per
Iran University of Medical Sciences
Razi Journal of Medical Sciences
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1
7
article
Retrospective study of management of chronic organized empyema with thoracoscopy versus thoracotomy
Hamid Reza Kadkhodaei
1
Mahtab Vasigh
2
Tehran University of Medical Sciences
Tehran University of Medical Sciences
Background: Empyema remains a challenging
issue for thoracic
surgeons. In the early stages of empyema antibiotic therapy and pleural space
drainage are the treatment of choice. In
organized empyema with pleural peel and re-expandable underlying lung,
decortication is the procedure of choice. There is agreement about the value of
Video Assisted Thoracoscopic Surgery (VATS) in the management of stages I and
II empyema, but there are doubts about its efficacy in stage III empyema. We
seek to evaluate the comparative merits of thoracoscopic versus open decortication
in the surgical management of patients with chronic postpneumonic pleural
empyema. Methods: From March 2004 to December
2010, 50 patients (43 males, 7 females, mean age: 37.6 years, range: 13-75
years) with chronic postpneumonic pleural empyema underwent decortications. It was a retrospective
cross-sectional study. The data was gathered by investigating the patients
medical records and analysed by SPSS17. Results: Decortication was performed by
open thoracotomy in 29 (58%) patients and VATS in 21 (42%). Mortality was 6.5%
.There was no difference in terms of re-operation, mortality and success rates.
The operation time in (OT) thoracotomy group was shorter (p=0.03). Hospital
stay, drainage duration and antibiotic therapy in VATS group was shorter. There
was no statistical difference in regard to the success rate between the two
groups. Conclusion: According to the results of this
study we found that success rate of VATS decortication is comparable to open
thoracotomy, however, a multicentric-randomized trial should be performed
before video thoracoscopic decortication becomes the gold standard for the
treatment of pleural empyema.
http://rjms.iums.ac.ir/article-1-2394-en.pdf
Thoracotomy
Thoracoscopic surgery
Empyema
Decortication.
per
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
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14
article
Serologic and electrophysiologic evaluation of patients with Myasthenia gravis
Zahra Vahabi
1
Shahriar Nafisi
2
Fatemeh Safarian
3
Zahra Safarian
4
Ali Akbar Amirzargar
5
Akbar Soltanzadeh
6
Hajir Sikarodi
7
Tehran University of Medical Sciences
Tehran University of Medical Sciences
Tehran University of Medical Sciences
Tehran University of Medical Sciences
Tehran University of Medical Sciences
Background: Myasthenia gravis is an
autoimmune disorder mainly caused by antibodies to the muscle acetylcholine
receptors (AChR-Ab) at the neuromuscular junction. Loss of these receptors
leads to a defect in neuromuscular transmission with muscle weakness and
fatigue. This antibody is not detected in all the patients and
electrophysiologic study is necessary in some patients as a
diagnostic tool. The
serologic and electrophysiologic tests in Myasthenia gravis are evaluated in
this study. Methods: One hundred twelve patients
entered in a cross-sectional study. Serum AChR-Ab was measured and Repetitive nerve stimulation (RNS) was done. The
frequency of positive AChR-Ab and abnormal RNS and the relationship between
them were determined. Results: Thirty (26.8%) patients were
males and 82 (73.2%) were females. Mean of age was 37.6±15.4 years. AChR-Ab was
positive in 71 (63.4%) and negative in 41 (36.6%). RNS was done in 101 patients
and was abnormal in 74 (73.3%) and normal in 27 (26.7%) patients. Ratio of
abnormal RNS was 84.4% and 53.7% in seropositive and seronegative patients,
respectively (p=0.001). Conclusion: There is significant
relationship between serologic and electrophysiological
findings in Myasthenia gravis. Combining electrophysiological and serological tests
could increase the accuracy of Myasthenia
gravis diagnosis.
http://rjms.iums.ac.ir/article-1-2395-en.pdf
Myasthenia gravis
AChR-Ab
RNS.
per
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
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20
article
Evaluation of the relation between Helicobacter pylori and Multiple sclerosis
Nafiseh Mohebi
1
Mansoureh Mamarabadi
2
Mehdi Moghaddasi
3
Tehran University of Medical Sciences
Tehran University of Medical Sciences
Tehran University of Medical Sciences
Background: Multiple sclerosis (MS) is the
most prevalent central nervous system demyelinating disease. There are known
risk factors for MS. However, there is uncertainty in its protective factors.
