Internal Medicine Today
Volume:13 Issue: 2, 2007

The convergence insufficiency is an inability to converge or to maintain convergence for prolonged near work or in the other hand an inability to obtain or to maintain sufficient comfortable binocular vision at near. The symptoms associated with convergence insufficiency are asthenopia, headache, intermittent diplopia, perceived moving of print when reading etc. These symptoms can be worse with prolonged near work, sleepness, stress, anxiety and illhealth. The clinical signs of this problem are remote near point of convergence,reduced positive fusional vergence and increase of exophoria at near.The stages of treatment are elimination of decompensating factors,correction of any refractive errors,vision training,prism prescription and surgery if required. The purpose of this study is the determination of mean and range of convergence insufficiency diagnostic tests in patients with convergence insufficiency. In this cross sectional study 74 patients aged 12-25 year with convergence insufficiency who refer to Alzahra eye center and had inclusion criteria selected randomly.After the determination of refractive errors by retinoscopy(with cyclopentolate %1 if needed)and best correction with subjective refraction, near point of convergence with millimeter rule,exophoria with alternate prism cover test and positive fusional vergence with prism bar was measured.One vertical row of reduced snellen chart with equivalent size approximately 20/30 used as a accommodative target.After collection of desired information,data were analysed by SPSS.14. From 74 subjects, 41 patient(%55/4)were females and 33 patient (%44/6) males. In this study the mean of near point of convergence, exophoria at near, positive fusional vergence were 11/97 ± 3/24 centimeter, 9/66 ± 4/36 prism diopter and 19/63±8/26 prism diopter respectively. There was not statistically significant relationship between sex and convergence insufficiency diagnostic tests (P>0.05). This study showed that the mean and standard deviation of near point of convergence,near exophoria and positive fusional vergence in most patients with convergence insufficiency were abnormal compared with patient without convergence insufficiency.Also in spite of normality of one diagnostic test,patient may have convergence insufficiency.

Ventilated_associated pneumonia is the most common acquired infection in ICU.The prevalence of pneumonia in intubated patients is 21 times more than other patients.Tracheal tube colonization is considered as a risk factor and affected with duration of intubation and decreased gastric acid.This study is conducted to determine the epidemiology and microbiology status in the patients admitted at loqman hospital poisoning ICU. The reaserch method was descriptive and it's technique was an observation-interview.Patients with positive endotracheal tube culture were entered the study, the sampling method was endotracheal aspiration.Qualitative culture and resistance pattern evaluation with Kirby-bauer method was used. We surveyed 180 intubated patients with mean age of 31.63±13.9 years old. 83.3 precent of the patients had recieved antibiotic therapy before sampling. Staph. coag. positive.(45.6%)was the most commonly isolated pathogen and followed by Klebsiella, Acintobacter and E.coli. Isolation of one organism was seen in 62.8% and multiorganisms in 37.2%. Temp≥38 was seen in one_third of the patients and WBC≥12000 was detected in 44 precents of the patients. There was a significant relationship between antibiotic therapy with fever. 11.1 precent of the patients died. There was a significant relationship between the kind of organism and survival, but there was a significant relationship between antibiotic therapy before sampling and patient's survival. Detection of Acintobacter with Klebsiella, E.coli and Staph. aureuse increases the probability of nosocomial pneumonia caused by AST III group. Lack of relationship between kind of organism and prior antibiotic therapy is considered as an alarm for resistant infections.

Hematologic values are extensively used for health evaluation. These values can be used for diagnosis and management of hematologic and nonhematologic diseases. Some factors affect these values, including age, sex, race, diet, and environment. Since these factors vary in various populations, they can cause differences in reference hematologic values. In this study 1040 healthy individuals were randomly selected in various locations of Mashhad from different age groups: 11-13, 14-18, and 19-55 years. Standard specimens were collected. Analysis of WBC, RBC, Hb, Hct, RBC indices, PLT and leukocyte differential counts were performed and reference values were calculated. Reference ranges for RBC, Hb and hemtocrit were higher in adult male participants. Platelet counts were higher in females. Hematologic reference values in adult males were: WBC (×103μl)= 6.45(3.3-9.6), RBC(×106μl)= 5.43±0.9, Hb (gr/dl)=15.9±1.96, Hct (%)= 47.2±7.2, PLT(×103μl)=231(133-329). Determination of hematologic reference values in this study showed obvious differences with previous studies. In particular MCV, MCH, MCHC, WBC, and platelet counts were lower.

schizophrenia is a kind of disease which decreases intelligent capacity and the ability of mind. In addition the symptoms that present in schizophrenia directly or indirectly are associated with intellectuality. Some researchers have shown such sort of association between the ability of mind and educational level with the grade of insight as well as clinical feature. The present study tries to show whether any association between insight and level of education is as well as positive and negative symptoms of schizophrenia. One hundred and twenty five schizophrenic patients aged 18-45 years old referred to Avicenna hospital in Mashad were included. The duration was since Ordibehesht of 1384 until Ordibehesht of 1386.The positive and negative symptoms of schizophrenia scale (PANSS) and Schedule for assessing the three components of insight (ASTCI) were used to assess the clinical features and the level of insight.SPSS-11 was used to statistical analysis and the method was Pearson co-efficiency analysis. There was a significant association between educational grades and insight (p<0.05) and negative association between mean scores of PANSS in three dimensions (negative, positive and global scores with total score of SATCI (P<0.05). There is positive association between educational and insight levels. Furthermore the negative relationship between the severity of disease and the insight level has presented the importance of focusing on this issue to predict the prognosis as well as acceptance of medication account of the important role of insight and compliance of the treatment.

