Tehran University Medical Journal

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The laparoscopic findings of 32 patients with chronic pelvic pain were compared with findings of 62 pain free women who were candidates for laparoscopic tubal sterilization. The most common findings, normal pelvis, was found in 50% of patients and 80.6% of controls that was statistically significant (P<0.01). There was no significant difference with pelvic adhesions, polycystic ovaries, pelvic relaxation between study and comparison group.

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Hysteroscopy is a new and precise method for evaluating of uterus, so it is valuable in evaluating infertile women. In 18 months, 363 hysteroscopies were done on patients who were visited in IVF center of Shariati Hospital for treatment of infertility. Incidence of abnormal hysteroscopy was 18%. 32% of these abnormal hysteroscopies was endometrial hyperplasia. In evaluating of laparoscopy and other factors of these patients there was a statistically significant relation between diagnosis of PCOD (polycystic ovary disease) and endometrial hyperplasia (P<0.008), but there is no significant relation between other diagnoses like endometriosis and endometrial hyperplasia (P<0.4).

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In a bacteriological study on 230 biopsies of patients suffering gastrointestinal disorders in Imam Khomeyni Hospital, 88 patients were selected as case and another 88 as control groups. Case group was treated by triple (Bismuth subcitrate, Metronidazole and Tetracycline) drugs for a period of 14 days. The latter treated by nonbismuth regiment eg. Amoxicillin and Ranitidine mainly. All of the patients were examined bacteriologically by biopsies in 1, 6 & 12 months after treatment. Obtaind data revealed that the Bismuth composed regiment was more effective than non-bismuth composing ones. In fact, bacterial eradication was approved in 89.8% of case group without recurrence of symptoms among them at least for entire year. Conversely, eradication occulted just in 23.5% of control group, frequent recruidescen Cl of pipriculear observed among them within one year.

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Improper drug prescription by physicians due to wrong diagnosis, wrong drug choise or other causes will waste national funds. The annual drug costs in Iran is 900 billions Rials. With approvement of prescription, it can be reduced to 500 billions Rials. Effective factors in costs reduction are: 1) Increasing medical knowledge and persistent education of physicians. 2) Spending more time for each visit. 3) Giving more information to physicians about pharmacological compounds. 4) Teaching symptoms and signs of the common diseases and proper diagnosis of them. 5) Checking the prescriptions of physicians.

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Brain's waves are produced by spontaneous activity of neurons. These waves are changed by neurotransmitters in the central nervous system (CNS). Concentration of these neurotransmitters can be changed by various drugs and total power of brain waves also increase or decrease by these drugs. In this research effect of Quinpirol and Sulpiride on the brain waves was investigated. Male wistar rats (weight 190-230) were aneasthetized with thiopental and two holes were made into the frontal and occipital area and two Ag/AgCl electrodes were fixed into these holes. One week after recovery, two electrodes were connected to the physiograph and the results were analyzed before and after intraperitoneal and intracerebroventricular (ICV) injection of drugs by PC computer. Our results showed that intraperitoneal administration (5 mg/kg) of diazepam reduced the depth of anesthesia. Conversely, intracerebroventricular injection of sulpiride increased the depth of anesthesia which was manifested by an increase in relative power of delta waves and reduction of relative power of alpha waves. This drug had a biphasic effect on EEG, at high doses in increased the depth of aneasthesia and total sleep. Wehteas depth of anesthesia was decreased at low dose. Simutanuos administration of sulpiride and quinpirole produced an effect on EEG similar to diazepam. As a result, biphasic effect of D2 agonist and antagonist drugs on brain waves are due to nonspecific action of these drugs on these receptors and this effect may be produced by other mechanisms

