Acta Medica Iranica
Volume:51 Issue: 3, Feb 2013

Malaria is considered a major health problem in Iran. There are different methods for vector control. In this study we tested the larvicidal effects of some Iranian plants. The methanolic extracts of 11 plants were prepared with percolation method. The larvicidal activities of them against malaria vector, Anopheles stephensi were studied using World Health Organization standard method. All LC50 values of methanolic extracts of plants that we screened were lower than 300 ppm. The methanolic extract of aerial parts of Lawsonia inermis and Stachys byzantina showed high larvicidal activity with LC50 values 69.40 ppm and 103.28 ppm respectively. The results obtained from this study suggest that the methanolic extracts of these plants have larvicidal effects against Anopheles stephensi larvae and could be useful in the search for new natural larvicidal compounds.

The serious influenza-associated complications among immunodeficient individuals such as those who are infected with human immunodeficiency virus (HIV), highlights the importance of influenza vaccination in these people. Therefore, the current study aimed to investigate the antibody responses to influenza vaccine in this group. Two hundred subjects were recruited, during autumn 2010 and 2011, to receive, trivalent inactivated influenza vaccine consisting of A (H1N1), A (H3N2), and B strains. Hemagglutination inhibition assay was used to measure the antibody titer against all strains of the vaccine prior and one month post vaccination. Seroconversion rate for A (H1N1), A (H3N2), and B were found to be 58.5%, 67% and 64.5%, respectively. No correlation was found between antibody titer and demographics factors such as age and gender; however, we found a significant correlation between antibody titer and CD4 cell count. Checking the local and systemic reactions after vaccination, the pain on the injection site and myalgia were the most common local and systemic reactions with 20% and 6.5%, respectively. As vaccination with influenza mount considerable antibody responses in HIV-infected patients, annul influenza vaccination seems to be rational in order to prevent or reduce the severe clinical complications induced by influenza virus.

Procalcitonin (PCT) is a prohormone that has been used as a marker for the diagnosis of bacterial infections. The aim of this study was to survey PCT levels in patients with cirrhosis. Sixty-four patients with hepatic cirrhosis and 32 healthy blood donors were enrolled in this study. Serum PCT levels was detected using immunoluminometric assay. The rate of positive PCT was higher in patients with hepatitis C cirrhosis (92.8%) than the other groups. Among other cirrhotic patients, positive PCT levels were 77% for hepatitis B, 70% for cancer and 53.3% for unknown groups respectively. Serum procalcitonin levels were significantly higher in cirrhotic patients with bacterial infection (2.65±1.11 ng/ml) than those without infection (0.59±0.16 ng/ml, P=0.0001). PCT assay in cirrhotic patients may help diagnosis of sepsis and reduce unnecessary antibiotic use.

Radiotherapy in the head and neck region and chemotherapy might give rise to oral mucositis which is a severe and painful inflammation. There is no known definite cure for mucositis. A number of studies have attempted to evaluate the effect of low-power laser on radiotherapy- and chemotherapy-induced mucositis. The present study was undertaken to evaluate the effect of low-power laser on the prevention of mucositis, xerostomia and pain as a result of chemotherapy. The subjects in this double-blind randomized controlled study were 24 adult patients who underwent chemotherapy during 2009-2010. The results showed that low-power laser was able to decrease the effect of chemotherapy on oral mucositis, xerostomia and pain in a variety of malignancies (P<0.05). It can be concluded that low-power laser might decrease the intensity of mucositis.

Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. Aside from pharmacological interventions, other complementary healing modalities have been introduced to assist patients in decreasing PONV and improving postoperative outcomes. This study examined acupressure as a safe complement to the more traditional approach of using drugs to prevent and/or relieve nausea and vomiting in the Cesarean section (C/S) under spinal anesthesia. In a prospective randomized clinical trial, 152 patients who were candidate for elective C/S under spinal anesthesia were evaluated in two groups (acupressure vs control groups). Subjects in the acupressure group received constant pressure by a specific wrist elastic band (without puncture of the skin) on the Nei-Guan acupuncture point, 30 min prior to spinal anesthesia. The incidence of PONV was assessed during the surgery, at recovery room and at 1st, 2nd and 3rd two hours after the surgery. Significant differences in the incidence of the post-operative nausea and vomiting were found between the acupressure and control groups, with a reduction in the incidence rate of nausea from 35.5% to 13.2%. The amount of vomitus and the degree of discomfort were, respectively, less and lower in the study group. In view of the total absence of side-effects in acupressure, its application is worthy. Our study confirmed the effectiveness of acupressure in preventing post-operative nausea and vomiting, when applied 30 minutes prior to surgery.

The objective of this study was to determine the prevalence and incidence of venous thromboembolism among critically ill medical surgical patients. In this cross sectional and retrospective study, we observed 243 patients who were first admitted at the intensive care unit. Patients who were diagnosed with deep venous thrombosis or embolism either by clinical or paraclinical methods were enrolled. Among 243 patients of ICU ward 12 cases of them were confirmed to have thromboembolism (prevalence of 9.4%).But the incidence of venous thromboembolism after 48 hour of ICU admission was 5.2%(6 cases). Among 6 VTE cases 3 of them didn’t receive any anticoagulant prophylaxis, 2 patients received LDUH 5000 unit twice a day and one patient received LMWH 60 mg daily but all developed VTE although receiving prophylaxis. We found that the prevalence of proximal lower limb DVT among medical-surgical critically ill patients remaining in the ICU for ≥3 days is about 9.4% and the incidence of that is about 5.2%. Further studies should be performed in order to assess the benefits and risks of venous thromboprophylaxis in Iranian patients.

Colorectal cancer is the second leading cause of cancer death worldwide. Through risk assessment of malignancy in polyps, screening programs can achieve the best results. This study aimed to determine the association between the grade of dysplasia and the location of colorectal polyps. 240 colorectal adenomatous polyps which were referred to department of pathology at Rasoul-e-Akram Hospital between 2005 and 2009 met the inclusion criteria. Demographic data and information about size of polyps, grade of dysplasia and location of polyps were collected and analyzed by Chi-square and t-test. 124 (58.8%) patients were male and 87 (41.2%) were female. The mean age of the patients was 61.6 years. 47 (19.6%) polyps were right-sided and 193 (80.4%) were left sided. 39 (16.2%) polyps had high grade dysplasia. 27 (12.8%) patients had 56 synchronous polyps (23.3%). 176 (73.3%), 39 (16.2%) and 25 (10.5%) polyps were of tubular, tubulovillous and villous types respectively. The greatest dimension of 110 (45.8%) polyps was <0.5 cm, 97 (40.4%) 0.5-1 cm, 22 (9.2%) between 1 and 2 cm and finally 11 (4.6%) >2 cm. High grade dysplasia was detected in 3 (6.3 %) of right-sided and 36 (18.6%) of left-sided polyps. The obtained results revealed that size of polyp and amount of villous component were strongly associated with high grade dysplasia. Left side location of polyps was independently associated with high grade dysplasia. Left-sided colorectal polyps must be treated more seriously, especially the larger ones with villous component. There was no association between age and gender and the grade of dysplasia.

Study of students’ knowledge about global warming can help authorities to have better imagination of this critical environmental problem. This research examines high school students'' ideas about greenhouse effect and the results may be useful for the respective authorities to improve cultural and educational aspects of next generation. In this cross-sectional study, a 42 question questionnaire with mix of open and closed questions was used to evaluate high school students'' view about the mechanism, consequences, causes and cures of global warming. To assess students’ knowledge, cognitive score was also calculated. 1035 students were randomly selected from 19 educational districts of Tehran. Sampling method was multi stage. Only 5.1% of the students could explain greenhouse effect correctly and completely. 88.8% and 71.2% respectively believed “if the greenhouse effect gets bigger the Earth will get hotter” and “incidence of more skin cancers is a consequence of global warming”. 69.6% and 68.8% respectively thought “the greenhouse effect is made worse by too much carbon dioxide” and “presence of ozone holes is a cause of greenhouse effect”. 68.4% believed “not using cars so much is a cure for global warming”. While a student’s ‘cognitive score’ could range from -36 to +36, Students'' mean cognitive score was equal to +1.64. Mean cognitive score of male students and grade 2 & 3 students was respectively higher than female ones (P<0.01) and grade 1 students (P<0.001) but there was no statistically significant difference between students of different regions (P>0.05). In general, students'' knowledge about global warming was not acceptable and there were some misconceptions in the students’ mind, such as supposing ozone holes as a cause and more skin cancer as a consequence of global warming. The Findings of this survey indicate that, this important stratum of society have been received no sufficient and efficient education and sensitization on this matter.

