Iranian Red Crescent Medical Journal
Year:2010 | Volume:12 | Issue:6|Papers Count:17

As per philanthropy policy of any National Societies throughout the world, the Iranian Red Crescent Society (IRCS) announced preparedness for assisting the affected people of Kyrgyzstan. To this purpose, the lRCS swiftly sent out a consignment including 1, 543 cartons of medicine, and 3000 pieces of bed sheets and pillowcases to the said country to be distributed among the most vulnerable and affected people.

Mansoon rains, floods and other disaster, all of these started in July 26, 2010. Pakistan was affected by the worse flood in the recent decade.Nearly, one fifth of the entire landmass and more than 20 millions of the population were directly affected in this flood.More than 1.9 millions houses and many infrastructures including transportation system, health facilities and schools were damaged or destroyed.About a quarter of the country’s harvest has been destroyed and the next year’s harvest seems to be threatened too. Estimated Sindh’s agricultural loss is at least US$1 billion which is quite high for a country with low GDP. Much of the cotton crop as one of the major Pakistan’s export has been wiped out. The social and economic effect of this tragedy seems to be already more than all the three recent major natural disasters namely Indian Ocean Tsunami in 2004, Southeast Asian earthquake in 2005 and Haiti earthquake in 2010.

Background: Chronic hepatitis C virus (HCV) infection is the major cause of liver disease related morbidity and mortality in hemophilic patients who needs regular blood product administration. Although genotype of infecting HCV is one of the prime predictors of response to antiviral therapy however, its distribution in hemophilic patients is still unclear and just few studies with low sample sizes have investigated this issue. Therefore, in this study, we aimed to identify this distribution in 367 Iranian hemophilic patients.Methods: Blood samples were received from 367 hemophilic patients with chronic hepatitis C detected during a nationwide screening program who referred to our center for therapeutic measures. HCV RNA viral load was detected using Amplicor test (Version 2). Genotyping was performed by genotype specific primers.Results: HCV genotype distribution was 1a in 58%, 3a in 18.5%, 1b in 14.7%, 4 in 1.1%, 2 in 0.8% and mixed in 6.2% and finally 0.5% of isolates were non-typable. Serum liver enzymes were not associated with HCV viral load and genotypes. Patients with severe bleeding tendency had significantly lower serum liver enzymes than those with a mild bleeding tendency.Conclusion: Genotype 1a followed by 3a and 1b were the most frequently detected HCV genotypes in Iranian hemophilic patients and there was no association between splenomegaly and viral markers and liver enzymes in these patients.

Background: While mesenchymal stem cells (MSCs) have been isolated from multiple tissue sources, the differences existed between the cells from different tissues have still remained to be clarified. This study compares MSCs from murine amniotic fluid (AF) with those from bone marrow (BM) tissues.Methods: AF and BM cells were collected from 10 NMRI mice at second weeks of their pregnancy and the culture was expanded. The isolated MSCs were then compared in terms of in vitro differentiation capacity, expansion rate and the percentages of senescence-associated b-galactosidase (SA- b-gal) positive-cells in their cultures.Results: Either cell appeared to be able to differentiate into bone, cartilage and adipose cell lineage. AF-cells were observed to be more proliferative than BM-cells. The population doubling time (PDT) of AF-cells was 92.6±13.9 hours compared to 168 ± 40 hours that was recorded for BM-cells. The percentage of SA- b-gal positive-cells in AF-cell culture appeared to be significantly lower than that in BM-cell culture.Conclusions: Collectively, it seems that murine AF housed MSCs with a relatively higher proliferation property than BM-derived MSCs and a typical tripotent differentiation potential comparable with marrow MSCs, hence it would be as an appropriate source of MSCs for use in regenerative medicine related studies.

Background: Pancreatic cancer is still a health problem worldwide. The present study aimed to report the clinical characteristics, prognostic factors and treatment outcomes of 55 cases of pancreatic cancer and the literature review and analysis.Methods: Between 1998 and 2008, 55 consecutive patients proven pathologically with adenocarcinoma of the pancreas and treated at our institution were enrolled. To find out the recent major series, a literature review was performed. We selected 35 major series including 257950 patients with pancreatic cancer for discussing the present study.Results: Twenty-four patients (44%) had resectable disease, 19 (34%) had locally advanced disease, and 12 (22%) had metastatic disease. There were 22 women and 33 men ranging in age from 16 to 76 years, with a median age of 57 years at diagnosis. After a median follow-up of 15 months (range=2-104 months) for surviving patients, 14 patients were alive and without disease, 3 patients were alive with disease and 38 patients had died due to disease. The 5-year overall survival was 27%.Conclusions: In this study and by analyzing the large data collection of recent major reported series, we found that pancreatic cancer tended to present at advanced stage, with a high frequency of locoregional and distant failure and a poor outcome. More effective local and systemic treatment for improving overall survival is needed.

nephropathy and emerged as a cause of allograft failure linked to immunosuppressive regimens in renal transplant recipients. This study develops a sensitive PCR method to detect the viremia and viruria as well as the incidence of BK virus infection in renal transplant recipients.Methods: A nested PCR method was developed and a total of 45 paired serum and urine samples from renal transplant recipient patients were collected and tested with the developed assay.Results: The threshold of the developed detection assay was 10 copies/ml of BKV DNA in samples. Our results also indicated that about 40% of the urine and 26.7% of serum samples were positive for BKV in renal transplant patients in this study.Conclusion: This Nested-PCR method was found a specific, sensitive and simple procedure for detection of viruria and viremia of BK virus in renal transplant recipients.

