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Izadi S, Smithers J, Shieh HF, Demehri FR, Mohammed S, Hamilton TE, Zendejas B. The History and Legacy of the Foker Process for the Treatment of Long Gap Esophageal Atresia. J Pediatr Surg 2024; 59:1222-1227. [PMID: 38184432 DOI: 10.1016/j.jpedsurg.2023.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 01/08/2024]
Abstract
Historically, children afflicted with long gap esophageal atresia (LGEA) had few options, either esophageal replacement or a life of gastrostomy feeds. In 1997, John Foker from Minnesota revolutionized the treatment of LGEA. His new procedure focused on "traction-induced growth" when the proximal and distal esophageal segments were too far apart for primary repair. Foker's approach involved placement of pledgeted sutures on both esophageal pouches connected to an externalized traction system which could be serially tightened, allowing for tension-induced esophageal growth and a delayed primary repair. Despite its potential, the Foker process was received with criticism and disbelief, and to this day, controversy remains regarding its mechanism of action - esophageal growth versus stretch. Nonetheless, early adopters such as Rusty Jennings of Boston embraced Foker's central principle that "one's own esophagus is best" and was instrumental to the implementation and rise in popularity of the Foker process. The downstream effects of this emphasis on esophageal preservation would uncover the need for a focused yet multidisciplinary approach to the many challenges that EA children face beyond "just the esophagus", leading to the first Esophageal and Airway Treatment Center for children. Consequently, the development of new techniques for the multidimensional care of the LGEA child evolved such as the posterior tracheopexy for associated tracheomalacia, the supercharged jejunal interposition, as well as minimally invasive internalized esophageal traction systems. We recognize the work of Foker and Jennings as key catalysts of an era of esophageal preservation and multidisciplinary care of children with EA.
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Affiliation(s)
- Shawn Izadi
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Jason Smithers
- Department of Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Hester F Shieh
- Department of Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Farokh R Demehri
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Somala Mohammed
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Thomas E Hamilton
- Division of General, Thoracic and Fetal Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Mohammed S, Kamran A, Izadi S, Visner G, Frain L, Demehri FR, Shieh HF, Jennings RW, Smithers CJ, Zendejas B. Primary Posterior Tracheopexy at Time of Esophageal Atresia Repair Significantly Reduces Respiratory Morbidity. J Pediatr Surg 2024; 59:10-17. [PMID: 37903674 DOI: 10.1016/j.jpedsurg.2023.09.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/08/2023] [Indexed: 11/01/2023]
Abstract
PURPOSE Esophageal atresia with tracheoesophageal fistula (EA/TEF) is often associated with tracheobronchomalacia (TBM), which contributes to respiratory morbidity. Posterior tracheopexy (PT) is an established technique to treat TBM that develops after EA/TEF repair. This study evaluates the impact of primary PT at the time of initial EA/TEF repair. METHODS Review of all newborn primary EA/TEF repairs (2016-2021) at two institutions. Long-gap EA and reoperative cases were excluded. Based on surgeon preference and preoperative bronchoscopy, neonates underwent primary PT (EA + PT Group) or not (EA Group). Perioperative, respiratory and nutritional outcomes within the first year of life were evaluated. RESULTS Among 63 neonates, 21 (33%) underwent PT during EA/TEF repair. Groups were similar in terms of demographics, approach, and complications. Neonates in the EA + PT Group were significantly less likely to have respiratory infections requiring hospitalization within the first year of life (0% vs 26%, p = 0.01) or blue spells (0% vs 19%, p = 0.04). Also, they demonstrated improved weight-for-age z scores at 12 months of age (0.24 vs -1.02, p < 0.001). Of the infants who did not undergo primary PT, 10 (24%) developed severe TBM symptoms and underwent tracheopexy during the first year of life, whereas no infant in the EA + PT Group needed additional airway surgery (p = 0.01). CONCLUSION Incorporation of posterior tracheopexy during newborn EA/TEF repair is associated with significantly reduced respiratory morbidity within the first year of life. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Somala Mohammed
