مجله مطالعات علوم پزشکی
سال بیست و پنجم شماره 2 (اردیبهشت 1393)

Pseudomonas aeruginosa is an opportunistic bacterium that is intrinsically resistant to different antimicrobial substances. One reason for this resistance is the expression of multiple drug efflux pumps, such as MexAB-OprM. Analysis of expression of the MexAB–OprM pump such as mexA with RT-PCR especially with commercial kit can largely aid in selection of suitable antibiotic treatment. Thus, the aim of this investigation was to study the expression of mexA and oprM genes using RT-PCR in clinical isolates. Following the extraction of RNA from 17 clinical isolates and synthesis of cDNA, the relative quantification of mexA and oprM genes were determined by RT- PCR with and without commercial kit, respectively. Over-expression of both mexA and oprM genes were seen in eight clinical isolates. This over-expression corresponded to 2-4 fold increase in MIC for carbenicillin.. The convergence between results obtained from using and not using the kit. Moreover, the convergence between only MIC for carbenicillin among several antibiotics used in phenotypic method and the expression of MexAB-OprM pump was found in all clinical isolates. Therefore, the application of phenotypic method and analysis of gene expression using RT- PCR with commercial kit, due to its ease of working, simultaneously is recommended.

Stroke is a clinical syndrome characterized by focal neurologic deficits. It is classified as one of the most important causes of impairment. Stroke has a critically impairing effect on the life quality of patients. Considering the importance of the problem and its treatment, we aimed to study the effects of sertraline on reducing the disabilities in stroke. This double blind control trial study was conducted on 67 patients (completers: N=67, Mean age 65.27 ± 6.17) who were selected randomly and were assigned to receive 9 months of treatment with either sertraline or placebo. The intervention group consisted of 40 patients from which three (7.5%) patients failed to be followed up because of the depression. The control group consisted of 40 patients and 11 (27.5%) were excluded during the study because of depression. There was a significant difference between the two groups regarding their sleep, social isolation, physical ability, emotional reaction and energy level, but the difference was not significant in pain scale. S ertraline could positively affect stroke patients in preventing several scales of quality of life, health profile and depression.

Onychomycosis is caused by dermatophytes, yeasts, and molds. The term onychomycosis refers to nail infections caused by dermatophyte and non-dermatophyte fungi. The aim of this study was diagnosis of onychomycosis agents and also comparison of the accuracy and sensitivity of PCR to conventional methods such as direct examination and culture. Our descriptive-experimental research is based on the usage of standard solid and liquid cultures of Trichophyton, Candida and Aspergillus for molecular testing on clinical specimens from patients. Universal fungal primers (ITS1 & ITS4) and specific Trichophyton rubrum primers (T-rub) were applied in this experiment. For the first time in Iran using an innovative protocol, direct DNA extraction and PCR confirmation of mediums mentioned above was performed in two hours. Furthermore, better sensitivity and precision of PCR rather than routine laboratory results such as direct examination and culture have been proved. Due to the high speed and precision of PCR method, it can be a convenient alternative for conventional methods such as direct examination and culture on clinical samples of onychomycosis.

Blastocystis hominis is one of the most common intestinal protozoan parasites in human and various animals which has a worldwide distribution and is often isolated from fecal samples in the parasitology laboratory. Given the relatively high prevalence and emphasis on pathogenic of Blastocystis hominis especially in immunocompromised patients in recent studies, this study was performed to investigate the prevalence of Blastocystis hominis in Tabriz in 2009-2010. In this descriptive cross-sectional study, the sample size was calculated 558 samples based on a statistical formula. stool samples from each of the cases were examined 3 times using direct examination with saline and lugol, staining with trichrome and formalin-ethyl acetate concentration method. A total of 558 cases, 146 (%26.17) had Blastocystis hominis positive and 412 (%73.83) had negative. The most common symptoms in cases that showed only Blastocystis hominis were abdominal pain (49.4%), anorexia (35.8%) and nausea (33%). Accordingly, Blastocystis hominis infection was the most common parasitic infection that in case of neglect can cause many problems for patients. Therefore, the use of appropriate diagnostic laboratory procedures in hospitals and medical centers can provide effective and accurate diagnosis that it will play an important role in the promotion of community health.

