MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2014 | Volume:36 | Issue:1|Papers Count:18

Background and Objectives: Percutaneous Nephrolithotomy (PCNL) is a gold standard in the management of complex renalstone ≥2 cm in diameter. Controversy exists regarding the optimal tract dilatation method in PCNL.The aim of this study was to compare the safety and complication rate of the balloon dilatation technique with telescopic method in nephrostomy tract dilation in percutaneous nephrolithotomy patients.Materials and Methods: This clinical trial study conducted on, 89 patients underwent PCNL in our center.Patients were divided into two groups according to dilation technique used: balloon dilatation technique group (28 patient) and telescopic technique group (61 patient). Patients matched according to sex and age. Xray exposure time, blood loss, and complications were evaluated.Results: The rate of stone free in balloon dilatation technique group was 100% and in telescopic one 80.3% (P=0.007). Hemoglobin decrease in balloon dilatation were 1.6±0.2 g/dl and in telescopic were 1.8±0.1 g/dl; No significant difference about hemoglobin reduction was seen in both groups (P=0.7). X-ray exposure time was 1.8±0.8 minute in balloon technique group and1.7±1.2 minute in telescopic group. The average of radiation dose was not significant difference between two techniques (P=0.1). We have not major complication in two groups.Conclusion: Both techniques of nephrostomy tract dilatation were effective with no significant differences in major complications. Rate of hemorrhage were similar in both of balloon dilatation and telescopic technique.

Background and Objectives: Obesity is one of the main causes of health problems in most countries. Adipose tissue secretes several proteins known as Adipokines, which have an important role in glucose metabolism system. The aim of this study was to evaluate the effect of acute endurance exercise on serum levels of adiponectin levels in elderly overweight individuals (men).Materials and Methods: 12 healthy male subjects were investigated. All subjects performed one session of endurance exercise including: 30 minutes of cycling at 70-75% of maximum heart rate. Blood samples were taken before exercise and immediately after exercise inorder to analyzing the serum levels of adiponectin, insulin and glucose.Data were analyzed using student's t-testand Pearson’s correlation. Statistical significance was set at p≤0.05.Results: There were no significant changes in the adiponectin levels following exercise (P>0.05). There was also no significant correlation between adiponectin and insulin resistance index (P>0.05). Glucose and insulin concentration and insulin resistance index significantly decreased following exercise (P<0.05). Furthermore, we observed a significant correlation between insulin and insulin resistance index (r=0.996).Conclusions: Although 30 minutes of cycling significantly altered glucose and insulin concentration and IR, had no significant effect on adiponectin levels.

Background and Objectives: Granulomatous lobular mastitis is one of the rare inflammatory diseases of breast. It can mimics the breast malignancies in radiology and clinical evaluations. The etiology of GLM is unclear. This study was performed to determine diagnostic and management aspects of this disease.Materials and Methods: We reviewed records of 38 cases with GLM between November 2009 and September 2012.The records contains of physical examination, past medical history, familial history, drug history, lab and histopathologic findings.Results: The mean age of patients were 42 years. (range22-62).All of the patients had children. The patients had history of Oral contraceptive usage, antibiotic therapy, reduction and mammoplasty. They didn’t have breast cancer in familial history. Some of them had dimpling and abscess, edema, inflammation, ulcer and firm mass in physical examination. In lab findings all cases had lymphocytosis. Size of masses were at the range of (2*2to8*6 CM). Locations of masses in most cases were in the superior lateral quadrant or central. Utrasonography showed an hypoechoic fibroglandular mass and collection. In pathologic findings Granulomatous reaction were seen.Conclusions: GLM is a rare chronic inflammatory lesion can mimics breast cancer in the absence of obvious etiology. Based on our findings, a history of child baring, lactation and OCP drugs usages plays important roles in the cause of GLM. The most common clinical sign in patients at first admission is found to be a painful mass in the breast. The information obtained from imaging was nonspecific. Imaging can't differentiate GLM from malignant or inflammatory conditions. Therefore, histopathological studies can differentiate these lesions from others. There is still no accepted strategy for management of GLM but corticosteroid therapy and surgery are using widingly.

