مجله پزشکی دانشگاه علوم پزشکی تبریز
سال سی و پنجم شماره 5 (پیاپی 107، آذر و دی 1392)

Backgrounds and Helicobacter pylori (H. pylori) infection is the most common chronic bacterial infection worldwide and its possible role in diseases out of digestive systems such as atherosclerotic and peripheral vascular disorders is controversial. The aim of this study was to investigate the effect of eradication of H. pylori infection on serum lipid profile، serum levels of CRP and fibrinogen. In a before and after clinical trial، 114 patients with H. pylori infection during the last 12 months were selected. Serum level of total cholesterol، HDL، LDL، triglyceride C Reactive Protein (CRP) and fibrinogen were measured. After a six weeks period of conventional treatment، measurement of these tests were repeated. A total of 73 patients، 34 males and 39 females with a mean age of 32 ± 10 (19 to 63) years. The mean serum total cholesterol، HDL، LDL، fibrinogen was respectively 259، 110، 289، 49. 6 and 180. 5 mg per deciliter and CRP 90 mg per liter after treatment، respectively، 266، 112، 305، 52. 2 and 181. 1 mg per deciliter and CRP 50 mg per liters. The mean CRP decreased after eradication (p<0. 001). There were no significant changes in most parameters. Mean HDL increased both in men and mean fibrinogen levels decreased in≤ 40 years group. Eradication of H. pylori might be effective in reducing the risk of coronary artery disease. Gender and age are two important factors involved in this field.

Backgrounds and Congestive Heart Failure (CHF) is a prevalent disease and has a great economic impact on health systems. Cardiac Resynchronization Therapy (CRT)، which synchronize biventricular contraction، is one of the most important therapies in these patients. Despite the exact selection of patients about 30% of patients do not respond to CRT. The aim of this study was to evaluate the O2 saturation and the pressure level of right side of heart and Coronary Sinus (CS) vein to predict the response to CRT. In this descriptive study، 30 patients were candidate for implantation of CRT echocardiography. The 6 Minute Walk Test (6MW)، right side and CS O2 saturation and pressure study was done before implantation. Echocardiography and 6MW repeated 6 months later. Based on response to the CRT، patients were divided into two groups: “responder and non-responder”. Date were compared between groups. O2 saturation was significantly lower in responders than non-responders. In non-responder patients the Right Ventricular (RV) and Pulmonary Artery (PA) Pressure was significantly higher than responders. Desaturation of CS blood flow in responders was probably due to higher levels of viable tissue which involve in contraction. Increase in right side and PA pressure in non-responders might be due to severity of heart failure which made CRT not effective in these patients. Evaluation of O2 saturation of CS blood flow، RV and PA pressure can use as an index in predicting the response to CRT and can help as additional indices in selection of patients with borderline indications for implanting CRT.

Backgrounds and Laparoscopic Esophagectomy، as a well established method، has been performed since 2000. Minimally invasive esophagectomy could be done in two the Laparoscopic Transhiatal Esophagectomy (LTS) with cervical incision or the laparoscopic gastric release with thoracoscopic esophageal release. From July 2011 to September 2012، we started to implement the distal esophageal cancer surgery with LTS method in those who had no metastasis or adhesion bound with no contraindications for surgery، and then we analyze the collected data. 7 men and 4 women were operated. The mean age of study was 65. 7±9. 1 years. The mean of operative time was 40±154 minutes. The mean postoperative intensive care unit stay and total hospital stay were 2. 72±1. 95 days and 10. 55± 4. 80 days، respectively. The cervical anastomosis (n=1) and post-operative pneumonia was the complication of this study; both of them managed medically. Oral feeding was started on third postoperative day in all of our cases. No mortality was observed. Short-term results of our first series of LTS were comparable with previous reports.

Aging، as a main period of life، is faced with many physiological and psychological problems such as malnutrition and depression. Some evidences manifested that malnutrition and depression could affect each other. Considering the lack of studies in this field in our region، this study designed to determine the nutritional status and its relation with depression in the free-living elderly individuals. This cross-sectional study was carried on 184 elderly people (male=97; female=87) with the age ≥ 60 years. All subjects were selected from daily care centers for elderly people in Tabriz city. Mini Nutritional Assessment (MNA) and Geriatric Depression Score (GDS) were used to evaluate the nutritional status and depression prevalence، respectively. More than 50% of subjects had inappropriate nutrition status (6. 2% undernourished and 46. 7% at risk of malnutrition). Prevalence of malnutrition in females was 5-fold more than males. The results of GDS test revealed that about 14% of elderly people had serve depression and 28. 3% had mild depression. There was a significant positive correlation between MNA and GDS tests in both gender (r=0. 42; p<0. 001) and this correlation were stronger in females. Nutritional and mental statuses of free-living elderly individuals were not in acceptable level. Therefore، it seems to be necessary that health professionals should consider these problems for promotion the quality of life for elderly as a priority.

