Journal of Medical Council of Iran
Year:2003 | Volume:20 | Issue:4|Papers Count:11

4 pateints with epigastric discomfort referred to imam khomeini hospital for upper gasterointestinal endoscopy were enrolled in this study, Helicobacter infection was confirmed with rapid urease test; culture and histological methods, with Gold standard tests were positive culture or positive PUT along histology.HPSAT was compared; and goldstandard for negative infection; was negative Rut; negative culture and histology.26 patients with positive infection: were treated with omeprazol tetracycline: metronidazol, Bismuth subsalsylate, for 2 weeks. then 1 and 3 month later reevaluated with goldstandard tests and HPSAT.Sensitivity and specifcity and accuracy of helicobacter pylori stool andtigen test, befor eradication was 78.6% , 92.3% , and 85.2% respectively. 1 month after eradication sesitivity and specificity and accuracy of test was 100% and 56.5% and 61.5% respectively and 3 month after treatment was 85.7% ,89.5% and 88.5% respectively. These results impilicate that HPSAT for primary these infection is an excellent method, but its specificity and diagnosis of pylori accuracy in early period follow up of eradication are low.Also 3 month following eradication and later, HPSAT has very good and acceptable results.

In this study, 96 files of patients with complications of shunt procedures for hydrocephalus during a 10 year period were reviewed. A total of 437 shunt procedures and 137 operations for complications of shunt procedures were conducted on 96 patients at neurosurgical department of Shohada hospital during a 10 year period.This study is aimed to evaluate all of the complications of shunt procedure and a comparison of their relative incidence and an evaluation of factors causing them. The most common complication was ventricular catheter obstruction (41.66%), followed by shunt infection (29.1%). We couldnot find any significant relationship between the sex of the patients, system, type and side of the shunt and complications, except for Pudenz shunt which had the lowest rate of shunt revisions in our patients.In addition, there was a direct relationship between the total number of shunt revisions and positive past history of shunt revision. The average number of revision procedures in our study was 1.7 which was not statistically different from other studies (1.5-2.5), but the relative frequency of our shunt infection was more than other series.

In traditional medicine, the depressed and exhausted patient extended his hand towards the doctor and by providing his history asked for his help. These days, the patient having some awareness and relative information about his/her problem enters in to a dialogue/consultation in solving the problem.In order to assess physician- patient dialogue, in teaching hospitals located in the North, South, East and West of Tehran, an in terview was conducted with 2000 patients while being discharged from the hospital. According to the patients remarks, the study showed that physicians listened patients" histories and complaints (86%), A honestly tackle them and pay respect to their personality (85%), but patients mostly males, educated ones and the older ones were critical of the fact that the physician did not have the needed discussions with them about the different treatment modalities (45%), possible adverse effects of the treatment regimen (53%), and the outcome of the disease(35%) if can be concluded that the physicians carefully listens to the patients complaints but themselves do not engage in sufficient dialogue.

senescence is associated with several changes in different organs including the endocrine system so much so that thyroid disorers in elderly are about 2 fods in the young with a 3-4% of elderly people suffer from hypo or hyper throdism. The aim of this stdy was to assess the frequency of thyroid disorders in people older than 60 in rehabilitation centers at Tehran. in this cross - sectional study, 340 over 60 year of age in 9 rehabilitation centers in Tehran were evaluated. Participants had no history of chronic diseases or consumption of drugs affecting the thyroid. All participants underwent a thorugh examination with emphasis on signs of thyroid dysfunction. Serum specimens were obtained for thyroid function tests (T3 - T4 - TSH). Of all the participants, 15 people were excluded.results showed 70.6 percent female and 29.4 percent as female. The mean age was 76.4+ 11 tears (60-105 years). The mean values of serum TSH, T3, and T4 were 2.17 Iu/ml, 108 ng/dl and 9.8 Mg/dl, respectively Serum TSH in 2.2 percent of participants was over 10 IU Iml and in 1.5 percent was between 5-10 IU/ml. Utilizing the IRMA method, 3.7 percent of participants had TSH>5 Iu/ml. Of the participants, 4.4 percent and 9.8 percent had TSH under 0.1 Iu/ml and between 0.1 and 0.3 lu/ml, respectively.according to the findings of this study we suggest screening tests for all persons abaove60 years -despite no apparent symptoms.

The main purpose of our Hospital Based Registry was to study the epidemiology of cancer patients who were referred to our center for treatment The information obtained from this study would enable us in the management of the personnel, education, research and treatment depending on the the needs of country. On the other hand this pilot study would serve as a basis to be compared with data both inside and out side the country. It is to be remembered that most epidemiological data about ctuntcancer from other countries refleets a relative prevalence.Our survey showed that after excluding skin cancer, in the male population the commonest cancers had been esophageal cancer, malignancies involving the lymphoid system, blood and lungs where as in the female population, breast cancer, cancer cervix and esophageal cancer were found to be common in that frequency. The data obtained during a 25 year period shows a decreasing frequency of cervical cancer whereas breast cancer is on the rise. Lung cancer also is on the rise but it is still low compared to other countries. Owing to the increase in population and since half of the population fall within an age range of under 20 years, leukemia and tumors of the brain appear to be more common in this age group. Bladder and laryngeal cancers because of their stoong correlation with factors such as cigarette smoking, opium and industrial pollution can be prevented to some extent. Esophageal cancers continue to remain as a dlilemma.Contrary to the above data, little progress has been achieved in the results and treatment.Since cancer, specially in the early stages is treatable, early defection remains the corner stone for these cases.In breast cancer, screening in susceptible patients not only decreases the occurance of invasive cancer but decreases mortalily from these cancers.

