Tehran University Medical Journal

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This prospective study evaluated the long-term results of intraoperative 5-FU in glaucoma patients undergoing trabeculectomy. 14 patients categorized as high risk (10 patients) or medium risk (4 patients) underwent trabeculectomy with 5-FU and were followed for a mean period of 32 months. Patients were evaluated for visual acuity, cup-disc ratio and IOP. The number of medications was also taken into consideration 78% (n=11) of patients achieved controlled IOP, (mean IOP of less than 21 mmHg) with or without medication. There was statistically significant reduction of IOP and number of medication after the operation. There was no significant complication observed during the follow up period.

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The most common cardiovascular surgery in the world and Iran as well, is CABG. One of the most important post-operative complication of this operation, that increase morbidity and mortality, is peri-operative MI. Incidence of peri-operative MI in CABG operations is between 2.5 to 5.5%. In this study we determined the prevalence and incremental risk factors of peri-operative MI in 300 consequative CABG operation, in the Imam Khomeini hospital. Diagnostic criteria for peri-operative MI were positive ECG finding (New and persistent Q.wave) and positive CPK-MB (Serum level>100 unit) at 3 different time: 1) Just before operation in the ward, 2) Just after operation in the ICU, 3) First post-operation day (At 8 A.M). In 300 patients positive ECG findings were seen in 7% (21 cases), positive CPK-MB was 12.7% (38 cases) and both of them were positive in 5% (15 cases). Therefore the prevalence of peri-operation MI was 5% (15 cases). Incremental risk factors in the patients with peri-operative MI were history of diabetes mellitus, hypertension, hyperlipidemia, left main disease, and endarterctomy. Therefore because of high incidence of peri-operative MI in CABG operation we should try to change the risk factors and decrease the prevalence of this complication.

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Cardiopulmonary resuscitation (CPR) is one of the most important skills that every body must know it in medical services. In educational hospitals, the (Newly-arrived residents are in first cell for management of victims, specially in emergency rooms and at nights. Their knowledge and ability for successful CPR have a direct relation with prevalence of total mortality and morbidity. This research has assessed the knowledge and attitude of the new residents about CPR, and for answering to this question: "Is the CPR workshops necessary for all of the new residents in the beginning of their courses". All of the 506 new residents were examined simultaneously in 2 separate years with a questionnaire consist of 50 questions about their CPR secence and skills and 8 questions about their attitude in CPR. These informations were analyzed by SPSS and EPI6 softwares. The mean correct answers were 55%±11.8. The best results were about arrythmias (68.6%) and airway management (63.6%) and the worst were about IV access (43.1%) and pediatric CPR (31.5%). These findings were similar in 2 sequential years. Their knowledge had significant relation with sex (P=0.002), their original university (P=0.031), their residency course (P=0.024) and their residency reception scores (P<0.001). Males and knowledge more than females. The max scores were from Kerman (62%) and Beheshti universities (60.5%) and the min score were from Hamadan (48%) and Kashan universities (37%). The orthopedic (62.5%) and urologic residents (61.6%) had the most knowledge and the gynecology residents (53.8%) had the least. The knowledge had no relation with the time of graduation. About their attitude in CPR: Their knowledge was moderate (65.8%), their abilities was moderate (58%) and their education about CPR in MD course had been low (51.5%). Their references for education had been individual studies (74.6%), CPR workshop had not been condected in the most universities (92.7%). knowledge about CPR is low (55.8%) and must be 100%. In advanced centers, continuous educations in CPR is essential. Residents with low scores have accepted in courses that have more CPR situations. Difference in knowledge of residents from different universities, show the different educations. Primary knowledge was low and after years, this is lower. Attitude of residents show the low knowledge, low ability, low education in MD, courses.

