Journal of Medical Council of Iran
Year:2010 | Volume:28 | Issue:3|Papers Count:12

Background: Better understanding of etiology, risk factors and symptomatology of osteoporosis can have a great impact on self care and preventive behavior. This is also true for nurses. This knowledge not only affects their lives but also have a positive impact on their job.Methods: In this study 389 randomly selected nurses completed a questionnaire with 37 questions about knowledge of osteoporosis, including questions on epidemiology, risk factors, symptomatology, and nutritional aspects of the disease. Questionnaire also included basic personal information and questions about dairy intake, exercise and smoking. Completion of the questionnaire was in a semi supervised manner. SPSS 16, soft ware was used for data analysis.Results: Eighty seven percent were female and 46% were married.Median age was 33 years (SD: 7.6) and median knowledge score was 21.7 through 37 maximum probable score. Misconception on symptomatology of osteoporosis was observed in 84% of the responders.The only significantly positive correlation for knowledge Score was higher degrees of education. Dairy intake was adequate in only 45.6% and it had also negative correlation with family crowding.Regular exercise was reported by only 38.7%. There was no correlation between adequate dairy intake and regular physical activity with knowledge score of responders.Conclusion: In comparison to other studies knowledge about osteoporosis is relatively good among nurses, but it is not enough.Dairy intake and regular physical activity were inadequate and these factors need more attention.

Background: Recently obesity in pediatric population is rising fast and its early onset complications (like those seen in adults) are keeping pace with it. It seems that a high level of urinary uric acid (UUA) could be the result of overproduction of uric acid in the body. On the other hand, it was shown to be the result of decreased urinary clearance of uric acid in some obese adults.Target of study is the mechanism of hyperuricemia in obese children and also the correlation between hyperuricemia and factors related to the obesity.Methods: We studied 75 severely obese children (42 boys and 33 girls) and compared them with 30 non-obese children (20 boys and 10 girls). Serum leptin, lipid profile, liver tranaminases, uric acid and creatinine and also 24 hours urinary uric acid and creatinine were measured, and uric acid clearance was calculated in each case.Results: Serum uric acid level (U.A) in obese children were significantly higher than those in control children, but urinary uric acid (UUA), uric acid clearance (CUA) and fractional excretion of uric acid (FEUA=CUA/CCR*100) were lower in the obese children than those in controls. The low UUA in the obese children suggests that their hyperuricemia was not the result of over intake of food containing uric acid. There was a close correlation between uric acid and age/body weight and it becomes closer as they aged and gained weight.Conclusion: These results suggest that hyperuricemia in obese children is mainly attributable to impaired renal clearance of uric acid and not to overproduction in the body and it will higher age and body weight.

Background: Resistance to beta-lactam antibiotics along with clinical isolates is frequently resulting production of b-lactamase enzymes. In recent years, the production of extended spectrum b-lactamases (ESBLs) and AmpC b-lactamase among clinical isolate especially Escherichia coli is greatly increased. On the other hand, beta lactamase genes have several subfamilies, and designing universal primers could be valuable to detect all of them. Therefore, the aim of this study was to survey prevalence of phenotypic ESBLs and detection of SHV and AmpC (CITM, FOX) –type b-lactamase genes by using universal primers through PCR.Methods: A total of 500 clinical samples were collected from hospitals of Tehran and 200 E.coli isolates were detected by standard biochemical tests. Subsequently, these isolates were screened for b-lactamase production by Disk diffusion method and combined disk. Resistant isolates were evaluated for molecular assessing of SHV, CITM and FOX genes by using PCR.Results: Among entire of 200 E.coli, 128 (64%) isolates were selected via phenotypic tests for detection of bla-SHV and bla-AmpC (CITM, FOX) genes via PCR. With 95% confidence, 7 (5.5%) and 13 (10.2%) E.coli harbor bla-SHV and bla-CITM, respectively. Fox gene was not detected in any samples.Conclusion: Results were showed that complete detection of b-lactamase enzymes is essential for resistant control and the appropriate prescription of b-lactam drugs. So using molecular assay with phenotypic test is important.

Background: Hepatitis C virus (HCV) infection has been identified as the major cause of chronic liver disease among patients on chronic haemodialysis (HD).The aim of this study was to identify the HCV genotypes among chronic HD who were HCV positive in Guilan province in North of Iran.Methods: All the patients on HD from eleven Guilan HD centers were enrolled; their sera were screened for anti HCV antibodies by enzyme-linked-immunosorbent assay (ELISA) and polymerase chain reaction (PCR) and genotyping was performed in positive anti HCV cases. SPSS 14 was used for analysis and P< 0.05 were considered statistically significant.Results: Out of 514 enrolled patients, 61 (11.9%) were serologically HCV positive and 32 (6.2%) had positive HCV RNA [CI 95%: (9.07-14.67)]. The most frequent genotypes were 1a and 3a with prevalence of 59.38% [CI 95%: (42.36-76.4)] and 40.62% [CI 95%: (23.61-57.65)], respectively. There was no significant relation between virus genotypes and gender or age. An important finding was the high prevalence of genotype 3a (64.7%) in Rasht, the capital city of the province. (P£0.05) Conclusion: HCV genotype pattern among HD patients in Guilan province is like non-Arab countries of Middle East; where genotype 1 is predominate.

