Clergy's Viewpoint Change Toward Mental Health and Stigma on Mental Illness: A Short Course Training

BACKGROUND

As stigma is one of the main barriers in promoting the mental health, the present study was designed with the purpose of reviewing clergy's viewpoint regarding the effect of mental health workshops on these barriers.

METHODS

For this study, by order of Iran's Health Ministry, a questionnaire was designed to examine the clergy's viewpoint related to mental illnesses and the consequent stigma. Ten faculty members and psychiatrists confirmed the questionnaire's validity after some modifications. In this research, 30 members of the clergy from the main religious city in Iran's "Qom" Seminary attended the training workshops for 2 days. The data obtained from the clergy's responses were analyzed using the SPSS software (ver.16) and descriptive and analytical tests. Also, the significance level was considered p < 0.05 in all tests. The results exhibited that the mean and standard deviation (Mean ± SD) of the clergy's attitude domain and awareness before the workshop was 1.90 ± 26.30 and 8.31 ± 1.64, respectively. Also, average and standard deviation (Mean ± SD) of their attitude domain and awareness after the workshop was 1.95 ± 29.73 and 1.18 ± 10.70, respectively.

DISCUSSION

The present study, which was designed to examine the clergy's viewpoint toward mental illnesses and the consequent stigma in the most considerable religious base in the country, illustrated that one strategy for reducing mental illness stigma in religious communities can be by holding training sessions to promote the clergy's awareness of and attitude toward mental health.

CONCLUSION

There was a significant statistical difference between their awareness and attitude scores before and after the workshop (p < 0.01). In the present research, the awareness and attitude of clergy toward mental health and stigma due to mental illness was relatively good and significantly increased by holding the workshop.

Electron microscopy situation in the diagnosis of minimal change disease; a 16-year survey

Introduction: Minimal change disease (MCD) is one of the most common diseases affecting glomeruli and causing nephrotic syndrome in both adults and children. Objectives: The aim of this study was to evaluate the degree of accordance between light, fluorescent, and electron microscopies in the diagnosis of MCD. Patients and Methods: In this cross-sectional study, we investigated kidney biopsies which were sent to the referral electron microscopy unit (affiliated to Shiraz University of Medical Sciences) from 2001 to 2016. The final diagnosis of MCD was based on the electron microscopy (EM) study. For each patient, the primary light microscopy (LM) finding was compared with EM diagnosis. The available patients’ demographic, clinical, and paraclinical data were extracted. All the statistical analysis was performed in SPSS 19.0 and P<0.05 was considered as statistically significant. Results: Among all 2865 kidney biopsies, the data of 143 (5.0%) patients with approved MCD by EM were analyzed. The mean age of patients was 23.1± 17.4 years since most of them were male (54.9%). Normal blood urea nitrogen (BUN) and creatinine were observed in 76.6% and 78.6% of them respectively. Around, 140 (97.9%) of patients had no tubular atrophy and interstitial fibrosis. The role of EM in the diagnosis of MCD for 61 (50.0%) of cases were essential, for 61 (50.0%) cases were helpful while there was no case with the role of non-necessary. The immunofluorescence (IF) study was performed for 99 (69.2%) patients. Among them, it was negative for 60 (60.6%) of cases and was positive for IgM and C3 in 19 (19.2%) and 11 (11.1%) of cases respectively. The proportion of flank pain was significantly higher among adults. Conclusion: The importance of EM for the diagnosis of MCD is indispensable and undeniable; while LM is not capable of independently leading to a certain diagnosis of MCD. Considering the limitations of using EM, the results obtained from this study can help with the appropriate use of electron microscopy and help physicians to reach earlier diagnosed.

