نشریه پژوهش در پزشکی
سال چهل و پنجم شماره 1 (پیاپی 177، بهار 1400)

Although lifestyle changes encompassing weight loss and exercise remain the cornerstone of non-alcoholic fatty liver disease (NAFLD) management, the effect of different types of exercise on NAFLD is unknown. So, the purpose of the present study was to evaluate the impact of eight weeks of High-Intensity Interval Training (HIIT) on liver lipids, liver enzymes, and insulin resistance of adolescents with fatty liver.

In the current experimental research, 23 children and adolescents with non-alcoholic fatty liver were randomly assigned into HIIT groups. The intervention was eight weeks of HIIT training consisting of 30 seconds of fast running at around 100–110 percent of max speed with a 30-second recovery interval, 3 sessions per week each session lasting for 32-36 minutes, whereas the control group had no regular physical activity. Variables were measured before and after the intervention in both groups. The data was analyzed running ANCOVA and Bonferroni post-hoc tests.

Significant differences were observed in VO2peak (HIIT9.38% vs. Control 0.62%), BF percentage (HIIT;-1.25% vs. Control; 0.31), WHR (HIIT;-1.24% vs. Control; 0.41), ALT (HIIT;-12.42% vs. Control 3.84%), AST (HIIT;-13.95% vs. Control; 4.80%), insulin (HIIT; -12.37% vs. Control -3.56%) and insulin resistance (HIIT; -15.24% vs. Control -2.83%) between HIIT and control groups (P<0.05), whereas the differences in blood pressure and fasting blood sugar between the two groups were not found to be significant (P>0.05).

It seems that the HIIT exercise can be helpful as a non-medical intervention to improve liver enzymes and in the treatment of obese/overweight adolescents with non-alcoholic fatty liver.

Changes differences in cardiovascular risk factors, especially fat variables in type 2 diabetic patients with fatty liver due to exercise further highlight the need for more research. The best type of aerobic exercise that has the most impact is still unknown. The aim of the current study was to investigate and compare the effects of interval, continuous, and combined aerobic exercise training on cardiovascular disease risk factors in type 2 diabetic patients with non-alcoholic fatty liver.

In an experimental study, 40 women with type 2 diabetes with non-alcoholic liver were randomly assigned to four groups: interval aerobic exercise groups (75-80% of maximum heart rate) each session for 30-40 minutes, continuous aerobic exercise group (60-75% of maximum heart rate) each session for 25-30 minutes, combined exercise group (interval and continuous), and control group (without regular exercise). The exercise training groups performed exercises by cycle ergometer for eight weeks, three days a week. For analysis and comparison between the groups, Covariance test was used. The t-dependent test was used for intra-group compression (α≤0.05).

Changes in hip circumference, waist circumference, BMI, and fasting blood glucose were significant in all three training groups (p≤0.05). In the continuous aerobic exercise group, in addition to the above mentioned factors, changes in total cholesterol, LDL cholesterol as well as systolic and diastolic blood pressure were significant (p≤0.05). Also, the changes in total cholesterol, LDL cholesterol, HDL, and systolic and diastolic blood pressure were significant in the interval aerobic exercise group (p≤0.05). In the combined exercise group, the increase in HDL cholesterol was also significant (p≤0.05). In control group, none of the variables was significant. Changes in hip circumference and body mass index were significant in comparison with the control group with the continuous group, the interval group, and the combined group (p≤0.05).

More variables were improved in the interval aerobic exercise group. Also, the rate of improvement in this group was higher than those in the other groups. As a result, interval aerobic exercise was found to have the greatest impact on improving cardiovascular risk factors.

New findings suggest that levels of Apo-A1 and Apo-B in the blood are more likely to predict the risk of coronary heart disease compared with other conventional lipid indicators. On the other hand, low-density lipoprotein oxidation, called ox-LDL, is known to be the most important process in initiating and accelerating the accumulation and deposition of fat in the arteries. The purpose of the present study was to determine the effect of eight weeks of rope training along with Portulaca oleracea supplementation on ox-LDL, Apo-A1, and Apo-B levels in overweight and obese girls.

