Tehran University Medical Journal

Accuracy Of 5 Node Sampling In Evaluating The Axilla In Operable Breast Cancer: A Pilot Study

R Omrani Poor

Background: To evaluate the accuracy of 5node sampling as an alternative to classic axillary dissection in operable breast cancer(stage I and II ) Method and Material: 5 largest nodes of level one were sampled in 26 consecutive patient with breast cancer undergoing modified radical mastectomy and axillary clearance between june 2002 to march 2004.

Result: False negative rate for 5 node sampling was 7.7%, of 14 cases with negative 5 node sampling 2 (7.7%) were found to have disease elsewhere in the axilla.

Conclusion: Sampling of 5 largest nodes accurately (92%) identifies patients with metastatic nodes.

Dietary Factors Associated To Obesity In Ahwaz Primary School Pupils

A.R Dorosty

Background: Increase in obesity prevalence in recent years are associated to genetics as well environmental and behavioral factors. Change in dietary patterns including fatty and high density energy foods consumption have been reported to be very important. This study aimed to determine dietary factors (daily energy and macronutrient intakes, energy percentage of macronutrient, energy and macronutrient intakes per kilogram body weight, frequency of cola, natural fruit juice drinking, dairy products except cheese, tomato chips, puff, chocolate and fast food consumption and eating speed) associated to obesity in Ahwaz primary school pupils.

Materials and Methods: Using two stage cluster sampling from 35 Ahwaz primary schools, all 10-11y students who had a BMI 95th percentile of Hosseini et al. (1999) reference, were identified as obese (n=150) and 150 same age and gender pupils (having BMI<85 percentile) were studied. Data on daily energy and macronutrient intakes were collected using 24 hour recall. Frequency of cola, natural fruite juice, dairy products except cheese, tomato chips, puff, chocolate and fast food consumption were obtained by food frequency questionnaire. Eating speed was asked from the pupil mother.

Results: Results indicated that daily energy, protein and carbohydrate intakes were significantly higher in obese students (p<0.05), but daily fat intake and energy percentage of macronutrient had no significant difference between two groups (p>0.05). macronutrient intakes per kilogram body weight were significantly lower in obese group (p<0.001). obese students had significantly higher potato chips and puff consumption (p<0.05). There was no significant difference between other foods consumption (p>0.05). Obese students used to eat faster (p<0.05).

Conclusion: In conclusion, high intakes of energy, protein, carbohydrate, tomato chips and puff and high eating speed were associated to obesity in Ahwaz primary school pupils.

Psychosocial Status In Iranian Adolescents With Beta-Thalassaemia Major

S Khodai

Background: The aim of this study is to describe the mental health and social profile of adolescent thalassemic patients through self-report and GHQ-12 test.

Materials and Methods: With convenience sampling, 156 consecutive adolescent thalassemic patients, recruited during a 20month period, filled in a semi-structured self-administered questionnaire in addition to a GHQ-12 questionnaire.

Results: 100 cases (64.1%) denied having health problems. 71 patients (45.5%) described their health status as not bad and 39 cases (25%) as good. The average GHQ-score was 6.12 (0.95 CI- 5.69-6.56). Nine cases (5.8%) scored low (0-1) and 21 cases (13.5%) scored borderline (2-3), while the score of 124 patients (79.5%) was favorable (4-12). There was a significant difference between mean scores in different age groups (p= 0.036) and 78 percent of those with low scores were in their late adolescent period (18-21 yrs). 15 patients (9.6%) had quit school due to their health problems. Mean GHQ score for quitters was significantly lower than those going on with their studies (p= 0.017).

Conclusion: These adolescent thalassemic patients seemed to have coped properly with their disease. Possibility of denial should also be considered. Further studies for detection of high-risk groups for psychosocial derangements can help us in applying appropriate and timely preventive and supportive measures.

Study Of The Effect Of Heroin Used In Iran, On Spermatogenesis Changes And Their Development In Balb/C Mice

S Fazelipour

Background: Heroin is one of the opiates which is used, as the most addictive drugs, in Iran. Considering the damaging effects of these drugs on the health of opiate addicts, investigation on the effects of heroin used in Iran, on male genital indicators including daily sperm production and its development, which has an essential role in fertility, seems to be necessary.

Materials and Methods: A total of 70 Bulb/c mature male mice, were divided into 5 groups of control, [intact (n=10), sham I (n=10) sham II (n=10)] and experimental groups [I (n=20), II (n=20], and 50 days after addiction to heroin (50 mg/kg) via intra peritoneal injection (IP), 6 mice from each groups were selected and after euthenizing, the testes and epididymes were removed. The rate of daily sperm production (DSP), epididymic sperm preservation (ESP) and the rate of sperm motility were measured accurately.

