37 2717-008X Urmia University of Medical Sciences 1804 آناتومی THE PREDICTING QUALITY OF LIFE BASED ON ILLNESS PERCEPTION IN MULTIPLE SCLEROSIS PATIENTS Shamili Farnaz b Zare Hossein c Oraki Mohammad d b Payam Moor University, Tehran c Payam Moor University, Tehran d Payam Moor University, Tehran 1 9 2013 24 6 379 392 03 09 2013 08 09 2013     Background & Aims : The aim of present research was to study the prediction of physical and mental aspects of quality of life in multiple sclerosis patients. The current study was important to pave the way for further investigation aimed for managing believes and perception in order to increase the quality of life in MS patients.   Materials & Methods : This non-experimental research was descriptive and correlative and was conducted on 100 members of MS patients that were selected by accessible sampling in Tehran MS Association. Clinical and demographic information were collected and the participants completed a range of questionnaire s. The data were analyzed by Pearson correlation and multivariate regression metod.   Results : According to the results illness perception can predict the physical and mental aspects of quality of life in multiple sclerosis patients.   Conclusion: Illness perception is effective on quality of life in multiple sclerosis patients. Further interventional study are necessary to improve the quality of life in MS patients.   SOURCE: URMIA MED J 2013: 24(6): 392 ISSN: 1027-3727
1805 آناتومی THE RESPONSE OF SERUM CORTISOL AND LIPID PROFILE TO A MODERATELY INTENSIVE AEROBIC EXERCISE IN NON-ACTIVE MIDDLE-AGED MEN Tartibian Bakhtyar e Yaghoobnezhad Fakhredin f Saboory Ehsan g kheradmand Fateme h e , Faculty of Physical Education, Urmia University f , Faculty of Physical Education, Urmia University g Neurophysiology Research Center, Urmia University of Medical Sciences h Cellular and Mulcular Research Center, Urmia University of Medical Sciences 1 9 2013 24 6 393 404 03 09 2013     Background & Aims : Incidence of cardiovascular disease and stroke can be due to decreased mobility or non-suitable life style. Exercise induces changes in blood lipids, cortisol . The aim of this study was to evaluate response of serum cortisol and lipid profile to a moderately intensive aerobic exercise in non-active middle-aged men .   Materials & Methods: Thirty middle-aged men with an age range of 40-50 years were volunteered in this study. The exercise group performed an aerobic exercise training on the treadmill up to 65% of maximum heart rate (HRmax) for 30 minutes. Blood samples were obtained from the two groups before, immediately after, and 12 hours after the exercise.   Results: Cortisol, triglyceride, cholesterol, and VLDL levels immediately after exercise in the exercise group showed a significant increase comparing to control subjects (p0.05). The difference between the immediately after exercise values with that of the base values of cortisol and lipids concentrations was significant, and it increased in the exercise group comparing with the control group (p<0.05). There were significant increase in cortisol, cholesterol, VLDL and LDL levels in the exercise group immediately after exercise comparing with the recovery condition (p<0.05).   Conclusion: Moderately-intensive aerobic exercise, with stimulation of cortisol, increases the blood lipid concentrations in order to increase their metabolism, and it provides a desirable condition to reduce the cardiovascular risk factors.   SOURCE: URMIA MED J 2013: 24(6): 404 ISSN: 1027-3727 1806 آناتومی DETERMINATION OF DEXTROMETHORPHAN IN PHARMACEUTICAL FORMULATIONS AVAILABLE IN DRUG MARKET OF IRAN USING HPLC METHOD Heidari Amir i Akbari Azam j Peirouvi Tahmineh k i Cellular and Molecular Research Center, Urmia University of Medical Sciences j Faculty of Pharmacy, Urmia University of Medical Sciences k Maternal & Child Obesity Research Center, Urmia University of Medical Sciences 1 9 2013 24 6 405 413 03 09 2013     Background & Aims : Quality control is the most common function to test and measure material and product. Quality control of active ingredients in drug formulation is to control the quality of the products of a company and evaluate their stability. The purpose of this study was to determine the amount of dextromethorphan available in drug market of Iran.   