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Ali Kamran
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Shawn Izadi
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Gary Visner
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Leah Frain
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Farokh R Demehri
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Hester F Shieh
- Department of Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Russell W Jennings
- Department of Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Charles J Smithers
- Department of Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
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Spencer BL, Krumm A, Izadi S, Hirschl RB, Modi BP, Ehrlich P, Newman EA, Zendejas B. How Many Operative Performance Ratings Does a Pediatric Surgery Fellow Need to Be Deemed Practice Ready? J Pediatr Surg 2024; 59:31-36. [PMID: 37845126 DOI: 10.1016/j.jpedsurg.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/06/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE Identifying the number of cases required for a fellow to achieve competence has been challenging. Workplace-based assessment (WBA) systems make collecting performance data practical and create the opportunity to translate WBA ratings into probabilistic statements about a fellow's likelihood of performing to a given standard on a subsequent assessment opportunity. METHODS We compared data from two pediatric surgery training programs that used the performance rating scale from the Society for Improving Medical Professional Learning (SIMPL). We used a Bayesian generalized linear mixed effects model to examine the relationship past and future performance for three procedures: Laparoscopic Inguinal Hernia Repair, Laparoscopic Gastrostomy Tube Placement, and Pyloromyotomy. RESULTS For site one, 26 faculty assessed 9 fellows on 16 procedures yielding 1094 ratings, of which 778 (71%) earned practice-ready ratings. For site two, 25 faculty rated 3 fellows on 4 unique procedures yielding 234 ratings of which 151 (65%) were deemed practice-ready. We identified similar model-based future performance expectations, with prior practice-ready ratings having a similar average effect across both sites (Site one, B = 0.25; Site two, B = 0.25). Similar prior practice-ready ratings were needed for Laparoscopic G-Tube Placement (Site one = 13; Site two = 14), while greater differences were observed for Laparoscopic Inguinal Hernia Repair (Site one = 10; Site two = 15) and Pyloromyotomy (Site one = 10; Site two = 15). CONCLUSION Our approach to modeling operative performance data is effective at determining future practice readiness of pediatric surgery fellows across multiple faculty and fellow groups. This method could be used to establish minimum case number requirements. TYPE OF STUDY Original manuscript, Study of Diagnostic Test. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Brianna L Spencer
- Section of Pediatric Surgery, Department of Surgery, University of Michigan Medical School, C.S. Mott Children's Hospital, 1540 E Hospital Dr, Ann Arbor, MI, 48109, USA.
| | - Andrew Krumm
- Department of Learning Health Sciences, University of Michigan Medical School, 221 Victor Vaughan Building, 1111 E. Catherine St, Ann Arbor, MI, 48109, USA
| | - Shawn Izadi
- Department of Surgery, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Ronald B Hirschl
- Section of Pediatric Surgery, Department of Surgery, University of Michigan Medical School, C.S. Mott Children's Hospital, 1540 E Hospital Dr, Ann Arbor, MI, 48109, USA
| | - Biren P Modi
- Department of Surgery, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Peter Ehrlich
- Section of Pediatric Surgery, Department of Surgery, University of Michigan Medical School, C.S. Mott Children's Hospital, 1540 E Hospital Dr, Ann Arbor, MI, 48109, USA
| | - Erika A Newman
- Section of Pediatric Surgery, Department of Surgery, University of Michigan Medical School, C.S. Mott Children's Hospital, 1540 E Hospital Dr, Ann Arbor, MI, 48109, USA
| | - Benjamin Zendejas
- Department of Surgery, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
