JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2009 | Volume:19 | Issue:69|Papers Count:15

Background and purpose: Several studies have been carried out on re-cut and de-stained sections regarding prostate biopsies and cytologic specimens of squamous cell carcinoma. However, few studies on lung biopsy are done. Due to small size of lung biopsies and for the prevention of lung rebiopsy, in this study P63 staining intensity between re-cut and de-stained slides of patients, specimens with lung cancer is researched.Materials and methods: This cross section study was performed on 100 patient specimens with lung cancer. We compared p63 staining intensity between re-cut and de-stained sections in lung cancer through 2 month intervals, until the 10th. Month after lung biopsy by immuno-histochemistry methods. Chi-square test was used for comparing the differences and p<0.05 was considered statistically significant.Results: Technical tissue fall in the slide was not seen. 93.93 % of SCC was stained by p63. None of small cell carcinoma was stained by p63. In the first 2 months, 53.34% of de-stained sections had similar staining intensity, compared with re-cut sections, and 46.66% were decreased in staining intensity and none of them were negative. During 2 to 10 months of storing, 38.98% of de-stained sections had similar staining intensity, 45 (77%) were decreased in staining intensity, while 15.25% were negative.Conclusion: With respect to results of this study and other studies, staining of p63 on re-cut and de-stained sections of lung cancer specimens in the first two months can be helpful. However, in the specimens which were stored for more than 2 months, we found no significant results.

Background and purpose: Pruritus is one of the common problems in hemodialysis patients with end stage renal disease. Approximately, 60% of these patients suffer from this condition. There are several causes for pruritus, thus, various treatments are applied in order to control it. The aim of this study was to evaluate the therapeutic effect of capsaicin on pruritus, compared with placebo, in hemodialysis patients.Materials and methods: This randomized double blind cross over clinical trial study, was performed on 34 hemodialysis patients with uremic pruritus in 1386. All patients were divided in two groups. One group received Caspian 0.03%, while the other, placebo for four weeks. Treatment was stopped for two weeks and continued as cross over technique. Pruritus scores were analyzed with Paired t-test and Repeated measurement ANOVA.Results: In this study, the difference between Mean of pruritus score before capsian treatment and in weeks following 1 to 4 was statistically significant (P=0.0001). In placebo group, the difference between pruritus score before treatment and in weeks 1 to 4 was statistically significant (P=0.0001). There was no significant difference before treatment in two groups, however, after each week, the difference was significant (P=0.0001). Repeated measurement test showed that reduction in pruritus severity in capsian group was more than placebo group, during treatment period (P=0.0001).Conclusion: Although our study indicated the appropriate effects of Capsian in pruritus, the placebo also has a good effect in controlling hemodialysis related pruritus. Our placebo had emollient property; therefore, we can apply it to control the pruritus in these patients.

Background and purpose: Early and accurate diagnosis of bacterial meningitis is critical concern. Optimum and rapid laboratory facilities are not routinely available for detecting the etiologic agents of meningitis. The objective of this study was the comparison of polymerase chain reaction (PCR) assay with culture, for the detection of bacteria in CSF samples from patients suspected of meningitis in Hospitals of Qazvin.Materials and methods: 100 CSF samples were obtained and divided in two parts. One part of samples was used for standard bacterial culture and gram staining. The remaining was used for DNA extraction. A PCR assay was performed with universal primers for 16S rDNA gene of bacteria. Performance characteristics of the test were determined.Results: The PCR method was able to detect bacteria in 36 cultures (..) positive and in 38 of 64 cultures were negative cases, showing sensitivity, Specificity of 100% and 40.6% respectively. Positive predictive value (PPV) was 48.6% and its negative predictive value (NPV) was 100%, however, Kappa coefficient showed the correlation of 2 methods to be at 0.33.Conclusion: There are advantages and disadvantages in performance characteristics of the conventional CSF culture and universal CSF 16S rDNA PCR. Therefore, it is recommended to use both methods in clinical practices, particularly in suspicious contaminated samples, with presumable presence of fastidious or slow growing bacteria and antibiotic consumption.

