TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)
Year:2004 | Volume:62 | Issue:8|Papers Count:14

Background: Trunk muscles have a major role in stability and integrity of spinal column. Quantitative recordings of muscle performance are basic components of rehabilitation program. Recording methods of muscle force are isotonic, isokinetic or isoinertial. Recordings with isostation 8200 apparatus are more similar to normal body movements. Up to now, because of sagita1plane locking in isostation B200, all of isometric functional recordings have been done in erect position of trunk (0 degree). Pay attention to noticeable effect of posture on the trunk muscles in activity, more investigations in this field are necessary. In order to do experiments, a special screw was designed; the main goal of this research was to study the effect of (0, 15, 30,45) degrees of trunk flexion on the isometric and dynamic torques.Materials and Methods: 53 healthy male subjects 24.72 (6.01) years old, participated in This semi-experimental research. After setting up position of subjects in B200 isostation apparatus, they were done five times dynamic movements in sagital plane and performing 3 times isometric contractions in flexion and extension directions respectively for 10 seconds, all data were stored in a floppy disk.Results: Paired Hest, indicated significant differences two by two between all isometric variables in 4 positions separately (P<0.01). ANOVA tests showed significant differences between all means of flexion and extension torques (P<0.01).Conclusions: Extension torques of trunk muscles were higher in all positions (0, 15, 30, and 45) degrees in comparison with flexion torques. Isometric extension and flexion torques increased linearly with increasing of trunk flexion positions. Relative differences of augmentation in flexion torques were more than extension due to upper trunk weight, gravity, hip flexor muscles and particularly stability of trunk in B200 apparatus.

Background: Thalassemia major is the most frequent hereditary anemia in Iran. In this study we wanted to evaluate liver status of these patients prior to bone marrow transplantation. Materials and Methods: Liver biopsies of 108 patients were evaluated for degree of iron deposition, fibrosis and inflammation, along with some clinical and paraclinical data.Results: In all of these patients some degree of iron deposition was found (16 percent had score 3 and 36 percent had score 4 of Marx and Sindram scoring system). Fibrosis was seen in 68 percent of patients, mostly of mild to moderate degree (HAI score: 1 to 4 ) and only 3 patients had severe fibrosis (HAI score: 5 and 6). Inflammation was absent in 30 percent of patients and others had mild to moderate degree of inflammation. Serum ferritin level above 1500 Microgram per liter was strongly related to increased degree of iron load, fibrosis and inflammation. Conclusion: Liver biopsy prior to bone marrow transplantation can be very useful in assessing degree of iron overload, fibrosis and inflammation.Conclusion: liver biopsy prior to bone marrow transplantation can be very useful in assessing degree iron overload, fibrosis and inflammation.

Background: In angioplasty of chronic total occlusion categorizing lesion characteristics may be useful for their impact on procedural success. There is controversy about the role of bridging collateral vessels in chronic total occlusion procedural outcome. This study investigated the effect of bridging collateral vessels on the success of coronary angioplasty in  patients with chronic total occlusions.Methods: Seventy seven consecutive patients undergoing coronary angioplasty for chronic total occlusion were classified into two groups. Group I patients had chronic total occlusion with bridging collateral vessels (27 patients), and patients in group II had not such vessels (50 patients). Results: Procedural success was achieved in 11 patients in group I and in 41 patients in group II (40.7% vs 82%; P=0.0002; relative risk 3.9; 95% confidence interval 1.7-6.4). Of 52 patients with successful results than patients with ≥3 months (63.5% vs 47.5%; P= 0.0001; relative risk 1.8; 95% confidence interval 1.3-2.6). Presence of a side branch of ≤2mm at occlusion point was a predictor of unsuccessful result (p=0.007; relative risk 2.9;95% confidence confidence interval 1.5-5.6). Conclusion: There are some morphologic variables which may be useful in guiding angioplasty in patients with chronic total coronary occlusion . presence of bridging collateral vessels is one of them , which appear to be inversely related to procedural success.

Background: Range of motion after total knee arthroplasty is an important factor measuring of the outcome and is crucial factor all of rating knee system. Our study was down to identify the most important factors that related with postoperative range of motion. Materials and Methods: We studied prospectively patients (68 knees) who had a primary total knee arthroplasty at the same center between 2000-2002. Ten preoperative factors (age, sex, extension lag, flexion contracture, flexion arc, tibiofemoral angle, body mass index, cause of joint destruction, prosthesis type about PCL retention or substitution, history of high tibial osteotony) were used to predict postoperative range of motion. Results & Conclusion: We used correlation analysis tree to identify the preoperative factors predicting the postoperative range of motion. The significant factors were preoperative range of motion, preoperative tlexion contracture and body mass index.

