مجله پزشکی دانشگاه علوم پزشکی تبریز
سال سی و چهارم شماره 4 (پیاپی 100، مهر و آبان 1391)

In recent years there are great emphasized on Psychological problem in different diseases. The aim of this investigation was to study the personality factors in Multiple Sclerosis (MS) Patients in compare with healthy subjects. In this study 30 patients with MS، compared with 30 healthy individuals who were demographically matched with the case group، in both groups Five Factor Personality Test was performed (Neo). The result of study showed a significant difference between two groups in neuroticism، extraversion، and agreeableness. But the difference in openness and conscientiousness wasn’t significant. The results of our study showed a relationship between MS and personality factors. Personality changes might be assumed as a cause of disease and can affect prognosis.

Human sperm contains a wide spectrum of cytokines; such as interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha). Their effects on semen quality are still under debate. This study aims at assessing possible association of these two cytokins with semen characteristics in patients with grade II-III varicocele. In this analytic-descriptive study، 30 male patients with grade II-III varicocele were recruited in Tabriz Sina Hospital within a 12-month period. Levels of IL-6 and TNF-alpha were measured in seminal plasma، spermatic vein sample and peripheral serum specimen. Correlations between these parameters and sperm count، motility and morphology were assessed. The mean levels of IL-6 were 23. 73±9. 02، 28. 73±11. 98 and 38. 20±13. 28 pg/mL in specimens from peripheral serum، spermatic vein and seminal plasma، respectively. The mean levels of TNF-alpha were 4. 78±1. 91، 5. 66±2. 95 and 6. 45±2. 55 pg/mL in specimens from peripheral serum، spermatic vein and seminal plasma، respectively. The mean seminal plasma IL-6 level was significantly higher in the cases with grade III varicocele. There were significant negative correlations between seminal plasma IL-6 and sperm count (r=-0. 46، P=0. 01) and motility (r=-0. 38، P=0. 04). There was no significant correlation between the spermatic vein and peripheral serum IL-6 or seminal plasma، spermatic vein and peripheral serum TNF-alpha with the spermatozoal parameters. Seminal plasma IL-6 is associated with worse spermatozoal parameters in seminal analysis of patients with grade II-III varicocele.

Patient''s rights are physical، spiritual، and psychosocial needs which have to be fully respected by health workers. The purpose of this study was to determine the problems of the patients referring to the physiotherapy clinic، and to compare with the Iranian patient''s rights charter. This study was a descriptive study that was performed in a group of patients who were referred to our clinic. Structured interview was used to collect the data. The collected data were classified with 6MP method and then matched with the Iranian patient''s rights charter; we then determined the rights that had not been accomplished. Study results showed that there was high deficiency in methods، therapeutic machines، and manpower domain of the interview; but، money and materials were of less deficiency. According to the Iranian patient''s rights charter، there was high deficiency in the first section of the charter (patient’s rights in receiving the optimal health services)، followed then by the relatively high deficiency in the second section of the charter (patient’s rights in receiving the patient’s information sufficiently). There was no complaint in the third، fourth، and fifth sections of the charter. The results of this study showed that two of the five sections of the Iranian patient’s rights charter had high percentage of deficiency and need to be taken into account while providing the physiotherapy treatment to the patients.

Nesfatin-1 is a recently discovered adipokine that is expressed in adipose tissue and involves in glucose regulation، insulin sensitivity and energy homeostasis. The aim of this study was to investigate the effect of single bout of aerobic exercise on serum nesfatin-1 levels in non-athlete elderly men. In this study، 12 healthy elderly men (Age 63. 41±2. 53 years، height 173. 17±6. 27 cm، weight 76. 90±7. 37 kg، and body mass index 25. 61±1. 52 kg/m2) volunteers randomly were elected. They performed one session of aerobic exercise including 30 minutes of cycling at 70-75% of HRmax، which was followed by 30 minutes of recovery. Three blood samples were taken before exercise، immediately after exercise and 30 minutes after recovery period. Data were analyzed by repeated measure ANOVA and Bonferroni test using SPSS 18. In 12 healthy men plasma insulin and glucose concentrations and insulin resistance significantly decreased after exercise (P<0. 05) and again returned to a higher level 30 minutes after recovery (P<0. 05). Cortisol levels significantly increased after exercise (P<0. 05). Plasma nesfatin-1 concentrations were not significantly altered after exercise and following 30 minutes of recovery (P>0. 05). Based on the findings of this study، although 30 minutes of aerobic exercise significantly alters glucose، insulin and cortisol concentrations but there was no significant change in plasma nesfatin-1.

