The Experimental Assessment Of Build Up Factor And Attenuation Coefficient Of Brass Compensator Applied In Intensity-Modulated Radiation Therapy (Imrt) For 6mv Photon Beam

Introduction: Recent compensators are commonly applied in IMRT. The precise properties of applied compensators such as thickness, attenuation coefficient and build up factor are intensively important for IMRT calculations. Method: The brass compensator used for 6 MV photon beam was studied to estimate the relative effect of thickness and field size on IMRT calculations. Various field size together with several compensator thicknesses were examined. Result: The average reduction of effective attenuation coefficient (EAC), for the fields of 10×10 cm2 to 20×20 cm2, was 9.94%. By increasing the field size, EAC was decreased. The major reduction of EAC due to increasing field size was found to be 9.62%. The build up factor was increased by 2% to 21.8% respect to field size and compensator thickness. Also, the build up factor was increased by adding up the thickness. The rate of changes ranged from 24% to 48 %.Conclusion: The compensator thickness and field size are significantly important to calculate the effective attenuation coefficient and build up facto

Vaginal progesterone on the prevention of preterm birth and neonatal complications in high risk women: a randomized placebo-controlled double-blind study

Background: Preterm birth is the major cause of neonatal mortality and morbidity

Objective: The aim of this study was to evaluate the effect of prophylactic vaginal progesterone on decreasing preterm birth rate and neonatal complications in a high-risk population

Materials and Methods: A randomized, double-blind, placebo-controlled study was performed on 100 high-risk singleton pregnancies. Vaginal suppository progesterone [400 mg] or placebo was administered daily between 16-22 wks to 36 wks of gestation. Progesterone [n=50] and placebo [n=50] groups were compared for incidence of preterm delivery and neonatal complications

Results: The preterm birth rate was 52%. Preterm birth rate before the 37 wks of gestation [68% vs. 36%: RR=1.89, 95% CI: 1.25-2.86] and also before the 34 wks of gestation [42% vs. 18%: RR=2.33, 95% CI: 1.19-4.58] in placebo group was significantly higher than progesterone group. Our study also showed that the administration of vaginal progesterone was associated with a significant reduction in the risk of birth weight

Conclusion: Prophylactic vaginal progesterone reduced the rate of preterm delivery, the risk of a birth weight

Gabapentin and Fluoxetine for treatment of psychological symptoms: a cross over study

The somatic and metabolic changes due to menopause can result in numerous symptoms including psychological symptoms. This study compares the effectiveness of Gabapentin vs. Fluoxetine in treatment of psychological symptoms of menopause. Methods:Eighty menopausal women with history of hot flashes and predefined psychological symptoms participated in a cross-over study conducted at the Amir-Al-Momenin hospital, Semnan, Iran. Participants were randomly divided into two groups: A and B. The study included two rounds of treatment, each 4 weeks long, separated by a two-week washout period. In the first round of treatment, group A was treated with Fluoxetine 20mg/d and group B with Gabapentin 300 mg/d. In the second round of treatment, group A received Gabapentin while group B received Fluoxetine [cross-over].All participants were asked to fill out the "Green Climacteric Scale" questionnaire at the beginning of the study and also following each round of treatment. They were also asked to monitor and keep track of the side effects of the medications by filling out another form. There was no significant difference between the two groups in age, body mass index, and age at menopause [p>0.05]. The severity of irritability, fatigue, difficulty in concentrating, difficulty in sleeping, nervousness, and palpitation reduced to a significantly greater extent when the participants were treated with Gabapentin than when they were treated with Fluoxetine. Side effects [tremor] developed in only 2 Fluoxetine users and 2 Gabapentin users during the first 4 weeks of treatment. Our findings suggest that Gabapentin is more effective in alleviating the psychological symptoms of menopause than Fluoxetine. Thus, we recommend Gabapentin 300 mg/d for menopausal women who primarily complain about psychological symptoms, or those with contraindication to hormonal therapy

Is it Necessary to initiate antibiotic therapy in children with pharyngitis?

