مجله پزشکی دانشگاه علوم پزشکی تبریز
سال چهل و سوم شماره 4 (پیاپی 154، مهر و آبان 1400)

Acute postoperative pain is still an issue in patients undergoing lumbar laminectomy surgery. We compared the effects of remifentanil and dexmedetomidine on pain intensity as well as the analgesic requirements in patients undergoing spinal surgery.

This randomized clinical trial study was conducted on 60 patients in the age range of 20 to 60 years with ASA (American Anesthesia Association) class one and two who underwent elective lumbar vertebrae laminectomy. Patients were divided into two groups: Remifentanil (group R) and Dexmedetomidine (group D). Before the induction of anesthesia in R group patients, 0.01 μg/kg/min remifentanil was used. In group D, 0.3 µg/min/kg dexmedetomidine was injected using a syringe pump. Postoperative pain score, nausea, vomiting, mean arterial blood pressure, and heart rate at recovery times, 6, 12, and 24 hours after surgery were recorded.

The propofol infusion rate was significantly lower in group D than in group R (P=0.001). Pain scores except for 6-hours after surgery was significantly lower in group D. Analgesic consumption was significantly lower in group D (P=0.021). Mean arterial pressure during surgery, after laryngoscopy, and recovery was significantly lower in group D (P<0.05). The mean heart rate after laryngoscopy was significantly lower in group D (P=0.033).

Intraoperative infusion of dexmedetomidine improved hemodynamic parameters during surgery and decreased pain score and morphine use after lumbar laminectomy surgery.

Hypertrophic cardiomyopathy is the most common genetic cardiovascular disease and is predominantly inherited in an autosomal dominant pattern. In this study, genetic analysis of a family affected by hypertrophic cardiomyopathy with three patients was done using whole-exome sequencing.

Whole-exome sequencing was performed on two affected individuals and one healthy family member. The candidate variant was evaluated using Sanger sequencing on other family members. Given the novelty of the candidate variant, it was also studied in 200 healthy individuals. Different bioinformatics analyses were performed to evaluate variant pathogenicity.

The candidate variant was present in two affected patients as well as in two apparently healthy siblings. This variant was novel and did not exist in any databases. An echocardiographic result on family members showed that another proband’s brother was affected and did not have a candidate variant. Also, this variant was not found in a population of 200 healthy individuals. Bioinformatics analysis revealed the pathogenicity of the variant.

Although all the early studies of the candidate variant showed it as a causative variant, further studies on more individuals of the family rejected its causality alone and from these results, concluding that the results of exome sequencing should be analyzed carefully, and necessitating further study in a pedigree with more affected individuals and functional studies to prove the variant as pathogenic.

STAT3 is an oncogenic signaling pathway found constitutively active in many types of human malignancies and plays a key role in cancer progression. Stattic is a small molecule, which selectively inhibits the SH2 domain of STAT3. In most studies, stattic has been proposed as a promising strategy STAT3 inhibition in cancer cells harboring constitutively active STAT3. However, the lack of proper formulation due to the poor water solubility and low bioavailability of stattic is a major limitation for its usage in the clinic. This project aimed to develop poly(ethylene glycol)-block-poly(caprolactone) (PEG-b-PCL)-based polymeric micelles loaded with stattic and evaluate drug encapsulation efficiency and release in the developed formulations.

In this experimental study, to prepare stattic loaded micellar formulations, the co-solvent evaporation method was used. The mean diameter and polydispersity index (PDI) of micelles were defined by the light scattering method. Encapsulated drug levels were measured using high-performance liquid chromatography (HPLC). Data were analyzed using GraphPad Prism software through one-way ANOVA.

Stattic was loaded in the polymeric micelles with encapsulation efficiency ranging from 40% to 73%. Drug loaded micelles were measured between 90 to 130 nm in size. PDI was obtained 0.3-1, and encapsulation of stattic in Polyethylene glycol-block-poly (α-benzyl carboxylate ε-caprolactone (PEG-b-PBCL) micellar formulation resulted in a more than 6-fold increase in the water solubility of stattic (0.36 vs. 0.06 mg/mL). Regarding high encapsulation efficiency, two micellar formulations were selected for further analysis in that both of them released 70-80% of the drug within the first hour, indicating burst release of the drug.

These findings show that PEG-b-PBCL copolymers can be a suitable vehicle for the solubilization of stattic.

The link between frequency domain analysis of ground reaction forces and hearing loss and blindness during walking is not well understood. Therefore, the purpose of this study was to investigate the frequency domain analysis of ground reaction forces in deaf and blind people during walking.

This study was quasi-experimental. The volunteer participants in the current study consisted of thirty males who were divided into three equal groups: blind, deaf, and healthy (control) groups. Frequency domain analysis of ground reaction forces in three groups was recorded by a foot scan system (sample rate: 300 Hz). The multivariate ANOVA test was used to compare between groups. The significance level was set at P<0.05 for all analyses.

The results showed that the frequency content with the power of 99.5% in the vertical component of ground reaction forces in both deaf (P=0.020) and blind (P=0.021) groups was reduced vs the control group. Also, frequency content with the power of 99.5% in the mid-foot in the deaf (P=0.020) group was more than the blind group (P=0.036).

