مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
سال پنجاه و هفتم شماره 9 (پیاپی 133، اسفند 1393)

It was designed as a pilot study in an academic medical center in Iran. The study started with 30 AKI patients at medical ward who were divided in to two groups through 1:1 randomization and received RRT (IHD) as “early group” or “late group”.

The SPSS statistical software was used for analysis. At the start of the RRT, eGFR was 10.62 ± 7.25 (ml/min/1.73 m2) in ED group versus 11.54 ± 6.52 in LD group. After 28 days follow-up, changing in eGFR was + 48.68± 39.43 in ED and +31.27 ± 23.28 in LD group, the difference was not significant in two groups (P= 0.15). Difference in duration of regaining renal function (duration that urine output recovered to 60 ml/h or eGFR rose 30% or more) in two groups was not significant (P=0.059; 8.7 in ED and 6.8 days in LD group).The mortality rate was the same in two groups.

The earlier initiation of RRT versus late RRT didn’t have any significant impact on kidney or patient survival.

The Skin and soft tissue infections are among the leading causes of outpatient visits to medical clinics or hospitals.These infections have a wide range of clinical severity. They can just be superficial infections with a curable course by medical treatments or they can be severe and life threatening without prompt diagnosis and justified interventions.The purpose of this study was to investigate the signs, symptoms and treatment protocols of soft tissue infections. In a cross-sectional study, the patients with soft tissue infections referred to Imam Reza Hospital during the years 1388-1391, who had the inclusion criteria, were enrolled.After collecting the data, the statistical analysis using SPSS software and chi-square and t-tests were performed. During the study period, 300 patients with a mean age of 42.9 ±17.32 years were evaluated. The mean hospital stay was 4.1 ±2.41 days.The most common underlying condition among them was intravenous drug abuse in 85 patients (28.5 percent). In 254 patients (84.6%) the initial diagnosis was cellulitis.In 56% of patients a single antibiotic regimen was prescribed from the beginning to the end of the treatment course.Overal, 6% of the patients eventually died. The most common soft tissue infection in the patients studied was cellulitis and the empirical antibiotic therapy resulted in good response and recovery in more than half of the patients.

Vitamin D (Vit D) deficiency is an important health problem that is prevalent the among elderly and probably is more prevalent in nursing home residents. So we conducted a study to evaluate the prevalence of Vit D deficiency in elderly nursing home residents and compared it with the other elderly population. In a cross-sectional study 140 aged nursing home residents (G1) & 140 elderly in the community (G2) were enrolled. Serum 25(OH) D, parathyroid hormone (PTH), Alkaline phosphatase (alp), Calcium, Phosphor, Albumin were measured in all subjects. We used t test, chi square test, ANOVA and correlation for statistical analysis of hypothesis. mean serum 25(OH) Vit D was 16.1±16.64 ng/ml in G1 and 39.62 ± 24.78 in G2 (p= 0.000) Vit D level less than 20 IU/ml was found in 75% of G1 and 24% of G2. There was a significant correlation between serum 25(OH)D and PTH in both groups, and between 25(OH)D and Alp in cases.(P=.001) In this study we showed that Vit D deficiency among the elderly in nursing home residents was higher than the adjusted population out of nursing homes. So we recommend to use replenishment methods or Vit D for the elderly who were more at risk.

Multiple sclerosis (MS) is a chronic, autoimmune, inflammatory nervous system disease. It leads to the loss of myelin in the white matter of brain, spinal cord and optic nerves, and causes tiredness, muscle cramp, tremor, unsteady gait and some inability to move. The present quasi-experimental study used a pretest-posttest design.This study was conducted in 2013 on 24 women, referring to MS association in Mashhad, Iran. The subjects with the age of 27-37, expanded disability status scale or EDSS 1-4, were purposefully and voluntarily selected and randomly allocated to the experimental and control groups (n = 8 in each group).Training program for groups was carried out in 8 weeks, three sessions per week, and each session lasted about one hour. Patients walking speed was measured, using 25-foot walk test, before and after exercise. The data were analyzed by descriptive statistics and using analysis of Repeated measures at a significance level of P ≤ 0.05. after training program, the subjects walking speed were significantly increased. Significant improvements observed in walking speed characteristics of the experimental group(P ≤ 0.05).significant differences observed between post test scores in the experimental and control groups(P ≥ 0.05).The results of within-group analysis of variance showed that the external intervention was significantly(p <. 05). Because of increased effect on walking speed, we recommended training program as a complementary treatment alongside medicinal treatments for MS patients. Acknowledgements: The authors would like to thanks all the workers Mashhad Multiple sclerosis’s Disease Association. The authors would also like to thank participants, For her assistance in performed programs training.

