MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2011 | Volume:33 | Issue:4|Papers Count:28

Background and Objectives: Glutathione (GSH) is the main interacellular anti-oxidant which act as a front line defensive mechanism against free radicals. Reduction of glutathione level, result in an oxidative stress state and gametogenesis and embryonic development. The aim of the present study is to investigate the effect of oxidative stress produced by injection of buthionine sulfoximine (BSO) on semen parameters and histology of testis in newborn and adult mice. Materials and Methods: In this study, 40 adult female mice and 20 adult male mice are used. The mice divided into 4 groups (10 in each group), including newborn and adult experimental and newborn and adult control. From the 2nd day of pregnancy the mice in experimental group received 2mMol/Kg BSO as ip for 15 days. Testis of the half of the newborns were studied on the 3rd day after delivery. The other half kept to become adult, spermatogenesis and semen parameter were studied in them.Results: In newborn mice the diameter of seminiferous tubules in experimental group were reduced in comparison to control group. In adult mice the number of sertoli cells and population of spermatogonic cells in experimental group were reduced in comparison to control group (P<0.05). In case of semen parameters, the number of sperms with quick motility were less than the control group but the number of sperms with slow motility and or abnormal morphology were higher than the control group (P<0.05). The diameter of seminiferous tubules in experimental group was also decreased.Conclusion: fetal exposure to oxidative stress induced by buthionine sulfoximine could affect fertility in adulthood.

Background and Objectives: Scar endometrioma is a rare event following cesarean section and in some cases after hysterectomy and pelvic laparoscopy. Patients with scar endometrioma are usually referred to general surgeon with diagnosis of incisional hernia or lipoma. Here, we present nine patients with diagnosis of mass in the surgical scar to emphasize the diagnostic procedures and therapeutical measures. Materials and Methods: Retrospectively, confirmed cases of scar endometrioma based on pathology reports in medical documents were selected.Data including clinical presentation, duration of symptoms, interval between operation and onset of the clinical symptoms, preoperative assessment and management were collected.Results: The mean age of patients was 29.7 years. In most patients, the common symptom was painful lump in the scar of previous cesarean section or laparotomy incision for ectopic pregnancy. Accurate preoperative diagnosis was made only in two patients. The duration of symptoms ranged from 3 months to 3 years. Ultrasonography or CT Scan had a little role in identifying the exact diagnosis. All patients underwent exploration and wide excision of the lump. There was no recurrence within a four-years follow up of the patients.Conclusion: Scar endometrioma is an important differential diagnosis in patients presenting with a painful lump in scars for caesarean section or laparotomy for ectopic pregnancy. Although extensive diagnostic work up has been suggested, surgical excision is both diagnostic and curative.

Background and Objectives: Nowadays, diabetes is one of the most common chronic diseases with an increasing incidence and prevalence in Iran and worldwide. Attitudinal and psychological factors have major roles in self-care and controlling diabetes.The aim of this study was to assess the role of health locus of control on self-care behaviors in patients with type II diabetes.Materials and Methods: In this research, 60 individuals from Tabriz diabetes center of Sina hospital were selected through randomized sampling. Data were collected through two questionnaires including multidimensional health locus of control and self-care behaviors.Results: There was a significant positive relation between the self-care behaviors and internal health locus of control and a significant negative relation between the self-care behaviors and chance. The results also revealed that internal control more predicted the self-care behavior. In addition, there was no significant difference between male and female with regard to the self-care behaviors and health locus of control.Conclusion: According to the findings of this study, the self-care behaviors showed a significant relation with health locus of control. In other words, tendency to the internal health locus of control causes an increase in the self-care behaviors.

