eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
367
367
article
Letter to the Editor
Hassan Mansouri Torghabeh
Mansouritorghabe@mums.ac.ir
1
Department of Experimental Hematology and Blood Banking, Tarbiat
I enjoyed the article by 1. Eivazi Ziai, et al. concerning
"Use of myeloperoxidase index as a suitable tool to
monitor response to therapy in patients with megaloblastic
anemia" that was published in the last issue of
the Medical Journal ofIslamic Republic of Iran. I I would
like to make some points regarding this study.
A. The authors mentioned that in primary evaluation
of 50 anemic patients who had referred to their center,
the peripheral blood smear and bone marrow aspirations
had shown typical megaloblastic features. As all of the
patients had been prescribed Vitamin BI2 and folate, it
shows that the study has been on the basis of megaloblastic
anemia due to vitamin BI2 and folate deficiency.
The patients have entered the study without assessing
excluding criteria for megaloblastic anemia, because there
are several other hematologic disorders with megaloblastic
findings in both peripheral blood smear and bone
marrow aspiration such as myelodysplastic anemia, liver
disease, and aplastic anemia.
It seems that evaluation of vitamin BI 2 and folate levels
in these patients would have been a necessary part
of diagnosis after observation of blood and bone marrow
smears that has been missed in this study.
B. It has been cited that a total primary number of 50
patients entered the study. Some of them have been ex-
cluded from the study due to existence of other diagnoses,
but not only have final numbers not been cited
but also all 50 have been included in the last extraction of
data, and no complementary patients were added.
http://mjiri.iums.ac.ir/article-1-565-en.pdf
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
363
366
article
SUPINE LENGTH, WEIGHT AND HEAD CIRCUMFERENCE OF NEONATES AT BIRTH IN URBAN AREAS OF ARAK AND FACTORS AFFECTING THEM
SMT AYATOLLAHI
1
M RAFIEE
2
From the Department of Biostatistics and Epidemiology, School
http://mjiri.iums.ac.ir/article-1-564-en.pdf
Neonates
supine length
head circumference
weight at birth
NCHS
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
349
361
article
NEURO IMAGING OF CNS LESIONS IN AIDS
HOMAYOON MOOSAVI
1
FARHAD KIOUMEHR
2
S. ABDULMAJEED ROOHOLAMINI
3
Background: The aim of this study was to review and characterize the pattern of CNS lesions in patients suffering from AIDS and to correlate these patterns with clinical disorders. Method: The MR scan, medical records and laboratory findings of 58 AIDS patients were reviewed retrospectively during April 1994 to November 1997 at the Olive view/UCLA and Shiraz Medical Centers, and the patterns of CNS involvement by secondary pathologic processes were divided into three types:
1- Focal parenchymal lesions with enhancement and mass effect that could be solid or ring shaped. 2- Focal parenchymal lesions without mass effect and enhancement.
3- Leptomeningeal enhancement with or without adjacent cortical involvement. Focal parenchymal enhancing lesions appeared to be caused by toxoplasmosis and primary lymphoma.
Multiple ring enhancing lesions were most common with toxoplasmosis. Focal parenchymal lesions without mass effect and enhancement were detected specifically in PML and all were deep within the white matter structure.
Leptomeninges with or without adjacent cortical enhancement were seen in CNS infectious diseases such as TB, cryptococcosis/coccidioidomycosis and herpes zoster as well as in secondary CNS lymphoma. Granulomatous meningo-encephalitis mostly presented as basal leptomeningitis while herpes meningo-encephalitis was typically located in the temporal lobe. Secondary lymphoma showed high vertex leptomeningeal involvement.
The medical history/clinical presentation/CSF findings/stereotaxic biopsy, therapeutic response and postmortem pathologic results were used to distinguish the different etiologic agents.
