Iranian Red Crescent Medical Journal Iranian Red Crescent Medical Journal Iran Red Crescent Med J http://www.ircmj.com 2074-1804 2074-1812 10.5812/ircmj en jalali 2017 5 26 gregorian 2017 5 26 18 4
en 27275398 10.5812/ircmj.23664 Prevention and Treatment of Flatulence From a Traditional Persian Medicine Perspective Prevention and Treatment of Flatulence From a Traditional Persian Medicine Perspective review-article review-article Context

The feeling of abdominal fullness, bloating, and movement of gas in the abdomen is a very uncomfortable sensation termed flatulence. Since flatulence is one of the most common gastrointestinal symptoms that is bothersome to patients, it is important to identify effective methods to resolve this issue. In modern medicine, management of flatulence is often not satisfactory. On the other hand, traditional systems of medicine can be considered good potential sources to find new approaches for preventing and treating flatulence. The aim of this study is to review flatulence treatments from a traditional Persian medicine (TPM) viewpoint.

Evidence Acquisition

In this study, the reasons for flatulence and methods for its prevention and treatment are reviewed in traditional Persian medicine (TPM) texts and then related with evidence from modern medicine by searching in databases, including PubMed, Scopus, Google Scholar, and IranMedex.

Results

From a traditional Persian scholar viewpoint, one of the most important causes of flatulence is an incorrect manner of eating; valuable advice to correct bad eating habits will be illustrated. In addition, traditional practitioners describe some herbs and vegetables as well as herbal compounds that are effective food additives to relieve flatulence. The anti-flatulent effect of most of these herbs has been experimentally verified using modern medicine.

Conclusions

Attention to TPM can lead to the identification of new preventive and curative approaches to avoid and treat flatulence. In addition, Persian viewpoints from the medieval era regarding flatulence are historically important.

Context

The feeling of abdominal fullness, bloating, and movement of gas in the abdomen is a very uncomfortable sensation termed flatulence. Since flatulence is one of the most common gastrointestinal symptoms that is bothersome to patients, it is important to identify effective methods to resolve this issue. In modern medicine, management of flatulence is often not satisfactory. On the other hand, traditional systems of medicine can be considered good potential sources to find new approaches for preventing and treating flatulence. The aim of this study is to review flatulence treatments from a traditional Persian medicine (TPM) viewpoint.

Evidence Acquisition

In this study, the reasons for flatulence and methods for its prevention and treatment are reviewed in traditional Persian medicine (TPM) texts and then related with evidence from modern medicine by searching in databases, including PubMed, Scopus, Google Scholar, and IranMedex.

Results

From a traditional Persian scholar viewpoint, one of the most important causes of flatulence is an incorrect manner of eating; valuable advice to correct bad eating habits will be illustrated. In addition, traditional practitioners describe some herbs and vegetables as well as herbal compounds that are effective food additives to relieve flatulence. The anti-flatulent effect of most of these herbs has been experimentally verified using modern medicine.

Conclusions

Attention to TPM can lead to the identification of new preventive and curative approaches to avoid and treat flatulence. In addition, Persian viewpoints from the medieval era regarding flatulence are historically important.

Traditional Persian Medicine (TPM);Modern Medicine;Flatulence Traditional Persian Medicine (TPM);Modern Medicine;Flatulence http://www.ircmj.com/index.php?page=article&article_id=23664 Bagher Larijani Bagher Larijani Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran Mohammad Medhi Esfahani Mohammad Medhi Esfahani Qoran, Hadis and Teb Sciences Research Center, Tehran University of Medical Sciences, Tehran, IR Iran Qoran, Hadis and Teb Sciences Research Center, Tehran University of Medical Sciences, Tehran, IR Iran Maryam Moghimi Maryam Moghimi School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran; School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9125135631 School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran; School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9125135631 Mohammad Reza Shams Ardakani Mohammad Reza Shams Ardakani School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Mansoor Keshavarz Mansoor Keshavarz School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Gholamreza Kordafshari Gholamreza Kordafshari School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Esmaiel Nazem Esmaiel Nazem School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Shirin Hasani Ranjbar Shirin Hasani Ranjbar Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran Hoorieh Mohammadi Kenari Hoorieh Mohammadi Kenari School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Arman Zargaran Arman Zargaran Pharmaceutical Sciences Research Center and Department of Traditional Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IR Iran Pharmaceutical Sciences Research Center and Department of Traditional Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 27275400 10.5812/ircmj.29615 Association Between Outcomes and Demographic Factors in an Azeri Turkish Population With Cystic Fibrosis: A Cross-Sectional Study in Iran From 2001 Through 2014 Association Between Outcomes and Demographic Factors in an Azeri Turkish Population With Cystic Fibrosis: A Cross-Sectional Study in Iran From 2001 Through 2014 research-article research-article Conclusions

The results demonstrated that the mortality rate was higher in CF patients with a positive family history, a consanguineous marriage, and residence in a rural area. Therefore, demographic factors play an important role in the outcome of cystic fibrosis. Unfortunately, these parameters, which can be managed easily and with low cost, have been overlooked.

Patients and Methods

This was a cross-sectional study and data were gathered for 331 patients using the census method, from March 2001 to September 2014 in Iran. Data was analyzed using logistic regression analysis, chi-square test, and independent sample t test using SPSS 18. Odds ratio with confidence intervals of 95% and P < 0.05 were considered significant.

Results

There were 85 (25.7%) deceased patients and 246 (74.3%) living patients at the time of the study. Of the 246 living CF patients, 202 (82.2%) were less than nine years of age, and 77 (90.6%) out of the 85 deceased CF patients had died younger than four years of age. There was a significant difference between outcome and location of residence. The risk of mortality was 50% less in urban patients than in rural patients (P = 0.03). The risk of mortality was approximately two times higher in patients with a positive family history than in those with a negative family history (P = 0.02). The proportion of mortality was approximately two times, or 94%, higher for those in a consanguineous marriage than for those in a non-consanguineous marriage (P = 0.01).

Background

Outcomesforcystic fibrosis patients are improving rapidly. The demographic factors are notable variables inoutcomes, which can be evaluated and modified.

Objectives

This study was designed to investigate the association between outcome and demographic factors in patients with cystic fibrosis.

Conclusions

The results demonstrated that the mortality rate was higher in CF patients with a positive family history, a consanguineous marriage, and residence in a rural area. Therefore, demographic factors play an important role in the outcome of cystic fibrosis. Unfortunately, these parameters, which can be managed easily and with low cost, have been overlooked.

Patients and Methods

This was a cross-sectional study and data were gathered for 331 patients using the census method, from March 2001 to September 2014 in Iran. Data was analyzed using logistic regression analysis, chi-square test, and independent sample t test using SPSS 18. Odds ratio with confidence intervals of 95% and P < 0.05 were considered significant.

Results

There were 85 (25.7%) deceased patients and 246 (74.3%) living patients at the time of the study. Of the 246 living CF patients, 202 (82.2%) were less than nine years of age, and 77 (90.6%) out of the 85 deceased CF patients had died younger than four years of age. There was a significant difference between outcome and location of residence. The risk of mortality was 50% less in urban patients than in rural patients (P = 0.03). The risk of mortality was approximately two times higher in patients with a positive family history than in those with a negative family history (P = 0.02). The proportion of mortality was approximately two times, or 94%, higher for those in a consanguineous marriage than for those in a non-consanguineous marriage (P = 0.01).

Background

Outcomesforcystic fibrosis patients are improving rapidly. The demographic factors are notable variables inoutcomes, which can be evaluated and modified.

Objectives

This study was designed to investigate the association between outcome and demographic factors in patients with cystic fibrosis.

Cystic Fibrosis;Deceased Patients Living Patients;Living Patients;Iran Cystic Fibrosis;Deceased Patients Living Patients;Living Patients;Iran http://www.ircmj.com/index.php?page=article&article_id=29615 Leila Vahedi Leila Vahedi Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Morteza Jabarpoor-Bonyadi Morteza Jabarpoor-Bonyadi Faculty of Natural Sciences, Center of Excellence for Biodiversity, University of Tabriz, Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Faculty of Natural Sciences, Center of Excellence for Biodiversity, University of Tabriz, Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Morteza Ghojazadeh Morteza Ghojazadeh Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Hakimeh Hazrati Hakimeh Hazrati Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Mandana Rafeey Mandana Rafeey Tabriz Children’s Hospital, Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran; Tabriz Children’s Hospital, Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-9141146982, Fax: +41-33373741 Tabriz Children’s Hospital, Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran; Tabriz Children’s Hospital, Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-9141146982, Fax: +41-33373741
en 27257511 10.5812/ircmj.24458 Distribution of Human Papillomavirus Genotypes in Iranian Women According to the Severity of the Cervical Lesion Distribution of Human Papillomavirus Genotypes in Iranian Women According to the Severity of the Cervical Lesion research-article research-article Conclusions

This study describes robust information on the distribution of HPV genotypes among Iranian women with and without cervical lesions. The present data may be of importance for designing future public health strategies, including HPV vaccination programs.

Results

In total, HPV infection was detected in 45.4% of the cases. The most common high-risk HPV (HR-HPV) genotype was HPV-16 (32.8%), followed by HPV-53 (9.1%). Within low-risk (LR-HPV) genotypes HPV-6 (22.2%) and HPV-44 (6.1%) were the most prevalent. HPV-16 was the predominant genotype in cases with cervical cancer (56.5%), ASCUS (34.4%), and HSIL (34.1%). HPV-6 was the most common genotype in normal cases (9.1%) and LSIL patients (18%). The prevalence of HPV positivity was significantly higher in cases with high-grade lesions (≥ HSIL) (64.2%) than in normal/LSIL (37.3%) (P = 0.033). The rate of HR-HPV infection was significantly higher in ≥ HSIL cases (61.2%) than normal/LSIL (27.9%) (P = 0.003).

Objectives

The aim of this study was to determine the distribution of HPV genotypes in Iranian women with different grades of cervical lesions.

Patients and Methods

From 2011 to 2013, a total of 436 Iranian women with convenience sampling strategy were included in this cross-sectional study. In detail, 287 women negative for intraepithelial lesion or malignancy, 32 with atypical squamous cells of undetermined significance (ASCUS), 50 with low-grade squamous intraepithelial lesion (LSIL), 44 with high-grade squamous intraepithelial lesion (HSIL), and 23 with cervical cancer were evaluated in this investigation. HPV genotypes were determined by INNO-LiPA HPV Genotyping Extra assay.

Background

Persistent infection with high-risk human papillomavirus (HPV) has been recognized as a major cause of cervical cancer. Distribution of HPV genotypes may differ according to the geographic region and the severity of the cervical lesion. Determining HPV genotypes’ specific distribution is useful for HPV surveillance and control programs. However, little is known about the distribution of HPV genotypes in Iranian women.

Conclusions

This study describes robust information on the distribution of HPV genotypes among Iranian women with and without cervical lesions. The present data may be of importance for designing future public health strategies, including HPV vaccination programs.

Results

In total, HPV infection was detected in 45.4% of the cases. The most common high-risk HPV (HR-HPV) genotype was HPV-16 (32.8%), followed by HPV-53 (9.1%). Within low-risk (LR-HPV) genotypes HPV-6 (22.2%) and HPV-44 (6.1%) were the most prevalent. HPV-16 was the predominant genotype in cases with cervical cancer (56.5%), ASCUS (34.4%), and HSIL (34.1%). HPV-6 was the most common genotype in normal cases (9.1%) and LSIL patients (18%). The prevalence of HPV positivity was significantly higher in cases with high-grade lesions (≥ HSIL) (64.2%) than in normal/LSIL (37.3%) (P = 0.033). The rate of HR-HPV infection was significantly higher in ≥ HSIL cases (61.2%) than normal/LSIL (27.9%) (P = 0.003).

