Tuberculosis case-finding and treatment in the central prison of Qazvin province, Islamic Republic of Iran

As a part of a comprehensive programme of tuberculosis [TB] control in the central prison in Qazvin, Islamic Republic of Iran, a programme of active case-finding was carried out from February 2004 to July 2005. From the 768 prisoners examined, 41 [5.3%] were suspected of TB and gave sputum samples. A total of 7 smear-positive TB cases were found, giving a TB prevalence in the prison of 910 per 100 000, 113 times the total TB prevalence in Qazvin province in the same year. From 7 diagnosed and treated patients, 4 were cured with the category 1 standard regimen, 1 completed treatment and 2 failed to complete treatment. Improvements are needed in TB case recognition of prisoners, especially newcomers

Dose tunneling the temporary vascular access extend its lifetime?

It is important that a reliable vascular access or dialysis catheter be available for doing replacement therapy in cases with uremia syndrome. Life time of a temporary access depends on its location; overall its life time is 2 to 3 weeks for Jugular vein. Regarding short life time of these temporary accesses, it is necessary to find a clinical way to increase the life time of such accesses. It seems that tunneling the temporary uncuffed access, prolongs its life time and reduces its complications, as well as its cost. This study was a prospective clinical trial, which has been done on 30 cases with uremia syndrome without usable vascular accesses who were divided into two groups, randomly. Inclusion criteria were acute renal failure and end stage renal failure with different etiologies. All of them had got temporary vascular accesses because of their need to emergency hemodialysis. The type of used accesses, was used the same [arrow] in all cases. Patients were followed up once a week for checking the fistula or returning of kidney function in cases who had acute renal failure. Presence of inflammation, redness, pus formation, bleeding, and sutures of the entrance site were checked weekly. Life time of catheter was determined as the time of its insertion to the time of its extraction, in weeks. Data analysis was done by SPSS [version 12] and expressed by mean and variance. One case out of 30 selected subjects was excluded because of poor cooperation with clinicians. Thirteen females and 16 males [44.8% vs. 55.2%] were treated in two groups; the first group or tunneled group included 14 cases, and the second group, non-tunneled group, included 15 cases. Mean of age and length of neck showed no significant differences between two groups. Nine cases had fever before catheterization, however there wasn't any relationship between life time of catheter and fever in both groups [P=0.49 and 0.24, respectively]. In this research, the most common reason for releasing the catheter in both groups was the fever due to catheter related infection, only [78.6% in tunneled group and 80.00% in non-tunneled group]. Mean life time of catheter in tunneled group was 6.71 +/- 0.9 weeks and, in cases of non-tunneled group it was 4.53 +/- 0.8 weeks; this difference was statistically significant between two groups [pvalue= 0.0017]. Subcutaneous tunneling the temporary vascular access can extend the lifetime of catheter and reduce its subsequent dangers and related costs due to repeated catheterization, with respect to routine method

Captopril for prevention of contrast induced nephropathy in patients undergoing coronary angioplasty: a double blind placebo controlled clinical trial

Contrast induced nephropathy is a potential cause of mortality and morbidity in patients undergoing angiography-angioplasty. Except for hydrating and probably low - isoosmolar contrast agents in high risk groups, other modalities have not provided benefit. We investigated preventive effects of captopril for contrast induced nephropathy during angiography-angioplasty. In a double blind placebo controlled clinical trial, 88 patients were randomized to two groups: 42 patients received captopril [12.5 mg] every 8 hours from 2 hours before the procedure until 48 hours thereafter, and 46 patients received placebo in the same manner. Serum creatinine was measured before and 48 hours after angioplasty. The data were analyzed by SPSS software, using unpaired student t-test for comparing mean creatinine rise in both groups and paired student t-test for the changes in serum creatinine in each group. The mean creatinine rise in captopril group [0.214 mg/dl] and placebo group [0.226 mg/dl] were not significantly different. The incidence of acute renal failure [creatinine rise more than 0.5 mg/dl] in the captopril [11.9%] and placebo group [10.8%] were not significantly different. Captopril does not effectively prevent contrast nephropathy, but it is not harmful for renal function and can be administered safely during angiography - angioplasty in patients with normal renal function. However, the effect of captopril in patients with high- risk characteristics remains to be clarified. Of note, we found a trend for less creatinine rise in diabetics who received captopril during the procedure in comparison to diabetics who received placebo

[Assessment of anatomical relationship between impacted lower third molar tooth and mandibular canal in panoramic view of men and women between ages 20-70 years old]

Background: It is likely that the inferior alveolar nerve injury occurs following the removal of the lower third molars due to the anatomic proximity. So preoperative radiographic assessments are necessary to determine the position of the mandibular canal. Radiography is the most standard technique for assessing the anatomic relationship between the third molars and the mandibular canal. Panoramic view can help to determine the relationship and position of the mandibular canal to the mandibular third molar

Materials and Methods: 664 panoramic radiographs of the individuals aged 20-70 years who showed 1128 impacted third molars were assessed. Photos of these panoramic images were obtained with a digital camera in similar conditions. The incidence of proximity of the root tips of the third molars and mandibular canal [in range of 2 and 3 mm] was detected. Four radiological signs [deflected roots, diversion of the canal, interruption of the cortical white line of the canal and the narrowing at the canal] were recorded in both sides and in different ages

Results: From 1128 impacted mandibular third molars, %79.3 had 2 roots and %20.7 had one root. In the teeth the roots of which had a distance with the mandibular canal, the proximity was observed in females more than in males. There was no significant relationship between proximity and age. In 558 teeth, one or both roots were superimposed over the mandibular canal. In those cases, there was no statistically significant relation between superimposition and age and sex. Deflection of the root and interruption of the white line of the canal were observed in the right side more than the left side. Diversion of the canal was seen more in the LT side. Narrowing of the canal showed no difference among the patients

Conclusion: In the present research, in significant cases of impacted third molars [in both gender and in both sides] there are radiographical signs for proximity of the mandibular canal and the root of impacted third molars, which increases the risk of inferior alveolar nerve injury