مجله پزشکی دانشگاه علوم پزشکی تبریز
سال چهل و دوم شماره 6 (پیاپی 150، بهمن و اسفند 1399)

Rising follicular keratin secretion, increasing sebum production, and Propionibacterium acnes are among the main etiology of acne vulgaris formation. Antibiotics are the predominant conventional treatment of acne. Antibiotic resistance is the main problem in the ordinary treatments of acne. Therefore, newer treatments are necessary. Intense pulsed light (IPL) is a novel therapeutic option with rapid application in this field.

Patients referred to us were randomized into two groups: group A (cases) and group B (controls). In addition to conventional antibiotic therapy, IPL was prescribed to group A while azithromycin alone was prescribed to group B. IPL treatment was performed weekly for five weeks and the patients were followed for three months. Declining inflammatory lesions count after the intervention was considered the remission scale.

In group A, moderate, partial, and complete remission occurred in 4, 9, and 7 patients, respectively. In group B, moderate, partial, and complete remission occurred in 10, 7, and 3 patients, respectively. Statistically, the remission difference was meaningful between the two groups.

IPL with conventional antibiotics is an effective treatment choice in moderate to severe acne vulgaris but also is a more accelerating agent in treatment versus antibiotics alone.

Portal hypertension refers to the pathological increase in portal pressure or pressure gradient difference between the portal vein and lower vena cava. This study aimed to determine the etiology and prognosis of portal hypertension in children of northwest Iran for ten years.

In this descriptive cross-sectional survey, 73 children under the age of 18 years with portal hypertension who were admitted to the Gastroenterology department of Tabriz Children Hospital for ten years were studied. These children were evaluated for demographic data as well as the underlying etiology according to the liver biopsy, abdominal ultrasound, and liver Doppler ultrasound records.

The most common cause of portal hypertension was cryptogenic cirrhosis with a frequency of 21 (28.8%). Out of the total number of patients, 7 deaths (9.7%) were observed whereas 84.7% of patients had successful treatment and were discharged without complications. Two patients underwent portosystemic shunt surgery. Liver transplantation was done for 2 cases. Sclerotherapy was performed for 35 patients (48.6%). Out of this group of patients 28 cases (80%) had a good response to sclerotherapy, 4 cases (11.4%) died, two were referred for portosystemic shunt, and one patient underwent liver transplantation.

The etiologic factors leading to portal hypertension have a wide diversity in terms of underlying disease and prognosis. A thorough assessment of the cause of portal hypertension is important for making the best therapeutic decision. Early diagnosis has a critical role in improving response to therapy and preventing complications.

Interleukin 8 increases in various types of meningitis, specifically acute bacterial meningitis inflammation, and it is important in the distinction between types of meningitis. The present paper aims at evaluation of the level of interleukin 8 in cerebrospinal fluid in acute adult bacterial meningitis.

All adult patients’ with diagnosis of suspected meningitis with symptoms of fever, headache, neck stiffness, and consciousness disorder. Lumbar puncture was taken in between the third and fourth vertebra by a specialist physician for all patients suspected with meningitis. To determine the level of consciousness, the GCS of the patients was determined and the cerebrospinal fluid was cultured and sent to the laboratory for the analyses of cell count, diffraction, CSF fluid glucose, CSF fluid protein, LDH, or lactate dehydrogenase, and the level of interleukin 8.

The mean of IL-8 protein was 296.17±48.57Pg/ml in patients with aseptic meningitis and 1088.96±526.55Pg/ml in the group of patients with septic meningitis. There was a significant difference between the two groups in terms of the amount of interleukin 8 (p = 0.009). Cutoff was 297.6 Pg/ml for the detection of positive bacterial meningitis with a sensitivity of 92% and the specificity of 83.1% was 297.6 pg/ml.

Interleukin 8 has a high sensitivity and specificity in the diagnosis of bacterial meningitis from aseptic meningitis, and along with the measurement of cerebrospinal fluid protein, it can be a good criterion for differentiation of bacterial from aseptic meningitis.

