MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES
Year:2000 | Volume:43 | Issue:69|Papers Count:24

Gonads, bone marrow and thyroid doses arising from seven x-ray examinations (11 projections) were calculated for 385 patients (185 male and 200 female), who were radiographed in x-ray department of Mashhad Ghaem Hospital.It is estimated that the highest gonadal dose of male patients was equal to 9.62±1.89mGy and resulted from pelvis (AP) examination. Lumbo saceral spine examination produced the highest gonad dose equal to 4.21±1.09mGy to female patients.Maximum bone marrow dose delivered to male and female patients were 3.53±0.62mGyand 2.88±0.73mGy respectively and were caused by lumbo saceral spine radiography.Cervical spine x-ray examination was responsible for highest thyroid dose of male and female patients. In this survey the corresponding values were 4.25±0.53 and 1.91±0.23mGy respectively.Estimated mean value of organ doses in this study were compared with the values reported by other researchers and also with the annual limits recommended by ICRP-60. Our estimated average doses to gonads and bone marrow of male and female patients from cervical spine and pelvic radiography are much higher than those reported by ICRP-60. This conclusion is also true for other surveys, this indicats that patient doses depend to various parameters such as: observation of radioation protection rules by radiographers, their skills and implementation of quality assurance programme. Any improvement of these parameters can reduce the doses to the levels recommended by ICRP.In this study all estimated organ doses are less than annual limits of 5mSv, except gonadal doses in pelvic radiography (AP) of male patients.

During the last few decades, Laser-has been used extensively in different brunches of Medical Sciences. Among these studies the biological effects of Low Power Laser (L.P.L) e.g. He-Ne Laser, specially the role of L.P.L on Wound Healing has been the subject of research for many workers.In the present study, 180 mice (healthy, adult, male, weighting 20-25gr) were used. On each mouse two full thickness circulary cataneous wounds (80±5mm2) were created symmetrically at 1.3 distal of dorsal Medline on both sides. The 180 mice were divided into 9 groups. (8 as the test and one as the control group). The right side wounds of 4 test groups were exposed to Laser beam for 250, 500, 750 and 1000 seconds once daily and the other test groups were exposed to the same total dose twice daily for 10 days after creating the wounds using a He-Ne Laser (l= 632.8, constant power=5 mwatt, made by Iranian Atomic Energy Agency). The Left side wounds of the test groups and all wounds of the control group were not exposed to Laser.The evaluation of Wound Healing was carried out both macroscopically and microscopically. In the macroscopic evaluation, decreasing the percentage of the wound's area was calculated on the 3th-13th days, every other day and was compared with the first day. In the microscopic evaluation, Wound Healing was compared pathologically in all groups on the first, fifth and nineth days. There were significant differences in Wound Healing between some of the test groups and the control group (with a=0.05).These effects were observed in both exposed (right side) and systemically in the left side of the test group's wounds. Also exposure time and deviation of exposure time into two each day was found to be effective in this phenomenon. The best result was obtained with 250 sec and twice irradiation per day.

Instillation of scolicidal solution, a part of the surgical treatment of hydatid disease may cause spreading of the solution into the neighborhood structures and some complications may occur.In this study, we investigated the side-effect of Silver Nitrate in the vicinty of the lung and respiratory tracts of rabbits, then clinical and histopathological changes were evaluated 3 months later. It was found that instillation of Silver Nitrate and exposure of the respiratory ducts and lung parenchyma to this agent, may cause some clinical and pathologic disturbances and should be used very carefully.

Objective: A retrospective review of, GI polyps and polyposis during 10 years since 1988 to 1998 in 01 department.Methods: Patients suspecious with GI polyps including hematochezia, anemia, vague abdominal pain, obstruction, intussuception were chosen. In colonic polyps, rectosigmoidoscopy, biopsy, barium enema, colonoscopy and polypectomy were done. In gastric polyps, radiography, gastroscopy and polypectomy were done. All polyps and biopsies were studied by expert pathlogists.Results: Among 145 patients with GI polyps 73.7% were male and 26.2% female. Peak age distributions were 28, 9% in 10-19 year period. 75.8% of the polyps were in the colon and 24.1% in the stomach. In colonic polyps 76.3% were male and 23.6% female. In gastric polyps 65.7% were male and 34.2% female. The most frequent symptom was hematochezia (80%). In colonic polyps 52.7% were juvenile, 4.5% adenomatous, 12.7% inflamatory and 10% hyperplastic. 3.5% of colonic polyps had dysplastic changes. In most of them polypectomy and in some total colectomy were done. In gastric polyps 85.7% were hyperplastic, 8.5% were adenomatous and 5.7% hamartomatous.Conclusion: In every patient with hematochezia, rectosigmoidoscopy and barium enema is needed. In anemic patients suspected having gastric polyp, gastroscopy and poloypectomy should be done.

