Journal of Research in Medical Sciences
Volume:13 Issue: 1, Jan & Feb 2008

The treatment of combined anterolateral posterolateral rotary instability has been done by correcting knee alignment, anterior cruciate ligament (ACL) reconstruction plus repair or reconstruction of the posterolateral complex. Because of the technical difficulties encountered in these operations and the need for more than two stages, and considering the controversy among the role of posterolateral complex (PLC) in valgus knees, this study was designed to observe the results of treating this instability by ACL-reconstruction alone, after correction of varus, without reconstruction of the posterolateral complex or further extra-articular manipulation. This was a clinical trial performed on 29 patients (29 knees) with combined anterolateral posterolateral rotary nstability. Subjective and objective instability signs were recorded. Arthroscopy was then performed and a valgus osteotomy was done to correct alignment. Then in a second stage, an ACL-reconstruction was carried out. Results, after a mean of 23 months follow-up, were compared to the conditions before surgery. Fisher exact test, X2 and Wilcoxon tests were used to analyze the data. P<0.05 was considered to be meaningful. Pain was relieved in more than half and locking was improved in all of the patients. Giving way of the knee was diminished from 79.3% to 6.9%. Special instability tests showed a significant improvement after surgery (P<0.001). Most of the patients returned to the preinjury level of work or sports. Based on the results of this study, ACL-reconstruction alone, after correction of varus, can be sufficient to address this combined knee instability without farther procedures on extra-articular structures and posterolateral complex, thus avoiding unnecessary complications and longer rehabilitation.

This study compared the triage of Iran-Iraq war-injured troops within the first two years of the war with that after the first two years. This was a retrospective study, which compared the triage of the admissions for abdominal injuries during the first two years of the Iran-Iraq War with that in the next 6 years. Out of nearly 50,000 cases, 1,176 ones were randomly selected and their triage information was recorded and analyzed. About 12.5% of patients were operated on within less than 8 hours during the first two years. From 1982 towards the end of the conflict (1988), the patients were treated within progressively shorter periods of sustaining injury; 68.8% were operated on within less than 4 hours of injury. The mean delay between injury and treatment in the first two years of war was 12 hours while it was 5 hours between 1982 and 1988. The difference was significant (P<0.05) but the mortality rate was not significantly different. Patient triage was conducted differently at various stages of conflict. Better patient triage after 1982, may have been due to improved care and more specialized triage of injured troops.

This survey was performed to determine the effect of unilateral lateral rectus recession in treatment of moderate angle intermittent exotropia. However, this type of operation and its long term results in patients with moderate angle exotropia have not yet been studied in Iran. Forty patients with basic type intermittent exotropia with moderate angle deviation (25-30.D) were included in this study. All patients underwent unilateral lateral rectus recession (8 mm) in the relatively non-dominant eye. Patients were visited and examined after operation, 1 day, 1 week and 1 month later and then, every 6 months up to 3 years. Data were analyzed by t-paired test. Before operation all patients had 25-30.D basic type intermittent exotropia. Two months after operation perfect orthophoria was observed in 33 (82.5%) subjects, 95.D undercorrection in 4 (10%) patients and 6-10.D undercorrection in 3 (7.5%) ones. At the last visit, findings included perfect orthophoria in 30 (75%) patients, 95.D undercorrection in 5 (12.5%) subjects and 6-10.D undercorrection in 5 (12.5%) patients. Preoperatively, none of the patients had fine stereopsis, 25 patients had moderate to good stereopsis and 15 patients had fair to poor stereopsis. Postoperatively, the data were changed to fine stereopsis in 18 patients, moderate to good in 18 patients and fair stereopsis in 4 patients. Results of this study indicated high effectivity of unilateral lateral rectus recession on moderate angle intermittent exotropia.

