@article{ author = {Naghshin, Roozbeh and Yahyapour, Fatemeh and ZoroufchianMoghaddam, Pejman and Ghourchian, Shadi}, title = {Breast tuberculosis in a postmenopausal woman with an insidious manner: a case report}, abstract ={AbstractMammary tissue, skeletal muscle, and spleen are less frequently affected by mycobacterium tuberculosis (TB).The most common age for breast TB is between 50 and 70. On this article, we are reporting a 72-year-old womanwho presented with chronic cough, lobar consolidation in right middle lobe (RML) on the CXR, and a massin her right breast revealed on the physical examination. Biopsy from the breast lesion showed granulomatouschanges and acid fast bacilli were detected by bronchoalveolar lavage. Treatment for TB was begun and thepatient showed significant improvement.Based on the patient’s age, breast carcinoma was suspected first. Sinus formation was found on her breast ultrasound.This is a common finding and not diagnostic for TB. Our report is a reminder that although breastmasses in older women tend to be more malignant, tuberculosis should be considered in differential diagnosis,especially in postmenopausal women. Moreover, breast TB can present with insidious growth without anysymptoms.}, Keywords = {Breast, lung, mycobacterium tuberculosis}, volume = {25}, Number = {1}, pages = {47-51}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-251-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-251-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {KamalFrutan, Saeid and Salehi, Hossein and Mansouri, Korosh and Bakhtyari, Mehrdad and Abootaleb, Hamid and Pedram, Sepehr}, title = {Comparison of nerve repair with end to end, end to side with window and end to side without window methods in lower extremity of rat}, abstract ={  Abstract   Background : Although, different studies on end-to-side nerve repair, results are controversial. The importance of this method in case is unavailability of proximal nerve. In this method, donor nerves also remain intact and without injury. In compare to other classic procedures, end-to-side repair is not much time consuming and needs less dissection. Overall, the previous studies in this field have just evaluated nerve recovery by non functional or functional parameters. As it has proven, the results of functional and non functional studies are not always matched. Therefore, this study was designed to evaluate this method by functional (Sciatic function index) and non functional parameters (histochemical study).   Methods: In this experimental study, forty adult male Wistar rats (200-250g) were used their left proneal nerve was cut and divided into four groups: 1- control group (n=10). In this group, nerve was exposed and cut and implanted onto adductor muscles, 2- end-to-end anastomosis (n=10). In this group, peroneal nerve cut and two segments were anastomosed end-to-end, 3- end-to-side anastomosis with window (n=10). In this group, peroneal nerve was cut and anastomosed with window to tibial nerve, 4- end-to-side anastomosis without window (n=10). In this group, peroneal nerve was cut and anastomosed without window to tibial nerve. After 1, 8 and 16 weeks, functional (Sciatic function index) and after 16 weeks non functional studies (histochemical study) were performed and the results compared.   Results: All experimental groups (group 2, 3, 4) motor recovery at 8th, 16 th week were not statistically different (p>0.05). In histological study axons count in end -to-side with window anastomosis were higher than other experimental groups (p<0.05).   Conclusion: According to our findings, the authors believe that end to side neuroraphy leads to axon growth and comparable functional recovery with end to end neuroraphy in rat model. Due to the fact that the diameter of nerves and muscles which might be neurotised in human are much bigger and not comparable with rat, it is suggested to set up some set of experiments on the bigger size animals such as primates in further studies for generalization of results to human being.  }, Keywords = {end-to-side nerve anastomosis, end-to-end nerve anastomosis, motor recovery, histologic study}, volume = {25}, Number = {1}, pages = {40-46}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-250-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-250-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Afshar, Saeid and Abdolrahmani, Fahimeh and VakiliTanha, Fereshte and ZohdiSeif, Mahin and Taheri, Kobr}, title = {Recognition and prediction of leukemia with Artificial Neural}, abstract ={  Abstract   Background : Leukemia is one of the mostcommon cancers in children, comprising more than a third of all   childhood cancers. Newly affected patients in USA are estimated as 10100cases, and if these cases are diagnosed late or proper treatment is not applied, then it can be mortal. Because rapid and proper diagnosis of leukemia based on clinical or medicinal findings (without biopsy) is impossible, we decided to apply artificial neural network for rapid leukemia diagnosis. For this aim we used clinical and medical parameters taken from 131 patients of Sina hospital of Hamadan.   Methods : We carried out independent sample T-test with SPSS software for 38 parameters. With regard to   the results of this analysis we selected 8 parameters that had lowest sig for ANN analysis (among parameters, whose sig were less than 0.05). Selected parameters of 131 patients were applied for training network with Levenberg-Marquardt learning algorithm, with learning rate of 0.1.   Results : Performance of learning was 0.094. The Relationship between the output of trained network for test data and real results of test data was high and the area under ROC curve was 0.967.   Conclusions : With these results we can conclude that training process was done successfully and accurately. Therefore we can use artificial neural network for rapid and reliable leukemia recognition.  }, Keywords = {ANN, artificial neural network, cancer, leukemia, prediction}, volume = {25}, Number = {1}, pages = {35-39}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-249-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-249-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Marbouti, Ladan and Jafari, Hassan and Noorizadeh-Dehkordi, Shohreh and Behtash, Hami}, title = {Pain-related disability measurement: the cultural adaptation and validation of “pain disability index (PDI)” and “pain disability questionnaire (PDQ)” among Iranian low back pain patients}, abstract ={  Abstract   Background: Low Back Pain (LBP) is still a medical problem in 21 st century. Having back pain and being   disabled by it are not the same thing. It is common to come across with patients who have simple back pain but surprisingly totally disabled and vice versa. In clinical practice, it is important to have a proper evaluation of disability and making a clear distinction between pain and disability. During the past two decades several selfreport measures and questionnaires have been developed to evaluate disability in LBP patients, however most of these questionnaire were designed in English language and based on European or American studies. The aim of this study was to develop and validate a translated and culturally adapt “Pain Disability Index (PDI)” and “Pain Disability Questionnaire (PDQ)” among Iranian patients with low back pain.   Methods: The Persian versions of the PDI, PDQ were created through systematic translation and crosscultural adaptation of the original questionnaires. The Oswestry Disability Index and Visual Analogue Scale were used for validation studies. Patients were asked to complete these questionnaires initially and also at 7 days later as retest.   Results: A total of 304 patients with acute and chronic LBP completed the Persian versions of PDI, PDQ,   “Oswestry Disability Index” (ODI) and “Visual Analogue Scale” (VAS). Among patients 111 patients participated for retest after seven days. The Cronbach’s alpha (coefficient of reliability) for the PDI and PDQ was satisfactory. The PDI and PDQ showed high and very high test-retest reliability (ICC=0.8 and 0.92 respectively). The Pearson correlation coefficient among PDI, PDQ with ODI was 0.64 and 0.72, and for PDI, PDQ, ODI with VAS was 0.36, 0.47 and 0.57, respectively (P<0.001).   Conclusion: The Persian version of the PDI and PDQ questionnaires are reliable and valid instruments to evaluate generic perceived disability in Persian-speaking patients with LBP. It is shown that PDI and PDQ are capable of measuring the disability in LBP patients. They could be used in clinical and research encounters with acceptable confidence.