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Helicobacter pylori (H.Pylori) is the most common human infection in the world. This agent has a strong role in pathogenesis of chronic gastritis and peptic ulcer. Therefore introducing of simple and cost effective tests are important for diagnosis of H.Pylori infections. ELISA has been considered as an alternative test compare with biopsy, histological staining, culture and urease test in diagnosis of H.Pylori infection. In this investigation, 111 patients referred to GI endoscopy department of Imam Khomeini Hospitals for U.G.I problems which were evaluated for H.Pylori infection. Culture and histological staining (GIMSA and H & E) were used as a gold standard test compare with ELISA-IgG and urease test. Sensitivity and specificity for ELISA were 90%, 93% respectively. This report suggests that ELISA is a cost effect and valid test in diagnosis of H.Pylori infection

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Acute appendicitis is the most common condidition, requiring emergency operation in children. Late appendicitis is still a major sours of morbidity and potential mortality. The charts of all pediatric appendectomy patients (150 cases) treated between 1367-1373 (Iranian calender) in Amir Kabir Medical Center were reviewed. Mean hospital stay was 4.7 days. Mean ages of patients was 8.5 years. Male to female ratio was 1.2/1. Most common symptom was abdominal pain (100%) and deep tenderness in right lower quadrant in 94.6%. Mean temprature was 37.2 and leucocytosis (more than 10000) were in the 76.3%. 14 patients had perforated appendicitis and most common pathology was acut supporative appendicitis. Accuracy of diagnosis was 96.6% and post operative pelvic abccess was 2%. Mortality occurred in one case (0.6%)

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Fever among elderly patients frequently marks the presence of serious illness. All such patients should be strongly considered for hospital admission, particularly when certain clinical features are present. In prospective case series study in Emam Khomeini hospital during 6-month period (March Through October 1991). All patients presenting to infectious wards who were 65 years or older who had fever (oral temperature 37.8°C or more) were studied. There were 101 patients (63 men and 43 women) with 65 to 92 years old (mean 73). The most important predisposing factor were, hypertension and heart disease in 20 patients, diabetes in 15 patients and pulmonary disease in 5 patients. Final diagnosis among 101 patients were: pneumonia 25 (24.8%), UTI 14 (13.9%) sepsis 12 (11.9%), cellulitis 16 (15.8%), IUO 4 (4.9%), malignancy 6 (5.9%) meningitis 8 (7.9%), gastroenteritis 4 (4.4%) brecullosis 7 (6.9%) and others 5 (5%). Outcome of them were complete recovery 41 (40.6%), relative recovery 42 (41.6%) and death 18 (17.8%)

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Family functioning in 103 neglectful and 102 non-neglectful low-families is examined using selfreport and observational measures. Neglectful mothers reported their Audiotaped as having more family conflict and less expression of feelings, but not less cohesive. Ratings of observed and Audiotaped family interactions indicated neglect families were less organized, more chaotic, less verbally expressive, showed less positive and more negative affect than comparison families. However, there were wide differences on measures of functioning among neglect families. Three distinct types of neglectful family functioning are identified and interventions for each type are suggested to improve parental-family functioning

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Back in 1957, when investigators produced a triple-stranded form of DNA while studying synthetic nucleic acids, few researchers paid much attention to the discovery. However, triplex DNA was never entirely forgotton and especially since 1987 its structural and functional importance in biological systems as well as its medical applications and therapeutic potentional have been extensively studied. It was suggested that in triplex DNA, the third strand was hydrogen bonded and positioned in the major groove of the Watson-Crick duplex. Protein binding assays show that triplex formation by HR21ap inhibits Sp1 binding to the Ha-ras promoter. These results suggest that the triplex formation by the Ha-ras promoter targed oligonucleotide may provide a means to specifically inhibit transcription of this oncogene in vivo. Triplex DNA can disrupt gene transcriptions and can be used as of this oncogene in vivo. Triplex DNA can disrupt gene transcriptions and can be used as a new strategy for treating viral diseases, such as AIDS, by blocking virus reproduction. As discussed in this article, for a number of reasons, interest in oligonucleotide designed for triplex helices on dsDNA is being steadily increased (including their potential artificial repressors of gene expression, mediator of site specific DNA cleavage and therapeutic use for genetic diseases, cancer and diseases caused by viruses).

