Journal of Kerman University of Medical Sciences
Volume:8 Issue: 2, 2001

Some investigators reported that there is a relationship between H.pylori chronic infection and the prevalence of acute coronary artery disease (CAD). It is suggested that H.pylori chronic infection causes some changes in serum levels of lipids and lipoproteins and produces inflammatory proteins which could give rise to thrombogenesis. In order to confirm any correlation between positive history of H.pylori infection and the occurrence of acute myocardial infarction due to CAD a study has been performed on 104 cases of acute myocardial infarction diagnosed by history, ECG findings and elevation of the enzymes. Serum levels of H.pylori specific IgG have been measured by ELISA technique. The results have been compared with those of 100 healthy subjects without gastrointestinal disease. The control group consists of 80 males and 20 females aged between 40-90 years (Mean 57 years for males and 56 for females). The case group consisted of 83 males and 21 females with the age range of 30-85 years (Mean 59 years for males and 64 years for females). This investigation showed that 39.4% of patients with acute myocardial infarction were positive for H.pylori-specific IgG and the remainder were negative. However only 16% were positive for H.pylori specific IgG among the control group. Therefore it is concluded that the seropositivity rate of anti-H.pylori IgG in the test group was greater than that of the control group and this difference was statistically significant (P=0.0002). However no relationship has been found between serum level of H.pylori-specific IgG and dyspepsia. No significant relationship has been observed between H.pylori infection and coronary artery disease risk factors (P>0.05). Generally the results indicated that H.pylori infection as a risk factor may have a role in causing myocardial infarction (Independent of other risk factors).

Delirium is a syndrome consisting of cloudiness of consciousness, attention deficit, and cognitive impairment, with quick onset, but varring paths in its progression. Delirium is more common after major surgeries in the elderly and hospitalized patients, resulting in high morbidity and mortality rates. The incidence rate that has been reported in previous studies varies from 1-3% in cataract surgery to 73.5% in orthopedic and open heart surgeries. The objective of the present study was to determine the incidence of delirium during the first postoperative 5 days in 250 patients older than 40 undergoing elective surgeries in Kerman. MMSE test was used to screen the population and DSM-IV was used to confirm the diagnosis. Postoperative delirium developed in 19 patients (7.6%; 95% Confidence Interval: 4.7% to 11.7%). It seems that postoperative delirium incidence in our surgery wards is lower than western countries which can be due to less risk factors such as alcoholism and loneliness. Nonetheless, attention should be paid to old patients undergoing prolonged major operations.

Malnutrition is one of the important health problems in developing countries. It may have undesirable effects on mental and physical state of children and is an underlying factor for many infections. The aim of this study was to find out the prevalence of malnutrition in 6-24 month old infants in the pediatric ward of University Hospital No.1 in Kerman. For this purpose, the weight and height of 560 infants aged 6-24 months who were hospitalized during 1 year were measured and compared with the weight and height of 496 peer children who referred to the health centers for monthly checkups. The nutritional status of both groups was evaluated according to the weight for age (Gomez), weight for height (Waterlow) and height for age (Waterlow) methods. 43.5% of hospitalized infants were girls and 56.5% were boys. In the control group, the percentage of girls and boys were 39.5% and 60.5% respectively. According to the weight for age (Gomez), the weight for height (Waterlow), and the height for age methods, the prevalence of malnutrition in hospitalized infants and control group were 76.2% and 60.5% (P<0.0001), 74.7% and 57.5% (P<0.0001) and 40.7% and 41% (P>0.23), respectively. According to the Waterlow method, there was a statistically significant difference (P<0.05) in malnutrition rate between boys (81.2%) and girls (65.5%) in hospitalized infants. The mothers’ educational level, birth order, and parents’ occupation had a significant role in the prevalence of malnutrition, but there was no significant difference in malnutrition of breast feeding and formula-feeding infants. The majority of malnutrition cases were seen in infants who were suffering from cardiac, respiratory and diarrheal disorders or urinary tract infection. With respect to the fact that malnutrition is the predisposing factor for many infections and increases the chance for hospitalization, it is proposed that all hospitalized infants should also be evaluated and treated for malnutrition. Therefore, in order to decrease the rate of malnutrition, the physicians and health care workers must acquire more experience in prevention, diagnosis, and treatment of malnutrition. The importance of proper feeding must also be explained to the families.

Melissa officinalis is a well known medicinal plant. Different studies performed in mice have shown the sedative, hypnotic, analgesic, antiviral and antimicrobial effects of this plant. The present investigation was undertaken to evaluate the effect of percolated extract of this plant against lethal seizure induced by intraperitonal injection of pentylenetetrazole (PTZ) in wistar rats. The study was performed on three groups of animals pretreated with different doses of extract via intraperitonal injection. After 30 minutes each animal received high dose of PTZ (90 mg/kg) for induction of lethal seizure. The control group received normal saline. In addition a positive control group pretreated with diazepam, a well known drug in the treatment of seizure, was used for comparison. The efficacy of the extract to protect the animals against lethal seizure was based on the latency of the appearance of the first sign of seizure or the latency of the different epileptic manifestations and decrease of mortality rate in each group. The results showed that various epileptic manifestations are delayed in diazepam pretreated animals and extract compared with control group. The dose of 50 mg/kg of the extract appeared to be significantly effective on the tremors and the myoclonic jerks of epileptic manifestations (P<0.05). In addition the mortality rate was significantly reduced in pretreated animals with this dose compared with control group (P<0.05). Mortality rate was 88% in saline group, 13% in 50mg group and zero percent in diazepam group. The results indicated that the extract of Melissa officinalis possesses anticonvulsant property.

