ORIGINAL_ARTICLE
The Role of Ultrasonography Guided Transthoracic Needle Biopsy in Diagnosis of Peripheral Pulmonary Mass
I ntroduction: Transthoracic needle biopsy (TNB) is a well established method for obtaining pathologic diagnosis in the lung masses that is performed after a previous negative bronchoscopy. The goal of this study was evaluation of the safety and accuracy of ultrasonography guided TNB in diagnosis of peripheral lung masses. Material and Methods: This descriptive study was done from 2005 to 2006 in Ghaem Hospital. 30 patients with peripheral lung mass, greater than 3cm in diameter and within 5cm from the chest wall, underwent ultrasonography guided TTNB. Data was gathered in a questionnaire and analyzed by descriptive statistics and frequency distribution tables. Results:Male to female ratio was about 1:2, and mean age was 61.2 years. 60% lesions were located in the right side. Adequate biopsy specimens were obtained in all patients; but TNB was diagnostic in 86.6%, 13.3% patients underwent thoracotomy for definitive diagnosis. Pathological diagnoses were malignant in 83.3%, with SCC and ACC being the most common, and benign in 16.6%, the most common of which was tuberculosis. Complications were observed in 13.3%, including pneumothorax in 6.6%, and hemoptysis in 6.6%; mortality was not observed. Conclusion:According to this study, TNB with ultrasonography guide due to appropriate diagnostic accuracy and low complication rate with low cost and good availability is recommended for diagnosis of peripheral lung mass.
https://mjms.mums.ac.ir/article_5568_4c3f55941089ba685c32508a13729273.pdf
2007-06-22
117
122
10.22038/mjms.2007.5568
TNB
Ultrasonography
peripheral lung mass
R
Bagheri
1
فوق تخصص جراحی توراکس
LEAD_AUTHOR
Z
Haghi
2
فوق تخصص جراحی توراکس
AUTHOR
M
Rahrouh
3
متخصص رادیولوژی
AUTHOR
M
Kalantari
4
متخصص پاتولوژی
AUTHOR
A.
Sadrizadeh
sadrizadeha@mums.ac.ir
5
فوق تخصص جراحی توراکس
AUTHOR
1-Yung RC, Tissue diagnosis of suspected lung cancer: selecting between bronchoscopy, transthoracic needle
1
aspiration, and resectional biopsy. Respir care clin N AM 2003Mar; 9(1): 51-76
2
2-Chen CC, Hsu WH, Huang CM, Hsu JY, et al. Ultrasound-guided fine needle aspiration biopsy of small pulmonary
3
nodules abutting to the chest wall. Zhonghua Yi Xue Za Zhi (Taipei) 1996 Feb;57(2): 106-11
4
3-Collins CD, Breatnach E, Nath PH, Percutaneous needle biopsy of lung nodules following failed bronchoscopic
5
biopsy. Eur J Radiol 1992 Jul-Aug;15(1): 49-53
6
4-Hayes MM, Zhang DY, Brown W. Transthoracic fine-needle aspiration biopsy cytology of pulmonary neoplasms
7
.Diagn Cytopathol, 1994, 10(4): 315-9
8
5-Silit E, Kizilkaya E, Okutan O, Pekkafali Z, et al. CT fluoroscopy-guided percutaneous needle biopsies in thoracic
9
mass lesions. Eur J Radiol 2003 Nov; 48(2): 193-7
10
6-Targhetta R, Bourgeois JM, Marty-Double C, Coste E, et al. Peripheral pulmonary lesions: ultrasonic features and
11
ultrasonically guided fine needle aspiration biopsy. J Ultrasound Med 1993 Jul; 12(7): 369-74
12
7-Liao WY, Chen MZ, Chang YL, Wu HD, et al. US-guided transthoracic cutting biopsy for peripheral thoracic lesions
13
less than 3 cm in diameter. Radiology 2000 Dec; 217(3): 685-91.
14
8-Pan JF, Yang PC, Chang DB, Lee YC, et al. Needle aspiration biopsy of malignant lung masses with necrotic
15
centers.Improved sensitivity with ultrasonic guidance. Chest 1993 May; 103(5): 1452-6.
16
9-Gouliamos AD, Giannopoulos DH, Panagi GM, Fletoridis NK, et al. Computed tomography-guided fine needle
17
aspiration of peripheral lung opacities.An initial diagnostic procedure. Acta Cytol 2000 May-Jun; 44(3): 344-8.
18
10- Sagar P, Gulati M, Gupta SK, Gupta S, et al. Ultrasound-guided transthoracic co-axial biopsy of thoracic mass
19
lesions. Acta Radiol 2000 Nov; 41(6): 529-32
20
11- George CJ, Tazelaar HD, Swensen SJ, Ryu J. Clinicoradiological features of pulmonary infarctions mimicking lung
21
cancer. Mayo Clin Proc 2004 Ju; 79(7): 895-8
22
12- Arslan S, Yilmaz A, Bayramgurler B, Uzman O, et al. CT-guided transthoracic fine needle aspiration of pulmonary
23
lesions:accuracy and complications in 294 patients. Med Sci Monit 2002 Jul; 8(7): 493-7
24
13- Lattin G Jr, O,Brien W Sr, Mccrary B, Kearney P, et al. Massive systemic air embolism treated with hyperbaric
25
oxygen therapy following CT-guided transthoracic needle biopsy of a pulmonary nodule. J Vasc Interv Radio 2006
26
Aug; 17(8): 1355-8
27
14- Aviram G, Schwartz DS, Meirsdorf S, Rosen G, et a. Transthoracic needle biopsy of lung masses: a survery of
28
techniques. Clin Radiol 2005 Mar; 60(3): 370-4.
29
ORIGINAL_ARTICLE
Investigation of Antipsychotic Induced Parkinsonism in Patients with Schizophrenia
I ntroduction: Antipsychotic drugs have an important role in psychiatric treatment. Their side effects such as drug induced Parkinsonism, which has been a historical challenge for patients and physicians, account a major cause of treatment rejection by the patients. Drug induced Parkinsonism is the second cause of Parkinson syndrome. The aim of this study was to evaluate antipsychotic induced Parkinsonism in patients with schizophrenia. Material and Methods: This cross sectional descriptive study was done in the year 1999 in Noor and Shariaty Hospitals of Isfahan. 200 patients with schizophrenia, affected with Parkinsonism complication, were investigated. Variables were sex, age, dosage and group of drug, duration of treatment, Parkinsonism criteria and simultaneous anti cholinergic prescription. Data was gathered in a questionnaire and analyzed by descriptive statistics and frequency distribution tables. Results: 122 men and 78 women were studied. 26.5% of patients had drug induced Parkinsonism, which was mostly seen in women (32% versus 22.9% in men), higher age (10-19 years: 0%, 50 years and higher: 33%), and when anticholinergic was not used simultaneously (35.7% versus 25% in anticholinergic users group). Prevalence of Parkinsonism, in high, medium, and low drug potentials was 28.7%, 29.4% and 19.2%, respectively. Differences in all of the above groups were not significant. Prevalence increased in dosage of less than 100mg (chlorpromazine equivalent dosage) versus 101-300mg (p>0.05), and in 3-6 months after onset of treatment (p<0.05). The most prevalence criterion was rigidity (84.9%). Parkinsonism was diagnosed in 11.76% of patients using atypical drug (clozapin). Conclusion: Anti psychotic induced Parkinsonism increased in higher ages, women and when anticholinergic was not used simultaneously. This side effect was found in all groups even with clozapin. It had a greater prevalence in the beginning of treatment but decreased with treatment continuation and anticholinergic prescription. Future studies particularly on the atypical groups are suggested.
https://mjms.mums.ac.ir/article_5569_ace126c1c7f6b205413679a811777e6a.pdf
2007-06-22
123
130
10.22038/mjms.2007.5569
Schizophrenia
Antipsychotic drug
Parkinsonism
Anticholinergic
GH
Ahmadzadeh
1
دانشیار بیماریهای اعصاب و روان دانشگاه علوم پزشکی اصفهان،
LEAD_AUTHOR
M
Forooghipoor
foroughipourm@mums.ac.ir
2
دانشیار بیماریهای مغزو اعصاب
AUTHOR
M
Babaeian
3
دستیار داخلی
AUTHOR
S.
Rezaie
4
دستیار گوش و حلق و بینی- دانشگاه علوم پزشکی مشهد
AUTHOR
1- Sadock BJ, Sadock V.A .Comprehensive text book of psykhiatry.7th ed. Philadelphia: Lippincott Williams and
1
Wilkins; 2000.
2
2- Kaplan HI.Synopsis of Psychiatry. Philadelphia: Lippincott Williams and Wilkins; 1998.
3
3- Rowland LP. Merritt,s neurology.10th ed. USA Philadelphia: Lippincott Williams and Wilkins;2000.
4
4- Cardoso F, et al. Etiology of Parkinsonism in a Brazillian movement disorders clinic. Neuropsiquiatr 1998 Jun;
5
56(2): 171-5.
6
5- Abad JM. Drug induced Parkinsonism clinical aspects compared with parkinson disease. Rev Neurol 1998 jul;
7
27(155):35-9.
8
6- Chabolla DR. Drug induced parkinson as a risk factor for parkinson disease a historical cohort study in olmsted
9
county mayo-clin. Proc 1998 Aug; 73(8):724-7.
10
7- Dhavale HS, et al. Prophylaxis of antipsychotic-induced extrapyramidal side effects in east indians: cultural
11
practice or biological necessity. J Psychiatr Pract 2004 May; 10(3):200-2.
12
8- Lambert, et al. Impact of present and past antipsychotic side effects on attitude toward typical antipsychotic
13
treatment and adherence. Eur psychiatry 2004 Nov; 19(7):415-22.
14
9- Schillevoort I, et al. Antipsychotic-induced extrapyramidal syndromes in psychiatric practice: a case-control
15
study. Pharm world Sci 2005 Aug; 27(4):285-9.
16
10- Carnahan RM, Lund BC, Perry PJ, Chrischilles EA. Increased risk of extrapyramidal side-effect treatment
17
associated with atypical antipsychotic poly therapy. Acta Psychiatr Scand 2006 Feb; 113(2):134-41.
18
11- Park S, et al. Effect of switching antipsychotics on antiparkinsonian medication use in schizophrenia:
19
population-based study. Br J Psychiatry 2005 Aug; 187:137-42.
20
12- Honer Wg, kopola LC, Rabinowitz J. Extrapyramidal symptoms and signs in first-episode, antipsychotic
21
exposed and non-exposed patients with schizophrenia or related psychotic illness. J Psychopharmacol 2005 May;
22
19(3): 277-85.
23
13- McCreadie RG, Srinivasan TN, Padmavati R, Thara R. Extrapyramidal symptoms in unmedicated schizophrenia.
24
J Psychiatr Res 2005 May; 39(3): 261-6.
25
ORIGINAL_ARTICLE
Role of Fibrin/Fibrinogen Degradation Products in Prognosis of Patientswith
Head Trauma
I ntroduction: Accident is the third common cause of mortality in population .Traumatic head injury is the most common cause of mortality among these events. In different studies, coagulation disorder is one of the most important factors for determination of severity of injury. The present study was designed to evaluate post traumatic fibrinolysis in adults after head injury. Material and Methods: In this descriptive cross sectional study, ninety six patients (22 patients with mild head injury and 74 patients with severe or moderate head injury), who admitted in Mashhad Shahid Kamyab Hospital for six months, were chosen randomly. All of them had only head injury and admitted in hospital in less than 6 hours after trauma. The clinical & paraclinical findings including FDP were evaluated. Data was gathered in a questionnaire and analyzed by descriptive statistics and frequency distributes tables. Results:Most cases of delayed hematoma happened within 14 hours of trauma. FDP value was correlated with severity of head injury and there was a meaningful correlation between FDP value and GCS. Higher FDP was seen with lower BMR, and vise versa. The most common cases with delayed hematoma were intracerebral hematoma. Conclusion: FDP may be a valuable predictive factor in traumatic head injury and changes in coagulation cascade may improve the outcome of patients with traumatic head injury.
https://mjms.mums.ac.ir/article_5570_5c7e7833ba1259e6854599b78fae73e2.pdf
2007-06-22
131
136
10.22038/mjms.2007.5570
Head injury
coagulation disorder
FDP
BMR
GCS
M
Ehsaee
000@ئعئس.شز.هق
1
دانشیار
LEAD_AUTHOR
Gh
Bahadorkhan
2
دانشیار
AUTHOR
F
Samini
سشئهدهب@ئعئس.شز.هق
3
استادیار - جراحی مغزو اعصاب دانشگاه علوم پزشکی مشهد
AUTHOR
1-YoumansJR.Youmans neurological surgery, 4th ed. v3. Philadelphia: W.B Saunders; 1996.
