نشریه پژوهش در پزشکی
سال بیست و چهارم شماره 3 (پیاپی 96، پاییز 1379)

Ependymoma constitute 5 % to 7 % of all primary CNS neoplasm. But their prevalence relative to other tumor type varies with patient age and presenting location. Ependymoma constitute approximately 1O % of intracranial neoplasm in pediatric population and up to 30 % of those encountered in children under 3 years of age. In spinal column, ependymoma constitute 60% of glial neoplasm, and opposed to intracranial tumors. These neoplasm exhibit a decided preditection for the fourth and five decade of life In these research which has done upon 25 patients with ependymoma in the Shohadaye Tajrish Hospital during the years 1372 to 1376, Thirteen of patients are male and 12 of them are female. The tumor has been more common between the ages of 0-20 years old in intracranial neoplasm and 21-30 years old in intraspinal neoplasm. Headache and lumbar pain have been the most common clinical manifestation. The majority (22) of lesions in conventional histologic grading have been low grade (Grade I,II) and the rest (3) high grade (grade III.IV).

Thid article is a retrospective study on 37 patients with Crohnchr('39')s disease, who have been admitted at Taleghani and Day general hospital during the past 14 years. This chronic inflammatory disease of gastrointestinal tract which is common in western world, had been rare in eastern countries including Iran until 30 years ago. The object of this study is to show the increasing incidence of Crohnchr('39')s disease in Iran during the past decades. Despite some similarities, we have found differences in our patients including sex distribution and gut involvement pattern. According to the writers point of view this differences are due to the small number of evaluated patients in this study. Increased incidence of Crohnchr('39') s disease in Iran is probably due to life style and diet modification, which are secondary to industrialization of the society.

In this study, 180 aut of 986 primary school children of Absard were evaluated for the presence of intestinal parasitic infections. Direct smears of one stool sample for each public were used in this study. The samples were selected from one urban and two rural areas. Afghan immigrants were also included in the study. Among study population, 69 % were infected by intestinal parasites. The most prevalent parasite was giardia lamblia (55 % ) and after that E-coli and Entamoeba histolytic had the highest prevalence. No difference was found in the prevalence of parasitic infections between boys and girls. Most of the infections were seen in 10-12 age group. 3rd grade students had the highest rate of infection among different educational levels. (25 % ) but no significant difference was found Mong students of different grades. Among school children 12. 7 % were infected by more than one parasite most of which were giardia lamblia and E Coli. 29 Afghan school children were included in this study, significant correlation was found between having an Afghan nationality and intestinal parasitic infection (P < 0.01). No difference was found in the prevalence of intestinal parasites between rural and urban regions. In this region, water contamination with parasites was not found Treatment of school children is not recommended due to high prevalence of intestinal parasites but water filtenation with sandy filters and health education are of high importance.

Clinical and Electrophysiologic features of Guillan-Barre syndrome in 23 children (1-15 y.old) were prospectively studied during 2 years (Jan. 97 to Jan. 99). These studies were performed at admission in hospital and one month later. 5 patients requied respiratory assistance (G5) and 15 patients were bedridden (G4). 2 patients had chronic GBS and one had recurrence after 6 months. Neurophysiologic findings in CPN were (in order of frequency): Decreased amplitude of CMAP (96 % ) , increased distal latency (74 % ) , increased F wave latency (69%) and decreased NCV (60%). Sensory nerve conduction, by examining sural nerve latency was normal in 78 % of patients. There was no significant difference between electrodiagnostic findings performed at admission and one month later, suggesting that diagnosis of GBS could be achieved as early as the first days of illness. The presence of fibrillation potentials in our patients can be indicative of prolonged course and recurrence. As previous reports, this sutudy confirmed the good prognosis of GBS in children compared to adults.

The objective of this study was to determine the distribution of the cause of death among children under 5 years with respect to the age and sex in Amirkola Children Hospital. The data of 536 child death was obtained during l 993-1997 on the basis of ultimate diagnosis in the death certificate using disease classification. The results shows that the most common cause of death in the neonatal period were infectious (33.6%), respiratory disease (28.2%), cardiovascular disease (8.7%) and congenital abnormality (7.4%), respectively. But for children with age I month to 5 years, the most common cause of death were infectious (41.7%), cardiovascular disease (14.4%) and blood disease (8.2%). We did not find any significant in the difference of distribution of cause of death between male and female, but it was significant in the two difference of distribution of cause of death between male and female, but it was significant in the two age group under study (P=0.000). With regard to high prevalence of the main cause of death, it is necessary to perform the more epidemiologic studies and to promote the health program in the prevention of infectious, respiratory and cardiovascular disease and to provide special therapeutic care unit for more reduction of under 5 mortality.

Rose questionnaire is a standard mean for diagnosing angina pectoris in epidemiological study. The present study was done to determine the prevalence of angina pectoris according to Rose questionnaire for chest pain, and to investigate the association of angina with several coronary hearh disease risk factors in Tehran urban population (district-13) during 1999 to 2000.

6028 person including 3492 women (58%) and 2536 men (42%) aged 30 years and above participated in a cohort study of "Tehran Lipid and Glucose Study". they were screened for hypertension, smoking status, hypercholestrolemia, low high-density lipoprotein cholesterol, obesity, diabetes mellitus and impaired glucose tolerance. A questionnaire including personal information (age, educational attainment), the use of medications for hypertension, diabetes mellitus, and dyslipidemia and standard Rose questionnaire were filled. 

