Researcher Bulletin of Medical Sciences
Year:2002 | Volume:7 | Issue:1 (27)|Papers Count:25

Background: Total Hip Arthtroplasty (THA) is a common orthopedic operation and preoperative planning has been reported to be an integral part of THA. The present study was carried out over the patients referring to Akhtar hospital between 1997 and 1999 to determine the efficacy of preoperative planning. Materials and methods: Those undergone unilateral THA, either cemented or noncemented, have entered this descriptive study. Patients' radiographs have preoperatively planned using Muller SLS-88 System and desired indices were compared with postoperative radiographs. Paired Hest was used for statistical analysis. Results: The study population included 21 males and 30 females with mean age of 58.4±12 years. Indices of "inclination" and "anteversion" were not compared, since standard values have been considered. Indices of X and Z that represent T and R lines have shown significant difference, however, the index of Y, representing the distance from the center of rotation to the prominent point of lesser trochanter, showed no significant difference. Thus, the resection lines of femoral neck were balanced according to the surgeon's experience, and finally the position of femoral component was not significantly changed. Conclusion: Preoperative planning is of significant value for the successful performance of THA. A clinical trial is highly recommended.

Background: Regarding the frequency of Total Hip Arthroplasty (THA) operation and controversies arisen considering the etiologic factors, treatment outcomes, and complications, the present study was performed over the patients referring to Imam Hossein and Pars Hospitals between 1994 and 1998. Materials and methods: It was a retrospective study of existing data type, where, patients undergone THA and followed up for at least two years were study. Initial data, etiologic factors, treatment outcomes, and complications were determined. Results: We studied 80 patients and 96 hips. There were 42 men and 38 women with a mean age at surgery of 48.5±13.1 years. The most frequent cause of THA was primary degenerative arthritis (36%), hip dysplasia (30%), and fracture of femoral neck (25%). Hip dysplasia and primary degenerative arthritis were the most common cause of THA in females and males, respectively. Complete and partial pain relief was reported in 88.7% and 11.3% of the patients. 5 patients have required accessory devices for walking. Patients with hip dysplasia were more susceptible to develop postoperative complications. The most frequent complications were prosthesis dislocation, difference in leg length, and neural complication. No case of postoperative infection, fracture, emboli, bladder and urinary tract injury or vascular complications was reported. Conclusion: With respect to differences found in etiology and complications with that appeared in references, epidemiological studies are strongly recommended.

Background: Rotational velocity of a joint may have significant effect on the resistive moment that is basically due to the viscoelastic deformation of soft tissue spanning the joint. Measuring this effect can clarify part of biomechanical behavior of a joint in motion. Most of the previous studies have focused on the effect of position on resistive moment. The aim of this study was to measure the effect of rotational velocity on resistive moment at human ankle joint undergoing dorsi-plantar flexion. Materials and methods: An experimental study was conducted-on 16 male university students. A twolink single-degree-of-freedom revolute rig was built. The proximal link fixed to the ground was secured to the shank and the distallink to the foot of each subject. Cyclic force up was applied to the distallink with constant predetermined velocity. Force and angle transducers mounted on the rig measuring resistive force and relative angle of the two links. Range of motion of the joint, moment angle curve at 11, 57, and 170 degrees per second, regressive curves and hysteresis were determined. Results: Both ankles of 16 male university students, totally 32 joints, aged 20 to 25 years, were tested. The difference between right and left ankles was found non-significant (p<0.01). Results showed maximum dorsi flexion angle of 16±5, maximum plantar flexion of 37±12, and a total range of motion of 58±17 degrees. Significant amount of hysteresis was observed, 36±7 percent of maximum resistive moment, but no significant difference was found in the amount of hysteresis at different joint velocities. The moment angle curves confirmed the nonlinear instantaneous elastic characteristics of the joint reported by the others. Two power function of the form M=bmθ was found, where b=3.7, m=1.043 (r2=0.98) for the upper, and b=2.3, m=1.054 (r2=0.94) for the lower part of the curves. Conclusion: Resistive moment is not function of the amount of the velocity, but is function of its direction. Thus, a pseudo-elastic model is suitable to explain biomechanical behavior of human ankle joint.

