Medical Journal of The Islamic Republic of Iran
Year:2010 | Volume:24 | Issue:1|Papers Count:10

Background: Gastroenterologists are required to obtain consent before undertaking any endoscopic examination. Published data indicate that in practice there are many deficiencies in this process. The aim of this survey was to determine the quality of information given to patients before the endoscopic procedures in Iran.Methods: A structured questionnaire about patient's informed consent before endoscopy was used. In the 3rd Iranian international congress of gastroenterology and hepatology, 100 endoscopists (gastroenterologist or internist) participated in this study regarding the quality of informed consent.Results: 90% of these physicians were male and 57% of them worked in Tehran (capital of Iran). The distribution of positive answers were as follow: Detailed information regarding the nature of the endoscopic procedure provided to the patient, 91%; the sufficient time to ask questions about the nature of the procedure, 82%; alternative diagnostic tests or treatment explained to the patient, 73%; patient informed about the possible complications of the proposed procedure, 32%; the patient informed about the mortality rate of the proposed endoscopic procedure, 15%.Conclusion: Although information about the procedure is given to the patients in 91% of the procedure, endoscopic practice must respect the ethical aspects of medicine and more attention need to be paid to informed consent and patient's information, especially about potential procedure- related complication and mortality

Background: Schizophrenia is a severe mental disorder and numerous genes and loci are beleived to be involved in this disease. Recent studies have reported a strong genetic association between DTNBP1 (dystrobrevin-binding protein 1) gene variants and schizophrenia.Methods: In this research, we used a case-control study to establish the possible association between the P1635 (rs3213207) polymorphism in the DTNBP1 gene and schizophrenia in an Iranian cohort of 200 unrelated patients and 200 controls. The allele and genotype frequencies of the polymorphism in the two groups were determined using PCR-RFLP and the data analyzed using logistic regression and Mantel-Haenszel chisquare tests.Results: The additive effect of the P1635 polymorphism in DTNBP1 and the previously reported G1001C polymorphism in the GRIN1 gene were investigated. Analysis of data revealed a strong association between the P1635 polymorphism and schizophrenia (AG genotype: OR=0.39, 95% CI=0.24-0.62, P<0.001).Conclusion: Our results indicated that the coexistence of the Aand C alleles from the two polymorphisms, P1635 and G1001C, increase the risk for schizophrenia.

Background: Parosteal osteosarcoma is rare low-grade malignancy which arises on the surface of the metaphysis of long bones; it has a low propensity to metastasize.Different surgical treatment options including marginal resection, wide resection and amputation were recommended for the tumor. The purpose of the study was to assess the results of different surgical treatment of the lesion.Methods: Thirty five consecutive patients with parosteal osteosarcoma were managed with four surgical techniques (Marginal resection, wide resection and prosthesis, wide resection and allograft application, and amputation) between 1378 -1387, and the results were retrospectively reviewed. The mean age of the patients when the surgery was performed was 30.37 (range, eleven to seventy one years), and the mean duration of postoperative follow - up was 51 months (range, eight months to ten years).Results: The mean time between the onset of symptoms and initial physician encounter was 15.98 months (range, 1.5 months to 60 months). None of the patients had metastasis preoperatively while three pulmonary metastases were detected postoperatively.Six patients had regional tumor recurrence postoperatively. The mean time of the recurrence postoperatively was 18.8 months (range, nine months to forty eight months). Three of thirty five patients assessed in the study died of pulmonary metastasis.All had dedifferentiated grading with different staging (Two patients had a stage of IIB and one with IIA). Medullary invasion was seen in one of them. One of the three patients was treated with Indomethacin for two years due to the misdiagnosis of myositis ossificans.Conclusion: Wide resection of parosteal osteosarcoma produces a satisfactory long - term outcome. However, individually - based treatment should be selected for each patient with parosteal osteosarcoma.

Objective: Shallots are important part of the diet for many people and there is long-held belief in their health enhancing properties. The aim of this study was to determine antifungal activity of shallot against reference fungal strains.Methods: Alcoholic and aqueous extracts of shallot (Allium hirtifolium) were tested for in vitro antifungal activities against Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, Penicillium gryseogenum, Alternaria, Microsporum canis and Trichophyton mentagrophytes. The minimal inhibitory concentration (MIC) was determined using broth macrodilution method. The effects of shallot extracts were also compared with those of miconazole.Results: Allium hirtifolium showed antifungal activity against all the fungi species tested with MIC values ranging from 0.058 to 0.8 mg/ml for alcoholic extract and 0.26 to 3.84 mg/ml for aqueous extract. The minimum fungicidal concentration (MFC) of alcoholic and aqueous extracts ranged from 0.1 to 12.8 mg/ml and 0.6 to 68.26mg/ml, respectively.Conclusions: The results indicate that crude juice of shallot has antifungal activity and might be promising, at least, in treatment of fungal-associated diseases from mentioned fungi.

