Galen Medical journal
Volume:3 Issue: 4, 2014

Diagnosis of psychogenic non-epileptic seizures (PNES) particularly in patients with epilepsy poses a challenge to physicians to care. This study is aimed at determining the frequency of depression and anxiety among Iranian patients with PNES. Sixty patients with PNES and one hundred age-and-sex matching healthy controls were enrolled in this study from January 2010 to January 2011. Patients had at least one psychogenic non-epileptic seizure recorded during video-EEG monitoring in an epilepsy care unit of Namazi Hospital, Shiraz, Iran. Demographic data were collected and Iranian validated versions of Beck Depression and Anxiety Inventory-2 questionnaires were used. Statistical analysis was conducted using Mann-Whitney U-test, Pearson’s chi-square test and independent T test. P < 0.05 was considered statistically significant. Of 60 PNES patients, 37 (61.7%) were female and 23 (38.3%) were male (P=0.767) and mean of the patients’ age was 24.9 ± 6.6 years (P=0.674). Among controls, 64 (64%) persons were female and 36 (36%) were male; mean age was 24.4 ± 2.1 years. Forty two patients (70%) and 36 controls (36%) had moderate to severe depression (P=0.001). Thirty eight patients (63.4%) and 10 controls (10%) had medium to high levels of anxiety (P=0.001). Frequency of depression and anxiety among patients with PNES is much higher than general population. Prompt diagnosis of these two common coexisting psychiatric disorders may help physicians for better evaluation and appropriate management of PNES patients.

Exercise-induced muscle damage can affect exercise performance. The purpose of this study is to examine the effects of Carnitine and Glutamine supplementation on markers of muscle damage and muscle soreness after physical exertion on football players. Twenty eight healthy male football players aged 21.1±0.7 were recruited in a double blind, randomized, placebo-controlled clinical trial on 3 weeks of supplementation. Before supplementation protocol, each participant had to run on a treadmill for 30 minutes at 75% VO2max. Participants were randomly divided into 4 groups: L-Carnitine, L- Glutamine, L-Carnitine plus L- Glutamine and placebo. Blood samples were obtained pre-exercise and immediately after exercise. Muscle soreness was assessed on both occasions and two days after each exercise. L-Carnitine and L-Glutamine supplementation for 21 days significantly decreased Creatine Kinase activity as a marker of muscle’s damage before (P=0.014) and after exercise (P=0.047), and muscle soreness two days after physical exertion (P=0.057). However, Lactate Dehydrogenase activity was affected by Carnitine supplementation after exercise. Chronic oral supplementation of Carnitine and Glutamine before exercise can reduce chemical markers of muscle tissue damage after exercise. In addition, these supplements may reduce muscle pain after exercise and optimize the processes of muscle tissue repair.[GMJ. 2014;3(4):207-15]

Macrolides, Lincosamides and type B Streptogramins (MLSB) are commonly used for the treatment of Staphylococcal infections. Inducible MLSB resistance (iMLSB) cannot be identified by standard methods of antibiotic susceptibility testing. D-test appears to be a reliable indicator of iMLSB strains. The aim of this study was to determine the prevalence of Clindamycin resistance phenotypes in Staphylococcus aureus (S.aureus) isolated from clinical samples in Shiraz, southwest of Iran. This cross-sectional study was performed on a total of 302 S. aureus isolates which were collected from two teaching hospitals in Shiraz during 2012. Methicillin resistant Staphylococcus aureus (MRSA) were screened based on their resistance to 30μg Cefoxitin disk. 168 Methicillin-sensitive Staphylococcus aureus (MSSA) and 134 MRSA isolates were tested in this study. The isolates were tested for susceptibility to Clindamycin (2 µg) and Erythromycin (15 µg) by Clinical and Laboratory Standards Institute (CLSI) recommended disk diffusion test. Of 302 collected S. aureus isolates, 134 (44.4%) were MRSA and 168 (55.6%) were MSSA. Inducible MLSB resistance was observed in 10.4% of all recovered MRSA and 3% of all MSSA isolates. The majority of MRSA isolates (77.6%) constituted MLSB phenotype (cMLSB); this phenotype was seen in 4.1% of our tested MSSA isolates. Finally, 12.0% of MRSA isolates and 89.9% of MSSA showed sensitivity to both Erythromycin and Clindamycin. Different resistance patterns in hospitals indicated that performing routine D-test for S. aureus infections is highly recommended for each medical center.

