Showing 155 results for SM
Beigi A, Kazemipour Sm, Tabarestani H,
Volume 68, Issue 3 (5 2010)
Abstract
Background: Induction of labor implies stimulation of contractions before the spontaneous onset of labor and is indicated when have benefits to eighter mother or fetus. Uterine contractions and an appropriate cervix are two important factors in labor and are contributed to good outcomes. Nowadays, there are many therapeutic modalities for it such as misoprostol. Both vaginal and oral misoprostol may be used for eighter cervical ripening or labor induction. The tablets are stable at room temperature. Regarding the issue importance and lack of similar studies in Iran, this study was conducted to compare the efficacy of sublingual and vaginal misoprostol for labor induction.
Methods: This study was conducted as a randomized double-blind clinical trial. In this
survey, 250 women were randomly assigned to receive 25 g vaginal misoprostol plus sublingual placebo or 25 g sublingual misoprostol plus vaginal placebo in Arash hospital Tehran, Iran from 2008 to 2010. The maternal and fetal complications, Bishop Score, and time of pain onset and it’s interval with labor were monitored in two groups analyzed.
Results: Mean Bishop Score, and time of pain onset and its interval with labor were similar in two groups (p>0.05). 43 patients (34.4%) in sublingual and 54 (43.2%) in vaginal group had normal vaginal delivery (p>0.05). The frequencies of maternal and
fetal complications were similar between two groups (p>0.05).
Conclusion: It may be concluded that there is no difference between efficacy of sublingual and vaginal misoprostol in pregnancy outcomes, maternal and fetal complications and so each one may be used according to pregnant woman’s condition and physician attitude.
Nikseresht S, Etebary S, Sadeghipour Roodsari Hr, Zarrindast Mr, Karimian Sm, Nabavi Zadeh F,
Volume 68, Issue 5 (6 2010)
Abstract
Background: Postpartum depression is a mood disorder that has harmful effects on mothers,
infants, family and relationships. Acute decrease of progesterone after delivery has been proposed as a cause for postpartum depression. This
hormone can affect neurotransmitters' function. Zinc (Zn) and magnesium (Mg) as trace elements exert their antidepressant effects through
neurotransmitter pathways. On the other hand, thiamin (Vit B1) deficiency leads to depression in animal models. The aim of this study
was to evaluate effects of combination of zinc, magnesium and thiamine on postpartum depression and role of nitrergic system.
Methods: One hundred ten female mice in five groups were used. Postpartum depression was conducted using progesterone injections. Combinations of
Zinc chloride, magnesium chloride and thiamine HCL were administered 30 minutes before open field and forced swimming test (FST). In order to
investigate role of nitrergic system, L-arginine and LNAME were administered.
Results: All treatment groups spent less immobility time than the control group (p< 0.05). Combined administration of Zn+ Mg+ Vit B1 caused the most reduction in immobility time. Administration of L-NAME in Zn+ Mg+ Vit B1 group caused reduction in immobility time while administration of L-arginine caused increase in immobility time in the same group.
Conclusion: Zinc, magnesium and thiamine can improve depressive symptoms by nitrergic pathway. These elements as supplement compounds could be alternatives for antidepressants in postpartum period.
Khazardoost S, Noorzadeh M, Abdollahi A, Mirrokni Sm,
Volume 68, Issue 5 (6 2010)
Abstract
Background: Preeclampsia, a specific syndrome in pregnancy, may summits mortality or morbidity in mother and fetus. Diagnostic methods are based on 24 hours urine protein measures which may be tedious, thus it is desirable to apply a faster and more applicable method for this goal. In this study we evaluate measurement of 8-hours urine protein in order to estimate 24-hours urine protein measure.
Methods: Fifty pregnant women were entered in a cross sectional study in Vali-e-asr hospital located in Tehran- Iran, during 2008-2009. A urine sample was given after 8-hours and urine volume as well as protein levels were calculated and compared with the same values of 24-hours urine measures. Other necessary data was obtained by history taking and physical examination as well as using patient's medical records.
Results: Mean of age was 27.5±5.4 years and mean of gestational age was 30.5±4 weeks. Mean of urine protein in 8 and 24 hours urine protein were 79±119 and 532±1218 mg respectively. Sensitivity, specificity, positive predictive value and negative predictive value of 8 hours urine protein were 61%, 98%, 88% and 90% respectively, in order to diagnosis of 24 hours urine protein to consider cut off point 105 mg for 8 hours urine protein. Mean protein levels were significantly higher in group with proteinuria ≥300 mg/24h in these two types of urine samples (p< 0.001).
