eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2010-02
23
4
241
246
article
Gallstone ileus and a three centimeters stone in terminal ileum: a case report
Seyed Hamid Moosavy
seyedhamid _moosavy@yahoo.com
1
Hossein Froutan
2
Mojdeh Habibi
3
Nesaa Aghazadeh
4
Yasir Andrabi
5
Hormozgan University of Medical Sciences, Gastroenterologist, Shahid Mohammadi Hospital Bandarabbas, Hormozgan, Iran.
Imam Khomini Hospital, Tehran University of Medical Sciences.
Imam Khomini Hospital, Tehran University of Medical Sciences.
Imam Khomini Hospital, Tehran University of Medical Sciences.
Imam Khomini Hospital, Tehran University of Medical Sciences.
Abstract Gallstone ileus is a rare complication of cholelithiasis found in less than 0.5% of patients. It is an uncommon cause of small bowel obstruction, accounting for 1% to 3% of all mechanical bowel obstructions and over 25% of nonstrangulated bowel obstructions in patients older than 65 years with a female predominance. We report a 60-year-old woman who was referred to our hospital because of abdominal pain, nausea, vomiting and constipation forty days prior to admission. An upright abdominal X-ray showed air fluid levels and an oval calcified opacity in the region of right iliac fossa. The ultrasonographic examination revealed air in billiary tree and several small stones in the gallbladder. Follow up of abdominopelvic CT scan showed severe distention of small intestinal loops, pneumobilia and a 3cm-calcified intraluminal mass. The clinical diagnosis of gallstone illeus was made, but unfortunately her general condition worsened with the decline in Glasgow Coma Scale declined since she was suffered an extensive cerebrovascular accident and eventually she died of cardiac arrest. Inspired by the mentioned case we reviewed the literature on the cause, diagnosis and treatment of gallstone ileus.
http://mjiri.iums.ac.ir/article-1-124-en.pdf
Cholelithiasis
Gallstone ileus
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2010-02
23
4
238
240
article
Transverse myelitis and heroin abuse: a case report
Bahram Haghi-Ashtiani
bhaghi2000@yahoo.com
1
Farzad Sina
2
Fowzieh Ben Isa
3
Mohammad Rohani
4
Baradaran Rezaei Hospital, Damghan, Semnan, Iran.
Iran University of Medical Sciences, Tehran, Iran.
Abstract The usage of heroin is associated with a variety of neurologic disorders, including acute transverse myelitis. In this study we present a 19 year old man who was suffered from insufflated heroin after several months of abstinence, and admitted to hospital emergency department, unconscious. He responded to fluid therapy and Naloxone, but could not move his legs on examination. He had flaccid paralysis of both legs, acute urinary retention and diminished rectal tone. Deep tendon reflexes were absent with downward plantar reflexes. Analysis of CSF was normal, and the MRI of the spine revealed confluent hyperintensity on T2-weighted images from the C5 to T2 vertebral levels involving the majority of the cord substance. The cord was mildly expanded without any enhancement after Gadolinium injection. Suggested mechanisms of heroin-associated myelopathy include hypotension, a direct toxic effect of heroin, vasculitis, and hypersensitivity reaction. Hypersensitivity was the predominant theory since the initial reports, implied that most patients with developed myelopathy had relapsed into heroin use after a period of abstinence. Treatment with either IV corticosteroids or immunopheresis could blunt the immune response, preventing disability. Efficacy of these methods require more studies in future.
http://mjiri.iums.ac.ir/article-1-123-en.pdf
transverse myelitis
drug abuse
heroin
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2010-02
23
4
233
237
article
Idiopathic granulomatous mastitis: report of 3 cases and a review of the literature
Farzaneh Ebrahimi-Fard
1
Arash Najaf beygi
a.najafbeygi@yahoo.com
2
Ali Kavyani
3
AmirHosein Jalali
4
Shahid Baheshti University of Medical Sciences and Health Services
Shahid Beheshti University of Medical Sciences
Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Absract Idiopathic granulomatous mastitis is a rare, inflammatory, and benign breast disease characterized by non-caseating granulomata and microabscesses limited to breast lobules. This condition presents as a firm breast mass that is clinically and radiologically indistinguishable from breast cancer, or as multiple or recurrent abscesses, or mastitis in a young non-lactating woman. Almost always, the diagnosis is made after surgical interventions to rule out other pathologies as differential diagnoses especially tuberculosis which is endemic in our country. We are going to report 3 cases of granulomatous mastitis besides a brief review of the literature. We emphatically recommend that although this entity should be kept in mind as a rare differential diagnosis, it shoud not be considered as the first one.
