Showing 171 results for MR
M Moghaddam, Smr Jazayeri,
Volume 53, Issue 2 (5-1995)
Abstract
AVNRT, (Atrioventricular nodal reentry tachycardia), atrial tachycardia and atrial flutter are 3 kinds of supraventricular tachycardia, which their mechanism are explained based on reentry. A 60-years-old man is presented with all of the above-mentioned arrhythmias, responsive to intravenous injection of adenosine. Radiofrequency ablation of the slow pathway territories cured all of them. Therefore, we suggest that there was a common pathway among all kinds of these arrhythmias, which were ablated with single RF lesion.
M Zargar, Mr Zafarghandi, H Mdaghgh, K Abasi, H Rezai Shirazi,
Volume 56, Issue 5 (6 1998)
Abstract
Nowadays, trauma is a major complex of industrial and developed countries. Integrated trauma systems have been used for many years to evaluate and minimize the severity of trauma outcomes (mortality and morbidity). We haven't had any trauma system or any comprehensive study, giving us proper information about our country trauma state. This article is based on comprehensive information of a descriptive prospective cohort study, performed in one year period in 3 major trauma centers in Tehran, evaluating 58005 Traumatic patients, referred to emergency rooms of these hospitals. In this article we have tried to represent a complete report of our patients' epidemiologic and demographic factors and trauma inducing mechanisms including traffic accidents, falls, gunshots, cutting objects ..., and their effect on the severity of injury and patients' outcome. Based on our study, traumatic patients are mainly young (age mode between 20-29) males (80%). The majority of patients were illiterate or had a low level of education. The most common mechanism of trauma was hitting of blunt objects (44.9%), however, it was car accidents in hospitalized and severely injured patients (39.9% and 53.7% respectively). The mechanism of trauma correlates significantly to the severity of injury, the need to hospitalization and the patients' outcome. In our study gunshots, car accidents and falls are the most important trauma inducing factors.
Mr Farah Vash. ,
Volume 58, Issue 1 (6 2000)
Abstract
Use of tissue expander in the recent decade has revolutionized the plastic surgery. The tissue expansion technique is advantageous in body reconstruction because it makes it possible to resurface the defects resulting from excision of burn scars with neighboring skin similar in color and texture and superior to skin grafts or distant flaps. Treatment of burn alopecia was a major problem in the past, but with the application of tissue expander this deformity is treated. We have learned by experience that tissue expander should not be used in the limbs, because of the high risk of complications. The best locations for tissue expander are in order: Scalp, face, neck and trunk. The incidence of burn induced deformities in Iran is high. In this research, I analyze the use of TE in 130 patients with burn deformities. The variables studied were: Sex of patients (43.1% male, 56.9% female), age groups, level of education, occupation, the anatomical site of burn, extension of burn, volume of tissue expansion, the location of placing the TE and complications.
R Omrani Pour , A Abasahl ,
Volume 58, Issue 1 (6 2000)
Abstract
To determine if pre-operative combined chemoradiation therapy increase sphincter preservation in the treatment of low-lying rectal cancer, 15 patients were treated with pre-operative chemoradiation: 5FU plus mitomycin C plus 4500-5000 Rad concurrent external beam radiotherapy between Jan 1997 and Jan 1999. There were 10 men and 5 women (Mean age: 49 y) with the diagnosis of invasive resectable primary adenocarcinoma of distal rectum limited to pelvis. Median tumor distance from anal verge was 3.3 cm (Range 0-5 cm) and half of the patients were absolute candidate for abdominoperineal resection. After 4-6 weeks, all patients were undergone proctectomy and eventually sphincter preservation surgery was done on 9 patients with colonal anastomosis. Function of sphincter was excellent in 6 of them (66%) and good in 3 patients (33%). There was no case of incontinence. Complications of surgery were minimal: One case of stricture (10%) and one case of partial rupture of anastomosis (10%). Complete pathologic response was achieved on one patient (6.6%) and combined pre-operative chemoradiation has changed the plane of surgery from abdominoperineal resection to sphincter saving in 69.2% of patients.
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.
M Rafiei , M Torkaman , Mr Sharbatdar Alaei ,
Volume 58, Issue 1 (6 2000)
Abstract
This cross-sectional descriptive study was undertaken to know the rate of intestinal parasites infestations in our school children population. A sum of 1155 fecal samples were analyzed from an equal number of children whose age were between 6-11 years old. The percentage of infestations were: Giardia lamblia (14.11%), hymenolepis nana (1.21%), ascaris lumbricoides (0.08%) and enterobius vermicularis (0.08%). We found no differences with regard to sex, age, father and mother levels of education, family size, body mass index (BMI) and the erythrocyte sedimentation rate (ER) between the stools positive and the stools negative cases. Nearly all cases of giardiasis (99.4%) were symptomatic. Eosinophilia was seen in (5.5%) of the infested children with giardiasis and in (0.5%) of the non-infested children, the difference was statistically non-significant (P=0.056). All cases of giardiasis (N=163) were treated with metronidazole 15 mg/kg/day in 3 divided doses for 7 days. Metronidazole was effective in (92.2%) of the treated children.
