modified triple pelvic osteotomy for the treatment of hip hypoplasia

The prevalence of hip dysplasia Is 1 in 1000. Several pelvic osteotomy methods have been developed to prevent early osteoarthritis, such as triple osteotomy. In this study we are going to introduce our new technique that was done on 4 patients with favorable short-term results. Four patients underwent triple osteotomy and fixation using a reconstruction plate and early weight bearing was started. The Harris Hip Score, limb length, center-edge angle, and acetabular inclination showed improvement. This modified technique is suggested for corrective surgery on adult dysplastic hips

[ level of propensity to outsource study: based on hospital services features by managers and staff perspective in hospitals of Shiraz university of medical science, 2010]

The inefficiency of financing health care in developing countries made led in many health policy-makers to consider alternate means of service provisions. Outsourcing public financed health services in private sector organization is one of the interventions. Advocates claim that the contracting out of health care services will improve the service delivery performances through stimulating competition among providers and also by creating economic incentives to improve performance through linking payment to provider performance. The purpose of this cross sectional study was to provide decision matrix to guide decision-makers whether outsource hospital services or not. Tow kind of questionnaire were developed and used. Findings showed that the most propensities of outsource is in nutrition services [87%], and the least is in nursing services [43.4%] based on administrators' attitude. Shaping of decision matrix showed propensity to outsourcing of nursing, radiology, laboratory services are high while nutrition services is been low. Some differences between of decision matrix and administrators' propensity to outsourcing in radiology and laboratory services. Lack of attention in characteristics of the hospital services might be one of the reasons. Cost saving is the main reason for outsourcing the services while administrators should consider as an effect and side effect of outsourcings

[Effects of a nursing intervention on improving selfefficacy and reducing cardiovascular risk factors in patients with cardiovascular diseases]

Patients adherence to medical recommendations requires new and effective strategies. Promoting self-efficacy is considered as an important measurement to help patients to participate in their own treatment protocol. This study was conducted to determine the effect of a nursing intervention on improving self-efficacy and reducing cardiovascular risk factors in patients with cardiovascular diseases in a public hospital in Urmia. In this single group before/after study, 81 patients with at least two cardiovascular adjustable risk factors were recruited. The self-efficacy intervention was presented to the patients and one of their family members. The self-efficacy was scored before, immediately and one month after the intervention. The Cardiovascular risk factors were measured before and one year after the intervention. Descriptive statistics, ANOVA with repeated measures, paired t-tests, and McNemar test were used to analyze data. Overall self-efficacy scores and its sub-groups were significantly improved after one month. There were significant differences in the mean BMI, HDL, LDL, systolic and diastolic blood pressures, and weight before and one year after the intervention. The number of smokers and patients with hyperlipidemia were significantly decreased one year after the intervention. However, there were not significant differences in the number of overweight patients and patients with hypertension before and after the intervention. Results showed that our intervention to improve self-efficacy had positive effect on the overall self-efficacy score and the scores of its subgroups. Our intervention was also effective in controlling cardiovascular risk factors and in reducing the frequency of smokers and patients with hyperlipidemia. It seems that combination of medical orders with selfefficacy improving interventions on patients and their families are influential in controlling cardiovascular risk factors

[Comparing the healing effects of topical phenytoin, conjugated estrogen and silver sulfadiazine on skin wounds in male rats]

Accelerating of skin wounds healing process has been focused by researchers in recent years. The aim of the present study was to compare the effects of topical phenytoin, silver sulfadiazine and conjugated estrogen on skin wounds healing in male rats. Accessing a way to accelerate skin wounds healing is still one of the important goals in medical science. This experimental study was accomplished on 32 male rats [8 animals in each group] with approximately equal body mass. Skin wounds were made with an area of 40 mm[2] and a depth of 0.5 mm on the back of the necks. Three groups were administered daily by topical phenytoin [1%], silver sulfadiazine [1%] and conjugated estrogen [625%]. Control group received no drug. Wounds healing was evaluated daily and the study was continued until the wounds healing completed. Silver sulfadiazine demonstrated to be the best treatment for the wounds healing; compared with the other medicines, it required significant shorter time of treatment. Silver sulfadiazine accelerates skin wounds healing in male rats

