Evaluation of cutoff point and power of neutrophil to lymphocyte ratio in diagnosing chronic inflammation in End-stage renal disease (ESDR) patients
Narges Sadat
Zahed
Assistant professor of nephrology, shahid beheshti university of medical sciences, Tehran. Iran1
author
Zinab
Karimi Mahali
resident of internal medicine, shahid beheshti university of medical sciences, Tehran. Iran
author
text
article
2015
per
Introduction: Inflammation can increase mortality and morbidity rate of ESRD patients. In some studies Neutrophil to lymphocyte ratio and Platelet to lymphocyte ratio were evaluated to detect inflammation. This study was conducted to evaluate the deterministic power, specificity and sensitivity of Neutrophil to lymphocyte ratio and Platelet and lymphocyte ratio in detecting inflammation indicated by Serum Albumin and C-reactive protein (CRP). Materials and Methods: According to our inclusion and exclusion criteria, we recruited 120 patient with ESRD admitted to Loghman hospital and Ashrafi Esfehani hospital were examined retrospectively in our study. Data were collected from hospital documents. Results: Basis on our study, Neutrophil to lymphocyte ratio and Platelet and lymphocyte ratio didn’t show a significant difference between normal patients and patients with inflammation. Conclusion: Although Neutrophil to lymphocyte ratio and Platelet and lymphocyte ratio are related to inflammatory conditions, but sensitivity and specificity of these testes are low for detecting inflammation.
medical journal of mashhad university of medical sciences
دانشگاه علوم پزشکی مشهد
1735-4013
58
v.
6
no.
2015
289
294
https://mjms.mums.ac.ir/article_5000_f0e19e6829a8131e67898b36d548b5b1.pdf
dx.doi.org/10.22038/mjms.2015.5000
Comparison of FGF21 level in type 2 diabetic patients with healthy subjects and correlation of its with metabolic syndrome components
Robab
Aboutorabi
Associate professor of endocrinology- endocrine research center- Ghaem hospital- mashhad- iran
author
Shokoufeh
Bonakdaran
Associate professor of endocrinology- endocrine research center- Ghaem hospital- mashhad- iran
author
Saeed
Islami
methodologist- Mashhad University of Medical Sciences, mashhad,iran
author
Fatemeh
Abbasi banazade
Fellow of Endocrinology- - Mashhad University of Medical Sciences, mashhad,iran.
author
text
article
2015
per
to have a potent antidiabetic effect in animal models. In human studies activity of this factor is associated with development of metabolic syndrome. The aim of this study was to compare the concentration of this factor in type 2 diabetic patients and healthysubjects and also relation of this factor with metabolic syndrome componentswas investigated. Methods: 30 type 2 diabetic patients and 40 healthy subjects were enrolled in this study. Demographic data of patients were recorded. HbA1c, FBS, lipid profiles, insulin level,liver enzymes and FGF21 were measured for all subjects. Insulin resistance was calculated by homeostatic model assessment of insulin resistance(HOMA-IR) formula.FGF21 level was compared between diabetic patients with healthy control group and also relation of this factor was determined with metabolic syndrome components. Results:Difference of FGF21 level was not significant between type 2 diabetic patients and healthy subjects.There were not significant correlation between FGF21 level and metabolic syndrome components. FGF21 was positively associated with SGPT level. Conclusion: It seems that FGF21 is not related to metabolic syndrome components in Iranian population, but this observation remains to be determined by large clinical studies.
medical journal of mashhad university of medical sciences
دانشگاه علوم پزشکی مشهد
1735-4013
58
v.
6
no.
