1 2383-4307 286 Special Comparison the Health –Related Quality of Life of Patients Suffering From Pemphigus with Healthy People Darjani A b Ghanbari A c Sayadi Nejhad A d Golchay J e Sadr Eshkevari SH f Alizadeh N g Headarzadeh A h b Guilan University of Medical Sciences c Guilan University of Medical Sciences d Guilan University of Medical Sciences e Guilan University of Medical Sciences f Guilan University of Medical Sciences g Guilan University of Medical Sciences h Guilan University of Medical Sciences 1 10 2008 17 67 1 9 27 11 2013 27 11 2013 Abstract Introduction: Pemphigus is a chronic autoimmune bullous dermatosis that predominantly was affected middle aged peoples. It requires serious therapeutic management and often repeated hospitalizations. However, little formally investigation has been performed concerning Heath-Related Quality of Life (HRQL) of patients who were affected by this disorder. Objective: Determining and comparing the Health-Related Quality of Life in patients suffering from pemphigus with healthy people. Materials and Methods: In this cross-sectional study 76 patients who confirmed pemphigus disease and 86 their healthy accompaniers were assessed. Two sample groups were paired according to sex and age.This study was performed in Razi hospital’s dermatological clinic in Rasht. A questionnaire composed of Persian translations of SF-36 and Sweden QoL (Quality of Life) were used for measuring of HRQL after determining of its validity and reliability. Data were collected and analyzed by using descriptive (distribution, mean ± SD) and inferential (t-test, chi-square, fisher exact test, ANOVA and Multivariant Regression Analysis). Results: In the pemphigus group there was a significant decrease of mean scores of all HRQL dimentions (p<0.0001). (Mean ± SD of patient's group was 69.38 ± 11.81 in Comparision to 85.43 ± 6.64 of healthy people). The factors influencing this impact were: job (P<0.01), older age group (P<0.04), prolonged disease(P<0.008), type of treatment (steroid+ adjuvant) (P<0.001),lack of university educations (P<0.005) and repeated hospitalizations (P<0.001).Multivariate regression analysis indicated that level of education(p<0.002), repeated hospitalization (p<0.001) and type of treatment (steroid+adjuvant) (p<0.001) have significant effects on quality of life in pemphigus patients. Conclusion: This study confirmed that pemphigus is responsible for great alteration in HRQL. Therefore, in management of this disease must be taken its impacts on various fields of life of the patients. Undoubtedly, every effort to warn health and economic managers would play a significant role in resolving of problems of these patients.
287 Special Ex Vivo Evaluation of the Accuracy of the Raypex5 Electronic Apex Locator to Detect Root Perforation Sadeghi SH i Abolghasemi M j i Guilan University of Medical Sciences, Rasht j Guilan University of Medical Sciences, Rasht 1 10 2008 17 67 10 15 27 11 2013 27 11 2013 Abstract Introduction:Root perforation diagnosis and immediate treatment of the lesion, can improve the prognosis of the treatment. Because of the limitations of radiographic method for determining proper location of the perforation, today using electronic apex locator devices was recommended for root perforation detection. Objective: Evaluate the accuracy of the Raypex5 apex locator for detecting root perforation and compare it with radiographic method. Materials and Methods:Twenty extracted anterior central teeth with apical foramen diameter equal to file 30 or 35 were selected. The roots were perforated using a 1/2 round bur at 1/3 middel of the root. Then, actual electronic and radiographic distance to perforation were measured. Data were analyzed using ANOVA with repeated measurements. Results:Raypex5 apex locator could detect root perforations in 55% of the cases. In these cases, no significant difference was observed between the mean electronic and actual length of the perfortion(p=0.29). There was no significant difference between the mean radiographic and actual length of the perfortion(p=0.444). There was no significant difference between the mean radiographic and electronic length. (p=0.819). Conclusion: Raypex5 could detect root perforation in only 55% of the cases.In these cases, electronic length had no significant difference with actual and radiographic length. 