مجله علوم پزشکی رازی
سال نوزدهم شماره 1 (پیاپی 94، فروردین 1391)

Preeclampsia is a severe complication of pregnancy, often associated with significant morbidity and mortality for both mother and newborn. The aim of this study is to evaluate if mean platelet volume during first trimester predict preeclampsia or preterm labour development. All pregnant women, in the first trimester, attending to prenatal clinic at Shahid Akbar Abadi Hospital for routine obstetric care during 2010 were enrolled. According to the study, blood sample was taken from women at the first visit in first trimesters and the third and recorded. After delivery, outcome data were obtained. A total of 400 women were included and 35 (8.8%) and 96 (24%) of them developed pre-eclampsia and preterm labor, respectively. Parameters of platelet during pregnancy were similar between groups. MPV values of pre-eclamptic women were not significantly different with normotensive counterparts. Our study did not provide evidence that MPV changes could predict preeclampsia or preterm labor development.

To define the dynamic organization of the neuromuscular system, we need useful tools that allow for the expression of the neuromuscular system in low dimensional term (i.e one variable), so it seems that relative phase provides a better measure of organization of the neuromuscular system. Besides, selection of a measure for research or clinical use should be motivated by several factors, including the measure reliability. To our knowledge there seems to exist no study that have ever investigated the reliability of the relative phase and deviation phase in healthy or Low back pain subjects in dynamic movement tasks. Twelve healthy volunteers and 12 low back pain patients performed repeated trunk bending motion in eight different conditions of high and low speed, in symmetric and asymmetric planes, with or without external load. All measurements were repeated on a second session, 7-10 days later. Mean absolute relative phase and deviation phase of lumbar-thorax and pelvis-lumbar were used to calculate coordination pattern and variability. Relative reliability was assessed using intra class correlation coefficient (ICC) and absolute reliability was assessed using standard error measurement, minimum detectable change and coefficient of variation. Results in healthy subjects revealed that relative phase and deviation phase showed good to excellent reliability, with ICC range of 5.3-8.4 and in low back pain group ICC range was0 /52-0/85 except in three asymmetric test conditions and one symmetric test condition. SEM values range for healthy subjects were 0/92-4/8 and for low back patients were 1/2-5/8. Relative phase and deviation phase are suggested as good parameter to use for evaluating coordination and variability in dynamic situations such as lifting and complex trunk movement and also for discrimination low back pain patients from healthy subjects.

Mean platelet volume (MPV) is associated with platelet reactivity. Large platelets contain more thrombogenic factors than small ones. Previous studies have shown platelet reactivity in patients with pulmonary thromboembolism (PTE).The aim of this study was to investigate the mean platelet volume (MPV) and platelet count in patients with PTE and healthy control subjects.

In This study, 210 patients with PTE were retrospectively evaluated. The diagnosis of PTE was made clinically and was confirmed with CT angiography. 210 healthy subjects matched for age, gender and body mass index (BMI) served as control group. We recorded the main demographic, clinical and laboratory data of groups. MPV values and platelet counts were measured at the first day of admission.

Mean age between PTE patient and control group was 52.6 ± 19.7 vs. 49.43 ± 20.68 years respectively (p=0.109). MPV was significantly higher among patients with PTE in comparison with control group (10.57 ± 1.08 vs. 9.80 ± 0.86 fL respectively; p= 0.000). Platelet count was not significantly different in PTE patients and control group (231.76 ± 92.22 vs. 243.76 ± 67.32 × 10 9 /L, respectively; p= 0.129).

MPV is a simple and easy test and it can be used as an activity marker of platelet function in PTE. It also shows the platelet production rate and stimulation. We have shown that MPV was increased in patients with PTE. Platelet count was not different between PTE patients and control group.

Learning is a complex process that many factors such as learning style has key roles on it. The goal of this study was to determine learning style of different field of medical residents. By random selection, seven medical fields (radiology, internal medicine, surgery, pediatrics, psychology, ophthalmology and emergency medicine) selected. Sixteen residents from each field were chosen. They asked to fill Kolb learning style Inventory. The most common learning style among medical residents was assimilator followed by converger. Considering assimilator and converger learning styles among medical residents is recommended that faculty members should use diagrams, lectures and self-learning methods.

The aim of this study was to examine the quality of life in patients with Parkinson’s disease (PD) using a Parkinson's Disease Questionnaire (PDQ-39) as a measure. In this cross-sectional study, 200 consecutive patients with PD who referred to Tehran University of Medical Sciences Hospitals were enrolled. The PDQ-39 was used for evaluation. Statistical tests like ANOVA, t-test and Spearman rank correlations were used to assess the relationship between duration and clinical stage of disease and the quality of life. The mean age of the patients was 57.32years (10.5 SD). 135(67.5%) were male and 65(32.5%) female. Most of the patients (46/5%) were in mild stage. The results showed total effect of PD on patient`s quality of life, on dimensions that measured by PDQ-39. The mean of Parkinson`s disease summary index (PDSI) was 35/17 ± 15/43.Also severity (p=0.008) and duration (p=0.0001) of disease had a significant effect on Quality of life. Quality of life deteriorated significantly with increasing disease Paying attention to other dimensions of quality of life than clinical symptoms is suggested to improve health related quality of life in patients with Parkinson's disease.

Brucellosis is a zoonotic disease that is common in developing countries such as Iran which is a serious medical impact. Vascular complications, including arterial and venous associated with Brucella infection, have rarely been reported. In a review of articles, it is clear that, only five cases of deep venous thrombosis (DVT) of the lower extremities and just one case of cerebral venous thrombosis, associated with brucellosis have been reported so far. In this article a case of DVT of the left leg in association with acute Brucella infection was reported. Apparently, this case report is the first case of DVT due to brucellosis in Iran. Patient is a 28-year-old male who presented with clinical manifestations of fever, unilateral calf pain and swelling. Peripheral venous doppler ultrasound showed DVT and patient was treated with anti coagulants. Through controlling the fever and decreasing the lower extremity. The patient discharged with warfarin therapy. During follow up, the patient came back with repeated fever, sweating, myalgia and bilateral knee swelling. Because of patient clinical manifestation and epidemiologic status, brucellosis serology test was recommended, which was positive in high titer. He was discharged with a prescription of anti-brucellosis treatment. In the course of treatment, the patient referred to hospital due to sudden dyspnea, cough, hemoptysis, pleuretic chest pain. In spiral CT with protocol PTE, pulmonary thrombo emboli was detected and standard therapy for PTE was administered. In the course of his hospitalization other etiologies of thrombo phelebitis were excluded. Finally, the patient's clinical presentation subsided with warfarin therapy and anti brucellosis multi drug regimen. Early detection and appropriate treatment of Brucellosis are crucial measures to prevent problematic complications of the disease. The author's case and those previously reported, suggest that brucellosis should be included among the etiologies and the infections which are taken into account in patients suffering from DVT, particularly in those coming from Brucella-endemic areas.