Iranian Red Crescent Medical Journal
Volume:14 Issue: 11, Nov 2012

Nausea and vomiting in pregnancy is a common complaint of nearly 50-80% of pregnant women. The problem begins around the 4th weeks of pregnancy and often stays up to the 12th weeks and may continue to the 16th week in a few patients. The aim of our study is to determine the effect of acupressure (on KID21 point) on nausea and vomiting of pregnancy. This single blind clinical trial study was performed on 80 women with nausea and vomiting in the first trimester of pregnancy. Women were randomly divided to two groups; study group with the acupressure on KID21 point and the placebo group with pressure on sham acupressure for 20 minutes per day in four consecutive days. The intensity of nausea was assessed by visual Analogue scale (VAS) and vomiting frequency was evaluated by counting during these four days. Then the results compared with each other. The intensity of nausea and vomiting between two groups on the fourth day was shown differences (P<0.001). Acupressure on KID21 point is more effective than sham acupressure in reduction of nausea and vomiting in pregnancy.

Diabetes mellitus (DM) has several ophthalmic complications and retinopathy is the most common of them. The aim of this study was to determine frequency of ophthalmic complications in diabetes mellitus. This descriptive study was performed on 140 type II diabetic patients in Shahid Beheshti Hospital during 2007-2008. All patients were assessed by questionnaire for age, gender, duration of disease, fasting blood sugar (FBS), hemoglobin A1c (HbA1c), blood pressure (BP), method of diabetic control, and examined by observation, slit lamp, and tonometer for detection of cataract, glaucoma, ophthalmic neuropathy. Retina observed by indirect ophthalmoscop, and lens +90 for detection of retinopathy and maculapathy. Data were recorded and analyzed. Fourty five (32.1%) males, 95(67.9) females with the mean age 53.49 9.72 years were evaluated. Mean duration of disease was 8.88 6.06 year and 71.1% of them had HbA1c over 7%, 6 (4.3%) had ophthalmic neuropathy, 1 case ptosis and 1 case with rubeosis were noticed. Retinopathy was seen in 51 (36.42%) patients which most of them were non proliferative diabetic retinopathy (NPDR) (29.2%). Maculopathy was seen in 35 (25%), patients with clinical significant macular edema (CSME) to be the most (23.6%). There was a significant difference in FBS levels between diabetic retinopathy and no diabetic retinopathy groups (P=0.042). The difference was also significant when HbA1c levels were compared between the two groups (P=0.003). The results show that higher FBS and HbA1c > 7% levels are associated with ocular retinopathy.

Many factors effect on management (surgical and nonsurgical) of adolescent idiopathic scoliosis (AIS). The purpose of this study was evaluation of the effects of generalized ligamentous laxity (GLL) on surgical treatment of AIS. 72 patients with AIS were studied between 2002 and 2009. 24 cases (33.4%) were placed in group A (normal) while 48 patients (66.6%) with GLL in group B. Our threshold for adding anterior approach was a curve which could not be corrected to < 50° on the supine lateral bending view. The mean age and follow up period were 16.4 (12-22 years) and 3.8 (2-6.5 years), respectively. In the first group, 12 (50%) were operated with combined anterior and posterior approaches while in the later; there were only 6 (12.5%). Curve correction was 73.3% in patients with GLL and 57.1% in patients without it. Both of these differences were significant statistically (P = 0.001). In preoperative planning of surgical treatment of AIS, GLL is an important factor. In this special group of patients due to much more flexibility, relatively larger scoliotic curves can be safely treated by single posterior approach.

To investigate the biochemical-physiological characteristics and genetic variations of Malassezia species isolated from pityriasis versicolor and seborrhoeic dermatitis patients. The aims of the present study were: firstly, to determine the distribution of Malassezia species in PV and SD in South-west Asia (Iran) and secondly, to analyze the DNA profile by RAPD-PCR of Malassezia species isolated from patients studied. Twenty two pityriasis versicolor and seborrhoeic dermatitis outpatients at Razi Hospital of Tehran University were included in this study. The samples were cultured and identified for Malassezia spp. by the conventional techniques based on the morphological, biochemical and physiological characteristics. Random amplification of polymorphic DNA polymerase chain reaction (RAPD-PCR) was applied for genetic variations of the isolates. M. furfur was the prevalent species isolated from pityriasis versicolor either alone (44/4 %) or in combination with M. globosa or M. sympodialis (44/4 %); while M. globosa was most frequently isolated from seborrhoeic dermatitis either alone (38/5 %) or combination with M. furfur (7/7 %). The RAPD analysis among Malassezia isolates was counteracted from 238 amplified products in 81 separable positions and indicated that all Malassezia isolates were composed of nine genetically distant groups. We found different physiological characteristics and genetic variations of Malassezia isolates from all patients. Moreover, RAPD-PCR can be used as a powerful tool in epidemiological investigation of dermatological disorders associated with Malassezia species such as pityriasis versicolor and seborrhoeic dermatitis.

