Journal of Isfahan Medical School
Year:2010 | Volume:27 | Issue:103|Papers Count:12

Background: Despite the advances in techniques and the improvements in surgical implants, treatment of distal femoral fractures remains a challenge in many situations. Long-term disability can still occur if inappropriate treatment is done. This study was conducted to evaluate the results of distal femoral nailing in treatment of the distal femur fractures.Methods: In this cohort study, among patients referred to Kashani hospital in Isfahan, Iran from December 2005 to December 2007, 36 patients with distal femoral fracture were enrolled in our study. Patients were treated with retrograde femoral nailing. The patients' demographic information, Anterior Cruciate Ligament (ACL) tearing, duration of surgery, volume of hemorrhage, and after-surgery complications such as stiffness, infection and rate of union was obtained and reported. Findings: The mean of time of surgery was 97.4±11.6 minutes. There were not any ACL tearing in studied patients. In first two weeks, infection was seen in 4 patients that recovered. The rate of union was 100% after 6 month. Conclusion: Regard to results, retrograde nailling has very good results in treatment of distal femoral fractures.

Background: Prolonged smoking is a leading behavioral cause of premature mortality and disability, resulting in approximately four million deaths annually worldwide. Base on past studies, mean age for start of cigarette consumption is 20 years old which needs society sensitivity. The purpose of this study was to assess the knowledge, attitudes and practice regarding tobacco use of college students in Iran. Methods: A modified existing questionnaire originally developed for use in the US was adopted. A Farsi version of the final questionnaire was approved by a bilingual panel of scholars. Iranian participants were students at a large University in Tehran metropolitan. A total of 958 usable surveys were collected. Both descriptive and inferential statistical tests were employed in data analysis. Findings: Compared to male participants, Iranian female students scored higher in both knowledge and negative attitude scale of the questionnaire regarding tobacco use. Male respondents also were more likely to smoke cigarettes and use other tobacco products and in heavier quantities. Female students, on the other hand, had a higher rate of starting smoking at age 20 years or older, while their counterparts in the opposite sex did so long before that age. Conclusion: The findings should provide exploratory information about aspects of tobacco use among students (as an important and reference class of the Iranian society), and based on the results, recommendations are made to national health policy makers and health educators for reducing tobacco related risks through improving related knowledge, attitude and practice. The other recommendation is to avoid one limit in this study, and broaden the scope of this survey to other Iranian colleges using more representative and large samples of university students.

Background: Cardiovascular disease (CVD) is the leading cause of mortality worldwide. Various studies show meaningful relation between ECG change in the rest and CVD mortality. Present study was performed to consider the relation between ECG and CVD risk factors in Iranian community.Methods: This cross-sectional study was performed on 3343 subjects aged ³ 35 years from three provincial cities of Isfahan, Arak, and Najafabad. Questionnaire including questions on demographic and lifestyle information, as well as weight, height, blood pressure, hip and waist circumference measurement was completed. Laboratory tests including total cholesterol (TC), LDL, HDL, triglycerides (TG) and fasting serum glucose were measured as well. Ischemic criteria of ECG included minor and major changes in ST segment, T wave, conductive disorders, blocks and arrhythmia. Collected data were analysed using SPSS15 software. Findings: Ischemic changes in women were 1.5 times more than men (P < 0.05). Mean age of Ischemic group was 5 years more than non-Ischemic group. Comparison of lifestyle variables indicated that physical activity reverse to nutrient index, was significantly more in non-ischemic individuals compare to ischemic individuals. Smoking show a significant difference between two groups too (P < 0.05). Anthropometric variables including body mass index (BMI), hip and waist circumference and diabetic and systolic blood pressure in Ischemic group were significantly higher (P < 0.05). Biochemical factors including TC, HDL-C, LDL-C in ischemic group were significantly higher than non-ischemic group (P < 0.05).Conclusion: Considering of ischemic change in healthy individual with unhealthy life style or with risk factors, these points should be considered in evaluating of these individuals.

Background: Lack of job control can lead to stress and threats individual’s subject well-being. The purpose of this research was to examine the relationship of job control and stress and subject well-being. Methods: Statistical population of the research was all of the personnel of Isfahan Petrochemical Company from which 151 persons were randomly selected via simple random method. The research method was correlational. To gather data, the following three instruments were used: Job control Questionnaire of Wall, Jackson and Mullarkey (1995), Subject Well-being Questionnaire of Mollavi (2007), and Job Stress of Eliot (1994). The obtained data were analyzed via one group MANOVA and multiple regressions. Also, mean of work groups in term of subject well-being and stress compared by ANOVA and Scheffe paired compares test.Findings: The relationship of job control with job stress was positive and significant (b = -0.36, P < 0.05), and the relationship of job control with subject wellbeing (b = -0.34, P < 0.05) also the means of subject well-being (P < 0.05) and stress (P < 0.05) were different in work groups technical and general staff. Conclusion: If the employees have job control at work, they will experience job satisfaction and decreased stress. Also their subject well-being will increase.

