Journal of Research in Medical Sciences
Volume:17 Issue: 10, Oct 2012

Psychological factors such as personality traits may affect the adjustment capacity and Quality of Life (QOL) in Ulcerative Colitis (UC) patients. Type D personality has some similarities with general personality traits of UC patients. The aims of this study were to compare NEO personality profile and type D personality between healthy normal group and UC patients; and to determine the possible relationship between type D personality and QOL in UC patients. The sample of study comprised of 58 UC patients and 59 healthy control subjects (from their family members). All participants were requested to fill out NEO-FFI، Type D personality (Ds14) Scale and WHO-Quality of Life Questionnaire. The findings indicated that UC patients scored higher in neuroticism (p<0/01); lower in extraversion (p<0/01) and openness (p<0/05) than healthy controls but their differentiation were not significant in agreeableness and conscientiousness. The findings showed that 59% of UC patients and 33% of the control subjects had type D personality; and the differences in frequency of type D between the two groups were significant (p<0/05). The mean QOL scores of type D personality in UC patients was significantly lower than patients without type D personality (F= 7/55، p<0/01). Type D personality could better predict QOL of UC patients than NEO dimensions. Differences were observed between UC patients and their healthy family members، in terms of personality factors. Type D personality may be regarded as an important factor that may bring about some adverse effects in QOL among UC patients.

Ulnar nerve entrapment at the elbow is the second most common upper extremity nerve involvement after median nerve involvement at the wrist or carpal tunnel syndrome (CTS) considering the frequency of occurrence in the upper limb with variable causes. Hemodialysis، because of elbow positioning during dialysis، upper extremity vascular-access، and underlying disease is one cause of ulnar entrapment. This study considers evaluating the effect of elbow positioning on ulnar involvement prevalence during dialysis. This cross-sectional study started in June 2011 and completed in December 2011. The patients receiving dialysis with at least one symptom or sign of ulnar nerve involvement underwent nerve conduction studies. Electromyography testing (EMG) performed to confirm the ulnar neuropathy. To review the ulnar nerve، patients must be in supine position with arm in 90° abduction and elbow in 135° flexion. We stimulated the ulnar nerve at three different points، including 6 cm above and 4 cm below the elbow and over the wrist. According to the electrophysiological data، the intensity of nerve entrapment and possibility of associated polyneuropathy determined. Clinically and electrodiagnostically، evidence confirmed that ulnar neuropathy was present in 11 (27. 5%) of 40 hemodialysis patients and in 10 (25%) of 40 peritoneal patients (P value: 0. 83). Also، the prevalence of median neuropathy in hemodialysis and peritoneal dialysis patients was 14 (35%) and 10 (25%)، respectively (P value: 0. 33). The frequency of median and ulnar neuropathy in hemodialysis patients is more than peritoneal dialysis، but this different is not significant. In addition، comparing sitting position with prolonged elbow flexion and supine position with elbow extension during hemodialysis، recommended doing hemodialysis in later position with using an elbow pad.

To compare the effect of betamethasonemethasone (betamethasone) and dexamethasonemethasone (dexamethasone) on maternal white blood cell (WBC) and differential count، erythrocyte sedimentation rate (ESR)، Apgar score، maternal and fetal plasma glucose and length of admission to delivery، gestational age at delivery in women at risk of preterm labor (PTL). STUDY DESIGN: Two hundred and forty pregnant women at risk for PTL with intact membranes or preterm premature rupture of the membranes (PPROM) were randomly allocated to receive either two intramuscular injections of 12 mg betamethasone at 24-h intervals or 4 injections of 6 mg dexamethasone at 12-h intervals. Blood tests for WBC and differential count، ESR and fasting plasma glucose were drawn before betamethasone or dexamethasone injection and after injection every 24 h for two days. Pregnancy outcome was assessed as Apgar score، fetal plasma glucose and length of gestation. In the preterm delivery group with intact membranes، no significant differences were found between the two groups in the maternal serum indicators of infection. The mean gestational age at delivery، 1- and 5-min Apgar score were higher in the dexamethasone group than in the betamethasone group. In the PPROM group، a significant rise in WBC count was occurred (12. 4 cells/mm3 vs. 10. 5 cells/mm3، P < 0. 001)، none of the other maternal serum indicators of infection and outcome variables showed significant differences between the dexamethasone and betamethasone groups. Dexamethasone compared to betamethasone significantly increased WBC count in women with PPROM، but in women at risk of PTL with intact membranes none of the maternal serum indicators of infection showed significant differences.