Shiraz hospitals [public and private] preparedness in dealing with disasters

Iran is a disaster-prone country and it can be considered as one of the most vulnerable countries for disasters in the world. Hospitals play an important role in disasters. This paper aims to study the preparedness of public and private hospitals in Shiraz dealing with disasters; to investigate and to identify problems and issues comparing current status with standards. In this cross-sectional study, 15 public and private hospitals were evaluated in Shiraz in 2010. The data was collected by using observation, interview and also a checklist including 10 fields and 220 questions. Then the collected data were analyzed by using SPSS. Totally, the results are as follows: the average disaster preparedness in the mentioned hospitals was 62/3%; evacuation, transport, traffic, communication and security fields were in the middle level; and emergency services, reception, training, logistics, human resources, commanding and management were in a good average level. Despite having an adequate preparation in the studied hospitals in Shiraz, appropriate measures should be taken to improve some fields such as evacuation, transport, traffic, communication, and security

Performance of antigen B isolated from different hosts and cyst locations in diagnosis of cystic echinococcosis

The aim of this study was to assess the performance of Antigen B [AgB] isolated from different Echinococcus granulosus intermediate hosts and from different cyst locations for immunodiagnosis of human cystic echinococcosis [CE]. Hydatid cyst fluids were collected from lung and liver cysts of sheep, liver cysts of goats, lung cysts of camels and cattle, and liver cysts of human. AgB was purified from each of these hydatid cysts fluids. Serum samples obtained from 47 pathologically confirmed cases of CE along with 30 sera samples from non-CE patients and 40 sera from healthy individuals were tested by ELISA using AgB prepared from different hosts or cyst locations. The highest sensitivity [97.8%] for diagnosis of CE was seen with AgB prepared from human liver cysts. This maximal sensitivity was followed by AgB isolated from those of sheep liver and lung cysts. The least sensitivity was found with AgB prepared from bovine lung cysts. The highest specificities [97.1%] were observed with AgB isolated from human liver cysts followed by those of sheep and goat liver cysts while the lowest specificity was seen with AgB isolated from bovine lung cysts. In view of the specificities and sensitivities of the different AgB, the best validity was found for AgB prepared from human liver cysts while the least validity was found with AgB prepared from bovine lung cysts. For any AgB-based tests, obtaining of the antigen from one of these sources will significantly increase the diagnostic sensitivity and specificity of the assay

Lipoid proteinosis in two Iranian sisters: a case report and review of literature

Lipoid proteinosis is a rare autosomal recessive disorder which may be seen within a family very occasionally. Herein, we report lipoid proteinosis in two sisters characterized by verrucous lesions and hoarseness of voice, dysphagia and multiple beaded papules along the margins of their eyelids, fissured lips and thick ferenulum

[Comparison of mobilizing and immobilizing splints on hand motor function in stroke patients: a randomize clinical trial]

Among several methods for the treatment of wrist-fingers motor function impairment after stroke, splinting is a method commonly used as complementary option. But there are so many controversies surrounding its efficacy. The aim of this study was to compare the effect of mobilizing and immobilizing splints on wrist-fingers motor function after stroke.In this experimental study, 31 stroke patients were selected and divided randomly into three groups including: mobilizing splint, immobilizing splint and control group. Participants in intervention groups wore their own splints for eight weeks, five days per week and on average six hours per day. Motor function was measured at baseline and the eighth week by fugl-meyer [FM] scale. The one-way ANOVA was used to compare scores of FM scale between three groups. Data analysis showed significant increase in motor function only in mobilizing splint group [p=0/001] and this increase was significant compared with other groups [p=0/001]. Based on these findings, using a mobilizing splint compared with immobilizing splint could have better functional results for treating wrist and finger motor impairment in post-stroke patients

Mesh diagram software programming and norm calculations for Iranian adolescences [Qazvin, Mashhad]

Nowadays, taking lateral cephalograms in natural head position is recommended however, the radiographic norms vary in different populations. Performance of cephalometric analysis has become much easier and more accurate using computer software. The aim of present study was to program software for Mesh analysis and constructing two normal Mesh templates for cities of Qazvin and Mashhad. This was a descriptive study in which the Mesh analysis software was programmed by means of Microsoft visual C++ based on Windows XP using My-SQL as database. The samples were NHP cephalograms from 11 to 13 years old adolescence with normal occlusion including 37 [21 girls and 16 boys] in the city of Qazvin and 65 [32 girls and 33 boys] in the city of Mashhad. The cephalograms were scanned and 4 Mesh templates constructed for each gender in each of two cities using Moorees method. The dimensions of each of the 34 landmarks of each template were statistically compared with each other by means of t- test in both boys and girls, separately. Among girls, 38 measures out of 68 [17 width and 21 height] and in boys 20 measures out of 68 [8 width and 12 height] indicated significant statistical differences between two cities. In addition to sex, age, and the dimensions of SN and N-ANS, the ethnical origin of patients should be considered when dentoskeletal analysis of abnormalities is performed

