Medical Journal of Tabriz University of Medical Sciences
Year:2001 | Volume:35 | Issue:49|Papers Count:21

Background and Objectives: Lectin histochemical studies have been reported to characterize terminal sugars of rat embryonic goblet cells which reside throughout the length of the small and large intestine.Methodology: Lectin from dolichos biflorus (DBA) which react specifically with N-acetyl - galactosamine, an adult terminal sugar for intestinal goblet cells was used for this study .In addition to this, three fucose binding lectins from aleuria aurantia (OFA), lotus tetragonobolus (LTA) and ulex europeus (UEA-1) which have different binding characteristics to terminal fucose, were also utilized.Results: The intestinal goblet cells started to appear on day 17 of gestation in rat embryos. These cells reacted strongly with OFA in both small and large section of intestine. UEA-1 reacted only with the goblet cells of the large intestine. LTA reaction was very poor while, DBA did not react with any goblet cells during intestinal development.Conclusion: The results observed indicate that embryonic glycoconjugates of goblet cell mucine are different from their adult form, and also fucose plays an important role for intestinal goblet cell development. It also might have protective and maintenance activities for mucus blanket, during late fetal period.

Background and Objectives: In terminology stress is used for explaining physiological and psychological responses against physical and emotional stressors. It occurs when normal capacity of body for compatibility is reduced. This study presents severity of hospital stressors on cardiovascular patients according to several factors such as sex, age and educational background.Methodology : The present study was performed on about 100 patients from both sexes who suffered from different heart diseases with relatively stable physical status. All of them received medical and non surgical therapeutics. Possible hospital stressors surrounding them were identified and presented as a questionnaire in 29 items. Each of stressors were classified as answered by patients as following : very much ,much, moderate ,little , a little bit and none. Data analysis was performed by applied and non parametrical approach (Kruskal wallis).Results: 100 patients prospectively with average age of 40-52 years males (33%) and 53-54 years females (67%) were randomly selected for this study. Their responses to 29 hospital stressors were assessed using questionnaire. Most common hospital stressors for both sexes were respectively : being in the hospital during holidays (94.80%), worrying about any patient in their family and being away from them (93.40%) , having a room mate critically ill (81.60%),not having enough insurance to pay for hospitalization (77.00%), to stay in bed or the same room all day (76/00%) , a sudden hospitalization (73.20%),being hospitalized far away from home (69.80%) , not understanding language or some words of nurses or doctors (69.80%), getting medications by family (67.20%) and extreme noise disturbance of staff and nonmedical team members (66.60%).Conclusion: Results of this research presents that stressors are more familial, cultural (educational) and economical, which can be dealt by upgrading hospital and personal administration.

Background and Objectives: Ephelides are one of the most popular skin diseases specially in the fair - skinned persons. Several modalities have been suggested for the treatment of this disease, cryotherapy being one of them.Methodology: 82 patients comprised of 11 males (13.4%) and 71 females (86.6%), referred to 7th - Tir Hospital, Tabriz during 1995-97 were treated by this method for their skin ailment . In 98% of cases, the lesions were on the face and in the rest, both hands and face were involved. All of them were treated by liquid nitrogen. Cryotherapy was given three times with a gap of 3 weeks period in between each and 3 seconds therapy for each lesion.Results and Conclusion: Results of the specific course of treatment shows that receiving of the classical curative therapy for the disease (three times with a gap of 3 weeks and for every lesion 3 seconds) was quiet satisfactory. In 95% of cases, the colour of lesions faded off and became as normal skin colour and still after 1.5 years no recurrence have been observed.

