Research in Medicine
Year:2004 | Volume:28 | Issue:1|Papers Count:16

Background: The relationship between body fat distribution and cardiovascular risk factors in obese population may be different from general population. This study was conducted to evaluate the relationship between WHR and cardiovascular risk factors in overweight and obese women and to determine a point of WHR above which the chance of having cardiovascular risk factors increased.Materials and methods: In this cross-sectional study, 2892 women age 20-78 years with BMI≥ 25 were included. Anthropometric indices were measured and BMI and WHR were calculated. Blood pressure was evaluated according to standard protocols. Subjects with SBP or DBP fell at or above levels defined as hypertensive, were placed in the high-risk category. Biochemical indices were measured in the fasting state.Subjects with FBS≥110 mg/dl were placed in the high-risk category. Women were, also, placed in high-risk category if their serum lipid concentrations, except HDL, were at or above the 75th percentile of NHANES III. For HDL, however, subjects were placed in the high-risk category if values were at or below the 25th percentile of NHANES III. Women were divided into quartiles based on their WHR. Quartile 1 (<0.8), quartile 2 (0.8-<0.84), quartile 3 (0.84-<0.9), and quartile 4 (≥ 0.9). Results: Quartile 4 had higher age, BMI and waist circumference than other quartiles. Low proportion of women with B~35 was in quartile 1 and high proportion in quartile 4. Significant increasing trend was observed for odds ratio of having low HDL-C, high TG, high TC/HDL-C and high FBS with increasing WHR. Controlling for BMI and simultaneous adjusting for confounding variables had no effect on this trend.Such trend was not seen in other indices. Odds ratio for having high LDL and high SBP was not significant in any WHR quartiles. Women placed in quartile 2, 3 and 4 had higher chance of having high diastolic blood pressure relative to quartile 1 (1.3, 1.5 and 1.6 times, respectively). Simultaneous controlling for confounding variables caused this chance to be disappeared.Conclusion: Results have revealed that in overweight and obese women, chance of having cardiovascular risk factors increased at WHR2:0.8, like normal women.

Background: Breast cancer is the most common female malignancy world wide and in Iran as well and is the second cause of death due to malignancy after lung cancer. Varieties of factors such as estrogen and progesterone receptors, and axillary lymph node involvement may influence the prognosis and therapeutic approach. However, mutation in HER2 gene may also affect the prognosis. In this study, we evaluate the relation between HER2, estrogen and progesterone receptors and axillary lymph node involvement, in primary breast carcinoma.Materials and methods: For this cross-sectional study, 102 patients with primary breast cancer were enrolled. Having prepared the sections, they were stained by H & E. Then, the size and type of tumor, severity, and number of involved lymph nodes were determined. On the other hand, we have identified the estrogen, progesterone and HER2according to the immunohistochemiostry staining.Results: Of 102 subjects, 65 (73.7%) were HER2 positive. We have found a significant association between the HER2 and number of involved lymph nodes (p<0.007), however, our results failed to show any significant association between estrogen and progesterone receptors and severity of diseases. Conclusion: The high frequency of HER2 gene mutation draws our attention towards the importance of this marker among Iranians, however, to confirm the role of HER2in breast cancer prognosis, we must conduct further studies.

Background: Prior investigators have stated that vasopressin may be effective in controlling intensive acute and chronic pain. The present study investigated the effect of vasopressin on acute and chronic pain in three models (Tail Flick, Hot plate and Formalin test) in mice.Materials and methods: Sixty male albino mice, weighed 25-30 gr were included. Desmopressin (10µg/kg) for the case group and saline at the same volume for the controls were injected interaperitoneally 10 min prior to the exam.Result: Results have revealed that vasopressin did significantly inhibit acute and chronic pain in case group as compared to the controls in any of the three models (p<0.01).Conclusion: The present data provide further evidences for the important role of vasopressin in relieving acute and chronic pain. It may play a role as endogenous pain regulating substance.

