[Survey of levels of anxiety and depression in parents of children with chronic illness]

Introduction: Parents who have children with chronic disease are susceptible to anxiety and depression. Parental anxiety and depression is associated with decreased sense of responsibility toward care, education and nutrition for their children and also for their mental disorder effect on their children's mental and emotional health. The purpose of this study was to determine parent's anxiety and depression of children with chronic disease in Tehran Mofid pediatric Hospital

Method: The present study is cross-sectional study that was conducted in 2010. 440 parents of hospitalized children with chronic diseases were selected with simple random sampling. Study's tool was Hospital Anxiety and Depression Scale. Data were analyzed with descriptive statistics and Independent t-test and Pearson correlation tests

Results: The results showed that 49.1% of parents had moderate to severe and 24.5% had mild anxiety. Also 31.8% of samples were with moderate to severe depression and 27.3% with mild depression. Child gender, location, duration of hospitalization of children showed significant association with the level of anxiety and depression [p<0.05], as well as a significant relationship between parent's gender, history of anxiety and parent's age with depression levels was observed [p<0.05]

Conclusion: According to results of this study, it is recommended to screen depression in parents of children with chronic illnesses in hospitals and clinics

[Performance of electrocoagulation process for removal of sulphate ion from aqueous environments using plate aluminum electrodes]

Sulphate ion is one of the main ions available in natural and waste water. The high rate of sulphate in drinking water causes health problems such as irritation and digestive problems and makes water taste bitter. The purpose of this study was to assess the efficiency of sulphate ion removal from drinking water through Electrocogualation process [EC] using plate aluminum electrodes. This study was conducted as a pilot plant using one glass tank in the volume of 1.3liter containing 6 plate aluminum electrodes. These electrodes were attached to a power supply in a mono-polar and parallel arrangement in order to switch the alternating current to the direct one. That is, each electrode was attached to positive and negative poles directly and alternately. The tank was filled with synthetic water containing sulphate ion with the concentration of 350 and 700mg/L. Percentage of sulphate ion removal in potential range of 10, 20 and 30 V, reaction times of 40, 20 and 60min and pH 7.0, 3.0 and 11.0 were measured. In this study the maximum efficiency of sulphate ion removal was in the electrical potential of 30 V, reaction time of 60min and pH 11.0. With increase of ion concentration, the time needed to achieve a suitable efficiency of removal increased, that is, it indicated the direct effect of pH and difference of electrical potential on removal of sulphate ion through EC process. The results of this research show that Electrocogualation technology can be introduced as a suitable and promising technique to remove sulphate ion from aqueous environments using plate aluminum electrodes

Percutaneous coronary intervention of osteal lesions in newly established tertiary care cardiac hospital

To assess the outcome of percutanious Angioplasty in patients with osteal lesions in Coronary artery Diseases. This is a retrospective analysis of all coronary angiograms performed at the catheterization laboratory of Karachi Institute of Heart Diseases [KIHD], a tertiary referral center in Karachi, Pakistan, between the periods August 2006 to August 2008. Fifty patients were enrolled which included thirty-five men and fifteen women and all were >40 years of age. Each patient had a single target osteal lesion: twenty nine patients underwent PCI for ostial LAD lesion [among them twenty males and nine females], six had ostial LCX [five males and one female], and fifteen patients had osteal RCA stenosis [10-male patients and 5- female patients]. After high-pressure balloon dilatation residual stenosis was reduced. Twelve patients were treated with bare metal stents [BMS] while thirty eight with drug eluting stents [DES]. In all cases the procedure was successful without any pre and post procedural complications. A key issue in the treatment of an osteal lesion is to assure that the stent is inserted proximal enough to fully cover the osteal junction. Improvements in technique, equipment, adjunctive drug therapy and better understanding of the procedure have remarkably changed the practice of interventional cardiology

Deficiencies in original articles accepted for publication in Pakistan journal of medical sciences: a retrospective analysis