Conclusion: Sensitivity of 8-hours urine protein is low but its specificity is suitable for normal mothers. We offer measuring of 8-hours urine protein as a valuable method for diagnosis of preeclampsia.
Mortezaeian Langroodi H, Rad Goodarzi M, Nakhostin Davari P, Shahmohammadi Aa, Mearaji Sm, Aarabi Moghadam My,
Volume 68, Issue 6 (6 2010)
Abstract
Background: Coarctation of aorta is narrowing of proximal descending aorta. Interventional procedures such as balloon angioplasty & stent implantation has been progressively in use as alternatives for surgery in increasing number of children with diagnosis of coarctation of aorta. The aim of this study was to evaluate the use of endovascular stent in children with coarctation of aorta.
Methods: We evaluated effectiveness and safety of stenting in all patients younger than 18 years old with coarctation and re-coarctation of aorta which treated by stenting between years 2004-9 at rajaei - heart centre in Tehran, Iran.
Results: we studied 53 patients younger than 18 years old with a follow up of six months. Totally 54 stents were implanted. Mean (±SD) age of the patients was 11.6±4.2yrs. Seventeen cases (32%) were younger than 10 years old, and 36 cases (68%) were 10 years and older. Mean (±SD) weight was 39.24±18kg. 16 cases weighting less than 25kg. Peak systolic pressure gradient (SPG) decreased from 46.26±17.07 to 1.03±0.19mmHg after procedure (p<0.001). There was no significant difference (p<0.001) in the gradient before and after stenting in the patients with native coarctation (Vs re-coarctation cases), less than 25 kg and under 10 years old groups. Complications developed in 44% of cases while dominantly were minor except in two cases re-dilatation of stent was not needed during six month of follow-up of the patients.
Conclusions: Stenting of coarctation of aorta can decrease complications and can be used safely in children weighing bellow 25kg and in children below 10yrs old.
Fesharaki M, Omolbanin Paknejad Smj, Kordi R,
Volume 68, Issue 6 (6 2010)
Abstract
Background: Asthma is a major health condition in Iran. This randomized clinical trial was aimed for the comparison of the effects of two exercise protocols (aerobic and aerobic-strength) on the pulmonary indices and quality of life of asthmatic patients.
Methods: The study was conducted in pulmonary ward of Dr Shariati Hospital in Tehran, and Research Center of Exercise Medicine of Tehran in 2009. Fifty six asthmatic patients were selected and after two weeks of education, their spirometric parameters were recorded and the St George's respiratory questionnaire was completed. Then patients were randomly assigned to two groups of A and B. For ten weeks group A did the aerobic-strength exercises and group B did only the aerobic ones at home. At the end, again their spirometric parameters were recorded and the questionnaire was completed. Finally 42 patients completed the study.
Results: After the intervention, FEV1 and FVC but not FEV1/FVC increased in group A. There were no changes in these parameters in group B. In addition, post-intervention FEV1 and FVC were significantly higher in group A than group B. All scores of St George's respiratory questionnaire were significantly improved in both groups but they were not different between them.
Conclusions: Our findings showed that regular aerobic exercises, individually or concomitant with strength exercises, could improve vital signs and quality of life of mild to moderate asthmatic patients. However, only aerobic exercises with strength ones improve spirometric parameters. Therefore, a combination of both aerobic and strength exercises could be considered in treatment protocols of asthmatic patients.
Edalati Fard M, Khatami Smr, Sadeghian S, Salari Far M,
Volume 68, Issue 6 (6 2010)
Abstract
Background: The relationship between Coronary Artery Disease (CAD) and the prevalence of Renal Artery Stenosis (RAS) has been demonstrated. Despite high incidence of heart diseases and high frequency of CAD risk factors among Iranian population, this relation has not been clearly determined. This study estimated the prevalence of RAS and its determinants in Iranian angiographic candidates. We also tried to find which risk factors of atherosclerosis are associated more frequently with renal artery stenosis.
Methods: In a cross-sectional study that was performed at the Tehran Heart Center, in Tehran, Iran, 146 patients who were candidate for angiography with suspected CAD were consecutively included. Selective renal angiography was performed following coronary angiography in all patients with established coronary artery stenosis and the presence and severity of RAS was evaluated.