Mr Ashrafi ,
Volume 58, Issue 1 (6 2000)
Abstract
To evaluate breath-holding spell (BHS) and its triggering factors, 47 children with BHS admitted to the out patients clinic of Children's hospital medical center, between Sept 1998-June 1999, were included in this prospective study. Diagnosis of BHS was made for cases by medical history, pediatric physical examination, EEG, ECG and lab findings. 4 cases were excluded from study because of paroxysmal epileptic discharges at their EEGs. Of 43 cases having BHS (M:F: 1.15:1), 74.4% were less there 24 months of age (Mean age 18.4 mo). 77% of patients had onset of BHS within 12 months of age. Family history of BHS in first degree relatives were found in 51% of patients. Parent consanguinity were found in 30% of cases. The commonest type of BHS were cyanotic (79.1%). Pallid (11.6%) and mixed (9.3%) were other types. Pain and anger were the commonest triggering factors. 78% of cases were iron deficient and 53% of cases had iron deficiency anemia.
Ghafarnezhad M, Shams Mr,
Volume 58, Issue 2 (7 2000)
Abstract
Asymptomatic bacteriuria is prevalent during pregnancy. It can lead to pyelonephritis, premature pregnancy and low birth weight. In this prospective study, to determine prevalence and risk factors of asymptomatic bacteriuria, 205 consecutive pregnant women who visited our prenatal care clinic in Mirza-Koochakkhan Hospital and had no urinary symptom were entered. Patients data were recorded using a questionnaire and urine samples were obtained for urinalysis and urine culture. We analysed data by using fisher exact and chi-squared test. 14 cases had positive urine culture (6.8%). Significant correlation was seen between asymptomatic bacteriuria and age, parity, past history of kidney stone, pyelonephritis, urinary tract infection, preterm delivery and pyuria pvalue <0.05. We suggest routine urine culture in first visit of high risk and 16th week of low risk pregnancies.
Ghlich Nia Omrani H, Ghaffar Poor M,
Volume 59, Issue 2 (5-2001)
Abstract
This syndrome is a very rare neurological presentation which was first reported by Susac in 1975, and usually involves the young women with triad of: (1) Visual loss due to occlusion of retinal artery branches. (2) Subacute encephalopathy with psychic manifestation, personality disorders, involvement of the cortico-spianal tracts, pseudo-bulbar, focal or generalized seizures and myoclonic jerks. (3) Bilateral sensory neural hearing loss with tinnitus. All of the symptoms and signs are pathologically due to microinfarcts. It's pathogenesis is unknown. Brain biopsy shows multiple microinfarctions. Diagnosis of this syndrome is based on the clinical tiard, retinal angiography and neuroimaging studies. In this report, a young lady of 25 years old was referred to neurology ward of Imam Khomeini Hospital with above mentioned symptoms an signes and was recognized as a case of this syndrome.
Ghlich Nia Omrani H, Ghaffar Poor M,
Volume 59, Issue 3 (8 2001)
Abstract
This syndrome is a very rare neurological presentation which was first reported by Susac in 1975, and usually involves the young women with triad of: (1) Visual loss due to occlusion of retinal artery branches. (2) Subacute encephalopathy with psychic manifestation, personality disorders, involvement of the cortico-spianal tracts, pseudo-bulbar, focal or generalized seizures and myoclonic jerks. (3) Bilateral sensory neural hearing loss with tinnitus. All of the symptoms and signs are pathologically due to microinfarcts. It's pathogenesis is unknown. Brain biopsy shows multiple microinfarctions. Diagnosis of this syndrome is based on the clinical tiard, retinal angiography and neuroimaging studies. In this report, a young lady of 25 years old was referred to neurology ward of Imam Khomeini Hospital with above mentioned symptoms an signes and was recognized as a case of this syndrome.
