Effects of Serum Vitamin D and Efficacy of Subcutaneous Immunotherapy in Adult Patients With Allergic Rhinitis

Immunotherapy is the standard of treatment for long-life relief of symptoms of allergic rhinitis. Vitamin D may affect the outcomes of treatment. This study evaluated the clinical efficacy of subcutaneous allergen immunotherapy in adult patients with allergic rhinitis based on the serum level of vitamin D. Patients with persistent allergic rhinitis and positivity for skin prick test were evaluated by Sino-nasal Outcome Test (SNOT-22) and Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ) before subcutaneous allergen immunotherapy and during the maintenance phase to assess the relation of the serum level of vitamin D and the clinical efficacy of immunotherapy. After immunotherapy, the greatest reduction in SNOT-22 scores were reported in patients with vitamin D sufficiency (39.0 ± 9.2), followed by vitamin D suboptimal provision (35.1 ± 12.1), insufficiency (25.0 ± 7.5), and deficiency (18.3 ± 6.0) (P < 0.001). The MiniRQLQ reduction in patients with vitamin D sufficiency, suboptimal provision, insufficiency, or deficiency was 30.7 ± 8.7, 27.1 ± 8.7, 20.0 ± 8.6, or 17.4 ± 7.1, respectively (P < 0.001). Both of SNOT-22 and MiniRQLQ scores decreased significantly following immunotherapy in patients with different levels of vitamin D. However, these effects were more pronounced when the level of vitamin D was sufficient.

[Prokaryotic expression of chimeric trimer protein [3M[2]e-HA2-NP] derived from conserved domains of influenza virus A/H1N1 as a promising universal subunit vaccine]

Background and Aim: Influenza A virus is an important respiratory pathogen which can cause high rates of morbidity and mortality during seasonal epidemics and pandemics. Current vaccines are not capable of producing effective immunity against different influenza virus subtypes. Designing universal vaccines using conversed domains of influenza virus antigens can overcome this limitation. The ectodomain of influenza M[2] protein [M[2]e], the hemagglutinin stalk domain [HA2], and nucleoprotein [NP] are the most conserved sequences among subtypes of influenza A viruses. The aim of this study was to attach part of the NP gene into the binary structure of 3M[2]e-HA2 and assessment of expression of a chimer trimer protein in prokaryotic system. This recombinant protein is considered as a promising antigenic candidate for a universal vaccine production

Materials and Methods: First, part of the NP gene segment of human influenza A/H1N1[PR/8/34]was amplified by PCR using designed specific primers. This amplified gene was cloned into pGEM-TEasy cloning vector. Then, the confirmed segment of NP gene was subcloned into PET28a/3M[2]e-HA2 recombinant expression vector, downstream of the HA2 segment. After confirmation of cloning, the chimer protein was expressed in E.coli BL21[DE3]

Results: The results of colony PCR, restriction enzyme digestion and sequencing indicated that the NP gene segment was correctly cloned into PET28a/3M[2]e-HA2. Chimer protein expression was analyzed by SDS-PAGE and confirmed by Western blotting

Conclusion: Design and production of recombinant protein [3M[2]e-HA2-NP] could be an important step towards the development of a universal influenza vaccine

Comparison of ultrasonography and radiography in diagnosis of rib fractures / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography.</p><p><b>METHODS</b>In this cross-sectional study, consecutive patients with minor blunt chest trauma and suspected rib fractures presenting in Imam Reza Hospital located in Mashhad-Iran, between April 2013 and October 2013 were assessed by USG and radiography. The radiography was performed in a posteroanterior (PA) chest projection and oblique rib view centered over the area of trauma. The time duration spent in taking USG and radiography were recorded. The prevalence and location of fractures revealed by USG and radiography were compared.</p><p><b>RESULTS</b>Sixty-one suspected patients were assessed. The male to female ratio was 2.4:1 (43 men and 18 women) with a mean ± SD age of (44.3 ± 19.7) years. There were totally 59 rib fractures in 38 (62.3%) patients based on radiography and USG, while 23 (37.7%) patients had no diagnostic evidence of rib lesions. USG revealed 58 rib fractures in 33 (54.1%) of 61 suspected patients and radiographs revealed 32 rib fractures in 20 (32.8%) of 61 patients. A total of 58 (98.3%) rib fractures were detected by USG, whereas oblique rib view and PA chest radiography showed 27 (45.8%) and 24 (40.7%) rib fractures, respectively. The average duration of USG was (12 ± 3) min (range 7-17 min), whereas the duration of radiography was (27 ± 6) min (range 15-37 min). The kappa coefficient showed a low level of agreement between both USG and PA chest radiography (kappa coefficient = 0.28), and between USG and oblique rib view (kappa coefficient = 0.32).</p><p><b>CONCLUSION</b>USG discloses more fractures than radiography in most patients presenting with suspected rib fractures. Moreover USG requires significantly less time than radiography.</p>

