مجله پزشکی دانشگاه علوم پزشکی تبریز
سال چهل و دوم شماره 5 (پیاپی 149، آذر و دی 1399)

Coronary Artery Disease (CAD) is a major cause of mortality in most countries. Many risk factors such as high blood pressure, hyperlipidemia, diabetes, age, sex, obesity, smoking, and family history play a role in CAD. The aim of this study was to evaluate the concentration of Total Sialic Acid (TSA) and Lipid Profiles (LP) with the Severity of the Vessel in patients with non-smoker and diabetic CAD, so that by measuring these parameters, effective help for diagnosis and prevention for healthy people Prone to CAD, and also control the treatment of patients.

In this study, 200 individual including 160 patient and 40 control group were considered. All patient groups were non-smokers and diabetic. Patients were divided into 4 groups according to the results of angiography: Patients with Normal angiography (n = 40) with one eclipse (n = 40), patients with double stenosis (n = 40) and patients with eclipse Three vessels (n = 40). The control group was chosen from people who had no history of CAD and other diseases. The lipid profile was measured by standard methods and serum total sialic acid was measured by ELISA method.

There was no significant difference between the two groups in age and sex, but there was a significant difference in family history (p<0.05). There was a significant difference in serum glucose level between the patient and the control group (p<0.05), Also hs-CRP serum levels were normal in two patient and control groups. Serum levels of cholesterol, triglyceride and LDL in patient group were significantly higher than that of the control group but HDL serum level was adverse (p <0.05), Also TSA serum level in the patient group was significantly higher than the control group (p<0.05).

Serum Total Sialic Acid level in non-smoker and diabetic CAD patients has a significant increase compared to the control group. It seems that the above biochemical parameters contribute significantly to the development and progression of atherosclerosis and CAD, by which timely measurements of these parameters in healthy individual probably can be helpful in preventing and improving CAD and controlling the treatment of patients.

Type 2 diabetes mellitus is a chronic metabolic disease, known as the most common type of diabetes and is associated with hyperglycemia, insulin resistance, and insulin-dependent infertility. Isoflurane and Propofol are two commonly used drugs in anesthetics that have different effects on various systems in the body; however, limited studies have been done on the impact of these two medications on the blood glucose level in diabetic patients. The purpose of this study is to compare the effects of Propofol and Isoflurane on the blood glucose levels in patients with type 2 diabetes mellitus who are surgical candidates.

This clinical trial study was conducted on a group of patients with type 2 diabetes mellitus who were candidates for elective surgery. Participants were selected based on the order of referral using convenience sampling method and entered the study after evaluating inclusion and exclusion criteria. First, patients' demographic data were recorded and then they were randomly divided into two groups to receive Isoflurane and Propofol. The vital signs of the patients were recorded before and during anesthesia every 15 minutes. Blood glucose levels were measured by the glucose meter before surgery and one hour after the start of the anesthetic maintenance.

There was no significant difference between the mean blood glucose level before surgery and at the end of recovery in any of the study groups. Moreover, the mean of blood glucose level before the surgery and at the end of recovery and the difference in the mean of blood glucose level in both groups of Isoflurane and Propofol in different time intervals were not significantly different (P< 0.05). Comparison of blood glucose level before and after surgery in each group showed that there was no significant difference in the level of glucose before and after the surgical operation in the Isoflurane group (P= 0.3), but in the Propofol group, the level of blood glucose had decreased significantly after the surgical operation (P= 0.014).

Maintenance of anesthesia with Propofol in comparison with the inhaled Isoflurane during the surgical operation can lead to a reduction in the blood glucose levels after the surgery compared to the preoperative state.

Limited energy intake with physical activity is effective to reduce health problems associated with obesity. It has been shown that PYY3-36 level increased after intense exercise. This study investigated effect of exercise therapy on appetite suppression and weight loss among obese and/or overweight women.

There was a quasi-experimental with a pretest-posttest design, two groups (control-exercise) study. Study population was overweight or obese women with 20-34 years old and body mass index 27-34 kg/m2. 13 women were randomly assigned in 2 groups (exercise group with 8 weeks of aerobic exercise training (n=7) and control group (n=6)). Weight, waist circumference, hip circumference, lipid profile, cortisol and PYY3-36 were measured at baseline and end of the study.

In baseline of study, there was no significant difference across the groups in factors mean (P>0.05).In control group, after 8 weeks, there was no significant difference in variables.(P>0.05) However, In exercise group significant decrease was observed in BMI, WHR, PYY3-36, TG, CHOLESTROL(TC) and LDL, compared to control group (P<0.05).

Aerobic exercise within the 80% of heart rate reserve is beneficial in lipid profile, appetite management and modified anthropometric factors. These studies demonstrate that a cortisol change is not along with PYY3-36 changes. We suggest the longer exercise training for this purpose.

