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Gh Oliaiy , M Akbari , H Bagheri , R Abolfazli , S Talebian , F Fattahi ,
Volume 55, Issue 5 (1 1997)
Abstract

Carpal tunnel syndrome (CTS) is considered by researchers because of its high prevalence, and several studies have been done to find the causes and factors which increase the chance for the syndrome. These studies have shown relationships between this syndrome with some physical parameters like wrist dimensions, weight and systemic conditions. There is no investigation on risk factors in CTS in our country. So the main goal of this research is to find and introduce predisposing factors for carpal tunnel syndrome. Methods: Seventy patients and 33 controls 22 to 70 years old were studied. Standard methods for median and ulnar nerve studies were used and questionnaires included physical measurements, history of diseases and personal information were completed for each person. Results: Patients had higher wrist ratio (mean difference, 0.0267, P<0.001), weight (mean difference: 6.098, P<0.001) and body mass index (mean difference: 3.376, P<0.001). Regression analysis showed strong positive relation between wrist ratio and median latencies. The strongest correlation was found between wrist ratio and median minus ulnar distal sensory latencies (Y2=0.4014, P<0.0001). No relation was found between weight and body mass index with median latencies. Seventy-nine percent of patients and 48.5% of controls had wrist ratio of 0.7 or greater (P<0.05). Seventy-two percent of patients with repetetive hand activities and 78% with associated conditions had wrist ratio of 0.7 or greater. Seventy-six percent had wrist ratio less than 0.7. No relationship was found between obesity, diabetes, thyroid disorders, rheumatoid arthritis, taking oral contraceptive, hysterectomy, oophorectomy, menopause and repetetive hand activities with involvement of carpal tunnel syndrome. Discussion: Wrist dimensions seem to be an important predictor for carpal tunnel syndrome also in patients with associated conditions. If individuals with squarer wrists are involved in special conditions, they may show symptoms of the syndrom. Carpal tunnel syndrome is caused by many factors but wrist dimensions seem to be a predisposing factor and provides an explanation for bilateral involvement or familial occurrence of it.
H Saberi , M Shaabani , M Mostaan , Sh Shahryaran , Sm Mirbaghery , A Forooghi ,
Volume 57, Issue 2 (8 1999)
Abstract

102 patients with ascites were enrolled in a sonographic study of abdomen and pelvis without awaring of history, clinical and paraclinical findings. So with only sonographic finding we suggested the diagnosis and etiology of ascites. All patients were hospitalized. Finally all the patients were diagnosed definitely and were compared with sonographic diagnoses done before. Results: In this survey 42% of patients had cirrhosis, 20.5% had malignancy, 14.7% had renal disease. Overall sensivity of sonography in diagnosing etiology was 91.1%, overall specifity was 97.8%, overall accuracy was 94.4%. Sensivity, specifity and accuracy of each group have also been determined separately.
Gh.r Oliaei , M Akbari , H Bagheri , Mr Hadian , S Talebian, N Ahamad Vand ,
Volume 58, Issue 1 (6 2000)
Abstract

