Background and Objectives: Sulfasalasin (SAZ) is the main drug of choice for the treatment of ulcerative colitis (UC). Existing sulfafyridin in sulfasalasin is nost therapeutically effective, however it is responsible for 5 - Aminosalicylic acid transport and its side effect. Keeping the therapeutical effects of drug, sulfapyridin has been omitted from mesalamin (MZ) to omit its side effects. Regarding mesalamin’s high cost, present study was conducted for the comparison of the effects and side effects of these two drugs in treating UC to clarify the cost - effectiveness of each drug.Materials and Methods: A total fourty patients with UC, who had the same severity of disease on the basis of clinical, laboratory, endoscopic and histologic findings and based on scoring, were treated randomly with SAZ or MZ. They underwent clinical examination after 2 and 6 weeks of therapy, followed up by clinical and endoscopic examination after 3 months. Results: Disease severity index in MZ group decreased from 15.1 (SD=3.4) at admission time to 6.9 (SD=5.6) 3 months after therapy, and in SAZ group from 14.4 (SD=4.4) to 4.6 (SD=4.7), that is, both drugs caused improvement in the severity of disease (p<0.0001). However, the comparison of the response to drugs in two groups didn’t show any significant difference (p>0.16). Few and mild side effects were observed in SAZ group.Conclusion: Therapeutic response of sulfasalasin and mesalamin in the therapy of UC is the same, however sulfasalasins side effects are few and mild.
Background and Objectives: Preperitoneal mesh technique is one of the best and successful surgical method for repair of recurrent and large bulky inguinal hernias. Mesh repair by this method is being utilized by several specialized hernia centers, and has brought down recurrence or rerecurrence rates less than 2 percent.Materials and Methods: A total of 2,718 patients having undergone inguinal herniorrhaphy during the five -year period in Sina Hospital were identified through their case reports, and 101 patients (99 males, 2 females) were found being operated by peritoneal mesh repair. Results: Nearly most of patients were farmers or manual workers or had an aggravating factor in developing hernia or recurrence of hernia or whose work demanded heavy physical labor. According to Stoppa hernia stratification, 42 patients were of type III and 59 patients were found as type IV. Sixty five patients underwent bilateral and 30 patients unilateral Stoppa repair, while remaining 6 patients had a laparoscopic transabdominal preperitoneal mesh repair. The other purpose of this study was to observe any complications developed during hospital stay and postoperative follow up period. There was one report of infection developed in incision, one case of hydrocele and a case of hematoma. A patient who developed cirrhosis had expired. Eighty percent of patients returned to usual daily activity 2 weeks after operation. Only one recurrence was observed occurring as a femoral hernia in five years follow up period.Conclusion: Although preperitoneal mesh repair makes duration of stay (average 3.5 days) longer as compared with traditional hernia repair, it is associated with more advantages such as less complications, lower recurrences and patients return fast to the their usual activity.
Background and Objectives: In patients with chronic renal failure , delayed visual evoked potential (VEP) in addition to peripheral neuropathy is reported. In this study delayed visual evoked potential (VEP) was tested in chronic renal failure (CRF) patients on hemodialysis and those with renal transplantion.Materials and Methods: A total of thiry three patients in two groups were selected for VEP test. Group I consisted of 17 patients with CRF on hemodialysis (aged 19-60 years) and Group II included 16 transplanted patients (aged 19-57 years). We studied pattern shift VEP (PSVEP) with 34 checks after ruling out diabetes and ophthalmologic examination. P100 wave latency and amplitude were compared between two groups with students t-Test. Results: VEP abnormality was seen in 35% of hemodialysed patients, while such abnormality was not observed in 16 transplanted patients. Mean P100 wave latency with 34 checks in group I was 110±9.95ms and in group II it was 103±5.28 ms and this difference was significant (p<0.05). P100 wave amplitude in group I was 6.9µv and in group II it was 9.4µv, however this difference was not significant (p>0.05). There was no significant relationship between VEP and hypertension, creatinine, PTH, duration of hemodialysis and transplantation (p>0.05).Conclusions: Delayed neural conduction in visual pathway is seen in patients with chronic renal failure, that can be improved after successful renal transplantation. Etiologic factors associated with abnormality might be circulating toxins or demyelination.
