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Mm Sadat, M Karami,
Volume 59, Issue 6 (11-2001)
Abstract

This was a retrospective review of a consecutive series of patients with spinal disease in year 2000, who underwent posterior fusion and instrumentation with Harrington distraction and Cotrel-Dobousset system to evaluate causes of hardware failure. Many cases of clinical failure has been observed in spinal instrumentation used in spinal disorder like spondylolisthesis, fractures, deformities, … . Thirty six cases that were operated because of spinal disorders like spondylolisthesis, fractures, deformities, …, were included in this study. Seventeen of this cases had breakage of device. Factors like age at surgery, type of instrumentation, angles before and after surgery and …, were compared in two groups of patients. The most common instrument breakage was pedicle screw breakage. Pseudoarthrosis was the main factor that was presented in failure group (P value<0.001). Other important causes were, age of patient at surgery (P value=0.04), pedicle screw placement off center in the sagittal or coronal plane of the pedicle (P value=0.04). Instrumentation loads increased significantly as a direct result of variations in surgical technique that produce pseudoarthrosis, pedicle screw placement off center in the sagittal plane of the pedicle, or using less than 6 mm diameter screw. This factor can be prevented with meticulous surgical technique and using proper devices.
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.


Karimi Shahidi Sm, Dabbagh Mohammady A, Iravani B, ,
Volume 60, Issue 1 (13 2002)
Abstract

Sepsis is one of the most critical medical emergency situations. Treatment with anti microbial drugs should be initiated as soon as samples of blood and other relevant sites have been cultured. Available information about patterns of anti microbial Susceptibility among bacterial isolates from the community, the hospital, and the patient should be taken in to account. It is important, pending culture results, to initiate empirical anti microbial therapy.
Materials and methods: In a descriptive study during 3 years (1377-1379), microbial and anti microbial susceptibility patterns evaluated in Amir alam clinical laboratory on 2000 specimen of blood culture received from 765 hospitalized patients at Amir Alam hospital wards.
Results: 113 specimens from 77 patient (10 percent) were positive for microbial growth. Enterobacter, S. aureus, S.epidermidis, Pneumococci, Ecoli, and Pseudomonas were the most common isolated etiologic agents(80 percent) . The most common organism was Entenobacter in 1377, S.aureus in 1378 and pseudomonas in 1379 There were significant change in patlern of organisms, increase resistance to some important available antibiotics and change in antibiotic susceptibility pattern during three years (disc diffusion method).
Conclusions: According to Results of this study due to change in pattern of organism and their antibiotic susceptibility, dynamic microbiological study provide important data for Ordering empirical and culture oriented treatment of patients with bacteremia, Sepsis, anti microbial Chemotherapy, anti microbial susceptibility empirical anti microbial therapy, microbial pattern.
Gharabaghian M, Sadeghy Sa, Mir Mohammad Sadeghi Sf, Rafieyani Sa,
Volume 60, Issue 4 (15 2002)
Abstract

Background: Cuffed pharyngeal tube is a device designed for ventilation of anesthetized patients. CPT has advantages over face mask including: maintaining of face mask can be difficult and boring after several minutes and mobility of the practitioner is reduced due to involvement of hands. Mask pressure can cause soft tissue and nerve damage around the nose. Anesthetic gas leakage from the mask adds to the operation room pollution. In difficult intubation CPT can be life-saving.

Materials and Methods: In our study CPT was compared with endotracheal tube (ET) in anesthetized patients. A scoring system for evaluating ventilation of patients was designed using symmetric chest wall motion during ventilation with anesthesia bag and sensing lung compliance through it, auscultation of breathing sounds, oscilation of bag with breathing and peripheral oxygen saturation by pulse oxymetry. Respiratory complications (pulmonary aspiration, Iaryngospasm and bronchospasm, nausea and vomiting) were looked for during anesthesia.