It is generally assumed that local muscular fatigue predisposes the individual to injury. Despite the significance of muscular fatigue and endurance, there are not much dynamic endurance studies for trunk muscles in the literature. Most of them have used isokinetic dynamometer which keeps the velocity of movement constant. In this studies with the help of an isoinertial dynamometer we have assessed the effect of repetitive and fatiguing flexion-extension movements patterns and motor output. 38 female subjects with no history of low-back pain for the 6 months volunteered for the study. A triaxial dynamometer was used that simultaneously provided measurement of torque, angular position, velocity impulse, work and power of each axis. Resistance were set independently for each axis by an interfaced computer. The subjects performed trunk flexion and extension movement against a saggital plane resistance equal to 50% of their maximum isometric extension strength in the upright position. The minimum resistance in the coronal and transverse planes were set-up at 5-7 Newton meters. The subjects were asked to perform trunk movement as quickly and as accurately as possible while exerting the maximum efforts until exhaustion. Immediately after dynamic test another isometric test was performed. A paired T-test procedure was performed among the selected parameters of the 1st middle and last 3 repetition cycles. The selected parameters are range of motion, velocity, torque, impulse, work, power, time interval and time of movement. Also, a paired T-test was performed between maximum isometric strength before and after dynamic test. All the selected parameters were significantly reduced in the saggital plane. Subjects displayed significantly less motor control and greater range of motion in the coronal and transverse planes in performing the primary task of flexion and extension. The reduction of the functional capacity of the primary muscles performing the required task is compensated by secondary muscle groups and the spinal structures is located in a more injury prone position, as identified by finite element models. In addition it is suggested that the fatigued muscles would be less able to compensate any perturbation in the load or position of the trunk. The repetitive loading results in a weakening of the viscoelastic passive elements of the spineless structure. The loss of ability to protect these weakened passive elements makes the spine susceptible to industrial and recreational injuries.
Bagheri H, Akbari M, Olyaei G, Talebian S,
Volume 59, Issue 2 (5-2001)
Abstract

The aim of this investigation is to compare the effect of applying two transcutaneous electrical nerve stimulation (TENS) current with different frequencies (2 Hz & 100 Hz) on Hoffmann reflex recorded from gastrosoleus muscle of healthy people. Forty female subjects between 20 to 30 years of age were participated in this quasi-experimental design. Twenty of them were exposed to the 100 Hz current and the remaining 20 to 2 Hz current on dermatome S1 root. The excitability of the alpha motoneurone was measured by H-reflex amplitude (peak to peak max/2) before and after the application of the TENS current for 30 minutes. The reflex was recorded and at measured before (TO) and after the application of TENS at different times (T1, T% and T10) up to 10 minutes. The mean values were compared by multiple paired T test (alpha=0.00825). The results indicate a considerable decrement in Hoffmann reflex amplitude after application of 100 Hz current in comarison with that of before the application. The effect last for 10 minutes after the TENS application, whereas the application of 2 Hz current results in increment of the Hoffmann reflex amplitude. The 5 and 10 minutes interval test dose not show any significance and the results were attenuated befor 5 minutes. As a conclusion high frequency of TENS (100 Hz) has an inhibitory effect on excitability of alpha motor neurone reflex lasting for 10 minutes, while low frequency of TENS (2 Hz) has an facilatory effect on the same motoneurone with short lasting effect.


Bagheri H, Akbari M, Olyaei Gh, Talebian S, Jafari F,
Volume 59, Issue 3 (8 2001)
Abstract

The aim of this investigation is to compare the effect of applying two transcutaneous electrical nerve stimulation (TENS) current with different frequencies (2 Hz & 100 Hz) on Hoffmann reflex recorded from gastrosoleus muscle of healthy people. Forty female subjects between 20 to 30 years of age were participated in this quasi-experimental design. Twenty of them were exposed to the 100 Hz current and the remaining 20 to 2 Hz current on dermatome S1 root. The excitability of the alpha motoneurone was measured by H-reflex amplitude (peak to peak max/2) before and after the application of the TENS current for 30 minutes. The reflex was recorded and at measured before (TO) and after the application of TENS at different times (T1, T% and T10) up to 10 minutes. The mean values were compared by multiple paired T test (alpha=0.00825). The results indicate a considerable decrement in Hoffmann reflex amplitude after application of 100 Hz current in comarison with that of before the application. The effect last for 10 minutes after the TENS application, whereas the application of 2 Hz current results in increment of the Hoffmann reflex amplitude. The 5 and 10 minutes interval test dose not show any significance and the results were attenuated befor 5 minutes. As a conclusion high frequency of TENS (100 Hz) has an inhibitory effect on excitability of alpha motor neurone reflex lasting for 10 minutes, while low frequency of TENS (2 Hz) has an facilatory effect on the same motoneurone with short lasting effect.


