Showing 749 results for AF
Firooz Bakhsh Sh, Safavi E, Zahed Poor Anaraki M, Derakhshan Deilami Gh ,
Volume 60, Issue 4 (15 2002)
Abstract
Background: Transbronchial lung biopsy (TBLB) is an attractive alternative to open lung biopsy as an initial diagnostic procedure for patients with diffuse parenchymal disease or localized densities beyond direct endoscopic vision. TBLB can be carried out safely without fluoroscopy in patients with diffuse lung disease. Since in our bronchoscopic department fluoroscopy is not available, we planned to evaluate the blind (without fluoroscopic guide) TBLB being performed in our department to determine the success rate in obtaining lung tissue, the sensitivity of the procedure and the risk of complications.
Materials and Methods: Sixty-four TBLB were done in our department during a six month period (March-September 1999).
Results: Lung tissue wasn't detected in two (3.1 percent) samples. Pathological results were helpful in 46 (71.9 percent) cases. No evidence of hemoptysis was found after the procedure. Three (4.68 percent) cases of pneumothorax were detected. Only one of them required chest tube (1.51 percent).
Conclusion: We concluded that blind TBLB was successful in our department with rates of complications comparable to other approved centers.
Gharabaghian M, Sadeghy Sa, Mir Mohammad Sadeghi Sf, Rafieyani Sa,
Volume 60, Issue 4 (15 2002)
Abstract
Background: Cuffed pharyngeal tube is a device designed for ventilation of anesthetized patients. CPT has advantages over face mask including: maintaining of face mask can be difficult and boring after several minutes and mobility of the practitioner is reduced due to involvement of hands. Mask pressure can cause soft tissue and nerve damage around the nose. Anesthetic gas leakage from the mask adds to the operation room pollution. In difficult intubation CPT can be life-saving.
Materials and Methods: In our study CPT was compared with endotracheal tube (ET) in anesthetized patients. A scoring system for evaluating ventilation of patients was designed using symmetric chest wall motion during ventilation with anesthesia bag and sensing lung compliance through it, auscultation of breathing sounds, oscilation of bag with breathing and peripheral oxygen saturation by pulse oxymetry. Respiratory complications (pulmonary aspiration, Iaryngospasm and bronchospasm, nausea and vomiting) were looked for during anesthesia.
Results: The results showed that CPT was successful as ET in ventilation of spontaneously breathing patients and incidence of respiratory complications with CPT was no more than ET. Airway resistance was significantly greater with CPT than ET (P<0.05). Patients with ET had significantly greater incidence of sore throat than with CPT (P<0.05).
Conclusion: Thus we concluded that CPT can be used for ventilation of anesthetized patients not predisposed to pulmonary aspiration and whose peak airway pressure does not exceed 20-25 CmH2O.
Mosaffa N, Mosafa N, Mirza Hosein Yazdi B,
Volume 60, Issue 6 (15 2002)
Abstract
Introduction: PMA is known to induce the differentiation of monocytes to macrophages. This agent also increases the killing effect of the monocytes/macrophages through oxidative burst and can be used as a stimulant for oxidative burst assay. The present experimental study was intended to investigate the in vitro effects of PMA on the differentiation, morphological changes, cell adherence and the viability of monocyted-derived macrophages (MDMs). Besides, MDM capacity for free radical production was assessed, indicating the oxidative burst events.
Materials and Methods: This experimental study has been design in Department of Immunology of S.B.M.U in Tehran Iran (year 2000). Peripheral mononuclear cells from adult Balb/c mice were isolated and cultured in complete tissue culture medium and divided in two group: control, (without PMA) and test (were added Pma=450 ng/ml). MDMs wee counted on the hours 1, 2, 3, 4, 6 and 18 and their characteristics were confirmed by morphological analysis (histological features) in both groups. Viability of MDMs was assessed using trypan blue. In the peak time of MDMs activation the oxidative burst was determined by NBT reduction.
