[Frequency of medically unexplained symptoms in homeopathy references of outpatients in isfahan university of medical sciences in 2008]

25-50 percent of all patients who are visited by GPs, have complains that are not medically explained. Their management is a challenge for GPs. In homeopathy [a method of alternative medicine] these symptoms are important for selection of remedies and in an effort to treat them. This study aimed at describing this existing situation by investigating the frequency of such complaints in the patients under study. This study is a cross-sectional study conducted in Isfahan in 2008 on 240 Patients who were visited in some of the clinics affiliated to Isfahan university of medical sciences. The patients were selected by convenient method. Data were gathered by the questionnaire and analyzed via SPSS 13.5 software using Chi-Square test. Out of 240 patients, 150 were women [%65.4] and 90 were men[34.6%]. 75.4 percent were 20-40 years old. 1.7 percent had no symptoms, 31.3 had 1-5 symptoms and 40.8 percent had 6-10 symptoms. The females had more symptoms than males. Symptoms of mind, GI, sleep and miscellaneous ones were 81.3, 80.4, 72.1 and 87.1 percent, respectively. The most frequent symptoms in each group were intrusive thought, salivation in sleep, waking frequently and dyspnea wearing tight collared clothes. Only 10.97 percent of patient referred to the physicians for these symptoms. The symptoms registered in homeopathy references have notable prevalence in the society but most of people with such symptoms will not go to a doctor for examination and treatment Therefore, it is very important to carry out more research regarding these symptoms. General population should receive more information and physicians, in turn, should use appropriate methods of therapy for treating these patients

Evaluation of the results of early mobilization following flexor tcndon repair of fingers

Immobilization and splinting after tendon repair, have traditionally been used as part of the treatment protocol for tendon injuries in fingers. There has always been a debate about the duration of immobilization among surgeons, because some complications after tendon repair are attributed to prolonged immobilization. In this study, the results of early mobilization following flexor tendon repair of fingers, have been evaluated. In a clinical trial, 192 patients with acute injury of FDP in Zone II who underwent tendon repair were studied. Those with simultaneous extensor injury, dorsal and volar injuries, fracture and nerve injury were excluded. In 48 cases, splints were removed after 14 days and in 144 cases [control group], immobilization was applied for 28 days. After splint removal both groups underwent physiotherapy for three month and final functional outcome was assessed according to Buck-Gramcko scale. In the study group 67 tendons were treated with four strand method and short term immobilization. In 45 tendon repairs, [67%] excellent results were obtained; in 11 cases, [16.5%], results were good, fair result in 6 cases [9%] and in 5 cases [7.5%] the result was poor. In two cases [4%], tendon rupture occurred during physiotherapy and had to be repaired again. In the control group, 185 tendons were repaired in which excellent results were attained in 133 cases, [72%], good result in 31 cases, [16.7%], fair result in 12 cases [6.5%] and poor result in 5 cases [2.7%]. Comparison of results in these two groups does not show any significant statistical difference, [P= 0.316]. Results of early mobilization after tendon repair are comparable with prolonged immobilization after repair. Hence, immobilization could be reduced to 2-3 weeks

[Evaluation of the effects of oral Ketamine as an adjuvant drug in treatment of renal colic]

Oral Ketamine is used as a low side effect analgesic in comparison with opioids, in different pain syndromes. This study is designed to evaluate the effect of oral Ketamine in renal colic treatment. In this clinical trial study 104 patients with renal colic, hospitalized in emergency department, were divided into two groups by Random block design. Group B received Pethidine [1 mg/kg up to 100 mg] and placebo, and group A received Pethidine with the same dose and Ketamine [0.5 mg/kg]. All patients were assessed for pain by using VAS chart, for nausea by a 0-3 scale and for the number of vomiting; at baseline and 1, 2 and 3 hours after taking drug. The results were analyzed by t-test. Average pain score and vomiting in all times and nausea score in one and three hours after receiving drugs were reduced significantly in patients who took Pethidine and Ketamine comparing patients who took Pethidine and placebo[p < 0.05]. Regarding the significant effect of Ketamine in reduction of pain, nausea and vomiting without side effects, it is possible to use Ketamine as an adjuvant drug in treatment of renal colic and to reduce narcotic dosage

impaired fasting glucose associated with increased risk of coronary atherosclerosis?

