Overlap syndrome: Association of chronic obstructive pulmonary disease and obstructive sleep apnea syndrome

Abstract: COPD and the OSAHS are both common diseases affecting respectively 10% and 5% of the adult population over 40 years of age. Their coexistence, which is denominated as "overlap syndrome", can occur in about 0.5% of this population

Aim and materials: To assess the existence of a prevalence of OSAHS in patients with COPD through a prospective analysis: 70 had a confirmed isolated OSAHS [group A] and 11 had an OS [group B], all were compiled from January 2007 to June 2012

Results: The prevalence of OS in our study was 13.6%, OS patients were older than the isolated OSAHS patients [p < 0.05] with a male predominance in the Overlap arm [p < 0.05], and BMI was similar between the 2 groups [p = 0.22]. Tobacco is retained as a risk factor and 81.8% of patients with Overlap were smoking [p < 0.05]. Clinical signs most reported are nocturnal snoring and daytime sleepiness. The Epworth Sleepiness Scale was higher than 10 in the 2 groups [p < 0.05]. The Berlin questionnaire realized in 30 subjects in group A, was positive [40% of cases] and was positive in 63.6% of 7 subjects in group B. Spirometry showed that vital capacity, FEV1 and FEV1/CV were significantly decreased in the Overlap group [p < 0.001]. The recording shows a sleep apnea-hypopnea index [AHI] similar in the two groups [p < 0.05]

Conclusion: There was no correlation between COPD and OSAHS. The latter is a risk factor for the first

[Effect of the sera of patients with multiple sclerosis on apoptosis and nitric oxide production of endothelial cells]

Multiple sclerosis [MS] is one of the chronic autoimmune diseases of the central nervous system with unknown etiology. The present study aimed to investigate the apoptosis and nitric oxide [NO] production of endothelial cells treated with serum of patients with MS and response to interferon beta [IFN- beta] therapy. Human umbilical vein endothelial cells were treated with sera from patients with active MS [in relapse], MS in remission, or sera from healthy volunteers [each n = 10]. Nitric oxide [NO] levels were determined in culture supernatants by Greiss method and endothelial cell apoptosis was assessed by annexin V-propidium iodide staining. Effects of IFN-beta-1b on endothelial cell apoptosis and NO production were tested at increasing doses [10, 100, and 1000 U/ml]. Compared with healthy people, only apoptosis of endothelial cells treated with serum of patients with relapsing phase increased, P<0.01; while there was no significant difference between apoptosis of endothelial cells treated with serum of patients in remission phase and healthy controls. Apoptosis of endothelial cells treated with sera of patients in relapse was decreased by IFN-beta-1b at 10 U/ml, P<0.05. The same dose also led to a significant increase in nitric oxide production. The results suggest that endothelial cells injury and apoptosis may play a role in MS etiology and represents a potential therapeutic mechanism of action for IFN-beta-1b in MS therapy

Woman abuse and pregnancy outcome among women in Khoram Abad, Islamic Republic of Iran

We carried out a descriptive analysis on the pregnancy outcome in 313 pregnant women [153 abused, 160 non-abused]. Abuse was statistically significantly correlated with mean weight gain during pregnancy, mean frequency of the prenatal care, prolonged labour [dystocia], premature rupture of membrane, low mean birth weight and mean gestational age at birth. Given the high likelihood that a woman will access health care services during her pregnancy, physicians providing prenatal care are in a strategic position to screen for partner abuse

Isfahan university of medical sciences: two decades of scientific achievements

Several studies indicate a significant growth in research activities and scientific achievements in Iran during recent years. Isfahan University of Medical Sciences as a main university has had a special situation in this regard. The aim of this study was to determine science productions of Isfahan University of Medical Sciences since its establishment, during 1985 till 2007. This was a descriptive study, performed based on the data retrieved from ISI Web of Science and Medline databases. Researchers of Isfahan University of Medical Sciences indexed 313 scientific article in Medline and 350 in ISI. Among all schools and centers affiliated to Isfahan University of Medical Sciences, school of medicine was ranked in the first place regarding scientific productions indexed in the 2 mentioned databases. This study demonstrates a significant growth in producing scientific articles in this university especially after the year 2000. Establishing the rewarding system for article writers, developing and expanding the infrastructures for internet, providing on-line services in this university, subscribing scientific databases and electronic journals, and running workshops in research methodology and scientific writing were among the most important factors causing this progress

