مجله دانشگاه علوم پزشکی شهید صدوقی یزد
سال چهاردهم شماره 2 (پیاپی 55، تابستان 1385)

Mandibular fracture is the most common facial bone fracture due to facial trauma. A variety of imagings have been used for diagnosis of mandibular fractures. However, the choice of imaging for diagnosis of mandibular fractures is controversial.Present study compares the accuracy of the three most common imaging methods in mandibular fracture diagnosis panoramic radiography, coronal CT and axial CT scan.

This cross sectional diagnostic study was performed on 45 patients with a clinical diagnosis of post traumatic mandibular fracture at the ENT department of Shaheed Sadoughi hospital,Yazd.‍‍‍ Patients underwent panoramic radiography and CT scan (both axial and coronal). Then, all were operated for reduction of fracture (either closed or open) and fixation done with arch bar and MMF in combination with or without rigid internal fixation. The physical examination and observation during operation was considered as the exact diagnosis. The radiological findings were reported by three different radiologists. Finally, the accuracy and sensitivity of each method was compared with the other methods.

There was no significant difference between the accuracy of panoramic radiography and coronal CT scan in all of the regions, but the accuracy of axial CT was significantly less than coronal CT in certain regions.

The accuracy of panoramic radiography and coronal CT scan in diagnosis of mandibular fractures is the same or higher than axial CT scan. Additionally, panoramic radiography is more accessible and less expensive than coronal CT scan. Therefore, this study recommends oral panoramic radiography as the first radiologic test for diagnosis and localization of mandibular fracture

Doppler ultrasonography (DUS) is the most preferable method for screening of carotid artery disease in patients undergoing CABG. The purpose of this study was to investigate the frequency of carotid artery disease and determine the relation between known risk factors of atherosclerosis and rate of carotid artery narrowing in order to identify high-risk groups among patients scheduled for isolated elective coronary artery bypass grafting (CABG) procedures.

Two-hundred ninety-one patients (222 males and 69 females) undergoing isolated coronary artery bypass grafting were preoperatively evaluated by carotid artery Doppler ultrasomography and the morphology of carotid artery was determined. Age, sex, cervical bruit, diabetes mellitus (DM), hypertension, hyperlipidemia, smoking, history of cerebrovascular event (CVE) and coronary angiographic findings were investigated to define the high-risk group for carotid artery disease. Data were analyzed by SPSS software and P<0.05 was considered significant.

Patients ages ranged from 35 to 95 years (mean of 57.6 + 10.4 years). Eleven patients (3.8%) had history of cerebrovascular events (CVE). 13 patients (4.5%) had cervical bruit. Left main coronary artery involvement was observed in 19 patients (6.4%). In 127 patients (43.6%) carotid scanning was normal, fifty nine patients (20.4%) had less than 50% stenosis (mild stenosis), ninty seven patiens (33.3%) had 50-70% stenosis (moderate stenosis), and eight patiens (2.7%) had more than 75% stenosis (severe stenosis). Calcified plaque was observed in 109 patients (37.5%). Previous cerebral ischemic events (P=0.297), diabetes mellitus (P=0.467), hypertension (P=0.110), hyperlipidemia (P=0.08), smoking (P=0.401), age >60 years (P=0.84), female sex (P=0.730), and left main coronary disease (P=0.390) were not identified as high-risk factors for carotid artery stenosis greater than 50%. But positive MI history (P=0.025), and cervical bruit (P=0.002), were significantly related to 50% carotid artery stenosis.

Based on the results of this study, we can not suggest DUS as a routine screening method in all patients undergoing CABG, except for patients with history of MI and cervical bruit. Another important finding was that 56.4% of patients posted for CABG had different degrees of carotid artery stenosis which requires a long term CVA prophylaxis program.

Vaccination with the major surface antigen of hepatitis B virus (HBsAg) induces anti-HBs antibody production and level of 10 IU/L is considered protective. It has been shown that the level of anti-HBs antibody does wane after vaccination. The aim of this study was to evaluate the persistence of anti-HBs antibodies in healthy Iranian children 10 years after primary vaccination.

