مجله علمی دانشگاه علوم پزشکی کردستان
سال بیست و ششم شماره 3 (پیاپی 113، امرداد و شهریور 1400)

Oliveria decumbens Vent is a medicinal plant used in Iranian traditional medicine for gastrointestinal disorders such as abdominal pain ,indigestion and diarrhea. The aim of this study was to evaluate the effect of Oliveria decumbens Vent hydroalcoholic extract on morphine withdrawal symptoms and diarrhea in mice.

40 Mice weighing 20-30g were divided into 5 groups of eight. Negative control and positive control groups received normal saline and loperamide respectively. Treatment groups received 5, 50, and 500mg/kg of O.decumbens extract. Morphine dependency was induced by intraperitoneal injection of morphine for seven consecutive days. On the eighth day, one hour after the last dose of morphine, different doses of the extract; normal saline, and loperamide were administered intraperitoneally and 30 minutes later naloxone was injected into all groups to accelerate the onset of withdrawal symptoms. After 10 minutes withdrawal symptoms including jumps, standing, and wet dog shakes started. Frequency and water content of stools and quality of stools (normal, loose, watery) were recorded for 60 minutes.  

The result of this study showed that the extract of O. decumbens significantly and dose-dependently decreased the frequency of excretion, jumping, standing on feet, wet dog shakes and the amount of fecal water in the treatment groups compared to those in the control group. (P<0.05) 

O. decumbens extracts made a significant improvement in morphine withdrawal symptoms and diarrhea.

The liver is exposed to large amounts of toll-like receptor ligands due to increased bacterial growth and increased intestinal permeability in patients with fatty liver disease. The aim of this study was to investigate the effect of high-intensity interval training and Lactobacillus Rhamnosus probiotic consumption on TLR4 and MYD88 expression in gut tissue in an animal model of non-alcoholic fatty liver.

In this experimental study, 40 rats (weighing 200-250 gr) were selected and randomly divided into 5 groups including healthy control, fatty liver, fatty liver + HIIT, fatty liver + probiotic, and fatty liver + HIIT + probiotic groups. In order to induce fatty liver, oral tetracycline 140 mg/kg/day in 2 ml of water in form of a solution was given to the rats by gavage for 7 days. HIIT exercise program performed on treadmill five sessions per week for 5 weeks. Data were analyzed by one-way ANOVA and Tukey post hoc tests.
P <0.05 was considered significant.

The results showed that TLR4 gene expression was significantly lower in HIIT, probiotic, and also HIIT + probiotic groups than in the fatty liver group (p=0.001). Also, the expression of the MYD88 gene in intestinal tissue was significantly lower in HIIT, probiotic and HIIT+probiotic groups than that in the fatty liver group (p=0.001).

Expression of TLR4 and MYD88 genes in adipose tissue induced by fatty liver, can be reduced by HIIT and probiotic intake. Therefore, these interventions can be considered as a non-pharmacological strategy in the treatment of fatty liver.

Diabetes mellitus (DM) is one of the most common metabolic disorders characterized by chronic hyperglycemia with impaired metabolism of carbohydrate, fat, and protein. The purpose of this study was to evaluate the effects of white button mushroom (WBM) powder on anthropometric indices, blood pressure, and liver enzymes in type 2 diabetic patients (T2DM).

This double-blind clinical trial included 41 T2DM patients between 23 and 50 years of age. Patients were randomly divided into intervention (n = 19 mushroom powder) and placebo (n = 22 corn starch) groups. Patients received 16 g dried WBM powder or corn starch/day for 8 weeks.  Anthropometric indices, blood pressure, and liver enzymes were assessed at the baseline and at the end of our study. An independent sample t-test was used to compare quantitative variables between the two groups. Comparison of the mean values before and after treatment in each group was performed by means of paired T-test. p<0.05 was considered significant.

Comparison of the results at the baseline and after 8 weeks showed no significant difference in regard to weight, body mass index, waist circumference, waist-to-hip ratio, and the waist-to-height ratio between the two groups (P > 0.05). However, the patients in the intervention group had a significant decrease in waist circumference and also lower weight at the end of the study compared to the baseline (P < 0.05). In addition, BMI reduction was significantly higher in the intervention group than in the control group (P < 0.05). There were no significant differences between the two groups in relation to hepatic enzymes, systolic and diastolic blood pressure at the end of the study (P > 0.05).

