Researcher Bulletin of Medical Sciences
Volume:12 Issue: 6, 2008

Endoscopic Variceal Ligation (EVL) is considered the selective method of therapy for patients who suffer from esophageal varices. In this article we evaluated the results and outcomes of patients who underwent EVL with multiband ligators due to their esophageal varices. We studied 95 cases of esophageal varices who underwent EVL at Taleghani Hospital between 2002 and 2007. EVL was applied because of active bleeding, primary or secondary prophylaxis for esophageal varice of grade 2 or above. The process was repeated every 3-4 weeks until the varices were occluded or become to grade 1 varices or small thrombosed ones. Their demographaic data were gathered and analyzed as well as all the informations about their recent procedure. Our studied subjects had the mean age of 51.53 ± 15.31 (ranged from 15 to 81). The average number of sessions for performing EVL were 1.81± 1.07 (ranged between 1 and 8 times). The mostprevalent cause for applying EVL was active bleeding. Complications were significantly more in patients whom were candidated for EVL by reason of active bleeding, compared to those who underwent EVL for either primary or secondary prophylactic reasons (P=0.02). Among cases who had developed any complications, the numbers of ligation sessions were significantly more than other patints (2.58±1.25 vs 1.40 ± 0.66, P<0.001). There was no case of death due to this mode of therapy. EVL as a selective mode of therapy for treatment of esophageal varices possesses a few cosequential complications and its application, therfore, is reasonable.

Congenital neurospinal dysraphism is the most common cause of neurogenic bladder among children. Myelomeningocele, which is the most common type of these lesions, is associated with neurogenic bladder in more than 90 percent of cases. Due to critical consequences of this disorder and high worldwide prevalence of urinary complications in these patients and because of no previous studies in our country, we evaluated patients with various types of spinal dysraphism refered to Labbafinejad and Mofid hospital between 1999 and 2005. In this study which was carried out on existing data, we evaluated 94 patients with various types of spinal dysraphisms. Type of spinal dysraphism, history of pyelonephritis, vesicoureteral reflux, renal damage, urinary incontinence, paraclinic findings, type of treatment and outcome of disease were reviewed in the patients records and these data were entered in to a data sheet and reported by descriptive-analytic statistics. Sixty eight patients (72.3%) had at least one episode of pyelonephritis. Hydronephrosis was reported in 34.1% of patients as well as vesicoureteral reflux in 35.1%, renal atrophy in 13.9% and end stage renal failure in 3.2% of them. Among 61 patients aged 4 years or older, 47 (77%) had urinary incontinence. Urodynamic studies were performed in 17% of patients to evaluate lower urinary tract function. Seventy six cases (80.9%) had paraclinic findings in favour of neurogenic bladder, from whom 59.2% had recieved medical treatments (CIC, anticholinergic agents, or both) to improve complications of this disorder; the mean age of these patients was 4.8 ± 4.4 years at the onset of medical treatments. Cystoplasty was performed in 35.1% of cases. Antireflux surgery was also performed in 9 patients (9.6%). 7 cases out of them underwent surgery without having any treatment for the underlying cause of reflux; in later follow-up, vesicoureteral reflux had relapsed in 6 cases of these latter group. It seems that urodynamic studies are the most accurate means in evaluation of lower urinary tract function and performing these studies in patients with spinal dysraphisms (in newborn period or early infancy) is necessary for diagnosis of urinary tract dysfunction and planning up the most appropriate management for these patients. Failure to treat the underlying cause of secondary vesicoureteral reflux would significantly jeopardize the success rate of any surgery that might inadvertently be done in an attempt to correct the problem.