The aim of the present study was to evaluate the protective effects of turmeric on intestinal damage and oxidative stress induced by Methotrexate. For this purpose, male rats were divided into 6 groups. Group I received normal saline orally. Group II received single dose of methoterxate (20 mgkg -1) IP at day of 30, the fifth and the sixth groups received turmeric extract received different dose of turmeric and single dose of methoterxate (MTX). Four days after MTX injection blood samples were taken to evaluation the total antioxidant status and jejunum samples were taken to determine antioxidant enzyme activities, aldehyde malondialdehyde (MDA), and histopathological assessment. The histopathology analysis showed that the mean difference between groups II received single dose of methotrexate and groups V and VI received methotrexate plus turmeric. There are epithelial cells necrosis, inflammatory cells, blunting and villus shortening in second group. However in groups V and VI have been shown to be ameliorated and decreased in pathologic results, especially in group VI. Biochemical result shown that the levels of superoxidase dismutase, glutathione peroxidase and catalase reduced in group II, but increased significantly (P< 0.05) in turmeric + MTX groups. MTX increased lipid peroxidation; however, turmeric decreased peroxidation significantly (P<0.05). These results revealed that turmeric extract by its antioxidant properties may protect the intestinal methotrexate-induced damage in rats.

Dizziness, vertigo and imbalance are common complains in patients referring to neurological clinics. In this article we are to find the factors related to secondary vertigo due to vascular causes verified with Brain-MRI (DWI). This study was conducted on 119 patients who were categorized into positive and negative groups for acute cerebrovascular causes of vertigo according to the result of their MRI (DWI) imaging. Comparing patients with normal and abnormal MRI, there was no significant difference in sex (p=0.49), age(p=0.08), history of tobacco usage(p=0.20), hyperlipidemia (p=0.46), diabetes mellitus (p=0.77), hypertension(p=0.13), ischemic heart disease (p=0.90), atrial fibrillation (p=0.33) and ischemic strokes (p=0.33). In physical examinations the difference in hearing loss (p=0.28), tinnitus(p=0.22), vomiting(p=0.63), abnormal gait (p=0.28), and positive head thrust test (p=0.37) was not significant in both groups but there was a significant difference in presence of Babinski sign (p=0.03), headaches (p=0.025), cranial nerve abnormalities (p=0.01), change in severity of vertigo with position (p<0.001), nistagmus (p=0.01) and abnormal finger to nose tests (p<0.001) in the groups. The results show that in patients with focal neurological deficits, headache and nistagmus vertigo is more likely due to central nerve system. Increase in vertigo in lying position can be a sign for peripheral causes but if vertigo increases in sitting positions, it is more likely caused by central system.

Backgrounds & The latest national research achievements studying on Iranian households in 1998-2000 implies that milk and other dairy products are consumed less than the recommended proportions. This research was designed to study the amount of milk consumption and related factors in West Azarbaijan in 2012-2013. In this cross sectional study, the data were collected by interviews with 650 households selected from three cities (Urmia, Mahabad, Khoy) and 9 rural areas of West Azarbaijan province by cluster systematic method. Demographic status and milk consumption of the households were completed by mothers. The data were analyzed with Chi‑square, t‑test, Anova with MS Access and SPSS software. The results indicated that 67% of the households were Azari, 32% Kurdish and only 1% were from other ethnicities. Highest level of education in household's head was elementary or junior high school and their occupations were independent workers. Results implied that each person consumes approximately half of the glass of milk (118 ml). The most widely consumed milk in urban and rural households was bulk milk (62.5%) whose average consumption was 478.6±22.6 ml in urban and 730.4 ± 64.4 ml in rural areas weekly. Milk consumption in Azari households was higher than other ethnicities (P< 0.05). Results indicated that urban households obtain more subsidized milk (55%) than rural (20%). After cutting the subsidies by the government in 2010, purchasing milk in urban was decreased to half while in rural it was substituted with bulk milk and not changed. Most consumed milk in households in West Azarbaijan province was cow bulk milk and their consumption was lower than the suggested amount (2-3 glasses a day). The most important factors in milk consumption were residency location, ethnicity, and socio-economic status. Designing and running policies in practical approach to increase milk consumption seems necessary and must be more considered. Solving milk contribution issues and culturalizing the community by media should be in high priorities.

