نشریه دانشور پزشکی
پیاپی 154 (امرداد و شهریور 1400)

Many of traditional infertility treatment methods due to lack of gamete are ineffective.  Differentiation of stem cells to gamete germ cells may be a good choice for producing gametes for treatment of infertility in clinique. Bone marrow mesenchymal stem cells (BMMSc) were obtained from femoral bone of adult NMRI mice by flushing method. Nano tube particles of titanium (TNT), retinoic acid and UV beam 254 ± 20 nm frequencies were used for differentiation of MSc to gamete germ cells. Ultrastructure of TNT was studied with FEM SE electron microscope. Fibrin coating of Nano tubes was evaluated by SEM. Nature and character of stem cells were measured using cluster– differentiation (CD) by flow cytometry confirmed by CD90, and CD31 markers.  Finally, MVH marker was used for assessment of differentiation of MSc to gamete germ cells with immunohistochemistry assay. Statistical data was analyzed by ANOVA and Mann-Whitney tests. Electron microscopic pictures by FE SEM showed homogenous ultrastructure of titanium nanotubes in 10-15 nm diameters. Coating of TNT by fibrin was confirmed by SEM. MTT assay showed most survival rate of MSc cells in 50 µg/ml concentration of TNT. By CD90 and CD31 markers, nature of the stem cells was controlled by flow cytometry. Finally MVH marker expression showed differentiation of MSc to gamete germ cells in treated as compared to control groups and was confirmed by immunohistochemistry. Application of TNT fibrin coated and UV beam can increase differentiation rate of BMMSc to gamete germ cells significantly as a clinical protocol.

Increased cardiomyocyte apoptosis is one of the main causes of diabetic cardiomyopathy. Considering the role of probiotics and exercise in improving the complications of diabetes, the aim of this study was to investigate the synergistic effect of endurance training and probiotic supplementation on the expression of Bax and Bcl-2 genes in cardiomyocytes of diabetic rats. 30 male Wistar rats with an average weight of 270 ±10 g were randomly divided into 5 groups: Normal Control (NC), Diabetic Control (DC), Diabetic Probiotic Supplement (SDC), Diabetic Training (TD), and Probiotic Supplement. Probiotic-Diabetic Training (STD). Training groups with an intensity of 60-65% VO2peak ran on a treadmill in 5 days a week and for 4 weeks. At the same time, the supplement groups received 2 grams of the probiotic supplement daily. Expression of Bax and Bcl-2 genes in the left ventricle of rats was studied by qReal-Time PCR and data analysis was performed by two-way analysis of variance with a significance level of p   Bax gene expression was decreased in all groups compared to the DC group (p <0.05) but in the TD group there was no significant difference compared to the STD (p = 0.918). Also, Bcl-2 gene expression increased in all groups compared to the DC group (p = 0.001) but in the TD group, this increase was more significant than STD (p = 0.002).   It seems that endurance training with probiotic supplementation with a synergistic effect on some factors affecting cardiomyocyte apoptosis can be effective in reducing the complications of diabetes in cardiomyocytes of diabetic rats.

Morphine can induce PCOS (Polycystic ovary syndrome) probably by changing glutamate level at the hypothalamic nuclei. This study used low doses of ketamine to survey the interaction of ketamine with morphine-induced PCOS. 48 female Wistar rats were selected as virgins in the weight range of 220-250 g, and categorized randomly into eight groups. The first group received morphine (5 mg/kg) intraperitoneally. The second to fourth groups received ketamine (1, 2, and 4 mg/kg). In groups 5 to 7, the ketamine (1, 2, and 4 mg/kg) was pre-injected to morphine (5 mg/kg) over a period of 20 min. Control group received only saline (1 ml/kg). After 48 h, the blood and serum specimens were provided to record hormone levels, and the animals’ ovaries and uteri were biometrically examined and stained by H & E. Statistical analysis was performed by analysis of variance (ANOVA) under α=0.05. The morphine as well as single ketamine induced the PCOS. However, taking ketamine prior to morphine caused a meaningful reduction in the number of cysts in the ovary. There was also a relative increase in uterine diameter in the group receiving morphine, which was stopped due to ketamine pre-treatment. These effects showed correlation with decreased levels of FSH, and change in estrogen, and prolactin amounts. The interference effect of ketamine with morphine is completely dependent on changes in gonadotropin level.

Irritable bowel syndrome is the most common, expensive, and debilitating gastrointestinal dysfunction. Psychological factors have a profound effect on its onset, duration and severity. This study aimed to compare the effectiveness of mindfulness based cognitive therapy and Iranian-Islamic positive therapy on pain catastrophizing and symptom severity in women with irritable bowel syndrome.

