مجله پزشکی دانشگاه علوم پزشکی تبریز
سال چهل و دوم شماره 4 (پیاپی 148، مهر و آبان 1399)

The majority of existing data concerning the leukocyte subsets distribution after daily consecutive exercise sessions are controversial because of the confounding effect of plasma shift into active muscles. The aim of this study was to investigate the Effects of the two consecutive anaerobic exercise sessions on leukocyte subsets distribution, blood lactate level and anaerobic power in female athletes with controlling the confounding effect from plasma shift.

This was an experimental study in which 30 subjects were randomized into experimental(EX) and control(Con) groups after body composition measurements and the Ex group experienced two anaerobic sessions (at 9.00 am and 15 pm),. Blood samples were taken before and after each session.

Both session elevated blood leukocytes and their subpopulations (monocytes, lymphocytes and granulocytes) count as well as blood lactate levels (P<0.05). Following to the first session, the increasing trend in leukocyte and granulocytes count was continued, however; the monocytes count and blood lactate levels returned to baseline level, while lymphocytes count was reached to levels even lower than baseline values (P<0.05). The mean and min power in the second session were lower than the morning session (P<0.05).

Although the effects of two consecutive sessions to induce leukocytosis and a consequent lymphocytopenia in elite female athletes was verified even after controlling of the confounding effect of plasma shift, however; because of the lack of similar evidences and some of methodologic limitations, more researches still remains to be done.

Physical activity and exercise training plays a protective role against cardiovascular disease via reducing risk factors. Swimming as one of the best aerobic activity and exercise modality recommended for preventing and treatment of cardiovascular disease. On the other hand, exercise training could effects cardiac muscle protein structure. Therefore, the propose of this study was to investigate the effects of eight-week swimming training on N-cadherin, beta catenin and Emerin gene expression in left ventricle of cardiac muscle in male Wistar rat.

In this study, twenty four male Wistar rat (8-week old) with an average (weight 237±33 in gr) randomly divided to three groups: Control (n=8), 8- week control (n=8) and swimming training (n=8). Swimming group participated in a swimming training for 8- week (5 seasons per week of 30 minutes floating on the water with moderate intensity) and the control group continued their usual lives. Twenty four hours after the last training session, the heart tissue of rats were extracted and β-catenin, N-cadherin and Emerin gene expression evaluated by Real Time-PCR. Data were statistically analyzed by one-way ANOVA and post-hoc Tukey methods (P<0.05).

The results of the study showed the expression of genes N-cadherin and beta catenin significantly higher in the swimming group than in the control group. However, Emerin gene expression in swimming group was significantly lower than in the control group.

According to these findings, it seems that eight-weeks of swimming training an effective way of improving the structure and function of the heart muscle cells by increasing beta catenin and N-cadherin.

Platelet-rich plasma (PRP) is one of the most important derivatives of blood. Over the past several years, the use of PRP has focused on the medical treatment in conditions such as skin rejuvenation and chronic ulcer treatment and hair loss. Also, PRP has been transmitted to the peripheral environment of the hair follicle through several intradermal injections to treat hair loss. The objective of this clinical trial was the evaluation of the effect of Platelet-Rich Plasma (PRP) in treatment of patients with androgenic alopecia.

In this randomized clinical trial, 20 patients with androgenic alopecia referring to dermatology clinic of Sina Hospital in Tabriz were assigned into the study. Interfollicular injections of Platelet-Rich Plasma (PRP), 0.1 ml/cm2 were performed 2 times in each patient in selected areas of the scalp at intervals of 30 days. The clinical manifestations and dermoscopy were used to evaluate the patients with androgenic alopecia. Before the intervention, 1 month, 3 months after the intervention were followed up, respectively.

Twenty patients (16 males and 4 females) were examined. The mean age of the patients was 32.88 ± 1.3 and in range of 24 to 48 years. The results of this study showed a significant increase in the mean number of hair in treated areas in the third month compared with the beginning of the study. In the treated areas there was an average increase of 13.9 after first month and 33.6 hairs per cm2 after 3 months.

According to the results of this study, PRP has a positive effect on the treatment of patients with androgenic alopecia.

