Koomesh
Year:2007 | Volume:9 | Issue:1 (25)|Papers Count:15

The past two decades have seen a major progress in the filed of pathphysiology and treatment of chronic lymphocytic leukemia (CLL). New findings suggested that CLL comprises two separate types of tumor with different prognosis outcome. CLL formerly was considered an incurable ‘‘oldman’s disease’’ caused by slowly accumulating, incompetent lymphocytes. Because elderly patients were expected to die with CLL rather than from it, the mainstay of therapy was to palliate symptoms with oral, alkylating drugs, such as chlorambucil.However, treatment with such drugs not only could not cure the disease, but also could shorten survival if given to patients with early-stage disease.This article summarizes some of the recent advances that have shaped a new way of thinking about this disease including epidemiology, diagnosis and prognostic factors. Treatment strategies, chemotherapy, monoclonal antibodies have been briefly discussed.

Introduction: Revolution of information in medical sciences as one of the important parts of knowledge has made the attention to medical education more critical. This study was performed to evaluate the satisfaction of Shahre-kord university medical students (interns and externs) from the quality of education in clinical courses.Materials and Methods: In this descriptive-analytical study, the rate of satisfaction of 77 medical students (interns and externs) from the quality of education in Shahre-kord university clinical courses was evaluated using a locally standardized questionnaire. The findings were classified as: high, moderate and low. Data were analyzed using SPSS software (version 11).Results: A total of 77 students completed the questionnaire. The high rate of satisfaction from the quality of education in different clinical clerkship periods was reported as follows: Internal medicine 25.7%, surgery (general surgery and orthopedic) 27/4%, pediatric medicine 17/5%, gynecology 6/3%, infectious disease 54/5%, neurology 36/5%, ENT 54/5%, ophthalmology 47/5%, poisoning 21/2%, psychiatry 37/7%, urology 6/3%, health science 17/6%. In addition, high rate of satisfaction from professional skills teaching was reported by 17.4% of the students. The most satisfaction rate in internal and pediatric courses was from morning reports and in surgery clerkship period, from outpatient clinic and theory courses. In gynecology period the lowest rate of satisfaction was reported from outpatient clinic and theory courses. High rate of satisfaction in minor clerkship periods was reported from ENT, infectious disease, psychiatry, and neurology periods respectively.Conclusions: In major clerkship periods, the students were unsatisfied from teaching rounds, outpatient clinic and theory courses. In contrast, high rate of satisfaction was belonged to morning report programs. Due to the low rate of satisfaction from gynecology, poisoning and urology courses and also un-satisfaction from CPR and labor management teaching, reviewing the educational programs by teaching managers is recommended.

Introduction: Young smokers have been more exposed to great stresses and mishaps in their lives, compared to non-smokers. This study was aimed to determine the prevalence of tendency to cigarette smoking and its reasons among medical students.Methods: This cross-sectional descriptive and analytical study was carried out on the population of medical students in Tehran. Two hundred and eighty students were selected by classified randomization from the students in term one, four and seven (students in each term was considered a separate group). Inclusion criteria were the same for all groups. The questionnaire comprised 45 questions including 29 common questions, 5 questions for smokers, 3 questions for recreational smokers, 7 questions for ex-smokers, and 2 questions for non-smokers. Data analysis was performed using descriptive statistics and Chi-square test by SPSS-10 software.Results: There was no female smoker among the students, except 5 percent of the students in term seven who had smoked recreationally. The most important reasons for cigarette smoking were for pleasure and decreasing anxiety. However, maintaining the health was the most important reason for the lack of tendency to smoking among male non-smokers. Female non-smokers had also the reason of unacceptable social impact of smoking for their disinclination.Discussion: The results of current study showed that medical students are predisposed to have tendency to cigarette smoking due to psychological stresses, which are most probably related to their academic major.

