Journal of Guilan University of Medical Sciences
Year:2007 | Volume:16 | Issue:62|Papers Count:17

Introduction: Type 1 diabetes is an autoimmune disease which is characterized by T-cell mediated destruction of pancreatic β-cells. A variety of environmental and genetic factors are involved in the development of the disease.Transforming Growth Factor Beta-1 (TGFb) is a multifunctional cytokine that affected regulation and difference of immune responses and there is abnormal secretion of this auto immune disease.Genetic polymorphisms in the TGFb gene influenced production and secretion of cytokine and figured as a risk factor in auto immune disease.Objective: In this study, single nucleotide polymorphism of TGFb at codon 25 is investigated in type 1 diabetic patients and compared with healthy controls.Materials and Methods: This was a case control study which 75 type 1 diabetic patients who had definitely diagnosed at least 2 years before sampling and were under Insulin therapy were selected. Control group were selected from voluntarily blood donors who had referred to IRAN Blood Transfusion Organization.Data were analyzed by SPSS and using chi- square test with 95% confidence interval.Results: The findings showed that there were not statistically significant differences in GC polymorphism at +915 between cases and control groups (p value 0.05).Conclusion Although TGFb polymorphism at +915 regions affects the production of cytokine regulates immune responses; this study showed that single nucleotide polymorphism in this region can not be involved in onset of type 1diabetes and can not be considered as risk factor.

Introduction: Coronary Artery Disease (CAD) is the main cause of death in many populations, including Iranians. The best way to control CAD is to identify and modify more effective local risk factors.Objective: The aim of this study was to determine and comparison of lipids, lipoproteins and lipoprotein (a) [Lp(a)] in patients with CAD had who referred to cardiovascular research center.Materials and Methods: This cross-sectional case-control study conducted in Yazd cardiovascular research center in 2004. One hundred patients (37 females, 63 males) with CAD and 92 controls (58 females, 34 males) were investigated. The fasting plasma Total Cholesterol (TC), Triglycerides (TG), High-Density Lipoprotein Cholesterol (HDL-C), was determined by routine laboratory methods. Lp(a), apo-A1 and apo-B100 were determined by Electro Immunoassay Method. Statistical test included, t-test for comparison of lipids and U-test for comparison of Lp(a) was used  in two groups. Results: TC and Low-Density Lipoprotein Cholesterol (LDL-C) in patients (227±35 and 147±40 mg/dl respectively) were higher than controls (208±54, p=0.009 and 127±39 mg/dl, p=0.002). There were not any significant differences in TG, HDL-C and apo-A1 between two groups, but apo-B100 in patients was more than(1.25±0.4 g/L) than controls (1.13±0.36 g/L, p=0.033) also Lp(a) in patients was higher(25±27 mg/dl) than controls (18.8±19.5), but differences was statistically significant only in women (p=0.016).Conclusion: Findings showed there is more relationship between high levels of cholesterol and cholesterol-rich lipoproteins with CAD and Lp(a) with CAD in women, TG is more effective risk factor for MI in our study population so these lipids and lipoproteins may be more effective local risk factors for incidence of CAD in some area of Iran.

Introduction: Nasal polyps are mucosal sac which contain edema, fibrian tissue, vessels, inflammatory cell and glands which origin from paranasal sinuses and nasal mucosa and is one of the most common benign nasal mass.Objective: Determine the relative frequency of some associated factors in patient with nasal polyp who operated at Amir- Al- Momenin hospital, Rasht.Materials and Methods: This is a analytical- descriptive study; which files of patients with nasal polyps who underwent polypectomy at Amir-Al-Momenin hospital during 2003-4 were collected. Variables including age, gender, history of previous polypectomy, smoking, blood group, serum eosinophilia, bilateral polyp, presence of polyp in the other side, presence of asthma, penicillin allergy, aspirin intolerance, diabetes and atopy were studied.Results: Put of 102 patients with nasal polyps 43% were female and 57% were male. More than 50% of patients were in 10-19 and 20-29 years age group. Only 18.6% of them had a history of previous polypectomy. 57% of them had bilateral polyps and 42.2% had unilateral ones. Incidence of asthma, aspirin intolerance, diabetes, atopy and penicillin intolerance in these patients were 6.8%, 1.9%, 8.8%, 9.7% and 0.9%. 14.7% of patients were smoker. Eosinophilia was seen in 11.7% of the patient.Conclusion: Asthma, aspirin intolerance, penicillin allergy are seen with lower frequency than other reports so researcher advised to perform more study to determine the prevalence of associated factors with nasal polyps in population.

