Studies in Medical Sciences
Year:2015 | Volume:26 | Issue:1|Papers Count:12

Background and Aims: Bladder cancer is the 11th most common cancer and the 14th leading cause of cancer deaths worldwide. Understanding the epidemiology of bladder cancer is very effective in the health planning of this cancer. According to lack of information in the field, the present study was carried out in order to investigate the epidemiology and trend of incidence of bladder cancer in Iran in 2003 to 2009.Materials and Methods: The required data for this cross-sectional study were extracted from the data published by the Ministry of Health during 2003 to 2009. Age and gender specific incidence rates were calculated and the time trend of sex-specific incidence was plotted during this period.Results: Evaluation of cancer registration data from 2003 to 2009 illustrated the ascending trend of bladder cancer in the country. And 27, 898 incident bladder cancer cases recorded in the whole country showed an increase from 2745 cases in 2003 to 4601 cases in 2009. The lowest and the highest incidence in men and women have been reported respectively in 2003 and 2008. Among the provinces of Iran, the highest and the lowest rate of bladder cancer incidence among Iranian males were reported respectively in Tehran province and in South Khorasan province. For women, the highest incidence rate is in South Khorasan province and the lowest incidence rate is in Kohgiluyeh and Boyer-Ahmad Province. The sex ratio of male to female was 4.63.Conclusions: Based on the results, the incidence rate of bladder cancer in Iran is rising. Although a proportion of this increase may be due to improvements in cancer registration system, still the probability of increasing the incidence of bladder cancer exists with increasing life expectancy, lifestyle and other risk factors. Thus planning to investigate the causes of this cancer can be useful in the primary prevention of the cancer.

Background and Aims: Depression probably causes changes in bone metabolism and induces bone loss and osteoporosis. This study was conducted to determine the relationship between depression and osteoporosis in women.Materials & Methods: In this descriptive-cross sectional study, 190 women above 40 eligible for the study were recruited and their level of depression was assessed with the Beck Depression Inventory Short Form 13, then bone density was measured by DEXA (Dual Energy Xray Absorptiometry) technique. Then after a physician’s diagnosis and according to WHO criteria, the participants were divided into three groups: normal, osteopenia, osteoporosis then SPSS version 17 and statistical analysis tests were used for data analysis.Results: The findings showed that mean ± SD age and body mass index of the participants were, 56.64±7.82 year and 29.9±4.88 m2.kg, the majority of the participants were homemakers (70.5%), most of them had enough income (81.6%), 46.8% of the participants were depressed, 42.3% of women were with severe depression, 36.7% of them with moderate depression, 39.4% of women with mild depression, 27.7% of women were not depressed but were diagnosed with osteoporosis. In this study, significant correlation between bone mineral density and depression was not found (p=0.32).Conclusion: This study showed that depression was not associated with osteoporosis in women.

Background and Aims: The purpose of this study was the standardization of the Social Phobia Inventory (SPIN) in nonclinical Iranian sample based on their sex, academic year, native/non-native trait and college.Materials and Methods: The participants were 1743 students of Shahed University who were studying in 2010-2011 academic year and were selected by cluster sampling and completed Social Phobia Inventory (SPIN). For the evaluation of validity, internal consistency and repeatability of the SPIN the concordant validity, Cronbach α coefficient and test-retest methods were used, respectively. In order to analyze the data Hotelling’s T-square test, multivariate analysis of variance, and Scheffé post-hoc test were used.Results: The results showed that there was a correlation between the marks of SPIN with anxiety subscales of the Anxiety subscales of the symptom checklist SCL-90-R (a<0.001, p<0.7) and SPIN has internal consistency (a<0.001, p<0.94) and reproducibility/repeatability (a<0.001, p<0.96). Also, the results indicated the mean of social anxiety in female students compared to males and non-native students compared to the native ones (p<0.05) and human sciences and medical students compared to other college students (p<0.01) was significantly higher. However, there was no significant difference between the students studying different academic years (F=0.42, p<0.000).Conclusion: This study besides providing schedules of normalization for students are presented according to their academic year, sex and college and emphasis that SPIN has favorable validity and reliability.

