Shiraz Emedical Journal
Volume:16 Issue: 7, Jul 2014

Patients’ understanding of heart diseases and their related experiences can affect education and prevention of coronary heart diseases. As the patients’ beliefs play a crucial role in the development of effective therapeutic relationship, psychological adjustment, and compliance with treatment recommendations.. The purpose of this study was to investigate the attitudes toward psychological risk factors for cardiovascular disease among patients referred to a cardiac rehabilitation center in Imam Ali Hospital in Kermanshah, Iran.Patients and This cross-sectional study was performed on 775 patients referred to a cardiac rehabilitation unit in Imam Ali hospital in Kermanshah, Iran. Data were collected using clinical interview, patients’ medical records, and Millon clinical multiaxial inventory (MCMI-III), and analyzed by descriptive statistics, including mean, standard deviation, and chi‐square test. Statistical analyses were performed using SPSS software version 18. The patients believed that the main cause of their illness is behavioral risk factors (42.0%). Then, they referred to psychological (36.3%), biological (4.3%), and environmental (3.8%) factors, respectively. 10.4% of the patients were not aware of the cause of their illness. Also, stress is the most important factor among the psychological factors (27.5%). The results showed that there was a significant difference among the patients in term of four attitudes (χ2 = 820.356; P < 0.01); and behavioral and psychological attitudes (χ2 = 6.025; P < 0.05). In fact, the patients identified behavioral problems as the main cause of their illness.. According to the patients’ attitudes, after the behavioral factors, psychological factors are the second cause of heart diseases. Therefore, ignoring these factors by members of the medical teams may lead to a poor performance of the treatments. As these factors are controllable, learning to control and manage them can prevent the development of subsequent cardiovascular events..

Context: Xanthelasmas, also known as “xanthomas” and “lipid islands” are yellow plaque-like lesions characterized by the presence of lipid-containing histiocytes..Evidence Acquisition: Xanthomas are most commonly found in the stomach within the gastrointestinal tract, and at this location they are called Gastric Xanthoma (GX). Clinical significance of GX is still unknown. It has been suggested that GX could be related to gastric injury. Here we reviewed five decades of studies on GX in the literature.. Since, GXs was reported to be associated with potentially serious conditions of the stomach, the whole gastric mucosa should be examined carefully and biopsy should be taken from the lesion during the upper gastrointestinal endoscopy for diagnosis and rulling out gastric malignity.. Gastric xanthomas should not be ignored and concomitant conditions should be treated..

The Incidence of multi-drug resistant tuberculosis (MDR-TB) is constantly increasing.. This study aimed to clarify an important missed link in Iran’s national TB plan..Patients and Through a 9-month period, all pulmonary TB patients diagnosed based on the national TB protocol, in Shiraz TB center, were selected and culture of TB colonies, drug susceptibility testing (DST), polymerase chain reaction (PCR) for detection of IS6110 gene, Isoniazid (INH) and Rifampin (RIF) tuberculosis resistance were done to collect data. Data were analyzed using SPSS.. In 92 included patients, (mean age 45.4 ± 15 years), DST results showed that 16 cases (17.4%) were resistant to INH, 19 (20.7 %) to RIF and 24 (26.1%) to both INH and RIF. Polymerase chain reaction identified IS6110 gene in 71 cases (77.2%) and gene mutations in 3 (3.2%) KatG, 3 (3. 2%) InhA, 9 (9.7%) both KatG and InhA, 17 (18.4%) rpoB and 20 (21.7%) in KatG, InhA and rpoB genes. Patients with INH-resistant tuberculosis were more than those with RIF-resistant (OR = 7.1).. Findings of the present study show that 4 out of five new cases of pulmonary TB patients who were diagnosed based on the national TB protocol (clinical symptoms and acid fast bacilli staining) had IS6110 gene (MTB, Mycobactrium TB) and at least one-fifth of this group had A kind of Drug Resistant TB. Therefore, by using PCR, as a complementary test, it could be possible to start 1st line anti-TB drugs for only MTB cases (up to 77% of the patients) and 2nd line drugs for MDR cases (15% of cases). This policy aims to achieve safety and better outcome for patients while saving human and financial resources in health care system.

Context: Vaccination is considered as the most cost effective method for the prevention of human diseases. For this prevention method, we need certain substances to increase or boost the antibody as well as cell-mediated immune response against various bacterial as well as viral pathogens. Until now, alum was considered as the safest adjuvant for human use, licensed by the United States Food and Drug Administration. Due to the poor adjuvanticity of alum, conventional vaccines require multiple recall injections, at different time intervals, to attain or sustain the optimal immune response. The present review discusses about the necessity of adjuvants for vaccines..Evidence Acquisition: A number of factors such as slow release of antigen (depot effect), more efficient delivery of antigen to draining lymph nodes, non-specific activation of antigen-presenting cells or of B and/or T-lymphocytes, increased uptake of antigen by antigen-presenting cells or increased recruitment of immune cells to the site where the antigen is present, can contribute to increased immune responses to immunization. Many of these factors involve the interaction of various immune system components and specific anatomical features, making them difficult to replicate in model systems in vitro.. Despite the development of many potent adjuvant formulations with vaccine antigen during the last 80 - 90 years, aluminum compounds are still the only approved adjuvants used for routine human vaccines.. Based on pre-clinical and preliminary clinical observations, it appears that the range of adjuvants accepted for human vaccines will expand in the coming years..