Galen Medical journal
Volume:1 Issue: 1, 2012

Hyperglycemia is a common problem encountered in hospitalized patients, especially in critically ill patients due to stress and using parenteral nutrition. Uncontrolled hyperglycemia may be associated with increased infection risk. The principal benefit of intensive insulin therapy is a decrease in infection-related complications and mortality. The aim of this study was the assessment of IIT effect on pathogen growth in ICU patients. We conducted a randomized controlled trial study where patients with brain trauma in grade 2 and 3 that received at least 50% of nutritional needs from parenteral nutrition. They randomly assigned to receive IIT or conventional glucose control. Pathogen growth, mortality, survival, APACHE II score, duration of hospital stay was assessed.Of 29 patients randomized, 26 patients completed the study. Survival duration, ventilator dependency and pathogen growth was improved in tight control group but not significant between two groups due to low sample size. In our study, IIT reduced pathogen growth without hypoglycemic episodes in head trauma patients.

The aim of this study was to investigate the effect of methimazole on Technetium-99m reabsorbing by thyroid gland, it may be possible to perform thyroid scan when the patients are on the methimazole, this can be time saving and decrease the adverse effects of discontinuing methimazolePatients and Among all the patients with hyperthyroidism who referred to nuclear medicine ward of Shiraz University of medical sciences, 50 patients were randomly selected. we asked the patients who were on Methimazole, to discontinue the usage of all drugs (not Methimazole) and foods which are effective on thyroid gland for 1 week, after that thyroid scan was performed for these patients. In The other episode, we asked them to discontinue the usage of all drugs (also Methimazole) and foods which are effective on thyroid gland for 1 week and then thyroid scan was performed again. Revealed data was analyzed under supervision of statistical specialist with descriptive methods on SPSS. 34 patients were males (68%) and other was females. Mean age of the patients was 53.5 years. (Min: 39 years and max: 75 years) Although The ROI (Region of Interest) of thyroid was increased in the patients who used methimazole before scan 398.72(SD: 191.73) than the patients who discontinued for one week 380.15 (SD: 112.49), but the difference wasn’t statistically significant. The ROI of peripheral tissue of the thyroid was decreased in the patients who used methimazole before scan 26.44(SD: 5.42) than the patients who discontinued for one week 27.0414 (SD: 5.57), but the difference wasn’t statistically significant. In conclusion, we demonstrated that methimazole pretreatment does not interfere with either the efficacy of ROI and reabsorbing of Technetium-99m in thyroid gland and peripheral tissues. A possible limitation of this study is the number of patients in the sample.So it seems that it may be possible to perform thyroid scan when the patients are on the methimazole, this can be time saving and decrease the adverse effects of discontinuing methimazole.

To study association between the serum level HbA1C and severity of sexual dysfunction and compare sexual function in Diabetic and nondiabetic women. A total of 240 diabetic women aged 20-60 years old take part in this study which we selected 120 patients with exclusion criteria such as lack of psychosomatic disorder and compared with 120 healthy nondiabetic women. These two groups were matched by age and other parameters. The demographic and medical history data were extracted by 2 questionnaires. Physical exam was done for all subjects and finally female sexual function index (FSFI) questionnaire was filled for them. Check of HbA1C was made with Ion exchange, column chromatography. Eighty eight persent of diabetic women and 72% of nondiabetic women had one or more problem in domains. There isn’t remarkable correlation between HbA1C <12% and FSF score, but in HbA1C >12%, FSF score decrease clearly (P<0.004)Severity of FSD in under weight or normal BMI diabetic women is less than overweight or obese diabetic women (P<0/036). There is a significant negative relation between educational and emotional level with FSD (P<0/001). Type of DM and FSD hasn’t any relation The prevalence of FSD in Iranian women is more than world researches. That is an important neglected problem with in women and physicians.

Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular junction associated with presence of antibodies against nicotinic acetylcholine receptors (nAChRs). The pattern of the MG varies in different ethnical and geographical regions. Data regarding the pattern of the disease in Iran is scarce. Thus we performed this study in order to describe the epidemiologic, clinical and laboratory characteristics of MG in Iranian population. Method and Material: This was a retrospective study being performed in Nemazee Hospital, a tertiary health care center affiliated with Shiraz University of Medical Sciences, from 2001 to 2010. The medical records were reviewed and the data were entered into a computer database. Data are presented as mean ± SD and proportions as appropriate. Overall we included 208 patients with MG among whom there were 62 (29.8%) men and 146 (70.2%) women. The mean age of the patients was found to be 33.19 ± 15.75 (range 1-85) years. The median age at onset was 28±2.3 years. Eight (3.9%) patients had family history of MG, 1.9% and 2.4% of patients had a background of Diabetes Mellitus and Rheumatoid disease in family, respectively. Thymoma was observed in 9.1% of patients. The presenting symptom was found to be ocular ones detected in 67 (34.9%) patients out of which 59 (30.7%) had bulbar and 12 (6.3%) had appendicular involvement. Edrophonium test was done for 28 patients out of whom 78.6% tested positive. The most common histopathology finding was thymic hyperplasia and the second most common was thymoma. This is the first study describing MG in an Iranian population. The pattern of disease was found to be much more similar to North America and Europe. MG was found to be more common in females consistent with western studies

