مجله دانشگاه علوم پزشکی گرگان
سال بیست و دوم شماره 3 (پیاپی 75، پاییز 1399)

Obesity by releasing inflammation factors such as Interleukin-6 (IL-6) cause atherosclerosis and cardiovascular diseases. Also, L-carnitine reduces inflammatory factor such as IL-6. The study was done to determine the effect of eight week endurance training with L-carnitine supplementation on IL-6, nitric oxide (NO), blood pressure, and body composition in young obese women.

In this clinical trial study, 40 volunteer young obese women (age: 23.3±2.3 yrs. and BMI: 31.1±1.4 kg/m2) randomly assigned in the endurance training with L-carnitine (ETL; n=10), endurance training with placebo (ETP; n=10), L-carnitine supplementation (LCS; n=10) and control (Con; n=10). The training protocol consisted of endurance training with gradually increasing of duration and intensity (25-min at 50% HR max and increased to 45-min at 70% HR max), three session a week for 8 weeks. The supplement groups consumed 3gr of L-carnitine daily, while the placebo group ingested the same amount of maltodextrin. Blood pressure and blood samples were obtained before and 36 hours after training protocol, and serum levels of IL-6 and NO were measured by ELISA method.

IL-6, weight, fat mass and fatty percent was significantly reduced in ETL and ETP groups compared to control and LCS groups (P<0.05), and this reduction was lower in the ELT than ETP group (P<0.05). Also, NO was significantly increased in the ELT and ETP groups compared to the LCS and controls (P<0.05).

Although the implementation of endurance training with and without L-carnitine for 8 weeks caused to decrease of IL-6, increase of NO and improved body composition, but the effect of endurance training with L-carnitine on decreasing of IL-6, weight and fat mass was significantly better.

Balance in intellectual disability individuals is very important due to the weakness in performing balance tasks. This study was performed to determine the effect of six weeks of vestibular stimulation exercises on the balance of children with mild intellectual disability.

In this clinical trial study, 30 intellectual disability boys were randomly divided into control and experimental groups. Subjects in experimental group were receiving vestibular stimulation training for six weeks. No intervention was performed on the subjects in the control group. A single leg test was used to screen the subjects with a balance of weakness. To assessment the static, dynamic and functional Balance, the Bruninks Oseretsky test was used and a Timed Up and Go (TUG) was used, respectively.

After the end of the training period, static balance, dynamic balance and functional balance was significantly increased in experimental group compared to controls (P<0.05).

Six weeks of vestibular stimulation exercises have a positive effect on static, dynamic and functional balance in intellectual disability boys.

Strength and flexibility are the factors affecting the athletechr('39')s performance. This study was done to determine the effect of eccentric training on knee strength and hamstring flexibility in active females with hamstring tightness.

In this clinical trial study, 24 active female athletes with hamstring tight were randomly divided into intervention and control groups. For measurement of strength, including the eccentric and concentric peak torque and the time to reach the peak torque in speeds of 60 and 180 degrees per second, isokinetic dynamometer device .For measurement of hamstring flexibility, a passive knee extension test was used six weeks before and after the eccentric training of hamstring.

After six weeks of eccentric training, a significant  improvement was observed in test scores of passive knee extension (PKE) test and also in the maximum torque and time to reach the maximum torque eccentric flexor knee in angular velocity of 60 degrees per second in the interventional  group compared to controls (P<0.05).

Eccentric training increases flexibility and eccentric strength of hamstring muscles in active females with hamstring tightness.

Performance and interactions of the couples having important roles in family sustainability. This study was done to evaluate the effectiveness of emotion-focused therapy on the performance component of couples referring to counseling centers.

In this clinical trial study, 28 couples with marital problems were randomly divided into intervention and control groups. Subjects had score lower than the cut-off point (120 points) using McMaster Family Assessment Device. Subjects in experimental group participated in ten sessions of an hour and a half of the emotion-focused therapy. Pre-test, post-test and one month follow-up were performed for each subject.