Results: The obtained results suggested that PMA had significant effect on the differentiation of monocytes to macrophages. The morphologic maturation tended to occur in earlier stages in the PMA treated cells comparing to the control MDMs. Also, the number of adherent cells was considerably more in PMA stimulated monocytes. The peak time of cell adherence in the presence of PMA was no the second hour. As the incubation period increased, the significant difference between the numbers of adherent cells in two culture systems decreased. However, viability decreased significantly in the PMA treated MDMs, i.e. PMA treatment induced rapid apoptosis in the MDMs after their activation. PMA stimulated MDMs markedly (60%). Also we mentioned that the primary un-stimulated MDMs only revealed (55%) of NBT reduction after treatment with PMA at NBT reduction stage.
Conclusion: Phagocytic function and oxidative burst assay in monocyte-macrophage lineage can be a diagnostic tool for identification and management of some Immunological abnormality and defect and can be establish distinct from other phagocytic system assessment.
Mostafavi F, Tavakoli M J,
Volume 61, Issue 1 (13 2003)
Abstract
Diabetes mellitus is the most common endocrine disease in childhood and adolescence. It has significant effects on growth and development of the involved patients.
Many studies have proved that in long term, diabetes causes an obviously decreased bone mass and linear growth in affected patients. Various studies have been done to determine the cause of these problems. In diabetic patients various degrees of calcium loss in urine have been detected.
Normally, the amount of calcium loss in urine of general population is less than 4 mg/kg/day, and the Ca/Cr ratio in a random urine sample is less tan 0.25.
Hypercalciuria may be the underlying cause of osteopenia and linear growth defect in diabetic children.
In our study, the urinary calcium loss of 50 diabetic children was determined. We tried to find a correlation between the amount of calcium loss in urine and plasma glucose.
These patients have been referred to Children's Medical Center during a 6 month period in year 2000. They had very higher incidence of hypercalciuria than the non-diabetic population, but we found no significant correlation between the severity of hypercalciuria and seventy of hyperglycemia in them.
Gharagosloo M, Khalili S, Hallaj Mofrad M, Karimi B, Honartnand M, Jafari H, Moosavi S Gh ,
Volume 61, Issue 1 (13 2003)
Abstract
Wide variations in the prevalence of asthma, allergic rhinitis and eczema have been reported in the world, between regions and countries. The international study of asthma and allergies in childhood (ISAAC) was developed to provide standardized method to ascertain the prevalence of asthma and allergies in different regions. Comparisons of prevalence rates across geographic regions may help to identify factors that influence the development of these conditions in individuals.
Methods and Materials: For doing this descriptive study the ISAAC written questionnaire was completed by the parents of 3000 school children aged 6-7 years in Kashan, the central area of Iran, with different geographic and cultural characteristics, during the fall of 1998.
Results: The overall cumulative and 12 month prevalence of wheezing were 10.2 percent, 6.9 percent in the girls and 18.2 percent, 13.1 percent in the boys respectively. The prevalence of doctor diagnosed asthma were 1.3 percent and 2.2 percent in the girls and boys. Rhinitis symptoms were reported by 14,7 percent, 16.9 percent and chronic pruritic rashes by 5.1 percent and 8.3 percent of the girls and boys respectively.
Conclusion: Allergic disorders are common in this area and prevalence is comparable to other parts of Iran and many other countries. Prevalence of asthma by medical diagnosis is relatively low with respect to other studies performed with the same methodology.
Sharifian R, Mohammadi S M, Ghasemi D, Safaei S R, Toogeh Gh R, Emami A H,
Volume 61, Issue 2 (14 2003)
Abstract
Neutropenic state with fever is exactly regarded as a medical emergency, with high mortality and morbidity rate, unless treated urgently and correctly. Every attempt should be made to find and establish the offending organism, but postponing treatment until obtaining culture results is not advised. Controversy exist on which antibiotic regimen to be used while waiting for culture results. Many antibiotic regiments both monotherapy or combination treatments have been used with varying result. The objective of this study is to compare the efficacy of cefriaxon monothenapy with ceftazidim. Plus Amikacin as initial empiric antibiotic therapy in febrile neutropenic patients.
Materials and Methods: We performed a randomized, single blind clinical trial in 57 adult (age>12 years), neutropenic (PMN<1000) patients with fever (Temperature, oral >38.5c) in Hematology ward, Imam khomeini hospital. After careful physical exam and obtaining blood & urine samples for culture, the patients were randomized to each of the two arms: Cefriaxon 2 grams daily, intravenously (arm A) and Ceftazidim 2g thrice daily plus amikacin 500 mg twice daily (arm B). Patients with shock, organ failure or previous antibiotic intake (during 48 hour before fever) were excluded. If needed, dose adjustment of drugs were allowed. Effervescence in 3 days following initiation of treatment, lasting 48 hours or more, were regarded as effective (positive result).
