MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2011 | Volume:33 | Issue:2|Papers Count:20

Background and Objective: As cardiovascular diseases are prevalent in developing countries, one of effective strategies in the prevention of such diseases is to improve knowledge and attitude toward the risk factors of cardiovascular diseases. This study was aimed to assess women’s knowledge and attitude toward cardiovascular disease risk factors and its relation with obesity and metabolic parameters.Materials and Methods: In this cross-sectional study, 89 women aged 11-67 years were interviewed face to face using a valid questionnaire to assess their knowledge and attitude toward cardiovascular disease risk factors. The knowledge and attitude status was classified into tertiles. After 12-14 hours of fasting, blood samples were taken and serum lipid profile and glucose were assessed. Obesity indices including waist circumference, body mass index and waist to stature ratio were estimated.Results: More than 70% of subjects had desirable knowledge and attitude. The knowledge and attitude status showed significant positive association with educational level and significant negative relationship with age, total cholesterol, LDL-c and the obesity indices.Conclusion: It is concluded that obesity and hypercholesterolemia are important factors influenced by the knowledge and attitude toward risk factors of cardiovascular diseases.

Background and Objectives: Studies have shown the effect of body position during and after bolus feeding upon gastric emptying. The aim of the present study was to compare the effect of lying in prone position and right lateral position on gastric residuals.Materials and Methods: This study is a cross over clinical trial performed in Al-Zahra Teaching Hospital in 2009. One hundred infants were selected by simple random method divided into two groups. In first group, the infant was laid in right lateral position and then prone position at first gavages. Then the gastric residuals were measured at 1 and 2 hours after initiation of feeding. On the contrary, the infant of second group, at first gavages was laid in prone position and then right lateral position and the gastric residuals were measured at 1 and 2 hours after initiation of feeding. Finally the gastric residuals in both groups were compared.Results: The gastric residual in prone and right lateral positions after gavages was reduced significantly (P<0.001). The result showed that the effects of both positions on gastric residual were equal and there were no significant differences in the amount of gastric residual between the two positions.Conclusion: Right lateral position and prone position have same effect on the gastric residual in preterm infants. Therefore, using of both positions after preterm infant gavages is recommended.

Background and Objectives: The range of mouth opening is a diagnostic sign in some clinical situations and has importance in treatment management. In order to distinguish decreased mouth opening, it is essential to establish normal range of the mouth opening in a certain population. The purpose of this study was to determine the normal range of the mouth opening by using hand fingers in students of dental faculty of Tabriz University of Medical Sciences in 2009.Materials and Methods: One hundred and fifty dental students (aged 19-47 years, the mean age of 27.94±8.10 years) were examined and divided into two groups; with and without temporomandibular joint dysfunction. Ability of subjects in putting three fingers (index, middle and ring finger) or four fingers (index, middle, ring and little finger) at vertical position in the mouth were evaluated. Furthermore, amount of maximum mouth opening and the width of three and four fingers of both hands were measured.Results: Seventy four percent of the subjects could put three fingers in the mouth, whereas 15.3% were able to put four fingers in the mouth. In addition, 10.7% of the participants were not able to put three fingers in the mouth. The mean of maximum mouth opening was 51.87±7.6 mm.Conclusion: According to this study, individuals’ fingers are not appropriate index for assessing the normal range of the mouth opening in subjects with or without temporomandibular joint dysfunction

Background and Objectives: Consumption of water contaminated with arsenic can cause various adverse health effects. Iranian standard of arsenic in drinking water is 50 mg/L, while World Health Organization (WHO) has recommended a maximum level of 10 mg/L arsenic in the drinking water. As some drinking water sources are contaminated with arsenic in Hashtrood (in neighborhood of Charoymagh) and also arsenic detection is not included in the current routine monitoring of the drinking water, this study aimed to trace the detectable amounts of arsenic in the drinking water sources of Charoymagh district in the East Azerbaijan province.Materials and Methods: Water supply, sanitation status and arsenic presence were studied in the Charoymagh district including residential villages. Water sampling and field works were carried out by environmental health experts. Ez arsenic test kit was used for testing the arsenic in the water samples.Results: Of 210 studied villages, arsenic was detected in the drinking water of 41 villages (19.52%). In eight villages, the level of arsenic in the drinking water was higher than the Iranian standard (50 mg/L) allowance. In 33 villages, arsenic concentration was 10 mg/L>, ³50 mg/L. A total number of 7290 individuals (22.06%) were exposed to arsenic in the drinking water which was higher than that recommended by WHO.Conclusion: It is concluded that Charoymagh district is an area with arsenic presence in some drinking water sources. It is necessary to replace the water sources of the villages with high level of arsenic with safe drinking water.

