Medical Journal of Tabriz University of Medical Sciences
Year:2012 | Volume:34 | Issue:3|Papers Count:25

Background and Objectives: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in upper extremity in which the median nerve is compressed in the wrist and assessed based on subjective, physical, and electrophysiological findings. The objective of this study was to determine the correlation among subjective, physical examination, and electrophysiological studies.Materials and Methods: Twenty five patients with CTS (totally 40 hands) from mild to moderate severity were recruited. Subjective (symptom severity scale, functional status scale, and visual analog scale), physical examination (Phalen’s test and median nerve tension test), and electrophysiological (median nerve distal sensory and motor latency) studies were performed for all subjects.Results: Higher intra-correlation was found among subjective findings than electrophysiological parameters. The inter-correlation between subjective and median nerve tension test ranged from low to moderate. Also, a low intra-correlation was found between electrophysiological findings. Furthermore, there was no significant correlation between the subjective and electrophysiological studies. Similar result was found between the median nerve tension test and the electrophysiological studies.Conclusion: Each aspect of the examination of the patients with CTS provides specific information of the diseases and cannot be replaced by one another. Therefore, it appears that any improvement in subjective and/or physical findings does not necessarily lead to an improvement in electrophysiological studies in median nerve in patients with CTS.

Background and Objectives: Creatine monohydrate is the most common supplements used by athletes. However, there are controversies related to its positive and negative effects. This study was conducted to determine the effect of long-term creatine monohydrate supplementation on serum cellular damage in young non-athlete male.Materials and Methods: 18 non-athlete healthy male (age= 22.88±2.90Yr; weight=73.58±5.45 Kg; height=173±6.79 Cm) were entered the study, they were subdivided into two groups, experimental (n=9) and control (n=9) groups. Each groups participated in two month of training. Experimental subjects consumed 0.07 g/kg/day of creatinin monohydrate (crm) during training protocol, and control group received 0.07 g/kg/day wheat flour as placebo. Venous blood samples were obtained before and 48h after last session of weight training.Results: The results indicated that Serum LDH and CK activity mean was significantly increased after two months weight training and CrM Ingestion (LDH 90%, P=0.004; CK 83%, P=0.006) and placebo-training (LDH 13%, P=0.001; CK 15%, P=0.009). Moreover, there were significant differences between groups for CK and LDH activities mean (PCK=0.018; PLDH=0.001) and changes range (PCK=0.002; PLDH=0.005) after the protocol.Conclusion: This observation suggests that CrM ingestion might have adverse cellular damaging effects.

Background and Objectives: There are insufficient data on the beneficial effect of skin massage on physiological parameters in preterm infants. In this research we decided to examine the effects of massage on physiological parameters in premature infants.Materials and Methods: In this study, 135 infants were entered and divided into 3 groups by using simple random method. The babies in the first group received 15 minutes of skin massage with olive oil for 10 days; second group of infants received the massage without use of oil. Infants in the third group did not receive any intervention, ten minutes after each intervention; infants’ vital signs were recorded.Results: The results showed a significant difference of respiratory rate in massage with olive oil group, compared with control groups (P<0.001). There was also a change of body temperature between both interventions groups with the control group (P<0.001).Conclusion: The findings of this study showed that, preterm infants massage doesn’t have any negative effect on premature infant’s physiologic parameters.

Background and Objectives: By now, numerous studied have tried to find prognostic factors in patients with acute lung injury (ALI); however the available data are controversial. The aim of the present study was to determine effective factors of outcome in children with ALI.Materials and Methods: In an observational cross-sectional study, 64 pediatric patients with ALI were recruited in a 22-month period in Tabriz Children’s Hospital. The pediatric Intensive Care Unit (PICU) outcome was determined and accordingly the patients were allocated in two groups; discharged patients and deceased. Patients’ characteristics including age and gender, underlying disorders, parameters of mechanical ventilations, arterial blood gass, organ involvement, presence of acute respiratory distress syndrome (ARDS) and pediatric risk of mortality (PRISM) score were compared between the two groups.Results: The PICU mortality rate was 51.6%. Independent predictive factors of mortality were higher (more negative) base excess (BE) higher positive end-expiratory pressure (PEEP) and peak inspiratory pressure (PIP), and higher on-admission PRISM score, as well as presence of other organ involvement and ARDS. Parameters such as age, gender, underlying disorders and length of stay, PaO2 and PaCO2 were not significantly different between the two groups. In multivariate study, however, high PRISM score was the only dependent predictor of mortality (³13.5, sensitivity: 75.8%, specificity: 90.3%). Conclusion: The PRISM score was the only reliable predictor of PICU-mortality in pediatric patients with ALI.

