فهرست مطالب

Medical Journal Of the Islamic Republic of Iran
Volume:26 Issue: 3, Autumn 2012

  • تاریخ انتشار: 1391/07/18
  • تعداد عناوین: 10
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  • Afsun Nodehi Moghadam, Maryam Moghadam Salimee Page 97
    Background
    Generalized joint hyper mobility predisposes some individuals to a wide variety of musculoskeletal complaints. Given the critical role of scapular position in function of shoulder, the aim of this study was to compare scapular position between persons with and without general joint hyper mobility.
    Methods
    By nonprobability sampling 30 hyper mobile persons at average of 22.86 ±2.77 years of age and 30 non hyper mobile persons (age 23.6 ± 2.73years) through a case-control design participated in the study. Scapular position was assessed according to the lateral scapular slide test. Independent t test and repeated measures ANOVA were used to statistically analyze scapular position differences between groups.
    Results
    Compared to non hyper mobile persons, those with General joint hyper mobility demonstrated a significantly higher superior scapula slide in dependent arm position (p=0.03). However, no significant difference was found between another scores between two groups (p>0.05).
    Conclusion
    The results suggest that altered scapular position may be an important aspect of General joint hyper mobility.
    Keywords: General joint hyper mobility, Static scapular position, Scapular kinematic
  • Shirzad Nasiri, Ahmadreza Soroush, Amir Pejman Hashemi, Anushiravan Hedayat, Kianoush Donboli, Farhad Mehrkhani Page 103
    Background
    Bilateral neck exploration is the gold standard for parathyroid adenoma localization in primary hyperparathyroidism. But surgeons do not have adequate experience for accurate surgical exploration and new methods are developed for surgery like unilateral exploration and minimally invasive surgery, thus, preoperative localization could reduces time and stress in surgical performance.
    Method
    80 patients with documented primary hyperparathyroidism and with raised serum calcium and parathyroid hormone (PTH) were selected. The results of ultrasonographic localization for each patient were compared with findings of surgery and 99m technetium sestamibi scintigraphy. Also variables such as preoperative serum calcium, PTH level and adenoma weight were compared between patients who had localized and nonlocalized adenoma with ultrasonography or Sestamibi scan. The data was compared with student’s t-test.
    Results
    In a prospective diagnostic tests’ accuracy, 80 patients with primary hyperparathyroidism were enrolled. Ultrasonography images detected enlarged parathyroid glands in 61 of 80 patients (76.3%) with sensitivity of 83.5% and positive predictive value (PPV) of 89.7%. Sestamibi scintigraphy detected adenoma in 63 patients (78.8%) with sensitivity of 85% and PPV of 91.3%. There was no significant deference between ultrasonography and scintigraphy in localization of adenomas. Both ultrasonography and scintigraphy used for determining localization, and they located 73 adenomas (91.3%) with sensitivity of 97.3% and PPV of 93.5%.
    Conclusion
    Ultrasonography as an accurate method for localization of enlarged parathyroid glands in primary hyperparathyroidism, is comparable in overall utility with sestamibi scintigraphy. This study suggests a strategy for initial testing with one method, followed by the alternate imaging test if the first test happen to be negative.
    Keywords: Primary hyperparathyroidism, Scintigraphy, Ultrasonography, Localization
  • Reza Mollahoseini, Ashkan Khajoo, Zeynab Sharifian, Mir Abolfazl Motiei Page 110
    Background
    Anterior interbody fusion of the cervical spine have become the gold standard for treating spinal diseases, hence the aim of this study was to compare long term follow up results in patients with cervical disk disease treated with anterior PEEK cage implantation and without it in anterior approach.
    Methods
    Retrospectively 63 patients with known cervical discogenic disorders who went under surgery with and without cage implantation were enrolled. The neurological examination and neurologic function were assessed by using the Japanese Orthopedic Association (JOA) scoring system and neurological cervical spine scale (NCSS) before and 8 years after surgery in each patient and at the end all complications were recorded.
