MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2004 | Volume:38 | Issue:62|Papers Count:22

Background and Objectives: There are reports indicating that fatty acid transport is affected by many biochemical parameters including trace metals. In this study the effect of Mn on oleic acid transport was investigated. Materials and Methods: EGS was prepared from rat intestin and incubated in appropriate medium containing oleic acid. The transported oleic acid inside the EGS is measured spectrophotometrically under different conditions of temperature and concentrations.Results: Mn inhibited oleic acid transport in a dose dependent manner. Oleic acid transport is further inhibited if Na+ is excluded from the medium.Conclusion: Oleic acid transport appeared to be a Na+ - dependent process and Mn may exert its inhibitory action by interfering with this system.

Background and Objectives: The use of chemical weapons produces widespread and indiscriminate casualties. The acute and chronic effects of these agents have been reported and documented. The purpose of this study was to assess quality of life in chemical attack survivors in Sardasht, Iran. The quality of lives of chemical victims were compared with the quality of lives of a general population sample. The impact of demographic characteristics and severity of disability on quality of life were examined too.Materials and Methods:The sample of the study consisted of 232 chemical attack survivors and 100 individuals as a control group. Data were gathered by interviewing and studying medical files. The interview schedule consisted of demographic information and quality of life scale in which physical, psychological and social aspects were measured. Information about medical consequences of chemical weapon exposure and severity of disability were obtained by studying medical files. Results: Chemical victim group consisted of 76 female and 156 male subjects. Females comprised 38% of control group. The mean age was 41.05 11.1 and 37.26 11.24 for chemical victime group and general sample population respectively. The results showed a decline in quality of life scores of chemical victims in comparison to the general population sample (p=0.00001). There were significant correlations between the life scores and occupation or education. A significant negative correlation was also found between the severity of disability and quality of life scores (p=0.0001).Conclusion: Late adverse effects of chemical weapons can cause some limitations in physical, psychological and social aspects of ones life and diminish the quality of life.

Background and Objectives: Sodium Benzoate mouthrinses named Plax have been introduced to the market which claimed that their use before brushing enhances dental plaque reduction through their ability to decrease the adherence of plaque to the teeth. Recently, a similar product has been introduced to the Iranian market. Since studies on Plax have contradictory results and the effectiveness of this type of domestic product has not been investigated adequately, this study was conducted to evaluate the plaque removal effects of this mouthrinse.Materials and Methods: A total of 50 dental students volunteered in this study. The volunteers were prohibited from any plaque control for 36 hours before the study. In the first appointment, after recording of plaque index, brushing was done by the investigator with an identical brush and similar method. In the next appointment procedures were the same as the previous step except for the subjects used for mouthrinse before brushing. The data were analysed by paired comparison t-test. Results: There was no significant difference between mean plaque index reduction with using the mouthrinse (1.47) and not using it (1.44) (p=0.422).Conclusion: with the limits of the present study it can be concluded that a single rinsing with pre-brushing mouthwash may not improve plaque removal efficacy of brushing.

Background and Objectives: Urinary incontinence is a distressing and disabling condition, presented with an involuntary loss of urine objectively and it causes social and hygienic problems. Researchers believe that childbearing is one of the major predisposing factors for stress urinary incontinence.Materials and Methods: This was an experimental study performed in order to assess the effects of pelvic muscle exercise on stress urinary incontinence. Data collecting instruments were patient files and a questionnaire that completed by interviewing with postpartum women those have signs of stress urinary incontinence during pregnancy. Samples were categorized in control and case groups every other day. Pelvic muscle exercise was trained only to the experimental group and both groups followed up 6 and 12 weeks postpartum. Data were analyzed by kappa- agreement test, t- test, X2 and kappa comparing between two groups.Results: According to the results of this study, pelvic muscles exercise during 6 and 12 weeks postpartum leads to a statistically reduction of the frequency of leakage (6 weeks p = 0/001 & 12 weeks p = 0/04 ) and further decreasing stress- related leakage case rather than control group.Conclusion: Regarding to relationship between stress urinary incontinence and pelvic muscle exercise, results of this study can be received as a document to health providers for training this exercise in peri and postnatal care.

