Medical Journal of Mashhad University of Medical Sciences
Year:2016 | Volume:58 | Issue:10|Papers Count:11

Introduction: Tuberculosis is an infectious disease influencing about one-third of whole world population. Pulmonary tuberculosis constitutes more than 80% of the Tuberculosis and causes millions of death worldwide. One of the most important methods for determining the effectiveness of treatment is negative sputum smear at the end of the second month of therapy. The aim of this study was to evaluate factors which influence sputum smear condition in pulmonary tuberculosis patients at the end of the second month of therapy.Methods: This cross-sectional study was performed on patients with positive smear tuberculosis who referred to clinics under supervision of Mashhad University of Medical Sciences from September 22, 2012 to September 22, 2014. Patients` demographic and clinical data were collected from their files, and factors affecting sputum smear condition (positive/ negative) assessed by at the end of the second month of therapy were logistic regression.Results: From 1141 pulmonary tuberculosis patients with positive smear, 76.2% had negative smear at the end of the second month of treatment. Out of this 42.7% were female and 30.3% were male. Gender, diabetes and bacillus level at the beginning of therapy had significant influence on sputum smear condition at the end of the second month of treatment.Conclusion: in tuberculosis patients the blood sugar (FBS) must be evaluated as soon as possible, and in case of diabetes the FBS must be controlled to prevent any negative effect on treatment process.

Introduction: Chronic kidney disease (CKD) is progressive kidney dysfunction for more than 3 months. High level of cytokines, including interleukin (IL) -6 and 10 are described as independent risk factors for morbidity and mortality in CKD patients. Current study was designed to evaluate factors predicting levels of IL-6 and 10 in end stage renal disease patients undergoing hemodialysis.Methods: In this analytical cross-sectional, patients referring hemodialysis ward of Loghman e Hakim hospital in 2014 were randomly selected. Demographic data, laboratory data (albumin, creatinine, calcium, phosphorus, PTH, CRP, CBC, ferritin, interleukins 6 and 10 and arterial blood gas) were measured. Correlation between interleukins and serum bicarbonate and other variables were evaluated by SPSS software and the regression models were designed with stepwise method for IL-6 and 10 in chronic hemodialysis patients.Results: Eighty four patients with mean age of 60.98 years and mean dialysis duration of 35.05 months were evaluated. The mean serum levels of IL-6 and 10 was 6.036 pg/ml and 17.46 pg/ml. Five variables (IL-10, HCO3, PH, and diabetes) were remained in the IL-6 model (R2=0.813), and Five variables (IL-6, HCO3, PH, and diabetes) were remained in the IL-10 model (R2=0.846).Conclusion: According to results, arterial blood bicarbonate, PH, and diabetes could consider as a prognostic factor to differentiate increased levels of IL-6 and 10 and related morbidity and mortality.

Introduction: The balance between oxidative stress and antioxidant activity is critical to the pathogenesis of many disorders including diabetic nephropathy. The aim of this study was to determine the Correlation between prooxidant – antioxidant balance (PAB) with microalbuminuria in patients with diabetic nephropathy.Methods: this descriptive cross- sectional study performed in Imam Reza Hospital in year 2012. Forty – six diabetic patients with microalbuminuria and Forty – three diabetic patients without microalbuminuria were enrolled in this study. Forty healthy volunteer selected as a control group. Microalbuminuria is defined as excretion of 30-300 microgram albumin in urine for every milligram of creatinin. The values of PAB were determined by using standard solutions and ELISA method. Pearson’s correlation coefficient method was used for specifying the correlation between our variables.Results: The values of PAB in diabetic patients were significantly higher than that in control group, however, there was no significant difference between PAB values among the two groups of diabetic patients with and without microalbuminuria. There was no significant correlation between PAB values and microalbuminuria in diabetic patients. There was a significant direct correlation between the PAB values andHbA1C in diabetic patients without microalbuminuria.Conclusion: The results of this study indicated that oxidative stress processes were significantly higher in diabetic patients compared with controls but there was no significant correlation between PAB values and microalbuminuria in diabetic patients.

Introduction: Accidental needle stick injuries (NSIs) are the greatest hazard that threatens health care workers (HCW). The prevalence of these injuries due to exposure to physical demands and mental stress has increased in the work place. This study aimed to assess the relationship of mental workload with needle stick injuries among nursing staff.Methods: This descriptive cross-sectional study was conducted on 175 randomly selected nurses who worked in the Alzahra Hospital in Isfahan, Iran in the winter of 2015. For collecting data, National Aeronautics and Space Administration Task Load Index (NASA-TLX), measuring mental load specialized questionnaire and Accidental needle stick injuries questionnaire was used. Data were collected and analyzed by independent t-test, chi-square and Mann- Whitney using SPSS 20..Results: Independent t-test showed that the mean in the dimensions of mental and temporal demand of work had a significant difference between those nurses who had needle stick and those who had not needle stick injuries (P<0.05). But had no significant association with other dimensions of workload. in other words in the six scales NASA- Tlx workload only two dimensions of mental and temporal demands had a significant direct association with needle stick nurses.Conclusion: Health care workers, especially Hospital staff nurses in addition to the physical needs, are often exposed to other related factors including psychological needs, official disputes, pressure of time, lack of social support, conflicting needs, loss of work speed control, etc. which play a decisive role in the prevalence of needle stick accidents in between them. Therefore, hospital managers must identify the causes of these demands is important step in the control of the accidents.

