Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 The Investigation of Relative Efficacy of Family Trainings and Life Skills on the Protection of Chronic Mental Disorders in Family The Investigation of Relative Efficacy of Family Trainings and Life Skills on the Protection of Chronic Mental Disorders in Family 1587 1597 13297 FA Hasan Toozandehjani PhD, Assistant Professor, Department of Educational Sciences, School of Humanities, Neyshabur Branch, Islamic Azad University, Mashhad, Iran; Journal Article 2011 02 27 Introduction: This research was done to investigate the relative efficacy of family trainings and life skills to the families of patients with chronic mental disorders in Mashhad. Methods: In this semi-empirical research, a sample of 300 subjects was chosen in stratified random and systematic approach from the families of patients with chronic mental disorders admitted in round the clock centers in Mashhad and who were in waiting list; these subjects were randomly divided to two groups of experiment and control and we introduced family trainings and life skills to experiment group. There was no training to control group. These two group were tested at the beginning of trainings and post training with instruments such as taking care of and mental disorders attitude questionnaire, life skills attitude questionnaire, California social adjustment questionnaire, Rosenberg self esteem, general health questionnaire and epidemiological mental disorders questionnaire. Result: The result indicated that training had no effect on the attitude of families toward taking care of mental disorder, but family members’ attitude toward mental disorder was changed. These trainings had influence on changing family member’s attitude toward life skills, social adjustment, self esteem, mental health increase and reducing mental disorders. Conclusion: The reason for efficacy of group method of life skills training as cognitive behavior is their educational foundation, because in this method it is emphasized on both cognitive and behavioral aspects. On the other hand, more efficacy of training needed more time. Also controlling influential factors can affect in more efficacy of these trainings. Keyword: Family trainings, Life skills, Chronic mental disorders Introduction: This research was done to investigate the relative efficacy of family trainings and life skills to the families of patients with chronic mental disorders in Mashhad. Methods: In this semi-empirical research, a sample of 300 subjects was chosen in stratified random and systematic approach from the families of patients with chronic mental disorders admitted in round the clock centers in Mashhad and who were in waiting list; these subjects were randomly divided to two groups of experiment and control and we introduced family trainings and life skills to experiment group. There was no training to control group. These two group were tested at the beginning of trainings and post training with instruments such as taking care of and mental disorders attitude questionnaire, life skills attitude questionnaire, California social adjustment questionnaire, Rosenberg self esteem, general health questionnaire and epidemiological mental disorders questionnaire. Result: The result indicated that training had no effect on the attitude of families toward taking care of mental disorder, but family members’ attitude toward mental disorder was changed. These trainings had influence on changing family member’s attitude toward life skills, social adjustment, self esteem, mental health increase and reducing mental disorders. Conclusion: The reason for efficacy of group method of life skills training as cognitive behavior is their educational foundation, because in this method it is emphasized on both cognitive and behavioral aspects. On the other hand, more efficacy of training needed more time. Also controlling influential factors can affect in more efficacy of these trainings. Keyword: Family trainings, Life skills, Chronic mental disorders Family trainings Life skills Chronic mental disorders https://jims.mui.ac.ir/article_13297_5dc86332c108bc63cafa5c4ea0d34ae1.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 Is Our Clinical Decision Making Based on the Best Research Evidence? Is Our Clinical Decision Making Based on the Best Research Evidence? 1598 1605 13298 FA Tahereh Changiz Pharmacologist, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. 0000-0002-2747-4666 Payam Kabiri Epidemiologist, Department of Epidemiology & Biostatics, School of Public Health, Tehran University of Medical Sciences, Tehran and Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Sara Mozafarpour Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Nima Khalighinejad Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Hajar Taheri General Practitioner, Isfahan, Iran. Atefeh Sadeghizadeh Resident of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Manizheh Kachuie Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Farzaneh Aminpour PhD Student, School of Management and Medical Information Science, Tehran University of Medical Sciences, Tehran and Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Journal Article 2010 12 27 Introduction: Evidence based practice is an approach to clinical practice which emphasizes the use of best clinical researches as a component of clinical decision making. The aim of this study was to determine the percentage of current clinical decision making and disease management which is based and supported by high-level evidence in an educational hospital located in Isfahan, Iran.Methods: A cross-sectional study was carried on 103 patients who were admitted during one month to seven Internal medicine wards in Alzahra hospital. For each patient, the primary diagnosis and primary treatment were recorded. Evidence based resources were then searched for randomized controlled trials (RCT’s), systematic reviews and clinical practice guidelines to find the best research evidence that the treatments were effective. The main outcome measure was the level of evidence which supports the primary intervention for the primary diagnosis of each patient.Finding: Level I evidence (at least one randomized trial) supported the primary intervention used in 68.9% of internal admissions and level II evidence (convincing non-experimental evidence) supported the primary intervention in 31.1% of admissions. None of patients received intervention with level III supporting evidence.Conclusion: Most patients had received high level supported interventions. It seems that we should repeat this study in other wards. Also it may be recommended to design some educational evidence based practice for non academic physicians. Introduction: Evidence based practice is an approach to clinical practice which emphasizes the use of best clinical researches as a