مجله علوم پزشکی رازی
سال بیست و سوم شماره 8 (پیاپی 149، آبان 1395)

All-trans retinoic acid (ATRA) has a variety of biological activities, including immunomodulatory action in a number of inflammatory and autoimmune diseases. The purpose of this study was to investigate the effects of all-trans retinoic acid on the treatment of autoimmune diabetes in mice and its effects on expressions of Peroxisome Proliferator-Activated Receptor gamma (PPARγ) gene.
Diabetes was induced by multiple low-dose of streptozotocin (MLDS) injection (40mg/kg/day for 5 consecutive days) in male C57BL/6 mice. After induction of diabetes, mice were treated with ATRA (20mg/kg/day i.p.) for 21 days. Blood glucose level was measured in 0, 7, 14 and 21 days after Streptozotocin induction induced diabetes. Splenocytes were tested for cytokines production by ELISA and Immune changes in spleens were tested by semi-quantitative RT-PCR. One-way analysis of variance (ANOVA) followed by Tukey’s test were used for comparisons between groups. P ATRA treatment prevented hyperglycemia in the diabetic mice. ATRA treatment also significantly inhibited the production of proinflammatory cytokines interleukin 17 (IL-7) as well as interferon gamma (IFN-γ) while increased the level of anti-inflammatory cytokine IL-10 and upregulation of peroxisome proliferator-activated receptor gamma (PPARγ) gene expression in spleens as compared with those in diabetic control group.
In conclusion, these findings indicate that ATRA may have a therapeutic effect against the autoimmune destruction of the pancreatic beta-cells during the development of MLDS-induced type 1 diabetes in mice.

Today, e-learning to patients is done more easily and more attractive along with text, audio, image and video as a new training method. But despite of many advantages of e-learning effectiveness in self care, it is observed in practice that in clinical settings and even educational environment performance of professional individuals is not appropriate in patient education. And due to lack of awareness among patients of the disease and its process, leads to patient readmission. This study aimed to literature review the necessity of E-learning application and its effectiveness in self-patient's care.
This study is a narrative review and searching in ERIC, Pubmed, Irandoc, Iranmedex, SID (Scientific Information Database), Magiran databases and Google Scholar search engine, with the keywords of Education, Effectiveness, Electronic, Patient, self Care was performed by two evaluators between 2000 and 2015. Among 87 articles, 24 valid and related articles were enrolled.
Patient education should be done with the aim of making them more independent in regarc to self-care. Patient related factors including choice of location and time of training, motivation and readiness for learning, cultural situation, socio-economic status, level of acceptance, level of understanding and education, easy interaction with their caregiver and factors related to the educational system, including the performance of-care systems, allocation of facilities, appropriate and skilled human resources, time and facilities allocation, necessity to identify audiences and their specific needs is emphasized. However, factors such as inadequate support and advanced age of patients, low literacy in developing countries, inadequate training and irregular follow up reduce the effectiveness of this method.
Training health personnel is essential for E-Learning. Also providing opportunities for interactive communication with patients and patient education for using e-learning system with content presentation is necessary.

The evidence showed increased sleep problems and reduced sleep quality in women. This study aimed to investigate the effect of rhythmic aerobic exercises on sleep quality in sedentary young women.
24 sedentary healthy young women were randomly assigned in two exercise training (n=12) and control (n=12) groups. Participants sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The training protocol includes sessions between 50 to 60 minutes at 60 to 80 percent of maximum heart rate, three sessions per week for eight weeks. The data was processed by using SPSS version 22 and Independent and dependent t-test.
findings showed a significant increase in sleep quality and Sleep efficiency in training group (P=0.000, P=0.000; respectively). Also, Sleep latency, Sleep disturbances and Day time dysfunction decreased significantly in training group (P=0.032, P=0.007, P=0.006; respectively). Eight weeks rhythmic aerobic exercises led to significant increase in sleep quality and Sleep efficiency and significant decrease in Sleep disturbances and Day time dysfunction in training group as compared to control group (P=0.000, P=0.000; P=0.001, P=0.029; respectively).
according to the results of present study, Regular participation in rhythmic aerobic exercises, led to improve sleep quality and reduce sleep disturbances in sedentary young women. Hence, it is suggested rhythmic aerobic exercises as an effective strategy to improve sleep quality in sedentary young women to be used.

