Zahedan Journal of Research in Medical Sciences
Year:2006 | Volume:8 | Issue:3|Papers Count:13

Background: Thalassemia is the most common hemolytic anemia in Iran and around the world that needs regular blood transfusion. Transfusion leads to iron overload in the body. Absence or irregular chelation therapy in these patients leads to various complications such as cardiac diseases, endocrine disorders and infectious diseases like HIV and hepatitis. The purpose of this study was to evaluate the hazard rate of endocrine disease and related factors using COX model.Materials and Methods: This cross-sectional study was carried out on eight-hundred and six thalassemic (406 male and 400 female) patients referring to Cooley’s ward of Dastgheib hospital in Shiraz who were studied using a structured questionnaire through enumeration method. Age of occurrence, demographic information, age of onset and type of transfusion, and age of onset and method of chelation therapy were specified. Specialist physicians diagnosed the complications.Data were analyzed using descriptive and analytical (Proportional hazard rate and its confidence interval using COX model) statistical.Results: The range of the subject’s age was between 1- 43 years and mean age ± SD was 15.34±6.82 years. The prevalence rate of hypogonadism, hypothyroidism, hyperparathyroidism and diabetes mellitus was 14.5%, 2.4%, 6.9% and 7.5% respectively and the mean age of onset of hypogonadism, hypothyroidism, hyperparathyroidism and diabetes mellitus was 18.42±3.6, 15.83±3.5, 16.98 ± 4.5 and 17.19 ± 4.8 respectively. There was a significant association between proportional hazard rate of all complications and age of chelation therapy onset (P<0/05).Proportional hazard rate of hypogonadism also was related to the sex and educational level of the patient’s mothers (P<0/05). Proportional hazard rate of hyperparathyroidism also was related to sex and occupational status of the patient’s mothers.Conclusions: Early onset of blood transfusion with late onset of chelating increases the occurrence probability and early onset of complications. To prevent these complications, it is recommended that onset of blood transfusion be according to the onset of chelating. Educational level of parents and educating parents and patients is very important. Progression of complications can be prevented by regular survey and early diagnosis of complications and can lead to high efficacy of patients.

Background: Several clinical studies have recently claimed that HCV infection could trigger the onset of diabetes mellitus (DM). In order to determine the prevalence of hepatitis C virus (HCV) among patients with type 1, 2 diabetes mellitus (DM) and investigate the influence of several epidemiological factors on HCV infection, we conducted this study.Materials and Methods: In this case-control study we evaluated 505 diabetic patients (135 mal, 370 female with the mean age of 54.5 years) who had referred to Diabetic clinic in Boo-Ali hospital (a teaching hospital in south east of Iran) in 2004. Serologic testing for anti- HCV was done using a third–generation commercial Enzyme–Linked Immunosorbent Assay (ELISA) and Real–time–PCR (HCV RNA) in order to confirm the anti-HCV positive samples. Diabetic patients were divided in two groups according to their HCV antibody status and were analyzed for the following variables: age, sex, type of diabetes, duration of disease, mode of therapy, late diabetic complication, previous blood transfusions, intravenous drug addiction, hospital admissions and major surgical procedures.Then results were compared with the findings from blood donors.Results: HCV infection was detected in one patient who had history of hospitalization and blood transfusion. However, a higher prevalence of HCV infection was not observed in diabetic patients in comparison with blood donors (P=0.46).There was no correlation between HCV and diabetic type, duration, age, sex (P>0.05).Conclusions: Upon the results of our study, we conclude that HCV infection is not a trigger factor for DM; therefore it should not be listed among the various extrahepatic manifestations of this viral infection. Although, further studies, possibly multicentre, are needed to estimate prevalence of HCV in diabetic patients.

Background: Crown fracture of maxillary incisors is the common injury which can lead to unfavorable psychological effects on both children and their parents. Moreover, it can create a malocclusion. The goal of this study was to determine the prevalence of crown fracture of maxillary incisors in primary school pupils in Zahedan.Methods and Materials: In this cross – sectional descriptive study, data were gathered through questionnaire, interview and clinical examination in 2190 school children,(1219 girls and 971 boys). The samples were chosen by a simple random method from five geographical areas in Zahedan. The data were analyzed using SPSS software and χ2 test.Results: The Prevalence of crown fracture in the studied group was 11.8% (95% CI: 10.5%-13.3%) with no significant difference between boys and girls. The highest frequency of trauma was observed in the 11 year age group. Falls were the major sources of trauma (44%) and the maxillary central incisors were the most affected. (P<0/05) Conclusions: The prevalence of crown fracture of the permanent maxillary incisors in primary schoolchildren in Zahedan was 11/8%. Therefore, provision of information to the children and parents and school staff about the importance of early management and ways of preventing dental trauma is essential.

