Journal of Research in Medical Sciences
Volume:10 Issue: 1, Jan & Feb 2005

This study was conducted to compare the efficacy of enzyme-linked immunosorbent assay (ELISA) for detectinganti-Helicobacter pylori (H. pylori) specific IgG antibodies in specimens of oral fluid and serum with bacteriological tests. Antral biopsy specimens, as well as serum and oral fluid samples were collected from 97 patients who underwentupper gastrointestinal endoscopy. The presence or absence of current H. pylori infection was determined by culture, histologyand urease detection. Anti-H. pylori specific IgG was detected in serum and oral fluid, using an established lab-made, and acommercial ELISA kit. The obtained data were compared with results of bacteriological tests. In all, 62 (64%) of 97 patients were positive for H. pylori by one or more of the gold standard tests (culture, histologyand urease detection). Lab-made enzyme-linked immunoassay of oral fluid had a sensitivity and specificity of 92% and83% respectively. A sensitivity and specificity of 87% and 83%, respectively, was obtained with the commercial kit. Lab-madeenzyme-linked immunoassay of serum samples had a sensitivity and specificity of 90% and 88%, respectively. A sensitivity of86% and specificity of 86% was obtained with the commercial kit. Detection of anti-H. pylori specific IgG in oral fluid by ELISA is comparable in sensitivity and specificity withserum based methods. Oral fluid based ELISA could provide a reliable, non-invasive method for the diagnosis of H. pyloriinfection. Saliva testing may have a role in epidemiological studies

Preeclampsia is the second cause of maternal mortality in the United States and accounts for 25% of perinatalmortality. Mild Preeclampsia could be treated without hospitalization, however in some cases, hospitalization seems necessary.Administration of magnesium sulfate (MgSo4) in mild preeclampsia is a matter of controversy.It is obvious that replacing intravenous magnesium sulfate with an oral preparation of magnesium, of course if it gains asufficiently high serum level, can be easier to use and less expensive. Up to the present time, we have not been able to find anypreviously done studies using oral magnesium preprations to treat preeclampsia. Thus, we tried to compare serum magnesiumlevel with oral magnesium chloride and intravenous (IV) magnesium sulfate therapy. This was a comparative experimental study. From January 2002 until April 2003, pregnant patients with mild preeclampsiaadmitted to Al-Zahra and Beheshti hospitals,Isfahan,Iran, between their 27th and 38th weeks of gestation were dividedinto 2 groups randomly. There were 33 patients in each group. The first group was treated with IV magnesium sulfate (2g/h) and the second group received oral magnesium chloride (4 g/2h). Magnesium level was checked in 0, 3, 6, 12 hours. Thecollected data were analyzed with t-Student test on a computer applying SPSS software. There was no statistical difference between the two groups regarding age, gravidity and gestational age. Magnesiumlevel rose in both groups (P

Lateral osteotomy is a major part of rhinoplasty for remodeling external facet of the nose and narrowing ofnasal base and dorsum after removal of the hump. There are two techniques for lateral osteotomy known as external and internal. Each of these provide advantages and impose limitations. The purpose of our study was to compare the severity of postoperative edema and ecchymosis between internal and external osteotomy techniques. This study was designed as a clinical trial on 30 cases. With randomization, one side of the nasal bone was selected for internal approach, and the other side, for external approach. Then, on the 1st and 7th days after surgery, the patients were scored for the severity of edema and ecchymosis. On the first day after surgery, not only edema, but also ecchymosis was lower with the external osteotomy than with the internal approach (P = 0.037, P = 0.002, respectively). The severity of ecchymosis, on the 7th postoperative day, was lower with the external approach, and the difference was significant (P = 0.011). The severity of both edema and ecchymosis on the first postoperative day was evaluated higher in females, with statistically significant differences (P = 0.05 for edema and P = 0.003 for ecchymosis). The extension of ecchymosis on the 7th postoperative day was higher in women (P = 0.05). There were no significant differences between the two approaches in medialization of the involved bones and no apparent asymmetries either. According to the results of this study, external osteotomy seems to be the approach of choice, provided that the surgeon has enough experience in doing it.

