Medical Journal of Tabriz University of Medical Sciences
Year:2017 | Volume:39 | Issue:4|Papers Count:13

Background: Peritoneal cytology has received little attention in the literature, but it may be an additional useful means in evaluating patients with primary gastric cancer. The aim of this study was to examine the diagnostic accuracy of peritoneal fluid lavage cytology in detecting peritoneal seeding in patients with gastric adenocarcinoma.Methods: A total of 50 patients with gastric adenocarcinoma who were candidates for laparotomy based on the findings of computed tomographic examination were recruited. Diagnostic peritoneal lavage (DPL) was performed just before laparotomy and the peritoneal lavage fluid was sent for cytological examination for presence or absence of malignant cells. Findings in terms of peritoneal involvement during laparotomy were regarded as the standard results.Results: DPL cytology was positive for the presence of malignant cells in the peritoneal fluid in 25 cases (50%). According to the intraoperative findings 22 patients (44%) had peritoneal metastatic disease, whereas in 28 patients (56%) no gross indicator of metastasis was detected. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of cytology in detecting peritoneal seeding were 59%, 57%, 52%, 64%, 1.38 and 1.40, respectively. The agreement between cytology and diagnostic laparotomy was 58%.Conclusion: According to the findings of the present study peritoneal lavage solely is not a proper diagnostic method for early recognition of resectable/nonresectable gastric cancers.

Background: Fractures of tibia and fibula are one of the most common fractures of extremities in traumatic patients. Treatment of these fractures usually is surgical fixation of the tibia but there is not plenary study about the fixation of the fibula.Methods: All patients refers to Rasool hospital from Oct.2009 to Oct.2011 that achieved including criteria were entered in this prospective education and divided in to two groups: group 1 with 31 patients that was treated with fixation of the tibia and the fibula and group 2 with 34 patients that was treated with fixation of the tibia without fixation of the fibula and then severity of pain after the surgery, time of union, complication of the treatment and duration of the surgery were compared between them.Results: In group 1 severity of the pain and time of the union were significantly less than group 2. No nonunion was observed in group 1 but one was seen in group 2 that finally required surgical management. Duration of the surgery in group 1 was significantly longer than group 2.Conclusion: Although fixation of the fibula has taken longer duration of surgery, have better clinical outcomes.

Background: Proper nutrition is one of the important contributing factors in health and preventing of obesity. This study was aimed to assess the consumption of snacks and their relationship with Obesity and lipid profile in overweight and obese adults in Tabriz.Methods: The present cross-sectional study was carried out on 422 men and women aged 20-60 years with body mass index (BMI) over than 24.99Kg/m2. Weight and height were measured and BMI were classified into four groups i.e."25-29.99Kg/m2" - "30-34.99Kg/m2" and "35-39.99Kg/m2" and "³40Kg/m2". Fasting blood sampling was taken to assess serum lipid profile. After completing the 80-food item food frequency questionnaire, median of weekly frequency consumption of snacks in relation to BMI and serum lipid profiles were analyzed using correlation coefficient.Results: There was a significant positive correlation between BMI and serum total cholesterol (P=0.001) and triglyceride (P=0.009) levels. The most common snacks were fruits and tea while low-fat milk and fruit cans showed the lowest weekly frequency. BMI showed a negative and positive correlation respectively with weekly frequency consumption of low-fat milk and tea. There was also found a significant negative correlation between serum total cholesterol and weekly frequency consumption of natural juices (r=-0.100, P=0.041), industrial juices (r=-0.147, P=0.002), also between serum HDL-c levels with weekly frequency consumption of ice cream (r=-0.120, P=0.016) and LDL-c levels with weekly frequency consumption of industrial juice (r=-0.140, P=0.005). Weekly frequency consumption of coffee and ice cream were negatively correlated with Serum triglyceride levels.Conclusion: Our findings support the beneficial effect of healthy snacks such as low-fat milk, juices on lipid profile as well as BMI.

Background: The existence of beta-lactmase among gram-negative bacteria such as Klebsiella pneumoniae, as a significant pathogen in nosocomial infection is the most important cause of resistance against beta- lactam antibiotics family. Class 1 integrons are mobile genetic elements which are mostly prevalent in drug-resistant bacteria. This study was conducted to determine the prevalence of phenotypic and genotypic ESBL-producing strains as well as the incidence of integron class 1 in ESBL-producing strains.Methods: Sixty three isolates of K.pneumoniae, confirmed by biochemical and phenotypic tests, were collected within six months. Susceptibility test was carried out by Disk diffusion method. Prevalence of ESBL producing strains were determined by using Combined Disk Test. Presence of bla TEM, bla SHV gene family and class I integron were detected by PCR technique.Results: Forty five (71.4%) of isolates were ESBL-producing. TEM and SHV gene family were existed in 66.6% and 68.9% of ESBL -producing isolates, respectively. Class I integron were detected in 24 (65%) and 19 (63.3%) of SHV and TEM positive strains, respectively.Conclusion: In present study, increasing level of ESBL producing isolates were confirmed. Also, this study intensely demonstrates the role of integron in the dissemination of ESBL-mediated resistance among the nosocomial isolates. Overall, using the proper treatment procedure according to the antibiogram pattern of the strains is specifically recommended.