Effect of Achillea millefolium aqueous extract on memory deficit and anxiety caused by stroke in ovariectomized rats

Introduction: Some studies indicated that the decrease of estrogen level in menopausal woman results in increasing the risk of stroke. Although estrogen is a neuroprotective factor, high consumption of this compound may develop breast cancer and endometriosis. The present study investigated the effect of Achilles millefolium extract, containing estrogenlike compounds, on memory impairment and anxiogenic-like behaviors caused by cerebral ischemia in ovariectomized rats. Methods: Permanent middle cerebral artery ligation was performed, as a model for studying postmenopausal condition, in 48 female Wistar rats weighing 200-250 g. The aqueous extract of A. millefolium was prepared and gavaged for 4 weeks after inducing cerebral ischemia. Memory and anxiety-like behavior assessments were evaluated by step-through and elevated plus maze apparatus, respectively. Result: According to the results, cerebral ischemia in ovariectomized rats induced amnesia and anxiogenic-like behaviors which were restored by 7 mg/kg of A. millefolium aqueous extract. Furthermore, inactivation of estrogen receptors (ERs) by tamoxifen (100 µg/kg, intraperitoneally) blocked the restoration effect of A. millefolium on behaviors induced by cerebral ischemia. Conclusion: It could be concluded that, oral administration of A. millefolium extract is able to restore memory impairment and anxiogenic-like behaviors induced by ischemia via ERs in ovariectomized rat.

Developing Vaccines Against Foot-and-Mouth Disease: a Biotechnological Approach

Foot-and-mouth disease (FMD) is a contagious viral disease of livestock with significant economic effect. It is prevalent in various regions of Asia, Africa, and South America. The causative agent of this disease is called foot-and-mouth disease virus (FMDV), which is a member of Aphthovirus genus. Vaccination is an effective technique to prevent the complications of FMD and to eradicate the disease in contaminated regions. Attempts are being made since the 1930s to develop potent vaccines against FMD. The history of vaccination against FMD has documented various types of vaccines including inactivated viruses and empty capsids, as well as attenuated and recently developed recombinant vaccines. Although the available inactivated virus vaccines effectively prevent FMD, they have several limitations such as expensiveness, short shelf life, and short-lived protection. Therefore, it is essential to provide other types of vaccine. To reach this goal, researchers used various platforms including bacterial hosts, yeast expression system, and mammalian cell culture, as well as microalgae and higher plants to produce recombinant vaccines against FMDV. Green plants offer numerous benefits including low cost, correctly folded recombinant, and improved glycosylation patterns. This study aimed to provide a review of the current status and recent progress in the field of producing effective vaccines against FMDV entailing empty capsid, attenuated vaccines, and recombinant subunit vaccines. In addition, the advantages and disadvantages of each type are described, and the biotechnological improvements of the production of anti-FMD vaccines in plant systems are discussed with prominent examples, thereby confirming the feasibility of plant species as effective bioreactors for the production of recombinant vaccines. To the best of our knowledge, traditional approaches are still the preferred methods to protect livestock against FMD. Modern approaches such as recombinant vaccine production are quite promising. However, they have to pass research and development phase and further trials before they can be registered and launched onto the relevant market.

Effect of silymarin and vitamin E on gentamicin-induced nephrotoxicity in dogs

Drug-induced nephrotoxicity is an important cause of renal failure in dogs. Aminoglycoside antibiotics, such as gentamicin, can produce nephrotoxicity in dogs, due to in part to an imbalance of pro- and antioxidants (oxidative stress). Silymarin (the mixture of flavonolignans extracted from Silybum marianum) has potentially beneficial antioxidant properties. A control group (saline, group 1, n = 5) was compared with dogs that were administrated gentamicin by intramuscular injection, at dosage of 20 mg/kg, once daily for 9 days (groups 2-5, n = 5 per group). The effects of vitamin E (group 3) and silymarin (group 4) alone and in combination (group 5) were compared for induced nephrotoxicity. Renal function was assessed using serum biochemical markers (creatinine and urea). Malondialdehyde (MDA) concentration were measured as a marker of lipid peroxidation. The activity of total serum antioxidants (TSAO) was assessed as a marker of antioxidant defences. Serum creatinine and urea concentrations were increased significantly and TSAO was decreased significantly in group 2 compared with group 1. Serum creatinine concentrations but not urea concentrations were significantly lower in groups 3 and 4 than in group 2 (P = 0.001). Serum MDA concentrations was significantly different between groups 2 and 3 (P = 0.01), 2 and 4 (P < 0.001) and 4 and 5 (P = 0.01). TSAO activity was significantly in group 4 (silymarin) than in group 2 (P = 0.002). Silymarin and vitamin E decreased gentamicin-induced nephrotoxicity in dogs.

