مجله مطالعات علوم پزشکی
سال بیست و هفتم شماره 12 (اسفند 1395)

Delirium is a common problem in hospitalized patients and may threaten the patient's life. Patients undergoing surgery may experience such a common complication. The high mortality in patients with delirium and lack of a rapid recovery from the disease, reveal the importance of addressing this problem. So the purpose of this study is to show the risk factors in the major head and neck cancer surgeries that cause delirium and help patients.
.In this study, 104 patients with head and neck cancer candidates for surgery in Imam Reza Hospital in Tabriz university of medical sciences were studied. Demographic characteristics and risk factors of delirium were recorded and a personality test of MMPI was performed . All selected samples were studied. Data, based on T-TEST and ANOVA were analyzed.
Based on obtained information %49.4 of study participants were female and %59.6 of men. More than16% of them had previous disease such as Hypertension, Diabetes, Cardiac Infarction, Atrial fibrillation and pulmonary disease.
Results showed that %90.4 of patients was without delirium and %9.6 of them has experienced delirium. Findings also showed that the most frequent diagnosis in terms of MMPI test sequence was related to anxiety disorder such as schizoaffective and severe depression. Results indicated a significant relation between literacy and the likelihood of patients experiencing delirium is P=%0.5. A significant relation between the type of surgery and the risk of delirium exists in the cancer of the larynx (P=%0.1) and also there was meaningful relation between the factors of the MMPI and delirium experiencing MA (p=%0.5) Pd (p=%0.5). There was no remarkable affinity between delirium and the existence of Hypertension, Diabetes, the residing period in ICU and the duration of Cardio Pulmonary diseases, potassium, sodium and glucose. The other findings also indicated that the MMPI test can be used as a tool to diagnose Delirium.
Because of high mortality in delirious patients we can get cognitive tests to recognize high risk persons to prevent. Psychic or psychotherapy is one of the first step of treatment.

It is more important to know which of physical activities could be the most effective way to cause angiogenesis. In this regards, we have investigated an 8-week aerobic training on vascular endothelial growth factor (VEGF) and Endostatin (ES) in sedentary women.
20 volunteer inactive women were chosen and were randomly divided in 2 groups of aerobic and control. Aerobic training programme consisted of 3 days per week for 8 weeks, each consists of 30 minutes with intensity of 65-70% of maximum heart rate was performed.. Before and after training, we have tested aerobic training and control group after an overnight fast. Blood Samples were used to conduct Enzyme-linked immunosorbent assay (ELISA). Independent and Dependent T-Test t were performed to see the significance level of (P Statistical analysis revealed that aerobic training increased VEGF and decreased ES to a significant level. Consequently, the results of Independent T Test revealed that there is an obvious difference (PThe results show that the equilibrium between angiogenesis and angiostatic agents. As a result, aerobic training is shifted toward angiogenesis factors. This result helps us to understand the process of angiogenesis consistence with aerobic training activities.

Nasal Colonization with Methicillin Resistant Staphylococcus aureus (MRSA) is known as an important risk factor in the development of dangerous infections.
The present study seeks to investigate the prevalence of MRSA nasal colonization among the preschool and school children under 14 in Urmia. To do so, specimens for culture were obtained from 400 children. Cultures and antibiograms with oxacillin discs were performed in Shahid Motahari hospital of Urmia.
81 cases (47 females, 34 males) out of 400, nasal colonization were observed. Of which 12 (5 females, 7 males) were resistant to methicillin. Colonization was slightly higher among the females with no statistically significant difference (P.value>1).
The results indicate that colonization with MRSA is present among healthy children in the studied population. Fortunately, the respective prevalence was not higher compared to other areas. Further attention is required by the health authorities to prevent the transmission of such organisms among children.

Development during childhood is vital for learning skills. Maternal omega-3fatty acids during pregnancy and lactation play important role in childhood development. The aim of this study is to determine omega-3 supplementation during lactation on the growth and development of infants.
This is a double-blind randomized trial. A total of 70 lactating women and their infants 15 days after delivery were selected. They were randomly divided into intervention and placebo groups. The intervention group received 1 gram omega-3 capsules daily and placebo group paraffin capsules for 3 months. Development of infants was assessed by using ASQ and growth by measuring weight, length and head circumference.
The main score of communication, fine motor and problem solving in the intervention group after 3 months supplementation of omega-3 fatty acids were higher in the intervention group than placebo. There were no differences in gross motor and social development between two groups.
In this study positive effect of omega-3 e on problem solving and social development were found. There were no differences in growth between two groups except head circumference.