Results: Of a total of 58 HIV seropositive patients, 12 (20%) appeared to be infected by toxoplasmosis, 7 ( 12%) by TB, 8 (14%) cryptococcosis, 5 (9%) coccidioidomycosis, 2 (3%) herpes zoster and 3(5%) cases were diagnosed as PML (progressive multifocal leuko-encephalopathy) according to high serum titer for papova virus group B. Sixteen cases revealed evidence of CNS lymphoma of whom 9 were diagnosed as primary and 7 as secondary CNS lymphoma. In 5 cases HIV infection itself was suspected to be the etiology of the abnormal MRI finding. Conclusion: In spite of newly developing MR spectroscopy techniques for differentiation of CNS lesions in AIDS, categorization of different MRl patterns of CNS diseases in HIV seropositive patients is still helpful in differentiating various types of common CNS lesions in AIDS.
http://mjiri.iums.ac.ir/article-1-563-en.pdf
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
345
348
article
APPLICATION OF THE PTSD SYMPTOMS SCALE (PSS) FOR IRANIAN PTSD PATIENTS
MAHMOUD MIRZAMANI
Mirzamani2003@yahoo.co.uk
1
MOHAMMAD REZA MOHAMMADI
2
MOHAMMAD ALI BESHARAT
3
the Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences
Background: This study investigated the applicability of the Post-traumatic Stress Disorder Symptom Scale (PSS) in a group of adolescents who had been directly involved in a disaster in Tehran.
Method: Participants were 20 adolescents who had survived a boat sinking in Tehran's city park in 2002. The assessment measures used were the Post-traumatic Stress Disorder Symptom Scale (PSS) and clinical interview based on DSM-IV
Results: Seventeen participants (85%) were diagnosed with PTSD using PSS and seventeen (90%) were diagnosed with PTSD by psychiatric interview.
Conclusion: The PSS appears to be an effective and efficient method of screening for PTSD.
http://mjiri.iums.ac.ir/article-1-562-en.pdf
PTSD
Scale
disaster
PSS
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
339
344
article
RELATIONSHIP OF SPERM PARAMETERS WITH LIPID PEROXIDATION IN ASTHENOZOOSPERMIC AND NORMOZOOSPERMIC MALES
HEIDAR TAVILANI
1
MAHMOUD DOOSTI
doostimd@sina.tums.ac.ir
2
HOJATOLLAH SAEIDI
3
SEYED MOHAMMAD HOSSEINIPANAH
4
HASAN HASANI BAFERANI
5
Department of Medical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences
Background: The lipid peroxides and their degradation products are highly toxic to spermatozoa and may play a major role in sperm dysfunction. The purpose of this study was to determine the level of lipid peroxidation as indicated by malondialdehyde (MDA) in the spermatozoa and seminal plasma of asthenozoospermic and normozoospermic males. In addition, correlation of lipid peroxidation with motility grades: a (rapid progressive), b (slow progressive), c (nonprogressive ), d (immotile ), percent of normal morphology, acrosome and tail defect, and concentration of spermatozoa was determined.
Methods: MDA of spermatozoa and seminal plasma was determined in 35 asthenozoospermic and 15 normozoospermic men by spectrofluorometry. Semen analysis was done according to the WHO standard.
Results: MDA in the spermatozoa of asthenozoospermic patients was significantly higher than normozoospermic males (0.14±0.0 1 and 0.09±0.0 1 nmol/1 0* 106 spermatozoa respectively, mean ±SE). A significant negative correlation was observed between MDA of spermatozoa with grade a motility and concentration of spermatozoa. In addition, a significant positive correlation was observed between MDA of spermatozoa with the acrosome and tail defect. The MDA value in the seminal plasma of asthenozoospermic and normozoospermic patients was 1.35±0.07 and 1.2±0.08 nmol/mL seminal plasma respectively (mean±SE). The MDA of seminal plasma exhibited a negative correlation with grade a+b motility and positive correlation with grade c+d motility and head defect.
Conclusion: Lipid peroxidation has a deleterious effect on semen quality and MDA is an index of lipid peroxidation which may be a diagnostic tool for the analysis of infertility in asthenozoospermic patients.
http://mjiri.iums.ac.ir/article-1-561-en.pdf
Asthenozoospermia
Lipid peroxidation
Semen Parameters
Human Spermatozoa
Semen Analysis.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
333
338
article
DETECTION OF BACTERIA BY AMPLIFYING THE 16S rRNA GENE WITH UNIVERSAL PRIMERS AND RFLP
SALAH RAHMANI
1
MEHDI FOROZANDEH
foroz@modares.ac .ir
2
MIRLATIF MOSAVI
3
ABBAS REZAEE
4
Department of Medical Biotechnology, School of Medical Sciences, Tarbiat Modarres University
Background: There is a conserved portion in the 16S rRNA gene of bacteria
which can be amplified by the universal PCR method. This fragment is 996 bp in length.
