MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2012 | Volume:33 | Issue:6|Papers Count:26

Background and Objectives: The prevalence of low birth weight (LBW) is one of the public health indices and factors involved in mortality and morbidity rates. The aim of the present study was to determine the role of maternal anthropometric characteristics on LBW incidence in Marand and Ajabshir, with the highest and the lowest LBW rates in East Azerbaijan province, respectively.Materials and Methods: This case-control study was carried out on those born in 2006-2007 in rural and urban areas of Marand and Ajabshir. Neonates with birth weight <2500g were defined as "cases" and those with birth weight of ³2500g were defined as controls. Cases and controls were matched by age and sex. Mothers of the infants were invited to health centers and maternal anthropometric data were collected using health records and face-to-face interview. All household and anthropometric data were compared between the cases and controls.Results: In Marand, maternal weight at the end of each pregnancy trimester and also weight gain at the third trimester in the controls were significantly greater than in the cases. In urban areas of Marand, maternal weight gain at the first trimester in the controls was significantly greater than in the cases. In rural areas of Ajabshir, those with low maternal weight gain during pregnancy significantly had more neonates with LBW. The mean maternal BMI in rural areas was lower than in the urban areas of Marand. There were significant differences between the two studied towns with regard to weight gain at the third trimester in urban areas, prepregnancy body mass index, maternal weight gain during pregnancy and at the second trimester in rural areas.Conclusion: Results of this study indicate the importance of maternal anthropometric measures particularly pregnancy weight gain in LBW incidence.

Background and Objectives: In vitro determination of C. difficile susceptibility is not routinely performed in the laboratories. The aim of this study was to determine antibiotic sensitivity of C. difficile isolated from hospital staff and also to evaluate recovery rate of C. difficile from stools by three methods.Materials and Methods: One hundred stool samples of hospital staff were collected. Three standard anaerobic methods were used to isolate C. difficile: direct plating on CCFA, inoculation on blood agar following enrichment by alcohol shock and 0.1% sodium taurocholate. Suspicious colonies with specific horse odor were identified by biochemical tests. All isolates were tested by disk diffusion method using 14 antibiotic disks. MIC of isolates were determined for vancomycin and metronidazole by E.test.Results: Eighteen C. difficile were isolated from staff of 13 different wards. The maximum and minimum number of C. difficile was isolated from internal, ICU wards (each 5 isolates) and orthopedic, physiotherapy wards (each 1 isolate), respectively. No resistant isolates to vancomycin and metronidazole were detected by disk diffusion or E-test. All isolates were found to be resistant to polymyxin B and ceftriaxone (100%). The rate of recovery by 0.1% sodium taurocholate enrichment method and alcohol shock was significantly higher than those by CCFA (P=0.02 and P=0.04, respectively).Conclusion: Personnel of Imam Reza Hospital in Tabriz can be considered as source of C. difficile infection. All tested strains were found to be susceptible to metronidazole and vancomycin. The rate of recovery by enrichment methods is higher than those by CCFA culture.

Background and Objectives: Poor quality of water used in the swimming pools can cause several fungal, parasitic, bacterial and viral diseases. Therefore, the aim of this study was to evaluate the water quality in the swimming pools and Jacuzzis in Tabriz.Materials and Methods: In a descriptive and cross-sectional study in 2008, among 22 swimming pools and 17 Jacuzzis in Tabriz, 11 and 8 pools and Jacuzzis were respectively selected. The samples were analyzed for pH values, coliforms and residual chlorine. All sampling and laboratory analysis were carried out based on standard methods of examination of water and wastewater.Results: The mean concentration of residual chlorine and coliform in the water of Jacuzzis was 0.075 mg/L and 7.1, respectively. These values were significantly different from the standard values (P£0.05). On the other hand, the mean concentration of the residual chlorine and coliform in the swimming pools were 1.75 mg/L and 2.14, respectively, which had no significant difference from the standard mean values (P³0.05). The mean pH values of the swimming pools and Jacuzzis were 7.71 and 7.82, respectively. These values were not different from the standardized mean values (P³0.05).Conclusion: The residual chlorine and coliform values in the swimming pools were consistent with the mean standard values. However, the mean values of the residual chlorine and coliform in the Jacuzzis were not in compliance with the standard values. Therefore, further attention should be paid to the Jacuzzis water. Moreover, all the samples were favorable in terms of pH values.

