[Liver enzymes disorders in women with polycystic ovary syndrome]

Introduction: Polycystic ovary syndrome [PCOS] is the most common endocrinopathy among women of reproductive age. Women with PCOS commonly display a cluster of metabolic abnormalities, including impaired glucose tolerance, insulin resistance and dyslipidemia. Some recent studies have also shown an association between PCOS and nonalcoholic fatty liver disease [NAFLD]. The aim of the present study was to investigate liver enzymes in Iranian women with PCOS and controls to explore determine any possible independent effects of PCOS on liver enzymes

Materials and Methods: Sixty PCOS and sixty non-PCOS women were studied at Vali-e- Asr Hospital of Tehran University. PCOS was diagnosed according to Rotterdam criteria. Data were obtained from patient's files and analyzed using SSPS version 19

Results: Gamma glutamyltransferase [GGT] level and BMI were significantly higher in PCOS women than in controls [p=0.001]. No significant differences were found between groups regarding age or serum levels of Alanine aminotransferase, Aspartate aminotransferase, triglycerides, high density lipoprotein, low density lipoprotein, fasting glucose, fasting insulin levels and HOMA-IR. GGT was significantly higher in lean PCOS women compared to their controls [p=0.002], although there was no significant differences in GGT levels between overweight/obese PCOS women and overweight/obese controls, and hence no correlation between BMI and GGT

Conclusion: Considering the association between PCOS and NAFLD, women with PCOS should be screened for liver disease

Future perspectives for hand transplant in Iran

Hand transplant program is a communion of physicians and researchers during the current decade. 72 hands and digits were transplanted in 53 patients over the past 13 years. Unlike a solid organ transplant, hand transplantation involves various tissues, so it is called and "composite tissue allotransplantation." This article discusses the plans for performing the first hand transplant in Iran

[Prolonged latent phase: maternal and neonatal outcomes]

Few studies to date have shown the adverse effects of prolonged latent phase. Related factors, maternal and fetal outcomes of prolonged latent phase were studied in order to prevent these effects. In a cross-sectional study, 224 women were assessed at Shohada hospital by using questionnaire, examination and follow up to calculate the latent phase duration up to 3cm dilatation. Of the total, 22.8% had prolonged latent phase and there was no difference in the maternal and fetal age/weight, gravid and parity, 41.2% were nulipars. None of the cases had delivery trauma, but 4 out of 7 meconium aspirated cases, 2 out of 6 hospital admissions, and both the 2 cases admitted in NICU were in prolonged latent phase group. None of the infants in this group had APGAR less than 8. There was no significant difference between APGAR<6 and meconium aspiration cases in the two groups. Massive post partum bleeding, cesarean section, and fever during/after delivery showed a significant difference. Other variables didn't show any significant difference. Parity had a direct correlation in the normal group and indirect correlation in the prolonged latent phase duration group. Maternal age and weight, gravid, parity, infantile weight, gender and gestational age have no effect on latent phase duration. The more the parity, the more prolonged the latent phase and this leads to more cases of cesarean section, fever during/after delivery and post-partum bleeding

Epidemiology and risk factors of 377 AIDS [HIV infected] patients

Oral manifestations of HIV infection are common and include oral lesions and novel presentations of previously known opportunistic diseases. Some risk factors are significantly contributed to probability of developing opportunistic infection of oral candidiasis. We have performed the current survey to evaluate their role in Iranian patients with HIV infection. Totally, 377 documented HIV infected patients were included. Oral candidiasis was investigated with clinical observation, direct smear, and culture. Meanwhile, CD4 count was determined at the first visit and following antiretroviral therapy. The study population included 316 males and 60 females with a mean age of 36.5 +/- 8.7 years. Patients were diagnosed for a mean duration of 2.9 years. The most common route of infection transmission was shared needles [117 cases or 31%]. In serologic tests, 11 cases [2.9%] were positive for HBsAg, 206 cases [71.5%] for HCV nucleic acid and 53 cases [14.1%] for tuberculosis infection. At the first visit 52 cases [13.9%] and following HAART 31 cases [8.2%] were revealed to have oral candidiasis. Mean CD4 count in patients with oral candidiasis was significantly less than other patients [193.8 vs. 349.7 cells, P=0.0001]; however, the difference was not significant at follow up. Prompt diagnosis and treatment of HIV infection may have a significant role in prognosis and clinical course of patients with HIV infection and could decrease the rate of opportunistic infections

innovative surgical technique for continuous suturing of prosthesis in mitral valve replacement

Mitral valve replacement [MVR] is usually performed in two methods of running and interrupted suturing. In running method, the suturing of the valve is usually with some traction on the annulus and also there is a risk of aortic valve injury. This study was conducted to evaluate a new technique for suturing to avoid these complications and decrease the time of cardiac arrest. One hundred and seventy-seven cases undergoing isolated MVR or MVR with other valve replacements were operated by the new method and compared with 77 cases of routine method, as control group. The patients were followed up 1-4 years. In the control group, one case of mortality occurred due to heart failure. In both groups one case of late mortality was observed not related to surgical operation. No paravalvular leakage or aortic valve injury was observed. The highlights of this technique are the simplicity of operation, short period of valve implantation and aortic clamp time, which indicated 6 and 11 minutes decrease in average time, respectively. This method is recommended for all cases of rheumatic mitral valve disease, especially for those having a small atrium

Pseudoaneurysm of right ventricle due to localized tuberculosis of myocardium: a case report

A 5-year-old girl was admitted to the hospital with chest pain, fever and dyspnea. Physical examination showed normal heart sounds, diminished pulmonary sounds in the left hemithorax and a normal ECG. On chest X-ray the heart was slightly enlarged with moderate left pleural effusion. CT scan revealed pleural effusion and a hypodense mass at the apex of the heart. A cystic mass was detected by echocardiography as well. The patient was operated as a case of hydatid cyst of the right ventricle. Intraoperatively a pseudoaneurysm of the right ventricle was found. The mass centrally consisted of clots and necrotic tissue and peripherally was composed of fibrosis and calcification. All of these tissues were removed and the communication between the aneurysm and right ventricle was repaired. The diagnosis of tuberculosis was confirmed by culture and microscopic examination. The patient underwent anti- TB treatment for 6 months and remained symptom-free after 4 years. It is believed that local expansion of tuberculous adenitis near the pericardium has caused a TB abscess, which in turn affected the myocardium and destroyed it