MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2004 | Volume:38 | Issue:64|Papers Count:21

Background and Objectives: A staged model of smoking adoption has been widely applied in the studies of adolescent smoking. This paper examined the effects of socio-environmental and personal factors on three stages of the smoking continuum among a sample of grade-10 male students, aged 14-19 years, at 20 high schools in Shiraz city.Materials and Methods: This is the first step of a longitudinal study related to adolescents smoking and predictors of transition in the stages. A self- administered questionnaire with 38 questions was distributed to 1132 grade-10 students among 45 classes from a possible population of 14000 students. Multivariate discriminant function analysis was used to analyze the data. Results: Overall 19.4 percent of students ased to smoke. Eighty Point six Percent, 16.9%, and 2.5% were never smoker experimenter and regular smoker, respectively. The discriminant function analysis indicated that attitude toward smoking, ever use of alcohol, ever use of illicit drugs and best friends smoked dominate the construct; the contribution of self-esteem is less important. Finally, these variables permitted the correct classification of 70.3 % out of students into the stages of smoking acquisition.Conclusion: The content of smoking prevention programs for adolescents should be adapted to each stages of smoking acquisition. This finding has important public health significance, but further research is required to determine if the association is causal.

Background and Objectives: Autonomic system dysfunctions in parkinson disease (PD) are not uncommon. Mechanisms of this abnormalities are degeneration of neuronal structures. Clinical manifestations of autonomic dysfunction in PD are abnormalities in the sudomotor, gastrointestinal and urinary functions, postural dizziness, hypersalivation, seborrhea and impotence. Postprandial hypotension and disturbances of sleep and breathing have also been reported as manifestations of autonomic dysregulation. The overall prevalence of autonomic symptoms varies from 76% to 93%.Materials and Methods: In this study 28 out of patients referred to Neurology Department were evaluated for autonomic system dysfunction clinically and also by two sensitive tests: baroreflex sensitivity test and skin sympathtetic skin response test. The control group included 20 patients without any neurologic disease and other medical problems with known autonomic complications such as diabetes mellitus or cardiac problems and hypertension.Results: The study shows that autonomic system dysfunction symptoms are common in PD than control group. The symptoms such as constipation, frequency, impotence and blurred vision differences were significant (p<0.05). Also normal orthostatic heart rate in PD is lower than control group. Our study shows that carotid baroreflex response in PD is weaker than the control group. R-R interval in EKG of patients with PD and control group in supine position are not different but with sitting position this parameter significantly differs between two groups. The results of sympathetic skin response (SSR) test showed abnormal response in patients with PD and distal latencies of tibial nerve stimulation were significantly high in them.Conclusion: Autonomic system involvement in PD is common and we recommend that physicians managing these patients shoud be aware of this fact. Therapeutic considerations are necessary in these situations. These involvements should not always be considered as drug side effects.

Background and Objectives: The objective of this study was to determine and compare serum zinc concentration in children with failure to thrive and well thrived (Weight and Height above 50th percentile) at Northwest of Tabriz 2001.Materials and Methods: This cross sectional study was conducted on 172 failure to thrive (as a case) and 154 well thrived (control) children that had been matched from the view point of age and sex. From all children 3 milliliter vein blood was obtained. Serum zinc was measured by atomic absorbtion spectrophotometer. Mean of serum zinc in two groups was compared using student t test and Chi-Square test.Results: The mean of serum zinc concentration in failure to thrive children was 77.65 ± 20 µg/ dl, and well grown was 85.8± 16.9 µg/dl, The difference between two groups was significant ( p<0.001 ). Serum zinc level of 35.9 % of cases and 22% of control group was lower than normal (p=0.028) and 6.5% and 6.7 % of cases and control were higher than normal range, respectively.Conclusion: The mean of serum zinc level in children with failure to thrive was lower than well thrived children.

