Journal of Research in Medical Sciences
Volume:9 Issue: 1, Jan & Feb 2004

Early,. diagnosis and repair make a better prognosis in Hirschsprung''s disease (HD) patients. Two basic approaches, namely single staged and multiple staged pull through are commonly applied to treat such patients. In this study we tried to compare short-term and long-term complications of the two procedures to provide a guide for choosing the safer and more effective approach. The study involved all the HD cases treated via either of the two common approaches during a seven-year period from 1995 to 2002 in Isfahan, Iran. Fourteen patients underwent single-staged repair (SS) but the remaining 48 were treated via a multiple-staged approach (MS). Short-term and long-term complications together with patients'' defecation patterns were compared between the two groups. Early wound infection was significantly more prevalent among MS group (9 (19%) in MS groups vs. 1 (7%) in SS group; P < 0.05). Intestinal obstruction, severe enterocolitis, and anastomotic stricture were considerably lower in SS repair than in MS procedure. Defecation patterns in both groups were comparable. Compared with the MS approach, the number of hospital admissions and total length of stay were significantly lower in the SS group. Although restoration of normal function is achieved with both procedures, early and late complications, number of admissions and the total length of hospital stay are considerably lower with the SS pull through. Therefore, with an earlier diagnosis, SS repair can be an improved strategy, which will bring a better prognosis for HD patients.

1,4-dihydropyridines are a class of drugs which are used in the treatment of some cardiovascular disorders. The prototype, Nifedipine, does not have optimal pharmacokinetic and pharmacodynamic properties. Several new derivatives of 1, 4-dihydropyridine have been produced and pharmacologically evaluated in order to find drugs with better pharmacological properties. Among them, those with a substituted heteroaromatic ring in the C4 position of the 1, 4-dihydropyridine ring, instead of the phenyl ring in Nifedipine, are most considered. In this study, eight novel derivatives of this class with “2-methylthio-1-(phenylamino)imidazole-5-yl” in the C4, C3 and C5 positions were prepared and evaluated as calcium channel antagonist agents. To prepare these compounds, Hantzsch method for the synthesis of 1, 4-dihydropyridine derivatives was deployed. An aldehyde was reacted with appropriate acetoacetate ester and ammonium acetate. This aldehyde was prepared in three steps. Cumulative doses were applied to determine the relaxing effect of the compounds on the longitudinal smooth muscle of male albino guinea pigs. Chemical structures of the compounds were characterized by 1H nuclear magnetic resonance, infrared and mass spectroscopy. The IC50 of each compound was graphically determined from the concentration-response curves. Two compounds were more active than Nifedipine. Both had lipophilic ester groups with low steric hindrance that met the merits of a better receptor binding of 1, 4-dihydropyridines. These derivatives have high potential for further study.

The question of whether chronic appendicitis can give rise to chronic abdominal pain has always been a matter of controversy. The main purpose of this study was to find a means of diagnosing chronic inflammation of appendix through clinical and histopathological procedures. A group of 18 patients complaining of frequent pain attacks in their RLQs were involved in our study. The patients'' history, clinical and lab findings were closely evaluated. All the patients underwent appendectomy and all their appendices were histopathologically examined. Chronic appendicitis was ruled in with a positive pathology report confirming chronic inflammation. All the patients referred for their follow-up visits in a period of one year. Histopathology reports confirmed chronic appendicitis in 16 of the cases (88.8%). From them 93.7% expressed complete pain relief in the follow-up visits. 62.5% of our patients were women and the rest were men. The patients were categorized into three age groups as those less than 15 years (18.75%), between 15 and 25 years (31.25%) and older than 25 (50%). It seems as if chronic appendicitis could be blamed for recurrent abdominal pain attacks. The dis- ease is easily cured via appendectomy.

Tennis elbow is a common orthopedic disease affecting elbow in middle aged people. Ninety percent of patients are cured using conservative treatments. In the past, emphasis was placed on the use of long arm splints for its treatment; however, recent studies put doubt on the use of this method of treatment for the complications arising from the application of splints. The results of using long arm splints for the treatment of This was a case series non randomized clinical trial involving 25 patients treated with long arm castsplints, and 25 patients treated without the use of splint. Local corticosteroid injections and oral NSAIDs were administered for all patients. The two groups were compared in the third week, third month and sixth month of their treatment for the presence of local tenderness and pain in passive flexion test of wrist and fingers against resistance. Using SPSS 9.0, data were analyzed via repeated measurements test of ANOVA Patients in case and control groups had mean ages 43.6 ± 7.2 and 43.6 ± 6 years, respectively. Prior to any treatments, all patients in this study suffered from pain and tenderness in the origin of forearm extensor muscles. Their pain exacerbated upon passive flexion of wrist and fingers against resistance. No significant difference was seen in third week, third month and sixth month (P value =0.32), and no significant difference was seen in the results of our tests regarding the presence of local tenderness and pain in passive flexion of wrist and fingers against resistance between the two groups After a follow-up period of six months, this study demonstrated no statistically significant difference between the two groups treated with and without long arm splints.

