MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2018 | Volume:39 | Issue:5 |Papers Count:15

Background: Congenital vertical talus (CVT) is a common foot deformity that occurs at birth and has two forms of syndromic and idiopathic. Treatments of this disorder include serial casting or surgical correction. Several studies have shown that Dobbs method (reverse Ponseti) is effective in improving deformity and function of the foot. The aim of this study was to evaluate 2-year treatment of syndromic vertical talus with this method. Methods: In this retroespective study, 21 patients with congenital vertical talus with neuromuscular disease and/or genetic syndrome from 2007 to 2014 referred to Shohada Hospital of Tabriz were studied. 35 feet (14 patients with bilateral and 7 patients with unilateral involements) with syndromic type of disorder, using manipulation and serial casting with Dobbs method (reverse Ponseti) treated by an orthopedic surgeon and serial radiographs in 2 years follow-up were performed to control. Results: The mean age of the patients was 16. 9± 20. 9 years and the average number of cast was 7. 5± 1. 6. Talocalcaneal angle and talus-base of first metatars angle significantly decreased after treatment (P<0. 0001). There was no significant age-related changes in the studied angles (P>0. 05). There was no significant correlation between talocalcaneal angle changes and the number of cast (P=0. 108), but there was a significant association between talus-base of first metatars angle (P=0. 015). Conclusion: This study showed that treatment with Dobbs method has successfully improved the foot deformity in the patients with syndromic CVT.

Background: Injury to posterior cruciate ligament (PCL) compared to the anterior cruciate ligament is not common. The damage has been reported that 3 to 20%. The goal of treatment is to prevent degenerative changes and improvement of patients function. The ideal treatment for posterior cruciate ligament (PCL) injuries is controversial. The purpose of this study was to compare the results of the reconstruction of the posterior cruciate ligament two ways with full arthroscopic and arthroscopic with arthroscopic with minimal invasive open. Methods: In this descriptive analytical study, 36 patients with grade 3 ligament injuries candidates to reconstruction were studied. They were in two groups of 18 subjects matched for age and types of injury were selected. The clinical, functional improvement and treatment failure were evaluated. Results: 18 patients underwent arthroscopic reconstruction of the posterior cruciate ligament with mean aged 42. 9 ± 7. 7 compared with 18 patients with mean aged 38. 2± 8. 2 in group with arthroscopic with minimal invasive open. Tegner scores and Lyshom score performance between the two groups were not statistically significant. Infection and knee motion limitation were not observed in the two groups. Positive posterior drawer test(PDT) was in All arthroscopic procedures in 1 (6/5%)patients and in arthroscopic with minimal invasive open were in 2(11. 1%). The mean posterior tibial displacement in both groups after the reconstruction of 4 millimeters and there was no statistically difference. Severity of pain after arthroscopic technique with mini-approach was significantly higher. Conclusion: Arthroscopy and arthroscopic technique with mini-approach reconstruction of the posterior cruciate ligament is favorable clinical outcomes in both methods. It seems to arthroscopic technique with minimal open approach to posterior cruciate ligament reconstruction was to be little benefit to patients. Selection of operation approach was related to our equipment.

Background: Increased levels of homocysteine (HCY) is known as a novel cardiovascular biomarker that the rising its concentration leads to increased cardiovascular disease. Due importance of physical activity in the prevention of cardiovascular disease, this study was aimed to evaluate the effect of regular exercise on serum levels of homocysteine and lipid profile in obese female. Methods: In a quasi-experimental study, 40 obese female were selected from among volunteers and randomly divided into experimental (n=20) and control (n=20) group. Experimental group is performed 8 weeks (3 sessions per week) aerobic exercise with 75-65 percent of maximum heart rate. HCY and lipid profile levels in the fasting state before and after the protocol was observed in both groups. Analysis of data at the level of 5% alpha error and was conducted using SPSS version 18. Results: 8 weeks aerobic exercise, significantly decreased in all parameters (weight, body mass index, body fat percentage and waist-to-hip ratio, LDL-c, TG, TC and homocysteine levels) (p≤ 0. 05). HDL cholesterol was increase post exercise, but there was no significant difference in compared with within and between group (p>0. 05). Conclusion: Regular physical activity is possible reduces plasma levels of cardiovascular risk factors in obese females, this reduced can be effective in preventing cardiovascular disease.

