MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES
Year:2017 | Volume:60 | Issue:3 |Papers Count:10

Introduction: Morphea is the most common variety of localized scleroderma، which forms a spectrum of sclerotic diseases that primarily affect the skin. The etiology and pathogenesis of morphea is not yet known; however، a multifactorial process is assumed to trigger an inflammatory and fibrotic cascade. The potential environmental factors involved include Lyme disease، trauma، radiation، drugs، and viral infections such as Cytomegalovirus (CMV). In this study، we sought to assess the relationship between morphea and CMV. Materials and Methods: Amplification of CMV DNA was detected by PCR on 41 paraffin-embedded tissue sections of morphea patients and 40 healthy skin samples. Data were analyzed by SPSS ver. 16 and P ≤ 0. 05 was considered statistically significant. Results: Among 41 patients، there were 17 males (17%) and 34 females(83%). Minimum and maximum age of patients was 12 and 72 years، respectively with mean age of 43. 5 years. Among 81 beta globin positive samples، CMV DNA was detected in nearly all samples of morphea patients as well as healthy skin samples. Only one sample from case group (2. 4%) and two samples from control group (5%) were negative for CMV DNA(P=0. 61). Conclusion: In this study، no significant correlation was found between the amplification of CMV DNA and morphea disease.

Introduction: Encephalitis is a relatively uncommon cause for admission in the pediatrics wards and is associated with high frequency of lifelong debilitating sequela. The aim of this study is to find the frequency and Etiology of encephalitis in the pediatric neurology service of Ghaem hospital Mashhad. Materials and Methods: This is a descriptive retrospective study among children who were discharged from pediatric neurology service of Ghaem hospital Mashhad (March 2008 up to September 2014) with final diagnosis of encephalitis. For finding the long term prognosis of encephalitis، we called all the available families and filled a questionnaire about neurologic functions. Results: During 6. 5 years، we registered 55 cases of encephalitis. The mean age was 4. 9 years، 50% were boys and 74% were city residents. The lowest seasonal incidence was in spring (15%) but it was almost equal in other seasons. CSF pleocytosis (WBC>5mm3) was seen in 23 cases ( 41%) and HSV PCR was performed in 49%(27cases ) of the cases. The causes of encephalitis were: acute disseminated encephalomyelitis (ADEM) 16%، HSV 16% (5%PCR positive [definite] and 11% PCR negative [possible])، chicken pox encephalitis 3% and 63% undetermined. Acyclovir was prescribed for 80% of the cases. In 77% of cases acyclovir was started in the first hospital. Long term follow up showed that 32% of children suffer from persisting sequela of encephalitis. Conclusion: ADEMis the most common causes of childhood encephalitis in Mashhad. In the state of Khorasan، pediatricians start acyclovir for most cases، at the first confrontation with childhood encephalitis.

Introduction: Metabolic syndrome is a cluster of major risk factors for cardiovascular diseases، including hypertension، dyslipidemia، obesity، and impaired glucose tolerance. Cardiovascular diseases are the most important causes of mortality and reduced long-term renal function in the kidney transplant recipients. Regarding this، the present study aimed to evaluate the prevalence of metabolic syndrome after renal transplantation and its effect on renal function. Materials and Methods: This study was conducted on 110 kidney recipients with no history of diabetes and stable renal function. The patients were evaluated in the first year after transplantation (at baseline)، and then 6 and 12 months later in terms of the prevalence of metabolic syndrome based on the Adult Treatment Panel III criteria. Subsequently، the renal function was compared between the patients with and without metabolic syndrome using the glomerular filtration rate (GFR) and serum Cr level. Results: According to the results، the prevalence of metabolic syndrome was 30% at the baseline، which increased to 44. 5% during the one-year fallow-up (P=0. 000). Furthermore، there was no significant difference between the patients with and without metabolic syndrome in terms of GFR and serum Cr level (P>0. 05). Conclusion: As the findings indicated، metabolic syndrome had a high prevalence rate mong the kidney recipient. Given the significant effect of this syndrome on enhancing the cardiovascular diseases، the timely diagnosis and treatment of the patients inflicted with this medical condition can promote the long-term survival rate.

Aminotransferases as inexpensive and accessible serum markers are highly beneficial in the detection of early-stage damages to hepatocytes. In addition to their use in the primary diagnosis of hepatic diseases، their association with diseases that are growing in prevalence، such as metabolic syndrome and cardiovascular diseases، are taken into consideration. These markers were first used nearly 60 years ago as markers of liver damage، but their use expanded to detect non-A، non-B hepatitis (hepatitis C) in the 1980s. In the late twentieth century، revision of the reference range of aminotransferases by using large groups of blood donors was emphasized and diverse results were obtained. In recent years، these studies have been questioned because they used certain social groups، and extensive studies on the general populations in different regions of the world have begun. However، in different studies، various results were obtained، highlighting the necessity of carrying out further population-based studies in different races. Unfortunately، in Iran، in spite of the increased prevalence of cardiovascular diseases and metabolic syndrome، no research on reference ranges of aminotransferases has been carried out with generalization capability and control for confounding factors. Thus، performing a study on the reference range of these markers with the mentioned features is recommended.

