Iranian Red Crescent Medical Journal Iranian Red Crescent Medical Journal http://www.irmj.ir 48 journal48 en jalali 1389 6 1 gregorian 2010 9 1 12 5 online 1 fulltext

en General Medicine General Medicine Editorial Editorial 524 524 http://www.irmj.ir/browse.php?a_code=A-10-12-178&slc_lang=en&sid=en V Wiwanitkit wviroj@yahoo.com 480031947532846007160 Yes

en General Medicine General Medicine Original Article Original Article Background: Dementia is characterized by progressive memory loss and other cognitive impairments. Memory impairments are apparent on tasks that require learning and retention of verbal or non-verbal information. Demented patients present severe impairments on recognition and recalling tasks. They have severe deficits in transferring information in to a long-term storage system. The present study investigated any difference between various memory processes in different reproduction phases contribute to discrimination between demented and non-demented elderly patients. Methods: Thirty one demented and 25 non-demented elderly patients were selected according to inclusion criteria; all of them were visited by a physician completing the Mini Mental Status Examination (MMSE) and California Verbal Learning Test-Persian version (CVLT-P). Results: Although demented and non-demented elderly subjects had no difference in relation to age and education, differences on clinical variables were significant and demented patients showed lower means than nondemented ones. A discriminate function analysis showed that CVLT-P had the ability to differentiate between demented and non-demented elderly patients and could correctly classify 94.3% of demented and non-demented older adults. Conclusion: Findings suggest that CVLT-P could discriminate satisfaction between these two groups and according to subscales, learning slope had the highest discrimination coefficient. So demented patients had more deficits in hippocampus causing failure of learning. Neuropsychology; Memory; dementia; CVLT; Iran 525 528 http://www.irmj.ir/browse.php?a_code=A-10-12-170&slc_lang=en&sid=en A Mani mania@sums.ac.ir 480031947532846007161 Yes T Hashemi 480031947532846007162 No H Haghshenas 480031947532846007163 No MT Garouci Farshi 480031947532846007164 No AH Shariat 480031947532846007165 No

en General Medicine General Medicine Original Article Original Article Background: Occupational injuries are a public health problem, estimated to kill more than 300,000 workers worldwide every year and to cause many more cases of disability. The aim of this study was to determine the effect of a training intervention on the implementation of an incident reporting system, perceived management commitment to safety and employees motivation to report incidents in Isfahan Steel Company. Methods: A quasi experimental research with case (185) and control (209) groups with measurements before the implementation of the incident reporting system and one year later was used to evaluate the effect of training intervention on the implementation of the incident reporting system, motivation to report incidents and perceived management commitment to safety. Results: The results showed that the implementation of the incident reporting system was more successful in case group than the control group especially on reporting NM's, MI's. In case group, perceived line management commitment to safety and employees motivation to report NM's, MI's significantly increased after the training intervention. Conclusion: Training intervention could promote implementation of the incident reporting system as a key factor of management support. Although the study shows some encouraging results concerning the reporting NM's, MI's, further studies are needed to evaluate whether the introduction of an incident reporting system with feedback has an effect on the number of major incidents. Occupational injuries; Incident reporting system; Near miss; Training intervention 529 534 http://www.irmj.ir/browse.php?a_code=A-10-12-169&slc_lang=en&sid=en M Amidi Mazaheri 480031947532846007166 No AR Hidarnia hidarnia@modares.ac.ir 480031947532846007167 Yes F Ghofranipour 480031947532846007168 No

en General Medicine General Medicine Original Article Original Article Background: Exentration is performed as an infrequent procedure for the treatment of locally invasive or potentially life threatening orbital neoplasm, when less invasive management are inadequate. This study was performed to report the epidemiological features of diseases treated by orbital exentration as well as surgical techniques used in south of Iran. Methods: In a retrospective study, records of all patients’ undergone exentration of the orbit between years 1986 and 2006, at the Khalili Teaching Eye Hospital were reviewed. Correspondingly, records of pathology were also searched for the same cases to confirm the pre-operation diagnosis in the charts. Results: There were 28 men and 20 women with a mean age of 50±23.9 years. Basal cell carcinoma (31%), squamous cell carcinoma (18%) and malignant melanoma (14%) were found to be the frequent ones. Consequently, eyelid was reported as the anatomic site for origin of tumors in 41.6% of patients. The exenterated cavity was left to heal by granulation tissue and epithelialization in 32 cases (66%), skin graft was placed in 13 cases (27%) and tissue flap were prepared for reconstruction in the remaining three cases. Conclusion: Basal cell carcinoma with secondary orbital involvement was the most common cause of orbital exenteration and healing by the granulation tissue was the main rout of reconstruction in our cases. Epidemiology; Orbital exenteration; Iran 535 538 http://www.irmj.ir/browse.php?a_code=A-10-12-181&slc_lang=en&sid=en N Owji owjin@sums.ac.ir 480031947532846007169 Yes M Mosallaei 480031947532846007170 No

