Quality of life of Iranian beta-thalassaemia major patients living on the southern coast of the Caspian Sea

In the present study, the aim was to explore the quality of life of thalassaemia major [TM] patients according to age, sex, school performance, severity and complications of the disease. A cross-sectional descriptive study was conducted. Quality of life was evaluated by 4 questionnaires; demographic characteristics, the short form 36 health survey [SF-36], Persian version of symptoms checklist-90-revised [SCL-90-R] and life satisfaction index [LSI]. 687 [41.08%] of the eligible patients with TM completed the questionnaires. With the SF-36 questionnaire, 329 [47.9%] participants had an excellent level of physical functioning. With the SCL-90-R questionnaire, 446 [64.9%] participants had a global severity index of > 0.7, considered psychiatric patients, 141 [20.5%] patients had GSI between 0.4 and 0.7, considered suspected psychiatric patients and 100 [14.6%] participants had GSI of < 0.4, considered non-psychiatric patients. The mean score of LSI questionnaire was 20.50 [SD 5.95], range 2-37. Beta-TM patients are at risk of psychiatric symptoms and need appropriate psychiatric counseling

[Detection of P53 gene exons 5 and 6 mutations among east azerbaijani women with breast cancer]

Breast cancer [BC] is the most common invasive malignancy affecting women worldwide. The tumor-suppressor P53 gene [P53] is frequently mutated in breast tumors. To use P53 as a target for therapy, it is important to accurately assess p53 mutation status in tumor samples. A total of 102 tumor samples were collected from breast cancer patients referred to Tabriz hospitals between the 2007-2009 period. DNA was extracted by Proteinase K- Isopropanol method and then performed amplification and sequencing of P53 from exons 5 and 6. Mutations in the P53 gene were detected in 17.6% of the patients. Including 7 polymorphisms [6.68%] and 11 mutations [10.78%]. Overall, 18.2% of the mutations were found in codons 160 [ATG>AAG] and 163 [ATC>AAG] in exon 5. Also 81.8% of the mutations observed in exon 6: codon 193[CAT>AAT], codon195 [ATC>TTC], codon 195 [ATC>AAC], codon 198[GAA>TAA], codon 220 [TAT>TGT], codon 213 [CGA>CTA], and codon 214 [CAT>CG]. No alteration observed in intron5 and all of polymorphism detected in 13399A>G nucleotide of exon 6. The majority of detected mutations are missense that located on DNA-binding domain of P53. This type of mutation usually leads to the production of a mutant protein with a compromised structure and altered DNA-binding capacity. This is the first report of its kind from the East Azarbaijan region. Our results indicate a rather high frequency of exon 6 mutations in P53 among patients with breast cancer. Furthermore, the mutation pattern appears differs from other regions. However, further studies are needed to determine the role of P53 mutations in breast cancer development

Knowledge, attitudes and practices towards HIV/AIDS among Iranian prisoners in Mazandaran province in the south-coast area of the Caspian Sea

HIV infection in the Islamic Republic of Iran is concentrated primarily among intravenous drug users. This study investigated the knowledge, attitudes and practices towards HIV/AIDS prevention of a random sample of prisoners in 5 prisons in Mazandaran province. Of 1760 individuals aged 18-65 years old completing the questionnaire, the mean age was 30.1 [SD 8.1] years [range 18 to 59 years]; 95.8% were male. Respondents had an average to fairly good knowledge about HIV/AIDS, with the percentages answering correctly ranging from 11.9%to 85.9%. However many had the misconception that [HIV/AIDS does not influence Iran] and [I will not be infected with HIV/AIDS under any conditions] and 63.6% agreed that lack of religious and moral commitment could spread AIDS infection. HIV/AIDS prevention efforts are needed for prisoners in Mazandaran province

[Effects of topiramate in the prevention of drug resistant migraine headache]

Migraine is the most common cause of headache. The aim of the present study was to evaluate the effects of topiramate [TPM] in the prevention of drug-resistant migraine headache. This is a double-blind clinical trial conducted on 70 patients between ages 15 to 45 years referred to the Bu Ali Sina Hospital in Sari with a history of migraine attacks based on International Headache Society criteria for a period of more than one years with a minimum incidence of 1 to 6 attacks per month. The drug rate performance was assessed by response rate to treatment, mean changes in the number and severity of migraine attacks compare with the placebo group for 3 months. Collected data were analyzed using analysis of variance [ANOVA], Newman-Keuls and Spearman's Coefficient Rank Correlation as the post hoc tests. GRAPHPAD software was used for analysis of the data. 66 of 70 patients completed the study. The mean age of the patients was 30.33 +/- 7.9 years. A significant reduction in the severity and frequency of migraine attacks was seen in all months [P<0.0001] for topiramate treated group in compare to placebo group. Responder rate for patients treated with TPM was significantly higher than placebo group [64.6%, P<0.0001] in the 3 rd month of the treatment side effects of treatment were transient and well tolerated. Low dose of TPM showed significant efficacy in prevention of migraine attacks within the first, second, and third month of treatment. Low dose of TPM seems to be a good therapeutic option for the patients with refractory migraine

