School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 17 1 1993 3 1 Comparison of Seven Days Antibiotic Therapy with Conventional Treatments of Bacterial Meningitis 1 8 OTHER Saeed Shafeeyi Khoeeyi Tabriz University of Medical Sciences,Iran. The sequelae of acute bacterial meningitis in children who were treated with ampicillin or chloramphenicol for seven days during the period khordad 1366 to Ordibehesht 1369 were assessed prospectively. 165 patients (85 boys and 80 girls) ranged in age from five days to 12 years (mean 31.5 months) were studied. Haemophilus influenza type B was isolated in 65 % , Streptococcus pneumoniae in 25% and Neisseria meningitidis in 10%. The mortality rate was 7.3%. No relapses occurred. 50 survivors had Neurologic-Psychometric Audiologic, and Ophthalmologic assessments performed for minimum of 1 year following their illness. Forthy children (80%) had no detectable sequelae; 20% had mild to severe handicaps. The frequency of sequelae was greatest among children with S. pneumonia meningitis (60%) and none among children with N. meningitidis. Complications included: Sensorineural hearing loss (14%), developmental delay (5.3%), speech defect (4.5%), motor defect (3%), hydrocephalus (1. 7 % ) , and seizure disorder (2 % ) . The frequency of observed sequelae among these patients is similar to that previously reported in children treated for ten to 14 days. Our finding indicate that seven days of intravenous antibiotic therapy is adequate for the treatment of bacterial meningitis in children.

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 17 1 1993 3 1 ‌‌Clinico Paraclinical Analysis in 544 Patients with Lumbar Disc Herniation and Their Results 9 16 OTHER Mahmood Tabatabayie Shaheed Beheshti University of Medical Sciences,Iran.‏ Mostafa Mohseni Shaheed Beheshti University of Medical Sciences,Iran.‏ SUMMARY Between 1358 to 1371, 32711 patients were visited in the private chinic of first author. Among them, 7935 patients (24 percent) have had low back and I or sciatica. 93 percent of patients in the last group responded to conservative treatment, but 544 cases who resisted to medical treatment were operated. Existing data in their files were analysed. The most common symptom was pain (99, 6 percent) and the most common findings were a positive " Stright leg rising test " (75 percent) and motor deficit (52 percent). Seven percent of cases were complicated, that the most common complication was superficial wound discharge (4 percent). RESULT Patients were followed up for a mean time of 10 months. In 75 percent the outcome were "Excellent", In 19 percent were "good", in 3, 4 percent were "fair" and in 2.2 percent were "poor".It seems that selection of patients and avoidance of complication are the most important in obtaining a satisfactory.

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 17 1 1993 3 1 The Concentration of Thyroid Hormones, Cortisol and ACTH Exposed to Chemical Weapons 17 22 OTHER Fereydon Azizi Shaheed Beheshti University of Medical Sciences,Iran. Masoud Amini Shaheed Beheshti University of Medical Sciences,Iran. Parvin Arbab Shaheed Beheshti University of Medical Sciences,Iran.   ABSTRACT In order to evaluate time course of changes in serum concentration of thyroid hormones, cortisol and ACTH in patients exposed to chemical weapons containing sulfur mustard, we measured serum concentrations of hormones on the first, third and fifth week following injury in 13 soldiers and compared them to the results obtained from 34 control men. Free T4 and T3 indices were decreased and rT3, cortisol and ACTH were increased in the first wek following exposure. There was subnormal TSH response to TRH in 2 of 3 men tested. Except for an increase in FT 41 and decrease in TSH by the third week, and steady decline in serum cortisol. Serum concentrations of hormone were unchanged until the fifth week after injury. The decline in serum cortisol occurred despite a constant increase in serum ACTH. By the fifth week only 1 of 13 men bad serum cortisol levels > 10µg/dl. We conclude that exposure to chemical warfare containing sulfur mustard results in alterations in serum concentrations of thyroid and adrenal hormones and ACTH, resembling changes seem in bum trauma. Some evidence of direct effects of mustard on endocrine glands exist.

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 17 1 1993 3 1 Relationship between Birth Interval with the Nutritional Status of Children 23 30 OTHER Mino Dokht Froozani School or Public Health, Medical Sciences University or Tehran,Iran.‏ Kazem Mohammad School or Public Health, Medical Sciences University or Tehran,Iran.‏ Fariba Kohdani School or Public Health, Medical Sciences University or Tehran,Iran.‏ Korosh Holakoie Naini School or Public Health, Medical Sciences University or Tehran,Iran.‏ ‏ SUMMARY The purpose of the present investigation was to study the relationship between the birth interval and the anthropometrical measurments of children aged 0-60 months in Bandar Abbas Suburbs. In order to remove the confounding effect of variables on the relationship between Birth interval and Nutritional status, some other variables also have been investigated. For this purpose, thirty clusters were selected at random and in each village fifteen to twenty children were randomly selected. Data was collected by interview and anthropometric measurement,[including weight (Wt) and height (Ht) were performed on 426 children (236 boys and 190 girls).) Data was analysed by the stepwise regression method. According to these results, it can be concluded that the short birth interval is one of the effective factors in ·the etiology of malnutrition (Wt for age, P=0.0014 and Ht for age, P=0.0095) in the children of this community. Also, number of death children was an effective factor in the etiology of chronic malnutrition, Ht for age (P=0.0001) and the increment of child's age was an effective factor in the accute malnutrition, Wt for Ht, (P=0.0024).

