مجله دانشگاه علوم پزشکی گرگان
سال بیست و سوم شماره 4 (پیاپی 80، زمستان 1400)

Differentiation of white adipose tissue into brown through hormonal and non-hormonal factors, causes weight loss and weakens in obese and overweight people. This study was performed to determine the effect of 12 weeks of interval exercise with different intensities on serum levels of fibroblast growth factor 21 and myostatin in obese and overweight males.

This clinical trial study was done on 47 obese and overweight males (20.5±0.73 years old). Subjects were randomly divided into four groups: control, interval exercise with low intensity, moderate intensity and high intensity. The exercise program consisted of 12weeks of interval exercise with light, medium and heavy intensity respectively with 58-63, 73-78 and 88-93 percent of Reserve heart rate for 25 to 63 minutes and three sessions per week. Serum indices of fibroblast growth factor 21 and myostatin were measured using fasting blood sample 48 hours before and after exercise program using ELISA method.

Performing 12 weeks of interval training with different intensities was not contribute to significant changes in the serum levels of fibroblast growth factor 21 and myostatin. Implementation of interval exercise at moderate and high intensities was associated with reduction of body fat percentage and increasing in maximal oxygen consumption (VO2max) in overweight and obese men (P<0.05).

Performing 12 weeks of low, medium and high intensity interval training without changing the serum level of fibroblast growth factor 21 and myostatin has a beneficial effect on improving body composition and increasing VO2max in obese and overweight young males.

Genu valgum is one of the most common lower limb malformations that affects on walking mechanics. This study was done to evaluate the effect of corrective exercise with Thera-band on the lower limb muscles’ co-contraction in males with genu valgum during walking.

In this clinical trial study, 24 male students with genu valgus with age range of 20-30 years were randomly divided into two control (n=12) and intervention (n=12) groups. Using the caliper, the intensity of the genu valgum was measured by assessing the distance between the medial malleolus of the subjects. Corrective exercises were performed for 8 weeks using Thera-band in interventional group. The electrical activity of selected muscles was recorded by electromyography system (biometrics ltd, UK).

In the interventional group, the knee joint flexor/extensor directed co-contraction was increased significantly during the heel contact phase in the post-test than that in the pre-test (P<0.05). There was also a significant increase in knee joint general co-contraction during heel off phase (P<0.05). In the interventional group, directed co-contraction of vastus lateralis / vastus medialis muscles during the swing phase was significantly increased during the post-test in compared to the pre-test (P<0.05). During post-test, knee joint flexor/extensor directed co-contraction during the heel, knee joint general co-contraction during heel off phase and directed co-contraction of vastus lateralis / vastus medialis muscles during the swing phase were more in the interventional group in compared to control group (P<0.05).

The increase of general co-contraction in the knee joint during the heel off phase reflects an improvement in activity of the knee support muscles after corrective exercises and increases balance and stability. There was also an increase in the knee joint flexor / extensor direction co-contraction, which increase the distribution of the load and pressure between the femur and tibia in the knee joint.

Eotaxin is a pre-inflammatory adipokinin secreted from adipose tissue that plays an important role in function regulating of adipose tissue. This study was done to determine the effect of high-intensity interval training on the gene expression of eotaxin in visceral adipose tissue and insulin resistance following metabolic syndrome in rats.

In this experimental study, 40 male Wistar rats (weight 180±20 gr) were selected and after 12 weeks of high-fat diet and the creation of the metabolic syndrome model were randomly divided into four groups including  control, metabolic syndrome, High-Intensity Interval Training (HIIT) and metabolic syndrome with HIIT. Rats in the high-fat diet were subjected to a special diet (30 to 40% fat) for 12 weeks to develop a model of metabolic syndrome. HIIT consisted of 5 to 10 interval 1-minute intensive running on treadmill at 80 to 95% of maximum speed and in slow alternations at 55% of maximum speed for 8 weeks. Insulin resistance using HOMA-IR mode is considered as a basic factor for determining metabolic syndrome.

