MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2008 | Volume:30 | Issue:1|Papers Count:30

Background and objectives: Cystic fibrosis (CF) is the most common severe lethal autosomal recessive genetic disorder in Caucasians. This disease is caused by abnormal flow of electrolytes across the apical membranes of epithelial cells, which appears with elevated levels of Cl- and Na+ in sweat, dysfunction of lung, pancreatic, gastrointestinal, reproductive and hepatic systems. CF has the incidence of approximately 1 in 2500 live birth. Responsible gene for CF is cftr gene located on human chromosome 7 including 27 exons. The results obtained from the studying of exon 10 indicated that there are many affected families from this region with unknown mutations. Therefore it was necessary to study the mutation of other exons in these families. This study could be applied to estimate the mutation rates of these exons in the studied population and also diagnose carriers and affected pregnancies.Materials and Methods: 48 affected families were referred by specialists to genetic center. DNA was extracted from peripheral blood of the patients and their parents. Then PCR was carried out and cftr gene analyzed for exons of 7, 11, 13, 17b, 19 and 21 by SSCP/Hd technique.Results: The difference in SSCP pattern of exon 7 observed in one of the families. SSCP pattern was different in exon 11 of 9 families. The difference in SSCP pattern of exons 13, 19, 20 was observed in 2, 2 and 1 families respectively. SSCP pattern of exon 17 didn’t show difference in any families.Conclusion: High heterogeneity was observed for the mutations of cftr gene in North-West population. Exon 11 showed more difference then other exons according to this study.

Background and Objectives: Use of mineral water for therapeutic purposes has an old past records. Being natural waters, absence of side effects, ease of usage and low price are important factors that make it necessary to do laboratory and clinical studies at this field. At present study effects of Jermuk bicarbonate calcium-rich alkaline mineral water on kidney parameters in renal stone formers were assessed and compared with Tabriz tap water.Materials and Methods: The study followed a randomized double blind clinical trial. A total of 42 renal stone-forming volunteers participated in the study. Subjects were instructed to drink mineral water and Tabriz tap water lasting for 2 month each. During the baseline phase and after each 2-month period, kidney parameters were assessed and subjects underwent kidneys sonography.Results: Jermuk mineral water is an alkaline and magnesium, bicarbonate, calcium and potassium rich mineral water. During the intake of mineral water urinary citrate and magnesium excretion and pH increased significantly compare to baseline phase (P£0.05), but no significant decrease was established at urinary oxalate excretion during the mineral water ingestion (P>0.05).Conclusion: Bicarbonate calcium-rich alkaline mineral water can increase urinary volume, pH, citrate, uric acid and magnesium excretion of renal stone forming subjects by consumption at enough volume (at least 2lit/day).

Background and Objectives: There is usually history of preceding infections 1-4 weeks before neurologic symptoms & signs of Guillain-Barre Syndrome (GBS). This study was designed to determine frequency of campylpbacter jejuni. Cytomegalovirus, Epstein-Barr virus and Mycoplasma pneumonia infections in GBS.Material and Methods: Serologic evidences of above mentioned infections in 60 GBS patients were compared with that evidences of 60 age and sex matched controls. IgM and IgG classes of the immunoglobulins were measured using sensitive ELISA method.Results: There were history of campylpbacter jejuni, in 45% of patients and 13.3% of controls, (P=0.001), and cytomegalovirus in 11.6% of patients and 1.7% of controls (P=0.036). History of Epstein-Barr virus in 15% of patients and 8.3% of controls (P=0.213), and Mycoplasma pneumonia in 3.3% of patients and 5% of controls (P=0.219) were detected. Children with serologic evidence of Campylpbacter jejuni infections showed axonal involvement in 65.3%.Conclusion: Serologic evidences of preceding infections of Campylpbacter jejuni and cytomegalovirus were significantly more in GBS patients compared to controls.

