[Frequency of worry and anxiety in epileptic children's mothers]

Adverse effect of children's epilepsy on family members, especially mothers, is an issue that has been less considered. One of these effects is anxiety increase in mothers. This study has been done with the purpose of determining frequency of worry and anxiety in epileptic children's mothers and recognizing the factors affecting it. This descriptive cross-sectional study has been done with the participation of epileptic children's mothers referred to Mofid Neurology Clinic of Medical Training and Therapy Center of Children. Anxiety level was determined by the State Trait Anxiety Inventory [STAI] standard questionnaire. The data was analyzed using t-test, Mann-Whitney test and one-way ANOVA and in all cases, p<0.05 considered as significant. In this study, 206 mothers were surveyed. The mean anxiety scores of mothers was 45 +/- 9.5. 84 subjects [40.7%] had mild anxiety, 71 [34.5%] had moderate anxiety and 51 [24.8%] had severe anxiety. Anxiety of mothers was significantly higher in cases such as education of child in special school [p=0.018], the high number of antiepileptic drugs [AEDs] consumed for controlling epilepsy [p=0.011], worry of death [p<0.001], permanent brain damage [p=0.036], drug side effects [p<0.01] and paralysis of child [p=0.030]. Mothers who had been previously trained about epilepsy in center, had lower anxiety [p<0.001]. This study showed that the majority of epileptic children's mothers had moderate and severe anxiety. This phenomenon will be higher in cases like child's education in special school, multi medication therapy and worries of side effects of epilepsy and will be lower by increasing mothers' awareness

Coronary artery bypass surgery and acute kidney injury: impact of the off-pump technique

Acute kidney injury [AKI] is a common major complication after coronary artery bypass grafting [CABG] especially when the cardiopulmonary bypass is performed. This study was conducted to evaluate the impact of the off-pump technique on the incidence of AKI, also to determine the major risk factors for AKI. In this prospective cohort study, 535 consecutive adult patients who underwent CABG between January 2007 and May 2010 in a tertiary Hospital. Some 64 of 535 patients were operated through the off-pump coronary artery bypass [OPCAB] technique and another 471 patients by the on-pump coronary artery bypass graft [CABG] technique. Stratified sampling was used to assign patients to be operated either by the OPCAB or ONCAB technique. The AKI incidence and severity were compared between the two groups. In OPCAB group 9.4% [6 patients] and in ONCAB group 4.1% [19 patients] developed AKI with no significant difference. Furthermore, the AKI severity was alike in the two groups and 10.5% [2 patients] in ONCAB and 33.3% [2 patients] in OPCAB group had mild AKI, 78.9% [15 patients] in ONCAB and 50% [3 patients] in OPCAB group had moderate AKI, and 10.5% [2 patients] in ONCAB and 16.7% [1 patients] in OPCAB group had severe AKI. As the differences of incidence and severity of postoperative AKI between OPCAB and ONCAB groups were not significant, further studies to find other useful protective methods such as free-radical scavengers, anti-inflammatory agents, and other modalities are recommended to prevent AKI

[ function of vulnerable and at-risk women in prevention of HIV/AIDS]

Regarding little information about sexual behavior of vulnerable women to AIDS, mentioned in the second report of Ministry of Health and Medical Education [2006], this study has been conducted to determine the function of vulnerable and at-risk women to AIDS in Tehran in 2009. This descriptive study was done on 128 vulnerable and at-risk women who participated in this study in Tehran in 2009. The samples were a combination of available visitor passed to Drop-in Centers, behavioral or triangular clinic and those who were introduced by participant women through Respondent Driven Sampling. Data were collected by trained interviewers. Quantitative and qualitative descriptive statistics was reported as numbers, percentages, and, also, Mean and Standard deviation respectively. Analytical findings and determination of differentiations and correlation were evaluated based on Chi-squared test. In this study only 22 [17.2%] of participants mentioned that they have always used condom. Partner unwillingness was the most common reason [64%] for not using condom. Twenty-four percent of participants have received free condom from triangular, Drop-in and health centers in the last year. Only 32[25%] had done HIV test. The study showed the function of at-risk women in prevention of HIV/AIDS is not satisfactory. If the situation continues in this way, vulnerable women and society will be at more risk

determination of clinical decision rule for estimation of mineral bone density in Iranian women