Therapeutic Outcomes of Pectoralis Major Muscle Turnover Flap in Mediastinitis

BACKGROUND: This study aimed to evaluate the therapeutic results and safety of pectoralis major muscle turnover flaps in the treatment of mediastinitis after coronary artery bypass grafting (CABG) procedures. METHODS: Data regarding 33 patients with post-CABG deep sternal wound infections (DSWIs) who underwent pectoralis major muscle turnover flap procedures in the Emam Reza and Ghaem Hospitals of Mashhad, Iran were reviewed in this study. For each patient, age, sex, hospital stay duration, remission, recurrence, and associated morbidity and mortality were evaluated. RESULTS: Of the 2,447 CABG procedures that were carried out during the time period encompassed by our study, DSWIs occurred in 61 patients (2.5%). Of these 61 patients, 33 patients (nine females [27.3%] and 24 males [72.7%]) with an average age of 63+/-4.54 years underwent pectoralis major muscle turnover flap placement. Symptoms of infection mainly occurred within the first 10 days after surgery (mean, 10.24+/-13.62 days). The most common risk factor for DSWIs was obesity (n=16, 48.4%) followed by diabetes mellitus (n=13, 39.4%). Bilateral and unilateral pectoralis major muscle turnover flaps were performed in 20 patients (60.6%) and 13 patients (39.4%), respectively. Complete remission was achieved in 25 patients (75.7%), with no recurrence in the follow-up period. Four patients (12.1%) needed reoperation. The mean hospitalization time was 11.69+/-6.516 days. Four patients (12.1%) died during the course of the study: three due to the postoperative complication of respiratory failure and one due to pulmonary thromboembolism. CONCLUSION: Pectoralis major muscle turnover flaps are an optimal technique in the treatment of post-CABG mediastinitis. In addition to leading to favorable therapeutic results, this flap is associated with minimal morbidity and mortality, as well as a short hospitalization time.

Central venous line complications and tip detection

Central venous line is one of a creative instrument that saves human's life in critical medical situation. Central venous line access is frequently involved in the disease management. It is used for rapid fluid therapy, transvenous pacemakers, infusion of some medications, hemodialysis or plasmapheresis and etc. Most of the emergency departments have some staffs that are trained for central venous line insertion but related complications occur during central venous line placement. Central venous line might have some complications and complication follow-up should be considered. Thromboembolism and infection are two important medical complications. Arterial puncture, hematoma, pneumothorax and hemothorax are mechanical Central venous line complications. Chest X-ray and some other techniques should be used for detecting these complications. Central venous line tip misplace is a considerable problem for emergency department staffs, previously chest X-ray has been used for central venous line misplace detection. In some recent studies, contrast-enhanced ultrasonography and intravascular electrocardiography have been used for central venous line misplace

effects of Fifa 2015 computer games on changes in cognitive, hormonal and brain waves functions of young men volunteers

Introduction: Computer games have attracted remarkable attentions in general publics with different cultures and their effects are subject of research by cognitive neuroscientists. In the present study, possible effects of the game Fifa 2015 on cognitive performance, hormonal levels, and electroencephalographic [EEG] signals were evaluated in young male volunteers

Methods: Thirty two subjects aged 20 years on average participated mutually in playing computer game Fifa 2015. Identification information and general knowledge about the game were collected. Saliva samples from the contestants were obtained before and after the competition. Perceptive and cognitive performance including the general cognitive health, response delay, attention maintenance, and mental fatigue were measured using PASAT test. EEG were recorded during the play using EEG device and analyzed later using QEEG. Simultaneously, the players' behavior were recorded using a video camera. Saliva cortisol levels were assessed by ELISA kit. Data were analyzed by SPSS program

