Research in Medicine
Year:2003 | Volume:26 | Issue:4|Papers Count:20

Background: Helicobacter pylori (HP) has been shown to be involved in the pathogenesis of chronic gastritis, peptic ulcer, intestinal metaplasia, atrophic gastritis, gastric carcinoma, and maltoma. Thus, determining the colonization of HP could be helpful for therapeutic approaches.Materials and methods: Touch smear of gastric biopsies were obtained from 72 patients referring to Endoscopy unit of Loghman Hakim hospital. Being exposed to the air, Giemsa staining was employed. Then, results of touch cytology were compared with histopathology. Results: Regarding the presence of HP, cytology and histopathology were in full agreement in 93% of the cases. In the remaining 7% of cases, cytology was positive and histopathology was negative. Sensitivity, specificity, and accuracy of touch cytology in HP detection were revealed to be 100, 87, and 93%, respectively. PPV and NPV of this method were 87 and 100%, respectively.Conclusion: Touch cytology is rapid, easy, and reliable technique for HP detection.

Background: Acute classic viral hepatitis includes A, B, C, D, and E. The frequency of acute viral hepatitis varies in different societies. Since we were unaware of the true profile of hepatitis etiology in Sistan and Balouchestan province, the present study was conducted in 1997-99. Materials and methods: It was a cross sectional study. All patients referring to pediatrics, internal and infectious diseases wards and a number of private clinics of Zahedan were included. Having confirmed acute hepatitis, patients were tested for HbsAg, IgM Anti HAV, IgM Anti HBV, IgM Anti HDV, and Anti HCV as needed. Hepatitis E was not investigated due to the lack of special kits. Results: Acute viral hepatitis was confirmed in 273 patients, of whom, 206 (75.5%) had hepatitis A, 39(143%) hepatitis B, 5 (1.8%) hepatitis C, 5 (1.8%) hepatitis D, and 18 (6.6%) had hepatitis non A-D. Among under-five-year old individuals hepatitis A was the most frequent (96%), however, hepatitis B was reported in 50% of individuals greater than 20 years old. Conclusion: Hepatitis A is obviously the most common cause of acute viral hepatitis in Zahedan. It is more frequent among under-five-year old children, however, in older patients (>20) hepatitis B is more prevalent.

Background: Lumbar laminectomy is a common operation in neurosurgery department, thus, recognizing its complications is of utmost importance. Spinal compressive epidural hematoma is a rare postoperative complication requiring prompt diagnosis and treatment. Materials and methods: In this retrospective study, 2900 cases of spinal operation referring during a 13-year period to Imam Hossein Hospital were reviewed. Results: Epidural hematoma was reported in 4 cases. The most common presenting signs were progressive paraparesis and disturbance of urinary sphincter. Complications were commonly diagnosed during the first 24 hours, where the most available tool of diagnosis was lumbar myelography.Conclusion: Complete recovery was reported in two cases, however, the other two cases were relatively recovered. Prompt diagnosis could cease severe complications.

Background: Chlamydial infection is a well-known gynecologic problem. Copper-T is a useful contraceptive method with a high rate of success. The present study was conducted with the aim of determining the chlamydial infection in copper-T users in Health Network in Tehran in 1998.Materials and methods: It was a historical cohort study. The study population included 99 copper-T users (case group) and 102 females using contraceptive methods other than copper-T (control group). Groups were matched according to the age and parity. Having a questionnaire completed, 4cc blood was obtained and chlamydia antibodies were detected using indirect immunofluorescence. Antibody titer of ≥l/8 was considered positive. Chi-square and t-test were used for data analysis.Results: No significant differences were noted in age, parity, occupation and economic status of both groups. Chlamydial infection was found in 24.3% of copper-T users and 15.7% of the control subjects. (NS) Conclusion: Copper-T has no impact on chlamydial infection. Further studies are highly recommended.

Background: Inappropriate body image in adolescents may lead to hazardous activities such as incorrect. dieting and inadequate calorie intake. Varity of factors are involved in forming inappropriate body image. The present study was performed to evaluate the body image of adolescent girls and boys in Tehran and determine its association with dietary pattern, physical status, and body weight.Materials and methods: The study population included 894 high school students aged 14-18 years old (15.96±0.98). Socio-economic status, body image, dietary frequency, and physical activity of subjects were asked by self-recorded questionnaire. Weight and height were determined and body mass index (BMI) was calculated. Logistic regression was used for data analysis. Results: Based on BMI, 14 and 13.6% of girls and boys were overweight and 12 and 26% were underweight. Untrue body image was more commonly reported in adolescents with appropriate weight, for instance, among girls of this group, 21 % considered themselves as overweight and 22% as underweight. These values were 10 and 23% for boys, respectively (p<0.001). Of studied variables, female sex (OR=1.52), underweight (OR=5.44), overweight (OR=11.96), lack of regular physical activity (OR= 1.49), and previous history of dieting (OR=2.73) were predictive factors of untrue body image.Conclusion: Inappropriate body image is a common problem in adolescents. This could influence on their dietary behavior. Body image-related factors should be kept in mind when educational strategies of this age group are drawn.

