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Ebrahimi Daeiani N, Mohammadi Hr, Airamloo M,
Volume 59, Issue 4 (9 2001)
Abstract

Inflammatory bowel diseases are one of the important reasons of the referral to GI practitioners in our country and Ulcerative Colitis is the more frequent type of these disease in Iran. In this study 200 cases of Ulcerative Colitis, which has been referred to Imam Khomeini Hospital during that last 5 year, were studied. Data was collected using the patient's records and face to face interview with them and their relatives. Majority of the patients were female (55 percent). Positive family history was seen in 28 percent of patients, autoimmune disease history in 8 percent, smoking history in 11 percent and smoking cessation history in 13 percent of patients. Most prevalent symptoms in the patients were nocturnal bleeding, rectal bleeding and bloody diarrhea. The most common involved area were recto sigmoid (58 percent) and descending colon (42 percent). Pan colitis was seen in 8 percent. Most people had complications and the most common complications was fissure (14 percent). Recurrence was seen in 83.5 percent of patients. With logistic regression analysis the only variable which showed significant relation with recurrence was male sex. According to the results of this study, it seems that ulcerative colitis clinical and epidemiological pattern in Iran is similar to many other countries, but the higher rate of recurrence and extra intestinal manifestations in patients shows that there is a growing need to reconsider the treatment efficacy in patients and correct the treatment methods.
Goshtasbi Nasab A, Majlesi F, Rahimi A,
Volume 59, Issue 5 (9 2001)
Abstract

The newborn's weight at birth is an important measure for newborn's health in all communities. Among developed countries, 70 percent of low birth weight (LBW) newborns are preterm. The corresponding figure for undeveloped countries is only 30 percent, there are also evidence of intra-uterine growth retardation among these countries. Among effective factors on LBW, maternal related factors have important role in promotion and improvement of infants and mother's health. This study is a descriptive-analytic one and was conducted cross-sectionally through a questionnair. The study population determined by simple random sampling from newborns under coverage of urban health centers in Kohgiloye and Boyerahmad province. Necessary data collected from existing medical and health records filed in the health centers. Among 285 newborns, 88.4 percent considered with normal weight, 4 percent with IBW and 11.6 percent with more than normal weight. 7.4 percent of cases were immature. 85.3 percent of the mothers in study population were in immune range of age for pregnancy and 7.6 percent of them were illiterate. Except the sex of newborn (P=0.0008) and gestational age at birth (P<0.001) none of the variables demonstrated a significant statistical relation with the birth weight. The results of this study confirm other research's findings and reveal that with improving material factors such as mother's age, employment and literacy, the factors which are effective on birth weight, will be dependent on physiological factors such as sex of newborn and gestational age at birth.
Fallahi G, Mehdizadeh M, Zandieh F,
Volume 59, Issue 5 (9 2001)
Abstract

One of the common problems in children and specially in infants is gasteroesophageal reflux (G.E.R). Present study was performed to compare diagnostic value of lower esophageal sonography with barium swallow. This study was conducted on 50 patients 1 month to 15 years age in center of pediatric clinic of Tehran, during the years 1999-2000. Patients suspected to have G.E.R studied with lower esophageal sonography and barium swallow and at the end, their results were compared with esophageal PH monitoring as a standard test. In this study sensevity of sonography was 90 percent against 50 percent for barium swallow but specifity of two test was the same 35 percent. We can concluded that sonography is a non invasive, low cost, with less side effects than barium swallow. We recommend sonography in place of barium swallow in diagnosis of G.E.R.
Khalesi Mh, Amirfattahi R, Sheikh Zadeh H, Khorsandi Mt, Motesaddi M, Abdi S ,
Volume 59, Issue 5 (9 2001)
Abstract

The main goal of this study is to determine the auditory feedback effects in improvement of speech production process in prelingual totally deaf children who used cochlear implant prosthesis. For this reason, we recorded speech of four prelingual cochlear implant children pre and post of operation. Then we extract some static features of vowels-such as fundamental frequency, formant frequencies, vowel duration and vowel energy-from their stable mid-section and analyze them using a longitudinal prosthesis-on/off analysis. These patients-where are in the range of 7-13 years old-were operated in the cochlear implant clinic of Amiralam hospital. At each session, patients read the sentences once in device-on condition and then after 30 minutes stay in device-off condition. Quantitative results show that at least for the features under study, the patient's reliance on the auditory feedback decreased consistently by time (about 65%-averaged on all three vowels under study and all patients). So we concluded that after a sufficient time of operation, the speech motor patterns of patients will be trained for the correct production of static features of vowels and the relation of patients to auditory feedback for the production of such features considerably decreased by time.
Karimi Shahidi Sm, Dabbagh Mohammady A, Iravani B, ,
Volume 60, Issue 1 (13 2002)
Abstract