Background and Objectives: Azelaic acid with its antibacterial effects and absence of bacterial resistance is useful in the treatment of acne vulgaris. The aim of this study was to evaluate the effects of Azelaic acid gel 10% with hydro alcoholic base and without alcohol in the base, in the treatment of the patients with mild to moderate acne vulgaris.Materials and Methods: In a randomized, double blind clinical trial, 80 patients (16 males and 64 females) with mild to moderate acne vulgaris were divided into two groups. The first group (40 patients) was treated with Azelaic acid gel 10% with hydro alcoholic base for 8 weeks and the second group (40 patients) with Azelaic acid gel 10% without alcohol in the base.Results: Both groups had significant reduction in the total lesion counts on the face (P<0.001). The process of recovery in both groups was similar. The remission of inflammatory lesions in the patients with greasy skin treated with Azelaic acid gel 10% with hydro alcoholic base, was significantly better than the other group (P=0.02).Conclusions: Azelaic acid gel 10% with hydro alcoholic base and without alcohol in the base, are effective in the treatment of mild to moderate acne vulgaris. Azelaic acid gel 10% with hydro alcoholic base is more effective in the treatment of the inflammatory lesions in the patients with greasy skin than the Azelaic acid gel 10% without alcohol in the base.

Background and Objectives: In spite of salt iodization program which began in Iran in 1989, there are controversies regarding the impact of iodine fortification in certain regions of the country such as West Azerbaijan province. The aim of the present study was to re-evaluate urinary iodine excretion and the prevalence of goiter during puberty in female schoolchildren aged 10-17 years in Urmia city.Materials and Methods: In this cross-sectional study, 500 female schoolchildren aged 10-17 years were enrolled by random cluster sampling from schools in different educational areas in Urmia. The schoolchildren were classified into 3 groups according to the puberty status: group 1: prepuberty (n=61); group 2: puberty (n=354) and group 3: post puberty (n=85). Urine iodine excretion and prevalence of goiter was evaluated.Results: The median urinary iodine excretion in groups 1-3 was 125 mg/L, 142 mg/L, and 170 mg/L, respectively. Prevalence of goiter in groups 1-3 was 3.3%, 14.6% and 8.3%, respectively. The prevalence of goiter between group 1 and group 2 was statistically significant (P=0.03). A significant positive correlation was found between age and urinary iodine excretion (P=0.008).Conclusions: This study revealed that 77.2% of the studied population was iodine sufficient. The highest prevalence of goiter was seen in schoolchildren at puberty (14.6%) reflecting the high metabolic rate, hormonal alteration during puberty as well as nutritional factors in particularly the demand for higher iodine intake.

Background and Objectives: In accordance with limited studies about the effect of Q10 ingestion on exercise- induced oxidative stress response, this study was conducted to identify the effect of short-term coenzyme Q10 supplementation on serum total antioxidant capacity (TAC) and malondiadehyde (MDA) after one bout of aerobic exercise in a group of inactive male.Materials and Methods: Twenty male (25±3 years, body fat 13±2.%) and VO2max 39±2 ml/kg/min were allocated in two equal groups: intervention group received supplement (2.5 mg/kg/day Coenzyme Q10) and control group received 2.5 mg/kg/day dextrose as placebo. After the supplementation period (14 days), all subjects were participated in aerobic exercise protocol with 75% VO2max on the treadmill for 30 minutes. Blood samples were obtained before the supplementation and also before and after the exercise protocol. Data were analyzed by repeated measure ANOVA, Bonferroni and independent t test at £0.05.Results: Coenzyme Q10 supplementation does not have a significant effect on oxidative stress index (MDA) (P>0.05). The serum MDA level increased significantly (P<0.05) and serum TAC decreased (P<0.05). After one bout of aerobic exercise increase in serum MDA and reduced in TAC in the placebo group were more prominent than in supplement group (P<0.05).Conclusion: The present results show that the increased resting total ant oxidative capacity following 14-days coenzyme Q10 supplementation can decrease the undesirable alterations of serum MDA in male inactive after one bout aerobic exercise.