Background: Streptococcal pharyngitis is the most common type of acute bacterial pharyngitis that may have different complications if remained untreated. On the other hand, antibiotics may impose side effects if prescribed for healthy subjects, thus, the appropriate diagnosis of affected individuals is of utmost importance. Previous studies have indicated the accuracy of Rapid Test for streptococcal pharyngitis, so the present study was conducted to determine the accuracy of Rapid Test among a group of Iranians.Materials and methods: For this clinical trail, 320 consecutive cases of sore throat were enrolled. Rapid Test was performed for all cases; however, culture was our gold standard for diagnosis. Finally, positive predictive value and negative predictive value were calculated.Results: The study population included 150 males and 170 females with the mean age of 21 ± 7 years. The positive and negative predictive values of Rapid test were 66% and 98.5%, respectively.Conclusion: With respect to the known complications of acute pharyngitis, we strongly recommend Rapis test for all patients with sore throat.

Background: The high prevalence of congenital hypothyroidism (CH) has been reported--previously, however the severity of CH has not been evaluated yet. This report illustrates the severity of CH in Tehran and Damavand.Materials and methods: From February 1998 to May 2003, 31 hypothyroid neonates (>37 weeks gestation) were detected during the CH screening program in Tehran and Damavand. Neonates were grouped in permanent (n=25) and transient CH (n=6). Those in the permanent CH were assigned in Dysgenetic (n=18) and dyshormonogenetic (n=5) groups. Dysgenetic cases were further classified in ectopic-hypoplastic (n=13) and athyroitic (n=5) cases. Serum thyroxine values and frequency distribution of sever hypothyroidism (T4< 42.8 nmol/l) were compared among the groups.Results: Mean (±SD) of T4 of permanent CH (38.0±42.2 nmol/l)was significantly lower than transient CH (101.9±46.5nmol/l) (p< 0.01). It was similar in dysgenetic (41.9±47.5nmol/l) and dyshormonogenetic (27.8±23.7nmol/l). Both latter groups showed significantly lower T4 values than transient CH (p<0.05). Athyreotic cases (11.1±5.9nmol/I) had lower T41evels than transient CH (p< 0.05). Severe CH was present in 18(72%) permanent, 1(16.7%) transiert, 8(61.5%) ectopic-hypoplastic, 5(100%) athyroitic, and 5(71.4%) dyshormonogenetic CH cases. Odds ratio of severe CH occurrence in permanent CH as compared to transient CH was 12.9(95% Cl: 1.27-130.54).Conclusion: The high prevalence of severe CH warrants an effective national CH screening program for early detection of CH cases and sufficient replacement therapy.

Background: Foreign body ingestion is a common occurrence in children and high risk groups of adults such as those with underlying esophageal disease, the mentally retarded, and those with psychiatric illnesses.Materials and methods: For this existing data type study all patients who had referred during a 4-year period (1993-96) to Loghman Hakim and Taleghani hospitals with the diagnosis of esophageal foreign bodies were included.Results: The study population included 77 children and 123 adults (89 females and 111 males). Most of the affected subjects aged 2-6 years. The most frequently ingested objects were coins (45.5%), bones (meat, chicken, fish) (33%), vegetable objects (8.5%), dentures (5%) and other metal and non metal objects (8.5%). The most prominent complaints were dysphasia with pain (54.5%), dysphasia without pain (21%), pain without dysphasia (8%), no dysphasia or pain (16.5%). Radiographic studies revealed soft tissue in neck region and foreign bodies in 84% of the cases. Rigid esophagoscopy was performed to remove the foreign bodies, however, in 12% of cases complications including bleeding of hypopharynx and esophagus (3%), tearing of mucous membrane (8.5%), perforation of esophageal wall and mediastinitis (0.5%) did occur.Conclusion: Early detection of esophageal foreign bodies is of utmost importance since their complications are serious and can be life-threatening.