Sepsis is one of the most critical medical emergency situations. Treatment with anti microbial drugs should be initiated as soon as samples of blood and other relevant sites have been cultured. Available information about patterns of anti microbial Susceptibility among bacterial isolates from the community, the hospital, and the patient should be taken in to account. It is important, pending culture results, to initiate empirical anti microbial therapy.
Materials and methods: In a descriptive study during 3 years (1377-1379), microbial and anti microbial susceptibility patterns evaluated in Amir alam clinical laboratory on 2000 specimen of blood culture received from 765 hospitalized patients at Amir Alam hospital wards.
Results: 113 specimens from 77 patient (10 percent) were positive for microbial growth. Enterobacter, S. aureus, S.epidermidis, Pneumococci, Ecoli, and Pseudomonas were the most common isolated etiologic agents(80 percent) . The most common organism was Entenobacter in 1377, S.aureus in 1378 and pseudomonas in 1379 There were significant change in patlern of organisms, increase resistance to some important available antibiotics and change in antibiotic susceptibility pattern during three years (disc diffusion method).
Conclusions: According to Results of this study due to change in pattern of organism and their antibiotic susceptibility, dynamic microbiological study provide important data for Ordering empirical and culture oriented treatment of patients with bacteremia, Sepsis, anti microbial Chemotherapy, anti microbial susceptibility empirical anti microbial therapy, microbial pattern.
Hasani M, Ebrahim Soltani A,
Volume 60, Issue 5 (15 2002)
Abstract

Anxiolysis and sedation with oral midazolam are common practice in pediatric anesthesia. Good or excellent results are seen in only 50% to 80% of cases, so we decided to investigate if addition of a low dose of oral ketamine to midazolam (ketamine2.5 mg /kg ^midazolam 0.25 mg/kg )resulted in better premedication compared with oral midazolam 0.5 mg/kg or ketamine 6 mg/kg alone.
Methods and Materials: in a prospective, randomized ,double -blind study we study 105 children (mean age 6 ,range 2-10 yr. ) undergoing non thoracic and non cardiac surgery of more than 30 min duration. The patients were in ASA 1, 2. After oral premedication the child's condition was evaluated by assigning 1-4 point to the quality of anxiolysis, sedation, and separation from parents in the induction room .The groups were similar in sex, age, weight, intervention and duration of anaesthesia.
Results: The score of sedation before transfer to the operation room was significantly better in the ketamine, midazolam combination group than in the ketamine or midazolam group. Success rates for anxiolysis and behavior at separation were grater than 90%with the combination, approximately 80% with midazolam and 70% with ketamine alone .The incidence of salivation, excitation, nausea and vomiting was grater in the ketamine group but were very low in other groups. During recovery there were no difference in sedation or time of possible discharge.
Conclusion: In summery, significantly better anxiolysis and separation were observed with a combination of ketamine and midazolam, even in awake children than with midazolam or ketamine alone. Duration of action and side effects of the combination was similar to those of midazolam.
Mohebby H, Banna Zadeh, Panahi F, Bahrami H,
Volume 61, Issue 1 (13 2003)
Abstract

