2024-03-29T01:04:27+04:30 http://mjiri.iums.ac.ir/browse.php?mag_id=18&slc_lang=en&sid=1
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Medical Journal of The Islamic Republic of Iran (MJIRI) Med J Islam Repub Iran 1016-1430 2251-6840 10.18869/mjiri 2008 21 4 Gastric Schwannoma: a case report H. Froutan Froutan@ams.ac.ir A. Shafaghi M. Hashemi S. Shariat-Torbaghan  Abstract Gastrointestinal mesenchymal tumors are a group of tumors originating from the mesenchymal stem cells of the GI tract. Digestive tract Schwannomas are rare mesenchymal tumors which occur most frequently in the stomach. We report a 56-yearold woman who was examined endoscopically for dyspepsia which she had suffered from since 3 years ago. Around gastric antral mass was seen. Surgical resection was recommended. The pathological examination revealed a spindle cell tumor that was strongly positive for S-100 protein stain and non-reactive for other markers. The literature is reviewed.  Schwannoma GIST mesenchymal tumor spindle cell tumor 2008 2 01 227 230 http://mjiri.iums.ac.ir/article-1-344-en.pdf
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Medical Journal of The Islamic Republic of Iran (MJIRI) Med J Islam Repub Iran 1016-1430 2251-6840 10.18869/mjiri 2008 21 4 The interobserver and intraobserver reliability of the Fernandez classification of distal radius fracture Dawood Jafari Hamid Taheri Hooman Shariatzadeh Farid Najd Mazhar najdmazhar@yahoo.ca Marzieh Nojomi  Abstract Background: With increasing knowledge concerning fractures of the distal radius, different classifications have been proposed. Reliability of most of these classifications has been assessed. The Fernandez classification has never been assessed for intraobserver and interobserver reliability, although this classification is commonly used. Methods: Five observers including one attending orthopaedic hand surgeon, one hand surgery fellow, two attending orthopaedic surgeons and one senior resident of orthopaedic surgery classified 42 standard anteroposterior and lateral radiographs of prereduction distal radius fractures. Four weeks later the radiographs were renumbered differently and reviewed and classified by the same observers. Reliability of classification was assessed by Kappa value. Results: The mean intraobserver Kappa value was 0.64 (0.53-0.73), indicating good or substantial reliability, while the mean interobserver reliability was 0.45(0.30- 0.71) representing moderate reliability. Conclusion: In contrast to previous classifications of distal radius fracture, which their intraobserver and interobserver reliabilities were poor or moderate in most studies, the Fernandez classification has good intraobserver reliability and moderate interobserver reliability, so it can be used by orthopaedic surgeons with more confidence. distal radius fracture Fernandez classification reliability 2008 2 01 223 226 http://mjiri.iums.ac.ir/article-1-343-en.pdf
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Medical Journal of The Islamic Republic of Iran (MJIRI) Med J Islam Repub Iran 1016-1430 2251-6840 10.18869/mjiri 2008 21 4 Base deficit in the immediate postoperative period of open-heart surgery and patient outcome F. Sabzi H. Teimouri hassan_teimouri@yahoo.com  Abstarct Background: Base deficit is a non-respiratory indicator of acid base status that evaluates the severity of shock at the cellular level. Base deficit results from cellular metabolism of pyruvate under anaerobic conditions. In this situation, base deficit is a sensitive marker of the magnitude of anaerobic metabolism and tissue oxygen deficit [1]. Several studies have shown a strong positive correlation between base deficit and the risk of morbidity and mortality in clinical situations such as circulatory shock, extracorporeal support and in children after operation for complex congenital heart disease. Methods: 136 consecutive cases with coronary artery disease and valvular heart disease were scheduled in the study. 20 variables were determined during the preoperative, intraoperative and postoperative periods. Statistical univariate analysis was performed differentiating patients whose initial base deficit after weaning from cardiopulmonary bypass was -8 meq and these whose base deficit was equal or more than -8 meq. Results: 39 patients had base deficit levels less than -8 (Group A) and 91 had a level of > -8 meq/L (Group B). Patients with a base deficit level of -8 meq/L or more were older and most of them were women. The prevalence of left ventricular ejection fraction less than 30% and coronary artery disease was not significantly higher in patients with base deficit of > -8 meq/L . No difference was found according to the presence of hypertension or diabetes in patients with base deficit levels of –8 or higher than in those with base deficit levels less than –8 (P >0.05). In the univariate analysis of preoperative variables, there were no differences with respect to factors such as age, sex, diabetes, preoperative hemoglobin level, hypertension, emergency operation and redo operation. Congestive heart failure was different between the two groups (P < 0.05). Three variables had a statistically significant difference in the univariate analysis and two of them were highlighted by the linear logistic model. Conclusion: The value of base deficit which was measured during the immediate postoperative open-heart surgery period is correlated with the volume of fresh frozen plasma and blood transfusion after open heart surgery and using of intra-aortic balloon pump after surgery. cardiac surgery outcome base deficit 2008 2 01 215 222 http://mjiri.iums.ac.ir/article-1-342-en.pdf