In this method, only one set of universal primers is used for the amplification of the
conserved region of the 16S rRNA gene, in common bacterial pathogens. Therefore,
using the universal PCR method, these bacteria are detectable only by one set of primers
then for detection of the bacteria, the PCR products are digested by the restriction
endonucleases. Since the restriction patterns of bacteria (RFLP) are expected to be
different from each other, on that basis we can identify the bacteria.
Methods: The conserved fragments of the 16S rRNA genes ofthe following
bacteria were amplified by the universal PCR method: Streptococcus pyogenes, Escherichia
coli, Pseudomonas aeruginosa and Neisseria gonorrhoeae. The PCR
products were digested by BsuRI (Hae III) restriction endonucleases and were electrophoresed
on agarose gel.
Results: The restriction patterns of these bacteria were different. Thirty isolated
E. coli and 28 isolated S. pyogenes from clinical samples were studied by this method.
The size of PCR products and RFLP patterns of every bacterium were the same as
standard strains. In comparison with culture method, the sensitivity of the universal
PCR is 92.3 %.The sensitivity of this method was determined up to about 11 and 190
bacteria for gram negatives and gram positives respectively.
Conclusion: These studies suggest that the universal PCR method accompanied
with RFLP is a very useful and rapid method, for detection and identification of bacteria
in body fluids.
http://mjiri.iums.ac.ir/article-1-560-en.pdf
Universai-PCR & Primer
16S rRNA gene
Bacteria
Detection
RFLP
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
329
332
article
BENEFICIAL EFFECT OF LOW DOSE CYCLOSPORINE WITH MMF (MYCOPHENOLATE MOFETIL) IN RENAL ALLOGRAFT RECIPIENTS
F AHMADI
f_ahmadish@yahoo.com
1
M LESSAN-PEZESHKI
2
M.R KHATAMI
3
M MAHDAVI-MAZDEH
4
S MAZIAR
5
S SEIFI
6
Department of Nephrology, Tehran University of Medical Sciences, Imam Khomeini Hospital
Background: Calcineurin inhibitors (CNI) have significantly reduced the incidence
of acute rejection. Nephrotoxicity however may contribute to long-term allograft
dysfunction. Mycophenolate mofetil (MMF) may allow cyclosporine (CsA) dose reduction
without increasing the risk of rejection.
Methods: In seventy-eight living unrelated kidney transplant patients with renal
dysfunction, we studied the effect of CsA dose reduction in association with MMF on
renal function and cardiovascular risk profile.
Results: We reduced the cyclosporine dose from mean 3.5±0.94 mg/kg/d to
2±0.51 mg/kg/d,p<O.OOOl. Mean follow up duration was 22.99±8.98 weeks. The
reduction of CsA was associated with decrement of median serum creatinine from
1. 7±0.99 mg/dL to 1.3±0.52 mg/dL,p<O.OOO 1. We found improvement in lipid profile,
mean cholesterol level from 212.73±41.72 to 199.69±37.33 mg/dL,p<0.002
and also with triglyceride from 195.28±92.21 to 167.64±60.82 mg/dL,p<0.005. No
rejection episodes occurred, and an improvement in systolic and diastolic pressure was
observed from 131.41±21.26 to 127.83±17.53 rnm/Hg,p<O.Ol and from 82.82±13.15
to 78.88±83 mmHg,p<0.03 respectively. No significant difference in plasma uric acid
level was observed after CsA reduction,p<0.06.