In the current experimental study, 40 individuals (20-25 yr) volunteered and were randomly assigned into placebo, complement, exercise, and exercise + complement roups. Exercise protocol of rope training was conductcted for 8 weeks, 4 days per week, 45 minutes per day. Participants of exercise + complement and supplemented groups received 1200 mg of Portulaca oleracea supplement per day for eight weeks. Blood samples were taken to evaluate ox-LDL, Apo-B, Apo-A1 serum levels before and after exercise. Data were analyzed running T-test and ANOVA in SPSS, version 20 (p <0.05).

The results showed that in all the three intervention groups, Apo-A1 levels increased significantly (exercise group: p=0.001; supplement group: p = 0.000; supplement + exercise group: p=0.002), and the values of Apo-B (exercise group: p = 0.002; supplement  group: p = 0.001; supplement + exercise group: p = 0.012) and ox-LDL (exercise group: p = 0.009; supplement  group: P = 0.026; supplement + exercise group: P = 0.049) in all three intervention groups decreased significantly.

It seems that the use of non-medical strategies such as aerobic training in the form of rope training and the use of Portulaca oleracea supplementation can be useful in controlling the risk factors associated with overweight and obesity.

The aim of the present study was to evaluate the efficiency and success rate in training air duct piping using laryngoscope video, considering the importance of air duct piping and claiming more success of direct laryngoscope video method with direct laryngoscope.

In the current interventional study, we enrolled 157 medical interns without any intubation experience in the Emergency Department of Imam Hussein Hospital during 2016. Individuals were divided into two groups: the first group, worked with the direct laryngoscopy, and the second group learned to work with the video laryngoscope. To evaluate and to compare the data in two training modalities, the performance of the individuals including seeing vocal cord, proper positioning, correct posture to the moulage, handling and correct insertion of the laryngoscope, and the successful intubation were recorded. All analyses were performed using SPSS, version 19.

Time of intubation and observing vocal cord in the group trained with video laryngoscope was lower than those in the direct laryngoscopy group (23.3±6.8 vs. 28.8±6.4 and 21.9±5.2 vs. 26.9±5.6 sec, respectively; P-value for both=0.001). Furthermore, failure in observing the vocal cords in the direct laryngoscopy group was higher than those in the video laryngoscope group (23.5 vs. 14.5%, P-value=0.217). The percentages of standing in the correct position in the video laryngoscope and direct laryngoscopy group were 85.5 and 66.7%, respectively (P=0.014).

It seems that given the time spent on intubation and the time of observing vocal cord in the group trained with video laryngoscope in comparison with the group who was prepared with a direct laryngoscope, applying video laryngoscope may have better effects in educating medical interns.

Ageing is associated with changes in the function of liver cells and the development of chronic liver disease. According to the theory of free radicals, the process of cellular aging is the result of a mutation caused by active oxygen species, more oxidative stress, and impairment in antioxidant defense of the cell. Exercise with the induction of antioxidant enzymes reduces free radicals and also prevents the aging process from producing free radicals. The aim of the present study was to investigate the effect of two protocols of interval and continuous training on the levels of antioxidant enzymes in the liver of old male rats.

An experimental study was conducted on 21 healthy rats (22-24 months). The rats were randomly divided into three groups: high intensity interval training (HIIT) (n=7), moderate-intensity continuous training (MCT) (n=7), and control group (n=7). A routine interval training program was conducted on a treadmill with an intensity of 80-100% of maximum oxygen consumption and a moderate intensity program with intensity 65-70% of maximal oxygen consumption, 5 sessions per week for 6 weeks. Then, 48 hours after the last exercise session, the liver tissue was isolated on ice and kept at -80 ° C until the test. The supernatant was used to determine the activity of superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase (CAT) enzymes as an antioxidant state for liver tissue homogenization. One-way analysis of variance was used to determine the difference between groups (P <0.05).

Superoxide dismutase enzyme (SOD) and glutathione peroxidase (GPX) were increased significantly in the continuous (P=0.002, P=0.005 respectively) and interval training (P=0.001) groups compared to control group. Catalase was increased significantly in the interval training group compared to the control group (P=0.015).