2015
295
301
https://mjms.mums.ac.ir/article_4991_9504b8f710c498d748167938a2683e9b.pdf
dx.doi.org/10.22038/mjms.2015.4991
Study of Risks in emergency department at Tabriz Imam Reza hospital
Mahbub
Puraghaei
Assistant Professor of emergency medicine
author
Jafar Sadegh
Tabrizi
Associate Professor of health services management
author
Saeed
Aslan abadi
Professor of pediatrics surgery
author
Peyman
Moharam zadeh
Assistant Professor of emergency medicine
author
Roya
Ghiami
Resident of emergency medicine
author
Navid
Elmdust
General Physician
author
text
article
2015
per
Introduction: Risk management is to prevent the risk and also manage it after occurrence and includes diagnosis, evaluation, analysis, control, reduction and prevention of the risk. The aim of risk management is to reduce the risks concerning patients and increase work safety for staffs. In this study risk management was evaluated in different steps in Imam Reza emergency department (ED). Methods: In this action research study, first we performed three focus group discussions (FGD) sessions including FGD session with ED nurses, a session with emergency medicine residents and a session with the laboratory, drug store and radiology staffs. Using these sessions, a questionnaire was design to clarify risks and to priority processing. To evaluate and define risk level in ED we used experts’ panel. For each risk, risk severity, its incidence and risk level was calculated. According to the risk level, their priority was processed and intolerable risks were defined for planning an intervention. Results: Based on expert panel, 11 subgroups with 415 risks were gathered. Among these, 3 risks including high volume of attendants, staff shortage and high patients load were recorded as intolerable risks in risk level 1, 2 and 3. The intervention was designed to reduce the attendants by giving 2 attendant cards for each patient. Conclusion: In this study we observed that intolerable risks are high volume of attendants, staff shortage and high patients load and the intervention program was designed to reduce the risks.
medical journal of mashhad university of medical sciences
دانشگاه علوم پزشکی مشهد
1735-4013
58
v.
6
no.
2015
302
309
https://mjms.mums.ac.ir/article_4998_8214c9d56e33b29c2acac1576c19d764.pdf
dx.doi.org/10.22038/mjms.2015.4998
The effect of Antibiotic Stewardship targeted against vancomycin and carbapenems in pediatric intensive care unit of Doctor Sheikh hospital
Farzaneh
Mohammadi
Resident of Pediatrics
Mashhad University of Medical Sciences
Imam Reza Hospital Mashhad Iran
author
Gholamreza
Khademi
Assistant Professor of Department of Pediatrics
Mashhad University of Medical Sciences
author
Monavar
Afzalaghaee
Assistant Professor of Department of social medecine
Mashhad University of Medical Sciences
School of medicine. Mashhad Iran
author
Mohammad Saeed
Sasan
Associate Professor of Department of Pediatrics
Mashhad University of Medical Sciences
Imam Reza Hospital Mashhad Iran
author
text
article
2015
per
Introduction: The inappropriate use of Broad- Spectrum antimicrobials in intensive care units (ICU) is a universal problem. The main goal of this study was to implement antibiotic stewardship program (ABS) concentrated on vancomycin and carbapenems, in pediatric ICU (PICU) of Sheikh hospital. As an accessory purpose we looked for the effect of ABS on the rate of antibiotic administration, length of hospital stay and mortality Material and Methods: This study was performed in 2 stages, at the first phase; we determined the causes of nosocomial sepsis and their antibiotic (AB) resistance pattern in the PICU, and then according to those findings a guideline for administration of vancomycin and carbapenems was performed. In the second stage the files of PICU patients were reviewed every other day (for 3 months), and recommendations about the compatibility of the prescriptions with the guideline were given to the responsible doctor. At the end, we compared the effects of the intervention with one month of prospective record of AB prescriptions without any recommendation. Results: We recorded 1676 and 673 patient/days during 3 month of ABS and 1 month of control. During ABS period, vancomycin use decreased from 294 to 178 for 1000 patient/days (P=0.001), carbapenems administration changed from 433 to 193 for 1000 patient/ days (P=0.001), the LHS decreased from 11.4 to 8.4 days (P=0.06) and mortality rate decreased from 10.2% to 7% (P=0.4). Conclusion: In a situation like Dr Sheikh PICU , implementation of ABS for vancomycin and carbapenems hasafavorable effect on AB usage rate.
medical journal of mashhad university of medical sciences
دانشگاه علوم پزشکی مشهد
1735-4013
58
v.
