مجله دانشگاه علوم پزشکی گرگان
سال بیست و دوم شماره 4 (پیاپی 76، زمستان 1399)

Selenium is an essential mineral found naturally in soil, water, and some foods. Today, selenium, as an antioxidant, is one of the vital elements in the human body. Although the human body needs a small amount of selenium daily, recent studies have shown that the same small amount of selenium is essential for maintaining healthy body function. It is challenging to choose the right dose of selenium. According to several studies in this present review, a daily supplement of 31.5-200 micrograms seems beneficial since the amount of selenium in various diseases is less than the amount in healthy people. The articles published in PubMed, Web of Science, Google Scholar and SCOPUS databases were screened and collected based on the keywords including selenium, oxidant, antioxidant, diabetes, cancer, toxicity, heart disease and liver disease. These keywords were chosen because of the antioxidant role of selenium as well as the prominent role of oxidation in the progression of these diseases. 150 articles published over a period of 20 years from 2000 to 2020 were used in this study. Articles about nano-seleniums, non-dietary supplements, and diseases caused by the underlying disease of metabolic syndrome were excluded and finally 121 articles were included in the study. A limited number of studies show that patients with multiple disorders may need to take higher doses of selenium (82.4 to 200 micrograms) than healthy people. In this study, seleniumchr('39')s antioxidant role in chronic metabolic disorders, including hyperlipidemia and hyperglycemia, and some cancers, were investigated. Also, the clinical significance of selenium deficiency in metabolic diseases, as well as clinical and experimental observations on the effect of selenium dietary supplements in the treatment of chronic metabolic diseases such as diabetes and atherosclerosis, and cancers, are briefly mentioned. Besides, the recommended toxicity and dose of selenium have been discussed.

Hypertension is associated with changes in the structure and function of the vessels. This study was done to evaluate the effect of aerobic training with Garlic consumption on matrix metalloproteinase-3, 9 (MMP-3, MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in obese postmenopausal women with hypertension.

This double-blind clinical trial study was done on 36 obese postmenopausal women with hypertension. Participants were randomly divided into 4 groups including control group, Garlic consumption, aerobic training and training with Garlic consumption. Subjects in training groups participated in a progressive aerobic training for eight weeks, three sessions a week (55% to 65% of the reserved heart rate and for 30 to 55 min). Garlic and training with Garlic groups consumed 1000 mg of garlic supplement for eight weeks (after breakfast and dinner). Two days before and after the protocol, blood samples were taken in fasting state.

The level of MMP-3 and MMP-9 were significantly decreased in Garlic, aerobic training and training with Garlic groups in compared to the control group (P<0.05). Also, the level of MMP-3 in the training with Garlic was significantly reduced in compared to the training and the Garlic groups (P<0.05). MMP-9 in the training with Garlic was significantly reduced in compared to the Garlic group (P<0.05). However, TIMP-1 level were significantly increased in the Garlic, training and training with Garlic in comparison with control group (P<0.05).

Aerobic training alone and in combination with Garlic affect on extracellular matrix thorough reduction of MMP-3, MMP-9 and increasing TIMP-1, improves systolic blood pressure in obese postmenopausal women with hypertension.

Coronary disease is the most common life-threatening among chronic diseases. Coronary angiography is one of the most important diagnostic procedures that have complications similar to other invasive procedures. This study was performed to determine the effect of changing sandbag weight on complications of femoral artery catheterization and patient comfort.

This single-blind clinical trial was performed on 140 patients who were referred to Amir Al-Mochr('39')menin Kordkoy hospital in northern Iran. Patients were randomly assigned into four groups consisting 35 patients. After angiography, sandbags with different weights (control group, first intervention, and second intervention, third intervention with weights of 4, 3.5, 3 and 2.3 kg) were placed on the angiography site for 6 hours. Bleeding, hematoma, pain and comfort of patients were recorded and compared immediately, 2, 4, 6, 8 and 24 hours after angiography.

Bleeding and hematoma were not observed in any of the patients. There was a significant difference in pain and patients comfort between groups (P<0.05). The third intervention group had the lowest pain and highest comfort at 6 and 8 hours after angiography. Also, the control group had the highest pain and the lowest comfort.

Reducing sandbag weight leads to decrease back pain and improves patient comfort without increasing vascular complications.

