[Comparative defense style used by nurses in stressful situations]

Introduction: Nursing is a stressful occupation that its related tensions could affect individual spiritual health. Therefore, defense style against stress is very important for nurses. The aim of this study was comparative defense style used by nursing personnel in stressful situations, in Abadan College of Medical Sciences

Materials and Methods: This descriptive study was carried out at the Abadan College of Medical Sciences. The study population consisted of 100 nurses from Abadan and Khorramshahr hospitals' that was selected by purposive Sampling method. Data were collected by questionnaires include demographic data and [Defensive Styles Questionnaire-40] that consist of three parts of mature defense style, neurotic and immature. Cronbach alpha of the questionnaire was 0.82 and data were analyzed using SPSS/18 software. Appropriate statistical analysis such as one way ANOVA, Pearson correlation coefficient and t-test were employed to analyze the collected data

Finding: The results showed that 67.3% of Taleghani Hospitals and 67.2% of Vali-e-asr hospitals' Nurses used mature defense style as defense mechanism. The mean score for mature defense style was 11.55???2.4 which illustrates that most nurses used this type of defense style

Conclusion: Although the results of this study showed that most nurses' in front of occupational exposure to stress used appropriate and mature defense mechanisms but around one - third of them used inappropriate defense mechanism. Teaching defense style to nurses to cope with anxiety and stress is suggested for future study work

Effect of hydroalcoholic extract of Avena sativa L. on morphine withdrawal signs in male mice

Background and Purpose: It showed that antidepressants may reduce the abuse potential of opioid. In other hand, studies showed avena sativa has antidepressant and sedative properties. So the aim of this study was to investigate the effect of ethanolic extract of Avena sativa on morphine withdrawal signs in male mice

Material and Methods: In this experimental study forty male NMRI mice [20-30 g] were randomly divided into 5 groups of 8: control groups received morphine and normal saline [10ml/kg] and other groups received ethanol [3%] and different doses of ethanolic extract of Avena sativa [50,100 and 200mg/kg] .Morphine dependency was induced using a four- day schedule method with 50, 50, 75 and 50 mg/kg dosing respectively. In fourth day 2 hours after single dose of morphine, naloxone was injected [5 mg /kg] and withdrawal signs were recorded with number of jumping and diarrhea, grooming, wet dog shake, teeth chattering, writing, climbing as scores of 0 to 3 during 30min.The data were expressed with one-way ANOVA for quantities and Mann-Whitney U test for qualities data's and they were analyzed with SPSS 15 and P values less than 0.05 were considered significant

Results: The present study findings showed that all doses of ethanolic extract_ of Avena sativa compared to control group, significantly and dose- dependently decrease the number of jumping in morphine dependent mice [56.12 +/- 6.46, 40.0 +/- 5.33 and 31.5 +/- 2.5 respectively]] P<0.05 and P<0.01 respectively].Grooming and teeth chattering also decreased with all doses of extract [P<0.05]. Wet dog shakes, climbing and rearing significantly decreased only by high doses [200mg/kg] of extract. Diarrhea also decreased with 100 and 200 mg/kg of extract [P<0.05]

Conclusion: Findings of present study showed that hydroalcoholic extract of avena sativa attenuate morphine withdrawal signs .But, Further studies need to be carried out to better understanding of their mechanism

[Effects of ciliary neurotrophic factor on oligodendrocyte progenitor cells differentiation and induction of opalin, olig expression in the cuprizone induced multiple sclerosis mice]

Oligodendrocytes are myelinating cells in the central nervous system [CNS] which develop from oligodendrocyte progenitor cells [OPCs]. Opalin is a unique molecular marker for mature and myelinating oligodendrocyte. Olig1/2 plays a regulatory function in the differentiation of OPCs to oligodendrocyte. Ciliary neurotrophic factor [CNTF] has been shown to play an important role in the proliferation and maturation of oligodendrocytes. In this study the effects of CNTF on Opalin, Olig1/2 expression in the cerebral cortical extracts of Cuprizone induced multiple sclerosis [MS] has been investigated. The mice were treated by Cuprizone for five weeks in order to induce MS. The mice were then divided into 3 groups. The first group was injected subcutaneously [SC] by CNTF in the amount of 2 microg/kg BW. The second group [SHAM] was injected SC by phosphate buffered saline [PBS] and the third group was left without injection as the control group. After five weeks the mice were killed and the cerebral cortex was harvested and the expression of Opalin and Olig1/2 was studied by Western blotting. The results from this study show that the expression of Opalin, Olig1/2 was significantly increased in the CNTF injected group as compared to the other groups. It is concluded that CNTF enhances Opalin, Olig1/2 expression and may play important role in the pathophysiology of MS. It is also concluded that CNTF may be a regulator in the differentiation of oligodendrocyte from OPCs

