مجله پزشکی دانشگاه علوم پزشکی تبریز
سال سی و هشتم شماره 1 (پیاپی 121، فروردین و اردیبهشت 1395)

Most people fail to have necessary dental care because theyre anxious to go to the dentist due to lack of the knowledge about dental procedures .The aim of this study was to evaluate the effect of verbal explanation in reduction of dental stress before third molar operation.
This study designed as controlled clinical trial. Totally 60 patients selected from those referred to the oral and maxillofacial surgery department, dental faculty of Tabriz. After verbal expranation, the questionnaire consisted of demographic characteristics (age, education, life status, number of dental visits before surgery) and mean of pain according to visual analogue scale (VAS) was recorded. Data were analyzed by descriptive statistics (mean ± SD), T-test and chi-square test by using SPSS.20 (P Based on VAS scale, the mean of stress in control group was higher than test group (5.91vs. 4.22 before surgery) and (5.61 vs. 3.115 after surgery) (P Verbal explanation can reduce the stress level in patients undergoing third molar operation.

Many studies have shown that the exercise has preventive effects on breast cancer. The objective of this study was assessment the effects of prophylactic and adjuvant therapy of endurance training on tissue IL-6 levels in mice with breast cancer.
Material and Forty female Balb/C mice were randomly assigned to Exercise-Tumor-Exercise (ETE), Exercise-Tumor-Rest (ETR), Rest-Tumor-Exercise (RTE) and Rest-Tumor-Rest (RTR) groups. After adaptation in the environment, two groups of mice performed continuous endurance training (8 weeks; %55-85 VO2max), and cancer cells were injected to all of them. Then, one group of trained and one group of non-trained mice continued the endurance training (6 weeks; %55-70 VO2max). Tumor volume was measured by a digital caliper weekly. Finally, the mice were sacrificed, tumor sample was homogenized and levels of IL-6 were measured by ELISA method.
There was significant difference (P=0.0001) in the IL-6 level among the groups performed endurance exercise after malignancy (RTE and ETE) and groups not performed (ETR and RTR). These results had with tumor growth rate (P=0.0001).
Intratumoral inflammation reaction leads to the progression and metastasis of cancer cells and the decrease of tumor volume in exercise groups is related to the decrease of inflammatory mediators such as IL-6. Finally the endurance training can be effective as a non-pharmaceutical method in prophylaxis and adjuvant therapy of breast cancer.

Coexistence of Familial Mediterranean Fever (FMF) with various systemic vasculitides, such as Henoch Schonlein Purpura (HSP) and other inflammatory disorders has been reported and MEFV gene has been suggested to play a significant role in the pathogenesis of this association. In this study, the rare MEFV mutations in patients with HSP from north west of country and its association with clinical symptoms of disease were evaluated.
Material and Forty unrelated patients were referred by specialists to the Molecular Medical Genetic Center of Tabriz. Clinical diagnosis of HSP was made according to published criteria. The control group consists of 200 ethnically matched persons apparently healthy without any kind of inflammatory diseases. Screening for the 3 mutations; R761H, P396S and R408Q were performed by using amplification refractory mutation system polymerase chain reaction (ARMS-PCR) and polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). X2 test and Fisher's exact test were used to statistical analysis.
Of 40 patients studied, 37 (92.5%) showed without mutation, while 3 (7.5%) had MEFV mutation that three of them were compound heterozygous for the P396S/R408Q mutations. There was a statistically significant difference between the patient group and healthy individuals regarding P396S and R408Q mutations (p = 0.0043). Findings suggest that P369S and R408Q mutations always together occurred and not only contribute to the susceptibility to HSP, also associated with clinical symptom of fever.
Our results suggest that some MEFV mutations could be a contributory genetic factor to HSP in the north west of the country.

Dexamethsone is one of the widely used glococorticoids that prescribe in many situations such as pregnancies that are prone to preterm delivery, so this study was conducted to investigate the effect of prenatal dexamethasone administration on the function of pituitary-gonadal axis and secretary function of testis of offspring of rats.
Material and In this study, 40 pregnant rats were divided into control group, sham group, and 3 experimental groups that receiving 0.5, 1, and 2 mg/kg doses of dexamethasone administered from the eighth day until the end of pregnancy Quaqu on day (QOD). After delivery, neonates and mothers received no treatment and after puberty, sampling from the heart and testis of male children was done, then plasma levels of testosterone,FSH, LH and the number of spermatogony, spermatocyte, spermatid, sertoli and leydig cells were determined. Results were analysed with the SPSS-20 and ANOVA and Duncan test (p≤0.5).
Results of this study revealed that, dexamethson administration leads to increase of FSH and, LH levels and decrease of testosterone levels and number of spermatogony, spermatocyte, spermatid and leydig cells.
Dexamethasone causes permanent disorders in reproductive system of male rats by inhibiting mitosis activity, increasing putative gonadotropin inhibitory hormone and impairing fetal testise development.

