Jundishapur Scientific Medical Journal
Year:2009 | Volume:8 | Issue:1 (60)|Papers Count:16

Objects: The aim of this study was to review of incidental pattern of upper and lower extremity joints dislocations among patients in Imam Khomeini Hospital, Ahvaz in 2005 for the first time which is the referral university hospital in the province of Khuzestan, Iran.Subjects and Methods: This was a retrospective and descriptive study among in and out patients in orthopedic surgery department of Imani Khomeini hospital during 2005 on the basis of a total amount of 64000 cases (62000 outpatient and 2000 admitted cases). The study was done for the presence of any dislocation, involved limb, age, sex, side of the involvement, accompanying injuries, mechanism of injury, open or closed dislocation.Results: There was a total amount of 128 dislocations (Men=85% Women=15%) 52.3% in the right side and 47.7% in the left side 64% of dislocations accompanied by a fracture and 30.5% needed hospital admission. In all cases there was only one joint involvement and the most common age of joint dislocation was in the third decade of life more than 77% of dislocation occurred among patients between 10-40 years old. Neurological damage was found in only one case and there was no vascular injury. Incidence of closed dislocation was 98.4% and the most common mechanism of injury as accident (32.8%). Joint dislocations were more common in the upper extremity (73.4%) in shoulder (21.1%) and in hand Mp joint (16.4%) In the lower extremity hip dislocation was more common (81.8%). Gallezia fracture dislocation was the most common form of a fracture dislocation combination (20.3%).Conclusion: Dislocation was more common in the male gender, upper extremity, right side and third decade of life. Accident was the most common mechanism of joint dislocation. Shoulder was the most common dislocated joint in the upper extremity and hip was so in the lower extremity. Most cases required short term admission in the Emergency Orthopedic Department and only one case of ulnar nerve injury was discovered among joint dislocation cases.

Objective: Assisted reproduction treatment (ART) entails a risk of ectopic pregnancy and early pregnancy loss. Serum ß-human chorionic gonadoropin (b-hcg) has been found to be predictive of pregnancy outcome. Our aim was to determine whether serum b-hcg levels obtained 16 days after ovulation are reliable predictors of pregnancy outcome.Subjects and Methods: In this retrospective study, 200 women who have achieved a pregnancy through ART treatment at the infertility clinic of Mashhad Medical Sciences University were evaluated. The treatment included IUI in 196 (98%), ICSI in 2 (1%) and IVF in 2 (1%). Serum samples were obtained on days 16 and serum b-hcg concentration was measured by immune-radiometric assay.Results: The mean age at treatment was 29 (range 19-35 y). One hundred and sixty women aged above 30 y and 40 cases aged below 30 y .Out of 200 patients with ART cycles 175 cases were found to be viable pregnancies (live fetus at 20 weeks gestation) and 25 patients resulting in spontaneous abortion. A statistically significant difference was found between the mean b-hcg value of the non-viable and viable pregnancies (P<0.001).Conclusions: A single serum b-hcg level 16 days after ovulation provides a useful predictor of pregnancy outcome.

Objective: There are many restorative designs for root canal treated maxillary premolars that each of which have their own advantages and disadvantages. One of this treatments is composite inlay restoration with fiber-reinforced composite which has sufficient retention, strength and acceptable apearence, as well as more compatibibility and less leakage than cast-metal restoration.Material sand Methods: In this - experimental study, after calculating a sample groups, 72 sound maxillary premolar teeth with the same size were chosen and fixed in acrylic resin so that the CEJ was 2 mm upper than the level of resin. The sample was randomly divided in to six groups of 12. Group 1 (positive control): intact teeth. Group 2 (negative control): root canal treated with MOD cavity preparation that had been extended 1 mm below CEJ. Group 3 and 4: root canal treated teeth with MOD cavity preparation for fiber- reinforced (Nulite F) composite inlay using Nulite F2 liner. Group 5 and 6: these groups were prepared in the same way as groups 3 and 4, differing in that, this specimens were restored by 3MP60 composite instead of Nulite F. Following restoration, all specimens was termocycled 500 times. Specimens of groups 1, 2, 3, 5 were loaded by the universal testing machine (Zwick z020, Germany) at speed of 0.5 mm/min. specimens in groups 4 & 6 onset were loaded by artificial mouth 1000,000 times then loaded by universal testing machine. Finally the results were analyzed using ANOVA test and comparasion multiple tests.Results: average fracture resistance for first group was 2.091 killo nioton, (kn) second group was 0.862kn, third group was 1.577 kn, fourth group was 1.431 kn, fifth group was 1.296 kn and sixth group was 1.170 kn. According to data analysis the deference between first and second groups to other groups was significant. Fracture resistance of 3th group with 5 & 6 groups and 4 th group with 6 group have significant deference.Conclusion: because of increasing of the fracture resistance in endodontically treated teeth that restorated with fiber-reinforced composite (Nulite F) and their significant deference in comparasion with conventional posteror composite (3MP60) as well as their other properties, can say that we can use fiber - reinforced composite as an acceptable method for reconstruction of endodotically treated maxillary pre molar.

