Iranian Red Crescent Medical Journal
Volume:14 Issue: 12, Dec 2012

Islamic medicine is regarded as a comprehensive medical school with a long, glorious and worldwide reputation. Some of the physicians of this school are famous worldwide and have contributed valuable services to the scientific world. Given the dramatically increasing prevalence of cancer and the relative inefficacy of current medications, there is a great demand for the introduction of effective therapeutic approaches. To this end, integration of traditional medicine with modern medical treatments represents a promising option. In this essay, methods of diagnosis and treatment of cancer have been mentioned from the viewpoint of five famous physicians before the Mongolian attack who used Islamic medicine, namely Rhazes, Akhaveyni, Ahwazi, Avicenna and Jorjani. The ideas discussed dates back to a period between the eighth and fourteenth centuries..

Emotional intelligence is the potential to feel, use, communicate, recognize, remember, describe, identify, learn from, manage, understand and explain emotions. Service quality also can be defined as the post-consumption assessment of the services by consumers that are determined by many variables.. This study was aimed to determine the nurses’ emotional intelligence impact on the delivered services quality.. This descriptive - applied study was carried out through a cross-sectional method in 2010. The research had 2 populations comprising of patients admitted to three academic hospitals of Yazd and the hospital nurses. Sample size was calculated by sample size formula for unlimited (patients) and limited (nursing staff) populations and obtained with stratified- random method. The data was collected by 4 valid questionnaires.. The results of study indicated that nurses'' emotional intelligence has a direct effect on the hospital services quality. The study also revealed that nurse''s job satisfaction and communication skills have an intermediate role in the emotional intelligence and service quality relation.. This paper reports a new determinant of hospital services quality..

Epstein Barr Virus (EBV) is one of the most common viral infections in human population. EBV has a significant role in pathogenesis of Hodgkin''s lymphoma, Burkitt''s lymphoma and nasopharyngeal carcinoma. The role of EBV in non-Hodgkin’s lymphoma, diffuse large B cell (NHL - DLBL) in the head and neck is controversial.. The purpose of this study is to find out the difference between the presence of Epstein Barr virus in nodal and extra nodal lymphoma of head and neck..Patients and A total of 30 cases of DLBL in two separate groups were collected from pathology department. The first group was consisted of 15 patients with DLBL of neck lymph node and the other was consisted of 15 patients with extra nodal DLBL of head and neck mainly in palatine tonsil. Both immune-histo-chemical (IHC) study and polymerase chain reaction (PCR) for detection of late membrane antigen (LMP) were performed on formalin fixed paraffin embedded tissue.. All 30 cases were negative for EBV in IHC method. But in PCR method, 10% of patients were positive for LMP gene. There were 2 positive cases in nodal lymphoma and 1 positive case in extra nodal lymphoma group.. Compare with PCR method, it seems that IHC is not a sensitive method for detection of EBV. Overall, the finding of EBV in NHL depends on site, type of lymphoma and the detection method..

There is an interest in finding new and safe antioxidants from natural sources such as medicinal plants.. The aim of this study was to evaluate the antioxidant activity of ten Iranian medicinal plants extracts.. For antioxidant activity, the radical scavenging activity, reducing power and phenolic contents of ethanol plant extracts were determined. Gallic acid was used as standard reference with well-documented antioxidant activity.. The highest antioxidant activity in terms of DPPH radical scavenging was found in Verbascum sinuatum L. Var (VS) with an IC50 equal to 263.52 ± 5.981 μg/ml and Rosa damascena Mill (RD) with and IC50 equal to 287.9 ± 5.675 μg/ml that are higher than gallic acid (IC50 = 25.32 ± 5.593 μg/ml). The highest antioxidant activity in terms of ferric reducing capacity was also found in Verbascum sinuatum L. Var extracts (in 85.08 ± 8.66 μg/ml concentration with absorbance 0.5). Also, this extract contains the highest phenolic compounds (8.53 ± 0.11 mg/g).. In this study, Verbascum sinuatum L. Var contains the highest level of phenolic compounds may be contribute to higher free radical scavenging activity and reducing power in comparison to the other plant extracts. Therefore this plant is a good candidate as natural antioxidant..

