MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2008 | Volume:30 | Issue:2|Papers Count:29

Background and Objective: Low glycemic index (GI) and glycemic load (GL) diet as a therapeutics object to management of postprandial glycemia and hyperinsulinemia, reduces risk of cardiovascular disease development in type II diabetic patients. Accordingly, this study design to determine glycemic Index and glycemic load intake of type II diabetic patients and their correlation with cardiovascular disease risk factors.Material and Methods: In this descriptive-analytical study, 65 (20 male and 45 female) type II diabetic patients that referred to endocrinal glands and metabolism clinic of Sina hospital in Tabriz, participated. Weight and height were measured and body mass index was calculated. Fasting venous blood sample were obtained for measuring glucose, lipid profile and insulin concentrations and Systolic- and diastolic blood pressure were measured. Nutritional intake was determined using three day-24 hour diet recall. Dietary average GI and GL was also calculated.Results: Mean of GI and GL were %59.0±3.5 and 112.5±79.6 g, respectively. Glycemic index only showed positive correlation with glucose level (r=0.28, P<0.05) and systolic blood pressure (r=0.26, P<0.05). Glycemic index correlated with Systolic blood pressure (r =0.29, P<0.05) and glycemic load correlated with triglyceride concentration (r=0.39, P<0.05) in women, respectively.Conclusion: In this study, glycemic index correlate with glucose concentration and systolic blood pressure. Systolic blood pressure and triglyceride concentration correlated with glycemic index and glycemic load in women, respectively. So low GI and GL diet suggest to reduce cardiovascular risk factors in these patients.

Background and Objective: By aging, some functions in the nervous system like spatial memory are subject to reduction. It is shown that short time physical activity can improve memory but there is no comprehensive study on the effect of long term exercise in this regard. So in the present experiment, we tried to clarify the effect of regular long term physical activity on spatial memory and learning of young and middle aged male Wistar rats.Materials and Methods: Thirty six 3 months old rats were allocated randomly to 4 equal groups. Experimental groups were exercised by treadmill 22m/min for one hour 6 days per week, for 3 and 9 months. By termination of training period, spatial memory of rats was tested using Morris water maze.Results: Our results indicated that physical activity increased spatial memory significantly (P<0.05) in young rats (6 months old) but not in middle age. Nonetheless, spatial memory of middle aged rats was significantly higher than young ones in both groups (P<0.05).Conclusion: This study suggests that spatial memory and learning increase via regular exercise in young rats. With progression of age up to 12 months of old (middle age) memory faces a further improvement while regular exercises could not induced positive effect on learning. Therefore, spatial memory possibly reached to optimal level in middle aged male rats.

Background and Objectives: Vancomycin has been widely used in the treatment of infections caused by Methicillin-resistant Staphylococcus aureus (MRSA). The emergence of vancomycin-intermediate S. aureus (VISA), heterogenous VISA (hVISA) and vancomycin resistant S. aureus (VRSA) in various parts of the world has been of great concern in clinical settings. This study was performed to evaluate the possible isolation of hVISA, VISA and VRSA strains in Tabriz, Iran.Materials and Methods: One hundred S. aureus isolates were collected from in-patients in Tabriz between September 2005 and July 2006. All of the collected isolates were identified using Gram staining, coagulase, catalase and DNase tests. MICs of our isolates were determined against vancomycin by E.test and disk diffusion method was also applied and the results were compared. For detection of hVISA strains we used the population analysis method.Results: Ninty eight percent of the S. aureus isolates were sensitive to vancomycin and MICs of the isolates were between 1.5-3mg/ml. We encountered two isolates with MIC=4mg/ml, which subsequent population analysis confirmed to be hVISA, i.e. the MIC increased to³8mg/ml. In disk agar sensitivity tests using 11 antibiotics the following sensitivity results were obtained: vancomycin (100%), rifampin (100%), ciprofloxacin (100%), cotrimoxazole (100%), cephalothin(74%), methicillin (62%), chloramphenicol (44%), clindamycin (43%), gentamicin (36%), erythromycin (31%) and penicillin G(1%).Conclusion: Our results showed that 98% of the isolates were sensitive to vancomycin and 2% of them were hVISA. Therefore vancomycin could still be used as a valuable drug for treatment of S. aureus infections. The detection of 2% hVISA in 100 clinical specimens in our study and worldwide increasing resistance to vancomycin and other glycopeptides in S. aureus clinical isolates indicate importance of antibiotic-sensitivity testing and MIC determination in S. aureus isolates from clinical specimens.

