فهرست مطالب

Iranian Journal of Medical Sciences
Volume:30 Issue: 2, Jun 2005

  • تاریخ انتشار: 1384/05/11
  • تعداد عناوین: 13
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  • M. Baghaei Page 51
    Background
    Zoonotic cutaneous leishmaniasis (ZCL) is a polymorphic disease which may show various clinical manifestations. Although genetic variability of the parasite is suggested to be one of the factors influencing clinical manifestations in leishmaniasis, no data exist regarding genetic polymorphism of Leishmania major. Therefore, determination of genetic variation within the species of L. major isolated from different cases of ZCL in Isfahan, Iran and its relation to clinical manifestation of the disease is investigated.
    Methods
    The internal transcribed spacers (ITS) in the ribosomal operon of 9 isolates of L. major from three clinically different forms of ZCL were amplified by polymerase chain reaction (PCR), followed by the digestion of the PCR product with two restriction enzymes. The profiles were visualized in agarose gel under UV light.
    Results
    The PCR product obtained for all isolates was about 1060 bp in size. Restriction analysis of ITS with both enzymes showed identical fragment patterns in samples isolated from clinically similar forms of ZCL, but highly diverse fragment patterns in those isolated from clinically different forms.
    Conclusion
    L. major causing ZCL in Isfahan is genetically a highly polymorphic species and a correlation may exist between genetic heterogeneity of the parasite and the clinical manifestation of the disease in human.
  • M. Mehdizadeh, M. Afarid, A. Attarzadeh Page 55
    Background
    Causes of blindness in children vary according to the region and socioeconomic development. Within a given country these causes vary with passage of time. This reflects different levels of socioeconomic development and provision of healthcare services. This cross-sectional study was undertaken to estimate the major causes of severe visual impairment in children and specially preventable and curable blindness in southern Iran.
    Methods
    145 students of Shiraz Blinds'' School, Shiraz, Iran, interviewed, examined and their medical documents reviewed. Causes of visual loss were analyzed according to involved anatomic area.
    Results
    145 students (290 eyes) were examined (53.1% girls and 46.9% boys), among which 42.1% had vision of no light perception. Eye dysgenesis was found in 21.4%, glaucoma in 15.9%, lens associated visual loss in 6.2%, optic nerve lesions in1.4%, retinal problems in 54.48% and corneal problems in less than 1%. Sixty five students had retinitis pigmentosa, which was the single commonest cause of visual loss.
    Conclusion
    The major cause of childhood blindness in this region is retinitis pigmentosa, followed by microphtalmia, eye dysgenesis and congenital glaucoma. Large proportion of these blind children had a positive history of consanguineous marriage in their parents and this seemed to be the most probable cause of increased frequency of genetic causes of childhood blindness.
  • D. Farzin, S.H. Hosseini, A. Shafaat Page 59
    Background
    About 40%-60% of schizophrenic patients are resistant to ordinary treatment, which result from interference with different neurotransmitter systems in the process of disease. The aim of present study was to determine the effect of famotidine on several symptoms of schizophrenia which was nonresponsive to neuroleptic treatment.
    Methods
    30 schizophrenic patients previously nonresponsive to ordinary treatment were categorized into two groups. Famotidine group received perphenazine plus famotidine and placebo group received perfenazine plus a placebo. Patients in both groups were followed for 6 weeks and assessed by the positive and negative symptom scales (PANSS) at weeks 0, 2 and 6 of the treatment.
    Results
    Both groups were similar in terms of positive and negative symptoms. In the placebo group, the total scores of PANSS (severity of the disease) did not change significantly. However, based on the total scores of PANSS, there was a significant difference between both famotidine and placebo groups at the end of sixth week (P<0.05). In terms of general psychopathology scale and aggressive risk, there was also a significant difference between both famotidine and control groups at the end of sixth week.
    Conclusion
    Famotidine can improve the symptoms of schizophrenic patients who were not responsive to neuroleptics.
  • A. Japoni, M. Hayati, A. Alborzi, Sh. Farshad, S.A. Abbasian Page 63
    Background
    Pseudomonas aeruginosa, as an etiological agent, has a prominent infection role in serious burned patients. Burned patients usually treated with antiseptic ointments such as silver sulfadiazine (SSD). This study evaluated the effectiveness of 1% SSD and different concentrations of silver nitrate solution (SNS) on resistant isolates of P. aeruginosa.
    Methods
    Three groups of P. aeruginosa isolates were collected consisting of 63 strains from burned patients (group I), 15 strains from burn-hospital environment (group II) and 70 strains from non-burn patients as control group. The Minimum Inhibitory Concentrations (MICs) of SSD and SNS were determined by agar dilution method and their susceptibility to SSD was evaluated by agar well diffusion method.