The incidence and prevalence of malignant nasopharyngeal cancers (NPC) are different in each part of the world. The prevalence of this malignancy is about 0.5 in every 1000 people in the USA, while it is about 20 in every 100 people in China. this difference is due to nutritional, environmental, and genetic factors, especially for endemic regions. This malignancy is more common in men and is often seen in the sixth decade of life. We decided to do this study from the point of epidemiologic, clinical, and radiologic findings in patients with nasopharyngeal cancers.

This is a cross-sectional descriptive study of patients who were admitted to the ENT ward with the diagnosis of nasopharyngeal carcinoma from 2004 to 2014. Thirty-two patients were studied from the point of age, gender, risk factors, clinical and radiologic findings.

Of 32 patients, 26 patients (%81) were male, and six patients (%19) were female. The mean age of the patients was 50.28 years old. Nineteen patients were self-employed, 4 were farmers, 3 were staffers, and 6 were house worker women. %84 of the patients had a negative family history of nasopharyngeal carcinoma. %66 of the patients had neck mass, and the second most common clinical finding was nasal obstruction. The most common site of tumor origin was the right lateral wall (%37), and the second was the left lateral wall (%28). Eight patients had erosion of the skull base, and 14 patients had tumor expansion to the paranasal sinuses and orbital cavity.

In patients complaining of a neck mass, nasal obstruction, and headache, nasopharyngeal cancer should be highly suspected. Nasal endoscopy and biopsy of the suspected lesion are needed for correct diagnosis and treatment.

This paper presents a method to improve medical radiography images based on the use of statistical signal moments.

In this paper, the image with noise is considered as a statistical signal, and the noise reduction is performed by using fractional moments. The fractional moment’s method, on the one hand, has a speed similar to the moment method, and, on the other hand, has not the limitations of the moment method, which sometimes achieves inaccurate results. The proposed method is ultimately examined on radiographic images (CT).

The information obtained from the fractional moments of the received signal is a criterion to estimate the noise parameters and the gray scales of the main image. One of the limitations of the proposed method is that the image should be sent several times, because in statistical discussions, we cannot make a decision with only one sample. The error of the proposed noise reduction method in terms of the number of times the original image was sent, is about 0.009, 0.0009, 0.0002, and 0.0001, for n = 3, n = 6, n = 9 and n = 14, respectively.

The simulation results show that the proposed method is more effective than the most conventional noise reduction methods, both in the low signal to noise ratio and in terms of image quality, and is more powerful than the most notable noise removal methods in restoring the subtleties and image details.

Cow’s milk is one of the first foods added to infants’ diet and cow’s milk allergy (CMA) is the most common food allergy in the first year of life. The aim of this study was to survey the frequency of infants with cow’s milk allergy using COMISS questionnaire.

In a cross-sectional, descriptive study, 100 infants were selected by a convenient method. Demographic information and clinical manifestations were completed based on COMISS Questionnaire for all infants. Data were analyzed using chi-square and independent t-test.

The finding of this study shows that from 100 infants (51 males, 49 females), with a mean age of 3.5 ± 1.4, 61% of them were breastfed, 30% were fed both cow’s milk and breast milk, and 9% were fed only cow’s milk. The probability of cow’s milk allergy using the COMISS Questionnaire was positive in 8% of infants. According to the criteria of this Questionnaire, 65% of infants acquired a score of 0-5, 27% scored 6-11, and 8% scored 12 and above A significant association was found between cow’s milk allergy and infant’s diet (p <0.001). A significant association was also found between growth index (weight p=0.05, height p=0.02, and head circumstance p=0.03) and CMA.

It seems that using non-invasive methods such as COMISS Questionnaire can be helpful for the diagnosis of CMA and also breastfeeding might be reducing the allergy to cow’s milk.

Oxidative damage is one of the main causes of Red blood cell (RBC) storage lesion which can reduce RBC survival during RBC storage in blood bank condition. In this study, we evaluate the effect of N-acetyl cysteine (NAC) as an anti-oxidant compound on RBC oxidative damage and RBC metabolism during storage of this product.

In this experimental study, 10 bag of packed RBC were provided to the Iranian Blood Transfusion Organization's Innovation Center were randomly selected and effect of NAC was investigated on metabolism, oxidative status and hematologic variables of RBC during RBC storage. The results of this study were compared between two groups of NAC treated RBC and untreated RBC (without NAC). All of the data were analyzed with SPSS statistical program (version 22).

