2024-03-29T11:17:20+04:30 http://rjms.iums.ac.ir/browse.php?mag_id=12&slc_lang=en&sid=1
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 THE RESULTS OF TRANSURETERAL LITHOTRIPSY OF URETERAL STONES IN HASHEMI NEJAD HOSPITAL M Etemadian M Mirzazadeh M.A Zargar A Kamali Transureteral lithotripsy(TUL) is a new approach to ureteral stones in Iran and relatively new method in other countries. The goal of the present study was to evaluate the first year of our experience with TUL in Shahid Hashemi Nejad Hospital. In this clinical trial study which was conducted from Sep. 2000 to Sep. 2001 a 8/5-10F Wolf semirigid ureteroscope and Swiss lithoclast and/or basket for removing ureteral stones were used in 270 cases. The patients were under investigation at least for 3 months. A questionnaire was developed which was completed by 100 patients. Based on completed questionnaires the results of TUL, success rate, complications regarding to stone characteristics were evaluated. Among 100 cases who completed 3-month follow-up, 75% were men (men/women: 3/1). Patients were from all age groups, from under 20 to over 60 (mean 41.6±3.4ys old). The most common groups were 40-50 years old cases and the least common ones were under 20. TUL was successful in 96 cases with no residual stone. In four cases, parts or all of the stone remained due to migration of stone up to calys. Two cases needed urgent open surgery because of ureteral perforation (one of them was already perforated before onset of ureteroscopy). Postoperative complications in patients were usually mild including: flank pain (23%), fever(12%) and hematuria(9%), which were all managed easily with conservative management. Three months after operation, IVU was done. The most common complication was incomplete disappearance of Hydronephrosis in 8%(4% stone rest, 3% memory of Hydronephrosis, 1% probable obstruction). Due to good results and few complications TUL seems a safe and effective method for lower and middle ureter stones. It can also be used for upper ureter stones when ESWL can not be done or is failed. Key Words: 1) Ureteral stone 2) Lithotripsy 3) Ureteroscopy 2004 3 01 817 821 http://rjms.iums.ac.ir/article-1-231-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 INDUCED MALARIA IN INTRAVENOUS DRUG USER: A CASE REPORT M Barati R Setareh Shenas M Rezaee Salim Malaria is a protozoal disease. It has four species (P. Falciparum, P. Vivax, P. Ovale, P. Malariae) that each produces disease in humans. Malaria is transmitted by female Anopheles bite to human. It can also be transmitted by blood transfusion or contaminated needle. Iran is divided to 3 zones for transmission of malaria: 1- north of Zagros mountain, 2- south and south-west, 3- south-east. In 1974 people who lived in north of Zagros became immune to malaria. In 1973 malaria was controlled in south of Iran. Later in 1944 and 1975 malaria increased and became epidemic in south of Iran especially in Hormozgan, Balouchestan and Kerman provinces and some transmission areas were also seen in the north. Since Tehran is still free of malaria transmission, those who live in Tehran and have never left this city would not get malaria from Anopheles bite. This article is the case report of a 30-year-old man who lived in Tehran. He was complaining of fever and itching from 4 days before admission. He had coryza, sore throat, cough, generalized bone pain and chills. He was IVDU for 2 years and had not taken opium for 25 days. He had no transfusion history and had never gone out of Tehran. We took samples and began treatment with diagnosis of endocarditis, but he did not get well and in bone marrow samples P. Falciparum was seen. Since the patient was living in Tehran and had never left it and since his symptoms mimicked withdrawal syndrome, malaria was not considered as his diagnosis, while malaria transmission with contaminated needle in IVDU may occur and can mimic withdrawal symptoms. Therefore, malaria should be considered in the differential diagnosis of FUO in IVDU. Key Words: 1) IVDU(Intravenous Drug User) 2) Induced malaria 3) Plasmodium falciparum 2004 3 01 823 827 http://rjms.iums.ac.ir/article-1-232-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 THE PREVALENCE OF FIBROCYSTIC CHANGES IN MAMMOPLASTY SPECIMEN REFERRED TO HAZRAT FATEMEH HOSPITAL FROM 1994 TO 2002 M Taklif A Hassan Pour Fibrocystic changes represent the most common disorder of the breast which its prevalence is reported up to 59% in journals. Hormonal imbalance is considered to be basic to the development of this disorder and is diagnosed frequently between the age of 20 to 40 years. The most clinical presentings are palpable mass or mammographic densities and calcifications or nipple discharge. In morphology many changes may be presented as fibrosis