Showing 518 results for Reza
Zavarreza J, Doosti M, Ariabarzin Sh, Soleymani S, Siavoshi F, Maserrat S,
Volume 65, Issue 1 (5 2008)
Abstract
Background: Helicobacter pylori (H. pylori) is one of the major causes of peptic ulcer, gastritis and gastric cancer. This bacterium has a special lipopolysaccharide (LPS), which is responsible for its pathogenesis and its high resistance against gastric acid and escape from the human immune system. This property makes it a target for further research and diagnostic goals. In this study, the extraction of the LPS and separation from the outer membrane is required.
Methods: The LPS was extracted from the outer membrane, or envelope, of H. pylori obtained from patients suffering from gastritis, gastric ulcer and gastric cancer. LPS extraction was performed using the proteinase K method. SDS-PAGE and silver staining were applied to investigate the electrophoretic pattern of the LPS. This pattern was compared with that of E. coli serotype O111:B4 and Salmonella serotype ATCC 14028.
Results: The extracted LPS has a ladder-shaped electrophoretic pattern and the bands are located in three groups: high, medium and low molecular weights.
Conclusion: The distribution of the bands of the ladder-shaped electrophoretic pattern is caused by the different number of oligosaccharide chains associated with the LPS. The high molecular weight bands represent S-LPS and the low molecular weight bands represent the R-LPS, which lacks the O-chain.
Dargahi H, Rezaian M,
Volume 65, Issue 1 (5 2008)
Abstract
Background: Quality assurance is a prevention-oriented system that can be used to
improve the quality of care, increase productivity and monitor the performance
management in clinical laboratories. ISO 9001: 2000 requirements are a collection of
management and technical systems designed to implement quality assurance and monitor
performance management in organizations.
Methods: A checklist was prepared to monitor the preanalytical, analytical and
postanalytical stages of laboratory performance management in 16 areas and all
laboratory activities in 14 of the clinical laboratories of the Tehran University of Medical
Sciences (TUMS) hospitals. Collected data were stored and statistically analyzed using
SPSS software.
Results: The best performance, in which 77.73% of quality assurance indicators were
observed, was found in Sina Hospital. However, only 57.56% of these indicators were
fulfilled at Farabi Hospital, with the lowest-level performance among the clinical
laboratories of TUMS hospitals. The highest level of compliance with quality assurance
indicators was in the hematology departments and for facility demands in management
areas. Overall, quality assurance indicators were appropriately followed in only 7% of the
clinical laboratories.
Conclusion: The average quality assurance observation rate in the clinical laboratories
studied was 67.22%, which is insufficient and must be remedied with stricter
enforcement of the ISO 9001: 2000 regulations.
Ziaee V, Fallah J, Rezaee M, Biat A,
Volume 65, Issue 8 (3 2007)
Abstract
Background: As future health care providers, medical students should be aware of the relationship between health and physical fitness, giving them an advantage toward attaining proper physical fitness. The exercise and fitness habits of first-year medical students in Iran are not known. This study examines the relationship between the body mass index (BMI) of an unselected group of first-year medical students and their personal physical fitness.
Methods: In this cross-sectional study, 513 first-year medical students were evaluated. BMI, skin folds (triceps, biceps, suprailiac and subscapular) and physical fitness were assessed in all students. Fitness was evaluated by the Eurofit test, which included body composition, cardiovascular endurance, flexibility, muscular endurance, muscular strength, power, balance and agility. The software SPSS (version 11) and Pearson's correlation were used for statistical analysis.
Results: The group surveyed was 67.8% female and 32.2% male, and 97.2% were entering medical school in 2004. The mean weight of the students was 60.1 kg, mean height was 163.9 cm and the mean BMI was 22.3 kg/m2. Underweight status (BMI<20) was observed in 27.1% of the subjects, 16.1% were overweight (2530). Overweight and obesity in males was higher than in females. The total physical fitness score in female students was better than that of male students. We found a negative correlation between physical fitness and weight, BMI, body fat and wrist to hip ratio in both genders. In addition, a positive correlation exits between hip circumference and physical fitness in both groups.