Background: Iodine deficiency disorder (IDD) is a worldwide health problem. Parts of Iran had been known as endemic areas for goiter. IDD was accepted as a priority health problem in our country, and a National IDD Council was formed in 1989. This study was performed to evaluate the National IDD Council program in 1996, in urban and rural areas of Kermanshah Province.Materials and methods: In this cross sectional study, 1400 schoolchildren (M/F ratio=1), aged 8-10 years, were selected and grading of goiter was performed in accordance to the WHO criteria. Serum T3 and T4 were measured by RIA and urinary iodine by digestion method. Results: The mean of T4, T3 and TSH were reported 9.5±1.3 µg/dl, 152.6±40 ng/dl, and 1.7±1µIU/ml, respectively. There were no differences between males and females or rural and urban residents. T4 above12.5 µg/dl was reported in one. TSH above 5µIU/ml was in reported in one, too. The median urinary iodine was 20 µg/dl in entire population. 75% had urinary iodine more than 10 µg/dl. Urinary iodine of <5µg/dl was found in 11 %. Total prevalence of goiter was 79% (80% in females and 77% in males). Conclusion: Results have revealed that 7 years after distribution of iodized salt and 2 years after more than50% of population used iodized salt, urinary iodine of school-aged children in Kermanshah Province has reached to WHO approved rate. However, goiter is still hyper endemic in Kermanshah Province.

Background: Prior investigators have shown that obesity and other cardiovascular risk factors are influenced by socioeconomic status of subjects in some societies. Lower socioeconomic status could be accompanied by obesity and other cardiovascular risk factors. The present study was conducted on individuals above 20 year sold living in Tehran 13th district in 1998-99 to determine the influence of educational level and marital status on dietary intake, Body Mass Index (BMI), Waist to Hip Ratio (WHR) and serum lipid profile.Materials and methods: Tehran Glucose and Lipid Study (TGLS) has being conducted on 3-70-year-oldsubjects since 1998.0ur study population included 408 females and 325 males, aged 20-60 years, for whom, a two-day dietary recall was filled. Subjects marital status and educational level were recorded, too. Initial data including weight, height, waist circumference, hip circumference, blood pressure, BMI, and WHR were all determined. FBS, 2h-PG load (75g) BS, Cholesterol, triglyceride, and HDL were measured and LDL was calculated according to the Freidwald formula. Subjects educational level was divided in four groups of illiterate, guidance school, high school, and higher education. For marital status, we had tow groups of single and married subjects. If EI/BMR ratio (Energy Intake/ Basal Metabolism Rate) was less than 1.27, it was considered as underreporting and the sample was dropped for data analysis. Results: Having age adjusted, WHR and triglyceride level were decreased and HDL, Zn and Vitamin B6 level increased as females educational level increased. However, for males, no significant differences were found in different educational levels. Married males as compared to single ones had higher energy intake (3001±625 vs. 2905±543 kcal) and iron intake (29.5±9 vs. 28.1±10 mg) (p<0.05). Moreover, married females as compared to single ones had higher energy intake (2471±483 vs. 228l±455 kcal), lipid level (89±31 vs. 83±32g), protein level (68±14 vs. 65±16g) and carbohydrate intake (358±77 vs. 324±70g)(p<0.05). Meanwhile, BMI and WHR of married females were significantly higher than single ones (p<0.01). Conclusion: Results have revealed that the educational level and marital status are associated with BMI, serum lipid profile, and some dietary intake, especially in females. Educational programs are highly recommended for poor-educated or single individuals.

Background: Cephalometery is the science of measuring head dimensions, so that the skull form and its development can be predicted. It has great progress during the recent two decades. The present study was conducted on 22-24-year old individuals in Tehran to determine the cephalic length, width, and index.Materials and methods: The study population included 953 males and 759 females, aged 22-24 years. Martin Saler scalope was used to measure cephalic length and width, then cephalic index was calculated. Based on cephalic index, the cephalic form was classified as: brachycephaly, hyperbrachycephaly, dolichocephaly, mesocephaly.Results: The mean (±SD) of cephalic length, and width was 141±11 and 186±12 mm in females and 146±12 and 193±16mm in males, respectively (p<0.001). Cephalic index Was 75±6 in females and males, respectively (NS). Brachycephaly was the most dominant skull form among the study population (42% in females and 37% in males), whereas the dolichocephaly was the rarest (11% in females and 9% in males).Conclusion: Results have revealed significant differences in males and females' cephalic length and width, however, in both groups, brachycephalic skull form was the most prevalent and the dolichocephalic skull form was the rarest.

