Journal of Guilan University of Medical Sciences
Year:2002 | Volume:11 | Issue:42|Papers Count:16

Skin cancers are the abnormal uncontrolled prolifration of skin. These are also the most common cancers of the human body.The most common types are Basal Cell Carcinoma (B.C.C), Squamos Cell Carcinoma (S.C.C) and Malignant Melanoma (M.M).In this study we reviewed the data of all registered skin tumors in all clinichopathological Labs (6 private and 2 supervised by Guilan university) during 1991-1998.Total number of registered tumors was 1126.The most common were B.C.C (717 cases), S.C.C (315 cases) and MM (37 cases). B.C.C and S.C.C were more common in men than women (399/195 and 318 / 120 cases respectively) but MM was more in women. The most common malignant skin tumors were in 60-69 years age group and the most common location of tumors were head and face

Cisplatin has been used as a chemotherapeutic agent widely. Its cytotoxicity is through binding with DNA, which will cause cell death. Cell cycle arrest death is among hypothesized cellular effects of Cisplatin. In this study, human ovarian carcinoma, (OV 2008) cells have been exposed to two different doses of Cisplatin and cell cycle arrest has been investigated. OV 2008 cells were exposed to 1µg/ml (IC50 of drug) and 3µg/ml (IC80 of drug) for one hour in RPMI medium supplemented with 10% fetal bovine serum (FBS) Medium. Cells were collected 48, 72 and 96 hours after exposure to Cisplatin with trypsinisation. As was shown with DNA content, Cisplatin caused increasing of G2 and S phases as well as decreasing of G1 phase 48 hours after exposure. G2 cell population was decreased from 48 hours to 96 hours time. However, S phase populations remained high untill 96 hours time. Our results revealed that there was not dose related differences in the cell cycle arrest caused by Cisplatin and no differences in the percentages of G1, S and G2 cells exposed to any of 1 or 3 µg/ml Cisplatin had. As a conclusion, cell cycle arrest pattern of OV 2008 cells exposed to Cisplatin was not concentration dependent and Cisplatin caused S and G2 phase cell cycle arrest .OV2008 cell lines were sensitive to Cisplatin in G2 and S phases without any indication of concentration

For determining the knowledge and attitude of pregnant women about delivery methods in health centers in Tehran, a cross- sectional study was performed on 400 women through a randomized sampling. Counseling provided the questionnaire with gynecologist, after pretest, it was completed through interview.80.3% and 82.3% of women were award about the pain after cesarean section and expensive of it respectively.The knowledge about other complications of cesarean section such as infection, Anesthesia and duration of hospitalization were ranged 57%-77.5% More than 68% of women were awarded about breech presentation, repeated cesarean and labor arrest as indications of cesarean section. 52.8% and 57% of them thought that the maternal and neonatal mortality rate in vaginal delivery is more than cesarean section respectively.It was seen a positive attitude to prefer cesarean instead of vaginal delivery in 36.8%, and choosing any method of delivery in 40% of women.67% of women had a positive attitude to normal delivery because of its safety for women health. There was a statistically significant association between the knowledge and job (P=0/03), level of literacy (P=0/00001), parity (P=0/01) and age of marriage (P=0/007).

It has given permit to health center for vasectomy by government since 1987, but it is not accepted easily due to cultural and religious factors and so wrong imaginations.Our purpose was to study the effects of education on acceptance of this procedure.So in a quasi-experimental study by multistage sampling 281 teachers were surveyed in 1996. We collected data with a questionnaire that developed by investigator. The experimental group participated in an educational program by lecture and flap chart.After 10 days their attitude to vasectomy were measured and the results were compared. There was not significant difference between mean Scores of attitude to vasectomy in two groups before training and pre and posttest in control group. Mean Scores of attitude to vasectomy were increased after training (control group X = 3.29, SD = 1.03, Experimental group X=3.68, SD=0.99, P<0.05) and there were a significant difference between two groups. Comparison of mean scores of attitude in experimental-group showed a significant deference in pre (X=3.22, SD=1.10) and posttest (X=3.68, SD=0.99, P<0.05).In comparison, mean scores in terms of Variables such as age group, level of education, the number of girls and boys (children) and occupation status of wife, were not significant deference.So, these results suggest that even with short educational programs, it is possible that suitable healthy behavior create in people.

