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Volume 64, Issue 2 (30 2006)
Background and Aim: Anxiety is the most common psychological distress in cancer patients. Many studies have been conducted to assess the prevalence of anxiety and depression and the predisposing factors of psychological morbidity in cancr patients. Patients knowledge of disease, their desire for more information, their satisfaction of given information and their attitudes’ towards communication of information about cancer are among issues that have not been well anddressed in assessment of psychological morbidity of cancer patients in Iran.
Materials and Methods: 250 cancer patients of 15-75 age group who were referred to Cancer Institute entered the study. The patients’ knowledge of disease, their desire for more information, their attitude and satisfaction were assessed by Questionnaire n1. patients’ anxiety and depression scores were assessed by Hospital Anxiety and Depression Scale (HADS).
Results: 30 of patients had severe anxiety symptoms and 17% suffered severe depression most patients’ knowledge of disease was “low” (32%) and “intermediate” (54%). There was no significant correlation between knowledge and anxiety and depression. Most patients (69%) believed that the information given by physicians had been “insufficient”. Depression score was significantly higher in this group of patients compared to other patients. Most patients (59%) had a high level of desire for gaining more information and 64% believed that physicians should inform patients of different aspects of disease as much as possible. There was no significant correlation between patients’ desire and attitude and anxiety and depression. Level of satisfaction was “low” in 29% of patients and “intermediate” in 39%. Depression and anxiety scores were significantly higher in patients who were less satisfied with given information.
Conclusion: Low level of knowledge in most cancer patients, their high desire for gaining more information, their dissatisfaction of given information and their positive attitudes towards full disclosure of information about cancer in this study, all indicate that complete and honest disclosure of information to cancer patients by physicians should be improved and encouraged. Although it seems that amount of information given doesn’t influence the psychological morbidity in cancer patients the patients’ satisfaction of given information, which has implications for the quality of patient-physician communication, plays a far more important role in occurance of psychological morbidity in cancer patients. Meanwhile, negative public opinion of cancer and its prognosis greatly influences the physicians functions and the quality of communication process, and also has negative effects on cancer patients’ psychological adjustment.
Volume 64, Issue 8 (13 2006)
Background: Drug abuse has been known as a growing contributing factor to all types of trauma in the world. The goal of this article is to provide insight into demographic and substance use factors associated with trauma and to determine the prevalence of drug abuse in trauma patients.
Methods: Evidence of substance abuse was assessed in trauma patients presenting to Sina trauma hospital over a 3-month period. They were interviewed and provided urine samples to detect the presence of drug/metabolites of opium, morphine, cannabis and heroin by “Morphine Check” kits. Demographic data, mechanisms of injury, history of smoking and drug abuse were recorded.
Results: A total of 358 patients with a mean age of 28.4 years were studied. The Patients were predominantly male (94.7%). There was a history of smoking in 136 cases (38%). 58 cases (16.2%) reported to abuse drugs (91.5% opium). The commonest route of administration was smoke inhalation (37.2%). Screening by Morphine Check test revealed 95 samples to be positive (26.5%). The preponderance of test-positive cases was among young people (of 20-30 years of age) with a history of smoking. Victims of violence and those with penetrating injuries also showed a higher percentage of positive screens (P=0.038 and P<0.001, respectively).
Conclusion: These results suggest that drug abuse is a contributing factor to trauma especially in violent injuries and among the young. Regarding the considerable prevalence of drug abuse among trauma patients, it’s highly recommended that all trauma patients be screened for illicit drugs
Volume 65, Issue 8 (3 2007)
Background: Anopheles superpictus is one of the main malaria vectors in Iran. The mosquitoes of this species are found throughout the Iranian plateau up to 2000 meters above sea level in the Alborz Mountains, south of the Zagros Mountains, and in the plains near the Caspian Sea and Persian Gulf. It has been reported that different geographical populations of An. superpictus play different roles in malaria transmission. Based on the presence or absence of a black spot/band on the apical segment of the female maxillary palpi, two morphological forms have been reported in this species. This work has been conducted to study other morphological features as well as the genetic structure of these two forms of An. superpictus in Iran.
Methods: The different morphological characteristics of 35 different populations were observed and recorded. An 887 bp portion of the mitochondrial DNA (mtDNA) cytochrome oxidase subunit I (COI) was amplified and assayed by restriction fragment length polymorphism (RFLP) using 18 enzymes and PCR-direct sequencing techniques.
