fa
jalali
1371
1
1
gregorian
1992
4
1
1
1
online
1
fulltext
fa
بررسی هیرسوتیسم در 107 بیمار
هیرسوتیسم در بسیاری از موارد یک مشکل زیبائی در خانمها بوده ولی در مواردی نیز بدنبال اختلالات هورمونی ناشی از یکسری مسائل هورمونی همانند بدکاری تخمدانها، غدد فوق کلیوی ، عوامل هیپوفیزی و یا مصرف داروها بوجود میآید . ضمن اینکه میتواند با مشکلات جدیتری همچون نازائی و یا بدخیمیهای غدد فوق نیز همراه باشد . لذا در برخورد با اینگونه بیماران به دو نکته اساسی فوق یعنی بیماری یابی و نیز رفع حالت ناخوشایند آن از نظر زیبایی که میتواند در سرنوشت خانمهای جوان موثر باشد توجه نمود . در برخورد با این بیماران توجه به وجود حالت مشابه در بستگان درجه ۱ ، وضعیت جثه (Body mass index ) ، شدت و انتشار پر موئی و وجود الوپسی و یا نازائی و سابقه مصرف دارو و همراهی آن با امراض غددی دیگر اهمیت پیدا میکند و در کاوشهای پاراکلینیک اندازهگیری تستوسترون سرم، پرولاکتین ، کورتیزول ، DHEA - S04 ونیز سونوگرافی جهت وجود کیستهای تخمدان اهمیت پیدا میکند • البته در اغلب موارد علت خاصی برای آن پیدا نشده و مساله فوق میتواند مشکل ارثی و نژادی باشد که جهت درمان موارد اخیر اپیلاسیون موها توصیه میشود . تعریف : رشد موهای زبر با حالت مردانه را در خانمها به طور کلی یا نسبی هیرسوتیسم مینامند . این تغییرات وابسته به آندروژن بوده که نه فقط وابسته به تخمدان است بلکه تحت تاثیر عوامل سن ، دیانسفال ، غده هیپوفیز و غده فوق کلیه نیز قرار دارد (۱)
SUMMARY
Investigation of Hirsutism in 107 Patients
Dr. Mir Hadi Aziz Jalali. Department of Dermatology, Razi Hospital Gilan University of Medical Sciences.
Today hirsutism is one of the problems of pateints referring to dermatologic & Endocrinologic clinics.
In 107 hirsute women the following indexes were investigated : age, marital status, menstruation rate of fertility , weight , similar problems in first grade relatives , distribution of hirstism (face , chin, chest ), alopecia , history of using drugs such as hormones psychotrops habit of smoking, coincident diseases, meosurement of serum testosteron, prolactin , cortisol and dehydroepiandrosteronedione levels and in suspicious cases sonography of ovaries is porfor meal.
From statistical analysis, Age distribution in 93% were between 15 - 35, mensaruttion irregularity 33% and unmarried cases 67% and from 33% married hirsutes , 70% had children, 19% were obese and in 57% similar problem could be seen in first grade relatives of patients.
Distribution of hirsutism was 46% in chin 13% in mandible and chin 21% in facial region .and 20% in chest and facial area .Alopecia in 10% could be considered coincidently , in 13% of cases history of using drugs such as hormones ( medroxyprogestron , Clomiphene , thyroid extract), and psychotrops ( chlordiazepoxide , diazepam , Amitriptyline, Trifluperazine, phenytoin and phenobarbital ) were positive. Only 10% of patients were smoker , in 14% of cases history of other diseases such as goiter , renal calculus , urinary tract infection peptic ulcer, could be found.
Also 4 cases of these hirsutes were suffering of infertility and in 5 cases ovarian cysts thickening of its surfaces detected from laboratory tests. Increasing of testosterone (21%) , prolactin (22%) cortisol(9%), and D.H.E.A (9%) were considered. No hormonal abnor mality were detected in 43 of 107 cases in our study.
