MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2010 | Volume:31 | Issue:4|Papers Count:25

Background and Objectives: Aging is a cause of bone mass reduction and osteoporosis. Bone mass reduction is due to both decreased bone formation and increased bone resorption. Zinc, as an essential trace element, has been shown to have a stimulatory effect on osteoblastic bone formation and an inhibitory effect on osteoclastic bone resorption. The aim of this study was to investigate the effect of Zinc supplementation on bone mineral density (BMD). Methods and Materials: This double-blind RCT was conducted on 32 osteoporotic postmenopausal women referred to rheumatologic clinic. The patients were randomly divided into two groups: (1) Intervention group (n=14): who received 220 mg/day zinc sulfate containing 50 mg elemental zinc daily for 90 days and (2) Placebo group (n=19): who received a placebo for 90 days period. Demographic and clinical information were collected by filling in a questionnaire. Nutritional intake was assessed using a 3 day food recall at the baseline and at the final of trial and X-ray absorptiometry was used for BMD measurement at baseline and end of trial.Results: Mean age and mean age of starting menopausal period was (57.96 and 48.61) years, respectively. There was no significant difference in age, level of education, anthropometric measures, and previous history of fracture between the groups at the baseline. BMD was improved up to 5.15% in intervention group compared with 2.8% in placebo group (P=0.08). Conclusion: Zinc could improve BMD in postmenopausal osteoporotic women; however, further investigations are needed.

Background and Objectives: Proper nutritional knowledge of women who organizing the nutritional policy of the family have a direct effect on the health of family members. This survey was designed to assess the nutritional knowledge, attitude and practice (KAP) among female employees of Tabriz University of Medical sciences and the efficacy of educational intervention on modifying these variables. Methods and Materials: This interventional study was performed on 447 female employees of Tabriz University of Medical Sciences. At the beginning of study Nutritional knowledge, attitude and practice were assessed by using a questionnaire. Educational intervention consisted of two hours lecture session and on educational booklet about the essentials of healthy eating. After two months, the efficacy of the intervention was assessed by the questionnaire which was used at the baseline. McNamara test and Cochran test were used for comparing the pre and post intervention measurements. Qualitative variables were compared with paired t-test.Results: Before the intervention 82.7%, 16.5% and 0.8% of the subjects had good, moderate and poor nutritional knowledge respectively. After the intervention the rate of good, moderate and poor knowledge changed to 89%, 10.5% and 0.5% respectively. Before the intervention 29%, 62.2% and 8.95% of the subjects had good, moderate and poor nutritional attitude respectively. After the intervention the rate of good, moderate and poor attitude changed to 33.6%, 59.3% and 7.1% respectively. Before the intervention 17.2%, 25.1% and 57.7% of the subjects had good, moderate and poor nutritional practice. After the intervention the above percentages changed to 15.2%, 33.3% and 51.5% respectively. None of the aforementioned changes in knowledge, attitude and practice were significant. Conclusion: Despised the good level of knowledge nutritional the level of practice was poor. One session of lecture and educational booklet were not effective to modifying the nutritional knowledge, attitude and Practice.

Background and Objectives: The life metaphors are the persons metaphoric view to life. The object of the study is to recognition the life metaphors, their qualities, positivity or negativity among the family members of schizophrenic patients compared with the families of healthy people. Methods and Materials: In a descriptive study we performed Osgood's Semantic Discrimination Test (SDT) in 20 family members of schizophrenic patients hospitalized in psychiatry unit, compared them with results of the test in 20 relatives of mentally normal persons. Results: The result showed that the life metaphors among the family members of schizophrenic patients were significantly different from healthy families and they were more negative than healthy people. Conclusion: In schizophrenia families negative metaphors which are related to the disorder, are indicative of a conditions which increase the probability of affection.

