Journal of Kermanshah University of Medical Sciences
Year:2006 | Volume:10 | Issue:4 (31)|Papers Count:16

Introduction: Febrile convulsion is the most common seizure disorder during childhood. Some studies have determined a role for low serum level of sodium and calcium on recurrence of febrile convulsions. This study designed to compare serum sodium and calcium level between two groups of patients with simple febrile convulsions and patients with recurrence of febrile convulsion during 24 hours. Materials & Methods: In this descriptive – analytic study, medical records of 109 patients with simple febrile convulsion and 144 patients with recurrent febrile convulsion who had been admitted in Shahid Fahmideh Hospital of Kermanshah, were reviewed. Data were analyzed by T- test. Results: Mean sodium and calcium level were respectively 139.56 ±   2.86 meq/lit and 9.23 ± 0.76 mg/dl in first group and 139.32 ± 2.75 meq/lit and 9.18 ± 0.8 mg/dl in second group. There wasn’t any significant difference between sodium and calcium level in two groups (P= 0.40 and P=0.63). Conclusions: This study revealed that serum sodium and calcium level in patients with febrile convulsion isn’t a predictor factor for recurrence of seizure.

Introduction: Leukemia is a malignant disorder resulting from clonal proliferation of lymphoid or myeloid precursors with arrested maturation. It has been shown recently that telomers and telomerase activity are involved in the control of cell proliferation, regulation of cell senescence in the most somatic cells, and unlimited proliferation capacity of the malignant cells including leukemic cells. Previous studies determined the frequent expression of telomerase activity in most human solid tumors and hematological malignancies, however so far few studies have addressed telomerase activity in both PB and BM in adult acute and chronic leukemia patients at diagnosis and after chemotherapy.Materials & Methods: In this study telomerase activity in adult chronic leukemia patients at diagnosis and after chemotherapy using PCR-ELISA was determined. Bone marrow and peripheral blood samples were obtained from 25 patients without any previous therapy, containing 17 patients with acute- and 8 patients with chronic leukemia. BM control samples obtained from the ribs of patients with heart diseases during operation. After separation of MNCs from PB and BM, cell extraction was prepared. TRAP-PCR was carried out on all prepared cell lysates and the PCR products were subjected to native PAGE and visualized by silver nitrate staining.High telomerase activity was detected in MNC’S from all leukemia patients at diagnosis. This activity in PB and BM of patients was respectively 11.4 and 7 fold higher than those of control group (p=0.001). Telomerase activity in BM MNC’S from leukemic patients was 3 to 4-fold of the activity in their PB MNC’S and 35-fold higher than the activity in PB MIN’S from healthy donors. After chemotherapy and response to treatment, telomerase activity decreased 5 to 10 fold in most patients (p=0.001).Conclusion: Considering the convenience of PB sampling and several fold increase in telomerase activity of PB samples from leukemia patients compared to control donors, it can be suggested as a primitive diagnostic tumor marker.

Introduction: The purpose of this study is to determine the clinical, echocardiographical and homodynamic variables observationally and prospectively and to determine the reaction to the results of the therapy with BMV (Balloon Mitral Valvotomy) considering its side effects in patients with mitral stenosis and comparison of them in both sexes. Materials and Methods: This study was done in 4 years on 300 patients suffering from mitral stenosis (moderate or severe) who were admitted in Madani Heart Hospital for BMV. In all these patients Transthorasic and Transesophayeal echocardiography, cardiac catheterization befor and after BMV were performed. Selective or nonselective coronary angiography in most of the cases was performed. The differences of the variables in both sexes were compared.Results: 300 patients, 218 females (72.5%) and 82 males (27.5%) with the average age of (38.7±1.4) that is, 13-72 years old were studied. In males incidence rate of CAD was higher, (P: 0.002). Mitral Valve Surface Area (MVSA) was less (P=0.0025) and the morphology or the valve score was not suitable for BMV (P<0.0001). Females tend to present more symptoms of heart failure at FC III-IV Level and diuretic use in them is more than males (P=0.058 and P=0.053 respectively). From the point of view of hemodynamic variables and the results and side effects of BMV and other clinical and echocardiographic variables no significant differences between two sexes were observed.Conclusion: The incidence of mitral stenosis in females was higher than males. Males with less valve surface area and unsuitable morphology and more intcnsie valve involvement in comparison with females with more valve surface area (VSA) and better morphology for BMV tend to show less clinical heart failure symptoms. TR in females was more than males. These findings reveal the fact that pathophysiological stenosis of mitral valve and the changes between the two sexes were different and the sex variable in determining the treatment strategy of this problem should be considered.