Objectives

The aim of this study was to determine the distribution of HPV genotypes in Iranian women with different grades of cervical lesions.

Patients and Methods

From 2011 to 2013, a total of 436 Iranian women with convenience sampling strategy were included in this cross-sectional study. In detail, 287 women negative for intraepithelial lesion or malignancy, 32 with atypical squamous cells of undetermined significance (ASCUS), 50 with low-grade squamous intraepithelial lesion (LSIL), 44 with high-grade squamous intraepithelial lesion (HSIL), and 23 with cervical cancer were evaluated in this investigation. HPV genotypes were determined by INNO-LiPA HPV Genotyping Extra assay.

Background

Persistent infection with high-risk human papillomavirus (HPV) has been recognized as a major cause of cervical cancer. Distribution of HPV genotypes may differ according to the geographic region and the severity of the cervical lesion. Determining HPV genotypes’ specific distribution is useful for HPV surveillance and control programs. However, little is known about the distribution of HPV genotypes in Iranian women.

Papillomavirus Infections;Cervical Cancer;Iran Papillomavirus Infections;Cervical Cancer;Iran http://www.ircmj.com/index.php?page=article&article_id=24458 Mostafa Salehi-Vaziri Mostafa Salehi-Vaziri Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Farzin Sadeghi Farzin Sadeghi Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Immunology and Microbiology, School of Medicine, Babol University of Medical Sciences, Babol, IR Iran Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Immunology and Microbiology, School of Medicine, Babol University of Medical Sciences, Babol, IR Iran Firoozeh Sadat Hashemi Firoozeh Sadat Hashemi Department of Gynecology Oncology ,Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, IR Iran Department of Gynecology Oncology ,Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, IR Iran Hayedeh Haeri Hayedeh Haeri Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran Farah Bokharaei-Salim Farah Bokharaei-Salim Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran Seyed Hamidreza Monavari Seyed Hamidreza Monavari Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran Hossein Keyvani Hossein Keyvani Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran; Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188602205 Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran; Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188602205
en 27257512 10.5812/ircmj.24775 The Effects of Oral Cryotherapy on Chemotherapy-Induced Oral Mucositis in Patients Undergoing Autologous Transplantation of Blood Stem Cells: A Clinical Trial The Effects of Oral Cryotherapy on Chemotherapy-Induced Oral Mucositis in Patients Undergoing Autologous Transplantation of Blood Stem Cells: A Clinical Trial research-article research-article Objectives

The aim of this study was to investigate the effects of local cryotherapy on the intensity of chemotherapy-induced oral mucositis in autologous bone marrow transplantation patients.

Patients and Methods

In this single, blinded, randomized clinical trial, 29 patients undergoing stem cell transplantation in Iran were selected by convenience sampling, and randomly allocated to control (n = 13) and intervention groups (n = 16). In the intervention group, cryotherapy was applied, while the control group received a normal saline mouthwash. The severity of the mucositis and neutrophil rate were investigated in five periods, based on the world health organization (WHO) scales. The data were analyzed using descriptive statistics, the Mann-Whitney test, repeated measures analysis of variance (ANOVA), and linear regression.

Conclusions

The results showed that cryotherapy is more effective than the saline mouthwash in reducing the severity of mucositis. This method is recommended for the prevention of mucositis in bone marrow transplantation.

Results

In both groups, the mucositis reached its peak intensity on the 7th day, and the least intensity was obtained on the 21st day. The neutrophil rate reached the minimum value on the 7th day, then increased up to the 21st day. The two groups showed no significant differences between the mucositis severity on the 14th and 21st days (P = 0.164), while the severity of the mucositis in the cryotherapy group was significantly less than that in the saline mouthwash group (1.81 < 2.54 and 0.13 < 0.92, respectively) on the 7th and 14th days (P < 0.05). There was no significant difference in the neutrophil rate between the groups.

Background

Oral mucositis is one of the irritating side effects of chemotherapy in patients undergoing bone marrow transplantation. However, up until now, the common methods of oral mucositis therapy have failed to show significant effects.

Objectives

The aim of this study was to investigate the effects of local cryotherapy on the intensity of chemotherapy-induced oral mucositis in autologous bone marrow transplantation patients.

Patients and Methods

In this single, blinded, randomized clinical trial, 29 patients undergoing stem cell transplantation in Iran were selected by convenience sampling, and randomly allocated to control (n = 13) and intervention groups (n = 16). In the intervention group, cryotherapy was applied, while the control group received a normal saline mouthwash. The severity of the mucositis and neutrophil rate were investigated in five periods, based on the world health organization (WHO) scales. The data were analyzed using descriptive statistics, the Mann-Whitney test, repeated measures analysis of variance (ANOVA), and linear regression.

Conclusions

The results showed that cryotherapy is more effective than the saline mouthwash in reducing the severity of mucositis. This method is recommended for the prevention of mucositis in bone marrow transplantation.

Results

In both groups, the mucositis reached its peak intensity on the 7th day, and the least intensity was obtained on the 21st day. The neutrophil rate reached the minimum value on the 7th day, then increased up to the 21st day. The two groups showed no significant differences between the mucositis severity on the 14th and 21st days (P = 0.164), while the severity of the mucositis in the cryotherapy group was significantly less than that in the saline mouthwash group (1.81 < 2.54 and 0.13 < 0.92, respectively) on the 7th and 14th days (P < 0.05). There was no significant difference in the neutrophil rate between the groups.

Background

Oral mucositis is one of the irritating side effects of chemotherapy in patients undergoing bone marrow transplantation. However, up until now, the common methods of oral mucositis therapy have failed to show significant effects.

Chemotherapy;Mucositis;Stem Cell Transplantation;Autologous;Cryotherapy;Normal Saline Chemotherapy;Mucositis;Stem Cell Transplantation;Autologous;Cryotherapy;Normal Saline http://www.ircmj.com/index.php?page=article&article_id=24775 Marzieh Askarifar Marzieh Askarifar Tabriz University of Medical Sciences, Tabriz, IR Iran Tabriz University of Medical Sciences, Tabriz, IR Iran Sima Lakdizaji Sima Lakdizaji Medical-Surgical Nursing Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, IR Iran; Medical-Surgical Nursing Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-4114770648, Fax: +98-4114796969 Medical-Surgical Nursing Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, IR Iran; Medical-Surgical Nursing Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-4114770648, Fax: +98-4114796969 Mani Ramzi Mani Ramzi Shiraz University of Medical Sciences, Shiraz, IR Iran Shiraz University of Medical Sciences, Shiraz, IR Iran Azad Rahmani Azad Rahmani Hematology and Oncology Research Center, Medical-Surgical Nursing Department, Tabriz University of Medical Sciences, Tabriz, IR Iran Hematology and Oncology Research Center, Medical-Surgical Nursing Department, Tabriz University of Medical Sciences, Tabriz, IR Iran Faranak Jabbarzadeh Faranak Jabbarzadeh Medical-Surgical Nursing Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, IR Iran Medical-Surgical Nursing Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, IR Iran
en 27257510 10.5812/ircmj.23320 Propylthiouracil-Induced Vasculitis With Alveolar Hemorrhage Confirmed by Clinical, Laboratory, Computed Tomography, and Bronchoscopy Findings: A Case Report and Literature Review Propylthiouracil-Induced Vasculitis With Alveolar Hemorrhage Confirmed by Clinical, Laboratory, Computed Tomography, and Bronchoscopy Findings: A Case Report and Literature Review case-report case-report Conclusions

Patients treated with PTU should be closely monitored and followed up, even if the drug has been used for several years. When patients develop progressive dyspnea with alveolar opacities on chest imaging that cannot be explained otherwise, alveolar hemorrhage should be an important differential diagnosis while investigating the case. Early diagnosis and prompt discontinuation of the PTU treatment are essential for improving patient outcomes.

Introduction

Propylthiouracil (PTU) is commonly used to treat hyperthyroidism and can induce antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Although this is a rare side effect, ANCA-associated vasculitis can progress to severe disease if its diagnosis and treatment are delayed, leading to a poor prognosis.

Case Presentation

A 43-year-old woman with Graves’ disease developed pulmonary vasculitis and diffuse alveolar hemorrhage (DAH) associated with ANCA against myeloperoxidase and proteinase-3 that was confirmed by computed tomography (CT) and bronchoscopy and treated with PTU. The symptoms and signs of alveolar hemorrhage were rapidly resolved after PTU withdrawal and treatment with corticosteroids. After 6 months of follow-up, the patient maintained complete ANCA-negative clinical remission status, as confirmed by normal CT and bronchoscopy findings. To our knowledge, this is the first documented case of bronchoscopic comparison of PTU-induced DAH before and after steroid treatment.

Conclusions

Patients treated with PTU should be closely monitored and followed up, even if the drug has been used for several years. When patients develop progressive dyspnea with alveolar opacities on chest imaging that cannot be explained otherwise, alveolar hemorrhage should be an important differential diagnosis while investigating the case. Early diagnosis and prompt discontinuation of the PTU treatment are essential for improving patient outcomes.

Introduction

Propylthiouracil (PTU) is commonly used to treat hyperthyroidism and can induce antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Although this is a rare side effect, ANCA-associated vasculitis can progress to severe disease if its diagnosis and treatment are delayed, leading to a poor prognosis.

Case Presentation

A 43-year-old woman with Graves’ disease developed pulmonary vasculitis and diffuse alveolar hemorrhage (DAH) associated with ANCA against myeloperoxidase and proteinase-3 that was confirmed by computed tomography (CT) and bronchoscopy and treated with PTU. The symptoms and signs of alveolar hemorrhage were rapidly resolved after PTU withdrawal and treatment with corticosteroids. After 6 months of follow-up, the patient maintained complete ANCA-negative clinical remission status, as confirmed by normal CT and bronchoscopy findings. To our knowledge, this is the first documented case of bronchoscopic comparison of PTU-induced DAH before and after steroid treatment.

Vasculitis;Antineutrophil Cytoplasmic Antibody (ANCA);Thyroid Disease;Graves’ Disease Vasculitis;Antineutrophil Cytoplasmic Antibody (ANCA);Thyroid Disease;Graves’ Disease http://www.ircmj.com/index.php?page=article&article_id=23320 Bo Chen Bo Chen Department of Radiologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Department of Radiologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Xiaoqing Yang Xiaoqing Yang Department of Internal Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Department of Internal Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Shihai Sun Shihai Sun Department of Surgery, Taian Second Chinese Medicine Hospital, Taian, Shandong, China Department of Surgery, Taian Second Chinese Medicine Hospital, Taian, Shandong, China Weina Guo Weina Guo Department of Rheumatologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Department of Rheumatologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Xiaosheng Li Xiaosheng Li Department of Radiologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Department of Radiologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Lei Zhang Lei Zhang Department of Radiologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Department of Radiologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Zhongliang Guo Zhongliang Guo Department of Internal Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Department of Internal Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Jie Han Jie Han Department of Rheumatologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Department of Rheumatologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, No.150 Ji Mo Road, Shanghai 200120, China. Tel: +86-2161569573, Fax: +86-2161569538 Department of Rheumatologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Department of Rheumatologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, No.150 Ji Mo Road, Shanghai 200120, China. Tel: +86-2161569573, Fax: +86-2161569538 Ning Li Ning Li Department of Rheumatologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Department of Rheumatologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China. Tel: +86-2161569573, Fax: +86-2161569538 Department of Rheumatologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China; Department of Rheumatologic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China. Tel: +86-2161569573, Fax: +86-2161569538
en 27257509 10.5812/ircmj.21522 Iris Metastasis in a Patient With Small Cell Lung Cancer: A Case Report Iris Metastasis in a Patient With Small Cell Lung Cancer: A Case Report case-report case-report Conclusions

Physicians should be aware of this rare site of metastasis. Early diagnosis is of paramount importance in order to effectively prevent the significant morbidity this condition can cause if left untreated.

