed of blood circulation, percentage of filter clearance, patient weight before and after dialysis, blood pressure before and after dialysis, also evaluated and registered.To consider the obtained results from BUN calculations we found out that 10% of individuals have URR 65%. In that the results are in accord with standard scales, and revealed adequate dialysis. About 34% were near accepted range (55%-64%). The rest of individuals about 56% were lower than accepted URR.

Although municipal solid waste (MSW) is generated every day , but with comparison to other municipal Environmental aspects such as Air pollution and Sewage, is not well considered. MSW management includes refuse production, storage, collection, transportation and disposal. Without adequate and reliable in formation and data about MSW generation rate and it's physical components, optimun planning and management is not obtainable. In this research the physical composition of Hamadan MSW was studied.Samples were takan by Truck-Load sampling and portional random method from June 1999 untile May 2000 and analyzed for physical components and moisture percent age.The results showed that the average generation rate, density of wastes and its moisture percent were 252.33 Tons and 204.83 kg/m3 and 22.46% respectively. Average percents of physical componets were 77.72% , 5.75% , 5.42% , 3.15%, 2.11% , 1.04% and 4.92% for Biodegriable materials (garbage), papers, plastics, textiles, metals, glass and other materials respectively. Also maximum generation rate was 328 tons in March and minimum generation rate was 196 tons in December.In general, with planning of enforceable reuse and recycling programmes, could be avoid of 183, 14, 13 and 5 tons of biodegriable materials , paper, plastics and metals burial respectively everyday.

In comparison of effects of various drugs with the same indications produced by different companies or comparing drugs manufactured in Iran with their foreign counterparts may result in producing drugs with higher qualities in our country. In this study the spasmolithic effect of two herbal drugs , gripe mixture and caraway mixture , that are prescribed as spasmolithic and carminative in infants were compared.2 cm of rat jejunum was placed in a organ bath containing tyrode solution (37 Co , 100% O2) . The jejunum was contracted because of acetylcholine (1 ml). when the muscle contraction reached the plateau the different volumes of drug were added to the organ bath. The inhibitory effect of drug indicated by physiograph , the intestine was washed two times. When the intestine reached the basal tonicity , the different volumes of second drug were tested. The results were compared using paired t.test The results show that both drugs inhibit the spasm induced by acetylcholine in rat jejunum . This inhibitory effect was dose dependent. The caraway mixture showed a higher effect in comparison with gripe mixture (P<0.05).The caraway mixture has a higher inhibitory effect on acetylcholine induced spasm in rat jejunum . It seems that it has the same effect on human.

Cholera is a disease with acute diarrhea caused by vibrio cholera which it's serogroups O1 is more responsible for several epidemy in numerous countries. There are two biotypes classic and eltor that has three serotypes ogawa, inaba and hikojima . This survey with beginning cholera epidemy in Hamadan was performed with aim to investigation etiology, clinical manifestation and laboratory findings in referred patients to health services in Hamadan province.The method of survey was descriptive cross-sectional research and were done in summer and autumn 1998. We described all of patients with acute diarrhea that were done culture from rectal swabs in TCBS (thiosulfate citrate bile salts sucrose agar) medium. From 718 positive cultures one hundred culture were chosen randomly and antibiogram test was performed for 10 current antibiotics.From 27380 patients were done rectal swabs in TCBS medium that 718 cases (2.6%) were positive culture which all of identified vibrio cholera seogroup O1 (with Eltor biotype and ogawa serotype). The patients were 50.6% male and 49.4% female. The most frequency in 20-29 years and 10-19 years age groups were 22.7% 17.7% respectively. The most frequency of cholera was seen in months August and September 65% and 28.5% respectively. The patients were admitted in hospital 18% cases and 82% cases were treated out patient. In the admitted patients(129 cases) had afebrile 95.3% , rice watery diarrhea 94.6% , vomiting 68.2% , abdominal pain 45.7%. Laboratory findings were leukocytosis 77.5% , hypokalemia 61.9%. WBC 21.7% and RBC10.1% was reported in stool examination. In antibiogram the most resistancy was reported to co-trimoxazole and furazolidone 99% and 98% respectively and most sensitivity to ciprofloxacine , nalidixic acid , tubromycin , doxycyline was reported 99% , 98% , 93% , 85% respectively. 5 cases (0.7%) were died due to acute renal failure. Leukocytosis, WBC and RBC in stool examination of some patients showed co- infection with other invasive intestinal pathogens or new serotypes of vibrio cholera. So we recommend that in epidemy of cholera , stool culture should be done for others pathogens and serotyping of all of isolate vibrio cholera.

Patients with hemophilia and thalassemia are two groups of hereditary disorders that, periodically, use blood and blood substances. The aims of the present study are determination of the frequencies of different types of coagulation disorders, and a comparison of the frequencies of ABO & Rh phenotypes among affected individuals with the control group (blood donors).The subject group were all affected persons were referred to hemophilia and thalassemia centers in Hamadan. Primary information was collected from their files, then were classified and analyzed. The control group were blood donors that were registered in Hamadan blood bank. Results showed that the different types of coagulation disorders in affected individuals referred to the Hemophilia and thalassemia centers during 1998 were Hemophilia A (61.96%), Hemophilia B (20.86%), Von Willbrand (5.52%), Platelet deficiency (4.91%), Factor XIII deficiency (3.68%) and Factor VII deficiency (3.07%).In general, results showed that in population with Hemophilia A, frequencies of A and O blood types were statistically different with the blood donors. The lowest rate of negative Rh, was in the population with thalassemia. The sex ratio of the affected persons was also different with control group.

