مجله دانشگاه علوم پزشکی اردبیل
پیاپی 51 (بهار 1393)

Patient education has an important role in controlling the diabetes. Tele-education is impressive due to the elimination of­­ both space and time limitation and establishing an effective relationship with client care. This study was carried out to determine the impact of tele-education by telephone and short message service on laboratory parameters in patient with type 2 diabetes. This experimental study carried out on patients with type 2 diabetes members of Urmia Diabetes Association. A total of 66 samples selected and allocated randomly in two intervention and control groups. Data gathered with demographic questionnaire and lab work. For intervention group education and telephone follow up had given for 12 weeks. Data were analyzed using descriptive and inferential statistical testes. Finding of the study showed decrease in fasting blood sugar (-29. 82)، glycosylated hemoglobin (-0. 54)، cholesterol (-13. 88)، triglyceride (33. 88) and insulin level (-4. 59) in intervention group after performance of education and telephone follow up. Telephone follow up and tele-education have a beneficial effect on controlling the laboratory parameters in patients with type 2 diabetes.

Nowadays, coronary artery disease is the most common cause of death in developed countries and in the whole world. According to the WHO reports, it will be the main cause of death in 2020. Myocardial infarction is the most common diagnosis among hospitalized patients in industrialized countries. This disease causes more mortality and morbidity than others. Coronary artery bypass grafting surgery (CABGS) is one of the common treatments for ischemic heart disease but it may have some complications. In this study we wanted to evaluate the incidence of CABGS complications in Imam Khomeini Hospital of Ardabil in the first month after CABG. This study was a cross sectional analytic descriptive type and performed on all of the patients underwent CABGS in Imam Khomeini Hospital during 2011-2012. All of the data from patients (like demographic, past medical history, physical exam findings, paraclinical findings and CABGS complications) were inserted in special forms after gathering, and analyzed by SPSS v.16. In this study, 211 patients were studied. About 145 (68.72%) of them were male and 66 (31.28%) were female. Seventy patient (33.17%) were more than 70 years old. About 33.22% of patients had a history of cigarette smoking and 9.95% were opioid abused. The 34.12% of patients had hypertension (HTN) history, 40.28% diabetes mellitus (DM), 17.06% history of hyperlipidemia and 63.98% had a history of the previous MI. Chest pain was the most common complication among the patients (93.36%). According to our study the prevalence rate of post CABGS complications were: bleeding after surgery 13.27%, postoperative myocardial infection 8.05%, neurological disorders 12.32%, renal complications 2.36%, respiratory symptoms 11.37% and 34.59% for cardiovascular complications. Also the total mortality was 5 (2.36%) persons. The data analysis showed that there was a significant relationship between sex with survival status, local infection and neurological disorders, and also there was a significant relationship between age with post CABGS survival, bleeding after surgery and renal complications. There was also a significant relationship between DM and post CABGS survival, local infections and respiratory complications and between HTN and local infections. According to the results of this study, the most common post CABGS complications were cardiovascular complications, especially arrhythmias.

Acinetobacter baumannii is an opportunistic Gram-negative pathogen with increasing relevance in a variety of hospital-acquired infections especially among intensive care unit patients. A. baumannii is mostly a cause of septicemia, pneumonia and urinary tract infection following hospitalization of patients. In this study antibiotic susceptibility pattern of A.baumannii isolates and molecular typing among isolates resistant by REP-PCR were determined. During study, the A. baumannii, were isolated from hospitals in Tehran. The isolates were identified using standard biochemical tests and antibiotic susceptibility was determined by the disk diffusion method. Extraction of DNA and molecular typing of isolates performed using CTAB method and REP-PCR, respectively. In this study 75 A. baumannii isolates separated from patients with an average age of 51 ± 18.45 years. The highest resistance rate was against azteronam (97%), ceftazidim (93%), cefepime (93%), piperacillin-tazobactam (93%), ciprofloxacin (93%) and ticarcillin (93%) while the lowest resistance rate was against tigecycline (n= 51, 68%), followed by tobramycin (n=24, 32%), ampicillin-sulbactam (n=21, 28%), amikacin (n=16, 21%), and carbapenems (n=11, 15%). The REP-PCR in resistant of A. baumannii isolates showed that the genotypes of A, B and C are the predominant genotypes in the resistant antibiotics. This study showed a high percentage of resistance to antimicrobial agents among genotypes A, B, and C of the A. baumannii isolates; therefore strategies to control the spread of A. baumannii isolates must be designed and evaluated.