Streptococcuscus Beta Hemolytic Group A is the most important pathogen causing which may lead to purulent and non purulent angina. Rheumatic fever is the most important complication that is the cause of 30% to 40% of cardiac disease and disablement. This study was performed to evaluate prevalence of Streptococcuscus Beta Hemolytic Group A and estimate role of clinical findings in children with Streptococcuscus angina diagnosis. antibiotic resistance was also assessed evaluated in the patients with bacterial pharyngitis. Throat culture was performed on 104 patients referred to Amiralmomenin hospital of Semnan at the age range of 5 to 15 years having angina without begin on antibiotic treatment after the completion of the questionnaire. A frequency of 1% have been assessed for Streptococcuscus Beta Hemolytic Group A, coagulase -positive Staphylococci and non-group A Streptococcuscus frequencies were 10.6% and 17.3% respectively. 100% of patients had pharyngeal erythema, 72% had fever, 55% had exudates and 52% had cervical adenopathy. The diagnosed Streptococcuscus was sensitive against penicillin, erythromycin and amoxicillin and resistant against cotrimoxazole. In examining Staphylococcus aureus antibiotic-resistance, only 40% of cases were sensitive to clindamycin and 40% were also sensitive to vancomycin. Very low frequency of group A Streptococcuscus has undermined the routine use of antibiotic and show that the clinical based diagnosis alone is not reliable and rational use of antibiotics requires the use of other diagnostic methods such as throat culture and rapid antigen test [RATs]. Also in analyzing coagulase -positive Staphylococci antibiotic resistance, we can see increased cases of resistance against neomycin and clindamycin which indicates the necessity of rational treatment of patients afflicted by strep to coccal infections

Attitudes toward menopause among middle-aged women in Semnan, Iran

The menopause marks a major biological transition in the lives of all women.Understanding the attitude of women about menopause facilitates the implementationof public health policies that focus on improving women's health. This study wasdesigned to determine the attitude of a group of Iranian women toward menopausewith respect to sociodemographic variables and menopausal status.A cross-sectional study was conducted at Primary Health Centers of Semnan during2012. A total of 747 women aged 45-60 years were interviewed Sociodemographiccharacteristics and attitude toward menopause were collected through a structuredpretested questionnaire. The attitude scale consisted of 17 questions, each rated ona five-point Likert scale with a total score of 85 points.The mean [ +/- SD] age of women was 51.3 [ +/- 4,5] years. Women were classified aspremenopausal [38.4%], perimenopausal [16.9%], and postmenopausal [44.8%].he majority of respondents [63.5%] were illiterate or have had low level of education [<9 years], and 86.3% were unemployed. The mean [ +/- SD] attitude score was 53.3 [ +/- 6.8]. Most of the women [71%] had neutral attitude, 22,8% had positive, and only6.3% had negative attitude toward menopause. Menopausal status, educational level,marital status, place of residency, and employment were not associated with women'sattitude. In general, women's attitude toward menopause ranged from neutral to positive. Theattitude did not differ significantly on the basis of menopausal status, educational level,marital status, place of residency, and employment

[Predictors of single-dose methotrexate treatment failure in ectopic pregnancy]

Background: The use of Methotrexate [MTX] is a good and common practice for the treatment of women who were diagnosed early with ectopic pregnancy [EP]

The aim of this study is to determine the predictors of treatment failure with a single dose of MTX injection

Methods: In this quasi-experimental research, we studied 70 women with ectopic pregnancies who were treated with MTX, according to a single dose protocol from 2010 to 2013. EP was diagnosed whenever an intrauterine gestational sac was not identified by transvaginal ultrasonography [TVUS], accompanied by an abnormal rise or plateau in human chorionic gonadotropin [PHCG] concentration. Briefly, women with ectopic pregnancies were considered candidates for MTX treatment if they were hemodynami-cally stable; did not desire surgical therapy, agreed to weekly follow-up; and did not have hepatic, hematologic, or renal disease

A Patient was considered a treatment success [group 1] if her pHCG levels decreased <10 m lU/ml after the first dose of MTX. Treatment failure [group 2] was defined as the need for a second or a third dose of MTX or surgery. The following risk factors were compared between the two groups: serum pHCG on the days 1 and 4, a > 15% decrease in serum pHCG between the days 1-4 of the treatment, age, parity, gravidity, the size of the ectopic mass and the endo-metrial thickness