6
no.
2015
310
315
https://mjms.mums.ac.ir/article_4996_e3f6e9a33384b3d53087772f1e121c88.pdf
dx.doi.org/10.22038/mjms.2015.4996
The effect of four weeks aerobic training with using L-carnitine supplement on lipid profile and blood glucose in diabetic men
Mohammad
Ramezanpour
Assistant of prof. department of physical education and sport sciences, Islamic azad university, mashhad branch, mashhad, iran
author
Mohammad
matboo
M.Sc. student of exercise physiology, Islamic azad university, mashhad branch, mashhad, iran
author
eyed Mahmoud
hejazi
Assistant of prof. department of physical education and sport sciences, Islamic azad university, mashhad branch, mashhad, iran
author
text
article
2015
per
Introduction: some researches show that the amount of L-carnitine is low in diabetic patients. L-carnitine consumption could be result in metabolic processes improvement in diabetic patients. The aim of this study is investigating the effect of four weeks aerobic training accompanied by using L-carnitine on glucose and lipid parameters in patients with diabetes type 2. Materials &Methods: In this semi experimental study, 20 diabetic men at the average age of 51.2 ± 2.58 divided into two groups. The first group had aerobic training and using 500 mg L-carnitine and the second group had aerobic training using placebo simultaneously. Training done for four weeks (3days in week) with 60% - 80% of maximum heart rate. Blood exams done before training and after it and data compared with t- test in independent groups. results: fasting blood glucose had significant decrease in the L-carnitine group comparing the placebo group. There was no significant difference in blood level of triglyceride, cholesterol, LDL and HDL between two groups. Conclusion: Finding indicate that L-carnitine cause significant decrease in fasting blood glucose but doesnt cause significant difference in lipid profile in diabetic men.
medical journal of mashhad university of medical sciences
دانشگاه علوم پزشکی مشهد
1735-4013
58
v.
6
no.
2015
316
321
https://mjms.mums.ac.ir/article_5060_ae75aeac4f36541501f0c1fe002bda15.pdf
dx.doi.org/10.22038/mjms.2015.5060
Frequency of Klebsiella Pneumoniae Producing Carbapenemase KPC in Clinical specimens of Mashhad during 2014
Fateme
roudbari
Department of cell and biology, Faculty of science,University of Mazandaran, Babolsar, Iran
author
Kiarash
Ghazvini
Antimicrobial resistance Research Center, Buali research institute, Mashhad University of medical Sciences, Mashhad, Iran
Department of Microbiology and Virology, School of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Somayeh
heydari fork
Department of cell and biology, Faculty of science,University of Mazandaran, Babolsar, Iran.
author
Mahdi
KouhiNoghondar
MSc Antimicrobial resistance Research Center, Buali research institute, Mashhad University of medical Sciences, Mashhad, Iran
author
Saeed
Amel Jamedar
Antimicrobial resistance Research Center, Buali research institute, Mashhad University of medical Sciences, Mashhad, Iran
Department of Microbiology and Virology, School of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Masoud
Youssefi
Antimicrobial resistance Research Center, Buali research institute, Mashhad University of medical Sciences, Mashhad, Iran
Department of Microbiology and Virology, School of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
text
article
2015
per
Introduction: Klebsiella pneumoniae producing B-Lactamase is an important medical concern. Therefore we aimed to investigate broad spectrum lactamase KPC-producing Klebsiella pneumoniae in clinical samples in Mashhad during 2014. Material and method After identification by biochemical methods, antibiotic susceptibility of Klebsiella pneumoniae isolates against 10 different antibiotics was identified using disk diffusion technique. To evaluate the presence of carbapenemase KPC enzyme, modified Hodge test (MHT) was performed and the minimum inhibitory concentration (MIC) of Meropenem as an indicator of Carbapenem class of β-Lactam antibiotics was determined using agar dilution test. Results Among the isolated bacteria, high level of resistance against cefazolin (54.44%), cefepime (49.46%), ceftazidime (45.19%), trimethoprim-sulfamethoxazole (46.26%) was observed. Modified Hodge test was performed for all 136 ESBL Klebsiella pneumoniaisolates and 20 were found to be positive for MHT. Furthered MIC test revealed that 2 isolate had MIC=4 μg/ml, 3 isolate had MIC=2, and remaining 15 isolates had MIC more than 8. Conclusion This study underscores the risk of increasing carbapenem resistant Klebsiella pneumonia specieswhich demands further attention in clinical settings.