Background: This study evaluated correlation between serum uric acid level with pulmonary hypertension and progress of pulmonary vascular disease in children with Congenital Heart Disease (CHD) and Eisenmenger syndrome.Methods: This case-control study was performed on 75 patients with congenital heart disease, from Mar 2001 to Apr 2004 that had referred to pediatric cardiology ward in Ali-Asghar hospital, Zahedan and then cardiac catheterization performed at Khatam Hospital. Among 75 patients ,25 cases suffered from Eisenmenger syndrome (group 1), 25 cases had pulmonary hypertension (group2) and25cases were in control with normal pulmonary artery pressure(group3).Then collected data were analyzed with SPSS and Chi-square, Mann-Whitney, Kruskal-Wallis and correlation tests and then results of three groups were compared to one another.Results: Mean age in Eisenmenger syndrome (group1) was 2.75+/-2.23years,in pulmonary hypertension (group2)3.52+/-3.76 and in control (group3)4.01+/-2.34 (P>0.05). There was no significant statistical difference between three groups regarding age and sex.(P>0.05)The mean pulmonary artery pressure was71.65+/-9.26 in group1,39.22+/-10.09 in group2 and 13.65+/-1.69 mmHg in group3.(P<0.001)The mean QP/QS ratio was 1.2+/-0.29 in group1,1.89+/-0.31 in group2 and1+/-0 in group3.(P<0.001)The mean RV pressure was92.2+/-12.72mmHg in group1,60.4+/-16.7 in group2 and25.44+/-3.29 in group3.(P<0.001)The mean pulmonary vascular resistance was0.952+/-0.1 in group1,0.33+/-0.12 in group2,and0.13+/-0.01 in group3.(P<0.001) there was a correlation between serum uric acid level and pulmonary vascular resistance in group1.(r=0.425,P<0.034) The mean serum uric acid level was6.83+/-2.07mg/dl,4.01+/- 1.14,4.45+/-0.75 in the three groups respectively (P<0.05). Also this study showed that there is no statistical significant relationship between mortality rate and serum uric acid in group1.Conclusion: In this study, a significant correlation between increased serum uric acid level and increased pulmonary vascular resistance in patients with Eisenmenger syndrome was found and there was no a significant correlation between serum uric acid level and pulmonary vascular resistance in other groups. So serum uric acid could be used for prediction of severity and progress of Eisenmenger syndrome in children with congenital heart disease (CHD).

Background: Female urinary and genital systems have anatomic and embryologic similarities and both structures and other pelvic floor organs may be damaged during pregnancy and delivery. Other factors such as age and BMI may also affect pelvic floor functions. Pelvic floor disorders such as urinary incontinence, (stress, urgent or mixed type), anal incontinence, pelvic organ prolapse and sexual abnormalities are common problems. The purpose of this study was to define the prevalence of pelvic floor disorders and to determine predisposing factors including ageparity, BMI (Body mass index) and mode of delivery.Methods and Materials: This prospective study was done on 612 randomly selected women aged 15 years or higher that referred to the gynecologic clinic of Ali-ebn-Abitaleb Hospital. These women were questioned about age parity, delivery method, and pelvic floor disorders including urinary incontinences, flatus and fecal incontinences, disparonia, hemorrhoids, based on which questionnaire was completed. Also women's weight and height were measured and BMI was defined. The data were analyzed with SPSS software and X2 test.Results: most of these 612 women occurred in age between 26-35 years (38.5%), and the lowest common age range was 56 years or higher(11.4%). 50.9% of the women had one pelvic floor disorder, 68.6% had two pelvic floor disorders, and 31.4% had three or more pelvic floor disorders. All types of pelvic floor disorders increased after the next deliveries. There was a significant difference between Body Mass Index and pelvic floor disorders including urinary incontinence (P=0.001), Constipation (P=0.001) and fecal incontinence. (P=0.014) But there was no significant difference between disparonia (p=0.33), vaginal relaxation (P=0.58), vaginal dryness (P=0.96), hemorrhoid (P=0.25) and Body mass Index and also the proportion of hemorrhoid, Constipation, fecal incontinence and urinary incontinence were higher in women with vaginal deliveries compared with other kinds of deliveries (caesarean- instrumental delivery). The lowest proportion was in cesarean delivery. Also disparonia in the instrumental delivery group was two times higher than the cesarean and vaginal delivery group.Conclusion: Pelvic floor disorders are very common and are associated with female aging, BMI, and parity. Caesarean delivery is not associated with a significant reduction in long – term pelvic floor morbidity compared with spontaneous, and instrumental vaginal delivery.