Cortical spreading depression (SD), a self-propagating depolarization of neuroglial cells, is believed to play a role in different neurological disorders including epilepsy and migraine aura. A brief period of excitation heralds SD which is immediately followed by nerve cell depression and later by prolonged excitation. The aim of the present study was to investigate relationship between SD and late phase of excitability and seizure burst activity inlateral amygdale of rat. Male Wistar rats with 250-350 gram body weight were used. We usedamygdale slices taken from Wistar rats. SD was induced by KCl. After superfusion of these slices with sub-epileptic concentration of bicuculline for 45 min, the induction of SD in the lateral amygdale resulted in presence of interictal and ictalepileptiform field potentials. After initiation of SD in lateral amygdale, glutamate receptors (NMDA, AMPA) antagonists as well as K+ and Ca++ channels blockers were able to decrease the amplitude of excitatory postsynaptic potentials. The results imply a possible role for SD in temporal lobe epilepsy in predisposed neural tissue with increased excitation or decreased inhibition. The study of the late phase of SD excitability may help us to understand the mechanism of SD action in associated neurological disorders. This finding may improve the therapeutic strategies for treatment of epilepsy.

Pain is one of the preceding claims of Parkinson's disease (PD), that its mechanisms have not been fully identified. The purpose of this study was to investigate the chemical pain responses induced by subcutaneous injection of formalin in male parkinsonized rats. In this experimental study, 40 Wistar male rats were used and PD was established by stereotaxic injection of 6-OHDA toxin into the striatum. Parkinson's disease severity determined by apomorphine-induced rotation test and then the pain response of 4 groups, the control, sham and 2 weak or full Parkinson groups, were evaluated using formalin test. Data were analyzed using ANOVA and Tukey test. In both acute and chronic phases of the formalin test, the symptoms of pain in different groups were same, but at the interphase stage, pain intensity increased more in Parkinson 's rats, especially in full PD group compared to control (p<0.01). These results suggest that the nigrostriatal dopaminergic pathway have important modulating role on chronic pain.

Poisoning is a common cause of hospital emergency visits in many countries. Incidence of poisoning is different based on cultural and economic characteristics. The aim of this study was to investigate the epidemiology of poisoning in pediatrics. This cross sectional study was performed on 336 patients under 13 years of age referring to Bu-Ali hospital during five years (2007-2011). Variables such as age, sex, residency place, hospitalized duration, cause of the poisoning, clinical signs, treatment and outcome were obtained by a checklist. Collected data analyzed by statistical methods in SPSS v16. Among the subjects, 197 patients (58.6%) were male. The average age of the children was 4.1 years and the most common age range was 1 to 4 years with (210 patients, 62.5%). The mean duration of hospitalization of children was 1.7 day (SD= 0.2), 77.7 % of the children were living in the city and the summer was accounted as a common season in which the patients referred to the hospital (32.7 %). The most used materials were drugs with 60.71% and in 86.6% of patients the cause of poisoning was accidental. Results showed that the most common cause of poisoning among children are drugs and methadone was the most commonly abused substance. It requires that parents should be trained about keeping their children away from drugs somewhere.

Visceral leishmaniasis is an important endemic disease in Iran and Meshkin shahr County is the most important foci of visceral leishmaniasis in Iran. The aim of this study is the survey of recent changes in epidemiological patterns of visceral leishmaniasis in Meshkin Shar area during 12 years. This is a descriptive retrospective study. Records of 193 cases with confirmed kala-azar disease were reviewed in the period of 2001-2012. Data collected from files and were analyzed using descriptive statistics and SPSS v.15. From 193 patients with confirmed kala-azar disease, 85% were resident in rural and 15% in urban areas. Among of these patients, 43% were female and 57% male. About 66% of patients were under 2 years old, 23% in age group between 2-5 years and 11% above five years. Among four parts of Meshkin Shahr County, in the first five years of the study, the most cases of the disease were from the central part, but in second six years the most cases were from the west part of this county and in latest year (2012) it has been coverted. Incidence of kala-azar was decreased during last 12 years. Because of high infection rate in dogs and considering important role of these reservoirs in conserving and distribution of disease, stopped health activities in any parts of area can increase the incidence of disease.