}, Keywords = {Low back pain, disability, pain disability index, pain disability questionnaire}, volume = {25}, Number = {1}, pages = {27-34}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-237-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-237-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Jafari, Dawood and Nozarnejad, Pouy}, title = {Outcomes of the isolated closed tibial shaft fractures treated nonsurgically}, abstract ={  Abstract   Background: Fractures of the tibia are important for their commonness and controversy in their management. Both conservative and surgical techniques have been introduced in an effort to speed time to :::union::: while minimizing the occurrence of complications. Standard treatment for low-energy tibial shaft fractures includes closed reduction and cast immobilization. The purpose of our study was to analyze retention of reduction after cast immobilization of simple isolated closed tibial fractures.   Methods : All cases of the diagnosed isolated closed tibial shaft fracture treated non-surgically at Shafa Yahyaeian Hospital, between 2006 and 2009 were retrieved from medical records. We reviewed all medical records and radiographs of these patients to inquire about the patients’ demographic data used to analyze the outcomes of the non-surgical treatment.   Results : Of the 26 patients examined, males were more commonly affected. The mean age was 27.46   (SD=7.58). The most common causes of injury were direct blow and motorcycle to pedestrian accident. Followup duration for each patient had an average of 9.12 months (SD=2.36). Using AO/OTA classification, distributed as 38.5% A1.1, 26.9% A2.1 and 34.6% A3.1 fractures. Most fractures were sustained in the lower third of the tibia (53.85%). All fractures eventually healed in an average of 13.7 weeks (SD=3.24). There was one case of delayed :::union::: in the 22nd week. In 92.3% of patients, shortening of bone was less than 1 cm, while in 7.7% patients, was more than 1.5 cm. We observed an anterior or posterior angulation > 10 ° in 2 (7.69%) patients. Moreover, in 4 (15.38%) patients we found varus angulation > 5°. Therefore, final deformity was observed in 8 (30.77%) patients. No patient had non-:::union:::, rotational malalignment of more than 10 degrees, an infection, or a compartment syndrome.   Conclusion : Our non-surgical treatment’s outcomes were not satisfactory, despite applying all principles for conservative treatment and selecting patients satisfying restricted criteria. Moreover, considering long-term physical disability with longer follow-up period, it seems that there still is a controversy in the treatment selection even for the simple tibial fractures.  }, Keywords = {Tibial shaft fractures, closed fractures, nonsurgical treatment, cast treatment}, volume = {25}, Number = {1}, pages = {21-26}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-248-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-248-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Froutan, Hossein and KashefiZadeh, Alireza and Kalani, Mohammad and Andrabi, Yasir}, title = {Lead toxicity: a probable cause of abdominal pain in drug abusers}, abstract ={  Abstract   Background: Lead toxicity is caused by ingestion, inhalation, or contact with particles or vapors containing lead. It can present with nonspecific signs and symptoms such as abdominal pain, constipation, irritability, difficulty concentrating, and anemia. In this study, we have tried to find a relationship between lead poisoning and drug abuse.   Methods: In a cross sectional study, drug addicts presenting with abdominal pain referring to GI center of   Imam Khomeini hospital in 2008 were observed. Patients having occupational contact with lead were excluded from the study. Required data included age, sex, clinical findings, Para clinic results and blood lead level. Results were analyzed through SPSS-15 software.   Results: 42 patients (all male) with average age of 46.9 ± 10.1 years were included in the study. Average   blood lead level was 51.17±27.96µg/dl. 22 patients (52.6%) had lead toxicity. A significant relation was found between lead toxicity and mode of opium drug use however relation between lead toxicity and duration of addiction was not significant. Similarly, a meaningful relation was found between lead toxicity and abnormal liver function test, urine tests, ECG, presence of basophilic stippling and hyperuricemia.   Conclusion: There seems to be a significant relation between opium drug abuse and lead toxicity. Further   studies with more cases and ethnicities are needed.  }, Keywords = {Lead toxicity, opium, drug abusers, abdominal pain}, volume = {25}, Number = {1}, pages = {16-20}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-247-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-247-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Mohammadzadeh, Ashraf and Farhat, Ahmadshah and Jafarzadeh, Mohsen and Hasanzadeh, Leili and Esmaeli, Habiballah}, title = {Advantages of kangaroo mother care in less than 2000 grams low birth weight neonates}, abstract ={  Abstract   Background: The aim of study was to compare the effect of Kangaroo mother care (KMC) and conventional methods of care (CMC) in low birth weight babies less than 2000 grams.   Method: One hundred babies with birth weight less than 2000 grams and without clinical problem were   randomized in two groups the intervention group (N=50) who received Kangaroo mother care and the control group (N=50) with conventional care. Two groups were compared in daily weight gaining, self confidence of mother, duration of hospitalization, clinical cyanosis and nosocomial infection. Collected data was analyzed by SPSS 11.5 software . Irct ID: IRCT201101091162N16.   Results: The KMC babies had better daily weight gaining average [18.31±7.57gm vs. 4.8±16.57gm (P<   0.001)] CMC: and also, self confidence of mother in KMC group was significantly higher than CMC group   (p<0.001). A significantly longer duration of hospitalization observed in CMC group [27.18±12.07 day vs.   16.24±10.04 day (P0.05).   Conclusions: In this study Kangaroo mother care had better effect on daily weight gaining, mother   confidence and shorter duration of hospitalization.  }, Keywords = {Kangaroo mother care, low birth weight, Newborn, conventional methods of care.}, volume = {25}, Number = {1}, pages = {11-15}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-246-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-246-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Mohebbi, Alireza and Ghanbari, Hadi and Sohrabi, Hamid Reza and Farjamnia, Arezoo}, title = {Active anterior rhinomanometric (AAR) evaluation of nasal airway resistance in normal Iranian sample}, abstract ={  Abstract:   Background: The most important and complex phenomenon of respiratory function of the nose is related to different nasal anatomy. The differences in facial anatomic structure between different races may also be reflected in nasal resistance and airflow. Caucasians has different facial anatomic structure which is the reflection of intranasal resistance or consequence of airflow. The active anterior rhinomanometric (AAR) is recommended   for objective assessment of nasal airway resistance (NAR) in inspiration and expiration which can be calculated via nasal airflow.   Methods: This study designed to evaluate the resistance of the nasal airway in Iranian samples and comparing with the standard methods. An epidemiologic case series cross sectional study was designed for 100 Iranian adult volunteer without nasal breathing problems and with AAR inclusion criteria. All subjects had to undergo a primary assessment of relevant symptoms of nasal disease and nasal examination before undergoing AAR assessment.   Results: The mean values of total nasal airway resistance sere 0/38±0/17 pa/cm2/s in inspiration and 0/41±0/27 pa/cm2/s in expiration at 150 pas pressure point. Unilateral nasal resistance in right and left in inspiration were respectively 0.88±0.69pa/cm2/s and 0.90±0.57at 150 pa/cm2/s pas pressure point. Also unilateral nasal resistance in right and left in expiration were respectively 0.95±0.72 pa/cm2/s and 0.95±0.57 pa/cm2/s at 150 pas pressure point.   Conclusion: The study concluded that nasal airway resistance had the same range as the standard in different races and also no correlation exist between nasal resistance and sex, age, height, weight and smoking. Our suggestion is more epidemiologic studies if there are any queries in Iranians' airway resistance in larger sample size and wider areas.}, Keywords = {Nasal airway resistance (NAR), rhinomanometry, race.