Introduction: Opiates have complex effects on seizure activity. They have both anti-and proconvulsive effects depend on their concentration. Low doses of morphine have anticonvulsant effects, while high doses have proconvulsant effects. Sudden morphine withdrawal results in shortterm proconvulsant effects. In the present, the effects of opioid receptors agonists and antagonists on spontaneous seizure activity in epileptogenic hippocampal slices were evaluated.Materials and Methods: Hippocampal slices (400 mm) were prepared from young Wistar rats (P15-25). Seizure activity was induced by continuous perfusion of the slices with low-Mg2+ ACSF. Extra cellular recordings were performed in the hippocampal CA1 pyramidal cell layer. Seizure activity was quantified by measuring the amplitude and duration of the ictal events as well as their number after and prior to the application of the agonists and antagonists of the opioid receptors. In addition, the numbers of interictal spikes were determined to complement the analysis of seizure discharges before and after drug application.Result: Our results show that DAMGO and Dyn-A (10 mM), as m and k-opioid receptor agonist respectively, cause a significant increase in the incidence and amplitude & duration of ictal activity and these effects were completely reversed following the appilcation of B-FNA and nor-BNI (10 mM) as m and k opioid receptor antagonist respectively. DPDPE (10mM), a selective d-opioid receptor agonist, caused a significant decrease in the incidence and duration of ictal activity and these effects were completely reversed by the addition of NTI (10mM), a selective d opioid receptor antagonist.Conclusion: Our finding showed that epileptic effects of morphine probably are established by activation of m and k opioid receptors and due to the activation of  d opioid receptor, morphine produces antiepileptic effects.

Introduction: Goiter is the enlargement of thyroid gland and is the most common disorder of the thyroid. Patients with goiter are usually euthyroid (simple goiter), but they may be hyperthyroid or hypothyroid. Since, proper diagnosis and treatment of goiter can prevent the morbidity of the disorder; the current study was performed to determine the prevalence of different types of goiter in school children in Semnan following 16 years of the production and providing iodized salt.Materials & Methods: In this survey, 9708 school children, aged 6-12 years old, were studied. Firstly, children with goiter were identified and then their thyroid function tests including T4 and TSH carried out, and the different types of goiter were determined according to the tests results.Results: The prevalence of goiter was 3.5% in school children, aged 6-12 years old; 4.1% and 3% in girls and boys, respectively. The prevalence of hyperthyroid, hypothyroid and euthyroid was respectively 8.9%, 28.9% and 62.1% amongs girlsr, whilst those were 9.2%, 25.7% and 65.1% in boys. The greatest number of children who suffered from goiter was the 8 years old students. The greatest number of hypothyroidism and hyperthyroidism was observed in 10 years old and in 8 years old children, respectively.Conclusion: These finding revelaed that that the campaign launched to prevent iodine deficiency by iodinating table salt has been highly effective after 16 years from the beginning of this campaign and the international standards for preventing disorders resulted from iodine deficiency have been achieved in the city of Semnan.

Introduction: Prevalence of obesity has increased steadily and markedly in both Westernized and non-Westernized countries. Few studies have examined the relationship of anthropometric indices with iron status indices. The objective of the present study was to assess the body mass index (BMI) status and its relationship with iron status indices among reproductive age group women in rural areas of Kerman province, Iran.Materials and Methods: In this cross-sectional study, 370 reproductive age group women (20-45 years old) were selected. General information data were gathered from each person using questionnaires and face-to-face interviews. Body weight and height was measured for each subject and BMI was calculated. Venous blood samples were drawn from subjects and plasma separated. In the study, iron status was assessed by measuring the concentrations of hemoglobin, plasma ferritin and hematocrit. Data were analyzed using one-way analysis of variance (ANOVA) and pearson's correlation coefficient tests.Results: The mean BMI of subjects was 24.3 Kg/m2. 19.7% and 15.9% of subjects were overweight and obese respectively. Mean BMI significantly increased with age (p<0.0001) and number of pregnancy (p<0.002). Furthermore, BMI was positively associated with age (r=0.32, p<0.0001) and number of pregnancy (r=0.26, p<0.003). Mean hemoglobin and plasma ferritin concentrations were significantly greater in higher weight and BMI quartiles. The hematocrit was also significantly greater in higher BMI quartiles.Conclusion: From these observations, it is concluded that obesity and overweight are important nutritional problems in rural women in Kerman province. In addition, obese women had higher iron stores than did the non-obese women. Therefore, obese reproductive age women are at low risk of depleting iron stores.

