Journal of Mazandaran University of Medical Sciences
Year:2011 | Volume:20 | Issue:80|Papers Count:14

Background and purpose: Breast carcinoma is the most common malignant tumor leading to death among women. Risk of Metastasis of the tumor, as a major cause of death and disability in these patients is associated with factors such as number of involved lymph nodes, size of tumor, patient age and microscopic degree of the tumor. The aim of this study was to determine the E-cadherin manifestation in invasive ductal breast carcinoma associated with axillary lymph node metastases.Materials and methods: In this cross-sectional study, slides, blocks and files of 100 subjects with invasive ductal breast carcinoma whan underwent radical mastectomy were collected from the medical records at the Imam and Shafa Hospitals in Sari during 2001-2008. The slides were reviewed and re-graded. Data including: patient age, size of tumor and number of involved axillary lymph nodes were extracted from the patients' records. Slides were prepared from paraffin blocks to present normal or abnormal E-cadherin expression by immunohistochemical method. Data were recorded in Checklists and analyzed by SPSS software using descriptive analysis, Chi-Square and Fisher's exact tests.Results: The prevalence of abnormal markers expression in the samples was 39%. There was no statistically significant relationship between the expression of abnormal marker and metastatic axillary lymph nodes and size of tumor (P<0.05), but it was significant with the degree of histopathology of the tumor (P<0.05) and age of the patients (P<0.05), as abnormal expression was seen more in higher histopathologic grade and age below 35 years.Conclusion: Due to lack of correlation between E-cadherin expressions with metastasis of lymph nodes in invasive ductal breast carcinoma, assessment of other etiologic factors such as other adhesive markers like dysadherin and other clinicopathologic factors for lymph node metastases seems necessary.

Background and purpose: Macular edema is a common causes of visual imparity in diabetic patients. Several studies have been done to evaluate prevention methods and management strategies. This study was performed to determine whether serum lipids accelerates the creation of macular edema.Materials and methods: Blood serum lipids in 180 diabetic patients referred to eye clinic of Shahid Beheshti Hospital were evaluated. Data obtained from patients were classified in three groups: diabetic retinopathy without macular edema (group 1), patients with mild diabetic retinopathy with macular edema (group 2) and patients with diabetic retinopathy with macular edema and hard exudates (group 3). The data were analyzed by SPSS version 18 using ANOVA Tukey test. P.value less than 0.05 were considered significant.Results: Total cholesterol in groups 1, 2 and 3 were 402.53±95.202, 213.52±17.204 and 201.113±74.228, respectively (P>0.05). The mean HDL in groups 1, 2 and 3 were 586.15±25.44, 920.22±32.47 and 009.11±49.48, respectively. The mean VLDL in groups 1, 2 and 3 were 396.22±09.37, 238.20±85.36 and 127.15±51.33, respectively (P>0.05). The mean TG in groups 1, 2 and 3 were 911.227±74.212, 448.109±43.187 and 741.238±28.218, respectively (P>0.05). The mean LDL level in group 3 (132.33±53.75) was statistically higher than group 1 (113.39±38.48) and group 2 (113.08±42.08) (P<0.05).Conclusion: The results of this study showed that, serum LDL, the intensity of macular edema and hard exudates plaques, are associated.

Background and purpose: In assisted reproductive (ART) laboratory, during the experimental manipulation, oocytes and early embryos are exposed to day light or artificial light for variable periods. The purpose of this study was to assess the effect of fluorescent light exposure, with intensity almost equal to that produced by microscopes in ART laboratory, on mouse early embryo development.Materials and methods: The bicellular embryos were obtained from superovulated pregnant female NMRI mice 48 hours after HCG injection. After washing, the embryos were randomly allocated in HEPES buffered HTF medium into three experimental and one control group. Two hundred and fifteen (group B), 222 (group C) and 229 (group D) bicellular embryos were exposed to fluorescent light of 800 LX for 5, 10 and 30 minutes at 37oC, respectively. The embryos of control group (215, group A), and also other groups (B, C and D) were kept on a heat plate during the time of experiment and protected from the light by covering the dishes with aluminium foil. Expanding and hatching blastocyst rates were recorded after 72 and 96 hours of culture, respectively.Results: The results demonstrated that 61.6%, 52.5% and 65.1% of embryos in the experimental groups (group B, C, and D respectively) and 61% of embryos in the control group reached to blastocyst stage. There was no statistically significant difference between the experimental and the control groups. Also the hatching rates and degeneration rates showed no significant differences between the groups.Conclusion: The fluorescent light of 800 LX for a period of less than 30 minutes had no significant effect on mouse embryo development in vitro.