Few studies have demonstrated that some chronic infections may have protective
effects on this disease. We carried this study to investigate the relation
between Helicobacter pylori (HP) infection and the prevalence and
severity of MS. Methods: In this case-control study, 163
MS patients and 150 sex- and age- matched controls were included. Blood samples
for IgG and IgM anti HP antibodies were collected from all individuals. Also
the Expanded Disability Status Scale (EDSS) was used to evaluate the MS
patients. Suitable statistical analysis was applied. Results: A significant difference was
observed in seropositivity between these two groups. (p<0.001), but no
significant difference was seen in seropositivity between conventional and
opticospinal MS (p=0.522). No significant difference was observed in
seropositivity among ages (p=0.075) and between genders (p=0.204). A
significant difference was seen in EDSS value between seropositive and
seronegative patients (p=0.017). Conclusion: We concluded that patients with
HP infection had lower incidence of multiple sclerosis and MS patients with HP
infection showed lower neurologic complications, which can demonstrate that HP
infection may have a protective influence on MS pathogenesis.
http://rjms.iums.ac.ir/article-1-2396-en.pdf
Helicobacter pylori
Multiple sclerosis
Immunological influences
Iranian patients.
per
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
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27
article
Catheter related complications and survival among Iranian ESRD patients treated in Hasheminejad hospital 2010-2011
Mohammad Kazem Shahmoradi
1
Morteza Khavaninzadeh
2
Kaveh Mousavi Kani
3
Tehran University of Medical Sciences
Tehran University of Medical Sciences
Kaveh International Chain Companies
Background: With the
innovative idea of Central Vein Catheter at the end of 80’s, treatment of
hemodialysis patients faced a significant change. Nowadays CVC’s are widely
used and as a result CVC related complications have become important for
surgeons. In this study survival and complications associated with CVC’s have
been studied in End Stage Renal Disease (ESRD) patients referring to Shahid Hasheminejad
Hospital during 2010-11. Methods: In this
cross- sectional and descriptive study, all documents of ESRD patients’ that had catheter insertion at Hasheminejad Kidney Center during 2010-11
were included and demographic data, catheter related side effects, site of
catheter, and duration of catheter
utilization were taken from the records
and major catheter related complications, reasons of catheter removal were
obtained by descriptive analyses. We also calculated survival of catheters by
Kaplan-meyer analytic method. Results: In this
study 150 records
were enrolled with 122 male and 28 female patients, and a mean age of 56±15
years (range of 19-87 yrs). Regression analyses had shown that increasing age
(p=0.003, RR=0.78), Hb (anemia), (p=0.04, RR=0.34), increased BUN (p=0.014,
RR=0.37) and Cr (p=0.023, RR=0.45) levels had significant correlation with the
side-effects. One and two months catheter survival were 88% and 69%,
respectively. Conclusion: Side effects were not higher than
similar western studies. Studied patients had higher rates of anemia. Catheter
thrombosis was reported as the second and local infection as the first common
side effects. Survival of central vein catheters in Iran was similar to earlier
conducted studies.
http://rjms.iums.ac.ir/article-1-2397-en.pdf
Central venous catheter
Temporary catheter survival
Complication.
per
Iran University of Medical Sciences
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35
article
Accomplishments of health system financial management reform implementation in units affiliated with MOHME
Masoud Abolhallaje
1
Peivand Bastani
2
Maryam Ramazanian
3
Kerman University of Medical Sciences
Kerman University of Medical Sciences
Kerman University of Medical Sciences
Background: This study was conducted to summarize the main
accomplishments of implementing the first phase of health system financial
reform (establishment of accrual accounting) from the management development
and resources assistants points of view
in universities affiliated with Ministry of Health and Medical Education
(MOHME). Methods: This was a cross-sectional descriptive research that was
performed in a census way in 2011. An
instrument tool was a teacher made 23-item check list in 8 dimensions that was
approved for its face and content validity with expert view and split half was
applied confirming its reliability. Data was analyzed using Excel. Results: The highest ratio of stated accomplishments was related
to recognition of revenues (86.5 out of 100) versus the lowest one
belonging to external effects (37.9 out
of 100). Moreover the most rate of diversion in answers was seen in units`
financial autonomy. Conclusion: According to the significance of establishing
accrual accounting accomplishments in units affiliated with MOHME and in order
to achieve a broader spectrum of expert views, it is recommended to conduct
similar studies with a qualitative approach on this study population.