Results: In the study of the effect of heroin on daily sperm production and sperm preservation between the control and experimental groups, no significant differences were observed. The effect of heroin on sperm motility between control and experimental groups, the difference were significant (P<0/05).

Conclusions: In this survey, it was indicated that, the heroin used in Iran, causes a decrease in healthy sperms of mice their motility, and consequently can affect on genital indicators.

The Efficacy Of Low-Dose Oral Corticosteroids In The Treatment Of Vitiligo Patients

M Mirshams-Shahshahani

Background: Vitiligo is an acquired pigmentary disorder that affects 1% of population. It presents as depigmented patches. One of the most probable theories regarding the pathogenesis of vitiligo is autoimmunity. Systemic corticosteroids may arrest the progression of vitiligo and lead to repigmentation by suppressing immune system. The objective of this study is to assess the clinical efficacy of low-dose oral corticosteroids in actively progressing vitiligo.

Materials and Methods: Seventy four patients with vitiligo were evaluated. The patients took daily doses of oral prednisolone (0.3 mg/kg) initially for 2 months. Then the dosage was halved monthly, for the five subsequent months of treatment. The effects of treatment were evaluated using photography&aposs before and after the study. Side effects were assessed at the first, second, third and fourth month of the treatment.

Results: Arrested progression of vitiligo and repigmentation were noted in 74.3% and 62.1% of patients respectively. The mean pigmentation was 26.8%. The localized form, lower age of disease onset, no hair whiteness on the lesions and less affliction percent showed increased repigmentation with statistical significance. There was no significant difference between sexes and positive family history of vitiligo in patients. The best therapeutic results were obtained for facial lesions and the worst for mucosal lesions. The side effects of treatment were minimal and did not affect the course of the treatment.

Conclusion: Low-dose oral corticosteroids are effective and have few serious side effects in preventing the progression of actively progressing vitiligo but regimentation is not significant and this regimen is effective in patients who are refractory to topical corticosteroids or phototherapy.

Occupational Exposure To Xylene In Workers, Employing At Pathology Wards Of Hospitals Belonging To The Qazvin University Of Medical Sciences

SJ Shah Taheri

Background: Nowadays, aromatic hydrocarbons such as benzene, toluene, and xylene are extensively used in the different environments and industries, causing adverse effects on individuals who are being exposed occupationally and environmentally to these hazardous compounds. In this study, occupational exposure to xylene in workers, employing at pathology wards of hospitals belonging to the Qazvin University of Medical Sciences have been investigated.

Materials and Methods: Methyl Hiporic Acid (MHA) as a main metabolite of xylene in urine was used to evaluate the workers exposure to this chemical. The urine samples were taken from all 30 workers from 4 hospitals, i.e. Kosar, Shahid Rajaei, Booali and Qods. Through this study, 30 administrative employees were also selected as control group. The direct DBA colorimetric method was used to measure MHA in the workers urine.

Results: The results obtained from this study showed that, there were significant differences between MHA and working days, type of jobs, and length of exposure time. This study also showed that, there were no significant differences between urinary MHA concentration and sex, age, and smoking habit.

Conclusion: Through this study, it was also clearly obtained that, xylene exposure can not affect on the total and direct serum bilirobin in the workers blood. Finally, it is worth mentioning that, although this study showed no acute exposure to xylene in hospitals pathology wards, the effect of chronic exposure to such compound cannot be ignored, therefore protecting workers against like these organic solvents are strongly recommended as their TLVs are considerably being reduced during these years

Newborn Nutrintional Status Using Anthropometry Method And Some Effectral Factors In Bojnord – 2001

M Khosravi

Background, Materials and Methods: In order to evaluation the newborn’s nutrintional status in Bojnoard, 566 healty, Single full term newborn were examined. In this examination, the indicators of weight for age, height for age, weight for height and head circumference for age in the beginning of birth were calculated and compared to National Center of Health Statistics Standards (NCHS), with making use of fifth percentile of reference society for malnutrition edge, was specified that, nutritional status in above newborn’s is better than reference society’s newborns. Results&Conclusion: The data analysis of this research showed that between mother’s near delivery weight (P = 0.037) and mother’s nutritional attitude (P= 0.004) and numbers of family( P = 0.006 ) with height for age, between newborn’s sex (P= 0.004), mother’s age(P= 0.038), mother’s near delivery weight(P = 0.042) and mother’s nutritional practice during pregnancy (P= 0.041) with weight for height and between mother’s age (P= 0.043), mother’s near delivery weight (P= 0.048), mother’s height (P= 0.025), mother’s nutritional knowledge (P = 0.046) with head circumference for age, there is significant statistic connection. Also there was a weak statistic connection between newborn’s nutritional status and grade of birth (P= 0.09), but there is no significant meaningful connection between wanted or unwanted newborn and mother’s nutritional knowledge.