One of the contributing factors in marital satisfaction is psychological issues. The aim of the study was to evaluate the correlation between females mental health and marital satisfaction. Current comparative cross-sectional study was conducted on 245 female subjects with psychopathology attending to a psychiatric clinic in Tehran during two years of 2005-2006. They had a former interview and afterwards fullfilled two questionnaires of ENRICH (for marital satisfaction) and SCL-90-R (assessing mental health). There was no significant correlation between ENRICH score and that obtained from SCL-90-R. However, factors of depression, anxiety, and obsession-compulsion was negatively correlated with marital satisfaction (P < 0.05); whereas, phobia was not related to it (P > 0.05). According to obtained results of correlation between mental health and marital satisfaction, it is recommended to consider marital distress of women with major psychiatric symptoms, especially amongst young couples and therefore, develop some scheduled combination treatment of pharmacotherapy and marital therapy strategies to enhance their marital satisfaction and improve the quality of life, particularly through out the management of anxiety, depression and OCD

Regarding the high prevalence of hearing loss among workers with long-term exposure to high level of noise, the importance of recognizing hearing loss etiology and assessing the effect of occupational health efforts to reduce the effect of noise pollution on hearing of workers, the present study is designed in the two groups of workplaces with and without high levels of noise in Rafsanjan (2006). In this historical cohort study, 120 workers were randomly selected in two groups; 1- sixty workers who had exposure to high level of noise (mean level of noise > 85 dB) and 2- sixty workers who did not have this exposure. Age, gender, experience and the daily working time among workers in the two groups were similar. Pure Tone Audiometry method was used for measuring hearing situation and the threshold considered for hearing loss was 20 dB. The proportions of workers with hearing loss in the two groups were compared using Chi-Square test, relative risk (RR) was calculated and 95% confidence interval for the target population was estimated. Mean level of noise in the workplaces with and without high level of noise were 108.3±6.0 and 68±4,0 dB, respectively (P<0.0001). There were 12% and 73% (P<0.0005) of respondents in exposed and none exposed groups who were suffering from hearing loss in their right ear giving a relative risk of 4. These proportions for hearing loss in left ear were 15% and 60% (p<0.0001), respectively, giving a relative risk of 6.3. workplaces with high level of noise which may cause hearing loss for workers still exist in the area of the study. More investigations are needed to explore the barriers and more occupational health efforts must be made to reduce the negative consequences.

Adenotonsillar hypertrophy is a common finding among children which in untreated cases may result in serious cardiopulmonary problems. There are limited studies about the effect of adentonsillectomy on pulmonary function parameters. Does adenotonsillectomy affect on pulmonary function? This study is performed to reveal this purpose. In a pre- and post-treatment clinical trial on 39 children between 6-13 years old with indication of adentonsillectomy due to obstructive respiratory symptoms (because of prominent hypertrophy of tonsils and/or adenoid tissue), 5 main Spirometric parameters were measured before and 2 months after adenotonsillectomy with a standard method and data were analyzed by paired t-test. 39 children (56% male and 44% female) with a mean age of 8.95±1.93 were evaluated. 4 main Spirometric parameters increased: FEV1/FVC from 89.1±12.7 to 97±4.6, FEV0.5/FVC from 70.9±15.5 to 81.1±11.8, FEV25-75 from 1.9±0.6 to 2.2±0.7, MEF50 from 2±0.6 to 2.4±0.7 and all the improvement was statistically significant (P<0.0001). There was no statistically significant change in FEV1/ PEFR index. Due to obvious changes of 4 main Spirometric parameters, it can be deduced that adenotonsillectomy is of effective roles in improvement of pulmonary function.

Considering the impact of family health on psychosocial health of community which itself depends on successful marriage with the basis of proper criteria for mate selection, and regarding our population that mostly consists of the youth and subsequent significant growing marriage and divorce rate, this study was conducted to identify the prioritized mate-selection criterion of marrying couples in Tehran. The total of 252 marrying couples referrying to urban health centers affiliated to Tehran university of medical sciences were randomly selected via a multi-stage sampling method. Data were collected by a questionnaire validated by content validity and made reliable by Cronbach’s alpha. It consisted of 3 distinct parts, including demographics (15 questions), family characteristics, appearance, emotional, socioeconomical and sociocultural status (44 questions) and one open question. A six-rate scale was designed for the questions from 0 (no importance) to 5 (very important). The first priorities included honesty (Mean=98.37%), loyalty (Mean=97.88%), understandin (Mean=96.45%), appropriate manner (Mean=96.26%), no addiction (Mean=95.86%), assertiveness (either at work or in life) (Mean= 94.10%) and serenity (Mean= 92.95%). The last priorities for mate selection were fellow-citizenship (Mean=43.83%), prosperity (Mean=43.81%) and Colleagueship (Mean=39.48%). It is concluded that psychological health is the most important topic through the mate-selection criterion, whereas the cultural and religious subjects are the least important ones.

