مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
سال شصتم شماره 4 (پیاپی 153، مهر و آبان 1396)

Patients with ESRD (End stage renal disease) are candidate for chronic dialysis. Some of them need to do hemodialysis which one of the ways is to contrive arterio-venous fistulas in extremity via surgery. After fistula maturated and appropriated for needling, we can do dialysis through fistulas. It is possible that fistulas destroy, before maturing.
Material and In this study, patients under 20 years old with ESRD referred by nephrologists for hemodialysis and elected by vascular surgeon, included. Patients investigated for age, sex, body weight (BW), blood pressure (BP), vascular diameter, fistula location, kind of anastomosis, and surgery difficulty that performed by one vascular surgeon.
This study was included 30 patients mean age 13±4.6 years. Fistulas location was in snuffbox 17(56.7%), antecubital 12 (40%), forearm 1 (3.3%). Kind of anastomosis was end to end in one patient and side to side in reminder. Early access failure happened in 4 (13.3%) patients. Surgery difficulty in early access failure that reported through vascular surgeon was significantly different (p=.039).
In our study, difficulty of surgery had been effective in early access failure. Age, sex, fistula location, vascular diameter, use of magnification, and body weight had not been effective in early artery-venous failure.

One of the most common infectious diseases in the world, is a respiratory infection that caused by attack of Staphylococcus aureus to the upper respiratory system. Due to the genomic diversity of species and toxins of Staphylococcus aureus strains and increasing antibiotic resistance of this bacterium, rapid detection of bacterium to reduce the transmission and spread of this pathogen in nosocomial infections is essential. The aim of this study was to survey the prevalence of tst gene and detection of antibiotic resistance pattern of Staphylococcus aureus isolates in respiratory system infection.
In this study 100 Staphylococcus aureus isolates from patients with respiratory infections were selected and the tst gene was proliferated with polymerase chain reaction and specific primers in this isolates were evaluated through gel electrophoresis. Study of the antibiotic resistance pattern of strains was done using the disk-diffusion method against 12 antibiotics, based on CLSI protocol.
In 14 of the 100 isolates studied, tst gene was identified. Most antibiotic resistance in this strains was oxacillin (100%) and the lowest antibiotic resistance was vancomycin (14.3%).
for producing different toxins in Staphylococcus aureus strains and the increasing antibiotic resistance of this bacterium, early diagnosis and appropriate treatment to prevent the progression of the disease caused by this bacterium is essential.

The purpose of this study was to predict the poor and excessive ovarian response using anti-Müllerian hormone (AMH) levels following a long agonist protocol in IVF candidates.
Through a prospective cohort study, the type of relationship and appropriate scale for AMH were determined using the fractional polynomial regression. To determine the effect of AMH on the outcomes of ovarian stimulation and different ovarian responses, the multi-nominal and negative binomial regression models were fitted using backward stepwise method. The ovarian response of studIED subject who entered a standard long-term treatment cycle with GnRH agonist was evaluated using prediction model, separately and in combined models with (ROC) curves.
The use of standard long-term treatments with GnRH agonist led to positive pregnancy test results in 30% of treated patients. With each unit increase in the log of AMH, the odds ratio of having poor response compared to normal response decreases by 64% (OR 0.36, 95% CI 0.19-0.68. The optimal cut-off points of AMH for predicting excessive and poor ovarian responses were 3.4 and 1.2 ng/ml, respectively, with area under curves of 0.69 (0.60-0.77) and 0.76 (0.66-0.86), respectively.
By considering the age of the patient undergoing infertility treatment as a variable affecting ovulation, use of AMH levels showed to be a good test to discriminate between different ovarian responses

The process of cardio-pulmonary resuscitation (CPR) is an immediate action toprevent or delay cardiopulmonary arrest. This study was done to find out the success rate of CPR and its relationship with the working shift of the personnel in emergency unit and the wards.
Material and In this analytical and cross-sectional study in 2016, 199 patients whom with cardio-pulmonary arrest in emergency unit and wards of Ali-ibn-AbiTalib and Khatam-al-anbia hospitals of Zahedan undergone (CPR), were investigated. Then, patient's information was collected through researcher-made checklist and eventually, SPSS software was used for data analysis. Data analysis was done by using descriptive statistics and Chi-square and T-tests.
36.7 percent of CPRs was successful. According to the findings, the average of patient's age was 43.6 years old. Also 50.3% of the subjects were male. 41.2% of CPR cases were done in the morning shift which didnt have a significant relationship with the outcome of CPR (P=0.72). Also, 28.6% of total number of patients before CPR were intubed and 69.9% of the patients who undergone unsuccessful CPR were not intubed before resuscitation.
The results of this study show that the success rate of CPR is almost higher than other studies. Although it was expected that the patient's intubation condition prior to CPR and the time interval between cardio-pulmonary arrest and the start of CPR would have an important impact on the outcome of CPR, but there was no significant relationship between them, it might have been because of the inaccurate registration of the available information in the projects; it is suggested that the related officials, should come up with the essential ideas to make sure that the personnel register the information accurately in the hospital to be used in further studies.

