Tehran University Medical Journal
Year:2001 | Volume:59 | Issue:1|Papers Count:23

The nervous system has an important and vital role in the human body, but unfortunately the repairment of damaged nervous tissue is very slowly. For a long time, The scientists have been involved in finding ways to speed up this process. Radiation of low power He-Ne laser has been suggested to as a way to improve this issue. In this study, 20 rats were divided randomly into control and case groups. The sciatic nevers of all these rats were damaged under general anesthesia and sterile conditions. The day of surgery was considered as the day zero. Rats of case group received every day laser radiation (λ=65 mm). At 27th day rats were killed by ether and the sciatic nerve was studied histologically. Data was analysed and the difference was significant. In the case group the repairment was faster.We concluded that low power He-Ne laser radiation on crushed sciatic nerve of the rats has accelerated the nerve repairment process.

A 4.5 years old boy with left postero superior lateral neck mass admitted to Shahid Rahnemoon hospital in Yazd. The mass had been noticed 2 years ago and there was no improvement after three times antibiotic therapy. On physical examination there were two masses on the neck. One of them was approximately 3×4 cm and the other was 2×2 cm.One of the masses was located in the left posterior auricular area and the other one in anterosuperior border of SCM. Both masses were mobile, non adhesive, with slight tenderness and without inflammatory signs (ie, redness, warmness etc). In surgery, the parapharyngeal deep neck space was filled by the yellowish-white color tumor with it’s «worm-like» projections, extended into the jugular foramen superiorly, lateral oropharyngeal wall medially and supra clavicular area inferiorly.Total resection of tumor was done. The patient was discharged after 5 days with good general conditions. Pathologic report was «Plexiform neurofibroma».

This study was conducted on 48 specimens of Rectus abdominis muscles for recognition and definition of passage and ramification of lower intercostal nerves. The main results of this study are as follows:1- The seventh and eight intercostal nerves penetrated to posterior layer of the Rectus sheath while other intercostal nerves perforated to dorsal layer of internal oblique abdominis aponeurosis.2- Distance between lateral border of the Rectus abdominis muscle till penetrate point for all nerves were 18 ±1 mm, but the subcostal nerve was 16± 1 mm.3- Each intercostal nerve was ramified in thickness of muscle and formed many branches that maximum of this was middle longitudinal region and minimum of that was lateral longitudinal region. In addition we did not observe the nerve anastomosis between intercostal nerve.4- The lower primary branch of the intercostal nerve after piercing of anterior layer of the Rectus sheath was named anterior cutaneous branch and terminated to abdominal skin.5- All of intercostal nerves at first was placed right angle to muscle Fibers but immediately decrease its and was placed parallel to muscle fibers.6- The entrance, passage and ramification of intercostal nerves in both male and female cadavers were similar.

The diabetes is an autoimmune disease, in which the role of autoantibodies is of a specific importance. The appearance of these autoantibodies can be the first symptom in the serum of type I diabetic patients, which may appear ten years before onest of the disease. The most important autoantibodies include Glutamic acid decarboxylase autoantibodies (GAD65-Ab). his can be used as a good tool for prediction in screening tests in type I diabetic patients.In the present study with prosedure RIA, we investigated the level of GAD65-Ab in patients with diabetes type I and their close relatives, and compared them with healthy persons.From the type 1 diabetic patients who have been suffering from the disease for periods of one week to twenty years, 63.3% of them had positive Anti-GAD658. This ratio was 8% in their close relatives, and 0% in healthy persons. The difference in Anti-GAD65 between the healthy persons and close relatives of patients was significant.This test may be employed in diabetes type I, as a screening test, and confirms the results of studies which have been conducted so far outside this country.

Breast cancer is a major cause of mortality in women due to malignant diseases and is the most prevalent type of cancer in western countries. According to investigations which has been done in Iran so far, the prevalence of disease in our country is also very high, therefore complete attention to clinical and pathological findings of this disease would be extremely essential. In this study, the direct relationship between axillary lymph node involvement and the aggressiveness of invasive ductal carcinoma has been brought into consideration.This study is a case series of 90 patients which all of them have had radical mastectomy because of breast cancer and all their samples has been referred to the center of pathology of Imam hospital. Based on modified Bloom-Richardson grading, all the samples have been graded. The study of all lymph node samples related to above cases has also been conducted along with the main study.The most frequent ages of disease was 31 to 40 and left breast had most involvement. from all cases, 12.2% were in grade I with 27.2% lymph node involvement, 66.7% grade II with 73.4% lymph node involvement and 21.1% in grade III with 100% lymph node involvement (p=0.00008).Based on statistical analysis we concluded that the axillary lymph node involvement in brest cancer is strongly associated with the aggressiveness of invasive ductal carcinoma.This important point should not be neglected in planning for treatment of this kind of disease.

