Tehran University Medical Journal

---

In this study, counter immunoelectrophoresis (CIE) and latex agglutination (LA) were employed to evaluate rapid detection of streptococcus group B (GBS) specific antigens in sera, urines, CSF and patient's blood cultures of infants suspected of septicemia and meningitidis. Out of 530 specimens which were investigated 73 blood cultures were found to be positive, including 4 (5.5%) specimens from these infants were positive for strep group B. GBS was also detected in the CSF of 1 specimen from these 4 infants. CIE was conducted on sera, urines and CSF of these patients and the number of positive specimens were found to be 3, 3 and 1 respectively. LA was also conducted on the same specimens and the number of positive specimens were found to be 3, 4 and 1 respectively. Detection of GBS specific antigens by LA and CIE on the supernatants of blood cultures after 24 hours incubation showed that all the 4 specimens were positive an indication that the sensitivity of these two imunological methods in 100%.

---

Group B streptococcus (GBS) is the most important pathogen identified in bacterial cultures in neonatal sepsis, sepecially with early-onset in developed countries (approximately 1-5/1000 deliveries). Neonatal colonization with group B streptococcus results primarily from vertical transmission during the birth process. GBS carrier rate in pregnant women varies from 4.6 to 41 percent in different geographic populations. Contamination of neonates during passage through the birth canal is high (more than 50%). Of the 191 pregnant women screened in this study, 28 (14.7%) were found to be colonized with GBS, by the culture method. Direct CIE and SCA tests on SBM (Selective Broth Medium) containing mixed flora showed that only 11.5% and 18.3% had positive reaction. A total of 530 patients were studied. GBS was isolated from the blood of 4 infants (5.5%, 4 vs 73 positive cultures). Of 181 cultures of CSF only one case was positive for GBS (8.3%) and had meningitis. In another part of experiment, two false positive reactions were found using serum specimen for detection of GBS antigen by CIE. Sensitivity of CIE and SCA both were 75%, specificity, 99.3% and 98.7%. Conclusion: Although specimen collection and microbiologic methods are important factors in identification of women colonized with GBS, there is significant variation in the proportion of women colonization with GBS. This study suggests that GBS is a much less important cause of neonatal sepsis, but further studies are needed to explore these important issues.

---

Brucellosis is an endemic disease in Iran with variety of clinical manifestation. Special characteristics of clinical diagnosis and treatment issues may cause some problems in manegement of patients. In this descriptive study 505 patients with Brucellosis retrospectively were evaluated from clinical point of view, Lab exams and therapeutic issues for 10 years (1990 to 1999). From 505 patients, 321 cases were male and 184 were female. 42.7 percent of cases were in age group of 10 to 30 years. Ingestion of un-pasteurized dairy products was detected in (66.7 percent) and 31.86 percent of cases were sheep herders. The most common symptoms and signs were fever (65 percent), sweating (61 percent), arthritis (30.09 percent), sacroilitis (21.5 percent), orchitis (8.2 percent), spondylitis (2-3 percent) and endocarditis (1.18). In this survery blood culture for Brucella melitensis became positive in 48.5 percent and bone marrow in 61 percent. Standard tube agglutination was positive in 96 percent (?1.80). Doxycyclin plus Rifampin was the most common regimen we used (37.8 percent). 4 patients died, but just one of those was directly because of Brucella Endocarditis. In this article we have discussed about some interesting cases as well.

---

Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: The prediction of the probability of difficult intubation and the associated problems before Induction of anesthesia could be lifesaving. The aim of this study was the investigation of association between the stage of thyroid cartilage prominency and laryngoscopic view for predicting the difficult intubation.
Methods: Five hundred and thirty five patients aged 18-60 years old, with prominent thyroid cartilage, "Adam's apple", enrolled in a cross -sectional study based on the stage of "Adam's apple" and the relationship with laryngoscopic view. After induction of anesthesia, laryngoscopy performed and laryngoscopic view of larynx was recorded, and analyzed according to Modified Cormackand Lehane's Scoring.
Results: No significant association between laryngoscopic view and thyroid cartilage prominency staging was observed. There was no significant relationship in females and aged under 50 y.o. The relationship in males with poor correlation coefficient was significant. The results are as follows: [male :(p=0.028, r=-0.096), Female: (p=0.821, r=0.082), <50 yrs: (p=0.87, r=0.007) no significant association for age decades and thyroid cartilage prominency stages, were observed. In ages above 50 y.o, difference was significant. Thirty patients had a laryngoscopic view in which the tracheal rings were visible just bellow the vocal cords.
Conclusions: As the increased age was related to laryngoscopic view and thyroid cartilage prominency stage it seems that there is relationship between ages over 50 y.o and difficulty of laryngoscopic view or intubation. With the observation of a view different from the grade I Cormack and Lehane's scoring, we named it the "stage Ia" that the tracheal rings are visible bellow the vocal cords during laryngoscopy.