http://mjiri.iums.ac.ir/article-1-122-en.pdf
Chronic mastitis
Breast mass
Breast abscess
Granuloma
Idiopathic granulomatous mastitis
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2010-02
23
4
224
232
article
Test-retest reliability and minimal detectable change for center of pressure measures of postural stability in elderly subjects
Reza Salehi
Salehi200@yahoo.com
1
Ismaeil Ebrahimi-Takamjani
2
Ali Esteki
3
Nader Maroufi
4
Mohammad Parnianpour
5
School of Rehabilitation Science, Iran University of Medical Science
Iran University of Medical Science, Tehran, Iran.
Shahid beheshti University of Medical Science, Tehran, Iran.
Iran University of Medical Science, Tehran, Iran.
Sharif industrial University, Tehran, Iran.
Abstract Background: Postural instability has been identified as a potential precursor of falls in elderly subjects. Postural stability in quiet stance is commonly assessed with center of pressure (COP) measures. The purpose of this study was to determine testretest reliability and minimal detectable change (MDC) for the center of pressure (COP) measures in the elderly subjects. Methods: Eighteen healthy elderly people over the age of 60 years participated in this study. For each subject the COP was recorded during quiet upright stance on different levels of postural difficulty (eyes open versus eyes closed, firm surface versus foam surface) and lean condition (forward and backward). All measurements were done on two sessions with 7 days interval. These indices: mean velocity, standard deviation of amplitude, standard deviation of velocity, phase plane parameter and area (95% confidence ellipse). Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and coefficient of variation (CV) were used to quantify testretest reliability. The MDC for each measure was calculated to quantify intervention effects. Results: In general, test-retest reliability of COP measures in the elder subjects was increased whenever postural difficulty of task increased in quiet standing. In standing conditions, mean velocity and phase plane parameter were the most sensitive and the most reliable measures. The lean range was the most sensitive and the most reliable measure, in the lean conditions. Conclusion: Center of pressure measures in the quiet standing especially in difficult postural conditions demonstrated high sensitivity in the older subjects. These results may be useful in quantification and assessment of balance performance and treatment efficacy.
http://mjiri.iums.ac.ir/article-1-127-en.pdf
Reliability
Minimal Detectable Change
Center of Pressure
balance
Elder People
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2010-02
23
4
218
223
article
Whether regular working hours can minimize the blood biochemical effects of shift working: a cross-sectional study in Iran
Masoumeh Ghiasvand
:masoumeh@iums.ac.ir
1
Ramin Heshmat
2
Koroush Soleimani
3
Occupational Medicine Research Center, Iran University of Medical Sciences
Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences,Tehran, Iran.
Civil Aviation Organization, Tehran, Iran.