Various systems of Computerized Tomographic (CT) staging and scoring have been applied to define the extent of sinus abnormality and the degree of mucosal thickening. Functional Endoscopic Sinus Surgery (FESS) has been used with considerable success rate to treat chronic sinonasal patients unresponsive to medical therapy. This study was designed to investigate the relationship between the result of CT scoring and staging and the outcome of surgery. The one year outcome of FESS together with preoperative CT staging and scoring were determined and compared with each other. Compared to those with higher stages (III and IV), patients with lower preoperative CT stages (I and II) had a significantly higher successful outcome of surgery. CT staging and scoring were obviously correlated. The results of this study show that preoperative CT staging and scoring are two useful means for better prediction of the long–term outcome of surgery one year after FESS.

Aggression, violence and Suicide are important problems of mental health in our society. They almost always cause disability, death, or other social problems. Appropriate measures can be taken if the distribution of behaviors and suicide risk are well studied in various psychiatric disorders. This was a cross-sectional study. We studied 801 psychiatric patients who were admitted in a psychiatric emergency unit in Isfahan, Iran, for aggression, violence and risk of suicide. Information was obtained from a 30-item questionnaire, filled by the same physician. About one-third of patients had aggression and/or violence on admission or during hours before it. It was most prevalent in men of 12-26 years old and in bipolar mood disorder patients. "High suicide risk" was markedly found in patients with major depressive disorder. Differences of these phenomena were statistically Our findings show a higher rate of aggression and violence in emergency psychiatric patients than in studies done in other countries. It may be due to higher prevalence of bipolar patients in the study field. The finding of "High suicidal risk" in major depression patients warrent systematic preventive programs.

There is growing evidence indicating that neuronal calcium channels play an important role in the mechanism of Morphine dependence. To investigate the acute and long-term effects of Verapamil in Morphine dependent mice. Mice were rendered dependent on Morphine by subcutaneous injection of Morphine over a period of 5 days. The effects of acute and chronic administration of phenylalkylamine calcium channel antagonist, Verapamil, on Naloxone induced Morphine withdrawal signs was investigated. A single injection of Verapamil proved to be effective in inhibiting some signs of Morphine withdrawal but ineffective in changing the number of jumps. The concurrent injections of Verapamil with Morphine prevented most signs of Morphine withdrawal. The results confirmed the crucial role of voltage-sensitive calcium channels in the adaptations that occur after long-term treatment with Morphine. Concurrent injections of Verapamil with Morphine could be used to prevent some signs of Morphine withdrawal.

Position of umbilicus is an important esthetic landmark and its absence or deformity may be associated with poor self-image. In abdominoplasty, the creation of a normal-looking, well shaped and sufficiently deep umbilicus on a normal position seems essential. The aim of this study was to determine the normal position of umbilicus and hence to improve the cosmetic result of exomphalos major repair. In a cross-sectional study the position of umbilicus was determined in a random sample of 200 healthy and normal neonates (107 boys and 93 girls) who were born in Isfahan University hospitals from Oct. 2002 till Mar. 2003, with respect to the xiphisternum and pubis. The normal umbilical position was 59.3 ± 5.2 percent of the way from the inferior border of xiphisternum to the superior border of the pubis in the midline and it was independent of gender and neonatal Recent years have witnessed major improvements in the survival of newborns with exomphalocele. The primary repair of the abdominal wall with umbilicoplasty is generally considered the treatment of choice, and the cosmetic appearance of the navel becomes increasingly important as children grow older. In repair of exomphalos major, the most esthetically pleasing result is obtained if the umbilicus is placed 59.3% of the way from the xiphisternum to the pubis.

University students are important parts of all educational systems. They are susceptible to different psychiatric disturbances, which in turn may cause considerable problems with their course programs. Depression is among the most important indices for investigation on human mental health status. This research was planed to study the prevalence and characteristics of depression and its consequences (suicidality, hopelessness, etc.) in nursing students at Shiraz University of Medical Sciences. All undergraduate nursing students at Fatemeh College of Nursing and Midwifery were tested with Beck Depression Inventory (BDI). This research revealed that 60% of students were depressed, 34% of them had mild depression, 18.4% moderate, 6% relatively severe and 1.6% severe depression. Mean score of BDI was not significantly different between female and male subjects (13.8 ± 9 in females vs. 15.2 ± 10 in males; total 14.1 ± 11) This research shows that there is still a high proportion of University students having depression, which necessitates considerable attention to their problems.

Dental amalgam is still the most useful restorative material for posterior teeth and has been successfully used for over a century. Dental amalgam has been widely used as a direct filling material due to its favorable mechanical properties as well as low cost and easy placement. However, the mercury it contains raises concerns about its biological toxicity and environmental hazard. Although in use for more than 150 years, dental amalgam has always been suspected more or less vigorously due to its alleged health hazard. Amalgam restorations often tarnish and corrode in oral environment. Corrosion of dental amalgam can cause galvanic action. Ion release as a result of corrosion is most important. Humans are exposed to mercury and other main dental metals via vapor or corrosion products in swallowed saliva and also direct absorption into blood from oral mucosa. During recent decades the use of dental amalgam has been discussed with respect to potential toxic effects of mercury components. In this article, the mechanisms of dental amalgam corrosion are described and results of researches are reviewed. It finally covers the corrosion of amalgams since this is the means by which metals, including mercury, can be released within oral cavity.

Mesothelioma is often diagnosed as a malignant scrotal mass without pain or inflammatory signs. It is a very rare tumor with quite uncommon sites of involvement. This form of malignancy generally involves pleura, with a differential diagnosis of undifferentiated carcinoma expectable in this area related to epididymis and rete testis.