Researcher Bulletin of Medical Sciences
Year:2007 | Volume:12 | Issue:3 (57)|Papers Count:16

Background: Several studies have indicated that compared to the men without baldness, bald ones have higher risk for development of coronary artery diseases(CAD), and androgen alopecia (AGA) is some how related to CAD. However, none of the previous reports has considered the coronary angiography as the gold standard for diagnosis of CAD. This study was performed to evaluate the validity of such conclusions from the dermatological and cardiological point of View.Materials and Methods: This Case-Control study was carried out on 400 men, who underwent angiography procedures for diagnosis of CAD. Sampled subjects were matched through their gender and age. Case group consisted of 200 male subjects who had positive results in their angiography and another 200 male subjects whom were found to have no pathological finding through their angiography were considered as control group. Subjects in both group were matched together as well as they were blindly assessed for scaling their baldness and in following, their data were analyzed by Chi-square test and their Odds ratio was calculated, as well.Results: Androgenetic alopecia was found in 137 (68.5 %) of patients in case group, whereas only 88 (44%) patients in control group had AGA. There was a statistically significant correlation between male's AGA and CAD (P=0.001). (95% CI: 1.8-4.2). Furthermore, patients with CAD were 2.8 times more than subjects in control group at risk of development of AGA. Conclusion: According to our findings, it seems that patients who have stage III of Vertex type of AGA (or above), have greater risk for developing CAD than patients without AGA.

Background: To understand the empowerment process and to raise the organization capacity to make the empowerment atmosphere and to study the empowerment components, consequently, the managers and employees views in these fields are of considerable necessity. The visions and assumptions of managers are too determinant to make decisions and manage personnel and organization. Also, employees' visions are effective in their empowerment acts in cooperation, participation and their job satisfaction. This study is performed to investigte the visions of managers and employees of Shaheed Beheshti Medical University, in the rate of the employees possessing of the components of the empowerment between the years 1384and 1385. Materials and Methods: This study was carried out by a descriptive-survey method on 377 managers and employees of Shaheed Beheshti Medical University and its affiliated colleges, whom were in formal employment or contract situation (192 managers and 285 employees). Random sample method was used and was chosen equal numbers of samples related collages and units. Data compilation method consisted of a questionnaire including 35 close-ended questions and demographic characteristics.Results: From the managers (P<0.0019) and employees (P<0.0001) point of view, the rate of the employees possession of the empowerments was not acceptable and managers' views differed from those of employees in this category (P<0.0001). There was a significant difference between women and men visions (P<0.001) and also a significant correlation between the age of managers and employees (P<0.023). Although there was no significant statistical correlation between the background of managers and employees, the difference between the vision of managers and employees of different educational grades was significant (P<0.001) as well as their difference between view points of managers and employees with different academic field of study (P<0.001).Conclusion: The rate of possession of the empowerments amongst managers and employees of Shaheed Beheshti University, was not in an appropriate level. It suggests that the managers of university pay more attention to the employees' potentials for deputing responsibilities to them and attempt many to make an empowerment atmosphere with their schematization to achieve the appropriate level.

Background: There is no specific center for poison control and surveillance in our country to gather information and analyze data. The Loghman Hospital is the only tertiary teaching hospital for poisoned patient in Tehran with more than 65 years of experience which serves from the resident population of capital city, so that most poisoned patients refer to this center. The aim of this study was to investigate the epidemiological feature of hospital-referred poisonings in Loghman hospital as a representative of capital city according to International Classification of Disease (ICD10).Materials and Methods: All adults and adolescents more than 12 years old admitted to the Emergency toxicology clinic of the Loghman hospital, from 21 March 2005 to 20 March 2006, were included in this study. We analyzed the clinical charts for etiological and demographical characteristics of the acutely poisoned patients whom were hospitalized. Variables including group of poisons, age, sex, history of mental illness and addiction, history of drug self poisoning and prognosis, were compiled and analyzed.Results: Among 28,002 patients admitted to the Emergency toxicology clinic, there was 12,167(43.45%) poisoned cases (5,578 females and 6,545 males and 51 unknown). Intentional poisoning was more common (83.6%) than accidental exposures (16.4%) including drug abuses. Pharmaceutical drugs, especially antidepressants and sedative hypnotics were the major causes of intoxication which codified as T42 (21.6%) and T43 (15.4%), respectively, followed by T40 (11.8%) that mainly consisted of the opiates. The overall number of poisoned patients whom were hospitalized was a bit higher in spring and summer (51.5%). Three hundred and four patients were died due to acute poisoning or its complications. The majority of them was due to narcotics' overdosage (33.22%), followed by pesticides (12.17%) (mostly aluminum phosphide), psychotropic drugs (8.55%) and alcohols (8.55%) (mostly methanol). Most of the deceased patients were male (73.35%) and 45.4% were below 40 years old.Conclusion: Although our rate of suicide is lower than western countries, the trend of deliberate self poisoning is more than population growth rate and because of substance abuse, the sex distribution of poisoning has been dramatically changed. It seems that national policy for controlling substance abuse is not efficient enough and needs urgent intervention, especially for high risk groups. To our knowledge, it seems that this unique center is the busiest clinical toxicology Department of the world.