288 Special Evaluation the Relation between Coronary Risk Factors, Metabolic Syndrome and 10 Year Ischemic Event According to BMI in Women above 19 Years in Central Part of IRAN Sadeghi M k Golshadi I l Roohafza H.R m Aghdak P n k Sedighe Taahere Hospital l Sedighe Taahere Hospital m Sedighe Taahere Hospital n Province Health Center 1 10 2008 17 67 16 23 27 11 2013 27 11 2013 Abstract Introduction: Coronary artery disease (CAD) is the most common etiology of mortality in women. Some risk factors other than obesity involved in it. Objective: Evaluation the relation between obesity, metabolic syndrome and 10 -year’s cardiac event according to BMI in women above 19 years old in central part of IRAN. Materials and Methods: In this cross sectional study, 6054 women over 19 years old in Isfahan, Najaf - Abad and Arak were studied by stratified sampling (in 2001). Demographic details, such as: weight, height, blood pressure and smoking status were considered. Then blood chemistry was done in same manner in three regions and all biochemistry data were collected in a central laboratory. Data was entered in SPSS-11 and analyzed by T-Student and the prevalence was studied. Results: The mean age of women was 38.7514.55 years. By increasing the Body Mass Index (BMI), disorder in blood sugar, lipids, waist circumference and blood pressure were increased (p0.05) besides, by increasing the Body Mass Index (BMI) metabolic syndrome, 10 years cardiac event were more prevalent in obese women(P<0.05). Conclusion: By regarding to attention to correlation between obesity with other cardiovascular risk factors and metabolic syndrome, body weight control is necessary in studied women to decrease cardiovascular risk factors. 289 Special Unit Analysis of Health Care Centers in Urban and Rural Area of Guilan Mohtasham Amiri Z o Rahimi Kalamroudi H p Davoudi A o Guilan University of Medical Sciences p Guilan University of Medical Sciences Guilan University of Medical Sciences 1 10 2008 17 67 24 32 27 11 2013 27 11 2013 Abstract Introduction: Cost analysis of different programs of health care centers is a very important tool for future managing and determining the real cost of health facilities and budget which needed. Objective: Determine the expenses of health care centers of Guilan province in 2002. Materials and Methods: In a descriptive study, 20 urban and 19 rural health care centers were selected through random sampling. Costs were classified to capital costs (values of buildings, vehicles, 0unusable materials and equipments) and recurrent costs (costs of buildings’ repairs, usable materials, drugs, vaccines, personnel’s salaries). A checklist was used for data collecting and analysis was done with SPSS version 11.5 software. Results: Mean total costs of urban health care centers, consisted of capital costs and recurrent costs were 514 million Rials with standard deviation of 242 million Rials. These costs were amount 262 ± 79 million Rials in rural health care centers. The most common type of costs was personnel’s salaries (60%) and then buildings’ values (15%-20%). Recurrent costs of urban and rural health care centers were 386 and 214 million Rials, respectively. Conclusion: Governmental budgets aren’t enough for health care centers that might have a great impact on their qualities. Pay more attention to human resources managing and concession facilities to private sections could be helpful to control of these costs. Similar studies are recommended in other areas 291 Special Comparison the Prevalence of Varicocele in First Degree Relatives of Patients and Kidney Donation Volunteers Mokhtari GH Noshad A.R Jamali M Sobhani A.R Gulian University of Medical sciences Gulian University of Medical sciences Gulian University of Medical sciences Gulian University of Medical sciences 1 10 2008 17 67 33 37 30 11 2013 30 11 2013 Abstract Introduction: Varicocele is an abnormal tortuosity and dilatation of the testicular veins within the spermatic cord. Varicocele is approximately found in 15% of the general population, despite of the high relatively prevalence of varicocele in the general population, and its association with impaired spermatogenesis and steroid genesis, the paucity available of information and majority of studies were centralized on pathophysiology, methods and results of