مجله پزشکی دانشگاه علوم پزشکی تبریز
سال سی و هشتم شماره 4 (پیاپی 124، مهر و آبان 1395)

Backgrounds and

Doppler waveform analysis of the umbilical artery is a powerful tool to evaluate probable pregnancy risks. So far, huge amounts of data on fetuses with three-vessel umbilical cords have been collected. Our objective was to evaluate the value of umbilical artery Doppler velocimetry in fetuses with single umbilical arteries. In this respect, two evaluation indices of the Pulsatility Index and the Systolic/Diastolic Ratio were considered.

Fetuses between 16 and 40 week gestational age were studied. A set of information was obtained from 50 cases with single umbilical arteries. Data were analyzed using chi-square (χ²) test. P-values less than 0.05 was considered significant.

The Systolic/Diastolic Ratio in the umbilical artery was abnormal in 29 fetuses (58%) and normal in 21 fetuses (42%). Pulsatility Index in the umbilical artery was abnormal in 28 fetuses (56%) and normal in 22 fetuses (44%). Fetuses with abnormal Doppler waveform analysis in their umbilical arteries were significantly more likely to be growth restricted (38%) and to more have complex malformations (18%) than those with normal Doppler waveform analysis.

Fetuses with single umbilical arteries and abnormal umbilical Doppler velocimetry had a significantly increased risk of adverse fetal and neonatal outcomes compared with those with single umbilical arteries but normal Doppler studies. When the fetus with isolated umbilical artery is the only observed fetus anomaly and the results of Doppler velocimetry are normal, it might be suggested that the risk of disorder in fetus is so low.

Backgrounds and

Methicillin-resistant Staphylococcus aureus is a cause of nosocomial infections leading to high mortality. Since these strains have become prevalent in the world, it is necessary to identify and type them.

This cross-sectional study was conducted to study a total of 1475 specimens collected from patients of Imam Reza and Sina hospitals of Tabriz in 2012-2013. Using phenotypic tests such as Gram stain, catalase, coagulase, DNase and mannitol fermentation 169 isolates of Staphylococcus aureus and by utilizing methicillin-resistance test 100 MRSA isolates were identified. SCCmec typing was performed by multiplex PCR method and the results were analyzed using chi-square tests using SPSS-18 software.

Disc agar diffusion test using cefoxitin disc (30 µg) showed methicillin resistance in 59% of our isolates. mecA and femB genes were identified in all of the MRSA isolates using PCR method. Frequency of SCCmec types and sub-types were as follow: SCCmecIII (77%), SCCmecI (5%), SCCmecIVa (1%), SCCmecIVc (1%), mixed isolates SCCmecIVc-III (1%) and Non typeable isolates (15%). Non typeable isolates recovered in two groups (10% without any band and 5% of multi-bands III-I). In this study, 82% of isolates were HA-MRSA, 3% were CA-MRSA and 15% were Non-typeable.

In our S. aureus isolates, the prevalence of methicillin resistance was 59%. The most frequent SCCmec type was SCCmecIII (77%). Our results demonstrated the spread of HA-MRSA isolates in the community and propagating CA-MRSA isolates in the studied hospitals.

Although several attempts have been made to decrease lipid profile through consumption of probiotic-containing products among pregnant women, limited data are available assessing the effects of synbiotic foods. This study was conducted to evaluate the effects of daily consumption of a synbiotic Gaz on blood lipid profile and biomarkers of oxidative stress including plasma total antioxidant capacity (TAC) and total glutathione (GSH) in pregnant women.

This randomized, double-blind, controlled clinical trial was performed on 52 primigravida pregnant women, aged 18-35 year old at their third trimester. After a 2 week run-in period, subjects were randomly assigned to consume either a synbiotic (n=26) or control food (n=26) for 9 weeks. The synbiotic Gaz consisted of a probiotic viable and heat-resistant Lactobacillus sporogenes (1×107 CFU) and 0.04 g inulin /g as the prebiotic. Patients were asked to consume the synbiotic and control Gaz twice a day. Biochemical measurements including blood lipid profile, plasma total antioxidant capacity (TAC) and total glutathione (GSH) were conducted before and after 9 weeks of intervention.

