Archives of Iranian Medicine
Volume:3 Issue: 4, Oct 2000

Background-Few data exists on the prevalence of the symptoms of asthma among young adults. The prevalence of this common disease among this age group in Iran is not known.Methods-We studied the prevalence of asthma among secondary school students (aged 11-16 years) in the city of Mashhad using a standard questionnaire. Trained medical students interviewed a total of 5,534 students (in 55 schools), including 3,038 males and 2,496 females. The following symptoms were used as asthma symptoms: Recurrent wheeze, recurrent cough or tightness in the chest at rest, wheeze, cough or tightness in the chest during the night and early morning and wheeze or cough during exercise. Students with one or two symptoms were considered as suspected asthmatics and those with three or more symptoms, or having been previously diagnosed with asthma, as probable asthmatics and students in any of these two groups were defined as symptomatic subjects.Results-Results showed that 232 students (4.19%) including 115 males (3.78%) and 117 females (4.69%) had probable asthma. Family history of asthma (39.2%), history of allergy (55.2%) and smoking habit of parents of asthmatic students (49.1%) were significantly higher than normal students (in all cases p<0.0001). Only 35.17% of these students had been previously diagnosed and were under treatment. However, most students with treatment history have used only bronchodilator drugs(51.8% of treated students); and 13.23% of them had anti-inflammatory drugs in their treatment regimen. In addition 969 students (17.5%) had suspected asthma including 468 males (15.4%) and 501 females (20.1%).Conclusion-These results indicated a relatively high prevalence of asthma among secondary school students in the city of Mashhad, for which most of them had not been diagnosed and were not under treatment.

Background-Dehydroepiandrosterone (DHEA) or it’s sulfate derivative (DHEA-S) is the major C19 steroid hormone secreted by the adrenal cortex. It has been claimed that it has an inverse correlation with atherogenesis through its antiproliferative effect. The aim of this study is to examine the effect of DHEA-S on coronary artery disease(CAD). Material and Method-In a prospective randomized study 202 patients with possible coronary artery disease who underwent coronary angiography between January 1999 and June 1999 were studied. They were allocated into two groups, group 1 (n=142, female: 39, male: 103) included patients who had more than 75 percent cross sectional area narrowing of at least one coronary artery, and group 2 (n=60, female: 28, male: 32) included patients who had no coronary artery disease. The age range was 18-75 years, and it was matched between the two groups. Level of DHEA-S (measured by two different methods; ELISA and RIA), fasting blood sugar, and full lipid profile (TG, total cholesterol, LDL-C, HDL-C) were measured in both groups. Other major coronary risk factors were also compared between the two groups.Results-The level of DHEA-S had an inverse linear correlation with age (r=-0.34 and p<0.01). There was no statistically significant correlation between the level of DHEA-S and coronary artery disease in different age groups in males or females. Likewise, there was no statistically significant correlation between the level of DHEA-S and blood sugar (p=0.08), HDL (p=0.41), LDL (p=0.09), body mass index (p=0.4), hypertension and current smoking.Conclusion-The present study does not confirm an inverse correlation between DHEA-S and coronary artery disease.

Background-Reduction of sulfated glycosaminoglycans (GAG) in the liver and kidney of streptozocin-induced diabetic rats has been attributed to lowered synthesis and perhaps higher degradation of such compounds in these organs. Objective-To measure hepatic lysosomal arylsulfatases A and B, (the enzymes responsible for the removal of sulfate groups from GAG), in starved and streptozocin-induced diabetic rats.Methods-Diabetes was induced by streptozocin injection (40 mg per kg body weight) through the caudal vein in rats. After two weeks, the livers were removed and homogenized. Activities of arylsulfatases A and B were measured and compared with those of the liver homogenates from healthy and starved rats.Results-The activity of liver arylsulfatase A in starved diabetic rats increased 2.15 fold as compared with normal starved animals, while that of fed diabetic rats was 3.16 fold higher than their respective control group. Increases of 1.70 and 1.94 fold in specific activities of arylsulfatase B was noticeable in the livers of diabetic animals under fed and starved conditions, respectively.Conclusion-It appears that increased hydrolysis of sulfated GAG by liver lysosomal arylsulfatases A and B in streptozocin-induced diabetic rats may be among the contributing factors in the reduction of such sulfated compounds in this tissue.

Background-Stool weight, frequency of defecation and transit time are all indices having a close relation with the quality and quantity of ones diet. The average diet in Iran has significant differences with that of western diet. Therefore, it is assumed that the above-mentioned variables follow specific norms which must be studied more accurately in Iran. Methods-A total of 1000 healthy Iranian subjects residing in the region of Shahr-e Kord, central Iran, were selected from the attendants to some urban and rural health centers. After providing the necessary information about the procedure of the study, they were requested to collect a 24- or 48- hour stool specimen in some special covered containers. The beginning and the end of the procedure was timed with carmine and activated charcoal as stool markers. At the end of the period, the collected stool was weighted and other required variables were obtained via questionnaire. The SPSS software, version 7.5, was used for analyzing the data by regression analysis and t-test. Results-The mean daily stool weight of the population under study was estimated to be 349±131g. On the average, the frequency of defecation was 1.5 times a day and the transit time was estimated to be around 12.5 hours using carmine and activated charcoal as markers. Stool weight had a significant correlation with four variables namely, male gender, higher body weight, higher age and amount of bread consumed in the daily diet. Moreover, increased frequency of defecation had a significant relation with decreased transit time using charcoal, higher body weight and higher daily stool weight.Conclusion-As compared to western communities who usually consume a low fiber and high fat diet, the Iranian population in our study had higher stool weight, higher frequency of defecation and shorter transit time probably due to their unique high fiber and low fat diet.

