مجله علوم پزشکی رازی
سال بیست و ششم شماره 1 (پیاپی 178، فروردین 1398)

Probiotics are defined as different microorganisms that may have positive effects on preventing or treatment of special pathologic conditions. Anti-cancer properties of these bacteria have been shown in few studies. The aim of this study was to evaluate anti-tumor effects of heat-killed L. casei and L. paracasei on K562 cell line (chronic myeloid leukemia). In this experimental study, bacteria were cultured in special medium at anaerobic condition, then, cells killed at temperature of 100°C. Killed cells were dried by lyophilization, finally were sterilized by autoclaving. Then, different concentrations of heat-killed bacteria (125, 250, 500, 1000 and 2000 μg/ml) were prepared separately. Anti-tumor properties of heat-killed bacteria were determined in vitro at 24, 48 and 72 h with MTT assay. Our result showed that heat-killed cells of L. casei and L. paracasei statistically (p˂0.05) have Anti-tumor properties in K562. In addition, Anti-tumor properties of heat-killed cells have direct relationship with concentration. Based on obtained results we conclude that the heat killed Lactobacillus can be used as a potential candidate for further studies on chronic myeloid leukemia treatmentces.

Academic students’ burnout can negatively affect academic performance. Thus, it is highly important to identify related factors, which can prevent this phenomenon. The present study explored the relationship between psychological capital and academic burnout by considering the mediating role of academic engagement among students of Kashan University of Medical Sciences. In this descriptive correlational study, multi-stage sampling was used to select 330 students (220 females; 110 males) in Kashan University of Medical Sciences in the 2017-2018 academic years. The participants provided their demographic data and filled in Fredricks engagement scale and, psychological capital scale. The data were descriptively analyzed and correlation analysis and structural equation modeling was used. The findings indicated that psychological capital could significantly and inversely predict students’ academic burnout. In addition, academic engagement has a mediating role in the relationship between psychological capital and academic burnout. Good statistical fitness was found in the proposed model and there was good agreement between the structured model and empirical data. In this model, all regression weights were statistically significant, and predictor variables could explain 0.51 of the variance in academic burnout. The promotion of students' psychological capital should be considered at the policy levels of education and implementation of effective interventions in counseling centers of medical universities. This can reduce their academic burnout through an increase in academic engagement

Many studies have shown the role of psychological and behavioral risk factors in the etiology and physiopathology of cardiovascular disorders. The purpose of this study was to investigate the relationship between depression and stress and anxiety with personality type D in patients with cardiovascular disease. A descriptive correlational study was performed on patients with coronary artery bypass referred to a rehabilitation center in Tehran Heart Center. About 378 pateints were selected using convienience sampling. The used tools were Depression Anxiety Stress Scale (DASS21), and de Denollet Personality Type scale 2005 (DS-14). The results showed that there is a significant positive relationship between personality type D (negative affect, prevent emotional) level of emotional distress (stress, anxiety, depression). Psychological factors have an effect on the severity of coronary heart disease in type D personality. Hence, it is necessary to care about psychological factors (negative affect and emotional inhibition) of coronary heart disease patients during their the process of treatment treatment.

Phenylketonuria (PKU) is a metabolic disorder caused by mutations in the phenylalanine hydroxylase (PAH) gene. After thalassemia, PKU is considered as the most common autosomal recessive disease in the Iranian population. Therefore, it is necessary to identify the disease-causing mutations in this population. According to the PAH database, one of the exons with the greatest number of mutant alleles is exon 6 and the surrounding introns. Accordingly, this study was designed to identify exon 6 mutations of PAH gene among PKU patients in Guilan province and compare them with studies conducted in other regions of Iran. In this descriptive cross-sectional study, 25 PKU patients and non-relatives (1 to 21 years old) from different regions of Guilan province were identified during a one-year period. After genomic DNA extraction, mutation detection was performed by polymerase chain reaction-sequencing method. The mutations and polymorphisms identified in this study included R176X (4%) and Q232Q (46%), respectively. The patient had mHPA phenotype and her parents were 3th degree relatives. Considering that the R176X mutation was only found in 4% of chromosomes in this study, achieving a complete spectrum of PAH gene mutations in PKU patients in Guilan province requires the analysis of 12 other exons. In addition, considering the difference of PAH mutation spectrum in different regions of Iran, comprehensive studies in different regions of Iran can identify specific mutations in each region and these studies can be used to advance the future preventive and therapeutic goals.