Background and Objectives: Sleep abnormalities are disturbances in regularity, quality and quantity of sleep which lead to dysfunction in everyday life. Insomnia, hypersomnia, disturbance in sleep - wake schedule, nightmares, night terrors, and sleep walking are among common sleep disorders. Although sleep has a significant role in mental and physical well being of human kind, and numerous studies have been carried out about its nature. Sleep disorders have not been fully studied. This study was aimed to investigate the prevalence of sleep disorders in mentally ill patients and to compare it with the same disorders in general population. Meanwhile long-term use of sedative and hypnotic drugs were studied in males and females in both groups. Materials and Methods: Our research was a descriptive, cross-sectional, comparative and retrospective study. One thousand and thirteen patients were studied. The age range was between 15 and 75 years. Four hundred and eighty two out of the subjects were randomly selected from general population of Tabriz and 531 psychiatric patients were selected by consecutive sampling from clients referred to two psychiatric clinics of Tabriz University of Medical Sciences. We used Sleep History Questionnaire (Kaplan & Sadock) to study sleep disorders in both groups. The data were analyzed with statistical methods of frequency, percent and chi-square (2).Results: General prevalence of sleep disorders in this study in general population was 35.22%. Daytime sleepiness and difficulty in falling sleep were 64% and 41.3% respectively and the highest among all sleep disorders in general population. Nightmares (16.9%), somniloguy (sleep talking) (26.4%), sleep paralysis (16.5%), sleep terror (9.6%) and sleep walking (7.1%) were among the frequent sleep disurbances we noted in our study. Psychiatric patients compared with general population used more hypnotic agents. The prevalence of sleep disorders in psychiatric patients significantly (p<0.01) was higher than general population. Daytime sleepiness was significantly more frequent in women (p<0.01). Complaints about sleep difficulties were increased with age in both gender (p<0.01).Conclusion: Overall finding in this study is that the sleep disorders are quite frequent in general population and psychiatric patients require careful evaluation and management.

musculoskeletal disorders in dentists who practice in Tabriz and risk factors associated with these symptoms.Materials and Methods: A total of 97 dentists were participated in this cross-sectional study. All the participants were interviewed using a self- administered questionnaire containing data on occupational, life-style and presence site and characteristics of pain. Then the data were gathered and the prevalence of the mentioned parameters and the relationship between the qualitative variables in the questionnaire were analyzed statistically. Results: The results of this study revealed that 63.2% out of men and 85.7% out of women had musculoskeletal disorders and there was a significant difference between male and female dentists in this regard (p=0.05). However 32% out of the participants had no pain. On the whole, the most common symptoms were neck pain (66.6% in women and 60.4% in men), followed by back pain (22.9%) in male and wrist pain (50%) in female dentists. In this study musculoskeletal disorders did not show any statistically significant association with employment time and weekly working hours and dominant hand. In 11.3% out of participant, these symptoms led to work off.Conclusion: Within the limits of this study it can be concluded that the musculoskeletal troubles have a high frequency among the dentists. Dentists usually remain on a prolonged uncomfortable postures and high static muscle load in the neck and back and extremities such as neck flexion and arm abduction etc. which may imply a risk for development of the troubles. Thus we presume that the avoidance of prolonged unsuitable positions and postures will decrease static muscle activity and the risks of occupational musculoskeletal disorders for dentists.

Background and Objectives: Infective endocarditis is the most common cardiac disease which may arise by metastasis and colonization of bacteria on the endocardium. This study was aimed to evaluate the knowledge of dentists about the latest prophylactic regimens for infective endocarditis.Materials and Methods: A total of 200 dentists who practice in Tabriz participated in this descriptive-analytical study. All participants filled out a questionnaire contained questions about their knowledge of the latest prophylactic regimens and their indications. The results were analyzed statistically to detect the correlations between age, sex, practice duration and the knowledge. Results: Regarding the knowledge about the indications of infective endocarditis prophylaxis, there was no significant correlation between age, practice duration and the knowledge (p=0.009 and p=0.308). However, correlation between age and practice duration by knowledge of the latest prophylactic regimens was significant (p<0.001). The relation between sex and knowledge was not significant (p=0.12). Conclusion: The results of this study indicate the necessities of reevaluation of current education programs for dentists in order to provide more information to dentists regarding the prophylaxis of infective endocarditis.