Pathological analysis plays an important role in the diagnosis, prediction and planning of cancer treatment. Using digital pathology, ie, scanning and storing digital parts of patient tissue, tools for analyzing these complex images now can be developed. Doctors use a computer diagnostic system from an intelligent assistant to accurately diagnose. These systems have great benefits in improving treatment efficacy.

In this study, the deep neural network classifier has been used with the help of the Tensor Flow framework and the use of the Keras-library. Input images are initially transmitted from a low pass filter to reduce noise effects. The pre-processed images are then imported into a convolutional neural network.

The results of the research reveal a significant difference in the accuracy values between different methods with the proposed method, which in some cases indicates an increase of more than 14.18% in the accuracy of the diagnosis. Another advantage of the proposed method is to provide high sensitivity to histopathologic images, which shows an increase of 12 to 18 percent compared to other studies. The reason for this is the excellence of extracting high-level features through convolutional neural network, which is accompanied by a reduction in the size of the feature vector.

The results showed a accuracy of %98.6 for skin lesions and %96.1 accuracy for breast cancer histopathologic findings, which offers promising results compared to the results of other studies.

Among the factors associated with cancer are the nitrosative stress and increased expression of some Matrix Metalloproteinase (MMP). Silibinin has an anti-tumor effect, therefore, the present study evaluates the effects of slibinin on nitrosative stress indices and Matrix Metalloproteinase -9 (MMP-9) expression in the animal models of breast cancer.

In this study, 48 Balb/c mice were divided into 6 groups (each group contains 8 mouse): healthy ( control and cancer ) and treatment groups: treatment groups included cancerous mice which receiving 20 mg, 40 mg and 80 mg of silibinin for 3 weeks. In order to induce cancer, 4T1 cell line was used. After enrolling serum and breast tumor samples, NO level and MMP-9 expression in breast tumor biopsy were evaluated. Data were analyzed using one-way ANOVA, Kruskal-Wallis and T-test (p <0.05).

The results revealed that the use 80 mg of silibinin resulted in significantly decreased in NO level in cancerous mice(170.88±15.42μM/ml) compared with untreated cancerous mice(190.38±21.19 μM/ml) (p=0.05). Furthermore, the use of three dose of silibinin led to a non-significant reduction of MMP-9 in the treatment group compared to untreated cancerous mice.

Silibinin treatment has been shown to improve nitrosative stress in breast cancer mice.

The aim of the present study was to determine the effect of Titanium carbide nanoparticles on stemness and senescence markers of mouse bone marrow derived mesenchymal stem cells.

After isolation of mesenchymal stem cells from mouse’s bone marrow, their surface markers were studied using flowcytometry. MTT assay, cell cycle analysis; colony forming assay, and senescent beta galactosidase staining were performed for cells treated with titanium carbide nanoparticles. Then, the expression of OCT-4 and Nanog genes were studied by qRT-PCR in titanium carbide treated mouse’s bone marrow mesenchymal stem cells (mBMSCs).

All mBMSCs showed spindle shaped morphology. Their identity was confirmed by flow cytometry of stained cells for CD11b, CD90, CD45, and CD44 markers. The MTT assay results showed that titanium carbide effect is time-dependent and no cytotoxic effects were observed in short treatment times. But toxic effects were observed after 72 or 144 hours of post treatment with doses range from 0.1 to 1 mM (P<0.05). Besides, cell cycle study detected more cell populations in G0/G1 and less percentage in S phase. The colony forming assay in treated cells exhibited smaller size of colonies. The beta galactosidase staining of treated cells demonstrated more positive cells (more aged cells). Finally, qRT-PCR showed significant down regulation of OCT-4 and Nanog (p<0.05).

Titanium carbide as an implant material could affect the viability, stemness and senescence of mBMSCs in negative manner.

Sepsis, which is a common inflammatory response to severe infection, is one of the major causes of mortality in hospitalized patients. Sepsis, severe sepsis or sepsis syndrome, and eventually septic shock, may be seen in the development of infection. The aim of this study was to evaluate the short-term and long-term mortality in patients with severe sepsis and septic shock in centers with low antibiotic resistance.

In this cross-sectional study, blood culture samples and peripheral blood samples were taken from all patients for para-clinical tests. The severity of severe sepsis and septic shock was assessed by the APACHE II and SOFA clinical criteria. Sepsis risk factors and primary causes of sepsis were recorded.

From 100 patients, 55% had severe sepsis and 45% had septic shock. SOFA24h and SOFA96h scores were significantly higher in patients with septic shock. The most common primary cause of sepsis was related to abdominal infections with a frequency of 42%. The frequency of confirmed positive blood culture was 53%. The most commonly isolated pathogen was E.coli with a frequency of 66%. Short-term mortality was 29% and longterm mortality was 28.2%.