Students points of view regarding effective factors in establishing communication between students and faculty members

In order to improve the educational process, it is highly important to recognize effective factors in establishing communication between students and faculty member. This study was performed to determine students' points of view concerning such factors. In this descriptive-cross sectional study, 162 students from Arak Medical University were selected through stratified sampling method in 2004-2005. A questionnaire consisting of two parts demographic data and 23 questions related to the assessment of effective factors in establishing communication between students and faculty was used. The scale of the questionnaire was a four point scale ranging from "very effective" to "having no effect". Data was analyzed by SPSS software using frequency distribution, mean and standard deviation. The groups' comparison was made by chi2. The most effective factors in establishing communication, according to students' views, respectively were faculty member's rhetoric and teaching skills [84%], his knowledge [81.5%], his experience [76.5%], and his moral behavior [68.5%], while more than 50% of students indicated that faculty member's age and sex, had no effect in this communication. Some educational features of faculty member which reflect his teaching skills and proficiency, and some of his personal and behavioral characteristics revealing his social communication, are effective in establishing communication. It is highly recommended to conduct workshops for improving this communication

Prenatal attitudes of female students toward child-parent interactional behavior

Bringing up children is one of the most complicated responsibilities an adult experience in his/her life. However, most people are not completely prepared to be a parent. Current study was carried out to analyze the attitude of participants toward becoming parent. This is a descriptive study in which questionnaire 1-1-PI which is consisted of 32 items was used. Sampling method was stratified random sampling. 400 questionnaires were distributed among participants and the data was analyzed using descriptive statistical methods. Findings demonstrated that 116 cases [31 percents] scored 0-64 and 63 cases [17 percents] scored 65- 95 and 192 cases [52 percents] scored 97- 160. These scores were respectively considered positive, neutral and negative overall attitude toward parenting. Some parents considerably lack fundamental parenthood skills. They are unaware of their children's needs, capabilities and potentials. A solution could be planning to improve [future] parents' awareness of children's development

Quality of patients' cares in the recovery wards of Isfahan University of Medical Sciences

Each member of society needs suitable services in recovery wards including patient safety in the ward, improvement and taking care of patients after surgery and anesthesia in order to decrease undesirable evidences, mortality and morbidity. The special characteristic of recovery cares is nursing cares. The nurse is one of the effective members of a health group and her/his effective role in admitting, preparing, caring, and physical, moral and social supports of patient is accepted by all experts of medical sciences. The aim of the present study was to determine standards observance in the recovery wards of the treatment centers of Isfahan University of Medical sciences [IUMS] in 2003. This was a descriptive study with easy sampling. The quality of cares given by personnel of recovery wards after anesthesia was determined by using questionnaire and checklist. Obtained data was analyzed by SPSS software. This study showed that in the recovery ward, most of the cases were managed near the standard status. Based on the criteria of patient discharge from recovery wards, the results demonstrated that nurses observed the criteria in most of the cases; only in reporting description of events during and after operation, 68.8% were substandard. Since the side effects of anesthesia may appear during the transfer of patient to the recovery room, in recovery room or even after transferring to the ward, so a codified recovery room care plan and professional and skilled personnel who have the ability to observe standards in recovery room can be effective in prevention and treatment of these side effects

Evaluation of il1-alpha and TNF-alpha serum levels in rheumatoid arthritis patients with active and inactive, with or without bone erosion

