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The cancer of breast is the most common malignancy among women and after cancer of the lung is the second cause of death in females. Thus, early diagnosis and treatment can have a effect significant in prognosis and clinical course of disease. One of the numerous controversial tissues to the clinical management of breast cancers is the role of fine-needle aspiration (FNA) to assess the accuracy and determine the role of FNA in breast cancer diagnosis, we performed both FNA and excisional biopsy in 86 unselected patients with palpable breast masses and correlated the cytologic and histopathologic findings. In our study, FNA had no false-negative and no false-positive results, and the sensitivity of diagnosis of malignant tumors was 88.8%, the specificity of diagnosis of benign lesions was 96.2% and the predictive values were 100%, respectively. On the basis of above study, breast FNA may add a measure of confidence in the diagnosis of benign lesions, provides a safeguard for preventing misdiagnosis of malignant lesion, and might expedite and reduce the cost of managing breast cancer. Also, breast FNA like any diagnostic method depends to individual techniques and continual practice.

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A variety of extracranial sites have been described for Meningiomas including the nose, various viscera, skin, eye and extraspinal tissue. Among them cutaneous Meningioma generally occur most frequently on the scalp, forehead or paravertebral areas. We are reporting in this article one case of cutaneous Meningioma in the forehead region with respect by reviewing the literatures is very rare tumor. Our patient is a middle age woman with right forehead mass from two years ago, in the skull X-ray and computerized tomography of our case intracranial lesion is not seen and also there is some thickening involving frontal bone. After the surgical excision of the mass and in the microscopic examination of specimens, histopathologic diagnosis is Meningioma (Meningotheliomatous type) and immunohistochemical study react for epithelial membrane antigen. In the clinical course, extracranial Meningiomas enlarge slowly and are usually cured by simple excision alone but incomplete excision may lead to recurrence, the things have been occurred in our patient.

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Background & Objective: Colorectal cancer is the most common cancer of GI and 2nd most common cause of cancer death in the world. The purpose of this study was to determine epidemiologic aspect and tumor characteristics of colorectal cancer for patients and compare them in young (<50 yr) and older (>50 yr) patients. Materials & Methods: In this cross-sectional study during 3 yr the samples of malignant colorectal cancer presented in Gorgan endoscopy and pathologic centers were collected. Data evaluated by statistically method. Results: There were 101 cases of malignant colorectal cancer. 61 cases were male and 40 cases were female. The mean age was 56±13.65 yr. 13.9% of patients were <40 yr. The type of tumor in 94% was adenocarcinoma, 2.9% lymphoma and 2.9% undifferentiated carcinoma. The site of involvement in 30 cases were rectum and in 71 cases were colon. The most common symptom was abdominal pain, constipation and rectal bleeding. The time interval between onset of symptom to diagnosis of disease in 58 cases was >6 mth. Family history of cancer in 36 cases was positive. Right colon cancer in young patient was significantly more than older (P<0.05). Positive family history of cancer in right colon cancer was significantly more other than. Positive family history of cancer in young patient was more than other (P<0.05). Conclusion: According to this study, colorectal cancer was high. Therefore, it is necessary to pay more attention to the symptom of young patient and providing a screening program in patients over 50 years old and young patients with positive family history.

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Background&Objective: Consultation prior to blood donation and screening tests of common blood born diseases such as Hepatitis B,C and AIDS are very important issue in blood quality assurance, therefore we decided to compare frequency of such diseases in blood donors and outpatients admitted in the blood transfusion centers. Materials&Methods: For this purpose the initial tests including HBsAg, HCVAb, and HIVAb were performed on all blood donors and outpatients' blood samples in Gorgan transfusion center by ELIZA methods during 2003 and confirmatory tests including neutralization for HBsAg, RIBA for HCVAb and Western blot for HIVAb performed in condition where ELIZA report was positive. Results: The blood donor in this study had the following positive results: HbsAg 2.5%, HCVAb 3%, HIV 0.35%. The same indeces for the out patients were positive as follow: 13%, 8.3% and 2.04% respectively. The other finding from this investigation indicate that the blood donors positive cases with the ELISA technique were confirmed by Western blot 92%, 20.1% nad 0% for HBSAg, HCVAb, as HIV respectively. The confimatory results of the positive out patient's cases were as follow, 97%, 47% and 60% for HBSAg, HCVAb and HIV respectivley. Conclusion: This study reveals frequency of Hepatitis B and C and AIDS among outpatients which considered being high risk group are more than the blood donors. We conclude that the measurement of HBSAg by ELIAZ methodes in comparision to the HCV and HIV are more accurate.

