DANESHVAR MEDICINE
Year:2005 | Volume:12 | Issue:58|Papers Count:14

Neonatal head size at birth is one of the indexes of newborn well-being and with other measures like his weight and length, it could give us useful information about the quality of intrauterine growth of fetus or prenatal care of the mothers.Objectives: The study was performed to determine the neonatal head circumference and other related factors.Material & Methods: The type of study was cross-sectional and the sampling method was simple random. The study was performed from March 2001 until March 2002 at 4 hospitals under supervision of Tehran University of Medical Sciences. Head circumference, weight and length were measured for each newborn. Data related to maternal or neonatal characters were collected by interviewing with the mothers and examination of the newborns.Results: There were 562 males (52.67%) and 505 females (47.33%) in the study. The mean of newborns' head circumference was 34.3cm with SD=1.84cm. The mean of males' head circumference (34.55) was more than the females' (34.12). Pre-term or low birth weight newborns had smaller head circumference than the other newborns (32.41 and 31.63 respectively). The mean head circumference of twins (32.22) was less than singletons (34.42). Moreover, the mothers who had vaginal delivery (34.22), and were 20 years old or less (33.96), for the first gravidity (34.13) or first parity (34.07) had newborns with lower head circumference in comparison with other mothers. There were statistical significant relations between the mean head circumference of newborn and sex (p<0.001), gestational age (p<0.0001), maternal age (p<0.03), birth weight (p<0.0001), multiple gestation (p<0.0001), type of delivery (p<0.05), Maternal gravidity (p<0.0001) and parity (p<0.0001). Furthermore, positive correlations between the newborns head circumference and gestational age (r=0.51, p<0.001), birth weight (r=0.62, p<0.001) and birth length(r-0.58, p<0.001) were found.Conclusion: The head circumference of 3.5% of our newborns was not in the range of  ±2SD, which means that these newborns must be examined more carefully to determine microcephaly or macrocephaly. Maternal gravidity or parity> 1, male sex, singleton pregnancy, birth weight>2.5 kg, maternal age more than 35 years, gestational age>37 weeks and cesarian section were significantly associated with larger head circumference. Moreover, the better the intrauterine growth of the fetus the more the newborn head circumference would be. Therefore, offering ideal situations for fetal intrauterine growth and preventing premature labor might increase the fetal head size at birth.

Introduction: The purpose of this study was to evaluate the relationship between the beta-hCG cervicovaginal secretion and preterm delivery.Material & Methods: In this study a cross-sectional analysis was used and cervicovaginal secretion specimens were obtained from women in their 24th- 36thweeks (each 6 days) of pregnancy who visited the emergency clinic with preterm labor symptoms. Exclusion factors include: ruptured preterm (PROM), poly hydroamnios, multiple gestation, abruptio placental, placenta previa, cervical cerglege, amniocentesis, bleeding, coitus during the past 24 hours, smoking, systemic diseases, gestational hypertension or pre eclampsia, history of ovarian cyst, chorioamnionitis, use of corticosteroid before sampling, fetal abnormalities, intra uterine growth restriction, use of lubricant or vaginal cream during past 24 hours and dilatation more than 3 cm. Samples were frozen at -200 centigrade and transferred to laboratory immediately and examined with Radio immunoassay method in 72 hours. Then, the patients were explored for the occurrence of preterm or term delivery. Results: The results showed that mean of Beta hCG level in cervicovaginal secretion was higher in group 1 (preterm labor and delivery) than group 2 (preterm labor and term delivery) and group 3 (control). The mean± standard error for human chorionic gonadotropin level in 24th- 26th weeks in groups 1, 2, 3 were (33.5 ±10.16), (7.12±6.46) and (0), in 27th - 29th weeks in groups 1,2,3 was (30.28±8.23) (23±13.44) and (7.80±4.74), 30th - 32nd weeks in group 1, 2, 3 was (30.20±2.23), (18.85±5.65) and (16.25±8.57), 33th - 35th weeks in group 1, 2, 3 was (36.90±5.98), (22.32±6.35) and (10.70±4.67), 36th weeks in group 1,2,3 was (38.76±10.99), (20.05±19.73) and (8.42±5.89), respectively. According to the results obtained in weeks gestation, the range of values for human chorionic gonadotropin in three pregnant. groups was extensive and Beta hCG Level mean became more extensive in 24th -26th weeks. ROC curve showed that Beta hCG cervicovaginal level, equal to or more than 22.5milli unit per milliliter, is associated with preterm delivery (97% sensitivity, 76% specifity, 81% positive predictive value, 96% negative predictive value). However the cut off for groups 2 and 3 was 18 mlu/ml (100% sensitivity, 93% specifity, 94% positive and 100% negative predictive value, respectively). However, the cut off for the second and third groups was 18 mlu/ml (48% sensitivity, 93% sepcifity, 87% positive and 62% negative, respectively). Conclusion: Measuring the b-hCGlevel in cervicovaginalsecretionsof the patientscan predictpreterm delivery.

