@article{ author = {Hashemi, M. and GhasemiFalavarjani, Kh. and AliakbarNavahi, R. and Mirfallah, K. and Bakhtiari, P.}, title = {Comparison of the Results of Intravitreal Injection of Triamcinolone Acetonide and Bevacizumab (Avastin) in Patients with Clinically Significant Macular Edema Unresponsive to Standard Treatment}, abstract ={    Background & Aim: Macular photocoagulation is the standard treatment for clinically significant macular edema (CSME), but some of patients do not respond to it. The aim of this study was to compare the results of intravitreal injection of triamcinolone acetonide (IVTA) and bevacizumab (IVB) in patients with CSME. Patients and Method: In this prospective randomized double-blind clinical trial, 51 eyes with CSME with at least one session of MPC (Macular Photocoagulation) and without response to it were included. The patients were randomly assigned to one injection of either 4 mg of IVTA or 1. 25 mg of IVB. Visual acuity (VA), intraocular pressure (IOP) and cataract were checked before and 1, 3 and 6 months after injection. Fluorescein angiography was performed before and 3 and 6 months after injection to evaluate macular integrity and leakage. Data were analyzed using Chi-square, Students' t-test and Friedman tests. Results: No significant change in VA was seen in either group in the first, third and sixth months of follow-up. There was no significant difference between the two groups in terms of VA 1, 3 and 6 months after injection. Although the measurements taken during the follow-up revealed an increase in IOP in IVTA group, the difference between the two groups was not significant. There was no increase in cataract formation in IVB group however, the incidence of posterior subcapsular cataract significantly increased in IVTA group 6 months after injection (P<0. 001). Macular leakage and angiographic resolution were improved significantly in the two groups (P<0.001), but no significant change was noted in foveal avascular zone visualization. Overall, the measurements taken after 3 and 6 months showed no significant difference between the two groups in terms of angiographic features. Conclusion: According to this study, the efficacy of IVB is the same as IVTA in the treatment of CSME unresponsive to standard treatment.  }, Keywords = { Bevacizumab, Triamcinolone Acetonide,Clinically Significant Macular Edema , Diabetic Retinopathy}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1261-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1261-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Vakili, M. and Forooghan, M. and Nojomi, M. and GhalehBandi, M. F. and Khodabandeloo, N.}, title = {A Survey on Serum Levels of B12, Folate and Homocysteine in Healthy Elderly Tehranis}, abstract ={     Background & Aim: Owing to decreased absorption of cobalamin in the elderly, cobalamin deficiency is a common problem in these subjects. On the other hand, insufficient vitamin B12 status may increase the incidence of atherosclerotic and neurodegenerative disorders. Recently investigators have recommended B12 monitoring in the elderly and detecting at risk subjects in the early stages of deficiency. The purpose of this study is to assess serum levels of B12, folate and homocysteine in the healthy Iranian elderly and to find a probable relation between them.  Patients and Method: This project was conducted as a cross-sectional study in Tehran. A total of 232 people aged 65-90 years, with a mean of 73 years, were recruited and data was gathered by measuring serum levels of homocysteine, folate, and vitamin B12, interview and physical examination. Blood samples were gathered and analyzed according to standard methods. Statistical analysis was done using SPSS 11. 5 software. Comparison of values were made using Chi-square and Students' t-test. The p-value of less than 0. 05 was determined significant.  Results: The variables were assessed in 102(44%) male and 130(56%) female subjects. The mean of serum B12 was 295 pg/ml (SD±170). 10% of cases had B12 levels less than 119 and 18% less than 160 pg/ml. B12 deficiency increased with ageing (p=0. 000),but there was not a significant relation with sex (p=0. 85). The mean of folate level was 8 ng/ml (SD±4. 9). 9. 5% of cases had folate levels below normal range without a significant relation to age (p=0. 06) or sex (p=0. 31). The mean of homocysteine (Hcy) concentration was 19. 3 μmol/l (SD±7. 1). Homocysteine values were more than 20 μmol/l in 33. 6% and more than 15 μmol/l in 67% of the subjects with no relation to ageing (p=0. 23). 42. 2% of males and 27. 7% of females had homocysteine values more than 15 μmol/l (p=0. 005),which was statistically significant. Correlation coefficients between the levels of homocysteine, serum B12 and folate indicated a significant inverse correlation (r = -0. 33, p= 0. 000 r = -0. 20, p=0. 002 respectively).  Conclusion: The results of this study show that the incidence of hyperhomocysteinemia, B12 and folate deficiency in the elderly is not lower than developed countries, and B12 deficiency seems to be functionally higher than western countries. It is suggested that the elderly use vitamin B group as medication or as fortified foods regularly.  }, Keywords = {Homocysteine, Vitamin B12, Folate, Elderly}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1260-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1260-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {AbdNikfarjam, B. and Amirghofran, Z. and Aflaki, E. and KamaliSarvestani, E.}, title = {Study of NOS2A Gene Polymorphism in Rheumatoid Arthritis Patients and Normal Individuals}, abstract ={  Backhground & Aim: Several lines of evidence have indicated that NO might be important in the pathogenesis of RA. NO could be synthesized by an enzyme called inducible nitric oxide synthase (iNOS). iNOS is expressed in the synovium, cartilage and lymphomononuclear cells of synovial fluid and lymphocytes and monocytes of peripheral blood of RA patients. Several studies have shown that iNOS gene (NOS2A) polymorphisms have been associated with a number of inflammatory and autoimmune diseases. In the present study the frequency of NOS2A gene polymorphism at positions -1659 C/T and +150 C/T was investigated in patients with RA and control subjects.   Material and Method: In the present case- control study the frequency of NOS2A gene polymorphisms at positions -1659 C/T and +150 C/T was investigated in 176 patients with RA and 232 control subjects using PCR-Allele specific and PCR-RFLP methods, respectively. SPSS version 10,Chi-square and Fisher's exact tests were used to study the differences in genotype and allele frequencies between patients and controls.   