Correlation between the ankle - brachial and toe - brachial indexes and coronary artery disease in patients with type 2 diabetes

Atherosclerotic coronary vascular disease [CVD] is a major cause of mortality and morbidity among diabetic patients. The ankle-brachial pressure index [ABI] is a simple screening procedure used in primary care settings for high risk populations, such as in diabetic patients, in whom medial arterial calcification results in falsely elevated ABI, which complicates?? the value of ABI in predicting CVD. The aim of this study was to determine whether ABI or Toe-brachial index [TBI] abnormalities can be used to identify asymptomatic type 2 diabetic patients with CVD. In this case control study, 91 patients with Type 2 DM were selected. All the patients, who had documented evidence for presence or absence of CVD, completed a questionnaire regarding medical history, following which TBI and ABI were measured using a handheld ultrasound Doppler. ABI values less than 0.9 and TBI less than 0.7 considered abnormal. Forty-four persons [patient group] had documented CVD and 47 had normal angiography [control group]. ABI <0.9 was present in 13.6% of the patient group and in 8.5% of control group; TBI <0.7 was present in 34.1% of the patients group and 23.4% of controls. There was no significant difference between abnormal ABI and abnormal TBI in the patients or and controls. Sensitivity and specificity of abnormal results in prediction of CVD was 13.6% and 91.4% for ABI and 34% and 76.5% for TBI. Our study shows lack of sensitivity of ABI and TBI in identifying diabetic patients with CVD due to accelerated atherosclerosis

[Incidence, severity and risk factors for retinopathy of prematurity in premature infants with late retinal examination]

To determine the incidence, severity and risk factors for retinopathy of prematurity [ROP] in premature infants with late retinal examination at Farabi Hospital from 2001 to 2006. In a cross-sectional study, hospital records of premature infants who were examined later than 9 weeks after birth were reviewed for possible risk factors of ROP including gender, singleton or multiple gestations, gestational age [GA], birth weight [BW], oxygen therapy, blood transfusion, phototherapy, and respiratory distress syndrome [RDS], as well as the age at initial examination. From 693 infants referred for ROP screening, 191 [27.6%] had late retinal examination at mean age of 144.8 +/- 158.4 [range 64-1460] days. Of these 191 infants, 75 [39.3%] had different stages of ROP, 58 [30.4%] had stage 4 or 5 disease and 27 [14.1%] had stage 5 ROP in both eyes which were untreatable. GA and BW were associated with development of ROP [P<0.001]. The high prevalence of premature infants with late retinal examination and high incidence of severe ROP necessitates prompt intervention to optimize referral and early screening of premature infants

[Evaluation of diagnostic value of fine needle aspiration in thyroid nodules]

Thyroid diseases particularly nodular lesions are among the most common diseases of human. Approximately 5% of the populations have palpable thyroid nodules which are detected in the routine Autopsy. Nearly 95% of thyroid nodules are benign wherease malignant nodules include 5% of them. Fine needle aspiration [FNA] has been recognized as a simple, inexpensive and available procedure for rapid diagnosis. The objective of this study was to determine the value of FNA in thyroid diagnosis. In this retrospective research, 536 patients with thyroid nodules reffered for FNA or hospitalized for thyroid surgery in Imam Reza Hospital from March 2002 until March 2005 were studied. Individual and laboratory data were gathered in a questionnaire and analyzed by descriptive statistics. This study included 107 men and 429 women and the average age of patients was 40 years. Out of 536 patients 12.7% had malignant, 70.3% benign and 8.6% yield suspicious results and 2.4% of FNAs were insufficient. Comparing the results of FNA and biopsy, FNA had the specificity of 89.5%, sensitivity of 91.5%, and accuracy of 93.7%; negative and positive predictive values were 80.9% and 95.5% respectively. These results reemphasized that, FNA is a simple and non invasive procedure and if performed carefully and evaluated by an expert pathologist is of high sensitivity and specificity

[Effect of hyperthyroidism on bone mineral density in premenopausal women]