To analyze the deficiencies in original articles accepted for publication in Pakistan Journal of Medical Sciences [PJMS]. All the original articles submitted to PJMS during April 2005 to March 2008 which were finally accepted for publication after peer review, were retrospectively analyzed for deficiencies. Main outcome measures were number and type of deficiencies with mean assessment score. The assessment score was based on the overall impression about the quality of the paper keeping in view the quantum of deficiencies. Manuscripts which had just problems with references or latest references were missing got six or seven points out of ten white those manuscripts with more deficiencies were considered average and got five points. The results were expressed as the mean score of deficiencies. This analysis did not include the manuscripts rejected during in-house review or after peer review and thus were not accepted for publication. Three hundred and forty two original articles accepted for publication were analyzed. Out of these 156 [45.6%] were primary acceptance, 67 [19.6%] were accepted after one revision and 119 [34.8%] after more than one revision. Mean number of authors was 2.99 +/- 1.62. Mean acceptance time was 4.88 +/- 2.21 months and mean publication time was 9.29 +/- 2.82 months. Mean score of deficiencies was 6.62 +/- 3.73. Most common deficiencies were: inappropriate Vancouver format of references in 259 [75.7%], extensive grammatical mistakes in 248 [72.5%], lack of recent references in 231 [67.5%] and un-necessary tables and figures in 152 [44.4%]. The mean assessment score was 6.58 +/- 1.08 [Range 1-10] one=worse, 10= excellent. Major deficiencies in the manuscripts accepted for publication in PJMS were inappropriate references, extensive grammar mistakes, lack of recent references besides un-necessary tables and figures. These can be rectified by the authors themselves provided they critically review their manuscripts and they may also require specific training for preparation of final manuscript before submission for publication

Effect of extracellular matrix on differentiation of mouse embryonic stem cells into insulin-producing cells

Evaluation of extracellular matrics [ECMs] effect on differentiation of embryonic stem cells [ESCs] to pancreatic beta-cell. Mouse ESC line, Royan B1, was subjected to differentiation into beta-like cells in a three-step method: generation of embryoid bodies [EBs], spontaneous differentiation and induction by Nicotinamide onto different matrices including poly L-ornithine/laminin, gelatin, and two different dilution of matrigel [1:30, 1:100] and control group [no ECM]. At the final step, differentiated cells were analyzed for expression of some pancreas-specific genes using "semi-quantitative RT-PCR ", for detection of insulin and C-peptide presence in cells using "immunocytochemistry" and for the evaluation of the amount of secretd insulin in response to glucose Using "insulin secretion assay". The semi-quantitative RT-PCR analysis of differentiated cells on 1:30 matrigel coated-plates showed consistent higher expression of beta-cell specific markers including Insulin I, Insulin II, Slc2a2 in comparison to the other ECMs. The results of immunostainig for C-peptide showed no significant differences between the experimental groups and finally insulin secretion assay revealed that differentiated cells on 1:30 matrigel coated-plates secreted more insulin in response to glucose in comparison to the other ECMs. Our results suggest that type of ECM may influence ESC differentiation into insulin-secreting cells and 1:30 matrigel was more effective. However, the success rate of differentiation needs further investigations using other appropriate ECMs

[Differentiation of human embryonic stem cells into insulin-secreting cells]

Type I diabetes mellitus is caused by autoimmune destruction of the insulin-producing beta-cells. A new potential method for curing the disease is transplantation of differentiated insulin- secreting cells from human embryonic stem cells. Human embryonic stem cell lines [Royan H1] were used to produce embryoid bodies. Differentiation carried out by growth factor-mediated selection of nestin positive cells. In final stage, these cells were expanded in the presence of bFGF, followed by addition of nicotinamide to promote differentiation of insulin- secreting cells. Cells were assayed by immunocytochemistry, RT-PCR, insulin secreting assay with Radio-immuno assay kit and Transmission Electron Microscopy. The cells were transplanted into immunosuppressed mice. Analysis of differentiation cells immunocytochemistry showed that these cells were insulin, glucagon, somatostatin and pancreatic polypeptide positive. RT-PCR reaction demonstrated the expression of pancreatic endocrine genes. Differentiation cells secreted insulin in response to glucose, but no significance difference in insulin concentration was observed with an increase in concentration of glucose. The implanted cells were vascularized and remained immunoreactive with insulin and glucagon. Transmission Electron microscopy of differentiate cells showed Golgi complexes, rough endoplasmic reticulum and a few granules but no true beta granules. The data showed that human embryonic stem cells can produce insulin secreting cells. However, more studies are needed to generate true beta cells

Characteristics of reviewers and quality of reviews: a retrospective study of reviewers at Pakistan Journal Medical Sciences

