Iranian Red Crescent Medical Journal
Year:2011 | Volume:13 | Issue:1|Papers Count:15

In line with implementing rules and regulations of National Society's voluntary services as "members and volunteer's active participation" besides dissemination and promotion of philanthropy and voluntary benevolence culture along with highlighting mandates and roles of volunteers at ordinary time and disasters, the Iranian Red Crescent Society (IRCS) as one of the most remarkable Non -Governmental Organizations (NGO) addresses the needs of affected people the activities of which requires groundwork of necessary arrangements and volunteer's bases could establish that. Volunteers Organization is administrator of organizing volunteers' capacities for the benefit of deprived and the needy of the community. Members and volunteers of the National Society render voluntary and humanitarian services in different levels one of the methods of which is rendering services through volunteers' bases. The aforesaid national plan is defined and implemented in three phases of establishing mosques, factories and district's bases.

Background: Zinc is an essential trace element with a prominent role in human nutrition. Zinc deficiency has been linked to growth retardation, hypogonadism in males, and lack of sexual development in females. It ranges from 50% in sub-Saharan Africa to 5% in high income countries. The aim of this study is to evaluate the prevalence of zinc deficiency in healthy children in Shiraz, southern Iran.Methods: In this study, 902 children aged 3-18 years old were randomly sampled for serum zinc level. Age, sex, weight, height, BMI, stunting and wasting indices were also recorded. With atomic absorption spectrophotometry method, the serum level of zinc less than 70 mg/dL was considered as deficient.Results: Mean serum level of zinc was 122.3±55 mg/dL. The prevalence of zinc deficiency was 7.9%. There was no relationship among serum zinc level and age, sex, height, weight or BMI, but mild wasting (weight for age) and mild stunting (height for age) were significantly more prevalent among zinc deficient children compared to children with normal or high level of zinc.Conclusion: Zinc deficiency in Shiraz is not as prevalent as other areas of Iran. It was significantly more frequent among stunted and wasted (malnourished) children. Difference in soil zinc level, recent wide prescription of zinc supplements by pediatricians and especial pattern of nutrition, considered as possible factors responsible for lower prevalence of zinc deficiency in Shiraz, deserve more investigations.

Background: Emerging data suggest a significantly increased prevalence of low bone mineral density (BMD) in men and women with multiple sclerosis (MS) compared to age matched controls. This study was performed to evaluate bone mineral mass in patients with MS in comparison to healthy age-and sex matched controls and to determine association of glucocorticoid use or ambulation ability with changing in bone mass in these individuals.Methods: Eighty two patients with MS and 328 age-sex matched healthy controls participated in the study. The Kurtzke expanded disability status scale (EDSS) was used to evaluate disability and functional capacity. Bone mineral density was measured using Dual X-ray absorptiometry. Serum calcium, phosphorus and 25 (OH) vitamin D levels were assessed.Results: The MS patients had significantly lower BMD at the lumbar spines, neck and total femur compared to age-sex matched controls. EDSS scores were inversely correlated with total femur and spinal BMD. There was a negative correlation with cumulative steroid dose and BMD only for femoral neck.Conclusion: BMD was significantly lower in MS patients. Decreased ambulatory status and glucocorticoid usage were associated with low BMD in MS patients. These patients should be encouraged to increase mobility and to have protective measures to maintain bone mass.