Background: There are various methods for codeine extraction and detection, for this, Liquid-Liquid-Extraction (LLE) and gas chromatography are useful tools. In case of higher recovery rate, more accurate results would be expected. In the present study, we have surveyed methods of codeine (and morphine) extraction and detection with higher sensitivity and accuracy.Materials and methods: The urine samples were collected from opioid abusers and each sample was divided in two; one was hydrolyzed by bath boiling water for 60 minutes with HCl, whereas the other didn’t. All samples extracted by the LLE system (Chloroform/2-Propanol, 9:1, 20 min shaking and centrifugation) and quantified using a Varian gas chromatography. For deriving, the product was exposed to BSTFA at temperature of 75 degrees centigrade for 25 min. Results: Results have revealed that the area under curve (ADC) on hydrolyzed samples was higher than non-hydrolyzed ones. The recovery rate was 89%.Conclusion: LLE can be used for codeine extraction since it demonstrates good sensitivity and accuracy.

Background: The measurement of DNA content or ploidy has become a useful tool for diagnosis and treatment of malignancies. The purpose of this study was to assess the incidence of DNA aneuploidy in children with acute lymphoblastic leukemia (ALL) and the relationship between aneuploidy and morphological subclass, immunological phenotype, leukocyte count, age, and sex.Materials and methods: DNA content and laboratory features were determined in 60 ALL patients, all of whom, were under 15 years old and have not received any treatment. DNA content was evaluated using flowcytometry.Results: Diploidy, hyperdiploidy, and hypodiploidy were reported in 50, 45, and 5% of patients, respectively. The mean DNA index was 1.21. We have found hyperdiploidy to be associated with lower leukocyte count (p<0.05).Conclusion: Prior investigators have not reported significant results, but mean age of hyperdiploid patients was lower than the diploid, meanwhile, early pre-B phenotype and L1 morphology among hyperdiploid patients were more common. Thus, Evaluation of DNA content can be useful and prognostic in ALL patients.

Background: Fine Needle Aspiration (FNA) has commonly been employed as a relatively non-invasive and reliable diagnostic modality, however, In Iran we lack adequate experiences. Materials and methods: In this retrospective study, 240 cases of CT guided FNA have been reviewed.Results: Of 240 cases, 225 FNAs (94%) had adequate specimens. Most cases had clinical diagnosis of malignancy. 100 cases were cytologically confirmed to have malignancies. Of these 100 patients, 82 also had needle biopsy, of whom 73 biopsies provide adequate specimens (90%). Of these 73 biopsies, 68 (93%) were histologicaly confirmed to have malignancies. Conclusion: To reduce the complications of invasive methods, we highly recommend CT guided FNA.

Background: Medical education program for general practitioner is the most common tool of medical education. We have evaluated one of these programs, which was held in Shiraz in 1998.Materials and methods: 45 general practitioners were asked to complete a pre-and post-test questionnaire. They were asked about the trainers behavior, program goal, trainees goal, and their satisfaction with the program.Results: The mean participants scores of pre- and post-test were 10.05 and 12.61, respectively (p<0.0001).Trainers behavior had the highest and trainees satisfaction had the lowest scores.Conclusion: Results have shown the effectiveness of medical education program., however, further programs should be evaluated so that the most appropriate strategy could be drawn.

In several conditions such as deep venous thrombosis, cerebral thrombosis, and valvular heart disease use of anticoagulants (eg, warfarin) is mandatory. Since most of the clotting factors depressed by oral anticoagulants are in the injury (extrinsic) pathway, the prothrombin time (PT) is the test of choice in controlling oral anticoagulant therapy. The PT results, however, show a significant interlaboratory variability. To harmonize the PT reports, a system that so called International Normalized Ratio (INR) was proposed. Using the INR, the interlaboratory variance should vanish and patients can be free to travel about without having any trouble with under- or over-anticoagulation. The current recommended INR ranges are 2.5-3.5 for patients with prosthetic mechanical heart valves, and those with myocardial infarction in whom oral anticoagulant therapy should be started. The recommended INR range for all other cases is 2-3. The INR should be the only reporting method for controlling oral anticoagulant dose adjustment.

Pena-Shokeir syndrome type II is a kind of congenital arthrogryposis, which is accompanied by microcephaly, ocular defect, and variety of cranio-facial abnormality. It is known as Cerebro-Oculo-Fascio-skeletal (COFS) syndrome. It is presented with reduced white matter, optic tract hypoplasia, and brain calcification. Patients are presenting with microcephaly, bimalformed ears, and other craniofacial abnormalities. In this article we present two Pena-Shokeir syndrome type II patients manifested by all craniofacial features of the disease as well as their neuroimaging findings.