eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2008-11
22
3
156
158
article
The relation between consanguineous marriage and mental retardation of the offspring
Mohhammad H. Nazarabadi
1
Arman Arghami
2
Mohsen Ghanbari
mohsen_ghanbarius@yahoo.com
3
Dept. of Human Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad,
Mashhad University of Medical Sciences, Mashhad, Iran.
AcademicVice-Chancellor Office, Mashhad University of Medical Sciences, Mashhad, Iran.
http://mjiri.iums.ac.ir/article-1-10-en.pdf
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2008-11
22
3
152
155
article
An unusual case of median nerve compression with ipsilateral supracondylar process
Dawood Jafari
1
Hamid Taheri
2
Hooman Shariatzadeh
3
Alireza Pahlevansabagh
pahlevansabagh@yahoo.com.
4
Farid Najd-Mazhar
5
Iran University of Medical Sciences, Tehran, Iran.
Iran University of Medical Sciences, Tehran, Iran.
Iran University of Medical Sciences, Tehran, Iran.
Department of Hand Surgery, Shafa Yahyaian Hospital, Baharestan Sq., Tehran, Iran.
Iran University of Medical Sciences, Tehran, Iran
Abstract The supracondylar process is a beak-like bony projection that arises from the anteromedial surface of the humerus. The process has rarely been associated with compression of the median nerve and seldom requires treatment. We report a case of a supracondylar process that caused tenting of the median nerve with elbow extension and pronation.
http://mjiri.iums.ac.ir/article-1-9-en.pdf
median nerve
Struthers’ligament
supracondylar process
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2008-11
22
3
149
151
article
Significant weight loss, nausea, and vomiting due to strongyloidiasis:a case report
Hossein Froutan
1
Ayatollah Bayatian
bayatian@yahoo.com.
2
Seied Mohsen Razavizadeh
3
Mohsen Nasiri-Toosi
4
Afshin Shafaghi
5
Tehran University of Medical Sciences, Chairman of Gastroenterology Dept.
Internal Medicine Ward, Imam Khomeini Hospital, Tehran, Iran.
Imam Khomeini Hospital.
Tehran University of Medical Sciences, Tehran, Iran.
Imam Khomeini Hospital.
Abstract Strongyloidiasis is caused by infestation with Strongyloides stercoralis, a free living tropical and semitropical soil helminth that has a larval form that penetrates intact skin. Clinical manifestations may be varied from an asymptomatic infection in immunocompetent hosts to a diffuse and fatal form in immunocompromised hosts. We report a 56-year-old man from Dezful (south-west of Iran) with a 6-month history of nausea, vomiting and significant weight loss (greater than 10%). Abdominal ultrasonography had no significant findings. Upper gastrointestinal series and abdominal CT were performed. Dilated bowel loops especially in the jejunum, with decreased mucosal folds were seen. Abiopsy specimen from the third part of duodenum showed strongyloides larvae, thus albendazole 400 mg twice a day for 3 days was initiated. He responded well to this treatment regimen.
http://mjiri.iums.ac.ir/article-1-8-en.pdf
strongyloidiasis
nausea
vomiting
albendazole.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2008-11
22
3
145
148
article
Outcome prediction of different groups of patients using a modified scoring system
Abbas Rabbani
1
Majid Moini
moinim@sina.tums.ac.ir,
2
Morteza Taghavi
3
Hossein Baradaran
4
Tehran University of Medical Sciences, Tehran, Iran.
Sina Trauma Research Center, Tehran, Iran.
Tehran University of Medical Sciences, Tehran, Iran.
Tehran University of Medical Sciences, Tehran, Iran.