Varicocele reparation. Regarding to the potential inheritance pattern, we desided to perform this study. Objective: Evaluate the hereditary behavior of varicocele through comparison of prevalence of disease in first-degree relatives of patients with known varicocele and normal healthy kidney donation volunteers. Materials and Methods: This is a cross-sectional study Sixty-two patients with known varicocele who were admitted for surgery in Razi hospital between September 2005 and October 2006 were enrolled in the study. Their healthy available first –degree relatives (N=88) were asked to refer and examin. A group of 100 men who were refered for voluntary kidney donation were selected as control group and were assessed for varicocele. Results: Among the 88 first –degree relatives of patients with a known varicocele, 40 cases (45.4%) and 11 cases (11%) of 100 men in control group had a clinically palpable varicocele on physical examination. There was a statistically different. Between two groups among the first-degree relatives, 32 cases (55.1%) of 58 brothers, 8 cases (26.6%) of 30 fathers had palpable varicocele. Conclusion: Clinical varicoceles are more prevalent among first-degree relatives (particularly brothers) of patients with known varicoceles and may be an indicator of hereditary behavior of the disease and necessity of screening for male family members. 292 Special Determine the Prevalence of Tuberculose Infection in Diabetic Patients in Qazvin Asefzadeh M Bijani B Kalantari Z I Boo Ali Hospital Boo Ali Hospital Boo Ali Hospital 1 10 2008 17 67 38 47 30 11 2013 30 11 2013 Abstract Introduction: In Different Studies, diabetes is one of the most important Causes of reactivation of latent tuberculosis. Objective: Determine the prevalence of tuberculosis infection in diabetic patients in Qazvin. Materials and Methods: This study was performed as per census in the clinic of diabetes of Boo Ali educational hospital from Mar 2004 to Feb2006. PPD test was asseced all patients and if the irresult was Negative, allergy skin test was used with diluted Tetanous-Diphteria Toxoid antigen, for evaluation of CMI (cell-Mediated Immunity). If the result was positive and there was no clinical and radiographic abnormality, patients were reffered for chemoprophylaxis. In patients with clinical or radiographic signs of tuberculosis was performed sputom smear and active cases, and then were reffered for treatment. Results: PPD test was performed for 571 diabetic patients. The Results was: 415(72.2%) 0 to 5mm, 88 (15/5%) 5- 10mm, 47(83%) 10-15mm and 43 (4%) >15mm .Alergy rate calculated as 27, 6 %. Four smear positive polmunary tuberculosis cases were detected (active case finding). In all detected cases were seen abnormal findings in apical regions and in 3 out of 4 cases cavitary were seen in radiologyic report. Conclusion: In this study 12.3 % of patients had more than 10mm induration in PPD skin test. Rate of alergy was comparable in diabetic patients to general population. Detection of 4 active cases of smear positive pulmonary tuberculosis implicates the high prevalence of tuberculosis in diabetic patients in comparison with general papulation. 293 Special Frequency of Related Factors of Oral Cancer in Guilan Province Yazdizadeh M Heydarzadeh A Rezai R Qazvin University of Medical Sciences Guilan University of Medical Sciences Dentistry clinic 1 10 2008 17 67 48 54 30 11 2013 30 11 2013 Abstract Introduction: Oral cancer is one of the main hygienic problems in many countries of the world. Its prevalence in various places of the world is different and like any other disease for better understanding is necessary to understand about this diseases distribution in different parts of Iran Objective: Determine the frequency of related factors of oral cancer in Patients who suffered from oral cancer in Guilan province in years 1996-2004. Materials and Methods: In this retrospective study we were collected oral cancer information from cancer registry center of Guilan and oral and maxillofacial surgery offices. Results: Among total samples were found 306 cases of oral Cancer which 186 patients (60.8%) were male and 120 patients (39.2%) were female. Rate of males to females were 1.55 to 1 and mean age of patients were (57.7 15.65years). The most age incidence of suffering mouth cancer was in the 7th