visfatin is a protein with insulin-like functions that secretes from adipose tissue and has been linked to obesity and insulin resistance, but the effect of exercise training on visfatin levels is unknown. The purpose of study was to compare the effect of aerobic and resistance training on plasma visfatin levels in type 2 diabetic women. 45 women with type 2 diabetes were selected by purposive sampling and subjects were randomly assigned in 3 groups.15 subject participated in an aerobic training (3 days/week, 20-50 min/day, 60-80% maximum heart rate), 15 subject participated in a resistance training (3days/week, 60 min/day,3 sets of 10 repetition,50-65% 1RM), and 15 subject were in control group who did not participate in any exercise program during the study periode. blood samples were collected for assess plasma visfatin, insulin, HbA1c and glucose levels before anf after 12 weeks of the training program and insulin resistance was calculated with HOMA-IR equation. Data analysis showed that aerobic training leads to significant decrease in visfatin concentration (p=0/04), whereas resistance training enhanced visfatin concentration (p=0/13). Also there was a significant decrease in glucose, HbA1c, insulin resistance, body mass index, waist-hip ratio and %body fat in experimental groups as compared with control group (p≤0/05). The aerobic exercise training-induced reduction of plasma visfatin is most likely the result of decrease in Anhtropometric and Glycemic indices and nonsignificant enhance insulin levels in type 2 diabetes women.

It is known that Hertwig's epithelial root sheath and stem cells of apical papilla (SCAP) can organize the odontoblast cells under favorable conditions resulting in continued formation of the root even after the pulp is necrotic. The aim of this case report was to demonstrate the continued development of the roots of an immature permanent tooth with necrotic pulp subsequent to conservative root canal treatment.Case report: The patient was an 8-year-old healthy boy with a severe carious lesion in the lower left first molar tooth with an immature root. The tooth underwent a conservative treatment approach, i.e. minimal filling with (k-files: stainless steel, Mani- Japan) and copious 2.5% NaOCl irrigation and then was medicated with calcium hydroxide (U.S.P. Sultan-USA). In this case, after one year developed mature apices was observed without any complication. It is hoped that in the future, regeneration and stimulation of normal continued root development in necrotic immature teeth will replace apexification. Procedures and much fewer cases of cervical fractures of the crown and root and improper root/crown ratios will be encountered.

Intrapericardial immature teratoma is a rare, primary cardiac tumor that often causes symptoms through pressure on the structures of the cardiovascular and/or respiratory system and can potentially be fatal. Immature teratoma has the potential to be malignant.Case Report: The patient was a three-day old term male neonate that was admitted in neonatal ICU due to respiratory distress. The neonate had tachypnea (RR>55/min), tachycardia (HR>170/min) and weak pulses. Echocardiography showed massive pericardial effusion and a large capsulated multi-cystic, fluid filled lesions on the anterior of the heart which was pressing on the right atrium and right ventricle. Chest CT scan confirmed echocardiographic findings. The baby emergently was referred for cardiac surgery and the tumor was successfully removed. Histopathologic report of tumor was immature teratoma grade I. The postoperative course was uneventful and one year later in outpatient follow up the infant showed normal development and normal echocardiogram and had no evidence of tumor relapse. Intrapericardial immature teratoma with massive effusion can cause tamponade in early days of life. Early cardiac surgery is life saving. These tumors are surgically respectable. Immature teratoma has the potential to be malignant, but in this case which was screened regularly every two months with serum FTP, LDH and HCG levels, echocardiography and chest CT scan, there were no signs of metastasis six months after operation.