Background and Objectives: As no report is available in Iran regarding palindromic rheumatism, the aim of the present study was to investigate the frequency, demographic, clinical, and laboratory characteristics of palindromic rheumatism in North West of Iran.Materials and Methods: In this prospective study, patients with recurrent arthritis were visited by a rheumatologist. Diagnosis of palindromic rheumatism was made after ruling out other causes of recurrent arthritis such as crystal arthropathy, seronegative spondyloarthropathies, Behcet’s disease, etc. In addition, Pasero and Barbieri criteria were applied in order to diagnose the palindromic rheumatism. Subsequently, the patients were followed up for at least one year.Results: Of 1225 patients with inflammatory arthritis, 34 (2.8%) patients were diagnosed as palindromic rheumatism. The rate of palindromic rheumatism to rheumatoid arthritis was 5.9%. The mean duration between the first episode of arthritis and diagnosis was 4.7 years. More than half of the patients (58%) had their first symptoms between the ages of 20 and 45. Male to female ratio was 1.8: 1. Attacks were monoarthritic or oligoarthritic in 33 (97.1%) patients. The most involved joints were knees and hand proximal interphalangeal joints. Duration of attacks was more than 5 days in only two patients. Rheumatoid factor, anti-cyclic citrullinated peptide antibody (anti-CCP), and ANA were positive in 13 (37%), 20 (57%), and 3 (13.7%) patients, respectively.Conclusions: Demographic, clinical and laboratory characteristics of our patients with palindromic rheumatism are different in comparison with those of similar studies from other countries.

Background and Objectives: Hypercholesterolemia can increase oxidative stress through elevation of reactive oxygen species (ROS) production. The aim of the present study was to investigate the antioxidative/prooxidative balance in rabbits receiving high-cholesterol diet for two months.Materials and Methods: Sixteen rabbits were randomly divided into two groups: the control group which received 100 g normal chow diet daily; and the treatment group with the same diet plus 2% of cholesterol. The blood sample was obtained at first, days 20, 40, and 60 of the experiment. Plasma was separated and kept at -76oC until use. The lipid profile was determined using enzymatic method. Superoxide dismutase and glutathione peroxidase activities were measured spectroscopically. Malondialdehyde (MDA) level and paraoxonase 1 (PON1) activity was determined by means of thiobarbituric acid and chemical methods, respectively.Results: At the end of intervention period, there was a significant increase in the plasma cholesterol (P=0.02), triglyceride (P<0.001), and LDL-C (P=0.041) concentrations; while level of HDL-C decreased significantly (P=0.036). The PON1 activity showed a decreased trend during the first two months reaching to 2.5 from 3.23 mmol/min/ml at the end of the experiment (P=0.001). However, there was about two-fold increase in the MDA level (from 6.77±0.91 to 14.50±3.00 nmol/ml, P=0.003). The superoxide dismutase and glutathione peroxidase activities were increased significantly (P=0.001 and P<0.001, respectively).Conclusion: An athrogenic diet can affect the lipid and lipoprotein profiles through changing the metabolic process. Meanwhile, this diet is also able to increase oxidative stress by disturbing antioxidative/prooxidative balance which, in turn, may lead to atherosclerosis development and progression.