The gene expression of eotaxin and insulin resistance in the metabolic syndrome group were significantly higher than the control group (P<0.05). Gene expression of eotaxin and insulin resistance was significantly lower in HIIT and metabolic syndrome with HIIT groups than the metabolic syndrome group (P<0.05). Also, the gene expression of eotaxin and insulin resistance was significantly lower in HIIT group than the metabolic syndrome with HIIT group.

It seems that HIIT may be an important factor in down-regulating eotaxin and insulin resistance in metabolic syndrome.

Diabetes is one of the most common non-communicable diseases with debilitating complications and mortality rate those results from insulin deficiency, resistance to it or both. The role of nutrition and some micronutrients in the development and progression of diabetes has been investigated. Studies have shown that Magnesium deficiency can reduce insulin secretion and cell resistance. This study was done to determine the association of serum Magnesium level with glycemic control, serum lipids and renal function in type 2 diabetes mellitus and pre-diabetic patients.

This case-control study was done on 70 patients with type 2 diabetes, pre-diabetes and 35 healthy individuals. Fasting glucose, HbA1c, lipid profile, creatinine and Magnesium were determined.

Serum Magnesium level in diabetic and pre-diabetic patients were significantly lower than control group (P<0.05). Serum Magnesium level had reverses correlation with HbA1c in diabetic patients. Serum Magnesium level had reverse correlation with glycemic index (FBS, 2hpp) and creatinine in control group (P<0.05) were evaluated in all groups but there was no significant correlation between Renal function test (Cr, eGFR) and serum Mg level.

Serum Magnesium levels in diabetics and pre-diabetics were lower than healthy individuals and had reverse correlation with HbA1c in diabetic patients.

Thyroid cancer is a common cancer of the endocrine system, and knowing the etiology can be effective in its treating. On the other hand, the FNA technique is not accurate enough, so finding a biomarker for thyroid cancer is of importance. This study was done to evaluate the NKX2-1 gene as indicator of differentiation of papillary thyroid carcinoma (PTC).

In this case-control study, 17 fresh PTC tissue samples and 20 adjacent-healthy tissues were collected during thyroidectomy in Isfahan, Iran. RNA extraction was followed by cDNA synthesis. The expression of the NKX2-1 gene was performed using specific primers (exon-junction and intron spanning) using the RT-qPCR method.

An examination of the quality and quantity of extracted RNAs showed that they were intact and suitable for making cDNA. Examination of the melting curve showed a specific amplification of the NKX2-1 gene. The difference in expression of the NKX2-1 gene between PTC and healthy-adjacent tissues was 0.947.

No difference in the expression of the NKX2-1 gene between the healthy tissue adjacent to the tumor and the tissue of the PTC tumor indicates that the PTC tumors were differentiated.

Since the onset of the COVID-19 (Corona Virus Disease 2019) pandemic, several challenges have been proposed to the disease and the causing viral agent. Accurate and rapid diagnosis of the virus is essential to control the spread and progression of the disease. Choosing a suitable sample in different phases of the disease will reduce the false-negative results. This study was performed to identify the SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) genome in the blood samples of COVID-19 patients.

This descriptive-analytical study was performed by census method on 100 whole blood samples of patients (50 recovery and 50 deceased) with a definitive diagnosis of COVID-19 (positive Real-Time RT-PCR test of nasopharyngeal swab samples) admitted to Shahid Sayyad Shirazi educational and medical center in Gorgan during 2020-21. Clinical and laboratory findings were compared in the two groups of patients. The viral nucleic acid was extracted from the whole blood samples of the patients, and the presence of the virus genome was investigated using primer and probes via the Real-Time RT-PCR method.