Introduction: Dry Socket (Alveolitis Sicca Dolorosa, ASD, Alveolar osteitis) is a common complication after removal of teeth, particularly after operations on mandibular third Molars. The incidence is from a few percent to 68% depending on which teeth were removed and the relative difficulty and upon the integrity of tooth Socket.Dry socket is usually due to difficulty in tooth extraction or because of lack of blood clot hit manifest with pain 3-4 days thereafter.Objective: Survey the incidence Rate of dry socket on patients who presented to the private clinic using local anesthetics.Materials and Methods: This is a descriptive and prospective study which 1486 patients who had referred to private clinic were studied from April 2001 – March 2004, 2363 teeth were extracted in routine method by local anesthetics.Age, gender, the number of teeth, the type of tooth, and the cause of dental extraction, the length of time for extraction and damage that had caused to the tissues were recorded. The patients were asked to report for any pain and other complaints by phone or return to the clinic for the necessary advice or treatment.Results: 2363 extraction teeth were carried out among 1486 patients of whom 1020 patients had one tooth extracted and 466 patients had more than one under local anesthesia over a three year period. Of 1020 patients who had single extraction only 34 dry sockets were seen (3.3%), and among 466 patients who had multiple extractions, 35 dry sockets were diagnosed (2.6%). The incidence of dry socket is related to place of dental extraction in the lower jaw (4.7%) and in the upper (1.3%).Only 69 dry sockets were diagnosed from 60 patients. The number of extraction teeth didn't produce dry socket.Conclusion: It seems that the increase incidence of dry socket in women as compare with men is due to use of contraceptive pills and hormones, and it is also due to excess use of mouthwash after dental extraction.

Introduction: The infer renal abdominal aorta and iliac arteries are the most common sites of chronic atherosclerotic occlusive disease and abdominal aortic aneurysm. Abdominal aortic reconstruction helped patients by extending their life and improving the life expectancy. Mortality rates related to elective surgery are approximately 5% at the best centers, rising to 40-60% in urgent surgery.Objective: The aim of this study is to: assess the postoperative complication and mortality rate of 119 patients who had abdominal aortic reconstruction.Materials and Methods: This is a retrospective study that carried out on 119 consecutive patients with atherosclerotic vascular disorders who underwent operation for abdominal aortic aneurysm and chronic atherosclerotic occlusive disease, between 1994 to 2004.The medical record of patients who underwent operation for abdominal aortic aneurysm and chronic atherosclerotic occlusive disease between 1994 to 2004 were collected. 119 surgeries were performed by one surgeon. Evaluating of risk factors, death and postoperative outcome (during the first 30 days) was performed base on usual methods. Data were analyzed according to standard health system research, Epi 3.3.2 and SPSS-10 comparative analysis through student test and chi-square test.Results: During 30 days after surgery, mortality rates were 6.7% in elective surgery and 22% in urgent surgery (p<0.001). Myocardial infarction was the most common cause of death, which occurred in 10 (8.4%) patients. The most common complications was bronchopneumonia, which occurred in 17 (14.3%) patients. Preexistent stroke disease was associated with an average mortality rate of 50% compared with 11.7% without this co morbidity (p<0.05) and associated with an average complication rate of 75% compared with 28.8% without this co morbidity (p<0.05). Preexistent chronic obstructive pulmonary disease was associated with an average complication rate of 55.6% compared with 25% without this co morbidity (p<0.05). There was no specific correlation between other associated diseases and risk factors with mortality and complication.Conclusions: The results showed there is low rate mortality for abdominal aortic aneurysm in elective surgery, so diagnosis and elective surgery offered low rate of mortality and complication and long life expectancy for the patients.