Smj Mortazavi, A Baghery Fard,
Volume 59, Issue 6 (11-2001)
Abstract

Dorsal traumatic dislocation of metatarsophalangeal joint of great toe is a rare injury. Ability to reduce the dislocation by nonoperative measures depends largely on the type of dislocation and involvement of the sesamoid complex. There are three basic types of dislocations. Type I cases are usually irreducible on closed reduction, the metatarsal head being incarcerated by the conjoined tendons with their intact sesamoids. In type II, the sesamoid complex disruption usually pemits closed reduction. We present an irreducible dislocation of the first metatarsophalangeal joint with fibular sesamoid fracture in an 80-year-old man. In addition, he had a concomitant dorsal dislocation of the second MTP of the same foot, to our knowledge only one case with this injury was reported in the literature.
Abolfazli R, Bagheri H, Soltani Ah,
Volume 60, Issue 3 (14 2002)
Abstract

Background: Auditory brainstem response (A.B.R) is one of the most important electrophysiological tests in evaluating of auditory system, especially for diagnosing of auditory nerve and brainstem disorders. It is a non-invasive test and has reliability and validity characteristic. There is no contra-indication for this test. One of the most important of stimulation parameters of A.B.R is click polarity (rarefaction, condensation and alternative). Some of the investigators believed that different polarities have no effects on A.B.R are affected by different polarities.

Materials and Methods: In this study, the results of ABR of 148 patients (296 ears) were compared with three different polarities of rarefaction, condensation and alternative half click stimuli. The cases were categorized in three groups of normal (60 cases), cochlear (62 cases) and retro-cochlear (17 cases). This classification were done according to the hearing level in pure tone audiometry results in three frequencies of 1000, 2000, 4000 Hz and to the site of the their disorders. The mean absolute latencies of waves I, III and V were obtained for each polarity. Inter-peak latency (I.P.L) of wave also measured in three groups (normal, cochlear and retro-cochlear).

Results: The results were showed a significant difference between absolute latency of wave I among different polarities on three above mentioned groups (P<0.05). There were no significant discrepancy for other waves of III and V and Inter-peak latency (I.P.L) of wave I to (P>0.05).

Conclusion: It was concluded that rarefaction polarity has better and more stable results of ABR tests.


Abolfazli R, Makari N, Bagheri H, Ahmadi M,
Volume 62, Issue 2 (12 2004)
Abstract

Background: Cerebrovasular diseases (CVD) are one of the most common anomalies which may affect on auditory cortex. In this research we have tried to evaluate the function of CANS in a group of 50-70 years old cerebrovascular accident (CVA) patients without hearing problem by using Persian version of C.S.T.

Materials and Methods: This cross-sectional analytic study was established at Loghman-e-Hakim Hospital on a group of 30 normal subject (15 male, 14 female) and a group of 40 patients with CVA including 30 patients (16 male, 14 female) with abnormal CT scan and 10 patients with normal CT scan.

Results: Routine audiologic test including: Pure tone audiometry, Immitance audiometry and speech audiometry were nearly normal in all cases. There were significant differences between mean scores of CST in the patients with CVA and control group (P< 0.05). There were no significant differences between mean scores of CST in male and females (P> 0.05). In spite of nearly normal hearing and high scores in the simple speech tests such as SDS, there were significant differences in mean scores of CST in both ears of CVA patients (P< 0.05). Another important point is that in some of patients with CVA.

Conclusion: Although common radiologic evaluations such as CT scan showed no anatomic or structural anomaly but central auditory assessments such as CST can show dysfunctions of CANS. Therefore, CST might be a valuable test in CANS batteries for the cerebrovascular diseases.


N Nokhostin-Ansari, M.r Hadian, H Bagheri, S Naghdi, Sh Jalaei , T. Khosravian-Arab,
Volume 64, Issue 2 (30 2006)
Abstract

Background and Aim: Spasticity is a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. The measurement of spasticity is necessary to determine the effect of treatments. The Modified Ashworth Scale is the most widely used method for assessing muscle spasticity in clinical practice and research. The purpose of this study was to investigate the interrater reliability of Modified Ashworth Scale in hemiplegic patients.