Background: Pain is a sign to identify the disease and mostly has a protective effect. Several side effects of chemical drugs caused more likely people are to use herbal treatment. Use of drugs and medicinal plants are common methods of pain control. The aim of this study was to evaluate the antinociceptive effects of Arctiumlappa L. leafh’ shydroethanolic extract (AHE) in male mice. Methods: This study contained 72 male mice with the weight of 25± 30 gr. Mices were divided randomly in two groups with 6 subgroups (n=6 for each group) including: Control group treated with AHE at doses of 100, 200 and 400mg/kg, morphine (1mg/kg) and case group treated with naloxone (2mg/kg) with dose 200 mg/kg of extract. In order to evaluate the analgesic effect of the extract, writhing and tail flick tests were used. Results: Doses of 200 and 400mg/kg of AHE significantly increased pain threshold compared with the control group in writhing and tail flick tests (P<0. 01). Also dose 400mg/kg of AHE have been showed mostly analgesic effect especially in writhing test compared with morphine group (P<0. 001). Conclusion: Analgesic effect of the AHE was observed in the tail flick and writhing tests and this analgesic effect of extract probably related to activation of opioid system.

Background: Hypertrophic scars are one of the complications following a burn injury. Intralesional corticosteroid injection is an invasive method for treatment of this complication. We had design a single blinded randomized control trial to deliver dexamethasone by phonophoresis and evaluate its efficacy on hypertrophic burn scars characteristics. Methods: 56 cases of hypertrophic burn scar due to burn injury allocated randomly to dexamethasone and control group. Individuals in case group received 10 sessions of dexamethasone 0. 4% phonophoresis. Patients in control group had placebo phonophoresis (ultrasound with normal routine aquatic gel without any dexamethasone) with the same protocol. At the beginning of study and one week after last session, hypertrophic scar characteristics and pruritus were measured by “ Vancouver Scar Scale” , and “ 5-D Pruritus Scale” respectively in both groups. Results: Despite mild improvement in Vancouver Scar Scale score one week after intervention in dexamethasone phonophoresis group in comparison to control subjects, but this difference was not significant (p<0/08). Pruritus score perceived subjectively were significantly lower one week after intervention in dexamethasone groups in comparison to control subjects (p<0/01). Conclusion: Dexamethasone phonophoresis is a safe and effective treatment method for burn hypertrophic scar pruritus, but its efficacy for scar characteristics improvement needs to be evaluated by larger studies with long-term follow up period.

Background: Infertility is defined as the inability to achieve pregnancy after one year of unprotected intercourse. A large proportion of infertile men fail to impregnate their female counterpart due to lack of sperm (azoospermia) or too little sperm (oligozoospermia). Infertility may also be due to estrogens, infections, heavy metals, cigarette smoking, reactive oxygen species (ROS) and sperm antibodies. Fas is a member of the TNFR (tumor necrosis factor receptor) family that is widely expressed on the surface of many different kinds of cells. Fas gene is involved in the apoptosis process. The purpose of this study was to evaluate the effect of Fas gene polymorphism in male infertility in a population in north of Iran. Methods: This study involved 132 patients with male infertility and 102 healthy controls. DNA samples were extracted from the peripheral blood and genotyped by RFLP-PCR method. Statistical analysis was performed using MedCalc. Results: The frequencies of AA, AG, GG in patients were 31. 81%, 54. 54% and 13. 63%, respectively and in controls were 45. 09%, 47. 05%, 7. 84%, respectively. Conclusion: It is concluded that there is no significant association between Fas-670A/G gene polymorphism and male infertility (p=0. 07). Further studies with larger numbers of patients are required to elucidate the potential role of Fas gene polymorphism in male infertility.