http://rjms.iums.ac.ir/article-1-2398-en.pdf
Health system financial management reform
Accrual accounting
Accomplishment.
per
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
2228-7051
2013-03
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45
article
Evaluation of postural stability while holding variable dynamic load in asymmetric postures in healthy men subjects
Soha Bervis
1
Sedighe Kahrizi
2
Mohammad Parnianpour
3
Bahram Mobini
4
Tarbiat Modares
Tarbiat Modares
Sharif Technical University
Tehran University of Medical Sciences
Background: Changes in load during
asymmetric holding may be associated with particularly high risk of loss of
balance and spinal injury. Therefore, in order to assess occupational lesions
and to make preventive rehabilitation programs in such conditions like holding dynamic
loads in asymmetric postures could be important. Methods: In a
cross-sectional study, COP amplitude and velocity sway were studied in 14 normal
male volunteers during holding static and dynamic load in symmetric and
asymmetric postures. Results: Similar Anterior-Posterior responses to the postures were
seen, although asymmetric postures showed a larger Medial-Lateral COP amplitude
and velocity sway
(p<0.05). While dynamic load increased Anterior-Posterior and Medial-Lateral
postural parameters in asymmetric posture (p<0.05), we observed increase
only in Anterior-Posterior direction in symmetric posture (p<0.05). Conclusion: The results showed that dynamic load challenges the
postural stability control, with a higher effect in asymmetric posture.
http://rjms.iums.ac.ir/article-1-2399-en.pdf
Postural stability
Variable dynamic load
Asymmetric posture.
per
Iran University of Medical Sciences
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53
article
The effect of change in the design of shoe\'s sole on the human stability during walking
Mansour Ziaei
1
Seyed Farhad Tabatabai Ghomshe
2
Hamid Reza Mokhtarinia
3
Maryam Maghsoudipor
4
Mostafa Hamzeiyan Ziyarani
5
Kermanshah University of Medical Sciences
University of Social Welfare and Rehabilitation Sciences
University of Social Welfare and Rehabilitation Sciences
University of Social Welfare and Rehabilitation Sciences
Institute for Higher Education of Kar, Qazvin
Background: Shoes is the first point of
contact between the foot and the ground in walking.Any change in that could affect
the balance and postural stability. The risks associated with slipping and
falling is related to the materials of footwear, surface condition, and
geometric design of the shoe sole. The aim of this study was to measure the
effect of different shoe sole tread groove depths on the stability during
walking on dry and slippery surfaces. Methods: In this semi-experimental study,
22 healthy young men with average age 24.5±3.43 years wore the oxford standard shoe and walked on
two different surfaces (dry and slippery) with three different groove depths
(1, 2.5 and 5 mm). In fact, there were six different test conditions. Data was
collected by the VICON Motion Analysis system and Force plate set. The Paired
T-test was performed to study the effects of groove depth and surface
contamination on the Coefficient of Friction (COF) and Fluctuations Rate
of Ankle (FRA). Results: The results showed that on
slippery and dry surfaces, increase in groove depths leads to increase of COF
and decrease of FRA (p<0.05). Also values of COF on slippery surface were
less than dry surface significantly (p<0.01). Conclusion: The aim of this study was to
find the groove depth which has the optimal stability. In our study, the
deepest groove (5 mm) was better for reduction of FRA and increase of COF
during walking on slippery and dry surfaces.
http://rjms.iums.ac.ir/article-1-2400-en.pdf
Balance
Slippery
Sole tread groove depth
Surface contamination
Stability.
per
Iran University of Medical Sciences
Razi Journal of Medical Sciences
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58
article
Evaluation of the diagnostic value of PCR and smear for diagnosis of tuberculosis in bronchoalveolar lavage
Seyed Ali Javad Mousavi
1
Mitra Barati
2
Mohammad Reza Kochari
3
Shima Javadinia
4
Mahshid Talebi Taher
5
Tehran University of Medical Sciences
Tehran University of Medical Sciences
Tehran University of Medical Sciences
Background: Tuberculosis (TB) is one the
oldest known diseases in human. According to its high prevalence in Iran, using
a diagnostic procedure with more rapid result than culture, more sensitive and
specific than smear and near to culture can help us to diagnose and treat the
disease rapidly and accurately, and thus control it in the community. So we
decided to evaluate PCR for the diagnosis of Tuberculosis in Broncho-alveolar
Lavage (BAL) and compare it with smear. Methods: Patients who were admitted at
Hazrat Rasoul Akram Hospital during 2 years of 2010-11 with the impression of
tuberculosis and underwent bronchoscopy were included. Their BAL was sent for smear, culture and PCR
for tuberculosis diagnosis. Data were analyzed by mean and standard deviation
and p Value under 0.05 was considered significant. Results: Forty seven patients with
probable pulmonary tuberculosis underwent bronchoscopy. BAL cultures were positive in 6 (12.8%)
patients, smears in 5 (10.6%) patients and PCR in 3 (6.4%) patients. According
to this result smear had 83% sensitivity, 100% specificity, 100% PPV and 98%
NPV. However PCR had 50% sensitivity, 100% specificity, 100% PPV and 93% NPV. Conclusion: Although PCR is a rapid and new
tool for TB diagnosis, smear- which is an older way- is simpler has lower cost
and is feasible in all points of Iran and still is a better method for TB
diagnosis.