Introduction: Mood disorders such as depression are the most common psychological disorders in postpartum period and stressful life events that occur during pregnancy or near to delivery increase probability of postpartum depression. These events have potentiality of changes of lifestyle and associated with physical and psychological diseases. Many studies such as those of Holmes and Rahe showed that there is a relationship between frequency and intensity of these events and the probability of occurring of disease. Therefore, this research aims to assess of the prevalence of postpartum depression and its relationship with stressful life events.Materials & Methods: This research was a Cross sectional study in which 975 of women who referred to Kermanshah Health Centers in 2006 were studied. The data were collected by Edinburgh Postnatal Depression Scale (EPDS) and Social Readjustment Rating Scale(SRRS). Descriptive statistics, x2, Fisher's Exact Tests and Logistic Regression Analysis, were used to analyze the data.Results: The findings showed that prevalence of postpartum depression was 17.5%. The results also showed that stressful life events like's change in number of arguments with spouse(p>0/001), trouble with in-laws(p=0/001), beginning or ending  of an educational period (p=0/015), changing in residency(p=0/017), marital separation(p=0/026), foreclosure of mortgage(p=0/037) and change in sleeping habits(p=0/049) had higher relationship with postpartum depression. A significant relationship between the intensity of events and postpartum depression was also found. (p<0/001)Conclusion: With regard to high prevalence of postpartum depression and its relationship with stressful life events, it is suggested that attention should be paid to mental health of women there fore educational and supporting programs should be considered ways against depression and stress are considered in pregnancy and postpartum periods.

Introduction: Nowadays the “addiction” is a great problem in the “mental”,”social”, and “health- care” fields. It results in lowering performance of occupational & educational functions in all social groups, and also leads to miscellaneous crimes. There are many different methods for Treatment of addiction, and the first step is detoxification, though it won’t be so successful without a vigorous maintenance therapy. Naltrexone is an opium antagonist which results in decreasing the craves for opiates and is used for maintenance therapy of addicts in Kermanshah Rehabilitating- Treating Center since 6 years ago. This study aims to determine the relapse rates of addiction in patients under maintenance therapy by naltrexone since March 2002 to September 2003.Materials & Methods: 150 opium addicts who were admitted in Kermanshah Rehabilitation Center for naltrexone maintenance therapy contributed in this 18 months period study. They received naltrexone for 6 months & followed thenafter for another 12 months in respect of their addiction relapse. In the first 6 months opium test (T.L.C) were done month by month & then in 3 months intervals for 12 subsequent months.Results: Relapse rate was 56.7% in the maintenance therapy phase, & 4.7% in the follow up period. The succession rate was 38.7%. In respect of educational & occupational status, the most succession rate was in high level situations & employees. The greatest relapse rate was in young adults (18-25 years old). In respect of the kind of the substance, the way & the occasions of consumption, the highest succession rates were seen in heroin, snuff way, & 2-3 times daily respectively.Discussion: In those addicts whose relapse is delayed till 9 months after detoxification, the chance of long term give up addiction is higher. The employees & those who have more social disciplines are more successful in ceasing opium abuse.

Introduction: Secondary intraocular lens implantation is one of aphakic vision rehabilitation in cases who are not satisfied with aphakic glasses and intolerant of or reluctant to use contact lenses.This study was done to evaluate and report results of surgical problems such as intraoperative and postoperative complications and visual acuity outcomes of secondary anterior and posterior chamber intraocular lens implantation in previously aphakic patients.Materials and Methods: Clinical Trial with (Before & After Treatment) design study was done on secondary lens implantation of 102patients, 42 females (41.18%) and 60 males (58.82%) from march 1994 to march 2003 (within 10 years), in Yazd hospitals affiliated to Yazd University of Medical Sciences, aged between 48 to 72 years (mean= 62.6 years), mean follow up time 20.2months, range from 6 to 72 months. A posterior chamber lens was used in 62 eyes (60.78%) and an anterior chamber lens in 40 eyes (39.21%). Demographic and clinical data were abstracted from patients' medical records.Results: Final visual acuity of 20/20 was achieved in 48 cases (47.05%), 51 patients (50%) was achieved V.A of 20/40 or better and 3 cases (2.95%) had decreased in V.A of 3 lines. Most common intraoperative complications were minor and postoporative complications mainly were not major and there was not main threatener complication and particular preventive factors intra and post operativelly.Conclusion: Optical rehabilitation with secondary intraocular lens implantation, as appears to be safe and effective alternative for correction of aphakia in the contact lens, or spectacles intolerant of or reluctant to use, can be performed successfully in carefully selected patients.

