association study between longitudinal changes of leukocyte telomere and the risk of azoospermia in a population of iranian infertile men

Background: Telomeres are evolutionary, specialized terminal structures at the ends of eukaryotic chromosomes containing TTAGGG repeats in human. Several human diseases have been known to be associated with dramatic changes in telomere length. The aim of the present study was to assess the correlation between the relative leukocyte telomere length [LTL] and infertility in a group of Iranian azoospermic males

Methods: In this casecontrol pilot study, relative telomere length [RTL] of peripheral blood leukocytes from a total of 30 idiopathic nonobstructive azoospermic males and 30 healthy fertile males was evaluated using real-time PCR. RTL was calculated as T [telomere]/S [single copy gene] ratio and compared between infertile and fertile groups

Results: Patients with azoospermia showed significantly shorter RTL than fertile males [0.54 vs. 0.84, p < 0.05]. The area under the receiver operating characteristic [ROC] curve was estimated to be 99.8%, suggesting LTL as a potential marker for the diagnosis of azoospermia

Conclusion: Our findings demonstrated a probable association between telomere shortening and azoospermia in a population of Iranian infertile men affected by idiopathic azoospermia

Assessing attitudes of medical students towards first contact with patient in Tehran [2016-17]

Background: Early experience of clinical arena as first situations can be effective in selection or refusing medicine as profession is so important that programmers and administrators should consider these settings as one of the most elements in educational programs

Materials and Methods: This study was a cross-sectional study and including presently studying students in medicine field of medical sciences universities. Sample size was estimated for 275 students. Participants were selected from schools of medicine: Iran University [IUMS], Shahid Beheshti University, and Islamic Azad University using stratified random sampling method. Data was collected in March of 2016 by a researcher made questionnaire determined its validity and reliability. Data was analyzed using chi-squared test, t-test, Mann-Whitney and Kruskal-Wallis test

Results: Mean score of medical students' attitude from 15 five-degree scale questions was 51.22 +/- 6.32. The mean scores of attitude in men and women were 51.37 +/- 6.16 and 51.06 +/- 6.53, respectively [p=0.687]. Overall, 13.8 % of students had positive attitude towards first contact with patient, 10.5 % of students had negative attitude and 75.6 % had no opinion. The mean scores of attitude towards first contact with patient in Iran university, Shahid Beheshti university and Islamic Azad university were 50.40 +/- 5.00, 52.71 +/- 5.91 and 46.12 +/- 5.97, respectively [p<0.001]. The mean scores of attitude towards first contact with patient in reformed educational system and old educational system were 52.35 +/- 5.83 and 46.12 +/- 5.97 respectively, with a significant difference between two types of educational system [p<0.001]

Conclusion: As respects more positive attitude of students in reformed educational system in comparison with old educational system, special attention to courses of early contact with patient may contribute to decreasing educational insufficiency and distance between theory and practice and lead to the satisfaction all of beneficiaries

Effect of Chemotherapy on Zinc, Copper, Vitamin D levels and inflammatory marker in adult acute lymphoblastic leukemia

Background: In acute lymphoblastic leukemia [ALL] the bone marrow loses its ability in the differentiation and maturation of blood cells at different stages. Zinc and copper are important co-factors for several enzymes and play an important role in maintenance of DNA integrity. Changes in serum levels of zinc and copper have been found in lymphoproliferative disorders. In the present study, the aim was to compare serum levels of zinc, copper, vitamin D, and inflammatory markers after eight courses of chemotherapy

Methods: Participants of this study included 30 ALL patients in the age range of 15 to 65 years. A 10 mL blood sample was taken before and after eight courses of chemotherapy. The concentration of Zinc, Copper, hs-CRP, vitamin D and malondialdehyde [MDA] were measured

Results: There was a significant increase in serum zinc [121.7 +/- 18.05 microg/dL before chemotherapy and 156.6 +/- 25.00 microg/dL after chemotherapy] and a significant decrease in serum copper [661.9 +/- 190.1 microg/dL before chemotherapy and 402.2 +/- 93.5 microg/dL after chemotherapy] and a significant decrease in Malondialdehyde and serum vitamin D were observwd. Further, no significant differences were observed in hs-CRP after chemotherapy

