MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2014 | Volume:35 | Issue:6|Papers Count:16

Backgrounds and Objectives: Nitric Oxid (NO), as a major signaling molecule in gastrointestinal tract, is produced by esoforms of NO synthase enzyme of arginine possessing, NO has a wide range of physiological and pathophysiological activities like colon cancer. Several studies have implicated that NO is a Key signaling molecule that regulates the processes of tumor genesis; Whereas Electromagnetic Fields (EMF) can affect the NO level in tissues, and according to the increasing use of weak EMF producing devices in homes, hospitals, workplaces, etc. Therefore, the present study was aimed to evaluate the efficacy of the prolonged exposure to the low frequency EMF on NO function in the isolated colon of rat.Material and Methods: In this experimental study, thirty adult male rats were divided into three groups: Experimental group (exposed to 1mT (militesla) and 50Hz for 140), Sham group (kept in the same condition but solenoid off) and control group (kept in normal condition). After 140 days, the mechanical response of longitudinal isolated strips of the isolated colon to L-NAME, were recorded using Power Lab-AtoD system.Results: Despite of few changes about the mechanical response of tissue in the experimental group comparing with other groups, no significant difference was obtained (p>0.05).Conclusion: The prolonged exposure to low frequency electromagnetic fields did not changed the nitric oxide level in the colon.

Background and Objectives: The desired segmentation of medical images is a pivotal problem in medical image processing. Segmenting the Left Ventricle (LV) in Magnetic Resonance Images (MRIs) is essential for evaluation of cardiac function. For the segmentation of cardiac MRI several methods have been proposed and implemented. The aim of this paper was to use the segmentation of LV chamber with more accuracy and comparing the results with current methods.Materials and Methods: A modified region-based active contour model was applied. A new semi-automatic algorithm suggested calculating the appropriate Balloon force according to mean intensity of the region of interest for each image. The database is included of 2,039 MR images collected from 18 children under 18. The results were compared with previous literatures according to two standards: Dice Metric (DM) and Point to Curve (P2C) to get error values.Results: According to defined standards, the obtained segmentation results are better than previously reported values in several literatures. In this study different points were used in cardiac cycle and several slices levels and classified into three levels: Base, Mid. and Apex. The better results were obtained at End Diastole (ED) in comparison with End Systole (ES), and on base slice than other slices, because of LV bigger size in ED phase and base slice.Conclusions: With segmentation of LV MRI based on novel active contour and application of the suggested algorithm for balloon force calculation, the mean improvement of DM is 19.6% in ED and 49.5% in ES phase. Also the mean improvement of P2C for ED and ES phase is 43.8% and 39.6% respectively.

Backgrounds and Objectives: The main purpose of one-stage full-mouth disinfection is the rapid elimination or depletion of all oro-pharyngeal pathogens using scaling and root planning, subgingival periodontal pocket irrigation and tongue disinfection. The aim of the present study was to evaluate the effect of this technique on serum levels of IL-17 and IL-23 in patients with moderate-to-advanced chronic periodontitis.Materials and Methods: This randomized clinical trial study conducted on 24 eligible patients with moderate to advanced chronic generalized periodontitis. 20 (11 male- 9 female), healthy subjects and with no history of drug therapy during the last 6 months were included in the study. Blood samples were taken from the patients before the intervention. Then, full-mouth disinfection was carried out in one session. Blood samples were taken again 6 weeks after the intervention. The ELISA method was used to evaluate serum levels of IL-17 and IL-23.Results: The Pre and post-treatment serum levels of IL-17 were 103.8±38.6 and 14.1±8.6 pg/mL, respectively (P=0.003); in case of IL-23, The Pre and post-treatment serum levels were 124.9±40.1 and 17±8.8 pg/mL, respectively (P=0.001). The differences were statistically significant in both cases.Conclusion: In patients with moderate-to-advanced chronic periodontitis, serum levels of IL-17 and IL-23 significantly decrease subsequent to one-stage full-mouth disinfection.

Backgrounds and Objectives: The Gastroesophageal Reflux Disease (GERD) introduced as a major predisposing factor of laryngeal and extra laryngeal disorders .This study designed to evaluate the correlation between the GERD and otolaryngology problems.Material and Methods: This descriptive cross -sectional study contained 40 pediatrics with GERD diagnosis. GERD was diagnosed based on the symptoms, radiological, endoscopic findings, and specific GERD questioner (GERDQ). First, all of otolaryngology complications evaluated and the findings were recorded by questionnaire, then medical treatments were started and after one and six months of follow up all of clinical finding were recorded. Results: The family history was negative in 85% of cases. Cough was the most common complain (57.5%). One month after treatment ten percent of gastrointestinal and 35% of ENT symptoms recovered. 6 months after the treatment 64.86% of both gastrointestinal and ENT symptoms were fully recovered. Conclusions: Our study revealed that Gastroesophageal Reflux disease should be suspected and treated in all children with prolonged and unresponsive otolaryngologic disease.