This study showed that WBM had no significant effect on liver protection. However, improvement in anthropometric indices in the intervention group indicated the potential effect of WBM on reducing T2DM complications.

Nowadays, drug abuse is a major problem in societies, and detection of drugs in urine is very important.  In general, immunochromatography (ICG) and thin-layer chromatography (TLC) are routine methods for the detection of drugs in urine. These methods are rapid and economical, but their accuracy rates for the detection of drugs at lower concentrations are low (< cut off). Morphine, amphetamine, and methamphetamine are conventional drugs that are widely used. The purpose of this study was to compare immunochromatography, thin layer chromatography (TLC), and gas chromatography (GC) methods for detection of morphine, amphetamine, and methamphetamine in the spiked healthy human urine samples and urine of addicted people. We also compared their detection limits with one another.

This was an experimental study and included urine samples obtained from healthy and addicted people referring to the laboratory of the 7th of Tir marriage counseling center in East Azerbaijan Province, in June 2016. After the collection of urine samples, samples obtained from healthy people were spiked with various concentrations of morphine, amphetamine, and methamphetamine. Then, all samples were tested by immunochromatography, TLC, and GC methods for the detection of morphine, amphetamine, and methamphetamine.

Results showed that ICG and TLC methods can not detect lower concentrations (< cut off) of morphine, amphetamine, and methamphetamine. While, GC can easily detect them in urine samples, even in lower concentrations (< cut off), and has a high detection limit and accuracy rate.

It can be concluded GC method is a powerful and accurate technique for the detection of drugs in urine samples.

Dyes are one of the most important pollutants in textile wastewater (TWW). Use of advanced oxidation processes (AOPs) as an efficient method can be useful for removal of these pollutants from the effluent of textile wastewater. In this study we evaluated the efficiency of the persulfate activation process, using ultraviolet (UV), in the presence of granular activated carbon (GAC) for removal of methylene blue dye (MBD). Also, we studied the effect of operating parameters on dye removal.

This experimental study was performed in a pilot-scale batch photoreactor. The effect of operating parameters including solution pH (between 3 and 9), dosage of granular activated carbon (0.6-5 mg/L), persulfate concentration (0.2-2 mmol/L), initial concentration of methylene blue dye (50-400 mg/L), and contact time (2-30 minutes) were evaluated. The final concentration of methylene blue dye was measured by using DR-6000 device. Mineralization of the process, in optimal conditions, was determined by measuring COD and TOC.

The highest efficiency of the process for removal of methylene blue dye (99% dye removal at an initial concentration of 50mg/L) was observed at pH = 3, granular activated carbon dose of 1 g/L, optimal persulfate concentration of 1 mmol/L, and after a 20-minute contact time. The removal rates of COD and TOC were 71% and 69.9%, respectively, and the decomposition rate of methylene blue dye was based on the first-order reaction (R2 = 0.99).

Considering the results of this study, the combined process had a significant efficiency to remove methylene blue dye and can be used as an efficient method for removal of the dye from the effluent of textile wastewater.

Wound infections, as a common nosocomial infection, are contributing factors to mortality. Determining the prevalence of common pathogens causing wound infections and their antibiotic susceptibility patterns plays a key role in the rapid treatment and prevention of such infections. This study aimed to analyze wound infections in hospitalized patients in a university hospital in Tehran and determine the antimicrobial susceptibility patterns of the isolated bacteria.

Data about 563 hospitalized patients from different wards of a university hospital, who had participated in the study from March 2017 to June 2019, were collected, and sample collection from the wounds was carried out. For the identification of pathogens, we used standard bacteriological techniques. The disk diffusion method was used to determine the antimicrobial susceptibility patterns of the isolates. Data were analyzed using SPSS 18.