Conclusion: Results showed that chemotherapy could decrease the burden of disease by increasing serum zinc and decreasing serum copper

Frequency of intestinal parasitic infections among individuals referred to the medical center laboratories in Nahavand City, Hamadan Province, Western Iran

Intestinal parasitic infections [IPIs] cause serious public health problem in the world, especially those located in tropical and subtropical areas. This study was conducted with the aim of obtaining frequency of intestinal parasites in referred people to the Nahavand city laboratories, Hamadan province, western Iran. A comparative cross-sectional study was conducted among checkup individuals and patients referred to laboratories of Nahavand County. A total of 371 stool samples [150 from checkup individuals and 221 from patients] were selected by using systematic random sampling during summer 2014. The stool specimens were examined macroscopically, and microscopically by using direct slide smear [saline wet mount and lugol staining], formaldehyde - diethyl ether concentration, trichrome staining and modified Ziehl-Neelsen staining techniques. The results were analyzed using SPSS version 16 and Chi-square test. Ninety two patients [24.8%] were infected with single or multiple intestinal parasites. The overall prevalence of IPIs in checkup individuals and patients was 21.3% and 27.1%, respectively. The frequency of the observed intestinal parasites was: Blastocystis spp. 72 [19.4%], Entamoeba coli 7 [1/9%], Endolimax nana 7 [1/9%], Giardia lamblia 5 [1/3%], Cryptosporidium spp. 3 [0.8%], Entamoeba hartmanni 3 [0.8%], Entamoeba histolitica/E. dispar 1 [0.3%], Trichomonas hominies 1 [0.3%], Chilomastix mesnili 1 [0.3%], Iodamoeba butschlii 1 [0.3%] and Enterobius vermicularis egg l [0.3%]. The proportion of observed protozoan parasites 91 [24.5%] is higher than helminthes infection 1 [0.3%]. The worm infections in Nahavand city was dramatically decreased over the past decades, induced increases in public health at the community level. Blastocystis spp. was the predominant intestinal parasite in people referred to the Nahavand city laboratories. Proportion of pathogenic IPIs among patients 4.07% [9 of 221] was higher in compare to the checkup individuals in which only one out of 150 [0.66%] Giardia lamblia was observed

Problems of Clinical Nurse Performance Appraisal System: A Qualitative Study

PURPOSE: The purpose of this study is to explore problems of clinical nurse performance appraisal system. METHODS: This study employed a descriptive qualitative approach. The participants were purposively selected from clinical nurses working across all of the hospital units in a large metropolitan teaching hospital in Tehran, Iran in 2012. Data were collected using five focus group interviews, which were audio taped. The number of participants in each group ranged from 7 to 10. The semi-structured interviews were guided by a set of nondirective questions, and continued until the data reached saturation. Data were analyzed using framework analysis. RESULTS: Four major themes regarding the problems of clinical nurse performance appraisal system emerged from the analysis of textual data. These themes were contextual problems, problems related to performance appraisal structure, problems related to performance appraisal process and those related to performance appraisal results. CONCLUSION: The findings of this study reveal that the nurse performance appraisal system confronts with various problems. Some of these problems are related to organizational context while the others concerned structure, process and results of the performance appraisal system. In order to achieve high quality of patient care as the final goal of performance appraisal, changing and revision of this system is necessary.

