Audiometric screening of first grade primary school students in Tehran, 2007-8

The incidence of hearing loss in pediatric population is estimated to be 2-5%. Most of the causes for conductive hearing loss can be easily diagnosed and treated. Hence, majority of hearing loss cases can be prevented by taking appropriate measures. This study was performed to examine the incidence and common causes of hearing loss among school children in Tehran. This cross-sectional descriptive study was performed on 1000 primary school boys and girls [grade 1] in Tehran. Simple random sampling from those schools that were selected as population clusters was used. Hearing loss was defined as lack of voice perception with different frequencies of 500, 1000, 2000, and 4000 Hz and intensity of 25 dB in pure tone audiometry. In this study, 433 cases had hearing disorder and were referred to the audiometric and tympanometric centers for further examinations. Eventually, 37 [3.7%] students were proven to suffer from hearing loss. There was a statistically significant association between hearing loss and previous history of neonatal jaundice, in-family marriage of parents, and congenital anomalies [P < 0.05]. in the light of the rather high prevalence [3.7%] of hearing loss and the easily treatable nature of the most common causes, more extensive and interventional studies seem necessary to include hearing assessment among the routine screening programs in the nation

[ role of laparoscopy for management of nonpalpable testis [NPT]]

Undescended testes is seen in 3.4% male neonates and 20% of these testes are nonpalpable. This study was done to evaluate the diagnositic and therapeutic effects of laparoscopy in children and young adults nonpapable testes. This descriptive study was done in Urology Department of Ghaem Hospital. 15 patients aged 9 months to 31 years and 19 Testes were studied. Through a 5 or 10 mm incision above umbilicus, 5 or 10 mm Hasson trocar was inserted under vision. 5 or 10 mm telescope was used to see whether the testis was present or not. If not, the operation was ended. Otherwise, the process followed by standard orchidopexy or laparoscopic orchidopexy or laparoscopic orchidectomy. 2 cases did not have testis [19 and 3 years], 9 cases had unilateral NPT [7 rights, 2 left]; three bilateral, and the last one, a case of testicular feminization with karyotype of 46 XY and cheif complaint of amenorrhea. 4 cases had standard orchidopexy and in the last three, one stage laparoscopic orchidopexy was done. In the testicular feminization case laparoscopic orchidectomy. All testes brought into the subdartus fascia, they remaind in the scrotume without athrophy. Laparoscopy is the best tool for diagnosis of non palpable testis. Laparoscopic orchidectomy is also the choice treatment for testicular feminization. Laparoscopic orchidopexy is feasible and can be a duplicate of open orchidopexy

Risk factors and laboratory diagnostics for post renal transplant tuberculosis: a case-controlled, country-wide study on definitive cases

Tuberculosis [TB] is a common cause of morbidity and mortality in renal transplant recipients. It is usually misdiagnosed because of lack of medical awareness and its infrequency in renal transplant recipients. 44 cases [0.3%] with post-transplant TB out of 12820 patients who had renal transplants performed between 1984 to 2003 were found from the hospital records of 12 major kidney transplantation centers in Iran. These cases were compared with 184 healthy transplant subjects whose transplants were performed by the same surgical team as the controls. The mean age of cases and controls was 37.7 [13-63] and 35.6 [8-67] years [p=0.3], respectively. The mean duration of pre-transplantation hemodialysis was 30.3 [3-168] months in cases and 18.2[1-180] months in controls [p=0.03]. A past history of tuberculosis was detected in 2 cases and 1 control [p=0.3]. The mean doses of initial and maintenance immunosuppressive drugs in cases and controls were not significantly different. A total of 25 cases [56.8%] and 60[32.6%] controls had rejection prior to diagnosis of TB [p=0.004; OR=2.7, CI95%: 1. 3-5.6]. To our knowledge, this is the first study that demonstrated increasing risk of post-transplant TB by extending the duration of pre-transplant hemodialysis and the number of post-transplant rejection episodes. Further study is needed to clarify our new findings specifically in respect of different immunosuppressive regimens

[Aphallia with urethrorectal fistula, bladder and urethral calculi]

