Relationship between post-kidney transplantation antithymocyte globulin therapy and wound healing complications

Wound healing disorders are probably the most common post-transplantation surgical complications. It is thought that wound healing disturbance occurs due to antiproliferative effects of immunosuppressive drugs. On the other hand, success of transplantation is dependent on immunosuppressive therapies. Antihuman thymocyte globulin [ATG] has been widely used as induction therapy but the impact of this treatment on wound healing is not fully understood. To investigate wound healing complications after ATG therapy in renal transplant recipients. The medical records of 333 kidney transplant recipients were assessed for wound healing disorders. Among these patients, 92 received ATG and 5 doses of 1.5 mg/kg ATG along with the standard protocol of drugs. The mean age of patients was 38.9 years. Of 333 recipients, 92 [23.7%] received ATG; 21 [6.3%] developed wound healing complications. There was a significant relationship between ATG therapy and wound complications [p=0.034]. Also, women were more likely to develop wound healing disorders than men [p=0.002]. No statistical difference was observed between age and wound healing complication [p=0.28]. There was no significant difference between the mean duration of hospitalization between ATG and Non-ATG group [p=0.9]. ATG increases the risk of overall wound complications. It is needed to pay more attention to the patients treated with this immunosuppressant to avoid the risk of re-interventions, lessen the duration of hospitalization and decrease the impairment of graft function

[Effect of methylene dioxy metha amphetamine administration during pregnancy on reproductive system of BALB/c mice]

The pregnancy period is very sensitive and complicative stages of life. It has been shown that addictive drugs such as ecstasy [MDMA: Methylene Dioxy Metha Amphetamine] can interfere in this stage. The aim of this study was to assess the effect of Methylene Dioxy Metha Amphetamine administration during pregnancy on reproductive system of BALB/c mice. In this experimental study, 10 and 5 female BALB/c mice were randomly selected as cases and controls, respectively. The pregnancy was induced following ovarian hyperstimulation with PMSG and hCG followed by mating with male animals. MDMA [5 mg/kg] and saline was injected intraperitoneally in day 7 and 14 of pregnancy in experimental and controls, respectively. The ovarian structure, as well as uterine tube, uterine horns and body, and vagina were studied histologically using light microscopy 27 days post delivery date. Data analyzed by using SPSS-17 and Chi-Square and Fisher exact test. The rate of primary follicles was decreased from 18.42% in experimental to 33.33% in controls [P<0.05]. The rate of mature follicles was significantly increased in experimental mice as compared to controls [P<0.05]. The number of atretic bodies was lower in experimental than controls. The cellular alterations were observed in some portions of uterine tubes and uterine horns after ecstasy administration. However, no alterations observed in other parts of reproductive system. This study showed that MDMA cause some structural alterations in the uterine tubes and uterine horns, increase follicular maturation and reduction of follicular atresia in BALB/c mice

Evaluation of psychiatric treatment effects on unexplained oral and maxillofacial sensory disorders

Sometimes, sensory disorders occur without any organic etiology which this entity could make problem in diagnose and treatment. Therefore, the aim of this present study was to evaluate the psychiatric treatment effects on unexplained oral and maxillofacial sensory disorders. In this experimental study, 20 patients with diagnosis of unexplained oral and maxillofacial sensory disorders whit out any organic origin were examined. The severity of symptoms was documented based on a 0-5 numerical scale by patients. The patients were referred to the psychologist for their problems. All subjects were controlled per two weeks for about 6 months and in each follow up their severity of symptoms were detected. The mean of severity of sensory disorders was compare before and after treatment by t- test. In this study, there was a positive correlation between psychiatric treatment and increasing in severity of patient's symptoms. The mean of severity of sensory disorders before treatment was 4 unit and after that reached to 1.1 unit. The rate of therapeutic effect was higher in men than women. Also, the rate of response to the treatment in patients with involutional melancholia was better than patients with other psychological disorders. The results of this study showed, that/ severity of unexplained oral and maxillofacial sensory disorders decreased after psychiatric treatments

Comparison of salivary ion activity product for hydroxyapatite [IPHA], alkaline phosphatase and buffering capacity of adults according to age and caries severity

