مجله علمی پزشکی جندی شاپور
پیاپی 37 (شهریور 1382)

Neonatal diabetes mellitus is a very rare form of the disease and estimated to occure one in 500000 births. Neonatal diabetes differs from insulin- dependent diabetes and its course is highly variable. Some patients have permanent diabetes, but others have transient diabetes with or without later recurrence. Most of these infants are small for gestational age (SGA), and present with hyperglycemia and glycosuria, resulting in severe dehydration and metabolic acidosis but with only minimal or no ketonemia or ketonuria. During a period of five years, from May 1996 to Feb. 2001, three infants were discharged from Imam Hospital of Ahwaz, the center of Khozestan province, with diagnosis of diabetes mellitus. After measurment of blood sugar level for several times above 400mg/dl and exclusion of sepsis the diagnosis of neonatal diabetes was made. The mean age of patients at the time of admission was 28 days. Two patients were admitted for respiratory distress and another one for inadequate weigh gain. Two of them were SGA. One of the cases who had severe growth retardation at birth, was evaluated for insufficiency of exocrine pancreas. No abnormal finding was observed. No facial dysmorphism or foot abnormality was noted. One patient had HLA DR3 haplotype. One patient was followed for 2.5 years, and another subjects, who have been followed, till now have required insulin therapy.

Objective to determine the sensitivity and specificity of cardinal sign’s of scleral rupture after ocular blunt trauma.Backgreumd trauma is one of the most important causes of ocular morbidity, and has been reported 1.4% to 5.6% of the prevalence of scleral rupture after ocular blunt trauma. The scleral rupture may be occult after ocular blunt trauma with subconjunctival hemorrhage and intraocular hemorrhage. Methods records of all patients with ocular blunt trauma who had undergone diagnostic peritomy surgery for scleral laceration were retrospectively reviewed. The eyes were categorized into two groups: 1, positive peritomy (scleral laceration) and 2: negative peritomy, then the recods were evaluated. Results with respect to clinical features, 73 patients (81.8% male, 19.2% female) had went disgnostic peritomy surgery. Patients’age ranged from 8 months to 65 years. Overall diagnostic peritomy was positive in 28.76% and negetive in 71.24%. The signs in positive peritomy group includes:decreased visual acuity in 80.9%, intraocular pressure 6 mm/Hg in 66.6%, limitation of ocular motility in 28.5%, APD (Afferent pupillary defect) in 57.1%, sub conjuctival hemorrhage and chemosis in 80.9%, hyphema in 95.2%, depth of anterier chamber change in 76.1% and not visible of fundus in 90.4%. Overall, the scleral laceration may be occurred after blunt truma. Therefore the patients show Cardinal sign's after ocular blunt trauma may need diagnostic peritomy surgery.

Pilonidal sinus is a relative common disease in adults. Although this disease has low mortality but its morbidity result in prolonged inability and high cost for the patients. In this study recurrence and complications due to traditional surgical procedures compared to a new procedure called Delayed Primary Closure (D.P.C).This is a clinical trial from 1377-1379 in Ahwaz university hospitals that 56 patients is evaluated. Thirty of these patients operated by traditional procedures (control group) and 26 patients by D.P.C (case group).From control group 11 (40%) patients were complicated by bleeding, wound infection and serous discharge but the other case group 5 (19%) patients were complicated (p<0.05). During two years follow up, one (4%) patient of the case group compared to 5 (17%) patients of control group recurred (p<0.05).This technique (DPC) can be considered as a useful procedure in treatment of pilonidal sinus but not in infected cases.

