Journal of Medical Council of Iran
Year:2003 | Volume:21 | Issue:1|Papers Count:13

Blood cultre is considered to be an ,accurate test to diagnose infective endocarditis, but in children its specificity are lower compaed to echocardiography.The aim of this study was to demonstrate the syperior role of blood culture and echocardiography in the early detection of infective endocrdiris in children 0 -15 years. Likewise the agents that proved to be effective or dangerous on the overall management. and morbidity and morbidity were evaluated. This study has not been conducted in this group in Iran.In this experimental study 36 chilren with age ranging 2-15 years were studied during a 5 year period .Patients who had a probable in fective endocarditis or had profracted fever were enrolled. A complete history, blood culture (3 times ), Serolog and hematology were obtained from all the patients. The treatment was carried out according to standard protocols on the basis of microscopic findings and negative blood culture and the length of treatment was based on control echocardiographies and CRP.The average age was 10.8 years and SD+ 3.48 Overall the male/female ratio was 2:1. fever was the most common complaint (100%) Sixty-six percent of the patients had fever for more than 7 days. Congenital heart disease was the most common underlying disease (66%) followed by Rheumatic heart disease (RHD) (22%) . Congestive heart failure (CHF) was present in 30.5% of cases. Blood cultues were positive in 42% and vegetations in 83.4% by two dimentional echocardiography (Echo) Blood culture and echo sensitivity and spectively . The most common site of vegetation the aortic valve area followed by the tricuspid valve. Staphylocous aureus was the most common infecting microorganism. There were 6 deaths (16.6%) due to different causes. Indicators for mortality include Negative cultues. infection with staph aureus. large vegetation and CHF. All mortalies had sided vegetations (P<0.05).In contrast to the high sensitivity of blood cultures in lE in developed countries, in the developing countries the result of blood culture is not reliable: therefore early echocardiography can have the best role in the early diagnosis of lE and can change the outcome of this potentially serious illness.

Yersinia enterocolitica is a bacteria from family enterobacteriacea that causes acute diarrhea mesenteric lymphadenitis, septicemia, exodative pharyngitis, secondary arthritis and erythema nodosum.Infectious diarrhea is considered as the most prevalent symptom of Yenterocolitica infection among children.During the Present study, 527 and 300 fecal samples were collected from patients with diarrhea, admitted at Qods and Bou-Ali Hospitals respectively, Located at the city of Gazvin, Iran. The smaples were examined for the containment of Yersinia ~ijterocolitica using CIN -agar, selective media and cold enrichment media. Results showed 7 positive samples, all were gathered from infunts. No Yersinia Sp. isolated from adult specimens.For comparison, two other pathogenic bacteria were included in our study, i.e. salmonella and Shigella.Sensitivity of the bacteria was tested againts 13 types of antibiotics by curby -Bayer method after isolation and the results are showed in the present study.

In this study, 500 newborns with an icterus of less than 2 weeks duration and a weighf of 1500 grams or more , and who had not been exposed to phofotterapy or an exchanoe transfusion were evaluated and their chincal icterus and the concentr ation of tofal and direet bilieef biliudin in the serum ealclated Between the yellow coloraion of the skin and serum bilirudin concentrafion , a signifcant corredation (r=0.808) is ted not refafal to age, sex weeghf of birth (excepf for weights less than isoo grams which was not waluated) and the speed of on increase in biliuhin con eentraion . More over, an appropriate model to predicf the concenfration of serum bilirubin on the basis of yellow coloration of the skin has been forwarded.

One hundred ten patients with different breast complaints underwent physical examination, mammography and open surgical biopsy in the Faghihi Hospital from 1373 to 1376.Mammographic reports of 110 patients were reviewed and the following results classified obtained: mass 75 (68%,), calcification 11 (10%.) and architectural distortions 32 (29%).Forty-one percent of spiculated masses were malignant with a sensitivity of 30%. specificity 83% and an accuracy of 46%. (P-value <0.0001). Microcalcifications were found in the malignant lesions with an accuracy of 32% (P-value =0.32). Overall accuracy of mammography was 74.5% with sensitivity 91% (P-value <0.04) and specificity 17% (P-value <-.0001). The results of this study show reasonable accuracy for mammography in detection of malignant breast lesions that is statistically significant.

