مجله پزشکی دانشگاه علوم پزشکی تبریز
سال سی و هشتم شماره 6 (پیاپی 126، بهمن و اسفند 1395)

Based on a new finding an axially rotated lumbar vertebra may be occasionally spotted on lumbar MR images obtained in non-weight-bearing position. This study was performed to evaluate the possibility of a relationship between this new finding and segmental instability after laminectomy.
Methods & Materials: A total of 96 lumbar MR images of patients with previous laminectomy with and without discectomy were reviewed. An axially rotated lumbar vertebra was reported when the posterior borders of two successive vertebral bodies were not aligned at the extreme parasagittal sections. The frequency of this imaging finding was compared before and after laminectomy.

An axially rotated lumbar vertebra was present in 3 patients (6.3%) before operation and in 6 patients (12.5%) after it. Only 3 new cases (6.3%) with axial vertebral rotation were identified after laminectomy. While the etiology of recurrent back pain was unknown in 3 cases, other underlying causes were disc reherniation in 22 patients, spondylolisthesis/ retrospondylolisthesis in 9 patients, presence of scar tissue in 8 patients, ligamentum flavum hypertrophy in 2 patients, infected operation site and diastematomyelia each one in 1 patient.

Laminectomy-induced segmental instability is not a probable cause of evident axial rotation of lumbar vertebra on MR images of patients with post- laminectomy syndrome.

In traditional medicine, the different parts of hops with the scientific name Humulus lupulus (Hops) are used for the treatment of various diseases including reproductive disorders. In addition, having a healthy child with the desired sex is ideal for most couples. Therefore, the study aimed to investigate the effect of alcoholic extract of hops flower plant on sex ratio of Syrian newborn mice.
In the experimental study, 80 mice weighing approximately 35 to 30 gr in the control, sham and experimental groups of male and female Syrian mice were studied. Each control group consisted of 8 mice; the experimental groups of male and female each consisting of 40 mice that were divided into three different experimental of eight 1, 2 and 3, respectively. Experimental groups received doses of 50, 100 and 150 mg/kg alcoholic extract of hops flowers every day for 35 days by gavage. On the last prescribing day, the male and female mice mate together from different groups and after the offspring birth, their sex ratio was evaluated by the chi square test.
The findings showed that consumption of alcoholic extract of hops flowers significantly increases the proportion of male infants than female infants.
Hops flowers extract might increase the serum levels of minerals such as potassium which in turn might lead to increased male to female ratio in infants possibly through altering the PH of the vagina area.

Because few studies are available about the effects of fruit and vegetable consumption in the reduction of diabetic complications. The aim of this investigation was to determine the association between diabetes complications and fruits and vegetables intake in patients with type 2 diabetes.
Methods & Materials: In this case-control study, 150 diabetic patients with complications during a visit to the health centers of malekan with 150 diabetic patients without complications after matched for age, sex and duration of diabetes, were selected. Diabetic patients with a history of smoking, hypertension, heart disease, and kidney were excluded and data were collected with interview and refer to the medical records by food frequency questionnaires (FFQ).

Average intake of fruit and vegetables in the patients case group was 1.28 and 1.82 serve per day and in control group respectively, 2.8 and 2.7 serve per day was reported. So that intake less than two serves per day of fruit and vegetables were associated with increased risk of developing complications. (Fruits OR:2.23 ,%95 CI:1.59-3.1, P=0.001, and vegetables OR:1.71 ,%95 CI:1.2-2.4, P=0.002).

Our findings indicate that less than 2 servings of fruit and vegetables daily intake can increase the possible risk of diabetes complications.

In recent years, associations between air pollution and cardiovascular diseases have been reported around the world. However, a few studies have been conducted in industrial megacities which face air pollution in Iran. This study aimed to determine the association between air pollution and hospital admissions for cardiovascular diseases in Tabriz.

We applied a case-crossover analysis to compute associations between daily concentrations of air pollutants including NO2, SO2, CO, PM10 and O3 and hospital admissions for cardio-vascular diseases. Daily hospital admission data from 2009 to 2011 were collected from five hospitals in Tabriz. Air quality data for the study period were obtained from the six fixed online air quality monitoring stations operated by Tabriz Air Quality Control Center. The daily mean temperature and relative humidity data for the same period were obtained from East Azerbaijan Meteorological Bureau.

