فصلنامه کومش
سال بیست و سوم شماره 5 (پیاپی 85، مهر و آبان 1400)

Visfatin is a pro-inflammatory adipokine that is abundantly expressed in visceral adipose tissue. The cytokine visfatin is increased in obesity and type 2 diabetes. Visfatin is an insulin-mimetic adipokine that may also play a role in the development of diabetes and inflammatory reactions. The aims of the present study were to investigate the association of visfatin gene polymorphism rs4730153 with anthropometric characteristics, visfatin level, insulin resistance and lipid metabolism in an Iranian diabetic/pre-diabetic population.

This case-control study was conducted on 70 participants with pre-diabetes/diabetes and 70 participants as a control group. Serum levels of insulin and visfatin were measured using ELISA kits and other parameters were determined by standard methods. The genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.

The results showed no significant differences in the levels of cholesterol, insulin, visfatin between diabetic and non-diabetic subjects (P>0.05). Regression analysis of genotypes showed that rs4730153 polymorphism is not associated with type 2 diabetes (P>0.05). There was no significant difference in genotype distribution and allelic frequencies between the insulin- sensitive, insulin- resistance, and intermediate groups (P>0.05). A significant difference in cholesterol levels were observed between patients with different genotypes (P<0.05).

These results indicate that there is no association between visfatin and Type 2 diabetes. There is no significant relation between rs4730153 polymorphism with diabetes and insulin resistance but it has association with lipid metabolism.

Previous studies indicated that the low-level laser therapy has an effective role in modulation behavior of human osteosarcoma cells, which leads to change of cell proliferation, differentiation and adhesion. The aim of this study was to evaluate the effects of low-level laser therapy on the biophysical behavior of osteosarcomas based on the surface topographic mapping and fractal dimension analysis.

Human osteosarcoma MG-63 Cells were cultured in DMEM-F12 with 10% FBS and were exposed by laser beams after reaching to confluence of 80% in the fourth passage. The lasers with characteristics of 532nm with the power of 25mW, 650nm with powers of 3mW and 150mw and 780nm with the power of 70mW were implemented for irradiation within 8 minutes and cell proliferation was assessed 72h after exposure time. In the next step, cell size changes in three dimensions were evaluated by using surface topographic mapping with atomic force microscopy and confocal imaging and fractal dimension analysis was performed by using the processing of confocal images.

The laser irradiation causes significant changes in proliferation, height, perimeter and area of osteosarcomas. Moreover, except 3mW laser, all of them create significant changes in fractal dimension compared with the non-irradiated cells.

Assessing the fractal dimension besides the evaluation of three-dimensional cell sizes can be considered as a reliable index for the prognosis of the osteosarcomas response to low-level laser therapy.

The present study was designed to evaluate the pattern of lower limb muscle activity during the gait initiation in patients with multiple sclerosis (MS) compared with healthy individuals.

16 female MS patients and 16 age, weight, high and sex-matched healthy subjects were selected by simple non-random sampling participants. Subjects also underwent a thorough neurological examination to assess their disability using the Expanded Disability Status Scale (EDSS≤4.5). Surface electromyography of tibialis anterior, soleus, biceps femoris, gluteus medius, rectus femoris were recorded during gait initiation. The activity of muscles including recruitment order, reaction time, and root mean square (RMS) were processed and compared in two groups.

In the patients group muscles had a significant delay (P<0.02) compared to healthy group. Examination of the RMS ratio of each muscle to the total muscles in the two groups showed that the soleus and gluteus medius muscles were significantly different between the two groups (P<0.05).

Surface electromyography activity showed that the recruitment order was the same in the healthy and multiple sclerosis patients. However, decreasing the share of soleus and gluteus medius muscle co-contraction relative to other selected lower limb muscles in the patients may be useful in examining muscle synergies at the gait initiation in future studies.