Background and Objectives: Reports are available that childhood and adolescent obesity have an important effect on adult morbidity and mortality. It has also been suggested that screening childhood obesity seems to be necessary with reliable and practical methods. Body mass index (BMI) is one of the common methods which can be used for determining obesity in every gender and ages.Methodology: Childhood obesity was screened for a period of one year (in year 1995) by assessment of body mass index. The study was carried out on 1,223 school children (616 males and 607 females) , aged 7-11 years in Tabriz city of Iran.Results: We observed that in two gender groups BMI value increased with age. Difference in the BMI value between female and male groups was statistically significant (p<0.0001). The differences in two groups especially in 50th centile at ages nine, ten, and eleven years were remarkable. We compared our results in the form of centile curves with international standard curves. The centile curves of our finding were lower than international curves, maximum difference was observed in 75th centile of male at 11 years and in 50th centile of females at 11 years.Conclusion: Although the results obtained does not clearly explain the differences observed in our study, however, in our view genetic and social factors might have played an important role in the differences.

Background and Objectives: Allergic rhinitis is the most common presentation of atopic disorders, and one of the important causes of morbidity, but much under diagnosed (Atopy are the special antibodies against one or more common allergen that become distinct with skin test).Economic consequences of allergic rhinitis is considerable . About 20 million persons in America suffer from this disorder. Economic consequences of allergic rhinitis is 500 million dollar in America every year. In England and American studies allergic incidences varies from 3.2% to 18%. Although this disorder has not been much studied in our country, however, it is estimated that about 10% patients suffers from the disease .Methodology: In this study we compared local steroids (Betamethasone drop) versus systemic antihistaminic (Dexchlorpheniramin) effects in allergic rhinitis symptoms and single blind form. The study was conducted on 72 patients, in Group I (Antihistaminic Group) which comprised of 36 patients , dexchlorpheniramin (2 mg Tid) was given for one month, and in Group II (n=36) the patients received betamethasone drop (2 drop every 8 hour) for period of one month.Selection of drug was intermittent. After treatment, symptoms and signs in two groups were compared with each other. The most common sign before begining of treatment was nasal congestion (95.%8 ), which after treatment with antihistamines declined to 18% and with usuage of local steroids it reduced to 8%. Results and Conclusion: Local steroids recover symptoms and signs as PND, weakness and chornea hypertrophy better than systemic antihistaminics. However, in symptoms and signs such as headache, congestion, local pruritus and rhinorrhea these two drugs have the same effects. The distinguishable difference was observed in the treatment with steroids, usuage of which reduced symptoms from 80% to 3% whereas, in group with antihistamins symptoms reduced from 80% to 50% in only 58% cases. In our view, allergic rhinitis better responds to local steroids.

Background and Objectives: The human is unique among mammals for his upright posture which is a main characteristic. Abnormal posture can produce pain. Head, neck and upperlimb dysfunction, after low back pain are the most common disorders. This research investigated two postural abnormalites in these areas.Methodology: The study was carried out on 495 women , Group1: 17-25 years old, mean 19 - years and Group2: 35-50 years old , mean - 40 years. Evaluation of posture was carried out by "plumb line" according to "Kendall and Mc. creary Theory". Variables of population cognition, the degree of head and neck abnormalities and severity of pain in the 7 regions were laid down in related questionnaire.Results: The results showed that the prevalence of forward head in first group was 75% while, in the second group it was 82%. Prevalence of round shoulder in left side in first group was 22.2% and in the second group it was 49%, round shoulder in right side was prevalent in 24.5% cases while, in second group it was observed in 51% of women.Significant difference was observed between variables of "age" and "round shoulder" (p<0.05), however, the relationship between "age" and "forward head" was not significant (p>0.05). Significant relationship was also observed between "abnormalities" and "pain" in the specific regions (Cervical, thoracic and shoulder) (p<0.05).Conclusion: The prevalence of round shoulder and forward head was high in the aforesaid 2 age groups. There is a correlation between pain and abnormalities.