Correct education of asthmatic patients by pharmacists play an important role in control of asthma disease and improvement of patients’ quality of life. This study aims to evaluate community pharmacists’ knowledge and skills by demonstrating the proper inhalation technique of asthma inhaler devices in Isfahan, Iran. One hundred community pharmacies located in the Isfahan city were approached and four asthma devices were assessed (25 each of them): Metered dose inhaler (MDI), MDI with spacer, turbuhaler and revolizer. The investigator selected one device and asked the serving pharmacist to demonstrate how to use the device. Investigator completed a checklist of inhaler device use immediately after leaving the pharmacy. In total, 100 pharmacists (including 70 males with the mean age of 42.3±12.1) were approached. More than half of the pharmacists approached with MDI (with or without spacer) did not know how to use the optimal technique (i.e. all steps corrected all through). The majority of pharmacists (>90%) approached with turbuhaler did not know the proper technique. More than 70% of pharmacist had an adequate technique in handling revolizer. There was an inverse relationship between pharmacist’s knowledge and skill and age and work experience (r=-0.18, p: 0.037, and r=-0.16, p: 0.05 respectively). The majority of community pharmacists lack the basic knowledge of proper use of commonly dispensed asthma inhaler devices. Considering, the positive impact of pharmacists in patient care and education, specific training and continuing educational programs directed specifically on asthma management is necessary.

Neuromyelitis Optica (NMO) is an autoimmune inflammation of central nervous system in which autoantibodies are released against AQP-4 (astrocytic water channels) and diagnosed with transverse myelitis and optic neuritis. Viral infections could be pro-inflammatory agents in body organs including nervous system. Due to such inflammatory reactions, autoantibodies would cross the blood brain barrier. Therefore, recognizing the viral agents may help us to prevent and treat NMO. The aim of the present study was to assess the possible association between NMO and mumps virus. This observational study was conducted on 25 NMO patients, 30 Multiple Sclerosis (MS) patients and 30 healthy individuals. Serum IgG and IgM antibodies against mumps, was detected by ELISA using Euroimmun kit (manufactured by Germany). Statistical analysis was performed by SPSS software. IgG titer was positive in 76, 53 and 46% of NMO patients, MS patients and healthy individuals, respectively. Statistical analysis demonstrated that level of IgG was significantly higher among groups, However, IgM levels showed no significant difference. Significant increase of IgG titer against mumps virus in NMO patients and low level of IgM may indicate that an old infection of mumps in NMO patients’ life could have a possible role in the pathogenesis of NMO.

Cerebral palsy is a group of multi-dimensional and non-stationary disturbances in motion. Children with cerebral palsy need a careful attention of their caregivers, especially their mothers, in their daily living activities. Therefore, presenting training programs to mothers in order to take care of their children with cerebral palsy is very important. This study examines the impact of determining the effect of care education of mothers of children with cerebral palsy on their maternal depression and anxiety referring to the selected hospital in Alborz university of Medical Sciences in 2017. In this experimental, research, 60 mothers referring to Bahonar Hospital in Karaj who had children with cerebral palsy were selected randomly, and then were divided into two control and intervention groups. The education program consisted of 6 domains for mothers during 6 sessions of 30 minutes over a period of two weeks. The training program focused on six areas such as child carriage, different forms of positioning, sleeping, getting dressed and undressed, feeding and nourishing, going to the toilet and urine control which were presented to mothers in the intervention group during six, thirty-minute sessions in two weeks. Depression and anxiety of mothers in both groups before and after the intervention were evaluated. To compare variables in two groups of control and intervention, two-samples independent T-test was used and to compare the average before and after in each group, the paired T-test was conducted. In order to analyze the homogeneity of data in quality variables, K2 or the accurate Fisher test was administered. Moreover, in order to mitigate the effect of pre-test, the average comparison of post-test was done using the ANCOVA covariance analysis and then the results were analyzed using SPSS 21. The results showed that the training program for taking care of children with cerebral palsy resulted in the reduction of mothers’ depression from mean 26.100 and standard deviation 3.546 to mean 18.966 and standard deviation 3.690 and anxiety from mean 20.966 and standard deviation 2.930 to mean 14.500 and standard deviation 2.788 in the intervention group (p˂0.0001). Considering the control group mothers, it can be stated that the results showed no significant changes in the depression and anxiety of mothers regarding the lack of training in this group. The maternal anxiety score remained at mean 25.266 and standard deviation 2.715 and the depression rate ranged from mean 26.300 and standard deviation 2.718 to mean 25.933 and standard deviation 2.970. The research results showed that use of training program on how to take care of children with cerebral palsy can reduce depression and anxiety in the mothers of children with cerebral palsy.

