Tehran University Medical Journal

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In this research 20 specimen from human whole milk and whey were studied with respect to lipoproteins, cholesterol and triglycerides, 2-8 months after parturition. The whey was separated by means of ultracentri fugation. Also the 24 hour diet history was recorded. The average lipoprotein components in normal human milk were, chylomicron 16.19%±11.98%, beta lipoprotein 36.71%±9.33%, pre beta-lipoprotein 8.61%±3.03% and alpha lipoprotein 38.49%±9.97%. These components were also measured in whey and the results were as follows: chylomicron 6.91%±1.55%, beta lipoprotein 47.32%±10.5%, pre beta lipoprotein 11.48%±4.4% and alpha lipoprotein 33.87%±7.84%. The percent average of the total lipoprotein content and its free forms were estimated in human milk. The average percent chylomicron content was 6.48%±1.43%, beta lipoprotein 33.85%±13.1%, pre beta lipoprotein 12.88%±2.78% and alpha lipoprotein was 47.25%±10.63%. The average ratio of alpha to beta lipoprotein (HDL/LDL) in human milk was found to be 1.10±0.51. Thus, we conclude that breast-feeding can be considered as a potential preventive factor against future cardiovascular diseases.

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We studied the effect of the selective alha-2 adrenoceptor blocker idazoxan and precursor serotonin (5-HTP) on anxiety-related behavior in rats. The conflict drinking test, and evaluator plus-maze were used as model. Idazoxan (2 mg/kg) showed an anticonflict effect, having doses dependently increased the number of punished lickes. 5-HTP showed that anxiolytic-like effect in both models. This drug reversed action and produced anxiogenic-like effect at high doses. In contrast, arecholine which is a cholinergic muscarinic agonist drug, produced anxiogenic-like behavior. At 2 mg/kg increased number of entrance (OE) and using time (OT) in open arms in montgomery's test. Anxiolytic-like effect of this drug was less than of chlordizepoxide. These results showed that increase release of noradrenaline in synaptic nerve terminals of neurons produced anxiety-related behavior. While high release of serotonin in this area reduced behaviors disorder in rats.

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In a descriptive study on 791 cases of normal vaginal deliveries within the period of 6 months (20th Sept 1994-20th March 1995) in Shariatti hospital, the duration of active phase of labor was evaluated. In 140 pregnant women (69 primigravida and 71 multipara) which had the inclusion criteria (single fetus, cephalic presentation, 37 to 42 weeks of pregnancy, admission before cervical dilatation of 3-4 cm, no need for augmentation of labor, forceps-vaccum or cesarean section) the mean duration for 1st stage was 2.31 hrs in primigravid and 1.56 hrs in multipara, for 2nd stage was 35 minutes in primigravid and 17.5 minutes in multipara. Maternal age, parity and fetal birth weight had influence on the duration of labor. Maternal age and parity each had independent and also additive effects on the duration of labor. Fetal birth weight of >3500 gr in multipara and >4000 gr in primipara caused lengthening of the duration of labor.

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Dysplasia Epipysealis Hemimelica (DEH) is a rare disease, prevalence is one in 1000000. The incidence is unknown. Its characteristics is abnormal cartilage growth accompanied by ossification of cartilages of epiphyses of long bones, bones of foot ankle and wrist. A hereditary or familial factor hasn't yet been known. Occurrence in males is three times more than females. Our case is a girl observed from 7 months of age to 5 years. The progression of disease and symptoms are reported. Other names of the disease are: Tarsomegaly, Tarsoephiphyseal Aclasis, Trevor's Disease, Benign Epiphyseal Osteochondroma.

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A cross-sectional study was conducted on type II diabetic patients during 1991-1996 in Isfahan. By systemic sampling, 715 patients were enrolled. Variables studied, include: age, gender, duration of diabetes, body mass index (BMI), literacy, smoking habits, hypertension, lipid profiles, fasting blood glucose (FBS), retinopathy, ischaemic heart disease (IHD), proteinuria and type of treatment of diabetes. Prevalence of IHD in males (37.4%) was more than females (32.6%). Logistic regression analysis revealed a direct association between IHD prevalence with age, BMI, hypertension, proteinuria, diabetic retinopathy and type of treatment. Conclusions: 1) The factors mentiond are good predictors of IHD, but genetic influences may also contribute to the risk of IHD. 2) As obesity and BMI are prone to medical manipulation, control of these risk factors may decrease prevalence of IHD.

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The culture results of 203 cases with different wounds were studies 150 of the latter were burn cases (mainly second and third degree burns), and 53 were of other types (surgical, traumatic, ect). Four subtypes of Bacillus cereus were isolated upon culture, and the different toxins produced in DHT broth with 0.1% glucose were assessed. The lethal toxin was injected intravenously to Syrian rats, none of whom died. VPR factor was assessed in the 4 subtypes. Three subtypes produced VPR in significant amounts.