Granzyme H serum levels variations with both reproductive hormone receptors, and related hormone receptors in breast cancer patients

Breast Cancer [BC] is the most common cancer in Iranian women, meanwhile the Iranian patients are relatively young. Granzyme H [GZMH] is a functional cytotoxic serine protease of NK cell granules, which expands the cell death-inducing repertoire of innate immune system. GZMH is constitutively and highly expressed in human NK cells, in order to possess chymotrypsin-like [chymase] enzymatic activity. The purpose of this study was to determine GZMH level, in BC and healthy women. 30 breast cancer patients, and 30 control women in premenopausal status, have participated in this study. GZMH, Estrogen levels, and ER,PR have been measured in cancer and healthy women subsequently, as using ELISA, Radioimmunoassay, and Immunohistochemistry methods. Mean GZMH value was lower in BC than healthy women [p<0.0001]. Our study has implicated suppressor existence, or the problem for producing of GZMH in patients group, and levels of estrogen that could not effect on making positive ER, PR

FABP9 mutations are not detected in cases of infertility due to sperm morphological defects in Iranian men

Fatty acid binding proteins [FABPs] are members of the intracellular lipid binding protein [iLBPs] family and most of them show tissue specific expression. FABP9/PERF15 [Perforatorial15] is the male germ cell-specific fatty acid-binding protein. It was first identified as the major constituent of the murine sperm perforatorium and perinuclear theca. To date, investigations in mice have demonstrated that this protein has a role in the male reproductive system, especially in spermatogenesis. Also, it has been reported that FABP9 can protect sperm fatty acids from oxidative damage. Recently it was shown that it can affect sperm morphology in mice. Based on these findings, we designed a study to evaluate if mutations of this gene can affect sperm morphology in humans. In this case-control study, DNA was extracted from peripheral blood of 100 infertile males with normal sperm count but with a number of morphologically abnormal sperms in their semen that was above normal. Four exons and one intron of the FABP9 gene were amplified by polymerase chain reaction [PCR], re-sequenced and then analyzed for mutation detection. We did not detect any mutation in any area of the four exons, intron 3 and splice sites of FABP9 gene in any of the studied 100 samples. There was no mutation in the exonic regions and the poor sperm morphology. However, we didn't analyze the promoter, intron 1 and 2 to establish conclusions regarding the association of these genic regions and sperm dysmorphology

Inhibitory effect of Lactobacillus rhamnosus on pathogenic bacteria isolated from women with bacterial vaginosis

Considering the high prevalence of bacterial vaginosis and its association with urinary tract infection in women and treatment of gynecologic problems occur when a high recurrence of bacterial vaginosis is often treated with antibiotics. The purpose of this study is to investigate the inhibitory effect of Lactobacillus rhamnosus on pathogenic bacteria isolated from women with bacterial vaginosis, respectively. 96 samples from women with bacterial vaginosis discharge referred to health centers dependent Shahid Beheshti University in 91-92 were taken by a gynecologist with a dacron swab and put in sterile tubes containing TSB broth and Thioglycollate broth and were immediately sent to the lab location in cold chain for the next stages of investigation. From Thioglycollate and TSB medium was cultured on blood agar and EMB and Palkam and Differential diagnosis environments, and then incubated for 24 h at 37[degree]C. Strains of Lactobacillus rhamnosus were cultured in MRSA environment and were transfered to the lab. After purification of pathogenic bacteria, MIC methods and antibiogram, Lactobacillus rhamnosus inhibitory effect on pathogenic bacteria is checked. Statistical analysis was done by SPSS software v.16. The results of this study show the inhibitory effect of Lactobacillus rhamnosus on some pathogenic bacteria that cause bacterial vaginosis, including Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Streptococcus agalactiae, Entrococcus, Listeria monocytogenes and E.Coli. Microscopic examination of stained smears of the large number of Lactobacillus and pathogenic bacteria showed reduced. The prevalence of abnormal vaginal discharge, history of drug use means of preventing pregnancy and douching, respectively, 61%, 55%, 42% and 13% respectively. Significant difference was observed between the use and non-use of IUD in women with bacterial vaginosis infection. Our findings indicated the Inhibitory effect of Lactobacillus rhamnosus on the pathogenic bacteria that cause bacterial vaginosis. The results of this study confirm the hypothesis of inhibit of pathogens growth that cause bacterial vaginosis supported by probiotics and can have beneficial effects in the prevention and treatment of bacterial vaginosis

