CHRONIC GRANULOMATOUS DISEASE IN SOUTHERN IRAN
Chronic granulomatous disease (CGD) has an incidence of 1/100,000 and represents a group of disorders of oxidative metabolism of phagocytes including recurrent infections with catalase positive microorganisms and chronic granulomatous inflammation.
During the last 3 years, repeated follow-up and physical examination of 14 males and 5 females diagnosed as CGD were reviewed for clinical presentations, complications, treatment, response and follow-up. CGD was diagnosed with the nitroblue tetrazolium (NBT) test. Death of siblings due to repeated infections occurred in 16 cases. NBT slide test was checked for in the parents and siblings of most patients.
According to the results, in 60% of cases the pattern of inheritance was X-linked and in the remaining 40% it was autosomal recessive. Pneumonia and lymphadenitis were the most common types of infection as well as the most common reason for hospital admission. During episodes of infection, most of the patients were anemic (94%) and underweight (82%).
Hypergammaglobulinemia, hepatomegaly and splenomegaly were noted in 88%, 80% and 65% of the cases, respectively. Only one case of esophageal obstruction existed which was relieved with prednisolone in combination with antimicrobial treatment. Two patients expired due to disseminated infection and another due to resistant pneumonia. In order to prevent repeated infection, patients were given co-trimoxazole as an alternative to cephalexin. Gamma-interferon was also given with a dose of 50 µg/m2 every other day to the patients with successful results.
Authors: Karimi A, Alborzi A, Sadeghi P, Amini R
Source: Iranian Journal of Infectious Disease and Tropical Medicine. 1999; 9: 6.
Prevalence of gestational diabetes in 2100 women in tehran
Gestational diabetes mellitus (GDM) is a disorder of carbohydrate metabolism which can be detected for the first time during pregnancy. Unless appropriate screening methods are used, this disorder is usually missed and causes complications for both the mother and the fetus. The aim of this study was to estimate the prevalence of GDM among pregnant women visiting university clinics. A total of 2,100 pregnant women were assessed in a cross sectional study. After recording the history of previous pregnancies, drug intake and evaluation of the present pregnancy through physical examination, ultrasonography and laboratory tests, all women underwent an oral glucose tolerance screening test with 50 g glucose according to recommended methods. The cut-off point of 135 mg/dl was considered in this study. All patients beyond this threshold were examined with the standard method according to the NDDG criteria (three-hours oral glucose tolerance test with 100 gram glucose). Ninety-six cases of GDM were detected. In our study, prevalence rate of GDM was 4.5% (CI, 95%=3.6-5.4). The mean age of these patients was significantly greater (30.5±5.4 years) than pregnant women without GDM (25.3±5.8 years) (p<0.001). Mean number of pregnancies, blood pressure and body mass index were significantly higher in the GDM group as compared to the non-GDM group (p<0.001). Sixty-two patients (65%) of the GDM group had no symptoms or clinical signs of the disease. By choosing a cut-off point of 140 mg in the screening test, some of the 96 GDM cases would be missed. We conclude that a screening test is mandatory for detecting GDM in all pregnant women even in asymptomatic cases with unknown risk factors.
Authors: Larijani B, Azizi F, Pajouhi M, Bastanhagh M, Marsosei V, Hossheinnejad A, Sajadi A
Source: Iranian Journal of Endocrinology and Metabolism. 1998; 1: 163.
THE EFFECT OF FLUOROCARBON ARTIFICAL BLOOD (FC-34) IN ACUTE VASOGENIC BRAIN EDEMA
Fluorocarbon liquids are able to facilitate oxygen transport. This is very important after an episode of acute ischemia. An animal model study was designed to study the effect of FC-34 in acute brain ischemia.
The left common carotid artery was ligated in three groups of anesthetized animals for 30 minutes to produce acute brain edema. The animals received 15 ml/kg saline (group 1), 10% manitol (group 2) and FC-43 (group 3). All animals were recovered and monitored for two weeks. The electrolytes, BUN, and creatinine levels were measured before (all animals) and after two weeks (survived animals). Pathological investigation was obtained by light and electron microscopy.
