Investigation of the awareness of the students of Shiraz dental school concerning the patients' rights and the principles of ethics in dentistry

Statement of Problem: Deliberating the patients' rights is one of the major human ethical and legal principles which can be investigated through the agenda of professional and medical ethics accordingly, the students of dentistry have to be educated about this issue and achieve the necessary skills in deliberating and concerning the patients' rights

Purpose: The present study aimed to investigate Shiraz dental students' awareness and attitude regarding the patients' rights as well as the principles of dental ethics in order to design methods for organizing and improving the ethics in dentistry

Materials and Method: The present descriptive-analytical study was conducted on 111 students of different departments of Shiraz Dental School. The study data were collected through a questionnaire designed based on the patients' rights charter in Iran, ADA ethical codes which are internationally acceptable in the field of dentistry, and the guidelines of the ministry of health, treatment, and medical education [No. 140588]. Then, the data were entered into the SPSS statistical software and analyzed

Results: Of all participants, 21.6% were men and 78.4% were women. According to the results, 71% of the students were acquainted with the patients' rights. In addition, the patients' characteristics, including gender and nationality, were not important for 58.6% of the students

Conclusion: The study findings showed that 71% of the participants were acquainted with the patients' rights Establishment of a comprehensive, integrated charter in Iran is needed. With rapid development of medical sciences, new issues appear which necessitate taking into account the mutual rights of the physicians, people, and patients

Expansion of human marrow derived mesenchymal stem cells and their transdifferentiation potential

The ability of mesenchymal stem cells [MSCs] to differentiate into other cell types makes these cells an attractive therapeutic tool for cell transplantation. In order to provide a source of human MSCs for autologus cell-based therapy, we have expanded MSCs from the bone marrow and analyzed the biological identities and transdifferentiation potential. The bone marrow of healthy donors was aspirated from the iliac crest. The adjacent cells expanded rapidly and maintained with periodic passages until a relatively homogeneous population was established. The identification of these cells was carried out by differentiation potential into the osteocytes and adipocytes. Transdifferentiation of human MSCs into hepatocyte-like cells was undertaken in response to a specific culture condition. The differentiation of MSCs into osteoblast is determined by deposition of a mineralized extracellular matrix. Adipocytes are identified by their morphology and staining. Hepatic cells were demonstrated in vitro functions characteristic of liver cells. We have defined conditions under which human MSCs can be isolated and expanded from human bone marrow. These cells can be amplified about 10[8]-fold in 6 weeks, and are capable of transdifferentiation into the cells of another developmental lineage

Tolerance induction by CD40 silenced dendritic cells through antisense

One of the valuable tools for inhibiting the specific gene expression is antisense technique. To determine T cell responses, co-stimulatory molecule expression on the antigen presenting cells is important. In the present study, the effects of high affinity antisense against CD40 mRNA on the function and phenotype of DCs [dendritic cells] were investigated. The DCs were separated from the mice spleens and then cultured in vitro. By means of lipofectamine 2000, the antisense was delivered into the cells and the efficacy of transfection was estimated by flow cytometry. Also, the mRNA expression and protein synthesis were assessed by real time PCR and flow cytometry, respectively. The DCs were transfected with 6 M antisense and 2 l lipofectamine 2000. The percentage of CD40 expression in DCs was 38%. The results showed that CD40 expression is reduced in DCs to 22% and 24%. By annexine V and propidium iodine staining, we could evaluate the viability of the transfected cells. The inhibition of CD40 gene expression was associated with the increase in IL-4 secretion. This shifted the DCs to stimulate Th2 cytokine production from the allogenic T cells. In addition, in the MLR, the DCs without CD40 expression showed poor allostimulatory effects. This finding is valuable in the study of the costimulatory molecules of DCs. These data demonstrate that direct interference of the cell surface expression of CD40 at transcriptional level by antisense confers tolerogenecity potential of DCs. This approach is a useful tool through which DCs become tolerogenic and can be studied as a potential therapeutic option for the autoimmune diseases and allograft rejection

