Avicenna Journal of Clinical Medicine
Year:2004 | Volume:11 | Issue:3 (SN 33)|Papers Count:15

This study was designed to evaluate results of neoadjuvant and adjuvant chemotherapy for nonmetastatic osteosarcoma patients. Forty four patients who were referred to Omid hospital from 1994 to 1999 were eligible to the study. For comparison based on different chemotherapy regimens which had been prescribed, all patients were classified into 3 different subgroups named as HDMTX (including high dose methotrexate and other drugs based on a protocol known as T10), 3 drugs (low dose methotrexate, vincristine and cyclophosphamide) and 4 drugs (low to intermediate dose methotrexate, vincristine, cyclophosphamide and adriamycine) regimens. While 2 and 5 years Relapse Free Survival (RFS) were 45% and 28% respectively, there was not any significant statistical difference between the groups. In addition Median Event Free Survival (MEFS) was 18.5 months and again there was not any significant statistical difference between groups (15.5 months for HDMTX, 21 months for 3 drugs and 24 months for 4 drugs regimens). Considering as a prognostic factor, effects of adriamycin prescription, neoadjuvant chemotherapy and adequacy of chemotherapy courses in MEFS were evaluated. Putting Adriamycin into regimen and adequacy of chemotherapy courses had a significant effect on MEFS improvement but neoajuvant chemotherapy didn't have such a significant effect.As methotrexate was integrated into all different regimen however with different doses the study didn't show improving MEFS with increasing doses of this drug.

Aphasia is a common manifestation of stroke and evaluation of relationships of aphasia and brain topography could lead to better understanding of cognitive neurophysiology. Consecutive 100 stroke patients with aphasia admitted in Valie Asr hospital, Khorasan in 2003 enrulled in this prospective study. Diagnosis of stroke and aphasia was made by a neurolosist and topography of involved cerebrovascular territories confirmed by topographic maps of brain in CT scan. Global, Broca and Wernicke subtypes of aphasia constituted 52%, 40% and 6% of the cases respectively. Based on the usual nourishment of Broca and Wernicke areas by anterior and posterior cortical branches of the middle cerebral artery, 79% of Global, 47% of Broca and 50% of Wernicke aphasias had a compatible infarct topography. Other cases had no congruent infarct topography with involved linguistic area of their brain.Specific cerebrovascular topography for subtypes of aphasia in stroke patients was not found. The effects of cerebrovascular lesions on linguistic functions are not predictable by their topography in CT scan.

Prevention of dependency to morphine or delaying to it and decreasing of tendency to morphine craving and also decreasing in morphine induced hyperalgesia (tolerance) were the aims of this study. Nitric oxide is one of the neurotransmitters, which involves in the Dopamine reuptake in striatum. Dopamine is one of the most important neurotransmitters in reward system in central nervous system and it has a critical role in morphine addiction and dependency, tendency and tolerance to it, so in this study we survied the role of L- NAME as a nitric oxide synthetase (NOS) inhibitor on the prevention of morphine addiction in rats. In this study we evaluated behavioral changes such as morphine craving by self - administration as a criterion for tendency, dependency by observation of withdrawal syndrom signs (e.g Jumping, wet dog shaking) and also responses to nociceptive condenced bim of light by using tail flick analgesia metric device in sham (consuming tap water), control (consuming increasing doses of morphine sulfate solution from 0.1mg/ml up to 0.4mg/ml) and test (treated with 45 mg/kg of L- NAME 30 minutes before consuming of morphine sulfate solution per day) groups. The results showed that pretreatment with L- NAME in test group lead to a significant decline in tendency to morphine craving, withdrawal signs and also a significant reversal of morphine induced hyperalgesia. We concluded that L- NAME is a potent agent in the prevention of morphine addiction.

One of the essential purpose of prenatal care is the measurement of fetal growth and also estimation of fetal age. Sonography is a valid device with measurement of femoral length, Scapula length, Biparietal diameter and abdominal circumference. To compare the value of these parameters in assessing fetal age a cross sectional study on 220 singleton pregnancies with the gestational age of 16-40 weeks was designed. Our cases who knew her LMP and had no history of previous disease and also fetal anomaly were assesed based on sonographic scores.Findings showed that scapular length and biparietal diameters are the best parameters for estimating gestational age. Multivariate regression showed estimation of G.A based on each of the variables alone is better than multivariate estimation. Results suggest that sonography is a valuable device for assessment of fetal growth and biparietal diameter and scapula length seem to be better indices for estimation of gestational age.

