[Comparison of salivary cotinine concentration in cigarette smokers, water pipe smokers and non smokers]

Water pipe smoking has become a public health hazard. The aim of this study was to measure and compare the concentration of salivary cotinine in cigarette smokers, water pipe smokers and nonsmokers. Forty-eight volunteers [16 cigarette smokers, 16 water pipe smokers and 16 nonsmokers] participated in this cross-sectional study. High sensitivity Salivary Cotinine Quantitative enzyme immunoassay kit was used to measure the salivary cotinine concentration. Non-parametric Kruskal Wallis test, Pearson's correlation coefficient and linear regression were used to determine the correlation between number of cigarettes smoked and concentration of cotinine. The mean concentration of salivary cotinine was 223.74[ +/- 181.56] ng/ml [the highest] in cigarette smokers, 106.24 [ +/- 135.23] ng/ml in water pipe smokers and 0.73[ +/- 1.24] ng/ml in nonsmokers. The difference in this respect among the 3 groups was statistically significant [P<0.0001]. In smokers, the level of salivary cotinine increased by 1.84 ng/ml per each time of cigarette smoking per week. This increase was 14.57 ng/ml per each time of water pipe consumption per week. The mean concentration of salivary cotinine was significantly higher among cigarette smokers compared to water pipe smokers and nonsmokers. However, one time consumption of water pipe caused a greater rise in salivary cotinine level compared to cigarette smoking

[Comparison of the substantivity of several mouthwashes and their effect on microbial plaque using epifluorescence microscope]

Several techniques have been used to assess the efficacy and substantivity of mouthwashes. Considering the variability of available mouth rinses, this study aimed to assess the substantivity of several mouthwashes and their effect on microbial plaque using an epifluorescence microscope. This crossover double blind clinical trial evaluated 0.2%, and 0.12% [from 2 different brands] chlorhexidine [CHX], Persica and cetyl pyridinium chloride [CPC] mouth washes as well as normal saline as the negative control. Non-stimulated saliva samples were obtained from 16 candidates at baseline, 30s, 1, 3, 5 and 7h after one time use of mouthwashes. Epifluorescence technique was used to assess the viability of bacteria. For clinical examination following prophylaxis, subjects were asked not to use any oral hygiene measure except for the provided mouthwashes [twice a day] for 4 days. A 10-day washout period was allowed between the use of mouthwashes. Repeated measures ANOVA and Scheffe's test were applied for the comparison of viable bacterial count between the groups and Kruskal Wallis test was used for the assessment of microbial plaque. Persica and 0.12% CHX maintained their substantivity for 3 and 5h, respectively. A significant reduction in bacterial count was observed up to 7h after the use of 0.2% CHX only [P<0.001]. On clinical examination, 0.2% and 0.12% CHX mouthwashes had significant differences with the others but had no significant difference with one another [P<0.02]. Persica and CPC had similar efficacy [P<0.02]. Efficacy of mouthwashes strongly depends on their substantivity. Daily application frequency of other mouth rinses should be increased in order to achieve an efficacy equal to that of CHX

Effect of zinc supplementation on serum zinc and calcium levels in postmenopausal osteoporotic women in Tabriz, Islamic Republic of Iran

Research on the zinc status of osteoporotic women is scarce. This randomized, double-blind, placebo controlled clinical trial assessed the effect of zinc supplementation on serum zinc and calcium levels in postmenopausal osteoporotic women. A sample of 60 women referred to a rheumatology clinic in Tabriz were randomly divided into intervention [220 mg zinc sulfate daily] and placebo groups. Anthropometric indices, dietary intake of zinc and calcium and serum zinc and calcium were assessed at baseline and after 60 days. Mean serum zinc concentrations were markedly lower than the normal range at baseline, but mean serum calcium levels were normal. In the intervention group serum zinc levels were significantly higher after 60 days [120.5 [SD 7.5] versus 70.5 [SD 4.6] microg/dL] while serum calcium levels were unchanged [8.6 [SD 0.1] versus 9.1 [SD 0.3] mg/dL]. The placebo group showed no significant changes in zinc or calcium levels. Postmenopausal osteoporotic women may benefit from zinc supplementation

