MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES
Year:2001 | Volume:43 | Issue:70|Papers Count:25

Dyslipidemia is common III kidney transplantation which can causes accelerated atherosclerosis and allograft dysfuntion and chronic rejection. Ealry detection and treatment of dyslipidemia can declines mortality and allograft dysfunction and rejection. 42 patients including 26 women with first time kidney transplantation and without other medical problem from 1996 to 1998 were studied. 4 weeks after transplantation, hypercholesterolemia was observed in 34.2% of patients (F > M) and reduction of triglyceride level was detect in 20% of patients. 5 months after transplantation augmentation in total cholesterol was detect in 51.7% and increase of triglyceride level in 41% of patients (F > M). Evaluation of lovastation (HMG-CoA reductase inhibitor) effect in hyperlipidemic patients revealed reduction of total cholesterol and LDLc. Lovastatin has no effect of triglycerid and VLDLc level.

Organ dose and effective dose were estimated for one hundred patients (50 males and 50 females) who were reffered to Mashhad Ghaem Hospital for chest X-ray examination.ODS-60 software was employed for organ dose calculation. This software is capable of computing absorbed dose of 26 organs as well as effective dose. This programme is based on the ICRP-60 recommendation and Monte Carlo technique. Our results show that in PA chest X-ray lung absorbs the highest dose. The average value for males and females equals to 1.01± 0.14 and 0.58±0.10 mGy respectively. The resulting effective dose for men and women are equal to 0.246 ±0.034 and 0.178±0.033 mSv accordingly.Effective doses obtained from this research were compared with the results of other workers, also with NRPB national reference dose levels. It is concluded that effective dose as computed in this work is several times higher than similar quantities published by other workers. It implies that X-ray diagnostic procedures in Mashhad Ghaem Hospital should be re-examined and all efforts have to be made to reduce patient dose.

In an attempt to determine the clinical value of fructosamine assay for monitoring type II diabetic patients, correlation of fructosamine and GHB was studied. In this study, 100 patients with type II diabetes mellitus were compared with 100 control subjects. Blood from each fasted subject was collected and were analyzed for fasting blood glucose, glycated hemoglobin, albumin and fructosamine. Results shows that in diabetic patients, there was satisfactory correlation between fasting blood glucose and glycosylated hemoglobin (r=0.64, P = 0.00) and serum fructosamine (r= 0.7, P = 0.00). There was also a significant correlation between GBb and serum fructosamine (r= 0.94, P= 0.00). In conclusion, fructosarpine assay can be used as a parameter for diabetes control.

Background: Regarding considerable leprosy population, as one of leprosy surveillance centers in Iran, we concernce ocular & orbital manifestations of the leprosy (Especially cataract) among Non-institutionalized patients attending the ophthalmologic clinics in Mashhad University of Medical Sciences.Material & Method: In a clinical trial 18 leprosy patients with cataracted eyes (n=20) I operated with extracapsular cataract extraction + intraocular lens (ECCE + IOL) method. Patients had complete ophthalmologic exam before surgery and 1, 3, 7 days, 3 month & 1 year after that. All patients received chloramphenical and betamethasone after surgery.Results: Visual acuity (V.A) Before surgery was light perception (LP) to 1.10 other ocular and orbiatal manifestations: lagophthalmus: 50% eyebrow lesion 72.4%, eyelash lesion 88.9%, entropion 25%, trichiasis 25%, corneal hyposthesia 50%, corneal infiltration 50%, pannus 75%, partial corneal opacity 35%, total corneal opacity 35%, inferior corneal opacity 55%, corneal neovascularization 45%, posterior synechia 30%, iris atrophy 80%, increased intra ocular pressur 5%. After surgery, VA improved in all cases: 55% (5/10-8/10) in 25% to (1/10-5/10) & in 10%, 5 meters count finger.IOL tolerated well & inflammation was minimal and acceptable.Discussion: It seems fair & satisfying adopt to the "ECCE + IOL" surgery as a standard Cataract management in leprosy patients.

