مجله پزشکی دانشگاه علوم پزشکی تبریز
سال سی و ششم شماره 3 (پیاپی 111، امرداد و شهریور 1393)

Respiratory Distress Syndrome (RDS) is an important cause of neonatal mortality and morbidity. Lamellar Bodies Cells (LBC) count has been introduced for RDS diagnosis. The aim of this study was to determine the validity of this method. Eighty-two premature neonates entered to this crossectional study, all their clinical and imaging information was obtained. Patients with distress syndrome criteria were marked. Gastric aspiration were performed and LBC were counted by sysmex, Xs 800 cell counter in all cases. The mean weigh of neonates was 1745±515 grams. The frequents of patients with and without RDS criterias were 33(40/24%) and 82(59/75%), respectively. LBC count in RDS and non RDS group was not differed significantly. (160±135 vs 151 ± 143 per microliter, P= 0.9). The sensitivity and specificity of LBC for RDS in cut off point of 80000 per microliter was 69% and 45%, respectively (P> 0/05). Based on clinical and imaging diagnostic tests for RDS, the LBC counting cannot be a reliable test for RDS prediction.

Diabetes mellitus (DM) is a metabolic disorder witch the Hyperglycemia as its common feature leads to increased glucose concentration in proteins surroundings. The result of hyperglycemia is non-enzymatic addition of sugars to proteins which called glycation. This reaction leads to structural and functional alterations in proteins surroundings. The aim of this study was to investigate the effect of Bee venom on preventing of the human hemoglobin glycation. In this experimental study, human hemoglobin was incubated in the presence and absence of glucose in different concentrations of Bee venom for five weeks in 37 C. The extent of free amino groups in hemoglobin structure, percent of β-sheets, soret band absorption and Heme degradation before and after incubation were examined using UV-visible spectroscopy and fluorometry methods. Glycation leads to heme degradation and increasing in β-sheet content of glycated hemoglobin compared to the control hemoglobin. Also, glycation decreases absorption of soret band in hemoglobin. Bee venom inhibits the glycation and decreases structural alterations in human hemoglobin in a dose dependent manner. Bee venom has a significant antiglycation effect and it can be used as a natural drug for preventing DM complications.

Resistin is a new hormone that is secreted from adipocytes which can be associated with obesity and insulin resistance. The effects of exercise trainings on resistin levels and its association with metabolic indices are unknown. The aim of the present study was to determine the response of serum resistin to aerobic exercise and its association with metabolic indices in women with type 2 diabetes Mellitus. In this quasi-experimental study, 40 women with type 2 diabetes were randomly divided into two experimental (n=20) and control (n=20) groups. The experimental group received 12 weeks of aerobic exercise, 3 times a week for 20-50 minutes at 50-70% of maximum heart rate. The control group was sedentary during the same period. Blood samples were collected to examine the biochemical variables in pre-and post-tests. The mean of age and BMI was 59/70±5/28 years and 31/80±3/87 respectively. Aerobic exercise decreased weight, body fat percent, body mass index, lipid profile, fasting glucose and glycosylated hemoglobin while resistin was increased (P≤0/05). Insulin levels and insulin resistance did not change significantly (P≥0/05), also there was a significant inverse correlation between resist in and cholesterol in post-test (P≤0/05). According to the increase in resistin levels and because of no significant change in insulin resistance, it is unlikely that resistin linked obesity to insulin resistance in type 2 diabetes Mellitus.

The Vesicoureteral reflux is defined as a backward flow of urine from the bladder into the ureter and renal pelvis, and gastro-esophageal reflux is known as a risk factor for Vesicoureteral reflux. And also, without proper it can cause complications and renal scarring. Sacral Ratio is proposed as an indicator of SR assessment in children with anorectal malformations system. The aim of this study was to investigate the association between the sacral ratio and the Vesicoureteral reflux. This case-control study was conducted on 268 children; there were 109 children with non-urinary complaints and 159 children with urinary complaints. After ensuring the absence of neurogenic bladder and pelvic abnormalities, chronic constipation, kidney stones, trauma, the pelvic sacral ratio was measured on radiographs of all children. The mean sacral ratio in children with and without urinary complaints and in children with urinary complaints with Reflux was 0.131 ± 0.79 and 0.131 ± 0.77and 0.158 ± 0.70, respectively. There was a significant correlation between the measured mean of the first and third group (P=0.008) and second and third group (P=0.008). The abnormal percent of this index in children with reflux was significantly higher than other two groups. There was significant correlation between lower sacral ratio and existence of Ureteral reflux.

