Hormozgan Medical Journal
Year:2013 | Volume:17 | Issue:3|Papers Count:14

Introduction: Prostatic adenocarcinoma is the most common malignancy of internal system and after lung cancer is the second cause of death in male. Genetic base of many neoplasms is related to suppressor tumor gene such as P53. Therefore, we aimed in this study, to assess the intensity of prostatic adenocarcinoma tissue staining with P53 staining method and its relationship with Gleason grade.Methods: In this cross-sectional study, during 2006 to 2008, all patients attending pathology ward of Shahid Mohammadi hospital with diagnosed prostatic adenocarcinoma enrolled for the study. Samples were stained with H & E staining and if adenocarcinoma was confirmed they stained with P53 stain using immunohistichmistry (IHC) method and severity of staining was recorded. We used colon cancer tissue for positive control and non tumoral prostate tissue for negative control. Data were analyzed using descriptive method and Chi-square test by means of SPSS.Results: 30 patients aged between 60 and 91 with mean age of 77.10±8.5 enrolled in the study. Grade of tumors vary from 2 to 10 and the most frequent grade was 7. Results show that with increase in the Gleason grade, intensity of P53 staining also increases. (P<0.001). Conclusion: Results demonstrated that there is a direct relationship between Gleason grade and intensity of P53 staining.

Introduction: This study was carried out to correlate histological findings in cervical lesions to human papilloma virus (HPV), as detected by polymerase chain reaction (PCR).Methods: In this descriptive study, out of 143 cervical biopsies, 50 biopsies, containing sufficient histopathologic criteria, were examined. PCR assay was performed with the primers GP05/06+and, as control, the beta-globin gene was amplified. The morphological findings were correlated to HPV positivity: koilocytic atypia, multinucleation, acanthosis, papillomatosis, dyskeratotic cell, mitosis in the lower basal third of the epithelium, hyperplasia of basal layers.Results: In 50 selected samples pathologic diagnosis was chronic cervicitis in 37 cases (74%) and cervical intraepithelial neoplasia (CIN) in 13 cases (including CIN I in 6 cases, CIN II in 5 cases, CIN III in 2 cases). HPV DNA was positive in 6 cases, including 5.4% of chronic cervicitis (2 cases) and 30.8% of CINs (including 33.3% of CIN I, 40% of CIN II). The analysis did not indicate any strong relationship between morphological criteria and HPV. The only finding showed an independent, straight and weak correlation between HPV and koilocytic atypia (P value=0.003 & Kappa=0.296) with sensitivity of 100% and a relatively low specificity of 63.6%. By excluding mild koilocytic atypia, this correlation was amplified (P<0.001 & Kappa=0.669) and appear acceptable sensitivity of 83.3% and specificity of 93.2%. The finding with highest positive and negative predictive value was the presence of definite koilocytosis (PPV=62.5% & NPV=97.6%).Conclusion: In spite of association of some HPV infection with chronic cervicitis, there is no correlation between severity of chronic cervicitis and HPV infection. Although koilocytosis is a good indicative criterion for HPV infection, nevertheless, there is some limitations in histological diagnosis of cervical HPV infection.

Introduction: Elderly is considered from 60-65 years old, and 35% of all surgeries related to this age group. Surgical complications in these patients have a high incidence and to reduce these complications Bispectral (BIS) monitoring during the anesthesia can be used. This study was designed to investigate whether BIS monitoring improves clinical anesthetic delivery, recovery profiles in elderly patients undergoing abdominal surgery with general anesthesia compared to standard clinical practice.Methods: In a clinical trial, 68 elderly patients (over the age of 60) having American Society of Anesthesiologists (ASA) physical status of I or III who were scheduled for elective abdominal surgery. Patients were randomly allocated to two groups that receiving general anesthesia with BIS monitoring as cases and without using of BIS monitoring as controls. To compare two groups, Kaplan-Meier test was used.Results: The time to orientation was faster in the BIS group compared to the control group. There were significant differences in the postoperative orientation time between the two groups. (P<0.001) Conclusion: Our findings indicate that, recovery time and discharge from recovery in BIS group was significantly faster than control group.