Backgroud and objectives: With surprising advances in cataract surgery techniques, reviewing and try to making better the anesthetic procedures is obviously mandatory. To evaluate safety and efficacy of lidocain gel in cataract surgery by phacoemulsification with corneal incision is in this background and have been done for this aim. Setting: Nikookari Eye Center, TUMS, Tabriz, Iran.Materials and method: We operated 25 cataract patients with lidocaine 2%gel as topical anesthetic agent in phacoemulcification, and foldable lens implantation procedure with corneal incision.23 other patients who had the same conditions, operated with traditional retrobulbar injection anesthesia. Sedation by intravenous midazolam also used in majority of the cases. Patients asked for pain and satisfaction at the end of procedure, and recorded in a questionare. Surgeon’s satisfaction and intra and/or postoperative complications also included in the same sheet.Results: All but one of the patients in the gel group tolerated the procedure well, and satisfied well. Pain score was sever in 1, moderate in 18, and weak in 6 cases in gel group, but all the retrobulbar group had severe pain at the time of injection, (p<001).The difference between patient’s and surgeon’s satisfaction was also statisticaly meaningful, (p<001). We had one case opening of posterior capsule in each group, and there was no post operative complication other than mild and transient corneal edema that resolved soon, and it was not apparent in second visit one week later.Conclusion: 2% Lidocaine gel can be used as an effective and safe anesthetic agent in phaco cataract surgery with corneal incision.

Background & Objectives: Restless legs syndrome (RLS) is a neurologic disorder characterized by an unpleasant sensation in legs at rest, which increases in the evening and relieves by motions and different activities. We studied this syndrome in patient with CRF and analyzed the effect of various parameters possibly involved in the etiology of RLS.Materials and methods: We investigated 194 patients (116 males and 78 females) with CRF (156 patients on chronic hemodialysis (HD) and 38 patients on conservative treatment with glomerular filtration rate (GFR)<50) using a structured questionnaire evaluating details of RLS, sleep apnea and other sleep disorders, and drug history. All patients diagnosed to have RLS by International RLS Study Group criteria. Daytime sleepiness was investigated with a modified Epworth Sleepiness Scale (ESS).Results: There was no significant difference on the mean levels of hemoglobin (10.1±.31g/dl versus 9.7±0.18g/dl; p=0.28) ‚ serum iron (74.3mg/dl±6.6 versus 72.2±3.6mg/dl; p=0.75), and ferritin (519.8±138ng/ml versus 684±97.4ng/ml; p=0.34) in patients with CRF who had RLS and those did not. HD Patients with RLS had longer history of dialysis compared to HD patients without RLS (34±2.5 months versus 51±6.7 months, p=0.025). There was a statistically significant difference in daytime-sleepiness in patients with CRF who did and did not have RLS (5.79±0.7 versus 2.95±0.33, p=0.001).Conclusion: Unlike general population, in patients with CRF, the presence of RLS has no relationship with level of serum ferritin or iron levels, or the degree of anemia. These patients had poor quality of sleep that is at least partly related to the presence of RLS.

Background and Objective: Reducing in efficient utilization of health services is one of the methods of reallocation health finance with preserving the quality of services. Assessing in appropriate utilization of services in present research was carried out. With regards rate of inappropriate admission and hospitalization of patients, this research was a step forward and aims to find inappropriate admission and inpatients rate in Imam Khomeini teaching hospital.Materials and methods: In this cross-sectional analytical study, admission and hospitalization 268 individual patients of Imam Khomeini teaching hospital were assessed using (Appropriateness Evaluation Protocol) AEP protocol. Patients, individual and social characteristics were studied too. The independent t-test and chi-square were used to analyze the data.Results: Analysis of the data shows that there were no meaningful relationships between, type of admissions with age, gender, and insurance plan. We also found no meaningful relationship between inappropriate admission and hospitalization with closed days. Conclusion: A small percentage of hospital admissions were inappropriate, which might be due to weakness in referral and treatment intervention on lower levels of health care system. Reduction in inappropriate length of stay (L.O.S.) has a profound effect on increase of productivity, waiting list, hostelling costs and hospital sepsis.Considering the finding at the present study, we need to put more effort to develop initiatives such as improving the discharge process, and performance of lower levels of health care system in order to hospitalization.

