Journal of Medical Council of Iran
Year:2002 | Volume:20 | Issue:3|Papers Count:13

G6PD deficiency is the most common enzyme deficiency in human beings-It can lead to severe hyperbilirubinemia which my progress to bilirubin encephalopathy, mental retardation and death in newborn infant.This cross sectional analysis was carried out in newborn services of Amirkola children hospital. In this study 165 icteric neonates (cases) and 123 nonicteric neonates were assessed. Enzyme activity were assesed by fluorescent spot test and the results were analysed by chi-square and fisher exact tests and a p value<0.05 was considered significant.G6PD deficiency was seen in 23.6% of the icteric and 11.6% of the nonicteric newborns (P <0.0001).36% of G6PD deficient and 18.2% of non-deficient neonates required exchange transfusion (P<0.0010).In view of the higher frequency of G6PD deficiency and the greater need for exchange transfusion in these patients, we suggest G6PD screening on cord blood at birth for all neonates, and G6PD level determination in all pathological jaundice of newborn.

Urinary tract infection is one of the most common infections in childhood that has considerable mortality and morbidity .According to the recommendations of some authorities, sonography is conducted in all children after the diagnosis is established whereas others Limit it to certain special occasions. The goal of this retrospective descriptive study has been to evaluate the results of sonography in children with UTI. For this purpose, we studied children admitted for UTI during 10 years (1988-1998) at Bahrami hospital. In all of them, one radiologist carried out sonography of urinary tract. 148 cases of UTI were evaluated out of whom in 125 cases UTI was confirmed by positive urine culture. The prevalence of UTI in girls and boys was 78% and 22% respectively. The incidence of UTI decreased as the age advanced and the most common group was found between 6-9 years. Most of them (91%) had fever on admission occuring mostly between 2-5 years. As age advanced the incidence of fever declined. The most common pathogen was E.Coli. 53% of patients had normal sonography, clinical sings of UTI were seen in 35% and in 24% they were associated with anomalies. The most common finding of infection was thickening of the bladder and the most common anomaly was hydronephrosis.

Eighteen patients underwent surgery for correction of intermetatarsal angle between first and second metatarsal bones. There were 12 females and 6 males, with an average valgus angle of 30° and intermetatarsal angle of 15°. Radiographic findings were either negligible or else absent. An oblique osteotomy in sagital plane, called "Ludloff Osteotomy" was performed on the shaft of first metatarsal bone. After rotating the distal fragment laterally to achieve a corrected angle, two fragments were fixed, using 2.7 or 3.5 mm AO screws. The mean time of following up of these patients was 3.2 years.By osteotomy, the average correction angles of varus and valgus were nearly 6 and 15 respectively.

Owing to the relatively non understanding of eye symptoms such as funduscopic appearances in patients with ulcerative colitis, this study was conducted to describe the clinical course and Lesions in the posterior segment in patients treated with oral steroids. This research was conducted on patients referred to Farabi hospital during the years 1991-1998 . Patients were evaluated regarding demographic variables, posterior segment presentations, prior treatments and clinical outcome. In all patients, oral steroids were advised.The effect of treatment following 6 month was assessed by funduscopic examination and visual acquity testing and analyzed by Mac- nemar.15 patients(7 male and 8 female) with age ranging between 19.5-26.5 were assessed during a 7 year period. In 46.7% of patients eye presentations included retinal detachment with choroidal infiltration. Visual acquity equal to more than 3.10 improved from 23% to 50% following oral steroid medication (p<0.001).Since oral steroids result in improvement and a reduction in posterior segment manifestations in patients with ulcerative colitis, the gastroenterologists are requested to refer the patients to ophthalmologists if eye manifestations of ulcerative colitis or other diseases of IBD group are observed.

Trauma remains one of the major causes of morbidity and mortality in countries. Out of trauma cases, head injuries forms a major component, and as a result plays a significant role in the disabilities. An epidemiological information is a prerequisite for any intervention to reduce such burdens. Several studies have been conducted on head injuries and we have tried in this study to answer some of the epidemiological aspects of head injury. In this cross sectional descriptive study during a one year period, patients with head injuries who were referred to sina, shohada and fayaz bakhsh hospitals were included.During this period, a total of 58000 patients reported at the Emergency center out of whom 10967 patients had sustained head injuries. which came to about 18.9% of the total patients. Mean age on the whole was 23.95(± 0.17) years and male to female ratio being 2.9 to 1. City accidents accounted for most of the head injuries (44.1%) and the commonest cause of head injuries was found to be motor vehicle accidents(34.5%). As regards consciousness evaluated according to Glasgow coma scale, 96% of the patients had mild injuries (GCS> 12), 1.4% had moderate injuries (GCS > 8 and < 13) and 2.2% had severe injuries (GCS < 8).83.4% of the patients received ambulatory treatment whereas 6.6% of the patients were hospitalized. Morbidity and mortality on the whole in these patients was found to be 2.2%.

