MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2010 | Volume:23 | Issue:2|Papers Count:21

Thrombotic microangiopathy is a clinicopathological study of a state that accompanies with fibrine and platlete thrombi within the microcirculation that accompanies with organ dysfunction, thrombocytopenia and nonimmune hemolytic anemia. Fragmented red blood cells and elevated lactic dehydrogenase are another important findings in this syndrome. The term of Hemolytic uremic syndrome (HUS) describes childhood TMA dominated by renal impairment and Thrombotic Thrombocytopenia Purpura (TTP) refers to adult case of TMA with predominantly neurologic manifestations. HUS syndrome itself is divided in to those with appositive history of diarrhea, that named typical- HUS. A typical HUS has as different causes familial form of a-HUS has been descripted. Abnormal complement cascade activation is a recently under focused cause of a typical HUS. ADAMTS-13 metalloproteinase activity is another important measurement to distinguish HUS and TTP.

Background and Objectives: Vitiligo is the most common acquired pigmentation disorder; which manifests as depigmented patches of skin; rarely mucosa and hair. The prevalence of vitiligo in different races is around 0.1-2%.Many factors have been proposed as possible etiologic factor including genetics, free radicals, autoimmune reactions, melanocytic growth factors deficiency, melatonic destruction. Here we studied the association between vitiligo and autoimmune diseases.Materials and Methods: In this prospective study 86 patients with vitiligo were questioned about the location of vitiligo, family history, treatment and therapeutic response. All patients were examined both clinically and with laboratory tests to detect the presence of autoimmune disorders including autoimmune thyroid disease, pernicious anemia, insulin dependent diabetes, systemic lupus erythematic (SLE) and Addison disease. The laboratory tests including TSH, T3, T4, Hg, Na, ANA, ESR and K were performed. We compared the prevalence of autoimmune disorder in vitiligo patients with that in a group of age-and gender-matched normal 11 years; 61% of ±population.Results: Average age of disease onset was 21.8 patients were female and 39% were male. The most common locations of vitiligo were hands (33.7%) and face (32.1%). The most common pattern of onset was vulgaris type (40%). Nearly one – fourth of patients had a positive family history of vitiligo. Prevalence of thyroid disorders in vitiligo patients and control group was 21.1% and 7%, respectively. The difference was statistically significant (P=0.008). Response to treatment in patients with positive family history was 20%, comparing with 37% in sporadic cases (P=0.01).Conclusion: The most common autoimmune disorder in patient with vitiligo was hypothyroidism (clinical and subclinical). Family history had a poor prognostic effect on response to therapy.Vitiligo, Autoimmunity, Thyroid Average age of disease onset was 21.8 patients were female and 39% were male. The most common locations of vitiligo were hands (33.7%) and face (32.1%). The most common pattern of onset was vulgaris type (40%). Nearly one-fourth of patients had a positive family history of vitiligo. Prevalence of thyroid disorders in vitiligo patients and control group was 21.1% and 7%, respectively. The difference was statistically significant (P=0.008). Response to treatment in patients with positive family history was 20%, comparing with 37% in sporadic cases (P=0.01).Conclusion: The most common autoimmune disorder in patient with vitiligo was hypothyroidism (clinical and subclinical). Family history had a poor prognostic effect on response to therapy.

Background and Objectives: Regular aerobic exercises such as swimming and treadmill running have different physiological effects compared with strenuous exercises. The aim of the present study was to evaluatethe effect of regular swimming exercise on plasma levels of TNF-a, IL-1b and of IL-6 cytokines in healthy and diabetic rats.Materials and Methods: In this study, 40 Wistar rats (250-300 g) were randomly divided into 4 groups, 10 in each group. Twenty animals were made diabetic by a single injection of streptozotocin (50 mg/kg, ip) and 20 animals remained as non diabetics. The exercise protocol was swimming (1h per day, and 5 days per week) for 8 weeks. The IL-6, IL-1b, TNF-a were measured before and after the exercise period.Results: The findings of this study showed that the level of IL-6 was increased significantly after a period of regular swimming exercise in both diabetic and healthy rats in both diabetic and healthy rats; an increase of 23 times and 9 times, respectively (P<0.0005). There was no a significant increase in the levels of IL-1b and TNF-a levels after exercise.Conclusion: According to the findings of this study, regular exercise increases plasma level of IL-6 and this increment is much higher in diabetic rats. Regular long-term swimming training is beneficial in diabetic and healthy individuals.