Abstract Background: In this study we aimed to examine the discrimination and calibration of a severity characterization of trauma (ASCOT) in our setting to determine whether its usage is appropriate to predict outcome of our trauma patients. Methods: This study was conducted in three hospitals. All patients admitted in studied hospitals were divided randomly into two equal subgroups. In each group, new coefficients for ASCOT were derived from the first subgroup of patients. Then the newly developed model was validated in the second subgroup and the measures of discrimination and calibration were calculated. Results: 78% of our patients were male and 27% were children. The study mortality rate was 6%, and 20% of patients had penetrating trauma. The average age of our patients was 28 ± 19 (Mean ± Standard Deviation).The area under ROC for ASCOTwas 0.96 and Hosmer-Lemeshow goodness of fit p value was 0.81. Conclusion: In spite of many differences of the trauma care systems between our country and western countries, current survival probability models can be used in our country after customization and development of new coefficients derived from regional databases.
http://mjiri.iums.ac.ir/article-1-7-en.pdf
ASCOT
ISS
customization
Iran.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2008-11
22
3
141
144
article
Noise exposure and risk of hypertension: a cross-sectional study
Mashallah Aghilinejad
1
Masoumeh Ghiasvand
2
Seyed Javad Haji-Miresmaeil
3
Faculty of Medicine of Iran University of Medical Sciences, and
Faculty of Medicine of Iran University of Medical Sciences, and Research Center of Occupational
Iran University of Medical Sciences.
Abstract Background: Previous studies have indicated an unspecific correlation between noise exposure and blood pressure disturbances. Blood pressure disturbances could be caused by the environmental hazards such as noise exposure. The aim of this study is to analyze whether there is a relationship between noise exposure and hypertension. Methods: Atotal sample of 218 workers working in a small workshop aged between 27 and 49 yrs answered the questionnaire in this survey. Blood pressure was measured in the sitting position after 5 minutes rest. Level of sound intensity in the workplace was measured by sound level meter (SKC Model CEL-480-440) and human noise exposure level was measured by audiometric device (MEVOX). The correlation between industrial noise and blood pressure was extracted. The t-test and Fisher’s exact test was used to compare the qualitative variables and quantitative variables with normal distribution as being applied in parametric tests. Odds ratio (OR) with 95% confidence interval (95% CI) was used to compare the magnitude of risk variables. Results: Sub-populations in this study consisted of 109 workers with noise exposure more than 85 dB (Case group) and the rest (i.e. 109 workers) with noise exposure less than 85 dB (Control group). High level systolic and diastolic blood pressure was more prevalent in the case group. Total hearing loss more than 25dB was significantly more prevalent in the case group (45% of case group have hearing loss). Adjusted Odds Ratio (OR) for the effect of age, food type and BMI on blood pressure was 3.56 (95% CI: 6.6 – 1.9). Conclusion: This study showed that high blood pressure (>_140/90 mmHg) was more prevalent in the case group. This finding persisted after adjustment was made for age, food type, and BMI. (Odds Ratio 3.56 (95% CI: 6.6 – 1.9)).
http://mjiri.iums.ac.ir/article-1-6-en.pdf
noise
hypertension
hearing loss.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2008-11
22
3
137
140
article
Fungal infection of the sinus and anterior skull base
Morteza Javadi
1
Shabahang Mohammadi
info@shabahangm.com,
2
Head & Neck Surgery, Hazrat-e Rasoul Akram Hospital, Iran University of Medical Sciences,
Head & Neck Surgery, Department & Research Center of ENT and Head &
Abstract Background: Invasive fungal infection is an opportunistic infection caused commonly by mucoraccae and aspergillus. It mostly occurs in patients with underlying disease. Since it has a high mortality and morbidity rate, considering a treatment strategy seems necessary. Objective: Since there has not been a clear protocol for treating these patients, we decided to establish a protocol for fungal infection of sinus and anterior skull base management. Methods: This retrospective and descriptive case study series included 30 patients. After confirming the pathogen, the authors came to a proper protocol for treatment which is mentioned later. Results: The site involvement included nose and orbital cavity (53.3%), anterior skull base and brain in conjunction with sinonasal (36.6%) and simple nasal cavity involvement (10%). 86.6% of the patients had underlying diseases. 56.6% of patients had diabetes as a single underlying disease, while 13.3% had both diabetes and renal failure in combination. Acute lymphocytic leukemia was present in 6.6%, renal failure in 3.3%, lupus in 3.3% and chronic lymphocytic leukemia in 3.3% of patients. Mortality rate was 40%. We categorized the patients into 3 groups: only sinonasal, sinonasal and orbit, and associated anterior skull base and brain involvement. Conclusion: Early diagnosis is an important factor in improving survival. Anterior skull base and brain involvement has a very poor prognosis.
http://mjiri.iums.ac.ir/article-1-5-en.pdf
sinusitis
rhinocerebral
nasal
orbital
anterior skull base.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2008-11
22
3
132
136
article
Ascitic fluid to serum bilirubin ratio for differentiation of exudates from transudates
Amir Hossein Boghratian
boghratianmd@yahoo.com
1
Majid Chalian
2
Hamid Chalian
3
Yaser Ghavami
4
Hazrat-e-Rasool Hospital (Internal Ward. GI section),
Iran University of Medical Sciences, Tehran, Iran.
