Background: Sport medicine is a relatively new scientific branch in Iran. In order to evaluate sport injuries in Iranian skiers we examined and followed all ski players who was injured while skiing in Shemshak slope during a skiing season (January to April 2000).
Materials and Methods: During a period of 3 months, a total of 32050 persons skied in Shemshak slope and 76 case of injuries were identified the injury rate was calculated as 2.3/1000 skiers. Among the injured organs knee (32%) and head and neck region (20%) were respectively the most common sites of injury. Sprain of the medial collateral ligament was the most frequent knee injury (28% of the cases). 26.7% of the injured cases were amateurs and 21% of them used hired ski instruments.
Results: In this study such factors as lack of exercise before skiing, fatigue and time of skiing (beginning or end of the season) were not found to be related to the injury rate. However, head and neck injuries in contrast to knee injuries were most frequent in the end of the season (P<0.01).
Conclusion: This study confirms the necessity of greater care of knee joints during skiing and probable need of wearing helmet for head protection in the end of skiing season. More studies are necessary to clarify other details regarding sport injuries in skiers.
Background: Posterolateral rotatory instability is one of the most complex problems in ligamentous injuries of the knee. It represents a challenging diagnostic and therapeutic problem for the orthopaedic surgeon. We present the results of biceps tenodesis in chronic posterolateral rotatory instabilily of the knee.
Methods: In this case series we included all of the patients with positive reverse pivot shift test and prone external rotation test at least 3 weeks after their trauma. We excluded the patients with varus malalignment of the knee and concomitant anterior cruciate ligament (ACL) rupture. Biceps tenodesis (Clancy method) was performed. We did not reconstruct posterior cruciate ligament (PCL) if its insufficiency was diagnosed in addition to posterolateral rotatory instability. Knee scoring scale of Lysholm was used during and after follow ups. The results were statistically compared using Wilcoxon signed rank test (WSRT), paired samples t-test and friedman test. Data analysis was done using SPSS (version 11.5) and Stata (version 8) computer softwares.
Results: Our series consists of 13 patients (12 male and one female). 31% of the patients had isolated posterolateral injury and 69% of the patients had combined posterolateral and PCL injuries. The patients were between 17 to 45 years old (mean 30.25 years). Follow up was between 4 to 44 months (mean: 31 months). At the end of follow up 85% of patients had negative reverse pivot shift test. Prone external rotation test at 30° of knee flexion was negative in 92% of patients. In 92% of patients giving way was negative and in 77% of patients pain was decreased. Before operation the average Knee scoring scale of Lysholm was 73 and at the end of the follow up it increased to 85 (p value<0.001).
Conclusions: Biceps tenodesis using Clancy method is a safe, effective and reliable method in management of chronic posterolateral rotatory instability of the knee. During surgery careful exploration of the common peroneal nerve is recommended. Although we found this method effective in combined posterolateral and PCL injuries the results are much better in the cases with isolated posterolateral injuries.
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MicrosoftInternetExplorer4
Background: Dendritic Cell (DC) is an important
antigen-presenting cell that present tumor antigen to CD8+ and CD4+ T- Lymphocytes and
induce specific anti-tumor immunity. In
order to induce effective anti-tumor response, an option is increasing the
efficiency of antigen presentation of dendritic cells and T cell activation capacity. The aim of the present study was to investigate the effect of dendritic cell maturation with protein components of toxoplasma gondii on cytotoxic T lymphocyte
activity and their infiltration in to the tumor.
Methods: For DC generation, bone marrow cells were cultured in the
presence of GM-CSF and IL-4 for five days. After that, LPS, protein
components and whole extract of toxoplasma gondii were added to the culture
media and incubated for another two days for DC maturation. To generate tumor,
mices were injected subcutaneously with WEHI-164 cell line. For immunotherapy 106 DCs
matured with different compounds were injected around the tumor site.
Infiltration of CD8+ T cells were determined by flow cytometry and cytotoxic
activity was measured by LDH detection kit.
Results: Immunotherapy with DCs treated with protein components of toxoplasma gondii
led to a significant increase in the activity of cytotoxic T cells and
infiltration of CD8+ T cells in to the tumor. Immunotherapy using protein
components of toxoplasma gondii significantly improved the survival of the mice
compared with other groups (p<0.0001).
Conclusion: Protein components of toxoplasma are able to increase DC capability in
induction of CTL-mediated
anti-tumor response and
increase infiltration of these
cells in to the tumor.
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MicrosoftInternetExplorer4
Background: Sleep and sleep deprivation plays a major role in EEG abnormalities and also
idiopathic and symptomatic seizures. The aims of this study were to compare
baseline EEG findings with waking and sleep EEGs after sleep deprivation in patients with sleep seizure.