In general, continuous and interval training increase the level of antioxidant enzymes in old male rats and this increase was more pronounced in high intensity interval training group.

Denervation or compression result in the destruction of the cell body of neurons in the anterior horn of the spinal cord. Environmental nerve damage in the form of retrograde affects the cell body of alpha neurons and causes central degeneration of neurons in the spinal cord. Agrimonia eupatoria from the Golsorkhian family has antioxidant and anti-inflammatory effects and is effective in the survival and division of neurons. Therefore, the present study was conducted with the aim of determining the neuroprotective effects of hydroalcoholic extract of the plant unaffected by neural density after compression of the sciatic nerve in rats.

In the present experimental study, a total of 36 male Wistar rats weighing 250-300 g were randomly divided into 6 groups of 6: control, compression, treatment A (compression + extract at 75 mg / kg dose), treatment B (Compression + ethyl acetate fraction at 75 mg / kg dose), C treatment (compression + N-butanol fraction at 75 mg / kg dose), and D treatment (compression + blue phase with 75 mg / kg dose). Ghafath plant hydroalcoholic extract was prepared using Souxelle method. In the control group, after anesthetizing the rats, the muscle in the sciatic nerve was split without nerve damage and in the compression group and the sciatic nerve treatment group, the right leg was compressed for 30 seconds. The first intravenous infusion was performed immediately after nerve compression and the second infusion was performed seven days later. After 28 days, the rats were subjected to perfusion and then the lumbar spinal cords were sampled, and the samples were serialized after the tissue passage and blockage steps and stained with blue toluidin and erythrosine. Neurotic densities were calculated using directory method and the results were compared running t-test and ANOVA.

The results of comparing neuronal densities between compression and treatment groups showed that all the treatment groups had a significant difference in neuronal density with compression group (P <0.001). Maximum neuronal density was related to n-butanol with a mean of (1864 ± 34), then the group alcoholic ( mean: 1614 ± 29) and the aqueous phase (1597 ± 24) and the Department of ethyl acetate with a mean of 1292 ±33.

It seems that the hydroalcoholic extract of Ghafas plant increases the density of the anterior alpha branch of the spinal cord after compression of the sciatic nerve in male rats, which may be due to compounds such as tocopherol, and with its antioxidant and anti-apoptotic effects can be effective in repairing the nervous system.

Due to the high prevalence of axillary nodules in mammograms, and the importance of hyloum and cortex dimensions  in suspicion to be pathological as well as the role of obesity as a risk factor in breast cancer and prognosis of patients with breast canister, determining the relationship between body mass index (BMI) and the size of the lymph nodes in the exile can affect the approach to the importance of the size of the lymph nodes. The current study was carried out to investigate the correlation between obesity and the size of lymph nodes in angiography in screening mammograms.

In a descriptive study (from October 1996 to September 1997), we examined 204 patients who referred to Mahdieh Educational, Research, and Medical Center for mammography screening. The length and width of the observed axillary nodules were measured. The HCR criterion (hilo-cortical ratio) was calculated. Using independent sample t-test and Fisher's exact test, the association between lymph node and hyloma dimensions, Brest, and Sen density with BMI was investigated. Multivariable linear regression was used to assess the independent association of lymph node dimensions with BMI after adjusting age and brest density. Pearson correlation coefficient was also used to evaluate the inter-rater reliability between the two mammographic commentators.

A strong and significant correlation was observed between BMI and length of lymph node R2 = 0.626), lymph node width R2 = 0.508), helium length (R2 = 0.558), helium width 64 /.= £ and HCR 35 /.= £ all of which are independent of breast age and density. No association was observed between BMI increase and Cortex lymph node thickness. Also, a strong correlation was observed between the increase in helium length and the increase in lymph node length ((R2 = 0.95). Similarly, a strong relationship was found between increase in helium width and lymph node width. Moreover, a significant correlation was found between HCR and BMI (R2 = 0/34).

