2023 CiteScore: 0.7
pISSN: 0044-6025
eISSN: 1735-9694
Editor-in-Chief:
Ahmadreza Dehpour, PharmD, PhD
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE).
Vol 40, No 3 (2002)
Articles
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Cytomegaloviurs (CMV) is the most frequent cause of congenital infection in humans. In various parts of the world the prevalence of antibodies to CMV ranges from 40-100%. The prevalence of primary infection with CMV in pregnant Iranian women and risk of congenital CMV infection in their neonates are unknown. To Determine the prevalence of CMV infection in primiparous pregnant (youner) women and incidence rate of cangenital CMV infection among preterm and full-term infants borned from these women, in serum of 164 primigravid women before delivery, CMV IgG and IgM antibodies were measured by ELISA method and CMV-DNA detection by PCR in ~10% of their infants. 100% of women were immune to CMV infection (CMV-IgG positive) were detected in mothers and newborns. Therefore, we can not compare gestational age and weight of infants in seropositive and serongegative mothers. Probably, in Iranian pregnant women, CMV screening test is not recommended.
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Endonasal endoscopic laser-assisted dacryocystorhinostomy has many advantages over conventional external dacryocystorhinostomy. This technique avoids a cutaneous scar and causes less surgical trauma and bleeding than that seen in conventional lacrimal surgery. A total of 20 endoscopic laser-assisted dacryocystorhinostomy in 16 patients were performed between 1998 and 1999. the procedure was successful in 90% of cases, with no major complications. This success rate is comparable with external dacryocystorhinostomy. Silicone tubing was applied in 11 cases. The difference of success rates between the two groups (with and without silicone tubing) was not significant. It seems that creading a patent rhinostomy plays a more important role to achieve desirable results. Endonasal endoscopic laser-assisted dacryocystor-hinostomy provides a simple, bloodless, and incisionless alternative to external dacryocytorhinostomy in the majority of the patients suffering from symptoms of lacrimal obstruction.
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The nodular thyroid diseas is one of the most common disturbances o the thyroid gland wheras malignant tumors are among the most unusual entities of it. Not only differentiation of these two spectra but also the problems to achieve early diagnosis and treatment, have been a matter of concern, research, and controversy. Two hundred patients were assessed at the Cancer institute of Imam Khomeini Hospital as a retrospective research, considering the aim of evaluating and comparing the results of ultrasound and fine needle aspiration cytology with the postoperative histopathologic report. The ultrosound findings included location, number, size, feature, echogenicity, and presence of calcification; and those of the fine needle aspiration cytology consisted of benign, malignant, and suspicious samples. The cases mentioned as recurrent cancer or metastases of previous thyroid cancer were omitted from the study. In this research we found a sensitivity, specificity, accuracy of 92.3% , 76.4% and 88.1%, respectively , for fine needle aspiration cytology and also showed that the sensitivity and accuracy of fine needle aspiration cytology in diagnosis of malignant lesions of solid nodules was more than in cystic or mixed nodules of thyroid. Moreover, the incidence of false negatives in malignant cases of the studied sample was 7.7% (11/43). This rate was very higher in mixed and cystic lesions compared to benign ones (20% versus 5.7%). According to ultrasound findings, we showed that micro-calcificantion had a significant higher frequency in malignant nodules in comparision with the benign ones (4% in benign lesions versus 35% in malignant ones). The rate of malignancy in solid lesions revealed a significant increment compared to cystic and mixed nodules (P<0.0001). Moreover, the potential for malignancy in nodules with low echogenicity was very higher than high echogenicity producting nodules.
