[Personality, intellectual and emotional state of patients with borderline personality disorder]

It is possible to explain the great discrepancy in the personality and psychopathology of patients with borderline personality disorder [BPD], partly, on the basis of differences in their profiles of personality, psychopathology, intellectual and emotional state. The aim of the current study was to assess these items in the patients with BPD. This was a descriptive-comparative study. Among the patients with diagnosis of BPD referring to Sanandaj health centers, 30 accepted to participate in this study. They were assessed by use of MCMI-III, emotional state questionnaire, and The WAIS-R. The results were compared with those of their matched, non-clinical group. SPSS software was used for data processing and data were analyzed by profile analysis and one way ANOVA. Profile analysis showed significant differences between the groups in all of the tests. Comparison of the single scales showed differences in a wide range of variables of personality, intellectual and emotional state. The results indicated an important role for the emotional elements in the development of personality disorders and also similarity of many of the clinical symptoms in these patients. Intellectual elements are also useful for explaining a fundamental part of the symptoms of BPD. These variables seem essential for understanding cognitive, affective and behavioral aspects of the patients with BPD

[Comparison of omega-6 and omega-3 fatty acids ratios in cow's milk between Iranian conventional and industrial production systems]

Cow's milk contains two families of fatty acids; omega-6 and omega-3, which are crucial in human health. It has been shown that the ratio between these two families is connected to the higher risk of chronic diseases. Therefore the ratio between them is more important than their quantity [The most desirable ratio is 1:1]. This study was aimed to quantify fatty acids profile and determine the ratio between omega-6 and omega-3 fatty acid families in cow's milk produced fewer than two different systems [rural and conventional]. Twenty cow's milk samples [10 rural and 10 conventional] from the dairy farms in Khorramabad city-Iran were collected. Fatty acids profiles were determined using gas chromatography. Conventional milk had higher omega-6 [2.12 +/- 0.4% vs 1.65 +/- 0.2%] and lower omega-3 [0.16 +/- 0.03% vs. 0.21 +/- 0.04%] in comparison with the rural milk. The ratio of omega-6 to omega-3 in rural milk was lower [8 to 1] than that in conventional milk [13 to 1] [p<0.01]. This study showed that milk produced in rural system has a better ratio of omega-6 to omega-3 therefore is healthier for human nutrition. It is also worth to mention that the ratio of omega-6 to omega-3 in cow's milk produced in both systems is far from the acceptable ratio in human nutrition

Infection of MSCs by adenovirus expression system expressing NRF2 as a cytoprotective factor

Poor viability of Mesenchymal Stem Cells [MSCs] following transplantation is one of the major challenges in their therapeutic application. Manipulation of MSCs by the genetic engineering method is one of the strategies used to protect the cells against cytotoxic microenvironment. However, maintaining multi differentiation capacity of MSCs following manipulation is important. We investigated if the manipulation of MSCs with NRF2 affects the multi differentiation capacity. MSCs were isolated from bone marrow. NRF2 was isolated and TOPO cloned into the pENTR vector. The recombinant vector was transferred into pAD/CMV/V5-DEST vector by gateway technology. Recombinant adenovirus was produced in AD293 cells, followed by being infected into MSCs. Expression of NRF2 was verified by RT-PCR. The NRF2 engineered MSCs were exposed to stress conditions followed by the evaluation of the cells viability and apoptosis. Finally, NRF2 expressing MSCs differentiation into osteoblast and adipocyte lineages was studied. NRF2 was successfully expressed in MSCs. NRF2- MSCs differentiation into osteoblast and adipocyte lineages indicating overexpression of NRF2 does not affect the differentiation property of MSCs. Expression of NRF2, a well known cytoprotective factor, by using adenovirus expression system does not intervene in the differentiation capacity of MSCs. NRF2-MSCs might be applicable for stem cell-based cell therapy in future

Impact of education on nutrition and exercise on the level of knowledge and metabolic control indicators [FBS and PPBS] of gestational diabetes mellitus [GDM] patients