Background and Objectives: Autoimmune diabetes mellitus (DM) or type-1 is a heterogenic disease which results from destruction of beta cells. Human leukocyte antigens, especially class II antigens, play a crucial pathogenic role in disease development. The prevalence of HLA antigens differs in many ethnic groups in different geographical areas. In this study, the freguency of HLA antigens determined in patients living in Tabriz city and the data compared with those of other countries and races.Material and Method: Two groups of subjects from the region were selected; the sample group consisted of 50 type1 diabetic patients and the control group consisted of 25 healthy subjects. After separating mononuclear cells from heparinizied blood samples by Ficoll-Hypaque, the complete panel of class I and class II antigens were examined and measured by microlymphocytotoxicity technique.Results: The frequency of DR3(P=0.046), DR4(P=0.000), DQ2(P=0.028), DR3/DR4(P=0.049) and DR3/DQ2(P=0.025) was much higher in patient compared to healthy subjects and all these antigens act as an etiologic factor in the patients group. On the contrary, DR15/16(2)(P=0.021), DQ3(P=0.022) and DQ7(3)(P=0.037) had a negative association with the disease because these antigens had a high frequency among the control (healthy) group in comparison with the sample (patient) group. Among all class I antigens, A69(28)(p=0.045) and CW6(P=0.042) antigens represented a positive association while B38(16)(P=0.034) antigen represented a negative correlation with type 1 DM. Moreover, BW6 and DQ2 had a higher frequency among female patients than the male ones (P= 0.047 and P= 0.034, respectively).Conclusion: The findings of this research represent that the screening leukocyte antigens, especially class II antigens, can be regarded as a valuable method in the recognition and determination of those subjects who are at the risk of the disease.

Background and objectives: Asthma is a chronic disease that the prevalence of its symptoms is about 1 to 30 percent and is increasing in many countries. Inhaled corticosteroids (ICS) are one of its basic therapeutic agents. The frequency of spray administered daily is one of the most important factors in patients’ adherence to treatment. This study was designed to compare the efficacy of different frequencies of ICS administration in the treatment of mild persistent asthma, in children.Materials and methods: In a randomized controlled trial the patients with mild persistent asthma at the age of 2-14 years receiving flixotide 1 puff twice daily for first 3 months and then 2 puffs once daily for another 3 months were compared with asthmatic patients with the same age and degree of severity who received 1 puff twice daily for 6 months.Results: the results of treatment showed no significant difference between two groups but treatment adherence was better in the first group (1puff twice daily for first 3 months and 2 puffs once daily for the next).Conclusion: The lack of significant difference between the results of treatment in two groups, and Increased parental adherence in first group suggest that lower frequencies of spray administration after a partial establishment of improvement, could be better tolerated.

Background and Objectives: Proper nutrition plays an important role in one's life time. Disregarding proper nutrition, especially during young adulthood, has adverse effects on one's health and competence. Results of the studies indicate that most of adolescents and young people have in proper eating habits and tend to consume junk foods and ready-to-eat/fast foods. Considering the importance of nutrition during this period, we have studied the dietary pattern of students in Tabriz University of Medical Sciences, with emphasis on junk food consumption.Materials and Methods: This Cross-sectional - analytical study was performed on 574 University students (354 girls and 220 boys) using a self-administered questionnaire, consisting of individual specifications and food frequency questionnaire. Data was analyzed using SPSS (ver.11.5).Results: The highest and lowest change in food patterns of students after entering university was seen in vegetable consumption (70.6% decrease) and the consumption of nuts (54.3% unchanged), respectively Data analysis also showed a decrease in consumption of vegetables, fruits, dairy products and nuts while an increase in consumption of junk food and fast food among exotic students was found which was statistically meaningful.Conclusion: The results confirm the change of dietary pattern toward an increase in the consumption of junk food, and decrease in the consumption of healthy foods after entering university, especially among exotic students.