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Liposomes as a drug carrier have numerous dominancy. Liophilization is the most propr form of these products for long-term maintenance, but this procedure is affected by unstabilizing agent that results in destruction of membrane, release of content and change in size and microbial contamination hence for prevention of the adverse effects, the protective role of sugars such as: Maltose, Fructose, Glucose, Galactose, Saccharose and Lactose were studied. For this purpose, after preparation of liposomal suspention, categorized in for duplicate groups and concentrations of 25, 50, 100 percent of these sugars were added to those. On the basis of color and consistency of products, the best method of freezing is as application of absolute alcohol and then chilling in-70 oc for 16 h. In survey of protective substances concentrations 0.7, 1.4, 2.8, and 5.6 percent of the mentioned sugars were used for calculating of leakage percent (Upon on the ratio of optical density of treated samples to untreated). In this study, released maltose had highest effect. Level of fusion and aggregation had any significant difference between pre and post lyophilized samples in centrifugation with 10000 rpm. Microbial state of recent samples were studied by culturing in SCD and SCDA media that indicated microbial growth in both samples.

 

 

 

 

 

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Liposomes as a drug carrier have numerous dominancy. Liophilization is the most propr form of these products for long-term maintenance, but this procedure is affected by unstabilizing agent that results in destruction of membrane, release of content and change in size and microbial contamination hence for prevention of the adverse effects, the protective role of sugars such as: Maltose, Fructose, Glucose, Galactose, Saccharose and Lactose were studied. For this purpose, after preparation of liposomal suspention, categorized in for duplicate groups and concentrations of 25, 50, 100 percent of these sugars were added to those. On the basis of color and consistency of products, the best method of freezing is as application of absolute alcohol and then chilling in-70 oc for 16 h. In survey of protective substances concentrations 0.7, 1.4, 2.8, and 5.6 percent of the mentioned sugars were used for calculating of leakage percent (Upon on the ratio of optical density of treated samples to untreated). In this study, released maltose had highest effect. Level of fusion and aggregation had any significant difference between pre and post lyophilized samples in centrifugation with 10000 rpm. Microbial state of recent samples were studied by culturing in SCD and SCDA media that indicated microbial growth in both samples.

 

 

 

 

 

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In the past, coronary artery bypass grafting was the treatment of choice for patients with symptomatic multi vessel coronary artery disease, but in recent years per cutaneous transluminal coronary angioplasty (PTCA) accepted as an alternative approach to revascularization. To assess the initial success and in hospital results of coronary angioplasty of more than one lesion per procedure in patients with multi vessel coronary artery disease, a retrospective analysis of patients who underwent selective coronary angioplasty at Imam Khomeini medical center from 1994-1997 were peformed. From 1994 to 1997 per cutaneous transluminal coronary angioplasty (PTCA) were done in 257 patients, that 201 (78.2 percent) were male and their age range 23-73 years. The numbers of patients with multi vessel coronary artery disease were 98 (38.13 percent), that complete revascularization (PTCA of more than one lesion per procedure) underwent in 34 (13.58 percent) of them (27 men, 7 women, age: mean±SD 48±9.8 range 30-70). A total of 71 lesions were tried, that 22 (31 percent) were type A, 45 (63.4 percent) were type B, and 4 (5.6 percent) were type C. Among patients 21 (61.8 percent) had unstable angina and 13 (38.2 percent) had stable angina. Procedures were successful in 68 (95.8 percent) of lesions and 31 (91.2 percent) patients were discharged fro procedural complications included 3 (8.8 percent) non-Q wave myocardial infarction and no mortality. Without any complication, (success defined as residual stenosis <50 percent). As a conclusion, in selected patients with multi vessel coronary artery disease PTCA of more than one lesion per-procedure is effective and safe.

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Background: Transbronchial lung biopsy (TBLB) is an attractive alternative to open lung biopsy as an initial diagnostic procedure for patients with diffuse parenchymal disease or localized densities beyond direct endoscopic vision. TBLB can be carried out safely without fluoroscopy in patients with diffuse lung disease. Since in our bronchoscopic department fluoroscopy is not available, we planned to evaluate the blind (without fluoroscopic guide) TBLB being performed in our department to determine the success rate in obtaining lung tissue, the sensitivity of the procedure and the risk of complications.

