پژوهش در علوم پزشکی
سال:1384 | دوره: | شماره: |تعداد مقالات:14

Background: Finasteride partially blocks the conversion of testosterone to dihydrotestosterone through inhibition of 5α - reductase in hair follicles. Finasteride cream can penetrate to dermis to arrive at hair follicle due to its solubility. Therefore, it is expected to be used in treatment of hirsutism with less systemic adverse effects. This study was designed to determine the efficacy of finasteride cream 0.5% in management of idiopathic hirsutism. Methods: Finasteride (0.5%) and placebo creams were administered to 35 women with hirsutism on the face. Medication and placebo creams, each one were used on one side of the face in an area of excessive hair growth, which were not necessarily symmetrical. The side for the finasteride and placebo creams was chosen randomly and blindly in 1cm2 areas on each side of the face. Hair numbers were counted and the thickness of all hairs was also measured by micrometer and their mean was calculated, at the start of therapy and after 6 months. Statistical analysis was done in SPSS software using Paired and Student t-tests. P-values less than 0.05 were considered significant. Results: The mean of hair numbers decreased at placebo-applied side from 12.20 ± 6.15 to 10.50 ± 4.90 (P<0.0001) and at finasteride- treated side from 11.37 ± 6.15 to 8.47 ± 4.62 (p<0.0001). Mean of hair thickness at placebo side decreased from 2.92 ± 0.84μm to 2.72 ± 0.79 μm (p<0.0001) and at finasteride side from 3.17 ± 0.90μm to 2.37 ± 0.79 μm (p<0.0001). Comparison of hair number and thickness showed no statistically significant changes in finasteride versus placebo treated sides. But, according to patients' view points, hair growth rate was diminished and hair was looser on finasteride treated side. Conclusion: Six months of topically applied finasteride (0.5%) does not affect on number and thickness of facial hirsutism significantly. Despite lack of objective changes, on questioning, most patients in finastride group perceived a decrease in hair growth with time.  

Background: Non-adherence to treatment is a problem of increasing concern for all stakeholders. This study was designed to determine the prevalence of non-adherence among the clients consulting internists or cardiologists at Bu- Alicina Clinic in Qazvin. Methods: A total number of 400 clients came to Bu-Alicina Clinic (center for internal medicine and cardiology) were randomly interviewed through a questionnaire during a two month period in 2003. Self-administered methods were used if the clients applied. The data were interpreted using statistical methods. Results: The clients were between 14 and 78 years old (33.7+8.5) and 57.5% of them were women and 42.5% were men. Of total number, 30.7% were consulting for continuation of their therapies and of these clients, 41.5% had poor-adherence to their current therapies. The more educated clients were 1.6 times (OR=1.62; 95% CI=0.71, 3.74) likely to be more adherent to the therapies. There was no significant difference between the internal diseases patients and cardiology patients in this regard (41.7%vs 40%). Of the total number of 400 clients, 79.5% had history of consulting to medical clinics during the last three months and 37.4% of them had non-adherence to their past therapies. The more frequent factors were: forgetfulness (13.3%), not to be able to afford to pay for treatment costs (10.3%), disbelieve to the doctor and consulting another ones (8.4%), long distance (8.4%), feeling that it is not important to take medications (7.4%), side effects (7.4%), disbelieve to the diagnosis (7.1%), religious considerations (6.5%), and misunderstanding or lack of information about the prescription (5.8%). No significant difference was found between men and women on this aspect. Conclusion: Patients need advice, supported information from professionals about their health and therapies. Certain studies must be done to determine the pitfalls and effective interventions address that barriers can be developed.  

