Zahedan Journal of Research in Medical Sciences
Volume:16 Issue: 11, Nov 2014

Resistin hormone is a polypeptide hormone belonging to the family of hormone-like resistin molecules. Controversial results have been reported between serum level of resistin and thyroid abnormalities, including hypothyroidism and hyperthyroidism. The purpose of this study was to evaluate the serum level of resistin hormone in patients with hypothyroidism and hyperthyroidism and its association with weight and body mass index. In this case-control cross sectional study 48 patients with hypothyroidism, 34 patients with hyperthyroidism, and 82 individuals as control group were considered. BMI, fasting resistin, TSH, and T4 serum levels were measured by enzyme immunoassay methods. Data were compared using t-test, Pearson correlation coefficient, and ANOVA to evaluate correlation between variables. p< 0.05 was considered statistically significant. Resistin serum levels in hypothyroidism and hyperthyroidism patients was significantly higher than the control group. There was not any significant correlation between resistin serum levels, BMI, age, and thyroid hormones level. Also in hypothyroidism patients a positive correlation was observed between BMI and TSH level, and a negative correlation between BMI and T4 level. The result of this study showed the increase in serum level of resistin in patients with thyroid dysfunction. This correlation was independent of BMI changes in patient. The findings suggest that changing in serum level of resistin may be considered as a criterion for diagnosis of thyroid dysfunction. Although, this hypothesis needs to be more study.

Tuberculosis is a global public health problem in the world. Microscopy of sputum smears is the most widely used method for diagnosing tuberculosis. However, many patients are smears negative for acid fast bacilli. Regarding the pathogenesis of the disease, the effectiveness of interferon-γ (IFN-γ) in bronchoalveolar fluid was investigated for the disease diagnosis. This descriptive study was performed at the Ali Ibn-e-Abitaleb hospital, Zahedan, between 2010 and 2012, to assess the role of IFN-γ level in bronchoalveolar lavage in distinguishing tuberculosis from other pulmonary diseases. In patients who required fiberoptic bronchoscopy as indicated, bronchoalveolar lavage was analyzed in terms of smear acid-fast staining and cytology. The participants were divided into TB patients group (the BK smear of bronchoalveolar fluid or the culture was positive) and pulmonary non-TB patients group (the smear was negative). Yet non-TB disease was definitively diagnosed by other means, as well. The fluid in each group was examined in terms of IFN-γ. Then, Mean IFN-γ levels in BALF were measured in these groups and then compared with each other. Eighty eight patients were enrolled in the study among which, 31 cases had TB and 57 patients suffered from pulmonary non-TB disease. Mean IFN-γ was 2.85±4.17 pg/mL in pulmonary TB patients and 2.21±1.21 pg/mL in pulmonary non-TB patients. Lack of significant differences between the two groups in IFN-γ indicate that this factor is not suitable for diagnosis of tuberculosis and differentiating it from other pulmonary diseases.

The trend today is to minimize the use of mechanical ventilation. Nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV) are 2 non-invasive treatments for respiratory distress syndrome (RDS). There is little study in literature comparing early use of NIPPV with NCPAP as primary modes of respiratory support. The aim of this study is to determine whether NIPPV and NCPAP would have different survival rates and possible complications. In this prospective clinical trial study, 120 preterm neonates (gestational age 28-36 weeks) who were admitted due to respiratory distress between January and May 2012 in the neonatal intensive care unit of Afzalipour hospital. Sixty infants were randomized to NCPAP and comparable infants to NIPPV (birth weight 1807.05±52 vs. 1882.50±56 g, gestational age 32.05±2.94 vs. 32.16±2.08 weeks, respectively). Patients were randomly allocated into 2 treatment groups using minimization technique. One group was treated by NCPAP and the second one treated by NIPPV. Survival analysis was applied to estimate and compare survival rates. Infants treated initially with NIPPV needed less endotracheal ventilation than infants treated with NCPAP (13.3 % vs. 41.7 %, p=0.001). Estimated survival rates at 24 h in NIPPV were 97% versus 82% for NCPAP group. We have seen that the risk of failure for those received NCPAP was nearly 4 times higher than NIPPV group. According to our results, among preterm infants with suspected (RDS), the use of NIPPV reduces the need for intubation and mechanical ventilation in comparison to NCPAP.

The purpose of this study was to investigate the presence, frequency and comparison of Aspergillus spp. in nasal cavity and bedroom of healthy volunteers and patients with allergic rhinitis. In this cross-sectional study, a group of patients with allergic rhinitis (N=50) were selected based on positive skin prick test. Healthy volunteers were chosen to be in the comparison group by matching in age, gender, and no history of respiratory system disease. Samples from nasal cavity and different parts of bedroom were collected and cultured. Cultured Aspergillus spp. was identified by standard mycological techniques. The most common species isolated from all samples of healthy volunteers was A. flavus (88%), followed by A. niger (76%) and A. fumigatus (74%). A. flavus (56%) was the predominant species isolated from all samples of patients, followed by A. niger (34%) and A. fumigatus (6%). A. flavus was the most prevalent species of Aspergillus both healthy volunteers and patients. The presence of Aspergillus in homes does not necessarily imply a cause and effect relationship with illness, but we speculate that A. flavus may be a major source of aeroallergens along with A. niger and A. fumigatus; and should alert physicians and healthcare professionals to do more vigorous environmental testing.

