مجله دانشگاه علوم پزشکی گرگان
سال بیست و سوم شماره 1 (پیاپی 77، بهار 1400)

Vitamin deficiency is common in patients with chronic low back pain and is one of the most important risk factors for chronic kidney disease. The aim of this study was to evaluate the effect of one course of core stabilization exercise and vitamin D intake on some of renal function biomarkers in patients with chronic back pain.

This single-blind clinical trial study was done on 48 women with chronic low back pain with random assignment in 4 groups of 12 people including control, exercise, vitamin D and combined groups. The exercise and combined groups performed 8 weeks of core stabilizing exercises with different levels. The vitamin D and combined groups received 50,000 IU vitamin D/week. Creatinine, urea and uric acid levels were measured before and after the interventions.

The results showed that 74.26% and 25.64% of the patients had deficiency and insufficiency of vitamin D, respectively. After 8 weeks, significant reduction was observed in creatinine, urea and uric acid indicators of the exercise, vitamin D and combined groups (P˂0.05). In addition, combined intervention induced more reduction in mean of urea, and uric acid levels in compared to the two other interventions but the effect of exercise on the reduction of uric acid was more than vitamin D intake (P˂0.05).

Both core stabilization exercises and vitamin D intake intervention can be effective in improving renal function in chronic low back pain patients having abnormal low vitamin D levels. On the other hand the combined intervention seems to have more effectiveness.

Anterior cruciate ligament (ACL) injury is one of the most serious knee injuries and it happens frequently during sports activities. Appropriate muscle activity is essential to provide joint stability and prevention of ACL injury. This study was performed to determine the effect of external focus instructions and functional training on basketball knee stabilization muscle activity timing.

This clinical trial study was performed on 48 healthy male basketball players of the Iranian Provincial League in the age range of 19-25 years. The basketball players were randomly divided into 3 groups of 16 people including control group, functional training group with feedback and group without feedback. The timing of the onset of electrical activity in the quadriceps, hamstrings, and Gluteus medius muscles of individuals before and after eight weeks in the single-leg landing task was examined by electromyography.

There was a significant difference between the groups at the onset of Biceps Femoris, Gluteus Maximus, Gluteus Medius, Vastus Medialis, Vastus Lateralis, Rectus Femoris and Medial Hamstring muscles. There was a significant decrease in muscle activity onset between functional groups with and without feedback in compared to control group (P<0.05). There was no significant difference between the training groups at the beginning of the activity of the mentioned muscles.

Functional basketball training with and without feedback can optimize the activity time of the knee stabilizing muscles, during exercises such as jump-landing, increase the stability of the knee joint and possibly reduce ACL injury in athletes.

Aspartame is a kind of artifical and non-sugar sweetener that is used as a sugar substitute in some foods and beverages. This study was done to determine effect of Aspartam on histomorphometric alterations, kidney function and expression of Bcl2, Bax, Caspase 3, P53 Genes in Mice.

In this experimental study, 36 adult male NMRI mice were allocated into four groups including control group and three experimental groups. The mice in the control group received 0.3 ml of distilled water by oral gavage for 90 days and the experimental groups received 40, 80 and 160 mg/kg aspartame, respectively orally and daily. One day after treatment, blood and kidney tissue samples were taken to evaluate biochemical, histomorphometric alterations and gene expression.

Renal capsule diameter, glomerulus diameter and height of the epithelial layer of distal and proximal tubules were significantly reduced in treated groups compared to control group with increasing dosage of aspartame (P<0.05). However, the size of the urinary space and the diameter of the lumen of distal and proximal tubules were significantly increased in treated groups in compared to control group (P<0.05). The level of blood nitrogen urea (BUN) and creatinine significantly increased treated groups in compared to the control group with increasing dosage of aspartame (P<0.05). Also, with increasing dosage of aspartame, Bcl2 gene expression significantly reduced in treated groups in compared to the control group (P<0.05) however expression of Bax, Caspase 3 and p53 genes were significantly increased in treated groups compared to the control group (P<0.05).

Aspartame can cause changes in biochemical, histomorphometric indices, expression of Bcl2, Bax, Caspase 3 and P53 genes in mice kidney.

