Internal Medicine Today
Year:2007 | Volume:12 | Issue:4|Papers Count:13

Background and Aim: Cutaneous appendages give rise to various types of neoplasms which generally according to embryologic and histologic features are divided to pilocebaceous and sweet- gland tumors. Sebaceous tumors are a subgroup of the former that the accurate diagnosis of them is very important. Some of these tumors not only can be malignant and life threatening but also have many common and overlapping histologic features with some other benign and malignant cutaneous tumors that sometimes make them difficult to be diagnosed accurately. In addition, these tumors may be an alarm for an internal malignancy. The purpose of this study is to asses clinicoepidemiologic features of sebaceous tumors and histopathologically review and reclassify them by applying the new diagnostic criteria. Materials and Methods: Among 134748 archived tissue samples during a thirty-year period (1976-2005) In pathology department of Emam Reza University Hospital in Mashhad, all tissue specimen with a definite, probable, differential or uncertain diagnosis of any kind of sebaceous tumors were elicited. If necessary, new slides with conventional and special histochemical stains were prepared. All tissue slides were restudied, clinical data were gathered and presented in charts and tables and finally analyzed statically. Results: Previous histopathologic diagnosis in 116 sebaceous tumors was confirmed, in 3 lesions, the diagnosis changed and 5 cases were excluded. 73 patients were men and 43 were women with a mean age of 34 year. These tumors included 66 nevus sebaceous, 24 sebaceous hyperplasia, 1 folliculo-sebaceous cystic hamartoma and 24 sebaceous carcinoma. In most instances previous pathologic diagnosis were correct and clinicoepidemiologic  features were in accordance with other worldwide reported cases, although some considerable mistakes in previous diagnosis and differences in clinicoepidemiologic features were noted. Conclusion: Sebaceous tumors are relatively uncommon tumors mostly benign, occruing in both sexes in a broad range of age. Regional geographic and lesional differences may be observed in pattern of involvement. For an accurate diagnosis, the pathologist must pay special attention to the wide range of differential diagnosis and to apply definite histopathologic criteria regarding differences in pattern of involvement.

Background and Aim: Working and employment are chief portion of human social life that can create stress in individual and in turn they will cause dissatisfaction, leaving profession and providing incorrect services to clients. Because of the importance of nursing and midwifery profession this study was carried out to determine profession stressor factors in nursing and midwifery community in Gonabad city. Materials and Methods: This descriptive study was to rank professional stressor factors. The Subjects were all nurses and midwives of Gonabad Medical University hospitals. A questionnaire was used to collect the data and in order to analyse them we used t-test and c2. Results: The results of this study showed that among professional stressor factors, economic factor had the first rank of stressor factors with 91.5% mean score. And among aspects of stressor factors, low incomes (with 90.67% of mean stress score), work difficult conditions (with 88% of mean stress score) and inadequate personnel (with 87.67% of mean stress score) gained other levels of stress factors in the study subjects respectively. Conclusion: According to the findings of this study, it is important for managers of hospitals to notice nursing and midwives low income and the difficult conditions of their profession. In this way they can reduce stressor factors among them and in turn it will cause satisfaction and increase in quality of patients cares that finally bring us community health promotion.

Background and Aim: Prostate cancer is mainly an old men disease. This cancer in its early stage is curable therefore if one knows this fact he may obtain a positive attitude and practice to prevent the disease. We decided therefore, to study the knowledge, attitude and practice of men pensioners in Rafsanjan towards prevention of prostate cancer. Materials and Methods: This descriptive study was done on 400 pensioners who were selected randomly. A questionnaire that divided into 4 parts including demographic information, knowledge, attitude and practice towards prevention of prostate cancer was applied for each person. After collecting the questionnaires, the information entered into SPSS version 13. In order to analyze the data descriptive statistics (tables) and analytical statistics (Chi2 and Fisher's exact tests) have been applied. Results: Findings of this study have shown that 55% (n=220) have good knowledge, 39.8% (n=159) have positive attitude and 6.7% (n=27) have good practice towards prevention of prostate cancer. Furthermore, the direct associations have seen between knowledge and attitude, attitude and practice, knowledge and practice. However, only the association between knowledge and attitude was not statistically valid. Conclusion: Given that knowledge has a positive effect on attitude and attitude has also a positive effect on practice, we should train high risk persons to improve their attitude and practice towards prevention of prostate cancer.