Results: The results of the present study showed a significant difference in NOS2A -1659 C/T polymorphism between the patients and controls (P=0.03). Wild type homozygote (CC) was significantly higher in normal subjects (75%) than patients (64.2%). No significant difference was observed between RA patients and controls in NOS2A +150 C/T polymorphism (P=0.33). Furthermore, there was no significant association between different clinical and paraclinical findings including erosion, deformity of joints, rheumatoid nodules, extra articular manifestations, CRP, RF and age of onset and -1659 C/T and +150 C/T NOS2A gene polymorphisms.   Conclusion: To the best of our knowledge this study was the first research on the NOS2A gene polymorphisms in RA patients. Our results revealing the significant correlation between -1659 C/T genotypes and RA, indicates the importance of iNOS polymorphism in the patients and suggest further studies in other ethnic groups.  }, Keywords = {Rheumatoid Arthritis (RA),Inducible Nitric Oxide Synthase,Nitric Oxide Synthase 2A Gene Polymorphism}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1259-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1259-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Nikeghbali, A. and GhasemiFalavarjani, Kh. and Modarreszadeh, M. and Hashemi, M. and Parvaresh, M. M. and Naseripour, M.}, title = {Long-term Results of Scleral Fixation of Dislocated Intraocular Lenses Using Haptic Externalization through a Small Corneal Incision}, abstract ={    Background & Aim: Several methods have been reported for refixation of dislocated intraocular lenses (IOLs). However, these methods are associated with some disadvantages including vitreous prolaps, vitreous traction, ocular collapse, intraocular hemorrhage, high astigmatism, and the need for complex intraocular maneuvers. The aim of this study was to evaluate the results of transscleral fixation of dislocated intraocular lenses (IOLs) by externalizing the haptics through a small corneal incision. Patients and Method:This retrospective, non-comparative, interventional study comprised 28 eyes (28 patients) in which IOLs were dislocated into the vitreous cavity. After bringing the IOL to the anterior chamber, a suture was introduced into the eye via scleral flap and retrieved via another flap. Then the thread was pulled out through a small clear corneal incision. The suture was tied to the externalized haptic, and the tied haptic was placed back in the anterior chamber and dialed to externalize the second haptic. After the second externalized haptic was tied, the IOL was reimplanted behind the iris. Data was analyzed using t-test. Results: Through the mean follow-up of 34.5 ± 23.8 months, the PC IOL remained well centered in all eyes and no tilt or dislocation was observed. The difference between the mean of best corrected visual acuity before IOL dislocation (0.35 ± 0.21 logMAR) and the mean after IOL refixation (0.38 ± 0.19 logMAR) was not statistically significant (P=0.2). In addition, the difference between the mean astigmatism at the final examination (1.35 ± 0.64 diopters) and the mean astigmatism before IOL dislocation (1.25 ± 0.69 D) was not statistically significant (P=0.19).Conclusion: Scleral fixation of dislocated IOLs using temporary haptic externalization through a clear corneal incision minimized the need for complicated intraocular maneuvers, and provided an easy and effective way to reposition dislocated IOLs. Long-term results are promising.  }, Keywords = {Scleral Fixation,Dislocated Intraocular Lens,Haptic Externalization}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1258-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1258-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Niazmand, S. and ErfanianAhmadpoor, M. and Hajzadeh, M. and Hosseini, Kh.}, title = {Inhibitory Effect of Ziziphora Clinopodioides Lam. on Rat’s Gastric Acid Secretion in Basal, Vagotomized and Vagal Stimulated Conditions}, abstract ={    Background & Aim: Ziziphora clinopodioides Lam. is a plant widely used in Iranian traditional medicine. Several reports have demonstrated antibacterial, antioxidant and anti-inflammatory properties of Ziziphora clinopodioides. The aim of this study is to investigate the effects of aqueous-ethanol extract of Ziziphora clinopodioides on rat’s gastric acid secretion and its probable mechanism.Material and Method: In this interventional experimental study, 24 Wistar rats weighing 200-250g were randomly divided into two groups: test and control. Tracheostomy and gastroduodenostomy procedures were performed on each rat. Gastric content was collected for 15 minutes by washout technique. 1 ml of three dosages (0. 5, 1 and 2 mg/kg) was introduced into the stomach of each rat in the test group and the same volume of saline was used in the control group. Total titratable acid was measured by a titrator. Data were shown as mean±SEM and analyzed by unpaired t-test. P<0. 05 was considered significant.Results: The extract inhibited acid secretion significantly in basal condition, but in vagotomized condition this inhibitory effect on acid secretion disappeared and the extract showed a stimulatory effect at the dose of 2mg/kg. Also,the extract showed an inhibitory effect at the dose of 1mg/kg in vagal stimulation condition.Conclusion: The extract exerted an inhibitory effect on acid secretion in basal and vagal stimulation conditions. The inhibitory effect of the extract was exerted via gastric vagal parasympathetic nerve.}, Keywords = {Ziziphora Clinopodioides Lam, Gastric Acid, Vagotomy,Vagous Nerve}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1257-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1257-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Nojomi, M. and Baharvand, P. and Kashanian, M.}, title = {Validation of Incontinence Quality of Life Questionnaire (I-QOL) in Incontinent Women}, abstract ={    Background & Aim: Urinary incontinence has a negative effect on physical, social, psychological and occupational aspects of health in women. The aim of current study was to assess the validity and reliability of the Persian version of urinary incontinence quality of life instrument (I-QOL) in order to determine quality of life in women with urinary incontinence and to promote the quality of medical cares and services.Patients and Method: Through studying evaluative diagnostic procedures and in order to assess the validity and reliability, I-QOL, psychological general well-being (PGWB) and Persian version of SF-36 questionnaires were offered to 373 eligible women with stress, mixed and urge urinary incontinence who were referred to educational hospitals of medical universities of Iran,, Hamedan, and Lorestan during six months. In order to measure the reliability, translated I-QOL questionnaires were completed by the patients 3 weeks later in the same clinics. We used Pearson correlation analysis, Cronbach’s-alpha, confirmatory factor analysis, and intraclass correlation coefficient to assess the validity and reliability ofI-QOL questionnaire. Results: Confirmatory factor analysis confirmed structural validity of I-QOL. The internal consistency (Cronbach’s-alpha) was 0.96. The range of internal consistency was between 0.78 and 0.93 for domains of I-QOL questionnaire. Reproducibility by intraclass correlation coefficient (ICC) was 0.96. The correlation between total I-QOL and the subscales of PGWB and SF36 ranged from 0.53 to 0. 