Assessment And Comparing The Efficacy Of Propofol Pretreatment With Dexamethasone In Prevalence And Severity Of Its Pain On Injection.

G Shoeibi

Background: One of the disturbing complications of propofol is pain on venous injection. Some investigators had reported that corticosteroids effectively induce and prolong the duration of local anesthetics. The aim of this study was to assess and comparing the efficacy of propofol pretreatment with dexamethasone in prevalence and severity of its pain on injection.

Materials and Methods: In a randomized, double-blinded, placebo-controlled prospective study, 90ASA I and II, 20 to 60 years-old patients scheduled for elective surgery under general anesthesia were enrolled. In all patients, one of the veins of both hands was catheterized with a 20 G catheter. Then randomly, and simultaneously 2 ml dexamethasone (8 mg) was injected to one of them and 2 ml of normal saline was injected to other. After 30 seconds, 2 ml propofol (20 mg) was injected to both hands, at the same time in 30 seconds. Pain intensity was measured using VAS system.

Results: The age mean was 32.87±5.61. Twenty nine patients were male (32.2%). The mean of pain during propofol injection was significantly lower in dexamethasone group than normal saline group (1.61 vs.4.21 respectively, p< 0.05). Also the pain incidence was significantly lower in dexamethasone group compared to normal saline group (20% vs. 57.78% respectively, p> 0.05).

Conclusion: Intravenous administration of 8 mg dexamethasone before propofol IV injection significantly decreases the pain on injection of propofol.

The Etiologies And Outcome Of ESRD In Children Medical Center From 1988 To 2003

A Madani

Background: Chronic renal failure defines as progressive and irreversible dysfunction of kidneys that could eventually terminated to end stage renal disease (GFR< 10% NL). Because of therapeutic problem and high mortality and morbidity and it &aposs implication quality of life , ESRD is one of the important dilemma of pediatric medicine .

Materials and Methods: In our study 216 patients evaluated .

Results: Male to female ratio was 1.1 . The peak of the presenting age of ESRD was 10 years old (8-12 y). Congenital urological malformation (30%) , glomerulopathies (20%) , hereditary nephropathies (14.3%) , multisystem diseases (7%) and nephrolithiasis (6.2%) are the most common etiologies of ESRD . VUR in 21% and congenital obstructive disease in 8.5% are the etiology of ESRD. In patients with age five years old and lesser common causes of ESRD are congenital urologic malformation and glomerulopathies. In other age groups , urologic malformation is the most common cause of ESRD. In etiologic assessment of two separate 7 years interval , (1988-1993) and (1996-2003) , there was not any significant change in frequency of etiologies but frequency of congenital obstructive uropathy decreased from 10 % to 5.7%. Total amount of VUR (VUR ± Neuropathic bladder) has not any change but frequency of primary reflux nephropathy decreased from 14.2% to 8%. In this study , in 145 patients hemodialysis continued and 28 cases had unsuccessful renal transplant (13.8%) . 7.4 % of patients had successful renal replacement therapy (RRT) and mortality rate was 7.4% . B

Conclusion: Based on that the most common cause of ESRD is all ages in congenital urologic malformations , early diagnosis and appropriate management of these cases are effective in decreasing incidence of ESRD and with respect to few cases of renal transplant and unsuccessful results in 65% of RRT , the approach of this problem should be revised.

Determination Of Appropriate Antibiotic In Bacterial Meningitis Of Children Based On MIC

S Noorbakhsh

Background: Bacterial meningitis is one of the most serious infections in infants and children. Three organisms include S.PneumoN.meningH.Influ are the most common cause of meningitis in children between 2M-14y age.Etest is a new method for determination the MIC of some antimicrobial drugs in agarose .This method is useful for some organisms like as S .Pneumo N.mening H.Influsensitive Streptococcus and anaerobic aerobic gram negative.

Materials and Methods: In this descriptive cross sectional study In 57 suspected meningitis children organisms isolated from blood CSF or other sterile boy fluid after culturing and antibiogram. .MIC of someorganisms detected by Etest method.

