فصلنامه علوم پزشکی دانشگاه آزاد اسلامی مشهد
سال پنجم شماره 4 (پیاپی 20، زمستان 1388)

Acute renal failure (ARF) is a common problem among the admitted neonates in Intensive Care Units. In most of the patients, ARF accompanies with a predisposing factor such as sepsis, heart failure, perinatal asphyxia or prematurity. Due to the relatively high prevalence of ARF in neonates, the present study emphasizes on the fact that misdiagnosis and under treatment of ARF can lead to adverse complications. So, our objective is to find the frequency and etiology of renal failure among the admitted newborns in a NICU.In this study, the profiles of 2400 admitted newborns in the NICU of Bahman 22nd Hospital of Mashhad over a period of 5 years were reviewed. There were 50 newborns with the inclusion criteria of renal failure. Patients’ serum creatinin and urine volumes were measured and compared with a standard table. Finally, the data was analyzed by SPSS, setting a significance level of P≤0.05.The prevalence rate of ARF was found to be 2.1% with a rate of 2.3% among the male neonates and that of 1.8% among the females which was not significantly different (P=0.093). Concerning the type of renal failure, 18 neonates (36%) were diagnosed as renal ARF, 31 neonates (62%) as pre-renal ARF and 1 neonate (2%) as post-renal ARF. In this study, the most common causes of ARF were dehydration (28%), respiratory distress syndrome (18%), Icterous and poor feeding (16%), asphyxia (16%) and Infections (14%), respectivelyPre-renal factors, especially dehydration and poor feeding are the most common causes of acute renal failure in newborns.

Steoporosis is currently one of the prevalent diseases. The effect of exercise on bone marrow density (BMD) has been documented for all age groups. The aim of this research was to compare the effects of endurance vs. resistance trainings on local Bone Mineral Density (BMD) changes. Thirty-six volunteer female university students (age average: 22.58±1.56; Body Mass Index average: 22.85±2.17), with sedentary lifestyles, were selected and randomly divided to three groups (n=12 in each group). These groups were determined as: The endurance group who ran for 36 sessions on a treadmill over a period of 3 weeks at 70 to 80 percent of the maximum heart-beat rate. They were required to run for 40 minutes per session on the other hand, the resistance group received 36 circuit training sessions at the rate of 70 to 80 percent of 1RM with 6 to 8 repetitions in 3 sets with 2 minutes of rest in between. The third group of the study was the control group.Both the endurance and the resistance training protocols induced significant increases in BMD in the areas of lumbar, neck and femur (P<0.05). However, the variation was more significant for the endurance group in the neck and femur while it was in the aerobic group where better effects were observed in the lumbar region (P<0.05). There was no considerable differences between the two modes of exercise (i.e. endurance and resistance) in terms of the increase of skeleton’s local bone mineral density.

Toll-like receptor (TLR) stimulation can lead to the activation of both innate and adaptive immune responses. Recently, some reports have pointed out to the role of membranous form of TLR2 in asthma pathogenesis. In this respect, this study aimed to examine serum and sputum levels of soluble form of TLR2 (sTLR2) in both patients with asthma and healthy individuals. Serum and sputum samples were obtained from asthmatic patients (n=33) and normal subjects (n=19). All the subjects were otherwise healthy. The asthmatic patients were classified into four groups according to Global Initiative for Asthma (GINA). Eosinophile count and total serum IgE were determined in peripheral blood and sputum. Also, we established a sandwich ELISA to measure the serum and sputum levels of sTLR. The means of sTLR2 optical density levels in serum and sputum samples of the asthmatics were significantly lower than those obtained from the healthy controls)0.44±0.12 VS 0.72±0.15 IU/ml, P=0.003). sTLR2 optical density decreased concomitantly with the increase in the levels of asthma severity, but the differences observed were not statistically significant. The levels of sTLR2 decreased in serum and sputum samples obtained from asthmatic patients, as compared to the healthy individuals.

Surgical treatment of Lumbar Disc Herniation (LDH) is one of the most common surgeries in the world. In many studies the success is related to the radiological results. The aim of this study, however, is to determine the effects of some psychological factors such as depression, anxiety and patients’ expectations concerning their satisfaction from Disk Herniation surgery (DHS).Sixty patients who were candidates for DHS were examined for depression, expectations, anxiety and satisfaction before and three months after the surgery using standard questionnaires.The patients consisted of 33 females (55%) and 27 males (45%). The average of pain acuity before the surgery was measured as 7.25 units which decreased to 2.1 units after the operation. 93.3% of the subjects were diagnosed with anxiety of different degrees and 66.7% with depression. 70% had high expectations. The patients’ satisfaction rate was ranging from 1.7 to 8.9 (mean= 5.5). Satisfaction gained the highest rate in the patients aging between 30-39 years old. Also, depression and high expectations were found to be associated with lower levels of satisfaction.Depression decreases patient’s satisfaction while low expectations can increase it.