Chronic vestibular dysfunction is a frustrating problem in the elderly and can have a tremendous impact on their life, but only a few studies are available. Vestibular rehabilitation therapy (VRT) is an important therapeutic option for the neuro-otologist in treating patients with significant balance deficits. The purpose of this study was to assess the effect of vestibular rehabilitation on dizziness in elderly patients with chronic vestibular dysfunction.. A total of 33 patients older than 60 years with chronic vestibular dysfunction were studied. Clinical and objective vestibular tests including videonystagmography (VNG) and dizziness handicap inventory (DHI) were carried out at their first visit, 2 weeks, and 8 weeks post-VRT. The VRT exercises were performed according to Cawthorne and Cooksey protocols.. Oculomotor assessments were within normal limits in all patients. Nineteen patients (57.57%) showed abnormal canal paralysis on caloric testing which at follow-up sessions; CP values were decreased remarkably after VRT exercises. We found a significant improvement between pre-VRT and post-VRT total DHI scores (P < 0.001). This improvement was most prominent in functional subscore. Our study demonstrated that VRT is an effective therapeutic method for elderly patients with chronic vestibular dysfunction.

Paranasal sinus CT has high sensitivity and specificity for sinusitis. However, this modality is costly and involves greater radiation exposure than plain radiographs. We tried to compare 10-cut limited CT scan and standard CT scan in the diagnosis of sinusitis. We conducted a cross sectional case series from August to December 2010 on 150 patients with non-randomized sampling method in academic hospitals related to medical school of Shahid Beheshti University of medical sciences. Using standard CT scan as the gold standard, the sensitivity and specificity of limited series were calculated for each sinus group.. In our study limited CT scan had a sensitivity of 92%, specificity of 94%, positive predictive value of 90% and negative predictive value of 95%. The limited CT scan is useful for confirming the clinical diagnosis of sinusitis.

According to World Health Organization (WHO) estimation, more than half of all pharmaceutical products are inappropriately prescribed, distributed, and sold and more than half of all patients use the medicines prescribed for them incorrectly. As more than 40% of therapeutic costs are pharmaceutical costs, this implies a significant waste of health resources in the world.. To find effective factors in irrational prescription of corticosteroids in Iran and design suitable interventions to decrease prescription rates of corticosteroids. A qualitative study was performed in 2009 on fifteen general practitioners in two groups identified by high and low corticosteroid prescription rates. Data analysis was performed by thematic analysis and the study's validity was based on training interviewers, use of interview guide, avoidance of imposing opinions, coding by two independent persons and use of all opinions obtained in the analysis. The effective factors in irrational prescription of corticosteroids can be divided into four categories: lack of knowledge, patient-physician relationship in terms of monetary cost, poor availability of proper alternative medicines and weak supervision of regulatory bodies. As the same results were found in both groups regarding the role of regulatory organizations and availability of alternative medicines, it seems that interventions in knowledge and the patient-physician relationship which were different in the two groups can be more effective for reduction of prescription in high rate prescribers although intervention in regulatory supervision and medicine availability could have a moderate effect in both groups. In addition the common feature in all the above categories was the gap between knowledge and actual practice which is significant on three regulatory levels, supervisors, physicians and patients, and should be noted for intervention design. The interventions applied in other countries can also be effective in decreasing irrational prescription of corticosteroids in Iran. These interventions include: standard clinical guidelines, essential medicines list, practical workshops, purposeful training based on problem-solving, training of all parties including pharmacists and patients, improved regulatory mechanisms, availability of assured quality medicines, availability of suitable alternatives to painkillers and realistic rational prescription policy.

Breast cancer is the most common malignancy in women around the world so finding new biomarkers for early detection and also study on molecular aspects of breast cancer is valuable. Cancer testis genes are a group of genes expressed solely in testis and in a range of human malignancies. In this study we determined the expression of cancer testis genes Tsga10, TEX101 and ODF3 in patients with breast cancer. Fifty patients with breast cancer were enrolled in this study. Breast cancer cell lines MCF-7 and MDA-MB-231 were also used to determine the expression of testis cancer genes. For both patients and cell lines, cancer testis genes of TSGA10, TEX101 and ODF3 were determined by RT-PCR. The presence of auto antibody against these genes in patients’ serums was carried on by ELISA method. Seventy percent of patients showed TSGA10 expression but none of them showed expression of TEX101 and ODF3. Fourteen percent of patients were positive for anti TSGA10 but all patients were negative for anti TEX101 and anti ODF3. Both of breast cancer cell lines exhibited very strong expression of TSGA10. Because of the important roles of Tsga10 in cell proliferation, we concluded that this gene may have a role in proliferation and survival of breast cancer cells and could be used for diagnosis and immunotherapy of breast cancer.

