Showing 129 results for روی
Ghasemi A, Jahanlou A, Hamdi K, Rezaei A,
Volume 69, Issue 4 (7-2011)
Abstract
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Background: Intrauterine insemination (IUI) is a less expensive
and less invasive treatment in comparison with other assisted reproductive
techniques, and it has been widely used for a variety of indications as well as
in the treatment of couples with infertility. The outcome of IUI
may be affected by numerous factors but in this study, we evaluated the effects
of cervical mucus removal undertaken before IUI
on clinical pregnancy rates.
Methods : In this randomized clinical trial study, all infertile women who were
candidates for IUI and attended Shahid
Akbar Abadi Hospital during 2009 and 2010
were recruited. The participants were randomly assigned into two groups. Cervical
mucus was removed prior to IUI in patients in group
A but in group B,
a classic IUI was done without removing
the cervical mucus. Pregnancy rates were assessed in the two groups by serum
levels of β-HCG
and detection of fetus in the uterus.
Results : 291 women including 143
in the classic IUI group and 148
in cervical mucus removal group completed the study. The pregnancy rates were 14.2%
(21 pregnancies upon 148
cycles) in the cervical mucus removal group and 7% (10
pregnancies upon 143 cycles) in the
control group (P=0.04, OR: 2.199 CI 95%: 0.997-4.85).
Conclusion: The
findings showed that cervical mucus removal could result in a two-fold increase
in pregnancy rate in comparison with classic IUI.
Thus, we suggest this practical and noninvasive method to improve pregnancy
rate in these patients.
Noori Daloii Mr, Maheronnaghsh R, Sayyah Mk,
Volume 69, Issue 6 (9-2011)
Abstract
Background: With approximately 386,000 deaths per year, esophageal cancer is the 6th most common cause of death due to cancer in the world. This cancer, like any other cancer, is the outcome of genetic alterations or environmental factors such as tobacco smoke and gastro-esophageal reflux. Tobacco smoking is a major etiologic factor for esophageal squamous cell carcinoma in western countries, and it increases the risk by approximately 3 to 5 folds. Chronic gastro-esophageal reflux usually leads to the replacement of squamous mucosa by intestinal-type Barrett’s metaplastic mucosa which is considered the most important factor causing esophageal adenocarcinoma. In contrast to esophageal adenocarcinoma, different risk factors and mechanisms, such as mutations in oncogenes and tumor suppressor genes, play an important role in causing esophageal squamous cell carcinoma. Molecular studies on esophageal cancers have revealed frequent genetic abnormalities in esophageal squamous cell carcinoma and adenocarcinoma, including altered expression of p53, p16, cyclin D1, EGFR, E-cadherin, COX-2, iNOS, RARs, Rb, hTERT, p21, APC, c-MYC, VEGF, TGT-α and NF-κB. Many studies have focused on the role of different polymorphisms such as aldehyde dehydrogenase 2 and alcohol dehydrogenase 2 in causing esophageal cancer. Different agents including bestatin, curcumin, black raspberries, 5-lipoxygenase (LOX) and COX-2 inhibitors have been found to play a role in inhibiting esophageal carcinogenesis. Different gene therapy approaches including p53 and p21WAF1 replacement gene therapies and therapy by suicide genes have also been experimented. Moreover, efforts have been made to use nanotechnology and aptamer technology in this regard.
Niroomanesh Sh, Dadashaliha M, Akrami M,
Volume 69, Issue 7 (10-2011)
Abstract
Background: Uterine contractions and an appropriate cervix are two important factors in labor contributing to good pregnancy outcomes. Oxytocin and prostaglandins, such as misoprostol, are used for the induction of labor. Misoprostol is used for cervical ripening and labor induction. The aim of this trial was to compare the efficacy and safety of titrated oral misoprostol solution with oxytocin for labor induction in pregnant women with an unfavorable cervix.
Methods: In this randomized double-blind clinical trial, 140 women with a gestational age of 34-42 weeks and an unfavorable cervix were recruited. The participants had an indication for labor induction and had been referred to the Women's Hospital in Tehran, Iran between January 2010 and January 2011. The participants were randomly assigned to receive 20 µg/hour titrated oral misoprostol plus intravenous placebo or 6 mU/min oxytocin plus oral placebo. In case contractions were inadequate, the drug doses were gradually increased. Pharmacological complications, the mean interval from the start of induction till vaginal delivery and delivery type were monitored and analyzed in both groups.