Hepatitis E is usually self-limited, but may be associated with high mortality in some situations. Hepatitis E virus (HEV) has a fecal-oral transmission cycle and is transmitted through environmental contamination, mainly water. Previous studies have shown that, HEV is responsible for more than 50% of acute hepatitis cases in young patients in developing countries. This study was aimed to determine the prevalence of anti-HEV antibodies among pediatric patients in Tabriz Children Hospital
The study was a cross sectional and descriptive-analytical survey on the children who had been referred to clinic of Tabriz children hospital. For each patient, demographic data including age, sex, area of residence, method of sewage and waste disposal and type of water supply, history of animal contact, history of surgery, blood transfusion and parent's addiction were recorded in questionnaires. Serum levels of specific anti-HEV IgG antibody were measured. The relationship between seropositivity and demographic characteristics was investigated.
A total of 252 children aged 2-16 years were studied. In 9 patients (3.6%), the sample was positive for anti-HEV IgG antibody consisting of 5 boys (2%) and 4 girls (1.6%). There was no significant statistic relationship between our demographic characteristics and seropositivity.
This study revealed 3.6% seropositivity for anti HEV antibody in children living in Tabriz. According to the present study, the prevalence of HEV is considerable in Iran. Thus HEV study is strongly recommended in the approach to all clinical hepatitis cases.

Infection is the major cause of death in burn injuries. There are several reasons which make burn victims susceptible to infection. Current study aimed to investigate the effects of different facts on bacteremia occurrence in burn patients.
This descriptive analytic study conducted in year 2013 and 486 burn patients which admitted to educational-clinical centers of northwest Iran, were included. Patients’ data including age, sex, lesion color, and percentage of burn were collected. Then we documented all interventions, blood tests and cultures and recorded colonies data.
In this study, 234 (48.1%) was male and 252 (51.9%) was female included with mean age 31.28±12.87 and bacteremia occurred in 51 patients .The most common wound infection agent was Klebsiella and the most common agent of bacteremia was Pseudomonas. In patients with extensive burn area, bacteremia and mortality occurred commonly (p=0.01, p=0.02). According to relationship between mortality rate and bacteremia, in group of bacteremia, the mortality rate was more (P=0.03) and central venous catheter increased the tate of bacteremia (p=0.002).The relationship between age and sex with bacteremia and mortality was not significant and in this research, the color of burn wound had no association with wound infection.
Klebsiella is the most common wound infection agent and Pseudomonas is the most common agent of bacteremia. Mortality rate is in a direct relation with bacteremia and then by widening of burn area, respectively. Invasive interventions, increase the bacteremia susceptibility and mortality rate in burn wards.

Although the etiology of multiple sclerosis (MS) - a chronic autoimmune disease of the central nervous system – has not been well understood, the role of environmental factors, particularly the lack of vitamin D has recently been considered. Therefore, this study was aimed to compare the intake of food containing vitamin D between the MS patients and healthy individuals.
This case - control study was carried out on 168 MS patients randomly selected from MS Society of East Azerbaijan province in Tabriz and 168 age and sex - matched apparently healthy individuals from relatives of the MS subjects or healthy volunteers in December 2012 -March 2013. Data regarding the consumption of food containing vitamin D, were obtained through completing a semi quantitative food frequency questionnaire and face-to-face 3-day food records by a trained interviewer.
Although the weekly frequency consumption of fat group did not show any significant differences between the groups, weekly frequency consumption of meat group, dairy products and miscellaneous foods such as hamburgers, bolognia, sausages, and fresh mushrooms in healthy volunteers were significantly higher than MS patients (P Our findings indicate the inadequacy of consumption of vitamin D containing foods among MS patients which probably reveal the necessity of nutrition education and vitamin D supplementation in MS.

According to the prevalence of obesity and its complications in Iran and worldwide, the cognition of effective methods that reduce the risk factors and implications in obese persons can have significant clinical appliances. Hence, the aim of this study was to determine the effects of 12 weeks of regular resistance exercise training on plasma levels of ghrelin in the obese men.
Material and Twenty obese men (BMI≥ 30, 18-32 years)) were selected and randomly divided in to the two resistance training (n=10) and control (n=10) groups. Resistance training was performed three times a week on alternate days for 12 weeks and included 8 exercises. At baseline and after last training session, blood samples were taken in 12-14 hours fasting state from all subjects and ghrelin plasma levels before and after the protocol were measured. The paired and unpaired t-tests were used for statistical analysis P value Compared to pre-training, after 12 weeks of regular exercise training, the plasma ghrelin levels significantly increased (P0.05).
The results of this study indicated that the long term exercise training significantly increases the ghrelin plasma levels. Hence, it is recommended that this type of training can be used as an effective and low-cost therapeutic method to control the body composition in the obese men.

