Hormozgan Medical Journal
Year:2011 | Volume:15 | Issue:2|Papers Count:15

Hepatocellular carcinoma (HCC) is the 5th commonest malignancy worldwide and is the third most common cause of cancer-related death. The prevalence is different in the world. The ability to predict patients at higher risk of recurrence and with a poor prognosis would help to guide surgical and chemotherapeutic treatment according to individual risk.As understanding of hepatocarcinogenesis has increased, the myriad of genetic and molecular events that drive the hepatocarcinogenic disease process, including angiogenesis, invasion and metastasis, have been identified. With advances in understanding of tumor biology, interest in molecular biomarkers of carcinogenesis has grown, both in terms of their prognostic significance and also their potential as therapeutic targets. Several molecular markers with prognostic significance have been identified in HCC. Not only these molecules may allow accurate prediction of prognosis of patients with HCC and allow targeting of therapy, but they may also represent novel targets for therapeutic agents.The aim of this review was to examine the current knowledge regarding the prognostic role of the most important molecular biomarkers in HCC. In this article prognostic value of the following molecular markers is discussed: tumor suppressor genes; oncogenes; cell cycle regulators; apoptotic regulators; markers of angiogenesis; markers of invasion and metastasis; growth factors and receptors; telomerase; markers of genomic instability; aneuploidy and markers of microsatellite instability.

Introduction: Methicillin – resistant S.aureus (MRSA) hss been recognized as an important pathogen in human diseases.Screening of health care workers allowed early detection of nasal carriage of MRSA and prevention of subsequent transmission. The aim of this study was to determine the frequency of nasal carriage of MRSA in Shariati hospital staff.Methods: This cross – sectional study was carried out on 85 personals of Shariati hospital in Bandar Abbas. Nasal swabs were cultured on Monitol – Salt Agar plates and incubate at 37oC for 24-48 hours. S.aureus were determined by Gram staining, Coagulase and DNase tests. MRSA strains were identified by plate agar dilution method. An oxacillin minimum inhibitory concentration (MIC³4 m/ml) was considered as methicillin resistant.Analysis of the results was performed by SPSS 16 software.Results: S.aureus strains were detected in 24 (%28.2) samples from which 4 cases (%16.6) were MRSA. No association among age, sex, occupation and duration of working and nasal carriage of S.aureus or MRSA was recognized. A significant association between carrier state and wards of the hospital was observed.Conclusion: Due to role of MRSA in nosocomial infections, detection and treatment of nasal carriers is of great importance.

Introduction: Genetics counseling has an important role in preventing genetics abnormalities. These abnormalities have economical, social, psychological and emotional stresses on families and on community. Therefore, it is necessary to have careful programs to increase the knowledge of people about the importance of genetics counseling. In this study, the necessary cases of pre-marriage counseling, regarding, genetic diseases, were investigated.Methods: In this Cross-Sectional descriptive study, 272 couples who were referred to Yazd, Nikoopour center from March to July 2008 were investigated. A designed questionnaire was completed for all couples and a sample of their peripheral blood was taken for testing blood indices. The data were analyzed, using Chi-square test with 0.05% significance level.Results: Regarding consanguinity, 39 (14.3%) couples were close relatives. In 35 (12.9%) couples there were diseases in first degree relatives, that indicates the necessity of genetic counseling. These diseases were in the second degree relatives of 19 (7%) couples and in the third degree relatives of 58 (21.3%) couples. Overall, 127 (46.69%) couples were candidate for genetics counseling.Conclusion: This study indicated the importance of doing genetic counseling for the newly married couples. It is recommended that the responsible organizations inform the young people about the importance of genetic counseling.