Results: During a twelve months period of study, a total of 57 patients (17female, 40male) were included. They were randomly selected to each arm of empirical treatment. Of 28 pts in arm A, 19 (67 percent), the treatment was effective, compared to 15 of 29 (51.7 percent) in groups B. The duration of fever after initiation of treatment was 37.9 ± 17 hours in arm A and 40. 1 ± 20 h in arm B. Blood and / or urine culture was equally positive in two arms (25 percent in arm A and 27.6 percent in arm B).
Conclusion: Cefriaxon monotherapy is at least equally effective in low risk neutropenic patients with fever compared to combination of ceftazidim plus amikacin at a decreased cost and probably (expected) less adverse side effects in our patients.
Ataei N, Madani A, Falakolaflaki B,
Volume 61, Issue 4 (15 2003)
Abstract
The nephrotic syndrome is the most common chronic renal disease of childhood.
Materials and Methods: In this study the clinical course, risk factors for relapse and the predictors of long-term outcome of 502 patients (median age 5 years)with primary nephrotic syndrome were followed for an average of 60 months (3.5 to 240 months) from 1981 to 2000.
Results: Among the 502 patients 5 (1%) achieved spontaneous remission and 313 children were initial responder. One hundred eighty four patients received at least 1 kidney biopsy (78 prior and 106 after initiation of treatment). Of 104 children with frequently relapsing steroid sensitive and steroid dependent nephrotic syndrome, levamisole induced prolong remission in 33 ( 31.7%) of patients. Cyclophosphamid and cyclosporine A induced prolong remission in 49 (50%) of 98 and 28 (41.3%) of 68 patients respectively. At the time of the final clinical evaluation, 73 patients (14.5%) were on remission 301 (59.9%) had relapsing 43 (8.6%) had persistent nephrotic syndrome 33 (6.6%) of patients evolving to end-stage renal disease (ESRD) and 6 (1.2%) of them with chronic renal failure died (infection and cardio respiratory were the cause of death in 5 and 1 patient respectively). Young age (1-5 y) at onset of disease and atopy were identified as an independent risk factors for relapse (P0.05). Patients with steroid dependent nephrotic syndrome (SDNS) or MCNS had better response to cyclophosphamide or cyclosporin than children with steroid resistance nephrotic syndrome (SRNS) or FSGS (P0.05). Persistent proteinuria, hypertension, microscopic or macroscopic hematuia, glucosuria were associated with progression to chronic renal failure (PO.05).
Conclusion: Steroid dependency and histopathology of MCNS in patients with nephrotic syndrome were significantly associated with good long-term prognosis. In contrast persistent proteinuria, histopatholoy of FSGS, hypertension, macroscopic or microscopic hematuria, and glucosoria were significantly correlated with unfavorable long-term outcome. Additionally our study showed a positive correlation between young age and atopy with higher rate of relapse.
Sadr Bafghi S M, Rafie M, Modares Mosadegh M, Ahmadiah Mh, Zandikarimi F, Aghili K,
Volume 61, Issue 4 (15 2003)
Abstract
Unstable angina (UA) is situated in a spectrum with myocardial infarction (MI) at one end of it and stable angina at the other end. To determine the clinical and paraclinical characteristics of unstable angina this study was designed.
Materials and Methods: Two hundred patients with definite UA who were hospitalized at cardiac care units (CCU) in Yazd were enrolled in this cross- sectional study. Clinical and para-clinical characteristics including class of severity of angina, clinical circumstances, drugs, risk factors, changes in ECG, and patient's condition at the time of leaving hospital were evaluated.