medical journal of mashhad university of medical sciences
دانشگاه علوم پزشکی مشهد
1735-4013
58
v.
6
no.
2015
322
329
https://mjms.mums.ac.ir/article_5059_c46bb5c2b7daee5753f4b99c113d4071.pdf
dx.doi.org/10.22038/mjms.2015.5059
The effect of 12 weeks resistance exercise on plasma levels of Apelin-12, Nesfatin-1 and resting heart rate in hypertensive elderly women
Maryam
Mokhtari
Department of Exercise Physiology, University of Shiraz, Shiraz, Iran
author
Farhad
Daryanoosh
Assistant Prof of Physical Education and Sport Science, Department of Exercise Physiology, University of Shiraz, Shiraz, Iran.
author
text
article
2015
per
Introduction: Adipokine including Apelin and Nesfatin secreted by adipose tissue and . The aim of present study was to investigate the effect of 12 weeks resistance exercise on plasma plasma levels of Apelin-12, Nesfatin-1 and resting heart rate in hypertensive elderly women Materials and Methods: In this study, 30 hypertensive elderly women were chosen and randomly divided in to two groups: Control and Resistance exercises group (training , 3 times a week for 12 weeks). Blood pressure, heart rate; and also plasma Apelin and Nesfatin concenterations were measured before and at the end of study. Data evaluated by using the dependent and independent t-test significant level data p≤ 0.05 was done. Results: That was found after 12 weeks of Resistance exercise significant differences in serum levels Apelin (reduce, p=0.02) and Resting heart rate (reduce, p=0.03) in the experimental group was occurs but in the control group,no significant changes in serum levels Apelin (p=0.50) and Resting heart rate (p=0.12) was occurs. Also, after 12 weeks of Resistance exercise no significant differences in serum levels Nesfatin (p=0.15) in the experimental group was occurs but in the control group, significant changes in serum levels Nesfatin (increase, p=0.05) was occurs. Conclusion: The 12-week resistance exercise , could reduction resting heart rate and blood pressure And thus eliminates the need to increase Apelin and decrease Apelin observed (negative feedback). The study did not exercise as an effective incentive to reduce Nesfatin.
medical journal of mashhad university of medical sciences
دانشگاه علوم پزشکی مشهد
1735-4013
58
v.
6
no.
2015
330
337
https://mjms.mums.ac.ir/article_5002_3a0a4a213417fec1fe6cd16f9222d034.pdf
dx.doi.org/10.22038/mjms.2015.5002
Compare Imaging Findings in Crohn's Disease with Intestinal and Peritoneal Tuberculosis to differentiate these diseases
Jahanbakhsh
Hashemi
, associate professor of radiology, Mashhad Medical Faculty
author
Donya
Farrokh
associate professor of radiology, Mashhad Medical Faculty
author
Amin
Bojdi
assistant professor of Infectious Disease , Mashhad Medical Faculty
author
Ehsan
Khoshbakht
Radiologist
author
Moein
Kheirollahi
Resident of Radiology, Mashhad Medical Faculty.
