[Acute renal failure revealing an Hereditary spherocytosis]

Hereditary spherocytosis, or Minkowski-Chauffard disease, is a constitutional anomaly of red blood cell that loses its elasticity and becomes brittle to mechanical stress, thus promoting its early destruction and causing an hemolytic anemia. This observation is about a 40-year-old patient hospitalized for acute renal failure revealing an hereditary spherocytosis

[Multiple myeloma in young patients]

Multiple myeloma is the most common type of malignant hemopathy, affecting mainly the elderly; the occurrence in adolescents and young adults remains exceptional. This is a 5-year retrospective study conducted at the Hematology Laboratory of the CHU Hassan II in Fez, including 13 patients with multiple myeloma whose age is less than or equal to 40 years. The average age of patients is 35.5 years, with a male predominance. The clinical signs are dominated by bone signs. The biological assessment shows a monoclonal gamma peak in 60% of cases, and renal failure in 38% of cases. Sternal puncture showed plasma cell infiltration in 30% of cases. 45% of the patients were treated by CDT, 55% by VDT, with good progress in 30% of cases over an average of 60 months. This study shows that myeloma in young people is marked by its clinical severity, but the therapeutic advances made it possible to improve the prognosis of the patients

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

[EDTA dentin conditioning and Micro-shear bond strength using SE and SEM]

The main objective of using adhesive material is the improvement of restorative materials bonding to dentin surface in clean environment. The aim of this study was to investigate the effect of EDTA on bond strength of composite resin to dentin surface when used at different times and concentrations prior to application of adhesive systems by employing Scanning Electronic Microscope [SEM]. A total of 100 dentin samples were prepared from 50 human premolars. These samples were divided into two groups according to bonding type [Clearfil SE Bond =group I, Futurbond NR=group II] and each one was classified 5 subgroups according to time and concentration of EDTA as follows: 1 - Control. 2- EDTA 15%, 30 seconds. 3 - EDTA 15%, 60 seconds. 4 - EDTA 24%, 30 seconds. 5 - EDTA 24%, 60 seconds. These samples were conditioned and composite cylinders were adhered to them. After 500 cycles of thermocycling, the testing for micro-shear bond strength was conducted on these samples. Another 10 samples were demineralized for 30 seconds with 6NHCL and deproteinized with 2.5% Naocl for 10 minutes, air dried with desiccators and viewed under SEM. Data were analyzed using one-way as well as three-way ANOVA and Tukey tests. The mean Micro-shear bond strength in group I [Clearfil SE bond] were: 31.88 [ +/- 13] for subgroup 1, 28.4 [ +/- 13] in subgroup 2, 29.8 [ +/- 9] in subgroup 3, 29.2 [ +/- 11] in subgroup 4, and 32.7 [ +/- 12] in subgroup 5. The mean Micro-shear bond strength in group 2 [Futurbond NR]: were: 22.6 [ +/- 10] for subgroup 1, 28.5 [ +/- 9] in subgroup 2, 27.3 [ +/- 10] subgroup 3, 32.4 [ +/- 15] in subgroup 4, and 31.1 [ +/- 14] in subgroup 5. There were no significant differences between the samples conditioned and the ones not conditioned with EDTA, time and the concentration of EDTA applied and also the two bonding types. EDTA conditioning prior to use of the two bonding agents under investigation in this study did not improve the bonding strength of the self etch systems, neither did the time and the concentration of EDTA applied

[Study of arsenic presence in drinking water sources: a case study]

