TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)
Year:2003 | Volume:61 | Issue:3|Papers Count:13

Background: This study was carried out to examine the comorbidity of depression and anxiety disorders. Materials and Methods: 261 depressed (n=153) and anxious (n=108) patients were psychiatrically interviewed, and then tested by two scales, BAI and BD1; 261 healthy subjects (matched with depressed and anxious patients) completed BAT and BD1 as well. Results: The results showed that %55.6 of depressed and %58.3 of anxious patients had respectively a comorbid anxiety and depression disorders. Conclusion: The detection of symptoms overlap revealed that depressed patients experienced most of the anxiety symptoms, and anxious patients reported most of the depression symptoms. The prevalence of depression and anxiety symptoms among healthy subjects will be discussed.

Background: One of the useful function of melatonin is its protective effect against endogenous oxidants. The object of this investigation was to study the protective effect of melatonin on stress-induced gastric lesions. Results: Our results show that pretreatment of animals with melatonin decrease the stress-induced gastric lesions dose dependently. L-NAME, a nitric oxide synthesis inhibitor, potentiat the stress-induce gastric lesions and melatonin produced gastro-protective effect against concurrent stress and L-NAME-induced gastric lesions. Conclusion: Our results indicate that melatonin may produce its gastro-protective effect Via increasing level of nitric oxide.

Background: Methicillin resistant staphylococcus aureus (MRSA) is a predominantly nosocomial pathogen which its prevalence has increased worldwide over the past three decades. Materials and Methods: This is a descriptive cross-sectional study. The following study is designed for determination of prevalence of MRSA infection through measurement of MICs of S. aureus isolates in Imam Khomeini Hospital (a teaching hospital) from November 2001 to January 2003. A total number of 402 specimens were isolated and specified as S. aureus by Imam Khomeini microbiology lab. Demographic and clinical data and results of MIC were analysed by Epilnfo 6 software. Results: During the study, staphylococcus aureus was isolated from 402 patients that 187 (46.5%) of isolates were MRSA and 215 (53.5%) were MSSA. Of 402 patients, 254 (63.2%) were male and 148 (36.8%) were female. The difference of the prevalence of MRSA between males and females was not statistically significant (p= 0.09). The difference in mean age in MRSA and MSSA groups was not statistically significant (p= 0.55). In the age group of < 1 month, the prevalence of MRSA infection was significantly higher than other groups (P=0.01). Conclusion: In this study, the prevalence of MRSA infection was increased, statistically significant in the presence of such factors as sepsis, longer duration of hospitalization, hospital- acquired infection, history of invasive procedure, history of antimicrobials used in the past 3 months and type of administered antimicrobial (s), history of hospitalization in the preceding year, certain underlying diseases, type of admission ward, type of infection, type of specimen and type of administered antimicrobials for treatment. Surprisingly, the prevalence of MRSA infection in IV drug user group was low that was statistically significant (p< 0.0001). In this study, there was no statistically significant difference in outcome between MRSA infected and MSSA infected patients. Based on results of this study, prevalence of infections due MRSA in this hospital are high, therefore addition to diagnosis of risk factors of MRSA infections, application of standard infection control practices should be done for limitation of these infections.

Background: Inverted papilloma is an uncommon benign neoplasm originating from lateral nasal wall. It commonly invades paranasal sinuses and sometimes invasion to orbit and intracranial structures are seen. There are many surgical methods for its treatment, one of them is endoscopic transnasal approach. Materials and Methods: Between 1997 and 2001, 11 patients with this tumor were operated in Amiralam hospital in Tehran and Shahid Rahnemun in Yazd. Nine patients were operated by endoscopic transnasal route and two patients by combined Caldwell-luc and endoscopic transnasal routes. Results: Tumors were on the right side in 3 patients, on the left side in 7 patients, and bilateral in one patient. There were no intracranial or orbital extensions. No pathologic report of malignancy was made. Surgical technique included complete tumor resection, anterior and posterior ethomidectomies, sphenoidectomy, frontal recess tumor resection and wide maxillary antrostomy, in cases in whom tumor was attached to lamina papyracea, the lamina was removed without any manipulation to orbital periosteum. Mean follow-up time was 29.8 months. There was no recurrence in 82% of cases. Tumor recurred in 18% of cases. No complications were seen. Conclusion: Although the standard treatment for this tumor is medial maxillectomy but endoscopic resection is an effective method in surgery of this tumor. It seems that if tumor does not extend to areas unreachable by endoscopic surgery, due to lower morbidity and excellent visualization of tumor, this method is preferable.

Background: Ambiguous genitalia means difference between gonads morphology and external genitalia. Gender assignment and surgical correction must be done as early as possible to assure unambiguous bonding between the parents and the child. The purpose of this study was to evaluate Ambiguous genitalia in a referral children surgical center. Materials and Methods: We retrospectively reviewed records of 200 patients admitted to children medical center hospital in a period of 16 years for Ambiguous genitalia surgery. Data about clinical and laboratory examination collected and analyzed. Results: The prevalence of female pseudohermaphrodism, male pseudohermaphrodism, ture hermaphrodism and Mixed gonadal digenesis was 70.5%, 20.5%, 5% and 4%, respectively. 76.5% and 23.5% of the patients was converted to female and male, respectively. 29% had congenital Adrenal hyperplasia of whom 86.5%, 10.5% and 3% had 21-hydroxylase deficiency, 11β hydroxylase deficiency and 3β HSD deficiency, respectively. 70.5% had 46xx karyotype and 21.5% had 46xy karyotype and the remainder were musaic. 52.5% had relative parents. The malformation were corrected by vaginoplasty (105 patient) and clitoral resection (51 patients). A variety of anomalies was seen. Conclusion: Age of presentation ranged from 1 day to 13 years. 151 patients were diagnosed in infancy, but only 43 patient was brought for treatment in infancy to this center by parents.

