Journal of Research in Medical Sciences
Volume:18 Issue: 6, Jun 2013

Considering the limitations of current pathologic methods in distinguishing two subtypes of hydatidiform mole and non-molar pregnancy, the utility of immunohistochemical markers in this regards and the importance of differentiating of mentioned pathologic patterns, in this study the expression of P63 in patients with complete hydatidiform mole (CHM), partial hydatidiform mole (PHM) and non-molar pregnancy was determined. In this study, formalin-fixed and paraffin-embedded tissues of 61 patients with definitive pathologic diagnosis of CHM, PHM and non-molar pregnancy retrieved. Diagnoses were based on the study of hematoxylin and eosin stained slides. Sections from all samples were stained for P63 marker using immunohistochemistry method. The nuclear immune reactivity of P63 marker in the three pathologic groups was determined by two pathologists. P63 immune-staining was used to evaluate 20, 26 and 15 non-molar pregnancy, CHM and PHM cases, respectively. Mean ± SD of P63 nuclear immune-staining in molar pregnancy (CHM and PHM) and non-molar pregnancy were 32.4 ± 17.4 and 18.9 ± 17.2, respectively (P = 0.006). The means were significantly different between non-molar pregnancy and PHM (P < 0.000), CHM and PHM (P = 0.02) and non-molar pregnancy and CHM (P = 0.04). Considering the findings of the current study, though the nuclear immunoreactivity of P63 was higher in molar than non-molar pregnancy and in PHM than CHM, but using this marker alone is not suitable as a diagnostic test due to its low sensitivity and specificity. It could be used as adjuvant test in conflict cases. It is recommended to evaluate the role of other immunohistochemical markers like Ki-67 in this regard.

Creactive Protein (CRP) and white blood cell (WBC) are pro-inflammatory markers. They are major pathophysiological for the development of metabolic syndrome (MetS). This study aimed to address the independent associations between MetS and WBC counts and serum CRP levels and evaluation of their magnitude in relation to the MetS, based on the sex in the Iranian adults. In this cross sectional study, subjects who met the MetS criteria, based on the ATPIII were selected from the Isfahan Healthy Heart Program database. A questionnaire containing the demographic data, weight, height, waist and hip circumference of the respondents was completed for each person. Blood pressure was measured and the anthropometric measurements were done, and fasting blood samples were taken for two hours post load plasma glucose (2 hpp). Serum (total, HDL and LDL) levels of cholesterol, triglyceride and CRP as well as WBC counts were determined. The univariate analyses were carried out to assess the relation between the CRP levels, WBC counts with the MetS in both sexes the. In men with the abdominal obesity, the higher levels of WBC count, high serum triglyceride and blood glucose levels, a low serum HDL level, and raised systolic and diastolic blood pressure were observed. However, the higher serum CRP levels were only observed in those with the low serum HDL-cholesterol levels. The mean values of the WBC counts were statistically different between the men with and without MetS, but the mean values of the CRP levels were similar between the two groups. In women, the mean values of WBC count and CRP levels were statistically different in the subjects with and without a MetS components (except for the low serum HDL levels and high diastolic blood pressure for the WBC measures and abdominal obesity for the CRP measures) and for those with and without MetS. The age and smoking adjusted changes in the CRP levels and WBC counts correlated with the number of Mets components in the women. The findings of this study suggest substantial implications for the prevention and management of the MetS and atherosclerotic diseases, as these involve the suppression of inflammatory conditions rather than the incitement of anti-inflammatory conditions.

The association of gastro-esophageal reflux (GER) with a wide variety of pulmonary disorders was recognized. We aimed to evaluate the effect of GER-induced esophagitis on airway hyper-reactivity (AHR) in patients and the response to treatment. In this cohort study, 30 patients attending the gastrointestinal clinic of a university hospital with acid reflux symptoms were included. All patients were evaluated endoscopically and divided into case group with esophagitis and control group without any evidence of esophagitis. Spirometry and methacholine test were done in all patients before and after treatment of GER with pantoprazole 40 mg daily for six months. There was a significant difference in the rate of positive methacholine test between the cases (40%) and the controls (6.7%) prior to anti-acid therapy (P<0.0001). After six months of treatment, the frequency of positive methacholine test diminished from 40 to 13.3% in the case group (P value < 0.05) but did not change in the controls (P=0.15). The presence of esophagitis due to GER would increase the AHR and treatment with pantoperazole would decrease AHR in patients with proved esophagitis and no previous history of asthma after six months.