Conducted studies about arsenic have shown that consumption of water contaminated with arsenic can causes different adverse health effects in consumers. World Health Organization [WHO] has enacted 10mg/L arsenic in drinking water as a guideline value. Regarding some reports about arsenic presence in a village of Hashtrood county and related health effects and also considering this fact that determination of arsenic as a poisoning chemical is not included in routine monitoring of water by responsible organizations, in present study all of drinking water sources in Hashtrood county in East Azerbaijan province were studied for arsenic presence. Water supply and its sanitation situation were studied in all of cities and residential villages [200 villages] by field visiting. Arsenic content of water samples were determined using Ez arsenic test kit, a product of Hach Company. For assurance of the kit results, 20 water samples with different concentration of arsenic were analyzed using Inductively Coupled Plasma [ICP] method and then achieved results was compared together. Arsenic was present in drinking water of 50 villages that in 9 villages its level was higher than Iranian standard [50mg/L]. During the study totally 11087 persons [21.96% of rural areas population] in Hashtrood county were exposed to different levels of arsenic via drinking water. Correlation between kit and ICP results was significant [R2 = 0.9715]. Studied region in present study is a polluted area to arsenic by geogenic sources. It is necessary to replace water source of villages with higher level than national standard with safe drinking water. Annually measurement of arsenic in drinking water of all villages spatially polluted villages should be considered by responsible organization e.g. Health Network and Rural Water and Wastewater Company. Used kit in our study is recommendable for this purpose

[Evaluation of quality of life in patients with diabetes mellitus, based on its complications, referred to Emam Hossein Hospital, Shahroud]

Diabetes mellitus is an important and global health problem and is the seventh leading cause of death in the United States. It causes a high mortality and produces many personal, familial, social and financial problems. This study was performed to evaluate quality of life in diabetic patients based on the complications. ????This study was performed on 150 patients with diabetes mellitus selected by unrandomized sampling from patients referred to Shahroud Imam Hossein hospital. Based on the disease complications the sample was divided into 4 groups: without complication, microvascular complication, macrovascular complication and miro-macrovascular complication. Quality of life was assessed in physical, emotional and social aspects with audit of diabetes dependent qoL [ADDQoL] questionnaire. Average age of the sample was 59 years. 79.3% of patients were married, 62.8% were uneducated, 78.7% of patients did not have any educational course about diabetes mellitus. The mean of the total score of the quality of life in without complication group was 60.4 +/- 11.6, in microvascular complication group was 56.4 +/- 10.4, in macrovascular complication group was 61 +/- 7.8 and in micro-macrovascular complication group was 50.1 +/- 11.7. The quality of life of 4 groups was significantly different [ANOVA, P<0.05]. There was not a significant correlation between demographic variables and the quality of life score. The results showed that diabetes mellitus complications have significant and advert effects on the quality of this patient's life. Therefore, rapid diagnosis of the disease and its complication and use of appropriate therapeutic strategies in prevention or decreasing the complication is essential

syndrome of Tolosa Hunt

The Syndrome of Tolosa Hunt [STH] is a curiosity whose pathogenesis is completely unknown. It is a diagnosis of elimination, obliging to review the list of the painful ophthamloplegias. We report five original observations by their mode of presentation. Our study relates five patients hospitalized for assessment unilateral of orbital and retro-orbital pains, with an attack of the occulomotricity, enroled between 1993 and 2004. The average age of our patients was 43,6 years. The cerebral scanner was performed in all cases and MRI in two cases only. The attack of the cranial nerves observed in our series was in four cases for the common oculomotor nerve, three cases for the external oculomotor nerve, three cases for the optic nerve, the attack of the ophthalmic branch VI was found in two cases. The advent of the scanner and the MRI simplified discussion of the differential diagnosis. The corticotherapy has a spectacular effect on the favorable evolution of the disease

use of 0.5 % lidocaine with fentanyl and pancuronium for axillary block

The present study was designed to assess the efficacy of fentanyl and pancuronium combined with dilute lidocaine solution for axillary block. One hundred adult patients undergoing upper limb surgery were randomly allocated to receive either 0.6 mL/kg of 1% lidocaine [6 mg/kg] or 0.6 mL/kg of 0.5% lidocaine [3 mg/kg] with 1 [micro]g/kg of fentanyl and 0.5 mg of pancuronium. The onset of sensory and motor blocks was significantly shorter in the 1% lidocaine group [p<0.05]. However no differences in analgesia or motor blockade were found between the two groups, during the later 20 min. after block. The procedure was considered successful in 100% of patients without the necessity of supplementary medication, and no adverse effects were observed in the two groups, and the time of the first request for analgesia was not significantly different between the two groups. We conclude that the addition of fentanyl plus pancuronium to the lidocaine solution, with an unknown mechanism of effect on major nerve block, reduces the dose of the local anesthetic and possibly systemic toxicity