ABSTRACT
As in many authorities, psychotic problems appear to be commuting. Claim of psychiatric disorder has become an important basis for offenders to defend themselves. Aim of this study was to investigate faking symptoms in forensic psychiatry evaluation of malingerers in Tehran. in a cross-sectional survey, in 1389, perpetrators with a judicial order were assessed by two psychiatrists, using American Psychiatric Association's Diagnostic and Statistical Manual 4th Edition [DSM-IV] standards for mental disorders at the Tehran center for forensic psychiatry. Forty one cases identified as malingerers and were evaluating in another specific conversation. Collected data analyzed with statistical methods and p<0.05 used for significance. In this study, behavioral symptoms [75.6%], Mood and affect symptoms [65.9%], cognitive function symptoms [56.1%], thought process symptoms [46.3%], perceptual disorder symptoms [34.1%] and thought content symptoms [19.5%] were observed respectively. Only thought process symptoms were significantly increased based on the educational level [p=0.045]. There was no statistically significant difference among other groups. In general, simulating the symptoms of mental illness is more likely to be observed in low socioeconomic estates and many will attempt to mimic simple symptoms of behavioral as well as mood and affect disorders. Probably, intelligence and reasoning ability of defendants has a close relation to expressed symptoms that should be considered during psychiatric interview
ABSTRACT
Measurements of mitral valve area [MVA] are essential to determine the severity of mitral stenosis [MS] and adopt the best management strategies. The aim of the present study was to compare MVA determined by two-dimensional [2D] planimetry to MVA measured by continuity equation [CE] in patients with moderate to severe MS. We evaluated 73 consecutive patients with the diagnosis of MS scheduled for balloon mitral valvuloplasty or with moderate to severe rheumatic MS admitted at the echocardiography clinic of Imam Khomeini Hospital in 2010. Using 2D images of mitral valve obtained from paraesternal short axis view, 2D planimetry of the mitral orifice area was performed by an experienced cardiologist. MVA by CE was calculated from aortic forward stroke volume divided by transmitral time-velocity integral. The mean value of MVA by 2-D planimetry was 1.0 +/- 0.3 cm[2]. The average values of MVA measured by PHT and CE were 1.0 +/- 0.3 cm[2] and 0.9 +/- 0.4 cm[2], respectively. The MVA determined by planimetry correlated well with CE [r=0.832, standard error of estimation [SEE]= 0.166, P<0.001]. The mean values of MVA calculated by CE highly correlated with those calculated by 2-D planimetry in patients presenting with both non-significant [r=0.701] and significant [r=0.761] AIs. When planimetry is not feasible, such as in severe calcification of mitral valve or after percutaneous balloon valvuloplasty, CE could be an alternative method for MVA measurement in comparison with PHT.
ABSTRACT
Transurethral Ureterolithotripsy [TUL] is a frequently used procedure in urology departments. Many urologists perform TUL without antibiotic prophylaxis; however the use of chemoprophylaxis before TUL remains a controversial issue in urology. Thisstudy was carried out to assess the safety of omitting antibiotic prophylaxis prior to TUL. In a prospective randomized clinical trial from January 2005 to December 2007, 114 patients with ureteral stones were enrolled; Fifty seven had preoperative antibiotic prophylaxis administered before TUL and fifty seven patients underwent TUL without antibiotic prophylaxis. The rate of postoperative infectious complications [fever, positive blood culture, significant bactriuria], the length of hospital stay and overall stone free rate were compared between the two groups. There was no statistically significant difference between two groups in the operation time, length of hospital stay, postoperative bacteriuria, positive urine culture, postoperative fever and overall success rate of TUL. It appears that the incidence of infectious complications does not increase in patients undergoing TUL without antibiotic prophylaxis if they have negative pre-operative urine culture and antiseptic technique have been performed thorough the procedure
Subject(s)
Humans , Male , Female , Ureteral Calculi , Lithotripsy , Prospective Studies , Postoperative Complications , Bacteriuria , FeverABSTRACT
<p><b>OBJECTIVE</b>To evaluate the sensitivity and specificity of CT scan findings in patients with blunt abdominal trauma admitted to the university hospital.</p><p><b>METHODS</b>All the patients with blunt abdominal trauma admitted at a tertiary teaching trauma center in Iran between 2005 and 2007 were enrolled in this study. In the absence of any clinical manifestations, the patients underwent a diagnostic CT scan. Laparatomy was performed in those with positive CT results. Others were observed for 48 hours and discharged in case no problem was reported; otherwise they underwent laparatomy. Information on patients?demographic data, mechanism of trauma, indication for CT scan, CT scan findings, results of laparotomy were gathered. The sensitivity, specificity and accuracy of the CT-scan images in regard with the organ injured were calculated. The sensitivity, specificity and accuracy of the CT scan were calculated in each case.</p><p><b>RESULTS</b>CT scan had the highest sensitivity for detecting the injuries to liver (100%) and spleen (86.6%). The specificity of the method for detecting retroperitoneal hematoma (100%) and injuries to kidney (93.5%) was higher than other organs. The accuracy of CT images to detect the injuries to spleen, liver, kidney and retroperitoneal hematoma was reported to be 96.1%, 94.4%, 91.6% and 91.6% respectively.</p><p><b>CONCLUSION</b>The findings of the present study reveal that CT scan could be considered as a good choice, especially for patients with blunt abdominal trauma in teaching hospitals where the radiologic academic staff is not present in the hospital in the night shifts.</p>