Spontaneous pneumothorax is a medical condition that potentially may be dangerous. Although several methods for management of this problem have been propounded, there is a great disagreement among the specialists about how to treat it and when more invasive treatments are indicated.
Materials and Methods: This study carried out in two phases. In first phase, 26 patients who had admitted to Imam Khomeini hospital from March 20, 1996 to March 19, 2000 and 50 patients admitted to Baqiatallah hospital between March 20, 1992 and March 19, 2002 with the diagnosis of spontaneous pneumothorax were studied retrospectively. In second phase, these patients were followed up.
Results: 39 patients (51.3%) had primary spontaneous pneumothorax, 35 patients (46.1%) secondary spontaneous pneumothorax and 2 (2.6%) neonatal spontaneous pneumothorax. 67 patients were male and 9 patients were female (male to female ratio: 7.5/1). Mean age of the patients was 35±20 years. Age peaks were the age group between 20 to 25 years old and age group more than 60 years old. Conducted treatments were observation in 3.9%, simple aspiration in 2.6%, thoracostomy alone in 81.6%, thoracostomy and chemical pleurodesis in 2.6%, thoracotomy and mechanical pleurodesis in 3.9%, thoracotomy and pleurectomy in 5.3% of cases. Mean duration of hospitalization was 8.9±7.3 days. Relapse of pnemothorax was seen in 36.9% of the followed patients. Mortality was 17.4% and all died patients had secondary spontaneous pneumothorax.
Conclusion: It seems that the management of spontaneous pneumothorax should be re-evaluated and the exact indications for conservative or more invasive methods of treatment should be defined.
Fard Esfahani A, Dabbagh Kakhki Vr, Eftekhari M, Zarpak B, Saghari M, Fallahi Sijani B,
Volume 61, Issue 4 (15 2003)
Abstract

Radioiodine therapy is the safest, simplest, least expensive and most effective method for treatment of Graves' disease. Due to difficulties in previous methods for dose determination, fixed dose method of 1-131 is now considered the best practical method for 1-131 therapy in Graves' disease, but there is no consensus on the dose. We compared two routinely recommended fixed doses of 5 and 10 mCi for this purpose.
Materials and Methods In this clinical trial, 59 patients with Graves' disease referred for radioiodine therapy were randomized into two groups, one group was treated with 5 mCi of 1-131 and the other with 10 mCi. All patients were followed for two years, with 6-month intervals.
Results: Totally, among 59 patients treated with 1-131, 20 (33.9%) patients became euthyroid and 19(32.2%) became hypothyroid, while failed therapy (no response or relapse) was noticed in 20 patients (33.9%). In the group treated by 5 mCi (33 patients), 10(30.3%) were euthyroid, 6(18.2%) were hypothyroid (overall cure of ^8.5%), while 17(51.5%) remained hyperthyroid by the end of the follow-up period. From the 26 patients treated with 10 mCi, the euthyroid and hypothyroid states were observed in 10(38.5%) and 13(50%)patients, respectively (overall cure rate of 88.5%), and hyperthyroid state in 3(11.5%). No relationship was noted between the outcome and age, sex, size of the thyroid gland and thyroid uptake, but the relationship between the disease outcome and the amount of administered radioiodine was significant (P<0.003). Although the incidence rate of early hypothyroidism (by the end of 2 years) in the group treated with 5 mCi is less than those treated with 10 mCi, the incidence of failed therapy is higher in the former group. In addition, it is known that long-term hypothyroidism prevalence is not significantly different by using different doses of I-131. On the other hand, if the initial dose is so little to cure, cost and time for perfect treatment, number of office visits and morbidity due to untreated hyperthyroidism are markedly increased.
Conclusion: Regarding lower rate of failed therapy with 10 mCi, and as there is no significant difference in late hypothyroidism between low doses and high doses of I-131, we concluded that 10 mci is the optimal fixed dose for treatment of Graves' disease.
Hasani M, Ebrahi Soltani A R,
Volume 61, Issue 4 (15 2003)
Abstract

The induction characteristic of halothane in nitrous oxide and oxygen were compared with halothane in oxygen alone and intravenous induction with thiopentum and succinylcholine.
Materials and Methods: A vital capacity technique was used for the gaseous induction groups using a mapleson F system and a 1-litre reservoir bag. four end points of anesthesia were recorded: time to cessation of hand grip, time to loss of eyelash reflex, time to jaw relaxation, and time to settled breathing after tracheal tube insertion .we also recorded sequential blood pressure and pulse rate , the incidence of adverse airway events and the acceptability of the induction technique .
Results: Induction with thiopentum and succinylcholine had a faster time to cessation of hand grip (p, 0.05) and jaw relaxation (p, 0.01). These differences disappeared with the final induction stage and halothane in nitrous oxide and oxygen had the faster time to regular settled breathing though this did not reach statistical significance. Cardiac stability was good and comparable in all groups.
Conclusion: These were few adverse airway events in any group and none caused oxygen saturation to fall below 96%. There was more excitation in the gaseous induction groups.
Fahimi D, Khosroshahi N, Al Hossein S M, Amin Nejad M, Ansari M,
Volume 61, Issue 6 (15 2003)
Abstract

Acute Pyelonephritis (APN) is one of the most common bacterial infections seen in children that may lead to renal scarring. Vesicoureteral reflux (VUR) is an important risk factor of renal damage but not the only one.