Background and Objectives: Producing extended-spectrum beta-lactamases (ESBLs) is one of reasons for drug resistance occurrence in Pseudomonas aeruginosa isolates. The aim of the present study was to evaluate antibiotic sensitivity patterns and presence of bla VEB-1 gene in P. aerugionsa isolates collected from Imam Reza and Shahid Madani Hospitals of Tabriz, Iran.Materials and Methods: During one year period (2008-2009), 85 isolates of P. aerugionsa were collected from ICUs of Imam Reza and Shahid Madani hospitals in Tabriz and identified by conventional bacteriological tests. The antibiotic sensitivity patterns of all isolates were determined. All isolates resistant to ceftazidim were selected for determining the ESBL production by CDT method. Bla VEB-1 gene was investigated by polymerase chain reaction method. P. aerugionsa 10.2 was used as positive control strain for bla VEB-1 gene.Results: Forty three isolates (50.5%) were resistant to ceftazidim. Sixty isolates (70.5%) and 15 isolates (17.6%) were resistant to cefotaxime and imipenem, respectively.Seventy nine percent of isolates were ESBL producer. Thirteen point nine percent of the isolates contained bla VEB-1 gene.Conclusion: Considering high resistance of P. aeruginosa isolates to third and fourth generation cephalosporins, it is necessary to avoid inappropriate use of antibiotics in treatment of ESBL producing organisms.

Background and Objectives: Lower limb amputation has different etiologies and it varies with socioeconomic issues and incidence of some diseases such as diabetes and vascular diseases.The aim of this study was to evaluate causes of the amputation, the amputation level and the incidence of amputation among male and female patients of different ages.Materials and Methods: In a retrospective and descriptive study between 2002 and 2007 in Tabriz Shohada hospital, the ttiology, level and type of amputations were assessed and results were analyzed.Results: One hundred forty six medical files with diagnosis of the lower limp amputation were selected. Trauma was the most common cause of amputation (46%), followed by the vascular diseases (42%) and infection (12%). One hundred seventeen patients (80%) were male and 20% were female.Conclusion: This investigation showed that trauma is the major cause of amputation in our region and vascular problems are of second significance.

Background and Objectives: According to the high prevalence of cervical discopathy in modern life and variety of new methods introduced every day, we aimed to evaluate recently established PEEK cage insertion procedure through neck disability index (NDI) and pain score measurements before and after the surgery.Materials and Methods: In this study, 30 cervical herniated patients diagnosed through medical history, physical examination and cervical MRI were selected. Before and 6 months after PEEK cage insertion, pain score was assessed using visual analogue scale (VAS) and NDI.Results: The mean age of the patients was 44.1±8.5 years. The preoperative mean neck pain score was 9.2±1.01 that postoperatively decreased to 2.81±1.81 (P<0.0001). The mean pre- and post-operative NDI was 31.5±10.19 and 6.85±2.10, respectively (P<0.0001).Conclusion: According to the results of this study, PEEK cage insertion surgery is efficient in reducing the pain score and neck disability index.Furthermore, this procedure has beneficial effects on ameliorating the signs and symptoms of radiculopathy.

Background and Objectives: Phenylketonuria is a congenital defect in phenylalanine metabolism. Some of these patients suffer from uncontrollable seizures that lead to frequent admissions in Pediatric Intensive Care Unit. The aim of the present study was to evaluate the frequency and types of seizure as well as electroencephalographic (EEG) findings in children with phenylketonuria.Materials and Methods: In a cross-sectional and descriptive-analytic study, 50 patients with phenylketonuria in Tabriz Children’s Hospital were assessed with regard to the frequency and types of seizure as well as electroencephalographic findings.Results: The mean age of the patients was 4.49±3.67 years. Twenty five patients were male (50%). The frequency of seizures was 34%. The most common type of the seizures was generalized tonic-colonic (35.3%) and infantile spasm (35.3%). Abnormal EEG was found in 88.2% of the patients with seizure. There was no significant correlation between the seizure and age (P=0.32), sex (P=0.50), and serum level of phenylalanine before treatment (P=0.45).Conclusion: Nearly one third of children with phenylketonuria suffer from seizures. Most of these seizures are infantile spasm or generalized tonic-colonic seizure and are accompanied with abnormal EEG findings.

Background and Objectives: Complex regional pain syndrome (CRPS) is a common complication in orthopedic surgeries. The aim of the present study was to evaluate the effect of calcitonin in the treatment of patients with CRPS. Materials and Methods: In a clinical trial, 30 patients with CRPS were randomly divided into two groups: 16 patients treated with only physiotherapy and 14 patients treated with physiotherapy and calcitonin spray. Changes in range of motion, swelling and pain were compared between two groups.Results: Significant difference was not noted in the range of motion amelioration and decrease in swelling between two groups. However, patients in physiotherapy and calcitonin group had less pain than the other studied group.Conclusion: According to effective pain reduction, patient satisfaction, lack of side effects and insurance coverage for calcitonin, this spray is recommended in the treatment and prevention of CRPS.