Omrani Poor R, Noori S,
Volume 59, Issue 5 (9 2001)
Abstract
Regarding the prevalence of cancer in tongue and the management procedure of cases who have recurrence in cervical lymph nodes after partial glossectomy and in order to determine appropriate management of neck in early oral tongue cancer it was decided to conduct a study. A retrospective review of 62 patients with T1,2 N0 M0 SCC of the oral tongue treated by only partial glossectomy at Cancer Institute of Tehran university was conducted (from 1991 to 2000). Most of these patients were in 7th decade of life, men were affected more than women. Cervical lymph node recurrence at 2 years was 45.1 percent (28 patients from 62). In 34 patients (54.9 percent) who had not any recurrence in neck, 12 patients had received prophylactic neck radiation therapy after operation. With excluding this group of patients, the rate of cervical recurrence in early oral tongue cancer will rise to 56 percent. According to these findings, it is recommended that elective node dissection should be considered in the initial management of T1,2 N0 M0 oral tongue squamous cell carcinoma in our country.
Najafi Mr, Tamizi Far B,
Volume 59, Issue 5 (9 2001)
Abstract
The use of Antiepileptic drugs (AEDs) in children may be associated with adverse effects especially behavioral and cognitive and teratogenic potential effects. The main propose of this study was to find an answer to the question of which factors in EEG of patients before AED withdrawal could have prognostic role in our decision. We studied 106 children whom their medication had been withdrawn 2 years after their last seizure. Before starting of this, an EEG was recorded and interpreted by an expert neurologist. Many variables such as background activity, focal spike, generalized sharp and spik waves, focal slowing, in comparison with the EEG of patient at the time of diagnosis, and also final result of the trace interpret also examined. Follow-up visits were scheduled every 3 months at least for one year. If seizure relapsed, AEDs was resumed and follow up terminated. The overall probability of remaining seizure free was analyzed as a function of time by Kaplan-Meier survical analysis. Prognostic factors affecting seizure relapse were evaluated by using the log-rank test. The overall probability of seizure recurrences was 24.8 percent (95 percent C.I, 22.5 to 28.5) at 12 months. EEG comparisons with previous times were a significant factor for prediction of relapses. Relative risk of this factor was about 1.98 (95 percent C.I, 1.01 to 3.91) (P<0.05). We found that EEG interpretation at the time of diagnosis was not a significant factor but if it divided by sex, there is a significant difference in gender (P=0.06). According to our study the rate of AED withdrawal in children is small. The benefits of continuing AED therapy must be weighted against the risk of potential adverse effects. EEG comparison with previous traces could be evaluated as a prognostic factor before AED withdrawal in children.
Ghaffar Poor M, Ghelichnia Omrani Omrani H, Saber Tehrani Mm, Ghanaati H,
Volume 60, Issue 1 (13 2002)
Abstract
Low back pain is among the most frequent medical complaints and a major public health problem. 1.7 percent of cases are caused by herniated disc, 20 percent of which require interventional treatment. Percutaneous laser disc decompression (P.L.DD) can be considered as an effective therapeutic alternative in certain cases.
Materials and Methods: To determine the efficacy of this method in Iran in patient's with low back pain due to disc herniation, 40 patients according to medical history, physical examination and MRI findings were selected for this study. Patients who had canal stenosis, marginal, osteophyte, advanced disc dehydration, ruptured posterior ligament and other contraindication were excluded. CT scan was used only for needle navigation. After proper positioning of needle, nucleous pulposus was evapourated with Nd-YAG laser. Total energy was 1200-1600j. The procedure was done out patient and follow up has been done at 1 day, 1 week, 1,3, 6 and 12 months.
Results: There was no serious complication. 80 percent of patients in one-year follow up showed significant clinical improvement.
Conclusion: Our findings suggests that percutaneous laser disc decompression can be considered as an effective alternative method of treatment for disc herniation and patient selection is the critical factor which determines success rate.
Zafarghandy Mr, Nasiri Sheikhani N,
Volume 60, Issue 1 (13 2002)
Abstract
"Arterial Thromboembolism" is the most common cause of "Acute Arterial Ischemia" of extremities. In this study, It is attempted to collect retrospectively some documentary information of all "acute arterial thromboembolic occlusions of the limbs".
Materials and Methods: In descriptive retrograde study in Sina General hospital, all related records in this regard were collected from March 1991 to March 1997. To reveal the statistical outcomes and analysis the associations between them as well, the statistical tests like nonparametric ones were employed.
