Studies in Medical Sciences
Year:2003 | Volume:13 | Issue:4|Papers Count:13

Introduction: One of the most common causes of sciatic nerve injury is injection into buttock area. Most of the injuries are due to toxic effect of drug that cause acute or chronic fibrosis. Direct injection to the nerve itself rarely occurs. Methods & materials: 60 cases of sciatic nerve injury due to buttock injection were undergone clinical and electrodiagnostic evaluation in 1999-2002. Results: 74% of patients were male & 26% were female. In 53% of cases left sciatic nerve injured and 47% of cases involved right sciatic nerve. One patient had bilateral involvement. 90% of injuries were due to diclofenac - Na injection and 10% due to other drugs such as piroxicam, vitamin B6, penicillin. In 88% of cases peroneal portion of sciatic nerve was involved and in 12% tibial portion. 13% of patients had severe lesion, 76% moderate and 10% mild. Discussion: Recommendations for prevention of this injury are: No diclofenac injection in age <15 and age >65, avoiding of diclofenac injection in thin patients, proper technique of injection by experienced staff, prescription of oral and suppository form of drugs as possible. According to severity of lesion, surgery for severe cases & rehabilitation (conservative) for mild and moderate cases are recommended.

Introduction: Application of antibiotics in prevention and treatment of infectious dieseases is a double-bladed razor, on one side spoils pathogen germs and on the other side has numerous complications and consequences. The most serious and dangerous among them are selection of resistant germs and formation of drug resistances. Selection and prescription of antibiotics is a complicated scientific process and requires accurate clinical judgment, awareness and acting according to the pharmacologic and microbiologic principles in diagnosis, treatment and consideration of each patients particular condition and his illness. Unfortunately in most cases, deciding to prescribe antibiotics lacks consideration of above factors. Methods & materials: In this descriptive study, 1090 prescriptions of 141general practitioners were evaluated in Urmia in 1988 and following criteria had been chosen: number of drug items in each prescription, frequency of prescriptions with antibiotics, methods of prescribing (dosage, doses per day, duration of treatment and drug interactions),... Results: Average number of drugs in each prescription was 4.12 and 53% of prescriptions included antibiotics. From prescribing method point of view, 47% were non-scientific (false dosage per instance in 3% of whole prescriptions, false doses interval in 27%, duration of treatment in 38%, interactions with other antibiotics and drugs 9%). Prescriptions consisted of 65.5% penicillin group, 11% sulfonamids, 6% cephalosporins, and 5.4% aminoglycosides (Total=87.9%). Discussion: Average drug items are proportionated with national statistics but it is much higher than world average. Antibiotics presence in 53% of prescriptions is a little higher than in the most countries and cities (United States, France, Tehran, Mashhad and Esfahan). Occurrence of 47% non-scientific prescribing with only 4 criteria in comparison with other sources, which have included relation of prescription and diagnosis (true and scientific selection of antibiotics) is high. The great portion of non-scientific prescribing was short duration of treatment course.

Introduction: Perinatal death complicated 1.5% of all births. Such loss is often difficult for families to cope with understand, accept, and may provoke self-recrimination and criticism of the physician. An autopsy can provide an explanation for a loss, often relieves parents and physician, and may reveal a specific disorder for which recurrence risks or strategies for prevention may take place. Objective: Determining of autopsy findings on stillbirths in Shahid Motahary hospital of Urmia from October 2001 to September 2002 (A ten months study). Methods: All of the stillbirths with consent for an autopsy examination were submitted for autopsy. Two pathology residents under supervision of a pathology staff performed autopsies. Result: Seventy-three fetal death occurred in ten months of study, consent for an autopsy examination was granted for 31 of them (42%). Abnormalities likely to be the cause of death were identified in 26 of cases (84%). Seventeen subject (55%) did not have structural anomalies. In 6 cases (19%) autopsy revealed previously unsuspected pathology, that altered parental counseling; and in three cases (10%) no pathologic finding are seen. Fourteen cases (45%) had structural anomalies. Severe macreration was present in 2 cases. Asphyxia and CNS malformations were the most frequent causes of death in this series. Conclusion: The cause of fetal death was determined by autopsy in 84% of cases in this study. The importance of perinatal routine ultrasound screening and perinantal autopsy is emphasized.

