مجله مطالعات علوم پزشکی
سال سی و سوم شماره 2 (اردیبهشت 1401)

Urinary tract infection (UTI) is one of the common infections in children which is rapidly acquiring more and more resistance to antimicrobial drugs in the worldwide. The aim of this study was to evaluate the frequency of SHV, TEM and CTX-M genes in Escherichia Coli and Klebsiella Pneumoniae strains isolated from UTI in children in 17 Shahrivar hospital from Rasht city, Iran.

In this descriptive cross-sectional study, 49 strains of Escherichia Coli and Klebsiella Pneumoniae were isolated from 17 Shahrivar hospital from Rasht city and identified by biochemical tests. The resistance and susceptibility of the strains to antibiotics was determined by both Kirby Bauer and Broth dilution methods. To evaluate frequency of SHV, TEM, and CTX-M genes in the isolates, the PCR method was used. To statistical analysis, χ2 test was used with SPSS software version 19.

In this study, the most resistance was observed to Ceftriaxone (88.9%) and ampicillin (81.5%) in Escherichia Coli and to ampicillin (95.5%) and Ceftriaxone (77.3%) in Klebsiella Pneumoniae. Of 49 isolates, 89.8% had SHV gene, 89.8% had CTX-M gene, and 100% had TEM gene.

We concluded that one of the reasons of increasing multi drug resistance in nosocomial isolates of UTI in Rasht may be an increase in horizontal transfer of plasmid genes between these isolates.

Acute phase reactants are unable to differentiate between bacterial and non-bacterial causes of inflammation and can only indicate inflammation. Recently, measurement of procalcitonin (PCT) levels has been used to minimize this problem. The aim of this study was to evaluate the diagnostic and prognostic importance of procalcitonin in the patients with acute exacerbation of chronic obstructive pulmonary disease.

In this descriptive cross-sectional study, 50 patients with acute exacerbation of chronic obstructive pulmonary disease diagnosed with spirometry were included in the study. At the beginning of the referral, measurement of blood levels of PCT along with sputum culture were fulfilled in these patients. Then the course of their disease, duration of the hospitalization, and the outcome of the disease were entered in a checklist made by the researcher. The patients were divided into bacterial and non-bacterial groups based on their results of sputum culture. All the information obtained from the patients was collected and entered into SPSS software version 16.

14 patients (28%) with mean serum procalcitonin level of 0.03 ± 0.17 required mechanical ventilation, whilst 36 patients with mean serum procalcitonin level of 0.01 ± 0.09 didn’t required mechanical ventilation (P = 0.01). Mean serum procalcitonin levels in the patients died in hospital were significantly higher than the discharged patients (P = 0.002).

Serum procalcitonin levels may be helpful in determination of the severity of the disease, differentiation of the bacterial exacerbations from viral ones, rational use of antibiotics, and length of hospital stay. It can also be used to manage and guide the treatment of the patients with acute exacerbation of chronic obstructive pulmonary disease.

Multiple sclerosis (MS) (MIM #126200) is a chronic, inflammatory, demyelinating disorder of the central nervous system (CNS) that is the most common reason for non-traumatic neurological defects among young people. The aim of this study was to evaluate the association between single-nucleotide polymorphisms (SNPs) in genes with vitamin D response elements (VDREs) in their regulatory regions and the risk of relapsing-remitting multiple sclerosis (RR-MS) in the Iranian Azeri population.

A total of 129RR-MS cases and 200 normal controls from West Azerbaijan were recruited in this study. We genotyped the fourteen MS susceptible variants in genes with vitamin D response elements that emerged from previous genome-wide association studies (GWAS), using Tetra-primer amplification refractory mutation system PCR (T-ARMS-PCR) assay in every participant. Chi-square, Fisher's exact test, and allelic and genotypic regression analysis were used to investigate the association of these polymorphisms with RRMS.