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 17 1 1993 3 1 Thyroid and Thyrotropin Hormone Concentrations in Healthy Women during Ramadan 31 35 OTHER Mah Talaat Nafar Abadi Masoud Amini Fereydoun Azizi This article has no abstract.

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 17 1 1993 3 1 ‌The Results of the Effects of Metoclopramide on Some Gastrointestinal Disorders 36 41 OTHER Khosro Nourbakhsb Department of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. The purpose of this study was to investipte the effects of metoclopramide on some gastrointestinal disorders. The author reports the results of a longitudinal study (since 1979 for 10 yrs) on 3700 patients with gastroesophageal reflux, heartburn, gastric peptic ulcer, gastritis, duodenitis, duodenal peptic ulcer and constipation due to decreas.ing intestinal peristaltism. The patients were 14-70 years old, of which 1550 were male and the remainders were female. Of 3700 patients, 2300 (62 % ) had reflux esopbagitis and heartburn 400 (12 % ) diagnosed as gastric ulcer, 600 (14 % ) suffered from constipation and 400 (12%) had duodenitis and duodenal peptic ulcer. Percentages of recovery were found as 75%, 45%, 85%, 70% in the above groups, respectively. The findings of this study have confirmed the results of other similar research works that have concludes the positive effects of metoclopramide in such patients.

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 17 1 1993 3 1 Iatrogenic Cushing's Syndrome Due to Cutaneous Corticosteroid Therapy 42 46 OTHER Hossein Assadian Associate prof. of Medicine, Shaheed Beheshti University of Medical Sciences,Iran. Summary A case of Cushing' s syndrome associated with application of topical clobetasol propionate (0.05%) is reported. Local application of clobetasol propionate is associated with adrenal suppression in normal subjects and on this basis, it has been recommended that less than 50 g per week be used. There have been sporadic case reports of cushing's syndrome associated with topical steroid but in all cases the amount applied was greater than 100 g per week, which would be considered excessive by present day guidelines. We report a well-documented example of this rare complication of the use of topical corticosteroid.

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 17 1 1993 3 1 Etiology of Anorectal Abscess 47 49 OTHER Iran pour Bustani Shaheed Bebeshti University of Medical Sciences,Iran. Korosh Kojouri Shaheed Bebeshti University of Medical Sciences,Iran. Summary Abscess formation in the anorectal region is a relatively common occurrence and contributes to a fair number of emergency surgical operations. In this paper the etiology of anorectal abscess is reviewed and an interesting case is presented. In about 20% of cases there many be obvious local cause such as infected fissure, thrombosed pile, trauma following local injection therapy, etc. In the majority of patients, i.e. about 80% no obvious cause is detected. It is widely accepted that in these cases the abscess originates from anal cryptitis and infection of anal glands which leads to the formation of an intersphincterlc abscess. From here the pus may travel and from abscess at different sites. A few may be associated with accompanying disease such as ulcerative colitis, tuberculosis, Crohn's disease, aids, septicemis, etc. An interesting case is described where a thin, sharp fish bone had penetrated the anorectal wall and got impacted in the perianal space and formed an abscess around it. It is stressed that on incising a perianal abscess the cavity should be palpated carefully for the presence of such foreign body. Their removal speeds up postoperative recovery.

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 17 1 1993 3 1 Embolization in Vertebral Hemangioma; the First Experience in Iran 50 56 OTHER Rahbar Shaheed Bebesbti University of Medical Sciences,Iran. SUMMARY Vertebral hemangiomas are very common abnormalities involving human spinal column. Two different kinds of these lesions, symptomatic and asymptomatic hemangiomas are noted in the spine. The asymptomatic ones are found incidentally in spinal imaging investigations and don not need any theraputic action. The symptomatic hemangiomas, which are not as usual as former one but, causes significant morbidities for the patient. Surgical removal and packing the hemangioma is a well established curative procedure for these hemangiomas, embolization has proved to assist the surgeon for complete removal of tumor. The amount of bleeding, duration of surgery and final improvement of symptoms are significantly affected by embolization. First experience of vertebral embolization in 3 patients have been discussed in this article.

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 17 1 1993 3 1 57 62 OTHER

School of Medicine, Shahid Beheshti University of Medical Sciences Research in Medicine 1735-5311 17 1 1993 3 1 Malignant Small Round Cell Tumor Originating In The Thoracopulmonary Region " Askin Tumor " 63 68 OTHER Farzaneh Jadali Shaheed Beheshti University of Medical Sciences,Iran. Rokhsareh Yadegar Shaheed Beheshti University of Medical Sciences,Iran. SUMMARY Askin tumor is a peripheral neuroepithelioma originating in chest wall. It is a very aggressive tumor and with Ewing's sarcoma are the most frequent tumors of chest wall. The tumor is composed of small round or ovoid cells arranged in sheets with pseudorossette formation. Some times around vessels, glycogen staining is some times positive in H & E but always positive in E.M. In E.M because of presence of neurosecretory granules and intermediate (Neuro) filaments they are supposed to have neuronal or1gm. On immunohistochemistry almost all of them are NSE+ and all neuronal antigens save for cbromogranine are variously positive in the cells. Genetically the cells have t(l l ,22) and in oncologic study they express the C.myc gene. They are very aggressive clinically and the survival for them is about 8 months after diagnosis the treatment is the same as Ewing's sarcoma.