Galen Medical journal
Volume:4 Issue: 1, 2015

letters to the editor provide an opportunity for readers to state their views about published articles. Research on this issue has been mainly on western journals and there is no study on the Iranian journals. The present study aimed to investigate this subject in Iranian biomedical journals. This was a bibliometric study. The databases of Iran Medex, Medlib, and SID were searched to find the letters published in Iranian biomedical journals. The letters in formats such as commentaries, concise articles, and the preliminary results of studies or brief reports were excluded from the study. 184 letters were found in Iranian journals; 49 of them were responses of authors to the criticism made by readers. As a result, the number of letters that commented on or criticized the original articles reduced to 135. For every 1198 articles published in Iranian journals, there is only one letter written in correspondence to published articles. 76% of letters published in 2010 to 2012. the Iranian readers are much less productive in writing letters to Iranian biomedical journals compared to their peers in other places. The low number of letters could be attributed to several issues including a broad unawareness of the importance of the letters and little incentive for writing letter.The sharp rise in the number of letters after 2009 indicates a boosted motivation of Iranians for writing more letters to the editor.

Psoriasis is a chronic and inflammatory dermatologic disease. Inflammatory biomarkers such as C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) are known as immediate and delayed inflammatory biomarkers, respectively. Due to the fact that anti-inflammatory drugs such as Infliximab are widely used in psoriasis treatment, the aim of this study was to evaluate ESR, CRP and PASI scores in patients treated with Infliximab in a 24 week trend. This study was accomplished as a before-after study. Twenty seven psoriatic patients were included and standard Infliximab therapy was applied. All patients underwent 3 times of blood collection and in each session CRP, ESR and PASI scores were measured at the beginning of study and at the 12th and 24th weeks of follow-up A total of 19 (70.4%) men and 8 (29.6%) women were evaluated. Mean age was 37.85±13.68 years. All three parameters had significant decrease in treatment course (p<0.001); however, no significant correlation was found between PASI and inflammatory biomarkers. Trends of ESR and CRP were significantly correlated in all patients (r=0.504, P =0.007) and males (r=0.739, P =0.036). Our study demonstrated that CRP and ESR decreased in Infliximab treatment, in accordance but non-regarded to PASI score decease. Regarding other studies results, using these biomarkers for treatment follow-up might need more caution.

Esthetic demands among patients have led to the introduction of tooth-colored restorations. Composite resins bond to enamel applying acid etch technique. Total etch adhesion systems are still considered as golden standard among bonding systems. However, clinicians have tendency towards using adhesive systems with a simplified application procedure. The aim of the present study is to compare the shear-bond strength of composite restoration to intact enamel of primary incisors using different conditioners, and adhesive systems. This experimental study was conducted in Shiraz University of Medical Sciences. 53 teeth were classified into 5 groups based on the bonding procedure. After composite build-up, specimens were placed in a universal testing machine at a cross-head speed of 1mm/min. Inter-group comparison of the shear-bond strength to enamel was analyzed employing One-way-ANOVA and Tukey post-hoc test. Data were statistically analyzed using SPSS (Version 17, Chicago, IL, USA). The highest shear-bond strength was related to the second (37% phosphoric acid etching + Margin Bond adhesive system), and the fifth group (37% phosphoric acid etch + Tokuyama Bond Force adhesive system), and the lowest bond strength was related to the third group (Tokuyama Bond Force adhesive system alone) (p value = 0.00). Based on the results of the present study, surface pre-treatment with 37% PA accompanied with self-etching adhesive system, increased the shear-bond strength in vitro. This method can be further studied in clinical settings.

Methicillin-resistant (MRSA) Staphylococcus aureus (S. aureus) are responsible for a vast number of nosocomial infections especially in immunocompromised subjects such as cancer patients. The presence of comorbidities including malignancies has been associated, with S. aureus bacteremia mortality. Thus, the detection of MRSA in this patients and the antibiotic susceptibility pattern of the isolates eases the selection of first-line medications and the prevention from further complications in cancer patients. The aim of this study was to determine the prevalence of MRSA infection and antibiotic susceptibility patterns of the isolates in pre and post-chemotherapy course in cancer patients. From May 2011 to July 2012, 200 nostril samples of cancerous patients were obtained and cultured on blood agar plates. After isolation and confirmation of S. aureus, antibiotic resistance pattern of the isolates was determined pre-chemotherapy and after the chemotherapy against vancomycin, tigecycline, linezolid, chloramphenicol, and oxacillin using disk diffusion test following CLSI guidelines. Chi-square test was used for data analysis. Among a total number of 200 various cancer patients (64.5% females), 42 (21%) cases were positive for S. aureus and 7 (3.5 %) were MRSA carriers. Mean ages of MSSA and MRSA infected patients were 50.97±15.94 and 53.57±18.28 years old, respectively. In vitro susceptibility pattern of the MRSA and MSSA isolates to the 4 tested agents did not differed significantly after the chemotherapy in contrast with pre-chemotherapy state. This study showed that chemotherapy does not change the susceptibility pattern of MRSA species to antibiotics of choice in cancer patients. However, the importance of controlling methicillin resistant staphylococcal infections in critical cases, specifically cancer cases, necessitates the early detection, further investigations on more effective medications.