}, volume = {25}, Number = {1}, pages = {8-10}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-238-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-238-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Manenti, Ambrogio}, title = {Health situation in Iran}, abstract ={Précis This debate article highlights the challenges of health situation in Iran and some influencing or relevant factors such as health sector, welfare system and social protection, social exclusion and civil society from the viewpoint of an international partner. Some advanced experiences in Iranian health system and the manner of system for international cooperation have also been discussed.}, Keywords = {Health situation, out of pocket expenditure, welfare system and social exclusion}, volume = {25}, Number = {1}, pages = {1-7}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-245-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-245-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Jamshidi, Khodamorad and Shirazi, Mehdi Ramezan and Hoseini, Mohammad Ghorb}, title = {Chondroblastoma of the patella treated with curettage and bone graft: a case report}, abstract ={ Abstract Patella is a relative uncommon site for chondroblastoma. Most of cases of chondroblastoma in patella reported in literature are treated with patellectomy. We treated a large chondroblastic lesion in patella of an 18- year-old male with curettage, burring & bone graft and the result was satisfactory after 3 years post operation.}, Keywords = {patella, bone neoplasm, chondroblastoma}, volume = {25}, Number = {2}, pages = {106-110}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-286-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-286-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Mozaffar, Mohammad and Haghighatkhah, Hamidreza and Zirakzadeh, Hatef and SaneiTaheri, Morteza and HosseiniZadeganShirazi, Fateme}, title = {Endovascular repair of traumatic pseudoaneurysm of the descending thoracic aorta: report of three cases and review of}, abstract ={ Abstract Traumatic descending thoracic aorta pseudo aneurysms have been treated traditionally with open surgery in the past, which have had noticeable rates of mortality and morbidity. A safer method of treatment for this disease is made possible with recent progress in endovascular treatment techniques. In this article, we present three cases of Traumatic descending thoracic aorta pseudo aneurysms that were treated with Thoracic endovascular aortic repair (TEVAR) and discharged from our clinic without any complication.}, Keywords = {trauma, pseudoaneurysm, descending thoracic aorta, endovascular repair}, volume = {25}, Number = {2}, pages = {99-105}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-285-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-285-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Kadivar, Maliheh and Hooman, Nakys}, title = {Role and structure of morning report in children’s teaching hospitals in Iran}, abstract ={ Abstract Background: Morning report is an integral component of medical training programs. It is conducted as "evidence based" or "problem based". It takes an efficient time of all members of the medical team in teaching hospitals, it seems necessary to evaluate its role in the education. Because of the importance of morning report in education, we evaluated the current and ideal conditions of morning report according to the opinions of medical teams in teaching children’s hospitals. Methods: A cross- sectional descriptive study conducted in three children’s teaching hospitals in Tehran in 2005. The opinion and perception of 358 participants, including faculties, residents, fellows, interns, and medical students, were collected by a questionnaire regarding the importance and structure of morning report. The data were presented as frequency and percentage. Results: 78% of respondents expected a high educational role for morning report. Although 317(88.54%) had a regular attendance in morning report, only 34.1% were satisfied from current condition. The majority believed that faculty had better to lead the sessions, and voted for case presentation to be selected by senior resident on call, despite the prominent current leadership of the faculty. Most of the participants (88.6%) preferred complicated and unusual cases for presentation. Current morning reports predominantly based on the presentation of the interesting or complicated cases were admitted on the previous day. A few number of cases were reintroduced after achieving the final diagnosis. In addition out-patients and those under observation in emergency room were usually ignored in the meetings. Conclusion: Regarding the educational role of morning report, there is a far distance between the present and ideal condition. Unattractiveness of presentations and poor participation in discussion might have negative impact on achieving the goals.}, Keywords = {morning report, traditional method, teaching hospital, educational strategy}, volume = {25}, Number = {2}, pages = {94-98}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-284-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-284-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Mardanpour, Kaykhosro and Rahbar, Mahtab}, title = {The functional outcome of surgically treated unstable pelvic ring fractures by open reduction, internal fixation}, abstract ={ Abstract Background: Unstable Pelvic fracture, a result of high energy antero-posterior compression injury, has been managed based on internal fixation and open reduction. The mode of fixation in Unstable Pelvic fracture has, however, been a subject of controversy and some authors have proposed a need to address the issue of partial breach of the pelvic ring elements in these injuries. This study was performed to evaluate the functional and radiological results of treatment of pelvic ring fractures by open reduction, internal fixation. Methods: Thirty eight patients with unstable pelvic fractures, treated from 2002 to2008 were retrospectively reviewed. The mean age of patients’ was 37 years old (range 20 to 67). Twenty six patients were men and 12 women. The most common cause was a road traffic accident (N=37, 97%). There were 11 type-C and 27 type-B fractures according to Tile’s classification. Thirty six patients sustained additional injuries. The most prevalent additional injuries were lower extremity fractures. Open reduction, internal fixation as a definite management was applied for all patients. Quality of reduction was graded according to the grades proposed by Matta and Majeed’s score was used to assess the clinical outcome. The mean period of follow-up was 25 months (ranged from 6 to 109 months). About 81.6% of patients had either good or excellent radiological reduction. Results: The functional outcome was excellent in 66%, good in 15%, fair in 11% and poor in 7% of the patients. There were 4 postoperative infections. No sexual function problem was reported. Nerve deficits recovered completely in 2 and partially in 3 of 11 patients with preoperative neurologic deficiency. There was no significant relation between functional outcome and the site of fracture Conclusion: Unstable pelvic ring fracture injuries should be managed surgically by rigid stabilization that must be carried out as soon as the general condition of the patient permits, and even up to two weeks. }, Keywords = {unstable pelvic fractures, clinical outcome, internal fixation, open reduction}, volume = {25}, Number = {2}, pages = {87-93}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-283-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-283-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Mahmoudian, Massoud and Aboutaleb, Nahid and Beiranvand, Farahnaz and Moazzam, Ashraf-Alsadat and Shafiei, Massoumeh}, title = {Noscapine antagonizes vasoconstrictor action of bradykinin in isolated human umbilical artery}, abstract ={ Abstract Background: It has been demonstrated that noscapine, an antitussive opioid alkaloid, could antagonize bradykinin- induced responses such as bradykinin effects in guinea-pig ileum, cough induced by bradykinin receptor agonist and angiotensin converting enzyme inhibitors, and brain damage after brain edema both in neonatal rat model and in patients with stroke. In the present study, the effect of noscapine on bradykinin-induced constriction of human umbilical artery was investigated. Methods: Segments of human umbilical cords were obtained from women with normal full term pregnancies. Concentration-response curves for bradykinin (1-1000 nM) were constructed in the absence and presence of noscapine (1-1000 nM). To show the specificity of noscapine for bradykinin-induced constriction in the tissue, the effect of noscapine (10 pM) on vasoconstriction produced by histamine were also examined. Results: The results showed that noscapine could antagonize the constriction produced by bradykinin in human umbilical artery. It was also demonstrated that noscapine was capable of reducing histamine-induced contractile response. Conclusion: It is concluded that noscapine can antagonize bradykinin-induced constriction of human umbilical artery in a nonspecific manner. Thus, noscapine is likely to find a clinical application in pathologic conditions accompanied by higher vascular sensitivity to bradykinin in pregnancy.