Showing 41 results for Clinical
M Akhyani , H Ghaninezhad Ahary , Z Safaie Naraghi , A Rezaie ,
Volume 56, Issue 5 (7-1998)
Abstract
Our purpose was demographic clinical and pathological aspect of BCE in patients seen in Razi Hospital, during a six-month period (75.8.12 to 76.2.12). Results: From the total 20000 patients, 103 cases of BCE were detected. (0.5%). The male female ratio was 1.71 BCE was more frequent in sixth decade. 40.8% of patients were fair skin (Type II), 54.4% tawny (Type III) and 4.9% brown (Type IV, V). 15.5% of patients had a past history of freckles and history of radiotherapy in childhood was present in 41.7% 89.3% had no history of acne and seborrhea. The scalp was the most common site of BCE. The most common clinical type was nodular BCE and solid BCE was the dominant histological feature. Conclusion: BCE was more common in male and fair skin patients with dry skin. In those having history of radiotherapy of the scalp, lesions were seen mostly on the scalp, forehead and neck: pigmented BCE was predominant in this group.
F Farzianpoor , A Bazargan ,
Volume 57, Issue 2 (5-1999)
Abstract
The present research evaluated the teaching of treatment hospitals of medical sciences universities in Tehran. The aim of research was a clinical diagnosis on particular nature of medical specialty, sub specialty fields promoting the quality of medical education and offering special services in teaching hospitals in comparison with standard measurements. An effective method in recognizing the strong and weak points of teaching and treatment services in teaching hospitals is choosing the Accreditation Model, that played a great role in this research. The steps to perform the model are as follows: 1) At the beginning, the medical education system criteria was mentioned according to model consisting of five parts: input-process-intermediate output-final input and outcome. The evaluation factors are: 1- Managing, treatment, teaching and research sections. 2- The theoretical, practical and experties of the faculty members. 3- The educational progress of assistants. 4- Resources, facilities, equipment and financial services in teaching of treatment center. 5- The ability to carryout teaching of treatment and clinical projects. 6- Patient satisfaction. 2) To determine if the variables are standard, the national and international documents (teaching standards of Cebec, Canada) were studied to compare the standards to the medical education system in medical hospitals. The viewpoints of board of directors in teaching hospitals were gathered. At last, the final model was devised according to the viewpoints and the final standard confirmed, 96.7% positive votes. 3) To determine the percentage role of evaluation factors, called the basis the investigation forms were filled by the managers of the hospitals according to interview and Delphi technique. The importance of each basis was investigated and confirmed in two stages in teaching hospitals in Tehran and all over Iran, according to the information. 4) According to the standards, many questions were constructed. The board of directors in teaching of treatment sections in every selected hospital determined the rank of each criteria on the hospital where they worked. After gathering the data by the investigator and determining the grades, the following linear-formula will be applied and the criteria to judge a teaching hospital on its credibility will be available. Y=a1x1+a2x2+... akxk. 5) Based on the data collected and the application of the linear formula, the hospitals in the study proved to comply with the accreditation standards. They were rated as satisfactory.
Salari M,
Volume 59, Issue 2 (5-2001)
Abstract
It is now generally recognized that anaerobic bacteria may be involved in most human bacterial infections that follow any form of surgery or are related to those body sites that have a large anaerobic population. Anaerobes must therefore be sought in a wide variety of clinical specimens. In this study, 3015 specimens of patients (1684 male and 1331 female) with periodontitis (160 cases), abcess (305), sinusitis (33) and enterocolitis (2517) wer investigated. The anaerobic isolates from patients with periodontitis were 244 cases, abscess 32, enterocolitis 42.
Salari Mh,
Volume 59, Issue 3 (6-2001)
Abstract
It is now generally recognized that anaerobic bacteria may be involved in most human bacterial infections that follow any form of surgery or are related to those body sites that have a large anaerobic population. Anaerobes must therefore be sought in a wide variety of clinical specimens. In this study, 3015 specimens of patients (1684 male and 1331 female) with periodontitis (160 cases), abcess (305), sinusitis (33) and enterocolitis (2517) wer investigated. The anaerobic isolates from patients with periodontitis were 244 cases, abscess 32, enterocolitis 42.
