Brachial Artery Aneurysm as a Limb Threatening Condition: a Case Report

Brachial artery aneurysms are rare but potentially limb threatening condition. The presented case here is a 52-year old male referred to the emergency department complaining a sudden onset and progressive pain with coldness of his right upper extremity during brushing. The right upper extremity was pulseless and three-dimensional computed tomography showed an aneurysm of the proximal right brachial artery associated with arterial occlusion in its distal branch. Embolectomy was done, the aneurysm resected, and the artery successfully re-vascularised by interposing a saphenous vein graft.

Sustainability indicators of Iran's developmental plans : application of the sustainability compass theory

The main purpose of this study was to analyze Iran's developmental plans in order to examine and compare their direction and conformity with the sustainable development theory via the compass of sustainability. The approach involves a content analysis used in line with qualitative research methodologies. The results indicated that, in the first developmental plans, there was no direct reference to sustainable development. In the second to fifth plans, the main focus was on the social, environmental, and economic dimensions of development; which were common elements seen in the policies of all the plans. An analysis of the fourth plan revealed that expressions related to sustainable development appeared more frequently, indicating a stronger emphasis on sustainable development by decision-makers

Evaluating the Effect of Melatonin on Pain Control and Quality of Life in Patients with Chronic Low Back Pain: A Randomized Clinical Trial

Background: Almost everyone experiences low back pain at some point in his or her lives. Low back pain is becoming more prevalent in low-income and middle-income countries much more rapidly than in high-income countries. The objective of this study was to evaluate the effect of melatonin on pain control and quality of life in patients with chronic low back pain.Materials and Methods: Sixty patients with low back pain aged 45 and 75 years, with a history of back pain more for than 12 weeks and visual analogue scale (VAS) score more than three, who were referred to pain clinics of Akhtar Hospitals (Tehran, Iran) during June to August 2018. Patients were randomly assigned to one of the melatonin or control groups. Control group received diclofenac sodium 25mg tablet two or three times daily and the experimental or melatonin group, in addition to receiving diclofenac sodium 25mg tablet twice a day, received melatonin tablet (3mg) 30 to 40 minutes before bedtime for four weeks. Before the beginning of the study, at the end of the fourth week, both groups underwent VAS test and the levels of IL-1β and TNF-α were measured in these groups and they were asked to complete the quality of life questionnaire. Analysis of the data done by using covariance and Shapiro-Wilk tests through SPSS 22.Results: Melatonin consumption reduced the pain and level of IL-1β and TNF-α in the experimental group compared to the control group (p<0.05). However, use of melatonin did not have a significant effect on quality of life (p>0.05).Conclusion: In general, it can be stated that use of melatonin, in addition to reducing the pain, reduces the anti-inflammatory factors in patients with chronic low back pain. Based on the results of this study, melatonin can be recommended as a supplement for treatment of chronic low back pain

Comparing the use of Memantine with Dextromethorphan and Placebo to Reduce Pain before Orthopedic Surgery

Introduction: To compare the use of Memantine with Dextromethorphan and placebo to reduce pain after orthopedic surgery.Materials and Methods: The present study was a double-blind clinical trial including180 patients undergoing elective orthopedic surgery of the lower limbs. Patients were divided randomly into three groups of 60 patients each. The first group (Group M) received 30 mg Memantine orally, the second group (Group D) received 45 mg of Dextromethorphan and the third group (Group P) received only placebo, two and a half hours before the operation. The intensity of pain (VAS score), sedation score, and nausea and vomiting were recorded postoperatively.Results: In this study, 60 patients were enrolled in each group. The total VAS (Visual Analogue Scale) score was significantly lower among patients receiving Memantine and the satisfaction was significantly higher compared to the Dextromethorphan and placebo groups (P-value <0.001).Conclusion: The present study results indicate that Memantine has a relatively better outcome compared to Dextromethorphan or placebo in reducing the post surgical pain among patients undergoing orthopedic surgeries. It also reduced the need for post surgical opioid use and improved the patients’ satisfaction. 

