Journal of Analytical Research in Clinical Medicine
Volume:2 Issue: 3, Summer 2014

The present study was designed to evaluate the prevalence of child abuse in a child and adolescent psychiatric clinical population .
This cross-sectional study was conducted in a clinical population of children and adolescents aged 8-18 years. 80 out-patients and 94 in-patients were selected according to probability proportional to size sampling. Kiddie Schedule for affective disorder and schizophrenia questionnaire, a demographic questionnaire, and child abuse self-report scale were filled for each subject. Data were analyzed by using Stata software.
Among the out-patient subjects 50 were male (62.5 %) and 30 were female (37.5 %); for in-patient these subjects numbers were 76 (80.9 %) and 18 (19.1 %), respectively. The mean age of subjects was 15.2 years in the in-patient group and 11.7 years in the out-patient group. In 66.1% of abuse cases the perpetrators were parents, 5.2% siblings, and 28.7% someone else. Among inpatient subjects, summed up prevalence rates of severe and very severe psychological abuse, neglect, physical abuse, and sexual abuse were 11.7%, 33%, 2.1% and 0%, respectively; for outpatient subjects these values were 3.8%, 11.2, 3.8% and 0%, respectively. Moreover, among inpatient subjects, prevalence rates of moderate psychological abuse, neglect, , physical abuse and sexual abuse were 27.7%, 27.7%, 24.5% and 4.3%, respectively; and for outpatient subjects these values were 30%, 27.5%, 11.2% and 0%, respectively. Subjects with ADHD suffered a higher rate of physical abuse, whereas, subjects with BMD suffered a higher rate of sexual abuse.
The prevalence of child abuse is highly prevalent in children and adolescents with psychiatric disorders. It is recommended that this population be screened routinely for child abuse.

Human immunodeficiency virus (HIV) attains high importance, because of its high fatality, disability, political and socio-economic impacts. Individuals living with HIV infection are poorly affected in terms of their psychological and socioeconomic aspect of quality of life. The aim of this study was to identify residence, marital, and employment characteristics of HIV infected subjects and to compare these characteristics prior of getting infection.
This study was cross-sectional, conducted on 64 HIV infected subjects referring the Counseling Center of Behavioral Disease in Tabriz, 2012. Required data was collected using self-administered questionnaire, which was validated by experts and reliability was ensured through respondent validity method. Finally data were analyzed with the help of SPSS for windows.
The result showed that 89.00% of patients were male. Mean age of participants was 37.00±8.84 years. Homelessness rate was 0% before acquiring infection when compared to 7.8% afterwards. The rate of unemployed was 3.8% that raised up to 62.5% after infection. Finally, it could be said that, after infection, divorced subjects increased from 0% to 27.6% respectively.
The findings showed that, homelessness, unemployment, and divorce have increased dramatically among HIV infected subjects.

Children with attention deficit hyperactivity disorder (ADHD) have serious social skill deficits and problems in relation with peers. this study aimed to compare theory of mind (ToM) in drug naïve children with ADHD with those with no psychiatric disorders at the same age.
This cross-sectional study was established in child and adolescent psychiatry clinic of Tabriz University of Medical Sciences. Drug naïve, male children and adolescents with a diagnosis of ADHD were enrolled as well as age and IQ matched healthy controls. Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, Child symptom inventory-4 and Conner’s Parents Rating Scales-Revised were used to measure psychiatric disorders and Sally-Anne false belief task andThe Reading the Mind in the Eyes task (Child) for components of ToM.
A total of 30 children completed the study in each group. Half of children with ADHD could not give the expected answer in Sally-Anne false belief task which was significantly lower than controls. They also showed a significantly lower performance in the Reading the Mind in the Eyes task. severity of ADHD was not correlated with score of Reading the Mind in the Eyes task.
children with ADHD have deficits in ToM compared to age and IQ matched controls in terms of social cognition and social sensitivity.