Sadr Bafghi S M, Rafie M, Modares Mosadegh M, Ahmadiah Mh, Zandikarimi F, Aghili K,
Volume 61, Issue 4 (7-2003)
Abstract
Unstable angina (UA) is situated in a spectrum with myocardial infarction (MI) at one end of it and stable angina at the other end. To determine the clinical and paraclinical characteristics of unstable angina this study was designed.
Materials and Methods: Two hundred patients with definite UA who were hospitalized at cardiac care units (CCU) in Yazd were enrolled in this cross- sectional study. Clinical and para-clinical characteristics including class of severity of angina, clinical circumstances, drugs, risk factors, changes in ECG, and patient's condition at the time of leaving hospital were evaluated.
Results& Conclusions: The average of age of patients was 61.85 years and 57% of them were female and 43% were male. The most prevalent risk factor among men was smoking (48.8%) and among women was hypertension (62.8%). According to Braunwald suggestion, patients were divided into 3 classes based on the severity of their diseases. Frequency distribution of patients in classes I,H and III were 24.5%, 4% and 71.5%, respectively. Normal ECG, was observed in 24.5% of subjects at the time of hospitalization and in 67% of patients when leaving hospitals. Frequency distribution based on the risk stratification was 22.5%, 58.5% and 19% in the low, medium and high risk groups, respectively. During hospitalization, acute myocardial infarction (AMI) was seen in 3.5% of individuals that majority of them belonged to class III of angina.
A Keshavarz Zirak , S.s Frooghi Al Davoov , A Soltani , B Ardashir Larijani ,
Volume 63, Issue 3 (6-2005)
Abstract
Background: Sub clinical hyperthyroidism is a state of subnormal serum TSH and T3,T4 within normal range, although usually without overt clinical manifestation but many disastrous complications especially in senile patient. In Iranian people, serum TSH is generally assayed by IRMA method. This study is aimed to determine the value of low serum TSH in these patients, better management and decision when encountered.
Materials and Methods: The populations under study are guys with serum TSH lower than 0.5mu/l and normal thyroid hormones without known thyroidal and non-thyroidal illness. A basal serum TSH and TSH 30 minutes after TRH injection intra venous were sampled and correlation of clinical signs and symptoms and basal TSH with sub clinical hyperthyroidism was considered.
Results: The population under study was categorized into five groups and prevalence of sub clinical hyperthyroidism was noted. In patients with b.TSH equal or lower than 0.1mu/l, 100%, 0.1-0.2mu/l, 75%, 0.2-0.3mu/l, 38.5%, 0.3-0.4mu/l, 14.3% and TSH levels greater than 0.4mu/l, were all normal. After analyzing of these data and determination of sensitivity and specificity of IRMA, it was concluded that IRMA is not sufficient to distinguish sub clinical hyperthyroidism, although there is a good linear (r=0.68 P<0.001) and cubic (r=0.79 P<0.001) relationship between b.TSH and d.TSH.
Conclusion: Since TRH test is not cost effective for all cases, TSH levels lower than 0.25mu/l, can be considered as sub clinical hyperthyroidism and levels more than 0.4mu/l, as normal. In cases with TSH level between 0.25 and 0.4mu/l, TRH test is needed in high-risk patients.
Jamshidi A.r , Gharib Doost F, Larijani B, Forouzesh Nia S M,
Volume 64, Issue 7 (8-2006)
Abstract
Background: Scleroderma is an important chronic disease with unknown ethiology and two subtypes: limited type: Skin involvement limited to distal of extremity and face. Diffuse type: Skin involvement is both distal and proximal of extremity, face and thrunk. Thyroid dysfunction is a main problem in these patients but there is no published data of Iranian scleroderma patients
Methods: This is a cross-sectional study to determine the prevalence of hypothyroidism (clinical, subclinical and autoimmune) in patients with scleroderma 125 patients with scleroderma selected and T3, T4, TSH Anti Tpo Ab and Anti TG Ab measured in them.