Three polymorphisms showed significant association (p-value < 0.05) with RR-MS. In particular, rs4410871 of PVT1 (p-value= 0.035, TT vs CC OR[95%CI]= 2.775 (1.253-6.146)), rs212405 of TAGAP (p-value=0.016, AA vs TT OR[95%CI]= 2.463 (1.255-4.835)), and rs7090512 of IL2RA (p-value= 0.008, CC vs TT  OR[95%CI]= 2.865 (1.433-5.731) ) were identified as susceptible risk factors in our group. 

The current study replicated fourteen susceptible variants in genes with vitamin D response elements and the risk of RR-MS in the Iranian Azeri population, which implies the existence of some similarities between the MS genetic structure of the GWAS populations and the studied Iranian Azeri population.

Smith-Lemli-Opitz syndrome (SLOs) is a developmental disorder with an autosomal recessive pattern of inheritance. During pregnancy, if screening tests in the second trimester of pregnancy show an increased risk of SLOs, additional complementary studies including ultrasound and genetic testing on amniotic fluid are performed. This study aimed to investigate the relationship between second trimester screening tests, ultrasound, and amniocentesis findings in SLOs occurrence.

This study was a cross-sectional descriptive study. 44 pregnant women referred to the perinatology department of Shahid Motahari Medical Education Center with positive results for SLOs were included in the study. The correlation between second trimester screening tests, ultrasound and amniocentesis findings in confirming SLOs as well as DHCR7 gene expression in terms of common IVS8-1G>C mutation were measured.

Data showed that one of 44 cases with high-risk second trimester screening test for SLOs was positive for IVS8-1G>C mutation of DHCR7 gene.

The findings showed that although positive screening tests are new screening methods for SLOs, genetic tests are also needed for definitive diagnosis.

Colorectal cancer is one of the most common cancers of the gastrointestinal tract, caused by predisposing factors like lifestyle and aging, and partly, due to genetic and inherited disorders. Due to the increasing incidence of this cancer in Iran, the present study was designed to determine the prevalence of osteoporosis and its relationship with serum levels of vitamin K2 in the patients with colon cancer before and after colectomy.

In this descriptive-analytical study, 38 patients with colon cancer who underwent colectomy in Imam Khomeini Hospital in Urmia were included in the study.Demographic information, BMD, and vitamin K2 levels of the patients before and after colectomy were collected and recorded in a checklist. Data were analyzed using SPSS Version 17 statistical software.

From 38 patients with colorectal cancer, 34.2% were male and 65.8% were female. The mean age of the patients was 58.5 ± 12.7 years. Reviewing bone density examinations done by Dual Energy X-Ray Absorptiometry (DXA) in hip and spine of the patients showed that osteoporosis was higher in both places after colectomy, and their significant differences between them (P-Values were 0.043 for hip and P0.009 for spine).

The results of this study showed that osteoporosis in the hip and spine of the patients with colon cancer increased after colectomy compared to it before colectomy. However, the correlation between serum vitamin K2 levels and osteoporosis was not significant.

Formation of free radicals in the kidney cells of diabetics leads to apoptosis of them and eventually nephropathy. The aim of this study was to investigate the effects of intervals and aerobic exercise along with astaxanthin supplementation on the expression levels of BAD, BAX and Bcl2 genes in the kidney tissue of rats with type 2 diabetes.

35 male Wistar rats with an average weight of 197.46±15.55 grams were randomly divided into two non-diabetic (5 healthy controls) and diabetic (30) groups, and after induction of diabetes, they were randomly divided again in 6 groups (with 5 rats in each group) including diabetic control, diabetes+supplement, diabetes+interval, diabetes+supplement+interval, diabetes+aerobic, diabetes+aerobic+supplement. The exercise intervention groups performed the program of aerobic and interval exercises for eight weeks as five days per week. Supplement groups received 3 mg of astaxanthin supplement per kilogram of body weight dissolved in 0.3 ml of olive oil by gavage every day. The expression levels of BAD, BAX, and Bcl2 genes were measured in the kidney tissue of rats with type 2 diabetes. One-way analysis of variance and Tukey's post hoc test were used for data analysis.