component of clinical decision making. The aim of this study was to determine the percentage of current clinical decision making and disease management which is based and supported by high-level evidence in an educational hospital located in Isfahan, Iran.Methods: A cross-sectional study was carried on 103 patients who were admitted during one month to seven Internal medicine wards in Alzahra hospital. For each patient, the primary diagnosis and primary treatment were recorded. Evidence based resources were then searched for randomized controlled trials (RCT’s), systematic reviews and clinical practice guidelines to find the best research evidence that the treatments were effective. The main outcome measure was the level of evidence which supports the primary intervention for the primary diagnosis of each patient.Finding: Level I evidence (at least one randomized trial) supported the primary intervention used in 68.9% of internal admissions and level II evidence (convincing non-experimental evidence) supported the primary intervention in 31.1% of admissions. None of patients received intervention with level III supporting evidence.Conclusion: Most patients had received high level supported interventions. It seems that we should repeat this study in other wards. Also it may be recommended to design some educational evidence based practice for non academic physicians. Evidence based practice Evidence based clinical performance Clinical practice guidelines https://jims.mui.ac.ir/article_13298_61d8a70e99aa97296b03374304e090c5.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 Genetic Evaluation of a Hereditary Familial Severe Obesity Due to Naturally Occurring Mutation in the Leptin Receptor and Structure Homology Modelling of the Mutated Molecule Genetic Evaluation of a Hereditary Familial Severe Obesity Due to Naturally Occurring Mutation in the Leptin Receptor and Structure Homology Modelling of the Mutated Molecule 1606 1616 13299 FA Arash Babaei Assistant Professor, Departmen of Giology, School of Scisnse, The University of Malayer, Malayer, Iran Seyed Jamal Moshtaghian Assistant Professor, Departmen of Giology, School of Scisnse, The University of Isfahan, Isfahan, Iran Journal Article 2011 02 27 Introduction: Obesity, a growing universal problem, is a disorder/illness related to several factors. These factors includ environmental, metabolic and genetic factors. Genetic studies have been undertaken for several different causative mutations involving obesity genes on different chromosomes and few mutations have been reported in that regard. Leptin is one of the most important adipose derived hormones with important role in regulating body weight through the inhibition of food intake and stimulation of energy expenditure. This hormone binds to leptin receptor that is present in surface of a number of cells especially to the ventromedial nucleus of the hypothalamus, known as the appetite centre, and it can activate intracellular signalling domains. A very small group of humans possess homozygous mutations for the leptin/leptin receptor genes which lead to a constant desire for food, resulting in severe obesity.Methods: Here we introduce a hereditary familial mutation in leptin receptor gene of two young sisters from a Kurdish-Turkish family who were suffering from severe obesity. Blood samples were taken from all member of the family and DNA was extracted from leukocytes. Sequencing was performed for suspected genes involving in severe obesity. Canonical structures Swiss homology modelling of these molecules was prepared.Finding: Data analysis showed that two sisters were homozygous for two different missense mutations in the leptin receptor. Their parents were heterozygous for these mutations.Conclusion: The data suggests that these mutations have impaired the leptin signalling and therefore have caused severe obesity in these two sisters. Introduction: Obesity, a growing universal problem, is a disorder/illness related to several factors. These factors includ environmental, metabolic and genetic factors. Genetic studies have been undertaken for several different causative mutations involving obesity genes on different chromosomes and few mutations have been reported in that regard. Leptin is one of the most important adipose derived hormones with important role in regulating body weight through the inhibition of food intake and stimulation of energy expenditure. This hormone binds to leptin receptor that is present in surface of a number of cells especially to the ventromedial nucleus of the hypothalamus, known as the appetite centre, and it can activate intracellular signalling domains. A very small group of humans possess homozygous mutations for the leptin/leptin receptor genes which lead to a constant desire for food, resulting in severe obesity.Methods: Here we introduce a hereditary familial mutation in leptin receptor gene of two young sisters from a Kurdish-Turkish family who were suffering from severe obesity. Blood samples were taken from all member of the family and DNA was extracted from leukocytes. Sequencing was performed for suspected genes involving in severe obesity. Canonical structures Swiss homology modelling of these molecules was prepared.Finding: Data analysis showed that two sisters were homozygous for two different missense mutations in the leptin receptor. Their parents were heterozygous for these mutations.Conclusion: The data suggests that these mutations have impaired the leptin signalling and therefore have caused severe obesity in these two sisters. Severe obesity Homozygous Missense mutations Leptin receptor Swiss homology modelling https://jims.mui.ac.ir/article_13299_1026d8c97a822ee171c6cbf939fe4aca.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 Evaluation of Medical Students’ Opininon about Quality of Education in Medial Emergency Ward in Isfahan University of Medical Sciences Evaluation of Medical Students’ Opininon about Quality of Education in Medial Emergency Ward in Isfahan University of Medical Sciences 1617 1627 13300 FA Babak Masoomi Assistant Professor, Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-5928-1770 Mostafa Dastgiri Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2011 03 20 Background: Large number of patients and their critical situation with a variety of complaints in emergency departments need special attention in training medical students in these sectors. Considering the deployment of Emergency Medicine depatment at the Isfahan University of Medical Sciences since two years ago becoming mandatory period for medicine interns, this study was designed to evaluate the quality of education provided to interns in the emergency department.Methods: This cross-sectional study was carried out in 2010 in Alzahra hospital (SA) in Isfahan. All of medical interns were studied in the emergency medicine department