Tehran University Medical Journal

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Hypertension is one of the most important modifiable risk factors of vascular heart disease. Control of hypertension in different age groups has a significant effect upon the control and prevention of vascular heart disease. A familial pattern is observed in the distribution of blood pressure in different societies. Family history of hypertension has a profound effect on the future risk of developing hypertension. The blood pressure of approximately 8150 inhabitants of Isfahan aged above 18 years was measured during 1993-94. Blood pressure measurements were performed according to the standards set by WHO i.e., on two separate occasions, in the sitting position, and from both arms. A questionnaire was completed consisting of 26 questions, including questions regarding history of hypertension in first and second-degree relatives. Cases with a blood pressure of 140/90 mmHg or more, were referred to the Cardiovascular Research Center of Isfahan for further evaluation. Mean systolic and diastolic blood pressure was higher in cases with a positive family history of hypertension. In this study, 37.4% of the men with hypertension and 45.4% of hypertensive women had positive history of hypertension in first-degree relatives. The association between positive family history and hypertension was not significant in men (P=0.62), but it was significant in women (P=0.000). This difference was less pronounced in the older age groups, which could be explained by the illiteracy of most of the older cases and their ignorance of the existence of hypertension in family members. After correcting for the effects of confounding factors, it appears that positive family history has a stronger association with the development of hypertension in women. Moreover, positive family history is a strong prognostic factor in the likelihood of hypertension in the children of affected cases. These findings emphasize the importance of routine blood pressure measurement in children and adolescents.

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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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Cystic Fibrosis (CF) is an inherited disease that affects multiple organ systems. It is the most common cause of severe progressive lung disease and exocrine panceratic insufficiency. In our investigation 67 patients had CF. Of these, 79% had panceratic insufficiency and 92% had lung disease under 2 years age. Also 67% of patients were < 2 percentile and 28% between 3-10 percentile weight for age. Unfortunately 27% of them died because of respiratory problems

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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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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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Diabetes Mellitus is one of the common diseases leading to dialysis. In a cohort study, diabetic dialysis patients were compared with non-diabetic dialysis patients for one year about age, sex, cause and times of admission and rate of mortality. The study was done on 101 patients. At the end of the study, 88 patients remained. Results were interprected by T-test and chi-square statistical analyses and signified with P value less than 5 percent. Results: Diabetes was the cause of 17.8 percent of renal failure in 101 patients. The mean age of diabetics was greater than non-diabetics (P=0.02). Mortality of diabetics in one year was 20 percent, similar to non-diabetics. Infection (chills and fever) was the most common cause of admission in diabetics (33 percent) and non-diabetics (25 percent) with no significant difference. Conclusion: Mortality and morbidity between diabetic and non-diabetic dialysis patients had no significant difference.

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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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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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S-J syndrome is a rare autosomal recessive disorder of short stature, blepharophimosis, puckerd mouth, myotonia, muscular weakness, pectus carinatum and stiff joints. Case report: first case: n.1. A boy aged 7 years. His main abnormalities included puckered lip, blephharophimosis, muscular hypertrophy and weakness, pectus carinatum, short stature, shoulder joint limitation and myopia. Myotonic discharges in EMG and muscular dystrophy in muscle biopsy observed. Hypoplasia of clavicle, generalized osteopenia, mild platyspondyly and delayed bone age were radiologic findings of this patient. Second case: A boy aged 8 years. His cardinal abnormalities were similar to case 1. Hip joint limitation, low set ear, anterior cortical opacity of lens, small testis and coxa valga were the other manifestations of this patient. Both patients have a normal IQ and parental consanguinity was also present. CBZ was used for both patients

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Tuberculos Gumma is one of the various clinical manifestations of cutaneous TB that is characterized by non tender, undolent subcutaneous nodules which progressively involve the skin and take the appearance of an ulcer. In this article, we present two young patients, affected with tuberculos gumma. One of them, presented with multiple abcesses on the face and extremities, associated with pulmonary involvement and arthritis of the left wrist. The other one had just one subcutaneous nodule on the face, with positive familial history of pulmonary TB and tuberculos lymphadenitis in her two brothers. Both patients were cured with anti TB treatments

