Host genome polymorphisms and tuberculosis infection: What we have to say?

Several epidemiology studies suggest that host genetic factors play important roles in susceptibility, protection and progression of tuberculosis infection. Here we have reviewed the implications of some genetic polymorphisms in pathways related to tuberculosis susceptibility, severity and development. Large case-control studies examining single-nucleotide polymorphisms [SNPs] in genes have been performed in tuberculosis patients in some countries. Polymorphisms in natural resistance-associated macrophage protein 1 [NRAMP1], toll-like receptor 2 [TLR2], interleukin-6 [IL-6], tumor necrosis factor alpha [TNF-alpha], interleukin-1 receptor antagonist [IL-1RA], IL-10, vitamin D receptor [VDR], dendritic cell-specific ICAM-3-grabbing non-integrin [DC-SIGN], monocyte chemoattractant protein-1 [MCP-1], nucleotide oligomerization binding domain 2 [NOD2], interferon-gamma [IFN-gamma], inducible nitric oxide synthase [iNOS], mannose-binding lectin [MBL] and surfactant proteins A [SP-A] have been reviewed. These genes have been variably associated with tuberculosis infection and there is strong evidence indicating that he genetic factors play critical roles in tuberculosis susceptibility, severity and development

B-lines: Transthoracic chest ultrasound signs useful in assessment of interstitial lung diseases

This prospective study was conducted to evaluate the value of sonographic B-lines [previously called ''comet tail artifacts''], which are long, vertical, well-defined, hyperechoic, dynamic lines originating from the pleural line in assessment of interstitial lung diseases [ILD] and compare them with the findings of chest high-resolution computed tomography [HRCT] and pulmonary function tests [PFTs]. Sixty-one patients with ILD underwent transthoracic lung ultrasound for assessment of the presence of B-lines and the distance between them. These findings were compared with that of chest HRCT [ground glass, reticular, nodular or honey combing] and PFT as forced vital capacity [FVC], total lung capacity [TLC], diffusion capacity for carbon monoxide [DLCO] and partial arterial oxygen pressure [PaO[2]]. All patients had diffuse bilateral B-lines. The distance between each of the two adjacent B lines correlated with the severity of the disease on chest HRCT where B3 [the distance was 3 mm] correlated with ground glass opacity and B7 [the distance was 7 mm] correlated with extensive fibrosis and honey combing. Also, the distance between B-lines inversely correlated with FVC [r = -0.848, P < 0.001], TLC [r = -0.664, P < 0.001], DLCO [r = -0.817, P < 0.001] and PaO2 [r = -0.902, P < 0.001]. B-lines that are lung Ultrasound signs seem to be useful in the assessment of ILD.

Role of meloxicam and/or L-carnitine in L-arginine-induced multiple organ dysfunction syndrome in rats

Multiple organ dysfunction syndrome [MODS] occurs in several conditions including acute pancreatitis [AP]. Reactive oxygen species and activation of pro-inflammatory mediators are the main forerunners in development of MODS. In the present study, we aimed to investigate the possible role of meloxicam or/and L-carnitine in L-arginine induced MODS. Rats were allocated randomly into five groups. Control group, MODS was developed by a single dose of L-arginine [250 mg/100g, IP], rats treated with meloxicam [4mg/kg, IP], animals treated with L-carnitine [500mg/kg, IP] and rats treated with both meloxicam and L-carnitine. All treatments were once daily for seven consecutive days and started directly after L-arginine injection. Serum and tissues' samples were prepared for biochemical analysis. Other hepatic or pulmonary tissues were examined histopathologically. L-arginine markedly increased serum level of alanine aminotransferase [ALT], aspartate aminotransferase [AST] and alkaline phosphatase [ALP]. Furthermore, L-arginine significantly increased the hepatic and pulmonary tissues TNF-alpha, MDA and NO content and myeloperoxidase [MPO] activity, while it significantly depleted GSH level. Administration of either meloxicam or L-carnitine significantly ameliorated L-arginine-induced biochemical changes. On the other hand the combined therapy of meloxicam and carnitine has an ameliorative effect which was greater than each drug alone. Treatment with both meloxicam and L-carnitine is more effective than either drug alone. This may be attributed to augmentation of their antioxidant-antiinflamatory effects