[Mental health status of beta-thalassemia major in Mazandaran Province in 2006]

Beta-thalassemia major [TM], a chronic, genetically determined hematological disorder, has received little investigation on the psychological aspects of the disease and the psychosocial adjustment of patients with this anemia. In the present study, the aim was to explore the nature of psychopathology according to age, sex, school performance, severity and complications of the disease in TM patients. A Cross-section descriptive study was conducted at the 14-Thalassemia Unit of different hospitals of Mazandaran province Iran in 2006,. Psychological aspects were evaluated by the Persian version of symptoms checklist-90-revised questionnaire. Information on relevant demographic characteristics, school performance, severity and complications of the disease was collected by one of the investigators who created the questionnaire. Analysis of data was done by Chi square method, t test and one way ANOVA. 687 [41.08%] of the 1672 eligible patients with TM completed the questionnaires. The mean age of the participations was 21.93 +/- 5.90 years and with a range of 15-45 years. 363 [52.8%] were female, 602 [6.87%] were single, 465 [67.7%] had not higher educational level. In our study, 446 [64.9%] of TM patients had GSI > 0.7 as psychiatric patients, 141 [20.5%] had GSI between 0.4 to 0.7 as suspected psychiatric patients, and 100 [14.6%] had GSI < 0.4 as non-psychiatric patients. These findings show that beta-thalassemia major patients are at risk for psychiatric symptomatology and need appropriated psychiatric consults

[ effect of esophagectomy and cervical esophagogastrostomy with or without of pyloromyotomy on emptying of intrathoracic stomach]

A gastric conduit is usually used to reconstruct the foregut after esophagectomy for cancer. The gastric emptying may be impaired after this operation, so some esophageal surgeons routinely add a pyloric drainage procedure. The aim of this study was to determine the emptying of the intrathoracic stomach after esophagectomy and cervical esophagogastrostomy with or without pyloromyotomy. Between January 2003 and April 2006, in a randomized controlled trial, 30 patients with esophageal carcinoma were randomized to have with or without pyloromyotomy as a gastric emptying procedure for the gastric conduit used for esophageal replacement. Patterns of gastric emptying in the vagotomized intrathoracic stomach were studied using radioisotope techniques. Gastric emptying [GE] was evaluated 8 weeks after the operation. Patients were available for 6 months follow-up. A total of 30 patients were enrolled in this study. Sixty percent [18] were male, and 40% [12] were female. Twenty three patients [76.7%] had squamous cell carcinoma and 7 [23.3%] had adenocarcinoma. Delayed GE was reported in 11 [73.3%] and normal GE in 4 [26.7%] of patients with Pyloromyotomy. Delayed GE was reported in 9 [60%] and normal GE in 6 [40%] of patients without Pyloromyotomy. There were not any significant differences between complications of post surgery in both groups. These findings were showed that esophageal surgery can be don't add a pyloric drainage procedure in esophagectomy and cervical esophagogastrostomy and that very few patients actually need it

[Psychological aspects in young adults with beta-thalassemia major, control group]

Beta-thalassemia major [TM], a chronic, genetically determined hematological disorder, has received little investigation on the psychological aspects of the disease and the psychosocial adjustment of patients with this anemia. In the present study, the aim was to explore the nature of psychopathology according to age, sex, school performance, severity and complications of the disease in TM patients compared with demographically matched healthy persons. A controlled anterograde cohort study was conducted at the Thalassemia Unit of Boo-Ali Hospital from June 2003 to November 2005 in Sari, Iran. Psychological aspects were evaluated by the Persian version of symptoms checklist-90-revised questionnaire. Information on relevant demographic characteristics, school performance, severity and complications of the disease was collected by one of the investigators who had created the questionnaire. 125 persons with TM completed the questionnaires and were compared with 125 controls and 250 totally. The mean age of the participants was 18.51 +/- 2.0 years and with a range of 15-25 years. 132 [52.8%] were female with equal family status, social and economic status. Patients group reported a significantly lower level of marital status [P<0.01], education level [P<0.0001], school performance [P<0.0001]. TM patients were found to have significantly more psychiatric disorders than the control subjects with GSI: 1.16 +/- 0.47 vs. 1.01 +/- 0.6; [P<0.03], PSD: 54.99 +/- 12.59 vs. 46.42 +/- 18.76 [P<0.0001], and PSDI 2.02 +/- 1.02 vs 2.45 +/- 2.22 [P<0.05]. We recorded significant changes in the mean scores of somatization [P<0.0001], interpersonal sensitivity [P<0.0001], depression [P<0.003], anxiety [P<0.05] and psychoticism [P<0.03] in the TM patients as compared to the control subjects. These findings show that beta-thalassemia major patients are at risk for psychiatric symptomatology and need appropriate psychiatric consultation

[ epidemiological and clinical assessment of admitted burned pregnant women in Shahid Mottahary Hospital burn center between January 1998 and October 2003]

