MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2013 | Volume:35 | Issue:3|Papers Count:19

Backgrounds and Objectives: Gastroschisis is a congenital defect in anterior abdominal wall on right side of umbilicus and abdominal viscera protrude from this defect. Reduction under general anesthesia is the routine method of treatment. Recently, to avoid complications of general anesthesia and intubation, reduction without anesthesia has been recommended.Materials and Methods: This study was conducted in Tabriz, Shahid Beheshti, Mashhad, Shiraz and Ghazvin medical universities between 2010 to 2012 all neonates with Gastroschisis were included and their parents were signed consent. Exclusion criteria were peritonitis, major anomalies and intestinal atresia. Then Gastroschisis was treated with or without general anesthesia.Results: Eighteen infants with Gastroschisis were enrolled the study. 8 cases treated without general anesthesia and 10 cases were reduced under general anesthesia. Infants in the second group had an increased duration of hospitalization, need for mechanical and prolonge, duration of TPN, need for subsequent surgical procedure and prolonge duration of stay in NICU, although it is not significant.Conclusion: Result of this study demonstrate whose patients was reduced without general anesthesia inward, have better outcomes to those whose bowel was reduced under general anesthesia and it seem inward reduction is a safe and effective method for treatment in this anomaly.

Backgrounds and Objectives: Neck and shoulder pain are common complaint in the general population and medical staff. In this study we tried to identify neck and shoulder pain risk factors in a group of medical students.Materials and Methods: In a descriptive-analytic study, 260 medical students who at least six months ago were entered the university were allocated they filled the modified form of Oswestry questionnaire that is related to head and neck pain and they are also aimed to identify the duration of computer use and weight of their bags.Results: 247 students were studied. 60.7% were female and 39.3% were male. Over all neck pain prevalence was 39.4 had neck pain and it caused mild disability. Risk factors for neck pain among students were their higher age, high BMI, carrying heavy bags and objects in daily routine, daily sleep hour’s and computer use were also important.Conclusion: Neck and shoulder pain have high prevalence in the medical students and all their risk factors are modifiable risk except age and we could eliminate neck and shoulder discomfort with changing life style change. but risk factors corresponding for neck pain in this study were all factors

Backgrounds and Objectives: Testosterone Enanthate Analog (Testosterone Enanthate: TE) is used by athletes to increase muscle size and strength and also in patients with low plasma testosterone levels. Studies show that high levels of testosterone may affect the plasma lipid profiles. The purpose of this study was to evaluate the effect of supraphysiological dose of TE injection on plasma levels of total cholesterol, triglycerides, very low density lipoprotein (VLDL), low density lipoprotein (LDL) and high density lipoprotein (HDL) of adult male rats.Materials and Methods: In this study, 35 Wistar rats were randomly divided into 5 groups, each group consisted of seven rats: In Group I- Gonadectomized rat group received 5 mg/100 g body weight of TE; Group IINot gonadectomized rat received 5 mg/100 g body weight of TE; Group III- gonadectomized rat received 0.5 ml olive oil; Group IV - Not gonadectomized rat received 0.5 ml olive oil; and Group V- Control group (intact rats not receiving any supplement). 60 days after receiving supplements, plasma levels of cholesterol, triglyceride, HDL and LDL were measured.Results: No significant difference in plasma cholesterol concentrations was found between different groups. Plasma triglyceride levels were significantly different in groups I (P<0.001) and II (P<0.05) and plasma VLDL levels in group I (P<0.001) and II (P<0.01) compare to it’s control group. No significant differences were found between groups I and II in the plasma LDL lipoprotein levels compare to the control group, but HDL levels decreased in group II compared to the control group (P<0.05).Conclusion: TE consumption increased plasma levels of triglycerides and VLDL and decreased HDL levels; hence, the risk of cardiovascular disorders is higher in the people who receiving TE compare to others.