were enrolled in this study at the end of their emergency medicine course. Quality of clinical training in emergency medicine was measured by a satisfaction questionnaire that was validated in consultation with the faculty member. The questionnaire scaling was Likert Scale with five scales range from the very favorable to very unfavorable. Questionnaires were completed by interns and the data was analyzed by SPSS software and ANOVA test.Finding: The mean scale of evaluation was 135.1 ± 12.5 (out of 165 maximum scales); educational quality in emergency ward was 75.8%. The minimum and maximum scales were 94 and 153 respectively.Conclusion: Although the quality of education in the emergency department has a good situation, but to reach an 100% favorable condition and national and international standards is necessary to fix the defects, especially defects of equipment. Background: Large number of patients and their critical situation with a variety of complaints in emergency departments need special attention in training medical students in these sectors. Considering the deployment of Emergency Medicine depatment at the Isfahan University of Medical Sciences since two years ago becoming mandatory period for medicine interns, this study was designed to evaluate the quality of education provided to interns in the emergency department.Methods: This cross-sectional study was carried out in 2010 in Alzahra hospital (SA) in Isfahan. All of medical interns were studied in the emergency medicine department were enrolled in this study at the end of their emergency medicine course. Quality of clinical training in emergency medicine was measured by a satisfaction questionnaire that was validated in consultation with the faculty member. The questionnaire scaling was Likert Scale with five scales range from the very favorable to very unfavorable. Questionnaires were completed by interns and the data was analyzed by SPSS software and ANOVA test.Finding: The mean scale of evaluation was 135.1 ± 12.5 (out of 165 maximum scales); educational quality in emergency ward was 75.8%. The minimum and maximum scales were 94 and 153 respectively.Conclusion: Although the quality of education in the emergency department has a good situation, but to reach an 100% favorable condition and national and international standards is necessary to fix the defects, especially defects of equipment. Medical student Intership Emergency ward Medical emergency course https://jims.mui.ac.ir/article_13300_62c1b075041300455ec2b54495d93c99.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 Results of Flexor Carpi Radialis and Flexor Carpi Ulnaris Tendon Transfers in Chronic Radial Nerve Palsy Results of Flexor Carpi Radialis and Flexor Carpi Ulnaris Tendon Transfers in Chronic Radial Nerve Palsy 1628 1637 13301 FA Abolghasem Zarezadeh Assistant Professor, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-5232-8532 Mohammad Dehghani Associate Professor, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Ali Zarezadeh Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Elham Nasri Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2011 03 20 Background: Palliative tendon transfer procedures for radial nerve palsy are continuing to evolve. There is a big history behind this procedure. Many studies are done and they have gradually led to describe two basic methods of transfer, using the flexor carpi ulnaris or the flexor carpi radialis for transfer. There are some differences in cosmetic and functional results of these surgical plans. This study was done to compare these two methods.Methods: This study was done in Alzahra hospital in Isfahan. 41 known cases of chronic radial nerve palsy that had the inclusion criteria were selected during 7 years. They had divided into 2 groups randomly. In one group, we used flexor carpi radialis (FCR) and in the other one we used flexor carpi ulnaris (FCU) to restore fingers (metacarpophalangeal joint) extension. Post operative plan was the same in both groups. A questionnaire was designed and each patient was evaluated by physical exam. The collected data was analyzed by SPSS software. The chi square, t, and Fischer tests were used for data analyzing.Finding: There was significant difference between fingers active extension, Ulnar deviation and cosmetic results in two groups (P < 0.05). The difference between wrist extension, infection and scar formation was not significant (P > 0.05).Conclusion: The use of FCR method had better results in our study. We recommend this method if the patient does not have any contra indications. Background: Palliative tendon transfer procedures for radial nerve palsy are continuing to evolve. There is a big history behind this procedure. Many studies are done and they have gradually led to describe two basic methods of transfer, using the flexor carpi ulnaris or the flexor carpi radialis for transfer. There are some differences in cosmetic and functional results of these surgical plans. This study was done to compare these two methods.Methods: This study was done in Alzahra hospital in Isfahan. 41 known cases of chronic radial nerve palsy that had the inclusion criteria were selected during 7 years. They had divided into 2 groups randomly. In one group, we used flexor carpi radialis (FCR) and in the other one we used flexor carpi ulnaris (FCU) to restore fingers (metacarpophalangeal joint) extension. Post operative plan was the same in both groups. A questionnaire was designed and each patient was evaluated by physical exam. The collected data was analyzed by SPSS software. The chi square, t, and Fischer tests were used for data analyzing.Finding: There was significant difference between fingers active extension, Ulnar deviation and cosmetic results in two groups (P < 0.05). The difference between wrist extension, infection and scar formation was not significant (P > 0.05).Conclusion: The use of FCR method had better results in our study. We recommend this method if the patient does not have any contra indications. Tendon transfer Flexor carpi radialis Flexor carpi ulnaris https://jims.mui.ac.ir/article_13301_e1f581b9f9af4ca9be996aa40da6759e.