Feyz Medical Sciences Journal
Year:2004 | Volume:8 | Issue:31|Papers Count:20

Background: Lumbar and thoracolumbar fractures are among the most common fractures of spine. Some instable fractures require fixation and TLSO brace. Nowadays, pedicular screw are more commonly applied for rapid fixation and bone fusion, thus, it seems as if brace may be used less commonly. The present study was performed to determine the role of brace in lumbar instable fracture after fixation with pedicular screw in Loghman hospital. Materials and methods: For this clinical trial patients were assigned in 2 groups of with and without brace. Radiologic and clinical examination data of 1, 3, and 12 months after surgery were used to determine bone fusion. Chi square and Fisher's exact test were used for data analysis. Results: Of 56 cases with thoracolumbar fracture, 48 were fixated with pedicular screw. Falling was the most common etiology, L1 was the most common affected vertebra, and burst was the most common fracture type. Groups were similar according to demographic features. Fusion rate was 60% with brace and 58% without brace in a 3-month follow up; however, it was 100% in both groups after one year. Residual back pain did not differ significantly between groups. Conclusion: Brace did not influence the outcomes. Thus, patients with instable thoracolumbar fracture may not require TLSO brace following the pedicular screw surgery.

Background: Contamination of the ecosystems by industrial and agricultural pollutants has been of major recent concern. Recent rapid industrialization in developed and even developing countries and the resultant high demands for industrial products has led to heavy metals pollution. The bioaccumulation of metals in food chain and ultimately in human body could exert deleterious effects on human health and especially on sperm quality and quantity. This study was conducted to examine the morphological changes and motility parameters disturbances due to mercury exposures on fish sperms. Materials and methods: This is an experimental study on fishes' sperm. The fishes were with average weight of 1018 ±73 grams. The sperms were exposed to mercury with different concentration; 0, 0.1, 1, 5, 10, 50 and 100 PPM. Their effects were evaluated by ultra morphological and motility parameters. Results: The study showed that mercury concentrates had not effect on sperm, but in 5ppm or more mercury concentration, dropped of sperm tails could be observed. Motility characteristics of sperms had influenced by mercury with 0.1 PPM concentration or more. Conclusion: The results reconfirmed that mercury toxicity may be exerted via respiratory systems inhibition, thus, ultra morphological changes may not be observed in early stage. Immotile sperm and dead sperm can not swim and find the ovum to fertilize it.

Background: With respect to neovascular deterioration of high risk diabetic retinopathy patients and controversy reports of diode laser treatment effects, the present study was carried out. Materials and methods: This clinical trial was performed on 386 eyes of 224 patients. Neovascular formation was assessed around optic nerve or retina. If they were considered as the high risk group according to the DRS criteria diode laser treatment would be achieved for 4-10 sessions. Then, patients were reevaluated and angiography would be carried out to decide whether to continue diode laser treatment. Role of diode laser treatment on neovascular) deterioration of patients has been assessed on 3-month follow ups. Results: Of 386 eyes, 210 (54.4%) have shown good response to diode laser treatment. In 31.3%, vascular deterioration was incomplete, whereas 14.3% had no response (p<0.000). Conclusion: Diode laser treatment is an effective therapeutic approach for neovascular deterioration of high risk diabetic retinopathy patients.

Background: Despite the high incidence and prevalence of CTS, there is no exclusive data about normal values increment of motor and sensory distal latencies of median nerve at wrist according to age. This research was done in electrodiagnosis lab of Physical Medicine & Rehabilitation ward in Nemazi hospital in Shiraz between 1374-1379. Material and methods: This study was performed on 1200 cases that had no history of paresthesia and numbness in both hands and no history of diabetes mellitus, systemic disease, and electrodiagnosis evidence of no cervical radiculopathy or peripheral neuropathy. Tinel's and phallen 's tests were also negative in all cases. Normal values, increment of motor and sensory distal latencies of both hands median nerves were studied and analyzed in ten age groups from 10-80 years. Results: In this study, the mean normal value for distal motor latency of median nerve was 3.3 ms (2.50-4. 20ms). Increment of this value is mild (about 0.1ms per decade after 5th decade of Age – 50 life) and could be calculated with the following formula: DML (8cm)= (3.30+Age- 50 /75) ±0.0025 age. The mean normal value for distal sensory latency of median nerve was 3.2ms (2.7- 3.70ms). Increment of his value is mild (about 0.1ms per decade after the 51hdecade of life) that could be calculated with the following formula: DSL (14cm) = (3.20 +Age- 50/100) ±0.0025 age. Conclusions: It seems that age has significant influence on distal motor and sensory latencies at wrist. We recommend electrodiagnostic evaluations to be performed according to the age.

Background: With respect to the heat stress-induced complications in environment with high temperature such as bakeries, we designed a study to detect heat stress on bakeries in Kashan city.Material and methods: For this descriptive study, 175 randomly selected bakers in 100 bakeries in Kashan were enrolled. To determine environment heat stress, we used WBGT instrument and WBGT indices. The measures were taken by standard ISO 7234 method in the hottest hours of summer. Variants such as baking technique, type of bakery, type of ventilation and bakery space were evaluated. Results: Of 100 bakeries, 51 used machinery technique and 49 had traditional technique bakeries. Of 175 bakers, 107 (61.1%) worked in heat stress situation. The rate of this stress was 54.2% and 45.8% in machinery and traditional bakeries, respectively. Exposed to heat in traditional bakeries were 3.3 fold more than machinery bakeries. Conclusions: We are worried about heat stress in bakeries of Kashan. This situation was more pronounced in traditional bakeries. We suggest changing traditional technique to modern bakeries.

Background: Hypothyroidism is a syndrome caused by the diminished level of thyroid hormones. Its prevalence has been reported 1-8% in adequate-iodine and 10-20% in low-iodine level regions. The present study has determined the epidemiology of hypothyroidism in Gilan. Materials and methods: For this retrospective study, demographic data of ELISA-documented patients with hypothyroidism were gathered during a 10-year period SPSS soft ware was use for data analysis.  Results: Of 407 patients, 84% were females. The mean age of females and males were 37.9±14.8 and 39.5±17 years. Hashimoto was by far the most common cause. Fatigue and weakness were the most common symptoms. All patients had goiter of 1st to 3rddegree. Conclusion: Results have revealed that hypothyroidism is a common complaint in 40-60 years old females. Thyroid tests should be performed in high risk population.

Background: With respect to the importance of recording diagnosis in patients' medical data for educational, research and legal and statistic aspects, we designed a study on patients' medical records that were hospitalized in Kashan's hospitals in 1381.  Material and methods: This study was performed on medical files of 51 specialists working in Kashan University of Medical Sciences. Totally, 1071 medical records which were selected randomly, averagely 21 records for each physician, were included. We used the list of standard principle of International Classification of Disease (ICD-10). Data extracted and separated according to each hospital and clinical field.Results: Data were recorded correctly in diagnosis, orders, and external events, 87%, 77%, and 65%, respectively. The rate of diagnosis records were in its high level in Matini hospital (92%), and were in lowest range in Naqavi hospital. The rate of order records was 95% in Shahid Beheshti and in lowest range in Naqavi hospital (72.9%). The rate of principle of external events records were-in highest range in Shahid Beheshti hospital (77.8%) and in lowest range in Matini hospital (50%). Conclusion: We found the rate of recording level was good. It is correlated with attention of specialist and supervisor of medical data committee of university.

Background: There are controversies about the surgical approach for patients with Keinbock's disease. The aim of this study is to compare ulnar elongation and radius shortening in treatment of these patients.Material and methods: We design a clinical trial on 21 diagnosed patients with stage 2 Keinbock's disease. We randomly separated these patients in two groups. The first group was treated with ulnar elongation and the other with radius shortening. We followed the patients radiological while physical examination for union or post operation complications was achieved. The treatment outcomes were analyzed in each group by sign test and between two groups by Fisher's exact test. Results: 11 patients underwent radius shortening and 10 were operated by ulnar elongation. Age and sex did not differe significantly between groups. Surgical approach outcomes did not show statistical significant difference between two groups but the results were better in radius shortening technique. Conclusion: Although we could not find any differences between these two groups, it revealed that the radius shortening technique has preferred outcomes to ulnar elongation. We suggest further studies with more samples.

Background: The spirometric indices are important values in asthmatic patients. There are some reports indicating that IgE and serum eosinophilia could help to interpret spirometric status. The aim of this study was to determine spirometric indices, IgE and serum eosinophilia of asthmatic patients in Kashan. Materials and methods: 154 patients were enrolled in this descriptive study. They were referred to a private clinic and Shaheed Beheshti hospital in Kashan. These patients were examined for spirometry, total serum IgE and eosinophilic count. Patients were assigned according to <5% eosinophilia, >5% eosinophilia and also IgE <150U/ml and IgE >150U/ml. Groups were compared with t-test. Results: The study population included 76 male and 78 females with the mean age of 34.8±16.8 years. Spirometric indices and serum IgE did not show a significant association (NS). FEV1 was 73.8±21.6 in patients with <5% eosinophilia and was 62.9±19.4 in patients with >5% eosinophilia (p<0.01). Other spirometric indices did not show a significant association with eosinophilia status. FEF25-75% did not differ significantly between groups (NS). Conclusion: In middle-ages asthmatic patients spirometric indices do not correlate with patient's IgE status. There is a reverse relation between IgE and spirometric indices except for FEF. Further studies are strongly recommended.

