مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
سال شصت و یکم شماره 5 (پیاپی 160، آذر و دی 1397)

Abstract In recent years, interest in research into the application of intelligent algorithms for diagnosis and categorization of diseases, especially cancer has increased dramatically. Tumor classification is an important task in medical diagnosis. Technological calculations are important due to their classification function in diagnosis of medical illnesses. Diagnosing and classifying medical images is a challenging task. To detect the malignancy of prostate cancer and the opioid or malignant breast cancer, deep neural network classifier, which is based on Tensor flow framework and Keras library, is used. In the training phase, educational images are considered along with the output class for the network. During training, the weight of the filter is updated every time. However, after several replications, optimal weights are updated and the network is trained to extract the best feature from the images. In this research, the proposed method due to using deep neural network and accurate feature extraction provides detection accuracy about 95.83% and 99.5% for breast and prostate cancers, respectively, which is more than 7% compared to other methods. Cancer is one of the most prevalent diseases in the world. Cancer is started from the cells, which are the basic building blocks making the tissue. One of the challenges in medical diagnostic techniques is the difficulty in analyzing dense tissues. Since the detection of the diagnosis by human is time-consuming and has a higher probability of error, the researchers have been trying to detect it automatically by using different algorithms.

There is no definitive finding about the association between vitamin D deficiency and autoimmune hypothyroidism. On the other hand, there is evidence that trace elements such as zinc undergo changes in the presence of hypothyroidism. This study was aimed to compare the prevalence of vitamin D and zinc deficiency in patients with hypothyroidism and healthy people in Birjand in the winter of 2016. In this case control study, 50 hypothyroid patients referred to endocrinology clinic of Vali-e-Asr Hospital in Birjand and 50 healthy subjects were selected from the general population. The two groups were matched in terms of age, gender and body mass index. After obtaining informed consent, blood samples received from participants and sent to laboratory for Vitamin D, Ca, Zinc, TSH and Anti TPO measurement. Data were analyzed by SPSS version 19 with the help of Chi-square, independent T test, Mann Whitney test, Pearson and Spearman Correlation tests and logistic regression test. P Overall 88% of patients and 68% of healthy subjects suffered from vitamin D deficiency (P = 0.016). 16% of the case group and 4% of the control group suffered from zinc deficiency (P = 0.046). In the case group, TSH was inversely and significantly associated with vitamin D (r = -0.530, P <0.001) and calcium (r = -0.551, P <0.001) and correlated directly and significantly with Anti TPO (r = 0/628, P <0.001). Also Anti TPO was inversely and significantly correlated with vitamin D (r = -0.286, P = 0.44). The results of this study showed that the prevalence of vitamin D and zinc deficiency in patients with hypothyroidism is significantly higher than the normal people. It is recommended that people with hypothyroidism be monitored for vitamin D and zinc deficiency.

Abstract Pericardial effusion is the accumulation of over-normal fluid in the pericardial space that is pathologic and causes cardiac dysfunction and sometimes death of the patient. We aimed to evaluate the etiology and mortality of pericardial window patients. A retrospective descriptive analysis was performed on all the patients with cardiac tamponade, who were admitted to cardiac surgery ward of Ghaem Hospital during 2013-2017. We included patients who had undergone transthoracic echocardiography by the cardiology service at least once. After completing the forms specific to information and considered variables, SPSS was used to analyze the data. P-values less than 0.05 were considered statistically significant. Of the 100 patients, 45 were female and 55 were male. The mean age of the patients was 57 years. The most common etiologies included viral infections (25%), tuberculosis (10%), malignancy (6%), chronic kidney diseases (4%), connective tissue disorders (4%), chronic liver diseases (3%), and history of open heart surgery (3%). In 45% of the cases, a specific etiology could not be established. The rate of mortality was reported 2%. Pericardial effusion and cardiac tamponade are life threatening conditions. However, timely medical intervention and surgery, as well as proper operative management, can effectively save lives and reduce patient mortality.

The aim of this study ws to evaluate knowledge and attitude towards euthanasia and understanding of  its pitfalls in medical education.

In a cross-sectional study in fall and winter 2015, medical students at different educational levels were asked to participate in this study. A questionnaire which was adopted from 3 foreign surveys after Persian translation by backward-forward method was used.  

The response rate was 88.36%. The reliability of the tool using Cronbach’s α was 0.72. The most common problem was detection of active involuntary euthanasia. In all, 67.2% were unable to define forbidden tasks for a critically ill patient. 84.9% agreed to ratify the law to introduce permissible cases of euthanasia. However, 62.4% were concerned about misuse of such law by some people, 77.6% were agreed euthanasia about themselves in complex medical situations. In all, 66.7% believed palliative medicine is a good way to relief patent's unpleasant symptoms, to Improve patient's quality of life.  

