Showing papers by "Shahid Beheshti University of Medical Sciences and Health Services published in 1995"

Reproductive function in men following exposure to chemical warfare with sulphur mustard

Abstract: To investigate the acute and chronic effects in young men of exposure to chemical warfare containing mustards, the time course of changes in serum concentrations of total and free testosterone, dehydroepiandrosterone (DS), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and prolactin was evaluated in 16 men in the first three months and testicular function in 42 men one to three years after injury. Serum total and free testosterone and DS were markedly decreased in the first five weeks after exposure. The lowest values were: total testosterone 237 +/- 165, free testosterone 22.5 +/- 9.7, DS 39 +/- 25; as compared to controls: total testosterone 773 +/- 245 ng/dl, free testosterone 35.5 +/- 11.2 pg/ml and DS 207 +/- 37 micrograms/dl. FSH, LH, prolactin and 17 alpha-OH progesterone were normal in the first week. The response to GnRH was subnormal in four of five subjects. LH increased by the third and FSH and prolactin by the fifth week. All hormone levels had returned to normal by twelfth week after exposure. In 28 of 42 men seen one to three years following injury, sperm count was below 30 million cells/ml, and FSH was increased as compared to men with sperm above 60 million cells/ml. Testicular biopsy showed complete or relative arrest of spermatogenesis. This study demonstrates that the exposure to sulphur mustard results in very low androgen levels and hypo-responsiveness to GnRH in the first five weeks and normalization by the twelfth week after injury. However, side effects of mustard on sperm cells persist and may cause defective spermatogenesis years after exposure.

Traumatic visceral artery aneurysm: presentation as massive hemorrhage from perforation into an adjacent hollow viscus.

Abstract: Background While diagnosis of extremity pseudoaneurysm is usually straightforward, pseudoaneurysms arising from visceral arteries may be occult. Perforation of a visceral artery pseudoaneurysm into an adjacent hollow viscus with subsequent hemorrhage has been rarely reported. Objective and design To retrospectively evaluate the cause, clinical presentation, and outcome of patients with bleeding traumatic visceral artery aneurysms. Materials and methods Records of nine patients with visceral hemorrhage due to posttraumatic arterial aneurysms. Results All had penetrating torso trauma 2 to 52 (mean, 12.3) weeks before presentation to our facility and had undergone 1 to 5 (mean, 2.2) prior operations. They had 2 to 15 episodes of hemorrhage into the gastrointestinal (seven cases), respiratory (one case), and urinary (one case) tracts. All underwent emergent surgery with ligation of the involved artery and resection of the corresponding portion of viscus. Evidence of prior attempts at hemostasis with multiple heavy ligatures was evident in all cases. All patients recovered without further complications. Conclusions Traumatic visceral artery aneurysms are usually due to penetrating trauma. They present as episodes of massive bleeding through one of the hollow viscera, and may stop bleeding without direct intervention only to occur again. Prompt operative therapy is usually necessary.

Organophosphate-induced chronic toxicity in occupationally exposed workers

Abstract: Org.lnophosphate chronic toxicity has been evaluated in this study. Biological screening for organophosphate insecticide-exposed workers is mostly recommended for mixers, loaders, fOI'lllulators and spraymen. We have studied 17 occupationally exposed persons to pesticides. Using Ellman's colorimetric method, their plasma cholinesterase activities have been measured. Results show that the appearance of some of the symptoms of chronic organophosphate toxicity depends on the extent of plasma cholinesterase activity reduction. Our results also indicate that headache, weakness, nervousness, memory difficulty, tremors, insomnia and dizziness are· the main problems demonstrated in these workers. MJIRI, Vol. 9. No.3, 221-225.1995.

Posterior segment triple surgery after traumatic eye injuries.

Abstract: Cataract extraction, posterior chamber intraocular lens (PC-IOL) implantation, and complete vitrectomy combined in a one-stage procedure were performed in 16 eyes (16 patients) with traumatic eye injuries undergoing anterior lensectomy (seven eyes), extracapsular cataract extraction (six eyes), or pars plana lensectomy (three eyes). Membrane peeling and intraocular foreign-body removal (13 eyes, 6 with intraretinal foreign bodies) were performed as needed. Surgery was performed from 1 week to 10 years after injury. After an average follow up of 8 months, 13 eyes (81%) had a visual acuity of at least 20/200; 50%, at least 20/40.

