Studies in Medical Sciences
Year:2005 | Volume:15 | Issue:4|Papers Count:11

Background & Aim: Microalbuminuria has been recently proposed as a marker of cardiovascular risk factor, but the underlying mechanisms are still poorly understood. The prevalence of this condition in clinically healthy subjects varies widely from 5% to 55% in different populations. The aim of this study was to evaluate the prevalence of microalbuminuria and its relation to established cardiovascular risk factors in a group of healthy subjects. Materials and Methods: 280 of 360 subjects that consecutively referred to clinical laboratory for check-up program were selected. The albumin/creatinine concentration ratio (ACR) in the morning urine specimens was calculated as an index of albumin excretion rate. Subjects were divided in normal and microalbuminuria groups. Cardiovascular risk factors, such as hypertension, body mass index, lipids and lipoproteins compared in two groups. We used t-test for comparison of lipids and lipoproteins, and U-test for lipoprotein-a in two groups. For distribution frequency of qualitative variable and determination of coefficient variation of microalbuminuria to other variable, chi-square and correlation test were used respectively. Results: A total of 140 out of 280 subjects (57%) were from to have microalbuminuria. Subjects with microalbuminuria had significantly higher values in prevalence of hypertension (56.5% vs. 17.4%), and plasma triglycerides (TG) concentration (220 +/- 120 mg/dl vs. 187 +/144 mg/dl, p= 0.01) in comparison to normoalbuminuria. No statistically significant differences were found between other risk factors such as plasma total cholesterol, low density lipoprotein- cholesterol (LDL-C), and Lp (a) in two groups. Discussion: we concluded that our study population had relatively high frequency of microalbuminuria. In addition albumin excretion rate was associated to hypertension and plasma TG, but not related to total cholesterol and cholesterol transfer lipoproteins.    

Background & Aim: Infant mortality is due to poverty and starvation, lack of knowledge and dominative polices in many countries of the world. In additional, it is one of the best indexes in evaluation of health at society which it depends on different factors. The aim of this study is the ecological survey about effective factors on IMR in provinces of Iran. Materials and Methods: Data were collected from Multiple Indicator Cluster Surveys (MICS) in 1998 , reports and population and development data sheet for Islamic republic of Iran Statistical center of Iran (SCI) in 2003, costs and incomes of families survey (SCI) in 2002,  National Heath Survey (NHS) in Iran in 1999. The dependent variable is IMR and the independent variables are women's illiteracy rate in 15-49 year, caesarean percent, family consumption costs, Urbanity percent, family size and employed women percent. The collected data were analyzed by using of multivariate statistical path analysis method. We estimate the direct and indirect and total effects of variables in this equational structure model. Results: Based on standardized coefficients, women's illiteracy rate (15- 49), as an important factor, in crease IMR about 0.816 that partly about 0.347 it's due to urbanity and caesarean percent. Consumption costs index of family about 0.353 have decrease and direct effects on IMR. A direct effect of caesarean percent about 0.236 on IMR was also seen. There was no significant effect regarding urbanity percent. Discussion: Women education is one of the most important factors in IMR. Reduction of women illiteracy rate caused to change behaviors and attitudes by making use of family income and spending it for them in order to improve mother nutrition. These indicators describe the major pathway to reduce infant mortality in terms of access to essential health care services and some aspects of quality of care. Therefore, it's necessary to implement programmers to reduce IMR and educational needs of women.  

Background & Aim: The development of nervous system during embryonic period is sensitive to the presence of exogenous agents like herbal extracts. Hyoscyamus niger, which have been used in traditional medicine in different disorders like nervous diseases, contains anticholinergic alkaloids. The aim of this study is to find out the effects of prenatal exposure of the alcohol extract of leaf of this plant on balance control and motor activity in inbred mice. Materials and Methods: In this study, the herbal extract was injected to Balb/C mice during 6-8 embryonic days (neurolation period) intraperitoneally. One month after birth, by using Rota-Rod apparatus and activity monitoring system, the time of balance control and motor activity were recorded. Results: The results showed that in treated mice, the time of balance control, ambulatory, stereotypic activities and distance traveled were decreased but the resting time was increased. Discussion: Therefore, it seems that this herbal extract exerts its permanent effects on the balance and motors systems due to the presence of its anticholinergic agents. In spite of using this plant for treating some disorders, it should be used with care during pregnancy.      

