مجله دانشکده پزشکی اصفهان
پیاپی 493 (هفته اول آبان ماه 1397)

Congenital adrenal hyperplasia is the most common cause of ambiguous genitalia, which can be obscured by ambiguous genitalia, weight loss, and premature pubarche. Therefore, this study aimed to evaluate the demographic characteristics and clinical findings of patients with congenital adrenal hyperplasia. In this cross-sectional study, 161 patients with congenital adrenal hyperplasia participated. All patients were followed up, and anthropometric findings of clinical examinations and paraclinical findings were accurately recorded in the files, and extracted from the records. Findings: 142 cases of deficiency of 21-hydroxylase deficiency (21-OHD), 10 cases of 3β-hydroxysteroid dehydrogenase (3β-HSD), 7 cases of 11-hydroxylase deficiency (11-OHD), and 2 cases of steroidogenic acute regulatory protein (StAR) were studied. 69 patients were boys and 92 were girls, with an average age of 9.39 ± 5.61 years. The prevalence of macropenia was 22.4%, as well as clitoromegaly 33.5%, ambiguous genitalia 14.3%, hirsutism 5.0%, premature facial hair loss 5.6%, and premature puberty 11.8%; and mean age of puberty was 8.89 ± 2.48 years. Based on the clinical findings, in children with ambiguous genitalia, macropenia, clitoromegaly, hirsutism, premature facial hair growth, and premature puberty, we should consider congenital adrenal hyperplasia.

This study aimed to evaluate and compare the risk factors of cardiovascular diseases among boy students in first and last years of education in medicine and dentistry in Isfahan University of Medical Sciences, Isfahan, Iran, in year 2016. In this descriptive cross-sectional study, boy students in first and last years of education in medicine (160) and dentistry (40) were enrolled. Then, students were divided into two groups based on being on the last or the first year of their school, and completed the prepared checklist. The checklist included demographic information, anthropometrics, Food Frequency Questionnaire (FFQ), International Physical Activity Questionnaire (IPAQ), and Perceived Stress Scale. Findings: The main score of stress was significantly higher in last year students (38.62 ± 7.54) compared to the first year students (30.06 ± 5.18) (P < 0.001). There were no significant difference between the two groups based on nutritional status and physical activity (P > 0.050 for both). The level of stress was high in last year students of medicine and dentistry. Physical activity and nutritional status did not show any significant changes in different study years

Electroconvulsive therapy (ECT) is one the most common methods of treatment in many kinds of psychiatric disorders. Because of increased muscle contractions and subsequent increase in oxygen consumption and heart rate during ECT, preoxygenation and respiratory support are of the utmost importance. Therefore, we decided to investigate the effects of various methods of preoxygenation on hemodynamic changes in such patients. This was a clinical-trial study conducted on 64 patients under 25 years of age, undergoing ECT, randomly divided into three equal groups. The patients were preoxygented for 5 (first group) or 3 minutes (second group) through a basic facemask, or four deep breaths (third group) prior to the induction of anesthesia. Blood pressure, heart rate, and blood oxygen saturation (SPO2) were measured and recorded, and the mean values compared in each group, before preoxygenation, one minute after induction, and at 1, 5, and 10 minutes after seizure remission. Findings: The mean arterial pressure (MAP) at 1 minute after induction, and 1 and 5 minutes after seizure had the highest amounts in the third group and lowest in the first group, with statistically significant difference (P < 0.050). The heart rate 1 minute after induction, and 1 and 5 minutes after seizure had the highest amounts in the third group and the lowest in the first group, with statistically significant difference (P < 0.001). The mean seizure duration had the shortest period in the first group and longest period in the third group (P < 0.001). Preoxygenation, 5 minutes before ECT, caused a significant decrease in changes in blood pressure and heart rate. On the other hand, the arterial oxygen saturation in this group showed less decline than the other groups.

 

Considering the significant impact of bronchiectasis on the quality of life, and lack of adequate study on the etiology of this disease, this study aimed to determine the frequency distribution and risk factors for bronchiectasis in patients referred to Alzahra hospital affiliated to Isfahan University of Medical Sciences, Iran, during the years 2017 and 2018.

In a descriptive-analytic study, 63 patients with bronchiectasis who had been admitted to Alzahra hospital during 2017-2018 were studied. Patients’ demographic and clinical characteristics, clinical manifestations, and complaints, as well as risk factors were determined. Findings: 34 patients (54%) were men and 29 (46%) were women. The mean age of the patients was 36.08 ± 15.3 years (range: 12-87 years). The most common primary complaint was cough associated with sputum with an incidence of 19 patients (30.2%). The history of severe respiratory infection was the most common reported risk factor for bronchiectasis in studied patients.

Our findings indicate that bronchiectasis is more common in the active age group of 20-39 years, and the prevalence of certain potential risk factors, including the history of severe respiratory infection, is higher in this group. Therefore, considering that the etiology of bronchiectasis is idiopathic in a significant percentage of patients, more studies are needed to determine the risk factors for the disease

Steroid hormones (estrogen and progesterone) have been hypothesized to play significant role in the cause of depressive symptoms. Therefore, this study examined the association between the use of oral contraceptive pills (OCPs) and depression in women referred at health care centers in Isfahan City, Iran during the years 2016-2017. In this cross-sectional anterograde study, 204 participants were assessed in two equal groups of women who used OCPs (group 1) or natural methods of birth control (group 2). Beck Depression Inventory (BDI-II) and demographic information questionnaires were used to collect the data. Pearson test was then applied to examine possible significant relationships. Findings: There was no significant relationship between depression severity (P = 0.930, r = -0.09) and depression score (P = -0.889, r = -0.014) with the use of OCPs; while there was a significant positive relationship between depression severity (P < 0.001, r = 0.507) and depression score (P < 0.001, r = 0.528) with the duration of using OCPs. In group 1, there was a negative relationship between the level of education with depression severity and score (P < 0.001, r = -0.36 for both). In group 2, only a negative relationship was found between the degree of education and depression score (P = 0.018, r = -0.235). To reduce depression symptoms and rate in women after taking OCPs, it is recommended to use other safe non-hormonal methods. Moreover, taking OCPs should not be utilized for more than a five-year period.