The complex nature of hemophilia and negative effects on patient body with spiritual state can affect patient’s quality of life. The improved facilities of patient care and access to replace therapies have increased related survival rate, but their socio-mental problems made another concern. The aim of this study was to evaluate the health related quality of life in various dimensions in adult patients with hemophilia. In this study cross-sectional, descriptive and analytical study, a total of 100 Adults with Hemophilia were recruited using A36 Hemophilia-QoL questionnaire, which is a specific tools for hemophiliac patients. The Mean age of patients was 32.16 ±11.68 years, and eighty tree patients were type A hemophilia, and 17 cases were type B hemophilia. The total QoL score in these patients was 71.88±26.89, which considered in the range of Moderate to Poor. There was a significant correlation between severity of diseases and quality of life status, as severe hemophiliacs had less QoL score (rho=0.351, P=0.001). The QoL was very poor in hemophiliacs who lived in urban area in contrast to patients who lived in the city (P=0.013), and single patients have a better QoL than married patients (P=0.155). Regarding the poor quality of life in adults with hemophilia, improving the quality of life in all its aspects seem to be essential in these patients.

Spleen is known as the largest lymphoid organ in human body and is responded orthe blood filtration; strengthen the immune system activity, hematopoiesis. Trauma and congenital problems are the most common indications for splenectomy. The aim of this study was evaluation the ten-year indications of splenectomy in Tabriz Children's Hospital. In this retrospective study that the hospital recors of all cases who underwent splenectomy in Tabriz Children's Hospital was studed and the indications of splenectomy in these children evaluated. Thirty four children were boys and 35 of studied children were girl. Mean age of boy children was 99.20 ± 42.77 months and the mean age of girl children was 125.42 ± 35.24 months (P=0.007). Major beta-talassemia (n=23) was the most common indication for splenectomy in studied children. Spleen size in 22 children was normal and in 47 children spleen size was great. Platelet drop in two cases, port vein thrombosis in 3 cases, heard failure in two cases, sepsis, recurrent meningitis, sepsis and CVA in one of the studied children were postoperative complication of study. Only seven cases of studied children were died after surgery that two cases of mortality causes was heart failure due to talassemia. In our study, trauma in 3 cases (4.34%) of the studied children was the splenectomy indications that one of these children had died. Major beta-talassemia, hereditary spherocitosis and idiopathic thrombocytopenic purpura were the most common causes of spelenctomy in the studied children and in our study, 5 of children with talassemia were died that 2 causes was heart failure due to talassemia, 2 cases due to port vein thrombosis and one case due to CVA. Postoperative complication rate was 23.18% and risk of infection and sepsis in our study was 3.07% and also the mortality rate in our study was 10.1%.

Oxidative stress has been implicated in various pathological consequences including such as cardiovascular disease, cancer, diabetes and aging. The present study investigated the effects of hydroalcoholic extract of Nasturtium Officinale on antioxidant status and DNA damage in arsenic –induced oxidative damage in liver and kidney tissue. In this experimental study, 48 male rats were selected and randomly divided into 6 groups: Group 1: normal healthy rat, group II was treated with sodium arsenite (SA) {i.p. injection at dose of 5.5 mg/kg body weight}, group III and group IV was treated with hydroalcoholic extract of N.Officinale (via gavage) at a dose of 200 and 500 mg/kg body weight respectively, group V and group VI was treated with hydroalcoholic extract of N.Officinale (via gavage) at a dose of 200 and 500 mg/kg body weight respectively + SA. Blood samples were collected and then examined antioxidant enzymes: Catalase (CAT), Superoxiddismutase (SOD) and Glutathion Peroxidase (GPx) activities, MDA (Malondialdehyde) content, 8-OHdG concentration in liver and kidney. Results of current study indicates that N.Officinale consumption significantly increased the activities of antioxidant enzymes and decreased MDA content, 8-OHdG(8-hydroxydeoxyguanosine) Concentration in liver. The consumption of plant extract significantly increased the activity of GPx in kidney. N.Officinale (Watercress) reduces the arsenic-induced oxidative damage in liver and it has the little protective effect in kidney.

