Showing 273 results for Men
Emamieh M , Emamieh Sh,
Volume 61, Issue 2 (5-2003)
Abstract
Since three decade ago, the application of the concept of finite element analysis (EEA) have received a keen interest among dental investigators. In practice the FEA provides detailed stress information regarding to a non-homogenious body such as craniofocal skeletal growth, tooth post ceramo-metal crowns and etc. The aim of this study was the determination of the influence of stress distribution at the cement interface of metal ceramic restoration-dentin.
Materials and Methods: An idealized metal-ceramic crown model was developed. The model was divided into very small segments. Various loading conditions was applied to the model. A super sap software was used for analyzing the stress distribution.
Results & Conclusion: The results of this study suggest that the higher shear stress was developed in the cervical region by two dimensional methods.
Sharifian R, Mohammadi S M, Ghasemi D, Safaei S R, Toogeh Gh R, Emami A H,
Volume 61, Issue 2 (5-2003)
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.
Mohagheghi M A, Nahvi Jou A, Sedighi Z,
Volume 61, Issue 2 (5-2003)
Abstract
Opioids are increasingly being recognized as the primary treatment for cancer pain management. Optimal treatment of cancer pain involves assessing its characteristics, considering different management strategies, evaluating side effects and adverse drug reactions and establishing the most appropriate therapeutic regimen. This study was designed to review the current status of pain management for advanced cancer cases using opioid analgesics.
Materials and Methods: A questionnaire was used to collect data on demographics, disease characteristics, and opioids use indicators in 700 cases of advanced cancer patients.
Results: A total of 700 cancer cases, 42 percent females and 58 percent males, between 17-80 years age range (Mean age of 57.25) were studied retrospectively. Cancers of breast (21 percent), colorectal (12 percent), lung (7 percent), stomach (7 percent) and bone either primary or metastatic (6 percent ) in women and stomach (17 percent), lung (12 percent), colorectal (11 percent), prostate (9 percent ), and bone (8 percent ) in men were the most common causes of opioids prescription in study group respectively. Advanced primary cancer (in 52 percent), bone metastasis (in 32 percent), and treatment complications (in 7 percent ) were considered as physical basis for pain in patients. Morphine (by injection), Opium (by oral intake) and methadone (injection and/or oral) were the most common opioids prescribed. Using equianalgesic conversion chart, the daily dosages and therapeutics schedules of morphine administration were as follows:
43 percent received 21-30 mg. in 2-4 divided doses
27 percent received >30 mg. in 3-5 divided doses
21 percent received 11-20 mg. in 2-3 divided doses
9 percent received 5-10 mg. in 1-2 divided doses
Conclusion: Pain management of cancer patients is not adequate and opioid use is not rational. New educational and managerial strategies are needed to optimize cancer pain treatment in routine medical practice. To overcome current barriers, WHO stepwise model for cancer pain control and palliative care is recommended. Publishing Standard Treatment Guidelines for different levels of health care system is another recommended approach to optimize cancer pain.
Atri A, Taj Mj, Yalda A R,
Volume 61, Issue 3 (6-2003)
Abstract
The genus acinetobacter are intestinal gram negative, encapsulated, non motile, aerobic bacilli, which are rod shaped during rapid growth and cocobacillary in stationary phase. Risk factors associated with nosocomial infections include: length of hospital stay, surgery, wounds, previous infection, fecal colonization, treatment with broad spectrum antibiotics, parenteral nutrition, indwelling central intravenous or urinary catheters, admission to a burn unite or ICU and mechanical ventilation. Acinetobacter meningitis occur infrequently and is generally found after neurosurgical procedures.
Here, we are presenting a 19 year-old female patient who developed multi-drug resistant (MDR) acinetobacter meningitis after operation on maxillary bone, but despite good clinical response to imipenem and amikacin succumbed aminoglycoside induced otoxicity.