In this study, the concentration of lactate and LDH enzyme activity in the NAC treated RBC were lower than the control group (without NAC). The concentration of malondialdehyde (MDA) as a lipid peroxidation marker in the NAC treated RBC was lower increase than the untreated RBC. Also antioxidant capacity was so higher in the NAC - RBC than in the control group, especially in the 28th day of RBC storage (Pday28 <0.05).

The results of this study indicated that the use of NAC as an additive solution could decrease oxidative damage via maintaining of the RBC oxidant capacity during RBC storage. In the future NAC may be used as an additive for maintaining of the RBC survival and RBC quality during storage of RBC in blood bank condition.

Although many warts are treated with usual methods, resistant cases are common problems. Bleomycin is one of the drugs used for resistant cases. The aim of this study was to compare the effect of cryotherapy and intralesional bleomycin injection combination with cryotherapy in the treatment of resistant warts.

Sixty patients with resistant warts were selected and randomly divided into two groups of 30 A and B patients. In each group, cryotherapy was performed three sessions during 0, third and, sixth weeks in case of visible lesions. In group B, in addition to cryotherapy in week 0, and in the presence of visible lesions during week 3, injections of intra-lesions of bleomycin 1 mg/ml were administered. Treatment outcomes and possible complications were evaluated during the third and sixth weeks.

The response to the treatment was defined as poor, moderate, and well by the physician, which was 16.7%, 53.3% and, 10% in group A after 3 weeks of treatment, respectively and was 16.7%, 50% and, 33.3% in group B, respectively. The response to the treatment after 6 weeks of treatment was 33.3%, 40%, and 26.7% in group A and was 6.7%, 40%, and 53.3% in group B, respectively.

Combined treatment of cryotherapy and intralesional bleomycin injection is more effective than cryotherapy in the treatment of resistant warts.

Sleep-disordered breathing is a common problem in children and is associated with increased cardiovascular morbidity. The circulating level of C-reactive protein, a pro-inflammatory protein, is associated with increased risk for atherosclerosis. The aim of this study was the comparison of C-reactive protein level and erythrocyte sedimentation rate in children with tonsillar hypertrophy before and after adenotonsillectomy.

All patients aged between 4 to 10 years who had underwent adenotonsillectomy due to obstructive sleep apnea were enrolled. Serum C-reactive protein and erythrocyte sedimentation rate were measured before and after adenotonsillectomy. Data were analyzed with SPSS version 19.

In this study, 384 patients were enrolled. The average age of the patients was 6.7 years. The C-reactive protein level in 91 patients (23.7 %) was decreased and in 286 patients (74.5%) did not change and in 7 patients (1.8%) it was increased. Decreasing serum C-reactive protein level and erythrocyte sedimentation rate was statistically significant after adenotonsillectomy (P-value < 0.05).

Obstructive sleep apnea induces a systemic inflammatory response so frequently associated with an increase in serum C-reactive protein and erythrocyte sedimentation rate that is reversible with surgery and if left untreated may lead to cardiovascular morbidity.

Astronauts and those in microgravity (MG) conditions are faced with neuromuscular challenges. On the other hand, high intensity interval training (HIIT) have been introduced as an effective factor in strengthening the nervous system. Therefore, the purpose of this study was to investigate the effect of six weeks of high intensity interval training under simulated microgravity condition on brain degenerating myelin basic protein (dgen-MBP) level in healthy male rats.

Metohds:

This experimental study was conducted on 30 male rats with an average weight of 189.2 ± 5.7 grams. They were randomly divided into 5 groups: Base line (n=6), MG control (n=6), HIIT control (n=6), HIIT (n=6) and MG & HIIT (n=6). The training groups performed the HIIT on a treadmill, with 30 seconds running time of 29 m/min and a 1 minute rest time of 13 m/s to until the fatigue. Rats were killed 48 hours after the last training session and an ELISA kit was used to evaluate the data related to dgen-MBP.

The results of one-way ANOVA showed a significant difference between the groups in the functional test variables and dgen-MBP (P≤0.05). In the meantime, the MG & HIIT group showed the highest amount of dgen-MBP compared to the control group.