Conclusions: This study suggests that academically competitive premedical students may not be involved in physical activity. Medical students should be encouraged to maintain a good BMI and perform physical exercise.
Rezaei Y, Rahim Nia A, Mirmohamad S M, Vaziri K, Fakhrejahani F,
Volume 65, Issue 9 (3 2007)
Abstract
Background: The knee is the most commonly injured joint. The internal components of the knee include the meniscuses, the anterior cruciate ligament (ACL) and posterior cruciate ligaments (PCL). Magnetic resonance imaging (MRI) is now used widely because of its high accuracy and noninvasiveness. Our objective was to diagnose internal knee component injuries by MRI and compare its diagnostic value with that of arthroscopic surgery.
Methods: This process research study was carried out between May 2004 and September 2006 on 90 randomly selected patients admitted to the orthopedic ward of Baghiatollah Hospital, Tehran, Iran. Each patient had arthroscopic surgery after undergoing MRI by an expert radiologist.
Results: Out of 90 patients, 81 were male and nine were female. The mean age was 31.6 years (range: 17-71). Among patients with normal ACL as shown by MRI, 42.4% were shown by arthroscopy to have a ruptured ACL. The sensitivity and specificity of MRI in ACL abnormalities were 73% and 77%, respectively. Only 1.3% of the patients with normal PCL by MRI showed PCL rupture upon arthroscopic examination. The evaluation of the lateral meniscus by MRI had a sensitivity and specificity of 40% and 94%, respectively. Likewise, in the medial meniscus, sensitivity and specificity by MRI was 70% and 98%, respectively.
Conclusion: According to our study, considerable differences exist between MRI reports and arthroscopic findings in the diagnosis of internal knee injuries. We therefore conclude that sole reliance on MRI reports is not reasonable for making treatment decisions and MRI should be used as just one of the diagnostic tools, in conjunction with other methods, such as physical examination and arthroscopy.
Rezaee M, Ghasemi M, Joneidi Jafari N,
Volume 65, Issue 13 (Vol 65, Supplement 1 2008)
Abstract
Background: Dermal- respiratory reactions to latex glove is a common problem and
sometimes life threatening. Among health care workers, dental working personnel have
extensive use of latex gloves. A few numbers of researches have been done in Iran about
prevalence of these reactions but there is no comprehensive study for dental workers. The
purpose of this study was to evaluate reactions to latex gloves amongst dental workers in
military dental health centers.
Methods: In this cross-sectional descriptive survey, dental workers with a minimum of
three months length of employment and most often use of latex gloves were asked to fill
standard questionnaire (derived from South Carolina Medical University) regarding latex
related clinical manifestation and personal medical history and predisposing factors Data
analysis was done by χ2 and Student's t test.
Results: In our study 330 personnel were assessed. The mean age and length of
employment was 31.6 and 8 years respectively. The most occupation was dentistry. A
total of 232 subjects (70.3%) reported latex gloves-allergic symptoms. 72 (21.8%) of
persons have history of atopy and food allergy was seen in 114 (34.5%). 63 (19.1%) of
subjects reported history of hand dermatitis. All of these predisposing factors had
positive regression with dermal and respiratory reactions.
Conclusion: In this survey the prevalence of allergic reactions was higher than similar
studies which may be due to type of gloves, lack of preemployment assessments and
other factors. Use of diagnostic methods such as serologic measures, SPT and pulmonary
function testing (such as spirogram) could be considered as tools for confirmatory and
differential diagnosis and important complementary for these studies. Because of
relationship between allergic reactions to latex gloves and some medical histories, it
seems to be necessary for preemployment evaluation and periodic health surveillance of
dental workers.