Aknowledment: This research is based on a master’s thesis under the supervision of the second author at the Faculty of Physical Education of Razi University. Introductoin: Type 2 diabetes is associated with increased cardiovascular risk factors such as: high blood pressure, hyperlipidemia, glycated hemoglobin, fasting blood glucose and lack of physical activity. Common type of exercises are aerobic exercises that improve glycemic control, lipid profile and blood glucose. The purpose of this study was to investigate the effects of aerobic exercise on changes of fasting blood glucose, glycosylated hemoglobin and cardiovascular risk factors in type 2 diabetes.

In this study, from patients visiting the Kermanshah Diabetes Association, 16 volunteers participated in the study as subjects and allocated into aerobic (n=8) and control group (n=8), randomly. Training program for the aerobic group included 3 sessions of running per week with 60 to 80% maximal heart rate for 8 weeks. Before and after the intervention, body weight, BMI, fasting blood glucose, HbA1c, lipid profile, systolic and diastolic blood pressure and vo2max were measured.

HbA1c, LDL-c, TG and fasting blood glucose were significantly decreased in aerobic group after intervention, but had no significant changes in control group. Vo2max was significantly increased in aerobic group. No significant changes were observed for HDL-c, cholesterol, systolic and diastolic blood pressure, body weight and BMI.

performing 8 weeks of aerobic reduced HbA1c, fasting blood glucose and improved lipid profiles but could not significantly affect blood pressure, body weight andBMI in these patients.

Acknowledgement: Our deepest regards goes toopen heart surgery department of ghaem hospital colleagues, Surgical Oncology Research Center and Surgical endoscopic research center whom without their sincere help this study could not be performed. hyperlipidemia is one of the major risk factors for coronary artery disease and progression of atherosclerosis. Severity of coronary artery stenosis and the extent of arterial involvement are important indicators in therapeutic planings. In this study we have evaluated the relation between increases in different serum lipids and the number of involved coronary arteries among candidates of coronary artery bypass. Method and materials: A total of 150 patients who underwent coronary artery bypass in open heart surgery department of Qhaem hospital were divided into three groups of single vessel, two vessels and three vessels involvement according to angiographic findings. Then lipid profile and prevalence of different hyperlipidemias were compared between these three groups. among our cases, single vessel disease was reported in 2.7%, two vessels disease was reported in 26% and three vessels disease was reported in 71.3%. Male to female ratio was 86 to 64. like other studies, prevalence of coronary artery disease was higher in male gender. Mean age was 58.2 years in our study. All groups were almost similar in age, sex and prevalence of MI and history of smoking. Comparing different types of hyper lipidemia between three groups, based on the number of involved coronary arteries, prevalence of total cholesterol and LDL hyper lipidemia were significantly higher in multi vessel disease. Total serum cholesterol and LDL level were important prognostic factors and indicators for prediction of extent of coronary artery disease.

Dermatophytosis is the most common fungal infection of human and animal. This study aimed to investigate the frequency of dermatophytes species among patients referred to medical mycology lab of clinic Vijeh in Kermanshah University of Medical Sciences and some of the factors affecting their frequency. In this study, all patients admitted to the Mycology Laboratory in 2012 were examined for dermatophytosis. Distinguish based on direct test with, KOH preparation and culture on Sabouraud Dextrose Agar with or without chloramphnicole and cyclohexamide. Other data such as, age, sex, job, contact with animal, pool, sport saloons and underlying disorders were collected with check list. During the one year study, 91 patients with dermatophytosis were diagnosed in medical mycology laboratory. The most common isolated dermatophyte was Trichophyton verrucosum with 47 cases(51.65%) and nearly %60 of these were women.Overall, 51 infected patients were females and 40 were males. The most frequent age group was 21-40 years with 57 cases. In this study the most common isolated dermatophyte was Trichophyton verrucosum. A high percentage of patients had a history of contact with animals and infected sites that could be anoided by teaching sanitation to prevent people from getting fungus.

