مجله علمی پزشکی جندی شاپور
سال بیست و یکم شماره 3 (پیاپی 138، امرداد و شهریور 1401)

Chronic low back pain is one of the most common and costly musculoskeletaldisorders in societies and is an important clinical and socio-economic epidemic, mostly in industry andnon-industry. The aim of this study was to a systematic review of the effectiveness of exercise protocolson lumbar proprioception in patients with chronic nonspecific low back pain.

From internal and external search engines, including Scopus, Semantic Scholar,Google Scholar, Pubmed, ISC, SID, Magiran, Irandoc, and Doaj with time limit 2010 to 2021 and the keywordsexercises, proprioception, non-specific, and chronic low back pain, the present study was doneusing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes).

Results :

Nine articles were selected based on inclusion criteria. These studies mainly focused on systematicreview effectiveness of exercise protocols on sensation and low back pain in people with non-specificchronic low back pain.

According to the research reviewed in the present study, it seems that exercise rehabilitationprotocols activate, strengthen, maintain, and increase the central region of the body, especially deepmuscles, particularly the multifidus and transverse abdomen, by retraining the pelvic lumbar region. Thediaphragm and diagonal of the abdomen and pelvic floor, which play a role in the important segmentalstability of the lumbar spine, improve the sense of depth and pain in patients with chronic nonspecificlow back pain.

Coxiella burnetii (causative agent of Q fever) is an important zoonotic diseasewith a universal occurrence. Ticks are natural and potential reservoirs of this bacterium and play aneffective role in the transmission of Q fever. This study aimed to investigate the prevalence of Coxiellaburnetii in hard ticks isolated from livestock in Sistan.

This cross-sectional study was conducted in five counties of the Sistan region. Thegenus and species of hard ticks were identified after collection from some domestic animals. The nested-PCR technique was used to identify the bacterial genome.

Results:

 Of all examined ticks, two genera, including 354 Hyalomma (59.399%) and 242 Rhipicephalus(40.6%) were identified. The hard ticks are in three types of species as follows: Rhipicephalus sanguineus(40.1%), Rhipicephalus nymph (0.5%), Hyalomma anatolicum (47.5%), Hyalomma sp. (1.5%), Hyalommanymph (10.4%), and Rhipicephalus (Boophilus) annulatus (0.16%). No infected specimen with Coxiellaburnetii was observed in the Sistan region.

According to the results of previous studies in Sistan and Baluchestan province and neighboringprovinces that reported a high prevalence of Coxiella burnetii in collected ticks, it seems that moreextensive research, with a larger sample size and host range, is necessary to clarify the situation of thispathogen.

Chronic inflammation is associated with the development of various diseases,including atherosclerosis and diabetes. The aim of this study was to investigate the effect of longtermselected aerobic exercises on changes in cystatin C and homocysteine in inactive and overweightmiddle-aged women.

Thirty non-athlete middle-aged women (mean age: 46.06±6.97 years, weight:71.82±9.11 kg, height: 156.9±5.24 cm, and body mass index: 29.2±4.11kg/m2) voluntarily participatedin this project and were randomly divided into the experimental and control groups The experimentalgroup performed selected aerobic exercises (65-75% of maximum heart rate) for eight weeks. Bloodsamples were taken before and 24 hours after the completion of the research protocol to measure thelevels of cystatin C and homocysteine. Analysis of covariance was used for intergroup comparisons andpaired t-test was used for intergroup comparisons.

The results showed that there was no significant difference between the experimental and controlgroups in cystatin C (P=0.09) and homocysteine (P=0.07) after eight weeks of selected aerobic exercises.A significant decrease was observed in weight (P=0.001) and body mass index (P=0.002) in theexperimental group compared to the control group.

Overall, the results of the present study showed that although the eight-week activity programimproved the body composition of overweight middle-aged women, longer periods of aerobicexercise are required to examine clearer biochemical results.

Early diagnosis and appropriate treatment of candidiasis in the infant’s mouthand nipple of breastfeeding mothers can have positive effects on the infant’s nutrition from the mother’smilk. Therefore, the aim of this study was to investigate the prevalence of Candida albicans fungal coloniesin the infant’s oral cavities and nipples of breastfeeding mothers.

