@article{ author = {Azadi, Mehdi and Kaviani, Saeed and Soleimani, Masood and Norouzinia, Mehrdad and Hajifathali, Abbas}, title = {Frequency of the most prevalent Thiopurine S-Methyl Trasferase alleles in referrals to Shariati Hospital in Tehran}, abstract ={Background: Patients with low or intermediate TPMT enzyme activity are at increased risk to develop severe hematopoietic toxicity after taking standard doses of thiopuring medications. The aim of this study was to determine the frequency of four allelic variants of the TPMT gene in an Iranian population. Methods: In this cross sectional study, samples were obtained from 127 Iranian volunteers in Shariati hospital and were analyzed using PCR-RFLP and Allele Specific PCR techniques to determine the presence of common TPMT Polymorphisms in this population. Results: Mutant TPMT alleles were found in 11.8% of subjects (15 out of 127). Nine had TPMT*2, 4 TPMT *3C and 2 TPMT*3A. Conclusions: Our data showed the necessity of TPMT polymorphisms assessment before administration of thiopurine drugs.}, Keywords = {TPMT, Polymorphism, pharmaco genetics, Iranian population }, volume = {12}, Number = {1}, pages = {1-7}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-166-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-166-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Saadati, Mojtaba and Barati, Babak and Shirazi, Mehdi}, title = {Detection of sea, sec and seq genes in Staphylococcus aureus nasal sampling acquiring from healthy carrier}, abstract ={Background: Various assays have been used to identify of enterotoxins produced by Staphylococcus aureus and because of antigenic similarities among enterotoxins, serological assay may not always be practical. The aim of this study was to detect of S. aureus enterotoxins (SEA, SEC and SEQ) genes by multiplex PCR assay. Methods: Of 150 strains obtained from nasal carriers, 95 S. aureus were confirmed by biochemical test. Multiplex PCR assay for the detection of genes encoding staphylococcal enterotoxins A, C and Q genes (sea, c and q) S. aureus was used. The nuc gene, which encodes thermonuclease was used as a target DNA to identify S. aureus.Results: DNA amplification fragments for the staphylococcal nuclease gene (nuc) was 397 bp, 552 bp for staphylococcal enterotoxin A gene (sea), 271 bp for staphylococcal enterotoxin C gene (sec) and 122 bp for staphylococcal enterotoxin Q gene (seq). S. epidermidis used as negative control and did not yield a PCR product. Among the 95 healthy human isolates from nasal carriage, forty one isolates (43/1%) were diagnosed as sea, sec or seq-positive. Twenty four (25/3%) isolates were sea gene, nine (9/5%) isolates were the sec gene and eight (8/4%) isolates were the seq gene and 54 (56/8%) of them were other se genes. Conclusion: Because Staphylococcus aureus was isolated in nasal healthy carrier, so the PCR assay could be useful in the routine direct detection of staphylococcal enterotoxin A, C and Q genes.}, Keywords = {Staphylococcus aureus - enterotoxin type A, enterotoxin type C, enterotoxin type Q, multiplex PCR}, volume = {12}, Number = {1}, pages = {8-16}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-167-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-167-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Mohammadzadehsedigh, Yashar and Rostaie, Mohammad hasan and Soleimanjahi, Hoorieh and Bakhtyari, Abbas}, title = {Development of a clone from established Bovine Kidney (BK) cell line and evaluation of its sensitivity to Parainfluenza type 3 and Herpes Simplex type 1 viruses.}, abstract ={Background: Application of continuous cell lines has got a special place in the virological researches. These cells are immortal and their chromosomes are aneuploid. Therefore, they can be passage without any limitation. The aim of this research was to choose the best way of producing clone of cells. Methods: in this study, Bovine Kidney (BK) cell line was used to be cloned through limiting dilution method in which Vero cells were used as feeder layer. Vero cells were first cultured in DMEM supplimented with 7% heat inactivated calf serum and after a monolayer were formed, their growth was arrested by Mitomycin C. The cloned cells after incubation were separated and cultured in a new flask. After several experiments different clones were obtained and cultured for further studies. Results: Karyotype of clone cells were determined and compared with original cells. It was shown that cloned cells were more homogenous in early passages and their karyotypes showed less variability than original ones. Cloned and original cells were inoculated with HSV-1 and Parainfluenza virus 3 in order to evaluate its biological abilities. Tissue culture of infectious dose 50 (TCID50) of each virus was calculated and it was shown that there was no significant different between the HSV-1 titers before and after cloning whereas the titer of the Parainfluenza virus 3 was significantly higher in the original cells. Conclusions: Cloned cells of BK showed more stable karyotype and were less sensitive to parainfluenza type-3 virus infection than original BK cells.}, Keywords = {cloning, BK cells, parainfluenza type3, Herpes Simplex Virus Type 1, karyotype}, volume = {12}, Number = {1}, pages = {17-23}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-168-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-168-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Fazeli, Mohammad sadegh and khajavi, Farrokh kamran and Jalali, Seyed Mehdi and Omranipour, Ramesh}, title = {Clinical and manometric findings before and after low anterior resection: patients with rectal cancer}, abstract ={Background: Low anterior rectal resection is an option for low rectal cancer. The aim of this study was to assess the clinical and manometric findings before and after low anterior resection in patients with rectal cancer. Methods: In a before-after prospective experimental study, 29 patients with colon cancer who were candidate for elective low anterior resection surgery in Imam Khomeini hospital were enrolled. In preoperative period, the data regarding the anorectal function were gathered and all the patients were assessed by an eight channel rectal manometer. After the surgery, patients