Age-Adjusted prevalence rate of angina according to Rose questionnaire was 12. 8 % in women (95% CI, 11.7 to 13.9) and 10. l % (8.8-11.2) in men. The prevalence of angina was higher in women than in men at each age group, with an increase in rate from the youngest to the oldest age group. The prevalence of more severe angina ( definite angina) was about two times of milder angina (possible angina), 11.6% versus 6.4%. In a logestic regression model, hypertension, educational attainment, diabetes, smoking status, and sex were each strongly associated with angina. Hypertension had the strongest and most consistent association with angina. No significant association was found between age, obesity, hypercholestrolemia, HDL and angina.

The results indicate that about one tenth of adult population are reporting chest pain. The present study is imited by its cross-sectional design and the relation of angina future coronary heart disease events should be assessed in follow-up of "Tehran Lipid and Glucose Study" population.

Considenig the high prevalence and unique features of Hodgkinchr('39')s disease, its non-specific symptoms at the beginning of the disease, existing controversy on the age distribution of patients and histopathological features and its unknown status in Iran. This study was conducted in Modarres, Taleghani and Imam Hosein Hospitals between 1992 to 1997 to assess primary symptoms and histopathological features. In a retrospective study based on existing data in the patients files, personal· information including age, sex, major signs and symptoms, histopathological features of hodgkin · s disease were obtained and recorded. There were 350 cases of hodgkinchr('39') s disease of whom 122 had complete files (72 men, 50 women aged 35± 18 ys). Among 122 cases; 83% had major signs and symptoms (3) and 73 % had solid cervical nodule on presentation. One-third of patients were in stage II and 43 % had nodular sclerosis. According to high prevalence of Hodgkinchr('39')s disease and involvement of patients in their active life period, it is recommended to conduct analytical studies to investigate the etiology of the disease.

We inspected on about 110 patients of spinal tumors in the neurosurgical department of Loghman-e Hakim Medical Center. According with our inspectation, we have considered the factors such as age, sex, pathology, clinical signs, radiology, kind of operation and…. cases were up to 16 years ( 15 % ) and the  17 ‏ others were adult. 62 (56%) were male and 38 (44%) were female. The most privalent spinal tumors were neurofibroma, meningioma and ependimoma. Their initial sign is weakness of limbs. We have observed positive sign in myelography (91 % ) spinal plain X Ray (55%) and C.T. Scan about (100%).

Decreased serum HDL is one one of the most lonmon lipiu disoides in paterts with colonary disease and the existing enidenie svggests that every lmg/dl decreaie in servn HDL inveases CAD risk by 2-3 % . This study was performed in 2000 to study HDL deterninants in tehran popolation. westudied 9514 individvais, 20-69 yers old who have participated in tehran lipid and gwcose study (tl62), inclvding 3942 men and 5571 woman. in all subjects a personal history questionnaire especially on physical activity and cigarette smoking, was filled out and clinical examination inclvding anthroponetic measurements were performed. Serum levels of total cholesterol, trig;ucerides, and HDL were ,easured. Women had a significantly hoher mear HDL than in men (45± 11 vs 38±9 mg/dl; P<0.001); low HDL level (HDL < 35 mg/dl) was observed in 31 % of men and 13 % of women (P < 0. 00 I). Obese subjects (BMI 30 Kg/m2) had a significantly lower HDL level than normal subjects(42± 11 vs 44± 1 I: P < 0.0001). Subjects with truncal obesity (WHR0.95 in ,en and WHR 0.8 in women) had lower HDL level than normal subjects (37 ±9 vs 39± 10 in mean and 44± 11 vs 48± 11 in women  P < 0.001 in both). Smokers had a significantly lower HDL level than nonsmokers (38± 10 vs 43±11; P<0.001) and low HDL level was two ties more common in smokers than in nonsmokers (36.4 vs two times more common in smokers than in nonsmokers (36.4 vs 18.2 pecent). Passive smokers had also lower wean HDL levels ( 42 ± 11 vs 43 ± 11; P<0.001). Mean HDL level was not different in subjects with different degrees of physical acfiuity. In multiple stepwise logistic regression, deferminarts of serum HDL level, in order of entering the model, were: Sex (OR 3.03, P<0.001), high WHR (OR 1.56; P<0.001), Cigarethe smoking (OR 1.63; P<0.0001), age (OR 0.99; P<0.001), obesity (OR I. 21; P < 0. 005), and possive smoking (OR 1.17; P < 0. 04). Physical activity did not enter the predictive model apart from age and sex which are constitutional, nonmodifiable variables, other modifiable determinarts of HDL level (obesity, truncal obesity, cigareth smoking, and passive smoking) can be used in community prevention programs in control of CAD.

Intussusception is the most common cause of intestinal obstraction in children aged 3 months to 6 years. Complete understanding of its clinical and radiographic manifestations can play a major role in the early diagnosis and treatment and prevents its complications. In this study plain abdominal X-rays of 51 patients with intussusception were evaluated. Suggestive radiographic signs of the disease were observed in 90% of study population. Thise findings indicate importance the importance of abdominal X-ray in the diagnosis of intussusception. The important signs of intussusception in their order of appearance were as follows: The distention of small bowel loops, sparse large bowel gas, soft tissue mass, signs of intestinal obstruction and crescent sign.

In this research 783 child of Day care centers (D. C. C) of Qazvin Alvand, Industrial Cities had stoll examination for Giardiasis.
Results were: Giardiasis was found in 13.5  % of children with peak incidence in 4-5, 6-7 years, more in female than male, incidence of Giardiasis were increased with decrease of Educational Level of mothers and increase of family members. Giardiasis was more in D.C.C of industrial, Alvand cities than Qazvin. D.C.C.