Cementless one-stage bilateral total hip arthroplasty in osteoarthritis patients: functional outcomes and complications

Total hip arthroplasty (THA) is one of the successful and cost-benefit surgical treatments. One-stage bilateral THA (BTHA) has a large number of advantages, although there are concerns about the higher complications in this procedure. Aim of our study was to evaluate the complications and outcomes of cementless one-stage BTHA in osteoarthritis patients. A total of 147 patients from 2009 till 2012, underwent one-stage BTHA in Milad and Erfan hospitals, Tehran, Iran. A prospective analysis of the functional outcomes and complications of one-stage BTHA through Hardinge approach in patients with osteoarthritis was performed. We evaluated all patients clinically and radiologically with serial followups. A clinical hip score based upon the modified Harris Hip Score (MHHS) was performed preoperatively and again postoperatively. During the period of study 89 men (60.5%) and 58 women (39.4%) with a mean age of 54.67±7.08 years at the time of presentation were recruited. The mean surgical time was 2.8±0.25 hrs. The mean hospital stay was 3.83±0.65 days. Hemoglobin level decreased significantly after operation (P=0.038). There was two deep venous thromboses, one superficial infection and one temporal proneal palsy but no pulmonary embolism, dislocation, periprosthetic fracture or heterotrophic ossification. The mean preoperative MHHS score was 41.64±5.42 in patients. MHHS score improved to 89.26±4.68 in the last followup (P=0.0001). Our results recommended the use of cementless one-stage BTHA through Hardinge approach in patients with bilateral hip osteoarthritis

Short-term outcomes of one-stage bilateral total hip arthroplasty in young patients (< 30 years old)

Total hip arthroplasty is one of the best treatments for restoring function and activity in young patients with advanced joint diseases. One-Stage Bilateral Total Hip Arthroplasty (BTHA) offers many advantages, which are important to younger patients and diminished costs and time in comparison with sequential THA. There is currently much concern about the safety of this procedure. The current study was designed to provide more information regarding THA in patients aged 30 years old or younger. Between April 2010 and September 2015, arthroplasty procedures were performed on 180 patients at the surgical centers of Erfan and Milad, Tehran, Iran. The patients that were entered in the study included those with bilateral hip involvement of Avascular Necrosis (AVN), Rheumatoid Arthritis (RA), Juvenile Rheumatoid Arthritis (JRA), Slipped Capital Femoral Epiphysis (SCFE), and Developmental Dysplasia of the Hip (DDH). The patients underwent one-stage bilateral total hip arthroplasties through the direct lateral approach. Standardized questionnaires were used to obtain mean Postel-Merle d’Aubigné (PMA) score, Oxford Hip Score (OHS), Visual Analogue Scale (VAS) Score, and Modified Harris Hip Score (MHHS), both preoperatively and post-operatively to evaluate functional outcomes. All patients were in the American Society of Anesthesiology (ASA) category 1 or 2. All complications were followed closely for a period of 4.67±0.54 years. From 141 males and 39 females, 84 patients had been recognized as ASA 1, and 96 as ASA 2. Mean age of patients was 27.04±2.74 years old (range: 16 to 30). The mean operation time and the average length of hospital stay were 156±23 minutes and 5.20±2.44 days, respectively. Overall, 3 patients developed unilateral temporary peroneal nerve palsy (1.66%), 2 intraoperative fracture (1.11%), and 2 patients (1.11%) showed deep vein thrombosis. There was no wound infection. Regarding the functional scores in the diagnosis of patients, improvement was better in AVN than, RA, JRA, SCFE, and DDH, respectively. There were significant differences between diagnosis and every functional score, individually (P<0.05). The current results showed that one-stage bilateral THA led to improvement in hip function and stable implant fixation at short to midterm follow up, which suggests the efficacy of one-stage cementless THA in bilateral advanced arthritis in patients younger than 30 years old

Relationship of Hypertension with High Ocular Pressure in Patients Referred to Amir’almomenin Hospital of Rasht in 2012

Introduction and Aims High ocular pressure is often related with open angle glaucoma. In this study we evaluated association of hypertension and some other underlying factors with high Intraocular pressure (IOP) in patients of Amir&rsquo;almomenin hospital during 2011-2012. Materials and Methods This is a descriptive retrospective study. 180 Patients with high IOP hospitalized during 2011-2012 in Amir&rsquo;almomenin hospital in Rasht were included. Collected data was analyzed by SPSS v.18. Results 55% of patients were women. Mean age of them was 67.64 &plusmn; 11.88. Mean systolic and diastolic blood pressure were 180 &plusmn; 16.7 and 136.8 &plusmn; 18.8, respectively. Mean right and left IOP were 16.16 &plusmn; 3.35 and 16.49 &plusmn; 3.76, respectively. There was a significant relation between gender, history of hypertension, alcohol abuse, hyperlipidemia and cardiac disease with high IOP in right eye (P 0.05). Conclusion Present study showed that systolic blood pressure and hypertension can effectively and positively be related with high IOP. But these changes were not affected by age. For getting more data, it is recommended to perform a longitudinal study for evaluation of indicated factors of this study and more advanced indexes such as determination of thickness of cornea for better evaluation of relations with high IOP. * Corresponding Author: Guilan University of Medical Sciences, Faculty of Medicine. E-mail: [email protected]