Results& Conclusions: The average of age of patients was 61.85 years and 57% of them were female and 43% were male. The most prevalent risk factor among men was smoking (48.8%) and among women was hypertension (62.8%). According to Braunwald suggestion, patients were divided into 3 classes based on the severity of their diseases. Frequency distribution of patients in classes I,H and III were 24.5%, 4% and 71.5%, respectively. Normal ECG, was observed in 24.5% of subjects at the time of hospitalization and in 67% of patients when leaving hospitals. Frequency distribution based on the risk stratification was 22.5%, 58.5% and 19% in the low, medium and high risk groups, respectively. During hospitalization, acute myocardial infarction (AMI) was seen in 3.5% of individuals that majority of them belonged to class III of angina.
Movafegh A, Mir Eskandari M, Eghtesadi Araghi P,
Volume 61, Issue 4 (15 2003)
Abstract
One of the disturbing complications of propofol is pain on injection and the incidence ranges from 28% to 90%. Metoclopromide is commonly used as an anti emetic drug. Some investigators reported that this drug could reduce the pain on injection of propofol. The aim of this study was to assess and comparison of the efficacy of propofol pretreatment with metoclopromide in incidence and severity of its pain on injection.
Materials and Methods: In a randomized, prospective, double-blinded, placebo-controlled trail, 150 patients 18 to 40 yr old were randomly allocated in one three groups. C group (2ml of normal saline), L group (40mg lidocaine in 2ml), M group (l0mg metoclopromide in 2ml). Immediately after injection of study or placebo drugs, 10 mg of propofol with injection rate of 0.5 ml/s (In 4 Seconds) were injected in to the same vein that was inserted to the most prominent dorsal hand vein. Pain severity was measured using Visual Analogue Pain Scale that were educated to the patients before the trail (0 for no pain and 100 for the most aggressive pain in life) and values other than zero was encountered pain appearance. Patients with signs of sedation were excluded.
Results: There was no statistically significant difference between patients in three groups in number of men and women (P = 0.66), age (P = 0.29) and weight (P = 0.49). Furthermore severity (P = differences (C = 41.18, L - 25.4 and M = 13.1, P < 0.001) and patients in metoclopromide group experiences lower pain than other two groups (P < 0.001). Pain incidence in Control group was 77.1% and it was significantly reduced in lidocaine and metoclopromide group (P = 0.002), but there were no significant difference between them (P = 0.051). The 0.69) and incidence (P ~ 0.29) of pain has no significant difference between men and women. Pain severity between three groups has significant results showed that metoclopromide could significantly reduce the seventy of pain on injection of propofol more than lidocaine (opposite to diazepam), but they had no difference in pain incidence. It might lie on the different mechanisms that they produce pain. Pain on injection of diazepam is primarily attributed to propylene glycol, as a vehicle, but the pain mechanism in propofol is remaining unknown.
Conclusion: Finally as regards to other useful effects of metoclopromide including postoperative nausea and vomiting and propofol induction dose reduction, especially when there is a medical condition where lidocaine is contraindicated, it may be a reasonable alternative before injection of propofol.
Klishadi R, Hashemi Poor M, Sarraf Zadegan N, Sadri G, Ansari R, Alikhasi H, , , , ,
Volume 61, Issue 4 (15 2003)
Abstract
The main purpose of this study was to evaluate the prevalence of overweight and obesity among guidance-and high school students and its relation to modifiable environmental factors.
Materials and Methods: The subjects have been 1000 girls and 1000 boys aged between 11-18 years, selected by multi-stage random sampling, their parents (2000 subjects) and their school staffs (500 subjects) in urban and rural areas of two provinces in Iran. Data have been analyzed by SPSSV10/ Win software.
Results: The prevalence of 85th < BMI<95th percentile and BMI>95th percentile in girls was significantly higher than boys (10.67±1.1%, 2.9±0.1% VS. 7.37±0.9%, 1.87±0.1% respectively, p<0.05). The mean BMI value was significantly different between urban and rural area (25.38±5.2 VS. 23.25±7.1, P< 0.05). BMI > 85th percentile was more prevalent in those with lower educated mothers (9.2+2.1 vs. 11.5+2.4 years of mothers education respectively). The mean of the total energy intake was not different between overweight or obese and normal- weight subjects (1825±90Kcal VS. 1815±85Kcal, P>0.05) but the percent of energy derived from carbohydrates was significantly higher in former than the latter (69.4% VS. 63.2%, P<0.05). Regular out-school sport activities were significantly lower and the time spent on television watching was significantly higher in overweight or obese than non-obese subjects (300±20 VS. 240±30 minutes/day, P<0.05). Significant linear association was shown between the consumption frequency of rice, bread, pasta, fast foods and fat/salty snack and BMI (p=0.05-0.06, p<0.05). A significant correlation was shown between BMI percentiles with serum triglyceride, high density lipoprotein-cholesterol and systolic blood pressure (Pearson r=0.38,-0.32 and 0.47 respectively).