61 and 0.47 to 0.59 respectively. I-QOL scores were found to be more closely related to well-being of PGWB (r=0.6) and social function of SF36 (r= 0.55).Conclusion: The obtained results showed I-QOL questionnaire has good reliability, validity and internal consistency for Iranian patients.}, Keywords = {Urinary Incontinence,Quality of Life, Validity,Reliability}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1255-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1255-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {MomenHeravi, M. and Sharif, A. R.}, title = {A Case Report of Leprosy of the Larynx}, abstract ={    Introduction: Leprosy is an ancient deforming disease caused by Mycobacterium leprae, which is still poorly understood and often feared by the general public and even by some in the health care professions. Fortunately, the outlook for patients has dramatically improved over the last three decades with the introduction of multi-drug treatment and management strategies that have somewhat diminished the stigma of this diagnosis. Here we report a case of leprosy of larynx. Case Report: A 45-year-old Afghan man who had presented with cough,dyspnea and hoarseness since many years ago was referred to our clinic due to worsening complaints. Because of the demonstration of acid fast bacilli in the smear of his sputum,diagnosis of tuberculosis was made and anti-tuberculosis treatment was initiated. However, he developed fever and his symptoms worsened,which led to his admission. On examination, there was a tender erythematous nodule in the right supraclavicular region, loss of eyebrows and eyelashes,and disseminated hyper-and-hypo pigmented cutaneous lesions on the abdomen, thorax and back. Chest x-ray was normal. In order to rule out laryngeal tuberculosis, laryngoscopy was done and granulomatous lesions were seen. Laryngeal and skin biopsy was performed. Both specimens revealed numerous acid fast bacilli, macrophages and foamy cells which were suggestive of lepromatous leprosy. Treatment was started based on multibacillary regime of WHO multidrug therapy. Conclusion: In conclusion, this report highlights the importance of systemic involvement in lepromatous leprosy, especially when the initial presentation is laryngitis or respiratory symptoms. Laryngeal leprosy may be mistaken with tuberculosis or laryngitis due to respiratory problems and the existence of acid fast bacilli in respiratory secretions.}, Keywords = {Leprosy, Larynx, Laryngitis , Mycobacterium leprae}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1253-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1253-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Morteza, N. and EbrahimiTakamjani, E. and Abdollah, V. and Jamshidi, A. A. and Kamali, M.}, title = {The Effects of Prophylactic Knee Braces on Athletes\' Performance}, abstract ={    Background & Aim: Knee injury is one of the major problems in sports medicine, and the use of prophylactic knee braces is an attempt to reduce the occurrence or severity of injuries to the knee joint. In addition to providing protection, a prophylactic knee brace should not inhibit normal joint function. The objectives of the present study were to examine the effect of three prophylactic knee braces upon athletes' performance. Patients and Method: This study was a randomized clinical trial in which 31 healthy male collegiate athletes volunteered as subjects to examine the effect of these braces on their knee function through isokinetic and functional tests in four sets: 1-without brace (control) 2- wearing knee sleeve without stays 3- wearing knee sleeve with four bilateral stays 4-with prefabricated brace. The order of sets was randomized and the domain limb was evaluated. The test protocol consisted of cross-over hop and vertical jump tests, in which the best jump distance of three trials was recorded. Then the subjects were administered an isokinetic knee flexion and extension test at 60deg/sec, 180 deg/sec and 300deg/sec, and the following isokinetic variables were recorded: peak torque to body weight ratio and average power. Repeated measures analysis of variance was used to evaluate the differences between 4 conditions. Results: Repeated measures analysis of variance revealed no significant difference between three trials in terms of peak torque to body weight ratio, average power, vertical jump and hop measurements,as they were tested within the three experimental conditions and one control condition (p>0. 05). Conclusion: These findings suggest that the selected brace/sleeves did not significantly inhibit athletic performance. Inasmuch as the function of knee joint was not impaired while wearing the neoprene sleeve without stays and knee sleeves are supposed to ameliorate knee joint position sense. it seems beneficial to use neoprene sleeves as the main structure of prophylactic knee braces.}, Keywords = { Prophylactic Knee Brace, Knee Performance , Isokinetics}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1252-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1252-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Moradi, S. and Darvishi, N.}, title = {Evaluation of the Prevalence of Metabolic Syndrome in Women with Polycystic Ovary Syndrome Referred to the Institute of Endocrine and Metabolism}, abstract ={    Background & Aim: Polycystic ovary syndrome (PCO) is characterized by insulin resistance with compensatory hyperinsulinemia. Insulin resistance also plays a role in the metabolic syndrome (MBS). So, we hypothesized that the MBS should be more prevalent in PCOS. Patients and Method: We conducted a cross-sectional study of all women with PCOS seen over a one-year period at the endocrinology clinic. 151 cases met the inclusion criteria for PCOS. The women were divided into two groups:1- women with PCO and the MBS (n=70) and 2- women with PCO lacking the MBS (n=81).Results: The mean age of the cases was 28 ±8 years,ranging from 16 to 48. The frequency of the MBS was 70 (46. 4%). The frequency of abnormal findings in all cases was as follows in descending order: Low HDL:71%, Increased waist circumference:55. 6%, High triglyceride:48%, High blood pressure:22. 6% and FBS>110mg/dl: 7. 3%. Conclusion: It is concluded that the MBS and its components are common in women with PCOS, placing them at increased risk for diabetes mellitus and cardiovascular diseases.}, Keywords = {Polycystic Ovary Syndrome , Metabolic Syndrome,Cardiovascular Disease, Insulin Resistance}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1251-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1251-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Modarreszadeh, M. and GhasemiFalavarjani, Kh. and Salehian, M. and SoltanSanjari, M. and Seddigh, N.