Background: Osteoarthritis (OA) is the most common joint disease occuring after middle age. Because of the high mobility of the neck, OA is common in the cervical spine. The purpose of this study was to determine and compare the effects of intermittent traction on patients with mild and moderate cervical OA. Therefore, 32 patients with cervical OA were recruited.Methods: Aclinical trial study was designed for patients with cervical OA that were randomly assigned in two equal groups. Control group received a routine physical therapy protocol which included moist heat, transcutaneous electrical nerve stimulation (TENS), and an exercise for neck and shoulder girdle. Experimental group received a routine physical therapy protocol plus intermittent traction (IT).Results: Pain and mobility improved in both groups. There was significant difference in interaction of the improvement of cervical pain between the two groups, the rate of pain reduction; sleep ease, medicine taking and range of motion (ROM) improvement in the experimental group were higher than that of the control group.Conclusion: The results justify the efficacy of IT, therefore it can be concluded that the IT is an effective modality for patients with mild and moderate cervical OA.

Background: The disrupted-in-schizophrenia 1 (DISC1) gene, on the chromosome position 1q42, was initially identified at the breakpoint of a balanced translocation, t (1, 11) (q42.1; q14.3), which segregated with major mental disorders in a large Scottish family.Methods: Our samples included 200 unrelated patients diagnosed with Schizophrenia on the basis of DSM-IV criteria and 200 normal controls, which were gathered from Iran. The allele and genotype frequencies of the polymorphism were determined using Polymerase Chain Reaction-Restricted Fragment Length Polymorphism (PCR-RFLP) and the data were analyzed by Logistic Regression test.Results: In this study we genotyped the rs821616 polymorphism (Serin704Cystein) located within exon 11 of the DISC1 gene. The samples were matched on the basis of sex and ethnicity. We used the case control study to determine the possible association between the ser704cys (rs821616) polymorphism and Schizophrenia. Analysis of data in the samples, revealed no association between the rs821616 polymorphism and Schizophrenia (OR=0.697, 95% CI=0.47-1.033, P=0.072).Conclusion: In this study we did not find any association between the rs821616 SNPand schizophrenia.

Introduction: It is demonstrated that the degree of clinical improvement in Parkinson's disease (PD) achieved by deep brain stimulation (DBS) is largely dependent on the accuracy of lead placement. In addition, individual variability in the situation of subthalamic nucleus (STN) is responsible for spatial inter-individual fluctuations of the real patient's target.Objective: Our study was aimed to identify the anatomic location of STN from midcommissural point (MCP) in Iranian Parkinson's disease patients who underwent DBS by means of a 3-dimentional magnetic resonance imaging (MRI).Methods: Forty-six patients with the PD were recruied as candidates for bilateral implantation of STN-DBS (92 subthalamic nucleuses) were recruited. All these patients had bilateral implantation at the same operation. DBS and MRI parameters including the target coordinates (X, Y, Z) and the distances from MCP to the center of STN in all three axes on both sides were reported and calculated for each patient.Results: The location of STN was approximated by a site with 11 mm lateral, 3 mm inferior and 3 mm posterior to the midcommissural point. This distance was significantly lower in PD patients who aged>50 years in both right and left sides in the Y-axis direction.Conclusion: Our findings led to a considerable set of information which could help neurosurgeons during DBS procedure in Iranian PD patients. Despite the differences observed between various population of PD patients in the anatomical location of STN, our results further depicted the clustration of active contact points in same region.

Meningeal melanocytoma is a rare tumor of nervous system, which originates from leptomeningeal melanocytes. The locations of melanocytoma in the nervous system are most frequently in the posterior fossa or along the spinal cord, and usually appear as an extra-axial mass. The manifestations of tumor are most often due to its compressing effect on adjacent nervous structures that causes various neurological signs and symptoms depending on its locations.It may also cause superficial siderosis of the central nervous system [1]. In this case we describe another manifestation of this tumor which raised intracranial pressure and developed its neurological signs and symptoms. The patient was a 33-year old man with a two-year history of headache and tinnitus, transient diplopia, and had also a three- month history of progressive bilateral visual and hearing loss. The medical investigations of the patient reveal raised intracranial pressure (RICP) with a high concentration of protein in the cerebrospinal fluid, and an extra-axial mass at the T11-12 level in magnetic resonance imaging of the spinal cord. The patient underwent surgical removal of the tumor, in which the pathological study characterized the tumor as a meningeal melanocytoma. After surgery the CSF pressure returned to normal state, and its protein level decreased. The patient's hearing loss improved significantly but the visual defect did not change.Base on various causes of the RICP, especially when there is abnormality in CSF protein without any known cause, we must consider melanocytoma as a treatable cause, and thus in such patients, performing spinal cord magnetic resonance imaging (MRI) is a valuble technique for diagnosis as well as investigation.

Bizarre parosteal osteochondromatous proliferation (BPOP), also known as Nora's lesion is a rare osteocartilaginous lesion composed of a disorganized mixture of cartilage, bone, and fibrous tissue. In this article we report a case of BPOP arising on the proximal and middle phalanx of ring finger in a 31 year-old woman. The clinical, radiographic, MR imaging and histopathologic findings of it are described. The symptoms regressed spontaneously in 2 month after incisional biopsy.

Intestinal malrotation is a general term used for any deviation from normal embryonic GI tract rotations. This abnormality, denotes a spectrum of conditions (non rotation, incomplete rotation) that according to the severity of anatomic consequence, can result in complications found in infancy, childhood, adolescence, adulthood or old age.This article, reports another case of intestinal malrotation leading to acute midgut volvulus and intestinal obstruction with introducing a new surgical technique to prevent recurrent volvulus and a review of the literature.