en Serum Concentration of lipoprotein (a) in Myocardial Infarction and Heavy Smoking General Medicine General Medicine Original Article Original Article 15 17 http://www.irmj.ir/browse.php?a_code=A-10-1-182&slc_lang=en&sid=en MT . Jalali 48003194753284600683 Yes A.A. Ehsani 48003194753284600684 No zakipour 48003194753284600685 No

en Long term effect of exposure to mustard gas on male infertility General Medicine General Medicine Original Article Original Article ?Background: Sulfur mustard is a noxious chemical and a carcinogen that causes acute and chronic injuries with both local and systemic effects. This study was conducted to investi- gate the long-term effect of sulfur mustard (mustard gas) on male infertility in couples, in whom the husbands were highly suspected of being exposed to mustard gas. Methods: A total of 91 couples, in whom men, highly suspicious of being exposed to mus- tard gas during the Iran-Iraq war, were fully examined by an urologist and a gynecologist, and urged to provide semen for three standard sperm analyses. Results: Of 91 couples, 40 were infertile 10 years after given that the frequency is ap- proximately 10-12% in normal population. In addition, thorough examination of the wives by a Gynecologist showed that of the foregoing 40 infertile couples, 8 (20%) of women suf- fered from infertility problems. The infertility of the remaining 32 (80%) was due to male factors as compared with 40-50% in the normal population. The results of the present re- search demonstrated that in the population under study, male factors had greater impact on infertility. Conclusion: The exposure of males to mustard gas played a distinct role in long term in- fertility. Mustard gas; Male Infertility; Iran 59 62 http://www.irmj.ir/browse.php?a_code=A-10-1-24&slc_lang=en&sid=en S. Shakeri sshakeri@sums.ac.ir 4800319475328460072 Yes

en A comparison between the levels of cyclosporine C0 General Medicine General Medicine Original Article Original Article Article Type: Original Paper Background: Cyclosporine A (CSA) with intra- and inter-individual variability in absorptive property needs individualized dose adjustment in patients receiving the drug. This study was performed to compare cyclosporine C0 (before morning dose) and C2 (two hours after morning dose) levels in order to adjust the maintenance dose of CSA in stable renal transplant patients in Shiraz, southern Iran. Methods: From October 2004 to June 2005, 64 kidney transplants of Nemazee Hospital entered our study. All patients underwent renal transplantation for the first time except one subject who received the second transplant. All patients received three immunosuppressive drugs of which CSA was administered in two divided doses in the form of microemulsion. The height, weight, blood pressure, periodical tests and C0 and C2 levels were determined at the time of referral, as well as one and 5 months later. The amount of CSA was adjusted based on C0 levels of 100-250 ng/mL. The patients were divided into two C0 subgroups with C0 levels of <100 and =100 ng/mL. In regard to C2, the two subgroups were <800 and =800 ng/mL. In addition to CSA, cellcept and prednisolone were administered to 47, immuran with prednisolone to 15, and only prednisolone to 2 patients. Results: Comparing the two subgroups of C0 and C2, no differences were observed between serum creatinine level, CSA doage and the drug complications. A significant correlation was found between C0 and C2 levels, and also between C2 level and CSA dosage. A negative correlation was seen between C0 level and serum creatinine. The coefficient of variation of the three samples of each patient was 10.89% for C0, and 8.94% for C2 with constant drug regimen. Conclusion: As there was no significant difference between mean C0 and C2 levels, and renal function at the start and the end of study, there seemed to be no need to recommend C2 level for follow up of renal transplan Cyclosporine; children; renal transplantation 63 68 http://www.irmj.ir/browse.php?a_code=A-10-1-25&slc_lang=en&sid=en Z. Bazargani bazarganiz@sums.ac.ir 4800319475328460073 Yes