Vascular calcification is a common complication in the chronic kidney disease (CKD) patients and the leading cause of morbidity and mortality in this patient. The aim of the present study was to evaluate a possible correlation between vitamin D receptor (VDR) gene FokI and ApaI polymorphisms with the expression of calcification biomarkers such as Fetuin-A and intact Parathormone hormone (iPTH) in hemodialysis patients (HD).
In this cross-sectional study, serums were obtained from 46 stable chronic HD patients. The serum levels of iPTH, Fetuin-A, vit D, calcium, phosphorus and VDR genotyping were determined by standard methods.
The serum levels of Fetuin-A, calcium did not differ between males and females but significant differences in iPTH and vitamin D levels was found in the study patients [(336.8±139 pg/dl) vs. (414.7±111.8 pg/dl) p=0.04 and (24.5±7.6 ng/ml) vs.(19.9±4.8 ng/ml) p=0.02 respectively]. A Significant correlations were found between serum Phosphorus and levels of serum calcium (r = –0.4; p = 0.002), vitamin D (r = –0.5; p = 0.001) and iPTH (r = 0.4; p = 0.001). iPTH level in FokI polymorphism, were different between genotype groups in study patient (p=0.02). There was a significant positive correlation between Vitamin D and iPTH levels in patients with aa genotype (p=0.02, r=0.4).
These findings suggest that FokI (rs2228570) polymorphism in exon 2 of the VDR gene may play a role in iPTH levels. Fetuin-A deficiency or high level of iPTH and its association with VDR gene polymorphisms may be useful to identify the high-risk group susceptible to renal failure and atherosclerosis. Although VDR gene FokI and ApaI polymorphisms could affect the levels of Fetuin-A and vitamin D, their direct role on atherosclerosis needs further studies in the future.

Status epilepticus (SE) are associated with high rates of morbidity and mortality, yet early diagnosis and treatment will improve patients’ outcome. This study was carried out to determine etiology, and early-outcome of our overall management of pediatric SE in patients admitted to Tabriz Children’s Hospital (Tabriz, Iran).
In this cross-sectional and analytical study from January 2013 to January 2014, 43 patients with SE under the age of 15 years were enrolled. Demographic characteristics, etiology and outcome of every patient were recorded. SPSS for Windows software was used for statistical analysis. P-value of less than 0.05 was considered to be statistically significant in all comparisons.
The highest rate of SE was happened in age-subgroup of 1-5 years. The two most common causes of SE in our patients were remote symptomatic (55.8%) and prolonged febrile convulsions (20.9%). Refractory SE (RSE) was detected in 15 (34.8%) patients. Poor early-outcome was shown in 8 (18.6%) patients (4 mortalities and 4 morbidities) of whom 5 (33.3%) had RSE, and 3 (10.7%) from SE group (P = 0.01). Young age was a risk factor for mortality (P = 0.01). Recurrent SE was occurred in 3 (7.0%) of patients.
Early-outcome of SE in children is mainly determined by age and underlying disorder.

This study was conducted to determine the frequency and pattern of antimicrobial susceptibility of Shigella spp. isolated from pediatric hospital in two different time periods between March 1995 to March 1999 and March 2009 to March 2013 in North-West of Iran.
The stool specimens were collected and examined for shigellosis by biochemical tests, and antibiogram was conducted according to Clinical and Laboratory Standards Institute protocol. One hundred and thirty-nine Shigella spp. isolated from year 1995 to 1999 and 38 Shigella spp. isolates collected from year 2009 to 2013 and examined for serotyping and antibiotic resistance pattern.
According to serotyping results Shigella flexneri isolated in 98.6% of isolates in the first time period, followed by Shigella boydii and Shigella sonnei (0.7%) but in the second time period just 47.3% were S. flexneri and 39.5% were S. sonnei, 7.9% were S. boydii and 5.3% of isolates were Shigella dysenteriae. Results indicated significantly increase in resistance to ceftizoxime, chloramphenicol, and amikacin (P = 0.004, 0.010, and 0.004 respectively), also, in Shigella isolates isolated in the second time period showed an increase in multidrug resistant (MDR) isolate and frequency of MDR isolates increased to 95.0% in the second time period.
We are facing with the increase in resistance to antibiotics in Shigella spp. especially MDR isolates. These results showed changing pattern of resistance in Shigella isolates and needs for planning and design antibiotics stewardships for controlling Shigellosis, especially in pediatric hospitals .

Prevalence of post-coronary bypass grafting surgery (post-CABG) atrial fibrillation (AF) is high, and it’s complications are serious. Prediction of this problem and prophylactic or presumably curative managements may be helpful not only in post-CABG AF, but also in other conditions that predispose patients to AF. The aim of this study was finding relationship between right atrial (RA) dyssynchrony and post-CABG AF occurrence.
One hundred patients who were candidates for CABG and they had sinus rhythm was evaluated. We measured RA dyssynchrony in tissue Doppler imaging (TDI) using initiation of P wave in the electrocardiogram to peak A wave (on TDI) in mid of RA free wall and mid of inter-atrial septum (IAS). The time difference from the onset of the P wave to the onset of the A wave at the right atrium (P-RA) and the IAS (P-IAS) was measured. RA dyssynchriny was defined as the difference between P-IAS and the P-RA. Patients were followed for occurrence of AF 72 h after CABG through Holter monitoring, the relation between AF occurrence and RA dyssynchrony was determined.
AF developed in 24 patients (24%), based on statistical analysis, lower LVEF and RA dyssynchrony had relationship with AF occurrence. RA dyssynchrony was significantly increased in patients with postoperative AF (36.67 ± 14.93 ms vs. 14.27 ± 13.77 ms,P We demonstrated that RA dyssynchrony based on TDI could be a predictor for the occurrence of post-CABG AF.