Rahbari Manesh A A, Ashrafi M R, Entezari A R, Bakhtiar Fhazely P,
Volume 61, Issue 5 (15 2003)
Abstract
Shigellosis is a acute inflammatory colon disorder that was developed by variety strains shigella and have high prevalence in infants, preschool children and Tropical climates particularly Iran. The purpose of the present study was to determine the frequency rate of neurologic complications with shigellosis.
Materials and Methods: In a cross sectional study, 390 patients with shigellosis that were hospitalized in Bahrami Hospital of Tehran in period of 5 years 1997-2002 were evaluated with Neurological Manifestations and Complications .
Results: This study revealed a frequency rate of 80% for Neurological complicaton (encephalopathy alone= 15.38%, convulsion alone= 43.08%), convulsion and encephalopaty= 18.47% , Ekiri syndrome= 3.07%).
Conclusion: The reason of difference this study with other world studies is probably Restricted of this study in The hospitalized patients and over diagnosed of convulsion by parents and Medical personalies. this results suggest that neurologic complication particularly seizure commonly associated with shigellosis also Ekiri syndrome in this study has had relatively high frequency rate. For this reason serious prevention and Rapidly Treatment of shigellosis is necessary.
Ghini Mr, Ghaffari S, Banki Ma,
Volume 61, Issue 5 (15 2003)
Abstract
Because of high prevalence of upper limbs pain and carpal tunnel sndrome and the need of proofing of diagnosis by nerve conduction study (NCS) testing of edian nerve is one of the most common exams in electro-diagnostic centers. In interpretation of findings of nerve conduction study presence of a normal range for findings is one of the most important points.
Materials and Methods: In this study we obtained the findings of nerve conduction study of median nerve in 60 normal persons.
Results: The mean of motor distal latency was 3.09 ms (SD: 0.35). The mean of sensory distal latency measured to peak of response was 3.04 ms (SD: 0.28) with increasing age mean of motor and sensory distal latencies increased. Most of findings had no significant difference with other references.
Conclusion: There is no problem in using of the normal ranges of the other countries for Iranian patients.
Safdariyan L, Motahari N,
Volume 61, Issue 5 (15 2003)
Abstract
Mohaghegh M H, Sarzaeim M R, Modaghegh H S, Zafarghandi M R,
Volume 61, Issue 5 (15 2003)
Abstract
This article is to verify mortality rate, cause of death, severity of injury (ISS),GCS, patient fate in hospital, pattern of specific organ injuries and some other characteristics among injured pedestrians and car occupants referred to three trauma centers in Tehran (Sina hospital, Shohada Tajrich hospital, Fayazbakhsh hospital) from May 1996 until May 1997.
Materials and Methods: 57367 patients were admitted to emergency department of these centers among which, 6027 victims of motor-vehicle accidents were included in this study.
Results: 71% of cases were pedestrians and rest was car occupants. M/F ratio was 1.8/5. Mean age was 29y. Motor vehicle accidents occurred most commonly during nights. The patients' GCS at arrival in emergency department had similar distribution in both groups. The most commonly injured organs in both groups were: integument, head and neck, extremities and bony pelvis. Thoracic and spinal injuries were more common among car occupants. Extremities and boney pelvis injuries were more common among pedestrians. The mortality rate was the same between both groups. Mortality rate was affected by GCS at arrival and severity of injury. Mortality rate among the old was 4 times the rate among the children. The accidents most commonly occurred on metropolitan roads and streets. The most common cause of death between both groups was head injury. Surprisingly head injury was a more common cause of death among the car occupants.
Conclusion: Pattern of specific organ injuries was different form the pattern in previous studies as the pattern was virtually the same between both groups except for spinal and thoracic injuries were more common among the car occupants.