All exercise intervention protocols and astaxanthin supplementation had significant effects on the BAD index in the kidney tissue of the type 2 diabetic rats (p=0.001). All groups, except endurance training (p=0.890), had significant effects on BAX index in the kidney tissue of type 2 diabetic rats (p=0.001). Also, the use of astaxanthin supplement along with endurance training caused significant changes in Bcl2 index compared to single endurance training (p=0.001).

The intervention of aerobic and interval exercises with or without astaxanthin supplementation in the eight-week intervention period has positive effects on the apoptotic biomarkers in the kidney tissue of rats with type 2 diabetes.

Coronary artery bypass graft surgery (CABG) is evaluated by measuring coronary sinus parameters through angiography or transesophageal echocardiography. However, there is little information about the changes related to these indicators, especially about the changes in the diameter and flow of the coronary sinus through transthoracic echo evaluation. The purpose of this study was to investigate coronary sinus flow in transthoracic echo in the patients with left ventricular ejection fraction (LVEF) more than 45% before and after CABG surgery.

In this clinical trial study, 30 patients with coronary heart disease and LVEF greater than 45% who were candidates for CABG were included in the study. Before CABG surgery, patients underwent transthoracic echocardiography, and coronary sinus peak velocity, coronary sinus blood flow (CSBF), and velocity time integral index (VTI) were measured. These values ​​evaluated again after coronary artery grafts and their difference was evaluated. SPSS version 23 software was used for statistical analysis of data and t-test, chi-square test and paired t-test statistical methods were used. P value below 0.05 was considered as significance level.

There was a significant difference between CSBF before (53.93±6.18) and after surgery (58.95±6.75) (P<0.001), which indicates a significant increase in this index after CABG surgery. Also, coronary sinus VTI index (CS-VTI) before surgery was 8.11 ± 0.70 and after surgery was 8.87 ± 0.82 (P<0.001). Coronary sinus diameter index (CSd) was 6.64±0.47 before surgery and 6.65±0.47 after surgery, which change was not significant (P=0.161). Also, the increase in CSBF after surgery adjusted for baseline variables was significant (P<0.001). None of the indicators of sex, age, cardiac risk factors, and the number of coronary arteries involved had significant correlations with CSBF.

The results of this study showed that transthoracic echocardiography significantly improves the amount of CSBF following CABG in these patients, which were completely independent from background information such as demographic characteristics, cardiovascular risk factors, and even the severity of vascular involvement in the coronary artery veins. Improvement in CSBF can occur without changes in coronary sinus diameter.

 Knee instability has become a debilitating problem among patients with knee osteoarthritis which may have many causes and complications. In this study, researchers evaluated the Knee Flexion Contracture (KFC), function, quality of life, and balance and its relationship with knee instability (KI). In this study, the researchers investigated the function, quality of life, Knee Flexion Contracture (KFC), and balance of the patients with knee osteoarthritis and its relationship with knee joint instability.

 In this double-blinded case-control study, 60 females with knee osteoarthritis participated and divided into two groups (30 in each) of osteoarthritis (mean age: 52.80) and without knee instability (mean age: 54.43) based on the knee instability index scores.Pain was evaluated with a visual analog scale(VAS), KFC with a universal goniometer, performance with WOMAC, and physical performance of the patients with the time up and go (TUG) and and time of up and down stairs tests, quality of life with the SF36 questionnaire, and balance with the Single Leg Lift test. Data were analyzed by SPSS version 22 software and independent sample t-test at a significance level of 0.05.

 The mean scores of KFC showed significantly difference between the two groups with and without KI (right foot: P=0.0001, left foot: P=0.001). Also, the mean scores of pain, fall times, WOMAC, physical function, quality of life, and One-legged balance were significantly different between groups (P=0.0001 in all variables). Regarding the time of up and down stairs, there was no significant difference between the two groups (P=0.057), although the difference between them was significant in the descent time (P=0.0001).

 According to the findings of this study, it was found that there was a significant difference between the two groups of osteoarthritis with and without KI in pain, function, KFC, quality of life, and One-legged balance, which paying attention to the causes and side effects of this problem makes it more clear.