Sadeghipoor Roodsari S, Mulaeian M,
Volume 61, Issue 4 (7-2003)
Abstract
Background: In this study, the results of "Urethral Advancement & Glanuloplasty" in repairing anterior hypospadias were considered. Hypospadias is a common urethral anomaly in boys. More than 65 percent of hypospadias cases are anterior (glanular, coronal and distal penil shaft). More than two hundreds original techniques have been applied to correct hypospadias. Each of these techniques has some complications. The most common complications of hypospadias repairing are fistula and meatal stenosis.
Materials and Methods: A total of 74 boys with anterior hypospadias underwent the procedure of "Urethral Advancement and Glanuloplasty" (UAGP) in our medical centers from March 1994 to April 1999. The procedure included: degloving, correction of chordee, urethral mobilization and glans plasty. Cosmetic results were excellent in most patients. There was no fistula, and also meatal stenosis was not observed after applying V-Flap of the glans.
Results & Conclusions: In a 1 - 6 year follow - up (mean 3.15 years, SD ± 1.79) the results functionally and cosmetically, were satisfactory in all cases with no long-tem complication or chordee.
Esmaeil Zadeh A, Mirmiran P, Mehrabi Y, Azizi F,
Volume 62, Issue 1 (4-2004)
Abstract
Background: Stenotic coronary arteryIt is essential to identify the best simple anthropometric index in any population to predict chronic disease risk. This study was designed to compare the ability of waist circumference (WC), body mass index (BMI) and waist-to-hip ratio (WHR) to predict cardiovascular risk factors in an urban adult population of Tehranian men.
Materials and Methods: This population-based cross-sectional study was conducted on 4449 men aged 18-74 years, participants of Tehran Lipid and Glucose Study (TLGS). Demographic data was collected. Anthropometric indices were measured according to standard protocol. Blood pressure was measured and hypertension was defined based on JNC VI. Biochemical analysis was conducted on fasting blood samples. Diabetes was defined as FBS≥126 mg/dl and dyslipidemia based on ATP II. The presence of “at least one” and “at least two” risk factors from the four major cardiovascular risk factors (hypertension, dyslipidemia, diabetes and smoking) was also evaluated.
Results: Mean age of men was 41.8±15.4. Mean BMI, WHR and waist circumference was 25.6±4.2 kg/m2, 0.91±0.07 and 87.7±11.7 cm, respectively. Of the three individual indicators, WHR had the highest sensitivity for all risk factors. No combination of indicators had higher average sensitivity + specificity than WHR alone. WHR had a higher percentage of correct prediction than BMI and waist circumference for all risk factors. No combination of measures was significantly more accurate than WHR alone, except for combinations where another indicator has been combined with WHR by “or”.
Conclusion: It is concluded that WHR is the best predictor of cardiovascular risk factors compared to BMI and WC in Tehranian adult men residing in district-13.
S Noorbakhsh , Sa Siadati , S Rimaz , S Mamishi , T Haghi Ashtiani , A Tabtabaei,
Volume 63, Issue 1 (5-2005)
Abstract
Background: Bacterial meningitis is one of the most serious infections in infants and children. Three organisms include S.PneumoN.meningH.Influ are the most common cause of meningitis in children between 2M-14y age.Etest is a new method for determination the MIC of some antimicrobial drugs in agarose .This method is useful for some organisms like as S .Pneumo N.mening H.Influsensitive Streptococcus and anaerobic aerobic gram negative.
Materials and Methods: In this descriptive cross sectional study In 57 suspected meningitis children organisms isolated from blood CSF or other sterile boy fluid after culturing and antibiogram. .MIC of someorganisms detected by Etest method.
