Iranian Red Crescent Medical Journal
Volume:9 Issue: 1, 2007

Hypertension as a community health problem, showing an increasing trend in many parts of the world. Controlling the disease depends on knowledge, attitude and practice (KAP) of general physicians as the main health providers in the community. In this study, the impact of KAP of general physicians on hypertension, as the first line of treat ment of hypertension was evaluated. In a cross-sectional study, 300 general physicians working in health and treat ment sectors of Fars Province, southern Iran were entered in our study and their KAP were determined utilizing a validated and reliable questionnaire. The questionnaire consisted of 52 items incorporated in four sections. The mean age of general physicians was 38.2 ±3.6 years. 64.2%, 20.3%, and 26.5% of general physicians were visited by four to eight, more than eight, and less than four hypertensive patients per week respectively. Although 99% of physicians believed in the importance of hypertension as a community health problem, but 12% had requested for appropriate paraclinical tests and 20% could handle hypertensive patients properly. Only 45% of physicians had measured their own blood pressure within the last year of practice. Scientific meetings and educational programs were more important than information provided by drug companies and journals in promotion of knowledge, attitude and practice of general physicians Since the physician’s knowledge, attitude and practice are important issues in controlling and prevention of hypertension, promotion of their knowledge on hypertension seems necessary in prevention of subsequent complications.

The kidney biopsy specimen is used for initial diagnosis of patients with SLE.who at the time of biopsy lack either diagnostic clinical manifestation and or serological markers. Another role is evaluation of renal dysfunction in transplanted patients when lupus has occurred in renal allograft. The aim of this study is correlating the findings of light, immunofluorescent and electron microscopy in thirty patients with lupus nephritis. The kidney biopsies of thirty patients with SLE were studied for purpose of cor relating the findings of light, immunofluorescent and electron microscopy. We studied 30 parameters in light microscopy sections, 5 parameters in semi -thin and EM sections, and IgG, IgM, IgA, C3, C4 and fibrinogen in different structures of specimens by immunofluroscent microscopy. The P value and measurement of agreement of kappa was calculated. In 25 cases LM and EM correlated completely including lupus nephritis class, activity and chronicity indices and presence or absence of immune complex deposition. In 5 cases discrepancy between Light Microscopy and Electron Microscopy diagnosis was found. Three cases were classified as class III according to LM and class II by EM. LM reevaluation of all three cases showed focal and segmental endocapillary cell proliferation with neutro philic infiltration. We found that LM study is cornerstone in the focal lesions because of the limited inclusion of glomeruli in EM. One case of class IV by LM, in EM shows massive (grade III) sub-epithelial depositions and grade I sub endothelial deposition and was classified it as Class V + VI. In LM, findings cellular crescent in six glomeruli, severe endocapil lary cell proliferation with activity index of (16/24) were detected. So the correct diagnosis was Class V + VI. The last case classified as IV in LM classification and revealed moderate esangial cell proliferation

Meningioma is the most common brain benign tumor with a higher prevalence in women. Regarding the conflicting reports on the probable effect of estrogen and progesterone in tumor growth and the putative role of growth during pregnancy, menstruation cycle, luteal phase and contraception, this study was undertaken to evaluate the role of estrogen receptor in relation to meningioma. Fifty patients with meningioma were divided into three groups of benign, atypical and anaplastic ones and the presence of estrogen and progesterone receptors for malignancy grading of the tumor was determined using avidine biotine immunohistochemistry method. Estrogen receptor was not seen in any of these patients. Progesterone receptors were present and significantly more in women and in benign tumor types. The receptor showed no correlation with age, but the malignant type was significantly more frequent in men. Women with this tumor are suggested to ovoid pregnancy or to be treated before, and not to receive any contraceptive pills containing progesterone. Patients in whom progesterone receptors are present and the tumor removal is incomplete, are anticipated to have medical problems or recurrence, particularly in old age, if the tumor removal is not possible by surgery, anti-progesterone therapy would be beneficial.

Toxoplasma gondii is an intracellular protozoan parasite, and causes zoonotic infection. Human latent toxoplasmosis occurs in about half the world''s population though most cases are asymptomatic. Toxoplasma encephalitis (TE) has become one of the more frequent opportunistic infection in HIV infected patients. This retrospective and descriptive study was carried out at the Referral Behavioral Counseling and Modification Center in Shiraz, Iran. We were able to review the medical records of 208 HIV infected patients. They were examined and their records were screened via the standardized data collection sheet for demographic characteristics. Diagnoses of TE based on the presence of at least two of the following a history of neurologicalsymptoms, neurological signs, suggestive CT, clinical and radiological response to antitoxoplasmosis medication. The seroprevalence of toxoplasmosis among 208 HIV/AIDS patients was (18.2%) (38 patients) while 4 (10.4%) and 34 (89.6%) subjects showed Toxoplasma seropositivity with and without TE respectively. The majority of these patients were in the 25-34 age group, male, unemployed, single and residence in Shiraz, southern Iran. Toxoplasmosis is a silent disease, which poses many diagnostic and therapeutic challenges. Based on findings of this study, we support a screening program of Toxoplasma infection. Primary chemoprophylaxis should be routinely given to all HIV infected with Toxoplasma seropositive status. Also HIV infected individuals with Toxoplasma seronegative status may be advised about preventive behavioral practice.

The majorities of bladder diverticula are acquired and are secondary to either bladder outlet obstruction or the upper motor type of neurogenic bladder. This study was undertaken to increase awareness and understanding the putative role of BPH (Benign Prostatic Hyperplasia) in the development of bladder diverticula and to compare cystoscopy and cystography in detecting bladder diverticula. During a 4-month period, 106 patients with BPH, who were admitted in the hospital for surgery, were examined by cystoscopy to detect bladder diverticula. Thirty-one patients were selected randomly and underwent cystography. In this study, the rate of bladder diverticula in patients with BPH was 27.4% by cystoscopy while by cystography, it was 48%.There was a slight increase of bladder diverticula with increasing age. This research also depicted that the detection rate of diverticula cystography in of urinary bladder was much greater than that of cystoscopy. This study shows that the prevalence of bladder diverticula is considerably high. The detection rate of cystography in diverticula of urinary bladder was much greater than that of cystoscopy. Considering this high prevalence and potential complications, we suggest cystography for the early diagnosis and possible treatment of bladder diverticula in older patients with lower urinary tract symptoms.

The present report describes clinical, radiographic, and pathological features of an external auditory canal giant apocrine hidrocystoma in a 36-year-old Iranian woman. To the best of our knowledge, this tumor has not previously been reported in this area. There was no evidence of local recurrence one year after surgery.