مجله دانشگاه علوم پزشکی گرگان
سال بیست و یکم شماره 2 (پیاپی 70، تابستان 1398)

Generalized anxiety disorder is a prevalent, chronic and disabling mental disorder. This study was done to compare the effectiveness of mindfulness based on stress reduction therapy and neurofeedback training on the clinical symptoms of individual with generalized anxiety disorder. This clinical trial study, was done on 20 individual with generalized anxiety disorder referring to counseling centers in the city of Neyshabur in north-east of Iran during 2017. The subjects were randomly divided into mindfulness based on stress reduction therapy and neurofeedback training. The first group participated in 8 sessions of mindfulness based on stress reduction, while second group participated in sessions of neurofeedback training. The participants completed generalized anxiety disorder 7-item scale, Penn state worry questionnaire, intolerance of uncertainty scale and metacognition questionnaire. Both the two methods were effective the reducing the generalized anxiety disorder symptoms, worry, negative belief about worry and intolerance of uncertainty (P<0.05). There was no significant difference between mindfulness based on stress reduction therapy and neurofeedback training in reducing the generalized anxiety disorder symptoms, worry, negative belief about worry and intolerance of uncertainty. Both of the two methods including the mindfulness based on stress reduction therapy and neurofeedback training are effective in reduction of the symptoms of generalized anxiety disorder.

Diabetic mellitus nephropathy is one of the most important implication factors in kidney´s physiological function in diabetes mellitus. Having major role in filtration, in hyperglycemic condition kidney has shown more damages in comparison with other tissues. This study was done to determine the effect of combined Atorvastatin and Zinc oxide on the biochemical and histopathological alterations in kidney of diabetic rats. In this experimental study, 40 female Wistar rats were randomly allocated into five groups including normal control (NC), diabetic control (DC), diabetic rats treated with atorvastatin (20mg/kg/bw daily, orally) (D+A), Zinc oxide (30mg/kg/bw daily, orally) (D+Z) and combination of each drug in half dose (daily, orally) (D+A+Z). Diabetes induced in rats by a single intraperitoneal injection of 60mg/kg/bw streptozotocin-diabetic.Animals treated for one month. At the end of the study, kidney weight and body weight and biochemical factors including creatinine and urea were measured to assess renal function. For determing the histopathology of kidney tissue, sections with 4-5 micrometer were stained with hematoxylin and eosin. The level of serum creatinine and urea was significantly increased in diabetic rats in compare to controls (P<0.05). Treatment of diabetic rats with half doses of combination of atorvastatin and Zinc oxide reduced the level of creatinine, urea and renal tissue damage in comparision with diabetic rats without treatment (P<0.05). This study showed that the combination of atorvastatin and Zinc oxide has effect on controlling diabetic nephropathy.

Hyperlipidemia and high level of serum total cholesterol are risk factors contributing to prevalence and severity of cardiovascular complications like coronary heart diseases. Lamiaceae plants have terpenoids and flavonoids can reduce triglyceride and cholesterol, therefore. This study was done to evaluate the effect of feeding with essential oil of Thymus deanensis Celak. on lipid profile, blood urea and liver enzymes in hyperchlostrolemic male Wistar rats. This experimental study was performed on 36 male Wistar rats. Animals were randomly divided into 6 groups (there were 6 rats in each groups). The groups including control, sham, two groups receiving 200 and 500 ppm Thymus deanensis essential oil and hyperchlostrolemia groups treated with doses of 200 and 500 ppm of Thymus deanensis essential oil. Hyperchlostrolemia was induced by giving high cholesterol (2%) and sweet almond oil (97.5%) diet. The animals were treated for 32 days with essential oil of the thyme. At the end of the 32-day trial, blood sampling was performed. Total cholesterol, triglyceride, urea and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) liver enzymes were measured. The level of ALT and AST in hypercholesterolemia rats were significantly increased in comparison with the control group (P˂0.05). Thymus daenensis essential oil significantly reduced level of triglycerides and cholesterol (P˂0.05). The high dose of Thymus daenensis (500 ppm) essential oil more than a low dose (200 ppm) significantly reduced the level of cholesterol and triglyceride (P˂0.05). Blood urea nitrogen significantly increased in hypercholesterolemia group in compare to control group (P˂0.05). After the administration of essential oil with a minimum and maximum dose in hypercholesterolemia rats, the level of urea in the blood significantly decreased (P˂0.05). The level of ALT and AST in hypercholesterolemia rats significantly increased in comparison with the control group (P˂0.05). AST level significantly reduced in the groups of rats which received minimal and maximal doses compared to the group hypercholesterolemia (P˂0.05). By lowering blood lipids, urea and liver enzymes after the use of essential oils, it seems that the Thymus daenensis dose-dependent is effective in improving liver function, kidney and high level of  lipid.