Background and Objectives: Anxiety is the most important factor of pain rate and mother's adaptation with pain. So, decreasing mother's stress and anxiety will increase their co-operation and adaptation which results the less pain, anxiety and the shortest labor in instructed mothers. More than 90% of women have experienced the childbirth pain once in their lives; most of them describe it as intolerable and tiresome. This attitude has caused women to select cesarean section without considering its side effects. The goal of this study is to investigate the effect of antenatal education on mother's anxiety and pain. Methods and Materials: In this prospective observational study 70 women have randomly allocated they were in their 16th-20th weeks of pregnancy. This group was taken practical and theoretical instructions of safe childbirth methods. Then we gathered a matches group of 70 women as control group. Patient of each group was being examined during labor and childbirth and data was compared between two groups. Results: The results showed that labor rate (Z=10.634, U=26), duration (Z=10.409, U=75) and anxiety (Z=10.135, U=71) of experiment group were less than control group, and their difference was significant (P=0.05). Conclusion: It seems that instructing theoretical points and practical skills increase mother's self- confidence and decrease their fear and anxiety during whole period of pregnancy and childbirth.

Background and Objectives: Helicobacter pylori is usually acquired in early childhood and it clonizes half of the world's population. More understanding its transmission patterns is important for future preventive strategies. Here we studied the seroprevalence of H. Pylori infection in family units to identify the perceptive risk factors of inter-familial transmission. Methods and Materials: We entered 116 consecutive children (2.5-16 yr) who underwent the upper GI endoscopy and gastric mucosal Biopsy for H. pylori detection. Indications of endoscopy among these patients were chronic abdominal pain, recurrent nausea and vomiting, chronic diareohea; their parents were evaluated serology of H. pylori specific antibody. Results: Gastric mucosal biopsy revealed H. Pylori prevalence of 60.3% among children and serologic study revealed that 57.8% of their mothers and 37.9% of their fathers were infected. We found a strong association between Helicobacter pylori positivity of children and mothers (P value=0.03). The mean age of infected children was 8.95±2.82 years and the mean age of uninfected ones was 7.31±3.41. None of the other environmental or life style conditions such as household conditions, number of family members, drinking water source and type of garbage disposal, use of Refrigerant were not statistically significant association with H.Pylori infection. Conclusion: The results suggest that infected parents, especially infected mothers, may have a key role in transmission of H. Pylori to their children.

Background and Objectives: Functional endoscopic sinus surgery (FESS) is one of the most common procedures in the field of Otolaryngology. Most authors divide complications into ‘minor’ and ‘major’ categories. Minor complications may include bleeding, infection, synechia formation, ostial stenosis, and tooth or lip numbness, or recurrence of disease. Major complications may include hyposmia/anosmia, exposure of orbital fat, damage to extraocularmuscles, blindness, vascular damage, exposure of durra, cerebrospinal fluid (CSF) leak, intracranial injury, or death. Purpose of this study was to evaluate the complications of Functional Endoscopic Sinus Surgery in a group of patients with chronic sinus disease. Methods and Materials: In a prospective cross- sectional study, without control group, 62 patients who underwent functional endoscopic sinus surgery for refractory chronic sinus diseases were evaluated for Otolaryngology and Ophthalmic complications. Results: Total numbers of patients were 62 cases of chronic rhino sinusitis with poliposis (46.8%), without poliposis (32.2%) and with tumors (21%). Mean age of patients was 38.35±13.97 years (range from 15 to 75). Among this 62 patients, there were7 (11.2%) patients with ocular complications (one cellulites (1, 6%) and six patients had lids swelling and conjunctival injection). Three patients had postoperative epistaxis and one patient had Cerebrospinal fluid (CSF) leakage. We noted that 83.77% improvement in the preoperative symptoms after surgery. Conclusion: Ophthalmologic and otolaryngologic complications of Functional endoscopic sinus surgery are usually minor and respond to conservative management.

Background and Objectives: The prevalence of overweight and obesity among children are dramatically increasing in developing countries. Obesity is not considered as a psychological disorders but it increases the risk of psychological disorders including, internalizing behavioral problems that consist of withdrawn, anxiety/depression, and somatic complaints. The purpose of this paper is to investigate the correlation between obesity/overweight and internalizing behavioral problems in girls of elementary schools. Methods and Materials: In this descriptive cross-sectional study that was performed in Tabriz we entered 300 elementary schools girls randomly allocated and their body mass index (BMI) was measured. Data collection was performed by Child Behavior Check List (CBCL). That contains 113 items, 32 items of them indicate internalizing behavior problems in children, which are scored on the base of rang 3-point scale ranking.Results: The results showed that overweight and obese groups had a greater score in withdrawn, anxiety/depression and internalizing behavior scales than normal weight groups. Overweight and obese groups had a greater mean score than normal group in internalizing behavior scale (Overweight: 11.78±0.71 (P<0.05) vs 8.19±0.45 in normal, Obese: 10.67±0.68 vs 8.19±0.45 in normal group P<0.05). Based on results, obesity/overweight had significant and positive relationship with internalizing behavior problems in girls (r=0.219, P<0.001). Conclusion: These findings show that obesity/overweight is associated with internalizing behavior problems. Overweighting can be a risk factor for increasing the internalizing behavior problems in girls. Therefore, prevention of obesity can prevents some behavioral problems from happening.