}, title = {Evaluation of the Prevalence of Systemic Diseases in Patients with Anterior Ischemic Optic Neuropathy in Rassoul-e-Akram Hospital}, abstract ={    Background & Aim: Several risk factors have been postulated to be associated with nonarteritic anterior ischemic optic neuropathy (NAION) however, the main cause of it has remained unknown. Considering the absence of similar study in Iran, the aim of this study was to evaluate the prevalence of systemic diseases in patients with NAION in Rassoul-e-Akram Hospital.   Patients and Method: In this retrospective cross-sectional study, all patients with the diagnosis of NAION who were referred to Rassoul-e-Akram Hospital between April 2003 and 2005 participated. Demographic data and the prevalence of systemic diseases, including diabetes, hypertension, hyperlipidemia, renal disease and rheumatic disease were evaluated. The information was gathered from the records of the patients and analyzed by SPSS software. Internal comparison and comparison of the prevalence of diabetes and hypertension in our cases with corresponding data in Iran's population were drawn. Data was analyzed using Chi-square test.   Results: A total number of 51 patients with a mean age of 51. 08 ±9. 93 years were included. Bilateral involvement of eyes was present in 21. 6% of the cases. Male to female ratio was equal to 1. The most common systemic disorders were diabetes mellitus, hypertension, hyperlipidemia and renal disease (39. 2%, 37. 3%, 35. 5%, 3. 9% respectively). The prevalence of hypertension in age group of >45 years was significantly higher than normal population (p=0.004). The prevalence of diabetes mellitus was also higher than its prevalence in Tehran's population (p<0.001).   Conclusion: Diabetes mellitus, hypertension, hyperlipidemia and renal disease are the most common systemic diseases associated with NAION,and should be considered in the evaluation of NAION.  }, Keywords = { Nonarteritic Anterior Ischemic Optic Neuropathy (NAION),Systemic Disease , Risk Factor}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1250-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1250-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Mohammadi, Sh. and Kadivar, M. and Hassannia, F.}, title = {A Case Report of Giant Cell Reparative Granuloma in the Nasal Cavity}, abstract ={     Introduction: Giant cell reparative granuloma (GCRG) is a rare benign fibrous-osseous neoplasm that mostly involves maxilla and mandible. Only a few cases of GCRG in the nasal cavity have been reported so far.   Case Report: A 37-year-old man was referred to the otolaryngology clinic with the symptoms of left-sided nasal obstruction and bloody discharge since 3 years ago and proptosis since 3 months ago. CT-scan and MRI showed a heterogeneous mass with fluid-fluid level that had caused severe bony destruction. Biopsy confirmed the diagnosis of GCRG.   Conclusion: Although GCRG is rare, its clinical and radiologic characteristics should be studied. This lesion should be considered in differential diagnosis when clinical data, CT-scan and MRI findings show a fibrous-osseous lesion in the nasal cavity.}, Keywords = {Granuloma,Giant Cell, Neoplasm, Surgical Excision}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1249-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1249-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Motevalian, M. and Otukesh, H. and HosseiniShamsabadi, R. and Chalian, M.}, title = {Therapeutic Drug Monitoring of Cyclosporine-A in Iranian Children with Kidney Transplant}, abstract ={  Background & Aim: Cyclosporine-A (CsA) is an immunosuppressant with a narrow therapeutic window. Inter-and-intrapatient variability in cyclosporine pharmacokinetics necessitates frequent blood level monitoring in transplant patients and total blood cyclosporine concentration used to allow dosage adjustment in transplant patients. The purpose of the present study was, first of all, to develop a precise and suitable method for therapeutic drug monitoring (TDM) of cyclosporine in children with renal transplant and to evaluate CsA blood concentrations in patients in order to find out the best time for sampling Iranian children with kidney transplant for TDM of cyclosporine. This can also help us achieve the best immunosuppressant with the least side effects for renal transplant patients.   Patients and Method: In this experimental study, 29 pediatric transplant recipients (16 boys and 13 girls) who had received renal transplant at least six months prior to the study participated. The mean age of the patients was 14. 5 ±2. 3 years (ranging from 8 to 20 years),and they all showed stable renal function. The patients were also receiving other drugs such as prednisolone, mycophenolate mofetil, iron and folic acid. The clinical status of the patients was recorded. The CsA blood levels were determined using radioimmunoassay (RIA) 0, 0. 5, 1, 1. 5 and 2 hours after drug administration. The data analysis was performed using Pearson correlation coefficient.   Results: Our results are indicative of good precision and�reproducibility of the method. Minimum detection limit of cyclosporine-A was 5 ng/ml and percentage yield was 86-109%. Inter-and-intraday variability for three cyclosporine-A blood concentrations were 8% and 5. 8% respectively. The mean blood concentrations 0. 5 and 1 hour after drug administration were 100 ± 3. 0 and 515± 19. 2 μ g/dl respectively. The mean serum creatinine level was 0. 9 (0. 1-1. 9) mg/dl. There was a high correlation between CsA dose, serum creatinin and C1. 5, while there was no correlation between age, serum creatinine and C1. 5 level. Also, there was no correlation between C0 and any of the above-mentioned parameters. These results show that C1. 5 level is the best indicator for TDM of cyclosporine-A in Iranian children and has the best correlation with dose and creatinin level.   Conclusion: The developed method is precise,sensitive and suitable for therapeutic drug monitoring of cyclosporine-A. Using single point monitoring can help to improve the cooperation of patients during TDM procedure, and for this purpose C1. 5 level seems more accurate than C0 level in pediatric transplant patients.}, Keywords = {Cyclosporine-A , Therapeutic Drug Monitoring (TDM),Blood Concentration}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1248-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1248-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Kashefi, F. and Ziyadlou, S. and Fadaee, A. and Ashraf, A. and Jafari, P.