golden factor in adherence to inhaled corticosteroid in asthma patients

Adherence to therapy is very important and many factors could be responsible for this issue. Suboptimal adherence to asthma therapy is a major contributor to poor asthma outcomes. Our aim is to find out the most important factor responsible for adherence to therapy in bronchial asthma patients. The study included 143 patients with persistent bronchial asthma. Factors that may affect adherence to therapy were studied. These factors included age, sex, residence, level of education, proper asthma education and whether inhaled corticosteroid [ICS] was taken alone, with long acting p2 agonist [LABA] in separate devices or with LABA in a combined form. Adherence to ICS was determined according to Medication Rating Scale. We found that 55.3% of patients that received asthma education were adherent to ICS while only 21% of patients that did not receive asthma education were adherent to ICS therapy. The difference was statistically highly significant [p = 0.003]. Other factors do not significantly affect adherence to ICS. Patients that used combined ICS with LABA in the same device were significantly more adherent to therapy [60.25%] than patients that used the same combination in 2 separate devices [34.5%]. All patients with well controlled asthma were adherent to ICS, while 47.5% of uncontrolled patients was adherent. Comparison between level of control and adherence to ICS was highly significant [p = 0.003]. This study showed how different factors may modulate adherence to asthma treatment and confirmed the importance of patient education in increasing adherence to asthma therapy

Discrimination between pleural thickening and minimal pleural effusion using color Doppler chest ultrasonography

The discrimination of pleural thickening from minimal pleural effusion may be difficult as both lesions appear as anechoic on grayscale ultrasound, hence, free of [echoes] does not confirm the presence of pleural fluid. To evaluate the value of color Doppler ultrasound in differentiating minimal pleural effusion that could be aspirated from pleural thickening and to compare it with grayscale ultrasound. This analytic cross-sectional study was done prospectively on 40 patients who presented with pleural based opacity in their chest radiographs compatible with minimal pleural effusion. Gray scale ultrasound was done for all patients then color Doppler ultrasound examination was applied to detect the presence or absence of fluid color sign. The presence or absence of pleural effusion was confirmed by aspiration of pleural fluid. The sensitivity of real time gray scale ultrasound in detecting minimal pleural effusion and differentiating it from pleural thickening was 95.5% while, specificity was 33%, and accuracy was 67%. The ability of ultrasound in discrimination of minimal pleural effusion from pleural thickening improved greatly by application of the color Doppler examination where the specificity of the method reached 100% while the sensitivity was 91% and accuracy was 95%. Application of color Doppler examination increases the accuracy of real time chest ultrasound to discriminate pleural thickening from minimal pleural effusion and hence color Doppler examination proved to be a useful diagnostic tool to real-time gray-scale ultrasound for diagnosis of minimal pleural effusion

possible role for gastroprotectives on aspirin-induced gastric ulcer in rats

Gastric ulcer is a discontinuity in the gastric mucosa that occurs due to imbalance between gastric mucosal protective factors and aggressive factors. The Aim of the present work was to test and compare the protective effects of an antisecretory H2 receptor blocker; ranitidine and other recently suggested gastroprotective drugs: L-arginine; a precursor of NO, zinc sulfate; an anti-inflammatory antioxidant agent and pioglitazone; a PPAR-gamma agonist, on a rat model of aspirin induced gastric ulcer. Acute gastric lesion was induced in rats by a single oral dose of aspirin 300mg/ kg body weight. L-arginine 200mg / kg b. wt, zinc sulfate 80 mg/ kg b. wt, and pioglitazone 10 mg / kg b. wt. were given alone and in combination with ranitidine 50 mg / kg b. wt for 3 days before induction of gastric lesion. Aspirin induced a significant increase in gastric mucosal lesion score and free and total gastric hydrochloric acid with a significant decrease in gastric nitric oxide and mucin levels as compared to normal group. A significant increase in gastric malondialdhyde and decrease in reduced glutathione as compared to normal group. L-arginine, zinc sulfate, and pioglitazone produced improvement of most of the measured parameters as compared to non-treated group. Combination of L-arginine and ranitidine was superior in prophylaxis against aspirin-induced gastric ulcer when compared to the effects of each drug used individually, and the other studied combinations. The role of HCl and NO seems more important in the pathogenesis of aspirin induced gastric ulcer, as evidenced by the better protective effects of combination of ranitidine and L-arginine in comparison to the ranitidine with either zinc sulfate or pioglitazone

Evaluation of the protective effect of isoprinosine against navelbine induced oxidative stress in mice