Consumption of synbiotic Gaz for 9 weeks resulted in a significant reduction in serum TAG (P=0.04), VLDL (P=0.04) and a significant rise in plasma GSH levels (P=0.004) compared to the control Gaz. No significant effect of the synbiotic Gaz consumption on serum TC, LDL, HDL or plasma TAC levels were observed.

Consumption of synbiotic Gaz for 9 weeks resulted in decreased serum triglycerides, VLDL-cholesterol and increased plasma total GSH levels compared with the control Gaz among pregnant women.

Backgrounds and

Rapid identification of Vibrio cholera is important in epidemics and bioterrorism wars. On the other hand, the conventional method is time consuming and costly. The aim of this study was to develop a rapid, inexpensive and high sensitive method based on magnetic nanoparticles for trapping bacterial DNA.

In this study, biotinalated probes were used for trapping Vibrio cholerae DNA. Finally designed primers were used to detect bacteria.

According to PCR identified results showed that only Vibrio cholera were identified, and; concluded that the biotinalated probe is specific for bacterium Vibrio choleraecholera.

According to the findings of this study, Sensitive and specific detection of the bacterium Vibrio cholerae is assessed and validated with this method efficiently. And in terms of time and at lowest costs are introduced an efficient method.

DWI is one of the useable sequences in MRI which currently being used in the assessment of vertebral column especially for malignant or benign causes. Considering that few studies have been performed regarding the use of DW sequences in spondylitis differentiating of disease with degenerative changes of vertebral yet; hence we intended to found the diagnostic value of DW sequence in spondylitis differentiating of infectious from degenerative changes of end plate type 1 with designing this study.

This study was carried out on patients who referred to the Pejvak MRI center with spondylitis lesions and osteochondrosis grade I, involving the vertebral column during 2012-2013; and to differentiate these lesions was used the T1, T2 and DWI sequences. Obtained results were analyzed by SPSSv16 statistical software.

In this study, in T1WI sequences the images of both groups was hyposignal and in T2WI sequences was hypersignal (p=0.01). In DW sequence with b value of 50, 400 and 800 (s/mm2) was observed that the signal changes in higher b value was apparent and in lower b value both detection had many similarities to each other due to the annoying effect of T2 Shine-through. As well as the mean of ADC map in spondylitisis images) 1.31 ± 0.24x 10-3 mm2/s (was less than osteochondrosis grade I with a mean ADC map (1.79 ± 0.24x 10-3 mm2/s) (P

The results of this study showed images with high b value could be having a good differentiation to distinguish the spondylitis from osteocondrosis.

In accordance with the limited studies on the effects of eendurance (ET) and resistance (RT) training with and without the garlic extract (GE) on metabolic syndrome, this study was conducted to identify and compare the effects of eight-weeks ET, RT and GE supplementation on malondialdehyde (MDA) and total antioxidant capacity (TAC) in rats with metabolic syndrome.

48 rats with metabolic syndrome (12-weeks, weight range of 310 to 350 g) in a randomized design were allocated into six equal groups: control (n=8), ET (n=8), RT (n=8), ET (n=8), RT (n=8), GE (500mg/kg, n=8). After familiarization of the rats with metabolic syndrome, 8-weeks (3 sessions a week) in an exercise protocol (ET, RT) with or without GE. Data were analyzed using one-way ANOVA and Bonferroni (Sig˂0.05).

The results show that ET and RT with GE consumption have significant effect on stress oxidative indices (TAC and MDA).

Endurance and resistance training along with GE consumption can increase the TAC base, reduce unfavorable changes in serum MDA syndrome.

