JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2009 | Volume:11 | Issue:1 (48)|Papers Count:14

BACKGROUND AND OBJECTIVE: Cervical cancer is the second most common cancer in women that early diagnosis of its preneoplastic lesion can reduce cancer development. The aim of this study was to evaluate P16 role as a biomarker in diagnosis of dysplastic and neoplastic lesions of uterine cervix with immunohistochemistry.METHODS: This study was done on samples of 96 women in pathology department of Shahid Yahyanejad hospital, Babol, Iran. The samples divided into 4 groups (30 cases of normal cervix, 30 cases of cervical immature metaplasia, 30 cases of cervical dysplasia and 6 cases of cervical malignancy of squamous cell type).Immunohistochemical method was performed using kit of Dako company, made in Denmark, (p16INK4a, Clone E6H4), on paraffin embedded samples. P16 staining results, histopathological findings and age of women were analyzed and compared.FINDINGS: P16 staining was positive in 10% of normal cervix (3 subjects), 30% of cervical immature metaplasia (9 subjects), 63.3% of cervical dysplasia (19 subjects) and 83.3% of normal cervix (5 subjects). In cases with dysplasia P16 was positive in 4 subjects of grade I, 8 subjects of grade II and 7 subjects of grade III that there was not a significant relationship. The sensitivity of P16 was 83.3% in uterine cervical squamous cancer and sensitivity was respectively 63.3% in dysplasia and 30% in immature squamous metaplasia. The specificity of P16 was 80%.CONCLUSION: Result show that P16 had suitable sensitivity and specificity for diagnosis of dysplasia and neoplasia of uterine cervix and can be used in diagnosis of cancer lesions.

BACKGROUND AND OBJECTIVE: Ovulation disorders are a common cause of infertility in women. A common cause of anovulation is polycystic ovarian syndrome. Anti-estrogens agents such as clomiphene citrate and tamoxifen citrate are used as first line treatment in polycystic ovary syndrome patients. About 25% of patients may resistant to clomiphene. The aim of this study was to compare the rates of ovulation and pregnancy between tamoxifen citrate and clomiphene citrate in polycystic ovary patients.METHODS: This randomized controlled trial study was performed on 150 polycystic ovary syndrome patients referred to Fatemeh Zahra infertile center and Mehregan hospital in Babol, Iran during 2005 and 2006. Patients randomly divided into two groups and stimulation with clomiphene and tamoxifen on cycle days 2-6 was done. On first cycle, patients were treated with clomiphene (100 mg) and tamoxifen (40 mg) and on the next cycle because of no ovulation or pregnancy patients underwent clomiphene (150mg) and tamoxifen (60mg). Ovulation and pregnancy rates were compared in two groups.FINDINGS: The rate of ovulation in the tamoxifen 40 mg (TMX) group was 41 of 75 (54.7%) and in the clomiphene citrate 100 mg (CC) group was 40 of 75 (53.3%). The rate of ovulation in the TMX group (60mg) was 60 of 73 (82.2%) and in the CC (150mg) was 44 of 70 (62.9%) (p=0.014). There were 5 pregnancies in the TMX group (6.7%) and 10 pregnancies in the CC group (13.3%) that there was not significant difference between two groups.CONCLUSION: According to the results of this study, for increasing ovulation rate and pregnancy in polycystic ovary syndrome patients who were resistant to clomiphene, tamoxifen can be used.

BACKGROUND AND OBJECTIVE: Intrauterine insemination (IUI) after ovulation induction is one of the infertility treatment methods that used before more invasive assisted reproductive techniques (ART) due to simplicity and low expenses. This procedure is performed in different kinds of subfertility such as male factors, cervical factors and unexplained infertility. The aim of this study was to determine the association of follicular response with IUI outcome.METHODS: This case-control study was done on 267 infertile couples under 35 years old in Fatemeh Zahra infertility center affiliated to Babol University of medical sciences, Babol, Iran that the result of IUI was positive in 89 cases and it was negative in 178 cases. Women with cervical factor and ovulation dysfunction who underwent clomiphene citrate, or clomiphene citrate and human menopausal gonadotropin were included in this study. Data include: age, duration of infertility, follicle number, number of IUI cycles and outcome were analyzed.FINDINGS: Pregnancy occurred in 89(33.3%) of 267 cases. The number of follicle in pregnant women (2.8±1.4) was significantly higher than non-pregnant women (1.9±0.9) (p=0.000). The mean age of pregnant women (24.3±3.8 years) was significantly lower than non-pregnant women (26.4±4.8 years) (p=0.000). The duration of infertility in pregnant women (2.67±2.3 years) was significantly lower than non-pregnant women (4.5±3.1 years) (p=0.000). There was not significant correlation between number of follicle with women age (p=0.599, r=0.032) and duration of infertility (p=0.475, r=-0.044).CONCLUSION: According to the results of this study, success of IUI in ovarian stimulation cycles depended on the number of follicle. So it is recommended to consider the number of follicle for success of IUI in ovarian stimulation cycles.