Objective: Hyperemesis gravidarum (HEG) is a debilitating illness affecting 0.3- 2% of pregnant women. It is characterized by continuous vomiting, dehydration, ketosis and muscle weakness. Conservative measures are not effective in severe cases. In these conditions, prednisolone therapy has been used, but yet there is no consensus on the therapy. The aim of this study was to assess the effect of prednisolone therapy in control of symptoms in women with HEG.Subjects and Methods: a randomized, placebo-controlled trial was conducted on women with HEG who were admitted at Ahvaz University`s hospitals from April 2006 to March 2008. Initially, they were divided in two (Prednisolone and placebo) groups. The prednisolone group was administered oral daily prednisolone (20 mg bid) until improved, and then tapered off over a few weeks, while the control group was given a placebo (multivitamin) with the same manner. All women also received promethazine, metoclopramide, intravenous fluids with electrolytes and vitamin supplements (B1, B6).Results: finally, 54 women in two groups (steroid: 28, placebo: 26) were analyzed. The mean age in both groups at admission was about 22 years. The mean gestational age at randomization was 10.7 (±2.3) weeks in the prednisolone group and 8.4 (±1.7) weeks in the placebo group. Among prednisolone group only 10 (35.71%) women versus 15 (57.68%) women in the placebo group needed hospital cares for women more than one week (P=0.18). Severe vomiting was seen only in 4 (14%) patients in the prednisolone group compared with 12 (46%) in the placebo group (P=0.01). Nineteen women (73%) in the placebo, compared with 12(50%) in the prednisolone group, were readmitted for hyperemesis (P=0.03). After one week, ptyalism was seen in 6 (6.12) in the prednisolone group versus in one (1.4) in placebo group (P=0.59).Conclusion: Prednisolone therapy is useful in resolution of symptoms in women with hyperemesis gravidarum. Further study with a larger size is recommended.

Objective: Diabetic mellitus is the most prevalent etiology for non traumatic amputations in the world that usually begin with a wound in lower extremities. About 15% of diabetic patients will have wound in their foot. According to texts there is relation between amputation and some factors like: male sex, neuropathy, vascular diseases, uncontrolled blood sugar, diabetes lasting more than 10 years and abnormal biomechanics of foot. The aim of this study was to determine the relationship between the rate of amputation of diabetic foot with some other variables of patients such as age, sex, where they live and also with specific factors of disease (like lasting time of diabetes, diabetes treatment).Subjects and Methods: This is an analytical descriptive study that performs retrospective work on the file of patients with diabetic foot infection who were admitted in Razee hospital in Ahvaz between years 1381-1383. A total of 198 patients were divided in two groups (with and without amputation) statistical analyses were employed using SPSS for windows by different tests.Results: The results showed, that there was not an significant relationship between the rate of amputation and sex, age, site of living, last time of foot wound and foot infection (P>0.05), but there was meaningful relationship between the rate of amputation with the duration of diabetes and the treatment of the disease (P<0.05).Conclusion: According to the results there is a suggestion for screening and precocious distinguish of diabetes and immediate treatment for diabetic patient, Also it is recommended to screen for people with positive family history for diabetes aged less than 45 and in patients more than 45 years overall condition every 3 years for preventing of vascular problems.