Background and Objectives: Acute myocardial infarction (MI) is usually accompanied by leukocytosis and increased neutrophils. However , still it has not been definitely recognized that whether this process is caused by myocardial defects or not. Few studies are availale which have reported about the relationship between neutrophil and short - term risks of myocardial complications such as congestive heart failure (CHF) after MI. In this case neutrophil count can be used as a predictor for CHF in patients with acute myocardial infarction.Materials and Methods: A sectional study was carried out on a population of patients with MI who had been hospitalized in CCU units. Blood samples were withdrawn from all of the patients to count neutrophils and also all interfering agents that could cause an increase in WBC counts were eliminated.Results: Total 50 patients , 84% men and 16% women , were studied. Among these 50 patients , 25 patients were affected by CHF (Ejection Fraction<40%). 32 patients (66%) showed relative neutrophilia (Neutrophil count>66%) while 36% showed no neutrophilia. Two groups were compared by T-test with respect to the average percent of neutrophils and the difference significant statistically ( p=0.001). Totally among 54% of patients who had been affected by CHF,92% showed relative neutrophilia (N> 65 %) at the beginning. Conclusion: This study clearly indicates that the presence of relative neutrophilia in patients with acute MI during the early 12-houre period is completely related to the incidence of CHF at first 4 days.

Background and Objectives: There are some educational organizations where the scarcity of teachers are evident. The assignment of student as a teacher has recommended by specialist as well as social- medical experts. The recruitment of senior students to teach the juniors have actually been practiced occasionally. The objective of this study was to evaluate the effectiveness of such cases.Materials and Methods: The third-year medical students were resided in health houses randomly to practise health related subjects. In one group the senior students "interns", who had been selected by chance, appointed as a tutor. In the other group a number of educational technicians with more than five years experiences in the same field were appointed too. At the end of the course 78 questionnaire were completed by learners on educational performances of tutors. The collected data were classified and analyzed.Results: In average, the total evaluation scores of educational technicians (E.Ts) performances was 84% and those of "Interns" was 80% (4% lower than those of "E.Ts"). However, the differences were significant.The responses to six out of eight questions concerning to "E.Ts" were excellent whereas of "Interns" were only two. On the other hand, in seven out of eight questions the "Interns" were ranked weak in comparison to the "E.Ts" who were ranked weak in only one question.Conclusion: As a final result it can be concluded that the perfomancecs of "E.Ts" due to their experiences in conducting the medical students on the field work were more efficient.

Background and Objectives: Amblyopia is an acquired deficiency in eye vision that is caused by an existing ocular disorder in the children. The main clinical conditions that lead to amblyopia include disorders that cause blurred images on the retina of one or both eyes. Strabismus is also one of the main causes. Because of its relatively high prevalence in pediatric ophthalmology (2-5% in different studies) and for its potential risks on losing ones vision, necessity of early diagnosis and adequate treatment becomes evident. The study was conducted to screen amblyopia among children aged 6-10 years in Urmia.Materials and Methods: In this study about 55000 cases were screened by Snellen charts. For diagnosis of actual patients and determination of causes of their illnesses, we used gold standard examinations with ophthalmologist. After that SPSS v9.0 soft ware was used for description and analysis of data. Results: 2955 out of children (5.3%) in the screening process met the referral criteria. Mean visual acuity of this group had a significant difference compared with those who did not have referring criteria. Also the rate of wearing eyeglasses in this group was more than others (p<0.00001). Despite the wearing of eyeglasses, correction in vision was not complete. Finally, 58.1% out of the referred cases had not got amblyopia but the remained (41.9%) were diagnosed as amblyopia. So its prevalence in the children aged 6-10 in Urmia determined as 2.2%. This ratio had significant differences from the gender point of view (2% in females vs. 2.4% in males, p<0.00001). Refractive error with 75.2% was the main cause of amblyopia. Other causes were such as strabismus, eye anomalies, ptosis, opacity and idiopathic.Conclusion: It seems that the results of this study are comparable with other studies and indicate high prevalence of amblyopia in these age groups as well as its preventability and adequate treatment with early diagnosis of causes.

Background and Objectives: Dermatophytosis refers a group of infections that cause keratinised tissues such as skin, hair and nails. Infections caused by dermatophytes are named according to the anatomical location involved as tinea capitis, tinea corporis, tinea barbae, tinea cruris, tinea manuum, tinea pedis and tinea unguium. The aim of this study was to evaluate tinea cruris in patients referred to the clinical laboratory of Tabriz University of Medical Sciences (1998-2001).Materials and Methods: This study was performed on 2150 cases referred to mycology laboratory. 291out of cases had lesions (positive samples) on crural folds. Skin scales were taken from suspected lesions. A portion of each clinical specimen was examined microscopically. The remaining portion of specimen was inoculated on mycologic media and results reported after 3 or 5 weeks.Results: The results indicated that 125 (42.9%) cases had tinea cruris caused by dermatophytes. 82 (28.2%) out of cases were male and 43 (14.7%) female. Other fungal agents such as candida 21 (7.2%) cases, malassezia 11 (3.8%) cases, bacterial agents such as corynebacterium minutissimum 82 (28.2%) cases were isolated.Conclusion: These findings suggest that epidermophyton floccosum with 93 (74.4%) cases is the most etiological agent of tinea cruris. Trichophyton mentagrophytes with 26 (20.8%) cases and trichophytone rubrum with 4 (3.2%) cases are the other agents responsible.