adenosis and cysts. The proliferative breast disease elevate the risk of developing cancer. In this study we evaluated the prevalence of fibrocystic changes in mammoplasty specimens from 1994 to 2002 in Hazrat Fatemeh Hospital. The goal of this research was to evaluate the prevalence of fibrocystic changes in asymptomatic patients on whom mammoplasty was operated only for cosmetic aspects. All these specimens were examined by a pathologist. The importance of this research was to show the high prevalence of these changes and not to confuse them with breast malignancies. The method was based on referring to pathology file of Hazrat Fatemeh Hospital in years mentioned above. The results represented 39 cases with fibrocystic changes from 83 mammoplasty specimens referred to pathology ward (47%). The age varied between 32 to 57 years old with average of 42 years. This study is unique in this category. Key Words: 1) Breast 2) Mammoplasty 3) Fibrocystic changes 2004 3 01 829 833 http://rjms.iums.ac.ir/article-1-233-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 THE RESULTS OF LIMB-SALVAGE PROCEDURES FOR HIGH GRADE OSTEOSARCOMA OF THE LIMBS KH Jamshidi M Jabal Ameli E Ameri Mahabadi Osteosarcoma is the most common type of bone cancer that involves adolescents and young people. Amputation is usually proposed by some surgeons after diagnosis which is not acceptable for the patients. In this article, the results of limb-salvage procedures for patients with high-grade malignant osteosarcoma were investigated. The survival rate, functionality of limb, and complications of the procedures were studied. Four approaches were used for reconstruction of limbs after removal of tumor: osteoarticular allografts, intercalary allografts, allograft with prosthesis, and prosthesis without allograft (custom-made prosthesis). Limb-salvage procedure was performed on 107 patients with high-grade malignant osteosarcoma of limbs (except pelvis) during 1995-2000. The patients were followed and assessed for a period of 2 to 5 years (average of 37 months). Seventy-five patients(70%) were alive and without evidence of local recurrence as distant metastases after the follow-up period. Bone intercalary approach showed excellent functionality for 80% of the patients, using Mankin functional evaluation system. Osteoarticular and prosthesis without allograft showed good functionality in 81.5% and 75% of the patients respectively. Overally, complications of the procedures, including fracture of the plate and screws, fracture of allograft, and infection happened in 48%, 44.7%, 12.5%, and 0% of the patients treated with intercalary allograft, osteoarticular allograft, prosthesis without allograft, and allograft with prosthesis, respectively. Key Words: 1) Osteosarcoma 2) Allograft 3) Limb salvage 2004 3 01 835 843 http://rjms.iums.ac.ir/article-1-234-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 AESTHETIC SEPTORHINOPLASTY IN BURNED NOSE F Hafezi H Karimi A.H Nouhi Patients who have survived thermal injuries to the face suffer from severe disfigurement and devastating deformities of full-thickness facial burns. Nose is the prominent central organ of the face which has crucial effect on aesthetic appearance. The plastic surgeon’s role to deal with such cases is to do any operations to produce a more pleasant look although the target organ could be the none burned areas of the face. It is a common belief that surgical interventions under the scarred or grafted nose are risky and may result in skin or covering graft necrosis. For this reason plastic surgeons have hesitation to perform aesthetic surgery on a burned scarred tissue. In the present study 11 cases, 8 women and 3 men with complete or subtotal nasal burn are presented. Classic aesthetic rhinoplasty operation was done to create better appearance and correct any internal or external deviations. These procedures were carried out under severely burned skins previously grafted and/or reconstructed noses. Cases were under control for about one year. There was no necrosis in any part of skin after surgery and it is believed that aesthetic rhinoplasty can be done safely in these victims with pleasing outcome. Key Words: 1) Rhinoplasty 2) Burned nose 3) Aesthetic reconstruction 2004 3 01 845 849 http://rjms.iums.ac.ir/article-1-235-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 A CASE REPORT OF SYNOVIAL CHONDROMATOSIS OF KNEE M.A Haji Ghasem M.R Alavi Dehkordy Synovial chondromatosis is a rare neoplastic condition which usually involves major joints. This tumor is a cartilaginous metaplasia which occurs within synovial membrane of joint or tendon sheets. Multiple cartilaginous nodules can become free from synovial membrane and float in the joint space. X-Ray almost always shows multiple calcified areas so