مجله پزشکی دانشگاه علوم پزشکی تبریز
سال چهلم شماره 6 (پیاپی 138، بهمن و اسفند 1397)

Cardiovascular disease is the main cause of death in many countries in the world, including Iran. High blood pressure is one of the most common risk factors for cardiovascular disease. The aim of this study was to estimate the deaths from cardiovascular diseases and all cause attributed to high blood pressure in West Azarbaijan province. In this study, the required data about the prevalence of hypertension was obtained from a national study on the prevalence and risk factors of hypertension in Iranian adults. The corresponding effect size for death from ischemic heart diseases, stroke and all-cause mortality were obtained from the results of a study on the data of Golestan cohort study. Data on the number of deaths by sex and the cause of death were obtained from the Death Registration System of the West Azerbaijan province. Cardiovascular disease accounted for 27% of deaths in the 25-64 years age group. The population attributable fractions of hypertension for death from ischemic heart disease, stroke and all cause death for men were 14.4%, 26.1% and 6.4%, respectively. In women they were 18.6%, 32.4% and 8.1%, respectively. The number of deaths attributed to the hypertension for aforementioned causes in men was 46, 30 and 154, respectively. In women they were 29, 28 and 120, respectively. Blood pressure has a significant contribution in death from cardiovascular diseases, especially stroke. It emphasize on the importance of programs for controlling and preventing hypertension to reduce its associated deaths in the province as one of the priorities of health programs.

Breast cancer, especially in women, is one of the most common cancers. Granolucyte colony stimulating factor (filgrastim), is used in the prophylaxi and treatment of neutropenia and infection in these patients. Pegylated form of this drug, pegfilgrastim, has entered the market in last decade. This study sought to examine the effects of filgrastim and pegfilgrastim in these patients. In this semi experimental trial study, 100 patients with breast cancer in the third course of cyclophosphamide and epirubicine chemotherapy regimen were selected. Patients were divided into two groups with 50 patients equally with random allocation list. Before chemotherapy, complete blood count test was taken and drugs were injected subcutaneously 24 hours after chemotherapy. Complete blood count test was taken from all patients in the first, second and third weeks after chemotherapy and variation of white cells and neutrophils were noted. Bone pain severity after drug perception was scaled with pain assessment tool. By comparison of patients in two groups of filgrastim and pegfilgrastim there was no statistically significant difference in the white blood cells and neutrophil count in the time interval of first, second and third weeks after chemotherapy (p-value >0.05). Patients of two groups did not have significant difference in bone pain severity statistically. Filgrastim and pegfilgrastim have the same effect upon increase of white blood cell and neutrophil count, treatment of neutropenia and bone pain after chemotherapy in breast cancer and have no priority to each other.

Hemophilia type A is the most common X-linked recessive bleeding disorder, which 45-50% of the cases are caused by intron 22 inversion of factor 8 gene. Carrier detection for prenatal diagnosis in affected families can be effective in order to reduce the spread of disease. Since the linkage analysis for detecting carriers is only possible in families with a family history of hemophilia A, therefore IS-PCR method was chosen as a convenient and reliable method for carrier detection of intron 22 inversion mutation even in sporadic cases of hemophilia A. This study was performed on families of hemophilia A patients with intron 22 inversion. After extracting DNA from peripheral blood leukocytes, IS-PCR technique was used to identify intron 22 inversion mutation types 1 and 2. Among the 9 cases that were analyzed for carrier status by IS-PCR, the results showed that 22/2% were without abnormal allele and 77/8% were carriers of intron 22 inversion mutation. Using Inverse Shifting PCR is a precise, rapid and reliable method for assessing rearrangements related to intron 22 inversion mutation type 1 and 2 for detecting hemophilia A carriers.

