Evaluation of the Ki-67 and MCM3 Expression in Cytologic Smear of Oral Squamous Cell Carcinoma

Statement of the Problem: Squamous cell carcinoma (SCC) is the most frequent oral cancer whose 5-year survival rate is 80% for early-detected lesions and nearly 30-50% for advanced lesions. Early detection of oral cancers and precancerous lesions can improve the patient’s survival and decrease the morbidity. Purpose: This study aimed to evaluate and compare the Ki-67 and MCM3 expression in cytologic smear of oral SCC (OSCC). Materials and Method: We examined 48 oral brush biopsies including 28 OSCC and 20 healthy non-smoking samples. Immunocytochemistry staining was performed for Ki-67 and MCM3 by using an EnVision-labeled peroxidase system, and labeling index (LI) was calculated. Results: Out of 28 OSCC cases, 27(96.4%) cases contained MCM3 positive cells and 22(78%) cases contained Ki-67 positive cells. All normal mucosa were Ki-67 and MCM3 negative. MCM3 and Ki-67 LI were significantly higher in OSCC than normal mucosa (p< 0.001). MCM3 LI was significantly higher than Ki-67 LI in OSCC group (p< 0.001). Conclusion: Immunocytologic evaluation of Ki-67 and MCM3 can be used for early detection of OSCC. Furthermore, MCM3 may be a more sensitive cytologic biomarker than Ki-67 in SCC patients

Assessment of human and physical resources in health houses and health-care centers providing emergency services: a study in Golestan province

Background and Aims: The right information on current situation such as physical space, equipment and manpower make it possible to assess emergency activities as well as to manage and provide qualified services to patients. The aim of this study was to determine human and physical resources in health houses and health care centers to provide emergency services in Golestan province. Background and Aims: The right information on current situation such as physical space, equipment and manpower make it possible to assess emergency activities as well as to manage and provide qualified services to patients. The aim of this study was to determine human and physical resources in health houses and health care centers to provideemergency services in Golestan province.Materials and Methods: The present descriptive cross sectional study was performed in Golestan province in 2012. The study population was health houses and health centers (both rural and urban). A multi-stage sampling method was exploited and required data were collected by check list through interviews and observations. All stagesof this research project were conducted ethically. Data were analyzed by descriptive statistics using SPSS 16.Results: The results of this study show that about 17.9 percent of health houses had no male health workers and a lack of female health workers was noticed in 2.4 percent of them. Similarly, there is not any nurse in 38.9 percent of health care centers. About 94.4 percent of centers suffered from having male nurse’s aid and 97.2 of them had no female nurse’s aid. The results further indicated that most of health houses were in a good level with regard to medical equipments (66.7%) and needed medications (63.6%). The majority of health care centers (63.9%) were indeed at intermediate level considering injection chamber and at very week level (52.4%) from the wound dressing point of view. The studied centers lacked the requisite medications and were at low levels. 74.33 percent of health care centers suffered from an apparent lack of dressing room facilities. About 85.3 percent of health centers showed ambulance deficit.Conclusion: According to the low levels of personal resources, equipment and physical spaces in studied health care centers, it is necessary to consider appropriate measures in order to improve the situation in these centers. Journal of Health in the Field, Vol.3, No.4, Winter 2016 Keywords: Personal resources, Physical resources, Health house, Health care center, Emergency services in Golestan province.Materials and Methods: The present descriptive cross sectional study was performed in Golestan province in 2012. The study population was health houses and health centers (both rural and urban). A multi-stage sampling method was exploited and required data were collected by check list through interviews and observations. All stages of this research project were conducted ethically. Data were analyzed by descriptive statistics using SPSS 16.Results: The results of this study show that about 17.9 percent of health houses had no male health workers and a lack of female health workers was noticed in 2.4 percent of them. Similarly, there is not any nurse in 38.9 percent of health care centers. About 94.4 percent of centers suffered from having male nurse’s aid and 97.2 of them had no female nurse’s aid. The results further indicated that most of health houses were in a good level with regard to medical equipments (66.7%) and needed medications (63.6%). The majority of health care centers (63.9%) were indeed at intermediate level considering injection chamber and at very week level (52.4%) from the wound dressing point of view. The studied centers lacked the requisite medications and were at low levels. 74.33 percent of health care centers suffered from an apparent lack of dressing room facilities. About 85.3 percent of health centers showed ambulance deficit.Conclusion: According to the low levels of personal resources, equipment and physical spaces in studied health care centers, it is necessary to consider appropriate measures in order to improve the situation in these centers.Journal of Health in the Field, Vol.3, No.4, Winter 2016Keywords: Personal resources, Physical resources, Health house, Health care center, EmergencyFor downloading the full text please click here