1
1618-1708.
2
2- Kushimoto S, Vamamoto Y, Shibata Y, Sato M., Koido Y. Implications of excessive fibrinolysis and jalphaplasmin
3
inhibitor deficiency in patients with sever head injury. Neurosur 2001; 49 (5): 1084-1090.
4
3- Corner KR, Lee KS, Kelly DL Jr. Correlation of admission fibrin degradiation products with outcome and
5
respiratory failure in patient's with sever injury. Neurosur 1998 Oct; 43(4): 532-36.
6
4- Vavilala MS, Dunbar PJ, Rivara FP, Lam AM. Coagulopathy predicts poor outcome following head injury in
7
children less than 16 years of age. J Neurosur Anesthesiol 2001; 13:13-18.
8
5-Cafferata HT, Robinson AJ, Aggeler PM, et al. Intravascular coagulation in the surgical patient. Amer J Surg
9
1969; 118: 281.
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6-Attar S, Hanashiro P, Mansberger A et al. Intravascular coagulation reality or myth. Surgery 1970; 68: 27.
11
7-Pondaag W. Disseminated intravascular coagulation related to outcome in head injury. Acta Neurochir Suppl
12
(Wien) 1979; 28: 98-102.
13
8-Preston FE, Malia RG, sworn MJ, et al. Disseminated intravascular coagulation as a consequence of cerebral
14
damage. J Neurol Neurosurg Pychiatry 1974; 37: 241-8.
15
9-Van der Sande JJ, Velt Kamp JJ et al. Head injury and coagulation disorders. J Neurosurg 1978; 49: 357-65.
16
10- Olson JD, kaufman HH, Moake et al. The incidence and significance of homeostatic abnormalities in patients
17
with head injuries. Neurosurgery 1989; 24: 825-32.
18
11- Kumuro E, Fukuda A, takemoto Y, Sato M, Kohoma A. [Disturbance of the coagulatory system in patients with
19
head injury in acute phase]. No Shinkei Geka 1985; 13: 53-8.
20
12- Churliaev IuA, Lycher VG, Epifantseva NN, Afanas'ev AG. [Clinico-pathologenetic variants of disseminated
21
intravascular coagulation syndrome in patients with severe craniocerebral trauma]. Anesteziol Reaminatol 1999; 3: 35-7.
22
13- String T, Robinson AJ, Blaisdell FW. Massive trauma. Effect of intravascular coagulation on progression. Arch
23
Surg 1971, 102: 406-11.
24
14- Becker S, Schneider W, Kreuz W, Jacobi G, Schurrer I, Nowak-Gotti U. Posttraumatic coagulation and
25
fibrinolysis in children suffering from severe crebro-cranial trauma. Eu J Pediatr 1999; 158 (3): 5197-5202.
26
15- Kushimoto S, Shibata Y, Yamamoto Y. Implications of fibrinolysis in patients with closed head injury. J
27
Neurotrauma 2003; 20: 357-63.
28
16- Keller MS, Fendya DG, Weber TR. Glasgow Coma Scale preDICted coagulopathy in pediatric traumatic
29
patients. Seminar Pediatric Surg 2001; 10: 12-6.
30
17- Stein SC, Chen XH, Sinon GP, Smith DH. Intravascular coagulation: a major secondary insult in non
31
traumatic brain injury. J Neurosurg 2002; 97: 1373-7.
32
18- Elsner H, Rigamonti D, Corradino G, Schlegel R Jr, Joslyn J. Delayed traumatic intracerebral hematoma: SpatApoplexie
33
report of two cases. J Neurosurg 1990; 73: 808.
34
19- Kaufman HH, Moake JL, Olson JD, Miner ME, duCret RP, Pruess JL, Gildenberg PL. Delayed and recurrent
35
intracranial hematomas related to disseminated intravascular clotting and fibrinolysis in head injury. Neurosurgery
36
1980; 7: 445-9.
37
20- Sawauchi S, Yuhki K, abe T. The relationship between delayed traumatic intracerebral hematoma and
38
coagulopathy in patients diagnosed with a traumatic subarachnoid hemorrhage. No Shinkei Geka 2001; 29: 131-7.
39
21- Kurokawa Y, Hashi K, Uede T, Matsumura S, Kashiwabara S, Ishiguro M. Enlarging of intracranial
40
hemorrhagic lesions and coagulative-fibrinolytic abnormalities in multiple-injury patients. 1989; 17:335-41.
41
22- Riesgo P, Piquer J, Botella C, Orozco M, Navarro J, Cabanes J. Delayed extracranial hematoma after mild head
42
injury: report of three cases. Surg Neurol 1997; 48: 226-31.
43
23- Inamasu J, Nakamura Y, Saito R Horiguchi T, Kanai R, Ichikizaki K. Delayed, but acute progressive epidural
44
hematoma after mild head injury. Am j Emerg Med 2001; 19: 324-5.
45
24- Lapoint LA, Von Rueden KT. Coagulapathes in trauma patients. AACN Clinical issues 2002; 13; 192-203.
46
25- Grenander A, Bredbacka S, Rydvatt A, Arochi R, Edner G, Koskinen LOD, Olivercrona M. Antithrombin
47
treatment in patients with traumatic brain injury, a pilot study. J Neurosurg Anesthesiol 2001; 13; 49-56.
48
ORIGINAL_ARTICLE
Effects of Transcranial Doppler on Therapeutic Decisions in Neurologic Patients
I ntroduction: TCD is an expensive diagnostic investigation for patients and health insurance companies. Based on the therapeutic view, cost-effectiveness of transcranial doppler (TCD) is important in patients with cerebrovascular disease. Material and Methods:This descriptive study was conducted in Neurosonology Center, Ghaem Hospital, Mashhad, within 2006-2007. Indication of TCD was made by neurologists previously. 200 TCD on 166 patients was performed by neurosonologists based on the standard protocol with AKAI device, France and 2MHz probe. The effect of TCD results on changing the dose and type of medicine and neurosurgical consultation of the patients was recorded. Data was analyzed with descriptive statistics and frequency distribution tables. Results: 166 patients (64 males and 80 females) with mean age of 53.4 years were investigated. Abnormal results were found in 27.5% of TCD. Performance of 3D TCD (15%) had influence on therapeutic decisions of the patients. Among this later group, 83% were patients with subarachnoid hemorrhage and 17% had high risk cardiac source of embolism or sever carotid stenosis with recurrent cererbral ischemic events. The cost of 200 TCD in non-private center was evaluated to be about 10 million thomans. Conclusion:Due to high expenses and low percentage of therapeutic influences, performance of TCD is recommended in a restricted group of patients. However TCD is a safe and non-invasive test for assessent of main cerebral arteries, which provide useful information.
https://mjms.mums.ac.ir/article_5571_1e9e40e442bd149e8bf364d0d4aa897c.pdf
2007-06-22
137
142
10.22038/mjms.2007.5571
Transcranial Doppler
Cost-effectiveness
Embolism
K
Ghandehari
ghandeharik@mums.ac.ir
1
دانشیار
LEAD_AUTHOR
M.R
Azarpajooh
azarpazhoohmr@mums.ac.ir, r_azarpazhooh@yahoo.com
2
استادیار - گروه مغزواعصاب، بیمارستان قائم (عج)
AUTHOR
1- Thomas K M,Gomes G R. Hand Book of Transcranial Doppler. Springer – Verlag ; 1997.35-56.
1
2- Tong D C, Albers G W. Normal Values. In: Babikian V L, Wechsler L R.Transcranial Doppler
2
Ultrasonography.second ed.Butterworth-Heinemann.1999. 33-42 .
3
3- قندهاری،کاویان, جعفرنژاد ،مجید. کاربرد و هرینه اکوکاردیوگرافی ترانس توراسیک در بیماران مبتلا به سکته مغزی. مجله افق دانش ، سال یازدهم، شماره 2
4
(سال 1384) ص 26 .
5
4 - Azar pazhooh M R, Chamber BR. Clinical application of transcranial doppler monitoring for embolic signals. J
6
Clin Neurosci 2006; 20 : 20-24
7
5- Ghandehari K, Shuaib A. Prevalence of patent foramen ovale detected by transcranial color coded duplex
8
sonography in cryptogenic stroke patients. IJR, 2004; 2: 51-53.
9
6- قندهاری، کاویان, حسن پور، محمد, صابر، سیامک. تفاوت های همودینامیک مغزبر اساس سن و جنس. مجله علمی دانـشگاه علـوم پزشـکی بیرجنـد ، دوره
10
.34-31 ص (1382)3 شماره ,10
11
٧- قندهاری، کاویان, شعیب، اشفق. مقایسه توپوگرافی تنگی قلمروکاروتید در بیماران سکته مغزی ایسکمیک با دو نژاد آمریکای شمالی و ایرانی. مجله علمی دانشگاه علـوم
12
پزشکی یزد. دوره پنجم , شماره ١٣٨٥)٤) ص٢٠-٢٣ .
13
8 -Ghandehari K. Microembolic signal monitoring in patients with acute stroke. Arch Iranian Med 2002; 5(2): 94-
14
9- قندهاری، کاویان, ایزدی مود، زهرا. کاربرد داپلر ترانس کرانیال در ارزیابی خطر سکته مغزی در بیماران با دریچه مکانیکی میترال. مجلـه پزشـکی هرمزگـان.
15
. 13-8 ص(1385) 10شماره
16
10- قندهاری ،کاویان, ذوالفقاری، علی, جعفر نژاد، مجید, مشرقی مقدم ،حمید رضا, کاظمی، طوبی. مونیتورینگ سیگنال های میکروآمبولی مغزی در بیماران بـا
17
دریچه مصنوعی قلب. مجله علمی دانشگاه علوم پزشکی بیرجند , سال هفتم,شماره 1381)1) ص13-9 .
18
11- Ghandehari K, Izadi mood Z. Effect of Oxygen inhalation on microembolic signals in patients with mechanical
19
Aortic valve. Acta Medica Iranica. 2005; 43: 215-217
20
12- Sloan MA, Alexandrov AV, Tegeler CH, Spencer MP, Caplan LR, Feldmann E. Assessment: transcranial
21
doppler sonographyreport of the therapeutics and technology assessment subcommittee of the American Academy
22
of Neurology. Neurol 2004; 62(9): 1468-1481.
23
13- Bajamani K, Gorman M. Transcranial Doppler in stroke. Bio Pharmaco. 2001; 55 (5): 247-257.
24
14-Nirkko AC, Baumgartner RW. Syncope. Front Neurol Neurosci 2006; 21: 239-250.
25
15 -Klotzsch C, Harrer JU. Cerebral aneurysms and arteriovenous malformations. Front Neurol Neurosci 2006; 21:
26
171-178.
27
ORIGINAL_ARTICLE
The Effect of Topiramate in Treatment of Children with Intractable Epilepsy
I ntroduction: 0.5 to 1% of children are epileptic, and 25% of these patients are resistant to therapy. Uncontrolled seizures produce multiple impairments in personal and social life of the patient. Any reduction in seizure number or obviation of them will raise quality of life and can refine educational, occupational and familial situation of the patient. Multiple studies in adults and children have shown efficacy of topiramate as mono or add-on therapy in reduction of seizures. The aim of this study was to evaluate the effects of this drug on intractable epilepsy. Material and Methods: This study was done as a clinical trial in Pediatric Neurology Clinic of Ghaem Hospital in the year 2005. 24 drug resistant epileptic patients entered the study. In all of them topiramate administered as add-on therapy in a daily dose of 3 mg/kg and increased up to 9 mg/kg, in a therapy period of at least two months. Any change in seizure number, probable side effects of drug consumption, and patients individual data was evaluated and recorded in a questionnaire and analyzed by descriptive statistics and frequency distribution tables. Result: Mean of seizure number of patients was 119.95 per month, which reduced to 53.41 after recieving topiramate. In 25% of patients seizures resolved completely and in 20.9% of them no improvement was noted. The results of this study implied the efficacy of topiramate in reduction of seizure number. Conclusion: Topiramate and other new antiepileptic drugs due to their effectiveness and lesser adverse effects can be used progressively, and in many cases they can be substituted for older antiepileptic agents.
https://mjms.mums.ac.ir/article_5572_b7602d1b35c53e637246e466a4e940a1.pdf
2007-06-22
143
148
10.22038/mjms.2007.5572
Intractable seizure
Topiramate
Drug resistant epilepsy
J
Akhondian
akhondianj@mums.ac.ir
1
دانشیار گروه کودکان
LEAD_AUTHOR
V
Jafari
2
رزیدنت اطفال، دانشگاه علوم پزشکی مشهد- بیمارستان قائم(عج
AUTHOR
1- Bleasel A, Wyllie E. Paroxysmal disorders. In: Practical strategies in pediatric diagnosis and therapy.2nd ed.