Introduction

Small cell carcinoma constitutes the most aggressive type of lung cancer, with the greatest propensity for early disseminated disease. Although commonly neglected due to its rarity and the presence of other comorbidities, cases of iris metastasis from small cell lung cancer have been reported in the literature.

Case Presentation

We present the case of a 76-year-old female. Once diagnosed, the patient already had disseminated disease with metastatic foci found in the spleen, liver, and brain. The patient received six cycles of combination carboplatin/etoposide chemotherapy, followed by cranial irradiation. After an initial response, two months after the completion of cranial irradiation, the patient complained of visual impairment and was referred to an ophthalmologist. A diagnosis of secondary glaucoma was made, caused by metastasis to the left iris.

Conclusions

Physicians should be aware of this rare site of metastasis. Early diagnosis is of paramount importance in order to effectively prevent the significant morbidity this condition can cause if left untreated.

Introduction

Small cell carcinoma constitutes the most aggressive type of lung cancer, with the greatest propensity for early disseminated disease. Although commonly neglected due to its rarity and the presence of other comorbidities, cases of iris metastasis from small cell lung cancer have been reported in the literature.

Case Presentation

We present the case of a 76-year-old female. Once diagnosed, the patient already had disseminated disease with metastatic foci found in the spleen, liver, and brain. The patient received six cycles of combination carboplatin/etoposide chemotherapy, followed by cranial irradiation. After an initial response, two months after the completion of cranial irradiation, the patient complained of visual impairment and was referred to an ophthalmologist. A diagnosis of secondary glaucoma was made, caused by metastasis to the left iris.

Iris;Lung;Carcinoma;Neoplasms Iris;Lung;Carcinoma;Neoplasms http://www.ircmj.com/index.php?page=article&article_id=21522 Minas Sakellakis Minas Sakellakis Division of Oncology, Department of Medicine, University Hospital, Patras Medical School, University of Patras, Rion 26504, Patras, Greece; Division of Oncology, Department of Medicine, University Hospital of Patras, Rion 26504, Greece. Tel: +30-2610999535, Fax: +30-2610994645 Division of Oncology, Department of Medicine, University Hospital, Patras Medical School, University of Patras, Rion 26504, Patras, Greece; Division of Oncology, Department of Medicine, University Hospital of Patras, Rion 26504, Greece. Tel: +30-2610999535, Fax: +30-2610994645 Stavros Peroukides Stavros Peroukides Division of Oncology, Department of Medicine, University Hospital, Patras Medical School, University of Patras, Rion 26504, Patras, Greece Division of Oncology, Department of Medicine, University Hospital, Patras Medical School, University of Patras, Rion 26504, Patras, Greece Gregoris Iconomou Gregoris Iconomou Division of Oncology, Department of Medicine, University Hospital, Patras Medical School, University of Patras, Rion 26504, Patras, Greece Division of Oncology, Department of Medicine, University Hospital, Patras Medical School, University of Patras, Rion 26504, Patras, Greece Haralabos Kalofonos Haralabos Kalofonos Division of Oncology, Department of Medicine, University Hospital, Patras Medical School, University of Patras, Rion 26504, Patras, Greece Division of Oncology, Department of Medicine, University Hospital, Patras Medical School, University of Patras, Rion 26504, Patras, Greece
en 27433349 10.5812/ircmj.23839 The Relationship Between Attachment Styles and Lifestyle With Marital Satisfaction The Relationship Between Attachment Styles and Lifestyle With Marital Satisfaction research-article research-article Conclusions

The results showed that the early relationship within the family environment supports a certain attachment style and the effects of the avoidant insecure and ambivalent insecure styles affect the interpersonal relations of the couples in adulthood. The effect of attachment styles on interpersonal relations is far greater than that of lifestyle.

Results

The results indicate that attachment style and lifestyle factors can predict marital satisfaction. There was also a meaningful negative relationship between insecure attachment avoidant and insecure attachment anxious-ambivalent styles and marital satisfaction. However, there was no meaningful relationship between secure attachment style and marital satisfaction.

Materials and Methods

The population in this study included all of the Bandar Abbas oil refining (BAOR) company employees, for a total of 292 people (146 couples). They were selected by multistage random sampling. The enrich marital satisfaction scale was used to measure marital satisfaction, the Collins and read’s revised adult attachment scale (RAAS) for adult attachment to determine attachment style, and the life style questionnaire (LSQ) for lifestyle. This research was a descriptive-correlative one, and for the data analysis, we used Pearson’s correlation factor and multivariable regression.

Background

Marital satisfaction is one of the deepest and the most basic human pleasures and should be established within the family environment; if not, couples might suffer emotionally. Several factors are involved, including attachment and lifestyle.

Objectives

The purpose of this study was to investigate the relationship between styles of attachment and lifestyle with marital satisfaction.

Conclusions

The results showed that the early relationship within the family environment supports a certain attachment style and the effects of the avoidant insecure and ambivalent insecure styles affect the interpersonal relations of the couples in adulthood. The effect of attachment styles on interpersonal relations is far greater than that of lifestyle.

Results

The results indicate that attachment style and lifestyle factors can predict marital satisfaction. There was also a meaningful negative relationship between insecure attachment avoidant and insecure attachment anxious-ambivalent styles and marital satisfaction. However, there was no meaningful relationship between secure attachment style and marital satisfaction.

Materials and Methods

The population in this study included all of the Bandar Abbas oil refining (BAOR) company employees, for a total of 292 people (146 couples). They were selected by multistage random sampling. The enrich marital satisfaction scale was used to measure marital satisfaction, the Collins and read’s revised adult attachment scale (RAAS) for adult attachment to determine attachment style, and the life style questionnaire (LSQ) for lifestyle. This research was a descriptive-correlative one, and for the data analysis, we used Pearson’s correlation factor and multivariable regression.

Background

Marital satisfaction is one of the deepest and the most basic human pleasures and should be established within the family environment; if not, couples might suffer emotionally. Several factors are involved, including attachment and lifestyle.

Objectives

The purpose of this study was to investigate the relationship between styles of attachment and lifestyle with marital satisfaction.

Attachment;Secure, Avoidant, Anxious-Ambivalent Attachment Styles;Marital Satisfaction;Lifestyle Attachment;Secure, Avoidant, Anxious-Ambivalent Attachment Styles;Marital Satisfaction;Lifestyle http://www.ircmj.com/index.php?page=article&article_id=23839 Korosh Mohammadi Korosh Mohammadi Department of Psychology and Consoling, Faculty of Human Science, University of Hormozgan, Bandar Abbas, IR Iran Department of Psychology and Consoling, Faculty of Human Science, University of Hormozgan, Bandar Abbas, IR Iran Abdolvahab Samavi Abdolvahab Samavi Department of Psychology and Consoling, Faculty of Human Science, University of Hormozgan, Bandar Abbas, IR Iran Department of Psychology and Consoling, Faculty of Human Science, University of Hormozgan, Bandar Abbas, IR Iran Zahra Ghazavi Zahra Ghazavi Department of Psychology and Consoling, Faculty of Human Science, University of Hormozgan, Bandar Abbas, IR Iran; Department of Psychology and Consoling, Faculty of Human Science, University of Hormozgan, Bandar Abbas, IR Iran. Tel: +98-9132282153 Department of Psychology and Consoling, Faculty of Human Science, University of Hormozgan, Bandar Abbas, IR Iran; Department of Psychology and Consoling, Faculty of Human Science, University of Hormozgan, Bandar Abbas, IR Iran. Tel: +98-9132282153
en 27275397 10.5812/ircmj.23418 The siRNA-Mediated Down-Regulation of Vascular Endothelial Growth Factor Receptor1 The siRNA-Mediated Down-Regulation of Vascular Endothelial Growth Factor Receptor1 research-article research-article Background

Angiogenesis is an important biological process involved in the proliferation of endothelial cells, tumor growth and metastasis. Vascular endothelial growth factor (VEGF) is considered as a prominent regulator of angiogenesis which exerts the aforementioned effect(s) through its respective receptors (VEGFR1 and VEGFR2). VEGF receptors are targeted as a therapeutic candidate for cancer growth inhibition. RNAi as a new and promising strategy has provided a useful means to specifically suppress gene expression in cancer cells.

Results

Fluorescent scanning, RT-PCR (27.68%) and western blot analysis (31.06%) showed that the expression of VEGFR1 was suppressed effectively.

Conclusions

The results of the current study showed that specifically designed siRNA can be considered as an appropriate strategy to suppress gene expression and might be a promising tool to prevent angiogenesis.

Objectives

The current study aimed to down-regulate expression of the VEGFR1 using siRNA.

Materials and Methods

This experimental study designed specific siRNAs against VEGFR1. Total RNA was extracted from human umbilical vain endothelial cell (HUVEC) and subsequently cDNA was synthetized. PCR was performed using specific primers to amplify the target gene. After double digestion and purification, the gene was cloned into pEFGP-N1 expression vector. Then, AGS cells were transfected with recombinant pEGFP-N1 using lipofectamin. The gene expression and down-regulation were evaluated by fluorescence scanning, reverse transcription PCR (RT-PCR) and Western blot techniques.

Background

Angiogenesis is an important biological process involved in the proliferation of endothelial cells, tumor growth and metastasis. Vascular endothelial growth factor (VEGF) is considered as a prominent regulator of angiogenesis which exerts the aforementioned effect(s) through its respective receptors (VEGFR1 and VEGFR2). VEGF receptors are targeted as a therapeutic candidate for cancer growth inhibition. RNAi as a new and promising strategy has provided a useful means to specifically suppress gene expression in cancer cells.

Results

Fluorescent scanning, RT-PCR (27.68%) and western blot analysis (31.06%) showed that the expression of VEGFR1 was suppressed effectively.

Conclusions

The results of the current study showed that specifically designed siRNA can be considered as an appropriate strategy to suppress gene expression and might be a promising tool to prevent angiogenesis.

Objectives

The current study aimed to down-regulate expression of the VEGFR1 using siRNA.

Materials and Methods

This experimental study designed specific siRNAs against VEGFR1. Total RNA was extracted from human umbilical vain endothelial cell (HUVEC) and subsequently cDNA was synthetized. PCR was performed using specific primers to amplify the target gene. After double digestion and purification, the gene was cloned into pEFGP-N1 expression vector. Then, AGS cells were transfected with recombinant pEGFP-N1 using lipofectamin. The gene expression and down-regulation were evaluated by fluorescence scanning, reverse transcription PCR (RT-PCR) and Western blot techniques.