It seems that people who are in a microgravity situation, by applying HIIT training for at least 6 weeks, can increase their dgen-MBP levels, improve their health and nerves, and increase the time to fatigue.

Rosa canina L. has high levels of carotenoids, flavonoids and, vitamin C antioxidant compounds that can withstand the destructive effects of exhaustive exercise-induced oxidative stress. The present study aims to investigate the effects of concurrent eight-week aerobic training and Rosa canina L. fruit hydroalcoholic extract on some liver enzymes and malondialdehyde of liver in male rats following an acute aerobic exercise until exhaustion.

The present research was an experimental study. Forty male Wistar rats were randomly divided into four groups (N=10): placebo (without exercise + distilled water 2 ml supplement), supplement (without exercise + Rosa canina L extract, 100 mg/kg), exercise (8 weeks exercise + distilled water 2 ml), combined (8 weeks exercise + Rosa canina L extract, 100 mg/kg). At the end of the experiment, half of the rats were killed immediately before exhaustive exercise; while the other half were killed immediately after performing an acute exhaustive exercise on the treadmill. Serum enzymes AST, ALT, and hepatic malondialdehyde levels were measured by ELISA and thiobarbituric acid methods, respectively.

The results show that in all groups except the combined group serum AST, ALT, and malondialdehyde of the liver were significantly increased following an acute exhaustive exercise compared to the prior exhaustive exercise (P<0.05).

The use of Rosa canina L Fruit hydroalcoholic extract with aerobic exercise prevented the increase of hepatic malondialdehyde and serum enzymes AST, ALT levels following an acute exhausting exercise.

Training of elastic walking is a new method for elasticity in gait and correction of the distribution pattern of plantar pressure in patients with low back pain during gait. This study aimed to investigate the distribution pattern of plantar pressure during gait in women with low back pain following 8 weeks-training of elastic walking.

The present study was quasi-experimental. In this research, 20 women with low back pain were divided into control (n=11) and experimental (n=9) groups. Subjects from the experimental group performed elastic gait training for 3 sessions per week for 8 weeks while the control group didn’t have any exercise program. The plantar pressure variables included the peak of vertical ground reaction forces, the time to peak of ground reaction forces, loading rate, the peak of plantar pressure on the ten foot regions, the peak of ground reaction forces on the ten foot regions, and displacement of the pressure center in two internal-external (copx) and anterior-posterior (copy) lines. The distribution pattern of plantar pressure during gait was recorded by a foot scan system (Sampling rate 300 Hz) in pre-training and post-training. Two-way ANOVA was used to analyze the data. The significance level was set at P < 0.05.

In the experimental group, the results of this study demonstrated lower peak vertical reaction force (FzMS component) during post-test compared with pre-test (P = 0.002). Moreover, findings showed that the main effect of group on peak pressure in the mid-foot region was significant (P = 0.011). The results showed no significant difference concerning the main effect of group, the main effect of time and effect, interaction time and group on peak vertical reaction force, displacement of pressure center, vertical loading rate, and walking stance time (P > 0.05).

The findings of this study showed that training of elastic walking does not have a significant effect on stance time. Also, training of elastic walking in the experimental group reduced the peak vertical ground reaction force (FzMS component) during the post-test compared with the pre-test that can correct the walking pattern and improve the chronic low back pain.

The purpose of this study was to determine the degree of alignment of prostate carcinoma in a rectal biopsy with radical prostatectomy in patients with prostate carcinoma to determine which biopsy samples are consistent with surgical specimens.

In this cross-sectional study, out of 122 patients with prostate cancer who had undergone radical prostatectomy surgery in Sina hospital of Tabriz 65 patients with clinical records and pathological reports of needle biopsy, and radical prostatectomy biopsy specimens were available.The required information was recorded in questionnaire made for this study, and then the pathologic report and Gleason score and lymph-vascular involvement of the specimens were determined separately and finally the Trans rectal pathology report of the biopsy was compared with the histopathology report of radical prostatectomy in each patient.