Background and Objectives: Acne is a common skin disease that if remains without treatment, permanent scars and pigmentation would be anticipated. These complications which affect mostly adolescents and young adults may lead to some important psychosocial Problems. Comedo formation has a basic role in the inflammatory lesions and permanent acne scar. With regard to the mechanism of superficial peeling that can be attributed to the disconnection of the bands between keratinocytes, Jessner solution can be used in treatment of comedon and acne.Materials and Methods: This study was performed on 15 patients with mild to moderate acnes. The patients enrolled, were treated with Jessner solution in 4 sessions with one week intervals. The surface should be washed with alcohol before treatment. After appearing the erythema the procedure must be stopped and the solution be washed off Patients should be advised to use sun block creams. Jessner solution is composed of various compounds such as salicylic acid 4% resorcinol 14% lactic acid 14% in the ethanol base. Results: In this study we compared the numbers of comedones, pustules and inflammatory papules in frontal area before and after treatment. The patients were also observed for probable complications. The result obtained in this study showed that the average number of comedones in the frontal area were 72.73 before and 36.93 after treatement. The average erythematous papules of face were 32.4 and 20.46 before and after treatment respectively. The average number of face pustules numbers reduced from 9.13 before treatment to 6.4 after that. In the aggregates, the number of comedones, erythematous papules, and pustules reduced significantly in this study. No especial complications were observed in our study.Conclusion: Regarding the simplicity, cost effectiveness of this method and also its safety, this procedure can be an appropriate alternative for treatment of acne.

Background and Objectives: Fiberoptic endoscopy is a highly efficient diagnostic tool which is now being increasingly used in pediatric age group. This study has been carried out to demonstrate indications for and common findings of endoscopy in children.Materials and Methods: We retrospectively reviewed the medical records and endoscopy indication and results of 385 pediatric patients (aged 1month to 16 years) who had endoscopy between Jan 2002 to Feb 2003.Results: we analyzed 385 children who referred for upper gastrointestinal endoscopy (224 boys and 161 girls).The most common age was 6-12 years. The indications comprised chronic abdominal pain (123), upper gastrointestinal bleeding (90), recurrent vomiting (84), assessment of varices (21), failure to thrive (19), chronic diarrhea (15), malabsorbtion (6), and miscellaneous (22). The most common diagnosis was gastric erythema and erosion (25.9%), followed by esophageal and gastric erythema (24.6%), esophageal erythema and mucosal break (15.1%), esophageal varices (13%) and normal findings (10.1%).The endoscopic findings in abdominal pain was gastric erythema and erosion (32.5%), esophageal erythema and gastric erythema (32.5%) and ulcer (5.7%). The commonest endoscopic appearance of upper gastrointestinal bleeding was gastric erythema and erosion (45.5%) followed by esophageal varices (32.2%) and peptic ulcer (21.1%). Conclusion: In our experience, upper gastrointestinal endoscopy is a safe and effective diagnostic procedure in the pediatric age group. Esophagogastritis is commonly seen in children, hence must be included in differential diagnosis of chronic abdominal pain and its management.

