Background: Despite the high incidence and prevalence of CTS, there is no exclusive data about normal values increment of motor and sensory distal latencies of median nerve at wrist according to age. This research was done in electrodiagnosis lab of Physical Medicine & Rehabilitation ward in Nemazi hospital in Shiraz between 1374-1379. Material and methods: This study was performed on 1200 cases that had no history of paresthesia and numbness in both hands and no history of diabetes mellitus, systemic disease, and electrodiagnosis evidence of no cervical radiculopathy or peripheral neuropathy. Tinel's and phallen 's tests were also negative in all cases. Normal values, increment of motor and sensory distal latencies of both hands median nerves were studied and analyzed in ten age groups from 10-80 years. Results: In this study, the mean normal value for distal motor latency of median nerve was 3.3 ms (2.50-4. 20ms). Increment of this value is mild (about 0.1ms per decade after 5th decade of Age – 50 life) and could be calculated with the following formula: DML (8cm)= (3.30+Age- 50 /75) ±0.0025 age. The mean normal value for distal sensory latency of median nerve was 3.2ms (2.7- 3.70ms). Increment of his value is mild (about 0.1ms per decade after the 51hdecade of life) that could be calculated with the following formula: DSL (14cm) = (3.20 +Age- 50/100) ±0.0025 age. Conclusions: It seems that age has significant influence on distal motor and sensory latencies at wrist. We recommend electrodiagnostic evaluations to be performed according to the age.

Introduction: Candidiasis, as an opportunistic infection, is caused by the Candida species. Although Candida albicans is classified in the body as an endogenic flora, it plays an important role in creating Candida related diseases. Candida vulvovaginitis in pregnant women, diabetes mellitus patients and those using multiple antibiotics and contraceptive drugs demonstrates the high resistance of the organism against conventional medication. On the other hand, recurrent vaginitis disintegrates the long-term process of treatment in majority of the patients. The present research was done with the aim of determining the optimum conditions for susceptibility testing before retreatment of patients.Methods: 10 isolates of Candida albicans obtained from 31 suspected patients suffering from recurrent Candida vaginitis were incubated with ketoconazole at two pH of 7.2 and 5.5 and two temperatures of 35ºC and 27ºC. The Microdilution broth test technique was used. The RPMI 1640 medium within the 96 well microplates with range of 12 tests was used to determine the MIC50 , MIC90 and MFC of the drug.Results: The obtained MIC50, MIC90 and MFC for ketoconazole at these conditions (T=35ºC and pH=7.2) were 0.25 to 1 μg/ml, 1 to 4 μg/ml and 64 to ≥ 512 μg/ml respectively, while these values at 27ºC, pH 5.5 were 1 to 8 μg/ml, 8 to 64 μg/ml and 512 to ≥ 512 μg/ml, at 35ºC and pH 5.5 the values were 1 to 8 μg/ml, 4 to 32 μg/ml, 256 to ≥ 512 μg/ml, while at 27ºC and pH 7.2 the values were 1 to 2 μg/ml, 8 to 32 μg/ml, 128 to ≥ 512 mg/ml, respectively.Conclusion: The obtained results confirmed that conditions with temperature of 35ºC and pH 7.2 resulted in better treatment outcomes than other conditions.

Background: Nerve conduction studies (NCS) are performed worldwide; however, we do not have standard values for our society. Motor nerve distal latency is a common electrodiagnostic study. The present study has performed on females aged 20-30 years to draw standard values for their median motor nerve distal latency.Materials and methods: Normal values of median motor nerve distal latency of both hands of 400 healthy females were determined. All candidates were right-handed. Standard techniques of electrodiagnostic studies were used and values of hands were analyzed by means of t-test.Results: The mean distal latency of median nerve of right and left hands were 3.36±0.23 and 3.29±0.24 msec, respectively. This difference did not reach the statistical significance.Conclusion: For some neurologic disorders such as carpal tunnel syndrome, the normal values of electrodiagnostic parameters are required. Our findings have showed the distal latency of median nerve in females who are at increased risk of carpal tunnel syndrome.

Introduction & Objective: Traumatic nerve damage is quiet a frequent event in the upper extremity. Microscopic reconstructive nerve repair is usually used to restore the continuity of the injured nerve. Restoration of the sensory ability of the nerve is of great importance in normalization of the hand function. Since we could not find an individual study comparing the sensory out come between median and ulnar repair, we designed this study to better understand the results of sensational out comes between these two nerves. Materials & Methods: During 3 Months period, 65 patients who had median, ulnar or both nerves injuries at the wrist level, and who had been operated upon in Hazrat Fatemeh Hospital were assessed with regard sensibility improvement were compared with each other. The criterias for inclusion were negative history of medical illness and adequate follow-up (at last 9 months) after surgery. The sensory evaluation was performed by monofilament test, static and moving two point discrimination, and the results were compared. Results: Of the 65 patients included in this study, the mean age was 27.2 years. The cause of trauma was predominantly laceration with glass. Ulnar nerve was the most commonly injured nerve (46.2%) and sole median nerve injury was observed in 36.9% of patients. In 16.9% of the patients both ulnar and median nerve were damaged. The mean time for patient evaluation was 24.5 months after surgery. Middle finger was the mostly impaired one in the test after median nerve injuries and the little finger was the mostly impaired one in the tests after ulnar injuries. The results show that the sensory return is better and higher in median nerve repairs in comparison to ulnar nerve repairs at the wrist level.Conclusions: In upper limb nerve injuries, radial nerve has the best prognosis and the ulnar nerve has the worst one. In our study, however it is shown that in the same condition of age, cause of trauma, time elapsed before surgery and surgical method, sensory return in median nerve is better that ulnar nerve at wrist level. This can be due to less complexity of the median nerve in terms of anatomy and topography, smaller motor component and easier exposure during surgery. Also, the best area for evaluation of sensory impairment and return after median nerve injury is the volar side of middle finger.

