JOURNAL OF MEDICAL RESEARCH (JMR)
Year:2003 | Volume:2 | Issue:1|Papers Count:10

Background: The most common cause of intraperitoneal adhesion bands is previous abdominal surgery. Postoperative adhesion formation results from a fibroproliferative inflammatory reaction. The possiblity of involvement of fibrogenic processes in adhesion formation and the anti-fibrogenic effect of D-penicillamine led us to test the effectiveness of this drug as a possible preventive measure for intraperitoneal adhesions. Materials and Methods: Eighty female rats were randomly divided into four equal groups of 20 rats. Intraabdominal adhesion bands were produced by intraperitoneal injection of 2.5 milliliter of a 10% sterile talc solution. The first group served as control, Group II received oral D-penicillamine 35 milligram per kilogram of body weight per day, Group III received oral colchicine 0.02 milligram per kilogram per day and Group IV received both drugs for three weeks. Formation of adhesion bands was then quantitatively graded in each group according to Nair classification. Results: Severe adhesions (grades 3 and 4) were found in 20% of the D-penicillamine administered group (Group II), whereas these types of adhesions were observed in 33% and 84% of the colchicine administered group (Group III) and the control group (Group I), respectively (p=0.003). Group IV, that had received both Dpenicillamine and colchicine, was omitted from the study due to a high mortality rate. Adhesion bands in the Dpenicillamine group were thinner and smoother in comparison to other groups. Conclusion: Lower grades ofadhesion were found in the D-penicillamine group in comparison to the colchicine and control groups. Therefore, it appears that D-penicillamine may be effective in the prevention of formation of adhesions in the rat.

Background: Surgery is usually accompanied by anxiety and apprehension. This, in particular, is obvious in children during separation from their parents and entry to the operating room. A variety of drugs and techniques, such as parenteral or oral medication and preanesthesia visits have been advocated in order to prevent or to minimize this problem. This study evaluated the sedative efficacy of ketamine and promethazine in children before an operation. Patients and Methods: One hundred patients with an age range of 2 to 10 years and in class I or II according to the American Society of Anesthesiologists, who had been referred as out-patients for elective surgery of the extremities and lower abdomen were enrolled in this study. The patients were randomly divided into two groups of 50 patients; one group received ketamine 10 milligrams per kilogram diluted in 5% dextrose water and the other group received promethazine 4 milligrams per kilogram orally one hour before operation. The patients were evaluated on the basis of their response to separation from parents and tolerance to intravenous cannulation. Results: The esults demonstrated that the response in the ketamine group was mild in 72%, moderate in 20% and severe in 8%, whereas the response in the promethazine group was 44%, 40% and 16%, respectively. Conclusion: Both ketamine and promethazine seem to be effective as oral premedicants for sedation before surgery in children, although orally administered ketamine was more effective than promethazine (p<0.05).

Background: Idiopathic scoliosis is the most common type of scoliosis. Adolescent idiopathic scoliosis curve of more than 10 degrees is reported to occur in 2 to 3 percent of youths younger than 16 years. The aim of this study was to investigate the relative frequency of idiopathic scoliosis among female high school students in Shiraz. Patients and Methods: Using a random clustering sampling method, four hundred female students from Shiraz, with an age range of 14 to 16 years, were selected for this study. After obtaining a medical history, physical examination was performed in standing and bending forward positions. Thoracolumbar X-ray was obtained for those who were diagnosed as having scoliosis in physical examination and then the angle of curves were measured using Cobb's method. Results: The relative frequency of scoliosis was 11± 0.03 percent. Five percent of the cases had curves of more than 10 degrees and 1.25 percent had curves more than 20 degrees. Inappropriate sitting (lateral bending) was significantly more frequent in girls with scoliosis (p<0.05). However, there was no statistical difference between healthy and scoliosis students in relation to performing regular aerobic exercises. Conclusion: According to this study, a high relative frequency of idiopathic scoliosis exists among our female school children. Therefore, it seems prudent that screening programs for early detection of scoliosis in schools become mandatory.

Background: Depression is one of the most common psychiatric disorders and its prevalence ranges from 10.5% to 62-9%. This study was undertaken in order to determine some of the etiological factors related to depression among university students in Yasuj. Patients and Methods: The study sample was selected from three different universities in Yasuj. A Beck questionnaire as well as a questionnaire for personal data especially those related to depression were used. The collected data was statistically analyzed using SPSS and chi-square tests. Results: Out of the 464 students included in this study, 35.6 percent had depression (38.5 percent of all males and 34.1 percent of all females). The highest prevalence rate (42.9 percent) was observed among Islamic Azad University students while the lowest prevalence rate (16.8 percent) was seen among students at Yasuj University of Medical Sciences. Non-native students, 20-24 year old students, and students whose parents had chosen their field of study suffered from a more severe depression. Students who were hopeful about their future occupation, students who participated in extracurricular activities and students who were more religious suffered from less depression. Also, depression was more common in students who had lost their mothers and in those who lived in dormitories. There was no relationship between depression and the occupation of the students' fathers, decease of fathers, level of parental education, the number of siblings, the absence of exercise, loss of friends, and the level of religious belief in the family. Conclusion: The results of this. study indicate that in order to decrease the prevalence of depression among students it is best to accept native students, allow the students to choose their field of study and encourage students to participate in extracurricular activities and to practice their religious beliefs and partake in-religious ceremonies.