Introduction: Subarachnoid hemorrhage is one of the cerebral strokes which are differentiated from other types by risk factors, lower age occurrence & kind of treatment. Researches have shown differences in incidence, age & sex of patients & mortality rate in different parts of the world .This study was aimed to evaluate the sex, age, season of admission, risk factors, clinical presentations & the rate of Subarachnoid hemorrhage patients who admitted at Farabi Hospital during 1992-2002.Materials & Methods: This retrospective- descriptive study was based on the available records of subarachnoid hemorrhage patients admitted at Farabi hospital between 1992-2002.Variables including patients` age, sex, season of admission, clinical presentation, blood levels of sugar & cholesterol, history of hypertension, smoking, diabetes mellitus & alcohol consumption were closely measured & analyzed.Results: Among 240 subarachnoid hemorrhage patients 62.5% were female & 37.5% were male. The highest rate was in age group of 50-59 & the lowest rate was 80-89. 46.7% had hypertension & 5.5% were diabetic. History of smoking presented in 15.5% of patients. The most common clinical presentation was headache.Conclusion: The results revealed that females were more susceptible to subarachnoid hemorrhage & the age of these patients are lower than the other kinds of strokes.Subarachnoid hemorrhage was more frequent in spring & winter. The most common risk factor was hypertension.

Introduction: Papsmear had done by health services since 1991 in Iran ,unfortunately detection of abnormal smear is very low although this cancer is 9th cause of death in 4four county in 1999.The goal of this research is to determine the cause of low quality of Papsmear in Hamadan Province.Method: We choose 1224 smears from total smear that had been evaluated by cytologist in 2000. All of smears were reevaluated with pathologist to have a valid answer to these questions; were smears prepared correctly? Were smears evaluated carefully? Then descriptive statistics was used to analyze the data. Results: Problems classified in 3 groups. First group related to smear’s collector (11/7%) including 43/7% related to loss of endocervical cell- 34/7% related to low cellularity - 28/8% related to coverage with inflammatory cell &4/2% related to poor fixation.Second group related to preparing smear by cytologist (74/5%), including coloring, sticking lamella to lame. 47/5% smear prepared was so bad that they were not valuable, 30/1% related to unfavorable stick, 14/2% to wrong coloring, 2/7% related to putting the lamella over lame.Third group related to quality of evaluation. There was 96/6% agreement between cytologist and pathologist in this case.Conclusion: This research demonstrated that the most significant point in low quality of popsmear was related to evaluation and the sensitivity of papsmear in Iran is much lower than that of standard (11/7% versus 70 %(.

Introduction: Eye's vascular diseases often occur in elderly people but the main causes of these diseases in the youth are under discussion. This study investigates fundamental causes of central and branch retinal vein occlusion.Materials & Methods: This study was conducted as case series, in which 20 patients (under 50 years old) with BRVO and CRVO in Imam Khomeini Hospital of Kermanshah during 1999-2003. Were evaluated these patients diagnosed by ophthalmologist and evaluated for systemic diseases by internal specialist.Result: The most common associated diseases found in these patients are Hypertension, Hyperlipidemia and diabetes. There wasn't found any mentioned causes in one of these patients. In this study, 8 eyes (72.7%) with supratemporal involvement in BRVo patients, one eye (9.1%) with inferonasal involvement, and four eyes (36.4%) with inferotemporal involvement were found, but no eyes were found with superatemporal involvement.Conclusion: It was concluded from this study that Hypertension and Hyperlipidemia two most a common causes in BRVO and CRVO diseases among young population but Hyperlipidemia is less common among old population.