Introduction: It is for many years that researchers are searching to find a way to treat muscular disorders including weakness and atrophy, which are consequences of the lack of movement. Therefore, clinicians are always waiting for a way to prevent these weakness and atrophy, especially when active movements are forbidden. In addition, there has always been a question whether muscle performance can be improved without performing any joint movements or muscle contractions. Studies have shown that mental practice can be a good answer for it. However, this effective, negligible risk and low cost method are not used by therapists. The present study was performed to compare the effects of mental practice and maximal Isometric exercise on increasing grip muscle strength.Materials and Methods: This study was carried out on 37 young healthy female (18-25years old) who randomly divided into mental practice, Isometric exercise and control group. The mental practice group performed imagined maximal isometric contraction of grip muscle for 3 weeks and the isometric exercise group performed maximal isometric contraction of some muscles, while the control group didn’t perform any imagined or physical practice at the same period of time. The amount of maximal grip strength was determined by hydraulic hand dynamometer before and after training. Data analysis was carried out using paired t-tse.Results: Performing mental practice and maximal isometric contraction produced a significant increase in isometric strength of grip muscles (p=0.000). While the control group didn’t show any significant changes (p = 0.453). Furthermore, there was no significant difference between the mental practice and the isometric contraction group.Conclusion: It is suggested that therapists combine this new method with the other common methods in their rehabilitation programs.

Introduction: Coronary heart diseases are increasing and one of the gold standards for diagnosis is coronary angiography (CA). Bed rest after CA may cause back pain. Since, there are a few studies about change position effects on reducing back pain and patients comfort during bed rest after CA in Iran, The study was designed to explore these effects in Taleghani hospital patients (2006-2007).Materials and Methods: This clinical trial was conducted on 130 patients hospitalized for coronary angiography. Each Patient was assigned randomly to either the control group, which remained supine position 6 hours of bed rest after CA, or experimental group. The experimental group was changed position hourly, varying between supine, elevated to 3o degrees and semi position (elevated to 45 degrees) during the first 6 hours after coronary angiography. Check list and numeric pain intensity scale were used for data collection.Results: None of patients developed bleeding, haematoma and arterial thrombosis, so there was no significant difference between two groups. There was significantly less pain intensity of back pain (P<0/001) and nausea (P<0/01) in experimental group. Urinary difficulty, Groin and leg pain were lower in the experimental group but they were not significantly different between two groups.Conclusion: Changing positions in bed without increased vascular complications may cause reduced back pain; promote physical comfort among patients who had undergone coronary angiography.

Introduction: There is a relationship between children’s survival, development and health and their feeding. Malnutrition is a common complication in most of the developing countries. Complementary feeding begins in infants when they can not obtain enough energy and nutrients from mother’s milk. Both early and late beginning of complementary nutrition lead to severe complications, and suitable age for feeding in infants is after month 6. The present study was performed to estimate the age of beginning of complementary feeding and related factors in infants of Semnan.Materials & Methods: In this cross sectional study, 400 infants aged 6-12 months were analized via questionnaire. In each of 8 health centers in Semnan, 50 mothers who referred to health care centers, filled up questionnaires.Results: 76.3% of mothers begin the complementary feeding from 6 months after delivery. The most common complementary food, which was used, was cereal (69.5%). Mean (±SD) beginning age of complementary feeding was 5.86±0.60 month. Most of mothers (97.5%) had been received information about infant’s feeding through appointments, books, vaccination card and pamphlet prior to their infants reach to age 6 month. There was a significant relationship between occupation of mother (P=0.049), age of mother (P=0.040), father's educational level (P=0.002), type of delivery (P=0.015) and the beginning age of complementary feeding. However, no significant relationship was observed between gender, type of milk, birth order, type of health care center, mother's educational level, first complementary feeding, type of mother's education and the beginning age of complementary feeding.Conclusion: The findings of current study showed that 97.5% of mothers were educated for beginning of complementary feeding in a suitable time; however, about 23% of them didn’t begin complementary feeding in an appropriate time. Therefore, it seems more effective education is necessary to give by health care centers to mothers especially for older mothers and those have normal delivery.

