مجله علوم پزشکی رازی
سال بیست و هفتم شماره 3 (پیاپی 193، خرداد 1399)

The most important complications of anal fistula are gas, fecal incontinence and fistula recurrence. Recurrence can lead to frequent hospitalization, multiple surgeries, more tissue damage, more time and high cost. Considering the fact that most causes of fistula recurrence can be preventable, we studied factors that were effective on recurrence.

In this cross-sectional (descriptive-analytical) study, 50 patients with recurrence of anal fistula that had referred to Rasoul Akram Hospital between April to September 2006 were enrolled. A questionnaire including age, sex, duration of disease, history of fistula surgery, history of abscess surgery, history of spontaneous abscess drainage, underlying diabetes mellitus, corticosteroid use, number of recurrence, the number and location of internal and external orifices were completed. The second part of the questionnaire was completed after the operation when the complete anatomy of the fistula and the previous surgical errors were determined. SPSS version 24 was used for statistical analysis.

50 patients with mean age of 42.5±12.3 years were studied and on average 3.33±4.0 years had anal fistula. In this study, 8 types of fistula recurrence were studied; 18(36%) patients  due to extensive superalevator collection, 7(14%) patients due to lack of internal orifices, 3 (6%) patients due to Inflammatory Bowel Disease (IBD), 6 (12%) due to inadequate follow-up, 6(12%) due to horseshoe fistula, 7(14%) due to rectovaginal fistula, 1 person (2%) due to retro rectal mass and 2(4%) patients due to unknown curve extension. There was also a significant relationship between the cause of recurrence and the type of primary tract of fistula (p= 0.035).

Using appropriate technique of anal fistula surgery based on patientchr('39')s condition and considering the main fistula tract, can reduce the rate of fistula recurrence and postoperative complications.

Today, cardiac involvement is one of the major obstacles in the treatment of patients with rheumatologic diseases. Such an involvement was introduced at the beginning of 20th century, but in the last decades, newly recognized clinical entities have been introduced owing to emerging highly sensitive, non-invasive or semi-invasive cardiac imaging techniques. Cardiac involvements in patients with rheumatologic diseases are different ranging from subclinical to severe manifestations. These manifestations are heterogeneous affecting different structures (pericardium, myocardium or endocardium). Arrhythmias may be the first manifestation of sarcoidosis. An intracardiac clot may also be a manifestation of Behcetchr('39')s disease, and finally, pericarditis may be a manifestation of scleroderma. In ankylosing spondylitis, cardiac disorders can cause gradual complaints such as decreased ability to function or weaken, which are misleadingly attributed to non-clinical aspects of the disease. They are presented at the time of diagnosis of rheumatologic disorder or afterward. The cardiac involvements can also be the first presentation of rheumatologic circumstances so that some patients with rheumatologic diseases may primarily visit a cardiologist when they are attacked by this disease. Cardiac involvements can cause mortality and morbidity in patients with rheumatologic diseases. Prompt recognition of cardiovascular abnormalities is necessary for timely and appropriate management. Therapies directed towards inflammatory process are crucial to reduce cardiovascular disease morbidity and mortality. They may require aggressive immunosuppressive therapy. Although aggressive treatment of primary rheumatologic diseases can reduce the mortality rate and improve them, there are no specific guidelines and recommendations for them so far.

Motorcycling is one of the major causes of road traffic accidents and motorcyclists are the most vulnerable road users. The present study aimed to determine the epidemiology of fatality caused by motorcycle accidents in Tehran province.

In this cross-sectional study, all the information of deaths related to motorcycle accidents during 2011-2016 were collected and investigated by the Legal Medicine Organization. Data analysis was performed using SPSS software version 25.0.

Of the 2098 dead cases in motorcycle accidents, 95.8% were men and 4.2% were women. Mean age of the deceased was 28/9±17/7 years with the highest frequency in the age group of 18-24 years (30.6%). The most important cause of death was head trauma (64.1%). In terms of the deceased’ status, 73.7% of the deceased people were drivers and 22.6%were pillion passengers. The highest rate of fatality was observed among those with under-diploma education (62.8%) and self-employed (38.2%). The major mechanism of motorcycle accidents resulted from collision with moving vehicles (76.6%). Most of the accident cases occurred in urban areas (80%) and the majority of deceased people died in hospital (53.9%).

Given the high mortality rate among men, younger ages, people with low education, urban roads and the fact that head trauma were the leading cause of death for most deceased, appropriate preventive measures seem to be essential for reducing motorcycle accidents.