Mortality causes in children 1-59 months in Iran

Mortality rate indicator for children under 5 years old is one of the important indicators in countries' development. Identifying the most common causes of mortality is one of the most important attempts to reduce mortality in children less than 5 years. The purpose of this study was to identify distribution of the mortality causes in Iranian children less than 5 years. This cross-sectional study has been carried out based on the results of data from the Child Mortality Surveillance System since 2007 to 2008. To determine the causes of death questionnaires have been designed which include personal data of the deceased child, medical history, and information on procedures at the time of hospitalization or death. Of 5926 deaths on children under 5 years which the questionnaires were filled out, 63.2% were postneonatal deaths [1-11 month]. Totally 60% of mortalities occurred in the rural areas and 52% of them had been among boys. The most common causes of mortality were the congenital and chromosomal abnormalities with 23.4%. The most incidences among diseases were respiratory system diseases. Carrying out more epidemiologic studies, providing health programs to control and prevent diseases with high incidences and delivering more specialized health facilities and services could be the proper strategies to reduce under 5 mortality rates in Iran

[Diagnostic values of fibrosis index in ultrasonography for differentiation of chronic viral hepatitis from liver cirrhosis]

Fibrosis index is a new index used for differentiation of cirrhosis from chronic hepatitis. If fibrosis index appears efficient in Doppler ultrasonography, it can be considered a good alternative for liver biopsy. Therefore, in this study we evaluated the diagnostic values of fibrosis index in ultrasonography for differentiation of chronic viral hepatitis from hepatic cirrhosis. This cross-sectional study included 104 patients, 19 patients with cirrhosis and 85 patients with chronic hepatitis. The diagnoses of cirrhosis and chronic hepatitis had been confirmed by biopsy. PSV, RI, EDV, PPFV and FI indices were calculated and compared between the two groups. Then, using ROC curve, we determined the cut-off-point for FI. The median of PSV and RI in the cirrhosis group was significantly higher than those in the chronic hepatitis group [p<0.05] but EDV median did not show any difference and PPFV was significantly lower in the cirrhosis group in comparison to the hepatitis group [p<0.001]. A fibrosis index of 3.365 or higher with a sensitivity of 94.7% and a specificity of 83.5% was the best cut-off-point for differentiating cirrhosis from chronic hepatitis. The area under curve was estimated at 0.948. Based on the results of this study, fibrosis index in the above- mentioned method could be a highly efficient index for differentiation of cirrhosis from chronic hepatitis and its sensitivity and specificity were higher than those of previously used indices.

[Comparison of serum zinc level in the coronary artery disease patients with healthy volunteers]

Several studies have demonstrated that zinc plays an important role in the development of cardiovascular diseases in Western populations. But there are limited data for other racial groups. This study aimed to investigate the association between serum zinc and coronary artery disease [CAD] in Iranian population. This descriptive-analytical study was conducted on 81 individuals, aged 30 to 70 years, referred to Dr. Heshmat Hospital of Guilan, northern Iran, for routine coronary angiography. Based on the coronary angiogram results, the participants were assigned into 2 groups; 41 CAD patients in case group and 40 healthy ones in control group. Furthermore, data about smoking habit, physical activity and anthropometric indices were collected by questionnaire and using standard protocols. Serum zinc was measured by atomic absorption spectroscopy. The mean serum zinc concentration in the case and control group were 73.50 +/- 1.61microg/dl and 78.47 +/- 1.66microg/dl, respectively. The mean serum zinc concentrations were significantly lower in case group than that in the controls [p<0.05]. Zinc concentration had negative correlation with age [r= -0.23 p<0.05], and positive correlation with weight [r=0.26 p<0.05]. Participants living in rural areas had lower zinc concentration than those in urban [p<0.05]. Serum zinc concentration was significantly lower in Iranian patients with abnormal versus those with a normal angiogram. It seems Serum zinc concentration correlates with some risk factors for coronary artery disease

[Antibiotic resistance pattern of cholera epidemy in Guilan province]

