effect of a positive reappraisal coping intervention and problem-solving skills training on coping strategies during waiting period of IUI treatment: an RCT

Background: waiting period of fertility treatment is stressful, therefore it is necessary to use effective coping strategies to cope with waiting period of intrauterine insemination [IUI] treatment

Objective: the aim of this study was comparing the effect of the positive reappraisal coping intervention [PRCI] with the problem-solving skills training [PSS] on the coping strategies of IUI waiting period, in infertile women referred to Milad Infertility Center in Mashhad

Materials and Methods: in this randomized clinical trial, 108 women were evaluated into three groups. The control group received the routine care, but in PRCI group, two training sessions were held and they were asked to review the coping thoughts cards and fill out the daily monitoring forms during the waiting period, and in PSS group problem-solving skill were taught during 3 sessions. The coping strategies were compared between three groups on the 10th day of IUI waiting period

Results: results showed that the mean score for problem-focused were significantly different between the control [28.54+/-9.70], PSS [33.71+/-9.31], and PRCI [30.74+/-10.96] [p=0.025] groups. There were significant differences between the PSS group and others groups, and mean emotion-focused were significantly different between the control [32.09+/-11.65], PSS [29.20+/-9.88], and PRCI [28.74+/-7.96] [p=0.036] groups. There were significant differences between the PRCI and the control group [p=0.047]

Conclusion: PSS was more effective to increase problem-focused coping strategies than PRCI, therefore it is recommended that this intervention should be used in infertility treatment centers

[Post treatment thyroid dysfunction and obesity in children with acute lymphoblastic leukemia and non-hodgkin's lymphoma: a brief report]

In most children with Acute Lymphoblastic Leukemia [ALL] and Non Hodgkin's Lymphoma [NHL] who have received chemotherapy with and without radiotherapy, some late effects due to treatment may occur such as endocrinopathies. We evaluated growth criteria [including short stature, obesity] and thyroid test function in 50 children with ALL [n=25] and NHL [n=25] 3-17 year-old in remission period who randomly received chemotherapy with [n=25] or without [n=25] radiation such as our treatment groups. The values for height, weight and BMI in less than 5[th] or more than 95[th] percentile considers abnormal. Six [12%] patients were in less than 5[th] percentile height [short stature]. Two patients [4.0%] had over-weight and 48 [96%] were in normal range of BMI. Six [12%] patients were in less than 5[th] and 3 [6%] were in more than 95[th] weight percentile. There was no significant difference between two different treatment groups for TSH [P=0.662] but there was a significant difference between these groups in case of T4 [P=0.049]. Mean and SD for T4 in patients with chemotherapy alone was less than in whom received chemotherapy plus radiotherapy. There was no significant difference between ALL and NHL groups for TSH, T4 [P=0.567, 0.528 respectively]. Two boys with ALL without history of radiation had hypothyroidism that had based on their laboratory data. Regarding to effects of thyroid dysfunction on short stature and obesity in adolescent with ALL and NHL, we suggest to have more attention about growth, thyroid test to avoid late side effect of malignancy treatment

[Prevalence of low mineral bone density in renal transplant recipients one year or more after transplantation]

Reduction in mineral bone density is a common complication following kidney transplantation and its adverse outcome could be minimized with well recognition and treatment. In this study we evaluated the prevalence of mineral bone density decrease in kidney recipients at least one year after the transplantation. Kidney recipients from whom transplant surgery at least a year had assed and had a good kidney function were selected. Mineral bone densitometry using X- ray energy absorptiometry was performed. The serum levels of Ca, P, Alkaline Phosphatase and Paratormone were measured and the collected data were statistically analyzed. Overall 182 patients were studied. The total rate of mineral bone density decrease was 87.4%. Osteopenia in the femoral bone was 73.6% and osteoporosis was 13.8%. In the lumbar vertebrae an osteopenia of 66.5% and an osteoporosis of 20.9% were noticed. Variance of analysis showed that there were no statistically significant differences between duration of dialysis before kidney transplantation [P=0.777, P=0.420], duration of kidney transplantation [P=0.927, 0.271], the mean of serum PTH [P=0.908, P=0.146] and calcium [P=0.348, P=0.265] in respect to densitometry of femoral bone and lumbar vertebrae. The frequency of mineral bone density reduction one year after kidney transplant in patients with a good transplanted kidney function was high

[Evaluation of maximum mouth opening after bilateral sagittal split osteotomy in patients with mandibular prognathism]

Mandibular prognathism is one of the most common skeletal disorders in Iranian population and so mandibular setback surgery is one of the most common surgeries in Oral and Mxilllofacial area. Ramus sagittal osteotomy is one of the surgeries which is done for the purpose of mandibular setback or advancement. The purpose of this study was to evaluate the progress of maximum mouth opening [MMO] after bilateral sagittal split osteotomy [BSSO] surgery in patients with mandibular prognathism. In this study, 36 patient's undergone BSSO surgery with Hunsck technique in order to correct manibular prognathism were taken into consideration. In all patients, fixation was done with three titanium screw in each side. Maximum mouth opening was measured before surgery and within 1, 3, 6 months after surgery. Repeated measurement was performed for data analysis [alpha = 0.05]. In the patients 81.32% of maximum mouth opening was gained after one mouth, 92.1/5 after three months and nearly total recovery [98.94%] after 6 months of surgery. The results confirm the concept that limitation in MMO is not a long lasting complication in bilateral sagittal split osteotomy surgery in patients with mandibular prognathism and it would approximatey be as same as before surgery after six months