Background and Objects: Prevalence and conditions that cause infective endocarditis are increasing today’s. Early recognition and treatment of endocarditis should be applied as a medical emergency. Purpose of this study is to obtain clinical and paraclinical criteria for response to treatment in patients with infective endocarditis.Materials and Methods: In a descriptive cross sectional study, 27 hospitalized patients with infective endocarditis based on the duke criteria have been studied .All patients received venous antibiotic treatment. During hospitalization, patients evaluated for responses of treatment on the base of clinical and paraclinical data and echocardiography. A questionnaire used for obtaining patient's information and the responses to treatment.Results: Of 27 patients 77.8% (p=0.00) had fever, 37% (p=0.125) had leucocytosis, where as 100% (p=0.003) showed positive CRP, Abnormal Echocardiography and systemic symptoms, which reached to normal ranges after treatment. Mean ESR at admission time was 90.67 (±14.62) mm/h and at end of treatment decreased to 80.81 (±17.21) mm/h. 29.6% (p=0.00) of patients had positive RF at the end declined to 11.1% (p=0.00). Mean CIC was 171.74 (±27.25) which reached to 98.19 (±34.96) (p=0.00), after treatment. 74% of patients showed abnormal U/A and at the end decreased to 7.4% (p=0.002). 100% patients had negative blood culture (p=0.008).Conclusion: Variation of C-reactive protein, Circulating immune complexes, rheumatoid factor, urinalysis, and conditional symptoms at first and of along the treatment is helpful for evaluation of the treatment and detection of probable complication.

Background and objectives: Asthma is a chronic disease with major public health and financial consequences. One of basic approaches in managing asthmatic patients is monitoring to maintain control and identifying cases of exacerbations. Poor adherence to treatment, poor baseline control of disease, frequent hospital admission and emergency department visits are among factors associated with poor outcome of asthma. Of parameters leading to disease exacerbation are Co-morbidities such as sinusitis as well, genetic and familial predisposition for asthma. This study was designed to follow patients regarding to achieving control, identify disease exacerbations and discover relation between exacerbation with poor treatment adherence, co-morbidities and history of atopy in patient or family.Materials and methods: In a cross sectional-analytic study, 400 asthmatic patients in the range of 2-14 years old who were visited at the specialized outpatient clinic of Tabriz University of Medical Sciences were divided and studied on the base of disease severity. At the end (at least one year treatment), patients were categorized based on level of disease control and one year after this stage, cases of exacerbation were identified and studied.Results: By excluding patients with poor adherence, 342 patients continued treatment as intermittent, mild persistent, moderate persistent and severe persistent asthma (38, 235, 61 and 8 patients respectively). After a period of one year treatment, the patients were divided as well controlled, partially controlled and uncontrolled (68%, 30% and 2% respectively). Cases of disease exacerbations were more if sinusitis, familial asthma history and poor adherence were present (p<0.01, p<0.01 and p<0.05 respectively). There was no significant relation between asthma exacerbation and history of allergy in patient or family (p=0.2).Conclusion: There is meaningful association between poor adherence, sinusitis and positive family history of asthma with disease exacerbations.

Background and objectives: Zingiber officinalis (Ginger) and Allium cepa (onion) have been used since the olden times. Recently it has been revealed that Ginger and onion have high antioxidant activity. Given role of antioxidants in sperm health, to reveal their effect on spermatogenesis, this investigation had been done.Material and Methods: For this experiment 25 male Wister rats were randomly divided into 4 experimental group (n=20) and one control group (n=5). They were kept in equal conditions such as: equal place, food and water. First and second experimental group were treated with onion juice and first group received 100mg/kg per day and second group received 50mg/kg-per day. Third and fourth experimental group were treated with Ginger and third group received 100mg/kg and fourth group relieved 50mg/kg. Drug administered with gavages for 20 consequence day. Animals were kept in standard conditions. In twentieth day testis of all groups were removed and sperm was collected from epididymis, then prepared for analysis.Results: Results showed that the percentage of sperm viability and motility in whole experimental groups significantly increased (p<0.05). But the sperm concentration significantly increased only in the first experimental group (p<0.05). But no difference in sperm morphology and testis weights in other groups comparing to control was observed. The statistical analysis was ANOVA method.Conclusion: Since in our study 20gr of fresh onion juice have significant effects on sperm number and percentage of viability and motility, so it seems that using of 1gr/kg fresh onion juice can be effective for sperm health parameters.