The evaluation of Papanicolaou (Pap) smear processing in the health centers of Shahrekord in 2005

چکیده: زمینه و هدف: تست پاپ اسمیر یک روش غربالگری مؤثر جهت بررسی تغییرات سلولی دهانه رحم قبل از تبدیل به سرطان مهاجم دهانه رحم است. این مطالعه با هدف ارزیابی فرآیند انجام تست پاپ اسمیر توسط ماماها و مقایسه میزان کافی بودن نمونه، کیفیت سیتولوژی نمونه و دقت تشخیصی در گزارش سیتولوژیست و پاتولوژیست و توافق این گزارشات انجام شد. روش بررسی: در یک مطالعه توصیفی – تحلیلی در بهار و تابستان 1384، 160 فرآیند پاپ اسمیر از مراکز بهداشتی درمانی شهر شهرکرد به صورت تصادفی انتخاب و به وسیله چک لیست استاندارد، عملکرد ماماها در خصوص نحوه شرح حال گیری و نحوه انجام تست پاپ اسمیر ارزیابی گردید. همچنین به طور تصادفی 360 نمونه پاپ اسمیر را که قبلاً توسط سیتولوژیست گزارش شده بود توسط پاتولوژیست مشاهده و میزان توافق بین گزارشات پاتولوژیست و سیتولوژیست (بر اساس دستورالعمل کشوری گزارش سیتولوژی زنان) به کمک آزمون آماری ضریب توافق کاپا محاسبه گردید. یافته ها: در زمینه شرح حال گیری از بیمار 15/96 عملکرد ماماها خوب و 85/3 موارد عملکرد ضعیف وجود داشت. در زمینه نحوه گرفتن نمونه پاپ اسمیر 72/88 عملکرد ماماها خوب و در 28/11 موارد عملکرد ضعیف بود. در گزارش پاتولوژیست فراوانی کافی بودن نمونه ها 5/85، عفونت ها 3/3، التهاب 4/64 و ناهنجاری سلول اپی تلیال 83/0 بود. توافق معنی داری بین گزارش سیتولوژیست و پاتولوژیست وجود داشت (05/0

A Comparative Assessment of Autologous Conditioned Serum and Ozone for Knee Osteoarthritis Treatment: Mid-Term Follow up

Background: Knee osteoarthritis is a common disease associated with knee pain, physical disability, and joint stiffness. The use of non-surgical treatment methods in patients with knee osteoarthritis is important. Autologous conditioned serum (ACS) is a new regenerative therapeutic method that was investigated by a limited number of clinical trials. So far, using ACS in patients with Knee osteoarthritis remains to be controversial among physicians. Thus, the current study was carried out to compare the therapeutic effects of intra-articular ACS and ozone injections in patients with knee osteoarthritis.Materials and Methods: This prospective, double-blind randomized clinical trial was conducted among 60 patients (30= interleukin-1 receptor antagonist (IL-1Ra) group, 30= ozone group) with knee osteoarthritis, who referred to the Pain Management Clinic of Akhtar Educational Hospital during 2018 to 2019. In the IL-1Ra group, 2 ml of IL-1Ra was injected into the knee joint. The regimen protocol consisted of 4 injections, performed on the first, seventh, fourteenth, and twenty-first days of the treatment and ozone group, 10 ml of ozone (30 μg/ml) + 5 ml of lidocaine 1% were injected into the knee joint. The regimen protocol consisted of 3 injections, performed on the first day of the treatment, one month after the first injection, and two months after the first injection. The severity of pain was assessed by the patients’ self-report of pain and using the visual analog scale (VAS), before the treatment and 1, 3 and 6 months after the treatment. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires were also measured at before and 6 months following treatment.Results: The changes in the VAS pain at different time periods showed statistically significant differences in the two groups, (P=0.0001). There was no significant difference between the two groups before the treatment and one month and three months after the initiation of the treatment; however, there was a significant difference between the two groups six months after the initiation of the treatment (P=0.0001). KOOS scores of symptoms, daily activities, and athletic and recreational functions were significantly higher in the IL-1Ra group, and the WOMAC scores of physical function and joint stiffness and the overall scores were significantly higher in the IL-1Ra group, (p<0.05).Conclusion: The intra-articular injection of IL-1Ra is a low-invasive, safe, effective, and long-acting method. In patients with knee osteoarthritis, clinical improvements and responses to the intra-articular IL-1Ra injection are better and longer compared to ozone injection. Therefore, it can be considered as a suitable choice in treating patients with chronic knee pain.

Comparison of the Effect of Intra-Articular Injection of Autologous (Orthokine) Interleukin-1 Receptor Antagonist (IL-1Ra) and Hyaluronic Acid in Pain Control of Knee Osteoarthritis