Impaired fasting glucose identifies individuals at high risk of progression to diabetes but the role of IFG as a coronary artery disease risk factor, independent of its progression to diabetes and its association with other coronary artery disease risk factors, is unclear. A cross-sectional study was conducted to evaluate the hypothesis that impaired fasting glucose increased the likelihood of atherosclerotic plaque formation. Blood chemistry data as well as traditional coronary artery disease risk factors from 812 patients referred for coronary angiography to heart centers in Shahid- Chamran and Sina hospital, Isfahan, Iran were recorded. The population were stratified into three groups according to American Diabetes Association criteria: normal fasting glucose [n=608], impaired fasting glucose[n=92] and diabetes mellitus[n=112].We use extent, Vessel and stenosis scores to indicate the coronary artery involvement. KrusKal-Wallis test showed that the means of extent, Vessel and stenosis scores are not significantly different between three groups[P> 0.05]. Multivariate linear regression analysis, using extent score of coronary artery disease as dependent variable and traditional risk factors and impaired fasting glucose as independent variables did not show any significant difference either. Our data suggested that impaired fasting glucose is not associated with increased risk of coronary atherosclerosis

effect of different concentrations of topical vitamin E on cosmetic appearance of hypertrophic and keloid scars

There are a few clinical trials on human that show the effect of topical vitamin E on keloid and hypertrophic scars. In this investigation we try to study this effect and also show the effect of the concentrations which have not been considered yet in improving hypertrophic scar and keloid healing. In a double-blind randomized clinical trial, 32 patients who had hypertrophic scar from 12 weeks ago were given three ointments including placebo and ointments contaning injectional vitamin E [d-a tocopheryl] with different concentrations [300Iu/mg and 600Iu/mg]. The scars size, erythema and hardness were evaluated by patients and physicians after 1, 4 and 12 weeks. Data was analyzed using ANOVA and Kruskal Walis tests. After 12 weeks there were no signs or symptoms of dermatitis and rash. Comparison of the scar size after 1 week showed difference between the high concentrated ointment with the others and in the 12[th] week all of the ointments were different [p<0.001]. Evaluation of the scar erythema, in the 1[th], 4[th] and 12[th] week showed significant difference between vitamin ointments and placebo [p<0.001], also scar hardness in the 12[th] week was significantly different between groups [p<0.001], but in the first and 4[th] week no difference was detected in hardness. This study shows that topical vitamin E has good effects on keloid and hypertropic scars. Their effect in decreasing size and erythema is more considerable than scar hardness

[Evaluation of treatment techniques in finger tip injury during 3 years in 15 Khordad hospital, Shaheed Beheshti University]

Considering the massive number of patients referring to the emergency department of 15 Khordad hospital with finger tip injuries, we decided to statistically survey the treatment modality practiced and also the most prevalent finger involved and compare the results with that of referenced books. In the study 288 patients with finger tip injuries who were referred to 15 Khordad hospital in a period of 3 years were enrolled and treatment modality and the fingers involved were evaluated. 63% of the injuries due to trauma were treated conservatively, 21% by volar V-Y Advancement flap, 6% by kutler flaps, 6% by skin graft and the remining 9% with cross finger flap. The most common finger involved was the index finger. The selected treatment modality depended on the nature of injury and discretion of the surgeon, with due consideration to the published literature. The index finger however was the commonly involved finger, whereas the books refer to the middle finger as the common site of injury

[Studies on the effects of turpentine oil on the serum concentration of lipids and lipoproteins of male rabbits]

The effects of turpentine oil on the concentration of lipids and lipoproteins of rabbit [as an animal model for human studies] were investigated. Thirty five healthy male rabbits were chosen and then randomly allocated into 13 groups. Different percents of turpentine oil and other oil compounds like vegetable oil, cholesterol and animal oil were given to each group [5 rabbits] separately or in combination. Blood serum lipid and lipoprotein levels were analyzed using routine laboratory methods. Treatment with 10% and 20% turpentine oil had a significant decreasing effect on triglyceride, cholesterol, total lipid, VLDL- cholesterol and LDL- cholesterol [P<0.05] and a significant increasing effect on HDL- cholesterol [P<0.05]. on occasions which rabbits were fed a combination of different oils such as turpentine oil, animal oil and vegetable oil or cholesterol, varying results were obtained which showed significant differences with the control group in some instances and in some other occasions had no significant difference [P>0.05]. Treatment with turpentine oil has a significant decreasing effect on the levels of serum lipids and lipoproteins [VLDL-cholesterol and LDL- cholesterol]