Many studies in vitro and in vivo have shown immunomodulating and antiviral activities of Isoprinosine [inosine pranobex]. Chemotherapy means the use of a drug which is most effective at, killing cells that are rapidly dividing. Vinorelbine [Navelbine, 5 oranhydrovinblastine] is a third-generation vinca alkaloid anti-tumor drug. It is widely used in the treatment of cancer such as advanced non-small-cell lung cancer [NSCLC] and advanced breast cancer. The aim of this study was to determine the possible protective effects of Isoprinosine in bacterially infected and non infected mice at a dose level of 8.75 mg/kg/day orally every second day for 15 days under the effect of anticancer Navelbine. Mitochondrial DNA fragmentation, Lipid pereoxidation [MDA], glutathione contents [GSH], phagocytosis test and serum level of immunoglobulin G and M antibodies were evaluated, a significant increase in liver homogenate and mitochondria protein carbonyl levels was observed in Navelbine alone treated mice when compared to control group. DNA fragmentation in homogenate and mitochondria was significantly increased in all test groups when compared to control group except Isoprinosine treated animal group which showed significant decrease in DNA fragmentation. The results of this study proved the immune protective and immunomodulatory effects of Isoprinosine against Navelbine induced toxicity in Pseudomonas aeruginosa infected and non infected mice

[Relation between social support and coping with stress in nurses in psychiatric ward]

Stress is the most common cause of mental and physical problems in employers. Nurses experience high level of stresses due to the nature of their job. Stress coping strategies effect on reaction against stresses. Social support has protective and effective role on stress coping strategies. Detect the relation between coping with stress and social support in the nurses who worked in psychiatric ward. This descriptive analytic study was done on 47 nurses of the psychiatric wards of Isfahan training hospitals. The demographic data checklist and stress coping strategies and Saratoz social support questionnaire were filled. Statistical methods such as t-student, Spearmen-Pearson correlation were used to analyze data. The mean age of the studied persons was 39.9 years old and the mean score of social support of them was 10.59 +/- 2.24. There was a reverse and significant relation between the social support and the age and duration of service, while there was a direct and significant relation between the social support and the education. There was a significant relation between sex and social support [more in singles] too. There was a direct relation between the social support and the ways of coping with stress [social-emotional support], a reverse and significant relation between social support and the reception and hopeful through. If there is more social support, increased using effective coping strategies and reduced using ineffective coping strategies. Considering the importance of the social support in high stress jobs such as nursing to increase the person's capacity against stress, increase social support by improving administrative relations and social security for the nurse personnel could be useful

Purines and oxypurines in myocardial ischemia

To evaluate the plasma levels of purine nucleosides and oxypurines in the presence of other risk factors as additional markers for the diagnosis of myocardial ischemia and severity of myocardial infarction. A case control study was conducted on 101 patients with ischemic heart disease [stable angina, n=19: unstable angina, n=29: acute myocardial infarction [AMI]; n=53 patients] admitted to the Cardiology Unit at Al-Kadhimyia Teaching Hospital, Baghdad, Iraq from January to November 2007 in addition to 31 healthy controls. Blood samples were aspirated from those with AMI within the first 12 hours of onset of chest pain. Plasma adenosine [ADO], inosine [INO], hypoxanthine [HYP], and xanthine [XAN] were analyzed by high-performance liquid chromatography. The mean plasma ADO, INO, HYP, and XAN levels were raised in unstable angina over the control values. More increase in all nucleosides and oxypurines was reported in the plasma of patients with AMI as compared to the controls and those of stable angina. The INO [p = 0.01] and HYP [p = 0.001] values were increased significantly in diabetic men with AMI and at age of Conclusion: The levels of purines and their catabolites could be used as additional indices for prior or current ischemia. Pretreatment with such nucleosides, or their oxypurine derivatives, is suggested to improve the regional ventricular function after coronary artery occlusion

Effects of trace elements on albumin and lipoprotein glycation in diabetic retinopathy