Materials and Methods: Sixty-Four TBLB were done in our department during a 6 month period (March-September 1999).

Results: Lung tissue wasn’t detected in two (3.1 percent) samples. Pathological results were helpful in 46 (71.9 percent) cases. No evidence of hemoptysis was found after the procedure. Three (4.68 percent) cases of pneumothorax was detected. Only one of them required chest tube (1.51 percent).

Conclusion: We concluded that blind TBLB was successful in our department with rates of complications comparable to other approved centers.

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Background: The aim of this investigation is to evaluate the histologic results of biopsy in women with atypical squamous cells of undetermined significance (ASCUS) cytologic diagnosis.

Materials and Methods: We reviewed a series of cases with ASCUS pap smears from March 1999 to Feb 2002 in Imam Khomeini Hospital (n= 104), Who had cervical biopsy indirected colposcopy (103) and in Onec endocervical biopsy obtained without colposcopy. In 60 patients before colposcopy and biopsy repeat pap smear was tabled.

Results: Biopsy revealed 28.8% SIL (14 LSIL and 16 HSIL), 1 invasive carcinoma and 1 endometrial carcinoma. Pap smear repeated for 60 women before colposcopy examination, which 7 (11.7%) of them were normal. ASCUS persisted in 45 cases (75%) and 8 cases (13.3%) turned out to be SIL (6 LSIL, 2 HSIL) of 7 normal repeat smear, 2 marked as LSIL by biopsy. In colposcopic examination 22 of 103 (21.4%) had normal view which one of them was LSIL histologically.

Conclusion: Based on these findings, it seems immediate colposcopy and directed biopsy are appropriate procedures for management of ASCUS and to detect underlying SIL.

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Background: Abnormal uterine bleeding (AUB) is a common presenting symptom indicative of abnormal menstrual bleeding patterns that may occur in anovulatory or ovulatory women.There are different ways to diagnose AUB, all requiring much time and energy. The purpose of this study was to evaluate and compare the value of endometrial biopsy, transvaginal ultrasonography with dilation and curettage (D&C) which is the current gold standard procedure.

Methods: A prospective-descriptive study was conducted on fifty patients referred to our center for refractory abnormal uterine bleeding who were candidates for hysterectomy. All patients underwent endometrial biopsy and transvaginal ultrasonography , followed by D&C as a Gold standard procedure in operating room just before surgery.

Results: Mean age of patients was 46.62 years. Transvaginal utrasonography offered a sensitivity of 70% and specificity of 68% demonstrating the lowest numbers compared to D&C. Endometrial biopsy had a sensitivity of 70% and specificity of 75% that was better than sonography alone.

Conclusion: D&C was the most useful and valuable procedure and addition of endometrial biopsy with transvaginal ultrasonography will not be of high value in diagnosis.

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Background: Non-palpable undescended testis (NUDT) is one of the problems encountered in pediatric surgery. As studies show, about 30-40 % of NUDT is associated with intraabdominal testis (IAT), in the case of IAT various surgical techniques have been presented for example multistage orchiopexy, orchiopexy by microvascular anastomosis orchiopexy by transaction of spermatic vessels at two stages, hormonal manipulation, in which there is no definitive success and there are several associated complications. Orchiopexy in one stage by transaction of spermatic vessels of the base of vas artery is a suitable method.

Methods: This study is descriptive and prospective and was performed in Bahrami and Tehran children hospital from 2000-2001 on intraabdominal undescended testis. The patients were followed for at least 2 years.

Results: From 31 patients, 70.9% were over 4 years old, 93.5% were hospitalized over 3 days, and operation time in 64.5% was lower than 3 hours. The most common early complication was vomiting (16.1%) and the most common late complication was wound infection (6.5%). There was a %80/6 chance of testicular anomaly. In follow up period, there was no decreasing in testicular size.

