مجله علوم پزشکی رازی
سال هفتم شماره 3 (پیاپی 21، پاییز 1379)

Circumcision is one of the most primitve Surgical Procedure for the boys. The first practice is done about 15,000 years ago. Before the 19th century it was almost like a religeous tradition. Since the advantages (hygienic and cural) was proved from that time, it has become current in the developed countries for the scientific point of views. This report is the result of 4700 cases of Neonatal Circumcision by Plastibell Device, during the seven years from 1991 to 1998 at Shahid Akbar Abadi maternity Hospital. The conclusion emphasizes on Neonatal Circumcision as a best period in which the most important approved profits are the protective role in UTI (and its assigned harmful complications), and penis cancer. Concerning the available documents, the less the age of the baby, the more profits and advantages would be. Based on these existing evidences, it is approved that penis cancer is the only cancer which is truley prevented by Neonatal Circumcision. The common complications such as local bleeding, meatitis and so on can be prevented by choosing best techniques and the required precision during surgical procedures and afterwards (especially by Plastibell Device), and if they occur, the care is easy and not expensive. Nowadays, the traditional beliefs on neonatal circumcision should be discarded so that the practical training courses could be held on by concerning authorities for interested physicians.

The ability of controlling balance is an essential part for all movements. In recent years, new theories in movement and balance has become the basis of some research in evaluating balance. In one of this new methods ( which is used in this study ) controlling balance is evaluated by measuring body sway in standing position during different conditions in which, the availability of sensory information has been changed. This study has a Quasi – Experimental design, and the sample consisted of 90 females, categorized as children, adults and elderly. According to the results, in altered sensory conditions the adults could control their standing balance more effectively than the other two groups. Besides, it seems that in children the function of vestibular system in controlling balance was not as effective as in adults. The results also show that in elderly, the importance of visual information in controlling balance was less than somatosensory information.

Systemic sclerosis is a disease with skin tightness. Besides of skin involvement, there may be involvement of different organs. Systemic sclerosis may be diffuse or limited, but in both of them Raynoud’s phenomen is common. This phenomen is due to vasoconstriction and vascular insufficiency and is a phenomen that makes problem for the patient and does not have any efficient treatment. One of the new drugs under research is Alprostadil, a prostaglandin El analoge. In this report, a case of systemic sclerosis with ulcer on the tip of fingers who has received new treatment, are introduced and discussed.

Mental retardation in children creates one of the most important for every society. Taking care of menatally retarded child causes many emotional and financial difficulties for the family. Needless to say, the prevention of mental retardation is the keyword in the management of the problem which is feasible in many situations. To acertain the etiologic factors causing mental retardion, all children with Intelligence Quotient (IQ) less than 70, who were referred to Mofid pediatrics hospital during a 9 months period from Mehr 1375 to Khordad 1376 (Sept 1996 – May 1997) constitute the subjects of this investigation. 150 children in the age range of 4 – 15 year old were included in the protocol. Based upon diagnositc studies, mental retardation in 20% of the cases (30 of 150 ) is attributed to prenantal causes, which the most important of them were: Genetic disorders, chromosomal aberration, metabolic diseases and intrauterine infections. In 24% of the cases (36 of 150), mental retardation could be attributed to perinatal causes, like: Brith asphyxia, premature labor, traumatic brith and twin delivery. Among postnatal factors which caused mental retardtion in 27.3% of cases (41 of 150), infections, trauma, intracranial hemorrages and hypothyroidism constituted the most predminant etiologic agents. We could not delineate the causes of mental retardation in 28.7% of the patients (43 of 150). Althogh our patients were in 4 – 15 years age group, but the majority of these children were aged 4 – 5 years. 72% of them had motor developmental delay and 65% suffered from epliepsy. Behavior disorder, visual and auditory impariments and cerebral palsy were aditional findings in mentally handicaped child. 42.7% of our study group were product of consanguineous marriage. Based upon this study it seems that considering the following steps can reduce occurrence of mental retardation to a significant degree. Prevention of premature birth when feasibel, treatment and control of infectious disease, paying more attention to prevention of trauma and accidents, performing screeing test at birth for early diagnosis of some metabolic disease (PKU) and hypothyroidusm and finaly avoiding consanguineous marriage, if any case of mental retardation has happened in the family previously.