}, Keywords = {noscapine, human umbilical artery, bradykinin, histamine}, volume = {25}, Number = {2}, pages = {82-86}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-282-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-282-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Shabahang, Hossein and Panahi, Ghazal and Noferesti, Gholamhossein and Sahebghalam, Helen and Robubiat, Somaieh and Bolurian, Moloo}, title = {Illness perception of breast cancer in affected women undergoing chemotherapy}, abstract ={ Abstract Background: The aim of this study was to investigate the various aspects of illness perceptions about breast cancer in affected patients. Methods: A cross-sectional study enrolled 140 patients with breast cancer in their chemotherapy period within 14 months. The revised Illness Perception Questionnaire (revised IPQ) was used to assess the disease representations of breast cancer. The data were analyzed by SPSS v.18 software. Results: The mean age of participants was 49.3±10.3 years. There was no significant correlation among the various items of illness perception of breast cancer in the affected patients with the demographic and clinicopathologic stages of the disease (P>0.05). The present study explored breast cancer to identity component 2.1(less symptoms attributed to cancer), timeline component 2.86 (encountered to a acute illness), treatment control 3.21 (less therapeutic belief), illness coherence 3.29 (less knowledge about cancer), serious consequences 2.79 (not attributing too much grave results), personal control 3.43 (illness controllable by the personal measures) and emotional representations 2.90 (emotionally good). Also most of our patients attributed stress as the cause of breast cancer (93.6%).The internal consistency of revised IPQ was 0.84 (Cronbach alpha). Conclusion: The patients affected with breast cancer perceived their illness to be short with better personal controllability. They had optimistic views towards the personal, familial and social implications of their illness. Also our patients showed less distress, anger and disappointment while being less optimistic about the treatment modalities and less coherent about their illness.}, Keywords = {breast neoplasm/therapy, chemotherapy, illness perception, revised illness perception}, volume = {25}, Number = {2}, pages = {76-81}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-281-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-281-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Sadeghi, Roya and Scriven, Angela and Garman, Sebasti}, title = {The influence of social environment on smoking behavior among adolescents in Iran}, abstract ={ Abstract Background: Research suggests that factors in the environment are major determinants of health behavior for populations. This cross-sectional study used a combination of quantitative and qualitative data collection methods to determine the prevalence of smoking and identify the possible associations between smoking and environmental variables among school pupils in Iran. Methods: A self-reported questionnaire was administrated and collected data from 2200, students15-18 from 100 high schools who agreed to take part in the research. The sample was selected from the Iranian Education System Database using a two-stage cluster sample based on a random sample of schools and pupils as a representative sample of this population. Almost 90% of respondents had completed the questionnaires. Examination of the test-retest answers over all questions among 70 students in two weeks interval revealed reliability coefficient ranges 0.72 to 0.98. The Adjusted Enter Logistic Regression Models were applied to significant variables identified through Chi square tests. In addition, 40 of the sample took part in focus groups exploring the facilitators and barriers to smoking behavior. Content analysis was also used to extract themes from the focus group discussions. Results: The effects of social environment variables including peers', mothers', and sisters' smoking on cigarette consumption among young people were explored in this study. Levels of cigarette availability and exposure, effects of parents' attitudes and supervision, legislation on tobacco control, expanding life opportunities and more options for leisure activities perceived as influencing factors on adolescent smoking were all highlighted in the focus group discussions. Conclusion: The qualitative and quantitative findings revealed the impact of social environment on smoking behavior among young people. This study provides strong evidence to support environmentally oriented smoking prevention programs targeting young people.}, Keywords = {adolescents, cigarette smoking, social environment}, volume = {25}, Number = {2}, pages = {66-75}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-280-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-280-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Shakiba, Shima and Mohamadkhani, Parvaneh and Poorshahbaz, Abbas and Moshtaghbidokhti, Nahale}, title = {The efficacy of Brief Object Relations Psychotherapy on major depressive disorder comorbid with cluster C personality}, abstract ={Abstract Background: Personality disorders have essential roles in developing and maintaining depressive episodes, though psychotherapies must approach both symptoms and personality problems. This study examined the efficacy of Brief Object Relations Psychotherapy on depression severity and perceived quality of life of women suffer from major depressive disorder comorbid with cluster C personality disorders. Methods: by purposive sampling method, 6 subjects which met the in/exclusion criteria, were participated in a single subject design study randomly. Interventions were arranged based on A/B with follow up design. Each subject completed Beck Depression Inventory (BDI-II) and original McGill Quality of Life Questionnaire (MQOL) every session during 3 baseline, 15 treatment and 3 follow up assessments sessions. Results: Patients totally reached 55% remission in depression severity with mean effect size 1.92 and 43% remission in perceived quality of life with mean effect size 2.08. Gains were maintained in follow up. Conclusion: The efficacy of Brief Object Relations Psychotherapy was statistically and clinically significant. Perceived quality of life reached to normal range, whereas cluster C personality disorders resistance remission from depression.}, Keywords = {object relations, depression, quality of life}, volume = {25}, Number = {2}, pages = {57-65}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-279-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-279-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Hamilton, Joh}, title = {The renewal of medical education in Iran: progress and challenge}, abstract ={}, Keywords = {}, volume = {25}, Number = {2}, pages = {53-56}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-278-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-278-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Moosavy, Seyed Hamid and Andrabi, Yasir and Esmaeeli, Sepehr and Amini, Abdolrahim}, title = {Small bowel obstruction by a terminal ileum carcinoid tumor: a case report}, abstract ={Abstract Carcinoid tumors are well differentiated neuroendocrine tumors with secretory components. These tumors are uncommon but the most common primary tumors of the distal small intestine. We present a rare terminal ileum carcinoid tumor presenting with a small bowel obstruction. A 65 years old man presented with intermittent, gen-eralized, dull and colicky abdominal pain accompanied with intermittent nausea, fever and chills for 1 year and post prandial generalized colicky abdominal pain from 5 days prior to admission. He also complained of weight loss and frequent constipations during recent year. His abdomen was soft with mild tenderness in periumbilical, right lower quadrant and left lower quadrant without guarding, rebound tenderness and palpable mass. Laborato-ry findings indicated anemia, and barium enema showed right lower quadrant mass effect in small intestine. Narrowing of terminal ileum was noted in colonoscopy. Free fluid in lower abdomen and pelvis with 37*28*25 paravertebral hypoechoic pelvic mass, without peristalsis was seen in abdomen and pelvic sonography. After mass localization in abdominal CT scan, laparotomy and excisional biopsy was performed. The diagnosis of carcinoid tumor was confirmed by pathologic report. Carcinoid tumors are rare tumors of the Gastro intestinal tract, however, they are the most common primary tumors of the small intestines. Most of these tumors have a very indolent course and may present with non specific symptoms. In view of the poor prognosis associated with the late diagnosis, it is imperative to think of this differential diagnosis in patients presenting with non specific symptoms and in intermittent partial bowel obstruction.