Showing papers by "Shahid Beheshti University of Medical Sciences and Health Services published in 1988"

Medical treatment of toxic goiter in an area of iodine deficiency

Abstract: The response to methimazole [1-methyl-2-mercapto-imidazole (MMI)] therapy, 10 mg twice daily in 15 patients and propylthiouracil (PTU) therapy, 100mg twice daily in 10 patients with diffuse toxic goiter was evaluated in an area of iodine deficiency (Tehran). The mean free T4 index (FT4I) decreased from 22.7± 6.8 (± SD) to 10.8± 2.8 In MMI-treated, and from 25.1± 6.8 to 13.2± 2.1 inPTU-treated patients, two weeks after treatment. The FT4I further decreased to 6.8± 4.3 and 8.5± 2.1 after four weeks ofMMI andPTU administration, respectively. The mean free T3 index (FT3I) was 415± 90, 162± 44 and 117± 46 in MMI treated and 430± 80, 210± 45 and 140± 53 in PTU treated patients before and two and four weeks after treatment, respectively. The mean FT4I and FT 31 had decreased more in the MMI treated groups as compared to the PTU treated patients, two weeks after treatment. In patients treated with MMI or PTU, 11 of 25 (44 %) had subnormal FT 41 after four weeks of treatment, of whom one had increased serum TSH. These results indicate that treatment with less than the recommended doses of thionamide compounds causes a rapid decline of thyroid hormone indices in patients residing iI). Tehran. The dosage of thionamide compou�ds as well as the duration of therapy with the initial doses necessary to induce euthyroidism, should be evaluated in various parts of the world. MJ/RI, Vol.2, No.2, 119-122, 1988

The role of fiberoptic bronchoscopy in the diagnosis of pulmonary tuberculosis

Abstract: From January 1982 to April 1987 , 1500 cases of fiberoptic bronchoscopy (FOB) were performed. Among these cases, 37 were suspected of having pulmonary tuberculosis but their sputum examination was either negative or they were not able to expectorate. In all these cases pulmonary TB was confirmed either by bronchoalveolar lavage (BAL) fluid examination or by biopsy. We conclude that FOB is a valuable means for detection of c1inically suspected but sputum negative pulmonary TB. MJIRI, Vol.2, No.1, 25-27, 1988 INTRODUCTION Tuberculosis remains a major cause of mortality and morbidity in developing countries. Tuberculosis con­ trol programmes which have been suggested by the W. H.O. and other relevent organizations have·led to a reduction in the incidence and annual risk of infection in areas in which they have been implemented correctly. I The corner stones of these programmes include: a) Vaccination and prevention b) Case finding and case holdi ng c) Treatment of the sources of infection In order to break the chain of transmission of disease, case finding is of special importance and usually is accomplished actively or passively.' In pas­ sive case finding, symptomatic individuals are sub­ jected to a more detailed work-up including a complete physical examination, Mantoux test, chest roentgeno­ gram and sputum smear' and culture. Although these procedures seem to be quite simple. in some cases, it is almost impossihle to obtain an adequate specimen for smear or culture, and in others. despite radiological and or clinical evidence of TB sputum examination is reported negative or the radiologic appearance sug­ gests non-tuherculous pneumonia hut response to ther­ apy is nilorpoor. On the other hand, itis not justified to treat all suspicious cases without bacteriological proof, 25 as aside from excessive cost. drug reactions may also appear. and fOI these reasons. FOB can be utilized. In the following study. we reviewed our FOB cases retros­ pectively. the result of which is reported. MATERIAL AND METHOD Records of 1500 cases of F.O.B. performed from April. 1978 to January, 1982 were studied retrospec­ tively. Of these cases, 37 underwent FOB because of a provisional diagnosis of pulmonary TB. 23 of these patients were male and 14 were female. Patients were he tween 22 and 87 years of age (mean age 25.7). 13 of these patients were smokers. Clinical symp­ toms of the patients are summarized in Table I. Radiological studies Radiological manifestations of the patients are summarized in Table II and consists of infiltrative Table I. Frequency of symptoms of the patients. Cough Sputum Hemoptysis Dyspnea Fever No. Of Patients 29 16 12 6 6 Percentage 78% 44% 33% 16% 16% Fiberoptic Bronchoscopy in Pulmonary TB Table II. Radiological manifestations of the patients. Infiltration Consolidation Reticulonodular Cavitation

Local production of primary powder of bacillus thuringiensis serotype h-14 in iran and determination of its insecticidal properties against culex pipiens and anopheles stephensi