Conclusion: This study suggests that CsA reduction is safe and is not associated
with an increased risk of acute rejection. It also has the potential to improve allograft
function and appears to reduce cardiovascular risk factors such as hypertension and
hyperlipidemia.
http://mjiri.iums.ac.ir/article-1-559-en.pdf
Cyclosporine-Mycophenolate Mofetil-Graft survival-Chronic Nephropathy- Hyperlipidemia
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
323
327
article
VASTUS MEDIALIS OBLIQUE AND VASTUS LATERALISACTIVITIES RATIO ON SELECTED DEGREES OF RANGE OF MOTION IN OPEN AND CLOSED KINETIC CHAIN DURING ISOMETRIC CONTRACTION
H FARAHINI
1
GR SHAH HUSSEINI
2
MJ SHATERZADEH
3
I EBRAHIMI TAKAMJANI
takamjan@tums.ac.ir
4
MS GHASEMI
5
School of Rehabilitation, Tehran University of Medical Sciences and Health Services, Tehran, Iran
Background: The purpose of this study was to investigate the ratio of Electromyography
(EM G) activities of the vastus medialis obliqus (VMO) and vastus lateralis
(VL) within seven angles of knee joint range of motion using isometric contraction in
open kinetic chain (OK C) and closed kinetic chain (CKC).
Methods: The dominant knees of 44 healthy female subjects (mean age: 24.84
with range: 20-30 years old) were analyzed. Surface electrode pairs were attached
over the VMO and VL by using Basmajian methods. The EMG biofeedback data was
collected while the subject performed isometric contraction on isometric and squat
exercise within 7 degrees (0° to 90°) with 15° intervals of knee flexion angle.
Results: Paired T-test andANOVA were performed between variables. Results
demonstrated that in this study there are significant differences: I) between OKC and
CKC exercise in 0°, 15°, and 30° ofknee flexion, II) between all angles in CKC
except: 0-15°,0-30°, 0-45°, 15-30°, 60-75°, and 75-90°, and III) between 15-60°,
30-60°, 45-60°, and 60-90° in OKC (p<O.OOl).
As a result in OKC and CKC respectively, 60° and 15° angles ofknee flexion
were most sufficient positions (i.e. increased VMONL activities ratios), -15° and 90°
ofknee flexion were the most insufficient positions and arc of movement between 45-
750 and 0-30° was considered as the most sufficient arc of movement.
Conclusion: As the result of this research and biomechanical and neuro-physiological
viewpoints, emphasized in the literature, our recommendations are: in early
phase or in early sessions of treatment of patellofemoral joint dysfunction, treatment
exercise done in CKC & sufficient position and after progression of the patient's condition,
OKC exercises could also be considered.
http://mjiri.iums.ac.ir/article-1-551-en.pdf
Patellofemoral Joint
Closed Kinetic Chain
Open Kinetic Chain
Electromyography
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
319
322
article
THE INCIDENCE OF FEBRILE CONVULSION IN EXCLUSIVELY BREAST-FED CHILDREN
J AKHONDIAN
j_akhondian@mums.ac.ir
1
R ESHRAGHI IVAR
2
From the Department of Pediatric Neurology, Ghaem General Hospital, Mash had University of Medical Sciences, Mashhad, Iran
Background: Febrile convulsion (FC) is one of the most common emergency
diseases in childhood that has an incidence of3-4%. The most common causes ofFC
are gastroenteritis and respiratory infections. We know that exclusive breast-feeding in
the first 6 months oflife decreases this disorder.
Methods: In this study we evaluated the frequency of exclusive breast-feeding
on children who had FC and were admitted in the pediatric emergency department of
Imam Reza hospital. Control group was 100 children, who were matched with the case
group.
Results: 65.5% of the case group had exclusive breast-feeding in the first 6
months oflife, compared with 7 5% in the control group. It was not significantly different
(p>0.05). However, 55% of children with complex FC had been exclusively breastfed
compared to 75% in the control group (p<0.05).
Conclusion: Exclusive breast-feeding in the first 6 months oflife does not have a
significant effect on FC, but it may protect children from complex FC which is a predisposing
factor for epilepsy.
http://mjiri.iums.ac.ir/article-1-550-en.pdf
Seizure
Febrile Convulsion
Exclusive Breast-Feeding
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
313
317
article
USING PHYSICAL EXAMINATION IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK WITH MODIFIED PARASCALENE APPROACH
FARAMARZ Mosaffa
1
MOHAMMAD MEHDI GHIAMAT
2
AFSHIN FOROUTAN
3
SIROUS MOMENZADEH
momenzadeh_s@yahoo.com
4
From the Departments of Anesthesiology and Intensive Care Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Background: Because nerve stimulators are not always available for brachial
plexus block, fmding the right injection spot for nerve blocks is important. In this study
we used physical examination to determine the appropriate spot for injection.