Results: The results showed that CPT was successful as ET in ventilation of spontaneously breathing patients and incidence of respiratory complications with CPT was no more than ET. Airway resistance was significantly greater with CPT than ET (P<0.05). Patients with ET had significantly greater incidence of sore throat than with CPT (P<0.05).

Conclusion: Thus we concluded that CPT can be used for ventilation of anesthetized patients not predisposed to pulmonary aspiration and whose peak airway pressure does not exceed 20-25 CmH2O.


Hajy Mohammadi F, Fard F, Taheri A, Hoozan B,
Volume 60, Issue 5 (15 2002)
Abstract

This study was conducted to evaluate effect of clonidine as a premedication on endoscopic sinus surgery bleeding.
Methods and Materials: during a randomized double blind clinical trial we compared two groups of patients who scheduled for endoscopic sinus surgery for polypectomy and etmoidectomy. 216 patients randomly assigned in two groups.In first group 2 hours befor surgery a 0.2mg tablet of clonidine orally adminestered to patients and in second group a 100 mg tablet of vit Bj(with same size and color- as
placebo)was adminestered to patients. The amount of bleeding measured in two groups.
Results: mean bleeding volume in clonidine group was 113+76 ml and in control group was 211 + 113 ml. There was a significant statistical difference between two groups (pO.0001).
Conclusion: Clonidine as premedication can reduce bleeding of endoscopic sinus surgery significantly.
Asadi Amoli F, Mohammadi S Z, Haeri H, Kasaei A,
Volume 61, Issue 2 (14 2003)
Abstract

There are few studies of eyelid's neoplasm in Asia which in comparison of references are some differences.
Materials and Methods: For this reason the retrospective study in 1103 patients which are referred to Farabi Hospital in 10 years period of 1988-1998 was performed. Epidemiological and histopathologic details were sough.
Results: 44 percent of the neoplasm were benign and 56 percent were malignant. The most prevalent benign neoplasm of eyelid respectively were Nevus (37.7 percent) hamartoma (19.6 percent) and papilloma (15.9 percent) and malignant neoplasm of eyelid respectively were basal cell carcinoma (78.7 percent), squamous cell carcinoma (11.8 percent ) and melanoma (2.4 percent ). The mean age in benign neoplasm was 36 years and in malignant ones 57 years, In benign tumors the most prevalent anatomical site respectively were upper eyelid, lower eyelid and inner canthus. But in malignant tumors it was occurred most frequently in upper eyelid in comparison to lower eyelid in addition occurrence of malignant tumors was prevalent in left but in benign neoplasm right and left eyelid were involved equally.



 


Sharifian R, Mohammadi S M, Ghasemi D, Safaei S R, Toogeh Gh R, Emami A H,
Volume 61, Issue 2 (14 2003)
Abstract

Neutropenic state with fever is exactly regarded as a medical emergency, with high mortality and morbidity rate, unless treated urgently and correctly. Every attempt should be made to find and establish the offending organism, but postponing treatment until obtaining culture results is not advised. Controversy exist on which antibiotic regimen to be used while waiting for culture results. Many antibiotic regiments both monotherapy or combination treatments have been used with varying result. The objective of this study is to compare the efficacy of cefriaxon monothenapy with ceftazidim. Plus Amikacin as initial empiric antibiotic therapy in febrile neutropenic patients.
Materials and Methods: We performed a randomized, single blind clinical trial in 57 adult (age>12 years), neutropenic (PMN<1000) patients with fever (Temperature, oral >38.5c) in Hematology ward, Imam khomeini hospital. After careful physical exam and obtaining blood & urine samples for culture, the patients were randomized to each of the two arms: Cefriaxon 2 grams daily, intravenously (arm A) and Ceftazidim 2g thrice daily plus amikacin 500 mg twice daily (arm B). Patients with shock, organ failure or previous antibiotic intake (during 48 hour before fever) were excluded. If needed, dose adjustment of drugs were allowed. Effervescence in 3 days following initiation of treatment, lasting 48 hours or more, were regarded as effective (positive result).
Results: During a twelve months period of study, a total of 57 patients (17female, 40male) were included. They were randomly selected to each arm of empirical treatment. Of 28 pts in arm A, 19 (67 percent), the treatment was effective, compared to 15 of 29 (51.7 percent) in groups B. The duration of fever after initiation of treatment was 37.9 ± 17 hours in arm A and 40. 1 ± 20 h in arm B. Blood and / or urine culture was equally positive in two arms (25 percent in arm A and 27.6 percent in arm B).
Conclusion: Cefriaxon monotherapy is at least equally effective in low risk neutropenic patients with fever compared to combination of ceftazidim plus amikacin at a decreased cost and probably (expected) less adverse side effects in our patients.

