Primary epidural varicosis as a rare cause of sciatica: a case report

Non-discogenic sciatica can be caused by any lesion along the course of the lumbosacral nerve roots and sciatic nerve. We aim to present a rare case of refractory sciatica in an otherwise healthy 25-year-old man. He complained of left leg pain without significant back pain. Extensor hallucis longus muscle was weak on the left side with limited straight leg rising. On magnetic resonance imaging, a space-occupying lesion resembling a sequestrated disc was noted that after surgical decompression, epidural varicosis was demonstrated

Frequency of cleft lip and palate among live births in Akbar Abadi hospital

Cleft lip and cleft palate are one of the most frequent congenital anomalies worldwide. This study was conducted in order to measure the frequency of cleft lip and palate among live births in Akbar Abadi Hospital. This is a descriptive study, dealing with 57526 cases of live birth out of 59477 medical files in Akbar Abadi Hospital from 2004 to 2008. All the collected data were recorded in specific data sheets. The frequency of cleft lip or palate or both was 103 cases in 57526 live births, which is 1.79 per 1000 live births. The frequency of cleft lip, cleft palate and concurrent cleft lip and palate were 0.53, 0.33 and 0.92 per 1000 live births respectively. Among the newborns with any type of this anomaly, 53 [51.5%] were males and 50 [48.5%] were females. Twenty nine neonates [28.2%] had limb anomalies, 13 [12.6%] had syndromic features, 4 [3.9%] had limb anomalies and syndromic features, and 3 [2.9%] had cardiovascular anomalies. Our study indicates a frequency of cleft lip and/or palate near to the average international figure, and close to the findings in European and East Asian countries. Furthermore, the frequency of cleft lip and palate in our study was different from American countries and India probably due to ethnic differences

[Comparison of blood loss in femoral shaft surgeries between tranexamic acid and controlled hypotension]

Blood loss reducing approaches improve surgery outcomes through producing an appropriate operation field and reducing transfusion need. In this study two blood loss reducing techniques were compared. In a randomized clinical trial study 60 patients candidate for elective femoral shaft operation were devided in two groups. The first group went under induced hypotensionand the second group received tranexamic acid. Anesthesia technique and surgeon were the same in both groups. Bleeding amountwas measured based on site operation site and reservoir observing, pads counting. Traputic interventions such as crystalloids or colloids and blood transfusion were done as needed. Results were evaluated by Mann-witney U test. Dry field and surgeons satisfaction was good in 23 patinets of the hypotention group [76%] and was moderate in the rest of the group. In the tranexamic group the results were good in 21 patients [70%]. There was no significant difference in reducing blood loss between the groups. Both of the studied techniques can reduce bleeding and improve operation field and surgeon satisfaction, meanwhile there was no significant difference in two approaches

Anatomy of arterial supply of the soleus muscle

Soft tissue defects of the lower limb are a challenge to the plastic surgeon but a soleus muscle flap often provides the solution. Various types of soleus muscle flap have been described, based mainly on the vascular supply. This study has been conducted as a descriptive study. The arterial blood supply of the soleus muscle was studied in 45 cadaveric lower limbs. The blood vessels and their branches to the muscle were dissected. The mean length of the soleus muscle was 37 +/- 2.2 Cm. In 66.7% of the limbs at least two branches arose from the popliteal artery trunk. The average distance of the first branch was 2.61 +/- 1.75 Cm distal to the fibular head. And the second branch was 3.88 +/- 0.7 Cm distal to the fibular head. The average number of branches to the soleus muscle from the posterior tibial trunk was 4.3 +/- 0.7. The average distance of the first branch was 9.4 +/- 2.3 Cm from medial malleolus and second branch was 15 +/- 3.4 Cm. The average number of branches to soleus arising from the proneal artery was 3.8 +/- 0.8. The proneal artery gave 2-5 branches to the soleus muscle in the limbs that in 95.6% of the limbs were found three branches from proneal artery trunk to soleus muscle. In this study have been shown, the distribution of the arteries entering the soleus muscle and how the information may be used in the design of soleus muscle flaps. However, clinical application of distal pedicle soleus muscle flaps in Iranian population is not beneficial and we do not recommend it to the surgeons