Background and Objectives: Upper gastrointestinal (GI) cancers are one of the most common causes of mortality.Combinations of internal and external factors such as trace elements are involved in initial development of upper GI cancers. The aim of this study was to evaluate and compare serum levels of zinc (Zn) and cupper (Cu) and Cu/Zn ratio in upper GI cancer patients and control group.Materials and Methods: In a descriptive cross-sectional study, 35 patients diagnosed with upper GI cancer and 41 healthy individuals were selected. Blood samples were obtained and the levels of Zn and Cu were measured using atomic absorption spectroscopy and graphite furnace atomic absorption spectrometry.Results: The mean serum level of Zn and Cu in upper GI cancer patients was 0.62±0.15 and 1.65±.0.33 ppm, respectively. The mean serum level of Zn and Cu serum in healthy individuals was 0.75±0.14 and 1.5±0.32 ppm, respectively. There was a significant difference between the patients and controls with regard to the Zn level (P<0.001). In addition, the Cu/Zn ratio in upper GI cancer patients and controls were 2.78±0.71 and 2.04±0.51, respectively. This difference was statistically significant (P<0.001).Conclusion: Based on the obtained results, it is speculated that changes of the serum trace elements, particularity Zn and Cu, in upper GI cancer patients might play role in biological alterations of the cancer cells.

Background and Objectives: Despite acceptable bond strength of self-etch adhesive resins to dentin, some concerns remain regarding their bonding effectiveness to enamel. The purpose of this study was to evaluate the effect of doubling application time of all-in-one adhesive resins on shear bond strength of composite resin to bovine enamel.Materials & Methods: Subsequent to removing the roots and mounting 176 intact bovine incisors in acrylic resin, the facial enamel surface was abraded with silicon carbide papers. The samples were randomly divided into 8 groups of 22. In groups 1-4, four types of all-in-one adhesive resins, including Clearfil S3 Bond, G Bond, Absolute 2 and Opti Bond All-In-One were respectively used according to the suggested time by the manufacturer. In groups 5-8, the same adhesive resins were used for twice as much time recommended by the manufacturer. Then the composite of each adhesive was placed in the plastic mold and cured. Subsequent to thermocycling, the shear bond strength test was carried out and the data were analyzed.Results: The highest bond strength value was related to Opti Bond All-In-One and the lowest value was related to Absolute 2. The adhesive resin type and time showed a statistically significant influence on bond strength (P<0.0005).Moreover, there were statistically significant differences among different adhesive resins (P<0.0005). Furthermore, the interaction between the adhesive resin type and time was statistically significant (P<0.0005).Doubling the application time resulted in a significant increase in bond strength only in two adhesive resins, Clearfil S3 Bond and G Bond (P<0.0005).Conclusion: The adhesive resin type was effective in bond strength to enamel and doubling the application time of Clearfil S3 Bond and G Bond adhesive resins resulted in a considerable increase in bond strength to enamel.

Background and Objectives: Oral cancer is one of the common cancers as well as one of the 10 most common causes of mortality all around the world. According to the role of environmental and geographical conditions in prevalence of the oral cancers, epidemiological studies are of great importance. The aim of this study was to determine the ten-year prevalence of oral cancers in patients referred to the department of pathology at Emam Reza Hospital, Tabriz, Iran.Materials and Methods: In an analytical-descriptive and retrospective study, medical files of 256 patients with oral cancer were evaluated. Demographic, clinical and histopathological data were extracted and analyzed.Results: Squamous cell carcinoma was the most common malignancy (79%), followed by salivary gland malignancies (13.6%) and sarcomas (3%). The male/female ratio was 2.46/1. The mean age of the male and female patients was 57.73±17.54 years and 61.29 ± 16.54 years, respectively. Tongue was the most common site of involvement (30%), followed by lip (28%). Nearly 96% of the squamous cell carcinomas were grade I. There was a significant negative correlation between the age and microscopic grade.Conclusion: Epidemiological pattern of the oral cancer in the present study was similar to that of the other studies. The male to female ratio and the mean age of the patients has increased during the study period.