Results: Among the morphological characteristics studied, there are significant differences between the two forms with regard to the length of the palp light band (p<0.01), wing length (p<0.5), and the distance from the branching point of the II/IV veins to the tip of the wing (p<0.05). Results also revealed that these two forms are sympatric in most localities of Iran. RFLP analysis and sequences of about 710 bp of the gene showed that there was great variation between and/or within the populations, but these variations were not associated with the morphological forms.
Conclusion: This is the first comprehensive study on the morphological and molecular characteristics of An. superpictus in the literature. To determine the role of these morphological forms or genetic haplotypes in malaria transmission, further molecular, cytological, morphological, and epidemiological studies are necessary.
Volume 72, Issue 2 (May 2014)
Background: Toxoplasma gondii, is a mandatory intracellular protozoa, that many people worldwide are infected with. In children, the infection enters central nervous system and leads to inflammation of the gray matter. Autism, is a complex develop-mental disorder, altering social communication, with unknown origin. Neuropathologi-cal changes in autism are the same as those occurred in brain toxoplasmosis. The objective of this survey was to evaluate positive serology of toxoplasma gondii, in autistic children. Methods: This case-control study was done on 3-12 years old children, referring to the neurology and psychiatry sub-special clinics of Baqiyatallah hospital and also autistic children of Omid-e Asr and Navid-e Asr general rehabilitation centers in Tehran, Iran. The study performed at 2012-2013. Forty autistic children were placed in the case group and 40 children, suffering from no neuropsychiatric disease or other ones, were placed in the control group. A folder, containing demographic data, type of the disor-der, onset of diagnosis and child characteristics at birth, such as time of birth (preterm/ term) fulfilled for each child. Sampling was done with 5 ml blood, for determining IgM and IgG antibody levels against toxoplasma gondii, using ELISA method. Data ana-lyzed by the software SPSS ver. 17 and descriptive and analytic analysis were done, us-ing central and dispersion indexes and also chi-Square test. Results: The autistic group contained 34 boys and 6 girls (85 and 15 percent respectively), with the average age of 6 (±2.71) years old [minimum of 2.33 and maximum of 12]. The average age at the time of diagnosis was 4.01 (±1.87) years old. 87. The non-autistic group contained 17 boys and 23 girls (42.5 and 57.5 percent respectively), with the average age of 5.67 (±3.09) years old [minimum of two and maximum of 12]. IgM and IgG serology of all autistic children were negative, while in non-autistic group, 2.5 percent (1 child) were positive and 97.5 percent (39 ones) were negative. There were no statistically significant difference among these two groups according to the serology results. (P=0.31). Conclusion: There was no statistically significant difference in comparing positive se-rology of toxoplasmosis, between the two groups. However, to obtain a perfect result, a larger sample size are required.
Volume 76, Issue 1 (April 2018)
Case Presentation: Our case was a 22-year-old primigravida woman and 17-18th week of pregnancy, who referred to an University Hospital in Mashhad, Iran with complaint of vaginal bleeding On October 2016. Her first trimester ultrasonography in 13th week of gestational age, reported a live single fetus with an anterior great placenta and cystic formation regarding molar pregnancy. According to above-report, Amniocentesis was done in 15th weeks of pregnancy and its result was triple X. After severe and life-threatening vaginal bleeding, she underwent an emergent hysterotomy. A fetus with no obvious anomaly and a great hydropic and vesicular placenta delivered. Episodic crisis of her blood pressure was best controlled with anti-hypertensive drugs. In our case, chemotherapy with methotrexate was started after poor decline of βHCG titration and definite diagnosis of gestational trophoblastic neoplasia. Remission was completely achieved after four courses of chemotherapy.
Conclusion: Differentiation between complete molar pregnancy with live fetus and partial mole is always challenging in obstetrics. Serious complications as preeclampsia and severe vaginal bleeding may become life-threatening. Coexisting molar pregnancy should be ruled out in a pregnancy associated with frequent and unexpectant vaginal bleeding. Amniocentesis and an expert radiologist can help to differentiate them. Following these patients is very important to reveal any trophoblastic neoplasia.