Background: Breast cancer is the most common malignancy among women. Survival rate depends on early detection and health care. The incidence rate of breast cancer varies by geographic region. The purpose of this study was to evaluate the epidemiology of breast cancer in Tabriz during two phases (2007-2009 and 2010-2012) Methods: All breast pathologic records were studied in all hospitals in Tabriz. Malignant cases were classified according to the tumor–node–metastasis classification. Data were compared across the study. S t atistical analyses were performed using Excel (Microsoft Excel 2010) and SPSS (version 16.0).Results: The results showed that the number of patients increased 52.76 percent in phase 2 compared to the first three years. A significant decrease in the diagnosis stage III was observed between phases 1 and 2 (P value=0.001, X2=21.721, CI=0.0001-0.001).Conclusion: Our results confirmed that a down staging trend in breast cancer has occurred in Tabriz, despite the lack of formal screening programs. This may be due to an increasing awareness among Azeri women about the warning signs of breast cancer, enhanced available health services, and an improvement in socioeconomic status.

Background: A shortened Gastrocnemius soleus underlies many biomechanical interactions which is a contributing factor to the development of movement impairment syndromes. So, the present study was done to assess the impact of shortened gastrocnemius soleus muscle on kinetic and kinematic variables in athletes to identify the compensatory movement patterns done in system. Knee and ankle torque, range of motion and ground reaction forces recorded by gait analysis system. Independent T test was used to compare parameters between two groups.Methods: This descriptive analytical study was carried out on 10 athletes which suffered from gastrocnemius soleus muscle shortness and ten healthy male athletes.Results: Shortness group displayed an increased knee flexion in swing phase, increased maximum adduction and extension of knee in stance phase, and increased maximum eversion in loading response of gait cycle. Athletes with limited dorsiflexion also displayed a reduced dorsiflexion range of motion, knee flexion angle in stance phase. Also, whole eversion time of ankle in loading response, knee flexion angle of heel contact were reduced in athletes with ankle dorsiflexion limitation. Finally, the mean external rotation and extensor torque of knee in stance phase and maximum torque of plantar flexion in loading response were increased in athletes with gastrocnemius soleus shortness group.Conclusion: Restricted DF ROM may alter movement mechanics in a manner that predisposes athletes to muscle skeletal injury. Therefore, the attention focused on the rehabilitation of gastrocnemius-soleus complex with an emphasis on motor control is important.

Background: TNF-a is one of the Proinflammatory Cytokines mainly seen in Adipose tissue, Lymphocytes and Fibroblasts which increases in obese men and this increment is associated with insulin resistance and lots of metabolic diseases such as diabetes. The following research aimed to investigate the effect of HIIT exercises on changes of TNF-a and insulin resistance index.Methods: This experimentation included 24 obese men with type-2 diabetes who were randomly divided into two groups of Control and HIIT (n=12). The HIIT group performed regular exercises for 8 weeks long (3 sessions in every other days of a week=30 training sessions in all). The assumptions of homogeneity of the slope of the regression line and also the linearity of the relationship between the scores before and after the practice is used and after the confirmation, Covariance analysis test is used (p<0.05).Results: HIIT training has a significant impact on TNF-a (p=<0.0001, f=41.058), Insulin Resistance (p=<0.001, f=51.825), Insulin (p=<0.0001, f=51.785) and Glucose (p=0.001, f=13.177).Conclusion: It is concluded that HIIT trainings per 8 weeks has been able to reduce the plasma concentrations of TNF-a and insulin resistance index in obese men with type-2 diabetes. HIIT trainings have possibly restrained TNF-a by reducing the production of IL-6 and TNF-a itself has restrained the activity of insulin and some of its poor effectors too.