were evaluated regarding current anorectal function and underwent rectal manometry for the second time. Results: The mean of defecation time was significantly higher in postoperative period compared with preoperative period (2.48±0.78 vs. 0.94±0.36 time per day). In postoperative period, gas incontinence was significantly higher in comparison to the preoperative period (27.59% vs. 0%). However, the fecal incontinence rates were comparable. Compared with preoperative period, max resting pressure was significantly reduced in postoperative period (53.20±17.45 vs. 64.32±17.33 mmHg). The same was true about max squeezing pressure (140.21±35.50 vs. 150.37±33.16 mmHg). Urgency also increased in postoperative period (48.28% vs. 0%). Conclusions: The results of this study revealed that following low anterior resection surgery for patients with rectal cancer, the defecation time, gas incontinence and urgency increase but max resting and squeezing pressure decrease.}, Keywords = {clinical findings, anorectal manometery, low anterior resection surgery, rectal cancer}, volume = {12}, Number = {1}, pages = {24-33}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-169-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-169-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Gharibi, Tayebeh and Ganjoo, Mahasty and Kamali, Farahnaz and Ahmadi, Shahnaz and Pouladi, Shahnaz and Vahedparast, Hakimeh and Motamed, Niloofar and Gharibi, Tahereh}, title = {Comparison of combined use of fluconazole and clotrimazole with the sequential dose of fluconazole in the treatment of recurrent Candida vaginitis}, abstract ={Background: fluconazole is one of the systemic anti-fungal agents and clotrimazole vaginal cream is a topical agent against Candida Albicans. In this study, comparison between of the two regimes (Fluconazole with and without vaginal clotrimazole) in recurrent Candida albicans was assessed .with that of sequential dose of fluconazole for the treatment of Candida vaginitis, this evaluation was done. Methods: A double blind randomized clinical trial was carried out on 80 married women (20-45 years old) having chronic vaginal Candidiasis. The patients were divided in to two groups (40 in each). The first groups received two doses of fluconazole at two different timing (Zero and 72 hours) along with clotrimazole vaginal cream 1% ( for 7 days ). The second group recived only two doses of fluconazole (Zero time and 72 hours later). Then the patients were examined at 2 and 6 weeks after the treatment. Results: The signs and symptoms of disease (itching, erythema, excoriation, edema and fissure) in both groups were significantly decreased after two weeks of the treatment (P = 0.00). The final examination of both groups also showed that the treatment was more effective in the first group compared to the second group. The difference was significant statistically (P<0.05). Conclusion: the data shows that adding topical clotrimazole in treatment of patients with recurrent Candida vaginitis Is more effective.}, Keywords = {fluconazole , clotrimazole , vaginitis, candidiasis}, volume = {12}, Number = {1}, pages = {34-39}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-170-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-170-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Niazi, Abbas ali and Sheikhzadeh, Abdolsamad and Danesh, Khalilollah and AlaviNaieni, Roya and Shahryar, Mosayeb and Narouie, Behz}, title = {Diagnostic value of pleural fluid adenosine deaminase activity in tuberculosis pleurisy}, abstract ={Background: Diagnosis of tuberculosis pleurisies is difficult because of its nonspecific clinical presentation and insufficient traditional diagnostic methods. We investigated the use of adenosine deaminase (ADA) activity in tuberculosis pleurisies. Methods: A number of 85 patients were analyzed with exudative pleural effusions. Using the ROC curve, we determined the optimal cutoff for TB pleurisy. Results: A number of 58 exudative samples were nontuberculous (non-TB) and 27 were tuberculosis (TB). There was statistically significant difference (p<0.0001) between the means of pleural fluid ADA levels among the TB and non-TB populations. The prevalence of TB pleurisy in the studied population was 31%. Using the cutoff point equal to 35 for diagnosing TB effusions the sensitivity and specificity 70.3% and 91.3%, respectively. The positive predictive value (PPV) was 79.1% and the negative predictive value (NPV) was 86.8%. A pleural fluid ADA value <19 IU/L suggests that a tuberculosis effusion is highly unlikely. Conclusion: Pleural fluid total ADA assay is a sensitive and specific test suitable for rapid diagnosis of TB pleurisy.}, Keywords = {adenosine deaminase, tuberculosis pleurisy, diagnostic value, exudative}, volume = {12}, Number = {1}, pages = {40-47}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-171-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-171-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Noohpisheh, Mohammad Kazem and Mohseni, Leil}, title = {Assessment of autologous serum skin test in chronic idiopathic urticaria}, abstract ={Background: In the vast majority of patients with chronic urticaria , the etiology is unknown. It has been noted that in one third of such patients it has an autoimmune base. Autologous serum skin test (ASST) is currently the best in vivo test for the detection of such patients. Our aim was to identify the prevalence of positive ASST among patients with chronic idiopathic urticaria (CIU) and to compare features of ASST + and ASST – groups. Methods: this study was done on 79 patients with CIU. Samples of 0.05ml of autologous serum and normal saline were separately injected intradermaly into the volar aspect of right and left forearm respectively. ASST Was deemed to be positive if a serum induced weal had a diameter bigger than a sailin induced response by < 1.5 mm was seen at 30min. Also we compare the clinical and laboratory parameters of ASST+ and ASST - groups.Results: Out of 79 patients with CIU, 39 patients (39%) had positive ASST and it was found that the frequency of attacks was higher in these patients (P=0.04). Conclusion: Significant percent of patients with CIU showed positive response to ASST which is most likely an autoimmune source for them. ASST can be used as a simple and cost - effective test for the detection of these patients, which has proven to be a therapeutic challenge to the treating physician.