Iranian Red Crescent Medical Journal Iranian Red Crescent Medical Journal http://www.irmj.ir 48 journal48 en jalali 1386 7 1 gregorian 2007 10 1 9 4 online 1 fulltext

en General Medicine General Medicine Original Article Original Article <p>  Background: Not much information is available about the effect of smoking and hypertension on the number and severity of vessel involvement and left ventricular ejection fraction (LVEF) at coronary angiography of young patients with coronary artery disease. The present study describes the relative importance and comparative effect of smoking and hypertension on severity of premature coronary artery disease. Methods: The study comprised 240 consecutive patients under the age of 45 years, with a diagnosis of acute myocardial infarction (AMI), unstable angina or stable angina, who underwent coronary angiography. Other aspects investigated included evaluation of smoking profile and HTN in each patient, LVEF, the number and type of vessel involvement as well as the severity of stenosis.<br />Results: Of 216 patients, 142 (approximately 60%) were smoker and 74 (31%) were hypertensive. Left anterior descending coronary artery (LAD) involvement was more common in smoker young patients who had more<br />severe stenosis of LAD vessel and lower LVEF than hypertensive young subjects. Higher frequency of right coronary artery (RCA) involvement and more severe stenosis of this vessel were found in hypertensive young individuals compared to smoker young patients. Conclusion: Our study indicated that smoking was more prevalent and also a more important risk factor in coronary artery disease of young adults. Smoker young patients tended to have more LAD involvement, more severe stenosis of this vessel and also lower LVEF, compared to hypertensive young patients. </p> Smoking, Hypertension, Premature coronary artery disease 177 181 http://www.irmj.ir/browse.php?a_code=A-10-1-1&amp;slc_lang=en&amp;sid=en H Shemirani med@mui.ac.ir 480031947532846009 Yes Department of Cardiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran KH Separham 4800319475328460010 No

en General Medicine General Medicine Original Article Original Article Background: Despite advances in antiemetic treatment, complications are still problematic for a significant<br />number of patients after chemotherapy. This study was performed to determine the efficacy of transcutaneous<br />electrical nerve stimulation<br />(TENS) in the control of nausea and vomiting in patients undergoing chemotherapy at Nemazee Hospital in<br />Shiraz, southern Iran.<br />Methods: 32 subjects with cancer from Outpatients Depatment in Nemazee Hospital affiliated to Shiraz University<br />of Medical Sciences, in Shiraz, southern Iran were enrolled. The patients were randomly divided into two<br />equal groups of TENS and placebo. Patients in both groups were matched for age, severity of nausea and vomiting<br />and type of malignancy. Cisplatin or cyclophosphamide was used for chemotherapy and granistron along with<br />dexametasone were used as antiemetic agents. In the test group, the p6 acupuncture point (acupoint) was stimulated<br />by TENS when the antiemetic agent was administered and continued during wakening every 2 hours for 72<br />hours after chemotherapy. The placebo group was similarly treated but with an off mode stimulator.<br />Results: In regard to the severity of nausea, no statistically significant difference was observed between the two<br />groups in the first 24 hours of chemotherapy but the intensity of nausea in the TENS group was significantly<br />lower than those of the placebo group during 48 and 72 hours of chemotherapy. The mean frequency of vomiting<br />during first, second and third 24 hours was significantly lower in the control group.<br />Conclusion: TENS can be used as an adjunct with antiemetics for controlling nausea and vomiting induced by chemotherapy. Transcutaneous Electrical Nerve Stimulation; Nausea; Vomiting; Chemotherapy 184 182 http://www.irmj.ir/browse.php?a_code=A-10-1-2&amp;slc_lang=en&amp;sid=en M. Rivaz 4800319475328460011 Yes M. Asadizaker 4800319475328460012 No N. Elahi 4800319475328460013 No M. Ramzi 4800319475328460014 No