Aging is associated with increased free radical production. On the other hand, sports activities with the improvement of antioxidant system can reduce the damage caused by aging. This study was performed to determine the effect of the coantinus training (MCT) and high intensity interval training (HIIT) on antioxidant enzymes in the heart of old rats. This experimental study was performed on 24 male Wistar rats aged 22-24 months. After two weeks of adaptation, animals were allocated into three groups including HIIT (8 rats: 100-80% maximum speed), MCT (8 rats: 65-70% maximum speed) and control group (8 rats the control group did not receive any intervention during the study. The training protocol was performed 5 days in week for 6 weeks. The heart tissues of rats were extracted 48 hours after the last training session. Gene Expression of superoxide dismutase (SOD) and glutathione peroxidase (GPX) was analyzed by the ELISA test. SOD was significantly increase in MCT (41.26±3) and HIIT (48.8±6) groups in compare to control (22.62±2) (P<0.05). GPX was significantly increased in MCT (1.96±0.07) and HIIT (2.28±0.03) groups in comparision with controls (1.37±0.04) (P<0.05) and this increase was higher in the HIIT group than in continuous training group. Continues training and high intensity interval training increase the amount of antioxidant enzymes in heart tissue of aging rats.

Fenvalerate is a component of the pyrethroid pesticide induces oxidative stress. This study was done to determine the effect of garlic extract (GE) and N-acetylcysteine (NAC) against fenvalerate-induced oxidative stress in the serum and testis tissue of rat. In this experimental study, 42 Wistar rats were randomly allocated into 7 groups including: control group, sham group (normal saline), the first experimental group receiving NAC (80 mg/kg/bw), the second experimental group receiving fenvalerate (10 mg/kg/bw), the third experimental group receiving fenvalerate (10 mg/kg/bw) + garlic extract (40 mg/kg/bw), the fourth experimental group receiving fenvalerate (10 mg/kg/bw) + NAC (80 mg/kg/bw) and the fifth experimental group receiving fenvalerate (10 mg/kg/bw) + garlic extract (40 mg/kg/bw) + NAC (80 mg/kg/bw). Injection of fenvalerate was performed intraperitoneally for 7 consecutive days in animals of intervention groups. Afterwards, for 10 consecutive days, NAC and garlic extract were injected. In this study, 1/40 LD50 fenvalerate was used. The activity of the catalase (CAT), glutathione S-transferase (GST), malondialdehyde (MDA) and total antioxidant capacity (TAC) were determined in serum and testis tissue in all animals. MDA level of serum and testis tissue in fenvalerate group increased significantly compared to the control group (P<0.05). The injection of NAC and garlic extract alone (P<0.05) as well as garlic extract in combination with NAC reduced MDA level of serum and testis tissue compared to fenvalerate group (P<0.05). Serum TAC level was significantly reduced in fenvalerate group compared to control (P<0.05). Serum TAC level was significantly increased in fenvalerate + GE group, fenvalerate + NAC group and fenvalerate + GE + NAC group compated to the fenvalerate group (P<0.05). GST activity of serum was significantly increased in fenvalerate group compared to control (P<0.05). GST activity of serum was significantly reduced in NAC, garlic extract and combination of NAC and garlic extact groups compared to fenvalerate group (P<0.05). In this animal model study, low dose (10 mg/kg/bw) fenvalerate induces oxidative stress. Garlic extract and N-acetylcysteine (alone and in combination) improve injures caused by fenvalerate.