In this research the immune system parameters of medical students in stressful and non-stressful conditions were studied. Two groups of male and female medical students (n= 170 in each group) of Tehran and Shahid Beheshti Universities were studied. One group had a stressful pre internship Examination (PIE), but the other group didnt have such an examination. Subjects who suffered from disorders that affected the immune system were excluded. Finally, the (PIE) group consisted of 147 subjects, and the non-(PIE) group consisted of 155 subjects. Then 40 subjects were selected randomly from each group. Peripheral blood was obtained at the same time. Number of T-helper cells (CD4), T-suppressor cytotoxic cells (CD8), Natural killer cells (CD56+CD16), complement system (C3, C4, CH50), Immunoglobulin M and G (IgM, IgG), Cortisol hormone, Eosinophils, Neutrophils and Lymphocytes were measured. The results showed that there was a significant difference between the (PIE) group and non-(PIE) group in CD4, CD8, CD4/CD8, CD16, C4, IgG and Cortisol. Also the level of CD8,C4, IgG and Cortisol of PIE group was significantly more than non-PIE group.

Some reports from endemic and non-endemic areas of the world that have reviewed diagnostic value of Widal test, show that Widal test has limited value in diagnosis of tyhoid fever, especially in endemic areas. Therefore, application of a more sensitive serologic method that could facilitate accurate diagnosis of the disease was investigated. In the modified Widal test, chloroform solution was used for antigen dilution. In this study 57 typhoid fever patients and 32 non – typhoid fever patients were examined.With the modified method, 87.7% of patients with typhoid fever showed an O agglotinin titer of, but with the common method, 45.5% of them showed the titer of. The results showed that the modified method could be used as a more accurate and more sensitive method compared to the common Widal test.

Thalassemia is a generally determined defect in hemoglobin synthesis. In B thalassemia minor, patients are not severely anemic and RBC count is slightly increased. Hemoglobin and hematocrit, in fact, are usually near normal limit. Morphology shows microcytic and hypochromic.Anisocytosis is only slight and not as marked as in iron deficiency. This is reflected in about normal RDW, but MCV and MCH are decreased. In hemoglobin electrophoresis Hb A2 is elevated. In this study RBC count, Hb, MCV, MCH, RDW, and Hb electrophoresis were estimated in 230 adults with beta thalassemia trait. MCH<30 with electrophoresis is the best indicator for screening of B thalassemia minor.

Paracervical block is a relatively simple method that is used by obstetrician to provide analgesia during labour and D & C. Lidocaine as a local anesthetic agent is used in paracervical blockage that has some potential side effects. In this study from the point of Lidocain morbidity, Normal Saline was used for this purpose. A randomized comparison of Lidocaine and saline for cervical anesthesia was performed.This is a double - blind randomized clinical trial. Number of patients at each group was 100 women. The inclusion criteria were: uterine size 14 weeks, patients who didnt have molar pregnancy, missed abortion, underlying painful condition. Subjects gave informed consent and were assigned randomly to receive Lidocain, %1 or Normal Saline.Subjects rated their pain on visual analog scale in three occasions. Using the SPSS did age, education, parity, previous abortion was collected and statistical analysis. Chi-Square test, T-test and variance analysis was done. Age, education, parity, the history of previous abortion have not significance difference in two groups. The mean  SD of pain intensity after speculum insertion, during dilatation and during curettage in Lidocain, group were 22.123.6, 35.727.9, 52.1527.2 and in Normal Saline group were 27.3525.7, 41.1532.3, 54.128.1, respectively. No significant difference was observed in pain rating reported in two groups (P>0.05). Complication rate was %7 in Lidocain group but Saline group has no side effect. Normal Saline is as effective as Leidocaine in paracervical anesthesia for dilatation & curettage.

Helicobacter pylori (HP) is a major cause of stomach disorders (Gastritis,gastric ulcer, adenocarcinoma and lymphoma). In this study the frequency of HP in gastric biopsies that sent to pathology department of Semnan University of Medical sciences between 1994-1998 were investigated. This study is a retrospective and descriptive, carvied out on 800 gastric biopsies. In the first time site and kind of lesions were determined by hematoxilin-Eosin staining and then presence of HP was confirmed by giemsa staining and frequency of Hp determined by specimens. Result indicated that the frequency of gastritis, ulcer and adenocarcinoma were 53%, 11.75% and 9.5% respectively and HP biopsies were positive in 57%. There was no cases of lymphoma. Gastritis and adnocarcinoma have highest (75%) and lowest (48.7%) rate of HP respectively. Also 69% of gastric ulcers were HP positive. Findings showed that the HP is a more prevalence in stomach lesions and due to high rate of HP infection among gastric biopsies, examination all of gastric biopsies for HP in recommended.