Aphallia is a very rare urogenital anomaly with incidence rate of 1 in 30,000,000. It usually coexists with other anomalies such as cardiovascular anomalies which are incompatible with normal life, and therefore infants are delivered stillbirth or live for a very short period of time. We present an 18 months old boy with aphallia associated with congenital urethrorectal fistula, bladder and urethral stones. All stones were removed endourologically, recto-urethral fistula was repaired and perincal urethrostomy was performed. The stones were composed of calcium phosphate colonized by klebiella pneumonia and proteus mirabilis. Urethrorectal fistula repairment was confirmed by cystography. Patient was discharged without a urinary catheter. In developed countries, management of such patients is to raise them as females. However, we must consider socio-cultural conditions, parents preference and patients tendency in management of aphallia

Early results and complications of 210 live donor mephrectomies

Objective To study the complications during hospitalization on subjects under going donor nephrectomy in the Ghaem Hospital, Mashhad, Iran. Methods The hospital records of 210 living kidney donors in the period, November 1989 to June, 1999 were.evaluated on a structured proforma using 51 variables. The SPSS Package was used for statistical analysis. Results Of 210 subjects, 159 were males and 51 females with a mean age of 29.38 years. Sixty one males and 37 females were married. Fifty one were related donors, 149 unrelated and the relationship of 10 was not known. The site of nephrectomy was abdominal [9], left lumbar, [159], right lumbar, [46] and bilateral lumbar, [5]. Complications encountered were 71 in 63 cases. Wound infection was seen in 26 cases, respiratory tract infections in 14, haemmorrhage in 8 and genitourinary complications in 5 donors. Conclusion The experience of living donor nephrectomy in Ghaem Hospital, Mashhad was good with no mortality and minimum complications

Transitional cell carcinoma of the bladder in a 17 year male

Epithelial tumors are rarely seen during the first two decades of life. We report a 17 year old male with primary transitional cell carcinoma [TCC] of the bladder

Correlation between expression of class I antigen and development of tumour infiltrating lymphocytes [TILS] from tumour biopsies of patients with bladder cancer

This report presents the findings of TIL development from tumour biopsies of patients with bladder cancer. Analysis of tissue sections showed the presence of T cells in intra-epithelial layer in 8 of 12 cases investigated. In a larger group of patients, TILs were established from 7 of 20 cases and expansion of these cells in Interluekin-2 [IL-2] in the presence of conditioned medium [CM] resulted in increase cell number to as many as 100 fold. Cell surface antigen profile of the cells showed characteristics of activated T cells and showed cytotoxic activity against tumour cell lines K256 and Daudi. In one case where TILs and tumour cell line from the same individual was established, it was found that TILs showed low levels of cytotoxicity against the autologous tumour cells. Investigation of correlation between class I antigen expression and TIL development revealed that all the 7 cases of positive TILs were established from tissue expressing normal levels of free chain of class I antigens. These results are indicative of the presence of IL-2-expandable T cells in tumour biopsy of patients with bladder cancer and demonstrate that the successful expansion of these cells correlates with the normal expression of class I antigens

Renal injuries in Mashhad university during the Iran-Iraq war: a comparison with world wars I and II and Vietnam

Missile injuries of the kidney are rare even in wartime. Of 4500 patients admitted to the Ghaem Medical Center in the first two years of the Iran-Iraq war, only 96 had injuries of the genitourinary tract [2.1%] and only 35 involved the kidney usually with multiple injuries to other viscera. The mortality for those with urogenital injuries was 8.3% [compared with World War I, 60% and World War II, 8.3%]. The advantage of early helicopter evacuation and prompt forward surgery is once more emphasized. The mean time between wounding and surgery was 48 minutes in this series [compared with 60 minutes in Vietnam and 16 hours in World War II]

Patent ductus urachus with stone in a 55 year-old man

Patent ductus urachus [P D U] is a rare malformation that is almost always seen in newborns. The incidence is 3 per 200,000 persons, with a male to female ration of 3 to 1.The Bartholomaeus carrolius in 1550 described PDU as an umbilical fistula for the first time. We report a case of PDU with stone in a 55-year old man