Angiogenesis;Gastric Cancer;Small Interfering RNA;Vascular Endothelial Growth Factor Receptor Angiogenesis;Gastric Cancer;Small Interfering RNA;Vascular Endothelial Growth Factor Receptor http://www.ircmj.com/index.php?page=article&article_id=23418 Moslem Jafari Sani Moslem Jafari Sani Biochemistry Department, School of Medicine, Shahroud University of Medical Sciences, Shahroud, IR Iran Biochemistry Department, School of Medicine, Shahroud University of Medical Sciences, Shahroud, IR Iran Foad Yazdi Foad Yazdi Biotechnology Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Biotechnology Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Masoomeh Masoomi Karimi Masoomeh Masoomi Karimi Immunology Department, School of Medicine, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, IR Iran Immunology Department, School of Medicine, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, IR Iran Javad Alizadeh Javad Alizadeh Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, IR Iran Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, IR Iran Majid Rahmati Majid Rahmati Biotechnology Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Biotechnology Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Ali Zarei Mahmudabadi Ali Zarei Mahmudabadi Biochemical Department, Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Biochemical Department, Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-9123277532, Fax: +98-2122830262 Biochemical Department, Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Biochemical Department, Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-9123277532, Fax: +98-2122830262
en 27275399 10.5812/ircmj.29548 Road Traffic Accident Victims’ Experiences of Return to Normal Life: A Qualitative Study Road Traffic Accident Victims’ Experiences of Return to Normal Life: A Qualitative Study research-article research-article Background

Road traffic accident (RTA) victims also suffer from different types of injuries and disabilities, which can affect their quality of life. They usually face with various physical, mental, and social problems. Most traffic accident victims had difficulty to return to normal life.

Objectives

This study aimed to understand the experiences of return to normal life in RTA victims.

Patients and Methods

This qualitative study with content analysis approach was conducted on 18 Iranian patients with disability in the upper or lower limbs caused by traffic accidents, who had passed a time between 3 months till 2 years. A purposeful sampling method was applied until reaching data saturation. Data were collected using semi-structured interviews. Afterwards, the gathered data were analyzed through conventional content analysis.

Results

By analyzing 498 primary codes, four main categories, including supportive needs, adaptation to the new situation, seeking information, and transition from functional limitation, were extracted from traffic accident victims’ experiences of reintegration to normal life.

Conclusions

The results of this study may help policy-makers to take steps toward health promotion and recovery of RTA victims. Considering the results of this study, it is a need for further research to investigate RTAs victims’ needs for reintegration to home and community. Access to training and supportive facilities like strong therapeutic, nursing and social support, and the possibility to participate in self-care activities is essential for reintegration to community in RTA victims.

Background

Road traffic accident (RTA) victims also suffer from different types of injuries and disabilities, which can affect their quality of life. They usually face with various physical, mental, and social problems. Most traffic accident victims had difficulty to return to normal life.

Objectives

This study aimed to understand the experiences of return to normal life in RTA victims.

Patients and Methods

This qualitative study with content analysis approach was conducted on 18 Iranian patients with disability in the upper or lower limbs caused by traffic accidents, who had passed a time between 3 months till 2 years. A purposeful sampling method was applied until reaching data saturation. Data were collected using semi-structured interviews. Afterwards, the gathered data were analyzed through conventional content analysis.

Results

By analyzing 498 primary codes, four main categories, including supportive needs, adaptation to the new situation, seeking information, and transition from functional limitation, were extracted from traffic accident victims’ experiences of reintegration to normal life.

Conclusions

The results of this study may help policy-makers to take steps toward health promotion and recovery of RTA victims. Considering the results of this study, it is a need for further research to investigate RTAs victims’ needs for reintegration to home and community. Access to training and supportive facilities like strong therapeutic, nursing and social support, and the possibility to participate in self-care activities is essential for reintegration to community in RTA victims.

Return;Life;Experiences;Road Traffic Accidents;Victims;Content Analysis Return;Life;Experiences;Road Traffic Accidents;Victims;Content Analysis http://www.ircmj.com/index.php?page=article&article_id=29548 Fatemeh Pashaei Sabet Fatemeh Pashaei Sabet Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran Kian Norouzi Tabrizi Kian Norouzi Tabrizi Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran; Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran. Tel/Fax: +98-2122180036 Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran; Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran. Tel/Fax: +98-2122180036 Hamid Reza Khankeh Hamid Reza Khankeh Department of Clinical Sciences and Education, Karolinska Institute, Stockholm, Sweden Department of Clinical Sciences and Education, Karolinska Institute, Stockholm, Sweden Soheil Saadat Soheil Saadat Sina Trauma and Surgery Center, Tehran, IR Iran Sina Trauma and Surgery Center, Tehran, IR Iran Heidar Ali Abedi Heidar Ali Abedi Islamic Azad University, Khorasgan Branch, Khorasgan, IR Iran Islamic Azad University, Khorasgan Branch, Khorasgan, IR Iran Alireza Bastami Alireza Bastami Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
en 27340558 10.5812/ircmj.23782 The Experience of Risk-Adjusted Capitation Payment for Family Physicians in Iran: A Qualitative Study The Experience of Risk-Adjusted Capitation Payment for Family Physicians in Iran: A Qualitative Study research-article research-article Conclusions

With regard to the current challenges in Iran’s health system, using risk-adjusted capitation as a primary healthcare payment system can lead to useful changes in the health system’s features. However, future research should focus on the development of the risk-adjusted capitation model.

Background

When a country’s health system is faced with fundamental flaws that require the redesign of financing and service delivery, primary healthcare payment systems are often reformed.

Objectives

This study was conducted with the purpose of exploring the experiences of risk-adjusted capitation payment of urban family physicians in Iran when it comes to providing primary health care (PHC).

Materials and Methods

This is a qualitative study using the framework method. Data were collected via digitally audio-recorded semi-structured interviews with 24 family physicians and 5 executive directors in two provinces of Iran running the urban family physician pilot program. The participants were selected using purposive and snowball sampling. The codes were extracted using inductive and deductive methods.

Results

Regarding the effects of risk-adjusted capitation on the primary healthcare setting, five themes with 11 subthemes emerged, including service delivery, institutional structure, financing, people’s behavior, and the challenges ahead. Our findings indicated that the health system is enjoying some major changes in the primary healthcare setting through the implementation of risk-adjusted capitation payment.

Conclusions

With regard to the current challenges in Iran’s health system, using risk-adjusted capitation as a primary healthcare payment system can lead to useful changes in the health system’s features. However, future research should focus on the development of the risk-adjusted capitation model.

Background

When a country’s health system is faced with fundamental flaws that require the redesign of financing and service delivery, primary healthcare payment systems are often reformed.

Objectives

This study was conducted with the purpose of exploring the experiences of risk-adjusted capitation payment of urban family physicians in Iran when it comes to providing primary health care (PHC).

Materials and Methods

This is a qualitative study using the framework method. Data were collected via digitally audio-recorded semi-structured interviews with 24 family physicians and 5 executive directors in two provinces of Iran running the urban family physician pilot program. The participants were selected using purposive and snowball sampling. The codes were extracted using inductive and deductive methods.

Results

Regarding the effects of risk-adjusted capitation on the primary healthcare setting, five themes with 11 subthemes emerged, including service delivery, institutional structure, financing, people’s behavior, and the challenges ahead. Our findings indicated that the health system is enjoying some major changes in the primary healthcare setting through the implementation of risk-adjusted capitation payment.

Payment System;Health Reform;Primary Health Care;General Practice Payment System;Health Reform;Primary Health Care;General Practice http://www.ircmj.com/index.php?page=article&article_id=23782 Reza Esmaeili Reza Esmaeili Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran Mohammad Hadian Mohammad Hadian Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran; Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188794302, Fax: +98-2188883334 Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran; Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188794302, Fax: +98-2188883334 Arash Rashidian Arash Rashidian Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Mohammad Shariati Mohammad Shariati Community Medicine Department, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Community Medicine Department, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Hossien Ghaderi Hossien Ghaderi Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran
en 27330831 10.5812/ircmj.23879 The Optimization of Molecular Detection of Clinical Isolates of Brucella in Blood Cultures by eryD Transcriptase Gene for Confirmation of Culture-Negative Samples The Optimization of Molecular Detection of Clinical Isolates of <italic>Brucella</italic> in Blood Cultures by <italic>eryD</italic> Transcriptase Gene for Confirmation of Culture-Negative Samples research-article research-article Conclusions

The results prove that the presented double PCR method could be used to detect positive cases from culture-negative blood samples. The Chelex 100 method is simpler and safer than the use of Qiagen Kit for DNA extraction.

Materials and Methods

A total of 100 patients with suspected brucellosis were included in this experimental study and given positive serological tests. Diagnosis was performed on patients with clinical symptoms of the disease, followed by the detection of a titer that was equal to or more than 1:160 (in endemic areas) by the standard tube agglutination method. Blood samples were cultured by a BACTEC 9050 system, and subsequently by Brucella agar. At the same time, DNA from all blood samples was extracted by Qiagen Kit Company (Qia Amp Mini Kit). A molecular assay of blood samples was carried out by detection of eryD transcriptase and bcsp 31 genes in specific double PCR reactions. The specificity of the primers was evaluated by DNA from pure and approved Brucella colonies found in the blood samples, by DNA from other bacteria, and by ordinary PCR. DNA extraction from the pure colonies was carried out by both Qiagen Kit and Chelex 100 methods; the two were compared.

Results

39 cases (39%) had positive results when tested by the BACTEC system, and 61 cases (61%) became negative. 23 culture-positive blood samples were randomly selected for PCR reactions; all showed 491 bp for the eryD gene and 223 bp for the bcsp 31 gene. Interestingly, out of 14 culture-negative blood samples, 13 cases showed positive bonds in PCR. The specificity of the PCR method was equal to 100%. DNA extraction from pure cultures was done by both Chelex 100 and Qiagen Kit; these showed the same results for all samples.

Objectives

The aim of the present study is the evaluation of culture-negative blood samples.

Background

Brucellosis is a zoonosis disease which is widespread across the world.

Conclusions

The results prove that the presented double PCR method could be used to detect positive cases from culture-negative blood samples. The Chelex 100 method is simpler and safer than the use of Qiagen Kit for DNA extraction.

Materials and Methods

A total of 100 patients with suspected brucellosis were included in this experimental study and given positive serological tests. Diagnosis was performed on patients with clinical symptoms of the disease, followed by the detection of a titer that was equal to or more than 1:160 (in endemic areas) by the standard tube agglutination method. Blood samples were cultured by a BACTEC 9050 system, and subsequently by Brucella agar. At the same time, DNA from all blood samples was extracted by Qiagen Kit Company (Qia Amp Mini Kit). A molecular assay of blood samples was carried out by detection of eryD transcriptase and bcsp 31 genes in specific double PCR reactions. The specificity of the primers was evaluated by DNA from pure and approved Brucella colonies found in the blood samples, by DNA from other bacteria, and by ordinary PCR. DNA extraction from the pure colonies was carried out by both Qiagen Kit and Chelex 100 methods; the two were compared.

Results

39 cases (39%) had positive results when tested by the BACTEC system, and 61 cases (61%) became negative. 23 culture-positive blood samples were randomly selected for PCR reactions; all showed 491 bp for the eryD gene and 223 bp for the bcsp 31 gene. Interestingly, out of 14 culture-negative blood samples, 13 cases showed positive bonds in PCR. The specificity of the PCR method was equal to 100%. DNA extraction from pure cultures was done by both Chelex 100 and Qiagen Kit; these showed the same results for all samples.

Objectives

The aim of the present study is the evaluation of culture-negative blood samples.

Background

Brucellosis is a zoonosis disease which is widespread across the world.