}, Keywords = {carcinoid tumors, small bowel obstruction, terminal ileum}, volume = {25}, Number = {3}, pages = {165-169}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-396-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-396-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Jafari, Davod and Liaghat, Omi}, title = {Shoulder duplication in constriction band syndrome: a case report}, abstract ={ Abstract A 2.5 year old girl is presented with both hands constriction bands leading to distal amputations and the rare deformity of shoulder duplication in the right side accompanying constriction skin marking over the affected shoulder. The cephalomedial scapula articulated with the clavicle and the caudolateral scapula articulated with humeral head. The most important physical finding which could explain the pathophysiology of this rare anomaly, was constriction band marking over the right shoulder. Shoulder range of motion was limited but still functional and no surgical intervention was required for the scapular duplication.}, Keywords = {Shoulder duplication, constriction band syndrome.}, volume = {25}, Number = {3}, pages = {162-164}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-405-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-405-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Al-Rajhi, Maryam and Narayanan, Sahasranamaiyer}, title = {Unusual presentation of the Conn\'s syndrome: a case report}, abstract ={ Abstract A 26 -year- old woman presented with rhabdomyolysis secondary to severe hypokalemia. Hypertension and metabolic alkalosis could lead to the suspicion of primary aldosteronism, which was confirmed by a decreased plasma rennin, elevated plasma aldosterone levels and high aldosterone/rennin ratio additionally. Additionally adrenal computed tomography showed an adrenal tumour. Blood pressure and hypokalemia returned to the normal level after adrenalectomy was performed. This case report highlights the need to be alert to the possibility of primary aldosteronism incidence in a patient presenting with rhabdomyolysis and hypertension caused by severe hypokalemia.}, Keywords = {Conn\'s syndrome, hypokalemia, rhabdomyolysis}, volume = {25}, Number = {3}, pages = {158-161}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-402-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-402-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Farhadi, Mohammad and Ghanbari, Hadi and Izadi, Farzad and Eikani, Maxine S. and Kamrava, Seyed Kamar}, title = {Effectiveness of adenoidectomy on tympanostomy tubes retention duration}, abstract ={ Abstract Background: The children with middle ear effusion need repeated re-tympanostomies. Adenoidectomy is an effective surgical intervention in the management of chronic otitis media with effusion in conjunction with in-sertion of tympanostomy tubes (TTs). To find out whether TTs in different positions decrease the rate of re-tympanostomies study was done. Methods: The present study retrospectively evaluated the effectiveness of adenoidectomy on retention of Shepard TTs in antero-inferior quadrant (AIQ) and postero-inferior quadrant (PIQ) with chronic, persistent or recurrent otitis media. Eighty-five children (one-hundred and seventy ears) underwent bilateral myringotomy and TTs placement with and without adenoidectomy with informed consent. Results: According to the TTs retention duration rate, there was a significant difference between adenoidec-tomy and non-adenoidectomy groups in AIQ. Conclusion: It was concluded that TTs placement in the AIQ in conjunction with adenoidectomy showed better improvement and prolonged ventilation. This study suggests that adenoidectomy is an effective surgical intervention in the management of otitis media especially when it is performed in conjunction with insertion of TTs. This significantly decreases tube extrusion rate especially in an AIQ, which might be due to improving eustachian tube function that consequently reduces repeated otitis media.}, Keywords = {chronic secretory otitis media, adenoidectomy, tympanostomy tube}, volume = {25}, Number = {3}, pages = {153-157}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-398-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-398-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Yeganeh, Ali and Abdollahi, Mahsa and NakhaeiAmroodi, Morteza and Farahini, Hosei}, title = {Comparison of the efficacy of local corticosteroid injection and physical therapy on pain severity, joint range of motion and muscle strength in patients with shoulder impingement syndrome referred to Rasool-e-Akram Medical Center from April 2008 to September 2009}, abstract ={ Abstract Backgrounds: Subacromial impingement is a common cause of shoulder pain and many patients with this condition recover with conservative management. The most commonly used modalities of nonoperative treatment include activity modification, anti-inflammatory medication and subacromial injection of steroid and ultrasound and physical therapy programs. This study assessed the value of physiotherapy versus subacromial corticosteroid injection in patients with shoulder impingement syndrome (SIS). Methods: Seventy three patients with SIS enrolled in the study and treated through physiotherapy (n=37) and subacromial corticosteroid injection (n=36). Two follow-up sessions accomplished at the end of 4th week and 3rd month of treatment respectively. Results: Corticosteroid injection caused dramatic improvement in the painful state (p<0.0001) and sleep dysfunction score (p=0.039) in the first follow-up. However, physiotherapy showed significantly better results regarding patients’ pain score (p=0.016) and their shoulder join range of motions (p=0.017 and p=0.029 for the abduction and extension, respectively) in their second follow-up. Conclusion: Our study results showed that subacromial corticosteroid injection primarily resulted in more improvement in the impingement symptoms. However, with the long-term follow-up the results were better for the physiotherapy. These results suggest that patients should not undergo surgery before having conservative treatment.}, Keywords = {shoulder impingement syndrome (SIS), physiotherapy, subacromial corticosteroid injection, randomized clinical trial (RCT)}, volume = {25}, Number = {3}, pages = {142-152}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-404-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-404-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Nasiri, Shirzad and Sorush, Ahmadreza and Hedayat, Anushiravan and Donboli, Kianush and sodagari, Nassim and Mosafa, Sar}, title = {Adenoma weight and biochemical parameters in primary hyperparathyroidism}, abstract ={ Abstract Background: Primary hyperparathyroidism is autonomous production of parathyroid hormone. After removal of adenoma, one of the surgeons concern is postoperative hypocalcaemia. There is no precise method to determine if patients have hypocalcaemia postoperatively. The purpose of this study was to determine the relation between parathyroid adenoma weights, postoperative serum calcium and serum biochemical parameters in patients with primary hyperparathyroidism. Methods: In a prospective study, eighty patients with single parathyroid adenoma were enrolled. Preoperative serum levels of calcium, phosphate, PTH, as well as Postoperative serum calcium and weight of adenomas were recorded. The level of significance was set to be p < 0.05. Results: There was no significant correlation between postoperative serum calcium, parathyroid adenoma weight (r= -0.17, p= 0.1), and parathyroid hormone level (r = -0.11, p = 0.3). However, a weak correlation between postoperative and preoperative serum calcium levels (r = 0.23, p = 0.03) was observed. Moreover, Serum calcium decline after adenoma resection was statistically correlated with adenoma weight (r = 0.36, p= 0.001), preoperative serum calcium (r = 0.92, p= 0.0007), PTH (r= 0.54, p= 0.0005) and ALP levels (r = 0.3, p= 0.006). Conclusion: Although preoperative serum markers and adenoma weight are unreliable in predicting postoperative serum calcium level, it is possible to estimate postoperative calcium decline by considering adenoma weight and preoperative serum biochemical parameters. }, Keywords = {primary hyperparathyroidism, adenoma weight, biochemical markers.