Journal of Arak University of Medical Sciences

A Case Report of Wolfram Syndrome

Mohammad Ahmadzadeh

Background: Wolfram syndrome is a rare neurodegenerative autosomal recessive disorder. That occurs in association with diabetes mellitus, diabetes insipidus, and optic nerve atrophy, hearing loss, urinary tract infection and nervous complication.

Case: The present report belong to a 24 years old girl who was effected by diabetes mellitus in 10 years old & has been effected by Diabetes insipidus, recurrent UTI, hearing loss and other type of disorders in 20 years old.

Conclusion: Strict control of blood glucose and regular fundoscopy, for early detection of optic atrophy are important. Step in management of this syndrome and quality of life is improved with hearing and vision aid tools.

The Roll of TNF-α and IL-17A in Post-Menopausal Osteoporosis

Ahmad Reza Behruzi

Background: Osteoporosis is characterized by low bone density and loss of structural integrity which can increase the risk of bone fracture and its side effects. In the recent studies, new evidences of the relationship between immune system such as TNF-&alpha and IL-17A and bone destruction have been accumulated. The aim of present study was to investigate serum level of TNF-&alpha and IL-17A in women with post-menopausal osteoporosis.

Materials and Methods: In this analytical study 40 women with post-menopausal osteoporosis and 10 healthy women were enrolled to the study based on inclusion and exclusion criteria. The serum level of TNF-&alpha and IL-17A were calculated by using ELISA method and compared between groups.

Results: The mean level of TNF-&alpha in case and control group was 957.7±479.01 and 418.09±176.7 respectively which in case group was significantly more than control group (p=0.001). The mean level of IL-17A in case and control group was 95.23±36.7 and 125.7±30.6 respectively which in case group was significantly less than control group (p=0.019).

Conclusion: The level of TNF-&alpha in women with post-menopausal osteoporosis was more than healthy women which can mention the roll of TNF-&alpha in pathogenesis of osteoporosis and potential therapeutic roll of anti TNF-&alpha agents but because of unclear roll of IL-17A in pathogenesis of osteoporosis we could not explain its mechanism in pathogenesis of osteoporosis. It seems more studies with regard to IL-17A roll in bone metabolism is required.

The Study of Prevalence Rate of Nasal Carriage of Staphylococcus in Patients who Reffered to Hemodialysis Wards and Control Group

Afsaneh Karami

Background: The Infections that are related to vascular access, are regarded as Important factor in mortality and morbidity in the patients with immune deficiency including hemodialysis patients. Staphylococcus aureus is the most common and most Important organism involved in this regard and it cause bacteremia and its complications in the patients is important. This organism can cause carriage states and its most frequent carriage source is in the nose. The aim of this study is determination of staphylococcal carriage states in the Zanjan hemodialysis patients and control group.

Materials and Methods: This cross sectional study is designed in the patients with chronic renal disease who were referred to the hemodialysis wards. Nasal samples were collected with sterile swabs. Then they were inoculated in the blood agar culture media and incubated at (35-37) degree for (24-48) hours. This method was taken for control group too. The collected data were analyzed with SPSS and Chi-Square statistically methods.

Results: Based on this study, 7.4 percent of patients and 11.1 percent of the control group were nasal carriers of staphylococcus aureus. The results did not show any meaningful statistically difference between the cases and control groups. But a meaningful statistically difference was observed in the Staphylococcus hemolyticus carriages and the nasal carriage of this organism was more common in the women of case group.

Conclusion: Based on our study, we don't find high prevalence rate of nasal staphylococcus aureus carriage among our case group, and It seems this organism isnot an important agent in our hemodialysis wards.

Relationship between Ghrelin, Obestatin and Some of Body Composition Variables in 50-70 Years Old Athletes and Non-Athletes Men

Akram Jafari

Background: Aging is associated with appetite decline, weight loss, reduced muscle mass and increased fat mass. Ghrelin and Obestatin are two peptides that effect appetite. According to importance of physical activity in energy balance and some body composition variables the aim of this study is investigate the amount of ghrelin, obestatin and some body composition variables and their relationship in athletes and non-athletes 50 -70 year old men.

Materials and Methods: This is an analytical study. Thirty athletes and thirty non-athletes 50-70 years old men took part in this research. Ghrelin, obestatin and some body composition variables include weight, muscle mass, fat mass, present boy fat and body mass index were measured.

