Evaluation of thyroid dysfunction and thyroid autoantibodies in patients with Vitiligo

Background and Objective: Vitiligo is one of the most frequent skin disorders with a prevalence of 1-2% in different populations. Although many theories have been suggested for its pathogenesis, but the most popular hypotheses is the role of autoimmunity in Vitiligo. This study was done to evaluate the thyroid dysfunction and thyroid autoantibodies in patients with Vitiligo

Methods: This case-control study was carried out on 45 patients with Vitiligo and 45 age- and sex-matched healthy individuals as control group. Age, gender, duration of the disease and type of Vitiligo were collected through a standard questionnaire. Thyroid autoantibodies including thyroglobulin antibody, anti- thyroglobulin and thyroid peroxidase antibody, and anti-TPO thyroid hormones Tetraiodothyronine [T4], Truodothyronine [T3] and thyroid stimulating hormone [TSH] in Vitiligo patients and healthy volunteers were measeared

Results: Serum level of T4 was significantly reduced in Vitiligo patient compared to controls [P<0.05]. Serum level of T4 in 20% of Vitiligo patient and 2.2% of control cases was less the normal level. Anti-TPO in 14 [31.1%] of Vitiligo patient and 6 [13.3%] of controls were higher than normal range [<60 lU/m] [P<0.05]. Serum level of anti- thyroglobulin was significantly higher in those with Vitiligo in compared to controls [P<0.05]

Conclusion: This study showed that the thyroid dysfunction particularly hypothyroidism and anti-TPO is more common in Vitiligo patients

[Effectiveness of cognitive- behavior religious training on feeling of hopelessness, worthlessness and dissatisfaction on nurses' life]

Introduction: Nurses are important resources in a community health system. Therefore, attention to mental health to this group seems to be essential. The aim of this research was to determine the effect of cognitive- behavior religious training on hopelessness, worthlessness and dissatisfaction on nurses' life

Materials and Methods: This study was quasi-experimental, in which 66 employed nurses in the Shahid Hashemi Nejad Hospital in Mashhad were selected and divided into two groups of experimental and control. The intervention was formed of 10 sessions of 90 minute long. Sessions were held three days a week for the experimental group. The instrument for collecting data was [Identity Crisis Questionnaire] Content validity was measured by 12 experts and reliability was determined by Cronbach's alpha [alpha=0.93]. The questionnaires were completed before and after a month of intervention. The data was analyzed by SPSS/18 and use of descriptive and analytical statistics includes paired and independent and covariance

Findings: Overall mean scores of hopelessness, worthlessness and dissatisfaction on nurses' life was 44.12+/-11.76 before intervention and 33.47+/-14.18 one month after change of intervention [P<0.001]. While control group did not have any significant change, but overall mean scores of one month before and after had a significant change [P<0.06]

Conclusion: Cognitive- behavior religious training is inexpensive, effective, essential and safe method to help mental health of nurses. It is recommended to enhance mental health of nurses and improve the quality of care, from this type of training is used

[Satisfaction of physicians and midwives participating in the rural family physician and insurance scheme with the plan in Isfahan province, 2010]

Job satisfaction is one of the most important factors in maintenance of a professional person and the job success, increasing the personal efficiency and the quality of services. On the other hand, it is a tool in the hands of managers in order to maintain the staff in their jobs. The aim of this descriptive study was to investigate the satisfaction of physicians and midwives participating in the family physician scheme with the plan. The study population was made up of 221 physicians and 144 midwifes. The tool was an author made questionnaire certified by experts as a standard, valid and reliable scale via content validity measurements through a pilot study. The average satisfaction of physicians and midwives was 44.34% while the highest satisfaction was 65% with the location of services and the lowest was 30.6% with the financial issues. In relation to the financial affairs, physicians were more dissatisfied than midwives, so satisfactions were increased by the increase in the amount of salaries. Over 4 years of implementation of family physician plan, the physicians and midwives satisfaction was shown to be still low. It is necessary to consider re-programming in the scheme in order to increase the amount of payments and create more motivational factors for physicians as well as to reduce working hours for midwives and establish appropriate levels of payments for them

[Comparison of contrast sensitivity and visual acuity after phacoemulcification with aspherical and spherical hydrophilic IOL implantation]

To compare aspheric and spherical hydrophilic intraocular lenses [IOLs] in terms of contrast sensitivity and visual acuity in photopic and mesopic conditions. This triple-blind randomized clinical trial was performed on 40 eyes of 40 patients at Al-Zahra Eye Center, Zahedan, Iran. The eyes were randomized to standard phacoemulsification procedure with spherical [Adapt, B and L] or aspherical [Adapt AO, B and L] IOLs. All operation were performed using the Alcon Infinity system by one surgeon and the IOL was placed within the capsular bag. Two months postoperatively, best corrected visual acuity [BCVA] in mesopic condition with brightness value of 8cd/m2 as well as contrast sensitivity with BCVA in mesopic and photopic conditions with and without glare of 3cd/m2 were determined using the Metrovision Monelci Contrast Sensitivity Device [53.8lux]. Quality of vision was compared between the two groups by comparing average contrast sensitivity at frequencies of 0.5, 1, 2, 5, 10 and 20 cycle per degree using t-test. There was no statistically significant difference between the study groups regarding BCVA or contrast sensitivity at different frequencies under photopic or mesopic conditions with pupil diameter of 5mm, and under photopic or mesopic conditions with glare. Considering the risk of visual loss due to IOL decentration. Besides contrast sensitivity, other factors such as price and ease of insertion and access should be considered for determining the IOL of choice in cataract surgery

