Journal of Medical Council of Iran
Year:2002 | Volume:20 | Issue:1|Papers Count:13

The aim of this study is measurement of biliary amylase levels in patients with cholelithiasis.Fifty patients with symptomatic cholelithiasis (acute or chronic) referred tc Ayatollah Kashani hospital affiliated to Isfahan Universsity of Medical Sciences, and in the investigations conducted the presence of cholelithiasis had been confirmed were included in the study .At operation 10cc of gall bladder fluid was aspirated by #18 needle and its amylase detected by colorimetric assay. Student t-test and regression analysis were used and a Pless than 0.05 was considered significant. The mean age of patients was 59.5j: 14.27 years for females (34 cases) and 53.5±10.7 for males(16 cases) (P=0.17).The amylase level in the bile was 3016.35±93.7 U/L in patients with chronic cholecystitis and 3729.77±87.6 U/L in patients with acute cholecystitis (P=0.8).The amylase levels were 385.5±98.5 in patients operated as emergencies and in those operated as elective cases they were 1106.7±54.8 U/L (P=0.3). The amylase levels in the female group were 3980±99 U/L and in thc male group 1181.12±53.3 (P=0.2) . A significant correlation was there between age and biliary amylase (P=0.027, r=0.3). These findings suggest the probability of Pancreatic juice reflux in patients with cholelithiasis.

Type I diabetes mellitus is the most common endocrine disease in childhood and adolescence that needs medical management and social support for the entire life.Diagnosis must be made in early stages of polyuria and polydipsia and not in end stage like ketoacidosis and coma. Repeated readmissions because of diabetes mellitus raises questions about peoples" knowledge about the disease, training and awareness of medical personnel and Patients overall management problems were evaluated. studies conducted in those admitted more than once because of diabetes showed some results worth consideration such as repeated admissions in crowded families, low socioeconomic status single parent family and adolescent age were specially present. To tackle this sociomedical problem, it is recommended and the child and family be provided full support.

Objective: To determine the relative incidence of malignant and nonmalignant pathology in patients presenting with gastric outlet obstruction (G.O.O.) in the era of HZ blockers and the management of H. pylori.The endoscopic reports and charts of 52 consecutive patients with G.O.O. studied between (1986-1999) were reviewed to determine etiology of G.O.O. at northeast of Iran. The diagnosis of G.O.O. was based on clinical presentation, upper gastrointestinal barium study and I or endoscopy. Patients with gastroparesis or a previously known cancer were excluded.Fifty seven Point seven percent (30 patients) had malignancy as the cause of G.O.O. 42.3 percent (22 patients) had benign disease. the patients with cancer tended to be male, older, and fewer had history of peptic ulcer disease. The incidence of malignancyin patients presenting with G.O.O. is grater than 50% .The etiology of G.O.O. can not be predicted by age, history of peptic ulcer or nonsteroidal antiinflamotory drug use. Endoscopic treatment of G.O.O. should be approached with caution because the etiology of pyloric obstruction can not be reliably established by endospopic examination.

In order to survey and compare the CRP of CSF with the other cerebrospinal fluid tests in Bacterial- Viral meningitis in children between O to 14 years old, a prospective study was carried out from october 1996 to September 1997 in Tehran.During this time, CSF Samples (by lumbar punction) were obtained from children who revealed symptoms of meningitis in three educational and therapeutic centers in Tehran and Subjected to biochemical and microbiological analysis. Also some positive samples obtained from patients in standard conditions a few years ago were added to these samples, Thus 80 positive bacterial and 50 positive viral Samples were prepared. In this survey a few samples of children with same conditions (Sex-Age)as the study group, but with clean CSF and negative culture were obtained from surgery departments with the consent of family as a control group.The prevalent organisms in the bacterial meningitis group, included 35 (43.75%) H.influenzae, 30 S.pneumonia, 11 N. meningitis,3 S.agalactae and one as Lmonocytogencs.In viral meningitis group, percentage of isolated viral agents were: mumps virus 50%, enterovrius 34% and herpes simplex virus 16%.1n this study, a meaningful statistical difference could not be observed between the sex of patients and infection (P<0.001).In the present study we compared the results of culture of CSF, with the results of serological and sensitive CRP test. Consequently in 80 bacterial samples, 72(90%) of them had a positive reaction of test. Neither viral samples nor control group, had a positive reaction in this test. more over, the sensitivity and specificity of the CRP test in differentiating bacterial meningitis from aseptic meningitis were found to be 90% and 100% respectively.

