مجله پزشکی دانشگاه علوم پزشکی تبریز
سال سی و ششم شماره 5 (پیاپی 113، آذر و دی 1393)

Parkinson’s Disease (PD) is a kind of motion disorders of central nervous system that is caused by degeneration of basal ganglia. Postural instability is one of the important clinical presentations of PD. The aim of present study was to determine the efficacy of balance trainings using balance simulator instrument on postural stability along with medications in this spectrum of patients. In this interventional study, thirty patients with PD and balance disturbances were selected and referred to rehabilitation ward during a 7-month period. Patients underwent 12 sessions of physical therapy programs for 4 weeks. Design of study was an interventional before-after trial. Evaluation was performed using Timed Up and Go (TUG), Berg Balance Scale questionnaire, falling risk and postural instability indices of Biodex instrument and obtained data were analyzed using t-test and wilcoxon statistical tests. The IRCT code for this study is 201212163217 N6. The mean TUG before trainings was 21.8±12.91 seconds and reached to 17.8 ±9.29 (s) afterward (P<0.001). The fall risk and postural instability of 29 patients improved after interventions and deteriorated just in one case. The average of BBS before exercises was 42.6±11.16 and increased to 48.4±7.06 after intervention significantly (P<0.001). Performing balance trainings lead to increase in walking speed, decrease in fall risk and improvement of postural stability and daily functional activities in patients with PD. Further studies for comparing the effectiveness of diverse rehabilitation treatments as well as long term follow up of patients will be necessary.

Daily use and persistence in food consumption, provides grounds for fraudsters to reduce production costs act to various adulterations and thereby threat people's health. This study carried out to survey new distinguish methods in the detection of fraud of produced lemon juice in Iran. Study was conducted with a diagnostic design on 45 samples of lemon juice from 45 factories of producing lemon juice in Iran. The tests of the amount of sodium, potassium, optical rotation, total amino acid and polyphenols were done according to reference books for the detection of fraud in produced lemon juice.Furthermore, the tests of amount of brix, pH, acidity and formalin index were conducted according to national standard of Iran. The condition of produced lemon juice of Iran showed that there was a significant difference between mean sodium of normal versus feigned lemon juice (23.73 vs. 87.33 mg/dL, P<0.0001), potassium (149.07 vs. 63.56 mg/dL, P<0.0001), optical rotation (1.91 vs. 0.72 meq/dL, P<0.0001), total amino acid (247.79 vs. 84.66 mg/dL, P<0.0001) and polyphenols (1.8 vs. 0.81, P<0.0001). Sensitivity of total amino acid, polyphenols, optical rotation, sodium, potassium, brix, acidity, formalin index, matter dry and pH methods compared with protein were 91.3, 100, 100, 100, 100, 66.17, 66.17, 66.17, 66.17 and 68.96, respectively. Values of potassium, optical rotation, total amino acid and polyphenols in feigned samples were low but value of sodium was high.

Wilm’s tumor is the second most prevalent intra-abdominal and fifth malignant in pediatric medicine. This tumor includes at least 6 percent of all cancers in children and 95% of all renal tumors in pediatrics. Regarding to its high prevalence and the importance of determining its outcome and therapeutic process for designing a better road map for these patients and also because of the lack of related studies in our region we decided to do this study in order to evaluate the clinical features and outcome of patients with Wilm’s tumor referring to Tabriz Children hospital from 2003 to 2009. In this descriptive study, All 44 patients younger than 14 years old which have been operated and received chemotherapy from 2003 to 2009 were enrolled in this study. Data such as age, gender, bleeding, weight loss, hemoglobin, platelet, WBC, PT and PTT counts and associated anomalies were gathered from the hospital records. Eight patients (18.2%) had received chemotherapy before the operation in our study. 50% of tumors was located in right side, 45.5% were located in left side and 4.5% were bilateral. Most of the patients (20 patients, 45.5%) were in stage III of the disease. Tumor histopathology was favorable in 36 (81.8%) and unfavorable in 8 (18.2%). Associated anomalies were seen in 3 (6.8%) patients. Most seen sign were mass feeling, weight loss, loss of appetite, malaise and fever in this study. Most complications were seen in liver and lungs. No statistically significant difference was seen between two genders regarding the outcome (p=0.48), complication (p=0.96) and disease stage (p=0.43). The outcome was statistically significant different between two kinds of histopathology (p=0.007). The age average was lower in our study comparing with similar studies. The histopathology of tumor was favorable in most of our patients and the majority was in stage III of the disease. As it was expected there was a significant relation between histopathology and the outcome of the patients.

