Shiraz Emedical Journal
Volume:5 Issue: 3, Jul 2004

Seven isolates of Streptococcus pneumoniae were isolated from sputum samples of suspected tuberculosis patients and characterized. Kirby-Bauer disc diffusion technique was adopted in susceptibility testing of isolates. Isolates showed the highest resistance of 85.7% to norfloxacin and ampicillin –cloxacillin, while the lowest resistance of 14. 3% was to caftaxidime and pefloxacin. The difference in resistance observed between norfloxacin and pefloxacine discourages a common practice where one antibiotic is used for susceptibility test and another (from the same group) is used for treatment. S. pneumoniae is significantly resistant to most of the commonly available antibiotics in Ekpoma and its environs.

Insulin resistance, impaired glucose tolerance and diabetes mellitus secondary to acromegaly generally improve following treatment of the underlying disease. In rare cases, in spite of normoglycaemia in the presence of active acromegaly, patients develop diabetes mellitus following hypophysectomy, to such an extent that insulin is required to control their diabetes. This article introduces the cases of 5 patients who underwent hypophysectomy between 1985 and 1996 at the Shariati and Imam Khomeiny hospitals in Tehran. In view of the above phenomenon, however, the regular measurement of blood glucose levels in post-hypophysectomy patients, even if normoglycaemic prior to surgery, seems to be a necessary step.

To evaluate the correlation of lipoprotein(a) with intimae-media thickness of Statistical significance was carotid artery in chronic renal failure patients(CRF), not yet on dialysis, hemodialysis(HD) and kidney transplant patients. One hundred-thirty subjects consisted of (group1) 29 (f =15, m=14) normal healthy persons, (grou2) 33 (f =18, m=15) chronic renal failure not yet on dialysis, (group3) 43 (f =19, m=24) hemodialysis patient and (group4) 25 (f =16, m=9) kidney transplant patients were selected and evaluated for Carotid-intimae-media(IMT) Sonography and cholesterol, Triglyceride, HDL-c, LDL-c and lipoprotein(a) (Lp(a)) as well as BUN and Creatinin measurements. IMT more than 0.8 mm and Lp (a) more than 39 mg/dl (by the kit) were considered abnormal. There was a significant difference between mean of Lp(a) in 4 groups (p=0.016). There was a significant difference between IMT of 4 groups (p<0.001), and significant difference between IMT of CRF patients with HD group (p=0.039).There was a significant correlation between IMT and age in group1 (p=0.035), group2 (p=0.017) and group3 (p=0.019). No association between duration of CRF or the length of the time patients had been on hemodialysis with IMT in groups 2 and 3 was found. In group3 positive correlation of Lp (a) with IMT was found (p=0.045). This study showed positive correlation of lipoprotein (a) with IMT in hemodialysis patients, the age was the most important factor in association with thickening of intimae-media complex in normal, chronic renal failure as well as hemodialysis and kidney transplant groups.

This study was designed to examine the relation between acculturation process and faulty coping in the form of drug use among newly arrived Iranian youth. A correlational research method was used for the purpose of this project. According to the results, a negative correlation was found between a subject''s acculturation success and drug use as a maladaptive coping. Those who have difficulty in integrating with the host culture are more likely to resort to faulty coping mechanism and more likely to suffer from adjustment difficulty.

Postoperative hypothermia is stressfull by elevating blood pressure and heart rate. This study evaluated the effects of warming IV fluid on perioperative hemodynamic status. Perioperative hemodynamic parameters measured in 60 patients undergoing orthopedic surgery divided in two groups according to intraoperative IV fluid temperature. Core and skin temperature of two groups decreased during surgery but reduced more in hypothermia group (P< 0.005). Postopertive mean arterial blood pressure increased more in hypothermia group versus normothermic group (p< 0.005). Shivering observed in 21 of 30 hypothermia and 11 of 30 normothermia group (p< 0.005) and recovery time was lower in normothermic group (36±5 vs. 26±3 min, p< 0.005). It was concluded that intraoperative IV fluid warming reduces perioperative changes of hemodynamic parameters

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are two important causes of mortality and morbidity in patients with diabetes. Mortality rates are <5% in DKA and about 15% in HHS, much of which are avoidable with appropriate management. The prognosis is worsened with aging, hypotension, coma and concomitant life-threatening illnesses.The criteria for DKA and HHS are somewhat arbitrary, although glucose level is higher and ketone body level is minimal in HHS, but they are two extremes in a spectrum of diabetic metabolic decompensation. In general, DKA occurs in type 1 and most often HHS occurs in type 2 diabetes; however, each type of diabetes may be associated with DKA or HHS. Both conditions are associated with marked dehydration, electrolyte disturbances and insulin deficiency and increased counterregulatory hormones, so treatment consists of water and electrolytes replacement and insulin administration. Recognition and treatment of precipitating factors and frequent monitoring of patients are considered the most crucial aspects of the management.

Azathioprine (AZA) is a purine antimetabolite. It is a prodrug of 6-mercaptopurine (6-MP); both are widely used drugs for IBD. Sustained leukopenia (that may cause malignancy), acute pancreatitis, and allergy are the most common complications. 6-MP and AZA can take up to 3 months or longer. Leukopenic patients were more likely to respond, more likely to have their dose of steroids reduced, and more likely to be adequately treated for complications of IBD. By using newer technologies, clinicians can determine the safe / therapeutic dose of these agents. The clinical usage of AZA and 6-MP include: inflammatory bowel disease, refractory sprue, autoimmune hepatitis, primary sclerosing cholangitis, minimal change nephrotic syndrome, IgA nephropathy, Myesthina gravis, Henoch-Schonlein purpura, rheumatoid arthritis, sarcoidosis, acute lymphoblastic leukemia, refractory anemia with excess of blasts, liver, lung, renal,and pancreas transplantation, and some dermatologic disorders (e.g., eczema, pemphigus,etc.).