To test the effect of some trace elements, on protein and lipoprotein glycosylation and their impact on the severity of diabetic retinopathy. A case control study was conducted in 42 diabetic patients [14 without retinopathy [DC]; 14 with non-proliferative diabetic retinopathy [NPDR]; 14 with proliferative diabetic retinopathy [PDR]] at Ebin Al-Haitham Specialized Hospital, Baghdad, Iraq for Ocular Diseases from February to December 2008. In addition to 20 age and gender matched healthy controls [NC]. The glycation of albumin, alpha-, pre beta-, and beta-lipoproteins was measured by agarose gel electrophoresis. Serum levels of cadmium [Cd], selenium [Se], chromium [Cr], zinc [Zn], and copper [Cu] were analyzed by flameless atomic absorption spectrophotometer. There was significant elevation in the mean serum glycated beta-lipoprotein in DC [p<0.05] and a near significant increase [p=0.06] in the means of both glycated albumin and pre beta-lipoproteins among the PDR and NPDR groups. Moreover, a significant reductions in serum means of Cd [p<0.05] and Zn/Cu ratios [p<0.001] were recorded in all diabetic retinopaths as compared to DC. The Cd level rises with the increase in duration of diabetes [p<0.001] and hyperglycemia [p<0.025] whereas, the serum Cr values decreases with the progression of diabetes [p<0.025]. Both glycation and oxidative processes are involved in the development of diabetic retinopathy, and changes in the concentration of Cd, Se, Cr, Zn, and Cu have some impact on the disease progression

Influence of biphenyl dimethyl dicarboxylate [DDB] on social play behavior of young rats

Biphenyl Dimethyl Dicarboxylate [DDB] is a synthetic analogue of schisandrin C, a component of Fructus schisandrae. It is a widely prescribed agent for the improvement of liver function of hepatitis patients and has been recently proved to possess immunomodulatory properties. In our earlier work, DDB was shown to interfere with behavior. The present work was to assess the possible effect of DDB on the play behavior. The study was carried out on young Sprague Dawley Rats. DDB was administered orally for seven consecutive days [100mg/kg/day]. Animals were isolated for about 28hr before the day of the experiment. Each pair was placed in an aquarium glass cage where the play behavior of a pair of animals was recorded by a special Infrared Video Camera allowing super night shots, for 25 min. Three major categories were assessed, namely "play social behavior", "non-play social behavior" and "non-social behavior". DDB was found to affect the play behavior of the partner rat where the "pounce on" and "pinning" were significantly increased. Parallel changes in brain NE were found. In conclusion, DDB was shown to change the play behavior of the partner rat

Benzene toxicity in shoemakers and role of vitamin A [as antioxidant]

The burden of liver disease in Egypt is exceptionally high. Unquestionably, additional factors contributing to liver disease burden remain to be elucidated. Human exposure to benzene in work environment is a gbbat occupational health problem; it may represent a risk factor for hepatotoxicity, liver cancer and hematotoxicity. The present study aimed to evaluate the hazardous effects of occupational exposure to benzene on liver and blood, as well as the protective role of the antioxidant [vitamin A] on hematotoxic and hepatotoxic effects among shoemakers who exposed to benzene. Twenty hundred and fifty workers were enrolled in this study after taking an informed consent; 140 occupationally exposed workers to benzene for more than 3 years [workers group; subdivided into non-treated and treated with vitamin A], and 110 workers never occupationally exposed to benzene [control group]. The benzene urine level, complete blood counts [CBC5], the liver enzymes, and the tumor marker, alphafetoprotein [AFP] were estimated. The benzene level in urine samples was significantly increased in shoemakers group. Benzene exposed non-treated workers showed significant increase in the liver enzymes and AFP, while the CBCs were significantly lower compared with both control group and benzene exposed treated group with vitamin A. Occupational exposure to benzene found to have hazardous effects, which were reflected on CBCs, liver enzymes, and AFP. Additionally, the vitamin A was observed to be effectively potent in ameliorating the haematotoxic and hepatotoxic effects in exposed workers. Periodic medical care and CBCs in combination with urinary benzene [UB] level were recommended in benzene workers

Frequency of abnormal thyroid function tests in Kuwaiti Arabs with autoimmune diseases

