TANAFFOS
Year:2006 | Volume:5 | Issue:4 (20)|Papers Count:13

Tuberculosis of the genitourinary tract is one of the late reactivation or complications of pulmonary tuberculosis which is mostly prevalent in young adults and middle-aged people. Renal tuberculosis is rare in children. We present a 4 year-old Afghan girl suffering from pulmonary and renal tuberculosis. The child presented to the hospital with severe malnutrition, fever and cough which initiated a month earlier. She had a history of close contact with her mother who was a smear positive TB patient. Radiologic findings in her chest x-ray were pulmonary infiltration in the right lower lobe along with right hilar adenopathy. The diagnosis of pulmonary tuberculosis was made based on the systemic and pulmonary signs and symptoms as well as the bacteriologic examinations. Anti-tuberculosis drugs were given to the child and after obtaining intravenous pyelography (IVP), voiding cystourethrogram (VCUG) and kidney CT-scan; the diagnosis of renal tuberculosis in addition to pulmonary tuberculosis was made. Urinary symptoms were treated by anti-tuberculous therapy.

Wegener's granulomatosis is a necrotizing granulomatous vasculitis with the prevalence of 3 in 100000. Pulmonary involvement is the most common form of disease manifestation detected in 95% of cases but onset of disease with other symptoms such as proptosis and hyperthyroidism is very rare.Our patient was a 29-year-old man who had been presented to the hospital with goiter, palpitation, fatigue, and proptosis in 1997. He underwent subtotal thyroidectomy and was treated with methimazole.After six years of treatment, he admitted to the hospital for the second time with arthritis, arthralgia, fever, hematuria and nodular pulmonary lesions. Open lung biopsy confirmed the diagnosis of wegener's granulomatosis.

Background: Thymus is a Iymphoepithelial organ composed of epithelial cells and Iymphocytes. Primary tumors of the thymus are uncommon and a definite risk factor has not been found. There are some reports regarding the association of the (EBV) Epstein Barr Virus with thymic epithelial tumors. This study was conducted to evaluate the presence of EBV genome in thymic epithelial tumor.Materials and Methods: EBV genome, EBNA2 was examined from DNA extracts of 41 paraffin embedded specimens in Cluding 16 thymic epithelial tumors as subject cases and 25 mediastinal lymph nodes as controls.Results: Nested PCR assay revealed that 31.25% of cases were positive for EBV genome.Conclusion: The presence of EBV genome EBNA2in thymic epithelial tumor suggesting that this association may be due to the endemic nature of EBV infection.

Background: Tuberculosis (TB) is a chronic infectious disease which is still a global health hazard. With the emergence of new more effective drugs, tuberculosis was expected to be completely eradicated; but, global reports show results to the contrary. It seems that, in addition to drug regimens, individual health and social factors should be taken into consideration. This is not achievable except by increasing the knowledge and creating a positive attitude towards this disease. The aim of this study was to evaluate the level of knowledge and attitude of high school students regarding TB in twenty-two areas of Tehran.Materials and Methods: A stratified, random sampling was performed in which 22 educational districts of Tehran were divided into five geographical areas (North, South, East, West and Central). Two educational districts were chosen from each geographical area out of which four high schools (2 boys and 2 girl’s high schools) were selected. In each high school, 40 to 45 9th, 10th and 11th-grade students were selected as the study group. A total of 5000 students were enrolled in this study and data were collected by face- to face interview and questionnaire.Results: This study showed that the knowledge level of students regarding TB was low and they also, had a negative attitude towards tuberculosis (especially boys). There was a positive relationship between the attitude and knowledge of students towards TB. The knowledge level decreased as the educational level increased.Conclusion: Considering the direct correlation of attitude and knowledge and also the import3nt role of attitude in preventive behaviors, increasing the knowledge of adolescents about tuberculosis seems to be essential. This aim can be achieved by establishing national tuberculosis control committee and scheduling programs for general education of all students of the country in this regard.