Survival of breast cancer in Southern Iran

Breast cancer is the most frequent cancer in women in the western world. With breast cancer now affecting one in ten women, it is important to know how this disease burden is shared among women. This study was undertaken to determine the survival rate of breast cancer in southern Iran. From December 2001 to December 2006, among 8000 hospital-based registered cancer cases in southern Iran, 863 individuals with breast cancer entered our study. One, 5, 10 and 15 year-survival rates were estimated by Kaplan Meier function. Mean age at the time of diagnosis of breast cancer was 46.3 years [SD=11.5]. About 25.4% had a previous family history of cancer in their first and 13.8% in their second degree relatives. About 92.5%, 71.3% and 41.4% of breast cancer cases underwent surgery, radiotherapy and chemotherapy, respectively. Nearly 11.7% of patients had a history of exposure to chemical materials. About 32.3% were passive and 19.2% were active smokers. Totally, one, 5, 10 and 15 year-survival rates were 97%, 67%, 45% and 25%, respectively. The survival rate had a significant negative correlation with age at the time of diagnosis. The survival rate of women with breast cancer in southern Iran seems to be identical to other parts of the country and stands between western and eastern European countries

Evaluation of clinical pathology knowledge in the clinical residents of medical sciences

Clinical pathology tests have very important role in the diagnosis, treatment and follow up of patients. Attention to all of the steps in test processing including, 1] patient preparation, 2] sampling, 3] specimen transferring, 4] enough knowledge of lab interference, 5] finding test pitfalls, and 6] ability of test interpretation regarding patients' clinic is very important in using a precise and accurate test. This study tried to investigate the above parameters among the residents. In this study, knowledge of the residents of internal medicine, pediatrics, general surgery and gynecology were evaluated in 29 routine clinical pathology tests including biochemistry, hematology, microbiology, coagulation and immunology. In this study, the median score of all of the residents was 44.88 of 100. The median score of residents in the same degree, but different course, showed significant difference and the scores of residents of internal medicine and pediatrics were higher than residents of general surgery and gynecology [P < 0.02]. The median scores of third and forth year internal medicine residents were higher than their peers in the first and second year [P < 0.04], but this difference was not seen in other residents. The final results of all of the residents were below than 50 percent. This study reveals the inadequate knowledge of residents about the clinical tests. It also shows that the trend to residency of general surgery and gynecology has caused less attention to clinical tests in medical students. In addition, it shows that residents do not receive sufficient education about clinical pathology during their residency. We suggest that the curriculum of education of general medicine during clerkship and residency should be changed with regard to clinical pathology

relationship between blood group type and visceral leishmaniasis in Iran

Visceral leishmaniasis [VL] or Kala-azar is still a common parasitic infection among children in Iran. This study was performed to investigate the relationship between blood group type and VL among Iranian patients. were enrolled. The bone marrow materials of 249 children who were clinically suspected for VL were provided from the posterior iliac spine by Jamshidi`s needle. LD bodies were identified in all cases and diagnosed as VL. The distribution of blood group type of all infected patients was compared with that of a control group of normal donors [2490]. There were 198 males and 51 females among VL patients. In both the VL and control groups, the maximum percentage was found in blood group O and minimum in blood group AB. Our results showed that the blood group was not a risk factor in the occurrence of VL. The ABO-Rh blood groups were not associated with the occurrence of VL in Iranian patients

Cancer occurrence in Fars Province, Southern Iran

Cancer is a significant health problem in the developing countries, and one that is likely to increase in future. Due to unavailability of data concerning cancer during the last 15 years in our area and young age structure of our country, this active hospital-based study was undertaken to determine the occurrence of cancer in Fars Province, southern Iran. Data including face-to-face interview with patients and a survey of their medical and demographic records in relation to all invasive cancers were actively collected from 1990 to 2005 from four university hospitals. Among 2993 cases of registered malignant neoplasms presented by site and sex, the crude incidence [CRs], and age-specific incidence and age-standardized incidence rates [ASRs] per 100,000 were determined, using the world standard population. Over a 5-year period, 1495 and 1620 cancer cases were registered in males and females, respectively, while breast cancer was at the top of 10 cancers in both sexes. With regard to the top 10 types of cancer, there was a remarkable difference between the results of our study and the estimated cancer incidence for Iran by Globocan 2000. Ethnic, racial and environmental factors may explain these differences but more studies in a longer time span are needed to clarify the causes

Primary hydatidosis of uterus and left fallopian tube

Hydatid cysts are known to occur in most organs especially in the endemic areas. However, its occurrence in uterus is extremely rare and it mostly occurs as a secondary involvement. Herein we reported on a 25-year-old woman with primary involvement of the uterus and left fallopian tube. The patient presented with a colicky abdominal pattern and fever and was admitted to the Emergency Ward