Results: 33 patients with scleroderma had hypothyroidism. (%26/4). Two patients with scleroderma had hyperthyroidism. (%1/6). %12/8 had clinical hypothyroidism. And %13/6 had subclinical hypothyroidism, %33/3 of patients with subclinical hypothyroidism and positive autoantibody had limited type. Where as %66/6 of patients with subclinical hypothyroidism and autoantibody had diffuse type, %28/5 of patients with clinical hypothyroidism and positive auto anti body had limited type. Where as %71/4 of patients with clinical hypothyroidism and auto anti body had diffuse type. All of patients with hyper thyroidism had diffuse type and autoantibody positive.
Conclusion: It seems hypothyroidism has an increased prevalence in patients with scleroderma and we suggest that thyroid function test must be done in primary evaluation of these patients
Nabavi Sm, Poorfarzam Sh, Ghassemi H,
Volume 64, Issue 7 (8-2006)
Abstract
Background: Multiples sclerosis is a common demyelinating disease of CNS and the main cause of disability in young adults all over the world so any research in different aspects of the disease has great value. researches in Iran are few in quantity and low in sample size. To determine clinical course and prognosis of the disease in Iranian MS patients we have studied these items in a considerable sample size.
Methods: Two hundred and three definite MS patients (according to MC’donalds 2001 criteria) included in this study and a planned questionnaire completed by visiting the patients or by degree of disability estimated according to EDSS (Expanded Disability Status Scale) score system. The results analyzed with SPSS software.
Results: Mean age of the patients was 35. All required examinations have been done by a neurologist and 60.6 percent were female. Mean duration of disease was 8.3 years. the main form of onset of symptoms was sensorimotor (mixed). Mean Attack rate was 5.5 times during the disease duration. Clinical course in 72.4 percent was relapsing-remitting type. Mean disability scale number according to EDSS was 5.2. Death rate was two percent. 69.3 percent of patients were able to work in the society. The degree of disability increased with increasing age, in lower educational state, in longer duration of the disease and in male gender.
Conclusion: The results of clinical course and type of MS, mean of disease duration from the onset and mean EDSS are compatible and comparable with similar studies in other countries though some results are different. For future large sample, multicenter studies recommended
Jafari S, Soltanpour F, Soudbakhsh A, Safavi E, Rokni Yazdi H, Navipour R, Hajizadeh E,
Volume 64, Issue 8 (8-2006)
Abstract
Background: Community-acquired pneumonia could be a life-threatening condition especially in elderly patients. The factors influencing the outcome in elderly patients are thought to be different from those in young adults. We compared the clinical and paraclinical profiles in elderly and nonelderly patients with community-acquired pneumonias.
Methods: In this cross-sectional study, seventy nine patients who were hospitalized with community acquired pneumonia over a period of one year were included. Patients' medical records were reviewed and data related to comorbid conditions, signs and symptoms, laboratory and radiographic findings were gathered using a checklist.
Results: The clinical features, laboratory parameters and complications from pneumonia were almost similar in 41 elderly (group I, age ≥65years) and 38 young (group II, age<65years) subjects. Delirium was seen more in elderly group (p=0.05). The average body temperature and pulse rate were significantly higher in nonelderly group. Sixty one percent of elderly patients and 21% of young patients have Po2 less than 60 (p=0.02). Smoking (29.1%), neurological disturbances (19%), congestive heart failure (15.2%), chronic obstructive pulmonary disease and diabetes mellitus (13.9%) were associated comorbidities in both groups. In non elderly group, immune compromise and IV drug use were more common as underlying comorbid conditions. Two of three mortalities were due to elder patients.
Conclusion: Community acquired pneumonia could have more serious clinical and abnormal laboratory features in the elderly than younger patients. Mortality rate may be higher in older patients. Comorbid conditions are frequently seen in both elderly and nonelderly patients with community acquired pneumonia, but IV drug use and immune compromise are more frequent in nonelderly patients.
Dargahi H, Rezaian M,
Volume 65, Issue 1 (3-2008)
Abstract
Background: Quality assurance is a prevention-oriented system that can be used to
improve the quality of care, increase productivity and monitor the performance
management in clinical laboratories. ISO 9001: 2000 requirements are a collection of
management and technical systems designed to implement quality assurance and monitor
performance management in organizations.
