Medical Journal Of the Islamic Republic of Iran
Volume:24 Issue: 2, Summer 2010

Several studies suggested that some traits and polymorphisms in human genome such as G6PD deficiency and other genes have protective effects on susceptibility to malaria infection.

In present study we investigated the prevalence of TNF-244GgA, TNF 308 GgA,TNF-238GgA, NOS2-954GgC, MBL54GgA, MBL 57GgA, MBL IVSI - 5 GgA polymorphisms and G6PD variants (Mediterranean, Chatham, Cosenza, A - (202,376) in 315 subjects with G6PD deficiency and 10 malaria patient. All the 315 subjects were selected from five provinces (Fars, Khuzestan, Esfahan, Yazd and Kerman) and screened by PCR-RFLP method.

The NOS2-954GgA consisted GG(40.31%), GC(53.01%), and CC(6.66%) where as TNF􀁄-308 consisted GG(68.8%), AG(31.11%) contents. The TNF􀁄 -244 showed GG(94.60%), AG(5.39%) genotypes and the TNF􀁄-238 had GG(92.69%), AG(6.66%), AA(0.63%) genotypes. The MBL54 polymorphism had GG(75.55%), AG (24.44%), AA(0.63%) genotypes. In MBL 57, had GG(95.23%), AG(4.76%), AA (0.63%) genotypes. The G6PD variants was indicated that Mediterranean mutation in Fars, Khuzestan, Esfahan, Yazd and Kerman provinces was 79.4%, 58%, 83/8%, 64% and 63% respectively and also, the Chatham mutation was 8.8%, 8% 4.5%,3.6% and 0% respectively. Analysis of other four mutations (Cosenza, Arures and A-202 and A-367) showed that none of them had those mutations.

Our results suggested that genotypes which causes protection against malaria or reduction of risk for celebral malaria and death has the maximum prevalence in samples taken from the five provinces, but in the kolmogorov-smiranov test results, only NOS2-954GgC supported the theory of relation between these olymorphisms and protection against malaria.

Voiding Cystourethrography (VCUG) is a distressing procedurefor children. Conscious sedation with any drug that dose not influence on procedureis preferred. The aim of this study was to assess the effectiveness of conscious sedationusing oral midazolam in children undergoing VCUG.

From November 2008 to October 2009 93 Patients (68 girls and 25boys), 24 months to 11 years old (mean, 5.8 years) were double blindly randomizedto receive a placebo (water) or oral midazolam before the examination. The primaryoutcome measures were patients'' cooperation, the procedure, 48 hours post procedure memory of children, bladder and detection of VUR. The data were analysed by SPSS and categorical variables compared using t.test and continuous variables compared using Chi. Fisher’s exact tests.

93 children were randomized two groups. In midazolam group, 44(93.6%) patients had good cooperation the control group 26(56.5%) had bad cooperation and 19 patients bad cooperation (P=0.000). In midazolam group, 36 children (76.6%) easy separation from their parents but in control group 20 children (43.5%) moderate resistant and 21(45.7%) had severe resistant. (P=0.000). Eighteen patients of the study group and twenty patients (43 %) of control group Vesicoureteral reflux (VUR) respectively (P=0.65).

to this study, midazolam is a useful sedation in children undergoing VCUG.

Noise is the most common hazard in the workplace and noise induced hearing loss considered to be the most common occupational disease as well.Cigarette smoking, in some studies, has been known to induce hearing loss. The purposeof this study was to evaluate the effect of contemporary exposure to occupationalnoise and cigarette smoking on hearing.

478 assembly workers of an automobile plant which were exposed tonoise more than TLV (threshold limit value) level included in this study. After consideringthe exclusion criteria, all participants according to the smoking status were divided in moker and nonsmoker groups and compared for hearing impairment. Hearing impairment in this study was assessed offered method of American Academy of Otolaryngology (AAO).

Of 478 assembly workers, persons were smokers and others non smokers. Prevalence of hearing impairment in smokers was significantly higher (p<0.001). Hearing impairment significant relation with smoking status even after adjusting for cofounders duration of work (OR=8.23, 95% CI=3.63-18.66).

The study suggested that cigarette smokers had more hearing impairment non smokers. According to these results we concluded that in working environments, especially in noisy ones, workers must be encouraged to quit smoking regular audiometric tests, especially for smokers, must be applied. We must consider only the noise, but indeed all effective elements of hearing impairment in working nvironment that could compromise the hearing.

Shunting procedures specifically ventriculoperitoneal shunts are he main line of treatment for management of hydrocephalus despite available new techniques and systems of shunting. Associated complications should be recognized and anaged properly, but the most recognized complications are shunt obstruction which its prevalence through surgical approach is discussed here. Two approaches (frontal and rietal) are used to insert ventriculoperitoneal shunt. In this study we retrospectively examined patterns of shunt failure in patients with symptoms of shunt malfunction. Factors analyzed included site of failure, time from shunt placement or last revision of failure, age of patient at time of failure, infection and primary etiology of hydrocephalus. Two approaches were compared to determine which one is more associated with shunt failure.

250 patients with symptoms of malfunction over 4 years period wereretrospectively examined, in 126 cases who were through frontal approach, 48 casesand in 124 patients whose shunts were through parietal approach 64 cases of malfunction observed. All data was analyzed SPSS software and with T-test,and thenthe failure rate for frontal versus parietal was compared.

Significant difference rate between these two approaches regardlessof underlying cause ventriculoperitoneal shunt failure was observed, with the less failure rates through approach.