exercise induces considerable physiological change in the immune system. The aim of this study was to investigate the effect of a single session high intense interval exercise (HIIE) in hypoxic and normoxic conditions on serum concentration of interleukin-6 (IL-6) and interleukin-10 (IL-10) in active men. The present study was semi experimental research Ten trained students volunteer in shahid Beheshti University participated in this study. General and clinical information was collected via questionnaire before exercise began. In addition some of body composition indexes of subjects were measured one day before exercise protocol. After determining maximum heart rate of subjects during HIIE which was consisted of three series, each series consisting of three one-minute repetitions with intensity of 80 to 85 percent of maximum heart rate and 2 minute rest between series in both hypoxic and normoxic conditions performed one week apart. Before, immediately after, and 1 h after exercise blood samples were taken from subjects. To measure IL-6 and IL-10 Elisa method was used. Finding showed that despite a significant increase in serum levels IL-6 due to HIIE between the two conditions did not differ significantly (p = 0.078). But with increased serum levels of IL-10 in HIIE there was significant difference between the two conditions (p = 0.003). The short-term exercise under hypoxic conditions with the appropriate intensity could modify the immune system response and increased levels of IL-10.

Vaccination is one of the most effective methods of prevention of hepatitis B throughout the world. The aim of this study was to check the level of HBsAb after vaccination in vaccinated 12 to 24 months children referred to Children's hospital in Tabriz. This descriptive, cross-sectional study was carried out on 200 children 12 to 24 months randomly. The questionnaires were filled out through interviews with children, for data collection: and child’s characteristics nutrition, were recorded. 5ml blood sample were taken, then antiHBs experiment was done quantitatively with the ELISA method, manufactured And values above 10IU/ml were considered as the optimal safety level. Data were analyzed using statistical software spss-17 and t-test and Pearson correlation coefficient. 93.5% of studied children over 10 Iu/ml Anti-HBs and showed respond to vaccination. Considering antibody titer There was not statistically significant with sex of children and weight gestational age of the mothers, type of feeding (breast milk and formula), gestational age, birth weight, Type of labor (p>0.05). Anti-HBsAb titers were related to the age of children (p=0.001). The immunity level decreased with increasing age. 6.5% of children were not safe. This study showed that safety caused by total injection of hepatitis B vaccine is desirable according to National vaccination program.

TIM-1, a member of the T cell immunoglobulin and mucin domain (TIM) gene family was implicated as a Rheumatoid arthritis susceptibility gene in previous studies. The aim of this study was to investigate the association of the genotype and allele frequencies of the TIM-1polymorphisms in patients with Rheumatoid arthritis. PCR-RFLP (Polymerase chain reaction–restriction fragment length polymorphism) & SSP-PCR (Single Specific Primer-Polymerase Chain Reaction) were used for investigating the presence of TIM-1 polymorphisms in 88 RA patients and 88 healthy controls. The genotype and allele frequency of TIM-1 polymorphisms were significantly different between the patient and controls. Significant association was observed between this polymorphisms and the risk of Rheumatoid arthritis. These results strongly suggest that 232A>G and -1637A>G polymorphism of the Tim-1 might be associated with susceptibility to RA.

Drug dependence is a physical, mental and social problem. That requires long-term and multilateral treatment. This study aimed to determine the impact of 8 weeks of aerobic training on changes beta endorphin, cortisol, growth hormone levels and anthropometric factors in recovering addicts. In this study, 30 male recovering addicts whit age 25-35 years, were randomly divided into two groups: control and experimental. The exercise protocol was 8 weeks of aerobic training, three times pre week. The duration and the intensity of exercise were gradually added at the end of each phase of training. Beta-endorphin, cortisol and growth hormone levels analyzed by using an ELISA in pre test and post test. Paired t test and independent t test were used to examine differences between and within groups. P<0.05 was considered statistically significant. The Results of this study showed that 8 weeks of aerobic training led to a significant increase in beta-endorphins, growth hormone and VO2max in the aerobic training group compared whit the preworkout (p<0.05) But despite the decrease cortisol, body mass index and body fat percentage after exercise showed no significant difference (p>0.05).The independent t-test results between the groups was only in variable growth hormone (p>0.05). Considering to the desired effect of aerobic training in increasing of beta-endorphin levels in recovering addicts in treatment centers and addiction clinics will be benefited from this training.