1
Philadelphia:Elsevier Saunders; 2004.673-704.
2
2- Shorvon S, Perucca E, Fish D, Dodson E. The treatment of epilepsy. 2nded. Oxford: Blackwell ; 2003.535-
3
3- Easterling D,Zakszewski T,Moyer M,Margul B,Marriot T,Nayak R.Plasma pharmacokinetics of topiramate,a
4
new anticonvulsant in humans.Epilepsia 1988;29:662.
5
4- Nayak R,Gisclon L,Curtin C,Benet L.Estimation of the absolute bioavailability of topiramate in humans without
6
intravenous data.J Clin Pharmacol 1994;34:1029.
7
5- Doose D,Walker SA,Gisclon L,Nayak R.Single dose pharmacokinetics and effect of food on the bioavailability
8
of topiramate,a novel antiepileptic drug. J Clin Pharmacol 1996; 36:884-91.
9
6- Wu W,Heebner J,Streeter A et al.Evaluation of the absorption,excretion, pharmacokinetics and metabolism of
10
the anticonvulsant, topiramate in healthy men.Pharm res 1994;11 (suppl.):s336.
11
7- Glauser T,Miles M,Tang P et al.Topiramate pharmacokinetics in infants. . Epilepsia 1999; 40:788-91.
12
8- Shorven S .D.Safety of topiramate:adverse events andrelationships to dosing. Epilepsia 1996; 37:S18-S22.
13
9- Sachdeo RC, Reife RA, Lim P, Pledger G.Topiramate monotherapy for partial onset seizures. Epilepsia 1997;
14
38:294-300.
15
10- Jayawant S, Libretto SE. Topiramate in the treatment of Myoclonic-Astatic epilepsy in children: a retrospective
16
hospital audit. J Postgrad Med 2003; 49(3):202-206.
17
11- Ferrari AR, Guerrini R, Gatti G, Alessandri MG, Pharm B, Bonanni P, Perucca E. Influence of dosage, age, and
18
co-medication on plasma Topiramate concentrations in children and adults with severe epilepsy and preliminary
19
observations on correlations with clinical response.Therap Drug Monit 2003; 25(6):700-708.
20
12- Bootsma HPR, Coolen F, Aldenkamp AP, Arends J, Diepman L, et al. Topiramate in clinical practice: Long
21
term experience in patients with refractory epilepsy referred to a tertiary epilepsy center. Epilepsy & Behavior 2004;
22
5:380-387.
23
13- Aykutlu E, Baykan B, Gürses C, Bebek N, et al. Add-on therapy with Topiramate in progressive myoclonic
24
epilepsy. Epilepsy & Behavior 2005; 6:260-263.
25
14- Grosso S, Galimberti D, Farnetani MA, Cioni M, et al.Efficacy and safety of Topiramate in infants according to
26
epilepsy syndromes. Seizure 2005; 14:183-189.
27
15- AL Ajlouni S, Shorman A, Daoud AS. The efficacy and side effects of Topiramate on refractory epilepsy in
28
infants and young children: A multi-center clinical trial. Seizure 2005; 14:459-463.
29
16- Giannakodimos St, Georgiadis G, Tsounis St, Triantafillou N, et al . Add-on Topiramate in the treatment of
30
refracyory partial-onset epilepsy: Clinical experience of outpatient epilepsy clinics from 11 general hospitals.
31
Seizure 2005; 14:396-402. et a
32
17- Placidi F, Tombini M, Romigi A, Bianchi L et al .Topiramate: effect on EEG interictal abnormalities and
33
background activity in patients affected by focal epilepsy. Epilepsy Research 2004; 58:43-52.
34
ORIGINAL_ARTICLE
A Study of Unilateral Proptosis and Etiology in Neurosurgery Department of Ghaem Hospital, 1995 - 2005
I ntroduction:Exophthalmia is defined as an abnormal protrusion of the eyeball; also labeled as proptosis. Proptosis, due to any cause, can compromise visual function and the integrity of the eye structure. The aim of this study was to evaluate etiological factors, clinical findings, imaging studies, histopathological, and prognostication in patients with exophthalmia. Material and Methods: This descriptive study was done from 1995 to 2005 in Neurosurgery Department of Gham Hospital of Mashhad. 50 cases with documented medical history, clinical examination, and pathology reports were studied. Data was gathered in a questionnaire and analyzed with descriptive statistics and chiary-square test. Results: There were 28 male (56%) and 22 female (44%) patients. Mean age was 32.9 years (with range of 10 months to 70 years); Mean age of female patients was 36.8 years and in male ones it was 27.8 years. Right eye was involved in 48% of patients and left eye in 52%. The most common cause of proptosis was meningioma with orbital involvement (12%), in 10% of cases it was located in the lesser wing of sphenoid and in 2% in the optic nerve sheath. Other common causes of proptosis were frontal bone osteoma with extension to orbit (8%), fibrous dysplasia (8%), orbital pseudo tumor (6%), sinus mucocele (6%), orbital cavernous hemangioma (6%), dermoid and epidermoid cysts of the orbit (6%), hydatid cyst (6%), carotid– cavernous Fistula (6%), and optic never glioma (4%). In 25%, proptosis was associated with decreased vision. Conclusion: The most common cause of proptosis in neurosurgery ward was meningioma; mostly lesser wing sphenoid meningioma, which in most cases was associated with decreased vision.
https://mjms.mums.ac.ir/article_5573_2e0f9cafdc7e6432ffea7c90a065cf7f.pdf
2007-06-22
149
154
10.22038/mjms.2007.5573
Exophthalmia
unilateral exophthalmia
Proptosis
decreased vision
M
Farajee
1
استاد گروه جراحی مغزو اعصاب
LEAD_AUTHOR
B
Ganjeie Far
2
رزیدنت گروه جراحی مغزواعصاب
AUTHOR
S.M.
Hosseini
hosseinism@mums.ac.ir
3
چشم پزشک دانشگاه علوم پزشکی مشهد
AUTHOR
1-Liesegang TJ, Deutsch TA, Grand MG editors. Orbit, Eyelids, and Lacrimal system. sanfrancisco: American
1
Academy of ophthalmology;2002-2003. Section 7, P.22-88.
2
2-Char D. Management of orbital tumors. Mayo Clin Proc 1993 68: 1081-1096.
3
3-Root man J, ed. Diseases of the orbit: A Multidisciplinary Approuch. Philadelphia: Lippincott; 1988.
4
4-Zajdela A, Vielh P, Schlienger P, ed al. Fine-needle cytology of 292 palpable orbital and eyclid tumors. Am J Clin
5
Pathol 1990 93:100-104.
6
5-Wilson WB. Meningiomas of the anterior visual system. Surv Ophthalmol 1981 26: 109-127.
7
6-Dutton JJ. Optic nerve sheath meningiomas. Surv Ophthalmol. 1992 37: 167-183.
8
7-Maroon J, Ken nerdell J, Brill man J. Tumors of the orbit. In: Wilkins RH, Ren gashary SS (eds). Neurosurgery.
9
New Yor: Mcgraw-Hill; 1996. 1481-1493.
10
8-Basso A, Carrizo A, Kreutal A. Trans Cranial approach to Lesions of the orbit. In Schmidek HH, Sweet WH (eds).
11
Operative Neurosurgical Techniques. Philadelphia: WB Saunders; 1995. 205-212.
12
9-Bartley GB, Fatourechi V, Kadrmas EF, ed al. The treatment of Graves. Ophthalmology in an incidence cohort.
13
Am J Ophthalmol 1996; [2]: 200-206.
14
10- Wenig B, Mafec M, Ghosh L. Fibro-osseous, and cartilagino. Lesions of the orbit and para orbital region.
15
Radiol Clin North Am 1998; 36: 1241-1259.
16
11- Weber A, Romo L, Sabates N. Pseudotumor of the orbit. Radiol Clin North Am 1999; 37: 151-168.
17
12- Curtin H, Rabinov J. Extension to the orbit from paraorbital disease. The sinuses. Radiol Clin North Am 1998;
18
36: 1201-1213.
19
13- Turgut AT, Turgut M, Kosar U. Hydatidosis of the orbit in Turkey: results from review of the diterature. 1963-
20
2001. Int Ophthalmol 2004 Jul; 25(4): 193-200.
21
15- Hrivastava RK, Sen C, Costantino PD, Della Rocca R. Sphenoorbital meningiomas: Surgical Limitations and
22
Lessons Learned in their long term management. J Neurosurgery 2005 Sep; 103(3): 491-7.
23
ORIGINAL_ARTICLE
Evaluation of Charactristics and Outcome of Treatment of Reflex Epilepsy
I ntroduction: Reflex epilepsy is a disorder, in which seizure attacks are induced by an external stimulus or, rarely, by a mental activity. The attacks in this disorder are usually provoked just in response to a specific stimulus and patients with this disorder have no unprovoked ictal event in most instances. This research was designed to study different reflex epilepsies and their appropriate managements. Material and Methods: This descriptive study was done by evaluating the medical files of 9676 patients with the diagnosis of epilepsy, visited in a 10-year period (1996-2006) in Dr. Nikkhah Clinic. 33 of them with the final diagnosis of reflex epilepsy were selected. The data (such as, types of seizure, type of stimulus, electroencephalographic findings, and therapeutic strategy) was recorded for each patient in questionnaire and analyzed by appropriate descriptive statistics and frequency distribution tables. Results: In the study population, 15 females and 18 males with reflex epilepsy, seizure attacks had been provoked by the following stimuli: visual stimuli in 21(63.6%) patients, chewing in 4(12%) patients, mathematical calculating processes in 3 (9%) patients, micturation in 3 (9%) patients, playing chess in one(3%) patient, and warm bathing in another one (3%) patient. Brain CT scan was normal in all of our patients. Seizure attacks were eliminated in 6 patients with visual-evoked reflex epilepsy after cessation of visual stimuli. Being unable to eliminate the stimulant factor, we started antiepileptic drugs for other patients. 90% of these patients have been seizure- free just with sodium valproate. Conclusion: In a suspected patient whose attacks are related to a specific stimulus, the practitioner should consider the nature and properties of stimulant precisely. The treatment consists of prevention from and elimination of stimulant, and pharmacological managements.
https://mjms.mums.ac.ir/article_5574_04bbc1053cd8d8e91bd51c10d55cd429.pdf
2007-06-22
155
160
10.22038/mjms.2007.5574
Reflex epilepsy
Seizure
Epilepsy
K
Nikkhah
1
دانشیار
LEAD_AUTHOR
P
Sasannejad
sasannejadp@mums.ac.ir
2
نورولوژیست
AUTHOR
M.
Saidi
saeedim@mums.ac.ir
3
استادیار
AUTHOR
A
Khosravi
4
رزیدنت - گروه مغزو اعصاب دانشگاه علوم پزشکی مشهد
AUTHOR
A
Shoeibi
shoeibia@mums.ac.ir
5
رزیدنت - گروه مغزو اعصاب دانشگاه علوم پزشکی مشهد
AUTHOR
1- Gowers W. Epilepsy and other chronic convulsive diseases: their causes, symptoms and treatment. New York:
1
William Wood; 1885.
2
2- Beaumanoir A .History of Reflex Epilepsy. In:Zifkin BG, Andermann F, Beaumanoir A, et al. Advances in
3
neurology,Reflex epilepsy and reflex seizures.Philadelphia:Lippincott-Raven;1998:1-4.