evidently that usually diagnosis can be established preoperatively. The patient of the present report is a 20-year-old male who referred with knee problems which he had for about 4 years. There was no evidence of boney calcification or erosion in radiography of his knee. Biopsy was taken from his knee mass which reported sunovial cyst with chondromatosis changes. In arthrotomy no loose body was found. Only a large mass about 10cm in diameter, which was attached to synovial membrane and capsule, was found and excised. This case is an uncommon manifestation of a rare disease. Key Words: 1) Knee 2) Synovium 3) Synovial chondromatosis 2004 3 01 851 857 http://rjms.iums.ac.ir/article-1-243-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 COMPARISON OF VITAMIN B12 LEVEL AND ITS NEUROLOGICAL SIGNS AND SYMPTOMS IN WELL-CONTROLLED DIABETIC PATIENTS WITH POOR-CONTROLLED ONES M Hagh Azali H Shahrad Bejestani A Kabir T Shooshtarizadeh Some studies have shown the relief of neurosensory signs in diabetic patients by vitamin B12 supplementation. Symptomatic therapy is not a goal in medicine therefore, for detecting causes of this relief, vitamin B12 level was compared in poor and well-controlled diabetic patients in this study. Diabetes mellitus, which is the most common metabolic disease, has systemic effect on immunity, neurosensory, cardiovascular, kidney, skin and other organs and it causes organic and psychological disorders in patients. It increases treatment cost and reduces the efficient personnel, directly and indirectly. Knowing the mechanism of vitamin B12 effect on neurosensory signs of diabetes mellitus can help us in preventive care. It has a significant high quality, it is more cost-benefit and is prior to treatment. This cross-sectioal study was carried out on 99 patients who referred to endocrine part of Rasool-e-Akram Hospital. Mean age of the patients was 58.5±4 and 55 patients(56.1%) were female. History taking, physical examination and blood sample was done for determining vitamin B12 and hemoglobin A1c. Vitamin B12 level was compared in poor and well-conrolled diabetic patients. SPSS software was used for analysis of the data. The most common signs and symptoms consisted of hand and foot neuropathy, polyuria, nocturia, retinopathy, polydypsia, amblyopia, weight loss, distal paresthesia, second cranial nerve neuropathy, touch and vibration sense loss and nephropathy. Vitamin B12 level had no significant difference in poor and well-controlled diabetic patients. Neuropathy, polyuria, polydypsia and retinopathy were the most common symptoms. Neuropathy in 43.4% of patients can be due to duration of diabetes in these patients(10 years). Chronic complications increase with duration of hyperglycemia. Insufficient use of vitamin B12 is not a risk facor for vitamin B12 deficiency. Cobalamine supplements are inexpensive and nontoxic. Adding these supplements in primary stages may prevent irreversible neurosensory complications. Because of low prevalence of vitamin B12 deficiency in patients with type II diabetes, prophylactic administration of vitamin B12 to all of these patients is not suggested. Long-scale, multicentered and controlled study for determining the patients with higher risk for vitamin B12 deficiency is also essential. Key Words: 1) Vitamin B12 2) Neurologial symptoms 3) Diabetes 2004 3 01 859 866 http://rjms.iums.ac.ir/article-1-236-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 ANTI TUMORAL AND DIFFERENTIATION EFFECTS OF ALKALOIDS OF HARMINE AND HARMALINE ON LEUKAEMIC CELLS TREATED WITH ATRA AND G-CSF F Zaker In acute leukaemia, the maturation of the malignant cells is arrested and the cells merely proliferate. In the recent years, beside chemotherapy combination of differential factors cytokins and cytotoxic agents have been used in treatment of acute leukaemia particularly acute promyelocytic leukaemia. The present study was an evaluation of proliferation, cytotoxicity and differentiation of Harmine and Harmaline as alkaloid derivates of Peganum Harmala on HL60 cells individually or in combination with ATRA and G-CSF. The data showed that these agents caused cessation of proliferation in dose and time dependent manner. Optimal concentration of anti proliferative effect was 0.4, 0.8 and 1.6μg/mL for Harmine and 6-10 μg/mL for Harmaline. However, both agents in concentration of over 6.4 and 10 μg/mL for Harmine and Harmaline were cytotoxic respectively. Combination of ATRA(10-7 M) and G-CSF(100 ng/mL) with each optimal concentration of agents extensively reduced proliferation compared with ATRA and G-CSF. Cells, induced with optimal concentration of these agents, showed some morphological changes and NBT positivity however, it was in lesser extent compared to ARTA and G-CSF. Most overt sign of myeloid