Diagnosis of myopathies using histology, histochemistry, immunohistochemistry and electron microscopy: a single center experience

Skeletal muscle biopsy is important for the diagnosis of motor unit disorders, systemic diseases and metabolic disorders. In some cases, routine histopathologic methods are not conclusive and histochemistry, immunohistochemistry and even an electron microscopic study are required. In this study, we describe our experience in the diagnosis of myopathies, considering all of the above-mentioned methods. During a period of 18 months, 43 specimens of patients with the impression of myopathy were submitted to the Pathology Department and were evaluated with H and E and histochemical stainings [PAS, Oil red O, ATPase, NADH-TR, Gomori Trichrome], immunohistochemistry [IHC] for dystrophin and electron microscopy. Three specimens were excluded from the study because there were only adipose tissues and no adequate muscle was present for evaluation. Twenty three [57.5%] males and 17 [42.5%] females with a mean age of 34 years were evaluated. The results were as follows: Becker's muscular dystrophy [5 cases, 12.5%], Duchenne's muscular dystrophy [3 cases, 7.5%], fascioscapulohumeral dystrophy [3 cases, 7.5%], limb girdle dystrophy [2 cases, 5%], polymyositis [6 cases, 15%], dermatomyositis [2 cases 5%], McArdle's disease [1 case, 2.5%], hypothyroidism myopathy [1 case, 2.5%], type 2 atrophy secondary to drugs and systemic diseases [2 cases 12.5%], congenital myopathy [2 cases 5%], McArdle [1 case 2.5%], unclassified myopathy [2 cases, 5%], and normal muscle biopsy [8 cases, 20%]. Although a genetic study was not available to confirm the diagnosis of cases such as fascioscapulohumeral myopathy, the diagnosis was made after putting all of the findings together including clinical presentation, family history, NCV, EMG, etc. In the cases with no definite diagnosis by the histology, histochemistry and IHC, we should perform an EM study to find out the distinct ultra-structural changes which can be diagnostic for some muscle disorders. EM study in conjunction with light microscopy of muscle biopsy could be very helpful in establishing the diagnosis of some types of myopathies

Knowledge, attitude and practice of mothers about neonatal swaddling in Jahrorn

Swaddling as a current custom in our country has many advantages and disadvantages. The mothers' knowledge about them affects the neonatal care. The present study aims to assess the mothers' knowledge, attitude and practice about swaddling. In the present study, 190 mothers in spring 2006 were studied through a questionnaire. Data including age, place of living, parity, job, education, and also the reasons, advantages and disadvantages of swaddling were collected. Moreover, knowledge, attitude and practice of mothers and their correlation with other variables were evaluated. More than 95 percent of the mothers swaddled their babies due to custom or recommendation of their families. Better sleep [36.3%] and strong foot [30%] were the most common reasons for swaddling, as stated by mothers. More than 90 percent of the mothers had no knowledge about the disadvantages of swaddling. There was a statistically significant correlation between the mothers' level of knowledge and their age, parity, place of living and education. In regard to swaddling as a current custom and with respect to many advantages and disadvantages of swaddling in growth, development and better care of infants, it seems that it would be better to provide pamphlets for increasing the mothers' knowledge

[Prevalence of needlestick injuries among the healthcare professionals in Zahedan medical sciences university]

Injury by sharp instruments and needles are major occupational health hazard for healthcare workers. This study was conducted to determine the prevalence rate and causes of injuries due to needle stick in healthcare workers in Zahedan University of Medical Sciences. In a cross-sectional study, 231 healthcare workers of university hospitals of Zahedan University of Medical Sciences were selected at random in 2007. Data were collected through questionnaire and were analyzed by SPSS 13. From all cases 77.1% were female 56.4% of them were expert, and 50.7% were nurses. Their mean age were 34 +/- 8.1 years. Needle stick prevalence was 64.9% during the whole history of career, and 57.2% of them had experiences of needle stick more than twice. Most cases of injuries were related to using needle 55.4%, and they were mostly prone to injury during injection and phlebotomy, 55.6%. The multivariate regression analysis showed that injury due to sharp instruments in university graduates was 60% less compared to those with high school or less, and the injury risk increases 5% in each year of increase in working experience. The findings of this study highlight the importance of training and preventive measures in healthcare centers particularly among high risk group