The age of the recovered patients (49.06±15.1 years) was significantly was lower than deceased patients (58.3±12.4 years) (P<0.05). Clinical symptoms including cough, shortness of breath, sputum secretion, and vomiting in deceased patients were significantly more than recovery group (P<0.05). The lymphocytes count and platelet level in the deceased group were lower than in the recovered group. Level of lactate dehydrogenase (LDH) was higher in the deceased group in compare to recovered group (P<0.05). The virus genome identified in the blood samples of 7 patients (3 recovered and 4 deceased), which had no significant relationship with the outcome of the disease.

The use of blood samples for the diagnosis of COVID-19 is not appropriate.

Coronary artery disease (CAD) is one of the major cardiovascular diseases that affect the global population. This study was performed to evaluate the electrocardiogram (ECG) changes of patients before and after coronary artery bypass graft (CABG) surgery.

This descriptive-analytical study was performed on 100 patients (71 males and 29 females) in the age range of 37 to 78 years (mean age of 57.87±8.14 years) by census method undergoing CABG surgery in Amir Al-Momenin Kordkoy Hospital, north of Iran during the second half of 2020. Data including age, sex, and results of ECG changes, including changes in heart rate and pulse rate (PR) the day before surgery, the day of hospitalization, 4 hours after surgery, 18 hours after surgery, one day, and two days after surgery was recorded in a questionnaire.

The highest mean heart rate and PR were observed at 4 hours after surgery and then heart rate and PR were reduced and on the second day, heart rate and PR were lower than  the day of hospitalization (P<0.05).

Considering the significant changes in ECG after surgery, careful examination and monitoring of patients, especially high-risk individuals led to early detection of significant changes in patients and reduced subsequently complications in patients with appropriate and timely treatment.

Periodontal disease has high prevalence in diabetic patients and the knowledge of them about the relationship between diabetes and periodontal disease is effective in the control of the blood glucose and progression of periodontitis. This study was done to evaluate the knowledge, attitude and practice of diabetic patients about periodontal disease in Gorgan north of Iran.

This descriptive-analytical study was done on 300 type 1 and 2 diabetic patients (136 males & 164 females) whom referred to governmental health centers in Gorgan, northern Iran during 2019. Demographic information, knowledge, attitude and practice were recorded using a questionnaire.

The level of good knowledge, attitude and practice were evaluated 51.7%, 44.3% and 25%, respectively. There was significant association between oral hygiene practice and gender and education (P<0.05). Good practice was observered more in females and in patients.

More than half of diabetic patients had moderate to good knowledge and attitude about periodontal disease but their practice was moderate to poor.

Pseudomonas aeruginosa is an opportunistic pathogen that is a major cause of mortality in immunocompromised patients. One of the most important mechanisms of resistance of this bacterium is biofilm formation. The aim of this study was done to determine the Effect of Morin on Expression of Biofilm Gene of Pseudomonas aeruginosa Isolated from burn wounds by Real time PCR.

In this descriptive-analytic study 60 sample were collected from burn wounds of patients admitted to the hospitals in Tehran, Iran. Samples were identified by using biochemical methods. The DNA of the isolates was extracted and then antimicrobial activity of morin analyzed by microbroth dilution assay. The presence of biofilm production genes was investigated by PCR. Finally, the expression of lasI gene in combination with Sub-MIC concentration of morin in biofilm-producing bacteria was evaluated using Real time PCR.

From 60 samples that analyzed by Multiplex-PCR, 12 (20%) Pseudomonas aeruginosa strains were isolated in which 12 isolates (100%) were carried lasI and lasR, genes, respectively. 3 isolates (25%) were carried rhlI gene. Sub-MIC concentration of morin in biofilm-producing bacteria reduced lasI gene expression in Pseudomonas aeruginosa.

Morin has significant efficacy on Pseudomonas aeruginosa and could be a good alternative for treatment of antibiotic resistant isolates.

brucellosis is one of the most common zoonosis diseases. Brucellosis is a systemic disease and affected several organs and tissue in human. This study was performed to determine the knowledge, attitude and practice about brucellosis control among livestock farmers.