Regional anesthesia is widely used to perform different surgical procedures including those performed on the extremities. In this study، the anesthetic effects of adding intrathecal neostigmine or magnesium sulphate to bupivacaine in patients under lower extremities surgeries were assessed. In this double-blind randomized clinical trial، 90 patients، candidate for lower extremities surgeries in a training hospital، were recruited. The patients with ASA class I and II aging from 20 to 65 years between 2009 and 2010 were evaluated. The selected patients were randomly assigned to receive either bupivacaine alone (Group A، n=30)، or bupivacaine plus magnesium sulphate 50% (Group B، n=30)، or bupivacaine plus neostigmine (Group C، n=30). Then sensory and motor onset and complete block and the time of recovery were measured. The sensory block onset time were 3. 03±0. 981 in group A، 3. 90±2. 71 in group B and 3. 7±1. 08 in group C and knee flexion time were not significantly different among the three groups (P > 0. 05)، whereas the time to complete motor block was significantly longer in group C and motor recovery time were significantly different between groups (P=0. 001). According to the obtained results، it may be concluded that magnesium sulphate is a safe and effective adjuvant for increasing the onset time of motor block.

Dry weight (DW) is an important concept related to patients undergoing hemodialysis. Conventional method seems to be time consuming and operator dependent. Bio impedance analysis (BIA) is a new and simple method reported to be an accurate way for estimating DW. In this study، we aimed to compare the conventional estimation of DW with measuring DW by BIA. This study involved 130 uremic patients، performed in Isfahan، Iran. DW was calculated by both conventional (CDW) and BIA (BIADW) method and results were compared based on different grouping factors including sex، underlying cause of renal failure (RF) (diabetic RF and non-diabetic RF)، body mass index (BMI) status، and sessions of hemodialysis. We also calculated the difference between DWs of 2 methods (DW diff = CDW-BIADW). The mean of BIADW was significantly lower than CDW (57. 20 ± 1. 82 vs 59. 36 ± 1. 77، P value < 0. 001). After grouping cases according to the underlying cause، BMI، sex، and dialysis sessions BIADW was significantly lower than CDW. Based on the combination of problems with CDW measurement which are corrected by BIA، and more clinical reliability of CDW، we concluded that although conventional method is a time-consuming and operator-dependent way to assess DW، DW could be estimated by combining both of these methods by finding the mathematic correlation between these methods.

Context: Rapid stretching of the skin over the weak connective tissue leads to development of striae distensae. Recently، researchers have shown special interest towards use of fractional photothermolysis in treatment of striae and several studies have shown its usefulness. Our aim was to assess the efficacy of Fractional CO2 laser in treatment of striae alba. Subjects and A randomized clinical trial was carried out in female patients with striae alba. Ninety two striae were randomly selected and divided into two groups. Five sessions of laser resurfacing، were performed in Group 1، every 2-4 weeks. Group 2 was treated with 10% glycolic acid+0. 05% tretinoin cream nightly during the study. Photographs were taken from the striae before and two weeks after the end of treatment. Mean surface area of striae compared between two groups. Patients’ views regarding the degree of improvement were assessed via visual analogue scale (VAS). Forty six striae in Group 1 underwent laser resurfacing and 46 matched striae in Group 2، were treated with topical cream. Mean difference of striae surface area، was significantly decreased after treatment in Group 1 (-37. 1±15. 6 cm2) in comparison with Group 2 (-7. 9±9 cm2) (P value <0. 001). Mean VAS was significantly higher in Group 1 (3. 05±0. 74) compared to Group 2 (0. 63±0. 66) (P value <0. 001). Fractional photothermolysis via Fractional CO2 laser is an effective and safe method for treatment of striae alba.

For healthcare workers، sometimes the conventional hepatitis-B virus (HBV) vaccination schedule might not provide seroconversion rapidly enough. The aim of this study was to compare the efficacy of conventional HBV vaccination with an accelerated schedule (days 0-1-21). In this randomized clinical trial، 161 healthcare workers were divided into two vaccination groups; group A underwent the conventional schedule (0-1-6 months) and group B received the accelerated program (0-10-21 days) of hepatitis B virus vaccine. The anti-HBs antibody was determined 30 days after completion of the third vaccine injection in both groups by enzyme immunoassay (EIA) (Abbot، Aux SYMsys). By using the Fisher’s exact and Wilcoxon tests، the results were analyzed. The protective level of anti-HBS was defined as titer ³ 10 MIU / ml. The seroprotection rate، 30 days after vaccination، were similar in both groups A and B; 96. 3% of the participants in group A and 92. 6% in group B had anti-HBS antibody ³ 10 MIU / ml. Our data indicated that compared to the classic HBS vaccination program an accelerated schedule could also be effective and achieve seroprotection more rapidly.