Background: Waste materials are a matter of concern in most societies. In our country there is no documented analysis of these waste materials, thus, the resent study was designed to analyze the hospital wastes physically. Materials and methods: It was a descriptive study. Samples were gathered from hospital wastes of Shah id Beheshti, Shabih Khani, Matini, Naqavi, and Akhavan. Totally, 60 samples were gathered during the study. Then, a 50-kg sample was prepared, for which, waste analysis was performed according to different particles. Results: Totally, 15012 kg wastes were gathered. Shah id Beheshti had the highest and Matini the lowest wastes. Different particles were as follow: decayed materials 15.7%, plastic 13%, papers 5%, cloth 4.5%, glass 3.7%, metals 2.1%, and nylon 1.9%. Average monthly amount of waste for each Shahid Beheshti hospital bed was 2.9 kg, for Naqavi, Shabih Khani, Matini and Akhavan hospitals were 3.6, 5.9, 4.5, and 3.7 kg, respectively.Conclusion: The monthly average amount of wastes is high in Kashan hospitals. It is worth surveying.

Background: With respect to environmental aspects of solid waste recyclable material and its economical importance in rural region, this study was performed in Kashan rural region. Materials and method: This experimental study was performed in warm, medium and cold climatic region of Kashan, where they had solid waste collection system. 36 samples were randomly collected yearly and its recycled components and economical values were measured. Results: Research was performed in 3 rural with 7200 population. As recyclable material in Kashan rural region household consisted of 9.7 percent of total solid waste material, this material valued 300 Rials per kilogram and estimated of its solid waste per month was 108.2 ton and its collection and sanitary landfill cost was 324600 Rials. Value of recyclable material was 3352 monthly and because of non collection and sanitary landfill 320000 was saved. Recyclable in household solid waste material had 3572 thousand Rials benefit monthly and it can repair some of rural solid waste collection cost. Conclusion: Rural solid waste can be recycled and sold. We recommend this survey in total area.

Background: Emergency department has a vital role for dealing with life and death situation. Monitoring and evaluating the quality of care issues with an accurate and adequate data information system is of utmost importance. The aim of this study was to determine the rate of data information which was documented in emergency record in two hospitals of Kashancity. Materials and Methods: In spring 2002, this existing type data study was performed. 540 records were selected through simple random sampling. Data collection was based on legal, administrative and financial issues as well as personnel who were responsible to complete the data (physicians, nurses and administrative unit).Results: The survey has revealed that 14%, 12%, 14% of legal, administrative, and financial issues were remained undocumented. Meanwhile, 17% of admission-related, 11% of nursing-related and 17% of medical-related documents were d. The highest rate of documented data was achieved by nurses and the lowest belonged to physicians. There were significant statistical differences between two hospitals for type of issues and personal, time of discharge, external causes and orders to discharge, where the lowest elements were completed. Conclusions: The rate of documented information in emergency records of these two hospitals was comparatively good; however, some documentation items such as time of discharge, recommendations in discharge would need to be improved.

Background: Cytomegalovirus (CMV) infection is quite common. This disease has different variations in clinical symptoms. The aim of this study was to identify the symptoms, diagnosis pathway and clinical variations of cytomegalovirus infection. Therefore, in a 10-year period children who were hospitalized or referred to pediatric hospitals of Tehran city were selected. Materials and methods: This is descriptive study was performed on 41 consecutive cases. Diagnostic criteria were rising of CMV IgG-Ab titer in two separated time with two weeks interval. Tittering methods for this specific antibody was Elisa. Demographic features such as age, sex, onset of symptoms, clinical symptoms and laboratory findings were evaluated. Results: Of 41 infected children, 71% were boys, 58.5% aged less than one year, and 92.7% had experienced the disease during their first year of life. The most common symptoms were neurological (83%), developing defect (76%), seizure (54%) and microcephalus (39%). 24.4% had positive urine culture for CMV (active disease). Hepatomegaly and splenomegaly were the most common non-neurological symptoms (29.3% and 17.1%, respectively). Conclusions: CMV infection is a congenital infection which transmits from mother to children, so it is better that pregnant women in first trimester period and immature neonate wouldn't been exposed to suspicious patient with CMV infection.

Hip fracture and dislocation is a common orthopedic complication. However, multiple fractures and dislocations is a rare event that was not found in the literature. A 28-year man referred to our unit with multiple trauma. He had the following fractures: femoral neck, subtrocantric, posterior edge of acetabulum, posterior hip dislocation as well as impaction fracture of femoral neck. He underwent an emergency operation and all fractures were fixated with cephalomedullary nails. In a 4-month follow up, he seems to be fine.