Medical Journal of Mashhad University of Medical Sciences
Year:2014 | Volume:57 | Issue:6|Papers Count:12

Introduction: Behcet's disease (BD) is an autoimmune disease, which can affect multiple systems in the human body. Recently, the effects of serum heat shock protein (HSP27) level and antibodies against it have been demonstrated in Behcet's etiology and pathogenesis. This study aimed to determine the serum levels of HSP27 and high-sensitivity C-reactive protein (hs-CRP) in BD, and their relationship with uveitis in these patients.Materials and Methods: In the current cross-sectional study, the sample size was calculated as 94 individuals. The subjects were divided into three groups: patients with Behcet’s uveitis (BD+U), BD patients without uveitis (BD-U), and those with idiopathic uveitis. The serum levels of HSP27 and hs-CRP were compared among the three groups. The serum HSP27 level was measured, using ELISA technique.Results: The mean serum HSP27 level was 28.81±7.593, 31.78±6.841, and 24.07±7.095 in BD-U, BD+U, and idiopathic uveitis patients, respectively. These results indicated that there was a significant difference between the three groups regarding serum HSP27 level (F=8.118) (P=0.001).Conclusion: According to the results, there was a significant difference in HSP27 level in BD+U and idiopathic groups; therefore, serum HSP27 level can be a sensitive marker for the diagnosis of Behçet's uveitis.

Introduction: Several adverse effects including hypocalcemia have been reported for phototherapy in the treatment of neonatal hyperbilirubinemia, but less have been reported regarding the effect of phototherapy on serum magnesium level. This study was carried out to determine the effect of phototherapy on serum Mg level in term neonate with hyperbilirubinemia.Materials and Methods: In a cohort study in 2012 all term neonates admitted for the treatment of hyperbilirubinemia, according to the local protocol, included. All sick babies and those who required exchange transfusion excluded. A blood sample for magnesium level assessment was taken before and also after 72 hr of conventional phototherapy. The serum magnesium levels before and after phototherapy were compared and a P- value less than 0.05 was considered being significant.Results: Overall one hundred and twenty neonates studied. The mean gestational age was 39.01±0.974 weeks and the mean birth weight was 3359.17±426 grams. The mean serum magnesium level before the phototherapy was 2.869±0.367 mg/dl and 72 hrs after the phototherapy decreased to 2.604±0.292 mg/dl (p value=0.001). No sign and symptom attributable to hypomagnesemia were observed.Conclusion: Phototherapy could decrease the serum magnesium level in term neonate with hyperbilirubinemia and the amount of this decrease could not cause any sign and symptom.

Introduction: Diabetic retinopathy is the leading cause of visual impairment in patients aged 25 to 74 years. It seems that Inflammation has an important role in the pathogenesis of diabetic retinopathy, so the aim of this study was to evaluate the association between high sensitive CRP level as inflammation markers and severity of diabetic retinopathy.Materials and Methods: This cross sectional study was conducted on 342 type II diabetic patients in Mashhad Ghaem and khatam hospital in 1390. Diabetic patients with a history of acute disease or previous inflammation, malignancy, liver or kidney failure, Pregnancy, breastfeeding or usage that interfere with HsCRP levels were excluded from study. Demographic profile from the patients was taken. Ophthalmologic examination was performed for all patients by an expert ophthalmologist. The association between hsCRP levels with the presence and severity of diabetic retinopathy was studied.Results: A total of 342 patients (108 male, 234 female) were enrolled. Prevalence of diabetic retinopathy in our patients was 30.4% (22.08% Non-proliferative retinopathy and 8.32% Proliferative retinopathy). This analysis showed that HbA1C and duration of diabetes were only independent predictive factors for diabetic retinopathy. There was a difference between the serum hsCRP levels of those with and without retinopathy, however, this difference was not significant (p=0.47).Conclusion: In this study, no association was found between hsCRP with the presence and severity of diabetic retinopathy.