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 The Effect of Post Suicidal Intervention Guideline in Primary Health Care on Severity of Suicidal ideation in Rural Area The Effect of Post Suicidal Intervention Guideline in Primary Health Care on Severity of Suicidal ideation in Rural Area 1638 1647 13302 FA Seyed Ahmad Mahmoudian Associate Professor, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-5328-1895 Amir Foroughi Resident, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Seyed Reza Eshagi Assistant Professor, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2011 03 20 Background: Suicide is an important problem of communities. This indecent behavior can cause organic, psychological, and social morbidities such as organ defects, family derangement, and rejection from family and community. Suicide repetition rate is high with only limited research been put to its prevention. With considering the situation of health care system of Iran, are uses of resource and guideline in this system useful for this care?Methods: This research was a randomized controlled trial. Attempted hospitalized suicide persons were entered into the study. Persons from villages or marginal area of Isfahan city in the supervision of health centers were divided to two groups randomly. WHO guideline was translated and revised according to situation of Iran. Then simple follow chart was designed. We integrated this protocol as a mental health pilot program to the health network of Isfahan province. The Behvarz (Primary health personnel) were educated several sessions about support and follow up of the patient. Intervention was done with telephone and verbally. Researcher visited the health house randomly. Intervention lasting 3 months; a control group was established prospectively without intervention. The outcome was measured by severity of suicidal ideation and repetition of suicide attempt.Finding: Mean score of suicidal ideation in intervention group before and after was19.8 and 10.5, that difference was statistically significant (P <0.001). In control group also this score was significant, let down 19.6 to 14. In run of this period no suicide was occurred.Conclusion: According to Beck score, integration of the model can decrease suicidal ideation so health system of Iran is appropriate site for care to these persons. In control group people also improved their mental status in many ways. Attraction of supportive resources such as family, friend, and spirituals do a significant role to improve mental health status and is an opportunity for managers.  Background: Suicide is an important problem of communities. This indecent behavior can cause organic, psychological, and social morbidities such as organ defects, family derangement, and rejection from family and community. Suicide repetition rate is high with only limited research been put to its prevention. With considering the situation of health care system of Iran, are uses of resource and guideline in this system useful for this care?Methods: This research was a randomized controlled trial. Attempted hospitalized suicide persons were entered into the study. Persons from villages or marginal area of Isfahan city in the supervision of health centers were divided to two groups randomly. WHO guideline was translated and revised according to situation of Iran. Then simple follow chart was designed. We integrated this protocol as a mental health pilot program to the health network of Isfahan province. The Behvarz (Primary health personnel) were educated several sessions about support and follow up of the patient. Intervention was done with telephone and verbally. Researcher visited the health house randomly. Intervention lasting 3 months; a control group was established prospectively without intervention. The outcome was measured by severity of suicidal ideation and repetition of suicide attempt.Finding: Mean score of suicidal ideation in intervention group before and after was19.8 and 10.5, that difference was statistically significant (P <0.001). In control group also this score was significant, let down 19.6 to 14. In run of this period no suicide was occurred.Conclusion: According to Beck score, integration of the model can decrease suicidal ideation so health system of Iran is appropriate site for care to these persons. In control group people also improved their mental status in many ways. Attraction of supportive resources such as family, friend, and spirituals do a significant role to improve mental health status and is an opportunity for managers.  Suicide Post-suicide intervention Primary Health Care Social support https://jims.mui.ac.ir/article_13302_a4d4ec4aa3c45731396ed6e65fee40b9.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 The Effect of Adding an Initial Dose of Mitomycin C into the Ve-sicular Delayed Six-Week Treatment in Patients with Superficial Bladder Cancer The Effect of Adding an Initial Dose of Mitomycin C into the Ve-sicular Delayed Six-Week Treatment in Patients with Superficial Bladder Cancer 1648 1654 13303 FA Farhad Tadayyon Assistant Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Hamid Mazdak Associate Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mahmoud Sarrafian Resident, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mazaher Hadi Resident, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Seyed Mojtaba Mirhashemi Resident, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Hatef Khorrami Associate Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2011 03 20 Background: Bladder tumors have a high incidence and despite being superficial in a majority of cases, the amount their relapse after transurethral resection of bladder tumour (TURBT) surgery is high. Treatment after TURBT with in vesicular methods is a way to overcome relapse. The purpose of this study was to determine the effect of implementation of adding a dose of mitomycin into the vesicular delayed six-week treatment of patients with superficial bladder cancer on the rate and degree of tumor recurrence in patients referred to Alzahra and Noor hospitals in Isfahan.Methods: In this prospective study, patients with superficial bladder tumors were selected and randomly devided in one of case or control groups. The sample size for each group was 18 patients. Patients in case group received a dose of mitomycin C after TURBT; then, both groups underwent delayed six-week treatment. Results in terms of numbers, time, grade, and stage of recurrence were analyzed using chi-square, Mann-Whitney, and Independent-t tests.Finding: 33.3% of patients in case group and 66.7% of controls experienced relaps (P = 0.04). The grade of relapsed tumor was significantly difference between the two groups (P = 0.001). The mean frequency of relapse was 0.5 ± 0.78 in case group and 1.1 ± 1.0 in control group (P = 0.04). The stage of relapsed tumors in the control group with the larger proportion was of type T1 (P = 0.006) but the time of relapse was not significantly difference between groups (P = 0.09). The relapse time was 12.5 ± 14.1 months in case group and 6.7 ± 3.7 months in control group.Conclusion: Considering the reduced number, stage, and grade of relapse in case group, the positive effect of immediately mitomycin after TURBT was proved. Studies with more patients and further follow-up period are necessary to review late relapses. Background: Bladder tumors have a high incidence and despite being superficial in a majority of cases, the amount their relapse after transurethral resection of bladder tumour (TURBT) surgery is high. Treatment