Background and Objectives: Breast cancer is the most common cancer among women and the second cause of death due to women’s cancer after the lung cancer. Early detection is very crucial in improving the outcomes and survival rates. The purpose of this study was to determine to what extent educational program based on health belief model (HBM) can change women’s health beliefs and behaviors of breast cancer screening.Materials and Methods: In a quasi-experimental study, 219 women referred to Health Care Centers in Tabriz were divided into case and control groups through cluster random sampling. Data were collected by using a self-administered questionnaire consisted of 4 sections: demographic characteristics, knowledge of the breast cancer and related screening methods, health beliefs and behaviors of screening. Three months after the intervention, the two groups sat for posttest.Results: Post intervention, there was a remarkable increase within the experimental group in perceived seriousness (P=0.02), threat (P=0.01) and benefit (P<0.001). However, within the control group there was a significant increase in perceived sensitivity (P=0.01) and a decrease in perceived seriousness (P=0.01). Moreover, there was a 15.4% increase in the frequency of breast screening examination in the experimental group. Overall, the screening behaviors in post intervention was significantly different between the two groups (P=0.03).Conclusion: The culturally-sensitive educational intervention based on HBM was to some extent effective in alteration of the health beliefs and screening behaviors. In future educational programs, it seems that focusing on perceived sensitivity enhancement and reducing the perceived barriers would have an important effect on mammography practice in long time follow up.

Background and Objectives: The aim of this research was to study the theory of mind deficit in schizophrenic patients with positive and negative symptoms, their siblings and its comparison with healthy people.Materials and Methods: In a causal-comparative study, 40 schizophrenic patients and 40 siblings were selected from Razi Hospital through available sampling method. Forty normal people as control group were also selected from employees of the Education Organization after matching with the patient group by multi-phase cluster sampling. All subjects were administered Baron-Cohen’s "Reading the Mind in the Eyes" test revised version. Data were then analyzed.Results: The results showed that theory of mind is impaired in people suffering from schizophrenia compared to the healthy people (F=69.54; P<0.01). This deficit is trait-dependent in schizophrenic patients. However, there was no significant difference between patients with negative and positive symptoms in type of the theory of mind deficit (state or trait).Conclusion: According to the findings, the theory of mind in schizophrenic patients seems to be impaired before being diagnosed and this deficit is exacerbated by the illness experience.

Background and Objectives: Alexithymia is a personality trait in individuals. The aim of the present study was to evaluate prediction of the alexithymia changes based on the personality components.Materials and Methods: In a descriptive-correlation study, 200 individuals among the students of Tabriz University were randomly selected.Twenty-item Toronto questionnaire (TAS-20) and the five-factor model (NEO-FFI) questionnaire were used for data collection.Results: The personality factors predicted 29% of the alexithymia variance. In addition, stepwise regression was used to reveal the differential role of each personality factors in alexithymia prediction. Accordingly, the roles of extraversion, conscience, openness, and neuroticism were 18%, 7%, 2% and 2%, respectively.Conclusions: The result of this study showed that the score of alexithymia can be predicted using the personality factors.

Background and Objectives: Some water quality parameters such as hardness are considered based on the consumers’ satisfaction. However, presence of some chemicals such as fluoride in concentrations more than standard levels could threat health of the consumers in long term. The present study aimed at providing the quality feature of drinking waters of East Azerbaijan province, in particular the fluoride.Materials and Methods: During the study, results of 668 analyses of urban and rural water sources in 19 towns available at Province Health Center were reviewed. Thereafter, fluoride concentration, hardness, pH, alkalinity and electric conductance (totally 3340 parameters) were extracted and after statistical analysis were compared with the standards. In the case of villages with high level of fluoride, re-sampling and analysis was conducted.Results: The electric conductance of the drinking waters ranged from 104 to 4660 ms/cm with the mean of 740±570 ms/cm. The value of hardness ranged from 40 to 1434 mg/L as CaCO3 with the mean of 228±100 mg/L. In 91.3% of the drinking water sources, fluoride content was £0.5 mg/L. In 22 drinking water sources, fluoride content was measured >1 mg/L leading to dental fluorosis.Conclusion: Consumption of water with high content of minerals and hardness should be limited if possible. Moreover, for water sources with fluoride content of >1 mg/L, new water source should be provided due to probable dental fluorosis.

Background and Objectives: Burn wound infection is the leading cause of mortality in burn patients. Using topical antibiotics is one of the most effective methods to prevent the burn wound infection. The aim of the present study was to assess and compare the effectiveness of Fundermol ointment and silver sulfadiazine 1% on the second-degree burn wounds.Materials and Methods: In a single-blind clinical trial, 50 burn patients referred to Imam Mousa Kazem Hospital Burn Clinic were studied. These patients had second-degree burn wounds and burn percentage of 1-10% and were randomly divided into two groups of Fundermol and silver sulfadiazine 1%. The healing time of the burn wounds were compared between the two groups.Results: The healing time of the burn wounds in the Fundermol group was significantly shorter than that in the silver sulfadiazine 1% group (P<0.001).Conclusion: The results of this research showed that Fundermol ointment is more effective than the silver sulfadiazine 1% in second-degree burn wounds.

