Razavi International Journal of Medicine
Volume:3 Issue: 4, Autumn 2015

Context: 

Thoracic insufficiency syndrome is a condition in which the thorax is unable to support either normal respiration or lung growth. This condition is a progressive one, and it can further develop into restrictive lung disease.

Evidence Acquisition:

 Currently, there is no simple laboratory test that can be used to identify thoracic insufficiency syndrome; it can, however, be identified based on a given patient’s history of respiratory symptoms, the findings of a physical examination, radiographs, computed tomography scans, pulmonary function studies and other laboratory tests of respiratory function. As is the case with other medical conditions, this syndrome should be monitored with clinical and radiological evaluations. However, if a patient undergoes obvious deterioration (as determined by clinical, radiological, and laboratory assessments), surgical intervention is advised. The most commonly proposed surgical intervention involves the use of a device known as the vertical expandable prosthetic titanium rib (VEPTR).

A direct enlargement of the thorax that will thus provide sufficient space for lung growth; the correction of both the threedimensional thoracic deformity and the progressive scoliosis. Recent findings have revealed that VEPTR instrumentation can result in a modest correction of the Cobb angle, with a decrease in the percentage of the predicted forced vital capacity value and accompanying chest-wall stiffness and decreased respiratory system compliance.

Getting a complete knowledge of the condition and evaluating different treatment modalities to treat Thoracic Insufficiency Syndrome.

Traumatic injuries exert significant burden on human populations around the world. Iran as a developing country is at top 5 deadliest countries regarding injuries; however, few studies have examined the descriptive epidemiology of trauma in Iran.

To describe injuries regarding age, gender and injury mechanism and also time trend in emergency departments of Shahid Rajaee Trauma Center affiliated to Shiraz University of Medical Sciences.

This descriptive cross-sectional study was carried out on all trauma patients (n = 21542) admitted to Shahid Rajaee Trauma Hospital (level I trauma referral center in Shiraz) between March 2011 and March 2012. Data were analyzed separately by age, gender, month of admission, and injury mechanisms (motorcycle collision, car-pedestrian accidents, car-car accidents, fall from height, stab wounds and gunshot injuries).

With a mean age of 36.0 ± 17.2 years, a total number of 21542 patients were visited, 16524 (76.7%) of whom were male. The male to female ratio was 3.3:1 with injured men being significantly younger than women (mean age 33.7 + 16.6 and 43.6 ± 19.2 years, respectively). There were 1492 trauma victims older than 60 years accounting for the smallest proportion of the population (6.92%). On admission, 1699 patients (7.9%) required cardiopulmonary cerebral resuscitation (CPCR) with a sex ratio of 2:1. Among those requiring CPCR, falling down was the major cause (45.24%) of injury in elderly (patients over 60 year) and car accident in those under 60 year (43.94%).

Injuries affect all age groups; however, the disproportionately at risk population is the productive youth. Preventive strategies should focus on reducing trauma incidence among young men at population level. Considering the higher number of incidents occurring in mid spring and late summer, authorities should devise preventive plans mainly through alteration of traffic rules in this period.

In the field of human breast cancer, the most recent researches referred to the influence of endogenous estrogen or exposure to environmental estrogen, as risk factors. Zearalenone (ZEN) as a mycotoxin and its derivative α- zearalenol (α-ZOL) are known nonsteroidal estrogenic compounds with potential endocrine disrupting properties. The present study was designed to investigate the effects of ZEN and α-ZOL on human breast cancer cell lines MCF-7 and MDAMB-468. Cell lines were treated by low and high doses of ZEN and α-ZOL (0, 1, 30, 62, 125, 250 and 500 ng/ml and 1, 2, 4, 8, 15, 30, 62 and 125 µg/ml) for 24 and 48 hours. Then MTT colorimetric assay was used to evaluate the cytotoxicity effect of ZEN and α-ZOL. Furthermore, morphological changes of treated and untreated cell lines were studied under an inverted microscope. The results obtained from the present study demonstrated that both ZEN and α-ZOL enhance the cell viability of MCF-7 especially at low doses (1 - 500 ng/ml) and at a high dose of 125µg/ml after 24 and 48 hours. However, this effect for α-ZOL was somewhat greater than that for ZEN. On the other hand, these estrogenic compounds did not have any effect on the cell viability of MDA-MB-468. No morphological change was observed in treated cells. These results show that ZEN and α-ZOL enhance the rate of cell division in ER positive cells and therefore, exposure to this mycotoxin may increase the risk of breast cancer.

Applying an appropriate method of analgesia in labor without alteration in its progression is of high importance. Previous literature did not provide much information about the effect of various kinds of anesthesia on the duration of active phase of labor.

