مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
سال پنجاه و هفتم شماره 8 (پیاپی 132، بهمن 1393)

The level of 1’25 dihydroxy vitamin D begins to decline early in the course of chronic kidney disease, owing to the decline in proximal tubular production of 1α hydroxylase. Vitamin D plays an essential role in muscle function, immune system, bone metabolism and cardiovascular.in addition to 1, 25 dihydroxy vitamin D, the level of 25 hydroxy vitamin D is decreased in uremic patients. This cross sectional study was performed in summer 1391 in hemodialysis centers of Loghman Hakim and Ashrafi Esfahani hospital. Inclusion criteria were adequate dialysis delivery with KT/V>1.2, age>15, serum albumin>3.5 and not missing dialysis more than two sessions in each month. The exclusion criteria were being on dialysis less than 3 months, Presence of Catabolic states (malignancy, and HIV).Calcium, Phosphor, Hemoglobin, parathyroid hormone (PTH),25 hydroxy D (25 OHD) and C-Reactive protein (CRP) were tested for all. 135 Patients, 62 were male (51%) and 66 were Females (69%) 85 patients (63%) had 25 OHD deficiency.43 patients had normal level and 7 Patients (5.2%) had toxic level. This study showed that 25 OHD Deficiency is common in our country and 25OHD supplements are useful for these patients. Therefore It was recommended to test the level of 25 OHD of the patients frequently. The removal of 25 OHD would result in functional improvement of patients. Acknowledgement:The authors especially acknowledge for the nurses of dialysis units for their collaboration. Confelict of interest: None declared.

the aim of the study was to evaluate the relationship between high sensitive CRP (hs-CRP) and bioelectrical impedance parameters in patients undergoing hemodialysis (HD).

This study was conducted on 38 patients undergoing HD since September of 2012. Bioelectrical impedance parameters including total body fat, fat free body, total body water (TBW),intra and extra cellular water(ICW and ECW), ECW/ICW and phase angle (PA) were measured. Serum hs-CRP was measured and Body Mass Index (BMI) was computed. Pearson`s correlation analysis was used to find out any correlation among variables.

A total of 38 patients (15 males and 23 females) with age of 48.58 ± 16 years were included in this study. The mean length of hemodialysis treatment was 46.34 ± 48.33 months. There was no correlation between hs-CRP and TBW, ICW, ECW and ECW/ICW and PA. There was a significant positive correlation between hs-CRP and total body fat and an inverse correlation with fat free body. We also observed a significant positive correlation between hs-CRP and BMI.

he results showed a significant positive correlation between hs-CRP and total body fat and an inverse correlation with fat free body in patients undergoing HD which showed the probable role of increasing body weight as well as total body fat on inflammation process in HD patients. Acknowledgment: his article is adapted from thesis 901160 for receiving national board of Internal Medicine specialty of Dr Mansoureh Hoseinzadeh. This study was supported by the Kidney transplantation Complications Research Center and a grant from Mashhad University of Medical Sciences.

Omega-3 polyunsaturated fatty acids have proven effects on hyperlipidemia and cardiovascular diseases. Given that there is no single consensus on the treatment of NAFLD and high levels of Omega-3 is found in flax seed oil and in this regard no study has been done in the world, we decided to evaluate the effects of flaxseed oil on non-invasive markers of fatty liver. In a randomised controlled trial, 60 participants with NAFLD were randomised to 2 months treatment with either Flaxseed or vitamin E(in two groups each 30).Weight, body mass index, waist circumference, liver enzymes, blood glucose, insulin and lipid profiles were measured before and after the intervention. In flax seed oil group ALT, AST, ALP (alkaline phosphatase)., TG (triglyceride)., Insulin was decreased and HDL (High density lipoprotein). Were increased significantly(P<0.05)..In vitamin E group, only the level of AST, ALT and total bilirubin was significantly decreased. (P<0.05). Flaxseed oil is effective and safe in the improvement of non-invasive liver markers of patients with NAFLD. However, further studies with a larger sample size are needed to confirm the efficacy and safety of this drug.