Background and Objectives: Diabetes mellitus results in wide disorders in central and peripheral nervous systems. Prevalence of cognitive disorders in diabetic patients is more compared to that in non-diabetic patients. Brain-derived neurotrophic factor (BDNF) prevents cell death by stimulating synthesis of antiapoptic factors in cell cultures. The present study aimed at investigating the effects of experimental diabetes on programmed cell death in hippocampus and its relation with the amount of BDNF and the related gene expression.Materials and Methods: Twenty male Wistar rats (200+20 g) were divided into two groups: control and diabetic. Diabetes was induced by injection of streptozotocin (single dose, 50 mg/kg). Duration of the study was 8 weeks. At the end of the experiment, the rats were anesthetized by thiopental sodium and then brain was removed. Immediately, the hippocampus was removed on ice and kept frozen by liquid nitrogen and kept in freezer -800C until detection. Hippocampus tissue was homogenized in prepared buffer and after centrifugation supernatant was used for determination of apoptosis, level of BDNF protein and its gene expression.Results: An increase in the amount of apoptosis following induction of diabetes was observed. Furthermore, diabetes induction increased the level of BDNF protein and its gene expression compared to the control group (P<0.05).Conclusion: Induction of diabetes increased the amount of apoptosis in the hippocampus of diabetic rats. As a defense mechanism, the level of BDNF protein and the related gene expression increases to prevent the apoptosis in the hippocampus.

Background and Objectives: Actinomycetes, the most widely distributed groups of microorganisms in nature, produce three fourth of antibiotics. Among these, streptomyces are of great importance. Therefore, we aimed at screening for antibacterial activities and molecular identification of isolated streptomyces in East Azerbaijan soils using 16SrDNA gene.Materials and Methods: Actinomycetes were isolated from soil samples of East Azerbaijan province. In primary screening bilayer method was used against test microorganisms namely B. cereus, E. coli, S. aureus, Y. enterocolitica, L. monocytogenes, K. pneumoniae, and S. flexneri. On secondary screening, isolates with strong antibacterial activity were selected for secondary metabolite fermentation. These metabolites were tested by disk diffusion method against the same microorganisms. For molecular recognition, the genomic DNA of the selected bacteria was extracted and the 16SrDNA genes were amplified and then sequenced. The sequences of 16SrDNA were studied based on bioinformatics assays.Results: Three hundred and ten actinomycetes were isolated out of 110 soil samples. In the primary screening, 44 showed antibacterial activity. Of these, 12 isolates were assessed in the secondary screening. The sequences of the 16SrRNA gene revealed that the isolate SC91 was similar to S. sampsonii with 97% 16SrDNA sequence similarity; the isolate SF51 with 82% to Streptomyces lividans; the isolate SG41 with 96% to Streptomyces mediolani; and the isolate was similar to Streptomyces albogriseolus with 98% similarity. The latter was registered in NCBI database.Conclusion: Results of this research suggest that the soil samples of different regions in East Azerbaijan have potentially unknown and novel species of streptomyces which can be exploited for production of novel antibacterial agents.

Background and Objectives: Nasal obstruction is a common complaint in the field of otolaryngology. Inferior turbinate hypertrophy is the most common reason. There are different surgical methods for treatment of the inferior turbinate hypertrophy. The aim of the present study was to compare the results of two surgical techniques, submucosal resection and submucosal diathermy of the inferior turbinate.Materials and Methods: In this clinical trial study, 60 patients were randomly divided into two groups of 30 patients and were operated with either submucosal resection or submucosal diathermy techniques. Comparison of improvement and complications was based on a questionnaire, postoperative follow up for 6 months, and Gertner-Podoshin scale before and after the operation.Results: Based on the questionnaire results, 27 of 29 patients (93%) in the diathermy group showed significant improvement, while 2 patients (7%) had partial improvement. In the resection group, 27 patients (97%) and 1 patient (3%) had significant and partial improvements, respectively. According to the Gertner-Podoshin scale, good nasal airflow was increased from 16 pre-operation to 25 post-operation (P>0.05). With regard to the complications, bleeding was less common in the diathermy group. There was no significant difference between the two groups regarding other complications including crust, nasal dryness, pain and unpleasant odor. However, pain and unpleasant odor were fewer in the resection group.Conclusion: Both techniques are effective in the treatment of inferior turbinate hypertrophy despite technical simplicity of the diathermy. However, according to the results of the both techniques, neither method is superior as the treatment techniques of the inferior turbinate hypertrophy.

