case of shared psychotic disorder with deadly outcome

thought to occur in persons who live close together, so that delusions of the primarily ill patient are transferred to the partner. A case of shared paranoid psychotic disorder, with primary diagnosis of persecutory delusional disorder in the husband is described. The delusion and its consequent safety behaviors were so strong that led to the family complete isolation, ceasing their relationship with the external world, gradual starvation and death of the daughter. This case showed how one's mind can act so badly against itself to the extend of starvation and dying. We think it is the most tragedy case report of shared psychotic disorder

Clinical and laboratory features of hypertrophic pyloric stenosis

Hypertrophic Pyloric stenosis [HPS] is the most common surgical condition of stomach and duodenum which presents with intractable vomiting during the first weeks of life and death is unavoidable if left without treatment. This study aimed at evaluating the clinical and paraclinical characteristics of the disease in order to emphasize the importance of this potentially life threatening disease. In this retrospective study, from 1358 to 1382 hospital records of all the infants admitted in Shiraz university hospitals with the diagnosis of HPS were studied. From the 231 infants studied, 202 [87%] were male and 29 [13%] were female [male to female ratio of 8 to 1]. Ten cases [4.3%] had positive family history of the disease. 35 [15%] of them were the first child of the family. The onset of symptoms was between 2[nd] and 5[th] weeks of life in majority of the cases [75%]. Olive mass was observed in 116 [51%] of the cases, while constipation, bloody vomiting and jaundice were documented in 36%, 2% and 9% of the cases, respectively. Upper gastrointestinal series was diagnostic in 86% of the cases. However, abdominal sonography was helpful in only 88% of the cases. With proper observation and early diagnosis [by means of abdominal sonography] of patients suffering from repeated episodes of vomiting, the mortality and morbidity of this disease can be reduced

Obsessive compulsive disorder symptoms and their association with trichotilomania, tic and body dysmorphic disorders

Obsessive-compulsive disorder [OCD] symptoms and the related disorders are subsumed under chronic psychiatric disorders which are of psychosocial and therapeutic importance. In most studies, the mean age of onset of significant OCD symptoms is adolescence period. The aim of this study was to evaluate OCD symptoms, Tic disorder, Body Dysmorphic Disorder [BDD] and Trichotilomania among middle school students in Shiraz, Iran. From the four educational district of Shiraz, South of Iran, 1682 middle school students, aged 14-16 yrs-old, were selected using a cluster random sampling. Persian standardized Moudsely Obsessive-Compulsive Inventory was used to assess obsessional symptoms. For evaluating BDD, Tic Disorder and Trichotilomania symptoms, a semi-structured interview was done according to Diagnostic and Statistical Manual-IVTR [DSM-IV-TR] criteria. Students with more obsessional symptoms were mostly girls and showed more positive family history. They were more likely from low socioeconomic class, and their average school grades were lower. They also showed high association with BDD and Tic disorders. This study confirmed body dysmorphic and Tic disorders to be more prevalent in individuals with obsessivecompulsive disorder symptoms. Girls, especially those from lower socioeconomic class, demonstrated increasing obsessional symptoms. Obsessive-compulsive disorder symptoms were found to affect school performance so its early diagnosis and management should be considered as a mental health priority

Anthrax: pathological aspects in autopsy cases in Shiraz, Islamic Republic of Iran, 1960-2001

Anthrax, like tuberculosis, shows a new epidemic spread in industrialized countries, revealing some ambiguous aspects to the disease and providing new challenges to medicine. Shiraz University of Medical Sciences has records of 7130 autopsies performed in the past 40 years, 33 of which are anthrax cases. We reviewed all the pathology slides of these cases and classified the organs involved in a search for unrecognized microscopic findings. The most common cause of death was sepsis, caused by organ involvement and direct cytotoxicity of Bacillus anthracis, in addition to its exotoxin production. Novel findings included hyaline membrane formation in respiratory system cases that is similar to acute [adult] respiratory distress syndrome and evidence of primary gastrointestinal involvement, showing the ability of the organism to pass the gastric barrier

Bone scintigraphy in acute lymphoblastic Leukemia

Leukemia is the most common childhood cancer and accounts for 30-40% of all malignancies. A retrospective review was performed of the hospital records of 9 children, 6 boys and 3 girls, aged from 2.5 to 15 years with ALL initially referred to Nemazee hospital Nuclear medicine center for whole body bone scanning between 2000 and 2002. Bone marrow pathology established ALL [L1] in two and ALL [L2] in 7 patients. All patients had abnormal bone scans involving both appendicular and axial skeletons. These comprised axial skeleton in one, appendicular in seven and both appendicular and axial in one patient. Knowledge of scitigraphic changes acquired in the setting of ALL will expedite the early diagnosis of leukemia at presentation. The potential use of bone scintigraphy is important in that, the correct diagnosis is made on bone scan and confirmed by the examination of blood film, bone marrow aspirate and trephine

Insulin adsorbance to polyvinylchloride [PVC] surfaces of Fluid container and infusion - set

In total parenteral nutrition [TPN] solution, adsorbance of insulin to polyvinylchloride [PVC] surfaces of fluid containers and infusion-sets, decrease the amount of insulin that reaches the patients. To clarify the binding sites of insulin and to propose a solution to overcome this problem. To each of four 1000ml. PVC bottles of 5% dextrose solution, 300 microunit of insulin per each milliliter of dextrose solution were added. Each bottle was then connected to an infusion-set and the system made to run at an infusion rate of 100 ml. per hour. One milliliter samples were then collected from both the PVC bottles and infusion-sets-terminal, separately, immediately at the starting point [time zero] and 15, 30, 45 and 60 minutes thereafter. The concentrations of insulin were checked using insulin kits. At the starting point [time zero] the mean of insulin concentrations among four PVC bottles was 213.79 microunit per each milliliter of 5% dextrose solution. No significant fluctuation was noted in the concentration of insulin in the PVC bottles through 60 thminute period. However the concentration of insulin at infusion-set- terminal decreased significantly at the end of the same hour [p value=0.004]. Our results demonstrate that the adsorbance of insulin takes place at the surfaces of infusion sets. It follows therefore that increase in the primary dosage of insulin added to PVC infusion solutions and the selection of a suitable infusion set [polyethylene] seem to be beneficial for overcoming this problem

Changing epidemiology of esophageal cancer in Fars province, Iran

Esophageal carcinoma is one of the most lethal gastrointestinal [GI] malignant tumors worldwide. The disease is known to have a high incidence in northern Iran; however, its condition in the South is not much clear. In this retrospective study we investigated the epidemiology and time trends of esophageal carcinoma in Fars Province, South of Iran. In a retrospective study, we reviewed pathologic reports of all laboratories in Fars Province, South of Iran, from March 1997 to March 1999 to find cases of esophageal carcinoma. Annual and average incidence in different age groups were calculated for both sexes, based on four censuses results. Esophageal carcinoma was the third most common GI cancer in Fars, with an average incidence of 2.95 per 100,000 in the population older than 15 years. The incidence of esophageal carcinoma was found to drop by 64% during the study period. This was mainly due to the decreased incidence of squamous cell carcinoma. Females developed squamous cell carcinoma in relatively younger age as compared to males. Our region in the South of Iran is one of the low incidence areas of esophageal carcinoma as compared to that of northern borders of the country and other parts of the world with some special features