Tehran University Medical Journal

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In this research 600 staff of an educational office (distric seven) were being studied before and after they were educated about breast self-examination. Necessary information was gathered before and after they were educated through questionnaires. The result of the study showed that the average scores of their awareness before and after they were educated was 42.3 and 44.2, respectively. Hence, there was a significant difference because of the education of self-examination women's breasts (P<0.0001). There was no difference between family members nor between those who had different marital status, concerning the awareness of breast self-examination. However, there was a large difference between the educational level of women who were studied and the educational level of their spouses, according to their knowledge concerned about monthly breast self-examination (P=0.04).

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Background: The aim of study was to determine the frequency of delay referring and related factors in patients with advanced breast cancer, in Imam Khomeini Hospital in the 2000.

Materials and Methods: Successively 200 patients were entered the study if they were consentient. A questionnaire was constructed and information was obtained through interviewing.

Results: From the cases, 64 patients (32 percent) referred without delay and 136 patients (68 percent) referred tardily. The patients who were late in comparison with patients who didn’t late, had significantly higher mean age (P=0.004), lower education level (P=0.002), and lower economic status (P=0.001). The frequency rate of single were lower among them (P=0.001), fewer percent were residual of big cities (P=0.01) and they had less rate of available physician (P=0.004). 24.3 percent of delay referring patients and 53.1 percent of patients without delay has a positive family history of breast cancer (P=0.001). 62.5 percent of delay referring patients and 85 percent of patients without delay were aware about importance of Self Breast Examination (S.B.E) (P=0.002) and respectively 84.4 percent and 98.4 percent were award about symptoms of breast cancer (P=0.01). 23.5 percent and 33 percent of patients with and without delay Knew the method of B.S.E respectively. It wasn’t a significant difference.

Conclusion: Lack of awareness about necessity of medical consultation, fear, carelessly, unavailable physician and poverty were the major causes of delay in patients who referred late.

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Defining the patient outcome and decision making about allocation of our limited fund and technology for comatose patients depends on our knowledge about frequency and outcome of various coma etiologies. We determined the various coma causes frequency and one-month outcome of non traumatic coma. . In addition the co existence of the primary neurologic signs with the one-month outcome of non traumatic coma was defined.
Methods and Materials: Our study is based on 130 comatose patients in a one-year study in Sina Hospital that consisted of 80 non traumatic and 50 traumatic patients.
Results: 74% of the cases were men and 26% were women. The most common etiology of coma was trauma (38.5%). The other common etiologies were cerebro‌vascular diseases (25.4%), cancer (10%) and hypoxia-ischemia (8.5%). The most common cause of coma in men was trauma (46.9%) while the vascular diseases were the most common etiology of coma in women (41.2%).In under 40 year patients trauma was the cause of coma in 57.5% of cases in respect to 28% in above 40 cases. On the other hand, vascular diseases and malignancies were the etiology of coma in 15% of under 40 year patients and 46.5% of above 40 year patients. Among traumatic etiologies of coma, subdural hematoma was the most frequent (40%). In our research none of patients who did not have one of pupillary, oculocephalic or motor reflexes in the 3rd and 7th day of the onset of coma had acceptable outcome after one month. With consideration of pupillary, corneal, oculocephalic and motor reflexes in combination, loss of at least two of them in the 3rd and 7th day accompanied with no acceptable outcome. On the other hand the presence of three or more reflexes in the 3rd and 7th day of coma was a good prognostic factor, with 80% and 88.9% chance of acceptable recovery respectively.
Conclusion: According of the study, the best time for prediction of outcome in a comatose patient, is the third or seventh the day after the onset of coma. Also relay on combination of brain stem reflexes, gives us more acceptable result.