Blood samples were collected from 146 children, 10 years after completion of primary hepatitis B vaccination course at birth. The sera were tested for anti-HBs, antibody to hepatitis B core antigen (anti-HBc) and HBsAg by use of ELISA technique.

At 10 years after primary vaccination, 70 (47.9%) children had protective levels of antibody (anti-HBs> 10 IU/L) with mean titer of 68.1 IU/ml. Moreover, 45 (30.82%) children were negative for anti-HBs antibody. Distribution of children according to anti-HBs concentration revealed that the proportion of subjects with antibody titer of 0-10 IU/L, 10-100 IU/L, 100-500 IU/L and 500-1000 IU/L was 52.1%, 24.6%, 20.5% and 2.7%, respectively. All children were negative for HBsAg, although anti-HBc was positive in 11 (7.5%) children. There was no difference in the seroprotection rates of males and females.

The results of present study show that after 10 years after primary vaccination with recombinant HB vaccine, 47.9% of the children had protective levels of anti-HBs antibody. On basis of the HBsAg and anti-HBc results, it seems that effective immunological memory exists in children. Additional follow-up studies need to be conducted to determine the duration of protection.

Though incarcerated populations are at a high risk of developing hepatitis C virus (HCV) infection, prisoners are not routinely screened for HCV infection. Approximately, 1 in 4 of the nearly 2 million prisoners in the U.S. is infected with HCV. Injection drug abusers are currently the main risk group. Among intravenous drug abusers over the world, the prevalence of HCV varies from 50-90% with an annual incidence of 10-30%. Prisons are a high risk environment for hepatitis C infection because of high incidence of drug abuse and high risk sexual activities. Serologic evidences show that HCV infection is present in one out of every three prisoners. The purpose of this study was to determine the seroprevalence of Hepatitis C infection and its associated factors among addicted prisoners in Khezrabad prison of Sari. Methodss: This was a cross – sectional study done in September 2001 at the Khezrabad prison for addicts in Sari. 312 addicts participated in the study and were selected by simple random sampling method. Their blood samples were tested by third generation enzyme immunoassay (EIA-3: sensitivity 100%, specificity 100%) at Sari's blood transfusion center. The data was collected via a questionnaire and interview. 230 prisoners (74%) completed the questionnaires. Associated factors of Hepatitis C infection were compared in 82 anti-HCV positive addicts (the affected group) and 148 anti-HCV negative addicts (the unaffected group). There were no significant differences about confounding variables between the two groups. Statistical analysis was done by , t test and multivariate logistic regression analysis.

Of the 312 addicted prisoners, 96 (30.8%) were anti-HCV positive. Major associated factors with Hepatitis C infection in the affected group included duration of addiction (mean 174 months), duration of imprisonment (mean 48 months), methods of drug usage (injection 82% and intranasal 44%), length of alcohol consumption for more than five years (60%), tattooing (66%) , shared usage of needles (31%) and razors (53%), multiple sexual partners (>74%) and the type of drugs (especially heroin 90% and hashish. 64%) (p<0.05) On multivariate logistic regression analysis,significant independent risk factors for HCV infection included tattooing (OR 100, 95% CI) , multiple sexual partners(OR4.97,95%CI)and history of surgery(OR 6.23,95% CI ) .

Hepatitis C infection is highly prevalent in addicted prisoners and high risk and unsafe behaviors are the main factors of contamination.

Hyperalgesia is considered as one the marked signs of subchronic diabetes mellitus that could affect the life style of patients. Considering the evidence on the antidiabetic and analgesic effects of Nigella sativa (NS), this study was designed to investigate the analgesic effects of NS on formalin-induced nociceptive responses (standard formalin test) in streptozotocin (STZ)-induced diabetic rats.

In this experimental study, male rats (n = 60) were randomly divided into control, NS-treated control, diabetic, sodium salicylate (SS)-treated diabetic, and NS-treated diabetic groups. For induction of diabetes, streptozotocin was used at a single dose. The treatment groups received oral administration of NS seed-mixed pelleted food (6.25%) for two months.