Results: Streptococcuswas the most prevalent ( 70%) and S.pneumon( 90% of all Streptococcus) H.infl 2%N.mening 4%and L.monocyt 6%(more than expected)Gram negative (Ecoli Klebsiella entrobacter and psudomona) 18%. There was significant difference (P =0.01)in type of organisms between age groups. S.pneumonia was more frequent in children > 2 year N.meningitis in>4yr old .Site of isolation :blood CSF (35.8*28.3%)other sterile site 18.4%concomitant positive culture in two site:17%.Mean age in Streptococcus was significantly different with Listeria (p=0.05) N.meningitis (p=0.04)H.influ (p=0.04).but no difference with StaphylococcusKlebsiella and E.coli Two type of H.inf were sensitive to Ampici or chloram both of them were sensitive to ceftiaxon. GBS were sensitive to PNC or Ampici Strep.nonAnonBnon- Cotrimoxazol>32mic/ml /PNC >256mic/ml/ Vanco>256mic/ml Strep.D: Cotrimoxazol>0.062mg/ml/ /PNC >0.016mic/ml/Imipenem>0.032mic/ml. Strep Pneumonia: All fo them were sensitive except 3 cases /Cotrimoxazol>2ic/ml /PNC =0.01mic/ml/Vanco>0.125mic/ m Vanco>0. 25mic/ ml/.Cotrimoxazol>2ic/ml / PNC =0.01mg/ml Vanco>0.125mic/ ml / Cotrimoxazol>2mic/ml /MIC-PNC >0.016mic/ml Therefore high dose of PNC is adequate for S.pneu because of Interm resistance to PNC All 3 N.menin were sensitive to PNCChloraCeftria and vanco Resistant to all drugs and high MIC for cefotaximeCIPRO>32mic/ml. E coli: Pseudomona Aerogenosa:: Ceftriaxon>256mic/ml/ /Genta>0.038mg/ml Imipenem>32mic/ml. Klebsiella only Sensitive to Cipro Staph .Aureous:Sensitive to ClindaCiproChloraResistant toCeftPNCand Cotri
Conclusion: Most type of N.meningitidisH.inf and S.pneumonia were sensitive to many drugs. Only minority of them were resistant to Ampicillin but sensitive to chloramphenicol and vice versa. limited number of pneumococcal resistance to penicillin is medium resistance( MIC:0.1-1) .we can treat this resistant type by increasing of penicillin dosage .The others were sensitive to all drugs. Therefore ampicillin and chloramphenicol are the drug of choice in empiric treatment of bacterial meningitis after neonatal period.
Kaviani H, Poor Naseh M,
Volume 63, Issue 2 (5-2005)
Abstract
Background: This Study aimed to validate the temperament and character inventory (TCI) in an Iranian sample of men and women with different ages. TCI contains subscales designed to measure seven different personality traits and characteristics.
Materials and Methods: In the first step, subjects (n=1212) completed the questionnaire. In the second step, to examine the reliability of the questionnaire, 101 randomly chosen subjects were re-tested one to two months after the first test. Also, in order to examine the validity of the questionnaire, 100 subjects were interviewed by two psychologists using a checklist based on the Cloninger&aposs biological theory of personality. The interviewers, who were blind to the subjects&apos scores on the seven subscales, rated each subject for the seven traits and characteristics on a 10-point rating scale (from 1 to 10).
Results & Conclusion: The results showed normative data for the subscales novelty seeking (NS), harm avoidance (HA), reward dependence (RD), persistence (Per), self directiveness (SD), cooperation (Co) and self transcendence (ST) for different gender and age classes. Correlations between the scores and ratings of the test and re-test revealed significant coefficients, confirming reliability for all subscales. A good internal consistency was found for each subscale. The results also showed no significant correlations higher than 0.40 among NS, HA, Per and RD the temperament subscales were independent from each other. The only significant correlation, higher than 0.40, among the character subscales was between SD and Co. Applied and clinical implication of the present findings will be discussed.
Sedighi I, Rahimi H, Kakhodaee A, A Siadati ,
Volume 63, Issue 3 (6-2005)
Abstract
Background: Bacterial meningitis is a fatal disease with high mortality and morbidity that needs emergency management. But due to nonspecific signs and symptoms it&aposs diagnosis in children is difficult. Recently procalcitonin has been used for diagnosis of serious bacterial infections like bacterial meningitis. We conducted a prospective study in children for evaluation of procalcitonin in differential diagnosis of acute bacterial and viral meningitis.
