Research in Medicine
Year:2005 | Volume:29 | Issue:3|Papers Count:23

An intellectual critique of researches is a fundamental procedure through which knowledge promotion. may be achieved. Different aspects of the subject should be sought. There are several points that made the critique of studies an important activity. These include: student critique, critique in order to process findings, verbal critique fol1owing the verbal research presentation, written critique following written research report, critique for the purpose of selecting abstracts, editorial critiques and critique for evaluating research proposals. There are five steps in critique process: comprehension, comparison, analysis, evaluation and conceptual clustering. Qualitative and quantitative critique of researches has different aspects in common. We have explained intel1ectualcritique and its components here. Finally, we have concluded that intel1ectualcritique should be observed in academic education and editorial office of medical journals should devote pages to this issue in their journals.

Background: Recent studies have shown normal thyroid function in infants whose mothers receive methimazole (MMI) during breast-feeding. This study evaluates the long-term effect of MMI on thyroid function and intellectual development of such children.Methods: 82 children aged 48-86 months were studied. 42 children had been breast-fed while their thyrotoxic lactating mothers received daily doses of MMI 20-30 mg in the first, 10 mg in the second and 5-10 mg for additional 10 months of therapy. Thyroid function of infants remained normal during the one year of MMI therapy of their mothers. 40 other infants served as controls. Serum T4, T3, and TSH concentrations, urinary iodine, thyroid antibodies, intelligent quotient (IQ), verbal and functional (performance) components (Wechsler and Good enough tests) were measured in al1children of case and control groups.Results: Height, weight, serum T4, T3, TSH and antithyroid antibody titers were not differed between children of case and control groups. The mean IQ was 107±17vs 106±16 (Good enough test) and 103±10 vs 103±16(Wechsler test) for children of thyrotoxic mothers and control children, respectively. There was no difference in verbal and functional IQ and their components between children of thyrotoxic MMI treated mothers and control children.Conclusion: Thyroid function and physical and intel1ectual development of breast-fed infants whose thyrotoxic lactating mothers were treated with MMI are normal at age 48 to 86 months.

Background: Patients with thalassemia major are classified as high risk group for blood-born viral infection due to multiple transfusions. We investigated the frequency of hepatitis C virus among thalassemic patients referring to Mofid Hospital in 2002. Meanwhile, the association between HCY infection and liver enzyme level was determined.Methods: During this retrospective study, 110 patients who had referred for transfusion to our department were included. Initial data including anti-HCV, HCY-RNA (if anti-HCY was positive), alanine transferees, aspartate transferees, and ferritin were gathered.Results: Anti-HCV was positive in 13 (11.8%) subjects among whom 11 (84.6%) were positive for HCV-RNA. All transfusions had been achieved prior to the National Program of Blood Product Screening for HCY (in Iran) that was commenced in 1996. Anti-HCY positive subjects revealed to have significantly higher ALT level (p=0.03), meanwhile, elevated liver enzyme (regardless of anti-HCY status) was more frequently found among patients with increased level of ferritin (p<0.001). Conclusion: Frequency of HCY was dramatically decreased among thalassemic patients following the screening program in 1996. However, routine investigations are still advisable. Iron overload due to multiple transfusions may contribute to impaired liver enzymes.

Background: Campylobacter spp. that have been frequently isolated from livestock's, meat and chicken cause acute diarrhea in developed countries. This study was conducted to screen the cases of diarrhea at two children hospitals in Tehran to detect the bactriologically confirmed cases of campylobacteriosis and to determine the rate of causative agents to different antimicrobial drugs.Methods: Five-hundred fecal samples of patients with acute diarrhea were received from two children hospitals, Children Medical Center and Mofid Hospitals during October 2003 and October 2004. Samples were received in Cary Blair transport medium to the Food Borne Disease Laboratory. They were then plated either directly on Brucella agar containing supplement or enriched in Preston broth for subsequent plating. The inoculated plates were incubated in microaerophilic condition for 48 hours. Drug susceptibility testing was performed using disk diffusion agar.Results: During the study period, 39 campylobacter strains were isolated (7.8%). Campylobacter jejuni was the dominant species isolated from the clinical specimen (75.7%). The rates of susceptibilities to different antibiotics were as follows: gentamicin, imipenem and colistin (100%), streptomycin and chloramphenicol (97%), neomycin (94.1%), ampicillin (88.2%), erythromycin (85.2%), tetracycline (70.5%), cefotaxime (58.8%), ciprofloxacin (20.5), carbenicillin (50%) ceftazidime (32.2%). All isolates were resistant to cephalexin.Conclusion: The frequency of recovery (7.8%) from children with diarrhea shows that the organism could be one of the major etiologic factors of diarrhea among children in Tehran. The high rate of resistance to quinolone warrants further for the possible reasons.