Conclusion: One stage orchiopexy by spermatic vessel transaction is a safe technique with high success rate and low complication rate with acceptable increase in operation time and hospital stay. Based on our experience, we recommend this technique for non-palpable undescended testis.

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Background: Cervical cancer is one of the most common cancers in women.Conization of the cervix is one of the best diagnostic and therapeutic modality in preinvasive lesion of the cervix.

Methods: In this retrospective study we have evaluated the indications,complications, cytopathologic results, diagnostic and therapeutic value of 44 patients who underwent cervical conization.

Results: Age of the study group ranged from 18 to 75 (mean=43.18, SD=±11.4), and their parity ranged from 0 to 10 (mean 4-5, SD=±2-3). Ten cases (22.7%) were menopauses. The main indication was inability to visualize the entire T.zone (19 cases/43.2%) that was more prevalent in menopauses (50%/5cases in menopauses and 41.2% /14 cases in premenopauses). Bleeding occurred in 2 cases (4.5%) and urinary infection in 1 case (2.3%). The most common histologic result after conization was mild dysplasia in 23 cases (52.3%). The most common colposcopic biopsy result was moderate dysplasia in 16 cases (36.4%).The most common pap smear result was HSIL in 16 cases (36.4%). Two cases (4.5%) had invasive cancer in colposcopic- biopsy: one of them had ASCUS in the pap and another one had HSIL. Four cases (9.1%) had invasive cancer in histologic report: one of which had ASCUS on the pap and the others had HSIL.

Conclusion: Pap smear in screening of cervical cancer are not reliable and colposcopy is more acceptable in LSIL and ASCUS. Gynecologists should develop the skill to perform an accurate knife conization because the classical indications for conization continue to be valid and it has a low complication rate.

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Background: The most frequently used test for evaluation of fetal health is the Non Stress Test (NST). Unfortunately it has a high incidence of false positive results. The combination of vibroacoustic stimulation with the NTS has been shown to reduce non reactive results.
Methods: A tests assessment method was chosen with a simple randomized sampling. 40 pregnant women with non reactive NST in the first 20 minutes who received VAS in one of Tehran University's Hospitals were compared with BPP scores. A vibroacoustic stimulation was applied for a 3 seconds on the maternal abdomen and fallowed within 10 minutes.Data collection tools were NST, sonography instruments ,NST result paper, tooth brusher, watch, demographic questioner and check list. Data analysis was made by descriptive static and by using the Fisher's Exact Test (with level of significant at p<0/05). All statistical analysis were performed using an spss/win.
Results: After VAS, 70% of non reactive tracing became reactive. All cases with fetal reactivity response after a VAS had a subsequent BPP score of 8 (negative predictive value of 100%). False positivity of VAS was lower than NST.
Conclusion: VAS offers benefits, by decreasing the incidence of non reactive test and reducing test time. VAS lowers the rate of false positive NST. VAS is safe and allows more efficient of prenatal services. This test could be used as a rapid antepartum test to predict fetal well-being.

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Background: Germ cell aplasia (G.C.A) is one of the most important testicular causes of infertility and azospermia.In this condition the seminiferous tubules are only lined by a single layer of sertoli cell. In some cases, there is focal area with spermatogenic activity.
Methods: We studied infertile men with G.C.A referred to Jahade Daneshgahi of Iran during 1381-82, retrospectively. All the cases had more than one biopsy of one testis.
Results: In 11.6٪ of 320 cases, comparison of multiple biopsy sites of a testis revealed: when one site showed G.C.A, another site revealed areas with spermatogenic activity. Considering the cases who showed germ cells in both sites, 15.3٪ of cases multiple biopsy sites appeared to have focal spermatogenesis, better maturation of germ cells or higher scoring area for urologic operation.
Conclusion: According to new techniques in treatment of infertility with ICSI (intra cytoplasmic sperm injection) in which fertility is possible with one spermatozoa or even spermatid (after recovery), biopsy of multiple sites instead of only one site is highly recommended in azospermic patient.