Background and Objectives: Polygalacturonase enzyme is produced in pectin and polygalacturonic acid culture media by a wide variety of microorganisms, such as Fusarium oxysporum, which have important application in medicine, pharmacology and food industries. The purpose of this study was to extract and purify polygalacturonase enzyme by ion exchange chromatography techniques.Materials and Methods:Fusarium oxysporum strain F58 was obtained from "Jahad Daneshgahi" institute. The previous studies have shown that this strain can provide large quantities of enzyme. Purification of polygalacturonase enzymes was achieved by cation exchange chromatography on CM-Sepharose Fast Flow column equilibrated to pH 5.5 with 50mM sodium acetate buffer. Elution of the column was carried out with 1 mol NaCl gradient. Results: The results of chromatography showed one enzyme activity peak between 0.2-0.4 of gradient salt in purification profile. Fractions with highest enzyme activity were pooled and the precipitated proteins were used for electrophoresis by SDS-PAGE methods. SDS-PAGE showed two distinct bands about 38 and 40 KDa. These two bands showed PG activity in gel containing pectin as substrate (Activity staining). Conclusion: Regarding the importance and value of this enzyme, scientific improvement and cost effectiveness of production processing, extraction, purification and production of this enzyme could be important due to its application in medicine and industry.

Background and Objectives: Aspergillus species are primarily opportunistic pathogens and, with a few exceptions, cause invasive disease only in an immunocompromised hosts. During last two decades, the importance of fungal disease has been increased dramatically due to an increased occurrence of tuberculosis, chemotherapy-induced neutropenia, AIDS, open chest surgery and use of antibiotics and immunosuppressive therapy. The production of extracellular phospholipases by pathogenic fungi such as A. fumigatus are involved in the degradation of target cell membrane phospholipids in invaded tissues. Materials and Methods: Using degenerate primers based on homologous amino acid sequences of fungal phospholipase B (plb) gene, PCR products of 545bp were generated. Sequence analysis revealed that the sequence had a high homology to published plb sequences sharing highest homology to Aspergillus oryzae PLB (76% identity). Inverse PCR was used to attempt to clone the entire plb1 genes. Initially, genomic DNA was digested with selected restriction enzymes and self-ligated with T4 DNA ligase to give circular DNA for inverse PCR (IPCR) for afplb1. IPCR with Xho I self-ligated digest gave product of 1.8 Kb for afplb1 and was found to encode the 3 ends of gene and using CAP assembly software this sequence was assembled with 545 bp sequence. Results: BLST X and GeneFinder analysis revealed that the first 960 bp of assembled total 2197 bp (after deletion of similar bp from both sequences) encoded the 3 end of afplb1 gene.Conclusion: The sequence availability of partial afplb1 gene and after that full sequence of this gene represents a major breakthrough in the study of this opportunistic pathogen and function of plb gene in pathogenesis of A. fumigatus. Also phylogenic tree analysis of afplb1 gene shows that plbs and potential plb analogues are contained in a large cluster of the plb family. A. fumigatus is more closely related to A. oryzae, A.niger, P.notatum, and N. crassa plb than other fungi.

Background and Objectives: The objective of this study was to investigate the effects of walnut on the lipid profile of normal and hyperlipidemic men.Materials and Methods: One hundred and twenty one male subjects (aged 28-65 years) were randomly assigned into two groups of normal and hyperlipidemic men. Each group was then divided into five subgroups, and fed 25, 50, 75, 100 and 125 grams of walnut per day for the period of 30 days. In the second period of feeding, only half of the subjects in each subgroup were asked to consume the different levels of walnut for another 30 days as the second phase of study. Blood samples were taken from subjects at the beginning and the end of each feeding period and were analyzed for cholesterol, LDL-cholesterol, HDL-cholesterol, VLDL and triglyceride.Results: At the beginning of the study, the mean values of cholesterol, LDL-C, triglyceride, VLDL and LDL/HDL were 218, 133, 213, 28, mg/dl and 4.5 respectively. They significantly reduced to 185, 105, 178, 32 mg/dl and 2.3, respectively at the end of the study. The highest reduction was observed in subjects consuming 75g/day of walnut. There was an increase in triglyceride level in some subjects consumed more than 100 g/day of walnuts. Conclusion: It is concluded that adding some amounts of walnuts into the normal daily diet may favorably modify the lipoprotein profile, and decrease the serum cholesterol in normal and hyperlipidmic men.