Background and Objectives: Knee osteoarthritis is one of the most common rheumatologic diseases. Proprioception has a critical role in joint protection. This study was performed to evaluate the level of this sensation and its relation with pain and radiologic findings. Methods and Materials: Proprioception were determined in 25 patients (mean age of 59.2±7.0 years) with knee osteoarthritis and in 10 healthy people (mean age of 54.9±4.6 years), using isokinetic dynamometer at 30, 45 and 60 degrees. Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC) were used for determination of pain scale and Kellegren-Laverene was used for radiologic scale. Statistical study was performed by Mann-Whitney U Test and Spearman Correlation. Results: The mean level of angular error for right knee in patients and control groups were as the following, Succeedingly; 6.09±4.03 and 2.28±0.93 (P=0.05). For left knee they were 6.086±5.13 and 3.19±1.78respectively (P<0.05). The mean level of angular error in those with Radiologic findings of grade 2 and 3 were 5.4±4.2 and 6.83±3.46 respectively. There was no significant difference between of mean level of angular error and serving of pain by VAS & WOMAC (P=0.22) (P=0.18). Conclusion: Proprioception involvement in knee osteoarthritis could increase the pressure and destructive process of knee joint, but its level of impairment is not correlate with the severity of pain and radiologic findings. It is important to improve Proprioception of the knee joint in each level of osteoarthritis.

Background and Objectives: The use of adhesive resins is one of the methods that improves marginal adaptation and reduces microleakage in composite restorations. The aim of this study was to compare the microleakage of class V composite restorations bonded with one–step and two–step self etching adhesive resins in vitro. Methods and Materials: In buccal surfaces of 30 extracted human sound premolars class V cavities were prepared. The teeth were randomly divided into two groups. In group 1 two-step self etching adhesive resin and in group 2 one-step self etching adhesive resin were used and the teeth were restored with composite. Following thermocycling, immersing in dye and sectioning, microleakage of the samples was evaluated under stereomicroscope. Wilcoxon test was used to compare the microleakage of occlusal and gingival margins in each group and in order to compare the microleakage of occlusal and gingival margins between two adhesive resins Mann-Whitney U test was used. Results: There were statistically significant differences in microleakage scores between occlusal and gingival margins in two groups (P<0.05). No statistically significant difference was observed in comparing microleakage scores of two adhesive resins in occlusal and gingival margins (P>0.05). Conclusion: In both groups, the microleakage in gingival margins was significantly more than occlusal margins and the microleakage of gingival and occlusal margins was not statistically different in two adhesive systems.

Background and Objectives: Depression is a common psychological problems with different arrow of medical and non medical treatment strategically. Problem solving therapy is a short term Psychological intervention treatment and can be used alone or combined with other treatment modality. Here we studied the effectiveness of problem solving therapy in reducing the severity of depression. Methods and Materials: In this prospective study we entered a group of students of Tabriz University whose depression diagnosed with Beck Depression Inventory (BDI) method. We randomly allocated them in to two groups, intervention group and controls. Intervention group received six session of problem – solving therapy (Goldfield and Dzurilla method). Finally we compared the level of depression in both groups by BDI method. Results: Totally 64 student (M/F 30.34, mean age 22, Range 18-26) were studied. BDI index was change from 19.97 to 15.96 in intervention group (P<0.01) but this change was not significantly in control group (pre 18.09 and 18.28 past). Conclusion: This study showed that problem solving therapy is an effective modality to reduction severity of depression.

