Research in Medicine
Year:2006 | Volume:30 | Issue:2|Papers Count:17

Background: Body mass index (BMI) is the most common index for assessing weight status of adults, at both individual and population levels. However, calculating BMI without an instrument is quite difficult and time consuming. The objective of this study was to test whether the proposed new and simple height weight difference index (HWDI) is valid for screening different weight status.Materials and methods: The data, obtained from adult participants of Tehran lipid and glucose study (TLGS) were used for this cross-sectional study. Height and weight of 10723 (4555 male, 6168 female) 18 to 70 year old subjects were used for calculating BMI (weight in kg, divided by height squared in meters) and HWDI (height in cm, minus weight in kg). Linear regression was used to determine the relationship between BMI and HWDI, and Kappa statistic was used to test the agreement between the indices.Results: There was an inverse strong relationship between BMI and HWDI (r=-0.98, p<0.0001). Cut-off points for different weight status, according to HWDI, based on current BMI references, were calculated by the prediction formula: HWDI = 163.4-2.67 BMI. HWDI had high sensitivity and specificity for obesity at all levels, and Kappa test, showed an excellent agreement between the two indices. Specificity of HWDI was high for total thin subjects, but sensitivity and Kappa for grades 1 and 2 thinness was low. Although a high sensitivity was observed for grade 3 thinness, Kappa was low for the grade 3 thinness. While considering all thin subjects all together, there was a high sensitivity and specificity, and a good agreement.Conclusions: HWDI can be used as an applied and simple index for diagnosis of different grades of obesity from normal status. Although the index can not determine different grades of thinness, but is useful to diagnose the status as a whole.

Background: Urinary calculi comprise one of the major and widespread problems in the urinary tract. Various factors playa role in the formation of urinary stones including nutrition, weather, sex, genes, and unease producing bacteria. The incidence of urinary stones in different societies ranges from 3 to 4 percent. This survey was done in 2004 on 100 patients presenting with urinary calculi in Labaffie Nejad Hospital.Materials and methods: Urinary calculi which had been extracted out from 100 patients, using ESWL approach, were studied. Tiny fractions of stones were put in culture tubes, (Thioglicoolate and T.S.B). Other fractions of stones were sent for chemical analysis.Result: During the analysis of 100 samples which were cultured, bacteria grew in 40 samples (40%). 53.88 percent of the stones were of mixed type. Microorganism isolated. From the stones were E.coli (37.5%), S.aureus (17.5%), Candida (12%), Enterobacter (10%), Klebsiella (10%), Providencia (5%), S.epidermidis (5%), Bacillus subtilis (2.5%). There was a significant relationship between a positive culture for E.coli and Calcium oxalate stones, and also between Enterobacter and uric acid stones, (p = 0.034 in both cases).Conclusion: Bacteria, both urease producers and non-producers of urease are capable of gathering Calcium crystals and thus constitute a significant factor in the formation of urinary stones.

Background: It is believed that diabetes mellitus (DM) increase the susceptibility to Helicobacter Pylori (HP) infection, but there is little information about the role of DM in being infected patients with HP. We studied the frequency of HP in diabetic patients referred to Taleghani hospital during 2003-2004.Materials and methods: In this case-control study, frequency of HP in diabetic patients referred to Taleghani hospital was studied. Case group consisted of 84 patients with documented diabetes mellitus and control group included dyspeptic patients without DM who were been matched to the case group. Both case and control groups underwent endoscopy. Patients who had history of using antibiotics during the previous month or proton pump inhibitors during the past week were excluded. Urease test was performed in all patients. In negative unease test, biopsy was taken to evaluate histological study of HP. Results: Mean age of case and control groups were 47.5±10.2 and 47.6±10 years, respectively. In both groups, male to female ratio was 46 to 36. Nineteen patients (22.6%) have diabetes type1 and others (77.4%) have diabetes type 2. Frequency of HP in case and control groups were 47 (51.1%) and 45 (48.9%), respectively and there was no significant differences between two groups. Odds ratio for being infected with HP in diabetic patients was 0.95 (95%CI: 0.7- 1.3). Conclusion: This study didn't demonstrate any relation between DM and HP in adult patients. So, high frequency of dyspepsia in diabetic patients can be attributed to other factors such as autonomal disorders.