Complications of gestational diabetes mellitus [GDM] have drastic effects on the health of the mother and fetus from different aspects. Sufficient knowledge and self care skills, especially regarding nutrition and exercise, play a major role in the management of GDM. This study aimed at determining the impact of education on nutrition and exercise awareness and metabolic control indicators [fasting and post prandial blood sugars] among a group of gestational diabetes mellitus [GDM] patients, referred to hospitals of Shiraz University of Medical Sciences. In this interventional study, 61 class A1 gestational diabetes mellitus [GDM] patients were selected through easy sampling and randomly assigned to two groups of experimental and controls. Before the intervention, we measured metabolic control indicators and levels of knowledge in both groups, using laboratory tests and a specifically designed and validated written test [containing 34 multiple choice questions respectively, with a reliability of KR20: 0.81]. Educational interventions were then implemented for about 6 hours weekly for the experimental group, and the expected outcomes were measured in both groups immediately following and again two weeks after the end of the intervention. Finally, the data collected were analyzed by SPSS software, version 11.5, using independent sample t-test, Chi-square and Bonferroni. The results of data analysis revealed that after educational intervention the means for knowledge and post-prandial blood sugars [1 and 2hpp] were significantly different in the experimental group [p<0/001]. Results show that the effectiveness of the educational intervention in the improvement of the level of knowledge and metabolic control indicators, emphasizing hence the need for appropriate interactive education among such groups

Ovarian cyst enlargement in a 14 year old female with persistent ascities, severe hypothyroidism and elevated serum CA-125 level

A 14 year old female complained of abdominal pain and distention with vomiting. The physical exam showed thyroid enlargement and ascites. The imaging evaluation demonstrated a large ovarian cyst. Laboratory tests depicted hypothyroidism and marked elevation of Carbohydrate antigen 125 [CA-125] levels. As the bone age was 10 years, more retarded than the chronological age, Van Wyk and Grumbach syndrome was suspected. Treatment with thyroid hormone was initiated and the condition improved dramatically with disappearance of symptoms and signs 5 weeks later

[Comparative effects of massage therapy and bandage on shoulder pain, edema and dysfunction after the modified radical mastectomy]

Mastectomic patients experience complications such as edema of the operated hand, shoulder pain and dysfunction. This study was conducted to compare the effects of manual lymph drainage and low pressure bandage on shoulder pain and dysfunction after modified radical mastectomy. In this clinical trial study, 90 women with radical mastectomy referred to the oncology ward of Imam Khomeini hospital [Tehran] were randomly assigned to three groups: the massage, massage+bandage and control groups. Groups were trained how to use manual lymph drainage massage and low pressure bandage. Shoulder pain intensity and dysfunction were measured at 7 and 30 days post-surgery. Edema was measured at 24 hours post-surgery and also 30 days post-intervention. Data were analyzed using descriptive and inferential statistics [one-way ANOVA and Kruskal-Wallis]. There was no statistically significant difference among three groups in the means of three measured variables [the arm circumference, shoulder pain intensity and dysfunction] before the intervention. Moreover, the results showed a significant reduction in the means of shoulder pain intensity and dysfunction among the three groups on the 30th intervention day [P=0.001], but the difference was not significant in the mean of arm circumference. Lymphatic drainage massage and low pressure bandage are effective in reducing post-mastectomy complications

[ effect of forceps type on results and complications of transbronchial lung biopsy]

Lung biopsy via the bronchus [TBLB] is among the routine diagnostic procedures for pulmonary diseases and is performed using either of two different kinds of forceps: cup and alligator. The purpose of this study was to compare the efficacy of two kinds of forceps on quality of biopsy as well as the side effects of TBLB. This was a prospective, observational and double-blind study in which four samples were biopsied from each patient via TBLB. The sample characteristics were recorded based on size, number of alveoli included, diagnostic value, and the side effects such as pneumothorax and bleeding. A total number of 44 patients and 176 biopsies were evaluated. Twenty one patients [47.7%] were males and 23 [52.3%] females. While considering the size of samples, of 88 biopsies via alligator forceps, 21.6% were small, 45.5% medium, and 33% large. Corresponding results for the cup forceps were 43.2% small, 29.5% medium, and 27.3% large. From 88 biopsies taken using alligator forceps, 18.2% were found to have diagnostic value whereas in the case of cup forceps the diagnostic value was 23.9%. While no significant pneumothorax was seen with alligator forceps it was observed in 9% of the cup forceps procedures. Significant bleeding was seen in 1% of the alligator forceps and 5.7% of the cup forceps procedures. Comparing two types of forceps regarding the effect on results of TBLB, alligator forceps produced larger samples and less side effects. There was no significant difference in diagnostic value between two procedures