The therapy had impact on increasing all of the performance components of couples, and the survival of the effect of treatment was evident in one month follow up. There was a significant difference between the scores of the two groups in all of the components of the post-test variable of family functioning (P<0.05). The difference between the pre-test and post-test scores of couples in the test group was 20.536±4.842 (P<0.05) and post-test-follow-up was 1.286±4.487. Also, the effectiveness of emotional therapy in components, general functioning of couples, affective responsiveness, behavior control, communication, problem solving, roles, and affective Involvement, significantly were remarkable.

The emotion-focused therapy intervention has a significant role in changing the components of couple’s performance. Therapists can use this approach in educational centers and counseling to help couples seeking divorce and incompatibility to improve the reduction of marital problems and increase their satisfaction and improve the general functioning of couples, affective responsiveness, behavior control, communication, problem solving, roles, and affective Involvement.

Obesity considered to be one of the major health problems and risk factors of a wide range of diseases including diabetes, cardiovascular diseases, blood pressure and various types of cancer. This study was performed to compare the effectiveness of integrated group psychotherapy and cognitive-behavioral stress management on body image and mindful eating of obese women.

In this clinical trial study, 45 obese women were randomly divided into three groups including integrated group therapy (first intervention), behavioral-cognitive stress management (second intervention) and control groups. All of the three groups fulfilled a pretest but the control group did not receive any intervention. Intervention groups received nine sessions of therapy. Data were collected through questionnaires of body image and mindful eating.

Reduction in worry in body image and mindful eating were observed in integrated group therapy and behavioral-cognitive stress management (P<0.05). However, the difference between mean values of body image and mindful eating scores in behavioral-cognitive stress management and integrated groups were 0.852 and 22.93, respectively which was not significant.

Integrated group therapy and cognitive-behavioral stress management was shown to have an effect on the body image and mindful eating in obese women.

Pain after tonsillectomy is one of the most common complications. This study was done to compare the effect of Gabapentin and promethazine as premedication to reduce pain after tonsillectomy.

This clinical trial study was performed on 104 patients aged 7-15 years who were candidate for tonsillectomy. Patients were randomly divided into gabapentin and promethazine groups. The first group received oral gabapentin 20 mg/kg/bw, and the second group was treated with promethazine syrup 0.5 mg/kg/bw one hour before anesthesia. Pain score was recorded based on the MOPS index and recorded and compared during 3, 6, 12, and 24 hours after surgery.

The mean±SD of pain severity in the intervention group with promethazine at 3, 6, 12 and 24 hours after surgery were 1.35±0.84, 0.9±0.87, 0.25±0.52, 0.04±0.19, respectively. Pain severity was 1.58±0.98, 1.13±0.91, 0.69±0.27, and 0.06±0.24 in gabapentin group, respectively. There was no significant difference between pain score of two groups in 3, 6, 12 and 24 hours after surgery.

Gabapentin and promethazine as premedication have a similar analgesic effect in patients after tonsillectomy.

Food restriction may have beneficial or detrimental effects on the brain functions such as learning and memory. Also, dopamine receptors are involved in learning and information retrieval. This study was performed to determine the simultaneous effect of food restriction and dopamine D2 receptor inhibition on spatial memory of rats.

In this experimental study, 60 male Wistar rats were allocated into 6 groups including controls, 25%, 50% and 75%, food restriction, sulpiride (D2 receptor antagonist, 4 mg/kg/day, ip), 75% food restriction and sulpiride and treated for 21 days. To evaluate the memory, an eight-point radial arm maze was used. Then, the catalase and malondialdehyde level of the hippocampus were measured.

Twenty-five percent food restriction caused to 11.8 percent decrease in spending time to find the food compared to control group (P<0.05). The 75% food restriction and or sulpiride injection significantly increased that time by 24.4% and 18.3%, respectively (P<0.05). The group with 75% food restriction were received sulpiride showed the most increase in the time of food finding compared to all groups (P<0.05). Catalase activity was only significantly reduced in the 75% restricted groups to 17.6% and 22.2%, respectively (P<0.05). Malondialdehyde production was significantly increased in the 75% food restricted groups to 50.2% and 59.3, respectively and sulpiride-received group to 31.2% compared to the control group (P<0.05).

Simultaneous applying of food restriction and inhibition of dopamine D2 receptors resulted in increased hippocampal prooxidant levels and exacerbated memory impairment.