Materials & Methods : For this purpose different pharmaceutical formulations of dextromethorphan with different serial number preparations were purchased from the market. Based on their standard methods of extraction (USP Pharmacopeia) the active ingredient dextromethorphan was extracted and determined by using HPLC Colum. The method utilize fluorescence detector.   Results : The results of this project on 40 commercial products were as follow: The respective forms of pharmaceutical tablets were 104-124% drops 87-92% simple syrup 91-119% and syrup mixture 109-120% of labeled.   Conclusion : The assay results obtained from forty commercially available formulations of tablet and syrup were more than the amounts declared which agree with the tolerances indicated by the USP pharmacopeia while the assay results for drops were less than the declared values.    SOURCE: URMIA MED J 2013: 24(6): 413 ISSN: 1027-3727 1807 آناتومی EVALUATION OF FREQUENCY OF GIARDIA LAMBLIA SUB SPECIES BY PCR-RFLP IN HOSPITALIZED CHILDREN,S STOOL SPECIMENS IN URMIA MUTAHHARI HOSPITAL Manafi Gholamreza l Hazrati tappeh Khosro m Diba Kambiz n Mohammadzadeh Habib o Asgharzadeh Mohammad p Gheibi Shahsanam l Urmia University of Medical Sciences m Cellular and Molecular Research center, Urmia, University of Medical Sciences n , Urmia ,University of Medical Sciences o University of Medical Sciences p Tabriz ,University of Medical Sciences Head of Maternal and Child Obesity Research Center, Urmia University of Medical Sciences, 1 9 2013 24 6 414 422 03 09 2013 09 11 2013     Background & Aims : Giardia lamblia is one of the most prevalent intestinal flagellate protozoan that infects a wide range of vertebrate hosts . Giardia is one of the most common intestinal pathogens in children causing sever intestinal disorder and growth retardation. This study was performed to determine subspecies of Giardia lamblia by the PCR-RFLP method, targeting the glutamate dehydrogenase(gdh) locus, in hospitalized children at the Urmia Mutahhari hospital, West Azarbaijan Province, Iran   Methods : In this study, thirty four stool specimen were collected from the hospitalized children in Urmia Motahhari hospital and dgiardia cysts were detected using microscopy. Cysts were partially purified by the sucrose density gradient method and then washed with sterile distilled water to effectively remove the PCR inhibitors. Genomic DNA of G.lamblia isolates was extracted by freeze-thaw cycles followed by phenol/ chloroform/isoamyl alcohol method. A single step PCR-RFLP assay was used to differentiate the assemblages A and B which been found in humans. In this method, 432 bp expected size were amplified and then for detection sub species were used of specific restriction RsaI and BspLI enzymes.   Findings : From 720 examined samples, totally 34 samples were positive in term of giardia cyst so the parasite spread rate was reported 4.72%. Analysis of PCR-RFLP on these samples revealed that 28 samples (93.3%) had the genotype BIII and two samples (6.7%) belonged to the subgroup BIV.   Conclusions : PCR-RFLP is a rapid and reliable method that enables us to effective genotype discrimination within Giardia assemblages using glutamate dehydrogenase gene, and makes it possible to identify the presence of mixed genotypes. In the base results, an animal source of infection is suggested.     SOURCE: URMIA MED J 2013: 24(6): 422 ISSN: 1027-3727 1808 آناتومی COMPARING THE EFFECTS OF CONTINUOUS AND INTERMITTENT PHOTOTHERAPY IN REDUCING BILIRUBIN LEVELS OF INFANTS Goodarzi Rakhshane Khamesan Behnaz Hamedi Yaghoob Yousefi Fateme Houshmandi Mohammad Mehdi Hormozgan University of Medical Sciences Hormozgan University of Medical Sciences Hormozgan University of Medical Sciences Hormozgan University of Medical Sciences Hormozgan University of Medical Sciences 1 9 2013 24 6 423 429 03 09 2013 03 09 2013     Background & Aims : About 60% of term infants and 80% of preterm infants are affected by jaundice in the neonatal period which 5-10 % of them require phototherapy. Phototherapy causes the separation of mother and infant, interfering with breastfeeding and there are also some concerns regarding to destruction of the genetic materials. Methods which might reduce the rate of photo would be useful. In this study, we compare the results of continuous and intermittent phototherapy methods on bilirubin levels of infants with hyperbilirubinemia.   