Superselective α-adrenergic blockers versus transurethral resection of the prostate: a prospective comparison of health-related quality of life outcome after treating patients with benign prostatic hyperplasia.

PURPOSE: We prospectively evaluated the impact of transurethral resection of the prostate (TURP) versus superselective α-adrenergic blocker treatment on health-related quality of life (HRQOL) in men with clinically diagnosed benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: A total of 219 patients with lower urinary tract symptoms (LUTS) caused by BPH were recruited in this study. Treatment modalities consisted of standard TURP (n = 104) and tamsulosin medical treatment (n = 115). HRQOL was assessed by SF-36-Item Health Survey 1.0. LUTS were estimated by The International Prostate Symptom Score. Patients' outcome 4 weeks after treatment was compared to pre-treatment status and to that of the other group. Statistically significant changes in each HRQOL scale from baseline to follow-up period were investigated. RESULTS: Baseline characteristics were similar in both groups except for the duration of disease before treatment that was longer in TURP group. Both treatments resulted in statistically significant improvements from pre-treatment in all scales of QOL after 4 weeks, with no significant differences observed between the two groups. In medical treatment group, there was a significant association between higher educational level and better QOL in all 8 scales. Our outcomes revealed a significant decrease in the IPSS in both groups but this improvement was more evident in TURP group. CONCLUSION: All scales concerning HRQOL were favorably improved 4 weeks after both surgical and medical treatment, and no significant differences were observed between these two treatment modalities for patients with symptomatic BPH. This information may aid patients when deciding which treatment option to take.

Comparison of the health-related quality of life between epileptic patients with partial and generalized seizure.

BACKGROUND: Epilepsy is defined as recurrent unprovoked febrile seizures, which cause disability in patients. This study aims to assess the health-related quality-of-life (QOL) in epileptic patients in Fars Province, southern Iran. METHODS: One-hundred epileptic patients, above 18 years, referred to Shiraz University of Medical Sciences affiliated clinics, were included. The QOL of patients with generalized and partial seizure were assessed using the Iranian valid and reliable Sf-36 questionnaire. Patients' socio-demographic and their disease features were also compared with each other using a questionnaire. RESULTS: In partial epilepsy group (n = 24), the married patients in social functioning (SF) aspect of QOL (64.42 ± 14.29) (P = 0.024), the patients on antiepileptic drugs (AEDs) monotherapy in both physical functioning (PF) (88.75 ± 11.57) (P = 0.030) and SF (75.00 ± 6.68) (P = 0.022) aspects, the employed patients in PF aspect of QOL (P = 0.023) (91.87 ± 8.83) and those with high income in mental health aspect of QOL (P = 0.036 and correlation coefficient = 0.413) got better scores compared with the partial epileptic patients who were single, on polytherapy, unemployed and had low to moderate income. In generalized epilepsy group (n = 76), patients on AEDs monotherapy in PF aspect of QOL (P = 0.025) (78.33 ± 24.36) and employed patients in vitality aspect (P = 0.023) (57.00 ± 28.25) had better scores. Data were analyzed using SPSS for windows. CONCLUSION: Epilepsy can affect patient's life in a number of ways such as their lives, marriage, occupation, and education. We can encourage patients to find a partner, continue higher education and try to find a job.

Impact of modified radical mastectomy on health-related quality of life in women with early stage breast cancer.

