مجله دانشکده پزشکی اصفهان
پیاپی 480 (هفته چهارم تیر 1397)

Today, the use of a combination methods to increase the effectiveness of treatment is considered very much. One of these methods is the use of X-rays in the presence of nanoparticles. In this study, the effect of 6-MV X-ray radiation on the viability of HeLa cells, in the presence of gold nanoparticles, was investigated.
HeLa cells were cultured and divided in four groups including control, gold nanoparticle, X-ray, and X-ray in presence of gold nanoparticle. In the gold nanoparticle group, the cells were incubated with 0.2, 1, and 5 μg/ml for 24 hours. In the X-ray group, the cells were exposed to X-ray with energy of 6 MV, and doses of 0.5, 1, and 2 Gy. In the group of X-ray in presence of nanoparticles, the cells were first incubated with nanoparticles for 24 hours, and then exposed to X-ray radiation under the same conditions. The viability of cells was measured using MTT assay at 24 and 48 hours after the intervention.
Findings: In the group of X-ray in the presence of nanoparticles, the viability of the HeLa cells reduced up to 50% at both 24 and 48 hours, in different concentrations. With the increase in concentration in a certain dose, cell survival could change up to 15%, but dose change was only significant in 2 Gy compared to other doses.
The viability of the HeLa cells during X-ray radiation, in the presence of gold nanoparticles, has a significant reduction. It can be concluded that simultaneous use of gold nanoparticles and X-ray increases cell death.

Epilepsy is one of the major and common neurological disorders. It has been observed that physical activity can be a complementary therapy to treat seizures. Nevertheless, studies regarding the effects of physical activity on epilepsy are largely performed on males, and there is little information on the extent of these effects in females, especially during pregnancy; since it appears that seizures during pregnancy have adverse effects on development of the offspring. The present study was designed to investigate the effect of aerobic training during pregnancy on pentylenetetrazol (PTZ)-induced seizure in mice.
The kindled female mice were divided into 4 groups; 1. the pregnant mice treated with pentylenetetrazol between the fourteenth and nineteenth days of pregnancy once in 48 hours, without physical training during the pregnancy; 2. the pregnant mice treated with pentylenetetrazol between the fourteenth and nineteenth days of pregnancy once in 48 hours, with moderate-intensity aerobic training during pregnancy between 1:00 and 3:00 p.m.; 3. the non-pregnant mice treated with pentylenetetrazol in yoked days with pregnant mice group and without physical training; and 4. the non-pregnant mice treated with pentylenetetrazol in yoked days with pregnant mice group with moderate-intensity aerobic training between 1:00 and 3:00 p.m. The seizure activity was measured for half an hour after pentylenetetrazol injection.
Findings: The aerobic training reduced seizure severity in female mice; and there was no difference in seizure severity between pregnant and non-pregnant mice.
These findings revealed that middle-intensity aerobic training could be a complementary therapeutic strategy to reduce the severity of seizure, especially in pregnancy.

Early diagnose of Parkinson's disease has been possible by using neuro-QWERTY index, a computational algorithm for analyzing users’ interactions with a computer keyboard. This research was devoted to study the reliability of neuro-QWERTY index; as detecting the reliability is necessary to clear the usefulness of diagnostic and screening tests.
Early Parkinson's disease database, which was used in aggregated format by Giancardo et al. in 2016 to introduce neuro-QWERTY index, and to assess its validity, was used in this study in original format to assess the test-retest reliability of neuro-QWERTY index. Intraclass correlation coefficient (ICC), Bland-Altman plot, and coefficient of repeatability (CR) were used for statistical analyses. Moreover, using DeLong’s statistical test, area under curves (AUCs) of receiver operating curves (ROCs) was compared for test and retest scores, and their average scores.
Findings: Intraclass correlation coefficient was 0.94, with a 95% confidence interval (CI) of 0.89 to 0.97. Bland-Altman plot showed that differences between test and retest scores were small. Coefficient of repeatability was 0.04, with a 95% CI of 0.03 to 0.05. The area under curves were 0.89, 0.90, and 0.92 for receiver operating curves of test score, retest score, and their average score, respectively. Differences between the areas under curves of receiver operating curves were not significant (P ≥ 0.25).
Neuro-QWERTY index have a good reliability. Therefore, it could act as a suitable candidate for screening of Parkinson's disease, considering simplicity and inexpensiveness of its measurements, no side effects, good validity in terms of sensitivity and specificity, and as shown in this study, its acceptable reliability.

The combinations of sedative and analgesic drugs are used commonly in pediatric patients with hematological malignancies undergoing painful procedures. In this study, we aimed to compare the sedative effect of combinations of ketamine-sufentanil and propofol-remifentanil in pediatric patients with hematologic malignancies undergoing bone marrow aspiration and biopsy.
In this randomized, double-blinded clinical trial study, 82 pediatric patients with hematologic malignancies with indications of painful procedures were enrolled according to inclusion and exclusion criteria. Patients randomly were allocated into two parallel groups. The first group underwent anesthesia with ketamine-sufentanil (sufentanil 0.5 µg/kg, and ketamine 1 mg/kg), and the second group with propofol-remifentanil (propofol 1 mg/kg and remifentanil 1 µg/kg). Hemodynamic features of sedation, as well as side effects, the time of starting the efficacy, and the time of staying in recovery room were compared between the two groups.
Findings: There were significant differences between the two groups in movements that needed repeating doses of sedative drugs, pain based on visual analogue scale (VAS), and sedation scale based on the University of Michigan Sedation Scale (UMSS). Besides, there was no significant difference between the two groups according to side effects.
Combination of ketamine-sufentanil and propofol-remifentanil are appropriate for sedation in the pediatrics undergoing diagnostic and therapeutic procedures such as bone marrow aspiration, bone marrow biopsy and intraspinal injection; but the combination of ketamine-sufentanil is better than propofol-remifentanil in pain relief, decreasing movements, and the need for repeating doses.

Chronic functional constipation is one of functional gastrointestinal disorders. Constipation has negative impact on quality of life (QOL). Pharmacological and non-pharmacological treatments are considered for constipation. This study was designed to compare the efficacy of polyethylene glycol (PEG) and abdominal massage on symptoms and quality of life improvement in functional constipation.
In this randomize clinical trial study, all the patients with functional constipation, based on Rome IV criteria, with age of 18-65 years, who referred to gastroenterology clinic of Rasoul-e-Akram university hospital, Tehran, Iran, were enrolled. The patients were randomly assigned to two groups of treatment with polyethylene glycol or abdominal massage. Basic demographic data, Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire, Bristol score, and presenting symptoms were recorded. We visited our patients in 2 weeks at the end of treatment and 2 weeks after completing treatment. Drug adverse effects and patient's adherence to treatment were recorded in data gathering sheets, too. The data were compared between the two groups using SPSS software.
Findings: 94 patients (47 patients in each group) completed the study. Constipation was more common in women, and low income, educated, and married patients. No significant difference was seen in demographic data between the groups. Quality of life score was significantly better in polyethylene glycol therapy than abdominal massage (P = 0.028). Moreover, symptoms (P = 0.032) and Bristol score (P Abdominal massage is a non-surgical non-medical modality for treatment of functional constipation. It is feasible, without any cost and adverse effect; but it is not an effective modality, lonely. Further studies should be considered to combine abdominal massage with other treatment modalities in these patients.