differentiation was observed using 10 μg/mL Harmaline. Fluorescent analysis showed an increase in CD11b and CD14 using Harmaline. Combination of ATRA and G-CSF with each agent caused differentiation similar to ARTA and G-CSF. These preliminary data showed that either Harmine or Harmaline in optimal and non toxic dose caused cessation in proliferation and some degree of differentiation using Harmaline. These results have opened a new window in the leukaemic in vitro investigation. Key Words: 1) Acute promyelocytic leukaemia 2) Cytotoxicity 3) Differentiation 2004 3 01 869 875 http://rjms.iums.ac.ir/article-1-237-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 DETERMINATION OF CORRELATION OF DIAGNOSTIC NASAL ENDOSCOPY WITH COMPUTER TOMOGRAPHY IN DIAGNOSIS OF NASAL AND PARANASAL SINUS DISEASES AND MALFORMATIONS AND FREQUENCY OF THESE MALFORMATIONS S Khorrami Nejad H Zadanfarrokh J Shokoohi CT scan is the best method in the diagnosis of paranasal sinus diseases. The object of the present study was to show the efficiency of diagnostic endoscopy in diagnosing nasal paranasal sinus diseases and anomalies. If this method proves to be accurate, patients who refuse surgery can be diagnosed, managed and followed up through a reliable method that is cost-effective and decreases the unneccessary irradiation of patients. The frequency of some of the anatomical variations and structural anomalies of the nose and paranasal sinuses was determined. During a 14-month period, 70 cases(studying both left and right sides) those who fit out criteria, were used for the study. The clinical and radiologic stages were determined, separately. A correlation between the clinical stage and the radiologic stage or the opacification index scoring was found. Endoscopy alone is not a good method to detect the structural anomalies of the septum and turbinates. But with the absence of these anomalies a better correlation was found with CT scan. Frequency of these anomalies in our study were in the range of other conducted studies. The maxillary sinus was the most common diseased sinus in chronic sinusitis, and anterior ethmoid sinus was the second most common. However, in other studies the anterior ethmoid sinus is the most common and maxillary sinus is in the second place. Key Words: 1) Endoscopy 2) CT scan 3) Paranasal sinus 4) Clinical and radiologic staging 2004 3 01 877 883 http://rjms.iums.ac.ir/article-1-238-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 STUDY ON THE VASCULAR EFFECTS OF CHRONIC ADMINISTRATION OF TWO SULFONYLUREAS, CHLORPROPAMIDE AND GLIBENCLAMIDE, ON THE HEALTHY RAT THORACIC AORTA M Shafiei H Homayounfar E Izadpanah M Mahmoudian Diabetes mellitus is one of the most common endocrine disorders with increasing prevalence. Cardiovascular complications are among the major causes of death in diabetic patients. Type II diabetes mellitus is generally treated with sulfonylureas. There are controversial reports regarding adverse cardiovascular effects of these drugs. Also evidence exists about differences in side effects between first and second generation sulfonylureas. Thus, an experimental and prospective study was performed. In this study, the vascular effects of two sulfonylureas belonging to the first(chlorpropamide) and second generation(glibenclamide) were investigated in healthy male rats. Healthy rats were treated with chlorpropamide(8mg/kg/day i.p.) and glibenclamide(0.285mg/kg/day i.p.) for one- and two-month periods and the response of isolated aortic rings to phenylephrine, acetylcholine and isosorbide dinitrate were then examined and compared to control. The results showed that chlopropamide pretreatment after two months caused a significant reduction in contractile response to phenylephrine. Moreover, a significant increase in endothelium-dependent relaxation in response to ACh was also observed after a two-month period of pretreatment with chlorpropamide. Such changes were not observed after one month administration so it appears that these changes are time dependent. Glibenclamide did not cause such changes after one-or two-month pretreatment. Calculated EC50s for either phenylephrine or ACh did not differ in test groups compared to control. So it is suggested that changes in the characteristics of smooth muscle alpha-1 adrenoceptors or endothelial muscarinic receptors may not be involved in the observed responses. The alpha-1 adrenoceptor-induced vasocontriction appears to be caused both by the release of intracellular Ca2+ and by the transmembranous influx of extracellular Ca2+. It has been demonstrated that glibenclamide may interfere with Ca2+ influx which in turn affects intracellular Ca2+ levels in arterial smooth muscle, leading to reduction to muscle contractility. Inhibitory effect of glibenclamide in the protein