Background: Considering the high morbidity and mortality, evaluation of different aspects of subarachnoid hemorrhage (SAH) can be effective in improving the disease consequences. This article evaluates the angiographic findings and some epidemiological characteristics of in Iran.Material and Methods: In an observational study on 580 SAH Iranian cases, we reviewed the information of SAH patients in whom the disease was proved with brain CT scan and/or LP. In all patients, standard subtraction brain angiography had been done; including AP, oblique and lateral views. In vertebrobasilar arteries, AP and lateral views was done.Results: Sixty percent of all patients were male. About sixty percent of patients were 30-60 years old. Angiographic findings were as follows: 136 (23.4 %) Aneurysm, 82(14.1 %) AVM, 325 (56%) normal angiography and 37(6.3%) patients had other problems. Mean age of aneurismal patients were 46 years old and %59 were male. Over ally, 149 aneurysms were seen, meaning that 13 patients had two aneurysms. Sixteen (10.7%) aneurysms located in posterior circulation, and 133 (89.3%) located in anterior circulation. Fifty (33.6%) aneurysms were located in ACA 46(31%) IN ICA 37 (24.8%) in MCA (17% of total aneurysms located in P.Comm.A), 10 (6.7%) in vertebral artery and 2(1.3%) in PCA. Conclusion: High prevalence of disease in comparison to other studies could be due to relatively high exposure of men to some risk factors such as smoking or due to high percentage of men in this study. Lower P.Comm A aneurysms is an interesting finding that could help us in better understanding of pathophysiologic mechanisms of disease and may has an implication in diagnosis and of patients. High percentage of normal angiography can result from doing the procedure during vasospasm, use of high osmolar contrast media or lack of full angiographic views.

Introduction: uterine cavity diseases are a major cause of infertility with a 10-15% prevalence among infertile couples. Uterine cavity abnormalities are classified as: polypoid lesions (polyps or myomas), maternal anomalies (eg. bicornate or septate uterus) and intrauterine adhesions. So it is reasonable to achieve a diagnostic procedure with a high accuracy and low cost and side effects. The purpose of this study was the comparison between HSG(I)and HDS and the gold standard was hysteroscopy.Materials and methods: in this prospective study, 45 infertile patient who referred to Mirza Koochak Khan Hospital were underwent hysterosalpingography (HSG), hydrosonography (HDS) and hystroscopy. Hydrosonography was carried out by the use of a foley catheter (French 8). Saline solution was slowly infused to distend the uterine cavity and the cavity was assessed by transvaginal sonography.Results: hysteroscopy found 34 cases, normal and uterine cavity abnormalities were as the following: Polyloid lesions (7cases), intrauterine adhesions (2 cases) and bicornate uterus (2 cases). Based on these results, HSG procedure had incorrect results in 7 of 45(15.6%) cases, 82% sensitivity, 85%specificity, 64% positive predictive value PPV and 94%negative predictive value (NPV). Whereas HDS had only one case with incorrect result (2/2%). As a matter of fact HDS had a diagnostic accuracy of 98% versus 84% for HSG.Conclusion:This study confirmed the superiority of hydrosonography to hysterosalpingography iq evaluation of uterine cavity diseases, due to higher diagnostic accuracy for HDS.

Background: The aim of this study To evaluate the incidence of post tuballigation syndrome in Mirza Koucheck-Khan Hospital.Materials and Methods: 301 women were admitted for tuballigatin at our unit during 2000-2001. J93 were operated immediate post partum while 108 several months later. A questionnaire designed before this study and patients followed up at least for one year.Results: thirty cases (12.3%) experienced post operative pelvic pain and 93 (31%) several abnormal menstrual cycles. Mild to moderate psychogenic disturbances were seen in 61 (20.3%) and 4 (1.3%) of patients respectively. The women aged 30 years or less did not experienced abnormal menstrual cycle (P=0.0928). Those patients who used IUD before tubal ligation revealed improvement in menstrual dysfunction. The procedure itself (Parkland or Pomeroy Hospital Techniques) had no effect on menstrual cycle dysfunction. 66.1% of patients who had irregular cycle before operation revealed normal cycle one year after procedure.Conclusion: This, study showed that tubal ligation did not reveal any significant post tubal ligation symptom. Most of women who had abnormal menstrual cycle, improved after tubal ligation.

Background: we studied the effect of hyperglycemia on the seizure threshold to PTZ in mice. Materials and Methods: In control group PTZ injected via the tail vein 30 min after saline injection. In test group glucose 40% was used via gastric gavage and the hyperglycemia was approved by determination of plasma glucose concentration. Results: In control group plasma glucose was 300.93 mg/dl showing a significant difference in comparison with test group 97.15 mg/dl (P<0.001). After induction of hyperglycemia we determined the seizure threshold induced by PTZ.Conclusion: In conclusion, our results showed that in hyperglycemic mice the seizure threshold to PTZ is reduced, probably because of decreasing the GABA activity in the CNS.

Background: One of the most important aspects of fetal well being is adequate amniotic fluid volume. This study was conducted To test this hypothesis that maternal oral hydration increases amniotic fluid index in pregnancies complicated by oligohydramnios.Materials and Methods: A randomized clinical trial was performed in Mirza Kochek-Khan Hospital. In this study, 44 patients were randomized in two groups. 22 in each of hydration and control groups, in both groups basal studies including amniotic fluid index (AFI) and urine specific gravity were performed. Patients in hydration group were instructed to drink two liter of water in two hours (250 ml every 15 minutes for total of 2 hours). Control group drank their usual amount of water. Two to four hours after completion of hydration, USG and AFI were again measured.Results: Delta AFI (AFI after treatment- AFI before treatment) increased significantly in hydration group compared with control group (16.4±14 vs 0.36±13.4, P<0.001). Conclusion: This finding suggests that maternal oral hydration increases amniotic fluid volume. With regard to pregnancy outcome (gestational age at termination, route of delivery [Cls v/s vaginal delivery], and neonatal outcome. No significant statistical difference was noted.