Materials and Methods: In a prospective process research, we measured CSF procalcitonin levels in 43 children older than two months referred to Markaz Tebbi hospital. According to the results of universal PCR the patients were divided into two groups: bacterial meningitis (n=11) and nonbacterial meningitis (n=32). To analysis the results, Mann-Whitney test was used.
Results: CSF procalcitonin level in bacterial meningitis was significantly higher than viral meningitis (1.72±0.9 ng/ml and 0.71±0.04ng/ml respectively,Pvalue= 0.00). A serum procalcitonin level >0.5 ng/ml had high sensitivity and specificity ( 90.1% and 97.1% respectively) in the diagnosis of bacterial meningitis.
Conclusion: CSF procalcitonin level seems to be a valuable marker in differentiating between bacterial and viral meningitis.
Mortazavi S.m.j, Moatamedi M, Moghtadaei M, Farzan M,
Volume 63, Issue 4 (7-2005)
Abstract
Background: In this study we evaluated the treatment of giant cell tumor (GCT) of long bones using cryosurgery combined with curettage and polymethylmetacrylate (PMMA) cementing.
Material and methods: From January 1999 to December 2004, twenty patients (mean age at the time of surgery 29.2 years) 13 females and 7 males were included in the study. Cortical disruption were presented in 7 patients 4 with soft tissue extension, but none of them had intra-articular extension of tumor, 3 patients presented with pathologic fracture of distal femoral lesions. These tumors were located in distal femur in 6 patients, proximal tibia in 7, distal radius in 3, proximal femur in 2, and each of proximal humerus and distal ulna in one patient. In each case diagnostic biopsy was done and surgical procedure performed including curettage, power burr of the wall, cryosurgery with liquid nitrogen and finally filling the space with PMMA cementing. The mean follow-up was 34 months (7 to 61 ).
Results: During follow-up, we observed one recurrence of GCT of proximal tibia. Secondary Aneurysmal bone cyst was reported at the site of one primary distal femoral lesion, without any finding in favor of a recurrence. Neurapraxia of the proneal nerve was occurred in one patient with proximal tibia tumor improved after 8 months.
Conclusion: Cryosurgery combined with power burr and PMMA cementing in the treatment of GCT could be an effective approach in tumor eradication. This method obviates the need for extensive resections and reconstructive procedure.
H Khalili, S Dashti, S Seifi, M Hadjibabaie, S Shafiei,
Volume 64, Issue 2 (4-2006)
Abstract
Background and Aim: Anemia is one of the common problems in patients with chronic renal impairment. The most common cause of anemia in this patients is a decreased in erythropoietin hormone excretion, however other common cause include low life of red blood cells, loss of blood during dialysis, frequent blood sampling, uremia, iron, vitamin B12 and folic acid deficiency. Until introduction of erythropoietin in 1982, blood transfusion was an alternative for correction and maintaining hematocrit in normal range in dialyze patients. In current date, any dialyzed patient take rh-erythropoietin .
Materials and Methods: The goal of this study is to evaluate erythropoietin utilization and comparing the effectiveness of the commercial product in the Iranian drugs market. The study was performed at nephrology and dialyze ward of Immam Khomeini hospital in a one year period.
Results and Conclusion: Of the 30 patients&apos subject of study, 13 patients received eprex and 17 received epocim. Average dose of erythropoietin 2000IU was three times per week. The average plasma hemoglobin and hematocrit of patients prior to the treatment were 9.38 g/dl and 28% respectively. Increase in the hemoglobin and hematocrit in the group who received eprex was significantly higher than epocim group (p=0.001 and p=0.026 respectively). The incidents of side effects including hypertension, headache, pain at injection site, and influenza-like in eposim group were considerably higher than eprex.
