Tehran University Medical Journal

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325 female students of Zahedan at the average age of 16.2 years old (16-22) were randomly selected to study the prevalence of iron deficiency anemia. Hb, hematocrit, MCV, MCHC, iron, TIBC and ferritin were measured. Results showed that in the population studied 3.4%, 27.7%, 4.3%, 11.7%, 25.5%, 11.4% had their Hb, MCV, serum iron, tranferrin saturation, ferritin respectively below the WHO standards. The correlation coefficient between Hb, MCV and hematocrit, serum iron was r=0.54, P<0.00001, r=0.38, P<0.00001 respectively. Also the correlation coefficient between transferring saturation, serum iron and ferrin was r=0.94, P<0.00001, r=0.31, P<0.00001 respectively. Our study shows that hematological and biochemical markers of iron status of the young Zahedan girls at puberty are lower than WHO standards and these girls might be at risk of iron deficiency anemia.

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In this research anxiety and depression and their association with 32 different factors in students of Hamedan University of Medical Sciences were measured. Levels of anxiety and depression were assessed by State-Trait Anxiety Inventory (from 2, Trait) and Beck Depression Inventory. A questionnaire made of demographic data, educational and noneducational activities, the presence of medical or psychiatric disorders (over last year) and students' feelings about relationships with their parents as well as educational and financial matters was given to the subjects. Seventy percent of all of the university students completed the two inventories plus questionnaire. Twenty-one percent had a number of 18 or more (the cut-off point for depression) in Beck inventory and 33.4% had a number of 51 or more (the cut off point for anxiety) in State-Trait Anxiety Inventory (from 2, Trait). Differents levels of depression and anxiety and associated variables in each group were determined and discussed.

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Disodium hemiphthalate Glycyrrhetinic acid (DHGA) possesses anti-inflammatory and analgestic activities. In our research, this agent was injected intraperitoneally to mice, according to the following schedule.
1) 25 mg/kg, 50mg/kg & 75mg/kg at 7th day of pregnancy.
2) 50 mg/kg & 75mg/kg at 8th day of pregnancy.
3) 50mg/kg & 75mg/kg at 9th day of pregnancy.
DHGA with doses of 50mg/kg and 75mg/kg at 7th, 8th and 9th day, delays the growth, decreases developing of ossification centers (specially in hand and foot middle phalanxes), decreases the number of caudal vertebrae of sacro-illiac joint and results in slight but important increases in fetus mortality.
Abbreviations
H & E=Haematoxylin & Eosin
CRL=Crown-Rump Length
BPD=Biparietal Diameter
W=Weight
ETS=Embryo Toxicity Score

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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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Between 270 patients complaining of symptoms of vaginitis, bacterial vaginosis was diagnosed in 68 women (%25) based on at least three of four criteria: 1. Homogenous vaginal discharge 2. Positive amine test 3. pH more than 4.5 4. Clue cell in wet smear. The results were compared to 55 normal controls.
Clue cell with more than %20 of epithelial cells was seen in %87 of cases and %5.5 of controls. A pH more than 4.5 showed the greatest sensitivity (%100) and the smallest specificity (%47). The most frequent complaints included increased discharge, bad odor, and sensing bad odor after coitus.

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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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Mullerian anomalies are one of the interesting but uncommon entities that gynecologists confront. The incidence is 1-6%, It is difficult to" anticipate the real incidence, because most of information is obtained from infertile or complicated patients with inadequate work-up. Recently endoscopic pocedures reveal more details about these anomalies. Today, classification of Buttram & Gibbons (modified by AFS [American Fertility Society]) is accepted. In this paper one patient with septate uterus, duplication of cervix and vaginal septum is introduced. According to information obtained, only one similar case is reported (by McBean et al). This entity is not conformed with AFS classification. Only in Toaff et al classification, there is a class similar to these patients. This entity is not explained by classic embryological theory of mullerian development