Tehran University of Medical Sciences, Tehran, Iran.
Iran University of Medical Sciences, Tehran, Iran.
Abstract Background: Regarding the diagnostic errors of the classic criteria including serum ascites albumin gradient (SAAG), total protein concentration and the adapted Light et al’s criteria in distinguishing transudate versus exudates, we evaluated the ascitic fluid to serum bilirubin ratio as a new criteria in this regard. We also evaluated whether the combination of bilirubin ratio with each of these classic criteria improves the diagnostic accuracy. Methods: One-hundred ascitic fluid specimens were analysed prospectively whereas the category of fluid was assessed according to the clinical diagnosis. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), overall accuracy, positive likelihood ratio (LR+), negative likelihood ratio (LR-) and the Youden’s index of each criterion alone and in combination with the bilirubin ratio were calculated. Results: SAAG seems to be the best criterion (specificity = 0.9090, PPV = 0.97, LR+ = 8.03, Youden’s index = 0.64). Bilirubin and LDH ratio criteria had equivalent specificity (0.8333 and 0.8205, respectively), accuracy (0.80 and 0.81, respectively), PPV (0.54 and 0.55, respectively), NPV (0.90 and 0.93, respectively) and LR+ (4.09 and 4.30, respectively) which generally were better than fluid total protein and total protein ratio but not as predictive as SAAG. The addition of bilirubin ratio to any criterion did not make any improvement. Conclusion: Ascitic fluid to serum bilirubin ratio, although not more predictive than SAAG, can be used as an alternative criterion in distinguishing exudative versus transudative ascitic fluid as it is more cost-effective in terms of laboratory processing and also more available.
http://mjiri.iums.ac.ir/article-1-4-en.pdf
Bilirubin gradient
ascites
transudative
exudative
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2008-11
22
3
125
131
article
Acrylic antibiotic-loaded bone cement: a basic study
Hossein Farahini
1
Mehdi Ghorbani
2
Ehsan Akbarian
eakbarian@gmail.com.
3
Orthopedic Surgeon and Fellowship of Knee and Arthroscopy, Rasool Akram
Rasool Akram General Hospital.
Shahid Beheshti University of Medical Sciences.
Abstract Objective: The aim of this study was to evaluate the efficacy of antibiotic-loaded bone cement in controlling local infection and in regard to its physical characteristics, elastic modulus, and tensile strength in-vitro. Methods: Acrylic bone cement, based on polymethylmethacrylate (PMMA) was mixed with the powder form of three antibiotics, i.e., gentamicin, tobramycin, and cefuroxime with different doses below 2gr per 40gr of cement powder thereafter, liquid monomer was added to process the cement. Sensitivity to common clinical isolates was assessed by counting the inhibition zone of each ALBC disc in cultured strains. Elution with normal saline was performed to evaluate the effects on ALBC disks and their antimicrobial efficiency. Cement structure, tensile strength, and elastic modulus were assessed by biomechanical tests to understand the characteristics of ALBCs after loading antibiotics with different doses and two methods of vacuum and manual mixing. Results: Gentamicin, tobramycin, and cefuroxime reduced bacterial growth significantly with doses more than 1gr of antibiotics in 40gr of the cement. Cefuroxime was less efficient than the other two antibiotics in controlling pseudomonas. Elution with normal saline has not affected antibacterial results, significantly. All the 3 antibiotics had the same pattern of physical characteristics while loaded in bone cement. Gross structure of ALBCs with different doses of the three antibiotics was the same as non-ALBC and the elasticity or strength did not decline after loading antibiotics. The elastic modulus of ALBC was increased by boosting the doses of antibiotics however, doses of 1gr to 1.5gr were the optimal doses in this regard. The tensile strength of ALBC was increased by doses of 1gr to 1.5gr of antibiotics however, below and above these doses, the strength was decreased, but it did not exceed the basic strength of non-ALBC. Vacuum mixing method increased strength and elasticity more than manual one, remarkably. Conclusion: Optimal protective effects of ALBCs against infection could be seen with mixing doses of about 1gr to 1.5gr of antibiotics in 40gr of acrylic bone cements by vacuum method, while optimal elastic modulus and tensile strength could be achieved at the same doses.
