Zahedan Journal of Research in Medical Sciences
Volume:17 Issue: 8, Aug 2015

Orthopedic fixation devices are widely used in treatment of spinal diseases. It is expected that application of dynamic stabilization confers valuable movement possibility besides its main role of load bearing. Comparative investigation between rigid and 2 dynamic fixation systems may elucidate the efficacy of each design. The goal of the present study is to evaluate the efficacy of three fixation systems mounted on L4-L5 motion segment. In this numerical study, a 3D precious model of L4, L5 and their intervertebral disc has been employed based on CT images. Three fixation devices have been also implanted internally to the motion segment. Finite element method was used to evaluate stress distribution in the disc and determine the overall displacement of the segment as a measure of movement possibility. Maximum stress in the disc has been observed in dynamic systems but within the safe range. The greater movement of the motion segment has been also appeared in dynamic fixations. Existence of the fixation systems reduced 58% of the load on intervertebral disc which might be exerted in intact cases. Use of the fixation devices can considerably reduce the load on the discs and prepare conditions for healing of the injured ones. Furthermore, dynamic modes of fixation confer possibility of movement to the motion segments in order to facilitate the spinal activities.

Klebsiella pneumoniae is among the most common and significant agents of community and hospital-acquired infections. Plasmid-mediated quinolone resistance (PMQR) was increasingly identified in Enterobacteriaceae family worldwide. Quinolones are broad-spectrum antibiotics the resistant to which has increasingly been reported among many bacterial species including Klebsiella. The current study was conducted to evaluate the prevalence of quinolone-resistant strains of K. pneumoniae in Zahedan during 2013 and 2014. In this cross-sectional study, 184 samples of K. pneumoniae were collected. Isolates were screened for quinolone antibiotics resistance using disk diffusion method according to clinical and laboratory standards institute (CLSI) guidelines. Also MIC (minimum inhibitory concentration) was used against the ciprofloxacin antibiotic by the dilution method in tubes. Based on the obtained results by the Agar disk diffusion test, 31.5%, 18.4%, 17.3%, 4.3%, 3.2% and 2.1% of the strains were resistant to nalidixic acid, ciprofloxacin, norfloxacin, ofloxacin, levofloxacin, and getifloxacin respectively. Our results show increased prevalence of quinolone resistance among K. pneumoniae in south-east of Iran. This may stem from their irrational prescription thus it is recommended that their prescription be based on antibiotic sensitivity test results. We also recommend further evaluation using molecular techniques and also preventive measures.

Heavy exercise cause muscle damage associated with very-high production of free radicals. The aim of this research was to evaluate the effect of acute and 14-day coenzyme Q10 supplementation on oxidative stress and muscle damage indicator in elite male middle-distance runners. In this experimental study, 18 male runners in a randomly and double-blind design were allocated in two equal groups: supplement Q10 group (n = 9, coenzyme Q10: 5 mg/kg/day) and placebo group (n = 9, dextrose: 5 mg/kg/day). Before and after supplementation acute and 14 days period (first and 14th day supplementation), all subjects were participated in a training like running (competitive 3000 meters). Blood samples were obtained in the 4 phases: one hour before and 18 - 24 hours after two running protocols. Malondialdehyde (MDA), total antioxidation capacity (TAC) and lactate dehydrogenase (LDH) were analyzed. Acute (1 day) and 14 days (short-term) coenzyme Q10 administration have not significant effect on basal parameters. The 14 days coenzyme Q10 supplementation induced increase of the basal plasma total anti-oxidative capacity (P < 0.05). The short-term coenzyme Q10 supplementation attenuated the exercise-induced increase in response of MDA in male group Q10 (P < 0.05). However, the acute and short-term coenzyme Q10 supplementation had not any significant effect on the exercise-induced increase response of total serum LDH. This research suggests that the 14-day coenzyme Q10 supplementation is more effective than the acute supplementation to overcome the exercise-induced adverse responses in some oxidative, and biochemical parameters. Therefore, short-term coenzyme Q10 supplementation is recommended to reduce exercise-induced adverse consequences.

The various studies related to different aspects of breast cancer has or is being carried out all over the world, but the breast cancer developing risk factors in patients and high-risk people have not been well understood yet. The ABO/Rh systems blood group role as a factor increasing risk to getting some pathology has proven. So the survey of probable association between ABO/Rh systems blood group and breast cancer can be useful. Patients and Methods;: This cross-sectional study included 197 women with breast cancer who referred to either Yazd Shahid Sadoughi hospital or Dr. Mortaz hospital during six years (2007 - 2013) because of diagnosis or treatment. The patient’s demographic and clinical data were extracted and evaluated from their clinical documents. During 6 years, 375 reports of breast cancer were registered in 2 hospitals totally, that only data of 197 reports can be surveyed. The mean and limit of patient’s age were 44 ± 5.3 years and 17 - 70 years respectively. Most patients (93.4%) have Rh+ blood group system. Blood type A+ was the most prevalent among patients. Then O+ and B+ was the most which their frequency distribution was 21.4% (42) and 9.1% (18) respectively. The least frequency distribution of this blood group system was related to AB+ which is observed in only 4% (8) of patients. Blood type A+ has the most association with breast cancer according to the findings this article and can be used as a paraclinical marker in treatment and consulting of patients and high-risk people.