Background and Objectives: From many years ago, operating room has been as a noxious place to their nurses. Most of them are prone to be involved by dermatitis, because of touching chemical materials, repeated washing of hands and wearing surgical gloves. Recognizing cases with dermatitis and its etiology and teaching personnels in preventing this will be useful. The purpose of this study was to determine the prevalence of operating room nurses hand or arm dermatitis.Materials and Methods: This was a descriptive study in which the operating room nurses consisted the community. Thirty-nine persons were chosen as a research sample based on understudy courses and simple sampling method, and descriptive statistics was used to describe the data.Results: Among 39 cases, 84.6% (33 persons) were in contact with harmful chemical materials as well as surgical gloves for 3.4 hours in every shift (x’=3/38).Conclusion: Many of operating room nurses prone are to dermatitis due to the contact with chemical lotions and cleansing agents (detergent), scrubing, repeated washing and contact with latex gloves. At least for one time they have a history of hand and forearm dermatitis.

Background and Objectives: Posterior fossa hemtomas are one of the rare complications of occipital traumas. They are almost always accompanied with skull fractures. From the clinical point of view, they are presented with brain stem compression signs and hydrocephalus, thus the diagnostic procedures must be done immediately.Materials and Methods: This study was a retrospective one, which had been included 89 patients with posterior fossa epidural hematomas.Results: From the 89 patients with epidural hematomas, 5 cases had posterior fossa epidural hematomas. The mean age was 15.8 years and there were occipital bone fractures in 3 cases.Conclusion: The immediate diagnostic and treatment procedures must be done because the posterior fossa has little compliance and the compression on brain stem is dangerous.

Background and Objectives: The beta- thalassaemia is one of the most common genetic disorders in Iran. About 10 -15 thousands of Iranian population are estimated to be affected by this abnormality and the risk for each Iranian, being a carrier, is about 1/30.Materials and Methods: The present approach was performed on more than 80 beta-thalassaemian patients from the central part of East Azarbaijan, Iran. The mutation analysis was performed using multiplex PCR, ARMS PCR and reverse dot blot analysis.Results: The results indicate that the IVS II- 1 (G→C) is the most common mutation, with a frequency of 32%. The frequency distributions of the other mutations were as follows: IVS I - 1 (G→C) 22.67%, Frame Shift 8/9 (+G) 18.6%, IVS I -110 (G→C) 16%, Condon 30 (G→C) 5.34% and IVS I - 5 (G→C) 2.6%. A pair of cases was revealed to be undetectable by using the primers conducted in this study Conclusion: The results obtained from the present study suggest that the prevalence pattern of the mutation on beta- globin gene in the area of the study may differ from those reported for other parts of the country. However, these outlines are favorably compared to those reported for Iranian immigrates in the United states.

Background and Objectives: Refractive errors have relatively higher prevalence in populations and myopia is byfar the most of them (25%). Many efforts have been made for correction of myopia. Radial Keratotomy (R.K) is one of them. The aim of this study was to evaluate the longterm refractive, keratometric and visual results after RK at Alavi Eye Hospital in Tabriz.Materials and Methods: This prospective study was done from 1997 to 2001 on 50 eyes from both sexes. In all patients slit lamp examination, fundus exam, refraction with and without cycloplegia, ultrasonic pachymetry and corneal topography were done and recorded. Through local anesthesia with a 0.2mm diamond knife, American incisions performed with standard nomograms (with regard to the age , sex , degree of myopia, pachymetry and topography). Slit lamp examination, visual acuity, checking refraction and topography were done in first week and 3 months after operation and in year 2001, as well as results analyzed with statistical methods.Results: the mean age of patients was 29 (74% male and 26% female). The mean duration of follow-up was 10.5 months. The average central pachymetry was 536.68µ, and had not meaningful relation with the degree of myopia. Average keratometry before and after operation was 43.75D and 40.67D respectively. The average myopia before surgery was -5.07 after which decreased to -1.50. Uncorrected visual acuity in 80% of the eyes was 8/10 or better. The most complaints after surgery were disturbances in night vision and blurred distance vision in 13 out of cases. Hyperopic shift was not seen and undercorrection was the most prevalent complication.Conclusion: With regard to the successful RK in correction of mild to moderate degrees of myopia, it is effective in cases of spectacle intolerance or vocational limitations.

