مجله علوم پزشکی رازی
سال هفدهم شماره 9 (پیاپی 79، آذر و دی 1389)

Poor pregnancy outcome and complications like pre-eclampsia, preterm delivery, premature rupture of membranes (PROM) and Intra Uterine Growth Restriction (IUGR) have special importance and finding new methods for their prediction have been always under serious concern. The purpose of the present study is to evaluate the poor pregnancy outcome in nulliparas who had microalbuminuria at the end of second trimester of their pregnancy. The study was conducted as a prospective cohort study on 490 nulliparous women who were at the end of the second trimester of pregnancy. Urine test for albuminuria and creatinine measurement was performed in all women and an albumin creatinine ratio (ACR) was calculated according to milligram per gram. The women were then divided into 3 groups of severe, moderate and mild microalbuminuria according to the ratio. Then the women were followed up to the end of their pregnancy and compared for preterm labor, pre-eclampsia, IUGR and PROM. Statistical analysis was performed using SPSS V.15. Student t - and Chi square tests were used for analysis. P value of less than 0.05 was considered as significant. There was no significant difference in regards to BMI, age and age of pregnancy at the time of sampling. Preterm labor {21 (55.26%) cases VS 65 (14.38%), p=0.001}, pre-eclampsia {19 (50%) cases VS 39 (8.62%) cases, p=0.001}, IUGR {15 (39.47%) cases VS 30 (6.63%) cases, p=0.001} and PROM {11 (28.94%) cases VS 47 (10.39%) cases, p=0.001} were more in the case group than control group. Gestational diabetes did not show significant difference between the 2 groups. Preterm labor, pre-eclampsia, IUGR and PROM were more in the women who had microalbuminuria at the end of the second trimester of their pregnancy.

Animal models of psychosocial stress are a good model for studying stress-related behavioral and endocrinological disorders in humans. The aim of present study is to investigate the effect of psychosocial stress on plasma testosterone level and pain perception. In this experiment 74 male rats (200-250 g) and 20 female rats (200-300 g) were used. In experimental groups (S1,S2), subjects were exposed to the attacks of stimulus (dominant) rats once a day for 5 consecutive days (30 min VS 4 hr). In control groups, subjects and stimulus rats were housed in different rooms (C1) or in adjacent cages in a room (C2). Pain perception was assessed by means of the Tail flick test. Testosterone was measured by radio-immunoassay. SPSS V.11 statistical software was used for data analysis. One way ANOVA was used to evaluate the results. Psycho-social stress reduced testosterone concentration in subject groups (S1, S2). Tail flick latency decreased significantly in S2 subject group (TFL: 4.2±0.4 s) and C2 control group (TFL: 4.2±0.2 s) as compared to C1 control group (TFL: 5.9 ± 0.8s). In addition there was significant difference between two subject groups (p<0.01). There was no significant difference between subject group (S1) and control groups. This study shows that psychosocial stress decreases plasma testosterone concentration and this effect is independent of length of daily encounters. But the pain perception depends on the length of daily encounters (30 min encounters did not, whereas 4 hr daily encounters did result in hyperalgesia).

Group B Streptococci (GBS) or Streptococcus agalactiae is one of the most common causes of sepsis and meningitis in neonates and of invasive diseases in pregnant women. It can also cause infectious disease among adults with underlying medical conditions like immunocompromised individuals. Polysaccharide capsule is an important virulence factor. Nine GBS serotypes (Ia, Ib, II to VIII) based on capsular polysaccharide antigens have been described. Distribution of capsular serotypes varies over time and by geographic location. The aim of this study was to detect the capsular serotype distribution in GBS clinical isolates based on genotyping of cps-gene cluster and to determine the predominant serotypes of GBS. In this cross sectional study a total of 50 GBS strains were isolated from various clinical sources including: urine, vagina, semen and urethral secretions. GBS was identified by Gram stain, catalase test, CAMP test and also resistance to 0.04 U Bacitracin and SXT disks. DNA was extracted from all the isolates using the wizard SV Genomic DNA Purification system, Promega, USA. The capsular serotype of the isolates was assigned by using a specific-two Multiplex PCR assay. For statistical analysis, Chi-square method was used. SPSS V.13 was also used. In the 50 GBS isolates, the predominant serotypes were III with 25 isolates (50%) and serotype V with 8 isolates (16%). Seven isolates (14%) belonged to serotype Ia and 7 isolates (14%) belonged to serotype II, respectively. Serotypes Ib, IV, VI, VII and VIII were not found and 3 strains were classified as nontypeable. Based on the results of this study, serotypes III and V were the predominant serotypes in GBS clinical isolates.