Primary dysmenorrhea is the most common cyclic pelvic pain and is also the most common gynecological problem worldwide and affects quality of life. The present study aimed to investigate the effect of isometric exercises on intensity and duration of pain and level of anxiety in the students with primary dysmenorrhea. In this randomized controlled clinical trial, 68 students living in dormitories of Shiraz University with primary dysmenorrhea were randomly assigned to isometric exercises and control groups. The intervention group performed isometric exercises since the third day of the menstrual cycle for 8 weeks. Pain intensity was measured using Visual Analog Scale (VAS). In addition, the anxiety level was assessed using Spielberger questionnaire. The data were analyzed using independent t-test, repeated measures ANOVA, and Bonferroni Post hoc test at the end of the second and third months of the study. Besides, P<0.05 was considered as statistically significant. Pain intensity and duration of pain was significantly reduced in exercises group (p<0.001). However, no significant difference was found between the two groups concerning the mean anxiety levels. Primary dysmenorrhea is a common complaint among young women. Isometric exercises seem to be an easy, non-pharmacological method for reducing primary dysmenorrheal.

Suicidal behavior and HIV/AIDS are considered as significant public health concerns. HIV infection has been associated with elevated risk of suicidal ideation.Methods and Materials: Cross-sectional and descriptive research design was used to record socio-demographic data of the study. The suicidal ideation scale BECK was used to determine and measure the frequency of suicide ideation and attempt in HIV infected (HIV+) persons referred to behavioral health counseling center of Rafsanjan University of medical sciences (RUMS) and Kerman University of medical sciences (KUMS) in 2012. Men had more suicidal ideation than women after the diagnosis of infection with HIV. More cases of HIV positive persons with duration of less than 10 and more than 14 years, and most cases of less than 40 years-old had suicidal ideation. There was no significant difference between suicidal ideation in HIV-infected individuals and factors such as gender, age, and duration of HIV-infection (p >0.05). Suicidal ideation and attempt is common in HIV infected patients which needs more assessment and prevention.

Motor vehicle Traffic injuries are indeed one of the most important worldwide health problems. Opioids can induce a depressant effect on the central nervous system which may increase the risk of traffic accidents. This cross-sectional case-control study was conducted in Marvdasht, Iran to investigate the presence of drugs in hospitalized non-fatally injured drivers of motor vehicles. The cases were 500 drivers of motor vehicle, injured in the road traffic accident and referred to the emergency ward. The controls were 500 patients hospitalized in the same emergency department due to non-traumatic reasons. They were asked about the abuse of any substance during the 72 hours before their referral to the hospital. Urinary samples of patients with negative history of drug consumption were analyzed. From the drivers, 237 (47.4%) of the case group and 278 (55.6%) of the control group had positive-substance consumption. Opium was the common drug abused in the two groups. An eight fold increased risk of road accident was observed for drivers who had used tramadol (OR= 8.2, 95% CI 4.9-13.7, p<0.001). Two or more illicit drugs (poly drug abuse) were detected in 24% of the cases and 31.8% of the controls (50.6% and 57.2% of drug abusers, respectively). Just for tramadol, the prevalence was higher in cases than controls. The results demonstrate the high proportion of illicit drug abuse among Iranian drivers. More health education and policies are necessary to steadily decrease drug abuse in our society.

To investigate about frequency of different subtypes of stroke in south of Iran This is a retrospective, single-center study conducted at Namazi Hospital, Shiraz, south of Iran. Age, sex, length of hospitalization and mortality of stroke patients were recorded by reviewing hospital medical records. 16 351 patients (53.6% male, 46.4%female) were recruited. Ischemic stroke (10750 patients, 65.7%), intracerebral hemorrhage(3282 patients,20.1%) and subarachnoid hemorrhage(1057 patients,6.5%) were the most common subtypes of stroke, respectively. In 1262 patients (7.7%) the stroke subtype could not been specified. Ischemic stroke and intracerebral hemorrhage were more common in men but subarachnoid hemorrhage was more common in women. Subarachnoid hemorrhage occurred significantly in younger patients. Mortality was significantly higher in intracerebral hemorrhage. Hospital stay was significantly longer in subarachnoid hemorrhage group. the distribution of the different subtypes of stroke in Iran is similar to Caucasians.