Detection;Chelex 100;eryD Gene;Brucella Detection;Chelex 100;eryD Gene;Brucella http://www.ircmj.com/index.php?page=article&article_id=23879 Mahsa Tabibnejad Mahsa Tabibnejad Department of Immunology and Microbiology, Arak University of Medical Sciences, Arak, IR Iran Department of Immunology and Microbiology, Arak University of Medical Sciences, Arak, IR Iran Mohammad Yousef Alikhani Mohammad Yousef Alikhani Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran; Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-9125443147, Fax: +98-8132533936, E-mail:; Mohammad Arjomandzadegan, Tuberculosis and Pediatric Infectious Research Center and Department of Microbiology, Arak University of Medical Sciences, Arak, IR Iran. Tel: +98-9188602576, Fax: +98-8634173518 Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran; Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-9125443147, Fax: +98-8132533936, E-mail:; Mohammad Arjomandzadegan, Tuberculosis and Pediatric Infectious Research Center and Department of Microbiology, Arak University of Medical Sciences, Arak, IR Iran. Tel: +98-9188602576, Fax: +98-8634173518 Mohammad Arjomandzadegan Mohammad Arjomandzadegan Tuberculosis and Pediatric Infectious Research Center and Department of Microbiology, Arak University of Medical Sciences, Arak, IR Iran; Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-9125443147, Fax: +98-8132533936, E-mail:; Mohammad Arjomandzadegan, Tuberculosis and Pediatric Infectious Research Center and Department of Microbiology, Arak University of Medical Sciences, Arak, IR Iran. Tel: +98-9188602576, Fax: +98-8634173518 Tuberculosis and Pediatric Infectious Research Center and Department of Microbiology, Arak University of Medical Sciences, Arak, IR Iran; Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-9125443147, Fax: +98-8132533936, E-mail:; Mohammad Arjomandzadegan, Tuberculosis and Pediatric Infectious Research Center and Department of Microbiology, Arak University of Medical Sciences, Arak, IR Iran. Tel: +98-9188602576, Fax: +98-8634173518 Seyed Hamid Hashemi Seyed Hamid Hashemi Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Zahra Naseri Zahra Naseri Blood Transfusion Research Center, High Institute for Research and Education in Transfusion, Hamadan, IR Iran Blood Transfusion Research Center, High Institute for Research and Education in Transfusion, Hamadan, IR Iran
en 27275401 10.5812/ircmj.35050 Preemptive Analgesic Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on Postoperative Pain: A Randomized, Double-Blind, Placebo-Controlled Trial Preemptive Analgesic Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on Postoperative Pain: A Randomized, Double-Blind, Placebo-Controlled Trial research-article research-article Conclusions

TENS can reduce postoperative pain in the early hours after inguinal hernia repair surgery.

Results

The mean estimated postoperative pain intensity was 6.21 ± 1.63 in the intervention group and 5.45 ± 1.82 in the control group (P = 0.08). In the intervention group pain intensity at 2 and 4 hours after surgery were 3.54 ± 1.48 and 5.12 ± 1.41 (P < 0.001), respectively. In the control group these values were 4.0±1.5 and 4.76 ± 1.39 (P = 0.04), respectively. No significant differences were observed in mean pain intensities at 6 and 12 hours.

Objectives

The aim of this study was to evaluate the effects of preoperative TENS on post inguinal hernia repair pain.

Patients and Methods

This randomized, double-blind, placebo-controlled clinical trial was performed on 66 male patients with unilateral inguinal hernias who were admitted to the Shahid Beheshti hospital in Kashan, Iran, from April to October 2014. Participants were selected using a convenience sampling method and were assigned to intervention (n = 33) and control (n = 33) groups using permuted-block randomization. Patients in the intervention group were treated with TENS 1 hour before surgery, while the placebo was administered to patients in the control group. All of the patients underwent inguinal hernia repair by the Lichtenstein method, and pain intensity was evaluated at 2, 4, 6, and 12 hours after surgery using a visual analogue scale. Additionally, the amounts of analgesic administered by pump were calculated and compared between the two groups.

Background

Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological analgesic method used to control different types of pain.

Conclusions

TENS can reduce postoperative pain in the early hours after inguinal hernia repair surgery.

Results

The mean estimated postoperative pain intensity was 6.21 ± 1.63 in the intervention group and 5.45 ± 1.82 in the control group (P = 0.08). In the intervention group pain intensity at 2 and 4 hours after surgery were 3.54 ± 1.48 and 5.12 ± 1.41 (P < 0.001), respectively. In the control group these values were 4.0±1.5 and 4.76 ± 1.39 (P = 0.04), respectively. No significant differences were observed in mean pain intensities at 6 and 12 hours.

Objectives

The aim of this study was to evaluate the effects of preoperative TENS on post inguinal hernia repair pain.

Patients and Methods

This randomized, double-blind, placebo-controlled clinical trial was performed on 66 male patients with unilateral inguinal hernias who were admitted to the Shahid Beheshti hospital in Kashan, Iran, from April to October 2014. Participants were selected using a convenience sampling method and were assigned to intervention (n = 33) and control (n = 33) groups using permuted-block randomization. Patients in the intervention group were treated with TENS 1 hour before surgery, while the placebo was administered to patients in the control group. All of the patients underwent inguinal hernia repair by the Lichtenstein method, and pain intensity was evaluated at 2, 4, 6, and 12 hours after surgery using a visual analogue scale. Additionally, the amounts of analgesic administered by pump were calculated and compared between the two groups.

Background

Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological analgesic method used to control different types of pain.

Transcutaneous Electric Nerve Stimulation;Analgesia;Inguinal Hernia;Postoperative Pain Transcutaneous Electric Nerve Stimulation;Analgesia;Inguinal Hernia;Postoperative Pain http://www.ircmj.com/index.php?page=article&article_id=35050 Mohammad Eidy Mohammad Eidy Department of General Surgery, Kashan University of Medical Sciences, Kashan, IR Iran Department of General Surgery, Kashan University of Medical Sciences, Kashan, IR Iran Mohammad Reza Fazel Mohammad Reza Fazel Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Monir Janzamini Monir Janzamini Department of General Surgery, Kashan University of Medical Sciences, Kashan, IR Iran; Department of General Surgery, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3155540021; +98-9123976157, Fax: +98-3155540111 Department of General Surgery, Kashan University of Medical Sciences, Kashan, IR Iran; Department of General Surgery, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3155540021; +98-9123976157, Fax: +98-3155540111 Mostafa Haji Rezaei Mostafa Haji Rezaei Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Ali Reza Moravveji Ali Reza Moravveji Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
en 27330834 10.5812/ircmj.33892 Leiomyosarcoma of the Broad Ligament With Fever Presentation: A Case Report and Review of Literature Leiomyosarcoma of the Broad Ligament With Fever Presentation: A Case Report and Review of Literature case-report case-report Conclusions

Although a leiomyosarcoma of the broad ligament is rare, practitioners should consider it when dealing with masses in the region of the broad ligament. If there is any suspicion of malignancy, especially in the presence of fever, it is recommended to avoid morcellation during laparoscopy.

Introduction

Leiomyosarcoma is a rare gynecologic malignancy that accounts for less than 1% of gynecological malignancies. Leiomyosarcoma of the broad ligament is an even rarer condition. According to Gardner’s criteria, the diagnosis is made when the mass is completely separated from the uterus and adnexa. So far, 23 cases of primary leiomyosarcoma of the broad ligament have been reported in the literature published in English.

Case Presentation

In September 2014, a 55-year-old, gravida 3, para 3 woman with a BMI of 30 and a chief complaint of fever and dizziness was admitted to the infectious-diseases ward of the Pars general hospital affiliated with Iran University of Medical Sciences in Tehran, Iran. Her symptoms had begun two weeks before. The results of a fever workup and examination for infectious, metabolic, and immunologic problems were all negative. Imaging modalities revealed an endometrial polyp, two calcified myoma in the body of the uterus, and a solid, heterogeneous 70-mm mass in the right para-cervical space, posterior to the broad ligament, and far from the ovary. After surgery, a histologic report revealed leiomyosarcoma.

Conclusions

Although a leiomyosarcoma of the broad ligament is rare, practitioners should consider it when dealing with masses in the region of the broad ligament. If there is any suspicion of malignancy, especially in the presence of fever, it is recommended to avoid morcellation during laparoscopy.

Introduction

Leiomyosarcoma is a rare gynecologic malignancy that accounts for less than 1% of gynecological malignancies. Leiomyosarcoma of the broad ligament is an even rarer condition. According to Gardner’s criteria, the diagnosis is made when the mass is completely separated from the uterus and adnexa. So far, 23 cases of primary leiomyosarcoma of the broad ligament have been reported in the literature published in English.

Case Presentation

In September 2014, a 55-year-old, gravida 3, para 3 woman with a BMI of 30 and a chief complaint of fever and dizziness was admitted to the infectious-diseases ward of the Pars general hospital affiliated with Iran University of Medical Sciences in Tehran, Iran. Her symptoms had begun two weeks before. The results of a fever workup and examination for infectious, metabolic, and immunologic problems were all negative. Imaging modalities revealed an endometrial polyp, two calcified myoma in the body of the uterus, and a solid, heterogeneous 70-mm mass in the right para-cervical space, posterior to the broad ligament, and far from the ovary. After surgery, a histologic report revealed leiomyosarcoma.

Broad Ligament;Leiomyosarcoma;Laparoscopy;Laparotomy;Fever Broad Ligament;Leiomyosarcoma;Laparoscopy;Laparotomy;Fever http://www.ircmj.com/index.php?page=article&article_id=33892 Shahla Chaichian Shahla Chaichian Minimally Invasive Techniques Research Center in women, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, IR Iran; Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran Minimally Invasive Techniques Research Center in women, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, IR Iran; Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran Abolfazl Mehdizadehkashi Abolfazl Mehdizadehkashi Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran; Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2122602478 Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran; Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2122602478 Kobra Tahermanesh Kobra Tahermanesh Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran Bahram Moazzami Bahram Moazzami Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran Fatemeh Jesmi Fatemeh Jesmi Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran Moezedinjavad Rafiee Moezedinjavad Rafiee Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran Katayoun Goharimoghaddam Katayoun Goharimoghaddam Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran
en 27433350 10.5812/ircmj.26452 The Effect of Trauma Intervention on the Satisfaction of Patients Admitted to the Emergency Department: A Clinical Trial Study The Effect of Trauma Intervention on the Satisfaction of Patients Admitted to the Emergency Department: A Clinical Trial Study research-article research-article Conclusions

In this study, trauma intervention increased satisfaction in patients admitted to the emergency department. Therefore, managers and personnel of hospitals and healthcare training centers are urged to implement trauma intervention in their hospitals or healthcare training centers.

Results

The mean score for total satisfaction after trauma intervention in the experimental group (45.6 ± 3.69) was significantly different from that of the control group (32.01 ± 7.78) (P < 0.001). Therefore, the levels of total satisfaction in the experimental and control group were favorable and relatively favorable, respectively.

Patients and Methods

This simple clinical trial was performed on 104 patients admitted for traumatic injury to an emergency department in Iran. Given that patients frequently enter an emergency department for care, the sampling of patients in the department was done on days that were randomly assigned to the study group. The experimental group received trauma intervention in four areas from their admission to the emergency department to their discharge from the hospital, and the control group received routine nursing care. The data were collected through a questionnaire that asked for demographic characteristics and then went on to ask about patient satisfaction. The satisfaction questionnaire was completed after the trauma intervention at the end of patients’ stay in the hospital. The data were analyzed using SPSS 22 software and descriptive statistical tests and analytical tests (independent t and Chi-square).

Background

Patient satisfaction is a key determinant of the quality of medical care. Moreover, satisfaction can be used as a criterion for examining the adequacy of the care, health, and competency of personnel.

Objectives

This study was conducted to determine the satisfaction of patients receiving trauma care in the emergency department of a hospital affiliated with Isfahan University of Medical Sciences.

Conclusions

In this study, trauma intervention increased satisfaction in patients admitted to the emergency department. Therefore, managers and personnel of hospitals and healthcare training centers are urged to implement trauma intervention in their hospitals or healthcare training centers.