 


Motesaddi Zarandi M, Amirabadi M, Yazdani N, Mohammadi Ardehali M, Torkashvand Z,
Volume 61, Issue 5 (15 2003)
Abstract

Eustachian tube connects middle ear space to the nasopharyngeal space. Upper airway obstruction, with any cause, can derange Eustachian tube function. Nasal septal deviation is one of the prevalent causes of upper airway obstruction which can affects the ventilation function of Eustachian tube.
Materials and Methods: This study was conducted on the patients who underwent septoplasty due to severe septal deviation leading to unilateral nasal obstruction in Amiraalam hospital from summer of 1378 till the spring of 1379.
Results: There was 140 patients whose data were as: female patients 34 (24.3%) male patients 106 (75.7%), mean age (22.7). Median age (20) years and mode of age (18) years of age. they were from 12 to 40 years of age.
Conclusion: Comparison between preoperative and postoperative middle ear pressures shows no any significant statistical difference (p=0.798).
Heidari Z, Mahmoodzadeh Sagheb Hr, Mohammadi M, Noori Moogehi S M H, Arab A,
Volume 62, Issue 2 (12 2004)
Abstract

Background: Cephalometry is one of the important branches of anthropometry that has wide uses in identification, forensic medicine, plastic surgery, orthodontics, archeology and determining the origins of races. This research was investigated to determine the head and face phenotypes among one-day newborn boys in two aborigines of Sistani and Baluchi who were resident in Zahedan.

Materials and Methods: The investigation is based on cross-sectional analytical descriptions of 420 newborn aborigine boys (216 Sistani & 204 Baluchi), who were clinically healthy, in Quds hospital in summer 1381, in Zahedan. In this study cephalic and prosopic indices were determined by classical cephalometric.

Results: The mean and the standard deviations of cephalic index were 83.67±4.80 and 83.64±4.77 and prosopic index 86.79±5.87 and 86.53±6.76 for Sistani and Baluchi subjects respectively. Based on the cephalic index, the dominant head types in sistani group were hyperbrachycephalic (37%) and brachycephalic (37%). In Blachui group, the hyperbrachycephalic (37.3%) and brachycephalic (35.3%) type were the dominant one. Furthermore, according to the prosopic index. The dominant face type among sistanis was euryprosopic type (42.6%). In Baluchi group, the dominant face type was also euryprosopic (39.2%).

Conclusion: This research showed no statistically significant differences in terms of head and face type indices between two aborigines of Zahedan. Based on this cross-sectional study, it seems that there is similarities between the aforementioned groups


S.h Mirkhani, M.r Mohammad Hasani, M Sanatkhar, R Parvizi, M Radpoor, J Zamni,
Volume 63, Issue 3 (12 2005)
Abstract


Kashi Ah, Fotouhil A, Hashemi H, Mohammadl K,
Volume 63, Issue 3 (12 2005)
Abstract

Background: The aim of this study was to provide data, on the distribution or intraocular pressure (IOP) in Tehran population.