The present study showed that the frequency content with the power of 99.5% in the mid-foot in the deaf group was more than the blind group. It can be stated that the frequency domain analysis of ground reaction forces has a clinical value. Therefore, the use of therapeutic interventions to improve the frequency domain analysis of ground reaction forces in deaf and blind people is suggested.

Scaffolds are one of the key components of tissue engineering that play an important role in cell growth. The present study aimed to prepare hydroxyapatite-gelatin nanoscaffolds containing vanilla.

In this in vitro examination, the scaffolds were prepared using the precipitation method. Then, vanilla was loaded into the prepared structures. Dynamic light scattering (DLS) and scanning electron microscopy (SEM) were used to evaluate the size and morphology of the scaffold. The surface charge of the scaffold (zeta potential) was also assessed by employing a Zetasizer. The loading of vanilla was evaluated via ultraviolet-visible spectrophotometry at 372 nm.

The results showed that the scaffold was well prepared and had good physicochemical properties, including appropriate particle size (110.23±0.42 nm), good particle distribution, high drug loading (65.03± 0.25%), and acceptable suspension stability (zeta potential equal to 36.42±0.80 mV). Descriptive statistics (mean ± SD) were used to report the results.

Based on the obtained results of the current study, we suggest that the prepared scaffolds can be used for in vitro and in vivo applications in future studies for tissue engineering. More investigations are needed to test the usefulness of these scaffolds.

Asthma is a heterogeneous disease whose inflammatory processes are involved in the pathophysiology of atherosclerosis and endothelial dysfunction, and increases the prevalence of cardiovascular disease. This study was designed to investigate the effect of 8 weeks of interval training on some of the effective factors in atherosclerosis in heart tissue of asthmatic rats.

In this experimental study, 15 rats were randomly divided into three groups of sham, asthma, and asthmatic-interval training. The model of asthma was induced by intraperitoneal injection of 1 ml ovalbumin for 2 weeks, and then asthmatic-interval training rats for 8 weeks participated in interval training. During the training protocol period, twice weekly intraperitoneal injections of ovalbumin 1 ml, and were placed into a glass container exposed to 5% ovalbumin spray. 48 hours after the last training session, the rats were anesthetized and their hearts were ejected. The levels of proteins expression of ICAM, VCAM, and galectin-3 were measured by immunohistochemistry, and western blotting, respectively. Data were analyzed using one-way ANOVA in SPSS at the significant level α=0.05.

The results of this study showed that the expression of ICAM (P=0.001), VCAM (P=0.001), and galectin-3 (P=0.001) was significantly increased in heart tissue of asthma rats. Whereas, interval training decreased the expression of ICAM (P=0.001), VCAM (P=0.001), and galectin-3 (P=0.01) proteins in the asthmatic-interval training group compared to the asthma group.

It seems that, interval training is effective in preventing atherosclerosis in patients with asthma.

Chronic urticaria is a skin disorder characterized by swollen pruritic plaques and papules last long at least for 6-weeks. The aim of this study was to determine the anti-TPO level in patients diagnosed with chronic urticaria, resistant to conventional treatments in order to test the possibility of thyroid hormone replacement with the aim of accelerating healing process.

In this case-control study, 63 patients with chronic urticarial and 63 controls without chronic urticarial were studied bye anti-TPO measurement. Anti-TPO level upper than 40 IU/ has been recognized as positive.

The prevalence of chronic urticaria among the case group was 3.5 times higher in women rather than men. Mean time of disease period was about 21.40±3.75 months. In this study, there was been no statistically significant association between age, sex, TSH level and anti-TPO concentration in both groups.

Anti-TPO level in patients with chronic urticaria was not significantly different from the control group. However, Anti-TPO levels were significantly higher in patients with longer duration of disease.

Leishmaniasis is a zoonotic disease and is known as a health problem in all of the world. The patient, a 47-year-old man car driver from the city of Bostan Abad, with a history of traveling to cutaneous leishmaniasis endemic provinces last year, was referred to the city health center with a 17 mm, no discharge and pus with a necrotic appearance skin lesion. Biochemical, hematological parameters and urine culture and analysis were normal. Three smears were prepared with sterile vaccinostyle from the margins of the wound and transferred to a specific medium in sterile conditions. After staining the prepared smears from the wound, amastigotes with a large nucleus and small kinetoplast in macrophages and active promastigotes in the liquid phase of the medium were observed. Polymerase chain reaction (PCR) was performed using ITS-1 by specific primers. In the PCR product electrophoresis was compared with the marker bands and 350 bp band weight determined. With electrophoretic patterns and comparison with positive control band, isolates parasites belonged to the Leishmania genus. In order to definitively diagnose the parasite species, a sequencing method was used. The results showed 99% homology with Leishmania major. Finally, the patient with a diagnosis of rural cutaneous leishmaniasis was induction with Glucantime drug. Diagnosis of suspected cases with cutaneous leishmaniasis is of major importance. If an infected patient is diagnosed in the early stages of the disease, the extension of the scar after recovery, as well as the possible complications of rural infection can be prevented.