[ comparison of tomography's accuracy between spiral cranex tome and linear promax for evaluating the quantity of bone in posterior of maxilla]

An accurate imaging technique has an important role in implantology. Presence of sinus in the posterior maxilla is a limiting factor for implant insertion in this area. Therefore it is necessary to evaluate the relationship between alveolar ridge and sinus. The aim of the present in vitro study was to compare the accuracy of Cranex Tome Spiral and ProMax linear tomography to assess bone quality for the preoperative planning of implants in the posterior maxilla. Tomographs were taken from 3 dry human skulls using both units. Three sites were selected in each side of posterior maxilla and marked with orthodontic wires meaning a total of 24 sites [12 sites for each unit]. Bone height and width were measured first on the tomography and then on the skulls after sectioning. In order to compare the measurement values between both units and to compare them with the values obtained from gold the Intraclass Correlation of reliability [ICC] was used. The minimum Intraclass correlation coefficient of reliability was 0.569 in two times measurements of width for ProMax, and the maximum of this coefficient was 0.950 in two times measurements of height for Spiral. The mean difference between the real measurements and the height measurements of both units were less than 0.3 mm and for the width measurements were less than 0.5 mm of the real measurements. This study showed in both units, the height measurements were more accurate than the width measurements and all the measurements by Spiral were more valid then those of ProMax. Generally quantitative accuracy of Spiral unit was found to be higher than ProMax unit. Both units proved to be sufficient for quantity measurements. Adjustment an individual imaging plane for each site of tomography increases the accuracy. The most distal sites of Spiral unit may need separate adjustment other than manufacturer demands

[Fibroblastic osteosarcoma in mandible: a rare case report and review of literature]

Osteosarcoma is a malignancy of mesenchymal cells that have the ability to produce Osteoid or immature bone. Osteosarcoma of the jaw is uncommon and represents 6-8% of all osteosarcomas. This tumor occurs most often in the third and fourth decades of life, which is 10-15 years older than the mean age for Osteosarcomas of the long bones. The Maxilla and Mandible are involved with a boot equal frequency and a slight male predominance, is noted. Mandibular tumors arise more frequently in the posterior body and horizontal ramus. Maxillary lesions are discovered more commonly in the alveolar ridge, sinus floor and palate. This article is a report of fibroblastic Osteosarcoma in the mandible of a 35 years old man that has been referred to pathology Department of Shahid Beheshti dental school. The specific characteristic of this case, is its histologic features, because fibioblastic Osteosarcoma is rare in jaws and most cases are chondroblastic Osteosarcoma

Smoking and asthma in 20-44-yearold adults in Urmia, Islamic Republic of Iran

To investigate the prevalence of smoking, asthma and asthma-related symptoms in relation to age, sex and smoking behaviour in Urmia, we carried out a cross-sectional study in 2004 using the International Union Against Tuberculosis and Lung Disease questionnaire, which includes some questions on smoking. We surveyed 2987 adults aged 20-44 years. Prevalence of wheeze, breathlessness with wheezing, asthma attack, use of asthma medication and nasal allergy were 4.8%, 3.3%, 1.2%, 1.1%, and 16.0% respectively. Current smokers comprised 16.4% of participants. Prevalence of asthma symptoms was significantly greater in smokers than non-smokers. Rates for asthma diagnosis and asthma medication were lower than the European Community Respiratory Health Survey median

[ breast feeding and measles vaccination in childhood be considered as risk factors for later inflammatory bowel diseases?]