This descriptive-analytic study, was performed on 300 rural literate livestock farmers in BuinZahra, Qazvin Iran during 2019. The knowledge, attitude, and practice, the related factors and demographic characteristics such as age, education level and family count were evaluated by structured six-part questionnaire including 30 questions.

The mean age of the subjects was 41.3±16.4 years. Although 90.7% had heard of brucellosis, only 14% had previous trained. There was a positive attitude about the use of methods to reduce the risk of infection in the family and the seriousness of the issue of animal brucellosis in 19% and 64% of cases, respectively. About 94.7% were attended to veterinarian in suspected cases and 96.7% examined the new animals. 97% were uses of new cheese and milk but the milk was boiled by 89.3%. The mean knowledge was 5.3 ranging from 0 to 8 points in them. There was a statistically significant difference in the knowledge score of individuals according to the information source (P<0.05). Knowledge score and number of household members had positive correlation (r=0.135, P=0.019).

There is medium-level knowledge about brucellosis in livestock farmers. The attitude and some actions (such as dealing with infected livestock) needed to be improved. The probable reason is the high cost of behavior modification in some areas, which has provided the gap between knowledge, attitude and behavior in this area.

The presence of many synthetic dyes in aqueous solutions can cause carcinogenesis and mutagenicity and affect human health. Reactive Red 198 is one of the types of azo dyes with complex structure, toxic, carcinogenicity, mutagenicity properties, and tolerable in the environment, which is discharged to the environment through the sewage of textile industries. This study was performed to determine the mineralization of 198 reactive red dyes by the hybrid advanced oxidation process UV/US/H2O2/O3 from colored wastewater using central composite design.

In this descriptive-analytical study several factors affecting on dye mineralization process including the presence of ozone gas and ultraviolet rays (UV) as well as the initial dye concentration, Ultrasound (US), contact time, pH, and hydrogen peroxide were investigated. Experimental design and optimization were performed by design of experiment software using central composite design and its optimal conditions were determined.

The maximum dye degradation efficiency of 100% was performed under optimal conditions including initial dye concentration of 200 mg/L, reaction time of 34 minutes, hydrogen peroxide concentration of 27 mg/L and pH=9 in the presence of ozone gas flow, ultraviolet rays and ultrasonic waves. Also, the influence of factors on dye removal including ozone, UV, initial dye concentration, US, contact time, pH, and peroxide were  58.8%, 19.3%, 2.3%, 1.5%, 1.1%, 0.6 %and 0.2 % ,respectively.

UV/US/H2O2/O3 hybrid process with advantages such as performance and high speed can be recommended for wastewater treatment in various industries.

Binding of antibiotics to nanoparticles increases the antibacterial potential of nanoparticles and antibiotics. This study was performed to determine the antibacterial and hemolytic effect of zinc / ferrite / cellulose nanocomposite (ZnFe2O4 @ Cell) (single nanoparticle), zinc / ferrite / cellulose nanocomposite was aminated with 3-aminopropyltriethoxysilane (APTES) with the name of ZnFe2O4@Cell@APTES (Coated nanocomposite) and ZnFe2O4@Cell@APTES@Van nanocomposite (coated nanocomposite bound to vancomycin) against gram-negative bacteria Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa) and gram-positive bacterium Staphylococcus aureus (S. aureus).

In this descriptive study, antibacterial-activity was evaluated by broth macro dilution method. Minimum inhibitory concentration (MIC) and minimum lethal concentration (MBC) were determined for E. coli, S. aurous and P. aeruginosa. The hemolytic activity of nanoparticles was investigated by colorimetric method.

Nanoparticles did not have hemolytic activity. ZnFe2O4@Cell and ZnFe2O4@Cell@APTES@Van did not have a significant antibacterial effect against gram-positive and gram-negative bacteria, and vancomycin binding resulted in antibacterial-activity. ZnFe2O4@Cell@APTES@Van inhibited the growth of Gram-negative bacteria Escherichia coli and Pseudomonas aeruginosa. The growth of E. coli was reduced to 85% at a concentration of 0.4 mg/ml and a concentration of 0.1 mg nanoparticles completely prevented the growth of P. aeruginosa. The growth of gram-positive S. aureus bacteria at a concentration of 0.3 mg/ml nanoparticles was completely stopped.

