wound healing effects of iloprost in patients with Buerger's disease: claudication and prevention of major amputations

This study analyzes the therapeutic effects of intravenous infusion of iloprost in wound healing, healing of the amputation stump wound, improvement in intermittent claudication and prevention of major amputation in patients with Buerger's disease. In a prospective study, 19 patients with known Buerger's disease, received intravenous iloprost infusion, 6 hours per day for 10 days. Iloprost with a dose of 0.5-2 ng/kg/min according to the patients' tolerance and using cardiac monitoring during the whole infusion period was administered for 6 hours/day using saline solution. Patients with larger wounds underwent simultaneous transmetatarsal or Ray amputation of the involved toe[s]. All patients were discharged after 10 days. Patients were followed to detect their healing changes. Nineteen patients, 19-55 years old received 0.5-2 ng/kg/min iloprost intravenously for 6 hours/day for 10 days. During this period, there was relative improvement in resting pain, but no significant amelioration was noticed in wound healing. In a 2 years follow-up, 14 patients showed a complete healing of the amputation stump and increased distance of walking without any pain. Some previous candidates of major amputation did not need amputation anymore. Five patients [26%] did not respond to therapy. Although Buerger's disease patients who were under iloprost therapy, may not show significant changes in wound healing during treatment and at discharge, late results have proved that iloprost infusion is promising in improving wound healing and claudication and preventing major amputations

Diagnostic accuracy of fine needle aspiration cytology: comparison of results in Tabriz Imam Khomeini Hospital and Shiraz University of Medical Sciences

It is more than 60 years that Fine Needle Aspiration [FNA] has been used for diagnosing palpable breast masses and has been known as an effective method for several years in Europe. In this study, we compared the diagnostic accuracy of FNA with open biopsy in Tabriz and Shiraz, Iran. We studied 100 patients with breast lesions in Tabriz Imam Khomeini Hospital from late September 2003 to late July 2004. FNA and open biopsy were done for all patients, FNA results were studied by pathologists in Tabriz imam Khomeini hospital and Shiraz University and pathological and cytological results were compared. According to cytology, 44% of samples were benign, 15% were suspicious, 33% were malignant and 8% were insufficient in Tabriz. These figures were 25%, 10%, 27% and 37%, respectively in Shiraz. Sensitivity of FNA was higher in Tabriz [89.79% vs. 69%] but specificity did not differ significantly in two groups [93.47% vs. 80.95%]. Positive and negative predictive values were 97.77% and 89.36% in Tabriz and 100% and 60.6% in Shiraz, respectively. FNA accuracy was higher in Tabriz than in Shiraz [93.47% vs. 80.95%]. If done by experts, FNA can be a reliable replacement for open biopsy in palpable breast masses. Evaluation of FNA samples during aspiration can decrease insufficient samples. FNA [at least in deprived areas] can be the first line of diagnosis in women with breast masses and is helpful to increase health standards and clinical supervision of patients

Evaluation of the effect of the education module [preparing for childbirth] on the level of anxiety during pregnancy and labor in primigravida women

Women are likely to be involved in anxiety two times more than men. One of the reasons for this increase is that stressors like pregnancy and labor are specific for women. 70 percent of primigravidas and 75 percent of multigravidas experience anxiety during their pregnancy. So, this research was done with the aim of evaluating the effect of education module [Preparing for childbirth] on the level of anxiety during pregnancy and labor in primigravidas referring to the Social Security Insurance clinic in Mashad. This study was a kind of semi-experimental clinical research that was done on 110 primigavidas. The method was goal-center sampling on three occasions; beginning of research, pregnancy period and labor by using the Cattells anxiety test. After determination of primary anxiety, experimental group was educated for [preparation for childbirth] in 3 meetings for 3 weeks, and about four weeks after the determination of primary anxiety. During labor, [dilation 3-5 cm] anxiety in two groups was measured. Findings showed that education significantly decreases the anxiety during pregnancy [p < 0.0001] and labor [p<0.0001], while in the control group, the level of anxiety during pregnancy and labor as compared to the initial stage was significantly higher. There was a straight correlation between hidden anxiety and the acquired scores during education [P=0.018, r=0.28]. [Preparation for labor] education declines the anxiety of pregnant females during their pregnant period and as soon as the education is stopped, its effect gradually decreases and anxiety again increases. The researcher therefore proposes that for reduction of anxiety in pregnant females, continuous education should be imparted to pregnant women