Postoperative intraabdominal adhesions are a significant cause of morbidity and mortality leading to mechanical bowel obstruction, female infertility. Since mast cells have been shown to be involved in peritoneal inflammation, we investigated a possible role for these cells in peritoneal adhesion formation and also we studied the role of mast cell stabilizers in the normal healing process of enterotomy with repair in a rat model. 38 wistar rats were studied. We divided the rats into two groups (adhesion model with 20 rats and repair model with 18 rats). In the adhesion model group we created adhesions in 20 rats using cecal scraping and the application of 95% ethanol. The rats were treated with saline or disodium cromoglycate (DSCG) as a mast cell stabilizer, intraperitoneally 30 minutes before laparatomy and at the time of abdominal closure.After one week the rats were killed and relaparatomy was done. The adhesions were assessed blindly using Hulka system for grading of adhesions. Then a portion of the cecal wall was excised and sent for pathological analysis. When the results in rats treated with DSCG were compared with those in rats treated with saline, the DSCG treated rats had significantly attenuation of adhesion formation (80% of control groups had adhesion grading score of II or III but only 20% of DSCG treated group had similar result).Histological analysis showed that DSCG significantly decreased the number of deregulated mast cells in the bowel wall compared with saline (7.28 ±1.4 mast cells/high power field (hpf) versus 10.98± 1.7 mast cells/hpf).In 18 rats in the repair model we performed one centimeter enterotomy on the anterior aspect of the cecal wall and repaired with 30 silk suture. These rats also were treated with saline (as a control group) or DSCG similar to the adhesion medal. We could not find any adverse effect. On the normal healing process of enterotomy and repair and adhesion was significantly lesser in DSCG treated group.

The aim of this study is the evaluation of boold levels of Cortisol and ACTH in diabetic patients. To do this, blood sugar, Cortisol and ACTH were measured in 100 normal individuals and 184 diabetic patients. Our findings indicate that blood concentration of cortisol and ACTH are greater than normal in diabetic patients, but in terms of these factors no significant differences are seen in diabetic patients with different levels of serum glucose. Normal values and other data of these factors are shown and discussed in this paper.

Background: 30 to 80 percent of pregnant women suffering from heartburn, because of different reports about the effect of sucralfate therapy and the limitation of studies in the field of training, this research were performed.Method: This research is a clinical trial method, triple-blind, that is done to pregnant women with necessary qualification, by multiple sampling method in three groups involving "placebo" "sucralfate", and "training", At first, clinical evaluation of the average of the last three days heart burn was done. and an interview was accomplished to acquire some information pertaining to their personal characteristics, fertility, health, and behavioral habits. After delivering medicine to its specific group and providing necessary training by educational group, after one week clinical evaluation was done against for analysing the normal distributed variables parametric were used and for nonnormal distributed variables nonparametric statistics were utilized.Results: Findings showed that there were significant difference between mean of times (Placebo P=0.002), (sucralfate P=0.032), (training P<0.0001), intensity (placebo P= 0.003), (sucralfate P= 0.020), (training P < 0.0001), duration placebo P < 0.000), (sucralfate P < 0.0001), (training P<0.0001) before and after manipulation.Decreasing of frequency of radiation rate after treatment were (26.1% in placebo group, 41.7% in sucralfate group and 82.6% in training group). Also outcomes indicated that training inttensity (P=0.004), times (P=0.004) and radiation (P=0.002) had the most efficiency in declining the heartburn. There were a positive linear relationship between acquired degree in education and the rate of improvement, that were for intensity (P=0.008  R=0.5), times (P= 0.024  R=0.4) and duration (P=0.011  R=0.2).Conclusion: Education "life style modification" as an efficient method can be put in the first priority for treating the heartburn of pregnant women, but for providing a point of view about sucralfate, it needs other research.

Objective: To assess the educational quality and quantity of morning reports in Ghaem Hospital Medical School.Material and Methods: This is a descriptive cross-sectional study performed through a questionnaire. The resulting data were stored and analysed by the statistic software SPSS/7.5. Results: We received 330 filled out questionnaires. The opinions Showed lack of discipline, low participation of the faculty, excess attention to the theoretical aspects, inappropriate election of subjects considering the students' level, undesirable room situation and to conclude, low educational efficacy of the morning reports. Discussion: Since morning report is considered an educational curriculum in the first place and takes a considerable time everyday, it seems a necessity to re-evaluate the current situation, set new objectives and adopt novel methods in medical education.

PUVA is one of the best therapeutic methods in dermatology. In this method the patients after use of Psoralen, must be irradiated with UVA. One source of UVA is the sun. UVA intensity of the sun changes during day times and also in different days, and changes with altitude and humidity.Because of these variations, we decided to measure UVA intensity of the sun in sunny days of spring, summer and autumn in Mashhad. In this study, UVA and UVB intensity measured separately from May to December of 1998.Mean intensity of UVA in all sunny days and in spring and summer in midday was 3.5 mw/cm2 and 4 mw/cm2 respectively.As a result: for every one Joul irradiation patient needs 4 minutes solar exposure in midday.