Age is the greatest risk factor for cardiovascular disease that is associated with shortens telomere. TRF2 and TERT genes expression in heart tissue   reduce in elderly. These geness are associated with shortens telomere. Exercise can play a useful role in maintaining the length of telomeres. This study was carry out to determine the effect of high intensity interval training (HIIT) and continuous endurance training on TRF2 and TERT gene expression in heart tissue of aged male rats. In this experimental study 24 adult aged male rats (88-96 weeks, 363±12 g) allocated into three groups including control, endurance training (5 sessions per week: with 60-70 of maximum speed of group) and HIIT (5 sessions per week: 80 percent in the first and second week, 90% maximum speed of the third week, 100 % until the end of the exercise for 6 weeks). Gene expression of TRF2 and TERT were assessment by Real-time - PCR and the quantification of gene expression levels using the Pfaffl formula. TRF2 gene significantly increased in HIIT and CET groups in compared to control group (P<0.05). TERT gene non- significantly increased in HIIT and CET groups in compared to the control group. It seems, 6 weeks of high-intensity interval training and continuous endurance training to be able regulate the growth and longevity of the heart cells by maintaining the length telomere by increasing TRF2 gene expression.

The resin secretions of Cannabis sativa are called Hashish, which has medicinal and psychological properties. The most important psychoactive compound of this plant is THC (Delta-9-Tetrahydrocannabinol), which can stimulate cannabinoid receptors in the body. This study was carried out to evaluate the effect of hydroalcoholic extract of Cannabis sativa on cell survival and osteoblastic differentiation of human mesenchymal stem cells. In this experimental study, mesenchymal stem cells derived from fat tissue of human abdominal were treated with 100 ng/ml concentration of hydroalcoholic extract of Cannabis sativa. Flow cytometry and RT-PCR techniques were used for detection of cells. The cytotoxic effect of Cannabis sativa extract and osteoblastic differentiation of cells were investigated using MTT method and Alizarin-Red staining, respectively. The karyotype analysis was performed with the preparation of extended metaphase chromosomes. The identity of the fat mesenchymal stem cells was confirmed by the expression of non-hematopoietic mesenchymal markers (CD90, CD44 and CD73) and the lack of expression of the hematopoietic marker (CD34 and CD45). The Alizarin-Red showed that the treatment with Cannabis sativa has no effect on the osteoblastic differentiation of human fat mesenchymal stem cells, and the treated cells were differentiated into bone cells same as control group. Also, Cannabis sativa extract has no effect on the structure, morphological status and number of chromosomes of these cells. This study showed that human fat mesenchymal cells in the presence of a hydroalcoholic extract of Cannabis sativa maintain the ability of osteoblastic differentiation. Also, this extract has no effect on the chromosomal karyotype of the cells.

Lung volume loss, airway obstruction and air flow limitation, and also hypertension are risk factors for mortality in patients with type 2 diabetes. This study was done to determine the effect of supplementation of saffron and exercise training on blood pressure changes, pulmonary function and spirometric indices in obese and overweight women affected by type 2 diabetes. In this quasi-experimental study, forty-eight type 2 diabetic obese and overweight women were non randomly divided into four equal groups including placebo, saffron + training, training + placebo, saffron plus placebo). The saffron group + training and training + placebo groups did aerobic training with intensity of 60-75% of maximal heart rate for 8 weeks (three sessions per week). A daily dose of 400 mg of saffron sprout powder (once a day) was used for two months. The variables were measured in the pre-test, 48 hours and two weeks after the last training session. Intra-group results showed a significant increase in pulmonary function variables (VO2max, FVC, FEV1, FVC/FEV1, PEF, MVV), and significant reduction in systolic blood pressure and anthropometric indices (weight, BMI, and body fat percentage) in all three groups of exercise, saffron and practice + saffron (P<0.05). However, the results intra-group showed a significant difference in the above variables between the exercise + saffron supplement group in compared to other intervention groups (P<0.05), also, the highest effect was observed in the exercise + supplemental group. According to the results of this study, saffron with exercise led to significant improvement in pulmonary volume and capacities, as well as a decrease in blood pressure in obese and overweight women affected by type 2 diabetes.