It has been established that a reduction in the serum lipids decreases the clinical effects and morbidity and mortality in patients suffering from coronary heart disease. Thus it was decided to conduct a study evaluating the effect of cardiac rehabilitation on lipid profile in cardiac patients. In this clinical trial which was carried out on 120 patients who had reported to the cardiac rehabilitation unit and were suffering from myocardial infarction, or else had undergone a coronary artery bypass surgery or an angioplasty.At first the 14 hour fasting blood samples of two groups were sent for serum total cholesterol (T.Cho), triglycerides (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) and in the same manner 12 weeks later, the same samples were taken and measured. The following data was obtained using students test.Sixty patients participated in cardiac rehabilitation program including 24 exercise sessions (45-60 minute/session), dietary consultation and mental health and 60 patients (control group) being the same as the intervention group in age, socioeconomic status, serum lipids profile, history of coronary heart disease and other risk factors who didnt participate in cardiac rehabilitation program because of being far from this center or other reasons.T.Cho, TG and LDL-C of intervention group had decreased in 70%,62% and 76% of patients and in 86% patients, HDL-C showed an increase. T.Cho, TG, LDL-C and HDL-C was normalized in 35%, 30%, 68% and 66%, respectively after finishing their 2 month course which overall showed a 20, 56, and 30 mg/dl reduction in serum lipids respectively and 0.8 reduction in LDL-C/HDL-C (P<0.05) and 5 mg/dl increase serum HDL-C( P<0.05 ) in intervention group vs. control group.The decrease in T.Cho, TG and LDL-C and increase in HDL-C in all patients and normalization of lipid profile in most of them shows the importance of rehabilitation in cardiac patients and the need for its continuity.

The effects of dietary zinc status on the development of convulsive seizures and zinc concentration in hippocampal area were studied in three groups of rats that receiving zinc adequate, zinc load and usual water diet. Hippocampal zinc level was determined by an atomic absorption spectrophotometer. Ninteen male rats were randomly assigned to three deitary groups and assesed in ten weeks.Seizure was induced in rats by administration intraperitoneal injection of lithium chloride and pilocarpine. Differences were tested for statistical significance with analysis of variance (ANOYA) followed by other tests. Seizure susceptibility of mouse was decreased by zinc loading. Zinc loading was accompanied by a marked increase in hippocampalzinc content. These results suggest that zinc coyld have preventive effect on the development of seizures and hippocampal zinc may play an important role in the patophysiology of convulsive seizure of epilepsy.

This report introduces a rare syndrome. This syndrome called FG syndrome and the first case introduced in Iran is a rare X-Linked recessive condition in which mental retardation is associated with congenital hypotonia, macrocephaly ,characterisitic face and constipation. The case is a 4 year old boy who presented with clinical symptoms of fever and seizures and was admitted of Imam Hossein Hospital. The seizures were tonic clonic in type and the history of seizures dated back to time when the patient was one year old the child was the 6 th issue and two maternal uncles of the patient had died during infancy. Patient had a huge head (dolicocephaly), short stature, prominent abdomen, mild mental retardation and a characteristic face. In x-ray skull, craniosynostosisis reported. An EEG was obtained which revealed seizure pattern. In CT scan of brain, corpus callosum was absent. for a cardiac murmur, an echocardiography was obtained which showed a mild aortic stenosis. A sonography of the urinary tract showed distension of the pelvis. All the finding were campatable with FG syndrome.

Hyperthyroidism may present, recur ,or accelerate during the postpartum period in the majority of the females. Management of thyrotoxic lactating women has been a subject of controversy and until the last decade, antithyroid medications had been prohibited in thyrotoxic lactating mothers. In the last 20 years, the concentration of antithyroid drugs in the milk of lactating women was reevaluated and clinical studies showed that propylthiouracil and methimazole could be administered safely to mothers, without deterioration of thyroid function in the breast - fed infants. Even when serum TSH is increased in a methimazole treated - mother, T4,T3,and TSH concentrations are normal in her breast -fed infant. Between the ages of 4-8 years,all infants who were breast fed by methimazole -treated mothers had normal physical growth, thyroid function tests and their global lQ and 11 subsets of lQ were comparable to control infants. this research proves the innocuousness of breast feeding infants by thyrotoxic lactating mothers taking antithyroid medications and physicians can advise lactating mothers to continue breast feeding of their infants.