This is analytic and cross sectional study is involved in investigating the passible counection between specific personal and social details (education, age, number of children, type of empolyment, medical history, drugs used, previous contraceptive method used and weight) with those who discontunued subcatancoustic implanted contraceptive device (Norplant).The subjects were women who visited khozestan Health centers in Abadan, Ahwaz, Khoramshahr, Shoshtar in 1377. The results were compared with those who continued using the device until its suable lifespan of 5 years (control group).In this study were studied and 782 medical vecords comprising 261 from Ahwaz, 387 from Shoosh, 113 from Shooshtar, 21 from Abadan and Khoramshahr were studied from this analytic. The reasons for discontinuation of the use of the contraceptive device were guated as development of side effects in 79.2% of cases)P=0.002) (mostly hyper menorhea, amenorhea,. .. ) and 20.2% for other reasons (vasectomy, wanting children, devorce using sps software), statistical analysis were performed, deiscriptive and analytical paived students t-test, chi square (X2) and life table, were collected.The results showed that education (P=0.001) and number of children (P=0.02) were two important factors. Among the cities selected Ahwaz had the highest discontinuatinve rate or 65.1% (P=0.001) and the lowest were Khoramshahr and Abadan with 4.2%.Among the health profasionals who implanted the Norp the highest number of implantations were performed by the midwires 73.01 (P=0.001) who also had the least discontinuation rate of 14.8.The data from the life table showed that the lifespan the device among women in Khozestan provice to be 26.9 month at the time of implantation 16.55 month in the first year, 9.3 month in the two year, 13 month in the three year and 8.5 month in the four year with followed by slow gradu dicountinued rate.

The role of matrix-metaloproteinase (mmp) in physiopathology of various inflammatory disease such as rheumatoid arthritis and malignant tumors was established. The aim of the present study was comparison the effectiveness of sodium alginate with commonly used steroid and NSAID anti-inflammatory agents. For this purpose, zymographic and cellular cytotoxicity methods were employed, using fibrosacoma cell line culture (Wehi 164). Sodium alginate, diclofenac dexamethesone and piroxicam (all 10-200 mg/ml) were incubated for 24 hours. Results showed that all the drugs produced dose - depedent reduction in (mmp) activites. In contrast, sodium alginate had lower cytotoxcity relative to other agents in this study. Sodium diclofenac had the highest cytotocity. Due to low cytotoxicity and similar inhibitory activity against mmp, further studies towards possible clinical utilization of this agent can be suggested.

Siezure is the most important symptom of epilepsy and in many other neurological disorders. Because of the side effects of the synthetic medicines, these days medicinal plants widely used in the control of convulsions. In this study the anticonvulsive effect of the hydroalcoholic extract of Thymus vulgaris on nicotine induced convulsions has been investigated in mice. Different Doses (100, 200, 400, 600, 800 and 1000 mg/kg) of the extract were administered intraperitoneally to test groups. For the positive control group diazepam (0.15 mg/kg) and for the negative control group normal saline (10 ml/kg) were injected intraperitoneally. After 30 minutes, nicotine (5 mg/kg) was given intraperitoneally and the time for conset, duration and intensity of the convulsion and mortality rate were recorded.The results of administered doses (100, 200, 400, 600, 800 and 1000 mg/kg) showed that the effect was dose dependent and the doses of 800 and 1000 mg/kg had the maximum effect on delaying the conset of convulsion decreasing the duration and the intensity of the convulsion, but at dose of 1000 mg/kg the mortality rate was high.After administration of extract (800 mg/kg), at o, 15, 30, 45 and 60 minuts before injection of nicotine, the time of onset and intensity of convulsion were increased and decreased respectively, while only at 0, 15 and 30 minutes before nicotine injection, the duration of convulsion was decreased significantly(P<0.05).The results of this study, showed that Thymus vulgaris has anticonvulsive effect. In order to know the mechanism of action of the extract, it needs more investigations on different animal models.