Background and Objectives: Oxidative stress is a state of imbalance between the free radical production and antioxidant defense systems. The aim of the present study was to evaluate the effect of amlodipine on antioxidant defense in an animal model of atherosclerosis. Methods and Materials: Thirty six male News land white rabbits were divided into four groups (9 in each group): normal control group (C), normal group receiving amlodipine (Am), high-cholesterol diet groups with and without amlodipine treatment (Cho+Am, Cho). After 8 weeks all animals in each group were scarified after anesthesia and blood and heart tissue samples were colleted. Results: The levels of cholesterol and triglyceride in groups of high-cholesterol diet were increased significantly (P<0.01) comparison with control group [(C: 49.1±0.6; Cho: 860.3±0.06; Cho+Am: 524.5±5.8), (C: 95.5±1.7; Cho: 446.6±2.5; Cho+Am: 138.6±1.8) respectively]. High cholesterol diet reduced super oxide dismutase (SOD), glutathione peroxides (GPX) and glutathione reductase (GR) activities no significantly compared with control and amlodipine administration increased them significantly (P< 0/01) [(C:2.04±0.16; Cho: 1.94±0.19; Am: 3.11±0.24; Cho+Am: 2.94±0.13), (C:356±26; Cho: 264±22; Am: 469 ±24; Cho+Am: 458±31), (C:0.24±0.01; Cho: 0.22±0.03; Am: 0.32±0.04; Cho+Am: 0.34±0.04)]. Malondialdehyde (MDA) level, increased significantly in high cholesterol diet rabbits compared with control. Amlodipine consumption caused significant reduction (P<0/01) in the MDA level [(C: 8.71±0.8; Cho: 14.38±1.1; Am: 8.63 ±0.6; Cho+Am: 11.18±1.4)].Conclusion: Amlodipine treatment by enhancing of antioxidant enzymes and reducing of MDA level in heart tissue has beneficial effects in prevention of the atherosclerotic symptoms and tissue injuries caused by oxidation stress produced in atherosclerosis.

Background and Objectives: Determining the stage and grade of liver fibrosis (LF) is important to predict prognosis and assessment of the rapeutic response in patients with chronic viral hepatitis. Liver biopsy is invasive and has several potential complications. Regular liver biopsy for patients follow-up is not acceptable. Aim of this study was to evaluate the correlation between serum hyaluronic acid (HA) level with stage and grade of liver Fibrosis in chronic hepatitis B and C induced viral hepatitis. Methods and Materials: This two year prospective study (2006-2007) was done on patients with chronic viral hepatitis B and C who had liver biopsy findings. Patients with concomitant artheropathy and any medicication that affects the serum level of hyaluronic acid were excluded. Blood samples were taken from each individual for measured of hyaluronic acid level. Results: From 69 patients (M/F 48.21, 34±10 years), 29 patients (42%) were infected with HCV and 40 patients (58%) were infected with HBV. Stages of Liver Fibrosis had a direct correlation with Hyaluronic Acid serum level (r=0.25, P=0.042), and had an indirect correlation with platelet count (r=0.37, P=0.0002). Grades of Liver Fibrosis had not meaningful correlation with Hyaluronic Acid and Alanin amino transpherase, levels, (r=-0.01, P=0.9 and r=0.21, P=0.09) respectively. grades of Liver Fibrosis had an indirect correlation with platelet count (r=0.36, P=0.003). Conclusion: Hyaluronic Acid serum level is a useful marker for determining the stage of LF in patients with chronic viral hepatitis it can be a useful anda noninvasive method for follow-up of these patients.