Background: Recent studies have revealed that neurotrophic and inflammatory factors are effective factors affecting nervous system. So, the purpose of this study was to compare the effect of two exhaustive aerobic and anaerobic physical activity on serum Brain-derived neurotrophic factor (BDNF) and C-reactive protein (CRP) levels and evaluate the relationship between them. Methods: 16 active students (age: 22. 27± 1. 15 years, BMI: 23. 29± 1. 14 Kg/m2, VO2max: 48. 26± . 1. 92 ml/kg/min) divided randomly into two groups. Tests used in this study consisted of Cunningham and Faulkner test for anaerobic group and Astrand test for aerobic group. Blood sample was taken before and immediately after exercise. Results: Both acute exhaustive anaerobic and aerobic exercise have increased BDNF levels significantly (P<0/05). Serum CRP levels following implementation of aerobic exercise decreased significantly (P=0/018), but anaerobic exercise caused no significant change in CRP level (P>0/05). Moreover, immediately after exercise, significant inverse relationship was found between BDNF and CRP levels in aerobic group. There were no significant difference between aerobic and anaerobic groups in serum BDNF and CRP levels (P>0/05). Conclusion: There were significant and positive impacts of exhaustive aerobic and anaerobic exercise on serum BDNF. It can be concluded that exhaustive aerobic activity has more impact on brain health than that of exhaustive anaerobic activity, due to its significant effect on decreasing serum CRP levels. However, the final decision on this issue requires further investigations.

Background: Pain is a protective sense in tissue injury time. Diabetes mellitus accompanies with undesirable neuropathic side-effects in long term. The aim of this study was to examine analgesic effects of hydroethanolic HeracleumPersicumL. leaf’ s extract (HHE) in diabetic and intact male mice. Methods: 96 male mice were divided into 9 groups: control, treated by morphine, treated by HHE (100, 200 and 400mg/kg, i. p. ), naloxone + HHE(200mg/kg) and STZ (60mg/kg, i. p) and STZ+ HHE(400mg/kg) randomly. To assess the antinociceptive effects of HHE, the animals were examined by tail-flick and writhing tests. Results: 200 and 400 mg/kg of HHE increased pain threshold compared with control group in writhing and till flick tests (p<0. 001). Also the effect of administration of 400 mg/kg HHE was moreanalgesic that of morphine alone (p<0. 001). Diabetic group had low threshold to pain compared to control group. Conclusion: HHE has antinociceptive and anti-diabetic effects. We suggest the analgesic effects of HHE may be due to opioid system and also it effect on prostaglandins synthesis.

Background: Tympanosclerosis is one of complications of chronic otitis media with accumulation of hyaline and calcified deposits intra tympanic membrane and middle ear's membrane. In most cases these plaques are of minimal clinical significance and result in trivial hearing dysfunction. Methods: 60 patients diagnosed with chronic otitis media and tympanosclerosis who were candidates for operation and met inclusion criteria were evaluated. Audiometric evaluations were assessed before and after surgery. Intra operative findings and Post operative clinical results were also evaluated after surgery. Results: 25(43. 1%) patients were male and 33(56. 9%) were female. Hearing dysfunction was monolateral in 62. 1% and bilateral in 37. 9%. The most common location of ossicular chain fixation is between incus and malleus reported in 24(41. 3%) patients. Conclusion: Middle ear surgery result is astonishing although other factors such as severity of sclerosis and fixation localization may also be influential in surgical results.

Background: Gestational diabetes mellitus (GDM) is a form of diabetes in pregnancy. Macrosomia is considered as the most important related adverse effect. Pervious GDM and impaired glucose tolerance increases the risk of type 2 diabetes. The aim of this research work was to investigate the risk factors of GDM. Methods: 48 pregnant women involved with GDM were evaluated and the risk factors were studied. Then, incidence of impaired glucose tolerance and type 2 diabetes were determined six weeks after delivery. Results: The results showed that 81% of studied women indicated BMI higher than 25, 70% of people were older than 30 years and 58% of them had familial history of type 2 diabetes. The weight gain of women (59%) was higher than desired level during pregnancy and 64% of them needed oral agents and insulin. Six weeks after delivery, IFG and IGT were obtained equal to 6. 66 and 3. 33 %, respectively. The same values, 3. 33%, were determined for IFG and IGT, simultaneously. Also, type 2 diabetes was not detected in the studied cases. Conclusion: It is important to consider the GDM risk factors in the first visit of pregnancy in order to decrease its complications. The encouragement of mothers for healthy nutrition and planned physical activity are necessary to suitable weight gain during pregnancy which is very important in prevention and control of GDM.