Results: Total number of the cases was 24 with " Acute Thromboembolic Arterial limb Ischemia" (3 in upper and 21 in lower limbs). The results were as follows: Female to male ratio =1/2, "Range of Age": 34-91, "Mode"=8th decade of life, "Mean"-64.48, "Etiology" Cardiac Origin in majority of cases ("A.F" in 57 percent) and Unknown Origin in 1/4 of cases. "Pain" was find in 95 percent, Grade HI ischemia in only 38 percent of patients on presentation and the others in Grade n. The most common "site of embolic occlusion" was "Femoral Ar." (76 percent). "Simultaneous Embolic Events" were fined in 29 percent. "Embolectomy" was performed in 79 percent (84 percent success rate) and "Primary Amputation" in 12.5 percent. "In hospital Mortality Rate" was fined in 24 percent and "Limb Salvage rate" in 68 percent. In conclusion, there were some logic relationship only between "Limb Salvage rate" and "Ischemic Grading" and also "Delayed diagnosis". There was also some significant direct relationship between "Mortality rate" and "Concomitant Embolic events".
Conclusion: This study was an explorative one that paves the way for further complementary investigations. Although there are many recommendations due to upgrading knowledge, attitude and practice of physicians as well as lay people Besides, the upgrading of educational and curative facilities should not be neglected.
Moeini Mr , Khorvash B, Monnajem Zadeh M,
Volume 60, Issue 1 (13 2002)
Abstract
This is a morbidity study about vascular trauma in Sina hospital, from 1974 to 1999. In this study morbidity is defined as amputation, wound infection, and recurrent thrombosis.
Materials and Methods: We reviewed the Patient's records and studied the effects of different factors such as type of trauma, associated injury, absence of capillary filling and presence or absence of distal pulse before and after surgery on morbidity.
Results: Reviewing 100 cases, we found 83 percent of them were thrombosis. The mean age was 32.5 years old. From the patients, 76 percent had penetrating trauma and the reminder had blunt traumas. Type of blunt trauma, associated injury, absence of capillary filling and the status of distal pulse, before and after surgery, time of surgery, muscular response to cautery and duration of hospital stay, all were associated with morbidity (P < 0.05).
Conclusion: In this study it is concluded that prompt diagnosis of vascular injuries, primary resuscitation and transferring the patients to proper centers and appropriate care of complicated cases, will help us to reduce morbidity.
Firoozbakhsh Sh, Safavi E, Zahed Poor Anaraki Mr, Derakhshan Deilami Gr ,
Volume 60, Issue 3 (14 2002)
Abstract
Background: Transbronchial lung biopsy (TBLB) is an attractive alternative to open lung biopsy as an initial diagnostic procedure for patients with diffuse parenchymal disease or localized densities beyond direct endoscopic vision. TBLB can be carried out safely without fluoroscopy in patients with diffuse lung disease. Since in our bronchoscopic department fluoroscopy is not available, we planned to evaluate the blind (without fluoroscopic guide) TBLB being performed in our department to determine the success rate in obtaining lung tissue, the sensitivity of the procedure and the risk of complications.
Materials and Methods: Sixty-Four TBLB were done in our department during a 6 month period (March-September 1999).
Results: Lung tissue wasn’t detected in two (3.1 percent) samples. Pathological results were helpful in 46 (71.9 percent) cases. No evidence of hemoptysis was found after the procedure. Three (4.68 percent) cases of pneumothorax was detected. Only one of them required chest tube (1.51 percent).
Conclusion: We concluded that blind TBLB was successful in our department with rates of complications comparable to other approved centers.
Hadian Mr, Otadi K, Oliaei Gr, Talebian Moghaddam S ,
Volume 60, Issue 3 (14 2002)
Abstract
Introduction: It is suggested that quadriceps muscle has an important role in stability & mobility of Knee joint in athletics and normal individuals therefore, the purpose of this study was evaluation of the strength in Power Athletics (PA) and Normal Un-trained Individuals (NUI) groups.
Methods and Materials: 31 Females (20 NUI & 11 PA) participated in this study. For measuring the strength, each individual performed 5 continuous concentric-eccentric maximal contraction at angular velocities of 90°/s, 135°/s. Twenty five percent of each individual (Maximum Voluntary Isometric Contraction) MVIC was determined and used as Pre-load force.
Results: Averages concentric & eccentric torques were greater in PA group in comparison with NUI group. The significant difference (P<0.02) existed between PA and NUI groups. Average concentric torques of quadriceps muscle decreased (with increasing of speed from 90°/s to 135°/s) and average eccentric torques increased. Average eccentric torques were greater (P<0.01) in PA & NUI groups in comparison with average concentric torques.
Conclusion: PA group strength was greater in comparison with NUI group. This is possibly due to the type of muscle fibers in this group have (greater type II fibers). Accordingly, it is critical to consider the role of eccentric exercise in PA group for preventing sport injury.