Surgical treatment of spinal deformity resulting from neurofibromatosis (NF) is a major challenge for orthopedic spine surgeons. There are several problems and complications including pseudoarthrosis and cure progress despite treatment. Progressive kyphoscoliosis is the most important spinal deformity. The present study aims to evaluate surgical treatment results in severe spinal involvement cases.
This analytical a-descriptive study evaluated 20 patients with NF, severe scoliosis and kyphosis (up to 50°) hospitalized and treated at our center during the past 10 years. The treatment failure rate and complications were studied.
In this study, 20 cases with NF and kyphoscoliosis with the mean age of 13.00 ± 7.18 years were studied. These case series were consisted of 13 (65%) males and 7 (35%) females. Overall treatment failure was 45%. However, it was 55% of failure happened in posterior fusion alone. Failure rate was reported 36% in the combined anterior and posterior fusion and mainly seen in younger than 8-years children. Surgical complications were found in 20% with pseudoarthrosis as the most common one. There were no infections and neurological complications. Statistically, there was a significant negative relation between age and curve progression in scoliosis and kyphosis during the 2 years follow-up period. There was not any significant difference between genders considering curvature progress.
The combined anterior and posterior fusion is probably more effective treatment, especially at early ages when more aggressive treatment is required since it reduces the treatment failure possibility.

Regarding to the importance of students Olympiads, and the need for evaluation of quality of questions, the aim of this study was to analyze questions (indices of difficulty coefficient and discrimination coefficient) of Fourth Olympiad examination among Iranian medical sciences students in the area of scientific thinking in basic science.
This study was descriptive-analytical study and was conducted in 2013 in the Tabriz University of Medical Sciences (Tabriz, Iran). The individual phase of this period, comprised from four phase and six parts included: designing conceptual map (CM) (three part designing CM, summarizing CM, and designing three questions), hypothesis generating, selecting variables, and analyzing the findings. Data analyzed using descriptive statistics and statistical tests in SPSS for Windows.
According to difficulty coefficient of selecting variable (82%) and making hypothesis was the easiest part (46%). And according to discriminate coefficient, analyzing the findings had the highest discriminate coefficient (83%), and selecting materials had the lowest discriminate coefficient (34%). Difficulty coefficient of the test was estimated about 63%, and discriminate coefficient was 66%. The results of Spearman correlation coefficient test showed that the correlation between scores related to designing CM with generating hypothesis equals to 85%, with selecting variable was 36% and with analyzing the results equals to 71%.
Based on the result of this study, it is necessary for a designer of test to focus on selecting variable part of the test for improvement of quality and validity of the test. Furthermore, regarding to effectiveness of CM, it seems logical to pay more attention to their use .

Cystic echinococcosis (CE) is one of the important helminthic diseases of human and animals, which causes by Echinococcus granulosus. Canids are its definite and grazers especially sheep, and cattle, and also wild herbivores are its intermediate hosts. Human can also be accidentally infected by a parasite. This study aimed to investigate genotypes of the hydatid cysts isolated from hydatidosis patients in order to confine the source of the infection, 2013.
In this cross-sectional study 55 paraffin blocks of identified hydatid cysts have been undergone genotyping using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The ITS1 region of rDNA has been amplified using BD1 forward and 4s reverse primers. PCR products have been digested using HpaII and RsaI restriction endonucleases. RFLP products studied using gel electrophoresis. Data were analyzed using SPSS for Windows using the chi-square test.
About 29 (52.72%), 16 (29.1%), 3 (5.45%), 3 (5.45%), 1 (1.81%), 1 (1.81%), 1 (1.81%) and 1 (1.81%) out of 55 hydatid cysts were located in lung, liver, spleen, kidney, heart, pancreas, brain, and femore, respectively. The frequency of hydatidosis observed higher in patients from rural areas (P = 0.013; odds ratio = 0.599; 95% confidence interval: 0.28, 1.27). Based on RFLP results, the entire studied hydatid cysts identified as sheep strain (G1).
According to the results of the present observation, it can be concluded that the majority of cases of human hydatidosis in East Azerbaijan Province are caused by sheep strain (G1) of E. granulosus, which indicates the sheep-doge cycle in the studied area.