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Congenital cyst of the pancreas is an uncommon problem in the pediatric patient. The common symptoms at the time of diagnosis have been abdominal mass and pain or fullness, nausea and vomiting. Despite of various paraclinic methods for diagnosis, ultrasound is now recognized as the most effective and best noninvasive method for diagnosis of pancreatic cyts. Surgical intervention is the best mode of therapy. Upper abdominal cystic mass are seen in the fetus and newborn infants. In Amirkabir Hospital, during 12 years from 1981 to 1993, 8 pancreatic cysts have been operated on and only in this case it was congenital.

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Some of ICU patients with Acute Renal Failure (ARF) require dialysis. Conventional or intermittent hemodialysis (HD) may cause hypotension and insufficient loss of fluids and toxins from blood. Peritoneal dialysis also my cause peritonitis and has lower efficiency than HD. We did continuous Venovenous Hemodialysis (CVVHD) for three ICU patients with ARF in Saint-Zahra Medical Center for the first time in our country. Method and Material: With a polysulfone membrane, blood pump, peritoneal dialysis solution, heparin, and a fix nurse, HD was done for 12-24 hours. Results: 1) Urea clearance was 18-50 ml/h. 2) Ultrafiltration was 160-1000 ml/h. 3) With dialysis, hemorrhage, coagulation disorder, and oxygenation recovered. 4) All of patients developed hyperglycemia and hypothermia. 5) All of patients died (two with septicemia and one with hypotension). Conclusion: In the absence of hemodialysis or peritoneal dialysis, CVVHD with present preliminary equipments is suitable and can excrete more toxins and fluids.

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The poll was designed to let the management system of the university know about the opinions, criticisms and suggestions of the faculty members and create a sense of cooperation and promote the level of relationships. In November and December 1997, short after the new Chancellor of the University was selected, the poll was conducted by the new board to reach the above goals. In this survey, all the faculty members of the University were questioned about the problems they faced in the University. A questionnaire of 23 questions in two pages was given to them and was returned by mail. About 47.5% of the questionnaire were returned. Analysis of the results showed that a significant majority (93%) of the respondents believed that Tehran University should be the best University of Medical Sciences in Iran, and that it dose have the capability to be so, however, a majority (66%) of them claimed that it is not so at the present. A significant majority of the respondents believed that education and research are the two most important duties of the University, and the health, treatment, and cultural duties rank next. Except for the Medicine and Health Faculties others were not satisfied with their status at the University. The satisfaction of the faculty members with educational and research performance of the faculties was questioned the results varied in different faculties. Dissatisfaction with research status was most obvious. Forty-six and 25 percent of the staff in the faculty of medicine were satisfied with educational and research performance of their faculty, respectively. The teaching staff were also questioned about their problems the most important of which was shown to be that of convenience. More than 90% of respondents stated that opinion poll is an appropriate way to relate the management of the University to the faculty members and emphasized on holding periodic sessions with the Chancellor of the University and personal visits to him.

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A retrospective study was conducted to investigate about breast cancer in Tehran from 1985 to 1995. All breast pathological records at five General District and Teaching Hospitals (18 general surgical wards) were reviewed and data were extracted. Overall, 3085 records were found (7291 female and 294 male). The final diagnosis was made for 2436 female records including 903 breast cancer (37.1%), 1430 benign breast disease (58.7%), 45 breast skin disease (1.8%) and 58 normal pathological report (2.4%). The dominant group age for breast cancer in women was age group of 40-49 years. The most frequent pathological stage was stage III. Breast cancer was also seen in 2.3 percent of women of 25 year old or younger. The diagnosis was also made for 278 men showing 32 breast cancer (11.5%), 23 benign breast disease (86%), 3 breast skin disease (1.1%) and 4 normal pathological report (1.4%). The results suggest that 3.5 percent of the overall breast cancer were men's, all having over 40 years of age with 60 years or older as the most frequent age. The most frequent pathological stage was stage III. The findings have some implications for public health professionals in terms of breast cancer screening in Iran.

