Tehran University Medical Journal

Anatomical comparative study of the renal arteries in one hundered cases of aortograms

M Naraghi

In this study, it has been observed that the natural similarity of the blood flow to both kidneys, despite the differences of length of the right and left Renal arteries, is due to the angle of distribution of these arteries. This angle has been determined to be of 66.7 degrees for the Left Renal Artery and only 51.5 degrees for the Right Renal Artery, in their normal anatomical aspects.

Study of lead effect on liver parenchymal cell of fetal rats by electron microscope

M Karimfar

To study the lead effect, we selected 14 females rats in which we had observed vaginal plague after mating, and divided them into a group of 8 female rats as the case group and 6 females as the control group. As drinking water the case group was given 0.13% lead acetate solution and the control group pure distilled water. Immediately after parturition the pups were killed and their livers removed. A small part of the liver was fixed in glutaraldehyde and osmium tetroxide in order to be studied with transmission electron microsope. The fixated parts were dehydrated and embed in Epon 812. using ultramicrotomoe, we prepared semithin seclions of the tissues, stained them with toludine blue, and studied them under light microscope. Further more we prepared thin sections of the tissue to be placed on grids coated with formvar. These sections were stained by uranyl acelate and lead citrate. Electron microscopic study was performed on them. Results: T.E.M. study showed the swelling and blebbing of nuclear envelop and endoplasmic reticulum and mithochondria of hepatocytes.

Methods of epithelial tissue culture in albino rabbit skin

SMH Nuri

With the intention of research of various methods of epithelial tissue culture we've studied five French Albino rabbits with an average of 8 weeks. In order to evaluate and control growth and proliferation of autologus cultured tissue samples were obtained on 1st, 5th and 8th days. After fixation of these samples and passing them through various processes, histologic sections were prepared. These sections were stained with H-E and studied by light microscope, we succeeded in developing the original donor surface by 18 times.

Evaluation of the effect of loads on static & dynamic parameters of vertebral collumn in 32 young males

Gh Oliaiy

The effect of some anthropometric factors and loading on paravertebral muscles was tested in this study. Thirty two healthy men with mean age of 25.25 years participated in this study. They didn't have history of low back pain since 12 months ago. The effect of weight, height, upper limb length, abdominal & chest circumference and upper body height and other factors e.g. body mass and functional capacity indexes on maximum isometric torque of paravertebral muscles and spinal range of motion in all planes of movement and effect of loading with 0, 5, 10, 15 kg loads on paravertebral factors e.g. dynamic torque, velocity, work, power, and slope of torque was examined with a dynamometer named ISOSTATION B-200. Correlation, analysis of variance and t-test was used in SPSS program. Results show that maximum isometric torque and functional capacity index increased with increasing weight abdominal and chest circumference and body mass index (P<0.05). Height, upper body height and upper limb length don't have effects on this factors, and anthropometric factors don't have effects on range of motion. Maximum dynamic torque, maximum velocity, work and power were significantly increased and time of movement & slope of torque were significantly decreased while load increased (P<0.05). This study showed that load-velocity relationship in limb muscles can not help the paravertebral muscles studies because paravertebral muscles histologically differ from limb muscles.

Reporting of antimicrobial susceptibility and microorganisms in neonatal sepsis in Children Medical Center Hospital

Sh Behjati

Infections are significant causes of mortality and long term morbidity in neonates especially in developing countries. Temporal and geographic differences in the relative frequencies of various neonatal pathogenes are well recognized. The outcome of neonatal infections can be improved if appropriate antimicrobial agents are promptly administered. In this report microorganisms of neonatal sepsis and susceptibility to various antimicrobials is determined.

Determination of minimum inhibitory dose of UVR on Ascaris-ova inactivation

K Imandel

Wastewaters are one of the most important sources for transmission of pathogenic agents in environment, so they should be disinfected in a manner that their overall qualities become accordant with WHO-guidelines, if it is needed to reus water correctly. Unfortunately, the protozoa and parasitic worm's eggs can not be destroyed by chlorination alone. This experiment was carried out in order to determine the efficiency of the UV-Lamps in inactivation of the Ascaris Lumbericoides-ova which is the most resultant organism among the other nematode eggs. The minimum inhibitory dose of UVR (UVC plus UVB irradiances) for Ascaris-ova complete destruction ascertained to be 420 miliwatts-seconds per square centimeter.

