MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES
Year:2019 | Volume:61 | Issue:6 |Papers Count:10

Introduction: Acute coronary syndrome (ACS) is an important cause of death. It is important to identify factors predicting mortality of these patients. The aim of this systematic review was to evaluate the prognostic role of platelet-to-lymphocyte ratio (PLR) in patients with ACS. Materials and Methods: PubMed, Embase and Web of Knowledge databases were searched for relevant studies in, December 29th 2018. Studies investigating the association of PLR with mortality of ACS patients were included in the systematic review. Data extraction and quality assessment are performed independently by two authors. Meta-analysis of hazard ratios and the results of diagnostic statistical methods was performed. Results: A total of Thirteen studies with 17111 participants were included in the systematic review. Significant association between PLR and mortality rate was observed in all but one study. The pooled hazard ratios of short-term and long-term mortality in high PLR group compared to low PLR group were 2. 187 (CI95%: 1. 56-3. 06) and 2. 40 (CI95%: 1. 69-3. 42), respectively. Moreover, PLR showed a moderate prognostic accuracy for short-term and long-term mortality with area under the SROC curves of 0. 710 and 0. 668, respectively. Conclusion: PLR is significantly associated with mortality in ACS patients and can be used alone or in combination with other prognostic markers and scoring systems to stratify the risk of these patients.

Introduction: Atherosclerosis is one of the most common causes of mortality in developed and developing countries, and chronic inflammation is an important risk factor for atherosclerosis. The study was aimed to investigate the effect of human lymphotropic virus type 1 (HTLV-1) infection on the progression of atherosclerosis in the HTLV-1 endemic area. Materials and Methods: Of 50 patients in 4 groups including 14 coronary artery disease+HTLV-1+ patients, 8 CAD-HTLV-1+, 17 CAD+HTLV-1-subjects and 11 healthy controls (CAD-HTLV-1-), blood specimens were obtained. Then, Tax gene expression was evaluated via real-time PCR, TaqMan method. Furthermore, lipid factors such as cholesterol, triglyceride, LDL and HDL were measured as common risk factors of coronary artery disease. Results: The HDL levels in CAD+HTLV-1+ group was significantly lower than the CAD-HTLV-1+ group (p=0. 04). Total cholesterol in CAD+HTLV-1+ group was higher than CAD+HTLV-1-and CAD-HTLV-1-groups (p=0. 001 and p=0. 001). Also, total cholesterol in CAD-HTLV-1+ group was higher than CAD+HTLV-1-and healthy groups (p=0. 001 and p=0. 002). The LDL level in CAD+HTLV-1+ group was significantly higher than CAD+HTLV-1-group (p=0. 001). Moreover, LDL level in CAD-HTLV-1+ group was higher than CAD+HTLV-1-group (p=0. 01). Conclusion: The HTLV-1 can alter the lipid profiles. Association between HDL, LDL, cholesterol and Tax showed that Tax as main virulence factor of virus by dysregulation of cytokines production, increasing of cholesterol, LDL and decreasing of HDL can facilitate the plaque formation in HTLV-1-infected patients.

Introduction: The amount of proteinuria is a predictor of renal outcome in kidney transplantation. In this study we investigated the relationship between the amount of proteinuria and interstitial fibrosis /renal atrophy (IFTA) in biopsy samples taken from kidney transplantation. Materials and Methods: In total 60 patients with proteinuria from November 2013 to May 2017 in Montaseriyeh hospital, transplant center of Mashhad, Iran were investigated. For all patients, Biopsy of kidney transplantation was performed. Then, the relationship between proteinuria and IFTA was evaluated. Results: Among 60 patients 25% had nephrotic range and 75% had sub-nephrotic range proteinuria. According to the severity of fibrosis we divided the patients into three categories: mild (IFTA<20 (, moderate (IFTA20-40) and severe (IFTA>40). The prevalence of IFTA was mild in 57. 8%, moderate in 32. 8% and severe in 9. 4%. According to the results of this study, there were relationships between amount of proteinuria and severity of fibrosis. Patients with nephrotic range proteinuria had more fibrosis (P<0. 005). Conclusion: Understanding the symptoms associated with fibrosis in transplanted kidney, may be useful in early diagnosis of development of fibrosis.

Introduction: Cardiovascular diseases are one of the most important causes of mortality in the world. Therefore, our goal in this study was to evaluate the average risk of cardiovascular disease in employees over 30 years of age in Shariati hospital in Mashhad in 1397. Materials and Methods: In this descriptive cross-sectional study, random sampling was used to select the samples. After obtaining written consent from the subjects, information was collected using a demographic questionnaire and anthropometric indicators. The software was designed for estimating the average risk level and SPSS V18 software was used to analyze the data. Results: Of 181 subjects in this study, 105 (58%) men and 76 (42%) women, the mean age was 1. 39 and the mean BMI was 25. 5. Triglyceride and age, cholesterol with weight, body mass index and age, cytological hypertension with height, body mass index and age, diastolic blood pressure with height, fasting blood glucose, body mass index and age were positively correlated. all subjects had a less than 10% for a risk of heart and brain disease. Conclusion: The results of this study showed that the mean of cardiovascular and cardiovascular disease risk was lower than 10% in subjects under study.