From Mehr 1374 to Esphand 1376, 234 patients with lower urethral stones underwent the rated by T.U.L procedure. Clinical and paraclinical evaluation were done in all cases. All patients have had episodes of urethral colic. No medical treatment and E.S.W.L were benefit as well. Of 234 patients 210 (89.6%) cases treated by intraureteral lithotripsy (TUL) successfully, but (10.4%) were failed In 41 (17%) cases some complications has seen which threaded property. In this study we found that for lower urethral stones, TUL is one of the best options for treatment and cost.

In this research effective doses of 385 patients (185 male and 200 female) arising from 7 x-ray examinations (11 view) have been assessed. The results have been compared with the values reported by ICRP-60, NCRP-89 and NRPB-289, as well as with the work of other researcher’s elsewhere.In all x-ray examinations studied in these work effective doses of male patients were greater than those of female patients.The highest average effective dose (3.68±0.91 mSv) is related to the radiography of Lumbosacral (lateral view) of male patients and the lowest (0.05±0.01 mSv) is due to waters radiography of sinuses in females. The comparison of our results and those reported by other researchers suggests that:A) effective doses caused by Lumbosacral (AP) radiography as calculated in this study is not significantly different from those suggested by ICRP-60, Martins in Spain and Shrimpton in England.B) The, same conclusion is correct for Davis's results for radiography of pelvis and NCRP-89 and Shrimpton's figures for cervical and skull examinations.C) Our assessment of effective dose resulting from the remaning types of examinations are significantly different from those reported by other workers. This is specially true for chest radiography.D) Average effective dose to the patients from skull, waters (sinus), cervical (AP, PA), thorax (PA) radiographies are less than annual limit of dose recommended for general population.E) Average effective dose following to Lumbosacral (AP, Lat), pelvis (AP) and cervical (AP, Lat) x-ray examination is more than annual limit of dose recommended for general population.

Rheumatic fever (RF) is generally classified as a connective tissue or collagen vascular disease.The rheumatic process is expressed as on inflammatory reaction that involves multiple organs:Primarily the heart, the joints and the central nervous system. The clinical manifestations of acute rheumatic fever follow a group A streptococcal infection of the tonillophargnx.The major sequle of RF is its ability to cause fibrosis of heart valves leading to crippling hemodynamics of chronic heart disease. In our study a total of 570 patients (416 female and 154 male) were followed for 5 years. ECHO cardiography showed:The most frequent sequle of rheumatic carditis was involvement of mitral valve (combined MS and MR).Mitral valve was involved in 97% and 33% of these patiants had combined mitral and Aortic valve involvement.The frequency of isolated aortic valve disease was 3% but combined with other valve aorta was involved in 59% of patients. Tricuspid valve was affected in 4% with other valve and pure TS were only 0.5%.

In order to determine the incidence and kinds of adverse events attributable to exchange transfusion in high risk neonates including ill and prematures, we have reviewed the medical records of neonates who underwent ET, and the following results obtained: Of 129 neonates, in this study 162 time exchange transfusion were done. 69.8% were premature and 30.2% were fullterm. There were low APGAR score in 39% of these patients. 72% had birth weight less than 2500gr. The main causes of jaundice in fullterm was Rh and ABO incompatibility, idiopathic, septicemia, while in prematures was idiopothic, Rh incompatibility and septicemia. 18.6% had more than one exchange transfusion.Adverse events due to ET was more common in preterm than fullterm infants, (P<0.05). The main complications was apnea, bradycardia, hypocalcemia, thrombocytopenia, bactremia, NEC and hemorrhage (Cerebral & pulmonary).One patient died during the procedure and 7 patients died 72 hr after ET due to septicemia, seizure, IVH, and pulmonary hemorrhage. In conclusion adverse events in premature is higher than fullterm and for prevention of these complications we suggest that total serum billirubin level as a determinant of exchange doing should be reevaluated.