Among short-term therapies, psychoanalytic approaches use the therapeutic relationship more than any other approach as a context for change. This study was conducted to evaluate the effectiveness of short-term object relation psychotherapy on interpersonal relationships, self-destruct behaviors and personality organization of patients with borderline personality disorder.

This clinical trial study was done on the 20 patients with borderline personality disorder who referred to medical clinics in Sari city in northern Iran during 2020. Patients were divided into two intervention and control groups by random sampling. Patients in interventional group were received short-term object relation psychotherapy in 16 individual sessions of 45 minutes once a week. The control group did not receive any intervention. Patients completed the structured clinical interview scales of First et al (SCID-II), the Bell’s object relations inventory (BORI), self-destruct questionnaire of Sharabaf et al and Kernberg’s inventory of personality organization (IPO).

Scores of interpersonal relationships, self-destructive behaviors and personality organization were significantly reduced in interventional group in compared to control group (P<0.05).

Short-term object relation psychotherapy is an effective therapy to reduce the symptoms of patients with borderline personality disorder.

Writing about emotions and emotional disturbances, improve the performance of an autonomous system, immune system and physical and mental health. The aim of this study was to determine the effect of narrative writing on stress intensity of attendants’ patients hospitalized in intensive care units (ICUs).

This single blind clinical study was done on 106 attendants’ of adult patients hospitalized in ICUs of Babol city in northern Iran. The patientschr('39') attendants were divided into two groups of 53 controls and intervention. Data were collected using stress (DASS21) questionnaire. Intervention was writing narration about feelings, thoughts and experiences related to the hospitalized patient and ICU in a notebook as daily for seven days in the intervention group.

The mean and standard deviation of overall stress intensity following intervention were significantly reduced in the intervention group in comparison with controls (P<0.05) (22.64±7.89 versus 17.15± 8.2). There was significant relationship between intervention and control groups in three areas of stress, anxiety and depression (P<0.05).

Narrative writing reduces the severity of stress in attendants’ patients in ICUs.

Diabetes mellitus is one of the most common metabolic and global health threats. The gene needed for the development of the TBX20 gene is the fusion of the gene, and the defect in the sequence and expression of this gene also causes heart defects. Due to significant prevalence of gestational diabetes mellitus in human population, this study was done to evaluate the effect of TBX20-induced gestational diabetes mellitus in the heart of the mice embryo at 11.5 days.

This experimental study was done on induced diabetic C57BL/6 female mice. Gestational diabetes induced by interaperitoneal injection of sterptozotocin at GD1. On the day of pregnancy 11.5, embryonic heart samples from these mice were isolated. After extraction of RNA, cDNA synthesis of RNA was performed. The Real Time-PCR technique was used to determine the expression of TBX20 gene. Expression level   of TBX20 gene in experimental and control was calculated using the 2–∆∆CT method.

Expression of TBX20 gene in diabetic specimens was twice as high as the control samples, which was statistically significant (P<0.05).

It seems, increasing TBX20 gene expression in embryonic heart tissue may be one of the complications of gestational diabetes mellitus and can lead to abnormalities in the heart embryo.

Bisphenol A (BPA) is the monometer of epoxy resins and polycarbonate plastics that plays an important role in the pathogenesis of cardiovascular diseases. This study was done to evaluate the effect of aerobic exercises on oxidative stress indices in heart tissue of male Wistar rats after poisoning with Bisphenol A.

In this experimental study, 20 adult male Wistar rats were allocated into four groups including control, aerobic exercise, BPA and BPA + aerobic exercise. Animals in control and aerobic exercise groups were receieved olive oil and the BPA (100 μg/kg) intraperitoneally, respectively. Animals in BPA + aerobic training group were treated with BPA (100 μg/kg) intraperitoneally for 30 days. Exercise program consisted of 25-64 minutes of running with 57-75% oxygen consumption, 5 sessions per week for two months. Indicators of oxidative stress in heart tissue including Gpx, SOD, TAC, MDA, CAT and AOPP were evaluated.

BPA intoxication induced a significant increase in the activity of SOD , GPX enzymes, AOPP and MDA levels and  reduction  in CAT enzyme activity and TAC level in compared to control group (P<0.05). While aerobic exercise could diminish the oxidative stress due to BPA intoxication. Aerobic exercise reduced the activity of the GPX, SOD and increased catalase activity in rats with BPA intoxication (P<0.05). Also, level of MDA and AOPP significantly reduced in in aerobic exercise group in comparison with with BPA intoxication (P<0.05).