بررسی ارتباط ابعاد فرسودگی شغلی با محیط فیزیکی و امکانات محل کار در بهورزان استان گلستان

ackground and Aims: Job burnout is the reaction of workers to chronic stress, with disastrous physical, psychological and adverse organizational consequences for employees. The aim of this study was to determine the relationship between the dimensions of job burnout and workplace physical environment and facilities among health workers in Golestan province.Materials and Methods: In the present cross-sectional study, 1141 respondents out of totally 1275 health workers in Golestan province participated in the survey. The sampling method was census. Data collection was done through a questionnaire dealing with physical environment and facilities of workplace as well as Maslach burnout inventory. Verbal consent was obtained from all participants and their responses werekept confidentially. Data were analyzed using SPSS and Chi-Square test at a significance level of 0.05 Results: The results of the present survey indicate that the physical condition of the workplace was assessed as weak by 17.4% of participants. Similarly, 24.8% of respondents assessed health house facilities asweak. There were significant relationships between emotional exhaustion and physical condition as well as workplace facilities (p&lt;0.005). The study, however, did not show a significant relationship between depersonalization and personal performance and workplace physical conditions and facilities (p&gt;0.005).Conclusion: Regarding the relatively poor workplace physical conditions and facilities, it is recommended to improve these conditions in order to decrease health workers emotional exhaustion.زمینه و اهداف: فرسودگي شغلي واكنش کارکنان در برابر تنش هاي مزمن می‌باشد و تأثیرات مخرب جسمی و روحی و پیامدهای سازمانی نامطلوبی را برای شاغلین به همراه دارد. هدف از انجام این مطالعه تعیین ارتباط ابعاد فرسودگی شغلی با محیط فیزیکی و امکانات محل کار در بهورزان استان گلستان بود. مواد و روش‌ها: در این مطالعه مقطعی، از بین 1275 بهورز شاغل در استان گلستان، 1141 نفر در مطالعه شرکت نمودند. ابزار جمع‌آوري داده ها شامل دو پرسشنامه شرایط فیزیکی و امکانات محل کار و پرسشنامه فرسودگی شغلی مزلاچ بود. از تمام شرکت کنندگان رضایت شفاهی کسب گردید و پاسخهای آنان محرمانه باقی ماند. داده‌ها با استفاده از نرم‌افزار &nbsp;SPSSو آزمون Chi-Square در سطح معنی داری 0/05آنالیز شد. یافته‌ها: 17/5% بهورزان شرایط فیزیکی محیط کار و 24/8% امکانات خانه بهداشت را ضعیف می دانستند. حیطه خستگی عاطفی با وضعیت محیط فیزیکی و وضعیت امکانات خانه بهداشت از نظر آماری ارتباط معنی داری داشت (0/005&gt;p). حیطه های مسخ شخصیت و کاهش عملکرد فردی با وضعیت محیط فیزیکی و امکانات خانه بهداشت از نظر آماری ارتباط معنی داری نداشت (0/005&lt;p). نتیجه‌گیری: با توجه به شرایط فیزیکی و امکانات نسبتاً نامطلوب خانه‌های بهداشت، به منظور بهبود و رفع خستگی عاطفی بهورزان بهبود شرایط فیزیکی و وضعیت امکانات خانه‌های بهداشت پیشنهاد می‌گردد

Therapeutic Effect of Intrastromal Voriconazole, Topical Voriconazole, and Topical Natamycin on Fusarium

Purpose. Evaluating the therapeutic effect of topical and intrastromal voriconazole and topical natamycin on Fusarium keratitis. Methods. 24 rabbits were selected. The stroma of their corneas was inoculated with suspension of Fusarium solani species complex. Seven days after injection they were divided into 4 groups randomly: the first group was treated with topical voriconazole (TV) 1% for one week, the second one with one-time intrastromal injection of voriconazole (ISV) 50 microgram/0.1 mL, and the third group with topical gel of natamycin (TN) for one week, and the last one did not receive any antifungal treatment. Finally the eyes were enucleated and sclerocorneal buttons were sent for histological and microbiological examinations. Results. After treatment the ISV group and TN group showed significantly lower clinical score and colony forming units than the control group (P=0.040 and P=0.026, resp.), but there was statistically no significant difference between control and TV groups (P=0.249) or between ISV and TN groups (P=0.665). In pathological evaluation, fewer chronic inflammations were reported in 2 of the 3 buttons from TV group and 3 of the 3 buttons from ISV and TN groups in comparison with the control group. Conclusion. Intrastromal injection of voriconazole seems to be effective in treatment of Fusarium keratitis as much as topical natamycin and these are more effective than topical voriconazole

