Journal of Medical Council of Iran
Year:2000 | Volume:18 | Issue:1|Papers Count:11

Previous studies have clearly shown that 2 weeks standard triple (Metronidazole + Bismuth + Tetracycline) or ranitidine + triple therapy (RMBT) always resulted in eradication of <80% in Iranian HP infected DU Patients. This is probably due to Metronidazole resistant rate of >40% in our DU Patients. The aim of this study was to compare 2 weeks clarithromycin - based regimen (Clarithroiycin + Bismuth + Tdracycline + Omeprazole= DCBT) with 2 or 3 weeks RMBT therapy and to elucidate which strategies. prolongation of treatment. Duration or replacement of Metronidazole by Clarithromycin) ,are more efficacious in HP eradication in DU patients in Iran.221 Patients with endoscopically proven DU ami positive rapid urease test in biopsy specimens presenting consecutively over;, 6 months period, were randomly allocated to three groups and recleved following regimens: A Omeprazole 2X20 mg, Clarithromycin 2x20 mg. Bismuth subcitrate 2X240 mg and Tetracycline 2X500 mg daily for Two weeks (OCBT). B: Ranitidine 2X300 mg. Bismuth subcitrate 2X240 mg, Metronidazole 2X500 mg and Tetracycline 2X500 mg daily for two weeks (RMBT). C: the same regimen as B but for 3 weeks. Eradication of HP was assessed at least S weeks after the completion of therapy with C 14 - urea breath test (UBT). The patients underwent a second endoscopy only if they had a positive UBT or were still symptomatic.221 patients were enrolled, and 205 patients had completed the 8 weeks follow-up (67 in A, 6S in Band 70 in C). Demographic data and endoscopic findings were comparable in all groups. Compliance was good with only one dropout in group B and one in C. Significant side effects were reported by 6.4%, of patients in A 17.7% in Band 14.2% in C; all of them were tolerable. Per protocol eradication rates of H. Pylori were as following: A (88.1%) higher than B (73.5 %) and C (71.4%) (A Versus B or C P<0.0). Eradication rates by intention to treat were as following: A (79.7%). B (67.65%) and C (68.5%).Prolongation of Ranitidinc + triple therapy from 2 to 3 weeks does not result in higher eradication rate of H.Pylori. Replacement of Metronidazole by Clarithromycin in OCBT regimen is clearly better than 2 or 3 weeks quadruple therapy, The 2 week OCBT therapy with 88.1% eradication rate by per protocol analysis in Iranian DU patients is still not the optimal and effective regimen required for HP eradication in other countries

Non-insulin dependent diabetes remains one of the most frequent chronic metabolic disorders complicated with innumerable disorders in the world. Its prevalence is on the rise because of the changes in life style but the role of diet as an etiological factor for non insulin dependent diabetes and impaired glucose tolerance remains uncertain.The role of diet in etiology of non-insulin dependent diabetes mellitus (NIDDM) and impaired glucose tolerance (IGT) remains uncertain. In this study, we compared nutrition status of three groups; newly diagnosed NIDDM patients (n=46), people with newly diagnosed IGT (n=57) and normal healthy people (n=101). The diet of participants was evaluated using "24 hour recall" and "food frequency" measurement methods.There was no significant difference in intake of energy, macro-nutrients and micro - nutrients in the three study groups. The ratio of fatty acids and simple carbohydrates in diet of all three groups were more than recommended dietary allowances. Although these results show no significant difference in intake of nutrients among diabetic, IGT, and healthy people; this study suggests that correction of the dietary pattern of diabetic patients and even healthy people is necessary. This issue needs more extended studies

A report of 9 wounded victims with thoraco - biliary fistulae along with a review of 35 cases reported in English - literature till now is the main content of this article.All the patients had liver and diaphragmatic injuries. In 6 cases, the fistula was pleuro - biliary, in one case broncho'- biliary, and in 2 cases it had been pleuro - broncho - biliary.The simplest diagnostic approach to pleuro, biliary fistula is to analyze the pleural-fluid for bilirubin. Biliptysis is pathognomonic of the broncho - biliary type and is definitely dangerous than pleura - biliary type. In order to avoid and overcome the fatal complications of it (biliary aspiration), patients should undergo immediate thoracotomy, repair of diaphragmatic tears, proper pulmonary resections etc.But in pleuro - biliary type the first therapeutic step is to drain the pleural space (Tube thoracostomy) along with the drainage of subdiaphragmatic space (Extraperitoneal), but paticnts whose fistulae continue to drain after 2 to 3 weeks or are complicated by thick bilious cmpyema there is a need for more aggressive approach such as thoracotomy, decortication and diaphragmatic repair. Despite the fact that thoraco- biliary fistulae are highly dangerous by themselves and may cause other fatal and dangerous complications, rapid and early diagnosis associated with appropriate and invasive operative measures will result in insignificant effects and insignificant mortality secondary to them would decrease.