The study of psychological problems in diabetic patients has been performed in low scale all over the world and the relevant information is too low inside the country. In this research by a systematic sampling among NIDDM diabetic patients over 20 year 01, 100 cases were chosen including 69 females and 31 males. The measurement tool for this evaluation was SCL-90-R and the psychological problems were studied in relevant to the factors such as age literary level, economical condition, marital status and posycholigcial family history. The analysis of research datas were performed by the use of SPSS computer software and X2 examination. According to these datas, it was shown that 55% of cases (66% females 41% males) were affected by serious psychological problems. Among the studied factors literary level had a meaningful relationship with psychological problems. (p<0.05) and the other factors were independent. Most problems were seen in illiteate group (70%). The most prevalent of these problems was related to somatization 89%, depression (78%) and anxiety (78%) and the least was related to phobia.

Acne vulgaris is a common, chronic and selflimited disease of pilosebaceous unit that presents as Inflammatory and noninflammatory Lesions and Sometimes scar.In this study, that is a cross-sectional descriptive trial with questionnaires about clinical aspects of disease, 3000 students of boy’s high school from Mashhad with age between 15-18 years evaluated in (1997).Results show that on the average, 62 0 of these students affected by acne disease with the highest prevalence in 17 years old (70.30%). The most common age of onset for acne was 14 (36.2%) and the most positive family history was found in brothers (28%) followed by sisters (25.6%). The most important aggravating factor, pointed by patients, was foods including sweets and nuts.In most cases aggravation of disease was in summer and the commonest lesion was comedo. The most common sites of involvement were face, anterior chest, shoulders and arms respectively.

In this prospective study the body temperature were evaluated among 100 Patients with myocardial infraction (MI) between 1377-1378. The temperature was individually and daily recorded using a standard method and the maximum temperature and its duration as well as its onset and termination date was recorded. The following results were obtained:1- Following the MI onset the highest temperature elevation was observed among females as compared to male subjects. Also it was more common among the younger subjects as compared to the elderly. However among the male subjects the time required to reach the maximum temperature is shorter.2- The most common temperature change, ranged between 37.5 and 37.9 and the maximum temperature most commonly occurred on the second day after MI followed by the third and first days respectively. The duration to reach the maximum body temperature was no longer than five days.3- The most common duration of fever after MI (58%) was one day and the extent of affected cardiac tissues did not change this time.4- In this study the most prevalent type of MI was of the inferior wall type (43%) and there was a clear correlation between the maximum body temperature, the extent of affected area and location of the affected wall.5- The most common risk factors of the MI were found to be a previous history IHD (51%) and hypertension (48%).6- Among male subjects it takes 1-3 days to reach the maximum body temperature as compared to 3-5 days among female subjects.

This study was done on 100 patients hospitalized for urinary stone somewhere in urinary tract who had undergone all the three imaging exams (KUB, US, IVU). The purpose of this study was to determine the value of plain abdominal radiography plus ultrasound examination of urinary tract in comparison with intravenous urography (IVU) in diagnosis of urinary tract stones. In these patients diagnosis of stone was established by surgical results or by passing stone. According to the results of this study we concluded that the plain Abdominal radiography (KUB) plus ultrasonography should be the method of choice at the first step in evaluation of urinary stones.

This research is an analytic descriptive study which conducted to determine effective factors on unintended and intended pregnancies. Puerperal women in sixteen hospitals of Mashhad were target population. 300 women which were selected through random sampling were interviewed with a questionnaire. Mothers of unintended pregnancies were compared with mothers of intended pregnancies; Using the contraceptive behavior and fertility behavior information provided by them. The results showed that fertility behavior of mothers was significantly different in two groups; Contraceptive behavior also was different in two groups. The results emphasize the need for improvement the quality of family planning services.

Objective: Estimation of newborn weight before delivery is very important in management of delivery for presentation of maternal and neonatal complication.Design: A descriptive analytic study method in Rafsanjan hospital was done.Material and Method: 260 full term pregnant women.Result: The mean birth weight was 3101.19±408. The lowest different in 75 the percentile between birth weight and estimation weight by measure of abdominal circumference was (±358g).The most correlation between birth weight and estimated weight was in measurement abdominal circumference. (r=0.622).Measurement of funal height in different maternal position showed that the greatest measurement was in position (1) and smallest measurement related to position 2.Conclusion: The was significant different between neonatal weight and different position of mother in measurement fundal height.