Background and Objectives: Recently laparoscopy has become a common out patient – base surgical procedure. An ideal anesthetic technique should provide a rapid and smooth induction, rapid recovery and minimal postoperative complications. In spite of no single ideal technique has been shown for outpatient laparoscopy, it seems that total intravenous anesthesia with propofol has more rapid induction and recovery profiles and less side effects, in comparison with inhalational agents. In This study we compared the total intravenous anesthesia with inhalational agents during diagnostic gynecological laparoscopy. We also evaluated the effect of N2o addition on intravenous propofol anesthesia. Methods and Materials: In this Prospective study 150 women (age: 25-45) who were in physical class I and II of American Association of Anesthesiologists and were candidate for diagnostic laparoscopy were elected. They randomly subdivided in three groups. Group one received anesthesia with thiopental, halothane and oxygen, group two received Total Intravenous anesthesia with propofol and oxygen. Group three received propofol anesthesia with 50% N2O-oxygen. The incidence and severity of post operative nausea and vomiting, degree of sedation, severity of pain and also stay in recovery unit were evaluated. Results: The incidence of Postoperative nausea and vomiting, sedation and time of discharge from recovery were significantly lower in group 2 and 3 compared with group 1 (P<0.05). Addition of N2O did not increase the incidence of Postoperative nausea and vomiting, but moderately increased the severity. There were not any significant difference between different groups in term of severity of pain and need for analgesia (P>0.05). Conclusion: Total intravenous anesthesia with propofol in comparison with inhalation anesthesia is a better choice for outpatient gynecologic laparoscopy. The results of this study showed that addition of N2O to propofol does not improve postoperative analgesia. Also, it did not increase the postoperative complications and recovery time.

Background and Objectives: Central Nervous System (CNS) tumors are those neoplastic diseases, that involving brain, spinal cord and meanings. They could be primary CNS tumors or metastatic tumors. Incidence of CNS tumors varies in different reports depending on the frequency of different age, gender and studied population. In this report we studied the frequency of different central nervous system (CNS) tumors in different age and gender during last 10 years in single center university hospital. Methods and Materials: Retrospectively, we studied the prevalence and type of different CNS tumors operated in the main university hospital of Tabriz University of Medical Sciences, during a ten year period from 1997-2006. Results: From total of 1781 patients with CNS tumors, 51.6% of tumors occurred in men and 48.4% in women. The most common ages period was 4-6 decade of life. 92.6% had tumors in brain, and 7.4% in spinal cord. 1180 cases of brain tumors were primary CNS (97.6%) and remainder were metastatic. The most common primary CNS tumor in adults was astrocytic tumors (29.6%). Conclusion: The result of this study showed that primary brain tumors were more prevalence than methastatic. Astrocytic tumors were the most primary tumor in adult.

Background and Objectives: Narcotic drug abuse and its consequences is one of the most important social concerns. In this study we aimed to examine the effect of life skills workshop on changing the knowledge and attitude of students towards Narcotic drugs. Methods and Materials: This study consisted of 293 student of Tabriz University of Medical Sciences. All recruitties were asked to fill in the questionnaires about knowledge, attitude and skills in addiction prevention. Then all recruitties entered a three session workup to increase the assertive skills. After above intervention all students again in the questionnaires. The post and pre intervention results were analyzed by statistical method. Results: The results of this study showed a significant increase in the level of knowledge (P<0.01) attitude (P<0.01) and social skills development after taking part in the life skills workshop (P<0.02). Conclusion: skills workshop, by increasing the cognitive capabilities is essential for university students.

Infection disease, maternal bleeding and pregnancy induced hypertension are the main causes of maternal death in the world. In this study we evaluated the outcomes of cardiovascular disorder in a group pregnant women who had pre-eclampsia and also had a history of cardiovascular disease before pregnancy. Eleven pregnant women were studied. Among these patient the most common cardiovascular disease was aorta valve stenosis (AS: 45.5%), mitral valve prolaps (MVP: 27.27%), and mitral stenosis (MS: 18.18%). Three women delivered by cesarean section (27.27%). Placental detachment and hemorrhage occurred in two patients (18.2%) and one patient delivered a low birth child.We concluded that gynecological catastrophes occur more frequently in patients with pre-eclampsia and concomitant cardiovascular problems.

Joubert syndrome is a rare disorder manifested by neuralgic, ophthalmic, renal, respiratory and radiological signs and Symptoms. Here we report an 8 months infant girl with history of neonatal respiratory distress. Hypotonia and (retinal dystrophy). She hospitalized in 4th mo for urinary fact infection and revealed that she had a unilateral multicystic and dysplastic kidney. It had broad forehead, hyperthelorism, depressed nasal bridge and bitemporal depression bilaterally, physical examination revealed; Rapid nystagmus in vertical and horizontal wards, wide open mouth with hyper salivation. In spite of normal physical growth she had delayed developmental milestones. Cranial MRI revealed vermis agenesis and molar tooth sign.