Results: The impact of playing computer games on cortisol concentration of saliva before and after the game showed that the amount of saliva plasma after playing the game has dropped significantly. Also the impact of playing computer games on mental health, before and after the game indicated that the number of correct answers has not changed significantly. This indicates that sustained attention has increased in participants after the game in comparison with before that. Also it is shown that mental fatigue measured by PASAT test, did not changed significantly after the game in comparison to before that. The impact of game on changes in brain waves showed that the subjects in high activity state during playing the game had higher power of the EEG signals in most of the channels in lower frequency bands in compared to normal state

Discussion: The present study showed that computer games can positively affect the stress system and the perceptual-cognitive system. Even though this impact was not significant in most cases, the changes in cognitive and hormonal test and also in brain waves were visible. Hence, due to the importance of this matter, it is necessary to create control systems in selecting the types of games for playing

Effect of dexmedetomidine on postoperative pain in knee arthroscopic surgery; a randomized controlled clinical trial

Various drugs are administered intra-articularly to provide postoperative analgesia after arthroscopic knee surgery. The purpose of this study was to assess the analgesic effects of intra-articular injection of a dexmedeto-midine following knee arthroscopy. Forty six patients schadualed for arthroscopic knee surgery under general anaesthesia, were randomly devided into two groups. Intervention group received 1microg/kg dexmedetomidine [D] and isotonic saline. Control group received 25ml isotonic saline [P]. Analgesic effects were evaluated by measuring pain intensity [VAS scores] and duration of analgesia. There was no significant difference between the two groups in terms of age, sex and weight. The mean of post-operation pain severity in 1, 3, 6,12, and 24 h was significantly lower in the intervention group [D] in comparison w] to toe contio] group [P]. toe mean of toe tola] dose oftramado] consumption was significantly lower in the mterven-tion group in comparison with the control group [P<0.001]. Intra-articular injection of dexmedetomidine at the end of arthroscopic knee surgery, alleviates the patients' pain; reducing the postoperative need for narcotics as analgesics, and increase the first analgesic request after operation

Effects of Ramadan fasting on lipid profile: a narrative review

Fasting during the month of Ramadan is a religious obligation, practiced by millions of people around the world. Ramadan fasting is essentially a fundamental change in lifestyle for one lunar month. This type of fasting may have significant effects on lipid profile. Although there is no scientific consensus about the effects of fasting on cardiovascular risks such as changes in lipid profile, some studies have revealed the positive effects of Ramadan fasting [and similar religious fasting] on lipid profile and cardiovascular diseases [CVDs] such as atherosclerosis and coronary artery disease. These effects may be related to factors such as different fasting durations [season-dependent], diets, and physical activities during Ramadan. An overall improvement in cardiovascular risk profile is noted during Ramadan fasting. Majority of studies have reported an increment in high-density lipoprotein [HDL] level, decreased triglyceride level, and no change or decline in total cholesterol or low-density lipoprotein [LDL] levels. Therefore, given the lack of comprehensive literature in this field, we reviewed some related studies in order to describe the impact of Ramadan fasting on lipid profile. It can be inferred that Ramadan fasting alters lipid profile by improving HDLcholesterol and reducing LDL-cholesterol in some cases. However, changes in triglyceride and total cholesterol during Ramadan are not uniform or similar. Moreover, Ramadan fasting is not associated with any changes in the prevalence of CVD or frequency of hospitalization

Evaluation of gender-related differences in response to oxidative stress in toxoplasma gondii positive serum