It is claimed that the interaction of altering immune system bowel maturation, and measles vaccine predispose the body to inflammatory bowel diseasesAlso it is proposed that breastmilk components during infancy, regulatemucosal immune activity to antigen and have protective role for ulcerative colitis and Crohn's disease. This study was a case-control study. Data were collected from patients' evidences and questionnaires that were filled up by face to face method for each groups of patients [including ulcerative colitis and Crohn's disease] and control groups [including IBS and GERD] They were selected from the patients <40 years who came to 3 clinics in Tehran during 2005 to 2008. Statistical analysis was performed in two steps univariate and multivariate analysis, using SPSS-16 software. Results: Ulcerative colitis group included 143 patients, Crohn's disease group involved 148 cases and control group included 307 patients. Breastfeeding in Ulcerative colitis and Crohn's groups had been less common than in control group [81.1% versus 88.3% and 83.8% versus 88.3% respectively], but the differences were not significant. [P-Values were 0.225 and 0.397 respectively] The difference between ulcerative colitis group and control group in measles vaccination rate [93% versus 89.9% respectively] was not significant [P=0.121]. Both Crohn's disease group and control group had vaccination rate of 89.9% [P=0.481]. There was not significant correlation between previous exposure to smoking, measles vaccination and breast feeding during infancy with extent and location of gastrointestinal involvement in ulcerative colitis and Crohn's disease [p>0.05]. Breast feeding and measles vaccination during infancy do not correlate with later ulcerative colitis or Crohn's disease in adulthood. There was not any correlation between smoking, easles vaccination and breast feeding with extent and location of gastrointestinal involvement in ulcerative colitis and Crohn's disease

[Forgiveness and marital satisfaction in combat veterans with post traumatic stress disorder and their wives]

Stress caused by various events such as war is regarded as one of the factors threatening mental health. Stressful life events and their consequences may result in post traumatic stress disorder [PTSD] which, in turn, will cause destructive effects, including marital mal-adjustment between couples. However, factors such as positive psychological sub-components, including forgiveness will have positive effects on symptoms of PTSD. The present research aims at predicting marital satisfaction in men suffering from PTSD and their wives, based on severity of PTSD symptoms in men and the rate of forgiveness shown by partners. In order to achieve the objectives of the research, first 103 patients under treatment in Jannat specialized hospital for psychiatric patients in Shiraz were chosen. In the next step, they were assessed through PTSD Scale. Based on the cut-off point by this scale, 42 of the patients and their spouses were selected in order to be assessed for forgiveness and marital satisfaction through forgiveness, and dyadic marital adjustment scales. Finally, the data was analyzed by stepwise regression method. The results showed that the higher score in forgiveness and the lower severity of PTSD symptoms can predict marital satisfaction in men suffering from PTSD and their wives. The findings of this research are in agreement with other studies conducted in various group particularly in combat related PTSD. This study emphasizes the role of forgiveness desire in increasing marital satisfaction and adjustment among combat related PTSD patients and their wives. The results of this study can be used to design and formulate programs and marital interventions based on forgiveness training for partners

Allergic disease in 6-7-year-old schoolchildren in Urmia, Islamic Republic of Iran

To determine the prevalence and risk factors of wheeze, eczema and rhinitis in 6-7-yearold schoolchildren in Urmia, the International Study of Asthma and Allergies in Childhood questionnaire was given to the parents of 2999 student. Prevalence rates for wheeze, rhinitis and eczema in the previous 12 months were 9.4%, 9.8% and 2.7% respectively. The parents of only 12.8% of the children with current wheeze reported them as having asthma. The main risk factors for wheeze were male sex, presence of rhinitis or eczema, and smoking in the home. Prevalence of asthma and other allergic disease was lower than in industrialized countries and underdiagnosis of asthma was common

[Primary plasma cell leukemia: effective treatment with intermediate dose melphalan]

Primary Plasma cell Leukemia [PCL] is a rare disease with no standard treatment, although, combination chemotherapy, BMT and intermediate dose melphalan have been shown to be effective, in some case reports. Patients usually present with anemia, thrombocytopenia, hypercalcemia, and renal failure. Diagnosis is confirmed by peripheral and bone marrow examination. We recently had a case in our department. A 43 years old gentleman presented with history of fatigue, weakness, weight loss, dyspnea and bone pain. Diagnosis of PCL was confirmed by PBS and bone marrow exam. The patient was treated using single intermediate dose melphalan [60 mg/m2/ IV] plus Dexamethasone with G-CSF support; after 3 weeks, complete remission was achieved. In the last visit, done 9 months after treatment, he was doing well clinically and his Lab data were normal. This case report confirmed the efficacy of intermediate dose of melphalan in the management of plasma cell leukemia