Differences in clinical isolates may affect the frequency of Extended Spectrum Beta-Lactamase enzymes (ESBLs) in some gram-negative bacteria. The aim of this study was to pattern survey of Antibiotic resistance of clinical isolates of ESBL strains and determination of enzymatic relationship with clinical specimen type.

In this descriptive-analytic study, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae and Enterobacter cloacae were identified by biochemical tests. Combination disk test was used to determine ESBL strains. Chi-square test with significant range of P<0.05 was used to examine the relationship between variables.

Out of 270 isolated gram-negative isolates, 95 isolates was produced ESBL enzyme. Of the 95 isolates, 28 isolates (29.47%) were E. coli, 22 isolates (23.15%), P. aeruginosa, 19 isolates (20%), A. baumannii, 17 isolates (17.89%) of K. pneumoniae and 9 isolates (33.3%) were E. cloacae. There was a significant relationship between the presence of ESBL enzymes and the type of clinical specimen, so that isolates with this enzyme had the highest frequency in the wound and urine specimens.

Considering the relationship between type of clinical specimen and the frequency of ESBL enzyme in resistant strains, some environmental factors and underlying variables such as the type of clinical specimen can increase the abundance of ESBL enzymes.

Low back pain occurs between the lumbar vertebrae and the sacral bone and is affected by factors that often occur when trying to perform a particular operation or during a collision. The purpose of this study was to investigate the effects of long-term wearing of lumbar brace on the electromyography frequency spectrum of trunk and lower limbs in low back pain older adults with pronated feet during walking.

This research was of a semi-experimental type. Fifteen patients with low back pain and pronated feet were selected as an experimental group (age: 68.3 ± 2.7 years) and Fifteen patients with low back pain and pronated feet were selected as a control group (age: 69.0 ± 3.9 years).The lumbar brace used in this research was Sacro Lumbar Support, BB-OPPO 2065 model, Taiwans. The electrical activity of the lower limb and trunk muscles were recorded by the electromyography system during walking in both pre and post-test. All statistical analysis was done on SPSS software by two way ANOVA analyses test at significant level of 0.05.

The findings in the experimental group demonstrated that the frequency content of the gastrocnemius medialis muscle during post-test was significantly lower than that during the pre-test (P=0.002). Also, two external oblique (P=0.007) and rectus abdominus (P<0.001) muscles showed a significant increase in their frequency content during post-test than that in the test pre-test.

Results demonstrated that using of lumbar brace can increase abdominal muscle activity in patients with low back pain and pronated feet.

The role of adipokines has been recognized in metabolic settings and obesity-related disorders. Therefore, the purpose of this study was to investigate the effect of 12-weeks of Pilates training on serum levels of some adipokines in inactive women with overweight.

Twenty four accessible healthy overweight women with average BMI of 27.2 ± 1.1 kg/m2 participated in this quasi-experimental study. They randomly divided into two groups: exercise group (n=12) and control group (n=12). Pilates exercise training was performed during 12-weeks (3 sessions per week, 60 min per session). During this period, the control group did not have any exercise activities. Blood samples were taken in two steps 48 hours before and 48 hours after the last session and after 12-14 hours of fasting to measure serum levels of visfatin, chemerin and resistin levels. The dependent t-test was used to examine the within-group changes and covariance analysis was used to examine the changes in between-group changes.

The results of this study showed that after 12-weeks of Pilates exercise training, visfatin (P= 0.012), chemerin (P=0.002) and resistin changes (P=0.005) in the training group had a significant decrease in post-test compared to the pre-test, as well as there was a significant decrease in serum visfatin levels (P = 0.035), chermerin (P = 0.018) and resistin (P=0.045) in the exercise group compared to the control group.

Based on the results of this study, Pilates exercise training is a stimulus factor for adipokines levels changes in inactive women with overweight. It is probably one of the causes of physiological changes is the activity of adipokines levels.

Inadequate pain management after lumbar disc surgery may result in increasing morbidity and duration of hospital stay. This study aimed to evaluate the efficacy of analgesic effect of diclofenac sodium in reducing the total dose of morphine after lumbar disc surgery.

This study was conducted in Shohada Teaching Hospital. Eighty-four patients with mean age of 51.74 ± 5.76 years were included in this double blinded clinical trial study. Patients were premeditated with diclofenac sodium supposition or placebo before surgery. After surgery, patients randomly assigned to 1 of 2 treatment groups: group A: diclofenac sodium supposition and group B: placebo. Visual analog scale and morphine consumption were recorded at 6 hours intervals up to 24 hours.