Materials and Methods: Thirty subjects (16 males, 14 females) with a mean age of 59.40 (SD =14.013) recruited. Shoulder adductor , elbow flexor , wrist dorsiflexor , hip adductor , knee extensor and ankle plantarflexor on the hemiplegic side were tested by two physiotherapists.

Results: In the upper limb, the interrater reliability for shoulder adductor and elbow flexor muscles was fair (0.372 and 0.369, respectively). The reliability for the wrist flexors was good (0.612). The difference in Kappa value for the proximal muscle (shoulder adductor 0.372) and the distal muscle (wrist flexor 0.612) was significant (²X=33.87, df=1, p<0.05). In the lower limb, the reliability for the hip adductor was fair (0.350), but for the knee extensor and ankle plantar flexor was moderate (0.518 and 0.542, respectively). The Kappa value for the proximal muscle (hip adductor: 0.350) and distal muscle (ankle plantar flexor0.542) had no significant difference (²X =1.35, df=1, p >0.05). The mean value for the upper limb (0.505) and the lower limb (0,.516) was not significantly different (²X=0.1407, df=1, p>0.05).

Conclusion: The interrater reliability of Modified Ashworth Scale was not good . The limb, upper or lower, had no significant effect on the reliability. In the upper limb, the reliability for the proximal and distal muscle was significantly different. However. The difference in the lower limb was not significant.When using the scale, one should consider it&aposs limitation.


H Fakhrzadeh, M Moradi, Mj Mahmoudi, N Naderpoor, M Bagheri Rad, M Ahmadzad-Asl , H Arefi,
Volume 64, Issue 2 (30 2006)
Abstract

Background and Aim: Quality of care and its concordance with scientific evidence has a significant role in improvement of prognosis in patients with acute coronary syndrome (ACS). The present study was performed to evaluate the quality of care in a TUMS-affiliated hospital.

Materials and Methods: The quality indicators of the process and outcome of care according to guidelines of the MONICA project was used in this study. 320 cases with primary impression of ACS (including 80 cases from each trimester during Aug-2003 to Jul-2004) were evaluated according to MONICA standard definitions of diagnosis, provided care and survival in 28th day after heart attack.

Results: The Equivalent Treatment Score (ETS) was 43.4 percent (95%CI: 32.86-53.94) and the Weighted Treatment Score (WTS) was 22.2 percent (95%CI: 13.36-31.03) in patients with definite myocardial infarction. The 28-day case fatality among the evaluated patients was 9.09 percent (95%CI: 5.85-12.33).

Conclusion: Although the measures of quality of care in this patient setting were acceptable in comparison with MONICA collaborative centers, however the difference between ways of hospital sampling (in the present study) and the population-based method (applied in the MONICA populations) should be taken in to consideration. Adding pre-hospital fatal events to this data set will decrease the precision of quality measures.


Z Ahmadinejad, Sh Phyroosbakhsh, Z.n Hatmy, B Bagherian, H Sabery, M Bahador, M Nikzad, M Jamali Zavare, A Hadady, M Hajiabdolbaghi, M Mohraz, M. Rasolinejad, A Soudbakhsh, A Yalda,
Volume 64, Issue 2 (30 2006)
Abstract

Background and Aim: Tuberculous pleural effusion occurs in 30% of patients with tuberculosis (TB). Rapid diagnosis of a tuberculous pleural effusion would greatly facilitate the management of many patients. The purpose of this study was to determine sensitivity, specificity, and predictive values of clinical, laboratory, radiographic findings in patients with tuberculous pleural effusion.

Materials and Methods: The cross sectional study was performed between august 2002 and March 2004 at a referral teaching hospital. Major clinical, laboratory, and radiographic findings were evaluated in 88 cases of pleural effusion, 33 with confirmed TB pleural effusion (TBPE) and 55 with a diagnosis other than TB (NTBPE).