Among five hundred and sixty-three samples, 382 (67.7%) had positive cultures. The most common isolated pathogens were Staphylococcus aureus (19.2%), Escherichia coli (17.7%), Acinetobacter spp. (14%), Pseudomonas aeruginosa (13.6%) and Klebsiella spp. (12.9%). Fifty percent of the Staphylococcus aureus isolates were resistant to cefoxitin. Escherichia coli and Acinetobacter spp. were resistant to most of the antibiotics.

Our study found that pathogens causing wound infections were highly resistant to commonly prescribed antibiotics. Identifying the etiological agents of wound infection and their antibiotic susceptibility patterns is essential, especially for the treatment of elderly patients and those hospitalized in intensive care. This can assist in designing a therapeutic strategy for these types of infections.

Postpartum period can be considered one of the most sensitive life stages. Special care is provided in different countries. The Aim Of this study is to Survey postpartum care and educational programs in Iran.

Data were collected by searching, Scientific Information Database, IranMedex, Magiran, Cochrane Library, PubMed, Google Scholar, Web of Science, Scopus databases were used. To searching articles in Persian sources, the keywords of the postpartum period, Clinical Trial, Program, Education, Care, Intervention, and English equivalent were searched from 2009 to 2019. Then, the titles and abstracts of the articles were evaluated by consort and Jadad Check List, and finally, 49 articles were reviewed.

Interventions in eight areas of home care, postpartum support, health promotion theory, physical training, counseling, e-learning, face-to-face Educations, group Educations. The variables included quality of life, postpartum depression, breastfeeding, the satisfaction of care, fatigue and asleep, and the performance of mothers.

Improving the quality of postpartum care needs to be enriched in the content of country care programs based on successful evidence of existing researches in the country such as visiting at home and by telephone mothers during the sensitive postpartum period in some cases can be seen

The aim of this study was to determine the relationship between cord arterial blood gas (ABG) indices and early neonatal complications in neonates born with fetal distress and also the threshold level of measured values ​​for the risk assessment of complications.

221 mothers with fetal distress who met our inclusion criteria participated in this 12 month cross-sectional study in Mashhad University of Medical Sciences from 2015 to 2016 . Blood samples were taken from umbilical artery of the neonates after birth. Early perinatal complications and their association with PH and BE at birth and 8 hours later and also the diagnostic values of the afore mentioned values were evaluated

221 pregnant mothers at 37-41 weeks of gestation (mean gestational age of 38 weeks and 4 days) who had developed fetal distress during hospitalization were entered into the study. Seizure (p<0/01), jaundice (p<0/015), gasterointestrinal complication (p<0/01) ,NICU haspitalization ≥ 1 week (p< 0/001) were significantly higher in the neonates with PH<7/2. Seizure (p<0/01), gastero intestinal complication ( p=0/049). NICU hospitalization ≥ 1 weak (p<0/001) were significantly higher in the neonates with BE < -14. The highest diagnostic accuracy rates for respiratory complications (85%) was related to BE measured 8 hours after birth. The highest diagnostic accuracy rates for seizure (88%) and gastrointestinal (77%) complications were related to PH measured 8 hours after birth. But for renal complications (82%) and jaundice (60%) it was associated with PH at birth.

PH and BE can be used as reliable predictors for some early neonatal complications.

Estimation and analysis of household expenditure patterns can always be considered as one of the most suitable tools to raise awareness of policy makers. The aim of this study was to investigate shares of different parts of Iranian household expenditures with emphasis on health care cost.

This descriptive study was conducted by using raw data about households expenditure obtained from Iran statistical center (1392-1396). The household expenditure patterns of 6 subcategories were analyzed. The share of health care expenditures on the basis of income quintiles were reviewed before and after Iran’s health hransformation program (1392-1396). Excel 2010 and Stata 14 softwares were used for data analysis and drawing the charts.

In urban households, the cost of housing and in rural households cost of food and clothing had the highest shares in  household expenditures. The costs of education in both groups of urban and rural households had the lowest share in household expenditures. The share of health care expenditures in urban and rural households has increased in the study years and after IHTP in all quintiles. Except for the fifth quintile in urban households, the results were similar.

The results showed significant alterations in the household expenditure pattern. The shares of health care expenditure after the IHTP has increased, indicating that the program has not been successful to achieve the goal of household financial protection.