Toxoplasma gondii [T. gondii] is the causative agent of toxoplasmosis. It infects up to one third of the human population. The aim of this study was to evaluate the effects of T. gondii infection on induction of oxidative stress in serum of infected men and women. This case-control study was carried out on 150 individuals who had referred to our center in Tehran. Serum was obtained from venous blood samples. Immunoglobulin G [IgG] anti-toxoplasma antibody enzyme linked immunosorbent assay [ELISA] test was performed on all of the samples. Those who were IgG positive were regarded as the case group [52 women and 23 men] and the others as the control group [43 women and 32 men]. The data were analyzed by INSTAT software using ANOVA followed by Tukey. Serum superoxide dismutase activity in men of the case group was significantly higher than in the control group [7.81 +/- 0.38 vs. 6.69 +/- 0.17, P = .045]. Catalase activity in men of the case group was significantly higher than the control group [8.64 +/- 0.55 vs. 6.23 +/- 0.38, P = .006]. Glutathione S-transferase activity and malondialdehyde level in women of the case group were significantly higher than the control group [5.98 +/- 0.24 vs. 4.73 +/- 0.28, P = .037 and 2.3 +/- 0.09 vs. 1.9 +/- 0.09, P = .032, respectively]. Catalase activity and glutathione level in women of the case group were lower than the control group [6.0 +/- 0.45 vs. 7.63 +/- 0.48, P = .043 and 0.62 +/- 0.05 vs. 0.89 +/- 0.05, P = .007, respectively]. T. gondii infection induces oxidative stress in women's serum because of the decreased catalase activity, glutathione depletion and increasing lipid peroxidation. The increased antioxidant enzyme activities in infected men were because of the adaptive response to the generated free radicals. Women were found to be more sensitive to the effects of toxoplasma infection on oxidative stress induction compared to men.

Hippocampal volume in childhood seizures

Many children with hippocampal sclerosis underwent surgery for treatment. Early childhood convulsion occurs in 2 to 4% of population and its prognosis is good in majority of cases. It seems that hippocampal anomalies are common in patients with neocortical epilepsies. The theory of hippocampal sclerosis association with temporal lobe epilepsy has been proposed 100 years ago. Recent studies demonstrated that there was a correlation between memory impairments and prolonged febrile convulsion [PFC], which might be a result of hippocampal injury. Transient hippocampus swelling might happen in complicated early childhood epilepsy or status epilepticus and result in hippocampal sclerosis

The assessment of health-related quality of life in scleroderma-interstitial lung disease

Introduction: Pulmonary involvement is the most common cause of mortality and disability in patients with systemic sclerosis and it significantly affects the quality of life in these patients. Therefore, early diagnosis and treatment of pulmonary involvement seems necessary in patients with SSc. In this study, we aimed to assess the health-related quality of life [HRQoL] in patients with Scleroderma-Interstitial Lung Disease [SSc-ILD] and its relationship with pulmonary function parameters

Materials and Methods: Considering the inclusion and exclusion criteria, 25 patients with SSc-ILD were enrolled in this cross-sectional study from April 2012 to June 2013. Full tests of lung function, including body plethysmography and diffusing capacity of the lungs for carbon monoxide [DLCO], 6-minute walk distance [6MWD], and pulse oximetry were performed. The HRQoL was assessed using St. George's and CAT questionnaires; also, dyspnea was evaluated for all the patients, using modified medical research council [MMRC] scale. Afterwards, the relationship between the total scores of HRQoL questionnaires and the severity of lung disease was analyzed, based on the recorded variables

Results: The mean age of the patients was 40.36 +/- 9.50 years and the mean duration of the disease was 7.16 +/- 4.50 years. A statistically significant inverse correlation was observed between 6MWD [r=-0.50, P=0.01], DLCO [r=-0.67, P<0.001], and CAT total score. In addition, there was a statistically significant negative association between CAT score and total lung capacity [r=-0.46, P=0.01]. Finally, a significant direct relationship was observed between the total scores of CAT and St. George's questionnaires [r=0.75, P<0.001]

Conclusion: The results of this study showed that CAT questionnaire is a suitable tool for assessing the quality of life in SSc patients; moreover, it is significantly related to the factors associated with pulmonary function. Therefore, the CAT questionnaire may be used to track pulmonary function in SSc patients

comparison of the complications between two surgical techniques of esophageal cancer

Introduction: Esophageal cancer is a common gastro intestinal malignancy. One of the most common techniques of surgery in esophageal cancer is transhiatal esophagectomy with esophagogastric anastomosis in the neck. This technique is accompanied by complications like chronic gastero-esophegeal reflux and late stenosis. This study was designed to compare the risk of complications after two surgical techniques for esophageal cancer: esophagogastric anastomosis with partial fundoplication and esophagogastric anastomosis without it