Evaluation of acute renal failure in neonates bedridden in Neonatal Intensive Care Unit [NICU] in Ghaem hospital

Acute renal failure [ARF] is defined as an abrupt severe decrease in glomerular filtration rate [GFR]. ARF is commonly seen in neonates admitted to neonatal intensive care unit. In this article, we have studied incidence, etiology, predisposing factors, management and mortality in neonates affected by ARF. A descriptive study was took placed at NICU of Qhaem hospital over a period of one year, between December 2005 and December 2006. 750 neonates were evaluated for ARF, according to having two of three following criteria: 1-oliguria: U/A<1/2cc/kg/h 2-BUN>20 mg/dl 3-Cr>1/2 mg/dl Patients were assessed for B.S [blood sugar], BUN, Cr, urine index [FENa, Uosm, BUN/cr, U/P osm, RFI, Una], ABG and kidney sonography. According to patient's response to the fluid therapy and kidney sonography, they were divided into two pre-renal and renal failure groups. Data were analyzed using descriptive statistics. From 750 neonates admitted in NICU, 38 patients [5%] demonstrated ARF. Pre-renal failure was found in 29 newborns [76.4%] and 9 neonates [23.6%]. Predisposing factors for ARF were as following: Asphyxia [42%], Respiratory distress syndrome [RDS] [26.7%], sepsis [13%], sever dehydration [13%] and congenital heart disease [CHD] [5%]. Nine infants [23.6%] were died. Mortality was significantly higher in intrinsic renal failure [88%]. ARF is still an important etiology of mortality in newborns. Diagnosis of predisposing factors [prematurity, asphyxia, RDS, ventilation and careful kidney control in newborn is essential in this problem

Mumps myocarditis as a cause of neonatal cardiogenic shock

The mothers may be infected during pregnancy with infectious agents. Mumps induced myocarditis, especially endocardial fibroelastosis, was previously a common disease of infants but is rare now. A 25 day old male infant admitted to the intensive care of our hospital because of cardiogenic shock. Further studies revealed ischemic electrocardiograms, poor ventricular function, and positive results by polymerase chain reaction [PCR] technique for mumps virus. Regarding this case, although is very rare but mumps myocarditis should be included in the differential diagnosis of left ventricular dysfunction in neonatal period

Relationship between serum lactate levels and morbidity outcomes in cardiovascular patients after CABG

To evaluate the relationship between postoperative serum lactate levels and outcome in patients undergoing open heart surgery and verify the clinical impact of hyperlactatemia[HL] and low lactemia[LL] during CABG in terms of postoperative morbidity and mortality rate. Descriptive study. Sina Heart Centre [non-university hospital in Isphan, Iran] from fall 2005 to fall 2006. Hundred consecutive patients undergoing cardiac surgery with cardiopulmonary bypass were admitted in the study. Post operative lactate concentration and other metabolic parameters were determined. Evaluation of lactate concentrations, pH values and base excess during the first 24 post operative hours were assessed. Hyperlactatemia was defined as a peak arterial blood lactate concentration exceeding 3 mmol/l. Pre- and intraoperative factors were tested for independent association with the peak arterial lactate concentration and HL. The postoperative outcome of patients with or without hyperlactatemia was compared. We found positive effect of time on lactate and pH levels. On day 1, HL and LL patients had comparable lactate concentrations, which remained significantly higher than those of HL patients. HL is frequent after cardiac surgery. Based on our analyses, postoperative measurement of lactate level appears to be clinically useful. A threshold of 3 mmol/L at ICU admission was able to identify a subpopulation of patients at higher postoperative risk. Sequential determinations identified patients at higher risk for major complication and thus the need for closer surveillance of their therapeutic responses and their metabolic consequences

[Prevalence of alloimmunization against RBC antigens in thalassemia major patients of Lorestan province in 1383]

