Journal of Arak University of Medical Sciences

Speech Skills in Down Syndrome Girls in Comparison With Other Mental Retarded Girls

Zahra Eftekhari

Introduction: Previous studies indicated that children, who acquired conversation concept, produce adjectives better than other mental retarded.
Other studies showed that Down syndrome children have lower linguistic abilities than other mental retarded children. The main goal of this research was to study the effects of Down syndrome on production of semantic skills.
Materials and' Methods: This analytic cross-sectional study was conducted on girls who studied in exceptional primary schools of Semnan city.
Samples were chosen systenlaticaly. At first, 38 Down syndrome girls, who were monolingual and with no sign of sensory and motor deficits, were selected.
Then, 37 mental retarded girls (non-Down syndrome), that mental retardation had no specific ethiology, were matched on date of birth, educational level, failuer in previous classes, parent's job and education. These 75 pupils participated in operative tests and those who were able to comprehend the concept of conversation were examined by Raven Colourd Progressive Matrices. At final stage, 30 educable girls were participated in production test.
Results: Our findings showed that:
1. The production of nominal and superlative adjectives were equivalent between two groups, but Down syndromes had lower ability in production of comparatives;
2. The simplisity of adjectives were as fallow: nominal> comparative> superlative, and big-small> tall-short> thick-thief> wide-narrow.
3. There were few samples able to produce superlatives.
Conclusion: This investigation revealed that girls suffering from Down syndrome have lower ability on production of semantic skills.

Comparing the Healing and Union Process of Allografts From Intramembranous Originated Banes With Endochondral Banes

Saeed Babaei

Introduction: At present, bone graft is unavoidable. In fact although among the all probable bone grafts, the autograft is the best choice, but because of some situations like two coincidence surgery upon one individual, size limitation of autografts (its impossible to get a big piece of graft from patient) increasing the bloodshed contingency, infection etc, made specialist to think about the possible substitution the allograft.
Materials and Methods: Seventeen Newzealandian rabbits were divided into four groups. The graft generator group consisted of one rabbit which was genetically different from other groups. The sham group composed of three rabbits which round autografts about 4 mm in diameter from their tibia were exchanged between rights and left tibias. These grafts were not deantigenized and a 4 mm vacant hole was created to see if it will repair spontaneously within three months. The control group consisted of three rabbits received a round 4 mm tibial autografts which double deantigenization process were done over them. The test group composed of 10 rabbits, received corticocancellous (intramembranous) allografts in left tibia and corticocancellous (endocondral). Allograft in right tibia all grafts were bearing the double deantigenization process.
Results: The rate of prosperity for CCl grafts was 80% and for CCE grafts was 60%.In sham group, healing process was extremely fast (in eight weeks).
In control group, healing process was done slower until six weeks but after 12 weeks it was compensated. The vacant holes were not repaired even after three months. Statistically, there was a meaningless difference between the rates of prosperity in both groups of grafts.
Conclusion: According to statistical assays, although the prosperous numbers of CCl were more than CCE grafts but this difference was meaningless. In the basis of histological assessments if the velocity of healing process is important, the CCI grafts are recommended

Sensation in Distally-Based Sural Island Flaps

Esmaeel Hasanpour

Introduction: Reconstruction of defects in heel and malleoli with exposed bone has always been a challenge. Heel is a weight bearing region which needs sensation. Distally-based sural island flap is one of the options available for these kinds of defects. Here, in this study we have paid special attention to how these flaps become sensate.
Materials and Methods: This case-series study carried out on 14 patients who reffered to 15 Khordad Hospital, Tehran, from 2000 to 2003 and their defects had been covered with distally based sural island flap. Appearance of pain, temperature, light touch and two - point discrimination evaluated in flap region and compared with the contralateral site.
Results: From 14 patients with this flap; 11 subjects (9 males and 2 females) entered into the study. Seven subjects had been injured during motorcycle accident. In 10 patients (91%), two-point discrimination in flap region was.13.2 mm, which was the same as the other side.
Conclusion: Covering the defects in heel, malleoli and distal third of leg with sural island flap is technically easy and with minimal donor site morbidity. Major vessels in the lower extremities are spared and this flap can be used in weight bearing areas with relatively good sensation.

Effectiveness of Acupressure in Treatment of Nausea and Vomiting in Pregnancy

Ali Reza Soosan Abadi

Introduction: Nausea and vomiting are among the prevalent complaints in pregnancy, but there is a controversy about their treatments. At present, because of the problems caused by these complaints for mothers and incompatibility with drug treatments physicians prefer to use non-drug interventions such as acupressure. In this study, we evaluated the effectiveness of acuptessure in treatment of nausea and vomiting in pregnancy.
Materials and Methods: This was a randomised clinical trial study. 120 pregnant women with nausea and vomiting complaints that submitted in prenatal clinics and referred to Alavi pain clinic in Arak were investingated.
After filling out of questionnaires, the participants were alternatively divided into case and control groups. In case and groups, wrist band (for 90 minutes) was fastened in appropriate and non-appropriate sites, respectively. The subjects were followed up at 24 hours in 3 times visit and their responses to treatment were evaluated.
Results: The incidence of nausea and vomiting in the case group was significantly lower than control group. The rate of improvement of patient symptoms in the case group was six times higher than control group. No serious side-effect was observed in studied population.
Conclusion: Our findings indicated that acupressure is a safe and appropriate method used for treatment of nausea and vomiting in pregnancy.