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Background&Objective: The presence of single or multiple nodules within the thyroid gland is a common clinical problem. It is immposible to differentiate benign and malignant follicular neoplasms in cytologic examinations.Estimation of risk of malignancy in thyroid nodules who are cytologically assumped to be follicular neoplasm has a critical importance.The aim of this research is evaluation of diagnostic value of thyroid FNA in follicular neoplasm. Materials&Methods: This survey was done on 476 patients with thyroid nodule whome were biopsied in a 7 years period (in 5th Azar hospital, Gorgan). Standard aspirations and biopsies techniques performed and nessassary smears prepared. Wet-fixed smear glass slides are placed immediately in alcohol (70%) 7-10 slides from the aspiration. The patients with cytologic report whome considered follicular neoplasm followed total thyroidectomy or lobectomy. Results: From 476 patients for thyroid nodules 412 cases(86.5%) are suitable for cytologic evaluation which 312 cases(77.9%) of them were benign and 14 cases(3.3%) were malignant.The rest(77 cases)reported to have follicular neoplsm, this patients also undergone thyroid surgery.The result of histological findings appeared in 32 cases(57.1%) follicular adenoma,15 cases(26.7%) non-neoplastic nodules,5 cases(8.9%) follicular carcinoma and 4 cases(7.1%)follicular type of papillary carcinoma. Conclusion: 9 cases (16%) found malignant among cases which cytologic reports considered as “follicular neoplasms” and subsequently undergone thyroid surgery (consist of follicular carcinoma and follicular type of papillary carcinoma), confirme the importance of histopathologic study of follicular lesions for differentiation between malignant and benign lesions.

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Background&Objective: Hospital infection is one of the important determinants on lengthening hospitalization and increasing the costs and mortality rates in hospitals. Intensive Care Unit (ICU) is one of the wards that are most afflicted with the incidence of this morbidity. This study involves investigating the incidence of infection in one of the Intensive Care Units. Materials&Methods: This study was designed in the form of a prospective cohort which was implemented on patients who were hospitalized in the ICU of Khatamol Anbia Hospital from September 21st 2002 for at least 72 hours and didn’t reveal signs of infection. The status and duration of using tracheal tube, ventilator, urinary catheter, and venous catheter, the duration of hospitalization in ICU and the time infection appeared were all recorded. Results: During the six months spent on this study, 234 patients were hospitalized in ICU, among which 50 patients were investigated. The group of these 50 patients cumulatively spent 528 days in ICU. During their hospitalization, 9 cases of infection occurred in these patients. The incidence of infection was 18% (with a 95% confidence interval of 7.35% to 28.65%). The incidence rate was 17 patients in 1000 person-year of hospitalization in ICU (with a 95% confidence interval of 8.8 to 106.3). Conclusion: Hospital infection is a relatively common complication among patients who have been hospitalized in ICU for at least 3 days. The frequency of infection reported in Iran is equal or more than the results of studies carried out in other parts of the world.

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Background & Objective: At least about 30 percentage of children hospitalize in hospital in their childhood. Hospitalization of children cause anxiety, due to separation from their parents ,fear of new environment, disabilities and continuation of life. This study was done to determine the effect of music on the rate of anxiety among 9-12 years old hospitalized children.

 

Materials & Methods: This semi experimental study was done on sixty 9-12 years old children who are confined to bed in Taleghani hospital in Gorgan north of Iran during 2002-3. 60 of children were divided to 2equal groups of intervention and control randomly. The tools of gathering data including information questionnaire, patients demographic, state – trait anxiety inventory for children Spillberger (STAIC), face anxiety children examined scale Piyeri (FACES) information was compared before and after the intervention the collect. For intervention group, 2 music therapies listening of music section, for the 2 continuous days and each section lasted for 20 minutes. The collected data before and after intervention were analyzed by using Kolmogrov-Smironov, c², independent-sample T test, Wilcoxon signed Ranks, Bartlet and Mann Whitney test.

