فهرست مطالب محمدرضا هادیان جزی

Introduction & Deviated nose correction is difficult and constitutes a very different issue from septal deviation. When correcting this deformity, traces of asymmetry can be detected. The authors demonstrate facial asymmetry accompanying deviated noses, and such asymmetry is usually ignored by surgeons, who typically concentrate only on nose deformities. A total of 5822 pre- and post-rhinoplasty photographs related to 547women and 124 men were reviewed. Three separate groups were selected out of the total population: Group A: Gross Nose and face asymmetry Group B: Nose asymmetry with no facial deformity Group C: Facial asymmetry with straight nose Different measurements were applied to the selected photos. These included measurement from the lateral canthi to the lateral mouth corners (D1) and from the mid-face to each most lateral part of the zygomatic arch (D2). Measurements from one side were compared to those from the contralateral side to identify true anatomic differences (Figure 1). There was a significant difference in the nose and face deformity group, as evidenced by a meaningful difference in both the D1 and D2 measurements We report a significant growth retardation of the mid-face and orbit on the concave side of the nose. This impediment may serve as the etiology for many asymmetries of the face and nose.

Introduction & The repair of soft tissue defect in lower leg and heel area with free flap is still a standard in reference books. However, there are disadvantages in the use of free flap like increased operative time, the damage of major vessels and the need for experienced microsurgeon. The use of local fasciocutaneous flap is usually impossible in these areas due to limited soft tissue, especially in moderate and large size defect. Reverse island sural flap is an island flap based on the vascular axis of the sural nerve, which gets reverse blood flow through communication with the perforating branch of the proneal artery in lateral malleolar gutter. This flap can be a good alternative to free flap for the reconstruction of lower leg and heel soft tissue defect. Between 1383 and 1386, 20 patients (18 male and 2 female), mean age 36 years were treated in 2 plastic and reconstructive centers for soft tissue defect of lower leg and heel area with reverse island sural flap. The mean follow up of patients was 6 months. After debridment and detection of defect size, flap was elevated. The flap was inseted in defect aria and the pedicle passed over skin in 18 patients and passed through subcutalous tunnel in 2 patients. Flap pedicel was removed after 2 months. In all patients, repair was complete, venous congestion was occurred in 16 patients. Superficial partial flap necrosis was present in 2 patients which were treated with conservative management. In 1 patient, bleeding from flap border was occurred, but stopped after 12 hours. According to the results of our study, reverse island sural flap is a good alternative to free flap for coverage of lower leg and heel soft tissue defect. Short operative time, easy technique and rapid ambulation of patient are the advantages of this flap.

Cerebral palsy is a nonprogressive disorder in body posture and movement, due to different etiologies. Different medical and rehabilitation interventions include massage have been used in these children. This study has been done to determine the effect of adding massage to occupational therapy on muscle tone of children with spastic cerebral palsy. This study was a double blind clinical trial. The children were recruited from clinics of University of Welfare & Rehabilitation Sciences. The individuals were divided to intervention and control groups. The routine rehabilitation techniques were done in 3 months in both groups. The intervention group received massage for 30 minutes before rehabilitation. Muscle tonicity was evaluated at the beginning of the study and 3 months later by Ashworth test. The data analysis was done by parametric (t test, paired t test) and nonparametric (Mann Whitney, Wilcoxon) tests. Thirteen subjects of case (intervention) group and 14 subjects of control group were studied. The average age in case group and control group was 49.5, and 42.1 months respectively. There were no statistically significant differences in Tonicity of upper and lower limbs, trunk and neck between intervention group and control group (P>0/05). In general based on the results of this study, adding massage to occupational therapy had no effect on tonicity of spastic cerebral palsied children. Regarding to some effects of massage mentioned in different articles on physical abilities of children with C.P. as well as executive limitations in this research, it is not possible to reject the effects of homeopathy on physical abilities of children with C.P.

Fucosidosis is a rare hereditary metabolic disease that is resulted from a deficiency in α-fucosidase enzyme activity. This deficiency produces accumulation of fucose-containing glycosphingolipids, glycoproteins and oligosaccharides in lysosomes of liver, brain and other organs. Phenotypes of this disease are various. Most of the cases have severe form or infantile type that begins in the first year of life with psychomotor retardation, coarse facial features and macroglossia (similar to mucopolysaccharidoses), hepatosplenomegaly and skeletal disorders (dysostosis multiplex). In milder types, clinical signs begin in the second year of life. The first sign is angiokeratomas (similar to Fabry disease). After that, thick skin, puffy eyelids, spastic gait and positive Babinski appear gradually. The case of the present report was a 13-month-old girl who referred due to motor developmental delay. In physical examination, there were developmental delay, growth retardation(weight, height and head circumference<5 percentile of normal), coarse facies, macroglossia, puffy eyelids, skeletal deformities and myelomeningocele in thoracic region. Laboratory studies revealed a deficient enzymatic activity of fucosidase and no mucopolysacchariduria.

This retrospective, cross-sectional and descriptive study was performed on 599 burned patients who referred to Mottahari Hospital during one year(20.3.2002-20.3.2003) to determine the incidence of different kinds of burns in children and adolescents. The age of 15 years old or less was the basis of selection. Studied variables were patients’ age and sex, cause of burning, duration of hospitalization, burned surface percentage and mortality rate of patients. Of these 599 patients (mean age: 5.8), 167 were hospitalized and 432 were outpatient. In hospitalized group, 97.6% of patients had thermal burn, 2.4% had electrical burn, but nobody had chemical burn. In outpatient group, 98.8% had thermal burn, 0.9% had electrical burn and 0.3% had chemical burn. This study showed that burning occurred in male patients more than females (58.6% vs. 41.4%). Children younger than 5 years old were the most affected group. Most of the patients had burned surface area (BSA) less than 10% and a few patients had BSA more than 90%. The mortality rate was 4.8%.

The baby's first words producing is one of the most important index of development. Development of talking is through a complex process that is influenced by both neuromaturation and human relationships (environment). It is not an imitative function in which children learn to repeat what they hear, but also it is a creative process through which children master a rule based, symbolic system. Talking development can be evaluated in 5 important dimensions: phonology, semantics, morphology, syntax and pragmatic. The receptive and expressive abilities of the child must be evaluated also. This paper discusses about the epidemiology, etiology and pathogenesis, clinical manifestations, how to assessment and make early diagnosis, differential diagnosis, management (treatment and rehabilitation) and prognosis of delayed or atypical talking in addition to above definitions. This paper also emphasizes on early intervention for children who develop significant behavior problems secondary to their communication difficulties and for whom long-term problems in social development are a major concern.