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Izadi S, Zendejas B, Meisner J, Kamran A, Mohammed S, Demehri F, Staffa S, Zurakowski D, Hseu A, Cunningham M, Choi S, Barnewolt C. Diagnostic Accuracy of Laryngeal Ultrasound for Evaluating Vocal Fold Movement Impairment in Children. J Pediatr Surg 2024; 59:109-116. [PMID: 37845124 DOI: 10.1016/j.jpedsurg.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/06/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE Vocal fold movement impairment (VFMI) secondary to recurrent laryngeal nerve (RLN) injury is a common source of morbidity after pediatric cervical, thoracic, and cardiac procedures. Flexible laryngoscopy (FL) is the gold standard to diagnose VFMI yet can be challenging to perform and/or risks possible clinical decompensation in some children and is an aerosolizing procedure. Laryngeal ultrasound (LUS) is a potential non-invasive alternative, but limited data exists in the pediatric surgical population regarding its efficacy. We aimed to investigate the diagnostic accuracy of LUS compared to FL in evaluating VFMI. METHODS A prospective, single-center, single-blinded (rater) cohort study was undertaken on perioperative pediatric patients at risk for RLN injury. Patients underwent FL and LUS. Cohen's kappa was used to determine chance-corrected agreement. RESULTS Between 2021 and 2023, 85 paired evaluations were performed with patients having a median (IQR) age of 10 (4, 42) months and weight of 7.5 (5.4, 13.4) kilograms. The prevalence of VFMI was 27.1%. Absolute agreement between evaluations was 98.8% (kappa 0.97, 95% CI: 0.91-1.00, P < 0.001). The sensitivity and specificity of LUS in detecting VFMI was 95.7% and 100%, yielding a positive predictive value (PPV) of 100% and negative predictive value (NPV) of 98.4% (95% CI: 90-100%). Diagnostic accuracy was 98.8% (95% CI: 93-100%). CONCLUSION LUS is a highly accurate modality in evaluating VFMI in children. While FL remains the gold standard for diagnosis, LUS offers a low-risk screening modality for children at risk for VFMI such that only those with an abnormal LUS or presence of clinical symptoms discordant with LUS findings should undergo FL. TYPE OF STUDY Prospective, single-center, single blinded (rater), cohort study. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Shawn Izadi
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | | | - Jay Meisner
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Ali Kamran
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Somala Mohammed
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Farokh Demehri
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Steven Staffa
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - David Zurakowski
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Anne Hseu
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Michael Cunningham
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Sukgi Choi
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Carol Barnewolt
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA.
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Meisner JW, Izadi S, Kamran A, Shieh HF, Smithers CJ, Bennett J, Demehri FR, Mohammed S, Lawlor C, Choi SS, Zendejas B. Screening for Vocal Fold Movement Impairment in Children Undergoing Esophageal and Airway Surgery. Laryngoscope 2023; 133:3564-3570. [PMID: 36892035 DOI: 10.1002/lary.30646] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/04/2023] [Accepted: 02/27/2023] [Indexed: 03/10/2023]
Abstract
INTRODUCTION Children undergoing cervical and/or thoracic operations are at risk for recurrent laryngeal nerve injury, resulting in vocal fold movement impairment (VFMI). Screening for VFMI is often reserved for symptomatic patients. OBJECTIVE Identify the prevalence of VFMI in screened preoperative patients prior to an at-risk operation to evaluate the value of screening all patients at-risk for VFMI, regardless of symptoms. METHODS A single center, retrospective review of all patients undergoing a preoperative flexible nasolaryngoscopy between 2017 and 2021, examining the presence of VFMI and associated symptoms. RESULTS We evaluated 297 patients with a median (IQR) age of 18 (7.8, 56.3) months and a weight of 11.3 (7.8, 17.7) kilograms. Most had a history of esophageal atresia (EA, 60%), and a prior at-risk cervical or thoracic operation (73%). Overall, 72 (24%) patients presented with VFMI (51% left, 26% right, and 22% bilateral). Of patients with VFMI, 47% did not exhibit the classic symptoms (stridor, dysphonia, and aspiration) of VFMI. Dysphonia was the most prevalent classic VFMI symptom, yet only present in 18 (25%) patients. Patients presenting with a history of at-risk surgery (OR 2.3, 95%CI 1.1, 4.8, p = 0.03), presence of a tracheostomy (OR 3.1, 95%CI 1.0, 10.0, p = 0.04), or presence of a surgical feeding tube (OR 3.1, 95%CI 1.6, 6.2, p = 0.001) were more likely to present with VFMI. CONCLUSION Routine screening for VFMI should be considered in all at-risk patients, regardless of symptoms or prior operations, particularly in those with a history of an at-risk surgery, presence of tracheostomy, or a surgical feeding tube. LEVEL OF EVIDENCE 3 Laryngoscope, 133:3564-3570, 2023.
