IRANIAN JOURNAL OF MEDICAL SCIENCES (IJMS)
Year:2003 | Volume:28 | Issue:3|Papers Count:14

Background: Patients with Graves’ disease exhibit a considerable rate of relapse after treatment with antithyroid drugs and require ablative therapy. Objective: The purpose of this study was to evaluate variables which can be used as prognostic factors in predicting the outcome of Graves’ disease after treatment with antithyroid drugs. Methods: Age, sex, duration of antithyroid drug therapy, pretreatment T3 and T4 values, T3 to T4 ratio, size of thyroid gland before and after treatment, and the effect of salt iodination were determined in 439 patients at an endocrine clinic in southern Iran during a 15- year period. The patients included 338 (77%) females and 101(23%) males with a mean age of 34.1±11.2 years. Results: Overall, the relapse rate was 62%. The relapse rates were 58% and 76% in females and males, respectively (P=0.001). The mean age was 35.0±11.6 years in the relapse group (n=275) and 32.6±11.3 in the remission group (n=164) (P=0.03). T4 was 20.4±6.3 and 18.1±5.4 mg/dl in the relapse and remission groups, respectively (P=0.000). In the relapse group, T3 was 443.0±189.5 ng/dl and in the remission group, it was 373.4±182 ng/dl (P=0.009). T3 to T4 ratio was higher in the relapse group (21.8±8.3 vs 18.6±7.0 ng/mg, P<0.005). Larger pre- and post-treatment thyroid size were associated with higher relapse rate (P<0.05 and P=0.001, respectively). Logistic regression analysis showed that male sex, old age, higher pretreatment T4, T3, and T3 to T4 ratio, and larger pre- and post-treatment thyroid size were associated with higher relapse rates. Iodinated salt consumption and duration of treatment beyond 12 months had no effect on the relapse rate.Conclusion: Patients with male gender, older age, higher pretreatment T3, T4 higher T3/T4 ratio, and larger thyroid size before and after treatment have higher risk of relapse.

Background: The relaxant and anticholinergic (functional antagonism) effects, histamine H__1 inhibitory effect, and calcium channel blocking effect of Nigella sativa have been demonstrated on guinea pig tracheal chains. Several therapeutic effects including antiasthma and dyspnea have also been ascribed to the seeds of Nigella sativa. Objectives:To evaluate the antitussive effect of this plant. Methods :The antitussive effects of aerosols of aerosols of two different concentrations of aqueous and macerated extracts as well as an extract of concentrated boiled seeds , codeine ,and saline were tested by counting the number of coughs produced 10 min after exposing animal to aerosols of different solutions of citric acid (n=7 for each solution). Results: The results showed significant reduction in the number of coughs obtained in the presence of both concentrations of aqueous and macerated extracts , boiled seeds extract and codeine(p<0.05 to p<0.01 ). The cough number induced in the presence of higher concentrations of aqueous and macerated extracts were also significantly less than those with lower concentrations (P<0.05 for aqueous and P<0.01 for macerated extracts). there was no significant difference between the number of coughs obtained in the presence of all extracts with that of codeine. Conclusion: These results indicate an antitussive effect of Nigella sativa comparable to that of codeine.

Background: Seizure disorders are common in infants and children. Cardiac dysrhythmias may manifest clinically as seizure disorders which, if missed, may cause serious consequence.

Background: An increasing success in induction of labor and subsequent termination of pregnancy in presence of unfavorable cervix requires cervical ripening in order to reduce complications and to diminish the rate of cesarean sections as well as the duration of labor. However, there is no consensus on the efficiency of conventional methods for cervical ripening.

Background: Sialic acid is a component of serum that is elevated in diseases such as diabetes and certain malignancies. The normal range of SSA concentration and serum neuraminidase activity in different populations are varied, probably due to racial differences

Background: Developmental dysplasia of the hip (DDH), formerly known as congenital dislocation of the hip (CDH) is a common congenital malformation which occurs worldwide with variable frequencies in respect to the race and geographic distribution.

Bakground: Granulocyte colony-stimulating factor (G-CSF) is a cytokine that stimulates hematopoiesis and induces proliferation and differentiation of granulocyte progenitor cells as well as production of bone marrow neutrophilic granulocyte colonies. Nowadays, human recombinant G-CSF (hr G-CSF) is uwde for the treatment of chemotherapy- and radiotherapy-induced neutropenia, and also in patients with bone marrow transplantation.