It seems that lack of awareness of the advances in palliative medicine and its goal to Improve the quality of life in dying patient is one of the reasons for the relatively high level of agreement for doing euthanasia.

Infective endocarditis refers to an infectious disease that often affects the heart valves (whether natural or artificial). Unfortunately, there are few studies on the epidemiology of infective endocarditis in Iran. The aim of this study was to evaluate the incidence of infective endocarditis in terms of demographic characteristics of clinical symptoms, underlying diseases and outcomes. Methods & Materials This study was a retrospective-prospective cohort study, which was done descriptively on patients with endocarditis. Accordingly, the information of patients in two hospitals of Imam Reza and Ghaem was followed and recorded in the checklist. The information was included in the field information as well as information about the patients' illness was entered in the statistical software and was evaluated descriptively. Results In our study we observed that of 19 patients evaluated in this study, 17 cases (89.5%) were males and 2 patients (10.5%) were females. We also observed that only 2 patients (10.5%) had heart attack after surgery, 4 (21.1%) patients had recurrent endocarditis after surgery, and 3 patients (15.8%) needed re-surgery due to other diseases and total mobility rates were positive in 9 patients. Conclusion Based on the results observed in this study, the high mortality rate of patients after endocarditis indicates the importance of attention to these patients. Accordingly, consideration of the clinical features of these patients can lead to better management of patients and promote their prognosis.

Labral tear is a source of hip pain in young age. Incidence of labral tear is very high. Hip Labrum is a specialized fibrocartilage tissue that surrounding the acetabular rim as a "O" shape ring and increased its depth. It has a main role to maintain the intraarticular pressure of synovial fluid and also has a critical role in hip joint stability.Hip arthroscopy has increased in popularity tremendously in the last ten years. Despite difficulties in joint access and patient positioninig and the fact that these type of surgery is high technical demanding, orthopedic surgeons trend is changing toward hip arthroscopy. For decades this injuries left untreated or treated with open surgical procedures but with evolution of the hip arthroscopy techniques, these years majority of these cases treated through modern new arthroscopic methods. we decided to explain the current concept of labral tear repair in the hip joint in this review article.

Abstract

Diabetes illness is one of the most common disorders in which psychological aspects play an important role in their development and development. Negative excitements such as anxiety and depression have been identified in diabetes. One of the ways to reduce negative emotions in patients is to teach life skills. The purpose of this study was to investigate the effectiveness of life skills training on decreasing depression and anxiety in patients with type 2 diabetes.

This quasi-experimental study was a trial and control group and a pretest design, a post-test with a three-month follow-up. The statistical population of all type II diabetic patients was referred to Ravand clinic of Kashan. In this study, patients who had more scores in the scale of depression and anxiety were selected according to entry criteria for a sample size of 30 people and were randomly assigned into two groups of experimental and control groups. The experimental group received 10 sessions of intervention in a group and control subjects were included in the waiting list. Both groups responded to the Beck Depression and Anxiety Scale before and after the experiment and were evaluated again after three months. To analyze the data, repeated measures variance analysis were used.

The results showed that life skills training significantly decreased the level of depression (F = 10.70, P = 0.003) and anxiety (F = 15.62, p = 0.001), and the results were also observed in the follow up phase was stable.

In general, the use of life skills training helps to raise awareness and change the attitudes of people and, ultimately, reduce disease.

Toxocariasis is caused by toxocara egg. The eggs, present in dog and cat feces, become infectious within weeks after they are deposited in the local environment. Visceral Larva Migrans (VLM) is one of the major diseases caused by eatingToxocara canis and Toxocara cati eggs, in which Toxocara canis is more significant. humans are consumed with with this worm is affected by toxocariasis. Humans become infected by food and contaminated water.
Materials &

In this study, 80 soil samples from 16 parks were collected from larestan. From each place about 200 gram and up to a depth of 5-3 cm of soil was collected. Subsequently, large particles were removed using a conventional sieve. Afterward, a 150-micron beaker was used for separation. Then, to carry out the concentration and separation of Toxocara eggs from the soil with saturated sucrose method, was used.

Of the total number of parks surveyed, 5 parks (31.25%) contaminated  with Toxocara eggs by saturated sucrose (sheathers) method and the number of eggs found was 32.

Toxocariasis is one of the zoonotic diseases. It is necessary to establish rules and regulations for not entering the dogs into parks. A more definitive diagnosis seems essential.