decades of life. In pathology, the squamus cell carcinoma with 205 cases (67%) was the most common malignant one. The second rank belonged to lymphoma with 27 cases (8.8%). Adenocarcinoma and mucoepidermoid carcinoma, with 12 cases (3.9%) were in third place of incidence. Tongue with 53 cases (17.3%), lower lip with 35 cases (11.4%) and finally tonsil with 29 cases (9.48%), were in 1st, 2nd and 3rd rank in incidence of malignant part of body. Conclusion: Most of the findings in this study were similar to previous studies. We need more accurate statistics to recognize the risk factors of suffering mouth cancer in various regions of country, which required integrated system of cancer registering. 294 Special Survey the Prevalence of Recurrence in Ultra Rapid Opiate Detoxification in Opiate and Heroin Dependents Najafi K Amir alavi S Zarrabi H Mohammadzadeh A Elaheh Sadat Khodaei E Salajegheh A Guilan University of Medical Sciences Guilan University of Medical Sciences Guilan University of Medical Sciences Guilan University of Medical Sciences Guilan University of Medical Sciences Guilan University of Medical Sciences 1 10 2008 17 67 55 64 30 11 2013 30 11 2013 Abstract Introduction: A wide variety of rehabilitation procedures can be applied in opiate dependents. Ultra Rapid Opiate Detoxification (UROD) is one of them resulted in ich influenced in detoxification in few hours however, the efficacy and safety of this procedure are questionable. Objective: Survey the Prevalence of Recurrence in Ultra Rapid Opiate Detoxification in Opiate and Heroin Dependents Materials and Methods: In this descriptive study, ninety opiate addicts who referred to Shafa Hospital were selected to undergo UROD. First, they were interviewed by principal investigators using ASI questionnaire. Urinary opium screen test was performed a week before detoxification and immediately after it. Subjective Opiate Withdrawal Scale (SOWS) and Objective Opiate Withdrawal Scale (OOWS) were applied before detoxification and 1, 6, 24 hours after that to assess withdrawal symptoms and signs. 6-month relapse was evaluated by urine screening test. Data was analyzed by SPSS statistical software. Results: 13 cases of 90 subjects failed to be followed. Among 77 remaining patients, 60(78%) relapsed in one-year. 50% relapsed in the first 3 months, 18% between 3 to 6 months, 6% between 6 months to one year and 3% after one year. Between subjective symptoms shaking, nausea and cramps in stomach and in objective signs vomiting and abdominal cramps were significantly different before and after detoxification. Prevalence of subjective and objective withdrawal symptoms and sings was significantly higher after detoxification. Conclusion: In detoxified Patients who under went UROD, didn’t find any considerable side effects due to anesthesia, organ function and severe psychiatric problems were not found. Of course, all of the subjects did not have any physical problem before UROD. UROD was effective to control some of the symptoms and signs of withdrawal syndrome while it did not show efficacy in controlling some others. The relative frequency of relapse rate in detoxified patients by UROD was 78% which was notably high. 295 Special Evaluation of Medical Residency Theses in Qazvin Asefzadeh S Asefzadeh SH Hashemi F Mashatan M Qazvin University of Medical Sciences Shohada Hospital Qazvin University of Medical Sciences Qazvin University of Medical Sciences 1 10 2008 17 67 65 72 30 11 2013 30 11 2013 Abstract Introduction: Theses are the most important sources of academic research and correct writing of them has important role in progressive of Educational and research Aims. Objective: Evaluate medical residency theses in Qazvin medical faculty with respect to writing and content. Materials and Methods: A total of 59 theses were submitted to study. A checklist consisting of 3 different parts structural, content and general characterized was completed for each case. Parameters related to structure and content were analyzed separately. Results: The field of the study most of theses (35.6%) was anesthesiology. Most of theses (55.9%) were designed and experimental studies. The overall writing of theses consisted of: 1.7% as weak, 74.5% as average and 23.5% as good. The weakest parts in theses were introduction, findings, conclusion and recommendations. Only 28.8% of the theses were published in journals. Conclusion: The overall most of medical residency theses, were on average level about writing and had very problems in various sections. Then, it is necessary to use some ways such as research workshops and Designing correct writing frame for promotion of quality of writing. 