BACKGROUND AND OBJECTIVE: Laparoscopy should be considered for evaluation of infertility. It is used for diagnosis and treatment of pelvic disorders, lysis of adhesion, reconstructive tubal surgery, myomectomy, cauterization of ovarian surface in polycystic ovarian disease, ovarian cystectomy and etc that may be followed with increasing fertility rate. The aim of this study was to evaluate the fertility rate following laparoscopy in infertile women.METHODS: This cross sectional study was performed on 75 infertile women who underwent laparoscopy because of non-response to infertility treatments. The information were studied including age, duration and type of infertility, type of surgery done by laparoscopy, and pregnancy rate following surgery and time gap of pregnancy after laparoscopy.FINDINGS: From 75 patients, 64 (85.3%) because of primary infertility and 11(14.7%) because of secondary infertility underwent laparoscopy. Laparoscopy showed that the cause of infertility in patients was adhesion, reconstructive tubal surgery, ovarian problems, endometriosis, and ovarian cyst. Fertility rate was 26(34.7%) following laparoscopy. The mean period of pregnancy following laparoscopy was reported 15.3±9.9 months.CONCLUSION: The results showed that laparoscopy is a suitable method in the diagnosis and treatment of infertility and can lead to the increase of fertility rate.

BACKGROUND AND OBJECTIVE: Endometrial cancer is one of the most common invasive gynecologic malignancies. Abnormal uterine bleeding (AUB) is the most common symptom in endometrial hyperplasia. Women with AUB are examined with dilation and curettage (D&C) to rule out any endometrial lesions including endometrial hyperplasia and carcinomas. This study was performed to determine the associated factors with endometrial hyperplasia.METHODS: This cross-sectional study was performed on 504 cases of D&C in Al Zahra teaching hospital, Rasht in 2005-2006. Cases were divided into two groups based on endometrial hyperplasia and absence of endometrial hyperplasia. Variables included: age of patients, menstrual pattern, high blood pressure, history of diabetes mellitus, contraceptive method used, nulliparity and infertility history were studied and compared.FINDINGS: There were 61 cases (12.1%) of endometrial hyperplasia including simple and complex (atypical and non – atypical). Independent factors associated with endometrial hyperplasia were diabetes mellitus (24.6% vs.11.1%) (p<0.003), hypertension (27.9% vs. 16%) (p<0.02), and oligomenorrhea (32.8 vs. 13.5%) that had a statistically significant relationship with endometrial hyperplasia (p=0.0001). No significant relation was found between the age over 45 years, nulliparity, taking OCP and infertility history with endometrial hyperplasia.CONCLUSION: According to the results of this study, women with history of diabetes mellitus, high blood pressure, menstrual pattern and oligomenorrhea are high-risk group for endometrial hyperplasia and carcinoma. They should be examined by proper diagnostic procedures such as D&C.

BACKGROUND AND OBJECTIVE: Parkinson is the most prevalent degenerative disorder of central nervous system. In this disorder other than muscular deficits, oculomotor abnormalities are seen. This is the consequence of basal ganglia impairment. The most common abnormalities include increased saccade latency, hypometric saccades and decreased saccade velocity. The purpose of this study was to compare saccadic parameters using videonystagmography in patients with idiopathic Parkinson’s disease and normal subjects.METHODS: In this cross sectional study, saccadic movements were investigated in 30 patients with idiopathic Parkinson’s disease and 30 normal subjects (35-70 years). Saccade latency, velocity and accuracy were quantitatively analyzed. Saccadic measurements were conducted using videonystagmography.FINDINGS: Parkinsonian group included 18 males and 12 females. Normal group included 20 males and 10 females. Average of horizontal saccadic latency in Parkinsonian patients was 0.4±0.2 and in normal group was 0.3±0.1 that was statistically significant (p<0.001). Accuracy of horizontal saccade in Parkinsonian patients was 36.7% and in normal group was 96.7 % (p<0.001). Velocity of horizontal saccade in Parkinsonian patients was 350.5±85.30 and in normal group was 493.3±79.9 (p<0.001). Differences in right eye was statistically significant (p<0.001).CONCLUSION: This study showed that patients with Parkinson’s disease manifest saccadic deficits. This suggests dopaminergic control of these ocular movements. We can consider these differences as the characteristic of Parkinson disorder in diagnosis and treatment.