}, Keywords = {chronic idiopathic urticaria, chronic autoimmune urticaria, autologous serum skin test, chronic non autoimmune urticaria}, volume = {12}, Number = {1}, pages = {48-53}, publisher = {Bushehr University of Medical Sciences}, doi = {10.19082/2539}, url = {http://ismj.bpums.ac.ir/article-1-172-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-172-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Movahed, Ali and Obeidi, Narges and Khamisipour, Gholamrez}, title = {Prevalence of Hemoglobinopathies and their associations with different types of hemoglobin and mean cell volume in the preuniversity students of Bushehr, 2007}, abstract ={Background: Hemoglobinopathies such as thalassemia and sickle cell disease are common genetic disorders. The aim of this study was to determine the prevalence of hemoglobinopathies and their associations with HbA, HbA2, HbS and HbF in the preuniversity students of Bushehr. Methods: Overall, 498 blood samples was collected in EDTA tubes. Hematological parameters including RBCs, Hb, MCV and MCH were determined by automatic analyzer. Measurement of HbA1, HbF, HbA2 and S band were done using Cellulose acetate electrophoresis. Samples with MCV< 80 fl and/ or MCH< 27 pg and/ or HbA2> 3.5% or HbF> 2% were diagnosed as Beta-thalassemia. Samples with positive sickle cell prep and had S band were diagnosed as SCA trait. Samples with HbA2 normal and low MCV or MCH were diagnosed as Iron deficiency or alpha thalassemia. Results: In our study, 74 samples had MCV< 80 fl and also 14.9% of female and 12% male had MCH 0.05). There was significant relationship between RBCs and HbA2 (p< 0.05). Conclusion: Our study showed that the prevalence of hemoglobinopathies is 28.2% and therefore it suggests that health care authorities must take steps to reduce the complications.}, Keywords = {hemoglobinopathies, CBC index, iron deficiency, sickle cell anemia trait}, volume = {12}, Number = {1}, pages = {54-59}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-173-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-173-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Beheshty, Akram and Barikani, Ameneh}, title = {Assessment of life quality in high school students with acne disease in Ghazvin}, abstract ={Background: Dermatological disease affects quality of life in all ages specially children and adolescence. This study was aimed to determine quality of life in students with acne disease. Methods: Overall, 400 students of high school who had acne were selected. Data were gathered with two standardized acne quality of life questionnaire (CADI and CDLQI) analysis was used with chi-square and spear mans rho test. Results: The mean age of the students was 15.8 ± 1 and 48.4 % and 51.6% of them were male and female, respectively. 31.2% of responders had high level aggression and13.7% had problems in their social activities. In addition, 30.8 % said they had depression feeling because of acne. The relation between sex and QOL wasn’t significant. But the relation between parents’ education and QOL was significant, statistically (p=0.001). Conclusion: Acne can affect social, educational, recreational and psychological functions.}, Keywords = {acne, quality of life, students, exudative}, volume = {12}, Number = {1}, pages = {60-66}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-174-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-174-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Hajebi, Ahmad and Faridnia, Peim}, title = {The Relationship between mental health and social support in health staffs of Bushehr oil industry}, abstract ={Introduction: This study evaluated the relationship between social support, mental health and also demographic factors in health staffs of Bushehr oil industry in 2006. Methods: This cross-sectional descriptive study enrolled all health staffs, except 9 subjects who refuse to participate (108 male and 41 female). Subjects were evaluated by demographic questionnaire, general health Questionnaire-28 and Social Support Scale. Statistical analysis was performed by two sample t test, ANOVA and Pearson correlation coefficient. Results: This study showed that female gender, 35-44 age range group, having college educations, marital status and families with 4-5 members have higher mental health and social support. Onshore shiftworker staffs in comparison with others have lower mental health and social support. Conclusion: Social support and mental health showed a direct and significant correlation. The changes of policies for promoting quality and quantity of supportive networks, especially for vulnerable staffs, can reinforce protective effects of social support.}, Keywords = {mental health, social support, demographic factors, oil industry }, volume = {12}, Number = {1}, pages = {67-74}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-175-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-175-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Badparva, Ebrahim and Fallahi, Shirzad and Aminizadeh, Hasan and Ebrahimzadeh, Farz}, title = {Prevalence of Enterobious vermicolaris in the primary school students of Kouhdasht rural regions in the academic year of 2007-2008}, abstract ={Background: Enterobious vermicolaris (EV) is a short-lived, tiny, and white human nematode that has afflicted almost one billion people all over the world. The prevalence rate of this parasite varies in diverse regions and is more common among children. This study was aimed to determine the prevalence of EV in primary school students of Kouhdasht rural regions. Methods: The students' parents filled out the questionnaires the samples were coded and gathered in the morning and were sent to the laboratory. The positive and negative results were recorded in a questionnaire after the samples were examined microscopically. Results: Out of 598 samples from the students of Kouhdasht rural regions, 202 ones (33.8%) were found to be afflicted with Enterobious vermicolaris. The obtained results as well as the variables included in the questionnaires were analyzed using chi-square test. Significant differences were observed between the results in terms of different rural areas, using soap regularly to wash hands prior to eating and clinical signs such as thinness, sleep disturbances, irritability, and anal itching. Conclusion: Since the parasite is transferred directly, there is a close relationship between the prevalence rate and the hygienic condition of the society. The exact diagnosis can decrease and prevent the parasite contamination by coordinating health condition with health instructions, as well as by providing health facilities.