The purpose of this study was to examine the frequencies of abnormal thyroid function tests and serum thyroid autoantibodies in healthy Kuwaitis and those with autoimmune diseases. Serum concentrations of sensitive thyrotropin, and free thyroxine were measured in 577 apparently healthy controls, 177 patients with rheumatoid arthritis [RA], 60 with systemic lupus erythematosus [SLE] and 25 with primary Sjogren's syndrome [pSS] using the immunochemiluminescent assay method on IMMULITE 1000. Serum microsomal and thyroglobulin auto-antibodies were also measured by passive hemagglutination assay. For analysis of the thyroid function tests, the subjects were classified into five categories: normal, sub-clinical hypothyroidism, overt hypothyroidism, euthyroid sick syndrome and biochemical hyperthyroidism. Subclinical hypothyroidism was seen in 1.7% of healthy controls, 10.2% of RA, 13.3% of SLE, and 16% of pSS patients. Among RA patients, the frequency of subclinical hypothyroidism in females [11.4%] was significantly higher than among males [5.4%; p < 0.01]. In SLE and pSS patients, all those with sub-clinical hypothyroidism were females. Overt hypothyroidism was seen in 1.4% of controls, 10.2% of RA, 8.3% of SLE, and 4% of pSS patients. Biochemical hyperthyroidism was seen in 0.2% of controls, 4.5% of RA, 5% of SLE and none of pSS patients. The euthyroid sick syndrome was seen in 0.4% of controls, 13.6% of RA, 16.7% of SLE and in none of pSS patients. Thyroid autoantibodies were present in 3.1% of controls, 12.4% of RA, 18.3% of SLE, and 12% of pSS patients. Our data show that abnormal thyroid function tests and thyroid autoantibodies occur frequently in Kuwaitis with autoimmune diseases. Therefore, ordering these tests in these diseases is recommended

Quality of death certificate completion by physicians in qualyopia, Benha

All physicians should be able to record the medical cause of death in a consequence order and issue death certificate according to the international form recommended by World Health Organization. In Egypt, most clinicians continue to list the cause of death as "cardiac arrest" or "cardiopulmonary arrest" on death certificate and the government organization accept them as causes of death. The forensic significance of death certificate may not become apparent until many weeks or months later. To evaluate the quality of death certificates issued in Qualyopia, Benha by determining whether any of the items missed or written wrongly or in a vague manner. Data of randomly chosen 200 death certificates issued within the year 2006 in Benha health offices was gathered to review the deceased personal data, medical cause of death, place, date and time of death, name and signature of the certifying physician. On reviewing a total of 200 issued death certificates, the full name, gender, age and residence of the deceased and the date of death were written in all certificates [100%], while the place of death were omitted in a small number of certificates [5%]. There was a vague indication of the medical cause of death in 12%, a correct cause of death with improper sequencing in 49%, and the mode presented as the cause of death in 24% and in 15%, the cause of death was absent The time of death was the commonest omission from death certificates [67%]. There is no place for the name and signature of the certifying physician in the certificates, only the name and signature of the certifying employees. The certifying physicians sign only in death declarations. Death certificates revealed serious deficiencies as regards cause and time of death; this can bring discredit on doctors, the profession as a whole and can also seriously prejudice the legal proceedings. As accurate issuing of death certificates should full within the capabilities of all doctors, aperiodic workshop about how to issue death certificate properly was recommended as well as establishment of quality control program before issuing death certificate

Comparative study between two methods for detecting cytomegalovirus in chronic renal failure patients

This work was- designed to evaluate and compare Human Cytomegalovirus [HCMV] ELISA and Polymerase chain reaction PCR methods for the detection of HCMV in chronic renal failure patients. Also, it aims to correlate HCMV infection with positive clinical history, duration of dialysis, blood transfusion and renal transplantation. The present study was conducted on 66 patients with chronic renal failure, divided into two subgroups [50 non-transplanted on hemodialysis and 16 renal transplanted patients], and twenty apparently healthy volunteers as control group. Both the patients and the controls have been studied for detection of HCMV infection by CMV specific IgG and IgM ELISA assay, and qualitative leukocytes PCR assay. Regarding CMV IgG and IgM were detected in 66 [100%] and 10 [15.1%] patients respectively. The patients' group was found to be positive for CMV IgM and PCR assays in a percentage of 15.1% and 45.4% respectively with statistically significant difference compared to the control group. By PCR, HCMV positivity was significantly increased more frequent among non-transplanted patients with frequent blood transfusion. However, frequent blood transfusion had no influence on the positivity of HCMV in renal transplanted patients. Also, duration of dialysis In non-transplanted patients had insignificant role on the positivity of HCMV. Although the positivity for CMV IgM ELISA was [12%] and [25%] among non-transplanted and transplanted subgroups respectively, the difference was statistically insignificant. Comparing the positivity for PCR which was [42%] and [56.25%] among non-transplanted and transplanted subgroups respectively, the difference was also statistically insignificant. The relative sensitivity and specificity of CMV IgM ELISA assay compared to CMV PCR were 30% and 97.2% respectively. We concluded that leukocytes PCR is a reliable test in screening HCMV infection and it is more valuable than serology in diagnosis of HCMV infection. Also, the determination of IgM antibodies for HCMV is not helpful in identifying patients at risk or in following the course of HCMV disease because antibody response is too slow and it has low sensitivity