Results: The sensitivity of culture of pleural effusion and tissue were 3% and 9.1% respectively. The mean of adenosine deaminase (ADA) values in TBPE was 36.7 U/L (±18.72), and the mean in the NTBPE was 28.2 U/L (±17.0). Both the sensitivity and specificity of ADA estimation in diagnosing tuberculosis were 55%. The sensitivity of PCR was 3% with specificity of 12.7% (positive predictive value, 50% negative predictive value, 70%). Younger age (p<0.024), positive history of exposure to TB patient (p<0.02), and the combination of fever, weight loss and sweating (p<0.01), were associated with tuberculous pleural effusion. There were also significant association between Positive sputum smear (p<0.001), positive sputum culture (p<0.006), positive pleural biopsy (p<0.001), pleural LDH>200 (p<0.005), pleural lymphocytes>50% (p<0.015) and TBPE.

Conclusions: In our region with a high incidence of tuberculosis, the most frequent cause of exudative pleural effusion is tuberculosis. We suggest that the diagnostic planning of pleural effusion should be determined in each region with a view to the adoption of regionally optimized diagnostic and therapeutic facilities.


Talebian S, Bahrami Sh, Olyaei Gr, Bagheri H, Hadian Mr,
Volume 64, Issue 7 (9 2006)
Abstract

Background: The purpose of this study was to measure isokinetic maximum and average peak torque of internal and external rotators of glenohumeral joint in volley ball and tennis players
Methods: This study was performed on 17 professional female athletes (7 tennis players &10 volleyball players) with age ranged 18-28 years. The subjects had played in a skilled team for more than 3 years. They were free from injury to their dominant shoulder in the past year. Subjects performed a five minute warm up by shoulder wheel and Maximum average Peak Torque (APT) were obtained unilaterally by a Biodex System 3 with the arm of players in 90 degree abduction at 120,180 & 210 o/s. Players performed five trails of concentric movements with 30 second rest between them.
Results: Maximum and average of maximum torques of shoulder rotator, in both groups, expect for internal rotators of tennis players, reduced by increase of movement speed (P<0.05). There are not significant difference between two groups in maximum, average of maximum torques and normalized data (ratio of maximum torque to weight). There is significant difference between two groups in percentage of APT of External rotator / Internal rotator ratio at 210 o/s (P<0.05).
Conclusion: Volleyball and tennis have no effect on isokinetic strength of shoulder rotators. In high speed, ratio of External rotator / Internal rotator is reduced. This indicates that increase in movement speed increase internal rotator in comparison to external rotator in these professional female athletes.
Davari Tanha F, Valadan M, Kaveh M, Bagherzadeh S, Hasanzade M,
Volume 65, Issue 2 (8 2008)
Abstract

Background: Preterm labor is defined as delivery before 37 weeks of gestation. Recurrence of preterm labor in future pregnancies is 6-8%. History of preterm labor is a strong risk factor for future preterm labor. Preterm labor is the leading cause of neonatal mortality in developed countries, but permanent morbidity in these premature neonates has many side effects for the newborn as well as their family members and society. For this reason we conducted a survey to identify risk factors for recurrent preterm delivery among primiparous women with previous preterm delivery.
Methods: This prospective case–control study included patients from three university hospitals, namely Imam Khomeini, Shariati and Mirza Koochakkhan Hospitals, all in Tehran, Iran. Subjects, including 539 primiparous women who delivered preterm (22–36 weeks), were divided into two groups: 47 had a second preterm delivery (study group) and 492 had first preterm delivery (control group). Exclusion criteria were induced preterm delivery due to medical indications in mother and primigravid. Data collection and analysis was performed using SPSS 10 and t-test and χ2 test were used to analyze the significance of the results.
Results: From a total of 6,537 deliveries, we found 539 cases of preterm delivery, among which 47 cases were identified as recurrent preterm delivery. The control group was composed of 492 deliveries. The recurrence of preterm delivery was 8.7%. Uterine anomaly, cardiovascular, renal and thyroid disease in mother and blood group A had a significant correlation with recurrent preterm delivery.
Conclusion: Expectant mothers with uterine anomalies, cardiovascular, renal or thyroid diseases or group A blood type should receive extra care, observation and instructions in order to limit the risk of preterm delivery and its subsequent effects.
Hadadi A, Rasoulinejad M, Maleki Z, Mojtahedzadeh M, Younesian M, Ahmadi S.a, Bagherian H,
Volume 65, Issue 4 (3 2007)
Abstract

