Journal of Birjand University of Medical Sciences
Year:2006 | Volume:13 | Issue:1|Papers Count:14

Background and Aim: Among late complications in mustard gas or sulfur mustard (SM) casualties, respiratory problems, especially chronic bronchitis and pulmonary fibrosis are the greatest causes of long-term disability. Cyclosporine has anti-inflammatory effects and is used in other pulmonary fibroses due to other factors. Thus, with respect to the role of oxidative stress in the pathogenesis of chronic bronchitis and pulmonary fibrosis, the therapeutic effects of Cyclosporine on delayed complications of mustard gas and the role of oxidative stress in the procedure were studied.Materials and Methods: In this experimental study, a group of six male mice received cyclosporine after five months of inhaling mustard gas. After killing the mice and obtaining tissue samples, biochemical analyses of hydroxyproline of lung, H2O2, vitamin C of serum, and also alveolar space percentage and inflammatory cell infiltration, the comparison between positive and negative control and also between case and positive control was performed.Results: Results indicated a significant decrease in alveolar space percent, lymphocyte infiltration, H2O2, and vitamin C in the positive control group. Cyclosporine administration decreased lung hydroxyproline and lymphocyte infiltration; and normalized H2O2 and vitamin C. Conclusion: Decrease of pulmonary alveolar space of the mice brings up two hypotheses. First: collagen precipitation and incidence of pulmonary fibrosis. Second: inflammatory cell infiltration and incidence of chronic inflammation that is corresponding to SM induced lung injury in chemical casualties. Decrease of H2O2 -that can be due to decrease of superoxide dismutase- and vitamin C, demonstrates decrease of antioxidant defense in the serum of the mice. Cyclosporine administration effects by normalizing these two agents-; i.e decreasing oxidative stress- induces a decrease in lung hydroxyproline (index of fibrosis) and lymphocyte infiltration (index of chronic tissue inflammation).

Background and Aim: Breast cancer is the most common type of cancer among women in most countries of the world. One of the most important diagnostic measures for early diagnosis is breast self-examination (B.S.E.). The present study aimed at determining the effect of health training on knowledge, attitude, and practice of female teachers in Yazd intermediate schools on breast cancer.Materials and Methods: In this quasi-experimental study , pre/post health education data gathering concerning 140 female teachers in Yazd intermediate schools was performed through questionnaires. Data analysis was carried out using SPSS statistical software and McNemar statistical test at significant level P≤0.05.Results: This study showed that B.S.E training was effective on knowledge, attitude, and practice of the subjects. In all the features, the difference was significant at the level P<0.001. No statistically significant relationship was observed between demographical factors (age, education, and work experience) and health training effect on the subjects' knowledge, attitude, and practice. It was found that before training 62.86% of the women did not perform B.S.E due to lack of familiarity with correct methods; but, after training this decreased to 33.57% (P=0.000).Conclusion: Generally speaking, it is important to note that the simplest, cheapest, and the most important method in early diagnosis of breast cancer is breast examination of patients by themselves and, also, by physicians. Paying attention to this matter is very helpful in screening and early diagnosis of breast cancer.