Osteoprosis is a well recognized health hazard for women who are the main group at risk.This study assessed the relative risk factors of osteoprosis in women referring to the Chamran Hospital densitometry center during the year 1386, with the aim of designing a formula to estimate the severity of osteoprosis based on its risk factors. This cross sectional analytic study used the data of outpatients [n=1047] who visited the Bone Densitometry Center of Chamran Hospital during the year 1386. Information was gathered using questionnaires, completed face to face and the cases underwent Dexa densitometry of the hip and vertebras. The data were analysed with SPSS software. Results Of the patients, 73% were menopausal the average and standard deviation of age and weight was 54.5 +/- [10.3], 69.5 +/- [10.8] and the average and standard deviation of T-score of hip and lumbar spine was -1.88 +/- [1.08], -1.04 +/- [1.05]. After assessment, the precipitating factors of osteoprosis of hip were age, menopause, time of menopause, history of fracture, history of taking calcium supplements and dosage, number of deliveries, and duration of breast feedings. The preventing factors were weight, OCPs, exercise, [P < 0.05] being significant the percipitating factors in vertebras were age, menopause, time of menopause, diabetes, history of fracture, history of calcium supplement usage and dosage, number of deliveries, timing of breast feeding and the preventing factor was weight, [p=<0.05] being significant. Using the use of stepwise regression analysis, a minimal mathematical model for predicting of bone density of hip and lumbar spine was formulated. Then the mathematical model of hip in the form of clinical decision rule [CDR] was validated with less number of independent cases. Using the method mentioned, along with clinical findings and history, persons at risk of osteoporosis can be identified and early prevention and treatment are possible. This can also prevent unnecessary expenses of diagnostic procedures for people without the risks of osteoprosis

Can educational programs help ease parental anxiety following their child first febrile convulsion?

Compared to other pediatric emergencies, febrile convulsions [FC], despite having an excellent prognosis, are a main cause of considerable anxiety among mothers of children faced with their child's first febrile convulsion. Consequently, one of the physician's most important responsibilities in the management of pediatric febrile convulsions is to educate and guide mothers on how to reduce their anxiety. This study was performed on mothers whose children had been admitted to Mofid Children's Hospital following a first febrile convulsion, to determine the effect of education on lowering the levels of maternal anxiety after their child's first febrile convulsion. In this sequential control clinical trial, 84 volunteering mothers were divided in two matched groups, the intervention and the controls. Maternal anxiety levels were determined in both groups by the State Trait Anxiety Inventory [STAI] standard questionnaire [pretest]. Following this, the intervention group of mothers underwent face-to-face education for 3 hours, whereas no intervention was used for the control group. After nine days, anxiety levels were determined in the two groups using the same questionnaire [post-test]. The data was analyzed using the Mann-Whitney, the Wilcoxon Signed Rank Sum, and the McNemar tests, and chi-square analysis. Results show that in the intervention group, maternal anxiety decreased significantly [p<0.001], whereas no significant difference was seen in the control group. This study demonstrates that maternal education on FCs significantly reduces maternal anxiety, in coping with stress following their child's first febrile convulsion, and considering the results of similar studies, educational programs are highly recommended for mothers having children who suffer from the condition

Crystal violet in culture media for diagnosis of neisseria species

Neisseria species are gram negative diplococci; an important characteristic of these bacteria is resistance against crystal violet. This study was done to investigate the effect of crystal violet on the growth of Neisseria, to observe the outcome of adding this substance in culture media for isolating these organisms, and finally to make a specific medium for isolation of the Nisseria species. The study was done in 3 phases: 1] Initially urethral discharge from 106 male patients with urethritis was cultured on NYC, chocolate agar and chocolate violet agar with various concentrations of violet from 1:100000 to 1:250000. We also made direct smears for gram stains. 2] Pharyngeal secretions from 230 healthy persons were cultured on chocolate agar, Muller Hinton agar, and Thayer Martin agar with different concentrations of violet between 1:50000 to 1:500000. Also direct smears were made for gram stains. 3] The standard strain of gonococcus [ATCC] were cultured on the three media. Concurrently we added various concentrations of violet from 1:50000 to 1:200000 to the above media and studied the effect of adding crystal violet on the growth of the standard strain. In first step, 69 out of 106 patients with urethritis were suspicious of gonorrhea, with positive culture of gonococcus on NYC medium from 64 patients. On chocolate agar only 54 positive cultures, [with 84% sensitivity against NCY medium], were seen together with a growth of normal flora. Chocolate agar plus violet in concentration 1:150000, showed 58 positive cultures, [with 91% sensitivity against NYC medium], with minimal growth of normal flora. In second step, 228 out of 230 healthy persons had positive culture of Neisseria, these organisms grew in different concentrations of crystal violet between 1:500000 and 1:50000. However, with minimal concentration of violet, there was a dense growth of normal flora and with gradual increase in concentration, normal flora grew sparsely. In direct exam, 228 cases of gram negative Neisseria like diplococci were observed. In third step, result of growth of the standard Neisseria gonorrhea in chocolate agar, Muller-Hinton agar and Thayer-Martin agar with and without different concentrations of crystal violet are as follow: In all media without crystal violet, the growth of the bacteria was perfect and abundant; while in media containing crystal violet, minimum colony count was observed in concentrations of 1:50000 and maximum colony count occurred at concentrations of 1:200000. To isolate pathogenic species of Neisseria, for e.g. gonococcus, we can use a specific chromogen medium like chocolate-violet agar 1:150000, or Thayer-Martin-violet agar or Muller-Hinton-violet agar with a concentration of 1:200000. Although nonpathogenic Neisseria have high resistance to crystal violet and were isolated from cultures with 1:50000 dilutions of this substance, but growth become sparse with higher concentrations. We can make chromogen media of varying strengths by adding different amounts of crystal violet in various media to get the desired results