To assess the effect of painless labor methods on the duration of active phase of labor.

80 pregnant women referring to Najmieh hospital in 2013, with tendency to painless labor, were randomly selected for this analytical cross-sectional study using simple random sampling technique. After taking history and physical examination, cases were under observation of an obstetrician. After achieving a 4 cm cervical dilation, cases underwent analgesia by epidural, spinal or general anesthesia. Applying analgesia to complete dilation and complete dilatation to fetus delivery, time intervals were recorded by an obstetrician.

Studied individuals had a mean age of 25.95 years. Type of applied analgesia for painless labor was epidural in 6 (7.5%) nulliparous cases, spinal in 58 (72.5%) cases and general anesthesia was applied in 16 (20%) individuals. There was no significant difference for analgesia to complete dilation time interval between analgesia methods (P ˃ 0.05). Also, there was no significant difference between applied analgesia methods for complete dilation to fetus delivery time interval (P ˃ 0.05). While, analgesia to fetus delivery time interval was significantly lower in general anesthesia method rather than epidural method (P = 0.034).

We found that analgesia-assisted labor shortens active phase and prolongs second stage of labor, it does not increase the risk of cesarean section as well.

Infections due to Staphylococcus aureus have long been considered as a big challenge to clinicians. The innate ability of this microorganism to develop resistance to different antibiotics, has led to the appearance of MRSA (methicillin-resistant Staphylococcus aureus) and lately VRSA (vancomycin-resistant Staphylococcus aureus) strains, which are considered as major problems for both patients and clinicians. In this study, we tried to evaluate susceptibility pattern of S. aureus isolates against some prevalent antibiotics as well as some infrequent ones. This inquiry was performed on 238 clinical samples, collected from different wards of Imam Reza Hospital of Mashhad between 2011 and 2012, which were previously defined as S. aureus and stocked in -70°C. Kirby-Bauer’s disc diffusion was performed for the following antibiotics: quinupristin-dalfopristin, linezolid, cefoxitin and mupirocin according to EUCAST 2014 (v. 4), cotrimoxazole, doxycycline, tigecycline, oxacillin based on CLSI 2012 (M100-S22) and vancomycin according to CLSI 2007 guidelines. Out of 238 samples, 5.88% were resistant to quinupristin-dalfopristin; 5.46% to linezolid; 60.92% to Co-trimoxazole; 31.93% to doxycycline; 18.90% to tigecycline; 5.04% to vancomycin; 9.24% to mupirocin; 43% to oxacillin and 46.21% of our isolates were resistant to cefoxitin. Coming across isolates with reduced susceptibility to quinupristin-dalfopristin and resistant to linezolid in this study are worrisome although these antibiotics are not used in our hospital. This might be a new challenge in the treatment of MRSA.

Recently, Tissue Glue or Octyl 2-Cyanoacrylate (OCA) has been extensively used in cardiac surgeries as surgical adhesives to replace sutures. Since the binder is in contact with live tissues, its tissue compatibility and non-cytotoxicity have major effect on enhancing the healing process. The purpose of this study was to evaluate the cytotoxicity of OCA on rat cardiomyoblast cell (H9C2) using MTT assay. Cells were cultured in the presence of various concentrations of the OCA extract. Then, morphological changes of the cultured cells were observed by light microscopy and their cytotoxicity by MTT assay. The morphology quality of the cells and their quantity were examined after 24- hour incubation up to 72 hours. Data were analyzed statistically by the ANOVA. The results showed that the percentage of survived cells amount of extract dilution ratio (1:4; 1:2; 1) were 80.4%; 79.6%, 77.5% respectively. Analysis of statistical test results does not show any significant differences between the optical density of the extract dilutions, and the control group indicating; consequently it has no significant cytotoxicity effect on the cells. The outcome of this study is that the OCA has no toxic effect on H9C2 cells.

Dental trauma is one of the most serious oral conditions especially among children. It frequently occurs in children from 6 to 13 years old, often involving teeth with incomplete root formation. The most common dental injury at this age is crown fracture.

Arguments: 

To provide this clinical guide, Pubmed and Scopus were searched using the following keywords: Immature, Incisor and Pulpotomy. More importantly, the latest clinical guidelines provided by the International Association for Dental Traumatology, British Society of Paediatric Dentistry, and the Royal College of Surgeons of England and National Institute for Health and Care Excellence were studied and incorporated into this paper (Grade 1 evidence).

Management of a young patient who has sustained such trauma includes a wide range of options based on the clinical and radiographic findings. Here we explain in detail the latter as well as covering available literature and guidelines.