ACTA MEDICA IRANICA
Year:2015 | Volume:53 | Issue:4|Papers Count:12

We have read the article titled “the evaluation of coagulation parameters and vessel involvement in behcet's disease. A clinical experience of behcet's disease: study of 152 cases” written by Harman et al., with interest (1). The authors aimed to evaluate demographic features, clinical features, and vascular involvements of Behcet's disease (BD). They also intended to assess prospectively and compare patients with and without thrombosis and healthy volunteers in terms of their biochemical, immunological, coagulation parameters. They indicated male-dominance in terms of vascular and ocular involvement in their study. However, they did not detect a significant difference in terms of active disease markers such as biochemical parameters, C-reactive protein, erythrocyte sedimentation rate, coagulation parameters between patients with and without thrombosis.

The aim of this study was to determine the prognosis and survival for patients with borderline ovarian tumor (BOT). A retrospective review of 30 patients with serous and mucinous BOT treated at or referred to our institution was performed. Fifteen patients (50%) had serous, and the others had mucinous BOT. About 86% of all patients in both groups were in stage I of the disease. The recurrent disease occurred in 7% and 21% of serous and mucinous tumors, respectively. All recurrences, except one in mucinous tumors, were found in advance stage disease. After a mean of 37 and 52 months follow-up, the overall survival was 100% and 93%, and disease-free survival was 93% and 79% for serous and mucinous tumors, respectively. In this series, advanced stage was associated with poor prognosis. However, to obtain more accurate information further studies with number of patients and longer follow-up is recommended.

Olfactory dysfunction is a known complication of diabetes and, despite its importance in the quality of life, is usually neglected due to its gradual progression. In this study, we aim to determine the prevalence and severity of olfactory dysfunction in diabetics and its association with microangiopathic complications of the disease (neuropathy, nephropathy, and retinopathy). Excluding the confounding factors, a case-control study of 60 eligible subjects, divided into a group of 30 diabetic patients and a group of 30 control subjects was performed. We used “absorbent perfumer's paper strips” method to test the olfactory threshold. In our study, 60% of diabetics were found to have some degree of olfactory dysfunction and a significant difference (P<0.01) between the olfactory threshold of the case and control groups was observed. There were no significant associations between the olfactory dysfunction and age, sex, treatment duration and microangiopathic complications.

Considering the high prevalence of osteoarthritis (OA) and since until now there has not been any human studies to evaluate the effect of sesame in OA patients, this study was designed to assess the effect of administration of sesame on inflammation and oxidative stress in patients with knee OA. Fifty patients with knee OA were allocated into two groups namely control and sesame group. 25 patients in the control group received 40 g placebo powder per day while 25 patients in the sesame group received 40 g of sesame seed daily during two months of study along with standard medical therapy. Serum total antioxidant capacity, malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were measured. In the sesame group, a significant decrease in serum MDA and hs-CRP were seen after two months of study (P<0.05). There was no significant difference in post-treatment serum values of MDA, TAC and hs- CRP between two groups (P>0.05). Serum IL-6 decreased significantly in both groups compared with baseline during the two-month study (P<0.05). There was a significant difference in mean serum IL-6 between two groups after treatment (P=0.001). Sesame seed is a natural and safe substance that may have beneficial effects in patients with knee OA, and it may provide new complementary and adjunctive treatment in these patients.

Social capital is a multi-faceted phenomenon in social sciences that massively affects many social fields. It can be a helpful factor in promoting health. Among the groups with high burnout, nurses have always shown higher levels of burnout. Studies have revealed that social capital can be an important factor affecting burnout. This study aimed to determine the extent of the effect of social capital on burnout in nurses of a trauma referral teaching hospital in Rasht. This was a descriptive correlational study conducted on 214 nurses of a trauma referral teaching hospital. Maslach standard questionnaire and the social capital questionnaire devised by Boyas and colleagues were used. Data were analyzed using descriptive statistics, Pearson correlation coefficient, and linear regression analysis to determine the extent of the effect of social capital on burnout. The study showed an inverse association between social capital and burnout. The intensity of the relationship was -0.451 (P<0.0001). Also, the linear regression model of social capital on burnout variable showed that the regression coefficient of social capital equaled -0.34. The determination coefficient of this regression model indicated that social capital explained 20% of burnout changes. The results showed high burnout in emotional exhaustion dimension and an inverse association between social capital and burnout. Thus, attempts should be made to promote social capital dimensions among nurses. Given the inevitability of job stress in a nursing environment, and managers should plan on improving the working conditions and training techniques to deal with such stress.

This study was conducted to evaluate the association between H. pylori infection and Iron deficiency anemia (IDA) among preschool children (age range: 40-75 months) at a tertiary referral hospital in Tehran. In a case-control study, the prevalence of H. pylori seropositivity was compared between 64 children with IDA diagnosis and 70 healthy non-anemic sex- and age-matched controls. Totally, 52 (81.3%) children with IDA and 10 (14.3%) non-anemic controls had a positive antibody level for H. pylori specific IgG and the difference between two groups was statistically significant (P<0.0001). H. pylori infection had a significant high prevalence among preschool patients with IDA. Eradication of H. pylori infection is recommended for patients with refractory IDA.

