JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S)
Year:2017 | Volume:34 | Issue:415|Papers Count:8

Background: Papillary thyroid carcinoma is the most prevalent malignancy of thyroid gland and is significantly lymphtropic. Epstein-Barr virus (EBV) infection may play an important role in the development of this malignancy. The aim of this study was to investigate the expression of Epstein-Barr virus nuclear antigen (EBNA), as a probable risk factor, in papillary thyroid carcinoma in a population of patients in Isfahan city, Iran, in the year 2015.Methods: This study was performed on 43 cases of papillary thyroid carcinoma confirmed by pathologist. Using qualitative polymerase chain reaction (PCR) method in formalin-fixed paraffin-embedded tissue specimens, EBNA expression in tumor tissue was investigated. Information on age, sex, tumor size, lymph node status and metastasis were collected from the patients' medical records. The collected data were analyzed using independent t and chi-square tests via SPSS software. Findings: EBNA antigen expression was detected in 9 cases (20.9%). The relationship between different factors and EBNA antigen expression showed a significant relationship between patients' age and gene expression (P<0.05). In contrast, other factors were not significantly correlated with EBNA gene expression (P>0.05).Conclusion: According to the results of this study, Epstein-Barr virus may have a role in pathogenesis of papillary thyroid carcinoma. Further studies with control group are necessary to confirm the issue.

Background: To increase the quality of surgery, getting to low levels of perioperative bleeding is needed in mastoidectomy; however, the existing methods have some complications. The aim of this study was to evaluate the effect of intravenous tranexamic acid on bleeding volume and surgeon's satisfaction during mastoidectomy.Methods: In this randomized clinical trial study, 69 patients with indications of mastoidectomy were evaluated. After obtaining informed consent, the patients were divided into two groups randomly. The case group received infusion of remifentanil (0.1 mg/kg/minute) during surgery as well as tranexamic acid (10 mg/kg) at the beginning of surgery. The control group received only remifentanil (0.2 mg/kg/minute) during the surgery. The mean volume of bleeding, hemodynamic parameters and the surgeon's satisfaction were compared between the groups. Findings: The mean bleeding volumes were 62.1±16.6 and 89.0±25.5 ml in the case and control groups, respectively (P<0.001). The rate surgeon's “great satisfaction” was 82.4% and 40.0% in case and control groups, respectively (P=0.004). The mean arterial pressure at 30 minutes after the surgery was lower in the cases than the controls (86.4±5.5 vs.90.4±4.7 mmHg; P=0.002).Conclusion: Our study showed that the administration of tranexamic acid is associated with lower perioperative bleeding and also increased surgeon's satisfaction. As the mean arterial pressure was lower in these patients, careful monitoring of the blood pressure is necessary during the surgery.

Background: Regardless of the exact reason, it is important to identify patients who are at greater risk for pain. There are few studies about the effects of age and gender in pain perception during and after deep vitrectomy; so, we performed this study to evaluate the effects of these two factors in this regard.Methods: In a descriptive study, 440 patients scheduled for deep vitrectomy were randomly allocated to three age groups, group 1: 17-34, group 2: 35-52, and group 3: 53-70 years old. General anesthesia was performed in the same manner in all the groups. Pain intensity [based on the visual analog scale (VAS)] and additional opioid consumption was assessed on entrance to the recovery room, and 30 and 60 minutes and 2, 4, 8, 16 and 24 hours after arrival it. Findings: Pain intensity in time of entrance to recovery room was 3.73±1.46, 3.05±1.08 and 4.19±2.03 in groups of 17-34, 35-52 and 53-70 years, respectively and the difference between the groups was significant (P<0.001). The patients aged 53-70 years had more pain intensity compared with the other age groups from arrival to the recovery room until 24 hours postoperatively (P<0.050 for all the times). In addition, the pain intensity was significantly higher in women compared to men from arrival to the recovery room until 4 hours postoperatively (P<0.05 for all the times). The number of patients requiring pethidine was not significantly different between the three groups all the times during 24 hours postoperatively (P>0.050 for all).Conclusion: Women and elder patients experience more intense pain after deep vitrectomy.

Background: According to WHO reports, human factors are major contributing causes in 60% of car accidents and 95% of all other accidents. The mortality rate of car accidents in Iran is over 15 times more than developed countries. Several indices contribute to the occurrence of dangerous driving behaviors. We aimed to assess the relationship between the frequency and severity of traffic accidents and aggression, smoking, and substance abuse.Methods: This was an analytical cross-sectional survey. Data were collected in Isfahan city, Iran, during the year 2015 through distribution of two questionnaires, Buss and Perry aggression questionnaire (AGQ), and a demographic researcher-made one. The data were analyzed using chi-square, post-hoc Tukey, Wilcoxon, Kruskal-Wallis, ANOVA, and Mann-Whitney tests via SPSS software. Findings: From 450 drivers, 26% had AGQ score of more than 78, and in 74% the score was less than 78. Smoking and substance abuse frequencies were 40% and 16.2%, respectively.28.8% of accidents were led to injury, 12.4% to death, and 58.8% to financial damages. Smoking and substance abuse had relationship with the number and severity of traffic accidents (P=0.001 for both). In addition, aggression had relationship with the number (P=0.017) and severity (P=0.006) of traffic accidents, too.Conclusion: This study shows significant correlation between the frequency and the severity of traffic accidents and aggression and substance abuse. The findings lay more emphasis on the significance of evaluating aggression and substance abuse in drivers by the responsible agencies.

Background: Urinary tract infection (UTI) is one of the most frequent infectious diseases and can occur in all age groups. Due to various complications of urinary tract infections, timely and proper treatment seems important. This study aimed to assess the antibiotic resistant pattern in Escherichia coli derived from outpatients and inpatients with urinary tract infections in Alzahra Hospital, Isfahan, Iran Methods: 135 isolates of Escherichia coli (from urine) were collected from September to February, 2013, from Alzahra Hospital (Isfahan, Iran). The samples were cultured on nutrient agar, Mac Conkey agar, Blood agar and Eosin methylene blue (EMB) agar. Bacterial susceptibility to antimicrobial agents was determined using Kirby-Bauer disk diffusion method as recommended by the Clinical and Laboratory Standards Institute (CLSI) guidelines. Findings: Among 135 Escherichia coli isolates, 91 isolates belonged to outpatients and 44 to inpatients. In total, 68% of the participants were women. Antibiotic resistance to ampicillin, ceftazidime, nalidixic acid and trimethoprim/sulfamethoxazole were higher than 50%. The rates of resistance to ceftazidime, ampicillin, trimethoprim/sulfamethoxazole, cefepime, and cefotaxime in outpatients were higher than in inpatients.Conclusion: Due to excessive use of antibiotics and increasing antibiotic resistance, it is necessary to perform antibiotic resistance tests routinely in laboratories.