Medical Journal of Tabriz University of Medical Sciences
Year:2001 | Volume:- | Issue:50|Papers Count:21

Background and Objectives: Unintended pregnancies are worldwide problem and one of the important causes of increase in world population. Induced abortion is a frequent consequence of such pregnancies leading to long term negative effects including various complications such as infection, uterine perforation and maternal death. The aim of this study was to recognize the effective causes of unwanted pregnancies in women of Tabriz city.Materials and Methods: This descriptive study was performed in three main governmental and private hospitals of Tabriz city in year 1997. 500 women hospitalized in Department of Gynecology and Midwifery were randomly selected and assessed by direct interview and questionnaire. Results: According to this study, out of 500 pregnant women studied, 37% of pregnancies were unwanted. 74% of them did not use any confident birth - control method inspite of having enough accessibility. There was significant relation between the number of previous pregnancies, live children, High maternal age, low level of maternal education and poor family economy with unwanted pregnancies ( p< 0.05 ). 75% of oral contraceptive users were pregnant due to improper utilization of the contraceptive pills.Conclusion: In order to prevent unwanted pregnancies and related complications, it is recommended that proper training of family planning should be started at high school level and continued after marriage, during prenatal care and delivery. There is also need for appropriate contraceptive counselling as a part of post delivery care.

Background and Objectives: Thyroid diseases, one of the commonest endocrine gland malfunctions are caused either by excessive production of iodinated thyroid hormones - a condition characteristic of hyperthyroidism or deficiency of thyroid activity , called as hypothyroidism. These diseases are commonly seen with skin signs, hair and nail abnormalities. Thus, the knowledge of these signs may lead to reach to main underlying diseases. The present study was conducted in Sina Hospital, Tabriz, to assess these signs in patients of hypothyroidism and hyperthyroidism, from year 1997 to 1999.Materials and Methods: This survey was carried out by cross-sectional method. Skin, hair and nail signs of the patients of hypothyroidism and hyperthyroidism were recorded in special charts and then were analysed with statistical methods.Results: In 120 cases of hyperthyroidism (70% women, 20-30 years old and 30% men) the following signs were noticed:Skin signs: Soft skin 66%, hyperhidrosis 50% , pruritus 16.6% and vitiligo 10%Hair signs: Soft hair 83.3% , thin hair 58% , diffused alopecia 41%Nail signs: Onycholysis 16.6%, rapid growth 8.3%50 cases of hypothyroidism were seen (70% women, 35-45 years old) and the following signs were observed in them:Skin signs: Dry skin 70%, ichthyosis 36%, puffy face 32%, myxedema 18% and vitiligo 8%Hair signs : Hair loss 70% , brittle hair 64% , delayed growth 46% , 1/3 lateral eyebrow hair loss 38% , diffused hair loss 28%, canities 2%Nail signs: Delayed growth 48%, thining 40%, onycholysis 38% Conclusion :As skin , hair and nail signs are commonly being familiar in hyper and hypothyroidism, so these signs should be clearly and distinctly noticed so as so lead to diagnosis of underlying diseases in early phases.

Background and Objectives: Breast cancer is the most common carcinoma in women and even though medically managed, it affects many lives today. Although the cause of breast cancer is unknown ,but identification of risk factors is important so that preventive measures can be taken for significant reduction in incidence rate. This study was done to determine the relationship of selected demographics, lifestyle and stressful factors leading to breast cancer in women.Materials and Methods: In this retrospective study 107 women who were attending various hospitals of Tabriz University of Medical Sciences for treatment, and 216 healthy women accompanying as visitors of patients, matched by age,level of education and area (rural/urban), were chosen as control group by convenience sampling.A questionnaire which contained some variables about demographics, lifestyle and stressful factors was developed by the researchers and data were collected by interview and measuring some anthropometric factors. In order to determine the relationship between variables and breast cancer, appropriate statistical tests including Chi-Square and Analysis Variance were used.Results: The results in relation to some demographic variables showed that there is significant relationship between level of education, economic condition, first degree family history of breast cancer, history of benign breast disease, age of menarche and rate of WHR (waist to hip ratio) and breast cancer (p<0.001), but no association was observed between the number of pregnancies, rate of upper body weight, height and BMI (Body Mass Index) and breast cancer (p>0.05). There were significant associations between sporting activity, intake of dairy products, vegetables and fruits and level of information about preventive measures and reduction in the risk of breast cancer (p<0.01). Most of cases (42.2%) had more stressful events before diagnosis in contrast with control group (10.7 %) and significant difference was observed between two groups (p<0.001).Conclusion: The present study, similar to other relevant research literatures showed that some variables such as intakes of dairy products, vegetables and fruits, leisure activity, level of education, information about the primary preventive measures can be considered as protective factors for breast cancer, but variables such as low economic condition, low education level, family history of breast cancer, history of benign breast diseases, and usage of oral contraceptives, rate of upper body weight (WHR) should be taken as risk factors for breast cancer. The results suggest for more steps to be taken to compensate for serious lack of available public information about risk factors of breast cancer and aim at educational programs at community level.