To study the characteristics, evaluate the performance of reviewers and quality of their reviews as being helpful for the authors and the editors to make a final decision on the manuscripts. Information was retrieved from 404 peer review proformas filled in by the Reviewers involving 377 manuscripts from July 2003 to November 2005.The information collected included age, sex, academic affiliation, number of publications, training local or overseas, punctuality, hand written notes or typed, participation in peer review workshops etc. Rating scale of 1-5 [1 meant casual and 5 detailed comments] was used to evaluate their comments regarding originality of manuscripts, comments regarding strong and weak points, tables, usefulness of the manuscript and interpretation of results. A total of sixty eight reviewers were evaluated. Majority of the reviewers 46[67.7%] were between the age of 40-60 years. Only three were female. Four [5.9%] reviewers had more than hundred publications to their credit while twelve [17.6%] had 51-100, thirty two [47%] had between 25-50 and twenty [29.4%] had less than twenty five publications. Fifty one [75%] were affiliated with academic institutions. Those who attended peer review workshops [38 out of 68] did a better review. Eleven [16.2%] did not wish to disclose their identity for various reasons. Based on their consistency and quality of reviews, fifteen reviewers were rated excellent by the Editors which included eight retired medical teachers, thirty three good and twenty as average reviewers. Performance of reviewers and quality of their reviews was mostly dependent on their interest in academics. Best reviewers were retired medical teachers personally known to the editors, those in private sector over 60 years of age and those who were exposed to any training programme in peer review system. There is a general tendency among the Editors to overuse efficient, punctual reviewers which must be checked to avoid burn out syndrome which ultimately affects the quality of their reviews. Editors should be consistently on the look out for good quality reviewers to expand their Reviewers Database which will eventually help improve the overall quality of the manuscripts and standard of the journal

Online edition of a journal: a great source of manuscripts and potential regional cooperation

Pakistan Journal of Medical Sciences [Pak J Med Sci] formerly known as 'Specialist', is a quarterly journal, published since 1984. It is indexed by EMBASE/Excerpta Medica and WHO Extra MED but not by Medline. Even though the journal is being published regularly for the last 22 years, its online full-text edition was introduced only in late 2002. We have assessed the impact of online edition of PJMS on the number of manuscripts received internationally, along with the improvement in the visibility of the journal during the last three years. The findings are presented here along with the proposals for the potential cooperation between the countries of the region. We started receiving increased number of manuscripts internationally in 2003 and this gratifying trend continues even today. In 2003, we received 37 manuscripts which increased to 62 in 2004 and 133 in 2005 [an increase of + 300% vs. 2003]. Initially, the authors from 10 countries were involved. Now this number has increased to 22. The geographical spread is as wide as four continents. Online submission of articles has also increased from within the country during this period. Taking Iran as an example of the contributing countries [as the authors from Iran have been our major contributors], we received 13 manuscripts in 2003, increasing to 21 in 2004 and 74 in 2005.The acceptance rate for the publication of articles from Iran has varied from 30 - 47% each year. Positive attitude of editorial staff and the helpful approach on the part of reviewers has facilitated the increase in the acceptance rate.This shows regional co-operation. Manuscripts from any country can have deficiencies. Those received from Iran have had their share of discrepancies. These discrepancies have ranged from problems with poor English, to inconsistency of format and quality of references and disregard for the 'instruction to authors'. Significant delays occur in the processing of articles due to too much time taken by the authors to give the feedback to the queries of reviewers and the return of proof- read articles, amongst many other elements. We feel that online edition of a journal not only helps to increase the visibility of the journal but also proves to be a great source of manuscripts, even without indexing by Medline, provided the regularity and standard of the journal is maintained. In addition, it is an important potential source of coordination between the regional countries to work together for the training of writers, reviewers and editors to improve the standard of medical journalism, and thus improve the standards of medical journals in the region

Benefits of early intervention in the progression of cardiovascular disease-role of rennin-angiotensin system blockade

It can be concluded that atherosclerosis is an insidious disease and it takes years to develop, through vessel wall injury and lipid accumulation. Early detection of CHD and certain risk factors like hypertension and insulin resistance are highly important and thus an early treatment of risk factors may alter prognosis significantly. RAS plays a central role in atherosclerosis, end-organ damage and thus cardiovascular morbidity and mortality. RAS blockade significantly reduces the risk of end-organ damage. ACE-Is and ARBs have a positive impact on cardiovascular morbidity, mortality and renal dysfunction. Newer application of ARBs like prehypertension and prediabetes are under investigations, with interesting new possibilities in the near future