Journal of Isfahan Medical School
Year:2000 | Volume:18 | Issue:57|Papers Count:18

According to the importance of weight gain during pregnancy and its relation with the type of mother's nutrition, we decided to compare the primary mother weight and her weight gain during pregnancy to the neonate weight after delivery in rural and urban areas of Isfahan. Therefore a retrospective and explaining and analysis study between 2000 samples of women coming to the center of health of lsfahan during 6 months in 1999 was done of which 400 ones were randomly chosen and required information as primary mother weight, her weight gain and neonate weight were gathered. The collected data was analysed with SPSS software.There was a meaning relation between the primary mother weight and her weight gain, also between mother's weight gain and the neonate weight. But there was no relation between the neonate weight at and birth time in city and villages.Although there was a meaning relation between mother's primary weight and her weight gain with neonatal weight, this relation is weak and there are lots of exceptions that shows the interference of other factors.

For correction of hump in scoliotic patient, I compared 18 patients with rib hump more than 3cm who undertaken costoplasty with 14 patints corrected by rib resection for recovery of vital capacity. It was found that there are no differences of recovery of vital capacity, between costoplasty and rib hump resection. So it in concluded that because rib hump resection is easier, we can use this technique instead of costoplasty, and we can use the ribs that we exaised as a good source of ban graft. But, in spite of better release after rib hump resection we can not expect better total lung capacity.

The presence of HLA antibodies in the sera of patients on dialysis is a problem or obstacle for kidney transplantation. These patients awaiting kidney transplantation may have been immunized by blood transfusion, previous organ transplant, pregancy or a combination of these. In order to evaluate the effect of transfusion and also the increasing numbers of it, on sensitization and the amount of HLA antibody production, we reviewed all end stage renal disease patients refered to our laboratory in Aliasghar Hospital for detection of HLA antibodies from March 1992 to March 1998.The tests were performed, using a panel of 25 different HLA typed lymphocytes and the microcytotoxicity method of NIH.The percent reactivity of each sera against the 25 panel cells were calculated and refered as precent panel reactive antibody (%PRA).Among our 314 patients (104 females and 210 males), 78 cases had no transfusion in their history, and HLA antibodies were not detected in their sera.The other 236 patients mentioned between one to more than ten times blood transfusions. Among these 236 patients, 52 cases (22.03%) had HLA antibodies in their sera. The percent of PRA had increased with the increasing numbers of transfusions.

Bronchial asthma is the most common chronic disease of childhood. Only recently some limited data have been published with regard of the prevalence of childhood asthma in Iran. The aim of this study was to determine the prevalence of symptoms suggestive of asthma in elementary school children 7-11 years in Shahrekord, Iran. A respiratory questionnaire was issued to the parents of 700 primary school children (350 boys and 350 girls).Those children who had reported any asthma related symptoms, underwent a medical interview and physical. examinations, among whom 39 of the most suspicious children were reffered for spirometry.Result of the self or parents reported diseases, the most common were respiratory allergy (2.7%), Allergy (2.3%) and Asthma (0.4%). Fourteen percent (14%) of the children reported wheezy breathing sometimes in their lives (wheeze ever) and 5% had dyspenea associated with wheeze, these later 5% are considered to have asthma.Prevalence of asthma symptoms in Shahrekord is less than western industrial countries, and the data are closer to those of Turkey and Greece.

The studies carried out on the organism development have contributed enormously to the progress made in embryology. Furthermore the findings of these studies have shed light on the developmental processed of organisms. However, it is worth mentioning that most studies performed so far have been on either the early embryo developed by in vitro fertilization or on the fully developed embryo. In this regard, the present study tends to investigate some of the aspects of in vivo development of embryo that have not yet been surveyed. Thus microscopic sections have been performed and the required photomicrographs have been prepared from decidua, trophoblast and embryo as a unit, followed by monitoring the morphological changes related to the maternal and embryonic intraction. Then the observations have been compared with that of in vitro fertilization results.