Materials and Methods: Through a population-based, cross-sectional study, a total of 4565 Tehran citizens were studied in the Tehran Eye Study. The findings of the participants (n=3834) 10 years and older free of glaucoma diagnosis or suspicion who had undergone applanation tonometry examination are presented. All participants received a standardized protocol included applanation tonometry, and some other ocular measurements, fundus examination, demographic data and an interview. IOP measurement was used to evaluate its distribution by age, sex, and some eye parameters.   ‎

Results: Mean ± SO IOP was 14.5±2.6 in the total population, 14.4±2.7 in men, and 14.5±2.5 in women. Normal range (mean±2SD) of IOP was determined to be 9.3 - 19.7 mmHg. IOP increased significantly with age and cup-disc ratio except for a fall in old ages. This relationship was also observed when we analyzed individuals without diabetes or hypertension history. IOP increased with darker eye pigmentation except for blue/gray eyes. There was a non-linear ‎increase of IOP from emmetropic to high myopic eyes. ‎

Conclusion: Mean and/or normal range of IOP and their associations have been reported with wide differences in various studies. It is wise that studies evaluate IOP distribution or associations in healthy people and glaucoma people separately and also report the prevalence of IOP risk factors in their population to allow for a logical comparison of studies.


V Marsosi, L Mohammadi Alamdari , H Shajari,
Volume 64, Issue 1 (30 2006)
Abstract

Background and Aim: In obstetrics, calcium antagonists, in particular nifedipine, have become increasingly popular for the management of preterm labor and are more effective tocolytic agents than beta 2-sympathomimetics. Our aim was to evaluate the effects of oral nifedipine therapy on ultrasonographic cord blood flow parameters in pregnant women with short cervical length.

Materials and Methods: In a case-series study, 20 patients at risk of preterm labor with shortening cervix in serial examinations were included. Patients received oral nifedipine administered 40 mg per day until 37w of gestational age (GA). Umbilical artery Doppler parameters including systolic/diastolic ratio (SD) and pulsatility index (PI) were recorded before and biweekly after nifedipine prescription.

Results: The mean of age was 25.55±4.58 years. The mean cervical length was 19.68±6.32. nifedipine consumption was initiated at the 26.4±4.12w and was terminated at 36.10±2.65w. The side effects of nifedipine were occurred in 2 patients (10%). In no patient no SD and PI measure get out of normal values. In contrast to PI, after nifedipine consumption SD was significantly higher than before (2.28±0.45 vs. 2.65±0.21). Two neonates (10%) were delivered before 37w and less than 2500gr. Just one neonate needed NICU stay.

Conclusion: Oral nifedipine can be used as a safe and effective tocolytic treatment in patients at risk of preterm labor with shortened cervical length.


M.h Baradaranfar, M Afkhami , A Mahmmodi,
Volume 64, Issue 2 (30 2006)
Abstract

Background and Aim: It seems that diabetes mellitus affects hearing system by several mechanisms including microangiopathy ,sorbitol deposition and glycosilation ,dealing to progressive bilateral sensorineural hearing loss which is related duration of diabetes.

Materials and Methods: This is a descriptive cross-sectional study performed on 300 patients with type 2 diabetes mellitus aged 30 to 50 years and a control group of 300 persons matched regarding age and gender .The cases were selected randomly and they were assessed by a quastionaire before performing audiogram. The exclusion criteria were conductive hearing loss sensorineural hearing loss with any other cause and other metabolic diseases .Audiometric test battery consisting of pure tone audiogram (PTA) and impedance were perfumed on both case and control groups.            

Reasults: In this study the hearing threshold in low and high frequencies in case group was higher than control group. In different age groups, the mean high and low frequencies hearing threshold in case group was higher than control groups. Based on duration of diabetes , the mean hearing threshold in the group with 8 to 18 years duration of diabetes was higher than the other two groups with 1 to 3 years and 4 to 7 years diabetes duration. The hearing level of hypertensive and normotensive diabetic patients were not significantly different. The mean hearing threshold was not significantly different between male and female diabetic patients.

