Tehran University Medical Journal

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With retrospective evaluation of 44 patients suffering from Guilan-Barre Syndrome (GBS), Chronic Idiopathic Demtyelinative Polyradiculoneuropathy (CIDP) and Myasthenia Gravis (MG) treated with intravenous immunoglobulin, we found following results: 1) Initial symptoms of improvement on forth or fifth days. 2) Maximum recovery for CIDP and MG were after 16-24 and 3-11 days, respectively. 3) No major complication, but mild side effects in 32% of patients. 4) In patients with GBS one grade improvement achieved after 8-30 days. 5) Intravenous immunoglobulin (IVIG) plus plasmapheresis had no advantages over IVIG alone. 6) No reasonable conclusion about relapsing rate and duration of response due to follow up restrictions.

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To determine the therapeutic dose of Mg according to BMI, serum level of calcium, creatinin and albumin a cross sectional study were carried on 150 cases of preeclampsia (100 mild, 50 sever type) in Valei-Asr Hospital through the years 1378-79. All of eligible patients had given a single dose of 4 gr Mg, sulfate intravenously, then had continued with 20 gr/lit, 28 drop/min through IV infusion. Mild and sever preeclampsia cases were similar about the mean serum level of calcium and Mg. Before beginning of treatment, but were significantly different about the mean of serum level of creatinin and albumin (P=0.0001). In univariat analysis there was significant direct correlation between serum level of Mg 6 hours after beginning of treatment with serum level of creatinine and albumin, and significant association with BMI (P<0.05). So the serum level of Mg in end of treatment, (P<0.05) in multivariate regression analysis, the serum level of Mg in 6 hours after and end of treatment was correlated positively with serum level of creatinine and albumin and negatively with BMI. Serum level of Mg 6 hours after=-0.2+0.8 (Alb. Level) +2.99 (creat level) –0.22 (BMI). Serum level of Mg in end of treatment=-0.2+0.8 (Alb. Level) +3.3 (creat level) –0.24 (BMI).

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CMV belongs to herpes viridea family and it is the largest human virus. Prevalence of CMV depends on age, race, geographic and socioeconomic factors. CMV infection has been a recognized complication of transfusion for about three decades, in an immature or compromised immune system situation. If a transplant candidate has not been infected with CMV and no CMV specific antibodies can be detected by serology, a primary infection could be transmitted via transfusion or transplantation. Patient who are under dialysis are susceptible to CMV infection, in addition of increase serum levels of p2-MG(Beta-2 Microglobulin).
Materials and Methods: we detected anti CMV (IgM -IgG) antibodies for 128 renal transplant candidates who were under intermittent heamodialysis and 1040 blood donors, as controls and compared serum p2-MG levels in 48 of the patients with 35 controls with ELISA technique. For 15 patients, R5 (Cuprophan) and for 7 patients S2 (Polysulphone) filters were used.
Results: Our data showed:
1-90 percent of normal blood donors and 89.8 percent of the patients were IgG positive. Statistical analysis showed no significant difference between these two groups (pO.Ol). This reflected high prevalence of CMV .
2- 0.2 percent of normal individuals and 2.3 percent of the patients were positive for IgM. There was significant difference in IgM between these two groups (p<0.01).
3- p2-MG levels in patient group were elevated and there was a significant differences between two groups (P <0.05 ) and no differences between common used dialysis filter in this study.

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Coronary Artery Disease (CAD) is a major cause of death worldwide including Iran.  The risk of developing disease in patients without symptoms is assessed in part by factors that are associated with disease. Among these factors family history points to the significance of genetic component in the risk of CAD. The identification of the genetic variants that confer risk for CAD is essential for detecting high-risk individuals, so preventative life style and therapeutic action can be taken before overt disease develops. So far more than 100 genes have been reported with possible role in developing risk for CAD. Matrix- Gla Protein (MGP) is one of these genes that association of its single nucleotide polymorphism (SNP) with CAD has been reported.  Among the polymorphisms, there are two promoter SNPs at position -7 & -138 that their association with CAD has been reported before. Here we investigated the association of these SNPs with CAD in Iranian population.
Methods: 150 cases and 150 controls were selected on the basis of their clinical assessments and angiographic reports. DNA was extracted from blood samples. The genotypes for both SNPs were determined using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method with size fractionation on Polyacrylamide gel.
Results: The comparison of allele & genotype frequencies between patients and controls showed that there is an excess of A allele at position -7 and T allele at position -138 among patients, although these differences were not significant (p<0.2, and p<0.5 respectively).
Conclusions: This study suggests no association of these SNPs with CAD in Iranian population. Confirmation of this finding needs independent repeat of similar studies.
Keywords: Coronary Artery Disease (CAD), Matrix Gla Protein (MGP), Single Nucleotide Polymorphism (SNP).

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Background: There are multiple diagnostic methods for evaluation of patients with low back pain with a radicular pattern, each one has it's own accuracy and diagnostic ability and so comparing them with each other would help the clinicians to find the best diagnostic method. The main objective of our study was to compare the diagnostic accommodation of electromyography (EMG) and Magnetic Resonance Imaging (MRI) findings in patients with low back pain and radiculopathy.

Methods: In this descriptive cross-sectional study, 101 patients with low back pain and radiculopathy attending to Sina Hospital in Tehran, Iran from 2007 to 2009 that had indication for both EMG and MRI were evaluated for their demographic characteristics and disease-related factors.

Results: Totally, 90 out of 101 patients (89%) had abnormal EMG findings and 94 out of 101 subjects (93%) had abnormal MRI results. The concordance rate was 88% (89 patients) with no significant difference (p> 0.05). The sensitivity and specificity of MRI were 95.6% and 27.3%, respectively, and the sensitivity and specificity of EMG were 91.5% and 60%, respectively.

Conclusion: According to the results of this study and in comparison with other studies it may be concluded that MRI and EMG are both accurate and use of them in a concomitant manner would result in increased diagnostic ability in patients with low back pain and radiculopathy.

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Background: Gitelman syndrome is a rare autosomal recessive disorder that typically presents with recurrent muscle cramps, carpopedal spasms, hypokalemic metabolic alkalosis, hypocalciuria and hypomagnesemia and high urine magnesium during adolescence. Mutation in the gene encoding for sodium chloride co-transporter in distal convoluted tubule causes electrolyte imbalance.
Case presentation: We present a 10-year-old boy complaining of carpopedal spasms, tingling of fingers and facial parestesia for three years prior to his admission in endocrinology clinic of H. Ali-Asghar Pediatric Hospital. The patient had metabolic alkalosis, hypokalemia, hypocalciuria, increased urine fraction excretion of Mg, serum magnesium of 1.8 mg/dl, normal serum calcium and phosphorus and normal blood pressure. His clinical manifestations recovered after potassium and magnesium administration.
Conclusion: A patient with Gitelman syndrome with normal serum Mg. is presented.