Background: Considering the prevalence of dysmenorrhea and its importance for women as well as social qualities and public tendency toward alternative complementary and herbal drugs, this study was carried out to determine the effect of Menastil on primary dysmenorrhea on students residing in Dormitories' universities of Saveh 2005.Materials and Methods: This placebo-controlled double-blind clinical trial was performed on 72 single students between 18 and 26 years old with primary dysmenorrhea. Data were collected through a questionnaire which included demographic factors, exercise, stress factors, use of medicines, and the McGill pain ruler for determining of pain severity. Subjects were classified into two groups of moderate (4£ Score£7) and sever (8£Score£10), base on their pain severity. Subjects with scores of less than 4 were excluded from this study. All Subjects randomly allocated into two groups (1) the experimental group who received the vials of Menastil and (2) the placebo group. Two drops of Menastil (calendula+mint) was used topically during the menstruation in the form of an abdominal massage for two months. The placebo group received the same mode of treatment with the vials contained baby oil and mint. The menstrual cramp levels were assessed, using a visual analogue scale (McGill Ruler) and severity of dysmenorrheal was measured by a verbal multidimensional scoring system. Data were analyzed applying Freedman and Mann-Whitney statistical tests.Results: Demographic characteristics (age, height, weight & menstrual status) were similar between two groups. The score of dysmenorrhaea reduced in both groups. The results showed that compared to placebo, Menastil decreased more the severity of dysmenorrhea so that the difference between two groups was significant (P<0.0001). Also, the consumption of pain relief agents and the amount of menstrual bleeding decreased by Menastil therapy. Moreover, there was no side effect with this mode ot treatment.Conclusion: The consumption of menastil decreases primary dysmenorrhea. The investigation of effects of long term consumption of menastil (6 months) is recommended.

Background: Few studies have examined the implication of major dietary patterns on plasma level of markers of inflammation. This study was conducted to evaluate the association of major dietary patterns with markers of systemic inflammation among Iranian women.Materials and methods: In this cross-sectional study on 486 healthy women aged between 40 and 60, we assessed usual dietary intakes by means of a food-frequency questionnaire. Dietary patterns were identified by factor analysis. Anthropometric measurements were performed and fasting blood samples were taken for measuring inflammatory markers.Results: The healthy pattern (high in fruits, vegetables, tomato and etc.) was inversely related to plasma concentrations of C-reactive protein (CRP) (β=-0.09, P<0.001), E-selectin (β=-0.07, P<0.05) and soluble vascular cell adhesion molecule-l (sVCAM-l) (β=-0.08, P<0.001). After controlling the potential confounders (further adjustment for BMI and waist circumference), the associations still remained significant for CRP (β =-0.05, P<0.05) and sVCAM-l (β =-0.04, P<0.05). In contrast, the western pattern (high in refined-grains, red meat, butter and etc) was positively related to CRP (β =0.08, P<0.001), serum amyloid A (SAA) (β =0.11, P<0.05), IL-6 (8=0.09, P<0.001), soluble intercellular adhesion molecule-l (sICAM-I) (β =0.05, P<0.05) and sVCAM-l levels (β =0.07, P<0.05). however, after additional control for BMI and waist circumference, the associations remained significant just for SAA (β =0.06, P<0.05) and interleukin-6 (IL-6) (β =0.07, P<0.001).The traditional dietary pattern (high in refined grains, potato, tea, whole-grains and so on) was positively associated with plasma levels of IL-6 (β =0.04, P<0.05) when we controlled for confounders including BMI and waist circumference. Conclusion: Our findings suggest an independent association between major dietary patterns and plasma concentrations of markers of inflammation. Indeed, this issue provides further support of the concept that effects of nutritional pattern on chronic diseases are being exerted via the inflammatory biomarkers.