}, title = {The Effect of SP6 Acupressure on Primary Dysmenorrhea in Medical Univesity Students in Birjand, 2006-2007}, abstract ={    Background & Aim: Dysmenorrhea is one of the most common problems in gynecology. Almost 50% of all girls suffer from dysmenorrhea and about 10% of reproductive girls are absent from their work for 1-3 days due to dysmenorrhea.Dysmenorrhea accounts for 600 million lost work hours and $2 billion lost productivity annually. Due to the bad effets of severe dysmenorrhea on girls, relieving the pain is important. One of the nonpharmacological methods to relieve dysmenorrhea is acupressure. This study aims to determine the effects of SP6 acupressure on primary dysmenorrhea in medical university students in Birjand between 2006 and 2007. Patients and Method: In a single-blind, randomized, clinical trial, 86 single students with regular menstruation and primary dysmenorrhea were chosen based on the history, interview and observation forms and divided into two groups of real acupressure and pelacebo acupressure. In the acupressure group, at the initial 24 hours of menstruation acupressure at the acupoint was applied to both sides. In the placebo group, at the initial 24 hours of menstruation the subjects were given placebo acupressure twice. The force applied to the acupoint was initially 1/21 kg increasing to 3/53 kg at the end of the therapy. SP6 was pressed with the thumb for 6 seconds and released for 2 seconds without pressure. Two complete cycles of pressure were performed on each leg for a total of 30 minutes. After that, the intensity of dysmenorrhea was measured by visual analog scale, including the rating from 0-10 cm, immediately, 30, 60, 120 and 180 minutes after the intervention. Data were analyzed using statistical tests called repeated measure analysis of variance and general linear model. Results: The results showed that the mean intensity of dysmenorrhea was statistically different between the two groups after the intervention (p<0. 001). Also, the mean intensity of dysmenorrhea immediately, 30, 60, 120 and 180 minutes after the intervention in the acupressure group was lower than that in the placebo group. Conclusion: SP6 acupressure decreased the intensity of dysmenorrhea without any side effects. Therefore, it can be used as an easy, cheap and non-invasive method for dysmenorrhea relief.}, Keywords = {Dysmenorrhea, Nonpharmacological Dysmenorrhea Relief Methods,Acupressure , SP6 Acupoint}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1247-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1247-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Azizjalali, M. H. and Behrangi, E.}, title = {Study of the Prevalence of Tinea Pedis in Swimmers of the West Pools of Tehran in 2007}, abstract ={      Background & Aim: Tinea pedis is one of the most prevalent fungus infections in humans. Since moist conditions probably favor growth of the fungus, the role of swimming pools has been well established in the propagation of dermatophytic foot infections.   Since swimming pools are the most important places for flare-up of clinical symptoms in asymptomatic persons and propagation of infections,and also the treatment of tinea pedis is time-consuming and expensive therefore, it is better to try for prevention of infections. The aim of this study was to determine the prevalence of tinea pedis in swimmers of the west pools of Tehran city in 2007. Yet preventive measures were taken by detecting and referring infected swimmers to medical centers.   Patients and Method: This cross-sectional study was carried out in 2007, in ten swimming pools selected randomly from the swimming pools of regions under the supervision of Iran University of medical sciences. Feet and toe clefts of 2500 regular swimmers, who went to the swimming pool at least once a week, were examined by a dermatologist and from the lesions clinically suspected to be tinea pedis, samples were taken and sent to the laboratory of mycology for direct smear and culture.   Results: Of the 2500 swimmers(1850 males and 650 females) ranging from 5 to 70 years of age, 16 individuals (0. 64%) including 12 males (0. 65%) and 4 females (0. 62%) showed positive culture for dermatophytes The infection was more prevalent in swimmers with an age range of 46-55 years. The main dermatophytes involved in tinea pedis in swimmers were: Epidermophyton floccosum 8 cases (50%), Trichophyton mentagrophyte, var. interdigital 4 cases (25%), and Trichophyton rubrum 4 cases (25%). Other organisms isolated from culture media included Candida, Corynebacterium minutissimum, Aspergillus niger, bactiria and saprophytes.   Conclusion: Our study revealed that tinea pedis was not frequent among swimmers.}, Keywords = {Infection , Tinea Pedis , Swimming}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1246-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1246-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Taheri, H. and Jafari, D. and Shariatzadeh, H. and NajdMazhar, F.}, title = {Introducing a New Pathophysiology of Congenital Clasped Thumb – A Rare Case Report}, abstract ={   Introduction: Congenital clasped thumb refers to spectrum of thumb anomalies with diversity of very mild cases with deficiency in extensor mechanism to severe abnormality in soft tissue and thenar muscles. Hypoplasia and absence of extensor pollicis brevis are usual and the patient is unable to extend the metacarpophalangeal joint of thumb.   Case Report: The present patient is a 12-year-old left-handed boy who has been referred due to bilateral deformity in his thumbs. General physical examination was normal except in his thumbs. The first web space was narrow bilaterally. In spite of full passive range of motion in the joints of thumbs, he was unable to extend the metacarpophalangeal joint of thumbs but he could extend the interphalangeal and carpometacarpal joints. During surgical treatment it became clear that the cause of inability to extend the metacarpophalangeal joint of thumb was not hypoplasia or aplasia of extensor pollicis brevis but abnormal insertion of this tendon. Both extensor pollicis brevis and longus tendons were inserted to the distal phalanx. Reinsertion of extensor pollicis brevis to the base of proximal phalanx was done in the right hand.   Conclusion: This report presents a new pathophysiology for congenital clasped thumb for the first time. According to these findings, in addition to aplasia or hypoplasia of extensor pollicis brevis tendon, abnormal insertion of extensor pollicis brevis to the distal phalanx can be an underlying causative factor in congenital clasped thumb.}, Keywords = {Clasped Thumb , Congenital Malformation, Extensor Pollicis Brevis , Abnormal Insertion}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1245-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1245-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Soleimani, M. J. and ZargarShoushtari, M. A. and Shahrokh, H. and HabibAkhyari, H. and KaffashNayyeri, R. and Fereshtehnejad, S. M. and Asgari, M.}, title = {Comparison Study of the Diagnostic Values of Serum Cystatin C and Creatinine in the Assessment of Renal Function in the Early Follow-up of Renal Transplant Patients}, abstract ={   Background ;Aim: Early detection of decreasing glomerular filtration rate (GFR) is critical to prevent graft rejection in post-transplantation period. Serum creatinine has several drawbacks as a marker of GFR, so serum cystatin C has been proposed as an alternative GFR marker. Thus, we prospectively evaluated the diagnostic value of cystatin C measurements compared with serum creatinine in the early postoperative phase.   