The animals in-group 1 died during the first five days, but one and four animals survived by two weeks in group 2 and 3 respectively (p<0.05). Pathological determinations indicated less cellular damage in group 3. No significant differences were detected in the levels of potassium, calcium, BUN, and creatinine before and after the experiment. Particle size and oxygen solubility of FC-43 are the major factors effective in oxygen transport in ischemic tissues.
Authors: Nematbakhsh M, Rahimi F, Rajabi P, Moradi I, Samarian H, Kabiri P, Jaafari MR.
Source: Research in Medical Sciences. 2000; 5: 35-41.
A THREE YEAR SURVEY OF MACULAR AMYLOIDOSIS IN THE DERMATOLOGICAL CLINICS OF ISFAHAN
Macular amyloidosis is a relatively rare disease. Basic changes appear to be amyloid material deposition in an apparently normal skin. The characteristic feature of the disease is a reticulate and ripple brown pigmentation in the interscapular regions, shoulder, back and chest. There are several reports indicating the association of the disease with rubbing against the skin.
Due to the high prevalence of the disease in our country especially among women and considering its devastating effects, such as disfigurement for women, we decided to perform the following study.
This analytical descriptive study was performed on 28 patients suffering from macular amyloidosis diagnosed by clinical and laboratory findings. The study was performed from October 1995 to October 1998 in the dermatological clinics of Isfahan University of Medical Sciences.
Twenty one females and 7 males with an age range of 15-50 years participated in this study. Positive family history was apparent in 43% of the patients. Clinically, the lesions composed of reticulate and rippled pigmentation and were frequently observed in the interscapular region, the upper arms and shoulders. The most common association in these patients was seborrhaeic dermatitis of the scalp and the face. In our sample, most patients mentioned the use of a nylon brush during bathing and a few relieved their itching with a nylon comb or brush.
The results showed that the female to male ratio was three to one which is in accordance with the higher incidence of disease among women in recent reports. The age range of the patients was between 15-34 years. A direct relationship was found to exist between the use of nylon brush or comb during bathing and exacerbation of disease. The traditional habit of using nylon objects during bathing might explain the high prevalence of this disorder in our community.
Authors: Asilian A, Hajheydary Z
Source: Iranian Journal of Dermatology. 1999; 2: 5.
THE IMPACT OF STRESS ON EXPRESSION AND SEVERITY OF PSORIASIS
To date no studies have been conducted in our country to determine the effects of psychogenic factors on psoriasis. It seems worthy to evaluate the triggering factors of disease in order to lengthen the remission period and decrease the costs and complications. This study was therefore performed to identify the relationship between stress and the expression and severity of skin lesions.
This prospective case-control study was performed on 95 subjects aged above 18 years in Razi Hospital by simple random sampling. The case group was selected from psoriatic patients and the control group from non-psoriatic patients in whom stress does not have any effect on their disease. The two groups were matched for age and sex. Stress was assessed by Holmes and Rahe protocol with some modifications approved by a psychiatrist. Severity of skin lesions in psoriatic patients was also assessed by the PASI score. Data analysis was performed by t-test, multiple logistic regression and correlation of Spearman using SPSS (6) software. The mean severity of stress was higher in than the in positive group control group (p=0.021). On the other hand, there was a relationship between stress and psoriasis expression; but there was no statistically significant correlation between severity of stress and severity of skin lesions in psoriatic patients (p=0.268).
With regard to the effect of stress on the expression of psoriasis, it is suggested to use psychological methods in addition to routine treatment: In this way it is possible to reduce emotional stress and shorten the course of this disease.
Authors: Ebn-e-Ahmadi E, Sooudi P, Dowlati Y
Source: Iranian Journal of Dermatology.1999; 2: 4.