مجله پزشکی بالینی ابن سینا
سال بیست و هفتم شماره 4 (پیاپی 98، زمستان 1399)

The increased response of T helper (Th) 22cells might be involved in thepathogenesis ofType 2 Diabetes Mellitus (T2DM). The present study aimed to investigate the transcription factor of Th22 cells (aryl hydrocarbon receptor [AHR]) and interleukin 22 (IL-22) in CD4+ T cells as well as the impact of oral empagliflozin treatment. The correlation between the aforementioned factors and clinical parameters was also determined among the patients.

In this case-control study, 50 patients under the treatment of metformin and gliclazide were divided into two equal groups, including the patients receiving empagliflozin (EMPA+) and not receiving empagliflozin (EMPA, as the control group). The peripheral blood CD4+ T cells were isolated on the initiation day of the study and after 6 months of therapy, and the gene expression levels of AHR and IL-22 were evaluated by real-time polymerase chain reaction. In addition, the production of IL-22 after activation was measured using enzyme-linked immunosorbent assay.

The levels of fasting plasma glucose and hemoglobin A1c diminished in the EMPA+ group after empagliflozin therapy, compared to those reported at the baseline (initiation day; P<0.001 and P=0.04). The gene expression level of IL-22 and production of IL-22 significantly reduced after 6 months of empagliflozin therapy (P=0.011 and P=0.001). A significant positive correlation between IL-22 production and its gene expression with AHR as well as between fasting plasma glucose and hemoglobin A1c was observed in the EMPA+ patients after therapy (P˂0.05).

In addition to antidiabetic effects, empagliflozin has anti-inflammatory impacts on the immune system, especially on Th22 cell-related factors.

Gastric Cancer (GC) is one of the deadliest cancers in the world. Recently, LINC00961, TPT1-AS1, and SAMMSON Long non-coding RNA (lncRNAs)have been discovered, which significantly contribute to the occurrence of various cancers. This study aimed to determine the expression levels of these genes in GC tissues, compared to healthy adjacent tissues, and the relationship of their expressions with clinical characteristics.

In this case-control study, the expression of LINC00961, SAMMSON, and TPT1-AS1 were evaluated in 40 pairs of cancerous and adjacent non-cancerous tissue samples in GC patients using qRT-PCR. Statistical analysis and graphing of the relationship between RNA levels and the clinic-pathological characteristics of GC were carried out using SPSS and Prism 5.00 software. Furthermore, Receiver Operating Characteristic (ROC) curve was drawn to represent the sensitivity and specificity of LINC00961, SAMMSON, and TPT1-AS1 expression as biomarkers of GC.

The expression of TPT1-AS1 and SAMMSON were significantly up-regulated, and the expression of LINC00961 was significantly decreased in GC specimens, compared to adjacent control samples. Our results showed that TPT1-AS1 and SAMMSON RNA levels in GC were significantly related to the tumor size and histopathological grade. Moreover, the ROC curve analysis of LINC00961 and SAMMSON RNA level demonstrated that these two lncRNAs had an appropriate sensitivity and specificity for the diagnosis goals.

Based on the results, LINC00961, SAMMSON, and TPT1-AS1 may play critical roles in exacerbating and even initiating GC due to their cellular pathways.

Acinetobacter infection is one of the most common nosocomial infections that its antibiotic resistance has increased in recent years.This study aimed to evaluate drug resistance to colistin in nosocomial infections with multidrug-resistant (MDR) Acinetobacterbaumannii.

This cross-sectional study was performed on 45 blood or body fluid culture samples collected from hospitalized patients at Sina Hospital, Hamadan, Iran, within 2018-2019.The Minimum Inhibitory Concentration (MIC) was determined using E-test trips and disk diffusion method to evaluate the resistance of Acinetobacterbaumannii to the antibiotic colistin according to the guidelines of the Clinical and Laboratory Standards Institute.The collected data were analyzed in SPSS software (version 16).