Patients and Method: In 78 renal recipients, serum creatinine and cystatin C were measured on the 3rd, 7th and 14th days of post-transplantation period. GFR was established by creatinine clearance with the cut-off point of 80 ml/min/1. 73 m2. The correlation between serum creatinine and cystatin C with GFR was determined. Sensitivity and specificity of these markers were analyzed by ROC procedures.   Results: There were 78 renal recipients (51 males and 27 females) with the mean age of 34. 56± 13. 36 years and mean body mass index (BMI) of 22. 36± 3. 46 kg/m2. Serum cystatin C was not influenced by gender, age and BMI. There was a significant correlation between serum creatinine and cystatin C levels with GFR on the 3rd, 7th, and 14th days (P< 0. 001). Analysis with ROC procedures showed a decrease in GFR (GFR< 80 ml/min/ 1. 73 m2) on the 7th day (P= 0. 023, AUC= 0. 694). Sensitivity and specificity of serum cystatin C were 67. 7% and 77. 9% respectively with the cut-off point of 2264 ng/ml.   Conclusion: Cystatin C has good sensitivity to estimate the renal function in the early post-transplantation period, but its value as a marker of GFR is decreased at the end of the first week.}, Keywords = { Cystatin C , Creatinine , Transplanted Kidney}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1244-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1244-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Rafiee, Sh. and Taghizadeh, Gh. and Karimi, H. and RahimzadehRahbar, S.}, title = {Body Part Identification in 1 to 4-year-old Children Living in South of Tehran}, abstract ={    Background & Aim:�The purpose of this study was to examine the development of body part identification in very young children. Body part identification is defined as the ability to point to body parts on a doll. The second part of this study compared body part identification on a doll with body part identification on the self in 1 to 4-year-old children. There are so many evaluations carried out in western countries,but they aren’t useful for different races, and if some of them are,there is no sufficient information available. Therefore, we decided to survey body part identification in our own country. Patients and Method: This cross-sectional study was performed on 90 children in the south of Tehran. The evaluated children were 1 to 4-year-old,including 46 girls and 44 boys. The nursery chief ,first,completed demographic parts of questionnaires and then the second section of questionnaires which consisted of body part names in order to determine the number of parts indicated for obtaining total grade of the survey. Results: The findings showed that there were significant differences between three age groups (p<.001). There was no significant difference between two gender groups,i. e. boys and girls, in mean scores of body identification on the self in all age groups(p<0. 05),but there was a significant difference between two gender groups in body identification on a doll in 2-3 and 3-4 year-olds(p<0. 05). Finally, there was no significant difference between body identification on the self and on a doll(p<0. 05). Conclusion: These results have several implications for the assessment of body part identification in young children. First, since 1-4-year-old children appear to be able to point to body parts both on a doll and on themselves, they can be asked to point to body parts either on a doll or, if they are reluctant,on themselves. Second,the children who are unable to point to body parts may be at risk for delays in language, cognition, and body scheme developmenttherefore,they should be screened or evaluated further.}, Keywords = {Body Image, Body Part Identification,Child Development}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1243-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1243-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Delshad, S.}, title = {Evaluation and Comparison of One-stage Surgery versus Two-stage Surgery in Children with Intersex Conditions due to Adrenal Hyperplasia}, abstract ={  Background & Aim:Many factors such as chromosomes, gonads, hormones and enzymes influence the development and differentiation of embryonic external genitalia. Any defect in these factors leads to intersex condition, a term used to describe discrepancy between external and internal genitals. Physical and emotional complications arising from genital ambiguity may be prevented by appropriate assessment and planning. This study investigated methods of treating patients with genital ambiguity and compared the results of two-stage surgery with one-stage surgery in the more common form of disorders of sexual differentiation that is female pseudohermaphroditism due to adrenal hyperplasia.   Patients and Method: A retrospective study was employed to evaluate the records of 65 patients undergone genital reconstructive surgery in Ali Asghar Children's Hospital, Tehran Children's Hospital, and Seyed-al-Shohada charity Hospital. 50 patients had female pseudohermaphroditism with adrenal hyperplasia origin and 15 patients had other types of intersex disorders. The timing of performing one-stage surgery was between 3 and 6 months of age and for the two-stage type of surgery, the second procedure was performed when the patient was between 5 and 6 years of age. Forty-eight patients with female pseudohermaphroditism underwent clitoroplasty, labioplasty and vaginoplasty to change the masculine external genitalia to feminine. In one-stage group, these procedures were completed concurrently, while in two-stage type, clitoroplasty and labioplasty were done at the age of 3 to 6 months and vaginoplasty was performed when the patient was 5 to 6 years of age.   Results: 36 out of 48 cases of female pseudohermaphroditism due to the adrenal gland hyperplasia underwent one-stage surgery. 12 cases had a two-stage surgery in which clitoroplasty and labioplasty were performed at the age of 3-6 months and vaginoplasty when the patient was between 5 and 6 years of age. Vaginal opening stenosis being the most common post-surgical complication was not observed in 41. 7% of one-stage surgery group and 75% of two-stage type. The obtained difference was statistically significant (p-value=0. 047).   Conclusion: In comparison to one-stage surgery, vaginal opening stenosis was not observed in two-stage surgery therefore, two-stage surgery is considered a better method to treat patients with genital ambiguity.}, Keywords = {Genital Ambiguity, Intersex ,Adrenal Hyperplasia}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1238-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1238-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {JabalAmeli, M. and Yeganeh, A. and Nojomi, M.}, title = {Axial Alignment of Lower Extremity in Adults}, abstract ={  Background & Aim: Normal axial alignment restoration in lower extremities is very important for surgeons that perform reconstructive surgeries. Since normal values of axial alignment in Iranian population aren't available, normal values in western countries are used in practice.   