Results: The success rate of MTX treatment was 77.1%. There were no significant differences between the two groups in regard to the age, parity, gravidity, the size of ectopic mass and the endometrial thickness in vaginal sonography, but the mean serum pHCG concentration on days 1 and 4 was lower in the success group than the failure group. We also observed a > 15% decrease in serum PHCG in 80.9% of the women from the success group and in 38.5% of the cases whose treatment had failed. The presence of fetal heart activity was seen in only one patient and this patient's treatment failed. Two patients had previous history of ectopic pregnancy and the treatment of both ended in failure

Conclusion: Among women with ectopic pregnancies who were candidates for MTX treatment, a high serum PHCG concentration on the days 1-4 and also a < 15% fall in serum pHCG between the days 1-4 treatment, are the most important factors associated with the failure of the treatment with a single dose MTX protocol. It is better to use these factors for making decisions about the initiation of the treatment or the continuation of it

Association of Helicobacter pylori Infection with Hashimoto's Thyroiditis

Autoimmune thyroid diseases [ATD] are multifactorial conditions that result from genetic predisposition in combination with environmental risk factors. Helicobacter pylori infection as an environmental risk factor has been proposed to imitate the antigenic components of the thyroid cell membrane and may play a leading role in the onset of the autoimmune diseases, such as Hashimoto thyroiditis. The aim of this study was to investigate the association between Helicobacter pylori [HP] infection and Hashimoto's thyroiditis [HT]. The participants in this case-control study included 43 patients affected by Hashimoto's thyroiditis, and 40 healthy individuals without history of autoimmune disease as the control group. Anti HP IgG and anti-TPO antibodies were determined using ELISA method. Results were considered positive when the IgG anti-HP value was higher than 30 lU/ml and the anti-TPO autoantibody value was higher than 75 lU/ml. The mean TSH level was 18.3 +/- 16.8 lU/ml for patients and 2.8 +/- 1.2 lU/ml for the control group [P<0.001]. 46.5% of the patient group and 10.8% of the control group were infected with HP. The association between HP and Hashimoto's thyroiditis was statistically significant [Odds Ratio=7.2, 95%, Confidence Interval: 2.0- 28.8, P<0.001]. The findings show that, there is an association between HP and Hashimoto's thyroiditis. To establish a definite correlation between them, more detailed studies with a more specialized examination and precise consideration regarding species of HP, genetic polymorphism of the host and investigation of environmental factors are needed

Effects of simvastatin pretreatment on clomiphene response in clomiphene - resistant women with polycystic ovary syndrome

Objective: The aim of this study is to determine if simvastatin pretreatment would change Clomiphene response in Clomiphene citrate-resistant [CC-R] women with [PCOS]

Materials and methods: This quasi experimental study included twenty five Clomiphene resistant women with PCOS. All patients received cyclic oral contraceptives pills [OCR] [SOpg of ethinyl estradiol and 150microg of desogestrol] from the 5th day of their spontaneous or progesterone [P] induced menstrual cycle; in addition, they received simvastatin [20mg/day] from the first day of cycle for two consecutive months. Then, patients were given 100 mg Clomiphene citrate [CO] [Iran Hormone, Iran] for five days starting from day three of their menstrual cycles. The primary outcome measures were ovulation and pregnancy rates. The change in body mass index [BMI], the mean number of follicles > 18 mm, the mean of follicular size and endometrial thickness on the day of human chorionic gonadotropin [HOG] administration were secondary outcome measures

Results: Ovulation occurred in 5 out of 25 [20 %] patients, but none of the patients conceived in this study. No important change in BMI was observed after using simvastatin [0.28+1.13; p=0.228]. In all patients with ovulation, the number of follicles > 18mm was one. The mean follicular size and endometrial thickness on the day of HCG administration were 19.67 +/- 2.04 and 7.00 +/-1.34, respectively

Conclusion: In this study, we did not observe the favorable effect on ovulation and pregnancy rates with CC following of simvastatin pretreatment in CC-resistant PCOS women. So, further studies with a larger number of patients, higher doses of CC and more cycles are necessary to make this obvious

[Association between androgenetic alopecia and hyperlipidemia: a comparative study]