Background: The object of this study was to investigate the antimicrobial resistance pattern among common nosocomial Gram-negative bacilli isolated from patients with nosocomial infections.
Methods: From June 2004 to December 2005, 380 isolates of common Gram-negative bacilli (Klebsiella, Pseudomonas, Acinetobacter and E. coli) from 270 patients with nosocomial infections in Sina and Imam Hospitals, Tehran, Iran, were evaluated for susceptibility to Imipenem, Cefepime, Ciprofloxacine, Ceftriaxone and Ceftazidime by Disc diffusion and E-test methods. Results: The most frequent pathogens isolated were Klebsiella spp. (40%), followed by Pseudomonas (28%), Acinetobacter spp. (20%) and E. coli (12%). The most active antibiotic was imipenem (84%). 26% of all isolates were sensitive to Cefepime, 26% to Ciprofloxacin, 20% to Ceftazidime and 10% to Ceftrixone. The susceptibility rates of Klebsiella to Imipenem, cefepime, ciprofloxacin, Ceftazidime and Ceftriaxone were 91, 25, 21, 13 and 7 percent, respectively and 91, 19, 17, 21 and 21 percent, respectively, for E. coli. Among Acineto- bacter spp., the susceptibility rate was 77% for Imipenem and 21% for Ciprofloxacin. Among Pseudomonas spp., 75% of isolates were susceptible to Imipenem and 39% to Ciprofloxacin. The comparison of the resistance status of microorganisms by both Disc diffusion and E-test methods showed a clinically noticeable agreement between these two tests.
Conclusions: Since antibiotic resistance among Gram-negative bacilli has increased, enforcement of policy regarding proper antibiotic use is urgently needed in order to delay the development of resistance. Although it is widely accepted that E-test is more accurate in determining the resistance of microorganisms, our study showed that the Disc diffusion test will give the same results in most occasions and is therefore still considered useful in clinical practice.
Talebian S, Olyaei Gr, Hadian Mr, Bagheri H, Mehrdad S,
Volume 65, Issue 4 (3 2007)
Abstract

Background: The changes in motor control after the use of a supportive belt can contribute to the understanding of its effects on performance. The aim of this study is to quantify motion pattern values relative to the spinal column during the use of a lumbosacral belt.
Methods: For fifty healthy female volunteers, the range of motion, maximum isometric torque and changes of phase angle of maximum torque and velocity in two positions, standing and sitting, in two directions, flexion and extension, following the use of a lumbosacral belt were measured using an isoinertial dynamometer (Isostation B200) and compared.
Results: Range of motion in both directions in both positions was reduced significantly (P<0.05). Significant reduction of maximum isometric torque was observed in flexion while sitting and in extension while standing and sitting (P<0.05). Phase angle of maximum torque and velocity also changed significantly in both directions and both positions (P<0.05).
Conclusion: The lumbosacral belt can act in different ways to prevent injury. It reduces the forces applied to lumbar vertebra and, by changing the maximum torque and velocity phase angles at the onset of range of motion, provides greater stability for joints. Furthermore, the belt can reduce stress imposed on the posterior joints of the spine and limits several momentary forces at the onset of joint movement. Under these conditions, joint injuries can be reduced and prevent some of the mechanical stress that causes lumbar joint disease.
Abolfazli.r, Mirbagheri.a, Rabbani Anari M,
Volume 65, Issue 7 (4 2007)
Abstract