Poor sleep quality is common during pregnancy, mindfulness based intervention may effect on mothers sleep quality. This study was done to determin the effect of group counseling based on mindfulness on sleep quality in nulliparous pregnant women.

In This clinical trial study, between 135 nulliparous pregnant women at 14-24 weeks, 29 women with poor sleep quality randomly assigned to intervention and control group. Intervention group attended weekly counseling sessions, for eight week, and the control group received only the usual prenatal care. The data collection tool were Pittsburgh sleep quality questionnaire and demographic information form. Intervention group, completed Pittsburgh sleep quality questionnaire at the beginning of intervention, after the end of the eighth session and one month after the end session and control group, at the beginning of study, 8 and 12 week after that, the questionnaire was completed.

The results of study showed that although the average score of sleep quality in two groups before the intervention was not statistically significant difference, but after intervention, sleep quality improved in the intervention group (P<0.001), and in follow-up, this result remained relatively stable until one month after intervention (P<0.004).

It seems that group counseling mindfulness based on stress reduction can be used to improve the sleep quality of pregnant women to have better mental health during pregnancy.

Patients undergoing mechanical ventilation cannot self-report pain because of intubation, altered levels of consciousness, and high doses of sedative agents. Therefore, inadequate pain management increases the duration of connection to the ventilator. The aim of this study was to evaluate the effect of pain control algorithm on pain intensity and duration of patientschr('39') connection to ventilator.

This clinical trial was conducted on 396 patients undergoing mechanical ventilation conveniently recruited from intensive care units of teaching hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences (Ahvaz, Iran) from August 2017 to June 2016. Participants were allocated to the intervention (n=198) and control (n=198) groups through permuted block randomization. Block size was four. In the experimental group, pain intensity was measured daily for 10 days using pain behavioral instrument and pain relief was performed based on pain control algorithm. In addition, the two groups were examined daily by a researcher-made checklist for weaning criteria from the ventilator for 10 days.

In the experimental group, pain intensity started to decrease from the first day of intervention (P<0.0001). The connection time to the ventilator was also reduced and this difference was statistically significant compared to the control group (P<0.0001).

The findings of this study showed that the use of pain control algorithm could lead to better pain management and reduce the duration of ventilator connection in patients admitted to intensive care units. However, to increase clinical utility and to achieve more targeted pain treatment, more focus on implement an algorithm and reassessment of patients’ pain is needed.

The beneficial effects of polyphenols to improve glycemic status in patients with type 2 diabetes have been reported in scientific studies. The aim of this study was to investigate the effect of oral ellagic acid (EA) supplement on glycemic index and insulin resistance in type 2 diabetic patients.

In this double blind randomized clinical trial, 44 diabetic patients were selected, and were randomly assigned to the intervention group (22 subjects) and placebo (22 subjects) and received a capsule containing 180 mg of EA per day or placebo for 8 weeks, respectively. At the beginning and end of the study, demographic information, anthropometric indices, food intake and physical activity, biochemical factors of fasting and two-hour blood sugar, plasma insulin level, glycosylated hemoglobin percentage (HbA1c) and insulin resistance (IR) were measured.

At the beginning and end of the study, there was no significant difference between the two groups in terms of anthropometric indices, food intake and physical activity (P>0.05). At the end of the study, receiving EA in the intervention group significantly reduced fasting and two-hour blood sugar means, plasma insulin levels, HbA1c percentage, and IR levels compared with placebo group (P<0.05).

EA supplementation can be helpful as a dietary antioxidant supplement in patients with type 2 diabetes by improving chronic side effects. This may be due to the antioxidant power of this polyphenol.

Pain is one of the common consequences of removing the arterial sheath. This study was performed to compare the effect of two methods of acupressure and ice pack on pain during arterial sheet removal in patients under angioplasty.