Statement of Problem: Tooth caries is influenced by different biochemical characteristics of saliva. As hydroxyapatite is the main component of enamel, salivary ion activity product for hydroxyapatite [IPHA] as well as alkaline phosphatase may be attributed to dental caries

Purpose: The aim of the present study was to compare salivary buffering capacity, alkaline phosphatase and IPHA of adults according to the dental caries and age

Materials and Method: One hundred and twenty 19 to 44 years old male individuals were divided into four groups according to the dental caries rate and age: group 1: 19-35 years old low dental caries [DMFT <5]; group 2: 19-35 years old high dental caries [DMFT 5<]; group 3: 35-44 years old low dental caries [DMFT <11] and 35-44 years old high dental caries [DMFT 11<]. Five milliliter of unstimulated saliva was collected, and then buffering capacity, the level of alkaline phosphatase activity and IPHA was determined for each sample. Data was analyzed by soft ware SPSS using two way ANOVA, Friedman and Mann-Whitney tests

Results: Mean and standard deviation of buffering capacity of group 1 to 4 was 2.66 +/- 0.54, 2.64 +/- 0.56, 2.70 +/- 0.70 and 2.26 +/- 0.82, respectively. The difference was not significance [p= 0. 305]. Mean and standard deviation of alkaline phosphatase activity of group 1 to 4 was 5.82 +/- 2.91, 5.30 +/- 1.52, 4.77 +/- 1.82 and 4.55 +/- 1.61, respectively. There was no significant difference [p= 0.692]. Mean and standard deviation of IPHA of group 1 to 4 was 29.39 +/- 0.61, 29.51 +/- 0.76, 29.14 +/- 0.56 and 29.75 +/- 0.75, respectively. The difference was significant [p= 0.049]

Conclusion: Based on the results of the present study, buffering capacity and the level of alkaline phosphatase couldn't affect dental caries, independently. However, the higher value of IPHA may be attributed to the higher dental caries rate. Ageing decreases alkaline phosphatase activity

Report of an odontogenic anterior mandible Keratocyte in a 50 years old woman with bucal swelling

Oral cysts are divided into two subgroups as odontogenic and non-odontogenic. One of the most common and important cysts is odontogenic keratocyst which called O.K.C. this lesion has a different nature and it is noted as a tumor lesion in recent years. This lesion most frequently appears in first and third decade of life and occurs in the posterior part of the mandibular bone. This lesion has a more extension than expansion. In this present study a case of O.K.C was presented with uncommon appearances. A 50 - year old female with history of expansion in the anterior part of mandibles was referred to the department of oral medicine, 600 NEZAJA center. Clinically, there were a bucal expansion without pain over the Teeth with crowding. Radiographic images and CT scan showed a unicystic radiolucency with teeth movement, without cortical perforation. After biopsy, the diagnosis of O.K.C was reported. Six months follow - up did not show any recurrent lesion. This article is recommended to the dentists because OKS has different clinical and radiographic findings. For this reason all cysts should be considered and evaluated

Treatment of mandibular deviation with the replacement of upper laterals with central incisors - a case report

Premature contact of teeth in posterior crossbite may be associated with facial asymmetry. To describe the surgical treatment of mandibular deviation associated with a marked facial asymmetry, and build up the two upper lateral incisors in place of the two upper central incisors. A 20 year-old boy with a unilateral posterior crossbite, noticeable facial asymmetry, and anterior crossbite is presented. He had a history of head injury in mixed dentition period. The upper central incisors were lost during trauma and the created space was replaced by the two upper lateral incisors. A removable appliance was used to correct the crossbite and it was followed by fixed appliances. Orthognathic surgery was done to complete the treatment. After that the two upper lateral incisors were built up and reshaped. Treatment resulted in a marked improvement in facial symmetry, elimination of the mandibular displacement and a stable occlusion. A patient with mandibular deviation and marked facial asymmetry was successfully treated surgically and two upper lateral incisors were built up and reshaped in place of the two upper central incisors

[Identification of total and fecal coliforms and heterotrophic to Microbiological method and E.Coli O157:H7 to immunological, and real time PCR methods in Isfahan water treatment plant]