}, volume = {25}, Number = {3}, pages = {136-141}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-403-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-403-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Borghei, Afsaneh and Qorbani, Mostafa and Borghei, Narjes Sadat and Kazeminejad, Vahideh and Seifi, Fatemeh}, title = {Effects of IUD on iron status in IUD users in Gorgan, Iran}, abstract ={ Abstract Background: CuT380A intra uterine device Intra Uterine Device (IUD) is used in the health system of Iran. The most important and frequent side effects of the IUDs are hypermenorrhea and polymenorrhea. In Iran, iron supplement are not prescribed for the IUD users and there are no documents indicating their iron reservation status. This study was performed to determine the iron status in Gorganian IUD users. Methods: This historical cohort study was performed on 100 IUD users (exposed group) and 100 non-IUD users (non-exposed group) in the Golestan province in north east of Iran in 2008. To evaluate the iron status hemoglobin and ferritin levels were measured. Data was analyzed by SPSS 13 by using Chi square and Independent T-test. A p-value less than 0.05 were considered as statistically significant. Results: Hgb less than 10.5 was seen in 5% and 6% of IUD users and non-IUD users respectively which was not statistically significant (OR: 1.43, 95% CI: 0.39-5.25). Low Ferretin Level (less than 15) was seen in 53% of IUD users and in 35% of non-IUD users which was statistically significant (OR: 2.35, 95% CI: 1.28-4.29) Duration of menstrual period in the two groups was statistically significant (7.5±2.4 vs. 6.4±1.8, p= 0.005) but interval of menstruation (days) was not statistically significant (26.7±4.7 vs. 28±11.2, p> 0.05). Conclusion: On the basis of the results obtained we suggest either routine iron supplementation following application of IUD, or use of the hormone releasing IUD as an alternative for copper IUDs.}, Keywords = {IUD, Anemia, Iron Deficiency}, volume = {25}, Number = {3}, pages = {131-135}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-401-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-401-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Jafari, Davod and Shariatzadeh, Hooman and NajdMazhar, Farid and Ghahremani, Mohammad Hossein and Jalili, Alirez}, title = {Enchondroma of the hand: the role of biopsy in the course of diagnosis and treatment}, abstract ={ Abstract Background: Enchondroma, is the most frequent bone tumor of the hand , but chondrosarcoma is rare at this location .There is a high possibility of correct diagnosis of enchondroma and differentiating from its malignant counterpart by precise clinical and radiologic assessment without biopsy, a subject of debate in the literature . At the present study we substantially investigate this problem, in our patients. Methods: Case records, radiographs, and histology of 52 solitary enchondroma patients who underwent operation in our hospital between 1998 and 2010, were reviewed. Special attention paid to pre and post –op diagnoses, and compared with each other. Results: Eighty-six percent of our patients were between the second to fourth decades of life, with a slight female predominance. In all, the primary diagnosis of enchondroma according to clinical presentation and radiographic appearance, supported by intraoperative gross appearance of tumor, and confirmed histologically by permanent section analysis. There was no mismatch between radiologic and histologic diagnosis. Conclusion: we concluded that correct diagnosis of enchondroma is almost always possible by precise clinical and radiographic assessment with no need for histologic confirmation before definitive treatment.}, Keywords = {enchondroma, hand, biopsy, treatment.}, volume = {25}, Number = {3}, pages = {127-130}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-406-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-406-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Azar, Maziar and KazemiGazik, Farid and Nikoobakht, Mahdi and Yousefi, Mohamad-Reza and Ghavami, Yaser}, title = {Long term effects of Gamma knife Radiosurgery for treatment of cerebral arteriovenous malformations}, abstract ={ Abstract Background: The Gamma Knife Radiosurgery (GKR) is an established management option for Cerebral Ar-teriovenous Malformations (AVMS). Therapeutic benefits of radiosurgery for arteriovenous malformations are complete obliteration of nidus with minimal neurological deficit. Methods: Radiosurgery was performed between February 2003 and April 2010 at Kamraniye day clinic, Teh-ran, Iran, using the Leksell gamma knife model B (Elektra Instruments AB, Stockholm, Sweden) on 82 consecu-tive patients with AVMs. The male-to-female ratio was 1.4:1(48M, 34F). The age of the patients ranged from 9 to 70 years (mean, 28.5±12 years). The marginal dose to the AVM nidus was 45 to 85% (median, 60%) isodose and ranged from 14 to 30 Gy (mean, 20.57±13Gy).The maximum dose ranged between 20 to 60 Gy (mean, 37.5 Gy ± 10.17Gy ). Follow up of patients for complete AVM obliteration and in the case of complications MRI were performed. Results: Complete obliteration of AVM was achieved in 56 cases (68.29%). It was marked in average 3.62 [SD=3.19] years (from 1 to 5 years) after GKR. Partial obliteration (≥50% reduction of the nidus volume) was marked in 24 cases(31%), and less than 50% reduction of the nidus volume was marked in 2 cases(2.4%) with a follow-up of 5 years. Complete obliteration of AVM had statistically significant associations with smaller score of Spetzler-Martin arteriovenous malformation grading system for AVMs. (p< 0.05) Conclusion: The Gamma Knife Radiosurgery can offer total and partial obliteration to acceptable percent of treated AVM with a low risk of morbidity. Higher success observed in patients with Spetzler-Martin Grade I and II AVMs, which was attributed to smaller volume of AVMs in this group. }, Keywords = {Gamma Knife Radiosurgery (GKR), Arteriovenous malformations, Obliteration rate}, volume = {25}, Number = {3}, pages = {119-126}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-397-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-397-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Rastegar, Seyed Khodakaram and Azar, Maziar and Ahmadi, Sayed Ali}, title = {A single posterior approach for vertebral column resection in adults with severe rigid kyphosis}, abstract ={ Abstract Background: Correction of severe kyphosis is a challenging operation in spinal surgery. A two stage operation has been commonly used: anterior release and decompression followed by posterior correction and fusion. We describe the posterior vertebral osteotomy technique for correction of severe and rigid kyphosis through posterior-only approach. Methods: Twelve patients (six male and six female ) with severe and rigid kyphotic deformity of the thoracic spine were treated by posterior vertebral column resection using a single posterior approach. The apex level of kyphosis was at the upper thoracic in five patients, the lower thoracic in four patients and mid thoracic in three patients. There was old fracture in one patient, congenital deformity in six, tumor in three and neurofibromatosis in two patients. After posterior vertebral column resection, segmental posterior instrumentation was used for  correction of the kyphotic deformity. Complications and radiographic findings were analyzed to evaluate clinical outcomes and radiologic changes of posterior vertebral column resection in patients with angulated kyphotic deformity. Results: The major curve correction was averaged 31.66 ° (SD=15.69) (45%). The resection was performed at the involve level in every patient. Posterior segmental fusion was achieved in average 8.9 (SD=1.7) segments. Anterior reconstruction was with titanium mesh cage in two and with cancellous chip packing in other patients. There were no neurologic complications after six month. Bony fusion achieved in all patients, and there was no correction loss. Conclusion: Satisfactory correction is safely performed by posterior vertebral column resection with a direct visualization of the circumferentially decompressed spinal cord. Although the performance is technically laborious, it offers good correction without jeopardizing the integrity of the spinal cord.