Background and Aims: Laparoscopic cholecystectomy is the treatment of choice for symptomatic gallstones. The term postcholecystectomy syndrome (PCS) comprises a heterogeneous group of symptoms and findings in patients who have previously undergone cholecystectomy.With the number of cholecystectomies being performed increasing in the laparoscopic era the number of patients presenting with PCS is also likely to increase.This study aimed to investigate the frequency and predisposing factors of retained stone after laparascopic cholecyctectomy to the referred the patient with CBD stone for preoperative endoscopic retrograde cholangiopancreatography (ERCP).Materials & Methods: A total of 993 patients were evaluated after laparascopic cholecyctectomy in Urmia Imam Khomeini Teaching Hospital between January 2011 and February 2014. The patients were categorized into two groups according to the presence or absence of retained stone after laparascopic cholecyctectomy, and the risk factors was compared between them.Results: Patients were 800 females and 193 males with a mean age of 48.70±16.82 (range 13-94) years. Retained stone after laparascopic cholecyctectomy occurred in 47 patients (4.75%). The two groups were comparable in terms of patient age, sex, body mass index (BMI), serum level of BIL, ALP, AST, ALT and CBD and intrahepatic bile duct diameter before operation and HTN, DM and duration of admit. The mean level of age and duration of admit and pre-operative serum BIL, ALP, AST, ALT and CBD and intrahepatic bile duct diameter before operation and HTN was significantly higher in the cases with retained stone after laparascopic cholecyctectomy.Conclusion: According to the results of the present study, the measurement of serum BIL, ALP, AST, ALT, and CBD and intrahepatic bile duct diameter before operation may be capable of predicting retained stone after laparascopic cholecyctectomy.

Background and Aims: Hypercapnia cause to increase rate of emergence time from anesthesia and decrease spontaneous breathing onset time and extubation meaningfully. The aim of this study was evaluation of effects induced hypercapnia on emergence from anesthesia with propofol in elective surgery Materials & Methods: In a clinical trial studying that was perforemd in anesthesiology departemnt of Tabriz Univercity on patient that underwent elective surgery, we evaluated the effects of induced hypercapnia on emergence from anesthesia with propofol.Results: Accordinly, 38 patients in normocapnia group and 38 patients in hypercapnia group were evaluated. Average age of patients in normocapnia group was 33±11.27 and in hypercapnia group was 36.94±11.56 years (P=0.134). The Average time of eye opening in patients of normocapnia group was 11.92±1.97 and in hypercapnia group was 7.98±1.74 minutes (P<0.001). The average time of mouth opening in patients of normocapnia group was 12.78±1.90 and in hypercapnia group was 9.30±1.91 minutes (P<0.001). The Averag time of spontaneous breathing in patients of normocapnia group was 9.34±2.40 and in hypercapnia group was 4.53±1.44 minute (P<0.001). The average time of extubation in patients of normocapnia group was 10.76±2.28 and in hypercapnia group was 6.38±1.77 minutes (P<0.001).Conclusion: The Average time of eye and mouth opening, spontaneous starting breathing and extubation in patients of hypercapnia group was significantly lower than normocapnia group.

Background and Aims: The aim of the present study was to compare graft survival and patient survival between diabetic and non-diabetic patients in the Imam Khomeini Hospital Transplant Center, during the years 2001 to 2011.Materials and Methods: This study was a retrospective cohort study. We used Kaplan-Meier test to calculate the patient and graft survival and t-test to compare continuous variables, Fisher exact test and x2 test to compare categorical data.Results: The mean duration of follow-up in patients with diabetes and nondiabetes was 37.09±53.15 and 34.49±62 months. five and 10 year patient survival rate among diabetic patients were 79 and 74.29%, while among non-diabetic patients were 89.28 and 81.01%, respectively. Five and 10 year graft survival rate among diabetic patients were 80 and 59.04%, respectively, and among non-diabetic patients were 84.35 and 77%.Conclusion: In this study, patient survival rate in diabetic and non-diabetics were significantly different (p=0.000), indicating the need for follow-up and ongoing management of diabetes after transplantation. There was no significant difference between graft survival rate in diabetic patients (p=0.243). The results showed transplantation is the best trapotic choice for diabetic patients.