Methods : In this cross-sectional study, 33 patients with sleep seizure attending the Neurology Clinic of Sina Hospital
in Tehran, Iran, during year 2009 were enrolled. After a baseline EEG, patients were asked to remain awake for 24 hours before taking a waking
and a sleep EEG. Finally, the baseline EEGs were compared with findings from waking and sleep EEGs after sleep deprivation.
Results : From 33 patients with sleep seizure, sixteen (48.5%) patients were female and seventeen (51.5%) were male. Patients aged from 7 to 49 years and the mean age of the participants was 26.83 (SD=10.69) years. Twenty patients
had no family histories of seizure contrary to 13 patients with a positive history for the disease. There was statistically significant differences between the baseline
and waking EEGs after sleep deprivation (P=0.042) as there was between baseline and sleep EEGs (P=0.041). Moreover, there was
significant differences between waking and sleep EEGs after sleep deprivation (P=0.048).
Conclusion: This study demonstrated the effects of sleep deprivation on EEG
findings in patients with sleep seizure. In patients with sleep seizure, waking
and sleep EEGs could be better demonstrated
after sleep deprivation than routine waking EEGs. According
to the results of this study, waking EEGs taken
after a period of sleep deprivation is superior to sleep EEGs
after the deprivation.
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MicrosoftInternetExplorer4
Background: One
of the difficulties in acetabulum surgery is appropriate exposure of the site
of surgery. Trochanteric flip osteotomy is one of the surgical methods for
superoposterior and posterior acetabulum exposure. However, due to possible
complications some surgeons prefer to avoid this procedure. This study was
undertaken to determine the outcome of surgical treatment of acetabular
fracture using trochanteric flip osteotomy.
Methods : In this prospective cohort study, 14
patients with acetabular fracture who had
been admitted in Imam Khomeini Hospital in Tehran, Iran, during 2003-2006 underwent trochanteric
flip osteotomy. The patients were followed for at least one year post-surgically.
Demographics, radiologic findings, intensity of pain using visual analogue scale
(VAS),
Harris hip score (HHS), force of hip abductors and complications were noted. Data analysis
was performed using SPSS ver. 13.
Results : The mean HHS was 82.5 (55-95). Heterotopic ossification was observed in three patients. There were
no cases of postoperative infection or non::::union::::. Only two patients showed
displacement of osteotomized fragments. Reduction was anatomic in 10 patients. In one patient, the
force of hip abductors was three-fifth. The mean hip pain was 3.4 based on VAS. There were no cases of
femoral head osteonecrosis. With respect to HHS, the final hip status was
excellent and good in four and six patients, respectively. Three patients had
fair and only one patient had poor condition.
Conclusion: It seems that trochanteric
flip osteotomy has much fewer complications in comparison to other methods justifying
its use in such cases.
Background: Choosing the right drug with the least side effects and highest effectiveness for the control of seizures in the elderly is important. The aim of this study was compare the efficacy of lamotrigine and levetiracetam in the management of epilepsy in the elderly.
Methods: This study was performed as a double-blind randomized clinical trial in patients that referred to the neurologic clinic at Sina University Hospital, Tehran, Iran in 2012. The patients over sixty years old with a diagnosis of epilepsy were selected. They had one seizure in year at least and one attack in the last 6 months. First, the patients divided to two groups Group one were treated with lamotrigine, 25 mg per day and group two were treated with levetiracetam, 250 mg per day for 24 weeks. In the absence of drug complications, the dose was increased to the maximum dose listed in the treatment protocol. Second the patients were followed in number of attacks, abnormalities in laboratory data and side effects of drug in 2, 4, 8, 12 and 20 weeks. The collecting data of the study were analyzed using descriptive and analytical statistics methods.
Results: Forty nine cases, 28 males and 21 females in lamotrigine group and 46 cases in levetiracetam group, 27 males and 19 females participated in the final analysis. Mean age of patients was 72.40±5.87 (63-85). Drug side effects were observed in 57 cases, 26 cases of lamotrigine group and 31 cases of levetiracetam group. Seizure frequency showed a declining trend in both groups but in lamotrigine group more than levetiracetam group in last week (P= 0.039).
Conclusion: The findings of the study showed lamotrigine and levetiracetam were effective in management of epilepsy in the elderly. Levetiracetam has a higher seizure-free effect than lamotrigine but lamotrigine is better tolerated than levetiracetam.