There are several studies conducted to investigate the pathogenesis of diabetic nephropathy، but the obtained results are controversial. It remains one of the most important reasons of mortality in diabetic subjects. Previous researches have indicated that cyclooxygenase 2 (COX2) has an important role in the pathogenesis of diabetic nephropathy. Additionally resveratrol is an herbal polyphenol and it has been beneficial anti-inflammatory effects during short-term administration. This study aimed to investigate the efficacy of long-term resveratrol administration on the activity of COX1، COX2 and nuclear factor kappa B (NF-κB) in diabetic Rats. Twenty four male Wistar rats (320-340 g) were randomly divided into four groups (n=6 for each group): normal control، diabetic control، normal rats treated with resveratrol، and diabetic rats treated with resveratrol. Diabetes was induced by injection of streptozotocin (50 mg/kg; i. p.)، 15 min after the prescription of nicotinamide (110 mg/kg; i. p.) and resveratrol (5 mg/kg/day) was gavaged for four months. At the end of protocol، blood glucose، insulin، urea and creatinine as well as the activity of renal COX1، COX2 and NF-κB were measured. Four-month resveratrol administrations significantly attenuated the enhancement of blood glucose، urea and kidney to body weight ratio in diabetic rats (p <0. 05 for all). Moreover، long-term resveratrol administration to diabetic rats reduced renal COX2 and NF-κB activities. Since the efficient control of blood glucose has a key role in preventing of diabetes complications and in regard to the anti-inflammatory effects of resveratrol in kidneys. It could be considered as a supplementation in preventing of diabetes renal complications.

Backgrounds and Different drugs have been used in acne vulgaris treatment but their effectiveness are not well known yet. Current study was aimed to evaluate therapeutic effects of doxycycline and zinc sulfate in acne treatment. In a double-blind randomized clinical trial study، 78 patients with mild to moderate acne vulgaris were divided in two groups: A) receiving 100 mg doxycycline daily، and B) receiving 30 mg elemental zinc. All patients received similar topical antibiotic. Inflammatory and non-inflammatory lesions score، side effects، serum zinc levels and patients’ satisfaction of therapies during study were evaluated between groups at beginning of trial، 4th، 8th and 12th weeks. Changes in mean inflammatory and non-inflammatory lesions score was statistically different in each group، but the difference between groups was not significant. Reduction in total lesion score was significantly higher in group A comparing with group B (p<0. 001). Patients’ satisfaction rate in group A group was higher than group B. Complication rate was significantly higher in doxycycline group than zinc sulfate group at the 8th week (p=0. 04). The serum zinc level change was not significant in each group، but the difference between groups was significant (p=0. 03). Oral zinc and doxycycline both are effective and recommended for treating the acne vulgaris.

According to the widespread prevalence of methicillin resistant Staphylococcus Aureus (SA). The glycopeptide vancomycine is the only uniformly effective therapy for infection. Importance of vancomycine antibiogram in treatment of Methicillin Resistant Staphylococcus Aureus (MRSA) needs to be evaluated. This study investigated prevalence of S. A resistance to vancomycin. All samples which submitted for culture during 6years period (2006-2012) were selected and cultured on Mac-Conkey and Blood Agars، and differential media. After the diagnosis and isolation of Staphylococcus aureus، antibiogram profile of the bacteria was determined by disk-diffusion test (Kirby-Bauer) and interpreted according to CLSI standards. Of 5736 samples of Staphylococcus، 3987 (%69. 5) specimens were positive for S. A. 3897 (%68. 1) strains of S. A were isolated from urine and 966 (%16. 9) were isolated from blood، and oters from wound، throat، sputum and etc. Antibiotic susceptibility results reveal that the prevalence was %4. 8. The antimicrobial susceptibility test of SA may defer by geographic regions. In this study، the prevalence of vancomycin resistant strains is increasing gradually and due to importance of vancomycin antibiogram in treatment of MRSA، more attentions and studies are recommended.