In this study, out of 45 patients, 24 (53.3%) and 21 (46.7%) of the subjects were male and female, respectively.The mean age of patients was estimated at 68.0±15.9 years. The antibiotic-resistance of samples was determined using the disk diffusion method. Accordingly, all samples were 100% resistant to ceftriaxone, ceftazidime, ciprofloxacin, cefepime, imipenem, meropenem, ampicillin sulbactam.Out of 45 culture samples examined with MIC, 39 (86.7%) and 6 (13.3%) of samples were sensitive and resistant to colistin, respectively.Based on the results of the disk diffusion method, 21 (46.7%), 19 (42.2%), and 5 (11.1%) of samples were sensitive, intermediate, and resistant to colistin

Based on the findings, colistin was effective against multidrug-resistant Acinetobacterbaumannii and is suggested to be used in cases of Acinetobacter MDR as an effective treatment in combination with other antibiotics.

Adolescent idiopathic scoliosis is one of the complex and common deformities of the spine. It is a condition that can cause a lot of pain and discomfort for individuals and has consequences and complications. There are different exercises and approaches for correction of this deformity, such as Schroth exercise. In this regard, the purpose of this study was to investigate the effect of corrective exercises on Cobb angle, flexibility, functional capacity, and quality of life of adolescents with idiopathic scoliosis.

This controlled clinical trial with pre-test and post-test design was performed on 24 adolescents with idiopathic scoliosiswho were randomly divided into control and experimental groups. Cobb angle, flexibility, and functional capacity were measured by X-ray imaging, flexibility box, and six-minute walk test, respectively. The collected data were statistically analyzed in SPSS software (version 23) using a mixed-design analysis of variance with repeated measures. It must be noted that a p-value of 0.05 was considered statistically significant.

Based on the results, after 10 weeks of Schroth exercises, there was a significant difference in the exercise group regarding the reduction of Cobb angle as well as the increase of flexibility and functional capacity. However, no significant difference was observed in the control group from pre-test to post-test (P≤0.05).

According to the results, it can be concluded that the Schroth exercise program that involves the whole motor chain can effectively decrease the lateral curvature angle of patients with idiopathicscoliosis. Therefore, this type of exercise can be useful to use to treat people with Idiopathic scoliosisdeformity.

Diabetic retinopathy is one of the most important and debilitating complications of diabetes with an increasing prevalence in most countries. It has a dramatic effect on peoplechr('39')s quality of life and increases the symptoms of anxiety and depression in patients with diabetes. Therefore, the present study aimed to determine the prevalence of depression in patients with diabetic retinopathy.

This descriptive/ cross-sectional study was conducted on 245 patients with retinopathy referred to the ophthalmology clinic of Farshchian Hospital in Hamadan during 2019- 2020. They were selected via available and consecutive sampling method and were evaluated for depression with the 21-item Beck questionnaire. Data were analyzed in SPSS software (version 16) at a 95% confidence level.

The mean scores of patientschr('39') age and duration of diabetes were reported as 54.47± 8.5 and 8.5 ± 4.15 years, respectively. In terms of gender, the majority of participants (58.7%) were female. The prevalence of depression in patients with diabetic retinopathy was obtained at 49.8% and in proliferative and non-proliferative retinopathy were 68.2% and 43%, respectively (P<0.001). The prevalence rates of depression in men and women were reported as 45.9% and 51.5% (P=0.428). Moreover, in patients treated with insulin and without insulin, the prevalence rates of depression were obtained at 50.4% and 49.2% (P=0.846). The correlation coefficients of depressive disorder with age and duration of diabetes were calculated at 0.123 (P=0.054) and 0.369 (P<0.001), respectively.

Depression is one of the most serious problems in patients with diabetic retinopathy. As evidenced by the results of the present study, the prevalence ofdepression is significantly correlated with the severity of retinopathy and duration of diabetes.

One of the high-risk groups for infection with coronavirus disease 2019 (COVID-19) is considered medical students. In this regard, this study was designed and carried out to evaluate the status of stress, anxiety, depression, and sleep disorders in the medical students of Hamadan University of Medical Sciences, Hamadan, Iran, during the COVID-19 pandemic.

This cross-sectional descriptive study was conducted in the first half of 2020 on medical students (clerks and interns). The information required for the study, including demographic characteristics, study year, accommodation in a dormitory or home, and levels of anxiety, stress, depression, and sleep disorders were online collected by completing the standard Depression, Anxiety, and Stress Scalequestionnaire and 7-Item Insomnia Severity Index, respectively. The data were analyzed using SPSS software (version 16). A p-value of less than 0.05 was considered statistically significant.