Abstract Background: Irregular Working hours, including night work and shift work, have been found to be associated with alteration in various levels of biochemical factors. And some studies have showed association between shift work and blood biochemical disturbances in blood. In this epidemiological study we investigated, whether regular schedule of working hours can minimize the associated biochemical effects. Methods: Atotal of 442 air traffic controllers between the ages of 21 and 59 years in this study filled out questionnaire, and triglyceride, total cholesterol, and HDL-C concentration and FBS were measured after 12- hours fasting. The correlation between shift work and the biochemical variables was measured. The SPSS software version 11.5 and STATAversion 8 were used for statistical analysis, the X2 and fisher's exact test used for comparing the qualitative variables and the parametric tests for quantitative variables with normal distribution. Odd's ratio (OR), and 95% confidence interval (95% CI) were used for estimating the effect of shift work on lipid profile and high blood glucose levels. Logistic regression modeling was used for multivariable analysis and adjusting the effect of different variables. Results: sample size of this cross-sectional study was consisted of 305(69%) shift workers and 137(31%) day workers. The mean age of the shift workers was 40 ± 10 years old and the day workers 40 ± 9.The mean of variables in the present study for total cholesterol, LDL-C, HDL-C, triglyceride and fasting blood glucose in the shift workers were respectively: 195±37mg/dl, 116.8±34.8mg/dl, 48.2±15.1mg/dl, 154±80mg/dl, 92±20mg/dl and in the day workers were respectively: 200±40mg/dl, 125.3±38.6mg/dl, 48.8±23.3mg/dl,151± 77mg/dl, 90± 14mg/dl. Adjusted Odd's ratio for the effect of shift working on the biochemical blood factors did not change the results. . Conclusion: This study showed that air traffic control workers with various shift did not have any disturbances in their biochemical blood factors, and this finding persisted after adjustment was made for age. These results could be due to regular shift schedule as well as periodic evaluation for biochemical blood factors in this group. But this study did not rule out physiological and behavioral effects of working shift on the shift workers. It was concluded that shift workers should be on regular working schedule and examined periodically for biochemical blood factors, physiological flunctuation (gastrointestinal, endocrinal, cardiovascular….) and behavioral effects induced by variation in shift working.
http://mjiri.iums.ac.ir/article-1-119-en.pdf
blood pressure
body mass index
cholesterol
high density lipoprotein-cholesterol
low density lipoprotein-cholesterol
triglyceride.
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2010-02
23
4
207
217
article
Cell death induction by Streptococcus pyogenes in four types of malignant cell lines
Zahra Eslami-Nejad
eslamie_33333@yahoo.com
1
Noureddi Nematollahi-Mahanin
2
Fereshteh Saffari
3
Hamid Mollaii
4
S. Ali Mohammad Arabzadeh
5
Department of Microbiology. Afzalipour Medical School, Kerman Universityof Medical Sciences. Kerman, Iran.
Department of Anatomy. Afzalipour Medical School. Kerman University of Medical Sciences.
Department of Microbiology. Afzalipour Medical School, Kerman University of Medical sciences.
Department of Microbiology. Afzalipour Medical School, Kerman University of Medical Sciences.
Department of Microbiology, Afzalipour Medical School, Kerman University of Medical Sciences.
Abstract Background: The interest in using bacteria as anti- cancer therapeutic agents dates back to the end of the19th century. Some bacteria like Salmonella and Listeria replicate effectively inside malignant cell lines and suppress their growth. The bacterium Streptococcus pyogenes has become medically famous as a flesh-eating pathogen since mid-1980s. It is the causative agent of a life threatening clinical condition called necrotizing fasciitis. S. pyogenes usually produces a range of lytic enzymes that promote bacterial pathogenesis. With these characters, could this bacteria. be employed as a curing agent for certain cancers? The aim of this study was to determine the influence of S. pyogenes on malignant cellular death (apoptosis or necrosis)- in an ex-vivo "experimental- interventional" study. Methods: The cytotoxicity of fifteen internalized streptococcal strains( including 12 clinical isolates, 2 known M types [M1, M3] and standard strain), on four types of malignant cell lines- A549, BT-20, PC-3, L-929- were tested by Trypan blue exclusion, DNAfragmentation and WST-1 methods. The streptococcal protease, lipase, DNase and serum opacity factor (SOF) were tested concurrently. The standard strain of Streptococcus (Enterococcus) faecalis was employed as negative control. The results were analyzed by statistical Minitab software. Results: The overall cytotoxicity rate of -internalized- S. pyogenes was 57% by trypan blue method and 50 % by DNA electrophoresis. False positive results occurred for the negative control in WST-1 therefore this test did not present reasonable results. The correlation between production of SOF, lipase, DNase and cytotoxicity of S. pyogenes was not significant (p > 0.05). However, 67% of the protease positive strains induced cellular death in at least one type of - malignant cell line (p<0.05). Conclusion: Our findings indicated that, some non-invasive S. pyogenes that cause benign infection like pharyngitis can induce cell death in various cancerous cell lines. It seemed that among bacterial products, the proteolytic enzymes- linked to the streptococcal pyrogenic exotoxin B (spe-B)- were more related to bacterial invasion.