Background and purpose: Stress due to infertility cause marital dissatisfaction, low self steam and decreased intercourse frequency in couples. According to different studies on psychosocial problems in infertile couples, this study was carried out to determine the prevalence of depression, anxiety and marital satisfaction in 200 infertile women referred to the Infertility clinics in Sari (2008).Materials and methods: In this descriptive study, 200 infertile women were selected among patients referred to the Imam Khomeini Hospital and Saint Mary Infertility Clinics. Three questionnaires including Ketel anxiety, Beck depression and Enrich marital satisfaction questionnaire were used for data collection. All patients were provided with information about the aim and purpose of the study and a consent form was signed if they agreed to participate in the study. Chi-square test for qualitative variables and the t-test for quantitative variables were used for data analysis using SPSS software (version 16).Results: Of those 200 original subject, 124 (62%) suffered from various degrees of depression. Of these, 55 (27.5%) had mild depression, 51 (25.5%) moderate depression and 18 patients (9%) had severe depression. Also 101 of 200 patients (50.5%) had no anxiety, 38 (19%) had mild anxiety, 35 (17.5%) had moderate anxiety, 22 (11%) had severe anxiety and 4 cases (2%) had very severe anxiety. Of those patients participating in the study %27 had marital dissatisfaction. There was a significant relationship between marital satisfaction with severity of depression and anxiety. In patients with low level of severity of depression and anxiety, marital satisfaction was high (p<0.05).Conclusion: According to the results of this study, it seems that professional assistance from psychologists and clinical psychiatrists is useful in helping infertile patients to cope better with stress caused by infertility.

Background and purpose: Invasive aspergillosis (IA) is a serious opportunistic infection caused by various species of Aspergillus in immnucompromissed individuals. Basically, rapid and early diagnosis prevents IA progression. The purpose of this study was to quantify and optimize detection of Aspergillus fumigatus DNA in blood samples using Real Time PCR.Materials and methods: Five milliliter blood samples of healthy volunteers were spiked with various dilutions of conidial suspension of Aspergillus fumigatus (106 to 101). DNA was extracted from blood using glass beads and QI Amp DNA Blood Mini Kit. The primers and hybridization probes were designed to amplify the 18S rRNA genes using the Light Cycler system and Fluorescence Resonance Energy Transfer.Results: All PCR reactions were negative with other species of fungal DNA with 100% specificity. Melting curve analysis showed the species- specific melting temperature patterns on 69.14oC which helps differentiating Aspergillus fumigatus. The lower limit was determined 101 CFU (100 fg) or 10 conidia or cells per PCR reaction which indicates a high sensitivity.Conclusion: Real-time PCR method employing hybridization probes is a highly specific and sensitive approach to determine the fungal load for early diagnosis and monitoring treatment.

Background and purpose: Hard water causes many problems in domestic and industrial usage. There are various techniques for removal of water hardness each with its own special advantages and disadvantages. The purpose of this study was to compare Polyaluminum Silicate Chloride (PASIC) method and Electrocoagulation (EC) Process in removing hardness from drinking water.Materials and methods: This study was carried out in coagulant drinking water of Ghouchan (Northeast of Iran)during winter 2009 to spring 2010. Jar test was used to investigate the effects of the hardness, turbidity, pH, residual aluminum on EC and PASIC. The efficacy of each method was analyzed using Covariance and Regression analyses.Results: The results demonstrate that PASIC coagulation was capable of removing 75% of hardness and95% of turbidity at optimum concentration of 1-5 (mg/L) in raw water. The EC process was able to remove97% of hardness and 50% of turbidity. The maximum percentage of hardness was seen at 30 volt, residual time of 60 min and pH=6.5-7.5.Conclusion: It seems that both methods were efficient and cost-effective in removing hardness and turbidity from surface water and can be used in coagulant drinking water.

Background and purpose: Inflammation is a common feature in hemodialysis patients which is characterized by increasing in inflammatory biomarkers such as C - reactive protein (CRP). One of the main predictors of complications and mortality in Dialysis Patients is increased level of CRP. The aim of this study was to determine the effect of intravenous vitamin C on the level of CRP in hemodialysis patients.Materials and methods: In this double blind randomized clinical trial, 60 patients were allocated in two groups (intervention and control). At the end of each hemodialysis session, the intervention group received vitamin C (500mg/5cc) intravenously, three times a week for 8 weeks and the control group received normal saline in a same way. The level of CRP was compared in both groups before and after the intervention. Data were analyzed by Independent T test, Paired T test and Chi-square tests.Results: According to this study, plasma level of CRP was significantly decreased in the intervention group (p<0.05) but in the control group there was no significant difference statistically.Conclusion: The use of intravenous vitamin C supplement reduces CRP level in hemodialysis patients.