Total and Fecal coliforms [TC and FC], heterotrophic plate count [HPC], were counted by microbiological method and E.coli O157:H7 were detected through immunological and Real time PCR methods in water intake and all of units of Isfahan water treatment plant [IWTP]. The microbial profile including TC, FC, and HPC, were monitored and turbidity and total organic carbon were analyzed in 8 locations of water intake, and unit operation and processes of IWTP, including, inlet, sedimentation, ozonation, and filtration and finished water. Immunological method through anti-serum kits and molecular method of RT-PCR were used to detect E.coli O157:H7 in the 8 locations and also the sludge of the sedimentation basin and filters backwash water of IWTP. Survival of E.coli O157:H7 in sludge sample of sedimentation basin was indicated by formation of agglutination particles in immunological method and through indicator probes in the RT-PCR method. However, E.coli O157:H7 was not detected in water samples of other units of IWTP. The removal percent of TC, FC, and HPC were: 59.5, 49, and 54.8% in sedimentation basin; 66, 45.8, and 57% in ozonation;: 98.8, 98, and 78.8 in the filtration; and 96, 100, 91% in disinfection, respectively. This study approved the existence of the pathogenic coliform, E.coli O157:H7 in the sludge of sedimentation basin. Absent of E.coli O157:H7 in the finished water indicates that the existing units of IWTP could eliminate these pathogenic bacteria, before reaching the final units of the plant, including the filters and disinfection

Evaluation of stability in advancement genioplasty: an 18-month follow-up

The main aim of advancement genioplasty is soft tissue and hard tissue stability which is important in improvement of the patients' aesthetics. The evaluation of the soft and hard tissue stability in advancement genioplsty was the aim of this study. The subjects in this study were 15 patients who presented with retrognathia. All of the 15 patients underwent advancement genioplasty alone to correct retrognathia. The soft and hard tissue pogonion in pre-operation, immediately post-operation, and 18 months after operation in tow groups of 9 patients with genial advancement equal or greater than 7 mm [means 7.16 mm] were assessed. After operation, no patient had infection or dehiscence and bone instability. In group 1 with advancement less than 7mm, hard tissue pogonion relapse was 0.60 +/- 0.66mm and soft tissue pogonion relapse was 1.55 +/- 0.46mm. I group 2 with advancement equal or more than 7mm, hard tissue pogonion relapse of 1.6 +/- 0.46mm and soft tissue pogonion relapse of 1.8 +/- 0.68mm were observed. Advancement genioplasty is a predictable operation specially when using rigid fixation. In this study, the result of operation in an 18 month period was stable

[Prevalence of orofacial complication among thalassemic patients in Thalassemia center of Qazvin]

Background: thalassemia is the most common monogenic disorder of which Homozygote type [major-beta-thalassemia] is the most severe hemolytic anemia in Iran. Regarding the importance of orofacial complications in these patients and not having enough information about this disease in Iran, it`s necessary to do a research in this point as well as knowing and reducing of orofacial complications of thalassemia

Materials and Methods: this descriptive [Case Series] study was done among all patients of Qazvin thalassemia center [110 patients]. Orofacial examinations [shape of face and nose, maxillary protrusion, oral paleness, delayed eruption of teeth, caries rate and type of occlusion] were done and their relation with medical treatment was evaluated. Statistical analysis was conducted by using SPSS software and x[2]test

Results: the prevalence of orofacial complications are ranged as fallow: Saddle nose [71.08%], maxillary protrusion [55.5%], paleness of oral mucosa [48.2%], rodent face [30%], deep bite [28.2%], spaces between maxillary anterior teeth [22.7%], open bite [13.6%], delayed eruption of primary [10%] and permanent [8.2%] teeth. Prevalence of occlusion types were decreased as fallow: class I, II and III. Caries index [DMFT and dmft] was significantly more among the thalassemic patients than healthy peoples [P<0.05]

Conclusions: the prevalence of orofacial complications of thalassemia was very considerable. This study also showed the importance of early diagnosis and intensive medical treatment in reducing these complications

Review of myofascial pain dysfunction syndrome and its prominence in military personnel