}, Keywords = {Enterobious vermicolaris, Graham Test, students, health facilities}, volume = {12}, Number = {1}, pages = {75-80}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-176-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-176-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Abedzadeh, Masoomeh and Taebi, Mahboobeh and Saberi, Farzaneh and Sadat, Zohreh}, title = {Quality of life and related factors in Menopausal women in Kashan city}, abstract ={Background: Menopause is a physiological event that occurs in women's life and result in physical, emotional and social changes which affects their quality of life. Because of controversial finding in previous researches and lack of such study in kashan city, this study investigated the quality of life in menopausal women and its related factors. Methods: A cross - sectional study was performed on 700 menopausal women aged 40-60 in Kashan city with cluster sampling. Menopausal Specific Quality of life questionnaire (MENQOL) was used for estimation of QOL and related factor such as age, job, educational level, marital status, duration of menopause, child at home, income satisfaction, marital satisfaction, exercise, smoking and family smoking were examined with statistical tests. Results: The quality of life was high in 17.9%, intermediate in 68.9% and low in 13.3% of women. Most of women had intermediate quality of life at vasomotor domain (67.3 %), psychosomatic domain (67.4%), physical domain(46.3%) and sexual domain (51.6%).Also there was a significant difference between quality of life and educational level (P=0.004), income satisfaction (P=0.01) and exercise (P=0.0001). Conclusions: Educational level, exercise and income satisfaction are related with quality of life in menopausal women. Based on our findings, we emphasis on teaching about menopause, its symptom and adverse effects. Also emphasizes the necessity use of non pharmacological methods such as exercise and change in life style and diet to improve quality of life in menopausal women.}, Keywords = {menopause, women’s quality of life, vasomotor, psychomotor, income}, volume = {12}, Number = {1}, pages = {81-88}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-177-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-177-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Shirazi, Mohammad hasan and Soltandalal, Mohammad Mehdi and Hajikhani, Sara and Pourmand, Mohammad reza and FallahMehrabadi, Jalil and MoghimiDariaie, Naser and Sirous, Mehrndokht and Eshraghi, Seied Saee}, title = {Evaluation of HP0605 and HP0971 genes of efflux pumps in Helicobacter pylori resistance to Metronidazole}, abstract ={Background: The presence of antibiotic resistance has been reported in H.pylori and it is a major cause of treatment failure. Five families of multidrug efflux pumps are defined in bacteria and resistance-nodulation-division (RND) pumps are found mainly in gram negative bacteria. TolC is one of RND pump components and play a critical role in drug resistance. It hasn’t been established that RND family has a role in drug resistance in H.pylori. In this study, we assessed the role of two efflux genes in resistant to metronidazole in H.pylori by evaluation of overexpression TolC genes by RT-PCR method. Methods: In five metronidazole resistant strains of H.pylori, total RNA was extracted. RNA treated with DNase and RNA reverse transcribed to cDNA. Aliquots of the cDNA solution were assayed by RT- PCR for HP0605 and HP0971 genes. The levels of mRNA expression were evaluated by densitometry analysis. Results: All five strains displayed overexpression for HP0605 basis of increased concentration of metronidazole. Three strains showed transcripts for HP0971. One of these had transcripts for HP0971 only in Metronidazole concentration equaled to 16 µg/ml but two strains overexpressed adapt to increase concentration of metronidazole. Conclusion: According to current study, HP0605 and HP0971 genes overexpressed due to increase metronidazole. So, increasing of Metronidazole affects in H.pylori΄s efflux system in transcription level.}, Keywords = {H.pylori, efflux pump, TolC, Metronidazole}, volume = {12}, Number = {2}, pages = {111-118}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-179-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-179-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Azarfarin, Rasoul and Bilejani, Iesa and Kianfar, Amir abbas and Mirinejad, Mousa and Alizadehasl, Azi}, title = {Diagnostic value of “base deficit” in arterial blood gas analysis in comparison with hyperlactatemia as an indicator of tissue hypoperfusion in cardiac surgery}, abstract ={Background: Hyperlactatemia is a well known index for tissue hypoperfusion which is not routinely measured in all surgical procedures. The aim of this study was to evaluate the diagnostic value of base deficit in detecting hyperlactatemia and also predicting its postoperative complications in cardiac surgery. Methods: In a prospective observational study, 487 patients who underwent elective coronary artery bypass grafting or valve replacement surgery were evaluated. The serum lactate level and arterial blood gas (ABG) tests were measured simultaneously 3-5 times during operation and every six hours until 24h after operation. Hemodynamic changes during the operation, and also postoperative major complications consisting cardiac, pulmonary, neurologic, renal, infectious complications and death were recorded. Criterion for hyperlactatemia was considerated serum lactate≥3 mg/dl and for metabolic acidosis, base deficit>5 mmol/L.Results: Intraoperative frequency of "at least one episode of" base deficit>5 mmol/L was 41.3% and also hyperlactatemia was 56.3%. There were sensitivity (48%), specificity (68%) and PPV (66%) of base deficit>5 mmol/L in diagnosis of hyperlactatemia, considering pre-test probability (56.3%) of hyperlactatemia and calculating LR=1.49 for "base deficit>5 mmol/L ", the post-test probability of hyperlactatemia was estimated 70%. Considering frequency (pre-test probability) of 26.5% for postoperative complications and calculating LR=1.40 for both base deficit>5 mmol/L and hyperlactatemia, the post-test probability of postoperative complications was estimated 40% (in both tests). Conclusions: Because of importance of major postoperative complications, 40% probability of these events by observing base deficit>5 mmol/L or lactate≥3 mg/dl can be sufficiently alert the anesthesiologist to do proper interventions.