Methods: All patients who were candidates for upper extremity surgery and
were either in class ASA I or ASA II, were selected. Paresthesia was elicited in the
operation field and the three middle digits using the physical examination method. 50
cases were included totally.
Results: Paresthesia in the operation field or the three middle digits was elicited
in 46 cases in which complete block was produced by local injection (success rate:
100% ). Paresthesia was elicited in the shoulder region in 3 cases and in the upper arm
in 1 case. In the latter case complete block was achieved by blind local injection. In the
former three cases general anesthesia was necessary. No adverse effects were seen.
Conclusion: Apparently, eliciting paresthesia in the operation field and the three
middle digits before injecting the anesthetic solution will increase the success rate and
reduce adverse effects.
http://mjiri.iums.ac.ir/article-1-548-en.pdf
Parascalene
Physical examination
Paresthesia
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
309
312
article
CONSOLIDATION TREATMENT WITH INTRAPERITONEAL CISPLATIN IN EPITHELIAL OVARIAN CANCER FOLLOWING NEGATIVE SURGICAL ASSESSMENT
A MOUSAVI
valrec2@yahoo.com
1
A TEHRANIAN
2
N BEHTASH
3
F GHAEM-MAGHAMI
4
M MODARES
5
P HANJANI
6
Tehran University of Medical Sciences
Objective: The goal of this study is to evaluate the efficacy of intraperitoneal (JP)
cisplatin as consolidation treatment, in epithelial ovarian cancer patients with pathologically
negative surgical reassessment, following first-line platinum-based chemotherapy.
Methods: This study included 22 patients with FIGO stage (IIc- IV) epithelial
ovarian cancer (EOC) which had no evidence of disease and were assessed by second-
look surgery. They were given 3 cycles of intra peritoneal (IP) cisplatin (100 mg/
m2) with 3 weekly intervals as consolidation therapy. Survival was compared to that of
a group of contemporaneous patients undergoing observation only, after completion of
standard therapy.
Results: Median age of these 22 patients was 56 years (30-70 years). Stage
distribution was II (3), III (16), and IV (3). Histologic grade was I (1), II (11), III (9),
and residual disease at completion of initial surgery was none/microscopic in 4/22 (17%)
patients. Median age of 43 patients who did not receive consolidation therapy was 52
years (28-74years). Stage distribution was II (7), III (32), and IV (4). Histologic grade
was I (8), II (17), III (15), and not recorded (3). Median follow-up for both groups
has been 46 months. Median disease-free survival (DFS) for the observed patients is
28 months and 44 months in the consolidation group. DFS distribution between groups
was compared using the log-rank test and found to be significant (p= 0.03)
Conclusion: Multivariate analysis revealed that the only significant predictor of
improved DFS was protocol treatment (p< 0.01). This study indicates that consolidation
IP cisplatin following negative second-look surgery is feasible, severe toxicity was
not frequent and may provide a favorable outcome in terms ofDFS compared to nonprotocol
patients who underwent observation alone. Further trials will be required to evaluate the role of consolidation treatment and improve its options in ovarian cancer.
http://mjiri.iums.ac.ir/article-1-546-en.pdf
Epithelial ovarian cancer
consolidation
intraperitoneal chemotherapy
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
303
308
article
DISPLACED- COMMINUTED INTRAARTICULAR FRACTURES OF THE ADULT DISTAL HUMERUS: FUNCTIONAL RESULTS AFTER INTERNAL FIXATION
N. Ensafdaran
Ensaf@yahoo.com
1
H. Nooraie
2
Z. Saremy
3
Department of Orthopedic surgery, Shiraz University of Medical Sciences, Shiraz, I.R. Iran
Background: Intra-articular T- type or Y- type fractures of the distal end of the
humerus are relatively rare, and consequently few surgeons will be able to attain extensive
experience with the surgical treatment of these injuries. The current emphasis is on
operative intervention with rigid internal fixation and early mobilization.
