Medical Journal of Mashhad University of Medical Sciences
Year:2013 | Volume:56 | Issue:5|Papers Count:12

Introduction: Using modern methods of education may effect on controlling the disease and reducing its complications. This study was conducted to examine the impact of nutritional education using blogs, group-collaborative blogs and SMS on glucose and lipids Profiles in patients with type II diabetes in 2012 in Kermanshah.Materials and Methods: The population consisted of patients with type II diabetes who were Referred to Kermanshah diabetic center using convenient sampling method, 60 patients were selected and divided into three groups of 20. Data are collected before and three months after educational intervention by biochemical test. Data was analyzed by using anova and paired t-test. The SPSS software version 16 was used.Results: The findings indicated that there was no significant difference in FBS and HbA1c in all three groups between before and after intervention. In the blogs, the levels of T-C (p<0.01) and LDL-C (p<0.01) were significantly reduced, but the levels of TG and HDL-C were not significantly different, In the group-collaborative blogs, the level of difference of T-C (p= 0.05) and LDL-C (p<0.01) were significant, but TG and HDL-C were not significant. Furthermore in SMS group, T-C (p=0.03), TG (p=0.05) and LDL-C (p<0.01), the differences were significant, but the difference was not statistical meaningful in HDL-C Level.Conclusion: Nutrition education using blogs, group-collaborative blogs and text messaging can be effective in reducing T-C, LDL-C and TG Level which may reduce the cardiovascular complications of diabetes. Using these methods in training patients with type II diabetes is recommended.

Introduction: Regarding the great amount of negative blood cultures, timely diagnosis of bacterial sepsis is not an easy goal. Thus, it seems that detection of certain factors such as TLR molecules could be helpful for diagnosis of sepsis and guiding appropriate antibiotics. The aim of this study was comparison of TLR2 and TLR4 gene expression in negative culture bacterial septic patients with healthy people.Materials and Methods: This case control study was performed on 30 negative culture bacterial septic patients and 30 healthy people, in 2012. The data were analyzed by SPSS soft ware and cutoff ratios were calculated by R soft ware. Results: The levels of TLR2 and TLR4 genes expression in negative culture and healthy control did not have any significant difference (p value TLR2:0.52) and (p value TLR4:0.099). The TLR4 gene expression in patients who had gram positive cocci sample smear but negative blood cultures in comparison to healthy control was significantly higher (p value: 0.004). Meanwhile, regarding TLR2 there was no difference (p value: 0.0928).Conclusion: TLR4 gene expression in patients with SOFA SCORE 0-3 in comparison to healthy controls had significant difference (with cut-off ratio of 9.54 and sensitivity and specificity of 67% and 71%). The same was true for negative blood culture bacterial sepsis in comparison to healthy controls, with cut-off ratio of 46.19 and sensitivity and specificity of 87% and 78%, respectively. So, evaluation of TLR4 gene expression may be useful to consider anti staphylococcus antibiotic therapy for patients with negative culture bacterial sepsis.

Introduction: Perception of cardiovascular risk factors has established new paradigms in the epidemiological approach to this problem. The understanding of the risk factors for CVD may yield important insights into the prevention, etiology, course, and treatment of this major public health concern. The objectives of this study were to identify the distribution of cardiovascular risk factors and their role in this disease, in adults in Qazvin City.Materials and Methods: This cross-sectional, descriptive study was carried out on 1400 male and female individuals in Qazvin city. The study population was chosen using a randomized cluster sampling method. Two physicians exam interviewed all the subjects. Anthropometric characteristics and serum biochemistry tests were measured. Analyses of data were carried out using SPSS (V.19) descriptive and analytic statistics. The statistical tests were significant at P<0.05.Results: Data related to BMI demonstrated that 39.8% of male participants and 42.1% of female participants were overweight, 13.9%of women and 9.8% of men had diabetes. Average systolic and diastolic blood pressures and average LDL-C level in men were more than women and average HDL-C level of serum in women was more than men .Furthermore, 15.1% of women and 28.9% of men had IFG and 10.4% of women and 9.3% of men had IGT.Conclusion: Prevalence of cardiovascular risk factors was high among adults of Qazvin. Educational interventions should be broad in order to increase knowledge level, change attitude, promote behavior and lifestyle.