Introduction: Nowadays, Hemi-Sync is a sound therapy method which is used in treatment of individuals with sensory and motor disorders. This method is based on sensory integration (SI) rule, and applies a binaural beat technology. Studies have shown that listening to these signals along with back ground sound (noise or music) provides a specific sensory integration and increases attention and learning.The aim of this study is to determine the effect of Hemi-Sync sound therapy on improvement of some of the adaptive behavior indicators and audio logic criteria in 16-21 year - old mental retards.Material & Methods: 6 mental retards aged 16 - 21 years old in Nemooneh Educational and Rehabilitation Center took part in this study. Data obtained were processed through single subject analysis procedure. To determine the effect of this therapeutic method, a questionnaire was used to evaluate some of the adaptive behavior indicators, also, trainers were interviewed (these made behavioral or non audiologic criteria), and hearing thresholds changes were evaluated (audiologic criteria).Results: Remarkable improvements were observed in some adaptive behaviors such as memory function, eye contact, following the orders, anger and aggressiveness, adaptation to changes, and also in interviews with trainers and audiologic criteria. Conclusion: This study revealed the significant effect of Hemi-Sync sound therapy on decreasing some of the adaptive behavior criteria accompanying the mental retardation. It is expected that these effects would be studied further in future.

Purpose: The research presents an overview of a two – compartmental model describing the decay of an injected glucose tracer in the blood plasma of some female subjects. The research was performed in 1996 at St. Thomas' Hospital, London.Material & Methods: The subjects were in their post-partum period and some were suffering from gestational diabetes during pregnancy. The subjects, intravenously, received an injected glucose and glucose tracer and the blood samples were taken at various times between 2 to 180 minutes after injection. Thus, the research aims at building a stochastic model for the concentration of glucose tracer in plasma and intravascular tissues to substitute the current deterministic model that does not account for the random effects. In this new method, we assume the concentration of glucose tracer in blood plasma in different times and subjects are different (with fixed variance) and the concentration of glucose tracer in each fixed time has a random process with truncated normal distribution. Therefore, uncertainty incorporates with the whole system, specially the two fluxes between compartments, loss of the second compartment and the initial concentration of glucose tracer in blood plasma. The parameters vary with time and samples thus, using the deterministic model for the concentration of glucose tracer is not appropriate.Results: To build a stochastic model, differential equations were used and the final model for the concentration of glucose tracer in both compartments was built in combination of bi-compartmental matrix and the moments of the random process. Conclusion: The comparison of the stochastic and deterministic model for the concentration of glucose tracer has shown a little difference between two models and they are almost the same. This similarity can be due to the small sample size or the similarity of the random process.

Introduction: Considering the anti diabetic effect of fenugreek seed and leaf has become clear, this study was conducted to evaluate the effect of aqueous leaf extract of fenugreek on the basal and active tone of thoracic aorta in an experimental model of diabetes mellitus. Material & Methods: For the purpose of investigation, male Wistar rats were divided into control, extract-treated control, diabetic, and extract-treated diabetic groups. Fenugreek extract was administered at doses of 100 and/or 200 mg/Kg (i.p.) every other day three days after the induction of diabetes for a period of 2 months. Body weight and serum glucose level were determined one week before the study and at 4th and 8th weeks after the experiment. In addition, after two months, thoracic aorta responsiveness under basal and active conditions was measured using isolated tissue setup.Results: The results showed that although there is no significant change in the basal tone in the extract-treated diabetic group in comparison with untreated diabetic one, but there was a significant reduction in the active tone following noradrenalin application in extract-treated diabetic group (at a dose of 200 mg/Kg) (p<0.01).Conclusion: It can be concluded that chronic treatment of diabetic rats with aqueous leaf extract of fenugreek in a dose-dependent manner could attenuate the noradrenalin-induced contractile response of aortic rings, while, the basal tone is not affected by such treatment.