Khatibi Mr, Shahram F, Haji Zadeh E,
Volume 60, Issue 4 (15 2002)
Abstract
Introduction: Rheumatoid arthritis (RA) is a chronic and systemic inflammatory disease of unknown etiology. It is characterized by symmetric joint involvement with progressive deformities. This leads to limitation of motion and reduction of activity daily living (ADL). Previous reports showed the beneficial effects of therapeutic exercises in these patients in the remission phase.
Methods and Materials: A clinical trial as a self-control sequential control study was designed to determine the effectiveness of a range of motion (ROM) exercise program in patients with RA, referring to Rheumatology Research Center between 1994-1995. ROM of the selected joints by Goniometer, and ADL by a questionnaire was assessed in all patients in 3 phases: when entering the program, after 6 weeks of observation, and then after another 6 weeks with the therapeutic exercises. The mean difference in these 2 period were compared by student paired t test. The analysis of differences between different subgroups (job, education, etc.) was done by one way variance analysis.
Results: Forty patients completed the program. The mean ADL increased from 0437±0.252 before exercise to 6.69±3.06 after exercise (P<0.001), and the mean scores of ROM increased from 0.278±0.28 to 8±3.57 (P<0.0001), both statistically significant. This was more pronounced in women and in those with ankle joints involvement. The type of disease onset and duration of the disease did not influence the effects of treatment. No increase in disease activity was seen.
Conclusion: This study showed the effectiveness of our ROM exercises in increasing functional capacities of patients with RA in remission phase.
Soroosh Ar, Mojtahed Zadeh M, Katiraei M, Ganji Mr, Zenali F,
Volume 60, Issue 6 (15 2002)
Abstract
Introduction: The objective of the present study is to compare the respiratory function and pain relief of two parenteral analgesics tramadol and morphine under clinical conditions.
Materials and Methods: The trial was conducted as an open label-randomized, single center study. The study was performed during 3 months in 1999. In total, 64 patients were enrolled in Shariatie University Hospital, while the other 32 patients were treated with morphine.
Results: There were 12 male and 20 female in either groups. The mean age was 48±15 in tramadol versus 43±16 morphine group. Concerning the amount of the medication given to the patients. It would be observed that tramadol patients received 194±72 mg and morphine patients 17±7 mg out of drugs. At study admission vital signs were recorded. The pulse rate, blood pressure and respiratory rate are presented revealing no obvious differences between the treatment groups. There was a broad range regarding the underlying type of operation, however, a laparatomy or a cholecystectomy was performed in 24 (75.0%) Vs. 26 (81.3%) patients, respectively. All 64 patients were receiving anaesthetics as stipulated in the protocol. Of them being diazepam, sufentanil, succinylcholine chloride and thiopental as the most frequent reported, 4 Vs. 3 patient were given additional fentanylin a mean dosage of 220 mg Vs. 83 mcg. The oxygen saturation was the main safety parameter of the present study. No obvious differences between the two treatment groups can be detected (P<0.472). Primary efficacy end point was the pain assessment. The pain intensity at each scheduled time point was recorded. At study inclusion no differences between the treatment groups uncured, but during the 24 hour observation period the tramadol patients were in advantage (P<0.001).
Conclusion: This study shows that long-term efficacy of tramadol is better than morphine.
Taheri A, Hajimohamadi F, Khagavy Mr ,
Volume 60, Issue 6 (15 2002)
Abstract
Introduction: Laser beam due to finest of incision and reduction of postoperative complication, facilitates airway surgery, but at the same time it increases the danger or firing and the airway management and protection becomes difficult during anesthesia. In this study, two general anesthesia methods (Intermittent Apneic Technique And Continuous Controlled Ventilation With Enveloped Endotracheal Tube) have been compared with each other mater.
Materials and methods: two groups, each consist of 25 patients 10 to 60 years old, and ASA I-II class and below 100kg weight who have been candidate for laser therapy, were given two mentioned methods of anesthesia. All patients were suffering from subglotic stenosis, vocal cord nodules, papillomatosis and oropharyngeal obstruction. Induction and maintenance of anesthesia, and monitoring during surgery (EGG, PETCO2, SaPo2, BP, PR) in both groups were the same.
Results: Homodynamic stability in the both groups were the same and there was no hypoxia and dysrhythmia. In apneic technique group, most of the surgeries needed 2-3 time of apnea, and each apnea duration was 2-4 minutes, without any hypercaphic (Peteco 2>47 mmHg) and hypoxic (Spo2<90 percent) state and duration of laser surgery was about 9-10 minutes. More satisfaction was gained with apneic technique because of having a better surgery filed. All the patients had no recall at the end of anesthesia and patietn's expenses were much lower with no danger of firing.
Conclusion: It has been concluded that intermittent apneic technique in upper airway laser therapy is a better technique of anesthesia.
