Hakim Journal
Year:2002 | Volume:4 | Issue:4|Papers Count:16

During the last two decades, the incidence of fungal infections has increased dramatically. Deep seated mycoses create serious problems for clinicians involving with certain patients, such as those with cancer, immunocompromised, and physiologically comproil1ised. A retrospective study of deep fungal infections was cal1ied out in the section of Medical Mycology, Pasteur Institute of IRAN from April 1994 to March 1998. Five hundreds and eighty one samples examined for deep fungal infections. Diagnosis was established by demonstration of fungus in direct and cultural examinations. In this study fungal infections proved in 151 patients including 77 men and 74 women. Sixty four fungal infections (42.4±8%) occurred in patients that had one or more predisposing factors for disseminated fungal infections. Eighty seven fungal infections (57.6±8%) occurred in normal patients. The most frequent mycotic infections are caused by candidiasis (76.8±6%). In this study more frequent predisposing factors in immunocompromised hosts were hematological malignancies, metabolic acidosis, hyperglycemia and organ transplant recipients. The incidence of infections in immunocompromised patients is extremely high, it is still possible that prophylaxis in early therapeutic intervention at a stage in which clinical sign of infections are still absent, also immunocompromised patients with problem helps to treatment, as a matter of fact. Therefore fungal infections should be treated aggressively and antifungal treatment started as soon as possible.        

This descriptive study was conducted to evaluate the function of referral, system in Kashan Health care delivery network in 1997. 1783 subjects were questioned at 23 health care centers including, health houses, rural and urban health centers in order to determine the referral rates to hospitals. Also measurement of feedback and follow up rates was done at those centers. The referral rates to second level were 21 %, in health houses, 11.9% in rural health center and 9.1% in urban health centers. The 95% confidence interval for the above rates was found to be 15.8 -26.2%, 8 -15.8% and 6.7 -11.5%, respectively. The indings indicated that 38.4% of the clients were referred to the paraclinical laboratories. In general, with a 95% confidence interval, patients referral to paraclinics was between 36.1% and 40.7%. In hospital centers 46.3% of clients were direct self-referral, 34.8% from specialists, 7% from emergency room, 4.1% from primary health centers, 2.4% from general practitioner, and 5.4% from other sources. The feedback rate was 71.4% for the patients referred from health houses, 50% from rural health centers and 49% from urban health centers. Overall the feedback and follow up rates were 66%, 73.3%, respectively. According to the findings and in the regard to lack of referral from general practitioner, it is necessary to reform construction of the health care delivery system. We recommend that detailed clinical Criteria of referrals be made for objective justification of referrals.  

CMV belongs to Herpes viridae family and it is the largest human virus. Prevalence of CMV depends on age, geographic and socioeconomic factors. For about three decades, CMV infection has been recognized to be a complication of transfusion in an immature or compromised immune system. If a transplant candidate has not been infected with CMV and no CMV specific antibodies can be detected by serology. Primary infection could be transmitted via transfusion or transplantation. In this study using serologic tests, we detected anti-CMV (IgM, IgG) antibodies (with ELISA) in 128 renal transplant candidates who were under intermittent hemodialysis and 500 blood donors, as controls. About 89.8% of transplant candidates and 86% of normal individuals were IgG positive. Statistical analysis showed no significant difference between these two groups. 2.3% of transplant candidates and 0.4% of normal individuals were positive for IgM There was significant difference in IgM between these two groups (P<0.01). This difference is due to transmission of CMV by transfusion as a primary infection or reactivating of latent virus because of immunosuppressed state in these patients. Policies and procedures to control transmission of this virus, follow up of high risk patients and appropriate therapy are critical for CMV syndrome prevention.      

Increased endometrial vascular density in Norplant users was shown and suggested to be due to either an increase in angiogenesis or excessive endometrial regression compared with the regression of individual blood vessels. A major feature of angiogenesis is endothelial cells' proliferation (ECP). This study was aimed to measure and compare the ECP activity before and after Norplant use. In a clinical trial study, 34 healthy fertile volunteers were studied before and after using Norplant. Three endometrial biopsies were taken from each volunteer, one before and two at different times after insertion. ECP were assessed by double immunostaining methods using anti-Ki67 and also anti-PCNA with anti-CD34. The ECP of pre- and post-insertion were compared using paired t test in each subject. Vascular and endothelial cells (EC) density were also measured. Correlation between the ECP and vascular density was also studied. Using anti-Ki67, a decrease of ECP was demonstrated from beginning first few weeks of Norplant use (0.7±0.031 % after 2 to 13 weeks of Norplant use, versus 12±2.8±before use, P< 0.05). During the next 13 to 42 weeks after using Norplant, a significant decrease of ECP was also observed using both markers. EC and microvascular density were significantly increased. Therefore, increased endometrial vascular density in Norplant users may be due to excessive Endometrial regression compared with the regression of individual blood vessels. However, it may partly be due to neovasculmization activity associated with the action of migratory angiogenic factors rather than mitogenic/proliferating factors.      

Silybum marianum has clinical applications in the prevention and treatment of liver diseases. It has been used in the treatment of toxic hepatitis, fatty liver, cirrhosis, ischemic injury, radiation and viral hepatitis. Several studies have reported that silymarin (the active constituent of Silybum marianum) protects liver cells from a wide variety of toxins and drugs including acetaminophen, ethanol, carbon tetrachloride, and D-galactosamine. Silymarin is also proven to be effective in inhibiting the promotion and growth of certain cancerous cells in vitro and in rats.      