after TURBT with in vesicular methods is a way to overcome relapse. The purpose of this study was to determine the effect of implementation of adding a dose of mitomycin into the vesicular delayed six-week treatment of patients with superficial bladder cancer on the rate and degree of tumor recurrence in patients referred to Alzahra and Noor hospitals in Isfahan.Methods: In this prospective study, patients with superficial bladder tumors were selected and randomly devided in one of case or control groups. The sample size for each group was 18 patients. Patients in case group received a dose of mitomycin C after TURBT; then, both groups underwent delayed six-week treatment. Results in terms of numbers, time, grade, and stage of recurrence were analyzed using chi-square, Mann-Whitney, and Independent-t tests.Finding: 33.3% of patients in case group and 66.7% of controls experienced relaps (P = 0.04). The grade of relapsed tumor was significantly difference between the two groups (P = 0.001). The mean frequency of relapse was 0.5 ± 0.78 in case group and 1.1 ± 1.0 in control group (P = 0.04). The stage of relapsed tumors in the control group with the larger proportion was of type T1 (P = 0.006) but the time of relapse was not significantly difference between groups (P = 0.09). The relapse time was 12.5 ± 14.1 months in case group and 6.7 ± 3.7 months in control group.Conclusion: Considering the reduced number, stage, and grade of relapse in case group, the positive effect of immediately mitomycin after TURBT was proved. Studies with more patients and further follow-up period are necessary to review late relapses. Bladder tumor Mitomycin C Relaps https://jims.mui.ac.ir/article_13303_4d8ab89733dd9a88f1a9d130ca675c2e.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 The Prevalence of Intestinal Parasitic and Fungal Agents in He-modialysis Patients in Isfahan The Prevalence of Intestinal Parasitic and Fungal Agents in He-modialysis Patients in Isfahan 1655 1667 13304 FA Afsoun Emami Naeini Associate Professor, Department of Nephrology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Alireza Shekarian Resident, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Shahrzad Shahidi Associate Professor, Department of Nephrology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-5442-6424 Mahdi Azami Department of Mycology and Parasitology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Seyed Hosein Hejazi Associate Professor, Department of Mycology and Parasitology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mahdi Tazhibi Assistant Professor, Department of Statistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2011 03 20 Background: Patients with chronic renal failure and hemodialysis, due to leukocyte dysfunction and reduced number, impaired immunological responses such as phagocytosis and chemotaxi and also, complement dysfunction are susceptible to opportunistic infections. In the field of intestinal parasitic and fungal infections in patients on hemodialysis are few studies and with the same goal, this study was conducted.Methods: 330 stool samples from hemodialysis patients with chronic renal failure were collected. After recording the patient profile in questionnaire, different tets with specific laboratory methods was performed on each sample.Finding: The prevalence of intestinal parasites and fungi in hemodialysis patients were 23.9 and 36.1 percent, respectively. Endolymax Nana (6.4 percent) and Geotricum Candidom (10.9 percent) were the most common fungi and parasite in dialysis patients. The highest rate of intestinal parasites and fungi were reported in the age groups of 65-51 years (29.7 percent) and over 65 (60.3 percent), respectively. Between age and prevalence of intestinal parasites and fungi was statistically relationship (P= 0.002 and P = 0.004, respectively). There was no significant relationship between gender and the prevalence of intestinal parasitic infections (P = 0.184), while the relation of incidence of fungal infections and gender was significant (P = 0.028). There was significant relationship between the prevalence of intestinal parasitic and fungal infections and the duration of dialysis and health status (P < 0.05) but with Location subjects no significant relationship was found (P > 0.05). The most common digestive symptom was constipation and then, abdominal bloating was reported.Conclusion: Considering that the prevalence of intestinal parasitic and fungal infections in patients undergoing hemodialysis is high, general physisians and specialists recommend that before different drugs prescribed, the patient parasitic and fungal infections of the intestines should be evaluated. Furthermore, the microscopic examination of stool culture and component tests of patients with chronic renal failure undergoing kidney transplantation should be considered. Background: Patients with chronic renal failure and hemodialysis, due to leukocyte dysfunction and reduced number, impaired immunological responses such as phagocytosis and chemotaxi and also, complement dysfunction are susceptible to opportunistic infections. In the field of intestinal parasitic and fungal infections in patients on hemodialysis are few studies and with the same goal, this study was conducted.Methods: 330 stool samples from hemodialysis patients with chronic renal failure were collected. After recording the patient profile in questionnaire, different tets with specific laboratory methods was performed on each sample.Finding: The prevalence of intestinal parasites and fungi in hemodialysis patients were 23.9 and 36.1 percent, respectively. Endolymax Nana (6.4 percent) and Geotricum Candidom (10.9 percent) were the most common fungi and parasite in dialysis patients. The highest rate of intestinal parasites and fungi were reported in the age groups of 65-51 years (29.7 percent) and over 65 (60.3 percent), respectively. Between age and prevalence of intestinal parasites and fungi was statistically relationship (P= 0.002 and P = 0.004, respectively). There was no significant relationship between gender and the prevalence of intestinal parasitic infections (P = 0.184), while the relation of incidence of fungal infections and gender was significant (P = 0.028). There was significant relationship between the prevalence of intestinal parasitic and fungal infections and the duration of dialysis and health status (P < 0.05) but with Location subjects no significant relationship was found (P > 0.05). The most common digestive symptom was constipation and then, abdominal bloating was reported.Conclusion: Considering that the prevalence of intestinal parasitic and fungal infections in patients undergoing hemodialysis is high, general physisians and specialists recommend that before different drugs prescribed, the patient parasitic and fungal infections of the intestines should be evaluated. Furthermore, the microscopic examination of stool culture and component tests of patients with chronic renal failure undergoing kidney transplantation should be considered. Intestinal parasites Intestinal Fungi Hemodialysis patients Prevalence https://jims.mui.ac.ir/article_13304_22935fba49f7d80d5adf1cfa6b0344f4.