Background and Objectives: From the viewpoint of the state of tuberculosis, the situation in all over the world, specially Asia is still critical. In this struggle, Iran is also involved with the problems of this disease. Considering that in our country there is not an accurate numerics and statistics information available for tuberculosis, thus, the performance of epidemiological studies on tuberculosis in different regions is necessary.Methodology: In order to determine the epidemiological state of tuberculosis, one of the current diseases in our country, a retrospective research was done during 1994-1996 and mid-1997 in Hashtrood region, on 2,244 patients, doubtful of tuberculosis. Of these patients, 62 cases were diagnosed to have tuberculosis. Conventional laboratory methods for the diagnosis of the agent of tuberculosis (Mycobacterium tuberculosis) were performed using Ziehl-Neelsen staining method and culture of Lowenstein-Jensen medium.Results: Of the patients included in this study, clinically 51.6% of the cases had extrapulmonary tuberculosis while 48.4% had pulmonary tuberculosis. From the viewpoint of sex distribution, females (58.1%) showed high involvement in comparison with males (41.9%).Tuberculosis was highly prevalent in patients of rural areas of Hashtrood region (77.4%) as compared to the patients living in city (22.6%). The patients were also studied from the viewpoint of age and occupational distributions, economic conditions and familial population.The treatment regimens done on the patients were quadruple therapy treatment consist of isoniazid, rifampin, pyrazinamide and ethambutol. Patients followed up after 5 months of the treatment, showed satisfactory results.Conclusion: The results of this study did not match with some other epidemiological studies performed elsewhere, therefore it seems that the spread of the tuberculosis in Iran and it's prevalence rate might communicate with geographical pertinence.

Background and Objectives: Many reports are available about management of aphthous ulcer, however, efficacy of corticosteroids injection in oral aphthous has not been reported so far, especially in big oropharyngeal aphthous ulcers and ulcers that didn’t cure in two weeks time.Methodology: During three years (from years 1994 to 1996) 140 patients with oral pharyngeal and laryngeal aphthous ulcers were studied. The patients were treated with intralesional injection with triamcinolone acetonide and examined weekly. Ulcers were reinjected biweekly as required.Results and Conclusion: In 105 patients, ulcers had resolved in less than two weeks time without treatment. Of the 35 patients whose ulcers persisted for more than 2 weeks, 18 were culture positive and were treated accordingly. The remaining 17 patients were diagnosed as having major aphthous ulcers. The usual sites for these ulcers were the floor of the mouth, lips, tonsillar fossa and epiglottis. The most common symptoms were pain and weight loss. Response to treatment was evaluated by pain relief, ulcer healing, and weight gain. All patients reported pain relief within 2 days of initial injection and most of them had marked reduction in size of ulcers. With the result of comfort in pain and improvement to take food, most of the patients had shown weight gain, and many experienced total resolution of symptoms and complete healing.

Background and Objectives: Radiological findings of the adulthood tuberculosis regarding mediastinal and hilar lymphadenopathy versus primary tuberculosis of the childhood are known to be uncommon. However, according to our investigations on 10 patients during a period of 12 years, its probability cannot be denied.Methodology: From 1983 to 1997 ten patients were assessed by collecting the required data from their medical records and the outcome of antituberculous treatment.Results: Mean age of the enrolled patients in this study was 31 years. They were referred with different clinical complaints and showed mediastinal lymphadenopathy on the chest x-rays. Hilar lymphadenopathy were noticed less commonly.Conclusion: Hilar and mediastinal lymphadenopathy are fairly common findings of the childhood tuberculosis, but in adults, although being very rare, does not occur unexpectedly, as witnessed by the recent investigations in United States and Canada for the time being.

Background and Objectives: Parasitic diseases caused by intestinal parasites are one of the health problem of national priority in our country.Methodology: This study was made on 984 stool samples of people of Mazreeh district in Khouzestan province during 1992-93. The sampling method was simple randomized technique and the stool examination was done by formalin - ether concentration method.Results: The following results were obtained: Trichostrongylus 18.1%, Hymenolepis nana 8.31%, Strongyloides stercoralis 6.9%, Heterophyidae 1.9%, Trichuris trichiura 0.9%, Entrobius vermicularis 1.5%, Entamoeba coli 57.1% , Iodomoeba buetschii 25.5%, Endolimax nana 6.7%, Giardia lambelia 4.9% , Entamoeba histolytica 4.7%, Chilomastix mesenili 2.7%, Entamoeba hartmani 1.9%. Conclusion: In this survey the association between infection of H.nana , S. stercoralis, Giardia lambelia and various age groups was significant (p<0.05).