296 Special Comparison the Women's Quality Life Before and after Hysterectomy Asgharnia M Esmailpoor N Alzahra Hospital Alzahra Hospital 1 10 2008 17 67 73 79 30 11 2013 30 11 2013 Abstract Introduction: Gynecologic disorders are the most common health problems among women. If drug treatments lead to fail, hysterectomy was considered. Objective: Determine and compare the women's quality of life before and three months after hysterectomies. Materials and Methods: According to chronic disorders (diabetes mellitus, cardio-vascular diseases) fifty five women were selected. Subjects were selected upon a pilot study and by consecutive non-probability sampling. Data were collected by a predetermined questioner and processed and analyzed with SPSS. Chi- square and t test were used for analyzing accordingly. Results: There was statistically different between mean scores of general health quality before and after hysterectomies (P<0/0001) but its depression component had no different. General disorders and clinical symptoms were different with different statistically degrees. (p=0.0005 for urinary incontinence to p=0.023 for urinary urgency).Pelvic pain (p=0.056) and vertigo (p=0.21) showed no statistical differences. Conclusions: After hysterectomy total health quality scores statistically improved but anxiety score showed less, and depression score showed no statistical difference. In order to more generalizing findings, recommended carrying out a larger study with benign and malign disorders separately. 297 Special Survey the Rate of Blood Donors loss Due to Unconfirmed Elisa Test in Blood Transfusion Organization in Fars Provience Kasraian L Blood Transformation Organization 1 10 2008 17 67 80 87 30 11 2013 30 11 2013 Abstract Introduction: Blood donors which their Elisa test were positive and their result were not confirmed, caused problem for blood banks, Units were discarded and donors were permanently deferred. Objective: Determine the prevalence and demographic characteristic of blood donors with false positive results in Shiraz blood transfusion organization. Materials and Methods: This is a retrospective, cross-sectional study that was done all blood donors who give blood in shiraz BTO from 1/1/2005 till 1/1/2007 then the rate of prevalence and demographic states of blood donors with false positive results in HBS, HCV, HIV was determined. Chi-square and T test was used for data analysis. Results: The prevalence of false positive result in blood donors was %2/17 that %80.4 of false positive results was due to hepatitis C, %5/2 due to hepatitis B , %14/2 due to HIV. The prevalent rate of false positive results was more in young , female , first time and low educational blood donors ( P < 0/05 ) Conclusion: Overall, false positive results caused to loss of 6135 Blood unit and permanent deferral of 5987 blood donors. Most of false positive results distributes in blood donor population. However this result was more in some blood donors with some demographic status, its better to use specific screening test for permanent the risk of blood donors. 298 Special Relationship between Justice and Effectiveness in Hospitals of Shahid Beheshti University of Medical Sciences Nasiripour A.A Mehrabian F Taghi zadeh H Islamic Azad University Islamic Azad University Islamic Azad University 1 10 2008 17 67 88 93 30 11 2013 30 11 2013 Abstract Introduction: Justice is the base of consistence in every social system and it provides balance for these systems considering justice control the predictability of organizational behavior. Regarding to the impact of this section customer's satisfaction has the most importance in the Health care organizations. Objective: Definition the relationship between justice and effectiveness in the educational hospitals related to '' Shahid behest'' medical science university. Materials and Methods: This is a correlation study that performed at the first six months of 2007. The research samples consisted of: 134 persons of hospital staff and 