Background: Allergic rhinitis is among the most common respiratory disorders that has been increased during the recent decades due to air pollution. Most of prior studies have investigated the association between allergic rhinitis and hearing loss among children, however, scanty reports address the issue among adults, thus the present study was conducted among patients referring to a university hospital and 3 private ENT clinics in Tehran during 2000-2004.Methods: For this cross-sectional study, 800 allergic rhinitis patients (their allergy was established via laboratory tests) comprised our case group while 840 non-allergic rhinitis patients who had referred to a surgery clinic served as controls. All subjects were scheduled for PTA, tympanometry and Eustachian tube function test (ETFT).Results: The mean hearing loss was reported 10±9.1db in case and 2.5±2.2db in control group (p<0.0005). None of the subjects had a completely nonfunctioning Eustachian tube, however, 140 cases and 120 controls had partial impairment.Conclusion: Allergic rhinitis may cause conductive hearing loss in adults, however, nonfunctioning Eustachian tube and otitis serosa are not seemed to be the etiologic factors.

Background: Entering university is a unique period in the young's life that may encompass great changes in their individual and social relations. The purpose of this study was to investigate the self-concept variations of students and its relationship with personal variants.Methods: In this descriptive study, 111 freshman and 102 senior students were randomly selected from Faculty of Rehabilitation in Shaheed Beheshti University to answer the Roger's self-concept test. Data was analyzed by SPSS software and chi square test.Results: Of 213 students, 13.1% had positive and 86.9% had negative self-concept. Results revealed that there was no significant association between marital status, age and gender with self-concept. Meanwhile, level of education did not influence self-concept.Conclusions: The above-mentioned findings suggest further psychological evaluation and adequate counseling services to promote students mental health.

Background: Anxiety is a frequent complication among epileptic patients which is usually disregarded or treated incompletely. The negligence in timely diagnosis and treatment may cause major subsequences. This study was achieved to determine the prevalence of anxiety among epileptic patients. Methods: During this descriptive study, 138 patients referred to the Neurology Clinic in Imam Hossein Hospital and Iranian Epilepsy Society were enrolled. Patients were assessed by SCL-90-R (symptoms check list- 90- revised) and demographic questionnaires. Results: It was revealed that 44.9% of the epileptic patients suffered from anxiety. Anxiety was more prevalent among unmarried jobless women as well as those with generalized epilepsy.Conclusion: Anxiety is more frequent among epileptic patients than general population. This attracts the attention of physicians for timely diagnosis and effective treatment of this curable disorder.

Background: Noise-induced hearing loss is among the most common cause of occupational-related hearing loss. Nowadays, noise-induced hearing loss is a disastrous event of industrial world that may influence all races, ethnics and age groups.Methods: This cross sectional study was performed on 100 workers exposed to noisy environment (greater 85db) in Azmayesh factory. Having excluded all confounding variables, sixty 25-64 year-old workers were included and a thorough physical examination and desired laboratory tests were instituted. PTA was achieved 48 hours after occupational resting for both ears.Results: Noise with the frequency of 4000Hz could impair hearing function since only 48.3% of workers had normal hearing parameters. This impairment may be more significant as the duration of exposure increased. Meanwhile, 72.2% of workers who have been exposed less than 10 years to noisy environment had normal hearing function, while after 20 years of exposure this figure was as low as 33.3%. Age was inversely correlated with hearing function. As 60% of25-34, 76.5% of 35-44, 37.5% of 45-54, and 42.9% of 55-64 year-old workers had normal hearing function. Conclusion: Hearing loss is a frequent complication of noisy environment. All industrial factories are strongly recommended to observe protective facilities if their workers are exposed to noisy environment of greater than 85db. Periodic hearing assessment is also suggested for susceptible workers.

