Tehran University Medical Journal
Year:2004 | Volume:62 | Issue:7|Papers Count:18

Background: Cellulite is a common problem in women and is due to some alterations in subcutaneous fat tissue and mainly involved thigh and buttock of young women. Different treatment (including medical and surgical) are proposed for this problem. In this paper, we evaluate therapeutic effect of yobelean cream(an a2 antagonist) in the treatment of the disease. Materials and Methods: Twenty women participated ina triple blind clinical trial lasting 4 weeks. Yobelean was applied on right thigh and buttock and placebo on left thing and buttock. Thickness of subcutaneous fat tissues was assessed by sonography and measuring circumference of thing in two fix point of thing before and after the treatment and also by patient s subjective evaluation. Results: Mean upper thing circumference lowered 0.5±0.62 Cm (p=0.002) and lower part up to 0.125±0.27 Cm (p=0.056). In sonographic evaluation, subcutaneous fat tissue lowered up to 3.6±3.9 mm (p=0.001) in upper part and 1.3±1.4 mm (p=0.0001) in lower part. This profile wasn t significant in left side. Conclusion: This study showed that local application of Yobelean is effective in reducing cellulite. Further studies with greater sample size and longer treatment course can prove results more carefully.

Background: Tinea capitis is a common dermatophyte infection which constitutes an important public health problem among children world wide.Materials and Methods: A total of 1568 patients with suspected tinea capitis were examined for causative fungal agents between 1994 and 2001.Results: Laboratory examination confirmed tinea capitis in 209 patients. Male affected more frequently (67.5%) than female (32.5%) and in both sexes, those who were 3-11 years old, more infected. Trichophyton violaceum was the most common etiological agent (37.8%) followed by Trichophyton schoenleinii (22%), microsporum canis (16.7%), Trichophyton verrocosum (14.8%), Trichophyton tonsurans (5.7%), Trichophyton rubrum (1%), Microsporum gypseum (1%) and Trichophyton mentagrophytes (0.5%). We isolated anthropophylic dennatophytes from more than 66% of cases. Higher disease incidence was found to be correlated with larger family and poor hygienic. The findings are discussed in relation to the childrens different socioeconomic and hygienic back grounds. Tinea capitis is known to spread easily especially among family members and among school children. Conclusion: Asymptomatic individuals may be a more important vector in the transmission of scalp ringworm. In addition to school as an important source of infection home might be an even more important source especially in families with asymptomatic carriers of T. violaceum or T. tonsurans.

Background: Detection of poisons as a postmortem finding has to diagnostic importance in forensic pathology. Using of tissues those need minimal handling of corpse is a goal. Opioid toxicity is the most common cause of poisoning in corpses those referred autopsy. So we decided to conduct a research on the site of injection as a valuable analytical tissue.Materials and Methods: In this study 54 corpses who returned to autopsy room at Legal Medicine Organization (LMO) during year 1380 with addiction to opioid were investigated. The latest injection side determined in each case. Cases with pre-mortem hospital admission, post- mortem putrification and signs of bums as any cases of death other than opioid injection were not included with study. In addition to used external examinations and autopsy the blood, urine, visceral and injection site tissues specimen were separately packed in standard containers, sent to Toxicological laboratory in that Organization.Results: The results of studies as samples with Thin Layer Chromatography (TLC) were achieved as follows: In toxicological exams on urine, blood, and visceral specimens, 47 cases (87%) yielded definitely at least one opioid positive result with 7 cases opioid negative results in all investigated specimens. No opioid positive result was achieved from injection result Was achived from injection sites samples of all cases. Conclusion: Conclusively this study mentions that laboratory examination on venous injection site with TLC to determine opioid injection is insensitive.

Background: Nitric oxide is involved in numerous biological processes as a neurotransmiter, and neuromodulator. So far different activity is attributive to its presence. Goal of present study is the assessment of androgenic steroide activity on the level of NO serum concentration and its interrelation with the animals anxiety.Materials and Methods: Due to 4 stages of sexual cycles, 40 female rats were selected and randomized to 4 group. The members in each group were subjected to vaginal smear, and estrous cycles stage determination. Blood samples were derived to determine the relation of anxiety to the nitrate and nitrite concentration of serum.Results & Conclusion: The results of the study are an indication that the anxiety during the length of experiment is under the influence of androgenic steroid activity, and nitric oxide plays a crucial role in this respect.

