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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
سال پنجاه و یکم شماره 4 (پیاپی 102، زمستان 1387)

92 صفحه، بهای روی جلد: 15,000ريال
تاریخ انتشار: 1387/10/11
تعداد عناوین: 11

فارسی
English

انتخاب همه

Evaluating the Correlation between HbA1c and Growth Parameters, Lipid Profile in Children and Adolescents with Type 1 Diabetes

Nosrat Ghaemi, Mahmoud Keramati, Rahim Vakili Page 197

Introduction
Type1 diabetes is the most common endocrine disorder in children. The disease is associated with a variety of complications including growth abnormalities. The aim of this study was to evaluate the role of diabetes and blood sugar control on physical growth (height and weight), growth parameters and lipid profile.
Materials And Methods
This descriptive cross- sectional study took place from July 2006 to July 2007. A total of 154 children and adolescents with diabetes type 1, evaluated for their growth parameters, lipid profile٫ and its correlation with duration of diabetes and mean HbA1C.
Results
The mean age of diabetes diagnosis recorded 6. 2±3. 1 year. The mean height growth velocity was 4. 8±1. 48 cm and the mean weight growth velocity 3±1. 5 kg in one year. In the first group with HbA1c< 8 (mean±1sd) height and weight growth velocities were 4. 8±1. 3 cm and 3. 03±1. 6 kg in a year respectively. In the second group with HbA1c > 8 (mean±1SD), yearly height and weight growth velocities measured 3. 2±1. 22 cm and 3. 03±1. 2 kg in turn. Moreover, in the first group TC, LDL, HDL and TG were 163. 1±34 mg/dl, 109. 3±22 mg/dl, 49. 5±1 mg/dl, 116. 3±55 mg/dl and in the second group 172. 6±46 mg/dl, 122. 4±80 mg/dl, 48. 5±1 mg/dl, 153. 3±1. 5 mg/dl in the order mentioned. In the group with disease duration less than 5 years, height and weight growth velocities were 5. 7±1. 4 cm and 3. 3±1. 6 kg and in group with disease duration more than 5 years, height and weight velocities reported 3. 74±1. 2 cm and 3. 3±1. 2 kg annually respectively.
Conclusion
According to this study, there was no correlation between the mean of height, weight growth velocities and metabolic control in both groups. However, the hight growth disorder and increase in the level of TG were correlated with the duration of disease. Also, lipid profile (dislipidemia) was associated with the lack of metabolic control.
Keywords: Iddm, height, weight, HbA1c, Lipid

Abstract View Paper Original: Persian
Evaluation of Visual Evoked Potential's Findings in Patients with Multiple Sclerosis

Mohsen Froughipoor, Alireza Khosravi, Morteza Saedi, Faranak Koranian Page 203

Introduction
Multiple Sclerosis is one of the commonest neurological disorders that because of its different clinical presentation, recurrent and progressive attacks, and age spectrum of patients who are usually young, has particular importance. Optic neuritis is common in MS patients and VEP is abnormal in most of the patients with optic neuritis. VEP is also abnormal in most of the MS patients who do not have the history of optic neuritis. The aim of this study was to compare the incidence of VEP in MS patients with and without the history of optic neuritis.
Materials And Methods
This study included 80 patients with definite MS diagnosis who referred to the MS Clinic Ghaem Hospital. A questionnaire used to collect the patients demographic and illness history. Patients were divided into two groups based on the history of optic neuritis. The full neurological examination including VEP carried out for the patients. Collected data analyzed with SPSS and statistical tests.
Results
The abnormal VEP found in 92.2% of patients with the history of optic neuritis. The incidence of VEP in patients without the history of optic neuritis was 57.5%. The VEP abnormality recorded 40.5% unilateral and 59.5% bilateral in the first group of patients. In the second group the VEP was 87% unilateral and 13% bilateral.
Conclusion
Many MS patients without the history of optic neuritis, had abnormal VEP, therefore VEP can be used for the early diagnosis of MS. Although, patients with the history of optic neuritis will have significant improvement with the time, but many cases with increased P100 latency is persistence, and can be used as a marker of the pervious optic neuritis attack.