The PAX4 gene encodes crucial transcription factors for cellular differentiation and development. PAX4 is essential for the production of pancreatic islet cell ancestors and their differentiation into beta cells. Proper function of this gene is essential not only in development but also in the survival and repair of beta cells, and mutations in it are associated with type 1 and type 2 diabetes. The present study was designed to investigate the effect of thymol on PAX4 gene expression in streptozotocin-induced diabetic mice.

In this study, 42 adult Wistar rats were randomly divided into 7 groups of six. Group A: healthy control group, group B: receive 160 mg/kg thymol by gavage every three days once a month, group C: streptozotocin-diabetic, and negative control group (diabetic control), Group D: Glycemic drug (metformin) 80 mg/kg gavage, group E, G and F are treatment group that gavage 40, 80 and 160 mg/kg, respectively they receive. Real time - PCR technique was used to evaluate the expression of PAX4 gene. Data analysis was performed using SPSS V.22 software and ANOVA was used for statistical comparison of samples.

The present study showed that the expression of PAX4 gene in diabetic rats treated with different Thymol doses had a significant difference compared to the diabetic control group (P-value < 0.001). In this case, the use of Thymol has led to an increase in the expression of PAX4 gene in pancreatic beta cells in diabetic rats, which was a dose-dependent increase of expression.

Thymol can be considered to improve disease in patients with diabetes mellitus by increasing PAX4 expression and decreasing blood glucose concentration.

The aim of this study was to investigate the ESR and IGFBP1gene expression changes in endometriosis model rats following a period of aerobic exercise and vitamin E intake.

In this experimental study, 25 adult Wistar rats were randomly divided into 5 groups of healthy control, endometriosis, endometriosis+ exercise, endometriosis+ vitamin E, endometriosis+ vitamin E+ exercise after creating endometriosis model. Vitamin intake was 200 kg/mg per rat body weight and swimming program was 8 weeks, five days a week for 30 minutes each day. One-way ANOVA test were used for data analysis.

The results showed that the highest expression of ESR and IGFBP1 gene was observed in endometriosis+ exercise+ vitamin E group and the lowest levels in endometriosis group. Intergroup comparisons showed that there was a significant difference between endometriosis and endometriosis+exercise, endometriosis+vitamin E and endometriosis+exercise+vitamin E groups in ESR gene expression (p=0.0016, p=0.026 , p=0.0335, respectively). There was also a significant difference between endometriosis group with endometriosis+exercise and endometriosis+exercise+vitamin E and also between endometriosis+exercise+ vitamin E groups with endometriosis+exercise and endometriosis+vitamin E groups in IGFBP1 gene expression (p=0.0019, p=0.0446, p=0.002, p=0.0222, respectively).

In general, the results of this study indicated that alteration of key molecules or signaling pathways and gene expression in endometriosis can improve the level of this disease and regular aerobic exercise as well as concomitant use of Vitamin E can help prevent and improve this disease.

Nowadays, obesity has become a problem in the developing country and left the government with huge treatment costs. Due to this, researchers have started large scale studies to find the best exercise protocols for fat loss. Two popular terms in the studies that investigate the effects of exercise training on fat loss are Maximal Fat Oxidation (MFO) and fatmax (exercise intensity which the maximum fat oxidation is occurred). In this study MFO, fatmaxand studies which assess the effect of exercise on fat oxidation are reviewed. Although a lot of research has been done to determine fatmax, the data are inconsistent. However, most researchers believe that the highest amount of lipid oxidation occurs at low to moderate intensities ranging from 35 to 65% of vo2max.

Disadvantages in social skills and, consequently, inability to create, the preservation and development of social relationships and interactions has been reported as a clear indication of Autistic children and are highly emphasized in diagnostic evaluations of these characteristics. The purpose of this study was to investigate the effect of Teach Body Language Skills Program on Social Skills of Autistic Children with High Performance.

In this quasi-experimental study, 30 autistic children with high performance 7-12 years old in Semnan city, Iran were selected through convenience sampling method. Then, randomly, 15 of them were placed in the experimental group and the other 15 were placed in the control group.Experimental group participated in body language training in 8 sessions (week a meeting and each session is 45 min). The control group was given no training. The subjects completed Elliott & Gersham Social Skills Questionnaire (1990) prior and after the training and 3 month later in follow-up. ANOVA with repeated measure was used to analyze the data.

According to the results, the mean of social skills and its components (assertiveness, self-control, collaboration) in the experimental group in the post-test stage were increased compared to the control group (p<0.05) which remained stable three month after the end of training.

The results showed that body language training program is effective in increasing the performance and acquiring changes in the social skills of Autistic Children with High Performance. Therefore, parents and coaches of children with autism are advised, given their evolutionary level, they will benefit from body language training that improves autism studentschr('39') social adjustment and social skills.