The most common Gleason score and radical prostatectomy score were 6 (41.5%) and 6(40%), respectively. The lowest frequency of Gleason score, radical of the prostatectomy, and Trans rectal biopsy score were 10 (3.1%), 8(4.6%)%), and 4(4.6%), respectively. Generally, 24.6% of the prostatectomy samples were similarly scored, while 63.1% reported Trans rectal biopsy specimens and 12.3% reported low Trans rectal biopsy. By grouping the samples into histopathology levels this association was 41.5% identical in terms of scores and 49.2% in excess and 9.2% in lower reporting. The most common histopathology degree was rarely (49%) in Trans rectal biopsy and moderate in 40% in radical prostatectomy about 43% of badly differentiated cancers in the surgical specimens remained at the same level and the highest reporting rates were in the group with a good degree of distinction (66%). The highest correlation between rectal biopsy samples and radical prostatectomy samples was at the 6th grade and lowest compliance rate was in 4th and 8th grades.

The highest degree of alignment was in the bad differentiation group, which indicates the high predictive power of biopsy specimens at this degree of differentiation. The present study suggests that the size of the smaller prostate and the high pre-surgical PSA may be predictive of increasing the Gleason score after radical prostatectomy.

Thalassemia is the most common hemoglobinopathy, worldwide. Chronicity and complications of thalassemia can affect the quality of life in these patients. Psychological aspects of transfusion-dependent forms of thalassemia (major and intermediate) are well-known, especially in adults. Aim of this study was to investigate the prevalence of mental disorders in thalassemia major and intermediate who were under 15 years old. This study was organized in thalassemia clinic in Tabriz Children’s Hospital from June 2014 to August 2014.

Sixty transfusion-dependent thalassemia patients were eligible in our study. Twenty-six patients were boys and 34 were girls. Mean age of the participants were 9 ±1. A standard questionnaire called K-SADS was used to collect the data during interview by patients and their parents. In this research, the data have been analyzed to demonstrate the prevalence of psychologic disorders and the relationship between psychologic disorders and demographic characteristics.

The prevalence of psychological disorders in our study was: ODD (37%), social phobia (20%), depression (18%), conduct disorders (10%), and enuresis (5%). Also, psychologic disorders had a significant relationship with age and education.

Our study confirmed that about 80% of the participants had one of the psychological disorders. Therefore, a regular psychologic consulting for children and their parents in thalassemia clinics is required.

Multiple Sclerosis is a myelin destroyer disease, which physical activity can be effective in improving it. Therefore, in the present study, the effect of swimming on oligodendrocytic cells and myelin tissue in rat brain of the Cuprizone model of MS disease is investigated.

In this study, 21 male Wistar rats were randomly divided into Control groups, Cuprizone and Swim + Cuprizone. For the induction of MS, Cuprizone 0.6% were gavaged for one month. The group of Swim + Cuprizone swam at the same time with gavage. The training program included 4 weeks of swimming for 5 sessions per week and 30 minutes. Immunohistochemistry technique was used to determine the percentage of immature and mature oligodendrocytes and Luxol fast blue solution for evaluation of myelin density. Image j software and One-way ANOVA was used to analyze the findings.

The mean percentage of immature and mature oligodendrocytes and myelin density in the Swim+Cuprizone group was significantly higher than that of the Cuprizone group (p≤0.05).

Swimming decreases destruction of the oligodendrocytes and myelin cells due to Cuprizone.

MicroRNAs are short non-coding RNA molecules that regulate different biological processes through regulating the expression of different genes and the miR-16 is one of the miRNAs that play an important role in obesity-related disorders. Therefore, the present study was conducted to determine the effect of high- intensity interval training (HIIT) alone and combined with resistance training (CHRT) on miR-16 expression in PBMCs of overweight/ obese middle-aged women.
Methods

Twenty-four overweight/obese, inactive, health middle-aged women participated in two homogeneous groups HIIT (5 bouts of running at 80%–85% of VO2max with active breaks at 60% of VO2max, 5 days/week, n=12) and CHRT protocols (3 day/week HIIT with 2 day/week resistance training protocol with 75-80% of 1-RM, n=12) for eight- week. MiR-16 expressions in PBMCs of overweight/obese middle-aged women were measured by real time- PCR before and 48h after the training protocols.