This cross-sectional study was performed on 98 breastfeeding mothers and theirhealthy infants. Samples were taken from the posterior area of the infant’s tongue and the nipple of thebreastfeeding mothers. Samples were transferred to a dextrose agar medium containing 0.05% chloramphenicolin the laboratory and were kept at 30 ° C for 48 hours and then the number of Candidacolonies was counted and recorded. The data were analyzed by SPSS 17 statistical software and t-testand Pearson correlation coefficient.

The mean number of cultured colonies from infants’ mouths and nipples of breastfeeding motherswas 64.44±42.99 and 102.62±63.56, respectively. In neonates born by cesarean section and nippleof their mothers, there were significantly more Candida colonies (P<0.05). There was a positive and significantcorrelation between the number of cultured colonies from the nipple of breastfeeding mothersand the infant’s mouth (P=0.000, r=0.796)

Candida culture was positive in more than half of the samples both in the mouth of the infantand in their mothers’ nipples.

Regular aerobic exercise improves learning, memory, and cognitive and SynapticPlasticity in Alzheimer’s disease (AD) patients. The aim of this study was to evaluate the levels ofcalcineurin and Ca2+/calmodulin-dependent protein kinase II mRNA after four weeks of aerobic trainingexercises and before AD induction in the hippocampus of male Wistar rats.

Thirty 8-week-old rats with an average weight of 195±20 g were initially randomlydivided into two groups of aerobic exercise or rest for four weeks. Then, each group was divided intothree groups of AD, sham, and injection. Then, 48 hours after the last training session, Aβ1-42, or DMSOwas injected into the hippocampus. Finally, after the isolation of the hippocampus, CaN mRNA and CaMKIImRNA levels were measured.

The results of this study showed that there was a significant difference between the groups inmRNA CaN and CaMKII mRNA levels (P<0.05). The results showed that aerobic exercise and AD pre-inductionhad a significant effect on increasing calcineurin and Ca2+/calmodulin-dependent protein kinaseII levels.

Overall, the findings of the present study showed that four weeks of aerobic training improvesthe molecular signaling of neuroplasticity in AD rats.

Idiopathic granulomatous mastitis (IGM) is a chronic inflammatory lesion thatmimics the clinical symptoms of carcinoma. Another type of chronic granulomatous mastitis is immunologicalmastitis, which is related to the infiltration of IgG4 plasma cells. This study aims to determine thestatus of IgG4 positive plasma cells in IGM samples.

This is an analytical-cross-sectional study. 46 women diagnosed with IGM wereselected for the study using census method. The percentage of IgG and IgG4 in plasma cells was determinedbased on immunohistochemical method. Age and type of surgery were also recorded. The datawas entered into SPSS software, version 22 and analyzed using statistical tests. P<0.05 were consideredstatistically significant.

The mean age of patients was 35.02±6.82 years. The mean percentage of IgG positive plasmacells among tissue inflammatory cells was 6923±23.42 and the mean percentage of IgG4 positive plasmacells was 23.39±22.33. Among infiltrated plasma cells, 1.89% were positive for IgG4 and the ratio of IgG4to IgG in plasma cells was 0.91. Based on the results of Pearson correlation test, a positive and significantcorrelation was found between the percentage of IgG4 and IgG in plasma cells (r=0.600, P=0.004).

A significant percentage of infiltrated plasma cells are IgG4 positive, which can play a role inthe development of IGM. Therefore, further investigation and comparison with immunological mastitisis recommended.

Premature delivery is called delivery before 37 weeks. It is estimated thatevery year, about 15 million babies are born with preterm delivery worldwide, which is approximatelyequal to 11% of the total number of deliveries. In this study, a number of pregnant women with 11-14weeks of pregnancy were evaluated in order to evaluate the value of cervical length at the end of the firsttrimester of pregnancy in predicting preterm delivery.

In this cohort study, 156 asymptomatic pregnant women with a gestational ageof 11-14 weeks were randomly selected and evaluated. Cervical length was measured by transvaginalultrasound using a standard method. Cervical length and gestational age at delivery were recorded in acomputer database along with demographic information, clinical history, and pregnancy information.

The mean length of the cervix in women with preterm delivery was 31.32±6.71 mm and inwomen with term delivery was 38.96±5.80 mm. Data analysis showed that shorter cervical length wassignificantly associated with preterm delivery. With a threshold of 34.5 mm, the length of the cervix from3rd month to 6th month could predict preterm delivery with a sensitivity of 76% and a specificity of 81%.

Measuring cervical length with transvaginal ultrasound in the second trimester can predictpreterm delivery.