Background and Objectives: Obesity is a growing cause of cardiovascular diseases. Accordingly, the aim in present study was to investigate the effect of Aerobic Training with Omega-3 Consumption on Soluble Adhesion Molecules in the Obese Women.Materials and Methods: In a double-blind study, 40 obese women (BMI≥30) 55 to 65 years were selected, and randomly divided into 4 groups (n=10 for each group): exercise-supplementation, exerciseplacebo, supplementation, and control. Subjects in the supplementation group consumed 2080 mg omega-3 daily and the placebo group consumed a 0.02 dextrose solution as a placebo. The exercise program comprised aerobic exercise to 45% to 65% maximum heart rate for 8 weeks; each session was sustained for 40 min and continued for 3 sessions per week.Results: Exercise, supplementation and combined exercise-supplement can sICAM-1 concentration significantly decreased (P<0.05). On the other hand, serum sVCAM-1 concentration decreased significantly only in the exercise-supplement group (combined) and IL-6 concentration significantly decreased in the exercise group and exercise-supplement group (combined) (P<0.05).Conclusions: Measurement of Adhesion Molecules is a useful method in the diagnosis of inflammation and vascular disorders. In addition, regular aerobic exercise and omega-3 supplements are two effective and moderating factors; in reducing the of adhesion molecules and pre-inflammatory cytokines.

Background and Objectives: Diabetic Retinopathy (DR) is a vascular complication of type 1 and type 2 diabetes mellitus. The aim of this study was to determine the effects of Calcium Dobesilate (CD) on decreasing Endothelin-1 (ET-1) and high sensitivity C-Reactive Protein (hs-CRP) serum levels in patients with diabetic retinopathy.Materials and Methods: Ninety adults with type II diabetes having DR complication were included in this double-blind randomized clinical trial study. Patients categorized in two groups of case (diabetic retinopathy patents treated with CD) and control (diabetic retinopathy patents without CD treatment), age and sex-matched randomly between two groups during seventeen month period in Tabriz Nikookari eye Hospital and Sheikholrais clinical center. The case group received 500mg of CD for three month, The serum level of hs-CRP and ET-1, was recorded in all patients before and after administration of CD and compared between both groups.Results: Ninety patients with diabetic retinopathy, including of 30 males and 60 females, with the mean age of 59.18±7.13 years were enrolled in the study. The mean level of serum endothelin-1 was significantly different in the case group than control group after treatment with CD as well (0.69±0.32 pg/ml vs.0.86±0.30 pg/ml; p=0.005), and also there was a significant different of mean serum level of hs-CRP after treatment with Doxium between the case and control group, as well (3.28±3.28 mg/L vs.4.67±3.75 mg/L; p=0.006; respectively).Conclusions: Treatment with CD can decrease the serum levels of ET-1 and hs-CRP as two important inflammatory biomarkers in patients with diabetic retinopathy. More studies are recommended to be carried out in this regard.

Background and Objectives: The application of pharmaceutical herbs instead of synthetic drugs is increasing in recent years because of their lower side effects and high varieties of efficient components. The study of antinociceptive effects of hydroalcoholic extract of Avicennia marina leaf seems to be necessary due to the existence of antinociceptive compounds types such as steroids, phytoalexins, flavonoids, carboxylic acids, triterpenes and tannins and its use in traditional medicine for pain cure. According to growing trend of using of pharmaceutical herbs, biologically active compounds in harra, the existence of rich ecosystem of mangrove and unique growing of this plant in Bushehr province, Antinociceptive effects of harra using formalin test in rats in present study have investigated.Materials and Methods: This study contained 24 Wistar male rats with the weight of 180-200 g. Rats were divided into four groups (n=6 for each group) including Sham, Control, receiving morphine at dose of 2 mg/kg body weight, and Tests groups receiving hydroalcoholic extract at doses of 200 and 400 mg/kg body weight. The injection of extracts was done 15 minutes before formalin tests intraperitoneally.0-5 and 20-60 minutes considered as acute and chronic phase respectively.Results: Avicennia marina has no effect on early response of pain but its effect on late phase of formalin test in chronic response of pain is significant (P<0.05). This effect was the same as morphine. According to our finding Avicennia marina extract significantly reduced pain sensation in inflammatory phase of formalin test. This may be due to its essential oil which has been reported to have antinociceptive effects.Conclusions: The hydroalcoholic extract of A. marina has antinociceptive effect in both phases which is caused by formalin, and this effect may be because of the flavonoid and tannin components in plants, which have antinociceptive properties.

