RESUMO
Background: thalassemia is accounted as the most common hereditary anemia through our region. Due to abnormality in synthesis of globin chains in red blood cell resulted from this disease, these globules have not natural life and then will die immediately. Appropriate therapy for this disease includes a regular monthly blood injection. However, in the approach patients will inevitably confront with side effects particularly iron overloads and iron sediment along tissue of body critical organs including heart, ductless glands and liver. Examining more research examples, by the study it attempted to determine more precisely plenty of adenoidal abnormality between the Iranian thalassemia patients for pre diagnosis and offering necessary medical measures
Materials and Methods: this was a descriptive research and included all the patients suffering from thalassemia major referring to medical centers linked with the Iranian blood transition institute. Census applied for sampling from all the patients. Initially, reports of adenoidal experiments as well as other associate parameters provided from medical folders
Results: from 437 understudy thalassemia patients, sexual mutation rate [SMR] was investigated along various age groups. There was no difference in those patients who, suffered from intermediate thalassemia and there was no relation between various age groups in the case of SMR classification [P=0/00]. Average of ferritin had no statistic difference among al 5 groups [P=0/6]
Conclusion: comparison of results between present research and similar studies conducted through Iran and those performed in abroad on growth abnormalities and puberty in thalassemia patients show that subject patients of this study statistically suffer from fewer difficulties than in case of patients in other studies
RESUMO
Vaccination with the major surface antigen of hepatitis B virus [HBsAg] induces anti-HBs antibody production and level of 10 IU/L is considered protective. It has been shown that the level of anti-HBs antibody does wane after vaccination. The aim of this study was to evaluate the persistence of anti-HBs antibodies in healthy Iranian children 10 years after primary vaccination. Blood samples were collected from 146 children, 10 years after completion of primary hepatitis B vaccination course at birth. The sera were tested for anti-HBs, antibody to hepatitis B core antigen [anti-HBc] and HBsAg by use of ELISA technique. At 10 years after primary vaccination, 70 [47.9%] children had protective levels of antibody [anti-HBs> 10 IU/L] with mean titer of 68.1 IU/ml. Moreover, 45 [30.82%] children were negative for anti-HBs antibody. Distribution of children according to anti-HBs concentration revealed that the proportion of subjects with antibody titer of 0-10 IU/L, 10-100 IU/L, 100-500 IU/L and 500-1000 IU/L was 52.1%, 24.6%, 20.5% and 2.7%, respectively. All children were negative for HBsAg, although anti-HBc was positive in 11 [7.5%] children. There was no difference in the seroprotection rates of males and females. The results of present study show that after 10 years after primary vaccination with recombinant HB vaccine, 47.9% of the children had protective levels of anti-HBs antibody. On basis of the HBsAg and anti-HBc results, it seems that effective immunological memory exists in children. Additional follow-up studies need to be conducted to determine the duration of protection
RESUMO
Background: Total Intravenous Anesthesia [TIVA] compared to general anesthesia has some pits and falls. Many drugs have been employed for this anesthesia. Propofol is accounted as the last advent anesthetic drug. It belongs to alkyl phenol families and has been accounted one of the best choices for the continuous infusion. Invention of midazolam as the first water soluble benzodiazepine was also an important event in anesthesia and it can be used as continuous infusion for the anesthesia
Materials and Methods: In this randomized controlled clinical trial, alfentanyl plus propofol or midazolam were used for TIVA anesthesia in 60 female patients undergoing Dilatation and Curettage [D and C] in Dr. Shariati hospital in March 2002 till March 2003. They were allocated reandomly in two group of alfentanyl plus propofol [propofol group] or alfentanyl plus midazolam [midazolam group]
Results: There was no significant difference in mean of age between propofol group and midazolam group [P>0.05], also There was no significant difference in preanesthesia condition such as blood pressure and heart rate between propofol group and midazolam group [p>0.05]. After induction of anesthesia there was a gross blood pressure decrease in both group that it was greater in midazolam group [85 mmHg versus 73 mmHg, P<0.05 ] following this, there was an increase in heart rate in both groups that it was modest in propofol group [98 Beat/Sec versus 118 Beat/Sec, P<0.05]. There was no significant difference in mean infused alfentanyl [P>0.05] also there was just one naloxane injection in midazolam group that have no significant difference between groups [P>0.05]. Recovery room stay was significantly lower in propofol group [25 minutes versus 39 minutes, P<0.05]
Conclusion: The results of this study was similar to Vuyk et.al. In their study there was a significant lower recovery time estimated by psychomotor reflexes and there was significant lower drowsiness, place and time orientation time compared to midazolam group. Finally according to the results of this study it can be resulted that TIVA with propofol is more suitable than midazolam and it can lower hospitalization time and cost. In future studies using other narcotics and other narcotics-anesthetic compounds with various dose can be mentioned
RESUMO
Background: The diagnosis of acute bacterial meningitis rests on CSF examination by lumbar puncture. Before lumbar puncture, intracranial mass lesions that increase intracranial pressure, must be ruled out, so brain CT-scan may be considered. In this study we evaluated the accuracy of physical examination for intracranial mass in patients with meningismus
Materials and Methods: 100 patients who had symptoms and signs of acute meningitis were evaluated and then brain scan was performed. After this, clinical manifestations were compared with CT results and sensitivity, specificity, positive and negative predictive values and accuracy were analyzed
Results: 73% of patients were men and 27% women. Most of patients were between 22 to 31 years old. 34% of patients had meningitis, 22% had SOL, 69% had one neurological symptom or sign at least. As a whole, sensitivity, specificity, pos. and neg. predictive values and accuracy in diagnosis of contradictions of L.P. are 90.9%, 37.1%, 28.9%, 93. 5%, 59%
Conclusion: This study shows that with help of symptoms and signs fundoscopy in patients suspected to have meningitis, we can perform LP without brain CT preliminary