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 Effect of Amniotic Fluid in Treatment of Post-Laparatomy Adhesion Formation in Rat Model Effect of Amniotic Fluid in Treatment of Post-Laparatomy Adhesion Formation in Rat Model 1668 1675 13305 FA Fatemeh Mostajeran Professor, Department of Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Maryam Manouchehri Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2011 03 20 Background: Intraperitoneal adhesion is one of the most important complications after laparatomy and it may cause many problems for patients in long time such as infertility, bowel obstruction, and chronic pelvic pain. This study was done to determine a way to reduce the formation of adhesion after laparatomy.Methods: In this experimental and laboratory study, 40 adult female rats divided in two equal groups, randomly (case and control). In stage 1, all of the rats were anesthetized. Then, we opened the abdominal wall; 6 about 2-cm incisions were made on the right side and in left, a 1 × 1-cm piece was excised from abdominal wall. In stage 2, after 2 weeks we opened abdominal wall and according to Cook scale, we scored adhesion banding; then we added 3 cc amniotic fluid in case and 3 cc distilled water in control group. In stage 3, after 2 weeks, we opened abdominal wall by midline incision and adhesion were scored. Data were analyzed by tests such as t-test and paired t-test.Finding: The adhesion was less in case group (P < 0.001). Also, the difference between grades of two groups was significant (P = 0.02).Conclusion: Adhesion bands after laparatomy is one of the most important problems in surgery. Many material was surveyed to prevent or treat adhesion band such as Normal saline, dextran 70, HAL-F, ePTFE, pentoxyfyline, promethazin…. In our study, we used bovine amniotic fluid to determine. Our study showed that amniotic fluid is capable to lyses of adhesion band after laparatomy. More researches are needed to find out positive effects of this material to use as anti adhesive agent in human. Background: Intraperitoneal adhesion is one of the most important complications after laparatomy and it may cause many problems for patients in long time such as infertility, bowel obstruction, and chronic pelvic pain. This study was done to determine a way to reduce the formation of adhesion after laparatomy.Methods: In this experimental and laboratory study, 40 adult female rats divided in two equal groups, randomly (case and control). In stage 1, all of the rats were anesthetized. Then, we opened the abdominal wall; 6 about 2-cm incisions were made on the right side and in left, a 1 × 1-cm piece was excised from abdominal wall. In stage 2, after 2 weeks we opened abdominal wall and according to Cook scale, we scored adhesion banding; then we added 3 cc amniotic fluid in case and 3 cc distilled water in control group. In stage 3, after 2 weeks, we opened abdominal wall by midline incision and adhesion were scored. Data were analyzed by tests such as t-test and paired t-test.Finding: The adhesion was less in case group (P < 0.001). Also, the difference between grades of two groups was significant (P = 0.02).Conclusion: Adhesion bands after laparatomy is one of the most important problems in surgery. Many material was surveyed to prevent or treat adhesion band such as Normal saline, dextran 70, HAL-F, ePTFE, pentoxyfyline, promethazin…. In our study, we used bovine amniotic fluid to determine. Our study showed that amniotic fluid is capable to lyses of adhesion band after laparatomy. More researches are needed to find out positive effects of this material to use as anti adhesive agent in human. Amniotic fluid Adhesion bands https://jims.mui.ac.ir/article_13305_b0f7ec2784174fdce2f2de20d3941d96.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 The Comparison of Microbial Culture and PCR Methods in Detection Of Cell Line To Mycoplasma The Comparison of Microbial Culture and PCR Methods in Detection Of Cell Line To Mycoplasma 1676 1683 13306 FA Mohammad Reza Arabestani PhD Student, Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Hossain Fazeli Assistant Professor, Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mahmmud Jedi Tehrani Professor, Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Fazel Shokri Professor, Department of Immunology, School of Medicine, Tehran University of Medical Science, Tehran, Iran Journal Article 2011 03 20 Background: Mycoplasma is a major contaminant of cell lines and is cosiderd as a serious problem of economic and biological importance in basic research, diagnosis, and biotechnology products. Detection of mycoplasma infection in cell cultures started on microbiological culture; later, other methods like DAPI staining and serological tests such as Indirect Immunofluorescnse, ELISA, DNA probe, PCR, PCR-ELISA, and Real-Timr PCR developed for detection of mycoplasma.Methods: In this study, a sensitive, specific, and rapid method was used for detection of varity of mycoplasma species in cell lines. This method was based on a PCR reaction using genus specific primers for 11 mycoplasma species.Results: Mycoplasma contamination using this assay was examind for 183 different cell line deposited in national cell bank of Iran. PCR showed that 48.6% of cell lines were contaminated with mycoplasma while 27.3% of them were found to be infected. In comparison to microbiological culture, PCR method was shown to be 100% sensitive and 70.7% specific.Conclusion: Our results using species specific primers reveald that the most important contaminating mycoplasma species in cell lines were mycoplasma fermentans, mycoplasma arginini, mycoplasma hyorhinis, and mycoplasma orale. We were also able to identify a number of cell lines which were contaminated whit more than one species of mycoplasma. Background: Mycoplasma is a major contaminant of cell lines and is cosiderd as a serious problem of economic and biological importance in basic research, diagnosis, and biotechnology products. Detection of mycoplasma infection in cell cultures started on microbiological culture; later, other methods like DAPI staining and serological tests such as Indirect Immunofluorescnse, ELISA, DNA probe, PCR, PCR-ELISA, and Real-Timr PCR developed for detection of mycoplasma.Methods: In this study, a sensitive, specific, and rapid method was used for detection of varity of mycoplasma species in cell lines. This method was based on a PCR reaction using genus specific primers for 11 mycoplasma species.Results: Mycoplasma contamination using this assay was examind for 183 different cell line deposited in national cell bank of Iran. PCR showed that 48.6% of cell lines were contaminated with mycoplasma while 27.3% of them were found to be infected. In comparison to microbiological culture, PCR method was shown to be 100% sensitive and 70.7% specific.Conclusion: Our results using species specific primers reveald that the most important contaminating mycoplasma species in cell lines were mycoplasma fermentans, mycoplasma arginini, mycoplasma hyorhinis, and mycoplasma orale. We were also able to identify a number of cell lines which were contaminated whit more than one species of mycoplasma. Mycoplasma Cell lines Microbiological culture PCR https://jims.mui.ac.ir/article_13306_846b8bb19a1488bb60ed22ad4af0db5b.