Journal of Shahid Sadoughi University of Medical Sciences
Year:2012 | Volume:20 | Issue:4 (85)|Papers Count:17

Introduction: Entropion and ectropion with involutional changes are the most common eyelid malpositions.Entropion is a condition in which the eyelid margin turns inwards against the globe and ectropion is a malposition in which the lid turns outwards or is pulled away its normal position from the globe. Knowledge of eyelid problems and their abnormalities is a key to plan a successful surgical procedure.Methods: This descriptive study lasted from Sep.2008 to March 2009. We evaluated 78 patients with eyelid malpositions who referred to educational hospitals of Yazd. The patients were examined by an eye specialist. Each patient’s demographic data, type of eyelid malposition, specific treatment results and 6-month follow up of each patient were recorded by the questioners and then were analyzed statistically by SPSS13 software, chi-square and fisher exact test.Results: Among 78 cases, entropion was observed in 41 cases (52.6%), trichiasis in 31 cases (39.7%), ectropion in 27 cases (34.6%) and distichiasis in 3 cases (3.8%). The Wies procedure proved to be influential in entropion treatment and lateral tarsal strip canthoplasty surgery also reported acceptable results in ectropion.Conclusion: The involutional changes were the most common causing factors for eyelid malpositions.Entropion appears most prevalently specially in right upper eyelid. The Wies and lateral tarsal strip canthoplasty procedures were thoroughly successful in treatment of entropion and ectropion of either upper or lower eyelids.

Introduction: Survivin gene, as an apoptosis inhibitor, plays an important role in development of breast cancer. The differential expression of survivin in cancer versus normal adult cells as well as an association between high expression of survivin and aggressive tumors has led to use of survivin as a molecular marker for diagnosis and prognosis of tumors. The underlying mechanism of survivin over expression in cancers is not recognized yet. There is a probability that some polymorphisms in this gene can result in uncontrolled manner of this gene. The C-31G, a widely studied polymorphism in the survivin promoter, could de-repress the cell cycle- dependent transcription of survivin gene, resulting in over expression of survivin. In this hospital- based, case- control study, we aimed to investigate the correlation between the genetic polymorphism of -31G/C, surviving promoter, and breast cancer (BC) in North West of Iran.Methods: In this case–control study, the -31G/C single nucleotide polymorphism (SNP) of survivin promoter in peripheral blood samples was collected from 94 breast cancer patients with pathologically confirmed BC and 82 healthy subjects. The data were analyzed by polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) and gene sequencing.Results: Statistical analysis showed that within breast cancer patients, genotype frequencies were 50%, 46.8% and 3.2% for -31G/G, -31G/C and -31C/C genotypes respectively, whereas they were 50%, 45.1% and 4.9 % for -31G/G, -31G/C and -31C/C genotypes in healthy individuals. Also the frequencies for -31 C allele were 26% and 27% in the cases and controls respectively. No statistically significant association was found between breast cancer and the variant genotypes (CC and CG).Conclusion: It seems that there was no significant association between -31G/C polymorphism, BC, and clinicopathological characteristics in the population of our study.

Introduction: This study aimed to compare the efficacy of 2 tocolytic agents of nifedipin and indomethacin for treatment of preterm labor and their complications.Methods: The study was conducted as a randomized clinical trial on 79 pregnant women who were admitted for labor pain at 26-33 weeks of gestation. In the nifidipin group (40 cases), oral nifedipin and in the indomethacin group (39 cases), indomethacin were prescribed rectally.Results: The two groups did not have any significant difference in regard to maternal age, gestational age, cervical dilatation, effacement and consistency.23 cases (59%) of indomethacin group, and 10 cases (25%) of nifedipin group did not respond to treatment (P=0.002). Non of the 16 remaining women of indomethacin group and 30 cases of nifedipin group delivered during 48 hours.1 women (6.25%) in the indomethacin group and 4 cases (13.3%) of nifedipin group delivered between 48 hours-7 days which no significant difference was observed. Mean gestational age at the time of delivery (for the women who responded to treatment during the first 2 hours) was 238.5±19.4 days and 246.4±15.4 days in the nifedipin and indomethacin groups respectively (P=0.182).17 cases (42.5) in the nifedipin group and 11 cases (28.2%) in the indomethacin group showed adverse effects (P=0.184).Conclusion: Indomethacin is less effective than nifedipin for the fast treatment of preterm labor, though in women who respond to treatment during 2 hours, delaying of delivery is similar to nifedipin.