Venous thromboembolism (VTE) is one of the three causes of mortality made by cardiovascular disease and pulmonary embolism is the most common preventable causes of mortality among hospitalized patients. Considering high prevalence, the importance of etiologic studies of diseases and different previous reports regarding the role of blood groups on occurrence of diseases such as VTE, this study was carried out to determine the blood groups of the hospitalized patients with diagnosis of VTE. This cross-sectional study was carried out on 200 hospitalized patients with the diagnosis of deep vein thrombosis (DVT) and pulmonary embolism (PE) in Imam, Fatemi and Alavi hospitals in Ardebil. The final diagnosis was made by c olour D oppler ultrasound and pulmonary CT angiography and blood groups and risk factors were determined. Results of this study analysed along with the previous epidemiologic reports related with blood groups in Ardebil and Iran population using chi-square and t-test and SPSS software. Of 200 patients with VTE, 140 patients were affected with DVT and 60 patients with PE. In this study, 92 patients were males and 108 were females. The mean age of patients was 52 ± 19 years. The most prevalent blood group was type A with a rate of 47.5%. There was no correlation between the diseases namely DVT or PE and blood groups (P=0.55). Frequency of type A (OR: 2.914) and B (OR: 1.608) in patients with VTE was more than Ardebil and Iran population but the type O (OR: 0.632) was less than those population. These differences were statistically significant. The frequency of type AB was similar in all groups. The Correlation between blood groups and venous thromboembolism, which have been discussed in many studies, have been investigated in Iran and at medical centres of Ardebil University of Medical Science for first time. It seems the type of blood groups (A and B) is effective in frequency of VTE. More studies are needed on the correlation between blood groups and VTE.

The risk of coronary artery disease increases with increasing of blood pressureboth in hypertensive and normotensive persons; on the other hand nutritional factors have asignificant effect on blood pressure. The purpose of this study was to assess theeffect of caffeine on blood pressure in sedentary healthy male during resistance exercise. In single-blind crossover study, twenty healthy and non-athlete male in the University of Mohaghegh Ardabili randomly selected and stratified according to age and BMI into twogroups: caffeine and placebo. The subjects performed repetitions to exhaustion at 60% of 1RM for any motion of chest press, leg press, squat and lat pulldown, 1 hour after taking caffeine (6 mg/kg body weight) or Placebo (similar dosage of starch). Blood pressure (BP) was measured before and 1 hour after taking caffeine and also immediately after any exercise. Data analysis was conducted using independent and paired t-test. Results indicated that systolic and diastolic BP and mean arterial pressure significantly elevated following caffeine intake at rest, but no significant differences were observed after exercise. These findings indicate that caffeine at this dosage level alters cardiovascular dynamics by augmenting arterial blood pressure in moderately non-athletes male at rest. However, it seems that taking caffeine before resistance exercise does not cause abnormal elevations in blood pressure in sedentary healthy male.

Extramedullary plasmacytomas are rare solitary soft tissue tumors that arise from proliferations of malignant transformed monoclonal plasma cell. Though they are closely related to multiple myelomas, they have better prognosis. The tumor is eradicated by surgery or local radiation therapy. This is a case-report study of solitary plasmacytoma tumor which involved left side maxillary sinus and underwent excisional biopsy confirmed by IHC.

Information technology can increase the quality of medical care and is a target for many of the pioneers in the development of clinical or medical information. Electronic medical record (EMR), one of such technologies, is a well-known and valuable system to access patient information in hospitals. Electronic medical records which are used for the purpose of providing basic health care are available through a network of computers. All units of the hospital such as examination room, conference room, emergency, patient care units, nursing stations, operating rooms, recovery units, laboratory, radiology, pharmacy and medical records should have access to it. Among its advantages are improved quality of care provided to patients, better organized information, improvement in the timeliness of the process, accuracy and completeness of documentation, patient access to electronic copies of records, prevention of medication errors and allergies, reduced medical errors, immediate access to information in different places, decision support technology and improvement in the process of doing. S urely the use of electronic medical records has created a new dimension to patient care and clinical practice and will provide a comprehensive system to support people in the community and enhance the quality of services provided to them.