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Volume 2, Issue 0 (9-1995)
The field of prenatal diagnosis of congenital anomalies has had great advances in recent years. Today we are able to diagnose different fetal anomalies in early developmental stages, and correct some of them, through prenatal fetal surgery.
In this paper, we begin by describing the advances in surgical treatment of some fetal diseases such as, diaphragmatic hernia, lung sequestration, pleural effusion, congenital cystic adenomatoid malformation (CCAM) urinary tract obstructions , sacrococcygeal teratoma and twin-twin transfusion syndrome, then discuss new fields of research generated by the study of fetal surgery.
Volume 6, Issue 3 (12-1999)
Schizophrenia is the worst illness that affects human mentality and is considered as a chronic mental disorder. According to the report of WHO, the overall prevalence rate of schizophrenia is 0.7-1% in any L·: population. Due to this high rate of prevalence, many studies have been conducted in this field. As incidence and severity of this illness are influenced by genetics, as an intervening factor, studies which are conducted to clear this issue seem necessary. Despite many reports of association of HLA antigens and schizophrenia in other countries, nothing was known in Iran. So, we decided to conduct this study. In this study, the frequencies of 52 antigens of class I and II were determined in 45 schizophrenic patients and were compared with those of control group. Of these 45 patients, 20 cases were female, with a mean age of 29 years and 25 cases were male, with a mean age of 35 years. All these patients were physically healthy. To determine the frequencies of the aforementioned antigens, microlymphocytotoxicity method was employed. The results show that the difference of frequencies of A9, AW19, 85,815,851, 8w6, CW3, DR5, DR11 and DQ1antigens is significant (P < 0.05) between case and control groups. Of these antigens, the relative risk (RR) was higher than 1 in Bw6 and Cw3 and lower than 1 in the others. It can be concluded that the antigens 8w6 (RR=4.6 and etiologic factor [EF]= 0.72) and Cw3 (RR=2.67 and EF=0.13) are positively associated with schizophrenia. Other may have a protective role. |
Volume 16, Issue 0 (6-2009)
Intoduction: Morgagni hernia is a herniation through the costosternal portion of diaphragm. Morgagni's defect usually occurs on the right side. Morgagni hernia is a rare hernia and occurs more commonly in adults.
Case report: A 4 years old child was referred to office for recurrent pneumonias. The patient was under treatment for his pneumonias since 2 years ago. On chest CT scan, transverse colonic segment and air fluid level was seen in the right hemi thorax.
Conclusion: With the diagnosis of Morgagni hernia, the patient was prepared for operation. Surgical approach was right thoracotomy. Herniated colon through morgagni defect was observed. The hernial sac was set free from a 2.5x2.5 cm defect in the anterior part of diaphragm. The colon was moved in to abdomen. The defect was repaired by 1-0 nylon sutures. After operation and often 1.5 years follow up, the patient is well with no complications.
Volume 18, Issue 90 (12-2011)
Background:
to work absenteeism. This disability which is usually due to spinal disc herniation prevents an
employee from doing his/her daily job, thus creating numerous destructive socioeconomic
consequences for him/her as well as the society. The goal of this study is to determine the patients
return-to-work rate after undergoing the lumbar disc herniation surgery and to study the related
factors.
The disability caused by the lower back pain is one of the leading factors contributingMethods:
2005 to 2009 at two TUMS (Tehran University of Medical Sciences) educational hospitals were
included in this study. Required data about the patients were gathered from the hospital documents,
and the return-to-work rate was evaluated by following up on patients via phone calls. Chi-square and
T tests were used for evaluation of quantitative and qualitative variables, respectively.
This study was a cross sectional study. All patients suffered from lumber discetomy fromResults:
work. From these 504 cases, 364 patients (72.2%) returned full time, and 140 patients (27.8%)
returned part time. A multivariate regression analysis showed that the return-to-work rate has a strong
correlation with age, sex, educational level, body mass index, positive expectation from the surgery
before doing it, doctor's encouragement, hospitalization time, manual work, and job satisfaction
(p<0.05) however, it had no significant correlation with marriage status, income level, impairment
request, insurance coverage, peer support, and the work category with respect to physical labor
demand (p>0.05).