This article have been compiled to introduce the MPDS syndrome and review the syndrome treatment approach, ethiology and clinical manifestation with an emphasis on it's importance in military personnel. This research is a descriptive- Liberian study, which this kind of studies refers to all of resources and precedents present in access. MPDS syndrome is a multi-factorial disease and usually doesn't have a unique reason. In despite of some believe that malocclusion is the main reason, some others believe in stress. Recent studies emphasize more on role of stress. Diagnosis criteria of MPDS are: 1-A vague pain that usually is unilateral. 2- Limitation opening. 3- Tenderness of masticator muscles. According to treatment aspects, this disorder is treated in two phases. The first phase includes patient education, behaviour shaping, desensitization, pharmacy therapy and physiotherapy. The second phase includes occlusal adjustment, orthodontic treatment and surgery. Meanwhile recent researches demonstrated that the first treatment phase would be successful about 75 to 90 percent by conducting this phase correctly and principally. Although general emphasis on psychological treatments, there is not a unique definitive treatment which have a high effect on most of patients. However because of probabilities in high incidence of this disorder in military personnel and their families, it seems the existence of a special clinical researching centre is necessary

[Strategic educational planning of dermatology in Iran]

Strategic thinking is the most essential part of educational planning. The main purpose of the present study is developing the Strategic educational planning of dermatology in Iran from 2007 to 2010. A qualitative investigation using focused group discussion was implemented for developing educational strategy in dermatology. Six to ten academic members of dermatologic departments and other stakeholders participated in this study. Strengths, weaknesses, opportunities and threats of dermatology education in Iran were analyzed. Strategic objectives in three domains, viz. education, research, and provision of health services were identified. Educational objectives included training personnel at different academic levels ranging from general practice and specialization to fellowship in dermatology in accordance with the needs of the general public. In the field of research, necessity for more national and international participation and scientific discourse was recognized. In the health services domain designing cost-effective techniques for optimal management of dermatological problems are needed. Results of this study underscore the necessity of support for decision makers in Iranian health system

[Prevalence of orofacial complication among thalassemic patients in thalassemia center of Qazvin]

Thalassemia is the most common monogenic disorder of which Homozygote type [major-beta-thalassemia] is the most severe hemolytic anemia in Iran. Regarding the importance of orofacial complications in these patients and not having enough information about this disease in Iran, it's necessary to do a research in this point as well as knowing and reducing of orofacial complications of thalassemia. This descriptive [Case Series] study was done among all patients of Qazvin thalassemia center [110 patients]. Orofacial examinations [shape of face and nose, maxillary protrusion, oral paleness, delayed eruption of teeth, caries rate and type of occlusion] were done and their relation with medical treatment was evaluated. Statistical analysis was conducted by using SPSS software and Chi[2] test. The prevalence of orofacial complications are ranged as fallow: Saddle nose[71.08%], maxillary protrusion [55.5%], paleness of oral mucosa[48.2%], rodent face [30%], deep bite [28.2%], spaces between maxillary anterior teeth [22.7%], open bite [13.6%], delayed eruption of primary [10%] and permanent [8.2%] teeth. Prevalence of occlusion types were decreased as fallow: class I,II and III. Caries index [DMFT and dmft] was significantly more among the thalassemic patients than healthy peoples [P<0.05]. The prevalence of orofacial complications of thalassemia was very considerable. This study also showed the importance of early diagnosis and intensive medical treatment in reducing these complications

Correlation of pemphigus vulgaris antibody titers by indirect immunofluoresence with activity of disease based on pemphigus area and activity score [PAAS]

Indirect immunofluorescence [IIF] has been used to identify and measure autoantibody levels in pemphigus vulgaris but data about relationship between clinical severity of disease and antibody titers by IIF have been conflicting. We conducted this cross-sectional study to correlate the severity of oral and/or cutaneous involvement in patients with pemphigus vulgaris based on Pemphigus Area and Activity Score with IIF titers. Sixty-one new pemphigus vulgaris patients were included in this study. Human prepuce was used as substrate for IIF and assessment of disease severity was based on Pemphigus Area and Activity Score. The mean +/- SD age was 44.04 +/- 30.46 years, with a range of 18 to 79 years. IIF was positive in 56 [91.8%] patients. There was a significant relationship between total disease score and IIF titers [[P<0.001]. Also a significant relationship was found between skin score [P=0.04] and mucosal score [P=0.04] with IIF titers. Our results show that there is a significant relationship between disease activity based on Pemphigus Area and Activity Score and antibody titers by IIF. Further studies are recommended to determine the usefulness of this technique for monitoring disease