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Affiliation(s)
- Jay W Meisner
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Shawn Izadi
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Ali Kamran
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Hester F Shieh
- Department of Surgery, Johns Hopkins All Childrens, St Petersburg, Florida, U.S.A
| | - C Jason Smithers
- Department of Surgery, Johns Hopkins All Childrens, St Petersburg, Florida, U.S.A
| | - John Bennett
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Farokh R Demehri
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Somala Mohammed
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Claire Lawlor
- Department of Ear, Nose and Throat Surgery, Children's National, Washington, District of Columbia, U.S.A
| | - Sukgi S Choi
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Benjamin Zendejas
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, U.S.A
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Izadi S, James Skubic J. Disparities in Compensation: The Price of Being a Resident. J Am Coll Surg 2020. [DOI: 10.1016/j.jamcollsurg.2020.08.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Izadi S, Mokhtari-Azad T, Zahraei SM. Measles vaccination coverage and seroprevalence of anti-measles antibody in south-east Islamic Republic of Iran. East Mediterr Health J 2015; 21:396-402. [PMID: 26369998 DOI: 10.26719/2015.21.6.396] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 04/06/2015] [Indexed: 11/09/2022]
Abstract
Discrepancies often exist between recorded immunization coverage and the real immunity level in a community. To estimate the vaccination coverage against measles in south-east Islamic Republic of Iran, a crosssectional study was conducted in 3 districts during summer 2011. Using probability proportional to size cluster sampling, 1368 children aged 30-54 months were selected. Serum samples of 663 who had received 2 injections of mumpsmeasles- rubella (MMR) vaccine were checked for anti-measles IgG. Vaccination coverage for the second dose of MMR vaccine was 93.7%. The prevalence of anti-measles IgG in those who had received at least 2 MMR vaccine doses was 94.6%. There was a statistically significant association between the serological results and variables that reflected poor accessibility to health services. Combining serological results with coverage data, the proportion of the community protected against measles was estimated as 88.6%, which was below the limits defined for the measles elimination goals.
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Affiliation(s)
- S Izadi
- Department of Epidemiology, Health Promotion Research Centre, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
| | - T Mokhtari-Azad
- Professor of Virology, National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - S M Zahraei
- Centre for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
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Davari B, Limoee M, Khodavaisy S, Zamini G, Izadi S. Toxicity of entomopathogenic fungi, Beauveria bassiana and Lecanicillium muscarium against a field-collected strain of the German cockroach Blattella germanica (L.) (Dictyoptera: Blattellidae). Trop Biomed 2015; 32:463-470. [PMID: 26695206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The German cockroach, Blattella germanica (L.) has been recognized as a serious health problem throughout the world. Control failures due to insecticide resistance and chemical contamination of environment have led some researchers focus on the other alternative strategy controls. Microbial insecticides such as those containing entomo pathogenic fungi could be of high significance. Lecanicillium muscarium and Beauveria bassiana grow naturally in soils throughout the world and act as a parasite on various arthropod species, causing white muscardine disease. Thus, these two species could be considered as entomopathogenic fungi. The current study conducted to evaluate the toxicity of Beauveria bassiana and Lecanicillium muscarium against German cockroach, Blattella germanica. Conidial formulations of L. muscarium (PTCC 5184) and B. bassiana (PTCC5197) were prepared in aqueous suspensions with Tween 20. Bioassays were performed using two methods including submersion of cockroaches in conidial suspension and baiting. Data were analyzed by Probit program and LC50 and LC90 were estimated. The obtained results indicated that both fungi species were toxic against German cockroach however; Beauveria bassiana was significantly 4.8 fold more toxic than L. muscarium against German cockroach using submersion method.
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Affiliation(s)
- B Davari
- Department of Medical Entomology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; Kurdistan Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - M Limoee
- School of Public Health, Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - S Khodavaisy
- Department of Medical Mycology and Parasitology, Kurdistan University of Medical Sciences, Sanandaj, Iran; Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - G Zamini
- Department of Medical Parasitology and Mycology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - S Izadi
- Department of Parasitology and Mycology, Tehran University of Medical Sciences, Tehran, Iran; Isfahan National Institute of Health Research, Isfahan, Iran
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Izadi S, Shahmahmoodi S, Zahraei SM, Dorostkar F, Majdzadeh SR. Seroprevalence of poliovirus antibodies among 7-month-old infants after 4 doses of oral polio vaccine in Sistan-va-Baluchestan, Islamic Republic of Iran. East Mediterr Health J 2015; 21:83-9. [PMID: 25876819 DOI: 10.26719/2015.21.2.83] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 11/03/2014] [Indexed: 11/09/2022]
Abstract
Despite high coverage rates of polio vaccine in the Islamic Republic of Iran, the seroconversion rates of infants may be inadequate. This study measured seroprevalence of antibodies against poliovirus serotypes 1 to 3 (PV1, PV2 and PV3) in 7-month-old infants who had received at least 4 doses of trivalent oral polio vaccine. A serosurvey was conducted in 2010 in rural areas of Chabahar, Sistan-va-Baluchestan province. Using cluster sampling, 72 eligible infants were tested for antibody against the 3 poliovirus serotypes according to WHO guidelines. Antibody titres ≥ 1:10 were considered positive. The seropositive rates for antibody against PV1, PV2 and PV3 were 84.7%, 95.8% and 70.8% respectively. Only 63.9% of participants were seropositive for antibodies against all 3 poliovirus serotypes. Except for PV2, the seroprevalence of antibody against the other 2 poliovirus serotypes, especially PV3, was unsatisfactory.