Materials and Methods: In this retrospective cohort study, 100 patients with distal two thirds of esophageal cancer who underwent transhiatal esophagectomy in Ghaem and Omid hospitals Mashhad University of Medical Sciences from 2005 to 2010 were included. Esophagogastric anastomosis to the posterior gastric wall was performed with a partial gastric fundoplication in the first group but simple routine anastomosis was done to the posterior gastric wall in the second group

Results: In a retrospective cohort study 100 patients entered the study with 59 male and 41 female and with a mean age 54.6 +/- 6.4 years. Squamous cell carcinoma was observed in 77% of the patients and adenocarcinoma was reported in 23% of them. Seventy-two percent of tumours were located in distal third and 28% were in middle third of esophagus. Esophagogastric anastomotic leakage was observed in 3 cases of fundoplication group and 7 cases of simple anastomosis technique [P=0.182] so there was no significant difference between the two groups. Benign anastomosis stricture was reported in one of the patients who underwent esophagogastric anastomosis with fundoplication, but it was observed in 8 cases with simple anastomosis technique [P=0.03] so there was a significant difference between the two groups

Conclusion: Esophagogastric anastomosis with partial fundal fundoplication is a safe technique with low incidence of anatomic leakage and late stenosis

relationship between diaphragmatic movements in sonographic assessment and disease severity in patients with stable chronic obstructive pulmonary disease [COPD]

Introduction: Pulmonary hyperinflation in patients with chronic obstructive pulmonary disease [COPD] can increase the breathing rate and reduce diaphragmatic movements by pushing the diaphragms downward and limiting their movements; this, in fact, can affect the breathing process. The purpose of this study was to compare diaphragmatic movements in COPD patients and healthy ones and to evaluate the relation of diaphragmatic movements and COPD severity in patients

Materials and Methods: This cross- sectional study was performed in Ghaem hospital, Mashhad Iran. Twenty-five COPD patients [case group] were selected, based on the inclusion and exclusion criteria. The patients' demographic and clinical characteristics along with factors related to pulmonary function were recorded. Patients were referred for sonography after pulmonary evaluation. The status of the left portal vein or one of its branches at the end of a deep expiration and a deep inspiration was considered as a marker. Twenty-five healthy non-smoker subjects, who were matched with the patients in terms of age and sex, were studied as the control group for the comparison of sonographic findings of the diaphragms

Results: The current study included 25 healthy subjects and 25 COPD patients, with the mean age of 59.2 +/- 12 years; approximately 84% of the subjects were males. Evaluation of the rate of diaphragmatic movements by sonography showed the mean of 42.08 +/- 12.15mm and 73.28 +/- 15.19mm in the case and control groups, respectively, which showed a statistically significant difference between them [P=0.02]. Statistical analysis indicated the relationship between the rate of diaphragmatic movements with factors related to airway obstruction. However, no relationship was observed between the rate of diaphragmatic movements and the factors associated with pulmonary hyperinflation or air retention

Conclusion: The rate of diaphragmatic movements as a parameter for determining exercise capacity in COPD patients could help with a better understanding of activity limitations in these patients

Role of conservative management in neck trauma: a case series study

Introduction: Given the fact that neck is a vital component of one's anatomy, injuries of this organ may be accompanied by fatal complications. In this article, we aimed to evaluate the etiology of neck trauma, simultaneous injuries of other organs, therapeutic methods for neck trauma, associated complications, length of hospital stay, at Ghaem Hospital over 10 years

Materials and Methods: In this retrospective study, we evaluated all cases of neck trauma at Ghaem hospital during 1994-2013. Patients were allocated into two groups of blunt and penetrating injuries. Trauma zone, therapeutic methods, coexisting injuries of other organs, associated complications, length of hospital stay, and mortality rate were evaluated in these two groups

Results: In this study, 75 [75%] and 25 [25%] cases were penetrating and blunt, respectively. Overall, 45% of the subjects had other simultaneous injuries and central nervous system injury accounted for the majority of cases. Zone II of the neck was involved in 89% of penetrating neck injuries and 70% of these subjects underwent surgery; conservative management was applied for 30% of the cases. Mortality rate was estimated at 3% for penetrating neck injuries and mean length of hospital stay time was 6 +/- 2 days. Moreover, 68% of blunt neck injuries were explored. The most common cause of surgery was vascular exploration [68%] and the most common surgical intervention was vein ligation [64%]. Mortality rate for blunt neck injuries was estimated at 5.2%, and mean mortality rate was 3.5% in both groups