Treatments of burn pregnant women is a difficult task because the vulnerable fetus is highly dependent on the health of the mother. This study was conducted to determine the epidemiology, etiology, clinical assessment and outcome of pregnant patients between January 1998 and October 2003. A 6-year retrospective descriptive study of burns in pregnant women hospitalized at Mottahary hospital [burn center] in Tehran was performed. A short structured questionnaire was used to collect data. The questionnaire covered demographic information, etiology, clinical manifestations, and outcomes. 74 [5%] of the 1480 women of reproductive age who were admitted for burn treatment during this period were pregnant. The mean age of 74 patients was 22.54 years [SD = 4.78] with a range of 16-35. The majority of the women [50%] were between 20 and 30 weeks of gestational age. The most common cause of burn was kerosene fire 52 [70%]. Most of the women 50 [68%] suffered from severe burns with TIBC>40%. 49 [66%] mothers and 50 [67.5%] died as a result of the burn damages. Burn size, TIBC, follow up of clinical manifestations for pregnant women, fetus and performance of proportional treatment protocols were the strongest predictor of mortality for mother and fetus

[Utility of magnetic resonance cholangiography, ultrasonography and liver function test in preoperative assessment of patients with symptomatic cholecystolithiasis and suspected biliary obstruction [a comparative study]]

Evaluation of suspected biliary obstruction is performed by common old methods such as Ultrasound, CT, and invasive cholangiography. These techniques have limitations due to the poor visualization of intraductal stones [US, CT] and the need for an invasive procedure [ERCP, PTC]. Magnetic resonance cholangiography [MRC] is noninvasive imaging modality that provides good visualization of the hepatobiliary system. The aim of the present study was to determine the utility of Magnetic resonance cholangiography, Ultrasonography and Liver function test in preoperative assessment of patients with symptomatic cholecystolithiasis and suspected biliary obstruction. Patients selected for elective open cholecystectomy with risk factors of common bile duct stones as suspected biliary obstruction underwent MRC, US, and Liver function test preoperatively. All patients underwent open cholecystectomy and intraoperative cholangiography in Imam Khomeini Hospital, Academic Medical Center of Medicine School, Mazandaran University of Medical Sciences, Sari, Iran from January 2003 to February 2006. 30 patients [11 male, 19 female] with the mean age 53.93 +/- 13.32 years in a range of 38-75 years underwent all preoperative and operative assessments. 81.81% Sensitivity, 87.5% specificity and 83.33% efficacy in MRC; 18.18% Sensitivity, 87.5% specificity and 36.66% efficacy in US, and 54.54% Sensitivity, 37.50% specificity and 50% efficacy in Liver function test were the results obtained for biliary stones. MRC has excellent diagnostic accuracy in the detection of biliary disease. Due to its non-invasive nature, MRI may have advantages over invasive cholangiography when diagnosis is the major goal of the procedure

[Comparison of the effects of Nifedipine with Magnesium Sulfate in arresting preterm labor]

Preterm birth is a major contributor to perinatal mortality and morbidity and affects approximately six to seven percent of births in developed countries. The aim of this study was to compare the tocolytic effects of nifedipine and magnesium sulfate in arresting preterm labor. This clinical trial study was performed on 60 women with singleton pregnancies at 23-36 weeks in preterm labor [regular uterine contractions<10 min and cervical dilatation apart despite bed rest, 50 mg pethidine and 500 cc bolus ringer lactate serum]. They received either oral nifedipine or intravenous magnesium sulfate. Both drugs had similar tocolytic effect. Also they had similar side effects, but in the first hour, mother pulse rate increased significantly in nifedipine group [103.3 +/- 6.65 beats per minutes and 78.9 +/- 1.99 beats per minutes] [p=0.02]. Nifedipine has significantly shown faster effects than magnesium sulfate [0.63 +/- 0.24 hrs versus 4.88 +/- 3.44 hrs] [p<0.025]. Oral nifedipine with the same efficacy and faster effect could be a suitable and convenient alternative option to intravenous magnesium sulfate in arresting preterm labor

[Effect of varicocelectomy on semen analysis parameters in patients with abnormal semen parameters]

Varicocele represents the most common corrigible surgery in infertile men. The aim of present study was to evaluation the effect of varicocelectomy on heptads semen parameters in patients with abnormal semen parameters. This study was conducted on infertile patients who have abnormal semen analysis according to WHO parameters and to an urologist diagnosis, they have varicocele size with grade II, III, they came to infertility clinic of Imam Khomeini Hospital, Sari, Iran, 2004. The Inguinal varicocelectomy was performed over these patients by a urologist. They follow up on the basis of varicocele, post surgery complication, and semen analysis for three months. 67 patients participated in this study with the mean age of 33/6 +/- 7/3 and a range of 20-50 years. The patients's infertility range was 2-20 years, and with the mean 6/5 +/- 4/02.%58 has varicocele with grade two and%42 with grade three. In this study, the significant change in total sperm count, sperm motility, sperm morphology [P<0.05], was observed in patients before and after varicocelectomy. It hasn't also observed any significant association between heptads semen analysis parameters and varicocele grade. Performing varicocelectomy could be useful improvement of semen analysis parameters and in the possible treatment of infertility in men as well