Introduction: Based on the recent data of WHO & Unicef, annually maternal mortality rate was 585000 cases per year, which 99% of them had been happened in developing countries. Pulmonary emboli, pregnancy hypertension, hemorrhage and infection were etiological factors for mortality. Methods: This descriptive and crosssectional study evaluated causes and rates of matenal mortality in West Azarbaijan from 1374 to 1376. Results: During 3 years research, maternal mortality rate was 38.5 cases per 100000 living births. The most causes of maternal mortality were order to hemorrhage (54.6%), pregnancy hypertension (21.2%), infection (6.6%), pulmonary emboli (3.3%). Indirect causes 3.3% and unknown causes were 12%. 58.5% of dead mothers have been cared in their pregnancy term, 36.9% of them had missed care and 4.6% of them were unknown from this regard. 73.3% of pregnancy term cares have been performed by health workers, 15.8% by midwives and 15.6% by physicians. 85.5% of labours were done in vaginal method and 14.5% in cesarean. According to statements of relatives, one of them was a diabetic, two of them has diseases and two of them had heart diseases. Conclusion: according to a great gap between maternal mortality rate of West Azarbaijan (38.5 cases per 100000 living births), and serious measure for removing this problem is necessary.

Introduction: Many people refer to physical-therapy clinic due to trigger points pain. It seems abnormal posture of head and neck is an important reason for this abnormality. The purpose of this study was to investigate the incidence of forward head and its relationship with activity of shoulder trigger points. Methods & Materials: A random sample of 506 subjects (253 girls and 253 boys), ranging from 14-17 years, participated in this study. Evaluation of posture was carried out by plumb line, according to kendall and Mccreary theory. Information about Musculoskeletal system was gained via examination, observation and point finder apparatus. Result: The result shows significant difference between forward head posture (F.H.P) with sex and height (p<%5), which meant that girls showed forward head posture more than boys. Also significant differences were noted between F.H.P and activity of trigger points in vertebral border of scapula, supraspinatus and infraspinutus muscles. There was no significant difference between trigger points in anterior deltoid, superior angle of scapula, lateral border of scapula with F.H.P. Discussion: High incidence of FHP in taller person and in girls is due to tendency of these groups for kyphsis and round shoulder, which promote the activity of trigger points of shoulder.

Introduction: HDV, a defective viroid, is related to hepatitis B virus (HBV). Its epidemicological properties are similar to HBV, and this virus has crucial roles in induction of chronic and fulminant hepatitis. Prevalence of this virus is very variable and HBV control is very useful in HDV control, regarding to this endemic region. Methods & Materials: 130 patients and donors randomly selected and they were studied for anti-HDV (IgM) by using ELISA method. Serum ALT was examined by a routine biochemistry method. All anti-HDV positive serums were also studied for anti-HBc. Results: Eight cases (6.15%) were positive for anti-HDV which 5 cases (7.6%) belonged to HBV+HDV positive patients and remainder (4.6%) belonged to blood donors. In 60% of HBV + HDV positive patients, IgM-HBc was positive. ALT level was abnormal in all HBV+HDV positive sera. Discussion: Since the epidemiological properties of HDV are similar to HBV and the prevalence of HDV in our region (Azarbaijan) is low, this rang may be related to controlling of HBV. Like the other findings, the prevalence of HDV in patients with liver diseases is higher than normal donors, so it needs more samples to study. Although there is no vaccine for HDV, control and management of HBV would be helpful in HDV control.