From the 1512 cases, the data of 753 cases were used in our analysis. The results of ANNs with importance analysis showed that the most important causes of hospital admissions due to I20 were O3, SO2, NO and PM10, for I21 were SO2, NO and NO2 and for I20.9 were O3, SO2, NO and NO2. According to the results, the air pollutants had greater adverse effects on females and older cases.

The results of this study showed that gaseous air pollutants including SO2, NO and O3 had the greatest effects on hospital admissions for cardiovascular diseases and significant effects on females and older people.

Staphylococcus aureus is one of the most important nosocomial pathogens. Pathogenicity of this organism is attributed to various virulence factors such as surface adhesion proteins, the ability to produce toxins and enzymes, rapid development of drug resistance and biofilm formation. The present study was conducted to investigate some of the virulence factors of S. aureus isolates.

A total of 30 isolates of S. aureus were collected from clinical samples of patients hospitalized in Shahid Beheshti hospital of Hamedan. Identification of bacteria was done using biochemical (catalase, coagulase and DNase) and molecular (PCR) tests. Thereafter, antibiotic susceptibility of the isolates and their ability to produce hemolysin, beta-lactamase and biofilm were assessed using disk diffusion, blood agar medium, acidimetric and microtiter-plate tests, respectively.

Hemolysis activities of the isolates on sheep blood agar showed that 8 (26.66%), 14 (46.66%) and 15 (50%) out of 30 isolates, produced α-, ∂- and β-hemolysins, respectively. While, using human blood agar media, the prevalence of these toxins were 40%, 53.33% and 13.33%, respectively. Twenty one isolates (70%) were found to be beta-lactamase producer using the acidimetric test. Meanwhile, the results of antibiotic susceptibility test indicated that penicillin was the less effective antibiotic (90% resistance). However, none of the isolates was resistant to vancomycin. Moreover, regarding to biofilm formation, 14 (46.66%) isolates strongly produced biofilms.

The results of this study revealed high frequencies of the virulence factors among the examined S. aureus isolates, specially the ability of biofilm formation and antibiotic resistance.

Visceral thrombosis especially hepatic vein thrombosis deteriorates the disease in cirrhotic patients. Thrombophilic genotypes are seen in most cirrhotic patients with portal vein thrombosis. The aim of this study is the comparison of thrombophilic genes frequency in cirrhotic patients with splanchnic veins thrombosis versus cirrhotic patients without thrombosis.

In a case – control study, we studied 100 patients with hepatic cirrhosis in Tabriz Imam Reza hospital after achieving inclusion criteria in the form of two groups (with and without visceral veins thrombosis). The frequency of genetic polymorphism of thrombophilia in two groups of cirrhotic patients was assessed.

The mean age of the patients was 48.1±18.1 years which were in the range of 15 to 85 years. 51 (51%) of patients were male and 49 (49%) were female. Thrombosis was present in portal vein in 24% of patients, in superior mesenteric vein in 7% of patients, in splenic vein in 14% and in 5% of patients in potal and splenic veins. There was no significant difference between two groups in G20210A, C677T, A1298C and PAI-I genes polymorphism (P=0.82, P=0.70, P=0.78 respectively).

With regard to the non-significant difference in frequency of thrombophilic gene polymorphism in two groups, we cannot assume prophylactic actions in cirrhotic patients for visceral vein thrombosis but we recommend more multicentric studies with more number of cases for clarifying the topic.