Background: Acute renal failure requiring renal replacement therapy after cardiac surgery is still a cause of major morbidity and mortality worldwide. A number of risk factors for the development of acute renal injury after cardiac surgery have been previously described and based on these variables; several scoring algorithms were proposed. Predictive value of these algorithms in Iran is not described. This study investigates these risk factors among our patients in southern Iran.Methods: Two hundred and forty patients with normal kidney function who were candidates for cardiac surgery were enrolled and their baseline data were collected. Diabetes mellitus and age were selected as more controversial preoperative risk factors. Clamp and pump time were also selected as intra-operative risk factors and the type of operation was also considered as an independent risk factor. The patients were categorized in two groups including group 1: Patients with post-operation normal kidney function and group 2: Patients with postoperation ARF. All patients were followed with serial measurement of serum creatinine post-operation.Results: The incidence of acute renal failure was 11.25%. Mean age of the patients in group 1 was 54.24±15.88 and in group 2 was 52.85±18.20 years. There was not any significant correlation between duration of clamp time and post operation acute renal failure. Clamp time in group 1 was 51.49±11.88 and in group 2 was 53.48±13.40 min. Duration of pump time in group 1 was 63.31±12.56 min and in group 2 was 78.07±10.85 min. The difference was statistically significant. Forty two (20%) of the patients in group 1 and 13 (50%) in group 2 were diabetic.Conclusion: Although several scoring algorithms are available for prediction of post-cardiac surgery complications, these can also be matched with our patients’ criteria enhancing their accuracy for our situation.

Background: Tibial diaphyseal fracture is the most common fracture of long bones. In Iran plating and undreamed tibial nailing (UTN) are the most commonly used methods and because of paucity of equipments such as c-arm and reaming sets, the reamed method is rarely used. This study compares these two methods.Methods: In a randomized clinical trial study including 100 patients (78 males, 22 females; mean age=24 years; range=16-50 years) undergoing UTN and plate-screw in the treatment of uncomminuted closed tibial shaft fractures (50 patients in each group) were compared regarding the union time and complications after a mean follow up of 16 months (12- 20 months).Results: the mean time to union was 16 weeks with UTN and 14.3 weeks with plate-screw fixation. There was 4 (8%) and 3 (6%) non unions after UTN and plating respectively. Plain radiographs in both groups showed angulation in 3 patients; all in distal third and in varus (6%). There was not any infection after UTN but one case of superficial and one case of deep infection were noticed after osteosynthesis with plate and screw (4%). Four patients after UTN and 4 patients after fixation with plate-screw required reoperation (8%).Conclusion: plate-screw osteosynthesis yielded satisfactory results in uncomminuted closed fractures of the tibial shaft comparable with UTN results.

Background: Exposure of workers to excessive noise and its complications including hearing loss as one of the most important health problems in industries. Standard Threshold Shift (STS) is considered as an indicator for monitoring of the effectiveness of hearing conservation program (HCP) implemented in the industries. This study was designed to determine the frequency of STS and hearing loss in steel industry workers.Methods: 310 steel workers with sound level exposure to unauthorized noise (85 dBA or higher) that had at least 3 years work experience were enrolled. Required data were recorded in a questionnaire through direct interview.STS was investigated using baseline audiogram and audiometric evaluations.Results: 22.3% of workers in 2008 and 41.3% of workers in 2009 had STS in both ears. There was a significant relationship between the sound exposure level and work experience with STS, while the relationship between age and STS was not significant.Conclusion: High frequency of STS in workers indicates unsuccessful hearing conservation program in the factory and careful implementation and reassessment of HCP seem necessary.

chological factors to increase maternal corticotrophin-releasing factor to play an important role in preterm delivery.This study was conducted to determine the effect of prenatal anxiety on spontaneous preterm delivery and low birth weight (LBW) in Babol, Northern Iran.Methods: 682 women with singleton pregnancies who were consecutively recruited between 20 and 28 weeks of gestation in Babol Health Care centers for prenatal care were enrolled. Women who had history of psychological and chronic diseases, pregnancy complications and taking medicine were excluded from the study. The gestational age was based on last menstrual period or ultrasound examination in first half of pregnancy. Anxiety was assessed using self-administered questionnaires: the Spielberger State-Trait Anxiety Inventory. The women were considered as case group with anxiety score ³45.Results: The mean Spielberger state and trait anxiety in women with preterm delivery were respectively 42.7±10.8 and 52.9±3.9, but the mean Spielberger state and trait anxiety in women with term delivery were respectively 37.81±5.71 and 50.68±5.20. A significant association was found between scores for both Spielberger state anxiety and trait anxiety ³45 and preterm and LBW. A high score state anxiety (³45) was significantly associated with an increase in preterm delivery.Conclusion: Screening for mental and psychological disorders among women in regular prenatal care is recommended.