4
3- Dreifuss FE. Classification of Reflex Epilepsies and reflex seizures, In: Zifkin BG, Andermann F, Beaumanoir A,
5
et al. Advances in neurology, Reflex epilepsy and reflex seizures.Philadelphia: Lippincott-Raven; 1998:5-13.
6
4- Commission on classification and terminology of the International League against Epilepsy. Proposal for revised
7
classification of epilepsies and epileptic syndromes. Epilepsia 1989; (30): 389-99.
8
5- Satishchandra P, Shivaramakrishana A, Kaliaperumal VG, et al. Hot water epilepsy: a variant of reflex epilepsy
9
in southern India. Epilepsia 1988 ;( 29): 52-6.
10
6- Falconer MA, Driver MV, Serafitinides EA. Seizures induced by movement: report of a case relieved by
11
operation. Neural Neurosurg Psychiatry, 1963 ;( 26): 300-7.
12
7- Karbowski K. Epileptic seizures imduced by vestibular and auditory stimuli. In: Beaumanoir A, Gastaut H,
13
Naquet R, et al. Reflex seizures and reflex epilepsies. Geneva: Editions Medicine et Hygiene; 1989. 255-60.
14
8-Lee SI, Sutherling WW, Persing JA, et al. Language induced seizure: a case of cortical origin. Arch Neural 1980;
15
(37): 433-6.
16
9- Loiseau P, Guyot M, Loiseau H, Rougier A, et al. Eating epilepsy. Epilepsia, 1986; (27): 161-163.
17
10- Trenite KN, Dorothee GA. Reflex seizures induced by intermittent light stimulation, In:Zifkin BG, Andermann
18
F, Beaumanoir A, et al. Advances in neurology, Reflex epilepsy and reflex seizures.Philadelphia:Lippincott-Raven;
19
(998):1-4.
20
11- Gastaut H. Conclusions of a symposium on reflex mechanisms in the genesis of epilepsy. Epilepsia 1 962; (3):
21
457-460.
22
ORIGINAL_ARTICLE
The Prevalance of Hypercholesterolemia in Middle-Aged and Elderly Population in Mashhad And its Relation to Hypothyroidism
I ntroduction: Both overt hypothyroidism (OH) and subclinical hypothyroidism (SH) have been reported to have side effects on body organs. Hypothyroidism can cause hypercholesterolemia, hyperlipidemia and diastolic hypertension, which are regarded as risk factors in development of coronary heart disease (CHD); on the other hand, the hypercholesterolemia due to hypothyroidism can be easily treated with levothyroxine. This study was performed to determine the prevalence of hypothyroidism in hypercholesterolemic subjects in Mashhad. Material and Methods: This descriptive study was performed in Mashhad City from May to Nowember 2002. A number of 4300 men and women aged 40 year or over in 97 different regions in Mashhad were interviewed and 2222 subjecs volenteerly encountered the study. A sample of 12-14 hr fasting blood was taken from volunteers and the total cholesterol (TC) was determined by enzymatic method (zist chime-Iran) for 2215 (758 men and 1457 women) subjects. Serum FT4 and TSH were determined by radio-immunoassay methods for 89 subjects with TC≥310 mg/dl and for 82 subjects with TC: 261-309 mg/dl. Individual and laboratory data were gathered in a questionnaire and analyzed using descriptive statistics and frequency destribution tables and χ2 t-test. Results: The results showed that 4.9% of men had TC ≥310mg/dl, 11.9%, 42.2% ,and 41% had TC concentrations of 261-309, 200-260 ,and 200g/dl. Twelve out of 89 (13.5%) subjects with TC>310 mg/dl were hypothyroid; 6 with OH (4women & 2men) and 6 with SH (5women & 1man). Hypothyroidism in women was more frequent than men and the female /male ratio was 3/1. The correlation between hypercholesterolemia and hypothyroidism at TC>322 mg/dl was significant (χ2=4.01, df=1, P=0.045). FT4 level in TC ≥310mg/dl was 13.05± 3.4, and in TC between 261-309 mg/dl 14.2±2.63; which was significant in the first group (t-test, p=0.024). Conclusion: These data demonstrated that hypercholesterolemia is prevalent in mean-aged and elder people in Mashhad and hypothyroidism, especially. SH form, is also frequent in hypercholesterolemic subjects. Female to male ratio is about 3:1, but seemingly younger women in Mashhad are more affected than what is seen in other studies. Therefore, the screening of thyroid function in hypercholesterolemic subjects especially in women is recommended.
https://mjms.mums.ac.ir/article_5575_1e2fb25ec2f60a9b1c0304bc52c880ee.pdf
2007-06-22
161
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10.22038/mjms.2007.5575
Hypercholesterolemia
Hypothyroidism
Overt hypothyroidism
Subclinical Hypothyroidism
Mashhad population
M.Al.R
Hadjzadeh
1
دانشیار
LEAD_AUTHOR
H
Neamaty
2
استادیاربخش فیزیولوژی - دانشگاه علوم پزشکی مشهد،دانشکده پزشکی
AUTHOR
1- Thomas D, Collet JP, Cottin Y, Cournot M, Ducimetiere P, Ferrieres J, et al. The best of epidemiology and
1
cardiovascular prevention in. Arch Mal Coeur Vaiss 2007;1:57-64.
2
2- Kitayama J, Faraci FM, Lentz SR, Heistad DD. Cerebral vascular dysfunction during hypercholesterolemia. Stroke
3
2007. (Epub ahead of print) [Medline].
4
3- Jeffrey MH. Lipoproteins and atherogenesis. Endorinol and Metabol Clin Nort Am 1998; 27:569-584.
5
4- Kreisberg RA, Oberman A. Lipids and atheroscerosis:lessons learned from ranndomized controlled trials of lipid
6
lowering and other relevant studies .J of Clinical Endocrinol &Metabol 2002; 87(2):423-437.
7
5- Kromhout D, Menotti A, Kesteloot H, Sans S. Prevention of coronary heart disease by diet and lifestyle evidence
8
from prospective cross-cultural , cohort , and intervention studies. Circul 2002; 05:893-898.
9
6- Laber U, Kober T, Schmitz V, Schrammel A, Meyer W, Mayer B, et al. Effect of hypercholesterolemia on
10
expression and function of vascular soluble guanyly cyclase.Circul 2002; 105:855-860.
11
7- Scott MG. The role of cholesterol management in coronary disease risk reduction in elderly patients. Endorinol
12
Metabol Clin North Am 1998; 27:655-675.
13
8- Cobbold C A, Sherratt J A, Maxwell S R J. Lipoprotein oxidation and its significance for Atherosclerosis: a
14
mathematical approach. Bull mathemat biolo 2002; (64): 65-69.
15
9- Bemben DA, Winn P , Hamm RM, Mergen L, Davis A, Barton E. Thyroid disease in the elderly . part I
16
.prevalence of undiagnosed hypothyroidism. J Fam Pract 1994 Jun; 38(6):577-82.
17
10-Biondi B, Palmieri EA, Lombardi G, Fazio S. Effects of subclinical thyroid dysfunction on the heart. Ann Intern
18
Med 2002; 137:904-914.
19
11-Monzani F, Caraccio N, Del Guerra P, Casolaro A, Ferannini E. Neuromuscular symptoms and dysfunction in
20
subclinical hypothyroid patients : benefical effect of L-T4 replacement therapy. Clinic Endocrinol 1999; 51:237-242.
21
12-Bindels AJ, Westendorp RG, Frolich M, Siedell JC, Blokstra A, Semlt AH. The prevalece of subclinical
22
hypothyroidism at different total plasma cholesterol levels in middle age men and women ,a need for case finding ?.
23
Clin Endocrinol 1999; Oxf 50(2): 217-20 .
24
13-Diekman T, Lansberg PJ, Kasterlein JJ, Wiersinga WM. Pervalence and correction of hypothyroidism in a large
25
cohort of patients referred for dyslipidemia. Arch Intern Med 1995; 155(14):1490-5.
26
14-Elder J, McLelland A, OُReilly DSTJ, Packard CJ, Seriese JJ, Shepherd J. The relationship between serum
27
cholesterol and serum thyrotropin, thyroxine and troidotropine concentrations in suspected hypothyroidism. Ann Clin
28
Biochem 1990; 27:110-113 .
29
15-Centanni M, Cesareo R, Verallo O, Brinelli M, Canettieri G, Viceconti N, et al.Reversible increase of intraocular
30
pressure in subclinical hypothyroid patients. Eur J Endocrinol 1997; 136(6):595-8.
31
16- حاج زاده موسی الرضا، رحیقی جواد، آقائی آزیتا. تغییرات عناصر معدنی در بافت های کلیه، کبد، قلب و عضله اسکلتی در رت هیپوتیروئید. مجله علوم پایه
32
پزشکی ایران ،جلد 8،شماره 1380)3)ص 152-147.
33
حاج زاده موسی الرضا، رحیقی جواد، آقائی آزیتا. اثرات کم کاری تیروئید بر عناصر معدنی در بافت های مغز، استخوان جمجمه و پوست در موش صحرایی. مجله
34
.243-237 ص(1385)4 شماره ،9 جلد ،علومپایهپزشکی
35
17-Levy EG. Thyroid disease in the elderly. Med Clin Nort Am 1991; 75(1):151-167.
36
18-Luboshitzky R, Aviv A, Herer P, Lavie L. Risk factor for cardiovascular disease in women with subclinical
37
hypothyroidism. Thyroid may 2002; 12(5):421-5.
38
19-Bemben DA, Hamm RM, Morgan L, Winn P, Davis A, Barton E. Thyroid disease in the elderly part 2.
39
perdictability of subclinical hypothyroidism. J Fam Pract 1994 Jun ; 38(6):583-8.
40
20-Series JJ, Biggart EM, O’Reilly DSTJ, Packard CJ, Sheperd J. Thyroid dysfunction and hypercholesterolaemia in
41
the general population of Glasgow, Scotaland. Clinica Chimica Acta 1998; 172:217-222.
42
21-Manciet G, Dartigues JF, Decamps A, Barberger GP, Letenneur L, Latapie MJ, et al. The PAQUID survery and
43
correlates of subclinical hypothyroidism in elderly community residents in the south west of France. Age-Ageing
44
1995; 24(3):235-41.
45
22- Rivolta G, Cerutti R, Colombo R, Miano G, Dionisio P, Grossi E. Prevalence of subclinical hypothyroidism in a
46
population living in the Milan metropolitan area. J Endocrinol Invest 1999; 22(9):693-7.
47
24- حاج زاده موسی الرضا، میرزایی جمال. بررسی ارتباط کم کاری تیروئید با بالا بودن چربیهای خون در مراجعه کنندگان به آزمایشگاههای دانشگاهی در مشهد
48
.مجلهعلومپایهپزشکی ایران 1380؛ جلد 4، شماره 1380)، 3)ص 122 تا 129.
49
25-Gloria LV, Dallas T. Obesity, the metabolic syndrome, and cardiovascular disease. Am Heart J 2001; 142:1108-
50
26-Scott MG. Cholesterol managament in the era of managed care. Am J Cardiol 2000; 85:3A-9A.
51
27-Sunil VR, Mark D, F.Xavier Pi-S, et al. Obesity as a risk factor in coronary artery disease. Am Heart J 2001:
52
42:1102-7.
53
28-Tietz NW. In:Titez N.W (eds) Text book of Clinical Chemsitry. First ed. Philadelphia: WB Saunders; 1987. P.360,
54
29-Pirich C, Müllner M, Sinzinger H. Prevalence and relevance of thyroid dysfunction in 1922 cholesterol screening
55
participants. J Clinic Epidemiol 2002; 53:623-629.
56
30-Sawin CT. Subclinical hypothyroidism in older persons. clin Geriatr Med 1995; 11(2): 231-8.
57
31-Weber KA. Subclinical thyroid dysfunction. Arch Intern Med 1997; 26:157(10):1065-8.