Parkinsonchr('39')s disease is a neurological disorder caused by the loss of dopaminergic neurons in pars compacta of substantial nigra. The most important symptoms of this disease include slow motion, lack of movement, tremor and imbalance. This study was done to determine the effect of probiotic Lactobacillus paracasei on motor disorders caused by injection of 6-hydroxy dopamine in Parkinsonchr('39')s model in male rats.

In this experimental study, 48 male rats were randomly allocated into six groups. To create an animal model of Parkinsonchr('39')s disease, a black body component in male rats was injected 6-hydroxy dopamine (6-OHDA) (0.5 mg/kg) unilaterally by stereotaxic apparatus. After 3 weeks of recovery, to evaluation of degradation rate, animals were received apomorphine, intraperitoneally. In the first experiment, rats were randomly divided into Sham and Parkinsonchr('39')s (injured) groups, the Sham group were received only water and food, and the injured group received 6-hydroxy-dopamine. In the second experiment, male rats were divided into 4 groups of 8 rats, each of the 4 groups was injected 6-hydroxy-dopamine and 21 days later, they were tested for assay of apomorphine. The results were recorded, then for 28 days, the first group was taken as control. The second group of saline, the third group of milk, the fourth group of milk and probiotic were gavaged. At the end of day 28, once again, each group was subjected to rotation of apomorphine test and the rotations were recorded.

The behavioral analysis of saline, milk, milk plus probiotics were indicated that the group receiving probiotic Lactobacillus paracasei plus milk was significantly less apomorphine rotation test than the saline group (P<0.05).

It seems that probiotic Lactobacillus paracasei can reduces Parkinson’s disease symptoms.

Knee osteoarthritis is one of the most common causes of musculoskeletal disability. This study was performed to determine the effect of endurance training and glucosamine consumption on Insulin-Like Growth Factor 1 (IGF-1) and Insulin-Like Growth Factor Binding Protein 3 (IGFBP-3) gene expression in knee tissue of mice with osteoarthritis.

This experimental study was performed on 30 adult male Wistar rats. Induction of osteoarthritis of the knee was performed by surgery. The animals were randomly allocated into 5 groups and each group consisted of 6 mice. Groups include: Control, Saline, glucosamine, train and train-glucosamine. The training program for eight weeks, three sessions per week and included 29-25 minutes running on a treadmill at a speed of 15 m/ min for the first week, and each week one meter per minute was added to reach 22 m/min for the eighth week. All animals followed 12-hour fasting and 48 hours after the last session of the session, anesthetized with intraperitoneal injection of Ketamine and Xylosin. The expression of IGF-1 and IGFBP-3 of cartilage was measured by Real Time PCR.

Expression of IGF-1 and IGFBP-3 increased to be 22% and 6% in control group compared to Saline group. Also, level of IGF-1 in exercise groups, glucosamine and exercise-glucosamine group was significantly increased compared to control group (P<0.05). The gene expression of IGFBP-3 in the exercise-glucosamine group was significantly increased compared to the control group (P<0.05).

Probably Chondrocytes secrete higher levels of IGF-1 during tissue damage that causes the structural synthesis of collagen 2 and proteoglycans and Finally, endurance training with consumption of glucose amine increases the expression of IGFBP-3 gene.

The undesirable and destructive effects of stress on the lives of many couples are grounds for marital burnout and consequently, the quality of the couple’s marital relationship is affected. This study was conducted to evaluate the effectiveness of mindfulness-based stress reduction (MBSR) training on reducing couple burnout among women.

This quasi-experimental study was performed on 30 married women referred to the Counseling and Psychological Services Center during 2016 with a score of 75 on their marital burnout questionnaire. Subjects were selected using available sampling method and randomly assigned to intervention and control groups that each included 15 members and the pre-test-post-test-follow-up method was performed. The intervention group participated in an 8-session course of mindfulness-based stress reduction training. No intervention was provided for the subjects in the control group until the end of the follow-up stage. The data were collected using Pines Marital Burnout Scale (1996) which were completed in pre-test, post-test, and one-month follow-up stages by subjects in both groups. In the study groups, the components of marital burnout including physical fatigue, mental fatigue and emotional fatigue were compared and evaluated.