Androgenetic alopecia [AGA] is the most common type of progressive balding that appears with early loss of hair, chiefly from the vertex. There has been significant relationship between AGA with coronary artery disease and related risk factors, such as hypertension in some studies. The aim of this study is to investigate the association between androgenetic alopecia with hyperlipidemia. This cross-sectional study was performed on 112 patients with vertex type AGA [in male grade 3 or higher Hamilton-Norwood scale, and in female grade 2 or higher Ludwig scale] [study group] and 115 persons age and sex matched, with normal hair status [Normal group]. None of participants had diabetes mellitus, hypothyroidism, liver disease, kidney disease and none of them had history of smoking and using drugs with effect on serum lipids. They were 20-35 years old and their body mass index were 20-30. Blood samples were obtained following 12 hours fasting status and serum levels of triglyceride [TG], cholesterol, high-density lipoprotein [HDL] and low-density lipo-protein [LDL] were determined using standard laboratory methods. Total cholesterol greater than 240 or TG greater than 200 or LDL greater than 160 or HDL less than 40 in men or HDL less than 50 in women were considered hyperlipidemia. In androgenetic alopecia group 46.4% and 47% of normal group were female. Mean [ +/- SE] of total cholesterol [172.4 +/- 3.1, 148.8 +/- 3.1, P < 0.001], TG [133.6 +/- 5.5, 88.3 +/- 4.3, P < 0.001], LDL [96.4 +/- 2.9, 84.9 +/- 2.7, P = 0.004] and HDL [54.9 +/- 2.0, 45.5 +/- 0.9, P < 0.001] in AGA patients were higher than normal group. 46.4% of patients and 52.2% of controls had hyperlipidemia. Relationship between AGA with hyperlipidemia was not significant [P > 0.05]. The findings showed that there is no relationship between AGA and hyperlipidemia. Regarding to high levels of total cholesterol, LDL and triglyceride in AGA patients, it seems that, AGA increases risk of coronary heart disease. To determine a definite association between AGA and hyperlipidemia more studies are recommended

Relationship between leucocytosis and left ventricular ejection fraction in patients with acute myocardial infarction

<p><b>INTRODUCTION</b>Myocardial infarction (MI) is common and affects a significant number of people annually. Death occurs due to either arrhythmia or heart failure. As leucocytosis, especially elevated neutrophil count, is a hallmark of inflammatory reactions in patients with MI, we investigated the relationship between leucocytosis on admission and left ventricular ejection fraction (LVEF) in patients with acute MI (AMI).</p><p><b>METHODS</b>Patients with AMI were enrolled in a case-control study. Blood samples obtained in the first 24 hours after the onset of pain were analysed for cardiac enzyme levels and cell count. Echocardiography was performed on Days 3-5. Patients with LVEF < 45% were assigned to the left ventricular (LV) systolic dysfunction group (n = 69) and those with LVEF ≥ 45% were taken as controls (n = 69). All patients were matched for variables such as hypertension, diabetes mellitus, hyperlipidaemia, family history of cardiac disease, age and gender.</p><p><b>RESULTS</b>Leucocytosis was higher in patients with systolic dysfunction (47.8%) when compared with the controls (20.3%), and was significantly associated with the development of LV systolic dysfunction (p = 0.001). Similarly, neutrophilia was more common in patients with systolic dysfunction than the controls (6.6% vs. 34.8%), and was significantly associated with LV systolic dysfunction (p < 0.001). Monocytosis was higher in the controls than the systolic dysfunction group (40.6% vs. 33.3%; p = 0.378).</p><p><b>CONCLUSION</b>Leucocytosis and neutrophilia in the acute phase of MI are important predictive factors for the development of LV systolic dysfunction. Leucocytosis can be used for risk stratification of such patients.</p>

Gabapentin effect on pain associated with heroin withdrawal in Iranian crack: a randomized double-blind clinical trial

