Newly detected hypertension in an Iranian population: an epidemiological study

Background: Early detection of undiagnosed hypertension may prevent or reduce the onset and progression of many diseases.Objective: To investigate the prevalence of undiagnosed hypertension in an Iranian population and its relation with socio-demographic, anthropometric, and biochemical factors.Methods: Four thousand five hundred nineteen subjects, aged 15-65 years, were eligible for the study. They were entered into the study through the cluster sampling method.Results: The overall prevalence of previously unknown hypertension was 24.2%. It was higher among urban dwellers who were poorly educated, married, and were manual laborers by occupation compared to other groups.Conclusion: Poor literacy status as well socioeconomic conditions may be positively associated with hypertension. Undiagnosed hypertension can be lowered by increasing access to routine blood pressure measurement, pre-employment medical examination, and improvement of the health seeking behavior in these groups.

[ 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

[Chronic. hepatitis. B]

Chronic hepatitis B is a major medical problem, distributing all over the world. Affecting more than 400 million people. In highly prevalence places, childhood transmission is the most common form but in low prevalence areas, injection, drug use and familial transmission are the main routes of acquisation of infection. Hepatocellular carcinoma and cirrhosis are significant problems of chronic hepatitis B. Exposure to HBV early in life may progress to hepatocellar carcinoma. The annual number of deaths from HBV infection and related diseases throughout the world is about 1.2 million. The goal of treatment of chronic hepatitis B with Lamivudin or INF-Alpha is sustained suppression of virus replication and liver disease remission. INF, Alpha and Lamivudin have similiar efficacy. The adventage of Lamivudin is that it is less expensive and is well tolerated and adventages of INF. Alpha are the short duration of treatment and absence of resistance but it is expensive and has many side effects. The response rate of INF. Alpha is better than Lamivudin but it is associated with a large number of side effects, sometimes we have to stop or decrease the dose of INF. Viral genotypes and other factors such as pretreatment viral load, fatty liver and liver histiology may alter the response rate. The long-term use of Lamivudin may be with the emergence of YMDD mutations. Treatment of YMDD form of chromic hepatitis B, with combination of Lamivudin and Adefovir dipivoxil, may improve liver function; and YMDD mutations may be over come. The emergence of YMDD mutations reduces the benefit of Lamivudin but does not negate it

[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

[Thyroid autoantibodies in chronic urticaria]

Osteoporosis is the most common metabolic bone disease with significant morbidity and mortality. This study is a part of national study of osteoporosis in Iran. We studied the prevalence of osteoporosis and osteopenia in Mashhad and correlation of bone mineral density with age, height, weight and BMI. Also, we studied correlation between bone mineral densities in different skeletal regions. We also determine prevalence of low bone mass in Mashhadian women based on Mashhadian women reference population. 1003 persons from Mashhad citizens [631 women and 372 men], aged between 20-79 years were selected by random cluster sampling from 2000 through 2003. Those who had known diseases or used medications affecting bone mineral density were excluded based on history and physical examination. We used LUNAR [DPX-IQ] device for densitometry and WHO criteria for interpretation. SPSS [11.5] used for analysis of data and P value less than 0.05 considered as significant. Mean of age, height, weight and BMI was 42.02 +/- 12.77 years, 157.66 +/- 7.16 centimeter, and 69.11 +/- 12.24 kilogram and 27.83 +/- 4.8 kg/m[2], respectively. Mean of age in men and women was similar but mean of height, weight and BMI was higher in men and difference between men and women in height, weight and BMI was significant. There was a positive, significant correlation between bone mineral density in vertebral column and femoral neck regions and correlation coefficient [r] between them was 0.7. There was a positive significant correlation between bone mineral density and following parameters: height, weight and BMI. Correlation between BMD and age was negative and significant. In women prevalence of low bone mass with US/European reference population was higher than with Mashhadian reference population. These findings support the importance of regional reference population for better interpretation of BMD results. Finally, prevalence of osteopenia and osteoporosis in Mashhad was 46.8% and 12.6%, respectively. Osteoporosis is a health problem in Mashhad. So we encourage preventive measures such as modification of nutrition, adequate Calcium and Vitamin D intake and life style modification. We emphasize on using of regional reference population for interpretation of densitometry results. Because of correlation coefficient [r] of bone mineral density in different sites of skeleton is 0.7; we recommend that bone densitometry should be done both in vertebral column and femoral regions

serum lead level of childern in emergency ward

Lead is neurotoxic metal and particularly harmful to the developing nervous system of young children. The U.S. Department of Health and Human services established a National goal to eliminate blood lead level more than 100 Microgram/lit in children age<7 years by 2010. Our perpous was to evaluate the serum lead blood level of 1-7 years old children in khorasan province. This cross sectional - descriptive study performed on 206 children aged one to seven years who were referred to pediatric out patients clinic and pediatric emergency service of Emam Reza medical center.Mashhad Iran from Jan. 200 1 - 2002 children age and blood lead levels were collected in special form. From all children before entrance to study 3 cc blood had been taken for blood lead level. Blood lead levels in all samples were measured by the same lab and same technician. Collected data were processed by descriptive statistics and frequency tables. In this study we measure blood lead levels in 206 children aged one to six years in Emam Reza Medical center pediatrics emergency service and out patients clinic. The mean age of children was 40/04 +/- 1 8/66 months and the mean blood lead level was 121/95 +/- 33/54 Mcg/lit and in 74/8% of children the lead levels were more than 100 Mc/lit. study showed the lead levels are more than other countries studies. Further epidemiologic studies should be performed for this very important heath problem of Mashhad children

Frequency of ABO hemolytic disease of the newborn [ABO - HDN]

Objective: the aim of this study was to determine frequency distribution of ABO-hemolytic disease of newborn [ABO -HDN], clinical and laboratory feature also evaluated

Materials and Methods: during 8 months all A or B blood group babies delivered from O -blood group mothers were elected in cina maternity hospital for 8 months - If Jaundice appeared in first 48 hours of life, routine hematologic tests were done. The diagnosis of ABO -HDN was based on jaundice in first two days of life with positive free Anti -A or Anti -B in serum of infant. Statistical analysis was performed by frequency distribution and chi - squire test, P-value of less than 0.05 were considered statistically significant

Result: a set-up ABO incompatibility between mother and baby was in 10,3 percent of singleton pregnancies, but frequency of ABO-HDN was 1.6 percent of births. Clinical and laboratory feature were normal. Spherocytosis was present in only one baby

Conclusion: the frequency of ABO- HDN was 1.6% of births, lower than usually expected; jaundice was the only clinical feature

Hyperekplexia and excessive startle response in an infant: a case report

We present an infant girl with hyperekplexia, hypertonia, hyperreflexia and a characteristic exaggerated response to nose tap. This disoeder is important to recognize because of the increased risk of apnea and sudden infant death. This infant responded to colnazepam