Effects of magnesium sulfate on bleeding time in premature labor

Several studies have shown that administration of magnesium sulfate prolongs the bleeding time. To investigate such effects in pregnant women in Shiraz, southern Iran. This study was conducted on 30 pregnant women aged between 18 and 32 yrs, with a gestational age of 20 to 37 weeks, who presented to Hafez and Zeynabiyeh Emergency Units affiliated to Shiraz University of Medical Sciences between January and August 1999, with premature labor pain or complaining of abdominal or back pain. The patients received tocolytic treatment with magnesium sulfate [MgSO4] in absence of any contraindication. The blood pressure and bleeding time of patients were measured upon admission to the labor room and before any intravenous infusion of MgSO4. Platelet count and serum magnesium level were also determined for each case. The aforementioned measurements and samplings were repeated following administration of 10 g MgSO4. A significant difference was observed between the mean serum magnesium level and mean arterial blood pressure, before and after MgS04 infusion. The mean bleeding time showed an increase of 27 seconds [15%] after infusion of Mg. Nevertheless, this value still remained in the normal range of 120-420 s. A direct relationship was found between the increase in serum magnesium level and the bleeding time. No change was observed in the mean platelet count. Magnesium therapy is associated with an increase in bleeding time in pregnant women, with no change in platelet count. This increase had no clinical significance and dose-independent

Avicenna's viewpoints on fever and it's comparison to modern medicine

In his book "Canon in Medicine [Al-Ghanoon]", Avicenna has specified a chapter containing two sections pertaining to fever. After defining fever and explaining it's different stages, he divides it into three types: hectic fever, infection-induced fever and daily fever. After accurate attention to the patient's history and key-points in examination, he focuses on fever signs and its treatment regarding each type of the three. In this article, we intend to discuss Avicenna's views on fever in comparison to those of modern medicine

Anthrax: pathological aspects in autopsy cases in Shiraz, Islamic Republic of Iran, 1960-2001

Anthrax, like tuberculosis, shows a new epidemic spread in industrialized countries, revealing some ambiguous aspects to the disease and providing new challenges to medicine. Shiraz University of Medical Sciences has records of 7130 autopsies performed in the past 40 years, 33 of which are anthrax cases. We reviewed all the pathology slides of these cases and classified the organs involved in a search for unrecognized microscopic findings. The most common cause of death was sepsis, caused by organ involvement and direct cytotoxicity of Bacillus anthracis, in addition to its exotoxin production. Novel findings included hyaline membrane formation in respiratory system cases that is similar to acute [adult] respiratory distress syndrome and evidence of primary gastrointestinal involvement, showing the ability of the organism to pass the gastric barrier

Accuracy of intraoperative frozen section diagnosis and touch imprint cytology: study on 1000 consecutive cases

Frozen section and touch imprint cytology are important diagnostic procedures for surgeons during operation and must be accurate if the patient is to receive maximum benefit. To assess the accuracy of intraoperative pathologic consultation including frozen section and touch imprint cytology during a five year period [1995-2000], a retrospective survey of 1000 consecutive cases of frozen sections performed by the staff pathologists of Shiraz Medical School and 211 touch imprint cytology cases related to some of these sections were studied focusing on accuracy. Also some 462 cases of frozen sections related to the 1000 samples were reviewed by the staff pathologists without complete clinical data and without any data from the surgeon to determine the importance of the surgeon pathologist relationship. The gold standard method for comparing the results of frozen section and cytology was permanent tissue diagnosis. The overall accuracy of frozen section for the 1000 cases was 93.6%. The accuracy of cytology was 93.1%. Also the accuracy of 462 frozen sections which were reviewed without clinical data was 85%. In conclusion, frozen section diagnosis is a highly accurate method. Touch imprint cytology is also a specific method and can be used in areas where facilities of frozen section studies are not available. The frozen section method achieves its highest accuracy when there is cooperation between the surgeon and pathologist and when used in combination with touch imprint cytology