}, Keywords = {kyphosis, posterior vertebral column resection, single posterior approach}, volume = {25}, Number = {3}, pages = {111-118}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-400-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-400-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Mosleh, Afsaneh and KhoshnevisAnsari, Shiva and Sorush, Maryam and Eghbalpor, Ali and Babaeian, Seifolah}, title = {Evaluation of the drug prescription status based on the WHO indices in pharmacies of health care centers affiliated to Tehran University of Medical Sciences}, abstract ={ Background: As a major responsibility, health authorities must control rational prescription of drugs (RUD). A way to analyze the regional status of drug prescription is the WHO’s recommended indices. The purpose of the study was to determine the status of drug prescriptions in pharmacies of healthcare centers under the authority of Tehran University of Medical Sciences based on the WHO indices. Methods: In this study, 28 pharmacies of health care centers under the supervision of Tehran University of Medical Sciences were selected and 3420 drug prescriptions were examined. Results: the study revealed that the average number of drug per prescription was 3.03 (SD=0.72). 56.49% of prescriptions contained at least one antibiotic. Moreover, at least one injectable drug was prescribed in 28.96% of prescriptions. Conclusion: Health authorities must play pivotal role in improving rational use of drugs. General practitioners are the major chain in RUD cycle. Results showed that we need to design some educational programs such as holding workshops on the RUD for physicians, public education and also producing related printed materials and advertising in the Media. These programs may improve the status based on the WHO indices which for example refers to the percentage of prescription of antibiotics & injections in the region.}, Keywords = {WHO drug prescription indices, Antibiotic prescription, Injectable drugs, Regional prescription, Health center pharmacy.}, volume = {25}, Number = {4}, pages = {222-225}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-472-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-472-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {KazemiNezhad, Seyed Reza and Mosavi, Fatemeh and Momen, Ali Akbar and Galehdari, Hamid and Mohamadian, Gholamrez}, title = {SMN1 and NAIP genes deletions in different types of spinal muscular atrophy in Khuzestan province, Iran}, abstract ={ Background: Spinal muscular atrophy (SMA) is the second most common lethal autosomal recessive disease. It is a neuromuscular disorder caused by degenerative of lower motor neurons and occasionally bulbar neurons leading to progressive limb paralysis and muscular atrophy. The SMN1 gene is recognized as a SMA causing gene while NAIP has been characterized as a modifying factor for the clinical severity and age at disease onset in SMA patients (SMA subtypes). The relationship between NAIP deletion and type of SMA remains to be clarified we investigated this gene alteration in all types of SMA patients. Methods: Molecular analysis was performed on fifty patients with a clinical diagnosis of SMA in Khuzestan province. In addition to common PCR-RFLP analysis for exon 7 and 8 of SMN1 gene, as an internal control we analysed NAIP deletion with PCR of exon 5 of this gene in a multiplex PCR with exon 13 of it. Results: Homozygous-deletion frequency rate for the telomeric copy of SMN (SMN1) exon 7 in all types (type I, II, Ш) of SMA was approximately 90% and the frequency of deletion in exon 7 and 8 together in all types estimated about 70%. Moreover NAIP gene was deleted in about 60% of these patients and this shows deletion in 91% of type I SMA patients. The correlation between NAIP-deletion and SMN1 mutation showed a high frequency rate. Conclusion: In this study, high frequency of NAIP gene deletion in all type of disease shows the importance role of it in disease pathogenesis. High frequency of NAIP deletion in SMA type I, also shows the importance of the gene in type and severity of disease so it may be a modifier factor in severity of disease.}, Keywords = {Spinal Muscular Atrophy (SMA), Survival Motor Neuron (SMN) gene, Neuronal Apoptosis Inhibitory Protein (NAIP) gene.}, volume = {25}, Number = {4}, pages = {216-221}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-471-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-471-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Omidi-Kashani, Farzad and Hasankhani, Ebrahim G. and Ebrahimzadeh, Mohamed H.}, title = {Anterior spinal surgery alone in the surgical treatment of thoracolumbar spinal tuberculosis: a prospective study}, abstract ={ Background: One of the important sites for extrapulmonary TB involvement is the skeleton. Tuberculous spondylitis (Pott’s disease) comprises 50-70% of the skeletal tuberculosis. Methods: In this case series study, we prospectively investigated the result of anterior surgery alone (anterior debridement, fusion and instrumentation) in the patients with spinal tuberculosis. The patients with immature skeleton, long segment disease or kyphosis more than 50° were excluded. All the cases were followed for at least 2 years (mean 31.4+/-6.4 months). Results: This study comprised of 23 (13 male and 10 female) cases with a mean age of 35.8 (SD=7.8) years old. Segmental kyphosis was corrected from +11.9° (SD=13.8°) preoperatively to -3.8° (SD=8.9°) after surgery that was mainly maintained at the last follow up visit. Bony :::union::: was achieved in all cases but one. Conclusions: Our results showed that in selected cases of tuberculous spondylitis, anterior surgery alone could be encouraging.}, Keywords = {Tuberculosis, Spine, Instrumentation, Fusion.}, volume = {25}, Number = {4}, pages = {209-215}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-469-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-469-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Jafari, Davod and Taheri, Hamid and Shariatzade, Hooman and NajdMazhar, Farid and Jalili, Alireza and Ghahramani, Moham}, title = {Relationship between radiographic carpal indices and grip strength}, abstract ={ Abstract Background: The measurement of hand grip strength has several clinical applications to evaluate chronic hand disability, response to treatment, and work capacity after hand injury. Methods: We measured hand grip strength of 41 adults and compared their maximum strength with radiographic indices. Results: There was a significant relationship between hand grip strength and carpal height, third metacarpal and capitate length (All p-values<0.05). Conclusions: In addition to established factors such as sex, upper limb muscle and joint status, wrist radiographic indices are significantly determinants of hand power grip.}, Keywords = {Wrist radiography, Hand grip strength, Wrist measurement.}, volume = {25}, Number = {4}, pages = {205-208}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-468-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-468-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Atefi, Najmosadat and Rahimi, Mahboobeh and Peyghambari, Shadi and Ghourchian, Shadi}, title = {Psychological status in patients with chronic urticaria}, abstract ={ Abstract Background: Chronic urticaria (CU) is a common dermatological disease that induces a substantial burden on individuals’ life. Also if one’s self-image changes (which usually happen in patients with dermatological diseases), it leads to anxiety or other various symptoms. We aimed to compare the psychological scales in patients with CU with non-dermatological individuals with the purpose of early diagnosis and appropriate psychiatric consult. Methods: In this study, psychological status of 30 patients with the diagnosis of chronic urticaria (lasting for more than 6 weeks) and 30 controls, chosen among the hospital staff were evaluated. Evaluation was carried out by using standard General Health Questionnaire (GHQ-28). Psychosomatic disorders, anxiety, depression and social functions were assessed. Data were analyzed by SPSS version 16, and the frequency indices and Chi- Square test. Results: Although from 30 patients with CU, 63.3% suffered from psychological disorders, this prevalence was estimated 46.6% in the control group. Altogether, psychological disorders in patients with CU were significantly (p=0.007) more prevalent than individuals without dermatological problems. Anxiety was the most common reported disorder. Conclusion: In our study, the most prevalent psychiatric disorders included anxiety, psychosomatic disorders, social dysfunction and depression, sequentially. It seems that depression is the least significant psychiatric disorder among patients who suffer from urticaria. Also, anxiety was the most reported disorder among them, which may be considered as the primary cause of the disease or it may be secondary to the disease process. This theory clarifies the importance of dermatologists and psychiatrists cooperation.