Background: Hepatitis C is a common infectious disease in thalassemic patients due to repeated blood transfusion. More than 85% of HCV-infected individuals develop chronic hepatitis, of which 25% may result in liver cirrhosis, hepatic failure or hepatocellular carcinoma. In thalassemic patients hepatic damage due to HCV infection is aggravated by transfusion iron overload. Materials and methods: In this clinical trial, 81 thalassemic patients were studied for evidence of HCV infection and response to α-IFN. Routine tests of transfusion transmitted infections were HBs Ag, HBs Ab, HIV Ab, and HCV Ab. Those revealed to have positive HCV Ab were tested for HCV-RNA by PCR. Liver function tests including SGOT, SGPT, PT, PTT were also checked. Liver biopsy was performed for those patients who had liver enzyme elevation. Recombinant α-IFN, 3 million units trice weekly, was administered for infected patients with positive HCV-RNA. HCV-RNA was checked 6 and 12 months later, whereas liver enzymes were checked every 3 months. Results: 22 patients had positive HCV Ab and 17 had positive HCV-RNA. In 8 patients, liver enzymes were increased, so liver biopsy was achieved. Their histological examination revealed mild chronic hepatitis (4 patients), chronic active hepatitis (3 patients), and severe hemosidrosis (2 patients). 12 patients received α-IFN for one year. In 7 patients (58%), after one year treatment, HCV-RNA became negative. HCV-RNA was checked 6 months after discontinuing treatment in 7 patients, which was negative in 5 patients. 2 patients relapsed. Conclusion: This study shows that clearance of serum HCV-RNA can be obtained by a prolonged course of treatment with α-IFN in thalassemic patients. Response rate is similar to non thalassemic patients, but with lower relapse rate.

Background: Chronic renal failure (CRF) patients have integrally required an arteriovenous fistula (A VF) to establish a vascular access for hemodialysis. The present study was performed on CRF patients in Shohada Tajrish Hospital between 1999 and 2000 to compare the efficacy of different types of AVF. Materials and methods: It was a clinical trial. 60 patients have been randomly distributed in two equal groups, according to the time of referral. AVF in the snuff box region was constructed between the cephalic vein and a branch of the radial artery, either side to side (STS) or end to side (ETS). Patients were followed for at least 6 months and the efficacy rate, failure rate, and venous hypertension following AVF construction were compared and analyzed statistically. Results: AVF was failed in 6 patients (20%) of STS group, of which 4 were due to thrombosis of the fistula and 2 were due to venous hypertension, however, in ETS group 5 cases (16.6%) developed failure, all of which were due to thrombosis. Conclusion: There was no significant difference in AVF efficacy between the two groups after 6 months follow up. Further with greater sample size are highly recommended.

Background: The incidence of cancer continues to grow throughout the world. Unfortunately we lack sufficient reports of cancerous patients, so determining the predisposing factors such as sex, age, habits, environmental features, etc in Iranian population have been ceased. The present study was conducted in Shohada Tajrish Hospital between 1993 and 1997 in Radiotherapy-Oncology department to survey the epidemiologic aspects of cancer in this referral center. Materials and methods: It was an existing data type study. Reports met the ICD-10 criteria of malignancy have been chosen, then the predisposing factors of age, sex, smoking, and marital status were determined. Results: Of a total of 2709 reports, 23 (0.8%) were benign lesions and the remaining 2686 (99.2%) were malignant tumors. The study population included 1532 (57%) males and 1154 (43%) females, with the mean age of 39.8±23 years. CNS tumors were by far the most frequent neoplasm (20%). CNS neoplasm and breast cancer were the most common tumors seen among males and females, respectively. Smokers were more frequently developed laryngeal and lung cancers. Conclusion: Differences revealed in epidemiology of cancer in Iran as compared with other countries required further studies.