Couple burnout is phenomenon which affects many couples. It is the main cause of emotional divorce, and it can provide a ground for formal divorce of couples. This study was conducted to evaluate the effectiveness of stress inoculation training (SIT) on reducing couple burnout among married women. This quasi-experimental study was performed on 30 married women whom refered to Aram psychological and counseling service center in Gorgan, norhern Iran during 2016. The subjects selected by available sampling method and were assigned into intervention and control groups via a non-randomized method. Subjects in intervention group were received the stress inoculation training intervention in eight 2-hour session in groups (one session per week). The control group did not receive intervention until the end of the follow up stage. The data gathering tool was Couple Burnout Measure of Pinez (1996) which was completed by all subjects in pre-test, post-test and one-month follow up. After treatment and one-month follow up, the stress inoculation training intervention was effective on reducing couple burnout and its components including physical fatigue, mental fatigue, and emotional fatigue (P<0.05). Stress inoculation training reduces couple burnout and its components in married women. Therfore, stress inoculation training recommends to be an appropriate interventional option for reducing marital problems and improving couple relationships.

Chronic and recurrent abdominal pain affect about 7-20% of children in school age, and it is responsible for 2-4% of children's medical referrals. Helicobacter pylori infection in children can cause gastrointestinal problems in childhood, and the lack of treatment and eradication can lead to serious complications. This study was done to evaluate the prevalence of Helicobacter pylori ELISA stool antigen in children with chronic abdominal pain. In this case control study, 33 children with chronic abdominal pain and 30 normal children were evaluated. The stool was tested by ELISA method to evaluate Helicobacter pylori antigen. 15.2% of chidern in the chronic abdominal pain group were positive for Helicobacter pylori. No positive case was found among control group. This difference between case and control groups was significant (P<0.05). Considering the high prevalence of Helicobacter pylori antigen in children with chronic abdominal pain, it is suggested that children with chronic abdominal pain without a definite cause screened for Helicobacter pylori infection.

Avulsion of permanent teeth is a common emergency condition in pediatric dentistry. The prognosis of avulsed teeth depends on the appropriate and efficient approach of unprofessional persons such as the parents and school teachers who are present at the incident site, prior to the professional dental visit. This study was done to evaluate the parental knowledge regarding emergency management of traumatic tooth avulsion in north of Iran. This descriptive-analytic study was performed on 264 parents (76.8% mothers and 23.2% fathers) of children aged 6 to 12 years old whom referred to Ayatollah Taleghani Hospital in Gonbad-e-Kavoos a twon in Golestan Provinece, northern Iran during 2015-16. The subjects were interviewed using a questionnaire form with 11 objective questions. The questionnaire included personal information and parental knowledge about traumatic tooth avulsion. 84.8% of parents had insufficient knowledge. The father`s and mother`s knowledge rate was 13.3% and 16%, respectively. There was no significant association between educational levels, age or gender and knowledge rate.80.8% of subjects did not received education about how to react after traumatic tooth avulsion. Parental knowledge regarding emergency management of traumatic tooth avulsion is very low. Considering the irreversible consequences of this injury in delayed management, increasing parental knowledge is necessary.

Childhood behavioral and emotional problems may be continus to puberty, even extend to elderly. This study was carried out to determine the role of family accommodation of child symptoms, parenting style and parental stress in prediction of anxiety disorder in children with 6 - 10 years old in Golestan province, north of Iran. In this descriptive-analytic study 300 children with 6-10 years old and their mothers were selected by randomized cluster sampling method during 2017. The questionnaires of family accommodation scale-anxiety (FAS-A, 2013), parent stress index-sort form (PSI-SF, 2000), Bamerind parenting styles questionnaire 1973 and Spence child anxiety scale-parent form (SCAS-P, 1998) were completed by the mothers. Increasing family accommodation and parenting stress significantly correlated with increasing children anxiety (P<0.05). The authenticated childbearing style by parents significantly correlated with reducing the anxiety in children (P<0.05), but authoritarian parenting and permissive parenting by parents significantly correlated with increasing the anxiety in children (P<0.05). Authenticated childbearing style along with authoritative parenting style, parental stress and family support could predict 49% of children's anxiety (F=97.91, P<0.0001). Authoritative and authoritarian parenting, parenting stress, family accommodation has an effective role in predicting children's anxiety.