 

Results: There was not any difference between the average of state anxiety and amount of face anxiety in both group before execution of music therapy but there was a significant difference for the intervention group after the music therapy (p<0.05). Also the decrease in the rate of anxiety in intervention group can related to the executing of music therapy.

 

Conclusion: Music therapy reduced the rate of anxiety among the 9-12 years hospitalized children.

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Background & Objective: Menopause effect on women quality of life and mental health. This study performed to determine the effect of supportive group therapy on menopause mental health condition in Sharekord.

 

Materials & Methods: This study is a quasi experimental research. 46 menopause women who had research condition divided in case and control group. We used GHQ28 and demographic questionnaire in 3 stages for data gathering. group therapy session perform for case group. Data was analysed with SPSS soft ware and analyctic and descriptive statistic index such as Paired T and correlation exam.

 

Results: After group therapy in all dimention performed, significant progress in case group (p<0.05). In addition there was significant difference between case and control group in mental health score after group therapy (p<0.05). There is no any correlation between demographic variable with mental health condition.

 

Conclusion: This study showed effectiveness of group therapy in mental health condition of menopause women. We recommend to use this method routinely for menopause women.

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Background & Objective: Preterm infants have less iron storage compared with the term one. Due to rapid growth they need more iron during infancy. This study was designed to evaluate the effect of early iron supplementation on hematologic indices and incidence of iron deficiency anemia in preterm infants. Materials & Methods: This experimental study was done on 20-days-old preterm breast-feed infants referred to the Gorgan-North of Iran primary health care services for vaccination, without any underline disease or growth retardation during 2005. They were divided to two groups (n=15 in each) and a questionnaire was completed for each case. Iron drop (2mg/kg) was given in the interventional group. Iron deficiency anemia was assesed in all sample T-student test and chi-square were used to analyze the independent variables and comparing the hematologic indices, after entering in SPSS-13 software and testing the normal distribution with komologrof-smearnoff test. Relative risk index (RR) was used to compare the two groups. Results: The relative risk of iron deficiency anemia in the interventional group was 0.4 folds [RR=0.4,CI %95 for RR=(0.091,1.749)]. No significant difference was seen between the two groups. Conclusion: The finding of this study showed that iron drop supplementation for preterm infant prevent the iron defeciency anemia, although this observation was not significant.

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Background & Objective: The atherosclerosis of left anterior descending (LAD) coronary artery because of subtending more than 50% of left ventricular myocardial mass, has long been the focus of concern regarding appropriate treatment. This study aimed to evaluate efficacy of Percutaneous Transluminal Coronary Angioplasty (PTCA) with stenting for treatment of proximal LAD disease. Materials & Methods: In this descriptive study, 75 patients with isolated proximal LAD atherosclerotic lesion treated with PTCA and stenting were followed up for 9 months. The stenosis of all patients was documented by coronary angiography prior to enrollment. Exercise tolerance testing (ETT) by Bruce protocol was performed before angioplasty and at the end of follow up period as well. Results: There were 44 (58.7%) males, and 31 (41.3%) females. The mean age of patients was 59.4 (range, 39 to 83 yrs). Clinical outcomes of 73 (97.3%) patients were satisfactory. Only two patients developed re-stenosis during the follow up period. The first patient developed myocardial infarction at the 3rd day of her admission, and the second one had an abnormal ETT after 9 months. Percutaneous coronary revascularization with stenting was performed, and both of them were discharged without any problem. Conclusion: This study demostrated that the nine months prognosis of patients with isolated stenosis of proximal LAD coronary artery that treated by PTCA and stenting was acceptable. This treatment improves clinical status and results in lower hospital adverse event rates and in appropriate clinical outcome.