Post-traumatic stress disorder (PTSD) comprises a collection of symptoms following exposure to injury-causing accidents of life. It is estimated that the prevalence of PTSD in children with malignancy and their parents is between 10-30% and even several years after treatment of malignancy this disorderremain in 20-20% of these patients.. This study investigated the prevalence of post-traumatic stress disorder in parents of children with cancer.. In this analytic-descriptive study, 256parents of children with cancer (mean age: 30.06 ± 14.6 years-old) that their children treated in pediatric hematology ward of Ali ebn-e Abitaleb (AS) teaching hospital of Zahedan city (south east of Iran) at 2009-2010 were evaluated. The demographic data and symptoms of PTSD were collected by standard questionnaire (based on DSM-IV). After data analysis was performed using statistical software SPSS (version 18).. All parents who were studied had PTSD. The severity of PTSD in 111 of parents was mild, in 103 (40.2%) moderate and in 42 (16.4%) parents was severe. Furthermore, there were a significant correlation between the severity of PTSD with number of children, age of parents, gender, literacy, religion and economic state (P = 0.001).. Our results showed that factors such as age, sex, number of children, educational state and religion of parents with economic state of the family can effect on the severity of PTSD. As for role of parents of children with chronic disease especially malignancy diseases on decline of psycho-social disorders with mental and physical supports of their children should be given the necessary recommendations and educations regarding PTSD..

Pyogenic bacteria and especially Staphylococcus aurous (S. aurous) are the most common cause of chronic osteomyelitis. Not only treatment protocol of chronic osteomyelitis occasionally is amiss but also this malady responds to treatment difficultly.. This study investigates antibiotic resistance pattern of S. aurous isolated from Iranian patients who suffer from chronic osteomyelitis by two disk diffusion (Kirby bauyer) and E-test (Epsilometer test) to find Vancomycin susceptibility and MIC (Minimum inhibitory concentration)..Patients and One hundred and thirty one patients who suffer from chronic osteomyelitis which have been referred to both governmental and private hospitals at 2010 were tried out for culturing of osteomyelitis site (sites). Antibiotic susceptibility and MIC of isolated bacteria were investigated by Kirby bauyer and E-test respectively.. Samples were collected from bone (73.4%), surrounding tissue (14.6%) and wound discharge (12%). S. aureus was isolated from 49.6% of the samples. According to disc diffusion, methicillin resistance S. aureus (MRSA) was 75% and Vancomycin resistance S. aurous (VRSA) was 0% and based on MIC, MRSA was 68.5% and VRSA was 0%. According to MIC experiments, maximum sensitivity was against to Vancomycin (90.2%) and ciprofloxacin (54.4%) respectively but based on disc diffusion, maximum sensitivity was against to Vancomycin (97.7%) and ciprofloxacin (43.2%), respectively (P = 0.001). E-test (9.8%) in comparison with Disc diffusion (2.3%) showed higher percent of intermediate susceptibility to Vancomycin (P = 0.017).. Comparison of antibiograms and MICs showed that Kirby bauyer technique especially for detection of VISA strains is not reliable comparison with E-test. Already VRSA strains have not detected in Iranian chronic osteomyelitis, Thus Vancomycin is the first choice for chronic osteomyelitis empirical therapy in Iran yet..

Backround: Laryngopharyngeal reflux (LPR) is the backflow of stomach contents above upper esophageal sphincter, into the pharynx, larynx, and upper aerodigestive system.. In this study, effects of omeprazole over voice quality in muscle tension dysphonia with laryngopharyngeal reflux was ınvestigated..Patients and Nine patients, 7 males and 2 females, aged between 27-43 (mean age:31) were included to this study. The diagnosis of muscle tension dysphonia with LPR was established by video laryngoscopy, rigid scope 70º. The laryngeal changes related with LPR were evaluated according to Reflux Finding Score. The patients received omeprazole 20 mg twice a day for a period of 6 months. None of the patients received voice therapy. Vocal hygiene guidelines were also explained to the patients. Objective and subjective voice parameters (Jitter, shimmer, NHR, Voice Handicap Index, and Auditive analysis; Roughness, breathiness, and hoarseness) were evaluated in this study.. After treatment with omeprazol, all the parameters showed an improvement in voice quality, but only VHI (P = 0) and shimmer (P = 0,018) are statistically significant.. For FD patients with LPR condition, we highly recommend that LPR treatment should be part of the treatment plan..