Background and Objectives: The use of laryngeal mask airway (LMA) is an alternative route in various surgeries such as gynecologic laparoscopy. However, air leak around LMA cuff may lead to gastric distension and inadequate ventilation during positive pressure ventilation in comparison with endotracheal tube (ETT). The aim of the present study was to compare laryngeal mask airway with endotracheal tube during gynecologic laparoscopy.Materials and Methods: One hundred women were randomly divided into LMA or ETT groups for airway management. During the laparoscopy, a surgeon, blinded to the type of airway, scored stomach size on an ordinal scale of 0-10 at initial insertion of the laparoscope and immediately before the conclusion of the surgical procedure. Oxygen saturation, EtCO2, and hemodynamic parameters (HR, BP) were compared between the two groups.Results: Demographic data, peritoneal insufflations time and total anesthetic time were similar for both groups (P>0.05). Alterations in gastric distension before or after peritoneal insufflations were similar in both groups (P>0.05). There were no significant differences in SpO2, ETCO2 or hemodynamic parameters during surgery or in recovery between two groups (P>0.05). With regard to the postoperative respiratory complications, cough was more common in ETT group.Conclusion: In this study we concluded that a correctly seated LMA or ETT provided equally effective pulmonary ventilation without clinically significant gastric distension in all patients.

Background and Objectives: Widespread usage of different chemical drugs for therapeutic purposes may impair spermatogenesis. Since calcium channels are present in the plasma membrane of many cells including sperm, the present study aimed at examining the effects of amlodipine (a calcium-channels inhibitor) and also pentoxifylline on sperm parameters in mice. Materials and Methods: Syrian male mice received 2.5 mg/kg/day amlodipine orally for 3 months and the sperms in culture medium exposed to 0.5 mmol pentoxifylline. After epididymal biopsy, total number of sperms, number of dead sperms, number of sperms with progressive and slow and in situ motility, and also sperms with acrosome reaction were studied by a light microscope.Results: There was no difference in total sperm numbers between control and treatment groups (P=0.44). After staining with eosine Y, number of dead sperms in the amlodipine receiving group increased significantly (P<0.001). Number of sperms with progressive motility in amlodipine group decreased significantly (P<0.001). Number of sperms with slow motility and in situ and sperms with acrosoaml reaction in amlodipine group decreased significantly (P<0.001).Conclusion: Oral amlodipine administration reduces the sperm progressive motility and acrosomal reaction, whereas oral pentoxifylline administration enhances the sperm progressive motility and acrosomal reaction.

Background and Objectives: The diagnosis of colorectal cancer in early stage increases the survival rate and quality of life in patients with colorectal cancer. The aim of the present study was to evaluate the relationship between the tumor markers of CEA and CA19-9 with diagnosis, staging and pathological finding in patients with colorectal cancer.Materials and Methods: One hundred confirmed colorectal cancer patients who were candidates for surgery were included in the study group. Demographical, clinical and pathological information were collected. Peripheral blood samples were obtained from patients preoperatively for serum assay of the tumor marker (CEA and CA19-9).Results: The mean age of the patients was 56.95±15.16 years. The mean serum levels of CEA and CA19-9 tumor markers were 101.63±18.9 mg/L and 83.53±39.55 KU/L, respectively. More than one third of the patients had abnormal range of tumor markers (CEA, 36% and CA19-9, 35%). Simultaneous increase in both tumor markers was observed in 17.5% of the patients. An increase in the serum level of CA19-9 was correlated with the number of the involved lymph nodes (P=0.03). Moreover, an increase in the serum level of CEA was correlated with the depth of invasion (P=0.05), number of metastatic lymph nodes (P=0.001) and stage of the disease (P=0.01). Simultaneous increase in both tumor markers was correlated with the number of metastatic lymph nodes (P=0.01).Conclusion: According to the results of this study, the elevated preoperative serum levels of CEA and CA19-9 may be indicative of the disease progression, but not diagnosis of the disease in early stages.

Background and Objectives: Cryptorchidism is the most common urogenital anomaly which has been evaluating in childhood. Understanding the hormonal, molecular and genetic predisposing factors is important to treat and protect this anomaly. The aim of the present study was to evaluate the prevalence of cryptorchidism in male members of the crypt orchid children’s families.Materials and Methods: A total of 1410 members of the cryptorchid patients treated between 2005 and 2007 were observed for presence of cryptorchidism.Results: There were 107 cases of cryptorchidism among male members of the cryptorchid children’s families (7.5%).Conclusion: In comparison with the prevalence of cryptorchidism in East Azarbaijan province (1.35%), the familial prevalence is 5.6 fold higher. This may imply a probable genetic predisposition.