Aerobic exercise activity has moderating effects on BPA intoxication in cardiac oxidative stress. Aerobic exercise can increase the amount of antioxidant enzymes that play an important role in modulating oxidative stress induced by BPA.

The increasing usage of cell phones, have raised concerns about the potential effects of these waves on the health of individuals. In the present research the effect of mobile phone radiation on the expression of DAZL gene in BALB/c mice were studied.

18 male mice were divided into three groups: Control, sham-exposed and experimental. Experimental mice were exposed to mobile waves for 2 hours daily, during 3 weeks. After 3 weeks, the testes were excised and RNA extraction and Real-Time PCR were performed. Sperm counts in deferen channel and the study of sperm motility in epididymis were done.

The percentage of non-progressive sperm motility significantly increased in experimental group in compared to control group (P<0.05).The level of DAZL gene expression in the experimental group was significantly lower than the control group (P<0.05). Weight of the testis, percentage of live sperm, percentage of rapid progressive sperm motility and percentage of slow progressive sperm motility non-significantly reduced in experimental group in comparison with controls.

Exposure to cell phone waves for 21 days and 2 hours a day impairs spermatogenesis by reducing the quality and motility of sperm and also reduction of expression of DAZL gene.

The acute exercise leads to the induction of some cardiac and inflammatory biomarkers that are related to factors such as severity, type, training experience, gender and environment. This study was conducted to compare the effect of acute endurance and resistance training at two different intensity levels of high-sensitivity cardiac Troponin T (hs-cTnT) and tumor necrosis factor alpha (TNF-α) in male runners and bodybuilders.

In this quasi-experimental study, 20 male runners and bodybuilders with an age range of 20-24 years were purposefully and accessibly selected. The study was performed with a pre-test-post-test design on 10 male runners (endurance training) and 10 bodybuilding men (resistance training). The runners ran 6 km with moderate (70-75% of reserve heart rate) and high (85-85% of reserve heart rate) intensities at intervals of one week, during separate sessions. Bodybuilders also performed resistance training at moderate (70-75% of one repetition maximum) and high (80-85% of one repetition maximum) intensities.  Bodybuilders also performed resistance training at moderate (70 to 75% of a maximum repetition) and high (80 to 85% of a maximum repetition) intensities. Blood samples were taken before and immediately after exercise. Then the serum levels of hs-cTnT and TNF-α were measured.

The serum level of hs-cTnT and TNF-α was significantly increased after acute running and resistance training with moderate and high intensities (P˂0.05), but intense acute exercise had a greater effect on increasing the levels of these variables. Also, the acute effect of intense aerobic exercise was associated with a greater increase in hs-cTnT level in compared to moderate-intensity aerobic exercise, high and moderate-intensity resistance training (P˂0.05).

In endurance and resistance athletes, the hs-cTnT and TNF-α responses are affected by the intensity of training and increase more with intense training. But the high intensity aerobic exercise is associated with a greater increase in hs-cTnT levels.

Car accidents are one of the most common causes of traumatic mental disorders. This study was done to evaluate the symptoms of post-traumatic stress disorder (PTSD) in patients with lumbar spinal dislocation fractures caused by road accidents.

This case-control study was performed on 100 patients with lumbar spine dislocation fractures due to road accidents. After the seventh day, they were admitted to the orthopedic and trauma wards of Imam Khomeini Hospital in Sari. It was done six months after hospitalization. Data collected from 100 non-injured individuals using the Marmar and Weiss Revised Event Impact Questionnaire (Impact of Event Scale - Revised: IES-R) were compared.

There was no statistically significant relationship between PTSD and age, sex, marital status, education of the two groups. In all subscales related to the effect of the event, ie avoidance, disturbing thoughts, and over stimulation indices, the mean score of the participants in the case group was significantly higher than the mean scores of the individuals in the control group (P<0.05). The mean in case group was significantly higher than the mean in the control group (P<0.05).

The results of this study indicate the important role of road accidents in the formation of PTSD symptoms.

Diabetes is one of the most common chronic diseases and also the biggest health problem in all countries. The world health organization has called it a silent epidemic. Self-care is one of the most important factors in controlling blood sugar in diabetics’ patients. This study was done to determine the relationship between self-care and glycosylated hemoglobin level diabetic patients in rural area in Golestan Province, northern Iran.

