Acta medica Iranica
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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
Intravenous regional block with phentolamine in the treatment of complex regional pain syndrome.
Complex regional pain syndrome (CRPS) is a variety of painful conditions following injury which appears regionally having a distal predominance of abnormal findings. This study, evaluate the use of phentolamine for sympathetic block and regional anesthesia in treatment of CRPS related pain. In this study, 68 patients with CRPS who were referred to pain clinics of Imam Hossein and Akhtar Hospitals and Gandy Center of Surgery between 2003-2008 were evaluated. ⋯ In this study level of pain relief was significant in various intervals and it showed significant difference in relief three months after block (P=0.04). CRPS due to SMP(sympathetically maintained pain) is thought to be alleviated by phentolamine. Intravenous phentolamine infusion is potentially a new significant option for the therapy of CRPS.
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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.
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Acta medica Iranica · Jan 2011
Outcome of continuous intrathecal opioid therapy for management of chronic pain in Iranian veterans of the imposed Iraq- Iran war.
Among patients with chronic unrelieved pain, war veterans of eight years long Iraq - Iran war deserve especial attention. They not only suffer from severe intractable pain but also should bear some intangible consequences of unrelieved pain and severe disability. This perspective study reviews the outcome of implantation of intrathecal opioid pumps in these patients. ⋯ No surgical complication reported. The study showed that this type of therapy in Iranian war veterans improved analgesia, increased self-report physical activity levels and in spite of high incidence of pharmacological side effects, most of the patients were satisfied with this type of therapy. These results are comparable to those of previous studies in this field.
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Acta medica Iranica · Jan 2011
An investigation into the effects of quality improvement method on patients' satisfaction: a semi experimental research in Iran.
Today, to increase effectiveness is a Strategy for success of organizations and their viability. In health care organization not only service cost- effectiveness is a major problem for productivity and organizational management but also customer-centred is in first priority. Because of these reasons, most of health organization trend to patient satisfaction for their viability. ⋯ The findings of the pre-intervention phase indicated that the satisfaction level had been low in both groups and it is not significantly different in the two groups (P> 0.05). There was a significant difference before and after following intervention in the case study group (P>0.0001). FOCUS PDCA is effective method for access to various objectives especially patient satisfaction. it is suggested other researcher assess effects of this strategy for other indexes and total care process effectiveness.