Shiraz E-Medical Journal
Year:2009 | Volume:10 | Issue:1|Papers Count:9

Publication of a new medical journal is a very tough decision because you should have something new and worthy to present in the world of medical literature.

Introduction: Endometriosis is the presence of endometrial glandular and stromal cells outside of the uterine cavity. This disease is found in about 10% of women of the reproductive age and in up to 50% of women with infertility. Surgery continues as the first-line treatment to eradicate endometriotic lesions but recurrence of the condition occurs in up to 47% of women.Materials and Methods: The aim of the present study is to determine prolactin levels in human culture of endometrial fragment. Endometrial biopsy in Premenopausal patient’s women referred to Toronto Center for Advanced Reproductive Technology (T.C.A.R.T) for infertility treatment such as uterine myomas or ovarian cyst. Endometrial samples were collected from a total of ten normal ovulating women on cycle days 19-24. The biopsies were obtained from the fundal region of the uterine cavity. Ten tissue fragments were cultured by three dimensional methods for each patient. Supernatant fluid sample was collected from endometrial samples which were cultured in a three-dimensional fibrin matrix.Results: Level of prolactin in Supernatant fluid of endometrial samples were placed in a three-dimensional fibrin matrix culture system were determined. These data showed Cell proliferation was observed in 91% of the wells. Angiogenesis was observed in 51 wells that showed cell proliferation (56%). The level of Prolactin in the supernatant fluid of wells that showed angiogenesis were increased (P<0.05) compare to supernatant fluid of wells that didn’t show angiogenesis.Conclusion: Prolactin might play an important role in promoting neovascularization and cell proliferation in establishment endometriosis. Prolactin is involved in the regeneration of the endometrium and the growth of endometriosis.

Purpose: we report initial experience of stapling hemorrhoidopexy in Iran.Methods: Forty-nine patients with symptomatic hemorrhoids were treated in three medical centers; 29 with Procedure for Prolapse and Hemorrhoids (P.P.H) (Ethicon Endo-surgery), and 20 with Straightforward Trans Anal Mucohemorrhoidectomy (STRAM-kit) (Tyco Healthcare, Norwalk, US). Patients were prospectively evaluated for postoperative pain, anorectal functional status, morbidity and postoperative complications. The follow up period was at least 6 months.Results: Forty-nine patients were evaluated. The mean age of the patients was 49.3 years. There were 23(46.9%) males and 26(53.1%) females. The median duration of symptom was 7.5 years. No mortality was reported. Urinary retention was the most common complication. Three patients had delayed bleeding. Postoperative pain was classified as painless, mild, moderate and severe. 39 cases (79.6%) had a mild to moderate pain relieved by an Acetaminophen tablet or NSAID. Thirty-six patients (73.5%) were fully satisfied with the operation result. All patients except one (99%) had returned to their normal functional life and their normal activity within 48 hours post-operation.Conclusion: Stapled hemorrhoidopexy is a safe effective procedure with low complication, minimal postoperative pain and early recovery.

Introduction: Increasing evidence is presenting in favor of laparoscopic repair of perforated peptic ulcer (PPU). A selected group of patients may benefit more with laparoscopic repair than with open surgery. Taking advantage from experiences of other workers, we tried to define this group of patients.Materials and Methods: This is a retrospective study comparing laparoscopic repair of PPU with open repair. We excluded patients with shock, generalized peritonitis, previous upper abdominal surgery, large ulcer (>10mm), gastric ulcer, and concomitant peptic ulcer complications from both groups. Closure of perforation in both groups was performed by simple suture closure with omental patch.Results: patients underwent laparoscopic repair required less analgesic postoperatively, returned to normal diet earlier, and had a shorter postoperative hospital stay. Laparoscopic repair took more time than open surgery.Conclusion: laparoscopic repair of perforated peptic ulcer is advantageous to open surgery by less postoperative pain, earlier return to normal diet, and earlier discharge from hospital. It may be considered as a safe treatment option for selected patients in routine clinical practice.