Although there are various methods for painless delivery such as using entonox gas, most of the people are unfamiliar or concerned about it yet.. The purpose of this study was to assess maternal expectations and experience of labor analgesia with nitrous oxide..Patients and In a clinical trial study, 98 pregnant women in active phase of delivery were studied randomly in two groups (intervention group = 49, control group = 49) after obtaining written consent. Efficacy, experience satisfaction, and also expectation of pregnant women about entonox gas in two groups were compared, likewise in intervention group before and after using entonox gas.. Most of the pregnant women receiving entonox gas had less labor pain (91.8%), and were satisfied with it (98%). The severity of pain in the most of entonox user was moderate level (46.94%), while for the control group it was severe (55.10%) which was significant, 40.82% of the mother in entonox group had a severe pain and 10.20% had a very severe pain, whereas in the control group (55.10%) of the mother had a severe pain and 26.53% of the had very severe pain (P = 0.004). efficacy of labor pain was in moderate level in most cases. 49% of pregnant women receiving gas described their experience as a good and excellent. 80.9% indicated that they will request the mentioned painless method in the future. The amount of suffering from gas side effects was mild in most patients of intervention group (63%). Expectations of the majority of pregnant women in intervention group (before receiving gas) and control group for painless delivery were weak (65.3%, 40.9%). The percentage of positive expectations had increased after receiving entonox gas (P = 0.01). There was a difference between the expectations of intervention group receiving entonox gas and control group (P = 0.001). Positive expectations were more in intervention group than the control group. Most differences of expectations in intervention group before and after receiving the gas were about higher efficacy (P = 0.001), more satisfaction (P = 0.001), fewer complications (P = 0.001), information about gas as painless delivery method (P = 0.02), and also previous experience of intolerable labor pain (P = 0.04).. This study has shown that using entonox gas caused less labor pain, favorable expectations and experiences and also more maternal satisfaction..

Breast cancer is the most common cancer among women worldwide. Based on the latest Iranian national cancer department report, the total number of women registered with breast cancer was 6976 cases during 2007. Five year survival is one of the indicators used for evaluation of the quality for care to different types of malignancies including breast cancer.. The aim of this study was to estimate survival rate of breast cancer in 6147 Iranian patients at a national level in different geographic regions.. 6147 cases of breast cancer, which had telephone number and were diagnosed between 2001-2006, were called to obtain information about their life status. Survival estimates were calculated using the Kaplan-Meier method, and the survival probability was calculated for the overall cohort and in different categories of gender, age and pathologic type of tumor. Hazard ratios (HR) according to demographic and risk variables were calculated by Cox''s proportional hazard model.. The overall 5-year survival rate was 71.0%. The mean survival time was different between men and women, which was statistically significant. The number of men involved with breast cancer was 172 (2.8%) of all cases. The 5-year survival rate for patients in age group 41-50 years was significantly higher than other age groups (P = 0.001). The likelihood of death was higher in patients with 61 years old or more years rather than those below forty years old (HR = 1.31; 95% CI: 1.12-1.55).. The findings of this study might help Iranian health managers: 1) to be more conscious about geographical and regional determinants which will affect overall survival rate. 2) To carry preventive activities such as public education particularly in Iranian men. 3) To think about screening and early detection of breast cancer..

Cerebral venous sinus thrombosis (CVST) is a frequent cause of cerebrovascular disease in Iran.. In this study, we report cumulative data of published Iranian studies in a systematic manner with critically appraisal and presenting future directions.. The authors systematically searched the ISI web of knowledge, Pubmed, Scopus, EBESCO and iranmedex for keywords attributed to cerebral venous sinus thrombosis. The methodological and demographic characteristics, etiology, site of involvement and clinical manifestations of the patients with CVST were investigated.. Seven eligible series with 465 patients were found. Age of the patients were between 29.5-43.8 in these series. The ratio of Female to male was 2.79. The Mortality rate was 11.4%. Oral contraceptive pills the single most common risk factor in the all series(40-71% of female patients). Headache(80-97%), sensori/motor deficits(39-64%) and seizure(20-62%) were the most common clinical presentations. Hemorrhagic transformation was seen in 11-58% of the patients. All included studies have substantial shortcomings. Majority of the studies were retrospective and only one study was population based. Despite the ethnic heterogeneity in Iran, none of these studies reported ethnic information. Detailed methodology was missing in all studies. The extent of investigation for hematologicalor neoplastic disorders was not clear methods. Only one study reported a subgroup with multifactorialetiology. Neither Barthel index nor modified Rankin scale were reported in any studies. The mortality was reported only in the three studies. The analysis of prognostic factors was not done in any study.. To overcome theses hortcomings, more well-structured epidemiologic studies should be conducted in Iran as a CVST-raising country..