PTK (Phototherapeutic Kertectomy) is the use of laser in corneal diseases. We can replace PTK for many other invasive procedures. The objective of this study is the assessment of this procedure in several cases in our practice.This investigation was a retrospective study, which was conducted based on comparison of 11 eyes with corneal eschars, induced by recurrent corneal erosions, pterygium surgery, corneal dystrophies and trachoma from 1994 to 1995.The mean age of cases was 32 years. The mean augmentation rate in hyperopia after one month was 1.5 diopter, and after one year it was 1 diopter. Although in two cases, the cylinder more than one diopter was induced, the mean rate for it was not increased significantly. One patient with recurrent erosion, who had not replied to any treatment, had no any complaint during one year follow up. During the follow up procedure, there were no any cases of vision loss among the patients.

This study was designed to determine if body mass Index was predictive of mortality in a sample of seriously ill hospitalized patients in intensive care unit (ICU) of Children’s Hospital Medical Center.There were 160 children from 1 month to 14 years in this prospective study for a period of 3 months in 1377. For all of the patients after calculation of BMI, the relation between age, sex, duration of illness, underlying diseases, positive family history of serious diseases, duration of admission in ICU, history of previous hospitalization, mechanical ventilation, albumin and PRISM score with mortality risk and outcome were determined. The percentile rank of BMI between 15 to 85 accepted as normal according to previous studies. In this survey the relation between BMI and outcome of the children in ICU were significant (P=0.0001). Also this relation was significant with the children in ages of 1 to 6 months, duration of hospitalization less than one or more than seven days, no surgery, mechanically ventiated patients.BMI, a simple anthropometric measurement of nutrition employed in community epidemiologic studies, has now been demonstrated to be a predictor of mortality in acutely ill children in ICU. Future studies examining variables predictive of mortality should include BMI.

Superficial mycosis of the skin is one of the most prevalent human infections. Within these infections, tinea pedis and tinea cruris have been studied. Different aetioligic causes play role in these infections which the most important of them are: Trichophyton rubrum, Trichophyton Mentagrophyte and Epidermophyton floccosum. Prevalence arrangement of these causes are deferent in societies.This study is a case series study which in the course of this period 42 affected patients to tinea pedis and 40 affected patients to tinea cruris have been studied. from patients with doubtfull clinical lesion, whom have referred to Razi Hospital within the first six months of the year 77, samear and culture were provided and in the meanwhile for consideration of possibile association of Dermatophytoses in these two location in cases of clinical doubt to tinea pedis among the affected patients to tinea cruris, smear and culture was made and it was observed that 40 of affected patients to tinea cruris, 4 patiemts simultaneously have tinea pedis (10%). in this study also, risk factors of tinea pedis and tinea cruris have been studied.Etiologic causes in tina pedis in this study with respect to arrangement are: T. Ment, T. rubrum and then Epid. floccosum and the causes of thinea cruris with respect to arrangement are: Epid. floccosum, T. rubrum and then T. Ment.In this study foot and groin Etioligic factors have been considered, it was observed that the patern of their etiologic causes in Iran with respect to other countries are different.

Abdominal masses in neonatal period is one of the main causes of patients bed ridden in infantile surgery wards. The rapid encounterance with these patients has caused a decrease in mortality and morbidity.This study is a kind of historical research which has been conducted on data base management systems of two above mentioned hospitals between years 1361-1378. The final outcome was only 25 cases. From these neonates, 68 percent were male and 32 percent were female. Most of the patients were in their first neonatal week. The etiologies related to urinary system (56 percent), were found to be in the first place. Tumors of different origins (20 percent), ovarian masses (12 percent) and gastrointestinal tract (12 percent) had their own places respectively.Majority of cases have had surgical operations (92 percents). The case fatality rate among these patients was 24 percent which most of it was because of benign causes. The rate of mortality in male was much larger than female neonates.We concluded that the inspection of embryo’s urinary system with ultrasound and primary examination of neonates, is vital and in most of the cases, an urgent surgery is indicated. Also laboratory assessment and radiological examination in suitable therapeutic procedures in first 48-72 hours is recommended.

A randomized clinical trial study was undertaken to evaluate the effect of intravenous oxytoxin (50 cases) and intracervical prostaglandin E2 (0.5 mg Tab, 50 cases) on the ripening of the cervix and frequency of successful inductions in patients with low Bishop score (< 5).Means of maternal age, gestational age, parity, BS at admission did not show any significant differences between the two groups. Until 6 hrs after beginning treatment, 72% of oxytocin group and 74% of PGE2 group were achieved active labor and until 12 hrs, 70% and 76% delivered respectively. It was no statistically significant difference. The mean drug administration to delivery time was 7.3 ±3.1 hrs in oxytocin group and 7.6± 3.1 hrs in PGE2 group (without significant difference). No difference in route of delivery was found between the two groups. Maternal complications were seen in 60% of oxytocin group and 46% of PGE2 group, without significant difference. Between maternal complications, frequency of diarrhea was higher at PGE2 group (P=0.02). Fetal Complications were seen 4% in the PGE2 group and 16% in oxytocin group, that was less in the first. RR=0.25 CI 95%: 0.06-0.97 P<0.05).

The objective of this study was to examine the correlation between both midfollicular FSH/LH ratio and number(s) of follicles with ovarian hyperstimulation syndrome (OHSS) in patients with polycystic ovarian syndrome (PCOS).This was carried out in IVF Unit at Mirzakouchak Khan Hospital. To induce ovulation, PCOS patients were stimulated with gonadotropines.Fifty four PCOS patients with normal basal level of FSH, LH were studied prospectively. 22 patients did not receive HCG and stimulation cycle was canceled due to OHSS. 32 patients received HCG and stimulation cycle was completed. In all patients mid-follicular (day 8 of stimulation protocol) serum FSH/LH ratio was measured. On the same day number of ovarian follicles were also counted using vaginal sonography.In canceled cycles, LH on day 8 was shown to be low along with increased number of follicles. The risk of cycle cancellation raised twice with one increment of FSH/LH ratio. Also, with increase of one follicle the risk of cycle cancellation increased 1.3 times.To induce ovulation by gonadotropine stimulation in PCOS patients, the dose should be carefully monitored. Measuring FSH/LH ratio and number of follicles on day 8 of stimulation protocol are reliable guides in order to predict those patients prone to develop OHSS.

This is a mortality study in internal medicine wards of Amir-alam Hospital, since the beginning of 1374 to end of 1376. Here, we reviewed, prevalence of diseases lead to death, the ward and invasive interventions and duration of admission of patients before death.In this study, records of 85 patients were reviewed.68.2% of patients were men and 31.8% women. Mean of age was 61.6% with minimum of 18 and maximum 95 years. The most prevalent diseases leading to death were cardio vascular (41.2%), cancer 29.4%, GI tract diseases (10.6%), pulmonary diseases (8.3%), CNS (7.1%), hemathologic (4.7%), DM (3.5%). Mean duration of stay in Hospital before death was 6.6 days (max 30- min 1). This figure in different wards were: ward 1(7 days), ward 2 (11 days), ward 3 (5.9 days) ICU (5 days) and CCU (4.7 days). 90.5% of patient died due to their diagnosed illnesses. Invasive tests and intervations were performed in 40% of them. As a whole 35 patient were died in CCU.This research and others like it shows the failures of our patient management system and can guide us in a approaching to better medical care

Pilonidal disease affects mostly young men during work and educating years and bears a host of complications. After excision of the pilonidal sinus, some surgeons leave the wound open (secondary healing) and others close the wound primarily. The aim of this study is to compare mean duration of stay, length of operative procedure, length of time to return to work, wound infection rate, recurrence rate, the residual scar, the amount of pain endured, number of dressings required after the procedure and the amount of time required for complete healing in pilonidal sinus patients undergoing each of the above procedures.Fifty patients with chronic pilonidal sinus were randomly chosen to undergo one of these surgical procedures. One-half were treated by surgical excision and fasciocutaneous flap (Group A), the other half were treated with surgical excision and secondary healing (Group B). All the patients were followed up during a six month interval.No cases of infection or recurrence were seen. Although Group A patients had significantly longer hospital duration of stay and the procedure performed was more time consuming, compared to those of Group B (P<0.001), But in this group of patients (Group A), the length of time to return to work, the residual surgical scar, the amount of pain and the number of postoperation dressings and the time required for complete healing were significantly less than group B patients (P<0.001).Considering the lesser complication rates observed in group A patients, and in view of the youth and health of the majority of pilonidal sinus patients which renders them tolerant to the lengthily procedure, the performance of the fasciocutaneous flap procedure is not only more cost effective but also results in more rapid return to work and greater patient satisfaction.This procedure is strongly recommended to other colleagues in this regard.

Between 1371 to 1379, of 10 patients with radial tunnel syndrome, 9 patients were treated by decompression of the posterior interosseous nerve. 8 patients were followed up more than 10 months. One patient improved without surgery. Half of the patients suffered from pain and all of them had variable degrees of paralysis in muscles innervated by deep branch of the radial nerve. The syndrome was diagnosed after an average of 26 months after onset of symptoms. 3 patients had associated endocrine disease and 2 patients suffered from another accompanied compression neuropathy. 8 patients performed strenuous, repetitive upper extremity tasks. EMG confirmed the diagnosis in all patients. The source of nerve entrapment was identified as the arcade of Frohse in 4 patients. Malignant soft tissue tumor was responsible for nerve compression in one patient. More than one pathologic site was responsible for nerve entrapment in another 4 patients. of 8 patients with enough follow-up after operation, pain was improved in all, but paralysis was improved in only half of them According to Ritts criteria, results were good in 50% of patients and in 50% of patients results were bad. All bad results were due to persistence of paralysis in affected muscles. One of four patients who had no improvement in paralysis, was satisfied with surgical result because tendon transfer was performed at the time of nerve decompression.It is recommended that all possible sites of nerve compression in the radial tunnel be explored and released.