Backgrounds and Adhesive capsulitis, characterized by pain and progressive stiffness of the glenohumeral joint, is a common cause of shoulder pain in patients referred to the outpatient clinic. Calcitonin is a thyroid hormone that provides analgesic effects in painful conditions including complex regional pain syndrome, trauma, vertebral metastasis fractures and etc. Intranasal calcitonin would lead to significant improvement in the treatment of shoulder adhesive capsulitis.
In a prospective, double blind, randomized, placebo controlled clinical trial study, 64 patients with adhesive capsulitis were divided into 2 groups. The active group received intranasal Calcitonin spray (200 u/day for 6 weeks) and placebo group received placebo spray. Patients of two groups were evaluated before and after intervention, with assessment of shoulder pain, shoulder range of motion and ability in performing daily activities.
At 6 weeks, there was greater improvement in shoulder pain, shoulder range of motion and ability in performing daily activities in the calcitonin group than placebo group. In intervention group, 22 (68%) patients experienced improvement while 10 (32%) patients did not experience improvement in their shoulder function. In placebo group, 9 (28%) and 23 (72%) of patients of the placebo group experienced and did not experience improvement of shoulder function.
A 6 week course of 200 u/day intranasal calcitonin spray has a significant benefit in shoulder adhesive capsulitis. Considering the noninvasive nature and lack of any significant complications of this treatment, intranasal calcitonin spray associated with physiotherapy and anti-inflammation medicines are recommended for the treatment of shoulder adhesive capsulitis.

Backgrounds and

Very few analytical studies are available on any association between Colorectal Cancer (CRC) among diabetic patients compared with non-diabetic subjects at least in Iran. The aim of this case control study was to determine the risk of CRC in type 2 diabetic patients.

In this study, 207 CRC cases, who had positive results by colonoscopy and biopsy, from Colonoscopy units in Tabriz Referral hospitals and 207 controls, gender and age matched had negative colonoscopy and biopsy results, was selected from the same centers with no history of any malignant tumor and nonneoplastic, Data were collected by questionnaires, and entered into the SPSS19. Multivariate logistic regression was used to estimate odds ratios adjusting for diabetes and risk of CRC.

of 414 patients studied, 194 (47%) females and 220 (53%) patients were men. The mean age and Body Mass Index (BMI) of patients was respectively, 59.52±13.8 and 26.47±3.8 Kg/m2. Of 207 patients with colorectal cancer, 48 patients were diagnosed with diabetes in contrast of 207 controls only 21 patients were diagnosed with diabetes. The final analyses indicate that diabetes increase the risk of CRC. (OR: 2.57, %95 CI: 1.25-4.58, P=0.006).

Our findings indicate that Diabetes increase the risk of CRC.

Backgrounds and Application of herbal plants instead of synthetic drugs has been increasing in recent years because of their lower side-effects and high varieties of efficient components. In this investigation, analgesic effects of hydroalcoholic leaf extract of RHUS CORIARIA (HRC) were studied on male rats.
In this experimental study, 42 adult male rats were divided into 7 groups: control, HRC (80, 100 and 300 mg/kg, i.p.), Morphine (1mg/kg, i.p.), aspirin (1mg/kg, i.p.), and naloxone (1 mg/kg, i.p.). The analgesic effects of HRC were assessed with writhing, tail-flick and formalin tests. The data were compared with One-way ANOVA test.
HRC significantly inhibited the number of contractions induced by acetic acid. All doses of HRC showed antinociceptive activity in the tail flick model. In formalin test, the highest effect observed was at the dose of 300 mg/kg (P The obtained data suggest analgesic effects for HRC, which may be mediated via both peripheral and central mechanisms. The presence of flavonoids might be responsible for the antinociceptive activity of this plant.

Backgrounds and

Urethral catheter is used for about 15 to 20% of hospitalized patients during their short-term hospitals stay which can predispose them to urinary tract infection (UTI). The aim of this study was to evaluate the prevalence and type of UTI in patients with urethral catheter at urology ward and role of antibiotic in the prevention of catheter related UTI.