Results

The mean score for total satisfaction after trauma intervention in the experimental group (45.6 ± 3.69) was significantly different from that of the control group (32.01 ± 7.78) (P < 0.001). Therefore, the levels of total satisfaction in the experimental and control group were favorable and relatively favorable, respectively.

Patients and Methods

This simple clinical trial was performed on 104 patients admitted for traumatic injury to an emergency department in Iran. Given that patients frequently enter an emergency department for care, the sampling of patients in the department was done on days that were randomly assigned to the study group. The experimental group received trauma intervention in four areas from their admission to the emergency department to their discharge from the hospital, and the control group received routine nursing care. The data were collected through a questionnaire that asked for demographic characteristics and then went on to ask about patient satisfaction. The satisfaction questionnaire was completed after the trauma intervention at the end of patients’ stay in the hospital. The data were analyzed using SPSS 22 software and descriptive statistical tests and analytical tests (independent t and Chi-square).

Background

Patient satisfaction is a key determinant of the quality of medical care. Moreover, satisfaction can be used as a criterion for examining the adequacy of the care, health, and competency of personnel.

Objectives

This study was conducted to determine the satisfaction of patients receiving trauma care in the emergency department of a hospital affiliated with Isfahan University of Medical Sciences.

Patient Satisfaction;Trauma;Emergency Department Patient Satisfaction;Trauma;Emergency Department http://www.ircmj.com/index.php?page=article&article_id=26452 Masoumeh Zakerimoghadam Masoumeh Zakerimoghadam Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran Somayeh Sadeghi Somayeh Sadeghi Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2166927171, Fax: +98-2166941668 Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2166927171, Fax: +98-2166941668 Shahrzad Ghiyasvandian Shahrzad Ghiyasvandian Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran Anoshirvan Kazemnejad Anoshirvan Kazemnejad Department of Biostatistics, Tarbiat Modares University, Tehran, IR Iran Department of Biostatistics, Tarbiat Modares University, Tehran, IR Iran
en 27275403 10.5812/ircmj.35483 Survey on Hypothermia and Hyperthermia in Poisoned Patients in a Unique Referral Hospital, Tehran, Iran Survey on Hypothermia and Hyperthermia in Poisoned Patients in a Unique Referral Hospital, Tehran, Iran research-article research-article Conclusions

Body temperature changes in human poisonings are a matter in need of special attention. A literature review did not reveal any controversy over hypothermia, but poisoning cases exhibit a variety of patterns of fever and hyperthermia. If there are no limits to the diagnosis of fever and hyperthermia, all cases with a poor prognosis which fail to respond to treatment could be categorized as drug-induced hyperthermia. Therefore, a different approach is needed for poisoning cases.

Results

Data were collected from 310 eligible patients. The mean patient age was 32.65 (with a standard deviation of 14.40). Of the patients in the study, 183 (59%) were male. Intentional poisoning in an attempted suicide was documented in 253 (81.6%) patients. The most prevalent poisoning agent was aluminum phosphate (18.70%), followed by methadone (10%) and opium (10%). Seventy percent of the patients (n = 217) were diagnosed and classified with fever or hyperthermia. A temperature ≥ 40°C was detected in just three cases. The highest mean temperature was found in patients poisoned with amphetamine, organophosphate and tramadol. Patients with alcohol and phenobarbital poisoning were included in the sample, but these patients were not diagnosed with hypothermia. WBC ≥ 10,000 cells/mL and CPK ≥ 975 IU/L were recorded in 57.7% and 13.2% of subjects, respectively.

Objectives

Our previous study’s findings in patients poisoned with organophosphate led us to the goal of this study: obtaining the initial tympanic temperature in patients poisoned by a variety of toxins.

Materials and Methods

A cross-sectional study reviewed the records of poisoned patients who were admitted to the toxicological intensive care unit (TICU) at Loghman Hakim hospital poison center (LHHPC) from February 2014 to February 2015. The data collected included gender, age, type of poisoning, the season during which poisoning occurred, vital signs, initial tympanic temperature (first four hours), presence of seizures, white blood cell (WBC) count, creatinine phosphokinase (CPK), length of stay and patient outcome. We determined the mean (SD) for normally distributed continuous variables, the median and interquartile range for non-normally distributed continuous variables, and the absolute and relative frequency (%) for categorical variables. All were determined using SPSS version 16.

Background

Body temperature is a critical criterion of health. Drugs and a variety of poisons can affect body temperature in poisoned patients, causing hyperthermia and hyperpyrexia.

Conclusions

Body temperature changes in human poisonings are a matter in need of special attention. A literature review did not reveal any controversy over hypothermia, but poisoning cases exhibit a variety of patterns of fever and hyperthermia. If there are no limits to the diagnosis of fever and hyperthermia, all cases with a poor prognosis which fail to respond to treatment could be categorized as drug-induced hyperthermia. Therefore, a different approach is needed for poisoning cases.

Results

Data were collected from 310 eligible patients. The mean patient age was 32.65 (with a standard deviation of 14.40). Of the patients in the study, 183 (59%) were male. Intentional poisoning in an attempted suicide was documented in 253 (81.6%) patients. The most prevalent poisoning agent was aluminum phosphate (18.70%), followed by methadone (10%) and opium (10%). Seventy percent of the patients (n = 217) were diagnosed and classified with fever or hyperthermia. A temperature ≥ 40°C was detected in just three cases. The highest mean temperature was found in patients poisoned with amphetamine, organophosphate and tramadol. Patients with alcohol and phenobarbital poisoning were included in the sample, but these patients were not diagnosed with hypothermia. WBC ≥ 10,000 cells/mL and CPK ≥ 975 IU/L were recorded in 57.7% and 13.2% of subjects, respectively.

Objectives

Our previous study’s findings in patients poisoned with organophosphate led us to the goal of this study: obtaining the initial tympanic temperature in patients poisoned by a variety of toxins.

Materials and Methods

A cross-sectional study reviewed the records of poisoned patients who were admitted to the toxicological intensive care unit (TICU) at Loghman Hakim hospital poison center (LHHPC) from February 2014 to February 2015. The data collected included gender, age, type of poisoning, the season during which poisoning occurred, vital signs, initial tympanic temperature (first four hours), presence of seizures, white blood cell (WBC) count, creatinine phosphokinase (CPK), length of stay and patient outcome. We determined the mean (SD) for normally distributed continuous variables, the median and interquartile range for non-normally distributed continuous variables, and the absolute and relative frequency (%) for categorical variables. All were determined using SPSS version 16.

Background

Body temperature is a critical criterion of health. Drugs and a variety of poisons can affect body temperature in poisoned patients, causing hyperthermia and hyperpyrexia.

Hypothermia;Hyperthermia;Poisoning Hypothermia;Hyperthermia;Poisoning http://www.ircmj.com/index.php?page=article&article_id=35483 Naser Mozafari Naser Mozafari Plastic Surgery Department, 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Plastic Surgery Department, 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Haleh Talaie Haleh Talaie Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-9122394067, Fax: +98-2155418175 Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-9122394067, Fax: +98-2155418175 Simin Dokht Shoaei Simin Dokht Shoaei Clinical Research and Development Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Clinical Research and Development Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Morteza Hashemian Morteza Hashemian Department of Anesthesiology and Pain Medicine, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, IR Iran Department of Anesthesiology and Pain Medicine, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, IR Iran Arezou Mahdavinejad Arezou Mahdavinejad Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
en 27280043 10.5812/ircmj.25062 Enigmatic Inv(9): A Case Report on Rare Findings in Hematological Malignancies Enigmatic Inv(9): A Case Report on Rare Findings in Hematological Malignancies case-report case-report Conclusions

Both the cases discussed in our study have inv(9) as the sole abnormality and are found to confer a relatively poor prognosis.

Case Presentation

We present the case of a chronic myeloid leukemia (CML) patient who showed intermittent relapse on treatment, with a rare appearance of clones with dual inversion (9) breakpoints [inv(9)(p22q34); inv(9)(p11q21)]. We also present the first report of inv(9)(p11,q13) as the sole abnormality in a patient with chronic myeloproliferative disorder(CMPD). Both the patients registered in 2012 and were from Kerala, India.

Introduction

Inversion of chromosome 9 had been widely discussed among geneticists and evolutionary biologists because of its significant impact on various hereditary disorders and in the evolution of man. The role of such inversions in human disease evolution is an area hitherto unclear.

Conclusions

Both the cases discussed in our study have inv(9) as the sole abnormality and are found to confer a relatively poor prognosis.

Case Presentation

We present the case of a chronic myeloid leukemia (CML) patient who showed intermittent relapse on treatment, with a rare appearance of clones with dual inversion (9) breakpoints [inv(9)(p22q34); inv(9)(p11q21)]. We also present the first report of inv(9)(p11,q13) as the sole abnormality in a patient with chronic myeloproliferative disorder(CMPD). Both the patients registered in 2012 and were from Kerala, India.

Introduction

Inversion of chromosome 9 had been widely discussed among geneticists and evolutionary biologists because of its significant impact on various hereditary disorders and in the evolution of man. The role of such inversions in human disease evolution is an area hitherto unclear.

Chromosome 9;Inversion;Chronic Myelogenous Leukemia;BCR-ABL Positive;Chronic Myeloproliferative Disorder Chromosome 9;Inversion;Chronic Myelogenous Leukemia;BCR-ABL Positive;Chronic Myeloproliferative Disorder http://www.ircmj.com/index.php?page=article&article_id=25062 Sangeetha Vijay Sangeetha Vijay Regional Cancer Centre, Division of Cancer Research, Medical College PO, Thiruvananthapuram-695 011, Kerala, India Regional Cancer Centre, Division of Cancer Research, Medical College PO, Thiruvananthapuram-695 011, Kerala, India Geetha Narayanan Geetha Narayanan Regional Cancer Centre, Division of Medical Oncology, Medical College PO, Thiruvananthapuram-695 011, Kerala, India Regional Cancer Centre, Division of Medical Oncology, Medical College PO, Thiruvananthapuram-695 011, Kerala, India Santhi Sarojam Santhi Sarojam Regional Cancer Centre, Division of Cancer Research, Medical College PO, Thiruvananthapuram-695 011, Kerala, India Regional Cancer Centre, Division of Cancer Research, Medical College PO, Thiruvananthapuram-695 011, Kerala, India Suresh Kumar Raveendran Suresh Kumar Raveendran Regional Cancer Centre, Division of Cancer Research, Medical College PO, Thiruvananthapuram-695 011, Kerala, India Regional Cancer Centre, Division of Cancer Research, Medical College PO, Thiruvananthapuram-695 011, Kerala, India Sreedharan Hariharan Sreedharan Hariharan Regional Cancer Centre, Division of Cancer Research, Medical College PO, Thiruvananthapuram-695 011, Kerala, India; Regional Cancer Centre, Division of Cancer Research, Medical College PO, Thiruvananthapuram-695 011, Kerala, India. Tel: +91-712522204, Fax: +471-2447454 Regional Cancer Centre, Division of Cancer Research, Medical College PO, Thiruvananthapuram-695 011, Kerala, India; Regional Cancer Centre, Division of Cancer Research, Medical College PO, Thiruvananthapuram-695 011, Kerala, India. Tel: +91-712522204, Fax: +471-2447454
en 27274399 10.5812/ircmj.29649 The Effects of Kangaroo Mother Care and Swaddling on Venipuncture Pain in Premature Neonates: A Randomized Clinical Trial The Effects of Kangaroo Mother Care and Swaddling on Venipuncture Pain in Premature Neonates: A Randomized Clinical Trial research-article research-article Conclusions

The results of this study indicate that there is no meaningful difference between swaddling and KMC on physiological indexes and pain in neonates. Therefore, the swaddling method may be a good substitute for KMC.