The base line mean pain relief and nausea and urinary retention were not statistically significant between groups (P>0.05). Weakness and fatigue, dry mouth and total morphine dose were statistically different (P<0.05).

Premedication with diclofenac sodium supposition in the patients underwent lumbar disc surgery, can reduce total dose of morphine consumption after lumbar disc surgery and some adverse effect of morphine such as dry mouth, weakness and fatigue.

Head and neck cancer is the sixth most common malignancy worldwide. Neoplastic lymphoma is a malignant origin of colonization of B cell, T cell and NK cell. It is the third most common malignancy in the head and neck area after squamous cell carcinoma and salivary gland tumors. Lymphoma is divided into Non Hodgkin's lymphoma (NHL) and Hodgkin lymphoma (HL) groups. They have two peak ages of 20-30 and 70-60 years. The first symptom of lymphoma in patients is usually a painless, enlarging lymph node. Then we can mention weight loss, night sweats, fever. Diagnosis is based on clinical findings and biopsy.The aim of this study was to determine the frequency and histopathologic subtypes of the head and neck lymphomas and to evaluate the clinical symptoms and diagnostic processes in patients with lymphoma diagnosed in ENT department of East Azerbaijan University of Medical Sciences.

The study population has 40 samples. There were 602 seropositive biopsies and 59 patients with diagnosed lymphoma, 19 of which were excluded due to lack of records and exclusion criteria.Patients' records were reviewed for age, sex, clinical presentation, laboratory tests, Paraclinic and pathologic outcome.

The Hodgkin's lymphoma was 62.5% more common than non Hodgkin's lymphoma. Most patients were in the age range of 10-20 years. Mean age of patients was 35.6 ±24 24.72. 82.5% of patients referred to the hospital with complaints of neck swelling.The most prevalent subtype of Hodgkin's lymphoma was nodular sclerosis (44%) and the most prevalent subtype of non Hodgkin's was diffuse large B cell 36%.

lymphoma should be considered as one of the differential diagnoses of cervical swelling in the diagnostic and therapeutic studies of patients. Also, males and age groups of 10-20 years and 60-70 years should be considered important.

Methicillin-resistant Staphylococcus aureus (MRSA) is known to be the most resistant pathogen in hospitals, which can infect both the health workers and patients. The most common site for colonization is the anterior part of the nose and throat. In order to prevent and control the infection and the role of medical personnel as a carrier for transmitting infection, the aim of this study was to determine the amount of nasal colonization with MRSA in the medical staff of Sina and Imam Reza Hospital in Tabriz.

The present cross-sectional study evaluated 400 participants. From the entire medical staff of Sina and imam Reza hospitals in 2017 who were willing to participate in this study. Sterile swabs inserted in to the anterior region of the nose. Then swabs were immediately cultured in a laboratory in mannitol salt agar blood agar for 24 hours and incubated for 48 to 72 hours, to determine the MRSA strains, Cefoxitin disc method was used in Muller Hinton Agar culture media. Descriptive statistical methods and Chi2 test was used for statistical analyses. P value less than 0.05 was considered statistically significant.

55% of the health care workers (220) were carriers of Staphylococcus aureus, mean age was 38.27 ± 8.72 years and 61.8% were male. Internal ward health care workers were common Staphylococcus aureus carriers and diabetes was the most common systemic disease. Out of 37.8% had a history of previous hospital admission and 87.2% had antibiotic use. Also, methicillin resistance was observed in out of 32.7% of subjects.

Constant control of infectious agents and the use of Proper antibiotics can be effective in controlling carriers and even drug-resistant cases.

Clubfoot occurs in approximately 1 in 1000 live births and is one of the most congenital birth defects. The Non operative technique for the treatment of idiopathic club foot is described by Ponesti as a popular method. Tenotomy is on integral step of this method. The purpose of this study was to evaluation of predictive factors for tonotomy at the initiation of the Ponesti treatment.

In this descriptive cross-sectional study, all patients with idiopathic clubfoot under the age of 6 months who had referred to the orthopedic clinic of Imam Khomeini Hospital in Urmia from April 1 to March 2017, and were treated by pontic method, were included in the study. Parametric statistical tests such as chi-square and t-test were used. The significance level for all tests was below 0.05. All analyzes were performed using SPSS software version 21.