Background: Teeth, apart from their physiologic function, play an important role in general appearance of individuals. Therefore any disorder in their growth and evolution will cause psychologic, social and even economic problems for the person. This observational cross- sectional study aimed to investigate relationship between dental occlusal patterns and obstructive nasal-upper airway- diseases. Methods: This study was performed in schools of No.4 Education at district of Isfahan in educational year 1381-82 between 607 students (277 male, 330 female) aged 9-12 years old. Results of accurate ENT and dentistry physical examination were registered and analyzed using SPSS software and Chi-square and Mantel - Hanzel test. Results: With increasing age, the frequency of abnormal occlusal patterns increases (from 45.5% to 68.2% in males and 25.8% to 48.5% in females, p=0.015). The increasing in degree of palatal tonsilar hypertrophy was related to higher frequency of abnormal occlusal patterns (36.7% in +1 tonsilar hypertrophy, and 70% in +4 tonsilar hypertrophy, p=0.02). Also, history of frequent common colds, and history of previous nasal fractures were related with abnormal patterns [58.9% (p=0.032), and 83.4% (p= 0.043%), respectively].Five other parameters including sinusitis, hypertrophy of nasal turbinates, rhinitis, nasal polyposis and nasal septal deviation were not associated with abnormal occlusal patterns (p>0.1). Conclusion: Some of obstructive upper airway diseases are related with abnormal dental occlusal patterns. These parameters can be simply diagnosed, treated or prevented.      

Background: It seems that there may be a relation between opium addiction and bladder cancer. This study has been performed to find this relationship in Kerman province. Methods: We evaluated opium addiction in 150 patients with bladder cancer (study group) and150 tumor-free patients (control group) and compared them by two-tailed t-test and X2 test. Results: The rate, duration, amounts and methods of opium abusing in the study group were significantly higher than control group. Conclusion: The results suggest that the carcinogenic effects of opium addiction may be related to the amount, duration and the method of opium abuse.    

Background: Approximately 10% of Iranian couples wishing to have a child experience some types of infertility which may impose a considerable psychological burden on them. The main objective of this cross-sectional study was to examine the level of anxiety and depression among infertile couples undergoing IVF or ICSI treatment cycles in Iran. Methods: Fifty infertile couples that who undergoing IVF (n=25) or ICSI (n=25) cycles were considered for this descriptive cross-sectional study. Also, 25 married couples (18-40 years old) with history of fertility served as control subjects. All husbands and wives were examined by means of Beck Depression and Spielberger Anxiety Inventories. Results: Comparing with controls, the highest rates of moderate and severe anxiety, were observed in women undergoing IVF (76% and 12%, respectively; P<0.05). However, the rate of depression among women in IVF group was comparable to women undergoing ICSI. Also, the highest rates of severe depression and anxiety were demonstrated among housewives (23.9% and 11%, respectively). The lowest rates of severe anxiety and depression were observed in husbands participated in either IVF or ICSI cycles. In addition, illiterates, compared with educated couples, undergoing IVF or ICSI program were shown to have the highest rates of both depression and anxiety. Conclusion: The results showed that the levels of anxiety and depression were higher in women, especially housewives, undergoing IVF or ICSI cycles than control subjects. Also, men showed lower rates of anxiety and depression than women undergoing IVF or ICSI. Therefore, this can provide useful information and guidance for health professionals working with infertile patients.  

Background: Frequent topical fluoride therapy through toothpaste, mouthrinse, professional gels and solutions causes decrease in incidence, pause and repair of dental caries in the enamel. These mechanisms are done through penetration of fluoride ions (F-) and their replacement with hydroxyl ions (OH-) of hydroxyappatite of enamel, interfere with microbial metabolism of dental plaque and bacteriostatic effect on some cariogenic bacterial strains such as streptococci. The aim of this study was to examine the effect of fluoride mouthrinse and toothpaste on the number of streptococcal colony forming units of dental plaque. Methods: 62 children with 6-7 years old were put in two groups. Samples of dental plaque from each group were collected both before and after use of the fluoride mouthrinse and or toothpaste. The samples were cultured on blood agar to find the number of streptococcal colony forming units (CFU). The mean colony forming unit was compared inter and intra groups before and after application of Fluoride products. Results: The streptococcal CFU of dental plaque before and after use of the mouthrinse and toothpaste respectively was (1240±1367, 1253±1341.5) and (551±716, 898±1151). Statistically, the streptococcal CFU in each group before and after use of the toothpaste and mouthrinse was significantly different. Conclusion: The findings of this study indicated that the fluoride toothpaste and mouthrinse reduce number of streptococcal colony forming units of dental plaque. Also this reduction was not depended on level of (F-) Ions, sort of vehicle of fluoride and frequent application of the fluoride mouthrinse and toothpaste.  

