Iranian Red Crescent Medical Journal
Volume:9 Issue: 2, 2007

? 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. 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. 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. The exposure of males to mustard gas played a distinct role in long term in- fertility.

Article Type: Original Paper Cyclosporine A (CSA) with intra- and inter-individual variability in absorptiveproperty needs individualized dose adjustment in patients receiving the drug. This studywas performed to compare cyclosporine C0 (before morning dose) and C2 (two hours aftermorning dose) levels in order to adjust the maintenance dose of CSA in stable renal transplantpatients in Shiraz, southern Iran. From October 2004 to June 2005, 64 kidney transplants of Nemazee Hospitalentered our study. All patients underwent renal transplantation for the first time exceptone subject who received the second transplant. All patients received three immunosuppressivedrugs 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 weredetermined at the time of referral, as well as one and 5 months later. The amount of CSAwas adjusted based on C0 levels of 100-250 ng/mL. The patients were divided into two C0subgroups with C0 levels of <100 and =100 ng/mL. In regard to C2, the two subgroupswere <800 and =800 ng/mL. In addition to CSA, cellcept and prednisolone were administeredto 47, immuran with prednisolone to 15, and only prednisolone to 2 patients. Comparing the two subgroups of C0 and C2, no differences were observed betweenserum creatinine level, CSA doage and the drug complications. A significant correlationwas found between C0 and C2 levels, and also between C2 level and CSA dosage. Anegative correlation was seen between C0 level and serum creatinine. The coefficient ofvariation of the three samples of each patient was 10.89% for C0, and 8.94% for C2 withconstant drug regimen. As there was no significant difference between mean C0 and C2 levels, andrenal function at the start and the end of study, there seemed to be no need to recommendC2 level for follow up of renal transplan

The incidence of trocar site herniation differs in various studies. The incidenceof 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 portsite with open port and effect of body mass index on the herniation using trocar site incisionin laparoscopic surgery. In this prospective, randomized clinical, a total of 100 patients were scheduledto undergo appendectomy, cholecystectomy, ovarian cyst excision, herniorraphy and diagnosticlaparoscopy at the Surgical Gastroenterology Service of The Baqiyatallah Hospital.Patients were randomly distributed into group OP (open port, n= 52) and group CP (closedport, n = 48). The follow up intervals were at 3 and 12 months after surgical operation Five patients in OP group developed incision hernia. Regarding infection, hematoma,there was no significant difference between the two groups. Surprisingly, in OPgroup the average BMI (kg/m²) in herniated patients was significantly less than nonherniatedcases. An important step to avoid post laparoscopic hernias is suturing the fasciawhenever the trocar diameter exceeds 10 mm. If surgeons tend to have an open trocarsite of 10 mm, particularly in facial defects; the trocar site is protected from incision herniain obese patients with high BMI.

Little is known about changes in total antibodies occurring during the progressionof tuberculosis or its treatment. Using passive and reverse passive hemagglutinationmethods, mycobacterial antibody and antigen were determined in sera of patients withacute smear-positive pulmonary tuberculosis. Fifty-nine patients were studied in different groups according to the duration oftreatment in various stages of disease. The first group that did not undergo treatmentshowed a very low level of antibody. The second group with less than 6 months of therapyhad a mean antibody titer of about 1:70. The third group underwent therapy for more than6 months and their mean antibody titer was about 1:970. The fourth group whose diseasewas under control and their treatments were discontinued, showed the highest level of antibodies(1:2760). A significant difference was found between the average antibodytiters and the duration of treatment and course of disease. No antigen was detectedin any patients except in group 5. A high antibody response seemed to occur after treatment when the bacteriawere disrupted and their antigens released. Absence of antigen may be due to the formationof antigen-antibody complexes.

One of the most dramatic sensory ocular anomalies is the low visual acuityof one eye known as amblyopia. The goal of preschool vision screening is to detect childrenwith amblyopia. Stereopsis is an important indicator of the state of binocularity. Previousstudies showed a disagreement on the reliability of stereo tests as screening tools foramblyopia. This study was performed to compare visual acuity testing with the ability ofTNO, Titmus and Randot stereo tests for detection of amblyopia. 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 visualacuity, 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 6-12years, were referred to pediatric eye clinic for complete physical examination. Sensitivityand specificity of each stereo test for detection of amblyopia was calculated. In screening situation, the sensitivity of stereo tests was 55.5% for TNO with acutoff point of 240", 48.8% for Titmus with a cutoff point of 70" and 44.4% for Randot stereotest with cutoff point of 100". Specificity of these tests in screening situation was86.9%, 94.4%, and 98.4% respectively. The respective sensitivity of these stereo tests inclinical situation was 74%, 68%, and 62%. Considering these fail-pass criteria, none of the TNO, Titmus, and Randot stereotests can be recommended as a screening method for detection of amblyopia in children.