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Drug therapy and prophylaxy in infectious diseases, from hygienic and economical point of view, are very important. Infections caused by pseudomonas aeroginosa were particularly severe, with high mortality rates. In the recent years pseudomonas aeroginosa continued to cause the most severe, life-thereating infections in burned patients, in spite of the introduction of a wide variety of antibiotics advised specifically for their anti pseudomonal activity. The aim of this study, in which many cases of ps.aeroginosa infections are assessed is to identify the drug resistance of this bacteria to penicillines, cephalosporins and aminoglycosides by antibiotic sensitivity test (disk ager diffusion). Results as percent of resistance to each antibiotic were 89% to carbenicillin, 55% to piperacillin, 89% to mezlocillin, 89.5% to ticarcillin+clavulonic acid, 85% to ceftriaxone, 95% to tobramycin, 5% of all isolates were not sensitive to any antibiotics.

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The present study demonstrated that comfortable listening and tolerance to loud speech, differs significantly between children with and without ADHD. Children with ADHD judged speech to be comfortable of tolerable at loudness levels significantly below those levels chosen by the children without attentional problems. Results of the present study could be interpreted according to the hypothesis presented as indicating that a central auditory ptocessing deficit exists in ADHD children. Other investigators in related disciplines suppot this assumption by identifiying existing problems in the central nervous system for gating and processing of information in children with ADHD. At present, it is hoped that the results and conclusion of the present study will shed light on improved educational management for children with attention deficit disorders. Although this study is based on our clinical findings and measurements, we do not negate the need to verify this clinical based study with data obtained from other carefully controlled studies.

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In a retrospective study, type, origin and relative frequency of pelvic masses during 3 years period in shariati hospital were studied. Ovarian mass was the most common pelvic mass with relative frequency of 88% including neoplastic 58% and non neoplastic 30%. Corpus luteom cyst was the most common cyst in non neoplastic group and serous cystadenoma was the most common in neoplastic group. The most frequent mass in malignant series was serous cystadenocarcinoma. Non ovarian masses was 6% and metastatic masses was 2% of ovarian masses. The average age was 42 years in neoplastic group excluding dermoid cyst which was 33 years and the average age was 32 years in non neoplastic group.

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This paper represents a retrospective study of 142 patients with skeletal tuberculosis during the years 1350 to 1357 at Shafa Yahiaian Hospital. Confirmation of diagnosis is made by positive culture or pathology. The mean age of the patients was 27.5 years (range from 1.5 to 72 years). Most of the patients were in the second, first and third decade respectively. 45.3% of the patients were female. The spine was the most common site and was affected in 40.88% of the patients. The next sites were knee, hip and elbow, in order of frequency. The commonest site in spine was thoracic. The mean of sedimentation rate in the first visit was 48. Tuberculin skin test was negative in 23% of the patients. Evidence of pulmonary tuberculosis in chest radiography was present in 48.61% of the patients. Five patients had tuberculosis osteomylitis without involvement of the joint.

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Intrauterine insemination (IUI) has been practiced since the late 1800's primarily for idiopathic infertility, and in men with deficient semen parameters. The procedure is done by placing washed sperm in uterus a few hours before ovulation. The records of 427 couples receiving IUI for treatment of infertility at Shariati hospital in 1370-74 were reviewed retrospectively. These patients had IUI in 574 cycles. Eighty patients became pregnant and delivery rate was 14% per cycle. Pregnancy rate is impressive when ovulation induction is combined with insemination timed just before ovulation. The success rate in Shariati hospital is comparable to other infertility centers in the world and cost of a cycle of IUI with HMG superovulation is approximately one third the cost of IVF-ET or GIFT cycle and avoids invasive oocyte retrieval and extracorporeal fertilization. So we suggest that women with refractory infertility without anatomic distortion of pelvis can have at least 3-6 cycles of IUI before IVF or GIFT.

