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Introduction: Regarding the extensive use of IUD, as contraception. The present study was conduced to evaluate the complications resulting from muliload 375 and T Cu 380A IUD inserted in women referred to the health and treatment settings of Kermanshah medical sciences university in the year 2002.
Materials and Methods: The study was descriptive-analytic, on 122 women using M.L 375 IUD and 245 others using T 380A IUD were fully assessed. The tools used to collect data were questionnaires evaluating the following variables: Pregnancy, bleeding, ectopic pregnancy, uterine perforation, and expulsion, pelvic inflammation disease (PID). To analyze the data, descriptive statistic and X², student-T and Fisher tests were used.
Results: Severe bleeding during menstrual cycle was the most common complication in the two study groups, especially in the multiload 375 IUD group (75% vs. 41.6%; P<0.001). The multiload 375 IUD had a significantly higher dysmenorrhea rate compared to the T cu 380A (%70.8 vs. %40.8; P<0.001). The rate of intera-uterine pregnancy was low for the two device %1.7 vs. %2, and occurrence of ectopic pregnancy in multiload 375 IUD was 0.8% and in T Cu 380A group was not reported. There was no uterine perforation observed for either device.
Conclusion: According to the results gained, the common complications in each group were not dangerous and their severe and threatening complications were uncommon. The most frequent complications were severe bleeding during menstrual period, dysmenorrhea and spotting which were not life threating and could be controlled by supporting and training their users, although these complications were seen more among those using M.L 375 IUD. These two device were effective enough to prevent pregnancy. It seems that using T Cu 380A IUD is more suitable for those who want to have a long-term contraception.

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  Introduction: Patients` staying in recovery unit is associated with risks and complications and is expensive. Decreasing the duration of staying can both increase patients` safety and decrease hospital costs. Laryngeal mask airway (LMA) as a new instrument has been widely used for airway management and in this study, its effect on recovery time is investigated.

  Materials and methods: In a double blind randomized controlled clinical trial, 62 ASA Ι & Π patients were divided into two equal groups. In one group laryngeal mask and in the other, tracheal tube was used. The anesthetic drugs were similar in both groups. Patients with upper airway infections, as well as patients undergoing thoracic and upper abdominal surgeries were excluded. Those with more than one hour duration of anesthesia and more than 30 seconds need for intubations were also excluded. Duration of anesthesia was measured in minutes. Duration of recovery staying (in minutes) and complications were also recorded. Data was analyzed using Chi Square and Mann Whitney U tests.

  Results: There were no significant differences in age, sex and mean time of anesthesia between the two groups. But mean recovery time in LMA group with 10.65 minutes and tracheal tube group with 16.71 minutes was significantly different (P=0.007). Two patients (6.45%) in LMA and 11 patients (35.48%) in tracheal tube group developed complications during recovery period which was a statistically significant difference (P = 0.004).

  Conclusion: Laryngeal mask airway, decreased recovery time and the number and severity of respiratory complications. Complications such as cough, laryngospasm, bronchospasm, and arterial hypoxemia were significantly less in patients with laryngeal mask airway compared to patients with tracheal tube, so the use of LMA is recommended.

 

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Introduction:The membranes used in haemodialysis may be manufactured from cellulose, modified cellulose or synthetic polymers. Such membranes, when in contact with blood will activate the complement system, which entails changes in leukocyte and platelet counts. Polysulfone is a synthetic membrane of high biocompatibility standards, whereas haemophane membranes are modified cellulose-based membranes. The biocompatible profiles of these membranes, has been studied by clinical reactions (i.e. hypotension, nausea, pruritis, …) during dialysis sessions. Both kinds of these membranes are used in Iran. The number and severity of these reactions define the degree of dialysis biocompatibility. Materials and Methods: In a clinical trial study which was carried out in Imam Khomeini hospital in Tehran, 100 hemodialysis patients were enrolled to this investigation. Their clinical reactions were compared during 3 sessions of hemodialysis with polysulfone and 3 sessions of hemodialysis with hemophan membrane. Each patient was the control of him/herself. Data was analyzed using Chi square test. Results:Mean age of patients was 48.85±17.56 years and 39% of them were female. The most common complications were hypotension and muscle cramps (each 21.5%). Hypotension was higher in sessions of polysulfon versus hemophane (18% versus 25%) but was not significantly different. Also other complications such as muscle cramp, nausea, vomiting, dyspnea, headache, chills and fever had no significant difference. Seizure did not occur in any patient. Conclusion: According to our findings the membrane’s type has no role in acute clinical complications during hemodialysis and in most patients, membranes can be used according to their availability. It seems their biocompatibility has no considerable clinical difference.