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Medical Journal of The Islamic Republic of Iran (MJIRI) Med J Islam Repub Iran 1016-1430 2251-6840 10.18869/mjiri 2008 21 4 Identification of yeast species in the oral cavity of Iranian soldiers by disk diffusion method M. Ghahri Ghahri14@yahoo.com M. Imami Gh. Babaee  Abstract Background: The disk diffusion method for identification of yeasts species was performed based on different but distinct susceptibilities of yeasts spp. to chemicals: janus green, ethidium bromide, 2,3,5-triphenyltetrazolium chloride, brilliant green, cycloheximide and rhodamine 6G. Methods: Atotal of 568 Iranian soldiers went under study for isolation and identification of Yeast species from their oral cavity. Asterile swab was used for each individual and specimens were collected from the nasopharynx region, then inoculated to petri dishes containing Sabouraud Dextrose Agar and incubated for 48 hrs at 37 °C. All colonies were counted and stocked in distilled water and stored in a refrigerator for further analysis. The yeasts were identified by the “disk diffusion test” [6,8]. This is a simple, rapid, accurate, and inexpensive technique presented by Sobczak [8]. By this method we identified yeast species within 24-48 hrs. Results: 51.4% of petri dishes were positive for yeast species and 318 strains were identified. Candida albicans, Candida kefyr, Candida tropicalis and Candida guilliermondii were the most common yeast species isolated from the oral cavity of soldiers. Conclusion: We used this method because of its simplicity and other beneficial characteristics for rapid identification of large and numerous isolates and the results were compared with other morphological characters such as chlamydospore and germ tube production. In addition, we used some type strains (Candida parapsilosis: PTCC 5089, Candida tropicalis: PTCC 5028,Saccharomyces cerevisiae: PTCC 5052,Candida lipolytica: PTCC 5063,Candida lipolytica: PTCC 5064), and the results were acceptable. yeast identification disk diffusion test oral cavity susceptibility testing yeast isolation 2008 2 01 209 214 http://mjiri.iums.ac.ir/article-1-341-en.pdf
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Medical Journal of The Islamic Republic of Iran (MJIRI) Med J Islam Repub Iran 1016-1430 2251-6840 10.18869/mjiri 2008 21 4 Cerebral hypercapnia-induced vasomotor reactivity in migraine with and without aura: a case-control study M. Moghaddasi Moghaddasim@irimc.org F. Sina B. Haghi-Ashtiani M. Rohani B. Zamani  Abstract Background: Dysfunction of the autonomic nervous system has long been a subject of considerable debate and a large number of studies have disclosed contradictory results. The aim of this study was to compare cerebral vasomotor reactivity in migraine with aura (MWA) patients with migraine without aura (MWO) ones. Methods: Ten MWA patients (7 females and 3 males mean age: 39.70 years, SD: 12.03 years) and 10 age and sex-matched cases with MWO (P=0.303, P=1.000, respectively) underwent cerebral vasomotor reactivity (VMR) measurement using trans-cranial Doppler imaging of the middle cerebral artery (MCA). All patients were examined during an attack-free interval. Results: Astatistically significant decrease in VMR value was seen in the migraine with aura group (2.8%, P=0.048) also systolic, diastolic and mean flow velocities were significantly greater in these patients (113.31, 59.13, 73.88, P=0.021, P=0.017 and P=0.049, respectively). Conclusion: Age-independent decrease in cerebral vasomotor reactivity in MWAas compared to MWO could support genetic involvement of brain autonomic control pathways in MWArather than MWO. Nitric oxide (NO) plays a major role, as a second messenger, in cerebral autonomic activity. Genetic involvement of its metabolic pathways may be a good explanation for observed dysfunction in MWA. Further molecular investigations could clarify this question. migraine with aura migraine without aura vasomotor reactivity CO2 inhalation 2008 2 01 203 208 http://mjiri.iums.ac.ir/article-1-340-en.pdf