Methods: A checklist was prepared to monitor the preanalytical, analytical and
postanalytical stages of laboratory performance management in 16 areas and all
laboratory activities in 14 of the clinical laboratories of the Tehran University of Medical
Sciences (TUMS) hospitals. Collected data were stored and statistically analyzed using
SPSS software.
Results: The best performance, in which 77.73% of quality assurance indicators were
observed, was found in Sina Hospital. However, only 57.56% of these indicators were
fulfilled at Farabi Hospital, with the lowest-level performance among the clinical
laboratories of TUMS hospitals. The highest level of compliance with quality assurance
indicators was in the hematology departments and for facility demands in management
areas. Overall, quality assurance indicators were appropriately followed in only 7% of the
clinical laboratories.
Conclusion: The average quality assurance observation rate in the clinical laboratories
studied was 67.22%, which is insufficient and must be remedied with stricter
enforcement of the ISO 9001: 2000 regulations.
Ghasemi Firoozabadi S, Shafeghati Y, Keyhani E, Kariminejad R, Oloomi Z, Moosavi F, Amini F, Najmabadi H, Behiati F,
Volume 65, Issue 9 (12-2007)
Abstract
Background: Fanconi anemia (FA) is a rare autosomal recessive disorder characterized by short stature, skeletal anomalies, increased incidence of solid tumors and leukemia, and bone marrow failure (aplastic anemia). FA has been reported in all races and ethnic groups and affects men and women in an equal proportion. The frequency of FA has been estimated at approximately 1 per 360,000 live births. In some populations, including Ashkenazi Jews, Turks, Saudi Arabians and Iranians, this frequency appears to be higher, probably as a result of the founder effect and consanguineous marriage. Because of extensive genetic and clinical heterogeneity (the age of onset, clinical manifestations and survival), diagnosis of FA on the basis of clinical data alone is unreliable and its molecular diagnosis is difficult. The diagnosis of FA exploits the hypersensitivity of FA lymphocytes and fibroblasts to bifunctional alkylating agents such as mitomycin C (MMC), diepoxybutane (DEB) and nitrogen mustard and differentiates it from idiopathic aplastic anemia. In this study, in addition to the patients' clinical profiles, a cytogenetic test using MMC was implemented for an accurate diagnosis of Fanconi anemia.
Methods: In this study, the lymphocytes of 20 patients referred for FA, and those of their normal sex-matched controls, were treated with three different concentrations of mitomycin C (20, 30, 40 ng/ml). Slides were prepared and solid stained. In order to determine the number and kind of chromosome abnormalities, 50 metaphase spreads from each culture were analyzed. Clinical information was obtained from patient files.
Results: Five patients manifested increased chromosome breakage with MMC, confirming the FA diagnosis. Two different concentrations of MMC (30, 40 ng/ml) were most effective.
Conclusion: The chromosomal breakage test is important for the accurate diagnosis of Fanconi anemia. DNA crosslinking agents used to treat idiopathic aplastic anemia may be lethal for patients with FA. Thus, aplastic anemia patients with unknown etiology, infants with congenital abnormalities involved in FA and siblings of FA patients should also be cytogenetically tested.
Nuraei A, Khajenouri R, Soleimani M, Dabbagh A,
Volume 68, Issue 4 (7-2010)
Abstract
Background: Patients with chronic renal disease, if not treated appropriately, will be usually terminated into an irreversible stage known as End Stage Renal Disease (ESRD), the final stage of kidney disease. End stage renal disease patients cannot excrete the appropriately potassium ion through the kidney. Among the crystalloid solutions, normal saline is devoid of potassium so it is used in a widespread manner in renal transplant patients. High doses of this solution may cause hyperchloremic metabolic acidosis that is accompanied by extracellular potassium shift and impaired splanchnic perfusion. The aim of this study was to assess the effects of two types of solutions, normal saline vs. lactated ringer in these patients during the perioperative period. Methods: In a double blind clinical trial, 108 patients were randomly assigned in two groups (54 in each), while were assimilated regarding all aspects except for the type of the crystalloid solution. Age, weight, duration of the surgery, total volume of the infused crystalloid, central venous pressure and sex were all assessed.
Results: The two groups were the same regarding the results gained for pre- and post- operative parameters. Follow up assessments did not show any difference between the two groups regarding above variables.