Meningiomas account for about 15–30% of all primary intracranial tumors. According to the 2007 WHO classification, meningiomas are divided into three grades (I, II and III). Recurrence is an issue following surgical treatment of meningioma, especially in grades II and III. HER2 (also known as erbB-2) is a 185-kD transmembrane glycoprotein with tyrosine kinase activity. HER2 is expressed in some human malignancies and can be a potential target for therapeutic intervention with selective inhibitors.
P53 is a totumor suppressor gene , which bond to DNA and stop cancer formation.
There are only a few studies on the relationship between meningioma and HER2 and P53 expression, and the results are different as well. The aim of this study was to determine this relationship.
Material and A total of fifty-seven paraffin blocks of meningioma were selected randomly, and immunohistochemical staining was then performed for each specimen.
Overall eight of the 57 meningiomas were HER2-positive and 6 of them were P53-positive. HER2 expression was observed in 4 (30%) of the 13 grade II/III or recurrent grade I , and 4 (9%) of the 44 grade I meningiomas without recurrenc.P53 expression was observed in 4 (30%) of the 13 grade II/III or reccurent grade I , and 2 (4.5%) of the 44 grade I meningiomas without reccrence. Consequently HER2 expression was detected in 14% of meningiomas and P53 expression was detected in 10.5% of them.
High grade meningioma and recurrent meningioma show more HER2 and P53 expression but significant difference was not seen between grade I without recurrence meningiomas and grade II/III meningioma or reccurent grade I meningiomas, from the point of view of HER2 and P53 expression. There is a signigicant relationship between p53 and her2 expression (P-Value=0.002). Study of HER2 and P53 expression may be useful for more accurate grading of meningioma.

Abnormal serum lipids profiles have been reported in human malignancies. Attempts have been made to correlate serum lipids in leukemia patients with the disease activity and response to chemotherapy.
Material and The aim of this study was to evaluate a possible prognostic significance of serum lipid profile in patients with acute leukemia before and after chemotherapy.
Fasting blood samples were obtained from 78 previously untreated patients at Tehran University of Medical Sciences hospitals at the time of diagnosis and after chemotherapy with complete remission. Total cholesterol, serum triglyceride, HDL-C and LDL-C were estimated by enzymatic kits.
A total of Seventy eight proved cases of ALL and AML with mean age of 24.87 years were studied out of which 53.8% were males and 46.2% were females. An altered serum lipid profile was observed at the time of diagnosis of patients. Statistically significant values included elevated TG(194.41±18.28mg%), reduced TC (128.97±8.53mg%),LDLC (82.84±6.76mg%) and HDLC(25.30± 1.22 mg %).After complete remission the lipid profile significantly was different, a reduction in TG (127.84±8.59mg%) and elevated TC(168.01±11.66mg%),LDLC(105.10±6.41mg%),and HDLC (37.38±1.78mg%) were observed.Values are given as mean±SD.
These results support the idea that cholesterol and its fractions(LDLC, HDLC), and TG determination might be considered as useful biochemical and prognostic markers in hematologic neoplasms.

The levels of liver enzymes (AST, ALT, and GGT) are associated with obesity, fatty liver and insulin resistance, and nutrition and regular physical activities contribute to reducing these risk factors. The objective of this study is to assess the effect of ten-week endurance training with ginger supplementation on indicators of inflammation of the liver in women with type2 diabetes.
Material and In a randomized clinical trial study, 46 diabetes women aged 45 to 60 years (30≤BMI) divided into four groups randomly: exercise (E), exercise ginger (EPG), ginger (G) or placebo (P) groups. The blood samples were taken after 12 hours of overnight fasting at baseline and 48 hours after the last training session to measure levels of insulin, FBS and liver enzymes (AST, ALT and GGT). Then subjects of exercise group and exercise ginger group took part in ten-week aerobic training program for diabetic people.
At the end of week 10, in the EPG and E groups the levels of AST and ALT were significant reduced (P≤0.05). Besides, the weight, body fat percentage, WHR), levels of FBS and HOMA-ir was decreased only in the EPG and ET groups (P≤0.05). Of course these changes were slightly higher in group of EPG. While there wasn’t any significant changes in the control group (P>0.05).
The present study showed that aerobic exercises withusing ginger was more effective in significantly improving the liver enzymes levels, FBS, HOMA-ir and body composition compared with just aerobic exercise or ginger in obese women with type 2 diabetesý.

Helicobacter pylori has infected almost half of people around the world . The annual incidence of helicobacter pylori infection is 4-15% and 0.5% in developing and developed countriesrespectively. The aim of this study was to review antibiotic resistance of this organism in Iran and other parts of the world.
In this study Pubmed, (SID),ISI, Embase, Google scholar and Scopus databases were searched. In this study 20 Iranian, 8 Asian, 3African, 2 American and 17 European articles have been selected and reviewed. Studies had been selected in the period 1994 -2014.
Iranian studies reported very high resistance against metronidazole (57. 4%), which is roughly consistent with the results of other Asian countries (46. 6%). The average resistance was lower in Iranian in comparison with African countries (97. 55%). The mean ciprofloxacin resistance was 18% in Iran; it was 13. 2% in France and 39. 47% in Italy.
The average antibiotic resistance is higher in Iran than developed countries . According to the available statistics various antibiotic resistance tests are necessary for better treatment strategy selection.