Diabetes mellitus is a self-management disease and depression is a common problem related to it. One of the causes of depression is serotonin depletion. The enzyme tryptophan hydroxylase is known as limiting enzyme in the production of serotonin in the brain. Aerobic exercise also has proven benefits in treating and reducing the incidence of chronic diseases such as diabetes. Thus in this study we examine the effect of aerobic training on serotonin and tryptophan hydroxylase of prefrontal cortex in type 2 diabetic rats.
This study is experimental and post-test. 30 rats were randomly divided into 3 groups: 1- healthy control 2-diabetic control 3- exercise diabetic, were divided. 2 and 3 groups for diabetes by intraperitoneal injection two weeks after the high-fat diet, streptozotocin (37mg/kg) received. Groups of aerobic exercise 5 times in the week and 8 week ran that duration and intensity on a treadmill in the final weeks respectively 55min /d and 26m/min arrived. 24 hours after the last exercise the prefrontal cortex of mice tissue samples of all groups were extracted and serotonin (µg/g) and tryptophan hydroxylase concentration was measured respectively by Elisa and Western Blotting from prefrontal cortex tissue samples. To evaluate the differences between the group of design analysis of variance (ANOVA) and Tukey post hoc test at the significant level was less than 0.05 were used.
Statistical analysis showed that serotonin levels in the diabetic group was significantly lower than the healthy control group (P=0.001) and exercise diabetic (P=0.009) and average serotonin between control group and exercise diabetic has no significant difference. Tryptophan hydroxylase results show that the average diabetic groups was significantly lower than the healthy control group (P=0.000). The results showed that the amount of tryptophan hydroxylase in the exercise diabetic group was significantly higher than the diabetic control group (P=0.000).
In this study, diabetes reduces serotonin in the prefrontal cortex. Some studies have shown that inflammation in type 2 diabetes increases the cytokines IL-6 and TNF-α, and these cytokines by increasing the activity of indolamine 2, 3 dioxygenase in the brain alters the metabolism of tryptophan and reduce the production of 5-HT. Chronic activity reduces systemic and tissue inflammation thus increasing serotonin in the brain. The reduction of tryptophan hydroxylase due to diabetes can also be the factors that affect in the decrease of prefrontal serotonin.

Osteosarcoma is one of the most prevalent malignant bone tumors . This study is designed to assess the prognostic effect of pathologic fracture and treatment options on survival of patients with osteosarcoma.
In this study, prognosis of 106 patients with limb osteosarcoma, which were treated at three hospitals in Tehran from April to August 2012 was evaluated. Patients were divided in two groups according to the presence of pathologic fracture at the time of diagnosis. Survival, local recurrence and distant metastasis were compared between groups. For patients with pathologic fracture, survival rate was compared according to surgical options (amputation or limb salvage). Chi-square and Independent sample T-test were used to compare means of the groups. Recurrence free and metastasis free survivals and final survival of the patients were calculated using the Kaplan-Meier method. To determine the predictive factors of survival, Cox-Regression analysis and estimating hazard ratio (HR) with 95% confidence interval were used.
Among 106 patients, 57 cases had not and 49 others had a pathologic fracture at the time of diagnosis. There were no statistically difference between two groups in Survival (P-value=0.36), local recurrence (P-value=0.91) and distant metastasis (P-value=0.73). There was no statistically difference in survival according to surgical options in patients with pathologic fracture (P-value=0.85).
pathologic fracture in limb osteosarcoma is not a poor prognostic factor. In patients with pathologic fracture limb salvage procedures can be performed without adverse effect on survival rate.

Bachground & Aims: Oral lichenoid reactions (OLR) and oral lichen planus (OLP) are clinically and histopathologically similar but their therapeutic approach are different. Due to the presence of dysplasia in oral lichen planus which effects prognosis, the aim of study was the evaluation of proliferation activity of OLPs and OLRs and their subtypes. AgNOR technique that is inexpensive and easy to perform was used to differentiate OLPs and OLRs and their subtypes.
in this cross sectional , retrospective study, samples consisted of 45 OLPs, 30 OLRs 15 normal oral mucosa (N) from healthy persons (as control group). The samples were stained by AgNOR technique. AgNOR dots were counted on 100 cells from basal and para basal layer . The mean AgNOR dost per nucleus were calculated. Proliferation index (number of cells with AgNOR dots≥ 5) was also determined. Variation in size of AgNOR dots was categorized into 2 groups.
There were significant differences between OLP(and its subtypes) and N and also between OLR(and erosive type) and N . Such a difference was also between reticular OLP and reticular OLR.with regard to AgNOR count.
Since reticular OLP had significantly higher AgNOR count than reticular OLR in our study, we can suggest the use of AgNOR technique for differentiation of reticular type of OLP from OLR on challenging histopathologic cases.

Endotracheal intubation is commonly performed in the intensive care unit. Many international guidelines for difficult intubation management are available and the intensivists think that any endotracheal intubation in ICU is potentially difficult with several complications.
After obtaining ethical approval, this descriptive and analytical study was conducted from 2014 to 2015 in the Urmia Emam hospital GICU. Demographic characteristic (Age, Sex), underlying diseases, mean of intubation, mechanical ventilation, ICU and hospital length of stay, frequency of difficult intubation, drugs used for intubation, mortality of patients were extracted from the medical information unit and entered to check lists. The data were analyzed with SPSS software ver.20. . P The mean of variables were as follows: intubation period 14.56±4.71, mechanical ventilation 13.24±5.54, ICU length of stay 18.11±10.16 and hospital 21.04±13.09 days. Frequency of difficult intubation was 9.31%. Mean number of attempts was 1.31 times for intubation and frequency of mortality was 35.17%. The Mean of intubation, mechanical ventilation, ICU and hospital length of stay period between 2 groups (difficult and non difficult intubation) were significantly different (P This study, like previous studies showed that difficult intubation had a negative influence on patients’ outcome in the intensive care unit.