Rheumatoid arthritis is the most common inflammatory joint disease with 1 percent prevalence in community which presents with symmetrical polyarthritis of hands with inflammatory behavior. Several studies in recent years were conducted for evaluation of inflammatory cytokines such as ILl-alpha [Interleukin la] and TNF- alpha [Tumor necrosis factor] in rheumatologic disorders including rheumatoid arthritis to find new treatment methods base to pathogenesis. In this study different serum levels of ILl-alpha and TNF- alpha in 160 rheumatoid arthritis patients with active and inactive disease and also disease with or without bone erosion are assessed. 4% of our patients had rheumatoid nodule and 70% of all patients had positive RF, ILl-alpha, and TNF- alpha levels. Active with bone erosion patients had ILl-alpha and TNF- alpha serum levels higher than active without bone erosion patients; it was not significant in T-test but it was significant in Mann-Whitney Test. The results was the same as expected; ILl-alpha, and TNF- alpha serum levels were higher in active with bone erosion in comparison with inactive without bone erosion patients

[ relationship between triglyceride level - HDL level - tumor necrosis alpha factor and its soluble receptors with lupus erythematosus activity]

Systemic lupus erythematosus [SLE] is a disease with life-threatening complications. Since evidence indicates that measurement of triglyceride [TG] and HDL levels and tumor necrosis alpha factor [TNF- alpha] and its types I and II soluble receptors plays a major role in evaluation of lupus activity, this study was conducted to investigate the relationship between the above mentioned factors and lupus activity in Tehran in 2005. In this cross-sectional study fasting blood samples were obtained from 86 SLE patients who had been entered into the study through convenient sampling and the disease activity was calculated using the Systemic Lupus Erythematosus Disease Activity Index [SLEDAI]. Scores >/= 6 were considered as active lupus and <6 as dormant lupus. Serum levels of TNF- alpha, sTNFR[1] and sTNFR[2] were measured through ELISA [Bender Medsystem] and blood TG and HDL through routine biochemical tests within 12 hours overnight fasting. The results were analysed by t-test, Mann-Whitney and Pearson correlation tests. 46 people [53.5%] suffered from dormant disease and 40 people [46.5%] from active disease. TG level had significant relationship with disease activity, sTNFR[2] [P=0.001] and TNF-alpha [P=0/01], while HDL level had inverse significant relationship with SLEDAI [P=0.007], TNF [P=0.01], STNFR1 [P=0.001]. There was no significant relation between TG and HDL with STNFR2. Multiple linear analysis of regression showed that three variables [TG, sTNFR[1] and sTNFR[2]] are maintained in the model for prognosis of the disease while TNF-alpha and HDL are omitted. Dislipoproteinemia [elevated TG and reduced HDL] correlates with SLE activity following an increase in TNF-alpha and its soluble receptors. Thus, serum levels of TG, HDL and TNF-alpha and its soluble receptors are connected with lupus activity and are valuable markers for the disease activity

Survey of research problems from the viewpoints of managers, scientific staffs and research experts in Isfahan University of Medical Sciences

Research is a key factor in developing a country. Its performance is due to the degree of solving problems and dem and s of a society. Evaluation of research problems and obstacles has its importance in any scientific fields. It explains defects of that field and it can develop it. According to the importance of above mentioned subjects, we designed a survey to evaluate problems to research policies and services from the viewpoint of managers, scientific staffs and experts of Isfahan Medical University. We performed a cross-sectional study in 2001 with a 38-item questionnaire. Our samples were all of managers and research experts of Isfahan Medical University and r and om samples of scientific staffs of colleges. The data of the survey were analyzed by SPSS ver10 with t-test, Mann Whitney, Kruskall Wallis, ANOVA and alpha- korenbach The most important research problems from the viewpoints of managers were: 1] Low relation between researchers 2] Insufficient time of scientific staffs for performing research due to educational duties 3] Lack of aims and programs of research policies. The most important research problems from the viewpoints of scientific staffs were the same.These problems from the viewpoints of research expert were: 4] Lack of aims and programs of research policies 5] Insufficiency of research budget. 6] Lack of team work culture According to the results, it seems that the most useful actions to take are amending informational services, defining research position against educational systems and explaining aims and plans in research policies