Seborrheic dermatitis (SD) is a common, chronic inflammatory disease. Inflammatory reaction and oxidative stress are thought to be effective in the pathogenesis of SD. Based on anti-inflammatory and anti-oxidant properties of emu oil, this study was designed to evaluate effects of emu oil on patients suffering from SD, and to compare it with routine treatments of SD with topical steroids and antifungal agents. This clinical trial was conducted on126 patients who were randomly allocated to 2 groups:62 in the clotrimazole vs. emu oil(group-1) and 64 in the hydrocortisone vs. emu oil(group-2). The right side of the face in both groups was treated with topical emu oil. The left side was treated with topical clotrimazole in the first group and with topical hydrocortisone in the second group. One month after the treatment, pre and post treatment symptom severity scores of pruritus, erythema and scales were compared. All 3 medications significantly improved pruritus, erythema and scales (p<0. 01). However, topical clotrimazole and hydrocortisone were significantly more effective than emu oil in improving scales (p<0.01), and hydrocortisone was significantly more effective than emu oil in reducing pruritus (p<0. 01). Comparing with topical clotrimazole, emu oil resulted in significantly more improvement of erythema (p:0.01).Emu oil is a potentially useful agent that significantly improves itching, erythema and scales associated with SD; however, it was less effective than hydrocortisone and clotrimazole which are routinely prescribed to treat SD.

The Le7 acupoint had been known as an acupoint for reducing pain of appendicitis. However, no study on the effect of its acupressure on post-appendectomy pain is available. The objective of this study was to evaluate the effects of acupressure of Le7 acupoint on pain, nausea, and vomiting after appendectomy. A single-blind randomized controlled trial was conducted on 70 post-appendectomy patients in a general surgical ward. Patients with inclusion criteria were selected consecutively and were randomly assigned into two groups. The intervention group received acupressure to the Le7 acupoint and the second group was the control group. The severity of post-operative pain, nausea, and vomiting measured hourly till the seventh post-operative hour. T-test was used to compare the mean of pain and nausea severity of two groups. Paired t-test was used to compare the mean of pain intensity of each group before and total mean of pain at post-intervention hours. Chi-squared test and Fisher exact test were used for nominal data. The mean of pain intensity in the intervention group was 5.10 ± 3.52 before intervention and decreased to 3.53 ± 0.75 in the post-operative hours (P = 0.018). The mean of pain intensity in the control group was 4.45 ± 3.16 before intervention and changed to 4.01 ± 0.92 in the post-operative hours (P = 0.32). However, the mean of pain intensity in the intervention group was less than the control group till 6th h after the surgery. No significant differences were observed between the two groups in terms of nausea and vomiting (P = 0.74). acupressure on Le7 acupoint was effective on post-appendectomy pain but did not affect nausea and vomiting. Further investigations are suggested with starting acupressure at the onset of pain or nausea and vomiting.

Elevated plasma homocysteine (Hcy) level has been established as a significant risk factor for venous thrombosis and cardiovascular disease. Homozygosity for the methylenetetrahydrofolate reductase (MTHFR) C677T mutation has been associated with elevated plasma Hcy concentration and may contribute to retinal vein thrombosis (RVT) development. The aim of the present study was to investigate whether the hyperhomocysteinemia and/or homozygosity for the MTHFR C677T mutation are associated with an increased risk for RVT. Our study population consisted of 73 consecutive patients (50-78 years old) with RVT and 73 control subjects (51-80 years old), matched for age and sex. Genotyping for the MTHFR C677T mutation was performed by polymerase chain reaction-restriction fragment length polymorphism technique and Hcy level was determined by an enzyme immunoassay kit. The prevalence of 677TT genotype was higher in patients than control subjects, but the difference in frequency didn’t reach a significant value (P = 0.07). The frequency of the 677T allele was 26% and 21.2% in patients and controls, respectively and did not differ significantly between the two groups (odds ratio = 1.3, 95% confidence interval (0.75-2.24), P = 0.33). Fasting plasma total Hcy level was significantly higher in patients than controls (P = 0.001). Our study demonstrated that hyperhomocysteinemia, but not the MTHFR C677T mutation, is associated with RVT.