Results: The mean interval from the start of induction till vaginal delivery in misoprostol group was shorter than the oxytocin group (11.07±3.42 vs. 14.87±3.21 hours, P=0.001). The frequency of pharmacological complications and vaginal or cesarean deliveries were similar between the two groups (P>0.05).
Conclusion: Use of titrated oral misoprostol is a safe and effective method for labor induction in pregnant women with unfavorable cervix. Misoprostol is associated with a shorter interval from induction to vaginal delivery than oxytocin.
Sadegh Fazeli M, Safari S, Kazemeini A, Larti F, Joneidi E, Rahimi M, Meisami A,
Volume 69, Issue 8 (11-2011)
Abstract
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Background: Hemorrhoid
is among the most common anorectal diseases and patients with high-grade disease
conditions need surgical treatment. Many surgical procedures are available to
treat the disease. The aim of this study was to compare the operative time and
outcomes, (post-operative pain and complications) of LigaSure hemorrhoidectomy
with those of the open conventional method.
Methods : This randomized single-blind clinical trial included 57 patients (28 in LigaSure and 29 in the open group). The
primary variable was the operative time for the excision of a single
hemorrhoidal packet. The other variables were post-operative pain measured by
morphine doses administered to control pain, scores of visual analogue scale (VAS) used to measure pain severity,
pain during home stay measured by doses of oral ibuprofen and the mean daily VAS scores, early complications
including bleeding and urinary retention, longer-term complications and time to
return to work.
Results : The demographic data were comparatively the same between the two
groups. The average time to excise a single packet of hemorrhoid was
significantly shorter in the LigaSure group (8.91
min vs. 17.35 min, P<0.001). Post-operative pain
measurements (morphine doses and VAS scores) were lower in the LigaSure group, but the differences were
not statistically significant (P=0.055 and 0.077, respectively). Complications of the two procedures were also comparable.
Neither of the groups returned to work in a shorter time.
Conclusion: LigaSure
hemorrhoidectomy seems to be a safe method and it can reduce the operative time
significantly. It may also have a modest effect on post-operative pain.
Amouzegar Hashemi F, Hamed Akbari E, Kalaghchi B, Esmati E,
Volume 69, Issue 9 (12-2011)
Abstract
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Background: More than 80 years, the standard treatment of locally advanced cervical
cancer was radiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrent
cisplatin-based chemoradiotherapy is the current standard of treatment for this
disease. Gemcitabine has potent radiosensitizing properties in preclinical and
clinical trials, so it can be utilized simultaneously with radiation.
Methods: Thirty Women with untreated invasive
squamous-cell carcinoma of the cervix of stage IIB to stage IVA were enrolled in the study in
Radiation Oncology department of Imam Khomeini Hospital in Tehran from
September 2009 to September 2010. Sixty mg/m2 gemcitabine followed by 35 mg/m2 cisplatin were
concurrently administered with radiotherapy to the whole pelvic region on day
one of each treatment week for five weeks One and three months after treatment,
patients underwent a complete physical examination and MRI to determine the response to treatment.
Results: The mean age of the participants was 58.13±11.83 (29-78) years. After 3 months of treatment, 73.3%
had complete and 26.7% had partial response to treatment.
Grade 3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3
leukopenia in 10% of the patients.
Conclusion: According to the positive results of this study in
stage IIB,
further phase II
and III
clinical trials are suggested to evaluate the role of chemoradiation by
gemcitabine in advanced cervical cancers.
Pourghassem J, Mahoori A, Akhbari P,
Volume 69, Issue 10 (1-2012)
Abstract
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Background: Oral
metronidazole has been previously demonstrated to decrease postoperative pain
after open hemorrhoidectomy. The aim of this study was to evaluate the effect
of topical metronidazole in reducing postoperative pain of hemorrhoidectomy.
Methods : In this double-blind, clinical trial forty 20- to 40-year old male patients were scheduled for hemorrhoidectomy under
spinal anesthesia at the Imam Khomeini Hospital in Urmia, Iran from April to
September 2010. The participants were assigned to receive topical metronidazole (n=20) or placebo (n=20). Pain intensity was assessed
using
a visual analog scale (VAS), the time of first narcotic request and morphine administrations were also
recorded.