Tenotomies were performed in 39 feet of 52 feet (75%). Of 22 feet with initial Pirani scores ≥ 5.0, 95.5% required a tonotomy. Of 11 feet with an initial scores≤2.5, only 18.2% required a tenotomy. There was a significant difference between the need for tenotomy and severity of the deformity at onset of treatment (P<0.001). Removal of the last cast, there was no significant difference between those that did and did not have a tenotomy (P=0.789). Those that underwent tenotomy did not require more casts. Casting began in the newborn period (≤ 30days) on 34 feet. Tenotomy was not needed in 11 feet. There was a significant difference between the need for tonotomy and age at beginning of treatment (P=0.018).

Tenotomy is not required in all cases. Severity of the deformity at presentation, especially hindfoot contracture and age at the beginning of treatment can predict the need for tenotomy

Infants born with congenital heart disease (CHD) typically present different clinical manifestations which make this condition hard to diagnose. Considering serious complications arising from misdiagnosis, inventing new methods and/or improving traditional diagnostic approaches has always been a research objective.

In this cross-sectional analysis, which took place in Children's Medical Center in Tehran, 150 infants admitted to an intensive care unit were evaluated based on echocardiographic findings from 2015 to 2017. Echocardiography was done due to abnormalities in physical examination and/or oxygen saturation level.

The sensitivity of clinical study value was 82% and the negative predictive value was 20%. The sensitivity of arterial oxygen saturation immediately after admission to the neonatal intensive care was 92%, the specificity was 34%, positive predictive value was 56% and negative predictive value was 25%.

In terms of high sensitivity, clinical symptom including tachypnea, cyanosis, arrhythmias, respiratory distress, cardiac murmur, or arterial oxygen saturation level in newborns may be useful for screening CHD. Among the clinical manifestations, cyanosis and respiratory distress are more valuable.

High expression of SIRT1 genes increases the expression of PGC1-α, which stimulates expression of GLUT4 glucose carrier in skeletal muscle. The aim of the present study was to investigate the effect of 8- week of HIIT training on the expression of SIRT1 and PGC1-α in male rats with type 2 diabetes.

The research method was experimental. sixty male Wistar rats, with average weight of 250 ± 20 g, after induction of diabetes by injection of Nicotinic Amide- Streptozotocin, were randomly divided into 5 groups: Base-line control (n=12), HIIT Control (n=12), HIIT (n=12), Diabetic Control (n=12), HIIT Diabetic (n=12). The training groups performed the HIIT on a treadmill for 8- week and 5 days a week, which speeded from 16 meters per minute to the end of the eighth week to 38 meters per minute. Twenty four hours after the last training session, the rats were anesthetized. Then, soleus muscle tissue was immediately extracted, and the level of SIRT1 and PGC1-α gene expression was measured by Real Time-PCR and scale .

Statistical analysis of two-way ANOVA showed that the mean PGC1-α and SIRT1 indices were significantly different between the two control groups and the untrained diabetic group. Also, HIIT exercise had a significant effect on PGC1-α and SIRT1 genes (P<0.05).

HIIT exercises lead to increased expression of GLUT4 and, consequently, insulin sensitivity. So, diabetic patients seem to have improved their health and muscle levels by employing HIIT training for at least 8- week in order to increase SIRT1 and PGC1-α.

In this research work, constructing and optimizing the applicability of a new electrochemical sensor based on modifying bare graphite pencil electrode with Ag Nano particles and prednisolone drug using cyclic voltammetry (CV) technique has been presented.

The successive voltammogrames at low scan rates were applied on the surface of bare pencil graphite electrode to produce durable and stable films. Scanning electron microscopy was used to characterize the modified surfaces of PGE/AgNPs and PGE/AgNPs/ Prednisolone. The new electrochemical sensor was successfully utilized to estimate caffeine contents in pretreated drug supplements and drinking samples.

The results revealed that this modified electrode has a good electro catalytic activity to oxidation of caffeine with obtained parameters of α = 0.65, log Ks =3.39 and Γ =3.4×10-4. Under the optimized conditions, Caffeine was determined over the concentration of 25-600 nmoLL-1 with limit of detection of 8.17 nmoLL-1.