Diabetic rats exhibited a higher score of pain at both phases of the formalin test (p = 0.031 and p = 0.034 respectively) and NS-treated diabetic rats exhibited a lower nociceptive score as compared to untreated-diabetic ones at both acute and chronic phases (p = 0.008 and p = 0.009 respectively). Meanwhile, SS administration significantly reduced pain score only during the chronic phase of the test (p = 0.009). On the other hand, NS administration in control rats caused a lower nociceptive score as compared to untreated controls (p= 0.046 and p = 0.039).

Two-month oral administration of NS seeds can attenuate nociceptive scores in an experimental model of diabetes mellitus and therefore could be considered as a potential treatment for painful diabetic neuropathy

Today, breast cancer is one of the most common causes of mortality and morbidty and also the leading health concern of the world.

This research was a descriptive study entitled Knowledge, attitude and practice regarding prevention of breast cancer in working women of Chaloos city. The sample size of study included 612 women working in governmental centers. The instrument for data collection was a researcher –made questionnaire. For data analysis, central and coefficient index chi square ,t-test ,one way analysis of variation, Kruscal Wallis, Pearson,s correlation coefficient and Fisher test were used.

The findings showed that the most of samples were in the 30-39 years age group,(39.7%) with an educational job(83/5%) and without history of breast cancer history in the family.(94/9%) Results also revealed that there was a weak positive relationship between knowledge and attitude (r=0.33) .The findings showed there was a significant statistical relation between knowledge and practice (p<0.05). Also, there was a significant statistical relation between knowledge level and breast self examination (BSE), time interval and also the time of performing BSE (p<0.0001) Similarly, the highest levels of knowledge were present in women with medical education and those with a bachelors or higher degree. The results showed that attitude scores were significantly different in various age, job and educational groups, (p<0.001, p<0.05,p<0.05) respectively

The results showed that most of the population under study had a positive attitude but didn’t have good knowledge or practice.

Streptomyces species are mycelial, aerobic gram-positive bacteria that are isolated from soil and produce a diverse range of antibiotics. Streptomyces griseus produces the antibiotic, streptomycin and forms spores even in a liquid culture. The gene cluster for the production of Streptomycin antibiotic contains strR gene that encodes StrR, a pathway-specific regulator. Then, this pathway-specific regulator induces transcription of other streptomycin production genes in the gene cluster. The overall aim of this work was rapid isolation and molecular detection of streptomycin-producing Streptomycetes, especially S. griseus, from Iranian soils in order to manipulate them for increased production of streptomycin.

This research used new initiative half-specific medium for isolation of Streptomycetes from natural environments, called FZmsn. The fifty colonies of Streptomyces strains grown on the surface of FZmsn medium isolated from environmental samples were defined on the basis of their morphological characteristics and light microscope studies. A set of primers was designed to detect strR by OLIGO software.

In colony-PCR reactions followed by gel electrophoresis, 6 colonies from Streptomyces strains colonies were detected as S. griseus colonies.

These native Streptomyces strains will be used for genetic manipulation of S. griseus in order to increase production levels of streptomycin.

Idiopathic osteosclerosis is a common radiopaque lesion in the jaw bones, which is asymptomatic and usually detected accidentally in various radiographs. The purpose of this study was to determine the radiographic features of idiopathic osteosclerosis in the jawbones of patients referring to the maxillofacial radiology center of Mashhad Dental Faculty.

In this descriptive study, panoramic radiographs of 300 patients ( 125 males, 175 females ) who had referred to the maxillofacial radiology department were evaluated for the presence of idiopathic osteosclerosis. The radiographic information included location, number, shape, size, relationship with teeth, pattern of density ( trabecular-cortical ) and demographic data ( age, sex ) and evidence of disease in the gastrointestinal tract and kidneys were also recorded . Then data was analyzed using chi-square and t-student test.