Introduction: Oral mucositis (OM) is one of the serious side effects of radiotherapy and chemotherapy. This study aimed to determine the prevalence of oral mucositis caused by chemotherapy and its risk factors in children with cancer to hematology and oncology wards of Doctor Sheikh Hospital.Methods: this was a cross-sectional study that was performed on 123 children with cancer who were referred to Doctor Sheikh Hospital in 2014. This was a field study and data were collected by observation and checklist. Then, all patients were examined in the first and second quarter of treatment. Data were analyzed by SPSS software analysis.Results: In this study, the mean of the age of the patients was 5.97 ± 2.93. There was a significant difference between the age and severity of oral mucositis in the first quarter (p=0.02) and second quarter (p<0.001). However, this result was not reported in the second quarter. There was a significant difference between the plaque index and severity of oral mucositis in the first quarter (p=0.002) and second quarter (p=0.011) of treatment.Conclusion: some risk factors such as age and plaque index affect the severity of oral mucositis in the first and second quarter of treatment. Also, Cyclophosphamide and cytarabine regimen play a role in the severity of oral mucositis in the first and second quarter of treatment. Therefore, take an appropriate and effective regimen and adequate oral hygiene reduce the severity of oral mucositis.

Introduction: Mild Cognitive Impairment is an intermediate state of cognitive function between the changes seen in normal aging and those observed in dementia. Early diagnosis and intervention at MCI stage can delay or prevent the onset of dementia. Preventive behavioral interventions, such as modifying the diet can play an important role in decreasing burden of the disease. The aim of this study was to determine the relationship between dietary patterns and mild cognitive impairment in the elderly women.Methods: This case-control study was performed on 245 retired elderly women (60 years and older) including 82 cases and 163 controls. Demographic questionnaires, physical activity questionnaires, food frequency questionnaires and mini mental state examinations were completed through interviews. Factor analysis approach was used to derive dietary patterns. All data were analyzed using SPSS V.16 software.Results: There were significant differences between the two groups in terms of education, job and study duration (P<0.05). We identified three dietary patterns including unhealthy, western and healthy dietary patterns. There was a statistically significant difference between the two groups only in terms of healthy dietary pattern (P<0.05). In the highest tertile of healthy dietary pattern, in comparison with the lowest tertile, the risk of mild cognitive impairment was 50% lower. (OR=0.496, CI 95%: 0.261 – 0.943).Conclusion: In the present study, only healthy dietary pattern was significantly associated with mild cognitive impairment and reduced MCI risk.

Introduction: Plasminogen activator inhibitor 1 (PAI-1) is a known cardiovascular risk marker in diabetes but its role in microvascular disease is not clear. The aim of this study was to evaluate relationship between serum PAI-1 level and presence and severity of retinopathy in type 2 diabetic patients.Methods: 175 type 2 diabetic patients were selected. Fasting vein samples were taken for assessment of fasting blood sugar, HbA1C, lipid profiles, creatinin and PAI-1. Urine was taken for assessment of microalbumin to creatinine ratio. All these patients then referred to the ophthalmologist for the evaluation of probable retinopathy. The correlation between serum indices like PAI-1 and retinopathy was assessed.Results: 59 patients (33.9%) had retinopathy. There was significant relation between albuminuria, systolic blood pressure and HbA1c with diabetic retinopathy. There was not significant relationship between retinopathy and serum PAI-1 level. PAI-1 was not different between non proliferative retinopathy compared with proliferative retinopathy.Conclusion: No significant statistical association was found between serum PAI-1 level and occurrence of retinopathy and its severity in diabetic patients but this observation remains to be determined by large clinical studies.

Introduction: According to studies, cesarean delivery is increasing in worldwide and there are many controversies about the psychological morbidity of cesarean delivery and most studies did not have a comprehensive approach to these problems.Methods: This cohort study was done on three groups of 25 pregnant women (total 75) that had labor in Imam Reza and Ghaem hospital. During the second week of postpartum period, questionnaires included demographic information Edinburgh postnatal depression scale (EPDS), Hamilton Rating Scale for Anxiety, General Health Questionnaire (GHQ) -28, Eysenck self esteem questionnaire, maternal attachment scale, were fulfilled by subjects. To ensure the accuracy of information that obtained from the questionnaire, psychiatric interviews were also conducted.Results: Three groups in terms of depression, self-esteem and general health were not significantly different from each other (0.05<P). In women with natural vaginal delivery and elective cesarean delivery anxiety scores, were 9.20 ± 6.43 and 14.76±8.26, respectively, and maternal attachment scores, 69.36±4.91 and 64.36±10.93, respectively that differences were statistically significant (0.05>P).Conclusion: Although depression and self-esteem in pregnant women who have elective cesarean section compared with vaginal delivery is not significantly different But these women in the postpartum period are more prone to anxiety problems and lower quality relationships with their babies, so will require further psychiatric follow-up in this period.