MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2011 | Volume:33 | Issue:3|Papers Count:15

Background and Objectives: It is assumed that imbalance of trace elements may trigger the onset of alopecia. The aim of this research was to assess the level of zinc and copper contents in the scalp hair and level of lipid peroxidation enzymes in serum of androgenetic alopecia and alopecia areata patients.Materials and Methods: This prospective study was conducted in Department of Dermatology, Sina Hospital and Department of Biochemistry, Tabriz University of Medical Sciences. The study population consists of 27 patients with alopecia areata and 27 patients with androgenetic alopecia. Moreover, 27 age- and sex-matched healthy control subjects were included. The level of zinc and copper contents in the scalp hair and serum and level of lipid peroxidation enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPX) and malondialdehyde (MDA) in the serum of androgenetic alopecia and alopecia areata patients and healthy control subjects were measured.Results: The mean hair zinc level in alopecia areata patients, androgenetic alopecia patients and controls were 98.33, 105.35 and 129.52 mg/dL, respectively. The mean level of hair copper level in the study and control groups were 7.91, 7.25 and 10.34 mg/dL, respectively. The mean serum level of SOD, MDA and GPX in the study and control groups were (1945.25, 1761.57 and 2296.77 mg/dL), (3.64, 3.49 and 1.62 mg/dL) and (129.11, 118.84 and 138.74 mg/dL), respectively. The zinc and copper contents of the hair and serum were significantly lower among the alopecia patients compared to the controls (P<0.05). The serum level of SOD and GPX was significantly lower and level of MDA was higher among the patients with alopecia areata and androgenetic alopecia compared to the controls (P<0.05).Conclusion: Low levels of zinc and copper in the hair and serum and low SOD and GPX along with high level of MDA in the serum may play a role in the pathogenesis of alopecia areata and androgenetic alopecia.

Background and Objectives: Childbirth experience is one of the most important life experiences for women. Quality of these experiences influences well-being of both the woman and her child, and relationship between mother and her child and also partner. The objective of this research was to assess the quality of nulliparous women’s childbirth experiences.Materials and Methods: This research was performed by using open and in-depth interviews along with verbal and non-verbal probing and purposive sampling. Volunteers expressed their views toward their experiences of vaginal childbirth next day after delivery. Speeches were taped and then recorded and analyzed using Colizzi method.Results: Five main themes, each composed of several sub-themes, were extracted. The main themes included physiological changes, psychological changes, midwife support, coping, changing of behaviors and views.Conclusion: The basis for maternity care should be influenced by women’s long-term experiences of childbirth. The results of this study can enhance the midwives’ ability to provide better prenatal care for the women in order to achieve their goals for a favorable childbirth experience.

Background and Objectives: Existing data show that using psychoactive drugs has increased among youths in recent years. Meanwhile, theory of planned behavior is an effective method to prevent non-healthy behaviors. Using this model as a theoretical framework, the aim of the present study was to evaluate the effect of educational preventive programs and resistance skills against substance use and perceived behavior control among university students in Hamadan.Materials and Methods: A quasi-experimental study was carried out among university students in Hamedan city during 2008-2009. A total number of 140 students were selected through randomized cluster sampling and were randomly assigned to intervention and control groups. A questionnaire, based on the theory of planned behavior, was applied to assess the variables of attitudes toward substance use, subjective norms, perceived behavior control, intention and ecstasy use.Results: The result showed that educational programs had significant effect on the average response for attitude toward drug abuse (P<0.001), subjective norms (P<0.001), perceived behavior control (P<0.001), intention (P=0.013) and ecstasy abuse (P=0.004) in intervention group.Conclusion: These findings suggest that applying the theory of planned behavior along with preventive methods are efficient tools for preventing the drug abuse.

Background and Objectives: Carrot seeds have been used in Iranian traditional medicine to treat diabetes mellitus. The aim of the present study was to assess hypoglycemic activity of the ethanolic extract of carrot seeds in normal and diabetic rats.Materials and Methods: The rats were divided into 5 healthy and diabetic (intraperitoneal administration of streptozotocin 65 mg/kg) groups; seven rats in each group. The rats in each group received ethanolic extract of carrot seeds orally. In the diabetic group the extract was administrated 72 hours after streptozotocin (STZ) injection. In seventh day, the blood glucose was measured using a glucometer. The ethanolic extract of carrot seeds was administrated two times a day in dose of 20, 50, 100, and 150 mg/kg for three days after STZ injection.Results: The extract in dose of 100 mg/kg (P<0.001), and 150 mg/kg (P<0.001) significantly reduced blood glucose level, 72 hours after the first administration of the extract.Conclusion: The results indicate that carrot seeds ethanolic extract has hypoglycemic effects at doses of 100 and 150 mg/kg in diabetic rats. Moreover, this extract possesses beneficial effect in decreasing liver cell injury and congestion in diabetic rats.