Background: Twenty percent of pulmonary arteriovenous malformations (PA VM) are type II PAVMs. This type of PAVM is characterized by less than 5 A VMs in the body and no other vascular anomalies such as A V fistulas or aneurisms. We studied seven cases of type II PA VMs in which surgical resection was the mainstay of treatment. All were free of symptoms and without relapse after the surgery. Materials and Methods: During a 26-year period, 7 subjects proven to have PAVM by imaging studies were entered in this cross-sectional study. Demographic, clinical and imaging findings along with results of catheterization and angiography were collected. All cases were operated on and followed to assess the results of surgery, complications and recurrence.Results: Seven cases were entered in this study (five males and two females). Seventy-one percent of our patients were in the first decade of life. Dyspnea and cough were present in 6 (85%) and 5 cases (71 %), respectively Physical exam showed polycythemia in 5 (71%), clubbing in 4 (57%) and arterial bruit over the chest in 2 (28%) cases. Two paradoxical emboli were seen, (one to the brain and one to the coronary artery). Fami/y history was negative. Chest x-rays revealed large PA VMs in 5 cases (71%). Diagnosis was made by CT-scan, catheterization, angiography, and histopathology Location of lesions was in the lower lobes in all cases. Surgical approach was lobectomy in 5 cases and segmentectomy in two cases. Operations were without any complication and the patients were symptom-free thereafter.Conclusion: Surgical resection of large PA VMs was completely curative without any early or late complications.

Background: This study was conducted to review the epidemiology, and biochemical data of pleural fluid to assess the potential contribution to occupational risk of patients with malignant mesothelioma (MM) in Iran.Materials and Methods: Hospital files of patients with MM of the pleura in Masih Daneshvari Hospital were reviewed between 1997 and 2004 and were evaluated in a cross-sectional study.Results: 66 patients (49 men and 17 women) with a mean age of 53.8±4.2 yrs were selected. Probable or known occupational contacts were detected in 8 (12.1%) patients. The diagnosis was confirmed by closed pleural biopsy in 26 (39.4%) cases. Statistical analysis showed significant cut-off for LDH and glucose level in pleural fluid analysis. Conclusion: Detailed occupational history must not overemphasize blind biopsy as the first diagnostic approach for MM of pleura and pleural fluid glucose as well as LDH had characteristic levels respectively.

Background: Complications of cigarette smoking are of the major obstacles of a society. Both active and passive smoking cause various forms of diseases in men, women and children. Since almost one third of the world's population are children under 14 years of age, preventing the unwanted health consequences of involuntary smoking can help in improvement of health as well as the health level of the society.Materials and Methods: In cooperation with the "Iran Statistics Center" and by using PPS method a number of families required for the study were selected among 22 districts of Tehran. After obtaining a consent, a questionnaire was filled out by a physician through interviewing the families randomly.Results: In this study, 214 families were questioned out of which 129 had at least one smoker member in their family (60.2%). A total number of 825 individuals were studied (including 270 men, 281 women and 274 children under the age of 14), out of which 87 men (32.2%), 42 women (14.9%) and overall 129 subjects (23.4% of the population over the age of 14 and 15.6% of the general population) were smokers. The mean number of visits to the physician by the children of all families was 3.7±1.8 per year. This number was 2±0.9 and 4.7±1.56 in the non-smoking and smoking families respectively (p=0.000).Mean exhaled CO level of a non-smoker or passive smoker of a smoking family was 20.2±5.8; whereas this rate was 6.6±3.5 in a non-smoker member of a non- smoking family (p=0.000).Conclusion: Comparison of the number of visits does not significantly indicate the disease-inducing role of passive smoking but only that these visits are more in families that smoke.

Background: Systemic lupus erythematosus (SLE) can affect all organ systems including the respiratory tract and skeletal muscles. Some of the respiratory findings can be attributed to respiratory muscle involvement. The purpose of this study was to clarify the characteristics of pulmonary function tests (PFT), especially maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) in females with systemic lupus erythematosus (SLE).Materials and Methods: During a 12-mounth period, forced vital capacity (FVC), FEV1, FEF25-75, MIP, and MEP were measured prospectively in 76 consecutive female patients, suffering active SLE. The measured values were compared to an age-matched group of healthy women.Result: FVC was lower in the patients than in controls (2.81 versus 3.64) P=0.000. Maximal inspiratory pressure (Plmax) was lower in the female patients than in 78 controls (3.42 versus 7.36) P=0.000. Maximal expiratory pressure (PEmax) was lower in the female patients than in controls (4.14 versus 9.68 kPa) P=0.000, There were no correlations between Plmax or PEmax and parameters of disease activity. Mouth occlusion pressure within the first 0.1 s of inspiration was higher in SLE patients than in controls (2.43 versus 1.38); however, the difference was not statistically significant (P=0.16).Conclusion: This study provides evidence of inspiratory and expiratory muscle weakness in SLE and may cause FVC reduction as well. The pathophysiologic mechanisms and the prognostic significance should be further investigated.