Background and Aim: Helicobacter (H.) pylori is responsible for one of the most common bacterial infections in the world. Probiotics such as lactobacilli prevent the multiplication of a wide range of human and animal pathogens. One of the useful potentials of probiotics is their antagonist effect on harmful microorganisms so that they would be effective in prevention and treatment of H. pylori. The present study was aimed to evaluate the inhibitory role of lactobacilli in foodstuff on H. pylori.Materials and Methods: In this study which carried out in Ghaem medical center of Mashhad University of Medical Sciences in 2003, after culturing 114 enteral biopsies, in 20 samples, H. pylori were obtained. Also, lactobacilli present in 12 kinds of dairy products were discriminated and their supernatants were collected. After H. pylori was cultured in Colombia-agar culture medium, the inhibitory effect of the supernatants on the bacteria was studied using Well Diffusion Agar Method. The obtained data was analysed by one-sided variance analysis at the significant level P≤0.05 through.Results: Mean diameter of lack of multiplication peripheral circle was 7.6±3.1 mm in all situations (P<0.05).Most of the H. pylori samples were inhibited by the supernatants. One-sided variance analysis was significant with respect to 12 dairy products. Mean diameter of lack of multiplication peripheral circle of unpasteurized dairy products (8.2±2.9) was more than pasteurized ones (7.5±3.4). Besides, mean diameter of lack of multiplication peripheral circle of H. Pylori against lactobacilli obtained from local dairy products (8.9±1.8) was more than those from outside dairy products (7.2±3.6).Conclusion: On the basis of the present study, everyday consumption of dairy products having probiotics; useful microorganisms particularly lactobacilli is effective against H. Pylori. Therefore, providing dairy products with useful lactobacilli is recommended.

Materials and Methods: The present study is a quasi- experimental one in which we had case and control subjects. Means of gathering data were questionnaires, recording files of overt behavior or check-lists, and screening to verify the existence of nymphs and adult pediculi. After determining the extent of infection to Pediculus Capitis among female elementary students in Zabol and holding pre-test on the basis of the obtained data, a hygiene program together with educational content was planned. Then, 175 fifth grade students infected with Pediculus Capitis were randomly divided into case – control groups. In the case group (87 students and their mothers) educational intervention was done. After 1.5 months post-test was carried out. The obtained data was analysed through SPSS statistical soft-ware by statistical paired t-test, and Chi-Square.Results: Among 1066 female elementary students under study, 313 cases (29.4%) were infected with Pediculus Capitis. After educational intervention the extent of infection in the case decreased to 17.6% but it did not change in the control. Besides, the statistical paired-t-test revealed a significant difference regarding the effect of hygiene educational program on knowledge, attitude, and hygienic behavior of the students and their mothers in the case group (P<0.001) but in the control group this difference was not significant. The statistical X2 test showed that there was a significant relationship between infection to Pediculus Capitis and variables such as parents' level of education, school level, number of washing during the week, having a bath at home, monthly income, family population, and using shared articles- e.g veil, scarf, comb, and towel- (P<0.02, X2= 84.8).Conclusion: The obtained results showed that the hygiene educational program had a positive effect on the decrease of infection to Pediculus Capitis among the studied subjects.

Background and Aim: Cervical smears contain endocervical cells which are accepted as representatives for cytological diagnosis. The purpose of this study was to compare the adequacy of cervical cytology sampling and endocervical cells together; using two sampling instruments, namely Cervix Brush and Ayres Spatula. Materials and Method: In a randomized controlled clinical trial, Pap smears of 184 women referring to family planning and health center were obtained by means of Ayres Spatula (95 cases), and Cervix Brush (89 cases). The cases were randomly chosen from the total population for Cervix Brush or Ayres Spatula cytology sampling. The pathologist, however, was unaware of the kind of device used for each smear. The pathologist interpreted Pap smear quality, endocervical and transduction zone count, bleeding cell count; and squamous cell count. Besides, cell changes were measured according to Betsa system. Finally, the obtained data was analysed through Fisher, Chi-square, and T-test at the significant level P≤0.05.Results: The quality of cells present in the smears was alike in both groups. In Cervix Brush group endocervical cells were found in 91% of the cases, and metaplastic cells in 19.1% but 78.9% and 13.7% of spatula samples were endocervical and metaplastic respectively. Thus, the difference between the two groups was significant (P<0.02). Less patients (8.5%) in cervix brush and more (22.2%) in spatula group reported discomfort. There was a significant difference between the two methods (cervix brush and spatula ayres) regarding ease of application and extent of pain (P=0.01).Conclusion: On the basis of the findings of the study Cervix Brush is superior to Ayres Spatula in obtaining endocervical smears.