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Only orchiectomy is still commonly used today either as a single therapy or in combination regimens. Hypophysectomy & adrenalectomy showed such devastating effects on the endocrine equilibrium as to be inconsistent with an acceptable quality of life or even with survival. Chemical adrenalectomy was also tried with drugs (eg. aminoglutethmide, spironolactone) leading to consequences superimposable to those of surgical adrenalectomy. Along with orchiectomy, three groups of substances are commonly used today for the hormonal therapy of prostate cancer: estrogens, LHRH agonists & anti androgens. Bilateral orchiectomy removes 90-95% of circulating testosterone. Clinical studies document 60-80% of positive responders to castration, on continued evaluation, relapse occurs usually within 6-24 months in responders, with a death rate of 50% within 6 months. The androgenic activity still remaining after castration may explain the partial & progressively decreasing effectiveness of this & other testosterone reducing therapies. Antiandrogens define substances that act directly at the target site, where interacting with steroid hormone receptors, they impede the binding of androgens. A trend towards the combination of testosterone-reducing & androgen-blocking treatment is developing in modern therapy of prostate cancer. This is due to the complementary characteristics of the two different pharmacological mechanisms that are involved. In this study castration+antiandrogen is compared to castration alone. The results demonstrate a significantly greater percentage of positive objective & subjective responses with antiandrogen than with placebo. In addition survival time was increased in patients treated with castration+antiandrogen than castration+placebo.

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Sixty-nine children with phenylketonuria (PKU) under coverage of Tehran Genetic Research and
Consultation Center, fed Lofenalac and Phenylfree were studied. The 24-hour dietary recall method was used
to determine food intake and blood samples were analyzed for iron parameters. The results showed that over
7% of the children had a low intake of energy, protein and iron. In addition, hemoglobin and hematocrit were
lower than normal in 3.1% of the children, while in 24.2% of them there was decreased serum transferrin
saturation percent. There was a statistically significant relationship between lenght of diet therapy and iron
parameters. The findings show that inadequate nutrient intakes may, over time, cause appearance of anemia signs in the children with PKU dependent on special formulations

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We evaluated the power of pregnant women's neutrophils in releasing the oxidant substances (such as H202, superoxide, ...) in the presence of luminol. In the presence of luminol these substances will emit light and we measured this light by a luminometer (chemiluminescence technicque). Baker's yeast was used for neutrophil activation.
This study includes 45 pregnant women (mean age = 30.7 years) and 20 controls (mean age 31.8 years).
Results : 1-the mean of maximum light in p.w (N-CL in p.w) was 209.1 mv (milivolt) and in controls 152.6 mv.
2-the mean of maximum time for N-CL in p.w is 10.3 min and in control 11.1 min.
We observed that N-CL (power of phagocytosis) in p.w increased (P< 0.01) but the time didn't.

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Staphyloccus aureus is one of the most important causes of nosocomial infections. In order to investigate the S. sureus colonization rate, 378 samples were taken from the nose and. throat of staffs of 4 university hospitals in Kerman.
The control group consists of the same number of people with similar age and sex distribution. Seventy three hospitalized paients were also tested in this respect. The prevalence of nasal colonization of S. aureus was 33% in the control group, 36.8% in the staffs and 38.4% in the patients (the differences were not statistically significant). Throat colonization were seen in 12.4%, 25% and 22%, in the control group, staff and patients, respectively.
In the staff and control groups, the rate of throat colonization was lower than the nasal colonization (P<0.0001). Also the throat carriage rate in the patients and staffs was higher than that of the control group (P=0.002).
No statistically significant difference was obsered between the distribution of age and the carriage rate of S. aureus.
In males 42% and in females 30.5% were nasal carrier of S. aureus, and the difference was statistically significant (P = 0.0005).
The rate of S. aureus colonization in the nose and throat (at the same time) in the males was twice the rate of colonization in females (P=0.00025).
No statistically significant difference was observed with respect to working department, or the type of work performed by staff and S. aureus carriage rate.
Higher rate of throat colonization in the patients and the staff of the hospitals over that of the control group, indicates the need for more preventive and control measurements with respect to nosocomial infection of the S. aureus

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SCL-90-R-scale was used to asses 1184 enrolled medical colleges students, Tehran University of Medical Sciences and Health Services. Out of nine orthogonal symptome dimensions of the instrument, paranoid ideation, interpersonal sensitivity and obsessive complusive were the most frequent in the study.
Difference between males and females was significant in depression, anxiety and phobic anxiety dimensions. Mean psychopathological dimensions in students with GPA lower than 14 were detected to be more significant than others