Background: Hysterectomy is the second most common major procedure following cesarean section in many countries while the abdominal hysterectomy is by far the most common surgical procedure. The comparison of laparoscopic assisted vaginal hysterectomy and abdominal hysterectomy was the goal of our study. Methods: A randomized clinical trial was performed in 51 patients who were elective candidates for hysterectomy for nonmalignant reasons in Omolbanin hospital affiliated to Mashad University of Medical Sciences from 2005 to mid 2007. By simple random sampling method, 25 patients were elected for laparoscopic assisted vaginal hysterectomy (LAVH) and 26 patients were put in the abdominal hysterectomy group. Demographic, preoperative and postoperative data were recorded in a questionnaire. After checking normality, the data were analyzed by student's t-test and chi-square when applicable. P < 0.05 considered as significance level.Findings: There was no difference in procedure time and total length of hospital stay between laparoscopic assisted vaginal hysterectomy and abdominal hysterectomy (P = 0.856, P = 0.537, respectively). The analgesics use was significantly lower in the laparoscopic assisted vaginal hysterectomy group than the other (P = 0.001) while the amount of blood loss was significantly higher in laparoscopic assisted vaginal hysterectomy group (P = 0.001). Return to normal daily activity was more reported to be good in the laparoscopic assisted vaginal hysterectomy in the follow-up visit after lapse of 2 weeks after operation (P = 0.330).Conclusion: As a whole, our study showed laparoscopic assisted vaginal hysterectomy to be a safe and recommended alternative to abdominal hysterectomy.

Background: The goal of our study was determination of the role of the intraoperative microvascular Doppler sonography (MDS) in cerebral hemodynamics in aneurysm surgery. Methods: Twenty five patients (14 female and 11 male) with mean age of 57 years, admitted for surgery of cerebral aneurysms were involved in this study within 15 months. Intraoperative 20 mhz microvascular Doppler sonography of aneurysm sac and surrounding vessels was performed intraoperatively, before, and after aneurysm clipping to confirm complete obliteration of the aneurysm sac and patency of surrounding vessles. After operation, arterial CT angiography was performed in 91% of patients and the data from intraoperative microvascular Doppler sonography was analyzed and compared with postoperative arterial CT angiograms.Findings: Microvascular doppler sonography with 1 mm diameter probe was able to insonate all surrounding vessles including perforating arteries and aneurysm sacs. Aneurysm clips were replaced 5 times during operations (21% of cases); 2 cases due to obstraction of surrounding vessles, 2 cases because of incomplete obliteration of aneurysm sac, and in one case because of both, obstraction of surrounding vessles and incomplete obliteration of the aneurysm. Mean time for operation of sonography was 7 minutas. Findings of postoperative CT angiography were consistent with those of intraoperative microvascular doppler sonography in all cases.Conclusion: Due to simplicity, safetiness, and not being time-consuming, and also because of giving invaluable information about patency of the surrounding vessles and complete clipping of aneurysm sacs, intraoperative microvascular doppler sonography is recommended in cerebral aneurysm surgery.

Background: We report the diagnosis, treatment and follow–up process of 22 cases of fungal sinusitis. Methods: This case- series study was carried out on 22 patients with fungal sinusitis that had treatment of endoscopy and antifungal drug. Past medical history, pathology, CT scan findings and treatment of patients were evaluated. Data analysis was done using SPSS. Findings: Twelve male (57%) and 10 female (43%) patients with the age of 16-73 years were a ssessed. Mucormycosis was seen in 18 (82%) and Aspergilosis in 4 (18%) patients. Diabetic mellitus (71%), chronic renal failure (CRF) (14.3%), and leukemia (9.6%) were reported as the most common underlying diseases. Maxillary and etmoid sinuses were the site of involvement. The most common sign was unilateral periorbital edema and proptosis (95%), and the most common symptom was unilateral change of visual acuity and cheek sensation (95%). All the patients had endoscopy surgery and treated with amphotricine B or ithraconazole and ceftrinaxone, metronidazole and vancomycine. Death was reported in 5 patients (22%) and renewed functional endoscopic sinus surgery (FESS) in 1 (4.8%). Conclusion: Functional endoscopic sinus surgery with amphotncine B or ithraconazole and follow-up are effective for fungal sinusitis.

Background: Duplicate publication is publication of a paper which overlaps with another published paper in many important parts and is essentially considered unethical. So, this study was carried out to evaluate the pattern of duplicate publication as well as determining the causes of this phenomenon among the papers of researchers of Isfahan University of Medical Sciences.Methods: All cases of discovered duplicate publication during 2005 to 2008 referred to the committee of ethics were studied. After confirmation of duplicate publication, the cases were assessed by interviewing and reviewing the documents; then the fundamental roots was drawn. After analyzing the cases and categorizing the fundamental causes, a classification and definition of duplicate publication phenomenon was presented.Findings: Out of the nine underwent duplicate publication papers, eight were “Copy publishing” and the other was “Least publishable unit” (or Salami Slicing). From sixteen journals where papers were published, only five had impact factor and six were Iranian. Seven papers were in Persian and two in English.Conclusion: According to our findings, our country’s scientific community is not familiar with the professional rules of scientific and research work, so most of the duplicate publications are uninformed and non-intentional. To prevent duplicate publishing, besides taking legal action against duplicate publication with copy right infringement, the way to interact with the trend of review of papers, correspondence with the editors of journals, and announcement of rules of committee of ethics in research should be taught to faculty members and researchers.

Psychogenic movement disorders (PMD), characterized by abnormal slowness or excessive movements or postures that cannot be directly attributed to a lesion or an organic dysfunction in the nervous system. Because of their rich spectrum of phenomenology and variable severity, psychogenic movement disorders present a major diagnostic and therapeutic challenge.Diagnosis of psychogenic movement disorders is facilitated by various clues include somatic and psychiatric complaints and movement disorders which phenomenology is incongruous with typical movement disorders. These include sudden onset often related to some emotional or minor physical trauma, secondary gain variable frequency of tremor, distractibility, and exaggeration of symptoms.In movie one you see a women that had many marital problems; she has different types of psychogenic movement disorders symptoms like dystonia, chorea, etc. After treatment and psychotherapy, psychogenic movement disorders symptoms were disappear (Movie No.2).