Changing epidemiology of esophageal cancer in Fars province, Iran

Esophageal carcinoma is one of the most lethal gastrointestinal [GI] malignant tumors worldwide. The disease is known to have a high incidence in northern Iran; however, its condition in the South is not much clear. In this retrospective study we investigated the epidemiology and time trends of esophageal carcinoma in Fars Province, South of Iran. In a retrospective study, we reviewed pathologic reports of all laboratories in Fars Province, South of Iran, from March 1997 to March 1999 to find cases of esophageal carcinoma. Annual and average incidence in different age groups were calculated for both sexes, based on four censuses results. Esophageal carcinoma was the third most common GI cancer in Fars, with an average incidence of 2.95 per 100,000 in the population older than 15 years. The incidence of esophageal carcinoma was found to drop by 64% during the study period. This was mainly due to the decreased incidence of squamous cell carcinoma. Females developed squamous cell carcinoma in relatively younger age as compared to males. Our region in the South of Iran is one of the low incidence areas of esophageal carcinoma as compared to that of northern borders of the country and other parts of the world with some special features

enigma of human T-cell leukemia virus type-1 [HTLV-1] infection in Iran

Human T-cell lymphotropic virus type-I [HTLV-I] was the first human retrovirus associated with malignancy. The prevalence of HTLV-I infection varies significantly in different regions of the world. In this study, the prevalence of HTLV-I infection among ethnic Jews living in Shiraz, South of Iran, was investigated. 286 blood samples were obtained. HTLV-1 antibody assay on serum samples was done by standard ELISA method. Western blot method was applied for confirmation of borderline results. None of the subjects was found HTLV-I seropositive using both ELISA and western blotting methods. Our preliminary results indicate that HTLV-I is not endemic in Jewish people living in Shiraz, the southwest of Iran

Cornoary artery atherosclerosis: post mortem evaluation of 100 cases in Shiraz

Cardiovascular diseases remain the chief cause of death in the world and atherosclerosis is the principal cause of myocardial and cerebral infarction and accounts for the majority of these deaths. Atherosclerosis of the coronary artery is a major cause of sudden and unexpected death but the incidence of this disease would be different according to geographic area. Our main goal in this study was to evaluate coronary artery disease especially atherosclerosis in the region and compare the results with those of the literature. We examined the hearts of 100 consecutive forensic pathology cases which were referred from medicolegal center to the pathology department of Shiraz University of Medical Sciences. Age of the patients was between 12 to 79 years, and most of them were in the young and middle age groups [75%]. In young, middle and old age groups the incidence of normal coronary artery was 52.5%,18 and 4.8% respectively. Incidence of more than 75% narrowing of coronary arteries in young, middle and old age groups was 0, 25% and 43% respectively and it shows that the incidence of coronary disease is increased with age. Frequency of atheromatous lesion and critical narrowing [more than 75%] according to vessel was as following: Artery. Atheromatous lesion. Critical narrowing. Left anterior descending 56% 35%. Right coronary 51% 27.5%. Left circumflex 49% 25%. According to the above-mentioned findings, frequency and severity of atheromatous lesions were most commonly present in the left anterior descending, right coronary and left circumflex arteries in descending order. Calcification with atherosclerotic lesion was not present with narrowing of less than 25%, but if the narrowing was more than 75% its frequency was between 66 to 100%. The most interesting finding was absence of myocardial infarction with more than 75% narrowing and single, double and triple vessel involvement

Colo-pleural fistula: a rare complication of carcinoma of colon

A 72-year-old male, a known case of non-insulin-dependent diabetes mellitus, was admitted for recurrent empyema. He was found to have developed a colo-pleural fistula, secondary to a small primary carcinoma of the splenic flexure of the colon. This rare complication should be considered in the case of chronic treatment-resistant empyema

Ki-1 [cd 30] positve anaplastic large cell lymphoma a morphologic and immunologic study in four cases

Four cases of peripheral lymph node enlargement are presented. All cases proved to be non-Hodgkin's lymphoma, positive for Ki-1 [CD30] and negative for Leu Ml [CDI5] antigens. The diagnosis of Ki-1 [CD 30+] anaplastic large cell lymphoma was made, all cases showing the distinctive nodal histopathologic features, The morphologic of the lymph node as well as the immunologic markers are discussed

Detection of human T-cell leukemia virus carriers in thalassemia patients in Shiraz: a brief report

The presence of human T-cell leukemia virus [HTLV-I] carriers in Fars province, southern Iran, was investigated. The sera of 160 randomly selected thalassemia patients, a well - known high-risk group for transfusion-associated viral infections, were screened for detection of antibodies to HTLV-I by the enzyme-linked immunosorbent assay method [ELISA], positive results were confirmed by Western blot [WB] analysis. Patients were ages 6 to 24 years, from Shiraz and nearby cities. Four patients were found to be seropositive