Introduction: In recent years, the number of women who delivered their first child at the age of 35 years and over has increased due to educational, economic and occupational reasons. Understanding the unfavorable pregnancy outcomes in women who delay the birth of their first child is very important. This knowledge is essential both for mothers and their care givers because knowledge on these pregnancies can be effective in improvement of pregnancy care for these women and for reduction of the adverse outcomes or for their early treatment.Objective: Investigate the pregnancy outcomes among the 35-year-old primiparous women who were covered by a national program and compare the statistics obtained in this study with available statistics in the articles and studies in other communities.Materials and Methods: In this retrospective descriptive study 500 primiparous women's records who were at the age of 35 and older were assessed to determine the percentage of relative frequency of the associated factors such as Hypertension, Diabetes, Preterm delivery, Low Birth Weight, Placenta Abruption, and Placenta Previa and Still Birth. Sampling method was based on the census .All pregnant women aged 35 and older who referred to Alzahra Maternity Hospital in Rasht for delivery of their first baby in a period of  5 years (1997-2002) were included. Multiple pregnancies were excluded. Also, the imperfect records were put aside.Results: The percentage of the investigated complications in primiparous women aged 35 and older was obtained as follows Hypertension 15.8%±3.1, Low Birth Weight 13.2%±3, Diabetes 3.6%±1.6, Placenta Abruption 2.8%±1.4, Still Birth 2.4%±1.3, Pre-term delivery 13%±2.9 and Placenta Previa 1.6%±1.1 .Conclusion: Results showed that the percentage of complications in primiparous women aged 35 and over was higher as compared with the statistics mentioned in text books for the ordinary population. Also, comparison of the finding of this study with some similar studies in the country indicated the increase in relative frequency rate of hypertension in old women. No significant difference was found in the relative frequency of Placenta Previa, Diabetes, Pre-term Delivery and Still Birth. Since many complications of this sort are preventable or curable by good prenatal care, it is recommended that the older pregnant women be take care carefully during pregnancy.

Introduction: Annually, one third of work related injuries belongs to the musculoskeletal disorders and low back pain is the most commonly reported injury. There are many therapeutic interventions available in the treatment of low back pain, but the most effective treatment is yet demonstrated. The present study was designed to compare the effect of an exercise program and ergonomic advices in the treatment of low back pain.Objective: The aim of this study consists of: comparative evaluating of an exercise program and ergonomic advices in the treatment of low back pain in nursing population at Mazandaran province.Materials and Methods: This is a randomized controlled clinical trial study which, 236 nurses matched by age, gender and body Mass Index were randomly divided into four groups. The first three groups were received intervention (group 1, therapeutic exercise combined with ergonomic advices; group2, therapeutic exercise only; and group 3, ergonomic advices only). The fourth group was given no intervention.  Pain on Visual Analogue Scale and disability on Oswestry Low Back Disability Questionnaire were measured at 1, 3, 6 and 12 months after intervention.Results: Statistical analysis indicated that there was significant differences on pain and disability measurements in all instances using ANOVA (p<0.001). A Repeated Measurements test showed significant improvements in the first three groups both on pain and disability following intervention (p<0.01). No significant changes were found in the fourth group (control group) neither on pain nor disability score.  Dunnet test revealed significant difference between each first three group (group 1, 2 and 3) and the fourth group on pain and disability (p<0.001).Conclusion: The results demonstrate that therapeutic exercise and ergonomic advices could be considered as effective approaches in the treatment of low back pain. Therefore, more emphasis should be put on regular exercise and ergonomic advices in the nursing population in order to prevent and control such a common and costly health problem.