Introduction: This study aimed at comparing the effect of anodal and cathodal electric stimulation (I. D. C.) on wound healing.Material & Methods: 42 male guinea pigs, weighting 300-500gr, were used in this study. The full thickness (epidermis and dermis) incision (3 cm in length) was made on the right side of the Para vertebral region. Then, animals were assigned to one of the following groups: control (n=10) and electric stimulation (n=32). Experimental animals were later subdivided into four groups. In two experimental groups, positive polarity was applied to the wound in the first 3 days and negative polarity was applied next. One of these groups was studied for 2 weeks and the other on for 3 weeks. Two other groups received negative polarity in the first 3 days, then received positive polarity. The treatment was administered daily (for 1 hour) with I. D. C. (80 pps, 300-600 mA and 3 ms pulse duration).Results: To evaluate the efficiency of the treatment protocols, stress, F max and area under Load Deformation curve were measured. After 14 days, the wound area decreased significantly in animals treated with cathodal or anodal electric stimulation. The wound area decreased significantly in animals treated with negative polarity in the first 3 days compared to those treated with positive polarity.After 14 days, in the animals that were treated with positive polarity in the first 3 days, stress was significantly higher than the control group (p<0.05).After 21 days, animals treated with positive polarity in the first 3 days, had greater tensile strength. Conclusion: The study indicates that both cathodal and anodal electric stimulations (I. D. C.) increase the rate of wound healing. But it seems that the use of positive polarity in the first 3 days is more effective on increasing the tensile strength of wound.

Introduction: Hearing loss is one of the most prevalent birth - defects. If remained unchecked it will probably cause delay in speech, language, and cognitive development. The screening Neonatal hearing as the most effective way of early detection of hearing loss is performed in most countries around the world.The main aim of this program was to screen neonatal hearing in 2 Tehran hospitals - namely, Milad and Hedayat hospitals.Material & Methods: During 12 months (from Oct 2002 till Oct 2003) 7718 neonates (3911 males and 3807 females) were screened. There were three stages in this project initial screening, prescreening and diagnostic tests.The first and second stages were performed by OAE screener and the last stage, ABR evaluation, done only for the neonates who were referred from initial and secondary screening. For statistical Analysis, SPSS Software was used and graphs were drawn by the Excel software.Results: 9 neonates out of 7718 (one per thousand) had hearing loss and were referred to related services. Prevalence of impaired hearing impair among neonates was similar to previous researches on this subject around the world.Conclusion: It seems that we must raise the level of public awareness about the importance of early detection and intervention for hearing loss. In general, we must establish appropriate infrastructures and background knowledge among those involved in this field, and in particular, we must gain the support of authorities.

Introduction: Today, the numerous uses of insulation, such as rockwool, glass wool, slog wool and so on, have increased to control and save energy in industries. Due to numerous applications, exposure level is increased in production, handling, installation and removal. Occupational exposure to fibers has been associated with irritation of skin and respiratory tract. The objective of this study was to determine occupational exposure to rock wool fibers.Material & Methods: The standard method for the determination of airborne fibrous particles in the workplace is NIOSH Method 7400 by Phase Contrast Microscopy. In NIOSH Method 7400, samples are collected on 25-mm cellulose ester filters. The filter is treated to make it transparent and then is analyzed by microscopy at 400-450x magnification, with phase-contrast illumination, using a Walton-Beckett graticule. Using counting rules B, only fibers <3 mm in diameter and >5 mm in length with aspect ratios of 5:1 are counted. Pulmonary function test is carried out by P.F.T spirometer to obtain VC and FVC test. Respiratory questionnaire is completed for case – control groups. Results: The result of counting fiber showed different levels in worker's breathing zone. The greatest and lowest measurement was found in saw unit and automatic package, respectively. Mean of exposure TWA 8 hours and actual exposure is 0.51 and 0.7 fiber/cc, respectively. Discussion and Conclusion: Occupational exposure does not exceed TLVTWA (ACGIH) and T-test has not been significantly different from occupational exposure level (p<0.001). Due to overtime work, occupational exposure was high and Hest was significantly different from OEL (p=0.001). Based on Hest significant difference was not found among VC, FVC and FEV1 and P values were 0.0124, 0.059 and 0.27, respectively.