Frequency of ABO hemolytic disease of the newborn [ABO - HDN]

Objective: the aim of this study was to determine frequency distribution of ABO-hemolytic disease of newborn [ABO -HDN], clinical and laboratory feature also evaluated

Materials and Methods: during 8 months all A or B blood group babies delivered from O -blood group mothers were elected in cina maternity hospital for 8 months - If Jaundice appeared in first 48 hours of life, routine hematologic tests were done. The diagnosis of ABO -HDN was based on jaundice in first two days of life with positive free Anti -A or Anti -B in serum of infant. Statistical analysis was performed by frequency distribution and chi - squire test, P-value of less than 0.05 were considered statistically significant

Result: a set-up ABO incompatibility between mother and baby was in 10,3 percent of singleton pregnancies, but frequency of ABO-HDN was 1.6 percent of births. Clinical and laboratory feature were normal. Spherocytosis was present in only one baby

Conclusion: the frequency of ABO- HDN was 1.6% of births, lower than usually expected; jaundice was the only clinical feature

[ study of relationship between PCNA and Ki67 [cell proliferation markers] and histologic parts of Wilms's tumor]

Background: Wilm's tumor is the most frequent primary renal neoplasma in pediatric age group. Classically it is composed of three histologic parts: Blastemal, Epithelial and stromal. Different factors are implicated as prognostic determinants. Nowadays special attention is paid to proliferation markers for determining the biologic behavior of tumors. In this study we tried to ascertain the proliferative index of 22 cases of Wilm's tumor in our center who have had rather good follow up [at least two years]

Materials and Methods: After reviewing the H and E slides, we stained sections with PCNA and ki67 and scanned them by image cytomertry. Then the proliferative indices for each histological part was determined

Results: We resuted that proliferative indices of blastemal and epithelial parts have significant [P< 0.0002] difference [increment] from that of stromal part. Also the patients were divided into those with recurrence [within two ys of primary surgery] and recurrence. The profileration indices of PCNA for those recurring tumors was significantly higher [PCNA= 22.3%] [P= 0.0015]

Conclusion: Finally we concluded that using proliferative markers in Wilm's tumor is useful as an effective prognostic factor

[ effects of dental graduate students' communication skills on patients' satisfaction in Mashhad University of Medical Sciences in 1383]

Introduction: effective communication between physician and patient has a positive effect on different aspects of medicine and increases patient's satisfaction. Nowadays, communicative skills training to medical professionals in order to foster knowledge, attitude and communicative skills is emphasized. Now, over focusing on technical cares and its expansion leads to use of ineffective communication methods traditionally, therefore key problems and main patient's issues remain unclear. This study was done in order to assess and analyze dental graduate students' communicative skills and the related effect on patients' satisfaction

Materials and Methods: 30 first year graduate students of dentistry and 30 patients of them were selected randomly. Film taking, interaction analysis system [IAS] and observation checklist were used for gathering data. A questionnaire was used for patient's satisfaction. Content validity was used for validity and Alfa test for reliability. Data were analyzed by descriptive, analytical statistics using SPSS software

Results: according to results, 43% of students in all of the communication skills fields, 63% in the socio-emotional skills, 20% in diagnostic field and 27% in the consultation and education field were in a desired level. In all of the assessment fields, by increasing communication skills, the patients' satisfaction increased. ANOVA test showed significant difference between mean of patients' satisfaction by communication skills leveling the all of fields. ANOVA in all the fields and in every 3 fields showed significant difference between mean of patients' satisfaction score [P<0.05]. Correlation test also showed linear correlation between communication skills and satisfaction. Correlation coefficient for communication skills in all of the fields and socio-emotional field was 0.01 and in the other two fields of diagnosis and consultation was 0.05 and significant. The linear equation supported this correlation too

Conclusion: communication skills are integral parts of physicians' clinical skills. We can increase the patients' satisfaction by proper use of verbal and nonverbal communication skills such as respect to patients, sympathy, using open-ended questions, active listening and using understandable vocabulary. These skills can also increase effectiveness of medical interview and treatment too. It is obvious that medical education administrators and instructors should plan training courses for fostering communication skills for medical students and staff