Background and objectives: Gentamicin, neomycin, streptomycin and ofloxacin are synthetic antibacterial agents belonging to the family of aminoglycoside and fluoroquinolone antibiotics with a very broad spectrum against microbial pathogens, especially gram-negatives and urinary tract infections which in nowadays have good effect in diseases treatment worldwide. The aim of this study was to see the effects of this drugs inducement, on testis apoptosis by Tunel assay in rat.Materials and Methods: fifty male Wistar rat were selected and randomly divided into five groups; one control (n=10) and four test (n=10) each. The test groups was received 5mg/kg (IP) gentamicin,50mg/kg(IP) neomycin, 40mg/kg (IP) streptomycin, and72mg/kg (IP) ofloxacin daily for fourteenth day; however the control group just received vehicle(IP). In fourteenth day the testis tissue of rat in both groups were removed and prepared for light microscopy, and the Terminal Uridine Nick End Labeling (TUNEL) technique was used to identify apoptosis.Results: The rate of TUNEL positive apoptotic germ cells average in gentamicin, neomycin,streptomycin, ofloxacin and control group were(24.15±10.17), (25.15±9.11), (15.15±11.14), (34.15±8.17), (7.3 ±2.41). The statical analysis was ANOVA method, (P<0.01).Conclusion: Since in our study the rate of TUNEL positive apoptotic germ cells in streptomycin group was significantly less than other treatment groups thus using this drug has fewer risk to consequence infertility in male rats.

Background and objectives: Hemodialysis patients face several physical and psychological stressful factors which leads to decrease their quality of life. Physical exercises as one of the side therapeutic methods can cause appearing some useful physical, mental and social effects.There is a little study in this field in Iran, and also regarding to this subject that in previous studies on the effect of physical exercises on quality of life in other countries, there are contradictory results specially in psychological aspect, so in this study we intend to deliberate the effect of physical exercises on whole quality of life, and beside this to deliberate its effect on different aspects of quality of life in hemodialysis patients.Materials and Methods: For this study 43 patients were selected. 35 patients practiced physical exercises for 8 week ( 3 times a week).Practicing program was done for one hour every session which included ergometer, treadmill, playing with ball.All data were gathered before and after interloping with combined and modified questionair including two parts (demographic charateristics and quality of life ). Interview method was used for gathering the data.Results: Results showed that physical exercises could improve quality of life (Mean ± SD of QOL: before= 153.7±17, after=187±14, P<0.001) and also in subcategories of quality of life (physical, psychiatric and social) could be promoted it significantly.Conclusion: By according to this subject that physical exercises can improve different aspects of quality of life in hemodialysis patients, it is suggested that all managers to adopt an attitude on preparing sporting goods and possibilities for hemodialysis patients in their home or hospitals, to reinforce and support their physical, social and psychological affairs for improving their quality of life.

Background and Objectives: Duchenne muscular dystrophy is a neuromuscular disorder with progressive muscle wasting and weakness. This disease is consequence of mutations in dystrophin gene located on X chromosome and its inheritance pattern is X-linked recessive. The incidance of this disease is one out of 3500 alive male newborns. In the absence of efficient treatment, detection of female carriers for genetic counseling and prenatal diagnosis is essential.Materials and Methods: Sixteen DMD families were referred to the laboratory by neurologists. DNA was extracted from the whole peripheral blood and was analyzed by gene tracking technique. All members of the families were studied by using 7 microsatellites located in and around the dystrophin gene.Results: forty three females at risk of being DMD carriers and 3 obligate carriers were studied and 29 (68.18%) female relatives were diagnosed as carriers or non-carriers.Conclusion: In DMD families with deletion, gene tracking is a reliable technique for carrier-status identification with 95-100% likelihood.

Background & Objective: Using splint is one of the principle treatment approaches is in the CTS, but the proper angle of it is not definitely clear. The purpose of this study is to establish the effect of wrist position on electrodiagnostic parameters to determine the appropriate splint position.Materials & Methods: 33 patients with clinical and electrodiagnostic findings of CTS and without peripheral neuropathy have been selected as case group and 28 healthy subject selected as control group. Standard motor and sensory electrodiagnostic tests were performed on both group at 5 min after application of special splint in 3 different wrist position (25 degree flextrion, 25 degree extension and neutral position).Distal motor and sensory latency, CMAP and SNAP amplitude and also motor and sensory NCVs were recorded in both groups.Results: The means of electrodiagnostic parameters have been compared by using of ANOVA test in 3 positions in both groups. There were no significant difference between parameters in 3 position in control group (P<0.05). In case group there were not significant differences between the CMAP and SNAP amplitude in 3 positions. Significant difference has been observed in distal motor and sensory latency and in motor and sensory NCVs between neutral and extension with flexion position. There were not significant difference between neutral and extension.Conclusion: The present study demonstrated that electrodiagnostic parameters in patients with CTS changes in different wrist position in CTS patients. For this reason it is necessary to prescribe splint in neutral or extension position.