Cholera is an infectious disease caused by a gram negative facultatively anaerobic bacterium called Vibrio Cholera from contaminated food or water. Cholera may be asymptomatic or indicated by mild to severe diarrhea. The main treatment of diarrhea is the replacement of water and electrolytes and if needed, antibiotic therapy. Antibiotic resistance varies in different parts of Iran. This study seeks. To determine the antibiotic resistance of V. Cholerae strains in Guilan province, summer 1390 [2011]. This descriptive study was performed on Vibrio Cholera isolates from the respective patients in 1390 summer epidemic in Guilan province. All samples were inoculated to Carry-Blair medium, then to alkaline peptone water [APW]. After incubation, a loopful of the culture was taken from the surface of APW on TCBS medium. After incubation the yellow colonies were cultured in KIA medium. Serologic tests were carried out by o1 polyvalent antisera, and if positive, the test was performed by Inaba and Ogawa monovalent antiserum. Disk diffusion antibiogram was done for the 7 antibiotics by Kirby Bauer method. Data were analyzed descriptively by Excel 2007 software. From the 161 samples, 142 were positive for cholera of which 140 [98.5%] were related to Ogawa serotypes. Eighty samples [57%] were from the females. The mean age of the infected people was 38 yrs [range 3-84 yrs]. The largest number of samples were sent from Lahijan [n=39]. All the isolated samples were positive for motility, indole, citrate and oxides tests. Antibiogram study revealed 97%, 90%, 23.5%, 20%, 11%, 10%, 1.2% of the samples were resistant to Nitrofurantoin, Co-trimoxazole, Chloramphenicol, Tetracycline, Doxycycline, Erythromycin, and Ciprofloxacin, respectively. In this study, resistance to Ciprofloxacine was 1.2% and 57% of the isolates were intermediate. It seems that resistance is low in IRAN. Regarding the high sensitivity of separated vibrio to Tetracycline and Doxycycline [76%], they may be useful in the treatment of cholera

Investigation of indoor and outdoor air bacterial density in Tehran subway system

The wide use of subway system by citizens underlines the importance of hygienic issues including indoor air pollution in these public places especially in metro stations. The aim of this study was to investigate the bacterial contamination in indoor and outdoor air of two metro stations [Imam Khomeini and Sadeghiyeh stations] in Tehran subway system. In this cross sectional study, three sampling locations were selected in each station. Also, sampling was conducted in indoor air of two types [old and new] of trains. The range of bacterial colony count was 35-1501 CFU/m[3]. Maximum and minimum bacterial contamination levels in Imam Khomeini and Sadeghiyeh platform stations were averagely 1073 CFU/m[3] and 242 CFU/m[3], respectively. 14 bacterial species and genera were isolated; among them the dominant species were Staphylococcus epidermidis, Micrococcus luteus and Bacillus spp. Results showed that bacterial concentrations in indoor air were higher than the outdoor air; also the bacterial counts correlated significantly with number of the passengers [p<0.001] and air temperature [p<0.001]

[Survey the histopathological findings in autopsy of poisoned patients with rice tablet [aluminium phosphide]]

Aluminium Phosphide [ALP] or rice tablet is one of the most commonly used pesticides in agriculture. Exposure of ALP with water, moisture and gastric acid produced phosphine gas [PH3] that caused to poisoning. Several histopathogical researches have shown edema, congestion, and leukocyte infiltration in different organs. More pathological researches are obviously required to describe the mechanism of poison effects on cells. To determine the histopathological findings in autopsy of liver, myocardium, and lungs of poisoned patients with rice tablet. This retrospective descriptive study was conducted on 80 poisoned patients with phosphine in the histopathology department of the legal medicine organization of Guilan in the years of 2001-2006. Stained sections of the liver, myocardium and lungs of poisoned patients were reviewed and histopathological findings were recorded. Data were analyzed by SPSS Ver.15 software. According to the data analysis, 60% of patients were male and the rest [40%] were female. Mean age was 31.45 years. Histopathological findings in liver were: Sinusoidal congestion [45%], fatty liver changes [20%], congestion of central vein [15%], fine cytoplasmic vacuoles [10%], PMN leukocyte clusters in Sinusoids [7%], nuclear fragmentation [2%], centri lobular necrosis [1%]. Histopathological findings in myocardium were: congestion [86%], necrosis [7%] and leukocyte infiltration [7%]. Histopathological findings in lungs were: edema [42%], congestion [33%], hemorrhage [11%], atelectasia [11%], capillary dilatation [2%], and thickening of alveolar septae [1%]. In this study, it was discovered that the most common histopathological finding in liver of poisoned patients with phosphine were sinusoidal congestion and fatty liver changes. Meanwhile, edema and congestion were the most common in autopsy of lungs. Congestion was the mostly-observed histopathological finding of myocardium

