Journal of Isfahan Medical School
Year:2011 | Volume:29 | Issue:150|Papers Count:10

Background: Thromboembolism is one of the major surgery complications with high rates of mortality and morbidity. We compared effects of two methods of heparin administration (continuous vs. intermittent) on coagulation state after peripheral vascular surgery.Methods: This randomized clinical trial was conducted on 120 patients underwent peripheral vascular surgery in Alzahra University Hospital in Isfahan, Iran. Patients randomized to receive continuous (750 u/kg/24h, n=60) or intermittent (150 u/kg/4h, n=60) heparin infusion. In the continuous infusion group, PTT was checked every six hours, and in the intermittent group PTT was checked 10 min after each dose and then 1 min before the following dose. Platelets counts, hemoglobin, hematocrit, and bleeding were precisely monitored.Findings: The two groups were similar in age, gender, concurrent disease, and type of surgery.Thrombosis was occurred in 18.3% and 3.3% of the patients in the continuous and intermittent heparin infusion groups respectively (P<0.05). PTT greater than 58.5 s was seen in 20% of the patients in continuous group versus 6.6% of the patients in intermittent heparin infusion groups (P<0.029). No cases of heparin induced thrombocytopenia or active bleeding was occurred, but decreasing in platelets counts was observed in one patient (1.6%) in each group.Conclusion: The intermittent heparin infusion has better outcomes compared with continuous infusion in preventing thrombosis after peripheral vascular surgery. Future studies with larger sample sizes and longer follow-ups are required before recommendation of this strategy for prevention of thrombosis after surgeries.

Background: Refractive surgery is the most rapidly evolving issue in ophthalmology. In this study, we compared the effect of two phakic intraocular lenses, Artisan and Artiflex, in refractive surgery.Methods: In a prospective clinical trial studyd 58 eyes of 29 patients with high myopia were treated by phakic intraocular lenses. Artiflex lens was used in 24 eyes and Artisan lens in 34 eyes. Patients were followed up for 6 months. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and refraction were assessed in both groups.Findings: Artiflex lens had better visual outcomes, but the difference with Artisan lens was only significant in first two months of follow-up. After 6 months, both groups had similar visual outcomes.Although astigmatism was greater in Artisan group in first three months, refraction in both groups was stable after 6 months and the results were not significantly different between the groups. Adverse reaction was not noticed.Conclusion: Artisan and Artiflex had similar long-term outcomes but refraction and vision establishment occur in a shorter period in Artiflex lenses.

Background: Organophosphates poisoning (OP) is the forth common cause of poisoning and the second cause of death in poisoned patients in Isfahan referral poisoning center. Early diagnosis and appropriate management can reduce both, the complications and mortality. In this study, we determined the predictive factors of endotracheal intubation in patients poisoned by organophosphorus pesticides.Methods: This was a descriptive analysis cross-sectional study. We collected the data of all poisoned patients referred to Noor and Ali Asghar hospital from 2009 June to 2010 October.Findings: In the study period, 43 patients with organophosphate poisoning were evaluated. The prevalence of muscarinic, nicotinic and central nervous system manifestations were 88.4%, 44.2% and 39.5% respectively. Vomiting (55.8%), sialorrhea (41.9%), change in mental status (30.2%), miosis (23.3%), and diaphoresis (23.3%) were the most frequent signs respectively. Overall mortality rate was 13.1%.There was a significant difference in miosis, respiratory distress, bronchorhea, central nervous sign and changes in mental status, and abnormal chest auscultation in endotracheal intubate patients. More than 35 years of age, more than 90 mmHg of diastolic blood pressure, greater than 126 mg/dl blood sugar, change in mental status, abnormal chest auscultation, central nervous system sign, miosis, respiratory distress, and bronchorhea would predict requiring to intubation.Conclusion: The found predicting factors can help emergency physicians to admit patients with organophosphates poisoning in the intensive care unit (ICU) to reduce mortality and morbidity.

Background: Many studies have recognized high-risk behaviors in prisoner populations. The prevalence of sexually transmitted diseases and blood born diseases in prisoners are often higher than the general population. AIDS and hepatitis are the most important diseases among prisoners. The purpose of the present study was to determine the prevalence of high-risk behaviors, in women prisoners in Isfahan, Iran.Methods: In this cross-sectional study, all of the women prisoners in the central prison of Isfahan were investigated. Demographic characteristics and high-risk behaviors information were fetched by a standardized questionnaire. Data was analyzed by descriptive tests andχ2, Kruskal-Wallis, and Mann-Whitney tests. P<0.05 was considered statically significant.Findings: 160 women prisoners were investigated. Smoking (31.3%), addiction (30.1%), multiple arrests (26.4%), extra-marital sex in their husbands (22.1%), alcohol drinking, extra-marital sex and temporary marriage (17.8%) were the most common high-risk behaviors in the studied population.Smoking, drinking and addiction was seen respectively in 92 persons (60.2%), 42 persons (26.9%) and 62 persons (39.2%) of prisoners family.10 women (6.4%) claimed intravenous drug abusing in their families.Conclusion: Regarding the results of this study, performing the harm reduction and preventing programs in prisons and obligation of raising awareness in high-risk groups is recommended.

Background: Dermoid cyst is one the most common developmental lesions in the embrioyonic period.The cyst can exist anywhere but commonly is seen in the midline of the body. One of the uncommon areas dermoie cysts are seen is temporal area (postauricular skin, the middle ear or, even rare on the Eustachian tube).Case Report: In this study, a rare case of a dermoid cyst located behind the ear with abnormal gradual growth in several years is reported.