Given the importance of understanding the underlying causes of risky behavior, the purpose of present study was to investigate the role of perceptions of parental scale, problem solving, and self-regulation in predicting incidence of high-risk behaviors amon students in Kermanshah city, Iran.
The study population included all school students (First to third grades) in Kermanshah, where 300 people of them were selected using cluster sampling multi-stage. Data analysis was performed using simultaneous and stepwise discriminate analysis method. Data were collected by high-risky behavior and self-regulation questionnaires, problem solving inventory, and perceptions of parental scale.
Result of data analysis showed that self-regulation, method of problem solving and perceptions of parental, plays an important role in predicting high-risk behaviors. Data analysis based on stepwise discriminate analysis showed that most of the structural coefficient related to self-regulation, self-control (one of the components of the problem solving method), Perceptions of Parental and father involvement (one of the components of the Perceptions of Parental), respectively. In other words, these features have the greatest role in predicting high-risk behaviors.
It can be concluded that the family environment and cognitive variables have a significant role in risky behaviors.

Vitiligo is an acquired disease due to progressive lack of performance of melanocytes and appears as ring depigmentated patches and macules. About %2 of people are involved and because of unpleasant appearance, it creates emotional stress on patients .So new and better treatments are needed. This study was conducted to compare effectiveness of topical tacrolimus with topical calcipotriol in pigmentation of vitiligo patients.

This study was done in double-blind randomized clinical trial on patients facial and hand vitiligo with under %20 involvement of body surface. Patients were categorized in two groups with tacrolimus and calcipotriol treatments and were evaluated and followed up for 12 months.

In statistical analysis, there was no significant difference between the effects of both drugs on progression of pigmentation, but their on facial vitiligo was better than hand vitiligo(p=0.04).Side effects of treatment in both groups were mild and no serious side effects were reported, but Tacrolimus had significantly minimal side effects rather than Calcipotriol (p=0.02).

In this study,efficacy of topical tacrolimus was better than topical calcipotriol on face and efficacy of calcipotriol was better than tacrolimus on hand vitiligo.

Free-living amoebae (FLA) include various genera habitat in water sources; some FLA can lead to severe complications in high risk people. The present study aimed to isolate free living amoebae using morphological methods in recreational water sources of Tehran.

This cross sectional study was performed during 8 months in 2014. Seventy five samples from Tehran were collected and filtered. Samples were cultured in 1.5 % non-nutrient bacto-agar. Plates were then monitored for the presence of amoebae daily and positive plates were cloned. In the present study, identification was based on morphological criteria and page key. The page key is based on morphological character of free living amoebae such as trophozoites shape, pseudopodia shape, amoebae nucleus, and endo and ecto-cysts in the cystic form. These criteria could lead to identification of amoeba at the family and genus level.

Out of 75 water samples, 18 (24 %) were positive for free living amoebae. Of 40 pond waters, 13 (32.5%) were positive including Acanthamoeba, Hartmannella and Vahlkampfiids (Naegleria) and out of 35 samples 5 (14.2%) strain belonging to Acanthamoeba were identified based on morphological criteria.

According to the presence of free living amoebae in recreational water sources, it is necessary to alert swimming pools authorities and high risk people. Additionally, posting alarming signs and educating the high risk people is of utmost importance to prevent free living amoebae-related infections.

Vesicoureteral Reflux (VUR) is one of the common urinary tract anomalies that may cause renal parenchymal damages. Recent studies show that microalbuminuria may be helpful in diagnosis of glomerular damage at early stages. The aim of this study was to evaluate the correlation between microalbuminuria and creatinine clearance, kidney scar, in grading of reflux.
Methods & Materials: In this cross sectional study 87 children with VUR were studied from 2012 to 2013 in Children’s Hospital of Tabriz/Iran. Three months after treatment of UTI, serum creatinine and urine microalbumin was measured and renal DMSA scan was done in all cases.
Mean age of patients was 4.49±2.64 years and 82.8% of them were female. Severity of reflux was mild in 23%, moderate in 33.3% and severe in 43.7% of patients. DMSA scan was abnormal in 58 patients (66.6%). With increase in grading of reflux the amount of albuminuria increased and creatinine clearance decreased but these change were not statistically significant (P=0.12). Urinary albumin in patients with scar (33.32±28.69 mg/24 hr) was significantly higher than patients without scar (10.82±8.83 mg/24 hr) (P=0.006). Frequency of scared kidney in mild, moderate and severe grades of reflux was 50%, 62.1%, and 78.9% respectively (P=0.07). Frequency of microalbuminuria was 31% in patients with scar while only 3.4% of patients without scar had micro albuminuria (P=0.003)
We did not find any significant correlation between micro albuminuria, creatinine clearance and abnormality in DMSA scan with reflux grading. However there was a significant correlation between micro albuminuria and scarred kidney. So micro albuminuria may be helpful in diagnosis of renal parenchymal damage. But, further investigations are needed to confirm this finding.