en General Medicine General Medicine Original Article Original Article Background: Several methods have been used to estimate adiposity with high precision, but BMI has become the most common marker in identifying overweight and obese subjects. This study was performed to present reference data for body mass index (BMI) of school children aged 6.5-11.5 years in Shiraz, southern Iran. Methods: The data of present study are based on a random multi stage sample survey of 2397 healthy school children in Shiraz, southern Iran. The participants were 1268 boys and 1129 girls and their heights and weights were measured in 2002-2003 academic year. Joint height-weight measurements were available for 2195 (91.6%) including 1138 boys (89.7%) and 1057 girls (93.6%). Healy-Rasbash-Yang (HRY) distribution-free method was applied to estimate BMI age-related centiles. Results: Cubic polynomials in age are shown to adequately fit the BMI data (on log scale). Children are now heavier than those born over ten years earlier. Boys BMI lie above girls to around 10 years of age, which is subsequently reversed for overweight and obese centiles. Conclusions: Comparison of these BMI curves with those of CDC charts showed substantial differences at every age and suggested the necessity for the use of locally based BMI norms for assessing body mass index of children in Shiraz, Southern Iran. Also, a positive secular trend in BMI is seen during the past decade in Iran. Body mass index (BMI); Reference values; School children; Secular trend; CDC charts 185 190 http://www.irmj.ir/browse.php?a_code=A-10-1-3&amp;slc_lang=en&amp;sid=en S. Ayatollahi 4800319475328460015 Yes Department of Biostatistics, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran F. Mostajabi 4800319475328460016 No

en General Medicine General Medicine Original Article Original Article Background: Spina bifida aperta is a lesion that communicates with the external environment; and includes<br />meningomyelocele and meningocele. We investigated all clinical presentations in meningomyelocele and meningocele<br />patients in Shiraz, southern Iran.<br />Methods: Patients’ files of spina bifida aperta who were admitted from 1989 through 2005 to Nemazee Hospital<br />were reviewed for meningomyelocele and meningocele in Shiraz, southern Iran. CSF shunting by ventriculoperitoneal<br />(VP) shunt was also performed.<br />Results: Out of 580000 patients, 100 cases of spina bifida aperta were registered. In 67 patients with meningomyelocele<br />and 33 with meningocele with male and lumbar and lumbosacral areas predominance, cystic mass<br />was more common. 35% of patients showed congenital anomalies including talipes equinovarus and congenital<br />hip dislocation that were more in meningomyelocele patients. 10% of the patients were operated in the first 72<br />hours and the others 1 month to 1 year after birth. CSF shunt insertion was more in meningomyelocele patients.<br />Among meningomyelocele patients, mortality occurred in 3 patients (meningitis in 2 and post-operative pneumonia<br />in one case).<br />Conclusion: It seems that water-thigh dural closure and use of dural patch could decrease the rate of postoperative<br />CSF leakage. Our results resembled the pattern in other series, except the low prevalence of hydrocephalus<br />and a male predominance. Earlier referral of spina bifida aperta patients should be encouraged, because<br />it could lower the complications and lead to better outcomes. Spina bifida aperta; southern Iran 191 196 http://www.irmj.ir/browse.php?a_code=A-10-1-4&amp;slc_lang=en&amp;sid=en S. Rakei foruzna@yahoo.com 4800319475328460017 Yes Shiraz University of Medical Sciences.shiraz.iran M. Taghipour 4800319475328460018 No A. Safarian 4800319475328460019 No A. Rahmanian 4800319475328460020 No