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Background: Laryngeal tuberculosis (TB) is one of the most common complications of pulmonary tuberculosis, which increased for various reasons such as more prevalence of immune system suppression diseases, increasing the survival of the elderly, immigrants from high-risk areas and the appearance of atypical or resistant organisms over the past two decades, and its clinical pattern changed compared to the past. In contrast to the past that patients complained about dyspnea, coughing and other symptoms, today, the main complaints of these patients are hoarseness and Odynophagia. In reality, the prevalence of laryngeal TB without pulmonary manifestation was increased these days. The purpose of this study was to evaluate these symptoms in laryngeal TB.
Case Presentation: In this case report study, we examined a 77-year-old man who was admitted to the otorhinolaryngology department of Shafa hospital of Kerman (an academic hospital of Kerman University of Medical Sciences), Iran in April 2019 due to hoarseness since 6 months before admission and the results of evaluation confirmed the presence of laryngeal tuberculosis in this patient. The patient treated with Anti-TB drugs (Isoniazid, Rifampicin, Pyrizinamide, and Ethambutol) according to standard protocol and responded appropriately to this medication regimen. Conclusion: Although laryngeal tuberculosis is a rare disease, it still occurs. Therefore, by increasing the incidence of tuberculosis, changes in the clinical pattern and its spreading mechanism, physicians should always be aware of the unusual clinical features of laryngeal tuberculosis and the possibility of developing it for early diagnosis and treatment. It should be considered as a differential diagnosis in all laryngeal diseases to prevent the complications of the disease and decrease the risk of transferring it to other people. |
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Conclusion: In this study, we investigated the epidemiological and clinical features of neck masses in Kerman. It is obvious that smoking is an important risk factor for neck mass malignancies. Also, the present study revealed that the incidence of malignant tumors increased with age.
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Results: 50 participants including 27(54%) men and 23(46%) women with an average age of 33±12.5 years and BMI of 25±5.5 kg/m2 were examined. After examining the vertebral and pelvic parameters, it was found that PI is significantly higher in women than in men (P=0.02). It was also found that with increasing age, the amount of Pelvic incidence also increases (P=0.043), so that in people over 60 years of age, the amount of pelvic incidence is significantly higher than other people (P<0.05). Further analyzes showed that BMI has a direct effect on the amount of Thoracic Kyphosis (P=0.03) and Lumbar Lordosis (P=0.04). Thus, the highest amount of Lumbar Lordosis and Thoracic Kyphosis was seen in people with BMI 30-34.9 Kg/m2.
Conclusion: The findings of the present study showed that spine and pelvis indices have an important effect on the occurrence of CLBP. Hence, it is highly recommended to check these parameters in asymptomatic people, especially in older people. |
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Results: According to the obtained results, metastatic involvement of cervical lymph nodes was diagnosed in 36.6% of patients (38 people). Of these, 30.7% of patients (32 people) were real positive. The results of ultrasound before surgery were shown as false positive in 9.5% of patients (6 people). Lymphatic metastasis was not seen in 58.4% of patients (60 people) before surgery, which was consistent with the pathology result after surgery (true negative). The positive predictive value of examining metastatic lymph nodes by ultrasound was estimated at 84.2% and the negative predictive value at 92.3%. The diagnostic accuracy of ultrasound was 89%, the sensitivity rate was 86%, and the specificity rate was 90% with the area under the curve AUC=0.884 and P<0.001. Ultrasound accuracy is not affected by tumor size, Hashimoto's thyroiditis and metastasis location (P<0.05). In patients with Hashimoto's thyroiditis, the tumor size increases significantly more than 10 mm.
Conclusion: Ultrasound alone has an acceptable diagnostic accuracy in detecting metastatic lymph nodes caused by papillary thyroid cancer. However, the incidence of false negative error increases as the tumor size decreases. |
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Results: We found 77.7% of the 150 patients had metastatic ALNs, indicating a high rate of lymphatic spread in this population. Ultrasound showed a sensitivity of 86.09% and a specificity of 51.52% in detecting malignant nodes. Radiological signs of cancer, like abnormal morphology and increased cortical thickness, were strongly linked to positive pathological findings. This shows that ultrasound is a useful tool for diagnosis.
Conclusion: The results indicate that ultrasound, as a non-invasive and accessible modality, can serve as a valuable diagnostic tool for identifying malignant ALNs in breast cancer patients. Integrating ultrasound with physical examination could enhance diagnostic precision, potentially reducing the need for invasive procedures such as biopsies. However, more research is necessary to establish the role of ultrasound in clinical protocols and investigate its potential to guide customized treatment strategies. Such advancements could optimize patient outcomes, enhance resource allocation, and ultimately contribute to more effective breast cancer management. |
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