Background and Objectives: Osteoporosis is the most common metabolic bone disease and in fact it is a silent epidemic problem that could causes many dangerous fractures. In this condition bone mass reduces, so fractures can easily occur. Considering the occurrence of fractures in hip, wrist and lumbar spine bones in older woman, this study has been designed for determining the bone density in those bones and balance in post menopause women with and without history of regular exercise in same socioeconomic condition in order to evaluate the role of exercise in bone density and balance.Materials and Methods: This was a cross-sectional study which has been done in Sina hospital of Tabriz. There were 60 postmenopausal women, 20 women in group one without history of exercise, 20 women in group two that had at least 5 year history of regular exercise before menopause, 20 women in group three that had at least 5 year history of regular exercise after menopause. Subjects with any metabolic or hormonal and neurologic abnormality excluded from study. Bone densitometry was performed from hip, wrist and lumbar spine with using DEXA bone densitometry instrument and balance was tested with the balance board instrument.Results: The mean age, mean menopansal age and mean BMI in 3 groups were 57.4±6.5, 47.9± 4.6 and 28.2±3.4 respectively. Mean of T-score of hip bone in first, second and third groups were -1.3±0.67, - 0.53±0.73 and -0.92±1.1 respectively. Mean of Z-score of hip bone in first, second and third groups were -0.4 ±0.91, 0.39 ±0.68 and -0.05±0.79 respectively. Mean of balance maintenance test (second) in first, second and third groups were 18.27, 43.33 and 29.9 respectively. There were significant differences between first and second groups in T-score of hip and balance test (P<0.05).Conclusion: The results of this study showed that the women with history of regular exercise before menopause had higher bone density in hip region due to osteogenic effect of mechanical load. According to these results recommendation of regular exercise can help to increase bone density and reduces the risk of fractures and its morbidity and mortality in elderly women. Exercise also improves the balance and reduces the risk of falling too. It is concluded that exercise has an important role in preventing of fractures.

Background and Objectives: Caudal epidural block is one of the most common regional anesthetic techniques used in neonate and children. Stable hemodynamics and prevention of nero transmitter release after caudal block in postoperative period leads to facilitation of surgical wound repair, reducing parents anxiety, surgeons satisfaction, decreasing hospitalization time and finance Aim of this study was assessment of supplementation of local anesthetic drugs with clonidin in epidural caudal anesthesia to increase duration and quality of analgesia.Methods: One hundred children aged 2-7 years, scheduled for elective lower abdominal surgery, were evaluated in this prospective randomized double blind and placebo controlled clinical trial in two equal groups to receive 0.25% bupivacain 1ml/kg combined with either clonidine 2µg/kg (group 1) or 1ml normal saline (group 2). Method of anesthesia was similar in both groups .analgesic consumption, systolic and diastolic blood pressure and heart rate were recorded.Results: Three patients (6%) in group 1 (first 1-2 hours) and 21 patients (42%) in group 2(up to 8 hours) required supplementary analgesia after operation (P<0.001). According to P values there were significant differences between two groups in the mean of systolic blood pressure (P<0.01), diastolic blood pressure (P<0.013) and heart rate (P<0.001).Conclusion: It seems that when added to bupivacaine, clonidine improves the efficacy and lengths of caudal analgesia in children.

