Tehran University Medical Journal

Survey of variations of coronary arteries of 463 cases

M Akbarie

Survey of anatomic variations of coronary arteries is the most fundamental of researches in the field of these vessels. For performing this survey, coronary arteries (CA'S) of 463 human heart cases (gathered from three different surces: 1) Legal medicine center corpses, 2) Cadavers of dissection rooms in medical schools, and 3) CA'S angiographic films from hospital centers) were studied. After comparison between the statistical results in this research and the foreign ones, similarities and differentes from this subjects were ascertained as below, that, there were relatively considerable differences between: the number of CA'S (presence of 2 or 3 branches), origin of S.A. node artery, and type of main left coronary artery divisions (2 or 3 branches producing), but, in the other instances no considerable differences were observed

Rapid identification of vibrio-cholerae O1 by coaglutination test using mono-specifis antibody

SA Bazargan

In our investigation, rabbit hyper-immune serum to V.cholerae ogawa was absorbed with V.cholerae inaba whole-cells and vice versa. Applying ammonium sulphate precipitation method, mono-specific g globulins were purified and concentrated from the absorbed whole serum. These antibodies were fixed on staphylococcus cowan 1 NCTC-8325 whole-cells, using different chemical fixatives. It was observed that maximum fixation of g globulin to protein-A was achieved by 1-propanol 50% at 3 hours, which revealed through single radial immuno-diffusion techniqe. The rectal swab samples were cultured in an enrichment bile-peptons broth. After 5 hours 37°C while agitations, one drop of each sample was mixed with one drop of vibrio-cholerae bivalent mono-specific coagglutination reagent (VBCR). The results were read after 2 to 3 minutes. Finally though statistical analysis sensitivity and specificity of coagglutination test were calculated to be 95.1% and 99.2% respectively, when compared to positive & negative controls and conventional culture methods. Using VBCR, coagglutination test can be therefore considered as a simple, reliable and rapid method to detect V.cholerae O1 in the stool of patients in endemic area and less equipped laboratories

The efficacy of antenatal steroid therapy in preterm neonates in Shariati Hospital

A Jamal

The newborn who is born before terms is a candidate for the development of idiopathic respiratory distress syndrome. The intense hypoxia and acidosis that ensue as the consequence of inadequate alveolar-capillary exchange of oxygen and carbon dioxid may prove fatal antenatal steroid therapy can affect RDS (Respiratory Distress Syndrom) and its complications. The newborn before 34 weeks have a significantly lowered incidence of RDS and neonatal mortality from RDS with antenatal steroid therapy. In a retrospective study we compared 37 preterm infants whose mothers had received corticosteroids to 29 similar but untreated infants. The study showed that antenatal steroid therapy reduced neonatal mortality from RDS more than reducing the incidence of RDS and further it was concluded that this beneficial effect was more significant in female fetus than male fetus, but it was not significant statistically

Anaesthesia in operations of congenital craniofacial abnormalities

B Jahangirie

Some syndromes that are characterized by abnormalities of the skull, facial bones, and mandibule, most of these patients are from the pediatric population. For the anaesthetic management of patients with various craniofacial dysostosis are as follows: 1) The necessary for careful evaluation of the airway by simply observing the patient. 2) Evaluation of the patient for abnormalities of the heart and lungs. 3) Patients may also have increased intracranial pressure. 4) Anaesthetic drugs and techniques: no particular drugs is recommended. Techniques controlled ventilation. 5) All patients should be cared in the intensive care unit after operation between 24-48 hours

Spontaneous pneumothorax

R Davari

A case with bilateral spontaneous pneumothorax was presented. Etiology, mechanism, and treatment were discussed on the review of literature. Spontaneous Pneumothorax is a clinical entity resulting from a sudden non traumatic rupture of the lung. Biach reported in 1880 that 78% of 916 patients with spontaneous pneumothorax had tuberculosis. Kjergaard emphasized 1932 the primary importance of subpleural bleb disease. Currently the clinical spectrum of spontaneous pneumothorax seems to have entered a third era with the recognition of the interstitial lung disease and AIDS as a significant etiology. Standard treatment is including: observation, thoracocentesis, tube thoracostomy. Chemical pleurodesis, bullectomy or wedge resection of lung with pleural abrasion and occasionally pleurectomy. Little information has been reported regarding the efficacy of such treatment in spontaneous pneumothorax secondary to non bleb disease