Coronary Artery Diseases (CAD) are the major cause of morbidity and mortality in most societies. Despite the invasive nature of angiography, it was used as a diagnostic procedure evaluates coronary artery diseases. This study was aimed at evaluating the Pattern of coronary arteries and anatomic risk factors of significant stenosis by 64-slice multi-detector computed tomography (MDCT). In this prospective-analytic study, CT angiography data of 200 patients with suspected CAD reviewed in order to identify the coronary arteries anatomy and determine the site of stenosis. Also, Length of LM and the first Diagonal from the origin of LAD were measured. There were three types of dominancy of coronary artery: 91% with Right Coronary Artery (RCA), 8% with Left Coronary Artery (LCA), two patients with co-dominant system. Also stenosis was observed in 6 (3%), 5 (2.5%) and 4 (2%) of arteries in LCx, RI and LM, respectively. In 21 (67.7%) of LAD stenosis were near the first diagonal (D1) origin and in RCA were near the SAN origin. There was no significant relationship between the length of LM and the first Diagonal and number of LAD branching and stenosis frequency in LAD.

Pediatric femoral neck fracture is a rare condition leads to <1% of all fractures in children which is associated with high rates of complications. At present study, we performed a long-term follow-up of 37 patients and analyzed the complications. This descriptive study contained 37 children (24 boys and 13 girls) who sustained femoral neck fractures. The patients were treated conservatively management or by internal fixation through closed or open means. The clinical and radiological outcomes were analyzed using Ratliff criteria. The mean age of patients was 11.1±3.4 years that completed an average follow-up of 3.14 years. The most common etiological factor was traffic accident. A satisfactory outcome according to Ratliff’s radiological and clinical criteria was obtained in 27 (73%) hips. Based on Delbet’s classification system, there were 2 type I (5.4%), 18 type II (48.6%), 11 type III (29.7%), and 6 type IV (16.3%) fractures. Avascular necrosis (AVN) was the most common complication that was seen in 8 of our patients. Other complications included 4 cases of coxa vara, 3 nonunion cases, one case of infection, 2 cases each of arthritic changes and premature epiphyseal closure. Despite of this fact that the fractures of pediatric femoral neck are very rare, incidence of complications is high which could lead to the long morbidities.

Apelin is a newly discovered adipokine which plays an important role in regulation of energy homoeostasis and improvement of insulin resistance. However, the effect of exercise training on apelin level in diabetic status is not khown, yet. The aim of this study was to determine the effect of aerobic training on plasma concentration of apelin and insulin resistance in type 2 diabetic rats. In this randomized experimental study, twenty diabetic male Wistar rats were divided into training and control group. Diabetes was induced by intraperitoneal injection of nicotinamide and streptozotocin. Four weeks after the development of diabetes, the training group ran 6-week on treadmill. After the training, plasma concentration of glucose, insulin and apelin were measured and HOMA-IR was calculated. There was a statisticaly significant decrease in plasma concentration of glucose and insulin and HOMA-IR, and a significant increase in plasma concentration of apelin was observed in training group compared with control group. Furthermore, a significant negative relationship between plasma concentration of apelin and HOMA-IR after 6 weeks aerobic training was found. It seems that 6-week aerobic training by changes in plasma concentration of apelin, glucose and insulin and HOMA-IR can be effective in treatment of type 2 diabetes in rats.

Postoperative pain is a common complication after hemorrhoidectomy operation. It may cause the patient discomfort, necessitate the narcotics, and other analgesics in order to control patient’s pain. The aim of this study was to evaluate the efficacy of local perianal bubivacaine in controlling postoperative pain after hemorrhoidectomy operations. In this clinical trial study, 80 patients were randomly divided into two and control groups. In the case group, 2 ml of bupivacaine was injected into the subcutaneous and muscular layers 3, 7, and 11 hours after operation. The patients were assessed for 24-hours postoperatively. There were just twenty-five patients of case group (62.5%) who needed analgesics postoperatively, while the entire patients in control group received analgesics (p<0.05). Urinary retention occurred in 11 patients (27.5%) of control group and in two patients (5.0%) of case group postoperatively (p<0.05). Injection of local perianal bupivacaine was effective in controlling postoperative pain and patients satisfaction. In addition, the occurrence of urinary retention was less common. Regarding the potential importance of post-hemorrhoidectomy pain, local bupivacaine is recommended for pain control and patient comfort after hemorrhoidectomy operations.

Finding an effective scolicide in treatment of hydatic cyst is an important fact. The present study was done to compare the effect of scolicides such as physical agents (temperature and smolarity), chemical agents (Albendazole) and aquatic extract of Harmel (Peganum harmala) in vitro. In this study, protoscolices were collected aseptically from sheep livers and lungs affected with hydatid cyst in Tabriz slaughterhouse. In laboratory, viability of protoscolices was determined by 0.1% Eosin staining. Scolicidal effect of 20%Nacl, 10% Nacl, 50% Dextrose, 2% Albendazol, temperature(-20oC, 40oC, 60oC) and various dilutions of Harmel aquatic extract (25%, 50%, 75%, 100%) were evaluated after 5, 10, 15 and 60 min. The results were analyzed by Duncan and Tucky tests. Twenty percent of Nacl after 60 min has significantly scolicidal effect than other agents (P<0.05), but it eliminated only 48.5% of protoscolices. The effect of 20% Nacl was better than physical, Chemical and plant agents, but long time for effecting limit using about it in surgery.