Human gene therapy has attracted increasing attention as a highly encouraging therapeutic approach to treat wide variety of diseases, other than genetically inherited and monogenic disorders. This approach entails the introduction and expression of a variety of nucleic acids into human target cells for therapeutic purposes. In this article, we review the history, highlights, recently progresses and future of gene therapy approaches.
The first gene therapy clinical trial was successfully performed in 1990s for treating an inherited genetic disorder, Severe Combined Immunodeficiency (SCID). Subsequently, the number of gene therapy clinical trials was exponentially continued to increase over the years. However, the initial results of these trials did not meet expectations.
In the last decade, due to improvements in the gene transfer vectors, the dreams of treating severe immunodeficiency and genetic disorders and cancer by gene therapy products is again closer to reality. Before gene therapy becomes an extensively accepted approach for treating wide range of diseases, some limitative intracellular and extracellular barriers need to be overcome. Currently, a wide range of gene delivery vectors have been developed to do this. A number of safe viral vectors and non-viral methods were innovated and used for successfully treatment of some inherited and immune deficiencies, ocular diseases and cancer. Viral gene delivery vectors are appropriate for gene therapy purposes which are based on long-term gene expression. Although, non-viral vectors are less efficient than former in gene transduction, they have utilities owing to their high target cell specificity, low immunogenicity and ability to transfer large size genes.
In conclusion, recent progress in the gene therapy approaches is somewhat realizing expectancies made many years ago, providing bright hopefulness for further achievements in the next years. Gene therapy appears to be final selective approach for the treatment of many human diseases in this century.

Umbilical cord blood has been increasingly used as an alternate source of hematopoietic stem cells in the treatment of Hematologic malignancies and life-threatening diseases. The success of engraftment and survival of patients after cord blood transplantation highly depend on either the number of infused total nucleated cells (TNCs) or the number of CD34 cells per kilogram of recipient body weight. A standardization procedure for cord blood (CB) storage before and during cryopreservation is critical. This work is concerned with the effect of CB storage temperature and storage duration through the stages before cryopreservation on cell recovery, viability, aggregation of cells.
Total of 30 CB samples were casual collected from Tehran hospitals and remittances to cord blood bank. Total cells and viability were calculated and aggregation was evaluated. Each sample divided to 4 sample and stored at 4ᵒC, 12 ᵒC, 22 ᵒC, and 37 ᵒC for different periods of time after 12, 24, 48 and 72 hours. Total cells and viability were calculated and aggregation was evaluated. Subsequently, these results were evaluated with ANOVA methods.
At the beginning of the experiment, the total number of cells was 5-10 million/ml. All the specimens were investigated after 24 hours. At 4 cº a decrease in the number of viability cells was observed that was statistically significant with a p0.005). A significant drop (p This study shows that the vulnerability level of cells outside the body from cord blood collection till separation and freezing is directly correlated with storage time and temperature, which is statistically significant with a p

It is well known that healthy and cancer cells are different in energy consumption. These differences lead to small changes in local temperature, so infrared thermal imaging (thermography) are applications for diagnosis of several types of cancer such as breast cancer. There are some problems in our country such as a variety of cultural and religious issues to take sample thermal images of the breast, so it is time consuming procedure to take samples. For verification of cancer detection algorithm from thermal images, its necessary to simulate the thermal profile of the breast as a database .One way to achieve optimal database is using thermal images of breast tissue that is simulated by computer.
Doing this needs some steps, first we used statistical software to achieve point of breast volume, and then we meshed this volume by using Gambit software. In the next step the volume that was created, was entered into the Fluent software in order to simulate normal breast, finally tumor with 2 cm diameter was put in certain depth (6 cm) with simulation thermal images of abnormal breast. Also, this tumor was put in different depth and evaluated the temperature changes on the surface.
It clearly shows that the tumor had considerable influence on the simulated thermal profile of the breast. It is possible to simulate various types of breast without any modern heat equipment and verifying validation of diagnostic algorithms.
Simulations of thermal profiles show that tumor, disrupts the heat distribution on the surface of the breast.

The junk food consumption is current between students. As this consumption pattern continue in adulthood and is related to appearance of chronic disease, so the present study examined the impact of education on the basis of the theory of planned behavior on junk food consumption among male students in level 8 in 2015 in Chenaran.
This survey was a quasi-experimental study with participating 50 male students in level 8 in Chenaran were randomly selected and divided in to control and test groups. Data were gathered through using a questionnaire. Variables were evaluated before and immediately and 1 months after intervention. Finally, the data were analyzed by spss statistical software (version 18)and descriptive and analytical tests.
After intervention there was decrease in junk food consumption, there fore there was significant difference in control group before and after intervention. There fore before intervention 20% of students were in low- consumption group, 56% in middle- consumption group and 24% in high - consumption group, since after intervention 64% of students are in low- consumption group, 20% in middle- consumption group and 16% in high - consumption group. There were no significant differences between two group regarding constructs of TPB in the pretest period. However after intervention significant change in awareness score (from 4.72±2.48 to 6.40±2.29),(p‹0.001), subjective norms(from 10.56±2.87 to 13.36±3.98),(p=0.001), perceived behavioral control (from 14.88±3.19 to 17.24±3.13),(p=0.001) and intention(from 6.12±1.42 to 7.24±2.24),(p=0.004), was seen in intervention group. But there was no significant change in the attitude score.
Due to the high consumption of junk food in between students and effectiveness of educational interventions of this study in decrease junk food consumption , so implementing educational interventions based on theories especially of planned behavior is essential.

