Journal of Ardabil University of Medical Sciences
Year:2008 | Volume:8 | Issue:2 (28)|Papers Count:17

Background & Objective: As renin-angiotensin system (RAS) activity could affect the severity of oxidative stress and inflammatory markers; the effect of enalapril and losartan on these markers in renal transplant recipients (RTRs) with RAS polymorphisms was assessed.Methods: After determination of RAS genotypes including angiotensin converting enzyme. (ACE I/D), Angiotensinogen (AGT M235T) and angiotensin II type I receptor (ATRI A1166C) by PCR, seventy-six RTRs recruited to four groups randomly: first group (17 patients) and second group (24 patients) were treated with E (E+: 10mg/daily) and L (L+: 50mg/daily) alone, respectively. The third group (17 patients as positive control) received E+L (E+L+: 10mg/daily + 50mg/daily) and the 4th group (18 patients as negative control) received no medication (E-L-).Hs-CRP and total anti-oxidant (TA) as inflammatory and anti-oxidative markers were measured after 2 months. After 2 weeks as washout period, E group changed to L and vice versa as a cross-over design. They were followed for another 8 weeks and hs-CRP and TA were retested.Results: Following up the patients (after 2,4 months of treatment) in treated groups revealed that hs-CRP and TA levels were significantly decreased and increased (consequently) in E+L+, L+, E+ groups (P<0.05). On analyzing the relationship between RAS polymorphisms with baseline hs-CRP and TA levels, CC genotype of ATRI had lower hs-CRP levels (P=0.04). But none of the RAS polymorphisms could predict the anti-oxidative and anti-inflammatory response rate to the drugs (P>0.05).Conclusion: E and/or L reduce hs-CRP and increase TA regardless of the RAS genotypes.

Background & Objective: Congenital melanocytic nevi are benign proliferation of melanocyte in the epidermis and dermis in fetal period. These nevi are mostly benign but there is a risk of malignancy in case of firmness, discharge, pain and bleeding. Aim of this study was to describe if they enlarge, these congenital nevi and risk factors of malignancy in this group of patients.Methods: This study was a descriptive analytic cross sectional study. The cases were the people who referred to Sina Hospital-Dermatology Clinic of Tabriz and had congenital melancytic nevi, the number of cases was 54 for all of them filled out questionnaires aires and the findings were investigated with SPSS and T- test.Results: In 50% of the patients, nevi were smaller than 1.5cm and 3.7% over 20cm and 46.3% between 1.5 -20cm. Secondary changes were found in 38% of cases in which the commonest one was hair growth. Other secondary changes were growth, site, Dermal keratosis, Hyper pigmentation and skin infection. About appearance of nevi border of them were regular and smooth in 92.6% and irregular in 7.4%. Suspicious sign of Malignancy findings were considered in 5.6% of cases and in 1.9% of cases developed malignant melanoma.Conclusion: This study showed that most of our nevi were benign and the risk of malignancy was low. But presence of induration and rapid growth in moderate or giant congenital melanocytic nevi should trigger us to evaluate malignancy of them. Furthermore malignancy risk in small nevi were much lower than the larger one.

