Razi Journal of Medical Sciences
Year:2011 | Volume:18 | Issue:87|Papers Count:8

Background: Imperforate anus is a common anomaly associated with many other anomalies. The aim of this study is determining the frequency of associated anomalies in children with imperforated anus.Methods: This retrospective, cross sectional study was conducted over 245 neonates and children (137 male, 105 female and 3 ambiguous genitalia) with imperforated anus diagnosis, in Ali-Asghar Hospital 1999–2008. Our information was extracted from patients' records. SPSS 17 was used for data analysis.Results: 50.6% of the patients had associated anomalies including 18% cardiovascular, 15.5% renal, 14.7% gastrointestinal, 13.9% vertebral, 13.1% genitourinary, and 8.2% external genitalia. The most prevalent associated anomaly was genitourinary system anomalies followed by cardiovascular anomalies.Conclusion: Patients with imperforated anus should undergo a detailed general physical, systemic and radiological examination (infant gram, echo cardiography, ultrasonography of urogenital system) in neonatal period for on time detection of associated anomalies.

Background: Ankylosing spondylitis (AS) is a spondyloarthropathy of unknown etiology, with widespread effect on axial and peripheral skeleton. The aim of this study was determination of pentoxifylline effect on Bath Ankylosing spondylitis Disease Activity Index (BASDAI) of uncontrolled AS patients in Rasool-e-Akram Hospital Rheumatology Clinic.Methods: This pilot study was performed on 30 patients with ankylosis spondylitis with BASDAI³4 ignoring their previous medical treatments. The patients received Pentoxifylline tablets 400 mg TDS and then evaluated 6 and 12 weeks after the treatment. Data were analyzed by Paired T test and p<0.05 was considered to be significant.Results: 30 patients (26 males (86.7%), 4 females (13.3%)) with ankylosing spondylitis were evaluated. Mean age of patients was 32.42±8.14. Mean±standard deviation of BASDAI was 6.53±1.72 prior to the treatment, which decreased to 5.17±1.58 after 6 weeks and 4.88±1.66 after 12 weeks of treatment (p=0.000). The differences of BASDAI before and after treatment with pentoxifylline were significant.Conclusion: Pentoxifylline can be advised for uncontrolled AS patients regardless of current or previous treatment.

Background: Vulvovaginal candidiasis occurs due to the overgrowth of candida in genital system mucosa of females. Symptoms and signs of vulvovaginal candidiasis are unspecific, therefore diagnosis is not certain. The aim of this research was comparison of the result of indirect immunofluorescence and ELISA with culture and direct microscopy examination in patients with vulvovaginal candidiasis.Methods: This was a comparative-descriptive study performed on 87 patients and 50 normal cases as controls. All specimens were examined using direct microscopy, culturing and complimentary test to differentiate the candida species from each other. Serological tests such as indirect immunofluorescence and ELISA were performed on sera of the patients. To compare the quantitative and qualitative data, t student test, chi-square and exact fisher test were used, if necessary.Results: Out of 87 specimens, 50 cases were diagnosed as vulvovaginal candidiasis. The most frequent isolated pathogens were C.albicans, C.glabrata, C.kefyr, C.inconspicua and C.famata, respectively. Also, in control group, the most frequent pathogens were C.albicans, C.glabrata and C.kefyr, respectively. In this study all of normal cases were negative in indirect immunofluorescence test and in patients group 42 person (84%) were positive and 8 (16%) negative. Control participants were negative in ELISA and in patient group 40 person (80%) were positive and 10 person (20%) negative.Conclusion: It seems in cases that direct microscopic and culturing methods is impossible, ELISA and indirect immunofluorescence can be used as an alternative method.