Lieshmania major is causative agent of zoonotic cutaneous leishmaniasis or wet form Leishmaniasis. Injection of alive parasite in a covered region of the body is a prevention method against the disease. Resolution of the Leishmania from involved tissues is depend on activation of cell immunity. The use of a suitable adjuvant plus low doses of alive parasite induces a decisive immune response and good protection against the disease.In this study BCG was used as an adjuvant plus different doses of alive L.major promastigotes to induce protection immunity against leishmaniasis in BALB/c mice. Results of two skin tests (before and after infectious challange) and clinical examinations (after infectious challange) showed capacity of the low doses of parasites (120 & 1200 promastigotes per mouse) with or without BCG to activate cell immunity against the disease. The moderate dose of parasite (12000 promastigotes per mouse) induced a partially protection. No protective effects were acquired with high doses of parasite (200/000 promastigotes per mouse) with or without BCG.According to above data the theory of using low doses of parasite in leishmanization was supported.

Giardia lamblia is an important cause of acute gastroenteritis in human world wide, that is more common in children. Since the culture of giardia lamblia was made possible in-vitro, many immunological studies were done. In the present study, G.Jamblia trophozoite prepared from TYI -S - 33 culture media were used as antigen to detect G.lamblia antibodies using indirect immunofluorescence antibody test (IFAT) in 50 serum specimens obtained from patients with symptomatic or asymptomatic giardiasis. Serum from 50 healthy subjects was used as control.Patients sera were 100% positive for anti G.lamblia antibodies with having 1:2 to 1:256 titer. Thirty six serum specimens (76%) from patients had a titer >1:16. Thirty three serum specimens (66%) from. healthy controls had a titer of 1:16 or lower. A titer of at least 1:16 was accepted as diagnostic for Giardeiasis which was found in 76% of patients. Since the patient's titer were significantly higher than controls the IFAT used in this study proved to be useful in detecting antibodies against G.lamblia and screening.

For detection of mutations in ß-globin gene, ARMS technique is usually adopted. In this technique the nucleotide present at the 3" terminal of the primer matched with the concerned mutation and with such a primer PCR is performed.The other property of genomic DNA which could be utilised for diagnosis of, ß-thalassaemia mutations is the sequences called restriction sites. These sites can be recognised by restriction endonucleases which are cutting the DNA molecules at these sequences. Some mutations may produce a new restriction site or abolish the existing ones For rapid screening of ß-thalassaemia mutations we can make use of the naturally occurring restriction sites. However, some mutations do not create or delete any restriction site. Keeping this fact in mind we have designed a special pair of primers that under special circumstances may produce GTAC sequence which is a restriction site for RsaI restriction endonuclease. This primer covers from nucleotide 6 to 31 of first intron of ß-globin gene. The third nucleotide from 3' terminal of the primer intentionally changed from A to G resulting in production of 5'-GTAC-3' sequence after PCR amplification. After restriction digest of PCR amplified DNA with RsaI restriction endonucleose, the IVSI nt5 (G→C) mutation readily determined.

Due to increasing the number of renal transplant recipients in Iran and as many of them are female in child bearing age (12-45 years) that didn't have any pregnancy, evaluation of fertility and pregnancy characteristics of these females are more important.The numbers of cases were 50 and control were 100. The research was done by direct observation of pregnant women during the pregnancy and evaluation of renal function and fetal well being by sonography - serial CBC> BUN, Cr and control of GFR. The nonpregnant women with kidney transplants were evaluated by questionnaires for menstruation, libido, and other fertility characteristics. The control group was choosed from obstetric ward of Beheshti Hospital.Mean age was 29.2±6.4 yrs. in cases and 27.9±8.8 yrs in controls. 20 pregnancy occurs in 18 patients with 2 patients 2 times pregnancy after transplanation. 40% of patients were amenorrhic due to hypogonadotropic hypogonadism effects. Mean menstrual period was 7.88 day (6.28 day control) , mean menstrual interval 32.4 day (28 day control) mean amount of bleeding was 2.2 pad/day (1.9 pad control) P>0.05 The libido improved after transplantation in 81.8% of femles. The mean interval of 35 months was from time of transplantation to concepts (Range 6-65 months). Successful pregnancy were 85% of cases, so pregnancy after renal transplantation may be safe if the patients have normal renal function.