Background: Complete blood count (CBC) is one of the frequently required tests in clinics and leukocytosis is the most frequent finding. Few modem studies have enumerated the conditions associated with leukocytosis. In this descriptive study, we evaluated its etiologies in 2 teaching infectious wards from 1382until 1383.Materials and methods: 100 inpatients with WBC (white blood cells) count of ³ 10000 cells/mm3 presenting at the Loghman Hakim and Labafinejad Medical center of Shaheed Beheshti Medical University were evaluated. Data were recorded on data sheets and analyzed. Results: We documented infection in 75 patients (75%). Of these 75 patients, 29 (38.7%) had pneumonia, 19(25.3%) had urinary tract infections, 14(18.7%) had skin and soft tissue infections, 4(5.3%) had bone and joint infections, 3(%4) had CNS infections, 2(2.7%) had cardiovascular infections, 2 (2.7%) had pharyngitis, 1(1.3%) had Gastroenteritis and 1(1.3%%) had intra-abdominal abscess. Non- infection causes of leukocytosis in the 100 patients included physiological stress (11%), medication and drug (5%), hematologic and malignant disorder (2%), and necrosis-inflammation (4%). 3 patients died without any diagnosis. The mean leukocyte count was 15386±4747.Conclusion: Infection, especially respiratory tract infection, is a prominent cause of leukocytosis (75%) but non-infectious conditions should also be considered. Despite few malignant cases in this study, malignancy should be ruled out in patients with a very high leukocyte count.

Background: Iodine deficiency disorder (IDD) is a worldwide health problem. Parts of Iran, such as Kohkilouyeh-va-Bouyerahmad, 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 2001 among 7-10-year-old children in Kohkilouyeh-va-Bouyerahmad province.Materials and methods: In this cross sectional study, 1200 children (M/F ratio=1), aged 7-10 years, were selected and grading of goiter was performed in accordance to the WHO criteria. Urinary samples were obtained from 120 children and urinary iodine was measured using digestion method.Results: Total prevalence of goiter was 7.7% (6.5% in girls and 8.7% in boys). The median urinary iodine was 17.7mg/dl. 84.7% had urinary iodine of more than 10mg/dl, while 14.3% had urinary iodine levels of <5mg/dl. None of the candidates has urinary iodine of less the 21mg/dl. There was no significant difference between sexes and urban or rural areas.Conclusion: Results have revealed that the total prevalence of goiter has significantly decreased among children in Kohkilouyeh-va-Bouyerahmad province, meanwhile, urinary iodine concentration of children has reached to WHO approved rate. Thus, Kohkilouyeh-va-Bouyerahmad province could be classified among "iodine-deficiency-free" areas in Iran.

Background: Hemophilia is a x-linked deficiency of factor VIII. The aim of the present study was to determine the frequencies of hepatitis Band C infections, markers of inflammation and liver function tests and also to assess the possible association between factor VIII inhibitor and hepatitis Band C infections in hemophiliacs of Hamedan Province of Iran.Materials and methods: Sixty-six patients with confirmed diagnosis of hemophilia were included, for whom, hepatitis Band C serology; aspartate aminotransferase (AST), alanine aminotransferase (ALT), factor VIII level and factor VIII inhibitor were evaluated. Results: Frequencies of hepatitis C antibody and hepatitis B surface antigen were 59.1% and 5%, respectively. Frequency of factor VIII inhibitor was 47.8% in hemophilia A group, and its presence was not neither associated significantly with hepatitis B or C infections nor with AST or ALT levels. There was a significant statistical association between duration of hemophilia and development of factor VIII inhibitor (P<0.03) and hepatitis C (p<0.01).Conclusions: Frequencies of hepatitis C and B are significant in hemophiliacs. Indeed, current screening of blood products might not be complete for elimination of blood-borne viruses and we strictly suggest revising this process in transfusion centers.