New research proposes the pluripotency of spermatogonial cells obtained from testis. These spermatogonia-derived stem cells are called embryonic stem-like cells that express embryonic stem cell markers and differentiate to the three germ layers.. The aim of the present study was to generate embryonic stem-like cells from neonatal mouse testis.. The Testis cells were collected from neonatal mouse. After decapsulation، testis was mechanically dissected and dissociated via a two-step mechanical and enzymatic digestion. The spermatogonia and sertoli cells were cultured together in Dulbecco’s modified Eagle’s medium (DMEM) supplemented with 15% FBS and LIF. Before one week، several small spermatogonia colonies were observed on top of the monolayer of sertoli cells. These colonies were passaged every four days. ES-Like cells colonies that resembled ES cell was appeared within 2-3 weeks (at passages 5). Real time PCR was performed to analyze the expression of a subset of pluripotency markers، as well as germ cell-specific genes. ES Like cells were confirmed with SSEA1، SOX2 and Oct4 immunofluorescence stainng as pluripotency markers.. The Results showed that at fifth passages، the pluripotency genes; Nanog and c-myc have significant increase in ES-Like cells in compare with spermatogonia cells، whereas the spermatogonial markers; Stra8، mvh، and piwill2 became downregulated. In addition to these pluripotency genes، the ES cell marker SSEA-1، SOX2 and Oct4 were expressed in the ES-like cells، similar to ES cells.. This researh indicates pluripotency evidence of ES-like cells derived from testis. ES-like cells shows some molecular characteristics with embryonic stem cells..

The purpose of this study was to examine the relationship between the type of inhaled medication, length of use, dosing, the inhaler use technique and the severity and duration of disease on the dental caries of asthmatic patients.. In the present study, the frequency of dental caries in the asthmatic patients and control group was examined. In addition the possible association of dental caries with disease duration, disease severity, asthma symptoms, chest wheeze, PFT values, and dose of medication and inhalation use technique was evaluated.. 40 asthmatic patients of both sex (20-30 years old) and 40 age and sex matched controls were studied. In asthmatic patients, the type, dose, duration of medications, the technique of inhaler use and severity and duration of the disease were recorded. The dental health status including DT, MT, FT and DMFT (decay, missing, filling teeth) were examined. In addition, pulmonary function tests (PFTs) were performed for both groups.. All PFT variables in asthmatic patients were significantly lower than those of control group except for FVC (P < 0.001 for all cases). All indices of dental caries in asthmatic group were higher than those of controls which was statistically significant for MT and DMFT (P < 0.005 for both cases). Only FT and DMFT in patients with 11-15 years asthma duration were significantly more than those of 6-10 years (P < 0.05 for both cases). There was no significant correlation between indices of dental caries and disease duration, PFT values; doses of medication or the technique of inhaler use; although the technique of inhaler use was relatively acceptable in all asthmatic patients.. These results showed that dental caries among asthmatic patients was more common than control group which can be due to using inhaler drugs or the technique of inhaler use..