Studies have shown that attention deficit disorder/ hyperactivity disorder increase the risk of smoking and drugs habit. This study was to investigate the signs of attention deficit/hyperactivity disorders in smoker and non-smoker students. According to this، 80 smokers and 100 non-smoking male students of Tabriz University were selected randomly. The participants were examined by vender Utah and Canners Adult questionnaires. The data''s were analyzed by SPSS software version 18. The results showed that there were significant differences in all components of adult ADHD between smokers and non-smokers. Smoker student had high level of ADHD components than non-smoker students. Finally، according to research results، it is necessary to have attention to ADHD problems in adult. Especially in our country، because our information about this problems very low.

Premature Rupture of Membranes (PROM) occurring before 37 weeks of gestation is referred to as Preterm Premature Rupture of Membranes (PPROM). This study was aimed to identify whether home caring of mothers، while they are under tight medical control، has any serious side effects on mother and fetus or not?

Patients with 26-32 weeks of gestational who complicated with PPROM were hospitalized for seven days and were treated with antibiotics and Betamethasone. Then patients were divided into two groups. “Group-I” were sent to home (Outpatient) and observation was continued and “Group-II” were hospitalized till the end of their pregnancy (Inpatient). All patients in Group-I were also hospitalized again at the beginning of the 32nd week and if it was possible، all pregnancies were ended on the 34th week.

The time interval between PPROM and delivery، prevalence of child hospitalization in neonatal unit، and intra-ventricular hemorrhage (IVH) were lesser in inpatient group. The rate of cesarean، need for ventilatory support، the period of child hospitalization in neonatal unit، prevalence and hospitalization period in NICU، and neonatal mortality were higher in inpatient group. The rate of metritis، chorioamnionitis، one and five minutes’ Apgar scores، premature placenta detachment، average of umbilical arteries base excess (BE) and pH، and the last biophysical profile (BPP) score were similar in both groups.

For patients who are well trained to know the risky symptoms and have immediate access to the hospitals and medical care centers، if they has a amniotic fluid index (AFI) more than 5cm، and the period between their PPROM and 34th week of their pregnancy is so long، they can be followed through the protocol in their homes.

Planning of a proper medical waste management program is a necessary for communities. The objectives of this study were investigated the knowledge and attitude of hospitals staffs and their practice toward proper medical waste management.

Among the 25 active hospitals in Tabriz 10-hospital were selected. An especial questionnaire was designed and distributed among the staffs in 7 different jobs category and the staffs practice condition was evaluated by 7 days monitoring and completing another especial check list by research team. The results were analyzed by SPSS software.

The level of knowledge and attitude were different among different hospitals and different job categories. The maximum level of knowledge and attitude belonged to physicians and specialists and the minimum for ancillary workers assigned to collect and transport medical waste and other cleaning workers. There were significant associations between knowledge and attitude and level of education and work. Monitoring of staffs practice indicated that their practice were not in agreement with a proper medical waste management.

In the implementation of medical waste management program the role of training of staffs is significant only in combination with monitoring and enhancing of their practice level. Having staffs with good level of knowledge and attitude is not enough. It is necessary in addition preparing basic needs، the motivation of staffs is being enhanced and then legal control of system، evaluation، monitoring، encouraging of staffs and etc altogether be implemented.