Background: Motor control evaluation and analysis of its specifications for diagnosis of neuromuscular diseases are a new approach III clinical electroneurophysiology, that is based on the changes of electromyography responses and classic reflexes in this field. Assessment of motor control by electromyography can produce new knowledge for clinical diagnosis or functional evaluation. Therefore, EMG and surface recording from muscles can evaluate one of the most complete aspects of motor control such as gait and walking. In this study quantitative power spectrum frequency used for changes of motor control strategies. Materials and Methods: Twenty five healthy subjects (15 women and 10 men) between 20 to 30 years old participated in this study. After attachment of surface electrodes on tibialis anterior and gastrocnemius muscles, subjects walked without foot wears on treadmill with three speeds, comfortable (80 m/min), slow (40 m/min) and fast (120 m/min).Results: Results indicated with increase of gait velocity, mean and median frequency of gastrocnemius muscle were reduced, whereas in contrast to it, mean and median frequency of motor units recruitment were increased significantly (P<0.05).Tibialis anterior muscle activities evaluated in tree gait speed and two types of contraction, concentric in initial swing and mid swing stages, and eccentric in late stance stage. Following increase of gait velocity, median frequency of concentric contraction was reduced, whereas in eccentric contraction, increase of median frequency was observed (P<0.05).In concentric contraction, the firing rate of motor unit recruitment was increased by increment of gait velocity (P<0.05), but in eccentric contraction, was no significant changes. At the same time, with increment of gait velocity in fast speed, values of RMS, ARV and lAV were increased (P<0.05). In comparison to maximal isometric contraction, muscle force estimation in fast speed was increased, and also muscle force was increased at slow speed walking in comparison with comfortable speed (P<0.05).Conclusion: Motor control mechanism will follow of specific patterns at individual changes level in constant environment and task, and on the basis of time and biomechanical factors show changes of behavioral movement. Therefore, increase of firing rate for high force is not parallel to increase of frequencies values of muscle contraction and cognition of subject from movement and type of task demand determine motor units recruitment.

Background: Diabetes mellitus (DM) is the most common pediatric endocrine disorder. Morbidity and mortality stem from acute metabolic derangement and from long term complications that affect small and large vessels and infections. Sometime special type of infection can be the first presenting symptom of DM. Association of DM and infection can act as a vicious cycle. Infection cause uncontroled DM and resulted in uncontroled infection. With awareness of these problems and according to some references that "local and systemic infections are not more common in diabetic children" we decide to have a study about diabetic children.Materials and Methods: The study done from Feb 1998 to Feb 2003 on 90 cases that admitted with diabetes mellitus. The patients were between 3 y- 18 y old with mean of 10.2 yr. Duration ofDM was between 0-94 no and mean of33.5 moo Results: Out of 90 cases, 40 patients have at least one form of infection and 25 cases (62.5%) female and 15 cases (37.5%) male. The most rate of infection was in 7- 9 yr old. Fungal. infections were the most common type of infection. The most common infection was vulvovaginitis (17 cases) that 6 of them came with cc of vaginitis resulted in diagnosis of DM. UTI was the second infection and sinusitis was the third.Conclusion: According to the results of this study, infections are more common and serious in diabetic children than healthy children and fungal infections were the most common type.

Background: Splenomegay is a common finding in numerous diseases such as hepatic, hematologic and metabolic diseases and also in any systemic inflammation. The purpose of this study was to evaluate the grading of splenomegaly in various diseases and to compare them with healthy control subjects.Materials and Methods: Sonography was used to evaluate splenic index (SI) in 640 patients and 200 healthy control subjects prospectively in Imam Khomeini hospital between 13,79 and 1381. To express spleen size, splenic index was used which is a known method. SI was obtained by the following formula: SI(cm2)= a(cm)x b(cm) where a is the transverse and b is the vertical diameter of the largest coronal sectional image of spleen.Results & Conclusion: Splenomegaly was present in high percentage of the patients, even though a majority of these spleens were not large enough to palpate. By grading of SI ,characteristic distributions of SI for different types of diseases were obtained. Obtaining and grading the SI by sonography appears to be a significant supplemental aid for evaluating and sub grouping splenomegaly, specially in patients whose spleen are not palpable.

Background: The efficacy of oral nalidixic acid was compared with intravenous cefriaxone in the treatment of acute shigellosis in children 6 mo-12 yrs old of age.Materials and Methods: In a randomized clinical trial (single blind) we studied 110 comparable patient admitted in Bahrami hospital with primary diagnosis of shigellosis (clinically suggested of shigellosis and confirmed by stool culture) at 2002-2003. Patients were randomly assigned to receive either intravenous ceftriaxone 50 mg/kg/day single dose for 2 days or nalidixic acid 55 mg/kg/day in divided doses for 5 days orally.Results: In the results, there was not any statistically significant difference in the diarrhea resolving period, fever resolving period, hospitalization period, negativation of sic and prevalence of shigellosis complications in the course of treatment between two groups. Conclusion: According to results, nalidixic acid is effective and safe as well as ceftriaxone in the treatment of acute childhood shigellosis. However we recommended, "nalidixic acid" is a good substitution for treatment of uncomplicated childhood shigellosis.