}, Keywords = {metabolic acidosis, hyperlactatemia, cardiac surgery, diagnostic value}, volume = {12}, Number = {2}, pages = {119-125}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-180-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-180-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Saberi, Hamidreza and Moraveji, Alireza and Parastouie, Karim}, title = {Metabolic syndrome among professional bus and truck drivers in Kashan, 2008}, abstract ={Background: The literature data and our own studies show that in drivers of transport vehicles, work-related risk factors for arterial hypertension, ischemic heart disease, and metabolic syndrome are largely intensified. These involve occupational risk factors as well as classic ones, such as obesity, limited physical activity, shift work, or tobacco smoking. However, studies published over the past two decades on the health of bus and truck drivers have received relatively less attention in developing countries. Methods: In a cross-sectional study 429 Kashan City male bus and truck drivers that enter the occupational health service for health examination were enrolled. The study focused on the presence of the metabolic syndrome, as defined by the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP ATP III) and statistical tests such as t-test, chi-square test and Pearson’s correlation coefficient were used to analyze the data. Results: The prevalence of metabolic syndrome according to ATP-III was 35.9% mostly at age range 30-39 years. The prevalence of overweight was 41% Obesity, 23.1% hypertension, 42.9% Diabetes, 7% hypertriglyceridemia, 53.4% and low HDL cholesterol, 48.7%. In addition, between diabetes and hypertension and between hypertension and smoking meaningful relation was seen (p=0.006). Conclusion: We observed a high prevalence of metabolic syndrome in these groups to be significantly higher than other groups in Iran. So, Occupation must be considered as a risk factor for impaired health status, leading to temporary or permanent disability to work.}, Keywords = {drivers, metabolic syndrome, diabetes, body mass index, blood pressure, obesity}, volume = {12}, Number = {2}, pages = {126-132}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-181-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-181-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Akbarzadeh, Marzieh and Razmi, Mani and Tabatabaie, Hamidreza and Alizadeh, Leil}, title = {Correlation of maternal factors and hemoglobin concentration during pregnancy Shiraz 2006}, abstract ={Background: Anemia in pregnancy is a serious condition, contributing to maternal mortality, morbidity and fetal morbidity and its prevalence varies between 35-100% in developing countries. This investigation is conducted to survey the correlation of maternal factors and the changes in hemoglobin in pregnant women. Method: In this study, 108 healthy pregnant women with gestational age of 10 to 14 weeks, chosen by cluster random sampling were included. The women were followed in three visits: at the end of the first, second and third trimester. In addition, correlation of Hb concentration with maternal factors including BMI, age parity, hyperemesis, gestational age, pregnancy interval and weight gain was investigated. Results: There was no significant correlation between BMI, parity, pregnancy interval, severe nausea and vomiting and also maternal age with hemoglobin level during pregnancy. Moreover, Multiple regression models showed that adequate maternal weight gain (P<0.009) and high hemoglobin (p<0.0001) in the first trimester were positive predictors and late iron supplementation was negative predictor of hemoglobin in pregnancy (P<0.006). Conclusion: Our data demonstrated that adequate maternal weight gain, high hemoglobin in the first trimester and also late iron supplementation could be as predictors in clinical settings in this query.}, Keywords = {Pregnancy, Hemoglobin, Maternal factors, anemi, Body mass index (BMI)}, volume = {12}, Number = {2}, pages = {133-141}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-182-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-182-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Saderi, Hoorieh and Karimi, Ali akbar and Loni, Marzieh}, title = {Study of frequency of bacteria isolated from blood culture and their antibiotic susceptibility pattern in a university hospital in Tehran}, abstract ={Introduction: Determining frequency of bacteria, isolated from blood culture and their antibiotic susceptibility patterns, has epidemiological significance and can help in selecting empirical therapy. This study was aimed to assess, the frequency of bacteria isolated from blood culture of patients suspected to bacteremia and their antibiotic susceptibility patterns. Methods: Culture of blood and determination of antibiotic susceptibility was done by standard methods. In this study, a variety of isolated bacteria types, antibiotic susceptibility, as well as age, sex and type of admission of patients were analyzed in a university hospital from 21 March, 2006 to 20 March, 2007. Results: During one year, blood culture was done for 5116 patients and bacteria were isolated in 912 cases (17.8%). Three most frequently groups of bacteria in blood cultures of patients were non-fermentative gram negative bacteria (Pseudomonas and Acintobacter spp), coliforms (Escherichia coli and enterobacter and klebsiella spp.) and coagulase negative staphylococci, respectively, which were isolated in 63.4%, 17.0% and 12.8% of patients, and constituted 93.2% of positive blood cultures. Higher resistance was shown in bacteria isolated from inpatients compare to outpatients. Conclusion: This study showed the influence of age, sex and type of admission (outpatient or inpatient) in a variety of isolated bacteria in blood culture. The result of this study were the same as the other studies in Iran and other countries in respect of the variety of isolated bacteria and antibiotic susceptibility and show increase of antibiotic resistance in these bacteria.