A total of 257 medical students were surveyed 55.6% of whom were female. The mean value of students’ age was 24.09±1.61 years. In this study, 171 (66.6%)  participants were interns and 105 (40.9%)were living in dormitories. Moreover, 62.3% (n=160) of the students were in contact with COVID-19 patients. After the pandemic, about 28.4%, 17.1%, 21.8%, and 20.6% of the participants were depressed, stressed, anxious, and with sleep disorders, respectively. There was no statistically significant relationship among the variables of demographics, accommodation in the dormitory, and their study year with stress, anxiety, depression, and insomnia.

The incidence of psychological complications, including anxiety, stress, depression, and insomnia, in the medical students of Hamadan University of Medical Sciences during the COVID-19 outbreak is high. In critical situations, such as the recent pandemic, appropriate prevention, early interventions, and access to mental health services are essential to prevent dysfunction and maintain the mental health of vulnerable groups.

Numerous approaches, including schema therapy, and an integrated cognitive-speech approach, have been suggested to reduce emotions and increase distress tolerance in people with stuttering. The present study aimed to make a comparison between the effectiveness of schema therapy and integrated cognitive-speech approach in emotional regulation and distress tolerance of individuals suffering from stuttering.

This quasi-experimental study was conducted based on a pre-test, post-test design, and a follow-up test with a control group. The statistical population included all individuals aged 18-30 who suffered from stuttering in Sabzevar city. The sample consisted of 30 people who were selected via convenience sampling and were randomly assigned to two experimental groups and one control group (n=10 in each group). The experimental schema therapy group underwent treatment in 12 90-minute sessions, the integrated cognitive-speech approach group received 12 60-minute sessions of treatment, and the control group received no treatments. The instruments of the research were Gross and John (2003) Emotional Regulation Questionnaire, and Simons and Gaher (2005) Distress Tolerance Questionnaire. These instruments were conducted on three groups in all phases of pre-testing and post-testing and follow-up. The one-way repeated measures ANOVA and Tukey post hoc test were used to analyze the data.

As evidenced by the obtained results, the schema therapy and integrated cognitive-speech approach had a significant effect on emotional regulation and distress tolerance of individuals suffering from stuttering(P<0.05).

The results of the present study indicated that none of the treatments outperformed the other ones; nonetheless, the integrated cognitive-speech approach was more effective in distress tolerance index.

The changes that occur in the female body with the onset of menstruation affect the psychological components, including mental health. This study aimed to compare the mental healthof adolescent females with early, late, and normal menarche.

This descriptive study was conducted based on a causal-comparative design. The statistical population included 9- to 17-year-old female students in Isfahan, Iran, who were selected through multistage random cluster sampling. The sample size was determined at 56, 37, and 43 cases in the group of students with normal, early, and late menarche, respectively. The data were collected using the Pediatric Symptom Checklist for school-aged children (age range: 3-18 years) (Jelink, Murphy, and Burns, 1986). Following that, the collected data were analyzed using SPSS software (version 25) through a covariance test.

According to the results, no significant difference was observed between the two groups of female students with normal and early menarche regarding mental health and its subscales. However, the adolescent females with late menarche had better mental health, compared to those with early and normal menarche (P<0.01).

Based on the results, it seems that the timing of the onset of menstruation affects mental health. The late menarche is associated with fewer mental health problems.

Nevus sebaceous is a cutaneous hamartoma accompanied by secondary tumors, such as syringocystadenomapapilliferum.Syringocy-stadenomapapilliferum is a rare benign tumor with a controversial differentiation between eccrine and apocrine.Most syringocystadenomapapilliferum involving the scalp arises from anevus sebaceous.

Herein, we report a 15-year-old adolescent female with a congenital skin lesion on the forehead undergoing surgical excision after changing in size and shape of the lesion.After surgical excision and histopathological examination, a diagnosis of syringocystadenomapapilliferum arising from a sebaceous mole was made.

Syringocystadenomapapilliferum is a rare skin tumor. Histological confirmation was required for a definitive diagnosis. Furthermore, surgery and complete removal of the lesion are needed for treatment