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Amenorrhea, an absence of menses is a symptom that generally brings teenagers for evaluation. This study was undertaken to determine the etiology of primary amenorrhea with especial concern to non classic congential adrenal hyperplasia (NC-CAH)-due 21 hydroxylase deficiency among female adolescents refered to clinics of Pediatric Endocrinology of Tehran and Iran University of Medical sciences and private office. One hundred and five female adolescents were studied. All patients were examined by pediatric endocrinologist.Routine lab tests, FSH, LH, prolactin, T4, TSH, 17-hydroxyprogesterone and in some cases ACTH Stimulation test for screening of NC-CAH due to 21 OH deficiency were performed. Chromosmal analysis, sonography of the ovaries and CT scan or MRI of the brain was performed in some of them. Forty-three patients (41%) had ypergonaldotropic hypogonadism and sixty two patiens (59%) ahd hypogonadotropic hypogonadism. Turner’s syndrome and constitutional delay of puberty were the most common causes of primary amenorrhea in our study. The frequency of primary amenorrhea in our study. The frequency of primary amenorrhea due to 21-OH deficient NC-CAH was 6.6% in overall (105 cases). This study shows that in a population with high incidence of consanguineous marriages, some rare genetic disorders such as 21 OH deficient NC-CAH are relatively common
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We investigated the vasodilatory effect of isoprenaline at large vessels (aorta, renal ans saphenous arteries, vena cava, renal and saphenous veins) in doxorbicin-induced model of heart failure. Thirty saline-treated (normal group) and thirty doxorubicin treated rabbits (1 mg/kg administered intravenously twice weekly for 8 weeks) were studied after 16 weeks of treatment. Chronic heart failure was confirmed by histopathology. Arteries and veins were cut as rings and so bathed in Krebs maintained at 37°C and gassed with 95% O2 and 5% CO2. Then all tissues were placed under different resting tensions and allowed to equilibrate for 1 hour. Then all the tissues were contracted with U-46619 (0.1 µM) nearly ten minutes before initial applications of isoprenaline. When the U-46619 (0.1 µM). induced contraction reached a plateau, concentration-response curves to isoprenaline were obtained. Isoprenaline was chosen as vasodilator resulting from stimulating beta-receptors in blood vessels. Maximum effect (Ema) and median effective concentration (EC50) were determined from each concentration-response curve and pD2 was calculatd as-log (EC50). Isoprenaline induced relaxations in all vessels. Aorta and renal artery were the most sensitive ones and had the maximum relaxations (15-20%). In relaxation due to β-adrencoeptor agonist isoproterenaol, the aorta and renal artery were the most sensitive vessels. Compared with control, in doxorubicin treated rabbits, Emax of isoprenalin was not modified in all the studied vessles. Relaxation responses were negligible and maximum responses in vena cava, and renal vein were only-5-10 percent. Of all vessels there was no significant difference between control and doxorubicin induced of heart failure in response to isoprenaline.
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This study was conducted to evaluate how neuroimaging procedures (MRI, SPECT) could be used in clinical setting for diagnosis of dementia.Forty out of 94 patients suspected of having a diagnosis of dementia, referred to Radiology Department for consecutive neuroimaging procedures, were selected. Patients’ medical records reviewed anda retrospective diagnosis was reached according to DSM-IV for Alzheimer’s disease (AD) and NINDS-AINS for vascular dementia (VaD). Mann-Whitney, fisher’s exact test, bivariat regression were used for analysis.Clinical features of majority of patients were complicated with mental symptoms. Subcortical lesions were observed in both dementias but it was significantly more frequent in the VaD (P=0.000). No significant differences in the number of patients with cortical atrophy between two groups was observed. Significant agreement between SPECT and retrospective clinical diagnosis was observed (kappa=0.18, P=0.02), but no significant pattern of hypoperfusion which could predict the clinical diagnosis was observed.This study emphasis on clinical diagnosis and the clarity of the referral process for doing neuroimaging evaluation. More sophisticated studies, either structural of functional such as volumetric measurement of medial temporal lobe, could be helpful to confirm clinicians in their diagnosis of patients with dementia.
