Medical Journal of The Islamic Republic of Iran (MJIRI)

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Six patients with mitral stenosis complicated by renal artery embolism studied prospectively are presented. In five patients there was unilateral and in one patient bilateral renal artery involvement. The diagnosis was confirmed by intravenous pyelography, retrograde pyelography, renal angiography, renal scan or a combination of these. All had atrial fibrillation, proteinuria and elevated LDH levels. Two had developed hypertension at the initial presentation. All patients were treated with anticoagulants and other supportive measures. One developed reversible acute renal failure and the others had an uneventful hospital course. Subsequent IV.P. and scans revealed nonfunctioning shrunken kidney in just one patient with complete obstruction of the main renal artery. We conclude that anticoagulation is an adequate substitute to embolectomy. The main role of surgery is in occasional patients who remain anuric despite medical therapy and in those whose angiography reveals complete occlusion of the main renal artcry.

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Written around 990 A.D., Hidayat-MllIaallemill Fit Tibb (Student's Guide ill Medicine) is the oldest general medical text known to have been written in modern Persian. Little is known of the author other than the fact that he was apparently a well experienced practicing physician by the name of Abu Bah Rabi' bin Ahmad al-Akhawaini from Bukhara who claimed to bea second generation student of Razi. The neuropsychiatric sections of the book are of particular interest because the author apparently had a personal interest in and reputation for treating the insane. According to one of the manuscripts he was known as the "Physician of the Insane" by his contemporaries. Following the line of other Islamic medical writers, the author has described the major neuropsychiatric disorders in the chapter dealing with the "Diseases of the Head and Brain". These include Melancholia, Mania, Epilepsy, Phrenitis, Lethargy, and Delerium. Hysteria is, however, described among the diseases of the female reproductive system. Both the terminology used and the authorities quoted betray the author's schooling in and devotion to the Graeco-Roman medical traditions adopted by early Islamic medical writers. He emerges as a hard-headed organic physician dedicated to the humoral doctrines of mental illness.

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Sulphur mustard (SM) is an alkylating agent that was first used as a chemical warfare agent during the First World War in 1917. SM is readily absorbed from the skin, respiratory and gastrointestinal tract and is distributed to several organs. SM may act rapidly and persistently upon DNA replicating mechanism of the individual cells during mitosis particularly in the hematopoietic system. Of 233 patients with SM poisoning, hematological investigations were performed in 213 of them. Mild changes were observed in red blood cells and its indices. Initial leukocytosis (> llxl09/L) was observed in 7.2% and leucopenia (‹4x 109/L) in 3.8% of the patients. Marked lymphopenia, neutrocytosis and eosinopenia (‹2%) were found in 36%,38%, and 25% of the patients, respectively. Bone marrow biopsy in 3 fatal cases revealed marked hypocellularity and dyserythropoietic changes. Apart from the respiratory complications, mortality from SM poisoning is mainly due to bone marrow failure.

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Following an outbreak of fascioliasis in Anzali Harbor in 1988, 452 blood samples were collected using a multistage sampling method for hematological and serological studies. After determination of eosinophilia in the samples, antifasciolia antibodies in the sera were also determined using enzyme linked immuno sorbant assay (ELISA) and counter-current immuno electrophoresis (CCIE). 64.2% of the samples were collected from women and omitting the age effect and P<0.05, the rate of infection was 1.16 times more in women than in men as shown by hypereosinophilia and ELISA test results. Age distribution of seropositivity in both sexes with p<0.001 was statistically significant and the highest rate of seropositivity was seen among the below 20 age group in both sexes. The highest expected rate of seropositivity (24.12) was observed in location six (Taleghan area), but an average and more uniform distribution was seen in other locations. 50% of the samples using ELISA techniques and 34.95% using CCIE were positive indicating that point prevalence of the disease was in Anzali Harbor. It must be noted that all antibody positive samples showed hypereosinophilia as well and that ELISA technique was 52.6% more sensitive compared to CCIE. Of the 50% antibody positive cases, 13.7% had only IgG, 26.5% both IgG and IgM and 37.6% only IgM showing the chronic, subacute and acute condition of the disease respectively. The remaining 22% of the cases were IgA positive. In this investigation an incidence rate of 19% was obtained using ELISA technique which was indicative of a fasciolia epidemic in the region.