From 603 final participants, at least 6 month after the surgery, 504 cases (83.6%) returned toConclusions:
determinants of the return-to-work rate after the lumbar disc surgery. From this study, it is apparent
that appropriate strategies and team work (between the patient, the surgeon, the rehabilitation
specialist, the occupational medicine specialist, and the employer) would elevate the job satisfaction
and positive expectations about the surgery, and therefore, they encourage the patient to return to
work at a suitable time which in turn, may increase the total return-to-work rate.
Our findings show the importance of work related and psychological factors as theVolume 22, Issue 135 (9-2015)
Background: The aim of this study was to investigate the effect of Pilates exercises on low back pain and abdominal and back muscle endurance in patients with chronic low back pain caused by disc herniation.
Methods: For this purpose, 30 male and female patients with chronic low back pain due to disc herniation (age =51.28 ± 5.16) were divided into experimental and control groups (n=15). The experimental group underwent 6-week Pilates exercises whereas the control group received conventional treatment at the same time. Analysis of covariance test was used to analyze the data. VAS scale, trunk flexion endurance test, and modified Biering-Sorenson test were used to assess variables, abdominal muscle endurance and back muscle endurance, respectively.
Results: Results showed that 6-week Pilates exercises caused a significantly low back pain reduction (p=0.001) and a significant increase in abdominal muscle endurance (p=0.001) and back muscles endurance (p=0.001) in the experimental group compared to the control group.
Conclusion: According to the findings of the study, Pilates exercises were effective in improving low back pain, abdominal and back muscle endurance in patients with chronic low back pain caused by disc herniation. Hence, cautious prescription of Pilates exercises for these patients would be beneficial.
Volume 24, Issue 160 (10-2017)
Background: The diaphragm is the main respiratory muscle; the diaphragm can rupture in the field of blunt trauma, penetrating trauma or occur following medical procedures. Approximately 0.8 to 1.6% of patients with blunt trauma are suspected to have a rupture of the diaphragm. As diaphragmatic rupture is a rare clinical condition, so it may be undiagnosed and associated with complications and high mortality and morbidity.
Case report: In this study we report a 53-year-old man, with history of blunt trauma five years ago, but during this period, remained undiagnosed. For shortness of breath, he visits physicians frequently and just receives medical treatment during these years. Finally, requested abdominal X-ray showed diaphragmatic rupture and herniation of the left side of the colon into the thoracic area.
Conclusion: Having a strong clinical suspicion, taking a thorough history of the patient, performing an accurate physical examination and doing an essential diagnostic procedures should all be considered to help confirm the diagnosis.
Volume 29, Issue 8 (11-2022)
Background & Aims: Between 5% and 15% of patients with low back pain suffer from lumbar disc herniation, so intervertebral disc disease is one of the most common causes of low back pain. Surgical intervention for lumbar disc herniation is recommended in patients with severe symptoms and has hopeful results. Although surgery can reduce pain and improve physical function in the short term, its long-term effect is debatable. Recurrence of disc herniation is one of the complications of primary surgery. The reported rate of recurrent disc herniation is 5 to 15% according to the evidence in the literature. Although there are different surgical methods for the treatment of recurrent disc herniation, there is a difference of opinion among surgeons in choosing the surgical method. Lumbar intervertebral disc herniation is a major disease of the spine. Surgical treatment is recommended in cases where patients have irreversible symptoms due to this disease. However, other techniques, such as fusion surgery, laminectomy, and percutaneous endoscopic lumbar discectomy, also apply new tools in line with minimally invasive spinal surgery techniques. Gathering information about various factors influencing the recurrence of the disease, such as individual demographic variables and the type of surgical procedure, helps in better planning for the treatment of intervertebral disc herniation. Numerous studies have been performed to determine the causes of recurrence of lumbar disc herniation, and various risk factors have been suggested, including disc herniation, trauma, age, smoking, gender, and obesity. The aim of this study was to determine the frequency of recurrence of lumbar intervertebral disc herniation in both hemilaminectomy and partial laminectomy.