Nowadays, educators pay attention to emotional intelligence which is defined as the ability to monitor and explain one’s own and other’s emotional experience and feelings to differentiate between them as well as applying necessary information for determining thoughts and actions. The goal of this study was to determine emotional intelligence of medical residents of Tehran University of Medical Sciences. By means of two stage cluster sampling, 98 medical residents of Tehran University of Medical Sciences were selected. Participants were asked to fill valid and reliable Persian version of Emotional Quotient inventory (EQ-i) questionnaire which had been developed due to Bar-On model. Seventy two filled-up questionnaires were returned (RR=73%). Mean EI score of all participants was 319.94 ± 32.4. Mean EI score was not significantly different between male and female also, single and married participants. EI did not differ significantly in residents in respect to their discipline. Mean responsibility subscale differ significantly between male and female participants (P=0.008). Multiple regression analysis showed that happiness subscale is a predictive factor for total EI score (B=-0.32, P=0.009). Responsibility subscale differed significantly between men and women participants and happiness subscale was a good predictor for emotional intelligence score. These factors should be considered in education of medical residents.

The aim of this study was to evaluate knowledge, attitude and practice of herbal remedies (HRs) in infertile patients. This was a cross sectional study in a referral infertility care center. Three hundred and six outpatients, both women and men, presenting for the first time with complaint of infertility at Arash hospital, were recruited. Verbal consent for participation was received. A self administered questionnaire was used. Main outcome measure was knowledge, attitude and practice of patients toward herbal medications. 47.3% of participants were knowledgeable of HRs with female gender and lower educational background being the associated factors in knowledge. 43.4% of patients with significant female dominancy had positive attitude toward HRs. 31% of participants were using HRs. Only 3.2% of those using HRs informed their physician. The most common health condition promoting herbal use was psychological (33.3%) and gastrointestinal (30.8%) disorders. 3.5% of participants used HRs as fertility treatment which was significantly observed in women and those with lower levels of formal education. A considerable proportion of our population had used HRs without sufficient knowledge and had positive attitude toward HRs. More importantly, patients did not disclose their use of HRs to physicians. Therefore, physicians should inquire about the use of alternative remedies and provide patients with appropriate information.

We describe a 69-year-old-woman with antecedent of breast cancer and recent transitory neurological symptoms. Physical examination showed yellow to orange skin pigmentation, more conspicuous on her palms and soles, while discoloration changes were absent in the eye and oral mucous membranes. Routine laboratory findings were not indicative of hemolytic anemia, liver or bile disorders, nephrotic syndrome, hypothyroidism or diabetes mellitus. We emphasize the role of her excessive ingestion of papaw and tomato. These foods are rich in carotenoids (β-carotene and lycopene), which are associated with pigmentation disorders. The skin discoloration improved in about two months after correction of the inadequate diet. Major concerns about differential diagnosis of yellow skin pigmentation are also highlighted.

Penetrating neck trauma is an important area of trauma care that has undergone evolution in the recent past. A remarkable number of changes have occurred in the treatment paradigm as new technologies have developed and as surgeons have explored the outcomes from different treatment protocols. Therapy has evolved from no treatment (before effective anesthesia and instrumentation), to non operative management, to routine exploration, to selective exploration and adjunctive invasive or noninvasive assessment. Penetrating neck injuries remain challenging, as there are a number of important structures in a small area and injury to any of these structures may not be readily apparent.