Materials & Methods : This study was a randomized clinical trial study which has been undertaken on 100 newborn infants, those who hospitalized in Bandar-Abbas hospital. Using simple Randomization technique, infants were divided into two groups. First groups were 39 newborn infants who were undertaken in intermittent phototherapy (phototherapy was one hour on and one hour off) and the rest (45 infants) were in continuous phototheraphy (phototherapy was on for two hours and 45 minutes, and off for 15 minutes). After starting phototherapy, the total billirubin was measured every 12 hours. Demographic data, feeding method, and incidence of complications were gathered.   Results : Mean of age, weight, feeding type and gender distribution did not have any significant difference between two groups. The levels of bilirubin reduced significantly for both groups (p<0.001). The reduction rate of bilirubin were higher in continuous than intermittent group (p<0.01). There were not any significant differences in duration of phototherapy and incidence of side effects in two groups who were under phototherapy.   Conclusion : The level of bilirubin reduction was higher in the continuous phototherapy group than intermittent phototherapy and duration of phototherapy for reducing hyperbilirubinemia was similar in two groups of full-term infants.   SOURCE: URMIA MED J 2013: 24(6): 429 ISSN: 1027-3727 1809 آناتومی EFFECT OF INTERVAL ENDURANCE TRAINING PROGRAM ON PLASMA EOTAXIN,ADIPONECTIN LEVELS , INSULIN RESISTANCE, SERUM LIPID PROFILE AND BODY COMPOSITION IN OVERWEIGHT AND OBESE ADOLESCENTS Ghasemnian Aghaali Ghaeini Abasali Kordi Mohamadreza Hedayati Mehdi Rami Mehran Ghorbanian Bouhlil , Tehran University Faculty of Sports Sciences, Tehran University Faculty of Sports Sciences, Tehran University Biochemistry Head of Cellular& Molecular Research center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences urmia university of medical sciences tabriz university of shahid madani 1 9 2013 24 6 430 440 03 09 2013 17 09 2013     Background & Aims : Eotaxin is an important chemokine in asthma prevalence and adiponectin, with anti-inflammatory properties, acts as an agent that can decrease the risk of diabetes and cardiovascular diseases. The purpose of this study was to examine the effect of eight weeks of interval endurance training on plasma eotaxin, adiponectin levels , insulin resistance, serum lipid profile, and body composition in overweight and obese adolescents   Materials & Methods : In this semi-experimental study, 36 healthy overweight and obese male adolescents were randomly assigned to training (N=18) and control group (N=18). The training group underwent eight weeks of interval endurance training program (40 min/d, 4 d/wk). Adiposity, insulin resistance, lipid profile, eotaxin, and adiponectin were measured before and after the completion of exercise training. To evaluate the results, Paired T-test, Pearson correlation coefficient, and Stepwise multiple regression analysis were used.   Results : The results showed that eight weeks of interval endurance training decreased the body weight, body fat percent, BMI, Insulin resistance , waist circumference , and triglycerides levels in training group (p0.05).also there was a significant and positive relationship between eotaxine with cholesterol and LDL levels following training (p<0.05). Moreover, stepwise multiple regression analysis show that there was a significant relationship between eotaxin and insulin resistance (p<0.05).   Conclusions : After eight weeks of interval endurance training, without changes in eotaxine and adiponectin levels decreased triglyceride, insulin resistance and central obesity in overweight and obese adolescents   SOURCE: URMIA MED J 2013: 24(6): 440 ISSN: 1027-3727 1811 آناتومی CORRELATION BETWEEN CERVICAL LENGTH BY TRANSVAGINAL SONOGRAPHY AT16-24WKS OF PREGNANCY AND PRETERM LABOR Mohamadjafari Razeyeh Najafian Mahhin Vahaby Elham Gharibzadeh safoora , Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences , Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences Tehran University of Medical Sciences, School of Public Health, Tehran University of Medical Sciences 1 9 2013 24 6 441 448 03 09 2013 04 09 2013     Background & Aims : At least two third of neonatal morbidity and mortality are due to preterm labor. Transvaginalultrasonography has an important role in diagnosis of cervical incompetency and prediction of preterm labor. T he aim of this study was to determine the value of ultrasonographically measured cervical length between 16-24 weeks gestation in the prediction of spontaneous preterm delivery.   