Acta medica Iranica
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Acta medica Iranica · Jan 2011
Randomized Controlled TrialEffects of combined intralesional 5-Fluorouracil and topical silicone in prevention of keloids: a double blind randomized clinical trial study.
Keloids are aesthetically disfiguring and severely disabling. The optimal treatment remains undefined. This clinical study, evaluate the efficacy and side effects of combined topical silicone and 5-Fluorouracil on the prevention of keloids. ⋯ The control group were treated by perilesional surgical excision of keloids combined with topical silicone and the trial group were treated with adjuvant treatment of intralesional 5-Fluorouracil. All patients were examined and assessment was done by an independent observer. the data collected were analyzed by SPSS statistical software with using tables and χ square tests. 75% of the cases in the trial group were keloid free 21% have keloid partially improvement and 4% have keloid recurrence, compared to patients in the control group respectively: 43%, 35% and 22%, findings suggest that efficacy of 5-Fluorouracil combined with topical silicone used for the prevention of keloid is comparable to other modality. The lack of any serious side effects and the evidence of recurrence at one year of follow-up make this an effective tool for the prevention of keloids.
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Acta medica Iranica · Jan 2011
Randomized Controlled TrialDoes intravenous fentanyl affect Apgar scores and umbilical vessel blood gas parameters in cesarean section under general anesthesia?
The administration of opioids during induction of general anesthesia is a matter of challenge in obstetric anesthesia. The aim of this study was to investigate the effects of intravenous fentanyl before induction of general anesthesia on the"1st and 5th minutes' Apgar scores" in neonates with elective cesarean surgery. In a double blinded randomized clinical trial on 60 parturients undergoing elective cesarean surgeries under general anesthesia in Vali-e-Asr Hospital, in Tehran, Iran, were divided randomly into two groups; the intervention group and the control. ⋯ Based on the results of this study, the administration of 1 µg/Kg intravenous Fentanyl, three minutes before induction of anesthesia for cesarean section can lead to a stable hemodynamic situation in mother and showed no effects on neonate`s outcomes. Fentanyl showed no effects on Apgar scores and on umbilical cord arterial and venous blood gases analysis and it probably can be used safely in elective cesarean surgeries. More studies are required to obtain a clear view.
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Acta medica Iranica · Jan 2011
Brain single photon emission computed tomography in anosmic subjects after closed head trauma.
Anosmia following head trauma is relatively common and in many cases is persistent and irreversible. The ability to objectively measure such a decline in smelling, for both clinical and medicolegal goals, is very important. The aim of this study was to find results of brain Single Photon Emission Computed Tomography (SPECT) in anosmic subjects after closed head trauma. ⋯ The difference between all the measures in cases and controls were statistically significant (P < 0.0001). There were no differences in age and sex between two groups. The brain SPECT is an objective technique suitable for evaluating anosmia following the head trauma and it may be used with other diagnostic modalities.
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Acta medica Iranica · Jan 2011
Case ReportsLumbar vertebral hemangioma with extradural extension, causing neurogenic claudication: a case report.
The authors present a rare case of lumbar vertebral hemangioma extending to the epidural space with a bisected appearance and impinging on thecal sac. This 52-year-old lady presented with one year history of low back pain and bilateral leg radiation. Plain radiography showed vertical linear streaks at L2 vertebral body and axial computed tomography (CT) scan revealed small "polka dot" appearance within the vertebral body. ⋯ The patient underwent an L2 laminectomy, spinal canal decompression and posterior spinal instrumentation. This study indicates that lumbar vertebral hemangioma can extend to the epidural space and cause neurologic symptoms. Magnetic resonance imaging may not show diagnostic features, especially in active lesions and plain radiography and CT scan may be helpful.
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Acta medica Iranica · Jan 2011
Case ReportsA rare electrocardiographic manifestation of a rare form of multiple electrolyte disturbances: hyperparathyroid crisis.
The surface electrocardiogram (ECG) has been used as a useful method for detection of metabolic disturbances for a long time. However, it may be difficult to distinguish the exact disturbance when more than one metabolic abnormality exists in a patient simultaneously. Although, "classic" ECG characterizations of common electrolyte disturbances are well described, multiple concurrent electrolyte disturbances may lead to ECG abnormalities that may not be easily detectable. ⋯ The exact pattern of the patient`s ECG (figure 1) can be interpreted as it follows: (1) Flattening of the T wave, (2) a prominent U wave, (3) prolongation of the descending limb of the T wave such that it overlapped with the next U wave (4) virtual absence of ST segment and (5) shortening of the QT corrected interval. In conclusion, it should be emphasized when the T and U waves are separated by a very short segment they can mimic the appearance of a prolonged QT interval. However, more investigation can demonstrate the exact electrocardiographic pattern especially in multiple electrolyte disturbances, when "classic" ECG patterns are not expectable.