Research in Medicine
Year:2004 | Volume:28 | Issue:2|Papers Count:15

Background: Breast cancer is the most common female malignancy and the main cause of death in mid-aged women. Genetic germline mutations in BRCA1/BRCA2 in Iranian women with breast or ovarian cancer have not been yet reported.Materials and methods: Clinical data, family history and blood samples were obtained from 83 females aged less than 45 years with primary breast cancer in order to survey genetic mutations in BRCA1/BRCA2. Exon 11 of BRCA1 and exons 10 and 11 of BRCA2 were analyzed by Protein Truncation Test (PTT), however, exons 2,3,5,13, and 20 of BRCA1 and 9,17,18, and 23 of BRCA2 were analyzed using Single-Strand Conformation Polymorphism (SSCP) technique.Results: We have found 10 genetic mutations for the first time among Iranian females with breast cancer. Of these, 5 were frame shift (4 were found for the first time), 3 were missense (with unknown influence on breast cancer), and 2 were polymorphism (one was common among Iranian and British subjects).Conclusion: Our findings reveal that each country must have a specific data bank of its own genetic mutations for breast cancer, based on which, screening planning may run. Epidemiologically, early breast cancer (before 45 years) and family history of breast cancer are quite adequate to run a screening program; however, sporadic breast cancer (with 5% probability of recognizing genetic mutation) is not cost effective.

Background: Supraventricular tachyanythmias (SVT), especially atrial fibrillation, are among the most prevalent arrhythmias. Atrial fibrillation could be found in patients with hyperthyroidism. The role of thyroid disorders in other supraventricular tachyarrythmias is not clear. Thus, this survey was designed to determine the relationship between serum TSH as the marker of thyroid function and supraventricular tachyanythmias in Shaheed Beheshti hospital in Zanjan.Materials and methods: This case-control study was conducted on 100patients with SVT including: atrial fibrillation, flutter, PSVT, MAT and atrial tachycardia, and 100 normal age and sex-matched controls. Serum TSH was measured by immunoradiometric assay and if revealed to be abnormal serum free T4 and free T3 were also measured by radioimmunoassay in the same laboratory centre. Data were analyzed by t-test and Chi-square test and odds ratios were calculated.Results: TSH abnormality was detected in 18% of patients and 7% of controls (p<0.05). Overt hyperthyroidism was detected in 9% of cases and 1% of controls (p<0.01). Differences between two groups for hypothyroidism and subclinical forms of thyroid dysfunctions were not statistically significant. Odd's ration for hypothyroidism in patients with AF was 2.6 and for hyperthyroidism in AF was 11. Odd's ratio for hyperthyroidism in PAVT was 8.5, but this ratio was not significant in general population. Conclusion: TSH abnonnality is more prevalent in SVT. In case of lack of suggestive symptoms or signs of thyroid dysfunction, we recommend thyroid function tests only for patients with AF. For patients with PSVT further studies with greater sample size are recommended.

Background: Injuries such as osteoarthritis may impair knee joint properioception that could result in further knee joint injuries. Different exercises are attempted to recover this sense so that favorable movement and stability can be achieved in different static and dynamic situations. Prior investigators have recommended a combination of closed chain and balance exercise for the affected individuals, however, the exact course of treatment have not been yet clarified. The present study was conducted to compare 3 different exercise techniques (closed chain, opened chain and balance) on properioception error of knee joint in healthy females.Materials and methods: For this quasi-experimental study, 26 healthy female students of Shaheed Beheshti University of Medical Sciences were selected. Subjects were randomly assigned in 3 groups. The first group (9 subjects) had exercise on balance board, the second group (9 subjects) had closed chain exercise for knee joint and the last group (8 subjects) had opened chain exercise. Evaluation was achieved before, during, and after the exercise. A goniometer was used for properioception error measurement.Results: Following 10 exercise sessions, properioception error was significantly reduced in the first group, thus, balance exercise could improve knee joint position sense; however, the other 2 techniques failed to show any significant reduction. Those who have greater error before the exercise have shown better outcome following the therapy.Conclusion: Balance exercise can be considered as an effective technique for repositioning of knee joint.

Background: Several epidemiologic studies indicate that some paternal occupations are associated with an increased risk of birth defects in offspring. Possible associations between paternal exposures and cardiovascular malformations were evaluated in previous studies.Material and methods: The case-control study was performed during an academic year between October 1999and 2000. All children with the diagnosis of atrial septal defect (ASD) were included in the study. The control group was selected through sex- and age- matched controls and paternal occupations were evaluated among both groups. The effect of exposure to special substances on induction of ASD in children were studied.Results: During one year, a total of 60 children (27 boys and 33 girls) aged 6 months to 16 years (mean 6.7 years) were admitted with the diagnosis of ASD at pediatric ward. Mothers age was between 15-38 years and fathers age was 18-58 years. The study showed that in the case group 43.3% (26 of 60) had fathers with occupations having exposed to different materials (painting colors, lead, copper, rubber, and welding material); however, in the control group only 5 patients (8.3%) had fathers with the same condition (OR = 11.9, CI= 95%: 4.2-33.9).Conclusion: The study showed that off springs of fathers who have been exposed to materials such as paint, metals, rubber, etc during the six-month period prior to the maternal pregnancy are at an increased risk of ASD.