Materials and Methods: In order to determine the association between dimercaptosuccinic acid (DMSA) scintigraphic and voiding cystourethrographic findings, a retrospective study was performed on 50 children (100 renal units) with APN that had been admitted to Bahrami Hospital from 1995 through 1998. Voiding cystourethrography (VCUG) and DMSA scan were performed in all patients within 1 to 2 weeks after termination of treatment and a second scan was performed 6 months later in patients whose kidneys showed cortical defects in the first one. The grade of reflux was based on international reflux classification (I-V). The DMSA scans were considered abnormal if one or more areas of decreased cortical uptake were noted (cortical defect). The scar was defined as persistence of these defects in the second scan. DMSA cortical defect and VUR were demonstrated in 42 (42%) and 26 (26%) of renal units respectively.
Results: Fourteen out of 26 renal units (54%) with reflux had cortical defects and 28 out of 74 renal units (38%) without reflux had cortical defects (P=0.15). Permanent renal scarring was noted in 25/ 42 of renal units (62 %) in second scan.

Conclusion: It seems that VCUG alone is insufficient as a screening modality to identity those kidneys at risk of damage and DMSA scan may provide additional information about this.

 


Noorolahi Moghaddam H, Naphisi Sh,
Volume 61, Issue 6 (15 2003)
Abstract

Autonomic nervous system dysfunction in diabetics can occur apart from peripheral sensorimotor polyneuropathy and sometimes leads to complaints which may be diagnosed by electrodiagnostic methods. Moreover glycemic control of these patients may prevent such a complications.
Materials and Methods: 30 diabetic patients were compared to the same number of age and sex-matched controls regarding to electrophysiologic findings of autonomic nervous system. Symptoms referable to autonomic disorder including nightly diarrhea, dizziness, urinary incontinence, constipation, nausea, and mouth dryness were recorded in all diabetic patients. Palmar and plantar SSR and expiration to inspiration ratio (E: I) and Valsalva ratio were recorded in all diabetics and control individuals by electromyography device. In addition NCS was performed on two sensory and two motor nerves in diabetic patients.
Results: There was no relation between age of diabetics and abnormal D: I ratio, Valsalva ratio and degree of electrophysiologic autonomic impairment. Also no relation between peripheral sensorimotor polyneuropathy and electrophysiologic autonomic impairment was found. Plantar SSR was absent in 80% of diabetics with orthostatic hypotension (p~ 0.019). Palmar and plantar SSR were absent in many diabetics in comparison to control group (for palmar SSR p~ 0.00 and for plantar SSR p< 0.015). There was no relation between diabetes duration since diagnosis and electrophysiologic autonomic impairment.
Conclusion: According to the above mentioned findings diabetic autonomic neuropathy develops apart from peripheral sensorimotor polyneuropathy and probably with different mechanisms. Remarkable absence of palmar SSR in diabetics with orthostatic hypotension can be due to its sympathetic origin. Absence of any relation between diabetes duration and electrophysiologic autonomic impairment can be due to late diagnosis of type 2 diabetes or no pathophysiologic relation between chronic hyperglycemia and autonomic neuropathy.

 


Jamshidi A R, Safavi E, Naji A, Sedighi N, Gharib Doost F, Saber S, Gholshahi H, Jvadi Nejad Z , Bhadorani A,
Volume 62, Issue 2 (12 2004)
Abstract

Background: Pulmonary involvement is a common and serious complication of rheumatoid arthritis. This cross sectional study sought to determine the prevalence of pulmonary disease in patients with rheumatoid arthritis on the basis of history, physical examination, chest X-ray and PFT.

Materials and Methods: 103 patients (81 Women, 22 Men) fulfilling the ACR (American College of Rheumatology) criteria for RA (Rheumatoid arthritis) were consecutively included in a cross sectional study. Detailed medical (including respiratory symptoms and the disease activity symptoms) and drug and occupational histories and smoking were obtained. All patients underwent a complete pulmonary and rheumatologic examination and conventional chest radiography. All patients underwent PFT that comprised spirometry and body plethysmography.Results for PFTs were expressed as percentage of predicted values for each individual adjusted for age, sex, and height.