Introduction: Sleep is a basic human psychological need, and is regularly repeating. It is the organism easily reversible binding and its relative immobility significant enhancement in response to external stimuli, compared with a threshold awakening is clear.Materials and Methods: This study was analytical.  The sample of study was included 296 respondents. Instrument for data collection was pittsburgh Sleep Quality Index (PSQI), which was to evaluate sleep quality.Results: The results of the present study indicated that sleep quality of patients and gender had a significant relationship [x2=4.7, df (1), p≤0.003], as men sleep relatively "better than women, and marital status of patients had a significant relationship with sleep quality [x2=6.5, df (5), p≤0.001].Conclusion: According to the results from the current study, there was a significant relationship between age and sleep quality, moreover, the results showed that, the number of hours worked per week had a significant relationship with the sleep quality.

Introduction: Breast cancer is the most common cancer type of cancer in women. There are different techniques to remove this cancer surgically. Although modified radical mastectomy (MRM) is still considered the gold standard procedure, breast conserving surgery (BCS) is gradually establishing its place as a safe and appropriate option. The aim of the study is to compare the psychological impact of these two procedures on the patients.Materials and Methods: In this study, patients suffering from breast cancer were divided into two groups based upon their surgical procedure. Their psychological status were assessed using Farsi version of two standard assessment tools: Symptom Checklist-90-Revised (SCL-90-R) and Zung Self-Rating Depression Scale. Data were analyzed with Student T test, using SPSS version 14.Results: The psychological and emotional status of both MRM and BCS groups were not significantly different before and immediately after surgery. However, all scores of symptomatic dimensions of SCL-90 in BCS group were significantly lower than MRM group. The same results were demonstrated in terms of Zung depression scale.Conclusion: It seemed that Psychological status of patients undergoing BCS was more favorable. However, psychological advantages of BCS will not appear soon if the patients were not instructed and educated about their own condition and the procedure which they had to undergo.

Introduction: Modern life threats the social and mental health of women by involving them in different forms of unhealthy life style, without social support for education of health manners. Therefore, it will lead to physical inactivity, Depression and weight gain. Regarding the application of theories and models of health education, the purpose of this study was to evaluate the impact of education, based on health belief model, on performing postpartum exercise in Iranian primipara women. Materials and Methods: This experimental study was carried out with the participation of 195 primipara women who were referred to health centers of Bandar Abbas, a city in central south of Iran, in the years of 1391-92. The Participants are primiparous women, coming to be visited to health centers, and will be randomly divided into three groups of 65 participants (1 intervention group an 2 control groups). Participants were interviewed using the HBM questionnaire. Education was given in four sessions on the basis of Health Belief Model for intervention group, while one session was held for second control group. First control group received the routine care of postpartum. Eventually, the collected data were analyzed by Frequency Distribution, Chi-Square Test and Anova.Results: Mean scores of perceived susceptibility, perceived severity, perceived benefits, perceived barriers, guide for action, self- efficacy in the intervention group before and after education showed a significant difference in comparison with control groups (p<0.0001).Conclusion: Health Belief Model-based education has positive impacts on behavioral improvement.

Introduction: Cardiovascular disorder  is the most common cause of premature morality in patients with rheumatoid arthritis (RA) with a relative risk of about twice compared with same age range of patients without Cardiovascular disease. People with rheumatoid arthritis and other chronic inflammatory conditions are at higher risk of heart disease. The purpose of this study was to determine and monitor heart diseases.Materials and Methods: Forty patients attending therheumatology outpatient departments and clinic of Ghaem Hospital with an established diagnosis of RA for over five years, as defined by the American Rheumatism Association criteria, were enrolled for this study. 90% were female. Mean age were 46.2±15.48. The patients that have previous heart diseases were excluded from the study. If everything was normal, Doppler M. Mode 2D-doppler echocardiography using VIVID3 device was performed. Results: Forty patients underwent all the investigations. The most common valvular disease were Tricuspide and Mitral valve regurgitation (72.5%, 52% respectively). In 70% of patient diastolic function was normal and there was significant relationship between systolic function (EF) and diastolic abnormality. Pulmonary hypertension was detected in 40% patients. Significant relationship was seen between D, Em and S, Sm (p=0.001, 0.043 respectively). but there were not a significant relationship between E, Em and A, Am (p=0.432, 0.844 respectively). Patients with RA were to have echocardiographic parameters of diastolic. Conclusion: It is possible that the longer period of disease of our patients caused a more evident diastolic dysfunction. Increased prevalence of diastolic dysfunction in old age, duration of rheumatoid arthritis was observed.