Introduction: We aimed to evaluate the antigenotoxic and cytotoxic effects of saffron as an endemic plant in our regionMaterials and Methods: Human gastric adenocarcinomatous cells (AGS) and colon cells were cultured in Dulbecco's modified Eagle's medium (DMEM) containing 10% FBS under standard conditions at 37°C in a 5% CO2-humidified incubator. The 2×105 cells in 200ul of complete medium were introduced to each well. Then MTT assay was used to measure the cellular changes for 200, 400, 800, 1200 and 2000 µg to ml extract in three studied cell lines AGS, HT125 and L929. Results: The L929 cells showed minor changes during the first 24 and 48 hours with extract concentrations of 2000 and 1600, respectively. But during the 72-hour interval significant changes in morphology took place in the same concentrations. While the decrease in AGS cells was more obvious, in the concentration of 2000, the live cell population reduced to 45%. No significant result was obtained in morphology and MTT test for HT125 cells.Conclusion: This study results support the increasing evidence that naturally occurring saffron extract may have an important role in cancer chemoprevention.

Introduction: Nutrition has an essential role in health promotion. In some diseases it has a serious impact on disease control. This effect implies the need to have basic knowledge about nutrition in health care providers.We assessed viewpoints of interns in Golestan University of Medical Sciences toward clinical application of nutrition education.Materials and Methods: This descriptive study was conducted on all (n=55) interns who spent the last academic year (September-December2012). Research measurement was a questionnaire(its validity and reliability was evaluated in previous studies) consisting of demographic and questions about proportion of time and existing chapters with clinical needs, their ability to provide counseling and need to adding proposed new chapters. A total of 46 questionnaires were returned. Data were analyzed through descriptive statistics.Results: Among the 46 interns (37females,mean age25.3±1), application of nutrition education in clinical section in58.7% was evaluated “poor and very poor”,15.2% of them considered “good” in their ability to assess patient’s nutritional status and 8.7% in their ability to nutritional counseling. Over all 8.7%assessed usefulness of their nutritional counseling advice “good and very good.”82.6% agreed with providing course on specific nutrition topics. All of them remarked the need for education in medical nutrition therapy in cardiovascular and renal diseases, 97.6%in diabetes and post surgical situations and 95.2%in infectious diseases.Conclusion: Based on these data, current curricular in medical schools is not adequate and need to revise. Our participant sidentified gaps in their nutrition knowledge and their need during clinical problems. We proposed a nutrition education program based on reported essential topics to improve their nutritional skills in clinic. By upgrading consultation skills in general practitioners, they can work better in future.

Introduction: Gynecomastia is the proliferation of the glandular tissue of the male breast with a prevalence of 40 to 56 percent of men. Its etiology is varied. In this study, we performed a combined surgical method using liposuction, resection of the remaining tissue (pull through), and circumareolar skin excision and presented the results.Materials and Methods: This was a prospective study carried out from 1388 to 1391 on 15 male patients (30 breasts) with gynecomastia. Patient data including grade, technique, and operations were evaluated.Results: The mean age was 22 years, (min=16, max=35). Resection of the remaining tissue was required in 8 patients. The mean amount of resection was 20 gr. Of these, 6 patients were grade IIb and 2 grade III Simons. In 7 cases, no glandular tissue was palpated following liposuction and no incision was required for excision of tissue. Among these, 4 patients were grade IIb and 3 grade III Simons.Conclusion: We recommend liposuction with or without excision of remaining tissue for grade I and II Simons gynecomastia and the combined liposuction, pull through, periareolar skin excision technique for grade III cases.