Background and Objectives: Postpartum depression is a mood disorder that, in addition to physical and psychological effects on the mother, has devastating effects on the other family members, especially in their relationships with the infant. This study was intended to examine the role of delivery type, infant feeding, and other related variables on the occurrence of postpartum depression.Materials and Methods: The mothers were selected among referries of health center affiliated to Tabriz University of Medical Sciences, through cluster sampling. Data were collected by demographic questionnaire and Edinburgh Postpartum Depression Scale, and analysis was performed through SPSS/16, using correlation coefficient and chi square and multiple regression analysis.Results: The results showed that 50.8% of 195 mothers were depressed. Type of delivery, type of infant feeding, maternal age and unwanted pregnancy had a significant contribution in predicting postpartum depression.Conclusion: Based on the results, advising about planning to pregnancy, age of pregnancy, proper choice of delivery and breastfeeding, and after delivery, giving information about symptoms of this disorder and its treatment is necessary.

Background and Objectives: Knee osteoarthritis (OA) is one of the most common causes of disability in old age. Myofascial pain and dysfunction is partly responsible for pain and disability in this disease. This study investigated the efficacy of myofascial trigger point therapy in patient with OA of knee.Materials and Methods: Sixty patients with bilateral knee osteoarthritis were divided into two groups. Thirty patients in each group were received 16 sessions of conventional physical therapy. In addition to physical therapy, intervention group also received myofascial trigger point’s therapy, too. The intensity of pain, physical performance, joint stiffness, physical function and range of motion of the knee joints were assessed in both group.Results: There were no significant differences in assessed variables between two groups. After treatment, the above variables compared with the pre-treatment results in each group and also with the post-treatment results of the other group. Except for physical performance which was not significantly differing in control group, both groups demonstrated improvement in all variables after treatment. Except for joint range of motion, improvement in all variables were better in intervention group than control group.Conclusion: Physical therapy is an effective approach for treatment of osteoarthritis of the knee. This effectiveness of physical therapy can be enhanced by adding the treatment of myofascial trigger points for treatment of pain and dysfunction in patient with knee OA.

Background and Objectives: Stuttering is a motor disorder that disrupts the fluent and connected speech flow and appears with different severity. The aim of this investigation was to explore the efficacy of prolonged speech technique in treating persons with severe stuttering.Materials and Methods: Thirty patients subjects with severe stuttering (8 to 14 years), received 20 sessions of speech therapy with prolonged speech technique. The control group consisted of 30 subjects with stuttering who did not receive the intervention stuttering severity was assessed by Stuttering Severity Instrument (SSI-3) before intervention, and immediately 4 months after intervention program. The results were analyzed.Results: A significant difference was observed between stuttering severity before and immediately after intervention (P=0.0001). There was also a significant difference between stuttering severity, before and at 4 months after intervention (P=0.0001). Those difference did not observe in control group (P>0.05).Conclusion: The results showed that prolonged speech technique is a efficient treatment method for individuals with severe stuttering and these individuals could maintain high levels of speech fluency even 4 months after intervention.

Background and Objectives: knee deformities associated with osteoarthrosis (OA) is a common presenting complaint in the orthopedic clinics. High tibial osteotomy (HTO) is an accepted procedure in the treatment of medial knee osteoarthritis with varus deformity. The methods for HTO include boths; open wedge osteotomy and closed wedge osteotomy. In this study compared the results of HTO with these two methods.Materials and Methods: In a descriptive study, 32 patients with genu varus deformity (42 knee) were included. Patients were divided in two age and sex matched groups and treated with open wedge osteotomy or closed wedge osteotomy. Patients in both groups were followed for six month and the results of treatments were compared.Results: 32 patients with genu varus deformity (10 cases (31.2%) bilateral) including 25 (78.2%) women and 7(21.8%) men were studied. Incidence of main complication after open wedge and closed wedge osteotomy were similarly (12.5%). The main complication in open wedge was intraarticular fracture and in closed wedge was peroneal nerve Paralysis. There were significant difference in operation time, time of weight bearing and return to daily activities between two groups (p<0.001). The varus correction angle, the Lysholm and the Tegner Activity score and Insall Salvati Index were not significanty different between two groups. Overall patient’s satisfaction in open wedge surgery was 87.5% and in closed wedge was 75%.Conclusion: Results of this study revealed that clinical outcome of patients in open and closed wedged surgery were not different and both methods are successful. However open wedge osteotomy has less neurological complications and higher patient’s satisfaction.