Introduction: One of the important chronic complications of diabetes is the involvement of peripheral nervous system which presents with burning pain and paresthesia and numbness of distal extremities. Painful diabetic neuropathy sometimes may responds to antidepressant or anticonvulsant drugs. One of the recent advances is the using of Coenzyme COQ10.Materials and Methods: This pilot and prospective randomized study was carried out on diabetic patients with neuropathic symptoms who referred to the clinic or endocrine research center of Ghaem Hospital in 2012-2013.The written Informed consent was obtained from each participant. Neurologic physical examination was done by one neurologist and nerve conduction velocity (NCV) was obtained. Then COQ10 was administered daily. At First 32 patients participated but only 15 cases completed the study. After 3 months the neurologic physical examination and NCV repeated and the results were compared with the previous data by the same neurologist.Results: Overall 15 cases were eligible and evaluated. NCV revealed mild symmetric sensory and motor axonal neuropathy in 4 and moderate in 8 cases, 3 patients had severe neuropathic involvement. NCV results before and after the treatment showed reduction in the number of cases with severe neuropathy which was statistically significant (p=0.006). FBS and HbA1C significantly reduced after the treatment (P<0.001) and (p=0.024) respectively. The effect of COQ10 on other laboratory variables (serum lipids and creatinin) was not significant.Conclusion: Our study showed that COQ10 can be effective on the relief of neuropathic symptoms and significantly reduces neuropathic pain.

Introduction: Nosocomial pneumonia is a major cause of mortality in critically ill patients in hospital that has a prevalence of 5-10 cases per 1000 admissions. Probiotics are live microorganisms that colonize oropharynx and digestive tract of the host and inhibit the natural flora from pathogenic flora. Therefore, their impact on the prevention of nosocomial pneumonia has been proposed. The purpose of this study was to review literatures about the effect of probiotics on the incidence of nosocomial pneumonia. Search for related studies on this was performed in two steps. In the first step PubMed, Scopus and Google scholar were searched with key words of pneumonia and probiotics and related studies were extracted. In the second stage related articles references were investigated and then the RCT studies between 2008 and 2014 were assessed. In this review 8 studies on the effect of probiotics in the prevention of nosocomial pneumonia were found that only 2 studies showed significant reduction in the development of ventilator associated pneumonia. Assessment of the effect of probiotics in nosocomial pneumonia needed further studies that should consider probiotics′ type, dosage, duration and rout of prescription.

Introduction: Multifocal skeletal tuberculosis is characterized by osteoarticular involvement of one or multiple sites and it may involve any bone structure.Case report: The reported case is a 22 years old female who presented by chronic simultaneous involvement of right ankle, right wrist and the joints in the spine. In this paper beside presentation of this rare case, we reviewed the literature on multifocal skeletal tuberculosis.Conclusion: Multifocal tuberculous osteomyelitis is an uncommon condition. However, its clinical and radiological findings may not distinguish it from malignant disorders. Hence, it may prudent to consider it in the differential diagnosis of patients with destructive bone lesions in multiple sites. The diagnosis of mutifocal tuberculous osteomyelitis requires high clinical suspicion for timely diagnosis and to prevent long term sequela.