Results : The VAS scores were lower in metronidazole than the control group but this
difference was not statistically significant, except after 24 hr post-surgically. Morphine administration
in the first 24 hr was lower in the metronidazole group (P<0.05).
Conclusion: Although metronidazole
could not prolong the time of first analgesic request, but application of
metronidazole gel is associated with lower analgesic requirement.
Chapari H, Farokhi F, Delirezh N, Javadi Sh, Tanhaye Kalate Sabz F,
Volume 69, Issue 11 (2-2012)
Abstract
Background: The characteristic of stem cells in self renewal and differentiation to different types of cells has stimulated the interests for using stem cells as a starting material for generating insulin secreting cells. We've evaluated the differentiation potential of Programmable cells of monocytic origin (PCMOs) into insulin producing cells effected from the growth factors and fibroblasts conditioned media (FCM).
Methods: Peripheral blood monocytes of rat were cultured for 6 days in RPMI with 15% FBS, β- mercaptoethanol, MCSF and interleukin-3. Then, these cells were incubated in differentiation media with HGF, EGF, Nicotinamide, 15% fibroblasts conditioned media and glucose for 15days. Morphological differences of cells were studied by invert microscope. In several stages, the amounts of insulin in supernatant of cells were measured by radioimmunoassay kit. Also productions of insulin from differentiated cells were studied with DTZ special staining.
Results: In response to MCSF and IL-3, monocytes dedifferentiated. These programmable cells of monocytic origin (PCMOs) were capable of differentiating into insulin producing cells in differentiation media. The morphology of differentiated cells was similar to Beta cells and the amount of insulin in supernatant of differentiated cells was much higher than PCMOs (P<0.05).
Conclusion: HGF, EGF, Nicotinamide and fibroblasts conditioned media are differentiation factors of PCMOs into insulin producing cells. According to the results insulin producing cells can be differentiated from programmable cells of monocytic origin in presence of fibroblasts conditioned media.
Katiraee F, Khosravi Ar, Khalaj V, Hajiabdolbaghi M, Khaksar Aa, Rasoulinejad M,
Volume 70, Issue 2 (5-2012)
Abstract
Background: Oropharyngeal candidiasis and antifungal drug resistance are major problems in HIV positive patients. The increased reports of antifungal resistance and expanding therapeutic options prompted the determination of antifungal susceptibility profile of Candida species isolates in Iranian patients living with HIV/AIDS (PLWHA) in the present study.
Methods: One hundred fifty oral samples from Iranian HIV positive patients were obtained and cultured on CHROMagar and Sabouraud's dextrose agar. All isolates were identified according to assimilation profile, germ tube, colony color and other conventional methods. Disk diffusion testing and Broth Microdilution of six antifungal agents were performed according to the methods described in CLSI.
Results: Candida albicans (50.2%) was the most frequent isolated yeast, followed by C. glabrata (22%). Non-Candida albicans species were isolated from 71 (61%) positive cultures. 25.7% of Candida albicans isolates were resistant to fluconazole (MIC≥64 µg/ml) as were 21.9% and 16.4% to ketoconazole and clotrimazole (MIC>0.125 µg/ml), respectively. Resistance to polyene antifungals including amphotericin B and nystatin, and caspofungin were scarce. 57.7% of candida glabrata isolates were resistant to fluconazole, 31% to ketoconazole and 35% to clotrimazole.
Conclusion: Screening for antifungal resistant candida isolates by disk diffusion or broth dilution methods in clinical laboratories is an ideal surveillance measure in the management of oral thrush in patients with HIV/AIDS. Although nystatin is widely used in clinical practice for HIV positive patients, there was no evidence of enhanced resistance to it. Regarding no resistance to caspofungin, its administration is suggested.
Aalami S, Nikoui V, Irani M, Bakhtiarian A,
Volume 70, Issue 7 (10-2012)
Abstract
Background: There are conflicting reports about zinc, a trace element, in the pathogenesis of hypertension and other cardiovascular diseases. The aim of this study was to evaluate the role of zinc in high blood pressure.
Methods: We conducted this study on 80 patients with primary (idiopathic) hypertension and 80 normotensive people with similar age who attended to Tehran Heart Center between 2007 and 2008. We examined the effect of zinc concentration on blood pressure in both sexes in four age groups (41-50, 51-60, 61-70 and 71-80 years old). We measured plasma zinc concentration by atomic absorption.