This study was prompted by reports suggesting a high prevalence of unrecognized obsessive-compulsive disorder (OCD) in the dermatology clinics. 140 consecutive dermatology referrals were screened for DSM-IV OCD using the Yale-Brown Obsessive Compulsive Scale (YBOCS). Illness severity was rated on the Y-BOCS, and symptom profiles and dermatologic symptom were established for all cases. 31patients (22.1%) qualified for a DSM-IV diagnosis of OCD, all of them were previously undiagnosed. The range and type of OCD symptoms covered the normal clinical spectrum. 33(23.6%) 0f patients had more than 1 symptom, and among OCD symptoms over washing was the most common. 39.7% of the positive cases scored 16 or higher. Dermatologic symptoms were various and did not seem to bear a direct relationship with OCD. These results suggest that there is a high prevalence of clinically relevant OCD in the dermatology clinics. This is an area that merits attention with regard to better recognition and treatment for OCD sufferers.

An important disease in the middle-aged is cardiovascular disease, including is a forwarding disease that is started in childhood and clinical effect will appeared in adults from middle-aged.From the other side on the other part, living without activity or motion cause to increase all of the main defect of mortality and risk of cardiovascular disease, become twice as much. WHO recommends: one of an important cases in preventing cardiovascular disease is doing activity for 30 minutes per day, at least this research study the relation between cardiovascular disease and background of physical activity in middle-aged period in old people membered in Isfahan retirement center. The sort of the study is a cross-sectional that its target population are old people membered in Isfahan retirement center. 255 persons were chosen by a simple random sampling. The method for gathering data was a questionnaire with 6 questions about characteristic of demography, 5 questions about cardiovascular diseases, 20 questions related to physical activity in the middle-aged period that was completed by organized interview. The conclusion showed that the prevalence of cardiovascular disease and hypertension in old people under examination is %32/2 and %46/7. Also, the result showed that there are statistic significant between cigarette usage and disusage from morbidity of heart disease (p=0/04) and also between morbidity and unmorbidity of hypertension and morbidity of cardiovascular disease (p<0/001). This research showed that the prevalence of cardiovascular disease and hypertension in old people membered in Isfahan retirement center is over expectation. Also it cleared that rate of walking, playing tennis, body exercises, cycling and mounting are effective in prevalence of morbidity in cardiovascular diseases. The study showed that the rate of walking, body exercises, running in the middle-aged between men and women is approximately equal and there are direct association between physical activity and level of education, in the other hand, what ever the level of education is up, physical activity will be more, too. but out of walking, cycling, mounting and running are in the middle-aged is equal with all level of education.

In today society, human life, in all dimensions, have been changed. marriage married life, sexual behavior, also, have been changed. Sex education can provide opportunity to learn about sex awareness and sex roles. Sex education helps youth to clarify their values, avoid risky behaviors and improve negotiation skills. Research goals are the study of sex education effect on prevention of sexual problems, health behavior, sex appropriate behavior, mental health, family health, and gender identity. In this study the research method was experimental and research design was post-test with one group. Statistical sample were 92(36 female, 56 male)university students. The sampling method was stratified. To collect data a questionnaire was used the questionnaire consists of 20 items with Likert type five –scale response option (with a score rang of one to five). The questionnaire face and content validity were established using a panel of experts. A Cronbach's aloha reliability of 0/84 was obtained of the questionnaire in a pilot study with 30 students. In the present study to analyze data t-test have been used. Six hypotheses were tested. The results showed that: 1)Sex education have effect on health behavior (t=13/006.p<0/0001). 2)Sex education have effect on sex appropriate behavior (t= 10/017,p<0/0001). 3)Sex education have effect on mental health and prevention of sexual problems (t=12/555,P<0/0001) 4)Sex education have effect on family health (t=9/720,p<0/0001). 5)Sex education have effect on appropriate gender identity(t=4/139,p<0/0001). 6)Effect of sex education is different between male and female students (t=0/556,p>0/000). The results of this research is consistent with other studies. For example Gibson and Mitchell(1999),Cooney (1991),Bee(1998),Berryman et.al (2002), Franken(2002), Jaff(1998), Santrock (1997), Schickedanz et al. (2001), Kvalem et al (1996), Millan st al (1995), Russell et al (1992), and Bhuiya et al (2002).

There exist wide variations among clinicians as to management of the child who presents with the first febrile convulsion. Most experts recommend lumbar puncture for infants with febrile seizure. However the risk of meningitis is very low in these patients. These indicate that a large number of “unnecessary” lumbar punctures would be done. Finding risk factors of meningitis in infants with febrile seizure can help physician to select patients for lumbar puncture. 45 patients with febrile convulsion and 15 with meningitis, 3 to 18 months of age between Jan. 2002 to Nov.2002 enrolled in a cross sectional study. Patients with electrolyte abnormality, afebrile seizure, history of neonatal seizure or developmental delay and CNS abnormality excluded. Clinical and laboratory data between the two groups were analyzed. 16 of 60 had less than 6 months age which 8 of them had meningitis (p=.007). 28 patients had complex seizure but 11 of them had meningitis (p=.017). Positive CRP in meningitis group was significantly different with febrile convulsion group (7 of 15 and 3 of 45, respectively). WBC count in 10 patients with meningitis was greater than 10000/mm3 and in febrile convulsion group only 14 of 45 had leukocytosis(p=.015). Although there is some statistically differences between clinical and laboratory data in meningitis and febrile convulsion group, lumbar puncture is still necessary in FC. Studies with large number of cases are recommended.