Vancomycin-modified nanocomposite has antibacterial-activity against both gram-positive and gram-negative bacteria and has the potential to overcome the antibiotic resistance of bacteria.

Familial hypercholesterolemia (FH) is one of the most common inherited familial diseases that cause lipid accumulation in tendons and arteries by increasing the level of low density plasma lipoprotein (LDL). The main cause of FH is a mutation in the low-density lipoprotein receptor (LDLR) gene. This study was performed to evaluate common mutations in LDLR gene in FH patients.

This descriptive study was performed on 100 patients with suspected familial hypercholesterolemia referred to Sepehr laboratory according to the Simon Broom international standard in Karaj city, Iran during 2015. After complate the questionnaire form and drawing the family tree, it was found that 17 of them had a history of disease in at least one of the first degree relatives. The presence of changes was investigated using PCR-SSCP method, and after identifying the suspected cases direct DNA sequencing was performed.

Among of 17 patients with a history of FH disease, 13 patients had a heterozygote mutation in the LDLR gene. Mutations included: c.97C>T, c.445G>T, c.651-653 (DEL3), c.652-654 (DEL3), c.682G>T, c.925-931 (DEL7), c.936-940 (DEL5), c.986G>T, c.2054C>T, c.2177C>T and c.313+1G>A. Four patients did not have mutations in their LDLR gene. In two patients the common polymorphism c.1959T>C was identified.

The LDLR gene was involved in the development of FH in the study population. However, another gene or locus may be involved in the outbreak of this disease in the studied population.

Poisoning is one of the most common causes of emergency room visits. Opioids and methadone are the causes of unintentional poisoning, especially in children, who have a high burden of emergency referrals in children's hospitals. This study was performed to evaluate methadone poisoning in the pediatric emergency department in Gorgan, North of Iran.

This cross-sectional study was performed on the records of patients admitted (85 boys and 70 girls) cases due to methadone poisoning in Taleghani Hospital in Gorgan, North of Iran during 2001-19 .The symptoms of patients and the costs of treatment and care of patients were analyzed.

A total of 258 cases of poisoning were registered, of which 155 (60%) were methadone poisoning. Poisoning occurred for 136 cases (87.8%) with methadone syrup and for 19 cases (12.2%) with methadone tablets. The mean of age and age range was 47.94±36.25 months and 4-156 months, respectively. The mean and standard deviation of the time interval from consumption to the time of admission was 164.84±160.11 minutes and the maximum and minimum time interval were 720 and 15 minutes, respectively. 34 cases (22%) were conscious, 110 cases (71.5%) had impaired level of consciousness, seven cases (4.5%) presented with cardio respiratory arrest and three patients (1.9%) presented with seizures and one child (0.1%) was dead. Moises, bradypnea and apnea were seen in 78 (51.3%), 62 (40%) and 7 (4.5%) children, respectively. Six children had a history of hospitalization due to methadone poisoning, of which 2 were the day before, 3 were the month before, and 1 was 2 years ago. Two children were addicted. The mean±SD of the number of hospitalization days were 2.39±1.57 and the minimum and the maximum were 1 and 9 days. The mean±SD of hospitalization cost was 7642249±5341725 Rials. The average consumption of naloxone was 6.83± 10.41mg and the minimum and the maximum were one and 68 milligrams.

The results of this study showed that meiosis is not observed in half of children with methadone poisoning. Therefore, it is recommended that in the case of children with impaired level of consciousness or seizures without a specific reason; methadone poisoning should be concerned as a differential diagnosis by medical staff and this diagnosis should not be ignored only in the absence of meiosis or respiratory dysfunction.