Abstract View Paper Original: Persian
The role of thoracoscopy in diagnosis of hidden diaphragmatic injuries in penetrating Thoracoabdominal Traumas

Reza Bagheri, Alireza Tavassoli, Ali Sadrizadh, Mohammadtaghi Rajabi Mashhadi, Faramarz Shahri, Reza Shojaeian Page 209

Introduction
Complications like chronic diaphragmatic hernia thoracoabdominal stab wound following conservative treatment, make it necessary to find a safe and exact diagnostic method. The aim of this work was to assess, accurate diagnostic value of thoracoscopy in occult diaphragmatic injuries in penetrating thoracoabdominal stab wound.
Materials And Methods
In the present prospective study, from March 2005 to October 2007 at Ghaem, Emam Reza and Shahid Kamyab Hospitals of Mashhad University of Medical Sciences, thirty patients with penetrating thoracoabdominal injuries, with stable hemodynamic and no need to emergent exploration were evaluated. They underwent thoracoscopy to evaluate probable diaphragmatic injuries, which were repaired via thoracoscopy or laparatomy and all patients evaluated for chronic diaphragmatic hernia by CT-scan, 6 months later.
Results
Mean age was 26.2 years and M/F ratio was 5:1. In thoracoscopic evaluations five hidden diaphragmatic injuries (16.7%) were observed, that 3 cases (9.9%) were repaired through thoracoscopic approach and laparatomy was inevitable in 2 (6.6%) patients. Lung paranchymal laceration was seen in 2 patients (6.6%), repaired with thoracoscopy and intra abdominal injury was seen in 1 patient (3.3%), repaired with loparatomy. No complication reported after thoracoscopy and there was no evidence of chronic diaphragmatic hernia in the chest and abdominal CT-scan performed 6 months later. In this study, the diagnostic accuracy of thoracoscopy in occult diaphragmatic injuries was 100%.
Conclusion
Because of high diagnostic accuracy rate, and minimal invasively diagnostic and treatment ability of thoracoscopy, this diagnostic method in all clinically stable patients with penetrating thoracoabdominal stab wound is recommended.
Keywords: Diaphragmatic injury, Penetrating thoracoabdominal stab wounds, Thoracoscopy

Abstract View Paper Original: Persian
Prevalence of Renal Artery Stenosis Following Diagnostic Coronary Angiography

Mahmoud Ebrahimi, Mohammad Reza Abolfazli Page 215

Introduction
Renal artery atherosclerosis is the most common cause of renovascular hypertension and ischemic nephropathy which is potentially a correctable problem by surgery or intravascular intervention. The prevalence of Renal Artery Disease (RAD) in hypertensive patients evaluated for Coronary Artery Disease (CAD) as the main symptom of atherosclerosis, in our population is unknown, we began evaluation of renal artery stenosis in these patients.
Materials And Methods
A prospective cross-sectional study carried out from March 2004 through January 2005 in cardiology department of Emam Reza Hospital, Mashhed University of Medical Sciences, Mashhad, Iran. Over all 255 of patients suspicious of CAD included in this study. Coronary angiography performed by femoral artery approach followed by renal artery angiography. Artery' involvement with more than 50% of the lumen (renal arteries or coronaries) classified as significant stenosis. Coronary stenosis divided into 1-, 2- or 3-vessel involvement. Collected data analyzed by SPSS.
Results
The patients were 129 males and 126 females, with the mean age of 58.5%+10.6. A total of 200 patients (mean age of 59.7±10.5) had CAD and the reminders had normal coronary arteries (mean age 61.5±10.3). The Prevalence of RAD in patients with CAD was 31% (63 patients; 19 bilateral and 44 unilateral stenosis), of significant RAD in 1-, 2-, or 3-vessel involvement were as follow respectively 24.27%, 35.7% and 36.5 %. In 55 patients with normal coronary arteries, the prevalence of RAD was 3.6% (p<0.001).
Conclusion
Many studies have shown the progressive nature of renal artery stenosis; therefore, early diagnosis will prevent its progression and other consequences. Our results suggest that CAD, especially when more arteries are involved, is a predictor of renal artery stenosis. Since 31% of our hypertensive patients with CAD had significant renal artery stenosis, we recommend that renal artery angiography be performed following coronary angiography for those patients with significant stenosis.
Keywords: Coronary Artery Disease, Angiography, Renal artery stenosis

Abstract View Paper Original: Persian
Results of one Stage Transanal Resection of Large Bowel in Hirschsprung's Disease

Mehran Hiradfar, Nona Zabolinejad, Mohammad Gharavi, Mahmoudreza Ashabeyamin, Bita Khorram Page 219