Introduction: Biological maturation is a potential factor for the variance of physical activity in adolescents. Therefore، the present study was conducted with the aim of investigating the major and moderating effects of biological maturation status and social support on the physical activity level of female adolescents using the biocultural model of maturity-associated variance in physical activity as a conceptual framework. Material and Methods: 630 female middle school students of Mazandaran province، Iran، selected through random multistage cluster sampling. The data were collected using the adult stature estimation، demographic form، social support questionnaire، and pedometer. Data analysis was performed using SPSS23 and PLS2 softwares. Results: The results suggest that there was a significant inverse relation between biological maturation and physical activity (r=-0. 289، P<0. 01). The structural equation modeling showed a goodness of fit of model. Therefore، social support was an important moderator for the maturity-associated variance in physical activity. Conclusion: Social support may reduce the negative role of early maturation on physical activity. Parental interpretation of changes associated with puberty and encouragement of the adolescents to accept it as a positive and natural event (no obstacle to physical activity) may play a more important role in the reduction of any negative effects associated with early maturation on physical activity.

Introduction The present study aimed to compare the acute and chronic responses of blood pressure، arterial stiffness، and peripheral arterial disease to 11 weeks of two different high-intensity interval training (HIIT) protocols in hypertensive patients. Methods: This study was conducted on 31 hypertensive patients who were randomly assigned into SDHIIT (n=10)، LDHIIT (n=11)، and control (n=10) groups. The patients in the SDHIIT group were subjected to HIIT protocol، including 27 repetitions of 30 sec at 80-100% VO2peak with 30-sec recovery intervals at VO2peak of 10-20%. On the other hand، the LDHIIT group performed four repetitions of 4 min at 75-90% VO2peak interspersed by four 4-min recovery repetitions at the VO2peak of 15-30%. Systolic and diastolic blood pressure، pulse wave velocity (PWV)، and ankle-brachial index (ABI) were measured before and after the first and last exercise sessions. Results: There was no significant differences between the two groups in terms of PWV after one session of training (P>0. 05). However، the SBP، DBP، and ABI significantly decreased in the two groups (P<0. 05). Considering the acute responses، a significant reduction was observed in the SBP (P=0. 03) and ABI (P<0. 01) in the LDHIIT and SDHIIT groups، respectively، after 11 weeks of training. Nonetheless، no significant difference was detected in PWV and blood pressure. Regarding the chronic effect of the two training protocols، the LDHIIT group showed a significant difference in all variables، except for ABI (P>0. 05). Conclusion: Based on the findings of the study، both HIIT protocols improved blood pressure and hemodynamic factors in acute forms. However، SDHIIT was more effective than LDHIIT in the improvement of blood pressure and other variables in the long run.

Introduction: Alzheimer's disease (AD) is the most common form of dementia among the elderly. Its pathohistological characteristics are the accumulation of extracellular β-amyloid protein and hyperphosphorylation of tau protein. This neurodegenerative disorder is assumed to start with synaptic dysfunction and chronic loss of neuronal cells. Researchers believe that neurogenesis appears in adulthood; therefore، replacement of the lost neurons can represent a therapeutic approach for the management and improvement of AD. The developing field of stem cell biology offers great therapeutic potential for chronic neurological conditions such as AD، particularly if joined with a multitargeted therapeutic approach. It has been shown that enriched environment positively affects patients' cognitive behaviors through various mechanisms، including modulation of neurogenesis. Conclusion: The current advancements in neurogenesis، stem cells therapies، and environmental enrichment in AD are reviewed in this article، and the potential barriers to the use of these treatments for AD patients are discussed.

Background & Aims: The provision of healthcare services is one of the main and vital necessities of every society، the lack of which is considered as a weak point for governments and leads to extensive social discontent. Regarding the increasing treatment costs، it seems essential to find a way to decrease the patients' expenses. Materials & Methods: This practical study was conducted in the Shahid Arefian Hospital of Urmia city، Iran based on the five phases of Lean Six Sigma. Out of the factors affecting patients' cost reduction، the cancellation of elective surgeries was investigated by the implementation of brainstorming meetings. Results: According to the results، the principal factors of surgery cancellations increasing patients' costs were paraclinic، clinical، and system factors، as well as the factors related to the surgeon and patient. The implementation of Six Sigma phases revealed that the sigma of the present process was 3. 1827 that is an undesirable value for a medical center since disorganization in this section is not compensable. Conclusion: In the brainstorming meetings held with the members involved in the project، the practical solutions of reducing the canceling factors were proposed and presented in two flowcharts. It is predicted that the implementation of the proposed solutions would upgrade the sigma of the process to 3. 5.