In this clinical trial, 90 patients were randomly assigned to three 30-member groups. In the ice bag group, an ice bag was placed on the right side of the patients’ femoral region for 15 min and then the sheath was removed. In the acupuncture group, the pressure was applied in the Heguchr('39')s point 20 min before the sheath removal. In the control group, only the nurse for 20 min. Visual analog scale touched the hand of patients (VAS) was used to measure the severity of pain.

The mean pain score in the ice pack and acupressure groups was 1.6 ± 1.6 and 2.4 ± 1.4, respectively, and in the control group was 4.03 ± 1.27. After the arterial sheet was removed, there was a significant difference between the three groups in terms of pain score (P= 0.0001). However, despite the lower score of the pain in the ice bag group, it showed no significant difference with the acupuncture group (P= 0.065).

Both intervention methods were effective in pain control. In addition, patients did not complain of either applying the ice bag or acupuncture. Thus, both of them can be used for this purpose.

Oral mucosa is one of the most debilitating complications of chemotherapy during the treatment period, which strongly affects the nutritional status of these patients. Therefore, this study aimed to evaluate the effect of sodium bicarbonate mouthwash on the prevention, incidence, and severity of oral mucosa in cancer patients undergoing chemotherapy in one oncology clinic affiliated to the University of Medical Sciences in western Iran from April 2019 to June 2020.

The present study was a quasi-experimental study with a pretest-posttest design. In this study, patients with cancer undergoing chemotherapy were allocated to the intervention and control groups by the random block method. Patients in the intervention group mixed two times every 8 hours and 7.5 ccs of sodium bicarbonate mouthwash each time. The Scales were completed for patients.

Findings showed that sodium bicarbonate mouthwash has been able to prevent the incidence of oral mucositis or reduce its severity of oral mucositis in patients undergoing chemotherapy that had no symptoms of oral mucositis at the beginning of the study. Therefore, there is not statistically significant difference in the objective evaluation score (F=4.21, P=0.74) and the subjective evaluation score (F=3.67, P=0.61) during the study in the sodium bicarbonate group. However, there was a statistically significant difference in the severity of oral mucositis in the objective and subjective assessment between the sodium bicarbonate group and placebo on follow-up days (P=0.01).

Sodium bicarbonate mouthwash maintains and promotes oral health by preventing the incidence and severity of oral mucositis in patients undergoing chemotherapy for three weeks. Therefore, the recommendation is to use sodium bicarbonate mouthwash as a therapeutic care measure in clinical settings at the beginning of chemotherapy for these patients.

Fatigue occurs during strenuous exercise in response to the accumulation of lactic acid in active muscles and blood.  The aim of this study was to compare two training methods (immersion in cold-water pond and yoga technique) on blood lactate during the return phase to the original state after a grueling exercise.

45 male soccer players were randomly divided into 3 equal groups and performed 15 minutes of recovery in cold-water immersion at 10 ° C and performing yoga techniques and passive rest (control) immediately after Cunningham intensive execise test. Blood lactate levels before, immediately, 5 minutes and 15 minutes after test in three the group was measured.

A significant increase in blood lactate levels immediately after exercise compared to baseline levels was observed in all groups (P<0.05). Significant differences were observed in blood lactate levels at 5 and 15 minutes of recovery compared to baseline levels in the two groups than control group (P<0.05). A significant decrease in blood lactate after 5 minutes in the immersed group and 15 minutes in the yoga group was more than the other groups.

Both methods are able to return the levels of blood lactate to the original state. However, the highest reduction in blood lactate was found at 5 min after immersing in pond of cold water, and at 15 min after the yoga practice.

Accreditation is the most common approach in evaluating and improving health care performance due to its dramatic positive effects on improving performance areas such as quality and safety. Considering the development of a national accreditation model for primary health care, the present study was conducted to assess the performance of Aradan comprehensive health service centers (Semnan, Iran) based on the national accreditation model.