Pregnancy-induced hypertension (PIH) is a pregnancy-specific condition that occurs after the 20th week of gestation. These physiologic changes can be aggravated by undernutrition. There are some evidence based on the importance of nutrient deficiency in developing this syndrome. Therefore, the aim of present study was to determine the nutritional risk factors for pregnancy induced hypertension in a group of pregnant women in Isfahan. In this case-control study, we recruited 46 Isfahanian pregnant women in two groups (with and without PIH). They were 19 to 45 year-old and they did not consume any antihypertensive or diuretic medications. Demographic questionnaire and food frequency questionnaire were filled in both groups. There were no significant differences in energy and vitamin E and C intakes between the two groups. Zinc and calcium intakes were lower in women with PIH compared to those without PIH (P = 0.04 and P = 0.007, respectively). Riboflavin and protein intakes were lower in women with PIH compared to subjects without PIH (P = 0.03 and P = 0.01, respectively). Lower intake of calcium, zinc, riboflavin and protein should be considered as possible risk factors for PIH. Adequate intake of dairy products which are good sources of mentioned nutrients are recommended to prevent PIH.

This study was carried out to determine the prevalence and risk factors of urinary incontinence in women aged 30 to 70 years, who were attending to a gynecologic hospital. During 2006, married women (aged 30-70 years) attending to a teaching gynecological hospital were assessed during their visits for any gynecologic diseases. We used a questionnaire with interview for collecting data. The potential risk factors were measured; i.e., the demographics, menopausal status, urinary symptoms (frequency, nocturia and urgency), urinary incontinence, (urgency, stress and mixed), body mass index, medical history (type of delivery, parity, gravidity, chronic illnesses, medication use, pelvic surgery and seeking medical care for their problem). The mean age was 46.5 (± 8.4) years. The mean parity was 5.1 ± 1.5. 27% of the participants reported urinary incontinence. Out of 111 women with urinary incontinence, 77 (18.7%, CI: 14.7-22.7%), 17 (4.1%, CI: 2.2-5.8%) and 17 (4.1%, CI: 2.2-5.8%) were classified as having stress, urge and mixed urinary incontinence, respectively. The overall prevalence of urinary incontinence was 18.9% (34 subjects) in women aged 30-44 years, 30.9% (46 subjects) in those aged 45-54 years and 37.8% (31 subjects) in those aged 55 years and older. Out of 117 menopause women, 39 (33.3%) were incontinent. On average, women reported 4.4 (± 1.06) diurnal and 0.55 (± 0.66) nocturnal voidings in 24 hours. Diurnal and nocturnal frequencies were different between continent and incontinent women. The high parity, excessive birth weight, pelvic trauma, constipation, chronic illnesses (specially diabetes) and gynecologic and other pelvic surgeries were known as risk factors for urinary incontinence. There was a significant association between urinary incontinence and high parity, excessive birth weight, pelvic trauma, constipation, chronic illnesses (specially diabetes), and gynecologic and other pelvic surgeries.

Sleep bruxism is a common sleep disorder with unclear etiology and no definitive treatment. Recent suggested medications are not often practically used due to their numerous limitations. Based on the fact that sleep bruxism occurs most often in the second stage of non-REM sleep, this study aimed to assess the effect of trazodone on sleep bruxism. This pilot study was conducted as a before-after design on 28 children and adolescents with 6-18 years of age suffering from sleep bruxism referring by children and adolescents mental health clinic, children dental specialists and pediatricians. The treatment started with 0.5mg/kg/day. In non-responders, it was weekly added by 0.5 mg/kg/day (with optimum of 2 mg/kg/day). Frequency of bruxism and related morning face/jaw pain were assessed daily from two weeks before (baseline) to four weeks after starting the intervention by the parents/roommate. Findings showed a significant reduction in the frequency of both bruxism and related morning pain from baseline to the 2nd and the 4th weeks of the intervention (P<0.001). Minor side effects such as drowsiness, nausea and dry mouth were seen among approximately one-third of the patients. These side effects were self-limited and tolerable. Trazodone could be effective in reducing the frequency of sleep bruxism and its related morning face/jaw pain. Well-designed placebo-controlled trials are needed to confirm the results.

One case of intraparenchymal Schwannoma of right occipital lobe is presented (first report of occipital lobe Schwannoma). The radiological and pathological features of this rare tumor are discussed, and the current theories for etiology of these intraaxial nerve-sheath tumors are reviewed.

A 4 month old Afghan male infant presented with partial albinism, hepatosplenomegaly and pancytopenia. Skin and hair shaft microscopic examination revealed large clumped melanosomes and Griscelli syndrome was diagnosed. Unless treated with bone marrow transplantation, it is a fatal disease in accelerated phase. Pediatricians should consider this syndrome in infants with abnormal light hair because early diagnosis could be life saving.