Comparison of efficacy and complication of classic and short palmar incision in the patients with carpal tunnel syndrome

چکیده: زمینه و هدف: معمولاً برای درمان جراحی بیماران مبتلا به سندرم تونل‌کارپال از روش برش کلاسیک جراحی باز استفاده می‌شود که منجر به ایجاد اسکار دردناک و عوارض بعد از جراحی و تاخیر در بازتوانی بیمار می‌شود. روش دیگر استفاده از برش کوتاه کف دستی است که به نظر می رسد خسارت وارده کمتری به بافت ها نسبت به روش کلاسیک داشته باشد. هدف از این مطالعه بررسی مقایسه اثربخشی و میزان عوارض این دو روش جراحی می‌باشد. روش‌ بررسی: در یک کارآزمایی بالینی بیماران کاندید عمل جراحی سندرم تونل کارپال بطور تصادفی در دو گروه 51 نفری قرار گرفتند. گروه شاهد به روش برش کلاسیک جراحی باز و گروه آزمون به روش برش کف‌دستی کوتاه تحت عمل جراحی قرار گرفتند. نتایج از نظر میزان عفونت، بروز اسکار جراحی، تندرنس و درد در محل برش جراحی، پارستزی و خواب‌رفتگی اندام، تست تینل (Tinnel) و فالن (Phalen) و بهبود علایم حسی بیمار در دو نوبت 3 هفته و 3 ماه بعد از جراحی ثبت و با استفاده از آزمونهای آماری فیشر، کای دو و t-student مقایسه شدند. یافته‌ها: از نظر بروز عفونت زخم، آسیب به عصب مدیان و شاخه کف‌دستی عصب مذکور، در دو روش موردی دیده نشد. در گروه آزمون و شاهد به ترتیب میزان تندرنس در محل برش جراحی در هفته سوم 8/7 و 8/58 و در ماه سوم 2 و 1/47 (05/0

Sedative and hypnotic effects of Iranian traditional medicinal herbs used for treatment of insomnia

For tens of centuries, plants have been highly valued and regularly used as medicine amongst the masses. Insomnia, a loss of sleep, is mostly treated by synthetic sleeping tablets these days. However, questions have been raised about the safety of prolonged use of artificial sedatives due to their deleterious side effects such as physical dependence. In recent years, there has been an increasing propensity to preclude insomnia by herbal medicines throughout the world. Many herbs have a lengthy background in terms of insomnia treatment in Iran. This paper gives an account of previously published research on sedative and hypnotic effects of medicinal herbs used for treatment of insomnia in Iranian traditional medicine

A comparative study pertaining to deleterious effects of diclofenac sodium and meloxicam on kidney tissue in rats

NSAIDs (nonsteroidal anti-inflammatory drugs) are a class of drugs with analgesic, anti-inflammatory, and antipyretic effects. Diclofenac sodium is one of the world's most widely-prescribed NSAIDs. Meloxicam is another NSAID that was approved in the last several years. Treatment with NSAIDs may result in renal damage. Relatively, little is known about com-parative nephrotoxicity of NSAIDs. Therefore, the present study was designed to compare the adverse effects of diclofenac sodium and meloxicam on renal tissue in rats. Forty eight Wistar male rats were randomly assigned into 3 groups of 16 animals each. Group C served as normal control and received normal saline. Group D and M received diclofenac sodium (2.3 mg/kg/day) and meloxicam (2.3 mg/kg/day), respectively. After 17 days, all rats were scarified. Their kidneys were then harvested and processed for histological examination. In addition to cellular details, renal tubular count and diameter were assessed with the light microscope. The data were analyzed using SPSS software. We found that the mean number of renal tubules was significantly lower in group D, than in group C. Moreover, the mean renal tubular diameter was significantly higher in group D than in group C. The present study showed that a considerable degree of nephrotoxicity resulted from diclofenac sodium, compared to meloxicam. We suggest that diclofenac sodium can be replaced with meloxicam

Evaluation Effects of Verapamil as a Calcium Channel Blocker on Acquisition, Consolidation and Retrieval of Memory in Mice

Many factors are involved in learning and memory processes including brain nuclei, neurotransmitter systems, and the activity of ion channels. Studies showed inconsistent effects of calcium channel blockers on learning process, especially memory consolidation; however, little is known about their effect on memory acquisition and retrieval. Accordingly, the present studyaimed to determine the effects of verapamil calcium channel antagonist as a representative of the phenylalkylamine group on different stages of memory and learning processes including acquisition, consolidation and retrieval in mice. In this experimental study, 150 male albino mice with a mean weight of 30 g were used. The mice were trained in a passive avoidance-learning task (1 mA shock for 2 seconds for evaluation of memory acquisition and consolidation and 3 seconds for evaluation of memory retrieval). The effect of verapamil (1, 2.5, 5, 10, and 20 mg/kg) on memory consolidation and the most effective dose of consolidation phase on memory acquisition and retrieval was assessed. For the evaluation of memory consolidation, the animals received the drug intraperitoneally immediately after training, while for evaluation of memory acquisition and retrieval, the drug was injected one hour before training. Memory retrieval test was performed 48 hours after training (the length of time it took the animal to enter the dark part of the device). The results showed that verapamil injection exerted no effect on memory acquisition and consolidation; nevertheless, it was capable to disrupt memory retrieval in 10 and 20 mg doses. These results indicate that as a phenylalkylamine calcium channel antagonist, high doses of verapamil can impair memory