Conclusion: Considering the severity of complications associated with neck injuries, early neck exploration is suggested for unstable cases or individuals with injuries deeper than the platysma. In addition, the role of diagnostic techniques such as helical computed tomography and interventional angiography was emphasized in the current study

role of tracheal stenting as an alternative treatment in cicatricial and non-operable tracheal stenosis

Tracheal stenosis is normally caused by trauma, infection, benign and malignant tumors, prolonged intubation or tracheostomy. The best treatment for tracheal stenosis is resection and anastomosis of trachea. Yet the major surgical complication of tracheal surgery is postoperative stenosis. The goal of this paper is to study the result of tracheal stenting as a replacement therapy for patients suffering from tracheal stenosis who are not good candidates for surgery. This study presents the results of stenting in patients with: Inoperable tumoral stenosis,Non-tumoral stenosis being complicated due to prior surgeries,Inability to undergo a major surgery. The study was performed between September 2002 and July 2011 and poly flex stents were used by means of rigid bronchoscopy. A total of 25 patients received stents during this study. Among them 15 patients suffered from benign and 10 suffered from malignant tracheal stenosis. The patients were followed up for at most 12 months after the stenting operation. The mean age of the patients was 35 years. The most common cause of stenosis was prolonged intubation [75%]. The most common indication for stenting was the history of multiple tracheal operations. The most common complication of stenting and cause of stent removal was formation of granulation tissue. 30% of patients with benign tracheal stenosis were cured and about 10% improved until they could stand a major operation. Ten patients in benign group and 2 patients in malignant group [20%] needed T-Tube insertion after stent removal but other patientcure by stenting. In benign cases stenting is associated with recurrence of symptoms which requires other therapeutic techniqus, so the stenting may not be named as a final solution in benign cases. However, this technique is the only method with approved efficacy for malignant cases with indication

Anterior trans cervicothoracic approach for complete resection of cervicothoracic mediastinal neurogenic tumors

Introduction: Neurogenic mediastinal tumors comprise a wide range of benign and malignant diseases. A group of these tumors, located at thoracic apex, sometimes spread to cervical spaces causing numerous surgical difficulties. In thoracotomy approaches, due to proximity of the tumors to major blood vessels, complete removal of these tumors from cervical spaces is impossible or may cause intraoperative severe bleeding or other dangerous incidents Because of the adjacent major vessels that are not visible. The aim of this study is to report cases of surgical treatment of such tumors using Anterior Trans Cervicothoracic Approach [ATCA]

Materials and Methods: All patients with neurogenic tumors and cervicomediastinal [CM] spread who underwent surgey with ATCA technique during 2005-2011 were included in our study. Then they were evaluated in terms of age, sex, clinical symptoms, radiological and pathological findings, technical success rate of the surgery, surgical complications and first-year relapse rate after the surgery

Results: Our study included 10 patients from whom 9 were female and 1 was male [M/F= 1/9] and the mean age was 27 years. The most common symptoms were pain and feeling of a lump. All patients were operated by this technique successfully. The most common pathological finding was neurofibroma [in 5 patients] and surgical complications occurred in 2 patients [20%] [Wound infection in 1 patient and brachial plexus injury in another patient]. There was no mortality. Disease relapse was reported in 1 patient ganglioneuroblastoma who underwent surgical resection for the second time

Conclusion: Considering the successful removal of the tumors and favorable exposure of major vessels in cervicomediastinal spaces, this technique is recommended to resect mediastinal tumors with spread to cervical spaces. However, a more definite conclusion requires further studies

Effect of mindfulness based stress reduction on quality of life [SF-36] and spirometry parameters, in chemically pulmonary injured veterans