Backgrounds and Objectives: Deformity of the knee associated with Osteoarthritis (OA) is a common presenting complaint in the orthopedic surgeries. The High Tibial Osteotomy (HTO) includes open wedge osteotomy and dome shaped wedge osteotomy. The aim of this study was to comparing the results of two osteotomy methods conducted on patients with geno varus deformity.Material and Methods: In a cohort study, 30 patients with genu varus deformity were studied. They were divided into two groups: Patients treated with open wedge osteotomy and dome shaped osteotomy. They were followed for six month.Results: Incidence of complication after operation in open wedge and dome shaped osteotomy were 6 (40%) and 4 (26.7%), respectively. The main complication in open wedge was intraarticular fracture while limb length discrepancy and in closed wedge was peroneal nerve Paralysis, a nonunion and two cases with no correction angle. There was no significant difference in operation time, time of weight bearing between two groups. Mean of the varus deformity in dome shaped was 12.7 degree and in open wedge was 9.3 degree. Functional scoring according to the Lysholm and the Tegner Activity score did not differed significantly and Insall Salvati Index was after dome shaped and open wedge osteotomy.Conclusion: Opening wedge osteotomy and dome shape treatments of proximal tibial had favorable results and similarly final function. But the dome-shaped osteotomy is simple and useful in cases with unilateral involvement with sever varus deformity.

Background and Objectives: Morphine as an addictive drug, increases the brain dopaminergic activity and creates a heavy reliance on the consumer. Due to an interaction between the dopaminergic neurons and the GABAergic neurons in the brain, the current study was aimed to the evaluate the efficacy of Phenobarbital on Creating Dependency of Morphine in Mature Mice Using the Conditioned Place Preference (CPP) Method.Materials and Methods: In this experimental study, 56 male mature mice with the weight of 30-35 grams were divided into three groups: the experimental, sham and control groups. The experimental group included 5 subgroups treated with: 1) either morphine, 2) Phenobarbital with dose of minimum, 3) Phenobarbital with dose of maximum, 4) morphine+ Phenobarbital with dose of minimum, and 5) morphine+ Phenobarbital with dose of maximum. Morphine was used for causing the dependency and CCP method was used to estimate the dependency.Results: There was no significant differences between the control and the sham groups and also between the control and Phenobarbital groups in preferring a special location to receive the drug. However, there was a significant difference between the control and the Phenobarbital with dose of maximum and morphine groups in preferring a location to receive morphine, and no significant attenuation was observed in the Phenobarbital with dose of minimum and maximum morphine groups in preferring the location for receiving the drug compared with the group receiving morphine alone.Conclusion: The phenobarbital as the GABA receptors agonist through an interaction with dopaminergic pathways influence the CPP induced by morphine.

Background and Objectives: Emergence Agitation (EA) is a common postoperative problem in children. It is characterized by the change in perception of the environment with signs of disorientation, hypersensitivity to stimuli, and hyper active motor behavior. The oral premedication is widely used in pediatric anesthesia to reduce the preoperative anxiety. Midazolam is currently the most commonly used premedicant in this regard; and somehow using the clonidine showed good results too. The aim of the present study was to compare the efficacy of oral Midazolam and oral Clonidine in prevention of EA among the post-operative pediatrics.Materials and Methods: In a double-blind randomized clinical trial, 127 children candidates for tonsillectomy and myringotomy were evaluated. Patients were divided into three groups: group M (n=42) received oral Midazolam (0.5 mgkg-1) 30 min before operation; group C (n=43) received oral Clonidine (4 mkg-1) 30 min before operation; and group P (n=42) just received oral placebo in the same time. Agitation scores were recorded before and after the intervention.Results: The final agitation score was significantly lower in the M and C groups comparing with placebo group. In separate measurements, the mean agitation score were significantly lower in the C group comparing with the M group. The frequency of EA was significantly lower in M and C groups immediately after recovery comparing with placebo group but this rate was conversely higher in the M and C groups until 20 min after recovery. The mean time of recovery was significantly higher in M and C groups comparing with placebo group. Vital signs were somehow stable in C group comparing with M group. The mean duration of agitation was similar between the three groups (P>0.05).Conclusion: The oral Clonidine and Midazolam may reduce the severity of EA after operation in children; this finding is much stronger for Clonidine.