Background: Schizophrenia and schizoaffective are chronic psychiatric disorders that decrease cognitive ability. In this study we examined the cognitive problem in patients with these disorders.Method and Material: This study is a descriptive- analysis research conducted 309 men hospitalized in Ebne-Sina hospital in Mashhad, including 195 paranoid schizophrenia and 114 schizoaffective (Bipolar type).All the patients underwent the MMSE test with 6 domains; then the results were analyzed.Results: Cognitive impairment in Schizophrenic patients was more significant than schizoaffective patients (P =0.04) particularly in speech and motoric aspects (P = 0.032).Conclusion: Speech and motoric skills in schizophrenic patients get badly damaged; therefore, paying attention to this cognitive impairment in the process of treatment is necessary. Schizoaffective patients have less cognitive impairment but they suffer from attention insufficiency and calculation problems. This difference could be a root for ethiological differences.

Background: Varieties of exercise therapy methods are used in rehabilitation in order to improve muscle function. Optimal function of muscles results in improvement of functional activities; as a result, these activities would be achieved in a shorter time with the reduction of energy wasting. The purpose of this study was to evaluate the effects of plyometric and strengthening exercises on the quadriceps muscle strength in girl students of Zahedan University of Medical Sciences.Methods and Materials: This experimental study was performed in Zahedan in 2005. Thirty six girl students aging 20 ± 1.2 years among residents of Mojtameh dormitory of Zahedan University of Medical Sciences were studied through simple non-probability sampling. Subjects were randomly assigned to either a plyometric exercises group or a strengthening exercises group. The quadriceps muscle strength (kg) was measured using hand-held dynamometer before and after 10 sessions of intervention. The first group received plyometric exercises. Strengthening exercises were given to the second group. Independent and paired t-tests were used for comparison between the pretreatment and post treatment results between groups and within groups, respectively.Results: The strength of quadriceps muscle was increased from 12.1 ± 3 to 14.7 ± 3.8 (kg) in the plyometric exercises group and from 12.4 ± 3.1 to 14.9 ± 3.9 (kg) in the strengthening exercises group (P<0.0001). No significant difference was seen between two groups after and before intervention. Independent-samples t-test identified that there was no significant difference between two groups with respect to mean difference of the quadriceps strength.Conclusions: The results, in spite of conventional opinions, showed that there was no difference between plyometric and strengthening exercises regarding quadriceps muscle strengthening. Both types of exercises increased the quadriceps muscle strength. Therefore, according to patient conditions, either type of these exercises can be used for exercise therapy in knee pathologies and the quadriceps muscle strength deficit.

Background: Liver is an important organ in carbohydrates and fatty acids oxidation and to clear toxic agent. Teucrium Polium is an herbal medicament used in traditional medicine without considering its side effects. The aim of this survey was to study the toxic effects of Teucrium Polium on serum levels of liver enzymes, lipoproteins and blood sugar.Material &Methods: The survey was carried out on 20 normoglycemic male rats with body weight, ranging from 200-280 gr that were divided randomly in two equal groups randomly. Test group were given Teucrium Polium extract (D=1/09) through gavages for 4 weeks. Control group received the same volume of tap water. At the end of the course, liver enzymes, serum lipoproteins and blood sugar were measured. Data obtained were analyzed by SPPS software v.12 and mean values were compared with student t-test. The results were expressed as mean ± SD and statistical difference considered meaningful if P<0.05.Results: the results of this survey showed that AST, ALT, and ALP, values of test group were significantly higher than that of the control group but other factors, which were evaluated in test and control group, did not show significant difference.Conclusion: This survey revealed Teucrium Polium use in male rats led to liver Toxicity by increasing liver enzyme value.

Catamenial pneumothorax is a rare clinical condition that was coined from a Greek root meaning monthly. It classically involves women in the 3rd or 4th decade of life. Since the first description in 1958, Just 229 cases of a unique entity of catamenial pneumothorax in women have been reported. The etiology of this disease is not clearly known. Endothoracic endometriosis or other unidentified problems make periodic spontaneous pneumothorax in this patients.The main presentations of this disease are dyspnea and chest pain within 48 to 72 hours from the onset of menstruation. In this paper we discuss etiology, clinical course, and thoracoscopic treatment of a 39 year old woman with catamenial pneumothorax. In addition, the world literature is reviewed.