The stress-inducible Heat Shock Proteins (i.e. HSP60) constitute one of the highly conserved protein and gene families. As one of the molecular chaperone proteins, they play essential roles in protein metabolism and protein translocation under both stress and non-stress conditions. In the present study, we try to characterize the 60 kDa Heat Shock Protein (HSP60) gene in dermatophyte pathogen Microsporom Canis (M. canis). This dermatophyte is one of the most important causative agents of dermatophytosis in human and animals. Some properties of M. canis have been investigated in molecular level; however, no information is available regarding the HSP60 in this dermatophyte. In the present study, we try to characterize the 60 kDa Heat Shock Protein (HSP60) gene in dermatophyte pathogen Microsporom Canis (M. canis). M. canis was obtained from patients with dermatophytosis and cultured in appropriate conditions. High molecular weight DNA was isolated from obtained mycelial mass by standard methods. Pairs of 21 nt primers were designed from highly conserved regions of the HSP60 genes in other eukaryotic cells. Mentioned primers were utilized in PCR using isolated genomic DNA template of M. canis. Predicted molecules have been amplified and were submitted for sequencing. By the time 1550 nucleotides of this gene are sequenced and analysed, that encoding a 497 amino acids protein. In the present study, we report the identification and molecular characterization of a M. canis gene encoding a protein belongs to the 60 kDa Heat Shock Protein family which will here be referred to as McHSP60. Analysis of the amino acid sequence of this gene revealed a considerable identity with other eukaryotic HSP60 such as those of C.immitis (97%), Aspergillus fumigatus (92%) and S.cerevisiae (74%). Investigation of amino acid composition in HSP60 revealed Alanine, Glutamic acid and Glysine as the most common amino acids in this protein. The amino acid composition of McHSP60 indicates the amount of Cysteine and Tryptophan are poor.

An investigation of the prevalence of occupational hand dermatitis in Loghman Hakim, a large teaching hospital in Tehran, was conducted. Information concerning the presence of occupational hand dermatitis, frequency of hand-washing and glove consumption, duration of contact with glove and wet environment, past history of hand eczema, personal and family history of atopy, kind of ward, kind of used detergent, underling systemic disease, history of systemic drug consumption, duration of employment, cigarette consumption, and demographic factors (including age, gender, hobbies, and occupation) was collected via a questionnaire and physical examination by dermatologist. To determine the type of occupational hand dermatitis, allergic or irritant, patch test was performed. The prevalence of occupational hand dermatitis was found to be 44% in total population. No relationship was found between occupational hand dermatitis and age, hobbies, frequency of hand-washing and glove consumption, duration of contact with glove and wet environment, cigarette consumption, duration of employment, type of ward, kind of used detergent, underling systemic disease, history of systemic drug consumption, and duration of employment. There were statistically significant differences between two groups of stuff (with and without occupational hand dermatitis) in their gender, past history of hand eczema, and personal and family history of atopy. Out of 43 stuff underwent patch test, 50% had allergic occupational hand dermatitis. The most common positive allergen was nickel. The high prevalence rate of occupational hand dermatitis among intra-hospital staff causes great concern about the health risks of these workers when they would expose to blood-borne diseases.