There are still needs for new therapy for treatment of Type 2 Diabetes Mellitus (T2DM). Bromocriptine has several advantages including plasma glucose and lipid reduction. This study was designed to examine the effectiveness of Bromocriptine on glycemic control in poorly controlled T2DM patients. In the present clinical trial study, 43 T2DM patients were investigated. Bromocriptine was administrated with a dose of 1.25 mg/day orally at bedtime. The mentioned dose was gradually increased up to 2.5 mg twice aday. The demographic characteristics, height, weight, fasting blood glucose, 2-hour postprandial blood sugar, glycosylated hemoglobin (HbA1C), lipid profile and creatinine were measured. Patients were followed-up during 1.5, 3, and 6 months later. The mean age of study was 55.0±7.2 years. Mean of baseline fasting blood glucose of patients were decreased from 184.3 mg/dL to 155.5, 148.9 and 159.5 mg/dL in 1.5, 3 and 6 months after treatment, respectively (p<0.0001). Two-hour postprandial blood sugarreached to 217.0, 205.1 and 201.0 mg/dL in baseline times from 276.6 mg/dL (p<0.0001). After three months observation, there was 0.8% reduction in HbA1C whereas, it was 0.9% in month six (p<0.0001). The concomitant treatment with bromocriptine and other antiglycemic drugs was effective in glycemic control of T2DM cases.

Endometrial carcinoma is one of the most common women gynecological malignancies. Unfortunately, screening programs in endometrial carcinoma is not successful such as cervical carcinoma. The aim of this research was to evaluate the tests in predictive of endometrial carcinoma prognosis for preoperation approach and treatment. In a cross-sectional study, 24 patients with endometrial carcinoma were investigated. Preoperative serum levels of P53, CA125, CA19-9, oestradiol in comparison with prognostic pathologic factors were evaluated, and the obtained results were analyzed. The mean age of study was 54/7+6/7 years. Serum levels of CA125 in endometrioid, serous, and clear cell carcinoma was 176, 270, and 480U/ml, Serum levels of CA19-9 was 157, 125, and 380 U/ml, Serum levels of P53 was 5/2, 9, and 12 ng/ml, Serum levels of oestradiol was 31/5, 47/5, and 120 Iu/ml. Serum levels of P53, CA125, Ca19-9, oestradiol in patients with endometrial carcinoma was higher than normal range. Also serum levels of these markers in patients with poor prognosis, like grade 3, clear cell carcinoma type, and extra uterine invasion is higher. The high preoperative serum levels of P53, CA125, Ca19-9, oestradiol were associated with poor prognosis. Therefore, serious intervention could be helpful in this regard.

In flexible flat foot the medial longitudinal arch eliminates while weight bearing and it has adverse effects on lower extremity chain. The purpose of this study was to investigate the effects of flexible flat foot on lower extremities, especially in hip joint function. In this descriptive cross sectional study, 487 feet of 6-12 years old children evaluated by static foot print. 14 girls and 14 boys with grade 1 and 2 flexible flat foot were selected as case groups and 21 girls and 2 boys with no sign of flat foot were selected as control groups. The following outcomes were measured in 4 study groups: range of active and passive internal and external rotation in sitting and prone position, the strength of internal and external rotator muscles, inter condylar and inter malleollar distance, apparent and true lengths of the lower extremities and Q angle. In girls with flexible flat foot, the internal rotation of the hip was significantly increased compared with that in boy (P<0/05). Similarly, the strength of internal and external rotator muscles was decreased significantly with the amount of 1 degree in manual muscle testing grades (P<0/05). It seems that the flexible flat foot is associated with an increase in internal and external rotation of the hip in early age. This may lead to some mechanical deficits in lower extremity with aging.

Testicular epidermal cyst is a very rare lesion in approximately 1-2% of testicular tumors. It،s also been referred to this lesion as Mono dermal cystic teratoma which is still controversial topic in this regards. In the most cases، the lesion was diagnosed by ultrasound epidermal cysts can be treated by keeping the testicles. In this study we report the clinical and morphological characteristics of left testicular epidermal cysts in a 22 years old patient، with a mass in the right testicle. With Preoperative diagnosis can be removed tumor while maintaining the testes.