en General Medicine General Medicine Original Article Original Article Background: Since the incidence of nosocomial Candida infections have been increasing in parallel with the raising in the number of patients involving in predisposing factors, determining the sources and the ways of acquisition of infection is necessary as an efficient strategy for controlling the diseases. The aim of this study is identification and strain typing of Candida strains isolated from hospitals to facilitate tracing the sources of infections in hospitalized patients in addition to assess the discriminatory power of some random primers by using RAPD analysis. Methods: Samples were collected from patients who were hospitalized in oncology, intensive care unit (ICU), and organ transplants wards of the Shohadaye-Tajrish Hospital affiliated to Tehran University of Medical Sciences, Tehran, Iran, and their environments. The yeasts were isolated on CHROMagar Candida. Species identification was performed by PCR-amplification of ITS1-5.8SrDNA–ITS2 region followed by restriction digestion with the enzyme MspI. To determine the probable origin of Candidia infections, in case of each patient whose the clinical and relevant environmental isolates were identified as the same species, a set of eight primers namely number 1 to 8, were applied in RAPD-PCR to find out the possible homogeny or variation within the isolated strains. Results: One hundred and four Candida strains were identified. The most common species was C. albicans (57.5%) followed by C. tropicalis (13.5%), C. glabrata (12.5%), C. parapsilosis (8.65%), C. famata (3.8%), C. krusei (1.9%), C. guilliermondii (0.96%). and C. lusitaniae (0.96%). While the source of infection for three patients were not determined by RAPD analysis, interpretable results from RAPD-typing of Candida species isolated from 8/18 of cases implied that the infections might originate from the exogenous sources. Moreover, according to the function of each primer, primer No. 1 was determined as a best primer for typing of Candida albicans strains. Conclusion: The species of yeast isolates were determined by PCR-RFLP. It was found that RAPD assay can point out the genomic variability within the Candida species. Besides, the method could show a probable relationship between acquired infections and their sources. Candida; Identification; PCR-RFLP; RAPD typing 539 547 http://www.irmj.ir/browse.php?a_code=A-10-12-177&slc_lang=en&sid=en Sh Fahami 480031947532846007171 No P Kordbacheh 480031947532846007172 No M Moazeni 480031947532846007173 No M Mahmoodi 480031947532846007174 No H Mirhendi mirhendi@tums.ac.ir 480031947532846007175 Yes

en General Medicine General Medicine Original Article Original Article Background: The roles of inflammatory cytokines and local placental thrombosis in patients with unexplained recurrent spontaneous abortion (URSA) have been shown. Since low molecular weight heparin (LMWH) and acetyl salicylic acid (ASA) have both anti-inflammatory and anti-coagulant effect, we evaluated their efficacy in patients with URSA. Methods: One hundred patients with a history of URSA referring to Obstetrics Clinic affiliated to Shiraz University of Medical Sciences between 2004 and 2009 were randomly divided into two groups. Fifty patients in thromboprophylaxis group were treated with LMWH (5000 unit; twice a day), ASA (80 mg daily) and calcium supplement (500 mg daily) after detection of fetal heart beat. Another 50 patients received no thromboprophylaxis. Live birth rate, obstetrical complications, prenatal and neonatal complications and hemorrhagic side effects were recorded. Results: Both groups were matched for mean age and mean number of pervious abortions. Thromboprophylaxis group had a higher rate of live birth (83.7%) in comparison to the control group (54%). No maternal or neonatal side effects were seen. There were no differences in obstetrical complications, prenatal and neonatal complications between the two groups. Conclusion: Thromboprophylaxis with ASA and LMWH seems to be safe and effective in patients with URSA Recurrent abortions; Thromboprophylaxis; Aspirin; Heparin 548 552 http://www.irmj.ir/browse.php?a_code=A-10-12-167&slc_lang=en&sid=en J Zolghadri 480031947532846007176 No F Ahmadpour ahmadpour@sums.ac.ir 480031947532846007177 Yes M Momtahan 480031947532846007178 No Z Tavana 480031947532846007179 No L Foroughinia 480031947532846007180 No