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Background: The incidence of inguinal hernia is 15 cases per 1,000 populations. The most common surgical methods of hernia repair are conventional open hernioplasty and laparoscopic hernioplasty. The advantages of laparoscopic hernioplasty are that the regional anatomy is observable, and bilateral herniorrhaphy can be performed at the same time. Since laparoscopic hernia is usually performed under general anesthesia, to shorten the length of hospital stay and to prevent complications, in this study, we evaluated the use of epidural anesthesia during hernioplasty.
Methods: This study included 20 male patients treated by a single surgeon. We recorded the PCO2 levels before, during and after surgery, as well as the pain and intra-abdominal pressure.
Results: Only one patient required conversion to general anesthesia. Three patients had hernia on the left side only, 14 patients on the right only and three patients had bilateral hernia. The PCO2 levels did not change (P=0.789). Fifty percent of patients had no postoperative pain. The median time to return to work or normal physical activity was 7 days.
Conclusion: Laparoscopic inguinal herniorrhaphy is a feasible alternative to open surgical hernia repair. Employing epidural anesthesia prevents the complications of general anesthesia. This method achieves a shorter hospital stay and time to return to normal activity, as well as reduction in pain. Controlled trials comparing laparoscopic and tension-free open herniorrhaphy are needed to further assess the relative benefits of this procedure.

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Background: The Fontan operation is the definitive operation for palliation of complex congenital heart disease with single –ventricle physiology. The use of the extra cardiac conduit has recently been gaining popularity. The purpose of this study was to compare the outcomes of extra cardiac conduit Fontan procedure (off-pump technique) and that of traditional technique (lateral tunnel technique) in which cardiopulmonary bypass is routinely used.
Methods: Forty one patients in different age groups underwent extra cardiac conduit Fontan procedure between April 2001 and December 2004. Data were collected from ICU sheets, files and during follow up visits. Under general anesthesia and through median sternotomy, using two temporary decompressing shunts, superior vena cava implanted on right pulmonary artery and a conduit interposed between transected inferior vena cava and main pulmonary artery. Fenestration was done in almost all patients and previous shunts were closed if there were any.
Results: Of our patients, 13 were female and 28 were male. Mean age of the patients was 11.1 years (SD=7.8).In 24.4% of cases Fontan procedure was done as the first palliative surgery and in 75.6% of them there was previous history of palliative procedures. In 6 patients (14.6%) we were constrained to use cardiopulmonary bypass which was predictable or necessary in 50% of cases. There was no reoperation due to post operative bleeding. Two cases suffered from prolonged plural effusion. Our in-hospital mortality was 9.8%. During 2-24 months follow up, we found two cases who were in NYHA functional class II and one case in functional class I.
Conclusion: Extra cardiac conduit Fontan procedure could be used in a safe way. The results of this study were comparable and even in some cases better than that of the traditional technique.

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Background: Propofol and Thiopental are intravenous anesthetics having relatively different hemodynamic influences and adverse effects. In addition, there is significant pain on intravenous injection of propofol. This study was performed to examine the effects of Propofol-Thiopental admixture on hemodynamic variables, pain on injection and hypnotic dose at the time of induction of general anesthesia.
Methods: One hundred and twenty-five ASA I or II patients scheduled for elective surgery were randomized into four groups for induction of anesthesia in a double-blinded manner. With an original concentration of Propofol of 1% and that of Thiopental of 2.5%, we used these drugs in each group as follows: group P100: Propofol alone group P75: ¾ Propofol and ¼ thiopental (volume/volume) group P50: ½ Propofol and ½ thiopental group T100: Thiopental alone (control group). Hemodynamic variables (before and after induction), score of pain on injection and hypnotic doses were recorded and statistically analyzed.
Results: Admixture of Thiopental and Propofol reduces the injection pain of Propofol, as admixtures P75 and P50 were significantly less painful on injection than P100. Induction of hypnosis was significantly more rapid in group T100 than in groups P100 and P75. The interaction of Propofol and Thiopental with regard to their hypnotic effect is additive. Therefore a reduction in the dose of one was compensated by proportional increase in the dose of the other drug for a hypnotic effect. After anesthesia induction, systolic and diastolic blood pressures were significantly lower in group P100 than in groups P75, P50 and T100. The heart rate after laryngoscopy and tracheal intubation was significantly lower in group P100 than in groups P50 and T100.
Conclusion: Propofol-Thiopental admixture causes minimal pain on injection for intravenous induction of anesthesia with modified hemodynamic effects in comparison with each drug when used separately.