In this study axial alignment norms in Iranian adults were determined and the results were compared with those of the studies in China and America.   Patients and Method: Through a cross-sectional design, axial alignment view of lower extremities was taken in 68 volunteers (34 males & 34 females) between 18 and 32 years old. The. average of axial alignment angles was measured. Data analysis was done by t-test and the existence of correlation was examined by using SPSS software. Then the results were compared to those obtained by the studies in China and America.   Results: The average angle between anatomical axis of femur and tibia was 5. 10 ,which was different from 60 in western countries studies.   Medial proximal tibial angle was 86. 30 ,which was different from Chinese and American studies.   The angle between mechanical axis of femur and tibia was 178. 50,which was not different from past studies. Tibia, in this study, had 0. 9 degrees tibia vara. and ankle was of 1. 7 degrees in valgus.   Conclusion: Lower extremity axial alignment angles in Iranian adults are different from those in Chinese and American adults. Based on the angle between anatomical axis of tibia and femur, women's knee has 1. 60 more valgus than men's. No correlation was found between axial alignment and height, weight, tibia and femur length.  �}, Keywords = {Lower Extremity Alignment , Femoral Axial Alignment,TibiaL Axial Alignment}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1237-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1237-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Jalesi, M. and Kamrava, K. and Doroudinia, A. and SahraneshinSamani, Sh. and Hamdarsi, N. and Pousti, B. and Izadi, F.}, title = {Mortality Rate in Patients Admitted to Otolaryngology Ward of Hazrat Rasoul-e-Akram Hospital between 1992 and 2003}, abstract ={    Background & Aim: Mortality statistics can be used in assessing course of diseases at the level of a hospital, a city or a country in order to evaluate the quality of health care systems. The aim of this study is to define the prevalence and common causes of otolaryngology-related deaths in otolaryngology ward of Hazrat Rasoul-Akram Hospital during an 11-year period. Patients and Method: In this retrospective study, all patients who had been hospitalized in ENT Ward and died thereafter were included. The individual medical records were then reviewed and information such as demographic data (age and sex), primary complaint, root and duration of hospitalization, diagnosis, treatment modalities, and place of death was recorded ethically and mentioned as descriptive statistics. Results:Among a total of 19266 admitted patients, 25 fatalities were recorded, showing an average of 1. 29 per 1000 admissions. Female to male ratio was 1. 27:1. The highest and the lowest mortality rates belonged to the age groups of over 50 and under 30. Malignancy was the first cause of death (28%) followed by severe infection or abscess of head and neck (24%). Conclusion: Compared to hospitals in other countries,the prevalence of mortality due to ENT causes in this teaching hospital showed a better health care condition in this ward. The most common causes of death in ENT Ward were malignant neoplasms and head & neck infections respectively.}, Keywords = { Mortality, Era, Nose and Throat (ENT), Prevalence}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1236-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1236-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Meratan, A. A. and Bigdeli, M. R.}, title = {Study of Prolonged and Intermittent Effects of Normobaric Hyperoxia Preconditioning on Glutathione Peroxidase Activity in Rat Stroke Model}, abstract ={  Background & Aim: Ischemic preconditioning (IPC) is an endogenous phenomenon that can induce ischemic tolerance (IT) in a variety of organs such as brain. In this study, we examined the intermittent and prolonged effects of normobaric hyperoxia (HO) on neurologic deficit scores, infarct volume, and glutathione peroxidase activity.   Material and Method: This experimental study was done in Shahid Beheshti University. The rats were divided into four main groups. The first two main groups were exposed to HO in prolonged (24hrs PrHO) and intermittent (4hrs×6days InHO) ways and the second two groups acted as controls and were exposed to 21% oxygen in the same chamber (room air, RA) continuously (24hrs PrRA) and discontinuously (4hrs×6days InRA). Each group was divided into three subgroups. After 24 hours,the first subgroup was subjected to a 60-minute MCAO followed by 24hrs of reperfusion. Then,the IT induced by InHO and PrHO was measured through neurologic deficit scores and infarct volume. The second and third subgroups were called sham __ operated and intact subgroups __ and used for the assessment of the effect of HO on glutathione peroxidase activity. Enzyme activities, arterial blood gases, and infarct volume were compared using one-way ANOVA test. The neurologic deficit scores were analyzed using the Mann-Whitney U test.   Results: Our findings indicate that InHO and PrHO are involved in the induction of IT. Pretreatment with InHO and PrHO can reduce neurologic deficit scores and infarct volume and increase glutathione peroxidase activity significantly. The catalase activity of prolonged HO groups was significantly more than that of intermittent HO groups.   Conclusion: Although further studies are needed to clarify the mechanisms of ischemic tolerance, InHO and PrHO seem to partly exert their effects via increasing glutathione peroxidase activity.}, Keywords = {Preconditioning,Ischemia,Glutathione Peroxidase,Stroke ,Normobaric Hyperoxia}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1235-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1235-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Imani, F. and Entezary, S. R. and TaghipourAnvari, Z. and MoradiLakeh, M.}, title = {Comparison of Remifentanil with Alfentanil for Endotracheal Intubation}, abstract ={  Background & Aim: Opioids, such as alfentanil, are used without neuromuscular blocking agents to facilitate endotracheal intubation in patients undergoing elective surgery. The goal of this study was to evaluate the possibility of endotracheal intubation with propofol and remifentanil and compare it to propofol and alfentanil, without neuromuscular blocking agents.   Patients and Method: A hundred ASA I patients undergoing elective inpatient surgery were scheduled in this prospective, randomized, double-blind study. The patients were divided into two groups: alfentanil (control group) and remifentanil (study group). In the control group, 50 μg/kg alfentanil was IV injected over 10 seconds, and after 45 seconds or occurrence of apnea, 2 mg/kg propofol was IV injected over 5 seconds. Thirty seconds after the administration of propofol, laryngoscopy and tracheal intubation were attempted. In the study group, only 5 μg/kg remifentanil was administered instead of alfentanil. Intubating conditions were assessed on the basis of ease of laryngoscopy, vocal cords opening, jaw relaxation, and limb movement (1 - 4 score). Intubation scores were analyzed by nonparametric tests and compared between the two groups.   