Backgrounds and Objectives: With the ever-increasing domain of medical technology and production of new tools in the last 30 years, the operational field of laparoscopy has expanded to the extent that few abdominal surgeries are not performed through this technique. Evidently, new laparoscopic techniques are in the way of reducing harm to patients, post-operative pain and improvement of many other parameters. Materials and Methods: 60 candidates of laparoscopic cholecystectomy, who met inclusion criteria, were evaluated in a clinical trial in two groups (case group: using single port; control group: using quadraport). The outcome of the two operational techniques was compared through comparison of post-operative pain severity, hospital stay and many other factors.Results: From all the patients, 58 (96.7%) were female and only 2 (3.3%) were male. The mean age of the patients was 47.2±11.9 in the age range of 29 to 70 years. The evaluation of the results of the multiple measurements plan showed that pain severity was significantly reduced in both groups (P<0.001) with no significant difference between the two groups (P=0.12). The mean duration of hospital stay in group A was 2.90±0.5 and 2.6±0.6 in group B which was also significantly different (P=0.03).Conclusion: Considering the longer hospital stay, duration of operation and post-operative analgesic use in single port laparoscopic cholecystectomy, it seems that this technique has no priority upon the standard quadroport technique.

Backgrounds and Objectives: Rehabilitation and physiotherapy have a major role in reducing the pain and increasing the functional ability in knee joint osteoarthritis. The aim of this study was to evaluate the effect of the Action Potential Simulation (APS) and Transcutaneous Electrical Nerve Stimulation (TENS) in patients with knee joint osteoarthritis.Materials and Methods: In a Randomized Clinical Trial, 70 patients with mild or moderate knee joint osteoarthritis were enrolled in the study first group (35 patients in each group). Received APS and for the secondgroup TENS and therapeutic exercise for 10 sessions were applied. The primary outcome of the study was upon the VAS and WOMAC scoring system and was evaluated before and after the intervention.Results: Five patients (7.1%) were male and 65 patients (92.9%) were female, the mean age of the patients was 57.1±7.7 years. The mean VAS and WOMAC scores improvement after treatment statistically were significant in both groups (P<0.001).Conclusion: In regard to findings of this study it seems that using APS and TENS combined with therapeutic exercise are effective in pain reduction and function improvement of the affected knee but there is no difference for choosing between them in treatment approaches.

Backgrounds and Objectives: Approach of supplementation usage and its effect on fatigue retarding had been attention of athletes and coaches. The aim of this study was to comparison the acute and chronic loading of sodium bicarbonate supplement on fatigue and performance indices after exhaustive aerobic activity in active men.Materials and Methods: 10 active men were selected and assign to experimental group. The participants had taken sodium bicarbonate supplement in two forms of acute and chronic loading. For determine the amount of lactate production and blood PH, blood samples were taken in four stages including’s before exercise and after either supplementation method usage and also immediately after exercise test. Modified BRUCE moderate-intensity test were done up to 75% of maximum heart rate as exercise test.Results: The result showed that bicarbonate supplement in form of chronic loading inhibits blood lactate accumulation significantly. Compared with acute model, chronic loading of sodium bicarbonate increased the duration of activity and blood PH up to 26 percent (P<0.05).Conclusion: It seems that chronic loading of sodium bicarbonate by improving the buffering capacity increase the amount of blood PH and retarding the fatigue period and induces the much time of activity.

Backgrounds and Objectives: Mutations in endothelial nitric oxide synthase (eNOs) gene can reduced NO production. It is an endothelial relaxing factor and its decrease accelerates the process of atherosclerosis. This study was designed to measure serum level of NO and the frequency of T-786C polymorphism in a group of patients with Coronary Artery Disease (CAD) in comparision with control.Materials and Methods: Sixty patients with angiographically diagnosed CAD and 60 age and sex matched CAD-free subjects were studied as control. Nitric oxide was measured by Griess Method. The genotype studies were carried out using allel specific PCR.Results: Serum levels of NO in patient groups were significantly lower than the controls (P<0.05). Significantly higher frequency of eNOs -786C genotype was found in CAD patients than controls (P<0.05), the differences reflected an increase in CC genotype at position -786 of No synthesis gene. Mean blood pressure was significantly higher in patient compared with controls (P<0.05).Conclusion: The low levels of NO and high blood pressure in patient group may be related to high frequency of T-786C polymorphism in patient group and conversely T-786C polymorphism may be a risk factor for coronary artery disease.

Backgrounds and Objectives: Gastroesophageal reflux disease is one of the most prevalent gastrointestinal disorders and the relationship between GERD and H. pylori is complex and effect of H. pylori eradication on GERD is controversies. The aim of study is to evaluate the effect of H. pylori eradication on GERD symptoms. Materials and Methods: In an interventional, before-after study, of 200 patients with chronic dyspepsia and positive H. pylori infection confirmed by rapid urea test or histology and underwent a 2 weeks period of quadruple anti-Helicobacter therapy and a subsequent 6 weeks of pure anti-acid therapy. Eradication's success was assessed based on urea breath test result at least 2 weeks after anti-acid cease, and the second validated symptom questionnaire then was filled out which contained the same questions as the first one. A validated symptom questionnaire about probable symptoms of GERD also filled.Results: GERD's symptoms (Regurgitation, Heart burn) were increased in the eradication group. (heart burn: 16% to 32% p=0.03), (regurgitation 13.6% to 15% p=0.04). Retrosternal pain was meaningfully decreased (36% to 29% p=0.04). Wheeze (1.4% to 0.5% p=0.03) and hoarseness (1.5% to 0.6 %p=0.03) had meaningful decrease.Conclusion: H. pylori eradication has variable effect on GERD's symptoms are infected individuals.

Backgrounds and Objectives: Localized sclerodermia is an inflammatory cutaneous disease with certain clinical presentations that primarily affects derma and subcutaneous adipose tissue and causes scar like sclerosis. Many different treatments have been recommended till now which most of them was upon case studies or with no control or limited number of patients.Materials and Methods: In a double blind randomized clinical trial, we studied 30 patients with localized sclerodermia who achieved inclusion criterias in the form of two groups (group A under treatment with methotrexate and group B under treatment with hydroxychlroquine, 15 patients in each group) stiffness of the skin and pruritus Was evaluated in the week 4, 8 and 12 examinations and all the data from patients was analyzed with appropriate analytical tests.Results: In our study, 9 (36%) of patients was male and 16 (64%) was female. The mean age of the patients was 36.8±13.5 yrs. Patients were at the age range of 13 yrs to 74 yrs. Mean MSS score for patients in methotrexate groiup before the intervention was 12.3±3.7 that decreased to 7.2±2.8. this number in the hydroxichlroquin group decreased from 10.7±4.1 to 7.7±3.4 and there was a significant difference between two groups analytically. The VAS regarding to stiffness of skin and cutaneous involvement before and after the treatment was significantly different (P=0.0001).Conclusion: With regard to minimal increase in liver enzymes in patients under treatment with methotrexate it can be resulted that both methotrexate and hydroxychlroquin is effective in reducing pruritus, skin hardness in patients with localizes sclerodermia and none of them is not preffered too each other.

Backgrounds and Objectives: Metabolic syndrome is a collection of risk factors which finally increase the risk of ischemic heart disease and type 2 diabetes mellitus in affected individuals. Our aim was to assess whether the presence of ischemic heart disease in parents increase make people the risk of metabolic syndrome in offspring’s or not?Materials and Methods: 137 persons aged 18 to 40 with a positive history of ischemic heart disease in their fathers, mothers or both were selected as the case group. Another group of 132 persons without a history of ischemic heart disease in their parents were selected as the control group. Metabolic syndrome was diagnosed based on ATP III (Adult Treatment Panel III) criteria considering high blood pressure, central obesity, impaired fasting glucose, high triglyceride level and low HDL-C levels.Results: The prevalence of metabolic syndrome in offspring of subjects with and without ischemic heart disease did not show any significant difference (14.0% vs. 11.5%; p>0.05). Comparison of the prevalence of metabolic syndrome in male and female subjects also did not show any significant difference (16.7% vs. 15.2%; p>0.05 for females and 11.4% vs. 2.6%; p>0.05 for males).Conclusion: The present study does not reveal any identifiable difference in the prevalence of metabolic syndrome in offspring of persons with and without the history of ischemic heart diseases; however, this does not diminish the importance of metabolic syndrome in offspring of patients with ischemic heart disease.

Backgrounds and Objectives: Given the importance of family in shaping the characters, current study was conducted to examine the role of gender, differentiation and attachment styles inon predicting the incidence of Alexeithmia.Materials and Methods: This descriptive correlative study was conducted. For to predicting alexithymia, and obtaining a predicting equation. The discriminant analysis method was used based on spss19 software. In this study, 325 students from Kermanshah Razi University were selected using stratified random sampling method. Data collection instruments was (DSI-R) questionnaire and adult attachment styles questionnaire, and for alexithymia we used FTAS-20 Questionnaire.Results: The results showed that secure attachment and avoidant attachment style and differentiation total score are able to predict the alexithymia. Therefore, if a person have the highest differentiation and secure attachment style and has the least avoidant attachment style, they are less likely subject to alexithymia characteristics. But the results showed that gender cannot predict the alexithymia.Conclusion: The results are with the family's role in the occurrence of alexithymia.

Backgrounds and Objectives: Atrial fibrillation (AF) is one of the most common cardiac arrhythmias which apart from macro embolic complications may result in cerebral ischemic areas caused by micro emboli and end up in progressive cognitive impairments. The object of the research is a comprational study of cognitive impairment inpatient with atrial fibrillation and healthy subjects based on MMSE Test.Materials and Methods: research method was descriptive-comparative method and 60 subjects (30 AF cases and 30 healthy subjects) who referred to Tabriz Cardiology Clinic were evaluated in a discretional-analytical study with Mini Mental State Examination (MMSE) questioner. Results: Results showed a significant differences between patients and healthy groups in Time Orientation, Place Orientation, registration, attention and Concentration, recall, Repetition, Writing and Copying subscales but there was no significant different between groups in Naming, 3-Stage Command and Reading.Conclusion: According to present results, it seems that atrial fibrillation predispose to patients cognitive impairment.

Backgrounds and Objectives: Recognizing the complications of rhinoplasty is important for both surgeon and patient. The aim of the present study was to evaluate the prevalence of complications after rhinoplastic surgery.Materials and Methods: In this study that was done between 2003-2005 patients who were admitted for rhinoplasty were observed for their hemodynamic changes, respiratory problems and other complications of rhinoplasty during a 24 -month period(2003-2005). Methods of anesthesia were similar in all patients. Data were collected using a check list and analyzed by SPSS.15 softwareResults: Two hundred and two patients, [78 (38.6%) males and 124 (61.4%) females] were enrolled in the study. There was no detectable complication in 131 patients. Different complications were seen in 68 patients. Twenty-one (10.4%) of patients experienced tachycardia and 7 (3.46%) of patients had arrhythmia during their surgery and hospitalsty.Conclusion: According to the results of this study, there are some complications such as tachycardia and arrhythmia, during postoperative period of rhinoplastic surgery.

Backgrounds and Objectives: There are debates about the reliability of fever detection via tympanic membrane by infrared detected. Some insisting on that this method is a way for core temperature measurement Similar to rectal measurement.Materials and Methods: in a cross sectional study 50 children (3-36 months) were evaluated for temperature measurement by both Infrared tympanic method and traditional rectal core temperature measurement were recorded and analyzed by statistical methods.Results: 50 children aged between 3 to 36 months entered to study, their mean age ±SD were 28±10 months. Their rectal mean ±SD temperature were 37.87±0.4 these measures for tympanic infrared technique were 36.49±0.5oC this difference was 1.38oC that was significant (p less than 0.0001).Conclusion: Tympanic measurement methods is simple and feasible but there is a significant difference between it and rectal temperature measurement, and addition it has a low sensitivity to detect fever in children below 36 months and it is not a convenient method for fever expression in children.

Gasterointestinal Stromal Tumor (GIST) is a mesenchimal tumor. Mostly originate from stomach however small intestine, esophagus, colon, and rectum are another sits of tumor growth. Rarely it originate in extra intestinal sites such as the omentum, mesenteries, or retro peritoneum. They are often asymptomatic and are detected as an incidental finding or after evaluation of nonspecific symptoms .However this tumor can present as a palpable abdominal mass, with abdominal pain and or gastrointestinal bleeding. In this manuscript we represent a patient with GIST of the stomach mesentery.