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Medical Journal of The Islamic Republic of Iran (MJIRI) Med J Islam Repub Iran 1016-1430 2251-6840 10.18869/mjiri 2008 21 4 Pulmonary function in ulcerative colitis A.H. Faghihi-Kashani A. Kabir aikabir@yahoo.com S.A. Javad-Moosavi  Abstract Background: Pulmonary involvement in ulcerative colitis (UC) is thought to be rare. There is not a definite document about the question that "Is the lung a target organ in inflammatory bowel disease?" The aim of the present study is to compare lung function between cases with UC and healthy controls. This study will also be of interest about searching the outbreak of pulmonary function abnormalities in a sample of Iranian patients with UC and factors associated with severity of UC. Methods: In an analytic cross sectional study between July 2006 and September 2007, we evaluated 70 patients with histologically confirmed UC and 70 matched healthy people. Our checklist addressed demographic variables, symptoms, smoking behavior, drugs, laboratory findings and pulmonary function tests. Results: None of the lung volumes and capacities were significantly different in cases as compared to controls. Severity of UC was mild in 65.7%. It was correlated with smoking (P=0.019) and allergy (P=0.017). Patients with moderate UC had lower hemoglobin (P<.001), MCH (P=0.002), MCV (P=0.047), MCHC (P=0.028) and higher REFF (P=0.032) and BF (P=0.01). Conclusion: The controversies about the relation between UC and lung disease can be due to different sample sizes, activity of UC at the time of measurement of lung volumes, methods of measuring lung capacities at the time of PFT and different nationalities. ulcerative colitis inflammatory bowel diseases respiratory function tests 2008 2 01 196 202 http://mjiri.iums.ac.ir/article-1-339-en.pdf
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Medical Journal of The Islamic Republic of Iran (MJIRI) Med J Islam Repub Iran 1016-1430 2251-6840 10.18869/mjiri 2008 21 4 Prognostic value of right ventricular myocardial performance index in patients undergoing coronary artery bypass surgery D. Javidi N. Saffarian research_cardio@yahoo.  Abstract Background: Right ventricular myocardial performance index (RVMPI) is a Doppler–derived parameter of non-geometrical ventricular function that measures both systolic and diastolic functions of the right ventricle. The aim of this study is to compare prognostic value of RVMPI with global RV function in patients undergoing Coronary Artery Bypass Graft (CABG). Methods: In a longitudinal study, 100 eligible patients who underwent CABG for coronary artery diseases were studied from March 2004 to September 2006. Global RV function and RVMPI changes were measured serially by Doppler echocardiography after surgery. Patients were divided into 2 groups. In group A, LVEF was < 40% and in group B, LVEF was >40%. Patients were followed for four months after hospital discharge. Statistical analysis included chi-square test, student t–test or one-way analysis of variance (ANOVA). Results: We studied the incidence of atrial fibrillation (AF), post-operative myocardial infarction, pericardial and pleural effusion, infection, readmission and also ventilation time and ICU duration. Global RVEF and RVMPI were not related to the incidence of post-operative AF rhythm, myocardial infarction, pericardial effusion, pleural effusion, infection and readmission in both groups. In group B, RVMPI had more prognostic effect on ventilation time and ICU duration, but this effect was not seen in group A. In group B, global LVEF and LVMPI had more prognostic effect on ventilation time and length of ICU stay in comparison with those in group A. Conclusion: In group B (EF>40%), RVMPI had the most prognostic effect on estimation of ventilation time and ICU stay duration, but in group A(EF < 40%), LVMPI had the most prognostic effect on them. right ventricular myocardial performance index coronary artery bypass surgery 2008 2 01 189 195 http://mjiri.iums.ac.ir/article-1-337-en.pdf
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Medical Journal of The Islamic Republic of Iran (MJIRI) Med J Islam Repub Iran 1016-1430 2251-6840 10.18869/mjiri 2008 21 4 Evidence-based assignment of diagnostic peritoneal lavage (DPL) sensitivity in penetrating abdominal trauma A. Afsharfard afsharsurgeon@yahoo.com M . Mozaffar H. Vafaei A. Kavyani A. Saberi M. Zeinalzadeh M. Sharifi  Abstract Background: There are a large number of patients with penetrating abdominal trauma who have normal vital signs and negative abdominal examination when referred to trauma centers. Agreat deal of controversy exists between authorities about screening these patients for emergency explorative laparotomy. Many references have reported more than 90% sensitivity for DPL as a diagnostic method to determine whether intraabdominal injuries were present and emergent laparotomy is indicated or not. This study is for reassignment of this sensitivity according to our own evidence. Methods: All of the patients with abdominal stab wounds and normal vital signs plus negative abdominal examination who were referred to Shohada-e-Tajrish hospital between March 2004 to December 2005, underwent local wound exploration and those confirmed to have peritoneal penetration, underwent emergency laparotomy. In the operating room and prior to surgery, under general anesthesia, DPL was performed. Then DPL results were compared with laparotomy findings and DPL sensitivity was assigned. Results: Of the total number of 34 patients, 8 had a positive DPL and positive laparotomy 2 had a positive DPL and negative laparotomy 8 had negative DPL and positive laparotomy, and 16 patients had negative DPL and negative laparotomy. Conclusion: According to our study, DPL sensitivity is much less than mentioned in trauma texts (approximately 50%). So, it is not a valuable tool to discriminate between operative and conservative approaches in penetrating abdominal trauma. We suggest more sensitive modalities. Laparotomy is the most sensitive approach but at the price of a high negative laparotomy rate. penetrating abdominal trauma diagnostic peritoneal lavage laparotomy stab wound 2008 2 01 185 188 http://mjiri.iums.ac.ir/article-1-336-en.pdf