Results: The result of this study showed that muscle mass significantly (p<0.01) and ghrelin insignificantly (p=0.16) were higher in athlete group. In addition percent body fat was lower in athletes group insignificantly (p=0.13). There was negative significant relationship between ghrelin and obestatin with muscle mass and positive significant relationship between ghrelin and obestatin with percent body fat in non-athletes group. There was strong relation between ghrelin and obestatin in both groups.

Conclusion: Regular participating in basketball training can increase muscle mass in 50-70 years old men. It seems that exercise training can delay aging effects on body composition by increasing some anabolic hormones such as ghrelin and growth hormone and it can change relationship between ghrelin, obestatin and some body composition variables.

Occult HCV Infection in Hemodialysis Patients with Elevated Liver Enzymes

Arezoo Aghakhani

Background: Occult hepatitis C virus (HCV) infection is defined as the presence of HCV-RNA in liver or peripheral blood mononuclear cells (PBMCs) in the absence of detectable hepatitis C antibody (anti-HCV) or HCV-RNA in the serum. Although occult HCV infection is less aggressive than classic chronic HCV infection, nevertheless it is important in management of hemodialysis (HD) patients. Occult HCV infection has been described in two different clinical settings: in patients with normal liver enzymes or in patients with abnormal values of liver enzymes. The aim of this study was to detect the occult HCV infection in hemodialysis patients with elevated liver enzymes.

Materials and Methods: This cross sectional study was performed in hemodialysis patients referring to 3 dialysis units in Tehran. In 30 anti-HCV negative HD patients with elevated liver enzymes, presence of HCV-RNA in plasma samples was tested by Reverse Transcriptase-Nested Polymerase Chain Reaction (RT-nested PCR). In cases with negative anti-HCV and plasma HCV-RNA, HCV-RNA was checked in PBMC specimens by RT-nested PCR.

Results: A total of 30 HD patients with mean age 54.4± 14.1years and mean dialysis duration 81.2 ±64.4 months were enrolled in the study. All HD subjects were negative for HCV-RNA in plasma and occult HCV infection with RT-nested PCR method.

Conclusion: Occult HCV infection was rare in HD patients with elevated levels of liver enzymes.

Prediction of Survival in Patients with Colorectal Cancer Referred to the Hamadan MRI Center Using of Weibull Parameter Model and Determination of its Risk Factors During 2005-2013

Javad Fardmal

Background: It can be used different models such as nonparametric, semi-parametric and parametric to estimation of survival. Depending on the nature of the data, some methods may be more appropriate. Using of appropriate model result more accuracy estimation of survival and it's affected. so the aim of this study estimation of survival and determination of its related risk factor. Materials and Methods: In this study, 169 patients with colorectal cancer who had treated in Hamadan MRI Center from March 2005 to Jun 2013 were evaluated. Survival time of patients is considered from diagnosis time to death or end of study. The effect of Demographic and clinical risk factors on survival is assessed by parametric model. follow up of patient Data were analyzed using Spss16 and R statistical software.

Results: The median survival was 4.3±40 months. Univariate analysis showed that the effect of staging of tumor, tumor grade, histology type of tumor, metastasis and relapse on survival were significant but in multivariate model histology type of tumor and metastasis were significant.

Conclusion: using of appropriate statistical model for detection of affected risk factor on patient with colorectal cancer can be prevented progression of disease and increased of survival of them.

Cytotoxic Effects of All-Trans-Retinoic Acid with Cisplatin on Esophageal Cancer Cell Line (KYSE30)

Mojtaba Amani

Background: All-trans retinoic acid(RA), an active metabolite of vitamin A, is widely used to induce cell differentiation. It has significant effects on growth and proliferation of epithelial cells. It also causes cell cycle arrest in G0/G1 phase and induces the apoptosis. cisplatin, a chemotherapy compound that cross-linking to DNA, and leads to apoptosis, it is commonly used for treatment of ovarian, head and neck, esophageal, gastric cancers and melanoma. Recent studies showed that RA enhances cytotoxic effects of cisplatin on melanoma and ovarian cancer. Our literature review showed that there is no previous study on the effect of RA in combination with cisplatin on esophageal cancer, hence current study conducted to investigate such combination treatment on esophageal derived cell, KYSE-30.