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Epidemiological studies have shown wide geographical and racial variation in the prevalence and patterns of immunodeficiency disorders. To determine the frequency of primary immunodeficiencies (PID) in Iran, the Iranian primary Immunodeficiencies Registry (IPIDR) was organized in 1999. the diagnosis of immunodeficiency in our patients was based on standard criteria. The patient’s data were extracted, by using a uniform questionnaire from their hospital records. Three hundred and twenty eight patients with PID have been registered in our registry till 2000. Among these patients, the following frequencies were found: predominantly antibody deficiency in 48.48% of patients (n=159), T-cell disorders in 25.91% (n=85), phagocytic disorders in 24.7% (n=81), and complement deficiencies in 0.91% (n=3). Common variable immunodeficiency was the most frequent disorder (n=73), followe by chronic granulomatous disease (n=55), ataxia telangiectasia (n=39), x-linked agammaglobulinemia (n=35), selective IgA deficiency (n=34). This study reveals that antibody deficiencies are the most frequent diagnosed primary immunodeficiency disorder in our patients, which is similar to that observed in other registries. A comparative study shows some differences between our results and other registries
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Ultrastructural changes in immature articular carilage were studied after treatment of 5-weeks-old rats with ofloxacin, a fluoroquinolone, and in magnesium deficiency.We concluded that quinolone-induced arthropathy is probably due to chelation of functionally available magnesium in joint cartilage as magnesium deficiency in joint cartilage could impair chondrocyte-matrix- interaction which is mediated by cation-dependent integrin-receptors of the β1-subfamily. With immuno-histochemical methods using monoclonal and polyclonal antibodies we showed that B1 integrins were expressed in rat joint cartilage. Joint cartilage lesions were detected in ofloxacin-treated and magnesium-deficient rats. Lesions were more pronounced in the quinolone-treated group. Expression of several integrins was reduced in the vicinity of lesions after oral treatment with 2×600 mg ofloxacin/kg body wt for one day. Gross-structural lesions (e.g. cleft formation, unmasked collagen fibres) in magnesium deficient rats were very similar but changes in intergrin expression were less pronounced. Alterations observed on the ultrastructural level showed striking similarities in magnesium-deficient rats and in rats treated with single doses of 600 mg ofloxacin per kg body wt.Typical observation were: bundle shaped, electron-dense aggregates on the surface and in the cytoplasm of chondrocytes, detachement of the cell membrance from the matrix and necrotic chondrocytes, reduced synthesis and/or reduced of extracellular matrix and swelling of cell organelles such as mitochondria.The results of this study confirm our previously reported finding that quinolone-induced arthropathy probably is caued by a reduction of functionally available magnesium (ionized Mg2+) in cartilage. Furthermore, they provide a basis for aimed studies with human cartilage samples from quinolone-treated patients which might be available postmortal or after hip replacement surgery
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Neonatal conjunctivitis (ophthalmia neona-tarum) continues to involve many neonates in areas with no eye prophylaxis. Povidone iodine solution is an effective antimicrobial agent with broad antibacterial and antiviral activity and it is less expensive and less toxic than the other agents. It seems to be a good alternative for routine eye prophylaxis, especially in developing countries. In a prophylaxis. Especially in developing countries. In a prospective trial, 360 infants born over a period of ten month in years 2000-2001 were divided in three groups randomly. Each infant received a 2.5% povidone iodine solution, or 0.5% erythromycin ointment or no prophylaxis as a control group. There were 17.5% , 10% and 5.8% of infectious conjunctivitis in control, erthromycin and povidone iodine groups respectively. In spite of reduction of clinical and infectious conjunctivitis in erythromycin compared to control group and in povidone iodine compared to erythromycin group, the only and most significant difference was between povidone iodine and control groups (P=0.0036 for clinical conjunctivitis and P=0.0089 for infectious ones). The most common organisms were gram-negative bacilli and staphylococcus aureus in all groups and chlamydia trachomatis was responsible for 9.5% of infectious conjunctivitis (4 th common agent) with an incidence of 1.7% in control group. As well, birth in unhygienic environment (mother defecation) and meconium staining of amniotic fluid were significantly associated with higher conjunctivitis rate but vaginal infection of mother had no such effect. We found that there is a high incidence of conjunctivitis with no eye prophylaxis.Povidone iodine is more effective, easiter to use and has no toxic reaction. So it seems that 2.5% povidone iodine solution is a good alternative for routine eye prophylaxis
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Hyperandrogenism affects 2-6% of all women. Hypertension is one of disturbances which is related to androgen excess. Higher intakes of vitamin C and vitamin E have been associated with lower blood pressure. Tho investigate the effect of these vitamin supplementation on blood pressure in hyperandrogenic women, a randomized, double-blind, placebo-controlled study was designed on 56 women 18-54 years old. Women were randomly allocated to one of four treatment groups: spironolactone plus vitamain C and viamin E (SCE), spironolactone plus vitamins placebo (SP), vitamin C plus vitamin E (CE), vitamins placebo (P). The treatment consisted of oral administration of 100 mg spironolactone, 1000 mg vitamin C and 900 mg vitamin E (alpha-tocopherol acetate) daily for about 3 months. Results indicated that compared to pretreatment, vitamins supplementation significantly lowered systolic (119.1±12.6 vs. 112.6±15.4 mmHg) and mean blood pressure (97.4±11.5 vs. 92. ±12.1 mmHg) SCE group (P<0.05), diastolic (87.3±12.7 vs. 80±12 mmHg) and mean group (P<0.05). Blood levels of vitamin C and alpha-tocopherol increased in all SCE and CE subjects. In conclusion, vitamin C and vitamin E supplementation reduced blood pressure in hperandrogenic women who are at risk of hypertension.