Balance and gait disorders are common motor complications after stroke. Studies have revealed that conventional physiotherapy cannot manage these disorders efficiently; so more studies addressing the causes of these complications and presenting efficient treatment protocols are crucial. Thirty hemiparetic patients (age range 40-60 years old) participated in this experimental study. Patients were randomly divided in to 2 groups. One group received Constraint Induced Movement Therapy (CIMT) (group1) and the other Mass Practice (group 2) for 3 weeks. Experimental assessments included stride velocity and kinetic parameters of gait (amplitude and velocity of center of pressure sways of paretic and non-paretic limbs in sagittal and frontal planes) that were recorded and compared before and after treatment. For statistical analysis of data, if distribution of data was normal, parametric tests of t and pair t-tests were used. If distribution of data was not normal, non parametric tests of Wilcoxon and Mann-Whitney were used. SPSS V.11.5 was also used for data analysis. In both groups, stride velocity increased (p=0.03, p=0.01). In CIMT group, COP sway for paretic and non-paretic limbs decreased in frontal plane (p=0.03, p=0.008). COP sway velocity for paretic limb decreased in both planes (p=0.01, p=0.03). For mass practice group, only COP sway amplitude for non-paretic limb decreased in sagittal plane (p=0.03). Physical therapy based on “Constraint Induced Movement Therapy” can more efficiently manage dynamic balance gait disorders by overcoming "learned non-use" phenomena and improving somato-sensory deafferentation to central motor controllers.

The stigma associated with mental illness adds to the public health burden of mental illness itself. In general terms stigma is the status loss and discrimination triggered by negative stereotypes. To our knowledge, this is not any large scale study of knowledge of and attitudes towards mental illness in Iran. Therefore, the aim of this study was to determine the knowledge and attitude of a community sample towards mental illness in city of Tehran. This cross-sectional study was conducted in city of Tehran between April and December 2009. By a multistage random sampling of household respondents, 800 subjects were recruited in the study. A modified version of the questionnaire developed for the "World Psychiatric Association Program to Reduce Stigma and Discrimination" was used. The method of collecting data was interview by trained interviewers. We used SPSS V.13 software for describing and analyzing data. Chi-square was used for subgroup analyses. The mean age of sample was 37.5 years (14.7 yrs) with 53.3% being males. Most of them (70%) mentioned that mental illness is treatable out of hospital and 74% of them believed patients with mental illness could have ordinary jobs. About 68% had a positive attitude towards friendly relationship with mental illness patients. About 52.5% of the subjects believed that people with mental illness are dangerous because of their violent behaviors. Only 17% of subjects were afraid of having conversation with a mentally ill person. Generally, socio-demographic variables were not associated with knowledge and attitudes of peoples towards mental illness strongly. There is not extensive stigmatization of mental illness in our sample. Compared to other similar studies, the views and attitudes of our sample towards mental illness were partially good and acceptable.

Werding-hoffmann disease is a degenerative disease of motor neurons that begins in fetus and continues to be progressive in infancy and childhood. Most of them die by 2 years of age because of respiratory failure. The simplest and most accurate method of diagnosis is detection of serum genetic marker of SMA. Case report: In this article a neonate with Werding-hoffmann disease is studied; the importance being that the disease was detected in his parents by DNA analysis. The two previous siblings died during infancy because of respiratory failure and muscular weakness. There was also a positive family history of an abortion during the second trimester; in other words an Autosomal Recessive (AR) disease affecting all of the 4 siblings. Werding-hoffmann is an AR disease with a rare familial incidence.

Despite the high incidence of esophageal and thymic carcinoma in human being, co-existence of these two malignant lesions is very rare. In this study we have reported an 81 year old man with a huge mediastinal tumor (Thymoma) and Squamous Cell Carcinoma (SCC) of esophagus. Case report: An 81 year old man presented with hiccups and progressive dysphagia for solids and was admitted in our hospital as a case of SCC of thoracic esophagus. Pre-operative evaluation showed a huge anterior mediastinal mass. The patient's past history goes back to about 4 years ago, when he was admitted in another center for ophthalmic surgery and chest radiography showed an anterior mediastinal mass. Because of his chief complaint (dysphagia), the patient underwent operation and through the left thoracotomy incision complete resection of mediastinal tumor and esophagectomy was done. Despite the high incidence of esophageal and thymic carcinoma in human being, co-existence of these two malignant lesions is very rare.