Shiraz Emedical Journal
Volume:6 Issue: 1, Jan 2005

Increased lipoprotein (a)[LP (a)] concentration was reported to be an independent risk factor for coronary heart disease (CHD).This study was performed to determine the level of Lp(a) and other lipids in patients with acute myocardial infarction and comparing them with matched healthy subjects. We studied a total of 43 cases who admitted to coronary care unit (CCU) for acute myocardial infarction (MI) and also 43 healthy subjects. Data collection comprised Lp (a), total cholesterol, LDL-cholestrol (LDL-C),HDL-cholestrol(HDL-C)level and medical history. The mean Lp (a) level in acute MI cases was 49.18mg/dl, and in the control group was 37.95mg/dl. There was significant difference between two groups (p=0.018).The mean total cholesterol, LDL-C and HDL_C, level in acute MI cases were 183.9, 106.5 and 58.12 mg/dl respectively and in control cases were 227,145.8 and 51mg/dl respectively. The mean level of Lp(a) in women (case& control) was 50mg/dl that was higher than men(37.1mg/dl). Also Lp(a)was independent of other lipids. As one of the first studies about Lp(a) in Acute MI patients, this study shows that average Lp(a) level in patients with acute MI is higher than control patients. Another interesting finding is that level in women is higher than men. We recommend complementary epidemiologic study to evaluate this finding.

Systemic lupus erythematosus is a chronic, debilitating autoimmune disorder that involves multiple organ systems. Nephritis is a component of systemic lupus erythematosus that influence the long-term outcome of the patients and remains the leading cause of death in theses patients. This study was performed to evaluate the demographic, clinical, and histopathological features of Iranian patients with lupus nephritis in Shiraz, Iran. A retrospective survey was performed on 200 patients with renal involvement and SLE who referred to Rheumatology Research Center of Shiraz University of Medical Sciences since 1976. Among 35 patients (17.5%), renal biopsy was not performed and excluded from the study. Patients’ medical recording files were reviewed for demographic, clinical presentation of SLE, development of nephritic syndrome, renal failure, end stage renal disease (ESRD) during nephritis, the mortality rate and probable causes of death. The mean age of the patients was 23.36±9.2 years at the time of diagnosis of SLE. Among the 200 performed biopsies, 35 cases had failure. The remaining 165 patients had the following WHO classification: class I in one, class II in 30, class III in 33, class IV in 58, and class V in 43 patients. The most frequent clinical presentations of SLE were arthralgia, edema, and skin rash. The mean value of SLE activity index (SLEAI) was 8.9. There may be differences of clinical and histopathological manifestations of SLE and lupus nephritis considering geographical distribution of the patients.

Gastrointestinal diseases are among the most common problems occurring during the post earthquake period. This study conducted to determine the frequency of gastrointestinal disorders after the Bam earthquake disaster. The injured people of Bam earthquake, admitted in some hospitals of Tehran, Yazd, Esfahan and Shiraz during the first 10 days of earthquake were studied. The epidemiological data and gastrointestinal complaints were fulfilled in the questionnaires. According to the type and severity of the physical injuries, the patients were divided into four groups (grade 1-4). 737 injured people including 361 (%49) male and 376 (%51) female with mean age of 30±14 were studied. Abdominal pain 143(19.4%), nausea 167(22.7%), vomiting 104(14.1%) and excessive gas 161(21.8%), anorexia 287(38.9%), early satiety 200(27.1%), heartburn 188(25.5%), fullness 154(20.9%), bloating 144(19.5%), distention 114(15.5%), belching 93(12.6%), regurgitation 74 (10%), dysphagia 34 (4.65), diarrhea 32 (4.3%) constipation 200 (27.1%), melena 24(3.3%), hematemesis 10(1.4) and hematochezia 5 (0.7%). According to the grade of physical injury, patients divided to 4 groups as follow: 139 (18.9%) patients in grade 1, 323(43.8%) patients in grade 2, 210(28.5%) grade3 patients in and 65(8.8%) patients in grade 4. Excessive gas, abdominal pain, belching and dysphagia were significantly more prevalent among patients with grade 3 injury. Anorexia, early satiety, distention and constipation were significantly more prevalent among patients with grade 3 injury. As a result, gastrointestinal disorders are relatively frequent among injured people of earthquake. Excessive gas, abdominal pain, belching and dysphagia were more prevalent among patients with grade 3 injury.

The serum level of calcium and inorganic phosphate in pregnancy is less well defined among Black – Nigerians, than among Caucasians. This case – control study assessed the relation of serum calcium and inorganic phosphate concentrations to pregnancy in Nigerian women. Blood samples were collected by venepuncture technique from 128 pregnant women during their first, second and third trimesters. A total of 72 non – pregnant women were recruited as controls. Serum calcium and inorganic phosphate levels were determined.Pregnant women had significantly lower serum levels of calcium and inorganic phosphate compared to controls (P<0.000 and P<0.001) respectively. There was a statistically significant progressive decrease in serum calcium and inorganic phosphate concentration from first trimester to third trimester (P<0.000 and P<0.001) respectively. Serum calcium and inorganic phosphate may be reduced during pregnancy due to inadequate dietary intake. The decrease in serum calcium and inorganic phosphate levels parallels increase in gestational age. This may result from mineral transfer from mother to developing fetus.

Using the method of Elmer et al (11), the germ tube test was performed for 10 previously confirmed germ-tube positive Candida albicans isolates, using sera obtained from human, rabbit, sheep, cow and goat blood. The possibility of germ tube formation within 30 minutes has been further confirmed in this study. Comparism of mean time of germ tube formation in the sera used showed a significant difference for cow and goat sera (P<0.05), with human serum inducing germ tubes at a faster rate. There was no significant differences (P>0.05) for both rabbit and sheep sera. Using Student t-test analysis, there was significant difference (p<0.05) when different atmospheric conditions of incubation were compared, with a faster rate of formation of germ tubes in 10% CO2. The preferential use of rabbit or sheep sera for demonstrating germ tube formation is suggested, to forestall possible transmission of infectious pathogens through human blood.

A 26 years old pregnant lady presented with abdominal pain for 15 days with 3-4 episodes of non-bloody bilious vomiting. She was febrile and had RUQ and LLQ tenderness. Laboratory data showed Anemia with increased nRBC, leukocytosis, thrombocytosis, increased PT. Abdominal paracentesis was cloudy in appearance with WBC: 17620 (seg. =95%), Pr: 3.5 g/dl, SAAG: 0.4. Mesenteric venous thrombosis was identified to be the final diagnosis.