Materials and Methods: KYSE30 cell line was cultured in presence of different concentration of RA alone and in combination with cisplatin. Then, cell death was investigated by colonogenic assay and acridine orange/ ethedium bromide staining.

Results: The results showed that RA concentrations &ge15µM cause differentiation of KYSE30 to squamous cell morphology, while lower concentrations decreases the colony formation (p&le0.05). These effects were also observed in combination with cisplatin and RA. The best effects on cell death were observed in 10 µM of RA of combination with 5 and 10 µg/ml of cisplatin.

Conclusion: The results suggest that low concentration of RA in combination with cisplatin are more effective than cisplatin alone in terms of apoptosis and necrosis of esophageal cancer, KYSE-30.

Assessment of Health Related Quality of Life by SF-36 Version 2 in General Population of Qom City

Reza Ghafari

Background: Today, the self-assessed health status is a standard part of epidemiologic and community based studies. The aim of this study is to assess and evaluate the health related quality of life in Qom city.

Materials and Methods: In this descriptive analytical study, population of 340 people over 18 years of Qom city entered the study by filling the questionnaires. A two-part questionnaire was used to collect data which the first part was related to demographic data including age, sex, marital status, education, occupation and place of residence. The second version of the SF-36 questionnaire was used to assess the quality of life.

Results: Generally, considering the all aspects of quality of life in this study, the mean (±SD) of scores was 67.69±14.78. This average was equal to 67.28±15.91 in men and 67.97±14.03 in women which showed a significant difference between them (p =0.030).

Conclusion: In this study the scores of women and single subjects were higher than other people. By the Persian version of 2nd version of SF-36 questionnaire, the quality of life people in different situations might be realized and impact of different demographic factors on quality of life could be measured.

Five-Year Evaluation of Epidemiological, Geographical Distribution and Survival Analysis of Breast Cancer in Markazi Province, 2007-2011

Amir Almasi Hashiani

Background: The prevalence and incidence of cancer in different parts of the world have different patterns. To recognize the frequency of malignancies in different social groups according to climatic conditions is considered as the primary component of prevention programs at different levels. This study was conducted to investigate the epidemiology, survival rates and geographical epidemiology of breast cancer in Markazi province.

Materials and Methods: In this epidemiological study, needed data were obtained from cancer registration program and death registration data. The data were analyzed by using SPSS software version 16 and Winpepi and significant level was 0.05. And to draw a map to show the breast cancer incidence rate in Markazi district, Arc view software was used.

Results: Out of the 400 cases recorded during the 5-year, 8.5% died due to breast cancer. 5-year survival rate was 87% and there was a significant correlation between survival rate and age. Most records were related to the age group 49-40 years and the highest incidence rate was in Arak. The trends of incidence rate was not significant.

Conclusion: The results showed that 5-year breast cancer survival rate is more than some other places which could be due to new and improved methods of treatment and methods of screening and early detection of disease. Other aspects of the epidemiology of the disease is similar to other parts of Iran.

Comparison the Prevalence and Severity of Dysmenorrhea Among Athletes and Non-Athletes and its Relation with Body Composition

Saeideh Mojarrad Ezbarami

Background: Primary dysmenorrhea is chronic cyclical pelvic pain associated with menstruation in absence of an identifiable pathological condition. The purpose of this study was to compare the prevalence and severity of dysmenorrhea among athletes and non-athlete girls and its relation with body composition.

Materials and Methods: In this cross sectional study 223 healthy students aging 20-30 years old from Guilan university randomly divided to two groups (72 athletes and 151 non-athletes). The athletes group engaged in regular physical activity for at least one year, three sessions a week and the non-athletes group were not engaged in any sports activity. Data were collected by questionnaire and anthropometric measurements.

Results: The prevalence of dysmenorrhea was lower in athletes than non-athletes group (61.1% vs. 88.8%, p<0.001). A significant difference was observed in mood symptoms, physical symptoms and severity of pain between two groups (p<0.05). Also there was statistically significant relationship between body fat and physical symptoms of dysmenorrhea in both groups. However, no statistically significant relationship was observed between physical symptoms of dysmenorrhea, BMI and WHR.

Conclusion: It seems that performing regular exercise can be used as a preventing, treating or supplementary method in control of the early dysmenorrhea.