مجله پزشکی دانشگاه علوم پزشکی تبریز
سال چهل و سوم شماره 5 (پیاپی 155، آذر و دی 1400)

Parental chromosomal abnormalities as well as changes in genes encoding thrombophilic factors are common causes of recurrent abortions. One of the causes of thrombophilia is Factor II (F2) gene mutation (G20210A) and plasminogen activator inhibitor gene (PAI-1) polymorphism (4G/5G). Therefore, the present study aimed to investigate the frequency of chromosomal abnormalities and the association of thrombophilic gene polymorphisms in patients with abortion in northwestern Iran.

In the present case-control study, cytogenetic analysis of 60 couples with a history of recurrent abortions was performed by the standard 72-hour culture of lymphocytes and G-banding. The polymorphism (5G/4G) of PAI-1 gene and the mutation (G20210A) of F2 genes were evaluated using RFLP-PCR and ARMS-PCR molecular methods, respectively. The obtained data were analyzed using statistical software.

No significant abnormalities affecting abortion were observed in cytogenetic studies; in the molecular study, the frequency of the 4G allele in patients and control groups were 54.2% and 33.3%, respectively; the frequency of 5G allele in the patients and control groups were 45.8% and 66.8%, respectively. The frequency of 5G/5G and 4G/5G genotypes is 25.0% and 41.6% in the patient group, and 55.0% and 23.3% in the control group, respectively. Also, the frequency of 4G/4G genotype in patients and controls were 33.3% and 21.6%, respectively.

The results of this study show that there is a significant relationship between the frequency of the 4G allele of the PAI-1 gene with susceptibility to recurrent abortions in northwestern women, while no was relationship between F2 gene mutation and recurrent abortions was observed.

ERCP is the gold standard procedure for diagnosis and potential treatment of biliary-pancreatic disorders with various distributions in different areas of the world. The study aimed to evaluate the findings, outcome, complications and technical experiences of ERCP, also by considering the correlation of findings with liver function tests (LFT) and imaging.

In this descriptive – cross sectional data-based study for 12 years from 2007, 626 (43.9% male and 56.1%female; mean age 60 Ys) consecutive patients were subjected with therapeutic purpose at two referral hospitals.

Epigastric pain (40%), jaundice (39.4%) and pruritus (38.1%) were the most common indications. CBD was cannulated by optimal wire- guided sphincterotomy in 486(77.6%) patients. Precut was performed in 65(10.6%) with successful cannulation in 61 cases (93.8%) and 7.7% of complications, including perforation. A total success rate of 98% was obtained. The most common diagnoses were CBD stone(s) in 322 (51.4%) and biliary-pancreatic cancers in 114 (18.2%) of cases. No LFT (ALT, ALP and Bilirubin) predicted the diagnoses. The higher concordance rate of imaging studies in comparison with ERCP was 75% for stone(s) and the lower rate of 11.1% for tumors. Metallic stents were used in 15(2.4%) of inoperable malignant cases with life expectancy of more than 6 months. Complications occurred in 29 cases (4.6%) including duodenal perforation (0.8%), pancreatitis (1.6%) and bleeding (1.2%). Mortality rate was 0.4%.

Although no single laboratory or imaging can exactly predict the finding or outcome, but by considering judicious case selection, appropriate use of available tools and standard techniques, the procedure could be safe with a few complications and higher success rates.

One of the most common childhood disorders is attention-deficit/hyperactivity disorder (ADHD). This study aimed to determine the prevalence of ADHD in children aged 6-11 years in Piranshahr city (Iran).

This descriptive-analytical study involved six hundred primary school students (300 girls and 300 boys) in Piranshahr city who were enrolled in the study using stratified random sampling. The frequency of ADHD was assessed using the short form of the Conners Teacher and Parent Rating Scale.

The frequency of inattention and hyperactivity indices in girls were respectively 13% and 15%, per Conners Parents Rating Scale, and 14.6% and 16.6% per Conners Teacher Rating Scale, while the frequency of ADHD index was 6.33% and 8.66%, respectively. The frequency of inattention and hyperactivity indexes in boys were respectively 11% and 17% per Conners Teacher Rating Scale, and 20.6% and 24.6%, respectively, per Conners Parents Rating scale, whereas the frequency of ADHD index was based on parents and teacher was 5.6% and 18.3%, respectively.

This study showed that the prevalence of children prone to ADHD in the Piranshahr region is relatively high in comparison with other regions of the country. Therefore, it is necessary to study this disorder in the identity card of children at the entrance to kindergartens and schools to identify the patients, so through timely and appropriate intervention, its important complications in adolescence and adulthood can be prevented.

Prematurity is one of the major health problems and common causes of neonatal mortality. One of the complications of premature infants is hyponatremia. The effect of hyponatremia on the prognosis of preterm infants has not been well studied. This study aimed to evaluate infants with late hyponatremia, its risk factors, and prognosis.

This descriptive analytical study reviewed preterm infants (<34 weeks) admitted to Al-Zahra or Children’s Hospital in Tabriz for one year (2019). Neonates diagnosed with hyponatremia after the second week were identified and evaluated for risk factors and short-term outcome.

A total of 186 neonates were studied. The mean gestational age of the neonates was 30 weeks (first and third quarters = 29-32 weeks). 101 (54.3%) infants were male. The route of delivery was the cesarean section in 60.7% of cases. Late hyponatremia was present in 50 (26.8 %) infants. Gestational age and birth weight were significantly lower in infants with hyponatremia than in the control group. Multivariate analysis showed that low birth weight, the use of prenatal steroids, and inappropriate weight for gestational age status independently predict the incidence of late hyponatremia. There was a significant relationship between the presence of prolonged late hyponatremia (over 7 days) and bronchopulmonary dysplasia and osteopenia of prematurity. However, no significant association was found between the presence of prolonged late hyponatremia in preterm infants with the length of hospital stay and in-hospital mortality.