Background and purpose: The purpose of this study was to determine the frequency of psychiatric diagnoses assigned by different consultation providers and to assess the demographic characteristics of patients in a general hospital.Materials and methods: Six hundred patients, who received psychiatric consultation, were studied. In total 40992 patients were admitted for a period of two years from March 2008 to March 2009. In this study, psychiatric consultations were assessed by demographic characteristics of patients, different departments where consultations were requested and diagnoses made by chief psychiatric resident of the hospital supervised by psychiatric specialist fellowship. Emergency consultations were performed by an assistant psychiatric from Zare university hospital.Results: Of those 40992 admitted patients, 600 (295 men and 305 women) patients received psychiatric consultation. The frequency of referral rate and psychiatric consultation was 0.9%. The highest referral rate was related to the department of internal medicine (2.4%) and the lowest was from department of Gynecology and Urology (0.1%). Psychological assessment was the most common reason (55.7 percent) for psychiatric consultation. The most prevalent psychiatric diagnoses were Dlyryum frequency (16%) and major depressive disorder (15%), respectively.Conclusion: Considering the relatively high rate of psychiatric consultation in this hospital, it seems that more training programs is required for personnel and specialists to increase general awareness about psychiatric diseases and mental disorders.

Background and purpose: Echinococcosis in dog, due to infection with adult stages of the tape worm Echinococcus granulosus, poses significant economic and public health problems in endemic areas of Iran particularly in Northern provinces. The objective of this study was to compare the prevalence of E. granulosus parasites in stray dogs' population of Sari city, in two separate studies carried out in 1999 and 2007.Materials and methods: In two studies performed in 1999 and 2007, 80 stray dogs were collected by shooting from urban areas of Sari city, Northern Iran. They were necropsied and gastrointestinal tract was opened. Recovered parasites were collected and the taxonomic study was carried out by measuring different parts of the body of parasites.Results: In these two studies, 30 and 50 stray dogs were studied in these areas. The overall prevalence rate of E. granulosus in 1999 was 46.7% in 30 stray dogs. In the second study carried out in 2007 no E.granulosus egg or adult worm was found in stray dogs.Conclusion: The reduction of the prevalence of E. granulosus in stray dogs seems to be due to increase of health care in this area, especially construction of new industrial slaughterhouse.

Background and purpose: Nowadays, obesity is known as one of the factors that has a role in the quality of life. The purpose of this study was to determine the consumption pattern of food and obesity of female students at the Mazandaran University of Medical Sciences.Materials and methods: This cross-sectional and analytic study was carried out on 116 female students of Mazandaran University data of Medical Sciences. Subjects were selected with randoml systematic sampling and food frequency was collected with food frequency questionnaire (FFQ) by interviews. Data were analyzed with excel and SPSS software using ANOVA and T-Test.Results: In this study, the average weight and height of students were 60.4 kg and 160 cm, respectively. Based on body mass index (BMI), 21.1% of the subjects were at low weight, 51.7% were at normal range, 29.3% were over weight and 6.9% were obese. The ratio of waist- to- hip circumference demonstrated that 49.1% of students were suffering from abdominal obesity (WHR>0.8).Conclusion: Results demonstrated the prevalence of overweight and obesity as well as energy and carbohydrate intake in studied subjects is relatively high. Therefore, more attention and also resources should be allocated to educate students on proper dietary regimen.

Background and purpose: Although much has been written about the health status of adolescents, little qualitative research has been published on educational health needs of female adolescents. The purpose of this study was to describe the educational health needs of female adolescents.Materials and methods: In this qualitative study, 67 female adolescents between 12-18 years of age and 11 key informants participated expressed their experiences on educational health needs of female adolescents, using semi structured interviews. Participants were recruited based on purposeful sampling and with maximum variety from rural and urban area of Sari city. All tape-recorded data was fully transcribed and thematic analysis was done.Results: The findings of this research on the adolescents' health-information needs emphasized on two overarching themes including adjusting education according to the needs (includes two subcategories: preferred content and method of delivery) and public participation in education (includes two subcategories: promotion of mass media performance and social networks participation in education).Each category consisted of some subcategories which were explained with experiences of participants.Conclusion: The results show that promotion of female adolescents' knowledge on reproductive health and life skills are the most important health-information needs.

Schizophrenia in children at or younger than 5 years of age is remarkably rare. Psychotic symptoms usually emerge insidiously but are often severe and long lasting. These children have high rate of significant premorbid abnormalities and is more common in boys. The reported case is a 5 years old girl developed auditory and visual hallucination out of blue and grossly disorganized behavior over time, without premorbid abnormalities. The child was diagnosed with very early onset schizophrenia (VEOS) based on multilinated surveys. The patient responded well to risperidone. Acute onset VEOS especially without premorbid abnormalities is extremely rare, complete clinical and paraclinical surveys should be done to exclude other similar disorders.