Background: Chronic pruritus is one of the major complaints in chemically-injured patients. It may cause many psychological problems and consequently, decrease the patient's quality of life. The aim of this study is to compare the safety and efficacy of Doxepin and Hydroxyzine in treatment of chronic pruritus due to Sulfur Mustard.Materials and Methods: This randomized, double-blind clinical trial was carried out in Baqiyatallah hospital on 50 chemically-injured patients for a period of 4 weeks. Patients randomly divided into 2 groups, first group (mean age of 42.3±5.4 years old) received Doxepin capsules (10 mg/day) and the second group (mean age of 41.1±6.2 years old) received Hydroxyzine capsules (25 mg/day). Pruritus score was measured by a standard questionnaire and Visual Analogue Scale (VAS).Results: the mean before and after-treatment puritus scores of Hydroxyzine, were 34.6±3.4 and 25.9±3.1, respectively (P<0.001) and those of Doxepin were 33.8±4.4 and 24.5±4.1, respectively (P<0.001). Both drugs decreased pruritus, similarly (P = 0.245). 18 patients in the hydroxyzine-received group and 11 patients in the Doxepin-received group were complaining from sedation as a side-effect (P=0.035).Conclusion: Both drugs are of significant effectiveness in decreasing pruritus. However, considering its fewer side effects, Doxepin seems to be more useful in these conditions.

Background: The Actinomycetes are gram-positive organisms that tend to grow slowly as branching filaments. They were thought to be related to both bacteria and fungi, but in recent years it has been undoubtedly shown that they are prokaryotic organisms. Actinomycetes have proved to be causal agents of many human and animal infections. They also play as an important rule in producing new antibiotic agents.Materials and Methods: Fifty soil samples collected from different regions of the country were analyzed to determine the presence and types of antibiotic-producing Streptomycetes using dilution plating method. Starch casein agar and glucose yeast extract agar were used as the culture media. 88 selected organisms from 140 isolates were subjected to chemotaxonomy determination. The isomeric form of diaminopimelic acid (DAP) was determined by thin-layer chromatography (TLC) of hydrolyzed whole-organism preparations. A sample of the hydrolysated extract was applied as a 2cm band from the base of the TLC plates. A standard containing meso and LL-DAP was also run at both sides of the sheet for comparison with test mixtures. The plates were developed for about 3 1/2 hours in a glass tank containing 40 ml methanol, 2 ml 6Mol HCl, 5ml Pyridine, and 13ml water.Results: DAP appears as green/brown spots, changing to yellowish with time. The LL-DAP, meso-DAP and hydroxy-DAP isomers have approximate Rfvalues. Approximately 97% of test strains contained LL-DAP and the remaining 3%, contained meso-DAP. Conclusion: This study demonstrated a wide variety of Streptomycetes bacteria isolates which are capable to produce antibiotics and TLC is an appropriate method in determination of them.

Background: Heart Failure (HF) and Dilated Cardiomyopathy (DCMP) are two common heart diseases among children. Carvedilol is the third generation of beta-blocker and although it has been approved in adults, very little is known about its safety, efficacy and dosing profile in children. This study is to evaluate the efficacy and safety of Carvedilol in children with HF or DCMP.Materials and Methods: This is a randomized double-blind study. We studied 30 patients with HF or DCMP for 6 months. 16 patients (2 DCMP & 14 HF) underwent standard medical therapy in addition to Carvedilol and the remained ones (2 DCMP & 12 HF) received the same regimen, except the placebo instead of Carvedilol. We visited all patients on a monthly basis program and echocardiographically, evaluated them for their systolic function indices including LVEF (Left Ventricular Ejection Fraction), EPSS (E Point Septal Separation), LVESV (Left Ventricular End Systolic Volume) and LVEDV (Left Ventricular End Diastolic Volume). Data were analyzed by t-test & Mann-Whitney test.Results: After 6 months of therapy, most of systolic function indices showed a more significant improvement in the Carvedilol group, including increase of LVEF (P=0.033) and decrease of EPSS (P=O.008)& LVESV (P=0.019). No significant side-effects were observed in our patients. Pearson correlation coefficient between some variables showed further improvement of LVEF & EPSS in males. Also, response of cardiomyopathic patients to Carvedilol was more than patients with heart failure.Conclusion: The Carvedilol is an effective and safe remedy for treatment of children with HF and DCMP.

Background: Antibiotics play an important role in treatment of acne. Physicians usually choose the best antibiotics based on their effectiveness, economical impacts, side effects and sometimes drug resistance surveys. In recent years, the latter issue (bacterial resistance) has faced the treatment of acne with some serious problems. This study was designed to illustrate the drug-resistance pattern of Propionibacterium acnes (P.acnes) obtained from patients with Acne vulgaris.Materials and Methods: In the present study, we tried to illustrate the resistance of P.acnes to common antibiotics used in treatment of acne, applying E-tests antibiogram method. After sampling, culturing and purifying P.acnae, MIC measures were obtained for eight cases of common antibiotics used for each individual patient, by the use of E-test quantitative method.Results: From the total of 88 patients, 25.6% were males and 74.4% were females. The average age was 28.8 years old. According to the results of this survey, 13% of P.acnes strains were resistant to erythromycin, whereas 10.7% were resistant to Clindamycin and 7.1% were to Co-trimoxazole. There was no resistance to other tested antibiotics (Cephalexin, Ampicillin, Minocycline, Doxycyline and Tetracycline).Conclusion: In general, mono-drug resistance was observed in 8.1% of cases and multi-drug resistance was found in 10.5% of strains. However, these rates are much lower compared to those mentioned in literature. The results of this study are more indicative of the fact that improper use of antibiotics plays an important role in failure of acne treatment in Iran.