Nowadays, one of the main problems of tuberculous treatment is drug resistance. Present study was designed to determine drug resistance of mycobacterium isolated from patients with pulmonary tuberculosis to anti-tuberculous drugs and to detect the influencing factors. In a cross-sectional study in 2012-2013, all smear positive sputum)125 samples) cultured and their anitibiogram were done in tuberculous laboratory of Shariati Hospital. Provided checklists were filled with corporation of Vicechancellor Mashhad University of Medical Science of and Mashhad Health Centers and other towns of province. Then by using SPSS software, resistance rate and influencing factors were evaluated. In this study the rate of resistance to Isoniazid was 7%, to Rifampin 7%, to Ethambutol 3.9%, to Streptomycin 11.8%, to Isoniazid and Rifampin (MDR-TB) 4%,. The highest rate of resistance was observed in 15-45 years-age group. Statistically, a close-to-significant relationship was observed between incidence of resistance and two factors including recurrence and grade of smear positivity. Results obtained for 20% of total cultured samples were non tuberculous Mycobacterium (NTM). Considering the MDR TB prevalence in Khorasan, DOTS strategy had to be carried out completely and appropriately to prevent incidence of more resistance cases. Considering the high rate of NTM, was has proposed that when diagnosing tuberculosis, culture and antibiogram had to be implemented for all patients to prevent tuberculosis aberrant treatment, that cause increasing resistance to drugs, and to give appropriate treatment for such patients at initial stages. Acknowledgment: This is no conflict of interest

Adiponectin and ghrelin are hormones involved in obesity. In previous studies, anti-obesity effects of green tea consumption have been examined. The aim of this study was to investigate the effect of green tea and aerobic exercise on serum adiponectin and ghrelin. Atotal of Twenty obese men volunteered and were divided randomly into case (n=10) and control (n=10) groups. Both groups performed aerobic training including slow running for 10 weeks. In addition to aerobic training, the experimental group drank one green tea bag containing two grams of ​​tea, three times a day. Before and after the intervention, blood sampling was performed. Data were analyzed using independent t-test and ANCOVA. Results showed that there was no significant difference in serum adiponectin and ghrelin levels between case and control groups. Furthermore, no significant difference was detected in body mass index, body weight, waist to hip ratio and body fat percent age between the groups, while the maximum oxygen uptake increased significantly in case participants. Green tea consumption and aerobic exercise for 10 weeks had no effect on serum adiponectin and ghrelin levels in men, but it could increase the maximum aerobic power. Acknowledgment: This study was supported by Hakim Sabzevari University, further more there was not any conflict of interest in doing this research.

The prevalence of complete heart block in Setting of acute STE myocardial infarction is 3-12% which increases in-hospital death. This study aimed to evaluate the Prevalence and in-hospital course of complete heart block in patients with acute STE myocardial infarction. This study was performed as Case-series on patients admitted with complete heart block in the setting of acute STE myocardial infarction. Patients data was recorded and analyzed by SPSS 16 and meaningful level < 0.05 considered significant. Patients with acute STE myocardial infarction (1485 patients) were admitted. Their mean age was 61 years old and 995 patients (67%) were male. Fourty five patients (3.03%) complicated with complete heart block) 22 women (48/9%) and 23 men(51/1%) p=0.028). Mean age of the patients with complete heart block was 71 years old. The relation between age and sex with complete heart block was statistically significant (p<0.001 and p=0.028 respectively). Thirty seven cases (82%) of block resolved in the first five days. Many of complete heart blocks (80%) in the setting of acute STE myocardial infarction occured in acute inferior myocardial infarction and 82% of these cases resolved in the first five days so after this time the necessity of permanent pacemaker implantation had to be consideredAcknowledgment: This is no conflict of interest Acknowledgment: This is no conflict of interest