Background and Objectives: Epilepsy is a group of syndromes characterized by paroxymal transient disturbances of the brain function that may be manifested by many clinical signs and symptoms. Its prevalence is being reported between 1-2% in different societies. The most common manifestation of this syndrome in children is tonic- clonic seizures also called as grand mal Epilepsy.Materials and Methods: In this study 6000 school children between 7-12 years old were initially evaluated by questionnaire, and the suspected cases were further observed clinically and by electroencephalography (EEG).Results: Out of the total students evaluated, 88 individuals were detected having history of epilepsy and 40 of them were found actually suffering from grand mal epilepsy. Abnormal EEG changes were observed in 60% of those with grand mal epilepsy.Conclusion: grand mal Epilepsy is a common symptomatic form of epilepsy in children, and electroencephalography is a useful diagnostic method in a clinical setting to evaluate epileptic syndrome, particularly in pediatric epilepsy patients.

Background and Objectives: The technique of guided tissue regeneration (GTR) has been reported to facilitate restoration of connective tissue attachment in periodontal defects. The purpose of this study was to evaluate guided periodontal tissue regeneration and the application of a composite bone graft (GTR-BG) in class II furcation defects and to compare it with the another composite bone graft (CG) technique performed a lone.Materials and Methods: Clinical trial was done on fifteen patients with two lower molar teeth with class II furcation defects. One tooth in these patients was treated by CG and another by GTR-BG. All of the patients were scheduled to obtain maintenance treatments on a regular basis for six months and eventually re-entry was done at the end of this period of time.Results: Probing depth reduction (PDR), attachment level (AL) and vertical open probing attachment (VOPA) measurements revealed that both treatment modes were relatively successful and had significantly improved the clinical and re-entry parameters (p<0.05 for PDR and AL, p<0.025 for VOPA). Difference between the two techniques was not statistically significant. There was a little gingival recession following two modes of treatment but the amount of gingival recession in GTR-BG was less than CG .Conclusion: The results of this study shows that both GTR-BG and CG treatment modes can be applied for the treatment of class II furcation involvement and can be compared with the other studies.

Background and Objectives: Cytogenetic abnormalities detected in pediatric leukemia has a significant role in relating disease’s pathophysiologic characteristics. The purpose of this study was to define chromosomal aberrations associated with leukemia in children.Materials and Methods: Bone marrow and peripheral blood samples were obtained from 50 children (33 males and 17 females) aged under 12 years with mean age of 6 years referred to Department of Hematology, Tabriz Children Hospital, Tabriz, from September 1997 to August 1998. Samples were analyzed by standard cytogenetic techniques to determine the karyotype.Results: GTG banding chromosomes were described according to ISCN classification. Acute leukemia (ALL) was the most common neoplasia of childhood(14 males and 8 females). Also, the majority patients in the study belonged to blood group A+(26%) (9 males and 4 females ). Chromosomal analysis of leukemia cells revealed the most significant chromosomal changes particularly aberrations such as translocation and acentric chromosomes (50%). The rate of chromosome aberrations in patients with leukemia showed significant difference compared with the control group (p<0.05).Conclusion: Chromosomal abnormalities detected in pediatric population is significant as an important prognostic factor in leukemia. The frequency and type of cytogenetic abnormalities was found comparable to those reported earlier in literature.

Background and Objectives: Iodine deficiency disorders are among the most important health problems in Iran. One of the major objectives of national committee of IDD, is to have clear and accurate knowledge on geographic distribution of endemic goiter in cities and provinces around the nation. The aim of present study was to determine prevalence of goiter in 14-18 years old female students of Shiraz, 8 years after iodinization of salt. Urinary excretion of iodine was also determined in order to assess the effect of consumption of iodized salt on prevalence of goiter.Materials and Methods: In this cross- sectional study, 1200 (3.18% of the population) high school female students, 14-18 years old, were selected randomly by proportionate multi- stage cluster sampling method. Subjects underwent clinical examination for the presence of goiter. Clinical examination and classification of goiter were made according to World Health Organization standard. A subsample of 107 high school children (about 10% of sample) was chosen to conduct the urinary iodine determination.Results: The results revealed that the prevelance rate of goiter was 25%. Grade 1B goiter was more prevalent (13.9%) than Grade 1A (7.4%). The present study also showed that mean sd of urinary iodine concentrations and urinary iodide/creatinine ratio in sub samples were 19.95 7.8 ug/dl and 190.63 115 ug/g respectively.Conclusion: Iodine deficiency according to two indices, urinary iodine level and urinary iodine/creatinine ratio in sub sample of high school girls were 4.7% and 12.1 % respectively. This necessitates to continue salt iodization programme and further studies should be carried out to investigate other factors that might be involved in genesis of thyroid enlargement.

Background and Objectives: Shunt operation for treatment of hydrocephalus is associated with several complications, the most important of them is shunt malfunction. Causes of shunt malfunction include infection, mechanical and functional obstruction. Shunt obstruction presents as hydrocephalus and majority of cases need shunt revision.Materials and Methods: In this study 100 patients with shunt malfunction were reviewed. They were then operated for revision.Results: Among the patients who underwent shunt operation for hydrocephalus and shunt malfunction, it was found that 12% of them had infection and 88% suffered mechanical obstruction as a cause of shunt malfunction.Conclusion: It was observed that the kind of shunt, technique of operation sterility and atraumatic instruments have major role in shunt complications.

Background and Objectives: Asbestos is a group of inorganic minerals in the form of long and short strong fibers that are used in chemical and insulation industries. In this survey respiratory capacity and prevalence of respiratory tract diseases were assessed among the workers of Tehran Iranit factory and were in contact with asbestos. The working condition and physiologic activity of respiratory tract were evaluated, and proper solution was presented to problems.Material and Method: This survey was carried out according to cross sectional methodology and thus, 350 workers were selected randomly from 850 labors engaged in the routine activity of factory. After filling the questionnaire their respiratory capacity were determind with the help of spirometer and then the volunteers were classified according to age, record of services, mode of contact and smoking habit.Results: The results showed that the prevalence of abnormality with respect to asbestos contact was not significant and the reason behind this statement is the frequent displacement of labor. 34% of the workers selected were suffering from obstructive (51%), restrictive (21%) and obstructive restrictive (28%) types of pulmonary diseases and 75% of them were smokers, while 25% were not.Conclusion: As the prevalence of pulmonary ailment in smokers was significantly more than non smokers, consequently recruiting the smoker labors should be prohibited and if taken they should be encouraged to quit smoking. Periodical physical examination, once every year at least and replacement of asbestos with chrocydolate or more safer kind are recommended.

Background and Objectives: Mepartricin is a semi-synthetic anti-fungal and anti-parasitic drug which is produced by culture of Streptomyces aureofaciens. The use of mepartricin on patients with benign prostatic hyperplasia (BPH) has been experienced with good therapeutic results and less side effects. The aim of this study was to evaluate the effects of this drug on the patients with benign prostatic hyperplasia and to observe for any side effects.Materials and Methods: 45 patients with BPH were selected and mepartricin was administered three times daily for 30 days. At the end of treatment and after 3, 6, 12 and 18 months, effects of the drug on these patients were evaluated.Results: There was a marked decrease in the volume of urine residue and increase in urine flow during and 3 months after treatment, but no change was noticed in the later months. No effect was observed on routine biochemical laboratory tests except for cholesterol and triglyceride which were declined in 8 patients. Side effects were seen in 7 patients which consisted of dyspepsia in 3, nausea in 1, constipation in 1 and decrease in libido in 2 cases.Conclusion: The use of mepartricin caused a marked decrease in urine volume and an increase in urine flow without any negative effect on hematological and biochemical tests.

Background and Objectives: Diabetes mellitus (DM) is a common chronic disease with serious complications. Half of the patients with diabetes are discovered to have DM on routine laboratory examination. The aim of our study was to evaluate certain risk factors associated with screening of the disease.Materials and Methods: This was a cross - sectional study performed in two areas of the village of Najafabad in Esfahan. The total patients studied were 12,228 with 2,333 persons being above 40 years. These patients were initially evaluated for the presence of 9 risk factors associated with DM and if any of these were found to have one or more of these risk factors, their blood sugar was then checked.Results: Among the total patients screened for risk factors of DM, 48 fresh cases were detected to have diabetes mellitus. The prevalence of DM in the cases above 40 years of age was 8.9%, which correlated well with available statistics. Evaluation of patients above 40 years for risk factors associated with the development of DM reduces expenses because instead of doing 2,333 blood sugar tests, only 800 actually were requiring the test to be done.Conclusion: Diabetes mellitus, a disease with serious complications can be detected by screening risk factors associated with it, with minimal expense especially in persons above 40 years age. DM is more prevalent in this age group and thus, it is recommended that this population should be screened by the risk factors presented here, followed by blood sugar test.

Background and Objectives: Spontaneous intracerebral hemorrhage (ICH) is defined as bleeding into brain parenchyma without accompanying trauma. In regard to high incidence of ICH (15 cases in 100,000 population), lower age (56 years), high mortality (44%), more controversies exist in treatment and effective factors in its outcome. Thus, ICH requires to be studied for evaluation of mortality rate and effective factors associated with the condition.Materials and Methods: In the present study, problems associated with ICH were studied in 80 patients divided in two groups: dead (38) and survived (42). Results: Fifty five percent of patients were males and 45% females, mean age was 58 years, most common signs and symptoms were: decreased level of consciousness and hemiplegia (58%), commonest risk factor was hypertension (80%) and the most common site of hemorrhage was basal ganglia (58%). Twenty nine percent patients were managed medically and 71% required to be operated. Conclusion: There was no significant relation between mortality and sex, age of patients and site of hematoma, overall mortality was 47.5%, 26% in medically managed group and 56% in operated patients. Initial Glasgow Coma Scale (GCS) of patients had reverse effect on mortality but direct effect on Glasgow Outcome Scale (GOS). There was no clear preponderance in relation to special blood groups. Results of craniotomy in ICH and craniectomy with ventriculostomy in intracerebellar hemorrhage were better than other operative procedures, however not statistically significant.

Materials and Methods: 24 male athletes underwent this study. They were divided into three groups. The first group received only one glass of tap water, second group received glucose as high glycemic sugar (1.5 g/kg BWT) and the third group received lentils as low glycemic suger index (2.6 g/kg BWT) half an hour and , 1 hour before the exercise, respectively. Blood samples were taken 15 minutes before exercise. All athletes performed increasing exercise work load on ergometer 57-71% Veo2 max up to 300 watts. After every three minutes pause, 25 watts was increased, and blood samples were again taken. ANOVA method was used for data analysis.Results: The results showed fatigue occurance in 19.3±1.98 min, 22.03±6.68 min and 20.5±4.2 min in first, second and third group, respectively. Vco2 and RQ (Respiratory Quotient) changes were statistically significant (p<0.05) for all groups during exercise, but blood glucose, oxygen uptake, Vo2 max, O2-Puls, Eqo2, Eqco2, Vo2-kg, ventilation and heart rate changes were not statistically significant in all the groups. With increasing exercise intensity, RQ arose. Statistically RQ changes were not significant between first and third group, however, these changes were significant between first and second group as well as between second and third group as (p<0.05). Vco2 depletion was significant for three groups during exercise (p<0.05). Rate of Vco2 depletion was significant between first and second group (p<0.05), but Vco2 depletion was not significant between first and third group and, second and third group. Conclusion: Intake of carbohydrate rich food with low or high glycemic index does have an impact on Vco2 and RQ changes, however, blood glucose, oxygen uptake and heart rate changes are not much affected. To increase athletic performance in short time exercise, glucose intake should be more before exercise and to increase athletic performance in prolonged exercise, intake of low glycemic index carbohydrate should be increased before exercise.

Background and Objectives: The present experiment examined the role of the glucocorticoids in basolateral nucleus of amygdala (BLA) on retention of passive avoidance learning.Materials and Methods: Male Wistar rats were implanted bilaterally with cannulae aimed at BLA and were trained in one trial step-through passive avoidance task (1 mA footshock, 1.5 s). Glucocorticoids receptor agonist (Dexamethasone) (0.1 ug/0.6 ul per side) was injected bilaterally into BLA immediately and 60, 90 or 120 min after training. Retention test was done two days later.Results: Results indicated that infusion of glucocorticoids receptor agonist immediately and after 60 min but not after 90 or 120 min after training into BLA significantly enhanced retention performance.Conclusion: The results shows that glucocorticoids play an important role on consolidation of emotional memory in BLA at least 60 min after training.

Mature cystic teratoma (dermoid cyst ) of ovary is the commonest tumor in the fertile periods. More than 50% patients remain asymptomatic and are incidentally noticed in laparotomy (appendectomy, cesarean section) or sonographic evaluation of pelvis. In symptomatic patient frequently cysts are observed with complications. In this study, a 24 years old female was referred with abdominal discomfort and bilateral discharge of yellow material from lower abdominal wall. She was earlier treated as a case of peritoneal tuberculosis with tuberculosis drugs for two years. Finally, the patient was operated and in laparotomy two cystic tumors of ovaries, containing sebaceous material and clusters of hair were found. This was a rare case of complicated dermoid cyst and is one of the unique cases being reported.