Objective: The aim of this study was to obtain relatively theoretical methods based on physical rules in interaction of radiation with matters which can be sensitively, rapidly and easily used in different radiotherapy centers.Subjects and Methods: In this study with the aid of the exponential attenuation rules of photon beams and inverse square distance rule, in 6MV and 18MV energy of 2100C Varian accelerator X-ray and 1.25MeV energy of Cobalt-60 g-ray in Ahvaz Golestan Hospital and considering the scatter radiation of therapeutic field and irregular field to be equal, the side of equivalent square field were calculated.Results: In this method, since the calculation was done taking into account the situation of the field, energy and position of the shield, a very good agreement with dose measurements showed ( with error, less than 2%). Not all of these considerations are taken into account in previous methods. In addition, the calculations can be done on a computer for each therapeutic irregular field.

Objective: The aim of this study was to evaluate the bond strength of self- etch adhesive system (AdheSE) with three dentin conditioning methods.Materials and Method: Sixty six human intact premolar was divided into 3 group (n=22), a flat dentin surface was made. In group 1: The tooth was etched by phosphoric acid (%35), then bonding material of AdheSE was used. In group 2: only bonding material was used. In group 3: The procedure was as the first group, but after etching, the tooth surface was deproteinized by Naocl (%5). Then with a cylindrical composite model were made. Thermolcycling was performed using 500 cycles, and subjected to a blade (cross head) with the speed of 0.5 mm/min .Collected data was analyzed using 1 way ANOVA test in addition to a Duncan test.Results: Results revealed that hypochlorite sodium (Naocl) decreased the bond strength. When acid phosphoric and then dentin bonding agent were used, mean bond strength (25.72 MPa) was the most. Excess etching increases the bond strength.Conclusion: When the self etching adhesives are used for repair of teeth, excess etching increases the bond strength.

Objective: Tuberculosis (TB) is a global health problem. One of the most important and effective ways of TB control is health education. Health planning depends on public health needs. The aim of this study was to assess the general population's knowledge about tuberculosis.Subjects and Methods: This study is a comparative descriptive study which was conducted in 2004 in Behbahan and Omidieh, two cities in Khuzestan province with different TB epidemiological index. Nine hundred and seventy five individuals referring to health centers of these cities were asked to answer questions about TB. Data were obtained from questionnaires with 92% reliability and 98%validity and were analyzed with SPSS software using t test with 95% confidence.Results: Of total 975 individuals 546 (56%) were living in Behbahan and 429 (44%) in Omidieh. Mean knowledge score for signs and symptoms, transmission and control of tuberculosis in Behbahan and Omidieh were 26, 10, 13 and 14, 6, 9 respectively. There was a significant difference in tuberculosis knowledge between two cities (P<0.05).Conclusion: This study showed that public knowledge about TB and it's control and management in Behbahan city is higher than in Omidieh city.

Objective: The aim of this study was to estimate mutation frequency in exon 15 of APC gene in Khuzestan FAP patients and their relatives.Subjects and Methods: We have analyzed 12 patients and 11 individual among their relatives. DNA extraction from EDTA treated whole blood was performed by routine salting out method. Three hotspot regions of axon 15 from APC gene were amplified separately with three primer pairs by PCR and the fragments have been analyzed for putative mutations by single stranded conformation polymorphism (SSCP) according to standard protocols and subsequent sequencing.Results: we found aberrant bands by SSCP method in seven patients and two related members, that compared with data from sequence analysis yield following results: five patients (24 to 35 years old) carried novel frame shift mutation (3195-3196 insT) leading to premature protein. In two patients whose SSCP were positive, no mutations in their two relatives were identified.Conclusion: In this report we have used SSCP as pre-screening method for mutation analysis of our samples and found putative mutations in nine of them. After sequencing, only in five samples "true mutation" could be confirmed it is interesting that approximately 50% of Khuzestan FAP patients carry mutation in axon 15 of APC gene. Noteworthy, in this work only a small region of the APC gene was subject of the investigation and interestingly, all patients showed the same new mutation. Studies with large number of samples can help us to know, whether this new mutation is predominant or even exclusive within Khuzestan FAP patients.