    Results
    In the first group, there were 15 males and 14 females (mean age: 49±10 years) and in the second group there were 27 male and 7 female (mean age: 47±9 years). The NCSS score was significantly different between two groups after surgery (p=0.035) but there was no significant difference before surgery (p=0.163). No statistical significance difference was also observed in JOA score and complications before and after procedure, but JOA post surgery score between two groups had significant difference (p=0.047).
    Conclusion
    In conclusion, present study showed that PEEK cage implantation is a highly useful alternative to the conventional treatment methods. Keywords:
    Keywords: Anterior cervical fusion, PEEK cage, Cervical disk diseases, Long term follow up
  • Hamidreza Yazdi, Mehdi Ramezan Shirazi, Omid Momen Shouli, Farzad Yazdi, Alireza Moslem Page 114
    Background
    To determine the efficacy of three different antiseptic solutions (Control group (I), Antibiotic solution – Neomycin and polymyxin (II), Chlorhexidine 0.4% (III), and povidone – iodine 10% (IV)) in disinfecting contaminated bone fragments.
    Methods
    Under sterile conditions, the femora of 12 rabbits were removed and cut into six millimeter pieces. A total of 200 bone specimens were obtained. All 200 specimens were dropped on the operating room floor for fifteen seconds and assigned to one of four experimental groups. Group I samples were cultured after immersion in normal saline solution (Control group). In other three groups, prior to culture the samples, they were washed with normal saline for ninety seconds and placed in an antibiotic solution (Neomycin & Polymyxin) (group II), Chlorhexidine 0.4% (group III), and povidone-iodine 10% (group IV) respectively.
    Results
    In group I, 22 of 50 specimens had positive cultures. Of 50 specimens of group II and IV, positive cultures were found in 3 and 2 grafts respectively after 10 days whereas no positive cultures were detected in any samples of group III.
    Conclusion
    Chlorhexidine 0.4% seems to be the best antiseptic solution for discontaminating the contaminated bone samples although it did not have any significant difference with povidone-iodine and other antibiotic solution.
    Keywords: Sanitizing solutions, Contaminated bone
  • Seyed Behnamedin Jameie, Narges Sadat Shams, Hosseini, Atousa Janzadeh, Mohammad Sharifi, Mahdie Kerdari Page 118
    Background
    Chronic pain is a frequent disability that negatively affects patient’s quality of life. Understanding of the possible relation between sociodemographic and medical variables with Health Related Quality of Life (HRQL) may help identifying the multidimensionality of pain and risk factors that limit physical and psychological adjustment of the patients. The present study was done to find these possible relationships, based on using Medical Outcomes Survey-Short Form (SF-36).
    Methods
    Among the patients who were referred to pain clinic of Iranian Pain Society, 101 consecutive outpatients were select based on the defined inclusion and exclusion criteria. All the participants in this study orally satisfied and were fully informed by a check list and SF-36 questionnaire. The possible impact of demographic variables, characteristics, diagnosis, analgesic use, smoking and opium addiction were collected as the first part of a routine pretreatment evaluation.
    Results
    Our findings showed significant relation between HRQL and gender (P<0.05), the rate of chronic pain in female was higher than male, and same results found for elderly patients compared to younger ones. Our findings also showed significant relation between employment and intensity of pain (p=0.001) as, employed patients showed less physical and psychotic problems than unemployed ones. The mean average of intensity of pain in these patients was 7.5±2.2; few patients used alcohol (4%), opium (1%) and cigarette (10%). Large number of participants used analgesic (%78.2). No significant difference between sociodemographic features with pain duration and quality of life was found. In contrast our data showed significant difference between pain intensity and quality of life (p<0.001).
    Conclusion
    Based on our findings it could be concluded that chronic pain in Iranian patients certainly leads to poor HRQL, the state is more serious in the elderly and female patients. Thus, in order to re-socialize the patients suffering chronic pain and decrease the impact of their pain on their life, these findings should be considered in any kind of pain relief therapy.