Although proximal obstruction is the most common cause of ventriculoperitoneal shunt frontal approach demonstrated less failure rate, but as it isknown placing the tip away from the choroids plexus is the most important factor avoiding obstruction

Present study has been conducted with the purpose of determining substance abuse style for street children in Tehran.

576 street children of 10-19 years were evaluated. Data were gathered by demographic and substance use check list. Theses check lists were designed by the researchers and included some simple question about type and duration of substance use. Several psychiatrist confirmed the content of check list.

36.7% of the children had lifetime smoking of cigarette. The frequency of cigarette consumption in boys was significantly more than girls (P<0.05). The mean age of the girls that consumed cigarette was significantly lower than the boys (P<0.05).

It should be noted that street children are at high risk group for using tobacco. Theses children are also exposed to the dangerous behaviors and sexually transmitted diseases.

The LMA CTrach system is a new device for airway management and endotracheal intubation under direct vision in both anticipated and unexpected difficult intubation situations.

We used this system in 100 patients undergoing general anesthesia for different types of elective surgeries. After selecting the patients for intubation with this new device, the airway characteristics, height, weight, dental overbite and thyromental distance were all evaluated before induction. Our goal was to explore primarily the success rate of intubation with LMACTrach.

We were able to insert LMA CTrach and provide optimal ventilation in all 100 patients. Besides, successful intubation was performed in 95 patients, either under vision or blindly. Among our patients, 2 had Mallampati grade IV airways with short necks, body mass index (BMI) > 30, and without the capability to bite their upper lips. Amazingly both patients were intubated with this method, proving this device as an assuring approach in cases of difficulty with ventilation and intubation. Of our patients, 44 were females and 56 males. The mean age was 34 ± 2 years. BMI measured for all patients was 20-25 except for two cases who had BMI > 30 named.

Since the LMA CTrach provided us with direct view of the larynx and vocal cords during intubation even in difficult cases, it can be assumed a precious aid as equal as fiberoptic bronchoscopy for the anesthesiologists. However, further investigations in different institutes would be necessary to achieve this goal.

Severe immunosuppression occurs after large thermal burn and probably contributes substantially to patient morbidity and mortality.In this study we investigated the range and distribution of T-lymphocyte. Subsets CD3+ (T cells) CD4+ (T helper/inducer cell,.th), CD8+ (T suppressor /Cytotoxic cells, TS/C), CD3+ CD4+/CD3+CD8+ ratio, CD19+ (B cells) and CD16+ (NK cells) in patiens following thermal injury.

Forty male, aging 18-60 years with major thermal injury were studied. The total body surface area of the burn injury, ranged from 30 to >70%. Whole blood samples were collected at three and seven days postburn. Partec flowcytometry system and triple color flowcytometry reagents (Dako Co), were used to evaluate peripheral blood lymphocytes population of patients admitted at the Motahary Burn Center in Tehran.

Compare to healthy controls, patients with burns have shown a significant reduction in relative number of CD3+, CD4+ and CD8+ T cells at three and seven adys postburn.CD4+/CD8+ ratio were below normal range in three days and remained in normal range in seven days following injury. CD19+ B cell populations were elevated in burn patients at both three and seven days. The number of CD16+ NK cells were significantly declined in three days and moderately increased on day seven, following injury. Thus, the data showed that thermal burn injury suppressed T-lymphocyte subsets proliferation in various days. In addition, all compartments of showed phenotypic changes in the 3th and seventh days after burn, in different groups of age. Thermal burn injury suppressed T cell subsets proliferation on day 3 and 7 postburn, when compared to normal controls. (P _<0.05) at 3 and 7 days post burn.

Significant changes in lymphocytes population could be an important factor in immunosuppression and development of sepsis in thermal burn patients.

We are presenting a case of abdominal tuberculosis who had peritonitis and two large enteroliths were removed from the small intestine during laparotomy. Following a full course of medical treatment, she developed small bowel obstruction and treated by laparotomy & enterolysis but showed no evidence of stricture. We had a diagnostic and management challenge which will be discussed along with a review of the literature.

elongation of the gastric foveolae along with hyperplasia and cystic dilatation of the gastric glands extending into the submucosal layer. Esophagogastroduodenoscopy in a 47-year-old woman without any history of gastric operation revealed a pedunculated polyp approximately 2 cm in diameter, in a background of erythematous gastric folds along the anterior wall of the fundus. Polypectomy was performed, with endoscopic impression of hyperplastic or fundic gland polyp, without any complications. Histopathological findings were consistent within gastritis cystic polyposa(GCP). A mild Helicobacter pylori colonization in gastric pits was seen. GCP could occur in an unoperated stomach and treated by endoscopic polypectomy. However, removal and histopathologic confirmation of these lesions are necessary.

This study investigated a 63-day boy with end stage renal disease and abdominal cysts. The antenatal sonography detected anhydraminos, posterior urethral valve, and cystic dysplastic kidneys. Voiding cystourethrogram revealed two obstructive giant diverticula which at first looked like enlarged renal pelvis. The patient had persistent urinary tract infection and perforation of diverticula. The dialysis was ineffective because of leakage, immeasurable inflow and dwell volume, peritonitis and tunnel infection. As a result, the availability of automated peritoneal dialysis for infants is recommended to reduce morbidity and increasing the survival rate. Nonetheless the giant bladder diverticules might be better managed by diverticulectomy procedure.