Background: Nosocomial infection is a serious health and financial problem.The purpose. of this study was to determine the extra hospital , stay attributable to nosocomial infection, sin surgical patients.Materials and Methods: All surgical patients admitted during February 20, 2000 to February 19,2001, to the 38 beds general surgery ward within a university hospital in Shiraz, Iran were included in this study. The study was planned as a pair wise matched case-control study nested in cohort design. A case was defined as any patient with one of four of the following nosocomial infections: Urinary tract infection (UTI), surgical site infection (SSI), blood stream infection (B.SI) and pneumonia (PNEU), whereby definitions for the nosocomial infections were based on national nosocomial infection surveillance (NNIS) system definitions. For each case, an appropriate match was selected, which resulted in 69 pairs of study patients. Results: In total, during the study period, the incidence of nosocomial infection during the study period was 17.59%. The mean extra length of hospitalizationdue to all major kinds of nosocomial infections was 6.62 days totally, which was obtained 4.4, 5.33, 8.73 and 9.2 extra days for UTI, PNEU, SSI and BSI respectively. Conclusion: Nosocomial infections add cOlisiderable costs to the health care system in Iran, therefore developing strategies, concepts to reduce the incidence of nosocomial infections are cost-effective and warrant, and an appropriate surveillance system based on international criteria is the cornerstone for this task.

Introduction: The coronary artery anomalies in tetralogy of Fallot (TOF), influence the timing and outcome of surgical measures, and then preoperative detection of these abnormalities is very important.Methods and Materials: With the aim of evaluation the incidence of coronary artery anomalies in TOF, we have retrospectively studied 369 patients (mean age: 7.8 ± 4.8 years referred to Shahid Rajaii Hospital from 1996 to 2000.The diagnoses were confirmed by echocardiography, catheterization and surgery.Results: The incidence of coronary artery abnormality was 6.8% (25/369) and the sensitivity of echochardidgraphy in diagnosis and detection of these anomalies was 80%. The most common anatomical anomalies were: a large conus branch in 13 (3.5%); single coronary artery in 6 (1.6%) left anterior descending artery (LAD) originated from right coronary artery (RCA) in 6 (1.6%); and enlarged RCA in one patient (0.3%). There were not significant differences between patients with and without coronary artery anomaly in the age of TOF diagnosis and rates of associated cardiac anomalies.Conclusion: In this study, we have shown a noticeable prevalence of coronary artery anomalies in a sample of Iranian patients with TOF. Because the surgical importance of these abnormalities and their effects on mortality and morbidity of patients with TOF, these results make us to detect these anomalies by more sensitive diagnostic methods.

Introduction: septic shock is one of the most important modifiable causes of death in the world. Underlying diseases predispose patients to sepsis and septic shock are numerous and special attention should be devoted to assessment of any underlying disorders to modify the outcome. So we decided to investigate the frequency of the underlying or predisposing disorders in patients with septic shock.Material and Methods: Over 7 years (1995-2001), in a case - series study, we collected clinical and laboratory data of 41 patients with septic shock and determined frequency of some risk factors and underling conditions.Results: The most frequency Ages was between 60-69 years old and septic shock was more frequent in females than males (56%), urinary catheter was the most invasive instrument in our patients. The mortality rate was 55% and most frequency origin of infection was gastrointestinal tract (31%). Most of patients had no underling diseases.Conclusions: Despite the availability of new antibiotics, mortality of septic shock was high, so efforts should be directed toward early diagnosis and appropriate management of these patents. Effective management of underlying disease in sepsis is critical for treatment of septic shock as the prevention is the management.

Introduction: Infectious disease are more prevalent among injection drug abusers. The aim of this study is to determine the most prevalent injection complications, in injection drug abusers of Isfahan.Methods: In this cross-sectional study, 400 injection drug abusers were studied. All studied subjects were examined clinically and according to their physical examination results and the history of previous complications like skin abscess, brain abscess, endocarditis, bleeding, arterial aneurysm and amputation, the prevalence of different complications was determined. Obtained data were analyzed using chi_square and one way analysis of variance.Results: In this study, 0.5 % had endocarditis, 27.75 % had skin abscess, 32.75% had arterial aneurysm, 23% had bleeding, 0.25% had brain abscess and 0.25% had amputation in their medical history. 6% of the injection drug abusers had history of admission. skin abscess was the most cause of admission comprised 25% of cases. Aneurysm was the ,most common complication in medical history and the most finding in examination but skin abscess was the most complication that had led to hospitalization. Discussion: Arterial aneurysm, skin abscess and bleeding have high percent among injection drug abusers. However other complications like endocarditis and brain abscess have low percent, they have high morbidity and mortality. Thus prevention and timely treatment of this complications is seems to be necessary.