N Rahimi-Fard, A Mirsalehian, P Maleknejad , N Ebrahimi-Daryani,
Volume 64, Issue 2 (4-2006)
Abstract
Background and Aim: Helicobacter pylori is the etiologic agent of chronic –active gastritis, gastroduodenal ulcers in humans, and a co-factor in the occurrence of gastric cancer and mucosa-associated lymphoid tumors, Adhesion of H.pylori to the gastric mucosa is a critical and also initial step in the pathogenesis of the disease. Bacterial adhesion inhibitory agents provide a novel pharmacologic approach to the management of infectious diseases.
Materials and Methods: 22 H. pylori strains, isolated from the antral biopsies of 49 patients with dyspepsia, gastritis, gastric ulcer, duodenal ulcer,…were assayed by ELISA (UPR)to investigate the diversity of attachment to 7 mamalian cell lines.
Results: The concentration of H.pylori and cell suspention ,the condition and temperature, can alter the attachment rate.Best bacterial concentration was equal to 1 Mc farland,and for cell suspension was 5*10 cells/ml.90 minutes in 37C incubation period result in maximum attachment. H.pylori can attach to all 7 cell lines, there are no significant differences between 22 H.pylori strains in attachment to cells. The attachment pattern of H.pylori to the cells showed significant reduction respectly from HepII, HeLa, SW742, AGS,HT29/219, HT29 to Caco-2.Maximum attachment were seen to HepII, HeLa and SW742 cells, and among these HepII was the best cells for this purpose.
Conclusion: Our studies suggest that Hep II, HeLa and SW742 cells could serve as a suitable in-vitro model for the study of H.pylori adhesions, attachment, inhibition of attachment and detachment assays and among these Hep II cell is prefer recommended.
H. Zahedi, V. Akhyani, Z. Hussain Khan, M. Yunesian,
Volume 64, Issue 3 (5-2006)
Abstract
Background: Hyperglycemia is a metabolic response to surgical stress. In this study, patients’ blood glucose changes were measured before, during and after elective eye surgeries under general anesthesia, with two methods: glucometer and glucose oxidase enzyme lab assay. Probable influencing factors and the correlation rate of these two methods were evaluated.
Methods: This analytic cross – sectional original study was performed on 230 American Society of Anesthesiologists (ASA) Class 1or 2 non–diabetic patients. All the patients underwent a similar general anesthesia and their blood glucose levels were measured simultaneously with two cited methods on three occasions.
Results: In all cases, post-surgery blood glucose in comparison to pre-surgery levels increased significantly in both methods irrespective of independent variables of the study. Considering these independent variables, increase in blood glucose levels was significant in most of the patients. The mean increase in blood glucose post-surgery in comparison to pre–surgery, measured with lab assay, had significant statistical correlation with the type of eye surgery but not with other variables like age, gender and duration of surgery. Correlation of the two methods were also partially significant statistically.
Conclusion: Considering the results of this study and the fact that blood glucose changes under general anesthesia is usually unrecognized clinically, we recommend blood glucose measurement in non–diabetic patients during long surgeries. It is advantageous to use Accu–chek (Sensor model) glucometer for this purpose.
Z. Hosain-Khan, M. Mohammadi, P. Eghtesadi,
Volume 64, Issue 5 (8-2006)
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.
Zafarghandi N, Torkestani F, Hadavand Sh, Zaeri F, Jalilnejad H,
Volume 64, Issue 11 (10-2006)
Abstract
Background: Hysterectomy is a common surgery as treatment for chronic and benign gynecologic problems. Eeach year more than half million women in USA undergo hysterectomy.
Methods: This analytical cross-sectional study, was done on 100 women who had underwent hysterectomy at least two years before the study and met inclusion criteria of study. During interview, the questionnaire were completed, then examination was done by gynecologist. Most of the information were collected from the patient’s files.