Due to considerable differences in distal latency and nerve conduction velocity in different races, and the necessity of setting a standard for each geographical area, we intended to determine the normal amounts of sensory and motor latencies and nerve conduction velocity of the median nerve in Iran is most common involvement among peripheral nerves. 1200 subjects, both male and female, were randomly selected from among healthy people of the community including all age groups. Obtained values for both sexes were separately examined considering the values for left and right hands. The results of data analysis indicated no significant differences between the two sexes or the right and left hands. Therefore, the whole population were assessed for the amounts of five parameters: sensory and motor distal latencies from wrist and palm, sensory nerve condition velocity, mixed sensory and motor potential of the median nerve. We obtained the mean, standard deviation, minimum and maximum amounts of the Iranian community, which can be a reference in the differentiation of abnormal cases from normal ones.

Background and Objectives: Carpal tunnel syndrome is the most common entrapment neuropathy, which after clinical examination is the best method for it’s diagnosis. The aim of this study is the comparison of the validity of some median sensory nerve conduction velocity measurement (MSNCV) techniques in diagnosis of carpal tunnel syndrome (CTS).Materials and Methods: Eighty five referred hands to electrodiagnostic laboratory with suspected CTS were recruited for this study. Subjects with no symptom or signs of median neuropathy were recruited as control group. Patients or control groups with positive history of cervical radiculopathy, peripheral neuropathy, or other disorders affecting neuromuscular function were excluded. In both CTS and control groups, electrodiagnostic studies including one-segment and two-segment techniques, for measurement MSNCV in wrist segment, were performed. In one segment study, transcarpal palm-to-wrist median mixed NCV was measured.In two segment studies antidromic transcarpal wrist-to-palm MSNCV (W-PMSNCV) and distoproximal ratio (D/P) were calculated.Results: ROC curves were constructed for one segment and two segment studies, from the patients and controls data.The W-P MSNCV £ 50.45 m/s, corresponding to an optimal cutoff point on ROC curves discriminated CTS from controls with sensitivity of 97.6% and specificity of 96.5%.D/P ratio at optimal cutoff point of ³1, discriminated CTS from controls with sensitivity of 97.6% and specificity of 83.5% the likelihood ratio (assessing the discrimination power of a test ) were 27.86, 14.08, 5.92 in W-P MSNCV, D/P ratio and mixed NCV, respectively.Conclusion: W-P MSNCV is more sensitive than D/P ratio and mixed NCV in diagnosis of carpal tunnel syndrome.

Studying of the anterior interosseous / median Latency rati of Al /Mlateucy ratio) is anew-diagnostic technique for evaluating anterior interosseous nerve damages. Anterior interosseous nerve is a purely - motor branch of the median nerve ,and in clinical examination, it may be difficult to differentiate between anterior interosseous nerue in jury and rupture of two first, second and third finger flexor tendons. Also, this technique may be helpful as a screen test for median berue injury at distal parts (such as corpal Tunnel Syndrome or (TS). In this study, one hundred hands of 50 (22 female and 28 Years) were studied. Al/M latency ratio. Was calculated to be 0.5 t 0.04 (mean ± SD). The fore, the obtwned range for two standard deviations was 0.42 to 0.58.

Introduction & Objective: Nerve conduction study is the most sensitive test for diagnosis of carpal tunnel syndrome (CTS). This test is normal in some patients with mild CTS. Median nerve conduction study evaluation after a provocative test (e.g. wrist flexion) maybe helpful for diagnosis of mild CTS. This study aimed to determine the effect of wrist flexion on median nerve conduction in patients suspected to CTS and in healthy subjects. Materials & Methods: In this case-controlled study, 20 patients (20 hands) with clinical signs of CTS and normal routine electro diagnosis test results and 20 healthy subjects were investigated. Measured parameters included median nerve distal sensory latency (DSL), nerve conduction velocity (NCV), compound nerve action potential (CNAP), distal motor latency (DML) and compound muscle action potential amplitude (CMAP AMP). The above noted parameters were measured before and after 5 minutes of full wrist flexion. Data were collected by filling out a questionnaire and were analyzed using Paired T-test.Results: Distal Sensory Latency increment and NCV decrement after 5 minutes wrist flexion in the patients group were statistically significant (p<0.05). The same parameters did not show a significant incremental or decremental change in the control group.Conclusion: Median nerve DSL and NCV measurement after 5 minutes wrist flexion may be helpful in determining more sensitive parameters in the electro diagnosis of CTS.