Background and Objectives: Benign prostatic hyperplasia (BPH) is a common condition in elderly men that causes lower urinary tract obstruction and bladder wall thickness. The purpose of this study was to evaluate the relation between bladder wall thickness and clinical findings in these patients before and after prostatectomy. Materials and Methods: In an interventional study, 25 patients with BPH presenting with lower urinary tract obstruction were pre- and postoperatively evaluated with regard to the bladder wall thickness, prostate volume, post-void residual volume (PVR), IPSS (International Prostatic Symptom Score), and uroflowmetry (Q-max).Results: The mean age of the patients was 69.24±9.12 years. Before and after prostatectomy, there was a significant difference between the bladder wall thickness (P=0.004), IPSS (P<0.01) and PVR (P=0.011) values.After prostatectomy, the mean Q-max increased from 6.52±2.55 ml/s to 16.16±5.07 ml/s (P<0.01). There was a significant correlation between the bladder wall thickness and the prostate volume (P=0.044) and between the bladder wall thickness and age (P<0.01).Conclusion: Evaluation of the bladder wall thickness before and after prostatectomy clearly demonstrated a high degree of correlation with bladder obstruction and relief symptoms.However, more studies are needed to show a significant correlation with IPSS.

Background and Objectives: There is controversy on the appropriate treatment of unstable distal radius fractures. The aim of the present study was to assess the surgical results of Pin-Plaster method in treatment of type C distal radial fractures of the AO classification.Materials and Methods: In a case series study, 23 patients with AO type-C distal radius fractures treated with Pin-Plaster method in Tabriz Shohada Hospital between 2008 and 2009 were studied. The patients underwent radiographic studies pre- and postoperatively and 6 months after surgery.Results: The mean age of the patients was 43.9 years. Nine patients had type C1; ten had type C2 and four had type C3 distal radial fractures of AO classification. There was statistically significant difference in the mean radial inclination, palmar (volar), radial length, radial shift and intraarticular step-off before and after surgery (P=0.001). Also we observed permanent acceptable correction ability of this method 6 month after operation comparing to early after operation (P=0.001).Conclusion: According to high correction ability, maintenance of this correction for six months, low cost and patient’s more mobility, the Pin-Plaster method is recommended in treatment of distal radial fractures.

Background and Objectives: Delayed closed reduction in a child with congenital dysplasia and dislocation of the hip (DDH) results in secondary degenerative changes in acetabulum and head of the femur, which prevents normal development of the hip. The goal of this study was to study surgical results of reduction of the hip and femoral varus osteotomy and its effect on acetabulum index correction in children with DDH.Materials and Methods: The present study was performed on 25 children aged 1-2 years with congenital dysplasia and dislocation of the hip who underwent open reduction through anterior approach incision and femoral varus osteotomy in Imam Khomeini and Shohada hospitals, Tabriz, Iran between 1988 and 1998.Postoperatively all the patients were assessed for acetabulum index, center-edge angle of the femur, range of motion of the hip and possible postoperative complications within 10-year follow-up.Results: There was neither avascular necrosis nor movement limitation of the hip. In one of the patients unilateral coxa valga was developed in the leg undergone surgery.Two of affected hips were dysplastic after 10 years. In the remaining cases, acetabulum had a normal shape and in comparison to opposite leg, there were no significant changes.Conclusion: The results suggested that after open reduction of a developmental dislocated hip in children aged 1-2 years, the decision for reconstruction of the acetabulum should be delayed at least for 3 years

Background and Objectives: Cerebral venous thrombosis (CVT) is an uncommon disorder which mainly affects women in childbearing ages. Clinical symptoms are variable, thereby making both diagnosis and treatment difficult. The aim of the present study was to report three successful treatment of progressive CVT.Materials and Methods: Three patients with progressive CVT who developed severe headache and blurred vision despite anticoagulant therapy were referred for endovascular treatment. After cerebral angiography, the involved venous sinus was detected. Thereafter, 20 mg of recombinant tissue plasminogen activator (r-tpa) was injected over 30 minutes into the thrombus site.Results: The studied patients were 41, 44 and 47 years old. Left lateral sinus and right lateral sinus was involved in two cases and one patient, respectively. All the three cases showed dramatic response to local thrombolysis and they were discharged four days after treatment with normal neurologic findings.Conclusion: Although standard treatment for CVT is anticoagulant therapy, this method of treatment is sometimes ineffective in progressive cases. In these cases, endovascular interventions and direct thrombolysis are recommended.