Nowadays, the application of FHR monitoring system is increased in obstetric departments. Using this system the fetal heart rate and uterine contraction can be determined. The most important applications are calculation of the fetal heart rate short term variation (STV) and uterine contraction during delivery. The designed system has two main sections; analog and digital. In the analog section using a continuous wave Doppler ultrasound, the Doppler shift frequency from the blood flow in the heart is detected. Also, a pressure gage circuit measures the degree of the uterine contraction. In the digital section, having digitized the analog Doppler shift signal, using a fast fetal heart rate algorithm, the fetal heart rate is estimated. In this algorithm the signal is processed faster and more precise than other proposed algorithms. After FHR estimation and contraction percentage measurement, these data are displayed on an LCD and their variations are plotted using an external printer. Data processing is performed using a high technology digital signal processing chip. Both the analog and the digital sections were constructed and tested separately. An assembly language programming was written to control different parts of the system; the data processing, user interface, display and printer. Technical data that achieved in this project can be implemented for the commercial manufacturing of the device in Iran.      

This study has been conducted to determine risk factors of still birth and neonatal death in Kurdistan province. In a population based case control study 133 case, including 40 still births and 93 neonatal deaths, were compared with 266 controls. Cases and controls were frequently matched based on place of residence in their rural or urban areas. The odds ratio of variables for developing still birth and neonatal death were estimated. Data analysed by Chi square, Mantel Haenzel and Woolf tests. The results showed that the sum of still birth and neonatal mortality rate are 17. 7 per thousand birth in province. It was respectively 19.1 and 16.1 in boys and girls, 22.2 and 13.8 in urban and rural areas. Proportion of neonatal mortality during first 24 hour after delivery, 2 days to one week and remaining interval until twenty-eight days after birth was 54, 21 and 25 percent, respectively. Significant determinants of still birth and neonatal mortality in this study were high risk pregnancy" and "illiteracy". Estimated odds ratio for "high-risk pregnancy" and "illiteracy" were 2.3 (95% confidence interval= 1.4-4.7) and 3.1 (95% confidence interval= 1.4-6.5), respectively. In conclusion, improving coverage and quality of family planning services, special attention to high-risk pregnant women during perinatal care and strengthening of programs against illiteracy can reduce perinatal mortalities in this region.      

This study was designed: First to determine whether or not motor skills difficulties and neuro - muscular dysfunctions occurred significantly in ADHD pupils aged 7-10 years; second, to explore the pattern and nature of difficulties found in such a group. The subjects were two groups of children: the ADHD group consisted of 22 students referred to Tohid pupils Psychologic service, and normal group consisted of 22 students with no known dysfunction, in the 4th zone of Tehran. The results indicated that ADHD group had significantly lower scores (P<.05) in the Lincoln Oseretsky Motor Development Scales (LOMDS) and Clinical observation (CO) than a normal group of pupils. Subjects with ADHD demonstrated relative strengths in the areas of visual motor integration and balance opened eyes. The results suggest that it may be helpful for occupational therapists to consider the areas of praxis and vestibular processing in the evaluation and treatment of children with ADHD and that in clinical practice.      

Cigarette smoking has been implicated as a major risk factor in chronic obstructive pulmonary disease, chronic hypoxic cor pulmonale, atherosclerosis, and related cardiovascular dysfunction. The mechanism for increased risk of vascular dysfunction due to smoking is not well understood, but it is presumed to be due to the absorption of tobacco smoke constituents that effect endothelial cell function. The purpose of this study was to investigate the effects of cigarette smoke extract on the rat pulmonary artery rings responses to endothelium-dependent relaxant (acetylcholine), endothelium-independent relaxant (nitroprusside sodium) and also to vasoconstrictor agent (phenylephrine). In this study, concentration-dependent responses of rat's pulmonary artery rings precontracted with 100 nanomol phenylephrine were tested to acetylcholine and nitroprusside sodium in the absence and presence of 0.1 ml of cigarette smoke extract. The responses were recorded isometrically with Grass FTO3 transducers and were displayed on a Grass model 7 polygraph. The findings of this study demonstrated that 0.1 milliliter of cigarette smoke depresed-endothium-dependent relaxant acetylcholine responses but did not effect on endothelium-independent relaxant responses. Also contractile responses to phenylephl1ne depressed by 2 ml of cigarette smoke extract; while they did not affect by 0.1 and 1 ml of cigarette smoke extract. In conclusion the results obtained in this study indicated that cigarette smoke extract impairs Endothelium-dependent relaxant responses of the rat pulmonary artery lings; but did not mpair endothelium-independent relaxant responses.      

This is a retrospective study on 100 self-introduced addicts referring to the shahid Khoeiniha center in south of Tehran in 1999. The data was gathered using a questionnaire including more than 30 variables and analysed. We used a stepwise discriminate analysis to find discriminating function. The variables "number of group therapy session" "non-pharmacological therapy" and "the cigarette smoking" showed significant effect on the success of quit addiction (P<0.0001 ).        

Crimean -Congo hemorrhagic fever is a zoonotic arboviral disease that is caused due to a virus of Nairovirus genus from Bunyaviridae family and transmitted from infected domestic animals to human through tick bite and from human to human nosocomially. Mortality rate of this disease could be as much as 30% of infected people. In a wide-spectrum survey that was carried out in the laboratory of arboviruses and viral hemorrhagic fever of Pasteur Institute of Iran, collaborated by WHO reference center for Arboviruses and viral hemorrhagic fever, Pasteur Institute of Senegal, using, specific serologic ELISA technique for screening the IgM, from 7 Jun 2000 to 5 Jan 2002 it has been shown that 81 patients out of 222 suspected patients from various Iranian provinces to be positive. The presence of specific IgG, assayed in 358 domestic animals out of 1205 tested suspeciouses has also approved.