Background and Objectives: Vitamin D is the only vitamin that acts as a hormone and its deficiency impairs insulin synthesis and excretion. This study aimed at evaluating the serum vitamin D level in children with type 1 diabetes mellitus and its correlation with HbA1C.Materials and Methods: In this analytical study, serum vitamin D level in 50 type I diabetic children was compared with that in 50 healthy subjects. In diabetic group, correlation between serum vitamin D level and HbA1C was evaluated as well.Results: The median serum 25 (OH) D3 level in diabetic group was significantly lower than that in the non-diabetic group (31.05 mmol/L vs. 42 mmmol/L, P=0.01). In the diabetic group, there were 19 cases (38%) with deficient and 31 cases (62%) with insufficient serum level of 25 (OH) D3, while in the non-diabetic group, there were 9 cases (18%) with deficient and 41 cases (82%) with insufficient serum level of 25(OH) D3 (P=0.03). There was no significant correlation between serum level of 25 (OH) D3 and HbA1c (P=0.7, r=0.06).Conclusion: Children with type I diabetes mellitus had low serum vitamin D level in comparison with non-diabetic healthy children. There was no significant correlation between serum vitamin D level and HbA1C.

Background and Objectives: Due to shortage of studies about the high prevalence of musculoskeletal complaints among dentists in Iran, we aimed at studying prevalence of musculoskeletal disorders among Tabriz dentists and determining the possible risk factors.Materials and Methods: In this descriptive-analytic study, 100 dentists (80 males and 20 females) in Tabriz, Iran were randomly recruited. Possible risk factors in work place were surveyed with a questionnaire including demographic characteristics and a schematic picture to determine the painful anatomic regions in the body. Results: Prevalence of neck, low back, shoulder, wrist and hand pains was high (48%, 38%, 25%, and 25%, respectively). Between height<171 cm and non-exerciser dentists with thigh and hip pain, the non-adjustable setting units and wrist and hand pain, visiting 5-10 patients in a working day and knee pain, rest time less than five minutes between two consecutive visits and shoulder pain, not observing standard position during static, access to far objects in sitting position and thigh, hip and leg pain and prolonged posture and knee pain, repetitive activities and pain in neck, shoulder, thoracic, elbow, knee and leg, there was significant relationship (P<0.05).Conclusion: Neck and low back pain was very prevalent among dentists. Performing repetitive work in static posture was associated with the most of occupational related painful regions in the body.

Background and Objectives: Many studies conclude that although every body of family members can be injured by domestic violence but, women have been continuously on the target of domestic violence more than others. Therefore, researchers in this study, we investigated domestic violence qualitative in an Iranian community to illustrate how it has been seated on everyday life and then, highlight its consequences on both individual & society.Materials and Methods: The study population was a group of women who have experienced domestic violence admitted to treating & legal centers of Tabriz. Data collected from 26 samples & 7 key informants, using unstructured interview technique and analyzed according to the Grounded Theory method of Strauss and Corbin (1998).Results: Findings revealed 3 major interrelated stages consist of change in subjective perceptions, being in tension positions & emancipatory oriented actions.Conclusion: Results of study in detailed imply a great dilemma on normal & abnormal behaviors in the family relationships alarming attention and action to resolve problem of domestic violence.

Background and Objectives: Emergence of drug resistant tuberculosis is a global concern. It might cause reduction in the rate of smear conversion in pulmonary tuberculosis. The aim of the present study was to examine the role of primary first line anti tuberculosis drugs resistance on the rate of sputum conversion.Materials and Methods: In a cohort study between 2005 and 2006, all smear positive pulmonary tuberculosis patients (90 cases) treated in Tabriz Tuberculosis and Lung Disease Research Center were included. Sputum smear and culture taken before and then 15 days and monthly for 6 months after standard four drug (INH, RIF, PZN, ETM) treatment were assessed.Results: There were 90 smear positive patients (47 males and 43 females) in the study period. The mean time was 1.5 and 1 month for smear and culture negativity, respectively. Only one case was resistant to INH, RIF, and STM, for whom second line drugs were started. Other four resistant cases had positive smear until six months of treatment but their cultures were negative at the end of second month. At the seventh month, their smears were also negative.Conclusion: Drug resistant tuberculosis is very infrequent in Tabriz and this mandates prompt surveillance and treatment of the patients in order to prevent emergence of drug resistant tuberculosis.

Background and Objectives: Ulcerative colitis (UC) and Crohn’s disease (CD) are immune mediated disorders of the intestine. Irritable bowel syndrome (IBS) is a functional, multifactorial disease. Several lines of evidence support the hypothesis that a low-grade mucosal inflammatory process may play a role in IBS pathogenesis. In this study we evaluated T cell population in colonic mucosa of IBS and IBD patients.Materials and Methods: In analytical descriptive study, 83 patients including 35 patients with ulcerative colitis and 48 patients with IBS compared with 37 healthy volunteers. Tissue samples was tacked by colonic biopsy during colonoscopy and evaluated by histological and Immunohistochemistry (IHC) ways.Results: Thirty five patients with ulcerative colitis and 48 patients with IBS and 37 samples in patient who were underwent colonoscopy for another reason and they had normal results were also studied. CD4+ and CD8+ T population in IBS patients with similar to healthy volunteers and their ratio were not difference between them but in ulcerative colitis CD4+ T cell counts and ratio of CD4+/CD8+ were significantly higher than healthy volunteer (p<0.001) and CD8+ counts were lower in comparison of IBS and healthy volunteer (p<0.001).Conclusion: Results of this study revealed that a CD4+ and CD8+ T cells infiltration does not have an important role in IBS mucosal immunity dysfunction.