This descriptive-analytical study was done on 239 male and female patients with type 2 diabetes (56.92±10.70 years) in rural area in Golestan Province, northern Iran during 2016. Data collection tool were a standard diabetes self-care questionnaire with demographic variables and HbA1C test. Completion of data and sampling was done by referring to the health center and calling patients.

There was no significant relationship between glycemic controls with any of the self-care items studied. Mean of HbA1c was 8.23±1.85%. 97 patients (40.6%) had good blood sugar control (less than 7.5%). Patientchr('39')s self-care had a mean of 3.58, of which the highest score was related to the dietary regimen (6.60) and the lowest was related to self-monitoring of blood glucose (0.88) and regular physical activity (2.3).

Self-care of the patients was moderate. Interventions to increase self-care of patients are recommended in this area.

The emergence of drug resistance in Mycobacterium tuberculosis and especially drug resistant strains has created problems for the treatment of tuberculosis control, worldwide. This study was performed to evaluate the changes in N-acetyltransferase (NAT) pattern of methylsonone in patients who did not respond to first-line treatment for Mycobacterium tuberculosis.

This descriptive-analytical study was performed on 200 patients with tuberculosis. After preparing the blood sample, saturated salt method was used to extract DNA. For the determination of quantity and quality of DNA, two methods of spectrophotometry and electrophoresis on agarose gel were used. The methylation pattern of NAT1 gene was investigated by HRM method.

34 patients were resistant to the first line of treatment. 18 patients showed hypermethylation pattern, 12 patients showed non-methylated pattern and 4 patients showed hypomethylated pattern. 166 patients were not resistant to the first line, of which 23 patients in hypermethylated group, 120 patients in group Non-methylated and 23 patients were in the hypomethylated row. There was a statistically significant relationship between methylation level and drug resistance (P<0.05).

This study showed that resistance to first-line treatment of Mycobacterium tuberculosis was related to the level of N-acetyltransferase gene methylation.

Using chewing tobacco is one of the most important health problems in ports of the southern coast of Iran. The prevention of this problem requires identifying the factors affecting this phenomenon. The aim of this study was to determine the prevalence of chewing tobacco and related factors among adolescents in South- East of Iran (2018).

This descriptive-analytical study was conducted on 204 male high school students through multistage sampling in two the ports of Konarak and Chabahar located in south - east of Iran during March to June 2018. The data collection tool was a self-administered standardized questionnaire including items about knowledge, attitude and prevalence of chewing tobacco among participants, intimate friends and family members of the study population.

Prevalence of chewing tobacco in life time and current use (pervious 30 days) was 71.8% and 43.1%, respectively. Supari was the main chewing tobacco were used (80.8%) by participants. The negative attitudes about chewing tobacco was a protective factor (OR=0.41) and easy access (OR=6.88), using by family members (OR=2.28), and close friends (OR=3.28) were the most important risk factors.

The prevalence of chewing tobacco was alarming in male high school students in south - east of Iran.

Anxiety disorders are one of the most common psychiatric disorders in childhood. Some studies have identified the household dimension as an important factor in causing these disorders. However, no convincing results have been achieved. The aim of this study was done to determine the frequency of anxiety disorders among of 8-12 years old children in families with single and multiple children.

This descriptive-analytical study was performed on 732 children (343 boys and 389 girl) referred to Taleghani hospital (except than psychiatric clinic) and offices of pediatricians in Gorgan, north of Iran during 2017. Subjects were recruited using available sampling method. Demographic questionnaire and Spence Anxiety Scale (SCAS) were completed. Variables including separation anxiety, social anxiety, general anxiety, panic attack, agoraphobia, obsession and compulsion, fear of physical damage were evaluated.

In all anxiety subgroups except general anxiety, mean scores were significantly higher in children with multiple children than single children (P<0.05).

This study showed a high prevalence of anxiety disorders in multi-child families compared to single-child families.

The use of packaged drinking water is on the rise nowadays in most countries, including Iran. Currently, more than 100 different brands of packaged drinking water are produced and distributed in Iran. This study was done to evaluate the quality of Iranian, foreign packaged drinking waters and municipal drinking water in Golestan Province, north of Iran.

This descriptive-analytical study was done on 56 packaged drinking waters of different Iranian and foreign brands, eight brands produced in Golestan province and a number of municipal drinking water samples were collected from Gorgan and Gonbad Kavous cities in northern Iran. To assess the quality of packaged drinking water and drinking water, their physicochemical parameters were compared with National Iranian Standards 1053 and WHO. Stiff and Piper diagrams were plotted to determine the type and hydrochemical facies of water samples. Gibbs and Schoeller diagrams were used to determine the water chemistry controlling factors of water samples and their water quality for drinking, respectively.

