[Comparison of the effects of laminectomy alone and laminectomy with fusion and fixation in the patients over 50 years of age with degenerative spinal canal stenosis]

Background and Aim: Low back pain is a major health problem. About 10% of patients develop chronic disability. Prevalence of some disorders such as spinal canal stenosis will rise with increasing age. When preservative treatment fails to improve symptoms in the patients with stenosis of the lumbar canal, surgical measures can be considered. Laminectomy alone or laminectomy with fusion and fixation are surgical procedures for spinal canal stenosis. Each of these procedures has its own advantages and disadvantages. Comparison of the clinical effects of these two methods in the patients with stenosis of the canal is a way to obtain more accurate results in order to select the appropriate procedure

Material and Methods: This retrospective study included 42 patients with degenerative spinal canal stenosis, who had underwent surgery at least six months ago. Selection of surgical procedure [single laminectomy or laminectomy with fusion and fixation] was based on clinical condition of every patient. Oswestry Disability Index scale was used for clinical comparison of the two groups at least 6 months after surgery

Results: Considering the results, we found no significant differences between the two groups in terms of surgical complications, radiculer pain improvement, low back pain and neurogenic claudication; but fusion and fixation laminectomy resulted in improved performance of the patients

Conclusion: The findings of this study and other studies suggest that laminectomy with fusion surgery is preferable for the treatment of degenerative spinal canal stenosis

Integrated assessment of air pollution in Tehran, over the priod from September 2008 to September 2009

Air pollution is a major problem in urban/industrial areas, like Tehran, and has several impacts on human health. This study aimed at assessing concentrations of criteria air pollutants [CO, SO2, NO2, O3, PM10] in Tehran, extracting patterns of hourly, daily, weekly, and monthly variations of concentrations, and making comparisons to National Standards and WHO Guidelines. Air quality data were taken from Air Quality Control Corporation and 5 sampling stations [out of 13] were selected for analysis according to data availability. Microsoft Excel 2003 was used for data analysis and plotting the charts. Patterns of temporal variation [hourly, daily, weekly, and monthly] of air pollutant concentrations were extracted. In some cases extracted patterns matched with the patterns proposed by other researchers. Pollutant concentrations were compared to National Standards and WHO Guidelines and it was observed that in most of the days, we exceeded the limit values. Air pollution in Tehran is quite high and there are many days that we exceed the standards; therefore appropriate control strategies are needed. Although the number of sampling stations is high enough to be representative of whole city, it is proposed that an independent sampling station is setup to check the validity of the measurements

Extremely low frequency magnetic flux densities measured near hospital in Tehran

The ever increasing rate of power consumption has led to an increase in public exposure to extremely low frequency magnetic fields [ELF-MFs] and brought severe concerns about their health effects. Considering previous studies and the facts about potential health effects of these fields, the present study aimed to evaluate the ELF-MF flux densities from power distribution lines near hospitals in Tehran. ELF-MF measurements were performed according to IEEE standard procedures-Std 644-1994 near the hospitals entrances using HI-3604 Power Frequency Field Strength Measurement System during three different time periods [i.e. 12-3 AM, 9-12 AM, 6-9 PM]. The results were analyzed using One-Way ANOVA Test. Mean, minimum, and maximum values of ELF-MF flux densities were 0.165 +/- 0.08 microT, 0.018 microT, 0.52 microT, respectively. There were no statistically significant differences in ELF-MF flux densities neither among different hospital groups nor among different time periods. The ELF-MF flux densities from power distribution lines around Tehran hospitals were much less than the standards values, implying that it can be considered only in epidemiological studies. In fact, in the case of powerful sources, magnetic field intensity is declined rapidly by distance and is limited to a few meters around the sources. This subject is considered as one of the main reasons for contradictory results in previous studies. Results of the present study can be used as a part of hospital patients' exposure to quantify the total exposure levels of patients as a critical and sensitive group in Tehran hospitals

[Native Tricuspid valve endocarditis in the absence of intravenous drug use]

We presented two non-addicted patients with Tricuspid valve endocarditis. The first patient was a 38-year-old diabetic female with; fever chills, anemia, and microscopic hematuria and pyuria that occurred during several weeks. The plain radiography of chest was normal and high resolution computed tomography [HRCT] of chest, was done because of predominant pulmonary symptoms and signs that revealed consolidation and cystic formation in the left parynchyma. Based on these findings in HRCT we decided to start anti-tuberculosis treatment, but no significant response was seen. Tran's Thoracic Echocardiography [TTE] was done and revealed large vegetation of Tricuspid valve. The second patient was a 45 -year-old man who admitted with acute fever and left lower lobe infiltrate and systolic murmur. TTE was normal but Trans Esophageal Echocardiography showed large vegetation on the Tricuspid valve. Staphylococcus aurous grew in 2/3 blood cultures. We suggest that right-sided endocarditis must be considered in any patient with fever and recurrent pulmonary symptoms and signs, with or without abnormal chest X- ray, heart murmur or intravenous drug addiction