Introduction: Feeling unhappy and lack of satisfaction are more common in unsupervised adolescents that affect on their quality of life. This study assessed the effect of Group Reality Therapy -one of the approaches for monitoring and controlling behaviors, accepting responsibility- on increasing happiness and improving quality of life in unsupervised adolescents.Materials and Methods: From unsupervised adolescents that lived in protected agencies in Mashhad, 40 boys were selected and simply randomly assigned to intervention and control groups. Experimental group was presented with 12 sessions of Group Reality Therapy. Both groups before and after the intervention responded to the Oxford happiness and WHO quality of life questionnaires. Data analysis was done by using the SPSS16 software, chi square and T-Test.Results: Educational level, age and the mean score of tests before intervention were not significantly different between the two groups (Pv<0.05). After intervention, significant difference was seen in mean of score quality of life test in the intervention group (84.1) and control group (63.3) and the mean (standard deviation) score of happiness test in the intervention group (35.1) and control group (19.86) (Pv<0.05).Conclusion: Group Reality Therapy is an effective approach in improving the quality of life, happiness and life satisfaction in unsupervised adolescents. Respectful environment, Expression of emotions and empathic understanding in group therapy are effective in increasing of hope and improving quality of life.

Introduction: NPO or absence of oral feeding in long term for hospitalized patients and insufficient attention to correct diet of them in hospitals can be seen. Regard to the impact of this issue on nutritional status and growth of children, this study with the aim of identifying the limitations about the nutritional supports of NPO children was done in Mashhad Dr Sheikh children hospital.Materials and Methods: This cross-sectional study was carried out in all wards of the Dr Sheikh children hospital with a questionnaire which included the items of nutritional cares for NPO children.Results: Results of the present study showed that the total NPO patients during the study were 31.7 percent of the all patients of the hospital. Reasons of NPO in these patients included esophageal atresia, diaphragmatic hernia, abdominal distention, intestinal obstruction, intestinal mal-rotation, imperforated anus, ileus, other surgery procedures, respiratory distress and loss of consciousness level, unclear reasons and carelessness of staff and biopsy.Nearly 88 percent of patients had total parenteral nutrition (TPN) during the NPO time. A total of 88.23 percent of patients received intravenous dextrose water serums during the NPO time and 52 percent of them received less than 10 percent of their energy needs during the NPO time.Conclusion: The present study showed that the most important reason of the NPO was surgery in Dr Sheikh children hospital and majority of the NPO patients did not receive sufficient energy during the NPO time. More future researches are needed on the nutrition of NPO children.

Introduction: Superior mesenteric syndrome is not a very common disease but it has a relatively simple pathophysiology. Being compressed by SMA from above to underlying structures of retro peritoneum like abdominal aorta, third part of duodenum is obstructed and causes the patient acute, or chronic and intermittent symptoms of obstruction.Case report: A 24 years old man with 4 years history of dysphagia to solid foods, complained of weight loss, semi liquid food dysphagia dysphonia and eyelid ptosis.In upper GI endoscopy; esophagus was normal, stomach was dilated and clues of food stasis were seen. Endoscopic Biopsies were normal. The patient underwent CT scanning in which stenosis of third part of the duodenum and dilatation of the proximal part to the stenosis are seen. After 3D reconstruction of CT scan images, it was noticed that the angle of origin of superior mesenteric artery from aorta was decreased.Conclusion: predisposing factor to superior mesenteric syndrome is excessive cachectia and since MNGIE syndrome appears with dysphagia, malnutrition and cachectia, the fat pad between aorta and superior mesenteric artery regresses and this can results in superior mesenteric artry syndrome.

Introduction: To report late presentation of bilateral retinoblastoma.Case report: A 3 year old girl presented with huge orbital mass enlarging over her face on the left side. She underwent exentration and histopathologic evaluation. A diagnosis of retinoblastoma was made. This patient had leukocoria of the right eye and another intra ocular mass. This patient represented a rare form of bilateral retinoblastoma with extensive progression.Conclusion: Although most of bilateral retinoblastoma cases are diagnosed early, there are neglected cases which present at advanced stage.