en The protective effect of body mass index in General Medicine General Medicine Original Article Original Article Background: The incidence of trocar site herniation differs in various studies. The incidence of these hernias is increased in patients who experience significant weight gain post- operatively. The aim of this study was to compare the complication of closed trocar port site with open port and effect of body mass index on the herniation using trocar site incision in laparoscopic surgery. Methods: In this prospective, randomized clinical, a total of 100 patients were scheduled to undergo appendectomy, cholecystectomy, ovarian cyst excision, herniorraphy and diagnostic laparoscopy at the Surgical Gastroenterology Service of The Baqiyatallah Hospital. Patients were randomly distributed into group OP (open port, n= 52) and group CP (closed port, n = 48). The follow up intervals were at 3 and 12 months after surgical operation Results: Five patients in OP group developed incision hernia. Regarding infection, hematoma, there was no significant difference between the two groups. Surprisingly, in OP group the average BMI (kg/m²) in herniated patients was significantly less than nonherniated cases. Conclusion: An important step to avoid post laparoscopic hernias is suturing the fascia whenever the trocar diameter exceeds 10 mm. If surgeons tend to have an open trocar site of 10 mm, particularly in facial defects; the trocar site is protected from incision hernia in obese patients with high BMI. Trocar site; Incisional hernia; BMI; Obesity 69 73 http://www.irmj.ir/browse.php?a_code=A-10-1-26&slc_lang=en&sid=en S. Fanaie safanai@hotmail.com 4800319475328460074 Yes

en Detection of Mycobacterial antigen and antibody in General Medicine General Medicine Original Article Original Article Background: Little is known about changes in total antibodies occurring during the progression of tuberculosis or its treatment. Using passive and reverse passive hemagglutination methods, mycobacterial antibody and antigen were determined in sera of patients with acute smear-positive pulmonary tuberculosis. Methods: Fifty-nine patients were studied in different groups according to the duration of treatment in various stages of disease. The first group that did not undergo treatment showed a very low level of antibody. The second group with less than 6 months of therapy had a mean antibody titer of about 1:70. The third group underwent therapy for more than 6 months and their mean antibody titer was about 1:970. The fourth group whose disease was under control and their treatments were discontinued, showed the highest level of antibodies (1:2760). Results: A significant difference was found between the average antibody titers and the duration of treatment and course of disease. No antigen was detected in any patients except in group 5. Conclusion: A high antibody response seemed to occur after treatment when the bacteria were disrupted and their antigens released. Absence of antigen may be due to the formation of antigen-antibody complexes. Tuberculosis; PPD; Antituberculous antibody; Reverse passive hemagglutination 74 79 http://www.irmj.ir/browse.php?a_code=A-10-1-27&slc_lang=en&sid=en N. Hadi hadina@sums.a c.ir 4800319475328460075 Yes M. Kabiri 4800319475328460076 No

en Evaluation of stereo tests for screening of amblyopia General Medicine General Medicine Original Article Original Article Background: One of the most dramatic sensory ocular anomalies is the low visual acuity of one eye known as amblyopia. The goal of preschool vision screening is to detect children with amblyopia. Stereopsis is an important indicator of the state of binocularity. Previous studies showed a disagreement on the reliability of stereo tests as screening tools for amblyopia. This study was performed to compare visual acuity testing with the ability of TNO, Titmus and Randot stereo tests for detection of amblyopia. Methods: A total of 1000 pupils, aged 6-12 years were examined in a field study in Shiraz. In addition to the 3 stereo tests of TNO, Titmus and Randot, the examination included visual acuity, cover testing and inspection of red reflex. According to definite fail pass criteria, abnormal cases were referred to pediatric eye clinic for complete eye physical examination. Similar to the first part, in the second part of the study, 100 amblyopic students aged 6-12 years, were referred to pediatric eye clinic for complete physical examination. Sensitivity and specificity of each stereo test for detection of amblyopia was calculated. Results: In screening situation, the sensitivity of stereo tests was 55.5% for TNO with a cutoff point of 240", 48.8% for Titmus with a cutoff point of 70" and 44.4% for Randot stereo test with cutoff point of 100". Specificity of these tests in screening situation was 86.9%, 94.4%, and 98.4% respectively. The respective sensitivity of these stereo tests in clinical situation was 74%, 68%, and 62%. Conclusion: Considering these fail-pass criteria, none of the TNO, Titmus, and Randot stereo tests can be recommended as a screening method for detection of amblyopia in children. Amblyopia; Screening; Stereopsis 80 85 http://www.irmj.ir/browse.php?a_code=A-10-1-28&slc_lang=en&sid=en M. Farvardin majidfarvardin@yahoo.com 4800319475328460077 Yes