en General Medicine General Medicine Original Article Original Article Background: Non-steroidal anti-inflammatory drugs (NSAIDs) remain as the initial approach to the<br />pharmacologic management in juvenile rheumatoid arthritis (JRA). Gastrointestinal (GI) damage associated with<br />NSAIDs is common in adults, but there are few studies available in children. This study was performed to<br />determine the GI complications due to the use of NSAIDs in a cohort of JRA patients by endoscopy.<br />Methods: Twenty-one patients with JRA who were using NSAIDs for at least 3 months were assessed clinically<br />and by endoscopy at Pediatric Immunology Clinic of Nemazee Hospital affiliated to Shiraz University of Medical<br />Sciences in Shiraz, southern Iran from June 1999 to June 2003..<br />Results: The mean age of the patients was 9.8 years (11 females), and the mean duration under NSAIDs<br />management was 16 months. The most common NSAIDs used was diclofenac. GI symptoms were found in<br />42.9% of patients including 33.4% abdominal pain and 9.5% vomiting. There was no significant difference<br />between the patients and symptoms free subjects in regard to mean duration of treatment. Macroscopic<br />endoscopic lesions were found in 85.7% and infection of Helicobacter pylori (Hp) in 14.3% of cases. There was<br />no significant relationship between endoscopic findings and duration of treatment or clinical symptoms.<br />Conclusions: Our data showed that patients using NSAIDs had frequent GI damage without any relationship to<br />the duration of treatment. There were also a high number of children with GI damage and without any clinical<br />complaint. Furthermore, we found no significant relationship between the duration of drug use and the GI complaints,<br />and no relation between duration and GI complaints to upper GI tract endoscopic lesions. The possibility<br />of GI derangements with NSAIDs in pediatric age group is high. Close monitoring of symptoms and prevention<br />measures are suggested. Endoscopic findings; Children; Non-steroidal anti-inflammatory drugs 197 200 http://www.irmj.ir/browse.php?a_code=A-10-1-5&amp;slc_lang=en&amp;sid=en S. Deghani dehghanism@sums.ac.ir 4800319475328460021 Yes R. Amin 4800319475328460022 No M. Imanieh 4800319475328460023 No S. Kashef 4800319475328460024 No K. Batebi 4800319475328460025 No I. Gakurya 4800319475328460026 No

en General Medicine General Medicine Original Article Original Article Background: Burn injury according to severity, extent and organ involvement leads to different mortalities<br />and morbidities. Considering burn injuries of similar extent, the mortality related to lower extremity seems to<br />be higher than that of upper extremity. This study was performed to compare the mortality and mean hospital<br />stay between two groups of burn patients with upper and lower extremities admitted to Ghotbeddin Hospital<br />during a two years period.<br />Methods: The present retrospective study encompassed 322 patients aged from 15-40 years with 45% females<br />and 55% males and burns of 15%-40% during a two years period. Depending on 2/3 or more of total burns; they<br />were divided into two groups with burns in the upper and lower extremities.<br />Results: Upon comparison of the mean hospital stay and mortality rate, it was shown that the mean hospital stay<br />in those with burns of lower extremity was two weeks, which was longer than that in patients with upper extremity<br />burns. Mortality in lower extremity burns was about 10% more than that of upper extremity.<br />Conclusion: It seems that treatment of lower extremity burns along with appropriate planning for intensive care<br />of this organ would help reduce mortality, save time and lower costs. Hospital stay; Mortality; Lower extremity; Upper extremity; Burns 201 204 http://www.irmj.ir/browse.php?a_code=A-10-1-6&amp;slc_lang=en&amp;sid=en M. Amini aminima@sums.ac.ir 4800319475328460027 Yes M. Kherad 4800319475328460028 No R. Sadeghimehr 4800319475328460029 No M. Mohammadi 4800319475328460030 No