Background and Objectives: Individuals who listen to certain types of music, based on the personality features, experience different emotional states and physiological responses. The research investigated the effects of music on cardiovascular responses in essential hypertensive patients based on Brain/Behavior Systems and comparing the obtained data with healthy individuals.Materials and Methods: 113 Essential hypertensive men and 98 healthy men completed Carve- White BIS/BAS scale; based on the final scores 50 patients (25 BIS and 25 BAS) and 50 healthy men (25 BIS and 25 BAS) were selected. First, the blood pressure and heart rate were recorded before stimuli induction; then, the participants experienced slow rhythm music. After that, 15 minutes relaxation and a cognitive task were done, finally, the participants experienced fast rhythm music. The blood pressure and heart rate were recorded after presenting of two types of music.Results: BAS patients achieved lower scores in systolic blood pressure and heart rate after presenting slow rhythm music in comparison with BIS patients. Also healthy BAS individuals achieved lower scores in systolic blood pressure and heart rate after presenting music with slow rhythm compare with healthy BIS individuals. And there was no significant score in systolic and diastolic blood pressure and heart rate after presenting fast rhythm music.Conclusions: The BIS individuals experience negative emotions more than BAS individuals. Therefore, the role of induced mood states is important in relation to physical health.

Background and Objectives: Massive Pulmonary Embolism (MPE) is a life threating condition. MPE is defined as a 50% or more occlusion of the main pulmonary arteries or obliteration of two or more of lobar arteries.Patients often die at the primary hours as a result of right heart failure, therefore finding the signs of Right Ventricular (RV) dysfunction is helpful in early diagnostic concern of MPE in first studies for example spiral CT scans in patients with respiratory symptoms. The aim of this study was to determine the CT angiographic findings due to RV dysfunction in patients with acute MPE.Materials and Methods: We conducted analytic study. This study was performed on 80 humans by using of CT angiography for evaluation of findings due to RV dysfunction. They were obtained from CT Angiography Department of Madany Hospital in Tabriz City.Results: The mean of maximum short axis diameter of RV in case group is higher than control group and it is statistically significant (p<0.05). The mean of maximum short axis diameters of right and left ventricular ratio in case group is higher than control group and it is statistically significant too (p<0.05). The mean of superior vena cava and azygus veins diameter in case group is higher than control group and it is statistically significant (p<0.05).Conclusions: Evaluation of RV afterload findings by computed tomography could be effective in prediction of sever MPE, faster therapeutic management and resultant decreased mortality.

Background and Objectives: Cardiovascular diseases are of the most common causes of death in the world. In this study we have compared the Enhance External Counter Pulsation) EECP) method with cardiac rehabilitation method based on clinical parameters and inflammatory markers in treatment of patients with cardiovascular diseases.Materials and Methods: 44 patients with coronary artery disease were randomized in two groups: EECP group (twenty one-hour session (22patients)) and cardiac rehabilitation group twenty sessions with specific protocol (22 patients).Patient’s information was collected before and after intervention. Outcomes of study was clinical improvement and increase in serum NO, decrease in hs-CRP and endothelin1 levels.Results: 20% of patients were female and 80% were male in the range of 35 to 75 years old. The hs-CRP level in EECP group was decreased from 1.52±0.7 to 1.27±0.4 mg/ml and was decreased from 1.98±0.6 to 1.75±0.6 mg/ml in cardiac rehabilitation group. NO level was increased from 7.87±0.99 to 8.21±1.27 ng/lit in EECP group and from 8.28±6.49 to 8.31±6.26 ng/lit in cardiac rehabilitation group. And, endothelin1 level decreased in both groups (P=0.38). But was not statistically meaningful.Conclusion: Both cardiac rehabilitation and EECP were effective in improvement of class of angina and quality of life. Increase in serum NO and decrease in hs-CRP and endothelin1 levels, in patients with coronary artery diseases, were seen. But these modalities did not show preferences to each other in therapeutic approaches, at present study.

Background and Objectives: Seizure is defined as a clinical state that represents with abnormal and paroxysmal discharges in the cerebral cortex. Epilepsy refers to a neurological disorder which a patient experiences two or more seizures through cut life. The related data regarding the prevalence of epilepsy are controversial. The aim of the present study was to assess the prevalence of epilepsy in Tabriz, IRAN.Materials and Methods: In a descriptive study, 4300 individuals from Tabriz were studied using door-to-door visits. History assessment and physical examination were carried out in probable epilepsy cases and findings were assessed Results: Of 4300 individuals, 46.9% were male and 53.1% were female. Eight individuals (0.18%) with a prevalence of 1.86 per 1000 people suffered from epilepsy. There was epilepsy prevalence of 2.47 per 1000 people and 1.31 per 1000 people in male and female, respectively. Epilepsy prevalence was 1.74 per 1000 people in the 0-9-year-old group, 2.94 per 1000 people in 20-29-year-old group, 2.84 per 1000 people in 30-39-year-old group, 3 per 1000 people in 50-59 year-old-group, and 23.8 per 1000 people in ³80-year-old group. Of the epileptic patients, 62.5% were male with a mean age of 35.79±24.69 years. Tonic (37.5%) and tonic-clonic seizure (25%) were found the most prevalent types.Conclusions: Total epilepsy prevalence was lower than those reported in other region. Epilepsy prevalence in males was higher than females, which differs from some other studies. Such difference is likely due to regional differences and difference in health level and people information in this region.