108 patients that were selected by categorized sampling. In order to gathering the data, two type of questionnaire have been used and for data analyzing regression analysis and Pierson have been used. Results: The mean perception of patients from procedural justice and instructional justice as follow squinty 54/25% and 77/25%. The mean perceptions of staff from distributive justice, procedural justice as follow squinty 32/75% and 30%). (The results described the positive correlations between fair wags and employees consents (r =%46) also fair between distribution and job satisfaction (r =%47). Conclusion: Regarding to significant relation between the equity perception with job satisfaction in staff and patient, close relationships between staff, mutual respect and properly accountability of hospital personal with costumers, setting objective standards and other variables in this study will increase effectiveness in health care organizations. 299 Special Genetic Predisposing of P53 Codon 72 on Developing of Breast Cancer in Postmenopausal Women in Isfahan Faghani M Nasiri E Bahadori M.H Mohammad Ghasemi F Guilan University of Medical Sciences Guilan University of Medical Sciences Guilan University of Medical Sciences Guilan University of Medical Sciences 1 10 2008 17 67 94 100 30 11 2013 30 11 2013 Abstract Introduction: Breast cancer is one of the most common cancers among women in worldwide. 53P the suppression gene tumor has a principal role in genomic stability and its function is variated by the codon 72 polymorphism. Objective: Investigate the codon 72 polymorphism of P53 and the effect of menopause on the development of invasive breast ductal carcinoma. Materials and Methods: A case–control study was conducted on 96 patients with invasive breast ductal carcinoma and their 96 matched controls in Isfahan. The different genotypes of the codon 72 of P53 gene were identified by using allele-specific polymerase-chain reaction. Breast cancer patients were divided into two groups: postmenopausal and premenopausal. Statistical analysis was performed by using χ2-test. Results: In control group, the distribution of Arg/Arg, Arg/Pro and Pro/Pro genotypes were 36.5%, 45.8% and 17.7% respectively. The distributions of Arg/Arg, Arg/Pro and Pro/Pro in case group were 70.8%, 21.9% and 7.3% respectively. There is significant statistical difference in the distribution of P53 codon 72 polymorphism between case and control groups (P<0.001). In addition, 76% of patients with Arg/Arg genotype were in post-menopause age group (P=0.05). Conclusion: The findings of this study indicated that the polymorphism of codon 72 P53 is a genetic predisposing factor for the development of invasive breast ductal carcinoma in the studied sample in Isfahan and most of the patients were in postmenopausal age group. 300 Special A Case Report of Abdominal Pregnancy Mirblouk F Moradi H Moradi Z Amini V Hemmati H Alzahra Hospital Radiography Clinic . Kosar Hospital Golsar Hospital Razi Hospital 1 10 2008 17 67 101 106 30 11 2013 30 11 2013 Abstract Abdominal pregnancy is a very rare condition of ectopic pregnancy with a high mortality rate for mother and fetus. It occurs when the gestational sac implanted outside the uterus, ovaries and fallopian tubes. Although this condition is potential life-threatening but often misdiagnoses of other variant ectopic pregnancy. Prompt detection in initial stage of pregnancy is necessary to prevention of dangerous complication. This present case-report was a patient who admitted in the Alzahra hospital during two decades. She was a 23-year old nulliparous woman with a history of primary infertility that underwent ovarian hyper stimulation with clomiphen citrate. She underwent transvaginal ultrasonography because of menstrual retardation, positive serum HCG test and spotting. It was diagnosed an incomplete abortion according to clinical symptoms and lack of gestational sac inside the uterus. Transvaginal ultrasonography was performed again for persistency the pregnancy symptoms after 4months. Diagnostic pelvic ultrasonography confirmed a 16-week intra-abdominal pregnancy. The ultrasonographic examination confirmed a 27-week intra-abdominal pregnancy. The woman was admitted immediately. The surgery was performed, without any complications. She recovered well and was discharged soon.