Preterm premature rupture of membrane (PPROM) is one of the serious problems during pregnancy. The aim of this study was to determine the probable relation between group B streptococcal and anaerobic infections and PPROM. For this purpose 100 pregnant women with preterm rupture of membrane were selected. In the case group the prevalence of? -hemolytic streptococcal and anaerobic microorganisms was determined by cervical and vaginal culturing. In addition the rate of several factors which can have some roles in etiology of PPROM was determined. The range of gestational age were 26-38 weeks. After proving PPROM, via specific methods in obstetrics samples were taken for culturing. The control group consisted of 100 pregnant women who were matched with the case group in gestational age and had no leakage of fluid. In this study, there were statistical associations between PPROM and variables like fever, maternal disease, sexual intercourse, opium addiction, smoking, fetal presentation, and prevalence of? -hemolytic streptococci group B and anaerobic infections (P<0.05). Prevalence of? -hemolytic streptococci group B and anaerobic in the case group were 5% and 1% respectively. In contrast in the control group, there was no positive case. On the bassis of the present study, it is concluded that, there is a relationship between fever and infection due to? -hemolytic streptococci group B and anaerobic with PPROM. Therefore by treatment of such cases, PPROM can be Prevented.

Ovarian hyperstimulation syndrome (OHSS) is a serious complication of controlled ovarian hypersitmulation (COH). Identifying risk factors of OHSS seems to be an important task because of two main reasons: increasing the incidence of infertility and the fact that around 1-7% of COH leads to OHSS. This study is a case-control study conducted in infertility center at Dr. Shariati hospital. 75 patients, candidate for assisted reproductive technology (ART), who developed OHSS after COH were selected as the case group and 120 matched patients without OHSS were selected as control group. Factors such as Body Mass Index (BMI), serum estradiol level on the day of HCG administration, presence of polycystic ovaries and patients’ age were investigated. The incidence of OHSS was higher in younger patients. The incidence of PCO in the case group (OHSS) (37.3%) was higher than that of control group (20.8%). Incidence of BMI>30 was higher in the case group as compared with the control group. The serum estradiol level on the day of HCG administration in the OHSS patients was higher than that of control group (1534±1177 pg/ml and 1124±739 pg/ml respectively). Regarding the increasing of infertility incidence and the development of new methods of COH, detecting the risk factors of OHSS plays an important role in reduction of this dangerous and even fatal disease.

One of the complications of Beta-thalasemia major is hepatobiliary disorders for example cholelithiasis (Gallstone). In this study frequency of hepatobiliary ultra sound abnormal findings in 200 patients in Kerman was investigated. Among 200 patients, 11 (5.5%) had gallstone. The average age of patients without gallstone was 10.07±4.9 years and that of patients with gallstone was 16.1±5 years. Therefore significant difference in this regard is observed (P<0.05). Five patients (2.5%) had thickened wall in gall bladder, and their mean age was 12±2.5 years and that of patients with normal wall thickness was 10.3±5.1 years with no significant difference between two groups. Sixty three patients (31.5%) had history of splenectomy and 137 patients (68.5%) had not this history. Among 11 patients with gallstone, 9 patients had history of splenectomy and 2 patients had not this history with significant difference between the two groups (P<0.05). No significant difference was observed in the average serum ferritin in patients with gallstone (3786.7±941.4) and in the patients without gallstone (3147.03±1239.7).

Vulvar liposarcoma is rare and there are only eleven cases reported since 1966. Primary sarcoma of the vulva constitutes 1-2% of all vulvar malignancies. Because of their locations and appearance, they may be easily mistaken as benign lesions. This is a report of a 65-year-old woman with a vulvar mass similar to a lipoma. The lesion, a soft tissue mass, was totally excised and was sent for pathologic study. The pathology report indicated a well-differentiated sclerosing liposarcoma. The clinicians should keep this diagnosis in mind in patients with a vulvar mass, since early diagnosis is imperative for a favorable prognosis.

Pyridoxine dependent seizures have been recognized as a rare and important cause of intractable seizures in neonates and infants. Prompt diagnosis and treatment can stop and prevent these seizures and consequential developmental disabilities. Furthermore it can eliminate the unnecessary administration of anticonvulsant medications and their side effects. The patient was 7 months old infant who was referred to Imam Reza hospital because of recurrent seizures. All paraclinical studies including BS, calcium, serum Amonium were within normal limits. Electroencephalography was indicative of hypsarrhythemia and cerebral CT scan was normal. The seizure was resistant to the current treatments. However it was stopped after the adminstration of B6.