Background and Objectives: The relationship between family context and environment with mental illness has been considered by researchers for many years. On the other hand disorganizations in family structure and function including conflict in roles, enmeshment in borders, alliance, affective involvement and loss of affective responsibility are main factors in development of depression. Here we studied the family functioning of patients with depression according to the theory of McMaster model and then compared with normal people.Materials and Methods: Fifty depressive patients were selected from two outpatient psychiatry clinics. The control group was selected from normal students and employees of Tabriz University. All patients were asked to complete the Beck Depression Inventory (BDI-II) and Family Assessment Device (FAD) questionnaires.Results: The depressed people acted poorer in most dimensions of family functioning than normal people. Depressed people had poor functioning in general functioning (P<0.001), communication (P<0.001), affective responsibility (P<0.001) and affective involvement (P<0.001). However, there was no significant difference in problem solving (P=0.69), control of behavior (P=0.43) and role (P=0.55) between the depressed patients and control group.Conclusion: Depressed patients have numerous dysfunctions in different aspects of their family functioning's.

Background and Objectives: Emergence of antibiotic resistance is a main problem in microbial infection control. Production of extended spectrum beta-lactamases (ESBLs) can cause antibiotic resistance in bacteria. This study was conducted to evaluate antibiotic sensitivity profiles and the presence of blaTEM gene in Escherichia Coli and Klebseilla. Pneumoniae isolates collected from different clinical specimens.Materials and Methods: In this prospective study (2008-2009) clinical specimens including tracheal aspirates, urine, blood, bronchial secretions, sputum, peritoneal fluid, wound and throat swabs were collected from educational hospitals of Tabriz University of Medical Sciences. We performed antibiotic sensitivity tests (Kirby-Bauer Method) on E.coli and K. Pneumoniae isolated from specimens. Antibiotic discs that were used in this study werecefotaxime, ceftazidime, ceftriaxone, azteronam, amikacin, piperacillin/tazobactam, cefuroxim, cefepim and imipenem. Combind disk test was also used by ceftazidime, ceftazidime/clavolanic acid, cefotaxime and cefotaxime/clavolanic acid. E. coli ATCC 35218 and E.coli ATCC 25922 strains were used as TEM-positive and negative controls respectively. BlaTEM genes were detected by using PCR technique.Results: From total number Of 41 E. coli isolates 36 (87.8%) contained blaTEM gene. All of the Ecoli isolates were sensitive to imipenem, while, 36 of them (87.8%) were resistant to azteronam and 40 of them (97.5%) were ESBL producers. From total number of 47 K. Pneumoniae isolates, all were sensitive to imipenem, while 43 of them (97.8%) were sensitive to cefotaxime, 41 isolates (87.2%) showed resistance to azteroname and 46 isolates (97.8%) were ESBL producers of which 35 isolates (74.4%) contained blaTEM genes.Conclusion: High rate of resistance in E. coli (80.4%) and K. Pneumoniae (91.4%) isolates .Undelines the importance of accurate sensitivity tests.

Background and Objectives: Both 2-dimentional and 3-dimentional computerized tomographies (CT) are useful for measurement of tissue volume and reconstruction of maxillofacial areas. The aim of this study was to compare these two modalities for volumetric measurement of maxillary sinus. Materials and Methods: This study was done on four human skulls obtained from the collections of department of anatomy. Sinus walls were sealed by rose wax and then actual volume of the sinuses were measure by water injection, as our gold standard. This measurement was performed three times for each sinus and the mean values of measurements were calculated. The skulls were also assessed radiologically by two dimensional and three dimensional CT. The results were compared by statistical methods.Results: No significant difference was found between two-dimensional and three dimensional CT measurement with actual sinus volume (P>0.05). The difference between two aforementioned CT methods was also insignificant (P>0.05).Conclusion: Volumetric measurements of maxillary by sinus two-dimensional and three-dimensional reconstructed image methods are reliable and accurate.