58
ORIGINAL_ARTICLE
Efficacy of Oral versus Intravenous Vitamin C on Serum Oxalate Level in Hemodialysis Patients
increase the risk of cardiac, vascular and bone diseases. Hemodialysis patients (HD) are at high risk for Scurvy disease due to dietary limitation and ascorbic acid losses through dialysis. Vitamin C also decreases HTN and accelerated arthrosclerosis. Thus, vitamin C supplementation is necessary for these patients. The aim of this study was to evaluate efficacy of oral versus intravenous vitamin C on serum oxalate level in hemodialysis patients. Material and Methods: This clinical-trial study was done on hemodialysis patients referred to the three treatment centers of Mazandaran Province. 41 HD patients, who had not consumed vitamin C for two months, were randomly divided into two groups, oral and intravenous. In intravenous (IV AA) group, vitamin C 500 mg/day was administered three times a week; and oral group received vitamin C 125 mg/day for two months. Oxalate serum level was measured before and after treatment. Individual, laboratory, and treatment complication data were gathered in a questionnaire. Intra group comparison was done with t-student test and inter group comparison was done with independent– sample t-test. Data were expressed as SE± Mean and p-valueResults: Serum oxalate level in each group increased, there was no significant differences intra group and between two groups (p= 0.3) (in oral, from 1.8±0.4mgl/L to 1.85±0.8mgl/L, P=0.4 and in IVAA from 1.8±0.7mg/L to 2.1±0.9mg/L, P=0.3). Conclusion: Oral and IV AA in the used dosage did not increase serum oxalate level and were safe to use as supplementation in HD patients.
https://mjms.mums.ac.ir/article_5576_b24afd7d1c6d06e9a4593a0398d05532.pdf
2007-06-22
171
176
10.22038/mjms.2007.5576
Oral and IV vitamin C
Hemodialysis patients
Serum oxalate level
Z
Kashi
1
فوق تخصص غدد. استادیار دانشکده پزشکی ساری
LEAD_AUTHOR
F
Spahbodi
2
فوق تخصص کلیه. استادیار دانشکده پزشکی ساری
AUTHOR
Sh
Ala
3
متخصص داروسازی بالینی,استادیار دانشکده داروسازی ساری
AUTHOR
N
Hendoee
4
داروساز عمومی. دانشکده داروسازی ساری
AUTHOR
1- Alkhunaizi A, Chan L. Secondary oxalosis: a cause of delayed recovery of renal functional in the setting of acute
1
renal failure . J am societ Nephrol 1996 7:2320-2360.
2
2- Thmpson C. Relationship Between vitamin C intake an increasing oxalosis. Seminars in Dialysis 1988, 1(2):94-98.
3
3- Ogawa Y,Machida N, Masahide J, Gakiya M, Chinen Y,Oda M, et al.Major factors modulation the serum
4
oxalic acid level in hemodialysis patients. Frotiers in Bioscience 2004 Sep; 9:2901-2908.
5
4- Ono K. Secondary hyperoxalemia caused by vitamin c supplementation in regular hemodialysis patients.Clin
6
Nephrol 1986; 26:239-243.
7
5- Melendez O. Intravenous vitamin C for Erythropoietin resistance Patient. Semin Dial 2002; 13:335-360.
8
6-Descombres E, Hanck AB,Fellay G. Water soluble vitamins in chronic hemodialysis patients.Kideny Int
9
1993;43:1319-1328.
10
7-Tarng D,Wei Y,Huang T,Kuo T, Yang W.Intravenous ascorbic acid as an adjuvant therapy for recombinant
11
erythropoietin in hemodialysis patients with hyperferritinemia.Kidney Inter 1999 ;55:2477-2486.
12
8 - Canvese C,Petrarulo M,Massarenti P, Berutti S, Fenoglio R,Pauletto D ,Lanfranco G,BergamoD,Sandri I,Marangella
13
M.long – term ,intravenous vitamin c leads to plasma calcium oxalate supersaturation in hemodialysis patients.Clin
14
Nephrol 1989;31:31-34.
15
9-Pru C,Eaton J,Kjellstrand C.Vitamin c intoxication and hyperoxalemia in chronic hemodialysis patient.Nephrol 39
16
1985:39(2):112-116.
17
10-Chan D,Irish A,Dogra G,Efficacy and safety of oral versus intravenous ascorbic acid for anemia in hemodialysis
18
patients.Nephrol 2005;10:336-340.
19
11-Kalantar-zadeh K,Kopple JD, Deepak S, Block D, Block G. Food intake characteristics of hemodialysis patients
20
as obtained by food frequent questionnaire. J Ren Nutr 2002; 12:17-31.
21
ORIGINAL_ARTICLE
Comparison of Immunity against Rubella before and after Measles–Rubella Vaccination in 15-23 year-old Women
I ntroduction: Rubella is an exanthematous childhood viral disease that its main importance is because of development of Congenital Rubella Syndrome (CRS) in infants born from non-immune mothers infected with rubella, especially in early gestational period. CRS is characterized by hearing defect, cataract, glaucoma, microcephaly, mental rethardation, cardiac anomalies and etc. Measles-Rubella mass campaign was done in late 2003 and 5-25 year-old people were vaccinated. In this study the effect of vaccination on the immunity against rubella was studied. Material and Methods: This retrospective cross- sectional study was done on women reffered to Central Laboratory of Imam Reza Hospital in 2002-2005. The study included 1698 women (1148 women aged 15-23 years) referred for counseling before vaccination and 354 women (162 women aged 15-23 years) after vaccination. Anti-Rubella IgG concentration was measured by ELISA method. SPSS 12 was used to analyze the data. Results: Immunity rates were 67.19% (70.38% in 15-23 year-old women) and 77.40% (89.50% in 15-23 year-old women) in women participated in this study before and after vaccination, respectively. Immunity of non-vaccinated women decreases by age increase. Conclusion: Statistical analysis showed the positive effect of vaccination on immunity status of vaccinated women (Z=5.11, p<0.001). Authors suggest that women older than 25 years should also be included in rubella vaccination program, as well.
https://mjms.mums.ac.ir/article_5577_186084cc928cdb9d8dcc8f1cefa8f702.pdf
2007-06-22
177
184
10.22038/mjms.2007.5577
Rubella
Congenital Rubella Syndrome
Vaccination
immunity status
M
Mahmoudi
mahmoudim@mums.ac.ir
1
دانشیار ایمونولوژی
LEAD_AUTHOR
E
Vahedi
2
پزشک عمومی، دانشگاه علوم پزشکی مشهد، ایران
AUTHOR
1- هاهیم، لارس آر. ویروس شناسی بالینی. محمودمحمودی,ترجمهاحسان واحدی،علی مرادی. مشهد: انتشارات دانشگاهعلومپزشکی مشهد،ص113-108
1
2 - Cherry JD. Rubella virus. In: Feigin C. Textbook of Pediatric Infectious Disease, 4th ed. Philadelphia: Saunders; 2004.
2
3 - Gershon AA. Rubella virus. In: Mandel, Bennet, Doglas. Principles and Practice of Infectious Disease, 5th ed. New
3
York: Churchill-Livingstone; 2000. 1708-12.
4
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During 1997 – 2000 . Journal of Research in Medical Sciences 2004; 2: 5-8.
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34- زندی،ک، تاجبخش، س، جعفری،م،غفاریان شیرازی،ح. تعیینسطحایمنیدختران در شرف ازدواجنسبت بهویروس سرخجهبهدوروش ممانعت ازهماگلوتیناسیون و
57
الیزادر شهرستان بوشهر. طب جنوب، فصلنامهپژوهشیدانشگاهعلومپزشکیو خدماتبهداشتیدرمانیبوشهر، ؛دوره 2، ،ش1(شهریور 40-35 (1378.
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35 - Doroudchi M, Dehaghani AS, Emad K, Ghaderi AA. Seroepidemiological survey of rubella immunity among three
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populations in Shiraz, Islamic Republic of Iran. East Mediterr Health J. 2001 Jan-Mar;7(1-2):128-38.
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36- غفوریان بروجردنیا ،م. افزایش سطح مصونیت نسبت به سرخجهدرزنان باردار شهرستان اهواز طی سالهای1378-68 . فصلنامهپزشکی باروریوناباروری،دوره 2، اش
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.21-15:(1380 بهار)6
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37- Ganjooie TA, Mohammadi MM. The prevalence of antibodies against rubella in pregnant women in Kerman, Iran.
63
Saudi Med J 2003 Nov;24(11):1270-1271.
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38- نانبخش، ف، سالاری، ش، برومند، ف، محدثی، ح، طراوتی، م، بهادری، ف. ارزیابی وضعیت ایمنی نسبت به سرخجه در بین دختران دبیرستانی شهر ارومیه در سال
65
.253- 246:(1380 پاییز) 3 ش ،12 دوره ،مجلهپزشکیارومیه . 1378
66
39- بابامحمودی، ف. بررسی وتعیین میزان تیتر آنتی بادی ضد سرخجه در سرم دختران دبیرستانهای شهرستان قائمشهر در سال 1376 . نامه دانشگاه،دوره
67
.64-59 (1381پاییز)36ش،12
68
40- صفار، محمدجعفر,عجمی، ابوالقاسم, پورفاطمی، فاطمه . بررسی وضعیت ایمنی سرخجه زنان در سن بارداری استان مازندران درسال های 79-78 . نامهدانشگاه،دوره
69
.8-1 (1380 تابستان)31ش11
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41- شمسی شاهآبادی، ع، افشار، ل، مساوات، ا،زین الدینی، ع، شیخ فتح اللهی،م. بررسی سطح آنتی بادی IgGوفراوانی افرادغیرایمن نسبت به سرخجهدردختران 14
71
تا 18 ساله شهررفسنجان در سال 1379 . مجلهدانشگاهعلومپزشکی رفسنجان، سال اول جلد 2، ش 7 -1 :(1380)1 .
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42 –ضیایی،س. بررسی میزان مصونیت نسبت به سرخجهدرزنان سنین باروری شهر کازرون. مجلهعلمی پژوهشی دانشگاهعلومپزشکی و خدمات بهداشتی درمانی اهواز،
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186 مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد تابستان 86 - شماره 96- سال 50
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78
اپیدمیولوژیک از طریق بررسی مبتنی بر جامعهدر جمعیت غیرواکسینه صفرتا 45 ساله شهرستان ارومیهدر سال1380 . مجلهپزشکی ارومیه،دوره 13، ش2(تابستن 1381)
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45- صوفیان،م. تعیین وضعیت ایمنی نسبت به سرخجهدر خانم ها بههنگامازدواج در شهراراک در سال 1380. فصلنامهرهĤورددانش، مجلهدانشگاهعلومپزشکی اراک،
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پزشکی و خدمات بهداشتی درمانی اهواز ، ش32(خرداد 1381):ص26-22.
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47- آهنچیان، علی. بررسی تیتر آنتیبادی IgG ضد سرخجه در دختران سال آخردبیرستان شهرستان مشهد. پایان نامه دکترای تخصصی، دانشکده پزشکی، دانشگاه علوم
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.61-56 .1382 ،مشهد پزشکی
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48- زمانی، علی, دانشجو، خدیجه. سرواپیدمیولوژی سرخجه در کودکان دبستانی شهر تهران. مجله بیماریهای کودکان ایران دانشگاه علوم پزشکی تهران، دوره 14،ش1
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.61-56:(1382بهار)
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49 - Pourpak Z, Zamani Sh, Kardar GA. Evaluation of national programming efficacy on measles and rubella vaccination
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in Iran. First international congress on immunodeficiency disorders 2005; 28 February- 2 March: Tehran, Iran.
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50 - Soleimanjahi H, Bamdad T, Fotouhi F, Roustai MH, Faghihzadeh S. Prevalence of HI antibody titer against rubella
90
virus to determine the effect of mass vaccination in Tehran. J Clin Virol. 2005 Oct; 34(2):153-4.
