JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S)
Year:2002 | Volume:20 | Issue:66|Papers Count:18

Aortic stenosis is seen in 1/4 of patients with heart disease. Nearly 80% of these patients are male. Aortic stenosis is congenital or acquired (degenerative). Diabetes mellitus and hypercholestrolemia arc known as risk factors for predisposition to aortic stenosis. Chest pain, exertional dyspnea, heart failure and sudden cardiac death arc serious complications of severe aortic stenosis. This study is a descriptive, analytical, case controle study that performed in 1378-1379.The patients with aortic stenosis or sclerosis that referred to Al-zahra Hospital for doppler echocardiography were asked about cigarette smoking and other risk factors for predisposition to aortic stenosis, and then the questionare was filled completely. 324 patients were classified into two groups. The case group were 162 patients with aortic stenosis or sclerosis and current cigarette smoking .The control group were 162 normal persons without the history of aortic stenosis and cigarette smoking. Sampling process was a simple randomized sampling. After completing the questinare and data collection, the data were analysed by SPSS (6) and results were obtained.Current cigarette smoking in the case group was 43%, and 57% of the cases didn't have history of cigarette smoking. Current cigarette smoking in the control group was 14%, and 86% of the control group didn't have the history of cigarette smoking. Prevalence of cigarette smoking in the case group was 3 times more than the control group. Odd's ratio (OR) is 4.6. (95% Cl: 2.6 to 8.2). Calculated P value is less than 0.001The most frequent cigarette usage (pack / year) is 20-39 pack / year group (51%).With regard to multiple adverse effects of cigarette smoking and predisposition to cardiovascular disease such as coronary artery disease (CAD), peripheral vascular disease (PVD), and aortic aneurysm, cerebrovascular disease (CV A), malignancies, pulmonary disease and on the other hand the high incidence of aortic stenosis and sclerosis in male gender, this case control study was performed for finding cigarette smoking prevalence in male group with aortic stenosis. According to the results of this study, prevalence of cigarette smoking in patients with aortic stenosis or sclerosis is 3 time more than persons without any aortic stenosis and cigarette smoking, so further research is needed for this problem.

There are some evidence that garlic can be used as a substance for reduction of blood pressure and plasma lipids. "Garlet" tablet is produced from garlic by kowsar company. When high cholesterol regimen is applied, more fatty streaks produce and the vessel permeability increases. The main objectives of this study are the effect of "Garlet" tablet on aggregation of fatty streaks, serum lipids, lipoprotein and electrolytes, and endothelial permeability of aorta in cholesterol - Fed Rabbit.Twenty eigth white rabbits were randomized in three groups.They were fed with 1% cholesterol food for thirty days. In addition they had received one (group I) or two (group 11) "Garlet" tablets orally every day. No tablet "Garlet" was given in group HT. The scrum level of lipids, lipoprotein, electrolytes were measured before and after the experiment. The endothelial permeability of aorta also was determined, and the aorta was objected for pathological investigation via pathological process.The results indicate a significant difference for serum lipids and lipoprotein before and after the experiment in all groups (P<0.05), but no differences were obtained between the groups. The endothelial permeability of aorta and the existence of fatty streaks in aorta wall were not difference between the groups. (P>0.05)It seems that one or two "Garlet" tablets may not affect the level of lipids and lipoprotein when high cholesterol regimen is used. These doses of "Garlet" tablet also may not reduce aorta wall fatly streak formation and endothelial permeability.