Backgrounds and Objectives: The mean platelet volume is an indicator for platelet disorders, which shows the rate of platelet destruction in peripheral blood, and platelet production in bone marrow. In this study we evaluated the role of (Mean Platelet Volume, MPV) in prediction of prognosis in (Idiopathic Thrombocytopenic Purpura, ITP).Materials and Methods: Fifty patients with ITP that were admitted toTabriz Pediatric Medical Center from Oct 2003 to 2005 were studied. Chronic ITP and other purpuras were excluded. The blood parameters including platelet count, WBC, Hb, and MPV were measured by CBC H1 and bone marrow aspiration was done by hematologist before treatment. The patients were divided based on MPV to three groups of low (MPV<7 fl), normal (MPV=7-11 fl) and high (MPV>11 fl) platelet volume. The patients followed in one, two weeks and one month after treatment.Results: In this study 42 % of patients had low, 40 % normal and 18 % high MPV before treatment. First week (P=0.004), second week (P=0.001) and one month (P=0.001) after treatment all patients in low and normal groups of MPV had good prognosis. But in the patients with high MPV, even though in first week (P=0.04) and second week (P=0.002) had favorable prognosis but after one month of treatment there was no statistically meaningful correlation between high MPV and favorable prognosis (P=0.161). The Patients with viral infections exposure or vaccination before disease had low or normal MPV and had good prognosis (P=0.001).Conclusion: Low or normal MPV before treatment in ITP patients and those who had history of viral infection or vaccination in last month before disease had favorable prognosis. But in patients with high MPV prognosis of diseases can not be evaluated.

Background and Objectives: Despite understanding of predisposing factors and attempts to prevent, nutritional rickets has made resurgence in many parts of the world. Although not all children with rickets will be hypocalcemic, but hypocalcemic seizure is the most common reason for admission of these children in hospitals. This study was aimed to assess the vitamin D deficient rickets in admitted infants and children, and to recognize the contributing factors in hypocalcemic seizure in these patients.Materials and Methods: In patients admitted in our children hospital in years 2004-5, having clinical findings compatible with rickets, serum levels of ionized calcium, phosphate, alkaline phosphatase, 25OHD3, measured and wrist X-Ray performed. All patients with vitamin D deficient rickets compared in two groups, seizure and non-seizure group.Results: During two years, 69 infants and children with vitamin D deficient rickets diagnosed. The mean age was 6.2±4.6 months, and 71% were male. 92.8% were under one year old, and 76.8% admitted in winter and spring. In under one year old patients, 70.3% were exclusively breast fed, and 54.7% did not received supplemental vitamin D absolutely. Patients with hypocalcemic seizure (53.6% of all) were younger (P=0.003) and had lower serum calcium level (P<0.001), in comparison with non-seizure group.Conclusion: Vitamin D deficient rickets still is one of our health and medical problems. Younger patients with this disorder are more prone to hypocalcemia and seizure.

Background and Objectives: Osteoporosis is one of the health problems that affects lives of many postmenopausal women. This disease is associated with many factors such as low physical activity. The present study was conducted to determine relationship between physical activity and bone mineral density in postmenopausal women.Material and Methods: This study carried on 58 postmenopausal women(50-70 years old).Measurement of bone mineral density (BMD) were performed at L2-L4 spine and FN hip with the use of Dual Energy X- ray Absorptiometry ( DEXA).Physical activity assessed by questionnaire for 3 days. To determine the relationship between quantitative variables chi-square test was used.Results: According to results of present study, after bone densitometry subjects were classified into 3 groups: 18 women with normal bone status (T-score³-1), 22 women with osteopenia (-2.5<T-score< -1) and 18 women with osteoporosis (T-score£-2.5). In normal group 72.2% had moderate activity and in osteoporosis group 77.8% had light activity. There was significant correlation between physical activity and bone mineral density in all groups (P=0.002).Conclusion: As there was significant correlation between physical activity and bone mineral density, therefore increasing physical activity is highly recommended to maintain bone mineral density in postmenopausal women.