Background and Objectives: Frontal lobe, especially prefrontal areas dysfunction, is one of the assumptions in the pathogenesis of schizophrenia. Consistent with this hypothesis, a deficit of prefrontal cortex oligodendrocytes was reported in schizophrenic patients. Quantitative Electroencephalography (Q-EEG) studies in these patients indicated that there is an increased in beta, delta and theta waves but a lack of alpha activity. The objective of this study was to study the frontal lobe beta activity in symptomatic and asymptomatic schizophrenic patients and normal individuals.Materials and Methods: Thirty patients diagnosed with schizophrenia (diagnosed by DSM-IV-TR criteria), and 30 normal individuals entered this study. Patients group was divided in to symptomatic and asymptomatic subgroups by Assessment of Negative Symptoms (SANS) and Scale for Assessment of Positive Symptoms (SAPS) tests. The results of SANS and SAPS indicated that 14 patients had negative and 16 patients had positive symptoms. Q-EEGs of patients and control groups were obtained from 8 areas of frontal lobes and the results were compared.Results: Results indicated that there were significantly differences between the groups in 4 areas of frontals waves (Fz, Fp2, Fpz, Fp1). Activity of beta waves, in patient groups was generally increased. Moreover in patients with positive symptoms, activity of beta was higher than in patients with negative symptoms.Conclusion: It is concluded that obtained beta waves from different areas of frontal lobes, in addition to borderline of frontal lobes, differed significantly from obtained beta waves from the same areas of frontal lobes in normal individuals.

Background and Objectives: Group training of life skills means how to use behavioral techniques in schizophrenic patients to manage their interpersonal and interpersonal deficiencies, to achieve independent lofe skills. The present study intends to investigate the effectiveness of training five different life skills, including; self-care skill, disturbance reducing skill, interpersonal communication skills, social contact and responsibility taking in schizophrenia patients.Materials and Methods: This study was a pretest and posttest designed study. Frothy schizophrenia patients were randomly allocated and divided in two equal groups, study and control group. Study group underwent twelve sessions of life skill training. Data was gathered by life skills profile questionnaire.Results: The results were compared between study and control group using test and gain score method. There were meaningful difference between study and control group in their social interaction skill and personal/social ability (P=0.001). There were not a meaningful difference in self care (P=0.230) and disturbance reducting skills (P=0.330) between these two groups.Conclusion: Training life skills including self-caring skill and disturbance reducting did not change noticeably in posttest in comparison with pretest. But in social contact skill, interpersonal skill and responsibility taking there was a significant difference statistically between pretest and posttest in study group.

Background and Objectives: It has been claimed that aspherical intraocular lenses can optimize image quality by limiting rays diffraction. This study aimed at comparing the wave front aberrations after cataract surgery with 2 foldable intraocular lenses; spherical Akreos Fit and aspherical Akreos Adopt AO.Materials and Methods: during a 12 month period we conducted a clinical trial study an evaluated wave front aberration in 3 group (20 eyes in each groups).aspheric (AO) and spherical (Akreous fit) intraocular lenses implanted in groups 1 and 2 respectively. Group 3 consist of 20 phakic age matched eyes. One month after cataract surgery, the aberrations were measured in each group. Individual Zernike polynomials and the root-mean-square (RMS) 2nd, 3rd and 4th order aberrations, high-order aberrations and the total RMS value were compared between the 3 groups.Results: The total and the high-order aberrations, as well as the spherical aberration were statistically significantly lower in the aspheric intraocular lens group comparing with the spheric intraocular lens and control groups. The 2nd and 4th order aberrations were also lower in the aspheric lens group comparing with the spheric lens group, but comparable with results in the control group. Our study showed some of aberration that exists after cataract surgery in intraocular akreos adopt ao lens are lower than intraocular akreos fit lenses.Conclusion: This study revealed that aberrations is lower and quality of vision is better in aspheric (AO) than spheric intraocular lenses.

Background and Objectives: Essential hypertension is psychophysiological disorder that both biological process and psychological risk factors such as stress, personality traits and coping style play a basic role on its creation and persistence. In this research we investigated personality traits and coping style of essential hypertension individuals and compared them with normal individuals. Materials and Methods: In this research, 50 essential hypertension individuals (22 males and 28 females) and 50 normal individuals (20 males and 30 females) were chosen in random matching with patient group. Data gathering was performed by Eysenck Personality Inventory (EOQ-R) and coping strategy questionnaires in both groups.Results: The result showed that patients with essential hypertension had significantly different personality traits compared to the normal group (P<0.001). Also there was difference in emotion focus coping style between two study groups (P<0.001). However, no significant difference was in problem focus coping style between two groups (P<0.475). Furthermore, a significant difference was noted between extroversion personality trait and emotion and problem focus coping style between male and female individuals in two groups.Conclusion: Result of this research revealed that essential hypertension individuals are angry, furious, anxious and ready to be depressed. When they encounter with stressful conditions they use more emotion focus coping styles than normal person.

