[ effect of shoe-heel height on the static and dynamic postural stability in healthy young women]

Wearing high-heeled shoes increases the height of the center of gravity and takes the line of gravity away from the center of the base of support. This may result in the loss of body balance. In this study the effect of 3 heel heights on the static and dynamic postural stability in healthy young women was investigated. In this cross-over quasi-experimental study with repeated measures, three dynamic indices of anteroposterior, mediolateral, and overall stability were determined using Biodex stabilometer and static stability using a modified CTSIB test. The measurements were made at 4 conditions of the feet, i. e., barefoot, and wearing shoes with a heel height of 3, 5, or 7 centimeters. The mean static stability index in the barefoot condition was significantly different from that in any the 3 conditions of wearing heels. With the eyes closed, the most unstable condition was in the case of the 7-cm heel, which caused also the most unstable dynamic condition; the differences were all statistically significant. The findings indicate that postural instability increases with increases in the height of shoe heels. On the whole, considering both the static and dynamic stability, the 3-cm heel can be recommended as the optimum-height hee

[Assessment of Schwann cell purity cultured in autologous human serum for spinal cord injury repair]

Background: Purity of cultured Schwann cell is very important in patients' outcome. The purpose of this study was evaluation of cell purity in a culture without nerve growth factors and fetal bovine serum

Materials and Methods: In this experimental study, for culture of human Schwann cells, nerve growth factors and fetal bovine serum were replaced by human autologous serum. Obtaining a consent from the close relative, nerve grafts were harvested and transported to processing unit where they were cultured in DMEM upon aseptic condition. Then the cultured cells were evaluated with S100 antibody staining for both morphology and purity

Results: Cell purity range was from 97% to 99% [mean=98.11+/-0.782%]. Cell count was 14055.56+/-2480.479 per microliter. There was not significant correlation between cell purity with either the culture period or the age of donors [P>0.05]. The Spearman correlation coefficient for the cell purity with the culture period and the age of donors was -0.21 and -0.09, respectively

Conclusion: We found that the replacement of nerve growth factors and fetal bovine serum with human autologous serum improves the cultured Schwann cells for clinical use with more safety and minimum reagents

[Comparison effect of different doses of Ketamine with Pethedine in reducing postoperative shivering after cesarean section]

Postoperative shivering is a common problem with multiple complications. This study was compared effect of low doses of Ketamine with Pethidine for controlling postoperative shivering. This clinical trial was done on 189 elective cesarean section with ASA class I or II who had postoperative shivering. Patients with grade 2 or higher were divided in three groups and were injected 0.3mg/kg Ketamine and 0.5mg/kg Pethidine intravenously. In 5[th] and 10[th] minutes after injection, they were investigated for shivering intensity. After 5 minute of injection drugs rate and intensity of shivering in Pethedine group was less than Ketamine group. Ketamine with 0.5 mg/kg was more effective than 0.3mg/kg dose of it and Ketamine[p=0.041]. In group with 0.5mg/kg dose of Ketamine, rate and intensity of postoperative shivering was more reduce than group with 0.3mg/kg of it in recovery [p=0/007]. In Pethedine group rate and intensity of shivering was more reduce then 0.5mg/kg dose of Ketamine[p<0/001]. This demonstrated that Pethedine is more effective than Ketamine. Although 0.5mg/kg dose of Ketamine has considerable effect on control of shivering but Pethedine is still a better choice for this side effect

[ relationship between physical and human resources in the intensive care units and patients mortality rate in hospitals of Markazi Province's:2007]

Recognition of mortality-related factors in Intensive Care Units[ICUs] could increase efficiency and effectiveness of these units. This research determined the relationship between the physical structure, human resources and their relevance to mortality rate in Intensive Care Units. In this cross-sectional study, all ICUs of hospitals in Markazi province were considered. Data gathering tools were resource [human, physical and training] questionnaires and checklists which their reliability and validity were accepted by Monitoring and Validation Center of Ministry of Health. Mortality rate after 24 hours of admission was also determined in relation to hospital resources and activities. Data were analyzed with descriptive statistics, Spearman and Kruskal-Wallis tests. Total score of human, physical and training resources in hospitals of Markazi Province is 55 percent of the country standard score. Mortality ratio after 24 hours of admission, to all patients [released and deceased patients] was highest in Vali-e-Asr hospital [25%] and lowest in Saveh Shahid Chamran Hospital[5%]. There wasn't significant difference in this ratio among hospitals. There were no significant difference between obtained scores of each resource [human, physical and training] among University, Social insurance and Qods [private] hospitals with respect to mortality rate 24 hours of admission. Human, physical and training resources have not direct effect on decreasing mortality rate after 24 hours of admission but can create necessary conditions for providing higher quality services

effect of adding intravenous Metoclopramide to Pethidine for postoperative cesarean section pain