Background and Aims: Dexametasone is used as a replacement therapy for opioids in reducing post tonsillectomy pain. This study was aimed to assess the effect of dexamethasone on reduction of pain and vomiting and the onset of oral intake after tonsillectomy.Material and Methods: This study was conducted on sixty 4-12 year-old patients scheduled for tonsillectomy or adenotonsillectomy in the present double blinded randomized clinical trial in two equal groups (control and study). Immediately after induction of anesthesia, the study group received dexamethasone (0.15 mg/kg) and the control group received equal volume of normal saline. The patients’ pain intensity and the presence or absence of vomiting were measured and recorded 30 minutes in the recovery room and 1 hour after surgery. In the ward after 2, 4, 8 and 24 hours, intensity of pain, occurrence of vomiting, onset time oral intake and systemic analgesic consumption were measured and recorded.Results: Pain intensity (based on CHEOPS) at the times, half-hour, 1, 2 and 4 hours after surgery in the study group was lower than the control group. (p<0.05) Statistical analysis showed significant differences between study and control groups related to the frequency of vomiting. (P=0.035) The mean onset time of oral intake in study group was 3.56 hours and in control group was 4.44 hours which was statistically significant. (P=0.001) Conclusion: Accordingly, intravenous dexamethasone before tonsillectomy or adenotonsillectomy in children reduces pain intensity up to 8 hours after surgery and reduces the occurrence of vomiting and onset time of oral intake.

Background and Aims: Better clinical outcomes are observed in patients who undergo thoracic procedures under thoracic epidural anesthesia (TEA). This study aimed to compare the outcome of diagnostic thoracoscopy between patients with General anaesthesia (GA) and TEA.Materials and Methods: In this randomized prospective study 30 candidates of diagnostic thoracoscopy underwent either GA (n=15) or TEA (m=15). Pre-, intra-, and post-operational vital signs and O2 saturation, pre- and post-operational parameters of arterial blood gas (ABG), and post-operational pain, need of analgesics, complications, hospital stay and mortality rate were documented and compared between two groups.Results: Vital signs and ABG parameters were comparable between the two groups. Although there was better condition in the TEA group, the mean post-operational pain, dose of analgesics and hospital stay were comparable between the two groups statistically. There was no case with intra-operational agitation, change to general anesthesia, complications, need for intensive care unit admission, or mortality.Conclusion: In candidates of diagnostic thoracoscopy, TEA is at least equal to GA in terms of intraoperational vital signs and parameters of ABG. TEA is superior to GA regarding post-operative pain and hospital stay, but this predominance does not reach a statistically significant level.

Background and Aims: Addictions affect an individual mentally, physically and socially. There are personal, interpersonal and social and environmental causes that interact in its development. The present study aimed to examine the effectiveness of cognitive behavior therapy and pharmacological intervention on increasing efficacy and improving the quality of life in men with substance use.Materials and Methods: This descriptive-analytical study was conducted on 40 men with substance selected by available sampling method and were divided into an experimental (n=20) and a control group (n=20). Pre-test and post-test was carried out and the data were collected using self-efficacy and World Health Organization Quality of Life Questionnaire.. Pharmacological interventions in both groups were under medical supervision, however, the experimental group received eight sessions of cognitive-behavioral therapy. The mean score of the two groups were compared by covariance analysis (ANCOVA).Results: The results of study showed significant differences between the mean scores of the pre-test and post-test of the experimental and control groups. Cognitive therapy had enhancing in self-efficacy and quality of life mean score in the experimental group. (p<0.001).Conclusion: The present findings indicate that pharmacological intervention with cognitive behavioral therapy can be useful in increasing self-efficacy and improving life quality in people with substance use.

Background and Aims: Multiple Sclerosis (MS) is the most common neurological disease in young adults which has made problems for young adults and also made them to be independent in their life.Clinical studies show that everyday life stress gradually can affect the activity of various body systems as well as immune system and also can damage and disturbed it. The objective of the current study was to compare the personality traits and emotional intelligence in female and male patients with multiple sclerosis.Materials and Methods: This descriptive and comparative study was conducted on 150 MS patients (58 men and 92 female) who referred to MS Society and Imam Khomeini Hospital in Urmia city. The tools for collecting the data were Emotional Bar on Intelligence Questionnaire and Short Personality Inventory (NEO - FFI - R). For analyzing the data, the statistical methods including means, standard deviation and T-test were used.Results: There was a significant difference between the five factor personality traits among men and women. There also was a significant difference between men and women considering emotional intelligence, responsibility, empathy, flexibility, stress tolerance, and problem solving.Conclusions: Medical treatment along with the psychological conseling and training emotional intelligence and Cognitive behavioral therapy are also suggested.