Hepatic triacylglycerols and plasma non-esterified fatty acids and albumin levels in cross breed cows in Ahvaz city of Khuzestan Province of Iran: an abattoir study

The aim of the present study was to compare the hepatic triacylglycerols (TAG) and total lipid and plasma Non-Esterified Fatty Acids (NEFA) and albumin in cows in different stages of productivity slaughtered at Ahvaz abattoir. So, a total of 203 blood and liver samples were collected from the indigenous hybrid cows immediately after being slaughtered at the abattoir. The cows were divided into 4 groups according to their pregnancy statuses: 1-8 months pregnant, 8-9 months pregnant, less and more than 1 month of parturition. Percentage of TAG and Total Lipids (TL) were measured in the liver and NEFA and albumin were measured in the blood circulation. All the liver samples in this study showed some degrees of fatty infiltration. The accumulation of fat in the liver rose significantly (p < 0.001) during the first month after parturition and returned to the same level of pregnancy after one month. We also noticed that plasma NEFA concentration was significantly higher (p < 0.05) during the first month of parturition and serum albumin level relegated to its lowest level (p < 0.05) in the last month of pregnancy. These results reveal that fatty liver is quite common in all the animals in the region especially in their early lactation. These findings indicate the necessity of reconsideration in the animal's food policies in the area and some especial approaches during the early phase of lactation.

Intrathecal fentanyl added to lidocaine for Cesarean delivery under spinal anesthesia--a randomised clinical trial

The addition of opioids to local anesthetics improves the analgesic potency of spinal analgesia. The purpose of this study was to evaluate the efficacy and safety of intrathecal fentanyl 15 microg when added to lidocaine 80 mg in patients undergoing Cesarean section under spinal anesthesia. Forty healthy parturients scheduled for elective Cesarean section using 80 mg of 5% lidocaine were randomly allocated to additionally 0.9% receive intrathecal fentanyl 15 or saline, as control. Characteristics of spinal block, intraoperative quality of spinal anesthesia, side effects, time of first feeling of pain (complete analgesia) and time to first request of analgesics (effective analgesia) were assessed. Duration of sensory block was prolonged in the fentanyl group (p < 0.05). The quality of intraoperative analgesia was also better. Incidence of side effects did not differ between groups. Duration of complete analgesia (140.2 +/- 29.06 minutes vs 77.90 +/- 20.21 minutes: P < 0.001) and effective analgesia (195.50 +/- 34.06 minutes vs 98.05 +/- 23.48 minutes: P < 0.001) were prolonged in fentanyl group. Adding fentanyl 15 microg to lidocaine 80 mg for spinal anesthesia for Cesarean section, improves the quality of intraoperative analgesia and increases the duration of analgesia in the early postoperative period without increasing maternal or neonatal side effects.

Cervical and thoracic components of multiorgan lymphangiomatosis managed surgically

We report a patient who presented for management of suspected metastatic carcinoma of unknown origin. The lesions proved to be lymphangiomatosis involving multiple organ systems. Surgical management of the thoracic and cervical components of this rare condition is described.

The incidence of Kawasaki syndrome in West Coast health maintenance organizations

BACKGROUND

Kawasaki syndrome (KS) causes an acute vasculitis of unknown etiology. It is a leading cause of acquired heart disease of children in Japan and the United States.

METHODS

We examined the incidence of KS in a well-defined population group of children < or =6 years of age, using data collected through the Vaccine Safety Datalink (VSD) project. The VSD database contains information on >1 million children enrolled in four West Coast health maintenance organizations (HMOs).

RESULTS

During 1993 through 1996 a total of 234 physician-diagnosed KS patients were reported in the 4 HMOs; 152 (65.0%) were boys and 195 (83.3%) were <5 years of age. The incidence of KS among children <5 years of age in the HMOs ranged from 9.0 to 19.1 per 100,000 person years. KS incidence was higher among boys in 3 of the sites. In the 2 sites with the highest number of KS patients, a seasonal occurrence of KS in winter and early spring was observed. Overall 226 (96.6%) of the KS patients were reported to have been hospitalized; hospitalization rates for children <5 years of age ranged from 9.0 to 16.8 per 100,000 person years.

CONCLUSIONS

The incidence of KS in the HMOs was similar to that reported in other population-based studies in the United States and higher than estimates for Australia and several European countries.