The aberrant expression of Dickkopf-1 (DKK1), triose phosphate isomerase (TPI) and fatty acid binding-protein 5 (FABP5) in lung cancer tissues and their presence in secretome of lung cancer cell lines were reported. Here, serum levels of these molecules in lung cancer patients were compared to those in a healthy control group. The patients’ group consisted of 50 newly diagnosed male patients with a mean age of 65.3±11.5 years (27 squamous cell carcinoma (SCC), 7 adenocarcinoma, and 16 small cell carcinoma). Thirty eight apparently healthy men (mean aged 65.1±11.4) served as the control group. ELISA was employed for quantification. Comparison between patients and controls revealed no significant difference, although FABP5 level was lower in patients (3.2 vs. 4.8; p=0.09). Analysis of each type of lung cancer with controls indicated that patients with SCC had significantly lower levels of FABP5 than in controls (2.7 vs. 4.8 ng/ml; P=0.03). Comparison between patients and controls revealed no significant difference, although FABP5 level was lower in patients (3.2 vs. 4.8; p=0.09). Analysis of each type of lung cancer with controls indicated that patients with SCC had significantly lower levels of FABP5 than in controls (2.7 vs. 4.8 ng/ml; P=0.03).

Multiple Sclerosis (MS) is the most common demyelinating and inflammatory disease of the central nevus system especially in young adults, but in a subgroup of patients the first clinical symptoms present after the age of 50. This clinical presentation is defined as Late-Onset Multiple Sclerosis (LOMS). The incidence and prevalence of MS including LOMS vary geographically. The aim of this study is to determine epidemiological characteristics of LOMS in Fars province, South of Iran. All patients aged over 50, known to have had definite MS according to MC Donald’s criteria, being members of Shiraz University Multiple Sclerosis Database (SUMSD), were evaluated in this study. The following data were recorded via a questionnaire indicating gender, age at the time of diagnosis, clinical course and details of disease- modifying therapies (Beta-Interferon). Among a total of 1705 patients, 7.2% were identified as having LOMS and 3.1% identified as having very late-onset MS (VLOMS). Mean age of the patients with LOMS at the time of diagnosis was 58.81 ± 2.6 years (20.8% were male and 107 (79.2%) were female). 8.9 % had EDSS 6 and more. 89.1% of patients received Beta-Interferon as a disease-modifying treatment including Avonex (16.3 %), Cinovex (32.6%), Rebif (14.1%) and Betaferon (26.1 %). In our study, 7.2% of all MS patients were identified as LOMS. In LOMS subgroup, clinical history and para-clinical data should be thoroughly evaluated to exclude more common conditions like cerebrovascular disease.

Nursing is considered as a profession at risk for high levels of stress and burnout, and these levels may be increasing as the care they deliver becomes complex. The purpose of this study was to investigate the relationship between burnout and socio-demographic characteristics of nurses. A cross-sectional descriptive-analytical design was used. The sample consisted of 194 nurses working in five hospitals of Hamadan University of Medical Sciences in Iran, who completed the Maslach Burnout Inventory (MBI) as well as a socio-demographic questionnaire. The data were analyzed using descriptive statistics, Pearson correlations, independent t-test and ANOVA. Results indicated moderate levels of emotional exhaustion, depersonalization and low levels of personal accomplishment. There was significant relationship between burnout and age, length of employment, and educational level. Identifying an integrative process of burnout among nurses is an essential step in developing effective managerial strategies in order to address the problem. To prevent burnout, further research is necessary to determine the factors associated with it so that recommendations can be made for future wellness interventions.