Introduction: Restless legs syndrome is a neurological disorder; hemodialysis patients seem to suffer more from this syndrome. Although the pathophysiology of restless legs syndrome is still unknown, assessment of factors associated with this syndrome can help to develop medical knowledge in this field. The present study assessed the relationship between restless legs syndrome, serum iron, and serum ferritin levels in patients on hemodialysis.Methods: This descriptive study was carried out with purposive sampling method on 168 hemodialysis patients who referred to the Urmia Taleghani Hospital Hemodialysis Unit. Data were gathered using restless legs syndrome questionnaire and laboratory Index of serum iron and ferritin. Data were analyzed using descriptive and inferential statistical tests.Results: The study results revealed that 38.7 percent of samples complained from restless legs syndrome whose average score serum iron was 78±29.3 mg. Results showed in hemodialysis patients with restless legs syndrome, serum iron and serum ferritin levels were significantly lower than hemodialysis patients without restless legs syndrome (p=0.02, p=0.005).Conclusion: Considering the high prevalence of restless legs syndrome in patients with hemodialysis, identification of factors associated with this syndrome and providing the necessary solutions for modifying or eliminating the factors, seem to be necessary. Since the relationship between indicators of iron and ferritin and restless legs syndrome in hemodialysis patients is confirmed, the results can be helpful in the treatment and management of these patients.

Introduction: Teeth are valuable sources of information for anthropological and paleontological studies due to the variation in their shape and size. Dental morphological characteristics are useful to provide information for phylogenic and genetic studies as well as understanding variation within and among species. The goal of this study was to determine variation of the Carabelli cusps within the 8-15 years old who referred to Dental School of Guilan University of medical sciences.Methods: In this research the stone models of 231 children (103boy and 128girl) aged 8-15 were evaluated to determine the frequency of Carabelli cusps. This research was based on Dahlberg scale that involves 8 scores. In order to analyze data, SPSS.v.11.5, and to report results, frequency tables and Chi Square test were used.Results: Prevalence of Carabelli cusps was totally 85.7%. Most of them, according to grade 1 of Dahlberg scale, were assigned to the small vertical ridges. Distribution of this feature among boys and girls was equal and no significant differences were found between the sexes (p=0.658).Conclusions: This feature has significant presence in Iranian society. This variation in the population of our study was more likely to grade 1, with 27.7% in general of which 22.3% was devoted to men and 32% to women. Therefore, the probability that Gene or genes which cause traits, are located on sex chromosomes is faded, and we can conclude it may be inherited by autosomal chromosomes.

Introduction: In order to improve the oral health, systematic analysis of oral health condition and related factors should be conducted. This study aimed to evaluate dental caries and some related factors in 35-44 years old men & women in five urban areas of Sistan and Baluchestan in 2009-2010.Methods: In this descriptive cross-sectional study, 550 people were chosen by random stratified clustering in five different urban areas of the province. All participants were examined and the DMFT index was determined. Demographic and social information and their oral health behaviors were registered in a questionnaire which was composed of 11 questions. The data were analyzed by SPSS (version 17) and descriptive statistic methods.Results: Statistical analysis showed that average of DMFT was 10.05±7.186. DMFT in females (11.43±7.5) was more than males (8.68±6.6) significantly (P<0.001). A significant difference was found between ethnicity and DMFT (P<0.05) while analysis did not reveal any difference between income, level of education, time and number of daily brushing. (P>0.05) Conclusion: Results of this study could be used by public health managers to plan and evaluate public health in the future. With an emphasis on improving high risk patients' situation, appropriate interventions can be designed to achieve good results in the short and long term.

Introduction: Fars province is one of the most important foci of leishmaniasis that includes two types of cutaneous (urban and rural forms) and visceral leishmaniasis in sympatry. To study leishmaniasis among suspected patients of cutaneous leishmaniasis in 5 counties of Shiraz, Firouz abad, Ghir Karzin, Farashband and Larestan, both microscopic and molecular analysis were carried out in the present study.Methods: The samples were smeared on the microscopic slides and were also stained by Giemsa. All smears were examined under a light microscope and the positive smears were scored for amastigote frequency. DNA was extracted from stained smears and Leishmania DNA was detected by amplification of ITS 5.81 s ITS2 fragments. Amplicons were analyzed using electrophoresis in 1.5% agarose gel containing ethidium bromide.Results: Among 34 studied patients, 29 cases (85%) were positive in microscopic and 32 (94%) in molecular analysis using standard PCR. All examined samples were infected with L.major except one (3%) that was infected with L.tropica. Most lesions due to L.major were located on the feet, whereas ulcer due to L.tropica was on the forehead.Conclusions: Preparing stained smears from active lesions of suspected patients (microscopic analysis) removes the problem of Leishmania preservation and transition to culture media. Also, intergenic variations in amplified fragment of ITS-rDNA cause to produce fragments with different length and based on this difference, we can identify L. major and L. tropica separately. Using microscopic and molecular methods in present study confirmed presence of L.major and L.tropica as the causative agents of CL in studied regions of Fars.