Study of spontaneous bacterial peritonitis etiologic agents and determination of their antibiotic resistance pattern

Spontaneous bacterial peritonitis [SBP] is a frequent and often fatal complication of ascites without a demonstrable intra abdominal cause. In adults, the organisms of SBP are usually gram-negative bacteria, but they may differ in children. Since these organisms are resistant to most antibiotics, identification of active antimicrobial agents and determination of resistance pattern are essential. The aim of the present study was also to determine the causative agents of SBP in children with liver disease and ascites, referred to pediatrics ward of Imam Khomeini hospital during 1384-85. In this study, ascites samples were taken from 85 patients with liver disease and ascites of Emam Khomeini Hospital, pediatrics ward, and they were examined by direct test, culture on different media and biochemistry tests. Antibiogram tests by disk diffusion were done on each positive sample. Of 85 examined samples, 32 bacterial and 2 yeast agents were isolated. Of bacterial cases, Escherichia coli [31.25%] and coagulase negative Staphylococci [18.75%] were the most isolated agents and the rest, included Streptococci and Enterobacteriaceae. Moreover, antibiogram tests identify that most of coagulase negative Staphylococci isolates as resistant to cotrimoxazol, amoxicillin, penicillin and cephalosporin [first generation]. The most of gram negative isolated bacteria were resistant to amikacin, vancomycin and gentamicin. Since the spontaneous bacterial peritonitis is not detectable by clinical signs, ascites samples should be examined in order to determine the etiologic agents. In general spontaneous bacterial peritonitis agents are mostly composed of normal flora bacteria, in our study most isolated bacteria were Escherichia coli and coagulase negative Staphylococci, two major normal flora of gastrointestinal tract and skin. The isolated bacteria showed a high antibiotic resistance against common drugs in our study. In general, this study showed that the major agents of spontaneous bacterial peritonitis should be identified by ascites examination and antibiogram test to establish a perfect treatment pattern in order to treat the patients rapidly

[Soluble CD26 and CD30 concentration in cutaneous leishmaniasis]

Introduction: Cutaneous leishmaniasis [CL] is the most common form of leishmaniasis that usually heals spontaneously with unsightly scar but rarely non-healing lesion of CL develops which is refractory to all types of therapy. It is shown that Th1 and Th2 response is associated with healing and non-healing form of the diseases, respectively. On the other hand, it is reported that CD26 and CD30 are associated with Th1 and Th2 types of response, respectively. In some diseases, there is a relationship found between level of CD26 and CD30 and Th1 and Th2 responses

Objective: The goal of this study was to determine the concentration of soluble CD26 and soluble CD30 [sCD26 and sCD30] as a possible marker for Th1/Th2 response in CL

Materials and Methods: The blood samples were taken from 36 patients with healing form of the lesion and 10 patients with non-healing form of CL who were referred to Razi hospital or Center for Research and Training in Skin Diseases and Leprosy in Tehran during 2003-2004. As a control blood samples were taken from 23 volunteers with no history of CL. In this study, the concentration of sCD26 and sCD30 were measured in plasma by ELISA method

Results: The results showed that the plasma levels of sCD26 and sCD30 were significantly higher in non-healing form of the disease than healing form of CL or control group [p<0.05]. The level of sCD30 was more prominent than sCD26. There was no significant difference in the level of sCD26 or sCD30 markers in healing form of CL compared to normal control group

Conclusion: Overall it seems that the level of sCD30 might be a useful marker to study the immune response in CL, which needs to be studied further

Study of the status of physicians-patient communication among medical interns

Proper communication between a physician and a patient is the key to diagnosis and management of diseases. Communication skills are essential for gathering information from patients, enhancing patients trust on physicians, relaxing them and managing them. The main purpose of this study was to determine the states of communication skills of medical interns to communicate with patients. In this cross sectional study, communication skills of 72 medical interns of Kerman Medical University was assessed based on a checklist completed with direct observation and a questionnaire completed through interview with patients. The checklist included two parts: the first part for individual characteristics and the second part for 24 specifications related to initiation of an interview, conducting an interview and completion of an interview. Another questionnaire with a similar structure was developed to gather patients' comments about communication of medical interns with them. Communication skills of medical interns were weak in 29.3%, moderate in 85.4% and good in 15.9% of interns. An agreement between observed communication skills and patients' survey results about greeting, asking patients' names and calling them by their names, acceptable physicians' appearance, listening to patients' words, friendly doctor- patient encounter, empathizing with patients [0.37, 0.26, 0.22.0.41 and 0.44 respectively] was seen. Results of individual variables show that relationship between age of patient and his or her opinion about communication was significant. Based on patient's survey, the communication score given to the student increases with age of the patient. The study shows deficits in doctor-patient communication of medical interns in history taking. Given the importance of communication skills, the necessity to teach them in clinical skill centers before real contact with patients is obvious