The neck is normally a concave and highly mobile structure. Facial and cervical skin is prone to burn scar contracture because of its thin nature. The goal of treatment is to reconstruct this region to achieve a good aesthetic outcome and also normal neck and chin mobilization. This study was conducted to compare the effect of one row of suture and three rows of suture in critical points of the neck to recreate cervicomandibular angle for better contouring of the neck. A cross-sectional study was performed from July 2006 until August 2010. A total of 65 patients underwent lower lateral face and neck burn scar contracture reconstruction. The mean age of participants was 25.5 years old. After designing a local flap, in 31 patients we applied one row of suture. In 34 patients, we used three rows of suture on each side of the neck incorporation with the recipient bed and the flap dermis or capsule to recreate a natural lower lateral face and neck contour (P<0.001). The standard deviation in hospitalization was 7±2 days for group A and 6±1 days for group B. In a two years follow-up, no blunting of cervicomandibular angle occurred and three rows of suture were superior according to present findings.

According to different geographical conditions, human health in different sub-regions of the world and cultural differences, the male factor infertility has heterogeneous causes in the world. This study was performed in an attempt to clarify the associated factors that might play a role in this respect in a group of Iranian infertile men. This study was a cross-sectional, descriptive and retrospective study. The information was obtained from the men who had attended the clinic from March 2004-2006. The factors that were studied in this research are the demographic characteristics, smoking, addiction, alcohol drinking, and exposure to lead, cimetidine and history of surgery. In 23.7 % of couples, the cause of infertility was pure male factor and in 19.3 % of them the problem was related to male and female factor both. The most important associated factors for male factor included smoking (29%) and history of varicocele operation (22%). Since the quality of individual and social life is related to fertility state, it seems that more comprehensive studies on factors affecting male fertility at the community level are justified and recommended.

The Distinction between malignant and benign pheochromocytoma has always been a diagnostic challenge over the last decades. To date, the only reliable criterion is metastasis. The aim of the present study was to investigate the possible expression of pituitary-tumor transforming gene (PTTG1) and retinoblastoma (Rb) in benign and malignant pheochromocytoma. Paraffin blocks of 44 and 11 patients diagnosed with benign and malignant pheochromocytoma were collected. Parameters such as sex, age, tumor size, necrosis, and histological features were compared between the benign and malignant groups as well as immunohistochemical labeling using specific antibodies. PTTG1 showed negative expression in all (44) benign and 9 out of 11 (81.8%) malignant tumors with only 2 out of 11 (18.2%) malignant tumors showed positive reactivity for PTTG1 (P: 0.037) with spindle cell histological pattern in both of them (P: 0.013). Although Rb expression in malignant tumors (81.8%) was slightly more than the benign ones (52.3%), no statistically significant correlation was observed (P: 0.087). These results suggest that PTTG1 immunostaining may play a key role in distinguishing between benign and malignant phaeochromocytoma. However, larger studies are necessary to confirm the outcomes of the present study.

Trauma is a common cause of death and disability in children. Proper approach to pediatric trauma involves adherence to ABCDE sequence in the primary survey and resuscitation in order to promptly recognize and manage life-threatening conditions immediately. This readily reviewed sequence includes A: establishment and maintenance of a patent airway while maintaining cervical spine immobilization; B: evaluation of breathing, ventilation and oxygenation, immediate treatment of tension pneumothorax, open pneumothorax and massive hemothorax; C: evaluation and treatment of circulatory compromise and shock; D: Disability and Neurologic Status, assessment of signs of increased intracranial pressure and impending cerebral herniation; and E: Exposure while preventing hypothermia. Implementing these assessment and management priorities can result in more favorable outcomes.

Giant uterine leiomyomas are extremely rare neoplasms and are challenging both diagnostically and therapeutically. A 49-year-old premenopausal female presented at our Department complaining of abdominal pain and distention for several years. Ultrasound (US), color Doppler US, abdominal computed tomography imaging after administration of contrast material, and abdominal magnetic resonance imaging were performed. Histopathologic examination revealed a pedunculated subserosal uterine leiomyoma. In this case report, we present abdominopelvic multimodal radiologic imaging findings of our patient with a giant subserosal uterine leiomyoma, in conjunction with histopathological findings.

We report a patient diagnosed with Whipple’s disease (WD) who presented only with neurological symptoms. Neuroimaging (MRI) showed lesions with marked mass effect similar to infiltrative tumors, which were hypersignal on long TR and hyposignal on short TR images, located in several areas of the brain. In serial controls, lesions resolved with gliosis and atrophic changes as well as migration of active infiltrative-like lesions to new areas. MR findings of the brain WD are discussed, which confirmed by stereotactic brain biopsy. Familiarity with the range of possible MR imaging appearances of WD enables the radiologist to place WD more effectively on the differential diagnosis which motivates the clinician to consider both the diagnosis and early initiation of treatment; so, this may significantly impact outcome.Moreover, repeated MR investigations may serve as a valuable method to evaluate efficacy of treatment and long term follow-up of WD involving the CNS.