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Background and Objective: Occult hepatitis B infection is a form of hepatitis in which despite of absence of detectable HBsAg, HBV-DNA is present in peripheral blood of patients. The mechanisms which are responsible for progression of OBI yet to be clarified but some investigators believed that the genetics and immunological parameters may are different in resistant individuals and patients. Cytokine network system could be leading alteration in viral immune response. The aim of this study was to investigate the relation between polymorphisms +874 region of IFN-Gama with occult hepatitis B infection. Materials and Methods: In this study, the plasma samples of 3700 blood donors were tested for HBsAg and anti-HBs by ELISA. The HBsAg negative and anti-HBc positive samples were selected and screened for HBV-DNA by PCR. HBV-DNA positive samples assigned as occult hepatitis B infection cases and ARMS-PCR technique were performed to examine the present polymorphisms in +874 region of IFN-Gama genes of patients with occult hepatitis B infection. Results: 352 (9.51%) out of 3700 blood samples were negative for HBsAg and positive for anti-HBc antibody. HBV-DNA was detected in 57 (16.1%) of HBsAg negative and anti-HBc positive samples. Our results showed that there was not any significant difference between patients and control group in polymorphisms in +874 region of IFN-Gama genes. Conclusion: This study showed that there is not any significant difference between polymorphisms in +874 region with IFN-Gama occult hepatitis B infection.

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Background and Objective: Quality of medical articles is effective at improvement of medical science. This study was done for determining of published medical articles quality in approved Medical Journals. Materials and Methods: This cross- sectional study was done on 690 medial articles, which published between 1983-2005 in scientific journals, approved by special Medical Journal committee of Ministry of health and medical Education (MOHME) in Iran, during 2007. Source of data was indexed medical journal in the Iranmedex database. Results: Type of study in 52% of articles was descriptive, 21.2% was interventional and 5.8% of them were analytical. In recent years the number of analytic and interventional articles have been increased significantly in comparison to other types (P<0.05). There was no qualitative type article in published papers. The percentages of original, case report and review articles were 44.9%, 36.9% and 14.1%, respectively. In recent years the rate of original articles has increased in comparison to case report and review articles (P<0.05). In 80% of articles, at least one statistical test was applied. 60% of articles were clinical and 82% of them have been written in Persian language. Conclusion: Findings showed an increasing trend in quality indexes of published articles. It seems in recent years, the changes of MOHME policies in evaluation of the research deputy of medical science universities implementation of research and scientific writing workshops ratting protocol of approved medical journals and academic members promotion guidelines, resulted in improvement qualitative index of articles.

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Background and Objective: Life saving with a high quality health care programs in the shortest duration is the mainstay of emergency department system. Frequent monitoring and quality control of this process and the satisfaction of patients are among the very important indices in hospital quality. This study was designed to evaluate the clients satisfaction in the hospitals affiliated to Golestan University of medical sciences. Materials and Methods: This descriptive cross-sectional study was done on 2400 referred patients in emergency departments of different hospitals in Golestan province, northern Iran during 2006. Data were gathered by questionnaire included demographic data and questions about satisfaction of outpatients and emergencies. The Data analyzed by SPSS-15 software and chi-square test. Results: Level of satisfaction in emergency department, was reported as follow: physician attention and behaviors (86%), nursing behaviors (85%) responsibility to patients (84.1%) status of the environmental temperature (83.9%) and cleaning (81.9%). The lowest satisfaction was related to behavior of guardsman (33.8%). In emergency ward, levels of patient's satisfaction were as following: Access to telephone (49.7%) quality of the meals (47.4%) quantity of meals (44.1%) and the lowest level of satisfaction of patient was neglecting the patient's right (8.2%). Conclusion: This study indicated that more educational programs, should be arranged for the emergency units employees to observe patients right.

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protozoan of Leishmania genus and in Iran by Leishmania infantum. The protective immune response against VL is cellular immunity through Th1 CD4+, which dominant chemokiens are IL12, IFN- γ  and IL18 and lead to Th1 response. Single nucleotide polymorphism (SNP) on IL-18 gene and its relation to IL18 levels in blood and IL18 function have been studied in many inflammatory diseases such as Behcect’s disease and tuberculosis. According to the important role of IL-18 in immunity against visceral leishmaniasis, this study was conducted to demonstrate the prevalence of genotypes on -607A/C in promoter region of IL-18 gene.

Materials and Methods: This descriptive and cross-sectional study was done on 91 pateints with confirmed VL, 105 healthy sero-negative controls and 78 seropositive controls during 1999-2009. Salting out method was used to extract DNA and ARMS-PCR was used to determine the genotype of -607A/C allele of individuals. Statistical analysis of genotypes was performed using Chi-Square test.