IUD is a highly effective, safe and well accepted contraceptive method with minimal complications.Methods: During the last three years we inserted copper T 380A IUDs in 200 women who had no side effects, in the family planning clinic, Zynab Women University Hospital. They were divided into two groups by random. One hundred women who have had cesarean section in their past history and one hundred who had normal deliveries. Then we evaluated the efficacy of IUDs in these two groups.Results: This study showed that the PID rates is higher when IUD is inserted during .the first 6 months after delivery, also expulsion rates were 3 in 100 women when IUD insertion is sooner than 8 weeks after vaginal delivery. These results are the same as the word's studies (3, 20, 21).Our study showed that 76.5% women had no complications but the PID, uterin bleeding, and dismenorria or pain rates were 10.5, 8.5 and 4.5 percent in this two groups. The failure rate with the copper T 380 A IUD is one percent in vaginal delivered group, we had no ectopic pregnancy or uterin perforation.Conclusion: There is no difference between the complications of IUDs in these two groups. So IUD is a highly effective, safe and weel accepted contraceptive method in women who have had cesarean section.

This evaluation is a descriptive research for this reason we evaluated 140 pregnant women with acute abdomen in Ghaem Hospital between 1992-1997. All of them experienced surgery. 63% of these patients were in first and 21% in second and 16% in third thrimester of pregnancy. The most common reasons were ectopic pregnancy (52%) and apandicitis (22%). 92% of patients had marked abdominal tenderness and 58% had nausia and vomiting. Rebound tenderness was less common (67%). 71% of the early diagnosis matched the laparatomic results but without utrine disorders 59% of the early diagnosis were correct. Fetomaternal morbidity and mortality certificately rised in the third thrimester of pregnancy. Except of ectopic pregnancy fetal complications occurred in 41% of cases, and the most common of them was fetal death (50%). Preterm labour (32%) and abortion (18%) were the other problems. As the result early diagnosis of acute abdomen in pregnancy will diminish the maternal and the fetal complications.

Juvenile Polyposis is a rare disease characterized by multiple juvenile polyps in the GI tract, predominantly in the colon. Although this condition usually presents in childhood, it may occur in both extremes of life. The more common presenting symaptoms include rectal bleeding, diarrhea, protein losing enteropathy and rectal prolapse. A family history is found in less than 50% of patients with an autosomal dominant pattern. Because the occurrence of malignancy has been documented in this condition, the affected persons should be treated and their first relatives should be worked up.In this report 2 cases of juvenile polyposis, in a 19 years old male and in a 31 months aged female are presented. The first case had innumerable colonic polyps and the other had multiple polyps in both small and large intestine. Total collectomy was performed on both of them successfully. Neither of them had a family history.

Acute congenital leukemia is a very rare form of acute leukemia and up to now 200 documented cases have been published and more frequently associated with acute myeloid leukemia. Acute congenital lymphoblastic leukemia is a very rare and up to now 20 cases have been reported. Acute congenital leukemia has poor prognosis and may be indistinguishable from transient myeloproliferative disorders. We present one case of acute congenital lymphoblastic leukemia in male newborn, in the first day of life with phenotypicaly Down syndrome and hepatospienomegaly, pallor, hyperleucocytosis>100000/mm3 with 84-100% blast in peripheral blood smear. There wasn't involvement of central nerves system and skin.Conservative management wasn't effective and he died at 34 days of life.

Crcinoid tumors are uncommon not rare neoplasms. The vast majority occuring in the GI tract. 85%. Tumors of other sites are being reported with increasing frequency.Carcinoids are the most common neuroendocrine tumor of the GI Tract and as a part of APUD-oma system with the appendix being the most common primary lesions 44% and then the small intestine 19% and rectum 15%. Gastric carcinoid represents only 2.5% of all GI carcinoids. Surgical excision is the treatment of choice.Massive upper GI bleeding is a very rare clinical feature for gastric Carcinoid. In this paper we present a 45 years old woman with such uncommon clinical state.

A 35 years old man was admitted to the emergency room because of confusion and fever. He complained of fever, chills and painful swollen right calf muscle from 30 days ago. The only important past medical history was polyuria, polydipsia and nocturia from many months. The tempreture was 40 degrees centigrde, pulse rate 115/min, respiratory rate 24/min and blood pressure was 150.80 mmHg on admission.Examination revealed a chronically-ill man with right calf edema and tenderness but without erythema and warmth.Laboratory findings include: WBC 14500 with 86% P.M.N., FBS=390 mg/dl, CPK=2500 IU/dl, LDH=2675 IU/dl. Sonography revealed viscouse fluid collection within right calf and right deltoid muscles. Blood cultures were positive for staph. Aureus. Percutaneous aspirations from calf were negative. The patient was treated with surgical drainage and intravenous antibiotic therapy.Surgical drainage yeild 1500cc of purulent fluid. He was discharged with no complains 2 weeks later.