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Background: Immediately after Comprehensive Medical Basic Sciences Examination (CMBSE), the secretariat of the Medical Basic Sciences Education Council (MBSEC) proceeds to rank medical universities according to the students’ scores both in individual academic subjects such as biochemistry, English and in all subjects put together. This study believes that the method used in ranking the universities according to the students’ English scores is not a proper method and thus doesn’t provide accurate results.
Methods: Seven of the major and smaller universities were selected. The language scores of all the students admitted to the medical schools of these universities during 3 academic years of 1378 to 1381 (2426 students in all) in both CMBSE and National university Entrance Examination (NUEE) were obtained. The language scores of each students in NUEE and CMBSE were matched.
Results: A significant correlation (max. R=69%, P<0.004 to min. R=27%, P<0.045) was observed between these two grades in all universities studied. Moreover despite the secretariat’s decision to calculate the scores and rank the universities in two separate groups of major and small universities, in some CMBSEs certain smaller universities were ranked in the group of major ones and in some others vice versa.
Conclusions: This has impaired the university ranking in the subject of English language. This study proposes two different ranking methods, that eliminate the present drawback in university ranking according to their student’s English scores.

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800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: In the last two decades, cryptococcosis has been gaining a distinct public health importance due to the growing number of AIDS cases. Considering the low sensitivity of direct examination with India ink and culture, use of sensitive techniques is crucial in the diagnosis of cryptococcal meningitis. Polymerase Chain Reaction (PCR) can be used to directly detect Cryptococcus neoformans in CSF samples to increase the diagnostic power in cases where conventional methods are unable to detect the organism.
Methods : In this cross-sectional study, CSF samples were obtained from 25 patients suspected of having neurocryptococcosis. The patients were referred to the Medical Mycology Laboratory of the School of Public Health affiliated to Tehran University of Medical Sciences from March 2009 to February 2010. Three different methods, direct India ink examination, culture and PCR were used to evaluate the CSF samples. Two 102 and 106 of Cryptococcus neoformans dilutions in 1ml of CSF were prepared and examined by the three methods. In PCR method, two primer pairs were selected to amplify the Cryptococcus neoformans URA5 gene. The sequences of primers were for A, B, C and D serotypes.
Results : Only in one case PCR, as well as direct examination and culture were positive. All the other samples were negative in PCR, direct examination or culture. Both CSF dilutions were positive in the three tests in the mentioned patient and the positive control.
Conclusion: PCR method can efficiently identify both control and positive samples of Cryptococcus neoformans.

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Background: Malassezia Species are often commensal of the human skin and scalp that opportunistically in exist of particular predisposing factors, their proliferation increases as, in dandruff and seborrheic dermatitis which both togather affect more than 50% of humans, the excess proliferation of yeast in scalp, leads to scalp-flaking and causes physical and mental disorder in peaple, spacially in youth that their health and hiar hygiene and beauty is more important for them. Thus, this survey has been done for rapid, easy and inexpensive method to diagnosis of abnormal proliferation and invasive condition of Malassezia yeast and can be more benefical for proper treatment.
Methods: Sampling with scalpel scraping from scalp of volunteer persons that had not bathed at least two day ago were done and preparation of direct microscopic slides and staining with methylene blue were accomplished. Then, survey of morpholgic characte-ristics, yeast quantification and mycelium detection were done by direct microscopic examination.
Results: From 140 scalp samples of adult persons of both gender (male and female) with different age groups, observation of malassezia yeast in 93.5% (131) were positive and 6.5% (9) were negative in direct microscopic examination. Results of yeast quanti-fication in positive cases were: mild or normal flora 25.2%, intermediate 24.5%, severe 50.3%. Detection of mycelium in positive cases were 22.9% (30) (P=0.007 df=2).
Conclusion: Application of an accessible, easy and inexpensive method and a determi-nated pattern (yeast quantification with direct microscopic examination) to distinguish normal flora from abnormal condition (excess proliferation and mycelium production) in cases of Malassezia yeasts can be more useful to rapid diagnosis of abnormal pro-liferation and invasive condition in order to initiate a proper antifungal treatment.

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