The main risk factors affecting the mortality of patients were age-related septic shock, cardiovascular disease; hypertension, immunosuppression, and SOFA score.

Occurrence of cellular damage in various tissues of the body and inflammatory response is evident during intense sporting competitions, such as half-endurance running racing. Therefore, the aim of this study was to determining the effect of acute and 14-day Coenzyme Q10 supplementation on inflammatory, anti-inflammatory, muscle and hepatic damage indicators response in elite male runners.

In quasi-experimental study, eighteen elite male middle-distance runners (aged 20.45±2.48 years, and body fat 7.4 ±1.63 % and VO2max 60.85 ± 3.96) in a randomized and double-blind design were allocated in two equal groups: supplement group (n=9, Coenzyme Q10: 5 mg/kg/day) and placebo group (n=9, Dextrose: 5 mg/kg/day). Before and after supplementation acute and 14-day period, all subjects were participated in a training like running a competitive 3000 meters. Leukocyte count, serum Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) and interleukin-10 (IL-10) concentration were analyzed before and after two like competitive running 3000 meters and supplementation protocols. Data were analyzed by repeated measure ANOVA, Bonferroni and independent t test, with a <0.05 significance level.

The short-term coenzyme Q10 supplementation attenuated the exercise-induced increase in response of ALT and AST and Leukocyte count (p<0.05). However, acute supplementation had no significant effect on any of the parameters. Also, short-term supplementation had no significant effect on baseline and exercise-induced response of IL-10.

Based on the results, Short-term supplementation of coenzyme Q10 may reduce markers of liver damage and muscle response to competitive and exhaustive exercise.

Anzaroot is a manna produced from Astragalus sarcocola Dymock (Family Leguminosae) that is widely distributed in Fars, Kerman, Baluchestan and Hormozgan in Iran. Since the study of the physicochemical properties and quality control (QC) of herbal materials results in the validation and standardization for clinical uses, in accordance with World Health Organization (WHO) guidelines, it is necessary to carry out for Anzaroot which has indication in traditional medicine.

Anzaroot was identified and determinated scientific name by a systematic specialist after purchasing from Niak pharmaceutical co. in gorgan. Physicochemical and pharmacognostical properties of Anzaroot have been determinated According to the WHO guidlines.

Anzaroot is a very bitter, crisp and fragile manna and non-stick in dry state, which is seen as separate binary grains under the microscope. The moisture content, foreign matter, sucrose content, total ash and watersoluble ash were reported 5.25 ± 0.2, 2.8 ± 0.2, 12.09 ± 0.04, 9.8 ± 0.5 and 2.9±0.15, respectively. It has significant foaming index, 72% Solublity in water and less than 50% in 96% ethanol and not swelling index. The levels of lead, mercury and cadmium were 0.0006, 0.0002 and 0.0007 ppm and total flavonoid content was reported 18.61 μg/ml with respect to standard Quercetin at 415 nm.

This study can be a novel idea for the discovery or development of pharmaceutical products based on Anzaroot of Iran and its diverse therapeutic properties, such as the common cold, contusion, and bone fracture in traditional medicine.

The use of HMB supplement is prevalence among athletes to reduce proteolysis and increase muscle mass. Therefore, the purpose of this study was to investigate the effect of short-term beta-hydroxy-betamethylbutyrate (HMB) supplementation on serum cortisol and testosterone levels in wrestling men following an exhaustive exercise.

Sixteen male wrestlers were randomly divided into two groups including: HMB supplementation (40 mg/kg body weight; n=8) and placebo (n=8). Both groups, after two weeks of supplementation, performed an exhaustive exercise. Blood was obtained before supplementation (Base), before exhaustive exercise, immediately after exhaustive exercise, one hour and 24 hours’ after exhaustive exercise. Circulating concentrations of cortisol and testosterone were assayed.

The results of this study indicated that there was no significant difference between the two groups at serum cortisol levels of resting state (before exhaustive exercise) and after exhaustive exercise (immediately, one hour and 24 hours later) (p<0.05). However, there was significant difference between the HMB and placebo groups at serum testosterone levels and testosterone/cortisol of resting state (before exhaustive exercise) and after exhaustive exercise (p<0.05).

In general, short-term beta-hydroxy beta-methyl butyrate (HMB) supplementation does not affect the serum cortisol in male wrestlers before and after an exhausting exercise. However, HMB supplementation can lead to a significant increase in serum testosterone and T/C before and after an exhausting exercise.

Obesity is a risk factor for several diseases including metabolic and cardiovascular diseases and is underlying cause of liver diseases. Researches indicate that life style modification via changes in physical activity levels and healthy diet can be beneficial for liver function. The aim of this study was to investigate the effects of aerobic training and garlic supplementation on serum levels of ALT and AST.