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Background: Laparoscopic hernioplasty is a standard technique with increasing interest of patients and surgeons. Bilateral hernioplasty can be performed by laparoscopy as well. The aim of this study is to show laparoscopic bilateral hernioplasty is an acceptable method and use of eye-shaped mesh getting the best result.
Methods: In 54 cases with bilateral inguinal hernia, under general anesthesia laparos-copic reconstruction with eye-shaped prolene mesh performed. All cases of recurrent, big, direct, indirect and femoral hernia were entered in the study.
Results: Seven of 54 cases were female. Four cases (male) had direct hernia, four female had femoral hernia and remaining of the study group had indirect form. Direct hernia 4 case (male), femoral hernia 4 (female) and remaining were indirect hernia. Operation performed without any complications in all cases. In 12 cases sac of hernia was too much enlarged so technique of bridge at the base of sac used. In five cases diameter of defect was more than 2 centimeter. In three of them defect repaired by suture before mesh insertion. Postoperative complications were seroma at distal of mesh in 23 cases (absorbed during 3 weeks spontaneously), reaction to mesh in one case (mesh and protack removed after 3 months of operation. Conservative management was ineffective and anterior repair performed), recurrence in one case (after 2 months of operation due to displacement of mesh in big direct hernia). Post operative hospital stay was 1.3 day (mean time). Painless movement and mobilization was obvious after 48 hours.
Conclusion: Laparoscopic bilateral hernioplasty using eye-shaped prolene mesh is an acceptable method with good results especially in indirect hernia. In direct hernia, repair of defect by suturing and fixation of mesh is preferred.

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Background: Multiple sclerosis (MS) and the gluten intolerance disease, celiac disease, (CD) are immune-mediated diseases. Better testing for antibodies associated with CD, including anti-gliadin antibody [AGA], as well as anti-endomysial and anti-tissue transglutaminase antibodies, has improved the diagnosis of CD. Certain neurologic conditions have a reported association with CD. Previous researchers have investigated the role of a gluten-free diet in the treatment of MS and found no benefits. Here, we investigate the possible immunological association of CD with MS.
Methods: Using ELISA, we estimated serum IgG and IgA anti-gliadin and IgA anti-endomysial antibodies in 34 MS patients, who were new or previous cases without immunosuppressant treatment for at least the last six months. The mean age was 29.6 years (range 15-46 years), with 30 patients relapsing-remitting, and four secondary-progressive MS. Thirty-four random anonymous blood donors were used as serologic controls (mean age 31.4 years, range 19-50 years). The individuals in both groups with elevated AGA (IgG or IgA) or anti-endomysial antibody (IgA) underwent duodenal biopsy.
Results: In the MS group, high levels of IgG AGA were found in 5.9% of the subjects, and 5.9% had elevated IgA AGA. In the controls, elevated IgG AGA was detected in 5.9% of the subjects and IgA AGA in 2.9% (p=0.051 and 0.48, respectively). For IgG and IgA AGA levels, no significant differences were found between the patient and control groups. IgA anti-endomysial antibodies were not found in either group. Upon biopsy, the specific pathological features of celiac were absent.
Conclusion: The same number of MS patients and controls had high levels of AGA, with normal levels of IgA anti-endomysial antibodies, which is more specific for CD, while the GI biopsies from both groups were not specific for CD. Therefore, AGA levels in any neurologic case should be interpreted with caution. The present study showed no association between MS and CD.

