[Waldenstrom's Macroglobulinemia in Cryptogenic Cirrhosis]

The coexistence of Waldenstrom's macrglobulinemia and cryptogenic cirrhosis has been rarely reported.We describe a 72-year-old man with compensated cryptogenic cirrhosis whose major clinical presentation was hyperviscosity syndrome. Serum protein electrophoresis revealed the presence of an IgM-kappa spike. Lambda light chain was found in urine. Bone marrow biopsy was performed, which showed at least 22%infiltration with atypical plasma cells. No bone lesion was found. ByWaldenstrom'smacroglobulinemia diagnosis, patient treated with melphalan, thalidomide and dexamethasone. After three weeks of treatment, his symptoms disappeared and serum immunoglobuline M decreased below 1000 mg/dl

[Evaluation of surgical complications after cochlear implantation in Fars center, south of Iran]

Cochlear implant, which used in patients with profound hearing loss, may followed by some major or minor complications. These complications depend on age of patient, kind of device, kind of incision, surgical technique and surgeon's skill. Major complications mostly need surgical intervention for treatment and, may persist for long time. Minor complications need medical treatment and don't need surgical intervention. In this descriptive study between 2004-2007, 100 patients subjected to cochlear implantation were evaluated for post operative complications. Overall complication rate was 14%. We had 4 major complications, including 2 device failure, one misplaced electrode and one cases with major hematoma. These complications managed successfully by surgical intervention or reimplantation. Facial nerve damage or wound breakdown were not seen in these patients. Minor complications including small hematoma, edema, wound infection, dizziness were seen in 10 cases that managed medically. In the recent years complications of cochlear implantation are reduced with increasing surgeon's skill, new surgical methods and development in device technology

Epidemiologic and ethiologic evaluation of deep neck infection in Shiraz Khalili hospital during 1996 - 2005

infections of the head and neck spaces are serious and dangerous due to vicinity to the great vessels and mediastinum. The most common source of infection leading to head and neck space abscess, are dental infection. This retrospective study was performed to determine the prevalence of head and neck space infections following dental infections, the spaces involved, the most common microorganisms involved in these infections and to determine the prevalence of head and neck space infections according to age and sex of the patients. In this retrospective study, the charts of 241 patients with head and neck space infections referring to Khalili hospital during the past 10 years was reviewed and data well assessed. The most common source of head and neck space infections was dental infections occurring in 141 patients [58.5%]. From these 141 patients, 79 patients were male and 62 patients were female. The most common age of involvement was the 3[rd] decade [39 patient 27.6%]. The second most common cause was tonsillitis occurring in 33 patients [13.7%]. The most common spaces involved in 141 patients with head and neck space infection following dental infections, were: simultaneous involvement of submandibular, sub mental and sublingual space bilaterally [Ludwig's angina] in 53 patients [37.6%] followed by sumbandibular space in 45 patients [31.9%] and Para pharyngeal space in 37 patients [26.2%]. Culture has been performed in only 34 patients from which bacterial growth occurred in 18 cases. The most common organism was non hemolytic streptococci [11 cases]. Head and neck space infection are dangerous and life threatening conditions that occur most commonly following dental infections so it seems that escalating the general knowledge about oral health, increasing dentistry centers and early and proper management of dental infections have a major role in reducing the incidence of head and neck abscesses

[Comparative assessment of diagnostic value of electrodiagnostic methods and radiologic evaluations in patients with clinical signs of cervical radiculopathy]

Cervical radiculopathy is one of the most common diseases that must be diagnosed early and properly to prevent its serious side effects. For this purpose different paraclinical methods such as MRI, X-ray, EMG, NCV and SSEP are used. Each of these methods has its limitations and some of them are expensive or invassive. The aim of this study was to compare the electrodiagnostic and radiologic methods in diagnosis of cervical radiculopathy. In this study 36 patients [22 Female, l4 Male] with complaint of cervical pain radiated to upper limbs were evaluated. The evaluation included EMG, NCV, MRI, X-ray and SSEP. Exclusion criteria were fracture dislocation and infection of bone joints or soft tissues .MRI and X-ray were performed in MRI centers of Isfahan, Sepahan and Alzahra hospital in Isfahan city. MRI was graded on severity of 1 to 3. EMG, NCV and SSEP were performed in electrodiagnostic center of Alzahra hospital by one professional technician. Results were compared with text books and analyzed by SPSS software. Sensitivity of SSEP was 28.6% and specifity was 100%. Partial agreement between SSEP and MRI existed in moderate and severe cervical involvements [P = 0.005]. Frequencies of abnormalities were: EMG 50%, NCV 5.6%, X-ray 33.3% and MRI 77.8%. This study shows that SSEP has lower value than EMG in diagnosis of cervical radiculopathy. Also in a patient with cervical radiculopathy, cervical MRI and EMG of upper limbs are necessary. SSEP abnormalities in the presence of moderate and severe MRI changes such as myelopathy, are more valuable. Therefore, SSEP in cervical radiculopathy is recommended before surgery

[ comparison of acute and delayed psychological effects of motor vehicle accidents in individuals referred to Imam Hossein Hospital of Shahroud in 2004]

Psychological complaints are common after motor vehicle accidents [MVA] and might be strong predictors for long term complications and problems of the accidents. This study was performed to compare the acute and delayed psychological complications of MVA in Shahroud. The sample consisted of 42 MVA victims selected by unrandomized sampling from those referred to Imam Hossein hospital. The general health questionnaire [GHQ] and symptom checklist-90-revised [SCL-90-R] were used for evaluating psychological symptoms and screening psychological patients. The mean scores of each psychological dimension in 4 phases: reception time, one, three and six months after the accident were obtained and were compared with statistical tests [t-test, repeated measures ANOVA and one-way ANOVA]. The average age of the sample was 24.4 +/- 8.5 years. The mean score of all psychological dimensions, except summarization and obsessive compulsive dimensions, increased from reception time to one month and 3 months later [p<0.05]. Then the scores decreased to 6 months after the accident time [p<0.05]. Three months after the accident time, unmarried patients had a higher score of depression compared to the married ones [p<0.05]. The mean scores of depression, phobic, paranoid and psychoticism were higher [p<0.05] in unemployed versus employed persons. Based on our results, the psychological problems started from accident time until 3 month later. Therefore, the fast and early diagnoses of the complications, use of appropriate pharmacological and psychological interventions, also effective planning for their rehabilitation are both essential and important

[Environmental risks of cleaning industries in Iran]

Population growth in the world has lead to a need for providing health, removing pollutants, and developing cleaning industries resulting in the consumption of more energy as well as petrochemical and natural raw material. This has caused the introduction of more pollution into the environment. Of the whole crude oil consumed in the world, 1% is used for the production of surfactants having capacity to emit CO[2] on a large scale. On the other hand, the wastes and waste water resulting from the activity of these industries need to be attended more both qualitatively and quantitatively because of having toxic material with low biologic potential for disintegration. The existence of hard detergents of ABS and other compounds which have physicochemical structures, thus having detrimental effects on environment, also shows the importance of attention to these wastes and wastewater. Moreover, regarding the high development of these industries, also considering the production of 420584 tons of powder and other products each year as well as a high production of wastes and wastewater which are left untreated in the environment, it calls a need to control these and their consequences. So, in this study it has been attempted to clarity the type and rate of these waste products as well as the wastes resulting from cleaning industries in Iran, and proper strategies to modify their health and environmental effects