Background & Aim: Microalbuminuria is a diagnostic tool for screening patients at risk of developing nephropathy. It is also known that patients with microalbuminuria have a greater incidence of cardiovascular events and early mortality. In this study reliability of the microalbuminuria as an indicator of a risk of progressive cardiovascular disorders was tested by detecting of the relationship between microalbuminuria and extension of atherosclerotic coronary lesions. Materials and Methods: The subjects for this study were 228 patients with angiographically confirmed coronary atherosclerotic lesions, mean of age 60 referred to Madani Hospital, Tabriz, Iran. Age and sex matched apparently healthy individual (n= 114) were used as the control group for comparative study. The levels of glucose and creatinine and that of post parandial glucose were determined in venous blood samples by standard methods. In random sample of urine creatinine with Jaffe method and microalbuminuria with immunoturpidimetric method in auto-analyzer was measured. The results were calculated by using statistical analysis. Results: The results shown that urine albumin/creatinine   ratio was higher than control group (CI=95%, p>0.05). A direct relationship between microalbuminuria and extension of atherosclerotic coronary lesions was noticed (CI=95%, p=0.009). The increased albumin/creatinine ratio was markedly correlated with diabetes (p=0) but there was no relation between albumin/creatinine and other factors significantly (p>0.05). Discussion: The presented results indicate the existence of significant correlation between extension of atherosclerotic lesions and microalbuminuria. The relationship between diabetes and microalbuminuria was meaningful. These facts may contribute to the higher cardiovascular risk in diabetic patients. An association between hypertension and microalbuminuria was noticed. The results suggest that although risk factors such as hypertension and diabetes are known to cause cardiovascular disease, microalbuminuria may be a contributor indicator of cardiovascular events.      

Background & Aim: Acne vulgaris is an inflammatory disease of sebaceous glands. Acne is the most prevalent inflamed skin disease with unknown cause that is characterized by forming comedones, erythematous papules and pustules. Acne prevalence percentage is 30-60% in adolescents. Age peak of acne occurrence for girls is in 14 - 17 years and for boys is in 16-19 years. 15 percent of acne occurs in server form and 85% are physiological acne that remain to second half of third decade of life and gradually are removed. The systemic antibiotic especially tetracycline have used as the selective treatment of acne vulgaris for many years. Long term using of this drug, will cause digestion side effects, however replacement of them with local treating decreases the side effects. Materials & Methods: This study was performed on 100 students of Urmia, in two groups so who were randomized to receive treatment with oral tetracycline (Igr/ per day for 16 weeks) and clindamycin 1% topical solution (16 weeks). Results: the results of this study showed there was no statistically significant difference between effects of oral tetracycline and clindamycin in number of open and closed comedones, papules and pustules (p= 0.6, t= 1.2). The most effect of tetracycline treatment was in 6thweek and clindamycin was in 4th Week (r= 0.71 p=0.03). Discussion: If further research can obtain the same results, in base of theses findings we can replace treatment of clindamycin (1%) by systemic treatment of tetracycline, to prevent side effects of long term tetracycline therapy because it have had caused mostly digestion side effects and has some problems to patient. Mean while, because of easy using of local treatment, it is more acceptable for the patient.  

Background & Aim: Electroconvulsive Therapy (ECT), though was controversial for 50 years, is still the core position for the treatment of severe and uncontrollable psychiatric disorders. After much more disputes and prejudices during the latest 20 years, this therapeutic method has been adopted as an effective approach to treatment according to the thorough scientific investigations all over the world. Especially, nowadays, it serves as well as one of the safest and most effective methods in the modern psychiatry. In Iran, ECT was introduced in 1935 and still is used for the routine treatments of psychiatric disorders. Those who believed that this method leads to an organic lesion in or disability of brain could not show any obvious documents involving brain pathology on patients undergoing frequent ECT. The purpose of this study was to assess alterations of memory before and after performing ECT in order to define whether it results in memory decreasing. Materials & methods: This study performed as a descriptive - analytic study over 100 patients in Tabriz, Razi hospital. The studied patients assessed by performing primary diagnostic approaches or by using MQ test about memory coefficient and then were treated by electroconvulsive and were evaluated repeatedly about memory coefficient by MQ test and assessment were repeated after 1 month. The results were analyzed by using SPSS software. Results: Patients with schizophrenia and other psychotic disorders, major depression, and bipolar disorders were included %48, %34 and %14 of disease groups. Respectively, decrease in memory coefficient in schizophrenia patients just after ECT was %4.22 and in patients with major depression and bipolar disorders was % 5.5 and % 6.5 respectively. Similar results were observed with some cure after 1 month. There was no relationship between personal and social factors such as sex, college successfulness, numbers and history of ECT therapy and ECT complication. Discussion: The result of this study enhancing the result of other studies shows that the decrease in memory of patients treated with electro convulsive is a temporary complication. But, for reaching to better result of treatment with less complication, performing the primary clinical examinations and identifying of background diseases especially in the ground of previous cerebral disorders can decrease its complications.        

