[Physiologic indices of patients before, during and after visit in coronary care unit at Imam Khomeini hospital in Ardebil]

Visit is an essential issue in hospitals and of patients' basic needs in coronary care units [CCUs]. However, there is no evidence regarding its physiologic effects on them. The aim of this was to determine the physiologic indexes of patients before, during and after visit at CCU of Imam Khomeini Hospital in Ardebil. In this descriptive study, 50 patients with acute myocardial infarction were selected through convenience sampling method. A questionnaire and a cardiac monitoring device were used for data collection. Content method and calibration the device were used for validity and reliability of the tools respectively. ANOVA with repeated measurements was used for data analysis. 72% of patients was male and 28% was female. Their mean age was 59.8. Significant differences were found between systolic, diastolic and mean arterial pressures; heart as well as respiratory rates; temperature; and oxygen saturation before, during and after the visits. Accordingly, the indexes increased significantly by the start of visits and turned back to the previous state after them with no significant difference in before-after amounts. It seems that the physiologic indices of patients change in normal range during visits and return to their primary state after 30 minutes from the end of visits with no clinical importance

[Surveying limb shortening in obstetrical brachial plexus palsy]

Prior investigators have demonstrated the effectiveness of brachial plexus reconstructive surgery in neonates with obstetrical brachial plexus palsy. In the present study, we compared limb growth in a group of neonates underwent surgery with those who were subjected for surgery but refused. Totally, 55 neonates received treatment during a 10-year period were selected. They were assigned in 2 groups: 25 who could not achieve biceps flexion during the first 3 months and underwent reconstructive surgery [case group], and 30 neonates who had been subjected for reconstructive surgery but refused [control]. Finally, the intact and the injured limb were measured from acromion to the third finger. C5, C6, and C7 were the most common affected sites, while, nerve graft was the most common microscopic surgical approach. Limb shortening was 0-3 cm in operated as compared to 3-25 cm in nonoperated neonates [p<0.05]. Neonates who could not achieve biceps flexion during the first 3 months should be scheduled for reconstructive surgery, mainly with nerve grafting

[ serum levels of Th1 and Th2 cytokine profiles in patients with different stages of chronic kidney disease]

Various abnormalities of the immune system have been demonstrated in patients with chronic kidney disease [CKD]. Patients with CKD commonly present with abnormalities of immune function related with impaired kidney function and the accumulation of uremic toxins. Th1 and Th2 cells produce predominantly some cytokine profiles. The aim of the present study was the determination of the levels of IL-13 and IFN-gamma in sera of end-stage renal disease. The correlations of IL-13 and IFN-gamma levels with clinical presentation of the disease were assessed. In this case-control study the serum levels of IL-13 and IFN-gamma were determined by a sandwich enzyme-linked immunosorbent assay in 30 patients on hemodialysis [HD], 30 patients with chronic renal failure [CRF], and 60 healthy individuals. Renal function was evaluated by measuring serum levels of creatinin, albumin and urea. The serum levels of IL-13 and IFN-gamma were differed significantly between patients and healthy controls. The serum levels of IL-13 was significantly increased in the HD group than in the CRF and control groups [13.7 +/- 3.9, 6.7 +/- 3.4, 4.5 +/- 3.3 pg/ml, respectively] [P=0.001]. On the other hand, the IFN-gamma plasma levels were significantly higher in CRF patients than HD patients and controls [38.8 +/- 18.8, 17.4 +/- 8.78, 12.5 +/- 8.9 pg/ml, respectively]. In the HD patients, low production of IFN-gamma in line with upregulation of IL-13 indicates that Th1/Th2 balance may shift towards Th2 dominance. It is possible that this imbalance contributes to the abnormality of the immune system in HD patients

Spinal accessory neurotization for restoration of elbow flexion in avulsion injuries of the brachial plexus

Avulsion injury of the brachial plexus is a disease of middle-aged population and is associated with psychological and economical problems. The present study demonstrates our 10-year experience with spinal accessory neurotization for restoration of elbow flexion in affected subjects in Tehran. During this clinical trial, 32 patients undertook spino-bicipital procedure, of whom 14 were treated with fascia lata to transmit biceps force to 2[nd]-5[th] flexors. Three years later patients were reevaluated for flexor performance.Medical Research Council [MRC] grading for these patients were as follow; MRC4: 21 patients [67%], MRC3: 8[25%], MRC2: 2[6%] and MRC1: in one patient [3%]. Of 14 MRC4-patients who were treated with fascia lata, 9 [64%] could carry a 9kg weight and 5 [36%] could carry a 4kg weight. Elbow flexion of 90? and wrist flexion of 25-30 were seen in all patients.Spinal accessory neurotization can be safely employed for restoration of elbow flexion in avulsion injuries of the brachial plexus