Mindfulness-based stress reduction intervention reduced marital burnout and its components (physical fatigue, mental fatigue, and affective fatigue) in the interventional group compared to the control group at the end of the intervention and after one month follow-up (P<0.05).

This study showed that mindfulness-based stress reduction training is an effectiveness intervention for reducing the level of marital burnout among women.

Perinatal mortality rate (PMR) is one of the main indicators in evaluation of health community and healthcare systems. This study was performed to determine the perinatal mortality rate in the referral third level of maternal and infant care center affiliated to Babol University of Medical Sciences.

This descriptive-analytical study was performed on by cross-sectional method and 19234 births (9751 male and 9483 female) from 22 weeks gestation to 29 days after delivery Ayatollah Rouhani Hospital in Babol, northern Iran during 2011-18. Data on the cause of neonatal death, maternal age, type of delivery, malformations, maternal underlying disease, maternal pregnancy-related conditions, and diseases at the time of death in neonate were collected from website of the Ministry of Health. Then each of the indicators was calculated per 1000 live births.

In this study, the PMR was calculated per 1000 live births which was 29.01 (boys 16.17 and girls 12.84). The portion of vaginal delivery was 9.67 and cesarean section was 19.34. Out of 558 perinatal deaths, 59.9% died due to intrauterine death with an index of 17.37 and 40.1% of deaths were due to infant death with an index of 11.63. Most neonatal deaths (74%) occurred within the first 24 hours of birth and in terms of gestational age 86.02% were <37 weeks of gestation with an index of 24.95, and low birth weight were 83.8% with an index of 24.31. Underlying disease was found in 25.6% of mothers and pregnancy-related conditions in 74.4% of cases. Fetal distress in 14.4% with an index of 4.20 was the most common disease associated with infant death or cause of death in preterm infants. Other causes of perinatal death were specific disorders of perinatal origin, birth defects, chromosomal abnormalities, and accidents were 10.09, 4.06, and 0.58 per 1000 live births, respectively.

The most and important factors of prenatal mortality wrer prematurity and low birth weight that major causes include maternal pregnancy-related conditions and maternal underlying disease, Therefore, emphasis on adequate prenatal care, identification and follow-up of mothers with underlying diseases can be effective in reducing perinatal mortality.

Infantile colic which can cause nervousness and anxiety in parents by fussing and restlessness in babies. This study was done to determine the prevalence and associated risk factors of infantile colic in Babol, the North of IRAN.

This descriptive-analytical study was done on 591 breastfeeding babies (321 females, 270 males) born with birth weight 2500-4000 grams and gestational age ≥37 weeks without any medical problem during 2016-18. They visited in age 2, 4, 8, 12 weeks by neonatologist. On the basis of parents complain and Wesselchr('39')s criteria babies were divided into three groups: Cramp with crying (colicky group), Cramp without crying and normal group. Then possible risk factors of infantile colic have been compared in three groups.

45.5% of babies presented cramp with crying as colic group. Time of restlessness was significantly more than morning during night and afternoon (P<0.05). Colic was higher in infants born by cesarean section (P<0.05), and in the first-born child (P<0.05). However, there was not significant relation with gender, mothers’ education, parents smoking and taking dairy product.

According to this study’s findings, nearly half of infants had the symptoms of colic, which was higher in first children, infants born by cesarean section and during night.

Thyroid nodules are common among the general population and they increase the risk of thyroid malignancies. This study was done to evaluate the correlation of findings of ultrasound based on Thyroid Imaging and Reporting Data System (TIRADS) and cytology of fine needle aspiration (FNA) based on Bethesda system to evaluate of thyroid nodules.

This descriptive-analytical study, was performed on 165 patients (152 females and 13 males) referred to the sonography center of Sayyad Shirazi Educational Hospital, Gorgan, northern Iran during 2018. Ultralosonographic features of nodules were recorded in the pre-filled checklist. According to TIRADS and endocrinologist clinical suspicion, couple of patients was eligible for FNA under the ultrasound guidance. The cytology of FNAs was reported based on the Bethesda system classification.