Background: Proprioceptive information that is prepared with brace is needed for balance. The purpose of this study is determining the effect of soft ankle support on static and dynamic balance tests in elderly.Methods: In this random clinical trial study we evaluate 22 older adult in two groups (case and control). Static balance is evaluated with double leg standing, tandem standing and single leg standing that is executed in three different situations (on firm surface with open eye, on firm surface with closed eye and on soft surface with closed eye) Dynamic balance is evaluated with 5 repetitive chair standing, timed walking (twice), functional reach (with open and closed eye) and four square stepping test. ANOVA Repetitive measure test is used for comparing case and control performance.Results: Findings don’t show any difference between different stage of evaluation before and after bracing in static and dynamic balance tests in case and control groups. (All P value more than 0.05) Only four square step test have better performance in case group (P=0.017) Conclusion: As we know joint supporter enhance joint proprioception in non weight bearing position but this information is less than enhancing balance performance (in weight bearing positions). Furthermore we haven’t any limitation because of balance treat for prescription of supporter for other goals.

Background: Hypertension is a common and asymptomatic disease that is easily treatable. If left untreated hypertension will lead to serious complication. Social and genetic and even dietary factors are involved in etiology of hypertension. These factors are different in different populations.Methods: This study was done in Arak province in 2004. cut of point for systolic blood pressure was over 140 mmHg and for Diastolic blood pressure was more than 90 mmHg. Sample size was 1000 cases. this study was a case- control one. a Clinical and anthropometric findings was recorded. Descriptive and Logistic regression analysis was done using SPSS software.Results: 313 Cases with hypertnsion and 765 normal persons in control group were compared to eachother. Risk factors were: Lower level of education (P<0.0001), obesity (P<0.003), short stature (P<0.001), poor relationship with parents (P<0.001), death of first degree family member (P<0.001), Aortic diastolic mumur (P<0.05) and family dissatisfaction (P<0.04).Conclusion: With Knowing these risk factors, we can establish programs in Media to improve population awareness and knowledge about Hypertension.

Nowadays by the new methods of the surgery and by decreasing it's complications more patients could be candidate for surgery but one of the existing complications that the surgeons should know it as much as possible is post operation bleeding. They should try to gain enough knowledge in order to be able to screen the high risk patient and prevent postoperative bleeding. By all these preventions if patient had bleeding during the surgery and after that, surgeons should know how to control it and choose the best way to have less complications and more effective treatments.

Mitochondria are ubiquitous in eukaryotes and are essential for survival. Their primary function is to support aerobic respiration and to provide energy substrates for intracellular metabolic pathways. Given its fundamental role in the human body, defects of mitochondrial function can have disastrous consequences.Human mitochondrial diseases encompass mutations of mtDNA and nuclear DNA. This review aims to provide an update on the involvement of mitochondrial DNA in human disease, its inheritance pattern and relationship between genotype and phenotype in mitochondrial diseases. Improved understanding of mtDNA inheritance and mutation penetrance patterns, offer significant prospects for more accurate genetic counselling and effective future therapies.

Introduction: Tonsillectomy is the most commonly performed operation in the field of Otorhinolaryngology. The most important complications of tonsillectomy include bleeding, damage to the surrounding structures, aspiration of blood, infection, and lung edema or abscess. We report a case of lingual artery aneurysm as a rare complication of tonsillectomy.Case Report: The patient is a 6 years old boy who presented to Taleghani Hospital Out-Patient Department, Tehran, with a painful swelling of the left neck and jaw since one month. There was a history of tonsillectomy 40 days back (10 days before the swelling began). On examination, we found a 6 times 6 cm mass involving the left submandibular area with some extension into the mandible.The patient was diagnosed provisionally as deep neck infection and was put on broad-spectrum antibiotics. Emergency angiography of the carotid artery and its branches showed no abnormalities. The mass, finally, was aspirated using a No.25 needle, and blood was collected. The patient was shifted to the operating theatre and the pseudoaneurysm of the lingual artery was confirmed.Discussion: Pseudoaneurysm of the lingual artery is a very rare complication of tonsillectomy, and is secondary to intra-operative trauma or post-operative infection. Lingual artery aneurysm usually presents with a painful neck swelling, massive bleeding from the tonsil bed or a unilateral palatine mass. It can be easily mistaken with a peritonsillar or parapharyngeal abscess. It is sometimes difficult to diagnose it using angiography, the reason of which is the course of the lingual artery as well as its anatomical loop around the superior constrictor muscle. Early diagnosis is of utmost importance in the management of the lingual artery pseudoaneurysm.