Results: In this study the most indication of hysterectomy was fibroma and the most common type surgery was total abdominal hysterectomy, and mostly were done without oophorectomy. 20% of cases were without or weak prior to operation and 80% with medium (or high) libido, after hysterectomy the figures changed to 41% and 59% respectively. After hysterectomy libido with P=0.001, frequency of coitus with P=0.001, and sexual satisfaction with P=0.013, significantly declined. Libido after hysterectomy declined with aging (P=0.01). There was no significant correlation between oophorectomy and libido.
Conclusion: Sexual function declines significantly after hysterectomy, with no association with oophorectomy and type of surgery.
Shamimi K, Aminian A, Moazami F, Jalali M,
Volume 64, Issue 12 (11-2006)
Abstract
Background: Abdominal compartment syndrome (ACS) is a clinical entity that develops from progressive, acute increases in intra-abdominal pressure (IAP) and adversely affects all vital organ systems In this study, the development of intra-abdominal hypertension (IAH) and ACS in a surgical ICU population is described and examined.
Methods: Over a one-year period (2004), urinary bladder pressure (UBP) was measured prospectively in all surgical patients with abdominal problems admitted to the ICU of the Imam Hospital complex. UBP of >20 cm H2O indicated IAH. ACS was defined as the development of multiple organ dysfunction including peak airway pressure (PAP) >50 cm H2O, Horowitz quotient <150 torr or urine output <0.5 ml/kg/hr in the setting of IAH. Data were gathered on all patients with IAH and ACS.
Results: We evaluated some 353 patients, consisting of 165 elective laparatomies and 188 emergency cases, including 28 trauma patients. The incidence of IAH and ACS was 2 and 1 per cent (7 and 3 patients, respectively). The mean IAP of these seven patients was 29.8 cm H2O. No elevated IAP was observed after elective laparotomy (165 patients), nor in emergency cases with temporary abdominal wall closure (29 patients). APACHE II score, PAP and worst base deficit were significantly higher in patients with elevated IAP. None of the three patients with ACS underwent decompressive laparotomy. The mortality rate for patients with elevated IAP was 85%, significantly higher than the total study population.
Conclusion: IAH is a rare disease of the rarity of IAH, routine measurement of IAP is necessary only in high-risk patients. Prophylactic temporary abdominal wall closure may prevent IAH and ACS in high-risk patients. Patients with elevated IAP have dismal outcomes. Critical care practitioners should become familiar with different aspects of IAH and ACS, including decompressive laparotomy.
Farrokhi M.r, Ansari Z,
Volume 64, Issue 12 (11-2006)
Abstract
Background: Meningiomas are common benign tumors of the brain. Meningioma patients have optimal functional recovery after surgical removal of their tumors. Some patients experience recurrence months or years after surgical resection. In this study, we try to determine the prevalence of recurrent meningioma and the correlation between recurrence and certain factors.
Methods: This retrospective descriptive-analytical study included all patients with recurrent meningioma at Shiraz University of Medical Sciences-affiliated hospitals during a 20-year period (1983 to 2003). We evaluated a series of data for each patient including age, gender, tumor volume, tumor shape, bone changes, brain edema, tumor location, histological subtypes, degree of tumor resection and duration between operation and recurrence. Finally, correlations between these factors and recurrence were investigated using SPSS software version 11.5, by the descriptive method.
Results: Among the 644 patients enrolled in this study, the recurrence rate of intracranial meningioma was determined to be 9.6%. Multivariate analysis revealed a statistical correlation between edema, bone changes, tumor volume, tumor volume, tumor shape and histological subtype, but no relationship was found between age, gender and tumor location. Our study shows a statistical correlation between radiotherapy and reduced chance of recurrence. Patients with malignant and atypical meningiomas have shorter periods between surgery and recurrence than those with benign types.
Conclusion: We recommend that all patients with these prognostic factors receive adjuvant therapy and closer follow-up. In consideration of the statistical correlation between the degree of tumor removal and recurrence in this study, we suggest more complete tumor resection to decrease the risk of recurrence.
