Quality of life in patients with bipolar 1 disorder: is it related to disorder outcome?

Bipolar 1 disorder [BID] and its treatments have shown to be associated with deep impacts on patients' subjective feelings and quality of life [QOL]. There are also some comments about impact of these feelings on course and outcome of patients with BID. This study was aimed to evaluate quality of life in patients with BID and to assess its relationship with course of disorder. Fifty patients with BID were recruited based on the Structured Clinical Interview for DSM-IV Axis I Disorders [SCID-I] from May 2008 and followed for 12 months. Quality of life and mood disorder recurrence were assessed through World Health Organization Quality of Life and SCID-I tools respectively at baseline and after 6 and 12 months. Repeated j measures analysis and logistic regression were used to analyze the independent effect of QOL and demographic factors on BID recurrence. Fifty patients [66% male; 48% never married; 48% in primary school level] with mean +/- SE age and age of BID onset 33.8 +/- 1.5 and 26.6 +/- 1.1 years were studied. They had 3.4 +/- 0.6 episodes already. Twenty eight percent suffered from recurrences during the follow-up. The QOL scores at baseline, after 6 and 12 months were 70 +/- 1.8, 69.6 +/- 1.1 and 73 +/- 1.3 respectively. There were no significant change in QOL and its sub-domains during the follow-up [P=0.37]. QOL showed no independent relationship with BID recurrences [P>0.1]. No change in the QOL during the follow-up could denote lack of effectiveness of routine interventions on this factor. Also, short-term follow-up might be concerned as the f possible reason. Of prime importance is to consider quality of life independently in treating patients with bipolar disorder

Bronchial anthracosis: a potent clue for diagnosis of pulmonary tuberculosis

Occupational exposure to carbon, silica, and quartz particles are predisposing factors for bronchial anthracosis. In some cases anthracosis may be associated with mycobacterium tuberculosis. This study aims to investigate the clinical, radiographic, and bacteriologic findings in bronchial anthracosis patients and its association with tuberculosis, This is a prospective study conducted between 1998 and 2001, A total of 919 patients underwent diagnostic bronchoscopy for pulmonary diseases. Of these, 71 patients showed evidence of bronchial anthracosis, 32 [45.8%] males and 39 [54.2%] females, age range, 30-92 years. The distinctive clinical features, nature of bronchoscopic lesions, and radiologic findings were analyzed prospectively and summarized, Bacteriologic studies and results of laboratory examinations were also assessed, Forty-one [57,8%] patients had positive smears or cultures for mycobacterium tuberculosis. Of 71 patients with bronchoscopic evidence of pulmonary diseases, 30 had previous occupational exposure, and 41 stated no previous exposure, Cavitary lesions on chest radiography, positive purified protein derivative tests and high ESR were more prevalent in tuberculous patients than the others. Bronchial anthracosis was caused by active or previous tuberculous infection. Detailed examinations for the presence of active tuberculosis should be performed in patients with such bronchoscopic findings in order to prevent the spread of tuberculosis and to avoid unnecessary invasive procedures

[Designing a registration system for suicide in Iran]

The goal of the present study was to design a registration system for recording suicide in Iran, capable of designing identification pathways, registration, and report and follow-up of suicide cases and deaths due to suicide. Through library assessments and surveying suicide registration systems in other countries [Denmark, India and WHO], potential methods of suicide in Iran were identified; also, potential methods of identifying suicide cases in the country were designed and finalized subsequent to group consultation. Suicide registration forms were designed, using the collected data. In this system: 1- The Health and Treatment Network is considered to be the appropriate site for the collection of data related to suicide, 2- Instances of suicide deaths and suicide attempts will be completely registered, 3- Data will be gathered from treatment centers and other contributing centers in general monthly forms, 4- Mental health attendants will enter the data into the computer system each month, in the suicide registration center affiliated to the health and treatment center, 5- The system will be primarily executed in two universities, 6- Training of target group [managers and personnel] in the primary stages of execution is important. The launch of the system for recording suicidal behavior in the country is the first essential step in the control and prevention of suicide