Evaluation of effective factors in the incidence of leukemia, especially pollutants, such as Sodium Sulfide and lead acetate, can contribute to the treatment of cancer and prevention of disease. Npm1 gene is a multiple Phosphoprotein that contains several action domains. Npm1 gene is encoded between nucleus and cytoplasm and performs several functions including protein ribosome transfer and control of centrosome proliferation. Npm1 mutations are transferred from the nucleus to the cytoplasm. This study was conducted to compare the effect of lead static poisoning and sodium sulfide on Npm1 gene expression in adult male rats.

In this experimental study, 48 adult male rats were allocated into 6 groups. The experimental groups include control, the first and second experimental groups were received sodium sulfide with doses of 300 mg/kg/bw and 600 mg/kg/bw, respectively. The third and fourth experimental groups were received lead acetate with doses of 30 mg/kg/bw and 60 mg/kg/bw, respectively. The fifth experimental groups were received maximum doses of sodium sulfide and lead acetate, respectively. Lead acetate and sodium sulfide were gavaged daily for 4 months. After that, blood was taken from the mice and RNA was extracted. Then, CDNA synthesis and Npm1 gene expression compared to Ywhaz gene were evaluated quantitatively using Real Time PCR.

Npm1 gene expression reduced in groups were received sodium sulfide at doses of 300 and 600 mg/kg body weight. Npm1 expression increased in lead static groups with doses of 30 and 60 mg/kg body weight.

This study showed that by increasing the expression of Npm1 gene expression, Threshold Cycle value decreases.

Cancer can spread to distant parts of the body through the lymphatic system or bloodstream. Angiogenesis is a fundamental step in the transition of tumors from a dormant state to a malignant. Some changes in cancerous cells can be improved and treated using herbal extracts. Salvia species in Iranian traditional medicine were used against various infections, inflammatory diseases.This study was done to evaluate the effect of aqueous extract of Salvia atropatana leaf on subcutaneous tumor model of CT26 colon carcinoma in Mice.

In this experimental study, for the induction of colon carcinoma, 26CT cells were injected into 18 BALB/c male Mice. Subcutaneous injection was done in the right side of the animal. When the size of the tumor was 50±350 mm3, 18 Mice were randomly allocated into 3 groups, including controls, aqueous extracts a breakdown of each dose 50 and 100 mg/kg/bw. The group containing the aqueous extracts of Salvia atropatana leaf was injected for 14 days, daily. To monitor the therapeutic effects, the parameters of the stopping rate in the growth of the tumor, the relative volume changes and the doubling of tumor volume were evaluated. After sacrificed the animals at the end the fourteenth day of the study, tumors were dissected for histological study.

The volume of tumors and the mean density of the number of vessels was significantly reduced in treated group 1 (50 mg/kg/bw of aqueous extracts of Salvia atropatana leaf) and treated group 2 (100 mg/kg/bw of aqueous extracts of Salvia atropatana leaf) in compared to control group (P<0.05). Reduction in density of cells and vascular sections was significantly reduced in treated group 1 (50 mg/kg/bw of aqueous extracts of Salvia atropatana leaf) and treated group 2 (100 mg/kg/bw of aqueous extracts of Salvia atropatana leaf) in compared to control group (P<0.05).

Aqueous extracts of Salvia atropatana leaf has anti-angiogenesis activity and significant inhibitory effects on tumor growth in animal model.

Increased ferritin levels have been implicated in the pathogenesis of diabetes. This study was done to determine the effect of continuous and interval aerobic exercise training on serum ferritin and iron level of induced diabetic rats.

In this experimental study, 32 wistar rats weighing 205±54 g were randomly allocated into four groups including healthy control, diabetic control, diabetic interval training and diabetic continuous training. The diabetic training groups were received 10 weeks of training following one week after the induction of diabetes by streptozotocin and nicotinamide. Fasting blood sugar ferritin and iron level was measured in each animal.

Induction of diabetes significantly increased serum ferritin and iron levels in diabetic control group compared to healthy control group (P<0.05). Serum ferritin and iron levels and fasting blood sugar significantly reduced in interval aerobic exercise and continuous aerobic training groups compared to diabetic control group (P<0.05). There was not any significant difference in the dependent variables between interval aerobic exercise and continuous aerobic training.