Gabapentin seems to be a safe and well tolerated medication for treating heroine dependence. This study examined the efficacy of gabapentin for relieving withdrawal-related pain due to heroin use. Sixty men were recruited from an inpatient psychiatric ward of Fatemieh hospital in Semnan and randomized to receive either placebo [n = 30] or gabapentin [1800 mg/day] [n = 30] for 7 days. Subjective Opioid Withdrawal Scale [SOWS] was measured as a self-administered scale for grading body pain at baseline, and on days 1, 2, 3, 4, 6, and 7. Mean of pain score had a significant decrease trend in both gabapentin and placebo groups. Pain severity during the most of detoxification duration was significantly lower in gabapentin group compared with the placebo group. It is suggested that gabapentin may have an effective role in removing heroin withdrawal-related pain

[Epidemiology of smoking in an Iranian population [Semnan province]: a population-based study]

Cigarette smoking is a known cause of systemic disorders such as bronchogenic carcinoma and cardiovascular diseases. The aim of this cross-sectional study was to estimate prevalence of smoking in 30-70 year old men in Semnan province in Iran. This survey was conducted in a sample population of 1695 men 30-70 years old, in October 2005 to February 2006 in both rural and urban areas of Semnan province. A multistage clustered sampling was performed with, first, 760 clusters [households] selected randomly using a systematic sampling technique. Then one or two more households in the neighborhood of each of the former households were also selected. Finally, in each household a 30-70 year old person was randomly selected and asked to complete a questionnaire. The overall prevalence of current cigarette smoking in men 30-70 years old was 24.1% [95% confidence interval: 22.1-26.1%].18.3% of them were daily and 5.8% occasional smokers. 26.8% of rural and 23.0% city resistant adults were cigarette smokers [P=0.053]. Prevalence of cigarette smoking in under 40, 40-49, 50-59 and >/= 60 years were 21.1%, 32.6%, 25.1% and 11.9%, respectively [all, P<0.001]. 19.7% of illiterates, 24.9% of primary, 30.8% of intermediate, 25.4% of high school and 11.8% of university level education were cigarette smokers[P<0.001]. 46.6% of them before, and 39.2% between 21-30 years have started cigarette smoking. Mean [ +/- SD] age for starting cigarette smoking was 24.1 +/- 8.0 years. Prevalence of cigarette smoking in Semnan, Damghan, Garmsar and Shahrood were 22.5, 23.2, 27.6 and 23.4% [P=0.554], respectively. Only 0.1% and 1.6% of them were pipe and tobacco smokers, respectively. 0.4% tobacco smoking was simultaneously with cigarette smoking. 15.2% non-cigarette smokers were passive smokers. Overall, 39.3% of Semnan province adults, aged 30-70 years, were active or passive cigarette smokers. Findings showed that prevalence of cigarette smoking in Semnan province in adults aged 30-70 years is high. Therefore, a community-based multiple strategies are required to combat with increasing rate of cigarette smoking and its complications

[Effects of intra-oral intake of different concentrations of sucrose on biobehavioral pain response to immunizations in infants]

An uncontrolled pain in infants can lead to permanent damage of the components of cognitive growth and development and change in response to painful stimuli. The aim of this study was to compare the effect of oral sucrose%20 and%50 on biobehavioural pain response to hepatitis B virus [HBV] vaccine injection in term newborns. In this triple blind clinical trial study, which was performed in Semnan Amir-Al-Momenin Hospital, 91 term infants were selected and randomly divided into three groups. Two minutes prior to immunization with HBV vaccine by intramuscular injection, 2 ml of 20% or 50% sucrose solution was given to the infants in, experimental groups, while, the infants in the control group were orally received only 2 ml of sterile distilled water. The pain response was measured by using Neonatal Infant Pain Scale [NIPS] tools before the administration of sucrose, immediately after injection and 5 min after injection. The results showed that the administration of 50% sucrose significantly reduces pain response in newborns immediately and 5 minutes after HBV vaccination [P < 0.05]. But the administration of 20% sucrose was effective only 5 minutes after HBV vaccine injection. The administration of 50% sucrose can effectviley reduce the pain due to HBV vaccination in infants.