Background and objectives: Decreasing the ability of conventional external radiation therapy with increasing of tumor size is one of the problems in the treatment of malignant tumors, because of restriction of tissue tolerance. Grid therapy is a technique used to deliver a high dose of radiation (15-20 Gy) in a single fraction to many small volumes within a large treatment field. The grid is a sheet consists of many small holes that shields some parts of treatment field. Dose distribution from megavoltage grid therapy differs significantly from that of conventional radiation therapy (i.e., many large dose gradients exist within the tumor volume). In this study we have designed and fabricated the Grid for use with the linear accelerator (Neptun 10 PC) of Imam Reza hospital of Mashhad that produces 9MV x-ray photons.Material and methods: First, we designed a grid block in a 7-cm thick piece of lead with solid work soft ware. The grid has a 16×square array of holes. When the button surface of the Grid is at the distance of 70 cm to radiation source, the holes diameter and center to center distance of beyond holes is 1.3 and 1.8 cm at the level of Isocenter, respectively. For fabrication of the Grid a custom block of lead alloy (75% Pb, 15% Sb, 10% Sn) that has adequate resistance against pressure and drilling thud, was selected. Then the Grid drilled with VMC (vertical machining center) curler. At the end, the Grid fixed on the linear accelerator of Imam Reza hospital of Mashhad and dosimetric properties of the grid (using 9 MV photon beams) has been measured.Results: The fabricated grid with this method has economic gain and is inexpensive than other methods. The whole directions have scrupulosity, and dosimetric characteristic of the grid is our evidence. The depth dose curves for the grid fields lie between those for an open portal and a narrow beam. The ratio of the dose delivered to the center of the shielded regions to that under the center of the holes, expressed as Valley-to-peak ratios, ranges from 17% to 28% at Dmax. The output factor for 9 MV photon beam is 78%.Conclusion: Characterization of the dosimetric properties has allowed clinical implementation of the grid. Grid therapy has allowed palliative treatment of large, deeply seated tumors and massive tumor bulk would most likely not benefit from a conventional course of radiation therapy.

Background and Objectives: Delusional disorder is a relatively uncommon psychotic disorder. The major psychiatric symptoms are systematized delusions without any other major psychiatric symptoms. Delusional disorder associated with significant complications such as job difficulties, divorce and separation, impaired interpersonal relationship and sometimes delinquency. Socio cultural factors have significant role in the etiology of this disorder. There are a few studies about clinical and demographical features of this disorder in our country, so this study was designed to evaluate the clinical and demographical features of delusional disorder in hospitalized patients.Material and Methods: This is a cross sectional study and the subjects were 68 patients who had delusional disorder diagnosis in their medical records. They were admitted to Razi hospital of Tabriz since1999 to 2003.The clinical and demographic features of these patients collected from their hospital records and the results analyzed with descriptive statistical methods.Results: the mean age of patients was 50years old, most of the patients were male (%79/5), married (%82/5), and the most common delusion were persecutory (%53). Other important clinical symptoms were auditory hallucination (%26/5), depressed mood (%54/5) homicidal idea (%35/5) and suicidal idea (%29/5).Conclusion: Delusional disorder is a serious psychiatric disorder with important psycho social impairment, many clinical symptoms and a very bad outcome. The most important clinical symptoms in this study were, persecutory and jealous delusions, depressed mood, suicidal and homicidal ideas. Unlike schizophrenia and mood disorders this disorder is more prevalent in aged and married patients.