Atherosclerosis of coronary arteries and myocardial infarction are the most common fatal cardiac diseases discovered in autopsies. The fact that formation of these lesions are preventable through exact health care programs necessitates collecting baseline information on the prevalence of such lesions as performed in this study. In this descriptive, cross-sectional study, from October 2002 to November 2003, during a randomly chosen month of every season, the hearts of autopsy specimens aging 15-50 years referred to Isfahan forensic center (204 specimens) were dissected and fixed in formalin 10% and coronary arteries were sectioned. In case of a definite or suspicious lesion, microscopic slides were also prepared. Otherwise, 3 random slides from each branch of coronary arteries were studied by a pathologist. Then the percentage of vessel obstruction was detected and stages of lesions were classified as fibrotic and complicated. Frequency of atherosclerotic lesions in 204 studied specimens (182 male and 22 female) was 29.4%. Atheromatous plaques were observed in 31.3% of the male and 13.6% of the female specimens. The most frequent involved branches were left anterior descending, right coronary, left main and left circumflex arteries respectively. Relative frequency of lesion increased with age. The frequency of atherosclerotic lesions in this study is comparable to other studies. The difference in relativefrequency of atheromatous plaques in both sexes is expectable, probably due to low number of studied women or the low prevalence of atherosclerotic lesions among young women.

Angiotensin converting enzyme inhibitors (ACEIs) are known to induce anemia following renal transplantation, dialysis and in renal failure patients. It seems that ACEIs cause anemia via inhibition of erythropoietin synthesis or inhibiting normal proliferation of early erythroid progenitors, which are normally stimulated by angiotensin converting enzyme. There are few reports on how ACEIs induce anemia in non-azotemic diabetic patients. We studied the effect of enalapril on inducing anemia in non-azotemic diabetic patients. This study included 94 diabetic non-azotemic patients (serum creatinine (sCr)? 1.5 mg/dl by jaffe reaction). Patients were divided into two groups, the first; with clinical proteinuria (P+) having a 24 hour urine protein? 300 mg or positive urine dipstick for protein, at least on two of three times tested, with an interval of 1 month and the second group without any signs of clinical proteinuria (P-). Only 32 patients completed the course of study; 17 as P+ and 15 as P-. Patients in both groups received 10 mg enalapril daily; and every 3 months, the dose was doubled until the dose of 40 mg/day was reached, unless any side effects emerged. Hemoglobin concentration (Hb), sCr and serum potassium (K+) were also checked regularly. Data were analyzed using t-Student test, paired t test, and chi-square test. A p value < 0.05 was considered as significant. Both groups of patients were matched from the standpoint of age and sex. The average baseline sCr in P+and P- groups were 0.8 ± 0.19 mg/dl and 0.8 ± 0.18 mg/dl respectively.(p = 0.97) After the study was completed, the average baseline sCr rose to 0.99±0.19 and 0.92±0.22 mg/dl in P+ and P- groups respectively. In P+ group, mean Hb was 14.1 ±1.30 g/dl and 13.9 ± 0.99g/dl before and after the study respectively.(p = 0.28) The same parameter for the P- group was measured as 14.1±1.00 and 12.9±3.30 before and after the study respectively.( This study shows that enalapril has no significant effect on inducing anemia in non-azotemic diabetic patients.