en General Medicine General Medicine Original Article Original Article Background: Due to increasing unresponsiveness and significant side effects associated with antimonial compounds,<br />alternative therapeutic modalities are suggested. Recently oral zinc sulphate has been reported to be<br />effective in the treatment of CL. The aim of this study was to evaluate the efficacy of oral zinc sulphate in the<br />treatment of CL.<br />Methods: The present study comprised 31 patients with clinical diagnosis of dry type leishmaniasis and parasitologically<br />proven cutaneous leishmaniasis of which 22 patients received a full course of treatment. Patients were<br />treated with 10 mg/Kg/day of oral zinc sulphate for 45 days and were followed through 20 and 45 days of treatment<br />as well as 45 days after cessation of therapy.<br />Results: Only 2 (9%) of 22 patients were cured after 45 days of treatment with zinc sulphate.<br />Conclusion: The administration of zinc sulphate for the treatment of CL seemed to be of inadequate therapeutic value. Cutaneous leishmaniasis; Leishmaniasis, Zinc sulphate 205 208 http://www.irmj.ir/browse.php?a_code=A-10-1-7&amp;slc_lang=en&amp;sid=en M. Yazdanpanah yazdanpanahmj@mums.ac.ir 4800319475328460031 Yes K. Mostofi 4800319475328460032 No M. Soleimani 4800319475328460033 No M. Ebrahimirad 4800319475328460034 No

en General Medicine General Medicine Original Article Original Article Background: Colorectal cancer is the second leading cause of cancer-related mortality and represents a major<br />public health problem in developed countries. The objective of present investigation was to determine the epidemiologic<br />aspects and clinical characteristics of colorectal cancer in Shiraz, southern Iran.<br />Methods: This was a retrospective study carried out during 2000-2005, and comprised 491 subjects with pathologically<br />documented colorectal cancer. They were registered in Fars Cancer Registry, affiliated to Shiraz University<br />of Medical Sciences, southern Iran. A questionnaire including data on demographic information, histological<br />types of cancer, site of primary cancer and metastasis were completed by trained interviewers.<br />Results: Among 491 subjects, 57.2% were male and the most common age was 65-75 years. Patients under<br />45 years of age represented 22.8% of all colorectal cancer cases while 32% were over 65 years old. Those<br />with a history of cancer in their first-degree relatives included 26.9% of the patients. Adenocarcinoma was the<br />most common reported histological type of cancer (96.1%). Among all subjects, 60.7% suffered from abdominal<br />pain, 28.4% abdominal distention and 28.0% rectal bleeding. Other symptoms included diarrhea/<br />constipation, nausea/vomiting, urogenital problems and mass sensation. The most common sites of<br />metastasis were lung, brain and ovary.<br />Conclusion: The incidence of colorectal cancer showed a remarkable increase in our region that might be due<br />to changes in life style, decreased physical activity, heavy smoking habits, dietary changes and increased prevalence<br />of obesity. Considering the elderly as the most vulnerable and the growing trend towards involvement of<br />younger subjects, more studies and screening seems to be essential. Characteristics; Colorectal cancer; Southern Iran 209 211 http://www.irmj.ir/browse.php?a_code=A-10-1-8&amp;slc_lang=en&amp;sid=en M. Saberi-firoozi saberifm@sums.ac.ir 4800319475328460035 Yes D. Kamali 4800319475328460036 No M. Yousefi 4800319475328460037 No D. Mehrabani 4800319475328460038 No F. Khademolhosseini 4800319475328460039 No S. Heydari 4800319475328460040 No

en General Medicine General Medicine Case Report Case Report Testicular microlithiasis is a rare condition characterized by deposition of calcium in the Lamina of semineferous<br />tubules of testis. The ultrasound of testicular microlithiasis shows bright 1-3 mm echogenic foci in parenchyma.<br />Herein, we report a first case of testicular microlithiasis in major beta thalassemia that was demonstrated in<br />testicle’s ultrasound Testicular microlithiasis; Beta thalassemia; Malignant precursor Scrotal ultrasound 212 214 http://www.irmj.ir/browse.php?a_code=A-10-1-9&amp;slc_lang=en&amp;sid=en A. Alaee ar_alaee@yahoo.com 4800319475328460041 Yes Z. Miabi 4800319475328460042 No