In a clinical trial, forty obese men (BMI>30 kg/m2 ) were randomly assigned into four groups (10 per each) including 1- Exercise+Sepplement (ES) 2- Supplement (S) 3- Exercise+Placebo (EP) and 4- Placebo (P). The subjects received garlic capsule two times per day (each capsule contained 500 mg garlic powder) or placebo (starch) over a period of eight weeks. The subjects in exercise groups performed a supervised progressive aerobic training (3 times a week, %50-%70 HRmax, 20-40 mins) at the same time. Before and after the experimental period body composition analysis was performed and blood samples were taken in a fasting state. Data were analyzed using paired t-test, One-Way ANOVA and Tukey’s post hoc tests at the significance level of P<0.05.

The results showed that ALT and AST levels were decreased following 8-week aerobic training (P<0.05). Garlic supplementation also decreased serum levels of aminotransferases (P<0.05). Inter-group differences were seen between exercise groups and placebo (P<0.05).

It can be concluded that aerobic training and garlic supplementation can decreases serum aminotransferases levels; however, garlic supplementation has no additional effect on the effects of exercise.

Diabetics have many disabilities, including neuronal damege hippocampus, and BDNF is an effective factor in this field. This factor has the most impact on the hippocampus, also TNF-α is an inflammatory factor that increases in diabetes, the purpose of this study was to investigate the effect of 6 weeks of High Intensity interval training on the gene expression of brain-derived neurotrophic factor (BDNF) in the hippocampus of male Wistar rats.

For this study, 48 male Wistar rats (4 weeks old) with 150± 10 g weight were categorized in 4 groups of: diabetic rats (n= 12), exercise diabetic (n= 12), control (n= 12) and exercise control (n= 12). For induction of diabetes, peritoneal injection of STZ solution (50 mg/kg) was used. After a week of familiarization with the environment and practice, high Intensity interval training protocol consisted of 3 days of training per week for 6 weeks with 50% to 110% of maximum oxygen consumption was performed. 24 hours after the completion of the exercise, the functional test was taken and the animals were autopsy 48 hours after the functional test. Finally, BDNF gene expression was evaluated using Real Time PCR technique.

Regarding the results, it was found that the high Intensity interval training intensified the expression of the BDNF gene and decreased the expression of the TNF-α protein. also The weight gain of the hippocampus has been observed along with increased expression of BDNF gene in the diabetic high Intensity interval training group.

Exercise can help prevent hippocampus tissue loss, and also prevent memory damage that caused by diabetes. Also, high Intensity interval training are effective in maintaining the physical fitness of diabetics, therefore high Intensity interval training are recommended for improvement in the physical condition and life of diabetics.

The expression of microRNAs as epigenetic regulators of lipid metabolism pathways disrupt in obese condition, in this regard miR-33b has particular importance. Therefore, the present study was conducted to determine the effect of eight-week high- intensity interval training (HIIT) alone and combined with resistance training (CHRT) on miR-33b expression in overweight/ obese middle-aged women.

Twenty-four middle-aged overweight/obese women participated in two homogeneous HIIT (5 days/week, n=12) and CHRT (3 day/week HIIT with 2 day/week resistance training, n=12) groups for eight-week. The HIIT protocol consisted of alternating bouts of high-intensity exercise at 80%–85% of VO2max with active breaks at 60% of VO2max and resistance training protocol conducted to circuit-weight training with 75-80% of 1- RM. MiR-33b expression levels were measured by real time- PCR 48h before and after the training protocols.

The miR-33b expression levels were increased in both groups but was significant only in the CHRT group (6.02 fold, p=0.002). However, there was no significant difference between miR-33b expression levels in two groups.

According to significant effect of CHRT on miR-33b expression as epigenetic lipid metabolism indicator, CHRT protocol can be considered as a non-pharmacological method for treatment of metabolic disorders associated with obesity.

Left ventricular free wall rupture is a potentially fatal complication of myocardial infarction. The prompt diagnosis of this condition is of high clinical importance. The patient, a 45-year-old man, with a history of hypertension and symptoms of chest pain and shock status, was admitted in the emergency department. Due to electrocardiographic changes consistent with myocardial infarction, he was transferred to cath lab for primary angioplasty (PCI). The initial echocardiographic assessment did not indicate any evidence of mechanical complication of myocardial infarction. Clinical condition of the patient did not improve after primary PCI. During the primary PCI, diagnosis of milking effect in the coronary arteries engendered suspicion of potential mechanical complications of myocardial infarction. Re-evaluation by echocardiography revealed left ventricular free wall rupture. Observing milking effect in angiography can be a result of mechanical complications of myocardial infarction.