91
ORIGINAL_ARTICLE
Visual Acuity and Contrast Sensitivity in Pseudophakic patients after Cataract Surgery
I ntroduction: This study was designed to determine the role of intraocular lens implantation in visual acuity and contrast sensitivity in pseudophakic patients. Material and Methods: This case control study was done in the year 2004 in Mashhad Ophthalmology Center of Khatam- al- Anbia. with convenience sampling method based on object visual acuity and contrast sensitivity in 85 pseudophakic patients (110 eyes) with a mean age of 63.83, and 20 age – matched phakic subjects (40 eyes) were compared. The visual acuity and contrast sensitivity at distance after correction of refractive disorders were measured by Snellen chart and Cambridge Low Contrast grating chart at 6 meter. Individual data, surgery date, visual acuity, and contrast sensitivity were gathered in a questionnaire and analyzed by descriptive statistics and frequency distribution tables. Results: Statistical test showed thatthe best corrected visual acuity in IOL group had no significant difference from that in the phakic group (p=0.36). But the contrast sensitivity reduces in the pseudophakic group comparing with the phakic group (p=0.004). These patients often complain of blur vision, despite of good visual acuity. Contrast sensitivity reduced significantly with increase of age in both groups of normal and pseudophakic patients. No improvement in contrast sensitivity and visual acuity was found over the time (Pva=0.174, Pcs=0.257). Conclusion: This study showed that intraocular lenses could provide good visual acuity for distance but there was slight reduction in contrast sensitivity. Contrast sensitivity test is an important tool for evaluation of visual function; especially age related changes or intraocular differences, which may not have been detected by visual acuity tests.
https://mjms.mums.ac.ir/article_5578_eff08ed2cd954fbdc0c3eed24dc2f6b8.pdf
2007-06-22
187
192
10.22038/mjms.2007.5578
Cataract
Pseudophakic
Phakic
Intra ocular lense
Visual acuity
Contrast Sensitivity
J
Heravian
1
دانشیار
LEAD_AUTHOR
A
Derakhshan
derakhshana@mums.ac.ir
2
دانشیار
AUTHOR
A.A
Yekta
yektaa@mums.ac.ir
3
دانشیار
AUTHOR
H
Ostadi Moghaddam
ostadih@mums.ac.ir
4
استادیار
AUTHOR
M
Mahjoob
5
دانشجوی کارشناسی ارشد - گروه اپتومتری دانشکده علوم پیراپزشکی و بهداشت
AUTHOR
1- Javit J, Brauwesles HP, Jacobi KW, etal. Cataract extraction with multifocal intraocular lens implantation:
1
Clinical, Functional, and quality –of-life outcomes: multicenter clinical trial in Germany and Austria. J Cataract
2
Refract Surg 2000; 26: 1356-1366
3
2- Bellows JG: Biochemistry of the lens: influence of vitamine salfhydryis on the production of galactose cataract ,
4
Arch . Ophthalmol. 1993; 16:762
5
3- Montes-Mico R, Alio J. Distance and near contrast sensitivity function after multifocal intraocular lens
6
implantation. J Cataract Refract Surg 2003; 29:703 – 711
7
4- Montes-Mico R, Charman WN. Mesopic contrast sensitivity function after excimer laser photorefractive
8
keratomy. J Refract Surg 2002; 18: 9-13
9
5- Sasaki A. Initial experience with refractive multifocal intraocular lens in a Japanese population. J Cataract Refract
10
Surg 2000; 26: 1001-1007
11
6- Teping C, Oran E , Backes – Teping C. Visual acuity at twilight and contrast vision in patients with bifocal IOL.
12
Ophthalmol 1994 Aug ; 91 (4) : 460-4
13
7- Hurst MA , Douthwaite WA. Assessing vision behind cataract a review of methods. 1993; 70:903-913
14
8- Regan D, Neima D. Low contrast letter chart as a test of visual functions. Ophthalmol 1983; 90: 1192-120
15
9- Hayashi K, Hayashi H , Nakao F , Hayashi F. Influence of astigmatism on multifocal and monofocal intraocular
16
lense. Am J Ophthalmol 2000 oct; 130 (4): 477-82
17
10- Supestein R, Boyaner D, Overbury O , Collin C. Glare disability and contrast sensitivity before and after
18
cataract surgery. J Cataract Surg 1997; 23: 248-253
19
11- American Academy of ophthalmology optics, Refraction, and contact lenses. LEO.1998.
20
12- Grosvenor, T. Primary Care optometry. 3 rd ed. Butter worth Heineman; 1996.14.
21
13- Wilkins AJ, Della Salas, Somazzi L,and Nimmo –Smith I. Age – related norms for the Cambridge Low contrast
22
Gratings, including details concerning their desing and use . Clin Vis Sci 1988; 2(3):201-212
23
14- kershner RM. Retinal image contrast and functional visual performance with aspheric, silicon and acrylic IOL.
24
Prospective evaluation. J cataract Refract surg. 2003 sfp; 29 (9) ; 1684 – 94
25
15- Afsar AJ, Patel S , wood SRL , Wykes W. A comparison of visual performance between a rigid PMMA a
26
foldable acrylic IOL. Eye 1999 Jun; 13 (pt 301): 329-35
27
16- Montes –Mico R, Espana E, Bueno I, Charman WN , Menezo JL.Visual performance with multifocal IOL.
28
Mesopic C.S under distance and near condition. Ophthalmol 2004 Jan; 11 (1): 85-96
29
17- Alfonsa JF, Fernodez-Vega L, Begona-Baamonda M, Montes-Mico Robert. Correlation of pupil size with visual
30
acuity and contrast sensitivity after implanation of an apodized diffractive intraocular lens. J Refract Surg 2007;
31
33:430-438
32
18- Negishi k , Ohnuma k , Hirayama N , Noda T . Policy – Based Medical services network study Group for IOL &
33
Refraction surgery. Effect of chromatic aberation on contrast sensitivity in pseudophakic eye. Arch Ophthalmol
34
2001 Aug; 119 (8): 1154-8
35
19- kohnen S, Ferrer A, Brauweiler P.Visual function in pseudophakic eyes with polymetyle methacrylate , Silicon
36
and acrylic IOL.J Cataract Refract Surg 1996 ; 22 suppl 2: 1303-7
37
20- Mela Ek, Gartaganis SP, Koliopoulos JX. Contrast Sensitivity function after cataract extraction and
38
intraocularlens implantation. Doc ophthalmol 1996-97; 92 (2): 79-91
39
21- Miyajima H , katsumio , Ogawa T, Guang JW. Contrast visual acuities in cataract patients. II. After IOL
40
implantation. Acta ophthalmol (copenh) 1992 Aug; 70 (4): 427-33
41
22- Paker M, Fine IH, Hoffman RS.Wavefront technology in cataract surgery. Dregon Heath & Science university ,
42
Eugene , oregon , USA. Curr Opin Ophtalmol 2004 Feb ; 15 (1): 56-60
43
23- Souza CE, Gereneta VM, Chaltia MR, etal. Visual acuity, contrast sensitivity, reading speed and wavefront
44
analysis, Pseudophakic eye with multifocal IOL (ReSTOR) versus fellow Phakic eye in non-presbyopic patients. J
45
Refract Surg 2006; 22:303-305
46
ORIGINAL_ARTICLE
Medical Treatment in Prevention of Rebleeding in Traumatic Hyphema
I ntroduction: Traumatic hyphema is among the most common challenges in ophthalmologic emergency. Its most common complication, rebleeding, is accompanied with poor prognosis. Rebleeding could cause corneal blood staining, glaucoma, and optic atrophy. Thus, the most important goal in hyphema treatment is prevention of rebleeding. This study was aimed to evaluate epidemiology, medical treatment, and short term complications of traumatic hyphema. Material and Methods: This was a descriptive cross-sectional study, done in the year in Khatam- al- Anbia Ophthalmologic Hospital in Mashhad. 100 patients with traumatic hyphema were evaluated by an epidemiologic questionnaire and complete eye examination in emergency room. They all were treated by topical corticosteroid and cycloplegic with or without systemic medication (prednisone or tranexamic acid) according to degree of hyphema .All patients were followed for at least 10 days. Data was analyzed, using descriptive statistics and frequency distribution tables. Results: 81% of patients were male with male to female ratio of 4:1. The patients’ mean age was 26.5+/-15.4 years old. 62% of patients were under 30 years of age. The patients’ right and left eyes were affected in 48% and 50%, respectively; 2% had both eyes affected. No statistically significant difference was found between right and left eye involvement. The mean visual acuity at presenting time was 4/10. There was a direct correlation between presenting visual acuity and severity of hyphema (p=0.043). No correlation was found between age, sex, and the type of trauma with severity of hyphema. The mean intraocular pressure (IOP) was 18 mmHg at presenting time. There wasn't any correlation between IOP and severity of hyphema. The mean visual acuity at the last follow up visit was 8/10. Rebleeding occurred in 10 patients out of 100 cases. The risk of rebleeding with medical treatment was 10%. Rebleeding was found to occur 4.3 days after trauma, averagely. In this study, it was seen in the cases with hyphema of the degree of 4 or more (the only risk factor for rebleeding, in this study). Conclusion: Traumatic hyphema is a common cause of refer to ophthalmology emergency room. Results of this study showed that complications of traumatic hyphema, especially rebleeding, could be prevented, significantly, with medical treatment.
https://mjms.mums.ac.ir/article_5579_c3cb8f18b513daee86e18213739e362e.pdf
2007-06-22
193
200
10.22038/mjms.2007.5579
Hyphema
IOP
Rebleeding
Medical Treatment
Complications
M.
Mousavi
1
دانشیار
LEAD_AUTHOR
M
Abrishami
abrishamim@mums.ac.ir
2
استاد
AUTHOR
S
Zareie Ghanavati
3
استادیار
AUTHOR
A
Eslampoor
eslampoura@mums.ac.ir
4
دستیار
AUTHOR
N
Mokhtari
5
کارورز- گروه چشم پزشکی، بیمارستان فوق تخصصی چشم پزشکی خاتم الانبیاء (ص)
AUTHOR
1- Walton W, Von Hagen SV, Grigorian R, Zarbin M.Management of traumatic hyphema. Surv Ophthalmol 2002;
1
47: 297–334.
2
2- Shingleton BJ, Hersh PS. Traumatic hyphema. In: Shingleton BJ, Hersh PS, Kenyon KR (editors). Eye trauma . 4
3
th ed. St Louis: Mosby; 1998. 104–114.
4
3- Berríos EB Dreyer R R. Traumatic hyphema. Int Ophthalmol Clin 1995; 35: 93–103.
5
4- Crouch ER. Management of traumatic hyphema: therapeutic options. J Pediatr Ophthalmol Strabismus 1999; 36:
6
238–250.
7
5- Read J, Goldberg MF.Comparison of medical treatment for traumatic hyphema. Trans Am Acad Ophthalmol
8
Otolaryngol 1974; 78:799-815.
9
6- Gilbert HD, Jensen AD.Atropine in the treatment of traumatic hyphema. Ann Ophthalmol 1973; 5:1297-1300. 7.
10
Thygeson P, Beard C.Observations on traumatic hyphema.Am J Ophthalmol 1952; 35:977-985.
11
8- Skalka HW.Recurrent hemorrhage in traumatic hyphema. Ann Ophthalmol 1978; 10:1153-1157.
12
9- Agapitos PJ, Noel LP, Clarke WN.Traumatic hyphema in children. Ophthalmol 1987; 94:1238-1241.
13
10- Fong LP.Secondary hemorrhage in traumatic hyphema.Ophthalmol 994; 101:1583-1588.
14
11- American academy of ophthalmology External disease and cornea 2002-2003: Basic and clinical science
15
cource.Sanfrancisco (CA): Academy ; 2003.362-371.
16
12- James C, Lai MD, Sharon Fekrat MD, Yolanda Barrón MS, Morton F, Goldberg MD. Traumatic Hyphema in
17
Children: Risk Factors for Complications. Arch Ophthalmol 2001; 119:64-70.
18
13- Rahmani B ,Jahadi H, Rajaeefard A. An analysis of risk for secondary haemorrhage in traumatic hyphema
19
.Ophthalmol 1999; 106:380-385.
20
14- Pieramici D, Goldberg M, Melia M et al. A phase III multicenter randomized placebo-controlled clinical trial
21
of topical aminocaproic acid (Caprogel) in the management of traumatic hyphema. Ophthalmol 2003; 110:2106-
22
15- Mitchel E, Opremcak Emmett T, Cunningham C, Foster S, Forster D, Ramana S R, Lopatynsky M. Basic and
23
clinical science course: Section 9: Intraocular inflammation and uveitis. Sanfrancisco (CA): American academy of
24
ophthalmology; 2003-2004.
25
16- Williams PB, Gray MK, et al. Topical aminocaproic acid in the treatment of traumatic hyphema. Arch
26
Ophthalmol 1997 Sep; 115(9): 1106-12
27
17- Cho J, Jun BK, Lee YJ, Uhm KB. Factors associated with the poor final visual outcome after traumatic
28
hyphema. Korean J Ophthalmol 1998; 12:122-129.