Background: Multiple sclerosis (MS) and the gluten intolerance disease, celiac disease, (CD) are immune-mediated diseases. Better testing for antibodies associated with CD, including anti-gliadin antibody [AGA], as well as anti-endomysial and anti-tissue transglutaminase antibodies, has improved the diagnosis of CD. Certain neurologic conditions have a reported association with CD. Previous researchers have investigated the role of a gluten-free diet in the treatment of MS and found no benefits. Here, we investigate the possible immunological association of CD with MS.
Methods: Using ELISA, we estimated serum IgG and IgA anti-gliadin and IgA anti-endomysial antibodies in 34 MS patients, who were new or previous cases without immunosuppressant treatment for at least the last six months. The mean age was 29.6 years (range 15-46 years), with 30 patients relapsing-remitting, and four secondary-progressive MS. Thirty-four random anonymous blood donors were used as serologic controls (mean age 31.4 years, range 19-50 years). The individuals in both groups with elevated AGA (IgG or IgA) or anti-endomysial antibody (IgA) underwent duodenal biopsy.
Results: In the MS group, high levels of IgG AGA were found in 5.9% of the subjects, and 5.9% had elevated IgA AGA. In the controls, elevated IgG AGA was detected in 5.9% of the subjects and IgA AGA in 2.9% (p=0.051 and 0.48, respectively). For IgG and IgA AGA levels, no significant differences were found between the patient and control groups. IgA anti-endomysial antibodies were not found in either group. Upon biopsy, the specific pathological features of celiac were absent.
Conclusion: The same number of MS patients and controls had high levels of AGA, with normal levels of IgA anti-endomysial antibodies, which is more specific for CD, while the GI biopsies from both groups were not specific for CD. Therefore, AGA levels in any neurologic case should be interpreted with caution. The present study showed no association between MS and CD.
Ramezanzadeh F, Noorbala Aa, Malak Afzali H, Abedinia N, Rahimi A, Shariet M, Rashidi B, Tehraninajad A, Sohravand F, Bagheri M,
Volume 65, Issue 8 (3 2007)
Abstract

Background: Considering the psycho-social model of diseases, the aim of this study was to evaluate the effect of psychiatric intervention on the pregnancy rate of infertile couples.

Methods: In a randomized clinical trial, 638 infertile patients referred to a university infertility clinic were evaluated. Among them, 140 couples with different levels of depression in at least one of the spouses were included in this substudy. These couples were divided randomly into two groups. The patients in the case group received 6-8 sessions of psychotherapy before starting infertility treatment and were given fluoxetine 20-60 mg per day during the same period. The control group did not receive any intervention. Three questionnaires including the Beck Depression Inventory (BDI), Holmes-Rahe stress scale and a socio-demographic questionnaire were applied for all patients. The clinical pregnancy rates of the two groups, based on sonographic detection of the gestational sac six weeks after LMP, were compared. The data were analyzed by paired-T test, T-test, χ2 and the logistic regression method.

Results: The pregnancy rate was 47.1% in the case group and 7.1% in the control group. The pregnancy rate was significantly related to the duration and cause of infertility and the level of stress in both groups (p< 0.001). The pregnancy rate was shown to be higher in couples in which the male has a secondary level of education (p< 0.001).

Conclusions: Psychiatric interventions greatly improve pregnancy rates, and it is therefore crucial to mandate psychiatric counseling in all fertility centers in order to diagnose and treat infertile patients with psychiatric disorders and help couples deal with stress.


Talebian S, Bagheri H,
Volume 65, Issue 12 (2 2008)
Abstract

Background: Joint trauma and injury are the most common causes of dynamic instability. Dynamic instability has a great effect on the lumbar spine, due to its three-dimensional motions. The greatest amounts of compression and shearing force are imposed at the points of maximum torque and velocity. The changes in these phase angles upon bearing various loads can cause some pathologic conditions. In this study, we examined the phase angle at maximum torque and velocity in the three planes of movement and then estimated their displacement upon external loads.