Background: The patient-physician relationship is one of the most important cues in medial practice. How a physician dresses and how she/he addresses the patients are two important factors in developing rapport. This study was conducted to determine patients preference for the style of the psychiatrists dressing and addressing.Materials and methods: This descriptive study was performed at the psychiatric clinics of a general hospital. The patients who were intended to take part in the study were selected and their demographicdata disorder type and disorder duration were recorded. Photos demonstrating 8 different styles of dressing (four for female physicians and four for male, based on Iranian culture) were shown to the patients and they were asked to select their desired style, meanwhile, they were requested to nominatethe way they preferred to be addressed.Results: The study population included 57 females and 53 males with the mean age of 30±10.5 years. Results revealed that white coat was the most popular for both male and female psychiatrists (41.8 and 40.9 percent, respectively, p<0.01).Conclusion: The psychiatrists style of dressing is important for psychiatric patients though it is not being paid much attention at psychiatric wards. It seems that paying further attention to this aspect will improve patient-physician relationship.

Background: Nausea and vomiting during pregnancy is quite a common complaint with known side effects. Prior investigators have reported the efficacy of ginger in this regard, thus, the present study was conducted to determine the effects of ginger in nausea and vomiting of pregnancy.Materials and methods: For this clinical trial 67 consecutive parturients who had nausea and vomiting were selected. Cases were similar according to the age, gestational age, parity, occupational status, and educational level. Having matched them according to the complaint severity and gestational age, they were assigned randomly in 2 groups (32 as cases and 35 as controls). Cases received ginger 250 mg/qid for 4 days, however, controls received placebo with the same regimen. Effects of ginger was evaluated twice a day for 4 days.Results: The mean age of the cases and controls was 24.1±4.8 and 23.3±5 years, respectively. The mean gestational age was 13±3 weeks, and the mean parity was 1.6±0.8.Cases have shown better response to the regimen (85% vs. 56%, p<0.05).Conclusion: Ginger could improve the severity of nausea and vomiting during pregnancy.

Background: Chronic renal failure requires intensive medical care such as dialysis and kidney transplantation. These interventions may result in different socio-psychological problems. The present study was conducted to compare these complications before and after the transplantation.Materials and methods: 75 patients who had been hospitalized in Taleghani and Shaheed Hasheminejad hospitals in Tehran in 1998 were evaluated. Finally, 54 patients who have undergone operation were selected. Demographic data, GHQ-28 questionnaire (to assess general health), revised from of SCL-90 (to assess anxiety and depression) and PDAS-II (to assess psychiatric disability) were completed before and after the operation.Results: Depression and anxiety did alter significantly. The mean depression was 8.25±8.10, and 7.09±7.11 before and after the operation (p<0.05), however, the mean anxiety was 6.06±6.19 and 5.00±4.987 before and after the operation (p<0.05). Kidney transplantation did not alter the psychiatric disability and also general health status.Conclusion: Results have revealed that dialysis-related psychological disorder (anxiety and depression) may decrease as the dialysis terminate, however, this alteration was not that significant to change subjects life style, at least during the study period).

Background: Mental disorders may interfere, aggravate or mimic medical conditions.Treatment of such disorders may improve the course of theunderlying disease and promote patients quality of life. This study was carried out to evaluate the characteristics of psychiatric referrals during one year (2002), in Taleghani hospital.Materials and methods: The study was performed by weekly analysis of all psychiatric consultations. Initial data including sex, age, referral ward, underlying disease, and cause of psychiatric consultation were gathered.Results: A total of 201 consecutive patients (1.6% of all admitted subjects to the hospital) referred for consultation. They were mainly referred from the Endocrinology (15%), CCU (13.6%), and Cardiology (12.6%) wards. The most frequent reasons of referral were: current psychiatric symptom (55%), presence of psychiatric history (15%), and aggression (10%).Main diagnosis turned out to be depression (36%), adjustment disorder (16.5%) and delirium (15%).Conclusion: These results highlight the role and functioning of consultation in a general hospital, but further studies are required to evaluate the importance of such a service to improve patient care and psychiatric education in various medical wards.

In this paper, we report a rare case who is a twenty-six years old woman with extramedullary organ involvement of multiple myeloma. The initiation of disease was solitary plasmacytoma in the second vertebra of the lumbar spine that received radical radiotherapy and then she underwent chemotherapy for one year with the diagnosis of multiple myeloma after expanding lesion to the bones and adjacent soft tissue, the bone lesions received palliative radiation because of threatened fracture. About there months later she found out multiple masses in her both breasts. The report of fine needle aspiration (FNA) was involvement of both breasts by multiple myeloma then she underwent palliative radiation to the breasts.Involvement of the breast by extramammary neoplasm is rare. Clinically and radiologically, secondary neoplastic masses may mimic primary benign and malignant neoplasm of the breast. A correct pathologic diagnosis of the breast mass is of considerable importance since the treatment of the primary and secondary malignancies of the breast is different. FNA is an invaluable method in differentiation of these two entities.

Biliary sludge or pseudolithiasis has been reported in patients who have received prolonged and/high doses of ceftriaxone. These are usually asymptomatic, but true bililary lithiasis is also rare. In general these adverse effects (sludge and pseudolithiasis) may develop even after seven to ten days of treatment that are usually asymptomatic. We report a six half-year old girl that was admitted to the hospital due to urinary tract infection. She had been treated with ceftriaxone for 14 days. She developed biliary colic due to biliary lithiasis after 14-day treatment. Ultrasonograghy has reported high level echo with posterior shadow in gal1bladder (true biliary stone). We recommend patients on prolonged and high doses of ceftriaxone and also those developing biliary colic should be considered for liver and gallbladder ultrasound and changes in antibiotic treatment if necessary.