29
18- Farber MD, Fiscella R, Goldberg MF. Aminocaproic acid versus prednisone for the - - treatment of traumatic
30
hyphema. A randomized clinical trial. Ophthalmol 1991 Mar; 98(3): 279-86
31
19- Romano PE, Robinson JA. Traumatic hyphema: a comprehensive review of the past half century yields 8076
32
cases for which specific medical treatment reduces rebleeding 62% from 13% to 5% (P<0001). Binocul Vis
33
Strabismus Q 2000; 15 (2): 175-86.
34
20- Edwards WC , Layden WE.Traumatic hyphema.Am J Ophthalmol 1973; 75:110-116.
35
21- Parver LM ,Dannenberg AL ,Blacklow B ,et al. Characteristics and causes of penetrating eye injuries reported to
36
the National Eye Trauma System Registry .Public Health Report 1985-1991;
37
22- Thach AB ,Ward TP ,Hollifield RD ,et al. Ocular injuries from paintball pellets.Ophthalmol 1999; 106: 533-
38
23- Crouch ER ,Williams PB.Topical ACA in the treatment of patients with traumatic hyphema.Arch Ophthalmol
39
1998; 116: 395-396.
40
24- Crouch ER , Frenkel M. ACA in the treatment of traumatic hyphema. Am J Ophthalmol 1976; 81: 355-360 .
41
25- Crouch ER , Williams PB. Trauma: ruptures and bleeding. In: Tasman W , Jaeger EM ,eds. Duane& Clinical
42
Ophthalmology. Philadelphia: JB Lippincott; 1993. 4:1-18.
43
26- Deans R, Noel LP, Clarke W .Oral antifibrinolytics and traumatic hyphema in children. Can J Ophthalmol
44
1992; 27:181-183.
45
27- Yasuna E. Management of tra umatic hyphema. Arch Ophthalmol 1974; 91:190-191
46
28- Rynne M , Romano PE . Systemic corticosteroids in the treatment of traumatic hyphema. J Pediatr Ophthalm ol
47
Strabismus 1980; 17:141-143
48
29- Milauskas A , Fueger GE . Serious ocular complications associated with blowout fractures of the orbit.Am J
49
Ophthalmol 1966:62:670-672.
50
30- Laatikainen L , Mattila J. The use of tissue plasminogen activator in post-traumatic total hyphaema. Graef s
51
Arch Clin Exp Ophthalmol 1996; 234:67-68.
52
31- Starck T, Hopp L, Held KS, Marouf LM,Yee RW. Low-dose intraocular tissue plasminogen activator treatment
53
for traumatic total hyphema postcataract and penetrating keratoplasty fibrinous membranes. J Cataract Refract Surg
54
1995; 21:219-2.
55
ORIGINAL_ARTICLE
Ankle / Brachial Indexin Thrombotic Cerebrovascular Disease Patients
I ntroduction: Previous studies showed that Ankle Brachial Index (ABI) score less than 0.9 increases probability of ischemic heart disease up to 2 times, risk of TIA/ stroke to quadruple, and asymptomatic carotid and popliteal artery stenosis to one and half fold. ABI Material and Methods: This cross-sectional descriptive study was done on 98 patients with thrombotic cerebrovascular accident in Yazd Shahid Sadughi Hospital, between February 2001 and February 2002. A questionnaire including demographic, clinical, and paraclinical data was completed and results were analyzed using descriptive statistics and frequency distribution tables. Results: Forty four percent of the patients were men. Mean age was 73/1 + 1/5. ABIConclusion:ABI0.07). Because of lack of samples in the present study, authors suggest a study with a larger sample group.
https://mjms.mums.ac.ir/article_5580_c595acd95c55d00d32ea29250a87333d.pdf
2007-06-22
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10.22038/mjms.2007.5580
Peripheral artery disease
ABI
Thrombotic cerebrovascular disease
M
Rafiee
1
دانشیار
LEAD_AUTHOR
M.H
Eslami
2
استادیـار
AUTHOR
M
Aflatonian
3
پزشک پژوهشگر - مرکز تحقیقاتی و درمانی قلب و عروق یزد
AUTHOR
S.M
Namayandeh
4
پزشک پژوهشگر - مرکز تحقیقاتی و درمانی قلب و عروق یزد
AUTHOR
S.M
Sadr Bafghi
5
دانشیار
AUTHOR
1-GBD, Christopher J, L Murray, Alan D Lopez. Global Burden den of Disease & Injury Compendium of
1
Incidence, Prevalence &Mortality Estimates for over 200 Condition. © WHO & Harvard University: 1998; (1) (3).
2
2-Zheng ZJ, Sharrett AR, chambless LE, et al. Associations of Ankle/Brachial Index with clinical coronary heart
3
disease, stroke and preclinical carotid and popliteal atherosclerosis: the atherosclerosis risk in communities (ARIC)
4
Study. Atherosclerosis 1997 May; 131(1): 115-25.
5
3-William R HIATT, Luana R HIATT. Peripheral disease handbook. 2001; 69-73.
6
4-Murabito JM, Evans JC, Larson MG, Nieto K, Levy D, Wilson PW. Framingham Study. The ankle – brachial
7
index I the elderly and risk of stroke, coronary disease, and death: the Framingham study. Arch Intern Med.2003
8
Sep 8; 163 (16): 1939-42.
9
5-Raymond D. Adams & Maurice victor. Principles of neurology (forth edition). 1989.
10
6-Sikkink CJ, Van Asten WN, et al.Decreased ankle/brachial indices in relation to morbidity and mortality in
11
patients with peripheral arterial disease. Vasc Med. 1997; 169-73.
12
7-Weitz J, byrne J, et al.Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical
13
review. Circulation 1996 ;( 94): 3026-3049.
14
8-Sen S, Wu K, McNamare R, Lima J, Piantadosi S, Oppenhemer SM. Distibution, Severity and risk factors for
15
risk factors for aortic atherosclerosis in cerebral ischemia. Cerebrovasc Dis. 2000 Mar- Apr; 10(2):102-9.
16
ORIGINAL_ARTICLE
Outcome of Femoral Neck Fractures in Children
I ntroduction:Femoral neck fractures in children, despite adults, are the result of high-energy trauma and, usually, accompanied with injuries of other parts of the body. The aim of this study was to evaluate the outcome and complications of femoral neck fracture surgeries. Material and Methods: This descriptive study was done on 68 children with displaced femoral neck fracture in Mashhad Kamiab Hospital between 1993 and 2003. Demographic characteristics, clinical, laboratory, radiography, and surgery results were collected by a questionnaire and analyzed by descriptive statistics and frequency distribution tables. Results: Of 68 patients, 72% had good radiographic results. Complications included AVN in 10 (14/7%), limb shortening in 9 (13/2%), premature epiphysial fusion in 5 (7/4%), coxa valga in 4 (5/9%), Coxa vara in 2(2/96%) slip in 1 (1/47%). Nonunion was not seen. Conclusion: Anatomical and surgery reduction of the fractured femoral neck lowers the risk of complications. Because of the rarity of this fracture that constitutes 1 % of the all pediatric fractures, Orthopedic surgeons treat only a few of such patients. The outcome of this fracture is strongly related to initial management.
https://mjms.mums.ac.ir/article_5581_ceb39b94add55b22526e70427b6b5545.pdf
2007-06-22
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10.22038/mjms.2007.5581
Fracture
Femur neck fracture
Reduction
AVN
Complications
M.T
Peivandi
peivandimt@mums.ac.ir
1
استادیار
LEAD_AUTHOR
M
Rahimi
2
دستیار ارتوپدی
AUTHOR
1- Gowers W. Epilepsy and other chronic convulsive diseases: their causes, symptoms and treatment. New York:
1
William Wood; 1885.
2
2- Beaumanoir A. History of Reflex Epilepsy. In: Zifkin BG, Andermann F, Beaumanoir A, et al. Advances in
3
neurology, Reflex epilepsy and reflex seizures.Philadelphia: Lippincott-Raven; 1998: 1-4.
4
3- Dreifuss FE. Classification of Reflex Epilepsies and reflex seizures, In: Zifkin BG, Andermann F, Beaumanoir A,
5
et al. Advances in neurology, Reflex epilepsy and reflex seizures.Philadelphia: Lippincott-Raven; 1998:5-13.
6
4- Commission on classification and terminology of the International League against Epilepsy. Proposal for revised
7
classification of epilepsies and epileptic syndromes. Epilepsia 1989 ;(30): 389-99.
8
5- Satishchandra P, Shivaramakrishana A, Kaliaperumal VG, et al. Hot water epilepsy: a variant of reflex epilepsy
9
in southern India. Epilepsia 1988; (29): 52-6.
10
6- Falconer MA, Driver MV, Serafitinides EA. Seizures induced by movement: report of a case relieved by
11
operation. Neural Neurosurg Psychiatry, 1963 ;( 26): 300-7.
12
7- Karbowski K. Epileptic seizures imduced by vestibular and auditory stimuli. In: Beaumanoir A, Gastaut H,
13
Naquet R, et al. Reflex seizures and reflex epilepsies. Geneva: Editions Medicine et Hygiene; 1989. 255-60.
14
8- Lee SI, Sutherling WW, Persing JA, et al. Language induced seizure: a case of cortical origin. Arch Neural 1980;
15
(37): 433-6.
16
9- Loiseau P, Guyot M, Loiseau H, Rougier A, et al. Eating epilepsy. Epilepsia, 1986 ;( 27): 161-163.
17
10- Trenite KN, Dorothee GA. Reflex seizures induced by intermittent light stimulation, In:Zifkin BG, Andermann
18
F, Beaumanoir A, et al. Advances in neurology, Reflex epilepsy and reflex seizures.Philadelphia:LippincottRaven;(998):1-4.
19
11- Gastaut H. Conclusions of a symposium on reflex mechanisms in the genesis of epilepsy. Epilepsia 1 962; (3):
20
457-460.
21
ORIGINAL_ARTICLE
Comparison of Incidence of Succinylcholine-Induced Fasciculation and Postoperative Myalgias
I ntroduction: Fasciculation and myalgia are common complications of succinylcholine and decrease of incidence and intensity of them will reduce succinylcholine-induced side effects. This study was done to evaluate the severity and prevalence of fasciculation and myalgia after succinylcholine and perform a comparison between three groups. Material and Methods:In this case – control study in 2006, 75 patients with ASA I and orthopedic surgery were evaluated in Imam Reza hospital. The patients divided randomly in to three same groups. In first group thiopental and succinylcholine 1.5 mg/kg was injected, in second group propofol 2 mg/kg and succinlycholine 1.5 mg/kg and in third group thiopental and succinylcholine 3 mg/ kg was administered. Fasciculation, intubation quality after 1 min, and myalgia after 24 h were analyzed. Demografic parameters, pain scales and fasciculation data were gathered in a questionnaire and analyzed by SPSS, descriptive statistics and frequency distribution tables. Results: Fasciculation rate was %76 in first group, 80% in second group, and %84 in third groups. Myalgia was %24 in first group , %28 in second group, and %20 in third group . There were no significant differences between group 1&2 and also 1&3 with respect to fasciculation, Intubation, and post–operative myalgia. Conclusion:We concluded that propofol aggregates muscular relaxation versus thiopental, and low-dose versus high–dose of succinylcholine and chang to phase II block had no differences regarding to these complications.
https://mjms.mums.ac.ir/article_5582_ce5976e87bfdae4f0e9be24340bf9f98.pdf
2007-06-22
211
216
10.22038/mjms.2007.5582
Succinylcholine
Propofol
Thiopental
Fasciculation
Myalgia
M
Taghavi- Gilani
1
استادیار بیهوشی
LEAD_AUTHOR
M
Razavi
razavim@mums.ac.ir
2
متخصص بیهوشی
AUTHOR
S.R
Nami
3
دستیار بیهوشی
AUTHOR
S
Jahanbakhsh
4
استادیار بیهوشی
AUTHOR
1 - Schereiber JU, Lysakowaski C, Fuchs-Buder T, et al. Prevention of succinylcholine-induced fasciculation and
1
myalgia: A Meta-analysis of Randomized Trials.Anesthesiology 2005; 103(4): 877-884.
2
2- Demers – Pelletier J, Drolet P, cirard M, et al. Comparison of recuronium and d-tubocurarine for prevention of
3
succinylcholine- induced fasciculations and myalgia. Can J Anesthesia 1997; 44: 1144 – 1147
4
3- Waters DJ, Mapleson WW: Suxamethouium pains: Hypothesis and observation. Anesthesia 1971; 26:127-141.