The effect of oral zinc sulfate on prevention of chemotherapy-induced oral mucositis in breast cancer patients treated with adriamycin and cyclophosphamide; a double-blind randomized clinical trial

Introduction: One of the most important complications faced by cancer patients is chemotherapy-induced oral mucositis (CIOM). In addition, the role of orally used zinc sulfate in its prevention and treatment is still a controversial issue and the results in this regard have not been conclusive. Objectives: Evaluation the effect of zinc sulfate supplement on prevention of CIOM in breast cancer patients treated with adriamycin and cyclophosphamide was the aim of this study. Patients and Methods: The current double-blind randomized clinical trial was conducted on 87 patients with breast cancer. Consumption of two oral zinc sulfate tablets and two placebo tablets with food was prescribed in the case (44 patients) and control (43 patients) groups, respectively. During the 4 cycles of chemotherapy, the incidence and severity of CIOM, the onset time of mucositis from the start of chemotherapy, the severity of pain, and the severity of dry mouth were recorded. In addition, the patients’ quality of life was recorded using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Results: Findings revealed that the severity of CIOM in the first, second, and third sessions with the values of 1.22±1.01, 1.18±0.97 and 1.02±0.79, respectively, was significantly lower in the case group than the control group with the values of 1.91±0.89, 1.80±0.92, and 1.67±0.85, respectively (P0.05). Conclusion: Oral zinc sulfate had a significant role in reduction of the incidence and severity of CIOM, the severity of dry mouth, and the severity of pain in the initial sessions of chemotherapy. However, no significant difference was in postponing the incidence of CIOM and the quality of life of patients in the case group. Trial Registration: This trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20150304021338N2; https://irct.ir/trial/51105, ethical code# IR.MUI.MED. REC.1399.277)

Clinical Outcomes of Intramedullary and Extramedullary Fixation in Unstable Intertrochanteric Fractures: A Randomized Clinical Trial

Background: The best method for repairing intertrochanteric fractures is still controversial. The fixation methods include extramedullary (EM) and intramedullary (IM). Studies that compare IM and EM fixations for unstable hip fractures are rare. In this study, our goal was to compare the efficacy of EM and IM fixation in treatment of unstable intertrochanteric fractures. Methods: A total of 113 patients with unstable intertrochanteric were randomized in this cohort study between March 2016 and June 2018 in trauma center of Kashani and Alzahra Hospitals, Isfahan, Iran. The patients were followed for a period of 12 months with sequential clinical and imaging evaluations. Baseline data were recorded at the time of injury. Radiographs were evaluated immediately post-operatively and at the scheduled follow-up intervals. Results: A total of 20 of patients were excluded during the study and finally 93 patients (43 males and 50 females) with mean age of 62.74 +/- 16.4 completed the follow-up sessions. Mann-Whitney test indicated a significant difference in tip-apex distance between the two groups. While the two groups were homogeneous in the baseline LEM score, it was not significantly different between two groups after 1 and 3 months of surgery as well. However, the LEM score was significantly higher in IM group after 6 and 12 months of surgery. Conclusion: According to our findings, IM nails (such as the cephalomedullary nail) afforded more advantages over EM devices (such as the DHS and DCS) in the treatment of unstable intertrochanteric fractures. Our results indicated that the final LEM scores as well as the time to union were better in IM fixation group

First application of total skin electron beam therapy for Mycosis Fungoids in Iran

Total skin electron beam therapy (TSEBT) is internationally considered as a treatment modality for cutaneous T-cell lymphoma for either curative purpose or palliative care. The first attempt to apply TSEBT in Iran took place at department of clinical oncology of Rock Center of Karaj. Irradiation was done by precise linear accelerator (ELEKTA) and was performed in the standing position of patient. To evaluate the treatment reliability and determination of physical characteristics of the clinical electron fields, specific measurements were done using thermoluminescent dosimeters. The results revealed that TSEBT can be routinely used by providing accurate dosimetric measurements to get homogenous dose coverage

Pain relief and associated factors in patients undergoing vertebroplasty due to osteoporotic vertebral fracture