Ramezanzadeh F, Tavafian S S,
Volume 61, Issue 6 (15 2003)
Abstract
Illicit drug abuse is a major area of interest for clinicians, as well as for public health and social authorities, but one of the major concerns is the illicit drug abuse during the periconceptional period and throughout pregnancy, because of its potential effects on the embryo and fetus. In this study we investigated the prevalence of illicit drug abuse in the first trimester of pregnancy in women who referred to Iran, Tehran and Shahid Beheshti universities of medical sciences, for prenatal care.
Materials and Methods: In this descriptive cross sectional study, a non-randomized sample of 2000 pregnant women that were in their second and third trimester of their pregnancy, were interviewed about drug abuse in their first trimester. Collected data were analyzed by SPSS software.
Results: The prevalence of illicit drug abuse in the first trimester was 2.5% which the majority of these drugs were in group B. The prevalence of drug abuse was 0.9% and alcohol usage and alcohol abuse was 0.2%, cigarette smoking was the most common drug abusing phenomena. Variables such as husband education, infertility and satisfaction with pregnancy have significant relation with drug abuse.
Conclusion: The results of this study support the need for continued education and this education must end in by itself to make dramatic changes in behavior. So results of this study showed that, improving education and knowledge of mothers and consultation with them in regard to risks and complications of drug abuse during pregnancy, would make dramatic changes in their behavior.
Rafiei M, Sadr S M, Mirjalili M R, Nayeb Zadeh M, Namayandeh S M,
Volume 62, Issue 1 (12 2004)
Abstract
Background: All the patients with Angina pectoris have not stenotic coronary artery. Syndrome x consists of patients with Angina pectoris and positive Exercise test along with normal coronary angiography. Syndrome x includes 25-30 percent of those who undergo diagnostic coronary arteriography at the different centers. In our study it was attempted to know the prevalence and characteristics of this special group in Afshar cath-lab.
Materials and Methods: In a prospective cross sectional descriptive study 200 patients who were admitted for coronary angiography evaluated in terms of Risk factors: HTN, Family history Hyperlipidemia, DM, Cigarette smoking , clinical symptoms , response to TNG, different symptoms, ECG and Exercise test. data in two subgroups with normal and abnormal Coronary angioghraphy were compared. Six patients were excluded because of ambiguous Coronary angiography.
Results: Among 194 patients 51 patients (26.3% )had normal coronary artery. 38.9% of female and 21.4% of males showed normal coronary angioghraphy (P = 0.013). The prevalence of risk factors among those with syndrome x and abnormal coronary Artery were as follow. HTN 37% vs 42% , Hyperlipidemia 50% vs 51% , smoking 25% vs 37% , DM 12% vs 28% , obesity 45% vs 47% Positive family history for CAD = 21.5% vs 47% respectively. Angina relieved suitably with TNG in 24% of those with syndrome x compared to 76% suitable response in those with abnormal coronary arteries.(P Value = 0.49 ). Regarding to functional class , 87% of patients with normal coronary artery belonged to class I and II. also 26% had atypical pain 50% had normal rest ECG and 51% achieved stage III or IV of Bruce protocol during Exercise test.
Conclusion: Syndrome x was more prevalent among women ,also angina was less typical and less responsive to TNG. Most patients had not positive familial history for CAD. normal ECG was more prevalent among those with syndrome x .
Rafeey M, Khatami Gh,
Volume 62, Issue 1 (12 2004)
Abstract
Background: There has been a little attention to pediatrics esophagus problems until recent years. The term esoghagitis can be used to described chemical, infectious, inflammatory, ischemic, immunologic and degenerative abnormalities. Prevalence of reflux esophagitis varies between 2 to 5 percent of general population but little data about its incidence in pediatric age groups. The aim of this study was to evaluate the epidemiology and prevalence of esophagitis and study of symptom, diagnostic measures, therapeutic intervention and prevention of its complication.
Materials and Methods: In this prospective and cross sectional study 500 patient under16 years with upper digestive complaints or alteration of their state of health under went upper endoscopy, with special attention paid to esophagus.