ABO incompatibility, is one of the most important cause of neonatal admision due to hyperbilirubinemia in Iran.The purpous of this study, was the prediction of moderate and severe forms of disease, by means of neonatal cord blood tests (direct coombs test, indirect coombs test with staging and total bilirubine level). The study was done on 96 full-term and AGA neonates with BW>2.5 kg whit blood group A or B, whose mother, have O blood-group. In these neonates direct coombs test, indirect coombs test with staging and total bilirubine level of cord blood specimen, was measured and the neonates observed 48 hr after birth, for development of hyperbilirubinemia. Data revealed that, total bilirubine level of cord blood, is the most useful predictive test in ABO - incompatible infants. (Sensitivity for bilirubine greater than 2mg/dl was % 100 and speeifity was%85). The staging of indirect coombs test, (sensitivity for stages greater than + 1 was %80 and specifity was %62.6) and direct coombs test (sensitivity % 100, specifity %20) was subsequently useful. The data support that, thease tests are useful for an early diagnosis of ABO- hemolyic diseae of newborn.

Staphylococcus aureus is a major cause of nosocomial infection. Clinical isolates of S. aureus have been shown to possess capsular polysaccharides (CPS). Among more than 11 serotypes S.aureus, type 2 is highly encapsulated and type 5 and type 8 are microencapsulated. The CPS have been shown to contain protective antigen. Despite of the previous studies on immunological properties of CPS (S. aureus) the role of microcapsule and opsonins on phagocytosis (killing step) of S.aureus types 5 and 8 are unclear. The main goal of present study is to report and discuss the effect of capsule and microcapsule on phagocytosis (Killing step) of S. aureus in presence of opsonins.In this study encapsulated S. aureus (type 2) and strain H were cultivated in BHI (Difco. inc) medium and S.aureus type 5 was grown in Columbia agar (Difco. inc). The method used to measure phagocytisis (killing step) of bacteria was carried out as described by Boros. polyclonal antisera against formalin killed bacteria were raised in rabbits.Results showed that phagocytosis (killing step) of microencapsulated strain (type5) was significantly induced by specific (P<0.0l) and nonspecific antibodies (P<0.03), while phagocytosis (killing step) of S.aureus type 2 was significantly stimulated only by specific antibodies (P<0.05). With regard to the present study, specific antibodies enhance phagocytosis (killing step) of S.aureus Types (2&5) and strain H significantly, While none specific antibody and complement are opsonic for S.aureus type 5 which is similar to finding of other researchers.

Mutagenesis, carcinogenesis and cytotoxicity in human organs and tissues are side effects of sulfur mustard gas (SMG). The toxic effects of mustard gas include: inhibition of mitosis, disturbance in cell cycle phases, and decrease cell respiration.Most of the toxic effects are related to alkylation of DNA and other critical target molecules.Mustard gas was the most common chemical warfare agent used by Iraq during 1980-1988 conflict against Iranian soldiers. In this investigation DNA content and the cell cycle phases of leukocytes from 31 victimes exposed to SMG, from Isfahan province, were compared with 30 healthy volunteer men as a control group.No significant difference were observed between the cell cycle phases and ploidy between the two groups (P>0.05). But one victim (3.2%) had a hyperploidy in white blood cell population (DNA index> 1).

Cataract extraction is the most common ocular surgery and the role of intra ocular lense is evident for all of the ophtalmologists. Viscoelastic agents are the expensive materials, which are used for intraocular lens implantation. Because of expense and also probable side effects of these agents on the corneal endothelium and lOP, we decided to do this study and made a quantitive and comperative study between the effects of methyl cellulose and air bubble on the IOP and corneal edema after ECCE and PC IOL.This was a clinical trial study and the cases were selected from the patients who come to Farabi Eye Center for ophthalmic examination. All of the patients who had cataract were selected for operation and then divided into two groups randomizely (with air bubble and methyl cellulose). 52 cases were operated with air bubble and 50 cases with methyl cellulose.Variations which were studied were:1) IOP which were measured with applanation tonometer.The comparison between IOP in two groups a day before operation & one day, one week &.3 weeks after operation had no significant difference (P<0.05) (air group 12.38 mmHg & methyl cellulose group 13.36 mmHg).2) Corneal thickness which was meassured with ultrasonic pachymeter show no significant difference on day before operation & one day, one week & 3 weeks after operation. But 8 weeks after operation revealed significant difference (air group 517 µ & methyl cellulose group 534µ).3) Measurement of corneal edema clinically revealed no significant difference between two groups. Regarding to the result which show no significant difference between two groups & even after 8 weeks corneal thickness & IOP were lower in air bubble group, we can implant IOL inside the eye with air bubble satisfactorily.