Background: Unintentional injury is a leading threat to children's health. No other study has documented association between health-related quality of life (HRQOL) as a personal factor and children's unintentional injury. This study examined the association between health-related quality of life (HRQOL) and unintentional injuries among children.Materials and Methods: Overall, 3375 children between 6-10 years old were randomly selected trom primary schools in Ahvaz city, Iran. HRQOL was measured by 56 items taken trom seven domains of TNO AZL child quality of life (TACQOL) parent form. We interviewed the parents to collect their information about incidence, cause and a brief description of injury within the past 12months prior to the study.Results: The response rate was 89%. There was a significant trend for increasing occurrence of injury with decreasing of HRQOL (P<0.001). Adjusted OR for injury was significantly higher in very low (2.38, 95% Cl: 1.45-3.86), low (2.18, 95% Cl: 1.34-3.56), medium (1.73, 95%CI: 1.06-2.83) HRQOL groups, compared to reference group (very high HRQOL). The median of total HRQOL (P<0.001) and all its domains (P<0.017) (except autonomous functioning) was less in injured group compared to uninjured one.Conclusion: This study revealed an association between HRQOL and unintentional injury among primary school children. This is a preliminary finding and so further investigations with a well-defined analytical design need to be done.

Background: Food borne diseases are still the major problem in both industrial and non-industrial countries and the prevalence of these diseases are on rise. Consuming of contaminated meats with Salmonella is the major source for distributing these diseases. Adding antibiotics in domestic animals' food causes antibiotic resistance so the resistant bacterium could be transfer to the human through the consumption of such foods. The aim of this study was to determine the Salmonella serotypes, and antibiotic resistance of isolated serotypes obtained from packed and non- packed meat and chicken purchased in different districts of Tehran, during 2004 and 2005.Materials and Methods: In this cross-sectional study, samples were taken randomly from 10 packaged meat suppliers and 17non-packaged meat suppliers. Out of 133 prepared samples, 67 ones were chicken and 66 samples were meat. Samples were weighted, separated (each 25gr) and put into 225ml of Buffered Peptone Water. Then homogenized by Stomacher and incubated at 37°c for 24 hours. After that 0.1 ml of solution poured into 10 ml of Rappaport Vassilidis broth and remained 24 hours in 42°c. Then, one loop of this medium was cultured on Hektoen Entro Agar and remained for a period of 24 hours in 37°c to enter Salmonella colonies. For the antibiotic sensitivity test, the agar disc diffusion was used according to the standard method.Results: Out of 67 tested samples of chicken, 32 samples (47.8%) were contaminated with Salmonella, as well as 19 meat samples (28.8%) (from the total 66 ones). The dominated serotype of both chicken and meat samples was S.thompson (54.6%). The results of antibiotic susceptibility showed that 90.6% of isolated chicken samples were resistant to Nalidixic acid, compared to 36.8% of meat samples.Conclusion: According to the observed antibiotic resistance in some of tested samples, special attention in quality control of food's safety in order to prevent the related diseases is needed.

Background: Continuing advances in medical care and nutrition have prolonged the lifespan and expanded the elderly demographics world-wide. Despite increasing elderly population within Iranian nursing homes, there has been a few dermatologic surveys in this field and the prevalence of skin disorders among this group is unknown.Materials and Methods: This study was carried out between November 2005 and February 2006 in Theran city to determine the prevalence of skin diseases within nursing homes of Tehran. We randomly selected 456 subjects out of 2500 old women and men and investigated their dermatologic and epidemiologic conditions.Results: among 2500 elderly subjects, 456(18.5%) were investigated. This study revealed that more than half of all nursing home patients suffered from at least one skin disease, the most common skin disease was dry skin. Seborrheic keratosis and pressure ulcer were the second and third common skin conditions, respectively. There was no case of scabies. Two patient had basal cell carcinoma, and one patient was suffered from Kaposi sarcoma.Conclusion: Our study revealed that skin diseases are important health problems in Geriatric population. The results suggest that dry skin is the most common skin disease within nursing homes which needs further attention of nursing home staffs to satisfy the dermatologic needs of this group of Iranian patients.