en General Medicine General Medicine Original Article Original Article Background: There is a strong association between chromosomal abnormalities and laboratory features and clinical course of the B-cell chronic lymphocytic leukemia (B-CLL). The aim of this study was to investigate the frequency and correlation of cytogenetic aberrations with laboratory and clinical features of the disease. Methods: Clinical and laboratory features of 65 CLL patients were collected from their hospital profiles and their blood and/or bone marrow were examined by conventional cytogenetics and interphase FISH methods. Results: Conventional cytogenetic methods identified 27.7% chromosomal abnormalities in 65 patients. I-FISH analysis for del13q, del11q and trisomy 12 revealed abnormality in 75.4% of patients. The results showed that IFISH improved the detection rate of chromosomal abnormalities and it enhanced detection. Statistical analysis was performed on sex, age, family history, Rai stage and CD markers on trisomy 12, del 11q and del 13q subgroups. There was a high frequency of Ray stages I and II within del13q subgroup, Rai stages III and IV within del11q subgroup and Rai stage II within trisomy 12 subgroup. Mean of CD38 in patients with del 11q was significantly higher than mean of patients with trisomy 12 and del 13q. Conclusions: High level of CD38 and presence of del11q indicated a poor prognosis and low level of CD38 and presence of del13q was indicative of good prognosis in Iranian B-CLL patients. Trisomy 12 had an intermediate prognostic value. Chronic lymphocytic leukemia; Chromosomal aberrations; Rai stages; CD markersö Iran 553 558 http://www.irmj.ir/browse.php?a_code=A-10-12-168&slc_lang=en&sid=en H Teimori 480031947532846007181 No MT Akbari mtakbari@modares.ac.ir 480031947532846007182 Yes GR Toogeh 480031947532846007183 No M Khaleghian 480031947532846007184 No

en General Medicine General Medicine Original Article Original Article Background: Heme oxygenase 2 (HMOX2) is an important antioxidative stress enzyme found in the endothelial cells of blood vessels and adventitial nerves. This enzyme in collaboration with heme oxygenase 1 metabolizes heme molecules into ferrous iron, carbon monoxide (CO) and biliverdin while the later is further converted to bilirubin. Both biliverdin and bilirubin are potent antioxidants, reducing the chance of atherosclerosis. HMOX2 also induces endothelial relaxation by synthesizing CO. Methods: Heme oxygenase 2 gene mutations were studied in 137 patients with atherosclerosis and in 100 normal controls. Pairs of primers were designed to amplify 2nd, 3rd and 5th exons of HMOX2 gene. These products were analyzed by single strand conformation polymorphism (SSCP) analysis and the shifted fragments were separated from SSCP polyacrylamide gel for further sequencing. Results: Two sequence variations were observed among 13 patients with atherosclerosis, consisting of C to A substitution in codone A70D (GCC to GAC) which was reported for the first time and A to G substitution in codone K89E (AAG to GAG). A significant association was noticed between A to G mutation in codon K89E of hemoxygenase 2 gene and the risk of atherosclerosis was supported with p=0.01 and χ2>6.82. However, no significant associations were observed among C to A substitution in codon A70D, p=0.11 and χ2>2.97 and the risk of atherosclerosis. Conclusion: Our findings denoted to the importance of K89E mutation in the development of atherosclerosis in Iranian cases. Further studies are required to show the importance of hemoxygenase 2 gene mutation in other populations. Atherosclerosis; Heme oxigenase 2; Coronary artery disease; Iran 559 563 http://www.irmj.ir/browse.php?a_code=A-10-12-172&slc_lang=en&sid=en M Zamani 480031947532846007185 No A Aleyasin ah_aleyasin@yahoo.com 480031947532846007186 Yes H Fakhrzadeh 480031947532846007187 No M Kiavar 480031947532846007188 No S Raoufzadeh 480031947532846007189 No B Larijani 480031947532846007190 No E Mahmoodi 480031947532846007191 No