Based on the findings of this study, low birth weight, prenatal steroid use, and lack of appropriate weight for gestational age were risk factors for late hyponatremia in preterm infants. Prolonged hyponatremia is associated with bronchopulmonary dysplasia and osteopenia of prematurity

Aerobic training somewhat corrects endothelial dysfunction in patients with coronary artery disease (CAD), but the most effective form of exercise is still unclear; therefore, the purpose of the present study was to investigate the effect of 8 weeks of continuous aerobic exercise on serum vascular endothelial growth factor (VEGF) as an angiogenic factor and endostatin (ES) as an angiostatic factor in male rats with coronary artery disease.

The subjects of the present experimental study were 30 healthy male 2-months old Wistar rats divided into three groups: the experimental group, the control group with coronary artery disease, and the healthy control group. After rupturing 20 of the rats by isoproterenol, 10 rats in the experimental group performed eight weeks of continuous aerobic exercise on a treadmill, with an incremental intensity of 50% in the first session to 78% in the last session, whereas both control groups did not exercise. Seventy-two hours after the final training session, blood samples were taken for serum VEGF and ES indices, and one-way ANOVA with Scheffer posthoc tests was used to compare the mean of variables among the studied groups.

The results showed that discontinuous aerobic exercise could increase the blood VEGF in rats with coronary artery disease (P≤0.01), while there was no difference in the level of endostatin in the experimental group compared with control groups (P>0.05).

It seems that continuous aerobic exercises can be used in the rehabilitation of patients with coronary artery disease and might be effective in the process of angiogenesis.

IGF-1 hormone decreases in patients with type 2 diabetes and NAFLD. The effect of exercise on this hormone requires further researches. The purpose of this study was to compare the effects of the interval, continuous, and combined aerobic exercise on IGF-1 hormone and body composition in type 2 diabetic patients with NAFLD.

In this study, forty female type 2 diabetes patients with NAFLD (mean age 50.6 ± 4.5 years, height 1.58 ± 0.07 m, weight 74.4 ± 9.9 kg) were randomized into four groups. The exercise training groups performed exercises by cycle ergometer three days a week for eight weeks. The groups included: interval aerobic exercise group (75-80% maximum heart rate), continuous aerobic exercise group (60-75% maximum heart rate), combined exercise group (interval and continuous), and control group. Variance analysis was used for analysis and comparison between groups. The t-dependent test was used for intra-group compression (α≤0.05).

Decreased body weight, BMI, waist circumference, waist circumference, waist-to-height ratio, body fat percentage, body fat mass, and increased IGF-1 were significant in all three exercise groups (P≤0.05). In the control group, increased hip circumference and decreased IGF-1 were significant (P≤0.05). Among the three exercise groups, the interval aerobic exercise group had the most effect on improving type 2 diabetic patients with NAFLD. Comparing between the groups, IGF-1, body mass index, waist circumference, hip circumference, and waist-to-height ratio were significant in the interval, continuous, and combined aerobic exercise groups compared to the control group (P≥0.05).

Interval, continuous, and combined aerobic exercise improves body composition and hormone IGF-1, and according to the findings, interval aerobic exercise had the greatest effect on diabetic patients with NAFLD. Therefore, it is recommended that these patients participate in aerobic exercise regularly, especially interval aerobic exercise.

I Restless legs syndrome (RLS), is a neurological disorder in which persons feel uncomfortable, especially at night, in the limbs and needs to move their legs. This condition worsens with rest. The aim of this study was to evaluate the frequency of restless legs syndrome in patients with renal insufficiency. In this case-control study, 180 patients with chronic kidney disease (90 hemodialysis patients and 90 non-dialysis patients) who referred to the nephrology clinic and dialysis ward of Imam Reza Hospital in Tabriz, were investigated. Data collection was done through a questionnaire form which was based on the criteria of the International Association for the Study of Restless Legs Syndrome. Among 180 patients in studied, 92 (51.7%) cases were male and 88 (48.3%) cases were female. The mean age of patients was 60.4 ± 17.2. So, 90 non-dialysis patients and 90 hemodialysis patients were evaluated. Of all the hemodialysis patients studied, 33 (37%) patients had restless legs syndrome, and among the non-dialysis patients, only 16 (18%) patients had restless legs syndrome. The frequency of restless legs syndrome is significantly higher in patients undergoing hemodialysis (P=0.001). There was also a meaningful difference about the frequency of restless legs syndrome among the male (77%) patients than females (23%) (P=0.001). A significant percentage (27%) of patients with renal failure suffer from restless legs syndrome and the hemodialysis patients are more involved in this disease, which needs more importance. Also, based on our findings in this study, men have a high probability of a conflict of restless legs syndrome than women.

Retrocaval ureter is a rare congenital disorder and surgery is necessary when the patient is symptomatic or having significant functional obstructions. The two cases referred to our center with severe hydronephrosis on their right sides. In both cases further evaluation with CT scan showed the diagnosis of retrocaval ureter. The retrocaval segment of the both ureters were isolated and after the excision of the narrow segments, end to end anastomosis have been done with transperitoneal laparoscopic technique. The laparoscopic ureteroureterostomy is a safe, effective and minimally invasive procedure and should be considered as a standard treatment for retrocaval ureter.