Results: Prevalence of RAS in study patients was 25.3% (men, 13.7% and women 47.1%, (p<0.001). We found that only 6.2% of the patients had bilateral R.A.S. Also, RAS≥50% was found in 17.1% of patients. Regarding number of defected coronary vessels, two- and three-vessel diseases were found in 30.0% and 39.0% of participants, respectively. No significant relationship was found between the number of involved coronaries and the severity as well as side of RAS (p=0.716) Significant multivariate predictors of RAS were female gender (p=0.001), advanced age, (p=0.046) duration of hypertension (p=0.032) and baseline serum creatinine concentration (p=0.018).
Conclusions: Routine angiographic assessment of renal arteries following coronary angiography is recommended especially in women as well as those with long-term duration of hypertension or renal dysfunction.
Mortazavi Smj, Baghdadi T, Farhoud Ar, Togeh Gh, Eftekhari M, Managhchi Mr, Espandar R,
Volume 68, Issue 6 (6 2010)
Abstract
Background: Radioactive synoviorthesis by injection of safe radioisotopes into the joints affected to chronic arthritis is accounted as a novel method to treat haemophilic arthropathy. The main goal of this therapy would be decrease in frequency of hemarthrosis and consumption of coagulation factors. In this study we assessed the effect of radioactive synoviorthesis on the frequency of hemarthrosis, factor consumption and other related parameters.
Methods: In an interventional study in Imam Khomeini Hospital in Tehran, Iran, after meeting of inclusion criteria and taking written consent, colloid 32p radiosynovectomy was performed for 56 joints with haemophilic arthropathy. After local anesthesia of injection site, one mci of 32P for large joints (knee) and 0.5 mci for small joints (ankle and elbow) was injected, respectively. Half of these doses were considered for children (age <12 years).
Results: The mean of age was 16.78 year old (Range: 2.5-36 SD: 7.46) and 98.2% of cases were male. Injected were knee 80.35%, ankle 12.5%, and elbow 7%. The mean of follow-up was 43.63 months (range: 3-102) that at the end, the result was 62% decrease in frequency of hemarthrosis (p=0.0001) and 84% decrease in factor consumption (p=0.0001). However, the involvement of other (non injected) joints during follow-up could lower the decrease of mean of total factor consumption.
Conclusions: Radioactive synoviorthesis can be a cost-effective alternative to decrease hemarthrosis and factor consumption in haemophilic arthropathy.
Farahnak Mr, Mirrokni Sm,
Volume 68, Issue 6 (6 2010)
Abstract
Background: Teratomas are tumors consisting of tissues derived from more than one germ cell line. Teratomas arise, most commonly in anterior mediastinum. Intrapulmonary Teratoma are among the rarest tumors encountered in pathology, in other words they are exceedingly uncommon, with only less than 100 cases documented by 1939.
Case presentation: We describe a 19-year-old woman with a short history of retrosternal chest pain and non-productive cough due to a benign intrapulmonary mature teratoma originating from the right upper and middle lobes. The clinical, imagings and pathological features of this rare tumor are presented and the relevant literatures are discussed.
Conclusions: Intrapulmonary teratomas are rare tumors. They originate from the third pharyngeal pouch and present as cystic lesions in the majority of cases. Histologically, benign teratomas comprise of two or three primordial layers. Patients present with chest pain, dyspnea, cough, hemoptysis and trichoptysis. Any Intrapulmonary teratoma should be resected due to its potential for malignancy and rupture.
Mahdi Aghili , Maryam Moshtaghi , Farhad Samiee , Ebrahim Esmati , Mahbod Esfahani , Hasan Ali Nedaee , Peiman Haddad ,
Volume 68, Issue 8 (November 2010)
Abstract
Background: The current standard of adjuvant management for gastric cancer after curative resection based on the results of intergroup 0116 is concurrent chemoradiation. Current guidelines for designing these challenging fields still include two-dimensional simulation with simple AP-PA parallel opposed design. However, the implementation of radiotherapy (RT) remains a concern. Our objective was to compare three-dimensional (3D) techniques to the more commonly used AP-PA technique.
Methods: A total of 24 patients with stages II-IV adenocarcinoma of the stomach were treated with adjuvant postoperative chemoradiation with simple AP-PA technique, using Cobalt-60. Total radiation dose was 50.4Gy. Landmark-based fields were simulated to assess PTV coverage. For each patient, three additional radiotherapy treatment plans were generated using three-dimensional (3D) technique. The four treatment plans were then compared for target volume coverage and dose to normal tissues (liver, spinal cord, kidneys) using dose volume histogram (DVH) analysis.
