trauma rehabilitation توانبخشی تروما
background: saddle nose deformities mostly result from trauma.most reports of saddle nose correction after trauma relate to isolated fractures,but in this article the experience of the authors is presented in relation to bone grafting for the correction of the saddle nose in multiple facial fracture patients.objectives: the current study aimed to report the results of a protocol for choosing the source of bone graft for dorsal nasal bone grafting in acute trauma patients with multiple facial fractures.patients and methods: in a retrospective study,archived files of maxillofacial trauma patients who were treated between 2005 and 2012 at mashhad emdad hospital (a level one trauma center) were reviewed.cases were selected in which a traumatic saddle nose deformity concomitant with other facial fractures had been corrected with dorsal nasal bone grafting.the donor site,type of fixation,access to the dorsum of the nose,associated facial fractures,shape of the graft (cantilever or l-shaped),and plane of dissection in the dorsum of the nose (subperiosteal or subcutaneous) were assessed.results: there were 11 patients treated using this method.the male-to-female ratio was 7:5.one miniscrew with the lag technique was the preferred method for the fixation of the dorsal nasal bone graft.splitcalvarial bone graft was the mostcommonly used type of bone graft.an open rhinoplasty approach and maxillary degloving were two commonly used incisions,and the most commonly associated fractures were maxillary lefort fractures.the cantilever design was used in eight patients for the correction of the saddle nose deformity,and in four patients the bone graft was inserted into the nose in the subcutaneous plane.conclusions: saddle nose reconstruction with bone graft in multiple facial fracture patients is a predictable method if surgical accesses to the region are carefully designed,considering the accompanying fractures.© 2016,iranian red crescent medical journal.
background: myosin heavy chain 9 (myh9) gene polymorphisms have been implicated in different types of renal disease,as well as in nephropathy attributed to type 2 diabetes mellitus.objectives: this study sought to analyze the association of myh9 gene polymorphism (rs4821481) with diabetic nephropathy (dn),urine albumin excretion value,and glomerular filtration rate (gfr) in an iranian diabetic population.methods: this case-control study included 201 diabetic patients with and without dn,who were referred to the diabetes and metabolic center,tehran,iran.the allele and genotype frequencies of rs4821481 were determined using arms-polymerase chain reaction (arms-pcr).in both groups,blood levels of fasting glucose,hba1c,urea,creatinine,uric acid,and lipids,as well as urine albumin and creatinine,were measured and gfr was calculated.results: patients who carried the rs4821481 polymorphism had significantly higher urinary excretion of albumin (p < 0.05) and insignificantly lower gfr values (p = 0.08).the frequency of rs4821481 snp was 22.8% in patients without dn versus 28% in the dn group,which was not statistically significant.only 2% and 3% of patients without dn and with dn,respectively,had two copies of the c allele.no significant association was found between the rs4821481 polymorphism and dn (or [95% ci] 1.56 [0.79-3.08],p = 0.19).conclusions: although we found an association between myh9 gene polymorphism and urinary albumin excretion,the results did not show a significant association between myh9 polymorphism (rs4821481) and risk of dn in iranian diabetic patients.© 2016,iranian red crescent medical journal.
background: wound healing is a process that occurs following skin lesions.shortening healing time is of critical importance as it reduces the risk of infection,complications,and costs.objectives: in this experimental study,36 male wistar rats each weighting approximately 200-220 g were studied in six groups,each with 6 animals for 21 days.hydroalcoholic extract of burdock root was prepared through the maceration method.the animals underwent a 2 × 2 cm diameter resection of cutaneous fragment on the dorsum.the first group was kept without treatment as the control group,the second group (negative control) was treated with eucerin,and the third group (positive control) was treated with ointment of phenytoin (1%).eucerin based-ointments from hydroalcoholic extracts of burdock root with concentrations of 20%,40% and 60% of weight/weight were administered to the animals in the other three groups twice a day.the lesion diameter and programmed euthanasia were analyzed through a surgical specimen resected for histopathology.results: the healing process was completed in 21 days in both no treatment and eucerin groups.in the phenytoin 1% group,the healing time was 16 days and in hydroalcoholic extracts of burdock root groups of 20%,40% and 60%,complete wound closure was observed in 16,16 and 14 days,respectively.all the treated groups and the control group showed significant differences when compared with the negative control and control group (p < 0.05).in addition,the histological study of the group treated with hydroalcoholic extracts of burdock root showed that symptoms and improvement of skin tissues had a better status.conclusions: the crude hydroalcoholic extract of burdock root was found to cause better outcomes in the healing process,acute inflammation,and fibrosis on the 7th,14th,and 21st day postoperatively.© 2017,iranian red crescent medical journal.
background: the prevalence of hypertension (htn) in developing countries might have a different pattern in different countries.objectives: this study aimed at investigating the current pattern of htn and evaluating its relationship with health complaints in elderly iranian individuals in 2012.methods: this cross sectional study used multistage sampling to investigate 1 350 iranian elderly subjects (≥ 60 years) living in the community.those elderly,who had a systolic blood pressure (sbp) ≥ 140 mmhg and/or diastolic blood pressure (dbp) ≥ 90 mmhg and/or those who used antihypertensive drugs during the previous two weeks,were considered as htn.a face-to-face interview was performed using a structured questionnaire,including demographic factors,awareness,treatment and control of htn,and health complaints for each individual.chi-square test and multiple logistic regression analyses were applied to detect the most important variables related to htn.results: hypertension was seen in 48.5% of individuals.awareness,treatment,and control of htnwere seen in 40.7%,82.5%,and 30% of individuals,respectively.elderly individuals with htn had significantly more experienced visual disturbances (p = 0.03),fecal or urinary incontinence (p = 0.006),nocturia (p = 0.002),attacks of shortness of breath (p = 0.004),and hyperlipidaemia (p < 0.001).after adjusting for potential confounders such as ethnicity,nocturia (or,1.34;ci 95%,1.02-1.75) and hyperlipidemia (or,1.94;95% ci,1.5-2.51) remained significantly relevant to htn.conclusions: the prevalence of htn was lower in elderly community-living iranians than developed countries,yet,was still considerable.nocturia and hyperlipidemia were the most common health complaints in iranian elderly with htn.© 2017,iranian red crescent medical journal.
background: pruritus during dialysis is a common complaint among patients undergoing hemodialysis.despite progress in medical science and technology in the field of hemodialysis,there is still no cure for pruritus.objectives: the aim of this study was to determine the effect of cool dialysate on the severity of pruritus during hemodialysis of patients with chronic renal failure.patients and methods: this study was a two-group,triple-blinded randomized clinical trial,with a parallel design.it consisted of 60 patients with chronic renal failure who were receiving hemodialysis at hemodialysis centers in mashhad.the patients were divided into two equal groups: 30 patients in an intervention group and 30 patients in a control group.initially,the patients in both groups underwent dialysis for one week (three sessions) with a standard dialysis solution (temperature of 37 °c).in the next phase,the control group received the standard dialysis solution,whereas the intervention group received a cool dialysis solution (35.5°c) for one week (three sessions).the severity of pruritus was recorded using a visual analogue scale (vas),with itching scored from 0-10 on an hourly basis during the dialysis sessions.results: before the intervention,there was no significant between-group difference in the severity of pruritus (p < 0.05).after the intervention,the severity of pruritus was significantly reduced (reduction of 3 points,itching score range of 0-10) (p < 0.0001).conclusions: dialysis with cool dialysate is a simple and cheap nondrug method,which was readily accepted by the patients.this method could significantly reduce the severity of pruritus in patients during dialysis.© 2016,iranian red crescent medical journal.