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Articles by Madjid Shakiba
Total Records ( 3 ) for Madjid Shakiba
  Mojtaba Miri , Hossein Ghanaati , Kavous Firouznia , Hasan Hashemi , Hamid Ara , Amir Hossein Jalali and Madjid Shakiba
  Our purpose in this study was to determine the results of CT fluoroscopy guided Percutaneous Vertebroplasty (PVP) in pain reduction from vertebral compression fractures and its complications. During a 3 year period, 59 patients (39 female, 20 male) with persistent low back pain and back pain underwent percutaneous injection of cement into the vertebrae under fluoroscopic guidance. Among our patients, 30 cases (50.8%) had thoracic pathology, 26 (44.1%) lumbar pathology and 3 (5.1%) both thoracic and lumbar involvement. Severity of low back pain and back pain was assessed by using visual analog scale (VAS) before and after one and 6 months intervals thereafter. The mean age of our cases was 63.5±11.3 years (range: 25-97). Thirty two procedures (54.3%) were performed for osteoporotic compression fracture, 13 (22%) for hemangioma, 9 (15.3%) for traumatic fracture and 5 (8.5%) for metastasis. Mean volume of cement injected was 5.3±1.6 mL (3-10 mL) in osteoporotic vertebrae, 4.7±1.4 mL (2-7 mL) in hemangiomas, 6.2±2.4 mL (3-10 mL) in traumatic fractures and 4.4±0.9 mL (4-6 mL) in vertebrae affected by metastasis (p = 0.17). Reduction in pain immediately after the procedure was seen in 71.9% (23 from 32 cases) for osteoporosis 77.8% (14 from 18 cases) for tumoral lesions and 55.6% (5 from 9 cases) for traumatic fractures (p = 0.48). Mean pain reduction after 6 months was significantly higher than mean reduction after one month (55.9±24.9% versus 45.7±24.8%; p<0.0001). CT fluoroscopy guided PVP is a safe and efficacious procedure resulting in pain reduction among patients with vertebral compression fractures.
  Hassan Hashemi , Mehrzad Mehdizadeh and Madjid Shakiba
  To evaluate the diagnostic efficacy anatomical measurements of distal esophagus by ultrasonography in diagnosis of gastroesophageal reflux in children. All children suspicious to Gastroesophageal Reflux Disease (GERD) according to clinical history and physical examination who were indicated for further studiy with endoscopy and esophageal biopsy (as the gold standard) and without known history or current ulcer were considered to enter the study. An ultrasonographic study (3.5 MHz probe (Aloka1700, Japan)) did for all patients and 6 anatomical parameters (including the esophageal diameter, esophageal wall thickness, esophageal mucosal thickness, hiatal diameter, subdiaphragmatic esophageal length and gastric wall thickness) were measured in the ultrasound. Then the patients underwent an upper gastrointestinal endoscopy and esophageal biopsies were taken. The histopathologic criteria for GERD were erythema, ulcer, barret esophagus and leukocyte infiltration. According to the sonographic and histopathologic results, for all measurements, we plotted the receiving operative characteristics (ROC) curve to assess the area under the curve (AUC) as an indicator for diagnostic efficacy. For the best variables, we selected cut off points and then calculated the diagnostic indices (including sensitivity, specificity, positive and negative redictive values). Totally 103 (57 patients (mean age of 4.7±3.5 years) and 46 controls (mean age of 5.2±3.9 years)) entered the study. The mean esophageal diameter was 12±2.7 mm (6-17) in patients and 10.1±2.4 in controls; the mean sub diaphragmatic esophageal length was 15.9±6.3 mm in patients and 22.2±9.9 in controls (both p<0.0001). Except for Gastric wall thickness, other sonographic measures were statistically greater in patients (all Ps = 0.016) Computing AUC of 6 variables revealed all of them are equal or >0.63 (all p<0.025) and the highest value was for esophageal diameter and subdiaphragmatic esophageal length (both 0.71). Dividing esophageal diameter by subdiaphragmatic esophageal length yielded a new variable that its AUC was 0.76. Considering a cut-off point equal to 7 mm for esophageal diameter yielded a sensitivity of 0.96 while for cut-off point of 14.5 yielded a specificity of one. Considering a cut-off point equal to 10 mm for subdiaphragmatic esophageal length yielded a specificity of 0.93 while for cut-off point of 0.3 yielded a sensitivity of 0.98. Considering a cut-off point equal to 7 mm for esophageal diameter divided by subdiaphragmatic esophageal length yielded a sensitivity of 1, while for cut-off point of 1.5 yielded a specificity of 0.96.
  Nasrin Ahmadinejad , Hossein Ghanaati , Kavous Firouznia , Aidin Khaghani , Alborz Salavati and Madjid Shakiba
  Low back pain is one of the most common causes of disability for individuals of working age in developed countries. Along with vast traumatic, infectious, tumors and infiltrative causes, degenerative disk transformations have been accepted as major etiologic factors. Lumbosacral Transitional Vertebra (LSTV) is one of the congenital factors that might cause disk degeneration. The purpose of this research is to assess the type and frequency of pathological findings in adjacent vertebra in a group of Iranian patients with LSTV. Patients and methods: In a cross sectional study between April 2006 and September 2007, we evaluated all patients who indicated to do lumbosacral MRI because of low back pain. All patients had Lumbar X-ray. Among them, considering plain AP lumbar spine x-ray for all patients, 91 patients were determined to have LSTV (Castelvi grade 2-4) that were enrolled in the study. Among 91 patients with LSTV, 58 (63.7%) were females (p = 0.01). The LSTV type IIIb (28.6%) was the most common type. The frequency of anterior osteophyt reached to its peak in level L4-L5 (51.6%) (p<0.0001). Such a trend was seen in posterior osteophyt. The frequency of the facet hypertrophy in the level L4-L5 was 46.2% and in the level L5-S1 was 31.9% (p = 0.04). Moreover, the frequency of the flavum ligament hypertrophy in these levels were 38.5 and19.8%, respectively (p<0.0001). The mean severities of disk degeneration in levels L4-L5 and L5-S1 were 2.8±1.3 and 2.5±1.3, respectively (p = 0.022). The frequency of disk herniation in the level L4-L5 was 67% and in the level L5-S1 was 34.1% (p<0.0001). In addition, the mean severities of disk herniation in these levels are 1.3±1.0 and 0.6±1.0, respectively (p<0.0001). Finally, the mean value of the disk height in the level L4-L5 was 9.6±2.0 mm and in the level L5-S1 was 7.4±2.6 mm (p<0.0001). It seems that pathologies have been increased in the level above the LSTV in compare to the level below it.
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