Outcomes of patients with humerus fracture under treatment with PHILOS plate.

BACKGROUND: Based on the contradictory results about the effect of an intramedullary nail in the treatment of humeral shaft fracture, in this study, we aim to evaluate the outcomes of patients with humeral fracture treated with PHILOS plaque. METHODS: In this cross-sectional study, which was performed to evaluate the recovery rate of patients with humeral fracture treated with PHILOS plaque referred to Shahid Beheshti Hospital in Abadan-Iran during 2015-2019. Constant Shoulder Score was evaluated six months and one year after the operation. RESULTS: The mean constant shoulder score was increased significantly after 1 year compared to 6 months (P<0.001). The means of constant shoulder score 6 months in type 4 of fracture was significantly higher than type 3 of fracture (P=0.03) but there was no significant relationship between the means of constant shoulder score 1 year after surgery and type of fracture. CONCLUSION: We suggest that orthopedic surgeons should pay more attention to the usage of PHILOS plate in patients with humerus fractures especially the type 4 fracture.

Modified Camitz versus BRAND Procedures for the Treatment of Severe Carpal Tunnel Syndrome: A Comparative Trial Study.

BACKGROUND: Carpal tunnel syndrome (CTS) is characterized by complications such as pain, paresthesia, and numbness in the fingers. There are some surgical therapies for the management of severe carpal tunnel, but differences exist between the treatments available for creating the opposition. The current study was conducted to compare the effect of modified Camitz and BRAND techniques on thumb opposition in patients with severe CTS. METHODS: A total of 40 patients with severe CTS who were candidates for opponensplasty were enrolled in this clinical trial study at Alzahra and Kashani hospitals, Isfahan, Iran, from 2014 to 2018. The patients were divided into two groups of modified Camitz and BRAND. Quick DASH-9 and Kapandji scores as well as pulp and side pinch and pronation angle were assessed before and after the surgeries. RESULTS: Quick DASH-9 score, Kapandji score, pulp and side pinch and pronation angle significantly improved post-operatively (P=0.0XXX, P=0.0XXX, P=0.0XXX, P=0.0XXX, and P=0.0XXX, respectively). But, no significant differences were seen in the mentioned variables between both groups pre and post-operative (P>0.05, for all the studied variables). No postsurgical complications were seen in any of the groups. CONCLUSION: The findings of the present study demonstrated that, both Modified Camitz and BRAND techniques are effective and safe techniques, yielding high improvements, but no serious complications. Both techniques can be considered for treatment of patients with severe CTS.

A survey on prognosis of anterior cruciate ligament (ACL) reconstruction surgeries following fixed loop and adjustable loop methods.

BACKGROUND: Anterior cruciate ligament (ACL) rupture is an important disease in the younger population and especially professional athletes followed by trauma. There are different surgical methods for repairing ACL rupture each having their own prognosis rates. Here in this study, we investigated and compared results of ACL reconstruction after the fixed loop and adjustable loop surgical procedure in patients with ACL rupture. METHODS: In this study, we evaluated 60 patients with ACL rupture and divided them into two groups each containing 30 patients. Fixed loop and adjustable loop ACL repair were performed for each group. Data regarding knee society score, static laxity, and joint range of motion (ROM), patient's satisfaction and returning to normal daily activities were collected and compared between two groups after 6 months follow up using SPSS software. RESULTS: We showed that there was no significant difference between two groups of patients regarding investigated factors (P>0.05). No surgical site infections were also observed during the study. CONCLUSION: Both fixed loop and adjustable loop grafting procedures for ACL repair indicate beneficial results and are effective in patients with ACL rupture. We suggest that orthopedic surgeons could use each of these methods according to their own experience and the patient's condition. There are no significant differences between these two methods in the prognosis of patients.

Clinical presentation of carpal tunnel syndrome with different severity: a cross sectional study.

Background: Carpal tunnel syndrome is a common neuropathy in the hand which presented with pain and paresthesia in the hands and the wrists. The aim of our study was evaluated clinical symptoms of patients with different severity of CTS. Methods: This study is a cross-sectional study was performed on 40 patients referred to Emam khomeyni Hospital in Tehran from 2017 to late 2019 with symptoms of CTS and have been diagnosed with a definite diagnosis. Results: A positive significant correlation was between severity of CTS and age, and reverse significant correlation was between severity of CTS with duration of symptoms. There were significant relationships between severity of CTS and shaking or ringing the hands symptoms, weakness or atrophy of the flexion test and reverse phalen test (P < 0.05). Conclusion: Clinical symptoms of CTS can be diagnosing different severity of disease, so considering of symptoms can plays a predominant role in the diagnosis of the disease.

Emergency peripartum hysterectomy in Isfahan; maternal mortality and morbidity rates among the women who underwent peripartum hysterectomy.

BACKGROUND: Peripartum hysterectomy is associated with significant morbidity and mortality. We determined the factors leading to and maternal mortality and morbidity rates among the women whose underwent peripartum hysterectomy in Iran. MATERIALS AND METHODS: This case-series study was conducted from March 2004 to March 2009 in the Department of Gynecology and Obstetrics at two central university hospitals (Azahra hospital and Shahid Beheshti Hospital) in Isfahan. Forty one women among 29,444 deliveries underwent peripartum hysterectomy. Women who had delivery before 24 weeks and a hysterectomy for other reasons like sterilizations were excluded. Incidence, indications and maternal complications including maternal death and urological, infectious and wound complications were evaluated after operation. RESULTS: During the study period, the incidence of peripartum hysterectomy estimated about 1.39 per 1,000 deliveries. The maternal mortality rate was 17.07%. There was no statistical difference in mortality rates between referrals and non-referrals women (P = 0.6). Post-operative complications included infection (22%), bladder injuries (7.3%), urine retention (4.8%) and wound dehiscence (4.87%). The main indication was placenta accreta 28 (68.3%). CONCLUSION: This study indicated the high rate of mortality among patients underwent peripartum hysterectomy. Evaluation of management during referring the patients and designing more studies to evaluate the mortality and morbidities are warranted.

Accuracy of amniotic fluid lamellar body counting for evaluating fetal lung maturity.

BACKGROUND: Respiratory distress syndrome (RDS) is one of the important causes of mortality in neonates. This study was designed to assess the role of the amniotic fluid lamellar body counting in predicting fetal lung maturity. METHOD: This study was conducted during 2010, April to 2011, February, at Isfahan University of Medical Sciences, Isfahan, Iran. One hundred and twenty eight amniotic fluid samples were obtained during normal delivery, or before rupturing the membrane in cesarean, and lamellar body was assessed by cellular counter. The respiratory statuses of neonates were determined at delivery and the optimal cut-off point was assessed by receiver operating characteristic (ROC) curve. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were evaluated in optimal cut-off point. RESULTS: One hundred and twenty eight amniotic samples and 131 infants were evaluated. The means of maternal and gestational ages were 28.12 +/- 3.84 years and 32.56 +/- 2.72 weeks, respectively. The mean of lamellar body was 31266 +/- 15831 microl in matured lung infants compared to 63081 +/- 16966 microl in immature lung infants (p < 0.001). The optimal cut-off point was evaluated as 47500 microl in predicted pulmonary maturity with sensitivity of 85.1%, specificity of 91.2%, positive predictive value of 92.6% and negative predictive value of 82.5%. CONCLUSION: This study indicated that lamellar body counting test has a high positive predictive value with a good sensitivity, specificity and negative predictive value. Future studies for different cellular counters are warranted.