مجله علوم پزشکی رازی
سال دوم شماره 1 (پیاپی 5، بهار 1374)

More than two decades ago, Henry T. Lynch reported a hereditary non polyposis colorectal cancer (HNPCC) which is seen in some families with dominant mode of inheritance, also know as Lynch Syndrome type I and II. This form to hereditary colorectal cancer has an early age of onset (Less than 45 years) with predominantly proximal colonic involvement (type I) and can also be associated with extracolonic cancer (type II). It is estimated that perhaps 4% - 13% of all cases of colorectal cancer are attributable to HNPCC. In this article, six cases of Cecal and / or ascending colon carcinoma are presented which are site-specific with a young age of onset, and one out of two of these patients are close relatives such as:brother and sister, mother and son and nephew and uncle, although for final Confirmation we need chromosome studies on these three families, but these could be considered clinically as Lynch 1- Syndrome pathology of most of these cases is of mucin-producing type adenocarcinoma.
It is concluded that, because of a high incidence of colonic carcinoma with a young age of onset (perhaps around 50%) in Iran, the incidence of HNPCC could be much higher than in western populations.

Remaining informed on the latest biochemical information is a necessity as well as a professional responsibility for any person involved in the field of medicine. The main and most readily available sources for updating the professional's knowledge are medical journals. In addition to foreign periodicals, there are a number of useful medical journals published in Iran. The first Persian language medical journal was published 90 years ago and throughout Iranian press history, the number of journals has varied during different Periods. Since 142 years ago when Iran first began its Publishing industry up to the victory of the Islamic Revolution medical periodicals have formed 3.4% of the total titles published, the oldest one being Issued 56 years ago In 1992, the number of Iranian medical periodicals was 31 (6.3% of total periodical titles), the majority of which is published by universities, government organizations and institutions and pharmaceutical companies. Of these titles, only three have International standard Serial Number (ISSN).

Acute Respiratory tract infections (ART!) are one of the most common problems encountered in childhood. In this article, epidemiology of ART! in the pediatric ward of Talegheni Medical center during a 5 year period from 1988 to 1993 was reviewed. 191 children were hospitalizid with ARTI. 184 (96.3%) suffered from LRT!, and of these, 150 patients had pneumonia (78.5%), 22 had Croups (11.5%), 12 had bronchiolitis (6.3%) and 7 Patients had Sinusitis (3.7%) .
Children between 1 month to 1 year of age were the most common age group in patients with pneumonia and croup and accounted for 52. 7% of patients. In the same age group, in patients with pneumonia, there were 50 boys and 26 girls. The difference is statistically significant (p

Chest pain, especially in the left hemithorax, is a very common symptom, which often causes a patient to immediately seek medical advise, since it is often deemed to be related to cardiac diseeses.
Some chest pains can be easily diagnosed and treated when a careful tilstory is taken and physical examination performed. One of the causes of chest pain which is common among housewives and some men is "flower pot carrier's syndrome' of 'sadjadi-maleki syndrome" which is being reported heve for the first time in medical literature In this syndrome, the patient's complain of upper chest pain which is aggrevated by change in position and teepirstory movements. Physical examination reveals tender zones. these patients often have a histoty of cartying Flower pots, cylinders and other things with chest support.
In this syndrome, para clinic findings almost always are normal A ceretutnistory and physical examination can result in a definite diagnosis which will eliminate patient anxiety, save time and money wasted for unnecessary laboratory tests.

In order to determine demographic characteristics and to estimate the prevalence of various rheumatic diseases encountered in rheumatology clinic in Tehran, this survey was conducted.
This study was carry out at Hazzrat-e Rasool university hospital, the major teaching hospital of Iran university of medical sciences and health services. The study population consisted of 3856 consecutive newly refered patients of various ages who were seen at the clinic between May 1992 and June 1995.
The patients were classified into diagnosis related groups (DRG) according to 1983 ARA classification of arthritis and rheumatism.
RESUL TS: The 3856 studied patients had a mean age of 40 years and 67% were women. Connective tissue disease was the most common DRG which was found in 29. 5% of the patients. Osteoarthritis and rheumatoid arthritis in various stages were the most common diseases found in 19. 6% and 17. 4% of the Patients respectively.
Soft tissue rheumatism was found in 18. 5%, infectious agents related rheumatic syndromes in 3%, Spondyloarthropathies in 3. 8%, and nonspecific arthritis in 1. 8% of the patients. No case of HIV related musculoskeletal problems was found in this survey.
Erythema nodosum, carpal tunnel syndrome, fibromyalgia syndrome and PSS were more common in women (F/M Ratio >8). and ankylosing spondylitis and gout in males (MIFRatio>8).
Juvenile rheumatoid arthritis, acute rheumatic fever and vasculitis were the most common diseases in pediatrics patients (age of first visit« 16 years), and osteoarthritis (OA), rheumatoid arthritis (RA) and extraarticular lesions in geriatric patients (age of first vtsite: 60 years).
RA (24. 4%), SLE (11. 6%), OA (10%) and vasculitis (6. 5%) were the most common diseases in 525 hospitalized patients. SLE was the major cause of patient mortality.
The results of this survey are compatible with data obtain from textbook and other similar surveys.

Hospital maintenance and maintenance management is a new area which has recently been given more attention. It has special importance in developing countries where its economic aspects necessitates specific planning.
In Iran, maintenance and problems associated with it have been considered to some extent in industry and related areas. However, it has not yet been given adequate attention in the health community, especially in hospitals. The present study was carried out to determine the maintenance conditions in five general hospitals during the year 1993-1994 with the use of descriptive method.
The required information was collected through questionnaires and checklists.
Due to inadequate accounting and financial records, we could not obtain exact figures concerning expenses in all these centers.
Also, it was found that there were no experts for repairing and maintenance of medical and non-medical tools and equipment in aI/ five hospitals under study. Furthermore, none of the fol/owing areas has been taken into account in these hospitals:1. Maintenance training
2. Maintenance committee
3.Instructions for controlling and checking the equipment before they are used.
4. Written instructions for maintenance
5. Personnel's responsibility in protecting and maintenance equipment
6. Providing a file for maintenance of the hospital building and equipments.

A known complication of chronic renal failure (CRF) is osteodystrophy.
In order to determine the effects of parathyroidectomy on treatment and prevention of osteodystrophy progression in patients with CRF, a retrospective study was carried out in 16 hemodialysis patients.
62% of the patients underwent total, 12% subtotal and 26% total parathyroidectomy with simultaneous autograft in shahid Rahnamoon, hospital during 1983-1993.
There was no recurrence of symptoms in any of the patients.
Hypocalcemia was found in 40% and hypophosphatemia in 30% of the patients with total parathyroidectomy without autograft and in one of the cases who had subtotal parathyroidectomy.
It is therefore concluded that total parathyroidectomy with autograft is superior to other conventional procedures, in the management of this complication.