In conclusion, it seems the training of two methods of aerobic interval and continuous training in induced diabetic rats with reduction of serum ferritin and iron levels, as well as improving fasting blood glucose and serum insulin seems to reduce insulin resistance index and improve glycemic status in induced diabetic rats.

People with asthma are at increased risk for cardiovascular disease and increased risk of death. Asthma is associated with the structure and function of vessel changes. In this regard, MicroRNAs, AKT and VCAM play an important role in endothelial function. So, the aim of this study was to investigate the effect of 12 weeks of interval training on expression of mir-126, mir-1185 AKT and VCAM in cardiac tissue rats with allergic asthma.

This experimental study was performed on 15 Wistar rats. Animals were randomly allocated into three groups (n=5) including healthy control, asthma control and asthmatic interval training. Ovalbumin solution was injected subcutaneously 3 times per week to asthma groups, and suffering from asthma was confirmed by increasing the amount of IgE. The asthma group participated in 8-week exercise training. The rats were anesthetized at the end of 8 weeks and then their heart tissue was isolated by surgical instrument and immediately placed in nitrogen fluid. Expression of mir-126, mir-1185, AKT and VCAM in rats cardiac tissue were evaluated.

AKT and VCAM expression was significantly increased in asthma control group compared to healthy control group (P<0.05). mir-126, AKT and VCAM expression were significantly increased in asthmatic interval training group in compared to asthma control group (P<0.05) while Mir-1185 was significantly reduced in asthmatic interval training group in compared to asthma control group (P<0.05).

Interval training by increasing mir-126, by reducing the expression of mir-1185, AKT, and VCAM reduces the risk of atherosclerosis in rats affected with asthma.

Proprioceptors of the plantar surfaces of the foot have less efficiency and the stimulation and reinforcement of them may be lead to reduction of falling risk. One of the methods to reinforce proprioceptor receptors in these individuals is using textured foot orthoses. The aim of this study was to evaluate the effect of textured foot orthoses on frequency spectrum of lower extremity muscles, stance time and comfort in individuals over age of 55 years during walking.

This quasi-experimental study was done on the 14 females and 14 males age ranged of 56-70 years with the ability to walk independently and with physical and mental health status. Subjects were compared during five conditions including without foot orthoses and using four foot orthoses (including small and large foot orthoses with two types of flexible and rigid), flexible and rigid large textured foot orthoses. The 8 electrodes were located on tibialis anterior, medial gastrocnemius, vastus medialis, vastus lateralis, biceps femoris, semitendinisus, gluteus, and erector spinae in 3 lumbar vertebrae region muscles.

Frequency content of tibialis anterior and vastus medialis was significantly increased in males than female (P<0.05). Vastus medialis frequency during walking with large foot orthoses was more than walking without foot orthoses (P<0.05). The comfort level was different during flexible large textured foot orthoses condition compared with flexible small textured foot orthoses condition (P<0.05). The stance time was not significant between all conditions.

Increased frequency content of the vastus medialis muscle can increase the absorption and decrease the vertical loading rate imposed on the foot, which in turn reduces the risk of injury of the lower limb in older adults.

Postural defects are increased among students due to inactivity. Their unwillingness to perform traditional activities, requires finding appropriate ways to increase physical activity. This study was done to compare the effect of selected Xbox Kinect games and normal on the posture in low activity students.

In this quasi-experimental study, 26 sedentary fourth and fifth grade students were non-randomly divided into two groups. During the 6-week period, one group engaged in 3 sessions per week of selected Xbox Kinect games and the other group engaged in routine school physical education activities during school hours. The photogrammetry and Kinovea software was used to study the posture of the joint angles.

In static posture, head position angle, thoracic arrow, horizontal scapula alignment, horizontal pelvic alignment, and body alignment were found positive effect in Xbox Kinect group in compared to  normal physical activity (P<0.05). There was not any significant difference between the two groups in Lumbar Arrow, Lumbar Angle, pelvic Tilt Pelvis, Knee Position, Quadriceps Angle and Foot Pronation.

