مجله سازمان نظام پزشکی جمهوری اسلامی ایران
سال سی‌ام شماره 2 (پیاپی 118، تابستان 1391)

Osteoporotic fractures are an important reason of morbidity and mortality in the elderly population, and impose huge economic burden on health services. There have been major advances in the treatment of osteoporosis and many steps can be taken to prevent or even reduce the risk of fractures. Orthopedic surgeons manage most of these fractures and are often the only physician seen by the patient, so they have great responsibility to diagnose, treat and follow these elderly patients. In this study we showed under-diagnosis and undertreatment of osteoporosis in patient with fragile fracture and it clearly demonstrated that the orthopedic surgeons lack sufficient training in osteoporosis diagnosis and treatment. We believe that the orthopedic surgeon have to be announced what responsibility they have to treat not only the fractures but also the hidden and dangerous disease of osteoporosis.

Since noise-induced hearing loss is a common problem and its prevention is important, we aimed to evaluate whether previous exposure to moderate level of noise could prevent subsequent high level noise-induced cochlear damage. This study was conducted on 10 guinea pigs randomly divided into two groups (n=5, each). Animals in control group exposed to 4 kHz, 105 dB SPL octave band noise for 4 hours, while in conditioned group animals exposed to 85 dB SPL, 4 kHz octave band noise, 6 hours/day for 5 days before exposing to 105 dB noise. One week later, the subjects euthanized for histological evaluationand the remaining and lost outer hair, inner hair and supporting cells were compared. Our results showed that outer hair cells row 1 was injured the most. A massive damage around the second turn of the cochlea was observed in control group. Conditioning significantly reduced the amount of hair cell loss. In conditioned group, the amount of hair cell loss was significantly reduced when compared to control (p < 0/05). Our findings confirmed that conditioning protects against noise-induced cochlear hair cell loss.

Senile cataract is the most prevalent cause of blindness in the world. Various factors are involved in the pathogenesis of senile cataract. The most important factor is oxidative stress. Oxidative stress is due to increased production of free radicals or reduction of antioxidant capacity in the body. Free radicals cause oxidative damage to cellular components and produce oxidative stress markers. The aim of the present study was to compare markers of oxidative stress associated with proteins andlipids in patients with senile cataract and healthy individuals. In this case-control study that was conducted on 45 patients with senile cataract and 45 healthy peoples, oxidative stress markers of proteins and lipids were measured in serum. Protein carbonyl and reduced total thiol as markers of protein oxidation and malondialdehyde as marker of lipid oxidation were investigated. SPSS 18 and appropriate statistical test were used for comparing average serum level makers of oxidative stress between patient and control groups. Serum protein carbonyl level in patient and control groups was 0.233±0.096 and 0.248±0.104, respectively, and there was no statistically significant difference (P=0.265), but serum malondialdehyde level was found significantly higher in patient group (10.32±2.53) than that measured in the control group (6.15±1.16) (P=0.001). The level of serum reduced total thiol level in patient and control group was 277.5±104.2 and 392.5±121.3, respectively. Serum total thiol was significantly lower in the senile cataract group compared with control group (P<0.001). Oxidation of lens proteins and lipids is a reason for cataract formation. Increased production of free radicals with aging and subsequently creation of oxidative stress conditions lead to oxidation lipids and thiol groups of proteins and can cause increased senile cataract risk. In present study decreased level of serum reduced total thiol and increased level of malondialdehyde in patient group in comparison with controls suggest involvement of oxidative stress in the development of senile cataract formation.

Approximately 90 percent of women experience one symptom of premenstrual syndrome (Hesiao, 2002) and these symptoms affect women's relationships with their family, work environment and society. Women suffering from Premenstrual syndrome (PMS) tend to have negative attitudes towards their own psychological changes. Negative attitudes and inappropriate adaptive reactions may bring about physiological consequences.This study aimed to investigate the effectiveness of counseling with cognitive-behavioral approach on reducing PMS symptoms.

The research method was quasi experimental with pre test-post test design and control group. The statistical population included 420 women aged 25 to 45 who were willing to cooperate through the call. The sampling was done voluntarily. After collecting the questionnaires, eliminating incomplete forms and according to the age range of participants (45-25 years), 34 women who were identified to suffer from Premenstrual syndrome were selected by available sampling method as the statistical sample and were randomly divided into two groups named control and intervention each of which containing 17 members. Hypothesizes were tested by co-variance analysis after 10 sessions of cognitivebehavioral consultation.

Statistical analysis of results indicated that the post-test scores have been affected by the independent variable (F=113.24, P<0.05, Sig (2-tailed) = P – Value = 0.00<0.05=α) and the total mean score of intervention group for ore-test declined from 36.87 to 26.32 at post-test. But, this amount for control group changed from 35.80 to 34.71 which did not show a significant difference.