Background and Objectives: The main objective of the present study was to evaluate the efficacy of second trimester screening for Down syndrome and trisomy 18 in a population of pregnant women in east Azerbaijan province.Materials and Methods: The study involved 300 consecutive women who attended the screening between the 15th and 20th weeks of pregnanc. A blood sample was obtained to measure alpha feto protein (AFP), intact human chorionic gonadotropin (hCG) and unconjugated estriol 3 (UE3). The combined risk assessment including maternal age, AFP, hCG and UE3 was performed in each individual using a computerized risk figure program. The positive screen results were referred to prenatal diagnosis to prenatal diagnosis clinic for further molecular and cytogenetic studies.Results: The mean age in study population was 25.11±5.47 years. Twenty one positive screen results (7%) were detected for Down syndrome and 9 positive screen results were detected for Edward syndrome (3%). The mean age in these groups were 30.62±7.88 and 30±4.26 years respectively. The remaining 270 individuals had negative screen results and the mean age in this group was 24.75±5.45 years. Prenatal diagnosis using interphase Fluorescence in Situ Hybridisation and standard cytogenetic techniques revealed Down syndrome in 3 positive screen results (7%). Two positive screen pregnancies for Down syndrome were terminated due to fetal death. In none of the positives screen results for trisomy 18, Edward syndrome was confirmed through the aforementioned techniques.Conclusion: The results of this study were comparable to the previous studies. These showed that second trimester study of pregnant mothers is a useful screening model for detection of Down syndrome.

Background and Objectives: Congenital heart disease (CHD) is one of the causes of malnutrition and growth retardation. Here we studied growth disturbance in different type of CHD. Materials and Methods: In this case-control study, 400 children with CHD (from 3 months to 16 years old age) were selected. Patients were divided into four groups: 1.acyanotic without pulmonary hypertension (PHT), 2. acyanotic with PHT, 3.cyanotic without PHT, 4.cyanotic with PHT. Body weight (Wt), height (Ht) and head circumference (HC) of these patients were measured and compared with those of matched control group. Results: The mean Wt, Ht and HC of the patients in group one was not significantly different from that of the controls (P>0.05). In group two, the mean Wt was significantly lower than control group (P=0.01). In group three and four, there were significant differences between the mean Wt and Ht compared with that of the control group (P<0.05). There was significant difference between the pulmonary pressure of patients in group 2 and 4 (P=0.0001).Conclusion: The findings of this study showed that children with congenital heart disease are susceptible to growth disorders and this is more significant in cyanotic patients. Growth disorders are more common and severe in cyanotic patients with pulmonary hypertension.

it is still a major challenge. We aimed at evaluating the incidence and complications of cholesteatoma in middle ear surgeries. Materials and Methods: In a retrospective observational study we evaluated the surgical results and complications of cholesteatoma operation.Results: In a six-year period one hundred and sixty six patients were studied. The mean age of the patients was 30.8 years with most incidences in age group of 21-30 years. The most common pathology was an isolated cholesteatoma. In 57.2% of patients, tympanic cavity, attic, antrum and mastoid were involved. The most common site involved in tympanic cavity and mastoid were oval window and tegman mastoid, respectively (47.6% vs 39.8%). Incus, the most involved ossicle, was noted to be totally (59%) and partially (40/9%) erosive. Erosion of Fallopain canal was the most common complication of cholesteatoma (32.5%).Conclusion: Cholesteatoma complications and its extension were higher in our study. Therefore increasing the knowledge of the society on otitis complications seems to be highlighted in the programs of health care system.

Allgrove syndrome or triple A syndrome, is one of the least understood entities among the ACTH resistance adrenal insufficiencies. This syndrome is characterized by achalasia, alacrima and adrenal insufficiency. Neurological and dermatological finding are also present. The molecular origin of the syndrome is not clear. An anomalous region on chromosome 12 q 13 could explain some abnormal findings of this syndrome. We report here a 7 year old boy with achalasia, alacrima, adrenal insufficiency and failure to thrive diagnosed as allgrove syndrome.

Unilateral or bilateral renal agenesis usually is accompanied with multiple organs structural defects. Association of renal agenesis with imperforated anus and ambigus genitalia called Wernestrup syndrome. In this report we present a case of Wernestrup syndrome with additional structural defects of heart and skeletal system. As far as we now this is the first report of this associations.