BACKGROUND AND OBJECTIVE: The history of biomedical research and results of valuable studies of scientists show importance of using animals in this research. The responsibility for experimental animals and concentration on animal right and welfare are moral duty of researchers. According to widespread animal use in research in our country, we explored experiences of researchers about the ethical principles of animal use in research in Kerman and Tehran University of medical sciences by phenomenologic study.METHODS: In this study, 10 experts in animal research with 15-20 years of work experience in the fields of physiology, pharmacology, biology, immunology and dentistry in Tehran and Kerman Universities of medical sciences, Iran were interviewed. Data analysis and exploitation of main themes was done based on interviews by using experimental animal guideline in Iran and themes were categorized.FINDINGS: In this study, 5 main themes were found. Theme1: more participants emphasized using minimum number of animals in their experiments except cases that they were obliged to use more animals. Theme 2: all participants explained about suitable methods of anesthesia. Theme 3: all participants knew about euthanasia methods and explained about limitations of that. Theme 4: the participants in this study emphasized on training of animal researchers. Theme 5: also, the participants stated that animal care personnel are not well trained.CONCLUSION: According to the results of this study, our expert researchers know ethical principles of animal use entirely but they can not use this knowledge because human and possession resources are limited and greatest limitation is well trained students and animal care personnel. So it is recommended to design appropriate training course according to researchers' requirement for using animals in research.

BACKGROUND AND OBJECTIVE: Behaviors, habits and life style have obvious effectiveness on human health. Also emotional features have direct relationship with general health. The aim of this study was to compare the relationship between pessimism, general health and emotional intelligence in college students at Shiraz University and Shiraz University of medical sciences.METHODS: This cross sectional study was performed on 203 college students (88 males and 115 females), at Shiraz University of medical sciences, and 201 college students (95 males and 106 females) at Shiraz University. They were randomly selected. Students completed Beck hopelessness scale (20-items), emotional intelligence (33-items), and Goldberg general health (28-items) questionnaires. Pearson correlation coefficient, independent t-test, and multiple regression analysis were used.FINDINGS: Pessimism and general health in medical college students were 11.3±4 and 28±20.6, respectively. Pessimism and general health in non-medical college students were 9.7±3.4 and 49±25.2, respectively that there was a significant relationship between pessimism and general health in both groups of students (p< 0.001). Also emotional intelligence in medical college students was 124.8±11.7 and in non-medical college students was 129.7±11.2 that there was a significant relationship between emotional intelligence and general health (p<0.001).CONCLUSION: The results of this study showed that pessimism in medical college students is more than nonmedical college students and general health and emotional intelligence in medical college students are less than non-medical college students. So it is recommended to use psychological method for removing pessimism and improving general health in medical college students.

BACKGROUND AND OBJECTIVE: Fluctuation of IOP in individuals can also be induced by the osmotic variations caused by water ingestion. In fasting, the individual ingests much water and other fluids in dawn and dusk that may lead to increased IOP and optic disorder. The aim of this study was to determine the effect of fasting on high fluctuation of IOP and optic disorder in healthy persons.METHODS: This analytical observational study was performed on 35 randomly selected healthy persons (70 eyes) at Shahid Beheshti hospital, Babol, Iran in the months of Ramadan and Zighadeh, 2007. IOP was measured with Goldman applanation tonometer, first in Ramadan month at 3 times: morning, afternoon and after dusk (breaking one’s fast) and then two months later (control month) in the morning and evening and then compared.FINDINGS: Average IOP in Ramadan month in the morning was14.4 mmHg, in the afternoon was 13.6 mmHg, and dusk (after breaking one’s fast) was 13.8 mmHg. Average IOP in control month in the morning was 13.4 mmHg and in the evening was 14 mmHg. There was a significant difference between Ramadan morning and control month morning (p=0.015). There was a significant difference between morning and afternoon of Ramadan (p=0.013). There was no significant difference between afternoon and dusk (after breaking one’s fast) in Ramadan.CONCLUSION: According to the results of this study, the rate of IOP between morning and afternoon in Ramadan and between Ramadan morning and control month morning was statistically significant. Since the increasing rate was not clinically valuable so the optic nerve can not be damaged.