Post-transplant lymphoproliferative disorder is a lymphocyte proliferating disease, usually of B cell origin, and rarely of T cell. Involvement of liver itself in liver transplant recipients as the primary organ is not common. Herein we report our experience in two patients who primarily presented in the allografted liver, both of whom were promptly diagnosed after liver biopsy and treated successfully. Now after a few months; both of the patients are alive with normal liver function tests and negative imaging studies.

The exposure to noxious agwents such as lead my cause lung disorders. In the present study, pulmonary function tests and self-reported respiratory symptoms in lead exposure workers were compared with matched control subjects. The frequency of respiratory symptoms were evaluated in a sample of 108 lead exposure workers and 100 control subjects with similar age using a questionnaire including questions on respiratory symptoms in the past year. Pulmonary function tests (PFT) were also measured in lead exposure workers and in controls. Most lead exposure workers (63%) reported work-related respiratory symptoms. Chest tightness (26%), cough (17%) and sputum (16%) were the most common symptoms and only 6% of lead exposure workers reported wheezing (P < 0.001 for all case except wheezing). Most PFT values were also significantly reduced among lead exposure workers (P < 0.05 to P < 0.001 except MEF75, MEF50, MEF25, and MMEF. The lead concentration in urine and serum of lead exposure workers were significantly higher than control (P < 0.001 for both cases). These results showed that c lead exposure workers have higher frequencies of respiratory symptoms higher serum and urine lead concentration but lower PFT values.

Approximately 80 percent of pregnant women suffer by some degree of nausea and vomiting. But the treatment of nausea and vomiting of pregnancy is rarely successful.. The aim of this study was evaluation the effect of mint on nausea and vomiting during pregnancy that its treatment in some recent research has been effective. In this double blind RCT, 60 pregnant women with nausea and vomiting of pregnancy were sampled and divided into two groups with Block-randomized method. mint group, in addition to giving the routine training, for four consecutive nights, before sleeping, a bowel of water whit four drops of pure mint essential oil placed on the floor near their beds and in control groups were used four drops of normal saline. The severity of nausea by using Visual Analog Scale (VAS) and severity of vomiting by counting the number of its in 7 days prior, 4 days during, and 7 days after intervention were assessed. The results showed that the severity of nausea and vomiting did not differ between the two groups in 7days before and after intervention by using repeated measurement test. But during intervention, the severity of nausea showed a decreasing trend (especially in 4th night) in the mint and an increasing trend in the control group. The severity of nausea within 7 days after the intervention had a decreasing trend in both groups; however, the intensity was lower in the mint than saline group but not statically significant. No meaningful relationship has been detected during and after intervention for the intensity of vomiting. The results of study showed that peppermint essential oil hasnt the effect on nausea and vomiting of pregnancy.

The purpose of this analysis was to evaluate the technological viability, basic safety and consequence of central pancreatectomy (CP) with pancreaticogastrostomy in properly chosen sufferers with noncancerous central pancreatic pathology. This research is centered on the infirmary charts of West China hospital. We recruited 20 individuals from 2007 to 2009 diagnosed with benign cancerous growth of pancreatic body and neck. They underwent pancreatic body and neck resection adhering to pancreaticogastrostomy. We carried out central pancreatectomy following pancreaticogastrostomy in 20 patients: 8 with serous cyst adenomas, 11 with mucinous cystadenomas, and 1 with neuroendocrine tumor. The position of all tumors was restricted to body and neck of the pancreas, measuring a mean ± standard deviation of 2.6±1.3cm. The mean post-operative hospital stay was 7 days (ranging from 6 to 16 days).There was no intraoperative additional complications. From a technical perspective, CP is a safe and sound, pancreas-preserving pancreatectomy for non-enucleable non-cancerous pancreatic pathology restricted to the pancreatic body.

Consumption of home-distilled alcohol may lead to epidemic or sporadic cases of severe acute methanol poisoning. The difficulty of establishing strict indications for hemodialysis in acute methanol poisoning is a widely recognized issue. The determination of the clinical, especially hemodialysis, and para clinical factors influencing patient survival in 46 acutely methanol poisoned patients was the aim of this cross sectional retrospective study. Clinical and paraclinical variables compared in surviving and non-surviving patients were hemodialysis and ventilation requirements, the level of consciousness, ABG parameters the serum methanol, creatinine and BUN levels. Only ethanol was used for ADH (Alcohol Dehydrogenize) blockade. Receiver operative curve characteristics showed that a serum methanol threshold level of 15mg/dl, instead of 25mg/dl, has a better sensitivity and rather the same specificity for predicting patient mortality. With no fomepizloe and using conventional hemodialysis, lowering the threshold of methanol concentration for hemodialysis initiation, may save lives in acute methanol intoxication.