Hosein Khan Z, Arbabi Sh, Ebrahim Soltani A,
Volume 65, Issue 1 (3-2008)
Abstract
Airway management is one of the most important subjects in medicine. This article reviews the history, assessment of airway prior to anesthesia, techniques and equip-ment of airway management and management of patients with anticipated and unan-ticipated difficult airways. This article covers recent literature on airway appliances and devices and their use in different circumstances. Airway assessment methods especially the recent Iranian method have been reviewed and discussed briefly in this article. On the whole the article covers the etiology of difficult airway and offers guidelines for safe practice of anesthesia in patients in whom airway is anticipated to be difficult.
Kaseb M.h, Moharrami M.r, Mortazavi S M.j,
Volume 65, Issue 1 (3-2008)
Abstract
Background: Tibial and femoral fractures, commonly seen in emergency departments, may be associated with various knee ligament injuries. The aim of this study was to determine the prevalence of such fracture-associated knee ligament problems, with especial attention to rapid diagnosis.
Methods: This study was carried out in patients with femoral or tibial fractures who were operated on in Imam Khomeini Medical Center from March 2003 to March 2005. All patients underwent surgical repair immediately after acute fracture, followed by a thorough knee examination. Patients with positive clinical findings were further evaluated using the stress view and arthroscopy.
Results: We enrolled 470 cases in this study, of which 266 were tibial and 204 were femoral fractures. There were 404 men and 67 women, with an average age of tibial fracture patients was 34.5 and 44.6 years for those with femoral fractures. Of all fractures, 66% were due to car accidents, 16% to industrial accidents and 8% due to falling. The overall prevalence of ligament injuries in tibial fractures was as follows: 6.58% ACL tearing, 2.5% PCL, 21.95% MCL and 14.63% LCL. The overall prevalence of ligament injuries in femoral fractures was as follows: 6% ACL tearing, 3% PCL, 14% MCL and 8% LCL.
Conclusion: The prevalence of ligament injuries of the knee was highest in distal femoral and tibial plateau fractures. It is prudent to perform a thorough knee examination once the fracture is stabilized in the operating room for the early detection of ligament injuries and prevention of further complications.
Oloomi Z, Moayeri H, Bahremand Sh, Vafaei P,
Volume 65, Issue 1 (3-2008)
Abstract
Background: Hyperuricemia is one of the oncologic emergency that occurs most often in patients with hematologic disorders particularly leukemia and high-grade lymphoma. This study was conducted in order to determine the prevalence of hyperuricemia with respect to prophylactic treatment (in particular allopurinol) in patients with lymphoproliferative disease in the pediatric hematologic ward of Imam Khomeini Hospital, Tehran.
Methods: In this retrospective cross-sectional study, 316 children (75 females, 241 males) under the age of 12 years participated. Among the subjects, 66 patients (20.9%) had lymphoma and 250 patients (79.1%) had leukemia.
Results: Of the 56 (17.7%) patients diagnosed with hyperuricemia, 13 with lymphoma (19.7%) and 43 (17.2%) with acute lymphoblastic leukemia, 52 patients showed hyperuricemia after induction of chemotherapy (p<0.001). Hyperuricemia was more prevalent in patients with more advanced disease (50.9% in stage IV, p<0.001). Hyperuricemia was more frequent in male patients (p<0.001). Among the 217 patients who had received prophylaxis (hydration, alkalization, allopurinol), 19 (8.7%) subjects had hyperuricemia compare to 37.3% in the group of patients who did not receive prophylactic treatment (p<0.001).
Conclusion: From the literature reviewed, a recombinant form of the urate oxidase enzyme (rasburicase) is a safe and effective alternative to allopurinol to rapidly control plasma uric acid concentrations in patients with hematologic malignancy at high risk for tumor lysis during induction of chemotherapy. In this respect, we recommend a prospective study to compare allopurinol and rasburicase in children with leukemia and lymphoma.