Background & Objective: Respiratory tract infections causes 4.5 million children death in the world annually that occur mostly in developing countries like Iran. Bacterial and viral pathogens are responsible for this event and Adenovirus is one of the major responsible agents. According to multiple survey, incidence of viral pathogens in different world region is different so local survey is needed to describe regional incidence of different viral pathogens. Rapid test for detection of respiratory pathogens help us to select appropriate treatment and avoidance of antibiotic over usage. So abuse the aim of this study was to evaluate incidence and clinical presentation of Adenovirus infection in children in Tehran with rapid test.Methods: This study is a descriptive-cross sectional analysis. All 3 month to 15 year old children with upper respiratory tract infection that come to OPD of Rasol-e-Acram Hospital in one year (1385) are included. Direct smear of patient's throat was evaluated by rapid chromatography test for adenovirus infection. SPSS software was used to analyse the data.Results: 160 children with upper respiratory tract infection with a mean age of 61.5 months were evaluated. 57.5% were boys and 42.5% were girls. 77.4% had fever, 66% had sore throat, 37.4% had cough, 27% pharyngeal exudates, 16.4% had abdominal pain, 15.7% had vomiting, 13.8% had cervical lymphadenopathy, 10% had diarrhea, 5.7% had petechea in palate and 1.9% had conjunctivitis. They admitted 24% in spring, 14.1% in summer, 23.1% in fall and 38.5% in winter. Adenovirus infection was detected in 10 (6.3%) cases, 4 (40%) boys and 6 (60%) girls with mean age of 83.7 (SD=58.5). they were detected 20% in spring, 30% in summer, 30% in fall and 20% in winter.Conclusion: Adenoviruses are responsible in 6.3% of upper respiratory infections in children. They become less prevalent with increasing age. Its prevalence did not obey seasonal pattern. Fever and sore throats are most common clinical signs and cervical lymphadenopathy is more prevalent in adenovirus infection than others.

Background & Objective: General physicians require a number of different resources to cover the broad scope of their practice. A critical point in their medical practice is timely access to the wide variety of clinical information sources that contribute to patient care decisions. The aims of this study were to assess information seeking behavior of Ardabil general physicians and their approach towards electronic sources.Methods: This study was done using Questionnaire research method. A total of 191 questionnaires were distributed among GPs and 167 relevant questionnaires were gathered. Data were analysed applying SPSS.Results: 75% of general physicians had access to internet. The majority of them were in search of information for Keeping themselves up-to-date and solving medical problems (78.4%). General physicians' first priority was text books, and the second priority was continuing medical education courses for meeting information needs. They used mostly books followed by medical journals as formal channels, and updated their information taking part in continuing medical education courses followed by congresses and seminar as informal channels. As obstacles to finding necessary information they reported lack of adequate time (61.7%), near to half of them (47.3%) reported lack of sufficient information resources in libraries, and unfamiliarity with medical databases (40%).Conclusion: General physicians are aware of the importance of internet in accessing information, but they did not use it as an important tool to answer questions rising in practice. The majority of general physicians used books to access information followed by continuing medical education courses, and used internet in the sixth rate. The majority of them used low rate the internet, electronic resources, and medical databases because of inadequate familiarity with them. General physicians need training in internet, web search tools and search methods, and medical databases.

Background & Objective: postpartum depression is a kind of psychiatric disorder that psychosocial factors relate with it. This study was performed in order to determine relationship between postpartum depression and psychosocial effects and determine the rate of postpartum depression in mothers visiting health-medical centers in city of Rasht.Method: In this descriptive-correlational study, 350 women were selected in the Random cluster manner. The instruments for gathering data were two questionnaires including psychosocial effects and Edinbugh test. The researcher completed these questionnaires through interview.Results: The results indicated that 16% of samples suffered from postpartum depression. The results indicated a significant correlation between the satisfaction of life and husband's relatives (p=0.021) the life's unpleasant events (p<0.0001) the psychological disorder history in family (p<0.0001) the post partum depression history in family (p=0.008) the unwanted pregnancy (p=0.041) tendency to abortion (p<0.0001) the satisfaction of mothers about the neonatal gendel (p=0.034) the satisfaction of husband's family about neonatal gentiv (p=0.005) the kind of communication with husband (p<0.0001) The kind of communication with husband's family (p<0.0001) and the postpartum depression.Conclusion: Nurses have important roles in secondary prevention and screening women suffering from postpartum depepression, and also in appropriate and quick referring them to psychiatrist. Nurses need to be knowledgeable about high-risk factors and share the information with mothers and their families.