The antihypertensive drug, clonidine, is a centrally acting alpha 2 agonist, useful as a premedication because of its sedative and analgesic properties. We examined the effect of clonidine given as an oral premedication in producing a bloodless surgical field in patients undergoing endoscopic sinus surgery. We also evaluated the relation between bleeding volume and consumption of fentanyl and hydralazine to control hypotension. This prospective double - blinded clinical trial was performed on 113 patients (ASA I, ASA II). Fifty-two patientsreceived oral clonidine (5 µg/kg) while the other 61 patients received placebo. During general anesthesia, the hemodynamic endpoint of the anesthetic management was maintenance of hypotension (MAP) at 70 mmHg for producing a bloodless surgical field. The direct control of MAP was attained with inspired concentration increments of halothane up to maximum of 1.5 vol % as needed. When it was unsuccessful, an intravenous fentanyl bolus of 2 µg/kg was also added. When both drugs failed, hydralazine, was given intravenously as a bolus and intermittently, 0.1mg/kg up to a maximum dose of 40 mg. Intraoperative bleeding was assessed on a six – point scale from 0 (= no bleeding) to 5 (= severe bleeding). Data were compared with chisquaretest, fisher''s exact test and Student t-test. There was less bleeding volume in the clonidine group (mean ± SD) than in the placebo group (144 ± 75 Vs 225 ± 72 ml, P

corneal thickness is an important factor in refractive surgeries such as Radial Keratotomy (RK), Photo Refractive Keratotomy (PRK) and Laser Insitu Keratomileusis (LASIK). This study evaluated the correlation between this factor and the degree of myopic refractory error. In this cross-sectional study, 224 myopic eyes (112 patients) which had undergone LASIK operation were assessed. These patients had referred to Aban Eye Clinic, Isfahan, Iran, during August and September 2002. Corneal thickness was measured by ORB SCAN Topoghraphy, and cycloplegic refraction was performed with autorefratometery and retinoscopy. Suspected keratoconus cases and hyperopic patients were excluded. The patients'' age was 27.2 ± 1.36 in men (N = 35) and 30.13 ± 1.04 in women (N = 77). Mean value of myopic refractory error in male patients was 5.1 ± 0.24D and in female patients was 3.8 ± 0.36D. Mean of corneal thickness was 540 ± 5.25 µM and 530 ± 5.88 µM in male and female patients respectively. There was no correlation between the degree of myopia and corneal thickness in any of the patients. Also in this research, no relations between the age and myopia were found. Right eye (P > 0.5, r = 0.124) Left eye (P > 0.5, r = 0.104). Based on our findings, corneal thickness and myopic refectory error do not seem to have any relations. (r = 0.039, p = 0.684).

Meningococcal diseases occur with a worldwide distribution as endemic or in epidemics with an overall mortality rate of 8% to 10%, mainly in patients with signs and symptoms of meningococcemia. Several investigators have devised scoring systems using clinical and laboratory parameters available at the time of presentation to prognosticate the outcome of the infection. This study was designed to determine the distribution of demographic, clinical and laboratory parameters among our patients and the relative frequency of individual Stiehm and Damrosch components. This was a prospective descriptive study, performed on patients with definite diagnosis of meningococcal infection admitted to Al-Zahra University hospital (adult and pediatric wards), Isfahan, Iran, between 1997 and 2002. The cases were 140 patients [99(70.7%) males and 41(29.3%)females] from 1 to 50 years old (25.5±1.32). Data were collected by filling checklists. SSPS software was applied to analyze the data using chi-square test. In this study, the relative frequency of individual Stiehm and Damrosch components were as follows: hypotension (10.7%), peripheral white blood cell count

Kaposi''s sarcoma rarely involves penis and is usually accompanied by other cutaneous, mucous or visceral lesions. We report a case of Kaposi''s sarcoma of penis.Although Kaposi''s sarcoma is known to be associated with an altered immune status, acquired immunodeficiency syndrome(AIDS) and other causes of immunodeficiency were not found in this case.

Although osteoid osteoma is a relatively common lesion, it rarely occurs at elbow. We report two cases of osteoid osteoma of elbow in trochlea. Diagnosis was delayed because of non-specific clinical and radiological features. The two patients suffered from flexion contracture of elbow due to synovitis, while at the same time, pronation and supination remained normal. Only one of the patients complained of specific nocturnal pain. Both patients had latencies between the onset of symptoms and the appearance of radiological signs. Open surgical excision of the nidus resulted in complete relief and motion recovery in both cases. Diagnostic difficulties and treatment options are discussed below.