Thalassemia major patients should continuously receive blood to survive. Permanent blood injection will expose patients' immune system to a broad spectrum of new antigens located on the surface of injected RBCs. Continuous exposure to foreign antigens may provoke antibody production against them in the patients who lack those Ags. This phenomenon is termed alloimmunization and can cause problems for preparation of compatible blood for transfusion. 65 patients were studied in this research. At first, questionnaires eliciting information about age, race, date of blood injection, splenectomy, presence of any underlying diseases, and any certain drugs[in patients' records] were filled out by all patients. For alloantibody screening, patients' serum samples were tested by the panels prepared in IBTO. Phenotypes of RBCs for Ags of ABH and Rh[D, C, E, c, e] were also determined by relevant antisera. Out of 65 patients, only one case [1.53%] had been allommunized. The age range of males and females were 13 +/- 6 and 13 +/- 5 respectively. All of the patients were of Lurish race. The first blood transfusion in all of them occurred at the age below 3. Seventeen subjects were splenectomized. The reasons for low prevalence of alloimmunization against RBCs in thalassemia major patients may pertain to similarity of patients and donors by descent, blood transfusion before the age 3, and splenectomy in a few patients. Identification of alloantibodies by using the panel cells was the best method to provide patients with antigen negative and compatible blood for transfusion

Analgesic effects of intra-articular fentanyl, pethidine and dexamethasone after knee arthroscopic surgery

Many different methods have been used in an effort to provide adequate analgesia after knee arthroscopic surgery. In this study analgesic effect of intra-articular fentanyl, pethidine and dexamethasone was compared. In a double blind randomized study 48 male patients undergoing knee arthroscopic meniscectomy were allocated to groups receiving intra-articular fentanyl 50 ig or pethidine 20 mg or dexamethasone 8 mg at the end of arthroscopy during general aesthesia. Postoperative pain scores using visual analogue scale were measured and also analgesic requirements and the time of ability to walk were recorded. Pain scores at one, two, six and 24 h after intra-articular injection were not significantly different for fentanyl and pethidine but were higher significantly for dexamethasone at all four mentioned times. The mean average time of ability to walk was significantly longer for dexamethasone. The analgesic requirements during the first 24 h after intraarticular injection were significantly greater only for dexamethasone too. Better postoperative analgesia, less pain score and shorter time to walk were achieved by fentanyl and pethidine in comparison to dexamethasone but the results were not significantly different between fentanyl group and pethidine

[Couples' Knowledge and attitude about sexuality in pregnancy]

Alteration in pattern of sexuality is known to be impressed by couples' believes about women's physical and psychological changes during pregnancy. The objective of this study is to evaluate the knowledge and attitudes of couples about sexual relations during pregnancy. In a descriptive study from February to April 2005, two hundred sixty six consecutive pregnant women referring to a university hospital were asked to answer a questionnaire containing questions their sexual status and some demographic data. In 122 cases the answers of the spouses was collected also. The answers were compared in divided groups according to age range, duration of marriage, parity and educational status. Fifty five percent of men and fifty eight percent of women had a negative attitude about sexual relations during pregnancy, and 60% of men and 75% of women presented incorrect knowledge about sexuality during pregnancy. Main reasons for decreased sexual relations in pregnancy were mentioned to be dysparaunia, and the fear of trauma to the baby, abortion, membrane rapture, preterm labor and infection. As couples' knowledge and attitudes about sexuality affect their general sexual behavior during pregnancy it is crucial to provide proper consultation regarding sexual relations in prenatal care services

Breath-holding spells: an analysis of 43 cases

Breath holding spells, very often misinterpreted as epileptic seizures, are most common in children aged 6 months to 6 years of age. In this investigation, we sought to prospectively document the natural history of breath holding spells [BHS] among children with cyanotic, pallid and mixed type BHS referred for neurological consultation. This was a cross-sectional study in which a total of 43 children [23 boys, 20 girls] with BHS, admitted to the out patient clinic of the Children's Hospital Medical Center, between Sept 1998 and June 1999, were enrolled. A structured interview was under taken at the time of initial consultation to confirm BHS and its type, associated phenomenon, family history, sex and age at initiation of spells. Laboratory, electroencephalographic and electrocardiographic tests were done. Patients were between 1.7 and 42.8 months [mean age 18.4 months]. In 76.8% of cases, BHS began during the first 12 months of age. Anger and pain were the most common triggering factors [65.1%].A positive family history of BHS was identified in 51% and parental consanguinity was found in 30% of cases. The spells were cyanotic in 79.1% [34 children]. 78% of cases were iron deficient and 53% of cases had iron deficiency anemia. The results of this study emphasize the role of genetic factors in BHS; measurement of hemoglobin and serum ferritin is recommended all such cases

correlation between serum lactate at the time of admission and the final outcome of neonates admitted in the intensive care unit, an initial assessment