Ashegh H, Rezaii J, Esfandiari K, Roueentan A, Abouzari M,
Volume 66, Issue 3 (2 2008)
Abstract
Background: Laparoscopic techniques for the placement of peritoneal dialysis catheters are becoming increasingly popular. Recently, with the improvements in laparoscopic surgery, various methods for the insertion of peritoneal dialysis catheters have been reported, indicating that the laparoscopic insertion is preferred over the open and percutaneous techniques. The aim of this study was to introduce and assess a simplified laparoscopic method for the insertion of peritoneal dialysis catheters in continuous ambulatory peritoneal dialysis (CAPD) patients.
Methods: We enrolled 79 consecutive end-stage renal patients (46 men and 33 women) with a mean age of 50 years (range: 19-83 years) in this study. During the surgery, a 5-mm trocar was placed in the left upper quadrant for the optics and another 5-mm trocar was placed to the left of the umbilicus. Using the second trocar, a tunnel was formed 2 cm left of the umbilical plane for the insertion of a Tenckhoff catheter. Under direct vision, the catheter was advanced into the abdomen. The catheter was tested for patency. Catheters of all subjects were capped for two weeks before dialysis initiation.
Results: The mean duration of the operation was 15 minutes. Ten patients died during the follow-up period, all due to other medical problems, and six patients underwent renal transplantation however, no deaths or complications were observed during surgery. Early onset complications were seen in 12 patients (15.1%). The most frequent late-onset medical and mechanical complications were peritonitis (6.3%) and hernia (3.7%). During a follow-up period of four years, removal of the catheter was required in two patients as a result of peritonitis.
Conclusion: We obtained a low complication rate and a high catheter survival rate with this laparoscopic insertion of the Tenckhoff catheter. We believe future experience will encourage the use of this safe, simple and quick procedure.
Rezaii J, Esfandiari Kh, Khalili Pooya J, Tavakoli H, Abdolrahman R, Salamati P, Abouzari M,
Volume 66, Issue 6 (5 2008)
Abstract
Background: Hypopharyngeal cancer usually presents with cervical mass, hoarseness, radiated otalgia, and dysphagea in the advanced stages. Radical surgery followed by radiotherapy plays an important role in the treatment of patients with hypopharyngeal cancer. However, there is no general consensus as to which is the best method of reconstruction after surgical resection. The aim of this study was to evaluate the complications of pectoralis major myocutaneous flap (PMMF) and gastric pull-up (GPU) techniques to reconstruct a circumferential defect after laryngopharyngoeso- phagectomy.
Methods: We retrospectively reviewed the records of 64 patients who underwent radical surgery and reconstruction with either PMMF or GPU technique. Demographic characteristics, tumor location, proximal margin involvement, history of radiotherapy, presence of lymphadenopathy, cervical dissection, and postoperative complications such as fistula, anastomotic site stenosis, swallowing dysfunction, and stoma stenosis were compared between the two groups. Postoperative complications of the reconstruction methods were compared.
Results: A total of 64 patients, 43(67%) in GPU group and 21(33%) in PMMF group, were studied. The groups did not differ in demographic characteristics. The locations of the tumoral lesions were in larynx (n=7), proximal esophagus (n=5), posterior cricoid (n=5), pyriformis sinus (n=7), posterior wall (n=7), and miscellaneous (n=41). Six patients (6.3%) had proximal margin involvement, 19 patients (29.9%) had history of radiotherapy, 26 cases (40.6%) had lymphadenopathy, and 49 cases (76.5%) had cervical dissection. There was no significant difference between the two groups regarding stenosis or swallowing dysfunction rates, but fistula was seen lower following GPU compared with PMMF (p<0.001).
Conclusions: The GPU technique results in similar functional stenosis or swallowing dysfunction rates, but lower fistula compared with PMMF reconstruction.
Valadan M, Rezaee Z, Mohammadpour J, Moghadami Tabrizi N,
Volume 66, Issue 8 (5 2008)
Abstract
Background: As an important diagnostic and therapeutic procedure for patients with intrauterine diseases, hysteroscopy permits a good view of the uterine cavity, thereby increasing diagnostic accuracy. Complications often encountered during hysteroscopy primarily concern problems with cervical dilatation and include uterine perforation, cervical tears, and the creation of false tracts. In this study, we investigate the utility of vaginal misoprostol for cervical dilatation in women undergoing hysteroscopy.