The prevention of postoperative vomiting following strabismus surgery in children with using Promethazine and Droperidol

V Shaigh al Islam

Children undergoing general anesthesia for strabismus surgery have a higher incidence of postoperative vomiting than those receiving the same anaesthesia for other types of ambulatory surgical procedures. Droperidol (0/0 75 mg/kg IV) and promethazine (0.05-1.0 mg/kg) were used in 100 children between 2-15 years old. Promethazine which has sedative property, anticholinergic antihistaminic, antiemetic and anti-motion sickness effects is recommended for children 0.05 mg-1.0 mg/kg of body weight IV. After induction of anesthesia and before operation and manipulation of the eye and combined with 0.5 mg/kg IM promethazine after operation. The incidence of vomiting following strabismus surgery might be reduced more than with intravenous droperidol

Serum Copper, Zinc levels and Copper/Zinz ratio as biochemical markers in diagnosis and prognosis of breast cancer patients

S Sh Sadr

Serum copper, zinc and the cu/zn ratio were measured in 55 patients with breast disease (20 with benign breast disease and 35 patients with breast cancer) and 30 healthy subjects. The mean serum copper levels were higher in breast cancer than in benign breast diseases (127.5 µg/dl versus 92.4 µg/dl) (P<0.0005) and controls (127.5 µg/dl versus 75.6 µg/dl) (P<0.0005). Patients with advanced breast cancer had higher serum copper levels than did patients with early breast cancer (163 µg/dl versus 103.9 µg/dl) (P<0.0005). Patients with advanced breast cancer had lower serum zinc levels than did patients with benign breast disease (68.9 µg/dl versus 135.9 µg/dl) (P<0.0005) and controls (68.9 µg/dl versus 129.9 µg/dl) (P<0.0005) but no significant difference have seen between serum zinc levels of early and advanced breast cancer patients (68.9 µg/dl versus 72.9 µg/dl) (P<0.05). Serum zinc levels were not decreased in patients with benign breast disease

Reports of cases of renal tubular acidosis with neurologic symptomes

M Ghafarpour

Proximal weakness specially in extremitas is a common neurologic symptom of patients, for which the physician should consider toxic, metabolic, infectious and paraneoblastic diseases affecting muscular system as well as primary myopathies. Osteomalacia is one of the most common considerations which is treatable but disabling as its natural course. Osteomalacia is the most often due to VITD or calcium deficiency but work up is necessary to find other primary defects that cause this disease. Renal tubular acidosis is one of these primary defects and osteomalacia secondary to it dose not respond to classic treatment of osteomalacia, so specific management is necessary. In this article we report six patients who have been referred to the clinic of neurology of Imam Khomeini Hospital since 1370 to 1374 with proximal weakness for whom RTA has been diagnosed

The evaluation and presentation of a rare case of gonadal dysgenesis

M Ghafarnejad

A seventeen-years old woman was presented with infertility and primary amenorrhea. She had normal stature, femate phenotype and normal development of breasts, external genitalia, vagina and cervix. Pelvic examination showed a large lobulated mass. On sonography there was a mass with probable origin of ovary. Paraclinic tests were carried out. Gonadotropins were in postmeno pausal limits. Alpha Fetoprotein, Beta Subunit (B-HCG) assay were normal Laparotomy revealed a gonadat mass on right side, normal uterus and left streak gonad. Pathologic report of tumor was dysgerminoma and teratoma. Due to pathology of tumor and Y chromosome, we advised the patient to remove the other streak gonad and have irradiatio

Intraosseous ganglion and report of five cases from orthopedic ward in Imam Khomeini Hospital

M Farzan

Cysts in bone are seen occasionally at or near its end and are filled with mucoid, glaird fluid. Typically, they have a thick fibrous wall similar to that of a "ganglion" of tendon sheath, are associated with no significant degenerative changes in the nearly near by joint, and seem appropriately considered to be collections in synovial spaces in unusual locations. Although they are rare and usually an incidental radiographic finding, intraosseous ganglions are being increasingly recognized as a source of wrist pain. Surgical treatment is best delayed, however, until all other possible etiologic factors for the patient's discomfort have been excluded. When indicated, curettage and bone grafting will adequately treat the condition. A careful exploration of the joint at the time of surgery helps rule out other undiagnosed causes for the patient's symptoms. Communications between the joint cavity and the intraosseous cyst are inconsistently demonstrated. The histologic features of intraosseous ganglions are identical to their soft tissue counterparts