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Coronary artery disease (CAD) is the most important cause of mortality and morbidity in the world. The knowledge of major risk factos can be useful in prevention of CAD. There is no known major risk factof in many patients with myocardial infarction (MI). the dermatoglyphic pattern in patients with myocardial infarction is an interesting matter and little information is available about this relationship. The objective of this study is to investigate the relation between the dermatoglyphic pattern as indication of genetic susceptibility in the incidence of myocardial infarction.We conducted a multi-center cross-sectional study of 900 patients with diagnosis of myocardial infarction admitted or refereed to six hospitals in three large cities in the north of Iran. The control group consisted of 900 subjects who were selected form those who were referred to police information system at the time when cases had been diagnosed. The dermatoglyphic pattern of finger lines was determined using classic categorization by supervision of experts in Identification Diagnosis Administration office. For each subject 10 fingerprints had been derived. Overall, 9000 fingerprints for cases and 9000 fingerprints for control group were obtained for cases and 9000 fingerprints for control group were obtained for analysis. The findings show that 55.3% of cases were male and 44.7% were female and 70.6% of patients had, Q-wave and 29.6% had non-Q wave MI. in patients group, the distribution of dermatoglyphic pattern was 7.2% arch type, 46.8% loop type, and 46% whorl type of fingerprints. In contrast, in the control group, there were 3.7%, 50.7% and 45.5% respectively. The odds ratio (OR) of arch type vs whorl type was 1.89 (P<0.0001) and odds ratio of loop type vs whorl type was 1.23 (P<0.0001). This result shows a statistical significant increase in the rate of arch type fingerprints in patients with MI roughly two times. Also, in subgroup analysis, the percentage of arch type was significantly increased in left thumb, left forefinger and left ring finger among caeses (P<0.0001) Our findings indicated that there is a significant relation between the arch types of fingerprint and the risk of MI. Thus, dermatoglyphic analysis osf subjects can help in early detection of persons with susceptibility to myocardial infarction, particularly among those without major risk factors, especially, among subjects with arch type pattern of fingerprint on the left thumb, left forefinger and left ring finger
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Tuberculosis is an important opportunistic disease among HIV- infected persons worldwide; from March 1999 to Feburery 2001 we had seventeen patients with HIV-infection and tuberculosis. Here we are presenting the clinical manifestations, diagnosis, treatment and outcome of them. All of them were male, 11 patients had pulmonary and 5 patients had extrapulmonary (pleural effusion 1, hepatic granulomatosis 1, lymphadenopathy 3), one patient had pulmonary and polyserositis tuberculosis. Tuberculin skin test was positive in 6 paitents and only six patients had CD4 cell count at the beginning of their diseas, thirteen patients had positive smear for acid fast bacilli and four paitents had pathology compatible with tuberculosis (caseating granulomatous). Three patients were hemophiliac, nine patients were injecting drug users, fourteen paitents were treated with 6 months regimens and five patients died. Six patients had the scar of BCG vaccination and others did not know anyting about it.
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This case series reports 100 patients with lung cancer and their presenting neurologic symptoms and sings. 78% of patients were maleand 22% were female. Mean age was 62±1.04 years with a peak age between 65 and 75 years. Most patients presented with pulmonary problems (58%) and neurologic deficits as the presenting manifestations were found to be 30% along with pulmonary symptoms and 12% laking them. Neurologic deficits were caused by local tumor invasion, metastasis and paraneoplastic syndromes in 16%, 23% and 3% of the cases respectively . Recurrent nerve pusly was the most common presenting neurologic sign. Common metastatic sites were spinal cord (12%) and brain (11%). Local invasion was mostly found in squamous cell and brain metastasisin adenocarcinoma. In refrence to spinal metastasis most patients had small cell and squamous cell carcinoma. Ophthalmoplegia as a paraneoplastic syndromeis not reported in lung cancer but one of our patients developed complete ophthalmoplegia in left eye with normal imaging studies that seems interesting and needs further investigation.
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The cytology study is effective and reliable technique in intraoperative consultation. This study was performed to evaluate the accuracy of the cytology study in intraoperative consultation of the breast lesions. 125 specimens of the breast lesions were examined and studied in Imam Khomeini Hospital during the years 1998-99. The sensitivity, specificity and accuracy for cytological method were 87.5% , 95%, 90.5% and for the frozen section 92.4%, 100% and 95.4% respectively. The false positive reports were 2% in the cytology technique and the most important source of error and false postivie reports was fibroadenoma in this method. By reviewing the results. It could be concluded that combination of these two techniques is beneficial and more reliable in intraoperative consultation resports of the breast lesions
