MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2000 | Volume:34 | Issue:46|Papers Count:15

Following an acute phase stimulus, such as inflammation many liver-derived plasma proteins are changed in concentration .In order to study the serum concentration of acute phase proteins in acute viral hepatitis CRP , Alpha-1- Antitrypsin (AAT), Alpha-I-Acid Glycoprotein(AAG) ,Haptoglobin, Transferrin, Ceruloplasmin, the third component of complement (C3) and the plasma concentration of fibrinogen were measured in patients suffering from acute viral hepatitis .The samples were obtained from 60 acute viral hepatitis patients; including 37 males and 23 females at the age between 3-45 in two groups of 21 HBS Ag+ patients and 39 HBs Ag - patients. The patients samples were compared with 60 healthy subjects who were similar to the sample group with respect to age and sex. The serum total protein and albumin didn't change significantly compared with control group (p>0.05).The pattern of hepatic enzymes changes in patients was identical to acute viral hepatitis. It was observed that in both groups of patients there were increases in the serum concentration of CRP, AAT, Ceruloplasmin, C3 and Fibrinogen compared with control group (p<0.01), but the AGG increased only in HBs Ag - group .The serum concentration of Haptoglobin in both groups of patients was decreased in comparison with control group (p<0.01)and it was lesser in HBs Ag + patients. Transferrin as negative acute-phase protein was decreased significantly only in HBs Ag - patients (p<0.01). As it was observed in contrast with other inflammatory disease the plasma concentration of Haptoglobin in both groups of patients decreased in spite of inflammatory changes by liver tissue in acute viral Hepatitis and AAG didn't show any increase. Although the serum concentration of CRP, AAT, C3, Ceruloplasmin and Fibrinogen increased but these increase were much lesser than found in typical form of inflammatory disease. In general,it seems that change in acute-phase proteins in acute viral hepatitis is not in typical form of inflammatory disease.      

Thalassemia is the commonest hemolytic anemia which is inherited as autosomal recessive trait. It is also the commonest single gene disorder in the world and is most seen in Mediterranean countries, middle east and south east - Asia. Beta thalassemia is the commonest form of this kind in Iran and because of its serious and lifethreatening problems in - homozygot forms, causes high cost and many financial duties to the health care system of the country. The incidence of this disorder is very high in some north and southern states of Iran. Its high incidence (about 8%) in Fars caused the government to force people to do the necessary blood tests before marriage. From the point of our knowledge which could not accept such high incidence rate in our city, we did a prevalence study of minor thalessemia in couples in Tabriz, in 1995. From 2052 male and female volunteers of marriage in our health care centers, we took blood sample for evaluating RBC indices, Hb F and A2 analysis and ferritin dosage after completing a questionnaire & used Technicon H1 cell counter for this purpose. Derived information analysed by computer with SPSS program. As a whole1 114 cases showed MCV <80 FL, which 22.8% of them had pure minor thalassemia and 9.6% had both minor thalassemia and iron deficiency. By statistical analysis the prevalence of beta minor thalassemia in Tabiz estimated 1.8%.      

This is a descriptive study to show the incidence and indications of cesarean delivery throughout the Eastern Azarbaiedjan province. For this purpose all the cesarean deliveries both in state and private centers were collected. (16170 cases). The number of birth was 59735 cases in 1997, which cesarean cases accounted to 27% (25.5% in state centers and 62.5% in private ones). Our findings show that the reason of cesarean delivery in the order of incidence are difficult delivery (25.3%) , pervious cesaren section (25%) , fetal distress (20.9%), malpersantation (8.86%), elective (7.51 %), bleeding in the third trimester (2.05%) , multiple pregnancy (1.2%) , systemic disease of mother (1.8%) and tubal ligation (0.88%). The indication of cesarean in private centers was as follows: fetal distress (36.9%), difficult delivery (20.3%), pervious cesarean (16.5%), bleeding in the third trimester (5.7%).      

Pregnancies and their related problems are involved in a remarkable percent of abnormal uterine bleeding (AUB). Thus, for finding the etiology of AUB, it is very important to be sure about the presence or absence of pregnancy. In aborted cases, the absence of placental villi, as a definite criterion of pregnancy, mistaken the diagnosis of pregnancy. In such cases, the presence of intermediate trophoblastic cells (ITC) could be used as another valuable criterion for diagnosis of pregnancy. Accordingly, in the present study both morphological characteristics of ITCs and correlation of their presence with other diagnostic values of pregnancy are examined. The specimens include 100 uterine curetting tissues which were referred to pathology lab for diagnosing the etiology of AUB. The specimens are sectioned, stained with H&E or PAS and studied with light microscopy. The results showed that ITCs are large cells having irregular, hyperchromatic and indented nuclei. These cells were present in all cases of pregnancies (61 cases), but were not found in nonpregnants. It is concluded that the presence of ITCs is a definite criterion for diagnosis of pregnancy. We also showed that the morphological characteristics of nuclei of these cells is a valuable tool for their diagnosis.    