Results: According to the results, -607C/C was the dominant genotype among the groups (35.8%). Distribution of genotypes among groups had not any significant difference. The lowest genotype among healthy sero-positive and patients were -607A/C and -607A/A, respectively. Statistical analysis of distribution of genotypes, did not reveal any significant difference among groups.

Conclusion: The dominant genotypes of VL patients, healthy sero-negatives and healthy sero-positives were -607C/C (38.5%), -607A/C (37.1%) and -607C/C (35.9%) respectively.

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Background and Objective: Anterior cruciate ligament (ACL) tear is one of the most common injuries at knee joint. This study was done to evalute the effect of reconstruction surgery on hamstring reflex in patients with ACL tear. Materials and Methods: In this Quasi- experimental study, 30 patients (16 males, 14 females) with ACL tear, with mean age of 26.52±8.72 years old were recruited during 2007. Patients were selected in a non probability sampling manner. The Kinsiological Electromyography and trauma mechanism were used for testing the hamstring reflex. Muscle activity were measured as a dependent variable. Data were analyzed with Paired T-Test, ICC, SEM and K-S tests. Results: Hamstring reflex in affected knee and after reconstruction surgery was 73.25±3.22 and 47.35±3.85, respectively. This difference was significant (P<0.05). Conclusion: Reconstruction surgery in patients with ACL tear at acute phase is effective in improvement of hamstring reflex.

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Background and Objective: Cardiovascular diseases are the most significant factors leading to death. This study was done to determine the effect of eight weeks aerobic training on level serum lipid and lipoprotein in non athletic women.

Materials and Methods: This quasi-experimental study was carried out on 30 non athletic women. Subjects were devided into control and experimental groups through gained Vo²max. HDL-c, total cholesterol (TC), LDL-c, VLDL-c, RF (TC/HCL) and subdermal fat percent were evaluted perior and after training for eight weeks as follow: three session in each weeks with one hour aerobic training in each session. Data analyzed using SPSS-14 and independent and dependent T student tests.

Results: The significant reduction of RF, TC and percent of subdermal fat were observed in experimental group after training in comparison with prieor phase (P<0.05). Significant reduction of RF, LDL-C, TC and subdermal fat were observed in experimental group in comparison with contols after training (P<0.05). The increase of HDL-c and reduction of TG and VLDL-c were observed in experimental group compared to control but these differences were not significant.

Conclusion: This study showed that aerobic training reduce total cholesterol, LDL-c, RF and percent of subdermal fat in non athletic women.

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Background and Objective: Incidence of fungal infections particularly fungal sinusitis is increasing in Iran and identification of causative agents is essential for its control and treatment. This study was carried out to determine the fungus paranasal sinusitis in non- immunocompromised patients in Tehran, Iran.

Materials and Methods: This cross – sectional study was done on 108 patients (73 males, 35 females) with chronic sinusitis ranged from 9 to 68 years, admitted to Amir Alam and Emam Khomeini hospitals in Tehran, Iran during 2006-07. Sinusitis in patients confirmed by radiologic images. Complementry information were obtained using questionnaires which including gender, job, presence of disposing disease diabetes and consumption immunocompromised drugs. Sinus samples were collected by washing and biopsy were carried out by two methods of fenestration and Cald-wel luc operations. Subsequently they were cultured on Sabouraud dextrose agar (SDA), SDA+chloramphenicol and blood agar (BA) media at 30°C and 37°C. Direct examination and fixative sample for histhologic evaluation was done and for colonies confirmation the slide culture method also was used.

Results: 8 cases (7.4 %) were positive for fungal sinusitis with following sub type: 6 cases (Alternaria Spp), 1 case (Paecilomyces) and 1 case (Aspergillus flavus). The most fungal sinusitis (5 cases) were observed in 30-39 years patients.

Conclusion: Considering the prevalence of 7.4 % fungal sinusitis and isolation of paecilomyces which is a rare subtype complematry investigation is recommended, in the field of research.