Background: The aim of this study was placental findings & maternal risk factors of low birth weight infants and correlations of this factors with low birth weight. Methods & Materials: This study was based on randomized selection of 100 low birth weight neonates with birth weight 1000-2500 gr (case group) and 100 neonates with birth weight equale or more than 2600gr (control group) through 6 months. Informations about maternal past history and health state obtained from medical charts and physical examination. The TSH titer of maternal serum determined for 110 patients and pathologic examination was done on placenta of all cases (200 neonates). Results: Mean maternal age was 24.48± 6.05 in case group and 25.80± 5.94 in control group. In the case group 16% of mothers were less than 18 years old and 10% in control group. Hypertension identified in 23% of case group (3% in control group). OR=9.65 (95% Cl: 3.31-26.84), history of previous low birth weight, abortion and IUFD (intra uterine fetal death), identified in 22% if case group (20% in control group) OR=1.12 (95% CI: 0.58-2.21) One of more pathological findings were present in 92% of LBW neonates and 74% in control group OR=4.04 (95% CI: 1.79-9.577). The common placental findings in case group were abnormal insertion of umbilical cords 56% (OR=1.17), increased syncytial knots more than 1/3 (55%) (OR=6.4) necrosis more than 10%, 16% (OR=4.5) and fibrin desposition more than 30% around the villouses 14% (OR=7.79). Discussion: In our study maternal hypertension increased the risk of low birth weight delivery 9.65 fold above baseline. Our data suggest that gross and microscopic placental findings are significantly associated with the risk of LBW (4.04 fold) and if there was maternal hypertension, the risk of pathologic findings in placenta would be 100%.

Introduction: There is not a standard method for infertility evaluation and doctors can not predict that the cause of infertility may influence pregnancy. The semen analysis ia s tool for evaluation the male fertility potential. However the test can not predict the result of in vitro fertilization. It is suggested that hypo-osmotic swelling test (HOST) can predict the result of IVF-ET. The aim of this study was to evaluate the correlation between HOST & result of IVF-ET cycles. Material & Methods: A simple study on 30 samples from patients who were-candidate for IVF treatment cycles in Madar Hospital & research & clinical center for infertility was performed. Fertilization rate (FR), SA, pregnancy rate (PR) and result of sperm viability were analyzed by ANOVA using SPSS-9 for windows. The level of p<0.05 was assessed significant. Results: Mean HOST results in different groups were compared. The significant difference was not seen in the FR rate, embryo transfer, BHCG, Clinical PR, on going PR, abortion, live birth rate & male age. Also, there are not correlation between HOS T-test & SA. Discussion: According to our finding, the result of HOS test has not correlated at IVF-ET. The test can not predict the IVF result. It could be benefit in the case of borderline SA.

Pica is a kind of nutritional disorder in which there is interest and great appetite to eat non - nutritional substances like chalk, ice, clay, paint, starch, aspirin and et cetra. There are nutritionan, physiologic, psychologic and cultural theories about this subject. However; main etiology of that problem is unknown. Pica syndrome is observed most commonly in children and pregnant women, espcially in the negroes with a low socioeconomic status. Pica is observed with iron deficiency and can be corrected after using of iron. Numerous complications of pica have been described, including abdo- minal symptoms (sometimes requires surgery), posioning by plumb, mercury and phosphorus and dentin caries and hyper or hypokalemia. This case is a 2.5 years old child who has been eating sands and soils from one year ago. The patient admitted in hospital due to abdominal pain and motion of the fine sands in the intestines and stomach was palpated. Terminally all sands passed from stomach and intestines. Hemoglobin was corrected and the patient was discharged after 2 days without requiring surgery.

Introduction: Infantile autism is a clinical heterogenous disorder with unknown etiology. Evidences from the relatively few family and twin studies suggest a genetic component. It is concluded that in some cases chromosomal rearrangements are the basic causes. The aim of the present work is to report a 4-year-old autistic boy with a genetic approch. Materials & Methods: Family history, pedigree pattern and chromosomes of the proband and his parents were studied (G-banding). Results: There was no any other case in his family history. Chromosomal study has revealed a maternal origin rearranged chromosome number 15. Conclusion: The results of present study confirmed that chromosomal study is one of the first necessities in the study of autism, and it will help us for a better genetic counseling with families with an autisic child.