In this study, semi-experimental research was done on three groups with the two-step plan of pre and post-test.The study sample consisted of 45 women with irritable bowel syndrome in the age range of 18 to 50 years in 2019 which were selected by purposive sampling based on inclusion and exclusion criteria with random assignment in three groups (one control and two experimental groups). To measure the research variables, ROME III diagnostic tool, the diagnostic structured interview for DSM-V-RV (SCID-I), Pain Catastrophizing Scale (PCS) and Bowel Symptom Severity and Frequency (BSS-FS) questionnaire were used in pre-test and post-test phases were used. The groups of mindfulness based cognitive therapy and Iranian-Islamic positive therapy were treated for 8 sessions and the control group remained in the waiting list. Data were analyzed using SPSS23 software and ANCOVA test.

The results showed that there was a significant difference between mindfulness based cognitive therapy and Iranian-Islamic positive therapy with control group in pain catastrophizing (p < 0.01) and severity of symptoms (P < 0.01), but no significant difference was seen between the two treatments (p>0.05).

Based on the findings of this study, it seems that mindfulness based cognitive therapy and Iranian-Islamic positive therapy can be used as a psychological treatment to reduce the catastrophizing and severity of symptoms in women with irritable bowel syndrome.

Intrauterine growth restriction (IUGR) is one of the pregnancy problems that can be caused by improper vascular changes. Due to the role of NK cells in IUGR and the difficulties of studying them in tissues, it is necessary to study them in peripheral blood. The aim of this study was to evaluate the percentage and number of peripheral blood CD3-CD56+CD16+NK cells in pregnant women with IUGR fetus.. 18 pregnant women with IUGR fetus and 15 pregnant women with healthy fetus were invited. The number and percentage of peripheral blood CD3-CD56+CD16+NK cells in both groups were assessed by flow cytometry. The percentage of CD3-CD56+CD16+NK cells in the patient and healthy groups was 24.11 and 26.17, respectively. The number of these cells was 97.27 in the patient and 129.7 in the healthy group. No significant difference was observed between the two groups by Mann-Whitney analysis. Spearman analysis showed a significant relationship between age and NK cells in the patient group. The comparison of percentage and number of CD3-CD56+CD16+NK cells in the patient group with the control group was not significantly different which could be due to the lack of analysis of NK cell subgroups. In future studies, analysis of NK subtypes should be investigated. Considering the significant relationship between age and the number and percentage of NK cells in the patient group, it seems that increasing age as a negative factor is associated with a decrease in these cells.

Obesity and elevated levels of inflammatory markers are associated with increased risk of chronic diseases such as type2 diabetes and cardiovascular disease. The purpose of this study was to investigate the effect of total body resistance exercise and Vaccinium arctostaphylos supplementation on body composition and C-reactive protein in obese women. In this quasi-experimental study, 52 sedentary women with the mean age of 39.1±4.9 years and body mass index of 33.7±3.1 kg/m2 were randomly divided into four groups: training, supplement, training + supplement and control. Subjects of training and training + supplement groups underwent total body resistance exercise for eight weeks. Supplement and training + supplement groups consumed capsules containing 500 mg of  Vaccinium arctostaphylos twice daily. Weight, body mass index, abdominal circumference, percentage of body fat and serum level of C-reactive protein was measured at the beginning and after eight weeks intervention. Data were analyzed by analysis of  Weight, body mass index, abdominal circumference and percentage of body fat decreased significantly in training and training + supplement groups compared to control groups after the intervention (P˂0.05). Serum C-reactive protein level was not significantly different among four groups (P˃0.05).    It seems that total body resistance exercise alone or combined with Vaccinium arctostaphylos supplements can improve body composition in obese women; however it may not lead to changes in C-reactive protein level.

In this study, determining the conditions and the effect of factors causing induced demand for Iranian health care markets was discussed. To investigate the situation of induced demand, the equilibrium conditions of demand and supply of health care services in 31 Iranian provinces during 6 year (2009-2014) have been considered. The assessment model was expressed in terms of panel data regression within error correction framework. The estimation of demand and excess demand equation in the urban areas covered by the Iranian health insurance organization showed excess demand in certain forms of induced demand. Findings show that outpatient and inpatient health care providers, as agents of applicants for this care, determine the conditions of additional demand in accordance with the model of providers of this care. Using the models and finding of this study, the policies for controlling the induced demand in the health care market could be recognized.

Fat deposition in the liver to the extent of more than 5% of the liver weight in the absence of significant alcohol consumption, viral infections and any etiology of liver disease is called non-alcoholic fatty liver. The aim of this study was to investigate the effect of combined exercises with the approach of "ultimate -fit" and coffee consumption on the levels of liver enzymes in middle-aged men with non-alcoholic fatty liver. The present study was quasi-experimental with pre-test and post-test design. 44 middle-aged men with fatty liver were purposefully selected and randomly divided into four groups: combined exercise (n=11), coffee consumption (n=11), combined exercise + coffee consumption (n=11) and control (n=11). Ultrasound and blood tests were performed to determine the amount of liver enzymes before and after the implementation of the research protocol. The practice groups performed the combined program for eight weeks in three regular sessions per week. Subjects in the coffee consumption group and combined exercise+coffee consumption received 10 grams of coffee every other day.  Data were analyzed by using analysis of MANCOVA. Serum levels of liver enzymes in all three experimental groups were significantly reduced compared to the control group (p < 0.05). In the experimental group, combined exercise with coffee consumption decreased alanine aminotransferase and in other cases no significant difference was observed. Combined exercise intervention with coffee consumption is effective in reducing liver enzymes. This intervention can be used for sedentary middle-aged people with fatty liver who are on the verge of aging.

Exercise training and nutritional interventions such as L-arginine ingestion have an effective role in controlling hypertension. Therefore, the aim of present study was to investigate the effect of 12-weeks endurance training and L-arginine supplement on the levels of asymmetrical dimethylarginine (ADMA) and nitric oxide (NO) in hypertensive women. 40 postmenopausal hypertensive women (55.26±2.56 years old, body mass index: 28.61±1.18 kg.m2) were randomly assigned in four groups (10 person) including: placebo, L-arginine, training and training+L-arginine groups. Endurance training program conducted for 12 weeks with 60-75 percent of maximum heart rate. L-arginine consumption considered 6 g daily. Blood sampling performed in pre and posttest (48 hours after last training session or L-arginine consumption) and ADMA and NO were measured by ELISA method. Data were analyzed by SPSS24 software and analysis of covariance test. ADMA in training and training+L-arginine groups indicated significant decrease compared to placebo and L-arginine groups (p < 0.05). NO levels significantly increased in all groups compared to placebo group (p < 0.05). Despite decrease in systolic blood pressure in L-arginine, training and training+L-arginine groups compared to placebo group (p < 0.001), decrease in systolic blood pressure in training+L-arginine group were significant compared to training (p < 0.001) and L-arginine (p=0.007) groups. L-arginine consumption increases the effectiveness of endurance training in decreasing systolic blood pressure that is partly exerted by further increase in NO levels.

Pain is a pervasive and distressing experience. Chronic musculoskeletal pain is highly prevalent in different communities. Exacerbation or improvement of pain is related to psychological factors in addition to biological aspects. The aim of the present study was to evaluate the structural model of the relationship between health oriented lifestyle, helplessness and pain self-efficacy in patients with chronic pain. The present study was a descriptive cross sectional study using structural equation modeling. We used available sampling for selecting 384 patients with chronic musculoskeletal pain as the study population including patients with chronic musculoskeletal pain referred to Najafabad private clinics. Research tools included health oriented lifestyle questionnaire (HPLQ, 1988), Pain Self-Efficacy Questionnaire (PSQ, 2007) and Learned Helplessness Questionnaire (LHQ, 1988). The data were analyzed by SPSS23 and AMOS with help of structural equation modeling. The results indicated the health oriented lifestyles had significant direct relationship with pain self-efficacy. Learned helplessness had relative reverse relationship with pain self-efficacy and had significant reverse relationship with health promoting lifestyle. Also the mediatory role of learned helplessness in the relationship to health promoting lifestyle was supported and a relative reverse correlation was obtained (p < 0.05).In general, the model of research was fit and the considered factor structure was optimal. Improving health promoting lifestyle was involved in pain self-efficacy in patients with chronic musculoskeletal pain.Changing and improving these indicators can be helpful in treatment along with medical treatment.

GDNF protects nerve cells against inflammation and oxidative stress caused by hyperglycemia. The aim of this study was to evaluate the effect of aerobic exercise with melatonin on GDNF gene expression and some indicators of oxidative stress in rats with diabetic neuropathic pain. Forty 8-week-old male Wistar rats (weight range 204 ± 11.3 g) were randomly divided into five groups (n = 8) including: diabetic neuropathy (50 mg/ kg streptozotocin intraperitoneal injection), diabetic melatonin neuropathy (mg/kg 10 melatonin daily for 6 weeks), diabetic neuropathy exercise (30 minutes of aerobic exercise at 15 meters per minute, 5 days a week for 6 weeks), diabetes melatonin neuropathy and healthy exercise and control. After confirmation of diabetic neuropathy by behavioral tests, exercise protocol and supplementation were performed. GDNF gene expression was measured by real-time technique and oxidative stress indices in spinal cord tissue by spectrophotometer. One-way analysis of variance and Tukey's post hoc test were used for statistical analysis. Exercise and melatonin reduced the sensitivity of the nervous system to thermal hyperalgesia and mechanical allodynia. Aerobic exercise with melatonin significantly increased GDNF gene expression and SOD and CAT enzyme activity and decreased MDA concentration compared to diabetic neuropathy group (P <0.05). Aerobic exercise with melatonin modulates the expression of GDNF gene and oxidative stress indices and improves the sensitivity of nociceptors to pain factors. It is recommended to use aerobic exercise with melatonin for diabetics to reduce neuropathic pain.