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Affiliation(s)
- S Izadi
- Health Promotion Research Centre, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
| | - S Shahmahmoodi
- School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - S M Zahraei
- Centre for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
| | - F Dorostkar
- School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - S-R Majdzadeh
- School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
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Izadi S, Ojagh SM, Rahmanifarah K, Shabanpour B, Sakhale BK. Production of low-fat shrimps by using hydrocolloid coatings. J Food Sci Technol 2014; 52:6037-42. [PMID: 26345025 DOI: 10.1007/s13197-014-1632-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 10/01/2014] [Accepted: 10/28/2014] [Indexed: 11/29/2022]
Abstract
Production of low-fat fried foods by using hydrocolloid coatings is a common method to avoid excessive oil absorption during deep-fat frying. The aim of this work was to evaluate the influence of hydrocolloid coatings (carboxymethyl cellulose, guar, tragacanth and zedo gum) on the oil content and quality parameters of shrimp after deep-fat frying. The hydrocolloid solutions (0.5, 1.0 and 1.5 % w/v) were used for coating. Coated and uncoated (control) samples were packaged and stored at -20 and after a week were fried at 170 °C for 90 s in sunflower oil. The results showed that all hydrocolloid coatings reduced oil content of fried shrimp. The coated shrimps with 1.5 % tragacanth solution had highest coating pick up and moisture content, and lowest oil content than the other samples. The coated samples had darker color and softer texture than the control sample. Sensory evaluation indicated that all coated and uncoated shrimps were acceptable.
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Affiliation(s)
- S Izadi
- Department of Seafood processing, Gorgan University of Agricultural Sciences and Natural Resources, Gorgan, Iran
| | - S M Ojagh
- Department of Seafood processing, Gorgan University of Agricultural Sciences and Natural Resources, Gorgan, Iran
| | - K Rahmanifarah
- Department of Pathobiology and Quality Control Urmia Lake Research Institute, Urmia University, Urmia, Iran
| | - B Shabanpour
- Department of Seafood processing, Gorgan University of Agricultural Sciences and Natural Resources, Gorgan, Iran
| | - B K Sakhale
- Food Technology Division Department of Chemical Technology, Dr. Babasaheb Ambedkar Marathwada University, Aurangabad, 431004 Maharashtra India
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Izadi S, Shahmahmoodi S, Zahraei SM, Dorostkar F, Majdzadeh R. Risk of polio reintroduction to border regions of Islamic Republic of Iran: seroprevalence study of children with at least 5 doses of oral polio vaccine. East Mediterr Health J 2014; 20:287-294. [PMID: 24952285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 12/18/2013] [Indexed: 06/03/2023]
Abstract
Movements of populations from countries where polio has not been eradicated is a concern in the Islamic Republic of Iran. A cross-sectional, community-based study was implemented in 2010 in 2 districts in Sistan-va-Baluchestan Province near the south-east border. The aim was to determine the seroprevalence of antibodies in children aged 20 (± 2) months who had received at least 5 doses of trivalent oral polio vaccine. Using cluster sampling, 365 children were enrolled for serological testing. Antibody titres ≥ 1:10 were considered positive. Seropositive rates for antibody against poliovirus serotypes 1, 2 and 3 were 94.1%, 96.7% and 78.3% respectively. The lowest seropositive rate was for antibody against polio serotype 3 (PV3) among boys (58.3%). Exclusive breastfeeding showed a direct relationship with antibody response to PV3 (OR = 2.0; 95% CI: 1.1-3.6). Improving community protection against PV3 is an urgent programme priority.