}, Keywords = {Chronic Urticaria, Psychological problems, Dermatology.}, volume = {25}, Number = {4}, pages = {200-204}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-461-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-461-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Onyiriuka, Alphonsus N.}, title = {Pediatric discharge against medical advice: experience from a Nigerian secondary healthcare institution}, abstract ={ Abstract Background and Objective: Often, discharge of children against medical advice has a negative effect on the well-being of the patient. To determine the prevalence of discharge against medical advice (DAMA) among hospitalized children and examine the reasons given by parents/guardians for such discharges. Methods: A retrospective 2-year medical records audit of children aged one day to 15 years discharged against medical advice was carried out in a pediatric unit of a secondary health-care facility. Results: The overall prevalence of DAMA was 6.3% while the prevalence among neonates was 7.5%, p>0.05. Sixty-two (56.4%) of all cases were less than 12 months old with neonates accounting for 40 (64.5%) of the 62. The prevalence of DAMA was 2.8 times higher in male neonates compared to female neonates. Thirty two (9.9%) of 322 male neonates compared to 8 (3.7%) of female neonates were DAMA Odd ratio, OR=2.8 95% Confidence Interval, CI= 1.26, 6.20). Majority (65.4%) of the signatories to the discharge documents were the child’s fathers. In only 5.5% of cases were the child’s mothers the signatories. Rate of re-admission was 13.6%. The commonest reason for DAMA in both neonates and older children was financial constraints. Parental disagreement with planned treatment and/or investigations ranked second in the case of neonates. Conclusions: DAMA is a common social pediatric health problem, especially among infants and has multifactorial etiology. Socioeconomic factors, parental misjudgment of improvement and disagreement with treatment plan were found to have a significant bearing to its occurrence.}, Keywords = {Children, Discharge against medical advice (DAMA), Hospital fees.}, volume = {25}, Number = {4}, pages = {194-199}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-457-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-457-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {Moosavy, Seyed Hamid and Froutan, Hussein and Andrabi, Yasir and Toosi, Mohsen N and Ghofrani, Hadi and Vahedi, Hamid and Keyvani, Hossei}, title = {Frequency of YMDD mutations in patients with chronic hepatitis B untreated with antiviral medicines}, abstract ={ Abstract Background: Investigators were suspicious of tyrosine-methionine-aspartate-aspartate (YMDD) mutations occurred only in patients who were treated by lamivudine. However, YMDD mutations of hepatitis B virus gene (HBV DNA) in patients with chronic hepatitis B (CHB) untreated with antiviral medicines was reported in some studies. The aim of this study was to evaluate YMDD mutations in Iranian Patients with chronic hepatitis B (CHB) untreated with antiviral medicines. Methods: In a cross sectional study, 151 adult patients with positive Hepatitis B surface antigen (HBsAg) (78 asymptomatic hepatitis B virus carriers, 73 active chronic hepatitis B patients or cirrhosis patients) were evaluated for YMDD mutants. The patients who were treated with interferon and Lamivudine or Adfovier in one year prior to the study were excluded. YMDD mutations of HBV DNA were detected by PCR-RFLP (PCR Restriction Fragment Length Polymorphism) in a single laboratory. Results: The mean (±SD) age of patients was 37±4 years. Eighty one (54%) cases were male and 70 (46%) were female. Eight cases (5.3%) out of 151 had YMDD mutations. The type of mutation in all of these patients was YSDD. There was no significant relationship between YMDD mutation and viral load and HDV Ab (p>0.05). Conclusions: The mutant strains of the YMDD motif of HBV polymerase can be found in some patients without lamivudine treatment. However, in view of rather clinically insignificant YMDD mutation frequency, routine testing for YMDD mutations prior to antiviral therapy is not recommended in these patients.}, Keywords = {Hepatitis B virus, YMDD mutation, Lamivudine.}, volume = {25}, Number = {4}, pages = {186-193}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-456-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-456-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {KhosraviSamani, Mahmood and PoorsattarBejehMir, Arash and Mohammadnejad, Gholamali and Sajadi, Behrooz and Fereshtehnejad, Seyed-Mohamm}, title = {The potential of honey to promote wound healing in periodontology: a pilot randomized clinical trial}, abstract ={ Abstract Background & Objectives: Honey has been used as a nutraceutical in many traditional and ancient remedies. Considering well documented benefits of honey to accelerate wound healing, for the first time we aimed to assess intra oral surgical wound healing process with honey. Methods: We designed a pilot randomized placebo controlled cross-over clinical trial. Patients who required bilateral Modified Widman Flap (MWF) surgery randomly assigned to receive either 15 cc topical Persian Thymus Vulgaris concentrated honey three times a day or normal saline as placebo with the same amount at the site of the surgery for seven consecutive days. After a 35-day wash-out period the study groups were crossed. The primary efficacy outcome was changes in healing index (Landry index) and the secondary efficacy outcome were changes in gingival and plaque indices (Loe & Sillness, Sillness & Loe indices). It also includes safety issues consisting of any allergic reaction, delayed healing or wound dehiscence. Results: Ten patients enrolled with the mean age of 36 (±1.5) ranged between 35-40 yrs. There was a significant improvement in wound healing considering time and treatment effects in both groups, although faster wound healing observed in honey treated patients (P<0.001). In both groups gingival indices were noticed to be improved by the time during the first phase of the study. Both groups displayed aggravated Plaque formation nevertheless it was merely statistically significant in the control group [F (3, 27) =12.88, P value < 0.001]. All wounds healed normally and no adverse events recorded. Conclusion: Our study established the safety, efficacy and feasibility of topical honey to promote periodontal surgical wound healing. (IRCT138901192547N2)}, Keywords = {Dental plaque, Gingivitis, Honey, Periodontal surgery, Wound healing.}, volume = {25}, Number = {4}, pages = {177-185}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-455-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-455-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} } @article{ author = {FaridiTazeh-kand, Nasrin and Moini, Ashraf and Eslami, Bita and Khajehdehi, Anooshe}, title = {Continous infusion of Remifentanil plus Ketamine compared with continous Remifentanil for pain relief in labour}, abstract ={ Abstract Background and objective: Pain relief during labour is an important determinant of a women’s birth experience. There are numerous pain relief techniques which can be used either with or without pain medication. The aim of our study was to compare the effect of remifentanil alone and its effect in pain relief while using with ketamine during labour. Methods: After obtaining informed consent and approval of hospital ethics committee, 40 women with gestational age between 38 and 42 weeks gestation in early labour were recruited for this study. They were randomly allocated into two groups: group RK (20 cases) received 25 μg remifentanil as a starting dose and continuous infusion of 0.06 μg/kg/min remifentanil plus 0.5 mg/kg/h ketamine for 4 hours via pump and group R (20 cases) received 25 μg remifentanil as a starting dose and continous infusion of 0.06 μg/kg/min remifentanil. Results: The baseline of pain scores were similar in both groups (5.75 ± 2.51 vs 7 ± 2.45, p= 0.12) but after 30 minutes to 120 minutes the VAS scores were significantly higher in R group (p< 0.001). The rate of patients who were satisfied (excellent and very good) in RK was 80% but in R group was 45% (p = 0.03). Nausea and vomiting were significantly higher in R group (p<0.05). Conclusion: The remifentanil plus ketamine produced better pain relief during labour with continous monitoring than continous remifentanil with no adverse effects for mothers and infants.}, Keywords = {Remifentanil, Ketamine, Analgesics opioid, Obstetric.}, volume = {25}, Number = {4}, pages = {171-176}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-454-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-454-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2011} }