[Frequency, clinical findings and outcome of foreign bodies in the upper gastrointestinal tract]

Foreign body ingestion is a potentially serious problem in children. Most of ingested foreign bodies pass through the gastrointestinal tract spontaneously, but some of them [20%] need endoscopic or surgical removal. Sharp foreign object may cause serious complications and need an emergency intervention. The aim of this study was to characterize the clinical features associated with foreign bodies in the upper gastrointestinal tract and to determine the clinical factors for their successful removal by endoscopic techniques. We analyzed retrospectively 120 cases of foreign bodies in the upper gastrointestinal tract at Children's Medical Center, Tehran. Depending on the type of the swallowed foreign body and its site obtained by routine neck and chest x-ray as well as existing symptoms, we decided to fulfill an emergency endoscopy or to wait. Of 120 patients with a mean age of 4 years, 75 [62.5%] were males and 45 [37.5%] females. There was a history of parents' presence as a witness in 93.3% of cases. Common sites of foreign bodies were stomach [66.6%], esophagus [25%], and duodenum [2.5%]; a coin was the most common foreign body [30%]. Other foreign bodies were disc battery [12.5%], and sharp foreign bodies [10%]. Most of patients were brought in the first 24 hours after ingestion of the foreign body. In only 8 patients, complications occurred. Foreign body ingestion in children is a serious problem which may need an emergency procedure. Still the best way is its prevention; children should not be allowed to play with coins, metallic objects, safety pins etc

[Tumors of the liver; a ten year study in Children Medical Center]

The aim of this study was to review the frequency, histopathology and outcome in children with tumors of the liver. Included in this retrospective/descriptive study were 30 children treated for liver tumors from 1375-1384 [ca. 1996-2005], at Children's Hospital Medical Center, Tehran, Iran. We included the clinical, radiologic, and pathologic data of our patients, focusing on the frequency, etiology and outcome. Patient ages ranged from three months to 12 years [median 3.8 years], with 18 males [60%] and 12 females [40%]. Of these, 17 patients had hepatoblastoma [55.66%], including 13 males and four females, with an age range of six months to five years. Four cases [13.33%] had neuroblastoma. Hepatocellular carcinoma [HCC] was found in three cases [10%], all of whom were carriers of hepatitis B. Two cases [6.66%] were diagnosed with mesenchymal hamartoma, two cases [6.66%] with hemangioendothelioma and two cases [6.66%] with rhabdomyosarcoma and leiomyosarcoma of the biliary tract. Abdominal swelling and hepatomegaly were seen in all of patients. Jaundice was observed in two cases. Serum alpha-fetoprotein levels greater than 500 ng/ml were seen in 17 cases [56.66%]. All patients were receiving specific treatment. The three-year survival rate was 65% for hepatoblastoma and 2% for HCC With the introduction of specific treatment, the survival rate for children with tumors of the liver has significantly increased. Further improvement can be achieved using diagnostic biopsy for hepatoblastoma, although it may result in complications, and preoperative chemotherapy followed by complete surgical excision [per International Society of Pediatric Oncology guidelines], yielding an outstanding survival rate of 80%

[Intestinal biopsy and anti endomyosial serologic test in children suspicious for celiac disease: a comparative study in children medical center]

Celiac is one the most common causes of malabsorption and is an autoimmune disorder resulting in damage to intestinal epithelial cells by self T lymphocytes. The main culprit is gluten. The aim of our study was to assess the histopathologic findings of patients suspicious to have celiac disease in their first admission and compare them with serologic findings [endomyosial antibody test: EMA]. The study is a prospective descriptional type and 95 patients suspicious to have celiac disease were included who went under upper endoscopy and sampling and also serologic studies. Histopathologic findings were grouped by Marsh classification. Specimens in Marsh stage 0 and 1 were also stained for leukocyte common antigen by immunohistochemistry. Ninety five patients, 49 males and 46 females, ranging from 9 months to 17 years [mean: 6.3 ys] were included in the study The most common complaint was abdominal pain. EMA test was positive in 43 patients. Most specimens were categorized as Marsh stage IIIA [51 cases] by histopatholgic examination, which can be seen in many other conditions. Only 16 patients were categorized as Marsh stage IIIB and IIIC, which are seen in established celiac patients No significant correlation was found between histopathologic and serologic findings. No difference was found between H and E staining and immunohistochemical staining in counting of intra- epithelial lymphocytes. Most of our patients had mild partial villous atrophy which is also seen in many other disorders and also EMA test was negative in this group. It appears that current assessment of celiac disease has many drawbacks and necessity of more specific methods is highly appreciated