Methods: In this prospective and retrospective study, we reviewed a series of 38
displaced-comminuted intra-articular T-type or Y-type fractures of the distal end of
the humerus that were operated through the trans-olecranon approach by a single
surgeon and fixed by multiple pins and/or screws over an 8 year period from June
1995-July 2003.The fracture patterns were classified according to RR (RisboroughRadin)
and a strict rating scale (Jupiter et al.) incorporating subjective data, objective
motion, and the functional status of the involved elbow was used for the results.
Results: At a mean follow up of 18 months, 14 results were rated as excellent
15 results as good 6 results as fair and 3 results as poor. Complications included
postoperative ulnar nerve neuritis in one patient non-:::union::: in one patient elbow joint
stiffness in two patients superficial infection in three patients and pin protrusion in three
patients. Over-all, follow up examination showed 76% excellent and good results, 16%
fair results and 8% poor results.
Conclusion: We prefer anatomical reduction and stable fixation with pin and
screw with limited soft tissue dissection in adults and in old patients with good bone
quality.
http://mjiri.iums.ac.ir/article-1-545-en.pdf
Humeral trans-condylar fracture
Comminuted intraarticular distal humeral fractures
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
297
302
article
NEW APPLICATION FOR THE BITEMPORAL (VISOR) FLAP IN RECONSTRUCTION OF ADVANCED LOWER LIP CARCINOMA
Masoud Motasaddi Zarandy
Motasaddi @Yahoo .com
1
Mojgan Kiani Asiabar
2
Layla Mostaan
3
Arman Taheri
4
Safa Samadzadeh
5
Otolaryngology Department, Amiralam Hospital, Saadi Ave.,Tehran, Iran
Background: Lip carcinoma is a common cancer with a good prognosis and
when patients refer early in the course of disease the results of treatment are acceptable.
Surgical procedures for reconstruction of lip defects are the use of remaining lip
tissue, tissue from the opposite lip, adjacent cheek tissue, distant flaps and microvascular
free flaps.
The bitemporal (visor) flap is a regional flap that is used in large advanced upper
lip lesions. This study shows that it can be used in the reconstruction of total lower lip
lesions. It is in the same operative field, the defect can be covered in the same
operation, spread of disease is detected more easily, and it can camouflage the scar. In
male patients it is very acceptable aesthetically and multiple surgical teams are not
required.
Methods: Two patients with advanced lower lip squamous cell carcinoma were
operated and the defect reconstructed with a bitemporal (visor) flap. After the hair is
shaved, a bipedicle temporal flap including the major branch of the superficial temporal
artery was swung in two portions over the defect, and a split-thickness skin graft used
to cover the donor site.
Results: Both patients had no major problem with deglutition or speech after
sectioning the pedicles.
Conclusion: The bipedicle temporal flap can be used for reconstruction of midface
defects. There is no report of! ower lip reconstruction with the bitemporal flap. This
study shows that the bitemporal flap can be used in reconstruction of total lower lip
lesions, especially in male patients. It is in the same field, the defect can be covered in
the same operation, spread of disease is detected more easily, it can camouflage the
scar and does not require two team management.
http://mjiri.iums.ac.ir/article-1-544-en.pdf
bitemporal flap
defect
reconstmction
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
291
295
article
EFFICACY AND SAFETY OF COMBINATION THERAPY OF INTERFERON-ALPHA 2B PLUS RIBAVIRIN FOR CHRONIC HEPATITIS C
Seyed Moayed Alavian
1
Hossein Foroutan Pishbijary
2
Shahram Mirmomen
mirmomen@ams.ac.ir
3
Hadi Ghofrani
4
Ali Kabir
5
Imam Khomeini Hospital, Endoscopy Ward, Tehran, Iran
Introduction: The aim of this study is to assess the therapeutic efficacy and safety
of a particular brand of IFN alpha (PDferon B®) in combination with ribavirin (RlBA)
on Iranian patients with chronic hepatitis C (CHC). The addition of RIBA to the standard
treatment with interferon (IFN) alpha led to an improvement in sustained virologic
response (SVR) from less than 20% with IFN monotherapy to 40-45% in combination
therapy.