Background and Objective: Evaluation of puberty levels in a population requires exact reference values for comparison. This study aimed to determine the age of puberty onset in girls living in Tabriz, Iran and its relation to body mass index (BMI).Materials and Methods: This cross-sectional study was conducted on 1000 female students, aged 7-17 years, in Tabriz between 2008 and 2009. Participants were selected by multistage random cluster sampling from school students. According to BMI, the participants were divided into 4 groups: obese, overweight, normal weight and underweight. Secondary sexual characteristics were evaluated by inspection and palpation according to Tanner staging. Menarche age, if any, was also recorded.Results: The mean age of puberty onset (breast stage II) was 9.58±1.15 years and the mean age of tanner stage II of pubic hair (P2) was 10.30±1.1 years. The mean age of menarche was 12.58±1.30 years. There was significant difference between the age puberty onset and BMI (P=0.002). The mean menarche age in the underweight and normal weight groups was significantly greater than overweight and obese groups (14.85 vs 13.81 years, P<0.001).Conclusions: Age of puberty onset is decreasing in our community. This study confirms that obese and overweight girls reach the puberty at a lower age than normal weight girls and their menarche age is less as well.

Background and Objectives: Pemphigus is an autoimmune intraepidrmal blistering disease which involves both skin and mucous membranes with pathogenic mechanism of autoantibodies against desmosomes. The aim of the present study was to evaluate circulating antibodies in pemphigus vulgaris patients and to compare them with those in first degree families of patients with pemphigus vulgaris and control individuals.Materials and Methods: We performed indirect immunofluorescence test in 70 patients with pemphigus vulgaris and of their first degree relatives in dermatology clinic. Seventy patients with dermatologic problems other than pemphigus vulgaris were enrolled as control group. Then the results of the patients and their first relatives were compared with those of the control group.Results: The mean age of the patients in our study was 41.14±12.57 years. The mean age of the first degree relatives and the control group was 39.04±15.43 and 36.61±13.51years, respectively. In total, 57.14% of the patients were female and 42.86% were male. There was no significant relationship between gender and incidence of the disease (P=0.232). Indirect immunofluorescence test was positive in 94.29% of the patients and in 11.43% of the first degree relatives. Significant relationship was observed between patients and their families and control group.Conclusion: Circulating pemphigus vulgaris antibodies in the first degree relatives of patients are more than those of the control group.

Background and Objectives: Studies indicate that simvastatin decrease brain lesions and symptoms in patients with multiple sclerosis. The aim of the present study was to investigate the effect of simvastatin on treatment of experimental autoimmune encephalomyelitis (EAE) as an animal model for multiple sclerosis.Materials and Methods: Male C57BL/6 mice were placed in two therapeutic groups. EAE was induced by immunization of mice with MOG35-55 peptide and complete Freund's adjuvant. Treatment with oral simvastatin (1 mg/kg/day) was started on day 3 before the immunization until 25 days after immunization. Non-treated EAE mice received phosphate buffer alone with the same schedule. Leukocyte infiltration into the brain, proliferation of spleen mononuclear cells and interferon-gamma (IFN-Y) and interleukin-10 (IL-10) production from cultured spleen supernatants and clinical score of disease were determined.Results: Clinical score and onset of EAE, number of infiltrating cells in the brain and cell proliferation in EAE-treated mice were significantly less than those in the non-treated EAE (control) mice (P=0.01). There was no difference between simvastatin and control group with regard to the level of IFN-Y production. However, IL-10 production was significantly enhanced in the spleen mononuclear cells in the treated EAE group compared with that in the non-treated EAE group (P=0.008).Conclusion: Treatment with simvastatin ameliorated the EAE by inducing Th2 cytokine (IL-10) and reducing the proliferation and infiltration of leukocytes into the brain of EAE mice. Therefore, simvastatin treatment may be effective in MS patients by immunomodulating of the immune response.

Background and Objectives: Homocysteine has been proposed as a potential risk factor for atherosclerosis. Numerous factors increase the level of homocysteine, among which is vitamin B12 and folic acid deficiency and smoking. The aim of the present study was to study the relationship between smoking status, vitamin B12 and folic acid with homocysteine in patients with ischemic stroke.Material and Methods: In a cross-sectional study through simple random sampling, 46 patients with ischemic stroke aged 45-75 years admitted in neurology ward of Emam Khomeini hospital in Tabriz were recruited. Moreover, 46 healthy individuals with matched age and sex were studied. Blood sampling was performed in order to measure the levels of homocysteine, vitamin B12 and folic acid.Results: The mean serum homocysteine level was 18.68±1.53 mmol/L in the patient group which was significantly higher than that in the control group (9.96±0.19 mmol/L). Anthropometric profiles (weight and wrist circumstance) and body mass index were inversely correlated with the serum homocysteine level. Furthermore, significant difference was found in the mean number of exercise per week between the control (2.95±0.50) and patient groups (0.42±0.21). In addition, the mean years of cigarette smoking in control group (0.36±0.26) was significantly less than that in the patient group (9.67±1.67).Conclusion: Insufficient intake of folic acid and vitamin B12 along with cigarette smoking increase the serum level of homocysteine and subsequently increase probability of ischemic stroke.