Successful treatment of malignant diseases by radiotherapy depends on a precise control of quality of treatment. So far, a through and precise quality control program has not yet been implemented at Tabriz Radiotherapy center. In this study, a quality assurance program, especially in relation to the system and to the treatment planning of patients, has been carefully implemented. This program included quality assessment of all parts of the CO-60 machine, mechanically and geometrically, output dose of the machine, and quality of protection of personnel and patients. About 204 therapy patients were selected for which treatment planning were carefully controlled. These treatment procedures were compared with those currently used at Tabriz Radiotherapy center. To determine the flatness of the field, profile curves have also been drawn. After the completion of the study, the followings were found and concluded: 1.Five mechanical errors, 2. Good conditions of electrical and radiological safety, 3. Good conditions of central axis dose rate and tray factor, 4. Significant difference in wedge factors ( -1.52% to -14.86% ), 5. A reduction of 0.02% - 3.62% in the prescribed dose when not calculating the effective fields, as applied to 20 patients, and 6. Lack of flatness by 1% - 2% of a 10.10 cm2 field area. Assessments by calculation and controlling the methods applied to all the parameters affecting the treatment planning, showed that quality of treatment of this center is fairly good. However, due to the large number of patients accepted from a large number in the waiting list and also the lack of enough facilities for treatment, treatment procedures have not been completely prescribed or applied. Therefore, for more effective treatment of patients, it is highly crucial and is highly recommended to establish at least one more radiotherapy center with highly qualified radiotherapists and medical physicists.      

Multiplication and harvesting of avirulent strains of T. gondii tachyzoites not only facilitates the studies of this strains, but also provides a comparison field with the virulent strains. Suspensions of mice brains containing tissue cysts of T. gondii were inoculated intraperitoneally to mice groups (each group contained ten mice). The all groups also received cyclophosphamide with the exception of one group. The tachyzoites were harvested from peritoneal cavities during 6 to 10 days after injection and were counted with hemacytometer . The data analyzead with mann- whitney test. The injection of cyclophosphamide to mice for harvesting avirulent tachyzoites was successful. There was a significant difference in two groups since the numbers of harvested tachyzoites from mice which were under influence of cyclophosphamide were greater than those in control group. In addition starting the cyclophosphamide injection from 1 to 2 weeks before inoculation was not influenced the numbers of tachyzoites. This study confirmed the utility of cyclophosphamide in harvesting avirulent T. gondii tachyzoites.      

Patients undergoing long term haemodialysis are usually suffering from dyspepsia. It is supposed that in these patients the increase of urea in stomach predisposes to acquisition of H.pylori infection leading to dyspepsia. This study was conducted to evaluate prevalence of H.pylori in patients with chronic renal failure (CRF) undergoing haemodialysis and its relation with clinical and laboratory finding, and to compare them with control group. In this study 65 patients with CRF (test group) and 109 patients having non – ulcer dyspepsia (control group) were studied. Results of our study showed positive rapid urease test in 45 patients (69.2%) of the test group, while this test was positive in 62 patients (56.9%) of control group (p > 0.05). In our haemodialysis patients having urease positive and negative tests no significant statistical differences were found regarding the duration of dialysis, level of blood urea and creatinine. It was concluded that H.pylori infection can not justify the prevalence of dyspepsia in CRF patients undergoing haemodialysis.      