Background & Objective: As cancer of cervix is one of the important facts, for women and probably causes in presence, furthermore early diagnosis and management in primary stages is very effective for prognosis of the disease and survival, the aim of the study was to measure the probable relationship of contraraceptive devices with cervical lesions.Methods: This study was a descriptive analytic study that was done by referring to all pathologic center (6 centers) in Ardabil and reviewing 399 reports of pap smear through sampling method (one of them because of chemotherapy was excluded from the samples).Results: In this study 90 persons 22.5% of pop smear's study were normal and 309 persons 77.5% were abnormal that include nonspecific cervicitis (298 persons) specific cervicitis (192 persons) and epithelial cell abnormality (105 persons) Regarding the use of contraceptive devices, 15 persons didn't use any device 3.8% And 172 persons 43% were using one of the natural methods or tubal ligation, and 131 persons were using OCP pills 32.9% 63 persons were using IUD 15.8% 18 persons 4.5% were using condom, and also DMPA was not used. Through chi test it was found that there was significant relationship between contraceptive methods and epithelial cell abnormality (p=0.008) and imperative cervicitis (p=0.001). There was a meaningful relationship.Conclusion: There was a meaningful relationship between using contraceptive methods and nonspecific cervicitis.

Background & Objective: Determining the level of lesion in lumber disc disease might be difficult, especially when there is a transitional vertebra. MRI is one the methods widely used in presurgery; however, presence of sacralization or lumbarization may lead to a incorrect diagnosis. This study aimed at evaluating the agreement degree between the results of MRI and surgery with the post-operative radiographic findings in patients with lumber disc herniation.Methods: Thirty patients with lumber disc herniation were evaluated in a diagnostic value study during a 15-month period of time. Presurgery MRI results, as well as the findings during operation regarding the level of herniated lumbar disc were compared with the radiographic findings, numbering the vertebra below the C2 after surgery. The radiologic assessment of involved segment was considered as the gold standard method. Transitional vertebrae were determined on the basis of radiologic findings.Results: There were thirty patients with lumber disc herniation, 16 males and 14 females, with the mean age of 40.83±12.57 years in the study. There was a high and significant degree of compatibility agreement between the results of MRI and findings during surgery with the radiologic data (kappa=0.719, p<0.001; kappa=0.859, p<0.001). The results of MRI and surgery were incorrect in 4 and 2 cases, respectively. All these cases had a transitional vertebra in lumbosacral segment (totally 6 patients with transitional vertebra); i.e. MRI and surgery were able to detect the right level of herniation in 33.3% and 66.7% of patients with either sacralization or lumbarization, respectively. The sensitivity of MRI and surgery was 87% and 93%, respectively.Conclusion: Our results showed that MRI and surgery can reveal the right level of LDH in majority of patients; however, when there is a transitional vertebra, this ability may significantly be decreased.

Background & Objective: During pregnancy, Hb and Hct are reduced, because of increase in  maternal plasma volume. Pregnant women need more iron, because of the increase in blood volume, blood cells, the growth of fetus and placenta, iron supplementation is performed. This study, measured blood index after different doses of iron supplement prescribed in healthy pregnant women in order to prevent excessive iron intake.Methods: In this cross-sectional analytical study, 150 healthy pregnant women were selected who were divided in to two groups. One group took daily (as control) and the. Other intermittent (as case=3 times in week) iron supplement from the second trimester. Blood samples of all cases in the first second an third trimester were analysed for complete blood counts (CBC). The Data were analysed by SPSS.Results: The reduction of Hb, HcT and RBC at second trimester was significant compared to the first (p<0.05). This difference was not significant among two groups concerning the blood index.Conclusion: Since there was no significant difference in blood index among the case and control groups, so, to prevent the side effects of iron over load, it's recommended, to use intermittent iron supplement in healthy pregnant women.

