Hormozgan Medical Journal
Year:2003 | Volume:7 | Issue:2|Papers Count:12

Introduction: Drain insertion in surgical wounds is common in different surgical operations. This study was aimed to investigate the effect of drain in cancellous bone graft from iliac crest. Method & Material: In this randomized clinical trial, 90 patients with single long bone fracture, comminuted more than 30%, admitted in Shahid Mohammadi hospital, Bandar Abbas, from January 2002 to March 2003 were randomly divided into two groups and underwent bone graft removal procedure from the iliac crest. In the first group (44 patients), no drain was inserted after the completion of the operation whereas the second group (46 patients), received a drain. The patients were followed for a six-month period. The results were analyzed by using Chi-Square and t-test. Results: There was no statistically significant difference between the two groups with regard to age, sex, the fractured bone, the anesthesia type and antibiotic reception, before and after the operation. In the postoperative follow up for at least 6 months, the difference between the two groups with regard to pain severity, need for dressing change, hematoma formation and infection was not statistically significant. Conclusion: It seems that use of drains in the wounds of patients in whom cancellous bone is removed from the iliac crest for bone grafting of a single comminuted long bone fracture is not necessary.

Introduction: Behcet's disease is an inflammatory disease and the aim of this study is to investigate the clinical outcome and presentations of central nervous system involvement in 500 patients with Behcet's disease in south of Iran. Method & Material: In this cross sectional study five hundred patients with Behcet's disease diagnosed by international criteria were studied for central nervous system manifestations from 1990-2000 in Behcet's disease research clinic, Nemazi-Hospital, Shiraz, south of Iran. The clinical diagnosis of central nervous system involvement was performed by medical team with aid of history neurological examination. Lumbar puncture and neuroimaging with CT and/or MRI. Patients suffering from headache with normal neurological examinations, lumbar puncture and imaging were excluded from the study. Information about disease course was extracted from patients' charts. The favorable outcome was defined as patients with full activity of daily living without any neurological deficit. Results: In this study of 500 patients with Behcet's disease, 15 patients (3%), had central nervous system involvement, with age ranging from 18 to 47-year old (mean age 32.5 yrs). Central nervous system involvement occurred from 2 to 20 years after onset of Behcet's disease and was followed ranging from 18 months to 12 years in this study. Spinal cord involvement was observed in 2 patients out of 15 (13.3%), both suffered from impotency. Nine of aneurysms, 4 patients (26.6%) had cerebral venous thrombosis, 3 (20%) patients had increased intracranial pressure, and 2 (13.3%) patients had papilledema in the absence of retinitis. Conclusion: Central nervous system involvement is one of the most destructive manifestations of Behcet's disease which is due to primary parenchyma involvement or secondary cerebral vessels involvement.

Introduction: Iron defiency anemia is the most common nutritional deficiency. The prevalence of iron deficiency with or without anemia in general population is 30%. This study was conducted to study the blood factors in mothers and their new borns. Method & Material: In this cross-sectional study all pregnant women who during a one month period, referred to Shariati Hospital were investigated. 10 ml blood from the women and their new born's umbilical cord was extracted and 144 of mothers with similar blood factors were selected. serum iron, TIBCResults: Serum iron, Hct, Hb were higher (p<0.03) and RDW, TIBC were lower (p<0.05) in mothers who received iron supplement during pregnancy. Ferritin was in the lower limit of normal Value in both groups. The same result was observed in their newborns. Conclusion: In this study, iron supplement during pregnancy caused higher Hct, Fe, and fewer anemias in pregnant women, but had no significant effect on ferritin, which shows that both groups have already been iron deficient and the supplement was not sufficient to treat iron deficiency.

Introduction: Early detection of breast cancer, the most prevalent cancer in women, plays an important role in the treatment of this otherwise fatal disease. Thus women's theoretical and practical knowledge of different screening methods can lead to an early detection of this disease. The present study aims at determining the extent to which women, referring to the health centers in Shiraz, have theoretical and practical knowledge of different screening methods such as breast self examination, clinical examination by physicians and mammography. Method & Material: One thousand women (35 years or more) who referred to 10 health centers in Shiraz were selected by stratified random sampling and filled out questionnaires containing demographic information and enquiries about the extent to which they were familiar both in theory and practice with the breast cancer screening methods. Results: The analysis of data revealed that the mean score of the women's theoretical and practical knowledge of different screening methods of breast cancer were 45% and 28.7% respectively. The women's theoretical knowledge was negatively correlated with their age (p<0.0001) but positively correlated with education. The women with history of breast diseases and those with a family history of breast cancer showed to have both higher theoretical and practical knowledge as compared with the other women (p<0.0001). Conclusion: We conclude that it would be necessary to upgrade women"s theoretical and practical knowledge about different screening methods in order to detect breast cancer in its early stages.

Introduction: In the recent two decades laparoscopic surgical interventions, especially for the gall bladder, have become popular. With these interventions patients could be operated and discharged in shorter period with a remarkable reduction in operation costs. Method & Material: In this cross-sectional study, from April 2002 to April 2003, all patients who had referred with gallstone and underwent laparoscopic cholecystectomy were prospectively analyzed. A total number of 104 patients (76 female, 28 male) were studied. Pertinent demographic characteristics, such as age, sex, clinical examination, and sonographic findings, operative findings, length of postoperative stay in hospital, duration of surgery, amount of blood loss and post operation complications were investigated. Results: Mean postoperative hospital stay was 36 hours, with return to normal activity in 7 days. There were no deaths related to the operation. The mean duration of surgery was 55 minutes. Most of the patients had less than 100 ml of blood loss. Post operation complication was 1% and only 2% of patients had to undergo open operation. The patients' satisfaction rate from the surgery was 96%Conclusion: Due to safety, more convenience, quickness, less complication (1%) and more patients' satisfaction (96%) it is recommended that laparoscopic cholecystectomy should be attempted in these patients as the treatment of choice, when applied by appropriate surgical skill and experience.