Heat shock proteins are a part of innate immune system and it change under various situations such as physical activities. There are many discussions about the mechanism of its secretion، following of physical exercise in human blood serum. However there is a question that increasing of Heat shock proteins is following of inflammation or because of cellular injury repair? This study was done on both athletic and inactive men. We collected serum samples for measurement before and after an exhausted incremental test (Bruce test). Data were analyzed by using statistical methods. Exhausted exercise had significant increase on indices athletic and inactive men serum. Range of changes of norepinephrine، heat shock protein 72 of athlete serums were significant more than inactive men after Bruce test. Amount of changes of creatine kinas between athletes group and inactive men group was not significant after test. high intensity of physical activity is create more stress and inflammation but more fitness assist with less damage against high intensity activities.

The aim of this study is to investigate the personality traits including’s: depression، anxiety، and stress among individuals with Multiple sclerosis (MS) and comparing this characteristic with normal individuals. Eighty person with MS (56 female، 31/62±6/88 year، and 24 males، 31/87±8/85 year) and 78 individual without MS (56 female، age: 33/20±6/60 year; 22 male، age: 32/00±7/73 year) selected through random sampling from MS Society in Tehran and MS clinic in Emam Reza hospital in Tabriz university of medical sciences and then divided to four groups: female with MS، male with MS، female without MS، male without MS. Variables of our study were neuroticism، extroversion، openness، agreeableness، conscientiousness، depression، anxiety، and stress which assessed via brief form of NEO Five Factor Inventory (NEO-FFI) and Depression Anxiety Stress Scale (DASS-42). Tukey showed that mean score of neuroticism، depression، anxiety، and stress in male and female with MS were higher than those in female and male without MS، and mean score of extroversion، openness، agreeableness، conscientiousness’ in male and female with MS were lower than those in female and male without MS. Personality profile of individuals with MS is a combination of neuroticism، low extroversion; openness، agreeableness، conscientiousness and high mean score of depression، anxiety، and stress.

Methadone induced Sexual dysfunction is one of the main reasons of noncompliance with methadone therapy. This study was designed to evaluate the relation between Sexual function with Methadone Dosage، and Testosterone and Prolactin Plasma levels. In a cross sectional study، 135 patients on MMT from 2 MMT centers were allocated with a simple random sampling method after getting a written consent form. Beck Depression Inventory (BDI) and International Index of Erectile Function (IIEF) were completed by the patients، and then a blood sample was taken for laboratory measurement of Testosterone and Prolactin. Collected data was analyzed using the statistical methods. The mean age of patients was 36. 38 ± 9. 44 years، 94. 8% of participants had some degrees of sexual dysfunction، Mean methadone dosage was 100. 2 ± 38. 4 Mg/day and Serum testosterone and prolactin levels were، 8. 7 ± 6. 6 and 4. 8 ± 3. 1 Microgram/Lit respectively. There was no significant association between mean of IIEF score with methadone dosage (r=-0. 021، P = 0. 8) and testosterone level (r=-0. 101، P = 0. 25) but There was significant association between mean of IIEF score and prolactin levels (r=-0. 18، P = 0. 039). On multiple regression test، only prolactin plasma levels was a significant predictive of IIEF score. Plasma Prolactin levels are the only sexual function Predictor of patients on MMT regimen.

Arsenic is one of the most hazardous metals. The objective of this study was to evaluate the preventive effects of vitamin E on a Rat model of arsenic induced hepatotoxicity. In this study 30 Wistar rats (immature and mature) were used and each was randomly divided to 3 subgroups. Subgroup received normal saline and subgroup 2 and 3 both received Arsenic، 3mg/kg، subcutaneously، but subgroup 3 also received vitamin E، 400mg/kg، intraperitoneally for 10 days. Histopathologic examination revealed cell swelling، fatty changes and necrosis in hepatocytes of Arsenic group. In subgroup 3 the severities of lesions were less than group 2. Leukocytosis in both arsenic and arsenic-vitamin E groups was observed، but there was no significant difference between them. Activity of glutathione peroxidase in arsenic group was significantly decreased in compared with control group. However in group 3، the activity of glutathione peroxidase was increased but it was not significant. Vitamin E supplement decreases the hepatotoxic effects of Arsenic.