Renal Failure (RF) is considered as a major cause of morbidity and mortality worldwide. Kidney transplantation remains the most appropriate therapeutic option in these patients. The allograft kidney is required to be washed in order to prevent thrombosis. The collected fluid form renal vein and ureter could be indicative of the kidney condition. The aim of this study was to evaluate the differences between the collected fluid from ureter and renal vein regarding the temperature, PH and specific gravity of the irrigation fluid at two different irrigation volumes of less and more than 500 mL. In a descriptive cross-sectional study, all renal transplantation patients. After the allograft, kidneys being harvested from the donors, they were irrigated via renal artery; collected fluid form renal vein and ureter was evaluated regarding temperature, PH and Specific Gravity SG at two different irrigation volumes of less and more than 500 mL. Twenty one subjects (11males, 10females) with a mean age of 34.23±11.86 years were studied. There were no significant relations between the irrigation fluid volume and temperature and also between irrigation fluid volume and PH of the collected fluid from ureter and renal vein (P=0.57 and P=0.56, respect). The SG of the collected fluid from ureter and renal vein had significant relation with the irrigation fluid volume (P=0.04). There was non-significant relation between the temperature and PH of irrigation fluid and collected fluid.

Exercise whole-body vibration by affecting the muscular system, increases the strength of the muscular system. This study was designed to investigate the effects of vibration on muscle performance in healthy, untrained, oldery men. in this randomized controlled trial semi experimental study seventy-two retired elderly men with a mean age of 67/2 ± 73 years were participated. The subjects were divided into three groups based on BOSCOO training plan and training was 6 weeks. Muscular function after training protocol with the test standard sit-to-stand and 5m fast walk was evaluated. Test sts after three sessions a week whole body vibration exercise as a significantly muscle was better than the other groups (p <0.05). The whole body vibration training three sessions a 5m fast walking performance significantly was better (p <0.05). The whole body vibration training can affect the nerve – muscle system especially in elderly population and have Reduce the possibility of falling.

Fumaria parviflora is a species of flowering plant native to Europe, Asia, and Africa, but it is common and widely distributed in many other parts of the world. F.parviflora is a weak tonic, slightly diaphoretic, diuretic, aperients and valuable in all visceral obstructions, particularly those of the liver, Liquorice is the root of Glycyrrhiza glabra from which a sweet flavor can be extracted. The liquorice plant is native to southern Europe and parts of Asia. Modern research has shown it to have effects uponliver, the endocrine system and other organs. It is tonic, diuretic, demulcent, expectorant, emenagogueand Laxative. The plants were extracted using maceration method. The extract were incorporated in absorption base and in the best formulation physicochemical tests such as content uniformity, creaming and coalescence, pH changing and microbial Challenge test were determined. After concentration of extract and freeze-dried them, weight from every 100gram extract of Glycyrrhiza were 16.6g and for Fumaria were 13.8gr. The pH of formulation after 3 month was in the range of 5.7-6.7. The prepared formulation appropriate physicochemical characteristics with respect to appearance, consistency, viscosity, content uniformity and stability parameters. The prepared formulation was stable in the experimental condition and this formulation can be selected for the clinical trial on skin disorders.

Toxoplasmosis is one of the main dangerous infective diseases and its diagnosis especially in the acute phase is very important. At this phase, the serum levels of the acute phase proteins such as CRP and HS-CRP increase and evaluating these proteins is one of the main indexes for diagnosis of the acute phase of infectious disease. The aim of this study was to investigate the serum level of HS-CRP in patients with acute myocardial toxoplasmosis. This survey was based on comparative study. After detecting acuteness of this disease using ELISA method, 48 serum samples of non-infected people and 48 serum samples of patients with acute myocardial toxoplasmosis was the first step of this survey. Then the measurement of HS-CRP serum level has been done with auto analyzer instrument and charts have been delineated by excel 2010 and SPSS 19 software. The HS-CRP serum level in patients with acute myocardial toxoplasmosis was 1388 mg/dl and the HS-CRP serum level in non-infected people was 5.3 mg/dl. Current results showed increase in level of HS-CRP in serum samples in acute phase of toxoplasmosis. Acute phase of many infection diseases such as myocardial toxoplasmosis increases some Factors, Such As HS-CRP; which in this regard HS-CRP is an important factors which can be considered as an important factor for diagnosis of this type of disease.