[Prevalence and multi-drug resistance of enteropathogenic Escherichia coli [EPEC] isolated from children under 5 years of age with diarrhea in Kashan Shahid Beheshti hospital during 2009-10]

Enteropathogenic Escherichia coli [EPEC] is the most important diarrheagenic agent among children in developing countries. However, recent studies have shown its prevalence in developed countries. The purpose of this study was to evaluate the prevalence and multi-drug resistant [MDR] of EPEC isolated from children under 5 years of age with diarrhea hospitalized in Kashan Shahid Beheshti hospital during 2009-10. In this descriptive study 313 fecal specimens were collected using rectal swab method from all children under 5 years of age with diarrhea hospitalized in Kashan Shahid Beheshti Hospital during 2009-10. Specimens were examined by PCR test to determine the eae Gene for detection of EPEC pathotype. The isolated multi-drug resistance pattern of EPEC was evaluated by disk diffusion agar. The antimicrobial disks used were ampicillin, nalidixic acid, ceftriaxone, ciprofloxacin, cefalexin, ceftazidime, streptomycin and imipenem. Of all 178 E. coli cases 51 [28.6%] EPEC pathotypes were isolated. The prevalence of EPEC was higher in children under 1 year of age. MDR rate in EPEC was 70.6%. The exact application of antibiogram test is necessary before antibiotic prescription for complete treatment and prevention of diarrhea caused by multi-drug resistance agents

[Comparison of ophthalmic artery velocity in eyes with NAION and normal fellow eyes]

To compare ophthalmic artery velocity in eyes with nonarteritic anterior ischemic optic neuropathy [NAION] with that of normal fellow eyes. In this case-control study, 20 patients with unilateral NAION and disease onset less than 8 weeks, were enrolled. Using color Doppler imaging, mean, maximum systolic and end diastolic ophthalmic artery velocities were evaluated. The results were compared between the fellow eyes. Twelve men and 8 women with a mean age of 54.6 +/- 11.8 years were included. Mean interval between disease onset and velocity measurements was 27.5 +/- 12.8 days. Mean [18.5 +/- 0.8 vs 19.9 +/- 2.8], maximum systolic [37.9 +/- 4.09 vs 39.7 +/- 3.1] and end diastolic [10.3 +/- 2.1 vs 12.3 +/- 2.5] ophthalmic artery velocities in NAION eyes were significantly less than that of the normal fellow eyes [P=0.01, P=0.001 and P<0.001, respectively]. No significant difference was found in subgroup analysis of patients with and without diabetes, and with and without systemic hypertension. NAION seems to be associated with changes in ophthalmic artery velocity

[Intra-operative hemorrhage by blunt versus sharp expansion of the uterine incision at cesarean delivery]

Reduction in amount of bleeding during cesarean delivery has a considerable impact on maternal health. To determine whether the method used to expand the uterine incision for caesarean delivery affects the incidence of intra-operative hemorrhage. This was a clinical, single blind trial, carried out at Kosar Hospital, Qazvin [Iran] during 2003-2004. The study population consisted of 1000 women who were randomly subjected to cesarean delivery with sharp or blunt expansion method. Demographic information, pre- and 48 hr post-operative hemoglobin and hematocrit levels were recorded. The data were further analyzed using SPSS software, chi-square pair, and t-test. Compared /vixh the blunt group, change in mean hematocrit [4.18 +/- 2.8 versus 3.36 +/- 2.7 or 10.9% versus 8.92%, p<0.001], incidence of postpartum hemorrhage [57.6% versus 42%, p<0.005] were significantly greater in the sharp group. In cesarean delivery, sharply expanding of uterine incision significantly increases intraoperative blood loss

[Frequency of beijing genotype in mycobacterium tuberculosis strains isolated from tuberculosis patients in city of Mashhad]

The Beijing genotype is one of the most important strains of Mycobacterium tuberculosis involving outbreaks of tuberculosis in various parts of the world. Unsought regarding Beijing genotype in Iran, is the reason this study is undertaken in order to evaluate the frequency of this genotype in Mashhad. This descriptive study was carried out on 113 M.tuberculosis Specimens isolated from patient with pulmonary tuberculosis in hygienic centers, located at Ghaem and Imam Reza hospitals in the City of Mashhad. In this study, Beijing genotypes were detected with PCR-based method, and spoligotyping. Results were processed with descriptive statistics and CI was evaluated. Beijing genotype was detected in 8 specimens of all the 113 isolated M.tuberculosis strains [7.1%, CI 95%, 2.36-11.84]. Out of 8 isolated specimens, 5 isolates belonged to Afghan patients and 3 specimens were isolated from Iranian patients. Out of 8 patients that were infected with Beijing genotype, 2 patients were male and 6 patients were female. Although the rate of Beijing family is low in Iran, in comparison to other Asian countries, however, one needs to adopt a suitable policy in order to prevent its spread