Results: The mean plasma zinc concentrations were 0.456±0.04 µg/ml and 0.551±0.055 µg/ml in patients with hypertension and in normotensive people, respectively, (P≤0.05). Nevertheless, the mean plasma zinc concentrations were 0.494 µg/ml and 0.486 µg/ml in men with and without hypertension, respectively. The mean plasma zinc concentrations of women with and without hypertension, respectively were 0.415 µg/ml and 0.596 µg/ml, showing a significant difference between two groups (P≤0.001). Moreover, there was a significant difference in plasma zinc concentration between hypertensive and normotensive people in 51 to 60 years age group (P≤0.05), but difference were not significant between other age groups.
Conclusion: The results of this study revealed the relationship between the decrease in plasma zinc concentration and increase in blood pressure in women and in the men aged 51 to 60 years.
Talebi-Taher M, Latifnia M, Javad-Moosavai Sa, Adabi M, Rastgar Lari A, Fatahi Abdizadeh M, Babazadeh Sh,
Volume 70, Issue 9 (12-2012)
Abstract
Background: Ventilator associated pneumonia (VAP) is one of the serious complications of ventilatory support, occurring in ICUs. The aim of this study was to determine various risk factors associated with the acquisition of Acinetobacter infection and its antimicrobial susceptibility pattern.
Methods: This cross-sectional study was performed in the ICUs of Rasoul-e-Akram Hospital in Tehran, Iran during the year 2011. A total of 51 endobronchial aspirates from intubated patients who had been clinically diagnosed to have VAP were studied bacteriologically. The in vitro susceptibility was determined by disk-diffusion and broth microdilution MIC methods.
Results: Out of 51 patients with VAP, 35 (66.66%) had positive cultures for Acineto-bacter species. In vitro susceptibility test revealed that a high percentage of isolates were resistant to imipenem, piperacillin-tazobactam, third generation cephalosporines, and aminoglycosides.
Conclusion: The antimicrobial resistance of gram negative bacteria, particularly Acine-tobacter species, is increasing and preventive measures need to be taken as a matter of urgency.
Amanollahi A, Naghizadeh J, Khatibi A, Hollisaz Mt, Shamsoddini A, Saburi A,
Volume 70, Issue 10 (1-2013)
Abstract
Background: Stretching exercises and massage therapy are both suggested for pain relief in fibromyalgia syndrome. Previous studies have not proved their superiority over each other. This study compared the therapeutic effects of friction massage, stretching exercises, and analgesics on pain relief in patients with fibromyalgia syndrome.
Methods: We evaluated 129 female patients with the diagnosis of primary fibromyalgia visited at the physical medicine clinics of Baqiyatallah Hospital in Tehran, Iran during 2010- 2011. Patients were randomly divided into three groups: the first group received 400 mg ibuprofen P.O. (3 times per day) and 25 mg nortriptyline (daily) P.O. as analgesic, the second group was treated by friction massage and the third group performed stretching exercises. Patients were assessed three times (initially, after one and four weeks) by visual analogue scale (VAS).
Results: The mean age of participants was 60.46 years. The mean age in each treatment group was 46.66 years in medication group, 46.73 years in stretching group and 46.65 years in friction massage group. Changes in VAS score over 4 weeks were 2.4, 3.1 and 1.9, in the first, second, and third groups, respectively. The changes in VAS were significantly different in the first and second groups rather than the controls (P<0.05).
Conclusion: The effect of stretch exercise on pain relief was similar to analgesics, but it was more effective than friction massage. Moreover, the therapeutic effect of stretching exercise on pain relief upon four weeks was more permanent than friction massage but it was similar to analgesics.
Haeri H, Shaker Gh, Asadi Amoli F,
Volume 70, Issue 11 (2-2013)
Abstract
Background: Warthin tumor- like papillary carcinoma of thyroid is a rare variant of papillary thyroid carcinoma. It is characterized by distinct papillary structures lined by oncocytic tumor cells with nuclear features of papillary carcinoma and marked lymphoplasmocytic infiltrate in the papillary stalks. This tumor derives its name from its resemblance to Warthin tumor of major salivary glands.
Case presentation: We report a 54- year- old man presented with bilateral thyroid masses. Histopathological study showed papillary structures lined by cells with eosinophilic granular cytoplasm and ground- glass nuclei with lymphoplasmacytic infiltration of the stalks.
