Delay in the diagnosis and treatment of oral cancer

Statement of Problem: Oral and pharyngeal cancer is one of the most mortal cancers; however, its quick diagnosis and referral is a crucial factor in enhancing the survival rate of the patients

Purpose: The aim of this study was to inspect the referral conditions and the reasons for the delay in curing the patients referred to the educational hospitals in Tehran

Materials and Method: In this retrospective -descriptive study, two hundred and fifty six files related to the oral and pharyngeal cancer were inspected. The documents were obtained from 5 educational hospitals specialized in the field of cancers. Eventually data related to the time difference between the first time of attending to lesion and diagnosing the cancer as patient's delay and until the curing as professional's delay were recorded

Results: The majority of cancers were squamous cell carcinoma [SCC]

The patient's delay was recorded in 110 files among the whole files

The mean of the time between the patients' first notice of the problem and the time visiting a primary care clinician was 270 days [range, 0-2520 days]. The mean of the time from when the patient visited a primary- care clinician to the starting time of definitive treatment was 90 days [range, 0- 270 days]

Conclusion: In this study, like other studies, SCC was the most common occurring cancer

Delays related to the patients were more than those related to the professionals. And at last, accuracy in recording the files and training the patients were recognized to be the most imperative factors to continue the treatment successfully

[Comparison of chemical compositions of the Tanacetum sonbolii essential oils using head space sorptive extraction and hydrodistillation methods]

Tanacetum sonbolii Mozaff. is an endemic species of Tanacetum growing in Iran, west Azerbaijan. The composition of its essential oil can be varied due to conditions of selected extraction method. Thus, the selection of suitable extraction method is very effective to obtain essential oil in native state. The purpose of this study is to apply head space sorptive extraction method at ambient and high temperature condition for essential oil extraction of Tanacetum sonbolii Mozaff. The compositions of extracted essential oils were investigated using gas chromatography-mass spectrometry. Also, solvent, temperature and time of desorption step and time of sorption step that influence on extraction efficiency were optimized. Results indicated that temperature of extraction method had significant effects on essential oil content. Using hydrodistillation method, 26 components, representing 96.5% of the oil were indentified but only 6 compounds [95.6% of the oil] were found in essential oil using HS-SE at real condition [23 °C]. Comparison of the major components percent levels of essential oils were shown that 81% of HS-SE essential oil is beta- and alpha-pinene. While using hydrodistillation method, about 50% of essential oil is sesquirerpenes such as alpha-cadinol and globulol. The sampling of essential oils at 23°C by HS-SE compared to conventional extraction methods at high temperature [such as hydrodistillation] caused to have different extractions results

[Comparison of the effect of WebQuest and lecture on students' learning of electrocardiogram interpretation]

Defects of instruction by traditional methods as well as worldwide technical advances have introduced new approaches to teaching and learning. WebQuest is an inquiry-oriented activity in which some or all of the information that learners interact with comes from resources on the internet. The purpose of this study was to compare the effect of WebQuest and lecture on students' learning of electrocardiogram interpretation. Using a quasi-experimental design, 42 nursing students were allocated to examination and control groups by the stratified random sampling method equally. The educational content was consisted of the diagnosis and treatment of cardiac rhythm disturbances taught during four lecture sessions to the control group and in five stages' WebQuest activity to the experimental group. The learning outcomes in both groups were examined before and after the intervention and two weeks after the intervention. Data was analyzed using descriptive and analytical statistics. There was no difference between the groups' learning scores before the intervention [P>0.05]. After the intervention, the scores of both groups increased. However, the scores of the students in the WebQuest group were higher than the students in the lecture group [P=0.022]. Both the teaching methods resulted in improving students' knowledge, but the WebQuest method was more effective than the lecture method to the learning of nursing students. The results of this study can help nurse instructors to replace traditional teaching methods with new methods

effect of numbers and locations of retentive on master casts on reducing the polymerization distortion of the maxillary complete denture

Polymerization shrinkage is one of the disadvantages of Polymethyl Methacrylate, resulting in distortion of resin denture bases. One of the methods, designed to reduce this distortion, is mechanical anchoring to the cast. This study aimed to evaluate the effect of numbers and locations of retentive holes on reducing polymerization distortion. This was an experimental study, including 48 similar master casts in 4 groups, fabricated during the study. A power analysis using a power factor of 0.8 and a significance level of 0.01 determined the sample size of 12 casts per each test group. Groups were assigned as: A [control]; B [one anchoring hole in midline along the posterior border]; C [additionally, two extra anchoring holes in lateral palate, between midline extending to ridge crest]; D [two more anchoring holes along the midline, within 15 mm and 20 mm from the posterior border]. An Olympus-SZX9 measuring microscope was used for the gap measurement across the denture base and cast interface. Variables were the gap distance between the denture base and the cast in midline, in PPSA and the mean gap in right and left lateral palate in PPSA. The data were analyzed with one-way ANOVA followed by the Post-Hoc test. Variables were significantly different in four studied groups [p=0.000] and the gap distance between the denture base and the cast in mid-palate was less affected than lateral palate in anchorage technique. In general, anchoring significantly reduced mean gap distances [p=0.000]. Generally, anchoring during processing, improved adaptation of the denture base to the master cast. Mechanical anchorage between denture base and cast significantly reduced the gap distances in lateral and mid-palate; and this decrease was significantly affected by numbers and locations of anchoring holes

effect of the blood glucose concentration on night work nurses'attention

The repairing effect of glucose on brain cognition functioning, especially attention has been studied widely.Cognitive performance and attention is a vital aspect in nursing practice. Decreased attention and nursing errors may result in substantial mortality, morbidity, and additional health care costs. The aim of this study was to determine the effect of the blood glucose concentration on night work nurses' attention accuracy in military hospitals in Tehran, Iran. A quasi-experimental study was carried out. A convenience sample of 60 nurses working in, two military hospitals in Tehran participated in the study. These nurses were randomly allocated in intervention and control groups. The study was carried out from Sep2009 to April 2010. Data were collected using a demographic data form and attention accuracy was evaluated by Toulouse- Pieron and Bonnardel test. Data collection and intervention was carried out during 4 to 5 am. The blood glucose concentration was measured before intervention, then nurses in intervention group received gr glucose solution, and nurses in control group drank water. One hour after intervention attention accuracy and blood glucose reevaluated in both groups. Data were analyzed by SPSS V. 15 software. The results indicated that glucose consumption improved the attention accuracy of nurses [P<0.001]. Based on the results, glucose consumption or carbohydrate diet in night work nursing effects on brain cognition performance especially accuracy

[ experimental micro leakage study of two self-etch and one total-etch fissure sealants]

The extreme vulnerability to decay in pits and fissures on the occlusal surfaces of the teeth has prompted dental scientists to seek methods of caries prevention. Various criteria, such as bond strength, micro leakage and marginal seal are assessed in the evaluation of sealants. Motivated by the role of pit and fissure sealants in caries prevention, the aim of this study was to compare the micro leakage of Enamel Loc sealant, Concise and Concise +Prompt L-pop resin-based sealants. An in vitro study was undertaken using thirty extracted third molars. The teeth were divided into three groups; an experimental group using Enamel Loc as a pit and fissure sealant, a group using Concise and a group using Concise +Prompt L-pop. The teeth were kept in methylene blue dye 2% for 4 hours, sectioned samples were observed with stereomicroscope for the extent of dye penetration and scores were based on Williams and Winter criteria. Three groups of data were statistically analyzed using SPSS 18. Non-parametric Kruskal-Wallis test was used to detect differences among groups [p>0/001]. The Enamel Loc sealant micro leakage was significantly more than the two other groups [p>0/001]. Furthermore, Concise micro leakage was significantly less than Concise +Prompt L-pop group [p>0/001]. The Enamel Loc sealant performed worse in terms of sealing ability than the Concise and Concise +Prompt L-pop resin-based sealants

Assessment of motor units recruitment at the knee extensor muscles

Biomechanical conditions of limbs can affect on motor unit recruitment [MUR] markedly. Surface Electromyography [SEMG] is an approach for evaluation of muscle activities and onset time during different fimctions. The purpose of this study is to use SEMG for detection of central motor control in different functions of knee extensor muscles. Ten healthy subjects contributed in this study. They were done five repetitions of knee flexion/extension in open and close chain separately during recording of SEMG simultaneously. Integrated EMG [iEMG] of three middle repeated cycles were detected according to chain [open- close] and kind of contraction [concentric- eccentric].then the Average of three slope of iEMG compared to each other. There were not significant differences in MUR of three extensor muscles for concentric and eccentric contractions in open chain but vastus medialis and lateralis muscles showed significant changes in close chain [P<0.05]. Result showed that there were significant differences of MUR for two kind of muscle contractions between open and close chains [P<0.05]. Recruitment of motor units has not shown difference in open chain between concentric and eccentric contractions. This process indicates representative similarity of control pattern in two kind of contraction in open chain. Concentric contraction at close chain cycle has more MUR in comparison with eccentric contraction. It is equal to more interference of contractible compartment in concentric to eccentric contraction. This happens due to the nature of two kind of contraction particularly in close chain cycle. Comparison between two chains indicated that more motor units contribute in close chain [concentric and eccentric]. It means that motor unit recruitment increased due to effect of increase of load in close chain

[Comparison of the effect of breath training and lower extremity aerobic exercise on pulmonary ventilation and maximal oxygen consumption of the patients with chronic obstructive pulmonary disease]

Chronic obstructive pulmonary disease deals with both emphysema and chronic bronchitis and is the fourth leading cause of death in females and fifth in males. These patients often are treated with chemical drugs which are costly and have different side effects. The aim of this study was to compare the effect of two ways of' pulmonary rehabilitation including breath training and lower extremity aerobic exercise on breed expiratory volume in the first second [FEV1] and maximal oxygen consumption [VO2 max] of the patients with chronic obstructive pulmonary disease [COPD]. This study is a randomized experimental controlled clinical trial and included 58 patients. 20 patients in breath training group, 20 in aerobic exercise group and the remaining 18 cases in control group. The study took 8 weeks to be completed and the collected data were analyzed by means of paired t-test, ANOVA, post hoc LSD. In this study post intervention comparison of the mean values of FEV1 and max between the patients in the breath training group and control group showed no significant difference, but a significant difference was noticed between the mean values of FEV1 [p<0.01] and VO2 max [p<0.001] in the lower extremity aerobic exercise group and the control group. The mean values of FEV1 and VO2 max revealed no significant difference before the beginning and after the end of this study. In pulmonary rehabilitation of the patients with COPD, lower extremity aerobic exercise is more effective than breath training in the improvement of FEV1 and VO2 max

[Effects of cool dialysate temperature on stabilizing hemodynamic parameters in diabetic patients undergoing hemodialysis]

Hypotension is the most common acute complication of hemodialysis. To ameliorate symptomatic hypotiension during dialysis, cool temperature dialysate has been recommended. Since reports show that not all patients benefit from cool dialysis, it seems necessary to determine which patients benefit more from cool dialysis. The aim of this study is to investigate the effect of cool dialysis on hemodynamic parameters in diabetic patients; serum nitric oxide levels also were determined to find any possible association. Twenty diabetic patients [mean age 63.3 +/- 7.5] were included in the study. Each patient was dialyzed twice, once using cool and once using warm dialysate solution. Apart from a change in temperature to 35°C, all other conditions remained the same during the study. Hemodynamic parameters including SBP, DBP, and HR were measured hourly, the number of hypotension episodes was also determined. Oral temperature was measured before and after dialysis. Serum urea and nitric oxide metabolites [NOx] were determined before and after hemodialysis. SBP, DBP, and MAP decreased significantly during warm, as compared to cool, dialysis. Maximum decreases in SBP, DBP, and MAP were seen in the third hour of dialysis and these were 18, 17, and 14 percent for warm and 6, 1, and 4 percent for cool dialysis respectively. HR showed no significant difference between the two groups. Compared to before dialysis, NOx levels decreased significantly in cool and warm conditions after dialysis [59 +/- 5 vs. 37 +/- 4, and 63 +/- 7 vs. 41 +/- 5, respectively, P<0.01]. Cool dialysis could decrease episodes of hypotension and stabilize hemodynamic parameters in diabetic patients. Mechanisms other than increased serum nitric oxide levels are involved in hemodialysis hypotension in diabetic patients

Job satisfaction of nurses in Shaheed Beheshti Hospital

Work is one of the interesting things that people can think or talk about. All of the managers must know factors related to motivation and job satisfaction. Studies show that job satisfaction in nursing and health care settings is low. Low job satisfaction diversely affects on nursing care. It causes decreased quality care, and increased hospitalization as well as cost. This descriptive study was conducted to determine nurses' job satisfaction at Shaheed Beheshti Hospital in Yasooj, 2004. All subjects including 115 nurses were selected. Data were collected by a questionnaire validated and made reliable by content validity and test-retest reliability respectively. 70% of the subjects had university degree and the rest had high school diploma. Average age was 33.45 +/- 10.25. 54.6% of them were female and 45.6% were male. 89.7% were married and 10.3% were single. Findings showed that 80% of the subject didn't have job satisfaction and 20% had enough job satisfaction. 62% of the subjects didn't have job security and 37.4% felt it. 89% had enough satisfaction about managers and 11% had occasional satisfaction. Results showed that most nurses were dissatisfied, which can be related to job insecurity, low job improvements and general vision of society about nursing particularly at small towns. Accordingly, nursing should be known to people