Emotional intelligence and anxiety, stress, and depression in Iranian resident physicians.

BACKGROUND: Residency is one of the most critical periods of medical education. Residents are susceptible in high risk for mental problems which can affect the doctor-patient relationship. Emotional intelligence (EI) correlates closely with stress and mental health. Considering the important role of EI in medical education and with regard to lack of studies in this group in Iran, this study conducted to determine the relationship between EI and stress, anxiety, and depression in a sample of resident physician in our university of medical sciences. MATERIALS AND METHODS: In this cross-sectional study, 245 residents were invited, but only100 questionnaires were analyzed, and the response rate was 41%. From this, 26 were men and 74 were women. Bar-on EI questionnaire, Depression Anxiety Stress Scales-21, for evaluating the stress, anxiety, and depression and demographic characteristics were used. RESULTS: The mean score of EI in resident physician was 330.24 ± 38.5. The mean score of stress, anxiety, and depression was 17.8 ± 8.6, 10.04 ± 7.99, and 10.49 ± 8.67 respectively. There was a negative relation between mean score of anxiety (R = -0.0525), stress (R = -0.639), and depression (R = -0.644) with a mean score of EI. CONCLUSION: Higher EI appears to be good predictors of lower stress, anxiety, and depression in resident physician.

Correlation between cystatin C-based formulas, Schwartz formula and urinary creatinine clearance for glomerular filtration rate estimation in children with kidney disease.

INTRODUCTION: Assessment of glomerular filtration rate (GFR) is an important tool for monitoring renal function. OBJECTIVES: Regarding to limitations in available methods, we intended to calculate GFR by cystatin C (Cys C) based formulas and determine correlation rate of them with current methods. PATIENTS AND METHODS: We studied 72 children (38 boys and 34 girls) with renal disorders. The 24 hour urinary creatinine (Cr) clearance was the gold standard method. GFR was measured with Schwartz formula and Cys C-based formulas (Grubb, Hoek, Larsson and Simple). Then correlation rates of these formulas were determined. RESULTS: Using Pearson correlation coefficient, a significant positive correlation between all formulas and the standard method was seen (R(2) for Schwartz, Hoek, Larsson, Grubb and Simple formula was 0.639, 0.722, 0.705, 0.712, 0.722, respectively) (P<0.001). Cys C-based formulas could predict the variance of standard method results with high power. These formulas had correlation with Schwarz formula by R(2) 0.62-0.65 (intermediate correlation). Using linear regression and constant (y-intercept), it revealed that Larsson, Hoek and Grubb formulas can estimate GFR amounts with no statistical difference compared with standard method; but Schwartz and Simple formulas overestimate GFR. CONCLUSION: This study shows that Cys C-based formulas have strong relationship with 24 hour urinary Cr clearance. Hence, they can determine GFR in children with kidney injury, easier and with enough accuracy. It helps the physician to diagnosis of renal disease in early stages and improves the prognosis.

Addition of intrathecal fentanyl or meperidine to lidocaine and epinephrine for spinal anesthesia in elective cesarean delivery.

BACKGROUND: A common and useful approach to pain management is administration of neuraxial opioids. OBJECTIVES: Whether addition of fentanyl or meperidine to lidocaine and epinephrine for spinal anesthesia in elective cesarean delivery has any effects on duration of postoperative pain. PATIENTS AND METHODS: This was a clinical trial, conducted on 195 pregnant women candidates for elective cesarean section. All patients were in ASA classes I, and II aged 17-45 years, and were randomly allocated to three groups named as meperidine (P), fentanyl (F), and placebo (S). In the three groups (P, F, and S), 25 mg meperidine, 25 µg fentanyl and 0.5 mL saline with lidocaine and epinephrine were injected into the subarachnoid space for spinal anesthesia, respectively. Perioperative complications and Apgar scores were recorded. Duration of analgesia was measured from the end of operation for 24 hours by using VAS. The first VAS≥4 was recorded as the end of the painless period. Characteristics of sensory and motor block were assessed. Statistical analysis was performed with SPSS software. RESULTS: The mean duration of analgesia with meperidine, fentanyl or placebo were 9.46 ± 0.6, 6.27 ± 0.45, 2.06 ± 0.13 hours, respectively (P < 0.0001). There was significant difference between the group P and the other groups. Patients on meperidine had faster, longer and higher sensory block (P < 0.0001) and faster and longer motor block (P < 0.0001). Frequency of sedation in the group F was more than the others (P < 0.026). There was no difference in Apgar scores between the three groups (P < 0.45). CONCLUSIONS: Addition of meperidine or fentanyl to lidocaine and epinephrine solution increases the duration of postoperative analgesia in cesarean section. Meperidine is a recommended adjuvant according to longer duration of analgesia and lower complications.

Effect of hepatic iron concentration and viral factors in chronic hepatitis C-infected patients with thalassemia major, treated with interferon and ribavirin.

BACKGROUND: Beta thalassemia major patients are vulnerable to transfusion-transmitted infection, especially hepatitis C virus (HCV), and iron overload. These comorbidities lead to cirrhosis and hepatocellular carcinoma in these patients. In order to prevent these complications, treatment of HCV infection and regular iron chelating seems to be necessary. The aim of this study was to evaluate the effect of hepatic iron concentration (HIC) and viral factors on the sustained virological response (SVR) in chronic HCV-infected patients, with beta thalassemia major being treated with interferon and ribavirin. MATERIALS AND METHODS: We enrolled 30 patients with thalassemia major and chronic HCV who were referred to the Hematology Clinic of Guilan University of Medical Sciences, between December 2002 and April 2006. HIC was measured by atomic absorption spectroscopy before treatment. The viral factors (viral load, genotype) and HIC were compared between those who achieved a SVR and nonresponders. RESULTS: Mean age of the 30 thalassemic patients, was 22.56 ± 4.28 years (14-30 years). Most patients were male (56.7%). Genotype 1a was seen in 24 (80%) cases. SVR was achieved in 15 patients (50%). There were no significant correlations between HIC (P = 1.00), viral load (P = 0.414), HCV genotype (P = 0.068), and SVR. No difference was observed in viral load (P = 0.669) and HIC (P = 0.654) between responders and nonresponders. CONCLUSION: HIC, HCV viral load, and HCV genotype were not correlated with virological response, and it seems that there is no need to postpone antiviral treatment for more vigorous iron chelating therapy.

The relationship between magnesium level and first 72 hours Rankin score and Rankin score in 1 week after an ischemic stroke.

BACKGROUND: We intended to investigate the serum magnesium impact upon the disability after ischemic stroke. METHODS: A total of 67 ischemic stroke patients who less than 6 hours had passed from their attacks participated in this cross sectional study. We have measured their serum magnesium level and determined its correlation with their Rankin Disability Score (RDS) in the first 72 hours (RDS0) and after 1 week (RDS1w) and its change in this period of time by using nominal regression method and repeated measure ANOVA in SPSS 17. RESULTS: There was a reciprocal statistical correlation between serum magnesium level and RDS0 and RDS1w. (P = 0.000 & 0.002 respectively). But it hasn't any significant statistical correlation with the changes of this score in this period of time (P = 0.513). CONCLUSION: Serum magnesium level is a good predictor for patients' abilities that involved by an ischemic stroke.