مجله دانشگاه علوم پزشکی اردبیل
پیاپی 73 (پاییز 1398)

Vaginismus is an uncontrolled contraction of the outer third muscle of the vagina that prevents intercourse. Based on the DSM-V-TR system, this disorder is associated with dyspareunia and "Genito-pelvic pain/penetration disorder". The purpose of this overview was to summarize population-based studies that reported the prevalence of vaginismus in the general population and to discover the discrepancies between studies.

This systematic review study was conducted on published articles on the prevalence of vaginismus in the world and in English. In selecting the articles, the keywords including Vaginismus, Prevalence, Incidence, Sexual Dysfunction, Genito-Pelvic Pain, Penetration Disorder with all possible combinations were systematically searched in the google scholar, science direct, PubMed, Cochrane databases. No search time limit was set to retrieve all relevant articles published by September 21, 2018.

Of the 10 studies, 4 articles reported prevalence of vaginismus in the general population. In selected studies, the incidence of vaginismus in the general population of women was reported 0.4% to 8%.

Different prevalence rates have been reported in different studies for vaginismus. In this review study, it was not possible to Meta-analyze and determines the overall prevalence due to the heterogeneity of the prevalence reports and different study methods.

Non-alcoholic fatty liver disease (NAFLD) is associated with mitochondrial dysfunction. The aim of the present study was to examine the effect of aerobic training along with resveratrol on cardiac expression of OPA1 and DRP1 in NAFLD male rats.

In this experimental study, forty eight male Wistar rats were classified into two groups: NAFLD (n=40) and Control-Normal (CN), (n=8). NAFLD was induced in rats with high fat diet and then subdivided into five subgroups, including patient (NAFLD), sham (SHAM), exercise-patient (TRNAF), supplement-patient (SUPNAF) and exercise-supplement-patient (TRSUPNAF). Training groups performed a running program on a motor-driven treadmill for eight weeks. Resveratrol (20 mg/kg) was injected into the SUPNAF and TRSUPNAF groups. Forty eight hours after the last training session, rats were anesthetized; hearts were excised and immediately frozen in liquid nitrogen and stored at -80°C for measuring the indexes. Statistical analysis was performed using a one way analysis of variance, and Statistical significance was accepted at p≤ 0.05.

The results indicated that the induction of NAFLD decreased OPA1 expression (p=0.001) and increased DRP1 expression (p=0.001) compared to CN. Also, in SUPNAFLD and TRSUPNAF groups, OPA1 (p=0.014 and p=0.001 respectively) increased and DRP1 (p=0.043 and p=0.007 respectively) decreased significantly compared to the NAFLD group.

It seems that exercise training and resveratrol alone or in combination by increasing OPA1 and decreasing DRP1 myocytes modulates heart damage in NAFLD patients.

Due to the prevalence of obesity and the subsequent development of metabolic risk factors, cardiovascular and fatty liver complications, exercise programs and the use of natural supplements can play a significant role in controlling and preventing these diseases. Therefore, the purpose of this study was to review the effect of eight weeks of combined exercise and Chlorogenic acid intake on C-reactive protein and liver enzymes in obese women.

In this quasi-experimental study, which was performed as a pre-test, post-test with a control group, a total of 48 obese women were selected purposefully and divided randomly into four equal groups (n=12); exercise, supplement, exercise+supplementation and control group. The exercises program consisted of 8 weeks of aerobic and resistance training, 3 sessions with 60 minutes per week. The chlorogenic acid supplement group received daily Green coffee in capsule form contain 400 mg powder for 8 weeks and the concurrent group performed exercise and received Green coffee simultaneously. By using blood sampling the variables were measured at baseline and after 8 weeks of intervention. Data were analyzed by t-test and ANOVA at significance level of p<0.05.

Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the supplement group were the lowest and in the exercise+supplementation group had the highest decrease and there was no significant difference in the control group. The C-reactive protein (CRP) in the training+supplementation group was significantly decreased and in the three experimental groups there was a significant difference compared to the control group (p≥0.05).

It seems that combined exercise and natural substances rich in chlorogenic acid can decrease inflammatory factors such as C-reactive protein and liver enzymes.

 Hydatid cyst is a major hygiene problem in Iran. In 80% of cases, only one organ is involved. However, multiorgan involvement has also been rarely reported. But it seems, the prevalence of hydatid cyst with the involvement of more than one organ in Iran is more than other world. The aim of this study was to evaluate the patients with hydatid cyst multi organ involvement in Ardabil province in northwest of Iran.

In this retrospective study, 34 patients with hydatid cyst with involvement in more than one organ were included. For each patient, a pre-designed questionnaire including name, age, education level, occupation, place of residence, cyst location, clinical manifestations and serologic test results were completed. Patients, who had previously a history of treatment due to hydatid cyst, were excluded from the study.