Introduction: Root canal obturation is a critical factor in success or failure of a root canal treatment. The material used for root canal obturation must be able to provide a perfect seal. This study aimed to compare the ability of gutta-percha/AH26 and resilon/epiphany to prevent apical microleakage.Methods: To conduct this experimental study, 32 extracted single root human teeth were used. Crowns of the teeth were cut and root canals were instrumented using hand K-file in a step-back manner. Smear layer was removed by irrigation with 17% EDTA for 1 minute. The samples were randomly divided into two similar groups and were filled with gutta-percha/AH26 or resilon/epiphany. The specimens were placed in 2% methylene blue solution for 48 hours. The teeth were sectioned longitudinally and the leakage was measured in a linear fashion from apex to crown by stereomicroscope. Data were evaluated by t-test.Results: Based on the study data, there was no statistically significant difference between Guttapercha/ AH26 and Epiphany/Resilon groups (p>0.05).Conclusion: Considering no significant difference between microleakage of gutta-percha and resilon, resilon could be considered as a suitable root filling material after conducting further studies about its physical, chemical, and biologic properties.

Introduction: Gestational hypertension and preeclampsia are important maternal and fetal–infant complications and they can be regarded as the second cause of maternal death as well. The present study aimed to assess the effects of hydralazine and furosemide on blood pressure in sever preeclampsia.Methods: One hundred patients with severe preeclampsia were enrolled. After spontaneous onset of postpartum diuresis and discontinuation of intravenous magnesium sulfate, patients were randomly assigned to receive either Hydralazine 10mg QID or furosemide10mg BID for 5 days. Patients’ blood pressure was recorded every 6h and the collected data were compared.Results: Postpartum patients with severe preeclampsia who received furosemide had significantly lower systolic blood pressure by postpartum fifth day (66% compared with 42%, P=0.016, OR=2.6) compared to those who had hydralazine. On the other hand, the time duration of response to treatment was lower in patients who received hydralazine compared with furosemide (24.3h compared with 31.4h, P=0.034).Conclusion: Furosemide proved to be more effective on blood pressure mean reduction compared with Hydralazine in women with sever preeclampsia.

Introduction: The present study aimed to evaluate effectiveness of group forgiveness therapy in reducing aggression among 11–13 year old boys.Methods: This semi experimental study (pretest-posttest design with control group) was conducted on 30 students who scored high on Aggression Questionnaire. The sample was selected through cluster sampling assignment and participants were randomly assigned into two experimental and control groups. The experimental group received forgiveness counseling via twelve group sessions of 1 hour duration each. During this period no intervention was given to the control group. Data was analyzed using Kolmogrov-Smironov, Levene F test, and t-test for independent and dependent groups.Results: Statistical analysis, using independent t test for between-group comparison, showed that compared to the control group, aggression both physical and verbal, anger, and hostility in the experimental group significantly decreased. Also result of dependent t test for within-group comparison showed that aggression and its dimensions were significantly decreased after implementing independent variable.Conclusion: The study findings revealed that group forgiveness therapy can significantly reduce aggression.

Introduction: Contamination of etched enamel to saliva before placement of sealant prevents the appropriate bonding and results in microleakage. Using bondings is effective for decreasing the microleakage. This experimental study aimed to evaluate the effect of bonding agent on microleakage of a fissure sealant before or after contamination to saliva.Methods: In this experimental study 40 sound premolar teeth were randomly divided into four groups. The prophylaxis was done and the teeth were etched with 37% phosphoric acid gel, then they were washed and dried. In the first group, Seal-Rite fissure sealant and Dentastic (Pulpdent, USA) without saliva contamination, and in the second group sealant with bonding agent after saliva contamination for 10s, were applied and cured for 40s. In the third group, fissure sealant without bonding agent or saliva contamination, and in the fourth group fissure sealant without bonding application was applied after contamination with saliva and then was cured. After thermo cycling, the teeth were placed in 50% silver nitrate for 2 hours. The buccolingual sections were applied and microleakage evaluation was made by stereomicroscope at 4X magnifications and results were evaluated with mann-whiteny test.Results: The fissure sealant group without bonding agent showed the most microleakage after contamination to saliva and use of sealant with bonding agent significantly showed decrease of microleakage.Conclusion: Use of bonding agent under fissure sealant in saliva-contamination status is beneficial for decreasing microleakage.