}, Keywords = {antibiotic susceptibility, bacteremia, blood culture, empirical therapy}, volume = {12}, Number = {2}, pages = {142-148}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-183-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-183-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Saberifard, Jamshid and Radmehr, Ali}, title = {Review of frequency of abnormal imaging finding in magnetic resonance cholangiopancreatography}, abstract ={Background: Magnetic resonance cholangiopancreatography (MRCP) has had a significant technical improvement during recent years. This method of imaging can have a broad range of clinical applications in imaging of pancreatic and biliary ducts. Recent studies have shown that magnetic resonance cholangiopancreatography is a comparable and better technique than other techniques such as sonography, CT scan and endoscopic retrograde cholangiopancreatography to assess pancreaticobiliary system. Methods: In this study heavily T2 weighted MR sequence was used to show slow flowing fluid as high signal intensity in bile ducts and main pancreatic duct. We reviewed MRCP imaging findings of 293 patients with pancraticobiliary diseases and analyzed the frequency of different pathologies and disorders during the years 1379 to 1385. Results: We found that stones in adults and also congenital diseases of bile ducts such as choledochal cysts in children were the most frequent pancreaticobiliary problems depicted by MRCP. Conclusion: MRCP is a valuable tool for diagnostic imaging of pancreaticobiliary system and can elegantly show different pathologies noninvasively and accurately.}, Keywords = {cholangiopancreatography, magnetic resonance imaging cholangiopancreatography (MRCP), bile ducts, pancreas}, volume = {12}, Number = {2}, pages = {149-156}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-184-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-184-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Behrouzi, Abdolhamid and Farashbandi, Firouzeh}, title = {Applications of Depleted Uranium in the first and second Persian Gulf Wars: a review article}, abstract ={Background: Depleted uranium (DU) is a byproduct of natural uranium enrichment process. Its unique characteristics (e.g. high density) caused to use in civilian and military fields extensively. In the military fields, DU is used in the bullets and projectiles war hats. The munitions containing DU were used in the recent wars, more strikingly in the Middle East region (first and second Persian Gulf wars, and Afghanistan). Due to its biological impacts, this study aimed to assess biological effects of DU using scientometrics by investigating papers indexed in Pubmed from 1990-2008, to reveal the number and type of articles and also the important dimensions of DU biological impacts as well as the core issues. Methods: In this descriptive epidemiologic study, quantitative methods (counting frequency of words) and scientometrics were used. Sample size was the total of the articles indexed in Pubmed during 1991- 2008, containing the terms "Gulf War" and "Depleted Uranium" in their title or keywords. Results: The most compromised body systems were urinary, nervous and cardiovascular. Other systems such as endocrine, musculoskeletal, immune and respiratory were also mentioned. Conclusion: Highly controversial results which have been stated in the surveyed articles about DU biological and environmental impacts caused the authors to recommend long term investigations for assessing its effects on recurrence to reveal potential late effects of DU.}, Keywords = {first Persian Gulf War, second Persian Gulf War, Depleted Uranium (DU), biological effects}, volume = {12}, Number = {2}, pages = {157-167}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-185-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-185-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Asadi, Sekineh and Saberi, Jamshid and Ghasemi, Khadijeh and Afrasiabi, Kolsoum and Nemati, Rez}, title = {A case with crossed fused ectopic kidney}, abstract ={Crossed fused ectopic kidneys are a rare renal anomaly. The autopsy prevalence of renal ectopia is more than clinical prevalence. Most presenting symptoms of crossed ectopic kidneys are nonspecific and most cases remain asymptomatic through their life and are diagnosed incidentally. The presented case was a 5 years old girl who suffered from episodic left flank pain that imaging findings on sonography and also technetium-99m dimercaptosuccinic acid (DMSA) scintigraphy indicated crossed fused ectopic kidneys.}, Keywords = {crossed ectopic kidney, sonography, technetium-99m dimercaptosuccinic acid (DMSA) scan, congenital anomaly}, volume = {12}, Number = {2}, pages = {168-171}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-186-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-186-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Bargahi, Afshar and RabbaniChadegani, Ozra and MohammadHasan, Zahir}, title = {Effect of shark cartilage on the cytotoxic activity of NK cells immune system}, abstract ={Background: On the basis of traditional medicine Shark cartilage have been used in the treatment of cancer especially immune related cancers. Then, we hypotheses that shark cartilage contains immune stimulatory ingredients. Methods: The immune stimulatory effect of shark cartilage derived proteins on the cytotoxic activity of natural killer cells(NK cells) from healthy human peripheral blood mononuclear cells (hPBMN) was studied. Shark cartilage proteins were purified by ion-exchange chromatography and ultra filtration. The effect of each protein fraction on the modulation of cytotoxicity of NK cells, as effectors, against K562, as target cells, was assayed by enzymatic LDH test. Results: The results from cytotoxic assay of NK cells and SDS- Polyacrylamide gell electrophoresis of shark cartilage protein fractions indicated that AR10 fraction, containing proteins with molecular weight of about 14.5 KDa is the most active ingredients of shark cartilage. Conclusion: Shark cartilage contains a 14.5 KDa protein that modulates NK cells activity of human immune system.