Pain relief has been received the highest level of medical attempts continuously but still many patients suffer from it. Narcotics' side-effects have led investigators to apply other techniques for controling acute postoperative pain to reduce narcotics requirements. Recently, some concepts have been presented implying that Metoclopramide does have analgesic effects and this led us to conduct the present study in order to determine Metoclopramide's effect on alleviating pain after cesarean section. In this clinical trial, 80 patients who were candidates of elective cesarean section were studied in two groups. 10 minutes before the cesarean section's ending time, the control group was given 25 mg Pethidine accompanied by 10 mg Metoclopramide and control group 25 mg Pethidine and distilled water. Then when patients were conscious after cesarean section, for a period of 6 hours received after-care for their vital signs and side-effects of prescribed drugs. Their pain score [VAS] and nausea rate was measured and if necessary, Pethidine was injected with certain dose. Injection time for first dose of Pethidine and its required amount were recorded in a checklist within first 6 hours after cesarean section. Data was analyzed using ANOVA and T tests. Prescription of Metoclopramide inhaunced analgesic effect of narcotics and a meaningful decrease was found in pain score [p=0.002] and nausea rate [p<0.005]. Injection time for the first dose of Pethidine was also prolonged hi the group who received Metoclopramide compared to control group [p=0.019] and an obvious decrease was occurred in received Pethidine's amount within the first hours after cesarean section [p<0.005]. Drugs side-effects were not found in patients. The results indicate that use of Metoclopramide accompanied by Pethidine in ending time of cesarean section, does have considerable effects in controlling acute pain after surgery and increasing analgesic effect of narcotic drugs. Therefore, use of Metoclopramide as a proper supplement drug with low side-effects is recommended

[ comparison of Dexamethasone and Metoclopramide effects on postoperative nausea and vomiting]

Postoperative nausea and vomiting is one of the most common problems in postoperative period. Patients' who are at high risk of PONV, may receive antinausea and vomiting drugs. The most common drug is Metoclopramide, but it's extrapiramidal signs and side effects such as lethargy, dizziness and headache especially in children lead us to perform this study, in order to compare Dexamethasone and Metoclopramide effects in PONV prevention. This study was a double-blind randomized controlled clinical trial. 262 patients [2-25 years] in ASA class I, II which were candidates for ENT, eye and laparatomy surgeries, divided into two groups randomly. One group received 0.1 mg/kg Dexamethasone IV and the other group received 0.1mg/kg Metoclopramide IV, 10-15 minutes before operation ending time. During recovery, the frequency of PONV was assessed. Data was analysed by Pearson test. PONV frequency in the two groups had no significant difference. Also PONV rate in the two groups had no significant difference in male and female. In prevention and treatment of PONV, Dexamethasone effect was same as Metoclopramide. Considering low expense, avalibility and low side effects Dexamethasone is a proper substitute for Metoclopramide in surgeries with high risk of PONV

Magnetic resonance angiography of intracranial aneurysms: comparison with intraarterial digital subtraction angiography

Background: the aim of this study is to determine sensitivity and specificity of 3D- Time-Of-Flight and Phase Contrast Magnetic resonance angiography [MRA] in comparison with intra-arterial digital subtraction angiography [IA- DSA] in detection of intracranial aneurysms

Methods: 54 patients with 22 aneurysms underwent MRA and then IA-DSA prospectively from October 2002 till December 2003

Results: MRA detected 20 aneurysm where as IA- DSA scored 22 [90.9%]. false positive in MRA was 18.1% [4 cases] and no false positive was in IA- DSA. So sensitivity of MRA in detection of intracranial aneurysms is 90.9%, and specificity is 88.8%. Positive predictive value of 83.3% and negative predictive value of 94.1% is also calculated

Conclusion: MRA is a valuable non- invasive technique in the detection of intracranial aneurysms that can be a proper screening test for this purpose