Background: Due to the limitations of more common treatments of osteoarthritis, pharmaceutical research has been increasingly conducted during the past two decades with the aim of determining the rate of recovery of the disease' symptoms and making the process of disease progression slow. The purpose of this study was to compare the effect of intra-articular injection of autologous interleukin-1 Receptor Antagonist and hyaluronic acid in pain control of knee osteoarthritis.Materials and Methods: A total of 60 patients with knee osteoarthritis were allocated to two groups of 30 in this randomized double-blind clinical trial. In the intervention group, injection of 2 milliliter of interleukin-1 receptor antagonist (Orthokine) into the knee joint was performed three times at intervals of one week (base time, seventh day and fourteenth day). In the control group, three injections of two milliliters of hyaluronic acid solution into the knee joint were performed at intervals of one week. Pain, symptoms, daily activities, sport-recreational performance, and knee-related quality of life were five outcomes investigated by completing two questionnaires, the knee injury and osteoarthritis outcome score (KOOS), Western Ontario, and McMaster Universities Arthritis Index (WOMAC) by the patients on two occasions before the start of treatment and six months after the last injection. Repeated measure and t-test were statistical tests used in this study.Results: The mean score of pain in the first month (p=0.005) and the sixth (p=0.049) in the intervention group was less than the control group. Based on the scores of the KOOS questionnaire, the mean score of symptoms (p=0.006), daily activities (p=0.001) and sport-recreational performance (p=0.037) in the Orthokine group were higher than the hyaluronic acid group after six months. Also, the results of the questionnaire WOMAC show that while before the start of treatment, the mean of physical performance in the Orthokine group is greater than the control group, there is no difference in any of the indicators of pain, dryness of the joint, physical performance, and total score (p=0.319) in the sixth month.Conclusion: According to the findings of this study, it seems that Orthokine has beneficial biological effects in patients with knee osteoarthritis. Intra-articular injection of Orthokine is a low invasive, safe and effective method, which can be considered as an appropriate choice in patients with chronic knee pain

Comparison of Ultrasound-Guided Local Dexmedetomidine Injection vs. Corticosteroid Injection in the Treatment of Chronic Plantar Fasciitis: A Randomized Clinical Trial

Background: Heel pain is commonly caused by chronic plantar fasciitis, associated with pain and activity limitation in patients. Although steroid injection is a popular method to treat this disease, it has side effects and provides short-term pain relief. The study was designed to investigate the effects of dexmedetomidine and corticosteroid injection in treating chronic plantar fasciitis. Materials and Methods: A total of 70 participants were divided into two groups. The intervention group received a mixture of dexmedetomidine (1μg/kg) with 1 ml of lidocaine 2%. The control group received a combination of 1ml of corticosteroid (40mg triamcinolone) with 1ml of lidocaine 2%. Outcome measures were evaluated with Numerical Rating Scale (NRS) and Maryland foot score (MFS) before, one, and three months after the intervention. Results: Significant improvements in NRS and MFS were observed in both groups at 1 and 3 months of follow-up compared to baseline(P<0.001). NRS score improvement in the first month was more significant in the corticosteroid group compared to the dexmedetomidine group. However, after three months, the dexmedetomidine group experienced greater pain reduction (P=0.012) and higher functional ability (P<0.001) than the corticosteroid group. Conclusion: Local injection of dexmedetomidine provided significant and long-term effects on pain severity and physical activity. Corticosteroids caused an immediate but short‑term effect, whereas sustained improvement in the dexmedetomidine group was observed during the follow-up

Circulatory system of red tail catfish (Phractocephalus hemioliopterus Bloch & Schneider, 1801): a corrosion cast study

Red tail catfish, Phractocephalus hemioliopterus, in one of the popular ornamental fish. The present study is aimed to describe and visualizes the cardiovascular system of this species with corrosion cast study method. For this purpose, 10 red tail catfish with 580 gr average weight were obtained and were filled their blood vessels and heart with fluid artificial resin made on the basis of methylmetacrylate after anaesthetizing and euthanizing. For complete polymerization and hardening of the methylmetacrylate, the fish were further submersed for 12-24 hrs in water bath following by 24-48 hrs submersion in a 25% solution of KOH to full maceration. Based on the results we describe the cardiovascular system i.e. the afferent and efferent vessels of gill, different parts of the heart, ventral aorta, dorsal aorta, intestinal and gastric vessels, liver, anterior and posterior parts of the kidneys, spleen, portal and hepatic vein

Back to the Individual-Social Life in patient with Avascular necrosis of femur by Bioresonance Technology (Case Report)

Background: More than 20,000 people annually develop avascular necrosis (AVN) worldwide, most of whom aged 20 to 50 years, and should refer to orthopedic surgeons for treatment. The quality of life of such patients is low due to chronic pain and sometimes they are deprived of their occupation and social life. Case Report: A 57-year-old male patient who developed AVN due to long-term treatment with corticosteroids and their complications was significantly recovered following EPT therapy in a three-year follow-up. Regarding the correlation between chronic diseases and SDH, to treat such patients, improve their quality of life, and help them back normal life, safe complementary therapies, such as bioresonance, are recommended. &nbsp