http://mjiri.iums.ac.ir/article-1-3-en.pdf
ALBC
acrylic bone cement
antibiotic
microbiology
biomechanics
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2008-11
22
3
120
124
article
A novel bedside technique for differentiation of exudative from transudative pleural effusion
Mohammad Homayouni
homayouni28@yahoo.com
1
Reza Hashemi
2
Ashraf Ashraf Askari
3
Head of Dept. of Internal Medicine, Shohada-e- Tajrish Medical Center,
Shohada Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Shemiran Health Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract Background: At present, differentiation between exudative and transudative pleural effusion is based solely on laboratory measures and is time-consuming. Asimple bedside method would be of great help to differentiate between these two types of effusions. We present a new method for this purpose assessed in 46 patients. Methods: Standard laboratory tests and our method were tested using the same fluid samples in 46 patients with pleural effusion. Aprincipal in physics called the capillary tube law (h=2a/rpg) was used to compare the samples. The imbibition of the fluid level less than 15mm signified exudate and greater than 15mm signified transudate. Results: Our data shows that this method is 74% sensitive and 89.4% specific compared to the standard method when analyzed statistically by the chi-square and Kappa agreement (Cronbach’s K) tests. Conclusion: The capillary tube test has an acceptable validity for bedside diagnosis of exudative or transudative effusions.
http://mjiri.iums.ac.ir/article-1-2-en.pdf
exudate
transudate
pleural effusion
CTT
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2008-11
22
3
111
119
article
A 5-year evaluation and results of treatment of chronic locked dislocations of the shoulder joint
Ali Akbar Khorsandi
alikhorsandi@yahoo.com.
1
Morteza Nakhaei Amroodi
2
Maziar Khorsandi
3
Syawash Mirsaid Ghazi
4
Shafa Yahyaian Hospital, Iran University of Medical Sciences,
Shafa Yahyaian Hospital, Iran University of Medical Sciences, Tehran, Iran.
Shafa Yahyaian Hospital.
Abstract Background: Chronic neglected dislocation of the shoulder joint can be defined as a neglected dislocation for more than a 3 week period. However, it has been shown that the negligence could range from a 24 hour period to 6 months1. Depending on age, signs, symptoms, etiology and types of dislocation, conservative treatment or surgical intervention could be considered. Methods: In this study, 16 patients (13 were male and 3 were female) were treated with chronic shoulder dislocations, 3 of which had bilateral dislocations. The age of this group ranged from 13-65 years with a mean age of 34 years. These patients were treated by closed or open reduction, either anterior, posterior or both approaches. Of 19 dislocations, 6 were anterior unilateral, 7 posterior unilateral, 1 anterior bilateral and 2 posterior bilateral dislocations. The mean period between dislocations and treatments was 3 months (from 4 weeks to 11 months), and the mean follow up period was 40 months (from 21 months to 5 years). Results: This study has shown that treatment varies according to pathology. In this study the mean size of head defects was 35% and the extent of severity determined the approach. Findings at the last follow up were assessed according to Rowe and Zarins score and of the 19 shoulders assessed, 9 showed good and 10 showed excellent results. There was no recurrence of the dislocation in any patient. Conclusion: In some selected instances, open reduction of a chronic locked neglected shoulder dislocation of a 6 months period or more in young patients is recommended.This method is, however, contraindicated in elderly patients in such cases a shoulder prosthesis is indicated.
http://mjiri.iums.ac.ir/article-1-1-en.pdf
locked neglected anterior or posterior dislocation
closed or open reduction
shoulder prosthesis