Background and Objectives: One of the common materials as a root-end filling is mineral trioxide aggregate ( MTA) that has various uses in endodontic. The aim of this study was to compare the micro leakage of white MTA in three diffrernt thicknesses as root –end filling materials.Materials and Methods: Seventy extracted human maxillary anterior teeth were randomly divided into 3 experimental groups each containing 20 teeth and 2 groups each containing 5 teeth used as positive and negative control groups. The root canals of the teeth were cleaned, shaped and obturated with gutta percha and AH-plus sealer .The apical 3 mm of each root was removed perpendicular to the long axis of the tooth using a diamond bur. In first, second and third experimental groups class I cavity in 1 mm, 2mm and 3 mm deep were prepared respectively and were restored with white MTA. In the positive and negative control groups, MTA was not used. All specimens were stored in synthetic tissue fluid for 48 hours .Then they were retrieved from this fluid and dried. Leakage was determined using a dye penetration method and observed with a stereomicroscope at a magnification level of 16. Accuracy of 0.1 mm was used for measurements. Data was analyzed using the ANOVA test at the 0.05 level of significance and Dunnett’s C for the comparison among groups.Results: Mean micro leakage in negative and positive control groups’ was zero and 3 millimeter respectively and in experimental groups were 0.4 mm, 0.2mm and 0.5mm for 1, 2 and 3 millimeter deep respectively. There was no significant difference among experimental and negative control groups (P>0.05) but differences were significant among experimental and positive control group (P=0.025).Conclusion: According to this in vitro study 1, 2 and 3 millimeter thicknesses of MTA can prevent leakage equally.

Background and Objectives: During recent years many factors has increased the nonepidemic diseases including cardiovascular ones. Atherosclerosis is one of the main causes of cardiovascular diseases. Some researchers suggested that calcium channel blockers can slowdown the process of atherosclerosis Materials and Methods: Thirty six male Newsland white rabbits were divided into four groups: The normal control group, normal group receiving amlodipine, and high-cholesterol diet group and high-cholesterol diet with amlodipine group. After 8 weeks all animals anesthetized and blood and tissues samples were colleted.Results: Amlodipine consumption in eight weeks reduced significantly (P<0.01) plasma endothelin-1 levels in both of high-cholesterol diet plus amlodipine and amlodipine groups. Amlodipine consumption caused significant reduction (P<0/01) in the level of endothelin-1 in heart tissue of high-cholesterol diet plus amlodipine group but did no effect on reduction of heart tissue endothelin-1 in amlodipine group.Conclusion: High-cholesterol diet caused enhancing of plasma and heart tissue endothelin-1 and amlodipine reduced plasma and tissue endothelin-1 levels in high-cholesterol diet group. In conclusion amlodipine treatment could have positive effects in pathology of heart diseases.

Background and goal: Research shows that there is relationship between attachment styles, Asthma and in this research the relationship between insecure avoidance attachment, insecure ambivalence attachment and asthma in interaction with gender factor has been investigated. In this research it was hypothesized that there is relation between asthma and attachment style.Method: For this purpose we selected 40 asthmatic patients (20 males and 20 females) and 40 healthy subjects (20 males and 20 females). For collection of information about variables, we used Adult Attachment Questionnaire.Findings: The results showed that asthmatic patients and normal group were significantly different in secure attachment and insecure avoidant and ambivalent attachment styles (P<0/001). In this research gender role in relation to style of attachment & asthma were investigated. The results showed that there is positive & significant relationship between style of ambivalent attachment & asthma in females.Conclusions: The results showed that, attachment style of asthmatic patients is insecure and ambivalent type.

Background and Objectives: Since in atherosclerotic vessels obvious and certain changes with abnormality in transferring of calcium ions are seen, some researchers suggested that calcium channel blockers can be effective in slowdown and improving the process of atherosclerosis.Materials and Methods: 36 male News eland white rabbits were divided into four groups: The normal control group, normal group receiving amlodipine, and high-cholesterol diet group and high-cholesterol diet with amlodipine group (5/mg/Kg/day) that rabbits take amlodipine by gavages. After 8 weeks all animals anesthetized and tissues samples were colleted.Results: In aorta in high-cholesterol diet diameter of internal layer was increased and cells due to accumulation of lipids are seen as yellowish white. Hypertrophy of endothelial cells, accumulation of lipids in endothelial layers with calcification in media indicates induction of athroma. With amlodipine consumption decreasement of athrotic injuries was observed. In carotid artery in high-cholesterol diet results showing incidence of athroma. With amlodipine consumption decreasement of athrotic injuries was observed. In kidney artery in highcholesterol diet atherosclerotic changes was not observed.Conclusion: Significant differences were observed among arteries of aorta, kidney and carotid in atherosclerosis. In kidney artery the groups of high-cholesterol diet and highcholesterol diet plus amlodipine were not different histologically but in arteries of aorta and carotid amlodipine consumption was effective in dcreasement of atherosclerosis process. This difference can be related to difference in structure of artery endothelial cells or different distribution of related receptors.