Results: On the basis of history: Their mean age was 43.3 ± 2.6 years (range: 17-74) and the mean duration of the disease was 69.3 ± 15.6 months. Rheumatoid factor was positive in% 61.2. No patients were 0.5Pack/Year smoker in whole life. Prevalence of pulmonary involvement based on radiographic and pulmonary function test detected in 41 patients (39/7%). The most frequent respiratory clinical finding was dyspnea (33%), (NYHA grade I in 17.5% and NYHA grade II in 15.5%), Cough (with or without sputum) in 13.6 %, Crackle was the most sign in pulmonary examination (5.8%). Chest X-ray was abnormal in 13.3 % that the most common finding in this study was reticulonodular pattern in 20 patients (19.4 %), and pleural effusion detected in 7 patients (6.7%). PFT was abnormal in 30 patients (29.1 %). A significant decrease of FEF 25%-75% below 1.64 SD. Small airway involvements was the most abnormal finding of PFT. No relation between rheumatoid arthritis disease activity (ESR>30, Morning stiffness>30', Anemia, thrombocytosis) with pulmonary disease was seen.

Conclusion: This study suggests a high prevalence of lung involvement in patients with rheumatoid arthritis.Therefore we recommend a complete investigation in patients with RA with any respiratory symptom.


Goharpei Sh, Jabal Amoli M, Karimi H, Hadizadeh Kharrazi H, Ebrahimi Takamjani E,
Volume 62, Issue 3 (11 2004)
Abstract

Background: Patellofemoral joint disorders are the most common cause of anterior knee pain in patients who referred to orthopedic clinics. Patellar lateralization cause anterior knee pain due to weakness of vastus medialis oblique muscle or tightness of lateral structures like lateral retinaculum or iliotibial band muscle.

Materials and Methods: For evaluation of this abnormality, plane radiography, CT scan and MRI are useful. In plane radiography only one view in a single joint position can be obtained, because of that it is not a good method to detect abnormal tracking during knee range of motion. The purpose of this study was to evaluate patellar tracking by kinematics MRI during five serial degrees of knee range of motion (40, 30, 20, 10, 0 degrees) in 30 patients with patellar lateralization and 10 normal subjects, aged 18-30 years.

Results and Conclusion: tistical analysis showed that in patients group, patella had the most stability in 40 degree of knee flexion and this stability reduced when knee reached to full extension. At this point, patella moved laterally and the most instability was seen during 20 to 0 degree of knee extension.


Rahimi Frd M, Zarea Zadeh N,
Volume 62, Issue 3 (11 2004)
Abstract


H R Sadeghi Poor , M Samarkhah , M Effat Panah , A Bahiraei , Sh Khaghani, R Ansari Toroghi ,
Volume 62, Issue 4 (11 2004)
Abstract

Background: This research was conducted for the purpose of determining the effect of hormonal and non-hormonal contraception on the mother milk and infants growth among lactating women received by south Tehran’s Health Centers. In this regard a broad spectrum study from December 2000 until February 2001 was done by Tehran university.

Materials and Methods: By sampling method, 200 lactating women were chosen randomly. They were divided into two groups according to their preferred method of contraception: 67 women chose hormonal method and 133 women chose non –hormonal method.

Results&Conclusion: During the time of the study on infants growth (increase in head circumstances, increase in height, increase in weight), There was no significant difference between the two groups. If we take the effect of contraceptive methods into consideration, the Triglyceride levels in non-hormonal group were increased considerably compared to the other group. Other ingredients were almost the same.


M Taslimi Taleghani , A Djazayery , S.a Keshavarz , H Sadrzadeh Yeganeh , A Rahimi ,
Volume 63, Issue 1 (5 2005)
Abstract

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.


Dargahi H, M Razavi,
Volume 63, Issue 2 (12 2005)
Abstract

Background: This research have presented focuses upon the cultural side of managerial coordination and control as manifested in Telemedicine Technology. Specifically, the research seeks to analyze and determines the attitude of clinical physicians about the role of specific dimensions of organizational culture and organizational structure may have upon effective managerial coordination and control in Telemedicine Technology in TUMS hospitals.

Materials and methods: We assessed the attitude of 82 clinical physicians in five randomly selected TUMS teaching hospitals in a mixed method of pooling Quantitative and Qualitative data using unstructured interview technique.