Caffeine is a well know substance with widely usage worldwide. Today some researches confirmed the conflicting effects of caffeine compound on cellular damage markers. The aim of this study was to determine the effect of different dosage of caffeine intake on some cellular damage markers in serum of male volleyball players after the one-single exhaustive resistance exercise. In a randomized double-blind design study, thirty elite male volleyball players (mean aged 21. 47±1. 45 years, fat percentage 10. 47±3. 11 % and BMI 23. 15±1. 26 kg. m2) were categorized to three equal groups: supplement groups (with 6 and 9 mg. kg-1 caffeine) and placebo group (6 mg. kg-1 dextrose). After the supplementation, all subjects were participated in one-single-session of resistance weight-training (with 80% of one repetition maximum until exhaustive). Changes in cellular damage indices (total serum CK, LDH and AST) were determined in three phases (Baseline, immediately and 24 hours after the training protocol). The normal data were analyzed by repeated measure ANOVA and Bonferroni at α≤0. 05. Different doses of caffeine intake had no significant effect on increased level of cellular damage serum enzymes immediately after exercise compared with the placebo group (P≥0. 05). Also, exhaustive resistance exercise significantly increased levels of 24-hour CK, LDH and AST in all groups (P≤0. 05). However, different doses of caffeine intake had not effect on increased levels of cell damage markers after 24 hours of exercise (P≥0. 05). Based on the present findings, it could be concluded that acute intake of different doses of caffeine did not significantly prevent further damage؛ however it was not made the deterioration of the indirect indices of cell damage in compared with the placebo group.

Bilateral cleft lip may induce several anomalies in face, nose and lip that may result cosmetic and functional problems apart from initial good surgery. The purpose of this retrospective study is to better reconstruction of lip anomalies in cleft lip with Abbe flap such as tight upper lip, short prolabium, tight gingivolabial sulcus, irregular lip scars and associated nasal deformities. In this retrospective study a total 20 patients (6-34 years old) with bilateral cleft lip received Abbe flap simultaneous rhinoplasty. The age ranged from 6 to 34 years. The average follow up period was 12 months. Flap was designed approximately 14 mm in length and up to 9 mm in width. After excised the scars from prolabium, flap inserted and lengthening was performed. Except 2 patients, rhinoplasty was carried out with or without cartilage graft for columella, alae and nasal tip. The average follow up period was 12 months. There was no complication in this study such as flap ischemia neerosis and lower lip deformity. Patients were satisfied from facial scar results. Upper lip vermilion bulk and symmetry were corrected and the length of the columella was desirable. Abbe flap was an effective reconstructive method for individuals with bilateral cleft lip.

Anxiety is as a common disorder can be treated with botanical medicines. Herbal medicine and complementary and alternative medicine have widespread usage among individuals with mood and anxiety disorders. The benefit effect of Lippia citriodora is proposed for treatment of various neurological diseases. In the present study the effect of Lippia citriodora extract on anxiety behavior was evaluated in adult male rats by elevated plus maze. In experimental study, Lippia citriodora extract at doses 50, 100, 200 and 300 mg/kg was administrated in adult male rats, interperitoneally. The control group was treated saline as vehicle. 30 minutes after treatment, anxiolytic effect of plant was evaluated by elevated plus maze during 300 s. Treatment of Lippia citriodora hydro-ethanolic extract at dose 200 mg/kg increased staying in open arm and ratio of open arm entries to whole arms entries (%OAE) and at doses 50, 100 and 200 mg/kg reduced ratio of time of first entry to open arm to time of first entry to whole arms (%OAT). Extract of Lippia citriodora leaves has anxiolytic effect in rats and the effect may be related to flavonoids and interaction with GABAergic system.

Approximately 20-50% of childhood cancer survivors will develop at least one endocrine disorder in their life time. The purpose of this study was to evaluate endocrine disorders caused by the disease or complications of treatment among cancer survivors. This cross sectional study was conducted on 72 survivors of childhood cancer patients with the age of 2-18 years, who were followed up in Pediatric Oncology Clinic of Tabriz children's hospital from September 2001 to March 2012. Age, gender, type and site of malignancy and prescribed medications were recorded. After clinical examination, Blood samples were taken and sent to the reference laboratory to measure serum levels of fasting blood sugar, calcium, phosphorus, thyroid and gonadal function tests. The mean age of patients at their diagnosis time and after treatment were 11.43±3.39 and 3.2 ± 1.34 years, respectively. 77.8% were male and 22.2% female. Acute lymphoblastic leukemia was the most common malignancy (55.5%). 88.9% of patients had received vincristine. 27.7% of survivors had at least one endocrine complication. Impaired fasting glucose, hypothyroidism, hypogonadism were 16.7%, 8.3% and 2.7%, respectively. Survivors of childhood malignancy are at risk of endocrine complications, especially impaired glucose metabolism, thyroid and gonadal dysfunction. The diagnosis and treatment of these disorders in vulnerable individuals can reduce mortality and improve their quality of life.