Conclusions: The results of this study demonstrated that both of the crystalloid
solutions assessed, normal saline and lactated ringer solution, are safe for using in patients undergoing surgical operation and there is not a risk of hyperkalemia in renal transplant patients receiving lactated ringer. This study was performed on live kidney transplants and the results were not applicable to cadaver transplants.
Akbarian M, Faezi St, Gharibdoost F, Shahram F, Nadji A, Jamshidi Ar, Akhlaghi M, Shafaee N, Akhlaghkhah M, Davatchi F,
Volume 68, Issue 5 (8-2010)
Abstract
Background: Systemic Lupus Erythematosus (SLE) is a prototypic autoimmune disease with diverse clinical manifestations in association with autoantibodies to components of the cell nucleus. SLE as a chronic autoimmune disease has a worldwide distribution. There is a wide variation in the natural history of SLE among different ethnic and geographic groups. Our SLE registry is one of the largest series in Asia-Pacific region. The aim of this study was to show the manifestations of SLE in Iranian patients.
Methods: This study is on clinical and Para clinical manifestations of SLE according to the database of the Rheumatology Research Center (RRC), Tehran University of Medical Sciences as a major referral center for rheumatic disease in Iran during the period of 1976 to 2009.
Results: A total of 2143 SLE patients were studied. The female to the male ratio was 8.8:1 and the mean age at the presentation was 24.2± 10 Years. Prevalence of clinical manifestations included: musculoskeletal, cutaneous, renal, neuropsychiatric, pulmonary, cardiac and hematologic were 85.2%, 83.1%, 66.6%, 24%, 22.3%, 17.5% and 67.1% respectively. There were seen positive FANA in 78.3% and anti-DNA in 70% of patients. Overlap syndrome and positive family history with other autoimmune diseases were detected in 14.9% and 3.4% of patients respectively.
Conclusion: The prevalence of some manifestations (such as cutaneous and renal involvement) in our patients were similar to those of nearby countries (with similar climate), while other manifestations (such as hematologic and joint involvement) were similar to the European countries (with similar ethnicity). Genetic and/or climatic factors may lead to different presentations of lupus.
Aghaei M, Gharibdost F, Zayeni H, Akhlaghi M, Sedighi S, Rostamian Ar, Aghdami N, Shojaa M,
Volume 68, Issue 12 (3-2011)
Abstract
Background: Systemic scleroderma (SSc) is a generalized
connective tissue disorder of unknown origin which most notably is
characterized by skin thickening and organ damage. Endothelin-1
(ET-1) antibody plays a role in skin fibrosis. The
aim of this study was to determine the prevalence and correlation of different
manifestations of SSc with ET-1
plasma levels.
Methods: This cross-sectional analytical study was conducted on 95
patients (91 women and four men)
with scleroderma in 2006. The patients had
been referred to the Rheumatology Clinic of Shariati Hospital in Tehran, Iran.
The demographic data and signs and symptoms were entered in a questionnaire and
endothelin-1 concentrations were measured.
Results: The mean age of the patients was 38±12.29 years.
Diffuse cutaneous SSc (dcSSc)
was diagnosed in 52 and limited cutaneous
SSc (lcSSc)
in 43 patients. Raynaud's phenomenon (91%)
was the most common manifestation in the patients. The relationship between the
resorption of terminal phalanges due to fibrosis with the plasma concentration
of Endothelin-1 was statistically significant (p=0.001).
Pitting ulcers had significant relationships with endothelin-1 concentrations
too (p<0.05). No other significant relationships
were found between the other manifestation of the disease and Endothelin-1
concentration.
Conclusion: In
this study, Reynaud's phenomenon was the most frequent sign in patients with
scleroderma. Thus, it could serve as a tool for the diagnosis of scleroderma.
As there were no significant relationships between the other manifestations of
scleroderma with endothelin-1, a cohort study with a
larger sample size is suggested.
Hasanzadeh Mofrad M, Homaeei F, Esmaele H, Ayate S, Nagave Reabe H,
Volume 68, Issue 12 (3-2011)
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.