Introduction: Oxyuriasis is one of the most common infections among children in developed and developing countries. The current study was performed to determine the prevalence of oxyuriasis (Entrobiasis) and related factors in children aged kindergarten and primary school in urban areas of Semnan province.Material & Methods: In this cross–sectional study, 688 students were selected by stratified–random sampling and a scotch test was prepared from each student. In addition, other data were collected through questionnaire. Data analyzing was carried out by Chi-Square test and logistic regression. P-value less than 0.05 was considered statistically significant.Results: Prevalence of oxyuriasis among children was 12.5 % (8.1% in kindergarten children and 13.4% in primary school children). The prevalence of Oxyuriasis was significantly difference in various cities of Semnan province; educated students in Damghan were in higher risk than other cities (OR = 2.47, % 95 CI: 1.26– 4.87). In addition, the students whose their mothers were illiterate or low education were exposed to higher risk compared to those students whose motherۥ s education were at secondry or high school level(OR = 0.49 , % 95 CI : 0.29 – 0.84 ) Furthermore, infrequent hand washing after toilet increased the risk of infection (OR = 1.94, % 95 CI: 1.15 – 3.26). The risk of infection was higher among the students who had tiredness feeling in comparison with those students did not show this symptom (OR = 2.61, % 95 CI: 1.30 – 5.25). Moreover, the results showed that a previous history of oxyuriasis increases the risk of future infections (OR=2.73, % 95 CI: 1.58– 4.71).Conclusion: These findings emphasized that personal hygiene education in mothers, especially for illiterate or low educated mothers, is necessary. It is obvious that a continuous education should be given to mothers until they achieve an appropriate level of education. This approach has more priority in Damghan.

Introduction: Diazinon (DZN) is an organophosphate that inhibits of acetylcolinesterase activity by phosphorylating of active site, in which could be resulted in damages of germinal cells and reproductive functions. Since this compound is extensively using in the agriculture, especially in the northern regions of Iran in order to control of pests, the present study was performed to investigate the influence of DZN on spermatogenesis in mice.Materials and Methods: Male mice were divided into three experimental, sham and control groups. The animals in the experimental group were injected with the consecutive doses of DZN (30mg/kg i.p, five consecutive days per week for one month). The sham mice were received only water injection and no injection were performed on animals in the control group. Animals were scarified 35 days after the latest injection of DZN. Then, the mice testis sections were prepared and morphologic aspects of testis and spermatogenesis processes assessed.Results: The DZN showed a significant decrease in number of germ cells, spermatocytes, spermatids, Leydig cells, blood vessels. In addition, the diameter of seminiferous in the testis of the mice decreased.Conclusion: The current finding showed that Diazinon is an environmental factor that can cause toxic effects on the morphologic parameters of germ cells. These results suggested that the DZN might be a factor that results in infertility in mice.

Orf is a sheep disease due to infcetion with a parapoxvirus. The infection is mainly transmitted to man by direct contacts and seldomly by contaminated instruments. Infection in human results in a benign and self-limited disease, generally. Although, rare complications have been mentioned, this is a report about a case of orf with erythema multiforme in a 54 year old woman.