Archives of Iranian Medicine
Volume:3 Issue: 1, Jan 2000

Objective-To determine the prevalence of sero-epidemiologic markers of Hepatitis B virus (HBV) in NIOC health organization personnel in Tehran, and to study the risk of exposure of medical staff (who are more exposed to patients and/or blood products.)Method-A sero-prevalence study was carried out on 600 subjects with no past history of vaccination against hepatitis B. Of these, 377 were more prone to exposure (high-risk group), and were compared to the rest of the subjects (comparison group) and the normal population.Results-A sample of 447 subjects were tested for all markers (HBsAg, HBsAb, and HBcAb), of which 101 (23%) were positive for at least one of the markers (CI95%: 19%-27%). Prevalence of HBsAg, HBsAb, and HBcAb were found to be 1.83% (CI95%: 0.97%-3.36%), 16.11% (CI95%: 13.3%-19.4%), and 17.86% (CI95%: 14.5%-21.8%) respectively. While no significant correlation was found with sex and years of service, significant correlation with age was found for seroprevalence of HBsAb (P<0.01) and HBcAb (P<0.05). No significant sero-prevalence of any marker was found in the high risk group compared to the comparison group in this study and population-based survey results. Significantly increased risk of seropositivity for HBsAg was found among laboratory personnel of laboratory as compared to the comparison group (RR: 8.8, P<0.05, CI95%: 1.4-54.6). Discussion-No significant increased risk of exposure based on serologic studies in health care personnel in communities where HBV is endemic, may be attributed to a balanced increased risk of occupational exposure. The reason might be that safe life styles and appropriate job behavior due to higher level of education and socioeconomic factors compared to general population in such communities could result in their equal risk of infection. Further studies are warranted to eliminate the role of socioeconomic status as a possible confounding factor in risk assessment studies for HBV exposure in health care workers.

Background-Gastric cancer is significantly more prevalent in north western than central Iran. Growing evidence has related Helicobacter pylori (HP) to gastric cancer worldwide. We assessed the prevalence of HP infection in high (Ardebil) and low (Yazd) prevalence gastric cancer provinces of Iran.Methods-Cluster sampling of healthy population aged less than 20 years was performed in Ardebil and Yazd provinces over a 2 month period. Five ml blood was drawn from each person and HP IgG was tested using ELISA (Diagnostic Corporation., sensitivity 98%, specificity 96%).Results-Seven hundred and eleven individuals (358 in Ardebil and 353 in Yazd) were enrolled. One hundred and seventy individuals (47.5%) in Ardebil and 108 individuals (30.6%) in Yazd were positive for HP (P<0.0001). Logistic regression analysis showed that no other factor except for increasing age is associated with increased H. Pylori infection in either area.Conclusion-HP infection is significantly more prevalent amongst individuals less than 20 years of age in areas with high prevalence of gastric cancer in Iran. Our data suggest a relation between HP infection and gastric cancer in Iran.

Objective-In this study, the effect of codeine alone and in combination with D2 dopamine agonist bromocriptine in pain sensation during simple tooth extraction or minor oral soft tissue surgery has been examined.Method-Patients (121 male and 91 female) who were undergoing one of the above procedures, were included in this double-blind study. They were given randomly one of the following medications: Codeine (10-20 mg), bromocriptine (2.5-5 mg) in different combinations controlled by a placebo and a dental lidocaine cartridge group. The medication was given 20 minutes before the procedure and the patients subsequently recorded their pain intensity on a scale of 0-3.Results-ANOVA showed significant difference between placebo group and cases who received the combination of bromocriptine and codeine (with certain dosages), but the analgesic effect was significantly lower than the lidocaine group (p<0.05).Discussion-Patients who received bromocriptine 5 mg plus codeine (10 or 20 mg) had a better effective response than those receiving either of the components alone or placebo. It appears that D2 activation potentiates the response induced by the opioid agonist codeine.

Background-The purpose of this study is to show the role of high-resolution CT scan (HRCT) in diagnosing active pulmonary tuberculosis. Previous studies show that the CT finding of centrilobular nodules and a tree-in bud appearance in HRCT is more sensitive than chest X-ray in detection of early endobronchial spread. As documented by Im and colleagues, 97% of patients with active pulmonary TB had evidence of bronchogenic spread of the disease on HRCT.Materials & Methods-One hundred and two patients clinically suspected of having active pulmonary TB with chest-X-ray appearances suggestive of the disease, underwent HRCT examination.Results-HRCT results showed that 76 patients (74.5%) had active pulmonary TB and further clinical work-up indicated that the final diagnosis of the disease was confirmed in 52 patients (51%). According to binomial test the combination of the two main HRCT appearances, the centrilobular nodule and "tree-in-bud" signs confirms TB diagnosis accurately. The sensitivity of HRCT in diagnosing active pulmonary TB in this study was 96% and the negative predictive value was calculated as 93%.Conclusion-We conclude that HRCT is a powerful and reliable diagnostic tool in TB diagnosis, which means that it can be used even before mycobacteriologic results are available.