Background and objective: The history of electrical stimulation as a method to affect muscle fibers has its roots in the Greek medical literature. Application of electrical stimulation can change muscle fibers from type II to type I. As a result, the muscle fibers transform into a more fatigue resistance type. This feature probably presents a new method in sport to enhance endurance records in the athletes. The main goal of this research is to evaluate the effect of stimulation usage on athletes endurance performance.Materials and Methods: This study is a clinical trial, interventional study that was performed on two cyclist groups, each one including 10 male athletes. The range of their age was between 17 and 20 years old. First group received electrical stimulation in conjunction to their routine exercises and the second group; just routine exercises. Record measurement was performed in three stages: before application of stimulations or exercises, after stopping stimulations and 8 weeks after that, naming them 0, 1 and 2 phases respectively. Variable factors in this study included distance, speed, energy consumption index and finally fatigue scale. Data analysis was performed by the help independent t-test and SPSS program.Results: Both groups had decrease in speed and distance records at stages (1), (2) in comparison with stage (0). However, these findings were less prominent in group 1. Similarly fatigue level was less prominent in group 1. These differences were significant between two groups, statistically. Energy consumption showed an increase between stage (0-1) and stage (1-2). This increase was observed more dramatically for group 2. However, statistically, this difference was not significant.Conclusion: Results of this research showed that use of electrical stimulation prevents decrease in endurance until 8 weeks after stopping stimulation. Also it showed decrease in energy consumption and fatigue feeling. However this method has no side effects. Therefore, it may be used as a practical adjacent technology in athletes pre-events preparation.

Background and objectives: Retinopathy of prematurity is diseases that affect 65% of premature newborns with low birth weight and could result in low vision and even blindness in majority of them. Early diagnosis could improve the success rate of treatment and reduce the complications of the disease. In the present study the incidence of the disease and factors that could increase its frequency is investigated.Materials and Methods: In the present study, 150 immature newborns are included. The cases, were whether hospitalized in NICU center in Alzahra Gynecology hospital, or referred from different cities of east Azerbaijan to private clinic. The inclusion criteria in study group were gestational age less than 36 weeks and birth weight lower than 2000gr. Results: Our study show that from the studied newborns, 82.7% had no ROP and 17.3% had ROP. The birth weight and gestational age in all ROP newborns were significantly lower than the non- ROP cases (p<0.01). Study of correlation between ROP and different parameters showed that there is a positive correlation between type of oxygen therapy, percent of O2 saturation, respiratory distress syndrome, presence of cardiovascular disease, cesareans asphyxia cyanosis apnea and septicemia and ROP occurrence.Conclusion: Prevalence of ROP in our study is lower than the advanced centers. Low birth weight and gestational age are important factors in acquiring ROP. There is a positive correlation between ROP and the presence of underlying disease in premature newborns.

Background and Objectives: Extended-Spectrum Beta-lactamases (ESBLS) are common kind of beta-lactamases in routine causative agents of nosocomial infections. Detection of this kind of resistance in laboratory (in vitro) is difficult, because some resistant strains will present themselves as susceptible, while they express resistance in vivo. This cause inappropriate treatment and may increase mortality rate due to misunderstandings in resistance detection. This study was conducted to evaluate epidemiological and microbiological aspects of ESBLs in two distinct genera involved in nosocomial infections, namely Klebsiella spp. and Escherichia coli.Material and Methods: In a period of one year (from October 2003 to October 2004), 221 and 255 isolates of Klebsiella spp. and Escherichia coli were isolated in medical centers and clinical laboratories of Tehran and Tabriz, respectively. While susceptibility tests were performed, all of the isolates were also examined using double disk synergy test (DDST), three dimensional test (TDT) and ESBL E-test methods for enzymatic beta-lactamase resistance detection.Results: Our finding indicated that prevalence of beta-lactamase resistant species in Tehran is high a compared to Tabriz. Prevalence of resistant species was evaluated as 31.4% and 12.2% for Klebsiella spp. and 6.1% and 1.7% for Escherichia coli in in-patient and out-patient groups respectively in Tehran. This prevalence rate for Tabriz included 21.4% and 9.1% for Klebsiella spp. and 4.6% and 1.1% for Escherichia coli in in-patient and out-patient groups respectively. Different patterns of resistance in in-patients and out-patient observed, in which higher levels of resistance were present in in-patients group.Conclusion: Our results revealed high prevalence of ESBL resistance in bacterial isolates from Tehran and Tabriz cities. Thus screening of clinical isolates for ESBL resistance is critical.