Joint disease، particularly rheumatoid arthritis is a debilitating problem of current communities. Because of probable anti-inflammatory characteristics of mangrove and its use in traditional medicine، we evaluated the anti-inflammatory effect of mangrove leaf extract on the treatment of Wistar arthritic rats. Herbal extract (400 mg/kg body weight) and ibuprofen (53 mg/kg body weight) daily orally (gavage) in rat different groups were given for 21 days. Arthritis was induced with subcutaneous injection of 0. 01 cc Complete Freund’s Adjuvant (CFA) into the sub plantar area of right hind paw of rats. ESR، ankle joint diameter، and arthritis index parameters were evaluated in both groups. Data was analyzed by statistical methods. ESR increased significantly (p<0. 05) in arthritic group compared with normal group، but there were not any significant difference between mangrove extract and ibuprofen groups. In ankle diameter was increased significantly (p<0. 05) after injury and because of the effect of extract and drug، paw swelling decreased from day 8 to 21. It seems that because of its different compounds، the mangrove leaf probably has been profound anti-inflammatory properties on the arthritis.

Exercise and stressor environments could lead to some immune changes in human body. The aim of this study was to investigate the effect of exercise on the serum interleukin-17، interferon-γ and highly sensitive (HS) CRP of the Endurance athletes in cold temperature condition. Ten young male endurance athletes (22±2years; 67. 4±2. 7kg) ran on a treadmill for 1h at %60 VO2max in conditions of normal (22±1˚c، 50±5 RH) and cold temperature (3±1˚c، 50±5 RH). The interleukin 17، interferon-γ، hs-CRP and cortisol concentrations were measured before، immediately after and two hours after exercise (during recovery). Body temperature، rating of perceived exertion and amounts of consummated water during exercise all was recorded. Data analysis was performed by statistical methods. There was no significant change in serum concentrations of interleukin 17، interferon-γ and hs-CRP athlete’s after and 2 h after exercise (p>0/05). There was no significant difference between this values in two environments (p>0/05). The amounts of cortisol increased significantly after exercise، in both normal and cold environment (p<0. 0001). A single session of exercise causes the circulatory release of cortisol. However، it seems that it cannot induce the alteration in inflammatory responses and increase cytokines and inflammatory markers.

Cleft palate is one of the most common congenital anomalies. Usually during palatoplasty surgeons put a mesh mixed with antibiotic at the lateral space of relaxing incisions and remove it 3-5 days postoperatively. It seems that it increases the postoperative pain decreases fluid intake risk of aspiration of mesh. Also it seems that it lead to expose of bare bone and probably maxillary growth retardation. The aim of this study was to compare the extent of bleeding، hospitalization length، analgesic and sedative drug treatment، feeding، and dehiscence between those closed without mesh and those with mesh. At this study 37 patients with cleft palate with or without cleft lip operated with two flap palatoplasty technique and lateral spaces closed without inserting mesh case group. Those cases were compared with 35 patients with cleft palate who operated with the same technique with inserting antibiotic mesh in lateral spaces. The length of hospitalization، extent of postoperative hemorrhage، prescription of analgesic & sedative drugs in both groups has significant differences and they were more prevalent in case group. Fluid intake in study group was much better than control. Because of high prevalence of adverse effect of mesh placement after cleft palate surgery we prefer to close the lateral spaces without mesh.