Results: The three-dimensional planning techniques provided 10% superior PTV coverage compared to conventional AP-PA fields (p<0.001). Comparative DVHs for the right kidney, left kidney and spinal cord demonstrate lower radiation doses using the 3D planning techniques (p<0.0001), the liver dose is higher (p=0.03), but is still well below liver tolerance.
Conclusion: Despite the department protocol using conventional planning, 3D radiotherapy provides 10% superior PTV coverage. It is associated with reduced radiation doses to the kidneys and spinal cord compared to AP-PA techniques with the potential to reduce treatment toxicity.
Forouzan Nia Skh, Hadadzadeh M, Mirhosseini Sj, Hosseini H, Abdollahi Mh, Forat Yazdi M, Rasti M, Dehghanizadeh H, Ghoreishian Sm,
Volume 68, Issue 9 (6 2010)
Abstract
Background: One of the most important components of coronary
artery bypass graft surgery is need for blood transfusion that increases
morbidity and mortality. The aim of this study was to evaluate the factors
affecting the need for blood transfusion during off pump coronary artery bypass
(OPCAB)
surgery.
Methods: In
this descriptive case control study 923
patients who had undergone OPCAB at Afshar Hospital in Yazd,
Iran, from July 2008 to January 2010
were evaluated. The data was gathered from their records and was analyzed.
Results: 54% of
male and 79% of female patient need
blood transfusion. Mean age in patients needed transfusion was 61.58±11.11
years and in other group was 60.27±10.98
years of the patients that needed transfusion (p= 0.08). 563
(61%) of the patients needed transfusion with the
average of two units. The need for blood transfusion was higher in female
gender (p< 0.0001),
low hematocrit (p< 0.0001),
diabetes (p< 0.001),
hypertension (p< 0.025)
and multiple grafts (p< 0.027).
There were no significant differences in preoperative hemostasis tests,
affection to hyperlipidemia, CVA or
renal failure, antiplatelet drug administration and the application of left internal
mammary artery between the transfusion and non transfusion groups.
Conclusion: In this study preoperative
hematocrit was most important risk factor in transfusion in patients that
underwent OPCAB. Female gender, preoperative
low hematocrit, multiple grafts, diabetes and hypertension increased the rate
of blood transfusion. According to the high prevalence of blood transfusion in OPCAB, considering factors that
affect the transfusion rate is essential.
Saberi H, Miri Sm, Poordel Namdar M,
Volume 68, Issue 9 (6 2010)
Abstract
Background: Topically applied tranexamic acid has been shown to decrease the
amount of blood loss associated with major spinal surgical procedures. The aim of this study was to evaluate the effects of locally applied tranexamic acid in epidural space on post-laminectomy blood loss.
Methods: One hundred patients who were scheduled to undergo laminectomy in Imam Khomeini Hospital in Tehran, Iran were enrolled in a clinical trial. Patients were divided into two groups of unilateral one level (n=50) and bilateral two level (n=50) laminectomy according to the extent of surgery. Each group was randomly allocated into two groups of tranexamic acid (n=25) and control (n=25). At the end of the operation, 250mg tranexamic acid, with volume of 5ml or 5ml of normal saline were poured on the site of surgery. The blood volume drained during first and second 24hr, and overall hemorrhage, plus the duration of post operative hospitalization were compared between the two groups.
Results: The bleeding volume in the 1st 24hr was significantly less in tranexamic acid than control group (p=0.001). The bleeding volume in the 2nd 24hr was significantly less in tranexamic acid than control group (p=0.001). The hospital stay was less in tranexamic acid compared to control group (2.16±0.37 Vs. 2.96±0.89 days, p=0.001) respectively.
Conclusion: Locally applied tranexamic acid in epidural space significantly reduces the amount of the 1st day, 2nd day and overall post-laminectomy blood loss, and duration of hospital stay.
MicrosoftInternetExplorer4
Vs. 2.96±0.89 days, p=0.001) respectively.
Conclusion: Locally applied tranexamic acid in epidural space
significantly reduces the amount of the 1st day, 2nd day and overall post-laminectomy blood loss, and
duration of hospital stay.