Insulinoma new concepts in management

Abstract: In this report, nine patients with insulinoma who were operated on be­ tween 19H5 and I

Rapid nutritional assessment of underfive year old kurdish refugee children in iran

Abstract: In an attempt to depict the nutritional status of Kurdish refugee children under five years of age. a rapid survey was conducted on 900 children in 9 camps of Kurdistan and Bakhtaran province in May 1991. The study in­ cluded anthropometric measurements on all. clinical examination of 731, and biochemical tests for anemia and protein energy malnutrition (PEM) on 160 subjects. The results showed half of the children to be anemic. Twenty per­ cent of the children had moderate to severe PEM by the most conservative criteria. This figure was around 40% in the 2 to 3 year old children. It was concludtd that 50% of the children required urgent nutritional intervention and the other half were potentially in danger. Although malnutrition was serious enough in the subjects, the sanitary condition of the camps was even worse. Any measure to rectify the situation in similar cases should include both public health and nutritional solutions. MIIRI, Vol. 9, No.2, 117-121, 1995. INTRODUCTION MATERIALS AND METHODS Volumc9 Number 2 Summer 1314 August 1995 Following lIle retreat of Iraqi forces from Kuwait and during the Kurdish uprising and clashes willl Ihe Iraqi government, hundreds of 1Il0usands of the Kurds began a mass exodus and sought refuge in Ihe weslern provinces of lIle Islamic Republic of Iran. During the months of March and April 1991 lIle number of refugees surpassed one million. In two out of five provinces hOSling Ihe refugees, namely Kurdistan and Bakhtaran, nine camps in five dis­ IriCIS were chosen for survey by qUOIn sampling. Alto­ gelher 900 under-five children were surveyed. The silUa­ tion pennitted us to clinically examine 73 I of the chil­ dren, 111m is, 84% of the IOUll subjects. In Mny, UNICEF represenlatives in Tehran, app:lt­ ently in urgenl need of objective information on lIle real nutrilional slatus of the refugee children, among spread of conflicting accounts by various visilOrs to the camps, ap­ proached lIle author of this reporl lO conduct a rapid nutri­ tiomd assessment of children under five years of age, lIle resull.5 of which are presenled here. 117 Weight was measured by Seca lever scales up 10 lOOg accuracy. Children under one year of age were weighed by a Saller scale (MS Weighing Equipment LId, London). A baby board was used to measure ienglll in children under 2 year.; of age (0.5 cm accuracy). Height in 2 to 5 year old children was measured using a Nivoloise l1lpe measure with 0.5 cm accuracy. Mid-upper arm circumfer­ ence was mec'lSured with an inelastic tape measure. D ow nl oa de d fr om m jir i.i um s. ac .ir a t 1 6: 18 IR S T o n W ed ne sd ay D ec em be r 11 th 2 01 9 Nutritional Assessment of Kurdish Refugee Children Table I. Prevalence uf low anthropumetry (-2 S.D) by age in buth sexes Age Stature/Age Weight/Stature Weight/Age (mo.) # N % # N % # N % (J-n 5 71 7.04 15 76 10.74 III 73 13.71J 6-12 II 94 11.70 19 94 20.21 32 94 34.04 12-24 42 190 22.11 50 181 27.62 78 189 41.27 24-36 40 132 30.30 22 132 16.67 47 134 35.07 36-48 55 126 43.65 8 122 6.56 36 124 29.03 48-60 47 120 39.17 II 116 9.48 34 116 29.31 60-72 34 96 35.42 5 94 5.32 25 97 25.77 0-72 234 829 28.23 130 815 15.95 262 827 31.68 N= Total number #= Number below -2 S.D. 'Yo= Percentage Table II. Prevalence of luw anthropometry (-2 Sol)) by ag-e in girls. Age Stature/Age (mo.) # N 0-6 2 33 6-12 4 41 12-24 19 96 24-36 24 68 36-48 24 56 48-60 22 59 60-72 16 49