http://mjiri.iums.ac.ir/article-1-118-en.pdf
Streptococcus pyogenes
cancer treatment
malignant cell
apoptosis
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2010-02
23
4
200
206
article
POTT\'S Disease: a review of 58 cases
Mohammadreza Ehsaei
1
Fariborz Samini
Saminif@Mums.ac.ir
2
Gholamreza Bahadorkhan
3
Department of Neurosurgery, Ghaem Medical Center,
Abstract Backgrounds: Pott's disease is a rare form of extrapulmonary tuberculosis, and presents with several clinical patterns. Delay in diagnosis and management may cause serious complications. We conducted a retrospective study between 1991- 2006 to evaluate clinical presentation, radiologic and laboratory findings, and therapeutic approaches to spinal tuberculosis. Methods: We reviewed clinical presentation, radiological and laboratory findings of 58 patients with spinal tuberculosis retrospectively. The diagnosis of tuberculous spondylitis was based on characteristic histology or microbiologic evidence of the disease. The results of study were recorded, and statistically analyzed by SPSS 11.5. Results: The most frequent symptom was back pain (84%), with thoracic region being the most affected site (46%). Paravertebral abscess noted in 67% of cases and the average time for diagnosis was 16 months. Conclusions: The 42 cases of this study underwent surgery and all were treated with drug therapy for 12 months . There was no worsening of the neurologic status in any patient. All patients with tuberculous spondylitis began to improve 3 months after chemotherapy and healed within 12 months in nonsurgical and surgical groups.
http://mjiri.iums.ac.ir/article-1-117-en.pdf
Antituberculous regimen
pott\'s disease
spine
spondylitis
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2010-02
23
4
189
199
article
The correlation between Q-angle (clinical) and TTTGdistance (axial computed thomography) in Firuzgar Hospital, 2008
Abbas Madani
1
Alireza Parsaii Sadr
2
Ali Yeganeh
yeganeh471@yahoo.com
3
Gholamreza Shahoseini
4
Iran University of Medical Sciences and Health Services .Tehran, Iran
Iran University of Medical Sciences and Health Services. Tehran, Iran
Iran University of Medical Sciences and Health Services.Tehran, Iran.
Iran University of Medical Sciences and Health Services .Tehran, Iran
Abstract Background: The purpose of this study was to evaluate the significance of the Q angle with respect to the patella position. We assess the correlation between the Q angles (calculated by clinical exam) in different positions and CT indices (with more impression on TTTG). Method: Atotal number of 68 knee joints of 50 cases entered the study. Clinical examination was used to measure Q angle (in 3 positions of sitting, standing and supine). CT scan performed in 2 axial view of proximal tibia, and distal femor for measurement of Tibial tuberosity-trochlear groove distance (TTTG) and other CT indices. Correlation between main variables calculated.and analysed with spss. Results: Supine Q angle were strongly correlated with standing Q angles and moderately with sitting Q angle. Sitting Q angle was moderately correlated with supine and standing Q angle and weakly with PTA. we found no other significant correlation between Q angle and CT indexes. Discussion: Our findings suggest that Q angle is not a valuable index for predicting the presence of patelofemoral malalignment.