Background and Aim: Mental health is perquisite for continuity preservation of social-occupational- educational function of society subjects and main target of applying health and mental plans is that   preservation. This study was conducted to estimate the mental health status (body healthy- anxiety- depressing, social function), demographic and occupational characteristics and survey of relation between headaches and mental health among Shiraz hospitals staffs. Materials and Methods: A random sample of 1023 staff constituting a 20% sample of the hospital staff population were selected and sampling method was categorical random sampling  and peer each group sampling method was systemically. Demographic, occupational and mental health data (by General Health Question 28 (GHQ28). for determine patients with headaches questionnaires were screened followed by clinical interviews, general physical and international headache society (IHS). Results: Of 1023 subjects 466 (45.6%) cases had mental disorders. Prevalence of mental disorders was 86(27.6%) cases in male staffs and 380 (54.3%) cases in male staffs. Average score of staffs were in index body health 6.74, anxiety 6.67, social function 6.48 depression 3.28 and mental health 23.2. In this study, characteristics on mental health were associated with abnormal sleep pattern, low body activity, dissatisfaction to job. In present results headache was affected on mental health and this two disorders was not independent. Conclusion: Result of this research found that mental disorders has high prevalence and that invokes, masters, that by recognition of mental health risk factors codifies intervention plans. Also with amendment of sleep status, creation  convenience for sporting activity in hospitals staffs and their creation  of satisfaction, can had worthwhile effect on status mental  health status. High co morbidity among headache and GHQ deserves more attention and especial strategies for prevention and treatment.

Background and Aim: It is necessary to teach and make the patients participate in their treatment and care specially on discharge from the hospital since they want to do self-care and treatment at home. This will make them aware of any problem and anxiety and help them to do self care and treatment well and effective, but some observations show problems and difficulties in this field. Quality and quantity of the given educations and knowing its sufficiency and insufficiency can be the base of decision making, planning and action .Then this research is done to determine the educational needs of the patient on discharge from Gonabad health and treatment centers. Materials and Methods: This is a cross sectional study done on random samples (394) the patient on discharge from Gonabab hospitals. The data were collected by a questionnaire and a checklist that were valid and reliable. SPSS software analytical and descriptive statistical methods were used. (P<0.05). Results: Based on the research findings 57% were, male, 42.6% were female the most (0.6%) married and 69% had guidance and high school degree and the rest were illiterated or had the other degrees. The presented teaching were sufficient by % 65/7 of the patients, 56.8% had sufficient knowledge and the rest had not enough knowledge and awareness. 33% needed average education and 10.2% need to be thought seriously. Statistical tests showed a meaningful difference between the patients educational needs on discharge with their educational degrees (P=0.02) but it was not meaningful considering the other demographic properties (P>0.05).Conclusion: Since it is an important problem and the presence of some insufficiencies it is recommended first to diagnose and find the main cause and effective item on educational insufficiency of the patient on discharge and then provide the needed facilities, staff education at work and educational programs in clinics before discharge, self care programs, then we should be assure of the patients basic needs through planning a program.

Background and Aim: Psychological distress and burnout can have negative effects on the well-being of the professionals and also on the quality of care they provide to patients. The aim of this study was to compare burnout and job satisfaction of nurses working in internal, surgery, psychiatry and Burn wards.Materials and Methods: A self-reported socio-demographic questionnaire was distributed among 180 nurses from psychiatry, burn, medical and surgery ward. The Maslach Burnout Inventory (MBI) was considered to measure burnout. Results: 25% of the participants met study criteria for burnout. MBI scores in different wards showed that decline in Personal Accomplishment (PA) was significantly more in burn wards and increase in emotional exhaustion (EE) was significantly higher in psychiatry wards. Male nurses were significantly more depersonalized than female nurses. Nurses working at night shifts were significantly more depersonalized. Conclusion: Special attention should be paid to nurses working in psychiatric and burn wards due to high psychological stress associated with working in these wards. Moreover, male nurses and nurses working at night shifts are more prone to burnout.

