نشریه پژوهش در پزشکی
سال بیست و چهارم شماره 1 (پیاپی 94، بهار 1379)

Dyslexia is a treatable disorder that attaches great importance if confused with studying unsuccess due to stupidity. To determine the prevalence of dyslexia and also all possible errors as well as establishing the relation between the disorder and sex of affected person and the level of their parents education, a prospective study has been carried out among the third grade students of Urmia elementary schools, in winter 1996. 2067 males and females school children were selected and surveyed. All of them have been selected by cluster random sampling and comparison has been achieved between affected ones and their classmates. Dyslexia prevalence was 3.2%, where female to male ratio was 6 to 13. A comparison between the affected and normal ones has revealed no difference according to the type of the error, but the higher rate of errors was seen in the affected group. A significant correlation was seen between dyslexia and the illiteracy of parents, especially mothers(p<0.01). Regarding its importance, investigating dyslexia is highly recommended in all elementary schools.

The importance of variations in lipid and lipoprotein-cholesterol level has been determined in many disorders including cardiovascular and metabolic ones. The following study has been achieved with the aim of determining the level of these factors and their standard variation criteria in patients with acute lymphoblastic leukemia (ALL). To meet this demand, serum lipid and lipoprotein-cholesterol were assessed in 42 patients with ALL, divided in two groups of children (under 15 years) and adults (over 15 years), in a two phase study: 1- before therapy, 2- after the first course of chemotherapy. Precipitation method and applying the acetate cellulose electrophoresis were our methods of choice. Results have shown a significant increase in TG and VLDL-C level in patients (before therapy) in comparison with the control group (112.7 to 142.2 mg/dl and 22.5 to 28.5 mg/dl, respectively), in the meantime, a significant decrease has been noted in HDL-C level (32.3 to 21.5 mg/dl). In patients with complete remission, the results have revealed significantly decrease in TG and VLDL-C levels after inducing chemotherapy (142.9 to 121mg/dl and 28.6 to 24.2 mg/dl), whereas significantly increase was determined in HDL-C level (22.0 to 29.8).

Food handlers could be major sources of intestinal parasites transmission (specially Giardia lamblia, Entamoeba histolytica) in case of not observing the hygienic rules. To determine the prevalence of intestinal parasiteschr('39') infection in food handlers in Nowshahr and Chalous, 1373-74, 411 food handlers in three major groups including: 1) chelokababi(120), 2) sandwich makers(61), and 3) groceries, dairy shops and confectionaries(230). Formalin-ether concentration technique was used to examine all the fecal samples. Finally, the overall prevalence of intestinal parasiteschr('39') infection was assessed 30.2% where 21.4% were pathogenic. The highest prevalence rate was seen in sandwich makers (36%). Giardia lamblia was the most common protozoal infection (9.2%), where Hymenolepsis nana was seen more than the other helminthes (3.1%). The prevalence of intestinal parasites infection has shown significant differences in food handlers according to age and the level of education. Infectious rate was recorded in candidates over 40 years old less than the others (20%), (p<0.025). Candidates with diploma or higher education have shown infectious rate of 11.4%, where this figure was 43.3% in illiterates (p<0.025).

In diabetes, the main part of treatment is left on the patient himself, so their knowledge in different aspects of treatinent, specially the nutritional management, is of great importance. Our study with the aim of surveying the nutritional knowledge of diabetic patients was conducted in Semnan, in 1997. In this descriptive study, the initial data were gathered through questionnaire and face to face interview of 255 diabetic patients (selected by simple sampling), referring to physicians, clinics and hospitals. Results have revealed that 74% of patients were aware of obesity disadvantages and 64% were aware of liquid oil preference to other oil products. They were informed of some disapproved sweet materials, containing simple and filtrated carbohydrates, whereas 78% of patients were not aware of increasing the diet meals and using foods containing soluble fibers with low glycemic index. In the meanwhile, 69% of patients have not consulted a nutritional specialist for diet planning. It seems as if patients need more information about diet effects on disease control, knowing useful, approved and disapproved foods and materials, and also managing diet planning .