Introduction: the cause of preeclampsia has not been precisely understood. One of the reasons, as stated by some, might be resistance to insulin however, the role of insulin resistance in occurrence of preeclampsia has not been proven so far. Hence, the objective of this study is to find out the relationship between insulin resistance and severe preeclampsia.Materials and Methods: In this case-control study 26 healthy pregnant women and 26 women with severe preeclampsia, for whom termination of pregnancy was concluded, were included. Both groups in terms of age, weight, parity and body mass index (BMI) were identical. Furthermore, FBS level, fasting blood insulin and resistance to insulin at the same laboratory and by similar procedures were evaluated for both groups throughout the study and documented in relevant forms. The data were analyzed by SPSS software and P value <0.05 was considered significant.Results: The results showed that the level of FBS was not significantly different in preeclamptic patients and healthy pregnant control (p=0.062). Moreover we found that the levels of fasting insulin was similar within two groups (P=0.80).Conclusion: In current study no relevant was observed between severe preeclampsia and resistance to insulin.

Background: Adenoid hypertrophy is associated with high morbidity rate in children. Although surgical treatment is indicated in severe cases, however, there are evidences that some medical interventions are effective in improvement. This study was conducted to evaluate the effectiveness of beclomethasone nasal spray on reduction of airway obstruction due to adenoid hypertrophy.Methods: In a clinical trial study 31 children between the ages of 3-13 years suffering from excessive adenoid hypertrophy were administered beclomethasone nasal spray (2 puffs each 12 hr) for duration of 8-week.All subjects were evaluated for adenoid size and grade of airway obstruction before and after the intervention by lateral neck radiography.A questionnaire was filled in by subjects’ parents to assess obstructive symptoms before and after the intervention.Results: Radiographic findings revealed that after treatment adenoid size was significantly less than its size before treatment and airway diameter was significantly more than before treatment.Also finding showed that severe and moderate forms of nasal obstructive findings after intervention were significantly less frequent than before it.Conclusion: According to our research, topical nasal beclomethasone can lead to decrease the size of the adenoid and the severity of upper airway obstructive signs and symptoms, as well as eliminating the daily somnolence of children with adenoid hypertrophy.

Introduction: Propanil is a pesticide with medium to low toxicity for mammals, but heavy ingestion of the poison can produce significant clinical manifestation. However, it has been reported rarely worldwide.Case report: A 15year old girl ingested propanil in a suicide attempt. The patient developed methaemoglobinemia, respiratory distress and decreased level of consciousness which needs intubation and paediatric intensive unit management.Discussion: Since the mechanisms responsible for the clinical manifestation of propanil are tissue hypoxia and methaemoglobinemia, the diagnosis and treatment of them could be lifesaving for the patient.

Mediastinal impalement is a very uncommon and often fatal injury and one of the most severe types of penetrating chest injuries. Patients with this type of injury always undergo operative intervention regardless of the hemodynamic state or associated injury and only a few cases have been reported in which the patient recovered without any sequel.We present a previously unreported case of mediastinal impalement injury in which a 20-cm long stab was entered through the manubrium and remained within the anterior mediastinum with no cardiac, great vessel or hilar injury. The patient remained hemodynamically stable and the foreign body which had penetrated the pericardium and been stopped near the pulmonary artery was extracted via sternotomy incision.Follow-up of the patient for about 9 months revealed no complication or residual effect of his accident.

The patients is a 40 year old man a case of acute myelomonocytic leukemia AML M4 (CD13+,CD33+,CD14+) who received induction of remission by 7; 3 (cytarabine 100 mg/m2 and Idarubicin12mg/kg) regimen, he also received 5;2 (cytarabine 100 mg/m2 and Idarubicin12mg/kg) as consolidation treatment. He was candidate for allogenic stem cell transplantation from HLA matched sibling but a few days after consolidation chemotherapy developed generalized erythematous raised skin papules that became confluent in some areas. Skin biopsy was taken.