Quality of the results section of original dental articles published in national Farsi and international English journals

Objective: Lack of scientific writing skills is one major problem encountered for publication of research results of Iranian scientists in accredited journals. As the result, many research projects or dissertation findings remain unpublished. This study aimed to assess the quality of writing of the "results" section of some original articles published in Iranian Farsi and international English journals

Methods: This analytical, cross-sectional study was conducted on 64 dental articles published in 3 international English and 3 Iranian Farsi journals. Selection of journals was non-random but articles were selected randomly based on specific criteria. A checklist containing 32 criteria regarding general statistics, context of the results, statistical tests, tables, charts and graphs was prepared. Obtained data were analyzed by SPSS 10 using Fisher's exact and chi square tests

Results: Farsi articles met 64.1% and English articles met 65.8% of the checklist criteria. No significant difference was found in the quality of the results section of Farsi and English papers [p>0.05]

Conclusion: Most papers did not provide adequate details in the results section to help readers better comprehend the subject

Association between vitamin D receptor gene BsmI polymorphism and bone mineral density in a population of 146 Iranian women

Osteoporosis is a bone disorder that reduces bone mineral density [BMD] and leads to bone fracture. In addition to different factors, gene polymorphisms have been revealed to be associated with osteoporosis. In this study, we investigated the association between the BsmI polymorphism of vitamin D receptor [VDR] gene [rs1544410] and BMD in a population of Iranian women. In this case control study, clinical risk factors for osteoporosis were obtained from the participants through a questionnaire for a case-control study. The World Health Organisation [WHO] criteria were applied for the diagnosis of the disease. Peripheral blood samples were obtained from 146 pre- and or postmenopausal Iranian women aged between 35 and 71 years [53.53 +/- 9.8]. The study population was classified for BMD into normal and osteoporotic groups, who matched for age, pregnancy status, menstrual condition, and body mass index [BMI]. The BMD of the lumbar spine [L1-4] and femoral neck was measured. Polymerase chain reaction restriction fragment length polymorphism [PCR-RFLP] was performed to detect and analyze the genotype. The frequencies of AA and GG were significantly different between the two groups [p value<0.05], with the first genotype being higher in the patients and the second being higher in the normal group. The GG genotype was significantly associated with increased BMD in the lumbar spine [p value<0.05] but non-significant in the femoral neck [p value>0.05]. BsmI polymorphism of VDR gene has a significant association with BMD in the lumbar spine and may have a minor effect on the proximal femur BMD in Iranian women

study of contractility of proximal surgical margin in esophageal cancer

The marginal length from main tumor in esophageal cancer is a considerable issue regarding surgical management and adjuvant treatment, so we decided to study the contractility effect on the proximal surgical margin after immersing it in 10% buffered formalin as a fixative. The proximal marginal length of ten sequential patients with esophageal cancer who underwent transhiatal esophagectomy were studied, on the operating table as fresh specimens, immediately after resection, and next 24, 48 and 72 hours after immersing in 10% buffered formalin. The contraction continued through the day 3, the mean contractility after one day was about 27%, after two days was 33% and after three days was 38%. This study shows how the proximal esophageal margin can vary by the time, after immersing in 10% buffered formalin and should be considered in every settings and reporting documents by pathologists

efficacy and safety of oxcarbazepine as add-on therapy in intractable epilepsy in children