This study focused on constructing and optimizing a new modified pencil graphite electrode to determine caffeine in its real samples. The simple, fast and cost effective electrodeposition technique was used to deposit AgNPs and Prednisolone. This electrochemical sensor also has some advantages such as high stability, desirable repeatability and acceptable sensitivity. So, this new sensor can be recommended for analyzing drug supplements and soft drinking samples with high accuracy and precision in analysis.

Shoulder impingement syndrome is one of the most common disorders in volleyball players, which can lead to a decrease in athletes' performance by altering their proprioception, muscles imbalances and movement patterns. The purpose of this study was to investigate the effect of eight weeks' focused scapular training on pain, proprioception, scapular kinematics and upper extremity performance in volleyball men with shoulder impingement syndrome.

In this study 30 male volleyball players with shoulder impingement syndrome was selected from statistical population as a sample and randomly divided into two groups of training (N=15) and control (N=15). The training group performed eight weeks of focused scapular training for 60 minutes in three sessions per week. Pre-test and post-test of pain, proprioception, scapular kinematics and upper extremity performance were measured in two groups.

The results showed that training significantly reduced pain (P≤0.001), reduced error of regeneration (P≤0.001), increased scapular upward rotation in 135 degrees (P≤0.001), and increased upper extremity performance (P≤0.001). There was no statistically significant increase in scapular upward rotation at 45, 90 and end of range of motion in the training group (p>0.05). No statistically significant changes were observed in the control group (p>0.05).

It seems that eight weeks of scapular focused training had an effect on the pain, proprioception, scapular kinematics, upper extremity performance of volleyball players with shoulder impingement syndrome.So it can be used as an appropriate training method in volleyball players with shoulder impingement syndrome.

External laryngeal trauma is rare. It has a population incidence of 1 in 137,000 in adults. In developing countries blunt trauma is more common than penetrating trauma. Blunt trauma may occur due to accidents, sports injuries or hanging. Laryngeal trauma manifests as a spectrum of symptoms and signs ranging from cardiopulmonary arrest to subtle changes in voice quality. The most common presenting feature of laryngeal trauma is hoarseness, followed by dysphagia and pain. Although blunt laryngeal trauma is rare, but it can be life threatening. So, its early and proper management will remarkably affect the immediate probability of patient’s survival and their long term quality of life.

In this cross-sectional and descriptive study, medical records of 30 patients with blunt laryngeal trauma, who were admitted in ENT ward of Imam Reza hospital over a 10-year period, were evaluated.

30 patients, including 27 (90%) males and 3 (10%) women were studied. Mean age of patients was 36.13±10.53 years. The most common cause of blunt laryngeal trauma was vehicle accidents. The most common presenting symptoms were neck pain and tenderness. Subcutaneous emphysema was the most common radiological finding. The most common laryngoscope findings were swelling and hematoma of true vocal cords. Treatment modalities were supportive therapy performed on 26(86.7%) patients, tracheotomy on 3(10%) patients and open surgery on 1(3.3%) patients. Also 2 (6.7%) patients required intubation.

In most patients suffering from mild trauma, conservative therapy is mostly administered. Any delay in early and proper diagnosis and treatment may be life threatening. So in such situations the patient's airway should be evaluated by skillful experts and emergency procedures have to be applied. Also any changes in patient's signs should be monitored frequently and the required diagnostic and therapeutic procedures must be applied.

Variations of the vertebral artery origin are congenital abnormalities that occur during embryonic development. The vertebral artery origins from the superior part of the first part of the subclavian artery and it provides the main blood supply of the posterior cranial fossa structures. Several variations in the vertebral artery origin and its entry to the transverse foramen have been reported in advance. However, mention to the variation of the right vertebral artery origin and its entrance to the transverse foramen is rare. By describing dissection of an old man cadaver, two vertebral arteries were observed which were arised from the first part of the subclavian artery at the right side, and they follow a different direction to enter the transverse foramen. One of the arteries rises in its natural direction and enters into the transverse foramen of C6, and the other arteries take an abnormal direction upwards and then enter the higher level surface into the transverse foramen of C4. It is necessary to mention, the artery on the left was in its normal state. Regarding neck root surgery, knowing these variations reduces arterial injury during surgery and angiography.