Background and Objectives: In human responses to sense of hearing and equilibrium, ear plays an important role. Hearing tends to encompass a crucial role in communication. For sound transmission middle ear acts as a notable anatomical and functional figure. In chronic otitis media, affected ossicles could resulted in significant hearing loss and communicational problems. Therefore, the current study was an attempt to evaluate ossicular lesions in chronic otitis media.Materials and Methods: During a two year retrospective study, all patients with chronic otitis media were studied.Results: Amongst 196 patients, the number of cases with ossicular lesion was 56 patients (29%), which a relatively high percentage of them had cholesteatoma in middle ear cleft 33 patients (59%). In 50%, lesion was apparent in more than one ossicle (2 or 3 ossicules) mostly affecting the incus. Occurance of otitis media among patients aged 11-30 years old was evidently high.Conclusions: One of the most common complications of chronic otitis media is ossicular lesion. Early diagnosis and proper treatment could decrease incidence of the complications, especially ossicular lesions, which in return enables the hearing loss handicap prevention.

Background and Objectives: Cervical cancer is the most prevalent cancer and leading cause of death among women in most developing countries. Pap smear has been recognized as a simple screening for diagnosis of infections and pre-cancerous changes. This study intends to evaluate the level of awareness and knowledge of Herisian females regarding the cervical cancer and Pap smear.Materials and Methods: The present descriptive study was conducted on 333 married women, visiting the health treatment centers of Heris, East Azarbayjan. Data were obtained through a questionnaire that was made up and its validity and reliability was assessed.Results: One hundred and twenty eight of women with the age of 15<years old were aware of cervical cancer (38.4%) and 203 were unaware (61%). The percent of women referring for pap smear test was 49.8 (half of participants) and the other half didn’t get this test.Conclusion: Regarding the low level of awareness (61%) about the cervical cancer among women in this region and the appropriate performance, it seems that vast educational programs are required to be run in order to promote the level of awareness and knowledge in women and their performance in order to prevent the cervical cancer.

Background and Objectives: Epilepsy is a major cause of morbidity in patients. Elaeagnus angustifolia has antioxidant and anti-inflammatory activity. The effects of this traditional herbal medicine on Pentylenetetrazole (PTZ) -induced seizure have not been studied yet. The present study evaluated the effects of E. angustifolia on PTZ induced seizure in male mice.Materials and Methods: 30 male mice (30±5 g) were randomly divided into 5 groups including: control, normal saline, phenobarbital and E. angustifolia’s extract group at doses 200 and 400 mg/Kg. The groups were intraperitoneally administered 3 mg/kg phenobarbital, 200 and 400 mg/kg E. angustifolia’s extract for 2 hours before PTZ injection and 1 ml/kg normal saline for one week (n=6 per group). Seizure induced by administration of PTZ (1%) solution via tail vein of mice. All data were expressed as mean±SEM. One way ANOVA used for statistical evaluation. Statistical significance was accepted at P<0.05.Results: The administration of Elaeagnus angustifolia’s extract at doses 200 and 400 mg/kg was significantly increased Seizure threshold in PTZ-induced mice compared with control group (P<0.001).Conclusion: The hydroethanolic extract of Elaeagnus angustifolia has anticonvulsant effects, possibly through an interaction with inhibitory and excitatory system, antioxidant mechanisms, and ion chennel inhibition.

The globally-distributed widow spiders are among the venomous and dangerous species of arachnids. Widow spider bites are prevalent in the majority of countries. Since widow spiders had not been previously spotted in the Eastern Azerbaijan Province, we decided to report the cases. This is the report of 4 patients, who had been bitten by widow spiders around Kaleybar and Ahar regions in Eastern Azerbaijan Province, Iran. The patients, complaining of black colored spider bite, had been dispatched to the Emergency Medical Services Center of the province. Based on the patients’ symptoms, we suspected the bites belonged to widow spiders. We visited the residence of the patients and finally managed to hunt the spider in the grain fields near Abish Ahmad, a subsidiary to the City of Kaleybar, where three cases had been bitten. Examinations of the hunted spider in the zoology laboratory of Tabriz University revealed its species as Latrodectus dahli. Bite of the widow spider results in stimulation of the nervous system, hypertension, tachycardia, muscle spasms, and severe pains in patients, which need hospitalization, palliative care, and in some cases antidotes.