Background and Objectives: The Forearm fractures are common among children and usually managed differently comparing with other similar injuries in adults. The aim of this study was to identify the risk factors of forearm fractures in children.Materials and Methods: In this clinical trial study, 86 patients randomly were divided into two groups: group A (treated with a long arm cast method) and group B (treated with Sugar-Tong splint method). The risk factors of distal radial fractures were evaluated.Results: Eighty six children less than 15 years with the mean age of 12.24±2.24 years old were studied. The compared with a true transverse fracture, the 10o, 20o, and 30o of obliquity increased the likelihood of redisplacement 3.23, 5.82, 12.14 times, respectively.Conclusion: The complete initial displacements of the fracture and increases obliquity of the fracture line are the most important risk factors for redisplacement.

Backgrounds and Objectives: There is currently no objective reliable diagnostic test for plantar fasciitis (inflammation of plantar fascia) in as much as diagnosis cannot be made on the basis of finding a heel spur on radiography (x-ray). Ultrasound is an excellent tool for evaluating common ankle problems. The aim of this study was to investigate the sonographic features of Plantar Fasciitis (PF).Material and Methods: This prospective study was conducted on 36 patients with heel pain and the physical characteristics of PF. In addition, 36 asymptomatic matched volunteers were recruited as a control group and were examined to provide a baseline as to the normal appearance of the plantar fascia. Sonographic examinations were performed with a commercially available scanner. The heel fat pad thickness was also measured.Results: The significant increase was observed in plantar fascia thickness, heel fat pad thickness, Heel pain, Morning Pain, Daily pain severity, Morning pain severity, weight, and BMI in patients with PF comparing with the control group (P<0.05). Plantar fascia thicknesses in conjunction with calcaneus were 6.24±1.12 and 2.76±0.88 mm in case and control groups, respectively; this different was statistically significant (P=.0001).Conclusion: Since the MRI is the modality of choice in the morphologic assessment of different plantar fascia lesions, sonography can also serve as an effective tool and may substitute MRI in the diagnosis of PF.

Backgrounds and Objectives: Periacetabular Osteotomy (PAO) is a well established method in treating the hip dysplasia in adults. Despite of the lack of information about the final outcome of the PAO operation, this procedure is frequently used. The aim of this study was to evaluate the results of PAO operation among patients with severe dysplasia of the hip joint.Material and Methods: In a simple randomized clinical trial study, 20 patients were divided into two groups and were treated with classical and limited surgical osteotomy. The patients were followed for six months. Results: The mean age of study was 26.7 years. The classical and limited techniques were performed on 11 and 9 years old cases, respectively. The amount of bleeding in the classical and limited methods were 661 ml and 477 ml respectively (P=0.001). The two groups did not differed in term of the hip functional joint. There was no difference of pain controlling between the two methods.Conclusion: The periacetabular osteotomy alone was successful for treatment in severe hips dysplastic. Rectus femuris tendon junction maintains had no effect on treatment results; both methods were successful in creating adequate coverage of the femoral head.

Background and Objectives: Vulvovaginal Candidiasis (VC) is a common mucosal infection in women caused by the opportunistic yeast-like fungus Candida albicans. A significant percentage of these patients (5%) subsequently experience recurrent candida infections. The diagnosis of vulvovaginits is based on the patient’s presenting symptoms and the clinical laboratory methods. The aim of this study was to characterize the Candida species isolated from patients with vulvovaginitis.Materials and Methods: All patients with the VC symptoms who were referred to the gynecologist’s clinic of Alzahra and Taleghani hospital were investigated. After sampling from vagina and cervix discharge, two direct slides were perpared and then stained with gram stain method. The vaginal discharges were cultured on suitable media for isolation and characterization of Candida species by related laboratory methods. Results: 120 samples obtained from patients. 77 patients (65%) were infected with Candida species. The frequency of the Candida albicans, Candida glabrata, Candida parapsilosis and the Candida tropicalis were 63 (81.8%), 9 (11.7%), 4 (5.2%), and 1 (1.3%), respectively.Conclusion: Candida albicans was the most common species leading to the Vulvovaginitis in patients with VC while other species were at the secondary importance stages.