Background and Aim: Many studies have shown a positive relationship between inflammatory factors and coronary artery disease (CAD). It has been proved that the total white blood cell count is an independent risk factor for CAD. A few studies have revealed the relationship between differential white blood cell count and CAD. The aim of this study was to investigate the correlations between coronary atherosclerosis and either total or differential leukocyte count.Materials and Methods: This cross-sectional study included 307 patients who were referred to coronary angiography ward of Imam Khomeini hospital in Tehran. Blood samples of all were taken and sent to laboratory to determine total and differential leukocyte count, fasting blood sugar, and cholesterol level. Then, coronary angiography of the subjects was done. After determining the degree of coronary stenosis it was matched with Gensini scoring system. For statistical analysis of continuous variables relationship, Pearson's correlation coefficient, and for determining the relationship between ordinal variables and continuous quantitative variables Spearman's correlation coefficient were applied. α≤0.05 was considered as the significant level.Results: The patients included 73.8% males and 26.2% females; and the mean age was 55.4 years. The average of total white blood cell count was 7400/mm3 in males and 7200/mm³ in females. The mean Gensini score in males was 41.6 and in females 25.6. There were significant positive correlations between coronary atherosclerosis and either total leukocyte count (P<0.020) or polymorphonuclear (PMN) count (P<0.04) after ignoring factors such as age, sex, body mass index, cigarette smoking, cholesterol, and hypertension.Conclusion: The significant positive correlations between coronary atherosclerosis and both leukocyte and PMN count can emphasize the role of inflammatory process in CAD.

Background and Aim: Management and control of Hypertension (HTN) is one of the main problems of hypertensive patients, which is caused by poor compliance of treatment in some patients. Since the knowledge level of patients may play an important role in management and compliance, this study was performed in Birjand Valiyy-e-Asr hospital to assess the knowledge of hypertensive patients about their disease.Materials and Methods: In this descriptive analytic study, 385 patients were selected from emergency, heart, CCU wards, and specialized clinics of Vali-e-Asr hospital in Birjand. Demographic data and knowledge of patients about the level of their BP (systolic and diastolic), signs and complications of hypertension were obtained through questionnaires. Validity and reliability of the questionnaires were approved by four cardiologists. The results were analysed by descriptive tables and Chi-Square test at the significant level P≤0.05Results: The findings showed that 28.4% of patients aged between 51-60 years (58±13.14). 77.1% and 44.9% of patients gave correct answers to questions regarding the level of systolic and diastolic pressure, respectively. 73% were aware of the range of their blood pressure; 79.9% and 59% were not aware that HTN is commonly an asymptomatic condition and it can cause renal failure respectively. Level of knowledge of 32.5% and 23.4% patients were low and moderate, respectively. There was a significant statistical relationship between the level of knowledge and gender, source of information (P<0.05) and also education, habitation, and occupation (P<0.001).Conclusion: Regarding the findings of this study, it is suggested that for the prevention of mortality increase and irremediable complications due to underestimating HTN, necessary training is required for susceptible hypertensive patients.

Background and Aim: Liposarcoma is one of the most common soft tissue sarcomas in adults, ranging in incidence from 9.8% to 16%, which is recognized through the presence of lipoblast cells. It reaches its peak incidence during the fifth and seventh decades of life in males. It develops predominantly in the lower extremity and retroperitoneum; also, there are some other uncommon localizations as well. Classification of liposarcoma is based on five histologic categories that generally reflect the degree of differentiation including well- differentiated, myxoid, round cell, differentiated, and pleomorphic liposarcoma. The present study was aimed at evaluating parameters such as age, sex, localization, and approximate incidence of liposarcoma among patients in three University Medical Centers in Mashhad.Materials and Methods: In this retrospective study of 10 years (1992-2002), all specimens sent to pathology laboratories, Imam Reza specialized clinic, Imam Reza and Ghaem hospitals; plus all soft tissue sarcoma samples- which diagnosed as liposarcoma were reviewed statistically.Results: Among 115 (0.12% of all specimens of soft tissue sarcoma) 26 (25%) items were liposarcoma (16 males, 10 females). Patients' age ranged between 16 and 77 years; mostly between 40 and 49. The most commonly site was lower extremity; and uncommon localizations were mediastinum, posterior of tongue, nasopharynx, labia majora, and esophagus. Histologically, the most common subtype and predominant pattern of liposarcoma was myxoid.Conclusion: On the basis of this study, Liposarcoma is a relatively common neoplasm in our region. Regarding the possibility of liposarcoma incidence in any site of the body, it is recommended to think of liposarcoma in your differential diagnoses when you observe a mass having cells similar to lipoblasts. Besides, since histological subtype is the most important prognostic factor, it is better to classify liposarcoma as far as possible. Because some samples represent a combination of two or three kinds (mixed type liposarcoma), multiple sampling from different sites of the tumor is recommended.