Methods: This triple-blind, randomized, placebo-controlled study was carried out at Mirza Khoochak Khan Hospital, Tehran, Iran. We excluded women who were pregnant, had genital tract infection, or history of cervical trauma. We randomly assigned 80 women with abnormal uterine bleeding or intrauterine lesions to receive either 200 μg vaginal misoprostol or placebo. Ten to twelve hours prior to hysteroscopy, the placebo or misoprostol was administered to the posterior vaginal fornix. Data regarding cervical response and outcome of operative hysteroscopy, as well as complications, were analyzed.
Results: The mean cervical width, as estimated by Hegar dilator, was significantly greater in the treated group (7.8±1.6mm) than that in the control group (5.6±2.2mm, p<0.001). In the misoprostol group, 28 (70%) patients required cervical dilatation, compared with 38(95%) in the placebo group (p=0.001). A significantly shorter median time of cervical dilatation to Hegar number 9 was found in the treated subjects than in the controls (60 vs. 180 seconds, p<0.001). The mean operative time was significantly shorter in the treated group (8.8±8.7 minutes) compared with that of the control group (13.1±10.1 minutes, p=0.043).
Conclusions: Vaginal misoprostol before operative hysteroscopy lessens the need for cervical dilatation, facilitating hysteroscopic surgery.
Taghizadeh-Jahed M, Jarolmasjed Sh, Mohamadnejad S, Rezaii A, Delazar A,
Volume 66, Issue 9 (5 2008)
Abstract
Background: Because of eventual side effects of chemical drugs, the efficacy of natural wound healing accelerators in long-term diseases and some situations is demanded to practitioners. The initial aim of our study was to assess full thickness excisional skin wound healing and inflammation diminution, Morphometrically and Histopathologically, after topical application of dried extract of Echinacea purpurea aerial part in rats, compared with zinc oxide.
Methods: Sixty wistar rats received four full thickness excisional wounds with the aim of surgical punch on the back skin under surgical anesthesia. All rats were randomly divided into groups 1, 2 and 3, of Echinacea purpurea, zinc oxide and control, respectively. All of them were treated topically once a day for 21 uninterrupted days. Healing of the wounds was daily measured by taking digital photographs and analysis. Histopathologic assessment was carried out in the 0th, 3rd, 7th, 14th, and 21st days of treatment period as well, and wound healing was assessed using 1 to 6 healing grades.
Results: According to Morphometric findings, the wound contraction rate in group 1 after 21 days of skin punching, with wound size of 0.18±0.03 mm2 in contrast with group 2, 2.81±0.21mm2, was much higher than that in other groups. Group 1 with wound contraction rate of 2.5 times in the day 7 and 3 times in the day 14 more than group 2, had the best wound contraction (p<0.01). histopathologic assessment revealed that, overall healing rate in the group 1 was highest (p<0.01).
Conclusion: Echinacea purpurea dried herbal extract could be a new capable remedy to accelerate skin wound healing because of its potential anti-phlogosis and wound healing stimulatory properties.
Mirhendi Sh, Adin H, Shidfar Mr, Kordbacheh P, Hashemi Sj, Moazeni M, Hosseinpur L, Rezaie Matehkolaie A,
Volume 66, Issue 9 (5 2008)
Abstract
Background: The clinical importance of yeast infections has increased in recent decades. There are 10-15 pathogenic Candida species. The current morphological and physiological methods for identification of Candida species are generally not easy to interpret and may be expensive or time-consuming. In the present study, we introduce and use a new approach for the identification and differentiation of medically important yeast species of Candida. In this method, size polymorphism of the internal transcribed spacer regions, ITS1 and ITS2, of the ribosomal DNA in various Candida species is used as the basis of species recognition.