kinase-C mediated contractile mechanism has also been suggested. The observed effect of chlorpropamide on phenylephrine-induced contraction can be attributed to such mechanisms and a longer pretreatment may be needed for glibenclamide to show its inhibitory effect on contractile response to phenylephrine. On the other hand, it has been shown that sulfonylureas may stimulate the proliferation of endothelial cells from large vessels. There may be a difference between chlorpropamide and glibenclamide in the time needed to cause such an effect. Also, it is possible that vascular effects of chlorpropamide are due, at least in part, to changes in the post-receptor cellular components which are involved in signal transduction. Results obtained in this study indicate that up to two months pretreatment with chlorpropamide and glibenclamide in healthy rats did not affect the aortic function in such a way to contribute to hypertension. Key Words: 1) Sulfonylureas 2) Glibenclamide 3) Chlorpropamide 4) Rat aorta 2004 3 01 885 893 http://rjms.iums.ac.ir/article-1-239-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 ANALYSIS OF PROPRIOCEPTION IN PRIMARY ARTHRITIC KNEES GH.R Shah Hosseini S.A Madani E Ebrahimi Takamjani H Negahban Siooki M.J Shaterzadeh Knee is a common site of osteoarthritis possibly because it is often subject to trauma. Primary knee osteoarthritis has no known etiology while secondary osteoarthritis can be traced to abnormal joint mechanics. Actually, osteoarthritis may be a physiologic response to repetitive, longitudinal impulse loading of the joint. Knee proprioception derives from the integration of afferent signals from receptors in the muscles, tendons, joint capsule, ligaments, meniscal attachments and skin. Muscles and joint receptors are the major sources of joint propriception. In patients with knee osteoarthritis both muscle weakness and joint laxity cause proprioceptive impairment. Because of different roles of mechanoreceptors in detecting proprioception in different angles of joint, researchers decided to measure knee proprioception with active and passive reproduction angle methods in different joint angles of knee. The purpose of the present study was to determine 1) if proprioceptive acuity correlated with different knee angles, 2) if there was any significant difference between the measurements of active and passive reproduction angles. In this study 30 subjects with primary knee osteoarthritis(mean age 59.8, range 50-65) were selected through non probability sampling. An electrogoniometer was used for evaluation of proprioception. Also, knee joint proprioception was assessed with both active and passive reproduction angle techniques. Based on the obtained results, individuals with knee arthritis were significantly less able to detect terminal range of active and passive extension of knee than the initial range(P<0.05). The results also showed that there was no significant difference in the measurements of threshold for the detecion of active and passive motions. Key Words: 1) Proprioception 2) Knee 3) Osteoarthritis 2004 3 01 895 902 http://rjms.iums.ac.ir/article-1-240-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 EVALUATION OF THE EFFECT OF SUFENTANIL DROP ADMINISTRATION VIA INTRANASAL ROUTE AS PREMEDICATION IN OUTPATIENT PEDIATRIC SURGERY SH Shahbazi R Bahri Najafi S.A.A Mousavi Premedication is commonly used in anesthesia. The purpose of premedicating children is to decrease anxiety, vagal stimulation, airway secretion and to prevent post operative psychological and behavioral problems. Different ways and drugs can be used for premedication to achieve this goal. Sufentanil which is a synthetic short acting opioid, can be used as a premedication. The aim of this single blind prospective study was to evaluate the effect of intranasal sufentanil drop in reducing anxiety, providing calmness during the separation of children from parents and causing sleep in them before operation. Sixty patients, aged 2-6 years, with ASA I and II of both sexes, were selected and then randomly divided into two groups of 30 patients each scheduled for outpatient pediatric surgery. Group I (n=30, study or sufentanil group), received 1.5μg/kg sufentanil drops (0.03ml/kg), group II (n=30, control group), received NaCl 0.65%(0.03ml/kg). Sufentanil drops were prepared with the leophylization technique by converting sufentanil 5μg/kg to 50μg/kg. This study showed that sufentanil decreased anxiety and helped calmness and made the children sleep in 86% of the patients in the study group and 63.3% in the control group(P<0.05) after 20 minutes of administering premedication administration. There was a significant decrease in response to mask between two groups(P0.05). This study showed that intranasal sufentanil as a premedication