Conclusion: In general, diabetic patients have a poorer hearing compared with normal population and there is a significant relationship between duration of diabetes and incidence of sensorineural learning loss.


J Hashemi, A Mohammadi, H Mirhendi , S Rezaei,
Volume 64, Issue 2 (30 2006)
Abstract

Background and Aim: While nowadays,great attainments have been achieved in curing and preventing the pathogenic fungal infections, and some how there has been reduction in the number of occurrences, the occurrences of opportunistic infections have been increased. Since the study of fungal infections in various organs (e.g.digestive system) is crucial ,and because of few study were done in this field in the world, it is decided to examine the apendectomide tissue for fungal contamination in Iran.

Materials and Methods: The work has been done for six months. After oparation sergery the appendix tissue in two media (formalin & normal salin) were carried out in the medical mycology laboratory at Tehran University of medical sciences. The specimens were examined directly and cultured in sabourauds dextrose agar with chloramphenicol (sc). In this experiment 200 appendicular tissues were examined.

Results: Out of them some fungi were isolated in 10 cases included 4 Candida albican (40%), 2 Candida tropicalis (20%),1 Cryptococcus sp. (10%),1 Candida sp.and 2 Geotrichum sp. Cryptococcus sp. was identified with mycological methods. This isolation related to a young man that has a history for long contact to pigeon.some of the fungi specially yeast can be a part of mycoflora in digestive system but the finding of Cryptococcus is uncommon.

Conclusion: In this study the fungi were isolated from 5% of appendisits and with pay attention to this finding that the most patients hadn.t background factors causing the proliferation of the fungal agents in the intestine, so with further studies it is probable to consider the fungi as the agents causing appendicitis in this patients.


G Tarighat Saber, S Zarei, A Etemadi, Mr Mohammadi , G Shams,
Volume 64, Issue 2 (30 2006)
Abstract

Background and Aim: Anxiety is the most common psychological distress in cancer patients. Many studies have been conducted to assess the prevalence of anxiety and depression and the predisposing factors of psychological morbidity in cancr patients. Patients knowledge of disease, their desire for more information, their satisfaction of given information and their attitudes’ towards communication of information about cancer are among issues that have not been well anddressed in assessment of psychological morbidity of cancer patients in Iran.

Materials and Methods: 250 cancer patients of 15-75 age group who were referred to Cancer Institute entered the study. The patients’ knowledge of disease, their desire for more information, their attitude and satisfaction were assessed by Questionnaire n1. patients’ anxiety and depression scores were assessed by Hospital Anxiety and Depression Scale (HADS).

Results: 30 of patients had severe anxiety symptoms and 17% suffered severe depression most patients’ knowledge of disease was “low” (32%) and “intermediate” (54%). There was no significant correlation between knowledge and anxiety and depression. Most patients (69%) believed that the information given by physicians had been “insufficient”. Depression score was significantly higher in this group of patients compared to other patients. Most patients (59%) had a high level of desire for gaining more information and 64% believed that physicians should inform patients of different aspects of disease as much as possible. There was no significant correlation between patients’ desire and attitude and anxiety and depression. Level of satisfaction was “low” in 29% of patients and “intermediate” in 39%. Depression and anxiety scores were significantly higher in patients who were less satisfied with given information.

Conclusion: Low level of knowledge in most cancer patients, their high desire for gaining more information, their dissatisfaction of given information and their positive attitudes towards full disclosure of information about cancer in this study, all indicate that complete and honest disclosure of information to cancer patients by physicians should be improved and encouraged. Although it seems that amount of information given doesn’t influence the psychological morbidity in cancer patients the patients’ satisfaction of given information, which has implications for the quality of patient-physician communication, plays a far more important role in occurance of psychological morbidity in cancer patients. Meanwhile, negative public opinion of cancer and its prognosis greatly influences the physicians functions and the quality of communication process, and also has negative effects on cancer patients’ psychological adjustment.