author
text
article
2015
per
Introduction: we aimed to determine the best differential diagnosis between Crohn's disease and intestinal tuberculosis. Abdominal and pelvic ct exams with oral and IV contrast and small bowel barium study findings are selected to differentiate intestinal tuberculosis from crohn’s disease. Methods: This was a cross-sectional retrospective study between 2001 -2011. The data was gathered from the medical records of patients with peritoneal and intestinal tuberculosis and Crohn's disease who were referred to Ghaem and Emam raza Hospitals. Twenty six patients with Crohn's and 22 cases of intestinal tuberculosis were selected. The data was extracted from the bowel and mesentery imaging methods including abdominal and pelvis CT-scan with oral and IV contrast, CT enterography, and small intestinal transit. The frequency of ten visible radiographic findings of medical records of patients was assessed and diagnostic value of each variable was evaluated in differentiating the two diseases. Results: There was a significant difference between the age of the patients with TB and Crohn's(p=0.013). Data of CT-scan showed there was a significant difference between the patients with and without thickening and multiple strictures (p=0.01), mural strification(p=0.015), mural calcification (0.038), mesentic hypervascularity or natural mesenteric vasculature, ascites, lymphadenopathy(all, p<0.001), fibrofatty proliferation(p=0.015), and necrosis(p=0.001). The other data showed that there was a significant association between mural strification and mesentic hypervascularity(p<0.001). Conclusion: our study showed CT-scan is effective in proper diagnosis of TB by imaging findings and could differentiate Crohn's disease. The mural calcification was evaluated as distinguishing factor of TB from Crohn’s disease. Necrotic lymphadenopathy in CT-scan can be assessed as a tool for differentiated TB from Crohn's disease.
medical journal of mashhad university of medical sciences
دانشگاه علوم پزشکی مشهد
1735-4013
58
v.
6
no.
2015
338
345
https://mjms.mums.ac.ir/article_4994_205b7ebad0f52c5e53f34d3918f19471.pdf
dx.doi.org/10.22038/mjms.2015.4994
Report of a very rare patient with angina pectoris due to aortic valve papillary fibroelastoma
Hamid
Hoseinikhah
Assistant Professor of Cardiovascular Surgery, Mashhad University of Medical Sciences
author
Alireza
Sepehri Shamloo
Research Administrator
author
Mehdi
Vahdati
Perfusionist of cardiac surgery wards Imam Reza Hospital, Mashhad University of Medical Sciences
author
AliAsghar
Moeinipour
Assistant Professor of Cardiovascular Surgery, Mashhad University of Medical Sciences
author
Gholamreza
Gorgiji
-perfusionist AND nursing of cardiac surgery wards Imam Reza Hospital, Mashhad University of Medical Sciences, Iran
author
text
article
2015
per
Introduction: Aortic Valve Papillary Fibroelastoma (AVPF) is the most common benign tumor of cardiac valves. Most cases of AVPF are completely asymptomatic and the diagnosis is made incidentally. However, ischemic heart attack, atrial and ventricular arrhythmia, and also thromboembolism complication especially in CNS system, are the most common presentations in symptomatic cases. Herein, we report a very rare case of AVPF in an old age patient presented with stable angina. Case presentation: A 60-year old woman was referred to our clinic with symptoms of stable angina. Transesophageal echocardiography showed a tumor suspected mass (1 X 1 cm) on aortic valve. Angiography was reported normal. Considering the presence of the symptomatic mass, patient underwent open cardiac surgery and tumor resected. Report of biopsy revealed the AVPF. Conclusion: Although treatment of asymptomatic AVPF is controversial; but, for symptomatic masses, surgical resection for avoidance of its complication is recommended. Result of surgical resection of AVPF usually is excellent and mortality, morbidity, and recurrence rate are almost low
medical journal of mashhad university of medical sciences
دانشگاه علوم پزشکی مشهد
1735-4013
58
v.
6
no.
2015
346
350
https://mjms.mums.ac.ir/article_5005_2fa33a332eccf4f37fe53cf31a8b14be.pdf
dx.doi.org/10.22038/mjms.2015.5005