Background: Mental health is a matter of controversy in psychiatry. Individuals' ability to coping with changes and stresses is one of the factors that may influence mental health. The goal of the present study was to assess psychological morbidly and coping strategies in freshman students of Shaheed Beheshti University of Medical Sciences in 2004.Methods: During this cross sectional study, 249 students received three self-report questionnaires. They were asked to complete the 28-item general health questionnaire (GHQ-28), Billings and Moos coping questionnaire as well as a demographic questionnaire. The data were analyzed with chi-square and t-tests. Results: Totally, 36.1% of students scored above the threshold of 23 for GHQ-28 with insignificant differences between genders. Suspected students used emotional inhibition and somatization as coping strategies more frequently than others (p<0.05), however, normal students (GHQ<23) used problem-solving strategy and cognitive evaluation more commonly than others (p<0.05). Attraction of social support did not show a statistical significant difference between suspected subjects and the group with GHQ<23. Conclusion: Subjects ranged within the normal limit of mental health employ more effective and active coping strategies and cognitive evaluation of problems and finding solution. With respect to the inseparability of life and education from stresses, educating students for effective coping strategies, especially during the first years of university can increase their immunity against psychological disorders.

Background: The incidence of complications of laparoscopic cholecystectomy has increased dramatically since the introduction and widespread use of laparoscopic cholecystectomy in 1990. Bile duct injuries are among the most important complications of this approach.Methods: From January 1998 to January 2002, a total of 155 laparoscopic cholecystectomy were performed at the Loghman Medical Center. A retrospective analysis of bile duct-related complications was carried out.Results: There were 6(4.4%) major complications including major bile duct injury, cystic duct leak, bile duct strictures, and hemorrhage that required laparotomy at later stage,Conclusion: Results revealed that laparoscopic cholecystectomy is an operation associated with low morbidity and mortality rate, but bile duct injury is still a major concern. We believe that clear demonstration of anatomy is the cornerstone of safe, successfullaparoscopic cholecystectomy.

Background: Most of the offending genes of diseases are quite big and complex with varieties of exons. Gene montage is a new technique for formation of a big linked DNA segment that could be easily detected by DNA sequencing or Denaturing High Performance Liquid Chromatography (DHPLC).Methods: Exons 2,20,23 and 24 of BRCA1 gene were linked and analyzed by DNA sequencing. Exons 2 and 20 are important exons that have recognized genetic mutations. Thus, the aforementioned exons were linked as follow: 23-20-2-24.Results: First, the wild type linked-DNA was analyzed by DNA sequencing in order to control the linkage protocol. Then, three previously recognized mutant DNA were analyzed by this technique in order to verify its clinical application in detecting gene mutation. All 3 mutations were detected by this technique. Conclusion: Gene montage technique can be easily employed in order to detect complex gene mutations such as those in BRCA1/2. Gene mutation detection is the true clinical application of this technique that can be used in genetic and screening laboratories.

Background: External quality assessment referred to the survey of different laboratories' results of a unique specimen as compared with a reliable reference. These assessments have been introduced since 1988 in Iran. Results were processed according to techniques of measurement and their accuracy was checked against the reference value.Methods: We have gathered results of 14 parameters in 9 courses of external quality assessment, then compare the mean of each course with the expected value using paired t-test.Results: Results have revealed the coincidence of measured parameters with expected results.Conclusion: Despite the empirical nature of consensus hypothesis, it is revealed to be true in external quality assessment, thus it can be used to calculate the target value.

Thyroid hemi agenesis with or without isthmus is a rare congenital disorder. Papillary thyroid carcinoma associate with hemi agenesis is very rare. A 42 years old female with chief complain of cervical mass was referred to our center. In physical examination, she had a 1.5x1.5 nodule in right lobe of thyroid. The result of thyroid nodule fine needle aspiration was reported papillary thyroid carcinoma. The right thyroid lobe was respected but there was not any trace of thyroid in left side and isthmus on trachea. In thyroid scan that was achieved one month later, iodine absorption was observed only in right thyroid bed. As a result the left lobe thyroid hemi agenesis and isthmus were approved. The final pathology report was thyroid papillary carcinoma. It was a rare case of thyroid hemi agenesis associate with thyroid papillary carcinoma that usually diagnosed accidentally.

Conversion disorder is a disturbance of bodily functioning that does no conform to current concept of anatomy and physiology of central or peripheral nervous system. It typically occurs in a setting of stress and produces considerable dysfunction. It is a common disorder, however in this report we have introduced a rare case who presented after the measles and rubella (MR) vaccination.