[Relationship between satisfaction and expectation with self-esteem and self-concept in patients using complete denture]

Denture acceptance as a complex process is dependent not only on ridge morphology, theoretical and practical skills of dentist, but on many psychologic factors which need to be considered seriously. The aim of this study was to determine the relationship between complete denture satisfaction and expectation with patient's self-esteem and self-concept. This descriptive-analytical study was undertaken on 52 patients [28 male and 24 female] referred to the prosthodontic department of Khorasgan Azad University. The mean age was 53.4 with the range of 35-70 years. The personality variables were measured using two standard psychological tests [Rosenberg and California tests]. Before and after full denture delivery, patients completed the denture expectation questionnaires. After using new dentures for 3 months, the patients" satisfaction was evaluated by related questionnaires. T-student, T-paired and Pearson coefficient tests were used for data analysis. There was no significant relationship between expectation and self-concept likewise between self-esteem and satisfaction [p= 0.42, 0.18]. A moderate relationship was found between self-esteem and expectation [p=0.05], while a significant relationship was obtained between self-concept and satisfaction [p=0.01]. According to this study, it was revealed that complete denture treatment did not have any significant effect on patients' personality variables, but there was a significant relation between patients' self-esteem and complete denture satisfaction. Also patients with high self-esteem scores showed better expectations with their dentures

Peculiarity of surgical tactics for management of ischemic heart disease in patients with left main coronary artery stenosis

The left main coronary artery disease has poor natural history. Sudden death, massive myocardial infarction, angina and poor quality of life indicate the ominous nature of the disease. Coronary artery bypass grafting remains the ultimate choice of its management. A relatively high mortality and morbidity of its surgical treatment described in literature leads to the actuality of this disease. This work is a part of our continuous effort for refinements in anesthetic and surgical techniques to reduce mortality and morbidity in such patients and is in the clinical practice at our institute for the last few years. During the period from February 1998 to October 2005, 74 patients underwent coronary artery bypass surgery for left main coronary artery stenoses, at Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore. All patients presented with angina, unstable in 62.2%. An old myocardial Infarction was present in 52 [70.3%] patients. An emergent surgery was needed in 5[6.8%], urgent operation was performed in 45[60.8%] patients and elective procedure was done in 24[32.4%]. Average stay in the hospital was 9.0+2.7 days. There were 2 hospital deaths and one late non cardiac death. The post operative recovery was eventless in majority of the patients. The return of patients to their jobs improved significantly [P < 0.005] three months after operation. Our current surgical results are certainly improved than many previous studies on coronary artery bypass grafting for left main stem stenoses

Surgical management of endobronchial tumors: analysis of 24 patients

To evaluate the variable surgical options performed in the management of endobronchial tumors and the factors determining selection of the appropriate surgical technique. Retrospective study of a series of 24 patients with endobronchial tumors who were diagnosed and underwent surgery in the cardiothoracic surgery department, Mansoura university hospital from January 1985 to March 2006. Full history taking and complete clinical examination, routine laboratory investigations, chest x-ray, and computerized tomography, and bronchoscope were done for all cases. Surgery was the line of treatment for all patients. Close sex distribution with age ranges from 20-64 years. Cough with expectoration was the main presentation. Zonal opacity was the most common radiological finding. CT chest showed sensitivity of 79.2% for detection of endobronchial lesions. Bronchoscopic examination revealed endobronchial lesions in all patients. Benign tumors were detected in 5 patients and malignant lesions in 19 patients, 14 patients were neuroendocrine tumors and 5 patients were other malignant varieties. Surgical interference included bilobectomy [7 patients], lobectomy [5 patients] pneumonectomy [7 patients], and one patient underwent surgical exploration for open biopsy while 4 bronchoplastic procedure were performed. Endobronchial tumors occur over a wide range of age without significant sex differentiation. Endobronchial tumor should be suspected in case of prolonged chest complaint inspite of maximal medical treatment. Bronchoscope is the main diagnostic tool and is important for detection of the provisional plane for surgery. Early diagnosis and screening should be established for early detection of endobronchial tumors and more conservative resectional and bronchoplastic techniques

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