Yegane A, Mottaghi A, Moghimi J,
Volume 69, Issue 3 (6-2011)
Abstract
Background: Unlike quantified MRI, no correlation has been stated between radiologic
findings and the clinical signs in patients with knee osteoarthritis. This study evaluates the relationship between quantified clinical signs including pain, restriction of movement, stiffness and structural changes with MRI and plain radiography findings. Methods: Eighty patients with knee osteoarthritis were successively recruited in the study in Rasole Akram Hospital from 2009 to 2010. Upon physical examination, quantified scales of pain and joint stiffness and limitation of movement were recorded and quantified findings of MRI and plain x-ray were reported during the paraclinical study. All the gathered data including the demographic characteristics of the participants were read to the statistical software.
Results: In MRI study, pain was significantly correlated with knee effusion (P=0.008), osteophytes (P=0.006), meniscal degeneration (P=0.036) and subchondral cysts (P=0.044) as was joint stiffness correlated with chondral lesions (P=0.020) and meniscal
degeneration (P=0.026). On the other hand, there were no relationship between pain and
joint stiffness or limitation of movement in radiologic studies but significant relationships existed between radiologic findings with bone marrow inflammation (P=0.015), chondral lesions (P=0.022) and subchondral cysts (P=0.014).
Conclusion: As shown in this study, MRI findings including chondral lesions, subchondral cysts and bone marrow inflammation were correlated with radiologic findings and osteophytes, subchondral cysts, joint effusion and meniscal degeneration were correlated with pain as were meniscal degenerations and chondral lesions were with joint stiffness. On the other hand, clinical findings (pain, stiffness and limitation of movement) had no correlation with radiologic findings.
Eini P, Esna-Ashari F, Mobaien Ar, Hasanzadeh M,
Volume 70, Issue 2 (5-2012)
Abstract
Background: Brucellosis is one of the most common infectious diseases in Iran with very different clinical manifestations.
Methods: In this retrospective descriptive study, all patients with brucellosis, who were admitted in Farshchian Hospital in Hamadan, Iran in 2005 to 2010, were enrolled in the study. The data were collected from the patients' medical records and were entered in forms for analysis.
Results: A total of 230 patients with brucellosis, including 130 (56.5%) male and 100 (43.5%) female patients with a mean age of 40.84±20.29 years, who mostly (72.2%) lived in rural areas were enrolled in the study. Outbreaks were most common in spring and summer and the main route of transmission was consumption of contaminated dairy products (60.3%). The most common symptoms were fever (77.4%), arthralgia (70%), sweating (47%), malaise and fatigue (46.5%). Arthritis and epididymo- orchitis were seen in 121 (52.9%) and 48 (8.20%) patients, respectively. CBC analysis showed leukocytosis in 20.8% of the participants. ESR rise was noted in 59.5% of the patients and 52.9% had positive CRP.
Conclusion: Given to various clinical presentations, brucellosis should be considered in the differential diagnosis of individuals with chronic fever with or without other organ abnormalities.
Hamid Reza Hemmati , Mehdi Sadat-Hashemi , Raheb Ghorbani , Toraj Jafari ,
Volume 72, Issue 12 (3-2015)
Abstract
Background: Inguinal hernia is a common surgical problem which increases with aging especially in men. A common method for treatment is surgical repair using prosthesis, Lichtenstein technique. One frequent complication after inguinal herniorrhaphy is soft tissues seroma. There are several methods to prevent or to drain seroma. Some surgeons suggest the insertion of closed suction drainage system but others disagree.
Methods: In this clinical trial study, 42 patients who are candidate for hernia repairing (Lichtenstein technique), referred to Amir Al-Momenin Hospital in Semnan, Iran, from 2011 to 2012, were randomly divided into two groups. So that, the list of eligible patients in the study, were numbered, and then using the patients' code, patients, who assigned an odd number in the registration list, were allocated to group 1, the remainder were placed in group two. The two first numbers in registration list (1 or 2), were randomly assigned to groups. Group 1 underwent hernia surgery without closed suction drainage and the second group underwent hernia surgery with closed suction drainage. The patients were evaluated for seroma, hematoma or wound infection after 24 hours, during days 4 to 7 and days 10 to 15 following surgery.