Background and Objectives: Air pollution is the major problem in industrial cities. It seriously threatens the inhabitants’ health, especially high-risk people like pregnant women’s. Spontaneous abortion could happen as a consequence of carbon monoxide in this situation. This study was aimed to examining the effect of environmental carbon monoxide concentration on the rate of spontaneous abortion.Materials and Methods: This study was conducted on 148 pregnant women who had spontaneous abortion (case group) and 148 pregnant women without abortion (control group). They were collected randomly from 10 hospitals in different area of Tehran between June 2010 to February 2011 and the correlation between spontaneous abortion and environmental carbon monoxide was investigated.Results: Two groups were matched by their age, their husbands’ age, age at the first childbirth, educational level, average of family income, previous delivery type, interval between deliveries, history of previous abortion, body mass index, parity, duration of residence in Tehran and the amount of time spent at work and outside of the home (P>0.05). The study revealed that the mean of environmental carbon monoxide concentration in case group (4.09±2.09 PPM) was significantly higher than control group (2.81±1.07 PPM) (P<0.001) and the rate of abortion was 1.98 times higher in highly concentrated areas (CI95% 1.55-2.53). There was also a negative relationship between gestational age and carbon monoxide concentration.Conclusion: The results of the study showed that there was a significant relationship between the occurrence of spontaneous abortion and the environmental carbon monoxide concentration.

Background and Objectives: The aim of the present study was to evaluate correlation between corneal biomechanical measurements and ablation depth in myopia and myopic-astigmatism after customized photorefractive keratectomy.Materials and Methods: In 96 eyes with myopia and myopic astigmatism, corneal hysteresis (CH), corneal resistance factor (CRF), Goldman-correlated intraocular pressure (IOPg), and corneal-compensated IOP (IOPcc) before and 3 months after custom PRK were measured. Preoperative manifest refraction spherical equivalent (MRSE), central corneal thickness (CCT) and ablation depth (AD) were recorded. The changes of parameters after PRK were calculated and correlation between attempted correction of MRSE and AD, between AD and the changes in CH, CRF, IOPg and IOPcc were examined.Results: Preoperative mean of AD was 74.81±31 m. The preoperative mean of CH and CRF (10±1.36 mmHg and 10.2±1.51 mmHg, respectively) was significantly higher than the corresponding postoperative values (7.55±1.81 mmHg and 6.74±1.72 mmHg, respectively) (P<0.001). The higher attempted correction of MRSE was correlated with higher AD (RS=0.87, P<0.001), higher CH (RS=0.41, P<0.001), and higher DCRF (RS=0.66, P<0.001).Conclusion: Changes in CH and CRF after customized PRK suggest alteration in corneal biomechanics correlating with attempted correction, and CRF was more affected than CH.

Background and Objectives: A woman’s perception of labor pain is affected by different issues such as cultural, social, psychosocial and environmental factors. Due to limited studies performed on labor pain in our country, we aimed at studying more on this topic.Materials and Methods: In this descriptive-comparative study, women’s hospitals were selected by using multistep random-sampling method considering each category’s segment. One hundred and fifty cases were randomly selected for each category. Data collection was done using questionnaire and labor pain was measured with visual analogue scale of pain (VAS) and interviewing.Results: In this study, in the state hospitals the mean score of pain in primiparas was 8.21±2.65, while it was 8.90±2.48 in the multiparas. In the private hospitals, the mean score of pain in primiparas was 8.90±1.09, while it was 9.07±1.13 in multiparas. The mean score of pain in private hospitals was higher than the state hospitals (P<0.001). The result of regression model showed that factors such as type of hospital, environmental, therapeutical and caring factors, and labor phobia are considered as items for predicting the rate of pain intensity. The relationship between fear, anxiety and social, treatment factors and the pain was not significant in primiparas. Also relationship between the level of supporting and the pain in primiparas was significant but it was not the same in multiparas.Conclusion: The results showed that the type of hospital, physical and environmental factors, treatment and care, labor fear and anxiety increased the pain intensity.