Antibiotics such as fluoroquinolones are used for treating infections caused by Gram-negative bacteria, including Acinetobacter baumannii strains some time have extended-spectrum β-lactamase (ESBL), but ESBL production is rather rare. Resistance to fluoroquinolones antibiotics is mediated by lactamases and other mechanisms of resistance. The aim of the present study was to investigate of the prevalence of ESBL production and clonal relatedness of A. baumannii in Iran. A. baumannii isolates identified from patients at hospitals in Kermanshah, Iran, were studied. The double disk method was used for detection of ESBL production. The susceptibility to different antibiotics was determined by the disk diffusion method (CLSI). Clonal relatedness was determined by pulsed-field gel electrophoresis (PFGE) and processed by Bionumerics 7.0 software. Statistical analyses were performed using SPSS-16.0. This study showed high prevalence of resistance to ampicillin and cefpodoxim (98.1 and 92.3%). Fifty-two of the 84 isolates were identified as ESBL producers. Only colistin and tigecycline remained active against all isolates tested. The PFGE identified eight distinct pulsotypes: A (N=9), B (N=10), C (N=2), D (N=5), E (N=9), F (N=15), G (N=1) and H (N=1). The PFGE profiles A, B and F were believed to be endemic (specially clone F that was dominant across different wards of the hospitals and appeared to be endemic) in the ICU, emergency, pediatric and infection area throughout the years. Early and timely detection of ESBL-producing A. baumannii clones is useful for preventing their spread within the hospital. PFGE analysis is helpful for detection of common strains in different wards and prevention of further spread of these pulsotypes to other hospital environment.

Idiopathic intracranial hypertension (IIH) is associated with visual loss in 25% of patients. Some studies point to frequent visual evoked potentials abnormality and its value in management of patients with IIH. Due to the lack of adequate research in this area, in the present study we assessed visual evoked potentials and perimetry changes in patients with IIH at admission and one month later. This cross sectional study was conducted on 30 patients with idiopathic intracranial hypertension. The diagnosis was confirmed according to Friedman and Jacobson criteria. Perimetry and visual evoked potentials were performed at admission and one month later. Results were analyzed by Independent t-test and χ2 tests. In this study, 27 (90%) of patients were female and the others were male. Perimetry abnormality was found in 24 (80%) patients at admission and 16 (53.3%) patients one month later. Also, visual evoked potential abnormality was seen in 7(23.3%) patients at admission and 5 (16.6%) patients one month later. There was no significant difference between mean waves’ latency (P100, N75 and N135) with perimetry changes at admission and one month later (p≤0.05). P100 latency abnormality was more frequent in men at one month follow up (p=0.009). Visual evoked potentials abnormality is less frequent than perimetry abnormality at admission and one month later. So, visual evoked potential is less sensitive than perimetry for follow up of patients with IIH. Maybe, men are more prone to optic nerve damage.

The aim of this study was determining the relationship between personality traits and happiness in patients with major thalassemia. The design of this study was descriptive (correlational study). The target population of this study was all under-treated patients with major thalassemia in Amirkola thalassemia center in 2011. Among these patients, 150 patients were sampled using simple random sampling method and Morgan''s table. The data were analyzed by means of calculating Pearson correlation coefficients and multiple linear regression analysis. The patients were asked to complete NEO-five factor Inventory (short form) and Oxford happiness inventory. Based on the results, the coefficient of regression analysis of NEO personality factors (big five) and happiness was 0.45, which shows a linear relationship between personality factors of NEO and happiness in patients with thalassemia. Thus, there is a statistically significant relationship among personality traits (neuroticism, extroversion, openness, agreeableness, conscientiousness) and happiness. Among personality traits, extroversion, flexibility, agreeableness and conscientiousness had positive statistically meaningful relationship with happiness i.e. patients with lower scores in neuroticism, were happier.

Trauma is a major health problem throughout the world, leading to death and disability especially in the first four decades of victims’ life. In Iran also, accident-related death has a critical situation with an increasing rate of 10-15% per year. The aim of this study was to determine the relationship between revised trauma score and mortality rate of traumatic patients within the first 24 h of hospitalization. A prospective cross-sectional study was conducted to investigate the association between revised trauma score and the mortality rate of traumatic patients within the first 24 h of hospitalization on 240 traumatic patients admitted to Khatam al-Anbia hospital. The obtained data were analyzed with SPSS software-15, using logistic regression, chi-square, and descriptive statistics. Seventy four point tow percent of patients were referred due to accident, of which 38.3% had multiple traumas. Fifty point eight percent of traumatic patients died within the first 24 h of hospitalization. The minimum and maximum revised trauma score in injured patients were 7 and 12, respectively. Also, 80% of mortality was seen in victims with a score of 9-10. Both the χ2 test and logistic regression showed a significant relationship between the first revised trauma score and the mortality rate of traumatic patients within the first 24 h of hospitalization (p=0.001). The results of this study indicate that the revised trauma score can be used as a tool to predict the mortality rate of traumatic patients.