Background: Academic success is of utmost importance among university students. The present study was conducted to assess the relationship between the academic success and learning and study strategy among university students of Mashhad University of Medical Sciences in 1999. Materials and methods: It was a cross sectional study. The study population included 412 students of medical, dentistry, and pharmacology courses. Foreign students or those who have average scores of less than 60% were excluded. Students' learning and study strategies were assessed by a self-reported questionnaire, LASSI, edited by Weinstein in 1987 prepared in Persian-version. Academic success was assessed based on grade point average (GP A). Chi square test, multiple regression analysis, spearman correlation coefficient and Kruskal Walis tests were used for data analysis.Results: It was found that 9 of 10 LASSI subscales were in significant correlation with academic success (p<0.05). Results of multiple regression analysis show that only the motivation, anxiety, and self-testing subscales demonstrated a significant regression coefficient with academic success. Conclusion: Having more successful learning and better academic success, learning and study strategies as a component of medical educational course, is suggested.

Background: Painful shoulder is a common orthopedic problem with known side effect sin case of leaving untreated. The present study was conducted in Akhtar Hospital between 1998 and 2000 to determine the Role of ultrasound in diagnosis of rotator cuff tear in painful shoulder. Materials and methods: 64 patients suffering from painful shoulder have enrolled for this clinical trial. Sonography was performed (using Dinamic Imaging, 7.5MHZ probe, Linear) and patients were followed 18 months to maintain definite diagnosis (either clinical or surgical). Results: The study population included 64 patients (53%males and 47%females) with the mean age of 35±10.9 years. Sonography has revealed to have a positive predictive value of 100% in diagnosis of complete rotator cuff tear, meanwhile, the negative predictive value was 100%. Sonography has misjudged one case as normal, however, further studies have shown partial tear. Conclusion: Sonography is an accurate method for evaluating rotator cuff tear. Further studies are highly recommended.

Background: There are many evidences implying the occurrence of listeriosis after consumption of contaminated foods and also several reports of milk and other products contamination with Listeria monocytogenes. The present study was carried out to determine the prevalence of Listeria monocytogenes in industrial and traditional cheeses in East and West Azarbayejan, Khorasan, and Tehran provinces, in 1997-98. Materials and methods: 150 cheese samples were studied during this descriptive study. Samples were collected randomly through 30 factories and 20 traditional cheese manufactures. Sampling was systematically performed in three consecutive seasons in 1998-99. Physical, chemical, and microbiological analysis was achieved on the basis of available standards in laboratories of Nutrition and Food Technology Research Institute. In order to detect injured cells of bacteria, a pre-enrichment step was performed in some processed cheeses. Results: Totally, 63 white cheese and 27 processed cheese samples including chedar, buttercheese, pizza, gouda, and casienated were collected from factories and 60 white cheese samples from traditional manufacturers. No bacterial contamination with Listeria monocytogenes was noted among cheese samples. Conclusion: 150 cheese samples have shown no contamination with Listeria monocytogenes . With respect to the various physical, chemical, and microbiological properties and also processing during manufacturing, we strongly suggest further studies considering positive or negative factors resulting in contamination.

Background: Prior investigators have strongly noted the association of chlamydial infection with arteriosclerosis and acute stroke. The present study was performed in Loghman Hakim Hospital in 2000, to determine the possibility of this association. Materials and methods: It was a case-control study. The case group (44 patients) included those hospitalized due to acute stroke. Their diagnosis was confirmed by clinical, serologic, and imaging techniques. The control group which was matched according to the sex, age, previous history of MI, and smoking, included those who were hospitalized due to diseases other than acute stroke. Serologic tests were achieved for anti-chlamydial IgG and IgA and also anti-chlamydia pneumoniae-specified IgG. Chi square tests, Fisher exact' test and odd's ratio were used for statistical analysis. Results: Anti-chlamydial IgG and IgA were reported in 7 (15.9%) and 24 (54%) patients of case and control group, respectively (p<0.001). Anti-chlamydia pneumoniae-specified IgG was found in 7 patients of the case group, whereas it was not seen in the control group. This difference is statistically significant (p<0.001). Conclusion: Results have revealed significant association between chlamydia pneumoniae and acute stroke. An experimental study seems helpful.

Background: Chronic hepatitis B is one of the major world health problems and there is millions of death because of the cirrhosis and hepatocellular carcinoma, but till now, the only method of estimating the degree of liver inflammation and fibrosis is liver biopsy. There are few controversial reports considering LFT for estimating the degree of liver fibrosis and inflammation, thus we have evaluated the correlation between liver function tests and liver inflammation and fibrosis in patients with chronic hepatitis B. Materials and methods: It was a retrospective study. All of the hepatitis B patients (confirmed by biopsy) who have had previous LFT tests were included. A pathologist who was unaware of the patients' LFT evaluated inflammation and fibrosis in accordance to Sheuer and Ishaks's classification. Results: Of a total of 139 patients, 42 were excluded due to accompanying diseases other than hepatitis B. The remaining 97 patients were included 57 males and 40 females with the mean age of 35.9 years (15-66). The mean interval between liver biopsy and LFT test was 4.2 days, where in more than 90% it was less than one week. AL T and total bilirubin had shown significant correlation with grade of inflammation (p<0.005). The most coefficient correlation was between grade and AST/ALT ratio that had reverse relation (p<0.01). Meanwhile, fibrosis revealed to have significant correlation with AL T, total bilirubin, and globulin. Conclusion: Despite the presence of significant correlation, liver biopsy is still the most reliable method of estimating the degree of fibrosis and inflammation.

Background: Regarding the importance of early diagnosis and management of primary and secondary intraspinal tumors and with respect to the lack of informative data of intraspinal tumors in Iran, the present study was carried out over the patients referred to Shohada, Shariati, and Imam Hossein Hospitals in Tehran in 1998-99. Materials and methods: In this retrospective study, 41 patients with neuropathologically confirmed spinal cord tumors were studied to determine the epidemiologic features. Patients" age, sex, anatomic site and the kind of tumor were all recorded. Results: The study population included 23 males and 18 females with the mean age of 38±17 years. All tumors were more prevalent in males rather than females except for meningioma and metastasis. The tumors in descending order were; nerve sheet cells tumors (34.1%), gliomas (34.1%), metastasis (14.6%), meningioma (12.1%), and teratoma (4.8%). Spinal tumors were more frequently located in thoracic regions. Ependymomas were the most common kind of spinal glioma as do the astrocytoma in children and the spinal meningioma in postmenopausal women. Lymphoma comprised half of the metastatic tumors in spinal cord. Conclusion: Results have revealed that the incidence of nerve sheet tumors especially schwannoma are as high as other countries. Spinal glioma had the highest frequency all over the other studies. Unlike other surveys, lymphoma was the most common matastatic tumor.

Background: Previous studies have suggested the effects of maternal BMI and weight gain on pregnancy outcomes, thus, the present study was conducted over 106 parturients referring to Imam Hossein Hospital to determine the maternal BMI and weight gain and its relationship with pregnancy outcomes. Materials and methods: 106 parturients had entered this longitudinal study. Initial data including weight, height, and previous deliveries were all recorded. Perinatal care was achieved. Maternal weight gain was determined and the relationship between pregnancy outcomes and maternal BMI and weight gain was noticed. Results: Of a total of 106 parturients, 101 (95.3%) aged 18-35 years. Most of the candidates (47.2%) had BMI of 19.8-26. 37% had weight gain below the standard level, whereas 35% had weight gain above the standard level. BMI was revealed to be correlated with weight gain. Preterm delivery was noted in 33.3% of the females with BMI between 26 and 29, however, normal candidates have experienced preterm delivery in 24%. Conclusion: Abnormal weight gain and BMI have shown to be associated with severe maternal and neonatal complications. Maternal education and consultation seems to be helpful.

Background: Children poisoning is the main cause of mortality and morbidity in industrial countries. Its profile has changed a lot during the recent years, thus the present study was performed in Loghman Hakim Hospital to determine the etiologic factors of this problem. Materials and methods: Under 12-year-old children referring to Loghman Hakim Hospital due to poisoning had entered this study. Initial data including age, sex, kind of poisoning, management and outcomes were all analyzed. Results: Of a total of 3199cases, 2819 (86.5%) had minor poisoning status and received adequate care and discharged. 380 (13.5%), including 228 boys and 152 girls, had serious poisoning and were hospitalized. Of these, 46.6% aged 1-3 year-old. 3 were died. Drug poisoning was by far the most common cause (45%), of which benzodiazepams (178), antideprresant (170), anti convulsive agents (88), other antipsychotic (23), and NSAID"s (88) were the most frequent drugs. Hydrocarbon poisoning (617 cases) and whitex and other detergent (242) were the other frequent cause of children poisoning. Conclusion: With respect to the high incidence of children poisoning physicians" education and well equipped poisoning centers are highly suggested.

Background: Urinary tract infection is a common pediatric problem, which has known side effects in case of leaving untreated. Its etiology and antimicrobial sensitivity is different in various geographical regions. The present study was conducted in Tehran Pediatric Hospital between 1995 and 2000 to determine the etiologic factors of urinary tract infection in infants and children and also determine the efficacy of cephalotin in UTI treatment. Materials and methods: It was a two-stage study. First a descriptive study to find the affected individuals, then a clinical trial to evaluate the efficacy of cephalotin. Children who had two positive urine culture and clinical manifestation of UTI were considered as infected individuals. They were given cephalotin at the dosage of 150 mg/kgld for 10 days. Treatment outcome and etiologic factors were all determined. Results: The study population included 72 girls and 12 boys, aged 3 months to 11 years. E.coli was the only microorganism, which was cultured. Cephalotin revealed to be an effective antimicrobial agent. Conclusion: Cephalotin has shown to be an effective agent. It has the least side effects and satisfactory results as well as low cost. It could be a good alternative for antimicrobial agents.

Background: Strongyloidosis is a prevalent disease that could lead to severe complications in case of incorrect diagnosis. ELISA is a sensitive, sufficient and serodiagnostic test for strongyloidosis. We have examined the efficacy of the two ELISA methods (pre and post absorption) in faculty of Hygiene, Tehran University of Medical Sciences, in 1999. Materials and methods: This clinical trial of diagnostic type has been carried out on 462 sera samples (37 of non-infected controls, 46 sera from patients with parasitologically documented strongyloides stercoralis, and 378 sera from patients with other parasitic infection). In this study crude soluble antigen was obtained from filariform larvae and we performed the ELISA test in two procedures. I) ELISA test (without pre absorption) was performed on all sera. 2) After pre-incubation of sera with extracts of crossreactive parasites (after absorption of cross-reactive IgG), the ELISA test was performed on the same sera. Sensitivity, specificity, positive and negative predictive values for both of the two methods was determined. Results: This study has been carried out on 462 sera samples. Sensitivity, specificity, positive and negative predictive values for ELISA test without pre-absorption were 91, 93, 59, 99 and for ELISA test after pre-absorption were 93, 96, 73, and 99, respectively. Conclusion: The modified ELISA (after pre-absorption) is more sufficient for the diagnosis of strongyloidosis. Further studies are appreciated.

Background: Regarding the high prevalence of anxiety and its known complications in mothers with hospitalized children, the present study was designed to evaluate the effects of mothers' participation in nursing care of hospitalized children on anxiety level of mothers in Mofid Hospital in Tehran, 1997. Materials and methods: This experimental study was conducted on 120 mothers who were randomly divided in two groups of case (40) and control (80). Following the second day of children hospitalization, mothers' anxiety level was controlled with Spillerger test. The case group was received education about nursing care of their children and participated in cares. Two days later, mothers' anxiety levels were controlled for the second time. Results: Factors such as mothers' anxiety, mothers' age, child's age, mothers" occupation, child disease, family size, family economic status, sex, previous hospitalization and use of tranquilizers were similar in both groups. Results have shown that state anxiety have greater decrease from moderate to mild in case group (33.5%, p<0.0001). In control group the decrease of state anxiety of mothers was much lesser than the case groups (2.5%). Trait anxiety has shown no significant difference between the two groups. Conclusion: Results have revealed that participation of mothers in nursing care of children can reduce the state anxiety.