[Survey the relationship between perfectionism and job burnout in nurses]

Perfectionism is considered as a characteristic personality for striving performance without deficiency of excessively high standards by tendencies for overly critical evaluations of ones behaviour; in addition job burnout is a variable that could be increased by unhealthy perfectionism and outcomes. Although perfectionism considered appropriate but it may lead to increase some problems like burnout in some vocations like nursing. Investigating the relation between perfectionism and job burnout in 344 nurses in Rasht in 2008. In this descriptive- correlation study, 344 nurses were selected by cluster random sampling of Razi, Dr Heshmat, Velayat, Poorsina and Amir- al- momenin Hospitals in Rasht. Frost multi perfectionism inventory was used for studying perfectionism and Maslach and Jakson's job burnout inventory was used for studying job burnout. Correlation coefficient and regression and Manova were used for data analysis. Our hypothesis imparted reverse correlation between positive relation and negative dimensions of perfectionism. The results showed that there was a negative relation between job burnout, organization, parental expectance and personal standards [t=-0.227,-0.131,-0.132 respectively, P<0.05]. Regression analysis showed that just organization dimension can predicted job burnout in our sample [Beta=-0/197, t=-3/555].In addition age was significant in two younger groups as a prespective variable in relation with profectionism criterion variable. This study showed that job burnout will be decreased by improving positive dimensions of perfectionism such as organization and personal standards. Also perfectionism in younger nurses is more than older ones, so it is better to improve positive dimensions of perfectionism to promotion the quality of their services

Specific PCR assay for rapid and direct detection of Neisseria meningitidis in cerebrospinal fluid specimens

Neisseria meninigitidis is one of the most frequently encountered microorganisms associated with central nervous system infections. The aim of this study was to evaluate a PCR-based assay for specific and rapid detection of N. meninigitidis in CSF specimens. Since April 2002 to July 2006, 130 CSF specimens were collected from patients suspected of having baterial meningitis. Bacterial isolation and identification was carried out according to the standard bacteriological methods. The PCR was used to amplify a 101bp fragment of capsular transport gene A [ctr A] of N. meningitidis. PCR yielded an amplified product with the expected size of 101 base pair fragment. Sensitivity test proved 500 mg of N. meningitidis DNA as the final detection limit and specificity test revealed no cross-reaction for a wide range of respiratory pathogenic organisms. The PCR assay was more sensitive than the bacterial culturing. It might be possible to apply this procedure for rapid diagnosis of meningococci in clinical samples

Should post kidney transplantation hyperlipidemia considered a risk factor for graft function?

Hyperlipidemia is a common problem after kidney transplantation.To uncover the real impact of post kidney transplantation hyperlipidemia on graft function and survival, and to determine whether it is just a biochemical phenomenon after using immunosuppressant or a part of disease pathology. 330 kidney transplants were managed in Sina Hospital Kidney Transplantation Unit affiliated to Tehran University of Medical Sciences, Tehran, Iran from September 1994 till February 2010. The demographic characteristics of the patients, causes of chronic kidney diseases, history of pretransplantation dialysis, pretransplantation comorbidities [e.g., hypertension, diabetes mellitus [DM], hyperlipidemia and coronary artery disease], rejection episodes, status of infection with cytomegalous virus [CMV], post-transplantation DM, hyperlipidemia, ischemic heart disease [IHD], and graft and patient survival were recorded. A serum creatinine level >2 mg/dL was considered as "graft deterioration," and return to dialysis as "graft loss." According to the presence or absence of post kidney transplantation hypercholesterolemia [>200 mg/dL] or hypertriglyceridemia [>200 mg/dL], the patients were classified into "hyperlipidemic" or "non-hyperlipidemic." The presence of clinical or paraclinical coronary artery disease was also determined in both groups.The incidence of hyperlipidemia elevated from 8% to 50% before and after transplantation. 2.7% developed clinical IHD. 13% of hyperlipidemics and 22% of non-hyperlipidemics developed graft deterioration. Among hyperlipidemics with deteriorated grafts 40% had premorbid diseases, 68% had CMV infection and 82% had hypertension. Only 22% had previous acute rejection and 27% received deceased kidney transplant.Post-kidney transplantation hyperlipidemia is just an associated phenomenon secondary to the use of immunosuppressant medications, which have no obvious impact on renal graft function and can be easily controlled by instituting dietary modifications and use of modern antilipid medications. Post kidney transplantation CMV infection and hypertension are considered as the main threatening risk for renal graft-even more dangerous than acute or chronic rejections