Glycoconjugates, particulary their sugar side chains, play important roles in ‎development. This investigation was undertaken to examine the chemical nature of ‎components in the Zona pellucida possibly related to follicular development.In this ‎study, lections conjugated to horseradish peroxides were used as specific ‎histochemical probes to characterize the structure of Zona pellucida.‎ ‎ glycoconjugates and changes in their composition during ovarian cycle. Three of five ‎lections for N-acetylation of galactose and glucose amine intensely stained the zona ‎pellucida. These observations suggest that the N-acetylgalactosamine (GaINAc) and ‎N-Acetylglucosamine (GIcNAc) -containing glycoconjuages in zona pellucida may be ‎of functional important in follicular development. We can use this data for causing ‎female infertility and to make special contraceptive‏.‏

Every year many people refer to emergency department due to poisoning and some of ‎them be treated and some die because of the intensity of adverse effect. Most patients ‎who refer to emergency department are those who commit intentionally for suicide ‎attempt and another group are those who are poisoned due to drug overdose. In this ‎study we reviewed annual number of death due to drug and chemical poisonings that ‎attend to sina hospital, Hamadan in the year 2001. This retrospective study was gather ‎based on poisoned file who refer to emergency department and died due to intensity ‎of adverse effects of poisoning. The results show that out of 1079 patients, 47 cases ‎have died because of intensity of adverse effects. Mortality rate in male was 74.5% ‎and in female was 25.5%. 68.1% was seen in those patients who committed suicide ‎and in the second degree was seen in drug abuser (21.3%). The greatest number of ‎death (12 patients) was seen between 10-20 year old and also above 50. Poisons ‎mostly used organophosphates-opiates and herbicides successively. And other drugs ‎and chemical came after them. The most common adverse effect leading to data was ‎respiratory depression. In most cases toxicological examinations on dead body were ‎negative, when the results of such examination were positive the majority of reports ‎were about arsenic and methanol. The highest rate of death (55.3%) occurred in those ‎patients who referred to the hospital more than 6 hours after poisoning. The results ‎showed that the rate of poisoning due to organophosphate insecticides and opiates are ‎higher than other drugs in Hamadan.‏

Kikuchi's disease or histiocytic necrotizing lymphadenitis is uncommon disease that first time was recognized in Japan. The etiology of disease is unknown. Clinical features consist with unilateral cervical lymphadenopathy, often with upper respiratory prodrome and associated in some patients with fever. More cases occur in women, commonly under 40 years of age. The involved nodes are usually firm with rubbery, discrete and sometimes tender. Occasional patients present with generalized lymphadenopathy, and rarely, hepatosplenomegaly occurs. Diagnosis has been made by surgical biopsy & histological lymph node appearance.The patient was a 27-years-old woman that was admitted in infectious ward of Sina Hospital in 2/1/2001. The patient had fever since 10 days and about 40 days she had a mass in her left cervical that grew gradually. In physical examination of patient showed erythema of pharynx, no exuda and a mass in left cervical area that was, nontender, rubbery , discrete with size 5×5 cm . Her temperature was 39.6°c. Initial diagnosis were Typhoid fever or Infectious mononucleosis. Laboratory tests were relative leucopenia (4000/mm3) with 48% lymphocytosis & 35% Atypical lymphocyte. She was admitted in hospital in date of 1/2/2001 with complients of fever, headache and vomiting. For the patient was performed surgical biopsy with initial diagnosis of lymphoma by specialist surgen. Pathologist was reported kikuchi's disease (histiocytic necrotizing lymphadenitis).In the diagnositic approach to unilateral cervical lymphadenopathy and atypical lymphocytosis, kikuchi's disease despite of the other more common cause as lymphoma, infectous mononucleosis should be considered

A 68 years old woman refer to our clinical of educational hospital because of decrease ‎appetite from 4 months ago, with constipation, polyuria and polydypsia, also she had ‎‎10 gk weigh loss during this time. In examination: she had blood pressure of 180/110 ‎mmHg, 3 small lymph nodes in sub mental region (1x1 cm) also palpable spleen. ‎Other examinations were totally normal. Before admission she had evaluated for ‎probable malignany by the resean of her symptoms, the results y evaluation was: ‎upper Gi-series, upper Gi endo scopy were normal. Abdominal sonography and CT ‎scan with contrast agents show only mild splenomegaly. Create=2.9 mg/dl. BUN=40 ‎mg/dl ca=12.5 mg/dl p=3.06 mg/dl AIp=185(100-240) CFR≈35 cc/min. PTH was in ‎normal limit. We evaluated the patient for probable solid tumors of breast and ‎multiple myeloma. The results of evaluation were normal, thus we refer the patient for ‎lymph node biopsy (submental lymphadenopathy). The result was non-caseaing ‎granuloma consist of multinuclear Giant cells with asteroid body. Angiotension ‎converting enzym level was high, the patients treated by prednisolon, the symptoms ‎subsided and creatinin decrease to 1.5 mg/dl aft 4 months of treatment‏.‏