Methods: The genomic DNA of 31 standard strains and 60 clinical isolates was extracted and PCR-amplified using two primer pairs (ITS1-ITS2 and ITS3-ITS4) separately. Both PCR products were mixed and analyzed after standard agarose gel electrophoresis. The species of the tested yeasts were identified by the electrophoretic patterns of the mixed PCR products of each sample, comparing the data obtained from the sequence analyses of ITS1 and ITS2 molecules.
Results: By this method, with the exception of C. albicans and C. dubliniensis, we were able to clearly differentiate nearly all common pathogenic Candida species, including C. albicans, C. glabrata, C. gulliermondii, C. parapsilosis, C. tropicalis, C. krusei, C. kefyr, C. lusinaniae and C. rugosa. All standard and clinical strains were identified correctly, without expensive methods such as sequencing and capillary electrophoresis.
Conclusion: It seems that the PCR-FSP method introduced in this study is the easiest molecular approach for the identification of a wide range of pathogenic Candida species and is applicable for diagnostic and epidemiological purposes in reference laboratories.
Tahmasebi Mn, Shahrezaee M, Kaseb Mh, Motaghi A,
Volume 67, Issue 1 (4 2009)
Abstract
Background: Anterior Cruciate Ligament (ACL) is one of the main knee stabilizing ligaments. Because of high incidence of ACL tearing especially in young athletes its reconstruction is very important. The aim of this study was to evaluate short-term results of anterior cruciate ligament ruptures using four strand hamstring auto graft and Bone patellar tendon autograph.
Methods: The study group included 96 patients (3 female and 93 male) with ACL teared who had been referred to our center in 5 years period (2002-2007). The subject which were Accessed in this study included meniscal injury concomitant chondral injury, determine the most common cause of ACL tearing, comparision of IKDC and lysholm score in all patients before and after surgery, and limitation of rang of motion of knee post operation.
Results: Involvement was in the right knee in 38 patients and in the left knee in 58 patients. Mean age of patients was 27.6 years (19-48). Mean surgical delay was 18 month (1-77). The most common cause of tear was playing soccer. Meniscal injury was in 78 patients. (Medial meniscus in 63 patients, lateral meniscus in 29 patients) Concommitent chondral injury was in 54 patients (56.25%). 68% of patients returned to preoperative functions sport activity. There was no limitation in extension and there was 6 patients limitation in flexion about 20º. In last visit of patients IKDS in class A and B was 96.
Conclusion: It is seem that arthroscopic reconstruction of ACL is a safe and good method in treatment of Knee stability. Use of IKDC and lysholm score for comparision of patients before and after surgery is helpful. The operation should be done early after injury. Reconstruction of ACL in older patients in the abscense of DJD is effective.
Tahmasebi Mn, Motaghi A, Shahrezaee M,
Volume 67, Issue 2 (5 2009)
Abstract
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Background: Knee
arthrosis is one of the most common and debilitating diseases in the advanced
ages. Regarding the fact that knee arthroplsty is the definitive and ultimate
treatment for this disease, we survey the short term result of this modality.
Methods: In this
survey 34 patients with knee arthrosis who have been admitted in Dr ali
shariati university hospital, Tehran, Iran in a five years period (2001-2006)
and have undergone knee arthroplasty. The relationship between, gender and the
operation results were evaluated using the system of knee society knee score
before and after the operation, causes of arthrosis, prosthesis to be used and
the complications of the surgery.
Results: patients
included 20 females and 14 males with the mean age of 67.37±5.25 year and the
age specterum (51-78). In 15 patients the operation was done only in right
knee, in 5 patients in the left knee and in 14 patients both knees were
operated. The mean of functional score of the operated knee reached from 32.68±4.14
before operation (26-45) to 68.67±6.45 after that (59-82) and the mean of knee
score reached from 30.6±3.8 before operation (22-39) to 86.4±6.34 after
operation (73-92).
Conclusion: Regarding
significant improvement in the functional score and the knee score and the low
complication rate of knee arthroplasty it is recommended that in case of
indication this operation be done as soon as possible because late attendance
increases complications.