Background: The aims of this study were to determine incidence and types of observable congenital abnormalities among births of Mirza Kochak-Khan, Imam Khomeni and Shariatti hospitals between first of November 2000 to the end of September 2001. Materials and Methods: We used neonates that survived for 24 hours after delivery. A questionnaire was specially designed to explore each of the objectives for our study. A group of experts that were thoroughly trained to completed questionnaires by interview to mothers and evaluation of neonates. Data analysis was performed and by Excel and SPSS. Results: Results showed that congenital abnormalities were present in 205 (3.2 %) of 6424 neonates, from 3 hospitals. The most frequent abnormalities consisted of musculoskeletal defects (37.3 %) , Nervous system defects (24.7 %), urogenital defects (24.3 %) head and neck defects (13.6 %).Conclusion: The result of this study showed that incidence of visible congenital abnormalities ratio in contrast to other countries have not significant difference but the types abnormalities were significant.

Background: LP(a) level in uremic patients is high. It has recently considered that the effect of androgens on lipids vary widely. The aim of this study was to determine the effect of nandrolone decanoate on lipid profile in chronic hemodialysis patients. Materials and Methods: thirty six stable male patients over 40 years who were under maintenance hemodialysis were randomized to receive nandrolone decanoate , 100 mg weekly for six month, by intramuscular injection on nondialysis day (Group A, N=18) or B complex (Group B, N=18). Between September 2001 and 2002, male hemodialysis patients more than 40 years old without history of high prostatic specific antigen (PAS) or sensitization to drug were started on treatment with androgen therapy. The evolution in the liquid profile was prospectively assessed immediately before the first dose of nandrolone decanoate (basal values) and at 2, 4 and 6 month of therapy. The evolution of lipids after withdrawal of androgens at 2 month after the last dose was also studied. The patients underwent hemodialysis 3 to 4 hours three times a week. The dialysis schedule was not modified during the period of study. Results: Mean decrease of LP(a) level in group A was significantly lower then group B in second month (p<0.05). Surprisingly HP level decreased also in second month. Other lipid parameters did not show significant changes. Conclusion: In this study we observed that nandrolone decanoate affects on LP(a) level< but the changes of it did not correlate with those of hemoglobin or other lipid parameters< suggesting that the underlying mechanisms are unrelated. Our finding might be affected by low dose of the drug. Further studies with higher doses will be requied to clarify the beneficial or adverse effects of this type of therapy.

The genus acinetobacter are intestinal gram negative, encapsulated, non motile, aerobic bacilli, which are rod shaped during rapid growth and cocobacillary in stationary phase. Risk factors associated with nosocomial infections include: length of hospital stay, surgery, wounds, previous infection, fecal colonization, treatment with broad spectrum antibiotics, parenteral nutrition, indwelling central intravenous or urinary catheters, admission to a burn unite or ICU and mechanical ventilation. Acinetobacter meningitis occur infrequently and is generally found after neurosurgical procedures. Here, we are presenting a 19 year-old female patient who developed multi-drug resistant (MDR) acinetobacter meningitis after operation on maxillary bone, but despite good clinical response to imipenem and amikacin succumbed aminoglycoside induced otoxicity.

Background: Atrial septal anomalies suggested to play important role in enhancing tendency to induce cerebral embolic events. This study was undertaken to find the frequency of atrial septal anomalies including Patent Foramen Ovale, Atrial Septal Aneurysm and Atrial Septal Defect in patients with etiologically unknown stroke categorized as cryptogenic. Materials and Methods: 32 patients were studied by transthoracic and transesophageal echocardiography. Results & Conclusion: The mean age was 50.2 years and standard deviation 10.9 years. 17 patients were male and 15 females, of them 40.6 percent had Patent Foramen Ovale, 15.6 percent had Atrial Septal Aneurysm and 6.3 percent had Atrial Septal Defect. 60 percent of patients who had Atrial Septal Aneurysm had also Patent Foramen Ovale.

Background: Essential hypertension is one of the risk factors of cardiovascular diseases. Hypertension etiology is not completely known, it seems that rennin -Angiotensin system has an important role in its etiology, Thus better recognition of this system and its activity changes or vascular reaction changes to different parts of this system during progressive hypertension can be more effective in better recognition of the disease progress and treatment. Materials and Methods: In this study responsiveness of mesenteric vessels of Goldblatt two kidney- one clip (2k-lc) renovascular hypertensive rats to angiotensin I and II with and with out captopril during a time of two , four , six and eight weeks after hypertension induction was investigated and compared with control and surgical sham groups. Results: This study shows that vascular responsiveness to angiotensin II in animals that passed four weeks of their hypertension , (p<0.05) and in the sixth and eight week of post induction hypertension (p<0.01 and p<0.001) has a significant different with both sham and control groups. Also it has been observed that an increased reaction to angiotensin II with an increased significant rate of arterial hypertension in hypertensive group. In the other hand in spite of inhibition of angiotensin converting enzyme by captopril in animals that have been eight weeks hypertension , on the contrary to other groups reactive to angiotensin I. Conclusion: Results of this study show that vessels reaction to angiotensin I and II increased due to six to eight weeks post induction renal hypertension. Captopril does not inhibite mesenteric vessels reaction to Angiotensin I in hypertensive Rats after eight weeks. Try to completely inhibit production of angiotensin II maybe a hopful way in controlling essential hypertension.