    Results
    In group I, 60 (95%) strains were resistant to SSD, whereas only 5 of them were resistant to SNS. In group II, eight out of 15 strains were resistant to SSD with MICs similar to group I while they did not show any resistance to SNS (P<0.001). In control group, all strains were sensitive to SSD and SNS (P<0.001
    Conclusion
    Most of burned patient isolates were resistant to SSD while most of them were sensitive to SNS. In contrast, all the control isolates were sensitive to SSD and SNS. Frequent administrations of SSD ointment in burned patients surely have caused resistant strains to emerge. Cessation of SNS application in clinic or less administration of SSD in non-burn patients did not induce resistance strains.
  • Sh. Mansouri, M.R. Shakibaie, S. Mahboob Page 68
    Background
    Enterococci faecalis are predominating species of Enterococci causing nosocomial infections. Acquisition of resistance to antibacterial agents, and ability to transfer the resistant genes made them clinically important. This study was performed to determine the frequency of isolation of different species of Enterococci, and the antibacterial resistance pattern of the isolated species.
    Methods
    Enterococcal species were isolated from clinical samples. In vitro susceptibility of the isolates to 10 antibacterial agents was tested by standard methods and β-lactamase production was detected using starch-iodide method.
    Results
    100 Enterococci were isolated from 585 different clinical samples. 73% of the isolates were E. faecalis, 13% E. faecium and 14% which were not identified as either one, were regarded as other enterococcal species. Highest rate of resistance (98% or more) was found for oxacillin and penicillin while vancomycin and chloramphenicol were among the most active agents. Resistance to antibacterial agents was more common for E. faecium and β-lactamase production was found in 81% of the isolates.
    Conclusion
    E. faecalis was the dominant species, with the higher rate of β-lactamase production. E. faecium was more resistant to antibacterial agents as compared to other isolates. 80% of the isolates had multiple drug resistance phenotypes (MDR). Low-level resistance to vancomycin (intermediate reaction in disk diffusion method, minimum inhibitory concentrations range ≥4-16 µg/ml) and presence of MDR isolates is very important and should be considered as an danger alarm for serious enterococcal infections.
  • N. Sarraf, Zadegan, A.M. Baghaei, M. Sadeghi, A. Amin, Zadeh Page 73
    Background
    Recent studies show cardiovascular disease (CVD) risk factors have the tendency to intermingle. Integration between some biological and homodynamic risk factors have made the new hypothesis for etiology of CVDs. The aim of this study was to determine the clustering pattern of metabolic variables and left ventricular (LV) mass among smoker and non-smoker individuals and the interrelationship between these risk factors.
    Methods
    50 smokers and 50 non-smoker healthy males aged 20 to 60 yrs participated in the study. After completing a WHO standard questionnaire regarding smoking habits, medications and history of other diseases, physical fitness, blood pressure, fasting blood sugar, plasma insulin, total cholesterol, HDL, triglycerides and lipoprotein (a). A 12-lead electrocardiography and echocardiography studies were done to determine the LV mass.
    Results
    No significant differences were found between smokers or non-smokers in regard to the studied metabolic variables except for LV mass (228.4±48.6 vs. 196.4±57.3 g; P<0.05). The interrelationship of metabolic syndrome variables and other CVD risk factors among smokers was greater than non-smokers (P<0.05). In the factor analysis, three components were retained both for smokers and non-smokers. A total of 59.5% of variance was explained in data for all subjects.
    Conclusions
    Smoking has probably no relationship with components of metabolic syndrome; however the correlation between these risk factors and other homodynamic measures and LV mass was greater among smokers than non-smokers. No single factor can explain the clustering of the metabolic syndrome among smokers.
  • K. Ahmadi, Renani, Gh. A. Ghorbani Page 80
    Background
    Measles is a contagious respiratory viral infection that accompanied with skin rash. Vaccination against measles has reduced the prevalence of the disease but sporadic measles epidemic still occurred in young people. This study, was carried out for the response evaluation of immunity against measles in Iranian soldiers living in garrisons.
    Methods
    In this study based on the history of measles, contact with measles cases, measles in the family and vaccination, 360 sera samples were obtained from male soldiers living in Tehran during years of 2003-2004 using ELISA method.
    Results
    Whereas, 48.9% and 22.5% of cases were negative for IgG and IgM respectively, 22.5% of the samples were seronegative for both IgG and IgM isotypes. The respective antibody titers of IgG and IgM were 14.45% and 36.56%. Regarding 22.5% negative cases for IgG isotype and 36.67% of positive IgM is indicative of possible latest outbreak.