Asgari M, Mirrokni Sm,
Volume 68, Issue 9 (6 2010)
Abstract
Background: Botulinum
toxin (Dysport) is a powerful semi-biological toxin. It has proved to be a
remarkable therapeutic agent for treatment of benign anal disorders. Different
results have been achieved from injection of botulinum toxin in order to
treatment of anal fissure since 1993. The aim of this study was to evaluate the efficacy of
botulinum toxin injection in the treatment of chronic anal fissure Comparing
with lateral internal anal sphincterotomy (LIS).
Methods: 36 patients
entered into two groups, Dysport injection and Lateral Internal Sphincterotomy,
randomly. Dysport group were treated by injection of 50 units of
botulinum toxin, 25 units of drugs in each side, and LIS was done in
surgery group by open method in left side. Pain, recovery and incontinency were
compared between two groups during six months of follow up.
Results: Based on this study,
treatment of anal fissure does not affected by age and gender. Regarding to
location of fissure, there was no difference between two different genders. Mean of age and ratio of gender were similar in both
groups. The severity of pain in surgery group was lower than Dysport group six
months after treatment (0.4±0.7 and 3.2±2.6 respectively, p<0.001). Recovery ratio in surgery group was higher than Dysport after six
months (95% Vs. 44.4% p<0.001). Gas or fecal incontinency did not reported after
six months in both groups.
Conclusion: Botulinum toxin is not efficacious in patients
with chronic anal fissure, comparing with LIS. More future studies are necessary for final judgement.
Ostadian N, Mirrokni Sm, Noorzadeh M,
Volume 68, Issue 11 (4 2011)
Abstract
Background: Simple cysts of pancreas are smaller than complex ones and are more likely to be located at the distal tail of the pancreas. Simple cysts are often asymptomatic and can be managed conservatively by observation. There seems to be few clinical trials to suggest the best treatments method for large symptomatic cysts of pancreas located at the head of the organ.
Case presentation: In this report, we describe an eight-year old boy with a large symptomatic true cyst at the head of the pancreas who was successfully treated by enucleation of the cyst, instead of the Whipple's procedure, without any ensuing complications.
Conclusion: Regarding the rarity of simple cysts in the pancreas, lack of studies to compare different surgical procedures and suggest the best methods to treat them and the considerable morbidity and even mortality of major surgeries (e.g Whipple's procedure) enucleation of these cysts seem to be appropriate for treating them with no early or late complications. More studies are needed to warrant the results of this report.
Forouzan Nia Skh, Mirhosseini Sj, Moshtaghion Sh, Abdollahi Mh, Hosseini H, Dehghanizadeh H, Bani Fateme Sa, Hosseini Sm,
Volume 68, Issue 12 (6 2011)
Abstract
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Background: Proper drainage of the mediastinal and pleural spaces following Off-Pump Coronary
Artery Bypass (OPCAB) surgery is essential
for the prevention of pleural and pericardial effusions, cardiac tamponade and
late complications such as constrictive pericarditis. Drainage tubes themselves
may induce some complications which can negatively affect the result of the
surgery. In this study we assessed a new technique for chest drainage following
OPCAB.
Methods: In this clinical trial, 171 patients were
allocated to two groups. In the control group, the drainage technique included
one drain in the left pleural cavity and another in the mediastinum, while in
the case group the drainage technique included one drain in the left plural
and one in the right pleural cavity.
Results: The amount of drainage in the case group was more than the control group (p=0.001).
We found significant reductions in the incidence of arrhythmias in the case
group (p=0.005). While one patient (1.2%)
needed reoperation for bleeding control in the control group, no patients
needed reexploration in the case group (p=0.497).
The duration of hospital (p=0.022) and ICU
(p=0.002) stays was shorter in the case group.
Conclusions: Based
on the results of this study, changing the position of mediastinal drains in
patients undergoing OPCAB surgery and shifting it to
the right pleural cavity, reduces complications, such as arrhythmia and
pericardial effusion, aside from establishing a better drainage.
Sadeghi Sm, Seyedmehdi Sa, Narimani Zamanabadi M, Sadeghi Sa,
Volume 68, Issue 12 (6 2011)
Abstract
Background: Sinus surgeries are usually associated with bleeding, thus can result in
hemodynamic instability. This study investigated the hemodynamic changes induced by remifentanil plus isoflurane administration in comparison with
propofol plus remifentanil in patients undergoing sinus surgery.
Methods: In this randomized clinical trial study, 96 patients were divided into two groups of isoflurane (1.2 MAC) plus remifentanil (44 patients, group A) and propofol (100 μg/kg/min) plus
remifentanil (52 patients, group B). Twenty-two patients in group A and 23 in group B were male. The remifentanil dosage (0.1 μg/kg/min) was equal
in both groups and all received 500 ml isotonic solution during the operation too. Premedications and anesthetic inductions of both groups were similar. The variables included age, BMI, blood loss during surgery, systolic and diastolic blood pressures, pulse rate and mean arterial blood pressure.
Results: The mean age, BMI, amount of blood loss, mean systolic (30 minutes before and after the intervention) and diastolic blood pressures (60 minutes before and after the intervention), pulse rate (30 and 60 minutes before and after the intervention), mean arterial blood pressure (60 minutes before and
after the intervention) were similar in both groups. The average mean arterial blood pressure, 30 minutes after the intervention (p=0.027) and the mean
diastolic blood pressure, 30 minutes after the intervention (p=0.011) in the case group had statistically significant differences with the controls.
Conclusion: Based on this study, the combination of isoflurane plus remifentanil could better maintain the hemodynamic stability during sinus surgeries.
Hasanzadeh Mofrad M, Homaeei F, Esmaele H, Ayate S, Nagave Reabe H,
Volume 68, Issue 12 (6 2011)
Abstract
Background: Female genital tract sarcomas are rare but most aggressive tumors of mesodermal origin. Little is known about the pathogenesis, risk factors, optimal treatment and outcome of these diseases. Therefore, we aimed to evaluate the clinicopathologic characteristics of patients with genital sarcoma.
Methods: This is a retrospective, cross-sectional study. The medical records of 43 female patients with genital tract sarcoma, hospitalized during a 16-year period (from 1991-2007) were retrieved from the medical records office of Ghaem Hospital in Mashad, Iran. The demographic data extracted from the records.
Results: The mean age of the patients was 46.95 years (ranging from 3-77 years). The chief complaint of the patients was abnormal vaginal bleeding (69.8%). The mean interval between the onset of symptom to the pathological diagnosis of sarcoma was 8.53 months (ranging from 1-36 months). Histologically, the tumors included: leiomyosarcoma (79.1%), endometrial stromal sarcoma (18.6%) and embryonal rhabdomyosarcoma (2.3%). Three patients (7%) were in International Federation of Gynecology and Obstetrics (FIGO) stage I, 20(46.5%) in stage II, 6(14%) in stage III and 14(32.6%) in stage IV. 48.8% of the patients had undergone chemoradiotherapy.
Conclusions: In most cases, our patients were referred so late or the disease was recognized very late due to being rare. We should consider this disease for every patient with unusual vaginal bleeding especially in post menopause women who their sonography has reported uterine mass.
Esmaeeli Azad R, Jamal A,
Volume 69, Issue 4 (6 2011)
Abstract
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Background: Diabetes insipidus is a rare disease which can be considered as a part of broad
spectrum of preeclampsia manifestations.
Case
presentation : A
39-year old primigravid woman, with an unremarkable past medical
history, was admitted in the 33rd week of gestation
for elevated blood pressure. On admission, her blood pressure was 140/90
mmHg and the only abnormal laboratory findings
were trace proteinuria and elevated liver enzymes. During the following days
her blood pressure rose to 150/100 mmHg
with deterioration of clinical and paraclinical status of the patient characterized
by excessive thirst, polydipsia and excretion of large amounts of diluted
urine. Having considered the patient's aggravating status, termination of
pregnancy was planned. Fortunately, all the clinical and paraclinical presentations,
including those related to the probable diabetes insipidus disappeared on the
second day of postpartum period.
Conclusion: Sign
and symptoms of diabetes insipidus should be considered in all cases admitted
for preeclampsia.
Ghanbari Z, Esmaeili M, Eftekhar T, Esmaeili M, Miri E,
Volume 69, Issue 5 (6 2011)
Abstract
Background: Overactive bladder (OAB) is one of the most prevalent diseases of lower urinary system. OAB disease is defined by the Standardization Subcommittee of the International Continence Society as urinary urgency, with or without urge incontinence, usually with frequency and nocturia with no proven infection or other obvious pathology. Treatment with the antimuscarinic agents tolterodine and oxybutynin is the mainstay of therapy for overactive bladder. The study was undertaken to compare the efficacy and side-effects of tolterodine and oxybutynin in a number of Iranian women.
Methods: This study consisted of two trials and done in Imam Khomeini Hospital in 2009 in one trial, 50 patients with overactive bladder were randomized to 4 weeks of treatment with 2 mg of twice-daily tolterodine, and in the other to 5 mg of three times a day oxybutynin. Urodynamic investigations, Episodes of urge urinary incontinence and adverse events were also evaluated.
Results: The results showed a good association between the questionnaire and cystometry data but urodynamic studies showed significant differences in efficacy. Tow groups showed significant improvements in all Symptoms, but The results showed that the two drugs had no significant differences in efficacy.
Conclusion: The data obtained by questionnaire indicated that both drugs increased quality of life but there were no significant differences between the two in symptom cure. Dry mouth was the most common side-effect in the two groups but unlike other studies it was higher in the tolterodine group. Therefore, our study did not show any preference between oxybutynin and tolterodine.
Hadadi A, Moradi-Tabriz H, Mehdipour Aghabagher B, Moslehi B, Esmaielzadeh P,
Volume 69, Issue 6 (6 2011)
Abstract
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MicrosoftInternetExplorer4 Background: Staphylococcus aureus infection pervasively occurs in communities and
hospitals and observing related guidelines is essential in preventing development
of antibiotic resistance in Hospitals. In this study we tried to determine the
prevalence of Methicillin and vancomycine resistant staphylococcus aureus (MRSA
& VRSA) and find the most suitable diagnostic tool and
treatment in affected patients.
Methods: This study was performed on hospitalized patients in Sina Hospital in Tehran,
Iran during 2009-2010. Eighty-five staphylococcus
aureus samples were evaluated for resistance to oxacillin and vancomycine
by both disc diffusion and E-test methods.
Results: The study population included 46 male and 39
female patients. The mean age of the participants was 51.46±19.21
years. The MRSA frequency was 50%.
67 (78.8%) patients had hospital-acquired
staphylococcus infection. The rate of hospital-acquired MRSA
was 93%. Length of hospital stay, undergoing invasive
methods, history of antibiotic use three months prior to hospitalization and its
kind were recognized as MRSA risk factors. There
were no reports of VRSA except one case of vancomycine-intermediate
S. aureus (VISA). The results of disk effusion and E-test
methods were consistent.
Conclusion: Considering
the prevalence of methicillin resistance in hospital-acquired infections, it seems
that oxacillin should not be used as the first-line option for empiric therapy
against S. aureus till
antibiogram results are available. Disc diffusion can also be reliably used
instead of the more expensive E-test.
Pahlavan-Sabbagh Mr, Khatami Smr, Salari-Far M, Boroumand Aa, Davoudi S,
Volume 69, Issue 8 (6 2011)
Abstract
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Background: Neutrophil
Gelatinase Associated Lipocalin (NGAL) is a new biomarker which can predict acute kidney injury (AKI) in critically ill patients.
Usefulness of NGAL in the early diagnosis of all types of AKI is under question. We
hypothesized NGAL is an early predictive biomarker of contrast-induced nephropathy (CIN).
Methods: In this process evaluation study, we enrolled 122 patients (Mean age 59.7±10.8 years) undergoing elective
angiography/angioplasty with contrast media during April to September 2009. Serial urine samples were
analyzed in a double-blind fashion by NGAL enzyme-linked immunosorbent assay. CIN was defined as a 25% increase in baseline serum creatinine.
Results : The prevalence of CIN was 30.3%. Significant elevations in urinary NGAL concentrations were noted within 12-h and 24-h after the procedure in patients with CIN. NGAL concentrations after 12 hours was 90.62±105.63 vs. 27.6±45.8 ng/ml in patients with and without CIN, respectively P=0.0001, and 79.78±117.7 vs. 30.92±52.84 ng/ml, 24 hours afterwards P=0.002. Some patients had AKI after five days of exposure rather than the second day (P=0.0001). We found using a cut-off point
of 8
ng/ml with a sensitivity, specificity, negative predictive value and area under
the ROC curve
94%, 25%, 91% and
0.75 respectively
are good for the prediction of CIN in 12-h urinary NGAL and a cut-off point of 5.5 ng/ml with respective values of 97%,
24%, 95% and 0.70 for 24-h urinary NGAL.
Conclusion: Urine NGAL may represent a sensitive
early biomarker of acute AKI after angiography/angioplasty. We recommend the routine measurement
of NGAL in
high risk patients receiving contrast agents.