Background and Objective: Chronic otitis media is an inflammatory process of the middle ear that is accompanied by irreversible pathologic changes and almost invariably is accompanied by tympanic membrane perforation. One of the basic principles of middle ear surgery for patients with chronic otitis media is reconstruction of the tympanic membrane for closure of the middle ear and reestablishment of sound transfer mechanism. Keeping in mind that anterior and subtotal tympanic membrane perforations have higher failure rate following reconstructive procedures, if we try to decrease the failure rate of reconstructive methods of these types perforations, this will affect the final outcome of chronic otitis media management positively. The aim of this study was comparison of two different techniques in reconstruction of anterior tympanic membrane perforations.Materials and Methods: In a case-control clinical trial over a 2 year period, between April 2004 and April 2006 in Tabriz Imam Khomeini Hospital, 60 patients with chronic otisis media having anterior tympanic perforations underwent tympanoplastic surgery. Thirty of the patients were operated by placing the temporal fascia graft under the anterior remnants of the tympanic membrane. In thirty others an incision was made in the anterior skin of the external ear canal lateral to the annulus creating an anterior flap, and the anterior edge of the temporal fascia graft was pulled beneath the annulus and entrapped under the anterior flap.Results: The average age in the entrapment group was 34.5 years old and in the group without entrapment was 34.3 years old and overall average age was 34.4 years old, 60% were female and 40% were male. There were 3 failures (90% success rate) in the group with entrapping and 5 failures (83.4% success rate) in the group without entrapping the graft (P= 0.448).Conclusion: Our main hypothesis was that there was a meaningful statistical difference between the success rates of the two techniques. After analyzing the findings we concluded that in spite of a few more cases of successfully reconstructed tympanic membrane with the entrapping technique, there was no meaningful statistical difference between the success rates of the two groups. So according to these data, the entrapping technique is not proposed as a routine method in approaching to anterior tympanic perforations.

Background and Objectives: It has been reported that elevated level of lipid per oxidation (LPO) in astenozoospermia causes damage of sperms and reduce the fertility. Recently minimum necessity of LPO for the reproducibility of the oocytes and sperms has been reported. In this study effect of high dose of Vit.E and Vit.C on the level of LPO in semen and in vitro effect of the vitamins on the vitality of sperms before and two months after complementary in Astenozoospermia were evaluated.Material and Methods: The couple’s refered to infertility ward, 40 normozoospermic fertile males and 60 idiopathic astenozoospermic infertile males were selected using a simple approach. Before treatment, semen samples were collected from the both groups twice and after treatment of the patients(Vit.E 400mg and Vit.C 1000mg per day for two months) two semen samples were collected from the individuals. The levels of the LPO (MDA), Vit.C and E in semen were measured by standard methods and motility and morphology of sperms were determined by who recommendation. Capacitating test of the samples was analyzed using Swim Up method. The ISM1 media culture was used to in vitro investigation of sperms motility.Results: Significant elevation in the percentage of motile sperms (b degree) was observed in the astenozoospermic males after two months treatment (P<0.05). Treatment with anti oxidant Vitamins without any effect on the concentration and morphology of sperms increased they motility (a and b degree) and vitality. The level of LPO reduced significantly (P<0.001) to normal level after treatment by the anti oxidants.Conclusion: In this study it was concluded that complementary Vitamins E and C with high dose by reducing the level of LPO increase sperm motility after capacitating test and by increasing the vitality of the cells improve the rate of fertility in vivo and in vitro conditions.