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Affiliation(s)
- S Izadi
- Health Promotion Research Centre, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
| | - S Shahmahmoodi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - S M Zahraei
- Centre for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
| | - F Dorostkar
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - R Majdzadeh
- Department of Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
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Izadi S, Shahmahmoodi S, Zahraei S, Dorostkar F, Majdzadeh R. Risk of polio reintroduction to border regions of Islamic Republic of Iran: seroprevalence study of children with at least 5 doses of oral polio vaccine. East Mediterr Health J 2014. [DOI: 10.26719/2014.20.5.287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Miri-Moghaddam E, Naderi M, Izadi S, Mashhadi MA. Causes of new cases of major thalassemia in sistan and balouchistan province in South-East of iran. Iran J Public Health 2012; 41:67-71. [PMID: 23304678 PMCID: PMC3521888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Accepted: 09/22/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Thalassemia is the most common monogenic disease in South-East of Iran. Despite the 70% reduction in Iranian thalassemia cases after thalassemia control comprehensive program, 601 affected babies were born in Sistan and Balouchistan Province, Iran from 2002 to 2010, so this study aims at investigating the causes of new thalassemia cases. METHODS Data from this retrospective cross-sectional study was collected through interviews and information in the patients' hospital records. RESULTS Data revealed that 52.4% of fathers and 78.4% of mothers of thalassemic children had elementary education or less. In addition, 78.6% of the couples did not undergo premarital screening for thalassemia and 71.2% of the couples were not notified of their own minor thalassemia until a child was born with major thalassemia. Of the diagnosed minor couples, about 25% did PND and the others did not carry out because mothers were unaware of proper gestational age and of the importance of this issue, financial problems, and the husbands' disagreement to take the tests. Moreover, 16 mothers, in spite of being diagnosed of having a major fetus, refused to terminate the pregnancy. CONCLUSION The most preventable causes for affected births include couples' unawareness of being minor and unawares of the PND importance and process.
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Affiliation(s)
- E Miri-Moghaddam
- Genetics of Non-Communicable Disease Research Center, Zahedan University of Medical Sciences, (ZUMS), Zahedan-Iran,Dept. of Genetics, Faculty of Medicine, ZUMS, Zahedan-Iran
| | - M Naderi
- Dept. of pediatric Hematology, Ali Ebn-e Abitaleb Hospital, Research Center for Child and Adolescent Health, ZUMS, Zahedan-Iran,Corresponding Author: Tel: +98 0541 3218998
| | - S Izadi
- Dept. of Epidemiology, Faculty of Health, ZUMS, Zahedan -Iran
| | - MA Mashhadi
- Dept. of Hematology-Oncology, Ali Ebne Abitaleb Hospital, ZUMS, Zahedan-Iran
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Shahbazi A, Akbarimoghaddam M, Izadi S, Ghazanchaii A, Jalali N, Bazmani A. Identification and genetic variation of fasciola species from tabriz, north- Western iran. Iran J Parasitol 2011; 6:52-9. [PMID: 22347297 PMCID: PMC3279890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2010] [Accepted: 08/05/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND Fascioliasis is considered as the most important helminthic infection of cattle and sheep. Traditional approaches using morphological and biologic characters cannot cause a certainty in the accurate and precise identification and intra-specific differences of Fasciola spp. In this study, we identified Fasciola species using ITS-1 marker and described genetic variation of each species of the parasite in isolates from Tabriz slaughterhouse in West Azerbaijan Province, north- western Iran. METHODS Overall, 100 samples (50 from sheep and 50 from cattle) morphologically detected as Fasciola worms were studied for identification of Fasciola species by PCR-RFLP method and intra-species variation of the parasite using RAPD-PCR technique. RESULTS A region of approximately 460bp in all samples was successfully amplified. There were no identifiable variations among the size of PCR products. Two and three fragments in samples correspond to F. hepatica and F. gigantica was seen, respectively, through PCR-RFLP method. No difference was seen in digestion pattern according to host (sheep or cattle). Different types of each species of the parasite was observed using RAPD-PCR technique. CONCLUSION We could have an estimate of frequency of F. hepatica and F. gigantic and different genotypes of the parasite in isolates from one locality in north- western of Iran. By extension of such studies in future to other animal hosts (buffalo and goat) and including more regions to sampling, the reliability of the results and their application for control programs in zoonotic diseases will be increased.
