Medical Journal of Tabriz University of Medical Sciences
Year:2013 | Volume:35 | Issue:4|Papers Count:18

Background and Objectives: Since the reduced renal excretion of tumor markers in the follow-up and treatment of patients with renal insufficiency or hemodialysis is controversial. The aim of this study was to evaluate serum levels of different markers CA15-3, AFP, CA19-9 and CEA in patients with impaired renal function.Materials and Methods: 100 patients admitted to the district hospital laboratory of Imam Reza and Amiralmomenin in Tabriz from July 2011 to November 2012 were selected for the study. Five groups of healthy, dialysis and non-dialysis patients with renal failure that were divided into three other groups based on creatinine clearance.Results: Relationship between different groups in serum markers CEA (P=0.99) and CA19-9 (P=0.29) was observed. In terms of serum markers AFP (P<0.001) and CA15-3 (P<0.001) correlation is observed. Correlation between creatinine clearance and the CEA (r=0.05, P=0.625), there was not significant, But the correlation between creatinine clearance and AFP-P<0.001 and r=0.53 between creatinine clearance and CA19-9 (r=-0.171, P=0.089) and between creatinine clearance and CA15-3 (p<0.001, r=-0.412) were significantly related.Conclusions: According to these results, it appears that the use of tumor markers in patients with impaired renal function should be performed with special precautions.

Background and Objectives: The effect of rehabilitation after intervertebral disc displacement surgery has not been studied yet and the proper time for starting of treatment is still controversial. The aim of this study is to assessing early rehabilitation period after lumbar disc surgery.Materials and Methods: In this clinical trial, 60 candidates of lumbar disc surgery were randomized in two groups, with 30-patient in each groups; group A were patients who received rehabilitation during the first 24 hours after operation and B were whom don’t received rehabilitation services. All patients were followed for three months after surgery. Severity of pain (based on VAS), functional status (using the Modified Oswestry index), physical examination findings quality of life (using the quality of life questionnaire sf-36) and returning to work were determined and compared among patients in group A and in group B.Results: The two groups were matched for age, sex, occupation and preoperational physical status. Changing of pain, findings of physical examination, returning to work and the functional score at the end of follow-up period in two groups were not significantly emotional problems was significantly lower in group A. Conclusion: According our findings, there wasn’t an eyecatching difference in two groups with and without early rehabilitation after surgery in midterm follow-up. So early rehabilitation has not additional benefit in these patients.

Background and Objectives: Cardiac Resynchronization Therapy (CRT) is a therapeutic modality in patients who suffering severe heart failure and Left Bundle Branch Block (LBBB). One of CRT adjustment methods is to convey the manufacturers designed program. There are also Doppler echocardiography’s methods for determining atrioventricular (AVD) and inter ventricular delay times (VV delay). This study has designed to compare CRT adjusting based on these two methods.Material and Methods: In a prospective study, CRT candidates referring to Shahid Madani Educational-Therapy and Research center of Tabriz Medical Sciences University were studied in two groups. In first group systolic and diastolic parameters were measured randomly by echocardiography and CRT programmed based on that findings. In the second group implementation only performed by manufacturer’s guide.Results: There was not any significant difference between these two groups in terms of background disease, and heart block, There wasn’t any significant differences between these two modality in term of clinical results pre-study function class, post-study function class, AVD and VVD.Conclusion: There is no additional advantage in choosing any of CRT adjustment methods based on echocardiography suggestion or based on manufacturer suggestion, comparing to each other from clinical point of view.

Background and Objectives: In high risk pregnancies mother and her fetus are in greater risk than normal pregnancies and an appropriate contraception method could prevent these risky conditions to be happened.Materials and Methods: High risk women from population unit and Kowsar center were referred and regarding the underlying medical diseases the best contraception method recommended and educated were implemented for them. After a year of education, women are surveyed again.Results: In our referees 390 women had the old age (>35 yrs) as their only risk factor. Hypertension was the medical risk in 23, cardiac diseases in 22, diabetes mellitus in 18 and asthma in 10 patients. The frequency of using different contraception methods among this high risk women was 72.8% and the most important reason for their uncompliance non satisfaction (15.9%.). 93.1% of women participant were agree with the implemented dejection and 77.2% of them were believed that those dejection were sufficient. The rate of satisfaction and usefulness about contraception method’s education were and respectively.Conclusion: We concluded that educating the women could not be enough and in order to obtain better results we need to educate husbands too.