Introduction: Population pattern in Guilan province like other provinces in Iran represents an increasing pattern in young population. According to higher prevalence of substance use among adolescents, its negative effects on this group and paucity of previous studies this study seemed necessary.Objective: This study was performed to estimate the prevalence of substance use between high school students in Guilan 2005-2006.Materials and Methods: This is a cross-sectional and descriptive study which was performed on 1950 Guilan’s high school students. Samples were selected by cluster sampling. Variables including demographic data (sex, age, school type, birth order and parents’ education), substance use and its kind, First motive for use, Last use and usage frequency were analyzed by SPSS software and chi-square and Fisher-Exact tests.Results: 23.7% of students had at least one time substance use with considering cigarette and 12.8% had at least one time substance use without considering cigarette. Proportional frequency of substance use in males (31.3%) was more than females (14.8%) (P=0.0001). General prevalence of substance use was: Cigarette (20%), Alcohol (10.5%), Opium (2.4%), Ecstasy (2.1%), Cannabis (2%) and Heroin (0.3%). There was significant difference between Alcohol (p=0.0001), Opium (p=0.0162), Ecstasy (p=0.0081), Cannabis (0.0001) and Cigarette (p=0.0001) and sex. Higher educational levels and higher ages in boys were related to higher substance use.(p=0.0014 & p=0.0002). In addition there was significant relationship between substance use in students and cigarette use among family members (p=0.0001).Conclusion: Substance use in male students was significantly higher than females. Higher educational level and higher age in male students were related to higher substance use. In addition prevalence of substance use in students with smoker parents was higher.There weren’t any relationship between birth order and kind of school, parents’ educational level and substance use. Regarding our results we have to give special attention to adolescents especially in high school boys with higher ages and educational levels and students with smoker parents.

Introduction: In the past 20 years, numerous studies have been done to improve the implantation process in ICSI. Several factors like: embryo quality, endometrial reception and etc. Can influence on uterine implantation. Uterine contraction at the time of embryo transfer alters pregnancy rates (PRs) after IVF. The first and the most important factors consist of avoiding the initiation of uterine contractility.Objective: Survey the effect of Piroxicam treatment on the pregnancy rate in ICSI. Materials and Methods: This was a clinical trial and double blind randomized study. 500 consecutive cycles of ICSI-ET including infertile couples were divided randomly into treatment and control groups. After blood studies (hormonal tests, …), Sonography, Hystrosalpingography and etc, the women with uterine problems like Myoma, Asherman's Syndrome and… were excluded. Then all of the couples with male factor, tubal factor, ovulatory factor and unexplained factors were included in this study. Control ovarian hyperstimulation (COH) was performed with long protocol. The case group (250 cycles) received an oral dose of 10 mg of Piroxicam, and the control group (250 cycles) received a placebo, 1-2 hours before fresh ET. An informed consent form was obtained for each patient's treatment. The main outcome was pregnancy rate (PR).Results: Data showed that the mean of age females' age and duration of infertility didn't have statistically significant between two groups. There was not statistically significant between the mean of Estradiol in 3rd day of period and mean of Estradiol in the day of HCG injection, mean of FSH, mean of LH, mean of follicle and mean of endometrial thickness in two groups (P>0.05). Also between the mean number of Oocyte retrieval (metaphase II), 2PN, embryo cleaved, embryo transferred and pregnancy rate in two Groups (P>0.05).Conclusion: Piroxicam treatments don't effect on PR in ICSI and it's appears that it isn't effective in the priming of uterus before ET.

Introduction: Trigeminal trophic syndrome, is an uncommon, ulceration which was occered, follow minor, repetitive trauma to anaesthetic skin within the trigeminal area.The main causes of this disorder consist of: neuro-sensory damages of trigeminal nerve, herpes zoster and herpes simplex virus neuritis and rarely arrised from post-surgical complication like removal of cerebello pontine angle eningioma.Case report: This report is dealt with a 54-years old woman who was afflicted by facial palsy, about 7 monthes after a surgery on her parotid gland and then, an ulcer occurred at her right ala nasi and nasolabial furrow.Her ulcer was painless, but had intermittent bleeding and discharge.Following failure of treatment with topical drugs and oral antibiotics she was eventually reffered to Razi hospital in Rasht.With suspicion to Trigeminal Trophic Syndrome, and for diffrentiation from other pathologies, she undergone cutaneous  biopsy. Its results were corresponding with the mentioned diagnosis.