Background and Objectives: A large percentage of all work-related illnesses are observed in the form of occupational skin diseases (OSD). In sensitized people latex glove allergies may cause contact dermatitis, which results in inflammatory epiderm, redness, itching and burning. In acute stages, in addition to pruritus, erythema, vesicules and edema are seen among the patients. This study presents the effects of contact irritants and tissue reactions according to sex, age, record of service, previous skin diseases, number of hand-scrubs, various surgical gloves, antimicrobial agents and subject of wetness.Materials and Methods: This study was done on 80 persons associated with surgical procedures i.e. doctors and nurses of Tabriz Teaching hospitals, who were selected randomly with average age of 20-69 years. Thus, the study included forty percent males and 60% females. They were asked for any case of coincidence by the way of questionnaire and a check list of 32 questions was given, which all of them replied.Results: Analysis of the results revealed that contact dermatitis is mainly related to latex gloves (94.9%), antimicrobial agents (35.3%) and the number of surgical scrubs and powdered gloves (25.5%). It seems that by giving some useful recommendations the hazards can be reduced significantly among related surgical teams.Conclusion: Considering wide range of related studies and findings, the hospital nursing administration should form a Latex committee for promoting awareness of natural rubber and usage of synthetic "Vinyl gloves" is suggested. Use of antimicrobial agents with standard concentration, usage of vinyl gloves and also drying hands with two towels are recommended for the prevention of potential hazards of allergy.
Background and Objectives: Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) of scalp and face are more prevalent carcinomas. These carcinomas frequently invade parotid region and upper face, hence need more investigations. The aim of this study was to investigate the effect of surgery on the treatment of malignant metastatic neoplastic disease of the parotid lymph node with or without radiation, excluding those with primary salivary gland tumor.Materials and Methods: Retrospective review of 20 patients, admitted in Imam Khomeini hospital with malignant parotid lymph nodes from primary cutaneous malignancies or lymphoproliferative disorders, was undertaken for study. The patients case files were reviewed and tabulated for age, gender, histopathological report, treatment and it’s outcome.Results: Out of 20 patients which met the criteria for the study, 16 of them had neoplastic nodes from cutaneous malignancies, 13 were observed with squamous cell carcinoma, two had metastatic neoplasm from melanoma, and one was having metastatic neoplastic node from basal cell carcinoma. Four patients showed neoplasm involvement from lymphoproliferative disorders.Conclusion: Metastatic disease of the parotid nodes or direct extension of primary cutaneous malignancy to nodes demonstrated a poor prognosis in this series, thus prognostification of lymphoproliferative disorders is more favorable.
Background and Objectives: An increasing trend in acute coronary events is being observed in premenopausal young women who are admitted in coronary care unit. With respect to above phenomenon, we decided to evaluate these patients prospectively in a cohort study, considering serum lipoprotein (a) [LP(a)] level and coronary risk factors. Materials and Methods: Out of 79 cases studied, 62 belonged to patient group and 17 cases were Results: From the patient group, forty six cases (75%) had LP(a) level of > 30 mg/dl and 16 (25%) had LP(a) level of <30 mg/dl as compared to the control group, which is a significant difference (p=0.033).Thirty nine cases from patient group were admitted with acute myocardial infarction, 30 of them had LP(a) level of >30 mg/dl, and 9 had<30 mg/dl, difference being statistically significant (p=0.04). Those patients who were admitted with thromboembolic events such as pulmonary emboli, cerebral emboli and occlusion of bypass graft vessels (4 cases) had LP(a) level of > 60 mg/dl, however this phenomenon was not observed in those cases with LP(a) level of <60 mg/dl.Conclusion: It can be concluded that there is a good correlation between abnormal elevated lipoprotein (a) and coronary artery disease in premenopausal women.