5
4- Spence D, Domen – Herbert R, Boulette E, et al: A comparision of rocuronium and lidocaine for the preventaion of
6
postoperative myalgia after succinylcholine administration . AANA J 2002; 70(5): 367-72.
7
5 - Brodsky JB,Brock-Utne JG, Samuel SI: Pancuronium pretreatment and post-succinylcholine myalgia.Anesthesiology
8
1979; 51: 259-261.
9
6 -Kararmaz A, Kaya S, Turhanuglu M, et al. Effects of high-dose propofol on succinylcholine-induced fasciculations
10
and myalgia.Acta Anaesthesiol Scand 2003; 47(2):180.
11
7- Manataki AD, arnaoutoglu HM, Tefa LK, et al. Continuous propofol administration for suxamethonium-induced
12
postoperative myalgia: Anaesthesia 1999; 54(5):419-422.
13
8- Mingus Ml, Herlich A, Eisenkraft JB: Attenuation of suxamethonium myalgias. Effect of midazolam and
14
vecuronium. Anaesthesia 1990; 45: 834-837.
15
9- Maddineni VR, Mirakhur RK, Cooper AR: Myalgia and biochemical changes following suxamethonium after
16
induction of anesthesia with thiopentone or propofol. Anesthesia 1993; 48:626 -628.
17
10- Bettelli G .Which muscle relaxant should be used in day surgery and when. Curr Opin Anesthesiol 2006; 19(6):600-
18
11- McLoughlin C, Leslie K, Caldwell JE: Influence of dose on suxamethonium –induced muscle damage .Br J
19
Anesthesia 1994; 73:194.
20
ORIGINAL_ARTICLE
A Case Report of Fetal Warfarin Syndrome
I ntroduction: Warfarin is an anticoagulant drug, reducing the synthesis of vitamin K dependent coagulant factors. It has fewer complications than heparin during pregnancy, but it passes easily through the placenta. Therefore it may induce unfavorable condition so called as fetal warfarinsyndrome. The common presentations of this syndrome are nasal hypoplasia, epiphysial calcification, and skeletal disorders. Fetuses exposed to warfarin in the first trimester of pregnancy have an increased risk of embryopathy (nasal hypoplasia and stippled epiphyses). Case Report:A male neonate with new symptoms of fetal embryopathy (femoral agenesis bilateral dislocation of hip, agenesis of corpus callozom) is presented. He was born postdate from a mother using warfarin 2.5 mg/kg during the whole pregnancy. He also had short lower limb, finger deformity, nasal hypoplasia, radioulnar dislocation, hydrocephaly, and brachiocephaly.
https://mjms.mums.ac.ir/article_5583_111596e64cad9ff8fc49447ea692dce6.pdf
2007-06-22
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10.22038/mjms.2007.5583
Agenesis
Embryopathy
fetus
Hypoplasia
Warfarin
Gh
Mamuri
gmamori@yahoo.com
1
استاد (فوق تخصص نوزادان)
AUTHOR
H.
Boskabadi
boskabadih@mums.ac.ir
2
استادیار ( فوق تخصص نوزادان)
LEAD_AUTHOR
H
Ehteshammanesh
3
دستیار تخصصی بیماریهای کودکان بیمارستان قائم (عج)
AUTHOR
1- Finkelstein y, Chitayat D, Schechter T, et al. Warfarin emberyo pathy following Low dose maternal exoposuse. J
1
obstet Gynecol can 2005; 27:702 – 206.
2
2- Sathien kijkanchai A, Wasant P. Fetal warfarin syndrome .J Mod Assoc Thai 2005; 88 (suppl 8): S 246-50.
3
3- Bates SM, Greer IA, Hirsh J, Ginsberg JS. Use f antithrombotic agent during pregnancy. Chest 2004; 126: 627 S-
4
4- Zakzowk MS. The Congenital Warfarin syndrome. J Laryngol 1986; 100: 215 - 219.
5
5- Hall JG, Pauli RM, Wilson KM. Maternal and fetal sequelae of anticoagulation during pregnancy. Am J Med
6
1980; 68: 122- 40.
7
6- Bony C, Zyka F, Tiran Rajaofera I , Attali T, De Napoli S , Alessandri JL . warfarin feto pathy . Arch Pediatr
8
2002; 9: 705 – 8.
9
7- Van Driel D, Wesseling J , Rosendaal FR, Odink RJ , Van der Veer E, Gerver WJ , et al . Growth until puberty
10
after in utero exposure to coumarins . Am J Med Genet 2000; 95: 438- 43.
11
8- Hall BD. Warfarin emberyo pathy and urinary treact anomalies. A J Mod Genet 1989; 34 /l 292-3.
12
9-Kaplan LC, Congenital Dandy. Walker malformation associated with first trimes ter warfarin: A case report and
13
literature review. Teratology 1985; 32: 333.
14
10- Pati S, Helmbrecht GD. Congenital schizencephally associated with in utero
15
warfarin exposure . Reprod Toxicol 1994; 80: 115 –12.
16
11- Di Saiu Pj. Pre gnancy and delivery of prosthesis. obstet Gynecol 1966 ; 28 : 496- 72 .
17
12- Ayhan A, Yapar EG, Yucek K, Kisnisci HA, Nazli N, Ozmen F. Pregnancy and its complications after cardiac
18
valve replacement . Int J Gynaecol Obstet 1991; 35: 117-22.
19
ORIGINAL_ARTICLE
Neuroborreliosis during Relapsing Fever and a Case Report
I ntroduction: Relapsing fever is a spirochetal disease that is caused by different Borrelia species. Relapsing fever is well recognized as an infection of the blood, characterized with episodes of fever, rigor and spirochetemia; but little is known about its predilection for nervous system. This report is supposed to present a patient with neuroborreliosis during relapsing fever. Case report:The presented patient in this paper is a 22 year old woman from Afghanistan with clinical features of meningitis and recurrent episodes of fever with rigor. In diagnostic evaluation, the patient had a CSF profile with aseptic meningitis pattern, and in third time peripheral blood smear spirochet was reported. With diagnosis of meningitis during relapsing fever, she was treated by intravenous ceftriaxone. With administration of first dose of ceftriaxone, Jarisch - Herxheimer reaction occurred. Patient was treated for 14 days by intravenous ceftriaxone. At the end of treatment, the patient was symptom free and had a normal CSF profile. Therefore patient was discharged. Conlusion: In the patients with aseptic meningitis in endemic regions, besides common agents, relapsing fever should also be considered.
https://mjms.mums.ac.ir/article_5584_c7d88f71b5d9786de526606223ce2877.pdf
2007-06-22
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10.22038/mjms.2007.5584
Borrelia
Relapsing fever
Neuroborreliosis
A.
Tavanaii
tavanaeea@mums.ac.ir
1
استادیار بیماریهای عفونی
LEAD_AUTHOR
A
Bojdi
bojdya@mums.ac.ir
2
متخصص بیماریهای عفونی
AUTHOR
S.
Rastegari
rastegarisara@yahoo.com
3
دستیار تخصصی بیماریهای عفونی
AUTHOR
M.R
Keramati
4
استادیار آسیبشناسی دانشگاه علوم پزشکی مشهد
AUTHOR
1- Mandell G, Bennett J, Dolin R. Borrelia Species (Relapsing fever) .In: Kyu Y R, Warren D, Johnson J.
1
Prinicples and practice of infections disease. 6 th ed.Polizzano F; 2005. Vol. 4. 2795 – 2797.
2
2 - Pichon B, Rogers M, Egan D, Gray J. Blood - meal analysis for the identification of reservoir hosts of tick -
3
born pathogens in Ireland. Vector Born Zoonotic Dis 2005 summer; 5(2): 172 - 180.
4
3- Cadavid D, Barbour A. Neuroborreliosis during relapsing fever: review of the clinical manifestations, pathology,
5
and treatment of infections in humans and experimental animals. CID J. 1998 Jan; 151 - 160.
6
4- Goldman L, Ausiello D. Relapsing fever .In: Hughes M, Perti W: Cecil textbook of medicine. 22 th ed. Murphy
7
K; 2004 .Vol.2. 1933 - 1934.
8
5- قوامی، ب. مقدم زرندی ر. ع : علایم بالینی و یافته های آزمایشگاهی بیماری تب بازگرد آندمیک در شهرستان زنجان. مجله علمی دانشگاه علوم پزشکی و
9
خدمات بهداشتی درمانی استان زنجان،َ ش31 - 30 ( بهار و تابستان 29:(1369
10
6- محمدزاده، ق. قریشی، ق : تب راجعه در کودکان مرکز آموزشی درمانی قدس قزوین (1372 - 75). مجله دانشگاه علوم پزشکی و خدمات بهداشتی درمانی
11
قزوین، سال اول.َش 1 (دوره جدید). : 38 .
12
7- Brahim H, Perrier - Gros - Claude JD, Postic D, Baranton G, Jambou R. Identifying relapsing fever borrelia ,
13
Senegal. Emerging infectious diseases. 2005 Mar; Vol.11.No.3 474 - 475.
14
8 - Negussie Y, Remick DG, Deforge LE, Kunkel SL, Eynon A, Griffin GE. Detection of plasma tumor necrosis
15
factor, interleukins 6, and 8 during the jarisch - herxheimer reaction of relapsing fever. J Experimen Med Vol. 175,
16
1992: 1207 - 1212.
17
9 - L Kasper D , S Fauci A , longo D , Braunwald E , L Hauser S , Jam16 th ed eson J. Relapsing fever. In: T
18
Dennis D, B Hayes E. Harrison,s Principles of Internal Medicine .16 th.ed . Randolph T; 2005. Vol.1.991 - 994.
19
ORIGINAL_ARTICLE
Hyperthyroidism and systemic embolism in the absence of cardiac dysrhythmia
I ntroduction: Hyperthyroid patients are at increased risk of systemic embolism due to cardiac dysrhythmia , especially atrial fibrillation. Most of these embolic events occur in central nervous system. Systemic emboli in the absence of cardiac dysrhythmia and in arteries of extremities are very uncommon. In review of literature only one case is reported. Case report: It report a hyperthyroid patient with an embolism in left upper extremity in the absence of cardiac dysrhythmia
https://mjms.mums.ac.ir/article_5585_46a0df6268984df5e7613841ab2783fb.pdf
2007-06-22
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10.22038/mjms.2007.5585
Hyperthyroidism
Embolism
Atrial fibrillation
Z
Musavi
mosaviz@mums.ac.ir
1
دانشیار گروه داخلی
LEAD_AUTHOR
P
Layegh
layeghpa@mums.ac.ir
2
استادیار گروه داخلی (غدد درون ریزو متابولیسم بالغین)
AUTHOR
1-Osman F, Gammage M, Sheppared M, Franklyn J. Cardiac dysrhythmia and thyroid dysfunction: The hidden menace?
1
J Clin Endocrinol Metab 2002;87: 963-967
2
2-Klein I, Levey GS. The cardiovascular system in thyrotoxicosis. In: Braverman LE, Utiger RD, eds. Werner &
3
Ingbar’s. The Thyroid: a fundamental and clinical text. 7th ed. Philadelphia: Lippincott-Raven 1996:607-615
4
3-Frost L, Vestergaard P, Mosekilde L. Hyperthyroidism and risk of atrial fibrillation or flutter: a population –based
5
study. Arch Inter Med 2004; 164:1675-1678.
6
4-Hendriksen O, Peterson CL. Embolic episodes after treatment of atrial fibrillation in a patient with thyrotoxicosis.
7
Ugeskr Laeger 1995; 157(29):4138-9.
8
5-Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. N Engl J Med 2001; 344: 501-509.
9
6-Haynes JH, Kageler WV. Thyrocardiotoxic embolic syndrome. South Med J 1989; 89(10): 1292-3(Abstract).
10
7-Bar-Sela S, Ehrenfeld M, Eliakim M. Atrial embolism in thyrotoxicosis with atrial fibrillation. Arch Intern Med 1981;
11
141(9):1191-2(Abstract).
12
8- Smith CD, Ain KB, Ryan S, Ngai BC. Systemic embolism in thyrotoxicosis without cardiac arrhythmia. Thyroid
13
1994; 4(2):209-11.
14