Background and Objectives: Low back pain is a multi factorial disorder which involves most active individuals of the society and leads to many social and economic problems. Many risk factors effect incidence and durability of low back pain, some of which could be changeable and reversible. This study tries to improve public health through both determining prevalence of low back pain among women of fertility age and clarification of related risk factors among young and middle age women.Material and methods: This cross-sectional study was carried out among women in fertility age (15-49 years) in Tabriz. Two hundred and fifty cases were selected from all health –treatment centers in Tabriz through two-staged randomized systematic method. The cases were completely satisfied from research and they had no excluding criteria. A questionnaire including demographic data, marital status, career, economic and social situation, smoking, exercise and presence of low back pain according to NHANES II was completed through a face to face interview. Then the cases’ weight, height and arm circumference were measured and their BMI were calculated. Finally the achieved data were analyzed by the statistical tests in SPSS software.Results: Seventy one of cases reported a low back pain lasting more than two weeks. The prevalence of low back pain among the population under study was 28.4%. There was such a significant relation among marital status, number of pregnancy and delivery, career and smoking with prevalence of low back pain that aging and elevation the number of pregnancy and delivery, the prevalence of low back pain increases. As well, low back pain was more common in married women, smokers and housewives. There was no significant relation among height, weight, BMI, exercise program, level of calcium, phosphor and vitamin D with prevalence of low back pain.Conclusion: Most of active women in fertility age are suffering from low back pain. Aging, marriage, housekeeping, smoking, several pregnancy and delivery may effect on incidence of low back pain.

Background and Objectives: Acne vulgaris is a self-limiting skin disorder involving pilosebaceous units of adulescences. Several factors have been suggested to influence acne including medication, climate, stress, diet, mensturation, genetic and sex. There are contradictory reports on the relationship between acne and cigarette smoking. The objective of this study was to examine the relation between distribution, severity of acne and smoking in a case-control study.Materials and methods: During 1 year of study a questioner on smoking habits, distribution, severity of acne was filled for 110 patients with acne Vulgaris alone and 110 patients suffering from acne Vulgaris and smoking, attending in the Sina clinic. Data were analysed by SPSS.Results: This study was carried out on 110 smokers (106 male, 4 female) and 110 non-smokers (105 male, 5 female). The mean age for beginning of acne was 16.11 (SD=2.3) & 16.44 (SD=2.31) for smokers & non- smokers respectively. The mean age of patient was 22.89 (SD=4.59) and 24.47 (SD=6.72) as compared above. There wasn’t any significant difference of acne severity between two groups, no association between site involvement and smoking could be found in smoker group but in the respect to non-smokers, The anterior aspect of chest was commonly involved (P=0.036). A significant relationship between acne severity and number of cigarettes smoked daily observed (P=0.02).Conclusion: An association between acne severity & cigarette smoking was found in this study and the involvement of anterior chest was more common.

Background and objectives: Refractory glaucoma is characterized by pain and medically uncontrolled intraocular pressure. To compare the effectiveness and safety of cyclocryotherapy and diode transscleral cyclophotocoagulation (TSCPC) in refractory glaucoma.Materials and Methods: This clinical trial has been carried out in 100 eyes (100 patients) with refractory glaucoma randomly treated with either cyclocryotherapy (I group) or diode transscleral cyclophotocoagulation (II group). Only Eighty-eight patients after 6 months examined in follow up periods. Intraocular pressure, corrected visual acuity, and complications were assessed in the early and late postoperative period. Follow-up ranged from 6 months to 11 months, mean 34.6±9.5 weeks. Data were analyzed using SPSS version 14 and chi-squared testing was used for categorical variables and a non-paired t -test for Continuous variables.Results: There was a statistically significant decrease in intraocular pressure after both cyclocryotherapy and diode transscleral cyclophotocoagulation at each time period. Before treatment IOP mean 45.82±9.19 mmHg in the I group and mean 48.4±12.59 mmHg in the II group. There were no significant differences in postoperative visual acuity change in cyclocryotherapy. After TSCPC visual function increased in 27.2 % of eyes (0.0005). After cyclocryotherapy only conjunctival oedema was observed in majority of cases. In the early postoperative period after TSCPC uveitis occurred in 2 eyes (4.2%), transient hypotony in 1 eyes, hyphaema in one eye.Conclusion: Diode cyclophotocoagulation decreases IOP more effective than cyclocryotherapy in refractory glaucoma but complications after TSCPC are more severe than after cyclocryotherapy.

