Comparison of doppler ultrasonographic findings in complicated and uncomplicated lower-limb varicose veins

Comparing anatomicopathologic findings in complicated and uncomplicated lower-limb varicose veins by ultrasonography. Totally, 231 consecutive patients [148 [64%] men; mean age, 46.8 +/- 14.3 years [range: 16-88 years]]; 155 [54%] left and 132 [46%] right variceal legs were evaluated by Doppler ultrasonography with color-flow imaging using a 7.5-10 MHZ linear probe. The lower extremity venous system [including perforators and valves] were evaluated in the supine and standing position, at rest and during Valsalva's maneuver. Chi square and Fischer's exact tests were used for statistical analysis. We also performed a logistic regression analysis considering presence of any type of complication as the dependent variable and anatomic pathologies as independent variables. Of the 287 limbs with varicose veins, 124 [43%] had at least one complication [ulceration, pigmentation or infection]. The highest complication rate was seen simultaneously with chronic deep vein thrombosis [DVT] with segmental obstruction [76.9] and the lowest complication rate in the incompetent valves was seen in patients with perforan vein reflux [50.4%]. Mostly, the complication rate was higher in patients with the pathology in comparison to patients without it [p values<0.005]. In a multivariate logistic regression model, presence of DVT and saphenofemoral incompetency were statistically significant in the model in comparison to other pathologies [OR=10.6 and 7, respectively, p values<0.02]. In 175 patients [75.8%] one of the legs were involved Presence of ulcer, pigmentation and infection are significantly associated with a higher incidence of DVT, deep vein, saphenofemoral and saphenopopliteal incompetency in patients with lower limb varices

Intracranial manifestations of tuberous sclerosis: a pictorial essay

Tuberous sclerosis is an autosomal dominant genetic disease that involves multiple organs. Hamartomas are the predominant lesions. Classically, tuberous sclerosis has been characterized by a classical clinical triad of facial angiofibromas [90%], mental retardation [50-80%], seizure [80-90%] and all three in 30% of the patients. Two major features or one major feature plus two minor features are necessary for the definite diagnosis of this disease. We had some patients admitted with different presentations of tuberous sclerosis and a past history of convulsion from childhood, skin lesions and also mental retardation with a new onset headache and a changed pattern of convulsion. In physical examination, facial angiofibromas and subungual fibromas were apparently detected. Brain CT scan study with contrast showed multiple calcified nodules associated with tubers, ventriculomegaly and also enhancing enlarged nodules at the foramen of Monro, which were suggestive of subependymal giant cell astrocytoma [SGCA]. MRI showed the same brain findings [tubers, white matter lesions and subependymal nodules associated with SGCA], which were detected better. After surgery, SGCA was proved. In abdominal and pelvic CT scan and ultrasonography, massive bilateral angiomyolipomatosis and focal hypodense hyperechoic liver lesions were detected

[ relationship between serum acid level and some cardiovascular markers in patients with myocardial infarctions]

Many reports indicate an idiopathic rise in sialic acid level after myocardial infarction [MI]. Such reaction attached to its correlation with both reactionary indices in the acute phase and fatty indices has been thoroughly studied and produced controversial findings. Hence, it is considered as an important diagnostic agent. To study the relationship between serum total sialic acid [TSA] level and several diagnostic markers including lactate dehydrogenase [LDH], creatine phosphokinase [CPK] and troponin in MI patients. This was a descriptive analytical study in which 30 patients with MI investigated. Blood samples were collected in three consecutive days following the occurrence of MI. Serum levels of TSA, CPK, and LDH were measured using spectrophotometric technique and troponin determination by ELISA. The data were investigated by SPSS using t-test and Pearsons correlation coefficient for further analysis. The serum levels of TSA and the target markers were considerably higher than recommended normal levels. There was a significant relationship between TSA and troponin [P=0.05, r=0.47] at the first day and TSA and LDH at the second day [P=0.01, r=0.52]. Regarding the results found in our study, higher level of TSA together with increase in concentration of several cardiac specific markers including troponin and LDH implies that it could be considered as an early diagnostic marker in cardiovascular diseases

[Job satisfaction and its affecting factors from the viewpoints of faculty members of Kermanshah University of Medical Sciences]

Human resource is one of the factors for organizations' survival. Generally, every organiza-ion's success depends on its employee's efforts as well as their job satisfaction. The aim of this study was to investigate the factors influencing job satisfaction from the viewpoints of faculty members of Kermanshah University of Medical Sciences. This descriptive cross-sectional study was performed on 156 full time faculty members of Kermanshah University of Medical Sciences. In order to collect the data, the demographic feAutres question-aire and the standard questionnaire of Smith, Kendall-Halley with little modifications were used. Data was analyzed by SPSS software using t-test, ANOVA, Pearson correlation coefficient, and Tukey test. The highest satisfaction belonged to nAutre of the job [4.41 +/- 0.70] and welfare opportunities proved to be the factor for lowest satisfaction [2.13 +/- 0.83]. Furthermore, there was a significant relationship between some occupational variables and job satisfaction. Faculty members of Kermanshah University of Medical Sciences are satisfied with their job and their job satisfaction would increase if some factors such as salary, lack of welfare opportunities, and their progress were taken into consideration