In developing countries، nutritional deficiency of essential trace elements is a common health problem، particularly among pregnant women because of increased requirements of various nutrients. Accordingly، this study was initiated to compare trace elements status in women with or without pre-eclampsia. In this study، serum trace elements including zinc (Zn)، selenium (Se)، copper (Cu)، calcium (Ca) and magnesium (Mg) were determined by using atomic absorption spectrometry (AAS) in 60 patients and 60 healthy subjects. There was no significant difference in the values of Cu between two groups (p>0. 05). A significant difference in Zn، Se، Ca and Mg levels were observed between patients with pre-eclampsia and control group (p<0. 001، p<0. 01، p<0. 01 and p<0. 001، respectively). Zn، Se، Ca and Mg levels were found to be 76. 49±17. 62 μg/dl، 8. 82±2. 10 μg/dl، 8. 65± 2. 14 mg/dl and 1. 51±0. 34 mg/dl in Pre-eclamptic cases، and these values were found statistically lower compared to the controls (100. 61±20. 12 μg/dl، 10. 47±2. 78 μg/dl، 9. 77±3. 02 mg/dl and 1. 78±0. 27 mg/dl، respectively). While Cu levels were 118. 28±16. 92 and 116. 55±15. 23 μg/dl in the patients and the healthy subjects، respectively. In addition، no significant difference was found between two groups with respect to Hemoglobin Concentration (HbC) and Total White Blood Cell Count (TWBC) (p>0. 05). Our findings indicate that the levels of Zn، Se، Ca and Mg are significantly altered in pregnant women with pre-eclampsia. This research shows that these deficiencies can not due to hemodilution.

Peroxisome proliferator-activated receptor gamma (PPAR γ) is a transcription factor، which is abundantly expressed in adipose tissue and has a direct link to adiposity. It seems that long-chain polyunsaturated fatty acids (LC-PUFAs) can regulate PPAR γ expression. The purpose of this study was to investigate the effects of n-3LC PUFA supplementation on plasma levels of PPAR γ and thyroid hormones in obesity. In a randomized double-blind controlled trial، 66 subjects with obesity were assigned to 2 groups. Participants in intervention group consumed omega3 capsules contained 1000 mg n-3 fatty acids (180 mg of eicosapentaenoic acid [EPA] and 120 mg of docosahexaenoic acid [DHA]) and placebo group consumed placebo capsules contained paraffin twice a day for 4 wk. Fasting blood samples and weight measurements were collected at the baseline and at the end of the trial. Plasma PPAR γ and thyroid hormones were measured by ELISA. Data were analyzed using a repeated measure model-two factor for comparing two groups in two times. No significant changes were observed in PPAR γ levels between and within the groups after supplementation (P>0. 05). N-3LC PUFA supplementation significantly increased T4 levels after 4 wk (P<0. 05) but T3 and TSH did not change significantly. Our study showed that n-3LC PUFAs supplementation increased T4 levels. However، no significant changes in T3، TSH and PPAR γ plasma levels were observed in obese adults.

Numerous studies have reported prehypertension (pre-HTN) as a risk factor for the cardiovascular diseases as hypertension (HTN). The present study aimed to evaluate the effects of pre-HTN on cardiovascular incidences among the females of Isfahan cohort study (ICS). Healthy female at baseline were followed for a median of 6. 7 years. They were divided into 3 groups of normal blood pressure، pre-HTN (120/80 < BP < 139/89 mmHg) and HTN (BP > 140/90 mmHg) based on their baseline measurements. The endpoints were ischemic heart disease (IHD)، stroke، CVD (combination of IHD and stroke) and mortality. Normal BP، pre-HTN and HTN were observed in 1073 (33%)، 1185 (36%)، and 994 (31%) participants، respectively. One hundred and ninety-eight subjects developed CVDs and 110 died. In the HTN group، the hazard ratio [HRs (95% confidence interval)] adjusted for age and other risk factors were 3. 44 (1. 95-6. 09) for IHD (P value < 0. 001)، 1. 28 (0. 59-2. 77) for stroke (P value = 0. 536) 4. 89 (1. 37-17. 45) for CVD mortality (P value < 0. 001) and 1. 70 (0. 98-2. 96) for all cause mortality (P value = 0. 060). Although، pre-HTN significantly increased the risk of IHD incidence in the crude model (HR 2. 21، 95% CI 1. 23-3. 97) and after adjustments for age (HR 1. 85، 95% CI 1. 02-3. 33)، (P value < 0. 001) the association did not remain statistically significant after including other risk factors in the model. Hypertension (HTN) to be a strong risk factor for CVD and IHD. However، in contrast to previous researches، pre-HTN was not found to be a risk factor for CVD، IHD or death independent to other risk factors in women.