We report and analysed 20 patents with blepharospasm and hemifacialspasm who had been treated with botulinum A toxin (BTA) injection between 1996 and 1998. The 20 Patients comprised 13 Females and 7 males. Their mean age was 50 years (SD:±12). 16 patients had idiopathic blepharospasm and 4 patients were diagnosed with hemifacialspasm. The mean duration of suffering was 20 months. Each patient received 120 IU of BTA Injections according to the standard pattern.The results of BTA injection were classified as: excellent result (an improvement of more than 75%) in 45%; a good response (an improvement of 50-75%) in 35%; a moderate response (an improvement of 25%-50%) in 15% and a minimal or no response in 5%. The complications of BTA injection were transient minimal ptosis, dyplopia and lacrimation.In one case notably ptosis appeared.The efficacy of BTA injection lasted 2-3 months. And more often needed to repeat the injections (12 patients).These patients follow up for 1 years after last injection; there were not seen recurrence of symptoms in most of them.Conclusion: BTA injection is a simple and effective out-patient treatment for patients with blepharospasm, causing no side effects and minor transient local complications.

Over a period of three years (1995-95), a study of stress urinary incontinence (SUI), was undertaken in the Urology Department of Imam Reza Hospital. SUI is a common syndrome in women in many countries, including Iran. It is stress evoked urinary incontinence caused by intra-abdominal pressure. Mr. Gitt's and Laughlin explained this surgical procedure for the first time. Forty-six patients with this complaint referred to our clinic. They were between 28-65 years of age, married, and multipart.SUI can be treated either medically or surgically. Medical treatment was given to twelve of these patients, but surgery was performed on the remaining 34. There are various surgical procedures used to correct this syndrome; but we used the no-incision urethropexy method. Prior to surgery routine physical exam, preclinical exam, kidney and bladder sonography, cardiopulmonary consultation, cytoscopy, marshal and bony tests were done. Whenever urine culture was positive antibiotic therapy was carried out. One month following surgery our success rate was 85.3%, and the unsuccessful rate was 14.7%. The most common complication was urinary retention (4) (cured by CIC, clean intermittent catheterization, in 5 days to 2 weeks), followed by dysuria, dyspareunia, and pain (8) (23.8%). Surgery for SUI is easy, non-invasive, more successful and less complicated than other methods of treatment.

Anti-Sperm antibody (ASA) is one of well-known causes of infertility but there haven't been any precise descriptions about it yet.Method & Material: This research is done prospectively on the clients of infertility clinic. Sperm anti-Sperm antibody (Spe-ASA) and vaginal ASA (Vag-ASA) were measured in 420 couples with disorders of sperm motility in Sperm gram (with/without varicocele) and also in couples that both Sides, after complete examinations and tests, had no certain cause for infertility.Findings: About 14-22% of the patients showed positive ASA. No couple showed positive Spe-ASA and Vag-ASA simultaneously. Vag-ASA cases were treated by appropriate prevention of sperm contact with vagina for 6 months.No meaningful relationship was found between semen volume, sperm morphology and positive Spe-ASA but there is a meaningful relationship between sperm count, sperm motility and positive Spe-ASA. There is no meaningful relationship between varicocele and Spe-ASA.

Because of the high prevalence of Depressive disorders and the importance of field surveys, we decided to study the point prevalence of depression in the students of Ferdosy University and the related psychosocial factors. 6% of the students were severely depressed, 16.4% moderately depressed and 44.3% mildly depressed.We studied the relation between depression and sex, age, educational factors and psychosocial stressors.

Introduction: Torsion of testis is one of the most important emergencies in urology, that is should be treated on time. In this article epidemiology, age, clinical features, predisposing factors, diagnostic methods particularly our facilities and different managements will be discussed.Method and Materials: The study was done in a descriptive-retrospective way on patient's who had been hospitalized in Imam Reza Hospital with diagnosis of testicle torsion or its appendices from 1993 to 1997. The total number of patients was 58 cases; from this number 44 cases were testicle torsion and reminder, 14 cases, were torsion of appendices.Results: The most common ages of appendices torsion were 12-15 years. Left testis was involved more than right side, but there was no significant difference between left and right in appendices torsion. The most common clinical features were sudden pain, swelling and tenderness, which latest one was emerged in torsion of appendices. In most cases no special predisposing factor found. 29.55% with torsion of testis has had a history of transient testicular pain. In 72.21% of testicle torsion and 25% cases of testicle torsion and 25% cases of appendices torsion U/S were used in diagnosis process.In all of patients with torsion of testis, who hospitalized with in primary 24 hours, the testis was conserved. 29.45% of cases orchiectomy has carried out. 28.54% of patients with appendices torsion were treated conservatively and 71.42% of cases under went surgical treatment. .Conclusion: Torsion of testis, in all cases of acute scrotum must be considered. In our circumstances, we used U/S as a diagnostic procedure. A large number of patients, who were -joined our services on time, the testicles were distorted in right direction and surgical procedure was performed conscontly.