[Geographical distribution of human resources in mental health provision system in 2007]

The present research was carried out with the aim of providing a geographical map and the distribution of indices related to the distribution of human resources in the mental health system in Iran according to regions covered by different medical universities. This study was carried out using the data present in mental health system reports in the year 2007. Subsequent to the adjustment of indices, data were presented by drawing descriptive and interpolated maps using Arc GIS 9.2. Also, the amount of each evaluated index, minimum, maximum and standard deviation of each index in different areas were reported. In 2007 the nationwide means of covered population to total population of the country, covered urban population to total urban population, covered rural population to total rural population, proportion of covered health centers, to total health centers, proportion of covered health and treatment rural centers to the total, proportion of covered urban health and treatment centers to the total, and the proportion of covered health headquarters to the total were 54.8%, 36.9%, 96.2%, 97.5%, 97.1%, 50.4%, and 41.4% respectively. The individuals providing mental health services comprised: 29282 assistants in nursing, 6529 health workers, 4595 trained general practitioners, 61877 health messengers, 692 psychiatrists, 27 child psychiatrists, 126 psychologists [56 clinical, 70 other], 652 professionals with master's degree in psychology [183 clinical, 469 other], 651 social workers, and 214 psychiatric nurses. There is favorable distribution of specialized human resources in the country's health system, however, there is an disparity between the distribution of specialized human resources and covered population

[Obstetric outcomes in pregnant women with and without uterine leiomyoma]

Background: Uterine leiomyomas [myomas] are the most frequent benign uterine tumors, several studies have suggested that each leiomyoma arises from a single neoplastic cell within the smooth muscle of myometrium and in 4 percent of pregnant women, sonographically detectable myomas are present

Methods and Materials: A cohort study done in years of 1385-86 to compare obstetric outcomes between normal pregnant and pregnant women with myomas, 87 pregnant with myoma and 375 normal pregnant selected for pre, intra and post partum complications

Results: Myoma in pregnancy is a risk factor for first trimester bleeding, spontaneous first trimester abortion, placenta previa, noncephalic presentation, post partum hemorrhage and cesarean delivery but frequency of preterm labor, premature rupture of membrane, placental abruption and intra uterine growth restriction were not different between group with myoma and control group. Furthermore the rate of post partum hemorrhage in group with myoma larger than 5cm in diameter was greater than in group with myoma 5cm or smaller in diameter [P=0.02]. After multiple logistic regression analysis, advanced maternal age, nulliparity were independently associated with presence of myoma in pregnancy

Conclusion: Presence of myoma documented by gestational sonography is associated with high risk pregnancies which necessitate patient education and labor staff preparation for intra and post partum probable complications controlling

prevalence of thrombocytopenia in patients with chronic hepatitis B and C

Thrombocytopenia is a relatively common extrahepatic manifestation of hepatitis c,even in the absence of cirrhosis.Also, thrombocytopenia has been reported in chronic HBV infection. The aims of present study were to evaluate the prevalence of thrombocytopenia in chronic HCV and HBV infection in the absence of cirrhosis and to assess the relationship between HBV and HCV infection and frequency of thrombocytopenia. 438 patients [219 patients with chronic active hepatitis B and 123 inactive carriers of HBV and 96 patients with chronic HCV infection] were enrolled in this study. Thrombocytopenia was defined as platelet counts below 150,000/microl. The prevalence of thrombocytopenia was 17.7% in patients with chronic active hepatitis B and 10.6% in HBV inactive carriers, 13.3% in patients with chronic hepatitis C and 5.3% in control group. The prevalence of thrombocytopenia in chronic hepatitis B and C was significantly more than control group. These results in Iran, with 2-3 million people with chronic HBV infection and around 400,000 with chronic HCV infection shows that HBV and HCV infections, even in the absence of cirrhosis, may be two causes of thrombocytopenia