Background and objective-In thyrotoxicosis, changes in urine output and serum creatinine (Cr) concentration has been related to increased glomerular filtration rate (GFR). The aim of this study is to clarify the mechanism of these changes.Methods-Forty-one thyrotoxic patients, 9 male and 32 female with the age range of 16-62 years were selected and body weight, 24-h urine output, serum and urine Cr concentration, and GFR were measured in the thyrotoxic state and two months after treatment. The data was analyzed by student ‘t’ test and paired ‘t’ test.Results-The following parameters were measured and are compared in thyrotoxic and euthyroid states respectively. Body weight: 58.4±10.6 Kg and 61.6±10.4 Kg after receiving anti-thyroid therapy (p<0.001). 24-h urine output: 1430±420 ml, and 1165±450 ml (p <0.001). Serum creatinine concentration: 0.7±0.11 mg/dl, and 0.84±0.13 mg/dl (p<0.001). 24-h urine creatinine concentration: 906±225 mg/l and 1081±285 mg/l (p<0.001). The change in GFR was not statistically significant, being 90.1 ml/min before therapy and 89.5 ml/min in the euthyroid state.Conclusion-Increased urine output and decreased serum creatinine concentration in thyrotoxicosis is not GFR related.

Background-Pulsed electromagnetic field stimulators are used for promotion of healing in various conditions such as bone, cartilage and ligament injuries, but there are controversies about the use of these stimulators for skin wound healing. Objective-The aim of this study was to investigate the effects of different pulse rates of pulsed electromagnetic fields (PEMF) on skin wound healing in rats. Methods-Forty-eight male Wistar rats were used in this study. After anaesthetizing and shaving, a paired full thickness incision wound (35 mm in length) was made on each side of the dorsal midline of the rats. The animals were divided into eight groups (n=6) namely control, sham and six treatment groups which were exposed to10, 20, 40, 50, 60, and 80 Hz pulse rates. Treatment groups were exposed to PEMF (4 mT) for 30 minutes twice a day for ten days after surgery. Wound healing was evaluated by measuring the maximum length, the surface area of the wounds and the healing fractions every two-days. The full contraction period of the wounds and the tensile strength of scars were also measured.Results-Results showed that: I -The absolute and normalized length of wounds in animals receiving PEMF (20 Hz) were significantly less than that of the sham (P<0.01). II -The wound healing duration in this group (12.7 days) was significantly shorter than that of the sham group (P<0.02). III - The wound tensile strength in this group was significantly greater than that of the sham group (P<0.01).Conclusion-We can conclude that PEMF with 20 Hz pulse rate is effective in promoting of wound healing.

Background- Medicinal plants play an important role in pharmaceutical preparations and medicine. Cichorium intybus has its own value in traditional therapy.Objective-In this study we tried to find out the most effective dose and suitable time of administration for optimum results. Methods-Doses of 25 mg/kg, 50 mg/kg, 75 mg/kg, 100 mg/kg, 125 mg/kg and 150 mg/kg were administered orally to the test group. The positive control group also received CCl4 and the negative control group received normal saline. In this investigation serum enzyme activities such as ALT and AST were measured and the histopathological examinations were also studied.Results-The maximum effective dose was 75 mg/kg. Histopathological findings and enzyme levels showed that the best protective effect was seen when given within 30 minutes after CCl4 toxicity.Conclusion-In mice, liver protection was observed at various doses of Cichorium intybus but optimum protection was seen with a dose of 75 mg/kg given 30 minutes after CCl4 intoxication.

Background-Unintentional poisoning is one of the most important causes of mortality and morbidity among children in many parts of the world today.Methods-In this descriptive retrospective study, medical records of 3895 patients (3790 out-patients) were studied from clinical and paraclinical point of view in 1995 at Loghman Medical Center, Tehran, Iran.Results-Kerosene (Hydrocarbon) was found to be the most common cause of unintentional poisoning in children (23.5%). Two hundred and sixteen products were identified as various causes of children poisoning. Fifty eight percent of child poisoning was under the age of six, with a peak age of 2-3 years (25%).Conclusion-Most children poisonings are due to available medications, hazardous liquids and house products.

OHSS with spontaneous ovulatory cycle is extremely rare. We report a case of severe OHSS associated with a spontaneous normal singleton pregnancy in a 24 year-old woman suffering from severe abdominal pain and dyspnea. Pelvic sonography revealed a 7-week intra-uterine single viable fetus accompanied by ascites and polycystic enlarged ovaries. She was given indomethacin orally and underwent repeated paracenteses, and then discharged after 26 days and delivered a normal baby at 38 weeks of pregnancy.

Acquired immunodeficiency syndrome is a major health problem in every community. We recently encountered 3 such cases in our neurosurgical department who proved to be HIV positive after surgery took place. All 3 patients were operated upon by the authors and we hereby report our experiences and findings.