Results

The findings revealed that pain was reduced to a great extent in the swaddling and KMC methods compared to the control group. However, there was no significant difference between KMC and swaddling (P ≥ 0.05).

Background

Hospitalized premature babies often undergo various painful procedures. Kangaroo mother care (KMC) and swaddling are two pain reduction methods.

Objectives

This study was undertaken to compare the effects of swaddling and KMC on pain during venous sampling in premature neonates.

Patients and Methods

This study was performed as a randomized clinical trial on 90 premature neonates. The neonates were divided into three groups using a random allocation block. The three groups were group A (swaddling), group B (KMC), and group C (control). In all three groups, the heart rate and arterial oxygen saturation were measured and recorded in time intervals of 30 seconds before, during, and 30, 60, 90, and 120 seconds after blood sampling. The neonate’s face was video recorded and assessed using the premature infant pain profile (PIPP) at time intervals of 30 seconds. The data was analyzed using the t-test, chi-square test, Repeated Measure analysis of variance (ANOVA), Kruskal-Wallis, Post-hoc, and Bonferroni test.

Conclusions

The results of this study indicate that there is no meaningful difference between swaddling and KMC on physiological indexes and pain in neonates. Therefore, the swaddling method may be a good substitute for KMC.

Results

The findings revealed that pain was reduced to a great extent in the swaddling and KMC methods compared to the control group. However, there was no significant difference between KMC and swaddling (P ≥ 0.05).

Background

Hospitalized premature babies often undergo various painful procedures. Kangaroo mother care (KMC) and swaddling are two pain reduction methods.

Objectives

This study was undertaken to compare the effects of swaddling and KMC on pain during venous sampling in premature neonates.

Patients and Methods

This study was performed as a randomized clinical trial on 90 premature neonates. The neonates were divided into three groups using a random allocation block. The three groups were group A (swaddling), group B (KMC), and group C (control). In all three groups, the heart rate and arterial oxygen saturation were measured and recorded in time intervals of 30 seconds before, during, and 30, 60, 90, and 120 seconds after blood sampling. The neonate’s face was video recorded and assessed using the premature infant pain profile (PIPP) at time intervals of 30 seconds. The data was analyzed using the t-test, chi-square test, Repeated Measure analysis of variance (ANOVA), Kruskal-Wallis, Post-hoc, and Bonferroni test.

Infant;Premature;Neonate;Pain;Venipuncture;Kangaroo Mother Care Infant;Premature;Neonate;Pain;Venipuncture;Kangaroo Mother Care http://www.ircmj.com/index.php?page=article&article_id=29649 Shahin Dezhdar Shahin Dezhdar Bushehr University of Medical Sciences, Bushehr, IR Iran Bushehr University of Medical Sciences, Bushehr, IR Iran Faezeh Jahanpour Faezeh Jahanpour Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, IR Iran; Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, IR Iran. Tel: +98-9177720846, Fax: +98-7714550187 Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, IR Iran; Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, IR Iran. Tel: +98-9177720846, Fax: +98-7714550187 Saeedeh Firouz Bakht Saeedeh Firouz Bakht Medicine Faculty, Bushehr University of Medical Sciences, Bushehr, IR Iran Medicine Faculty, Bushehr University of Medical Sciences, Bushehr, IR Iran Afshin Ostovar Afshin Ostovar The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, IR Iran The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, IR Iran
en 27330833 10.5812/ircmj.30332 A Case of Homocystinuria Misdiagnosed as Moyamoya Disease: A Case Report A Case of Homocystinuria Misdiagnosed as Moyamoya Disease: A Case Report case-report case-report Conclusions

In cases of unusual vascular lesions, metabolic diseases must be considered. In homocystinuria, early diagnosis and treatment are important. Blood homocysteine levels can be returned to normal, and some complications can be prevented.

Introduction

Homocystinuria is a hereditary disease caused by a defect in the enzymes involved in metabolizing methionine. Homocystinuria can influence many systems and may be mistaken for other diseases, including Moyamoya disease. Here, we report the case of a 10-year-old male patient with a diagnosis of Moyamoya disease who had been monitored for that for an extended period. The patient’s diagnosis was changed to homocystinuria as a result of lens subluxation and cataract findings.

Case Presentation

A 10-year-old male patient presented with vomiting, headache, lethargy, muscular weakness, and eye redness. The patient was mentally retarded, his right pupil was hyperemic, and he had muscle weakness on his left side. In addition, his blood pressure was high. The patient’s history included a diagnosis of Moyamoya. A neck and cranial computed tomography (CT) angiography showed no flow bilaterally past the bifurcation of the carotid artery. The patient’s bilateral internal carotid arteries were determined to be occluded. It was considered that his eye findings could be compatible with a metabolic disease. On metabolic screening, the patient’s homocysteine level was very high. In addition, a heterozygous A1298C mutation was identified in MTHFR. Therefore, the patient was started on a diet free from homocysteine and methionine. In addition, his treatment regimen included vitamins B12 and B6. With these treatments, the patient’s complications regressed.

Conclusions

In cases of unusual vascular lesions, metabolic diseases must be considered. In homocystinuria, early diagnosis and treatment are important. Blood homocysteine levels can be returned to normal, and some complications can be prevented.

Introduction

Homocystinuria is a hereditary disease caused by a defect in the enzymes involved in metabolizing methionine. Homocystinuria can influence many systems and may be mistaken for other diseases, including Moyamoya disease. Here, we report the case of a 10-year-old male patient with a diagnosis of Moyamoya disease who had been monitored for that for an extended period. The patient’s diagnosis was changed to homocystinuria as a result of lens subluxation and cataract findings.

Case Presentation

A 10-year-old male patient presented with vomiting, headache, lethargy, muscular weakness, and eye redness. The patient was mentally retarded, his right pupil was hyperemic, and he had muscle weakness on his left side. In addition, his blood pressure was high. The patient’s history included a diagnosis of Moyamoya. A neck and cranial computed tomography (CT) angiography showed no flow bilaterally past the bifurcation of the carotid artery. The patient’s bilateral internal carotid arteries were determined to be occluded. It was considered that his eye findings could be compatible with a metabolic disease. On metabolic screening, the patient’s homocysteine level was very high. In addition, a heterozygous A1298C mutation was identified in MTHFR. Therefore, the patient was started on a diet free from homocysteine and methionine. In addition, his treatment regimen included vitamins B12 and B6. With these treatments, the patient’s complications regressed.

Metabolic Disease;Lens Subluxation;Moyamoya Disease Metabolic Disease;Lens Subluxation;Moyamoya Disease http://www.ircmj.com/index.php?page=article&article_id=30332 Meltem Erol Meltem Erol Department of Pediatrics, Bagcilar Training and Research Hospital, Istanbul, Turkey; Corresponding Author: Meltem Erol, Department of Pediatrics, Bagcilar Training and Research Hospital, Istanbul, Turkey. Tel: +90-5324578397, Fax: +90-2124404242, E-mail: Department of Pediatrics, Bagcilar Training and Research Hospital, Istanbul, Turkey; Corresponding Author: Meltem Erol, Department of Pediatrics, Bagcilar Training and Research Hospital, Istanbul, Turkey. Tel: +90-5324578397, Fax: +90-2124404242, E-mail: Ozlem Bostan Gayret Ozlem Bostan Gayret Department of Pediatrics, Bagcilar Training and Research Hospital, Istanbul, Turkey Department of Pediatrics, Bagcilar Training and Research Hospital, Istanbul, Turkey Ozgul Yigit Ozgul Yigit Department of Pediatrics, Bagcilar Training and Research Hospital, Istanbul, Turkey Department of Pediatrics, Bagcilar Training and Research Hospital, Istanbul, Turkey Kubra Serefoglu Cabuk Kubra Serefoglu Cabuk Department of Ophtalmology, Bagcilar Training and Research Hospital, Istanbul, Turkey Department of Ophtalmology, Bagcilar Training and Research Hospital, Istanbul, Turkey Mehmet Toksoz Mehmet Toksoz Department of Radiology, Bagcilar Training and Research Hospital, Istanbul, Turkey Department of Radiology, Bagcilar Training and Research Hospital, Istanbul, Turkey Mahir Tiras Mahir Tiras Department of Pediatrics, Bagcilar Training and Research Hospital, Istanbul, Turkey Department of Pediatrics, Bagcilar Training and Research Hospital, Istanbul, Turkey
en 27330832 10.5812/ircmj.28076 Study of the Effects of Diazinon on Fetal Liver in BALB/c Mice Study of the Effects of Diazinon on Fetal Liver in BALB/c Mice research-article research-article Conclusions

Our data showed that inhalation of Diazinon during pregnancy increased the hepatocyte area and hepatocyte apoptosis while it decreased the sinusoid area of the fetal liver.

Materials and Methods

Twenty-five pregnant BALB/c mice (25 - 30 gr) were divided into five equal groups in the animal lab of Baqiyatallah University of Medical Sciences, Tehran, Iran. The normal group was without any intervention, and two sham groups received an emulsifier as 0.52 and 5.2 μL/volume (5000 cc in desiccator) and two experimental groups received Diazinon 1.3 and 13μL/volume from the seventh to eighteenth days of pregnancy every other day via forty minutes of inhalation. The pregnant mice were killed on the eighteenth day of gestation and their fetuses were removed and evaluated for fetal growth and liver development. Five fixed fetuses were dehydrated through a series of graded ethanol, embedded in paraffin wax and their whole bodies were sectioned sagittally and stained via the hematoxylin-eosin method. Quantitative computer-assisted morphometric studies were done on the fetal liver tissues occupied by hepatocytes, blood islands, liver sinusoids, and apoptosis.

Background

Diazinon is an organophosphate that is broadly used as a pesticide to control insects and environmental pollutions. This toxic material is absorbed via inhalation, contact, or digestion and affects different tissues.

Results

The mean crown-rump of the fetuses and their mean weight were increased in the experimental group as compared to the sham and normal groups, but the differences were not significant. The mean percentage of the hepatocyte area significantly increased in the experimental group as compared to the sham and control groups (P < 0.0001). However, the mean sinusoid area significantly decreased in the experimental group as compared to the sham and control groups. The mean percentage of the area occupied by apoptotic hepatocytes in the experimental group - 13 μL /volume (8.6143 ± 1.00945) and 1.3 μL /volume (6.1091 ± 0.93093) - significantly increased as compared to the normal and sham groups (P < 0.0001).

Objectives

This research was a histomorphometric and immunohistochemical study of the fetal liver of mice after exposure to Diazinon.

Conclusions

Our data showed that inhalation of Diazinon during pregnancy increased the hepatocyte area and hepatocyte apoptosis while it decreased the sinusoid area of the fetal liver.

Materials and Methods

Twenty-five pregnant BALB/c mice (25 - 30 gr) were divided into five equal groups in the animal lab of Baqiyatallah University of Medical Sciences, Tehran, Iran. The normal group was without any intervention, and two sham groups received an emulsifier as 0.52 and 5.2 μL/volume (5000 cc in desiccator) and two experimental groups received Diazinon 1.3 and 13μL/volume from the seventh to eighteenth days of pregnancy every other day via forty minutes of inhalation. The pregnant mice were killed on the eighteenth day of gestation and their fetuses were removed and evaluated for fetal growth and liver development. Five fixed fetuses were dehydrated through a series of graded ethanol, embedded in paraffin wax and their whole bodies were sectioned sagittally and stained via the hematoxylin-eosin method. Quantitative computer-assisted morphometric studies were done on the fetal liver tissues occupied by hepatocytes, blood islands, liver sinusoids, and apoptosis.