Comparison of Dermatoglyphics and Human Leukocyte Antigens in Patients With Insulin-Dependent Diabetes Mellitus in Markazy Province

Mohammad Ali Shariatzadeh

Introduction: Insulin-dependent diabetes mellitus (IDDM) or type 1 diabetes is an organ-specific autoimmune disease that caused by destruction of insulin-producing beta cells of the pancreas. Etiology of this disease is still unknown. It is seen that genetic and environmental factors play an important role for susceptibility to develop type 1 diabetes. The relationship between HLA associated factors and susceptibility to IDDM disease, was reported by several investigators. Also, some studies show that dermatoglyphics is associated with type 1 diabetes. However, it is maybe there is an association between HLA and dermatoglyphics inpatients'with type 1 diabetes and these characteristics could be applied for diagnosis of disease.
Materials and Methods: In this study, the prevalence of HLA (with using standard microlymphocytotoxicity method) and dermatoglyphics determined in 30 Iranian patients with IDDM and 30 normal healthy controls with similar ethnic background and the same geographical area.
Results: A significantly higher frequency of HLA-DQ, A2, DR3 and DQ2 were found in IDDM cases compared to the controls. The results obtain from dermatoglyphics showed that line ab was reduced in male and female type 1 diabetes. The reciever operating chractristics curve showed that the positive point for lines ab in right and left hands were 34.7 and 35.25, respectively.
Discussion: There is no association between HLA and dermatoglyphics.
With considering of genes encoding of HLA separated from genes determining dermatoglyphics, HLA typing and dermatoglyphics seem to be interesting tools for genetic studies related to type 1 diabetes. Further studies are recommended in order to provide more insight into the susceptibility to this disorder.

Comparing the Effects of Adding Pancoronium and Fentanyl to Lidocaine During Intravenous Regional Anesthesia

Hoshang Talebi

Introduction: Many patients because of ischemic heart diseases, cerbral or pulmonary diseases are not appropriate candidates for general anesthesia in upper limb surgeries. Intravenous regional anesthesia (IVRA) is one of the anesthetic procedures for these patients. The aim of this study was to compare the effects of adding Pancronium and Fentanly to Lidocaine during IVRA.
Materials and Methods: In a single-blind clinical trial investigation, 46 patients-who were candidated for hand surgeries-were studied. The subjects were randomly classified into two groups. The first group who used 38 cc Lidocaine 0.5% and 2 cc sterile water (control group) and the second group who used 38 cc Lidocaine 0.5% besides 50 mgr Fentanyl and 0.5 mgr Pancronium (trial group) for sensory and motor blacking. Data analysis was performed by t-test through SPPS 10 software.
Results: The average time for storing of sensory and motor block in trial group was significantly faster than control group. Additionaly, the average time for starting of sensory and motor block in control group was significantly lower than trial group.
Conclusion: This study revealed that adding of Fentanyl and Pancronium causes better motor and sensory block and provide better relaxation for muscles during surgery.

Evaluation of Postoperative Analgesic Effect of Intramuscular Pethedine, Compared to Indomethacin and Diclofenac Sodium Suppositories in Pain Relief After Inguinal Hernioplasty Patients

Ali Akbar Abdollahi

Introduction: Pain is one of the main complaints of many postoperative patients. Narcotic and NSAID drugs are used to control postoperative pain.
Recent studies suggest different results of pain relief by NSAID group. We compared analgesic effects of intramucular Pethedine to Didofenac Sodium and Indomethacin suppositories due to inguinal hernioplasty.
Materials and Methods: This study was a clinical trial study over 55 patients of 17-60 years old who underWent unilateral inguinal hernioplasty.
These patients divided into 3 groups. The first group included 17 patients who received 100 mg Indomethacin suppository every 8 hours to relief postoperative pain. The second group of 18 patients who received 100 mg Diclofenac Sodium suppository every 8 hours and the third group induded 20 patients who received 0.5 mg/kg body weight Pethedine intramuscularly every 8 hours. The first dose of each drug started 2 hours after termination of operation. Tue sevrity of pain was checked by visual analogue scale method every 2 hours for 24 hours. Mean pain severity recoded and compared in 6 hours intervals.
Results: The averages of pain severity in the first 24 hours were 23±12 for Indomethacin, 31±9 for Pthedine and 27±12 hours for Diclofenac Sodium groups. There was no significant difference in whole 24 hours.
Conclusion: We concluded that Indomethacin and Diclofenac Sodium suppositories are good substitutes for intramuscular Pethedine to relief postoperation pain during the first postoperation day.

Poems Syndrome: A Case Report With Literature Review in Iran

Afsaneh Talaei

Introduction: POEMS is a rare systemic disease. This syndrome is usually associated with multiple mylom and skin changes. By now, it has been reported two cases of this disease in Iran.
Case: The patient was a 53 years old male who had history of hospitalization for recurrent pulmonary infections. Additionally, he had history of hyperthyroidism and idoide treatment. In the last presentation, he was hospitalized because of low back pain. Bone marrow aspiration findings showed that the cause of low back pain is multiple mylom. In abdominal computed tomagraphy, splenomegaly was cleared that all of these systemic findings are representatives of multiple mylom and POEMS syndrome.
Conclusion: In this study a POEMS syndrome patient that suffering from hyperthyroidism was introduced.