Background: Previous researchers have evaluated the influence of physical exercise or physical activity on pregnancy outcome, but the influence of daily physical activities in details including energy expenditure, biomechanical load and exercise before and during pregnancy have remained unclear. This study evaluates the relationship between daily physical activities as a biomechanical load and energy expenditure and physical exercise during household activities with birth weight, type of delivery and Apgar score.Methods: The participants of this study were household, first parity women who referred to a prenatal care center in southern Iran.132 volunteer women were eligible to be enrolled according to their general health and not having any absolute or relative limitation for participating in any kind of activity. Information about daily physical activity was collected through a personal interview using a structured questionnaire during two separate days of ninth month of pregnancy. Data on delivery were recorded from recorded documents of mothers in the hospital.Results: There was no relationship between biomechanical and energy load and birth weight. There was a significant correlation between Apgar score and biomechanical and energy load. Infants of mothers who exercised before or during pregnancy had a significant higher weight than the non-exercise group. Apgar score indicated no significant difference among those having exercise and those without before and during pregnancy. There was no significant difference in the biomechanical load and energy expenditure in the two types of delivery.Conclusion: Daily activities in normal range do not induce any harmful effect on birth weight; increasing biomechanical load as a result of some maternal body postures that may be harmful for infant health at birth time.Physical exercise before and during pregnancy may have a positive effect on birth weight.

Background: Amblyopia is a relatively common condition in which visual acuity through an eye is subnormal despite no overt pathology. Pattern visual evoked potential (PVEP) can detect any defect from optic nerve to occipital cortex and pattern electroretinogram (PERG) can detect retinal defects specially the ganglion layers.This study was performed to evaluate the cortical and retinal activity in strabismic and anisometropic amblyopia.Methods: PVEP and PERG were recorded simultaneously in 40 amblyopes (20 strabismics and 20 anisometropics) and 20 normal control subjects. Normal subjects were age and sex matched with patients.Results: The P100 latency in PVEP was increased in both groups of patients but the P100 amplitude was reduced only in anisometropic group. In PERG, the amplitude of P50 was reduced in all patients with no significant change in latency.Conclusion: Beside reduced PVEP responses in strabismic and anisometropic amblyopia, the activity of retina reduced too. It is likely that retinal impulses can affect the development of visual system.

Background: Juglans regia leaves have been used in folk medicine to alleviate inflammatory diseases. This study investigates the antinociceptive, anti-Inflammatory and acute toxicity effects ofJuglans regia L. leaves in mice.Methods: 351 Male and female albino mice were divided into negative (saline), positive (morphine or diclofenac) controls as well as test groups (n=6-8). The acute (intraperitoneally) toxicity was evaluated for 2 days. Antinociceptive activities were done using hot-plate and writhing tests. Anti-inflammatory effects were studied using xylene induced ear edema and cotton pellet tests.Results: The LD50 values of J. regia aqueous and ethanolic extrats were 5.5 and 3.3 g/kg, respectively. The aqueous (2.87 and 1.64 g/kg) and ethanolic (2.044 and 1.17 g/kg) extracts showed antinociceptive activity in hotplate test. The pretreatment of naloxone (2 mg/kg, s.c.) did not inhibit the extracts activities. The extracts exhibited antinociceptive activity in writhing test, which were not blocked by naloxone. In xylene test, both extracts showed anti-inflammatory activity in some doses. The extracts showed anti-inflammatory activity against the chronic inflammation.Conclusion: J. regia leaves demonstrated antinociceptive effect through non-opioid receptors and antiinflammatory effect against acute and chronic inflammation. The extracts ofJ. regia could be considered as a promising analgesic and anti-inflammatory agents against diseases such as rheumatoid arthritis.

Background: Low intensity pulsed ultrasound (LIPUS) has been shown in healing of fractures. This study investigates the effect of LIPUS as a fracture-healing adjunct on the denervated tibial fractures in rabbit model.Methods: Twenty four male Dutch rabbits were randomly divided into four groups including two control and two ultrasound-treated (US-treated) groups. A standardized mid-tibial osteotomy was performed in the right tibia.Ipsilateral sciatic nerve was cut two centimeter above the right knee. After three days, the rabbits of US-treated groups received the therapeutic dose (100 mW/cm²) of ultrasound for 15 minutes per day until the 6th and 8th week and the control groups did not receive any treatment. The rabbits were sacrificed at weeks 6th and 8th post surgery and the external fixator and tibia were carefully removed. Radiographs were taken by lateral and anteroposterior views. Mechanical testing of rabbit’s tibiae was used. The specimens were taken from callus of fracture for histomorphometric study of trabecula in the fractured area. Immunohistochemical staining for ki67 was used to evaluate cellular proliferation.Results: Radiographs showed the callus was visible indicating the ossification of the callus tissue without any significant difference between US- treated and control groups. Biomechanical, histomorphic and immunohistochemical evaluations had no significant difference between control and US-treated groups after 6 and 8 weeks postoperation.Conclusion: These finding suggest that ultrasound therapy with features which applied in this study had no significant effect on denervated tibial fracture repair in rabbits.