Conclusion: Warthin tumor-like papillary thyroid carcinoma could be mistaken for benign lymphoepithelial lesions such as Hashimoto thyroiditis, Hurthle cell tumors and tall cell variant of papillary carcinoma. Follow- up information on the previously reported cases has suggested that these tumors behave similarly to usual papillary carcinoma.
Yarandi F, Ahmadi Fs, Rezaei Z, Izadi N, Sarmadi S, Abbasi S, Aghaamoo Sh, Akrami M,
Volume 71, Issue 1 (4-2013)
Abstract
Background: Steroid cell tumor is one of the rare ovarian tumors and forms 0.1% of all ovarian tumors, divided to three subgroups. Steroid cell tumor that are not otherwise specified (NOS) are the most common type and represent 60% of steroid cell tumors. One of the most known signs of this tumor is hormonal function, especially androgenic effects of it. Primary treatment consists of eradication of tumor via surgery.
Case presentation: The patient is a 29 years old female with history of poly cystic ovarian syndrome since 10 years ago, who attended to the clinic of General Women Hospital of Tehran in January 2011. In pelvic ultrasonography, there was a 6449mm mass in the right adnexa consisting of homogeneous component. She underwent laparotomy and unilateral salpingoophorectomy was done. Pathological report was steroid cell tumor of ovary.
Conclusion: The aim of this study is reporting one of the rare tumors of ovary and assessment of the correct way of diagnosis and treatment of it.
Af Zand Parsa, N Gilani Larimi, A Esteghamati, M Motevalli,
Volume 71, Issue 2 (5-2013)
Abstract
Background: It has been shown that coronary artery calcium scoring (CACS) can be used as a diagnostic method in coronary artery disease (CAD). The relationship between CACS and calcium metabolism in the body has been shown. The arterial calcification is an organized process similar to bone formation which is controled by parathormone (PTH). The relationship between PTH as an osteoregulatory factor and CACS has been also indicated. In this study, we tried to assess the value of serum PTH and CACS in patients planned to undergo coronary angiography (CAG) in order to find a simple, cost -benefit, noninvasive way, for ruling in/out obstructive CAD.
Methods: In a cross sectional study in Imam Khomeini hospital in 1390, CACS by using non-enhanced multi detector computed tomography (MDCT) and measurement of serum level of PTH, Calcium and Phosphate were done in 178 patients suspected to CAD which were scheduled to undergo coronary angiography serum PTH was measured by immuno-radiometric assay (IRMA) and serum Ca and Phosphate were measured by spectrophotometry methods.
Results: Of 178 Patients, 50 patients were females and 126 patients were male. Mean age of them was 56.2±11.6. The correlation coefficient between CACS and Gensini score (0.507, P<0.001), PTH (0.037, P=0.693), Ca (0.062, P=0.499) and Phosphate (0.061, P=0.506) were obtained. The level of serum PTH in the patients with and without coronary artery disease were 21.8±11.6 pg/dl, 23.2±11.5 pg/dl (P=0.427) respectively.
Conclusion: Our study showed association between CACS and CAD that was statistically significant while no relationship was found between PTH, CACS and CAD.
A Mousavi, S Akhavan,
Volume 71, Issue 2 (5-2013)
Abstract
Background: Ovarian mucinous borderline tumors are divided into two morphologic groups: endocervical-like and intestinal type. Most endocervical adenocarcinomas exhibit mucinous and/or endometrioid differentiation, they infrequently metastasize to the ovaries but may simulate primary ovarian tumors (both atypical proliferative or borderline and carcinoma). In patients with mucinous adenocarcinoma in the abdominal cavity, caution should be exercised in interpreting the possible primary site of the tumor on the basis of the immunohistochemical profiles. The presence of human papillomavirus (HPV) DNA is assessed to determine whether the ovarian neoplasms were metastases or primary independent neoplasm. Approximately 90% of endocervical adenocarcinomas are related to high-risk human papillomavirus (hr-HPV) with the remainder being unrelated to HPV. Both types metastasize to the ovaries very infrequently. Ovarian endocervical-type (mullerian) mucinous tumors and tumors composed of a mixture of endocervical-type mucinous, serous endometrioid, squamous, and indifferent cells with abundant eosinophilic cytoplasm reported to date have been primarily limited to borderline and micro invasive types. We report a-36-yr old woman with adenocarcinomas of uterine cervix who also had ovarian mucinous borderline tumor.