Background and Objectives: Mycoplasma pneumoniae is responsible for 15–20% of all cases of community-acquired pneumonia. The aim of the present study was to compare culture, ELISA and PCR methods in detection of Mycoplasma pneumoniae at hospitals of Tabriz University of Medical Sciences.Materials and Methods: Between May 2009 and November 2009, 200 patients were enrolled in the study. Patients were suspected to Mycoplasma pneumonia respiratory infection based on the clinical findings. Single blood sample was collected for ELISA testing and throat swab or bronchoalveolar lavage was used for both PCR and culture.Results: Two hundred patients, 50.3% males and 49.7% females with median age of 25 years, were studied. Mycoplasma pneumoniae infection was diagnosed in 12 (6%) patients with PCR method, in 10 (5%) cases with ELISA IgM and in 4 (2%) cases by culture technique. Mycoplasma pneumoniae infection was most prevalent in 5-20 year old patients.Conclusions: PCR method is more sensitive than ELISA and culture techniques. Results of this investigation indicate that PCR on a single throat swab specimen is a rapid, sensitive, and specific test that may greatly simplify the diagnosis of respiratory infection caused by Mycoplasma pneumoniae.

Background and Objectives: Percutaneous endoscopic gastrostomy (PEG) is a new feeding technique when oral intake is not adequate. The aim of the present study was to determine the indications and complications of PEG insertion and to study post-procedural nutritional status.Materials and Methods: In a cross-sectional study, 100 adults admitted to Imam Reza Hospital during 2006-2009 for PEG were evaluated. Patients’ nutritional status and complications were assessed for 6 months after PEG insertion.Results: PEG insertion was successful in all 100 patients (64 males and 36 females). The indications for PEG were neurological causes (in particular stroke) in 66 patients, recurrent aspirations in 14 patients, trauma in 9 patients, Guillain-Barre syndrome in 6 patients, esophageal tumor in 3 patients and hypoxic encephalopathy in 2 patients. Ninety nine patients were followed up for at least one time after the tube insertion. Major complication was peritonitis (1 patient). Minor complications were PEG site infection (8 patients), tube blockage (5 patients), aspiration pneumonia (4 patients), and leakage (2 patients). During 6 months of follow-up, oral feeding was resumed in 27% of the patients and the tube was removed subsequently.Conclusion: PEG is a minimally invasive gastrostomy method with low morbidity and mortality rates, and it can be easily followed up and replaced when clogged.

Background and Objectives: Today application of cavity disinfectants such as chlorhexidine after cavity preparation and before placement of restorative material has gained wide acceptance. However, some researchers believe that these materials interfere with function of adhesive resins. The aim of the present study was to evaluate the effect of chlorhexidine on microleakage of gingival margin of composite class V cavities restored with one-step self-etch (seventh-generation) adhesive resin in bovine tooth in vitro.Materials and Methods: In buccal surfaces of 60 sound bovine permanent incisors, class V cavities were prepared with occlusal margins at the enamel and gingival margins in dentin. The teeth were randomly divided into two groups of 30. In group 1, the samples were restored without chlorhexidine while group 2 specimens were restored using chlorhexidine. In order to restore the teeth, in both groups one-step self-etch adhesive resin (Clearfil tri S Bond) and Z100 composite (using incremental technique) were used. After finishing and polishing, the samples were subjected to thermocycling. Thereafter, they were immersed in 2% basic Fushin solution for 24 hours. Following sectioning, the microleakage of gingival margin of the samples was evaluated under stereomicroscope.Results: There was no statistically significant difference in microleakage between the two groups (P=0.91).Conclusion: The use of chlorhexidine as a cavity disinfectant had no effect on microleakage of gingival margin in composite class V cavities restored with one-step self-etch adhesive resin.