This study investigates the effects of dietary regimen and aerobic exercise on plasma levels of antioxidant vitamins and lipid peroxidation. Twenty patients, at least with one involved vessel with more than 70% stenosis selected and plasma levels of Vit.C, Vit.E and malon dialdehyde (MDA) were measured by HPLC and thiobarbitoric acid method respectively. The patients were treated with a low caloric, low cholesterol, high fiber dietary regimen and aerobic exercise for 4 months. The parameters were determined after two and four months. The results were compared with the corresponding values obtained from forty healthy volunteers (control group). The results showed lower values for Vits C and E levels and Vit.E/chol ratio with an increased levels of MDA compared with the control before treatment (p<0.001). The MDA level in patients with two or three obstructed vessels were higher than patients with one obstructed vessel. The former group had also lower levels of Vits C and E and Vit.E/chol ratio. The treatment of patients resulted in a marked increase in the Vit.C level with no marked difference in Vit.E concentration and Vit.E/chol ratio. In the patients, before teratment, regression coefficient between MDA with plasma levels of Vit.E, Vit.C and Vit.E/chol. was negative. After 4 months of the treatment, the highest regression coefficient was due to serum levels of MDA and Vit.C. A negative and meaningful relationship was observed between Vit.E and MDA. Their regression coefficient could be written as [MDA=4.3-0.43 (VitC)] and [MDA=4.04-0.09 (Vit.E)]. In conclusion, a low caloric, low cholesterol, high fiber dietary regimen and aerobic exercise together with an increased level of VitC lead to the reduction in lipid peroxidation in CHD without any considerable change in the plasma level of VitE.      

The purpose of this survey is determining of the prevalence of different lesions of middle ear, with special respect to chronic otitis media (COM) in our society, and also searching about predicting of middle ear lesions before surgery with the use of preoperative audiometry. In this study, which is consisted of 50 cases, 88% of surgical procedures on middle ear has been done because of COM. The prevalence of chronic perforations with and without cholesteatoma was 18% ant 52%, respectively. In the cases of COM without cholesteatoma, granulation tissue, tympanosc1erosis, chronic perforation without any of them was 16%, 14%, 26%, retraction. The prevalence 'of retraction pocket with cholesteatoma was 10% and without cholesteatoma was 8% . Cholesteatoma existes in almost half of the eases of COM. Ossicular erosions were found at 40% of all patients and 45% of COM. As a result when there is air - bon gap of 30 dB or more we should think with 70% of confidence about serious lesions. Sensorineural hearing loss (SNHL) was prevalent at 20% of all patients and 18% of COM. The most common form of SNHL was sloping loss. When there were other kinds of pathology at middle ear the effect of size of perforations of tympanic membran was not significant.      

In order to identify major bacterial agents that cause nosocomial infections and also detection of drug resistance to current antibiotics, a cross - sectional study was carried out in three hospitals of Medical Sciences University of Hamadan. In this study 942 samples were collected from different parts of kitchen, emergency section, injection and dressing rooms, and patient rooms. The samples were cultured on E.M.B and Blood agar by sterile wet cotten swab. A smear was also prepared for Gram staining, 174 strains were tested against antibiotics using agar disc diffusion method. The mean of frequency of contamination was 48.6% in three hospitals. The distribution of Gram negative bacteria was 52.3% and Gram positive bacteria were also 47.7%. The highest contamination was obtained from kitchen, but the lowest contamination was in injection and dressing rooms. The most important bacteria were: Staph aureus, Staph epidermidis, E. coli, Bacillus subtilis, Klebsiella, Enterobacter, Pseudomonas, Lactobacilli, Diphtheroides and Entercocci. The most drug resistance was observed in Staphylococci, E.coli, Klebsiella, Enterococci and Pseudomonas aeruginosa. There was high resistance for ampicillin, tetracycline, sulfametoxazole, penicillin and cephalexin.      

Massive air emboli during open heart surgery results in major structural brain damage. Opening cardiac chambers to the atmosphere, cannulation of the heart and aorta, air entrainment following removal of the aortic clamp, restoration of cardiac function, perforation of the pump lines ,sudden displacement of cannulas from the heart, high flows of CPB machine and occlusion of venous lines and at last negligence of perfusionist are all the causes of this severe complication. Certain treatment is prevention of it to occur. Studying 1469 patients' records from 1994 - 1998 admitted to the Tabriz Cardiac Surgery Department indicates only three cases of air emboli discharged from the hospital without evidence of central or peripheral neurological complication. Incidence of the complication mentioned above is 0-11% in multicenters departments.      

Hydatid disease is common infection in Iran, with involvement of any organ. Humans acquire infection by ingestion of viable parasite eggs with their contaminated food. The hydatid cysts tend to form in the liver and lungs but may be found in any organ of the body, including brain, and bones. However, bone involvement in hydatid disease was 1-2%, and spine involved in over 50% of all bone infection, sacral region very rarely involved, and that consist of 1-2% of all bone disease. We repot a rare form of hydatid disease in sacrum in a 42 year old man with complain of low back pain from 4 year prior to diagnosis. His diagnosis established by CT Scan and bone biopsy.