Tau protein is a microtubule-associated protein that plays a critical role in microtubule dynamics and maintaining the structure of neurons. Tau isoforms with three or four repeated domains at the c-terminal are known as 3R or 4R isoforms, respectively. Hyperphosphorylation of tau impairs its original structure and function and causes accumulation of tau as tangled filaments known as neurofibrillary tangles. The aim of this study was to review the structure and physiological function of tau and also the role of accumulation and deposition of tau in induction of neurodegenerative diseases.

Relevant reports about the deposition of tau protein in neurodegenerative diseases were summarized from scientific articles.

Deposition of the filamentous tau in neurons and glial cells causes cell damage and induces neurodegenerative diseases such as Alzheimer’s disease (AD), cortico-basal degeneration (CBD), and progressive supranuclear palsy (PSP). The type of tau isoform and its site of deposition in neurons, astrocytes, and oligodendrocytes are different in these diseases, which can be a useful clue for precise diagnosis of the above mentioned diseases. In AD both 3R and 4R isoforms are deposited only in neurons, but in PSP and CBD only 4R isoform is deposited in neurons and glial cells.

Knowledge of the physiological functions and pathogenesis of tau and decreasing the hyperphosphorylated form of tau by inhibition of protein kinases, can lead to development of a diagnostic and therapeutic strategy for neurodegenerative diseases induced by tau protein.
Tau protein, Protein kinases, Neurofibrillary tangles, Tauopathies

Approximately 85% of Iranian hospitals are general hospitals. Considering the limitation of resources, improvement of hospital efficiency is an absolute necessity. Efficiency, as the output-input ratio, indicates the use of the lowest amount of inputs to produce the greatest amount of outputs. The aim of this study was to determine the efficiency of general hospitals in Iran and identification of the factors affecting the efficiency of the hospitals.

In this cross-sectional and descriptive study we used the Pabon Lasso model and three performance indicators. i.e., bed occupancy rate (BO), the average length of stay (ALS), and hospital bed turnover (BT) to determine the efficiency of the Iranian general hospitals in 2017. Data were analyzed by SPSS software and charts were drawn using Power BI software.

There were 834 general hospitals with 108257 beds in Iran in 2017. The average BO, ALS, and BT were 62.8%, 2.6 days, and 93 times respectively. Only 15% of the general hospitals were located in zone III of the Pabon lasso model and had acceptable efficiency (high BO and BT). Factors such as hospital ownership, type, size, age of hospital building, and staff number were significantly related to hospital efficiency. Private and social security hospitals, non-teaching hospitals, and hospitals with 100-200 beds and 2-4 staff per bed had more efficiency in comparison to the teaching hospitals.

Because of the low efficiency of most general hospitals policymakers and senior managers should take necessary measures for the improvement of the efficiency of the hospitals.

Human fascioliasis is a water and food-borne parasitic disease and has become endemic in the coastal provinces of the Caspian Sea. Limited reports of the disease and its diagnosis have resulted in ignoring the disease and a significant rise in the number of neglected patients in other parts of the country.

In this study, a 50-year-old man living in a village of Kamyaran, in Kurdistan Province in Iran was referred to a hospital with complaints of weight loss, epigastric pain, and anorexia from two months ago. The patient-reported history of consuming raw vegetables and plant foods. Laboratory studies revealed anemia, leukocytosis, eosinophilia, high ESR, low serum iron, and elevated liver enzymes. A Spiral CT scan of the liver showed hypodense areas without enhancement in the arterial phase and with relatively homogeneous enhancement in the delayed phase. Ultrasound studies showed multiple hetero and hyper-echoic areas without walls in different parts of the liver. Finally, Fasciola hepatica was diagnosed after stool examination by formalin ether concentration method and also positive ELISA test. The patient was treated with triclabendazole 500 mg/day for two days. In the follow-up, the clinical status of the patient was better and we found improved laboratory test results.

The present report highlights the need for paying more attention to the occurrence of this disease in Kurdistan Province by health care systems.
Human fascioliasis, Fasciola hepatica, Kurdistan, Iran