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Our purpose was demographic clinical and pathological aspect of BCE in patients seen in Razi Hospital, during a six-month period (75.8.12 to 76.2.12). Results: From the total 20000 patients, 103 cases of BCE were detected. (0.5%). The male female ratio was 1.71 BCE was more frequent in sixth decade. 40.8% of patients were fair skin (Type II), 54.4% tawny (Type III) and 4.9% brown (Type IV, V). 15.5% of patients had a past history of freckles and history of radiotherapy in childhood was present in 41.7% 89.3% had no history of acne and seborrhea. The scalp was the most common site of BCE. The most common clinical type was nodular BCE and solid BCE was the dominant histological feature. Conclusion: BCE was more common in male and fair skin patients with dry skin. In those having history of radiotherapy of the scalp, lesions were seen mostly on the scalp, forehead and neck: pigmented BCE was predominant in this group.

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Food, it's production and preserving has been one of the most important problems in human life. Limitation of production due to climatic, geographic and papulational situations and conservation due to providance and prosecting for solution of one of the most fundamental human needs, has been discussed much. Difference between the lands, temperature, humidity and rainfall on one hand and texture and accumulation of papulation on the other hand, not only has limited the amount and kind of food production but also has improved the preserving methods as much as possible. Extra production in fertile lands and confirmed need for receiving food in deserts and dry areas, makes the need of exchanging and transfer of food inevitable because of economic and ethical matters and sanitation of food. Avoidance of being contaminated and resistance against decay seems very important and vital. So process of preserving and conserving of eaw or cooked food became a fundamental problem. In previous 200 years, many advanced methods have been designed for preserving food in which the role of conserving and packing in vital often. Because of industrial production, conserved food have a great influence on sanitation of people nutrition, and herefor the rate of diseases from consumption of contaminated food has been reduced in industrial countries and the tensancy of people to use conventional food has been decreased gradually. Because of high cost of industrial conserved food production some people produce conserved foods in the way which is not hygienic. That may have a high risk when ingested. In this article we discuss about unwarranted conserved foods productions.

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Nowadays, trauma is a major complex of industrial and developed countries. Integrated trauma systems have been used for many years to evaluate and minimize the severity of trauma outcomes (mortality and morbidity). We haven't had any trauma system or any comprehensive study, giving us proper information about our country trauma state. This article is based on comprehensive information of a descriptive prospective cohort study, performed in one year period in 3 major trauma centers in Tehran, evaluating 58005 Traumatic patients, referred to emergency rooms of these hospitals. In this article we have tried to represent a complete report of our patients' epidemiologic and demographic factors and trauma inducing mechanisms including traffic accidents, falls, gunshots, cutting objects ..., and their effect on the severity of injury and patients' outcome. Based on our study, traumatic patients are mainly young (age mode between 20-29) males (80%). The majority of patients were illiterate or had a low level of education. The most common mechanism of trauma was hitting of blunt objects (44.9%), however, it was car accidents in hospitalized and severely injured patients (39.9% and 53.7% respectively). The mechanism of trauma correlates significantly to the severity of injury, the need to hospitalization and the patients' outcome. In our study gunshots, car accidents and falls are the most important trauma inducing factors.

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Effects of preanaesthetic medication are as follows: 1) Promotion of mental and emotional relaxation. 2) Inhibition of nausea and vomiting after surgery. 3) Stability of haemodynamic response. We performed 105 patients, randomized, single blind clinical trial, preanaesthetic drugs, promethazine and droperidol: A comparison of haemodynamic response for patients in elective surgery at imam hospital. 105 patients were divided in three groups. Promethazine group 35 patients, dropetidol group 35 patients and normal saline group 35 patients. Systolic and diastolic blood pressure and pulse rate were recorded before and after intramuscular injection. Patients of promethazine and droperidol groups responded with decreasing in blood pressure and pulse rat lower than normal saline. But haemodynamic response did not show any difference between two groups (promethazine and droperidol).