S.z.ghodsi, Z.n. Hatmi, A. Nikfarjam, F. Safar, P.noormohammadpoor, M. Asheghan,
Volume 64, Issue 3 (1 2006)
Abstract

Background: Acne is one of the most common skin diseases especially in adolescence. Different studies have reported unequal rates of facial acne prevalence in different countries and populations. Only a few cases of acne in the trunk area (back and chest) have been reported in literature. Although our clinical experience shows lower prevalence of truncal acne in comparison with facial acne, a community based study is needed to support this experience.

Methods: A total number of 1001 high school students, selected randomly from 5 out of 20 education-ministry subdivisions of Tehran, were included. In each area two high schools (one for boys and one for girls) with almost 100 students per high school were selected. Demographic data, family history and clinical findings were recorded in the questionnaires. Consensus Conference on Acne Classification was used for acne grading.

Results: One thousand one high school students, 503 girls and 498 boys ,were included. Prevalence of acne was 91.1% for face (95%CI: 83-99%), 93.4% in boys and 88.6% in girls. It was 53.4% for back (95%CI: 46-62.2%), 58.5% in boys and 36.9% in girls. Whereas for chest the prevalence was 36% (95%CI: 27-45%), 34.9% in boys and 36.9% in girls. Mean age of the students with truncal acne was 16.1 years where as 15.9 in others. This difference was significant (P<0.05). Positive family history was higher in students with truncal acne (P<0.001).

Conclusion: Truncal acne is less prevalent than facial acne. Acne on the back is significantly higher in boys than girls (P=0.002). Severe forms of acne in back may be more prevalent in boys. Positive family history can increase the risk of truncal acne.


A Rahimi, E. Mohammad Razzaghi ,
Volume 64, Issue 4 (1 2006)
Abstract

Background: Injection drug use (IDU) in Iran is not rare and is one of the main factors in opioid overdose. The objective of this study was the qualitative assessment of overdose, related factors, and available interventions.

Methods: A qualitative method was employed. Six districts of Tehran with a population of 400,000 inhabitants were selected. The districts were different in socioeconomic characteristics, urban structures and prevalence of IDU and crime. A total of 81 key informants from different sectors and 154 injection drug users (IDUs) were selected by purposeful, opportunistic and snowball sampling, and interviewed individually or in groups. Ethnographic observations were done for studying the life situation of IDUs.

Results: In one district no cases of IDU were found. In other districts, overdose in IDUs was reported to be common. Heroin injection alone or in combination with other drugs was the main reported cause of overdose. Reportedly, wrong estimation of drug purity was the most important reason. Even in the districts with highest rate of IDU and overdose, most clinics and hospitals did not have enough facilities necessary for management of acute opioid overdose.

Conclusion: According to the high prevalence of overdose, provision of preventive education of drug users and their relatives and availability and accessibility of emergency services is highly recommended.


F. Ghaemmaghami, A. Mousavi, Z.b. Ale Mohammad,
Volume 64, Issue 5 (1 2006)
Abstract

Background: Cervical cancer is one of the most common cancers in women.Conization of the cervix is one of the best diagnostic and therapeutic modality in preinvasive lesion of the cervix.

Methods: In this retrospective study we have evaluated the indications,complications, cytopathologic results, diagnostic and therapeutic value of 44 patients who underwent cervical conization.