Background and purpose: Malassezia, a yeast-like fungus found in normal skin flora is known to be associated with various skin diseases, along with systemic infections. Our aim was to determine the in -vitro susceptibility of Malassezia spp. to ketoconazole and fluconazole.Materials and methods: In this study, we identified 99 Malassezia isolates from patients with pityriasis vesicular by morphological and biochemical criteria. In vitro susceptibility testing was in macro-broth dilutions, conducted based on the National Committee for Clinical Laboratory Standards (NCCLS) M27-A proposed standard. The results were analyzed statistically by Mann-Whitney.Results: The Malassezia isolates were identified as M. globosa (42), M. furfur (39), M. obtusa (10), M. sympodialis (6), and M.slooffiae (2). The rate of MFC of ketoconazole against Malassezia spp. was 0.06-2 mg/ml, while the MFC of fluconazole against Malassezia spp. was 2-64 mg/ml. The minimal inhibitory concentration (MIC90) of ketoconazole against Malassezia spp. was 0.03-1 mg/ml, while the minimal inhibitory concentration (MIC90) of fluconazole against Malassezia spp. was 0.5-32 mg/ml.Conclusion: Although fluconazole can be an effective treatment option for pityriasis versicolor, in our study, fluconazole MICs were higher than ketoclonazole.

Background and purpose: Ultra sonography is the method of choice in pre-natal diagnosis of fetal anomalies; however, sonography has limitations in oligohydramnios, maternal obesity and complex fetal anomalies. MRI, is a method with high contrast resolution, large FOV for fetus, placenta and uterine, along with multiplanar images. The aim of our study is to compare the sonographic and MRI findings in fetal anomalies by two radiologists who perform MRI test to show additional data relative to sonograpgy.Materials and methods: This research was a case series study and performed in Imam Khomeini Hospital in Sari in year 84-86. All pregnant women with gestational age of more than 20 years were evaluated with sono-graphically for fetal anomalies by one radiologist. Additionally, patients with abnormal fetuses were evaluated with MRI testing and the MRI films were examined again after birth. The sonographic and MRI findings were matched together.Results: The fetal anomalies in this study include: CNS abnormalities 47%, urinary tract abnormalities 39% and gastrointestinal abnormalities 14%.Conclusion: The sonography and MRI findings were similar in 60.8% of cases studied; sonographic findings were more than MRI in 8.6% of cases.  MRI findings showed more than sonography in 30.4% of cases presented. Thus, MRI has a complimentary role in pre-natal diagnosis of fetal anomalies.

Background and purpose: Termination of pregnancy in fetus with severe anomaly is legal in Iran. This study was done in order to compare the rate of effectiveness and complications of intra-amniotic PG and oxytocin, with rising induction in patient candidates for second trimester abortion, at Fatemieh Hospital, in Hamadan.Materials and methods: In a randomized clinical trial study, 40 pregnant women in their second trimester with fetal CNS anomalies, were divided into two groups (N=20). In the first group, one PG E2 Amp was injected intra-amniotic at first and then, 20 IU oxytocin was infused in 500 ml serum ringer for each patient. The infusion rate was increased up to induced effective concentrations every 15 to 30 minutes. In the second group, 50 IU oxytocin was infused with 1000 ml serum ringer and thereafter, an- other infusion of 50 IU oxytocin was added into the remaining 500 ml of serum. The rate of infusion was regulated on the basis of induced effective concentrations. Finally, both groups were compared for labor duration and probable side effects.Results: The rate of success in both groups was 100%. The mean duration of labor was 19.75±5.9 hours and 30.2±6.49 hours in the group with intra-amniotic PG with oxytocin and rising induction group, respectively. This difference was statistically significant (P<0.00). Diarrhea was seen in only one case with intra-amniotic PG injection. Differences between the frequencies of side effects in both groups were not statistically significant.Conclusion: This study showed that the mean duration of laboring intra-amniotic PG with oxytocin method, is less than of rising induction method.