Background and objectives: Percutaneous nephrolithotripsy in selected cases represents the method of choice in treatment of urinary stones. The results of that are excellent and stone free rate is more than 90% but the sideeffects on kidney had less studied. To evaluate renal injury relative this procedure preoperative and post operative urinary levels of Beta 2 macroglobulin, a sensitive markers of renal tubular damage were studied.Materials and methods: Urine samples of 20 patients who were treated for renal stones by PCNL were collected before and after 24 hours, 3 days, 7 days and 14 days in both for measuring beta 2 microglobulin. The increase and decrease of beta 2 microglobulin and its relation with stone size and duration of lithotripsy have been analyzed. Also 20 patients after varicocelectomy were included in this study as control group.Result: PCNL and varicocelectomy were done without special complication. There was significant rising of urinary beta 2 microglobulin in early period after PCNL. There wasn't relation between increasing beta 2 microglobulin and duration of surgery or size of stone (p=0.983, p=0.165).Conclusion: PCNL is an effective treatment of renal stone with a transient tubular damage. It has no permanent deterioration on renal function.

Background and Objectives: Diabetes is a metabolic disorder that is produced by low secretion of insulin or resistancy to insulin. Oxidative stress is an imbalance between the free radical production and antioxidant defense systems of the body. This condition is strongly related with diabetes and symptoms of it.Methods: Diabetes induced by injection of streptozotocin in male rats (STZ, i.p injection, single dose, 50mg/Kg). Exercise performed for 8 weeks and one hour every day. 40 male rats (200+20 g) were divided into four groups (control, control with exercise, diabetic, diabetic with exercise). At the end of experiments, the rats were anesthetized deeply by ether and then decapitated by guillotine. Hippocampi of animals were removed on ice immediately and kept frozen. Tissue was homogenized in prepared buffer and after centrifugation produced supernatant was used for determination of SOD, GPX and CAT activities, and MDA level.Results: Diabetes reduced SOD activity and GPX of hippocampus in diabetic rats significantly (P<0.05). MDA level increased in diabetic rats significantly compared to control group (P<0.01). In response to exercise MDA level decreased in diabetic rats (P<0.01) and SOD and catalase activities increased significantly (P<0.05).Conclusion: Swimming exercise by increasing the activity of hippocampus antioxidant enzymes and decreasing the MDA level has beneficial effects in prevention of nervous symptoms of diabetes mellitus and tissue injuries by oxidative stress produced by this disease.

Background and objective: Laparoscopy is considered the gold standard for the evaluation of tubal disease, but it is an invasive and costly procedure. CAT is simple, inexpensive and non – invasive method. HSG is suffering from positive and negative results. The aim of this study was the comparison of these three methods in predicting of tubal factor infertility.Materials and Methods: Anti-Chlamydia trachoma is IgG were determined in 144 infertility patients' sera by means of ELISA methods. Laparoscopy and HSG were carried out in all patients. The positive CAT results were compared with HSG and laparoscopy with respect of their predictive value of tubal factor infertility. The results were analyzed using SPSS software. For determination of cut off point Roc curve was applied.Results: In 16 (11.1%) of the 144 patients studied the CAT was positive. The statistical analysis of results revealed the sensitivity of CAT in determining tubal factory infertility 54.1% specificity 97.5% positive and negative likelihood predictive value was 21 and 0.47, respectively. The same results in HSG were 62.5%, 91.6%, 7.5 and 0.4, respectively.Conclusion: Our results indicated that not only CAT is a simple and inexpensive procedure, but also it is more likely positive than HSG in predicting tubal factor infertility. It is recommended in predicting of tubal factor infertility CAT should become an integral part of fertility work-up.

Background and Objectives: In this research, effect of elasticity of arterial wall on wall shear stress waveform has been studied. This phenomenon has been considered on cardiovascular pathology using fluid and solid interaction model (FSI).Materials and Methods: The Newtonian fluid model for blood and linear elastic model for arterial wall was used. Large deformation theory has been implied to simulate arterial wall displacements. Fluid-solid interaction based transient numerical simulation have been used to consider wall displacement on model With pressure based boundary condition and Moens-Korteweg wave velocity equation, boundary condition for various elastic modulus adopted at outlet of model.Results: Results have showed the significant decreasing in mean flow rate (up to 33%) with increasing elastic modulus of vessel wall. This change is due to variation of wall dispensability with wall elasticity. Variation of flow waveform is due to change in pressure gradient waveform with wall elasticity. Results showed that the significant changes in wall shear stress waveform. These changes have been included both decreasing of maximum wall shear stress and generating of negative wall shear stress regions.Conclusion: It can be concluded that low wall shear stress and opposition of direction of wall shear stress during a cardiac cycle may be increased risk of endothelial injury and formation of atherosclerosis plaque or calcified arterial wall segment. Therefore, these parameters can be used as index factors for diagnosing development of these diseases.