Background and Objectives: Vascular trauma is a life-threatening condition. On the other hand, it is the third cause of deaths in human populations. This study has been developed for assessment of signs, types, and causes of vascular traumas and types of performed treatments. Materials and Methods: This study was conducted on 124 patients with vascular traumas at Tabriz Imam Khomeini Hospital, from April 1998 to March 2000, in which 5 cases were females and 119 were males.Results: The most frequent of them were arterial. Isolated venous lesions were found in 15 cases. The most frequent arterial trauma was femoral artery trauma and the most frequent venous one was popliteal. The average hospitalization period was 10.5 days and the average amount of blood transfusion was 3.35 U. The greatest of cases included penetrating stabs or sharp bodies traumas (63%) and the blunt trauma was 21%. There were both penetrating and blunt traumas in 16% of cases. In blunt trauma, the involvement of lower limbs was more frequent. The majority of patients were operated within the first 9 to 10 hours and the most frequent operation was end-to-end anastomosis. There were 6 cases of amputation often in lower limbs (5 cases) and one case in upper ones. The cause of amputation in 3 cases was infection and the most common microbial cause was streptococcus. The most common forms of injury were complete or partial vascular injury, and mortality occurred in 4 out of 124 patients (3.2%).Conclusion: The signs, types of vascular lesions, and performed treatments are similar to previous published statistical data.

Background and Objectives: Welding is connection of two wires locally and as a result in this process fumes are produced. Since in welding, distance of welder face to the site of connection is not more than 50 centimeter, fumes cause damage to the tissues specially respiratory system and it is the the main cause of pulmonary diseases in welders. These side effects show themselves as chronic pulmonary abnormalities and carcinogenic effects. For diagnosis of pulmonary abnormalities including restricting and blocking diseases clinicians can use chest x-ray and spirometery.Materials and Methods: In this study that developed as a case-control, 70 male welder labors with age of 20-70 in Ardabil that worked minimally with electrical welding for three years, were chosen. Via spirometery of volumes and capacities of pulmonary special Forced Expiratory Volume after 1s (FEV1), Forced Vital Capacity (FVC) and ratio of them were determined. For comparison of these parameters, the same number of persons with the ages and economic conditions without no disease were chosen and spirometery was done in this group. Comparison of two groups carried out using unpaired Students t test.Results: Results of this investigation showed that volumes and capacities of pulmonary in welders in comparison with normal persons had significant differences. Comparison of FEV1 between welders (1.87 ± 0.22 Liter) and normal person (2.95 ± 0.11 Liter), and comparison of FVC between welders (2.64 ± 0.5 Liter) and normal person (3.22 ± 0.2 Liter) showed significant differences (p<0.05). Since existence of high abnormality in respiration like cough and mucus in welders and high ration of FEV1/FVC in welders (70.83 in comparison with normal 91.16), chronic bronchitis exists in the welders. Gases like fosgen, nitrogen and materials such as lead, mercury cause these abnormalities. Cupper, nickel, iron and magnesium exist in fumes produced by welding and can destroy alveolus and pulmonary tissues and produce diseases such as bronchitis.Conclusion: In according with results obtained, we suggest welders to use the masks while welding to prevent from the side effect of fumes on pulmonary tissues. In addition, welders should be encouraged to perform necessary pulmonary tests every six months.

Background and Objectives: The maintenance phase of periodontal treatment is a part of therapy that starts immediately after the active treatment of gingivitis and periodontits. The aim of this study was to evaluate the compliance of patients in our society with maintencnce recalls and also determine the correlation between the compliance and some variables such as gender, age, occupation and type of therapy.Materials and Methods: In a retrospective study, we studied the medical files of 700 patients in two private periodontal offices, and the required information recorded on the forms prepared for this study. In these forms, patients were classified by age, sex, occupation and type of therapy and their compliance with supportive periodontal treatment (SPT).Results: In general, 3.4% out of the patients had complete compliance, 7.3% had fair compliance, 53.3% had sporadic compliance and 36% of the patients never return for SPT. There was a significant relationship between the compliance with gender and occupation, but the relationship between the compliance with age and type of therapy was not significant.Conclusion: According to the results of this study, dentists must emphasize the need for maintenance therapy after the active periodontal treatment to their patients.

