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Biomedical subjects

A Moghtaderi

Publications and source records attributed to A Moghtaderi.

7 recordsLinked to original sources

Tuberculous myelopathy: current aspects of neurologic sequels in the southeast of Iran.

OBJECTIVE: The spinal cord may be affected in different ways in the course of tuberculous infection. The objective of this study was to determine the epidemiologic features, clinical manifestations, pathophysiologic mechanisms, neurologic sequels, and treatment outcomes of tuberculous myelopathy in the southeast of Iran in which the disease is endemic. METHOD: A retrospective study was scheduled. All cases of tuberculous myelopathy treated in our hospital over the last 7 years were reviewed. Only those with histologic or microbiologic confirmation or those who responded to antituberculous therapy were included. RESULTS: During a 7-year period, 43 cases of tuberculous myelopathy were found. The most frequent clinical manifestations were backache (86%) and fever (67%). Twenty patients were paraparetic or paraplegic and 40% had kyphosis. Imaging studies revealed thoracic and/or lumbar spine involvement in 92% of patients with tuberculous spondylitis. Fifteen, five and two patients had sensorimotor spinal cord syndrome, radiculomyelitis and intramedullary syringomyelic syndrome, respectively. Forty-seven percent required surgical intervention. There was improvement in 81% of the cases. CONCLUSION: Different pathophysiologic mechanisms acted on the clinical manifestations of spinal neurotuberculosis. A good outcome is expected if the diagnosis is made in the early stages before the appearance of spinal deformity and neurologic deficits.

Adolescent↗

An evaluation of gender, body mass index, wrist circumference and wrist ratio as independent risk factors for carpal tunnel syndrome.

OBJECTIVES: The aim of this study was to evaluate the role of gender, body mass index (BMI), wrist ratio (WR) and wrist circumference as independent risk factors for carpal tunnel syndrome (CTS) and to analyze the strength of association of these factors. METHODS: We have undertaken a case-control study in 128 CTS patients and 109 controls. Based on clinical and electrophysiologic criteria, 109 female and 19 male CTS patients as well as 62 female and 47 male control subjects were selected from patients and their relatives referred to our hospital. In total, 179 hands with CTS in three groups of severity (mild, moderate and severe) were examined. Height, weight, BMI, wrist width, depth, circumference and ratio were measured in all patients and control group. Mean values of different risk factors for CTS group and controls were measured. A logistic regression analysis was conducted to evaluate odds ratio of different risk factors. RESULTS: The mean values for BMI and WR were greater in CTS patients than in the subject group. Thirty-four, 89 and 57 patients had mild, moderate and severe CTS, respectively. Mean age, BMI, wrist circumference and ratio were not statistically significant in the three groups. Female gender, increased BMI and increased WR had odds ratio of 9.95, 1.75 and 1.12, respectively. CONCLUSION: Our study confirms that female gender, obesity and square wrists are independent risk factors for CTS.

Adult↗

Aspergillous sinusitis.

Chronic invasive aspergillous sinusitis is an uncommon disease that usually occurs in healthy individuals. Chronic invasive aspergillus sinusitis is inadequately characterized entity. Despite its rarity, it is going to be recognized increasingly. We report a neglected patient who received several courses of antibiotics before definite diagnosis. Clinical manifestations, differential diagnosis and treatment are discussed. A high degree of awareness for an early diagnosis may participate to improve the poor prognosis.

Adult↗

Cerebral arteriovenous malformations: influence of angioarchitecture on bleeding risk.

BACKGROUND: To evaluate the angioarchitecture of cerebral arteriovenous malformations (cAVMs) with special regard to its influence on the risk of intracranial haemorrhage. METHODS: Clinical and neuroradiological data of 171 patients with cAVMs, who were treated at our department, were analysed retrospectively. The angioarchitectonic data were obtained from angiographic series, cranial CT scans and MR images. A chi(2) test was conducted to correlate the parameters and determine the P values. FINDINGS: The following parameters correlate to an increased risk of haemorrhage: diameter of the nidus < or =2 cm (P<0.001), number of arterial feeders < or =2 (P<0.001), diameter of the main feeder < or =1 mm (P<0.0001), number of veins draining the nidus < or =2 (P<0.001), exclusive deep drainage (P<0.05), and low or middle flow-velocity (P<0.01). Specific angioarchitectonic features such as venous stenoses, varicose dilatation of the draining vein, arterial aneurysms of the feeding artery, arteriovenous fistula within the nidus, contralateral drainage and sinushypo/-aplasia did not alter the bleeding rate. INTERPRETATION: Various angiographic features were correlated with the occurrence of intracranial haemorrhage in patients with cerebral AVMs. In addition to the well-known factors influencing the bleeding risk of cAVMs like size, pattern of venous drainage and location within the brain our data demonstrate the importance to look at the diameter of the main feeder and the number of draining veins showing a better correlation.

Adolescent↗

Tuberculous radiculomyelitis: review and presentation of five patients.

BACKGROUND: The southeast region of Iran is an endemic area for tuberculosis. Tuberculous radiculomyelitis (TBRM) was considered a rare form of parenchymal neurotuberculosis. OBJECTIVE: To analyze the clinical, laboratory and electrophysiological data of patients with TBRM. We report five patients and review the literature. METHOD: We searched Medline since 1966 and reviewed all cases of TBRM, excluding those with Pott's disease. We then evaluated the clinical and electrophysiological data of our patients. RESULTS: Five patients (two men), with a mean age of 25 years, were assessed. The mean duration of symptoms before diagnosis was 4.5 weeks. Three patients had clinical manifestation of tuberculous meningitis (TBM). Diagnosis was based on sputum smear and culture, cerebrospinal fluid (CSF) culture and polymerase chain reaction (PCR) gene amplification of Mycobacterium tuberculosis. Paraparesis or paraplegia, sphincter incontinence and Babinski sign were the main clinical features. CSF analysis was compatible with chronic meningitis. Electromyography showed radiculopathy in all patients and peripheral nerve disease secondary to axonal damage in only three, while myelography showed adhesive arachnoiditis in three. CONCLUSION: Despite the rarity of TBRM, clinical features were well described. To prevent neurological sequelae, early diagnosis and treatment is mandatory. Electrophysiological study may predict the prognosis.

Adult↗