From October 2012 to March 2013, all catheterized patients in urology department of Imam Reza Hospital, Tabriz University of Medical Sciences were enrolled to this cross sectional study. Urine culture was detected from one hundred patients before catheterization and 1, 3 and 7 days after catheterization and urine-analysis with urine culture were performed for all samples.

100 patients (95 male and 5 female) with folly urethral catheter in post urology operation were evaluated. The mean age of the patients was 67.04 ± 9.29 years. Mean hospitalization duration was 7.05 ± 0.97 day. Mean negative culture period of patients was 2.90 ± 1.99 days. Urinary culture was positive in 20% of the patients. A second and third urinary culture was positive in 5% and 6% of patients, respectively. E. coli was isolated from 30%, 60% and 66.7% of the samples on first, second and third days, respectively.

Prevalence rate of positive urinary culture was increased in patients with urethral catheter. E.coli was the most common isolated organism. Therefore, an appropriate antibiotic therapy should be used for the hospitalized patients. Unnecessary catheterization should be avoided and the health professionals have to follow the recommendations of the catheterization guidelines.

Backgrounds and

Bisphosphonates are synthetic compounds with structures similar to inorganic pyrophosphate (an endogenous regulator of bone mineralization). Prevalence and significance of diseases such as osteoporosis and cancer is increasing day by day, and although bisphosphonates have a high safety margin, like any medicine, they can have some side effects too. This study aims to improve the interaction between doctors with each other and with their patients in order to raise awareness and reduce possible problems by assessing the level of awareness of patients taking bisphosphonates drugs regarding the side effects and relevant considerations.

In this study, the target population was composed of bisphosphonates users patients admitted to Shahid Gazi hospital of Tabriz in in 1393. Data were collected using a structured questionnaire based on Peterson’s book). The data were analyzed on the basis of descriptive statistics methods (frequency, percentage, mean and standard deviation) using SPSS version 22.

In this study, 50 patients were studied. Analysis of patients’ awareness of possible side effects and interactions of drugs showed that 54 percent (27 people) were not aware of any of the possible side effects and drug interactions and 46 percent were aware of at least one of the side effects; however, no one was aware of the Osteonecrosis of jaw.

Bisphosphonate drug users’ awareness of its harmful effects following oral surgery, especially osteonecrosis of jaw, is low. Therefore, in order to raise awareness and reduce the side effects of the drug it is necessary to provide complete information in the brochures of the drug. Moreover, the interactions between the doctors with each other and with the patients need to be increased.

Backgrounds and

Androgen excess is a diagnostic criterion for PCOS. There are different cut off points to identify androgen excess in various societies. Since the mean levels of androgens among women of various races vary widely, it has been suggested that the normal ranges or limits of androgen levels should be determined specifically among well-characterized women of each population.

Data from the study of PCOS prevalence was analyzed for purpose of the present cross sectional study. The cut off point for androgen excess was defined using K-means cluster analysis according to the level of androgens among 923 women aged 18-45. Data analysis was performed using SPSS version 15.

Serum concentration levels of early follicular phase equal or greater than 8.76, 1.331 nmol/L, 345.07 and 2.9 ng/milL for FAI, TT, DHEAS and A4, respectively were used as cut off levels for androgen excess. Subgroup analysis showed that androgen excess cut off point varies in age and BMI subgroups. FAI cut off for androgen excess in women aged less than 35 years were 5.1, 4.85 and 6.3 in normal weight, over weight and obese women, respectively.

According to the findings of present study hormonal components to define androgen excess vary in early and late ages of reproductive period. Results showed that androgen excess is diagnosed as lower levels of FAI, DHEAS and A4 in women older than 35 in comparison with women aged less than 35. This disorder should also be determined in normal weight, overweight and obese women separately.