Background and Objectives: Vitreous hemorrhage is one of the serious diseases that causes visual acuity loss. This study was done to describe the etiology, clinical characteristics and therapeutic results of spontaneous vitreous hemorrhage.Materials and Methods: During a six months period, all patients with spontaneous vitreous hemorrhage were retrospectively studied in clinic of Nikoukari Hospital, Tabriz. For 51 eyes of 47 patients a complete physical examination and paraclinical work up was done, then final visual results were evaluated. After 6- 15 months (average 7 months) follow up period, visual acuity, background disease, common etiologic causes, slitlamp and ophthalmoscopy examinations were performed.Results: Out of 47 patients included in the study, 27 (57.4%) were men and 20 (42.6%) women. Average age of these patients was 57 years. The most common causes of spontaneous vitreous hemorrhage were: proliferative diabetic retinopathy (47%), retinal vein occlusion (37.2%), age - related macular degeneration (7.8%), retinal breaks (3.9%), posterior vitreous detachment (1.9%) and Eals disease (1.9%). Before treatment, visual acuity was less than 0.1(5 .8%cases ), hand motion and finger count were 11.7% and<6 (82.3%) respectively. After treatment visual acuity increased up to 0.1 (17 cases). Medical treatment, laser photocoagulation and deep vitrectomy surgery were done in 3 (5.9%), 18 (35.3%) and 14 (58.8%) cases respectively.Conclusion: Proliferative diabetic retinopathy was the most common cause and retinal vein occlusion and age - related macular degeneration showed an increasing prevalence rates. This study showed that visual results of retinal laser photocogulation and deep vitrectomy were statistically significant (p<0.05).
Background and Objectives: Autorefractometer is usually used in every eye clinic. Clinical retinoscopy and Jackson cross cylinder refinement are very accurate methods for measurement of refractive errors. The aim of this study was to evaluate accuracy of autorefractor Topcon RM-A2000 for measurement of refractive errors.Materials and Methods: In a prospective study of refractive errors, a total of 300 patients, between 5-75 years old, underwent clinical retinoscopy, Jackson cross cylinder refinement and refractive error measurement with Topcon RM-A2000 autorefractometer for both the eyes. Sphere, cylinderical power and cylindrical axis examined by of autorefractometry were compared with the findings observed with clinical retinoscopy and Jackson cross cylinder refinement.Results: In our study, myopic shift was observed in eyes of all patients on autorefractometry due to instrument myopia.Conclusion: It is concluded that autorefractometry is an instrument for refractive error estimation and the results should be refined before spectacle prescription
Background and Objectives: Schizophrenia is a mental disorder which causes severe psychological and occupational problems. Manner of treatment, long - term follow up and even family life style are important factors in determining the rates of deterioration. The aims of this study were to prospective evaluate the rate of deterioration in chronic schizophrenic patients, as well as to study the patients socioeconomic status, number of hospitalizations, quality of care and level of their functioning.Materials and Methods: One hundred patients who had been schizophrenic for about four years were followed up in a prospective study. Several factors including age of onset, sex distribution, geographical distribution (urban versus rural), degree of deterioration in male and female patients, socioeconomic level, number of hospitalization, length of hospitalization, quality of care and compliance, and level of functioning according to the Global Assessment of Functioning (G.A.F) scale were thoroughly examined.Results: This study showed that schizophrenia had a relatively earlier onset in our patients compared to the available data about schizophrenic patients in western countries. The ratio of patients coming from urban areas versus rural areas was 2:1. Fifty five percent of patients were hospitalized less than three times, 18% less than five times, and 21% had been for more than six times. Quality of care and patients compliance was poor. The score of G.A.F. scale compared to western data was low and in about 80% of cases it was even lower than 40.Conclusion: These findings suggest that therapeutic interventions for patient with schizophrenia should be enhanced and expanded from mental hospitals to society and families.