Studies have shown that Mindfulness Based Stress Reuction [MBSR] has positive effect on physical and psychological dimensions of chronic illnesses. In this study for the first time we examine the effect of this new technique on quality of life and pulmonary function in chemically pulmonary injured veterans who have chronic pulmonary problem, psychological problems and low quality of life. Forty male pulmonary injured veterans were randomly replaced in two groups with 20 participants [MBSR and control Wait List [WL]]. Then MBSR group received 8-weekly session intervention. We evaluate quality of life [used SF-36 questionnaire] and Spirometry parameters two times; before and after intervention in two group. We used "mixed factorial analyses of variance" test for analyzing data in each dependent variables. Then if we have significant interactional effect, we used "paired - sample t-test" for comparing before and after intervention data of each group, and "Independent-Sample t-test" for comparing after intervention data of two groups. The MBSR compare to WL group improved SF-36 total score, [F[1,38] =12.09, P=0.001], "Role limitations due to physical problems" [F[1,38]= 6.92, P=0.01], "Role limitations due to emotional problems" [F[1,38]= 7.75, P=0.008], "Social functioning" [F[1,38]= 9.89, P=0.003], "Mental health" [F[1,38]= 15.93, P=0], "Vitality" [F[1,38]= 40.03, P

Emergency conversion from off pump to cardiopulmonary bypass in patients with coronary artery bypass graft surgery

As off pump Coronary artery bypass grafting surgery [CABG] is a developing method in coronary cardiac surgery, most surgeons are anxious about the danger of emergency crash conversion. In this observational study we tried to show the rate and outcome of conversion In this descriptive study about 477 coronary offpump CABG patients were operated in Ghaem hospital in Mashhad, Iran, from Jan 2012 to Jan 2013. In this group 20 patients needed to convert to Cardiopulmonary Bypass [CPB] immediately. We analyzed these 20 patients and produced the results. There was no cerebrovascular accident [CVA] and no neurologic problems. There was one death among these 20 patients. There was one case of renal failure who was the same patient that expired.75% of these 20 patients had hypertension and 45% had diabetes.20 patients [4.19%] had an emergency switch to On-pump CABG and only one death occurred among 20 patients

Pepsin and bile acid concentrations in sputum of mustard gas exposed patients

Gastro-esophageal reflux has been suggested to be associated with several pulmonary complications such as asthma, and post-transplant bronchiolitis obliterans [BO]. Pepsin or bile salts in the sputum is shown to be an optimal molecular marker of gastric contents macro/micro aspiration. In this study, we investigated sputum pepsin as a marker of micro-aspiration in sulfur mustard [SM] exposed cases compared to healthy controls. In a case controlled study, 26 cases with BO and 12 matched healthy controls were recruited and all cases were symptomatic and their exposure to SM was previously documented during Iran-Iraq conflict. Pepsin levels in sputum and total bile acids were measured using enzymatic assay. The severity of respiratory disorder was categorized based upon the spirometric values. The average concentration of pepsin in sputum was higher in the case group [0.29 +/- 0.23] compared with healthy subjects [0.13 +/- 0.07; P +/- 0.003]. Moreover, the average concentration of bile acids in the sputum cases was not significantly different in comparison to the controls [P = 0.5]. Higher pepsin concentrations in sputum of SM exposed patients compared with healthy control subjects indicate the occurrence of significantly more gastric micro-aspiration in SM exposed patients

[Validity and reliability of the Chen internet addiction scale]

This study was conducted in order to determine the validity and reliability of Chen Internet Addiction Scale [CIAS] among the medical students of Tehran University of Medical Sciences. This was a cross sectional study on 214 medical students of Tehran University who completed the Chen Internet Addiction Scale [CIAS] and Internet Addiction Scale [IAS] in autumn and winter of 2010-2011. The sampling was performed with available sampling method. After translation of CIAS, the face validity was confirmed by three community medicine specialists. Then IAD, demographic and internet use data forms were filled by the medical students. Validity and reliability of CIAS questionnaire was evaluated with factorial analysis, internal consistency, convergent validity, and Cronbach alpha test by SPSS soft ware. In the validity investigation of CIAS, convergent validity shows [r=0.85] with [P=0.001] and factorial analysis by varimax rotation, revealed five factors. In the reliability investigation of CIAS, results of cronbach alpha, was [alpha =0.93]. The validity and reliability of CIAS was acceptable but due to the lack of an approved gold standard in the diagnosis of internet addiction, further studies are needed for agreement on clinical diagnostic criteria in order to determine proper cut off point for the questionnaire. This is a fundamental step in the planning, preventing and treatment of this disorder