Ameloblastoma is a benign tumor of odontogenic epithelial origin. there is a high incidence of local recurrence associated with these tumors, but distant metastasis is rare.In this report we describe a case of delayed pulmonary metastases from an ameloblastoma of the mandible which occured 10 years after surgical resection of the primary tumor but with no recurrence at the primary site.

Uric Acid stones consist of 5-10 percent of urinary stone. %70-80% of these stones are pure type. Because of open surgery complications, medical therapy is prefered in this situations. Uric acid solubility is better in the alkaline urine, so that in urine with PH> 6. More than %90 of uric acid is solved, and with alkalinization of urine we can prevent two important factors of uric Acid stone formation including supersaturation and crystalization.For this manner two common drugs are potassium citrate (50 MEq/day) and sodium Bicarbonate (650 mg/q6h). This study is a prospective clinical trial. By convenience sampling 62 patients were placed in two groups (31 patients in each group). The greatest diameters of stone before and after treatment was assessed. Applying sonography in two dimentions and stone surface was calculated (mm2). This is a more precise evaluation with regarding to stone size and treatment efficacy in reducing stone size in comparison with one-dimentinal imaging.We evaluated the urine pH during sutdy. In this study each two drugs were effective and there was no statistically significant difference between two groups, so that there is no superiority between this two drugs, thus preserving of urine pH in alkaline range. (By these drugs) and self monitoring of urine pH (By urinary dipsticks) are one of the most effective treatment modalites in there pationts.

Pap smear testing is the best technique for evaluation and diagnosis of cervicovaginal infections. Considering the importance of diagnosis and early treatment can prevent from development of these infections. we decided to demonstrate that there is no significant difference between frequency of cervical pathogens in smear with and without reactive changes.This descriptive - analytical retrospective study, carried out in Alzahra Hospital of Isfahan during the period sep. 1996-2001.This was performed on 900 cervicovaginal smears of women in fertility period (450 samples for each group).Frequency of cervical pathogens in smears with and without reactive changes were 39.1%, 37.3% respectively (P = 0.58).So there is no significant difference between two groups. Frequency of these pathogens were Coccobacilli (61.9%), Candida (34%), Trichomonas vaginal is (3.5%), Actinomyces and Herpes simplex virus (0.3%).Considering this point that there is no significant difference between prevalence of cervical pathogens in smears with and without reactive changes, determined necessity. Pay more attention to smears without reactive changes. Therefore, these smears were studied the same sensitivity.

Pulse oximetry is a noninvasive and continuous monitoring of oxigenation which has been used extensively in medicine. In spite of accuracy in pulse oximetry, there are some instances which parameters shown by this device are reliable. For example: reduction of perfusion in organ joined to the instrument. This study is done in order to improvement of finger perfusion with digital block and effect of this technique on hemoglobin saturation, height and lag time of plethismographic wave. 105 patients which were candidated for elective surgery in Kashani Hospital was selected and following induction of general anesthesia, the index finger was blocked by lidocaine and compared with nonbloekcd finger in opposite hand. the lag time of plethismographic wave in blocked finger was less than nonblocked finger.(P<0.05) The mean wave height in blocked finger was higher than the nonblocked finger.(P<0.05) It was understood that digital block probably can dilate digital vessels as a result of sympathetic block which imporoved perfusion lead to more reliable finding in pulse oximetry parameters.