Studying the staffs job satisfaction in admission unit of training hospitals affiliated with Shiraz University of Medical Sciences

Job satisfaction is one of the key factors affecting professional success which, in turn, allows an organization to achieve its objectives. And ultimately it can result in individual and social health. Thus, managers are highly concerned with factors affecting job satisfaction. In this study, it was decided to investigate factors determining the staffs job satisfaction. It was a descriptive analytic study in which data were collected by a standard questionnaire in nine training hospitals affiliated with Shiraz University of Medical Sciences in 1380. The questionnaire was given to fifty people working in admission unit. The data were analyzed by t-test, kruskal-wallis, pearson correlation and one way ANOVA. Findings of the study revealed that there was a significant relationship between sex and job satisfaction on the one hand and promotion and salary on the other. There was also statistically meaningful relationship between organizational position and job satisfaction. In order to increase the productivity in admission units, the staffs job satisfaction must be fulfilled. In addition, by reducing the gap between different social classes and achieving a logical distinction in exploiting economic and social rights, we can make organizational objectives closer to staffs expected tasks

Stress analysis of all-ceramic three-unit dental bridges using finite element method

Mechanical fracture is a common cause for the failure of three-unit dental bridges, particularly the all-ceramic ones. The goal of the present study was to evaluate the effects of convergent angles of the abutments on the peak and distribution of mechanical stresses within the prosthesis and at the restoration abutment interlace of a three-unit all-ceramic bridge using finite element method. The cloud points of three-D geometrical data of the second premolar and first and second molar teeth were obtained using ATOS Scanner system and utilized for the reconstruction of a surface model of the three-unit bridge in CATIA software. Data were than transferred to I-DEAS software for mesh generation and finite element analysis. Two EF models were developed with convergent angles corresponding to the up and low defined range including 171900 and 168700 tetraherdal solid four-node elements, respectively. The models were subjected to two different prosthesis materials and three different load cases. The maximum tensile stresses occured on the gingival surface of the second premolar retainer and at the tooth/restoration interface on the marginal distal surface of the second molar abutment. The peak tensile stress was relatively lower for the model with the higher convergent angle but the difference was not significant. Changing the prosthesis material from IE[2] to Dicor desreased the stresses within the prosthesis. Higher safety factor was found for IE[2] due to its higher mechanical strength. Moreover, it was proved that load condition played an important role on the mechanical stress observed

investigation of the admission units of educational hospitals affiliated to Shiraz University of Medical Sciences and health services

Hospitals as main health care providers have always received great attention. And in hospitals attention was paid to the admission unit and its management and organization. This unit plays an important role in the evaluation of the hospital. It is a descriptive study in which nine inpatient admission units and six outpatient admission units were examined. The data were collected by questionnaires, checklists and interviews with the managers of the admission units. The findings revealed that admission units did not have enough educated personnel. The admission and emergency units did not have appropriate equipment. These units did not carry out some of their major tasks and did not play any role in discharging and transferring the patients. The results put emphasis on the improvement of the admission units based on the accepted standards in terms of their location, man power, equipment and also faciliating and accelerating the process of admission of the patients

biomechanical study of lateral release and Elmslie-Trillat procedures to restabilise the maltracking patella

The resistance of patella against lateral displacement [i e. the stability], was studied under a range of conditions in vitro at a range of knee flexion angles. Muscle forces were applied in physiological directions along the separate quadriceps muscles. Normal muscle actions with constant tension showed constant patellar stability up to sixty degrees knee flexion, and then a significant increase at ninety degrees. A pathological knee was simulated by relaxing vastus medialis, and lateral stability then dropped by 47% Isolated retinacular release in the pathological knee did not improve stability significantly towards normal, while 6mm tibial tubercle medialisation restored stability by 52% towards normal, except neat full extension. Combined release plus tubercle medialisation restored stability 59% towards normal in knee flexion and 23% up to ten degrees flexion