Study DesignDescriptive, cases series study.PurposeTo evaluate clinical findings and results of treatment of patients with spinal osteoid osteoma who underwent surgery.Overview of LiteratureOsteoid osteoma is a benign tumor with spinal involvement rate of about 10%. It is manifested during adolescence with symptoms such as painful scoliosis. To treat the problem, operation on the patients and excising the nidus are suggested.MethodsThis descriptive study was conducted on 11 patients with spinal osteoid osteoma at our orthopedic educational center. All patients were treated through open surgery and nidus curettage. All samples were pathologically confirmed. Imaging methods (spiral computed tomography-scan) was used in preoperative planning. Scoliosis and other clinical findings were studied.ResultsThe study was conducted on 11 patients comprising 6 females (54.5%) and 5 males (45.5%) with the mean age of 14.6 years. Mean deviation of scoliosis resulting from spinal osteoid osteoma was 22.8 degrees. There was more scoliosis in the involvement of the lumbar vertebra. In comparison with adults, scoliosis was more severe in youths. There was one case of vertebra body involvement with manifestation of painful scoliosis. Due to lack of careful preoperative examination, the surgery was repeated for this case. No sign of recurrence was observed in patients who underwent open surgery and all scoliosis in the follow-up had improved.ConclusionsBased on our findings, surgical excision of spinal ostoeid osteoma was successful and complete recovery was achieved in spinal deformity in the course of follow-up. Scoliosis is often seen during adolescence and lumbar involvement is more severe.

Background: One of the spine deformities is scoliosis, and Cobb angle is generally used to assess it. Objectives: In this study, a computer-aided measurement system (CAMS) was presented as a new repeatable and reproducible approach to assess the Cobb angle in idiopathic scoliosis patients. Methods: Python libraries, including OpenCV and Numpy were used for image processing and design of the software. To assess the repeatability and reproducibility of the CAMS, a series of 98 anterior-posterior radiographs from patients with idiopathic scoliosis were used. Assessments were done by five independent observers. Each radiograph was assessed by each observer three times with a minimum break of two weeks among assessment. The single measure intraclass correlation coefficient (ICC), the mean absolute difference (MAD), and the standard error measurement (SEM) values were used for intra- and inter-observer reliability. Results: The inter-observer analysis indicated that the ICCs ranged from 0.94 - 0.99, and the MAD between manual and CAMS were less than 3°. For intra-observer measurements, the combined SEM between all observers for the manual and CAMS was 1.79° and 1.27°, respectively. An ICC value of 0.97 with 95% confidence interval (CI) was excellent in CAMS for inter-observer reliability. The MAD of CAMS was 2.18 ± 2.01 degrees. Conclusions: The CAMS is an effective and reliable approach for assessing scoliotic curvature in the standing radiographs of thoraco-lumbar. Moreover, CAMS can accelerate clinical visits, and its calculation results are reliable.

Background:Aminoglycosides and mainly gentamicin are the most important antimicrobial agents. Two different methods of administration exist: Single and multiple doses. There has always been a controversy about the less harmful administration method, to minimize adverse effects of gentamicin – deafness and renal insufficiency. In this study, it was aimed to compare two different methods of administration to figure out the least harmful treatment method.Materials and Methods:In a clinical study, eighty patients aged 12–55 years who were admitted with sepsis syndrome were included in the study; they were divided into two groups: The first group received single-dose treatment (5 mg/kg) whereas the second group was treated with multiple doses (1.7 mg/kg three times a day) of gentamicin.Results:The results show that blood urea nitrogen (BUN) and creatinine (CR) levels were decreased in the first group. Both blood urea nitrogen and creatinine and also mean glomerular filtration rate was increased in the same group. In the second group, mean BUN and CR levels were increased while the GFR was decreased in the same group. There was also a gradual increase in GFR in the first group. GFR <80 was decreased from 20% to 5.1% in the first group while increased from 5% to 27.5% in the second group. Results of audiometric studies show 6.1% hearing problem in the first group and 12.8% in the second one.Conclusions:Results of the present study showed that nephrotoxicity and ototoxicity are minimized in single-dose administration compared to multiples doses.

Introduction: There are various methods of training for medical students in different colleges. Fast knowledge transfer and maximum learning are the main goals of education. Due to the limited time and also high volume of content knowledge during residency, using the best methods of training can play an important role in enhancing the skills of residents. In the current study, small group discussion as a teaching method was compared with the traditional method. Methods: In this cohort study, two groups of residents that had finished a 4-year course of orthopedic residency training programs in Tabriz and Urmia universities of medical sciences was being examined. They were divided in two groups. In order to compare the impact of the training on residents, it was compared with the result of the State Board standardized exam. The number of residents passing the written test and the Objective Structural Clinical Examination (OSCE) per year have been identified and compared with the groups under investigation. Results: Fifty-one residents, including 4 women (7.8%) and 47 men (92.2%), were studied for this purpose. Success rate for the small group discussion in the written exam was 59.2% and in the OSCE was 24% (95% CI). On the other hand, the success rates for the group who were trained in the traditional way were 37% and 16.6% in the written exam and OSCE, respectively. In both cases the differences were significant. Conclusion: The small group discussion method is an effective method in residency training in surgical fields that increases medical students' learning abilities compared to traditional methods of education.

Background: The use of telemedicine has received considerable attention in recent decades and it has partaken different applications such as teleradiology, telepathology, remote surgery, and so on. Telemedicine has been an approach with broad publications and a technology adopted by broad categories of healthcare users. The use of new technologies at each stage of teleradiology creates new challenges. Like any system, the lifecycle of the system development from production to maintenance requires actions to take. Methods: Based on the PRISMA checklist, a robust search strategy was developed to identify all available studies meeting the inclusion and exclusion criteria. A literature search was conducted in March 2018 for a week for searching in PubMed/ MEDLINE, Scopus, and Web of Science. We excluded articles published before 2000, non-English articles, all kinds of reviews, conference papers without full texts, notes and news, books, letters to editors, gray literature, authors' opinion, educational materials, and ad hoc implementation in the technical scope. All full-text literature in English concerning the assessment, evaluation, patient outcome, economics, and managerial aspects with a local or wide implementation in the form of original articles and case studies were included in this review. Then, data were imported into an Excel file. Results: The articles were published between January 2000 and October 2018. A full, deep review revealed that most articles were related to the hospital environment. The financial evaluations comprised cost-effectiveness, cost prediction, initial cost reduction, and plummeting transporta-