Appendicitis is one of the most prevalent emergency surgeries which manifests itself as an acute abdomen presentation and its differential diagnostic identifications are always of great importance.Since most studies and researches conducted in the country on this disease has been retrospective, we embarked on conducting a six months prospective study on all the patients who referred to Sina Hospital round the clock with acute abdomen complaints. During this period. with the collaboration of our research colleagues. information on 611 patients with acute abdomen complaints was registered on transferable to computer for analysis coded forms 10 he studied.Clinical Diagnostic manifestations before the operation and during the operation as well as pathological reports after the operation were registered in existing forms and the prevalence of the differential diagnoses were compared (see tables 1, 2. and 3).The age and sex prevalence of the disease was also taken into consideration in this study and was compared with the reports from other countries.The noticeable point, which was quite different from those of the foreign reports, was the higher prevalence of the acute abdomen complaints among men compared to women (1.37/1) and higher prevalence of the appendicitis among men in the patients with acute abdomen (2.9/1) (see diagrams 1 and 2), which might be due to irrational consumption of the antibiotics by women with the supposition of some gynecologic diseases or late reference of them due to cultural background or some other issues, which is necessary to he dealt with in separate research proposals in future.

In a semi experimental and prospective study, pregnant term women who were referred to Fatemieh hospital, Shahrood for termination of pregnancy were choosen for one of the oxytocin Infusion Method: low dose increment in 20 minute intervals (Traditional Protocol) and high dose increment in40 minute Intervals (New Protocol).Sampling was convenience.The results of this research indicated that there were statistically significant differences between the Low dose and high dose oxtocin in: first day failed induction (p<0/000) , second day failed induction (p<0/003) and the rate of secarean delivery. The induction-start of labor pain (P<0/000) , mean time of induction - delivery (p<0/001) and second stage (p<0/002) was significantly longer whit low dose oxytocin increment in 20 - minute Intervals than high dose oxytocin increment in 40 - minute intervals.No significant difference was found between the low dose and high dose regimen in Uterine hyperstimulation (p=0/1), and postpartum hemorrhage (p=1).

To determine the incidcnce of fetomaternal hemorrhage (FMH)in patients undergoing normal vaginal delivery (NVD) and cesarean section (C/S), Kleihauer - Btke test was performed in 208 paturients Comprising 125 patients (60.0%) undergoing NVD and 83 patients (39.9%) undergoing C/S. Some degree of hemorrhage Was detected in 18.8% of patients with 15.9% demonstrating up to 24 ml of FMH. 1.9% demonstrating 25 to 30 ml of FMH and 1%. demostrating significant (greater than 30 ml) FMH. The incidence or FMH in NVD patients was 12.1% and in C/S patients was 6.7%. The mean value or FMH in NVD patients was 11.4 ml and in C/S patients was 13.7 ml .Statistical analysis or two groups reveal no difference in "mean ". In our stndy, however, necessary doses or the drug (300 microgram) would adequately protect from Rh sensitization in patients with less 30 ml of FMH, so this determination is mandatory for all Rh negative parturients.

The use of autogeneous bone graft is usual for the reconstruction of bone defects in routine practice. The problems of producing and utilization of grafts have encourrged investigators to search for a suitable alternative and Bone Matrix gelatin (BMG) is one of be named. Because of the importance of the issue and the need of the country s health care requirements, this study wsa conducted in rahhits in order to evaluate and compare the effect of BMG and autograft on the reconstruction of bone defects.The  desing of the study was experimental and data was collected using a questionnaire and microscopic observation. Male white New Zealand rabbits were used for this study. Using Urist technique, BMG was produced and grafts were removed from rabbits left iliac bones. The grafts were placed on right sided maxilla and BMG was applied to fill the defects. Then, the rate and amount of reconstruction were compared in the two groups at 7 th, 14 th, 24 th, and 60 th days aeter operation according to the following items:1- Type of osteogenesis 2- cartilagetormation 3- rate of bonetormation 4- In flamation types.The results showed a reduction of inflammation and increase in bone formation through time. This indicates that BMG, like autograft, can be useful in the reconstruction of bone defects in rabbits.

Sickle cell anemia, in heterozygous form, although appears to have a high incidence in Iran, particularly in the Southern provinces; unfortunately has not received the right attention and thus creating screening and prevention problems for haemoglobin disorders. Because of, laboratory and clinical similarities between, Indian Arad haplotype of sickle cell anemia which is estimated to have a high incidence in Iran, and, sickle beta talassaemina which is more frequent in this country, might cause diagnostic problems.In this article we present three cases with sickle cell anemia wich were diagnosed as sickle beta halassaemia. Eventually, we suggest determining haematological indices of patients parents and measuring HbF in suspected patients precisely by alkali denaturation, after the patient haemoglobin electrophoresis, to reduce incorrect diagnosis.

Anthraax is a global disease caused by bacillus anthracis a spore forming. gram positive rod .lnfectfd after an accidental contact with animals or contaminated animal products. The disease in humans usually presents in therr froms:cutaneous gastrointestinal and respiratory. B.anthracis spores have been extensivcly used in the production of biolgical warfare agents. The goal of this lecturfe is increasing the knowledge of physicians with the pathogenesis clinical findings, prevention and treatmant of anthrax.