Etiology and prevalence of preterm deliveries in Dr. Shariatie Hospital, 1996-97

V Marsusi

One hundred and sixty preterm deliveries were done at our center in (1996-97). Classification according to etiology shows that 30% of these deliveries were due to PROM, and 13.75% had to be induced secondary to underling fetal or maternal indication, in 35.6% there were maternal or fetal pathology, and in 20.6% there were no recognized reason (idiopathic). The various etiologic factors were evaluated in 160 term deliveries as control group. The preterm deliveries had significantly higher rate. There were 40 cases of perinatal mortality that included 77% of total perinatal mortality in (1996-97). Acute lack of neonatal intensive care unit in Iran requires closer attention in the future.

A comparison between topical Griseofulvin and topical Clotrimazole in Tinea Versicolor

P Mansoori

Griseofulvin is a well-known, effective, systemic antifungal agent which has not been used topically in the current clinical practice. In order to treat the common superficial fungal infection of tinea versicolor, a new topical formulation of griseofulvin (1%) was tried in 105 patients during a double blind study and its efficacy compared with placebo (its vehicle) and clotrimazol (1%) solutions. As a result, 17.9% of patients treated by griseofulvin, 38.9% of patients on clotrimazole and 3.3% of patients receiving placebo were completely cured. This study suggests that in proper solvent, topical griseofulvin might show its antifungal action.

Comparative study of laparoscopic and histerosalpingographic findings in 291 infertile couples

A Moini

Incidence of infertility is 15-20%. Tubal and peritontal factors are responsible for 30-40% of infertility cases. In evaluation of infertile women, hysterosalpingography (HSG) is the first test in evaluating of fallopian tubes and laparoscopy is the gold standard test for diagnosing tubal problems and pelvic adhesions. In this study we evaluated 291 infertile couples. Study is prospective, descriptive and cross sectional. After ruling out male, ovulatory and cervical factors, HSG and laparoscopy was done for all women. In response to pathologic process, right or left tube will be damaged by the same rate (P<0.05). In evaluating of tubes, similarty of findings in HSG and laparoscopy was 50%. Sensitivity and specificity of HSG in diagnosing of patency of tubes was 82% and 81%, respectively, but sensitivity of it in diagnosing of peritubal adhesions is low (31%), but specificity is good (88%). After dividing the patients into groups with and without past history of pelvic surgery, we find that similarly of findings in HSG and laparoscopy in patients with positive history is lower than those with negative history. So, diagnostic accuracy of HSG in patients with past history of pelvic surgery is low (P<0.05).

Grid pattern Argon Laser photocoagulation for diabetic diffuse macular edema

R Karkhane

Purpose: to determine the effect of Grid pattern laser photocoagulation on diabetic diffuse macular edema with assessment of visual outcome. Patients & Methods: The author reviewed the medical records of 84 eyes of 62 patients with diabetic diffuse macular edema treated with Grid pattern green Argon laser photocoagulation in Farabi Eye Hospital between the years 1992-1995, the follow-up period was 16-48 months (average 24.55±6.42, median 28 mounths). Results: Visual acuity was improved in 11.9% unchanged in 65.4% and worsened in 22.7% of eyes. Conclusion: In assessing long-term visual outcome, Grid laser photocoagulation is an effective modality in maintaining or improving visual acuity.

A survey of prevalence of hypertriglyceridemia and low HDL in the population of Isfahan with age over 20 years

N Sarrafzdegan

Regarding the importance of cardiovascular disease in the health of societies, Hyperlipidemia is considered as an important risk factor. One of the case recently put forward in the fat profile, is high TG (triglycerides) and low HDL-C (High Density Lipoprotein). Nowadays, we believe that TG without the presence of low HDL-C is not considered as a risk factor for cardiovascular disease. So it was decided to perform a descriptive study to define the prevalence of this syndrom, like other risk factors, in urban population of Isfahan. Samples were selected by random sampling method and the sample size, to have reliability of 95%, was about 1200 from the people over 20 year old in 6 age groups and 2 sexes. After inviting the people while going fast (about 14 hours), a questionnaire including perfect identifications was filled and blood factors include total cholesterol, TG, LDL-C (LOW Density Lipoprotein), HDL-C and F.B.S (Fasting Blood Sugar) were measured. Then the statistical analyzing of data was done to define the relation between TG and HDL-C. Regarding the coefficient of correlation and P.value <0.05 in different age and sex groups (except over 70 years old group which was not significant) was defined that TG has an inverse relation to HDL-C and the prevalence in the urban population of Isfahan is 19.7%. Results got from studying the relation between TG serum level and high LDL/HDL fraction (equal or more than five) showed that the more TG gets, the more the fraction is and regarding to its prevalence (11.6%) in Isfahan. It can be a risk factor for cardiovascular disease. So regarding the high prevalence of High TG and low HDL-C syndrome, treating this syndrome can be considered as one of the primary prevention methods. To fufil the latter goal firstly the syndrome must be identified and the related patients must be treated. So the patients with high TG must be tested for HDL-C and LDL-C too. And secondly therapeutic actions to increase HDL-C and to decrease TG level must be done.