The mean age was significantly lower in patients with malignant nodules (35.4 vs 44.8; P<0.05). Frequency of malignancy was 8 times higher among females than males (16 vs. 2). TIRADS 3 and 4 were the most common categories among the others with the prevalence of 44.4% and 32.3%, respectively. Bethesda 2 and 4 were the most prevalent categories with prevalence of 58.8% and 20.6%, respectively. The strongest agreement was observed between TIRADS 2 and Bethesda 2 that showed benign findings. Kappa index was 0.061 between TIRADS and Bethesda (P<0.05). Echogenicity, echogenic foci, shape, and margin of nodules were seen significantly more in malignancy.

The most accurate prediction of TIRADS belongs to benign nodules. The correlation between TIRADS and Bethesda was evaluated to be significant overall and the maximum level of correlation was at benign findings. Therefore, these two systems can efficiently be used in order to rule out malignancies and reduce the rate of invasive interventions.

Behavioral disorders among children and adolescents are common and incapacitating which cause many problems for the families and the patient themselves and associated with high prevalence of negative social consequences. This study was done to evaluate the prevalence of psychiatric disorders among children and adolescents in Gorgon, north of Iran (2019).

This descriptive-analytical study was performed on 1025 children and adolescents aged 6-18 years in Gorgan, north of Iran (2019). Subjects were selected by Multistage Cluster Sampling. Digital version of K-SADS test was studied for 24 types of child and adolescent psychiatric disorders. Sampling was done by trained psychologists, among general population and by referring to the house of people. Psychiatric disorders included mood disorders, behavioral disorders, neurodevelopmental disorders, substance abuse disorders, and elimination disorders.

The prevalence of psychiatric disorders among children and adolescents was 13.2%. This prevalence was 14.3 % and 12.1% in males and females, respectively. According to age groups, The prevalence of psychiatric disorders was common in 6 to 9 years olds with 17.8% which in comparison with other age groups was significant (P<0.05). Eliminatory disorder with 6.1% was the most common illness followed by behavior (6%), tension disorders (4.8%) and neurodevelopmental disorders (3.3%).

The prevalence of psychiatric disorders among children and adolescents in this area is in a median range compared to other domestic and overseas.

Unhealthy lifestyle is the main cause of morbidity, mortality and preventable complications in the elderly. Performing health promotion behaviors are one of the most effective factors in maintaining and improving health. This study was done to determine the health promotion lifestyles in the elderly people.

This descriptive-analytical study was performed on 110 elderly people aged 60-88 years referred to teaching and medical centers in Gorgan, north of Iran during 2019. Data was collected using Health Promotion Lifestyle Profile 2 (HPLP-II) questionnaire. This questionnaire includes six dimensions of spiritual growth, responsibility for health, interpersonal relationships, stress management, physical activity and nutrition for evaluation health promotion behaviors status. The total score range of the instrument ranges from 52 to 208. A score of 52-103 was considered low level of compliance with health promotion behaviors and a score of 104-155 and scores above 156 was considered intermediate and high level, respectively.

The mean±SD of health promotion lifestyle was 143.52±17.36. There was a significant relationship between lifestyle and demographic characteristics (P<0.05). Spiritual growth and interpersonal relationships had the highest score among the six dimensions of health promotion behaviors.

Health promotion lifestyle in the elderly was low in terms of physical activity and stress management.

Developmental disorder and environmental factors are considered as the main causes in postural abnormalities in children and adolescents. This study was done to evaluate the role of BMI, physical activity and the use of electronic device in the status of trunk abnormalities in male adolescents.

This descriptive-analytical study was conducted on 480 boys of 13 to 15 years old in Golestan province, northern Iran. Trunk abnormalities were measured using a spinal mouse. Physical activity was assessed using a standard physical activity questionnaire. Use of electronic device was measured using the form of rate of use of electronic device.

Kyphosis abnormality in 13, 14 and 15 years-old male adolescents were reported 70%, 65% and 75%, respectively. In addition, 60% of 13 years-old, 40% of 14-years-old, and 50% of 15-years-old adolescents had lordosis abnormality. There was a direct and significant correlation between kyphosis abnormalities with BMI and using electronic device as well as a reverse significant correlation between lordosis abnormality and BMI was demonstrated.

This study indicated that trunk abnormalities are relatively common in male adolescents in Golestan province, northern Iran. Also, BMI and the use of electronic device can also affect these abnormalities.