The burden of psychiatric disorders in the developed countries has been identified by the screening questionnaires and standard clinical interviews at a high level, but the epidemiological studies of psychiatric disorders in our country are brief and their numbers are few. Planning for providing essential mental health services to the people requires us to be knowledgeable about the present status of psychiatric disorders in the society. The objective of this research was to carry out the epidemiological study of the psychiatric disorders in the individuals 18 years and above in urban and rural areas of Hamadan province. 664 individuals selected through randomized clustered and systematic sampling methods among the existing families of Hamadan province and the Schedule for Affective Disorders and Schizophrenia (SADS) questionnaires completed by the clinical psychologist. The diagnosis of the disorders was based on DSM-IV classification criteria. The results of the study showed that the overall prevalence of psychiatric disorders in the province was 11.28% (17.2% in women, 5.8% in men). The anxiety and mood disorders with 5.87 and 2.71% respectively had the highest prevalence in the province. The prevalence of psychotic disorders in this study was 0.60%, neuro- cognitive disorders 1.35% and dissociative disorders 0.75%. In the group of mood disorders, major depression with 2.56% and in the group of anxiety disorders, phobia with 2.56% had the higher prevalence. This study showed that 8.13% of studied individuals suffered from at least one of the psychiatric disorders. The prevalence of psychiatric disorders in the province among the individuals in the age group of 66 years and above was 13.33%, individuals whose spouses had passed away 18.75%, urban residents of province 9.81%, illiterate individuals 12.80% and housewife individuals 12.31% was more than other individuals in the sample.Being aware of this matter reveals the responsibility of the health policy makers and programmers in prevention, treatment and medical education more than before , in relation to preparing application and executive plans in Hamadan province for mental health.

The architectural and structural analysis of Delaire was developed to evaluate complex craniofacial structures without relating the individual to a so-called normal or average group. This analysis is especially valuable in two regards: first, this analysis is based upon mutual balance of the cranial and facial structures; second, statistical averages are avoided. But , the problem that causes fault in using this analysis is difficult identification of location of its landmarks and its influence on acquired results. The main goal of this study was evaluation of the repeatability of Delaire cephalometric analysis. Forty lateral cephalograms of patients aged 17-30 that who had no experience of previous surgical or orthodontic treatment with no history of injury to craniofacial structures were selected. The cephalograms were traced ( 5 landmarks: M, FM, Pts, CT, Clp) twice by two observers separately with an interval approximately 40 days between replicate tracings. Both observers registered the X and Y co-ordinate values of each landmark for subsequent statistical analysis. The results of this study showed that statistically significant differences existed for landmarks FM and Clp in first observer and for Pts in second observer for X co-ordinate values and there were no statistically significant intra-observer error for Y co-ordinate values. There was no statistically inter- observer error too. In summary, we concluded that there is desirable level of inter-observer repeatability in landmark identification in Delaire analysis but there is statistically significant intra-observer error in landmark identification in this analysis that maybe due to low experience of observer in this regard.

H.pylori has been discovered as an etiologic agent for peptic ulcer and gastric cancer. It is well known that eradicating H.pylori is an essential step in curing ulcer disease. Many regimens are currently available but none of them can achieve 100% eradication rate.In this research, anti-bacterial effect of extracts of: fennel, dill, caraway, cinnamon and antibiotics of: ciprofloxacin, Tetracyclin and amoxycillin were investigated against H.pylori by disk diffusion method and flow cytometry. In this study we used culture and rapid urease Test, catalase, oxidase and also staining to recognize H.pylori in 30 biopsies that has been taken from patients.14 cases (46.66%) were positive for H.pylori infection. Disk diffusion method was used to detremine the sensitivity of H.pylori to some selective antibiotics and plant extracts. In analysis of information it has been used from nonparametric Cochran test and for comparisons between plant extracts of different groups, the Mcnemar and Bonferroni tests was used. In this study, bacterial viability was surveyed after being subjected to plant extracts and antibiotics by flow cytometry.Results showed that all of the bacteria were susceptible to plant extracts and the highest sensitivity was obtained with dill. All bacteria were susceptible to ciprofloxacin, tetracyclin and were resistant to amoxicillin. Flow cytometry showed that ciprofloxacin had bacteriocidal effect, tetra cyclin had bacteriostatic effect and could not kill bacteria whereas plant extracts had bacteriostatic effect.