Hyperthyroidism is a state of high bone turnover, but there is controversy about its effects on bone mineral density. It is more common in females [F: M ratio 10:1]. Since post-menopausal women are potentially at risk for osteoporosis because of aging and estrogen deficiency and because hyperthyroidism is more common in females, this study was done to determine the effects of hyperthyroidism on bone mineral density [BMD] in premenopausal thyrotoxic women. In this case- control study 50 women with untreated hyperthyroidism [age- range 20-50 yr] from outpatient endocrine clinics in the years 2004 - 2005 were selected. Patients who used drugs or had diseases that affect bone mineral density were excluded. After history taking and physical examination, thyroid function tests, PTH, phosphorus, calcium, alkalin phosphatase, fasting plasma glucose and creatinine were measured and then bone densitometry by LUNAR [DPX-IQ] device was performed. One hundred and ten age- and weight - matched healthy women from participants in Iranian Multicenter Osteoporosis Study [IMOS] were selected as controls. SPSS version 11.5 was used for data analysis and P value less than 0.05 cosidered as significant. Mean of age, height and weight was similar in patients and controls. Forty seven cases [94%] had Graves' disease and 3 cases [6%] had toxic solitary adenoma. Mean duration of disease before diagnosis was 6.02 +/- 4.38 months. There was no significant difference in mean of bone mineral density in vertebral column [p=0.83] and also in femural neck [p=0.74] between patients and controls. There was no correlation between bone mineral density in vertebral column and also in femural neck with serum levels of T4, T3, TSH and FT4I. There was no correlation between bone mineral density and duration of disease before diagnosis and also between bone mineral density and age. Hyperthyroidism is a known state of high bone turnover, but in hyperthyroid premenopausal women with disease of short duration and without other risk factors of low bone mass, bone densitometry could not be recommended as a required routine measurement

[Prevalence and prognostic relevance of sick euthyroid syndrome in intensive care unit patients in Emam Reza Hospital]

Altered thyroid function in patients with non-thyrodial illness is a usuall finding and these biochemical changes called sick euthyroid syndrome [SES]. Our propose from this research is to estimate the relative frequency of SES and prognostic relevance of alteration in thyroid function indices in critically ill patients whom admitted in ICU. This prospective analitical study was preformd in Imam Reza Hospital intensive care unit patients. A specimen of venous blood was collected within the first 24 hours of admission for the evaluation of the baseline thyroid function indices and second specimen was collected at the time of patient death or discharge from ICU. T4, T3 [RIA] T[3] RU [RIA method], TSH [IRMA] and free T[4] [Direct one step RIA] were measured for all patients There were 29 males and 21 females, with age range of 16 to 83 years and mean age of 44 years [ 44+21.9]. Thirthy three patients [66%] showed evidence of SES and 17 patients [34%] were as non SES group. Mortality rate in SES and non -SES group was 24 and 3 patient respectively [72% vs. 17.6%, P < 0.01]. The commonest profile of thyroid indices was isolated low total T[3] [type I SES], and then combined low total T[3] and T[4] [Type II SES]. We found low [T3] [type I] in 51% of patients, and low T[3] and T[4] [type II] in 49% of them Relative morality rate have not any difference in two groups. Comparison of mean values of thyroid indices between single system and multi system illness groups showed statistical difference in TSH [P= 0.05] and FT4. [P=0.031] Comparison of thyroid indices between two survived and non survived group showed statistical difference in T3 [p = 0.047] and T[4] [P=0.036].Predictive value of normal T3 with good outcome measured 82% against 54% for normal T4. Relative frequency of SES in our patients was 66% and in them thyroid hormones have statistical relation with final outcome and severity of underling illness

[ role of HbA1c in the diagnosis of gestational diabetes mellitus]

Gestational Diabetes Mellitus GDM is the most common metabolic disorder during the pregnancy with numerous fetal an maternal complications.It seems that the frequency of GDM is increasing so it necissitates a greater attention and more study in this field. The aim of this research is to find an alternative or at least an adjuvant method for diagnosis of GDM which is traditionally made by the time consuming and cumbersome 3 hour oral glucose tolerance test. This research is a prospectively designed study on pregnant women who were in the 24[th] to 32[nd] week of gestation. The main purpose of this study is to defining the role of HbAlc [HPLC method] in the diagnosis of GDM in comparison with the 3 hour Glucose Tolerance Test [GTT], according to carpenter- coustan criteria. 105 cases with a mean age of 29 years and an age range of 18 to 50 years were in the following groups:43 persons normal,15 had impaired glucose tolerance [IGT] and 47 were in GDM group, range of HbAlc [mean +2SD] in these three groups were:%3.66%5.8,%2.81-%7.45 and%2.79-%8.91 respectively. There was a significant difference [p-value<0.05] between the means of HbAlc in normal, IGT, and GDM groups but due to the wide range of variations in persons with GDM, it wasn't possible to determine a suitable lower cutoff and only the upper cutoff of%5.85 for discriminating patients with GDM from other groups especially normal persons was achieved. This cutoff was able to diagnose%38 of GDM without any normal one [no false positive result]. The most correlation exists between HbAlc with GTT3hour [r = 0.55] and fasting blood glucose [r = 0.504]. Using the upper cutoff of%5.85 for HbAlc is able to discriminate persons with GDM who have higher than this value from normal ones, but due to the wide range of variations in lower values in person with GDM and overlapping of it with the normal values,there is not a suitable lower cutoff [with high specificity and sensitivity]