Low attention to dairy product consumptions and high intake of junk foods and bakery products might be related to high prevalence of chronic diseases because of their fat content and fatty acid composition. In this study we investigated the kind and amount of fatty acid content in Iranian junk foods، dairy، and bakery products Some common brands of Iranian’s junk foods، dairy، and bakery products were chosen randomly from different supermarkets in Iran. The amount of 10 g sample was considered for fatty acid analysis by gas chromatography equipment with flam ionization detector. In this study stearic acid (C18:0) and palmitic (C16:0) acid have the highest amount among other saturated fatty acids in all groups. In junk foods and bakery products، the most common trans-fatty acid (TFA) is elaidic acid (C18:1 9t) with ranging from 2. 4% to 18. 5% and in dairy products vaccinic acid (C18:1 11t) has the high level of TFAs among others (2. 1% to 11. 5%). The amount of TFAs in Iranian junk foods and bakery products was in a high level.

The main source of studies about effects of opium consumption on heart and brain attacks originates from Iran Therefore the aim of the present study was to assess opium addiction as a probable influencing factor for ischemic heart disease and ischemic stroke. A cross-sectional study was carried out in two Cardiology and Neurology clinics in Eastern Iran in 2011. Diagnosis of Ischemic Heart Disease (IHD) and Ischemic Stroke (IS) was made by Cardiologist and Stroke Neurologist respectively. The influence of gender، hypertension، diabetes، hyperlipidemia، cigarette smoking، oral and inhaled opium consumption on distribution of IHD and IS were evaluated. Five hundred fifty eight patients (307 females، 251 males) with mean age 56. 2 years enrolled the study. On adjusted odds ratios of our whole 558 patients، only hypertension and diabetes had a significant influence on occurrence of IHD; (p=0. 000 and p=0. 000) respectively. Oral and inhaled routes of opium addiction did not have a significant effect on occurrence of IHD; [OR=1. 172، 95% CI=0. 624-2. 203، p=0. 621] and [OR=1. 820، 95% CI=0. 811-4. 085 p=0. 147] respectively. Hypertension and diabetes were significant risk factors of IS in our 558 patients at multivariate analysis; (p=0. 000، p=0. 020). Oral opium addiction was as significant protective factor of IS in our study group; OR=0. 211، 95%CI= 0. 079-0. 564، p=0. 002، while inhaled opium addiction did not have a significant effect on occurrence of IS in our patients at; OR=1. 760، 95% CI= 0. 760-4. 076، p=0. 187. Oral opium consumption is a protective factor of IS but not IHD. Inhaled opium addiction does not have a significant influence on occurrence of IS and IHD.

Matrix metalloproteinases comprise a family of enzyme degrade components of extra cellular matrix. There are single nucleotide polymorphisms in the promoter regions of several genes with ability to influence cancer susceptibility. The aim of this study was to analyze association between MMP3 promoter polymorphisms and colorectal cancer occurrence and progression. In this case-control study 120 colorectal cancer patients and 100 controls were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) on the genomic deoxyribonucleic acid (DNA). The patients group was divided into different subgroups: a subgroup without metastatic activity (M-) and a subgroup that had developed metastasis (M+). There was a significant difference in frequency of the MMP-3 genotype between cases and controls (c² = 16. 17; P = 0. 0003). The 5A homozygote in patients and controls was significantly different. The frequency of the 5A allele among affected patients (67. 91%) was significantly higher than among the healthy controls (49%; c² = 16. 17، P = 0. 00005). At the time of diagnosis، individual who was carrying the 5A allele was more represented in the M+ subgroup than in M- subgroup (c² = 7. 49; P = 0. 006، OR = 3. 86; 95% CI، 1. 43–10. 33). The difference between M- and controls did not observe statistically significant (c² = 0. 009; P = 0. 92). Our results suggest that the presence of 5A polymorphism at the MMP-3 promoter region may favor the growth and the metastasis process in colorectal cancer patients and could be looked at as a risk factor for a worse prognosis.