Background: Human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) are three important prevalent infections all over the world. The aim of this study was to determine seroprevalence of HIV, HBV and HCV infections and high risk behaviors in persons who referred to the behavioral counseling center of Hamadan, west of Iran.Methods: This was a cross-sectional study which was done on 379 persons who referred to the behavioral counseling center of Hamadan. All persons after obtaining the informed consent were tested for serologic markers including HBs Ag, HCV-Ab and HIV-Ab by ELISA and western blot methods.Results: Of the 379 persons, 71.5 % (271 cases) were male and 28.5% (108 cases) were female. HIV infection was reported in 4% (15) of persons. HBV and HCV infections were reported in 2.9% (11 cases) and 35.6% (135 cases), respectively. The most common high risk behaviors were injection drug user and history of prison with 52.5% (199 cases) and 40.4% (153 cases), respectively.Conclusion: According to the results, injection drug users and prisoners are at the highest risk for HCV, HIV and HBV infections.

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare inflammatory bone disease. It is a diagnosis of exclusion based on the clinical, radiological and pathological criteria. The awareness of the corresponding feature can help avoid of unnecessary diagnostic procedures and prolonged antibiotic therapy. We present a case of 4.5 year old girl, diagnosed with CRMO who were followed for 6 months as a case of chronic bacterial osteomyelitis and received long course of antibiotic therapy.

Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. Skeletal abnormalities have been described in association with ALL including osteoprosis and bone fractures. Different factors including the disease itself or soluble products of malignant cells and treatment agents like cytotoxic drugs, methotroxate, corticosteroids and radiotherapy may be responsible for defective bone homeostasis in these patients. Orthopedic conditions and pain may be the first manifestation of acute leukemia and it is important for physicians to recognize the skeletal manifestation of acute childhood leukemia because of a delay in diagnosis has adverse effect on survival. We present a child with ALL that refer with multi bone fractures as a first manifestation of the disease.

Dear Editor, Indeed, topical ocular anesthesia has been part of modern ophthalmology for more than a century. All forms of anesthetics can be toxic, particularly when abused.1 In Iran, the most common topical anesthetic is tetracaine. Most of the patients abuse it after UV keratitis or foreign body removal. The ocular surface and cornea are the most common sites of such toxicity.Systemic side effects are rare.Unfortunately, it is growing as a health problem nowadays. Primary prevention is recommended by education of the workers to avoid abusing it. Here we report a oneeyed, 48-year-old man referred to us with an eye disorder from a few days ago following corneal foreign body removal. Corneal epithelial defect, ring infiltration, stromal edema, and descemets folds were observed at slit lamp examination (Figure 1-A).In the history, he mentioned topical tetracaine use. He was asked to discontinue taking it. Ocular surface culture was performed but the result was negative.Topical autologus serum and oral steroid were administered.After one week, the size of epithelial defect was decreased (Figure 1-B) at the third week, there was no significant change in epithelial defect size (Figure 1-C). Lateral tarsorrhaphy was carried out (Figure 1-D).One week later, the corneal epithelial defect was totally healed. After 2 months, the tarsorrhaphy was opened and the patient had clear cornea with no epithelial defect or infiltration (Figure 1-E). Two years later, the patient returned with the same primary clinical feature (Figure 1-F).

associated with psychiatric symptoms.A profound psychological distress is made after the diagnosis of infection, and several psychiatric disorders including AIDS phobia, bereavement and grief, anxiety and depression were shown as a reaction to the infection.Associating the infection to the stigmatized and illegal behaviors by the family, friends, and others, especially in the developing countries, as well as the nature of the infection that is frustrating and incurable, both affect the patients enormously.3 A lack in investigations on the psychiatric symptomatology of HIV infection in our country, which surely affects the patient’s compliance and management process, convinced us to assess the frequency and severity of psychiatric symptoms in those living with HIV in Razavi Khorasan Province, northeast of Iran.