en Bowel movement patterns in children with acute appendicities General Medicine General Medicine Original Article Original Article Background: Acute appendicitis is currently one of the most important causes of acute abdominal peritonitis and emergency laparatomy. Despite its low mortality, it remains a cause of concern for surgeons due to the postoperative complications of wound infection, sepsis, intrabdominal abscess and even bowel obstruction resulting from adhesions. High incidence of acute appendicitis provides a strong impetus for further studies. This study was conducted to determine the bowel movement patterns and dietary fiber consumption in pediatric patients with appendicitis in Shiraz, southern Iran. Methods: The study included 202 pediatric patients under the age of 18 years at Nemazee Hospital affiliated to Shiraz University of Medical Sciences, who had undergone appendectomy with the preoperative diagnosis of acute appendicitis from March 2003to March 2004. Using a written semi-standard questionnaire, the variables recorded were age, gender, stool consistency, number of bowel movements, type of bread consumed, habit of fruit and vegetable consumption, clinical presentation (signs and symptoms) and the time taken from the onset of symptoms to arrival in hospital, the date of patients admission to the emergency room to the time of surgery, and the duration of postoperative hospitalization. The pathology of appendicitis was clarified and recorded. Results: The patients aged from 3–18 years (mean: 11.2±3.6 years), with a male to female ratio of 2:4. Anorexia was the most common symptom, affecting 78.7% of patients. Of 31 patients with constipation, 58% did not report daily regular intake of fruits while the others had regular fruit intake. Only 3 patients (9.7%) had regular daily consumption of vegetables, and 27 patients (87.1%) had pathology reports of fecalith, while in the nonconstipated patients, only 1.2% had such reports. The abdominal pain was periumbilical in many patients (42.6%), which shifted to McBurny po Acute appendicitis; Children, Dietary fiber; Constipation 86 92 http://www.irmj.ir/browse.php?a_code=A-10-1-29&slc_lang=en&sid=en S. Dehghani dehghanism@sums.ac.ir 4800319475328460078 Yes

en Comparison of the effect of local anesthetic cream General Medicine General Medicine Original Article Original Article Background: A number of studies have shown that orally administered sweet-tasting solutions reduce feeling of pain during invasive procedures. The local anesthetic cream EMLA has recently been shown to be safe for use in neonates. The present study aimed to compare the pain-reducing effect of EMLA cream with that of orally administered glucose during venipuncturing of newborns in Yazd city. Methods: A randomized, controlled, double blind clinical trial was performed on 220 newborns undergoing venipuncture for clinical reasons. EMLA cream was applied to the skin of 106 of the newborns, along with orally administered sterile water as placebo. In addition, a 30% solution of glucose was administered orally to 114 neonates whose skin was treated with vitamin A+D cream as placebo. Symptoms associated with pain while venipuncturing measured by Neonatal/ Infant pain scale (NIPS) and crying time was compared between the two groups. Results: There were no differences in background variables between the 2 groups. The results showed that the NIPS scores were significantly lower in the glucose group (Median: 2) compared with the EMLA group (median: 3) (p<0.001). The duration of crying in the first 2 minutes was significantly lower (p<0.01) in the glucose group (median: 2 sec) than in EMLA group (median: 9 sec). The NIP values higher than 3 were observed in 12.3% and 29.2% of neonates in glucose and EMLA groups respectively, where the difference was found to be statistically significant (p<0.05). Conclusions: Our study showed that compared with EMLA cream, orally administered glucose can be more effective, tolerable and convenient in reducing pain from venipuncturing in neonates. Neonatal/Infant pain score; EMLA cream; Oral glucose 93 98 http://www.irmj.ir/browse.php?a_code=A-10-1-30&slc_lang=en&sid=en M. Noorishadkam mahmood 7072005@yahoo.com 4800319475328460079 Yes