Background: There are few recent prospective studies regarding role of surgery for the treatment and diagnosis of tuberculosis (TB). We conducted this study in our department and the results are presented.Materials and methods: From 20 February 2003 to 21 September 2003, patients who underwent surgery for diagnosis or treatment of TB at the Department of Surgery, Masih Daneshvary Hospital were enrolled in the study. We designed a data form and details of history, radiology, laboratory, bacteriology, operation, complications, histologic studies, as well as results of surgery were recorded. Clinical follow up was scheduled prospectively. Statistical analysis ofthe data forms were done at the end of the study.Results: During the study period, (7 month) 18 patients enrolled in the study. There were 7 females and 11 males with mean age of 34.16 (range: 12-76 years). Twenty six operations were performed on 18 patients which are listed below: Thoracotomy 6, surgical bronchoscopy 6, lymph node biopsy 4, laparatomy 2, video assisted thoracoscopy (VATS) 2, chest tube insertion 2, chest wall resection 1, insertion of stent in the right main bronchus 1. Goals of surgery were: diagnosis in 8, diagnosis and treatment in 6, and treatment alone in 4. In all patients goals of surgery were successfully achieved. There was no mortality, but 3 major complications occurred (persistent air leakage in one patient, severe bleeding after right pneumectomy in one patient and occlusion of the stent by granulation tissue in one. All complications resolved with appropriate treatment. Diagnosis of TB was based on histological findings of surgical specimens or isolation of Mycobacterium TB or both.Conclusion: Whenever indicated, surgery has a definite role in the treatment and diagnosis of TB. Results of surgery are good with few complications.

Background: Septoplasty is one of the most cornmon and basic procedures in ear, nose and throat surgery. Due to the presence of several resident organisms and their proximity to vital regions of the head and neck, any infection in this region is of special importance.Implementation of optimal preparation (Prep) of the surgery site has been widely accepted as the most important inhibiting factor for post surgical infection in all branches of surgery including ENT, so we decided to study the effects of preoperative prep on the incidence of post operative infections.Materials and method: This study was conducted as a clinical trial on septoplasty candidates chosen among patients visiting the ENT clinic of Boo Ali and Taleghani hospitals during the years 1997 - 2005. 150 candidates were chosen (78 as cases and 72 as the control group) according to order of visit. Preoperative prep was omitted in all the subjects in the case group, while routine prep with Povidone -Iodine was implemented in controls. Both groups were examined for post surgical infections. Statistical analyses were done by SPSS and Fisher Exact Test.Results: In the case group were 22 females and 56 male with average age of 24.6±5.1 years and in control group were 17 female and 55 male with average 25.3±6.4 years. Signs of infection were observed among one patient in each group (p<0.9).Conclusion: The current study revealed no change in the incidence rate of post-op infection. It seems the sterilization and careful prep of the surgical site is not necessary for performing septoplasty and it is better to pay more attention to the surgical technique, reducing the duration of surgery, and optimizing pre and post operative care.

Background: Prisoners are susceptible to dermatological diseases due to their communal life in prison, high-risk behaviours and being under stress. The aim of our project was to investigate the prevalence of dermatological diseases in an Iranian prison.Materials and methods: In this observational-cross sectional study 1404 prisoners were randomly selected and examined by two dermatologists. Results: All the examinees were male prisoners. Their average age was 34 +/- 11.2 and average time of imprisonment was 1.9+/- 2.8 years. 7% of cases (97) complained of generalized itching and 10% (140) had a localized itching. Tattoos were seen on the body of 261 prisoners (19%). 783 person (56%) (CI 95%: 53-59%) had a dermatological disorder and 621 (44%) were totally healthy. Truncal Acne Vulgaris was the most common disorder that was seen in 184 cases (13%). 158 cases (11.2%) had Tinea Versicolor. Other diseases were Facial Acne Vulgaris in 78 cases (5.5%), Dry Skin in 75 cases (5.3%) and Hand Eczema in 55 cases (4%). The average age of patients with Facial and Truncal Acne was lower. However, Acne was seen more in the patients with history of addiction. Scabies was more prevalent in crowded rooms. Conclusions: The most prevalent skin diseases were truncal Acne and tinea versicolor; our finding revealed that scabies prevalence is meaningfully related to duration of imprisonment. It is recommended that all the prisoners should be examined before entering the prison and also periodically during their imprisonment in order to receive suitable treatment and decrease the risk of transmitting contagious diseases in prison.

Background: HIV/AIDS is a major worldwide health concern. The present study was conducted to determine knowledge and attitudes towards AIDS among high school students in Pakdasht.Material and method: Six hundred and fifty five students (404 females and 251 males) from 10 pre-university centers participated in the survey. An anonymous self-administered questionnaire was used to measured knowledge (40 "true, false, do not" items), attitudes (16 items, 5-point 8 Likert-type scale), and seven query (age, sex, educational field, sources of information, adequacy of information, need to more education and suitable ages).Results: Attitude toward HIV/AIDS was positive. General knowledge of 45.5% students was good (true responses to more than 75% of items), 45.2% was moderate (true responses to 50- 74% of items) and only 9.3% had weak knowledge (true responses to less than 25% of items); however, results revealed low level of knowledge to oral sex, heterosexually contact, and the protective role of condom. TV was identified as the most frequent source of information, while 90% indicated the need for receiving HIV prevention education in the future.Conclusion: These defects may lead to further exposure to and contamination with HIV/AIDS. Thus, we recommend further surveys in this regard.