Quality of life (QOL) improvement is the main objective of treating patients with irritable bowel syndrome (IBS). This study aimed to assess the validity, reliability, and factor analysis of IBS-QOL-34 questionnaire as a common transcultural instrument for Iranian IBS patients. Two hundred and forty patients with IBS (based on gastroenterologists’ diagnosis according to ROM III criteria) were referred to Digestive Health Clinic in Psychosomatic Research Center have been selected in this study. Aside with IBS-QOL-34, MOS 36-item short-form health survey (SF-36) and IBS severity index (IBSSI) questionnaires were completed by the cases for determination of correlation coefficients; the data were analyzed using descriptive statistics, factor analysis, Cronbach’s alpha, Pearson correlation coefficient by Statistical Package for Social Sciences (SPSS) software, version 18. Total reliability of the questionnaire was reported by using Cronbach’s alpha as 0.95, ranging from 0.65 to 0.90. Correlation coefficients of concurrent implementation of IBS-QOL with SF-36 and IBSSI resulted in -0.61 and 0.64, respectively. Exploratory factor analysis using varimax rotation identified eight principle components, which will determine QOL at 67% variance. According to the results, IBS-QOL-34 questionnaire has good psychometric properties in the research community and can be safely used as a valid tool to assess QOL of patients with IBS for healthcare and therapeutic purposes.

Crimean Congo hemorrhagic fever (CCHF) has high morbidity and mortality.Therefore the treatment effect of Ribavirin with and without intravenous Immunoglobulin (IVIG) in viral Crimean Congo hemorrhagic fever was evaluated. In a clinical trial study, 40 patients with confirmatory positive serology test, 12 (30%) received Ribavirin and IVIG (case group) and 28 (70%) received only ribavirin as standards therapy (control group). The patients were followed and compared by defervescence and other clinical symptoms, and laboratory results such as white blood cell count (WBC), platelets; liver function test (LFT) and duration of hospitalization and mortality rate after eight weeks. The mean (SD) period for defervescence and stopping bleedings was five (0.6) days in case group and five (0.5) days in control group with no significant differences (P=0.27). The mean period for return of WBC to normal was three (0.6) days in case group and five (0.8) days in control group (P=0.002).The mean period for return of LFT to normal was three (0.9) days in case group and seven (0.5) days in control group which showed a meaningful difference (P=0.001).Normalization of platelets was returned within four (0.8) days in case group compared to 6 (0.6) days in control group. Mortality was observed in three cases of each group. Considering our results, using IVIG in viral hemorrhagic fever (VHF) may need further evaluations.

Child and adolescent psychiatry has benefited from the application of self-report questionnaires because it is short, less costly and easy to apply. So we select the Strengths and Difficulties Questionnaire (SDQ) and evaluate the agreement between the self-report and parent report form. Subjects were 1934 adolescents.11-18 years old After obtaining the samples consent, SDQ parent rated form and self-rated form were filled. The collected data were analyzed using the STATA statistical package version 9. The adolescents obtained higher total difficulty scores than their parents, but it was not significant (P value = 0.203). Boys had higher total difficulty scores than girls by parent informant (P value = 0.001), but by self-report girls had higher total difficulty scores than boys (P value = 0.42). 11-14 years had higher total difficulty scores by parent report than self-report (P value = 0.42), but 15-18 years had higher total difficulty scores by self-report than parent report (P value = 0.36). SDQ self-rating from adolescents may contribute better to the diagnostic process in the clinical setting.

in a formative evaluation, we were supposed to find whether an innovative program has some merits to be continued or not. We also determined the critical points of the program. The evaluated program was a clinical pre-clerkship curriculum launched for departing to a less stressful medical clerkship. we analyzed the information contained in the students’ logbooks. Using Dundee Ready Education Environment Measure standardized questionnaire, we also assessed the students’ perception of learning environment within six clinical departments. Totally, 64% of expected patient contacts, and teaching of more than 71% of required skills at 4 departments were carried out and students had more positive than negative perspective of their learning environments. The evaluand is a worthwhile program to be continued, though it needs some considerations for improvement.