Introduction: Rubella is a slight and often subclinical infection which is not usually accompanying with serious complication but rubella infection during pregnancy specially the first trimester can cause virus transmission to fetus and lead to TORCH syndrome and death of fetus. This study was conducted to determine the Rubella seroprevalence in women at child bearing age in Bandar Abbas. Method & Material: In this cross-sectional study 260 women who referred to the health center for premarital or pregnancy tests were participated. The blood sample of subjects was tested using indirect ELISA assay to detect rubella IgG and IgM antibodies. Data was analyzed using Ep16 statistical software and p<0.05 showed to be significant. Results: Seropositivity among women aged 14-20, 20-30, and 30-40 were 86.5%, 88.9% and 92.4% respectively. Less than 1% of subjects showed positive rubella IgM result. Results showed no correlation between age and rubella seropositivity but a significant correlation was observed between literacy level, place of residence and rubella seropositivity. Discussion: The results of this study showed that 12% of women at fertility age were at risk of catching rubella and transmitting to their fetus, therefore it is suggested that women's immunity to rubella should be determined before marriage and in the case of lack of immunity to rubella vaccination is recommended or immunization against rubella be performed in all girls in pre-marriage age.

Introduction: Prophylactic antibiotic is usually given to women under going elective cesarean section. Studies on antibiotic prophylaxis in low-risk patients are limited. This investigation has been conducted to assess the effect of intravenous cephazolin in these patients. Method & Material: This clinical trial was performed on 60 women who were candidate for cesarean section and were low-risk for post-cesarean infection. Subjects were divided randomly into two groups. In experimental group after umbilical cord clamping subjects were given intravenous cephazolin (2 doses of 1 g every 6 hours). In control group subjects received no antibiotic prophylaxis. Then subjects in two groups were followed up for ten days for febrile and infectious complications. Data were analyzed using t-test and p<0.05 showed to be statistically significant. Results: There was no correlation between mean temperature and infectious complications in women with or without antibiotic prophylaxis (p<0.05). Moreover the mean temperature in the first, second, third, seventh and tenth days showed no significant differences in both groups (p<0.05). Discussion: Although antibiotic prophylaxis is usually prescribed for women undergoing elective cesarean section, results of this study showed that there is no need to administrate prophylactic antibiotic to elective cesarean section patients who are low-risk for post-cesarean infection. More extensive studies are recommended.

Introduction: Despite the surgical techniques developed, the regeneration of the papillae adjacent to dental implants is still a matter of debate. This study was designed to determine whether the distance from the base of the contact point to the crest of the bone would correlate with the presence or absence of interproximal papillae adjacent to single-tooth implants. Method & Material: A clinical and radiographic retrospective evaluation of the papillae level around single tooth implants and their adjacent teeth was performed in anterior maxilla in papillae in 10 patients (6 women and 4 men) using the Jemet index. The presence to absence of papillae was determined and the effect of the distance from contact point of implant or adjacent tooth to the crest of the bone on the papillae level was analyzed. Results: When the measurement from the contact point to the crest of the bone was 5.89 or less and the Fixture Abutment Junction (FAJ) to contact point was 6.47 or less, the papillae was present almost in 100% of cases. Conclusion: These results clearly show the influence of the bone crest on presence or absence of papillae between implants and adjacent teeth.  

Introduction: Some genetic disorders may be misdiagnosed as routine diseases. This is true also for Werner's syndrome which may mimic scleroderma. Werner's syndrome typically begins with graying of hairs in second decade of life and skin changes, hoarseness, early cataract, leg ulcer and diabetes ensue before age 34. Patients with Werner's syndrome are prone to a variety of malignancies and accelerated atherosclerosis. Case: Here in we present a 32 years old lady with Werner's syndrome who was under extensive evaluation due to hoarseness. Skin stiffening was the leading cause of referral to us. Constellation of symptoms along with family history of similar condition in her sisters denoted the presence of Werner's syndrome as the cause of condition. Conclusion: Early cataract, diabetes in early ages, family marriage and positive family history are the main symptoms that a systemic scleroderma patient should remind Werner syndrome to the practitioner.

Introduction: Rigid spine syndrome (RSS) is a term first proposed by Dubowitz to describe a subset of patients affected by myopathy with early spinal contractures as a prominent feature. Recently the first locus for RSS was mapped to chromosome 1p35-p36. Case: We present here a 12 year-old boy complained of generalized weakness and stiffness and gait disorder from two years ago. Who referred to Shahid Mohammadi Hospital Bandar Abbas, Iran. Flexion contracture of the elbows and loss of motion of spine and proximal weakness were the main findings. Radiographs of the affected joints were normal. ECG was normal. CPK and LDH were moderately elevated. A myopathic pattern was noted on EMG. A muscle biopsy showed extensive fiber necrosis with nuclear internalization that suggest muscular dystrophy so this case can be presented as a rare case of RSS in Iran. Conclusion: Muscle biopsy of these patients shows unspecific pathologic variations, but genetic investigation of these patients can help in definite diagnosis of the disease.