ارزیابی وضعیت منابع انسانی و فیزیکی خانه های بهداشت و مراکز بهداشتی درمانی در جهت ارائه خدمات اورژانسی: مطالعه ای در استان گلستان

Background and Aims: The right information on current situation such as physical space, equipment and manpower make it possible to assess emergency activities as well as to manage and provide qualified services to patients. The aim of this study was to determine human and physical resources in health houses and health care centers to provide emergency services in Golestan province. Background and Aims: The right information on current situation such as physical space, equipment and manpower make it possible to assess emergency activities as well as to manage and provide qualified services to patients. The aim of this study was to determine human and physical resources in health houses and health care centers to provideemergency services in Golestan province.Materials and Methods: The present descriptive cross sectional study was performed in Golestan province in 2012. The study population was health houses and health centers (both rural and urban). A multi-stage sampling method was exploited and required data were collected by check list through interviews and observations. All stagesof this research project were conducted ethically. Data were analyzed by descriptive statistics using SPSS 16.Results: The results of this study show that about 17.9 percent of health houses had no male health workers and a lack of female health workers was noticed in 2.4 percent of them. Similarly, there is not any nurse in 38.9 percent of health care centers. About 94.4 percent of centers suffered from having male nurse’s aid and 97.2 of them had no female nurse’s aid. The results further indicated that most of health houses were in a good level with regard to medical equipments (66.7%) and needed medications (63.6%). The majority of health care centers (63.9%) were indeed at intermediate level considering injection chamber and at very week level (52.4%) from the wound dressing point of view. The studied centers lacked the requisite medications and were at low levels. 74.33 percent of health care centers suffered from an apparent lack of dressing room facilities. About 85.3 percent of health centers showed ambulance deficit.Conclusion: According to the low levels of personal resources, equipment and physical spaces in studied health care centers, it is necessary to consider appropriate measures in order to improve the situation in these centers. Journal of Health in the Field, Vol.3, No.4, Winter 2016 Keywords: Personal resources, Physical resources, Health house, Health care center, Emergency services in Golestan province.Materials and Methods: The present descriptive cross sectional study was performed in Golestan province in 2012. The study population was health houses and health centers (both rural and urban). A multi-stage sampling method was exploited and required data were collected by check list through interviews and observations. All stages of this research project were conducted ethically. Data were analyzed by descriptive statistics using SPSS 16.Results: The results of this study show that about 17.9 percent of health houses had no male health workers and a lack of female health workers was noticed in 2.4 percent of them. Similarly, there is not any nurse in 38.9 percent of health care centers. About 94.4 percent of centers suffered from having male nurse’s aid and 97.2 of them had no female nurse’s aid. The results further indicated that most of health houses were in a good level with regard to medical equipments (66.7%) and needed medications (63.6%). The majority of health care centers (63.9%) were indeed at intermediate level considering injection chamber and at very week level (52.4%) from the wound dressing point of view. The studied centers lacked the requisite medications and were at low levels. 74.33 percent of health care centers suffered from an apparent lack of dressing room facilities. About 85.3 percent of health centers showed ambulance deficit.Conclusion: According to the low levels of personal resources, equipment and physical spaces in studied health care centers, it is necessary to consider appropriate measures in order to improve the situation in these centers.زمینه و هدف: مدیریت و ارزیابی فعالیتهای اورژانس و ارائه خدمات مطلوب به بیماران، تنها با داشتن اطلاعات صحیح از وضعیت موجود از قبیل فضا، تجهیزات و نیروی انسانی در مراکز اورژانس امکان پذیر است. هدف از انجام این مطالعه تعیین وضعیت منابع انسانی و فیزیکی خانههای بهداشت و مراکز بهداشتی درمانی در جهت ارائه خدمات اورژانسی بود. مواد و روشها: این مطالعه به صورت توصیفی و از نوع مقطعی انجام شد. جامعه پژوهش را مراکز بهداشتی درمانی شهری، روستایی و خانههای بهداشت استان تشکیل میداد. ابزار جمع آوری اطلاعات، چک لیست و روش نمونه گیری، چند مرحلهای بود. روش جمع آوری دادهها مشاهده و مصاحبه بود. تمام مراحل این طرح با رعایت موازین اخلاقی و پژوهشی انجام شد. جهت تحلیل دادهها از آمار توصیفی با استفاده از نرم افزار آماری SPSS.16 استفاده شد. یافته ها: بر اساس نتایج مطالعه، 17/9% خانههای بهداشت بهورز مرد و 2/4% بهورز زن نداشتند. همچنین 38/9% مراکز پرستار، 94/4% بهیار مرد و 97/2% بهیار زن نداشتند. اکثر خانه های بهداشت از نظر وضعیت تجهیزات و داروهای مورد نیاز اورژانس در سطح خوب قرار گرفتند. اکثر مراکز از نظر وضعیت تجهیزات اتاق تزریقات در سطح متوسط، از نظر وضعیت تجهیزات اتاق پانسمان در سطح خیلی ضعیف و از نظر وضعیت داروهای مورد نیاز، در سطح ضعیف قرار گرفتند. 74/33% مراکز اتاق پانسمان و 85/3% آمبولانس نداشتند. نتیجه گیری: با توجه به سطح ضعیف نیروی انسانی، تجهیزات و فضای فیزیکی مراکز بهداشتی درمانی، لازم است تدابیر مناسبی به منظور بهبود وضعیت موجود این مراکز اندیشیده شود.&nbsp; &nbsp; &nbsp; &nbsp