Introduction: Few studies is in literature related to evaluation of impact of positive pressure ventilation (PPV) on thoracostomy tube removal in Iran. We decided, in this study, to evaluate the impact of PPV on recurrent pneumothorax (PTX) after removal of thoracostomy tubes (TT).Methods: A case-control study was performed for evaluating 122 chest tubes in 109 mechanically ventilatedtrauma patients during a one year period.61 chest tubes randomly assigned tobeclamped and the others observed as control group. After 6 hours, portable CXR obtained. All chest radiographs were reviewed to identify recurrent PTX. The collected data was analyzed using SPSS statistical software and P<0.05 was considered significant.Results: Rate of post-clamping PTX was 11.5%, (7 of 61). There was a significant difference between case and control groups in recurrent pneumothorax (P=0.013).6 of these 7 patients (85%) who their chest tube discontinuation resulted in recurrent pneumothorax, underwent tube thoracostomy for pneumothorax or hemopneumothorax.5 of these 7 patients had been demonstrated airleak during hospitalization. A significant statistical association between the first CXR in emergency department and presence of airleak in ICU was detected (P<0.001). Moreover, there was a significant association between airleak during admission and incidence of recurrent pneumothorax (P<0.001).Conclusion: Regarding to remarkable incidence of post-clamping pneumothorax (11.5%) in despite of careful patient selection for chest tube discontinuation in this study, chest tube removal for patients on PPV is not a safe method. It has been demonstrated that once discontinuation criteria were met, in patients who undergone tube thoracostomy for pure hemothorax and did not reveal airleak during their hospitalization, thoracostomy tube removal is safe, even on positive pressure ventilation. Nevertheless, the surgeon decision for timing of chest tube removal is superior.

Introduction: Exercise and environmental stressors cause alteration in different components of the immune and hormonal systems. Therefore, the purpose of this study was to explore the changes of serum cortisol and salivary IgA of athletes after a single bout of exercise cold, warm and natural environments.Methods: Ten young male athletes who ran on a treadmill for 1 hour at %60 VO2max in environments of natural (22±1oc, 50±5 RH), cold (3±1oc, 50±2 RH) and warm (35±1oc, 50±5RH). Blood and Saliva samples were collected to measure cortisol and SIgA before, after exercise and 2 hours after recovery. In addition, during exercise body temperature, athletes’ consumption water, Plasma Volume Changes, perceived exertion (borg scale) were measured. In order to analyze the data, Repeated Measure and Bonferroni tests at the significant level of P<0.05 were utilized.Results: The cortisol concentration increased significantly after exercise, in three environments (P<0.0001). This increased values were significant in warm in comparison with cold (P=0.04) and natural (P=0.031) environments. SIgA concentrations, in three environments, did not have significant changes after exercise. However, these values reduced significantly after exercise in cold environment compare to natural (P=0.021) and hot environment compare to natural (P=0.035).Conclusion: Exercise in the three environments causes increase serum cortisol as well as stimulating the Hypothalamic-Pituitary-Adrenal (HPA) axis. But, exercise had no effect on the levels of SIgA. However, regard to a significant reductions of these values in cold and warm environments than natural environment after exercise, is possible a risk of respiratory tract infection in cold and warm environments.

Introduction: Attention deficit hyperactivity disorder (ADHD) is a disorder manifest in early childhood with symptoms of hyperactivity, impulsivity, and inattention. The symptoms affect functioning. ADHD has a wide range of prevalence and different prevalence had been reported in the world. The purpose of this study was to determine prevalence of ADHD in Bandar Abbas primary school students in 2010.Methods: This cross-sectional study was performed on 800 primary students of Bandar Abbas primary schools in 2010. The subjects were selected through a multistage random sampling method. The data were collected using diagnostic criteria from the DSM-IV questionnaire. We analyzed data using statistical tests such as chi-square and t-test.Results: In this study, 400 male and 400 female pupils were under investigation. Average age was 9±1.4 (mean±Sd). Based on teacher's and parents reports 11.6% and 12.3% of students were found to have ADHD, respectively. ADHD prevalence according to agreement of both parents and teachers was 9.5%. Factors such as gender and poor academic performance had significant association with ADHD (P<0.05), while age and grade had not significant association with that.Conclusion: ADHD in pupils of Bandar Abbas is estimated to have moderate prevalence compared to other regions of Iran. Because of consequences of ADHD in individual, screening children with poor academic performance seems to be necessary.