Background: Rabies has been reported in all provinces and cities of Iran, although there has been no molecular study regarding different groups and subgroups of rabies virus by phosphoprotein gene. In this study, firstly, 48 and then 85 recent rabies isolates recovered from cases reported throughout Iran identified the evolutionary origins by molecular method of phosphoprotein gene region.Materials and methods: All the suspected samples from all over the country has been tested by IF method, then all the positive cases have undergone grouping and sub-grouping by molecular tests of phosphoprotein gene.Results: Three groups (I, II, III) and subgroups have been shown in different parts of country by phylogenetic analysis. Khorassan province has the highest rate of diversity of groups and subgroups (all the 3 groups have been identified in this province), which might be the origin of infection in neighboring provinces and all over the country respectively.Conclusion: In this study, the results of different samples obtained from cities and provinces (which could be the complement of Canadian results) confirmed the emergence of 3 different groups of rabies virus. In addition, the widely dispersion of mentioned groups and sub-groups in all provinces could be shown.

Background: The main surgical side effects and complications in many cases are due to the long duration of the anesthesia. Obviously these phenomena are related to the use of anesthetic drugs which have effects on liver blood flow, immune system and homeostasis. One important effect is activation of complement system. In this study we tried to evaluate and compare the effect of general and regional anesthesia on the activation of complement system.Material and methods: This was an analytic, descriptive and cross sectional study. 30 fresh serum samples were taken from 2 groups of patients undergoing orthopedic surgery with general and regional anesthesia induction. The samples were collected once before starting the operation and again 24 hours after. Blood samples from patients receiving regional anesthesia were labeled as Rl and R24, and from those exposed to general anesthesia as Gland G24, according to the sampling time. Hemolytic index of complement activation was evaluated by Kopensky method in veronal buffer system.Results: Significant decreases of complement activation in G group samples were shown after 24-hours. CH50 index in Rland G1 sample were almost similar. Ch50 index was significantly decreased in G24 samples as compared to R24. No significant differences were observed between R1and R24.Conclusion: The statistical analysis of CH50 index in 2 groups explains that general anesthesia decreases the hemolytic activation of complement system. This study demonstrates the deleterious effect of general anesthesia on the activation of the complement system which constitutes an important defense system against infection.

Background: Autoimmune hepatitis (AIH) is a chronic inflammatory liver disorder of unknown etiology. The search for gene polymorphisms has suggested that Glutathion-s-transferase (GST), enzymes that metabolize carcinogens, drug, and foreign compounds, may play a role in susceptibility to autoimmune liver disease and its severity. The objective of this study was to investigate for a relationship between the glutathion-s-transferase M1, T1 and PI genotypes and type 1 autoimmune hepatitis.Materials and methods: In a case-control study, we investigated glutathion S-transferase (GST) PI He (105) Val, T1, and M1 polymorphisms in 64 type 1 AIH patients and 100 healthy controls that were selected consecutively. GSTM1 and GSTT1 polymorphisms were analyzed by a Multiplex PCR procedure, whereas GSTPI polymorphism was analyzed by PCR-RFLP.Results: GSTM1 and GSTT1 null genotypes (deletions) were determined in 33(51.6%) and 15 (23.4%) patients with type 1 AIH, and 56 (56%) and 22(22%) controls, respectively. Comparison of patients and controls relative to GSTM1 and GSTT1 genotypes revealed no significant difference between them. Regarding GSTP1 genotypes, 25(39.1%) heterozygotes, 7 (10.9%) homozygotes in the case group and 38(38%) heterozygotes, 14(14%) homozygotes in the control group were observed. The allele frequency of GSTP1 (Val) was 30.4% and 33 % in patients and controls, respectively. There were no significant variation in GSTP1 frequencies between cases and controls.Conclusion: These results suggest that there is no association between GST M1, GSTT1 and GSTP1 gene polymorphisms and type 1 autoimmune hepatitis in Iran.