[In vitro evaluation of Candida albicans adherence and growth on GC and acropars soft liners]

Adherence and growth of Candida albicanson denture soft lining materials can result in clinical problems, and deteriorations of the materials. Prevalence of denture stomatitis in association with candida albicans has been reported to range between 11%-67%. The aim of this study was to evaluate the adherence and growth of Candida albicanson two type of denture soft liners [GC and Acropars] and comparison to control group [Acropars acryl]. Twenty-two specimens of each soft lining material and 10 acrylic specimens [polished and not polished] were made and incubated in a suspension of Candida albicans. After rinsing, the specimens were stained with acridine orange and examined under fluorescent microscope. For statistical analysis One-way ANOVA and Post Hoc, TukeyHSD tests were used. The highest and the least adhesion and growth were found in the not polished and the polished groups respectively. Also, adherence and growth on Acropars soft liner was significantly more than GC soft liner [p<0.05]. Significant difference was found between polished and not polished acryl [p<0.05]. According to results, precise attention in selection of correct material with the lowest side effects and it's production steps seems mandatory

Relationship of pharmacist interaction with patient knowledge of dispensed drugs and patient satisfaction

A prospective survey of pharmacists' tasks and patients' knowledge and satisfaction was conducted in 35 randomly selected community pharmacies in Tabriz, Islamic Republic of Iran. The total pharmacist interaction received a mean score of 3.05 out of 5. Providing written directions for use attained the highest score of 0.98 out of 1. Patients scored 3.18 out of 5 for knowledge about their medicines. There was a close correlation between patients' knowledge of dispensed drugs and pharmacist interaction [r = 0.95]. Mean total prescription filling time was 7.6 min, but only 1.4 min was spent on pharmacist-patient counselling. The interaction between pharmacist and patient increases patients' knowledge about dispensed medicines and their satisfaction with the pharmacist's activities

Lingual schwannoma: a case report

We describe an 18-year old male patient with a 5 months previous history of swelling at the posterior mobile part of the tongue. The patient had difficulty in swallowing and speaking at the referral time. Examination of the oral cavity showed a swelling of 2X2 cm on the posterior part of the tongue, more towards the right side. Macroscopically, the entire lesion was removed with its capsule. Histopathological examination of the surgical specimen showed a schwannoma

Cystic teratoma of the pancreas

Congenital cystic lesions of the pancreas are rare findings. Furthermore, dermoid cyst of the pancreas is exceptionally uncommon. A review of the world literature showed that only 18 documented cases of dermoid cyst of the pancreas were reported so far. The pre-operative evaluation of this lesion is rather questionable, with definitive diagnosis taking place intraoperatively. Herein, we presented a 4-year-old female with a symptomatic 6-cm cystic mass in the head of her pancreas

Calcaneal osteosarcoma; a case report

Osteosarcoma of the foot is rare and, when presents, commonly observed in adults. We report a case of osteosarcoma of the calcaneus in an 11-year-old girl who was presented with a 4-month history of pain and swelling on her left ankle and inability to walk in her left lower extremity. On examination, there was a diffuse swelling involving her left ankle joint and foot. The radiograph showed soft tissue with calcification and ossification that involved the calcaneus with cortical bone destruction. Histologically, the tumor was consisted of variable foci of lacy osteoid formation and spindle pleomorphic stroma with typical osteoblasts. This rare location, histologic characteristics, and differential diagnostic points are discussed