Background & Aim: TransCranial Doppler (TCD) is a technique that measures blood flow velocity of main intracranial arteries based on Doppler principle and sonography. Regarding to role of practice in sonographic techniques such as TCD and implementation of this method in Razi and Imam medical centers of Tabriz University of Medical Sciences since 1999, we decidid to study repeatability of the TCD measurements. . Materials and Methods: We included 20 admitted patients to Razi medical center in neurology ward, in all of them mean flow velocities of 11 main intracranial arteries including: middle, anterior, and posterior cerebral arteries, carotid siphons, vertebral arteries of both sides and basilar artery were detected by the first examiner. Then within 0-3 days another examiner using same instrument studied the same patients. Finally, recorded data were compared with each other and analyzed with repeated measure statistical method. Results: Differences of mean flow velocities measurements in all of the above mentioned arteries were not significant and Korenbakh alpha of 0.8167 was found which revealed high repeatability and corresponded with published information. Discussion: Experienced examiners can use transcranial Doppler study without significant differences in the measurements.    

Background & Aim: Biliary tract diseases are common and one of their major signs is making change in diameter of the biliary ducts. To interpret this sign correctly, it is mandatory to know the mean and normal range of the diameter. The main goal of this study was to establish the mean and normal range of diameter of Common Bile duct (CBD) in adults by sonography. The minor purposes were to determine if there is correlation between the diameter of CBD and body parameters such as age, weight, height of subjects and asses whether a significant difference exists between the established total mean by this study and the literature; and also between the means of CBD diameter of male and female groups. Materials and Methods: By a prospective study the CBD diameter of 106 adults aged between 18 and 60 measured by sonography. All persons included in study were referred to. Sonography department of Imam Khomeini Hospital (Tabriz) and had not complained, pertaining to hepatobiliary tract. Results: The established mean and 95% confidence levels are 3.82±2.26 mm. There is no significant difference between this mean and the mentioned mean in majority of the literature (4 mm), p>0.05. Between means of females and males also doesn't exist a significant difference (p>0.05). There is positive correlation between CBD diameter and weight and age parameters. Discussion: In daily practice of clinical sonography, we can refer to these data and differentiate normal from abnormal subjects. Our study is an observational type and cannot display a causative relationship.  

Background & Aim: Hypertensive disorders are one of the most common causes of pregnancy complications. As the pathogenesis of this disease is not clear and as there are so many reasons to prove the role of sex hormones in this disease, so this study tries to investigate the changes of serum progesterone, total testosterone, .free testosterone and dehydroepiandrosterone sulfate (DHEAS) levels in the patient with preeclampsia. Materials & Methods: Four above mentioned hormones were compared between nineteen patients with preeclampsia who were referred to Kosar Hospital of Urmia and seventeen normal pregnant selected cases. All subjects in two groups were primigravid women with same gestational age and body mass index. T test was used as a statistical way of analysis. p<0.05 was considered as significant. Results: There were no significant differences in maternal age, gestational age and body mass index. Progesterone and .free testosterone levels were significantly lower in patients with preeclampsia than in the control group (p<0.05). There were no significant differences in total testosterone and DHEAS. Discussion: Sex hormone binding globulin increases in preeclampsia, so that it can decrease the amount of free testosterone in serum. On the other hand, progesterone can relax smooth muscle of vessels result in decreasing of blood pressure. It can be concluded that decreasing of progesterone in preeclampsia may play a role it in the pathogenesis of preeclampsia. Of course to sum up everything, so many complementary studies are needed.    

Background & Aim: RCM due to primary systemic amyloidosis is a rare case (Particularly rarity of the diagnosis in vivo). Prognosis of the patient is poor and routine management is not effective. I observe only two male patients with documented diagnosis of the RCM during recent seven years in spite continuous clinical work, and only the present case had a systemic amyloidosis as the etiology of RCM Case report: This patient was a 31 years old man with complain of fullness sensation at the RUQ of abdomen and dyspnaea is presented from 8 months before his death. The results of the complete evaluation of the patient by the invasive and non-invasive methods showed RCM Needle biopsy of liver and bone marrow showed amyloidal fibrils. The patient was expired because severe heart failure and liver dysfunction eventually. Discussion: Case reports of the RCM are to systemic amyloidosis with specific characters are recorded from the different countries. This disease isn't curable approximately and its predisposing factors are unknown. Deliberative problem of the patient is a prolonged history of nandrolon injection and intake of proteinous drugs. He was a professional athlete (body building).