The mean age of patients was 36.41 years. 61.8% of the patients were housewives and 64% were rural residents. The most commonly involved organs was liver and simultaneous involvement of liver and lung was observed in 38.2% of patients and was more in women. The association of the right lung cyst with the liver cysts was greater than that of the left lung. Only in 43% of the patients, the serologic test was positive for hydatid cyst, and the relationship between serologic test and type of involvement was not significant.

Regarding the high incidence of hydatid cyst involvement in more than one location in our region, in all patients, especially women with liver hydatid cyst, other organs, especially the lungs, should be investigated

Recently it has been shown that some adipose tissue-derived hormones, such as apelin and omentin, can be effective in regulating metabolic metabolism. So the aim of the current study was to examine the effect of 12-weeks Pilates’ body training on serum levels of apelin and omentin-1 in inactive and overweight women.

This is a pre-test and post-test clinical trial study in which 28 volunteer overweight women with average BMI of 27.2±1.1 kg/m2 participated. They were randomly divided into training group (n=14) and control group (n=14). Pilates exercise training was performed 3 sessions per week, 60 min per session for 12 weeks. In order to measure the changes in serum levels of apelin and omentine-1, blood samples were taken after 12-14 hours at fasting status in two steps, 48 hours before the first training session and 48 hours after the last training session. The paired t-test and the ANCOVA test were used to examine intra-group and inter-group differences, respectively.

Based on the findings of this study, 12 weeks of Pilates training had a significant decrease in apelin serum levels in both intra-group and inter-group with significance level of (p=0.001) and (p=0.009) respectively. Serum levels of omentin-1 also changed significantly in both intra-group and inter-group. The serum levels of omentin-1 in the exercise group significantly increased after 12 weeks compared to pre-training with significance level of (p=0.002) and in comparison with the control group with significance level of (p=0.003).

Regarding to the results of the current study and the positive effect of Pilates exercise on adipokines levels, it seems that Pilates exercise can be a functional factor for regulating adipose tissue hormones (adipokines) in obese or overweight women, and overweight people can do Pilates exercise  based on their ability.

Third molar impaction (wisdom tooth) is a widespread phenomenon. It is indeed very important to study the impacted teeth pattern in the community since it will help to develop an appropriate treatment plan for individuals of the community. The aim of this study was to investigate the impaction pattern of mandibular third molar in Ardabil population.

In this study, the panoramic radiography of 382 patients referred to the Ardabil Dental Clinic, ranging 18-40 years old that had a couple of third molar teeth were investigated. The radiographs were investigated to collect data corresponding to depth-of-impaction, the distance between the canal and inferior alveolar, number of roots, shape and connection between the roots as well as the damages to neighboring structure. The collected data were coded to be analyzed through Chi-square and t- test in SPSS software.

Among the cases, 42.4% and 57.6% of the subjects were male and female respectively. There is no significant difference between men and women for number of roots and the connection between them, whereas noticeable differences between men and women were observed for depth of impaction, distance from Inferior alveolar canal, the shape of the roots and damage to neighboring structures.

The results suggest that most of the cases had vertical angulation, regarding depth of impaction, most of the teeth were categorized in Class-B, regarding distance from Inferior alveolar, and most of the cases were in the vicinity of the canal and had two separate canals. Regarding damage to neighboring structures, most of the cases were categorized as a radiographic bone loss

Tea is a hyperaccumulator of fluoride and chronic fluoride intake is associated with multiple negative health outcomes. In this study, six brands of commercially available black and green tea were selected and the fluoride level in tea infusions tested using an ion-selective electrode method.

In this experimental study, the fluoride contents were determined using  ion-selective electrode (Mettler Toledo, USA) in four types of black tea and two types of green tea at different brewing time (3,5,15,30,60 and 120 min). The amount of tea fluoride at any time was investigated by repeated measure ANOVA and two-way ANOVA.

Repeated measure ANOVA analysis showed that fluoride release for green and black tea increased as increased brewing time (p<0.05). Based on the two-way ANOVA and Bonferroni test results, the mean of fluoride concentrations was high in B black tea in all brewing time. E green tea, D black tea, F green tea, A and C black tea released less fluoride respectively p≤0.05.

The results of this study showed that the fluoride content of black and green tea in different companies was different. In regard to the impact of the cultivation site and the plant characteristics which the tea is made, companies should include enough information about their product to inform consumers. The amount of fluoride in the all examined tea increases after 3 and 120 min of brewing.

Gestational diabetes is one of the most common medical problems during pregnancy, which has many negative consequences for mother and fetus. Knowledge of women about gestational diabetes and educational planning based on needs assessment can be effective for early diagnosis and reduction of possible complications of gestational diabetes. The aim of this study was to determine the educational needs of diabetic pregnant mothers in Meshgin health centers in 2018.