Background and Aim: Zinc element is one of the essential trace elements that participates in many enzymes structure and is essential for growth, development, reproduction, central nerves system and immune system function. This study was down for determine serum zinc in 6 years old children in Birjand. Materials and Methods: In this cross-sectional study, 214 six-year old children, were randomly selected. 3ml blood venous was obtained of children and serum zinc level was measured by atomic absorption spectrophotometer. Data was analyzed by SPSS software. Results: 55.1% of the subjects had deficiency. Mean of serum zinc was 75.56±29.84 μg/dl. There were no significant differences in serum zinc in children with normal growth and subjects that were stunted or underweight or wasting (based<2SD of mean of standard population). Conclusion: Administration zinc supplements and other study for risk factor of zinc deficiency are recommended.

Background and Aim: Conflict and mismatching in employee's opinion in national organizations is component of their nature and conflict management is one of the hardest as well as the most important duties of a manager that can increase efficiency and revenue of organization. Presented research has been done in this point of view; Study of knowledge, attitude and performance of managers with conflict management background in faculty of medical sciences of Shahroud (2006). Materials and Methods: This research is a cross-sectional and applical studies. Paying attention to limitation of research substrade and essential need to adequate data, all data have studied in the way of capitation and a questionnaire consist of 6 general questions and 51 professional questions about knowledge, attitude and performance of managers connected to conflict, and have been prepared and given to managers. To analyse data SPSS and INSTAT soft wares was used, and conclusions displayed through diagrams and tables. Results: Paying attention to conclusions of analysed data I found that 7.6% of research substrade are major managers, 30.3% are median managers and 62.1% are basis managers as well as 39.4% of them are females and 60.6% the rest are males.16.7% of managers have degrees under bachelor and 83.3% have upper than it.27.3%of manager have management experience lower than 10 years and the rest have more than 10 years. Just 6.1% of the managers passed didactic session and 93.9% had not tutorial terms. Knowledge grade of managers is 14.18/20 (intermediate level), their attitude grade is 45.62/55 (positive) and the average grade of performance is 110.76/150 that is normal and near good level.Conclusion: Paying attention to essential knowledge and positive attitude to conflict and its role on conscious performance of managers in this field can represent that holding didactic sessions for managers and creating essential skills in usage of conflict management techniques improve efficiency and revenue of organizations.

Background and Aim: Pressure ulcers are a major complication of spinal cord injury (SCI) that might stay with the injured person during his or her lifetime and have the human and economic costs for the individuals with SCI and his family and society. Educational programs are mechanisms for the transferring essential information to the patients and caregivers. The aim of this study was to evaluate the effect of education on knowledge of caregivers and the process sore healing in veterans with SCI. Materials and Methods: This was a quasi- experimental study. That was conducted among 15 veterans with SCI, living under care in their houses. Data was obtained through interviews made by a qualified nurse’s. Through inspection, we obtained the ulcer care was based on guideline’s of the Agency Health Care Policy and Research (AHCPR). The wound was assessed by using the Pressure Sore Status Tool (PSST). The SPSS statistical software was used for statistical analysis and Wilcoxon statistical test with a significant level of P<0.05 was chosen. Results: Education resulted in the increase of the knowledge of caregivers and their performances by comparing the grades of the evaluation of the wounds in the round before and after training doesn’t show a significant difference, but comparing the results of the second and the third round before and after training (education) showed a relatively big difference (P<0.05).Conclusion: Enhanced, individualized education about the prevention and management of ulcers was effective. Then if this educations are related to the patients conditions, his knowledge and the way he or she lives will even be more effective. Taking part of the medical staff in educating the families and the patients and taking further action after being discharged from the hospital should be more considered.

TCRBCL is a rare variant of diffuse large B cell lymphoma. In the recent classification of WHO its diagnostic criteria is a T cell rich B cell lymphoma with large B cells occupying less than 10% of tumoral cell population. In all cases of T cell rich large B cell lymphoma, T lymphocytes are predominant and there are a variable number of B cells including centroblasts, polynuclear and Reed-Sternberg like cells. Thus, peripheral T cell lymphoma and lymphocyte predominant Hodgkin's disease are included in the differential diagnosis. The present study describes a 54-year-old man with TCRBCL presenting with axillary mass and striking morphological similarity with Hodgkin's lymphoma. However, further assessments led to accurate diagnosis. While lymphocytepredominant Hodgkin's lymphoma has a better prognosis, T cell rich B cell lymphoma is a high grade malignant large cell lymphoma, so applying the immunohistochemical and cytogenetic techniques is required for correct diagnosis.