Background: Due to the characteristics of the low CRP and WBC count in acute pyelonephritis, Procalcitonin (PCT) measurement can be a useful and practical option in acute pyelonephritis. According to different results in the investigation of the diagnostic value of PCT; the aim of this study was to evaluate the diagnostic value of PCT in differentiation of the lower urinary tract infection from acute pyelonephritis.Methods: All patients with a diagnosis of urinary tract infection in Imam Reza and Sina hospitals were enrolled in this study. Positive urine culture was considered as a urinary tract infection. If urinary tract infection with a pathogen colony more than 105 or more than 104 colonies is marked in person, it was considered as a urinary tract infection. In all patients, leukocyte count, ESR, CRP, and serum PCT was measured. In all patients with febrile urinary tract infection, radioisotope scan was performed. If a parenchymal defect was found in scan, they were considered as acute pyelonephritis. And also, patients without fever and normal radioisotope scan were considered as urinary tract infection. The end prolactin levels were compared according to final diagnosis.Results: In this study, 100 patients were studied: 47 patients with acute pyelonephritis, 53 cases with cystitis. Mean age of patients in acute pyelonephritis and cystitis did not differed significantly; but its P value was 0.106, which was significantly higher than the cut-off point. Gender also had no significant differences between two groups (P-value=0.948). The mean of Procalcitonin was 6.34%; with the range of 2% - 38%.Conclusion: No statistically significant differences were found between both groups. But the mean of WBC was higher in acute pyelonephritis than cystitis. ESR levels between bath groups were significantly different and it was significantly higher in patients with acute pyelonephritis. The mean of Procalcitonin in the two groups had no significant difference.

Background: Growth retardation is a common finding in cystic fibrosis (CF) patients. Recombinant human growth hormone (rhGH) has shown promising results in improving weight, height and clinical status of CF patients. In this study we aim to evaluate efficacy of rhGH on physical growth, clinical status and pulmonary function in CF patients.Methods: In this prospective clinical trial we recruited 34 CF patients with mean age of 62.05±31.11 month. Patients were followed for 6 months and then were treated with rhGH 0.35 mg/kg/week for the next six month. Measurements included height, weight, growth velocity, pulmonary function, hospitalizations, outpatient antibiotic use and Insulin-like growth factor-1 (IgF1) before and after rhGH therapy.Results: Growth velocity, Insulin-like growth factor-1 levels, hospitalization and antibiotic therapy were significantly improved after rhGH treatment. Pulmonary function evaluations including forced vital capacity (FVC) and forced expiratory volume (FEV1) showed no significant difference, before and after rhGH therapy.Conclusions: These results show significant effects of rhGH treatment on growth and clinical status of CF patients, but didn’t positive effect on Pulmonary function.

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most common mental diseases in children. Fatty acids are important components of nerve cell myelin. Essential fatty acid deficiency leads to behavioral abnormalities similar to nervous disorders, such as ADHD. The purpose of this study was to determine the composition of fatty acids in plasma phospholipids and whole erythrocyte in the ADHD boys.Methods: This is a case-control study in which 36 boys with ADHD and 37 boys without ADHD -aged 6-12 years- were participated. ADHD children were diagnosed with clinical diagnosis and psychiatric questionnaires by a psychiatrist. Then fatty acids of plasma phospholipids and whole erythrocyte were extracted.Results: The mean content of sum of saturated fatty acids (P=0.004) and arachidonic acid (P<0.001) of plasma phospholipids were significantly lower and mean concentrations of oleic acid (P<0.001) and sum of monoenes (P<0.001) were significantly higher in the ADHD group compared to the control one. However in the total RBC, the mean concentrations of stearic acid (P=0.003), arachidonic acid (P=0.04) and α-linolenic (P=0.02) acid were significantly lower and the mean content of linoleic acid (P=0.01) was significantly higher in the ADHD group compared to the control one.Conclusion: Fatty acid composition of plasma phospholipids and RBC in the ADHD children differed from that of the non-ADHD children.

Background: Cyclophosphamid is one of the anticancer drugs which cause alkylation on DNA in cells. These drugs reduce blood cells and affect bone marrow tissue. Hpericum perforatum (HP) is a medicinal plant which its hem opoetic effects on bone marrow function and blood parameter were investigated in this study.Methods: The 42 male Wistar rats with 220-250 gr body weight were divided in 6 groups randomly (n=7): control group, treated group by cyclophosphamide (15mg/kg, i.p), treated with HP, and treated groups (cyclophosphamide 15mg/kg, i.p, +100 mg/kg HP, cyclophosphamide 15mg/kg, i.p, +200 mg/kg HP and cyclophosphamide 15mg/kg, i.p, +400 mg/kg HP). After the examination the blood samples were collected from heart directly and analyzed for RBC, HCT and Hb and Fe. Statistical analysis Results of this study were performed using SPSS statistical software, All data were expressed as mean±SEM and differences were considered statistically significant with P<0.05.Results: The bone marrow tissue was injured by cyclophosphamide with reduction in number of blood cells and increase blood iron significantly. The extract of HP showed that the treated animals have increase in blood cells and reduced blood iron compared with cyclophosphamide induced group significantly (P<0.001).Conclusion: The results showed that the extracts of Hypericum perforatum can bone marrow protect against the deleterious effects of Cyclophosphamide, and the blood parameters and serum iron close to normal levels.