Materials & Methods : A prospective cohort study examined cervical length by transvaginal ultrasonography between 16-24 weeks gestation. A total of 75 women who referred to prenatal clinic of imam Khomeini and Razi educational hospitals in Ahvaz and met inclusion criteria after measuring cervical length (c l) by transvaginal ultrasonography (TVS). They included two groups (36 cases with c l =26-30 m and 40 cases with cl=30-35mm. Then they followed until delivery.   Results : The incidence of preterm labor in c l=26-30 mm was 38% and in group with c l=30-35 mm was 50%. Respectively, in the multivariate analysis, age, parity, job, education, and cl. There was a statistically sign ificant relation between cl and preterm birth. (p<0.01)   Conclusion : Mechanical and chemical factors can effect on the cl and cause preterm labor. A short cervix seen on 16-24 weeks gestation was a strong predictor of preterm birth.   SOURCE: URMIA MED J 2013: 24(6): 448 ISSN: 1027-3727 1812 آناتومی CRITERIA FOR ASSESSMENT OF SUPERIOR MESENTERIC ARTERY SYNDROME Davarnia Ghazaleh Rad Saeed Tarzamani Mohammad Kazem Tabriz University of Medical sciences Radiology Department, Tabriz University of Medical sciences Radiology Department, Tabriz University of Medical sciences 1 9 2013 24 6 449 454 03 09 2013 03 09 2013     Background & Aims: Superior Mesenteric Artery Syndrome (SMAS) is a rare cause of upper intestinal obstruction manifested by retching or vomiting. Thanks to the difficulties arising in its diagnosis, it is usually done by elimination of other causes. We tried to report on the radiological manifestation of this rare syndrome aiming to find reliable predictable signs in imaging.   Materials & Methods : The findings obtained from abdominal MDCT and barium meal of 50 adult patients with clinical symptoms suspected for SMAS.   Result : Our study showed two radiographic signs for diagnosis of SMAS: which are dilatation of descending duodenum because of D3 compression and decreased aorto-mesenteric angle. Multi-Detector-Computerized-Tomography (MDCT) was preferable to obtain the exact angle range between SMA and aorta. There was a significant correlation between D3 diameter and aorto-mesenteric angle (p<0.01). 3 cases were diagnosed as SMAS, among 50 cases enrolled in this study. The mean angle was 17±1 degree and the mean D3 diameter was 0.46±0.024 cm.   Conclusion: MDCT is preferable imaging modality compared to barium study where we can exclude other simulating causes with different symptoms. It can provide the exact angle between SMA and aorta which is a essential imaging sign for diagnosis.   SOURCE: URMIA MED J 2013: 24(6): 454 ISSN: 1027-3727 1813 آناتومی SURVEYING THE PATH OF INFORMATION AND THE ERRORS WITHIN THE I HOSPITALS INFORMATION SYSTEM (HIS) IN IMAM KHOMEINI MEDICAL EDUCATION CENTER Nazari Hassn Rashidi Ali Molavi Mehran Islamic Azad University, Mahabad Branch Urmia University of Medical Sciences Mahabad Branch, Islamic Azad University 1 9 2013 24 6 455 462 03 09 2013 03 09 2013     Background & Aims : Errors in the Health and Medical Systems has multi-dimensional parameters . Human parameters, system, equipment are the error making factors and by managing these parameters such errors can be reduced. The aim of this study was to survey the path of information and errors within the HIS system.   Materials & Methods : T his study was based on analytic al method in which the hospital information system of Urmia Imam Khomeini Medical Education center were analyzed in doing so the technical errors also the human errors in the path of information from deferens parts of the hospital in the HIS system were found using a prepared che c klist. Finely t he algorithm of errors or in other words the path in which there was a high technical and human error were reported.   Results: According to t he finding s there wa s a great gap between the human errors and the education level of operators ( p =0/000). In contrast there was a signatures difference between the human errors and different working times ( p >0/05). Also there was no significant difference between the human errors and various parts of the hospital working with HIS (P<0/05). By analyzing the path of information in the system of HIS , it was seen that maximum error occurs in the time shifts of nights and holidays and the clinical wards up to 40% and 33.33%, Respectively.   Conclusion: By paying attention to the changes in the needs of the h ealth area as time goes on, the information system should adapt itself to the changes these changes should be in parallel with the changes in the structure and the missions so that it would fulfill the needs of operators and prevent errors.    