[ study of relationship between menorrhagia and gestational diabetes]

Gestational diabetes is defined as carbohydrate intolerance of variable severity with onset or recognition during pregnancy. Approximately, 4% of pregnancies are affected by diabetes mellitus, 90% of which represents gestational diabetes mellitus [GDM]. Detection of risk factors of GDM may reduce the risk of complications. One of the new risk factors is menorrhagia. This study was conducted to identify the relation between menorrhagia and gestational diabetes. This case-control study was performed on the pregnant women who were referred to GDM and prenatal clinics in the endocrinology and metabolism centers of Shariati, and Taleghani hospitals as well as Iran endocrinology and metabolism institute of Tehran. In this study, data collection from the patients were carried out by interview method. Sampling was performed by convenience method. Case group included 60 women with gestational diabetes and control group included 60 women without gestational diabetes that they were selected at the same period of time. Demographic characteristics, history of menorrhagia and its etiology, were compared between two groups. We excluded subject with history of fetal macrosomia [weight >4500g], pre-pregnancy diabetes, diabetes in previous pregnancy, neonatal morbidity and mortality, recurrent abortion, smoking before and during pregnancy and preterm delivery. The case and control subjects were matched based on their age, parity, pre-pregnancy body mass index, diabetes mellitus in first-degree relative and the history of still-birth or malformed fetus or neonates. Demographic characteristics and etiology of menorrhagia were similar between two groups. Relative frequencies of menorrhagia were 41.7% and 6% in the case and the control group, respectively [p<001, Odds Ratio=6.43]. A history of menorrhagia can be an independent predictor of gestational diabetes mellitus. If selective screening is implemented for gestational diabetes mellitus, such history should be considered in the decision of whom to test

Relation between duration of menstruation and gestational diabetes in women referring to teaching hospitals in Tehran

Gestational diabetes is defined as carbohydrate intolerance of variable severity at or during pregnancy. Approximately, of pregnancies is affected by diabetes mellitus, of which represents gestational diabetes mellitus [GDM]. Detection of risk factors in GDM may reduce the risk of complications. A new risk factor suggested is abnormal menstrual duration. This case-control study was conducted to determine the relation between duration of menstruation and gestational diabetes in women referring to teaching hospitals at Tehran in 2005. 120 women [60 in case group with GDM and 60 in control group without GDM] referring to GDM and Prenatal Clinics in Shariati and Taleghani hospitals were selected by convenience sampling. An information form was completed by interview for data collection. Content and test re-test methods were used for validity and reliability respectively. Demographic characteristics and abnormal duration of menstruation as well as its etiology were compared between the groups. Those with the history of fetal macrosomia [weight >4500g], diabetes, diabetes in previous pregnancies, neonatal morbidity and mortality, recurrent abortion, smoking before or during pregnancy and preterm delivery were excluded from the study. The groups were matched in terms of their age, parity, body mass index, diabetes mellitus in their close relatives and the history of stillbirth or congenital anomalies. Demographic characteristics and duration [in the case and in the control] as well as etiology of abnormal menstruation were similar between the groups [p=0.34]. No significant relation was found between duration of menstruation and GDM. The relationship between duration of menstrual bleeding and gestational diabetes is disputable

Iron status of babies born to iron-deficient anaemic mothers in an Iranian hospital

We investigated the relation between maternal anaemia and neonatal iron status in 97 mothers and their babies. Haemoglobin [Hb], serum iron, total iron binding capacity and serum ferritin were determined. Mothers were divided into 3 groups: iron-deficient anaemic [22.7%], non-anaemic iron-deficient [27.8%] and non-anaemic non-iron-deficient [49.5%]. There was no significant difference in the mean ages of the 3 groups but there were significant differences in relation to parity, Hb and serum ferritin levels. There was no significant difference in the mean value of serum iron or total iron binding capacity among the neonates of the 3 groups. Babies of iron-deficient anaemic mothers had significantly lower levels of serum ferritin [115.3 ng/mL] than nonanaemic, non-iron-deficient mothers [204.8 ng/mL] but not compared with the non-anaemic iron-deficient group. Maternal iron deficiency may affect iron status in their babies and predispose them to iron deficiency