Asthma and other allergic diseases in 13-14-year-old schoolchildren in Urmia: an ISAAC study

We determined the prevalence and risk factors of asthma, allergic rhinitis and atopic eczema in 3000 13-14-year-old schoolchildren in Urmia, Islamic Republic of Iran. We used the International Study of Asthma and Allergies in Childhood [ISAAC] written and video questionnaires. With the written questionnaire, the prevalence of current symptoms [within the past 12 months] was: wheeze 14.5%, allergic rhinitis 23.6% and eczema 10.1%. Self-reported asthma ever was only 2.1%. With the video questionnaire, the prevalence of wheeze was lower; 7.4% for wheeze at rest ever and 4.6% during the past 12 months. Boys had a significantly higher prevalence for most items examined except for eczema

[Assessment of phalen test and tinal sign in diagnosis of carpal tunnel syndrome in Emam Reza Hospital in Mashhad]

Carpal Tunnel syndrome is the most common peripheral nerve entrapment, which is due to median nerve compression in carpal tunnel in anterior portion of the wrist. Phalen and Tinel tests are common clinical diagnostic tests. This study assessed sensitivity and specificity of Tinel and Phalen tests. This is a descriptive study of patients who came to electro diagnostic center of Emam Reza hospital of Mashhad during 18 months. E.M.G and N.C.V are standard diagnostic tests in the most articles and also our study. This study was done on 771 cases [1223 hands].Data were studied in validity table of clinical tests compare to Para clinical tests. Our finding showed 86% sensitivity and 75% specificity for clinical tests. Most of patients aged 40-50 years. Female to male ratio was 7/1. % 30.5 was severe. % 40 of severe cases had Thenar atrophy. The most symptoms were paresthesia, pain, nocturnal hand paresthesia. There were 6 double crush syndromes. Concordant findings of Phalen and Tinel tests have acceptable sensitivity, specificity, and positive predictive value but we also suggest other tests for exact diagnosis

[ comparison of titer of Helicobacter Pylori antibody in patients with gastric carcinoma and control group in Zahedan]

Gastric cancer is the second most common cause of cancer related death in the world. Helicobacter pylori infection is associated with chronic gastritis, a known precursor of gastric cancer. Carcinomas have been shown to be related to a high prevalence of H.Pylori infection. We study titer of H.Pylori antibody in patients with gastric cancer and in patients with non-ulcer dyspepsia. During an eleven-month course [October 2001- September 2002] we studied the relation between H. Pylori infection and gastric carcinoma in a case - control study in Zahedan hospitals. The subjects divided into two groups; 40 control subjects and 40 patients with gastric carcinoma. IgG Antibody to H. Pylori was checked in serum of patients in both groups by ELISA method. Each group comprised of 21 male [52.5%] and 19 female [47.5%]. Mean age was 53.18 and 56.58 years in control and case group, respectively. Anti-H Pylori IgG was positive in 100% of patients with gastric carcinoma but only in 28% of the control subjects. Chi-test demonstrated a significant correlation between gastric cancer and Antibody test. [P= 0.000]. Patients with gastric carcinoma had higher titer of IgG 85.67 in contrast to those who did not have cancer. Like other epidemiologic studies this study revealed that H pylori infection is associated with an increased risk of gastric carcinoma and is considered as a cofactor in the pathogenesis of this malignant condition

Effect of relaxation program on the rate of ventricular arrhythmia in patients with myocardial infarction

Relaxation is one of the efficient methods in decreasing the occurance of ventricular arrhythmia. The aim of this study was to assess the effect of relaxation methods on the rate of ventricular arrhythmia in patients swith myocardial infarction. This study is a clinical trial in which 60 patients with myocardial infarction have been randomly divided into two, experimental and control groups. Data collecting tools were a demographic characteristics form and also a ventricular arrhythmia checklist. In order to assess the effect of relaxation, relaxation method was performed on experimental and control groups and the rate of occurance of ventricular arrhythmia was compared before and after relaxation in both groups. Most of the studied cases were married with primery education level and their monthly income was more than 2000000 Rials. The findings of this study showed that the rate of ventricular arrhythmia in the experimental group was lower in comparison with the control group and this difference was statisticaly significant. Relaxation can be used as an efficient element in decreasing ventricular arrhythmia in patients with myocardial infarction