It seems that the increase in the size of the lymph node is not related to the thickness of the cortex. Lymph nodes may be used in screening mammograms as an obesity biomarker and related pathologies; there is an excellent correlation between the dimensions of lymph node and obesity

One of the concerns in impressioning in dentistry is the marginal adaptation of the restoration which affects the accuracy and precision of the impression. Therefore, the aim of the present study was to compare the effects of conventional and digital impression techniques on the marginal adaptation of zirconia restorations in the classical chamfer preparation design.

In the present experimental study, 20 stainless steel die-casters were fabricated and divided into two groups. In the first group, intraoral scanners were used to taking impression and in the second group, one-step impressioning was carried out using panacil additive silicones. All specimens were cemented on their dies under a pressure of 5 N and their vertical and horizontal gap values ​​were measured using stereo microscope.

The mean vertical gap before cementation in conventional impression group was 47.15 microns and 31.79 microns in digital method. Mann U Whinee test results showed no significant difference between the two groups (P <0.2). Vertical gap after cementation in the conventional method was 80.35 microns and 67.46 microns in the digital group, indicating no significant difference between the two groups (P <0.6). The amount of marginal adaptation was similar regardless of the type of impressioning (p <0.9). The marginal adaptation values in the horizontal dimension in the conventional technique group were 66.97 microns and 53.91 microns in the case group, which were not statistically significant (P <0/8).

The results showed that each of the digital and conventional approaches was within the clinically acceptable ranges in terms of the impact on the marginal adaptation of the zirconia restorations.

There are a few studies in Iran on the relationship between health culture, human papillomavirus, and cervical cancer. In the present study, a pathological investigation was carried out in health culture focusing on Human Papillomavirus (HPV) diseases.

In a cross-sectional study, using mixed method design, 220 patients were studied. In the qualitative study, the grounded theory was used. Data were collected using in-depth interviews with 20 (10 men and 10 women) authorities. Finally, the paradigm model was presented.

Knowledge, attitude, and practice of the studied population were evaluated to be at good level (P = 0.001). Also, women's knowledge was significantly higher than men's (P = 0.04). The existence of a cultural problem related to the prevention of sexually transmitted diseases was regarded as the dominant paradigm of the society. Incompatibility of information with growth of children, increasing age of marriage, decreasing age of puberty, increasing information exchange, increasing population, increasing migration, changing economic conditions, disruption of parent-child relationship as causal factors, lack of safe and restrictive approach, failure to achieve a minimum consensus on the management system, lack of decision-making based on dynamic experties, lack of authority among clergymen, lack of elites and religious leaders on the issue, lack of awareness of existing capacities as interventionists, and a spirit of diversity, coping with individual humiliation, lack of awareness, this problem being a managed project, weakening the spiritual spirit, and the rise of materialism were the contextual factor, which have resulted in a decrease in STD control based on a program consistent with the country's culture.

Existence of the cultural problems related to preventing sexually transmitted infections is the dominant paradigm of the society.

The number of rhinoplasty surgeries has increased dramatically in the past decades in Iran. Researchers have analyzed different affective variables considering this growth, but a less talked subject is the psychological role in this surgery’s applicants. This research was performed to investigate the effects of physical appearance perfectionism and unconditional self-acceptance and life quality on the prevalence of applying for rhinoplasty surgery.

  The study was performed using case-control method on 73 women asking for rhinoplasty with an age range of 20-35 years and 73 women not applying for rhinoplasty with the same age range as the control group. Both groups were selected from patients of five ENT doctor offices in Tehran. All candidates were analyzed using body dismorphic disorder scale proposed by Yale-Brown. Those with positive results were removed from the research. Both groups were evaluated using physical appearance perfectionism survey (PAPS), Unconditional self-acceptance query (USAQ), and short life quality form (SF-36).

The age of requesting group was 27.5 ± 5.2 years and the control group 26.9 ± 4.4 years. Both groups were similar in gender and education, economical, and social status. Scores of physical appearance perfectionism in case group was 8±6/38 and 9±2/33 in control group (P<0.01). There was a difference between Unconditional Self-acceptance query and life quality between the two groups (P<0.05).

It seems that physical appearance perfectionism, unconditional self-acceptance, and life quality have roles in demanding for rhinoplasty surgery.