Background and Objectives: Oxidative injury of DNA and lipids may be supervised by renin-angiotensin system (RAS). In the study the effect of losartan (L) and/or enalapril (E) on reduction of DNA damage was evaluated regarding to renin-angiotensin system polymorphisms.Materials and Methods: After determination of genotypes of the angiotensin converting enzyme (ACE I/D), angiotensinogen (AGT M235T) and angiotensin II type 1 receptor (ATR1 A1166C) by polymerase chain reaction, 64 renal transplant recipients randomly allocated to one of the four groups: first (13 patients) and second (20 patients) groups were treated with E (E+: 10mg/d) and L (L+: 50 mg/d) alone respectively. The third group (13 patients) as positive control received E+L (E+L+: 10mg/d + 50 mg/d) and the forth group (22 cases) received no medication as negative control (E-L-). The subjects were followed for 8 weeks. After 2 weeks washout period, E group changed to L and vice versa as cross-over design. They were followed for another 8 weeks. Before and after 2 months treatment, we checked the serum 8-OHdG and Malondialdehyde (MDA) as biomarkers of DNA damage and lipid peroxidation respectively.Results: Serum 8-OHdG levels were significantly decreased in the E+L+ and L+ groups (6.07±1.1ng/ml to 3.6±0.58ng/ml, P=0.000; 5.30±0.86ng/ml to 3.6±0.47ng/ml, P=0.001 respectively). 8-OHdG level was not decreased significantly in E+ group (6±1.19ng/ml to 4.7±1.39ng/ml, P=0.07) and E-L- group (5.30±0.84 to 5.6±0.88ng/ml, P=0.11). Patients with DD genotype of ACE and CC genotype of ATR1 had higher serum 8-OHdG levels at the baseline (P=0.02, P=0.002 respectively). Only TT genotype of AGT had the most ant oxidative role regarding to kind of above treatment regimens (P=0.01). We found a remarkable correlation between MDA and DNA damage levels before and after intervention (r=0.48, P=0.000; r=0.35, P=0.006).Conclusion: Although serum 8-OHdG level is higher in DD and CC genotypes of ACE and ATR1 polymorphisms; the protective effects of L+ and E+L+ on DNA breaks are surprising regarding to the RAS genotypes. TT genotype of AGT had important role in prevention of DNA break regarding to kind of treatment.

Our case is an 8 years old boy in whom the skin change was found a week after birth. Initially the involvement was limited to limbs but gradually it involved whole body skin. The skin manifestations are composed of hyper and hypo pigmented patch whit in each other. Pathologic finding was compatible with dyschromatosis universals hereditharia. This disease is a rare pigmentary disorder which is characterized with irregular hyper and hypo pigmented macula and patch in a reticular pattern. Skin manifestation can be limited to limbs or can be diffuse in all body skin. The lesions begin mostly several weeks after birth until 6 year of age.

Neonatal asymmetric crying facies has incidence of approximately 1 per 160 live births, the cause is either facial nerve compression or faulty muscle and /or nerve development. Depressor anguli oris muscle agenesia or hypoplasia is one of the important causes. Ultrasound imaging of facial muscles and electro diagnostic study may be useful for diagnosis. Associations of this facial defect with congenital anomalies have been reported, including cardiovascular anomaly, genitourinary, CNS and rarely other anomalies.In this report 10 infants with facial asymmetry are presented that are caused by congenital hyperplasia of the depressor anguli oris muscle on one side of the mouth.

Prevention and management of postpartum hemorrhage are considered as one of important aspects of maternity care. This descriptive-analytic study is performed to determine the quality of presentational cares of postpartum hemorrhage in labor, delivery room and postpartum ward in gynecological and obstetrical centers of Tabriz. This article reports the results of study on 150 mothers who were selected by convenience sampling method and the prevention activities of postpartum hemorrhage were determined by observation.