Peptic ulcer disease (PUD) includes both gastric and duodenal ulcers. There are three major factors which affect its aetiology: Consumption of NSAIDs, Helicobacter pylori infection and hyperacidity state. The objective of the present study is to compare two Anti Helicobacter Pylori eradicative regimens (OCA and OCM) to determine for the preference of replacing Metronidazol with Amoxicillin in Mashhad.Randomized sampling was used to select 120 endoscopic proven PUD patients for this study. The patients had referred to the hospitals of Mashhad University of Medical Sciences during the years of 1385-88 (HS). They were equally divided into two groups (60 patients in each group). All the individuals were required to complete a questionnaire and received the Urea Breath Test. Then, the first regimens prescribed for the first group consisted of Omeprazole (20mg/Bid), Clarithromycin (500mg/Q12H), and Amoxicillin (1gr/Q12H). For the second regimen, the patients in the second group were given the same prescription except for Amoxicillin (1gr/Q12H) which was replaced with Metronidazole (500mg/Q12H). H pylori infection was mostly frequent in the third and fourth decades of life. Most of the patients were male with lower level of education. The comparison between the two treatment protocols did not show any meaningful differences (P=0.927).Although the efficacy of these two regimens is near equal, due to better results of Amoxicillin, mainly tolerance and lower complications, OCA regimen is preferred.

There are about two millions of wounds caused by mammal biting annually. In our country, the current trend in the increasing cases of people bitten by animals remains of prime importance from sanitary-economic point of view. This study was carried out by determining and specifying the registered cases of animal biting for the last 3 years. The cases had referred to an anti rabies clinic in Mashhad. The present study tends to find out a more precise distribution rate of the disease in order to be able to have more efficacious plans and control in the community. Initially, all the files reflecting information about the patients who had referred to the anti-rabies clinic located in No. 2 Healthcare Center of Mashhad. The cases were studied separately for each year; i.e. the years of 1385 through 1387 HS. Then, based on the required data gathered. Distributive tables were made for each year. According to the findings of the study, 3809, 3294 and 3535 cases were bitten by animals in different regions in Mashhad during the years of 1385, 1386 and 1387, respectively. The percentage of bitten cases aging in a range of 10-19 years old was more than the incidents in the other groups. Also, the number of bitten males was more than the bitten females. In addition, it was found that the quantity of biting cases in urban areas was more than those in the rural regions. The findings also indicate that the amount of cases that received partial treatment was more than those who had complete treatments. Furthermore, most of the cases were bitten by dogs and the upper and the lower limbs were the most affected parts of the body. During warm seasons, young males are at risk of biting. After the incident, washing the wound with water and soap as well as rabies vaccination are recommended.

Liver is the main organ in the metabolic process of carbohydrates. Alterations in carbohydrates metabolism and diabetes mellitus (DM) are common in cirrhotic patients. For instance, resistance to insulin is an important prognostic factor in liver cirrhosis. The aim of this study is to determine the incidence of diabetes and its effective factors in cirrhosis patients, as compared to the normal group. This case-control study was conducted on 100 patients with cirrhosis who were admitted to Aria, Bahman 2nd and Shahrivar 17th Hospitals. The subjects were selected through simple random sampling. Based on the criteria adopted for this study, the patients were qualified to enroll in the study. Checklists were completed for the patients. The presence of DM on the part of the subjects was diagnosed either by having a history of DM and the use of anti-diabetic drugs such as glybenclamid and insulin, or FBS > 126 mg/dL at two times. Data analysis was performed using Pearson Chi-square and Fisher exact test. Out of all patients 37 were females and 63 were males (Mean age 63.57 years). Prevalence of DM and IFG in these patients were much more than normal population (P<0.05). There were significant statistically relationship between sex (F>M) and age>60 years in diabetes and cirrhosis patients in compare with normal group (P<0.05). Family history of DM and severity of cirrhosis were also associated with DM (P<0.05). Among complications of cirrhosis, prevalence of DM was more in patients with encephalopathy and ascites.In this study, our findings indicate that cirrhotic patients are at the increased risk of DM occurrence. Female sex, age>60 years, family history of DM, severity of liver disease and presence of encephalopathy and ascites were associated with DM occurrence in these patients. The Regular screening for DM can be useful for early diagnosis and treatment of these patients.

Multiple Sclerosis (MS) is a disease of central nerve system which involves the brain and spinal cord. The cause of this disease is still unknown. This disease causes some disorders in conducting the nerve and electrical currents by destroying the myelin. Thus, due to the vital acuity of the problem, the purpose is to study the effect of aquatic exercises for 8 weeks on the balance improvement in female MS patients.This is an applied research study with a Quasi-Experimental method. The present study was carried out on 45 female MS patients who were randomly selected from 100 MS patients. The subjects, aging from 20 to 50 years old, fell in a range of 4±1 years in terms of duration of illness with a range of 1-5 degrees of illness. They were divided into two groups: Experimental group consisting of 25 patients and the Control group with 20 patients. The Experimental received the treatment as programmed for 8 weeks with 3 sessions per week. The treatment included exercising at a maximum heart beat rate of 40 to 50 percent of intensity. The quality of life (QOL) was determined for both groups of the study before and after the study, using FAMS, Version 2. Finally, the gathered data were analyzed by using descriptive statistics and dependent sample t- test. The findings indicate that after 8 weeks of aquatic exercising, the balance was meaningfully improved in the Experimental group (P=0/000). A significant difference was observed in their differences of means from the pre-test to the post-test, in terms of QOL (P=0.000). However, there was no significant difference between the pre- and post-test grades of the Controlled group, in this regard (α=0.05). There was an average of 9.28% of improvement in the Experimental group’s quality of life after the treatment. Such a difference is regarded as remarkable improvement for MS patients.Considering the results of this research, it seems necessary to propose aquatic exercises for MS patients. Therefore, it is recommended these exercises be practiced by the MS patients under the supervision of specialists as a supplementary remedy besides the medical treatments.