Early hypocalcemia, which occurs in the first 48 hours of birth, is an important electrolyte disorder of neonatal period. Delay or failure of its diagnosis may result in dangerous and irreversible complications such as seizure and death. This prospective- cross sectional study had designed to evaluate prevalence, etiology and clinical presentation of early neonatal hypocalcemia in Fatemieh and Ekbatan hospitals of Hamedan in 2002. This study was done by preparation of the checklist of necessary information getting from the patients file and then analysis the data with SPSS10 software. 25 cases out of 180 neonates of less than 48hours life had hypocalcemia, 17 cases of them experienced asphyxia, 7 cases were premature and 1 case was infant of a diabetic mother. Clinical presentation of early hypocalcaemia were: seizure, decreased neonatal reflexes and excitability. Results showed that early neonatal hypocalcemia was relatively frequent in our study group and its clinical presentation was similar to other studies which were carried out in other countries, but the first cause of this disorder in our study was asphyxia while in other countries it was prematurity.

Lesion of the gastric mucosa is the most prevalent side effect of aspirin. Flavonoids with actions such as antioxidant, free radical scavenger and lipid peroxidant inhibitor can prevent mucosal lesion caused by aspirin. In this research effect of quercetin, as the most abundant flavonoid in human diet, was investigated on preventing ulcerogenic effect of aspirin or Acetyl Salisylic Acid (ASA). Eighteen male Wistar rats (220-330gr) were randomly divided into 3 groups (6 in each group). In all groups consumption materials were adminstrated only once in acute form. First and second groups, as control groups, received ASA vehicle (1ml, orally) and ASA suspension (300mg/kg, 1ml, orally) respectively. The third group had a pretreatment with quercetin (200mg/kg) half an hour before consumption of 300mg/kg ASA. After consumptiom the materials animals were kept 3hours, after that stomach was removed and was assessed for macroscopic and microscopis stomach mucosal lesions. Our results showed that, oral adminstration of ASA (300mg/kg) caused considerable stomach mucosal lesions (P<0.05) and pretreatment with quercetin decreased the lesions (P<0.05). Therefore quercetin can be effecttive in protecting stomach mucosa against ulcers caused by ASA. Although the mechanism of quercetin action is not known, it might be used for mucosal protection with further investigations.

The cause of heel pain or pain at Antromedial part of heel is unknown, so precise method of treatment is also unknown. Heel spur is one of important factor that may affect response to treatment in heel pain and in the present study its effect on the treatment of heel pain is evaluated. In this clinical trial 126 patients suffering from heel pain were treated medically (Oral NSAID, heel pad and local steroid injection). According to imaging study patients were divided in two groups (group one with heel spur, and group two without heel spur). After 4 weeks follow up improvement of heel pain occurred in 62 cases of group two and 34 cases of group one. Thus heel spur causes resistance to medical therapy.

A number of patients with severe obstruction due to hypertrophic cardiomyopathy have derived benefit at least over the short-term from inventional infarction of a portion of the interventricular septum by the infusion of alcohol into a selectively catheterized septal artery, with reduction of the outflow gradient and improvement in symptoms. This paper contains successful TASH on a symptomatic patient with high LVOT gradient and methods and complications.

Ellis Van Creveld syndrome or chondroectodermal dysplasia is a rare disease characterized by the triad of postaxial polydactyly, chondrodisplasia of long bones, resulting in acromesomelic dwarfism, and ectodermal dysplasia. In this study, three newborns with this syndrome, consisting of acromesomelic dwarfism, postaxial bilateral polydactyly, nail hypoplasia and narrow thorax, short ribs with respiratory problems are presented.