Prevalence of carpal tunnel syndrome in patients with cervical radiculopathy

A remarkable number of out patients referred to physical medicine, orthopedic, neurologic clinics are the ones with the chief complaint of sensory-motor dysfunction in the distribution of median nerve on hands and upper limbs. Usually, it is thought these symptoms and singns are due to carpal tunnel syndrome [CTS] existence. However, in the majority of cases symptoms are not eliminated in spite of the most invasive treatments [e.g. surgical release of median nerve at wrist]. Further studies such as electrodiagnosis confirm radiculopathy in these patients. Several studies in past years have estimated the synchronous prevalence of CTS and Radiculopathy to be 22 to 70 percent. On the basis of these the double crush syndrome theory has been suggested. Estimation of synchronous prevalence of CTS and radiculopathy is a way to confirm this theory. This study is a descriptive study. The patients studied were persons with the numerous complaints in the upper limb and cervical area that had existence of radiculopathy in them been confirmed by several means such as physical examination and Electrodiagnosis. 183 patients were entered in the study and they considered from the aspect of synchronous prevalence of CTS. From 183 patients entered in the study, due to bilateral radiculopathies in both upper limbs in some patients, the total number of upper limbs studied were 264. Among them the existence of synchronous CTS in 96 upper limbs was confirmed [36.6%]. Percentages of different roots radiculopthies prevalence were as following: [C6]; 75%, [C7]: 93.75% and [C8]: 3.12%. According to 36.6% prevalence of synchronous CTS in patients with cervical radiculopathy, this rate is less than that of previous studies but more than that of recent studies. Although frequency of involved roots in this study doesn't fit with previous studies but match with electrodiagnosis texts

[Comparison of nerve conduction abnormalities in lumbosacral radiculopathy and axonal polyneuropathy]

The clinical differentiation between lumbosacral radiculopathy and generalized peripheral neuropathies of the distal-axonal type is often difficult. In such cases, the electromyographer relies on the presence of paraspinal or proximal muscle denervation and normal sensory conduction studies to indicate radicular disease. These criteria are often is inadequate, such as in elderly patients, when amplitudes of sensory nerve action potentials may be reduced as an age-related phenomenon. So if motor conduction changes in lumbosacral radiculopathy and generalized peripheral neuropathies are adequately described, a useful electrodiagnostic criterion for differentiation of radiculopathy and neuropathy will be available. Patients were entered in this study that met strict clinical and electrophysiological criteria for L5/S1 lumbosacral radiculopathy or generalized peripheral neuropathies of the distal-axonal type. The distal axonopathy group consisted of 19 men and 17 women, and lumbosacral radiculopathy group consisted of 28 men and 22 women. To minimize classification errors resulting from age-related changes, we excluded patients older than 60 years. Lower limbs of all patients were examined, recorded parameters included compound muscle action potential [CMAP] amplitude, distal latencies and conduction velocities; minimal, mean and maximal latencies of F-waves, and maximum-minimum latency ranges, and persistence of F waves of tibial and deep peroneal nerves. The mean values of minimal, mean and maximal latencies of F-waves of tibial and deep peroneal nerves in neuropathy group were significantly more prolonged than lumbosacral radiculopathy group [p<0.001]. The mean CMAPs amplitudes and persistence of tibial and deep peroneal nerves F-waves in neuropathy group were lower than lumbosacral radiculopathy group [p<0.001], but mean latency range of F-waves for both nerves in lumbosacral radiculopathy group were significantly more prolonged, [p<0.001], that this prolongation is more significant in deep peroneal nerves [p=0.004]. In young persons that significant decrease of SNAPs amplitude can reliably help to decision, mere dependence to motor conduction studies is not necessary. Also when there is denervation in proximal muscles that innervated by L5-S1 roots, the radiculopathy is more probable than neuropathy. When a patient is presented with numbness and paresthesia in lower limbs, and sensory nerve conduction or electromyographic studies can not help to decision, in these cases motor nerve conduction studies especially various parameters of F-wave such as; minimal latency, latency range and persistence could be useful

Evaluation of the 10th External Quality Assessment Scheme results in clinical microbiology laboratories in Tehran and districts

We evaluated the performance of microbiology laboratories in the 10th run of the external quality assessment scheme [EQAS] in Tehran and districts. Each laboratory was sent 2 species of bacteria for identification. Of the 487 laboratories that participated, 437 returned their findings. While 77.0% and 69.9% correctly identified Staphylococcus saprophyticus and Citrobacter freundii respectively, only 29.8% correctly identified Acinetobacter baumanii, 25.3% identified Enterococcus faecalis and 35.6% identified Enterobacter agglomerans. However 78.7% and 79.5% of the laboratories reported correct -results for susceptibility testing for S. saprophyticus and C. freundii respectively