Background and Objectives: Diabetes is assosiated with neuropatic disorders. It is related to vascular or ischemic disorders. Intermittent Pneumatic Compression (IPC) has been recomanded for treatment of peripheral circulatory disorders. IPC is based on phases of intermittent positive pressure. The purpose of this study was to determine the effect of IPC on diabetic peripheral neuropath.Materials and Methods: In this study, 17 subjects (13 men, 4 women) with diabetic neuropathy, were studied. They received 60 mmhg of IPC for 45 minutes in10 sessions, three time weekly. Neuropathy was measured by electrodiagnostic testes. Data were analyzed by using Repeated Measures ANOVA.Results: Nerve Conduction Velocity (NCV) of tibial, peronal and sural nerves significantly improved after the modally sessions.Conclusion: This study showed IPC therapy improwed diabetic neuropathy and increasing of NCV as a sign of improvement.

Background and Objectives: According to dimensions of mental disorders and researches focusing on mental disorders in the general population, the relationship between alexithymia, positive affect and negative affect with mental disorders has been investigated in this paper.Materials and Methods: for this study, 300 students were randomly selected from Razi University. In order to gather the data, questionnaires of sq_90, alexithymia (FTAS-20) and scale of positive and negative effects (PANAS-X) were employed. For data analysis, statistical indices such as correlation and regression were used.Results: The results obtained from the data analysis showed that there is a significant and positive correlation between Alexithymia and negative affect with mental disorders. It was found that there is a significant and negative correlation between negative affect and mental disorders.Conclusions: The results indicated that Alexithymia and negative affect can predict mental disorders; however, positive affect is not able to predict the mental disorders. Conclusion: Based on the results of this study, the Alexithymia and negative affect have a negative role in mental health.

Backgrounds and Objective: Glaucoma is the most common cause of irreversible blindness in worldwide and trabeculectomy is the gold standard surgical treatment in these patients.Materials and Methods: In this study the medical recordings of the patients who underwent trabeculectomy surgery reviewed and patients recalled for examination.Results: Records of 209 trabeculectomy surgery were evaluated. Most of patients (96%) before their surgery had been received antiglaucoma medications and preoperative mean deviation in perimetry was -12±6.3 and mean cup to disc ratio was 0.79±0.2. Mean preoperative intraocular pressure was 30±9.7 mmHg which was decreased to 13.6±5.2 mmHg (P=0.001) after surgery. We re-examined 78% of patients and in theses patients mean intraocular pressure were increased to 16.8±4.3 mmHg (P=0.001).Conclusion: Most glaucoma patients underwent trabeculectomy in more advanced stage of disease; however success in early postoperative period is higher than 90%.

Background and Objectives: Placental Growth Factor (PlGF) is a member of Vascular Endothelial Growth Factors (VEGF) family, which can directly act on angiogenesis, tumor cells motility, tumor metastasis, growth and tumor survival. The purpose of this study was to investigate the preventive effect of siRNA on PlGF gene in gastric cancer cells.Materials and Methods: In this experimental study, gastric adenocarcinoma cells (AGS) with 40 picomol concentration of small interfering RNA (siRNA) related to PlGF gene and cellular migration test was carried out, using wound healing model.Results: PlGF gene 24 and 48 hours after of treatment, expression inhibition showed that migration of AGS cells was prevented compared with control condition, but in 72 hours’ time interval, treatment samples showed migration reduction more than control sample.Conclusion: According to these results, reduction of PlGF gene expression may prevents AGS cells migration and metastasis.