During recent years, consumption of nutritional supplements has become popular in the athletes to enhance muscle power, function, and hypertrophy. The aim of this study was to investigate the effects of circuit resistance training and saffron supplementation on plasma testosterone and cortisol in young college men. 44 healthy male were divided into four groups including: water-training, sweat petals-training, style saffron-training and stigma-training. Resistance training consisted of 12 stations (each station lasts for 30 seconds at 40% of one repetition maximum) for 2 weeks (5 sessions per week). Saffron was used daily, 500 mg twice a day, in the morning and immediately after exercise. Blood samples were taken before and 48 hours after the last session and were used for analysis of testosterone by Elisa kit and cortisol by Elecsys system. Results showed there is No significant difference in testosterone (P=0.093) and cortisol (P=0.378) between the groups. Variations inner groups showed significant increase in plasma testosterone levels in all groups (P<0.05) and a significant decrease in plasma cortisol levels in group stigma-training (P<0.038). Also, significant increases in testosterone to cortisol ratio in groups stigma-training (P=0.001) and (P=0.031) was observed. But no significant changes in the other groups were observed. Circuit Resistance training improves the testosterone and cortisol; however this improvement was increased when this training combined with saffron supplements.

Ciprofloxacin resistance in Staphylococcus aureus strains due to efflux pumps has become a significant challenge. This study was performed to evaluate the frequency and gene expression of norA and norB efflux pump genes and their role in resistance to ciprofloxacin in clinical isolates of S. aureus. In this experimental study, a total of 250 clinical samples were collected from different hospitals in Tehran and S. aureus isolates were identified. Antimicrobial susceptibility patterns were determined by disk diffusion method based on CLSI standard. The presence of norA and norB efflux pump genes in ciprofloxacin isolates were detected using PCR method. Finally, active efflux pump was evaluating using MIC of ciprofloxacin-Ethidium bromide and Real Time PCR method. Among 250 clinical samples, 50 S. aureus isolates were recovered and the results of antibiotic susceptibility tests show that 34 out of 50 S. aureus isolates (68%) were resistant to methicillin (MRSA) and from the 34 MRSA, 12 isolates (24%) were resistant to ciprofloxacin. Moreover, the norA and norB genes were found in 100 % and 83% in isolates, respectively. Real Time PCR results show that more resistant strains had increased expression in norA and norB efflux genes. The potential role played by norA and norB efflux pumps in the development of resistance to ciprofloxacin in clinical isolates of S. aureus and the detection of these genes could be important for suggestion of an effective treatment model for the S. aureus infections.

Continuous and interval exercises cause losing weight and changing in adipose tissue. The goal of this study is to investigate the effect of single bout of continues (CON) and high intensity interval exercise (HIIE) on the VEGF levels in adipose tissue of obese male Wistar rats. After high fat diet for eight weeks, 30 rats with BMI: 0.68 g/cm2 were chosen. The exercise program in HIIE group was 5sets with 100% vVo2max and 4 sets with 30% vVo2max. The intensity in CON group was 65% vVo2max. Both groups started their exercise after 3 minutes of warming up. The control group didn’t take part in any exercises. Immediately after exercise animals were anesthetized and then visceral and subcutaneous adipose tissues were removed. Measuring the VEGF levels was performed with western blotting method. we found that the single bout continues exercise has increased 39% VEGF levels (P= 0.05), while single bout HIIE has decreased (P=0.012) in visceral adipose tissue. VEGF levels in subcutaneous weren’t measurable because of low levels of VEGF or mistake in removing tissue. Continues exercise was effective in increasing of VEGF. Decreasing of VEGF levels was due to hypo perfusion in HIIE group during exercise. Because of dysfunction of angiogenic capacity in adipose tissue of obese people to stimulate more adaption and accurate diagnosis, recommended that changes of VEGF levels should measure in different times after exercise.