Staphylococcus aureus encode variety of virulence factors genes which may induce various infections individually or synergistically. The aim of this study was to assess virulence factors including collagen binding (Cna)، and Fibronectin binding (FnB) proteins at molecular level، in S. aureus strains isolated from clinical and nasal specimens of patients admitted to University Teaching Hospitals of Tabriz. In a limited period، from July to February 2009، 1936 various clinical specimens and 504 specimens from anterior nares from cardiac patients were collected. The S. aureus isolates were identified by phenotypic methods and later confirmed by PCR with detection of nuc and femB genes. MRSA strains were identified using disk diffusion method and later confirmed by detection of mecA gene. Multiplex PCR was performed to detect the above mentioned genes as well as to spot virulence factors coded by cna and fnb genes. From 1936 various clinical samples and 504 nasal specimens، 121 and 214 non-duplicate S. aureus strains were isolated respectively. cna was identified in 80. 99% clinical and 17. 29% nasal S. aureus strains. cna had higher prevalence in isolates from septic arthritis، osteomyelitis and endocarditis. fnb was identified in 65. 29% clinical and 54. 67% nasal S. aureus strains and had higher prevalence in isolates from endocarditis، osteomyelitis and burn associated wounds. In both clinical and nasal S. aureus strains، prevalence of virulence factors in MRSA was higher than MSSA. The results of this research indicated that simultaneous detection of nuc، femB and mecA genes not only helps for identification of ُS. aureus isolates، but also is specific and useful for rapid detection of MRSA isolates. Higher prevalence of virulence factors in clinical isolates as compared to strains responsible for colonization and in MRSA over MSSA، shows the role of these factors in invasion and pathogenesis.

Recurrent pregnancy loss (RPL) determined by spontaneous pregnancy before 20th gestational week. It imposes a great psychological and financial burden on families. The aim of this study was to investigate chromosomal aberration in couples with RPL. From 1991 to 1996، a total number of 400 couples (800 patients) with Recurrent Pregnancy Loss (RPL) were karyotype by standard lymphocyte culture and GTG banding technique. We detected different kind of Chromosomal aberration such as Robertsonian translocation، inversion، deletion، sex chromosomes abnormality among 32 (4%) out of 800 patients. The current study demonstrated the presence of chromosomal aberration in RPL. According our data، to determine chromosomal aberration of fetus of carries couples، amnion fibroblast analysis is recommended.

Noise pollution is a major health risks for resident of crowed areas. The aim of this current study was to determine the level of noise pollution in central locations of Tabriz. Monitoring was performed using a Sound Analyzer. All measurements were conducted during the midday (12:30 to 14:30pm) and in the evening (17:00 to 19:00pm) at the height of at least five feet above the ground and the microphone was pointed upward at an angle of 70 degrees to the sources. LAeq noise levels of 2 hours of measurement were highest in Shohada and Shahrdari Squares and were significantly higher than limit values. The Lmax was 85 db in Shohada Square during midday and 90. 2 dB in Shahrdari Square during the evening. The highest recorded noise levels was recorded in Shardary Square، nevertheless in the Sahib al amr Square the recorded noise level and LAeq in the midday was higher than evening. The result of the study demonstrated that in the evening hours noise pollution levels in the central areas of Tabriz were higher than midday. The noise levels alteration in the examined areas were in the range of ±5dB in the evening hours. Noise levels exceed limit value both in midday and evening hours in central areas of Tabriz، so making an intervention program for reducing noise pollution level is essential.

Pulmonary arteriovenous malformation (PAVM) is rare condition. Because of its little signs and symptoms and high mortality rat it remains undiagnosed and its accurate diagnosis is very important. Here we present a 39 Y/O female with PAVM in her right upper lung lobe that was discovered incidentally after a chest stab wound. Because of unavailability to embolization it، the lesion was treated by right upper lobectomy. The most important finding in our case is the presence of PAVM as a single finding and not association with other anomalies. Despite availability of a huge burden of diagnostic tools، any asymptomatic mass in the lung is a diagnostic dilemma in most cases. Computed tomography guided angiography proved to be the best available modality for diagnosis of PAVM.

Distal femoral fracture with intramedullary nail in situ is a rare situation. We report here a case of healed femoral shaft fracture with intramedullary nailing for three years، who has recently had an un-comminuted supracondylar re-fracture with nail tip cut-out as a result of minor trauma in the presence of osteoporosis.