Background and Objectives: Umbilical vascular catheters are routinely inserted in critically ill newborn infants in most neonatal intensive care units (NICU). This study aims at assessing the incidence and risk factors of umbilical catheter associated thrombosis in newborn infants using color Doppler.Materials and Methods: In a cross-sectional analytic-descriptive study, 256 newborn infants with umbilical catheters were evaluated in Tabriz Children Hospital during a 15-month period. Color Doppler ultrasonography was employed for detection of vascular thrombosis associated with the umbilical catheter placement in the first 24-48 hours after admission, weekly until discharge and 72 hours after discharge. Accordingly, the patients categorized into two groups; those with or without thrombosis and possible risk factors were investigated.Results: Among 256 newborns, 12 cases (4.7%) had vascular thrombosis. One hundred and forty four catheters were placed in umbilical artery, 35 catheters in umbilical vein and 77 catheters in umbilical artery and vein. The rate of thrombosis was 6.9 and 5.7% in the umbilical artery and vein catheters, respectively. There was no significant relation between sex, birth weight, delivery age, type and size of catheter, location of catheterization, underlying disease and type of administered drugs with thrombosis formation.The only significant risk factor was duration of the catheterization (5.3 days in thrombosis vs.3.3 days in non-thrombosis groups; P=0.005). In 75% of the cases, thrombosis was detected 72 hours after extraction of catheters.Conclusion: Prolonged duration of the umbilical catheters is accompanied with increased risk of thrombosis. Assessment of the patient by color Doppler ultrasonography is recommended after extraction of the catheters.

Background and Objectives: The aim of the present study was to compare the effects of aerobic exercise, resistance training and combination of aerobic plus resistance training on glycemic control, cardiovascular risk factors, and body composition in patients with type 2 diabetes mellitus (T2DM).Materials and Methods: In this interventional study, 152 adults aged 33-69 years with T2DM were recruited from clinic of endocrinology. After a 2-week run-in phase training, 80 subjects were randomly divided into four groups of 20 individuals; aerobic, resistance, combined training, and control groups. Exercise training was performed three times per week for 52 weeks.Results: Significant reduction in the mean HbA1C was noted in the three training groups. All subjects of the training groups showed improvement in postprandial glucose level, blood pressure, Vo2max, and muscular percentage. Furthermore, the reductions of triglycerides in the aerobic and combined training groups were significant.Also, a significant change was observed in body fat percentage in the resistance and combined groups. Combination of two forms of exercise training led to better enhancement in HbA1C and triglycerides compared with each of the aerobic and resistance groups.Conclusion: Both aerobic and resistance trainings are effective interventions for management of T2DM complications.However, the combined training is associated with further enhancement in the studied parameters.

Superior vena cava (SVC) syndrome is caused by compressive effects of intrathoracic lesions on SVC and subsequent occlusion in venous drainage of head, neck, arms and upper part of chest. SVC syndrome causes different signs depending on the intensity of involvement.Here, we report a 54-year-old man with SVC syndrome due to calcified lymphadenitis, which is one of the rare causes of this syndrome.

Congenital pulmonary airway malformation is a rare hamartomatous lesion of the lung, which is mostly cystic and fatal. This malformation is the most common congenital lesion in the lung. This lesion is congenital; however prenatal ultrasound examination can assist in prenatal diagnosis. Here, we report autopsy of a 20-weeks fetus with congenital pulmonary airway malformation. This report includes macroscopic and microscopic findings as well.

Mucormycosis is a highly aggressive fungal infection which has the most aggressive behavior among all fungal infections. This infection typically affects immunocompromised patients and is rare in healthy individuals. Foreign bodies in open injuries may serve as the most common feature of mucormycosis infection in healthy patients. Early diagnosis is essential for successful treatment. Her, we report mucormycosis in a 52-year-old female without any systemic disease, with the history of an extraction of a maxillary first molar for about one month ago. Signs and symptoms included pain in the socket, swelling in maxillary alveolus with diffuse erythema, discharge in the socket, necrotic and exposed bone. In histopathological study, mucormycosis was reported. The patient was treated with debridement, fluconazole, nutritional support and hydration which resulted in patient’s recovery. Foreign bodies like dental calculus and delayed epithelialization in the socket may be considered as the predisposing factors in this case.