Kawasaki syndrome hospitalizations among children in Hawaii and Connecticut

OBJECTIVES

To estimate the incidence and describe recent trends of Kawasaki syndrome (KS) in 2 different areas of the United States.

METHODS

Retrospective analysis of Hawaii and Connecticut State KS hospital discharge records for children younger than 5 years.

RESULTS

In Hawaii, 175 KS hospitalizations for children younger than 5 years were reported during 1994 through 1997; the annual hospitalization rate per 100,000 children was 47.7. The rate for Hawaiian children younger than 1 year (83.2) was greater than that for 1- to 4-year-old children (39.0), and most hospitalizations occurred prior to age 2 years (median age, 17 months). In Connecticut, 171 KS hospitalizations for children younger than 5 years were reported during 1993 through 1996; the annual hospitalization rate per 100,000 children was 18.8, and the median age at hospitalization was 28 months. For both states, most hospitalizations were for boys. Although no clear seasonality was apparent, monthly peaks occurred in some of the years from December through March.

CONCLUSIONS

Kawasaki syndrome seems to remain an endemic disease in the United States. A high KS annual hospitalization rate was seen in Hawaii, especially in children younger than 1 year, whereas in Connecticut, the KS rate was more consistent with those previously reported in the continental United States. Arch Pediatr Adolesc Med. 2000;154:804-808

Reye's syndrome in the United States from 1981 through 1997

BACKGROUND

Reye's syndrome is characterized by encephalopathy and fatty degeneration of the liver, usually after influenza or varicella. Beginning in 1980, warnings were issued about the use of salicylates in children with those viral infections because of the risk of Reye's syndrome.

METHODS

To describe the pattern of Reye's syndrome in the United States, characteristics of the patients, and risk factors for poor outcomes, we analyzed national surveillance data collected from December 1980 through November 1997. The surveillance system is based on voluntary reporting with the use of a standard case-report form.

RESULTS

From December 1980 through November 1997 (surveillance years 1981 through 1997), 1207 cases of Reye's syndrome were reported in patients less than 18 years of age. Among those for whom data on race and sex were available, 93 percent were white and 52 percent were girls. The number of reported cases of Reye's syndrome declined sharply after the association of Reye's syndrome with aspirin was reported. After a peak of 555 cases in children reported in 1980, there have been no more than 36 cases per year since 1987. Antecedent illnesses were reported in 93 percent of the children, and detectable blood salicylate levels in 82 percent. The overall case fatality rate was 31 percent. The case fatality rate was highest in children under five years of age (relative risk, 1.8; 95 percent confidence interval, 1.5 to 2.1) and in those with a serum ammonia level above 45 microg per deciliter (26 micromol per liter) (relative risk, 3.4; 95 percent confidence interval, 1.9 to 6.2).

CONCLUSIONS

Since 1980, when the association between Reye's syndrome and the use of aspirin during varicella or influenza-like illness was first reported, there has been a sharp decline in the number of infants and children reported to have Reye's syndrome. Because Reye's syndrome is now very rare, any infant or child suspected of having this disorder should undergo extensive investigation to rule out the treatable inborn metabolic disorders that can mimic Reye's syndrome.

Impingement after total hip arthroplasty related to prosthetic component selection and range of motion

This study was designed to define the relationship between different combinations of prosthetic head diameters, neck lengths, and acetabular containment angles, and range of motion before component impingement. Three cadaveric pelves with attached lower limbs were mounted in their correct anatomic position. Acetabular and modular femoral stems were inserted into each of the six hips. For each combination of femoral head diameter, neck length, and acetabular liner overhang, the range of motion to impingement was measured in flexion, extension, abduction, adduction, external rotation, internal rotation, and internal rotation with 90 degrees hip flexion. These experiments suggest that the maximum range of motion before impingement can be attained by increasing the prosthetic head diameter and avoiding longer neck lengths with skirts. Acetabular liners with greater overhang decrease motion in all planes except flexion when the overhang is positioned posteriorly.

High-output congestive failure due to arteriovenous fistula resulting from lumbar disc surgery--a case report

A patient is described who developed high-output congestive failure following surgery to a lumbar disc. Diagnosis of arteriovenous fistula was suggested by the signs of high-output state and a continuous bruit heard over the low back scar. Confirmation was demonstrated by abdominal aortography. Corrective surgery resulted in resolution of congestive failure.