Results: No adverse event including hematoma, seroma or wound infection occurred in either group with or without closed suction drainage in the first 10 days after surgery. Only one patient carried wound infection during days 10 to 15 following operation who was in the group with closed drainage (P=1.00).
Conclusion: In this study, Seroma and hematoma was not observed in patients with and without closed suction drainage. To avoid drains' complications, indiscriminate use of antibiotics, prolonged hospital stay, we do not recommend the use of drains in this type of surgery.
Zahra Qaempanah , Hossein Arab-Alibeik , Marjan I Ghazi Saeed, Mohammad Ali Sadr-Ameli,
Volume 73, Issue 4 (7-2015)
Abstract
Background: Warfarin is the most common oral anticoagulant. This drug is used for the prevention and treatment of thromboembolic patients. It is difficult for physician to predict the results of warfarin prescriptions because there is narrow boundary between therapeutic range and complications of warfarin. Therefore drug dose adjustment is normally performed by an expert physician. Decision support systems that use extracted knowledge from experts in the field of drug dose adjustment would be useful in reducing medical errors, especially in the clinics with limited access to experts. The aim of this study was to propose a method for boosting the maintenance dose of warfarin for a maximum period of three days to eliminate disruptions in International Normalized Ratio (INR).
Methods: In a retrospective study, from December 2013 to February 2014 in Shahid Rajaee Heart Center, Tehran, Iran, 84 patients with International Normalized Ratio below (INR) the therapeutic range was selected who was undergone a boosting dose during three days. Patients with unstable maintenance dose were excluded from the study. In this study, data from 75 patients receiving warfarin therapy were used for developing and evaluation of the proposed model. The INR target range for 37 patients out of remaining 75 cases was between 2.5 and 3.5, while for 38 patients the intended INR range was between 2 and 3. A separate fuzzy model was designed for each of the above-mentioned therapeutic ranges.
Results: The recommended dose for 37 patients having INR therapeutic range of 2.5 to 3.5 has mean absolute error and root mean squared error of 1.89 and 2.78 respectively for three days. These error rates are 1.97 and 2.88 respectively for 38 patients who are in therapeutic range 2 to 3.
Conclusion: The results are promising and encourage one to consider this system for more study with the aim of possible use as a decision support system in the future.
Ali Hosseini Bereshneh , Danesh Soltani , Reza Roodbarani , Mohammad Hossein Modarressi ,
Volume 74, Issue 2 (5-2016)
Abstract
Stem cells are undifferentiated and multi pluripotent cells which can differentiate into a variety of mature cells and tissues such as nervous tissue, muscle tissue, epithelial tissue, skeletal tissue and etc. Stem cells from all different source have three unique features: 1) Proliferative capability: Stem cells are capable of self dividing and self renewing for long periods or more than six months at least that called immortalization. 2) Undifferentiated nature: It’s considered as one of the essential characteristics of stem cell, so it doesn't have any tissue-specific construction. 3) Differentiation to the different cells from all organs: This ability can Induced by tissue specific transcription factors. Because of that, they are so important in prevention and treatment of human disease. Depending on the sources from which they derive, they have different types which can be used to produce special cells and tissues. The most significant types of stem cells are; embryonic stem cells (ESCs) which are derived from embryos, adult stem cells (ASCs) which are derived from differentiated cells in a specific tissue, induced pluripotent stem cells (iPSs) which are produced from adult differentiated cells that have been genetically reprogrammed to act resemble to an embryonic stem cell and cord blood stem cells which contains haematopoietic stem cells and derived from the umbilical cord after gestation. By providing a medium containing of special growth factor, it is possible to orientated stem cell differentiation pathway and gained certain cells from them. The important uses of stem cells includes damaged heart tissue cells improvements and bone tissue repairing, cancer treatment, damaged neurological and spinal tissue repairing, improving burns and injuries and the treatment of diabetes, infertility and spermatogenesis dysfunction. Furthermore, the application of them in gene therapy is an important issue in the modern medicine science due to the role of them in transferring gene into different cells. Today, this method have had considerable progress in the treatment of many disease. In this review study, some aspect of stem cells like types and characteristic, origin, derivation techniques, storage conditions and differentiation to target tissues, current clinical usage and their therapeutic capabilities will be discussed.