Toxoplasmosis is a zoonotic disease which occurs mostly through ingestion of tissue cysts or oocyst excreted by infected cats. This study was conducted to determine the sero-prevalence of toxoplasmosis in two migrating Lore and Khamseh tribes in southern Iran living in tents with their domestic animals. During 2010, using cluster random sampling method, 357 blood samples were collected from two migrating tribes (Khamseh and Lore) in both genders and age groups of 8-80 years in Fars Province, southern Iran. Samples were tested for prevalence of toxoplasmosis using IgG Indirect Fluorescent Antibody Technique (IFAT). Findings in both tribes were compared regarding age, sex and lifestyle. Prevalence of toxoplasmosis among both tribes was 12.3%. There was a significant difference for prevalence of toxoplasmosis between Khamseh (15.6%) and Lore (6.77%) tribes. No significant difference was observed between males (14.3%) and females (10.8%). The rate of infection increased with age. The highest prevalence was seen among those who used unhygienic water from well (15.7%). No relationship was observed between the prevalence of toxoplasmosis and the rate of abortion. In our study, sero-prevalence was lower than other studies in Iran. It seems that lifestyle trends like low consumption of vegetables and absence of cats in their lives are the most important factors for this low prevalence. This infection may be due to their lifestyle of consuming undercooked barbecue meat.

Despite more than a decade experience of annual student congresses in Iran, major scientific writing weakness still exists in students’ abstracts submitted to the Annual Research Congress of Iran’s Medical Sciences Students (ARCIMSS). Assessment of these abstracts can provide information on common scientific writing errors and subsequent development of abstract quality for the future congresses. Assessment of writing errors and peer review process of accepted abstracts in ARCIMSS 13th forms the central idea of the present study. In this cross-sectional study, from all 505 accepted abstracts, 17 abstracts were excluded and the remaining 488 abstracts were evaluated for affiliation and educational level of the presenter, presentation type, writing errors and the scores of reviewing process for each abstract. Writing errors were compared based on the presenters’ affiliation (Student Research Committee (SRC) affiliated and non-SRC affiliated) and educational level. Also, correlation between students and faculty members’ reviewing scores in peer review process was evaluated. Writing errors were seen in 242 (49.6%) abstracts and the majority of errors were seen in the “author’s affiliation” section (26.6%). The frequency of writing errors was significantly lower in SRC-affiliated abstracts comparing to non-SRC affiliated (P=0.038) that was not significantly different from postgraduate and undergraduate presenters (P=0.34). There was no significant correlation between pre-congress and during-congress peer reviewing scores (P=0.399, r=0.05). There were significant writing errors in accepted abstracts. This issue underlines the necessity of educational interventions performed by SRC members in order to develop students’ skills in abstract writing based on standard guidelines.

Lichen Planus is a common mucocutaneous disease with unknown etiology. Immunodeficiency is a known predisposing factor to this disease. Oral Candidiasis which is an opportunistic fungal infection, commonly affects healthy and immune-compromised patients. Candida has different species bearing different treatments. In this study, researchers aimed to detect the frequency and colonization rate of Candida and its association with different factors such as lesion types of oral lichen Planus (OLP). Thirty seven untreated oral lichen Planus patients, attending the Clinical Department of Oral Medicine at Shiraz Dental School in 2011, were selected. Swab method and CHROMagar media were used to obtain samples incubated for 48 hours at 30 ºC. Fungal species were detected considering colony color changes. In the culture test, approximately 80% of samples were positive of non-reticular type. About 40% of positive samples were of Candida non-albicans (C.Non-albicans) type. Among C. Non-albicans, 85% were non-reticular type among OLP patients. There was no significant statistical difference in prevalence of Candida albicans (C.albicans) and C. Non-albicans in OLP patients. Based on results, certain biotypes of Candida were not confirmed responsible for OLP patterns.

Mullerian Adenosarcoma, a rare tumor, is composed of mixed mesenchymal and epithelial elements. The epithelial component is typically benign and admixed with malignant Sarcomatous Stroma. This tumor can be distinguished in approximately 8% of all uterus sarcomas and commonly originates in the endometrium as a growing polypoid mass in the uterine cavity. All age groups are affected but the average age of uterine Adenosarcoma is about 58. Case report: We aim to introduce a 14-year-old case of uterine Adenosarcoma as a rare occurrence, presenting with menometrorrhagia and formation of uterine fragile polypoid mass which extends into vagina. Total Abdominal Hysterectomy (TAH) and staging were performed. She had been clinically disease-free in a 40-month post operation follow-up. Distant metastasis is a very rare phenomenon, albeit the necessity of long-term follow-up seems necessary. Data accumulation of individual cases with such unusual neoplasm is essential for further experience provision.