Background and Objectives: Behcet’s disease (BD) is a vasculitis syndrome affecting various systems of body . The peripheral nervous system (PNS) is affected rarely in this disease.Methodology: For the first time in Iran, in this prospective study, the status of the PNS of patients was evaluated.Results: Twenty five (50%) patients were complaining of symptoms such as numbness and paresthesia. Neurologic examination was normal in all except one. NCV study was abnormal only in the same patient which also showed peripheral neuropathy. Four patients had Carpal Tunnel Syndrome (CTS). The comparison of the mean NCV of the sural, superficial and deep peroneal nerves and the mean amplitude of sensory nerve action potentials of superficial peroneal and sural nerves with control group showed a prominent decline in the former group (p<0.01).Conclusion: With respect to above findings, it can probably be suggested that involvement of the PNS in BD is more common than is thought of at present, but it is mainly sub clinical.

Background and Objectives: The objective of this clinical prospective study was to determine the upper normal limit of median and tibial Somatosensory evoked potential (SEP) latencies with equipment and circumstances available in electrodiagnosis center of Tabriz Shohada Hospital, so as to help in differentiating normal from abnormal values in patients referred to this hospital for SEP evaluation.Methodology: After stimulating median tibial nerves in sixty extremities of sixty randomly selected normal subjects (age:4-73 years), each nerves evoked response was recorded from four different sites (four montages).Results and Conclusion: The upper limit of normal value calculated as mean +3SD for median SEPs were asPI=31.3ms. The corresponding figures follow: N9=11.5 ms, N11=12.9 ms, N13=15ms, N14=15.7 ms, NI=23.1ms, for tibial SEPs were as follow: N11=13.7ms, N21=25.9ms, N24=29.4ms , PI=51.9ms, NI=60.1ms. Minimum central conduction velocity for the median and tibial SEP were calculated as 27.2 and 25.4 ms respectively. Owing to the differences observed in this study as compared with studies performed in other countries, it is strongly recommended that the former be used in patients admitted to this center to prevent over -or underdiagnosis. Also to find accurate normal range in extremes of age and height, further age and height - specific controlled studies are recommended.

Background and Objectives: Asymptomatic bacteriuria is frequently observed in elderly persons. The major contributing factors are aging changes and comorbid illnesses. This prospective study was carried out to understand the prevalence and type of organisms in asymptomatic bacteriuria in elderly persons resident in elderly institution. The study also aimed at observing the number of patients changing to symptomatic without treatment in duration of time as well as the effect of bacteriuria in mortality of these persons without antibiotic therapy .Methodology: 17 males and 11 females who were all above 60 years old were selected and studied for a period of four months. None of them had utilized urinary catheter or were on antibiotics.Midstream urine was collected from the patients and samples were inoculated onto blood agar and McConkey agar plates.Results and Conclusion: The study revealed that asymptomatic urinary tract infection was prevalent in 39.2% male and 45.45% female patients.The most common bacterium isolated was E.coli. Urologic predisposing factors were: benign prostatic hypertrophy (7.64%), prostatitis (5.88%) in males and urolithiasis (3.8%) in both sexes. Microbial strain alteration or appearance of clinical symptoms were not seen. Bacteriuria didn’t show any effect of mortality in our patients who were not on antibiotic therapy.