Anterior cruciate ligament (ACL) reconstruction is one of the most common procedures in orthopedic surgery but no clear guideline regarding the timing of reconstruction has been established. It is assumed that the delay in ACL reconstruction may predispose the patient to cartilage destruction. The purpose of this study was to determine the association between chondral lesions and the chronicity of ACL tear and to estimate the best timing of ACL reconstruction following injury in order to reduce the rate of secondary chondral lesions. In this cross sectional study, 438 consecutive patients who underwent ACL reconstruction between Aug 2007 and Feb 2013 in Shahid Gazi Hospital (Tabriz/Iran) were enrolled. Arthroscopic findings related to chondral lesions and the study variables including age, sex, BMI, time from injury and the mechanism of trauma were recorded. The data were analyzed using descriptive and inferential statistical tests using SPSS software. The mean age of the patients was 29.3 (range: 17-53) years, and the mean BMI was 25 (range: 18-33) kg/m². The mean time from injury (TFI) was 24 (range 1–180) months. A total of 298(67.8%) patients had one or more chondral lesions and 56 (12.8%) had grade 3 and 4 chondropathies. We found a significant correlation between the age of the patients and the existence of chondropathy (R=0.32, p<0.001). According to our analysis the age of the patients was the best predictor of chondral lesions and each year of aging increases the chance of severe chondropathy around 8% (OR=1.08, 95%CI (1.04-1.13)). Significant correlation was also found between time from injury and chondral lesions. The cut-off point to predict significant increases of chondral lesions was around 12 months after injury. (Area under the curve [AUC] = 0.57; with 51% -63% CI; sensitivity = 62%; specificity = 50%). The age of the patients and the time interval from injury are the main predictors of chondral lesions associated with ACL injury. ACL reconstruction is best carried out within the first 12 months post injury in order to minimize the risk of secondary chondral lesions.

Pneumonia is a leading cause of death in early life, and it is the most common cause of hospital admission and mortality due to an infectious disease in adults worldwide, especially in developing countries. Despite the fact, basic and epidemiological studies of the etiologic agents, common pathogens and the outcome of the disease are negligible and inadequate in these communities. To date, so few studies of epidemiological and demographic patterns of this clinical syndrome, as well as its more common bacterial or atypical pathogens, have been conducted in Iran. This review article is a survey of the published articles about the most common etiologic agents of community-acquired pneumonia (CAP) in Iran, with especial emphasis on comparing the results. A total of 21 studies regarding community-acquired pneumonia in Iran were found. Of these, 11 studies were conducted in the pediatric age group. 7 in adult age group and one in both. In two studies age group was not specified. Knowing the etiologic agents of community-acquired pneumonia is a key to its justified treatment. Considering the insufficient data, designing and conducting more comprehensive studies in this regard seems necessary in the region.

Obstructive sleep apnea syndrome (OSAS) is characterized by nocturnal episodes of upper airway obstruction and may be complicated by psychiatric disorder. An 18 year old female was admitted at Ebn-e-Sina psychiatry hospital with depression and suicidal attempts. Because of poor response antidepressants, she underwent electroconvulsive therapy for 3 sessions which was not effective and each session was followed by severe vomiting, vertigo and dyspnea. As the patient was severely obese and had hypertrophied adenoids, she underwent polysomnography study which revealed severe sleep apnea with an apnea-hypopnea index of 58.5. Treatment with continuous positive airway pressure (CPAP) subsided the depressive symptoms. As OSAS patients are not often aware of their nightly apnea, the diagnosis may be delayed.Mood disturbances accompanied by obesity and history of snoring should suspect for having this condition.