Silybum marianum and Kombucha tea contain thousands of antioxidant compounds, which known as a drug, used for hepatoprotective agent. Liver exposes to many of oxidant and carcinogen agents; therefore; the antioxidant compounds are beneficial for its natural health. In this study the hepatoprotective effects of silymarin and Kombucha tea against Thioacetamide (TAA) induced liver toxicity in wistar rats were investigated and compared. In this experimental study we used 35 male white wistar rats and they were categorized into seven groups: (I), treated with thioacetamide (TAA) for 3 weeks (II), treated with TAA and silymarin (400mg/kg) (for 3 weeks)(III), treated with silymarin (400mg/kg) then were treatment TAA (for 3 weeks)(IV), treated with TAA and silymarin (200mg/kg) (for 3 weeks)(V), treated with TAA and Kombucha tea (50mg/kg) (for 3 weeks), treated with TAA, silymarin and Kombucha tea (for 3 weeks). TAA significantly has increase Aspartate aminotransferase (AST), Alanine Transaminase (ALT), Alkaline Phosphatase (ALP), Lactate Dehydrogenase (LDH) but not the same for bilirubin. The treatment by silymarin and Kombucha tea produced a significant reduction in serum enzyme levels (AST, ALT, ALP, LDH) and reduction in bilirubin content. The results show that the protective effects of silymarin and Kombucha tea against the thioacetamide induced hepatotoxicity that may be due to the existence of polyphenol substances in the plants, these substances have an antioxidant function.

Multiple Sclerosis (MS) is an autoimmune disorder in central nervous system characterized by neuroinflammation. In this study, the effect of Epigallocatechin-3-Gallate (EGCG) on learning and spatial memory was investigated following a demyelination induction using lysolecithin injection into the rat hippocampus. In this experimental study, for the demyelination induction, 2µl lysolecithin (LPC) was injected streotaxically into the dentate gyros. Then, animals received 30mg/kg catechin for 7, 14, and 28 days after demyelination induced by lysolecithin. Subsequently, the spatial memory was investigated by a radial maze. Repeated measurement used for statistical evaluation. The impairment of the spatial memory was more significant 7 and 14 days after the LPC injection. Hence, food finding time has increased significantly compared to the control group (P<0/001). Moreover, the administration of EGCG has improved the spatial memory so that receiving EGCG for a longer time e.g. 28 days after demyelination induction can significantly recover the learning and spatial memory compared to the LPC-receiving group (P<.001). The long-term administration of EGCG can improve the spatial memory and learning of rats. Hence, it can be suggested as a treatment for demyelinated disease such as MS.

Complications of orbital floor reconstruction is a big challenge for patients and specialists. The purpose of this study was to investigate the results and complications of the orbital floor reconstruction using different materials and to compare them. In This Retrospective study consisted of 12 cases with orbital floor fractures treated at Imam Reza Hospital of Tabriz Medical University, Iran, between June 2012 and May 2013. Patients’ clinical data were retrospectively analyzed for gender, age, reconstruction material, and complications. Autogenous bone, Nasal septum, titanium mesh, and Medpor were implanted under the periosteum of the orbital floor in 3, 2, 4 and 3 cases respectively. All of the patients except 3 cases, showed satisfactory appearance. Diplopia and limitation of globe movement were resolved in 50% of the cases. Complete infraorbital nerve recovery were observed in 2 cases after 8 weeks. Subciliary incision was adopted in our surgery. There was no statistically significant difference among groups of patients in regard to the effectiveness of treatment using different materials. Appropriate diagnosis, early intervention, proper material selection and accurate orbital floor reconstruction were the key factors for successful treatment.

Anterior Cruciate Ligament (ACL) tear is one of the most common sport injuries of the knee and arthroscopic reconstruction by bone drilling and graft placement is the accepted treatment. The aim of this study was to compare the results of two different techniques of ACL reconstruction namely transportal (anatomic) and transtibial (non-anatomic) femoral tunnel drilling. In a comparative clinical study, 60 ACL-deficient patients were operated using transportal ACL reconstruction and compared with another 60 patients treated with transtibial technique. They were compared in terms of performance and ligament stability. Our results showed that comparing the two groups, there were no differences in terms of Lysholm score (transtibial: 96.2 versus transportal: 97.2), post-operative Tegner score (transtibial: 6.3 versus transportal: 6.6) and knee range of motion but IKDC score was significantly better in the transportal group (p<0.001). Anatomic transportal ACL reconstruction technique yields superior results in terms of knee ligament stability comparing to non-anatomic transtibial femoral tunnel drilling.

Leeches are a group of round worm that belonged in Hirudina order. They live in freshwater, soil and wetlands. Some leeches are predators and feeding of worms, insect’s larvae and snails, whereas some of the other is bloodthirsty and feeding invertebrates and vertebrates. Although leeches can have important therapeutic but sometimes cause serious problems in humans and animals. In the present report, a 22 year old woman living in Tabriz admitted to infectious diseases ward of Sina hospital, with diarrhea, nausea and gastroenteritis symptoms. After clinical and parasitological experiments, leeches were confirmed in the patient's gastrointestinal secretions.