Background: Aerobic training is a well-supported as a useful component of an exercise. One of the most common adaptations that occur in this type of training is creating new vessels and increased angiogenesis factors. Aerobic training can be effective on angiogenesis. The aim of this study was to investigate the effect of aerobic training on (Vascular Endothelial Growth Factor, VEGF) expression in diabetic rats. Methods: 40 Rats divided to two categories equally, diabetic and non-diabetics rats. In case group, diabetes was created through a combination of streptozotocin (STZ) and high-fat meal. Then each category of diabetic and non-diabetic animals will be divided into two groups: \ training (6 days per week on a motorized treadmill) and non-training. At first, the rat began for 10 minutes a day and at a speed of 10 meters per minute, with a slope of 10%. Speed and duration of the exercise, gradually increased, until the duration and intensity of exercise respectively to arrive 1 hour and 26 meters per minute. 48 hours after completion of training period, Cardiac muscle will be removed and immediately placed into liquid nitrogen. Cardiac protein expression of VEGF investigated with method of Elisa. For data analysis, One Way Anova and tukey test will be used to find differences between groups. Results: Diabetes significantly decreased cardiac expression of VEGF protein level (control group: 480. 67± 14. 77 compared with diabetic group: 360. 12± 33. 35; P<0. 001). Also, 8 weeks of aerobic training significantly increased cardiac VEGF protein level in healthy (control group: 480. 67± 14. 77 compared with training group: 621. 4± 34. 06; P<0. 001) and diabetic rats (diabetic group: 360. 12± 33. 35 compared with diabetic training group: 471. 88± 25. 55; P<0. 001). Conclusion: It seems aerobic training can via angiogenic path incurred diabetes improvement. Also, as for results of yielded from this study and kindle regulatory processes by VEGF that via aerobic training be impressed, it is get worth strategy that it can lead in diabetes on development of new therapy methods.

Background: Wart is a common disease which is caused by a group of viruses called Human Papilloma Virus. The most type of wart is common wart and the most prevalent site of involvement is hand. Complete recovery, no recurrence and effectiveness in all patients are not obtained by any of therapeutic methods, so in this study we decided to compare therapeutic effects of 5-FU with cryotherapy in treatment of common warts of backhand. Methods: In a one year period from March 2012 to March 2013, 60 patients that referred to dermatology clinic of Sina hospital with the diagnosis of backhand wart included the study. Patients were divided into two groups, one treated with cryotherapy (30 patients) and one threated with 5-FU (30 patients). Age and gender of patients, number of lesions and duration of involvement were documented. Treatment by topical 5-FU was implemented twice a day for 4 hours each course for 4 weeks, Second group was treated by cryotherapy (liquid nitrogen spray), two sessions with a two-week interval between sessions. Their response to treatment was evaluated as good, moderate and weak. Results: There was no difference in age, gender and mean of duration involvement and number of lesions between two groups. Response to treatment was considerably better in 5-FU group: 60% compared with 26. 7% (P=0. 02). Rate of complications were lower in 5-FU group of treatment, with a statistically significant difference compared to the cryotherapy group (P<0. 001) too. In separate evaluation of complications only scar formation was equal in two groups and pain and bullae formation were lower in 5-FU group with a statistically significant difference (P<0. 001 both). Conclusion: According to limited studies in this field, results of this study could be the base of more comprehensive studies in evaluating the efficacy of 5-FU in treatment of common warts. Appropriate therapeutic response in addition to lower rates of complications by 5-FU treatments can make a major change and lower the psychosocial burden of this disease dramatically.

Kaposiform hemangioendothelioma (KHE) is an intermediate vascular tumor which occurs in children and commonly associated with Kasabach-Merritt syndrome (KMS). It commonly occurs in skin, trunk, extremities, and retroperitoneum. We report a 7 months year old boy with a huge intaabdominal KHE without KMS.