[Clinicopathological study of scarring alopecia: a retrospective study of 207 patients]

Cicatricial alopecia means permanent destruction of hair follicles that leads to scar formation. This alopecia is irreversible. According to our knowledge, there has been no previous study about the causes of scarring alopecia in Iran. Our objective was the study of this entity in Iran. In a retrospective study, skin biopsies of the patients with clinical diagnosis of scarring alopecia since April 1998 to March 2001 in the file of department of pathology of Razi Hospital were evaluated. Among 9000 of skin biopsies, 207 had the diagnosis of scarring alopecia. These specimens underwent reevaluation. Data on demographic and clinical features were obtained from patients' files. The mean age of patients was 35.2. According to sex distribution, 49.3 percent were women and 50.7 percent were men respectively. The causes of scarring alopecia in order of decreasing frequency were as follow: Discoid lupus erythematous, lichen planopilaris, folliculitis decalvans, basal cell carcinoma, deep folliculitis, morphea, cicatricial pemphigoid, follicular mucinosis, aplasia cutis congenita, dissecting folliculitis, granuloma, epidermal nevi, necrobiosis, and psoriasis. In eight cases no specific pathologic diagnosis was reported for scarring alopecia. Discoid lupus erythematous was the most frequent cause of scarring alopecia in this study. Lichen planopilaris and folliculitis decalvans were the next frequent conditions respectively

Value of fine needle aspiration in diagnosis of palpable breast masses

Fine needle aspiration [FNA] as a cytological method for the evaluation of breast masses was first performed in 1930, and of present is used as a routine method for the evaluation of breast masses. Aspiration via fine needle as a diagnostic tool is easy, accessible and relatively non - invasive. The purpose of this study was to determine the diagnostic value of this method and its comparison with open biopsy in determining the nature of breast masses. This prospective study included 62 females with palpable breast masses who were candidates for breast biopsy. Mean age was 43.7 +/- 14.3 years [16-68 years]. All patients had palpable breast masses and underwent FNA prior to conventional open breast biopsy Excised tissues and FNA samples were studied by a pathologist who was blinded to the patient's name and her medical history. According to histopathological exam, there were 40 [64.5%] benign and 22 [35.5%] malignant. Incidence of malignancy was higher in the larger masses. When FNA reports were compared with final histopathology reports, there was one false negative and one false positive report. Positive predictive value [PPV] and negative predictive value [NPV] were 95.5% and 96.7% respectively. This study demonstrates that FNA is safe and accurate diagnostic procedure in evaluation and diagnosis of breast masses. We recommend it to be used as the initial diagnostic test for all palpable breast masses. To avoid any misdiagnosis, open biopsy should be performed when needle aspiration is negative or the masses are clinically suspicious for malignancy

[Evaluation of dentists' engagement in taking and recording medico-pharmacological history of their patients in the city of Mashhad]

Introduction: the objective of this study was to detect the extent of which the dentists in the city of Mashhad pay attention to the goals of taking and recording medical and pharmacological records [Medical history] of their patients

Materials and methods: a sample of 80 out of 345 registered dentists in the region were selected through simple random sampling. To collect data, a standard questionnaire [valid and reliable] based on Likert scale was prepared appropriate statistical methods including descriptive statistics, Ki Square test, One sample T-test, and Wilcoxon signed rank test, were used for data analysis

Results: 1. Dentists in the region where the study was conducted did not care enough for the goals of taking patients' medical history. 2. Dentists' attention to the goals of recording data was above intermediate

Conclusion: we can deduce that the dentists need continuous education and an effective management system for evaluation of performance is necessitated