Fever is one of the most common causes of children’s admission at hospitals. Among the predominant causes of fever in children; infection, autoimmune diseases, malignancies and poisoning are some to be mentioned. It is an established fact that focusing on the main cause of fever plays a pivotal role in the treatment of fever but this is not always the case and perhaps time is needed to follow and conduct investigations to arrive at the correct diagnosis. During this time, it is important that high fevers especially those associated with convulsions or septicemia should be promptly treated.In this study conducted in the summer season 1995, in 180 children with an age range of 5 days to 14 years, infections such as shigellosis, urinary tract infections, typhoid fever, septicemia, pneumonia, gastroenteritis, meningitis and arthritis were found to be the most common causes of fever.Acetaminophen and cold sponging were the measures utilized to bring down fever.

A computerized study, based on visual and auditory stimulus was performed to evaluate the effects of methylphenidate and chlordiazepoxide on the simple and selective reaction times.Subjects under study were chosen randomly from medical, dentistry and pharmacy students in Tehran University of Medical Sciences, later fifty two students (21 female, 31 male) from this pool voluntarily participated in this study.Every subject received a single dose of methylphenidate, chlordiazepoxide and placebo in the afternoon between 12 noon until 4pm for three different days. Reaction time tests were conducted before and after drug administration.The majority of reaction time tests speeded after methylphenidate and chlordizepoxide administrations. Some of the reaction times showed a meaningful reduction following chlordiazepoxide administration (P <0.05).Compared to the other studies, reaction times in the male subjects were significantly shorter than those of female

The Norplant Implant is a highly effective mean of contraception. Users of this long- acting method are protected against conception for as long as 5 years. This method proved to be unparalleled as a means of contraception and its effects approached that of surgical sterilization techniques.The primary mechanism of action of Norplant implants is suppression of ovulation.In this study, during the last 5 years, we implanted Norplant in 305 women in the family planning clinic, Zaniab Women University Hospital. The norplant was removed in 207 women for various reasons. Thus the discontinuation rate had been 46.55% and the failure rate being 0.32%. The main reason for discontinuation had been dysfunctional uterine bleeding (52.66%), because such bleeding disorders create problems in marital relations and above all create difficulties in conducting religious obligations, This study shows that the number of women seeking removal of norplant increased with the passage of time. In conclusion, Norplant is not a suitatle contraceptive method for l110slemsespecially shia women.

Since a knowledge of the incidence of rubella infection during pregnancy and the level of immunity of women during the childbearing age .are important criteria to evalume the occurrence of rubella infection in the uterus, in a seroepidemiological study sera of 1008 pregnant women who were exposed to individual suspected with rubella infection and 2000 sera of pregnant women 15-45 years of age and apparently fit were obtained from several medical treatment centers during 1992-1998 in Tehran, and sera evaluated at the virology division of Pasteur Institute of Iran. Anti- rubella virus IgM was investigated by enzyme- Immunoassay (EIA) in sera of women, 2.5% of pregnant women had anti- rubella virus specific IgM, and the rate of infection significantly decreased with age (P <0.005).Rubella antibody titer was measured by Hemagglutination- Inhibition (HAL) test in sera of healthy pregnant women, seroprevalence of anti- rubella virus was about %94 in women and the geometric mean titer (GMT) of rubella antibody was found to be 32.55. Finally, the low incidence of rubella infection during pregnancy and the high prevalence of rubella antibody in reproductive years in Tehran, indicate that the incidence rate of congenital rubella syndrome should be low in this city

Primary glycosuria is a benign state where in despite normal blood sugar, glucose is detected in the urine of the affected person. Since this disease has not been reported in Iran so far, a case of familial renal glycosuria is being presented which was referred to Jehadi Daneshgahi laboratories of Tabriz. Two boys of a family living in Tabriz reported for routine laboratory tests. They had glycosuria despite normal blood sugar level. Results of further tests revealed the following results:Oral Glucose Tolerance Test (OGTT) was normal, the level of uric acid in blood and urine was less than normal level in both cases, glucose excretion in urine within 24 hrs was more than 15 grams and aminoaciduria and phosphaturia were found to be absent.These patients besides sometimes having a feeling of thirst didn't have any other complications. Their father had a Type 11 Diabetes Mellitus (NIDDM), but their mother and sister had normal blood sugar and normal urine. Thus as per the criteria for investigations, these two boys had primary renal glycosuria

Today, Hepatitis is considered to be the most common cause of chronic liver disease and ranks as the first cause for liver transplantation in the D.S.A. Hcv is one of the most causes of chronic liver disease in Hemophiliacs, CRF and thalassemic patients. The most common route of transmission of this virus is via blood and infected blood products. Transfusion of infected blood, drug addiction, sexual relations beyond the established family network and use of personal use items such as shavers are important factors of transmission. The sole way to prevent this disease is screening blood products, increasing peoples' knowledge and avoiding high risk activities.