Background-Coriander (vernacular Geshniz) seeds have been traditionally used in Iranian medicine for their carminative, diuretic and anticonvulsant effects.Objective-The anticonvulsant effects of the aqueous and ethanolic extracts of Coriandrum sativum seeds were studied in mice in order to evaluate the folkloric use of this plant.Methods-Two anticonvulsant evaluation tests, namely the pentylenetetrazole (PTZ) and the maximal electroshock tests, were used for assessing antiseizure effects.Results-In the pentylenetetrazole test, the aqueous and ethanolic extracts prolonged the onset of clonic convulsions and the anticonvulsant activity of high dose extracts (5 mg/kg) were similar to that of phenobarbital at a dose of 20 mg/kg in the PTZ test. Both extracts in high doses decreased the duration of tonic seizures and showed a statistically significant anticonvulsant activity in the maximal electroshock test.Conclusion-Results indicate that the aqueous and ethanolic extracts of C. sativum seeds may have a beneficial effect in petit mal and grand mal seizures.

Background-All-Trans Retinoic Acid (ATRA) is a subgroup of the retinoid family, which induces a complete remission in acute promyelocytic leukemia (APL). It causes differentiation and apoptosis in immature malignant promyelocytes. It is not clear whether induction therapy with ATRA followed by intensive chemotherapy is superior to chemotherapy alone in the outcome of these patients.Objective-To investigate the results of treatment with ATRA and intensive chemotherapy in acute promyelocytic leukemia (APL).Methods-A total of thirty patients were enrolled into the study and were treated with ATRA in a prospective study at Shariati Hospital from 1996-99. ATRA was prescribed with a daily dose of 45 mg/m2. In case of ATRA-induced maturation or hyperleukocytosis, intensive chemotherapy was given with cytarabine and idarubicin. This was followed by two additional courses of the same chemotherapy as consolidation. ATRA syndrome was treated with dexamethasone.Results-At the time of diagnosis, clinical and subclinical coagulopathy and all-trans-retinoic acid induced maturation was seen in 96% and 73.3% of patients, respectively. In 26.7% of patients, the response was partial or inconspicuous. All clinical and laboratory evidence of coagulopathy was corrected during the ATRA therapy. ATRA syndrome occurred in 11(42.3%) patients. With a median follow-up period of 1.5 years, 65.4% of patients showed complete remission.Conclusion-This study shows that ATRA is a safe and appropriate treatment for APL, which improves disease-free states and overall survival as compared with chemotherapy alone. We recommend the use of all-trans retinoic acid for induction therapy followed by intensive chemotherapy in patients with APL

Background-The number of liver transplantations are increasing in Iran. Precise knowledge concerning the anatomical dimensions and the effect of racial and environmental factors on them is of importance. This study was carried out to determine the anatomical dimensions of the liver، its vessels and biliary ducts in cadavers autopsied in the Medical Foundation in 1997. Methods- A total number of 40 cadavers without any abdominal surgeries or crushed intra-abdominal organs were studied. The personal and demographics attributes along with anatomical dimensions of the hepatic artery، portal vein، biliary، hepatic and cystic ducts ducts، their variants and probable anomalies along with the total liver weight were recorded. Results-The cadavers were within the age range of 37±9 years and the weight range of 64±9 Kg. In all cases the portal vein was normal with a length ranging 8. 3±2. 2 cm. In 15% of the subjects the hepatic artery (right branch of superior mesenteric artery) was abnormal. The length of extra-hepatic ducts was 8. 6±1. 7 cm and the weight of the liver was 1453±260 g. Conclusion-The anatomical dimensions of liver، its vessels and biliary ducts were different from western reports. It is recommended to perform more detailed research on corpses from habitants of the region.

Deletion mapping studies suggest that genes on the long arm of the Y-chromosome (Yq) may play a pathogenetic role in a group of short males. Although recent researchers have postulated that growth genes are located on the most proximal portion of the long arm of the chromosome, the precise location has not been determined. We report a case of an adult male with a short stature and 46,X, del (Yp) del (Yq) karyotype. The deletion breakpoint on Yq was determined by the use of sequence-tagged site markers and was found between sY182 (5E) and sY151 (5F). This case suggests that the growth determinant gene(s) is/are located distal to sY182 and is/are more distal from the regions, which were previously reported.

Palatal myoclonus is a rare and unique neurological disorder which can be primary or secondary to lesions of the central tegmental tract in the brain stem. This is a case report of a patient who complained of hearing a continuous disturbing noise for many years. Later an affective disorder superimposed on his previous complaints and confounded his auditory complaints. The co-morbidity resulted in attributing the complaint of hearing noise to his psychotic states and as a hallucinatory phenomenon. Thorough clinical and paraclinical examinations revealed that the patient had primary palatal myoclonus and the misattribution of the auditory complaints had resulted injudicious prescription of antipsychotics. Administration of appropriate therapy resulted in improvement of both problems