Four of the most important morphometric parameters of distal end radius (DER) are Radial inclination, Ulnar variance, Palmar tilt, and Radial length. Measurement of these parameters are applicable in the diagnosis and treatment of the injuries around the wrist and distal part of the forearm, namely fractures and dislocations. The current study was designed and executed to measure the morphometric parameters of the DER in patients referred to Aban hospital located in Tehran.

A single hospital-based cross-sectional study was conducted on 100 patients (50 male and 50 female) referred to ’Aban’ Hospital in Tehran from July 2017 to August 2017 for the radiography of the wrist and DER. Since the data was not normally distributed, Mann-Whitney test was used for data analysis, and the level of significance was considered less than 0.05.

A total of 100 radiographic images were included in the present study (male= 50, female= 50). Participants' age range was between 18-62 years with an average of 38/5 years. The average values of radial inclination, radial length, and ulnar variance were 17.5° ± 5.3, 10.04 mm ± 2.6, and 3.6 mm ±1.8, respectively.

No significant difference was found between the average size of the distal radius end morphometric parameters between the right and left side and the two sexes.

Intravenous thrombolysis is an approved treatment method for patients with acute ischemic stroke and is recommended by multiple guidelines. However, it seems that it is less frequently used in the developing countries compared to the developed countries. The purpose of the present study was to estimate the percentage of patients with acute ischemic stroke, eligible for intravenous thrombolytic therapy, at Loghman Hakim hospital, Iran, and also to determine the main barriers for implementation of this method.

In the current descriptive study, 586 patients with acute ischemic stroke at Loghman Hakim hospital in 2018 were enrolled. Frequency of patients who missed thrombolytic therapy and the causes were recorded. SPSS, version 19, was used for data analysis.

From among 586 patients with acute stroke, delayed referral in 444 patients (76%), multiple contraindications to receive tissue plasminogen activator in 44 patients (31%), followed by minor or recurrent stroke in 35 Patients (25%) were the main barriers to receive tissue plasminogen activator in patients.

The major barriers for thrombolytic therapy in patients with acute ischemic stroke in this setting were delays in hospital arrival. Increasing patient information about the importance of referral to health centers in time has the most prominent role in increasing the use of thrombolytic therapy in patients with stroke.

The current survey aimed at structural evaluation of Ph.D. and MSc theses at the School of Medicine, Shahid Beheshti University of medical sciences in 2018, based on the ISO 7144 to determine if the required frameworks were considered.

In the present descriptive research, 66 Ph.D. and MSc theses at the School of Medicine, Shahid Beheshti University of Medical Sciences were surveyed following content analysis. A list of ISO standards and their multiple indicators based on the last edition of ISO 7144 was the main tool for the purpose of data collection. The surveyed standards include: structural and physical form, contents page, abstract, Chapter 3, Persian foot note, pictures, tables and charts, and resources. Data obtained were checked for their agreement with ISO 7144 using frequency table, Percent, Min, Max, Mean and standard deviation in SPSS, version 25.

The degree of structural compliance was found to be 68% with PhD disertations showing more compliance (p<0.05). In Ph.D. studies, chapter 3, pictures, tables and charts and abstract were among the more considered (very High) items compared to other items of international standards and the least considered (very little) items were structure, resources and contents page. In MSc theses, grade pictures, tables and charts, contents page, and chapter 3 were among the more considered (very High) items compared to other items of international standards and the least considered (very little) items included resources, abstract, and the structure.

It seems that the overall structural compliance rate is acceptable but lack of some indicators is a concern; thus, trainings are recommended to improve the structure of these theses.

Kidneys are the vital organs of the body. Left and right renal arteries supply blood to them. Variations are common in the pattern of kidney vessels and this variety includes the accessory and aberrant renal artery.

During routine dissection of an approximately 65-year-old male cadaver, we observed that below the origin of the left main renal artery, an accessory renal artery originates from the abdominal aorta and enters the left renal hilum. Also, the left main renal artery is divided into anterior and posterior trunks before entering the hilum, that the anterior and posterior trunks are divided into three and two branches, respectively.

Awareness of anatomy and variations associated with the kidney, such as the presence of an accessory renal artery, is of great clinical importance and helps surgeons and specialists during surgical and medical procedures.