Diarrhea is one of the most important causes of children mortality in developing countries. Gastroenteritis causes mortality in children younger than five years old annually; meanwhile، Yersinia species are one of the main agents causing diarrhea. In this study the effect of temperature on invasive property of Yersinia species were investigated by using HEP-2 cell culture. In total 50 Yersinia species from French and Iranian surceases including Yersinia enterocolitica (n=30)، Yersinia intermedia (n=14)، Yersinia frederiksenii (n=2)، Yersinia kristensenii (n=1) and Yersinia aldovae (n=1)، were used. The activity of mentioned Yersinia species was determined on HEP-2 cells at 22C and 37 C، by using HEP-2 cell culture. Only 10 tested Yersinia species were showed property invasive at 22C. and Yersinia enterocolitica was the most invasive strain (20%). The results showed that environmental species are also capable of causing diseases. The comparison results، of isolates from French with Iran، showed that in general European isolates were more virulent than Iranian isolates. In addition the environmental species of Iran were not capable of causing diseases. The antibiotic susceptibility testing of isolates showed that nearly 88% of all isolates were sensitive to tested antibiotics، regardless of isolate sources Environmental species are capable of having invasive property which is temperature dependent.

Backgrounds and In the past decade، survival rate of Very Low Birth Weight (VLBW) neonates increased dramatically due to the advances in pre and post natal cares. On the other hand، high birth and survival rate of VLBW neonates has made some difficulties in post natal growth evaluation. This study was aimed to evaluate the growth parameters in VLBW infants at the chronological of 36 months. This cross-sectional study was carried out in Alzahra teaching Hospital Tabriz. IRAN on VLBW infants at their chronological age of 36 months. National center for Health Statistics (NCHS) curves were used for evaluation of growth parameters. 55 girls and 55 boys with mean birth weight of 1218 grams (720-1500 grams) were recruited. 18% of studied subjects had length and 24% had weight and head circumference below third percentile. About one-fourth of VLBW infants don’t reach above the third percentile in growth parameters at chronological age of 36 month.

Backgrounds and Short stature is one of the most common problems in pediatric endocrine medicin. Meanwhile، celiac disease is one of the well-known causes for short stature. Since bread is rich in Gliadin protein and it is one of the most common foods in our society، we designed this study to evaluate the frequency of celiac disease in idiopathic short stature children without gastrointestinal symptoms in north - west of Iran. In this descriptive analytic study we studied 200 children younger than 12 years old with short stature and without gastrointestinal symptoms were studied. Total serum IgA، IgA and IgG anti-tissuetransglutaminase (TTG) antibodies، IgA and IgG anti-endomysial (EMA) antibodies were measured. Cases with the serum level of the antibodies more than 20 IU/ml underwent، intestinal biopsy was performed to confirm the celiac disease existence. A total of 200 children (93 boys and 107 girls) were studied. Anti EMA in 2 cases (1%)، anti TTG in 6 cases (3%) and both antibody was positive in 8 cases (%4). Characteristic histological changes were compatible with celiac disease in 5 cases (2. 5 %). There was no significant difference in comparison of chronological age، bone age، height z-score، and weight، height growth velocity between children with and without celiac disease. 2. 5% of short stature children had celiac disease which was significantly higher than normal population. So it is important to evaluate the celiac disease in short stature children with no gastrointestinal symptoms.

Backgrounds and The Whole Body Vibration (WBV) training has been considered as a training tool for the athletes، non-athletes، elderly individuals. The aim of this study was to determine the effect of WBV training on electromyography indexes of knee extensor muscles in non-athletic girls. Twelve non-athletic student girls randomized into experimental (n=10) and control (n=10) groups. Amplitude and frequency of electrical waves related to right feet knee extensor muscles was measured in a Maximal Voluntary Isometric Contraction (MVC)، one day before and after WBV training. The vibration group was treated for 4 weeks (3 times/ week) with 30 HZ frequency، 2. 5 mm amplitude and in 5 situations of squat (knee 900، 1200، 1800، right feet and left feet). The time of each training set was 30 seconds followed by a 20 seconds as rest time between each set. There was no significant differences in amplitude and frequency of electrical waves of rectus femoris، vastus lateralis، vastus medialis muscles between both groups in pre- and post-tests (p>0. 05). The significant differences was found in amplitude and frequency of electrical waves of rectus femoris، vastus lateralis، vastus medialis muscles in experimental group in pre- and post-tests (p<0. 05). WBV training may affect the electromyography indexes of knee extensor muscles in non-athletic girls.