    Keywords: Chronic pain, Health, related Quality of Life, SF, 36 questionnaire
  • Mohammad Akbari, Roghayeh Mousavikhatir Page 125
    Background
    Lower limbs antigravity muscles weakness and decreased functional ability have significant role in falling. The aim of this study was to find the effects of aging on muscle strength and functional ability, determining the range of decreasing strength and functional ability and relationship between them in healthy women.
    Methods
    Across-section study was performed on 101 healthy women aged 21-80 years. The participants were divided into six age groups. The maximum isometric strength of four muscle groups was measured using a hand-held dynamometer bilaterally. The functional ability was measured with functional reach (FR), timed get up and go (TGUG), single leg stance (SLS), and stairs walking (SW) tests.
    Results
    Muscle strength changes were not significant between 21-40 years of age, but decreased significantly thereafter. Also, there was a significant relationship between muscle strength and functional ability in age groups.
    Conclusion
    Both muscle strength and functional ability is reduced as a result of aging, but the decrease in functional ability can be detected earlier.
    Keywords: Aging, Dynamometer, Functional performance, Muscle strength
  • Davood Jafari, Hamid Taheri, Hooman Shariatzade, Farid Najd Mazhar, Alireza Jalili, Mohammad Ghahramani Page 132
    Background
    Radiography is the most widely available imaging modality. Precise evaluations of wrist x-ray can help diagnosis and evaluate the prognosis of many wrist disorders.
    Methods
    We measured length, angles and indices in 150 posteroanterior and lateral wrist x-rays to determine normal dimensions and variations according to age and sex. All x-rays were made with standard exposure, with the wrist and forearm in a neutral position.
    Results
    The average carpal height ratio was 0.52±0.03 with the Youm method and 1.5±0.09 with the Nattrass method. Mean ulnar variance was +0.99±1.6 mm and mean radial inclination was 25±4 degrees. The average radial tilt was 10±5.1 degrees. Mean scapholunate angle was 50±8.4 degrees (normal range 40 -60).
    Conclusion
    Carpal height, third metacarpal and capitate length were smaller in women than in men. There was a significant positive relationship between all dimensions. Our data base may be used to follow-up in conditions such as carpal instability, osteoarthritis and osteonecrosis, as well as for clinical research.
    Keywords: Wrist measurements, Wrist radiography, Wrist indices
  • Sheikh Shoib, Javid A. Malik, Haamid Bashir, Tasleem Arif Page 140
    Bronchoalveolar carcinoma presenting as non-resolving consolidation is an uncommon presentation. The typical presentation of bronchoalveolar carcinoma is asymptomatic (solitary nodule) and remains without symptoms even as disease disseminates. We report a case of bronchoalveolar carcinoma presenting as non-resolving consolidation in a young male with productive cough, exertional breathlessness and physical examination revealing the features of right lower consolidation on x-ray chest, with subsequent CT of the chest and bronchoscopic examination revealed bronchoalveolar carcinoma. Patient had good score and was managed conservatively.
    Keywords: Bronchoalveolar carcinoma, Solitary nodule, Non, resolving consolidation
  • Hojjat Hossein Pourfeizi, Jafar Ganjpour Sales, Asghar Elmi, Ali Tabrizi Page 143
    Osteoid osteoma is a benign bone tumor and accounts for 10% of benign tumors. Almost any bones can be involved but half of cases involving femur or tibia. Osteoid osteoma is a rare tumor of the scapula with only 18 reported cases in the literature. We presented a case of osteoid osteoma of the scapula in right shoulder in angle of coracoid and geloneid in a 34- year old woman. She had right radicular shoulder pain increased at night for 4 years. An important point about this case is that, patient was treated in long-term with miss diagnosis of cervicospinal discopathy. The key of diagnosis in this patient was paying attention to the nature of night increasing pain and performing bone scan. After the operative curettage of the tumor, the pain dramatically stopped and a few weeks of physical therapy led to full range of motion in her shoulder.
    Keywords: Osteoid osteoma, Scapula, Shoulder
  • Karim Poorsattar Bejeh Mir, Arash Poorsattar Bejeh Mir Page 147