Background and Objectives: Postoperative nausea and vomiting (PONV) is frequent adverse event of anesthesia and surgery. Patients after middle ear surgeries are in greater risk of PONV. Likewise, this complication may destroy results of reconstruction and anatomical alignments. Numerous antiemetics have been studied for the prevention and treatment of PONV in patients scheduled for middle ear surgeries. This study aimed at comparing intravenous ondansetron and dexamethasone in this regard.Materials and Methods: In a double-blind randomized clinical trial, 219 candidates of middle ear surgery were randomized in three groups; O, D and P and studied in Tabriz Imam Reza Hospital. Patients in group O received ondansetron (4 mg, IV), in group D received dexamethasone (8 mg, IV), and in group P placebo prior to induction of anesthesia. Incidence of PONV, as well as its severity (according to Beilville scoring system) was documented during 24 hours after surgery and compared between the three groups.Results: During 2-8 and 8-16 hours after operation, the incidence of PONV was significantly higher in group P (P<0.001). Similar results were documented regarding the severity of PONV.Conclusion: Intravenous ondansetron and dexamethasone are both more effective than placebo in controlling the PONV after middle ear surgeries. Dexamethasone is significantly more effective than ondansetron in preventing the PONV.

Background and Objectives: Parasitic diseases are among the most common infectious diseases in the world. As no data are available on prevalence of intestinal parasites among primary school children in Tabriz, we aimed at assessing the prevalence of this disease, related risk factors, environmental status and behavioral habits among 6-12 year old children in Tabriz.Materials and Methods: Subjects were primary school children (6-12 years old). Based on geographical map, Tabriz city was divided into 5 areas. From each area, 2 urban health centers were selected. Ninety children attending each selected health center were randomly subjected to stool examination.Results: Of 900 pupils, 361 (42.1%) were females and 539 (57.9%) were males. Three hundred and ninety six individuals (44%) were affected by one or more intestinal parasites. The most prevalent pathologic parasites were Giardia (8.8%) and Cryptosporidium (7.7%). There was no statistical difference between girls and boys regarding the prevalence of pathologic and non-pathologic intestinal parasites.Conclusions: Findings of this research show that parasitic infections exist among the pupils in Tabriz and infectious transferring ways are active. It is necessary to educate and guide parents and teachers for special planning in order to eradicate and eliminate the related causes.

Background and Objectives: Treatment of bicondylar type of tibial plateau fracture is a challenging problem. The aim of this study was to evaluate treatment outcome of bicondylar tibial plateau fractures by modified Hybrid External Fixator (HEF).Materials and Methods: In a descriptive study, 28 patients with bicondylar tibial plateau fracture treated by HEF device in Tabriz Shohada Hospital were evaluated and postoperatively followed up for 9-12 months. We used a semicircular and one circular wire instead of the one or two loop of conventional HEF device for a better range of motion of the knee joint. Treatment outcomes including quality of walking, union condition, knee range of motion, complications, and the final outcome according to the knee score (rusmussen) were checked.Results: Twenty-eight male patients, with the mean age of 40.54±13.83 years were enrolled in the study. Complications occurred in 8 (28.6%) patients; 7 cases with superficial infection and 1 patient with deep vein thrombosis. All complications were managed medically with no significant consequences left. All the patients were able to walk with no aid except in one case. In 96.4% and 89.3% of the cases, the clinical and radiological outcomes were good to excellent, respectively according to the knee score. In 85.7% of the patients, the knee range of motion was in normal limits.Conclusion: Bicondylar tibial plateau fractures could be effectively and safely managed with innovative design of HEF device.

Background and Objectives: Clinical and epidemiological characteristics of Henoch-Schonlein purpura (HSP) vary in different geographical areas. The aim of this study was to determine the clinical features and long term outcome of HSP in our institution. Materials and Methods: In this cross sectional study, medical records of 75 patients with diagnosis of HSP admitted to Tabriz Children’s Hospital during 2001-2007 were reviewed. The studied variables included demographic and clinical features, recurrence rate and long term outcome.Results: The mean age of the patients was 6.81±3.06 years. The male to female ratio was 2.5 /1. Purpura was detected in all the patients. Gastrointestinal (GI) symptoms were found in 73.3%, arthritis in 65.3% and renal involvement in 34.6% of the patients. Fourteen patients (18.6%) had GI bleeding. Nephritic and/or nephrotic syndrome was detected in 16 patients (21.3%) and 9 patients (12%) underwent renal biopsy. Patients were followed for 23.85±15.21 months. Three patients (4%) developed chronic kidney disease in long term follow-up. Recurrence was detected in 9 patients (12%). There was no significant correlation between sex, recurrence rate and clinical symptoms (renal and intestinal involvement and arthritis). Frequency of the renal involvement was significantly higher in children older than 8 years old (P=0.02).Conclusion: Distribution of age, sex, frequency of clinical symptoms and recurrence rate in our institution is similar to other studies. But the frequency of chronic kidney disease in our study is higher than that reported in the literature. This may be explained by longer follow up and performance of study on admitted patients in a referral center.