Intranasally administered midazolam and sufentanil were compared with placebo as a premedicant for 150 patients aged 2 to 7 years, undergoing tonsillectomy.Thirty minutes before delivery to the operating room patients were randomly assigned to receive either intranasal midazolam (0.2mg/kg), sufentanil (2µg/kg) or saline normal (placebo). A "blinded" observer evaluated preoperative emotional state, heart rate, blood pressure and respiratory rate.Most patients in group's midazolam and sufentanil could be comfortably separated from their parents. The midazolam and sufentanil groups appeared to be more sedated and more cooperative during induction of anesthesia with a lower preoperative heart rate and blood pressure (P<0.05). Midazolam provided somewhat better sedation and cardiovascular stability than sufentanil.

It is essential for radial keratotomy surgery to determine corneal thickness preoperatively because appropriate incisional depth plays essential role in the effectiveness of surgery and prevention of corneal perforation. Any change in corneal thickness after RK will influence on selecting incisional depth for repeated surgery. Also relationship between changes in corneal thickness and age, sex and the interval between the operations is important. This research has been performed to address these problems.Medical records of 200 patients (101 males & 99 females) which were operated in Isfahan Farabi Hospital in 1995-1998, were studied. The informations were recorded in the information assembly tables including sex, age, interval between the operations and corneal thickness before and after surgery at 5 standard points. Then statistical tests were performed. The results are as bellow:Average of change in corneal thickness were: Central point 10.96±13.8 micron (2%); Superior point 6.82±29.8 micron (1.34%); Inferior point 9.01±28.8 micron (1.77%); Temporal point 12.1±26.4 micron (2.34%); Nasal point 5.14±34.4 micron (1.13%) Therefore corneal thickness was increased after RK surgery and it is important in repeated surgery for eye surgeon. These changes in corneal thickness at 5 standard points are related to sex with a confidence of level of 95% and in females were more. The changes of corneal thickness at 5 standard points are related to age and interval of operation with a confidence of 35%.

Meningitis is a common infectious disease. In every 500 children under four years one of them is affected. It is more seen in neonates. The most common complication of bacterial meningitis is deafness. Brain stem auditory evoked potential (BAEP) is a useful test for evaluation and diagnosis of hearing disturbances especially in children. BAEP is abnormal among 20-30 percent of patients with meningitis. In these prospective study 51 children (31 males and 20 females) less than 4 years with bacterial meningitis that hospitalized in Al-Zahra hospital between 1996-1999 were selected and BAEP test was done. In 52.9 percent of patients abnormality of this test were detected. 19 percent of patients had definite delay in language. So BAEP should be done after complete treatment of bacterial meningitis in children, and based on results, specific treatment and follow up should be done.

The existence of unusual sound in the heart of children and teenagers has made the parents worried, and search about the cause of its formation is usual and necessary. Principally unusual sound of the heart in elementary and guidance ages is caused whether because of congenital heart disease or acute rheumatic fever. In this research 191 patients were studied by echodoppler in Noor Hospital for two years. The cause of left sternal border murmur in 159 cases was tricuspid and pulmonary regurgitation which is a normal finding. The reasons in others were ASD, VSD, PDA, PS and AS which needs follow-up and treatment on-time. Therefore in most cases during mentioned ages the murmurs don't have organic origins, and one can lose the parents' worry just by reassurance. Also can save the patient from activities and sport movement restrictions.

Periventvicular Intraventricular hemorrhage is the most common in premature newborn less than 34 weeks gestational age and with weight less than 1500 gr. In this research we studied the incidence and complication of ICH. In nursery ward in one year study include 2 stage. In stage 1: Sonography of the brain was done in 50 newbornsin 4-7 days afterbirth in premature newbornwith gestational age less than 34 weeks and weight less than 1500 gr. The incidence of ICH was 4%. In stage 2: Etiology, kind of hemorrhage acute and long-term complication of all newborn with ICH was studied in 10 newborns for one year. Although newborn with ICH was limited but neurologic complication and dead was seen in all patients. Prevention of ICH and immediate diagnosis is most important in newborn with ICH.