Pharyngeal packs are commonly used to prevent of postoperative nausea and vomiting (PONV) and Sore throat during nasal surgery following tracheal intubation. the aim of this study is evaluation of effectiveness of pharyngeal packing in the prevention of PONV.This study with random sampling performed on 120 adult patients scheduled for routine nasal surgery referred Boo – Ali hospital in Tehran, Iran from March 2011 to March 2012. the study was approved in the ethical committee of Azad University and written informed consent to participate in the study. All subjects randomly allocated to Group A or Group B to have and not to have pharyngeal packing during surgery, Respectively.The incidence of PONV and sore throat in the recovery room,at 2 and 6 h were recorded by a 100 mm long visual analogue scale (VAS). Data were analysed using non-parametric tests in SPSS 18. Significant difference was set at p<0.05. The average age of patients was 27.6 ± 7.1 years. The average of age in Group A was 29.2 ± 2.8 years and in Group B was 27.4 ± 3.2 years. The difference in throat pain scores in the two groups at each assessment time was statistically significant. The difference in PONV scores were not statistically significant. The usage of pharyngeal packing during nasal surgery leads to decreased incidence of sore throat in experiment group compared with the control group. Also has no effect on the incidence of PONV.

Cyclic vomiting syndrome (CVS) is characterized by recurrent episodes of intense nausea and vomiting interpreted with symptom free period. As data regarding the pattern of disease in our region is scarce, we performed this study to investigate the pattern of pediatric cyclic vomiting in Shiraz, southern Iran. Methods and Patients: This study was performed in Nemazee Hospital, territory health care center affiliated with Shiraz University of Medical Sciences from 2000 to 2010. Medical files were reviewed and data was collected by means of a checklist. Patients were divided into two groups including 1-13 years of age as children and those 13-18 years of age as adolescents. Overall, 43 patients with CVS were included, among whom there were 26 (60.5%) females. The mean age at first attack was found to be 6.2 (3.7) years. Ten patients (23.3%) had a family history of migraine among which there were 8 females. The most common clinical complaint was found to be abdominal pain in 32 (74.4%) patients. GI (gastrointestinal) disorders were more common in the adolescent group rather than the children group (p=0.007).The most common trigger factor was upper respiratory tract infection (URI) detected in 13 patients (30.2%).The most associated disorder was abdominal migraine in 5 (11.6%) patients. Anemia was more common in the adolescent group (p=0.009) than in the children’s group. There were no radiological and laboratory abnormalities among these patients. The most commonly used medications were anti-migraines in 31 (72.0%) patients as there is no definite drug for CVS, knowing the common trigger factors which culminate in CVS in each region can be of great importance and can prevent attacks in the prodromal phase.

Myocardial infarction (MI) is one of the most important health burdens worldwide. Aspirin as an non- Steroid Anti—inflammatory drug, has been proven to be a protective factor to decrease the incidence, however its effect of MI size is still unknown. We designed this study to compare the biomarkers after MI in patients with and without aspirin intake. 378 patients were enrolled and the results showed lower cardiac troponin T and Creatine Kinases in patients with protective dose of aspirin intake. In addition, Creatine Kinases were significantly higher in patients with no history of MI. We conclude that aspirin can reduce the size of the infraction. Also, higher enzymes can be due to higher muscle content in patient without MI history

A 32-year-old female, gravid two, para one, with Cushing’s syndrome (CS) was admitted to our hospital at 25 week of gestation with severe hypercortisolism. Basal urinary free cortisol (UFC) was elevated about 10 times above the upper limit of normal in two separate times and plasma cortisol failed to suppress after an overnight 1mg dexamethasone suppression test but Adrenocorticotropic hormone (ACTH) level was suppressed. An abdominal non-contrast magnetic resonance imaging (MRI) disclosed a 3-cm right adrenal mass (Fig. 1). Due to her critical general condition, the adrenalectomy was not performed. At 30 week of gestation, by the diagnosis of severe preeclampsia she underwent an emergent cesarean section. Two weeks later, right adrenalectomy was performed via laparotomy. Pathologic examination of the gland showed a benign adrenocortical adenoma. The newborn was a healthy male who weighed 1850 gram. There was no clinical or biochemical suppression of adrenocortical function in child and they were discharged after 40 days.