Background: Iron overload is the main cause of morbidity and mortality in patients with beta thalassemia major.Effective and convenient iron chelation remains one of the main targets of clinical management of thalassemia major. The combined treatment with deferoxamine and deferiprone could have an increased chelation efficacy and allow drug doses and toxicity to be reduced.Methods: Eighty patients with thalassemia major were randomized to receive one of the treatments: deferoxamine given in combination with deferiprone and deferoxamine alone. Changes in serum ferritin and any toxicity were determined.Results: After one year, the mean serum ferritin (±SD) in deferoxamine alone group decreased from 2945 (±591) ng/ml to 2, 451 (±352) ng/ml (p<0.001). In the group treat with deferoxamine and deferiprone, a dramatical decline was noticed from 2986 (±612) ng/ml to 2, 082 (±221) ng/ml (p<0.001). A significant improvement was observed after 6 months of combination therapy. The main side-effects were skin reactions (deferoxamine alone), nausea and arthralgia (combined therapy).Conclusion: Combination therapy is a practical and effective procedure to decrease severe iron overload in patients with beta thalassemia major.

countries, among both children and adults. This study was undertaken to determine the cases suicide in 6-15 years old children.Methods: Between Jan.2005 and Jan.2008, data from 292 children (239 girls and 53 boys) aged 6-15 years who attempted suicide and were referred to the Loghman Hakim Medical Poison Centre affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran were enrolled. The Children Suicide Questionnaire (CSQ) was applied.Results: The percentage of girls who attempted suicide was 81.8% against 18.2% for boys. Most of them were from 12 to 14 years old.43.8% of the children were in a poor socio-economic class.55.5% of the study period was between 6.00 pm and 12.00 pm.41% of the respondents reported cases of mental illness in their family.41.6% of the children had previously attempted suicide while 95% of suicide attempts took place at home and in 36.6% of suicides, there was a family argument. Depression (28%) and epilepsy (27.1%) were the most cited cases of personal problems using antiepileptic drugs (23%), benzodiazepine (23%), and antidepressants (20%).Conclusion: This study suggests a collaboration between pediatricians, psychiatrists and psychologists.

An elderly woman with multiple medical problems developed cytomegalovirus (CMV) colitis following a prolonged hospitalization. She presented life–threatening colonic bleeding mimicking a neoplastic process while the final diagnosis was CMV colitis. This is an uncommon presentation of CMV colitis in an immunocompetent patient needing a high index of suspicion to proceed early with proper diagnosis and therapy.

Torsion of a wandering spleen is an atypical cause of an acute abdomen. Herein we report a case of a wandering spleen in a 24 year-old female patient who presented with vague clinical findings of acute abdomen, a laparotomy was performed and the infracted spleen was removed. In such cases, prompt intervention to prevent complications is mandatory.

Dear Editor, In December 26, 2003, Bam was devastated by an earthquake of 6.3-6.6 Richters. Health facilities and 120 schools were destroyed.Water, electricity and telephone lines were down. A state of emergency was declared. In addition to recruiting medical aid, international search-and-rescue teams were dispatched to provide medical care, effective air evacuation and relief missions. Like similar disasters, management was not without problems.Medical officials in Bam faced with numerous managerial dilemmas; this audit assessed officials in charge of management (medical authorities, Health Bureau, Civil Affairs Bureau, county hospitals and authorities in charge of health posts, Chancellor of Kerman University, Deputy Minister of Health, Head of Baseige Task Force, Head Doctor of Bam Guards Corp, administrator of Army Field Hospital, Administrator of Iranian Guards Field Hospital, Medical university deans, Head of Search and Rescue teams, etc.) then-stationed in Bam.

Dear Editor, Discussing the relevance of immunization of foreigner rescuers to Haiti people, in the recent disaster devastating this country, Ghorbaniet al.1 in their Editorial have proposed that all rescuers need to be vaccinated against Hepatitis A Virus (HAV) infection. As it is addressed in the above-mentioned article, rescuers who came from developed countries were less likely to be seropositive for HAV infection; so it is reasonable that we consider vaccination for all these rescuers entering Haiti and other areas with the same hygienic conditions. Although, as declared in the mentioned debate, it seems logical that vaccination of travelers to the developing countries is likely to prevent outbreaks in the national scale, evidence barely can support this presumption; current data proposes that vaccination of travelers to HAV prevalent areas, despite its high value on preventing infection in the vaccinated people, has little effect on national disease rates.

There are not enough available data to show that newborn infants more likely experience adverse reactions to drugs than adults. A lack of awareness or attention to critical aspects of drug administration techniques can result in therapeutic misadventures. One of the most common potential errors in drug administration techniques is inappropriate dilution.When we noticed symptoms of phenobarbital and digoxin overdose in our patients which was confirmed by laboratory tests, an investigation was carried out aiming at disclosing the causes. Review of the nursing practice in our hospital suggested that the overdosing was due to the undetermined drug in the dead space of a 1 ml syringe.