Trauma is the third cause of death and the main cause of disability in Iran. Children are more susceptible to trauma due to physiological conditions and the growth process. This study was done to evaluate the epidemiolog of pediatric trauma in Hamedan, Iran during 2016-2017. This descriptive-analytical study was done on 482 traumatic children (330 boys, 152 girls) at the age of 0 to 14 years whom referred to Besat Hospital in Hamedan, Iran during April 2016 to March 2017. Age, gender, season, type of troma and the outcome of trouma were recorded for each subject. The highest rate of trauma was observed between the ages of 7-14 years old (40.5%). The rate of trauma was significantly higher in boys than the girls (P<0.05). The most rate of trauma occured in summer (36.9%). The most common, place, cause, type, region of traumas were home (44%), falling down (53%), fracture (35%), and region (41%) respectively. Regarding the subsequence of discharge of subjects, 10 deaths and 42 disabilities after trauma were observed. Regarding the most common type and place of accidents, providing safety at home and knowledge of parents are nesscery for preventing of pediatric teruma in Iran.

Chronic itching reduces the quality of life of patients undergoing hemodialysis. This study was done to determine the effect of chronic itching on the quality of life of patients under hemodialysis in north of Iran. In this descriptive-analytical study, 111 patients with mean age of 58.36±12.7 years were randomly selected from hemodialysis centers of Golestan province from May to December 2017. Demographic data, quality of life (Itchy QOL questionnaire), Xerosis, pruritus intensity (Balaskas 1998), and laboratory tests including calcium, phosphorus, alkaline phosphatase, parathyroid hormone, blood urea nitrogen, creatinine, hemoglobin and hematocrit were evaluated. The mean score of itching severity and overall quality of life was 29.27±7.46 and 41.4±10.44, respectively. There was a significant correlation between the severity of itching and the overall score of patients' quality of life (P<0.05). Correlation between severity of pruritus with symptom dimension, functional dimension and emotional dimension was significant (P<0.05). There was a significant correlation between severity of itching and Xerosis and serum calcium level (P<0.05). There was a significant correlation between Xerosis and calcium level with increased itching (P<0.05). Itching reduced the quality of life in hemodialysis patients in north of Iran.

Managed health care is one of the main components of universal health care systems, which recently has drawn more attentions. Therefore, based on the high costs of health system, poor quality of services, reduce efficiency, it is necessary to study and design a model to distinguish managed form unmanaged systems in Iran. This study was done to evaluate the managed health care in contagious and non-contagious diseases in Golestan province, northern Iran during 2016. This descriptive-analytic study was done based on data collected from all urban and rural health centers of Golestan province, north of Iran during 2016 using standard checklists. Data were analyzed according to rural and urban area and type of diseses. Managed health care of tuberculosis was considerd in first rank following by hypothyroidism, leishmaniasis, hypertension, brucellosis and finally diabetes in a respective manner. In addition, managed cares in rural centers significantly had better condition than those of urban centers (P<0.05). This study showed that managed care in rural areas is better than urbans and the tuberculosis has well condition according to managed health care.

Breast cancer is one of the most common types of cancer among women. HER-2 molecule as the receptor of tyrosine kinase from the family of epithermal growth factor is a major cause of cancer. The Herceptin protein molecule, which is an anti-HER-2 antibody, can play an important role in the diagnosis and treatment of breast cancer. This study was done to subcloning of Herceptin gene, expression in the prokaryotic system (E.coli) and produce Herceptin recombinant protein for use in the treatment of breast cancer. In this descriptive – laboratory study, Herceptin gene from synthesized construct was isolated by enzyme digestion, and then subcloned to the expression vector pET28a. Subcloning of the gene was confirmed using PCR and enzyme digestion. After transferring the vector into E.coli BL21 DE3, expression of the recombinant Herceptin gene was induced by IPTG. The recombinant protein was evaluated by SDS-PAGE and purified with Ni-NTA column chromatography and finally verified by western blotting using anti-histidine antibody. The survival of cells adjacent to recombinant Hercaptin by MTT was investigated. Following the subcloning of the Herceptin gene, PCR and enzyme digestion, the 741 fragment of the Herceptin gene was confirmed. Confirmation of Herceptin's recombinant protein and its evaluation on SDS-PAGE gel about 27 kDa was done. The recombinant protein was also confirmed with anti-histidine tag. The purified protein adjacent to the SKBR3 cell line was able to block the growth of cancer cells. Regarding the expersion of HER2 antigen on surface of breast cancer cells, Herceptin can act as antibody blocker and it arrests the growth of breast cancer cells.