Background and Objectives: Familial Mediterranean fever (FMF) is a hereditary disorder characterized by recurrent self-limited attacks of fever and polyserositis. The disease is associated with mutations in the (MEFV) gene. The M694V mutation carries a significant risk for amyloidosis. The purpose of this study was to evaluated renal involvement in different genotypes of familial Mediterranean fever among patients diagnosed in East Azerbaijan state.Material and Methods: Five hundred genetically identified FMF patients were included in our study and their demographic Characteristics, clinical manifestation and laboratory findings were studied respectively. According to their genotype and heterozygocity or homozygocity patients were divided into 4 groups (M694V/M694V, M694V/other, other/other, E148Q/other). Renal involvement defined by the presence of glomerular hematuria and persistent proteinuria unrelated to other conations.Results: Among our cohort we discovered nine patients (1.8%; M/F: 5/4) with renal involvement. Eight of them Kidney biopsy was performed and it was compatible with amyloidosis. One patient had acute glomerulonephritis with meningeal proliferation and these patients had E148Q mutation. The most frequent mutation among other patients was M694V (42%).Conclusion: The results of this study showed that in other ethnicities ‘like previously reported results M694V mutation is the most important genetic factor for renal involvement in FMF.

Background and Objectives: training sessions has become a common habit among athletes aiming to reduce soreness, but there aren't strong scientific rational behind this belief. Hspb1 gene, which expressing heat shock protein 25 has an important role in recovery and adaptation to exercise. The aim of this study is to investigate the Hspb1 gene expression following post eccentric exercise cooling, during primary and late recovery. Materials and Methods: Fourthy male Wistar rats (n=40; W= 300±10gr) were divided into two groups of exercise (Ex group) and exercise with cold water immersed group (Ex+CWI). Each group furture subdivided in to three subgroups based on three time- courses (0, 3, and 48 h after exercise). Exercise consists of 90 min interval downhill running (18*5 min, 2 min rest between intervals, 20m/min, and 17o decline). Post exercise cooling consists of 10 min of cold water immersion in 10oC water. Hspb1mRNA level was measured in soleus muscle using Real-Time PCR. The results were studied by statistical methods.Results: Gene expression of Hspb1 increased 3 hour’s after exercise in both groups, but the difference between two groups was not significant in this time course. However Hspb1mRNAexpression in Ex+CWI group 48 hr after-exercise was significantly less than Ex group (P=0.016).Conclusion: This study indicates that cooling after eccentric contraction. Exercise may suppress Hspb1 gene expression during late recovery period and interfere with protective role of this gene during the recovery of skeletal muscle after exercise.

Background and Objectives: neonatal hyperbilirubinemia is a common problems during neonatal period that may be associated with neurodevelopmental later in life. There are several known risk factors for bilirubin encephalopathy, including total serum bilirubin levels and bilirubin albumin ratio. The aim of this study was to determine relationship between neurodevelopmental delay and total serum bilirubin and bilirubin albumin ratio.Materials and Methods: In a descriptive analytic method, 186 neonates who had serum bilirubin levels more than 18mg/dl and were treated with phototherapy or exchange transfusion were studied. Total serum bilirubin and bilirubin albumin ratio were determined and they were followed for one year and during this period Ages & Stages Questionnaires, ASQ score was determined in five neurodevelopment domains at their 4, 8 and 12 months of age.Results: One hundred sixty four neonates were treated with phototherapy and 22 with exchange transfusion. The mean bilirubin albumin ratio was 5 and 6.6 in phototherapy treated and exchange transfusion groups respectively (p=0.01). ASQ score was less than cut off point in two domains in 5 (2.8%) of these patients. ASQ score in its communication domain at 8 months age was lower in patients with bilirubin-albumin ratio more than 7 [47.1±10.9 vs. 51.8±7.3 (p=0.03)]. In patients with total bilirubin greater than 25mg/dl the ASQ score in its communication domain was significantly lower than it in neonates with total bilirubin less than 25mg/dl (48.4±8 vs. 44.2 ±9.8 p=0.05). There was not significant relation between ASQ score in other domains at 4, 8 and 12 months ages of measurement and total serum bilirubin or bilirubin albumin ratio.Conclusion: The ASQ score in its communication domain was decreased at 8 mo in patients with higher bilirubin-albumin ratio and at 12 mo in patients with higher total serum bilirubin. It is recommended future studies to determine the relationship between neurodevelopment domains and total bilirubin and bilirubin-albumin ratio.