Behnaz Haeri Behbahani , Ahmad Reza Dorosty , Mohammad Reza Eshraghian ,
Volume 67, Issue 6 (9-2009)
Abstract
Background: The sensitivity and specificity of body mass index (BMI) percentiles of CDC2000 standard which is used in determining obesity in Iranian children was compared with child real obesity identified by fat mass index (FMI) and obesity status in these children based on BMI and FMI was compared too.
Methods: Weight, height and triceps skinfold (TSF) thickness were measured in 1800 primary school children in Sabzevar, Iran. Fat mass (estimated from TSF) and weight were divided by height squared to calculate FMI and BMI, respectively. FMI at or above the 90th percentile of age- and sex- specific data in this study was considered as criterion for real obesity, and BMI≥95th and 85thResults: Based on the CDC cut-offs, the prevalence of overweight and obesity in our children were 7.9% and 4.8%, respectively. From the real obese and non-obese children identified by the FMI, 43.3% and 0.6% were identified as obese according to BMI, respectively. In addition, the sensitivity and specificity of 90th percentile of BMI to identify children as obese, were 71.1% and 98% respectively.
Conclusions: The efficacy of BMI in determining childhood obesity may be less than expected and it appears that FMI in comparison with BMI, is a better indicator of obesity in children, but more studies in this area are required.
Abdolreza Soudbakhsh , Habibollah Mortazavi , Mahbobeh Hajiabdolbaghi , Mehrdad Hasibi , Sirous Jafari , Hamid Emadi Kochak, Esmaili Djavid,
Volume 67, Issue 6 (9-2009)
Abstract
Background: Finding a reliable diagnostic method for brucellosis is the most challengeable problem. In this study we determined the optimal diagnostic cut-off point for ELISA test.
Methods: We gathered 56 confirmed cases of brucellosis. Furthermore blood samples from 126 controls including 73 healthy controls and 53 without brucellosis febrile patients were collected. In all of the cases and controls ELISA Ig G and ELISA Ig M levels were measured and compared with each other by Box plot graph and the Receiver Operating Characteristic (ROC) curve. The sensitivity and specificity of ELISA Ig G and Ig M were fixed in different cut-off values and Ig G and Ig M levels yielding maximal sensitivity plus specificity were selected for determination of optimal cut-off point.
Results: The nineteen patients had positive blood cultures for Brucella melitensis. The standard agglutination test results were 1/160 or more in 54 patients. The Box plot graph indicated a high degree of dispersion for Ig G and Ig M data in patients with brucellosis compared with febrile patients without brucellosis and healthy controls. We observed partial overlap for Ig M data (not for Ig G) between cases and controls. The area under ROC curve for discrimination of cases and healthy controls was more for Ig G than Ig M.
Conclusions: The ELISA Ig G is more reliable test than ELISA Ig M in diagnosis of brucellosis. Using cut-off of 10 IU/ml and 50 IU/ml have the most sensitivity (92.9%) and specificity (100%) for ELISA Ig G test, respectively.
Jalal Rezaei, Khalil Esfandiari, Hassan Tavakoli , Mahmood Sadooghi , Mehrdad Hasibi , Mehrdad Behzadi ,
Volume 67, Issue 6 (9-2009)
Abstract
Background: Central venous catheter (CVC) related infections are important complications of cathter application. This study assessed the usefulness of mupirocin in prevention and control of these infections.
Methods: In this randomized clinical trial, consecutive surgical patients requiring central venous catheter (for more than 2 days) in Amir-Alam Hospital from 2006-2008 were enrolled. Patients were divided in two groups in “case group” patients received topical mupirocin 2% every 48 hours at the time of insertion of catheter and dressing change and for “control group” mupirocin was not used. All of the patients received chlorhexidine and enoxoparin as complementary treatments. Two groups were comparable in regard of age, sex and risk factors.
Results: One hundred eighteen patients enrolled in the study (57 in case and 61 in control group) completed the study. 84 catheters in case group and 88 catheters in control group were inserted. The catheters in 90% of patients were inserted in jugular vein. At the end of study 29(16.8%) patients (16 in control versus 13 in case group) had catheter colonization (p=NS). Catheter related bloodstream infection was observed in 16(9.3%) patients (6 in case versus 10 in control group) (p=NS).Catheter related local infection was seen in 2(1.1%) patients of control versus none of mupirocin group. (p=NS).