Background and purpose: Diabetes type 1 is a chronic disease in children during their childhood, which may have unfavorable effects on children, family and society. By enhancing self- care in children having diabetes type 1, we can reduce these effects. Self- care in children also can be affected by factors such as family reaction. The purpose of this research is to determine the relationship between self-care in diabetic children and their family’s reaction.Materials and methods: This research is a non- experimental and correlative study which determines and specifies the relationship between diabetic self- care in children, who are affected by diabetes and their family’s reaction. 133 children between the ages of seven to fourteen suffering from diabetes type 1 were chosen with above continuous method for two months from selected centers. Collecting information, observation and questionnaire forms were used.Results: The results obtained from this study, showed there is a meaningful relationship between child's self- care and reaction of their family (p=0.000). Variants such as age, sex, rank of birth and length of disease period are not considered as an interfering element in relation between self caring and family reaction.Conclusion: The results from this research reveal that the self caring of children in an average level has a direct influence and relationship with family reaction and at the same time, the direct and strong correlation with the diabetic child’s knowledge regarding their functions and performances. We suggest that educational programs should be provided for these children and their families, in order to promote self caring of children and their family’s reaction. We also propose conducting similar research, by using case- control method, to identify other factors in this regard.

Background and purpose: Noise is one of the most harmful factors in the environment. It is also one of the harsh phenomenons in this century that people are exposed to. Exposure to noise higher than threshold limit value could cause some physical and mental disorders. High traffic flow due to recent increase in number of vehicles causes higher noise pollution. There are few studies regarding the evaluation of noise pollution in the environment in some Iranian cities. Thus, it is necessary to measure sound pressure level and other related parameters for noise pollution control. Identification of the effective factors on noise pollution is the best approach for promotion of individual, as well as, public health and safety. The aim of this study is to evaluate the noise level in the city of Sari.Materials and methods: There exist various methods for calculating the equivalent noise level regarding to noise measurement period. The most ordinary method is DL (day average sound level), that takes 15 hours of sampling (7 am- 10 pm), based on regulations that was approved by the National Environmental Protection Association in year 2003. This method was used for evaluation of noise level in this study. In the first stage, sampling locations were selected, followed by measuring sound levels at the height of one’s hearing zone (1.6 m above the ground surface). A calibrated sound level meter (Model Cell-490, Casella CEL, England) was used for all measurements. The SPSS software V.15 was used to perform T-test analysis.Results: The results showed that the mean (SD) DL was 75.52± (4.41) dB. The minimum and maximum sound pressure levels during the sampling period were 47 dB and 121.5 dB respectively. Due to the measurement of various circumstances, some times, and also, sampling locations, measure sound pressure level was high.Conclusion: The mean sound level during the daytime period was higher than the national standard levels. Therefore, environmental noise control is the best approach for the prevention of noise related to adverse health effects.

Background and purpose: The increasing effect of liquisolid systems on dissolution behavior of poor soluble drugs has been proved. In this research, the effect of glycerin, as a nonvolatile solvent, on release profile of indomethacin was evaluated.Materials and methods: The Avicel as carrier and silica as coating powder material in 20: 1 ratio were used. Indomethacin was dispersed in glycerin with different ratios. The binary mixtures of Avicel and silica were added to the mixture containing the drug and glycerin under continuous mixing. Starch as disintegrate was mixed with all formulations for a period of 10 minutes. After preparing several formulations, the release profiles were evaluated. To evaluate any interaction between indomethacin and the other components in liquisolid formulations, the differential scanning calorimeter (DSC) was used.Results: The results showed that liquisolid formulations exhibited significantly higher drug dissolution rates in comparison with directly compressed tablet. The enhanced rate of indomethacin dissolution from liquisolid tablets was probably due to an increase in wetting properties and surface area of drug particles available for dissolution. Also, it has been shown that the fraction of molecularly dispersed drug (FM) in the liquid medication of liquisolid systems was directly proportional to their indomethacin dissolution rate (DR). An attempt was made to correlate the percentage drug dissolved in 10-minutes with the solubility of indomethacin in glycerin.Conclusion: The liquisolid compacts technique can be a promising alternative for the formulation of water insoluble drugs, such as indomethacin into rapid release tablets.