[ relationship between the plasma level of cyclosporine-A and drug dose in patients of Kermanshah Kidney Transplantation Center]

Nowadays the main problem in transplantation is the complexity of host immune system protection against the immunological and destructive reactions of the transplanted organ. High serum level of the immunosuppressive drug may cause toxicity and low serum level leads to the rejection of the transplanted organ. Cyclosporine has been known as the most effective immunosuppressive drug. Our goal in this study was to determine the relationship between cyclosporine serum level and administered dose in renal transplant recipients in order to find the optimum cyclosporine dose in Kermanshah kidney transplantation center. This descriptive-analytical study with simple sampling was done on 80 renal transplant recipients [51 males and 29 females] in Kermanshah transplantation center. At least 6 months after transplantation, in patients with stable conditions, cyclosporine peak and trough levels were measured by specific monoclonal, Radio Immuno Assay [RIA] method over a period of 3 months. Other biochemical parameters were measured too. Data were analyzed by 2 and ANOVA tests. Mean cyclosporine Trough and Peak levels were 271.9 +/- 85.2 and 904.5 +/- 414.2 ng/ml respectively, for the treatment dose of 3.25 +/- 1.46 mg/kg B.W. There was no significant difference between trough and peak levels in all three administered doses and the range of administered dose was 1.79-4.71 mg/kg B.W. According to the findings, cyclosporine serum concentrations and the administered dose range differed from other studies. This may be due to pharmacologic and pharmacokinetic differences of the drug and individual physiological characteristics of patients. The minimum dose of 1.79 and maximum dose of 4.71 led to optimum treatment in stable patients and could prevent rejection or toxic effects. Cyclosporine peak level was obviously different from other studies; however it showed better relationship with clinical status. Conversion from the routine cyclosporine C[trough] monitoring to C[peak] monitoring is recommended in Kermanshah kidney transplantation center

[ relationship between the plasma level of cyclosporine-A and drug dose in patients of Kermanshah kidney transplantation center]

Nowadays the main problem in transplantation is the complexity of host immune system protection against the immunological and destructive reactions of the transplanted organ. High serum level of the immunosuppressive drug may cause toxicity and low serum level leads to the rejection of the transplanted organ. Cyclosporine has been known as the most effective immunosuppressive drug. Our goal in this study was to determine the relationship between cyclosporine serum level and administered dose in renal transplant recipients in order to find the optimum cyclosporine dose in Kermanshah kidney transplantation center. Methods: This descriptive-analytical study with simple sampling was done on 80 renal transplant recipients [51 males and 29 females] in Kermanshah transplantation center. At least 6 months after transplantation, in patients with stable conditions, cyclosporine peak and through levels were measured by specific monoclonal., Radio Immuno Assay [RIA] method over a period of 3 months. Other biochemical parameters were measured too. Data were analyzed by chi[2] and ANOVA tests. Mean cyclosporine Trough and Peak levels were 271.9 +/- 85.2 and 904.5 +/- 414.2 ng/ml respectively, for the treatment dose of 3.25 +/- 1.46 mg/kg B.W. There was no significant difference between trough and peak levels in all three administered doses and the range of administered dose was 1.79-4.71 mg/kg B.W. According to the findings, cyclosporine serum concentrations and the administered dose range differed from other studies. This may be due to pharmacologic and pharmacokinetic differences of the drug and individual physiological characteristics of patients. The minimum dose of 1.79 and maximum dose of 4.71 led to optimum treatment in stable patients and could prevent rejection or toxic effects. Cyclosporine peak level was obviously different from other studies; however it showed better relationship with clinical status. Conversion from the routine cyclosporine C[trough] monitoring to C[peak] monitoring is recommended in Kermanshah kidney transplantation center

survey of endemic goiter in school children in Kermanshah

In the fall of 1991, the incidence of goiter was determined in 1078 male and female school children in Kermanshah city. The study was considered from two view points i.e., clinical examinations and measurements of levels of iodine excreted in urine, and was performed in three age groups: 7-11 years of age, 12-15 years of age and 16-18 years of age. Clinical examination showed 16.5% occurrence of goiter in boys and 21.2% occurrence in girls of all age groups. The most common type of goiter in boys was la with occurrence of about 14.2% whereas la and Ib were the most common in girls with occurrence of 14.9% and 3.6%, respectively. The results obtained from laboratory studies showed that the levels of iodine in urine of healthy boys was about 89.17 +/- 4.7 micrograms iodine per gram of creatinine, and in healthy girls 97.9 +/- 3.5 micrograms iodine per gram creatinine, which indicates a significant difference in the levels of excreted iodine between the two sexes. The levels of iodine in urine was decreased considerably in children with goiter, up to 47% in boys and 58% in girls. The results obtained from this survey indicate that Kermanshah province fits in the moderate-deficiency region of the Hetzel classification for having a maximum of 35% occurrence of goiter. Furthermore, 25 to 50 micro g iodine consumption per gram creatinine becomes one of the urgent priorities of the national campaign against iodine deficiency disorders