Background and Objectives: Synthetic drugs are more effective substances in improvement of wounds healing. The main objective of this study was to histopathologically evaluate the effect of celecoxib on primary intention healing of stomach surgical wounds in rats.Material and Methods: Male Wistar rats were randomly assigned into three groups; sham, negative control and experimental groups. A gastrotomy incision with the length of 1 cm was made in greater curvature of the stomach of the rats, and then was sutured in two layers. Experimental group was treated with oral celecoxib (15 mg/kg solved in 10 ml/kg dimethyl sulfoxide 5%) daily for 15 days. Negative control and sham groups received dimethyl sulfoxide 5% and normal saline (10 ml/kg), respectively, in the same manner. Histopathological studies for evaluation of healing were carried out in euthanized rats using H& E and Masson's trichrome staining methods.Results: The numbers of fibroblasts and capillary buds in the experimental rats were significantly more than those in the sham and negative control groups (P<0.05). Epithelial gap in the experimental rats was smaller than that in the two other groups (P<0.05). There were significant differences of collagen contents in the region of wound healing between the experimental and two other groups (P<0.05). Differences between the sham and negative control groups of the mentioned factors were not significant.Conclusion: The results of this study indicate that celecoxib shows a beneficial effect on the surgical wound healing of stomach in the rats.

Background and Objectives: Studies Over the last decade, methicillin-resistant Staphylococcus aureus (MRSA) strains have become endemic in hospitals worldwide. Emergence of multi-drug resistant S. aureus significantly differs between health centers. Therefore, the present study aimed at determining the incidence of resistance to oxacillin, vancomycin, rifampin, linezolid and fusidic acid in Staphylococci obtained from various culture specimens.Materials and Methods: In an analytic-descriptive cross-sectional study, 150 specimens obtained from hospitalized patients in Tabriz Sina and Imam Khomeini Hospitals with positive result for S. aureus were evaluated. Resistance to oxacillin, vancomycin, rifampin, linezolid and fusidic acid was determined by disk diffusion method. The minimum inhibitory concentration (MIC) was also determined by E-test stripes.Results: The resistance rate of S. aureus to oxacillin, rifampin and fusidic acid was 54%, 10.7% and 1.3%, respectively. There was no case with resistance to linezolid. Resistance to vancomycin was intermediate in 5 (3.3%) isolates. In 2.7% of the cases, there was simultaneous resistance to vancomycin (intermediate) and oxacillin which were susceptible to rifampin. The rate of resistant isolates to oxacillin was more in specimens obtained from wound, blood, tracheal tube and secretions of nasopharynx comparing with the sensitive cases. The rate of resistant isolates to rifampin was more in specimens obtained from wound and tracheal tube comparing with the sensitive cases.Conclusion: The resistance rate to oxacillin and rifampin has been elevated among S. aureus comparing with the previous reports. There is a good coverage between oxacillin or vancomycin and rifampin.

Farber’s disease or Lipogranulomatosis is one of the rare lysosomal storage disorders caused by acid ceramidase deficiency resulting in accumulation of ceramid in tissues. Farber’s disease is an autosomal recessive disease. Children with significant neurologic involvement usually die early in infancy, whereas patients without or only mild neurological findings suffer from progressive joint deformation due to periarticular granulomas, subcutaneous nodules, hoarseness and finally respiratory insufficiency caused by granuloma formation in respiratory tract and interstitial pneumonitis leading to death in the third or fourth decade of live. In this paper, we report a 2.5-year old female with hoarseness from early infancy and thereafter subcutaneous nodules and arthritis (classic type of the disease).