Background & Objective: Tuberculosis is more prevalent in developing countries and death from tuberculosis meningitis is strongly associated with delays in diagnosis and treatment. Polymerase chain reaction (PCR) has been incorporated as a diagnostic tool for the diagnosis of tuberculosis. The rapid results and greater sensitivity compared to traditional microbiological methods makes PCR a suitable technique in tuberculosis, especially in tuberculosis meningitis, when diagnosis is difficult or when rapid diagnosis is needed. However, the possibility of false positive and false negative results must be considered. The aim of this study was to compare the conventional bacteriology (culture Ziehl-Neelsen staining) with polymerase chain reaction (PCR) technique for rapid diagnosis of tuberculosis meningitis.Methods: This study included 25 clinically diagnosed patients that were suspected to have tuberculosis meningitis and 10 other bacterial or viral meningitis patients were investigated. DNA was extracted from CSF and the NESTED PCR using specific primers were done.Results: In 25 samples, Mycobacterium tuberculosis DNA was detected in 9 (36%) by PCR, 2 (8%) and 1 (4%) with culture and direct smear was obtained, respectively. whereas no DNA bands were detected in patient with the other 10 meningitis. The entire procedure was repeated and the same result was obtained.Conclusion: The findings of this study indicated that PCR is a powerful method for rapid and sensitive diagnosis of tuberculosis meningitis. In a way that it decreases obtaining the results from several weeks in bacteriological methods to one to two days, especially in smear negative patients. This is very important in tuberculosis meningitis because it is a medical urgency and needs rapid diagnosis and early treatment.

Background & Objectives: There are several methods for PDA closure. This study compared results, -complications and cost effectiveness of surgical and nonsurgical PDA closure with coil.Methods: Patients who admitted in Shahid Madani Hospital in 2005 surgical and nonsurgical closure of PDA were included in this study. Data were obtained from patients units. All cases followed up for six months. Data were analyzed thorough SPSS.Results: From 21 patients of nonsurgical method in two cases (9.5%), coil embolizations were occurred to pulmonary artery, that they were removed in cath lab and then referred to a surgery unit. One case (4.5%) has residual shunt at PDA, that who was waiting for second coil. In six month follow-up, PDA completely was closed in 18 (86%) patients and no complications were seen. In surgical method there were 42 patients. In six month follow-up, there were residual shunt in 2 (4.7%) cases and chylothorax in 1 (2.3%) patient, transient left diaphragmatic paresis in 2 (4.7%) and transient vocal cord paresis in 2 (4.7%) cases were seen. Mean at hospitalization and ICU, laboratory tests and radiographic examinations in nonsurgical method were significantly less than surgical method (P<0.0005). There was no significant difference in drug cost between two methods (P= 0.793). Mean cost of instruments and total hospital cost of the patients in nonsurgical method were significantly more than surgical method for high cost of coil (P<0.0005), but men payment of patients to the hospital in two groups did not have any significant difference (P= 0.056).Conclusion: In general, PDA closure through nonsurgical method had better and effective results and complications. However, it is more expensive.

Background & Objective: It is now clear that the adult mammalian subventricular zone (SVZ) contains a population of neural stem cells (NSCs) that give rise to neurons and glia. Owing to their rarity, and a paucity of NSC-specific markers, the neurospher assay (NSA) is a common and selective method for isolating and understanding the biology of embryonic and adult neural stem cells. There are different methods for neurosphere growing from different regions of the CNS including Lateral ventricles. The objective of this study is introducing a new and effective strategy for more neurosphere firming from the SVZ of the adult mouse brain lateral ventricle using NSA.Methods: Two different methods were used in order to isolate and culture the SVZ of the lateral ventricles using NSA. In the first method (Ritze and Reynolds method) the rostral part of the SVZ of the lateral ventricles was dissected into single cell suspension and cultured using NSA. In the second method (vibratome resecting of the brain) after cutting the brain into 400mm serial sections using a vibratom, the SVZ was micro dissected from all sections of rostral part of lateral ventricle and cultured separately, using NSA. Primary neurospheres were counted seven days after plating. Then the mean numbers of neurospheres generated in two different methods were compared.Results: The mean number of neurospheres generated by sectioning method was much higher than the one generated using first method (P<0.0001). The distribution and frequency of neurosphere forming cells (or NSCs) is not the same along the antero-posterior axis of the rostral part of the lateral ventricle. The greatest frequency of neurosphere forming cells was detected in 0.74mm rostral to the bregma.Conclusion: Second section method, due to more neurosphere generation, in comparison with the first method is more appropriate and efficient for neurosphere forming from the SVZ of the lateral ventricle.