Four comprehensive health service centers in the Aradan district participated in this cross-sectional study during fall 1399. The research tool was a checklist consisting of 39 standards and 231 evaluation measures defined in twelve performance dimensions extracted from the national accreditation model to comprehensive health care centers. The study was conducted in two stages of self-assessment and external assessment after educating managers and staff of healthcare canters regarding the nature of accreditation, contents of the assessment tool and method of completing it. The performance level of healthcare centers was determined based on compliance of accreditation requirements, which is embedded in the used model. In this regards, the scores of 1, 0.5 and 0 were allocated to "full compliance", "partially compliance" and "no compliance" respectively; therefore, the level of compliance of embedded requirements from healthcare centers in each measure, standard and dimension were calculated as a percentage.

The compliance rate of comprehensive health service centers with accreditation standards/measures in the “self-assessment” and “external evaluation” are 71.47 and 15.43 percent, respectively. The “community-centered services” dimension with a score of 93.75% and the “service delivery evaluation” dimension with a score of 0, had the highest and lowest performance levels in terms of compliance with accreditation standards in the self-assessment part; while in the external evaluation part, the “service continuity” dimension with 29.63% and the dimensions of “community-centered services”, “quality and safety of services” and “health systems research” with a score of 0, had the highest and lowest level of performance, respectively.

The performance of the centers, which took part in this study, has notable weaknesses, which emphasizes the need to design and implement promotional interventions with the participation of experts and process owners.

Sexual function and quality of life (QOL) are compromised in female with multiple sclerosis (MS). Recent studies emphasize on functional suspension training using body weight resistance against gravity. Therefore, the purpose of this study was to determine the effect of total body resistance exercise (TRX) on sexual function and QOL in patients with MS.

Among 93 female patients referred to Isfahan Multiple Sclerosis Society (IMSS) 34 females in the age range of 20 to 50 years with expanded disability status scale of 1-4 were selected as a statistical sample. The participants were intentionally selected into two of control (n=15) and experimental (n=19) groups. The experimental group received the TRX program for 8 weeks and the control group received their usual care.

The results showed that there was a significant improvement in physical function (P=0.001), role limitations due to physical problems (P=0.001) and emotional (P=0.015), physical health (P=0.018), sexual function (P=0.018) and sexual satisfaction (P=0.040) of the experimental group compared to the control group. However, no significant differences were found n relation to pain (P=0.485), emotional well-being (P=0.468), energy (P=0.459), health perceptions (P=0.600), social function (P=0.116), cognitive function (P=0.896), concern about their health distress (P=0.118) and mental health (P=0.091), between the two groups.

TRX has the necessary components to improve the physical dimensions of quality of life and sexual function of patients with MS.

The neuroprotective effect and pleiotropic functions of PPARα agonists (peroxisome proliferator activated receptor-alpha) such as fenofibrate and bezafibrate have been demonstrated by the previous studies. The current study evaluated the antiepileptic effects and neuroprotective functions of fenofibrate in pentylenetetrazole (PTZ)-induced kindling seizure in mice.

Adult male NMRI mice were randomly assigned into three groups (n=8): Control, untreated kindled mice and fenofibrate-treated kindled animals. Repeated intraperitoneal injections of PTZ (45 mg/kg) once every 48 hours were used to develop the kindling seizure for 21 days. Treated mice were administered orally fenofibrate at doses of 30 mg/kg/day. Plasma level of brain-derived neurotrophic factor (BDNF), brain level of malondialdehyde (MDA) and histopathological changes were evaluated at termination of the study.

Fenofibrate administration considerably improved the seizure latency in treated kindled mice. Fenofibrate significantly (P<0.05) decreased plasma BDNF level in treated kindled mice (12.06±0.08 ng/mL) compared to PTZ group (13.43±0.20 ng/mL). Treatment with fenofibrate significantly (P<0.05) decreased MDA level of brain by 68% in treated kindled mice compared to PTZ group. In addition, fenofibrate improved the histopathological damages in treated kindled animals.

