[ report about a case of gestational trophoblastic tumor associated with ectopic pregnancy]

Gestational trophoblastic tumor associated with ectopic pregnancy is a very rare event. This paper reports a case of an invasive mole arising from a tubal pregnancy. Patient is a 26-year-old G2L1Ep1 who was referred to Isfahan Beheshti Hospital due to rise in BHCG level after surgery of ectopic pregnancy [EP]. The patient had initially been treated with salpingectomy. The pathologic study of specimen was invasive mole. The patient underwent two period of MTX treatment. Because of sonographic report of adnexal mass, the patient underwent laparotomy. The result of laparotomy was invasive mole. The patient underwent EMACO regimen and was released when the BHCG was 1. Appropriate monitoring of BHCG titers following surgery of EP is important not only to diagnose persistent EP, but also for rejecting the presence of GTT. In addition, follow up of the pathologic report is also important, although the clinical diagnose seems to be correct

[Comparison of nested case-control and cohort analysis methodologies using a district TB registry data]

The nested case-control study has become popular as an efficient alternative to the full-cohort design. This study compares the results of a nested case-control analysis approach with the full cohort analysis. A cohort of 276 subjects [new cases from a TB registry] was used for this study. Cox Regression model was used for the full cohort analysis. In order to do the nested case-control analysis, for each death, three random controls were selected from those who did not suffer from the outcome at the time of the outcome took place. Case control data was analyzed by the conditional logistic regression model. Results from both cohort and nested case-control analyses show that treatment group is the only variable that affects on the outcome. Gender, place of residence, and age has no effect on the outcome. For binary exposure variables with trivial effects [e.g. Gender and place of residence], the relative efficiency of nested case-control study design is approximately 75%. Results of this study show that nested case-control study is not only an easy and cost-effective method for data analysis but also is as robust as cohort analysis in rate ratio and its variance estimation

[Effects of vitamins E and C in reduction of preeclampsia blood pressure incidence in primigravids]

The preeclapsia causes about 5-10 of pregnancies to be complicated and leads to increasing maternal morbidity and mortality rate in both mother and fetus. One of proposed preventions is using of antioxidants during pregnancy. Therefore, the aim of this study was to investigate the effects of vitamins E and C on the pregnancy-related blood pressure as the major sign of the preeclapsia. In this clinical trial study, 150 primigravids, aged 20-35, gestational age 20 weeks, singleton, negative family history of preeclampsia, chronic hypertension or other organic disease, with normal BMI, nonsmokers, moderate socioeconomic level and without molar pregnancy and polyhydramnious, are divided into two equal groups of case and control. The case group received 500 mg vitamin C and 400 IU vitamin E every day. The control group received no vitamin. Using a questionnaire, the data were obtained and analyzed using t, paired t and Fisher exact statistical tests. The preeclampsia rates were 2 [2/6%] and 11 [14/7%] in the case and control groups, respectively [p<0.01]. In the case group, the mean of systolic pressure befor and after study were 96.1 +/- 9.7 and 109.8 +/- 9.5 mmHg, respectiely. In the control group this parameters were 94.6+8.7 and 113.8 +/- 8.7 mmHg, respectively [p>0.05]. In the case group, the mean of pressure was 60.2 +/- 8.3 mmHg before diastolic and 65.5 +/- 3.8 at the end of pregnancy and after the intervention. In the control group, this parameter was 59.6 +/- 20 and achieved to 72.2 +/- 16 at the end of the pregnancy [p<0.01]. Our results showed that use of 400 IU vitamin E and 500 mg vitamin C during pregnancy prevented incidence of preeclampsia and reduced mean diastolic pressure, but had no effect on mean systolic pressure. Therefore, it is recommended to use the medications in the high risk-pregnant women

effect of health education based on health belief model on preventive actions of smoking in grade one, middle school students

World health organization has proclaimed the prevalence of smoking among 15 years old European region students, more than 24 percent. The cigarette smoking indicator in our country among over 15 years old individuals is 11.9 percent and in the province under survey is 15.6 percent. This research has been performed in order to study the effect of health education program based on health belief model [H.B.M] on preventive actions of smoking in middle school students. This is a quasi-experimental study, done on 248 students of grade one in middle schools of Boukan city [119 boys and 129 girls] that were randomly divided into experimental and control groups. Data collection tool was a questionnaire including 77 questions based on health belief model [perceived susceptibility, perceived severity, perceived benefits and perceived barriers to smoking, and cues to action] and preventive actions of smoking. After data collection in the first stage, action was taken with regard to educational intervention and then in the second stage [after the intervention], data was collected again. Data was analyzed using T test. Results showed that the mean score of all parts of health belief model in experimental group [except for perceived barriers] after educational intervention compared to before intervention was increased significantly and also the mean score of all parts of HBM after intervention was significantly increased in experimental group compared to control group. The results of this survey show that by increasing the score of health belief model parts; including, perceived susceptibility, perceived severity and perceived benefits, adopting preventive actions of smoking also increases. Therefore, the results of this survey confirm the efficiency of health belief model in adopting preventive actions of smoking

[Comparison of self-esteem and coping responses in infertile and fertile couples from Shahrekord, during 2003-2004]