Methods: This study is analytical and retrospective. This study was performed on patients who have had at least 6 months since surgery for the treatment of lumbar intervertebral disc herniation and have obtained informed consent. 400 patients who were candidates for lumbar intervertebral disc herniation surgery in Mortaz Hospital in Yazd from 2016 to 2019 were divided into two groups in terms of the type of surgery, hemilaminectomy and partial laminectomy, and were evaluated and compared during six-month to three-year follow-up. Patients who were candidates for lumbar intervertebral disc herniation based on diagnosis and imaging results were used as the inclusion criteria. Patients with spinal canal stenosis, lumbar spine slippage, and dissatisfaction to participate in this study were excluded. Data included age, gender, body mass index, smoking, type of occupation (light or heavy), type of disc herniation (extruded or non-extruded), diabetes status, recurrence time, and type of surgery (partial laminectomy or hemilaminectomy). In the follow-up and review of the treatment process, information on recurrence of disc herniation was referred to. In addition to assessing the relationship between the type of surgery and recurrence of disc herniation, other possible risk factors for recurrence of disc herniation in terms of its impact on the type of surgery were studied.
Results: The frequency of the first group consists of patients who underwent partial laminectomy and includes 338 patients (84.5%) and the second group of patients who underwent hemilaminectomy surgery which includes 62 patients (15.5%). The overall risk of recurrence, regardless of the surgical procedure, was 35 in 8.8%. In the group of 338 patients who underwent partial laminectomy, 26 patients (7.7%) had a recurrence of lumbar intervertebral disc herniation. In the group of patients who underwent hemilaminectomy, 9 out of 62 patients had a recurrence of disc herniation, which is equivalent to 14.5% of patients. In this study, no significant difference was found between the recurrence rate of lumbar intervertebral disc herniation in two methods of hemilaminectomy and partial laminectomy, which was evaluated by the Chi-square test (P = 0.08). The mean age of the samples was 47. 0.8 with a range of 15 to 79 years. In 338 patients who underwent partial laminectomy, the mean age was 47.98 years and in 62 patients who underwent hemilaminectomy, the mean age was 47.25, which was not significantly different from p = 0.689. Also, the mean duration of recurrence after partial laminectomy was approximately 6 months and in hemilaminectomy was 9 months. This relationship was evaluated by T-Test and was not significant with p = 0.135. The results of this study showed that in the sex variable, there was no difference in the recurrence rate of lumbar intervertebral disc herniation in both surgical methods of hemi laminectomy and partial laminectomy in males, but was significant in females with P = 0.036 In this study, diabetic and non-diabetic patients had no difference in recurrence rate in partial laminectomy and hemilaminectomy (p = 0.261). According to the results, there is no significant difference in the recurrence rate of lumbar intervertebral disc herniation in hemilaminectomy (P = 0.170) and partial laminectomy (P = 0.251) according to the type of disc herniation. According to the results of this study, the risk of recurrence of lumbar intervertebral disc herniation in people with light occupations in partial laminectomy surgery is lower than in hemilaminectomy surgery. Also, the risk of recurrence in non-smokers in partial laminectomy and hemilaminectomy was 7.2 and 17.3, respectively, and was significant with p = 0.030. The risk of recurrence of lumbar intervertebral disc herniation in the age range of 54-45 years was less in partial laminectomy than in hemi laminectomy. Regarding body mass index, none of the intervals had an effect on the risk of disease recurrence.
Conclusion: Based on the results of this study, there is no statistically significant difference in the recurrence of intervertebral disc herniation in both surgical methods of hemi laminectomy and partial laminectomy. However, the factors influencing the recurrence of intervertebral disc herniation were identified in this study, which made a difference between hemi laminectomy and partial laminectomy in the studied patients. According to these factors, risk factors can be determined to prevent the recurrence of disc herniation after surgery. Factors such as gender, age range, smoking, and type of occupation were identified in this study. Depending on the type of occupation, a suitable intervention for disc herniation surgery can be selected with fewer possible complications. In the present study, body mass index and weight were calculated on the outcome of surgery and hernia recurrence without any effect. However, due to the effectiveness of this risk factor, similar studies are needed to be more certain. To confirm the findings obtained in this study and also to compare them, it is suggested that other studies be performed with a higher number of samples and multicenter sampling.
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