As the early and accurate diagnosis of all diseases, including skin disorders directly influences the duration of treatment and its costs, which may be a significant burden, it is very important for physicians to be familiar with all types of diseases, especially those with a higher incidence in population. Considering that disease patterns vary from region to region and there is no demographic data on patterns of skin diseases in Fars Province, we aimed to assess the frequency of skin diseases in admitted patients to Dermatology Ward of Shahid Faghihi Hospital. The medical records of 1450 patients, who completed a questionnaire during the years 2008 to 2011, were evaluated in this retrospective study. Demographic data and diagnoses of skin diseases were analyzed by SPSS software and classified according to the International Classification of Diseases (ICD-10). Pemphigus (12.5%), drug rash (11.7%) and eczema (10.5%) were the most common cause of referral to dermatology ward. The mean age of patients was 41.89±20.79 and the average length of hospitalization in this study was 9.34 days. The high occurrence rate of Pemphigus and drug rash indicates that further study is required to root out the underlying causes. Proper health policies should be implemented to manage these diseases.

Nail disorders comprise approximately 10% of all dermatological conditions. Abnormalities in the color of nails are called ungal dyschromia or chromonychia. Ungual dyschromia may be endogenous or exogenous. Yellow discoloration of the nails has been reported during the last years as separate observation related to drug administration, during hemodialysis and associated with pulmonary diseases as yellow nail syndrome.Case reports: A 23-year-old female patient was diagnosed with yellow nails induced by application of a specific nail polish. A 67-year-old man presented with transient nail discoloration as a result of the exacerbation of his chronic pulmonary disease. Our cases illustrate transient yellow discoloration of finger nails associated with the use of nail polish, and with an acute episode of chronic bronchitis, with full recovery in the absence of any treatment.

Acute pancreatitis (AP) is a common clinical disease caused mainly by gallstone impacting the distal common bile-pancreatic duct and alcohol abuse, but other potential causes as Endoscopic retrograde cholangiopancreatography (ERCP), intra duct papillary mucinous tumor and hypercalcemia are claimed. The incidence of AP has been increasing in recent years. Accordingly, AP is a multifactorial disease associated with tissue edema, acinar necrosis, hemorrhage and the release of digestive enzymes to the pancreatic interstitium and to the systemic circulation with increased cytokine production and release, which can ultimately lead to deleterious local and systemic effects. Previous evidence suggests that the pathogenesis of both AP and chronic pancreatitis can be associated with oxidative stress, regardless of the etiology of pancreatitis and is considered as a major pathogenic factor in AP. In fact, reactive oxygen species (ROS) are the important mediators in the initiation and development of the disease which destroy the cellular membrane, releasing the digestive enzymes and cellular proteins into the pancreatic interstitium.

In some acute critical illnesses, the function of Hypothalamus-Pituitary-Adrenal axis can be impaired. This event is called «Critical Illness-Related Corticosteroid Insufficiency» (CIRCI). We conducted a study to determine which of the CIRCI patients need steroid therapy. This study was performed on patients who were admitted in Pediatric Intensive Care Unit (PICU) in Nemazee Hospital, affiliated to Shiraz University of Medical Sciences, Iran. In first 24 hour of PICU admission, Serum cortisol levels were measured immediately before, 30 and 60 minutes after IV administration of 250 μg of synthetic adrenocorticotropic hormone (Synacthen®). Their clinical conditions and paraclinical data were followed and recorded. Twenty four patients were enrolled in the study. Twelve patients (50%) had CIRCI. CIRCI was defined as Random Serum Cortisol (RSC) <10 μg/dl or elevation of serum cortisol level after Synacthen administration below 9 µg/dl. The results of serum cortisol level usually were ready one day after blood sampling. Based on general condition, blood pressure and serum electrolyte levels, all CIRCI patients were improved when serum cortisol levels were determined. Therefore, steroid therapy was not started for them. Finally, all of the CIRCI patients improved and after a few days, all of them were discharged from the hospital with good conditions. Findings of our study showed that corticosteroid therapy is not needed as a routine treatment for CIRCI patients. This is in agreement with some other studies. but in contrast to some articles who recommended corticosteroid therapy for patients with CIRCI. There is lack of consensus about optimal approach to CIRCI in children, therefor; well-designed RCTs and systematic reviews are needed to determine proper treatment recommendations for these critically ill children before administration.