Use of "kangaroo care" to alleviate the intensity of vaccination pain in newborns

It has been demonstrated that newborns feel pain completely. Thus, they should be treated with this in mind. Recent research showed that non-pharmacological interventions such as "Kangaroo Care" may be useful for decreasing pain in newborns. We tried to determine the effect of kangaroo care on the pain intensity of vaccination in healthy newborns. This study was a randomized case-control clinical trial. Subjects were 60 healthy full-term newborns delivered in a general Hospital, in Iran, from March to July 2006. They were randomly assigned to case and control groups. The case group received 30 minutes skin to skin contact, whereas infants in the control group were put, wrapped in a blanket, aside the mothers. Behavioral changes of newborns were evaluated and observed 2 minutes before, during, and 3 minutes after the intervention. All procedures were filmed. An assistant who was blinded to the study, scored behavior changes using Neonatal/Infant Pain Scale. Heart rate and oxygen saturation levels as displayed on the pulse monitor and duration of crying were recorded using a stopwatch. Mean pain intensity during the intervention v was significantly lower in the case group [P<0.006]. Mean pain intensity 3 minutes after intervention was also significantly lower in the case group [P<0.021]. Mean duration of crying was significantly lower in case group as well [P<0.001]. Kangaroo care may be used to decrease pain intensity in newborns undergoing painful procedures

[Brain computed tomography scan in meningitis patients with deterioration of consciousness]

Due to life-threatening complication of LP in patients with deterioration of consciousness due to meningitis [=brain herniation] the LP procedure safety without brain CT scan is debated. This descriptive cross-sectional study was done on patients suspected of meningitis with decreased consciousness referred to the infectious emergency of Emam Reza Hospital, Mashhad, Iran from April 2006 to March 2008. All patients underwent physical examination [neurologic and ophthalmoscopic] of the patients by residents of infectious diseases. Data [results of physical examination, neurologic, ophtalmoscopic, brain CT scan and LP] were collected. Then statistical analysis was performed with SPSS software and descriptive statistical methods. 136 patients were evaluated. The mean age of patients was 43.88 +/- 21.185 years and 58.5% [24] of the cases were male. The result of brain CT was normal in 53.7%. The most frequent abnormal brain CT results were hypodencity lesions [12%]. 2.4% [1] of patients had abnormal CT-Scan with space occupying lesion with mass effect and midline shift, and final diagnosis was brain abscess due to chronic mastoiditis. This study showed that abnormal finding of brain CT-Scan in adult meningitis with loss of consciousness is approximately 50% and mass effect was seen in 2.4% of patients

Serologic evaluation of HIV-1 and syphilis in patients with clinical anogenital wart

Genital infection with human papilloma virus [HPV] is the most common sexually transmitted disease in the United States. Patients having genital warts are at excessive risk of HIV and syphilis. Uninformed patients with high risk behaviors can help spread this condition in society. Therefore, CDC recommends HIV and syphilis screening for those with a sexual transmitted disease or a sexual risk factor. But this strategy is rarely considered in Iran. The aim of this study was to evaluate the cost-effectiveness of HIV and syphilis screening tests in patients with genital wart. In this case-control study, 100 patients with genital wart referring to Dermatology Department of Imam-Reza Hospital [August 2005 - August 2007] were included as the case group. This study was approved by the local ethics. The Control group was the same in number, age average, sex and marital status. All 200 patients studied considering HIV or syphilis infection. Finally, collected data were statistically analyzed by SPSS software, using chi[2] and student T test. Male to female ratio was 0.87. Majority of patients aged 30-39 years. Two patients were HIV positive and only one had Syphilis, without significant difference with the control group [Pv =0.29, Pv =0.50]. Screening is not cost effective in patients with asymptomatic anogenital warts. Since both HIV positive cases were intravenous drug abusers, this study emphasized on HIV and syphilis screening in patients with high risk behavior

Assessment of the immune system activity in Iranian patients with major depression disorder [MDD]

Major Depression Disorder [MDD] is a common disorder with prevalence of 15% among men and up to 25% among women. In recent years the association of immune system alterations and MDD has been investigated. Assessments of immunologic and inflammatory responses in these patients enhance our knowledge of the etiology and pathogenesis of this disease. To investigate the changes in immunoglobulin and cytokine serum levels and lymphocyte subsets in patients with MDD. We studied 37 adult patients with MDD, diagnosed based on DSM-IV diagnostic criteria, and 15 healthy controls matched with the patients. Plasma concentration of interleukin-4 [IL-4], IL-10, TNF alpha, and IFN gamma were measured by ELISA and serum immunoglobulins by SRID. Total number of NK cells [CD16 and CD56], B cells [CD19], and T cells [CD8, CD4, and CD3] were determined by flow cytometry. We found no significant differences in plasma concentration of IL-4, IL-10, TNF-alpha, IFN-gamma, and immunoglobulins as well as total number of NK cells, B cells, and T cells between major depressed patients and healthy control subjects. We conclude that in our patients, there were no significant differences in immune system activity between MDD patients and controls