Background: Osteoporotic vertebral fracture (OVF) is a common spinal fracture in the elderly population treated with conservative or surgical techniques. Patients with such fractures may experience chronic pain due to nonunion and instability, deformity with kyphosis and neurologic symptoms due to neural compression. Surgical interventions have definite roles in treatments especially when conservative therapy fails. Cement augmentation in forms of vertebroplasty and kyphoplasty or even surgical fixation with or without column reconstruction are among our armamentarium to deal with problems arising during the treatment of these patients. Methods: We entered patients with OVF who did not respond to conservative treatments for more than 4 weeks and were candidates for vertebroplasty. Pain Visual Analog Scale (PVAS) was assessed for patients before the procedure, in the first month and 6 months after surgeries. We also analyzed factors including time passed from fractures, amounts of injected cement, age, sex, types of fractures, segmental kyphosis and sites of fractures. Data were collected and analyzed using SPSS software version 24. Results: A total number of 140 patients entered. The mean age of the patients was 64.90 +/- 7.97 years. Mean preoperative pain level was 8.35 +/- 0.97 points on VAS (0-10) score. The mean Post-operative VAS score after one month and after six months were 4.65+0.66 and 5.28 +/- 0.75 respectively. The mean consumed cement volume was 5.77+1.40 ml. Cement volume of more than 5 ml was injected for 53.6 of patients. 78.7 of fractures were located in T10-L2 levels (thoracolumbar fractures). 14.2 of fractures in L3-L5 (lumbar fractures) and 7.1 in T4-T9 (thoracic fractures). 53.6 of the patients had kyphosis levels below 20 degrees. Reduction of pain in patients younger than 60 years was more than patients older than 60 years but both groups indicated pain reduction (P<0.001). The end-plate fracture had a higher likelihood of pain relief compared with burst or retropulsed fractures (OR=1.161). Patients with thoracolumbar fractures had higher chances of pain reduction compared with other locations (OR=1.870). Kyphosis less than 20 degrees and also cement volume more than 5 ml had also significant effects on reducing the pain after surgeries (OR=2.054 and OR=2.412 respectively (P<0.05)). Conclusion: Vertebroplasty is an effective option in treating patients with OVF who have not respond to conservative treatment. Factors such as younger age, OVFs involving either end-plates, more than 5 ml of cement injection, segmental kyphosis below 20 degrees and thoracolumbar fractures are associated with better results for pain amelioration

The Role of Routine Preoperative Magnetic Resonance Imaging in Idiopathic Scoliosis: A Ten Years Review

Study DesignProspective study.PurposeTo determine the role of routine preoperative magnetic resonance imaging (MRI) to detect the incidence and risk factors for intraspinal anomalies in patients with idiopathic scoliosis.Overview of LiteratureThe incidence and risk factors for intraspinal anomalies in patients with idiopathic scoliosis are controversial, and the indications for preoperative MRI in these patients vary among centers.MethodsInformation on patients with idiopathic scoliosis who were surgical candidates over 10 years (age at presentation, sex, magnitude and apex of major curve, intraspinal anomalies detected by MRI, and neurological examination results) were recorded, the patients were grouped according to the intraspinal anomaly, and the data were analyzed.ResultsOf the 271 patients with idiopathic scoliosis, 27 had neuroaxial abnormalities (9.9%). Of these 27 patients, 14 (52%) underwent a neurosurgical procedure. Significant differences were observed in the frequency of early disease onset and male sex (p<0.05) between the group of patients with neuroaxial abnormalities on preoperative MRI and those who did not have a cord anomaly. No difference was detected in the magnitude or direction of the curve.ConclusionsNeuroaxial abnormalities in patients with idiopathic scoliosis and a normal neurological examination were highly frequent (9.9%). Missing these abnormalities before surgery could inflict catastrophic postoperative complications. The incidence of neuroaxial abnormalities was higher in male patients and in those with early onset disease. Thus, MRI is essential for all patients with idiopathic scoliosis who require medical intervention

Study and analysis of the functions of al-Urf in understanding and inferring the religious rules

Religious rules in Shiite jurisprudence are inferred from the four sources of the Qur'an, Sunnah, reason and consensus. But, in addition to these sources, some foundations such as common law (al-urf) are also mentioned. Referring to common law is widely used in the words of jurists. Based on it, the question arises here: what are the roles of common law and Irtikazat in common law in understanding and inferring the religious rules? This article seeks to answer this question and tries to study and analyze the functions of common law in understanding and inferring the religious rules. The research hypothesis is that common law and Irtikazat in common law are used in understanding the words of religious arguments, subjecting and de-subjecting of common law for the religious documents, proving or denying some rights and other issues that are used by jurists and lawyers in the process of inferencing. One of the findings of the present study is that most scholars of the Islamic jurisprudence and law have not distinguished between these two foundations. But, it is more correct that common law is considered from the category of objective matter in the practical life of people, while Irtikazat in common law are from the category of subjective matter