The concentrations of physicochemical parameters (except bicarbonate) were within the range of national drinking water standards 1053 and WHO. The average nitrate concentration in all packaged drinking and drinking water was within the standard range. The fluoride concentration of all packaged drinking waters and drinking water was within the range of WHO standard. However, only 14 samples of all packaged drinking and drinking water samples are within the range of 1053 National Iranian Water Standard. The total concentration of soluble solids and the total hardness of packaged drinking water were within the range of 1053 NW. There was also a significant difference (P<0.05) between the chemical parameters of magnesium, sodium, chloride and nitrate in packaged drinking water produced in Golestan province with the municipal drinking water samples.

The amount of fluoride in drinking water in this study was less than desirable and required fluorination. The quality of packaged drinking water in Golestan province is better than the municipal drinking water.

The increasing development of agricultural and aquaculture activities along the rivers has reduced the quality of running water. The aim of this study was to evaluate Chehel-chai River water quality with national sanitation foundation water quality index (NSFWQI), Iran water quality index for surface water (IRWQISC), Canadian water quality index (CWQI).

This descriptive-analytical study, was performed on all of 7 sampling stations based on standard factors such as availability, land use type, geology and dispersion along the river, 12 water quality parameters including dissolved oxygen, fecal coliform, pH, biochemical oxygen demand (BOD), chemical oxygen demand (COD), temperature, organic phosphate, nitrate, ammonium, turbidity, total soluble solids and electrical conductivity and 5 cations (sodium, calcium and magnesium) and anion (chloride and sulfate) along the river for summer and autumn seasons 2018 (42 sample) with the standard method was measured.

The amount of phosphate and turbidity increased from station 2 to downstream due to the existence of fish ponds and agricultural drainage. BOD, COD and fecal coliform values at station 6 have increased significantly with due to urban effluent output. River pollution in the summer has increased due to reduction of river flow and after station 3 (promenade) to the downstream, which is due to the entry of agricultural fertilizers and urban wastewater discharge. According to the average of IRWQISC and NSFWQI, the water quality of Chehel-chai River in the sampling station in the area of Minoodasht city (station 6) is in bad class. The CWQI index showed that the water of the Chehel-chai River is suitable for drinking and aquaculture at the border of the class, for agriculture in the bad class, and in terms of recreation and livestock use in the higher class.

The mean values of the above indices indicate high pollution quality class, and since this river is used for water supply for agricultural and aquaculture, management strategies are necessary.

Congenital anomalies are one of the major causes of neonatal mortality. Congenital heart disease (CHD) is the most common birth defect world wide, and recent studies about CHD have reported congenital heart disease approximately is about one percent of all live births. This study was done to determine the frequency of congenital heart disease using ecocardiography in patients with extra-cardiac anomalies in Gorgan peadiatric center in north of Iran.

In this descriptive study, 55 girls, 84 boys a total of 139 patients were in the age range of birth to 12 years of age whom have referred to Taleghani Teaching and Medical Center in Gorgan during 2012-17. 139 cases of congenital heart disorders with echocardiographic report sheet in their medical record were evaluated. Information of patients including age, sex, ethnicity, type of extra-cardiac, anomalies, cardiac anomalies (simple, complex and ductal anomalies), cardiac murmur status, and clinical symptoms were extracted from their medical records.

From of total of echocardiography, 139 patients (88.5%) were affected by congenital heart disease. The anomalies were included of 88 cases (56.05%), 48 cases (31.21%), 2 cases (1.27%) simple, complex anomaly and ductal dependent anomaly respectively. The other disorders accompanied with congenital heart diseases were 17 cases (12.2%) with cleft palate, 4 cases (2.9%) with congenital diaphragmatic hernia, 8 cases (5.8%) with closed anus, 52 cases (37.4%) with Down syndrome, 4 cases (2.9%) with Turner syndrome, 4 cases (2.9%) with ileum atresia, 11 cases (7.9%) with Esophageal atresia, 7 cases (5%) with Hirschsprungchr('39')s disease, 6 cases (4.3%) with urogenital anomalies and 26 cases (18.7%) with other extra-cardiac abnormalities.

Down syndrome and cleft palate are among the highest prevalant anomalies with congenital heart diseases.