Introduction
Hirschsprung's disease is a developmental disorder of the enteric nervous system, characterized by functional obstruction. Absence of ganglion cells in the distal colon resulting in a functional obstruction. The aim of this study was to evaluate the results and complications of one-stage transanal endorectal pull-through (OTEPT) in the management of patients with Hirschsprung's disease.
Materials And Methods
A total of 40 children (31 boys and 9 girls) aged 3 days to 60 months underwent OTEPT procedure over a period of two-years at Dr. Sheikh pediatric Hospital. This study was approved by the local committee of Medical Ethics. Median follow up period was 9.10 months (range, 3 to 33 months).
Results
Mean operation time recorded 101.60 mins (range, 25 to 270 minutes). Hirschsprung's disease developed conventional in 55% (short segment in 30%), Ultra-short in 32.5% and long segment in 12.5%. Mean length of resected bowel measured 17.31 cm, 2 patients underwent laparatomy because of extension of aganglionic segment beyond the sigmoid colon. Mean NPO time and need to rectal tube after the operation were 4.35 and 4.41 days, respectively. 8 patients required urinary catheters after the operation with the mean remaining time of 3.30 days, 20% needed ICU care after surgery and mean hospital stay was 5.76 days. Post-operative complications included entrocolitis (n=2) and abdominal distension (n=1). One patient expired due to non surgical reason (heart failure).
Conclusion
OTEPT procedure is a safe method with low incidence of postoperative complications. In Hirschsprung's disease confined to the rectosigmoid region, the hazard and morbidities associated with laparatomy and colostomy are avoided with this technique.
Keywords: Hirschsprung's disease, One stage resection, Transanal

Abstract View Paper Original: Persian
The Outcomes of Redo-Coronary artery Bypass Grafting

Mohammadhasan Nezafati, Mohammadd Abasi Tashnizi Alireza Karamrodi Page 225

Introduction
Application of off-pump technique for reoperative coronary artery bypass grafting (Redo CABG) has been limited by technical difficulties, potentiation for embolism of athermanous debris from the involved grafts, resulting in myocardial infarction, and rapid hemodynamic deterioration.
Materials And Methods
In this descriptive study from 2002, at Cardiac surgery Department of Emam Reza Hospital, a total of 77 consecutive patients underwent redo CABG (64 ONCAB and 13 OPCAB) The outcomes of off-pump (OPCAB) and on-pump (ONCAB) redo CABG were compared. Surgical technique in 2 patients (%11) was converted from OPCAB to ONCAB due to hemodynamic instability, severe adhesion or graft injury; and in one patient (%7) the conversion from ONCAB to OPCAB was for severe aorta calcification.
Conclusion
Propensity matched comparison of the outcome of OPCAB with ONCAB for redo CABG showed that OPCAB was associated with significant reduction in postoperative complications, volume of blood transfusion and hospitalization length. OPCAB can be safely and effectively applied for reoperative CABG, in selected cases.
Keywords: OPCAB, Redo CABG, ONCAB

Abstract View Paper Original: Persian
Congenital Absence of One of the Pulmonary ArteryBranches

Hasan Mottaghi, Mohsen Horri Page 229

Introduction
Absence of one of the pulmonary artery branches is an uncommon congenital defect. Most of these patients have other associated cardiac deficiencies. Early diagnosis and surgical intervention may prevent irreversible pulmonary hypertension and collateral circulation formation.
Materials And Methods
A cross-sectional descriptive study was done from 2001 to 2006 on the records of 18 patients with absence of one of the pulmonary artery branches that referred to the EmamReza Hospital, Mashhad University of Medical Sciences (a tertiary referral hospital). Patients’ data including history, physical examination, chest X-Ray, cardiac catheterization and angiography reviewed and analyzed statistically.
Results
Among 18 patients, 13 (72.2%) were males; the mean age of those on diagnosis was 11.8±10.8 years (Range 1-38 years). Except one, all of them had associated congenital heart defects. Most of these abnormalities were complex form of CHD, and Tetralogy of Fallo was the highest abnormality (7 cases). Seventeen patients (77.8%) had occult left pulmonary artery (LPA). CXR findings in all patients included heart and mediastinum deviation toward the absent pulmonary artery.
Conclusion
Early diagnosis and surgical intervention may allow normal growth of the pulmonary artery and prevent collateral formation and irreversible pulmonary hypertension. Therefore, complete evaluation for the absence of pulmonary artery branch in suspicious infants, especially those with CHD, is mandatory.
Keywords: Absence of one of pulmonary artery branches, Congenital heart defect, Echocardiography, Catheterization, Pulmonary hypertension, Children

Abstract View Paper Original: Persian

علمی مصوب

مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد

Medical Journal of Mashhad University of Medical Sciences

دوماهنامه پزشکی

آخرین شماره | آرشیو

ISSN: 1735-4013

صاحب امتیاز:

دانشگاه علوم پزشکی مشهد

مدیر مسئول:

دکتر عبدالله بهرامی

سردبیر:

دکتر غلامحسین کاظم زاده

تلفن نشریه: ۰۵۱-۳۸۵۳۳۶۳۰

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فهرست مطالب

مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد سال پنجاه و یکم شماره 4 (پیاپی 102، زمستان 1387)

مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد

Medical Journal of Mashhad University of Medical Sciences

مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
سال پنجاه و یکم شماره 4 (پیاپی 102، زمستان 1387)