The results of this study showed that cognitivebehavioral therapy had positive effects on PMS symptoms of female staffs of Science and Industry University and have relieved their symptoms.

grip strength is an important prerequisite for good performance of the upper limb and also as an indicator of disease activity. Hand strength decrease with trauma, surgery and during inflammatory diseases. Therefore it is important to know factors that increase hand strength. This study was designed to investigate the effect of elbow position on hand strength. In this survey hand strength was evaluated on right and left hand of normal people (45 women and 55 men) in faculty of rehabilitation. People in this survey didn’t have any euromuscloskeletal problem. A standard hand dynamometer was used to measure the hand strength in full extension and 90 degrees of elbow flexion. This survey was a descriptive analytic cross sectional study. There was significant different between means of right hand strength in 90 flexion (x= 49.08) and full ext of elbow (x=50.41) in males.There was significant different between means of right hand strength in 90 flex (x= 28.89) and full ext of elbow(x=30.13) in females.Results indicated that hand strength was significantly higher when the elbow was in full extension.All of these evaluations did on left hand and their results were almost the same. This study shows that various elbow position can change hand strength. the knowledge of how changes in elbow position affect strength of the hand can be used to train patients by therapist.With this knowledge, an individualized program can be designed to train the patient in the specific upper extremity positioning that provides the greatest efficiency to maximize performance.The findings are valuable in the evaluation, and rehabilitation of hand injuries and training patients how to do activity of daily living.

Infections are considered as the most common reason of referral and hospitalization in Intravenous (IV) drug abusers. This study has been conducted to clarify epidemiologic specifications of these patients including their personal details (age, sex, education, etc.) and type of the drug injected and their most common infections. This descriptive cross-sectional study has been conducted in Infectious Disease Department of Imam-Reza Hospital between 2007 to 2009 in Mashhad. 62 drug users were enrolled in study and personal IRAN and epidemiological details, symptoms, mode of addiction and their complications were collected through questionnaires. Data were analyzed by descriptive statistical methods and frequency tables. The study revealed that crystal is the most common used drug (83.9%), followed by Heroin, Norchizak & Tamchizak, and Sheereh (a remnant of opium). The most common reason for admission was skin and soft tissue infection (33%). Anti HCV, Anti HIV, HBSAg, and Anti HTLV1 were positive in 71%, 14.5%, 8.1%,and 8.1%, respectively. In this article, unlike other surveys around the world,the most common type of drug used for injection was crystal and the degree of HCV positive cases was higher than similar studies inIran. High prevalence of necrotizing fasciitis, higher percentage of gram Negative bacillus in blood cultures as well as greater number of HCV positive, are probably due to the crystal usage. Hence, it seems reasonable that more advanced studies Should be conducted in this regard.

The first step of identification and management of behavioural problems is evaluation of epidemiology of this dilemma that could be consider as a guide for teachers and clinicians. The purpose of present study is Evaluation of epidemiology of behavioral problems in primary school of Tehran satellite cities. In this cross sectional study that performed in 347 elementary school student, we select 5 satellite cities of Tehran randomly and in each city select one girl and one boy school, in each school one 5 classes and in each class 5 students were selected randomly. We used Rotters Behavioural Disorder Questionnaire for evaluation. ANOVA and T- Test was performed for statistical evaluation. Findings show prevalence of hyperactivity 14.2%, anxiety and depression 6.4%, conduct disorder 4.18%, antisocial disorder 0.3% and attention deficit 6.8%. Between the cities Karaj and Eslamshahr among the grades first and fifth grades and interm of gender boys have higher rates of disorders. based on our findings teachers should be educated on behavioral disorders of children and method of educating and facing with them with educational pamphlet. Boy's schools and Eslamshahr and Karaj have higher priority.

Neuropathic pain results from injury to or dysfunction of the central or peripheral nervous ystem. Diabetic peripheral neuropathy, post-herpetic neuralgia, and trigeminal neuralgia are among the most common types of neuropathic pain. Patients with these types of pain usually suffer from localized symptoms such as constant or intermittent paresthesia, tingling, burning sensation or spontaneous pain. Neuropathic pain is an unpleasant sensation and experience that could adversely affect the quality of life of patients.They often responds to treatment with difficulty and based on the current treatments, only 40 to 60% of patients with neuropathic pain achieve partial relief. Antidepressants (tricyclics and serotoninnorepinephrinereuptake inhibitors), ligand of calcium channel α2-δ subunits (gabapentin and pregabalin) and topical lidocaine have been considered as the first-line therapy for neuropathic pain. Opioid analgrsics and tramadol are generally recommended as the secondline therapy. Other agents such as antiepileptics (e.g.carbamazepine), antagonists of N-Methyl-D-aspartate receptor (e.g. memantine, dextromethorpham), and topical capsaicin have been mainly classified as the third-line treatment for neuropathic pain.Due to the importance of neuropathic pain, reviewing its novel nonpharmacological and pharmacological modalities seems necessary.

Olfactory groove meningiomas OGM are rare, benign intracranial tumors. They arise from the anterior cranial fossa at the cribriform plate of the ethmoid bone through the suture with the planum sphenoidale. Meningiomas are rare in children and their peak age of incidence is 12 and is slightly more prevalent in boys. Because of their slow growth they are diagnosed at a late stage when they usually have already reached a large size. OGMs surgery is a special challenge for neuro and skull base surgeons because of their proximity to the vessels of the anterior cranial circulation and the optic nerves.in this case report we describe a huge invasive OGM with extensive spread to orbital and paranasal sinus region of a 13 Years Old male patient.