    Conclusion
    Single vaccination against measles during childhood was not protective and requires booster injections.
  • J. Mehvari, M. Rafieian, Kopaei Page 84
    Background
    A wide range of preventive medications for migraine attacks, with varying efficacy is currently in use. Studies comparing the efficacies of these drugs would be of value in the proper treatment of the disease. The present study compared the frequency, duration and intensity of migraine attacks during and following treatment with cyproheptadine (4 mg, twice daily) or Blellergal (belladonna 0.1 mg, ergotamine 0.3 mg and phenobarbital 20 mg).
    Methods
    118 patients 15 to 45 year-old with migraine headaches were randomly allocated to groups I (n=36), II (n=40) and III (n=42) and treated during three consecutive phases of 45 days. In phase one all groups received two oral placebo tablets daily. In phase two, group I continued with placebo, groups II and III received cyproheptadine (4 mg, twice daily) and Bellergal (three tablets daily), and finally, in phase three all groups were treated with placebo, respectively.
    Results
    Cyproheptadine and Bellergal treatments significantly reduced the frequency, duration and intensity of migraine attacks. These parameters remained low during phase three (placebo) in cyproheptadine treated patients as compared to those who only received placebo. But there was a rebound effect following discontinuation of Bellergal.
    Conclusion
    Cyproheptadine and Bellergal seem to preventive migraine attacks. Cyproheptadine is a preferred choice because its effects were partially preserved following withdrawal.
  • A. Shahla, S. Charehsaz, R. Talebi, M. Omrani Page 88
    Abstract: Vitamin D (VIT D) deficiency is determined by serum 25-OH-D. Several studies revealed high prevalence of VIT D deficiency in females of the Asian sunny countries. 162 females referred to Urmia Orthopedic Clinics, with bone and muscle pain with the ages 15 up to 40 yrs participated in the study. The individuals were not pregnant, lactating, with no systemic or neurological diseases during the course of the study. From the serum level of 25-OH-D it was found that 57% were severely VIT D deficient (25-OH-D<10 ng/ml), 25% were mildly VIT D deficient (25-OH-D=10-20 ng/ml) and only 18% were normal (25-OH-D>20 ng/ml). The results of this study revealed that inadequate exposure to sunlight was the main cause of vitamin D deficiency.
  • J. Fariaby, M. Mohammadi Page 91
    Despite numerous studies on the prevalence of temporomandibular joint disorders (TMJDs) in adults, those performed in children are limited. This study determined the prevalence of TMJDs in 9-12-year-old Kermanian boy students living in Southeast of Iran. 240 boy students selected by randomized method and studied through a descriptive cross-sectional epidemiologic survey including interviews and physical examinations. Overall, 11.7% of the boys had TMJDs, 1.7% limitation in mouth opening and 5.4% deviation on jaw opening. Attention to temporomandibular joint disorders in children is necessary by preschool examination in order to prevent their progress in later stages of life
  • H. Amoozegar. M. Mirshakeri, N. Paishva Page 94
    The overall incidence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in Iranian population is estimated around 10%-14.9%. G6PD deficiency is an X-linked disorder and 80% of donors are usually male. At present, donors’ blood is not routinely screened for G6PD deficiency in Iran blood bank where for detecting such enzyme deficiency, reliance is placed on pre-donation data. Thus, the G6PD deficient blood may be transfused to G6PD deficient premature neonates, resulting in prolonged or severe hyperbilirubinemia. Fluorescent spot method was used to determine G6PD deficiency in 450 blood samples collected from male donors stored less than 7 days. This was followed by the pre-donation questionnaires for the history of previous diseases or jaundice. Of which 27 (6%) samples were G6PD deficient. None of the donors tested for G6PD deficiency recalled, and stated in their pre-donation questionnaires, any history of previous diseases or jaundice. Six percent G6PD deficiencies among the male donors in Shiraz blood bank was a noteworthy prevalence, which was independent of the pre-donation questionnaires. Therefore, regardless of the questioners'' data, it was recommended to screen the blood bags for this enzyme prior to use for simple or exchange transfusion in premature infants.
  • R. Vakili, M. Horri Page 97
    Turner syndrome is a sex-chromosome disorder occurring in one out of 2500 female births and characterized by growth retardation, gonadal dysgenesis and cardiovascular anomalies. The 45, XO karyotype is the most frequent type of this disease. Herein, we report on a 6-year-old girl with Turner syndrome and 45, XO karyotype presenting with short stature. She had dextrocardia and hiatal hernia. To the best of our knowledge, the association of Turner syndrome, dextrocardia and hiatal hernia is quite rare.
  • H. Mansouri Torghabeh Page 100