Introduction: The purpose of this study was to compare the white and gray matter of the brain, cognitive function and some physical fitness factors active and low active elderly women. Materials and Methods: This study was a causal-comparative study. The statistical population was the elderly of the members of the Jahanideh Shahr club. Among them, 25 elderly women aged 60-86 years were volunteered (average height 155. 63 cm, weight 65. 64 kg, and BMI 28. 27 kg / m2). . Subjects completed the Mental Status Questionnaire (Feltin et al., 1975) for assessing dementia and measuring cognitive performance score. MRI images were obtained from the subjects to examine the white matter and gray matter content. The analysis of the images was done by Voxel-based morphometric method (Ashbourne and Fristo 1997). In addition, physical activity score of Beck (Baecke & et al 1982) was measured and the subjects were divided Purposefully into active and low active groups. Functional tests of upper and lower muscular endurance and strength and lower extremity flexibility were performed. Results: There was no significant difference between the two groups (active and low active) in density of the white and gray matter of the brain and the cognitive performance score. However, the mean score of physical activity and physical fitness indices, muscular endurance, upper strength and upper flexibility in the active group was significantly more than that of the low active group. Conclusion: There was no difference between the two active and non-active groups in white matter and gray matter of the whole brain. However, if there was a possibility of a regional comparison between the components of the brain, probably, a significant difference could be observed.

Introduction: Drug errors are a potentially hazardous occurrence that can be used in the treatment systems as one of the challenges and criteria for patient safety assessment. In this study, some of the main medication errors were evaluated in internal wards of Ramsar Imam Sajjad Hospital. Materials and Methods: This was a descriptive prospective cross-sectional study. Subjects were including 200 files of patients hospitalized in internal wards of Imam Sajjad hospital between March and September 2017. Gathered data were including demographic data obtained from patient’ s file, drug orders documented in patient’ s file and drug orders transferred to patient’ s drug cardex. Medscape was used for evaluating of any drug interactions. Results: A total of 1888 prescribing were noted from 112 different drugs, in overall 200 investigated files, 166 cases of drug interaction were noted. There was significant relationship between number of drug use and hospitalization period with detection of drug interaction (p<0. 05). Of 1720 registered orders, 223 medication errors occurred by the physicians and 36 errors by the nurses in drug transcription and administration. Physicians’ contribution in medication error was more (86. 1 %). Nurses ’ contribution in transcription error and drug order running was 13. 9 %. Conclusion: Appropriate feedback of results of the present study could be effective and valuable in reducing medication error.

Introduction: Epidermolysis bullosa is a group of acquired or inherited mechanobullous skin disorder, characterized by blister formation in response to physical traumas and hot weather. They differ according to severity, clinical feature, prognosis, histology and heredity pattern. Case report: Miss J is a 24 years old girl. She was admitted at Emam-Reza hospital, Mashhad University of Medical Sciences, Iran due to confusion, severe anemia, respiratory distress, sepsis, general weakness and generalized skin bullae. The skin bullae have appeared since the third day of her life. The patient looks like a severely pale small child. Her body weight was 24 kg and her physical growth was far less than her chronological age. Her skin biopsy was compatible with epidermolysis bullosa. Her general feature improved after administration of fluid, blood products and wide spectrum antibiotics. Conclusion: While the patients might have life threatening medical problems, physicians should be familiar with manifestations and treatment of rare and severe cases of epidermolysis bullosa.

Introduction: Prevalence of cardiovascular disease in diabetic patients is more than general population and its adverse events are more common, though multiple different protocol of glucose control in acute coronary syndrome were proposed, in this study two different protocol of controlling blood sugar level for decreasing hospital adverse events were compared. Materials and Methods: 200 diabetic patients with acute coronary syndrome in Imam Reza Cardiology Department after 48 hours insulin therapy randomly divided in to two groups: intensive control, in this group we checked blood glucose level before meal and two hours post prandial (6 times a day) and insulin depending on chart with target fasting glucose70-110 mg/dl and two hours post prandial lower than 180 mg/dl. second group was conventional control with checking fasting blood glucose level daily, with using the diabetes treatment like before admission with target of fasting glucose 70-130 mg/dl. All patients have been visited daily and major adverse cardiac (MACE) events were recorded. Results: Overall 12% of all patients had recurrent ischemia (10% of intensive group versus 14% in conventional group, p=0. 0514), Reinfarction in one patient of conventional group (p=1. 000), arrhythmia in 5 patients (2. 5%), 3 patients (3%) of conventional group versus 2 patients(2%) of intensive group (p=1. 000), ventricular dysfunction in 85% of patients, 84 patients (84%) of intensive group versus 86 patients (86%) of conventional group (p=0. 843) and intra hospital mortality rate was 4%, 5 patients (5%) in conventional versus 3 patients (3%) in intensive group, (p=0. 721). Conclusion: depending on the study we didn’ t find any significant differences in major adverse cardiac events in two groups.