Researcher Bulletin of Medical Sciences
Year:2007 | Volume:11 | Issue:6 (54)|Papers Count:11

Background: Renal cells are not fully differentiated at birth. So we do not have enough information about renal electrolyte excretion to follow renal function in neonates. Renal insufficiency and renal immaturity could be evaluated using renal electrolyte excretion as a noninvasive method.Materials and Methods: This is a descriptive study conducted in 2004- 2006 on all healthy neonates attended in nursery of Mahdieh Hospital. The first fresh urine sample was collected and analyzed for Na, K, Ca, P, Creatinine and Uric acid. In our study Sampling was census and plan for data collection was observation and we used T-test, Chi-square and Regression analysis for statistic analysis.Results: We studied 210 neonates and found different levels of urinary electrolyte in comparing with reference ranges. There was a significant correlation between urine sodium and neonatal birth weight (R=0.183 and P<0.008) and a difference in urine K/Cr between two kinds of delivery (P<0.057).Conclusions: We conclude that urinary levels of electrolytes are different with reference range in our neonates and they may correlate with neonatal birth weight and kind of delivery.

Background: Skin problems are prevalent among students. Children of vulnerable age group are in close, continuous contact to each other in school environment. However, little information is available about the prevalence of eczema and infectious skin disorders among students. This study was aimed to investigate the prevalence of infectious skin disorders along with dermatitis and eczema in schools in Tehran.Materials and Methods: It was carried out on 1017 students in the selected primary and guidance schools affiliated to Shaheed Beheshti Medical University in Tehran.Results: Eczema and dermatitis were as follows: Dry skin 63 percent (most common), Keratosis pilaris 41 percent, Dennie Morgan fold 34 percent and eczema 7.2 Percent. Disorders of contaneous infectious: wart 1.4, labial herpes simplex 1.1 , paronychia 0.2 and impetigo 0.1 percents were seen.The mean age of the subjects examined was 10.7±2.4 years old (6-15). According to this study, there was a meaningful relationship between the family history of eczema and its prevalence among the students. The relationship between dry skin and Dennie Morgan fold and clinical eczema also proved to be significant.Conclusions: Eczema and dry skin disorders were more common than infectious disorders in our survey. In this regard, it is suggested to give instructions on the basic principles of preventing such disorders and manage through emollient and the proper bathing process.

Background: Chronic pain is one of the most frequent reasons for patients to seek medical care. Since the involvement of imidazoline binding site in the modulation of pain is still in debate, therefore, in our research, we investigated the antinociceptive effects of imidazoline compounds such as ketoconazole.This is an antifungal agent with imidazoline structure.Materials and Methods: Albino Sperague dawley rat (N=6 200-250gr) were used throughout the study. We used formalin test in this research as an animal model of chronic pain.Results: Our results showed that ketoconazole (5,10,20 mg/kg i.p) producet a dose-dependent antinociception in rats (p<0.01). on the other hand, Yohimbin could not inhibit the analgesic effect of ketokonazol and Benazolin a ligand of I2 reseptors (2.5, 5, 10 mg/kg) inhibited the analgesic effect of ketoconazole but Efaroxan , an antagonist of I2 recoptors, coud not block the ketoconazole effect.Conclusions: We suggested that ketoconazole produces its antinociceptive activity via I2 receptors.

Background: Considering the prevalence of peptic ulcers and their complications and also existence of discrepancies about the effect of epinephrine injection with and without Argon Plasma Coagulation (APC) and lack of any report in our country, this investigation was carried out in Taleghani hospital in 2004.Materials and Methods: In this clinical trial, 60 consecutive patients with bleeding peptic ulcers were treated by combination of APC plus epinephrine injection (26 Cases) or epinephrine injection alone (34 Controls). Patients with malignant ulcer, contact bleeding and adhesive clot, renal insufficiency and coagulopathy, recent consumption of NSAIDs, hemodynamic instability and history of upper gastrointestinal surgery were excluded. Rebleeding rate (fresh blood or coffee ground materials in emesis or nasogastric tube or melena or both) and decreasing hemoglobin at least 2 gr/dl in 24 hour were analyzed using Fisher's exact test, Chi square test, independent sample T-Test and Mann-Witney test. P<0.05 was considered significant.Results: The two groups were similar in age, sex, hemodynamic state, location, type and greater dimension of ulcer. Rebleeding rates in cases and controls were 7.7% and 20.6% , respectively (P<0.3). Of course, the relative risk of rebleeding among controls was 2.68 times greater than cases. The cases and controlshad no statistically differences in need for surgery (3.8%vs. 11.8%), units of transfused packed cell (4±2.6vs. 3±2.9), days of hospitalization (7.9±7.4vs. 5.7±3) and mortality rate (3.8%vs. 5.9%).Conclusions: Injection of epinephrine plus APC has no effect on bleeding peptic ulcer. It seems that repeating the study with proper sample size will clarify the level of differences correctly.