Background: Breast cancer is the most common cancer in women and the second cause of death among them. There are several treatment methods for breast cancer, one of which is radiation therapy. There are two important methods of radiation therapy: tangential field and single oppositional field. Main goal of this study is evaluation of factors that have a role in producing acute side effects such as skin burning in breast cancer patients treated by electron beam, in order to decrease these side effects. Methods: From 1/2003 through 7/2004, 200 consecutive patients were evaluated during 18 months in seid-al-shohad hospital, whose mean age was 49 years old. In this study a questionnaire was used including some questions about personal profile such as patient's name, address, registration number, age and some other factors. All patients who were candidated to enter in this investigation filled out the questionnaire at the end of radiation therapy. The patients were examined and their skin burning grades were evaluated by RTOG scale. Data were analyzed by chi-square test using SPSS 11 software. Results: None of patients showed grades O or 4 of burning. 31.5 % of Patients showed grade 1, 64.5 % showed grade 2, 4 % showed grade 3 of burning. There was statistically significant correlation between posterior axillary field and skin burning and there was not any meaning between the other factors. Conclusion: It is necessary to pay more attention to posterior axillary field planning including field size, location, photon energy, depth and dose of treatment.  

Background: Adverse cardiovascular events have been reported in body builders taking anabolic steroids. Adverse effects of AAS on endothelial function can initiate atherosclerosis. This study evaluates endothelial function in body builders using AAS, compared with non-steroids using athletes as controls. Methods: We recruited 30 nonsmoking male body builders taking AAS, 14 in build up phase, 8 in work out phase, and 8 in post steroid phase, and 30 nonsmoking male athletes who denied ever using steroids. Serum lipids and fasting plasma glucose were measured to exclude dyslipidemia and diabetes. Brachial artery diameter was measured by ultrasound at rest, after cuff inflation, and after sublingual glyceriltrinitrate (GTN) to determine flow mediated dilation (FMD), nitro mediated dilation (NMD) and ratio of FMD to NMD (index of endothelial function). Result: Use of AAS was associated with higher body mass index (BMI) and low density lipoprotein–cholesterol (LDL-C). Mean ratio of flow mediated dilatation after cuff deflation to post GTN dilatation of brachial artery (index of endothelial function) in body builders taking AAS was significantly lower than control group (0.96(0.05) versus 1(0.08); p=0.03). After adjusting BMI, age and weight, no significant difference was seen in index of endothelial function between two groups (p=0 .21). Conclusion: Our study indicates that taking AAS in body builders doesn’t have direct effect on endothelial function. Future study with bigger sample size and measurement of AAS metabolites is recommended.

Background: Intracerebral hemorrhage (ICH) is the third most frequent cause of stroke and accounts for 10 to 15 percent of all strokes in whites and 30 percent of them in blacks and Asian Population. The commoner sites of hemorrhages are different among populations and complications of them are different too. Methods: In the present descriptive observational study, we studies 226 ICH patients admitted in Al-Zahra Hospital in Isfahan, Iran, from November 2001 to November 2003 and evaluated them for their symptoms and signs according to size and location of their hemorrhages recognized by CT-scan at the time of admission. Results: From our 226 patients (126 men and 100 women), 38.5% of them had thalamic hemorrhage, 24% had lobar hemorrhage , 22.5% had putaminal hemorrhage , 8% had pontine hemorrhage , 6% had cerebellar hemorrhage, and 1.3% had internal capsular hemorrhage. Seizure was commoner in lobar and putaminal hemorrhages. Vomiting was present in 100% of cerebellar hemorrhage cases. Headache was present in 100% of cerebellar hemorrhage cases and between 66-83% of cases with hemorrhage cases in other sites. Coma was common in pontine hoemorrhage. Conclusion: ICH accounts for 28.5% of our all stroke admissions.The incidence of intracerebral hemorrhage increases with age, reaching a maximum between the ages of 60 and 80 years old, and is higher in men than women and right side than the left side. We found that thalamic hemorrhage was the commonest site of hemorrhage among our patients second by lobar hemorrhage and more than half of our patients had headache or vomiting on the day of admission. Overall acute mortality rate depends mainly on the position and size of hemorrhage, which we can estimate them by the CT- scan. Diabetes mellitus is not considered as a risk factor, in contrast to hypertension.    