The terms otomycosis and mycotic otitis externa are used to describe acute or chronic intlamation of the external ear caused by or secondarily infected by fungi or yeasts. In the present study 87 patients, 16 males and 71 females, were studied the diseases were more prevalent in 20-40 years age group in both sexes and prevalence of diseases was more greater in female than male. The etiologic agents identificated Aspergillus 79%, candida albicans 15% and other 6%.Itching was most common, followed by hearing impairment, pain and discharge.

History and objectives: One of the vulnerable groups of society is less than 2 years old children. Therefore it is necessary to consider the essential health care for them. Attention to growth of children is important for identifying health or disease state in them. Measuring height and weight are of the easiest means to achieve this goal. Serial measurement and comparison of the data of two regions are more valuable.Methods and Materials: Height and weight were measured in 6470 neonates, infants and children up to 24 months old in 1377.The measurement was performed by experienced staff of health and obstetrics in urban and rural health care centers during forty days. The measurement was performed while the children had no shoes and were least clothes.Results: Weight and height were heiger in boys than girls and T. test showed significance different in this regard (p<0.05). There is no significant difference between the weight and height of the urban regions versus rural ones.Conclusions: Kashanian infant's weight more than Tehranian infants are heavier than Shirazian infants before six months of age, Kashanian infant's weights more than. Qazvinian ones but thereafter they become less heavier than Qazvinian infants. Less than 2 years old boys in Kashan are heavier than their counterparts in Hong-Kong, but less than one year old girls are less heavier in comparison to Hong-Kongian infants. Kashanian infants including girls and boys are heavier than American infants less than 6 months of age but thereafter kashanian infants become less heavier.

The main objective of this study is to evaluate safety and effectiveness of regime of clomiphene citrate (c.c) and prednisolone for patients who failed treatment with clomiphene alone. We considered 30 anovulatory patients who failed to ovulate after administering clomiphene alone. Ovulation was confirmed by Basal body temperature and mildluteal phase progestrone. Pregnancy was confirmed by rising levels of B-HCG and serial abdominal sonography. Thirty seven of cycles were ovulatouy (62%). Basal body temperature in ovulatary cycles were 36.5-37-1°C. With Basal body tempreture and serial ultra-sonography ovulation was confirmed (70%). Seven patents (23.3%) were pregnant who were infertile for 6-10 years.comment: clomiphene citrate resistant anovulatory patients have high rate of ovulation and pregnaney after treatment with clomiphene and prednisolone. Prednisolone is a good choice compared Dexamethasone because of minor glucocorticoidy effects.

Ocular bee sting have various Manifestations.These manifestations include: Keratoconjunctivitis, Corneal, infiltration, Corneal Perforation, Iritis, Hyphema, Anterior and/or Posterior Capsular Opacification of the lens, Lens Subluxation, Mydriasis, Iris Atrophy, Optic Neuritis and Retinopathy. Treatment depends on the type of lesion and should be done without delay for avoiding other complications such as Amblyopia.Reaction, in response to ocular bee sting, depends on the amount of venom and patients immune response.However when the problem is only presence of the sting in the eye its extractions is not necessary because sting itself is inert.

Spontaneous Dissection of a Coronary artery Can Cause MI and Sudden death. Two-thirds of the described Cases have occurred in women, and one half of these were associated with the Post partum State. The LAD is the most frequently involved artery. This report is about a case of unstable Angina Due to Spontaneous Coronary artery dissection (SCAD) is detected in Coronary Angiography.

Klippel Trenaunay Syndrome is a rare disease, with uncertain Etiology, variable expression, whose cardinal signs are: cutaneous hemangiomas, hypertrophy of soft tissues and skeletal structures.we report a rare form of this syndrome with multiple cystic hygroma in a newborn.

We studied the economic burden of depressive disorders for patients and society.In this study we compared the number of medical visites, paraclinical investigations and the days of occupational absences in one year in 100 depressed outpatients and the control group. We found significant differences between depressed patients and control group in the variables (P<0.01).