Parathion is an organophosphate compound that is frequently used as an insecticide. Paraoxon is the metabolic product of parathion which previously reported that inhibits GABA uptake by rat cerebral cortex synaptosomes. The aim of this study is to investigate possible underlying inhibitory mechanism(s) of paraoxon on GABA uptake, in synaptosomes prepared from rat cerebral cortex. After preparation of synaptosomes, kinetic studies were performed to determe the effect of paraoxon on Km and Vmax of GABA uptake. Acetylcholine and its antagonists (atropine and mecamylamine) were used to evaluate cholinergic dependency of GABA uptake. Type of GABA transporter involved was determined using beta-alanine and DABA. The results of the study showed that paraoxon significantly decreased Vmax (175.2±4.23 vs. 80.4±2.03 pmol/mg protein/min, P<0.001) of GABA uptake while had no effect on its km (9.80±1.02 vs. 9.09±0.92μM in paraoxon and control groups respectively). DABA significantly decreased GABA uptake (P<0.001) while beta-alanine had no effect. Acetylcholine had no effect on GABA uptake. On the other hand, neither atropine nor mecamylamine could reverse the inhibitory effect of paraoxon on GABA uptake. In conclusion, it seems that paraoxon acts as non-competitive anatagonist of GABA uptake, which affects kinetics of GABA uptake in nerve endings. We also conclude that the inhibitory effect of paraoxon on GABA uptake is cholinergic-independent

HIV /AIDS infection is one of the most important causes of illness and death worldwide. Since, blood and body secretion are sources of HIV/AIDS transmission, health personnel, especially midwives are considered as high risk target groups. Knowledge and attitude of midwifery personnel about HIV/AID prevention can affect on their health behavior. This study aimed to assess knowledge, attitude and practice of midwives about HIV/AIDS prevention in the selected hospitals of Isfahan in 2006. in this descriptive analytical study, using a consensus, all of 58 midwives of selected hospitals of Isfahan including: Dr. Shareeati, Amiralmomenin, Askarieh, Eisabne-maryamand beheshti participated in the study. Our data consisted of a checklist of the practice observation and a questionnaire including 3 parts of demographic, knowledge, and attitude questions. Data were analyzed using SPSS 10 an applying ANOVA, t-test, Fisher’s Exact test, Pearson and Spearmen's Correlation tests. 58 midwives aged 35.4±7.8 took part in the study. Majority had a good knowledge (96.6%), positive attitude, (93.1%), but moderate practice (70.8%) about HIV/AIDS prevention. Only 29.3% had a good practice. There was a significant difference between permanent and temporary employed midwives (P<0.05) and also a weak but significant correlation between practice score and the years of their clinical work (Pearson correlation, r= -0.3, P<0.05). This study demonstrated a moderate practice of midwives in spite of their high knowledge and positive attitude about HIV/AIDS. It seems that further studies are needed to find effective factors on their behavior and further interventional projects to improve their health.

Patient satisfaction survey is an instrumental component in monitoring the hospital’s quality of care, in relation to cost and services. Many studies have been conducted throughout the world to determine the patient satisfaction and its related factors. This study was carried out to evaluate patient satisfaction and its related factors. A cross sectional study was based on in-hospital patient who attended the Taleghni hospital between April 2006 and August 2006. Sample size was determined as 476 from 5021 by randomized sampling. Sample sizes in each ward were according to the proportion of hospitalized patient. Participants were interviewed privately face to face in the hospital at discharge time. Interviews were conducted by trained interviewers using pre tested questionnaires (Verona Service Satisfaction Scale- VSSS 32). Correlation between total satisfaction and Patient’s age, education) was estimated by using Pearson’s Correlation. Prevalence and confidence interval (CI) of unsatisfied patient was calculated. In majority, 83% of patients were quite satisfied with their care and 1.5% was dissatisfied (CI=0.7-2.2). 93% of patient was most satisfied with physician communication and treatment. Only 49% of patients were satisfied with nutrition status. There was no relationship between age, educational status and total satisfaction. Percentage of patient-faithfulness was 66%. 65% of admitted subjects were recommending this hospital to their friends. Patients whose in-hospital course was between 11-15 days were more satisfied with hospitalization among both sexes. In general, patients were quite satisfied with their hospital care.Further studies similar to this survey is offer to improve the quality of care and overall health-care outcomes.