Protection of the catheter site by antimicrobial agents is one of the most important factors in the prevention of infection. Povidone iodine and chlorhexidine gluconate are the most common used agents for dressing. The purpose of this study was to compare the effects of povidone iodine, chlorhexidine gluconate and octenidine hydrochloride in preventing catheter related infections. Patients were randomized to receive; 4% chlorhexidine gluconate, 10% povidone iodine or octenidine hydrochlorodine for cutaneous antisepsis. Cultures were taken at the site surrounding catheter insertion and at the catheter hub after removal to help identify the source of microorganisms. catheter related sepsis was 10.5% in the povidone iodine and octenidine hydrochlorodine groups. Catheter related colonization was 26.3% in povidone iodine group and 21.5% in octenidine hydrochlorodine group. 4% chlorhexidine or octenidine hydrochlorodine for cuetaneous disinfection before insertion of an intravascular device and for post-insertion site care can reduce the catheter related colonization.

Refraction problems, motor disorders, sensorial disorders, physical and psychic traumas of eye may be responsible for development of strabismus. Anemia may cause sensory-neural disorders in children. We investigated the relationship between anemia and accommodative esotropia in children. Sixty-four patients with accommodative esotropia were evaluated. This group was identified as patient group (group 1). Eighty-three pediatric patients, who were not esotropia and only had refraction problems, were identified as control group (group 2). The difference between the groups was statistically analyzed evaluating patients for anemia. 33 of 64 patients with accommodative esotropia in group 1 were male, as 43 of 83 patients with refractive error in group 2 were male. The mean age of patients in group 1 and 2 were 6 ± 3.92 and 6.37 ± 2.74 (P > 0.05) respectively. There was significant difference between two groups, when mean hemoglobin value of those was compared (P < 0.05). Hb level may affects the accommodative esotropia.

As the fact that today is conducted a number of scientific research works in the field of medicine, it is necessary to define the steps by which it is carried out to make it universal and to have scientific value. This paper describes the research methods, study design, the way in which one should be written, and why it is important to publicize the same. Special emphasis is placed on scientometrics as the science that evaluates scientific papers and their citation in the selected sample of journals. The paper also answers why scientific research works should be carried out and what kind of satisfaction they provide to the researcher.

Diaphragmatic neurilemmoma (schwannoma) is an extremely rare tumor that is often discovered incidentally. Even when diagnosed, patients are commonly advised only to attend regular follow-up appointments as conventional tumorectomy is enormously invasive and confers relatively few benefits. Here, we report a unique case of a diaphragmatic neurilemmoma with concomitant symptomatic cholecystolithiasis, who was treated successfully by pure laparoscopy. The entire operation lasted 65 min, and patient was discharged uneventfully on the 3rd post-operative day. The follow-up for 29 months has shown with no recurrence or symptoms.

Klippel-Feil syndrome is a rare condition characterized by the congenital fusion of two of the seventh cervical vertebrae. A 50-year-old woman presented with a 2-year history of neck pain and ataxia for 1 year. She had not urinary incontinence. She was referred to a neurosurgeon by a neurologist because of her progressive gait ataxia. Risk for brachial plexus injury because of compression or stretching by the clavicle accelerate with age. Therefore, the surgical approach of adults’ patients with Sprengel’s deformity can intend suitable surgical conclusions.

Orbital solitary fibrous tumor (SFT) is a rare tumor and orbits are a very uncommon site. It is mostly noted to arise from mesenchymal structures like pleura and peritoneum. The diagnosis of orbital SFT cannot be made with certainty on clinical or radiological evaluation alone and requires immunohistochemical studies for confirmation. Orbital SFT’s usually show an indolent clinical course and a complete cure can usually be achieved with complete resection. We describe clinical presentations, radiological and operative findings, and pathological features of a patient with orbital SFT along with a review of literature.