en Reduced incidence of early complications of surgical General Medicine General Medicine Case Report Case Report Background: Wound-related complications are major sources of trouble in post-operative period and slow down the wound healing process. This study was performed to determine the incidence of early wound related complications in laparoscopic versus open abdominal surgeries. Methods: Medical records of 104 elective laparoscopic (A) and 106 diagnosis matched open surgeries (B) including appendectomy, cholecystectomy, ventral hernia repair, and bariatric surgery were retrospectively reviewed between Jun 2002 and Jan 2005. Study data included patients’ sex, age, wound class, type of operation, and occurrence of early wound related complications. Surgical wounds were evaluated for presence of early complications during the post-op period and 10 to 15 days after the operation. Results: The two groups were not different regarding age, sex and wound classes. Wound infection developed in 7 patients [RR: 0.06 (0.01-0.77) (95%CI)] and none in patients of group B. Incidence of Hematoma was similar in the two groups; one case in each. No patients in the two groups experienced seruma nor wound dehiscence. Gender, age, and wound classes were not associated with higher rates of wound complications. Conclusion: Laparoscopic surgery significantly reduced the incidence of early wound complications, namely wound infection, and is a safe and efficient alternative to conventional open procedures. Wound complications; Laparoscopic surgery; Open surgery 99 103 http://www.irmj.ir/browse.php?a_code=A-10-1-31&slc_lang=en&sid=en S. Fanaie safanai@hotmail.com 4800319475328460080 Yes

en Maternal hematocrit status affecting Pregnancy outcome General Medicine General Medicine Case Report Case Report Low and high maternal hematocrit can influence outcome of pregnancy.Anemia is frequently observed during pregnancy. This study was performed to determine the maternal hematocrit status affecting pregnancy outcome in babol, northern Iran. The present cohort control study was conducted from Dec 2001 to Dec 2002 and comprised 609 randomly selected pregnant women who attended Yahyanejad Hospital for antenatal care and delivery. Women with hemoglobinopathies such as thalassemia were excluded from the study. Maternal characteristics including hematocrit values were recorded at the first antenatal care visit when 3ml blood collected from each woman was sent to the laboratory for CBC. Anemia marked by hematocrit<34% in the first trimester was associated with a significantly increasing risk of low birth weight (<2500 g) and preterm delievery which was indicated by the gestational age of less than 37 weeks. High hematocrit values (>40%) did not increase the risk of low birth weight or preterm delivery. The risk of low Apgar score, operative deliveries and admittance to the newborn intensive care unit (NICU) were significantly increased in women with high and low hematocrit. Thus pregnant women with abnormal hematocrit are at high risk and due awareness is required of how to prevent complication and dismal outcome of pregnancies by special clinical care. Hematocrit; Anemia; Low birth weight; Preterm delivery; Pregnancy outcome 104 108 http://www.irmj.ir/browse.php?a_code=A-10-1-32&slc_lang=en&sid=en F. Nasiri amiri nasiri_fa@yahoo.com 4800319475328460081 Yes Yahyanejad Hospital, Babol University of M. Hajiahmadi 4800319475328460082 No Yahyanejad Hospital, Babol University of Z. Basirat 4800319475328460083 No Yahyanejad Hospital, Babol University of

en The Third International Congress on Health Medication and Crisis Management in Natural General Medicine General Medicine Letter to Editor Letter to Editor The Third International Congress on Health, Medication and Crisis Management in Natural Disasters, organized by Iran's Basij Medical Society, was held at Razi International Conference Center, Tehran, Iran on 12- 14 December 2006. The following is a brief report of the Congress and the issues discussed. Natural Disaster, Physiotherapy and Rehabilitation, Treatment of the Injured in Disasters and Management of Natural Disasters (Table 1). Presentations on help and rescue did emphasize the role of public education and 109 110 http://www.irmj.ir/browse.php?a_code=A-10-1-33&slc_lang=en&sid=en Sh. Bolandparvaz 4800319475328460084 Yes Department of Surgery, Medical School, Shiraz University of Medical Sciences M. Masjedi 4800319475328460085 No Department of Anesthesiology, Medical School, Shiraz University of Medical Sciences