Background and Objectives: As the awareness about the dangerous side effects of synthesis antibiotics is growing, the request for natural alternatives of these drugs has been increased. Natural materials reduce the danger of these side effects. Brassica Napus L. is a medicinal plant which has diverse applications in traditional medicine. This study aims to investigate the antibacterial effects of Brassica Napus L. alcoholic extract on some of pathogenic bacteria.Materials and Methods: In this experimental study, the turnip with scientific name of Brassica Napus L. has been used. Having prepared the alcoholic extract, the effect of 50mg/ml, 100 mg/ml, 200 mg/ml and 400 mg/ml of this extract were studied using well diffusion agar and disk diffusion agar on Staphylococcus aureus, Bacillus cereus, Escherichia coli and Pseudomonas aeruginosa bacteria. The test of defining the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) was done using serial tube dilution. Results: The Brassica Napus L. alcoholic extract prevented the growth of Staphylococcus aureus, Bacillus cereus, Escherichia coli and Pseudomonas aeruginosa bacteria. The Minimum Inhibitory Concentration from the growth of this bacteria ranges from 12.5 mg/ml to 100 mg/ml.Conclusion: The Brassica Napus L. alcoholic extract has significant inhibitory role in the growth of pathogenic bacteria in vitro. Meanwhile, more researches are recommended due to reaching more inclusive results.

Background and Objectives: Nitric Oxide (NO) is a signaling molecule produced by the NO Synthases (NOS) enzime and is known to incorporate in the regulation of many reproductive events that occur in the Fallopian tube (FT). The aim of this study was to investigate the production of endothelial NOS (eNOS) in the ciliated and secretory cells of luminal epithelium of FT and alteration of eNOS during parturition.Materials and Methods: In this case-control study a total of 20 FTs samples obtained from two groups of women including: 10 FTs from the women at luteal phase of the menstrual cycle and 10 FTs of healthy pregnant women during parturition .Samples were fixed in 10% buffered formalin and paraffin sectioned for immunohistochemical evaluation.Results: Localization of eNOS in the ciliated and secretory cells of luminal epithelium of FT was seen in both groups. However, we did not found anyexpression of eNOS in smooth muscle cells of all groups (p>0.05). No significant difference in expression of eNOS was seen between luteal phase and healthy pregnant groups. Conclusion: Regarding the no significant differences in expression of eNOS in ciliated and secretory cells of luminal epithelium between pregnant women at term and women at luteal phase of menstrual cycle, the results suggested that activity and function of cilia in both groups are same.

Backgrounds and Objectives: Preterm infants are at risk for respiratory distress syndrome. In several studies Continuous Positive Airway Pressure (CPAP) in combination with surfactant is more effective comparing with just CPAP method. This type of treatment is known as Intubation, SURfactant, Extubation (INSURE). This study was aimed to determine the risk factors for the INSURE failure.Material and Methods: This descriptive analytic study was conducted in NICU of Al Zahra Hospital. All preterm neonates with gestation age less than 37 weeks who need surfactant replacement therapy according clinical manifestations were investigated. Infants intubated in delivery room were excluded from study. All neonates received surfactant according to INSURE method. Patients who intubated in first 72 hours of INSURE were considered as failure group and neonates without need for intubation were allocated as success group.Results: There were not statistically significant differences regarding gender, mode of delivery, maternal risk factors, and first blood gas analysis between groups. The mean birth weight and gestation age were significantly lower in the failure group were 1342±545g and 28.7±2.9 wk, respectively, which were significantly lower than success group (1688±472g and 31±2.2wk, p<0.001). Apgar score at 1 and 5 minutes were 5.7±2.1 and 7.5±1.3 in failure group and 7.6±1.5 and 8.8±1 in success group (p<0.001). The Fraction of inspired oxygen (FiO2) requirement, severity of disease in chest x-ray, need for repeated doses of surfactant, packed cell transfusion, patent ductus arteriosus and intra-ventricular hemorrhage were significantly different between groups (p<0.05).Conclusion: preterm neonates with lower gestation age and birth weight, low Apgar score at 1 and 5 minute, higher Fio2 requirement, and higher RDS score are increase the risk for INSURE failure.

Rhabdomyosarcoma (RMS), as the most common soft tissue sarcoma in childhood is divided into three types: embryonic, alveolar and undifferentiated sarcoma. Early detection and timely treatment are effective in increasing the survival rate. RMS can rarely occured in the breast tissue. We report an unusual occurrence of a metastatic embryonic RMS to the left breast in a 12 -year-old girl who its primary lesion on her left leg had been excised by surgery two years ago. She also had a tumor excised from her left thigh one year later.