Colorectal cancer prevalence according to survival data in Iran in 2007

Colorectal cancer is a common and lethal disease with 5000 new cases reported each year in Iran. This study was done to estimate the 1, 2-3 and 4-5 year point prevalence of colorectal cancer in Iran. In this descriptive study we studied the follow-up of 2342 patients with colorectal cancer documented in the cancer registry in Iran during a time period of 4 years from March 2001 to March 2005. One-year, 2-3 year and 4-5 year point prevalence were estimated from incidence rates in different years and proportion of patients surviving 0.5, 1.5, 2.5, 3.5 and 4.5 years after diagnosis. Proportion of cases surviving 0.5, 1.5, 2.5, 3.5 and 4.5 years from diagnosis were 79.2%, 65.08%, 57.36%, 51.76% and 48.87% respectively. Estimation of prevalence at 1, 2-3 and 4-5 years were 4156, 5715 and 4283 cases, respectively. Cumulative 5 year prevalence was 13954 cases. Estimates of prevalence at 1, 2-3 and 4-5 years are necessary for the evaluation of initial treatment, clinical follow-up and point of cure, and also for identification of patients who need further social support or health care. Therefore 1, 2-3 and 4-5 year point prevalence estimation are necessary in health service planning for cancer management. Colorectal cancer is a common and lethal disease with 5000 new cases reported each year in Iran. This study was done to estimate the 1, 2-3 and 4-5 year point prevalence of colorectal cancer in Iran. In this descriptive study we studied the follow-up of 2342 patients with colorectal cancer documented in the cancer registry in Iran during a time period of 4 years from March 2001 to March 2005. One-year, 2-3 year and 4-5 year point prevalence were estimated from incidence rates in different years and proportion of patients surviving 0.5, 1.5, 2.5, 3.5 and 4.5 years after diagnosis. Proportion of cases surviving 0.5, 1.5, 2.5, 3.5 and 4.5 years from diagnosis were 79.2%, 65.08%, 57.36%, 51.76% and 48.87% respectively. Estimation of prevalence at 1, 2-3 and 4-5 years were 4156, 5715 and 4283 cases, respectively. Cumulative 5 year prevalence was 13954 cases. Estimates of prevalence at 1, 2-3 and 4-5 years are necessary for the evaluation of initial treatment, clinical follow-up and point of cure, and also for identification of patients who need further social support or health care. Therefore 1, 2-3 and 4-5 year point prevalence estimation are necessary in health service planning for cancer management

[Comparing the effects of IV and intranasal midazolam administration on pain, anxiety and fear of children undergoing painful invasive procedures]

Among children, there are several painful diagnostic or therapeutic procedures especially in malignant disease which may evoke fear and anxiety that may interfere with the treatment. Due to various reports on the efficacy of midazolam, we compared the effects of intranasal versus intravenous midazolam in reducing the pain, fear, and anxiety in children undergoing painful procedures at Loghman hospital between 2005-2006. This randomized clinical trial was conducted on two 30-participant groups of patients aged 4-15 years who were to underwent painful procedures [including bone marrow aspirations and lumbar punctures]. One group received intravenous Midazolam and the other one did intranasal Midazolam before the procedures. Pain was measured based on Bieri facial pain scale, whereas anxiety was determined based on Yale-Pas scale. Fear was measured and analyzed between the two groups by Chi-square and fisher's exact tests. Side affects were documented in both groups as well. 50% of patients in the IV group, and 53.3% in the intranasal group had the Yale-PAS anxiety score of above 37, which was yielding a significant difference [P<0.9]. 90% of the subjects in the intranasal group had mild pain while 10% had moderate one. In the IV group 74% experienced a mild pain and 25.9% suffered from moderate pain, whereas 10% experienced none at all. No significant difference was observed between the levels of pain amongst two groups [P<0.9]. In both groups fear bacame less during and after the procedure and it was significantly decreased in intranasal group. Since the effect of intranasal and IV Midazolam on reducing the pain, anxiety, and fear is not significantly different, regarding the simplicity of intranasal administration, this approach may be of further compliance and more practicality for analgesia of painful procedures

[Knowledge and attitudes towards HIV/AIDS among high students of Pakdasht in 2003]

HIV/AIDS is a major worldwide health concern. The present study was conducted to determine knowledge and attitudes towards AIDS among high school students in Pakdasht. Six hundred and fifty five students [404 females and 251 males] from 10 pre-university centers participated in the survey. An anonymous self-administered questionnaire was used to measured knowledge [40 [true, false, do not] items], attitudes [16 items, 5-point Likert-type scale], and seven query [age, sex, educational field, sources of information, adequacy of information, need to more education and suitable ages]. Attitude toward HIV/AIDS was positive. General knowledge of 45.5% students was good [true responses to more than 75% of items], 45.2% was moderate [true responses to 50- 74% of items] and only 9.3% had weak knowledge [true responses to less than 25% of items]; however, results revealed low level of knowledge to oral sex, heterosexually contact, and the protective role of condom. TV was identified as the most frequent source of information, while 90% indicated the need for receiving HIV prevention education in the future. These defects may lead to further exposure to and contamination with HIV/AIDS. Thus, we recommend further surveys in this regard