Medical Journal Of the Islamic Republic of Iran
Volume:27 Issue: 3, Autumn 2013

Number of Iranian articles published in ISI journals has increased significantly in recent years. Despite the quantitative progress, studies performed in Iran represent low collaboration in research; therefore, we decided to evaluate collaboration in Golestan University of Medical Sciences (GOUMS) research projects. In this cross-sectional study, all GOUMS research projects that had got grants from the university between 2005-2007 were studied. Among 107 research projects included in our study, 102 projects were evaluated and checklists were completed. The researcher''s questionnaire was sent to the principle investigators (n= 46) of the projects and eventually 40 questionnaires were collected. The review of 102 research proposals shows that 10 projects (9. 8%) have been performed in collaboration with other organizations. Scientific outputs in these projects have been more than projects which were confined to the university (98% compare to 68%; p= 0. 04). The total cost of the projects under study was a little more than 300, 000 US$. In just 12 projects (11. 8%) a part of the cost had been provided by organizations outside the university. About 50% of researchers declared that they had chosen their research topic based on their «personal interest». Only 1 project was performed by the demand of nongovernmental organizations and 12 researchers reported no collaboration in their activities. This study shows that collaboration in GOUMS research projects is low. Moreover, collaborations with governmental and nongovernmental organizations are trivial. The scientific outputs in collaborative research projects are much more than other projects.

Delay in diagnosis and treatment of perforated appendicitis may cause life-threatening complications. The aim of this study was to determine and compare pre-operative total and direct bilirubin levels in cases of simple and perforated acute appendicitis in order to improve the clinical decision making. This prospective observational study included eighty patients who underwent open appendectomy, during a one-year period from March 2010 to March 2011 in the surgical department of Hazrat-e-Rasool Akram Hospital, an academic teaching hospital in Tehran- Iran. Pre-operative total and direct levels of bilirubin were compared in two groups of histologically proved appendicitis (simple and perforated), each including 40 patients. Eighty patients who underwent open appendectomy including 70% men and 30% women with a mean age of 34±11 years in Group I (perforated appendicitis) and 47.5% women and 52.5% men with a mean age of 33±14 in Group II (simple appendicitis) were included in this study. The mean bilirubin levels were higher for patients with perforated acute appendicitis compared to those with a non-perforated simple appendicitis (1.04±05 mg/dl vs 0.7±0.1 mg/dl) and this difference is highly significant (p<0.01). Assessment of preoperative total bilirubin is useful for the differential diagnosis of perforated versus acute simple appendicitis and total bilirubin should be used as an independent parameter in the early diagnosis of appendix perforation.

Thrombolytic therapy is the only approved treatment for acute cerebral ischemia. The hemorrhagic transformation is the greatest complication of this treatment, which may occur after recanalization of occluded artery. The aim of this study was to determine factors associated with clinical improvement and worsening in patients with acute ischemic stroke treated with intravenous thrombolysis. Thirty seven patients who were treated with intravenous thrombolysis between August 2010 and August 2012 who had the inclusion criteria were studied. In this prospective study, all of the admitted patients in stroke unit, monitored for at least 48 hours. We registered all patients’ information in a stroke data registry and followed them for at least 6 months. Thirty seven patients with acute ischemic stroke who treated with recombinant tissue plasminogen activator (r-TPA) were studied. There were hemorrhagic transformations in 9 (24%) patients. Seven of them (18%) revealed intracerebral hemorrhages (ICH) within the control brain CT after 24 hours without any deterioration of neurologic symptoms (asymptomatic ICH). Although outcomes of patients with symptomatic post r- TPA hemorrhages were worse than non-hemorrhagic post r-TPA patients, there were no significant differences between asymptomatic post r-TPA hemorrhages and non-hemorrhagic post r-TPA patients, according to the National Institutes of Health Stroke Scale (NIHSS) at admission (p = 0.2), after 24 hours (p= 0.07) and after 7 days (p= 0.06) post treatment. If the r-TPA protocol is followed carefully, the risk of symptomatic hemorrhage is low (about 7%). Taking r-TPA was feasible and safe in our study population; thus, it can be applied for other Iranian patients.

Learning disability is one of the most noticed subjects for behavioral specialists. Most of the learning difficulties are caused by senso-motor development and neurological organization. The main purpose of the present research is to examine the role of delayed perceptual-motor development and brain damage in origination of expressive writing disorder (EWD). The studied sample is 89 pupils divided into two groups, one of which is pupils with expressive writing disorder (n=43) and the other is pupils without expressive writing disorder (n=46), consisted of second and third grade elementary school students. First of all, students with EWD are selected through dictation test and intelligence test, and then the two groups, students with and without EWD, would take the Bender Gestalt test. The average score of perceptual visual-motor development and brain damage of two groups is compared using T test for independent groups and χ2 test. Results show that there is a significant difference in perceptual visual-motor development between students with EWD and students without EWD (p<0.01). Based on the results, perceptual-motor development of students with EWD is lower than students without EWD. There is no significant difference in brain damage between those with EWD and healthy people, (p> 0.05). Based on our findings it could be concluded that those who are relatively more developed than their peers, in terms of visual-motor perception, are more successful in education, especially in expressive writing.