Fenofibrate ameliorated the plasma level of BDNF and brain level of MDA accompanied with the brain histopathological damages in kindling seizure in mice that might be associated to improving the seizure behaviors.

The present study aimed to investigate the effect of co-exposure to heat stress as an environmental stressor and psychological stress on serum levels of testosterone in male rats.

This study was performed on 40 healthy adult male Wistar rats during a period of 40 days. The rats were evenly and randomly divided into three exposure groups and one control group. The rats in the heat stress group were exposed to 36 ° C and 20% humidity. The rats in psychological stress group was daily exposed to three types of stress: strobe light, cage tilt, and noise. The rats in co-exposure group also experienced both types of heat and psychological stresses.  Then, the level of testosterone was measured in all groups.

The results showed that the co-exposure group (4.20 ng/ml ±1.15) had lower hormone levels than the two exposure groups that were separately exposed to heat stress (4.35 ng/ml ± 1.15) and psychological stress (4.98 ng/ml ±1.51); while the level of hormone in the control group was 5.41 ng/ml ± 1.69 (P>0.05). The results of univariate analysis showed that the co-exposure group had the highest difference in hormone levels compared to the control group and the largest effect size.

In general, heat and psychological stress can each affect the level of testosterone as one of the components of reproduction system. However, co-exposure to these two types of stressors may lead to more severe effects on the testosterone level.

Striatum is the major input site of the basal ganglia.  Lesion of striatum caused motor and cognitive impairments. Recent evidence has suggested that physical activity can improve cognitive and learning disorders caused by brain damage.  The present study examined the effect of bilateral microinjections of ibotenic acid in neostriatum of the BG and forced treadmill exercise on anthropometric characteristics and learning and spatial memory of male rats.

48 male Wistar rats were randomly divided into six groups: Control, Sham-lesioned, Lesioned, Exercise, Exercise + Sham-lesioned and Exercise + lesioned. Lesion was made by bilateral microinjection of ibotenic acid into neostriatum. The exercise groups were subjected to a protocol of running on a treadmill for four weeks

Findings showed that ibotonic acid microinjection significantly decreased learning and spatial memory (P<0.05). Forced treadmill exercise could get better learning and spatial memory, but it could not significantly improve learning and spatial memory impairment induced by ibotenic acid injection in striatum. On the other hand, four weeks forced treadmill exercise enhanced anthropometric characteristics in lesion group (P = 0.03).

The present results suggest that striatum had a main role on learning and spatial memory, while four forced treadmill exercise could not improve spatial learning and memory impairment induced by ibotenic acid injection in striatum.

One of the most common complications of peripheral vascular catheter is phlebitis. According to the anti-inflammatory role of Rosemary, this study aimed to determine the effect of rosemary ointment on the phlebitis and infections caused by peripheral vascular catheter in children admitted to the pediatric ward.

This double-blind clinical trial study was conducted on 96 children admitted at pediatric ward of Ganjavian Hospital in Dezful, Iran in 2017. Children were randomly divided into intervention and control groups using permuted block randomization. In the intervention group, 0.5 cc of rosemary ointment was used and in the control group Eucerin ointment was used in the distal IV cannula site. IV cannula site was monitored for every 12 hours for up to 72 hours for control phlebitis and every 24 hours was cleaned and re-ointment was used. If the phlebitis was detected, the IV cannula was isolated sterilized and sent to the laboratory for culture.

Catheter survival time in the intervention group was 9.98 hours higher than the control group (P=0.027) and the incidence of phlebitis in the control group (37.5%) was higher than the intervention group (18.8%) (P=0.034). There was no significant difference in the catheter cannulation in the culture medium between the two groups (P=0.213).

Local application of rosemary ointment can reduce the incidence of phlebitis due to intravenous catheter in children, therefore, it is recommended as a substitute for reducing phlebitis.