Introduction: The origin of stone formation is super saturation and for defect in crystallization inhibitors. Obtaining the results of a 24-hour urine collection is essential to the selection of the most appropriate intervention for preventing kidney stone recurrence. However, the recently accepted definitions of normal urine values are not firmly supported by the literature. In addition, availability of information about the relationship between risk of stone formation and the levels of urinary factors is of great importance. Methods: According to exclusion and inclusion criteria, 144 subjects were selected for the study. Cases were patients with a history of passing more than 2 kidney stones (95 persons). Controls (49 persons) were patients with a history of passing one kidney stone in the past 2 years. The information was gathered. By the researcher for the history of passing kidney stone, the amount of protein taken during the week (eggs and meat), the results of the 24 hour urine collection including calcium, uric acid, exallat, Cytrate, Sodium, Phosphate, and volume and was registered in the questionnaire.Results: Hypercalciuria, high level of urine Na, uric acid and phosphate excretion had significant relation with recurrent kidney stone (p=0.005, 0.049, 0.004 and 0.02 respectively). Hyperuricemia was inversely associated with recurrent renal stone. The risk of recurrent renal stone increased with urine calcium concentration (p=0.001) and hypercalciuric state in linear by linear association test (p=0.007). Conclusion: The traditional definitions of normal 24-hour urine values may need to be reassessed, and their association with risk of stone formation may be continuous rather than dichotomous. 24 hour urine calculation for calcium, uric acid, sodium should be done for all patients with recurrent kidney stones and dietary recommendation of more water intake should be stressed.

Aims: To evaluate clinical and electrophysiological characteristics of patients suspicious of CTS referred to our clinic; we decided to carry out the study.Material & Methods: Patients referred by different specialists, were interviewed and the results of the clinical and electrophysiological exams have been investigated.Results: 77.1 % of the patients were female with mean age of 48 years. 41.9% had pain and 52.9% suffered from paresthesia in their hands, as the most common symptom.52.9% have had the problem for 6 months, 28.6% for a period of years, and 18.6% for more than 2 years.22.9% of the patients reported the history of hand trauma, 11.4%R.A, 11.4% hypothyroidism, 4.3% hyperthyroidism; in 8.6% the problem had begun during or after pregnancy, 80% had bilateral CTS.Most patients had severe CTS in their right hand; moderate CTS in the left. The rate of positivity of special clinical tests was different, flick test seemed to be more specific (more positive).On the whole, the findings revealed moderate hypothesis in median sensory area of the hand, reduction of APB force, and thenar atrophy.Conclusion: It seems that CTS, is more common in women than men and in some jobs. Also some underlying disorders play important predisposing role in the syndrome. In this study, bilateral syndrome was more common than the unilateral one. It is suggested that in clinical evaluation of the patients suspicious to CTS, pain associated with paresthesia is the key symptom. In clinical examination, flick sign is more positive than other tests and considered a good clinical diagnostic tool.

Introduction: Helicobacter pylori are a gram negative, microaerophilic bacteria. This bacteria with some elements such as shape, urease, vac A, cag A and etc could lead to gastritis, peptic ulcer, stomach cancer and MALT lymphoma. It bacteria could be isolated from saliva, stomach, esophagus, blood, dental plaque, maxillary sinus and coronary artery. Urease test is the most common diagnostic test for diagnosis of H.Pylori since it has high specificity and sensitivity. H.Pylori can be colonized in adenoid and tonsils because these elements are located in entry of aero digestive tract. Different studies obtained different results about colonization of H.Pylori in adenoid and tonsil. Methods: In this study, 100 patients who had Aden tonsillectomy or tonsillectomy were selected. After surgery two 2-3m3 samples were obtained from superior and inferior pole of tonsil and adenoid. Then, these samples were thrown in 1cc of urease. Changed color was observed during 20min, 1 hour, 3 hours and 24 hours. Sample with purple color was considered positive.Results: There were 67 male and 33 female in the study. The mean age was 10.28 ±7.14. A total of 590 samples were extracted from 100 patients, 24 samples were positive during 24 hours. These 24 positive samples belonged to 15 patients. Among which 10 patients were positive for H.Pylorpi in 3 hours and 5 patients were positive from 3 to 24 hours.Conclusion: H.Pylori can be colonized in adenoid and tonsillar tissues.