Human Bocavirus (HBoV) infection is of worldwide distribution. There is increasing evidence that HBoV is pathogenic for the human gastroenteric tract. However, less data are available on the role of HBoV in gastroenteritis. The present study was aimed to determine the prevalence of HBoV in children with gastroenteritis. Real-time PCR TaqMan was used to screen 200 stool specimens that had been referred to the virology laboratory for HBoV evaluation. All of samples were collected on viral transport media. Of the 200 stool samples analyzed, 16 (8%) were positive for HBoV. Human Bocavirus positive samples from patients aged between 1 to 5 years with acute gastroenteritis infection suggest a minor role of HBoV in gastroenteritis (p=0.0001). The study showed a high prevalence of human Bocavirus in young children with acute gastroenteritis diseases in Iran, suggesting that HBoV play a role in the pathogenesis of gastroenteritis.

Smoking has physical, psychological, and social impacts on women’s health and subsequently the community’s health. Therefore, it is important to have an estimation of smoking among Iranian women. Since comprehensive data are not available in this respect, the authors performed a systematic review and metaanalyzed all high-quality studies in this field. All available electronic papers were searched by certain keywords and were included in this study according to the inclusion criteria regardless of the publication year. Furthermore, non-electronic resources including the final report of research projects, dissertations, unpublished papers (grey literature) and books published by the Iranian ministry of health were also evaluated in the study. The materials were assessed for their quality and meeting the inclusion and exclusion criteria. Considering the high degree of variability in many selected studies, we used random effect method for meta-analysis. The highest and lowest rates of cigarette smoking among women were 10.5% and 0.04%, respectively. The prevalence rates of smoking were different in various subgroups; ranging from 0 to 0.4% in students, 1.1 to 3.1% in adults, and 1.4 to 8.7% in all subgroups. According to the meta-analyses performed for the subgroups, the mean age of participants, performing the study in urban or rural areas, and the year of paper publication were major sources of heterogeneity. The studies were highly different with regard to their findings, and it seems that there is an age and time trend for the findings. Furthermore, the prevalence of smoking was different in various regions of the country.

To determine the effects of probiotic yogurt on performance and health status of young adult female endurance swimmers. In a randomized controlled trial, 46 endurance swimmers girls with mean age of 13.8 ±1.8 years, weight of 48.6±7.5kg and height of 159±5.6cm, were studied. Subjects were randomly assigned into two groups, receiving either 400 ml probiotic yogurt (intervention group) or ordinary yogurt (control group) daily for 8 weeks. At the beginning and at the end of the study, the 400-m free swimming record was done and the Harvard Step test was employed to measure VO2max. Statistical analysis of the data was performed using SPSS software. This trial has been registered with IRCT ID of IRCT2012122311849N1. Average changes in the records of the intervention and control groups were 3.9 and 0.5 seconds, respectively (p= 0.22). The intervention group complained of dyspnea for 2.4 days and the value for the control was 4.4 days (p=0.024). Values for ear pain were 0.5 and 1.6 days (p=0.008) respectively. The average number of episodes of respiratory infection in the intervention group was 0.9 day, which was statistically fewer than that in the control group (1.4 days), P=0.009. A reduction in the number of episodes of respiratory infections and duration of some symptoms such as dyspnea and ear pain was observed. Due to the reduction in upper respiratory tract infections of the athletes following intake of probiotic yogurt, improvement in VO2max is possible.

Pediatric lower urinary tract scoring system (PLUTSS) is a questionnaire contains items for assessment of wetting episodes, voiding frequency and pattern. It is used for screening and evaluation of the response of children with lower urinary tract symptoms to therapy. We studied the validity and reliability of Persian translated version of this questionnaire among Iranian children. One hundred and ninety-seven children aged 5-15 years with urinary tract infection, voiding dysfunction, enuresis were enrolled in this study. Thirty-three healthy age-matched children without urinary complaint were considered as controls. PLUTSS questionnaire was filled out for all children. Sonography was performed to rule out urogenital abnormalities. Internal consistency, test-retest reliability, and validity of the questionnaire were assessed using Cronbach’s alpha, intra-class correlation coefficient, and ANOVA test respectively. ROC curve was used to define cut-point and its validity in discrimination between groups. P-value < 0.05 was considered significant. The means for PLUTSS items were 6.8 (±5.4) for voiding dysfunction, 14.4(±5) for enuresis, 10.5(±7.8) for recurrent and 8.9(±6) for single urinary tract infection, and 1.9(±1.8) for controls (p<0.001). Cronbach’s alpha for the 14 items of questionnaire was 0.74. The intraclass coefficient correlation for assessing test-retest reliability was 0.82 (p<0.001). ROC curve showed cut point of 5 for differing case from controls with sensitivity of 97.0 and specificity of 74.9(p<0.001). Persian translated PLUTSS has a proper validity and reliability as an instrument for screening children with urinary tract symptoms but some questions need to be changed in some way to be understandable by our culture.

Hydatid disease is a parasitic infection caused by Echinococcus granulosus (larval form) in humans with lesions most frequently encountered in the liver and lungs. It can rarely involve extra-hepatic organs. It is endemic in some regions of Iran. The omental hydatid cyst is a very rare manifestation of the disease. This report presents the interesting case of a very large omental hydatid cyst.

Cartilage hair hypoplasia (CHH), is a rare cause of metaphyseal chondrodysplasia and short stature. Other features included hair abnormality, immunodeficiency, anemia, gastrointestinal disorders (Hirschsprung disease, celiac, …) and increased risk of cancer. The disease is an autosomal recessive disorder and previously has not been reported in Iran. We report a 9-year-old boy diagnosed as cartilage hair hypoplasia, with severe short stature, metaphyseal chondrodysplasia, hair hypoplasia, Hirschsprung disease, hypothyroidism, vesicouretral reflux and renal stone. Renal stone and hypothyroidism have been reported in cartilage hair hypoplasia with lower frequencies. This is the first report of cartilage hair hypoplasia in Iran.