Regarding the importance of cardiovascular disease in society health and with respect to known high risk of hyperlipidemia, hyperglycemia, obesity, and hypertension in these patients, and also regarding the lack of epidemiological studies in this field, specially in rural area, this study has been conducted on 2705 candidates over 30 years old [1296 males (48%) and 1409 females (52%)] by multiple-phase randomized sampling, in 100 villages. Serum level of cholesterol, triglyceride, HDL, and sugar were obtained on fasting blood samples. For diagnosis of diabetes and IGT, glucose tolerance test with 75 gr glucose was performed. Then blood pressure, body weight and height, and body mass index (BMI) have been measured. Waist/buttock ratio was considered as a factor for evaluating abdominal obesity. The mean BMI was 28.6 mg/dl). No significant variation has observed in LDL-C level. In the meantime, no significant differences have been noted in these factors in patients with incomplete remission, before and after the therapy. Regarding the fact that HDL-C, unlike TG and VLDL-C, is less influenced by diet and other factors such as stress; serial determination of HDL-C level is highly recommended in patients with ALL , in this way a powerful tool for evaluating the disease procedure along with chemotherapy efficacy would be achieved.  Moderate to severe obesity has been recorded in 34.7%, 37.1% and 22.3% of patients with diabetes, IGT, and normal individuals, respectively. The mean of waist/buttock ratio was higher in diabetic patients (p<0.001). Abnormal waist/buttock ratio makes individuals more susceptible to diabetes (2.9 times). One fifth of patients with diabetes have diastolic blood pressure more than 89 mmHg and half of them have systolic blood pressure of 139 mmHg and above, whereas these figures were 1/10 and 1/5 for normal individuals, respectively. The mean of TG was 322 ±282, 206± 178, and 178±124 mg/dl in patients with diabetes, IGT, and normal individuals, respectively. These differences were statistically significant (p<0.001). In diabetic patients, the prevalence of triglyceridemia was 2.1 times more than normal individuals and 1.6 times more than patients with IGT. Cholesterol level of 239 mg/dl and higher was recorded in 12.6% of normal individuals. Hypercholesterolemia makes patients more susceptible to diabetes (3.9 times). The mean of LDLcholesterol was recorded 145 ± 43.6, 134 ± 38.9, and 121 ± 36.1 mg/dl in patients with diabetes, IGT, and normal individuals, respectively (p<0.001). HDL-cholesterol below 35mg/dl was seen in 45.9% of diabetic patients. LDL/HDL ratio above 5 has been recorded in 17.8%, 19.3%, and 9% of patients with diabetes, IGT, and normal individuals, respectively. The prevalence of diabetes in patients with cholesterol/HDL ratio above 4.5 was 2.4 times more than patients with cholesterol/HDL ratio of 4.5 and below. Results have implied that obesity, hyperlipidemia, and hypertension are common findings in diabetic patients. Regarding its potential hazard, intervention in life style is strongly recommended.

Pregnancy-induced nausea and vomiting is a common complaint and about 80-88% of pregnant women have experienced it. This study has been conducted regarding limited drug therapy and the efficacy of acupressure and Neiguan point (po). This clinical trial of cross over type has been performed in gyneocologic clinics with randomized sampling in two phase of control and case, 1998-99. In the case phase an elastic band (Sea band) has been fastened over the wrist on p6 for 5 days, then in the control phase the same elastic band has been fastened over the same area on the other wrist to fulfil our placebo effect 100 pregnant women have been assessed where 76% were primigravid and 84% were 17-24 years old. In 58% of all cases, gestational age of 10-12 wecks has been detected. Results have implied that number, duration, and severity of nausea and the number of vomiting were significantly different in the case group. Regarding the fact that acupressure is a simple method with minimum expenses and side effects, using such a method for eliminating the number, duration, and severity of nausea and vomiting in pregnant women is strongly recommended.

Gallstones are among common complaints of human societies. Its prevalence has been estimated about 10% in western societies. As operational manipulation is still the method of choice in symptomatic gallstones, post-operative side effects and complaints, like remained gallstone in common bile duct, are studied. In a retrospective study we have reviewed the files of the patients hospitalized in Shariati Hospital due to post-operative side-effects of cholecystectomy, 1997. We have studied 34 patients with post-cholecystectomy syndrome. The mean age was 61. RUQ pain was the most common complaint of the patients, and high level of alkaline phosphatase was the most common laboratory finding. Remained gallstones were diagnosed much more than bile duct stenosis and stump syndrome. Among 26 patients with remianed gallstones, sonography has successfully diagnosed 21 cases, wliereas ERCP has determined definite diagnosis. Endoscopic sphincterotomny was successfully performed in 18 patinets, but the remaniers(16 patients) required surgical intervention Remaining gallstone is the most common complaint of post-cholecystectomy syndrome that demands careful attention during gall bladder surgery, especially in old patients. In case of encountering this problem, endoscopic sphincterotomy should be the first choice, fortunately it succeeds in more than half of the patients, then in case of unsuccess, reoperation is recommended.

HIV infection is a chronic disease in which different endocrine glands could be involved either directly by the virus itself or indirectly by many factors especially oportunistic infections at the late stages of the disease. bacause the duration and the manifestations of the infection is related to the General factors, we evaluated the hypophysial, thyroid, adrenal and the gonadal hormones in 15 adult HIV+ Iranian men, categorized in various clinical stages. Although there were no obvious clinical manifestations, but the present data showed a positive correlation between the decline of T3 and CD4+ peripheral blood cells(r=0.87,p<0.05). Although the mean of PTH level in patients was less than seronegative controls (p<0.01), and there was a positive correlation between the decline of PTH and CD4+ blood cells (r=0.88,p<0.05) but this decline was not to that level which causes alteration in calcium homostasis. The mean of patients growth hormone levels was lower than seronegative age matched controls (p<0.01), but this decline was mainly due to low levels of this hormone in hemophiliacs. Basal serum cortisol level was high in 80% of patients but the increment in ACTH levels were only seen in those patients who had higher percents of CD4+ cells Serum testosterone was elevated in 5, decreased in others and there was no normal correlation between the concenteration of this hormone and gonadotropins. There were high estradiol and prolactin levels in 33% of patients who and low testosterone and gonadotropins, with previously proven hepatit dysfunction probably due to hemochromatosis .