Results: For successful telemedicine utilization, most of clinical physicians believed that we need organic organizations that have involved leadership, open and free communication of mistakes and success, desire to experiment with new ideas, support for continuing education, support for new things, clear rules to follow and acknowledge performance goals.    

Conclusion: The data indicate that organizational is most important to utilize successfur telemedicine technology.


Kalbasi G, Talebian Moghaddam S, Ebrahimi Takamjani S, Oliaei Gr, Maroofi N, Galaei S,
Volume 63, Issue 2 (12 2005)
Abstract

Background: One of the most important concerns in orthopedic medicine is the low back. Considering the importance of muscle function in preventing LBT by controlling too much load and stress applied on the spinal joints and ligaments.

Materials and Methods: The aim of this research was to determine the timing and level of activities of lumbopelvic muscles in response to postural perturbations caused by unexpected loading of the upper limbs in standing on three different supporting surfaces (neutral, positive slope, negative slope) in 20 healthy females 18 to 30 years old ( = 23.20 SD = 2.55 ). The electromyographic signals were recorded from the deltoid, gluteus maximus, internal oblique abdominis and lumbar paraspinal muscles of the dominant side of the body to evaluate the onset time, end time, level of muscle activity (RMS) and duration of different muscles in one task and one muscle in different tasks.

Results: The results showed that the agonists (posterior muscles) activated at first to compensate the flexor torque caused by loading and then the antagonists (anterior muscles) switched-on to compensate the reaction forces caused by agonist activities. With regards to continuous activity of internal oblique and its attachments via thoracalumbar fascia to the transverse processes of the lumbar vertebrae, it can be considered as one of the major stabilizer muscles of the trunk .

Conclusion: Finally the results indicated that supporting surface type didn’t have any effect on timing and scaling of muscle activities in different tasks suggesting that probably spinal and trunk priprioceptors are just responsible for triggering postural responses and they don’t have any role in determining timing and scaling.


Kalantari M, Raeisosadat Ma, Ahmadi J, Nahvi H, Fallahi G, Mehrabi V,
Volume 63, Issue 3 (12 2005)
Abstract

Background: The purpose of this study is to determine the incidence of electrolyte and ABG abnormalities in infants with HPS and also we evaluate other parameters of the study. ‎

Materials and Methods: This descriptive study covers 161 infants with HPS hospitalized in children Medical center of Tehran university underwent surgical repair from march 1996 to march 2002 . ‎

Results & Conclusion: The results indicated that Hypokalemic metabolic alkalosis had occurred in 40% of patients. ‎The sex ratio was 3/1 =M/F and the most time of presentation was between 15t and 5st week and the most presenting sign was vomiting. Clinical icter happened to be found in 15% of patients. The incidence of accompanying anomalies was 9% and olive sign was palpable in 40%. ‎The best way for evaluating and diagnosis was sonography. ‎The mean period to begin postoperative feeding was 30 hours&apos no complication related to option was reported after operation.


Sedighi I, Rahimi H, Kakhodaee A, A Siadati ,
Volume 63, Issue 3 (12 2005)
Abstract

Background: Bacterial meningitis is a fatal disease with high mortality and morbidity that needs emergency management. But due to nonspecific signs and symptoms it&aposs diagnosis in children is difficult. Recently procalcitonin has been used for diagnosis of serious bacterial infections like bacterial meningitis. We conducted a prospective study in children for evaluation of procalcitonin in differential diagnosis of acute bacterial and viral meningitis.

Materials and Methods: In a prospective process research, we measured CSF procalcitonin levels in 43 children older than two months referred to Markaz Tebbi hospital. According to the results of universal PCR the patients were divided into two groups: bacterial meningitis (n=11) and nonbacterial meningitis (n=32). To analysis the results, Mann-Whitney test was used.

Results: CSF procalcitonin level in bacterial meningitis was significantly higher than viral meningitis (1.72±0.9 ng/ml and 0.71±0.04ng/ml respectively,Pvalue= 0.00). A serum procalcitonin level >0.5 ng/ml had high sensitivity and specificity ( 90.1% and 97.1% respectively) in the diagnosis of bacterial meningitis.

Conclusion: CSF procalcitonin level seems to be a valuable marker in differentiating between bacterial and viral meningitis.



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