Results: Age of the study group ranged from 18 to 75 (mean=43.18, SD=±11.4), and their parity ranged from 0 to 10 (mean 4-5, SD=±2-3). Ten cases (22.7%) were menopauses. The main indication was inability to visualize the entire T.zone (19 cases/43.2%) that was more prevalent in menopauses (50%/5cases in menopauses and 41.2% /14 cases in premenopauses). Bleeding occurred in 2 cases (4.5%) and urinary infection in 1 case (2.3%). The most common histologic result after conization was mild dysplasia in 23 cases (52.3%). The most common colposcopic biopsy result was moderate dysplasia in 16 cases (36.4%).The most common pap smear result was HSIL in 16 cases (36.4%). Two cases (4.5%) had invasive cancer in colposcopic- biopsy: one of them had ASCUS in the pap and another one had HSIL. Four cases (9.1%) had invasive cancer in histologic report: one of which had ASCUS on the pap and the others had HSIL.

Conclusion: Pap smear in screening of cervical cancer are not reliable and colposcopy is more acceptable in LSIL and ASCUS. Gynecologists should develop the skill to perform an accurate knife conization because the classical indications for conization continue to be valid and it has a low complication rate.


Z. Hosain-Khan, M. Mohammadi, P. Eghtesadi,
Volume 64, Issue 5 (1 2006)
Abstract

Background: Difficult intubation (DI), often unexpected, remains a primary concern for anesthesiologists. The purpose of this study was to compare the sensitivity and specificity of ULBT with sternomental, thyromental and interincisor distances in predicting difficult intubation.

Methods: In a prospective study, 380 patients undergoing general anesthesia were included. In all patients sternomental, thyromental and inter-incisor distances and the ULBT score were evaluated preoperatively. The Cormack grade was determined after the induction of anesthesia and grade 3 or 4 was considered as difficult intubation. The best points with highest accuracy were determined by ROC curve. Sensitivity and specificity of these tests in predicting difficult intubation were calculated and evaluated.

Results: In 19 (5%) patients, intubation was difficult. ULBT class III, inter-incisor distance less than 4.5 cm, thyromental distance less than 6.5 cm, sternomental distance less than 13 cm were considered as difficult intubation and there were significant differences between them and laryngeal view (P<0.05, McNemar) but there was no difference between laryngeal view in both sex. The sensitivity and specificity of ULBT is significantly higher than thyromental and sternomental and Inter-incisor distances (the specificity were respectively 91.96% vs. 64.77%, 70% and 82.27% and accuracy were respectively 91.05% vs. 76.58%, 71.32%, 81.84% and 59.53%)

Conclusion: We conclude that the specificity and accuracy of ULBT is significantly higher than inter-incisor, thyromental and sternomental distances and is more accurate in airway assessment.


A. Rahimi Movaghar, A. Farhoudian, R. Rad Goodarzi, V. Sharifi, M. Yunesian, M.r. Mohammadi,
Volume 64, Issue 6 (3 2006)
Abstract

Background: In the year 2003, an earthquake in Bam led to death and injury of many of the inhabitants. The aim of this study was to the changes in opioid drug use in the survivers eight months after the earthquake in comparison with the month before the quake and its related factors.

Methods: An epidemiologic survey was carried out on 779 survivors, selected by desert sampling from the Bam citizens in the age of 15 and over. Bivariate and multivariate Logestic regression analysis were done for examining the relationship between an increase in opioid use and various factors.

Results: An increase in opioid use was reported in 18.3 percent of men and 2.3 percent of women. Odds Ratio (OR) for increase in opioid use was 9.4 times more in men than in women (95% CI=4.9-18.0). In men, increase in opioid use was related with the history of opioid use during the month before earthquake (OR=5.6, 95% CI=2.4-13.1), age (OR in age group 30 to 44 was 4.7 times more than age below 30, with 95% CI from 1.8 to12.1), and PTSD (OR=3.7, 95% CI=1.5-9.2). In women, it was only related to the history of opioid use during the month before earthquake (OR=43.8, 95% CI=12.5-154.0).

Conclusion: The findings show that following disasters, especially in the areas or groups that drug use is common, an increase in the drug use might occur. In these situations provision of preventive and treatment interventions particularly for at risk population is necessary.



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