Comparison of laparoscopic findings in women with chronic pelvic pain with findings of pain free women who were candidate for laparoscopic tubal sterilization

A jamal

The laparoscopic findings of 32 patients with chronic pelvic pain were compared with findings of 62 pain free women who were candidates for laparoscopic tubal sterilization. The most common findings, normal pelvis, was found in 50% of patients and 80.6% of controls that was statistically significant (P<0.01). There was no significant difference with pelvic adhesions, polycystic ovaries, pelvic relaxation between study and comparison group.

One year evaluation of epidemiology, morbidity and mortality in diabetic dialysis patients

Sh Sarrafian

Diabetes Mellitus is one of the common diseases leading to dialysis. In a cohort study, diabetic dialysis patients were compared with non-diabetic dialysis patients for one year about age, sex, cause and times of admission and rate of mortality. The study was done on 101 patients. At the end of the study, 88 patients remained. Results were interprected by T-test and chi-square statistical analyses and signified with P value less than 5 percent. Results: Diabetes was the cause of 17.8 percent of renal failure in 101 patients. The mean age of diabetics was greater than non-diabetics (P=0.02). Mortality of diabetics in one year was 20 percent, similar to non-diabetics. Infection (chills and fever) was the most common cause of admission in diabetics (33 percent) and non-diabetics (25 percent) with no significant difference. Conclusion: Mortality and morbidity between diabetic and non-diabetic dialysis patients had no significant difference.

Comparison of Oxytocin and sucking on length of the third stage of labor and first day haemorrhage

Sh Niroomanesh

Post partum haemorrhage (PPH) and retained placenta are the most common serious abnormalities encountered during the third stage of labour. PPH is one of the most common causes of mortality in childbirth, particularly in developing countries. The incidences of PPH and retained placenta have decreased with the use of synthetic oxytocin and controlled cord traction (CCT). Weather such treatment is valuable is open to question because of the lack of clinical and physiological studies. Unfortunately, oxytocic drugs are not available to about half the women of developing countries, who do not deliver under the care of a trained midwife. We know that sucking stimulates uterine contractions in lactating women. This effect is probably mediated by the high plasma oxytocin levels that occur during preparations for breast-feeding and again within 3 min of the start of sucking. Traditional birth attendants (TBAs) do not have the skill to administer injectable oxytoxics. It has become the practice in some TBA training programmes to teach that the risk of PPH can be reduced if the mother puts her baby to the breast immediately after delivery. Objective: To determine the effect of sucking immediately after childbirth on the length of 3rh stage and amount of bleeding in the first day. This is a semi-experimental study. It was done in Tehran'e Mirzakochak hospital. 100 women received oxytocin intramuscularly and 120 women were placed in sucking group. Then the lenghth of 3rd stage and amount of bleeding in the first day was compared between two groups. Results: The duration of the third stage and number of pads different between oxytocin group and sucking group (4.42 vs 6.08 min) and (10.58 vs 11.72 number). As for the, parity, gestational age, maternal systolic and diastolic blood pressure, infant weight and hight, the results showed no significant difference between the groups. As for the, maternal age, the results showed differed significantly between the groups. As for the gestational age, the results of the research showed that between the gestational age and the duration of the third stage, there was a reverse correlation in multipare women. So when gestational age decreases the duration of third stage will be longer. As for the maternal age, parity, systolic and diastolic blood pressure, infant weight, infant hight, infant sex, the results showed that there was no correlation between these and the duration of the third stage.

Radio frequency in treatment of AVNRT arrhythmia

M Moghaddam

AV-node modification by catheter RF energy delivery is treatment of choice in the symptomatic patients with AVNRT. This study included 30 patients with AVNRT (19 women, 11 men). We did slow pathway ablation in 29 cases successfully. Maximum effective energy delivery was 40 watts for 40 msec. 1:1 AV conduction increased from 290±40 msec before ablation to 340±65 msec after ablation. Also AV-node ERP increased from 235±35 msec before ablation to 280±65 msec after that. There was no recurrence of arrhythmia in the group with slow pathway ablation during 28 months follow-up. We did fast pathway ablation in one case. In this patient AH interval increased from 120 to 200 msec, maximum RF energy delivery was 20 watts for 20 msec (2 times). Recurrence of non sustained PSVT occurred in this patients 20 months after RF ablation. There was no case of permanent AV Block. We recommond slow pathway catheter RF ablation in patients with symptomatic AVNRT.