Volume 76, Issue 9 (December 2018)
Methods: This case-control study was conducted in health centers of Urmia University of Medical Sciences in May 2015 until March 2016. A total of 100 pregnant women with gestational diabetes and 100 healthy pregnant women were entered into the study by nonrandom and available sampling. The level of vitamin D was measured and levels were divided into three levels. Vitamin D levels were considered less than 20 ng/ml, 20-30 ng/ml and more than 30 ng/ml as deficiency, insufficiency and sufficient, respectively. Exclusion criteria include pre-pregnancy glucose tolerance, history of medical disease, and supplementation with vitamin D.
Results: The mean age of women in the study group was 30.31±5 years and in the control group was 28.83±4.95 years (P=0.06). The vitamin D levels in GDM and control groups were 7.25±4.76 ng/ml and 11.93±16.12 ng/ml, which is lower in the gestational diabetes than the control group (P=0.01). The severe deficiency of vitamin D in the gestational diabetes group and in control group were 34% and 27% respectively (P<0.0001). There was a significant difference in mean fasting plasma glucose level between gestational diabetes group and healthy pregnant group (P<0.001). There was no relationship between vitamin D levels and body mass index of pregnant women (P=0.1).
Conclusion: In this study, the majority of patients had vitamin D deficiency and in the gestational diabetes group, vitamin D deficiency was significantly higher than the control group. The severe deficiency of vitamin D in the gestational diabetes group was higher than patients without gestational diabetes.
Volume 77, Issue 4 (July 2019)
Methods: This study was a qualitative study of content analysis. The data of this study were conducted by focus group discussion, semi-deep interviews with the participation of the target community of students, parents of students, school principals and school health instructors, general manager of the Office of Community Nutrition (Department of Education) includes manager, deputy and school health officer, from October 2016 to January 2017 in city of Gonabad, Iran. Participants were selected through targeted sampling and data collection continued to saturation. Data were analyzed using contractual content analysis method based on five steps of Graneheim and Lundman. Data management was done with NVivo software, version 11 (QSR International, Victoria, Australia), but data analysis and interpretation were done manually.
Results: The findings from group discussions and semi-deep interviews with stakeholders were categorized into twelve themes. The main strength, perceived in "Perceived Individual Benefits" and "Perceived Executive or Management Benefits". The main perceived weakness was "Physical Disadvantages", "Tablets Disadvantages", "Disadvantages of Programming" and "Disadvantages of the Program". The main perceived barriers was "Educational and Information Barriers", "Barriers of Pill Consumption" and "Management and Administrative Barriers". "Modifying the Executive Program", "Individual Perception Modification" and "Reform the Shape of Pills" were suggested as a corrective mechanism from participants’ view point.
Conclusion: According to the results of this study, the most important challenges of the "Schools Iron Aid National Plan" were "Educational and Information Barriers", "Administrative barriers", and "Barriers to Pill Consumption". Therefore, in order to do better, the Iron Supplementation Program requires intervention at individual, interpersonal, inter-organizational, and intra-organizational levels to provide comprehensive support for the program and, ultimately, increase program productivity.
Volume 80, Issue 7 (October 2022)
Methods: Amongst the patients who were referred to Shiraz Shahid Fagihi Hospital for Thyroid fine needle aspiration biopsy from August 2017 to January 2018, 114 patients participated in this study. LA was performed for 41 patients, and 73 underwent the thyroid nodule fine needle aspiration biopsy without LA. Patients' pain and anxiety were scored using the visual-analog-score and Spielberger anxiety scale. The nodules were categorized into five groups. Pain and anxiety of patients were compared considering their nodule sizes to assess the effects of LA in the reduction of pain and anxiety considering the nodule size.
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Results: The patients undergoing LA had a mean age of 44.69 years old and average body mass index (BMI) of 26.7, the patients who performed thyroid nodule fine needle aspiration biopsy without LA had a mean age of 48.17 years old with an average BMI of 26.0. The patients with the maximum nodule size of<10 mm, experienced more pain during the fine needle aspiration biopsy without LA, but there was no significant difference between the S/T-anxiety of these patients. There was no significant difference between the pain and anxiety scores of the patients with larger nodules.
Conclusion: The more pain experienced by the patients with the smallest nodules can be attributed to the need for more needle manipulation due to the small nodule size and less precision while piercing the needle into the nodule. Thus, it can be suggested that in patients with a small nodule size, less than 10mm, usage of LA prior to fine needle aspiration biopsy can reduce the pain significantly. |
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