Xbox Kinect games are a good way to correct postural deviations in sedentary students in low activity student.

Genu varus deformity is associated with changes of lower limb muscle co-contraction and running economy. This study was done to evaluate the effect of using of brace in three different knee flexion angles on running economy and lower limb muscular co-contraction in individuals with genu varus.

This quasi-experimental study was done on active soccer male students including 15 healthy subjects (average age of 22.86±1.55 years) and 15 subjects with genu varus (average age of 22.13±1.80 years). The amount of electrical activity of the muscles (tibialis anterior, medial gastrocnemius, vastus medialis, vastus lateralis, rectus femoris, biceps femoris, semi-tendinosus) were recorded by electromyography system during four conditions of with and without using knee brace. After that, directed and general co-contraction was computed during running. The angles of brace were 15, 30, and 60 degrees. The values of VO2 max were recorded using of gas analyzer system to compute running economy.

The ratio of respiratory exchange was significantly more in the genu varus group than healthy group (P<0.05). However, the acute effect of brace was not significant on running economy and ratio of respiratory exchange. The main effect of brace was significant for general co-contraction of knee joint during the loading phase (P<0.05). Paired wise comparison revealed significant greater general knee co-contraction during brace conditions (P<0.05). However, the general knee co-contraction during loading phase reduced while using brace 15 degree. The main effect of “brace” for ankle joint general co-contraction during the push-off phase was significant (P<0.05). Paired wise comparison revealed significant greater general ankle co-contraction during brace conditions at push-off phase (P<0.05).

Knee brace did not change running economy. However, the using of brace 15 degree improved general knee joint co-contraction during loading phase.

Type II diabetes is a major globle health problem that can lead to disability and early death. This study was performed to evaluate the association of TCF7L2 (rs7903146) polymorphism with type II diabetes.

This case - control study was done on 100 patients with type II diabetes and 100 healthy subjects. Following DNA extraction, TCF7L2 (rs7903146) genotype was determined and compared between two groups by Tetra-Arms PCR method.

The frequency of CT genotype was 25% and 56% in healthy subjects and patients, respectively (P<0.05). The frequency of TT genotype was 2% and 6% in control and patient groups, respectively. In the co-dominant model, rs7903146 was dependent on type II diabetes.

Human heterozygote for Lucos TCF7L2 (rs7903146), which contains T alleles, are high risk for developing diabetes mellitus.

Multiple sclerosis (MS) is one of the most common diseases of the central nervous system. MS is more common among women. Gait pattern dysfunction is a relevant symptom in these patients. This study was conducted to compare the electromyography activity of selected lower extremity muscles and the ellipse area of center of pressure during unplanned gait termination in female patients with multiple sclerosis and healthy individuals.

This case-control study was performed on 10 female patients with MS (classified based on the EDSS scale) and 10 healthy subjects matched for height, age and weight. Electromyography activity of rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), semitendinosus (SM), gastrocnemius medius (GM) and tibialis anterior (TA) and center of pressure (CoP) recorded using foot pressure system during unplanned gait termination. Subjects were instructed to stop, as soon as possible, in response to an auditory cue delivered when the heel strike phase accidentally.

Vastus Lateralis muscle activity was significantly higher in able-bodied group than patients (P<0.05), whereas in the patient group gastrocnemius medius muscle activity increased significantly (P<0.05). Also, the ellipse area of center of pressure significantly reduced in MS group in compered to able-bodied group (P<0.05).

Increased gastrocnemius medius muscle activity in MS patients may be due to their attempt to slow down the displacement of the center of mass to limit the tibia forward translation consequently, attempting to control balance as a strategy to limit the ellipse area of center of pressure to prevent fall.

Age-related cataract is one of the most important causes of blindness. Early detection of cataracts can help alleviate the problems caused by this disease. This study was performed to evaluate the visual acuity and contrast sensitivity of patients with early cataract.

This descriptive-analytical study was performed on 54 patients (108 eyes) in the age range of 35 to 50 years with early stage cataract referred to Alzahra Ophthalmology Hospital in Zahedan, souh-west of Iran. The ethnicity of all the participants was Baluchi and Sistani. After correcting the refractive errors if the inclusion criteria were met, visual acuity with E chart at 6 m and Pelli Robson contrast sensitivity chart at 3 m were measured as monocular.