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 The Frequency and Type of Neoplastic and Nonneoplastic Ovarian Cysts in Cystectomy Specimens The Frequency and Type of Neoplastic and Nonneoplastic Ovarian Cysts in Cystectomy Specimens 1684 1694 13307 FA Ahmad Sobhan Ardakani Associate Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Fereshteh Mohammadizadeh Associate Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Fatemeh Sadr Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2011 03 20 Background: Ovarian cysts are among the most frequent pathologic states of the ovary. The goal of this study was to determine the frequency and age distribution of various types of ovarian cysts.Methods: In this cross-sectional investigation, 200 women with ovarian cyst who had undergone ovarian cystectomy in Beheshti hospital in Isfahan between years 2007-2009 entered the study. Three age groups including prepuberty, reproductive, and postmenopausal were considered. The cysts were categorized as nonneoplastic or neoplastic. Data were extracted from pathology reports and patients’ records. SPSS software was used for data analysis.Finding: Mean age of the patients was 31.4 ± 9.8 years. 1.5%, 92%, and 6.5% of the patients were in prepuberty, reproductive, and postmenopausal age groups, respectively. 42% of the cysts were neoplastic and 58% were nonneoplastic. No statically significant relationship was observed between the nature of the cyst and age group. Overall, endometriosis with frequency of 18% was the most frequent cyst. Among neoplastic cysts, serous cystadenoma and dermoid cyst, each with frequency of 31.2% were the most common types. There wasn’t any significant relationship between the mean ages of various neoplastic cysts. Endometriosis with the frequency of 31% was the most common nonneoplastic cyst and there wasn’t any significant relationship between the age group and the type of nonneoplastic cyst. Conclusion: The majority of ovarian cysts are nonneoplastic and endometriosis is the most frequent type of ovarian cysts in surgically removed specimens. Most of the ovarian cysts are observed in reproductive age.Keywords: ovarian cyst- neoplastic cyst- nonneoplastic cyst- endometriosis- serous cystadenoma- dermoid cyst. Background: Ovarian cysts are among the most frequent pathologic states of the ovary. The goal of this study was to determine the frequency and age distribution of various types of ovarian cysts.Methods: In this cross-sectional investigation, 200 women with ovarian cyst who had undergone ovarian cystectomy in Beheshti hospital in Isfahan between years 2007-2009 entered the study. Three age groups including prepuberty, reproductive, and postmenopausal were considered. The cysts were categorized as nonneoplastic or neoplastic. Data were extracted from pathology reports and patients’ records. SPSS software was used for data analysis.Finding: Mean age of the patients was 31.4 ± 9.8 years. 1.5%, 92%, and 6.5% of the patients were in prepuberty, reproductive, and postmenopausal age groups, respectively. 42% of the cysts were neoplastic and 58% were nonneoplastic. No statically significant relationship was observed between the nature of the cyst and age group. Overall, endometriosis with frequency of 18% was the most frequent cyst. Among neoplastic cysts, serous cystadenoma and dermoid cyst, each with frequency of 31.2% were the most common types. There wasn’t any significant relationship between the mean ages of various neoplastic cysts. Endometriosis with the frequency of 31% was the most common nonneoplastic cyst and there wasn’t any significant relationship between the age group and the type of nonneoplastic cyst. Conclusion: The majority of ovarian cysts are nonneoplastic and endometriosis is the most frequent type of ovarian cysts in surgically removed specimens. Most of the ovarian cysts are observed in reproductive age.Keywords: ovarian cyst- neoplastic cyst- nonneoplastic cyst- endometriosis- serous cystadenoma- dermoid cyst. https://jims.mui.ac.ir/article_13307_97fa70856aa8095cb1a6c7343a84bd85.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 Distribution of Patients with Septic Shock in Gynecology wards in A Period of Ten Years Distribution of Patients with Septic Shock in Gynecology wards in A Period of Ten Years 1695 1700 13308 FA Zahra Shahshahan Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Sareh Boroumand Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2011 03 20 Introduction: Septic shock is an important and serious disease. The major aim of this research was to find demographic factors and etiology of septic shock.Methods: In this retrospective descriptive research, 400 patients with the diagnosis of septic shock who were admitted in obstetric and gynecologic words of Alzahra and Beheshti hospitals in Isfahan during ten years were evaluated. The data about age, marital status, and etiology was gathered.Results: Most of the patients were in 25-35 years and married. The most prevalent etiology of the disease was septic abortion. Most of the patients had 2 or more children and lived in town. Most of patients had history of surgical treatment plus medical treatment, had admitted for 5 days or more in hospital, were treated by 3 antibiotics and most of them lived.Conclusion: This research concluded that etiology of most of the septic shocks was septic abortion that has done illegally and in non sterile condition because of economical and social problems of having more children. This emphasized the importance of people education for avoidance of doing illegally induced abortion and septic abortion.   