Predictive factors of hyperbilirubinemia in newborns at University hospital in northern Iran

756-760Jaundice or hyperbilirubinemia is one of the most frequent problems of neonatal period and involves about 60% of term and 80% of preterm neonates in the first week of birth. Hence, here we investigated the epidemiological, relevant factors and causes of neonatal jaundice in this study. . Data of 126 records of neonates who were hospitalized due to jaundice between January 1, 2011 and January 30, 2012 at the 17th Shahrivar Hospital, Guilan University of Medical Sciences, Rasht, Iran were checked and evaluated. Data was gathered based on a questionnaire that had two parts: (i) demographic and (ii) causes and risk factors of jaundice. Data were analyzed by SPSS software ver.18 using descriptive tests, Student’s T, Chi-square and Linear Regression tests. There were 65 (51.6%) males and 61 (48.4%) females. Mean age of them was 6.98±4.32 days. One-Hundred one patients (80.1%) had pathologic jaundice; 107 neonates (84.9%) born term of which 106 (84.1%) were exclusive breastfed. There was significant correlation between gestational time (P=0.019), existence of Rh incompatibility (P=0.001) and ABO incompatibility (P=0.009) with mean of level of admitted bilirubin. Time of gestations (P=0.001), Birth weight (P=0.024), history of jaundice in siblings (p=0.001) and gestational age between 37 and 38th week (P=0.003) were predictive factors for pathological hyperbilirubinemia in this study. Results of our study showed high frequency of pathological jaundice in hospitalized infants. Prognostic factors of this study can help in better screening of type of jaundice

Therapeutic effects of medicinal plants on isoproterenol-induced heart failure in rats

Aims: Natural products still serves as a hope for some illnesses which modern medicine fails to cure. Many people, either knowing their effects or not, are using these herbal products. Treatment of chronic heart failure (CHF) is yet a complicated clinical challenge and there is need to improve or make new therapeutic targets. Finding new agents for CHF is an important subject in cardiovascular drug research. In this study, we evaluated the effects of ten herbals on treatment of CHF on isoproterenol-induced model. Methods and results: Ninety-six male Wistar rats (16 weeks old) were used in 12 groups. Transthoracic echocardiography was performed on the rats for confirmation of CHF model by decreasing ejection fraction. After 4 weeks’ treatment, hearts were removed and blood samples were collected in tubes to measure plasma levels of laboratory findings. Our results showed that the mean of ejection fraction in model rats was 51.82 ± 3.49 percent and all of our used natural products could significantly increase the ejection fraction (P < 0.01). The most effective herbals in improving the ejection fraction were Allium sativum (30.69 %), Peganum harmala (26.08 %) and Apium graveolens (24.09 %). The best results in decreasing NT-ProBNP, was obtained from Allium sativum, Peganum harmala and Berberis vulgaris respectively. Our results showed that none of natural products had toxic effect on renal and liver tissues. Conclusion: Our results showed that Allium sativum, Peganum harmala and Berberis vulgaris could significantly improve cardiac function by improvement of left ventricular remodeling, lowering hs-CRP and NT-ProBNP and echocardiographic indexes without liver or renal side effects

Prevalence of Strongyloides stercoralis and Other Intestinal Parasites among Institutionalized Mentally Disabled Individuals in Rasht, Northern Iran

Background: We aimed to determine the status of strongyloidiasis in mentally disabled population in the institutional places in Rasht City, the capital of Guilan Province, northern Iran. Methods: This cross-sectional study was conducted in 8 institutions for mentally retarded population in Rasht in 2013. Before collecting the samples, a questionnaire was filled out for each participant by an expert person. A single  stool sample was obtained from each of the 173 subjects and examined using direct wet mount, formalin-ether concentration technique and agar plate culture method.  Results: A total of 173 mentally disabled individuals aged 2-57 (25.69±11.56) yr old were studied. Stool examination showed that 51 (29.5%) cases were infected with at least one parasite. Of 173 studied cases only 10 (5.8%) individuals were infected with pathogenic parasites, of which 2 (1.2%) cases were infected with Strongyloides stercoralis and 8 (4.6%) with Giardia lamblia. On the other hand, 42 (24.3%) of the studied population were infected with non-pathogenic intestinal protozoa such as Blastocystis hominis (n=29, 16.8%), Entamoeba coli (n=16, 9.2%) and Endolimax nana (n=4, 2.3%). Mixed protozoal infections were observed in 8 (4.6%) individuals. Conclusion: The prevalence rate of S. stercoralis in mentally disabled individuals in Rasht was somewhat higher than those of normal population of the province. The same picture was seen when the prevalence of G. lamblia and non-pathogenic protozoa in normal and mentally disabled populations were compared