Background and purpose: Quality of data in patient record is not a new issue. Data quality requires many details, which in this article we analyzed for validity of consent. This is a patients right and hospitals must pay attention to it, prior to providing their services.Materials and methods: This is a descriptive chart review research. Variables are age, sex, type of admission, degree of understanding, general condition at time of admission, and the person who signed the consent for chart, using medical information, validity of consent and education of admission clerk. This was a pilot study within each hospital, according to the number of clerks, thus, 30 records were reviewed. Validity of consent confirmed with comparison of consents with the standards. Data was analyzed with SPSS software, X2 statistics were used for determining the relation between variables and P<0.05 was significant.Results: Results showed that of the 540 records which were reviewed, 266 (49.4%) of the patients were males and remaining were females. Range of age was from 1 day to 89 years of age. Type of admission for 258 (47.8%) was emergency and the others were admitted electively. Degree of conscious for 477 (88.5%) were awake and 442 (82%) were in good general condition. The 403 (74.6%) consent for care were not valid and 125 (23.1%) of the consent for using data of medical records in research was also not valid.Conclusion: The results of this research indicated that most consent is not reliable. Every effort must be made to ensure the development of consent validity.

Background and purpose: Presently, computers and the development of information technology have resolved many limitations in the health and medical arena, and have also opened many doors to improve communication, information and ability for better patient care, in health and medical care provider centers. Moreover, they have many applications such as virtual reality, medical data-bank, tele-health, expert systems and information-networks. The purpose of this study was to evaluate reporting software of ADS9 counteri’s program.Materials and methods: This research is a descriptive study which was performed in 2008. Population of this study include employees in office of statistics of Medical Universities in Iran, that work in conjunction with Hospimp software and is answerable regarding Hospimp software in the Ministry of Health and Medical Education. For data collection, researcher used a two-part questionnaire for evaluating general and specified criteria pertaining to the software. The analysis of data was used in descriptive manner with SPSS. The grade of variables studied in this research involved: evaluation of general properties, specified properties, statistical reporting, data-bases, goal of groups and aim of the program with Hospimp software, that is, in average 37.5, 22.58, 41.66, 57.14, 36.36 and 27.27, with a standard deviations of 0.09, 0.08, 0.15, 0.2, 0.15 and 0.14.Results: Technical tissue fall in the slide was not observed. 93.93 % of SCC was stained by p63. None of the small cell carcinoma was stained by p63. In the first 2 months, 53.34% of distained section’s had similar staining intensity, compared with re-cut sections, 46.66% of cases were decreased in staining intensity and none were negative.Conclusion: Generally, in the evaluated dimensions, Hospimp software has more blind spots rather than strength spots. General properties of the software have a better intensity level, than its specified properties. In order to improve and develop useable software’s in the health and medical arenas, we will recommend the development of international standards in designing, production, testing, measuring and software conservation.

Background and purpose: Lack of spirituality, remoteness of real purpose and a defeat versus cultural offense, is one of the many anxieties that families and compassionates, along with society and educators encounter. Without any doubt, knowledge of the Quran and positive attitude, are reasons for promotion of spirituality, recognizing and reaching the real goal of creation and protection against cultural offense. The aim of this research is the study knowledge and attitudes of academic members from the Mazandaran University of Medical Sciences, related to Quran and finding strength and weakness in this connection, in order to establish cultural programming.Materials and methods: This research is a cross sectional in which 88 board members completed a questionnaire, with the reliability and validity being proved. Knowledge and attitude of the members pertaining to the Quran was researched by the questionnaire. This study was performed in the Mazandaran University of Medical Sciences in 2007. Statistical methods were SPSS 15, ANOVA and T tests.Results: Sexuality and marital status was not effective in the Quranic test grade. In an action environment, along with the type of official order, a meaningful difference was found in the Quranic test grade. Consequently, individuals who received higher test scores had special features that were extracted separately.Conclusion: It appears that Quranic education in the age of 10 or less and attending in comprehension sittings, in addition to paying attention to Quranic meaning at the time of reading and comprehension of Quran at home, may have an effective role in promotion of board member’s knowledge regarding the Holy Quran.

Bisphosphonates are currently used in metabolic disorder of bone; however, there have been few studies that reviewed the role of anti-inflammatory and immune modulatory effect of this agent in in-vivo. Bisphosphonates were divided in two classes regarding the structure and mechanism, including amino and non-amino bisphosphonates. The effect of bisphosphonates on cytokine related to in-vitro was complex and related to type and dose of bisphosphonates, examination of cell type and cell culture evaluation system. However, amino bisphosphonates activated inflammatory cytokine regarding to in-vivo and chronic usage of this agent, can stop the production of these cytokines. Present study surveyed the anti -inflammatory and immune modulatory effect of bisphosphonates and clinical trial, along with recent knowledge about potential mechanism of this component.