Acute appendicitis is currently one of the most important causes of acuteabdominal peritonitis and emergency laparatomy. Despite its low mortality, it remains acause of concern for surgeons due to the postoperative complications of wound infection,sepsis, intrabdominal abscess and even bowel obstruction resulting from adhesions. Highincidence of acute appendicitis provides a strong impetus for further studies. This studywas conducted to determine the bowel movement patterns and dietary fiber consumptionin pediatric patients with appendicitis in Shiraz, southern Iran. The study included 202 pediatric patients under the age of 18 years at NemazeeHospital affiliated to Shiraz University of Medical Sciences, who had undergone appendectomywith 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 andvegetable consumption, clinical presentation (signs and symptoms) and the time takenfrom the onset of symptoms to arrival in hospital, the date of patients admission to theemergency room to the time of surgery, and the duration of postoperative hospitalization.The pathology of appendicitis was clarified and recorded. The patients aged from 3–18 years (mean: 11.2±3.6 years), with a male to femaleratio 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 theothers had regular fruit intake. Only 3 patients (9.7%) had regular daily consumption ofvegetables, and 27 patients (87.1%) had pathology reports of fecalith, while in the nonconstipatedpatients, only 1.2% had such reports. The abdominal pain was periumbilical inmany patients (42.6%), which shifted to McBurny po

A number of studies have shown that orally administered sweet-tasting solutionsreduce feeling of pain during invasive procedures. The local anesthetic cream EMLAhas recently been shown to be safe for use in neonates. The present study aimed to comparethe pain-reducing effect of EMLA cream with that of orally administered glucose duringvenipuncturing of newborns in Yazd city. A randomized, controlled, double blind clinical trial was performed on 220 newbornsundergoing venipuncture for clinical reasons. EMLA cream was applied to the skin of106 of the newborns, along with orally administered sterile water as placebo. In addition, a30% solution of glucose was administered orally to 114 neonates whose skin was treatedwith vitamin A+D cream as placebo. Symptoms associated with pain while venipuncturingmeasured by Neonatal/ Infant pain scale (NIPS) and crying time was compared betweenthe two groups. There were no differences in background variables between the 2 groups. The resultsshowed 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 2minutes was significantly lower (p<0.01) in the glucose group (median: 2 sec) than inEMLA group (median: 9 sec). The NIP values higher than 3 were observed in 12.3% and29.2% of neonates in glucose and EMLA groups respectively, where the difference wasfound to be statistically significant (p<0.05). Our study showed that compared with EMLA cream, orally administered glucosecan be more effective, tolerable and convenient in reducing pain from venipuncturingin neonates.

Wound-related complications are major sources of trouble in post-operativeperiod and slow down the wound healing process. This study was performed to determinethe incidence of early wound related complications in laparoscopic versus open abdominalsurgeries. Medical records of 104 elective laparoscopic (A) and 106 diagnosis matchedopen surgeries (B) including appendectomy, cholecystectomy, ventral hernia repair, andbariatric surgery were retrospectively reviewed between Jun 2002 and Jan 2005. Studydata included patients’ sex, age, wound class, type of operation, and occurrence of earlywound related complications. Surgical wounds were evaluated for presence of early complicationsduring the post-op period and 10 to 15 days after the operation. The two groups were not different regarding age, sex and wound classes. Woundinfection developed in 7 patients [RR: 0.06 (0.01-0.77) (95%CI)] and none in patients ofgroup B. Incidence of Hematoma was similar in the two groups; one case in each. No patientsin the two groups experienced seruma nor wound dehiscence. Gender, age, andwound classes were not associated with higher rates of wound complications. Laparoscopic surgery significantly reduced the incidence of early wound complications,namely wound infection, and is a safe and efficient alternative to conventionalopen procedures.

xLow 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.

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