Backgrounds and Objectives: Mineral trioxide aggregate as one of the root-end filling materials has excellent biocompatibility. Two different compositions of white and gray MTA were manufactured by Iranian and foreign companies. The aim of this study was to compare histopathological reaction to Iran made and foreign gray MTA in connective tissue of rat.Materials and Methods: Forty rats were divided in to 5 groups of 8. The polyethylene tubes were filled with foreign, Iran made gray MTA and empty ones implanted in subcutaneous connective tissues. The samples were examined histopathologically after 7, 15, 30, 60 and 90 days and were scored as followings: 0, without inflammatory cells; without inflammatory reaction. 1, less than 25 inflammatory cells; mild inflammatory reaction. 2, 25 to 125 inflammatory cells; moderate inflammatory reaction.3, more than 125 inflammatory cells; severe inflammatory reaction. Kruskal-Wallis and two way ANOVA were used for statistical analysis with a significance level of P<0.05.Results: Overall, inflammatory reactions were reduced in all groups gradually. Experimental groups had moderate to severe inflammation in 7 days interval which had significant difference with the control group having mild to moderate inflammation (P=0.04). There were no significant differences between experimental groups and control group in other intervals (P>0.05).Conclusion: Cellular inflammatory reaction of subcutaneous connective tissue of rat to Iran and foreign made gray MTA were similar.

Background and Objectives: Preservation of teeth and their supporting structure up to elderly implies the high oral hygiene and also the efficacy of the health care system. On the other hand early extraction of teeth especially when done because of financial issues is unfavorable and is a manifestation of a deficient oral care system and a lack of oral hygiene knowledge. The aim of this study is to assess reasons for tooth extraction and their prevalence in Tabriz dental faculty.Methods and Materials: In a cross-sectional and descriptive survey, general information, the causes and rate of tooth extraction and the oral hygiene status of patients referring to department of Oral & Maxillofacial surgery in Tabriz University of Medical Sciences were assesses. Data were analyzed with Chi-Square test using SPSS software for any statistical differences between tooth extraction reasons and other studied variable (such as educational status).Results: 900 teeth were extracted. Unrestorable tooth tissue loss (40.5%), prosthetic problems (35.6%) and periodontal diseases (15.1 %) were the most prevalent reasons for the extraction. Mandibular first molar was the most extracted tooth (17.52%). The extraction rate had a reverse and statistically significant relation with the oral hygiene and educational status (P<0.05).Conclusion: caries, pre-prosthetic reasons and periodontal problems were the most prevalent reasons for extraction. According to the result, it seems that with oral hygiene instruction and promotion and by early prevention we can prevent the most prevalent causes of tooth loss.

Airway foreign body is a common problem in infants and children. Most airway foreign bodies become lodged in the bronchi, because their size and configuration allow passage through the larynx and trachea. Larger objects become impacted in the larynx, at times causing complete obstruction, an acute emergency. Irregular foreign bodies or orientation in the sagital plane may produce only partial obstruction, allowing adequate air movement around the obstruction. Resulting laryngeal edema can lead to complete obstruction. These patients have symptoms of obstruction and hoarseness. It can mimic croup and may lead to delayed diagnosis and complications. In this report a 15 months infant is presented who had hoarseness and admitted with croup diagnosis. Patient was admitted in Tabriz hospital. In laryngoscopy, foreign body upon th right true vocal cord was removed with foceps.

Complete androgen insensitivity syndrome is characterized by normal female appearance, including external genitalia in the presence of a 46 xy karyotype. CAIS is a rare disorder, the prevalence is estimated at between 1 in 20000 and 1 in 60000 live births. However, this condition is found more frequently in the subpopulation of girls with inguinal hernias, and the incidence of CAIS has estimated to be 0.8% to 2.4% in girls with inguinal hernias. In this article two cases of CAIS have been reported.Case 1: An 18 years old girl with chief complains of primary amenorrhea, in physical examination bilateral palpable testes in inguinal areas. Ultrasonography revealed the absence of uterus, fallopian tubes and proximal vagina. She had a 46 xy karyotype. After consultation, she underwent bilateral orchiectomy and reared as female.Case 2: A 16 years old boy that had reared female in neonatal period, but after bilateral inguinal herniorrhaphy, five years later she reared as male. After puberty and secondary sexual development this misguided boy underwent bilateral mastectomy and he encountered with some psychosocial problems.CAIS results in total feminization and the female role should be supported with postpubertal orchiectomy to avoid the risk of malignancy.