Dear Editor, The practice of emergency medicine is the ability to perform indicated clinical procedures in a skillful and safe manner.Due to multiple factors, including the unpredictable nature of emergency medicine, clinical experience may be quite variable. So clinical experience in the emergency department (ED) is the foundation of emergency medicine.In teaching hospitals, clinical encounter is an increasing significant component of medical students' curriculum and one of the clinical experiences of medical students is emergency medicine.Thus, all students who are graduated from medical schools should be capable of handling emergency situations.While the clinical encounter is understood to be a significant educational experience, little is known about the information of medical students in response to clinical problems, specially in emergency cases. To date, many studies address physicians' information needs but few authors report studies describing medical students' information needs in the ED. The present study aims at analyzing the information needs of medical students in emergency departments which differs from most of the past studies by focusing on the information needs of students, rather than those of clinicians.This study seeks to provide a better understanding of students' information needs and analyzes the content of questions of medical students in response to a clinical encounter that can impact on the clinical education quality, the recognition of students' educational needs, and the educational improvement in emergency and better management of patients by medical students that decreases patient's stay and promotes patient's satisfaction.

Pneumatosis intestinalis (PI) is an uncommon disorder characterized by an accumulation of gas in the large or small bowel wall, and has been associated with a variety of disorders and procedures. Organ transplantation, bowel ischemia, inflammatory bowel disease, obstructive airway disease, infectious agents, and the administration of steroids or immunosuppressive agents are well known to predispose PI.1 We present a patient with PI determined during exploration, referred to our hospital with a preliminary diagnosis of gastrointestinal system perforation.A 60-year-old male was sent to our hospital with abdominal pain and progressive abdominal distension for 2 days. Lung rear-front x-rays showed free air below the diaphragm. The emergency laparotomy showed serosal and mucosal thickening in the form of segmentary involvement in the ileum section of the intestines and pinhead-sized air-filled sacs in the intestinal serosa and mesentery tissue (Figure 1). No perforation foci were encountered in the stomach, or bowel. PI was therefore suspected under the circumstances; biopsies were taken from the intestinal serosa and mesentery and the laparotomy was concluded. In the pathological examination of the biopsies, connected air filled cysts positioned under the serosa were observed. Crohn’s disease was diagnosed as a result of the biopsies taken from the ulcers.

Dear Editor, I read with interest the recently published article by Imaniet al., 1 in your journal, in which five out of the 230 (2.17%) tested household contacts were seropositive.We do not have enough data regarding family prevalence of hepatitis C virus (HCV) infection in the literature. Blood and blood products transfusion used to be the main risk factor for transmission of HCV, yet the main risk factor has recently changed to intravenous drug abusing (Injecting drug users; IDUs).The prevalence of HCV infection in general population of I.R. Iran is low5 and it means that the main risk factor for transmission of HCV infection, IDUs, is low in our general population. The study reveals that we should be aware of transmission of HCV infection in families, but I would like to add some points for more discussion about this issue. The risk of transmission of HCV by sexual rout is very low; 6 the other risk factors such as sharing the razors and tooth brushes may be responsible as well. I would like to ask the physicians to train the family of patients more regarding prevention of HCV transmission.Sexual health precautions and avoiding sexual contact during the menstrual period, according to Islam rules, is mandatory. Another point about the study by Imaniet al. in which four out of the mentioned five seropositive household contacts (80%) were the cases' wives and the remaining one (20%) was one of their sister, is the probability of IDUs history in the family positive for IDU especially in the one infected sister which means the transmission had occurred due to a high risk behavior and not intrafamily.We do not have any information about this risk factor in positive family cases in the article.