SOURCE: URMIA MED J 2013: 24(6): 462 ISSN: 1027-3727 1814 آناتومی AMYOTROPHIC LATERAL SCLEROSIS OR KENNEDY'S DISEASE: A CASE REPORT OF A PATIENT WITH THREE YEARS OF MISDIAGNOSIS Taheraghdam Aliakbar Pashapour Ali Mostafaei Somaiyeh Sadeghi Hokmabadi Elyar Tabriz University of Medical Sciences Tabriz University of Medical Sciences Neuroscience Research Center (NSRC), Tabriz University of Medical Sciences, Neuroscience Research Center (NSRC), Tabriz University of Medical Sciences, 1 9 2013 24 6 463 466 03 09 2013     Kennedy's Disease (KD) Bulbar and spinal muscular atrophy (BSMA) is an adult onset, X-linked, recessive disorder caused by expansion of a polymorphic CAG tandem repeat. Because Kennedy’s clinical symptoms overlap with some other neuromuscular disorders such as amyotrophic lateral sclerosis (ALS) or spinal muscular atrophies, KD sometimes is misdiagnosed or left unnoticed. Here we describe a case of Kennedy’s disease confirmed by genetic testing who had been diagnosed and treated with ALS for three years. We describe a 56-year-old man presented with progressive onset of lower limbs muscular atrophy, weakness, and fasciculations since five years ago. He also complained of instability and fatigue when walking. Since three years ago, he had difficulty in swallowing and talking. He denied any sensory symptoms and sphincter disturbances. On examination at disease beginning he had normal mental status, bilateral facial palsy, tongue atrophy and fasciculation. The patient had lower limb muscle atrophy with mild weakness. The deep tendon reflexes all were depressed and the plantar responses were abolished. There were no sensory and cerebellar signs. Neuroimaging didn't show any significant pathology. Electrodiagnostic examination (EDX) revealed neurogenic pattern with low compound muscle action potentials (CMAP) and acute and chronic denervation pattern in tested muscles, so the patient diagnosed with ALS and treatment started with Riluzole, six months ago we visited him again with new onset sensory symptoms of face and limb parenthesis. Sensory examination revealed mild impairment of pinprick and thermal senses at limbs although senses of vibration and joint position were normal. He had also perioral and facial fasciculations. Since patient's signs and symptoms progression was gradual with developing of sensory findings we questioned the initial diagnosis and reevaluate it later on, EDX study showed decreased lower extremities CMAP with absent F-wave and H-reflects. All sensory parameters were near absent. Genetic studies revealed an increased CAG repeat number (50 normal up to 34), confirming the diagnosis of Kennedy disease. KD is the most common disease which is confused with ALS and recognition of KD is important because its prognosis, natural history, family testing, and management is different from ALS so it is necessary to rule out KD in suspected male cases of ALS.  SOURCE: URMIA MED J 2013: 24(6): 466 ISSN: 1027-3727 1815 آناتومی RARE VARIATIONS IN BRANCHES OF AXILLARY ARTERY CASE REPORT Ghasem Saeedi Borujeni Mohammad Javad Khordad , Elnaz Department of Anatomical Science and Cell Biology, Mashhad University of Medical Sciences Mashhad University of Medical Sciences Mashhad University of Medical Sciences 1 9 2013 24 6 467 471 03 09 2013     Axillary artery originate from subclavian artery and feed axilla walls and after inferior border of teres major, this artery continues its route as brachial artery and several branches originate from it. So far some various variation of axillary artery and its branches are reported. Since axillary artery feeds the upper limb, it seems essential to be aware of its branches and variations. In this case we observed variation in axillary artery and its branches: thoracodorsal artery which is resumption of subscapular artery in normal situation , originates from lateral thorasic. subscapular artery which derived from the third part of the axillary artery is sandwiched between two roots of median nerve at its origin and anterior and posterior circumflex humeral arteries originated from subscapular. profunda brachii (a branch of brachial artery in normal situation) was resumption of subscapular artery. noticing the possibility of existence of these variations in the upper limb can be valuable and help surgeons to reduce the potential of mistakes and side effects in surgery   SOURCE: URMIA MED J 2013: 24(6): 471 ISSN: 1027-3727