Background: One of the most common techniques of nasal tip surgery in rhinoplasty is conservative resection of cephalic portion of nasal alar cartilage; although, there is a controversy about its effectiveness on nasal tip rotation in textbooks and articles. Therefore, in this research, we have studied the effect of conservative resection of cephalic portion of alar cartilage on nasal tip rotation. Methods: 35 patients were selected from the patients who were candidates for septoplasty, after getting their agreement. In surgery we performed conservative resection of cephalic portion of alar cartilage. Nasolabial angles were calculated, using the lateral photographs of the patients before and six months after surgery. The means of these angles were analyzed with t-paired test. Results: The means and standard deviations of nasolabial angles before and six months after surgery were 91.49±7.35 and 91.57±7.04, respectively. Calculated P-value was 0.52. Conclusion: There was no meaningful difference between means of nasolabial angles before and six months after surgery (P-value was greater than 0.05). Therefore, in this research we concluded that conservative resection of cephalic portion of alar cartilage has no effect on nasal tip rotation.  

Background: Hepatitis B vaccination is recommended for all individuals with renal failure. Nevertheless, the response rate for this vaccine in hemodialysis patients is low. This study was designed to determine the response rate to hepatitis B vaccination in chronic renal failure (CRF) and end stage renal disease (ESRD) patients and those factors that influence it. Methods: We evaluated antiHBs level after primary vaccination in 32 predialysis and 93 dialysis patients. HBsAg positive patients were excluded. AntiHBs titers were determined in the period of 1 to 6 months after completion of vaccination. Results: Seroconversion (antiHBs>10mIU/ml) was found in 100 patients (80%), but an excellent response (titer>100 mIU/ml) was observed only in 74 (59.2%). Response rate were 71.9 and 82.8 in predialysis CRF and ESRD patients, respectively, but this difference was not significant (χ2-test; p=0.183). Predialysis patients showed an excellent response more than dialysis patients (χ2-test; p<0.05). Age, sex, and initial serum creatinine didn’t influence response rate. Response rate in patients with diabetic mellitus was lower than others (62.2% vs. 87.5%) (Χ2-test; p=0.001), and multiple logistic regression analysis showed a significant risk for vaccination nonresponse when patients were diabetics (odds ratio 4.38; 95% confidence interval: 1.70-11.24, p=0.002). Conclusion: Our result showed that 1) hepatitis B vaccine nonresponders are more likely to have diabetes mellitus and 2) response rate in predialysis patients is the same as in dialysis patients but predialysis patients, as compared with dialysis patients, were more inclined to show an excellent response.  

Background: The rate of cesarean delivery has increased in last decade, whereas it has some complications. This study was conducted to determine the incidence of fetal laceration injury in cesarean delivery in Al-Zahara teaching maternity hospital (Rasht, June1999-October 2000). Methods: It was a retrospective study using records of all neonates delivered by cesarean section during a 16 months period in Al-Zahara teaching maternity hospital. Maternal and neonatal records were reviewed in those cases with documented fetal laceration injuries. Lacerated and non-lacerated neonates were compared for maternal and neonatal characteristics. Results: There were 21 lacerated neonates (approximately %o. 4) out of 5289 neonates delivered by cesarean section during the study period. The incidence of laceration appeared to be higher in breach presentation and fetal distress when the indication of cesarean was considered (1.1% and 1%; p=0.045 and p=0.0026, respectively). Conclusion: Fetal laceration injury is a rare complication of cesarean delivery in cases of breech presentation and fetal distress

Background: The artificial methods of cranioplasty such as using metals or alloplastic materials have some disadvantages, comparning with autogenic bone flaps. We tried to show that the autogenic flaps have less complication when used in cranioplasty. Methods: With good sealing of bone flap after extraction and preserving in -70 to -800 C, in Immounology Department, the autogenic bone was fixed in the previous site. Results: From 10 patients, one of them developed infection and osteomyelitic bone was extracted. No bone resorption was detected. Conclusion: Comparing with other studies of autogenous bone flap cranioplasty, we have similar rate of complication. In other studies, the rate of infection was almost equal to our results. So using autogenous bone in our center is advisable.  

Alopecia universalis, generalized vitiligo, and Graves' disease are three autoimmune diseases that affect hair follicle, melanocyte, and thyroid gland, respectively. Even though association of each two of these disorders is common, but according to literature review by MEDLINE, this was the first case report of Graves' disease, alopecia universalis, and generalized vitiligo all together in one patient. Pathogenic mechanisms of multiple autoimmune responses and treatments of her skin problems are discussed.