The prevention of intraocular presure (IOP) has an outstanding effect upon successful ophtalmic surgery. Some stages of induction of anesthesia, like laryngoscopy and endotracheal intubation, cause the IOP increase which has dangreous consequences in open eye injuries. The purpouse of this study is the comparison of IOP changes during the induction of anesthesia using thiopental and propofol under equal conditions to carefully examime the effect of them on the IOP to choose more effective drug in decreasing IOP and prevention of an increase in the IOP following laryngoscopy and intubation. Ninty patients randomly selected to receive either thiopental 4 mg/kg (Group 1) or propofol 2.5 mg/kg (Group 2) for the induction of anesthesia. Both groups received sufentanil 0.15 μg/kg before the induction and atracuium 0.7 mg/kg after the induction of anesthesia. The IOP was measured four times: at preinductional stage, postinductional stage, during laryngoscopy, and 15 seconds after successful intubation. Both groups had a significant decreace in the IOP following the induction of anesthesia (p

Acute pseudo–obstruction of the colon or ogilvie syndrome results in massive colonic dilatation that may lead to a life threatening perforation. Pseudo–obstruction are terms used to denote a condition in which patients appear to have signs and symptoms suggestive of intestinal obstruction without an evident mechanical source. This problem is often seen in association with other diseases and occasionlly complicates the post-operative course of patients who have under gone one of several typesof operations, particulary abdominal surgery. Predisposing factors include different medical and surgical illness. Renal failure and Kidneay transplantation are perdisposing factors: The presented case was a complication of renal failure, who was diagnosed and operated because of peritonitis secondary to cecal perforation. Colonic decompression by means of colonoscopy is the most effective therapeutic modality for pseudo – obstruction of colonic dilation. If the bowel is ischemic or perforated, surgical intervention will be indicated.

In this research the effects of low power Ga – As Laser irradiation applied to acupuncture points on subjective symptoms in chronic Lateral epicondylitis were studied. The method of this study was quasi Experimental. Thirty two patiens (age range 22 – 57 years) with clinically diagnosed chronic lateral epicondylitis took part in this study. All referred patients were examined (exclusion and inclusion criteria) by a physician who also examined selected patients after the treatment period. All of the patients were categorized at random, into two groups for laser (n=16) or control (n=16). In the control group, the laser was placebo, but because these patients were to be treated (ethical reasons), we used pulsed ultrasound to treat both groups (basic treatment). Mean value for pain (Vas–10 cm) in laser group was lower than control group in the 5th (P=0.008) and the 10th (P=3.7× 10 ) sessions. No significant difference was observed between both groups in the 1 st session. Mean value for isometric grip strength (N) in laser group was higher than control group in the 10th (p=0.01) session. No significant differences were observed between both group in the 1st and the 5th sessions. It is concluded that low power Ga – As laser stimulation applied to acupuncture points was found to improve subjective and objective symptoms in chronic lateral epicondylitis.

A study was carried out on levels of ascorbic acid changes in patients with type II diabetes mellitus. The purpose of this study was to determine total plasma and mononuclear leukocytes ascorbic acid levels in diabetic patients blood in different age groups and four groups with respect to glucose and comparison with those of normal individuals. The subjects include 62 patients with type II diabetes and 38 normal individuals both within the age range of 30 to 65 years. The results show no correlation between total plasma and mononuclear ascorbic acid levels and the glycemic control method. Also there is no correlation between the mean of total plasma and mononuclear leukocytes ascorbic acid levels, glucose, stage and duration of diabetes. The mean of total plasma and mononuclear leukocytes ascorbic acid does not significantly differ between patients and normal subjects (p>0.05), but analysis of the existing data indicate a marked decrease of total mononuclear leukocyte ascorbic acid levels in patients with glucose above 250 mg/dl when compared with normal individuals and patients with glucose below 149 mg/dl (p