Abstract: Three media formulated from molasses and cornsteep liquor and another media based on the basal medium formulation of IPS-82 were assessed for the growth and production of insecticidal properties of B. thur­ ingiensis H-14 .• Bacterial powders prepared from the broth cultures were assayed against the larvae of Culex pipiens and Anopheles stephensi. A standard powder of IPS-82 was included in the assay for comparison. Good . growth was obtained in all the media and all powders were effective against the two types of mosquito larvae. Media with the basal medium formulation of Institute Pasteur Paris were the most effective. Molasses III media was also very favorable. The concentrations required to kill 50% of the larvae of Culex pipiens and Anopheles stephensi for these two were as follows: Media with the basal medium formulation of Institute Pasteur Paris: 24hr. Lc50 and it's 95% confidence limits of Culex pipiens and Anopheles stephensi = 0.0025,0.0031,0.0018 mg/lit 0.1792,0.2603,0.1508 mg/lit Molasses III Media: 24hr. Lc50 and it's 95% confidence limits of Culex pipiens and Anopheles stephensi = 0.0103,0.0115,0.0092 mg/lit 0.1994,0.2223,0.1769 mg/lit The investigation shows that these media can be used for the production of B.thuringiensis H-14 primary powder. MJIRI, Vol. 2, No.3, 229-236, 1988 VOlume 2 Number 3 Payiz 1367 Safar 1408 Fall 1988

Intrathoracic kidney: a ct-scanning view

Abstract: We report a patient who was admitted to the department of medicine with palpitation, dyspnea and left flank pain, Chest X-ray revealed a mass in the left lung. The lesion was evaluated as a pulmonary tumor, with a high suspicion of malignancy. Intravenous urography, sonography, and CT­ scanning revealed a thoracic kidney at the location previously thought to be a lung mass. This is the first report of a CT-scanning evaluation of thoracic kidney. MJ/Rl, Vol.2, No.2, 161-163, 1988

Important diag nostic and surgical points in horseshoe kidney surgery

Abstract: Prom April, 19�3 until December, 1987, 15 patients with horseshoe kidneys underwent surgery in Shahid Labbafi Nejad Medical Center. Pyelolithotomy was done in 11 cases, pyeloplasty in 2 cases, and nephrec­ tomy in 2 cases. Symphysiotomy was performed in 14 of these patients. Preoperative angiography was not done in any of the cases and midline transperitoneal approach was utilized in all of the cases. We consider angiography an unnecessary invasive procedure in the great majority of the horseshoe kidney operations. Midline transperitoneal approach is far superior to flank approach in horseshoe kidney surgery. We also prefer symphysiotomy in these cases, since it improves drainage from horseshoe kidney pelvices. MJIRI, Vol.2, No.3, 175-178, 1988 VOlume 2 Number 3 Payiz 1367 Safar 1408 Fall 1988 INTRODUCTION Table I: Age distribution in 15 patients with horseshoe kidney. The horseshoe kidney is probably the most common of all renal fusion anomalies. 1 When symptoms due to horseshoe kidney are pre­ sent, they are usually related to hydronephrosis, infec­ tion or calculus formation. According to Latham and Smith surgical interven­ tion is required in 28% of patients with horseshoe kindeys.2 Culp and Winterringer and Dajani used an ex­ traperitoneal flank incision3,4 but we prefer anterior midline transperitoneal incision because access to isthmus and vascular hemostasis and bilateral opera­ tion simultaneously are easier We also consider preop­ erative angiography an unnecessary invasive test. Our approaches.and results will be discussed. METHODS AND MATERIAL: From April, 1983 until December, 1987, 15 patients with horseshoe kidney underwent surgery at Shahid Labbafi Nejad Medical Center. 10 were male and 5 were female. Age distribution is shown in Table 1.

Survival in patients with malignant gliomas of the brain

Abstract: The present retrospective study was designed to analyze factors with prognostic values a) within, and b) significantly associated with, short-term (12months or less) and long-term (more than 24 months) survival times, i n 72 consecutive patients treated for malignant gliomas. Among 41 (57%) short-term surviving patients, the absence of both aphasia and motor deficit (as initial presenting symptoms), postoperative radiation therapy alone or in combination with chemotherapy, and reoperation were associated with a relatively better survival prognosis. Among 15 (20.8%) long-term surviving patients, postoperative radiation therapy and anaplastic, as histological type of astrocytoma, were marginally associated with improved survival time. The addition of conventional chemotherapy to postoperative radiation therapy failed to show a significant improvement in survival time in both survival groups. The long-term survival was significantly associated with the following factors: age (under 51 years), reoperation and the absence of lymphocyte infiltration. A satisfactory quality and duration of survival was achieved in a minority of patients with malignant gliomas. Furthermore, a more appropri­ ate postoperative antitumor therapy may increase the number of these patients, by avoiding fatal injuries to the normal brain tissues induced by postoperative antitumor therapies. MJIR1, Vol.2, No.3, 201-206,1988 Volume 2

Seizure due to diphenylhydantoin -methylphenioate interaction

Abstract: Signs and symptoms of D PH toxicity were seen in an epileptic child who had received DPH and MP concurrently. In the absence of liver and kidney disease and any intercurrent infection, and with the patient's recovery following the withdrawal ofDPH, it appears that drug-drug interaction is the most logical explanation for D PH intoxication. MlIRI, Vol.2, No.2, 159-160, 1988