The aim was to determine the diagnostic accuracy of sonography for ovarian torsion. In this analytic descriptive study, 323 women with suspected ovarian torsion underwent a transabdominal sonography. Findings of sonography were compared with laparatomy. The ultrasound correctly diagnosed 72.1% of ovarian torsion cases and missed 27.9% of these cases (false negatives). There was a strong correlation between sonography and surgery with a kappa value of 84.0%. The sensitivity and specificity of sonography for diagnosing ovarian torsion were determined 72.1% and 99.6%, respectively. Also, sonography had a positive predictive value (PPV) of 96.9%, a negative predictive value (NPV) of 95.9%, and a total accuracy of 96.0% for detection of ovarian torsion. Sonography is excellent to evaluate patients with suspected ovarian torsion. Abnormal blood flow is highly predictive of ovarian torsion.

Prediction of the malignant course is important in patients with stroke in order to begin interventional treatment strategies. In this study, predictive value of electroencephalography was evaluated in detection of malignant cases. In this study electroencephalography findings were evaluate in 36 patients suffering stroke. Data were analyzed with Fishers exact test. Fourteen patients had malignant and 22 patients had a non-malignant course. Six patients in malignant course group and 1 patient in non-malignant course group had focal delta activity (p=0.008). Electroencephalography findings had predictive value in malignant course in stroke patients.

The objective of the present study was to estimate the contribution of environmental pollutants to hospital admissions for cardiovascular disease (CVD) on subjects living in Kermanshah. This study is an ecological analysis. Data of CVD was collected from the largest CVD hospital of Kermanshah during 1 March 2010 until 30 February 2011. The air pollution data were obtained from environmental center. Magnitude of association was estimated by Poisson regression model. Among air pollutants PM10 and CO was significantly associated with hospital admission for CVD. This study suggests that short-term exposure of people with some air pollutants such as PM10 and CO could increase CVD hospital admission.

This survey was done to determine the prevalence of head lice (Pediculus capitis) at the girls of primary schools in Damghan district. In this descriptive study 2700 students was examined and data of them recorded in questionnaire and analyzed by χ2 test using SPSS-12. Totally 97 students (3.6%) were infested with pediculosis. There was a significant correlation between the age, habitat and infection rate (p< 0.05). According to the result of this study head lice infestation is the health problems in schools. Therefore controlling program must perform to prevention the prevalence of pediculosis.

Occurrence of leukemia in thalassemia major is a rare presentation. Here we report two cases of thalassemic patients, developing acute lymphoblastic leukemia. The genetic analysis revealed that, female and male patients were homozygous for IVSI-6 and IVSI-5, respectively. Two years ago the female patient presented by a high leukocyte count (154,000 µL) and male one also presented by 80,000 WBC/µL count 1 year ago. Microscopic examination of both patients revealed lymphoblasts that morphologically accommodate with ALL-L1 that were confirmed by photocytometry.

Sonozaki syndrome or pustulotic arthro-osteitis is a relatively rare chronic illness which belongs to the group of seronegative arthritis. Sonozaki syndrome includes arthro-osteitis and symmetrically localised palmoplantar pustulosis. The disease is characteristically non-erosive and transient and does not lead to contracture deformities. Early recognition of the disease can prevent misdiagnosis. Hereby، we describe a 51-year old woman with palmar pustulosis and involvement of the left sternoclavicular joint and peripheral oligoarthritis.

Gastrointestinal symptoms are common in systemic lupus erythematous (SLE) patients and more than half of them are caused by adverse reactions to medications and infections. Cases of mesenteric vasculitis in SLE are well described; however, we describe a condition of severe, recurrent lupus vasculitis accompanied with hypocomplementemia as the initial presentation of SLE. Lupus should be suspected in any patient with computed tomography findings of ischemic enteritis, even without lupus-related symptoms or signs. C3/C4 levels may be helpful.

Salivary glands tumors account for less than 5% off all neoplasm in the head and neck. Pleomorphic adenoma is the most common type. Those typically arise in the palate, rarely found in the nasopharynx and nasopharyngeal tumors are usually malignant.Here we report a rare case in 61-year-old woman, who had progressive nasal obstruction for about 6 months, without any disease in the nose, but had a round nasopharyngeal mass and pathologic diagnosis as pleomorphic adenoma. Nasopharyngeal pleomorphic adenoma is a rare tumor.