Background: Hemorrhoids are one of the most frequently occurring and disabling conditions of mankind. Direct current electrotherapy seems to be a good modality of treatment for hemorrhoids. The main goal of this study was to assess the effect of electrotherapy on different anal canal pressures. Patients and Methods: Thirty patients (21 males and 9 females) with symptomatic internal hemorrhoids grades II and III, who were unresponsive to medical therapy and had no other anorectic diseases, underwent electrotherapy. The mean age of the patients was 40.1 years with a range of 23-64 years: Rectal manometery was performed on these patients, 1-8 days before and 4 weeks and 4 months after the operation. The mean resting and squeezing pressures were calculated preoperatively and compared with postoperative results. Stationary resting pressures (1, 2, 3 and 4 centimeters from the anal verge) and maximum squeezing pressures. were analyzed by the same method. Results: Mean resting pressure and mean squeezing pressure was 53.15±19.09 and 95.19±30.06 before and 50.87±17 and 92.05±26 after electrotherapy. No significant statistical difference was observed in the anal pressures before and after electrotherapy of hemorrhoids (p>0.05). No clinical problems or obvious complications, such as incontinence, occurred in the patients after operation. Conclusion: Treatment of hemorrhoids using electrotherapy does not change anal canal pressures and does not compromise the anal sphincter's function, thereby preserving anal physiology.

Background: Lower extremity rotational problems are common in orthopedic clinics. Establishing normal values of rotational angles .are mandatory for screening normal subjects from subjects who need more evaluation and treatment. In this study, normal values of five standard rotational angles were measured using clinical methods. Patients and Methods: In a cross-sectional study, 756 subjects with no history of musculoskeletal disorders, were selected from schools and health centers of Shiraz using a cluster random sampling method. These subjects were divided into 18 groups according to chronological age with equal numbers and equal gender distribution in each group. Five rotational angles in both lower extremities of all subjects in all groups were measured. According to terminology recommended by the "American Pediatric Orthopedic Society", normal values were defined as within two standard deviation of the mean. Results: According to this study, thigh-foot angle changed from -12±30 in infancy to 12±10 at the end of age 18; transmalleolar axis changed from -8±21 in infancy to 17±9 at the end of age 18; foot progression angle changed from 13±11 in year one to 5.5±5.5 at the end of age 18; lateral rotation of the hip changed from 80±8 in infancy to 44±13 at the end of age 18; medial rotation of the hip was the only angle with meaningful statistical difference between males and females. In females, this angle changed from 30±24 at birth to 35±17 at the end of age 18 while the figures for males were 26±21 to 32±14, respectively. Conclusion: Comparing the results of this study with similar studies from other countries, there are some significant differences. This can be due to genetic, environmental and life style factors that can affect rotational profiles. Therefore, it seems that these values are more useful for our population than normal values from other countries. Because of the population diversity in Iran, further studies in other parts of our country can add valuable data.

Background: In recent years there has been an increase in the survival rate of patients suffering from beta thalassemia major. This finding is mostly due to progress made in the medical management of these patients. However, less attention has been paid to psychosocial aspects of the illness. Patients and Methods: In this study, the rates of hopelessness and anxiety in 23 beta thalassemia major patients, who comprised all of the registered cases at the Thalassemia Center of Yazd were determined. The age range of the patients was 12 to 18 years. Fifty-four healthy students who were the classmates of the patients and who were both sex- and age-matched served as the control group. Two questionnaires (Beck Hopelessness Scale and the Trait Anxiety Inventory) were used for the evaluations. Results: The results showed that there was no statistically significant difference between the rates of hopelessness in thalassemic patients as compared to their healthy classmates. However, thalassemic patients were significantly more anxious than their classmates (p=0.025). Conclusion: It can be concluded that beta- thalassemia major patients are more anxious than healthy subjects probably due to the unpredictability of their physical condition and the invasive procedures that are used to manage their problems. Therefore, there is a need for psychosocial support in these patients which can be facilitated by physicians, psychologists and social workers.

Schwannoma is a neurogenic tumor that rarely involves the peripheral nerves. This tumor is benign and arises from nerve sheath cells. A 43-year-old female presented with a mass in the lower and posterior part of the right side of her neck for five months duration. The patient also had numbness and pain in her right hand fingers and shoulder girdle on the same side. CTscan showed a hypodense mass at the C7 level in the posterior aspect of the neck. Surgery was performed through a right supraclavicular incision in order to excise the deep and firm mass located in the right brachial plexus. The histopathologic report of the specimen was in favor of schwannoma. Two months after surgery, the symptoms of the patient gradually disappeared.