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This survey, evaluated the level of awareness and knowledge among the medical staff about conditions and methods of performing cardiopulmonary ressucitation. The study sampling comprised 497 subjects including 208 residents and 262 interns of ten university hospitals in Tehran. In regard to the basic principles, this has been 43.54% (SD = 13.36%), in drug and fluid therapy 31.22% (GD = 13.22%), in electroshock 43.6% (SD=21.12%), in appropriate approach to the problem 34.73% (SD=13.42%) and in complications of CPR 17.7% (SD = 15.25%). Considering the results of the project, the medical staff have insufficient knowledge of CPR md it does not improve significantly during internship and residency period. Therefore, there is a great necessity for the medical students to attend basic and advanced CPR courses during their study

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With the intention of research of various methods of epithelial tissue culture we've studied five French Albino rabbits with an average of 8 weeks. In order to evaluate and control growth and proliferation of autologus cultured tissue samples were obtained on 1st, 5th and 8th days. After fixation of these samples and passing them through various processes, histologic sections were prepared. These sections were stained with H-E and studied by light microscope, we succeeded in developing the original donor surface by 18 times.

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Regarding the importance of cardiovascular disease in the health of societies, Hyperlipidemia is considered as an important risk factor. One of the case recently put forward in the fat profile, is high TG (triglycerides) and low HDL-C (High Density Lipoprotein). Nowadays, we believe that TG without the presence of low HDL-C is not considered as a risk factor for cardiovascular disease. So it was decided to perform a descriptive study to define the prevalence of this syndrom, like other risk factors, in urban population of Isfahan. Samples were selected by random sampling method and the sample size, to have reliability of 95%, was about 1200 from the people over 20 year old in 6 age groups and 2 sexes. After inviting the people while going fast (about 14 hours), a questionnaire including perfect identifications was filled and blood factors include total cholesterol, TG, LDL-C (LOW Density Lipoprotein), HDL-C and F.B.S (Fasting Blood Sugar) were measured. Then the statistical analyzing of data was done to define the relation between TG and HDL-C. Regarding the coefficient of correlation and P.value <0.05 in different age and sex groups (except over 70 years old group which was not significant) was defined that TG has an inverse relation to HDL-C and the prevalence in the urban population of Isfahan is 19.7%. Results got from studying the relation between TG serum level and high LDL/HDL fraction (equal or more than five) showed that the more TG gets, the more the fraction is and regarding to its prevalence (11.6%) in Isfahan. It can be a risk factor for cardiovascular disease. So regarding the high prevalence of High TG and low HDL-C syndrome, treating this syndrome can be considered as one of the primary prevention methods. To fufil the latter goal firstly the syndrome must be identified and the related patients must be treated. So the patients with high TG must be tested for HDL-C and LDL-C too. And secondly therapeutic actions to increase HDL-C and to decrease TG level must be done.

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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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AV-node modification by catheter RF energy delivery is treatment of choice in the symptomatic patients with AVNRT. This study included 30 patients with AVNRT (19 women, 11 men). We did slow pathway ablation in 29 cases successfully. Maximum effective energy delivery was 40 watts for 40 msec. 1:1 AV conduction increased from 290±40 msec before ablation to 340±65 msec after ablation. Also AV-node ERP increased from 235±35 msec before ablation to 280±65 msec after that. There was no recurrence of arrhythmia in the group with slow pathway ablation during 28 months follow-up. We did fast pathway ablation in one case. In this patient AH interval increased from 120 to 200 msec, maximum RF energy delivery was 20 watts for 20 msec (2 times). Recurrence of non sustained PSVT occurred in this patients 20 months after RF ablation. There was no case of permanent AV Block. We recommond slow pathway catheter RF ablation in patients with symptomatic AVNRT.

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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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259 consecutive colposcopic examinations were done at colposcopic unit in Shariati Hospital during 1995-97. 58 cases were omitted due to lack of biopsy report. There were 167 cases of concordance and 34 cases of discordance between results of pap test colposcopic directed biopsy in these cases. We evaluated the value of pap test as a screening test versus colposcopic directed biopsy and found sensitivity of 42.4%, specificity of 94%, PPV (Positive predictive value) of 60.8%, and NPV (Negative predictive value) of 89.3%, false nagative and false positive rates were 57.8% and 5.3%, respectively. If pap test and HPV DNA screening were done simultaneously, almost all invasive cancer and HiSIL would be detected

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To determine circumcision prevalence and complications in under 5 year old boys. We assessed 181 boys in a cross sectional study at a rutal area in Tehran suburbs, in Jan 1997. Data were collected by an interview about age, circumcision age and method, type of complications, nationality and parent literacy. 126 boys (69%) were circumcised, (mean 12 months). Only 27 of them (21.4%) were circumcised in neonatal period. 62 boys (49.2%) were circumcised with ring methods (plastibell or clamp), 54 boys (42.9%) with surgical methods and the others (7.9%) with nonmendical methods (traditional). Complications were 9.5% (16) and the higher circumcision age was related significantly with higher complications (P<0.04). In our study was no complication in the boys who circumcised under six months. Complications prevalence were high (9.5%). In neonatal period 34% (9) and in postneonatal period 53% (52) of boys were circumcised with inappropriate methods with age. The most common complications were local infection (43%)