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Background and Objective: Trauma is the most common cause of death in all individuals between 1 and 44 years and the third most common cause of death regardless of age. The abdomen is the third most commonly injured region of the body. Some intra abdominal organ injured more than others, related to mechanism of injury, size and location of organ in abdominal cavity. This study was carried out to determine the prevalence of intra abdominal injuries due to penetrating trauma. Materials and Methods: This retrospective descriptive study was done on 114 patients admitted to 5 Azar hospital in Gorgan, Iran due to penetrating abdominal trauma during 2002-07. Gender, age, type of injury causes of trauma and hospitlalization period were obtained form patients files. Results: 92.1% of patients were male. The mean age of subjects was 24.8 years (9-70 years) with highest frequency between 20-24 years. Two (1.8%) deaths directly related to abdominal stab wounds related to hemorrhagic shock. The most common cause of penetrating abdominal injury was knife wound (78.9%). The mean time spent in hospital was 4.6±2.8 days. In 53 patients, cause of trauma were either related to pentration into peritoneum or passing through in. Small intestine injuries (14 %), rupture of diaphragm and concurrent lung injuries (7%) were the common damage organs. Conclusion: This study showed that the knife was the main cause of abdominal penetrate trauma and peritoneum was the most common damage tissue.

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Background and Objective: Nosocomial infections are one of main causative agents of mortality among hospital patients. This study was done for the determination of efficacy of commercial disinfectants such as: formaldehyde, glutaraldehyde, microten, the alcohol 70 and savlon–alcohol on isolated saprophytic fungi from hospital environments. Materials and Methods: This descriptive study was done on 33 isolated fungi from teaching hospitals of Tehran during 2009-10. The identified samples were randomly chosen. Stock fungal suspensions were supplied from each fungus with cells ranging 0.5-5×10⁴ micro g/cfu in 1ml with spectrophotometer at the wavelength of 530 nm. For evaluation of antifungal activity of commercial disinfectants formaldehyde, glutaraldehyde, microten, alcohol 70 and savlon–alcohol disinfectants, 0.25cc stock solutions were mixed with 3.75 cc disinfectants solutions and the new diluted samples held at 25c for 15, 30 and 60 min. The culture medium was checked for growth of fungi until 8 weeks. Results: Following specific period isolated fungi were including Aspergillus spp with 39.4%, Penicillium spp with 36.4%, Fusarium spp with 12.1%, Rhizopus with 6.1%, Alternaria and Circinella with 3 %. Formaldehyde 8% and glutaraldehyde 8% with activity against 63.6% and 39.3% were effective disinfectants at 15 min. Formaldehyde 8% with activity against 74.8% of fungi, was effective disinfectant at 30 min. Glutaraldehyde 8% and formaldehyde 8% with 100% prevention of growth were effective disinfectants at 60 min. Conclusion: According to this study formaldehyde 8% and glutaraldehyde 8% showed to have the highest antifungal activities. Synergetic fungicidal activity of comenercial disinfectants, dependent on time and concentration.

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Background and Objective: Ultraviolet (UV) radiation is a important disinfectant. Fungal infections with resistant isolates in patients culminate in recurrence of disease even with worse condition. This study was done to evaluate the efficacy of ultraviolet radiation on drug susceptibility of Candida Spp. to itraconazole, fluconazole and amphotericin B. Materials and Methods: This laboratory study was done on 12 Candida spp. isolated from patients according to NCCLS M27- A method. Samples were suspended with sterile saline and optical density was read by spectrophotometer at the wavelength of 530 nm. Serial dilutions (0.0313-16 µg/ml) and (0.0313-128 µg/ml) were supplied for itraconazole, amphotericin and fluconazole, respectively. MICs were determined after 48h incubation at 35°C. Following UV radiation for 1, 2, 5, 10, 60, 90 and 120 seconds MICs were determined, subsequently. Results: The highest MIC pre UV radiation was (>128 µg/ml) for fluconazole. After UV radiation, MICs were steadily decreased for all mentioned drugs while after 10 sec, MICs of itraconazole and amphotericin B were >0.0313 µg/ml. Secondary MICs significantly decreased with respect to MICs obtained in pre UV radiation (P<0.05). Conclusion: UV radiation reduces MICs of Candida spp. to itraconazole, fluconazole, amphotericin B.