Comparative Study of Hearing Impairment among Healthy and Intensive Care unit Neonates in Mashhad, North East Iran.

INTRODUCTION According to World Health Organization (WHO) 2001 statistics, hearing disorders are the most common congenital disease, and the incidence rate among high-risk newborns is as much as ten times as high as that in healthy neonates. However, 78% of screening test failures are well-baby nursery babies. The Joint Committee on Infants' Hearing (JCIH) has emphasized the importance of early diagnosis and treatment in neonates with hearing impairments in order to preserve their maximum linguistic skills. The aim of our study was to compare the prevalence of hearing loss among babies in the neonatal intensive care unit (NICU) and the rooming-in unit (RIU). MATERIALS AND METHODS Neonates born in three hospitals in Mashhad between 2008 to 2010 were studied prospectively and screened for auditory disorders using the oto acoustic emission (OAE) test at the time of discharge and 3 weeks later. To confirm hearing loss, the auditory steady state response (ASSR) test was used among those participants who failed both OAE tests. RESULTS Two-thousand and sixty-three neonates from the NICU were screened and compared with a control group consisting of 8,724 neonates from the RIU or the well-baby nursery. At the end of the study, hearing impairment as confirmed by failure in the ASSR test was diagnosed in 31 neonates (26 in the control group [0.30%] and five in the NICU group [1.94%]). CONCLUSION In our study, the prevalence of hearing disorders among NICU neonates was 6.5-times greater than that among babies from the RIU or well-baby unit. This observation demonstrates the importance of universal screening programs particularly for high-risk population neonates

Extracellular-Vesicle-Based Therapeutics in Neuro-Ophthalmic Disorders

Extracellular vesicles (EVs) have been recognized as promising candidates for developing novel therapeutics for a wide range of pathologies, including ocular disorders, due to their ability to deliver a diverse array of bioactive molecules, including proteins, lipids, and nucleic acids, to recipient cells. Recent studies have shown that EVs derived from various cell types, including mesenchymal stromal cells (MSCs), retinal pigment epithelium cells, and endothelial cells, have therapeutic potential in ocular disorders, such as corneal injury and diabetic retinopathy. EVs exert their effects through various mechanisms, including promoting cell survival, reducing inflammation, and inducing tissue regeneration. Furthermore, EVs have shown promise in promoting nerve regeneration in ocular diseases. In particular, EVs derived from MSCs have been demonstrated to promote axonal regeneration and functional recovery in various animal models of optic nerve injury and glaucoma. EVs contain various neurotrophic factors and cytokines that can enhance neuronal survival and regeneration, promote angiogenesis, and modulate inflammation in the retina and optic nerve. Additionally, in experimental models, the application of EVs as a delivery platform for therapeutic molecules has revealed great promise in the treatment of ocular disorders. However, the clinical translation of EV-based therapies faces several challenges, and further preclinical and clinical studies are needed to fully explore the therapeutic potential of EVs in ocular disorders and to address the challenges for their successful clinical translation. In this review, we will provide an overview of different types of EVs and their cargo, as well as the techniques used for their isolation and characterization. We will then review the preclinical and clinical studies that have explored the role of EVs in the treatment of ocular disorders, highlighting their therapeutic potential and the challenges that need to be addressed for their clinical translation. Finally, we will discuss the future directions of EV-based therapeutics in ocular disorders. Overall, this review aims to provide a comprehensive overview of the current state of the art of EV-based therapeutics in ophthalmic disorders, with a focus on their potential for nerve regeneration in ocular diseases

The global, regional, and national burden of adult lip, oral, and pharyngeal cancer in 204 countries and territories:A systematic analysis for the Global Burden of Disease Study 2019

Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts

Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries