Medical Journal of Tabriz University of Medical Sciences
Year:2018 | Volume:39 | Issue:6 |Papers Count:15

Background: Since the introduction of 4 trocar laparoscope as a golden standard practiced worldwide, there has been an attempt to possibly reduce the number of trocars to achieve better results. Nowadays the alternative 3 or even 2-port LCs have gained attention due to their potential impact on decreasing post-operative pain, leaving less scars behind and maintaining cosmetic superiority. This study aimed at investigating the superiority of 3 port LCs vs the conventional 4 port ones in terms of their technical feasibility, safety and other benefits. Methods: In this clinical trial study, 100 patients with gall bladder stones admitted at Sina Hospital, in Tabriz from Sep. 2013 to Sep. 2014 were randomly divided into two groups of 50 each; one was treated using 4 port technique and the other by means of 3 port technique. Intraoperative findings and postoperative complications were carefully recorded and analyzed. Results: The two parameters-conversion of surgery and bile duct injury-were nil for both groups. Gall bladder perforation in 3-port group happened to be less than 4-port group (17. 50 vs 28. 50) that is (P=0. 027). No significant difference was reported on other factors including liver bed bleeding or length of operation. Conclusion: The fact that in port 3 LCs the operating time will not take any longer and complications are no more than those in 4-port LCs proves them technically safe and feasible. additionally 3-port LCs have some postoperative advantages such as less scars and maintained cosmetic superiority.

Background: Methicillin Resistant Staphylococcus aureus (MRSA) strains are one of the main bacteria responsible for development of nosocomial infections. Therefore, the detection and identification of these strains can be very effective in the treatment. The aim of this study was to determine the pattern of antibiotic MRSA strains isolated from clinical samples in Ali ibn Abi Talib hospital in 2014. Methods: In this cross-sectional study, 119 isolates of methicillin-resistant Staphylococcus aurous were isolated from 460 samples; antibiotic resistance pattern was studied by disk diffusion method. The MRSA strains were first approved by Cefoxitin disk. Results: The highest and lowest resistances were found in penicillin and vancomycin, respectively. Distribution of resistance in MRSA strains in children was allocated to the highest percentages. Conclusion: According to the increasing prevalence of antibiotic resistance, especially for resistant strains to several antibiotics, rapid detection, on time and accurate resistant strains by using international standards, in order to make appropriate treatment options and preventing the spread of resistance between strains is necessary.

Background: Diabetes is one of the main causes of neuropathy. Metabolic control is essential to hinder its process. The present study was designed to investigate the effect of aerobics training on metabolic control in type-2 diabetic men with peripheral neuropathy. Methods: Twenty-four male subjects with Type 2 Diabetes were randomly assigned into two groups (each group comprised of 12 subjects): 1-Aerobics training (43± 6. 4 yrs, 86. 5± 15. 3 kg) 2-control (42± 4. 6 yrs, 89. 3± 11. 9 kg). Aerobics training consisted of 20 to 45 minutes walking and running with 50 to 75 percent of heart rate reserve, three sessions per week for 3 months. Before and 48h after last training session, body composition measurements were performed and then fasting and after-meal blood samples were taken. Results: We observed no significant changes in weight, fat percentage and body mass index following intervention (P>0. 05). Furthermore, fasting and OGTT glucose and HbA1C levels significantly decreased and lipid profile improved significantly (P<0. 05). We also observed significant inter-group difference only for HbA1C and HDL-C (P<0. 05). Conclusion: Based on the findings of the present study, it could be concluded that aerobic exercise regimen could be a safe non-pharmacological strategy to achieve an optimal metabolic control in type-2 patients with peripheral neuropathy.

Background: People with the knee osteoarthritis (OA) might change their kinematic and kinetic patterns as a compensatory mechanism possibly to decrease pain during movement. These alterations in movement pattern might contribute towards weakness of the involved muscle groups such as the quadriceps muscle group. The aim of this study was to evaluate the surface electromyography (SEMG) of the quadriceps of people with the knee OA during ascending and descending in stairs with different heights. Methods: Fourteen female patients with the knee OA aged between of 50 to 75 years, participated in this study. Electromyography of three muscles including rectus femoris, vastus medialis and vastus lateralis were collected using a 16-channel ME6000 EMG system when participants ascended and descended a set of stairs with heights of 15, 19, 23 cm. The recorded signals were band pass filtered, their root mean square (RMS) was calculated, and was compared between different conditions. Results: The activity of muscle during ascending the stairs was higher than descending (p <0. 05). Reduced activity was observed in the swing step (the second step) than the stance step (the first step) (p <0. 05). Conclusion: The results of the study revealed the differences of thre muscles of quadriceps act during stair ascending and descending in stairs with different heights.

Background: Apoptosis in skeletal muscle plays an important role in tissue dysfunction disease such as muscle atrophy. Current evidence suggests that exercise trainings may alter apoptosis-related signaling in skeletal muscle. Therefore, the present study was investigated the effect of 12 weeks of aerobic training on some indices of skeletal muscle apoptosis in rats. Methods: This study was conducted as a two-group experimental design on 20 randomly selected three month old male rats. Then divided them into two groups of training group (n=10) and control group (n=10). Rats in training group participated in 12 weeks of aerobic training program. 48 hours after the last training session, the soleus muscle of rats in both group were isolated and Bax, Bcl2 and caspase-3 genes expression evaluated by Real Time-PCR. Results: The results indicated that there is a significant difference in gene expression of Bcl-2 (P< 0. 01) and Bax to Bcl-2 ratio (P< 0. 05) between control and training group. Furthermore, there was no significant difference between the two groups in expression of Bax and caspase-3 (P> 0. 05). Conclusion: The 12 weeks of aerobic training was effective in increasing skeletal muscle mitochondrial anti-apoptotic protein. However, considering the alterations of caspase-3 expression, more researches are needed to identify the effects of exercise training on skeletal muscle apoptosis.

Background: Toxoplasma gondii is intracellular parasites that cause many symptoms such as encephalitis and congenital disorders. Marrubium vulgare, Salvia officinalis and lippia citriodora are herbal drugs that used to kill this organism. Our objective were to evaluate the therapeutic effect of Marrubium vulgare, Salvia officinalis and lippia citriodora in killing of toxoplasma gondii tachyzoite and evaluation by MTT assay Methods: In this survey we used Marrubium vulgare, Salvia officinalis and lippia citriodora suspension plus RPMI medium containing peritoneal tachyzoite after incubation at 37 C0. The measurement done by MTT assay and statistial assesment done by spss19 software. Our investigation based on two mediam (invitro and invivo) to approve our results. Results: In RPMI medium the killing with three herbal drugs were seen and the decrease of Absorbance were seen by MTT assay. The means of OD were 0. 05 to 0. 16 in presence of herbal drugs but the means of OD were 0. 9 to 2. 3 in absence of herbal drugs. Conclusion: Marrubium vulgare, Salvia officinalis and lippia citriodora are herbal drugs that are very useful to kill toxoplasma tachyzoite in invitro condition.

Background: Purified mouse IgG2a (a product that could be used in medical research) subclass could be used for animal immunization to production of polyclonal Antibody and to obtain hybridomas in Monoclonal Antibody Production Procedures. The goal of this study was to purify the mouse IgG2a. Methods: In one step, Ion exchange chromatography was carried out for purification of mouse IgG and then in second step, ProA affinity chromatography was used for IgG2a purification. The chosen method for determination of purity was reduced and non-reduced SDS-PAGE. ELISA method was used for titer and isotype determination. Results: Mouse Igs with a protein concentration of 27mg/ml (volume: 3CC) was applied on Ion exchange column. Purification by Ion exchange chromatography yielded about 28mg of mouse IgG. Eight mg mouse IgG2a was obtained by ProA affinity chromatography. In reduced SDS-PAGE analysis of purified antibody, two bands were seen in 25& 50 KDa MW positions. Isotype determination of purified mouse IgG2a with mouse isotyping Kit showed the presence of mouse IgG2a isotype with a kappa light chain in related fraction. Conclusion: Purified mouse IgG2a subclass was obtained with purity more than 95%. Due to the obtained high purity we concluded that Ion exchange chromatography following by ProA affinity chromatography could be a suitable method for purification of mouse IgG subclasses with high quality. Our product is an economical and suitable product that takes a step towards self-sufficiency of the country.

Background: Pterygium causes visual disturbance due to ocular surface irregularity. The convenient method to investigate this irregularity is measurement of ocular aberration. The aim of this study to investigate the impact of pterygium excision with conjunctival autograft together with corneal polishing on ocular higher-order aberrations (HOAs). Methods: This study was performed on 34 patients with primary nasal pterygium who had an indication for surgical excision in November 2013. All patients underwent a detailed ophthalmologic examination preoperatively and at the third postoperative months. Pterygium excision was performed by the same surgeon. Corneal topography and ocular higher-order aberration were measured by ITRACE. Results: Numerous parameters including mean value cylinder and spherical refractive error, visual acuity, root mean square values of total HOAs were found to be significantly improved at 3 month after pterygium surgery. There was significant difference between preoperative and postoperative mean refractive cylinder (-6. 77 ± 1. 08 diopter (D) vs. 2. 25 ± 0. 34 diopter (D), respectively, P < 0. 0001). Log Mar best corrected visual acuity (0. 11± 0. 03) was significantly higher than preoperative values (0. 04± 0. 02)(p<0. 001). Preoperative mean refractive sphere was 4. 92± 0. 79 diopter (D) which was significantly higher than postoperative refractive sphere 0. 66± 0. 41 diopter (D) (P< 0. 0001). All parameters (Total, Lo total, Defocus, Astigmatism, Coma, Trefoil: P<0. 001 and Ho total: P=0. 001 and secondary: P=0. 04) except for total spherical aberration (P = 0. 38) were found to be lower when compared with the preoperative values. . None of the patient harbor against the rule astigmatism preoperatively and a significant scope of with the rule cases changed to oblique astigmatism at 3 month which statistically significant (P<0. 001). Conclusion: Pterygium excision can significantly improve visual acuity and most of the pterygium-induced HOAs.

Background: Being the first-line treatment of patients, emergency units have an especial importance. The mortality of patients in the emergency department is a problem that has been exacerbated in recent years. Further studies on the causes of death are required in the emergency for correct judgment. This study is conducted in order to better understand the causes of death, in patients referred to emergency unit of Tabriz Imam Reza hospital in 2014 – 2015. Methods: This cross-sectional study was carried out on the profiles of all patients admitted to the emergency department of Tabriz Imam Reza hospital. Demographic data and causes of death were extracted. Results: Of the 604 patients who died in the emergency department, 60. 6% were men, 54. 6% derrram and 31. 5% had over 75 years. The most common causes of death were internal illnesses (22. 2%) and trauma (19%). In total, 39. 1% patients were died before in the emergency department and 32. 1% of patients were referred from anther hospitals. Conclusion: It seems that internal illnesses and trauma are the most common causes of death in the emergency department. The high rate of mortality shows the importance of early aids and proper referral system.

Background: Carbon tetrachloride is one of the chemical toxins, disturbing hematopoietic texture and changing the blood parameters. In this study the protective effect of Mangrove, s leaf extract on hematopoietic texture of rats induced by carbon tetrachloride is investigated. Methods: 42 male rats were divided randomly into 6 groups (n=7): group induced by CCl4 (carbon tetrachloride 1: 1 with olive oil, 0. 5ml single dose, i, p), sham(taking olive oil, 0. 5ml/day, i, p single dose), treated groups: (1, 2 and3 by carbon tetrachloride 1: 1 with olive oil, 0. 5ml single dose and 200mg/Kg, 400mg/Kg and 800mg/kg AME /day for 96 hrs, i, p) and control (taking normal saline, 0. 5ml/day, i, p). After the examination the blood samples were collected from heart directly and blood parameters such as RBC, WBC, Pl, MCV, MCH, MCHC, Hb, Hct, Albumin, bilirubin and total protein separation of serum were analyzed. Results: The necrotic hematopoietic texture, WBC, Platelets, serum Albumin and total protein of the treatment groups showed a significant increase rather than group induced by ccl4 (P<0. 001). Conclusion: The Avicennia marinahydroethanolic extract has antioxidant and flavonoids compounds which probably have protective effects on hematopoietic texture from toxic agents such as CCl4.

Background: Previous studies have shown the association of genetic factors such as PAI-1 4G/5G polymorphism with susceptibility to breast cancer patients. The aim of this study was to investigate the effect of this polymorphism in breast cancer patients from North West of Iran. Methods: 160 breast cancer patients and 160 healthy individuals were selected. Peripheral blood-DNA samples were taken and used for PCR amplification using the allele specific primers. Results: Based on molecular studies, all patients and control group were divided into three genotypes 4G/4G, 4G/5G and 5G/5G. Genotype distribution between patients (11. 25%, 71. 25% and 17. 50%, respectively) and controls (10. 62%, 71. 87% and 17. 50%, respectively). Additionally, the frequencies of the 4G and 5G alleles between patients (46. 87% and 53. 12%, respectively) and control group (46. 56% and 53. 43%, respectively). Conclusion: The genotypic and allelic frequencies of PAI-1 4G/5G polymorphism showed no significant difference between breast cancer patients and control individuals in this cohort.

Breast Crawl is initiating breastfeeding and evidence based method. Followed by numerous studies on breast-feeding, and mother and child heath, BC was discussed for which a protocol was presented. There are few studies on BC method. For the first time in Iran, we performed this method in Alzahra hospital of Tabriz where we came across an interesting case. The report is about a term infant who was put on the mother's abdomen to find the mother’ s breast. The infant was stuck to the mother’ s skin due to abundant Vernix and could not move despite her attempts. This lengthens the expected time for BC method, but in the end, the infant managed to reach the mother’ s breast and started sucking on her breast without any help. There are various causes that might prolong BC implementation time or even prevent you from doing it. This case mentions to a problem that never listed in breast crawl guideline and may be selected as a hindering factor for breast crawl in future.