Expression of miR-16 increased significantly in the both training protocols (HIIT: 2.32 fold, p=0.001 and CHRT: 4.96, p=0.006). However, there was no significant difference found between training protocols.

The eight weeks of HIIT and CHRT training are lead to equally changes in the expression of miR-16, as an anti-inflammatory epigenetic factor, in PBMCs of overweight/obese women.

Walking is one the common daily activities. With the beginning of middle age, weakness in the lower limb muscles can reduce the ability to walk. The use of foot orthoses reduce the load on the limbs and supports the joints during walking. The purpose of the present study was to investigate the acute effect of foot orthoses on the frequency spectrum of ground reaction forces during walking in the older adults.

In this semi-experimental and laboratory study, 21 elderly (15 females and 6 males) with a mean height of 164.19±4.26 centimeters and weight of 80.04±3.50 kg, and age of 66.00±3.50 years were volunteered to participate in the study. The walking trials were done during three conditions including walking without foot orthoses, walking with small and large textured orthoses. The Bertec force plate (made in USA) with dimensions of 40 * 60 cm was used to record ground reaction forces.

The results of this study did not show any significant differences between walking without foot orthoses, walking with small and large textured foot orthoses for frequency of 99.5%, median frequency, frequency band and number of essential harmonics (P>0.05). However, the comfort level during wearing of large texture insole condition significantly increased compared to other conditions (P<0.05).

The textured foot orthoses do not affect the frequency spectrum of ground reaction forces; however, it improves the comfort of the individual while walking.

Peripheral neuropathy is a common complication of diabetes which can lead to impaired postural control. The aim of the present study was to investigate the effect of 12-week resistance training on balance, risk of falling and distribution of foot pressure in diabetic women with peripheral neuropathy.

In a randomized clinical trial, 30 women with type 2 diabetes and diagnosed with peripheral neuropathy were randomly assigned into experimental (n=15) and control (n=15) groups. The experimental group underwent a circuit resistance training program with 50 of one-maximum repetition, 3 -sessions per week over 12 weeks. Before and following the experimental period static and dynamic balance, posture control and risk of falling were assessed.

Static and dynamic balance indices improved following the exercise intervention (P=0.0001). Moreover, risk of falling index decreased in the experimental group compared to control condition (P=0.0001). However, foot pressure distribution was unchanged following exercise intervention (P>0.05).

Circuit training improved balance and risk of falling in diabetic patients with peripheral neuropathy. Therefore, they are suggested to include circuit training as a safe non-pharmacological intervention to improve balance and walking and to prevent falling.

Heart disease is a multifactorial disease with genetic background and environmental factors involved. And new studies believe that markers such as apolipoprotein AI are a better criterion for diagnosis. Therefore, the purpose of this study was to investigate the effect of eight weeks of regular aerobic exercise on apolipoprotein AI gene expression and lipid profile indices in obese women.

Methods:

In this experimental study, 30 healthy obese women aged 35-30 years were randomly selected and divided into control (n =15) and experimental (n =15) groups. The experimental group underwent 8 weeks of regular aerobic exercise at 60-75% of the heart rate reserve three sessions per week for 60 minutes each session. Apolipoprotein AI mRNA expression was measured by Semi-quantitative-RT-PCR method and lipid profiles were measured in both pre-test and post-test.

The apolipoprotein AI gene expression was significantly increased in the experimental group compared to the control group (P<0.05). Also, TG (P = 0.003), TG LDL in the experimental group showed a significant decrease compared to the control group and HDL level in the experimental group was significantly higher than the control group (P = 0.001)

The regular aerobic exercise has an important role in reducing cardiovascular diseases through increasing apolipoprotein AI gene expression and improving lipid

The use of Surgicel is one of the methods used to stop bleeding during various surgical operations, especially neurosurgery. The use of Surgicel may cause complications such as inflammation, delayed tissue repair, and necrosis. This case is a 60-year-old woman with a history of craniotomy and reaction to Surgicel who presented to the hospital with symptoms of seizures. The patient underwent craniotomy after a mass diagnosis in the parasagittal region. After reviewing this case, we concluded that the use of Surgicel can have complications for patients, Therefore, it is recommended to use Surgicel in the patient's body so that it is not treated as a mass, abscess, or hematoma in the postoperative period.