The jaws and associated with fascial spaces infections are common and some times result in serious complications. To better understand the etiologic and predisposing factors in these infections, we conducted a cross sectional study.The cohort consisted of 56 patients with jaws and associated facial spaces infections admitted to oral and maxillofacial surgery Shariati Hospital between Feb 1 1999 and Jul 31 1999. Data concerning source and location of infections, age, sex, oral hygiene, smoking, alcohol and drug abuse, underlying systemic disease, were evaluated. Also the most frequent teeth to cause infection were identified. - 71.4% (N =40) of the patients had odontogenic infections while the remaining 28.6% (N =10) had nonodontogenic infections.- Underlying systemic disease was the prevalent cause in nonodontogenic infections.- A finding of this study was the predominance of male patients (62.5%) against female (37.5%).- The most common age range for two groups of infections was 20 to 30 years.- 75% of patients had a poor oral hygiene.- The buccal space was the most frequently encountered location for odontogenic infections.- Intrabone was the most frequent location involved in nonodontogenic infections.- First mandibullar molars were the prevalent cause in odontogenic infections.

Smoking in most countries around the world is the leading preventable cause of premature mortality and morbidity. According to the existing data, three million deaths annually could be reach ten million per year in just less than 20 years.Medical students as future doctors play an important direct role in tobacco prevention and non_medical university students stand as a model of non_smoking educated character among others. Therefore, Knowledge of smoking control in the whole society.Thus, We set out of determine the habit of smoking among university students by a cross - sectional study. A number of medical and non - medical schools of Tehran were randomly selected. A number of medical and non_medical school of Tehran were randomly selected. A questionnaire designed according to standard WHO & IUATLD questionnaire was then filled by first year and final year students of each school. A total of 1066 properly filled questionnaires were analyzed. Out of this population,174 smokers (16.3%)were found that consisted of 150 male(25A% of males) and 24 female (5% of females) students. A significant difference existed between rate of smoking in first year( 12.3%) and final year students (20.1%).Seven(2.7%) of the 24 female students study in the first year and the remainder(7.8% of final year females) study in the last year of university (P<0.05) Moreover, medical students, males and females, smoked significantly more than their non-medical counterparts (p<0.05) .The data indicate that male students smoke with a similar rate of general population, While female students smoke more than estimated for Iranian female poulation. More importantly, smoking rate increases significantly during university years which shows lack of appropriate presentation of facts related to smoking, to students. Accordingly, integration of related topicis in curricula of both medical and non_medical universities seems sessential.

Transferrin is an iron carrier in blood stream and iron binding to it takes place through a specific membrane receptor at the cellular level. A small amount of the external portion of the receptor is cleaved and released in to the blood. This protion is called soluble Transferrin receptor (STR). STR is increased in Iron deficiency Anemia and decreased in Acute Iron poisoning. To consider the value of STR measurement in determination of Iron overload in β thalassemia, STR levels were determined in 56 thalassemia patients and 23 apperantly healthy volunteers, by ELISA method. Results were compared by T-student test. The mean values of STR in case and control were 8.06±0.45mg/l and 1.5±0.17mg/I respectively. The means showed a significant difference (P<0.0001).Then the cases were divided in to two groups on the basis of having regular or irregular blood transfusion. The mean values for STR levels were 6.70±0.73mg/I and 9.42±0.76 mg/I respectively, which did not show a significant difference(P=0.45).STR level is proportional to the ineffective erythropoesis in thalassemic patients, so regular blood transfusion is a method to reduce ineffective erythrnpoesis and prevention of its side effects such as abnormal growth of bones and osteoporosis, but because there is not any significant difference between the two thalassemic patients groups, we may conclude that they have not such a big difference in the ineffective erythropoesis.

Post traumatic stress disorder (PTSD) is one of the most common psychiatric disorders among veterans. Many of them suffer from violence and legal problems but there is no report of filicide in patients with PTSD and a relationship between this disorder and criminal activity isnot well understood. ln this article, an iraniar veteran with chronic PTSD and major depressive disorder commiting with filicide is being introduced. He murdered his 3 years old daughter and injured his wife 6 years ago during a flushback episode. As the patient wasnot psychotic and epilepsy was ruled out, relationship between PTSD and criminal activity in subject was discussed. It seems that PTSD without psychotic symptoms may account for criminal activity at least in some patients.

Human papilloma virus (HPV) is innoculated into the female genital tract via sexual contact, and causes histological changes and related signs and symptoms.The clinical manifestations may be in the form of condyloma accuminata as well as precancerous lesions in various parts of the female genital tract. These days HPV is incriminated to be the causative agent of cervical cancers. Elaborated subclinical diagnostic are based on the measurement of virus DNA.Treatment consists of medical treatment, surgery and destructive methods.New home friendly drugs have been popularized in recent years. The latest drugs are imiquimod which could be used at home on an outpatient basis or protocol and the advrese drug reactions are minimal compared to comparative treatment regimens. Subclinical infections due to HPV do not need Specific treatment.Despite the prevalence of these infections, standard remedies are still not available.