[Evaluating the blood glucose measured via glucometry in diagnosis of hypoglycemia in neonates]

Hypoglycemia is one of the most prevalent problems seen in neonates and can lead to irreversible brain damage if not to be diagnosed in time. Today, the blood glucose is mostly checked by laboratory methods that have a significant delay and can result in many adverse effects such as vessel rupture. The goal of this study was to evaluate the value of the glucometry device in diagnosis of hypoglycemia in neonates. This study has been conducted over 156 hospitalized neonates in Amir al momenin Hospital, Semnan, Iran. The blood glucose in all cases has been simultaneously measured by both laboratory methods [glucose oxidase as the golden standard] and glucometer. These measurements along with the relevant data for neonatal risk factors were recorded in the checklist. The blood glucose measurements of less than or equal 35 mg/dL in first two hours after birth, less than or equal 40mg/dL in 3 to 24 hours after birth, less than or equal 45 mg/dL in more than 24 hours after birth are considered as hypoglycemic. 58 neonates [37.2%] were hypoglycemic.The measurement of blood glucose levels via glucometer for hypoglycemia detection had a high precision [Area under curve = 0.941, Standard error =0.018, P= 0.0001]. The optimum cut-off point yielded to equivalent of 51mg/dL. So that for fasting blood glucose of less than or equal 51mg/dL, sensitivity, specificity, positive, and negative predictive values were, respectively, 94.7%, 81.6%, 75.3%, and 96.4%. Findings show that, blood glucose levels measured by glucometry have good accuracy for diagnosis of hypoglycemia in newborns. Thus, it is recommended that in case of screening and frequent need of monitoring neonatal blood glucose, this device be used as a suitable replacement of laboratory methods.

[Treatment efficiency in children with severe to profound hearing impairment: a comparative study of general language stimulation and developmental-descriptive approach based on morphological changes]

In speech therapy, treatment efficacy includes 3 specific fields as treatment effectiveness, efficiency and effects. Treatment efficiency compares two approaches or more with each other. The aim of this study was to compare of two approaches: general language stimulation and developmental-descriptive approach. It has been done as an interventional-longitudinal study with14 participants [primary school students with hearing loss] for two educational years. All changes in different parts of language were assessed by decontextualized language test, storytelling, action verb and sentence writing in the end of each year. Total number of affixes in storytelling, derivational suffix in action verb test, expression of prepositions and adverb [location] as well as perception superlative adjective in decontextualized language test had statistically significant changes [P<0.05]. Findings show developmental-descriptive approach has more positive effects because of specificity of language treatment goals.

Acetyl salicylic acid resistance in patients with chronic stable angina and the correlation with coronary risk factors

To evaluate acetyl salicylic acid [ASA] resistance in patients with cardiovascular diseases and evaluate correlation with coronary risk factors. One hundred and twenty-four patients with stable coronary artery diseases [CAD] were enrolled in this cross sectional study from the outpatient clinic of the Department of Cardiology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran, between May 2008 and August 2008. All patients had prior history of cardiovascular disease and were under treatment of 80 mg daily ASA for at least 7 days. Aspirin resistance was measured by urinary 11-dehydro-thromboxane beta-concentrations with an enzyme immunoassay kit. Approximately 49.2% patients were resistant to ASA, 15.3% borderline response, and 35.5% were sensitive to ASA. Acetyl salicylic acid-resistant patients were more likely to be smokers and older ages [63% versus 45.4%] [37.7% less than 60 years, 53.7% between 60-69 years, and 63.3% aged >/= 70 years]. Other variables such as gender, diabetes mellitus, hypertension, cholesterol, triglyceride, high-density lipoprotein [HDL], low-density lipoprotein [LDL], and hemoglobin levels were not significantly associated with aspirin resistance. Acetyl salicylic acid resistance was present in a high number of patients with chronic stable angina. Moreover, advanced age and smoking had a direct influence on the aspirin resistance

[Serum lipids status and its disorders among 30-70 years old population in Semnan province, Iran]