Case presentation: The patient presented with abnormal uterine bleeding and lower abdominal pain. She had a history of uterine cervix polyps. Pelvic ultrasound showed a right adnexal mass and a large cervical size. Histological diagnosis in uterine cervix biopsy revealed adenocarcinoma of cervix. Radical hysterectomy type III with bilateral salpingo-oophorectomy was performed. Histological finding in adnexal mass revealed borderline mucinous tissue of ovarian tumor. Testing for HPV DNA in the tumoral tissue was negative. This confirms that the ovarian tumor is not metastatic from endocervical adenocarcinoma.
Conclusion: We conclude that in a patient with tumors that involve two organs, complete diagnostic investigation should be done to distinguish the primary origin. The factors that affect cell proliferation, can probably have synchronous effects on the two similar cells.
Farnaz Sohrabvand , Mohyeddinmahdi Shirazi , Mamak Shariat , Fatemeh Mahdiyin,
Volume 71, Issue 3 (6-2013)
Abstract
Background: We are in new era of knowledge and treatment of women with PCOS. We should find management modalities that can improve their life quality. Due to high prevalence of PCOS, and zinc deficiency in Iran, importance of antioxidants such as zinc on treatment and improvement of PCOS complications, and due to the disadvantages of the current treatment for the disease (i.e. OCPs), finding an efficient alternative therapy with no or less side effects seems to be as important as some methods for changing the life style of these women. This study was performed to assess zinc levels in PCOS versus non PCOS patients to determine if zinc can be helpful in PCOS management.
Methods: This is a case-control study which was performed from January 2012-2013 in 100 infertile women aged 20-45 years who were referred to Vali-e-Asr infertility clinic. Fifty patients had PCOS according to Rotterdam Criteria (case group) and 50 were infer-tile women without PCOS (control group). In both group, serum Zinc levels were deter-mined and the data was gathered using the SPSS software and analyzed by descriptive (percent, mean, standard deviation) and analytical 2, ANOVA, Mann-Whitney and Correlation).
Results: Results did not show a significant difference between case group and control group in respect to serum Zinc levels (P>0/05).
Conclusion: Due to no difference between case group and the control one in zinc levels, it seems that zinc supplementation in PCOS patients is not necessarily useful or of clinical importance. Obviously studies with larger sample size can probably define the role of zinc in these patients.
Reza Karbasi-Afshar , Reza Noroozian , Ayat Shahmari , Amin Saburi ,
Volume 71, Issue 3 (6-2013)
Abstract
Background: Sympathetic complex of over-activation kidneys is one of the main causes of primary hypertension (HTN). We aimed to assess the efficacy and safety of sympathectomy using 5Fr mariner catheter ablation on patients with refractory hypertension.
Methods: In this prospective cohort study, patients who received three or more anti-hypertensive medications with 160mmHg systolic blood pressure (BP) or more were randomly included and divided into 2 groups. Cases in the first group were undergone to renal denervation and the second group was treated by previous antihypertensive medications. Both groups were followed for six month by assessing BP and adverse effects.
Results: One hundred and seventeenth patients (54%) out of 212 screened patients were included in the first group (renal denervation) and 95 patients as the second group. The mean of BP changes in the first group was 35/15 mmHg with standard deviation of 22/11mmHg. (P<0.001) in the second group, the mean changes of BP was not statistically significant. (5/0mmHg± 22/11, P=0.79 for systolic BP and P=0.96 for diastolic BP). 92% of 117 patients in the first group had a favorable BP decrease, which was defined as a 20mmHg or more decrease in BP, in comparison with 15% of 95 patients as controls (P=0.001). There was no observed complication after denervation in the first group.
Conclusion: It seems that the sympathetic renal denervation can be an effective and safe method for treatment of refractory hypertensive patients indeed of routine medications although further studies with longer follow up duration and more cases are suggested for confirming this issue.
Farideh Keypour , Ilana Naghi ,
Volume 71, Issue 3 (6-2013)
Abstract
Background: Tubal sterilization is the permanent and effective contraception method. This can be performed at any time, but at least half are performed in conjunction with cesarean or vaginal delivery and are termed puerperal. The most complication after tubal ligation is ectopic pregnancy. Ectopic pregnancy is the leading cause of maternal death in first trimester.