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During a 5-year experience with 32 adrenal tumors with different basic problems in the Department of Endocrinology , Taleghani Hospital, 25 were found pituitary dependent Cushing's syndrome, "Cushing's disease." The treatment of patients with Cushing's disease depends on the presence or absence of pituitary tumor. Ifno pituitary tumor is demonstrated, irradiation can be given to the pituitary gland and if a pituitary tumor is present, hypophysectomy is the treatment of choice. If pituitary ablation fails to relieve the symptoms of Cushing's syndrome, bilateral adrenalectomy is usually performed through the posterior approach. With regard to the poor results of radiation and hypophysectomy in Iran, these patients were referred directly for bilateral adrenalectomy to the Department of Surgery, Taleghani Hospital. The disease was predominatly seen in the young age group, females were more frequently affected than males and the common manifestation of hyperadrenocorticism were obesity, plethora, amenorrhea, and hirsutism. The diagnosis was made by a series of laboratory, roentgenographic, and C. T. scan studies. The surgical ablation of the target organs was usually performed by the posterior approach, and the pathologic results of operated patients were nodular hyperplasia and diffuse hyperplasia.

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Human T-ceil lymphotropic virus, type 1 (HTL V-I) is considered to be the causative agent of adult T-cell lymphoma/leukemia and spastic paralysis, and seems to be common in Khorasan Province. 300 blood samples from Mashhadi and 180 from Gonbadi blood donors were obtained (all samples from healthy subjects). Serological screening was done by passive particJe- agglutination test and confirmed by Western blot test. 10% of Mashhadi and 3.3% of Gonbadi residents were positive for HTLV-1 antibodies. Our findings suggest that Mashhad may be within a previouslyunrecognised endemic region for HTL V-I which may be a major health problem for Khorasan Province.

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This paper aims at briefly specifying an analytical approach for the understanding of diet and nutrition in Islam and its effects on the promotion of health within the society. The Qur'an and other Islamic literature on Hadiths (Traditions), Figh (Jurisprudence) and traditional medicine are studied. The specifications of the Islamic food, the significance of the use of a diet compatible with the nature of the human body, manners of fostering hygienic principles, and ways and means of improving nutrition in the society are duly elaborated. The study further verifies that Islam has an independent approach towards nutrition, which is based on social and economic justice. It also shows that people should have equal opportunities to acquire a sufficient and legitimate amount of food for subsistence. The study also concludes that the world oppressors are the ones who have brought about poverty and starvation to a large number of humans in the world. One of the most important responsibilities of Muslims and the Islamic States is to eradicate such an oppression.

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A better understanding of the mechanism of chromosomal aberration formation could be obtained by using DNA repair inhibitors. Immortalized normal human (MRC 5 SVI) and ataxia telangiectasia ( AT 5 BIV A ) fibroblastic cell lines were treated with adenosine arabinoside (ara-A) and cytosine arabinoside (ara-C), both potent inhibitors of DNA dsb repair, alone or in combination with x-rays at G2 or S-phase of the cell cycle. The length of G2-phase for both cell lines was determined by autoradiographic labeling to be about 4.5-5 h. A similar result was obtained by scoring of chromosomally damaged cells following treatment with ara-A or ara-C for various time intervals before fixation. The results obtained in this study show that in spite of many similarities between the action of ara-A and ara-C, e.g., inhibition of DNA synthesis cIastogenic effects at G2 and S-phase and also lack of synergism as a possible consequence of these similarities, ara-A was found to have a different effect on rejoining of x-ray induced DNA lesions than that of ara-C. Ara-A caused inhibition of chromatid deletion rejoining, interpreted as inhibition of rejoining of DNA dsb at all sampling times before fixation, whereas ara-C showed a synergistic effect on radiation-induced DNA lesions, resulting in an increased frequency of chromatid deletions. Thus there appears that these inhibitors have different modes of action on x-ray induced DNA lesions, which may suggest a peculiar and important difference in the nature of these two nucIeosides.

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