BACKGROUND: Systematic reviews favor a better body image and sexual activity in patients who have undergone conservative breast surgery (BCS) compared to modified radical mastectomy (MRM). In those patients with the same survival, MRM remains the surgical choice among both surgeons and patients in Iran as well as in many other countries. This cross-sectional study focuses on health-related quality of life in early stage breast cancer patients following BCS and MRM. METHODS: From all post-op patients who referred to the Motahari Clinic, Shiraz, Iran, we used a convenient sampling method to select 160 MRM patients and 127 who underwent BCS. Translated copies of the EORTC QLQ-C30 (version 3) and the EORTC QLQ-BR23 questionnaires, in addition to a third questionnaire which was customized and prepared for this study, were completed by the patients under our supervision RESULTS: The two groups were compared by a multivariate method (Hotelling's trace test) after controlling for variables with unequal values such as disease stage, hormonal and radiotherapy treatments, and patients' role in the choice of surgery. We noted a significant difference (P < 0.001) attributed to a significantly better BI in the BCS group (average: 78.49 ± 23.14) compared to the MRM group (average: 60.71 ± 23.14). DISCUSSION: We concluded that in terms of body image, BCS has a better impact on health-related quality of life.

Assessment of anti-HBs antigen in 6- to 9-year-old children routinely vaccinated via vaccination program in Iran.

OBJECTIVE: To determine persisting antibody levels to hepatitis B virus (HBV) antigen in healthy children, aged 6-9 years, vaccinated at birth. METHODS: Blood samples were collected from 374 vaccinated children (178 girls and 196 boys) and 57 unvaccinated children, attending Shiraz Primary School, Shiraz, Iran from September 2002 to April 2003. An HBV surface antibody (anti-HBs) was determined using enzyme-linked immunosorbent assay. RESULTS: The anti-HBs titer was detected in 17% of the 8-year-old children, 7.7% of the 7-year-old children and 46.6% of the 6-year-old children. The decrease was greatest in the 9-year-old children; more than half (54.3%) had a titer of less than 10 IU/ml, indicating a decrease in antibody levels with increasing age/time. Conversely, more than 35% of the 6-year-old children had a titer greater than 150 IU/ml compared with 24, 12 and 7% of children at the age of 7, 8 and 9, respectively, whose antibody titer was less than 150 IU/ml. CONCLUSION: Antibody titer declined with time. In comparison with other countries, the antibody titer in Iranian children was much lower.

Modulation of hematology changes by polymorphism of glutathione S-transferase M1 and T1.

Workers in the petroleum distribution trades experience relatively low-level exposures to gasoline vapors whose consequences have not been fully elucidated. The purpose of this study was to investigate changes in the hematological parameters among filling station workers who were occupationally exposed to gasoline. The target group for the study consisted of 41 workers from eight filling stations of Shiraz (south of Iran). The control group consisted of 27 healthy subjects matched for age and sex from general population. The complete blood count analysis was done in one laboratory. Using PCR-based method, the genotypes of glutathione S-transferase T1 (GSTT1) and M1 (GSTM1) were determined. Workers were divided into three exposure groups according to employment history: duration less than 1 year, 1-5 years, and more than 5 years. Comparison was performed using Kruskal-Wallis test. In the individuals with the presence of both GSTT1 and GSTM1 functional alleles, comparison between four exposure groups revealed no significant difference for studied hematological variables. There were statistically significant differences between study groups, with only one functional allele, either GSTT1 or GSTM1, for relative number of lymphocytes (chi(2)=9.147, df=3, P=0.027) and neutrophils (chi(2)=9.951, df=3, and P=0.019), and absolute number of lymphocytes (chi(2)=9.135, df=3, and P=0.028), and RBC (chi(2)=10.586, df=3, and P=0.014). These findings could indicate the possible protective effect of concurrent presence of GSTM1 and GSTT1 enzymes on the hematopoietic system of filling station workers.

Tuberculin reaction and BCG scar in children vaccinated at birth

In this study, 1576 healthy children under 6 years who had received BCG at birth were tuberculin tested. About 71.5% had retained their BCG scar. The average size of tuberculin reactivity was larger in the group with BCG scar than without, the difference being statistically significant [P < 0.05]. The relative frequency of children showing a negative reaction increased with age; at 4 years about 68% of vaccinated children were negative. There was a positive linear relation between the size of BCG scar and diameter of tuberculin reactivity. After 4 years, tuberculosis infection should be suspected with a positive tuberculin test, especially if the reaction size is >10 mm