http://mjiri.iums.ac.ir/article-1-115-en.pdf
Q angle
TTTG. CT scan
patellofemoral malalignment
anterior knee pain
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2010-02
23
4
184
188
article
The impact of anxiety on sleep quality
Azizeh Afkham-Ebrahimi
afkhami@iums.ac.ir
1
Maryam Rasoulian
2
Zahra Taherifar
3
Maryam Zare
4
Psychiatric Institute.Satarkhan, Niayesh, Next to Shahid Mansouri St
Psychiatry Department. Rasoul Akram hospital .Tehran-Iran
Psychiatric Institute.Satarkhan, Niayesh, Next to Shahid Mansouri St
Psychiatric Institute.Satarkhan, Niayesh, Next to Shahid Mansouri St
Abstract Background: A significant relationship between psychiatric disorders principally depression and anxiety and insomnia is well-known in general population. Ahigh percent of insomnia sufferers report anxiety symptoms. Anxiety is also frequently seen in medical patients whom complaints of sleep problems are often prominent. Method: 250 outpatients with various medical complaints participated in the study and completed Pittsburgh Sleep Quality Index(PSQI) and Beck Anxiety inventory (BAI). Results: The patients reported moderate anxiety on BAI. Significant correlations were found between anxiety and four components of sleep sleep quality, sleep latency, sleep duration and habitual sleep efficiency. Conclusion: The correlation of sleep complaints with anxiety symptoms indicated a high interrelatedness between anxiety and sleep complaints. Insomnia is a disorder of hyperarousal. Nonetheless inqury into mechanisms of arousal regulation could further explain the anxiety and sleep disorders as well.
http://mjiri.iums.ac.ir/article-1-114-en.pdf
Anxiety
sleep quality
Beck Anxiety Inventory
Pittsburgh Sleep Quality Index
eng
Iran University of Medical Sciences
Medical Journal of The Islamic Republic of Iran (MJIRI)
1016-1430
2251-6840
2010-02
23
4
177
183
article
Surgical treatment results of acute acromioclavicular injuries
Mahmoud Jabalameli
1
Mohammad Rahbar
2
Mehdi Ramezan Shirazi
Mehdi.shirazi@yahoo.co.uk
3
Shafa Yahyaian Hospital, Iran University of Medical Sciences, Tehran, Iran
Shafa Yahyaian Hospital, Iran University of Medical Sciences, Tehran, Iran
Shafa Yahyaian Hospital, Baharestan Sq., Tehran, Iran.
Abstract Background: Different methods of surgical treatment for acromioclavicular(AC) joint injury were considered in the literature. The purpose of the study was to compare intra- articular AC repair technique with the extra-articular coracoclavicular repair technique for the patients with Rockwood type III and VAC joint injury when indicated. Methods: Nineteen consecutive patients with Rockwood type III and VAC joint injury were treated with intra-articular (Group I - 12 cases) and extra-articular (Group II - 7 cases) repair technique between 1380 - 1386, and the results reviewed. When the diagnosis was established, the mean age of the patients was 32.5 years (Range, 18 - 60) group I and II 31.8 years (Range, 18 - 60) and 34 years (Range, 22 - 58) respectively. The mean duration of postoperative follow - up was 24 months. The Constant shoulder scoring system was applied to obtain clinical results. Results: Only in group I, the post-surgical complication was associated with fiber allergy, wound infection and pin site infection in two patients respectively. No pain was detected in fourteen cases. Four patients in group I had occasional mild pain during sport activity, while one case in this group reported severe pain during resting which prevented the patient from activity. Also, there was an ossification in thirteen patients particularly in group I. Clinical results showed the mean constant shoulder score was 93.4 in group I and 97.1 in group II. Conclusion: At the time of the follow - up, there was a clear difference between both groups regarding to postoperative pain and discomfort. Therefore, it seemed that potential cause of pain was due to postoperative complications. An interesting postoperative complication without interfere in the functional outcome was coracoclavicular space ossification in most cases. This was probably because of soft tissue injury during the operation. It seemed that surgical treatment of Rockwood type III and VAC joint injuries when indicated had acceptable clinical results particularly if the extra-articular AC repair technique (screw fixation) was chosen. The new arthroscopic surgical technique with endobutton may decrease the rate of complications such as fracture site ossification and morbidity although more study in this field is required.
http://mjiri.iums.ac.ir/article-1-113-en.pdf
acromioclavicular
joint
intra-articular repair
extra-articular repair