Methods: Using the B200 isoinertial dynamometer, 13 subjects were tested in three stages as follows: 1) Familiarization with tests and apparatus. 2) Warm-up and three maximum isometric tests, with a rest interval between each test, in the three axes of lumbar motion including: flexion/extension, rotation to right/left, lateral flexion to the right/left. 3) Five dynamic tests in these three axes of motion without load, with 25% maximum voluntary torque, and with 50% maximum voluntary torque. Special software was used to analyze the raw data and detect the occurrence of maximum torque and velocity in the dynamic range of motion at each of the three axes.     

Results: When the load was increased, the maximum dynamic torque in each of the three axes increased (P<0.05). The increase in load shifted the phase angles toward the maximum torque and velocity (P<0.05), with a positive correlation between changes in torque and velocity phase angles (P<0.05).

Conclusions: Rather than being a function of the biomechanical pattern, the changes in maximum torque and velocity of the phase angles following an increase in motion resistance to the outer range of the three axes are actually a control behavior in the motion processing system in dynamic movement.


Ghanbari Z, Emamzdeh A, Bagheri M,
Volume 66, Issue 6 (5 2008)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Macrosomia is a term applied to newborns with a birth weight of >4000g. This condition leads to several maternal and fetal complications including maternal traumas as well as newborn injury. This study was designed to evaluate the risk factors of macrosomia among Iranian women.
Methods: This cross-sectional study performed between July 2001 and July 2002, included 2000 term deliveries involving newborns with birth weights of >2500g. The records of 77 mothers of live born infants weighing >4000g were compared to those of the control group (231 women). Stillborn and neonates who were <2500g were excluded from the study.
Results: Among the 2000 deliveries performed in Imam Hospital, 77(3.8%) of the newborns weighed >4000g and 12(0.6%) weighed >4500g. The mean age of the mothers, maternal BMI, history of diabetes mellitus, multiparity, fetal sex and underling maternal disease were found to be associated with increase risk of fetal macrosomia. There was no significant relationship between prolonged gestation, weight gain more than 16kg during pregnancy and past history of macrosomic delivery and macrosomia.
Conclusions: It is possible to prevent macrosomia by weight and diabetes control before the decision to become pregnant. To prevent pregnancy among multipara mothers aged >35 years old, highly protective contraceptive methods should be used. Furthermore, if a mother is diagnosed with a macrosomic fetus by sonography or other imaging methods, more care should be taken during the delivery to decrease the risk of fetal injury, such as asphyxia and brachial plexus palsy.  


Abdollahi A, Bagheri R, Maddah Gh, Rajabi Mashhadi Mt,
Volume 66, Issue 6 (5 2008)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Stromal tumors of the gastrointestinal tract (GISTs) are uncommon and the cell of origin is actually mesenchymal. Stemming from smooth muscle, 90% of GISTs, or leiomyomas, are found in the lower two thirds of the esophagus. Typically solitary, multiple tumors (leiomyomatosis) are occasionally reported. Remaining intramural during their growth, most of their bulk protrudes toward the esophageal outer wall, with a freely-movable, normal-looking overlying mucosa. In this study, we report a rare case of esophageal leiomyomatosis treated by esophagectomy.
Case Report: A 70-year-old man presented with discomfort upon swallowing, dysphagia, nausea, belching and weight loss. After a barium swallow, only dilatation of the esophagus from the retained food and saliva was seen. CT scan revealed a 10-cm dilatation of the thoracic esophagus. An endoscopy and upper GI series was performed, but no pathology was found. Esophageal manometry and pH monitoring for gastroesophageal reflux were normal. Upon endoscopic ultrasonography, a thickening of the esophageal wall was identified 20-30 cm from the dental arch. The patient was diagnosed with a GIST, referred to surgeon and a transhiatal esophagectomy was performed. The patient was discharged from the hospital in good condition and has had no problem during the one-year period of follow up. 



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