Forty five premature babies with gestational age less than 37 weeks were evaluated prospectively in two groups between 24 to 72 hours after birth. Twenty five infants with a mean weight of 2073. 32 (range 1500 - 2500g) were studied in the electrical incubator. Rectal and abdominal skin temperature, heart rate, oxygen and humidity level of the canopy and the room temperature were also measured. Continuously the level of oxygen inside the canopy was 21% during the study and no decrease was observed. The SaO2, heart rate and respiratory rate were in the normal range and no evidence of carbon dioxide narcosis, hypoxia, acidosis or adverse thermoregulatory behavior were observed in the two groups and statistical analysis of the indices between the two gruops did not show a. meaningful difference. The differences between these two groups were not significant. The new non - electric incubator confirmed its safety and efficiency in providing a warm environment for non -distressed premature babies for two hours period.

Tobacco consumption is recognized as a major risk factor for many diseases such as; cardiovascular diseases, stroke, and some cancers. Studying of smoking pattern is important to recognize the high-risk groups, and to use control and prevention programs. The aim of this study was to determine the prevalence rate of smoking, and to show the pattern of smoking by age, sex, educational attainment, and deprivation. This study was under taken in 1600 inhabitants (aged 18-84 years) using a self-completed questionnaire in 1999. The prevalence rate of daily smoking was 30 percent. Of them 44.7 percent had started smoking before the age of 18. The habit of smoking was more common among illiterate and less educated males, and the deprived groups (P<0.01). However, there was no significant difference between various age groups. The mean age to start smoking was 20.7 years. After cigarette smoking, Ghalian (3.5 %), Pipe (0.7 %), and Chopogh (0.2 %) were the common inhalants consumed among the population. Because of a high prevalence of smoking in the study population the control and prevention of smoking should be considered as a health priority in preventing these diseases. Educational programs for teenagers, persons with low education and people with low income as a means of prevention of tobacco use and the provision of facilites during the leisure time of the people should be taken into consideration.

The study evaluates the relationship between maternal weight gain pattern and birth weight neonates. Our study group included 437 pregnant women who were referred to health centers affiliated to Tehran Univ. of Med. Sciences during a one year period.Data about maternal weight gain at the end of each trimester and total maternal weight gain were recorded. Seven co-variables also were included in this study as independent variables, inducting: age, parity, height, prepregnancy BMI prepregnancy weight, neonatal sex and gestational age.Utilizing correlation coefficient, it was seen that there were significant direct relations between gestational age, prepregnancy weight, total weight gain, weight gain in second trimester, parity, age, height and EMI with: birth weight (P<0.01).In multiple regression analysis, each kilogram of total weight gain in the mother was associated with a significant increase in fetus weight of 76.5 gr (P<0.01). In comparing means of birth weights of different groups of maternal weight gain in each of the trimesters, It was noticed that only in second trimester, an increase in materanl weight gain results in significant increase in mean of birth weight (P<0.05).The results suggest that specific patterns of maternal weight gain particularly weight gain in the second trimester are related to neontal weight gain.

Wegener"s granulomatosis disease (WGD) involves frequently the subglottic and tracheal regions which leads to stenosis of the air way in these regions. It is possible that such stenosis might persist after other features of the disease have subsided. Selection of an appropriate treatment protocol have always been a subject of controversy and most procedures advocated have been procedures other than resection and ananstomosis for their management.A 37 year old woman who was treated for 6 years with the diagnosis of WGD, was referred to us with sever dyspnea while all other manifestations of the disease were in remission. Radiologic and broncoscopic investigations showed remarkable stenosis in subglottic area and upper trachea. A broncoscopic biopsy from the stenotic area was reported to have granulomatous lesions in favor of WGD. Frequent broncoscopic dilatations employing rigid bronchoscopy were not successful to relieve the narrowing.A resection and anastomosis was performed, removing anterolateral portions of tile subglottic area and 2cm of the upper trachea with a thyrotracheal anastomosis. The patient recovered uneventfuly and 6 months after operation, the patient is normal as for dyspnea and voice and there are no signs of recurrence. A role of surgical resection of the stenotic tracheal and subglottic regions and resnastomosis of the two ends in patients who have developed stenosis due to Wegner"s disease not responding to medical treatnent does exist.

Today in histopathology, emphasis is specially laid on Molecular Pathology. Some however believe that the gold standard diagnosis should be based on molecular appearance. Some suggest that the classification of histopathology of tumors should be based on the molecular pattern, because morphology alone is not enough to explain all the tumor characteristics.In this article based on practical practice and scientific approach, the importance of diagnosis on the basis of morphology is emphasized. Moreover, reports of molecular pathology and immunohistochemistry serve as diagnostic ancillary method in the diagnosis and follow up of diseases, and on this basis, molecular investigations can be founded. As regards to classification of tumors, molecular Pathology along with, histomorphology can be helpful in arriving at a diagnosis.