}, Keywords = {cytotoxicity, NK cell, shark cartilage, purification, immunotherapy }, volume = {12}, Number = {3}, pages = {181-188}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-190-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-190-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Izadi, Mojtaba and Eghdami, Anoosh and Khorshidi, Davood and Nazem, Farzad and Zarifian, Asghar}, title = {The investigation effect of heparin infusion on plasma glucose and Lactate during submaximal exercise}, abstract ={Background: Many investigations have demonstrated that increasing fat availability increases fat oxidation and decreases carbohydrate use in the whole body and skeletal muscle. The purpose of this study was to determine the effect of heparin infusion on some influential factors in aerobic metabolism and performance during submaximal cycling. Methods: Thirty healthy males (15 as control and 15 as target group) cycled for 20 min at 70% maximal O2 uptake (VO2max) in two separate stages (baseline and infusion of heparin or lactose. Blood samples were drawn immediately followed up exercise for calculating plasma glucose and lactate concentration and lactate dehydrogenase activity (LDH). VO2max also monitored. The finding are compared by T test (Independent-sample and Paired- samples T test) in two groups (P<0.05). Results: The finding showed that heparin infusion had not influence on plasma glucose, lactate concentration, and LDH activity (P<0.05). Also VO2max and heart rate had not significantly changed in posttest condition compare to pretest (P<0.05). Conclusion: Our findings suggested that heparin infusion is not affect aerobic capacity and carbohydrate substrate utilization during submaximal exercise. Additional investigation is required to directly identify these supplementations on the substrate utilization and fat-carbohydrate metabolism and exercise performance.}, Keywords = {heparin, free fatty acid, metabolism, aerobic exercise, lactate, glucose }, volume = {12}, Number = {3}, pages = {189-197}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-191-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-191-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Tabatabaie, Seyed Abdolhossein and Asharin, Mohammad Reza and Assadi, Majid and Nabipour, Iraj and Ebrahimi, Abdol Ali and NasiriAhmadAbadi, Mojdeh and Moghadam, Mansour and Pourbehi, Mohammadrez}, title = {Comparsion of influence of enoxaparin with unfractioned heparin on acute myocardial infarction with ST-segment elevation}, abstract ={Background: Most patients with acute myocardial infarction with ST-segment elevation (STEMI) are still treated with pharmacological reperfusion which is not always successful. The aim of this study was to determine whether enoxaparin was associated with superior efficacy and safety compared with unfractionated heparin (UFH) in the STEMI setting. Methods: In this clinical trial, 150 patients less than 75 years old (104 men and 46 women) with STEMI who were scheduled to undergo streptokinase (1.5 milion unit per hour) randomly assigned to receive enoxaparin (40 mg intravenous bolus then 1 mg/kg subcutaneously BID) (group 1) or weight adjusted UFH from 24 to 48 hours after streptokinase (group 2). All patients underwent predischarge coronary angiography. Results: A number of 75 patients in group 1 (mean age 58.9 ±9.4) and 75 pateints in 2 (mean age 56.3±9.0) were studied. Two groups were well matched with respect to main risk factors and also other concomitant medications. Time from onset of symptom to start fibrinolysis and myocardial regions infarction were similar in both groups (p=0.13). Left ventricular ejection fraction were 45.2 ± 5.6 % in group 1 and 40.3 ± 7.3 % in group 2 (p=0.056). Major bleeding just was in 2 cases of group 1. Minor bleeding was in 10 cases of group 1 and 5 of group 2 (p>0.05). Conclusion: Our data showed a benefit of Enoxaparin compared with UFH in patients receiving fibrinolysis for STEMI with a mild trend toward an excess of bleeding. However, further well designed studies to assess these results with following patients for a longer period of time and also comparing therapeutic effects are needed.}, Keywords = {ST-segment elevation myocardial infarction, enoxaparin, unfractionated heparin, fibrinolysis}, volume = {12}, Number = {3}, pages = {198-205}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-192-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-192-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Samilipour, Hooman and Azizi, Fatemeh and Motamed, Niloofar and Taiebi, Niloofar and DelavarKasmaie, Hossein and Karimi, Mojtab}, title = {Restless leg syndrome and its association with serum ferritin in dialysis patients in Bushehr province, 2006}, abstract ={Background: Restless leg syndrome (RLS) is a sensory-motor disorder that affects 6-83% of dialysis patients. Increased Urea and creatinine, and Iron deficiency anemia resulting from renal failure are some causes of restless leg syndrome. This study was aimed to evaluate this issue. Methods: A cross sectional study was done on 130 dialysis patients in 5 dialysis centers of Bushehr Province. The diagnosis of RLS was made using the criteria of the International Restless Leg syndrome. The length of renal failure, number of weekly dialysis, erythropoietin dose per week, dose of mineral Iron per day, other co morbidities and medications, ferritin level, and predialysis BUN were determined. Results: In this study 43 (33.1%) patients had restless leg syndrome who consisted of 18 (41.9%) women and 25 (58.1%) men. Positive family history was significantly associated with restless leg syndrome (p<0.016), and these patients had restless syndrome 3.39 times more than the others. Sex, age, ferritin level, length of renal failure, and BUN were not associated with restless leg syndrome. Conclusions: Restless legs syndrome is a common finding in dialysis patients in Bushehr Province. RLS was not associated with ferritin level in our study, but was significantly associated with family history of RLS.