Imaging is the mainstay of diagnostic criteria in tuberculosis (TB) diagnosis, especially in children; however, the exact role of chest X-ray (CXR) and thoracic CT scan (TCT) still remains controversial. The aim of this study is to compare digital chest X-ray and thoracic CT scan in childhood tuberculosis. In this retrospective comparative study, 38 children under 15 years old with proved diagnosis of TB who were admitted to Massih Daneshvari hospital during 2010 to 2012. Digital chest X-ray and spiral thoracic CT was performed before starting medication. Direct smear for acid-fast bacillus was positive only in 38%. Positive tuberculin skin test was seen in 51% of the cases. Chest X-ray was normal in 36.8% of children, while CT scan was negative only in 21%. Overall sensitivity of thoracic CT scan and chest X-ray were 78.9% and 63.2%, respectively which show no significant difference. CT scan detected lymphadenopathy, nodule/nodular infiltration, collapse and pleural effusion/ thickening significantly better than chest X-ray; however, there was no significant difference between CXR and TCT in detection rate of consolidation/ground glass opacity, bronchiectasis, cicatricial volume loss and cavity/abscess. This study proposed that investigation of children suspicious of tuberculosis by digital chest X-ray is still of great value. It seems that thoracic CT scan in children suspected of tuberculosis infection can be limited only to investigation of complications in selected patients.

In cosmetic problems, compressive symptoms, toxicity and suspicion of malignancy, the best choice of multinodular goiter treatment are surgery. There are several surgical methods. Here we managed to describe the results of total thyroidectomy method for multi nodular goiter surgeries. Patients and In this cross sectional study, from January 2009 to January 2011, 101 included patients with multi nodular goiter underwent total thyroidectomy. Outcome assessment was performed for two weeks, 1 month, 2 months, 10 months and 20 months after surgery for each patient. All data were analyzed with using SPSS-19 software. Of 101 included cases, with mean age of 47.1 ± 12.9 years, 10 cases were male and 91 cases were female. Bilateral gland involvement showed in 88.11%. The fine needle aspiration results were negative for malignancy in 41.6% of patients and were indeterminate and suspicious in 53.5% and 5% of cases. Transient recurrent laryngeal nerve palsy was observed in only one case. Transient hypocalcaemia showed up in 25 patients. Incidental malignancy was determined in 15.84% of patients: one patient with medullary carcinoma, two cases with folicullar carcinoma and 13 patients with papillary carcinoma. All these cases were female and had been presented bilateral involvement of multi nodular goiter. No recurrence appeared. We believe that, despite the higher rate of post-operative complications, total thyroidectomy will be more beneficial in the surgical treatment of benign thyroid disorders.

The objective of this study was to investigate the prevalence of different kinds of swallowing disorder and it’s severity in patients after stroke. Patients and In this cross sectional study, 91 consecutive stroke patients were screened by the Northwestern Dysphagia Patient Check Sheet (NDPCS) and the Gugging Swallowing Screen (GUSS). Forty seven percent of those assessed demonstrated signs of oropharyngeal dysphagia. Mild dysphagia was seen in (10.98%) patients, moderate dysphagia was present in 14.28% and 22% patients had severe dysphagia. Dysphagia is common after acute stroke and its presence can have serious consequences. These results emphasize the importance of assessment and management of swallowing function in stroke patients.

We aimed to investigate the alpha and beta-thalassemia mutations and assess the association of hematologic indices with mutations. Patients and In this cross sectional study, we assessed 275 suspected thalassemia carriers. Amplification refractory mutation system-polymerase chain reaction and Gap PCR were used for detection of mutations. CD 36 - 37 (-T) and -α3.7/αα were most common mutations. Mean of corpuscular hemoglobin and corpuscular volume was less among beta-thalassemia carriers in comparison to alpha-thalassemia carriers (P = 0.001). Detected mutations were different from other regions in Iran. After iron therapy, mean of corpuscular volume (MCV) was < 69 fL and mean of corpuscular hemoglobin was < 23 pg, may be classified as beta-thalassemia carriers.

Osteoid osteoma is a benign bone tumor that is composed of osteoid and atypical woven bone. This tumor included 11 - 12% of all benign skeletal lesions. Overall occurrence of phalangeal osteoid osteoma is rare but in hand is extremely rare. In previous reports involvement of the phalangeal bone of the finger describe only in few cases. In this study, we report a case of a 25 years old man with a 2 months history of pain, enlargement, swelling in proximal phalanx of right fourth finger.

Valproic acid is a commonly used anti-epileptic drug (AED) for prescription to control convulsion attacks. The aim of this study was to provide a review of drug management among adult epileptic population. Topic words that searched were “Valproic acid, Pharmacokinetics, Epilepsy and Iran” that search in DOAJ, Google Scholar, PubMed and Web of Science. A total of approximately 1200 articles were found and at the end, 41 articles were reviewed. With an oral dose of 10 - 15 mg/kg/day in three divided doses, target blood level ranges from 50 - 100 mg/L. With a half-life of 9 - 16 hours, it seems that the valproic acid has a variable absorption phase. The pattern of metabolic pathways seems to be through the glucuronide conjugation and mitochondrial β-oxidation. The drug causes delay in carbamazepine elimination and may increase the amount of its metabolites. Valproic acid could decrease the clearance of amitriptyline and nortriptyline. Aspirin increase its’ trough level. The doses of olanzapine suggested to be reduced when co-medicated with valproic acid. To specify the amount and effects of administrated dose an attentive pharmacotherapy- guideline seems to be useful. Due to CYP450 dependent metabolic pathways (inhibition or induction), therapeutic drug monitoring (TDM) in simultaneous prescription of valproic acid with carbamazepine, lamotrigine, phenytoin, topiramate, amitriptyline, nortriptyline, aspirin, meropenem, olanzapine and clonazepam, manifested to be necessary in clinical practice.