Background: Occupational stress is one of the most common hazards in workplaces and leads to different physical, mental, and behavioral outcomes and complications. Medical residents, due to the nature and characteristics of their job, confront various stressors. This study has been designed in order to identify the frequency of occupational stress in medical residents and factors influencing it.Methods: This cross-sectional study was conducted on 305 residents with various specialties in Rasoule-Akram Hospital on spring 1389. For measuring the degree of stress, we used Osipow occupational stress inventory. T-test, Chi-Square, ANOVA and Logistic regression were used to evaluate associations.Results: Response rate was 87%. Most of the residents had moderate stress. Average score of total stress was 147.06 from 250. The most frequent stressor was work overload (31.05 from 50) and responsibility (29.55 from 50). Stress significantly increased with shift work (OR=4.591, CI=1.31-16.13, p=0.017), surgery (OR=3.769, CI=2.10-6.76, p=0.001) and also correlated with lower rest time (OR=1.962, CI=1.12-4.08, p=0.048) and higher weekly work hours (OR=1.242, CI=1.10-2.34, p=0.050).Conclusion: The most frequent stressors were work overload and responsibility, so it is recommended that in order to reduce stress, work hours must be limited and the residents must be strongly supported. In addition, some education and consultation for specialty choice must be given to the physicians.

Background: Early diagnosis of multiple sclerosis (MS) disability is very important in managing patients. The aim of this study is to use Heidelberg Retinal Tomography (HRT) to evaluate the Retinal Nerve Fiber Layer (RNFL) of MS patient as a predictor factor of their disability scales.Methods: In this cross-sectional study a total of 69 patients with Relapsing-Remitting MS (RR.MS) were selected based on the revised McDonald criteria. They were examined by a neurologist to calculate their Expanded Disability Status Scale (EDSS) scores. Patients' demographic information and related data such as history of Optic Neuritis (ON) and used Interferones were collected. Patients were referred to ophthalmology department in Rasool-e- Akram Hospital for assessment of their RNFL thickness using HRT method. Data was analyzed by SPSS software and p<0.05 was considered to be significant.Results: The range of patient's age was 17 to 59 years. The mean of EDSS scores of men and women were 2.69 micrometer and 2.86 micrometer that showed no significant difference (p=0.63). Spearman Correlation showed that there is no significant correlation between EDSS and mean RNFL thickness in both left and right eyes (p=0.081 for the right and p=0.052 for the left). Also, there was no significant correlation between EDSS and mean RNFL thickness of both eyes in patients with or without optic neuritis (p=0.66, 0.28). Mean RNFL thickness of both eyes showed no significant difference in patients with and without optic neuritis (0.209).Conclusion: This study pointed out that no decrease was detected in RNFL thickness by increasing EDSS scores using HRT method. There are evidence that both HRT and Optical Coherence Tomography (OCT) methods can show decrease of RNFL but OCT appears to be more sensitive.

Backgrounds: Tonsil reduction by use of radiofrequency waves is one of the newest therapeutic modalities, especially for obstructive large tonsils. The aim of this study was comparing short term and long term results of radiofrequency tonsillotomy and traditional cold dissection tonsillectomy in adult patients with recurrent tonsillitis.Methods: a prospective randomized clinical trial on 72 adults with recurrent tonsillitis was performed in a tertiary referral university hospital. Traditional tonsillectomy in 34 cases and radiofrequency tonsillectomy (RF) by use of Radiofrequency Induced Thermotherapy (RFITT) probes in 38 cases were performed under general anesthesia. Time of surgery, amount of intraoperative bleeding, recovery time, post-surgical pain, dysphagia, weight loss, and time of return to normal diet and activity were measured.All the patients were followed for 24 months for recurrence of tonsillitis episodes. Statistical analysis was performed using SPSS version 16, chi square and Mann-Whitney U tests.Results: Mean time of surgery (16.89 vs.46.07 minutes) and recovery (14.32 min vs.17.11 min), and amount of intraoperative bleeding (15-20 cc vs.250-300cc) were significantly less in the RF group than the traditional tonsillectomy group (p<0.005). There was no difference between the two groups in the recurrence of tonsillitis episodes after 24 months.Conclusion: Tonsillotomy with RF is a simple, rapid, and effective method in adult patients with recurrent tonsillitis.