Introduction: Seizure is a clinical state that represents with abnormal and paroxysmal discharges in cerebral cortex and epilepsy is a neurological disorder in which the patient has experienced two or more seizures through cut life. The purpose of this study was screening of epilepsy among school children in Bandar Abbas.Methods: In this cross-sectional study, among 63836 school children, 110 epilepsy cases (aged 6-19 y/o) were diagnosed and evaluated. Data including demographic characteristics, family history, past medical history, risk factors, treatment protocol and side effects of drugs were recorded. Data were analyzed by SPSS version 16 software.Results: The prevalence rate of epilepsy in our study was 1.7 per 1, 000. The highest rate of epilepsy was in the 6-11 years old age group (41.82%). Prevalence rate of epilepsy in girls was more than boys.Family history of epilepsy was positive in 34 patients (30.91%).Positive past medical history of febrile convulsion was reported in 52.73%, head trauma in 34.55% and meningoencephalitis in 2.73% of the cases. The results showed significant relationship between epilepsy prevalence and history of febrile convulsion (P<0.05).Generalized Tonic Clonic Epilepsy was reported in 41.82% of the cases.Conclusion: In this study, positive history of febrile convulsion and family history of epilepsy were two major risk factors but, age, sex and meningoencephalitis were not.

Introduction: Supplementation is a simple and effective intervention method in public health for control of parasite and infectious diseases in infants. The current study was conducted to determine the effect of supplementation with zinc and vitamin A in growth rate and morbidity of respiratory and diarrhea infections.Methods: In a randomized clinical trial, 628 infant between 6-60 month years old assigned to four groups; vitamin A and zinc, vitamin A, zinc and control. After collection of data with a questionnaire, interview and weight and height measurement, they were analyzed by regression and analysis of covariance.Results: Supplementation with zinc and vitamin A was associated positively with infants weight. It was also observed maximum and minimum of weight difference mean in vitamin A and control groups, respectively. In contrast, no significant differences among four groups in height mean, duration and incidence rate of respiratory and diarrhea infections was observed.Conclusion: This study showed that supplementation with zinc and vitamin A increases infants weight. However, no effect on height increment as well as preventive effect for diarrhea and respiratory infections was observed.

Introduction: The academics who do educational plan have a crucial role in learning behavior and, personality modeling of students. This research aims to determine the main factors that based on academics view points, effect on students' learning.Methods: In this study, the research individuals include 23 non-clinical academics. Data were collected by using a researcher-made questionnaire whose content validity and its reliability was approved. The data were analyzed using descriptive methods and Pearson correlation coefficient.Results: The results show that based on the viewpoints of the academics teaching skill with mean 30.57, behavior aspects with mean 14 and scientific aspects with mean 13.28 are the first properties of the academics for the students learning. In teaching skill aspect, attention to innovation at teaching, lesson plan for every section, a reasonable proportion between content of materials, effective use of time, continuity and consistency of materials, in scientific aspects, directing learning based on new science, good scientific background of the lecture, using the main references, and in behavioral aspect, respect for students were the main factors which affect the students learning.Conclusion: As academics' viewpoint is important and affect on students learning process, recognizing and using their ideas is effectual.

Introduction: Health care organizations encounter with new telemedicine technology create channels for cooperation, education and teleconsultation. Telemedicine is a technology communication for clinical care of patients. Achieving health care in Hormozgan province is a great problem because of its privation and existence of Islands. This study review the possibility of use of telemedicine in Hormozgan.Methods: This study was descriptive- cross sectional. Research population included: chancellor, information technology manager and medical specialists. Sample size was the same as population size.Necessary data were gathered by standard questionnaire called“ telemedicine measurement tool”rendered by Medicare. Data analysis was done by using SPSS software.Results: from total of 141 specialists, 85.5% of them indicated consultation and 71.6% of them indicated education as the best usage of telemedicine technology. Lack o technical staff and initial costs were respectively indicated by 68.8% and 66.7% of the specialist as the main barriers of telemedicine implantation.9.2% of them have experienced teleconsultation and 7.1% tele-education. Strategic plan, supporter physicians and suitable support for implementation of telemedicine exists. Internet bandwidth was 128 kbps in average and there were no videoconferencing supplements.Conclusion: Despite existence of optimal administrative culture, with existing inappropriate infrastructure and current level of specialist's knowledge, university is not able to render telemedicine services.