en General Medicine General Medicine Case Report Case Report Incidental vaginotomy, a potentially severe complication, has occasionally been reported in cesarean sections<br />performed after prolonged second stage labor. There is controversy on the significance of vaginotomy and its<br />consequences in cesarean section. Ureteral injury has been reported as a possible complication of cesarean<br />section. Herein, we present a case of anterior vaginal incision instead of lower uterine segment, where the right<br />ureter had been obstructed by sutures. The injury was detected and corrected during the operation. Thus incidental<br />vaginotomy in cesarean section must be taken seriously and avoided as far as possible. It is also crucial<br />to inspect and preserve the integrity of ureters in such cases. Cesarean; Vaginotomy; Ureter 215 216 http://www.irmj.ir/browse.php?a_code=A-10-1-10&amp;slc_lang=en&amp;sid=en J. Nasouhi jnasouhi@yahoo.com 4800319475328460043 Yes A. Mahdavi 4800319475328460044 No S. Gity 4800319475328460045 No

en General Medicine General Medicine Case Report Case Report Systemic lupus erythematosus (SLE) is an autoimmune disease with multiple organ involvements and abdominal<br />pain as the most common gastrointestinal symptom.<br />Herein, we describe a case of SLE presented with abdominal pain and massive ascites that had a good response to<br />the high dose of prednisolone. Acute lupus peritonitis; Massive ascites 217 219 http://www.irmj.ir/browse.php?a_code=A-10-1-11&amp;slc_lang=en&amp;sid=en Z. Habibagahi Zahrahabibagahi@yahoo.com 4800319475328460046 Yes M. Nazarinia 4800319475328460047 No E. Aflaki 4800319475328460048 No K. Zahedi 4800319475328460049 No S. Shenavandeh 4800319475328460050 No M. Jahanbani 4800319475328460051 No

en General Medicine General Medicine Case Report Case Report Anaplastic thyroid carcinomas are undifferentiated and highly aggressive tumors of the thyroid follicular epithelium,<br />with a disease-specific mortality approaching 100 percent. This study reports ten cases with advanced<br />anaplastic thyroid carcinoma with ineffective surgical interventions. Between 2001-2006, we treated 10 patients<br />with anaplastic carcinoma of the thyroid. All patients presented with advanced phase and were documented by<br />pathological study. The surgical intervention was thyroidectomy in 3 cases, debunking surgery in other three, just<br />tracheostomy in three cases, and only biopsy in one patient. All of our patients died in 4 days to 8 months after<br />surgery. Surgical intervention had no benefit in treatment of advanced anaplastic carcinoma of the thyroid and<br />the suitable surgical intervention was to maintain an open airway. Early recognition of the disease is essential to<br />allow prompt initiation of therapy. There is no cure for advanced situations, and surgery, radiotherapy, and chemotherapy<br />play no important role in the treatment. Anaplastic thyroid carcinoma; Surgical intervention; Cancer 220 223 http://www.irmj.ir/browse.php?a_code=A-10-1-12&amp;slc_lang=en&amp;sid=en F. Safarpor safarpor@yahoo.com 4800319475328460052 Yes M. Hedayati Omami 4800319475328460053 No M. Aghajanzadeh 4800319475328460054 No F. Mohammadi 4800319475328460055 No B. Najafi3 4800319475328460056 No S. Hoda 4800319475328460057 No

en General Medicine General Medicine Letter to Editor Letter to Editor Serological markers of past or present HBV infection<br />were reported in 4-90% of HIV infected patients1<br />and a significant association was reported between<br />serologically positive HIV infection and detectable<br />HBS Ag and anti-HBC.2,3 As HIV positive men with<br />HBV infection are at increasing risk of liver related<br />mortality,4 the present study was conducted to determine<br />the seroprevalence of HBS Ag in patients with<br />HIV infection in Shiraz, southern Iran. 224 225 http://www.irmj.ir/browse.php?a_code=A-10-1-13&amp;slc_lang=en&amp;sid=en M. Davarpanah 4800319475328460058 Yes M. Darvishi 4800319475328460059 No D. Mehrabani 4800319475328460060 No