Background & Objective: Migraine is one of the chronic and Common Kinds of headache. Among important treatments which are advised for improvement of acute migraine attack, there are tryp tans and Ergot Alkaloids Because of side effects of Ergot Alkaloids Like nausea, vomiting, lack of appetite, Peripheral vessel contractions and induced headache and its limited consumption and patient’s age limitation, the patients face some difficulties using Ergot Alkaloid. On the other hand Tryp tans are Consumed as a monotherapeutic regimen but Ergot Alkaloids must be used with metoclopramide in order to prevent nausea and also they should be used in the acute phase of migraine so we decided to Compare the two groups of drugs so that if they have positive effectiveness in favor' of Tryp tans, using them would be advised.Methods: The range of age for patients was 20-40 years who suffered from classic and common migraine according to IHS criteria, were randomly placed in two groups. One group (36) was treated in the acute phase of disease by sumatryptan and the other (39) by a combination of 3 dihydroergotamine and naproxen and metoclopramide, and therapeutic effectiveness was studied by three Criteria of intensity, attack and frequency of attack. After the treatment, they were analyzed through chi square. Results: In terms of intensity, duration and frequency of the headache after the treatment, there was no significant difference between two groups and the results in both groups were the same.Conclusion: As there were no significant statistical difference between the effect of two drugs on attack intensity, headache duration and frequency in patients of classic and common migraine, and because of the complications of Ergot Alkaloids like vomiting it should be consumed with metoclopramide and because of vessels contractions which may result in the organs gangrene and induced headache, and its maximum dose is 6 mg per week, sumatryptan is advised as the monotherapeutic.

Background & Objective: Hyperlipidemia is one of the main causes of cardiovascular diseases which have a high mortality throughout the world. Consumption of products containing specific strains of microbes as probiotics, produces positive effects in the host by balancing the flora of the digestive system. L.casei is a probiotic and the aim of this study was to evaluate the effects of consumption of milk containing L.casei of lserum lipid profile of rats fed high lipid diet.Methods: This was an experimental study in which 30 male albino wistar rats with a body weight of 200±15gr were randomly allocated to two groups of treatment and control each containing 15 rats and adapted to a high lipid diet (11.47%) and water containing milk (25%). Rats in both groups received high lipid diet and water containing 25% milk for 48 days with the difference that rats in the treatment group received water containing L.casei considering that water consumption is created throughout the experiment, the amount of L.casei added to milk was calculated to each rat consumed 109CFU bacteria per day.Results: Independent t-test revealed that at a level of a=0.05 mean levels of total cholesterol and LDL-C of rats in the treatment group was significantly lower than that of control group (p<0.05), but the mean levels of triglyceride, HDL-C and VLDL-C was not significant. Also increase in body weight was significantly higher in the treatment group compared to the control group (p<0.01).Conclusion: Long term daily consumption of milk containing L.casei improve serum lipid profile by lowering total cholesterol level and also increase the rate of body growth.

Background & Objectives: Measurement of body Weight and height and determining of body mass index (BMI) according to age is one of the most important international indicators for evaluation of growth and physical health. The present study aimed to evaluate growth indices for schoolgirls 7-19 years of age living in Ardabil to compare with standard reference values and similar studies in Iran.Methods: To assess the status of growth pattern of 7-19 year girls in Ardebil during 2005, with a descriptive cross-sectional study, 3996 healthy girls were selected by the multi stage sampling method and their age, body weight, height and body mass index were recorded, then 5, 10, 25, 50, 75, 90, 95 percentile, mean and standard deviation in different age were analyzed and compared with NCHS and selected regions of IranResults: The mean of Height and weight in urban girls is higher than their peers in rural regions. Height growth was more during the ages of 9-12 with its peakin 9 years old with 6 cm annually. The highest increase in weight was at age 13 which was estimated 5.5 kg annually. Mean of height and weight in girls of Ardabil is less than their peers in Tehran, Kerman, Esfahan but more than their peers in Zahedan. Of the height, weight and body mass index percentiles in girls of Ardabil aged 7-19 years were less than their American peers according to National Center for Health Statistics data.Conclusion: All of percentiles anthropometric factors in girls Ardabil aged 7-19 years were less than NCHS standard.