This descriptive, cross-sectional study was conducted by- census on 689 pregnant women referring to Meshgin health centers in the spring and summer of 2018. Data were collected using a valid and reliable questionnaire of Hashemi-Beni and colleagues (2015) including three parts: demographic information, knowledge and educational needs assessment for mothers with gestational diabetes. Data were analyzed using SPSS 16 software.

The mean age of pregnant women participating in the study was 26.94±6.22 years, with an average gestational age of 24.36±9.18 weeks. 22 persons of 689 pregnant women were diagnosed with gestational diabetes, and the prevalence of gestational diabetes was 3.2%. The mean score of knowledge of diabetic pregnant mothers about gestational diabetes questions was 9.95±3.79 out of 13. In all items of gestational diabetes, at least one third of diabetic mothers reported need for education.

Diabetic pregnant mothers, despite of high knowledge about gestational diabetes, still need to be trained in this regard. Therefore, it is necessary to hold leveled training courses to complete the information of mothers for better care of themselves

In the pathogenesis of endometriosis, a variety of genes are involved. The aim of this study was to investigate the GATA2 gene expression changes in endometriosis rat model following a period of aerobic exercise and vitamin B6 intake.

For this purpose, 25 adult Wistar rats were randomly divided into 5 groups, including: healthy control, patient control, patient+training, patient+vitamin, patient+vitamin+ training. In order to create an endometriosis model, rats were first anesthetized and after opening abdominal muscle, ovarian tissue and part of uterine tissue were removed and were inserted into a sterile container with one cc of PBS and sliced. Tissue fragments were transplanted into the abdominal and ovarian areas. The amount of vitamin intake was 60mg/kg and swimming program lasted 8 weeks, 30 minutes a day, five days a week. One- way ANOVA test and Tukey post hoc test were used for data analysis.

The results showed that a period of swimming exercise program in the patient + training group significantly increased the GATA2 level compared to the patient control group (p≤0.001). Also, the GATA2 gene expression level was significantly increased in the patient + training + vitamin group compared to the patient control group (p=0.002). However, its level in the patient group was significantly lower than that of the healthy control group (p≤0.001).

Regular aerobic exercise combined with intake of vitamin B6 may decrease GATA2 gene expression level in endometrial rat model.

Primary sclerosing cholangitis is a rare and progressive cholestatic disease characterized by narrowing of the biliary tract. Despite high levels of ulcerative colitis, early diagnosis of primary sclerosing cholangitis before the diagnosis of inflammatory bowel disease is rarely reported. 

Case history:

 A 28-year-old woman with no history of medical disease visited our clinic because of a mild generalized pruritus. In initial blood laboratory tests with elevated liver enzymes was observed. In Magnetic resonance cholangiopancreatography (MRCP) was introduced primary sclerosing cholangitis to the patient. Therefore, the patient was under colonoscopy and extensive colitis with terminal ileum involvement was detected and the diagnosis of ulcerative colitis was confirmed in the pathology.

Patients diagnosed with primary sclerosing cholangitis should undergo biopsy colonoscopy to rule out inflammatory bowel disease, even if they have no digestive tract symptoms.

Urinary tract infection (UTI) is one of the most common types of hu man infections and Escherichia coli and Klebsiella pneumonia are the main causes of urinary tract infection among the gram negative bacteria. The prevalence of extended-spectrum β-lactamases (ESBLs) among these bacteria and hence resistant strains to β-lactam antibiotics have increased in recent decades. Several types of extended-spectrum β-lactamases, such as TEM, SHV and CTX-M have been identified, which are prominently present in the strains of E. coli and K. pneumoniae. The objective of this study was to determine the prevalence of TEM and SHV genes in E. coli and K. pneumoniae isolates of urinary tract infections by using phenotypic and molecular (PCR) tech niques in microbiology laboratory at medical school of Tabriz Islamic Azad University.

In this cross-sectional descriptive study, 50 isolates of E. coli and 50 isolates of K. pneumoniae collected from uri nary tract infections from out-patients in Tabriz. Antibiotic sensitivity patterns of isolates were stu died against 14 antibiotics by disk diffusion test (Kirby Bauer) and also confirmatory tests were performed using combined antibiotic tests. Finally TEM and SHV genes were investigated using molecular methods (PCR).

Twenty five isolates (25%) out of 100 bacterial isolates were identified as ESBL-producing isolates of which 13 isolates (26%) were E. coli and 12 isolates (24%) were K. pneumoniae. The TEM and SHV genes were detected in 2% and 4% of E.coli and 0% and 2% of K. pneumoniae isolates, respectively.

The presence of these genes among our isolates confirmed ESBL genes in these medically important bacteria leading to resistance against β-lac tam antibiotics which are routinely used in their treatments. The low frequency of the studied genes could be because of the source of our isolates from out-patients which are not generally exposed to antibiotics