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Mycosis Fungoides (MF) is a cutaneous T-cell lymphoma (2,5). Alopecia is rarely seen in this disease, and the reported cases are in the form of follicular mucinosis (1,2,4). In this case report a patient is presented whose lesions all showed alopecia without mucinosis. Furthermore there was a patch of alopecia without any epidermal changes, which was clinicaly identical with alopecia areata, and histologically identical with MF. After six months of treatment there is regrowth of almost normal hair on all of the lesions

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Tuberculoma is one of the Causes of the space occupying lesions in brain. Its manifestations can mimic many diseases such as tumor, vasculitis, and multiple sclerosis.
A Patient with brain tuberculoma secondary to epidymitis is reported. His symptoms and signs were very
similar to the patients with multiple sclerosis. The physicians must keep in mind this disease in the differential
diagnosis with many disorders especially multiple sclerosis

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Migraine as one of the most common types of headaches with high intensity and prevalence, affects life significantly. This study was devised to determine the effects of migraine on economic status and life quality of Iranian surffcres.
"Pain database questionnaire", prepared by the International Association for the Study of Pain (IASP) in the year 1995, was translated to Farsi. Then we modified it regaiding cultural, geographical and social characteristics of Iran. 65 patients (55 women and 10 men) were recruited form neurology clinic consultants. Those patients who met the International Headache Society. (IHS) criteria for migraine, were interviewed using IASP questionnaire. Pain effects on sleep, marital life, social, recreational and sexual activities, quality and quantity of drug consumption as well as using paraclinic procedures were considered.
Significant decrease in sleep duration was seen during pain (7.4 ± 1.9 h) compared to pain-free conditions (6 ± 3.7 h) (P < 0.001). The effects of pain on marital life, social, recrealtional and sexual activities during pain were compared with pain-free conditions based on a zero to ten ranking schedule,. Wilcoxone test showed statistically significant (P < 0.02) differences.
We concluded that the economic effect of migraine and its impact on patients' quality of life are significant and should be considered in health planning and disease management

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In this study, it has been observed that the natural similarity of the blood flow to both kidneys, despite the differences of length of the right and left Renal arteries, is due to the angle of distribution of these arteries. This angle has been determined to be of 66.7 degrees for the Left Renal Artery and only 51.5 degrees for the Right Renal Artery, in their normal anatomical aspects.

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The effect of some anthropometric factors and loading on paravertebral muscles was tested in this study. Thirty two healthy men with mean age of 25.25 years participated in this study. They didn't have history of low back pain since 12 months ago. The effect of weight, height, upper limb length, abdominal & chest circumference and upper body height and other factors e.g. body mass and functional capacity indexes on maximum isometric torque of paravertebral muscles and spinal range of motion in all planes of movement and effect of loading with 0, 5, 10, 15 kg loads on paravertebral factors e.g. dynamic torque, velocity, work, power, and slope of torque was examined with a dynamometer named ISOSTATION B-200. Correlation, analysis of variance and t-test was used in SPSS program. Results show that maximum isometric torque and functional capacity index increased with increasing weight abdominal and chest circumference and body mass index (P<0.05). Height, upper body height and upper limb length don't have effects on this factors, and anthropometric factors don't have effects on range of motion. Maximum dynamic torque, maximum velocity, work and power were significantly increased and time of movement & slope of torque were significantly decreased while load increased (P<0.05). This study showed that load-velocity relationship in limb muscles can not help the paravertebral muscles studies because paravertebral muscles histologically differ from limb muscles.

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Wastewaters are one of the most important sources for transmission of pathogenic agents in environment, so they should be disinfected in a manner that their overall qualities become accordant with WHO-guidelines, if it is needed to reus water correctly. Unfortunately, the protozoa and parasitic worm's eggs can not be destroyed by chlorination alone. This experiment was carried out in order to determine the efficiency of the UV-Lamps in inactivation of the Ascaris Lumbericoides-ova which is the most resultant organism among the other nematode eggs. The minimum inhibitory dose of UVR (UVC plus UVB irradiances) for Ascaris-ova complete destruction ascertained to be 420 miliwatts-seconds per square centimeter.