A total of 27 patients (9%), exhibited 40 foci of idiopathic osteosclerosis with different shapes and sizes (4 cm2 to 1/09 cm 2 ), most of which had well defined borders (65%) and trabecular density (62/5%) . The most common region for these lesions was in the mandible, especially in the second premolar (47/5%) and first molar (42/5%) regions and the majority had no connection to the teeth (57/5%). The lesions were most prevalent in the second decade of life (29/6%) followed by third and fourth decades. (25/9%)

The results of this study were the same as that of previous similar studies. In addition, chronic renal failure was seen in 1/3 of patients with idiopathic osteosclerosis .

Breathing rehabilitation techniques are designed to reduce symptoms, decrease disability, increase participation in physical and social activities, and improve the overall quality of life for individuals with chronic respiratory disease. However, the role of these techniques remains unclear. This study examined the effects of pursed-lip breathing (PLB) education on the respiratory function, arterial blood gases and day to day life in patients with COPD.

A before-after quasi-experimental research was conducted on 40 patients with COPD at Shahid Beheshti Hospital in Kashan. Spirogram and ABG were tested before and after three-months of PLB exercise and a questionnaire (AQ20) was used to assess day to day activities. Wilcoxon matched- pairs signed-rank and descriptive tests were used for statistical analysis of collected data.

The study showed that after three months breathing exercise, O2 saturation was significantly increased (P=0.002). Although there was an increase in PaO2 , it was not significant. In addition, a decrease in PaCO2 (P=0.014) and the respiration rate (P < 0.000) was observed. The level of activities of daily living was also increased (P < 0.000). Forced expired volume second one (FEV1%) and forced vital capacity (FVC) did not change.

We conclude that pursed-lip breathing education can improve lung function, arterial blood gas levels and also the levels of day to day activities. Therefore, breathing exercises education should be a part of physiotherapy programs in COPD patients until improvement in the quality of their life.

Incomplete anesthesia of inflamed teeth is a well known clinical occurrence and the purpose of this study was to evaluate the effectiveness of Ibuprofen as a premedication in improving the quality of anesthesia in patients with inflamed teeth pulps.

Forty patients with the diagnosis of irreversible pulpitis in one mandibular tooth were selected. Two other teeth in the same quadrant were selected as controls. Electric pulp tester (EPT) was used in this study to evaluate the quality of anesthesia. The subjects were divided into two groups randomly, and after recording of pulp tester response in each group, one of the two drugs ibuprofen or placebo was administered 1 hour prior to anesthesia injection. After injection, EPT measurement was recorded. The reversed EPT scale was used for evaluation of the depth of anesthesia.

Data was analyzed to statistically compare the results before and after anesthesia and drug administration in cases and control group .Significantly lower TSLs were observed in the ibuprofen group (Pvalue= 0.001).

This study concluded that preoperative administration of ibuprofen (if not contraindicated) 1 hour before local anesthesia injection is an effective method for achieving deep anesthesia during RCT of teeth with irreversible pulpitis.

Contact dermatitis is an inflammatory reaction of the skin and mucosa to either external or internal factors. It can be divided to two forms of irritant contact dermatitis and allergic contact dermatitis. Nickel is one of the most common materials that causes allergic contact dermatitis and is widely used in orthodontic appliances. The inflammatory reaction to this metal in orthodontics is usually stomatitis and angular cheilitis is very rare. We report 4 cases of angular cheilitis in orthodontic patients and discuss about their causes and treatments.

To report a case of unilateral severe visual loss and bilateral optic disc cupping secondary to brain metastasis of bronchogenic carcinoma Patient and

A 48 year-old woman presented with severe visual loss of left eye without redness or pain or any systemic findings .Clinical findings included decreased visual acuity of left eye to 4 m CF and (+3) positive Marcus-Gunn reflex .There was asymmetric optic disc cupping associated with visual field defect in left eye The neurologic investigations showed a secondary metastatic tumor in the brain from bronchogenic carcinoma.

Before making a diagnosis of normal -tension glaucoma in asymmetric optic disc cupping and normal intraocular pressure, ophthalmologists should rule out neurologic defects and brain tumors.