Perforation is one of the most serious and potentially fatal complications of peptic ulcer disease. Based on patient's clinical condition, the traditional treatment of peptic ulcers often involves a definitive wound procedure or simple closure of the perforation cavity. The purpose of this study was to investigate the association between serological and pathologic findings in Helicobacter pylori infection with perforated peptic ulcer in surgical patients at Urmia Imam Khomeini Medical Center. In a cross-sectional study, 80 patients with perforated peptic ulcer and 80 control subjects who underwent endoscopy due to uncomplicated peptic ulcer were entered this study at Imam Khomeini Medical Center of Urmia in 2017-2018. During the operation, a biopsy specimen was taken from the stomach wall and sent to the laboratory for pathologic and blood sent for serologic (IgM and IgG) examinations. Patients in the control group with uncomplicated peptic ulcers underwent a gastric biopsy during the endoscopy process; they were also examined for the same anti-H. pylori immunoglobulins. Data were analyzed statistically using SPSS-21 software. Of the 80 patients in the study group, 51 (63.8%) were male and 29 (36.2%) were female. In the control group, 42 (52.5%) were male and 38 (47.5%) were female. The mean age in the case and control groups were 51.83 ± 17.94 and 47.75 ± 12.89 years, respectively (p = 0.149). Fifty one (63.8%) of the case patients compared to 38 (47.5%) of control patients were IgM positive for H. pylori (p = 0.02). Regarding IgG, 41 (51.3%) of case patients were positive, while 55 (68.8%) of control patients were recorded as positive (p = 0.01). Our pathology results were positive for H. pylori in 66 (82.5%) of case patients compared to 48 (60%) of control patients, respectively (p = 0.001). Of 80 case patients, ulcers were detected to be prepyloric in 59 (73.8%) patients, body of stomach in 12 (16%) and duodenum ulcers in 5 (6.25%) patients. Statistically significant differences observed between case and control groups (p< 0.05) and our results suggest that closure of the perforated wound and eradication of H. pylori can be the first step in the treatment of perforated peptic ulcer disease and could prevent the recurrence of the disease. Further studies using large numbers of patients and their follow up is recommended.

Considering the increased rate of obesity and diabete and their relationship with liver disease this research was performed to determine the effect of eight weeks endurance training with chlorella supplementation on serum levels of liver enzymes in type 2 diabetic middle aged women. In this semi experimental research, 40 non-athletic type 2 diabetic women (45-65 years old) with BMI greater than 25 were voluntarily divided into four groups: control, chlorella supplementation, endurance training and endurance training with chlorella. Training group performed walking and running three sessions a week for eight weeks, with an intensity of 65%-85% of maximum heart rate for 25 to 40 minutes. Chlorella group consumed chlorella capsule at a dose of 600 mg two times a day. 24 hours before and 48 hours after training, 5cc blood samples were taken from the brachial vein in the fasting state to measure liver enzymes including: Alanine transaminase (ALT), Aspartate transaminase (AST), and Alkaline phosphatase. One-Way ANOVA test was used to evaluate the effectiveness of the exercise protocol. All statistical test were performed considering p<0.05 meaningful. Ther was a significant difference among control and cholorella group after 8 weeks training on the enzymes AST and ALP: (respectively p=0,004 , p=0,006) .Also variations of enzym ALT in chlorella and endurance training+chlorella groups had a meaningful difference with control group (respectively p=0,022 , p=0,027). The chlorella supplementation decreases liver enzyme levels in type 2 diabetic patients and can be helpful in treating of fatty liver type 2 diabetic subjects.

A 34-year-old woman with systemic lupus erythematosus who had two kidney transplants and 4 months after the second transplant, with symptoms of fever, malaise, night sweats and chest pain was referred to Al-Zahra hospital. In lung CT scan results of this patient lesion similar fungus ball was seen and for this patient was diagnosed fungal infection. Due to loss treatment, BAL samples were taken from patients and were sent to the microbiology laboratory. Based on microscopic and phenotypic test results patients diagnosed with pulmonary nocardiosis and According to antimicrobial susceptibility testing was treated by the drug co-trimoxazole. Nocardiosis opportunistic infection in immunocompromised patients is one of the main causes of death and should be properly diagnosed.