Background: Growth is a suitable indicator of health and appropriate nutrition among children. It may delay due to insufficient intake of energy, protein, vitamins, and minerals. Indeed, growth can efficiently evaluate child*s health and nutrition status.Materials and methods: During this cross sectional study 300 children aged 0-36 months were randomly selected. Data were gathered through face-to-face interview with their mothers and also determination of their weight and height. Nutritional status of children was determined and the role of dependent and independent variables was evaluated.Results: Results have revealed that 3, 13.3, and 2.7% of children had present and past, past, and present malnutrition, respectively. A significant correlation was noted between past malnutrition with child age (p<0.01), birth weight (p<0.005),age at which complementary feeding was started (p<0.03), and father's job (p<0.04). Meanwhile, a significant correlation was found between past and present malnutrition with child age (p<0.04), birth weight (p<0.0004), and duration of breast feeding (p<0.001). Finally, there was a significant association between present malnutrition with sex (p<0.005), and b\duration of breast feeding (p<0.001).Conclusion: Malnutrition is a major problem among the children of this region. A proper programming to solve the problem is highly suggested.

Background: Inguinal hernia and symptomatic genital diseases are common surgical problem. Late diagnosis and treatment of these abnormalities can lead to irreversible complications such as intestinal strangulation, infertility and psychosomatic problems. Most of these disorders can be diagnosed during childhood period.Materials and methods: As a cross-sectional study, 3205 elementary school boy students have been examined.Results: Abnormalities were detected in 213 children (6.6%). 78(2.4%) had inguinal hernia, 28(0.9%) had hydrocele, 75(2%) had undescended testis and -25(0.8%) had hypospadiasis. Meanwhile, two cases of epispadiasis, one case of varicocele and three cases of micropenis were also reported. Ambiguous genitalia and apenia were not seen in our subjects. Most of the parents were not alert about their childrn's anomalies. Conclusion: According to the high incidence of penoscrotal anomalies and low public knowledge, educational and screening programs are recommended.

Background: For conservation and continuous of educational, occupational and social performance, the well-being is the goal of mental health and providing information and statistical data in relation to mental disorders are the original requirements for mental health policies. The present study was conducted to determine the prevalence of mental disorders in interns of Shahid Beheshti university of medical sciences during a 6-month period.Materials and methods: For this descriptive study, 2 separate questionnaires, one dealing with demographic and the other GHQ-28 were completed. Results were compared in two groups of healthy and suspicious subjects according to the sex, marital status, living places before entering university, present living places, hopefulness to career, economic status, presence of underlying disease, abuse of substances (alcohol, opium, and canabis), and tendency to marriage.Results: Result showed that at the cut off point of 22 for men and 21 for women, 52.1% of the interns were suspicious to have any kind of mental disorders. Mental disorders were more frequently reported among females, married interns, interns living in rental house, non interested interns to medicine, disappointed interns to their career, low economic status subjects, interns with underlying disease, and substance abusers.Of these, female sex, lack of interest, disappointing, low economic status, and underlying disease have shown significant association with mental disorders.Conclusion: Mental disorders are quite common among these interns. Our data can be used as a statistical source to plan for mental health policies.

Fibrodysplasia ossificans progressiva is a connective tissue disease. The prompt diagnosis is of utmost importance since surgical interventions are not indicated except in rare cases. We present a 5-year girl admitted due to the swelling on the back of her neck developing on her right scapula and shoulder during the recent two mounts. The course of disease was progressive in which gradually resulted in limitation of the range of motion of shoulder joint and neck. There were some other clinical findings such as ossification in distal port of the right femur and increased uptake in bone scanning at the same time.

Superior mesenteric artery (SMA) aneurysm is one of the rare visceral aneurysm with different clinical manifestations. There are few reported cases worldwide, each being reported in a specific situation. In this paper, a rare case of disease with fistulization of SMA to jejunum, causing massive GI bleeding is reported. Having DSA studies completed, the patient was operated and SMA was ligated after the midcolic branch. Patient left the hospital with no complications even after 18 months.

Tonsil calculus is not a common disease. It may present with bad oral smelling, sore throat and peritonsillar abscess. However, to our knowledge, recurrent neck abscess have not been reported yet. A 39-year old man admitted in hospital due to swelling and tenderness in Right side of his neck. This condition was repeated thrice during the recent 2 years. Examination revealed a big tonsillolith.Tonsillectomy with drainage of abscess was performed. Patient has no sign of recurrence during the year.