in children can decrease anxiety and help sedation and sleep in this age group. Key Words: 1) Children 2) Premedication 3) Sufentanil 4) Intranasal drop 5) Anxiety 2004 3 01 905 911 http://rjms.iums.ac.ir/article-1-241-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 EPIDEMIOLOGICAL STUDY OF ATTEMPTED SUICIDE IN JIROFT, KERMAN(AUTUMN 2001) A.R Zohoor M.R Aflatoonian Attempted suicide mainly occurs in obstinate, disturbed and hostile individuals and in ones who can not easily communicate with others. It is committed with awareness and aimed to hurt oneself. Since health care centers should pay high expenses to treat the patients and also suicide is a big sin in Islamic culture thus, it was decided to analyze the characteristics of all consecutive referrals for suicide attempt to emergency department of Jiroft Hospital. This cross-sectional study was carried out to investigate the epidemiology of attempted suicide in all related referrals to Jiroft emergency department(2001). The studied population included all people who referred to emergency department after suicide during this study. The questionnaire provided in this study included questions about history of addiction and depression, demographic characteristics, method of attempted suicide and the most effective factors in suicide attempt. The collected data was analyzed by SPSS program and using Chi square test. Results of the study showed that from all cases, about 3% referred for being hurt by suicide. In 75% of the patients the route of suicide was drug poisoning, 20% poison and 5% cutting of vessels. The most important factor that influenced suicide was family problems(29%), sickness (29%), problems with spouse(18%) and economic problems(7%). About 36% of cases had a history of using depression drugs and 16% had a history of addiction to at least one of the opioids. Due to plenty of suicide attempts among young persons and since family problems are known to be the most effective factor in suicide therefore, authorities have to try hard to recognize vulnerable group and offer psychotherapy services to them. Key Words: 1) Attempted suicide 2) Emergency 3) Epidemiology 2004 3 01 913 919 http://rjms.iums.ac.ir/article-1-242-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 VOLUNTARY SCAPULAR WINGING: A CASE REPORT M Eyvaz Ziaee F Sharafi Voluntary winging of scapula is a very rare anomaly. There is no organic defect in the patient. It is a psychosomatic disorder. We report three cases of voluntary winging of scapula between 12 to 35 years of age, who referred to Shoulder Clinic of Shafa Hospital within 8 years. They were under treatment and control in shoulder surgery unit of Shafa Hospital. Key Words: 1) Scapula 2) Scapular winging 3) Voluntary winging 2004 3 01 921 926 http://rjms.iums.ac.ir/article-1-244-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 COMPARISON OF THE THERAPEUTIC EFFECTS OF 25 U AND 50 U DOSES OF BOTULINUM TOXIN IN CHRONIC ANAL FISSURE R Azizi SH Eslami Chronic anal fissure is maintained by contraction of the internal anal sphincter. Sphincterotomy, which is successful in 85% to 95% of patients, permanently weakens the sphincter and therefore might be associated with anal deformity, infections and incontinence. The object of the present study was to compare the therapeutic effects of 25U and 50U doses of botulinum toxin in chronic anal fissure. 69 patients received intrasphincteric injection of botulinum toxin type A (Dysport). 58 patients with idiopathic, non-complicated chronic anal fissure were included in a non randomized prospective trial of intrasphincteric injection of botulinum toxin type A (Dysport). The patients were assessed only by clinical evaluation. Patients were divided into two treatment groups based on the number of botulinum toxin units injected. Patients in the first group(No=34) were treated with 25 unit. Patients in the second group(No=24) were treated with 50 unit. Two months after treatment, 26 patients in the first group and 16 patients in the second group had healing scar. Symptomatic improvement was observed in 3 patients in the first group and in 2 patients in the second group. According to statistical analysis which was done via Chi-square test no significant difference was found between two groups. Therefore, it can be concluded that botulinum toxin is safe and effective in the treatment of chronic anal fissure. It is less expensive and much easier to perform than surgical treatment. The healing rate is not related to the dose. No permanent or temporary damage to the continence mechanism was detected in these patients. Key Words: 1) Anal fissure 2) Toxin 3) Botulinum 2004 3 01 927 931 http://rjms.iums.ac.ir/article-1-245-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 COMPARATIVE STUDY OF DIAGNOSTIC