Introduction: Eye's vascular diseases often occur in elderly people but the main causes of these diseases in the youth are under discussion. This study investigates fundamental causes of central and branch retinal vein occlusion.Materials & Methods: This study was conducted as case series, in which 20 patients (under 50 years old) with BRVO and CRVO in Imam Khomeini Hospital of Kermanshah during 1999-2003. Were evaluated these patients diagnosed by ophthalmologist and evaluated for systemic diseases by internal specialist.Result: The most common associated diseases found in these patients are Hypertension, Hyperlipidemia and diabetes. There wasn't found any mentioned causes in one of these patients. In this study, 8 eyes (72.7%) with supratemporal involvement in BRVo patients, one eye (9.1%) with inferonasal involvement, and four eyes (36.4%) with inferotemporal involvement were found, but no eyes were found with superatemporal involvement.Conclusion: It was concluded from this study that Hypertension and Hyperlipidemia two most a common causes in BRVO and CRVO diseases among young population but Hyperlipidemia is less common among old population.

Introduction: There is a direct relationship between the prevalence of some parasitic diseases and the presence of those etiologic agents in water. There are possible contamination of water resources to parasites, due to increasing the groundwater level and environmental conditions. The purpose of this research was to determine the contamination rate of wells drinking water to parasites in Mazandaran Province north of Iran, during 2002-2003.Materials and Methods: In this cross-sectional study, 989 water samples which randomly taken based on the population of towns and number of health centers from 12 cities of Mazandaran province, and transferred to the laboratory in sterile containers were estimated. Water samples were then filtered and analyzed according to the WHO guidelines. Direct method and logol staining procedure were used to identify the parasites. If cryptosporidium was seen, floatation (sheather's sugar) and modified Ziehl-Neelsen staining method were performed. Parasites count was undertaken using McMaster counting slide (0.3 ml).Results: 197 out of 989 water samples were contaminated with different parasites. From 197 contaminated samples, 20 different types of parasites were separated of which 53 (26.9%) were pathogenic, 100 (50.8%) non pathogenic, and 44 non-infective stages of parasites.Conclusions: In most of Mazandaran areas, drinking water contamination to parasites is more than 15 percent. The results of other researchers in different populations, confirmed the prevalence increasing of intestinal parasites. According to the results and considering the direct correlation between safe water and human health, proper implementation of providing hygienic drinking water should be enforced.

Introduction: Kidney Transplanted Patients who treated with immunosuppressive drugs can develop Malignancues. Kaposi's sarcoma (KS) is one of the most common post transplant malignancies. A variety of factors appear to contribute to the development of KS including: genetic factors, sex hormones, immunosuppression and oncogenic viruses. These Study present three cases of kidney transplant recipients who had KS and cytomegalovirus (CMV) infection simultanously in the first year after transplantation.Cases: Three cases of kidney transplantation in ages (50, 53, 43) who had been treated with cyclosporin neural, steroids, mycophenolate mofetile presented with purple skin lesions and constitutional complaints in the first year of transplantation. Necessary workup was down, biopsy of the lesions confirmed KS and immunohistological assay for PP65 confirmed CMV infection.Conclusion: Although many factors involved in KS in these 3 patients occurrence of KS simultaneously or shortly after CMV infection suggest CMV is involved in inducing of KS .

Introduction: Anorexia nervosa is a disorder in which the person avoids keeping normal weight, afraid from weight gaining and misconcepts about her body and form's significantly. This disorder is recognized by distored body image and persistence on thinness until hungriness, it usually begins in adolecense and more prevalence in female than male.By considering its course and prognosis and lack of similar practice in this area, this paper addresses positive effects of long term hospitalization in anorexia nervosa.The Case: This is a case report of 20-year girl who was admitted to Women Psychiatric Ward of Farabi Hospital by persistence of her family (2005). chief symptoms are weight loss, avoiding eating, maintained believed to fatness, non medication therapies accompanied with drug therapy was considered for her in period or hospitalization period ( Six month ) and discharged with relative improvement.Conclusion: Although course and prognosis of anorexia is variable and prognosis is not good totally, therapeutic changes in this patient are good and long term treatments using different methods of therapy are required for these hinds of patients.