Hepatitis D virus (HDV) infection is characterized by rapidly progressive liver disease with adverse prognosis in most patients. Although interferon is the only approved anti-HDV therapy، evidence regarding the efficacy and safety of its various regimens is either old or scattered. We searched systematically Medline، EMBASE، Scopus، the Cochrane Central Register of Controlled Trials، and ISI. The studies that evaluated treatment of chronic HDV infection with standard or pegylated interferon for at least 48 weeks were identified. Our inclusion criteria were positive anti-HDV antibody for 6 months and positive HDV-PCR at the start of study. We performed a meta-analysis for proportions using the arcsine transformation in random effects model. Sustained virological response (SVR) rate (negative Polymerase chain reaction (PCR) 6 months after cessation of therapy) was the end point of interest. Data were abstracted from 14 studies containing 227 chronic HDV-infected patients who received standard or pegylated interferon alpha-2a or -2b. Twenty-one and 30 patients of 71 and 156 who received standard or peginterferon، respectively، beyond 48 weeks achieved SVR. Pooled SVR rates were 29% [95% confidence interval (CI) 19; 41] and 19% (95% CI 10; 29)، respectively. The rates of treatment withdrawal were similar. Our systematic review indicates that the literature lacks sufficient evidence to establish precise recommendations for treatment of HDV infection. Meta-analysis of these studies shows that standard dose of peginterferon is more effective than high dose of standard interferon as anti-HDV therapy.

Second National Medical Sciences Olympiad was done in Shiraz in August 2010 with aim of indentifying scientifically talented individuals، motivating students and orienting extracurricular activities. This Olympiad was done in 3 areas، basic sciences، clinical sciences and management. In clinical sciences، we used TOSCE (Team Objective Structured Clinical Examination). In this article we report the details of this exam and participants'' satisfaction. This Olympiad in Clinical Medical Sciences was held in 2 levels: Individual and team. In the team stage، 9 teams from 9 universities participated. We used TOSCE for measuring clinical competency of teams. Each team consisted of 3 students. We designed 12 stations based on emergency medicine in medical and surgical fields. The time considered for each station was 15 min، after doing this exam the view of students was measured using a valid and reliable questionnaire. Most of the students believed that TOSCE was a useful examination for measuring competency. More than 50% of students reported that success in this exam needs clinical competency، team work and problem solving ability. Nearly، half (48. 1%) of students believed that 15 min is not enough for each station and they need more time. The results of this study showed that this kind of exam is useful for measuring clinical competency from students'' viewpoint.

Myoepithelioma is an uncommon benign neoplasm that most likely occurs in the parotid gland. Extra-salivary myoepitheliomas are rare، with less than 10 cases reported in the sinonasal cavity. We present a rare case of benign myoepithelioma with recurrent behavior، abundant extensions to adjacent structures، and resistant to treat clinical course، which influenced the patient’s quality of life for more than 18 years. Histologic، immunohistochemical، and the potential differential diagnoses are discussed. The patient refused to undertake any more treatments، but after 15 months of follow-up، the lesion did not progress further.

A parathyroid lipoadenoma is a very rare cause of mediastinal mass. The clinical features of this pathologic entity is similar to those of the more common pathologic variants of parathyroid disease associated with primary hyperparathyroidism. A 58-year-old woman presented with huge multinodular goiter. Her thoracic CT scan was done before surgery، showed a posterior mediastinal mass. On microscopic examination، the thyroid was composed of thyroid follicles in varies sizes، compatible with a multinodular goiter and the mediastinal mass، microscopically، was composed of epithelial cells arranged in follicular and cellular nests pattern alter with abundant mature adipose tissue، morphologically closely resembled parathyroid tissue. Thyroid، mesenchymal and neuroendocrine origin for this tumor excluded by immunohistochemistry and the mass was diagnosed as a parathyroid lipoadenoma. In our case، there is a non functional parathyroid lipoadenoma with a very rare presence.

There are a limited number of Food and Drug Administration (FDA) -approved medications for the treatment of autism. Meanwhile، oxidative stress and neuroinflammation are supposed to play a causative role in autism. N-acetylcysteine may provide cystine، a precursor for glutathione (GSH)، which is an important antioxidant factor in the brain. We here report a child with autism، whose symptoms were markedly decreased after taking oral N-acetylcysteine 800 mg / day، in three divided doses. His social interaction was significantly increased. The score of social impairment on a visual analog scale decreased from 10 to 6 in the two-month trial. The aggressive behaviors decreased from 10 to 3. This case suggests that N-acetylcysteine may decrease some symptoms of autism.