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Medical Journal of The Islamic Republic of Iran (MJIRI) Med J Islam Repub Iran 1016-1430 2251-6840 10.18869/mjiri 2008 21 4 Patient satisfaction after scoliosis surgery E. Ameri ebrahimameri@yahoo.com H. Behtash B. Mobini B. Bouzari V. Tari  Abstract Background: Patient satisfaction with the cosmetic result of spinal fusion surgery was studied in 40 cases of adolescent idiopathic scoliosis. Neutral or dissatisfied patients were compared with satisfied patients in several physical and psychological characteristics. The aim of the study was to determine whether adolescents generally report satisfaction with the postoperative appearance of their back after the correction of severe curves and whether preoperative medical and/or psychological factors could distinguish between patients who report satisfaction with the cosmetic surgical result from those who report neutrality or dissatisfaction. Previous reports emphasize the need for medical outcome research that evaluates both patient satisfaction and technical success. Patient satisfaction with spinal surgery has largely been evaluated in retrospective studies and most consistently is related to postoperative cosmesis and degree of curve correction. Methods: 40 adolescents with idiopathic scoliosis without any comorbidity who were 10 years of age or older were studied preoperatively by physical and psychological measurements. Results: Of patients undergoing surgical correction of severe curves, 50% reported satisfaction with the cosmetic result. Neutral or dissatisfied patients were more likely to have a King II or King IV curve types and less correction than satisfied patients. Preoperative psychological difficulties (P< 0.05) and unmet expectations regarding postoperative cosmesis (P<0.05) were more common among neutral or dissatisfied patients. Conclusion: Most adolescents with idiopathic scoliosis expressed satisfaction with the cosmetic surgical result. Preoperative physical characteristics, psychological difficulties, and unrealistic expectations regarding postoperative cosmesis are associated with patient neutrality or dissatisfaction. patient satisfaction adolescent idiopathic scoliosis spinal surgery 2008 2 01 177 184 http://mjiri.iums.ac.ir/article-1-335-en.pdf
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Medical Journal of The Islamic Republic of Iran (MJIRI) Med J Islam Repub Iran 1016-1430 2251-6840 10.18869/mjiri 2008 21 4 Aclinicopathological survey of esophageal cancer in patients referred to a gastroenterology clinic in Tehran, 1991-2005 H. Froutan Froutan@ams.ac.ir M.S. Keshmiri A. Shafaghi  Abstract Background: Esophageal cancer is one of the major malignancies, with various epidemiological aspects in recent years in developing countries, including increased prevalence and variations of pathologic patterns. This may be due to increasing rates of Barrett’s esophagus, gastroesophageal reflux, smoking and obesity. This study was performed from 1991 to 2005 in order to evaluate various clinicopathological aspects of esophageal cancer in patients referred to a gastroenterology clinic in Tehran. Methods: This retrospective cross-sectional study was performed according to data from clinical records, including demographic information, pathologic and endoscopic reports. We used SPSS/12 software for statistical analysis. Chi-square and ANOVAtests were used and a P-value less than 0.05 was considered significant. Results: 156 patients (87 males and 69 females) with an average age of 62.4±10.3 years (mean ± SD) were studied. 105 (67.3%), 39 (25%), and 12 (7.7%) patients had squamous cell carcinoma (SCC), adenocarcinoma and metastatic carcinoma, respectively. The location of tumors was 20.6 % (32 patients) in upper third, 35.2% (55 patients) in middle third and 44.2% (69 patients) in the lower third of the esophagus. There was no significant relation between sex and age of patients with the type of cancer and location of tumors. There was a significant relation between the location of tumors and cancer pathology (P<0.001). Conclusion: In our study, esophageal cancer had no significant epidemiological variations, so SCC was still more common than other esophageal cancers. Upper and lower thirds were the most common locations of SCC and adenocarcinoma of the esophagus, respectively. adenocarcinoma endoscopy esophageal cancer pathology squamous cell carcinoma 2008 2 01 173 176 http://mjiri.iums.ac.ir/article-1-333-en.pdf