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Background: Post-menopausal hemorrhage is one of the most common complains in gynecologic clinics. More than 60% of these cases have abnormal findings in diagnostic work ups. There is contraversy about the best diagnostic method for evaluating post-menopausal hemorrhage. The aim of this study was to evaluate the results of Trans-Vaginal Ultrasonography and compare its result to ones derived from direct endometrial biopsy and Hysteroscopy findings.

Methods: In a cross-sectional study, menopausal women who attended the outpatient clinic of Arash Hospital, Tehran University of medical Sciences, from April 2005 to March 2006 with the complain of hemorrhage were evaluated. In all of these patients, after getting informed consent, Trans-Vaginal Ultrasonography, Dilatation and Curettage and Hysteroscopy were performed.

Results: The total number of 90 women was recruited to the study with the age range of 41-80 years. The mean age of participants was 53.84 ± 6 years and 4.3 ± 5.1 years had passed from their menopause. The mean thickness of endometrium, measured by Trans Vaginal ultrasonography was 6.25 ± 3.7 millimeter. In the biopsy derived specimens, the most finding pathological presentation was atrophy (48.9%) and the Proliferative endometrium had the second prevalence (36.7%). Atrophy (44.4%) and Proliferative endometrium (33.3%) were the most prevalent finding in Hysteroscopy. There was a significant difference in endometrial thickness between groups of different pathological findings. A significant difference in endometrial thickness was also seen between groups with different Hysteroscopic finding. By grouping the data according to endometrial thickness, it became evident that endometrial thickness can predict the outcome of endometrial biopsy and Hysteroscopic finding efficiently. We used ROC curves to find the best grouping threshold for endometrial thickness to achieve the best sensitivity and specificity.

Conclusion: Measuring the endometrial thickness by Trans-Vaginal Ultrasonography is an appropriate non-invasive test for screening post-menopausal hemorrhage. 

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Background: Mongolian spots are the most frequently encountered pigmented lesions in newborns. The patches appear at birth or shortly there after, rarely later the MS in term newborns in always present at birth. The shape of MS was commonly either irregular or indefinite, with its borders gradually blending with the surrounding skin. The color most frequently observed in all ethnic groups was blue- green. For the Negro population the color was commonly greenish– blue the next most common color in the total population was blue- gray. Brown coloration in the form of brown specks on a back ground of blue was present in ten percent Negro Newborns. The most common location is the sacragluteal region, which frequently is the only part affected. MS occasionally are found in the extremities in those cases with extensive involvement, particularly in the shoulders. The presence of MS in the head or neck has been called aberrant Mongolian spot. The macula has been variously described as irregularly round, oval, roughly triangular, heart shaped, resembling a tennis racket, and angular. The size may vary from a dot of a few millimeters to six or more centimeters in diameter the mark of ten disappears during the first or second year of life. Those marks distant from the sacral region are said to be more apt to persist than the typical sacral one and the buttocks was the site of predilection. Its incidence varies from over 80% in Asians (Mongolian and Chinese) to 10% of white infants. Only a limited number of studies were carried out in Iran. Our objective was to study Mongolian spots incidence and common locations in newborns at Shariati hospital.
Methods: During 2004-06, 2305 consecutive newborns were examined at Shariati hospital. Diagnosis of Mongolian spot was based on clinical impression with Pediatricians.
Results: Mongolian spot was observed in 11.4% neonates. The most frequent site of involvement is the sacral, followed by the gluteal area. Mongolian spot did not show a significant relationship to sex, gestational age, mother’s age groups and delivery type (p>0.05) but the relationship between Mongolian spot and birth weight groups was significant (p<0.05).
Conclusion: Incidence of mongolian spots in our patients was simila