Angiofibrom is the most common benign tumor of nasopharynx. Because of site of its origin (Superior border of sphenopalatine foramen), this tumor can extend to nasal cavity, paranasal sinuses, ptrygomaxillary fossa, infratemporal and temporal fossa and Intracranium. The most common symptoms are epistaxis and nasal obstruction. Diagnosis is based on Physical findings and radiology, biopsy may cause fatal bleeding and is avoidedIn a 14 Year old male with a large angiofibroma of nasopharynx, that had extended to nasal cavity (bilaterally), right maxillary sinuse, right ptrygomaxillary and infratemoral fossa, sphenoid sinuse and intracranium (Through parasellar), we prefered to use LefortI osteotomy for removal of the tumor, Because This approach provide an excellent direct access to above regions without facial scarring. This approach for surgery of angiofibroma was Performed for first time in Medical University of Esfahan.

To assess the feasibility and potential benefit of delaying delivery in women with advaned preterm labor. In this randomized clinical trial, 258 singletone gestations with gestational age between 26W - 35W, 6D and cervical dilatation 4 , 5 and 6 cm, with intact membrane, without fetal or maternal indications for delivery on admission that hospitalized at two Isfahan public hospitals AI Zahra & Shahid Beheshti were selected. 129 women recieved tocolytics (intervention group) and 129 women did not recieve tocolytics (control group). in addition, all the patients less than 34.0 weeks gestation recieved corticosteroid. Finally, chi- square &analysis of variance & t-tests were used for statistical analysis. Delivery was delayed in 55% of the intervention group more than 24 hours and in 31 % more than 48 hours.This results for control group was 23.2% and 7% (P<0.002).The relative neonatal death was 29.5% in the intervention group in comparison 10 control group 43.4% (P<0.014).A delay of at least 24 - 48 hours in advanced preterm labor allows demonstrated much benefit with administration of antenatal steroids and many more women in preterm labor could benefit from maternal transfering a high risk center.

Malignant melanoma is a malignant tumor originating from epidermal melanocytes. It's location in the oral cavity is extremely rare. It strikes mainly male subjects and its frequent site of involvement is palate. As a routine, every pigmented lesion of the oral cavity with undetermined origin must be biopsied. The prognosis often proves poor and surgery combined with chemotherapy, is the first choice treatment. Case report: The patient was a 51 yr old male with a blue-black plaque with surface nodules, involving the main part of the left half of palate, and the adjacent maxillary gingiva. It originated from a slowly enlarging pigmented macule from 2 yrs ago. There was no other suspicious pigmented skin lesion anywhere on the body. General physical examinations were not remarkable. Lateral & AP skull x-rays were normal, and so were routine laboratory tests.Histologic examination revealed an ulcerated squamous epithelium, underlied by neoplastic proliferation of melanocytes forming extended fascicles from junctional zone into the epithelium and underlying soft tissues. Melanocytes were spindle shaped with vesiculated nuclei harbouring prominent eosinophilic nucleoli. The neoplastic tissue was teemed with melanin. Findings were diagnostic for primary mucosal melanoma. Two weeks after biopsy the patient presented with enlarged submandibular lymph nodes revealing histologic evidence of metastasis.

  Oral contraceptive pills (OCP) are one of the most common using contraception methods. There is much different study about OCP effects on blood pressure.This study performed on 169 healthy women who used OCP for 5 years as case group & 169 healthy women who didn't use any contraception method as control group.There were matched in age, weight, child number, smoking & basal systolic & diastolic BP.Both syst. & diast. BP measured at beginning of study in both group and repeal every sLx months up 10 5 years.Statistic analysis showed: significant difference between mean of syst.& diast .BP in case group before and after this period (p<0.00l).There isn't any significant difference between mean of syst. & diast. BP in control group before & after this period. (P >0.05) Mean of syst. & diast. BP has significant difference between two groups at the end of study (p<0.001).Although using OCP doesn't cause hypertension but increase significantly BP in women.There was only one case in case group who have clinical hypertension at the end of study (BP> 140/90).