Introduction: Positive consequences of job satisfaction promote prosperity, physical and mental health and increase rate of training and qualifications. The present study intends to evaluate relationship between occupational stress and job satisfaction among obstetrician.Methods: The assessed populations in this descriptive study consist of obstetrician. 130 samples, using convenience sampling, were selected. HSS-35 (Hospital Stress Scale) and Smith Job satisfaction questionnaires were used for evaluation of obstetricians’ stress. The collected data was analyzed by SPSS statistical software.Results: Findings indicated that components and criteria of occupational stress could significantly predict job satisfaction and determine 79% of job satisfaction variations.Friedman test showed that in the opinion of participations, of components of job satisfaction, occupational features are in first stage, salaries in the second, occupational condition in the third and professional stands in the fourth stage. The finding also clarified that 40 years old and younger obstetrician had more job satisfaction in comparison with 41 to 50 and 51 to 60 years old obstetrician.Conclusion: Occupational stress obviously is one of the negative factors which can affect job satisfaction.

Introduction: Problem-based learning (PBL) is possibly one of the most innovative methods in medical education. In this training method, small groups of students work on a subject and learn the educational goals which include basic and clinical sciences. The aim of this study was comparing students’ and facilitators’ satisfaction in teaching pediatric course materials by two methods of large group PBL and lecture-based teaching.Methods: In this analytic study, all pediatric theory course students (40 students) were divided into 5 groups.6 PBL training sessions was added to regular conventional lectures of pediatric subjects. Students’ and facilitators’ satisfaction data for both methods of teaching were collected during the semester. Finally the data was analyzed using descriptive and inferential statistics.Results: The results of this study indicated that most students preferred PBL over the lecture-based traditional teaching in the most of the aspects (P<0.05). Tutors activity did not show any significant difference in both methods. Tutors managed this form of PBL effectively within time restraints and reported that they enjoyed the process.Conclusion: Based on the findings of this study, the modified problem based learning methodology can be successfully used with larger groups of students.

Introduction: Clinical reasoning skills play a major role in the ability of doctors to make diagnosis and reach treatment decisions. This study is a report of use an innovative assessment tool: key feature exam, in problem solving domain. The main purpose of this study was to compare key feature results with routine multiple choice questions in internal medicine department.Methods: Final year internal medicine students (n=100) of Shiraz medical school participated in this study. They implemented in multiple choice questions exam, then participated in key feature exam. Reliability, item’s difficulty level and item's total correlation as discriminative index, about key feature exam have been considered.Results: The maximum, minimum and mean scores of the students in key feature exam were 23.7, 41.2 and 30.91, respectively. The reliability of key feature exam was 0.68 (chronbach's alpha). The item's difficulty level scores were between 0.3-0.8 in all key feature questions and item's total correlation was 0.16-0.54. Correlation between key feature exam and multiple choice questions exam was 0.25 (P<0.05).Conclusion: The results of the present study suggest that key feature examination may be a better method for evaluating clinical reasoning skills of medical students.

Introduction: Although evaluation of students is always stressed by educational specialists, but one of the accepted methods for evaluation, is self assessment. The purpose of this study was to compare the self and instructors assessment in clinical skills of midwifery students who are completing their education in Shahrekord university of medical sciences.Methods: In a cross-sectional study, self assessment of 47 last year midwifery students for clinical skills in gynecology and obstetrics subjects as an evaluation in final examination, was compared with clinical instructors’ assessment. Descriptive and analytic statistics with SPSS was used for data analysis and P<0.05 was considered significant.Results: Mean and standard deviation of the scores for gynecology subjects evaluation based on total score of 130 for 26 items was 86.42±7.79 for the instructors and 82.46±12.60 for the students. This difference was not statistically significant. The same statistics for obstetrics subjects were 136.40±10.57 and 134.19±27.98 out of 190 for 38 items for the instructors and for the students, respectively. This difference was also not statistically significant.Conclusion: The results of study showed that students are able to judge their performance accurately. Assessing and including the student evaluation can improve the processes of evaluation.