1
10
http://journal.gums.ac.ir/browse.php?a_code=A-10-1-464&slc_lang=fa&sid=1
2019/04/22
1398/2/2
2019/04/22
1398/2/2
دکتر میر هادی
عزیز جلالی
Yes
استادیار بخش پوست- دانشگاه علوم پزشکی گیلان- بیمارستان رازی رشت
fa
بیماری شیهان گزارش هفده مورد از رشت
در یک دوره هشت ساله ، ۱۳۵۹ - ۱۳۶۶ ، در جریان طبابت در شهر رشت هفده مورد بیماری شیهان مشاهده شده سن آنان در هنگام زایمان توام با شوک خونریز ۷± ۳۰ میانگین ± ۱ انحراف معیار )سال و در هنگام مراجعه 10±41 سال است .ضعف عمومی ، رنگ پریدگی وآمنوره سه علت شایع مراجعه این بیماران است . نه نفرتوسط همکاران دیگر با تشخیص بیماری شیهان (۴نفر ) هیپوتیروئیدی (۳ نفر) ، هیپوگلیسمی (۱ نفر )، و اغماء (۱ نفر) معرفی شده بودند، در معاینه همه بیماران تقریبا" تمام تظاهرات کم کاری همه جانبه هیپوفیز را داشتند . سطح 144 سرم مساوی ۱/۳±۲ (میانگین±1 انحراف معیار، حدود طبیعی(۴-۱۲) mcg / dl ، سطح TSH سرم 7/1± ۲ (میانگین± ۱انحراف معیار ، حدود طبیعی تا۵)u/mlµ و سطح کورتیزول پلاسما 7/2 - 5/3 (میانگین ± 1 انحراف معیار ، حدود طبیعی ۹ - ۲۴ ) dl / mcg بود.
پس از دو هفته درمان مقدماتی با حدود ۳۰ میلیگرم پردنیزولون در روز ، درمان با دوز کم لووتیروکسین سدیم، ۲۵ تا ۵۰ میلیگرم در روز شروع شد و به تدریج هر ۴-6 هفته دوز آن به مقدار ۲۵ میکروگرم در روز افزایش یافت تا به دوز جانشینی حدود 8/1 میکروگرم به ازاء هر کیلوگرم وزن بدن در روز رسید و در همین مدت دوز پردنیزولون هم به تدریج کاهش یافت تا به دوز جانشینی ۵ تا 5/7 میلیگرم در روز رسید . برای ایجاد قاعدگی و تامین استروژن لازم از مواد استروژنی توام با پروژستوژن استفاده میشود .
SUMMARY
During eight years, 1359-1366, seventeen cases with Sheehan's disease was seen. The age of the patients at the time of postpartum hemorrhagic shock was 30±7( mean± 1 SD ) years and at admission was 41 ± 10 ( mean ± 1 SD) years . weakness , palor, and Amenorrhe a was the three most common presenting complaints . Nine patients was referred with the diagnosis of Sheehan's disease (4 cases), hypothyroidism ( 3 cases ), hypoglycemia ( 1 cases), and coma ( 1 cases ).
Clinially all of the patients had almost all the symptoms and signs of panhypopituitarism. Serum T4 was 2 ± 1.3 ( mean - 1 SD , normal range 4 - 12) mcg/dl , Serum TSH was 2 ±1.7 (mean ± 1 SD , normal range up to 5)/µ/ml, plasma cortisol was 3.5 ± 2.7 , normal range 4 - 24 ) mcg/dl.
After two weeks treatment with about 30 mg prednesolone per day treatment with levothyraxine was begun ; first with 25to 50 mcg daily , The 25 mcg increment perday every 4 to 6 weeks , till The replacement dose of about 1.8 mcg/kg/dug was achieved . Mean while the dose of prednesolone was tapered down to 5 to 7.5 mg a day. For replacement of estrogen and inducing menstural cycles, combiened estrogen and progestogen therapy can be instituted.
11
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http://journal.gums.ac.ir/browse.php?a_code=A-10-1-364&slc_lang=fa&sid=1
2019/04/222019/04/9
1398/1/20
2019/04/222019/04/9
1398/1/20
دکتر محمد حسن
هدایتی امامی
Yes
استادیار داخلی - دانشگاه علوم پزشکی گیلان- بیمارستان دکترحشمت رشت
دکتر عباس
قنبری
No
استادیار داخلی - دانشگاه علوم پزشکی گیلان- بیمارستان دکترحشمت رشت
fa
لوسمی میلوئید مزمن در کودکان و گزارش یک مورد
SUMMARY
Chronic Myeloid Leukemia In Children And a Case – Report Dr. Roya Ejte mai , Assistant.
professor, Gilan University of medical Sciences, Rasht .
The case is a ten-years - old boy. During examinations for massive splenomegaly, his disease has been diagnosed chronic Myelogenous leukemia (CML), and also philadelphia chromosome was revealed during chromosomal analysis.
The patient was treated with chemotherapy • laboratory and clinical signs showed improving conditions within 2 or 3 months , but due to recurrence of symptoms, a bone-marrow transplant ation has been intended for him.
Chronic myeloid leukemia constitutes less than 5% in children. It includes two major types which are :
1/ Adult type
2/ Juvenile type
Its conventional or adult type is considered a panm yelopathy which involves all of the he mic (and at least some kinds of lymphocytes) lineages.
This disease is characterized by following cases :: 1.Expansion of the total body granulocyte pool ; 2. Myeloid hyperplasia in the bone marrow; 3.Extramedullary hematopoiesis ; 4.Special cytogenic marker or philadelphia (PH') chromosome .