The purpose of this study was to evaluate the effect of four weeks incremental training with silybum marianum supplementation on Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Lactate dehydrogenase (LDH), and resting Creatine phosphokinase (CPK) levels among wrestlers.

Twenty volunteer wrestlers were randomly divided into 2 groups of 10 participants namely "Exercise with silybum marianum supplementation, and placebo with training". Written consents were received from everyone. Silybum marianum supplements were administerd every day three times at 300 mg for four weeks. At the baseline, blood samples were collected one hour, 24 hours, and 36 hours after the same wrestling exercise. Independent t-test, repeated measures ANOVA, Bonferroni post-test were used for data analysis.

AST values were significantly decreased in 24 hr (p=0.004) and 36 hr (p=0.001) post exercise training in silybum marianum group. There was also a significant decrease in CPK values 24 hr (p=0.03), and 36 hr (p=0.001) and in ALT levels 24 hr (p=0.001) and 36 hr (p=0.001) after exercise in the silybum marianum group. LDH levels were not significantly different between groups. According to the analysis of variance with repeated measures of CPK (p=0.02), AST (p=0.003) and ALT (p=0.011), there was a significant decrease in silybum marianum group.

According to the results of the present study, long-term supplementation with silybum marianum may lead to a decrease in serum markers of muscle injury, and better confrontation with the enzymes produced after training.

The intense and exhaustive exercise causes oxidative stress and cell damage. The purpose of this study was to investigate the effect of short-term ginseng supplementation on biochemical markers of cell damage following intense anaerobic exercise.

In this semi-experimental study, 20 active girl students with the mean age of 22.85±3.7 years were randomly divided into experimental (n=10) and control (n=10) groups. Subjects of the experimental and control groups respectively received two capsules of ginseng (1036 mg) or placebo daily for seven days. All subjects participated in an intense anaerobic exercise test (Rast) after supplementation period. Lactate, lactate dehydrogenase and aspartate aminotransferase levels were measured in three phases; baseline, after supplementation and immediately after anaerobic exercise test. Data were analyzed by repeated measure ANOVA. 

Lactate, lactate dehydrogenase and aspartate aminotransferase levels significantly increased after the exercise test in the two groups (p˂0.05). However, there were no significant differences in levels of Lactate p=0.35), lactate dehydrogenase (p=0.14) and aspartate aminotransferase (p=0.47) between experimental and control groups following exercise test.

Based on the findings of this study, it can be concluded that short-term ginseng supplementation has no effect on biochemical markers of cell damage following intense anaerobic exercise.

Aging is a process in which structural and functional changes occur in the heart. This study was performed to compare aerobic and resistance training on some oxidative markers and TGF-β in cardiac tissue of elderly rats.

For this experimental study, 27 Wistar rats (mean age 24 months) were randomly divided into three groups of control (9 rats), resistance training (9 rats) and endurance training (9 rats). After one week of endurance training, rats in the endurance group performed their training on a zero-degree steep treadmill for 8 weeks and 2 days a week. Resistive exercise group also performed on the ladder for eight weeks and seven days a week. The research variables were measured by ELISA using Zellbio Germany kits. Data were analyzed using one-way analysis of variance.

In the present study, it was found that the effect of eight weeks of aerobic and resistance training on GPX (p=0.005), SOD (p=0.002) and TGF-β (p=0.005) was significant in the heart tissue of elderly rats. As a result of the post hoc test, it was found that there was only a difference between the experimental and control groups.

The results of this study indicate the role of aerobic and resistance training in improving oxidative stress indices in the heart tissue of elderly rats.

MicroRNAs are small endogenous single-stranded non-protein-coding RNAs that often act as negative gene regulators at post-transcriptional level. These molecules actively participate in a wide variety of cellular events, and are involved in pathogenesis of different malignancies, e.g. lung cancer. With a heterogeneous nature, non-small cell lung cancer comprises more than 80% of lung cancer cases. As of recent, expression profile of non-protein-coding RNAs have been considered in various normal and morbid tissues, and possible roles of microRNAs in gene regulation have been speculated. Functionally, a growing body of evidence categorizes these molecules as “oncomiRs” and “tumor suppressive RNAs.” Through high through-put screening of genome, it has been demonstrated that the expression pattern of specific microRNAs is associated with the outcome of non-small cell lung cancer. Furthermore, quantitative gene expression assessment has revealed that microRNAs with a high expression level in the normal lung often become down-regulated in lung tumors, indicating their possible role as tumor suppressive microRNAs. On the contrary, another group of microRNAs was found to be up-regulated in lung cancer tissues, hence, the name “oncomiR”. In this article, we will have a review on introduction, synthesis, and processing of microRNAs, and their importance in normal and abnormal cells, normal and cancerous lung tissue, and mechanisms involved in expression dysregulations, function, definition methods, and ultimately, application of these molecules as biomarker in clinic.

According to statistics breast cancer is highly prevalent in Iranian women and poses a risk to their physical and psychological health. This study aims to determine the effectiveness of ACT on interleukin 6, biological age, pain intensity, and stress in female breast cancer patients in Tehran.

This is a quasi-experimental study with a pretest-post test with follow-up design (three and six months after first follow-up). The research sample was selected from all women with breast cancer in Tehran based on research entry criteria and via voluntary sampling. Participants were randomly assigned into two experimental (n=10) and control (n=10) groups. The experimental group participated in 8 group sessions which lasted one hour and a half, and the waiting group received their normal treatment until the end of the study. The research data was analyzed with repeated measures ANOVA.

The results of data analysis showed that the treatment program was able to decrease biological age, pain intensity, and stress and was stable throughout time (p<0.01).

Therefore, it could be concluded that this treatment can improve the biopsychological condition of cancer patients.

The purpose of the present study was to determine the effect of resistance training on atrogin, eotaxin and IL-10 indices in obese women.

In this semi-experimental study, 30 obese women aged 30-45 years for South Tehran Branch Islamic Azad University were selected and divided into two groups of resistance training (n = 10) and control (n = 10). In the pre-test, and 24 hours before the start of the exercise, the individual characteristics of the subjects and the research variables (atrogin, eotaxin and IL-10) were measured in blood. Subsequently, the subjects in the resistance training group performed their training program, which was initially 1RM using the Brazilian formula. Subjects then began their workouts for 8 weeks, three sessions per week at 40% intensity and 5 repetitions in the first week, and the intensity gradually increased to reach 90% at week 20 with 20 repetitions. Data were analyzed using dependent t-test, two-way ANOVA, and Bonferroni test.

The results showed that a period of resistance training had no significant effect on the level of atrogin and eotaxin in obese women but had a significant effect on IL-10 level.

Regarding the lack of significant effect of resistance training on atherogenic and etotoxin, it is recommended that obese women use resistance training in consultation with physician.

In December 2019, a new type of viral pneumonia emerged in Wuhan, Hubei Province, China. Subsequently, the World Health Organization (WHO) named this unknown virus as (2019-novel coronavirus) on January 12, 2020, and then designated as “SARS-CoV-2”. This novel disease has no comprehensive guidelines of treatment, diagnosis, control, and prevention. An evidence-based guideline needs to be developed forthwith for frontline physicians and other involved healthcare workers in the fight against COVID-19 pneumonia. Therefore, we prepared this guideline following WHO recommendation, clinical studies, and clinical data of different studies. At present, the RT-PCR technique is approved as a determined diagnostic method for COVID-19. In addition, CT scans and Chest-X-Rays play a prominent role in follow up treatment and recovery statues of disease, and applicable for early detection of COVID-19. Regarding the treatment, drugs such as Chloroquine, an anti-malarial drug, and Lopinavir/Ritonavir, an anti-HIV drug, have shown significant antiviral activity against COVID-19. Other candidate drugs such as approved nucleoside analogues (favipiravir and ribavirin) and experimental nucleoside analogues (Remdesivir and Galidesivir) may have potential antiviral activity against COVID-19. Further, Pegylated Interferon Alfa-2a/b, an approved drug for the treatment of HBV and HCV, can also be exerted to stimulate the intrinsic antiviral response in patients with covid-19. Eventually, we further discussed other potential therapeutic agents and diagnostic strategies for the treatment, detection, and evaluation of covid-19 pneumonia to assist the healthcare workers in clinical sections.

Enterobius vermicularis is the most common worm infection worldwide. The prevalence was reported 17.2% among preschool children in Iran, 2017. High prevalence of this parasite in crowded environments would spread the parasite and conserves the parasite carreiers. This study aimed to examine prevalence of Enterobius vermicularis infection in 2-6 years old children in affiliate kindergartens of Iran University of Medical Sciences, Iran, Tehran, 1397.

In this descriptive cross-sectional study, the prevalence of Enterobiosis Vermicularis was evaluated using Graham and Stool tests in contrast with the prevalence of other intestinal parasites.

The prevalence of different types of intestinal protozoa was 19.8% in children whom one of their family members works at Iran University of Medical Sciences and affiliate hospitals. While the prevalence of Enterobacter vermicularis, as the only worm infection was 0.9%, and no other helminthic infections were seen.

This low prevalence of intestinal worms like Enterobius vermicularis in recent decades may be due to community health improvement, although that is commendable, the important point is the possibility of the extinction of humanitychr('39')s continual symbiosis and a demand to predict its future consequences as well as increase in different type of allergies