Prevalence of diabetes in the families is important. There are difference in prevalence of the disease in different cultures and different areas. We studied prevalence of diabetes in relatives of patients in our country. This study was descriptive and retroespective. Patient selection was convenience. There was 432 records of diabetic patients which were hospitalised in Firooz-Abadi Hospital from 1998 to 1999. From 378 records informations about type of diabetes, sex and history of diabetes in their relative were extracted and analysed with Chi–Square (X2–test). Prevalence of type 2 diabetes was 78.6% and of type 1 was 21.4%, most were female (type 1 63%, type 2 66%). Diabetes in relatives was type 1 47%, type 2 28%. First degree relatives were more involved than other relatives. Parents were more involved than others, specialy mothers (P=0.0006 in type 1 DM and P=0.001 in type 2). In mothers transmitions to daughters was more than sons (type 1 P=0.001, type 2 P=0.00004). Prevalence of diabetes in relative of type 1 diabetes is more than type 2 and females are more involved than males. Diabetes in parents especialy in motheres was than other relatives. Transmition from mothers to daugthers was more than sons (type 1 diabetes P=0.001, type 2 P=0.00004). Genetic transmition in Iranian people is different from other countries and more studies can be done in this area.

Legal surgical pregnancy terminations are commonly performed in Iran. Lidocaine is used widely for cervical anesthesia during suction curettage . Lidocaine carries the potential risk of side effects and toxicity if over – dosed. The aim of this study was to compare lidocaine and saline for cervical anesthesia to blunt the reported pain during curettage. For this purpose a double – blind randomized clinical trial was conducted on 85 women presenting for legal pregnancy termination procedure.Participants received either paracervical submucosal injections of 1% lidocaine (n=44) or saline (n=41) just before cervical dilation. Anxiety level or all subjects about the procedure was assessed by using of Anxiety Self – evaluation Questionnaire. Self – roported pain intensity was assessed after dilation and 30 minutes after procedure. Eighty–five eligible women presenting for legal pregnancy termination procedure participated in the study. No statistically significant differences were found between lidocaine and saline subjects on prior pregnancies, abortions, and level of anxiety about the procedures. Pain intensity ratings in lidocaine and saline treatment subjects did not differ significantly at any point. Furthermore, of those women receiving lidocaine, toxicity symptoms were not reported. To minimize lidocaine side effects and toxicity for a curettage procedure, saline could be considered for the paracervical injection solution. The local anesthesia mechanism of saline may be distention rather than blockage of specific autonomic nerves when there is no waiting period.

A 40 year-old man was referred to our center with obstructive uropathy. In spite of removing the stone, serum creatinine remained high, so a kidney biopsy was performed. Acute Tubulointerstitial Nephritis “TIN” was reported by light microscopy, Linear deposition of IgG and C3 along tubules were detected by immunofluorescence studies. In his serum Anti – TBM activities was also detected which was of IgG class. Plasmapheresis and immunosuppressive treatment were very effective in this patient. To the best of our knowledge this is the first confirmed case of Anti – TBM, reported in Iran.

The essential goal of this study was to idendify the prevalence of hyperthyroidism in atrial fibrillation (AF), and interrelation to sex and age. The study was sequentiol and the method was requesting TFT in 100 patients with AF Seeking medical attention in Iran Medical Siences University Hospitals. These tests constitute of TSH, T4, T3 RUP (ELISA method). In 100 patients of AF 14 cases were hyperthyroid. All of them were 38 years old or younger. Co-incidence of AF and hyperthyroidism in old age is very low, and interrelation of AF and hyperthyroidism for age needs additional study. The prevalance of hyperthyroidism and AF Was 14% in this study. According to sex, 15.4% were men and 13.5% were women.