مجله پزشکی دانشگاه علوم پزشکی تبریز
سال سی و هفتم شماره 1 (پیاپی 115، فروردین و اردیبهشت 1394)

Kidney involvement in cancer patients is an increasing problem that needs more complex, collaborative and specialized care. Increasing number of patients are treated with new classes of medications that predispose them to kidney injury. With increasing the population age of cancer patients who are already at increased risk for kidney disease, emerging kidney toxicities associated with drugs targeting VEGF and other signaling pathways are problems that nowadays we are facing for management of these patients. Myeloma- associated kidney disease, cancer and treatment-related microangiopathies and glomerulonephritis, stem cell transplant-associated kidney injuries, all are exciting and expanding horizons in this field.

Success rate of ESWL depends on the consistency, size, shape, location, and the attenuation of urinary calculi. Body mass index (BMI), an objective measure of obesity, has been proposed as a predictor of ESWL success rate outcome; however, this hypothesis has not been confirmed yet in more controlled studies. This study was aimed to evaluate the relationship between the success rate of ESWL and the BMI. In this cross-sectional study, we evaluated 80 patients with urinary calculi who underwent ESWL during a one-year period. The patients were categorized in 4 groups based on their BMIs as following: BMI 19-24.9, BMI 25-29.9- BMI 30-34.9, and BMI ≥35kg/m2 the patients were matched regarding the age, gender, stone specifications (frequency, location, chemical components, and stone size). Six weeks after completion of ESWL, the patients were categorized into stone free (SF) group and stone residual group (SR) group. The results were analyzed and compared between groups. Eighty patients (47 male, 33 Female) with the mean age of 45.66±9.03 years were studied. All patients had solitary, upper urinary tract stone. The chemical analyses showed that the calcium oxalate was the most common type in)64 patients 80%) cases. The frequencies of SF and (SR) patients were 50 (62 %) and 30 (37.5%), respectively. mean BMI in SF and SR were 42.28±4.58 and 33.85±3.66 kg/m2 respectively. BMI predictive value for stone residue had the sensitivity and 80% and 78%. Higher BMI leads to the more SR encountered after ESWL. This was more prevalent in those with BMI ≥30 kg/m2. BMI greater than 30 kg/m2 negatively affect the success rate of ESWL and other therapeutic measurements should be considered in this patients.

Coronary Artery Disease (CAD) Occurs as a result of atherosclerosis. There are several factors which are closely associated with CAD. Cell adhesion molecules such as Vitronectin (VN), could play an important role. The aim of the present study was to evaluate the VN and hs-CRP levels in a group of Non-Smokers with CAD and correlation with extent and Severity of CAD. In this study 200 person included: (160 patient and 40 controls). Patients were divided based on angiographic findings in to 4 groups including: 40 individuals with no vessel disease, 40 individuals with single vessel disease, 40 individuals with double vessel disease and 40 individuals with triple vessel disease. The control group had no history of heart disease. Exclusion criteria were factors such as liver, kidney and lung diseases and malignancies. Serum levels of VN were determined by (ELISA) method (Glory Science) and serum concentration of hs-CRP was measured by Immunoturbidometric method. The mean age of patient and controls were (58 ± 7 years and 56 ± 8). There was no significant difference between the two groups in their age and sex. Serum VN and hs-CRP levels in patient groups were significantly higher than control groups (p<0.05 for all). Moreover, serum levels of VN in patients with triple-vessel and one-vessel disease were significantly higher than control group (p<0.05 in all cases). Serum levels of hs-CRP in patient groups were significantly higher than controls (p<0.05). Serum levels of Vitronectin and hs-CRP were significantly higher in Non-Smoker CAD patients as in comparison with controls. Their association with the extent and severity of the lesion was present also.

Postpartum Hemorrhage (PPH) is one of the major causes of maternal mortalities, and it needs to be management in a high quality center. The aim of this study was to evaluate the outcome of patients with postpartum hemorrhage who admitted to the obstetric ICU of Alzahra Hospital of the Tabriz University of Medical Sciences. In this retrospective study, one year records of all patients with PPH were studied their demographic data, details of their primary admission or referral, duration between onset of PPH and arrival, their condition at admission, resuscitative measures, procedures to manage PPH, presence or abscenss of disseminated intravascular coagulation (DIC) and its management, duration of ICU stay, and finall outcome were recorded and evaluated. from the total 43 patients with PPH, 29 were admitted to the ICU. 6 were referred from other hospitals and the remaining were admitted in ordinary ward. The time interval between the onset of PPH and arrival was ranged between 2-72 hours. All patients were conscious on arrival. Five patients were hypotensive. Resuscitative measures were included oxygen supplementation, fluid resuscitation and blood transfusion. Hemorrhage was controlled with uterine massage and drug administration in 6 patients, 23 patients underwent surgery. 5 patients had DIC which was managed with blood component therapy. Mean Duration of stay in ICU was 3 days. We didn’t detected in this retrospective study any registered mortality. PPH is one of the most common causes of obstetric ICU admission. If the management of patients with PPH is carried out in a unit with high therapeutic qualities quality, it would lead to low maternal mortality.