Acute bacterial meningitis which is a pediatric emergency with high mortality and morbidity must be diagnosed and treat promptly. Often diagnosis of bacterial meningitis from viral meningitis is difficult after some days. Determination of some inflammatory mediators’ example IL-6 and HS-CRP were useful in differential diagnosis of bacterial and viral meningitis.. This study attempted to Determining HS-CRP and IL6 in serum and CSF in children suspected meningitis and Comparing value HS-CRP and IL6 in bacterial/viral meningitis..Patients and Of children that hospitalized in pediatric emergency ward (Ghaem Hospital Mashhad university of medical science, in duration 01 Dec 2010-01 Dec 2011) and for they performed lumbar puncture, 1cc serum and CSF of they were taken to laboratory and have measured IL-6 with Elisa method and HS-CRP with immunoturbidometry method, patients were followed up and finally we compared levels of this two mediators.. Finally, this study performed on 81 children and infants. From 81 cases, 27 cases (33.3%) had bacterial meningitis 27 cases (33.3%) viral meningitis and 27 cases (33.3%) had normal CSF. IL-6 concentration in the CSF and serum were significantly raised in cases of bacterial meningitis (P = 0.001, P = 0.01) but HS-CRP concentration in the CSF and serum were not significantly raised in cases of bacterial meningitis (P = 0.46, P = 0.29). Mean IL-6 concentration in the CSF in bacterial meningitis was (180.74) and in viral meningitis was (39.08). Mean HS-CRP in CSF in bacterial meningitis was (2.22) and viral meningitis was (1.29). Mean HS-CRP in serum in bacterial meningitis was (8.23) and viral meningitis was (6.36).. The measurement of IL-6 in the CSF and serum in potentially a very useful diagnostic tool for differential diagnosis of bacterial and viral meningitis..

Situs inversus totalis is a rare condition, which presents difficulties in diagnosis and treatment of gallstones due to the reversal location of abdominal organs. In this article we present 2 cases of women in age of 51 and 55 years with situs inversus totalis and gallstones. There are described the clinical and imaging features, also the laparoscopic surgery with the difficulties encountered by right handed surgeon. In patients with situs inversus totalis, laparoscopic surgery may be performed safely by a surgeon with experience..

Skin problems caused by neuropathy and antipathy are common manifestations of diabetes. The most serious about such problem is the diabetic foot, which may lead to eventual ulceration and amputation, and will decrease a patient’s quality of life dramatically.. The aim of this study is to assess the level of foot self-care and foot conditions in diabetic patients, and to demonstrate the role of self-care education in diabetic foot care.. Patients and A total of 80 diabetic patients were included in the study, all of whom had referred to «Yazd Diabetic Research Center.» The levels of their foot self-care were recorded in pre-test questionnaires, and then all of the patients were visited and educated by a Dermatologist for their foot self-care on a monthly basis, after which their post-test results were recorded through a second administration of the same questionnaire. Eventually, data from the pre and post-test questionnaires were analyzed to identify the possible effects of education.. A total of 80 diabetic patients (34 males, 46 females) with a mean average age of 53. 53 ± 10. 19 and mean average duration of diabetes 12. 42 ± 6. 73 years were assessed. A significant increase in foot self-care through education was observed (baseline 27. 06 ± 8. 77, vs. post education 43. 12 ± 8. 77; P = 0. 0001). After education, foot and nail lesions improved completely in 84% and 62. 8%. Moreover, 77. 8% of patients had suitable shoes and 79. 6% had suitable socks.. Our findings showed that foot self-care education could improve knowledge and performance of patients about various foot problems, and was significantly important in preventing ulcers..

The importance of proper qualitative evaluation of EEG parameters during surgery has been recognized since many years. Although none of the characteristics based on the frequency, entropy, and Bi spectral characteristics have been regarded as a good predictor for detection of the depth of anesthesia alone. So it seems necessary to study multiple characteristics together.. In this study we tried to introduce the best combination of the mentioned characteristics.. EEG data of 64 patients undergoing general anesthesia with the same anesthesia protocol (total intravenous anesthesia) were recorded in all anesthetic stages in Shohada Tajrish Hospital. Quantitative EEG characteristics are classified into 4 categories: time, frequency, bi spectral and entropy based characteristics. Their sensitivity, specificity and accuracy in determination of the depth of anesthesia are yielded by comparison with recorded reference signal in awake, light anesthesia, deep anesthesia and brain death patients. Then, with combining 2, 3, 4 and 5 of characteristics and using coded algorithm we determined the error degree and introduced the combination yielding the least error.. Fifteen vectors (of dimension two to five) which yielded the best results were introduced. Vectors combined of entropy based characteristics obtained 100% specificity and sensitivity during all 4 stages.. The combination entropy based characteristics had high accuracy in predicting the depth of anesthesia. Reevaluation of classic indices cortical status index and BIS seems necessary. The next step is to find a system to simplify the evaluation of this information for technicians..