Pseudomonas aeruginosa is one of the important nosocomial Gram-negative bacilli which are resistant to most of antimicrobial agents and antibiotics. This opportunistic bacterium is capable of causing life threatening infections in patients, especially in those with immunodeficiency such as those in ICUs and burn wards. This study was conducted to detect antibiotic susceptibility and also molecular typing of P. aeruginosa isolates from burn infections by using RAPD (Random amplified polymorphic DNA).

Totally 124 P. aeruginosa isolates collected from burn patients consisting of burn infection discharge and blood specimens by application of conventional microscopic, culture and biochemical identification tests. The collected isolates were studied for their antibiotic susceptibility patterns using routine antibiotics ceftazidim (30 µg), aztreonam (30 µg), carbenicillin (100 µg), polymixin B(300 u), colistin(100 µg), gentamicin(10 µg) and ciprofloxacin(5 µg) by disc agar diffusion method and detection of genotypes by two short primers namely 272(5’-AGCGGCCAA-3’) and 208(5’-ACGGCCGACC-3’) according to RAPD-PCR method.

Results of antibiotic susceptibility tests showed high resistance to aztreonam (70.1%), ceftazidime (66.1%), colistin (61.2%) and gentamicin (47.5%), but less resistance to ciprofloxacin(18.5%) and polymixin B(13.7%). Based on antibiotic susceptibility 41 patterns were detected. RAPD-PCR created 32 genotypic profiles with base pair length ranging from 250 to 10000. Each genotype showed between 1 and 8 different weight DNA bands. Genotype 3 was the most prevalent, identified in 42 isolates (33.8%) and accommodated isolates with similar antibiotic susceptibility patterns, while in other genotypes no similar susceptibility patterns were encountered.

Our P. aeruginosa isolates collected from burn infections were most resistant to aztreonam (70.1%), but least resistant to polymixin B (13.7%). The test isolates showed 41 antibiotic susceptibility patterns and 32 RAPD genotypes. Genotype 3 was the most prevalent and accommodated isolates with similar antibiotic susceptibility patterns, but in other genotypes, isolates with similar antibiotic susceptibility patterns was not detected. Some isolates with similar antibiotic patterns underline possibility of their transfer among burn patients and suggest need for restricted conditions and microbiologic surveillance in the burn wards.

Understanding the muscle activity during gait in patients with adolescent idiopathic scoliosis (AIS) is clinically important. The objectives of this study was to analyze electrical activity of erector spinae muscles at T6 (EST6), T10 (EST10) and L3 (ESL3) levels as well as gluteus medius (GM) muscle during walking in female adolescents with and without idiopathic scoliosis.

Twenty female adolescents with right thoracic scoliosis and 18 healthy adolescent control females (all 11 to 17 years old) participated in this study. An imaging system synchronized with a MA300-16 electromyography system and bipolar surface electrodes were used to measure electrical activities of EST6, EST10, ESL3 and GM muscles during gait. Repeated measure analysis of variance and MANOVA were used for the comparisons within and between groups.

During the right stance phase, the activity of right EST6 and left GM muscles in scoliotic patients were significantly (1.8 and 1.4 times) greater than that of control group (P=0.03). In the left stance phase, scoliosis group showed higher activity at right and left GM muscles than control group (P=0.04). In the right and left swing phase, the EMG activity of right GM and right EST6 muscles of scoliotic patients was respectively greater than that of controls. The right over left ratio of EST6 muscle activity for scoliosis group was higher than that for control group at all phases of gait cycle except for the right swing phase.

AIS patients displayed greater activity in the right EST6 and the right and left GM muscles during walking. AIS patients presented asymmetrical muscle activity in EST6 muscle. EMG assessment during gait might have clinical importance in the detection of scoliotic curvature progression.