Introduction: 60 percent of hospitalization causes of intravenous drug users are infection, of which 5 to 15 percent of them due to endocorditis. Infective endocorditis is a common infection among intravenous drug users and can cause high mortality and morbidity. This study was conducted to evaluate clinical and para-clinical presentations of drug users.Methods: In a descriptive study we evaluate 33 narcotic addicts with documented infective endocarditis in two tertiary care hospitals in Tehran, Iran; Imam Hosein and Loghman Hakim hospitals during 2002-2008. Demographic information, clinical manifestation, radiologic, laboratory and echocardiographic data were evaluated. The data were analysed using SPSS software.Results: 82% of patients were in 20-40 year old age group.52% of the cases were referred to the hospital with main complain of fever and cough and 27% with pain and fever. Fever was observed in 91% of the patients. Positive blood culture was observed in 9 cases and negative blood culture in 14 cases. The most common involved valve was tricuspid.Mortality rate was 45%.Conclusion: Endocarditis should be considered in intravenous drug users when they present with fever. Blood culture may be negative due to previous use of antibiotics and poor technique of culture.

Introduction: Sleep and rest have an important role on re-storage, maintenance and increase of patient turnover and health. Physical illness accompanied with pain and other inconvenience could disturb sleep. So, the aim of this study was to evaluate sleep quality and its associated factors in hospitalized patients in Babol teaching hospitals.Methods: This Cross-Sectional study was carried out on 200 over 18 years old patients who were inpatient in various wards of Babol hospitals and were selected by cluster sampling. Data was gathered by means of two questionnaires: The Pittsburgh Sleep Quality Index (PSQI) and sleep affecting environmental factors questionnaire. Analysis of variance with SPSS software was used for data analysis.Results: Half of the participated patients were men and half of them were women. Mean age of the patients was 49.3±16.68.84% of the patients were married and 39% of them were illiterate. Mean total sleep quality score of patients was 5.97±3.02.36.4% of the patients had desirable sleep quality and 63.6% of them showed undesirable sleep quality.Mean sleep quality score of patients in different wards had significant difference (P<0.02), as patients in the orthopedic ward had the worst sleep quality and patients in the lung ward had the best sleep quality. The sleep quality had a significant correlation with duration of bed rest (P<0.001).Conclusion: Most of the patients in this study showed undesirable sleep quality.As sleep affect performance and quality of life, implementing a necessary policy for removing or controlling sleep disturbance could help the patients.

Introduction: Medical errors represent a serious public health problem and pose a threat to patient safety. This study aimed to determine the hidden threats in the incidence of medical errors at public hospitals in Tehran.Methods: In this descriptive study, the population included all process owners (12-person teams) in public hospitals of Tehran. The sample size was 396 individuals, selected by stratified sampling technique.A pre-designed questionnaire was completed for each individual. Factor analysis was used to analysis the data.Results: In this study, 23 hidden threats in the incidence of medical errors in Tehran public hospitals got 55.52% of total data variance. Medication information and policies and procedures were respectively responsible for 7.29% and 5.2% of total variance. More over, 0.96% and 0.87% of the variance were, respectively, related to professional culture and quality improvement program of hospital.Conclusion: There are several hidden threats that affect the incidence of medical errors but are not easily identifiable in Tehran public hospitals. Hospital administrators need to identify hospitals with hidden threats and plan for their management, particularly in the field of drug information.

Introduction: Acute hemorrhagic of infancy (AHEI) is a cutaneous leukocytoclastic vaculities that usually occurs in infants and young children that characterized by mild fever, hemorrhagic skin lesion, edema.It usually recovers spontaneously.Case Report: We describe a 11- months old boy with acute hemorrhagic edema of infancy with palpable erythematous rash on face, upper and lower limbs associated with edema and leukocycoclastic vaculities.Conclusion: AHEI is a uncommon condition, however, it could be considered in patients with skin lesion. It is necessary to differentiate from other similar conditions.