Background and Objectives: Unsuited heels of shoes may cause difficulties, sometimes irreversible injuries for users, thus, introduction of complications seems necessary. The present study was performed in order to investigate the effects of shoe heel on flexibility and deformities of ankle joint and foot in employed women. The main goal was to detect the effects of different heights of shoe heels on range of motion (R.O.M) of ankle joint and first metatarsophalangeal (M.T.P) joint, and then compare the results obtained for different heights of shoe heels with each other.Methodology: The study was performed on 148 employed women aged between 20-30 years who used the same kind of shoes for at least past 3 years, continously on all days for standing and walking. The data were collected in a form of questionnaire with information about age,height, weight and kind of heel. Complications of knee joint, ankle joint and foot that were evaluated by examination and then range of motions of ankle joint and 1st M.T.P joint were measured by goniometer.Results: The results observed suggested that using different kinds of shoes at work place, does not have any significant effect on the most of range of motions and flexibility of foot and its joints, however, the results have shown significant differences in inversion of foot and M.T.P joint flexion between the women who used the shoes with 3 cm height heels and who were wearing other types of shoes. Statistical analysis of range of motions with T-Test and comparison of the averages of range of motions in 3 different types of heels with Chi- Square and Analysis of Variance (ANOVA) indicates that shoes with flat heels have more complications on knee, ankle and foot of employed women, however, no significant difference was observed between usuage of different kinds of shoes on complications.Conclusion: Results of study reveals that using 3 cm height heels while at work, have a better efficiency for joints of users feet.

Background and Objectives: The purpose of this study was to operate patients with intractable Meniere’s disease. This is the first kind of study performed in Iran. Surgical intervention was offered to patients with Meniere’s disease who had failed medical treatment and had disabling symptoms. Surgical options included babyrinthectomy, vestibular neurectomy, and endolymphatic sac surgery.Methodology: This was a prospective study in which 7 patients were operated by this technique and followed up for 17 months. After simple mastoidectomy, openning of facial recess, sigmoid sinus decompression and openning of posterior fossa dura, endolymphatic sac was found by fenestrometer and was opened. At the end of operation a ventilation tube was put in the tympanic membrane. All of them had failed medical treatments earlier and were unsatisfied of living. They were operated with sigmoid sinus decompression and sac enhancement.Results: After operation 5 (71%) of them were cured. The two (29%) of them were satisfied in reducing of their vertigo attacks. The audiometry showed improved hearing in two of them (29%) while stable hearing in others.Conclusion: In comparison to simple sac surgery, the sigmoid sinus decompression and sac enhancement with opening of facial recess and ventilation tube showed better results in curing patients.

Visualizing eclipse with naked eye have been reported previously to cause eye injuries. Ten patients with eye complications were referred to our hospital. All of them were males and had been exposed to eclipse occured on 11 th August,1999 at Tabriz. On examination 9 of them had mild to moderate keratitis and were treated by topical steroids. One patient had central scotoma with dropping of vision to 4/10. He applied protective glasses .He was initially treated by I.V. administration of corticosteroid (1.5 mg/kg/day) and then treatment was continued orally. Vision returned to normal at the end of week three.

Acute myeloid leukemia (AML) is a malignant disorder that induces anemia, neutropenia and thrombocytopenia. Although AML is an aquired disorder, but immunologic and genetical factors may be involved in it's etiology.A few articles about familial leukemia and also familial hematologic and nonhematologic malignancies were reported previously. However, no data is available about evidence of AML and plasma cell leukemia in a family.This is the first report about the matter from Tabriz. Similar malignant changes were observed in both father and son. Probably as genetical factors were involved in this family, we conclude that cytogenetic factors must be studied in all of hematologic neoplasms.

The gonadal artery is known in male as testicular artery and in female as ovarian artery. Testicular arteries are long thin vessels that arises from the aorta immediately below the origin of renal artery. Each passes inferolaterally under the parietal peritoneum, the right lies anterior to the inferior vena cava and posterior to the horizontal part of the duodenum, right colic and ileocolic arteries. The left testicular artery lies posterior to the inferior mesenteric vein, left colic artery and lower part of the descending colon. Each crosses anterior to the genitofemoral nerve, ureter and the lower part of the external iliac artery, passing to the deep inguinal ring to enter the spermatic cord with other constituents. In females, the ovarian artery arises on each side from the abdominal aorta just below the origin of the renal artery. Each ovarian artery descends to the pelvis below of the peritoneum to reach the ovary by the way of infundibulo pelvic ligament and mesovarium. In our study we observed left testicular artery arised from coeliac trunk, where as right testicular artery was regularly from abdominal aorta, which is a rare case till reported.