Background and Aim: Nurses are exposed to different types of stresses during their work. As a stressor, "burnout" is the decrease of personal adjustment with chronic stress leading to physical and emotional discomfort, negative attitude towards the profession while on duty. According to Maslach's theory organizational factors, interpersonal relationships, and intra- personal factors are the major causes of burnout. This condition brings about a lot of complications in one's family, personal and social life, and organization. This survey was designed to evaluate burnout rate among nursing staff in teaching hospitals in Birjand.Materials and methods: This descriptive- cross sectional study was performed on all nursing staff of teaching hospitals in Birjand, who were selected through census sampling .Data gathering means were a multisegmental questionnaire including demographic characteristics, and Maslach burnout inventory (MBI); to evaluate emotional exhaustion, depersonalization, and lack of personal accomplishment. In order to analyze the data, statistical tests including X2, Pearson's correlation coefficient, and independent t-test at the significant level P≤0.05 were used.Results: More than third (35.5%) of the individuals, reported weak emotional exhaustion, 54.2% intense depersonalization, and 37.5% intense lack of personal accomplishment. The nurses' professional burnout rate between male and female in the domain of emotional exhaustion (P=0.02) and in depersonalization (P=0.034) were significant. Lack of personal accomplishment mean score was also varied between married and unmarried subjects (P=0.028). There was also a significant difference in the frequency of depersonalization in different working shifts (P=0.029).Conclusion: Job burnout is a common phenomenon among nurses. It is related to a number of factors such as working condition, work experience, high workload, stresses, job satisfaction, gender and hardships of working condition. Therefore it is suggested that these factors be surveyed more precisely and find ways to reduce job burnout.

Long QT syndrome, which is defined by corrected QT interval longer than 0.45 seconds in men and 0.47 sec in women , could be divided into idiopathic (congenital ) and acquired forms. The idiopathic form is a familial disorder that can be associated with sensorineural deafness (Jervell and Lange- Neelson syndrome), which is transmitted with an autosomal recessive pattern. Although this syndrome could be simply diagnosed by observing QT interval in ECG, specially when history of syncope and seizure –like attacks and frequent convulsions are present, most of the time electrocardiography is interpreted as normal and the patient undergoes neurological treatments. The case under study is the first one diagnosed in the cardiology department of Imam Reza hospital as JLN Syndrome in recent years. Patient was a 12 year old girl with sensory neural deafness and recurrent syncope. For many years, the patient had been treated with antiepileptic drugs without feeling any better and with frequent syncopal episodes. After referring the patient to out- patient clinic of cardiology in Imam Reza hospital, QT interval of 520 msec was noticed, and betablocker, propranolol, with maximal tolerated dose was started. Because of high risk criteria in the patient, internal cardiac defibrilator was indicated and the patient was referred to Tehran Rajaee hospital for further management. Early diagnosis and treatment of congenital long- QT syndrome needs a highly suspicious of clinician and enough attention to ECG in a person with a history of syncopal episodes so that the physician would be able to help this group of patients, who are mostly children and teenagers, and rescue them from sudden cardiac death and complications of neurological medication.