BACKGROUND AND OBJECTIVE: Ocular traumas are major causes of morbidity. Work and car accident, assault and war are the most common causes of eye trauma. Patients referred from medicolegal centers to Farabi hospital to determine the type of trauma, causes and the percent of morbidity. The objective of this study was to assess the causes, type and intensity of ocular trauma in patients referred from medicolegal centers to Farabi hospital, Tehran University of medical sciences, Tehran, Iran.METHODS: The present study was preformed on all cases of ocular trauma referred from medicolegal centers to Farabi hospital from August to September 2007. Initial data including sex, age, visual acuity, time and place of accident, antomic structure and the cause of trauma were evaluated.FINDINGS: From 295 patients, 255 were male (86%) and 40 were female (14%). The range of their age was between 18 to 70 years old. The most common place of injuries in male was out of house (80%) and it was a significant difference with female (p=0.000). More common site of injuries was eye lid in 124 (45%), conjunctiva in 111 (40%) and cornea, anterior chamber, lens, vitreous and retina in 60 (15%). The causes of trauma included assault in 193 cases (65.4%). Also sustained trauma in right eye was more than left eye (152 cases (51.5%) vs. 118 (48.5%)).CONCLUSION: Assault is one of the most common causes of eye trauma in patients especially in young ones referred from medicolegal center to hospital. Prevention of eye related trauma should be considered. Therefore, it is necessary to instruct students, parents and teachers in order to decrease eye trauma.

BACKGROUND AND OBJECTIVE: Tracheostomy is frequently performed in critically ill patients for prolonged intubation. Despite of different benefits, tracheostomy associated with complications. Choice of best time and outcome for tracheostomy in critical patients who require mechanical ventilation is controversial. This study was conducted to assess the indication and early complications of tracheostomy in the intensive care unit patients in Shahid Beheshti and Shahid Yahyanejad hospitals, Babol, Iran.METHODS: This cross sectional study was performed on all patients who underwent tracheostomy in ICU of Shahid Beheshti and Shahid Yahyanejad hospitals of Babol, Iran during 2001-2006. Patients were assessed for indication for tracheostomy, timing of tracheostomy and early complication including infection, bleeding, air leak and inflammation.FINDINGS: From 96 subjects, indications for tracheostomy were prolonged intubation in 71 subjects, unable to intubation in 9 subjects, and other causes in 16 subjects. Early complications were observed in 15 that include infection in 7, bleeding in 3, air leak in 3 and inflammation in 2. Complication occurred in 3 of 17 subjects that tracheostomy was performed on them before 2 weeks and 12 of 72 subjects that tracheostomy was performed on them after 2 weeks. There was a significant correlation between the time of tracheostomy and complication (p=0.049).CONCLUSION: According to the results of this study, the most common cause of tracheostomy is prolonged intubation and local infection was the most common complication. So it is recommended to prevent the infection following tracheostomy with proper care and antibiotic selection.

BACKGROUND & OBJECTIVE: Chondrodysplasia punctata (CPD) describes a diverse group of bony dysplasias, all of which share in common punctate calcification of cartilage. Symptoms include shortening of limbs, cataracts, dry and scaly skin and congenital heart diseases. In autosomal recessive form, renal and cardiac anomalies are rare. In this report, a rare case of rhizomelic chondrodysplasia punctata (RCDP) with congenital heart disease (TOF) and renal anomalies was presented.CASE: Patient is a 16-day old male infant admitted to NICU with respiratory distress and cyanosis. He was with congenital heart disease, nose bridge hypoplasia, renal anomaly, anus malposition with no cataract. The diagnosis of chondrodysplasia punctata was based on symptoms. The infant underwent mechanical ventilation and renal failure treatment but died due to neonatal sepsis.CONCLUSION: According to reported cases, in patients with RCDP evaluations for congenital heart and renal anomalies should be considered.