The comparative study of side effect of the two kinds of LD combined oral contraceptive pills containing Norgestimate and Levonorgestrel

Sh Ghazizade

In order to compare the new generation of oral contraceptive pills containing Norgestimate (NGM) with currently available pills containing levonorgestrel (LNG) a clinical trial was conducted. 413 women (age 18-35 years) with no contrainindication to pill use entered the study and randomly received one type of pills. Premenstrual syndrome and depression were significantly decreased in NGM group (P=0.00016, P=0.005), on the other hand, breast tenderness, mood changes and hair loss were significantly increased in LNG group (P=0.001, P=0.042, P=0.011). Comparing two groups with each other, following variables were significantly lower in NGM group: headache (P<0.05), vertigo (P<0.05), cloasma (P<0.05), acne (P<0.04), depression (P<0.05), appetite change (P<0.03). Overall patient satisfaction was similar in two groups.

One year survey of hospitalized psoriatic patients and their treatment in Razi Hospital

F Farnaghi

During one year survey, 77 psoriatic patients were hospitalized in the dermatology department of Razi Hospital. This comprised 19% of admitted patients in this period. 29% (n=22) of psoriatic patients had previous history of hospitalization. On admission, the mean age of patients was 32.8 years, the mean and peak age of disease onset were 26.46 and between 11-20 years, respectively. 14% (n=10) of the patients had a family history of psoriasis and 70% (n=7) of those with a positive family history had their age of onset under 20 years. Involvement of different regions was as follows: Scalp: 88% (n=68), nails: 53% (n=41) and joints (arthritis): 10% (n=8). Psoriasis was associated with scrotal tongue in 19% (n=13) and with geographic tongue in 10% (n=8) of patients. Regarding the medical treatment, the drugs which were used most frequently were tigason in 34% (n=41) and ditranol in 22% (n=26) of the cases. The mean duration of hospitalization was 39.29 days and most patients were discharged from the hospital in a good condition without any serious complication. During this period 9% of patients had a relapse of their disease.

Endometrial hyperplasia in hysteroscopy, Report of 363 cases of hysteroscopy

M Aghahosseyni

Hysteroscopy is a new and precise method for evaluating of uterus, so it is valuable in evaluating infertile women. In 18 months, 363 hysteroscopies were done on patients who were visited in IVF center of Shariati Hospital for treatment of infertility. Incidence of abnormal hysteroscopy was 18%. 32% of these abnormal hysteroscopies was endometrial hyperplasia. In evaluating of laparoscopy and other factors of these patients there was a statistically significant relation between diagnosis of PCOD (polycystic ovary disease) and endometrial hyperplasia (P<0.008), but there is no significant relation between other diagnoses like endometriosis and endometrial hyperplasia (P<0.4).

Comparison of new therapies in peptic ulcer

B Phathollahzade

In a bacteriological study on 230 biopsies of patients suffering gastrointestinal disorders in Imam Khomeyni Hospital, 88 patients were selected as case and another 88 as control groups. Case group was treated by triple (Bismuth subcitrate, Metronidazole and Tetracycline) drugs for a period of 14 days. The latter treated by nonbismuth regiment eg. Amoxicillin and Ranitidine mainly. All of the patients were examined bacteriologically by biopsies in 1, 6 & 12 months after treatment. Obtaind data revealed that the Bismuth composed regiment was more effective than non-bismuth composing ones. In fact, bacterial eradication was approved in 89.8% of case group without recurrence of symptoms among them at least for entire year. Conversely, eradication occulted just in 23.5% of control group, frequent recruidescen Cl of pipriculear observed among them within one year.

Quantitative and qualitative evaluation of drug prescriptions in south Tehran, Shahre Rey and Islamshahr

H Aslesoleymani

Improper drug prescription by physicians due to wrong diagnosis, wrong drug choise or other causes will waste national funds. The annual drug costs in Iran is 900 billions Rials. With approvement of prescription, it can be reduced to 500 billions Rials. Effective factors in costs reduction are: 1) Increasing medical knowledge and persistent education of physicians. 2) Spending more time for each visit. 3) Giving more information to physicians about pharmacological compounds. 4) Teaching symptoms and signs of the common diseases and proper diagnosis of them. 5) Checking the prescriptions of physicians.