Methods: 69 naive patients aged 18 years or older with CHC were enrolled and
treated with 3 mega units (MU) IFN alpha-2b three times a week plus 800-1200 mg
RIBA per day for 48 weeks and the patients were followed for 6 months. The efficacy
was evident at the end of treatment and at the end of follow-up in terms of sustained
normalization of alanine aminotransferase and sustained serum H CV-RNA loss.
Results: The rates of sustained biochemical and virologic response were 63%
and 61%, respectively. Virologic response was 83.1% and 86.4% at weeks 12 and 48
as well. No patients had serious complications.
Conclusion: Although we had no control group using standard IFN alone, our
preliminary findings showed an acceptable and promising response rate to PDferon.
On the other hand, it seems that adverse events with PDferon are as other standard
IFNs.
http://mjiri.iums.ac.ir/article-1-543-en.pdf
Interferon
Ribavirin
Hepatitis C
Treatment
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
287
289
article
PREVALENCE OF TRAUMATIC TYMPANIC MEMBRANE PERFORATION IN PATIENTS WITH A PATULOUS EUSTACHIAN TUBE
Ali Asghar Peyvandi
aliapeyvandi@yahoo.com
1
Mohammad Ebrahim Mahdavi
2
Department of Audiology, Shahid Beheshti University of Medical Sciences, Rehabilitation Faculty,
Background: With respect to physical relations in force and pressure, we hypothesized
that the prevalence of traumatic tympanic membrane perforation in patients
with a patulous Eustachian tube is greater than normal, because in Eustachian tube
patency, the internal air pressure of the middle ear will not increase after compression,
subsequent to trauma. Therefore the force upon the tympanic membrane may cause it
to perforate easier.
Methods: In this study we evaluated 45 patients with traumatic tympanic membrane
perforation. After otoscopy, modified inflation-deflation test was performed to
determine the opening, closing, and residual pressure of the Eustachian tube.
Results: Approximately 60 percent had a patulous Eustachian tube, 27% had
poor Eustachian tube function and 13% had normal Eustachian tube function.
Conclusion: It appears that patients with a patulous Eustachian tube are probably
at high risk for traumatic tympanic membrane perforation.
http://mjiri.iums.ac.ir/article-1-539-en.pdf
Patulous Eustachian Tube
Traumatic Tympanic Membrane Perforation.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2006-02
19
4
281
285
article
ASSESSMENT OF THE EFFICACY OF PARA CERVICAL BLOCK IN CONJUNCTION WITH CONSCIOUS SEDATION ON PAIN CONTROL DURING OUTPATIENT HYSTEROSCOPY
Simin Atashkhoii
siminatashkhoii@yahoo.com
1
Sohrab Negargar
2
Simin Tagavi
3
Department of Anesthesiology, Alzahra Hospital, Tabriz University of Medical Sciences,
Background and Objective: Hysteroscopy is considered as very important in
the investigation of abnormal uterine bleeding. It is usually performed as an outpatient
procedure under either local or no anesthesia. This study was designed to compare the
combination of paracervical block (PCB) and conscious sedation with paracervical
block or conscious sedation alone for outpatient hysteroscopy in terms of pain control
and patient satisfaction.
Methods: A total of 60 women with abnormal uterine bleeding were considered
eligible for the study. Patients were randomized into three groups. Group A (20 patients)
underwent diagnostic hysteroscopy with conscious sedation, in group B (20
patients) paracervical block was performed, and group C (20 patients) received both
conscious sedation and paracervical block. Main outcome measures were pain control
during the procedure, the postoperative pain score at 15 min, 60 min, and 24 h after the
procedure, and patient's satisfaction rate.
Results: There were significant differences between combination therapy with
other groups in terms of pain control during the procedure (paracervical block plus
sedation versus the other two groups: p<O.OO 1 ), and in postoperative pain at different intervals
(group C versus A and B groups,p<O. 001 ). Satisfaction rate in group C patients was
higher than the other patients (paracervical block+ sedation versus group A and B,p<O.OOl ).
Conclusion: Both paracervical block and conscious sedation anesthesia can be
used for diagnostic hysteroscopy, but their combination resulted in improved analgesia
both during the procedure and postoperative pain and patient satisfaction compared
with monotherapy.
http://mjiri.iums.ac.ir/article-1-538-en.pdf
Hysteroscopy
Paracervical Block
Conscious Sedation
Anesthesia.