Along with routine semen analysis sperm, functional tests are recently used for fertility evaluation. Because varicocele is considered as one of the etiological factor in male infertility.The aim of this research was to evaluate the effect of varicocele on semen parameters and sperm hyperactivation.Twenty patients with grade III varicocele were included in this study. Semen parameters were analysed according to WHO, before and 45 days and 90 days after varicocelectomy. Sperm hyperactivation was analysied as follows: Semen were processed by swim-up or percoll and it was divided into two parts, one part was left at room temperature and then heat-induction was carried out on the other part of semen at 40°c for 4 hours.Hyperactivation was recorded before and after heat induced hyperactivation.The percentage of the total sperm density and morphology showed a significant improvement after varicocelectomy but the percentage of motile sperm didn't significantly improve. The percentage of total, progressive and heat induced hyperactive motile sperm decreased before varieocelectomy at 40Éc for 40°c hours, however after varicocelectomy the percentage hyperactive sperm in percoll processed sample showed a significant increase compared with before varicocelcetomy at 40°c for 4 hours.This improvement might increase frequency rate in vivo and in ART cycle in vitro in percoll processed samples.

Considering the large number of published articles indicating positive effects of calcium in preventing preeclampsia and decreasing the mean systolic and diastolic blood pressure, it was decided to undertake this prospective case - controlled study.Out of the 963 pregnant women (28-34 WK), 66 were chosen who had a positive Roll over test. This group was then divided into two groups of each 33 in number; the control group receiving 2 grams of calcium daily until the end of pregnancy and the non-con troll group receiving no calcium.In the contrail group, 8 cases (24.24%) developed preeclampsia as compared to 14 cases (42.42%) in the non-control group (P=0.28).The mean systolic blood pressure in the control group was (113.03±17.22 mmHg) and (119.69±17.93 mmHg) in the non-control group (P=0.12). The mean diastolic blood pressure in the control group was (72.87±11.11 mmHg) and (78.48±12.40 mmHg) in the non-control group (P=0.58).In all of the cases, P>0.05 which indicates that there is no significant difference between the two groups with respect to preeclampsia, and blood pressure. Therefore, administering 2 grams of calcium to pregnant women with a positive Roll over test during the 28-34 weeks of pregnancy does not lead to any -significant decrease in preeclampsia or lowering systolic and diastolic blood pressure.

One of the most important but infrequent complications of discectomy is discitis. On the other hand, major surgical operations usually induce a transient increase in erythrocyte sedimentation rate (ESR). So in order to use ESR as a screening tool in diagnosis of deep infection after discectomy such as discitis, we must measure it in patients after discectomy but without any complication. This is a prospective study on 50 patients after discectomy. Inclusion and exclusion criteria consists of: 1- Patients must have preoperative ESR within normal range, 2- No clinical or laboratory sign of systemic illness preop., 3- No fever or other signs of infections must be found in patients postoperatively.We measured ESR before operation and in days 1, 3, 5, 7, 14, 21, 28 and 35 after operation. After discectomy in most patients ESR rose rapidly and reached its maximum by the third day after operation. As a whole, greater values of ESR were seen in patients whose operation involved more disc spaces. In most patients with one disc ESR reached its normal range 2 weeks after operation, but in patients whose operations involved more disc spaces, ESR reached its normal range by the fifth weeks. If after 2 weeks ESR does n't reach its normal range, in patients whose discectomy involves only one level or after 5 weeks in patients whose discectomy involves more than on level, we must suspect discitis if other signs of infection do exist. If the diagnosis of discitis is delayed, serious complications may occur.

Contrast nephrophathy is applied to serum creatinine increase more than 0.5mg/dl or 25% of basal creatinine 48 hrs after contrast injection. Contrast-induced nephrotoxicity is one of the drug-induced nephrotoxicity and also one of the various causes of renal failure that increases the hospital stay. One of the characteristics of this etiology which is distinguished from the other causes, is its preventability, so obtaining correct statistics of the patients is needed. Referring to the available references, it is obvious that such study's not only present in Isfahan city but also it is not present in our country.This study was done in 100 patients whom were candidate for coronary angiography in Noor hospital, Isfahan. Serum creatinine was measured before and 48 hrs after coronary angiography and also on days 4.7, 14 for those who had creatinine increase more than 25% of basal creatinine. Contrast nephropathy was present in 3% of our patients, that one of 95 nondiabetic patients (1%) and two of 5 diabetics (40%) had contrast-induced nephropathy. The incidence of contrast-induced nephropathy is 2%-16% in the majority of statistics. Regarding our results, the incidence of contrast nephropathy in our patients is not more than the world's statistics.