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This is a retrospective study of the treatment of 68 cases of spine injuries to make an objective assessment of clinical and radiologic results and to introduce the good results of C.D segmental instrumentation. 68 patients, with an average follow up of 36 months, who suffered from thoracolumbar, lumbar and cervical spine fractures and dislocations, underwent surgical and nonsurgical treatment according to the clinical and radiological datas. Patients with more than 50 percent of loss of body height, more than 50 percent of canal compromise and neurologic deficits underwent surgery. With the C.D instrumentation, it was possible to provide solid, short internal fixation with restoration of the sagittal profile without loss of correction. For patients eith heavy works, over-weights and especially, shattered vertebral bodies, to prevent loss of correction, combined posterior and anterior interbody fusion is highly recommended.

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In the present research work, a specific 285 bp DNA fragment was used for detection of Mycobacterium Tuberculosis complex. 100 samples were chosen randomly from sputum specimens that were negative with conventional methods (direct smear, culture, and radiometry), and examined by PCR 7 cases of them were positive. Also, 20 sputum specimens were obtained from suspected patients to tuberculosis, and examined by three methods (culture, radiometry and PCR). The sensitivity of PCR compared with culture and radiometry was 100%, the specificity of PCR compared with culture was 91.66%, and compared with radiometry was 68.75%. Therefore, results of PCR revealed, this method is more sensitive, specific and rapid and it can detect ycobacterial infectious agents within one day period.

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Introduction: It has been shown that repeated large volume paracenthesis associated with intravenous albumin infusion is a rapid, effective and safe therapy of massive ascites in cirrhosis. Our aim was to investigate wether IV infusion of albumin is necessary in large volume paeacenthesis therapy of cirrhotic ascites. Methods: 37 patients with tense cirrhotic ascites who were intractable to diuretic therapy were randomly assigned in two groups. 16 patients (group A) were treated with paracenthesis of 4 lit/day plus intravenous albumin infusion (7 gr/lit), and 21 (group B) with paracenthesis without albumin infusion. Hemodynamic status, liver and kidney function and serum lectrolytes were assessed before, while and after paracenthesis. Results: Paracenthesis without IV albumin did not induce significant changes in standard renal function tests, serum albumin, serum electrolytes and liver function tests. One patient from each group developed renal impairment. Two patients from group A and 3 from group B developed asymptomatic hyponatermia. One patient from group A died due to hepatic encephalopathy during paracenthesis. Conclusion: Intravenous albumin infusion is not necessary during large volume paracenthesis for treatment of tense ascites in cirrhotic patients.

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Clostridium difficile toxin was checked in fecal extract of 62 ulcerative colitis patients and 62 normal controls, by Elisa and cell culture methods. Clostridium difficile toxin was found in 48.71 percent of ulcerative colitis patients in their acute exacerbations, and in 26.08 percent of cases in their remissions. This toxin was found in the fecal extract of only 3 percent of normal controls. Chi-2 analysis showed that the differences between normal individuals and patients with ulcerative colitis were significant (P<0.001), but these differences between two groups of ulcerative colitis patients either with exacerbations or in remission were not significant (P>0.05).

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Introduction: The regulation of neuroendocrine axis is one of the most important goals in the treatment of Rheumatoid Arthritis. Disease modifying drugs such as chloroquine with low dose steroid is the first choice in clinical practice by some physicians. This combination therapy is evaluated by this study. Methods: This survey is a prospective study on furty patients. Variables for determining the activity index of disease were joint tenderness, joint swelling, morning stiffness and erythrocytes sedimentation rate in two years follow up. Results: Decrementation of disease activity index was statistically significant before and after treatment, joint tenderness (X²=7.205, P=0.007), morning stiffness (X²=19.253, P=0.00001), joint swelling (X²=14.107, P=0.0001), ESR (T=2.428, P=0.02). Conclusion: The combination of chloroquine with low dose steroid is beneficial in the treatment of Rheumatoid arthritis