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Affiliation(s)
- A Shahbazi
- Tabriz Research Center of Infectious and Tropical Diseases, Tabriz University of Medical Sciences, Tabriz, Iran
| | - M Akbarimoghaddam
- Department of Medical Parasitology and Mycology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - S Izadi
- National Institute of Health Research, Tehran, Iran
| | - A Ghazanchaii
- Department of Medical Parasitology and Mycology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - N Jalali
- National Institute of Health Research, Tehran, Iran
| | - A Bazmani
- Tabriz Research Center of Infectious and Tropical Diseases, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding Author: Tel: 09143040279.
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Metanat M, Sharifi-mood B, Izadi S, Miradi M, Ghorbani-Vaghei A, Dawudi S, Fayyaz-Jahani F. Seroepidemiology of Helicobacter pylori Infection Among Health Care Workers. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.1188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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16
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Kaviani A, Mehrdad N, Najafi M, Hashemi ES, Yunesian M, Ebrahimi M, Hooshmand H, Izadi S. Comparison of naproxen with placebo for the management of noncyclical breast pain: a randomized, double-blind, controlled trial. World J Surg 2008; 32:2464-70. [PMID: 18787893 DOI: 10.1007/s00268-008-9731-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Breast pain is a common symptom in patients attending breast clinics. Although most patients experience mastalgia of mild to moderate severity, approximately 15% of patients suffer from severe pain that causes significant distress and some disturbance in their daily life that lead them to seek treatment. Despite a considerable number of drugs suggested for decreasing the severity of mastalgia, there is no standard treatment for the complaint. In this study, we investigated the effect of naproxen on reducing the complaint of breast pain compared with placebo. METHODS Eighty-one women suffering from noncyclic breast pain were recruited to a randomized, double-blind, clinical trial between January 2002 and September 2004. All patients were suffering from this complaint for at least 3 months before the study. Patients were randomly assigned to two groups. Patients in the case group received naproxen 250 mg BD. Patients in the placebo group took placebo in a similar manner. The intensity of mastalgia was assessed before and twice after intervention by using a Visual Analogue Scale. RESULTS Forty-two of 81 patients were recruited randomly as cases and the remaining 39 were assigned placebo. Of these 24 and 22 patients fulfilled the study protocol respectively. The mean age of patients was 35 (SD = 7.5; range, 19-55) years. The mean pain severity at the beginning of the study was 5.8 and 6.1 in naproxen and placebo groups, respectively. The severity of pain was decreased significantly at the end of the study in both groups (3.9 in patients and 3.7 in controls (P = 0.005 and 0.0001)). Although the decrease in pain severity in each individual group was statistically significant, it was not significant compared with one another (P = 0.64). CONCLUSIONS Breast pain is a complex symptom that can be relieved significantly with reassurance. According to the result of this study, naproxen has no superiority over placebo in reducing noncyclic breast pain.
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Affiliation(s)
- A Kaviani
- Department of Surgery, Imam Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Keshavarz Blvd., Toohid Sq., Tehran, Iran.
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Arbabi M, Nejatisafa A, Mohammadi M, Yousefi S, Mahdavian S, Izadi S, Berzins K. The prevalence and experience of harrassment of people with mental health problems living in the community in Iran. Eur Psychiatry 2008. [DOI: 10.1016/j.eurpsy.2008.01.1258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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18
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Krishnan R, Izadi S, Morton CE, Marsh IB. Use of Frost sutures in an orbital trauma patient with extensive conjunctival oedema and pseudoproptosis. Int J Oral Maxillofac Surg 2007; 36:649-51. [PMID: 17391921 DOI: 10.1016/j.ijom.2007.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2006] [Revised: 12/07/2006] [Accepted: 02/02/2007] [Indexed: 11/17/2022]
Abstract
Frost sutures are temporary suspension sutures conventionally used in oculoplastics. The case is presented here of a patient with multiple orbital fractures who developed worsening conjunctival chemosis and pseudoproptosis. This patient was managed successfully with Frost sutures. To the best of the authors' knowledge, there is no documented use of Frost sutures in this type of case. It is emphasized that this technique should only be considered following rigorous exclusion of retrobulbar pathology and careful attention towards early detection of raised intraocular pressure.
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Affiliation(s)
- R Krishnan
- Walton Daycase and Outpatient Centre, University Hospital Aintree, Rice Lane, Liverpool L9 1AE, UK.