Well-being has a permanent effect on the physical and mental health of individuals; this effect is applied in different ways. The purpose of this research is to evaluate the effect of achievement motivation, ego strength and psychological capitals on psychological well-being. In this research, 201 students of Tehran University (110 women and 91 men) we're selected by available sampling method and they answered Beshart’s Ego Strength Questionnaire, Luthans’s Psychological Capitals Questionnaire, Hermes Achievement Motivation Questionnaire and Psychological Well-Being Scales Questionnaire. The results were analyzed using correlation and Bootstrap method with R software. Research data suggested that the variables of achievement motivation, ego strength and psychological capitals had effect, these effects were direct and indirect. Furthermore, achievement motivation had indirect effect on psychological well-being by mediation of the variable of ego strength and psychological capitals. On the whole, this supposed research model had suitable fitness and we can approve the positive role of achievement motivation, ego strength and psychological capitals in psychological well-being.

Dietary restriction and exercise training are practical intervention for weight loss and increasing lifespan. However, the effect of dietary restriction with or without exercise training on muscle mass and strength remain unclear. In addition, signaling process and proteins involved in this field have not been clearly specified. Therefore, the purpose of this study was investigating the effect of dietary restriction with or without exercise training on β-catenin and glycogen synthase kinase-3β gene expression in soleus muscle of male rats. 24 male rats randomly divided into three groups: control (Con), dietary restriction (DR) and dietary restriction+ exercise training (DR+EX). Within three months of research, All animals in Con group were fed ad libitum, while animals of DR and DR+EX group had daily access to 50% of the intake of the ad libitum-fed Con animals. Rats in DR+EX group participated in the exercise training program for 12 weeks. 48 hours after the last training session, the skeletal muscle of rats were extracted and β-catenin and glycogen synthase kinase-3β mRNA evaluated by Real Time-PCR. One-way ANOVA and post-hoc Tukey were applied for statistical analysis of the data (p< 0.05). β-catenin gene expression of DR and DR+EX group was no-significantly lower than the Con group (38% and 8.8% respectively, p˃0.05). However, glycogen synthase kinase-3β gene expression of DR group was significantly higher than the Con and DR+EX group (449% and 177% respectively, p<0.05). Overall, a 12-week dietary restriction (-50%) increased the glycogen synthase kinase-3β gene expression in Wnt-signaling pathway of skeletal muscle. This may be associated with a decreased muscle mass and strength. However, it is likely that the addition of exercise training to dietary restriction alleviates loss of skeletal muscle.

Anorectal fistula resulted from the obstruction and infection of anorectal cryptoglandular glands is a common surgical entity. Although a number of treatment modalities have been proposed for this condition, recurrence rate is still high. In this study, long-term outcomes and complications of the LIFT (Ligation of Intersphincteric Fistula Tract) procedure were assessed in patients with anal fistula. This study is largest study with largest number of patients and longest follow up period in Iran and Middle East. In this prospective analytic clinical study, 50 patients with anal fistula referred to a tertiary colorectal clinic and underwent LIFT operation were enrolled from 2012 to 2017 and the patients were followed up for at least one year after the operation for any complication or recurrence. Outcomes and complications of the LIFT procedure as well as contributing factors were determined. A total of 50 patients studied in this study, including 43 males (86%) and 14 females (24%). Mean age of patients was 51.84±9.7 years and patients we followed up for a mean of 3.5±1.2 years after the operation. There were 12 recurrent cases and 32 cases with complications including 18 abscess/ infection and 14 gas incontinence. 71.4% of females and 25.6% of male subjects revealed complications showing significant difference (p<0.05). Longer time passed from the surgery, led to more recurrence (p<0.05). Other factors showed no significant association with recurrence and complications (p>0.05). In general, according to our results, it can be concluded that LIFT is an effective procedure in patients with anal fistula. Gender is a predicting factor for postoperative complication and the time passed from last surgery is the contributing factor for recurrence.