Introduction: Septic shock is an important and serious disease. The major aim of this research was to find demographic factors and etiology of septic shock.Methods: In this retrospective descriptive research, 400 patients with the diagnosis of septic shock who were admitted in obstetric and gynecologic words of Alzahra and Beheshti hospitals in Isfahan during ten years were evaluated. The data about age, marital status, and etiology was gathered.Results: Most of the patients were in 25-35 years and married. The most prevalent etiology of the disease was septic abortion. Most of the patients had 2 or more children and lived in town. Most of patients had history of surgical treatment plus medical treatment, had admitted for 5 days or more in hospital, were treated by 3 antibiotics and most of them lived.Conclusion: This research concluded that etiology of most of the septic shocks was septic abortion that has done illegally and in non sterile condition because of economical and social problems of having more children. This emphasized the importance of people education for avoidance of doing illegally induced abortion and septic abortion.   Septic shock Sepsis Septic abortion Induced abortion https://jims.mui.ac.ir/article_13308_91df814c65a828c59c6217aebd6a27c2.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 Leptin and Fertility Leptin and Fertility 1701 1713 13309 FA Fateme Sadat Amjadi PhD Student of Reproductive Biology, Department of Anatomy, Tehran University of Medical Sciences, Tehran, Iran. Ensieh Salehi MSc Student, Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran. Shaghayegh Haghjooy Javanmard Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2010 12 13 Leptin, the adipocyte-derived hormone that plays a key role in energy and body weight homeostasis, has recently known as a mediator in the reproductive system. Leptin acts as a link between fat tissue and reproduction in human and is a signal which transmits the information to the brain; where is adequate fat in stores to cover the energy requirements of reproduction. Leptin acts on reproductive system at multiple levels including hypothalamic-pituitary-gonadal axis. It influences puberty, mensturation, pregnancy, and lactation. The nutritional suboptimal conditions such as eating disorders and obesity can influence serum leptin levels and are associated with some reproductive system disorders such as amenorrhea and polycystic ovarian syndrome. Future studies are expected to clarify the exact role of leptin in human reproductive physiology and pathophysiology.Keywords: Leptin, Fertility, Hypothalamic-pituitary-gonadal axis. Leptin, the adipocyte-derived hormone that plays a key role in energy and body weight homeostasis, has recently known as a mediator in the reproductive system. Leptin acts as a link between fat tissue and reproduction in human and is a signal which transmits the information to the brain; where is adequate fat in stores to cover the energy requirements of reproduction. Leptin acts on reproductive system at multiple levels including hypothalamic-pituitary-gonadal axis. It influences puberty, mensturation, pregnancy, and lactation. The nutritional suboptimal conditions such as eating disorders and obesity can influence serum leptin levels and are associated with some reproductive system disorders such as amenorrhea and polycystic ovarian syndrome. Future studies are expected to clarify the exact role of leptin in human reproductive physiology and pathophysiology.Keywords: Leptin, Fertility, Hypothalamic-pituitary-gonadal axis. Leptin Fertility Hypothalamic-pituitary-gonadal axis https://jims.mui.ac.ir/article_13309_45b02e9da70144e563ddb3407d8718ae.pdf
Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 28 121 2011 02 20 Colonoscopic findings Colonoscopic findings 1714 1715 13310 FA Hamid Kalantari Associate Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Journal Article 2011 02 06 COLONOSCOPY OVERVIEW — A colonoscopy is an exam of the lower part of the gastrointestinal tract, which is called the colon or large intestine (bowel). Colonoscopy is a safe procedure that provides information other tests may not be able to give.Colonoscopy is performed by inserting a device called a colonoscope into the anus and advanced through the entire colon. The procedure generally takes between 20 minutes and 1 hour.REASONS FOR COLONOSCOPY — The most common reasons for colonoscopy are to evaluate the following:As a screening exam for colon cancerRectal bleedingA change in bowel habits, like persistent diarrheaIron deficiency anemia (a decrease in blood count due to loss of iron)A family history of colon cancerAs a follow-up test in people with colon polyps or colon cancerChronic, unexplained abdominal or rectal painAn abnormal X-ray exam, like a barium enema or CT scanTHERAPEUTIC COLONOSCOPYThe most common reasons are the following: Polypectomy, Band ligation of hemorrhoids, Injection or cautery techniques for the treatment of diverticullum with active bleeding or a visible vessel or a vascular ectasia.COLONOSCOPY COMPLICATIONS — Colonoscopy is a safe procedure, and complications are rare but can occur:Bleeding can occur from biopsies or the removal of polyps, but it is usually minimal and can be controlled.The colonoscope can cause a tear or hole in the colon. This is a serious problem, but it does not happen commonly.It is possible to have side effects from the sedative medicines.Although colonoscopy is the best test to examine the colon, it is possible for even the most skilled doctors to miss or overlook an abnormal area in the colon.  COLONOSCOPY OVERVIEW — A colonoscopy is an exam of the lower part of the gastrointestinal tract, which is called the colon or large intestine (bowel). Colonoscopy is a safe procedure that provides information other tests may not be able to give.Colonoscopy is performed by inserting a device called a colonoscope into the anus and advanced through the entire colon. The procedure generally takes between 20 minutes and 1 hour.REASONS FOR COLONOSCOPY — The most common reasons for colonoscopy are to evaluate the following:As a screening exam for colon cancerRectal bleedingA change in bowel habits, like persistent diarrheaIron deficiency anemia (a decrease in blood count due to loss of iron)A family history of colon cancerAs a follow-up test in people with colon polyps or colon cancerChronic, unexplained abdominal or rectal painAn abnormal X-ray exam, like a barium enema or CT scanTHERAPEUTIC COLONOSCOPYThe most common reasons are the following: Polypectomy, Band ligation of hemorrhoids, Injection or cautery techniques for the treatment of diverticullum with active bleeding or a visible vessel or a vascular ectasia.COLONOSCOPY COMPLICATIONS — Colonoscopy is a safe procedure, and complications are rare but can occur:Bleeding can occur from biopsies or the removal of polyps, but it is usually minimal and can be controlled.The colonoscope can cause a tear or hole in the colon. This is a serious problem, but it does not happen commonly.It is possible to have side effects from the sedative medicines.Although colonoscopy is the best test to examine the colon, it is possible for even the most skilled doctors to miss or overlook an abnormal area in the colon.  https://jims.mui.ac.ir/article_13310_a8fce534946205342d958571e15558df.pdf