Background and Objectives: Congenital aural atresia (CAA) occurs in 1 per 10000 to 20000 live - births and leads to conductive hearing loss. CAA can be associated with inner ear abnormalities. Management of unilateral CAA is controversial. Various surgical approaches, timing of repair, associated microtia, and variable hearing results play a role in this controversy.Materials and Methods: There were 11 cases with CAA who underwent correcive surgeries. Preoperative and postoperative hearing levels, associatied microtia, pneumatization of mastoid air cells, course of facial nerve, ossicular chain position, surgical approach, method of ossicular reconstruction, complications, sex and age distribution were evaluated among these 11 cases.Results: Hearing improvements were excellent in 8 out of 11 cases in which postoperative speech reception threshold (SRT) was 30 dB or less.Conclusion: Repair of CAA can be done successfully in patients older than 4 years of age with pneumatized temporal bone and significant conductive hearing loss.

Background and Objectives: Determination of colloid osmotic pressure (COP) is extremely important in diagnosis and prophylaxis of several diseases. Relationship between COP and total protein (TP) concentration with constant albumin to globulin ratio (A/G) has developed previously as empirical models. The A/G variation plays an important role in COP calculation for such determination. The purpose of this study was to determine the relationship between COP,TP and colloid absorption(Abs).Materials and Methods: 300ml human serum was obtained. Serums with different TP and A/G were prepared by adding proteins. In order to obtain sample with different TP and constant A/G, each sample was diluted with saline. COP, TP and Abs were measured and obtained equation between these factors. For more clinical validity of such equation, serum TP of 50 hospitalized patients were measured and classified into three groups: TP<5gr/dl, 5gr/dl<TP<6GR TP and dl>6gr/dl. Abs was measured with spectrophotometer and COP measured through colloid osmometer and calculated with obtained equation.Results: The following equation was obtained as a satisfactory relationship between COP, TP and Abs in human plasma. All coefficients were statistically significant.COP = 1.8 x Abs x TP + 5.5 (r2=0.92)Conclusion: Since determination of Abs is easier than measuring of A/G ratio, this proposed equation can be an easy method for calculation of COP in Emeregency rooms in which colloid osmometer not available.

Background and Objectives: The roles of contractility disorders of gallbladder and bile stasis have well been defined in the development of gallbladder diseases. Opium addiction may be causative in this view.Materials and Methods: We prospectively studied 100 consecutive patients with acute cholecystitis underwent early open cholecystectomy regarding variables like age, gender, parity, obesity, oral contraceptive, addiction to opiate, socioeconomic problems and other systemic diseases.Results: In this study there was a higher prevalence of biliary tract disease in the patients with positive history of addiction to opiates.Conclusion: It is clear from this study that older females, multipar patients with the history of opium usage have increased risk of biliary tract disease and gallstone formation, and stasis, which includes temporary cessation of bile-flow into the intestine and stagnation in the gallbladder. This has also been assigned as a major role in functional disorder and stone formation and diseases.

This case of osteoid osteoma is reported for two reasons. First, for its rarity and unusual location and second because it demonstrates that the history of a painful condition may lead to the correct diagnosis . A 17-year-old boy experienced spontaneous nightly pain in the distal phalanx of his right forth toe. At first because of pain, sewelling and tenderness infection was considered and he received antibiotics. After several months x-rays showed a cystic lucency and after surgery the diagnosis of osteoid osteoma was established.

Pulmonary Arteriovenous Fistula (PAVF) is one of the most rare congenital malformations of the pulmonary vasculature and most of them are seen in association with congenital hereditary hemorragic telangiectasia (Rendu- Osler- Weber syndrome). Although most of these patients are asymptomatic , they may be presented with signs and symptoms like dyspnea, cyanosis, hemoptysis, hemothorax and clubbing of fingers. Rarely it may be complicated with transient ischemic attacks (TIA) or stroke and brain abscess. Angiography is the standard procedure for diagnosis of PAVF but spiral CT has also been used with comparable results. Because of complications of PAVF most of patients need some kinds of treatment. Surgery and pulmonary artery embolization are the two main treatments of choice in this condition. We present a 13 year- old boy with headache, hemoptysis and dyspnea who was admitted with hemoptysis and early fatiguability on exertion. Radiology examination showed lobulated mass in RLL and right hilum. Finally surgical intervention proved excellent results. Surgery is the best treatment of isolated (single) AVM or PAVF.