Infertility is an illness in which, women during a years of sexual intercourse and without the use of contraceptive methods, are unable to become pregnant. Self-esteem is a psychological method by which a person assesses oneself. Coping responses are conscious rational ways for dealing with the anxieties of life. Psychological researches in infertile couples showed that infertility is a bio-psychosocial crisis that can create psychological problems in these individuals. Therefore, the aim this study was to compare self-esteem and coping responses in fertile and infertile couples from Shahrekord during 2003-2004. In a cross-sectional study so couples of fertile and so couples of infertile referred to gynecology clinic of Hojar hospital in Shahrekord were selected, randomly, during 6 month period. Questionnaire included Coper Smith self-esteem, Billings and Moos coping responses. Sata were analyzed by t-test and Spearman correlation. The results showed that the average of self-esteem scores in infertile couples [27.3] is less than [32.7] fertile couples [p<0.05]. Also there was no significant difference between infertile and fertile couples on the coping responses [p>0.05]. Psychologic effects of infertility is very important and should be considered intensivery in in fertile couples to decrease the following problems

Job strain and blood pressure in nurses during work shifts

The purpose of this study was to determine the effect of job strain intensity on blood pressure [BP] during nurses' work shifts in the hospitals of Mashad University of Medical Sciences. For this descriptive cross-sectional study, 150 nurses who met the inclusion criteria were chosen by cluster sampling. A questionnaire was used to gather the data including personal characteristics, height, weight and intensity of job strain. Blood pressure was measured three times: in the beginning, middle and the end of the work shift. Women constituted 79% of the participants, and 80% were married. Eighty-nine percent of nurses had a Bachelor's Degree, and 31% had BMI>25. There was a significant relationship between job strain and age, marital status and the hospital unit where they worked. The results imply the significant effect of job strain on the difference in first-second, and second-third systolic BP, but not on differences between diastolic BPs. General linear models indicate a significant relationship between working in emergency unit and first-second systolic BP variations. Marriage and divorce have significant relationship with the first-third systolic BP variations. In this study job strain had a significant effect on nurses' systolic BP at shift work

[Factors associated with esophageal cancer in the southeast part of the Caspian Sea]

Introduction: Esophageal cancer is the 8th prevalent cancer [4% of all] around the world and the sixth leading cause of death from cancers .The Northeastern parts of Iran [Caspian littoral areas] are one of the most prevalent areas of esophageal cancers in the world

Objective: In this study, we examined relationship between esophageal cancer tumor histology and variables like age and sex, in pathologically confirmed cases in the Northeastern of Iran [Caspian littoral margins]

Materials and Methods: This descriptive cross-sectional study was conducted in the health care services and pathologic centers in Golestan Province. All pathologically confirmed esophageal cases were enrolled in the study and demographic data were listed. Data were analysed with SPSS-10 software. Variables were compared with one-way ANOVA and Mann-Whitney tests for continuous variables and chi-square for nominal/categorical variables. Level of significance was set at p-value less than 0.05

Results: Four hundred and ninety one pathologically confirmed esophageal cancer cases from 1996 through 2000 were included in this study. Squamous cell carcinoma was the dominant tumor histology in this study and it was more common in females. We found that tumor histology is highly related to gender and this association is independent of age factor. Our finding revealed that this association is only applicable to older age groups [older than 50]

Conclusion: Results from this study suggested that demographic factors might be different in esophageal cancer cases in different geographic areas. Our finding can be a reflection of distinctive etiology for esophageal cancer in the Caspian littoral areas

[Ileal substitution for ureteral loss]

Background and Objective: In patients with unilateral or bilateral loss with high length [More than 10cm] and with different etiologies, ileal substitution is good alternative when other procedures are not suitable. The objective of this study was to survey the effects and complications of ileal substitution for ureteral loss

Cases: Sixteen patients were operated in urologic ward of Shahid Labbafinejad hospital with ileal substitution for ureteral loss during 1994-1999. Twelve patients were male and four were female with mean age 28 years [3-47 years]. Etiology was complications of surgery and ureteroscopy in 11 and TB in 2 and ureteral avulsion in one due to trauma. Follow up was 9-60 months and 3 patients missed follow up. Pre.op sonography, IVP and DTPA isotope scan in all patients revealed severe hydronephrosis in 11 patients. Post.op sonography and scan showed much improvement of kidney function. In 2 patients, hydronephrosis persisted that nephrectomy was performed

Conclusion: In cases with high ureteral loss, which other procedures like uretero-ureterostomy or transuretero-ureterostomy or autotransplant or kidney descending or Boari-Flap cannot be done, ileal substitution is good alternative with low complication

Evaluation of T lymphocyte subsets in children with beta thalassemia major

Peripheral blood T lymphocytes and their subsets were studied in 31 patients with beta thalassemia major [age 2-12 years] and compared with 14 age-and sex-matched healthy controls. Three monoclonal antibodies [anti-CD3, anti CD 4, anti -CDS] were simultaneously applied for detection of th [CD3+ CD 4+] Ts/c [CD3+ CD8+] and Th/Ts ratio by flowcytometry respectively. The results of this study showed a slight increase in the number of T lymphocytes, T CD 4+ T CD8+, and CD 4+/CD8+ ratio; but this increase was not statistically significant [P>0.05]. No primary defect in T cell subsets was detected and it was suggested that continuous regulation of iron balance is an important factor in decreasing immunological disturbance