Conclusions: Mupirocin was not effective to control and prevention of bacterial colonization and catheter related infection.
Saeideh Dahaghin , Ahmadreza Jamshidi , Seyed Arash Tehrani Banihashemi , Jaleh Gholami , Mohammad Hossein Forouzanfar , Masomeh Akhlaghi , Alireza Khabazi , Elham Noorolahzadeh , Mojgan Barghamdi , Bozorgmehr Arabzadeh , ,
Volume 67, Issue 6 (9-2009)
Abstract
Background: Osteoarthritis is the most common form of arthritis in the world. This study presents the evidence on the prevalence of symptomatic hand osteoarthritis in urban community. To add to the evidence on the prevalence of symptomatic hand osteoarthritis in urban community.
Methods: Inhabitants (age≥15 yrs) in 22 randomly selected districts (Tehran) participated in a Community-Oriented Program for Control of Rheumatic Diseases (COPCORD) evaluating major rheumatic disorders, including osteoarthritis. Eventually, 10, 291 inhabitants completed a Questionnaire (75% response-rate). Trained interviewers asked participants whether they had had any pain, swelling, tenderness, or morning stiffness in the right/ left hand during previous seven days. Participants underwent a complete physical examination if they had any musculoskeletal complaint or extra-articular manifestation of rheumatic disease. Osteoarthritis was defined as presence of palpable nodules (Heberden’s/ Bouchard’s nodes, CMC1’s squaring), pain, tenderness, swelling, or a combination of them on that joint (DIP-PIP-MCP-CMC1). Clinical hand osteoarthritis was positive if at least one joint showed osteoarthritis.
Results: Symptomatic hand osteoarthritis was present in 2.8%(CI 2.3-3.4) (52.6% female, mean age 37.1±16.3). Prevalence was higher in females (4.3% vs. 1.3%, p=0.000) and increased with age (0.1% in people <30 versus 23% in people >70, p=0.000). The most common signs in the DIP, PIP and CMC1 joints were bony enlargement, followed by tenderness and pain on movement.
Conclusions: our study confirms the evidence of high prevalence of symptomatic hand osteoarthritis in an urban community. The prevalence, pattern of hand joints involvement and relationship with age and sex in this study performed in an Eastern community resemble those in Westerners, which calls for further attention by appropriate services.
Ebrahim Hassani , Rasoul Farasatkish , Evaz Heydarpour , Mohammadzia Totoonchi , Alireza Mahoori ,
Volume 67, Issue 9 (6 2009)
Abstract
Background: Measuring end tidal carbon dioxide (ETCo2) is one of the methods used for estimating arterial carbon dioxide (PaCo2) during general anesthesia. ETCo2 measurements maybe obviate the need for repeating arterial puncture for determination of arterial PaCo2. This study performed to determine the accuracy of ETCo2 levels as a measure of PaCo2 levels in patients undergoing coronary artery bypass graft and also to evaluate variation of the gradient between PaCo2 and ETCo2, peri- cardiopulmonary bypass operation. Methods: In a prospective, cross-sectional study, a total of 40 patients with age 57±11 (35-73) years old undergoing coronary artery bypass graft were enrolled. ETCo2 levels (mmHg) were recorded using side stream capnography at the time of arterial blood gas sampling, before (T0) and after (T1) cardiopulmonary bypass. Results: Mean P(a-ET)Co2 at T0 was 4.3±4.4mmHg, with the mean PaCo2, 33±6mmHg and mean ETCo2, 29±5mmHg and these values at T1 were 4.5±4.1mmHg, 33±5mmHg and 29±2mmHg respectively. There was no variation of the mean gradient (PaCo2-PETCo2) during, before and after cardiopulmonary bypass (p>0.870). Significant correlation was found between ETCo2 and PaCo2 at T0 and T1 (r=0.754 and 0.685respectively and p=0.001). Conclusion: Capnography is a non- invasive and a safe technique for determining arterial PCo2 and for measurements of ETCo2 that correlate well with PaCo2 values in healthy patients undergoing coronary artery bypass graft. ETCo2 measurements maybe sufficient measures of PaCo2 in selected patients and obviate the need for repeatingarterial blood gas determination. Further study is warranted.