Objective: Hypertensive emergency is one of the most important conditions in the emergency department with high mortality and morbidity if not treated effectively. Hypertensive emergency is commonly treated with sublingual nifedipine. This drug is very short acting and it may decrease blood pressure suddenly, resulting in dangerous side effects such as myocardial ischemia and sudden cardiac death. We intended to find of a safer route of administration. Therefore, we compared the rate of blood pressure decline following sublingual and chewing-swallowing routes of administration.Subjects and Methods: A quasi-experimental clinical study was performed on 160 patients with hypertensive emergency. All patients with blood pressure ³210.125 mmHg and without sign of end organ damage were selected randomly into those receiving sublingual or chewing-swallowing 10 mg nifedipine capsules. The data collection tools consisted of an information sheet and a semi-automatic sphygmomanometer. Information sheet had two parts, the first was related to demographic data and the second part was the check list of blood pressure (systolic, diastolic, mean) and heart rate at 5, 10, 20, 30, 60 and 120 minutes after administration. All data include quantitative and qualitative were analyzed with paired comparison, t-test and Chi-square.Results: The results of this study showed that there was significantly greater fall in the rate of blood pressure in the sublingually-treated group compared with chewing-swallowing group at 5, 10 and 20 minutes after taking 10 mg nifedipine (P=0.04, 0.01, 0.06 respectively). There was no significant difference in diastolic blood pressure between both groups during the time of study. After 30 minutes the fall in systolic and diastolic blood pressures in both groups was similar. There was no significant difference in heart rate among both groups but there is some trend to the increase the rate. There was 23% decrease in mean basic blood pressure among the patients before and after treatment in sublingual and chewing-swallowing groups (P=0.0001). There was no significant correlation of blood pressure abatement rate in both groups as dependent variables of age, sex, positive history of risk factors and current drugs as independent variable.Discussion: The chewing-swallowing route may be safer than sublingual route since it reduces pressure less rapidly during the first 20 minutes of administration.

Objective: Ibuprofen is a none-steroidal anti-inflammatory drug that is used for intensive to moderate inflammatory pains. This drug imposed some gastrointestinal (GI) disorders such as gastritis to the GI tract. Thus, preparation of Ibuprofen suppository especially for pediatrician who manages an anesthetic children with disability of swallowing or children sensitive to oral dosage forms is very useful. Besides, some difficulties with poor dissolution rate and bioavailability of the drug in the form of suppositories have been reported. Therefore; the aim of this study was to find an opportunity for solving the problem.Materials and Methods: In this study the effect of different quantities of drug (50, 100 mg), of two sizes (60, 100 mm) in the base of Witepsol H15 and W35 were used. Also, b-cyclodextrin in different concentrations of 5% and 10% for enhancing solubility and colloidal silicon dioxide for uniformity of suppository drug content and Tween 80 with 0.25, 0.5 and 1 percent concentrations were used in consecutive tests.Results: The results of different evaluations indicated, that, a better formulation could be prepared using Witepsol H15 with 100 mg Ibuprofen (60micron particle size), 0.5% Tween 80, 10% b-cyclodextrin and 0.5% colloidal silicon dioxide. The release of Ibuprofen in this formulation was 75% at 42.52min.Conclusion: Comparison of all formulations showed no significant difference in most parameters (P>0.05) excepting the formulation with Tween80 and b-cyclodextrin which showed a significant differences (P< 0.05) in drug release.

Objective: Temporomandibular disorders (TMD) are one of the most common problems in the head and neck area. Depending of its indexes, the prevalence of TMD among different societies has been reported differently by various researchers. The aim of this study was to determine the incidence of types of malocclusion in patients with temperomandibular disorders referred to dental school of Ahvaz during 2005-2006.Materials and Methods: This descriptive cross -sectional study was based on interview and observation of 216 twenty to sixty year old patients with the average of 31.6 years of age that suffering from TMD. To determine the relationship between malocclusion and TMD the SPSS software and proportional comparison test was used.Results: The prevalence of TMD was 59.76% in females, 40.3% in males and 50.9% in patients between 20 to 30 years old. The most common sign of TMD was joint sounds (61.1%) and the less common was limitation in lateral jaw movement. 15.7% of the patients had normal occlusion, 58.8% Cl I malocclusion, 9.8% Cl II d1 malocclution, 11.5% Cl II d2 malocclusion, 4.2% Cl III malocclusion, 10.6% Crossbite, 8.3% open bite , 40.8% abnormal overjet, 30.1% abnormal overbite , and 59.8% had crowding.Conclusion: The prevalence of TMD was higher in females than males, and the age of prevalence was 20-30. The most common sign of TMD was joint sounds and the less common was limitation in lateral jaw movement.The prevalence of posterior open bite and decreased overbite in TMD group was significant (p=0.000), but there was no relationship between other types of malocclusion and TMD.