Maximum incidence in children is at the age of 10 - 20. this disease has 3 phases.
Median survival in C.M.L from diagnosis is usually 3 to 4 years.
The goal of treatment in chronic phase is amelioration of leukocytosis and organomegaly. True remission is rare. The goal in the second and thire phase is reversion to chronic phase.
Drugs used are usually Busulfan and Hudroxyurea . Treatments such as splenic irradiation or splenectomy provide mostly a temporary relief, and are applied to prepare the patients for bone marrow transplantation
In general, when patients are in the first chronic phase , a bone marrow transplantation often leads to success. The more progressive the phases, the less the chance will be.
However, the extent of experience in children has been little. Therefore, there is a need for more investigation and reseach.
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http://journal.gums.ac.ir/browse.php?a_code=A-10-1-365&slc_lang=fa&sid=1
2019/04/222019/04/92019/04/9
1398/1/20
2019/04/222019/04/92019/04/9
1398/1/20
دکتر رویا
اجتماعی
Yes
استادیار اطفال-- دانشگاه علوم پزشکی گیلان- بیمارستان هفده شهریور
fa
دردهای جلوی قلبی در اثر بیماریهای احشاء همراه با تغییرات (E.K.G) WEDDESKY PHENOMENON گزارش شش مورد
در این بررسی شش مورد دردهای جلوی قلبی در اثر بیماریهای احشاء از جمله: سنگ کیسه صفرا، کله سیستیت حاد و مزمن، پانکراتیت حاد و مزمن و زخم اثنی عشر فنومن ویدنسکی) ارائه شده است. شش بیماری که مورد مطالعه قرار گرفته اند چهار مورد مرد ( دو مورد مبتلا به کیسه صفرا، یک مورد مبتلا به سنگ کیسه صفرا ) همراه با زخم اثنی عشر و یک مورد مبتلا به زخم اثنی عشر و دو مورد زن ( هر دو مبتلا به سنگ کیسه صفرا ) بوده اند. در این زمینه بیماران بدون اینکه مبتلا به بیماری کرونری قلب باشند، در حین درد تغییرات T-ST در الکتروکاردیوگرافی داشته اند. مدت درد در این بیماران ایجاد دردهای جلوی قلبی در اثر بیماریهای غیر قلب طولانی بوده و بیش از نیم ساعت طول کشیده، و به داروهایی چون نیتروگلیسیرین زیرزبانی و کلسیم بلوکر جواب مناسبی نداده اند. پس از درمان با عمل جراحی ( سنگ کیسه صفرا ) یا درمان های متداول ( زخم اثنی عشر)، بیمار از درد جلوی قلبی شکایت نداشته و تا ماهها بعد از درمان تغییرات EKG مشاهده نشده است .
SUMMARY
REPORT OF 6 CASES WITH ELECTROCARDIOGRAPHIC ST- T CHANGES DURING CHES PAIN INDUCED BY UPPER ABDOMINAL DISORDERS.
DR. AUNOSI BAR/ICAR ; CHIEF CARDIOLOGIST GIULAN UNIVERSITY OF MEDICAL SCIENCES RASHT. IRAN
6 Cases of precordial pain caused by upper Abdominal Problems including gall stones, Acute cholecystitis , Acute pancreatitiy and Duodenal ulcer are being reported in this article.
4 males ( Two with cholecystitis , one with gall stonest Duodenal ulcer and one case with Duodenal ulcer alone ) and two female patients of cholelithiasis with chronic
cholecystitis are included in this Case report .
All these Patients had sT - T changes in their Electrocardiogram during chest pain, while coronary Artery disease was excluided later on. In these cases chest Pain was prolouged more than half an hour without any response to Nitrate or Calcium Bloeker.
After treatment of Duodenal ulcer or after Gall bladder Surgery ST - T Pattern of their EKG became normal and the Patients are sympton tree without any Chest Pain for a long time.
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http://journal.gums.ac.ir/browse.php?a_code=A-10-1-366&slc_lang=fa&sid=1
2019/04/222019/04/92019/04/92019/04/9
1398/1/20
2019/04/222019/04/92019/04/92019/04/9
1398/1/20
دکتر انوش
برزیگر
Yes
استادیار بیماریهای قلب و عروق- دانشگاه علوم پزشکی گیلان- بیمارستان دکترحشمت رشت
fa
عوارض قلبی عروقی قرصهای ضد بارداری خوراکی
SUMMARY
Cardiovascular complication of oral contraceptives Mohammad Reza Afraz M.D. cardiologist Assistant professor, Gilan university of medical sciences, Rasht.
Soon after the introduction of oral contraceptive agents in 1960, the potential risks of cardiovascular disease became apparent. Most investigators agree that there is an increased incidence of hypertension, myocardial infarction, cerebrovascular accidents, and thromboem bolic disease in users of oral contraceptives. The use of oral contraceptive agents not only increases these risks but also in the presence of other risk factors multiplies the chances of certain cardiovascular complications .