1-3% of the population suffer from epilepsy. Up to 30% of them develop refractory epilepsy and their seizures occur more than once per month despite receiving at least 2 first line antiepileptic drugs. In this group, more efficacious antiepileptics are needed. This study was undertaken to evaluate the efficacy and safety of Oxcarbazepine as an adjunction therapy in children with refractory epilepsy. From Feb 2004 until Sep 2006, 30 patients with refractory epilepsy aged between 4 and 14 years were evaluated in a before and after type study. The patients had seizure ranging from once monthly to more than 10 times daily and none of them had used Oxcarbazepine previously. They received Oxcarbazepine 30 to 50 mg/kg/day orally in combination with their current antiepileptic drugs and were regularly assessed for seizure frequency and side effects for 10 months. With Oxcarbazepine adjunction therapy, 10% of the patients became seizure-free, 36.6% experienced more than 50% reduction in seizure frequency, and 13.3% had increasing seizures. The drug was especially effective in the patients with partial seizures [77.7%]. Brief and transient adverse effects were seen in 36.6% of the patients which disappeared with treatment continuation. Wilcoxon signed ranks test showed that oxcarbazepine was effective in the treatment of refractory seizures [P=0.003] and as shown by Fisher's exact test, it was more effective in partial seizures [P=0.0043]. The results showed that Oxcarbazepine was a useful medication in the treatment of refractory epilepsy, especially the partial type, in children

Relationship between celiac disease and refractory idiopathic epilepsy in children

Epilepsy occurs with a yearly incidence of 40 per 100,000 children, of which more than 25% are resistant to drug therapy. Epilepsy may occur in autoimmune diseases like lupus, celiac disease and myasthenia gravis. In this study, the relationship between celiac disease and refractory epilepsy was evaluated in children with idiopathic epilepsy. Hundred-fifty-five children [mean age, 6.7 +/- 3.3 years] with idiopathic and cryptogenic epilepsy referred to the neurology clinic were studied in two groups; drug controlled epilepsy [control, 82 patients] and refractory epilepsy groups [case,73 patients]. Both groups underwent serological tissue transglutaminase antibody measurement by ELISA. In seropositive cases, small intestine biopsy was conducted. Data analysis was performed using student's t test and 2 test. Seven [0.04%] patients had celiac disease based on a positive tissue transglutaminase antibody and three patients [0.01%] based on a positive biopsy. Three patients [2.4%] with drug controlled epilepsy [control group] and five with refractory epilepsy [case group] had seropositive celiac disease [p=0.255]. In the biopsy survey of six seropositive patients, one patient [1.2%] in the drug controlled epilepsy and two patients [2.7%] in the refractory epilepsy group had positive biopsy for celiac disease [p =0.604]. One seropositive patient did not cooperate for biopsy. If the relationship between celiac disease and epilepsy, especially in cases of symptomatic or oligosymptomatic celiac is proved, using gluten free diet increases the ability to control epilepsy particularly in refractory cases. We suggest celiac disease survey is not required in patients with idiopathic epilepsy

Immunogenicity of recombinant hepatitis B vaccine in health care worker of Boo-Ali hospital in Tehran, Iran, 2002-2004

Although recombinant hepatitis B vaccine is effective in a majority of population, a significant percent may do not respond [up to 10%]. Old age, obesity, heavy smoking and immunologic impairment have been associated with lower anti -HBs responses. In the present study, the efficacy of vaccine and effects of the abovementioned factors have been evaluated. Of 111 health care workers in Boo-Ali hospital, 72 participants completed primary vaccination series and antibody tittering. They received 20 micro g of recombinant HBV vaccine [Heberbiovac, Cuba] in standard schedule. Anti-HBs was determined by ELISA test [Diakey, South Korea] one month following the third dose. The lowest completion rate was reported among nursing staff and physicians [17%]. Seroprotection [anti-HBs >/= 10IU/L] was achieved in 86.1% of participants. Among seroprotected individuals, 52.8% were low-responders [anti -HBs titer of 10-99IU/L] and 33.3% were good responders [anti-HBs titer of >100IU/L]. The independent predictors of responsiveness were age less than 40 [OR=3.5, 95%CI=1.8-14.6, p<0.05], non-smoking status [OR=2.9, 95%CI=1.5- 17,2, p<0.05], and body mass index less than 25kg/m[2] [OR=4.3, 95%CI=l.9-18.0, p<0.05]. Of 10 non-responders, 7 received booster dose while anti-HBs titer was determined only in one. The primary factors associated with completion of immunization may not be amenable to job-education level. Non-compliance among non-responders was quite high [90%]. This situation seems to be grim for health care workers and warranted appropriate interventions