Background

Diazinon is an organophosphate that is broadly used as a pesticide to control insects and environmental pollutions. This toxic material is absorbed via inhalation, contact, or digestion and affects different tissues.

Results

The mean crown-rump of the fetuses and their mean weight were increased in the experimental group as compared to the sham and normal groups, but the differences were not significant. The mean percentage of the hepatocyte area significantly increased in the experimental group as compared to the sham and control groups (P < 0.0001). However, the mean sinusoid area significantly decreased in the experimental group as compared to the sham and control groups. The mean percentage of the area occupied by apoptotic hepatocytes in the experimental group - 13 μL /volume (8.6143 ± 1.00945) and 1.3 μL /volume (6.1091 ± 0.93093) - significantly increased as compared to the normal and sham groups (P < 0.0001).

Objectives

This research was a histomorphometric and immunohistochemical study of the fetal liver of mice after exposure to Diazinon.

Diazinon;Fetal Liver;Apoptosis;Histomorphology Diazinon;Fetal Liver;Apoptosis;Histomorphology http://www.ircmj.com/index.php?page=article&article_id=28076 Fatemeh Saraei Fatemeh Saraei Department of Biology, Islamic Azad University, North Tehran Branch, Tehran, IR Iran Department of Biology, Islamic Azad University, North Tehran Branch, Tehran, IR Iran Mehrangiz Sadoughi Mehrangiz Sadoughi Department of Biology, Islamic Azad University, North Tehran Branch, Tehran, IR Iran Department of Biology, Islamic Azad University, North Tehran Branch, Tehran, IR Iran Gholamreza Kaka Gholamreza Kaka Neurosciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Neurosciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2126127286 Neurosciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Neurosciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2126127286 Seyed Homayoon Sadraie Seyed Homayoon Sadraie Department of Anatomy, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Department of Anatomy, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Mohsen Foaddodini Mohsen Foaddodini Department of Physiology, Birjand University of Medical Sciences, Birjand, IR Iran Department of Physiology, Birjand University of Medical Sciences, Birjand, IR Iran
en 27340559 10.5812/ircmj.33115 Toxoplasmosis Neuroretinitis: A Case Report Toxoplasmosis Neuroretinitis: A Case Report case-report case-report Conclusions

Although toxoplasmosis NR is rare, it should be considered in the differential diagnoses of NR.

Case Presentation

A 13-year-old girl presented with painless subacute visual loss in her right eye for a week at Khatam-Al-Anbia eye hospital in Mashhad, Iran. Following comprehensive evaluation, a diagnosis of toxoplasmic NR was made. The NR favorably responded to classic anti-toxoplasmosis treatment. A juxtapapillary retinochoroidal scar appeared after disc swelling resolution.

Introduction

Neuroretinitis (NR) is considered to be an inflammatory condition which is characterized by optic disc edema and, as a result, formation of a macular star figure. NR is an atypical presentation of toxoplasmosis infection, and such cases are quite rare.

Conclusions

Although toxoplasmosis NR is rare, it should be considered in the differential diagnoses of NR.

Case Presentation

A 13-year-old girl presented with painless subacute visual loss in her right eye for a week at Khatam-Al-Anbia eye hospital in Mashhad, Iran. Following comprehensive evaluation, a diagnosis of toxoplasmic NR was made. The NR favorably responded to classic anti-toxoplasmosis treatment. A juxtapapillary retinochoroidal scar appeared after disc swelling resolution.

Introduction

Neuroretinitis (NR) is considered to be an inflammatory condition which is characterized by optic disc edema and, as a result, formation of a macular star figure. NR is an atypical presentation of toxoplasmosis infection, and such cases are quite rare.

Neuroretinitis;Ocular Toxoplasmosis;Optic Neuropathy Neuroretinitis;Ocular Toxoplasmosis;Optic Neuropathy http://www.ircmj.com/index.php?page=article&article_id=33115 Nasser Shoeibi Nasser Shoeibi Retina Research Center, Khatam-Al-Anbia Eye Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Retina Research Center, Khatam-Al-Anbia Eye Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Seyedeh Maryam Hosseini Seyedeh Maryam Hosseini Retina Research Center, Khatam-Al-Anbia Eye Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Eye Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Retina Research Center, Khatam-Al-Anbia Eye Hospital, 91959-61151, Mashhad, IR Iran. Tel: +98-5137285290, Fax: +98-5137245363 Retina Research Center, Khatam-Al-Anbia Eye Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Eye Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Retina Research Center, Khatam-Al-Anbia Eye Hospital, 91959-61151, Mashhad, IR Iran. Tel: +98-5137285290, Fax: +98-5137245363 Razie Bayani Razie Bayani Eye Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Eye Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
en 27275402 10.5812/ircmj.35412 The Effects of Group Play Therapy on Self-Concept Among 7 to 11 Year-Old Children Suffering From Thalassemia Major The Effects of Group Play Therapy on Self-Concept Among 7 to 11 Year-Old Children Suffering From Thalassemia Major research-article research-article Conclusions

The results showed that group play therapy improves self-concept in children suffering from thalassemia major.

Objectives

The aim of this study was to determine if group play therapy could significantly increase self-concept among children with thalassemia major ages 7 to 11 years old in teaching hospitals of Golestan province, Iran, in 2012.

Patients and Methods

In this randomized, controlled clinical trial, 60 children with thalassemia major were randomly assigned to intervention (30 children) and control (30 children) groups. The intervention included eight 45 to 60 minute sessions during four weeks, during which the intervention group received group play therapy. The control group received no interventions. Self-concept was measured three times using the Piers-Harris children’s self-concept scale: before, immediately after, and a month after the intervention.

Results

For the intervention group, results showed that the mean self-concept score was significantly higher at the second point in time compared to the baseline (P < 0.001), going from 60.539 to 69.908. Likewise, comparing the first and third time points, the mean score significantly increased and reached 70.611 (P < 0.001). Furthermore, changes in the mean score from the second to the third time point, though non-significant (P = 0.509), followed the trend, going from 69.908 to 70.611. For the control group, comparing the first, second, and third time points did not result in any significant change in the mean score (P > 0.05).

Background

Children suffering from thalassemia have higher levels of depression and lower levels of self-concept.

Conclusions

The results showed that group play therapy improves self-concept in children suffering from thalassemia major.

Objectives

The aim of this study was to determine if group play therapy could significantly increase self-concept among children with thalassemia major ages 7 to 11 years old in teaching hospitals of Golestan province, Iran, in 2012.

Patients and Methods

In this randomized, controlled clinical trial, 60 children with thalassemia major were randomly assigned to intervention (30 children) and control (30 children) groups. The intervention included eight 45 to 60 minute sessions during four weeks, during which the intervention group received group play therapy. The control group received no interventions. Self-concept was measured three times using the Piers-Harris children’s self-concept scale: before, immediately after, and a month after the intervention.

Results

For the intervention group, results showed that the mean self-concept score was significantly higher at the second point in time compared to the baseline (P < 0.001), going from 60.539 to 69.908. Likewise, comparing the first and third time points, the mean score significantly increased and reached 70.611 (P < 0.001). Furthermore, changes in the mean score from the second to the third time point, though non-significant (P = 0.509), followed the trend, going from 69.908 to 70.611. For the control group, comparing the first, second, and third time points did not result in any significant change in the mean score (P > 0.05).

Background

Children suffering from thalassemia have higher levels of depression and lower levels of self-concept.

Beta-Thalassemia;Play Therapy;Group Play;Self-Concept Beta-Thalassemia;Play Therapy;Group Play;Self-Concept http://www.ircmj.com/index.php?page=article&article_id=35412 Ome Kolsoum Tomaj Ome Kolsoum Tomaj Pediatric Nursing, Golestan University of Medical Sciences, Gorgan, IR Iran Pediatric Nursing, Golestan University of Medical Sciences, Gorgan, IR Iran Fatemeh Estebsari Fatemeh Estebsari Department of Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Taraneh Taghavi Taraneh Taghavi Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran Leili Borim Nejad Leili Borim Nejad Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran Maryam Dastoorpoor Maryam Dastoorpoor Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran Afsaneh Ghasemi Afsaneh Ghasemi Department of Public Health, School of Public Health, Fasa University of Medical Sciences, Fasa, IR Iran; Department of Public Health, School of Public Health, Fasa University of Medical Sciences, Ibn Sina Square, Fasa, IR Iran. Tel: +98-7153316308 Department of Public Health, School of Public Health, Fasa University of Medical Sciences, Fasa, IR Iran; Department of Public Health, School of Public Health, Fasa University of Medical Sciences, Ibn Sina Square, Fasa, IR Iran. Tel: +98-7153316308
en 27354921 10.5812/ircmj.35006 Successful Management of Two Cases of Placenta Accreta and a Literature Review: Use of the B-Lynch Suture and Bilateral Uterine Artery Ligation Procedures Successful Management of Two Cases of Placenta Accreta and a Literature Review: Use of the B-Lynch Suture and Bilateral Uterine Artery Ligation Procedures case-report case-report Introduction

Placenta accreta is an increasingly common complication of pregnancy that can result in massive hemorrhage.

Case Presentation

We describe two cases of placenta accreta, with successful conservative management in a referral hospital in Tehran, Iran. In both cases, two procedures were performed: compression suture (B-Lynch) and a perfusion-decreasing procedure (bilateral uterine artery ligation). We also present the results of a narrative literature review.

Conclusions

The double B-Lynch and uterine arterial ligation procedure in cases of abnormal placentation might be strongly considered in fertility preservation, coagulopathy, coexisting medical disease, blood access shortage, low surgical experience, distant local hospitals, and no help.

Introduction

Placenta accreta is an increasingly common complication of pregnancy that can result in massive hemorrhage.

Case Presentation

We describe two cases of placenta accreta, with successful conservative management in a referral hospital in Tehran, Iran. In both cases, two procedures were performed: compression suture (B-Lynch) and a perfusion-decreasing procedure (bilateral uterine artery ligation). We also present the results of a narrative literature review.

Conclusions

The double B-Lynch and uterine arterial ligation procedure in cases of abnormal placentation might be strongly considered in fertility preservation, coagulopathy, coexisting medical disease, blood access shortage, low surgical experience, distant local hospitals, and no help.

Placenta Accreta;Postpartum Hemorrhage;Uterine Artery;Ligation Placenta Accreta;Postpartum Hemorrhage;Uterine Artery;Ligation http://www.ircmj.com/index.php?page=article&article_id=35006 Maliheh Arab Maliheh Arab Department of Gyneco-oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Medical Education, School of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Gyneco-oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Fax: +98-2177543634 Department of Gyneco-oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Medical Education, School of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Gyneco-oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Fax: +98-2177543634 Behnaz Ghavami Behnaz Ghavami Department of Obstetrics and Gynecology Shariati Medical Center, Tehran University of Medical Sciences, Tehran, IR Iran Department of Obstetrics and Gynecology Shariati Medical Center, Tehran University of Medical Sciences, Tehran, IR Iran Samaneh Saraeian Samaneh Saraeian Department of Gyneco-oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Gyneco-oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Samaneh Sheibani Samaneh Sheibani Department of Gyneco-oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Gyneco-oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Fatemeh Abbasian Azar Fatemeh Abbasian Azar Department of Gyneco-oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Gyneco-oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Seyed-Mostafa Hosseini-Zijoud Seyed-Mostafa Hosseini-Zijoud Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran