Researcher Bulletin of Medical Sciences
Year:2005 | Volume:10 | Issue:1 (43)|Papers Count:12

Background: Previous studies have shown that CMU and CMR tests have more sensitivity than other routine NCV tests in diagnosis of carpal tunnel syndrome(CTS).The objective of this study is the assessment of diagnostic value of these two tests.Materials and methods: In this clinical trial study that was performed on 100 suspected cases of CTS, the difference between sensory potentials of median and radial nerves in thumb (CMR) as well as sensory potentials of median and ulnar nerves in ring finger (CMU) were recorded and then the comparison was made between the findings and gold standard methods (Electromyography and clinical criteria).Results: CMU has more sensitivity and specificity than CMR method. In addition, its specificity and positive predictive value is 100%. The use of CMR in addition to CMU dose not increase the diagnostic power of CMU method.Conclusion: CMU is recommended as the first step in diagnosis of carpal tunnel syndrome.

Background: MTBE is an Oxygenated material additive to the petrol. This material is used in lead free petrol in order to help the fuel burn better and its formula is CH3(CH3)3. As the result, the elimination of Tetra Ethyl and lead Tetra methyl, used for better burning of fuel, would cause the reduction of air pollution and refinement of air from organic lead compounds. This material has high solubility in water and very low biological resolution property. As the result, the leakage of petrol containing above material through underground reservoirs in petrol stations can cause distribution of contamination in underground waters or would bring about the danger of contaminating drinkable water wells in cities.Materials and methods: In the first phase was designed is to determine the location of 107 fuel stations in the city of Tehran Out of this umber about 22 stations supplied liquid gas and therefore they were eliminated from the list. Then location of above stations transferred on to a 1/35000 map. By studying geological maps and topography of Tehran district and examining the movement trend of underground water from these maps we studied the movement trend of underground waters. In this phase, with regard to the information obtained from Water and Sewage Company of Tehran province, about 384 wells in an area of 2500 sq.m were located.Results: The overall places selected were 55 locations that from each location 4 samples were taken and then by mixing 4 samples one final sample was chosen for sending to the laboratory. This has been measured by Chromatography Gas equipment together with FID detector. Three locations of the overall sampling locations showed some measurable contamination but less than the standard level therefore in the final phase for each suspected location 5 independent water samples were obtained and once again they were measured. The results of the second phase test were negative.Conclusion: The results obtained show that after 2 years of using lead free petrol in the city of Tehran, at the present the underground resources of this city are free of any contamination with the above agent. But in some locations some contamination with the above mentioned agent has been shown, although very little, and this would increase the danger of contamination of underground waters with the MTBE.The final conclusion is that all locations in danger of contamination should be periodically tested by Water and Sewage Company of Tehran Province in order to protect the quality of drinking water in the city of Tehran and this is a vital factor.

Background: Wilm's tumor is the most common primary malignant renal tumor of childhood.Improvement in surgical techniques and postoperative care, desirable response to the radiotherapy and multiagent chemotherapy and finally multimodal approaches to the Wilms' tumor led to the dramatic change in the prognosis and treatment responses.Materials and Methods: In this article we aim to assess 5 years results of Wilm's tumor in Mofid children's hospital since 1375 to 1379. All patients with Wilms' tumor entered in this investigation during mentioned years. Patient's characteristics as age, sex, disease stage, histopathologic features, and treatment modalities were recorded and analyzed with many statistical tests like Wilcoxom, Kruskall- Wallis and Spearman tests.Results: During the 5 years survey, 54 cases entered in the evaluation. The most common first reported signs and symptoms were abdominal mass in 88.9% of patients. 51.9% of patients were in stage II of disease, whereas 35.2% were in stage III and 13% were in stage IV. In advanced stages unfavorable histopathology were the predominant features, in such a manner that all 7 patients with stage IV disease were in the unfavorable histopathologic features. Metastases were seen in 24.1% of patients especially to the lung (84.6%). After NWTSG treatment protocol good response were seen in 83.7% of cases whereas 16.3% of patients died of their diseases.Conclusion: According to the patients stage we can choose mode of therapies. Aggressive protocols may be used for advanced stages of diseases and minimal therapeutic interventions in the lower stages to achieve the best results. Further studies to determine the best protocol according to the patient stage and histopathologic features is recommended.

Background: The studies of Friedwald and colleagues during the past 30 years about serum level LDL - Cholestrol Measurement show that the calculated methods for determination of LDL -Cholestrol level except of (Tg>400 mg/dl) hypertriglyceridemic, type 3 hyperlipidemic and non fasting patients have acceptable correlation with ultra centrifuge method. Because the calculated LDL -Cholestrol depends on the biologic coefficient varriation of total cholestrol, Tg, HDL, LDL, however, analytic evaluation by direct enzymatic method is necessary. The goal of study is comparing of enzymatic method (WAKO) for direct measurement of LDL -Cholestrol with calculated Friedwald and Delong methods.Materials and Methods: We investigated 525 non fasting patient's serum by randum sampling of patients who referred to the Labafinejad hospital serum LDL-cholestrol evaluated by enzymatic (WAKO) method with Diagnostic Kit. Then results of direct method compared with calculated methods (Delong and Friedwald).The validity of all three methods are evaluated by opspecs charts and sigmametric methods.Results: This study mean age was 52 Intra assays total cv of direct LDL-cholestrol in comparing to Friedwald and Delong methods were 2.6% and 1.6%, respectively. According to the linear regression analysis r value for Friedwald and Delong were 0/901, 0/894 respectively. Total analytical error of enzymatic, Friedwald and Delong were 8/5%, 9/3% and 0/3% respectively.Conclusion: According to the opspecs chart and sigmametric methods, enzymatic method with calculated methods had acceptable, correlation. Because of enzymatic method had maximum sigma number, best functional of point in opspecs chart, minimal observation control and no limitation of calculated methods, there for this method showed best efficacy and could be replaced to other methods.

Background: Previous studies have shown that acoustic reflex latency may abnormally increase in some retrocochlear lesions specially brainstem disorders affecting auditory system. Because temporal characteristics of impedance apparatus affect acoustic reflex latency, each laboratory should use normative data for specific equipment in determining acoustic reflex latency. The aim of this study was to determine normal values of ARL in octave frequency 500-2000 Hz and Broad Band Noise (BBN) for the immittance instrument used in Hearing Researches Center of Shahid Beheshti rehabilitation faculty. Ear effect and stimulus parameters on ARL were further studied.Materials and Methods: This descriptive analytic research was conducted on 28 normal hearing persons with age ranging from 18 to 45 (mean=27 years and SD=5.9 years). Contralateral and ipsilateral acoustic reflex thresholds (ART) were obtained by tonal stimuli 500-2000 Hz and BBN (only in contralateral stimulation). ARL was defined as the time interval between onset of the stimulus and the first detectable compliance change and determined in ART+10 dB intensity level.Results: The results of present study shows that ARL depends on frequency and intensity of acoustic reflex eliciting stimulus and increases with increasing frequency and decreases with intensity increases.There is no statistically significant difference between right and left ear ARLs in each ipsilateral and contralateral stimulation.Conclusion: ARL characteristics depend on the eliciting stimulus parameters such as frequency and intensity and are more stable in lower frequencies than higher frequencies. It is recommended that the normal values of ARL are determined in children and aged persons.

Background: Thrombocytopenia is a hematologic problem in neonates admitted to NICU. According to the frequency of thrombocytopenia and its complications and because of lack of such research in our country, this study was carried on neonates admitted to Mofid NICU during 2003-2004.Materials and methods: In a cross-sectional study, all neonates who were admitted to NICU, enrolled the study. They categorized to three groups regarding platelet count: non thrombocytopenic, mild to moderate thrombocytopenia and severe thrombocytopenia. Incidence of thrombocytopenia was determined and contribution of variables such as sex, gestational age, intrauterine growth retardation, intraventricular hemorrhage, sepsis, placental insufficiency and operation to occurrence of thrombocytopenia was analyzed.Results: There were 436 admissions (264 male, 172 female) during the study period, the overall incidence of thrombocytopenia was 25.2% (110 cases), which half of them had mild-moderate thrombocytopenia and half of them developed severe thrombocytopenia. Thrombocytopenia was significantly associated with prematurity, intrauterine growth retardation, intraventricular hemorrhage, sepsis and placental insufficiency. There was no relation between occurrence of thrombocytopenia and sex or operations performed in neonates.Conclusion: It seems that thrombocytopenia and its associated factors are prevalent in neonates admitted to NICU. Analytic cohort studies are recommended for identification of risk factors in neonatal thrombocytopenia.

Background: With respect to identified complications of stress incontinence, one of the most common types of incontinence, and controversies regarding its management and complications and lack of knowledge in this regard, this clinical trial was conducted to compare the effects of exercises in low pelvic muscles and vaginal cones on controlling stress incontinence at Farse province in 2001.Materials and methods: 61 grand multiparous women with normal urinalysis as well as FBS, and a history of stress incontinence for one year were included in the study after cystometry and confirmation of normal bladder volume by stress pad, vesical trigone, and pelvic myometrical tests. Those with diabetes, urinal and vaginal infections, cystocele (grade 3 & 4), uterus prolapse, forceps or vacuum delivery, macrosomic newborn, multiple pregnancies and previous pelvic operations were excluded. The subjects were randomly divided into two groups. After instruction, the first group (31 women) performed low- pelvic-muscle exercises 60 times a day (a 10-secondcontraction followed by a 10-second relaxation in each time) and the second group (30 women) practiced vaginal-cone exercises twice a day, each lasted 30 minutes over 12 weeks. Their sexual satisfaction was also assessed during this period. Different statistical tests were used to identify changes and differences between the groups.Results: Finding showed that, in general, both methods resulted in similar outcomes with no significant difference. In the first group, %32.3, %61.2, %6.5 and in the second group, %26.7, %63.2, and %10 of the subjects gained complete, 1st grade and 2nd grade control over their incontinence respectively (P<0.001).Conclusion: With regard to similar outcomes of the two methods, clients views and preferences may be incorporated in the selection process of these therapies.

Background: During the recent years, postpartum complications resulted in a 50% maternal mortality rate in our country. Although postpartum care services are accessible for the majority of mothers, however, it seems adequate attention is not paid to the quality of services, which could lead to mothers morbidity and mortality. This study aimed to access the quality of care in postpartum wards of Shaheed Beheshti medical university hospitals.Materials and Methods: This research is a descriptive study to describe the quality of care in postpartum wards of Shahid Beheshti medical university hospital. Using quality sampling 60 women who had normal vaginal delivery and had at least one alive child and no medical and surgical history were recruitted to the study. The assessment of vital sign, uterus and perineum, urinary system, GI system, breast and extremities and out of bed considered to be evaluated in this study. Observation and check list assessed these services.Results: The study was performed in the postpartum wards of Shaheed Beheshti medical university had 1 to 2 pregnancies and 83/4% had 1 to 2 alive children. Majority of woman had no history of dead infant and/or abortion. Quality of vital sign assessment and other care items were evaluated as weak.Majority of postpartum care, such as assessment of vital sign, uninary and GI systems were performend by nurses. Uterus, perineum, breast and extermitics examinations were done by resident and family of mothers helped woman to get out of bed.Conclusion: Result of the research showed that quality of care in postpartum ward of Shaeed Beheshti medical university hospitals is weak and needs to be improved in all aspects. This study shows that quality of postpartum care in the defined hospitals is weak. The study provided defined standards for postpartum care, which is necessary for regular monitoring and evaluation and so objective interventional programs to improve system of care. This study provides a valuable tool for evaluation of postpartum care services which can help the managers in planning, supervising and improvement of postpartum care services.

Background: Tonsillectomy is one of the most common surgeries in children. We studied prevalence of tonsillectomy complications in an university medical hospital and in a private hospital in Tehran, 1992- 2002.Materials and Methods: This retrospective study was performed on 4042 patients who has undergone tonsillectomy in a 10 years period. 2708 tonsillectomied patients in university medical hospital (first group) comparisoned with 1334 tonsillectomied patients in a private hospital (second group).Tonsillectomies were done in first group by junior ENT residents and in private hospital by ENT specialist. Both group comparisoned for complications as hemorrhage, hematoma, upper airway obstruction and tongue edema, recurrent vomiting, parapharyngeal space infection, dental complications, hoarsness, anesthetic complications, break down of surgery needle in tonsillar fossa and death.Results: Complications rate in university medical hospital (first group) was 3.95% and in private hospital (second group) was 0.45%. Bleeding that is the most common complication in post tonsillectomy patients was 2.18% in first group and zero in second group. Conclusion: Due to high prevalence of tonsillectomy in our country and because of high prevalence of post surgical hemorrhage that sometimes leads to death, tonsillectomy must be performed by an experienced ENT specialist and anesthesiologist.

Background: Despite marvelous improvements in the 20th century, discrimination and violation against women still exists in many parts of the world, which is deeply rooted in cultural problems. This descriptive study was conducted to assess physical injuries resulted from violating acts in women referring to forensic Medicine center in Tehran 2004.Materials and Methods: 171 women over 16 years of age sustained physical injuries were selected by convenience and purposive sampling methods. Data collection tools included a questionnaire and a standard checklist of the center. By interviewing and using the checklist to assess the severity of the injuries with the aid of a forensic medicine specialist, data were gathered over two months. Descriptive and analytical methods in statistics were applied for data analysis.Results: Most subjects were between 2635 and the majority of them (%55.5) was sustained injuries by their husbands. Feet and hands were mostly injured (45.5) and most damages (%68.3) included bruising and echymosis. Most subjects were economically and psychosocially supported at the time of violation.Based on standard scaling in forensic medicine, the severity of damages in 66.7% of cases was ranked moderate.Conclusion: It can be concluded that various complications of violating acts and physical injuries resulted from them can disturb maternal, social, and partnership roles of women and lead to work miss and heavy economical losses in the society. Paying attention to women as a susceptible part of the population and solving their problems are recommended.