Increasing the standard of living and life span has resulted in a notable growth of the elderly population in human societies. World health Organization has reported that 590 million populations of the elderly in 2000 will be increased to 1,100,000,000 by 2025.The present descriptive study aimed to investigate the causes of hospitalization in the elderly people in Rasht. The data showed that from 7499 elderly patients (>65 years) 52.6% and 47.4% were men and women respectively. Young old people (65-74 years) constitute 70.3% of the study population. Our findings indicated that chest pain (13.9%); dyspnea (11.2%) and abdominal pain (10.4%) were the most common complains of the subjects respectively. We also found that cardiovascular disease was the most leading cause of hospitalization in this population (37%); and then trauma and orthopedic disabilities (10.8%), respiratory disease (7.4%), sight problems (5.2%), cancer (4.6%) and the vessel disease of brain (4%). The hospital records showed that 12.5% of hospitalized elderly patients had died during hospitalization. The results clearly showed that non-communicable diseases were the most common causes of hospitalization in the elderly in Rasht. So younger training and expending centers and elderly unity are needed.

Tobacco use is the major avoidable cause of disease and death. This investigation was undertaken to evaluate the efficiency of trans-theoretical model of change in smoking cessation among secondary school teachers in Tabriz by use of nursing intervention. This investigation was a quasi-experimental research. Participants in this research were 200 male graduate teachers of five educational districts in Tabriz. Subjects were randomly divided to two control and experimental groups (100 in each).The independent variable was nursing smoking cessation intervention and dependent variables were: self-efficacy, decisional balance, and smoking behavior. Data collection instruments were socio-demographic and smoking history, smoking behavior, self-efficacy and decisional balance questionnaires.Descriptive and analytical statistic (dependent and independent T-test, x2, and . . .) was used for testing the research hypothesis. Results showed 48 (58.5%) subjects of experimental group quite smoking completely after nursing intervention (x2 = 44.336, p<0.001). Comparison of smoking behavior (t=6.482, P<0.001) and self-efficacy (t=6.697, P<0.001) in experimental group before and after intervention, showed statistical significant difference. Decisional balance in experimental group before and after intervention, and also in comparison with control group, did not had significant difference. Although trans-theoretical change model was useful in designing nursing smoking cessation intervention, but more research is needed for decisional balance construct in diverse cultural groups.

Adverse effects of smoking are found on respiratory, cardiovascular, and immune systems, as well as on drug metabolism, homeostasis, and physiology. Our purpose was study the effects of passive smoking on body systems that in recent years there is more attention in this field.It is suspected that in passive smokers smooth induction of anesthesia impaired.In a prospective study 140 cases who were undergoing elective surgery, were allocated to one of following three groups: Active smokers (group 1), passive smokers (group 2), and non-smokers (control group).Respiratory events including cough, breath holding and laryngospasm were noted in 79% of smoker group, 81% of Passive smokers and 7.5% of non smokers group, 81% of passive smokers and 7.5% of non smokers group. Both active and passive smokers had a higher incidence of adverse respiratory events than non smokers (P<0.0001 and P<0.0008 respectively).There was no significant difference among active and passive smokers according to their respiratory events (P<0.21).Passive smoking as active smoking cause hypersensivity of airway and deteriorate smooth induction of anesthesia.

Todays due to immunological and surgical techniques and increasing complication related to hemodialysis, increasing number of patients scheduled for renal transplant and secondarily ocular complication of immunosuppressive agents increased. Therefore early diagnosis & management of these complications can prevent devastating problems. Our aim was to determine the incidence and type of ocular complication of renal transplant and its correlation with other variables such as, age sex, donor type and duration of renal failure and dialysis.We selected 42 patients without history of any ocular disease and surgery. In each visit, complete eye examination was done. Patients received 500 mg Methyleprednisolone intravenously that started one day before operation and continued 2 days postoperatively, then changed to Prednisolone 20mg/daily. Also postoperatively, Cyclosporine A and Azathioprine started with 5 and 1 mg/kg respectively and continued with tapering doses. The results compared pre and postoperatively with Chi- square and Mann Whitney tests.Total number of patients was 42 cases and donor was three groups: cadaver, relative and non- relative. Of all patients, male & female were 76% and 24% respectively with average age 34.4 year (14-54) with mean 12.6 months follow up (6-24). The most common complication was cataract (45%) but no significant correlation was found between cataract and total dose of steroid, age, sex, duration of dialysis and renal failure. In 7% of patients open angle glaucoma and in 5% bilateral peripheral dendritic herpetic keratitis without inflammation developed.Regarding the ocular complication of renal transplant drugs, it is better that these patients followed regularly to prevent of complication and early treatment.