Bone grafting includes auto graft types which could and allograft be used for filling the bone defects and enhance the healing process in cases of traumatic and non-traumatic fracture. Because of Limitations of the auto graft method and increasing the morbidity, allograft type of graft are more considered. The purpose of this study was to compare the autograft and allograft methods. In this study, 100 patients with long bone fractures were divided into two groups (50 patients in each groups). They were matched for age, sex and type of fracture. In one group cancellous autograft was applied and the other group was treated with chips allograft. The amount and rate of union and complications were compared between the two groups. Studied group, 100 patients, (37 ± 10 years, 55 male and 45 females). Union rate in the autograft group was 92% and in allograft group was 86%, there was no significant difference between the two groups. Union duration in autograft was 3.2 ± 0.5 months and in allograft group it was 3.4 ± 0.8 months. The time of the union between the two groups showed no significant difference. The most important complication of autograft group was nerve injury5 (10%) and hematom formation (14%) at the site of removal of the graft, in the allograft group, only a patient (2%) complicated with infection. In both methods, there is a high percentage of union and fracture healing. Duration of union is similar between the two types of grafts, but the morbidity in the autograft method was higher than allograft method.

The aim of this study was to evaluate the effects of ethanolic extract of saffron on oxidative stress markers in the hippocampus of experimental models of MS. Induction of Multiple Sclerosis (MS) was carried out by direct single injection of 0.01 % ethidium bromide (EB) into the Cornu ammonis (CA1) of hippocampal formation. One week after MS induction, animals received intrahippocampal (5 μg/rat and 10 μg/rat) injection of the saffron. At the end, the bilateral hippocampi were dissected to measure oxidative stress parameters. one-way ANOVA followed by Tukey test were used for Statistical analyses activity. Hippocampal injection of EB had no effect on catalase (CAT) activity, but it induced significant increment of antioxidant enzymes GPx and SOD (P<0.05). Short-term local injection of saffron extract significantly reduced the activity of GPx and SOD enzymes (P<0.05). But the activity of CAT was significantly increased following microinjection of saffron extract (P<0.05). The results of the present study show that the local injection of EB may cause increased production of free radicals. Antioxidant capacity and activity are increased. Saffron extract as a potent antioxidant modulates oxidative stress markers, probably through scavenging of ROS and clearing of cells milieu from free radicals.

Club foot is a congenital skeletal problem. Its incidence rate is one in 1000 of live births. Various surgical methods treatments have been developed for its treatment. Ponsti method is one of the reknown manipulation and serial casting methods. The purpose of this study was to evaluate the long-term results of this method.

In a descriptive study 63 patients with Clubfoot who was treated with Ponsti method were followed in an 8 years period. The success rate and recurrence of the condition was studied in the follow up period.

63 infants, including 42 boys and 21 girls were studied.61 patients were typical type and other were syndromic. Mean of Pirrani score was 3.9. Success rate after a year was 90.4%. Recurrence rates based on equinos varus 36.5%.

The ponseti method treatment is an effective and high successful method and it is the recommended method for all typical and syndromic cases.

Various mutations on endothelial Nitric Oxide synthase (eNOs) gene can cause reduced production of NO and may accelerate the process of atherosclerosis. The study was designed to investigate the frequency of T-786C gene polymorphism in a group of patients suffering from CAD in North West of Iran، The association of the polymorphism with other risk factors including: Antioxidant activity indices، Lipid Peroxidation and MDA were also determined. One hundred twenty subjects including 60 patients with angiographically diagnosed CAD and 60 age and sex matched normal control were studied. Exclusion criteria were; diabetes melitus smoking، preexisting malignancies and liver disease. The activities of SOD، GPX and TAC enzymes in the blood samples were determined in both groups using Randox Kits in an automated chemical analyzer (Abbott، model Alcyon 300، USA). The concentration of MDA in the serum samples were assayed by spectrophotometerically using Thiobarbitoric acid reaction. The genotype studies were also carried out concomitantly using allele specific PCR. Erythrocyte SOD، GPX activities and blood TAC level were reduced significantly in patients with CAD (P<0. 05 in all cases). The levels of serum MDA in CAD patients were significantly higher than controls (P<0. 05). The significantly higher frequency of eNOs -786C genotype was detected in CAD patients that indicate the significant association of C allels with CAD. The association between oxidative stress parameters and decrease Antioxidant activity may suggest their involvement in the pathogenesis of atherosclerosis. Increased frequency of T-786C polymorphism might be another risk factor in the progression of coronary artery disease.