Many evidences have shown that aerobic exercise can alter the function and release certain neurotransmitters such as opioids in the brain. In this research, the effect of endurance exercise (running on a treadmill for six weeks) and oral magnesium sulphate on pain threshold of addicted rats following withdrawal syndrome was investigated.
In this study male wistar rats weighting 250±20g were used. Morphine sulphate 0.4 grams per liter was added to the animal’s water and after 21 days they were addicted to morphine. Endurance exercise training was used to train animals for six weeks. At the end of the second, fourth and sixth weeks of exercise protocol, naloxone hydrochloride were injected at a rate of 3 mg/kg. Magnesium sulphate 10 grams/liter was dissolved for six weeks in drinking water of animals that were taking magnesium sulphate. A tail-flick apparatus were used to evaluate the effect of exercise and magnesium sulphate on pain threshold.
Results showed that treadmill running exercise (p According to the findings of this study, it seems that the effect of exercise can be potentiated with magnesium sulphate and may be helpful to ease the pain at withdrawal period.

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease characterized by death of motor neurons leading to devastating muscle weakness and wasting and weight loss. It causes mixed picture of lower motor neuron (LMN) and upper motor neuron (UMN) dysfunction. The wide spectrums of atypical presentations can frequently lead to expensive work-up and undue delay in diagnosis of ALS. Occasionally, brain MRI of ALS patients shows some lesions in white matter. Moreover, cerebrospinal fluid (CSF) analysis demonstrates oligoclonal bands (OCB) in a few subjects. Because of the UMN signs, brain white matter lesions and presence of OCBs in CSF, ALS can be misdiagnosed as Multiple Sclerosis (MS).Also, some findings in ALS mimic central nervous system (CNS) vasculitis. We are reporting a case of ALS in a 48-year-old man presenting with subacute progressive spastic diparesis and brain white matter lesions which was initially misdiagnosed by MS and CNS vasculopathy.

Iron deficiency is the most common nutritional deficiencies in the world. So that 15% of the total world population is involved. The present study examined the association between iron deficiency anemia and primary hypothyroidism and the prevalence of iron deficiency anemia and primary hypothyroidism, respectively, in patients with iron deficiency anemia and primary hypothyroidism.
This cross-sectional descriptive study was done on 50 patients. The patients were divided in two groups. First group as iron deficiency anemia patients were tested for hypothyroidism. The Second group hypothyroidism patients were tested for iron deficiency anemia. For all the patients, laboratory tests were performed to confirm hypothyroidism and iron deficiency anemia.
Total of 24 patients with hypothyroidism, 12 cases (50%) patients were found with iron deficiency. The rate of iron deficiency is 15% in normal population. Total of 26 patients with iron deficiency anemia 8 cases (30.8%) patients found with hypothyroidism. The rate of hypothyroidism is 5% in normal population. This study revealed that co-incidence of these two diseases in two groups of patients is higher than normal people.
According to the results obtained in this study high prevalence of primary hypothyroidism in patients with iron deficiency and the high prevalence of iron deficiency in patients with primary hypothyroidism were found. It seems that the primary hypothyroidism and iron deficiency are connected with each other. However, it is recommended to perform similar study in a larger scale in order to demonstrate the strong relationship between the two diseases.

Dyslipidemia is a major problem in T2DM causing atherosclerosis diseases. We investigated the relationship between CETP Taq1B polymorphism and HDL-c concentrationsconsidering dietary fat intake in Tehranian dyslipidemic and normolipidemic T2DM patients.
Material and In the presentcross-sectional study 184 T2DM patients were investigated. We used FFQ questionnaire, anthropometric measurements and biochemical tests. PCR-RFLP was used todetermine polymorphism. We performed Chi-square and ANOVA and ANCOVA for statistical analysis.
The frequency of B1B1 genotype was significantly different according to patients’ lipid profile status (P=0.01). There was no significant relationship between genotype and HDL-c concentrations. The interaction between CETP Taq1B polymorphism and total fat intake was significant in normolipidemic patients (Pinteraction= 0.02). There were no such a relationship in dyslipidemic patients. In addition, patients with B2B2 genotype and low total fat intake had significantly higher HDL-c concentrations in comparison with B1B1 genotype (P=0.03).
Patients with B1B1 genotype were more likely to be dyslipidemic. The relationship between CETP Taq1B polymorphism and HDL-c concentrationswas affected by dietary total fat intake in normolipidemic T2DM patients.