The relative risk of thrombophlebitis or pulmonary embolism in oral contraceptive users is 2 to 11 times that of nonusers, representing a significant morbidity rate but rare death . this effect is thought to result from an increase in coagulability and antisteroid hormone antibodies caused by these agents.
Myocardial infarctions are extremely rare events in women ingesting oral contraceptives and are usually limited to women over the age of 35 years who smoke or Women who are hypertensive, diabetic, or have a history of toxemia have a higher rate of myocardial infarction."
The cause of myocardial infarction in oral contraceptive users is thrombotic and not atherosclerotic.
The risk of stroke is also strongly affected by the presence of other factors. Factors which increase the chances of this complication include hypertension, smoking, migraine headaches, hypercholesterolemia, and possibly mitral valve prolapse.
The majority of users will have a mild elevation, and 5 percent will have significant rise in blood pressure, representing an incidence 2 to 3 times that of nonusers. In most cases the hypertension is mild to moderate and reversible after discontinuing . A few instances of malignant hypertension have been reported. The effects of these agents on the renin angiotensin system and sodium metabolism are possible mechanisms of the hypertension.
Despite the increased risk of vascular disease, a normal young woman who uses oral contraceptives is at a very small risk of thromboembolism, stroke, myocardial infarction or arterial hypertension. In general , the cardiovascular effects of the oral contrac
eptives might possibly be minimized by advising women to consider alternative methods of contraception if ( 1 ) they have had previous thromboembolic disorders (phlebitis, pulmonary embolism, stroke, or myocardial infarction); (2) they show preminent risk factors for thromboembolic disorders including severe varicose veins, heavy cigarette smoking, blood dyscrasias, hypertension, and possibly diabetes mellitus ; and (3) they are 35 years of age or older and are cigarette smokers who choose not to stop smoking.
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http://journal.gums.ac.ir/browse.php?a_code=A-10-1-367&slc_lang=fa&sid=1
2019/04/222019/04/92019/04/92019/04/92019/04/9
1398/1/20
2019/04/222019/04/92019/04/92019/04/92019/04/9
1398/1/20
دکتر محمد رضا
افراز
Yes
استادیار قلب و عروق- دانشگاه علوم پزشکی گیلان- بیمارستان دکترحشمت رشت
fa
اپوئیدها(Opioids) و دستگاه گوارش
SUMMARY
The term opioid was coined to refer in a generic sense to all drugs, natural and synthetic, with morphin - like actions. Three distinct families of peptides have been identified so far in gastrointestinal (GI) nervous system in mammalian.
These peptides include : dynorphin, Met - enkephalin and leu - enkephalin .
Results from studies about opioid which have been started 15 years ago , depend on species , dosages, route of administration and laboratory techniques. Nerve fibers are observed in different parts of GI tract by antiopioid antibody , radioimmunoassay and immunocytochemistry.
The myentric plexus, mucosa , submucosa, circular and longitudinal smooth muscle and perivertebral ganglion of sympathics are innervated by dymorphin and enkephalinergic fibers .
Effect of endogenous opioid are accomplished by special receptors that 8 types of them are known so far. Mu - 1 µ_1) and delta (δ) receptors are preferentially responsible for the effects of opioid in human GI tract. physiological and pharmacological properties of endogenous opioid in different parts of GI tract such as motility and secretion are
hotels Bed dionicced in this article about.
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60
http://journal.gums.ac.ir/browse.php?a_code=A-10-1-368&slc_lang=fa&sid=1
2019/04/222019/04/92019/04/92019/04/92019/04/92019/04/9
1398/1/20
2019/04/222019/04/92019/04/92019/04/92019/04/92019/04/9
1398/1/20
دکتر عبدالرسول
سبحانی
Yes
استادیار فارماکولوژی- دانشگاه علوم پزشکی گیلان- دانشکده پزشکی- گروه فارماکولوژی
fa
جذام بیماری قرنها
SUMMARY
The object of this article is to review the main subject of leprosy.
According to our knowledge at least in more than 12 Iranian provinnces, leprosy is endemic.
Clinical epidemiology feature some aspect of imunology and new theraputical procedure have been discused in this reviw.
61
73
http://journal.gums.ac.ir/browse.php?a_code=A-10-1-369&slc_lang=fa&sid=1
2019/04/222019/04/92019/04/92019/04/92019/04/92019/04/92019/04/9
1398/1/20
2019/04/222019/04/92019/04/92019/04/92019/04/92019/04/92019/04/9
1398/1/20
دکتر جواد
گلچای
Yes
استادیار پوست- دانشگاه علوم پزشکی گیلان- بیمارستان رازی رشت