Backgrounds and Objectives: Despite the widespread availability of antibiotics, antibiotic resistance uropathogens are increasing. The most common mechanism of antibiotic resistance is production of extended spectrum B-lactamas (ESBL). ESBLs are derived from TEM-1 ,TEM-2 and SHV-1 ancestoral plasmids. Currently, according to a variety of mutations in these plasmids, there are more than 90 types for TEM and 25 types for SHV plasmids.Materials and Methods: In this study, 146 uropathogenic Escherichia coli (UPEC) isolates were collected. Isolated organisms were identified by standard biochemical and microbial tests. Antibiotic susceptibility was examined by disc diffusion method and isolates with ESBL, were recognized. The presence of TEM and SHV plasmids in isolates were examined by PCR method.Results: According to molecular estimations, TEM and SHV plasmids would be detected in 68.1% of isolates. But, TEM and SHV plasmids were detected in 18.1% and 13.6% of isolates, Separately. It seems that a chromosomal gene of beta lactam resistance was responsible in 52.1% of samples.Conclusion: According to increase level of antibiotic resistance among UEPC isolates, complete recognition of ESBLs is necessary and also trying to understand who they affect antibiotics resistance.

Background and Objectives: b1 integrin acts as mechanical receptors and vinculin is major protein in the focal adhesion site that transfers mechanical signals. The purpose of this study was to investigate the effects of eccentric exercise on b1 integrin and vinculin proteins in fast and slow-twitch muscle of male Wistar rats.Materials and Methods: Eighteen Rats (286.44±29.7) following appropriate acclimatization with the environment and treadmill machine, were divided randomly in to three groups (Exp1, 2 and Controls).They ran 40 min downhill running on a 16 degree down sloped treadmill with the speed of 20m/min. After 48 h, animals were anesthetized and Soleus and EDL muscles were excised to measure β1integrin and Vinculin proteins using ELISA method. After 24 and 48 h, animal serum was also taken to measure Creatine Kinase activity. Data were analyzed using T-test and one way ANOVA. The level of significant was set at p<0.05.Results: Result showed that Creatin Kinase increased but not significantly. After 48 h following eccentric exercise, b1 integrin and Vinculin significantly decreased (22 and 21% respectively) in the slow-twitch muscle. And also in the fast-twitch muscle b1 integrin was decreased (17%), but Vinculin was increased (7%) significantly.Conclusion: Because of increasing the Creatin kinase, about of eccentric exercise could cause injury, and protein degradation is continuing in the slow-twitch muscle even 48 h after the exercise. Hypertrophy and constriction induced injury will be continued in a longer period. However more researches are needed.

Presence of ~3000 known different compounds in human exhaled breath are reported concentrations there are changing in different diseases and can be used as biomarkers. This review (consisting of 58 papers) focused on the available knowledge on exhaled biomarkers mainly nitric oxide, hydrogen peroxide, aldehydes and hydrocarbons. Nitric oxide has been used in many pulmonary inflammatory diseases including asthma, chronic obstructive pulmonary disease (COPD), diagnosis of atopic asthma and chronic cough as well as monitoring is of corticosteroid therapy. Hydrogen peroxide is increased in asthma, acute respiratory distress syndrome, cystic fibrosis, COPD, lung cancer and also in systematic disease such as breast cancer and rhumatic arthritis. Exhaled aldehydes is monitoring also useful for the oxidative stress. An inverse correlation was observed between malondialdehyde and FEV1. Hydrocarbons, such as benzene and toluene, are increasing in lung cancer, cardiac transplant rejection, asthma, rhumatic arthritis, acute myocardial infarction and schisophrenia. Monitoring of exhaled biomarkers is a non-invasie, repeatable, real time measurment and applicable to children. Therefore, investigations on exhaled biomarkers have attracted more attention in respiratory medicine, and development of sensitive and specific analytical methods is highly demanding.

Tuberculosis presents with protean faces in renal transplantation. Recipients In majority of cases it is extra pulmonary and have nonspecific symptoms that confabulate the un experienced clinicians, on the other hand treatment of tuberculosis has it difficulties and antituberculosis regiment affect the cyclosporine blood level and predispose the allograft to rejection episodes. Here we report two cases of post transplantation tuberculosis. First Ptients presented with sever back pain and walking disabilities shortly after renal transplantation and furture imaging study disclosed lumboar vertebral destruction and second patient presented with fever and paraaortic lymphadenopathy in both patients mycobacterial tuberculosis involvement confirmed histologically.