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Post partum haemorrhage (PPH) and retained placenta are the most common serious abnormalities encountered during the third stage of labour. PPH is one of the most common causes of mortality in childbirth, particularly in developing countries. The incidences of PPH and retained placenta have decreased with the use of synthetic oxytocin and controlled cord traction (CCT). Weather such treatment is valuable is open to question because of the lack of clinical and physiological studies. Unfortunately, oxytocic drugs are not available to about half the women of developing countries, who do not deliver under the care of a trained midwife. We know that sucking stimulates uterine contractions in lactating women. This effect is probably mediated by the high plasma oxytocin levels that occur during preparations for breast-feeding and again within 3 min of the start of sucking. Traditional birth attendants (TBAs) do not have the skill to administer injectable oxytoxics. It has become the practice in some TBA training programmes to teach that the risk of PPH can be reduced if the mother puts her baby to the breast immediately after delivery. Objective: To determine the effect of sucking immediately after childbirth on the length of 3rh stage and amount of bleeding in the first day. This is a semi-experimental study. It was done in Tehran'e Mirzakochak hospital. 100 women received oxytocin intramuscularly and 120 women were placed in sucking group. Then the lenghth of 3rd stage and amount of bleeding in the first day was compared between two groups. Results: The duration of the third stage and number of pads different between oxytocin group and sucking group (4.42 vs 6.08 min) and (10.58 vs 11.72 number). As for the, parity, gestational age, maternal systolic and diastolic blood pressure, infant weight and hight, the results showed no significant difference between the groups. As for the, maternal age, the results showed differed significantly between the groups. As for the gestational age, the results of the research showed that between the gestational age and the duration of the third stage, there was a reverse correlation in multipare women. So when gestational age decreases the duration of third stage will be longer. As for the maternal age, parity, systolic and diastolic blood pressure, infant weight, infant hight, infant sex, the results showed that there was no correlation between these and the duration of the third stage.

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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 order to compare the new generation of oral contraceptive pills containing Norgestimate (NGM) with currently available pills containing levonorgestrel (LNG) a clinical trial was conducted. 413 women (age 18-35 years) with no contrainindication to pill use entered the study and randomly received one type of pills. Premenstrual syndrome and depression were significantly decreased in NGM group (P=0.00016, P=0.005), on the other hand, breast tenderness, mood changes and hair loss were significantly increased in LNG group (P=0.001, P=0.042, P=0.011). Comparing two groups with each other, following variables were significantly lower in NGM group: headache (P<0.05), vertigo (P<0.05), cloasma (P<0.05), acne (P<0.04), depression (P<0.05), appetite change (P<0.03). Overall patient satisfaction was similar in two groups.

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During one year survey, 77 psoriatic patients were hospitalized in the dermatology department of Razi Hospital. This comprised 19% of admitted patients in this period. 29% (n=22) of psoriatic patients had previous history of hospitalization. On admission, the mean age of patients was 32.8 years, the mean and peak age of disease onset were 26.46 and between 11-20 years, respectively. 14% (n=10) of the patients had a family history of psoriasis and 70% (n=7) of those with a positive family history had their age of onset under 20 years. Involvement of different regions was as follows: Scalp: 88% (n=68), nails: 53% (n=41) and joints (arthritis): 10% (n=8). Psoriasis was associated with scrotal tongue in 19% (n=13) and with geographic tongue in 10% (n=8) of patients. Regarding the medical treatment, the drugs which were used most frequently were tigason in 34% (n=41) and ditranol in 22% (n=26) of the cases. The mean duration of hospitalization was 39.29 days and most patients were discharged from the hospital in a good condition without any serious complication. During this period 9% of patients had a relapse of their disease.

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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.