To determine the complications of gold sodium thiomalate therapy in rheumatoid arthritis (RA), 32 patients with active RA (27 female, 5 males) treated for a mean period of 28 æ 14 weeks were studied.From these patients, 62.5 (46-79) percents showed at least one drug reaction. Pruritus was the most common complication occurred in 59 (42-76) percents, and was accompanied by skin rush in 37 (15-57) percents of cases. Renal, mucosal and post-injection complication developed, each in 16 (3-29) and percents of patients. Hematologic and pulmonary reaction occurred in 12.5 (1-24) and 9 (1-19) percents of cases respectively. Drug reaction resulted to discontinuation of gold therapy in 19 (5-32) percents of patients. Majority of drug reactions occurred during the first 15 weeks of therapy.In comparison to reports coming from other studies, drug reactions in Iranian patients were more frequent but less severe.

Denture stomatotos os a common problem of the denture wears, and it’s etiology is not clear from the literatures. Some studies show that the etiology is Candida albicans, while other reports point out the other agents including Candida aldicans. The present study was designed to evaluate the prevalence of oral candidacies in patients using complete denture with different datas.50 subjects all wearing complete denture participated in this study. The palatal mucosa was swabbed and swabs were cultured in Sabouraud’s medium containing 0.005% chloramphenicol then cultures were tested with common mycological lab tests.In 80% of patients oral candidacies have been diagnosed. In the investigation a direct relation between the oral candidacies and removal of denture at night, denture cleanliness, presence of any suction and symptoms of denture stomatitis was shown. No relation between the oral candidacies and sex, smoking habit, succeptible disease, angular cheilitis, the recent condition of denture and the retention of denture were found.The findings of our investigation indicates that Candida albicans is the causative agent of denture stomatitis while other factors such as denture cleanliness, removal of denture at night and presence of any suction may be considered as well.

Different aspects of multinomial statistical Modelings and its classifications has been studied so far. In these type of problems Y is the qualitative tandem variable with T possible states which are considered as classifications. The goal is prediction of Y based on a random Vector X Î IRm. Many methods for analysing these problems were considered. One of the modern and general method of classification is Classification and Regression Trees (CART). Another method is recursive partitioning techniques which has a strange relationship with nonparametric regression. Classical discriminate analysis is a standard method for analyzing these type of data. Flexible discriminate analysis method which is a combination of nonparametric regression and discriminate analysis and classification using spline that includes least square Regression and Additive cubic splines. Neural network is an advanced statistical Method for analyzing these types of data.In this paper properties of multinomial logistics regression were investigated and this method was used for modeling effective factors in selecting contraceptive methods in Ghom province for married women age 15-49.The response variable has a trinomial distribution. The levels of this variable are: nothing, pills, traditional and a collection of other contraceptive methods.A collection of significant independent variables were: place, age of women, aducation, history of pregnancy and family size. Menstruation age and age at marriage were not statistically significant.

The purpose of this study was to assess the prevalence of malnutrition and related factors that may affect the nutritional status of 0 to 59 month old children in the rural areas covered by the Birjand district health network.A total of 626 children were selected by random, sampling. Data were collected using a questionnaires and face-to-face interviews with the mothers and by measuring weight and height of the children. The nutritional status of the children determination was based on the z-score (cut-off poing under-2Sd from median reference population).Based on the z-score and under 2-standard deviation from median of NCHS in rural areas of Birjand, 18.5%, 40.1% and 3% of children were suffering from past-and-present, and present, malnutrition, respectively. Therefore the highest prevalence of malnutrition was related to the past- malnutrition and the stunting was the main problem. The chi2 test showed a statistically significant relationship between the children’s past malnutrition and fathers literacy (P<0.001), also between the children’s past and present manutrition and mother’s literacy (P<0.021) and past malnutrition (P<0.001). There was also significant relationship between, father’s main occupation, per-capita income (P<0.0001, P< 0.025 respectively) and children’s past malnutrition in the cases under study. In this research, relationship between sex and prevalence of malnutrition in both present-past and past malnutrition was meaningful, (P<0.024, P<0.017 respectively).This study did not show a significant relationship between nutritional independent variables and nutritional status of the children.