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Izadi S, Sohrabpor H, Izadi S. Study of the effect of renal transplantation on methacholine challenge test in patients with end-stage renal failure in Shahid Doctor Labafinejad Hospital in Tehran, Iran. Transplant Proc 2007; 39:892-4. [PMID: 17524842 DOI: 10.1016/j.transproceed.2007.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Pulmonary complications are common in patients with chronic renal failure (CRF). The objective of this study was determine the effect of renal transplantation on pulmonary function, using a methacholine challenge test. This interventional study included 14 CRF patients on maintenance dialysis who underwent serial spirometry and astography before and after renal transplantation. None of them was known to have clinically important pulmonary or heart disease. The results of spirometry, astography, echocardiography, and chest X-ray were normal. Five patients were men and all others were women. The overall age range was 15 to 45 years (mean age = 28.6 +/- 10.9). For every patient four times astography was done. The mean values of spirometric and astography indices before and after renal transplantation were within normal limit. But by repeated measure analysis of variance, the results actually showed improved airway responsiveness (although within normal limits). The most common pathological lung condition in CRF is pulmonary edema, usually due to a combination of fluid overload and abnormal permeability of the pulmonary microcirculation. However, our patients had no symptomatic pulmonary edema, but minor degrees of fluid retention are virtually impossible to detect clinically and could not be excluded. Therefore, it seems that disappearance of subclinical pulmonary edema was the likeliest cause of an increase in minimum dose of methacholine, and therefore improvement in airway responsiveness after renal transplantation.
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Affiliation(s)
- S Izadi
- Iran University of Medical Sciences and Health Services, Tehran, Iran.
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Holakouie Naieni K, Izadi S, Salehi M, Chinikar S. R2235 Study of infectivity of Crimean-Congo haemorrhagic fever cases in Sistan va Baluchestan province of Iran, 2003–2004. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)72074-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sharifi-Mood B, Fazaeli A, Izadi S, Mokhtari S. P544 Fifteen-year experience with pulmonary hydatidosis: clinical manifestation, diagnosis and treatment. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70387-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
This article presents a case of bilateral posterior dislocations of the crystalline lens in a patient with epilepsy who presented with reduced vision and anisocoria 2 weeks after having sustained head injuries during a seizure. The possibility of lens dislocation was raised only at this time, and subsequently confirmed on computed tomography. Such patients may require prompt referral to the ophthalmologist to treat complications such as functional aphakia, uveitis and more seriously pupillary block glaucoma. This case highlights the importance of ocular examination of head injuries to rule out possible ophthalmological pathology.
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Affiliation(s)
- S Izadi
- Royal Liverpool University Hospital, Liverpool, UK
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Abstract
OBJECTIVE To measure the human lamina cribrosa thickness (LCT) in vitro in fully hydrated specimens and to determine whether there is any association between thickness and age or sex. METHODS 45 fixed human optic nerves, age range 9-90 years, were dissected from the globe and frozen sectioned. The study was divided into two parts: the first investigated the overall change in LCT and cribrosal beam thickness (CBT) with age, and the second divided eyes into two specific age groups (38-49 and 78-87 years) and assessed differences with respect to age and sex. RESULTS LCT ranged from 345.4 to 555.9 microm between the samples. A positive relationship was found between LCT and age (LCT = 2.41xage+365.5, 95% confidence interval (CI) for slope 1.31 to 3.52; r(2) = 0.30, p<0.001). A regional difference in CBT was observed, with beams being thickest at the posterior cribrosa (mean 14.8 (standard deviation (SD) 2.2) microm) and thinnest at the anterior cribrosa (9.8 (SD 2.4) microm). CBT increased with increasing age. Differences related to sex were also found, with females having relatively thinner LCT than males, irrespective of age, but this was not statistically significant. CONCLUSIONS This study shows an increase in human LCT with increasing age. This changing structural property of the lamina cribrosa may have implications for its functioning with respect to compliance and reversibility, and has particular relevance to glaucoma, where increasing age has been identified as a strong risk factor for the development of the disease.
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Affiliation(s)
- A Kotecha
- Department of Visual Science, Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK
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Moghtaderi A, Izadi S, Sharafadinzadeh N. An evaluation of gender, body mass index, wrist circumference and wrist ratio as independent risk factors for carpal tunnel syndrome. Acta Neurol Scand 2005; 112:375-9. [PMID: 16281919 DOI: 10.1111/j.1600-0404.2005.00528.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- A Moghtaderi
- Khatam General Hospital, Department of Neurology, Zahedan University, Zahedan, Sistan and Baloochestan, Iran.
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