The humeral immune response against mycobacterial pathogens and BCG vaccine is still, poorly understood. It is not known if antibodies raised against BCG react with all pathogenic M. tuberculosis strains. The, question arose during the development of a tuberculosis detection system based on antibodies. It was found that antibodies raised against cells of avirulent TB strain H37Ra and against whole sonicates of BCG do not react consistently with whole cells of pathogenic TB strains and very poorly with whole BCG cells. These antibodies; however, react very well with the internal components of the BCG cell (i.e. A 60 and cytoplasmic constituents).

Background: Myasthenia gravis is an autoimmune disease characterized by weakness and fatigue of voluntary muscles. Thymectomy is considered an effective therapeutic option for patients with myasthenia gravis. The purpose of this study is to evaluate the efficacy of thymectomy by partial stemotomy for the treatment of non-thymomatous myasthenia gravis. Materials and Methods: From 2002 to 2006, patients with non-thymomatous myasthenia gravis who underwent thymectomy through a partial median sternotomy were studied prospectively and analyzed to evaluate the results of thymectomy performed by this technique.Results: There were 10 patients (8 women and 2 men) and the mean age at the time of thymectomy was 25.9 years. Eight patients (80%) were in class IIA of Osserman's classification while 2 patients (20%) were in class IIB. Mean duration of symptoms before operation was 2 years. Mean follow-up was 9±3 months. Mean postoperative hospital stay was 6.1 days (5 to 10 days). Pathology examination revealed thymus hyperplasia in all patients. There was no mortality. Complications occurred in two (20%) patients. One (10%) patient needed mechanical ventilation for 24 hours postoperatively. After 6 months of follow-up, 2 patients (20%) had complete remission of symptoms, 5 (50%) had a significant improvement, 2 (20%) had a mild improvement, whereas one patient (10%) had no improvement in his clinical symptoms.Conclusion: Partial median sternotomy may be a useful surgical approach to the thymus, as demonstrated by the good functional and aesthetic results, associated with low morbidity and no mortality.

Background: Smoking is the leading cause of preventable deaths worldwide. Since the price and expense of tobacco products are important factors relating to smoking and tobacco control, it is necessary to calculate the expense of daily smoking in order to enforce tobacco control programs. This study was done to assess the expense of daily smoking among smokers in Tehran.Materials and Methods: A cross-sectional study was done among a random population sample of 3026 smokers in different areas of Tehran. Data collection was done via WHO and IUA TLD (International Union Against Tuberculosis and Lung Disease) questionnaires by questioning health-care workers. Finally data were analyzed by Chi-Square, Fischer's exact and logistic regression tests.Results: Among 3026 participants, 2413 (80.9%) persons were male. The mean age of the population was 40±12.7 years. 49.2% of the population (1439 persons) had below diploma degrees and the maximum frequency distribution of occupation belonged to employees (36.7%). The mean age otinitiation of smoking was 21±8. 19 yrs. and the mean number of cigarettes smoked daily was 16.81±10.61 cigarettes. 41.8% of population (1192 persons) had daily smoking expense of 2,510 to 4,500 Rials. The mean was 4,680±388.78 Rials. In evaluation of daily smoking expense according to gender, over 6,500 Rials daily expenditure was more frequent among men (20.1%) in comparison with women (13.5%) (P=0.000). Persons with daily income of less than 50,000 Rials, spent 9.3% of it for smoking.Conclusion: Because of the low price of cigarette in Iran, there is huge expenditure on smoking. Therefore, it is recommended to pay special attention to economical strategies in tobacco control programs and to coordinate with WHO Framework Convention on Tobacco Control (FCTC).

Background: Asthma is an inflammatory disease of the airways. Oxidants are of the important factors damaging the airways. Moreover, an inappropriate correlation exists between oxidants and antioxidants in asthma. Vitamin C is one of the major protective antioxidants of the airways. Thus, we evaluated the concentration of Vit C in plasma and white blood cells of asthma tic patients.Materials and Methods: A case-control study was performed on 50 asthmatic patients referred to Masih Daneshvari Hospital. Data were collected through the general information and 24h dietary recall questionnaires and then the effect of independent variables on plasma and wac ascorbic acid concentrations was evaluated by statistical analyses using biochemical tests.Results: Data showed that plasma and WBC ascorbic acid deficiency exists in 38% and 92% of asthmatic patients, respectively. There was a significant difference in plasma and WBC Vit C concentrations between case and control groups (p<0.0001). There was a positive significant correlation between the level of plasma ascorbic acid and dietary Vit C intake (p=0.0001).Conclusion: The present study showed a relationship between asthma and ascorbic acid levels in plasma and in WBCs. More precise studies are recommended for better determination of asthma and vitamin C correlation.