Results: Streptococcuswas the most prevalent ( 70%) and S.pneumon( 90% of all Streptococcus) H.infl 2%N.mening 4%and L.monocyt 6%(more than expected)Gram negative (Ecoli Klebsiella entrobacter and psudomona) 18%. There was significant difference (P =0.01)in type of organisms between age groups. S.pneumonia was more frequent in children > 2 year N.meningitis in>4yr old .Site of isolation :blood CSF (35.8*28.3%)other sterile site 18.4%concomitant positive culture in two site:17%.Mean age in Streptococcus was significantly different with Listeria (p=0.05) N.meningitis (p=0.04)H.influ (p=0.04).but no difference with StaphylococcusKlebsiella and E.coli Two type of H.inf were sensitive to Ampici or chloram both of them were sensitive to ceftiaxon. GBS were sensitive to PNC or Ampici Strep.nonAnonBnon- Cotrimoxazol>32mic/ml /PNC >256mic/ml/ Vanco>256mic/ml Strep.D: Cotrimoxazol>0.062mg/ml/ /PNC >0.016mic/ml/Imipenem>0.032mic/ml. Strep Pneumonia: All fo them were sensitive except 3 cases /Cotrimoxazol>2ic/ml /PNC =0.01mic/ml/Vanco>0.125mic/ m Vanco>0. 25mic/ ml/.Cotrimoxazol>2ic/ml / PNC =0.01mg/ml Vanco>0.125mic/ ml / Cotrimoxazol>2mic/ml /MIC-PNC >0.016mic/ml Therefore high dose of PNC is adequate for S.pneu because of Interm resistance to PNC All 3 N.menin were sensitive to PNCChloraCeftria and vanco Resistant to all drugs and high MIC for cefotaximeCIPRO>32mic/ml. E coli: Pseudomona Aerogenosa:: Ceftriaxon>256mic/ml/ /Genta>0.038mg/ml Imipenem>32mic/ml. Klebsiella only Sensitive to Cipro Staph .Aureous:Sensitive to ClindaCiproChloraResistant toCeftPNCand Cotri

Conclusion: Most type of N.meningitidisH.inf and S.pneumonia were sensitive to many drugs. Only minority of them were resistant to Ampicillin but sensitive to chloramphenicol and vice versa. limited number of pneumococcal resistance to penicillin is medium resistance( MIC:0.1-1) .we can treat this resistant type by increasing of penicillin dosage .The others were sensitive to all drugs. Therefore ampicillin and chloramphenicol are the drug of choice in empiric treatment of bacterial meningitis after neonatal period.

Effect Of Socio- Economic Status On The Efficacy Of Nutrition Education In Promoting The Nutritional Knowledge, Attitude And Practice In First-Grade Guidance School Girls In Tehran

M Taslimi Taleghani

Background: Adolescence (10-19 years) is one of the most challenging periods in human development. A second period of rapid growth occurs during the teen years. Not much information is available on the effect of the socio-economic status on the outcome of nutrition education in teenage girls. Objective : The purpose of this study was to determine the effect of socio- economic status on the efficacy of nutrition education in promoting the nutritional knowledge, attitude and practice in first-grade guidance school girls in Tehran.

Material & Methods: A total of 300 students were selected from 11 guidance schools by simple sampling and divided into three groups: 1- guide-book, 2- group discussion, 3- control. The knowledge and attitude data were collected using pre-test and post-test questionnaires and the personal-socioeconomic data were collected using general questionnaires. The students in group 1 were given the guide-book and required to study it at home, while group 2 students were told to discuss among themselves the contents of the guide-book. The control group was given nothing to study or to do.

Results: Nutrition education did not have a significant effect on the increase in the attitude score in the students whose grade-point average and their mother’s education level were high. (p= 0.13, p=0.29). Only mother’s education level independently from the type of education was associated with the difference of knowledge score means (p =0.07).There was interaction between nutritional education and monthly pocket- money with regard to the increase in the knowledge score (p =0.03).

Conclusion: Overall, exception of monthly pocket money, the effect of education on the nutritional knowledge and attitude was independent from other variables. Only mother’s education associate with the difference of knowledge score means.

A Study Of The Relation Between IQ And Personality Types Among Male And Female Students Of Tabriz

B Vafaee

Background: Psychologists have been thinking that some personality types may have a higher IQ comparing with the other types, and this could be considered as a general belief. Eysenck, the eminent British psychologist, described the introverted people to have a higher. Intelligence comparing with the extroverted people.

Materials and Methods: We maintain two objectives from this study. Firstly if there is a relation between the IQ and personality types or not and secondly the mean IQ of which group is higher and thirdly, what is the relation between sexes.

Results: 297 students were selected randomly from Tabriz University and Tabriz Medical Sciences University. Every examination was given both Raven IQ test and Eysenck personality inventory and examination answered the both tests at the same time. Both tests were evaluated by the standard scoring system. The results of both tests were extracted then statistical evaluations ofx and t-test were done. No significant and meaningful relation was found between IQ and personality types pf Eysenck ( introversion- extroversion, neuroticism, emotion stability) among male and female students. Also introverted students and extroverted students did not have significant differences in the mean of IQ.

Conclusion: Altogether these kinds of findings seem to be interesting, judging about psychological and behavioral characteristic of people needs more studies, and a single IQ or personality test is not sufficient. Therefore reaching an exact conclusion as a scientific fact will be possible by further researches.