ACCURACY OF INTRAOPERATIVE CYTOLOGY AND FROZEN SECTION IN IRAN UNIVERSITY OF MEDICAL SCIENCES HOSPITALS FROM JULY 2001 TO DECEMBER 2002 M Kadivar D Sayadpour Zanjani Performing frozen section is a common intraoperative consult with the goal of determining the lesion as benign or malignant. Since frozen section needs specific technical requirements and costs a lot therefore, in some studies cytology is used as an alternative method. Most of these studies have been done on specific organs and a few of them on all organs of the body. Therefore, we prospectively studied the usefulness of intraoperative cytology and frozen section in the diagnosis of 100 consecutive cases. The study used sensitivity, specifity and accuracy as statistical tools for comparison. The intraoperative results were compared with final histopathologic diagnosis. For intraoperative cytology the sensitivity, specifity and accuracy were 95.8%, 92.5% and 95% respectively and for frozen section these were 97.2%, 96.3% and 97%. There were not any significant differences between these statistics(P>0.05). These data confirm the value of intraoperative cytology in diagnosis of all mass lesions. This method can also be use as an alternative technique to frozen section in case there is no technical requirements or as a complementary method in all specimens. Key Words: 1) Intraoperative cytology 2) Frozen section 3) Body mass lesions 2004 3 01 933 940 http://rjms.iums.ac.ir/article-1-246-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 AUDITORY PERCEPTION TEST FOR MILD TO PROFOUND HEARING-IMPAIRED INDIVIDUALS(5-20 YEARS) IN BAGHCHE-BAN DEAF SCHOOL IN KARAJ(2002) M Mazaher Yazdi Y Lotfi S Malayeri Z Jafari Nowadays it is known that doing pure tone audiometry just gives us some information about the degree and the type of hearing loss. Therefore a question is posed: How does a man use his hearing for speech perception and what is the necessity of using auditory perception tests? This research was a developmental study which was done in two stages: the first stage included modifying the items and the second stage was their evaluation. Our sampling was mainly on the basis of test and evaluation. At first, Allen G. Serwatka criterion for designing the test items was considered. In modifying the orginal APT/HI, care was taken to include Persian items which provided information on Persian phonemes, phonetics and sentence structure as well as active vocabulary of mild to profound hearing-impaired people which was presented through pictorial images. In order to prepare test items, we took full advantage of a number of speech and language pathologists’ points of view. Also, to determine content validity, test items were reviewed by 5 audiologists working in the field of Rehabilitative Audiology. To assess test validity and reliability, 60 hearing-impaired students from Baghcheban Deaf School in Karaj were selected and tested. The tests included otoscopy, puretone and immitance audiometry, auditory perception test-retest, and closed-set speech recognition test. After analysing data an accepted content validity was obtained(88.4%). Significant difference was observed between test scores and hearing loss(P<0.05). Significant difference was obtained in scores of 7 to 11-year-old students and 15 to 17-year-old ones, when hearing loss was over 70 dBHL(P0.05). Additionally, significant correlation was observed between APT/HL scores and closed-set speech recognition scores(P<0.05). Significant correlation was observed in test-retest scores(P<0.05). Based on the obtained results, this study is reliable, the items have good content validity and criterion validity is high between this test and closed-set speech recognition test. Therefore, this test is useful for auditory rehabilitation centers. Key Words: 1) Auditory perception test 2) Sound Detection 3) Discrimination 2004 3 01 943 949 http://rjms.iums.ac.ir/article-1-247-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 SERUM ZINC CONCENTRATION IN IRANIAN WOMEN IN THE THIRD TRIMESTER OF PREGNANCY I Nourmohammadi F Sharifzadeh M.H Badakhsh A.R Akbarian A Moaveni S Nouri It has long been known that zinc is an important trace element which has a major role in a number of biochemical reactions and systems in human body. The significance of zinc on the course and outcome of pregnancy has been studied in many countries. The objective of the present study was to determine the status of serum zinc in pregnant Iranian women in the third trimester and compare these findings to healthy controls in an effort to find out first if expectant Iranian mothers are zinc deficient and if this deficiency has a detrimental effect on the outcome of pregnancy. Our study group comprised 100 pregnant women all in the third trimester of pregnancy. Blood