Journal of Isfahan Medical School
Year:2016 | Volume:34 | Issue:395|Papers Count:6

Background: In intertrochanteric fractures، dynamic hip screw (DHS) is the most frequently used tool، but several studies did not give good results for this device in reverse-oblique and transverse fractures. Current study aimed to compare fixation results of reverse-oblique intertrochanteric and short-segment subtrochanteric fractures using dynamic condylar screw (DCS) and DHS in patients referred to Alzahra and Kashani Hospitals in Isfahan, Iran.Methods: In a cross-sectional study، medical files of the patients referred to emergency units of the two hospitals who were diagnosed with intertrochanteric or subtrochanteric fractures and underwent DHS or DCS surgery more than 6 months before were assessed; they were invited for follow-up visit and examination. Written consent forms were taken from all the patients upon their entry; and they were examined in terms of complications including nonunion and failure of device and level of fracture improvement. These cases were evaluated by simple radiography ,too. Results obtained from examination of patients in addition to demographic information were recorded in the data collection form for each patient.Findings: Perfect union was observed in 14 (of 25) patients in DHS group and 21 (of 25) patients in DCS group (56% vs. 84%) six months after the surgery. Bone union was significantly better in DCS group (P=0.031). In addition, six months after the surgery, the devices used in 14 people in DHS group and 24 people in DCS group were fixed and the difference between the two groups was significant (P=0.001). 14 and 24 patients had total recovery in DHS and DCS groups، respectively (20% vs. 44%) with a significant difference (P=0.020).Conclusion: Considering obtained results, it can be concluded that using DCS is recommended over DHS due to severity of pain, bone union and fixation of the device.

Background: The succinylcholine as a muscle relaxant is used in patients undergoing electroconvulsive therapy; so far، cisatracurium has not been used routinely and any study has not been done on it. Only limited use of cisatracurium has been reported in the literature. The aim of this study was to compare the changes in heart rate and blood pressure induced by succinylcholine and cisatracurium in patients who are undergoing electroconvulsive therapy.Methods: This clinical trial study was randomized double-blinded without controls. The study included 68 patients who were candidates for receiving electroconvulsive therapy. Using convenience sampling method, the patients were divided into two equal groups. Randomly, each group received one drugs (cisatracurium or succinylcholine). The collected data were analyzed using independent t and chi-square tests.Findings: The mean duration of seizures, spontaneous respiration recovery time since the cessation of seizure, duration of seizure to full consciousnesd, residence time of recovery were significantly different between the two treatment groups (P<0.05 for all). As، the mean duration of seizures was more in cisatracurium group (38.02±8.16 s) compared to succinylcholine group (29.87±5.23 s); but, spontaneous respiration recovery time since the cessation of seizure, duration of seizure to full consciousness, residence time of recovery more in succinylcholine group.Conclusion: Cisatracurium is established as an intermediate-acting muscle relaxant with intermediate effect duration. Using low dose of cisatracurium، compared to succinylcholine, tends to shorter mean time to spontaneous respiration with much less complications after electroconvulsive therapy; it seems that cisatracurium can be a good alternative for succinylcholine in electric convulsive therapy.

Background: Poisoning is a common cause of seizure in an emergency department. Type of the seizure can be isolated, recurrent or as status epilepticus. Since accessing to different poisons and drugs is various among people of different societies and because of seizure complications، we investigated the prevalence of different type of seizures in poisoned cases.Methods: In a cross-sectional descriptive and analytic study، all cases with poisoning due to drugs or poisons admitted in Noor Hospital, Isfahan, Iran, during May 2014 till October 2016 were enrolled and those with seizure were evaluated regarding different variables including type of seizure and outcomes. Data were recorded in a check list and analysis using SPSS software.Findings: From 2319 evaluated patients, 137 cases were recorded to have seizures (101 cases of isolated type and 35 cases of recurrent or status epilepticus types). 123 patients committed suicide. Most of the cases were in age of 20-29 years. The seizure was common more in men. The most common drug in isolated seizure type was tramadol (61.4%)، combination of different drugs (8.0%) and anti-convulsants (7.9%); and in recurrent and status epilepticus type، tramadol (37.1%)، combination of different drugs (28.6) and anti-depressant and stimulants (8.6% each one) were the most used drugs، respectively.Conclusion: Isolated seizure was the most prevalent type of seizure in cases with poisoning. Most of the observed seizures were in men, age of 20-29 years, and by tramadol tablets.

Background: Esophageal cancer is the sixth cause of cancer mortality worldwide. While it is the sixth prevalent cancer in Iran, its incidence has been decreasing during the past 3 decades. Belonging to the HMG-box protein family, TOX3 (TOX high-mobility group box family member 3) gene is located on 16q12 chromosome. This study aimed to compare the expression of TOX3 gene in cancerous and non-cancerous tissue of esophagus.Methods: In this case-control study 40 formalin-fixed، paraffin-embedded (FFPE) samples of cases of esophageal Squamous cell carcinoma (SCC) and healthy tisuue were assessed. Samples were collected from patients referred to Imam Khomeini Hospital، Ahvaz، Iran، during 2005 to 2010. Total RNA was extracted and complementary DNA (cDNA) was synthesied. The relative gene expression was determined using quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR) and quantified using 2-ΔΔCT method.Findings: The expression of TOX3 gene was lower in tumor tissues compared to normal tissues. However,  it was not statistically significant (P>0.1).Conclusion: Our study revealed that the expression of TOX3 is lower in squamous esophageal cancer. Consequently، by considering all the data about the expression of TOX3 gene from various resources، it could be suggested that the TOX3 gene might act as a tumor suppressor in esophageal squamous cell carcinoma. Therefore، further studies should be done to elucidate the exact mechanism of action of the gene as a tumor suppressor in Squamous cell carcinoma.

Background: This study aimed to evaluate the diagnostic value of anti-Mullerian hormone (AMH) marker in predicting response to treatment of infertility in patients with polycystic ovary syndrome (PCOS).Methods: This study was conducted on 80 patients with PCOS who were candidates for infertility treatment. In all patientd the serum levels of AMH, follicle-stimulating hormone (FSH)، luteinizing hormone (LH), testosterone and estradiol were measured in the 3rd day of menstrual cycle; then were treated using clomiphene. For the patient who responded to clomiphene human menopausal gonadotropin (HMG) was added. Then, in the patient with follicle of size of 17 mm, human corionic gonadotropin (HCG) was administered followed by intercourse after 36 hours. After 14 days from HCG injection, βhCG was measured. In patients with positive βhCG, transvaginal sonography was done after 2 weeks. The relationship between serum level of AMH and pregnancy rate were assessed. P value of more than 0.05 was concedered as significant.Findings: Cut-of-point for AMH level according to presence or absence of pregnancy was 4.85 ng/ml and it was not statistically significant (P=0.079).Conclusion: This study shows that the serum level of AMH is not an appropriate predictor of responsing to treatment with clomiphene + gonadotropin in weman with PCOS.