Results: Among 500 children (205 male, 207 female), pathology reported esophagi is in 325 cases. Majority of the patient were 8 to12 years. Most common complaints was abdominal pain (45/7%) and the second complaints was vomiting (13%), but most common complaints in severe esophagitis was melena (66%) and hematemes(18/8%). Most of patient (63% ) had a mild grade of esophagitis. When difference between endoscopy and pathology compared: Mild esophagitis in endoscopy (67%) ,but in pathology was (63%), moderate esophagitis (14/7%) in endoscopy was (17%) in pathology and severe form 2/8% in endoscopy but (4/9%)in pathology.
Conclusion: According to results of our study in children age group with chronic abdominal pain ,vomiting ,excessive regurgitation, failure to thrive, we noticed that esophagitis is common etiologic factor. Histological esophagitis frequently occur in the absence of gross endoscopic findings and we need biopsy and histological examination to confirm diagnosis.
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.
Haddadian K, Rezai O, Sadeghi S, Modarres Zamani A, Sharifi G, Nazemi Rafie A,
Volume 62, Issue 3 (11 2004)
Abstract
Background: Regarding the complications of chronic intractable epilepsy, the presence of respectable lesions in many these patients that can be diagnosed with noninvasive sensitive techniques such as MRI and SPECT and the unrecognized significance of epilepsy surgery in our country, we have decided to review the management of medically intractable epilepsy in patients, who underwent epilepsy surgery in neurosurgery department of Loghman Hakim hospital between 1997-2003.
Materials and Methods: In this study we retrospectively review 30 cases of medically intractable epilepsy that had underwent epilepsy surgery. All patients before surgery were investigated with brain MRI, brain SPECT, EEG and IQ test. Type of surgery was determined by MRI, SPECT and EEG findings. Pre - and postoperative seizure frequency and surgery complications studied. Seizure control was measured with Engel criteria.
Results: Patients mean age was 22.4 years. Three cases (10%) were females that all underwent temporal mesial lobectomy. In 18 cases (60%) there were concordant brain lesion with seizure origin that 9 cases (30%) underwent mesial temporal lobectomy and remainder 9 cases (30%) underwent lesionectomy.other12 cases (40%) that have uncertain brain lesion but suffer from drop attack due to one or combination of atonic, tonic, tonic clonic, clonic, myoclonic, absence or clonic underwent anterior callosotomy. patients that underwent mesial temporal lobectomy, anterior callosotomy and lesionectomy were seizure-free in 77.7%, 58.3% and 55.5% of cases respectively.
Conclusions: Provided to correct patient selection for epilepsy surgery we can manage intractable epilepsy properly. Regarding to the complication of intractable epilepsy, acceptable epilepsy surgery results and available sensitive noninvasive diagnostic techniques such as MRI in our country, epilepsy surgery should be considered seriously in our country and promoted.
Rafiei M, Sadre Bafeghi S M, Afkhami Ardakani M, Namaiandeh S M, Orafa A M, Ahmadieh M H, Dehghan Hr, Rafie R, Rahmanian M,
Volume 62, Issue 3 (11 2004)
Abstract
Background: To evaluate the ability of Ankle/Brachial Index (ABI), that is a sensitive and specific test for detection of PAD, to foretell the possibility of ischemic heart diseases in diabetic patients.
Materials and Methods: All of diabetic patients who visited in our diabetes research center between May 2000 and May 2001 and were confirmed diabetics since 2 or more years ago were enrolled in the study. The ABI was calculated for all of the patients and their demographic specifications and ischemic heart disease risk factors were recorded. All of the patients refer to perform an exercise test, but 279 patients were conferred to performing stress test. They were containing: 127 patients with ABI =<1.1(group I) and 47 patients with ABI>=1.4(group III) as case groups and, 105 patients with 1.1 60 years (P = 0.02). 238 patients were in group I (25.1 %), 625 patients in group II (65.9 %) and 85 patients in group III (9 %). 52.8% of 125 patients in Group I, 19.6% of 107 patients in group II, and 44.7% of 47 patients in Group III had positive exercise test. I, II (P 0.00)- II , III (P = 0.05) A total of 108 patients from among the 279 patients had positive exercise test (38%), and most of them were from groups I &III. 72.2% of group I , and 52.5% of group II had high blood pressure (P 0.00). Both hypertensive and normotensive patients with ABI =<1.1 & >=1.4 had positive exercise test significantly more than patients with 1.1=1.4 is an independent predictor of coronary artery diseases in diabetic patients especially in those who are hypertensive.