Metabolic syndrome is a combination of disorders such as: central obesity, hypertension, increased blood glucose and impaired blood lipids. This study was carried out to determine the prevalence of metabolic syndrome among students of Lorestan University of Medical Sciences during 2011-2012. This study was a cross-sectional survey carried out on 214 students in an age range of 19-27 years. Subjects filled demographic questionnaire and their fasting blood samples were collected to measure their TG, FBS and HDL cholesterol. Then metabolic syndrome was defined having at least three of the ATP III criteria as the following: triglycerides ≥150 mg/dL; high blood pressure (systolic blood pressure≥130 mmHg or diastolic blood pressure ≥ 85 mmHg); fasting glucose≥110 mg/dL; waist circumference ≥102 cm in men and ≥ 88 cm in women and HDL<40 mg/dL in men and<50 in female. Prevalence of metabolic syndrome among students was 1.9%. And 45.8 % of subjects had one component of metabolic syndrome. The most prevalent metabolic syndrome components had high fasting blood sugar (16.8%) and low HDL (39.7%). The results showed that the important metabolic syndrome risk factors among students were high fasting blood sugar and low HDL. Acknowledgment: This is no conflict of interest

Cancers are major causes of morbidity and mortality around the world. They are among top three causes of mortality in developed and developing countries including Iran. Epidemiology of cancer in different regions is affected by ethnicity, age, gender, cultural and lifestyle factors. This study aimed to investigate epidemiology of various cancers in Khorasan Razavi province of Iran in 2008.

This descriptive and cross-sectional studyused the Khorasan Razavi cancer registry data which is a branch of Iranian National Cancer Registry. After censoring nonresidents and repeated cases, 5617 patients were investigated. Age standardized rates (ASR) and frequency of different cancers according to gender and incident rate in different age groups were calculated using SPSS V. 18.

Of total 5617 recorded cases in 2008, 44.6% were female and 55.4% were male. Average age in male and female patients was 57.1 years± 18.5 and 61 years±18.5 respectively. ASR was 167.5/105 and 133.0/105 in males and females respectively. The most prevalent cancers in this province for both genders were skin cancer (12.7%), stomach cancer (15.9%), breast cancer (9.5%), esophageal cancer (9.2%) and colorectal cancer (7.4%).

There was a large variation in mortality and prevalence of various cancers in Khorasan Razavi province. A significant difference was also existed between different cities of the province, which might be due to different quality of collecting data. Further studies were needed to investigate the trend of these cancers. Acknowledgements: we Acknowledge Khorasan Razavi Cancer registry staff for providing the data. This is no conflict of interest

Inhalation of cold air can cause illness and sometimes death. In this study, the relationship between various indicators of wind chill and mortality from heart disease was studied. death -toll from heart disease statistics (2007-2011) and data on temperature and wind speed were used. Wind chill indices (Steadman, Passel and Siple, heat dissipation and Passel and Siple Index, Modified American Meteorological Organization) and Baker indices calculated using the Pearson correlation were compared with mortality. Autocorrelation function of the time delays for evaluation and analysis of variance was used to compare means. To investigate the incidence and mortality among men and women, the chi-square test of independence (c 2) was used.Mortality from heart disease and wind chill indices (excluding Baker and heat dissipation characteristics of Passel and Siple) were positively correlated during January and February. The highest mortality rate was in the age group 67-77, 78-88 and was observed in women. Delay time 1 to 5 days, wind chill indices were correlated with minimum temperature. In general, the lower the temperature, the mortality rate was increased during January and February. In this respect, planning to reduce the mortality in vulnerable individuals, was used.

Sometimes in reconstruction of abdominal wall after resection of its tumors, the defect is too large and therefore there is no chance to cover it with skin. The aim of this report was presentation of 5 cases that had undergone successful reconstruction of abdominal wall defect with mesh. In five patients who had undergone resection of abdominal wall due to its tumors, artificial mesh was used as a replacement for the abdominal wall. The mesh ((mersilene or prolene)) was sutured to the margins of fascia and after growing of granulation tissue over the mesh, split thickness graft was placed over it.None of the patients had local or systemic recurrence in 11& 56 months follow up. Our report showed that after extensive removal of abdominal wall tumors, if it was impossible to cover the defect with natural tissue, artificial mesh could be used as its replacement. Acknowledgment: This is no conflict of interest