Introduction: Cleft lip (CL) and cleft palate (CP) are among the most common congenital anomalies. Constituting 65% of head and neck anomalies in isolated or syndromic forms, they are considered as the most common head and neck congenital deformities in children.Methods: 15 children from the Tabriz Children Hospital were evaluated in this descriptive-analytic cross sectional study that possessed unilateral and bilateral cleft lip and palate with inclusion criteria. The effect of nasal floor reconstruction on the size of alveolar cleft and palatal anterior fistula formation were evaluated in primary unilateral and bilateral cleft palate.Results: There were 11 (73.3%) male and only 4 (26.7%) female patients in the sample group. The mean duration from first consult to reconstructive surgery was 3.4±1.8 months (1 to 9 months range). The width of alveolar cleft and alveolar ridge angle on cleft side compared to normal side in sagittal and coronal axis was significant after nasal floor reconstruction (P=0.001, P=0.02), while septal angle changes were not significant (P=0.26), which means no increase in septal deviation has been documented.Conclusion: Considering the significant changes of alveolar cleft width and alveolar ridge angle on cleft side compared to normal side in sagittal and coronal axis after nasal floor closure, this method can be applied as a new interventional surgery in primary unilateral and bilateral cleft palate.

Introduction: Enoxaparin is widely used in acute coronary syndrome patients to prevent progression of coronary artery disease. Pain of injection site is the unpleasant result of subcutaneous Enoxaparin injection which causes the patient physical discomfort. One of the nurses’ tasks is applying techniques which cause the reduction of damage to the patient. This clinical trial study investigates the effect of injection duration of subcutaneous Enoxaparin on site-pain intensity in acute coronary syndrome patients hospitalized in Coronary Care Unit.Methods: Seventy 30-75 year-old acute coronary syndrome patients hospitalized in coronary care unit were selected randomly. Enoxaparin was injected randomly to either right or left side of abdomen with a 12-hour interval during 10 seconds and 30 seconds. In order to assess the site pain intensity, visual analog scale (VAS) was used before and immediately after injection. Data analysis was done by descriptive statistics and non-parametric tests.Results: Results indicated that mean of pain intensity before 10 seconds is 0.78±4.93, after 10 seconds is 15.95±19.43, before 30 seconds is 0.64±3.79 and after 30 seconds is 8.08±12.91. Thus, 30 second duration of injection resulted in significant less pain intensity (P=0.000). There was no relationship between pain and sex, age and educational level.Conclusion: According to the study results, increasing injection duration of subcutaneous Enoxaparin to 30 seconds reduces the site pain intensity.

The Calcifying Cystic Odontogenic Tumor (CCOT) is an uncommon lesion that demonstrates considerable histopathologic diversity and variable clinical behavior. A CCOT is rarely found in everyday practice.According to Kramer and Pindborg as well as majority of other authors' classification, since 1992 the World Health Organization favored the use of the term calcifying cystic odontogenic tumor, described it as a cystic or neoplastic-like odontogenic pathological lesion of the jaw, and classified it as a benign odontogenic tumor. Ultrasonography (USG) is an inexpensive, non-invasive, and almost an available technique that is well tolerated by patient. In recent years many investigations focused on the use of ultrasonography in maxillofacial region as well as in intra osseous lesions of the jaws. This paper describes a 34 year old female with a painless mild swelling in the left anterior maxillary region associated with an impacted lateral incisor.The Panoramic, lateral occlusal and periapical view findings showed well-defined corticated unilocular mixed lesion with cluster of small pebbles calcifications. USG examination, using linear probe transducer, and also evaluation of location, size, internal echoe and boundary of the tumor were performed and documented. The main USG features of the tumor appeared as anechoic pattern cystic like lesion with some calcifying contents. Pathologic diagnosis was obtained by examining the surgical specimen. Therefore, ultrasonography may be used as an effective supplementary diagnostic tool for maxillofacial lesions.