Antibiotic resistance is one of the most problems in microbial infection control. Production of β-lactamases can lead to resistance against the third generation cephalosporins and carbapenems. This study was conducted to evaluate the antibiotic sensitivity profiles and the presence of blaIMP gene in Escherichia coli isolates, collected from clinical specimens in educational hospitals of Imam Reza and Shohada in Tabriz.
In this study 100 Escherichia coli were isolated. These isolates collected from patients in educational hospital (Imam Reza and Shohada). They were identified by using conventional bacteriologic tests. Antimicrobial susceptibility test was performed according to Kirby- Bauer method. Confirmatory test for production of metallo- β-lactamase was also performed by using Modified Hodge test (MHT). blaIMP gene was detected by using PCR technique.
Results of antibiotic susceptibility tests revealed that the resistance rate against imipenem, meropenem, ertapenem, gentamycin, ciprofloxacin, ceftazidime, nalidixic acid, ceftriaxone and cefepime were 3%, 3%,4%, 44%, 69%, 64%, 79%, 68% and 53%, respectively. Result of MHT test revealed that 3% (3) isolates were metallo-β-lactamase producers. PCR amplification revealed that 5% (5) of isolates carried blaIMP gene.
According to the more than 60% resistance of isolates from medical educational centers to the third generation cephalosporins and fluoroquinolone. In this study, we pose a consumption of carbapenemes as an alternative for serious bacterial infections. Even limited carbapenemase inducing resistance must raise awareness among hospital infectious control staff.

Trauma is known as one of the most cause of mortality. Face is directly exposed to the various injuries of its soft tissue and bones structures. The aim of this study was the evaluation of etiology of mid faces fractures in patients.
Material and This research designed as a cross-sectional study and 64 patients which were referred to the department of Oral and Maxillofacial Surgery of Imam Reza teaching hospital were selected. All data were recorded in the special forms as retrospective manner. Data included age, gender, treatment type and symptoms of the trauma. Results were analyzed by descriptive statistics (mean and standard deviation and percent -frequency).
Among 64 patients, 51.6% of fractures were related to the accidents. 87.5% of the patients were male in which most fractures occurred at mean age of 32.2±13.8 with frequency of 35.9%. Most of the fractures happened in spring and summer.
The most common injured site was zygoma bone with the frequency of 87/5%.

One of the most common postural abnormalities which is seen in 60 percent of patients with neck and shoulder disorders is Forward head posture. The purpose of current study was the comparison of contribution ratio in scapular rotator muscles over dominant and non-dominant arm abduction on loading in women with and without Forward Head Posture.
In this case-control study 18 women with Forward Head Posture and 14 healthy women were studied. The subjects were matched based on weight, height, age, dominance of upper extremity and voluntarily participated. The contribution ratio of Serratus Anterior, Upper and Lower Trapezius muscles were recorded by surface electrodes during arm abduction with loading.
The independent t-test results revealed that the upper trapezius muscle activity ratio of dominant arm in subjects with forward head posture is significantly greater than healthy ones (P= .011), whereas the significant difference was not revealed in non-dominant arm. There were also no significant differences in Serratus Anterior muscle (p>.05) and Lower Trapezius muscle (p>.05) ratio between the groups.
Because of the changes in contribution ratio of Upper Trapezius, a simple assessment of head posture through the shoulder muscles can provide useful information for the examiner to decide on prescription of corrective exercises for patient.

Vitamin-D receptor (VDR), plays a key role in the development of cardiovascular diseases in hemodialysis patients via the modulation of the serum levels of calcium and parathyroid hormone. In this study, we aimed to determine the genetic association of VDR gene polymorphisms with serum levels of vitamin D, parathyroid hormone and fetuin-A in hemodialysis patients.

Forty six hemodialysis patients and 43 control cases were studied. VDR Genotyping was determined by polymerase chain reaction-restriction fragment length polymorphism. The serum levels of iPTH, Fetuin-A and Vit D were measured by enzyme-linked immunosorbent assay.

There was no significant difference in the genotype frequencies between two study groups in both Fok І and Apa І polymorphisms (p=0.2). There was significant difference in serum iPTH levels in Fok І polymorphism (p=0.02) and Vit D levels in Apa І polymorphism (p=0.04). Although a significant positive correlation between iPTH and Vitamin D levels in aa genotype of patients (p=0.02, r=0.4) and Vit D and Fetuin-A levels in FF genotype of control group (p=0.001, r=1) was seen.

Polymorphisms of VDR gene Fok І and Apa І play a key role in the development of cardiovascular diseases in hemodialysis patients.