Backgrounds and The deformity of the knee associated with osteoarthritis (OA) is a common complaint in orthopedic operation. High Tibial Osteotomy (HTO) is a well known procedure in medial knee osteoarthritis with varus deformity therapy. The aim of this study was to evaluate the possible risk factors affecting the results of surgery. In this Cohort study، 25 patients with genu varus deformity and osteoarthritis were studied. Clinical outcome of patients were determined based on Knee Society Score (KSS). According to the KSS grading، there were 17 (68%) excellent or good clinical outcome and 8 (32%) fair or weak outcome. There were not significant differences between two type of clinical outcomes in smoking، tibial plateu fracture، lateral cortex fracture and miniscal injury. But، patient’s age، degree of genu varum، BMI and duration of osteoarthritis were differed significantly between two groups. According to the Logistic regression model there were significant effects of variable including BMI، duration and severity of osteoarthritis and degree of genu varoom in determination of clinical outcome. Open wedge HTO had good or excellent results in most of patients. Factors like BMI and severity of osteoarthritis and Genu Varum will be likely to affect patient outcome.

Backgrounds and Vesicoureteral reflux incidence and indications for imaging survey had been investigated by many studies for many years but the obtained results are controversial. This study was aimed to evaluate this issue in our region. In this prospective study، 125 patients with urinary tract infection were eligible for inclusion، all were febrile (central temperature above 38. 3 °C) with positive urine culture، after urine were sterile imaging study include voiding cystogram has been done. The severity of reflux was categorized in five grades. all information include age and sex were recorded and analyzed. Of total 125 patients (80 female 45 male) aged between 2 and 96 months with urinary tract infection، vesicoureteral reflux was detected in 55 cases (44%). Reflux occurred in male more than female (49% vs 39%). The incidence of reflux in aged under one years old was similar in female and male (50% in both roughly). Urinary tract infection occurs more frequently in female comparing with male (1. 7 times). the incidence of reflux was more common in male than female total (39% vs 49%) but the incidence of urinary reflux was same as much as 50% following upper urinary tract infection in age under one years old in both gender.

The tissue engineering with possible opportunity for repairing، replacing، maintaining، or improving the function of damaged tissue or organ had made a promising approach for treating human life quality. Nano-fibrous electrospun substrates which provide three dimensional substrate can mimic the extra cellular matrix to support the growth of cells. Combination of natural and synthetic polymers improves the strong signaling pathways and also proper cell behavior on the scaffold. In this study nano fibers were prepared with gelatin، PLGA and Gelatin/PLGA via electrospinning; and the cell growth and proliferation of fibroblast L929 on these scaffolds were evaluated. Gelatin was used to improve the biological property of the PLGA nanofibers. After making the Nano-fibers the SEM was used to take some to take some photos، then growth of fibroblast cells was analyzed using the SEM and reverse microscopics. Microscopic images showed that the first 24 hours of cell culture، cells behaved similarly in the three scaffolds but After 72 hours; the Gt/PLGA nanofibers provided a better substrate for adhesion and proliferation. While gelatin Nano-fibers had less growth rate after 72 hours. Also these results were confirmed by SEM. PLGA/Gt nanofiber due to activation of signaling pathways relevant in adhesion protein expression and replication are suitable for tissue engineering. This behavior may be very similar to the natural structure of the extracellular matrix.

Strongyloides stercoralis is a human’s intestinal nematode with global expansion. This parasite is common in tropical and subtropical regions. The 11-year-old male patient from Miyandoab with 39 °C fever referred to Tabriz Children Hospital، Tabriz، Iran، and admitted with the acute myeloid leukemia Tcell type cramping abdominal pain and severe diarrhea associated with cervical lymphadenopathy. Patient was undergoing to induction therapy with Prednisolone، Vincristin، Daunoru-Bicin، and L-Asparginase. Due to severe diarrhea and dehydration، it was conducted stool examination and detected Strongyloides stercoralis rhabditiform larvae. The patient were treated with Albendazol and serum therapy.