Background and Objectives: The prevalence of psychiatric disorders in the developed countries has been identified by the screening questionnaires and standard clinical interviews at a high level, but the epidemiological studies of Psychological disorders in our country are brief and their numbers are few. Planning for providing essential mental health services to the people requires us to be knowledgeable about the present status of psychiatric disorders in the society. The objective of this research was to carry out the epidemiological study of the psychiatric disorders in the individuals 18 years and above in urban and rural areas of East Azerbaijan Province. Materials and Methods: One thousand two hundred and eighty six individuals selected through a randomized systematic and clustered sampling methods from the existing families of East Azerbaijan Province and the Schedule for Affective Disorders and Schizophrenia (SADS) questionnaires completed by the clinical psychologists. The diagnoses of the disorders were based on DSM-IV classification criteria.Results: The results of the study showed that the prevalence of psychiatric disorders in the study population of the Province is 15.33 percent which was 18.23 percent in the women and 12.51 percent in the men. The anxiety and mood disorders respectively with 8.48 and 2.89 percent had the highest prevalence in the Province. The prevalence of psychotic disorders in this study was 0.39 percent, neuro-cognitive disorders 1.94 percent and dissociative disorders 1.63 percent. In the group of mood disorders, major depression with 2.26 percent and in the group of anxiety disorders, obsessive compulsive disorder with 2.26 percent had the higher prevalence. Conclusion: This study showed that 10.89 percent of individuals that were studied, suffered from one of the psychiatric disorders. The prevalence of these disorders in the Province among the individuals in the age group of 66 years and above with 13.95 percent, individuals whose spouses had passed away 22.92 percent, residents of Tabriz city 12.45 percent, illiterate individuals 13.85 percent, retired individuals with 26.47 percent was more than other individuals in the sample. Being aware of this matter reveals the responsibility of the health policy-makers and programmers, prevention, treatment and medical education more than before in relation to preparing application and executive plans in East Azerbaijan Province for mental health.

Iranian soldiers and citizens were attacked by chemical warfare used by Iraqi army during Iran- Iraq war (1980-1988) several times. Many acute and chronic manifestations, like psoriatic plaques and bullous eruptions, have been reported. This is the first report of co-occurrence of psoriasis and bullous pemphigoid in a chemical warfare victim.The patient is a 42- year- old woman injured by sulphur mustard in Sardasht, Iran (1985). Five years after injury, some scaly erythemtous plaques appeared on her skin and pathologic report showed psoriasis. Eight years after exposure the patient was referred with similar plaques and at the same time with several intact bullae on her limbs and trunk. Pathologic examinations of specimens taken from bullae confirmed the bullous pemphigoid. A good response to 40 mg prednisolone daily obtained but psoriatic lesions relapsed several times and other therapies were performed. Co-occurrence of psoriasis and bullous pemphigoid has already been reported but not in a chemical warfare victim. Further studies must be done on the mechanism of this correlation.

A 14-year-old male presented with the chief complaint of bilateral progressive ptosis, which began approximately two years ago. He gradually felt weakness in his limbs. Initially, there were some differential diagnoses, such as spinal muscular atrophy (SMA) with bulbar involvement, neuromuscular junction problems, and some myopathies like myotonic with proximal predilection (proximal myotonic myopathy). With electrodiagnostic study, we ruled out these diagnoses. Kearns-Sayre syndrome (KSS) is a rare myopathy and usually presents with other systemic signs and symptoms, which should be considered as a differential diagnosis in all cases with myopathy and ptosis.

Gastroesophageal reflux (GER) is a common pediatric problem which is not perceived adequately by parents and medical providers. Clinical manifestations such as regurgitation of unprocessed milk, poor weight gain, and respiratory symptoms should alert the physician about this disorder. Endoscopy, 24 hour esophageal pH monitoring, the upper GI series, and scintigraphy are among the used diagnostic modalities of this disorder. Prompt diagnosis and medical or surgical treatment with antireflux procedures as needed can prevent its complications such as Barrett’s esophagus and stricture. In this article we present an 18 month old patient who developed severe esophageal stricture as a complication of prolonged GER because of delayed diagnosis, and underwent a previous unsuccessful antireflux procedure, treated with colon interposition procedure at Tabriz Imam Khomeini Hospital.