Background: Smoking is considered as the first preventable cause o mortality worldwide. There are many predictive factors on cessation including social, family and individual issues. High nicotin depeudency is one of the effective causes that makes the cessation harder for the smoker. There are quite a few ways to estimate the rate of nicotin dependency in practice and one of the most sutable and noninvasive ways is fagerstrom test. Materials and Methods: This is a study. Data obtained frome all smokers who had participated in the group therapy smoking cessation courses of Tehran smoking cessation clinic. The questionnaires were designed based on these data and Nicotine dependency rate was evaluated via Fagerstrom test (FT).The smokers declared that they were not smoking since the third session of the cessation course, then this claim confirmed by testing the expiratory carbonmonoxide rate. Finally the obtained data were analyzed by T-test and chi-squre test via spss version 12.Results: There were 987 samples in the study in which 786 persons (79.6%) were males. Evaluation of the nicotine dependency rate showed that more than half of the smokers (544 persons, 52%) had high dependency, 330 smokers (33.8%) had the average dependency and 112 smokers (11.4%)had the low dependency. At the end of the course, 642 person were successful and rate of cessation was 65% (nonsmoking even one puff after third session)and 73 persons were missed (27.6%). After diminishing the missing group, the rate success in cessation was 89.6%. The maximum rate of success in cessation was among the smokers with low Nicotine dependency (79 persons, 70.5%) and the minimum rate of success was among the smokers with high nicotine dependency (323 persons, 59.4%) (P=0.00) Conclusion: According to this study the smokers with high nicotine dependency had a poor opportunity to become successful, so its recommended to design special classes to follow them up in a longer period of time and use combination therapy for them.

Background: Prevalence rate of coronary artery disease (CAD) is high and the trend is increasing. Diagonal ear lobe crease (ELC) has been introduced as a diagnostic physical sign for CAD and the aim of this study was to evaluate the association between ELC and CAD in whom were candidates for angiography. Materials and Methods: In this descriptive study, 106 consecutive patients were studied in three hospitals in Tehran for presence of ELC and CAD. ELC was categorized based on Ishii classification and CAD was defined based on angiography. The colleagues who visited candidates did not know patients' final diagnoses. The presence of ELC in both patients and control groups was analyzed with chi square test and odds ratio in sample was calculated and confidence interval was estimated in population with probability of 95%. Results: The study was conducted on 106 consecutive persons. The average age was 50.1±14.1 years. Sixty six percent were men and 34 percent women. Fifty seven individuals (53.8%) had CAD. In persons without CAD, 13 (26.5%) had ELC and in CAD patients, 34 persons (59.7%) had ELC (P<0.0001). CAD patients had 4.1 times exposure with ELC in comparison of controls and confidence interval was estimated 1.8-9.2.Conclusions: The presence of ELC is associated with CAD. Future diagnostic researches are suggested to determine the strength of this marker.

Background: The development of extensive erythropoiesis has been recognized as the feature of major B thalassamia and to some extent minor thalassaemia. The aim of study was to investigate whether the patients with thalassemias need to receive folate supplements.Materials and Methods: This was a historical cohort study. Folatelevel in the serum and red blood cell samples measured using RIA method with Delshid Gamma counter. The normal level of the kit for folate was 3-16 ng/dl and 150-450 ng/dl in the serum and red blood cells respectively.Results: 18 families enrolled in this study. From each family three have been selected, two were thalassemics major and minor matched by age and another was a normal subject. The folate level in the serum was 0.98±1.15 and 7.1±3ng/dl in the B thalassemias major and minor groups respectively. IT was 6/5 1/4 in the normal subjects (p<0/0001). The level of folic acid in the red blood cells in the heterozygote thalassaemias and the normal group was 316±117and 227±120ng/dl, respectively (p<0/06).Conclusions: The study showed that folate supplementation is necessary in the Thalassaemia major cases to prevent the folated deficiency but it is not necessary for B heterozygote thalassaemias.