samples were taken from both study and control groups and assayed for serum levels of Zn, albumin, alkaline phosphatase and hemoglobin. The results showed significantly lower levels of zinc(P<0.0001) and albumin(P<0.0001). A significant correlation was also found between serum zinc level of mother and weight of neonate(P<0.0001). The correlation between the fall in serum albumin with that of serum zinc in this study supported low serum zinc in late pregnancy. These findings indicate deficient level of zinc in the latter third of pregnancy which suggest a tendency for insufficient maternal nutrition. However, it is premature to recommend a reinforcement of routine zinc supplementation for healthy mothers. Key Words: 1) Zinc 2) Third trimester 3) Pregnancy 2004 3 01 951 956 http://rjms.iums.ac.ir/article-1-248-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 COMPARISON OF ISOFLURANE-PROPOFOL & ISOFLURANE-THIOPENTAL EFFECTS ON PLASMA NOREPINEPHRINE LEVEL FOLLOWING PAINFUL STIMULUS AT EQUAL ANESTHESIA DEPTH SH Naser Nejad V Hassani H Farahini L Hosseini Gohari M Fani M.R Mohaghegh Dolat Abadi P Rahimzadeh Responses to painful stimulus are associated with broad spectrum of physiological changes in human body. One of these significant responses is an increase in plasma norepinephrine level that may cause pathophysiological changes in the body. The present study attempted to investigate plasma norepinephrine level changes by inducing appropriate anesthesia depth under BIS monitoring and using different drugs for induction and maintenance of anesthesia. Thus, thiopental and propofol were used for induction and isoflurane as maintenance drug, then norepinephrine level was measured following painful stimulus. Sixty ASA I patients candidated for elective ACL repair surgery, in the range of 15-45 years old, were randomly allocated into two groups. BIS monitoring was performed to measure depth of anesthesia. For all of the patients, midazolam was administered to reach BIS 70. Then blood sampling was done to measure basal norepinephrine level. Thiopental in group I and propofol in groups II were administered to reach BIS 40. Then 3 mcg/dl fentanyl as analgesic and 0.5mg/kg atracurium to facilitate intubation were injected. Endotracheal intubation was done in at most 15 seconds and patients who had difficult or prolonged intubation were excluded. Three minutes after intubation, blood sampling was done to measure norepinephrine level. Isoflurane at dose 1.2% was administered to maintain anesthesia. After stabilizing anesthesia depth(BIS=40), skin incision was allowed to repair ACL and after 3 minutes blood sampling was done to determine plasma norepinephrine level. By using ELISA method, plasma norepinephrine level was measured after laryngoscopy and Isoflurane administration and skin incision. Data showed that basal norepinephrine level in propofol group was 0.245±0.113mcg/dl(mean±SD), in thiopental group was 0.210±0.105mcg/dl(Pvalue=0.225). Norepinephrine level after laryngoscopy in propofol group was 0.236±0.125mcg/dl and in thiopental group was 0.216±0.118mcg/dl(Pvalue=0.534). Norepinephrine level after skin incision and isoflurane administration in propofol group was 0.229±0.102mcg/dl and in thiopental group was 0.223±0.128mcg/dl(Pvalue=0.716). It was concluded that norepinephrine level changes did not have significant difference in propofol and thiopental and isoflurane groups. Key Words: 1) Plasma norepinephrine 2) Thiopental 3) Propofol 4) Isoflurane 5) BIS monitoring 2004 3 01 957 961 http://rjms.iums.ac.ir/article-1-249-en.pdf
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Razi Journal of Medical Sciences RJMS 2228-7043 2228-7051 2004 10 38 A RARE CASE REPORT OF NONIMMUNE HYDROPS FETALIS DUE TO MEDIASTINAL IMMATURE TERATOMA IN AUTOPSY OF FETUS M Hoormazdi A Hassanpour Mediastinal immature teratoma in autopsy of fetus is a very rare phenomena which has been reported so far just in two cases. The case of the present study was a 24-week dead female fetus delivered by C/S for intrauterine death. The mother was a 30-year-old lady (gravide 2, para 2) who referred to sonographist due to lack of fetus movement. In sonography intrauterine fetal death and hydrops fetalis was reported. There was no positive history of previous abortion or congenital anomalia in her first bady. Positive gross autopsy finding was pleuretic cyanotic edematous fetus and one solid mediastinal paracardiac mass. After classic cutting a mediastinal mass measured 3×2×2cm was seen. Hypoplasia of two lungs and heart due to compression effect of mass was evident. Microscopic examination of the mass revealed an immature teratoma. Key Words: 1) Fetus autopsy 2) Mediastinal immature teratoma 3) Hydrops fetalis 2004 3 01 963 966 http://rjms.iums.ac.ir/article-1-250-en.pdf