Little information is at hand on the diagnostic values of the clinical symptoms and signs in the level diagnosis of patients with lower lumbar disc herniation. We examined one hundred and thirty nine consecutive candidates for lower lumbar discectomy. Monoradicular pain with sings attributed to the fifth lumbar and first sacral root dysfunctions were evaluated independently in each patient. Intra-operatively, all patients were assessed by a single neurosurgeon for the level of disc herniation. We reached the conclusion that the diagnostic vale of clinical features of the herniated fifth lumbar disc is higher than that of the fourth lumbar disc herniation. The value of clinical presentation in the level diagnosis of lower lumbar disc herniation is highly specific, but rather insensitive.

The distribution of total plasma homocysteine concentrations in relation to the sex and age is described, in a population of Shiraz, South West of Iran and compared to those reported in other populations. Two hundred and one healthy males and 201 healthy females aged >15 y were randomly selected. Total Plasma homocysteine concentrations were measured using high performance liquid chromatography. the mean plasma homocysteine level was significantly higher in men (geometric mean 7.3#mmol/L) than in women (geometric mean 6.3#mmol/L, p<0.001). the geometric mean levels for age ranges 15-25, 26-36, 37-74, 48-58, 59-69 and 70-80 years, were 5.9, 5.4, 5.2, 6.7, 7.3 and 7.6#mmol/L in women and 7.5, 8.7, 5.9,5.9, 7.2 and 9.1 3mmol/L in men respectively. The first data on homocysteine distribution in a representative sample from South West of Iran indicate that the ethnic differences have an important impact on homocysteine metabolism.

A 19-year-old girl referred to our clinic complaining of a painless lump on the left side of her tongue. The patient had no history of dysphagia, lingual paresthesia or bleeding. Physical examination revealed the presence of multiple enlarged lymph nodes on the left side of her neck. histopathology of lingual mass and lymph nodes showed pleomorphic adenoma. to our knowledge, this is the first case of pleomorphic adenoma of the tongue with metastasis to the cervical nodes.

Brucellosis is a rare cause of acute acalculous cholecystitis. We report a 45-year-old, previously healthy, man with brucellosis who presented with abdominal pain due to cholecystitis.

Hyperekplexia is a rare non-epileptic disorder characterized by an exaggerated and persistent startle reaction to the unexpected tactile and acoustic stimuli. The disorder is occasionally associated with generalized muscular rigidity and has the clinical hallmark of positive nose tapping test. The disease is inherited in an autosomal dominant fashion Recessively inherited and sporadic forms of the disorder are also seen. Neonatal hyperekplexia is extremely rare but importnat because, if undiagnosed and untrated, the disease can be fatal. Hyperek-plexia is easily mistaken for commoner disorders such as spastic cerebral palsy and epilepsy. Clonazepam is of benefit, but it does not always stop the prolonged spasms. Forced flexion of baby"s head toward the trunk is the most effective treatment. We report a young female infant who presented with excessive jerky movements of the limbs in response to tactile stimuli, associated with episodic generalized stiffness and irritability since her birth. Marked improvement was seen following the use of clonazepam.

Sclerosing hemangioma of the lung is extremely rare. Herein, a case of sclerosing hemangioma of the lung in a 44-year-old woman is reported. On admission, the patient complained of pain in the left lower neck and upper chest. Chest x-ray revealed a mass in lingular lobe of the left lung. The patient underwent surgery and a mass was removed through left posterolateral thoracotomy. Pathologic findings confirmed selerosing hemangioma. Selerosing hemangioma of the lung should be considered in asymptomatic patients or those with symptoms in chest or lower neck.

Nekam"s disease is a rare dermatosis characterized by a distinctive seborrheic dermatitis with prominent facial eruption. It is further associated with violaceous, papular, and/or nodular lesions on the extremities and trunk, typically arranged in a linear and reticulate pattern. Herein, describe a patient with Nekam"s disease, which resembled Darier"s disease in clinical manifestation. The patient responded partially to the treatment with oral isotretinoin.