Background and Objectives: Treatment and suppression of atherosclerotic lesions is a fundamental goal in atherosclerosis patients. Antioxidants and hypolipidemic agents suppress the development of atherosclerosis. The objective of this study was to determine the effect of Hypericum perforatum L. on treatment of atherosclerosis in hypercholesterolemic rabbits.Materials and Methods: Twenty rabbits were assigned to four groups: group I (normal diet for 75 days); group II (1% cholesterol diet for 75 days); groups III and IV (1% cholesterol diet for 45 days). Thereafter, group III received the normal diet for additional 30 days, while group IV received normal diet plus H. perforatum (150 mg/kg.bw) for an additional 30 days (regression period). Blood samples were collected from rabbits on days 0, 45 and 75 days.Results: At the end of the study, serum biochemical factors (apoB, MDA, OX-LDL) decreased in groups III and ΙV. However, the serum biochemical factors were more decreased in groups IV compared to the group III in regression period.Conclusion: The results suggest that polyphenolic substances derived from H. perforatum may contribute to a reduction in serum biochemical factors and subsequently regression of the atherosclerosis.

Endovascular procedures for treatment of central nervous system vascular lesions are rapidly expanding. This type of treatment is becoming less invasive but more effective during the recent years. Neuro-endovascular management has become an important therapeutic option in the varieties of brain and spine disorders including intracranial aneurysms, arteriovenous malformation, acute ischemic stroke, dural arteriovenous malformations, vasospasm following aneurysmal subarachnoid hemorrhage, carotid cavernous fistulae, tumors and vascular malformations of the head and neck, extracranial carotid and vertebral disease and cerebral venous system thrombosis. In this review we briefly discuss the neuro-endovascular procedure indications in the above mention disorders.

Background and Objectives: Metacognitive therapy is based on the principle that meta-cognitive is very important for understanding the way of cognitive function and the way of producing our conscious experience about ourselves and the world around us. The aim of the present study was to evaluate the effectiveness of metacognitive therapy in improving major depressive patients.Materials and Methods: In a single case experimental study, three patients were followed up at 1, 3 and 6 months by using multiple-baselines in 8 sessions. Instruments were included structured clinical interview, the Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and Dysfunctional Attitude Scale (DAS).Results: The metacognitive therapy created significant changes in depression and anxiety symptoms and dysfunctional attitudes of the depressive patients.Conclusion: The metacognitive therapy focusing on the control of cognitive process instead of cognitive content could be effective in treatment of the patients with major depression.

Background and Objectives: The laryngeal mask airway supreme (LMA-S) is a new airway device designed to minimize the risk of aspiration. We studied the success rates of the LMA-S insertion and the incidence of any complications compared with the conventional LMA in orthopedic surgery patients with normal airways.Materials and Methods: In a randomized clinical trial, 122 patients undergoing elective lower limb orthopedic surgery were studied in two study and control groups. Airway management in the study and control groups was with LMA-S and conventional LMA, respectively. The collected data including the success rate of insertion and ventilation, and the incidence of any complications associated with the use of the device were analyzed between two groups.Results: The LMA-S was easily inserted in 96.8% of 62 patients in the study group and in 81.7% of 60 patients in the control group (P=0.02). Nausea was observed in 6.5% of the study group and 20% in the control group (P=0.02). There was no difference in incidence of postoperative sore throat and abdominal pain between the two studied groups (P>0.05). The mean sealing pressure significantly differed between two groups (P=0.04).Conclusion: Our report indicates that the LMA-S is a valuable addition to airway devices for patients with normal airways.

Rabies is a viral disease of the central nervous system (CNS). Clinical suspicion of rabies is based on a history of an animal bite. The initial symptoms may be fever and pharyngitis. Pain and paresthesia of the area along with the probable headache and anorexia can be seen. There is no treatment for rabies. We report a rabies case in this paper.

Neuroachantocytosis, a form of hereditary chorea, is a degenerative multisystem disease presenting with several types of abnormal movements such as dystonia and chorea together with other neurological problems including neuropathy, amyotrophy, seizure and ataxia. Here, we report a 52-year old male with recurrent or mandibular dystonic attacks together with progressive chorea at limbs, seizure, ataxia, and depression. With diagnosis of neuroachantocytosis, the patient received clozapine and botulinum toxin injection resulting in partial response.

Chorea is a complex, rapid, irregular and fluctuating hyperkinetic movements with several etiologies. A rare type of generalized chorea is post-pomp chorea occurring after cardiac surgery especially in children, but it is rare in adults. Here, we report a 75-year old man with chorea and gait difficulties ten days after cardiac surgery. Neurological exams, excluding chorea, and paraclinical tests were normal. Magnetic resonance imaging of brain revealed old diffuse ischemic changes. Among chorea medical treatments, pimozide resulted in mild improvement. We started clonazepam plus pimozide, thereafter choreic movements and gait gradually improved.