There was a significant correlation between visual acuity and contrast sensitivity (P=0.033, r2=0.205). The mean of visual acuity and contrast sensitivity were not significantly different in the two Baluchi and Sistani ethnicities. But visual acuity and contrast sensitivity were significantly different in the two genders (P<0.05).

Early cataract, although having a minor effect on visual acuity, can reduce contrast sensitivity. Therefore, measuring of contrast sensitivity in normal light condition in patients with early cataract who complain of blurred vision despite normal visual acuity can more accurately assess their visual function.

The most common enterohemorrhagic Escherichia coli strain is the O157: H7 serotype, which is one of the most important intestinal pathogens and can cause complications such as hemorrhagic colitis, hemolytic uremic syndrome and acute renal failure. The aim of this study was to evaluate the enterohemorrhagic Escherichia coli causing molecular outbreaks of foodborne illness in Iran.

In this descriptive cross-sectional study, 189 fecal swab specimens were examined during April to September 2018. All suspected isolates were tested for biochemical tests. The isolates were confirmed by molecular PCR and evaluated by antimicrobial susceptibility tests.

From 189 stool swab samples studied, 98 Escherichia coli isolates were detected based on phenotypic tests. Most of the outbreaks occurred in summer and the prevalence of enterohemorrhagic Escherichia coli was 24.5%, which 4% of them were non-O157H7. Most patients were between 1 and 12 years of age and the highest antibiotic resistance to cotrimoxazole and chloramphenicol was observed at 80% and 79%, respectively.

This study showed an increase in enterohemorrhagic Escherichia coli with 24.5% and an increase in antibiotic resistance to the antibiotics of chloramphenicol, cotrimoxazole and carbapenems. Increased resistance to imipenem and meropenem antibiotics makes it difficult to treat beta-lactamase-resistant strains.

Gilbertchr('39')s syndrome is a relatively common genetic disorder, which is caused by defection in uridine diphosphate glucuronosyl transferase enzyme. The indirect bilirubin increases in this syndrome, although the function of the liver is normal. Gilbertchr('39')s syndrome can be seen in 3 to 10% of different populations. According to the differences in ethnic groups in Golestan Province, no studies have been conducted on the prevalence of the syndrome in the province, so far.This study was conducted to determine the prevalence of suspected Gilbertʼs syndrome in Golestan province in north of Iran.

This descriptive-analytical study was performed on 1664 subjects with 18-45 years old referring to rural and urban health centers in Golestan province, North of Iran during 2014. Liver function tests were normal in subjects. Fasting blood samples were taken from each subject and total bilirubin was tested. People with a total bilirubin of more than 1.5 mg/dl were treated with a single oral dose of rifampin 600 mg. After taking rifampicin, the individuals with an indirect bilirubin level of more than 1.3 mg/dl were found suspected of Gilbert’s syndrome.

The prevalence of suspected Gilbertchr('39')s syndrome was 5.8%. Moreover, suspected Gilbert’s syndrome was more common in males than females (10% in males and 4.3% in females) (P<0.05). According to ethnicity, the prevalence of suspected Gilbertchr('39')s syndrome was 5.4%, 5.4%, and 6.8% in Sistani, Fars and Turkmen subjects, respectively. This difference was not significant. The prevalence of suspected Gilbertchr('39')s syndrome in three ethnicities was higher in males than females and it was statistically significant in Sistani and Fars ethnicities (P<0.05) but not significant in Turkmen ethnicity.

Suspected cases of Gilbertchr('39')s syndrome were more common in men than women, and more prevalent in the Turkmen ethnic group.

Fish is one of the creatures which have the bio-accumulation of heavy metals. Terapon puta belongs to the order of Perciformes, is a benthic species in the waters of the Persian Gulf. This study was performed to evaluate the bio-accumulation of iron and nickel metals in the muscle of Terapon puta.