http://rjms.iums.ac.ir/article-1-2401-en.pdf
Pulmonary tuberculosis
Bronchoalveolar lavage
PCR.
per
Iran University of Medical Sciences
Razi Journal of Medical Sciences
2228-7043
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66
article
Evaluation of prevalence of sexual dysfunctions and its related factors in women
Robabeh Mazinani
1
Mandana Akbari Mehr
2
Adis Kaskian
3
Maryam Kashanian
4
University of Social Welfare & Rehabilitation Science
Azad University, Karaj
Tehran University of Medical Sciences
Background: The aim of this study is to evaluate the prevalence of
sexual dysfunctions and their related factors in women referring to health
clinics in Tehran. Method: The study was performed as a descriptive analytic study.
For this purpose, 405 married women were selected from 4 clinics of four
geographic areas (north, south, west and east) in Tehran city (30 people from
each center) through randomized and multistage sampling. The assessment was
done by using demographic questionnaire and Sexual Function Questionnaire
(SFQ). The research data were analyzed by independent t-test and one-way ANOVA
and correlation test. Results: The results of data analysis showed general prevalence of
sexual dysfunction in women were 31%, so that the prevalence of hypoactive
sexual desire was 33%, the prevalence of sexual arousal disorder was 16.5%. The
prevalence of orgasmic disorder was 25% and the prevalence of painful sexual
disorder (dyspareunia) was 45.5%. Conclusion: The assessment of related factors showed that age of
women, duration of marriage, positive history of psychiatric disorders and
using psychotropic medication and also history of sexual abuse had significant
correlation with sexual dysfunction.
http://rjms.iums.ac.ir/article-1-2402-en.pdf
Sexual dysfunction
Sexual desire disorder
Sexual arousal disorder
Orgasm disorder
Dyspareunia.
per
Iran University of Medical Sciences
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article
Case report: Monitoring of blood pressure and pulse rate and sending the information to physician by Global System for Mobile Communications
Elyas Mostafapour
1
Mohammad Pourfakharan
2
Ehsan Hosseini
3
Abolfazl Mostafapour
4
Seyyed Arash Javad-Mousavi
5
Mohammad Hasan Pourfakharan
6
Tehran University of Medical Sciences
Ganjineh Salamat Research Co
Farahan Division, Arak
Ganjineh Salamat Research Co
Shaheed Beheshti University of Medical Sciences
Kashan University of Medical Sciences, Kashan
Background: Hypertension
is a common chronic disease with increasing prevalence worldwide. Regular close
monitoring of blood pressure is key point of hypertension management. Home
monitoring of blood pressure has its own problems such as lack of early access
to a physician in case of emergency. In this study we have designed a device
that could send the patient’s self-measured blood pressure to physician. Case report:
A 56 year old woman with a 6 year history of hypertension was enrolled to
the study. After giving information
about using the device, we gave it to her. With each use of device at home we
received an SMS (Short Message Service) on patient’s blood pressure that were
coordinated with self-recorded blood pressures. This device consisted of a
designed electronic board and installed components (such as programmed mobile
board and micro controller) placed on the board and attached to a blood
pressure measuring device. After pushing a button, the blood pressure was
measured spontaneously and data shown on an LED monitor and sent through GSM
(Global System for Mobile Communication) by a sim card to the physician. Conclusion: This new
device helps physicians to control patients’ blood pressure closely without any
extra cost. Also using this device will decrease the rate of complicated
hypertensive attacks.
http://rjms.iums.ac.ir/article-1-2403-en.pdf
Hypertension
GSM
Remote monitoring.