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Introduction: Clubfoot is one of the most common foot deformities in children. The initial treatment of clubfoot is nonsurgical. The succes rate of this treatment is 5-80%. If clubfoot does not respond to this treatment, surgery is indicated. Surgical treatment of clubfoot has several complications. The preferred method of surgical release in textbooks is a modified Mc Kay procedure with Cincinnati incision but it may have various complications such necrosis, excessive scar, infection, dehiscence and recurrence. The purpose of this article is to investigate surgical treatment of clubfoot with two incision procedure instead of Cincinnati incision. Materials and Methods: In this descriptive study 50 children (81 feet) with clubfoot disease who did not respond to nonsurgical treatment, since 1999 until 2002, in Al-Zahra hospital were selected and underwent soft tissue release procedure by posteromedial and lateral incisions. After operation they were followed for at least two years. Every six months patients were assessed for early postoperative complications, clinical and radiologic recurrence. Data was presented using descriptive statistics. Results: 74% of patients were male. Their mean age was 3.40.69. There was positive family history in 14% of patients. Clinical recurrence was seen in 6 patients, (9 feet) (5 male, one female) that all had bilateral involvement. The most common type of recurrence was metatarsus adductus. There was no skin necrosis or deep wound infection after surgery but 2 cases of superficial infection was seen which were treated by drugs. Conclusion: Regarding the excellent results of this procedure and obtained correction and the least skin complications in comparison to textbooks we suggest the two incision procedure instead of Cincinnati incision in treatment of most club foots

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Introduction: Abdominal pregnancy is 1 in 10000 live births and advanced abdominal pregnancy is rare. Abdominal pregnancy is associated with high morbidity and mortality with the risk for death 7 to 8 times greater than tubal ectopic pregnancy and 90 times greater than intrauterine pregnancy. In this article a case of advanced abdominal pregnancy is reported. Case: The patient was a 35 year’s old (G4P3) woman presented with undelivered pregnancy after two years. After diagnostic procedures laparatomy was done. During the operation, fetus adhesion to the omentum was released. A 9 kg calcified fetus was delivered. Then the placenta and left adnex was removed completely. Conclusion: Regarding the high mortality rate of abdominal pregnancy, in every pregnancy specially in the precence of it’s risk factors (such as PID, history of ectopic pregnancy, history of infertilitry and using drugs to induce ovulation, IVF, prior tubal surgery and …) and also suspicious symptoms, this probability and early intervention must be considered.

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Background: Brucellosis, a zoonotic disease with worldwide spread, is a common disease in Iran and is endemic in Markazi Province. Brucella osteomyelitis, on the other hand, is a rare disease. Here we reported a case of brucella osteomyelitis of the tibia following trauma. Case: The patient was a 22 year old man referring with chronic draining tibia ulcer. He had a history of trauma of the tibia, dating back to 3 years ago, for which local prosthesis had been prescribed. Later on, the prosthesis had been removed due to infection. Staining of the tissue samples indicated the presence of gram-negative coccobacill and brucella growth in the culture of excretions. Conclusion: This case was reported because of rare presentation of brucella and the educational implications of the patient with respect to the possibility of brucella development in chronic ulcers or prosthesis. Although uncommon, brucellosis should be regarded as a potential cause of osteomyelitis in patients with a record of physical contact with animals.