This descriptive-analytical study was performed on 30 pieces of Terapon puta caught in the Jefreh pier area of Bushehr, north of the Persian Gulf during the summer of 2019. Length (mm) and total weight (g) of fish were measured. The concentrations of iron and nickel in fish muscle tissue for human consumption were compared with international standards and calculated according to the US Environmental Protection Agency (USEPA) method for fish consumption, estimated daily uptake (EDI), and pollutant risk index (CR). After preparation, bioassay and, digestion of fish muscle with concentrated nitric acid, the concentration of iron and nickel (mg/kg) in muscle tissue was measured with ICP-OES.

The mean concentrations of iron and nickel in muscle tissue of fish samples were calculated 36.08±15.72 and 0.39±0.13 mg/kg, respectively. There was a significant difference between the concentrations of iron and nickel in the muscle tissue of the Terapon puta in the sampling area (P<0.05) and these values were lower than the standard and meaningless the muscle tissue of the Terapon puta in the sampling area compared to the FDA standard. The highest concentration of metals was observed in the length class of 20-25 cm and weight class of 230-260 g. Linear regression analysis showed that a strong increase (R2=0.9) between the concentration of iron and nickel with the length and total weight of fish. The daily uptake of both metals was obtained by consuming Terapon puta muscle tissue for consumers below the USEPA reference dose. The concentration of iron in the muscle tissue of Terapon puta was lower than the international standards. Nickel concentration was more than allowable limit according to WHO standards. The carcinogenicity risk index for nickel was acceptable.

Concentrations of iron and nickel in Terapon puta were considered acceptable for human consumption in terms of toxicity. The risk index for Terapon puta was less than one; therefore, the consumption of Terapon puta will not cause adverse health effects for consumers.

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder that can be time-consuming and cause considerable disruption to routine activities, occupational functioning, social activities, and relationships with others. This study aimed to determine the prevalence of obsessive-compulsive disorder among high school girl students.

This descriptive cross-sectional study was done on 342 high school female students in Amol city, northern Iran in the academic year of 2018-19. Cluster random sampling mehod was applied in this study. The Maudsley OCD Questionnaire was used for screening and the Yale-Brown Obsessive-Compulsive Questionnaire was used to confirm obsessive-compulsive disorder.

98 students (28.7 %) had positive symptoms. The highest frequency was related to slowness and repetition (37 cases), followed by doubting (36 cases), repetitive checking (35 cases), cleaning (31 cases), and finally rumination (12 cases). Among the 98 screened individuals, 67 were positive based on the Yale-Brown questionnaire. Severity of the obsessive compulsive disorder was mild in 37 cases (55.2 %), moderate in 21 cases (31.34%) and severe in 9 cases (13.43%).

The prevalence of obsessive-compulsive disorder observed in one-third of high school students in the area.

Early diagnosis of Alzheimerchr('39')s disease (AD) seems necessary due to the high cost of care and treatment, the uncertainty of existing therapies, as well as the worrying future of the patient. This study was conducted to AD diagnosis by MRI images using artificial intelligence methods.

In this research, a computer system for early detection of AD with using machine learning algorithms is presented in the framework of computer-aided process. Conditional random field and Inception deep neural network have been adapted for brain MR images to detect AD. Since hippocampal tissue is one of the first tissues to be affected by AD, hence for the early detection of this disease, the hippocampus was located from other brain tissues firstly and then due to the extent to which this tissue is affected, the diagnosis was made. Conditional random field could accurately extract hippocampal fragments of different shapes in all three brain planes. These components serve as the basis for feature extraction by the deep network. The proposed method was tested on standard ADNI dataset images and its performance was demonstrated. The used Inception network has been trained on the huge ImageNet dataset. One of the important steps is knowledge transfer of the problem under consideration. To facilitate this, data augmentation process was applied according to the shape and structure of the hippocampus.

The implemented method in this research, achieved to 98.51% accuracy for two-class classification of "Alzheimer" versus "Normal control" and achieved to 93.41% accuracy for two-class classification of "Mild cognitive impairment" versus "Normal control", which increased by 2.56% and 8.41%, compared with the rival methods, respectively.

The achieved results of this study showed that the using of artificial intelligence techniques has highly accurate in diagnosing AD according to MRI images.