Objectives: Among bacterial agents involved in bacteremia or septicemia, Staphylococci have a high importance. Surviving on dry surfaces for long times, in addition to colonization on skin and nasopharynx facilitates the spreading of these bacteria particularly from hospital personnel to patients causes increase in nosocomial infections. The main purpose of this study was detection of Staphylococci species and determination of their frequency among bacteremic hospitalized patients in Ahvaz city, Iran.Materials and Methods: In this cross-sectional study, positive blood cultures collected from patients with Staphylococcal bacteremia were surveyed. These patients were hospitalized in four hospitals dependent to Ahvaz Jundishapur University of Medial Sciences, since Jan.2005 to June.2006. Three blood samples, taken at 2-hour intervals were inoculated into the bottles of culture medium. The samples belonged to the patients with two staphylococcal positive cultures out of 3 samples, were studied. Isolated colonies were stained by Gram`s method and their species were determined by standard biochemical tests.Results: Thirty six (41%) out of 88 Staphylococcal-induced bacteremia cases in Golestan, Talaghani, Razi and Shafa hospitals of Ahvaz caused by Staphylococcus aureus  and the other cases of bacteremia caused by coagulase-negative species were as following: 32 S. epidermidis (36%), 10 S. lugdunensis (11%), 6 S. heamolyticus (7%), 2 S. cohnii (2.5%), and 2 S. xylosus (2.5%). In adition, the most of Staphylococcal isolates belonged to the patients who were hospitalized in burn sections (19.4%), chemotherapy (17%) and infectious section of Razi hospital (17%). The highest number of Staphylococci species (60.2%) was isolated from female patients.Conclusions: The results of our study showed that coagulase-negative Staphylococci were the most common isolate (60%) in the patients with staphylococcal bacteremia. This rate was 85% in Shafa hospital (a centre for thalassemic and patients under chemotherapy). Therefore, special attention is needed to be given to immunocompromised patients, who are the greater risk of bacteremia caused by Staphylococci species. We suggest that attention should be taken during disease surveillance especially for detection of the uncommon coagulase-negative Staphylococci in nosocomial diseases.

Objective: the aim of the present study was to evaluate the prevalence of nasal mucosal contact point in rhinology patients and association between contact point and sinunasal symptoms.Subjects and Methods: We compare the sinunasal problem and contact point (endoscopic & imaging) in 59 patients without (sever septal deviation, chorneal hypertrophy. large ethmoid bula and paradox turbinate) by fisher aaaaaaaa7 chi square test and review the literature.Results: The prevalence of nasal mucosal contact point in our study is 13.6 percent; there is no association between contact point and patient s symptom such as headache, facial pain, nasal blockage.Conclusion: Nasal mucosal contact point occurs between the septum and structure of the lateral nasal wall and contact point can be visualized either endoscopically or radiologically on CT scan. The nasal mucosal contact point in the physiological status of the nose is best detected on CT scan of paranasal sinus. As we found no association with headache, facial pain and nasal blockage and contact point, it appears unlikely that surgery is relieving these symptoms permanently by relief of contact points.

Paragangliomas are neoplasms that arise from paraganglionic "bodies" of the autonomic nervous system. These paraganglia are distributed symmetrically and segmentally in the para-axial regions of the trunk and are typically related to arterial vasculature and cranial nerves of the ontogenetic gill arches. We repot a case of vagal paraganglioma with all diagnostic therapeutic approach which has not been reported previously in this manner.