Cardiovascular diseases are the most common cause of mortality and morbidity in new societies. Dyslipidemia is one of the main causes of coronary artery disease. Since there is not comprehensive information about this subject, we aimed to survey dyslipidemia in urban and rural communities/areas in Semnan province. An epidemiologic cross-sectional study was conducted among 3799 persons who were 30-70 years old in Semnan Province, Iran. Multistage cluster sampling was performed, and subjects were selected from urban and rural populations of Semnan, Shahroud, Garmsar and Damqan. Data were collected through questionnaires, then a blood sample was collected from selected patients with 12 hours fasting for evaluation of triglyceride [TG], cholesterol, high density lipoproteins [HDL] and low density lipoproteins [LDL] levels in urban and rural communities. Totally, 3799 persons enrolled in this study with mean age 41 +/- 10.2 years that 44.6% of them were male. High TG was seen in 29.1%, high LDL in 11.8% and low HDL in 30.7%. Prevalence of all kinds of dyslipidemia was higher in Shahroud. In conclusion, prevalence of dyslipidemia among 30-70 years old was higher than expected. So that, comprehensive preventive and educational programmes on lipid disorders and related diseases are necessary

[Association between skin tag and diabetes mellitus]

Skin tags are small, benign, soft and pedunculated skin tumors. A possible association with impaired carbohydrate metabolism has been suggested in previous studies, but the results are not conclusive. This study was performed in order to determine association between skin tag and diabetes mellitus. This study was carried out on 80 patients with skin tags as a case group and 80 patients without skin tags as a control group that they were referred to Semnan dermatological clinics. Then fasting blood sugar [FBS] were checked out in both two groups. In addition, height and weight were measured in all patients and body mass index [BMI] calculated for each of the patient. 43.8% and 55% of patients were respectively female in the case group and the control group. Age mean [ +/- SD] was 44.3 +/- 16.6 and 37.3 +/- 18.9 years in the case and control group, respectively. BMI mean [ +/- SD] index was 28.0 +/- 4.3kg/m2 in the patients with skin tag, whereas, it was 25.5 +/- 5.1 kg/m[2] in the patients without skin tag [P=0.001]. Patients with skin tag had higher frequency of diabetes than patients in the control group [27.5% vs. 5%] and also the case group showed a higher frequency of pre diabetes than the control group [20% vs. 15%]. The probability of presence of diabetes mellitus in the patients with skin tag was 6.82 times more than the patients in the control group [Odds ratio=6.82, 95% Confidence interval: 2.06-22.56, P=0.002]. Our data suggest that there is an association between skin tag and diabetes mellitus. Therefore, screening of patients with skin tag is recommended for early diagnosis diabetes mellitus

[Relationship between alopecia areata and serum ferritin, TIBC and serum iron levels]

Alopecia areata is a common disease that affects the life quality of patients. Iron deficiency has been suggested to play a role, but its effect is controversial. We decided to evaluate the relationship between alopecia areata and serum ferritin, TIBC and serum iron levels. In this study, 30 patients who were diagnosed with alopecia areata by a dermatologist and 30 healthy individual as the control group were evaluated. All the cases [patients and control group] were referred to Semnan Central Lab for the following laboratory tests: CBC test [WBC, HGB, PLT, MCV, MCH, MCHC], serum ferritin, serum iron and serum TIBC. Mean serum ferritin [P<0.001], serum iron [P<0.001], transferin saturation [P<0.001] and mean hemoglobin [P=0.002] were significantly lower in patient group comparing to the control group. Mean TIBC [P<0.001] was significantly higher in patient group in compared with the control group [P<0.001]. Our findings indicate that there is a relationship between alopecia areata and low serum ferritin, low serum iron and increased TIBC. Therefore evaluation of serum iron status and treatment, if needed, with iron supplements is recommended in alopecia areata patients

[Effects of cognitive therapy, drug therapy and combined therapy in improvement of major depression]

Major depression is one of the most common psychological disorders that exert a high impact on the life of patients and their families. There are many treatment methods for depression. The purpose of the present study was to determine the effects of cognitive-behavior therapy and drug therapy on improvement of major depression. This clinical trial was performed in Semnan [Iran] in 2008. 56 Patients with major depression were selected and assigned into 4 groups. All of the patients completed the Beck test and a demographic questionnaire before start of interventions as pre test. The post test was completed after the end of intervention. Findings showed that all of the methods have significant effects on improvement of depression, but combined therapy [cognitive behavioral therapy + drug therapy] is the best [P<0/05]. According to findings of this work, we suggest that team work approach consists of psychologists and heart Psychiatrists can be suggested for treatment of the patients with depression