Abdolreza Pazoki , Ghasem Bagherpour , Amirraza Motabar ,
Volume 67, Issue 10 (1-2010)
Abstract
Background: The electrothermal bipolar vessel sealing system is an adjunct to the hemostatic technique, which has been successfully used in many abdominal operation, recently made available to thyroid surgery. The purpose of this was compare the outcomes of new hemostatic technique with traditional method of clamp and tie.
Methods: In this retrospective cross-sectional study has been done in surgery's wards of Milad & Rasul- Akram hospitals in Tehran, Iran. During three- year period between 2005-2008 all patients with different kind of pathology that need operation were assessed. Time duration of surgery and hospital stay and post surgery complication in two group, ligasure (n=45) and clamp & tie (n=145) were compared with each others.
Results: No difference was seen between two groups in time duration of surgery. Significant difference was seen in hospital stay and complications of surgery. Time of operation in Ligasure group was 132/22 minute and in clamp and tie group was 130/10 minute. There was found significant difference in duration of hospital stay and postoperative complication. Hypocalcemia were seen in two and 24 cases in Ligasure and Clamp & Tie group, respectively (p<0.05). Hospital stay was 2.18 versus 2.65 day in ligasure and clamp & tie group, respectively (p=0.005).
Conclusions: Although Ligasure is easier than clamp & tie for surgeons but no reduction in time duration of surgery was seen in ligasure group. The advantages of this method in this study was reduction of hospital stay and complication.
Mahin Tafazoli , Reza Saeedi , Mahbobeh Gholami Robatsangi, Seyed Reza Mazloom ,
Volume 67, Issue 10 (1-2010)
Abstract
Zahra Ahmadinejad , Abdolreza Soudbakhsh , Atefeh Tayebi ,
Volume 67, Issue 10 (1-2010)
Abstract
Background: Sepsis is the leading cause of hospital admission and mortality. One marker for differentiation between infectious and non-infectious diseases is serum procalcitonin (PCT) level. The goal of this study was evaluation of serum procalcitonin level for differentiation among infectious & non infectious systemic inflammatory response syndrome (SIRS).
Methods: In a cross sectional study 263 patients with probable symptoms of sepsis that admitted to emergency department of Imam Khomeini Hospital Complex in Tehran, Iran, between 2006 and 2008, were evaluated for serum procalcitonin level by semi quantitative method. The clinical findings, demographic and laboratory data were identified by reviewing the medical notes.
Results: A total of 263 patients enrolled in the study. Mean age in study patients was 46.9 year (20.7) and most of the patients were male (65.8%). In 104 patients (39.5%) serum procalcitonin level was less than 0.5 (ng/ml), in 49 patients (18.6%) was between 0.5 and 2 (ng/ml), in 74 patients (28.1%) was between 2 and 10 (ng/ml) and in 36 patients (13.8%) was more than 10 (ng/ml). Sixty three patients (60.6%) with PCT<0.5ng/ml, had non-infectious SIRS, while all patients with PCT≥10ng/ml, had infectious SIRS. Procalcitonin level in patients with infectious SIRS was significantly more than patients with non-infectious SIRS (p<0.0001). Sensitivity of test for cut off point of 0.5, 2 and 10 (ng/ml) were 89.2%, 67.1% and 22.8% respectively, and its specificity for cut off points of 0.5, two and 10 were 82.9%, 96.2% and 100% respectively.
Conclusions: Procalcitonin level in combination with an appropriate clinical assessment can help us in beginning of antibiotic therapy timely and improve diagnostic and prognostic evaluation of patients with sepsis.