An assessment of neonates in order to pinpoint early recognition of circulatory failure, institution of appropriate treatment, and in assessing response in sick neonates in intensive care units and their outcome is one of the major concerns of the neonatologists. None of the routine assessments such as ABG, and scoring systems [SNAP II PE, CRIB] are highly sensitive in this regard. Tissue hypoperfusion, resulting from any threatening illnesses, leads the neonate to anaerobic metabolism and lactate generation. Blood lactate concentration has been used widely as reliable indicator of tissue hypoxia in this regard. We evaluated the possible relationship between arterial blood lactate level at time of admission and the outcome of 50 neonates who were admitted in neonatal intensive care unit [NICU] of Children's Medical Center in 2004. Other parameters such as clinical findings, SNAP II PE and CRIB scores, ABG indices, a possible need for mechanical ventilation and the duration of assisted ventilation were also considered along with the predictive value of blood lactate concentration. In alive neonates, lactate levels [21.3 +/- 10.6 mg/dl] were significant, comparing to those who died [42.0 +/- 26.5 mg/dl] [p=0.037]. The significant correlation between blood lactate concentrations and 02 saturation in ABG [p=0.02], and lactate levels and respiratory system involvement were relatively correlated [p=0.049] Blood lactate concentrations could be a useful tool in the prognosis of outcome in sick neonates in the intensive care units

22; 22 Robertsonian transolocation in a patient with repeated abortions

Robertsonian translocation is one of the major chromosomal re-arrangements and comprises 18% of total genetic abnormalities. It occurs between different chromosomes and chromosomal segments and less than 0.2% of individuals carry a symptomatic chromosomal rearrangement. However, the t[22;22]is a rare phenomenon which mainly manifests as familial monosomy or trisomy. We report on a 30-year old woman who was referred to a pathological laboratory in Kerman, Iran. She had no mental retardation, but suffered from repeated abortions. On the basis of GTG-banding and karyotyping, it was found that a Robertsonian translocation in the chromosome 22;22 was the primary cause of this syndrome

comparison of controlled release ketoprofen and piroxicam in treatment of rheumatoid arthritis and osteoarthritis

The efficacy and tolerance of controlled release ketoprofen 200 mg, and piroxicam 20 mg were compared in a placebo controlled, randomized, double blind cross-over clinical trial in 40 patients with rheumatoid arthritis and osteoarthritis. All patients received both drugs for two weeks and placebo for two weeks sandwiched between them. Placebo was also given for the first week of the trial to serve as a washout period. Two patients did not complete the study because of ineffectiveness of treatment. Both drugs were found to be effective, though ketoprofen demonstrated significant differences in its favour, as judged by the degree of pain at rest and on passive and active movements, joint tenderness, 15 meters walking time, the number of paracetamol tablets consumed as "rescue" analgesic and patient's and investigator's preference. Controlled release ketoprofen seems to be an effective and well tolerated anti-inflammatory analgesic in both rheumatoid arthritis and osteoarthritis

Management of displaced supracondylar fractures of humerus in children

Thirty children with displaced Supracondylar fractures of humerus were studied between the ages of 3-16 years. Group I included 8 children who reported soon after injury and were treated by open reduction and internal fixation. Group II patients [10] had presented 2 weeks after injury and were managed by callusoclasis and POP in extension. The patients in group III [12] sought advice after 6 months of injury with cubitus varus deformity and were treated with osteotomy. The group I revealed excellent functional and cosmetic results. The children in group II mostly developed some limitation of movements while patients in group III had satisfactory correction of cubitus varus deformity. In conclusion, the treatment of Supracondylar fractures of humerus gives proper results only after sound clinical judgment, correct surgical approach and good team work between orthopaedic and medical rehabilitation departments