en General Medicine General Medicine Original Article Original Article Background: Antiphospholipid antibodies, including lupus anticoagulants and anticardiolipin (aCL) antibodies are associated with a wide variety of disorders including malignancies. The aim of this study was to investigate the prevalence and prognostic significance of aCL antibodies in Iranian patients with acute myeloblastic leukemia (AML). Methods: Forty-one patients with AML (27 men and 14 women, mean age 34.9±16.7 years) were included in this study. aCL IgG and aCL IgM antibodies were evaluated in patients before induction chemotherapy. All patients were followed up for chemotherapy response. Results: Antibodies (IgG, IgM or both) were found in 26 of 41 patients (63.4%), of whom 19 (46.3%) had a low titer, 6 (14.6%) a moderate titer and 1 (2.4%) a high antibody titer. No correlation was found between complete remission or relapse and aCL antibodies positivity. Conclusion: aCL antibody titers are slightly to moderately elevated in patients with hematologic malignancies, and these antibodies do not correlate with disease prognosis. Anticardiolipin antibody; Acute myeloblastic leukemia; Clinical significance; Iran 564 567 http://www.irmj.ir/browse.php?a_code=A-10-12-171&slc_lang=en&sid=en M Ramzi ramzim@sums.ac.ir 480031947532846007192 Yes M Ayatollahi 480031947532846007193 No J Tahmasebi 480031947532846007194 No N Cohan 480031947532846007195 No

en General Medicine General Medicine Short Communication Short Communication Background: Herpes simplex encephalitis (HSE) is a fatal infection of the central nervous system. The early diagnosis of HSE is crucial because the early introduction of antiviral therapy can significantly decrease mortality and morbidity associated with this disease. This study was carried out to determine the clinical manifestations, laboratory findings and the outcome of the children admitted due to a presumptive diagnosis of HSE to Amirkola Children Hospital; a referral hospital in the north of Iran, during 2006-2007. Methods: This cross-sectional study was performed on patients with diagnosis of HSE in Amirkola Hospital, affiliated to the Babol University of Medial Sciences in the north of Iran. All of the children with a diagnosis of encephalitis were enrolled in this study. After admission, a special investigation including CSF analysis, electroencephalogram (EEG), Computerized tomography (CT scan) and/or magnetic resonance imaging (MRI) were performed. PCR (Polymerase Chain Reaction) analysis for herpes virus DNA was done on CSF sample in all patients. All the patients with a clinical diagnosis of herpetic encephalitis were treated with acyclovir at the time of admission but every patient with a positive PCR was assumed as a definite diagnosis of HSE. Clinical manifestations, laboratory findings and outcome of patients were collected. At the end of the study, frequency of HSE was reported according to the PCR for HSV DNA among the children admitted due to encephalitis. Results: The mean age of the patients was 5.58±3.46 years. The most common clinical manifestations were fever (70%), nausea, vomiting (54%) and headache (44%). Seizure was more common among girls, and was significantly more prevalent in younger patients. Abnormal EEG was presents in 42%, abnormal CT-scan in 38% and abnormal MRI in 48% of subjects. PCR was positive in 34% of our patients. All patients were discharged from the hospital after treatment with acyclovir. Conclusion: Herpetic encephalitis should be considered in each patient admitted with sudden change in the level of consciousness in a previously healthy child with fever and antecedent viral infection. Herpes simplex; Encephalitis; PCR; Mortality; Children; Iran 568 571 http://www.irmj.ir/browse.php?a_code=A-10-12-175&slc_lang=en&sid=en R Barari Sawadkohi sawadkohi1330@yahoo.com 480031947532846007196 Yes M Ahmadpour-Kacho 480031947532846007197 No

en General Medicine General Medicine Short Communication Short Communication Background: Viral infections were reported to be the cause of some human malignancies. The exclusive presence of EBV (Epstein-Bar virus) and HHV6 (Herpes Human Virus 6) has been investigated in previous studies. As such comparisons had never been carried out on salivary gland neoplasms, this study aimed to determine any relationship between these two viruses in salivary gland neoplasms. Methods: Seventy eight formalin-fixed paraffin embedded tissue samples of salivary gland tumors were enrolled. The enrolled patients were those who referred to the Department of Oral Pathology of Isfahan University of Medical Sciences and to the state hospitals and private clinics in Isfahan, Iran from May 1995 to July 2005. The paraffin blocks were investigated for presence of HHV6 and EBV genomes by PCR. Results: Out of the 78 samples, 15 were positive for both EBV and HHV6 infections while 6 were only positive for EBV, 21 were HHV6 positive but negative for EBV and 36 samples were reported negative for both viruses. A relationship was visible between EBV and HHV6 genomes. Conclusion: The significant relationship between HHV6 and EBV genomes and salivary gland neoplasms denotes to the question that should be answered in the light of further research whether HHV6 infection in salivary gland tumors can increase the incidence of EBV infection. PCR; Herpes Human Virus 6; Epstein-bar virus 572 575 http://www.irmj.ir/browse.php?a_code=A-10-12-176&slc_lang=en&sid=en M Razavi 480031947532846007198 No M Monirifard Mmonirifard@dnt.mui.ac.ir 480031947532846007199 Yes S Sharif 480031947532846007200 No N Khodaian 480031947532846007201 No

en General Medicine General Medicine Case Report Case Report Primary appendiceal lymphomas are exceedingly rare neoplasms mostly ignored until histological examination of appendices. We report a case of primary appendiceal lymphomas in a 22–year-old man. Appendectomy was performed under diagnosis of acute appendicitis. Macroscopically a fleshy intramural mass in middle third portion of appendix was observed. Microscopic examination revealed a diffuse large B-cell lymphoma inducing acute appendicitis. Further medical workups of the patient was unremarkable and the disease was restricted to appendix. After initial simple appendectomy, the patient underwent adjuvant chemotherapy and was healthy after two years. This case emphasized great value of detailed histological examination of all appendices. Appendix; Lymphoma; Appendicitis 576 578 http://www.irmj.ir/browse.php?a_code=A-10-12-174&slc_lang=en&sid=en M Ghasmei a.zghasemi@yahoo.com 480031947532846007202 Yes S Abedian-Kenari 480031947532846007203 No

en General Medicine General Medicine Case Report Case Report Sarcomatous transformation (dedifferentiated chordoma) in chordoma is a very rare condition and has been emphasized as a distinct entity because of its more aggressive clinical course. Here we describe a case of dedifferentiated chordoma arising from the sacrococcygeal region of a 60-year-old man, in third tumor recurrence. This tumor showed features of sarcoma with areas more typical of chordoma The chordoma-like areas expressed cytokeratin, epithelial membrane antigen and S-100 protein in all tumor cells and the spindle-cell component exhibited vimentin positivity in all of them but negative for other markers. The results showed that the sarcomatous areas as seen in the recurrent chordoma lack epithelial cell features of chordoma and suggest the possibility of altered differentiation pathway of the tumor stem cell or emergence of a new malignant cell population within the recurrent tumor. Chordoma; Dedifferentiated; Sacroccocygeal 579 581 http://www.irmj.ir/browse.php?a_code=A-10-12-173&slc_lang=en&sid=en N Azarpira negarazarpira@yahoo.com 480031947532846007204 Yes F Asadian 480031947532846007205 No S Torabinegad 480031947532846007206 No

en General Medicine General Medicine Letter to Editor Letter to Editor 582 584 http://www.irmj.ir/browse.php?a_code=A-10-12-179&slc_lang=en&sid=en P Ebadi Padideh_ebadi@yahoo.com 480031947532846007207 Yes F Eftekhar 480031947532846007208 No MR Asadi 480031947532846007209 No D Mehrabani 480031947532846007210 No M Hasankhorami 480031947532846007211 No MH Karimi 480031947532846007212 No K Bagheri 480031947532846007213 No

en General Medicine General Medicine Hypothesis Hypothesis The endometrial stem cells were shown to have an excellent pluripotency potential. Human endometrium contains a small population of mesenchymal stem cells (MSC) that may be responsible for its cyclical growth and may provide a readily available source of MSC. However, endometrial stromal cells are easier to isolate and expand with less technical problems compared to bone marrow MSCs. Here we hypothesized that endometrial stem cells may differentiate into osteogenic cells as one of the most important issues in orthopedic surgery associated with bone loss in traumas, infections, tumors or congenital disorders. Endometrial stem cell; Osteoblast; Differentiation 585 587 http://www.irmj.ir/browse.php?a_code=A-10-12-180&slc_lang=en&sid=en J Ai 480031947532846007214 No D Mehrabani mehrabad@sums.ac.ir 480031947532846007215 Yes