}, Keywords = {RLS, BUN, ferritin, uremia }, volume = {12}, Number = {3}, pages = {206-213}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-193-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-193-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Fouladi, Zahra and Afshari, Pourandokht and Gharibi, Tayebeh and Dabbagh, Mohammad Ali}, title = {The comparison oF Zataria multiflora boiss (Avishan Shirazi) and Clotrimazol vaginal cream in the treatment of candidiasis vaginitis}, abstract ={Background : Vaginal candidacies is a second common infection in women. There are some evidences regarding efficiency of Zatoria Multiflora Boiss (Z.M.B) on dysmenorrea, leukorrea, and spasm. This study was conducted to assess the efficiency of Z.M.B in the treatment of candidacies vaginitisis. Methods: This double-blind trial was performed on the patients suffering from candidacies vaginitisis. Thirty-five patients received Z.M.Band 38 received Clotrimazole vaginal cream randomaly for 7 days. Data were analyzed using Chi-Square and Mc-Nemar tests. Results: There was significant improvement of signs and syndroms. in two groups (P0/05). Furthermore, 54/3% of patients taking Z.M.B and 47/4% of cases receiving Clotrimazole vaginal cream had complete improvement. Conclusion: The study demonstrated those Zataria multiflora Boiss could be a useful therapy for vaginal candidacies.}, Keywords = {vaginal candidacies, zataria multiflora Boiss, antifungal, clotrimazol}, volume = {12}, Number = {3}, pages = {214-224}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-194-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-194-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Ebrahimi, Abdol Ali and Ebrahimi, Sekiineh and Aghouli, Mahmou}, title = {Survey of resistance rate of Shigella species isolated from children with diarrhea Fasa, Summer, 1383}, abstract ={Background: Shigellosis is an acute inflammatory infectious colitis which is caused by genus Shigella. The bacterial identification in large number of stool specimens and antimicrobial susceptibility test are useful for diagnosis and treatment. Methods: In this study the total number of 414 stool specimens of children under 8 years old were refered to various laboratory centers for determination of possible bacterial infection in Fasa city were. The diagnostic biochemical serological tests as well as antimicrobial susceptibility test were done. Results: Out of 414 stool specimens 48 (11.5%) cases were positive (S.flexneri, 50% S.sonnei, 31.% S.dysenteriae, 12.5% S.boydii, 6.%). Conclusion: This study emphasizes on the pediatric evaluation of resistancy of the antibiotics using in children.}, Keywords = {children, stool culture, Shigella, antimicrobial resistance test}, volume = {12}, Number = {3}, pages = {225-230}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-195-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-195-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Nabipour, Iraj and Najafi, Arezoo and Bolkheir, Amir Rez}, title = {Anticancer and cytotoxic compounds from seashells of the Persian Gulf}, abstract ={Background: Pre-clinical studies for isolation and purification of marine compounds continued at an active pace since the last decade. Today, more than 60% of the anticancer drugs commercially available are of naturally origin thus the sea is a very favorable bed for the discovery of novel anticancer agents. Methods: A total of known 611 seashells species in the Persian Gulf were investigated for synonymy in OBIS database. Then, all the species, including their synonymy were searched in PubMed databse to find their isolated bioactive agents. Results: From 611 known seashells in the Persian Gulf, 172 genera/species had bioactive compounds. Anticancer agents were isolated and purified for 8 genera. These compounds had various structures they were polypeptide, polysaccharide, glycoprotein, alkaloid, cerebroside, and cembranoid which had different mechanism of actions including induction of apoptosis, destroying the skeletal structures of the cells, immune bioactivity and inhibition of topoisomerase I. Spisulosine is the only anticancer agent which is currently under clinical trial. Conclusions: Although, the known seashells from the Persian Gulf have potential anticancer and cytotoxic compounds but a very few investigations had been reported. Further investigations for isolation and purification on bioactive compounds from seashells of the Persian Gulf is recommended.}, Keywords = {seashell, anticancer, marine, cytotoxic, Persian Gulf}, volume = {12}, Number = {3}, pages = {231-237}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-196-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-196-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} } @article{ author = {Tabib, Seyed Masood and Nabipour, Iraj and MohseniAzad, Anali and Iranpour, Darioush and Farzaneh, Mohammadrez}, title = {A case of apathetic hyperthyroidism with exudative low SAAG ascites}, abstract ={The development of ascites in hyperthyroid patients is a rare phenomenon and usually occurs in the context of exaggeration of right-sided heart failure , so it is categorized as high SAAG ascites. In this case report, we present a 73-year-old man who was referred to us with anorexia, severe weight loss, anemia, lower limbs pitting edema, and also exudative, low SAAG ascites. Extensive work up revealed that these constellation of signs & symptoms were consequent to decompensation of his chronic right-sided heart failure resulting from apathetic hyperthyroidism.}, Keywords = {low SAAG ascites, exudative ascites, apathetic hyperthyroidism, right-sided heart failure }, volume = {12}, Number = {3}, pages = {238-243}, publisher = {Bushehr University of Medical Sciences}, url = {http://ismj.bpums.ac.ir/article-1-197-en.html}, eprint = {http://ismj.bpums.ac.ir/article-1-197-en.pdf}, journal = {Iranian South Medical Journal}, issn = {1735-4374}, eissn = {1735-6954}, year = {2009} }