Background and Objectives: Surgery is the main treatment of pilonidal disease. Management of post excisional cutaneous and subcutaneous defect is an important problem. Various techniques have been introduced in this regard; however, the best approach is yet open to debate. This study aimed to evaluate the results of complete excision and marsupialization.Materials and Methods: In this retrospective setting, profiles of 320 patients with pilonidal disease operated by excision and marsupialization technique in Tabriz hospitals between 2001 and 2009 were studied. Patients’ demographics, as well as short-term and long-term outcomes were recorded.Results: In total, 320 cases with pilonidal disease, 288 males and 32 females with the mean age of 26.3±8.5 years were enrolled. Majority of the cases (98.8%) were discharged on second day of operation. The mean time of surgical wound healing was 4.4±3.2 weeks after the operation. The one-year recurrence rate was 1.3% and reoperation was indicated in 0.3%. There were a few morbidities without mortality.Conclusion: Complete surgical excision and marsupialization is a safe and effective procedure with a few complications in treating the pilonidal disease.

Background and Objectives: Treatment of choice for enterococcal infections is usually synergistic combination of penicillin or a glycopeptide with an aminoglycoside (gentamicin or streptomycin). The efficacy of this combination is of debate due to emergence of multidrug resistant enterococcal strains. The main aim of this study was to determine the rate of intestinal colonization with antibiotic resistant enterococci among patients admitted to high risk wards and also out-patients.Materials and Methods: This study was performed by collecting stool or rectal swab specimens. Obtained isolates were confirmed as enterococci and characterized up to species level. Minimum inhibitory concentrations (MICs) of ampicillin, gentamicin and vancomycin were determined by agar dilution and/or E-test. Polymerase chain reaction (PCR) was performed to detect vanA/ vanB and E. faecalis/ E. faecium genes.Results: Among 291 tested enterococcal isolates, 240 (82.4%) isolates were resistant to gentamicin and 84 (28.8%) were resistant to ampicillin. Of these, 12 (14.2%) strains showed high level resistance to ampicillin (MICs, ³ 256 mg/ml). Sixty three enterococcal isolates were resistant (MICs, ³ 32 mg/ml) or intermediate (MICs, 8-16 mg/ml) to vancomycin. Of these, 15 strains showed high level resistance (MICs, ³ 256 mg/ml) possessing vanA (n=12) and vanB (n=3) genes.Conclusion: Prevalence of intestinal colonization of antibiotic resistant enterococci, especially among high risk ward patients such as hematology/oncology and ICUs is of medical concern proposing improvement in antibiotic policies.

Background and Objectives: Intraabdominal adhesions (IAA) are common complications after abdominal surgery. It is believed that statins such as lovastatin may play a role in prevention of postoperative adhesions. This study aimed at evaluating the effect of intraperitoneal lovastatin on the postoperative intraabdominal adhesions in rat.Materials and Methods: In an experimental clinical trial model, 20 male rats were randomized in two 10-rat groups. The rats in group 1 (the control group) were given only 10 cc of 0.9% NaCl intraperitoneally, whereas in group 2, solution of lovastatin (30 mg/kg) in 10 cc 0.9% NaCl was employed. Number and strength of fibrotic bands as well as adhesion score were compared between the groups seven days after the first laparotomy. The serum urea, creatinine, AST, ALT, ALP and total bilirubin were also determined at the end of the study.Results: Intraperitoneal lovastatin reduced the number of the fibrotic bands more effectively than the normal saline in the control group (0.60±0.52 vs.1.60±0.52; P<0.001). Similar results were documented for the severity of adhesions (0.20±0.42 vs.1.50±0.53; P<0.001). With regard to the overall scores of adhesion, the Lovastatin was again more effective than the normal saline (.80±.79 vs.3.10±.88; P<.001). The serum measured parameters were not significantly different between the two groups at the end of study, except for the serum AST level which was significantly higher in the case group (214.60±35.88 mg/dL vs.161.60±29.23; P<0.001).Conclusion: Intraperitoneal lovastatin (30 mg/kg in 10 cc normal saline) may effectively decrease the number and severity of the intraabdominal fibrotic bands. However, increase in serum level of AST was also detected in the case group. Therefore, further studies are recommended to determine the optimal dosage with minimal complications.