Introduction: Differences in airway anatomy make the potential for technical airway difficulties greater in infants than in teenagers or adults. Endotracheal intubation by direct vision using a laryngoscope is frequently associated with an increase in arterial blood pressure and heart rate. In different studies, time to intubate with Glide ScopeÒ was longer than with Macintosh in which might be accompanied by more hemodynamic responses.Materials and Methods: Sixty four infants who were scheduled for elective surgery requiring general anesthesia with orotracheal intubation were randomly assigned to intubation by direct laryngoscopy using a Macintoshsize 1 blade or intubation using the GlideScope Ò. Systolic and diastolicblood pressures, heart rate and oxygen saturation were recorded at the following time points: 1. Before induction 2. After induction and before intubation 3,4. One and five minutes after intubation.Results: No significant differences were found either between two groups or among the different study periods. Duration for laryngoscope and intubation with Glide ScopeÒ was 20.87±7.95 (mean±standard deviation) and with Macintosh was 15.4±4.1 (P value < 0.01).Conclusions: Regarding to similar hemodynamic responses in both groups of this study and also longer duration for laryngoscopy and intubation in GlideScopeÒgroup, it seems that this longer duration that resulted in more stimulation has no significant effect on hemodynamic status and oxygen saturation in infants.

Background: Acute coronary syndrome (ACS), which ranges from ST- segment elevation myocardial infarction (STEMI) and non- ST-segment elevation MI (NSTEMI) to unstable angina (UA) is a major reason for hospitalization in the United States. Cardiovascular diseases are the leading causes of mortality in Iran (46% of all deaths). The great majority of coronary heart disease (CHD) patients have at least one major risk factor. Dyslipidemia has been identified as one of the most important modifiable risk factors for coronary heart disease.The aim of stady was to evaluate the frequency of dyslipidemia in ACS patients according to National Cholesterol Education Program Adult Treatment Panel III guidelines (NCEP-ATP III). Material and Methods: We performed a descriptive survey of patients admitted in cardiac ward of Loghman hospital from November 2003 to March 2004. In this period of time 611 patients admitted with the primary diagnosis of acute coronary syndrome. Their lipid profile measured at the first 24 hours of their admission.Results: Their final diagnoses were acute myocardial infarction in 32%, Possible unstable angina in 26%, definite/probable unstable angina in 22% and non cardiac chest pain in 20%. Patients with the final diagnosis of acute coronary syndrome were 490 persons with the mean age of 61±2.2 year and 50.6 precent of them were female. Their mean total cholesterol was 214.4±53.8 mg/dl, mean triglyceride was 181.8±122.2 mg/dl, mean HDL-C was 47.1±14.3 mg/dl and mean LDL-C was 132.8±43.8 mg/dl. ACS patients had dyslipidemia in 61.8% and only 18.2% had normal serum lipids. Mean total cholesterol, mean triglyceride and mean LDL-C were significantly higher in women than men (p<0.001, p=0.037, p<0.001 respectively).Great majority (90.5%) of ACS patients had at least one of the major CHD risk factors and only 6.3 precent had LDL-C<70 mg/dl.Conclusion: Dyslipidemia is prevalent in ACS patients and ought to be diagnosed and treated immediately.

Background: On the basis of cervical cancer incidence and the value of papsmear and its efficiency, there are controversies about the efficiency of Cervex-brush. So this research was done on postmenopausal women referred to gynecology clinic of Imam Hossein hospital. The aim was to evaluate the efficiency of pap smear test for cervical cytology sampling with two instruments of Ayre-spatula and Cervex brush. Materials and Methods: In this research pap smear test has been taken from menopausal women attending Imam Hossein and Taleghani Hospital during 2003-2005.Two handred menopausal women participated in this study. The patients divided in to two groups. In one group pap smear were done with Ayre-spatula and samples were taken by Cervex-brush in the other group. Slides samples were fixed by cytofix and reviewed and reported by a pathologist based on the Bethesda category.Results: The mean age for patients in spatuala group was 59±3.8 year for Cervex-brush and there were no significant differences. Pap smear efficiency was 57% with spaula and 71%in Cervex-brush (P<0.04). Relative risk and attribute risk of unsatisfactory pap smear with spatula was 1.5 and 14 percents, respectively. The unsatisfactory samples were more in spatula groups than Cervex-brush.Conclusions: It seems that Cervex-brush is better than spatula due to more pap smear efficiency and satisfactory samples that need for pathologic evaluation. Our results support the routine use of Cervexbrush to reduce unsatisfactory smear rates in the cervical cytology screening programs in postmenopausal women and prevention of side effects and complications.