Position changing with blood distribution in different portions of lung can produce V/Q mismatch, and finally extend to oxygenation disruption. Thus, if position changing has done versus of patients pulmonary problem types, not only does not cause oxygenation improvement, but also induce gas exchange impairment, and with provocation of hypoxemia and respiratory acidosis, results complication serious.Goals of this research were determination of semi-fowlers position and its duration effect on the arterial blood gases (ABGs) in patient under mechanical ventilation hospitalized in general ICU.For study goals attainment, 30 ICU patient (22 men and 8 women) under mechanical ventilation was choosen. After recording patients demographic data on questioner, at first an arterial blood sample in supine position, obtained. Then patients immediately had been placed in semi-fowlers position and after 15, 30, 45, and 60minute lying in this position, samples of arterial blood obtained and sent to laboratory Findings showed that semi-fowlers position had not positive effect on oxygenation and gas exchanges. Also, findings certificated that the effect of lying duration (15, 30, 45, 60 minute) in semi-fowlers position on oxygenation and gas exchange wasn't significant.Finally conclusion is that without consideration of lung pathology, semi- fowler's position should not be used because this position not only does not induce oxygen- improvement, but also causes gas exchange impairment, and also create pressure ulcer in susceptible body portion such as sacral and coccygeal.

While a low bone characterizes osteoporosis mass there is a well-recognized overlap in bone mineral density (BMD) measurements between groups of subjects with or without vertebral fracture. To investigate whether differences in trabecular architecture may contribute to the presence or absence of fractures independent of the bone mass fractures and non fracture groups matched for age, gender, and BMD were assembled. Transiliac biopsies and corresponding lumbar spine BMD measurements from 31 women and 16 men with vertebral fracture were compared with those from 22 women and 11 men without fracture. Lumbar BMD (L1-4) was measured using a Hologic 2000 densitometer. The lumbar BMD was similar in women with and without fracture (0.63g/cm3 ± 0.10 SD and 0.71g/cm3 ± 0.17 SD, n.s.) and in men with and without fracture (0.72 g/cm3±.12 SD and 0.76 g/cm3 ± 0.17 SD, n.s). Undecalcified iliac crest biopsy sections, 8 m thick, were analyzed for remodeling variables and trabecular architecture using osteomeasure and TAS image analysis system. No significant difference was found in either gender between fracture and non fracture groups in percent bone volume (mean 10% in all groups), or in the wide range of remodeling and architectural variables measured, including the trabecular width, number, and separation, mean trabecular plate density and fractal dimension, as well as several indirect indices of connectivity including the node terminus ratio, marrow star volume, and trabecular pattern factor. On the basis of this evidence it was concluded that there is no difference in the trabecular architecture between patients with crush fracture and controls when account is taken of bone mass. This suggests that micro anatomical disruption is a predictable intrinsic feature of bone loss. However, there remains the possibility that the two-dimensional character of the structural deterioration measured indirectly is not sufficiently sensitive for the complex cancellous system.

In order to reduce anxiety, establish sedation, analgesia, and maintenance of cardiovascular stability, preanesthetic medication, usually, Benzodiazepines and Anticholinergics are administered before CABG Clonidine, a α2 adrenoceptore agonist, produces sedation, somnolence, anxiolysis and analgesic effects by influence on central adrenergic cardiovascular neurons. Prolongation of respiratory support and time to extubation are associated with applying long acting opioids. Therefore, we compared Clonidine, Lorazepam with Morphine, Lorazepam in terms of duration of respiratory support and time of extubation. This double blind randomized clinical trial study was done on two groups consisting of 20 candidates of elective CABG. Group A received Morphine sulfate 0.1 mg/kg IM+Lorazepam 1 mg p.o and Group B received Clonidine 0.2 mg p.o. + Lorazepam 1 mg p.o. At the time of arrival on the operating table, the patient's grade of sedation and consciousness, heart rate and mean arterial pressure were recorded. These parameters had no significant inter groups differences Two groups , were same as gender, weight and ASA class .Duration of respiratory support in ICU was 9.3±2.4 hour for Group A and 7.6±1.2 hour for Group B (p<0.05). Time of extubation in ICU was 10.06±2.4 hour for Group A and 8.29 ± 1.21 hour for Group B (p<0.05) A significant difference was observed. So we concluded that Clonidine instead of Morphine as premedidication in elective CABG reduces duration of respiratory support and time of extubation, during providing stable hemodynamic and adequate sedation. Therefore Clonidine can be an appropriate alternative to Morphine in these patients.

Hemangioma is the most common benign tumors of bone. The most common site of involvement is skull and spine .The long bones and short tubular bones are rarely involved.X- Ray reveals multinuclear lytic lesion.Hemangiomatosis (involvement of multiple bones) is rare and its treatment is Radiotherapy, but in solitary lesion surgical excision and bone graft is the choice treatment. Spontaneous healing also has been reported. We report a patient with bone hemangiomatosis and unusual pattern of involvement.