Case presentation: We present a 33 years old woman gravida5, para4, all normal vaginal delivery, presented with complaints of delayed menstrual period, pelvic pain and spotting. She underwent tubal ligation for two times. For the first time she had puerperal Pomeroy tubal sterilization after third child delivery. Intra uterine pregnancy occurred three years later. One day after vaginal delivery of fourth child, she underwent post partum tubal ligation with the Parkland method. Tubal pregnancy occurred nine months later. Physical examination identified acute abdomen. Pelvic ultrasound showed no gestational sac in uterine cavity. The sac with fetal pole was in right adnexa. Beta-HCG was 2840mIU/ml. She underwent laparotomy. Surgical management included salpingectomy with cornual resection in both sides. The surgery identified Ectopic pregnancy.
Conclusion: Any symptoms of pregnancy in a woman after tubal ligation must be investigated an ectopic pregnancy should be excluded. Ectopic pregnancy must be considered, in any woman with lower abdominal pain, missed period and vaginal bleed-ing. Conception after tubal sterilization can be explained by fistula formation and re-canalization of fallopian tube.
Hassan Seirafi , Amirhooshang Ehsani , Mahbobeh Sadat Hosseini, Bahador Samavati , Fatemeh Gholamali , Pedram Noormohammadpour ,
Volume 71, Issue 4 (7-2013)
Abstract
Background: Alopecia areata (AA) is a common cause of noncicatricial alopecia that occurs as a patchy, confluent or diffuse pattern. Exact etiologic factor of AA not yet recognized. Among many hypothesis, relationship between AA and autoimmune disease, especially thyroid disorders, was more interesting. The objective of this study was to determine the prevalence of thyroid test disorders in the patients with alopecia totalis and universalis in comparison with normal population.
Methods: We analyzed medical records of 100 patients, including 44 male and 56 female in Tehran Razi Hospital from 1388 to 1389. The mean age was 24.1 years. Patients having totalis and universalis form of AA considered as case group while 100 normal person (42 male and 58 female with mean age of 26.1) who had not any form of AA considered as control group. Both groups had not any sign of thyroid disease at clinical examination according to their available medical records. Collected data were analyzed statistically in SPSS software 17th version.
Results: In the majority of patients (54%) the disease was manifested in the first two decades of life. History of atopia was seen in 9.8% of patient. Presence of the similar disease in first-degree family members was seen in 14.3% of patients. Abnormal T3, T4 and TSH were significantly higher in case group. Abnormal T3 uptake was higher in case group but not statistically significant.
Conclusion: Paraclinical thyroid disorders were significantly higher in the alopecia areata patients than in normal population. There was no significant association between the age, sex and duration of disease and presence thyroid dysfunction.
Shima Javadi Nia, Samileh Noorbakhsh , Anahita Izadi , Fahimeh Soheyli Pour , Azardokht Tabatabaei , Mohammad Reza Shokrollahi ,
Volume 71, Issue 4 (7-2013)
Abstract
Background: Urinary tract infection (UTI) is one of the most common infections in infants and children, especially in their first decade of life. These patients are more susceptible to renal scars and other possible complications like growth retardation, arterial hypertension, proteinuria, isostenuria, and finally chronic renal failure. Trace elements like vitamins and minerals are essential for efficient metabolism and proper function of various body systems namely immune system. In this trial we compared the relation between serum levels of zinc, vitamins A and D in children inflicted with UTI and control group.
Methods: This was a cross-sectional study on 25 patients with UTI admitted to pediatric wards of Rasul Akram Hospital and Bahrami Hospital. They were compared to 40 other patients admitted in surgical wards for elective surgery. Serum levels of zinc, vitamins A and D were measured in both groups.
Results: Seventy two percent of the patients were male and 28% female. The average age was 2.17. Despite the lower levels of vitamins A and D in cases than controls, the difference was not significant (P=0.4 and P=0.9, respectively). However, serum levels of zinc were significantly lower in cases than controls (P<0.05).
Conclusion: Vitamins A and D may play some role in patients’ vulnerability to UTI, but this supposition needs more research on larger samples, considering differences among patients of various age groups and their nutritional status.
According to the study, lower levels of zinc were associated with susceptibility to UTI thence, its administration might be helpful.