Results: There were no demographic differences such as age,weight and sex between the groups. Although, laryngoscopy, jaw relaxation, and limb movement scores were similar in both groups and there were no significant differences, vocal cord opening was significantly wider in the study group than the control group(P = 0. 028).   Conclusion: This study revealed that the use of propofol and remifentanil provided excellent conditions for tracheal intubation in most patients in the same way as propofol and alfentanil, and the score of vocal cord opening in the study group was better than alfentanil group. Therefore, to avoid administering muscle relaxants , remifentanil and propofol can be used for laryngoscopy and endotracheal intubation in healthy young patients.  }, Keywords = { Alfentanil, Remifentanil, Propofol}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1234-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1234-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Izadi, F. and Iravani, K. and Abdolmotalebi, F.}, title = {Efficacy of Surgical Managements in Patients with Subglottic Stenosis Referred to Rasoul-e-Akram Hospital}, abstract ={    Background & Aim: Subglottic stenosis affects the quality of life greatly and on occasion may compromise to life. There are multiple surgical managements for it,and each has its own advantages and disadvantages. The aim of the present research was to define success of surgical techniques in patients with subglottic stenosis referred to Rasoul-e-Akram Hospital. Patients and Method: This cross-sectional study was performed on 42 patients referred to otolaryngology department of Rasoul-e-Akram Hospital between 2000 and 2007. Before performing operation,the degree and length of stenosis was defined by direct laryngoscopy and endoscopic examination. Based on the success of decannulation and direct laryngoscopy, the efficacy of operation was evaluated. Statistical analysis was done by t-test and Chi-square. Results: The mean age of the patients was 23. 3 years with standard deviation of 11. 2. 32 patients (76%) had history of prolonged endotracheal intubation. In 23 patients, endoscopic surgery was done with laser or cold microsurgery or bugienage. 19 patients underwent open surgery which included 16 cases of laryngofissure with stent and 3 cases of resection with end-to-end anastomosis. The overall success of operations was 73%. Conclusion: Selection of proper method and technique in successful management of these patients is very important. In our study, the highest percentage of success was through resection and anastomosis and then with laryngofissure.}, Keywords = {Subglottic Stenosis , Laryngofissure, Laryngeal Stent}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1233-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1233-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Ansari, Sh. and Vossogh, P. and Dahanzadeh, M.}, title = {Outcome of Treatment and Survival Analysis in Pediatric AML Non APL in Ali Asghar Children’s Hospital (1988-2003)}, abstract ={     Background & Aim: AML accounts for about 15% of all childhood leukemia. The improvement has been seen over the past decades after treating with chemotherapy alone. The outcome has been better for children and it has had long term survival for all patients treated with BFM protocol chemotherapy. The aim of the present study was to investigate long-term survival in patients referred to Ali Asghar Children's Hospital.   Patients and Method: The study was carried out on all 83 children with nonAPL AML who had been treated based on BFM protocol from 1988 to 2003 in Ali Asghar Children’s Hospital and did not receive blood or a marrow transplant. Through this study, information about sex, age, type of subgroup, clinical signs, treatment and survival (event free survival) was gathered in order to have better treatment and follow-up. This study was carried out as Cohort survey and the obtained data was analyzed via SPSS software.   Results: Of 83 patients, 55 were male and 28 were female. The mean age of the cases was 7. 3 years old, ranging from 6 months to 13 years. 4% of the patients died during remission from complications of therapy. 10 patients (12%) did not respond to treatment after chemotherapy. 69 of the cases (83. 1%) gave complete response to therapy. Mean duration of follow-up was 5. 5 years. 36. 1% (30 cases) of the patients suffered relapse. EFS (event free survival) of the patients was 53. 62 ± 6%, and 5-year survival was 44. 58 ± 5. 46%.   Conclusion: 30-50% of the patients treated with BFM protocol chemotherapy had long-term survival,while bone marrow transplant could raise long-term survival to 60-70%.  }, Keywords = {AML (acute myeloid leukemia) , Long-term Survival,Bone Marrow Transplant , Chemotherapy,BFM Protocol}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1232-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1232-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Ehsanipoor, F. and Ardalan, M.}, title = {Study of the Correlation between Acetaminophen Consumption and CSF Glucose in Febrile Convulsion}, abstract ={   Background & Aim : Hyperglycemia and hyperglycorrha ch ia are common associations of febrile seizures. Rapid release of cortisol and adrenaline after seizures as a stress reaction induces elevated glucose concentration. During fever release of interleukin-1 beta, an endogenous pyrogenic cytokine, inhibits insulin release and stimulates the secretion of cortisol. This may explain the correlation between CSF glucose concentration and body temperature in the present report . The purpose of our study was to assess the correlation between acetaminophen consumption and CSF glucose in febrile convulsion.   Patients and Method : In this cross-sectional analytic study ,we analyzed CSF samples taken from 63 children with febrile convulsion whose ages ranged from 3 to18 months. Comaprisons between the mean CSF glucose concentrations in the children who had taken and not taken acetaminophen within 6 hours before convulsion were made using Students' t-test and Mann-whitney test.   Results: CSF glucose levels were significantly higher (P =0. . 0001) in children who had not taken acetaminophen (82±8 mg/dL, n =) as compared with children who had taken acetaminophen (53±4 mg/dL, n=).   Conclusion: The use of acetaminophen decreases CSF glucose concentration in febrile convulsive children.}, Keywords = {CSF Glucose, Acetaminophen, Febrile Convulsion}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1231-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1231-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} }