Transplantation and repair of meniscus instead of meniscectomy

M Moatamedie

The basis of this paper has been planned on the functions of the meniscus and its effects. i.e. the existence of meniscus will prevent arthritis in other word torn-off (wholly meniscus and/or partly) will lead to suffering from arthritis. In view of the above, it is reasonable that attempt will be made to amend the torn meniscus instead of the surgical removal (meniscectom). The amendment may be done by the surgical operation and/or arthroscopy. (It is more advisable to use the arthroscope, because the least troubles may occur). In the meantime, meniscus transplantation from one individual to another, or meniscus prosthesis may be used. In the year 1371 (from Khordad to Bahman) 20 people - 18 males & 2 females - who were suffering from torn meniscus (diagnosed through arthrography and arthroscopy) were amended. In this connection, we should inform that 18 patients had peripheral torn meniscus who were amended, and the 2 remainders had central torn meniscus which torn parts were removed. After six months the patients were examined again, and no clinical marks - torn-off locations - could be observed i.e. fibrous tissues had completely filled us the torn places. Therefore, it is emphatically insisted that amendments should be performed on torn meniscus, especially when tearing is in peripheral parts of the meniscus

The role of cytoskeleton on the development of neural tube in chick embryo by immunoperoxidase method

T Mehrannia

The effect and arrangement of cytoskeleton (microtubules, microfilaments and neurofilaments) in neurulation of chick embryo examined by immunoperoxidase method from stage 6 to stage 12. The results were as follows: 1) Microtubules aggregated in the perinuclear region from which they radiated to take longitudinal course beneath the membrane. 2) Microfilaments were aggregated in the apical ends (free-surface) of neural epithelium causing the cells to become flask-shaped. 3) Neurofilaments (Nfs) had no important role in neural tube formation

Survey on prevention of depression and it relation to demographic indicators among high school students of Tehran, 1372-73

A Nourbala

In order to determine the prevalence of depression among high school students of Tehran, the Beck depression test questionnaire was distributed among 1478 students of Tehran 19 districts, using a methodical approach. Data gathered after completion of the forms showed the following results: 11.4% of the students were on the border line of affliction, 12.6% had a medium degree of disorder, 4.2% suffered from a severe level and 0.4% showed a much higher degree of depression. The older these students were, the more prevalent was the depression among them. The girls showed a higher degree of disorder than the boys at a 1.4 to 1 ratio. The lowest degree was found among students of mathematics, whereas the students of literature showed the highest level. The rate was much lower among students of Shahed schools than that observed among students of evening classes. The research showed no relationship between the students depression and their parents profession. However, the higher level of parents' education was associated with lower levels of depression among their children. Finally, lower levels of disorder was observed among residents of private housings in comparison to what was found among students residing in leased or mortgaged dwellings

Study of application, causes of the discontinuation and problems of OCP (Oral contraceptive pills)

Sh Nieroomanesh

This research is a descriptive analytical study which been carried out for the purpose of study of application period, causes of the discontinuation and the problems arising from the application of the edible pills as a pregnancy preventive method among the women of Tehran (1989). 986 women have been studied in two groups as follows: A) The women who have used the edible pills (737 women). B) The women who are currently using the pills (249 women). Of 95.8% of the total (986 persons) have been informed the method of pills use and 40.6% have indicated pills as their favorite method. Mentall disorder was the most common complication resulted from application of the pills. Investigation also indicates that highest percentage of duration of use was above four years (33%). Among the reasons which resulted in the cessation of the method for more than one month, medical reasons have been mentioned by most of the persons studied

Research study of diversity of Rh and ABO blood groups in 110 psoriatic patients

M Valieghanie

Psoriasis is an common, chronic, recurrent, inflammatory disease of the skin, characterized by red scaling plaques on the skin surface. The morphology of psoriatic lesions allows classification of the different types of psoriasis that included plaque type, pustular type and Erythrodermic type. I have studied the relationship between distribution of RH and ABO blood groups in 110 psoriatic patients and compared with control normal blood groups. The result of this study was as follow: The rate of blood group type AB was significantly lower than that of the control normal blood group ABO