Health workers are at the forefront in the diagnosis, treatment, and care ofpatients with COVID-19, which can increase the psychological burden, stress, and anxiety of staff. Thepurpose of this study was to determine job stress and related factors of the operating room staff duringthe COVID-19 pandemic.

This descriptive study was performed on the operating room staff of hospitals inGuilan province in 2021. The variables evaluated in this study included the relationship between age,gender, marital status, level of education, the field of study, employment status, and anxiety. In order tocollect data in this study, the standard SPIO job stress questionnaire was used and the data were analyzedusing an independent t-test.

In this study, 120 people in the age range of 47-23 with a mean age of 31.47±8.79 years participated.Men had less stress than women and married people showed more stress. In terms of job status,officially employed people had the least stress and people who served in the military had the moststress. In terms of field of study, anesthesiologists showed the highest stress level, and the operatingroom had the lowest score. In terms of education level, those with a master’s degree had the highestscore, and those with an associate degree showed the lowest score.

The results of this study showed that with age, job stress also increases and in terms of gender,women had more stress. In terms of marriage, married people showed more stress, which could bedue to having a family and the stress of the family being infected with the virus. In terms of job status,officially employed people showed less stress, in terms of field of study, people with a degree in anesthesiahad more stress, and in terms of education, people with a higher degree showed more stress.

Continuous exercise with moderate intensity and the use of nanocurcuminsupplementation has the potential to control and reduce tumors of the central nervous system, includingglioblastoma. We assessed the simultaneous effect of moderate-intensity continuous exercises andnanocurcumin supplementation on STAT3 gene expression in mice with glioblastoma multiforme braintumors.

Subjects and Methods:

 Thirty-five male Wistar rats were randomly divided into seven groups of fiverats: basal control (BC), 4-week control (4wC), basal cancer control (BT), 4-week cancer control (4 wT),cancer+training (TE), cancer+nanocurcumin (TN), cancer+ exercise + nanocurcumin (TEN). After injectionof cancer cells in the forehead, the animals were treated with nanocurcumin by gavage at the dose of 80mg/kg for 28 days, five days a week, and started moderate-intensity continuous training on the treadmillfor four weeks, three days/weeks, 25 to 40 minutes per week at a speed of 18 m/min. Finally, and thenrats were sacrificed and data were collected.

Moderate-intensity continuous training with nanocurcumin supplementation significantly reducedtumor volume and STAT3 gene expression in the TEN group (P<0.05). But this decrease was notsignificant in the TE and TN groups.

Conclusion:

 It seems that with decreased STAT3 gene expression and brain tumor size, the combinationof moderate-intensity continuous training and nanocurcumin supplementation has a therapeutic role inthe treatment process of glioblastoma multiforme brain tumors.

Iron overload is seen in various tissues, including the pancreas, liver, andmuscles in type 2 diabetes. The aim of the present study was to investigate the effect of high-intensityBodyPump training on indicators related to iron stores and blood glycemic control in women with type2 diabetes.

In the present quasi-experimental study, 20 women with type 2 diabetes wererandomly selected and divided into two groups: BodyPump and control. BodyPump training was donefor eight weeks, three sessions per week and each training session included 90-60 minutes of moderateintensityBodyPump training (75-80% of the reserve heart rate). Fasting blood sampling was performedbefore and after the intervention period. For statistical analysis, the paired sample t-test and independentt-test were used at a significance level of P≤0.05.

The results of the present study showed that BodyPump significantly reduced glycosylated hemoglobin(P<0.001), insulin resistance (P<0.001), serum iron (P=0.041), and ferritin (P=0.019) comparedto the control group.

BodyPump training may reduce excess iron in pancreatic, liver, and muscle tissues by modulatingiron and ferritin stores, resulting in reduced insulin resistance, which causes glycemic control inwomen with type 2 diabetes.

Heavy physical activity increases oxidative and metabolic stress, and factors affecting body recovery and its speed to a normal state are of particular importance [3]. Improper recovery after one training session can lead to an unfavorable performance in the next session. Long-term and repeated inappropriate recoveries can also eventually lead to overtraining by causing fatigue [4]. Active recovery increases blood flow and thus accelerates the athlete’s recovery [6]. Also, the use of massage as a therapeutic and relaxing method is widespread in sports races for preparation before the race, between two races, and return to the original state after the race [9]. One of the main benefits of sports massage is its positive effect on sports performance, which leads to reducing the time of returning to the original state after physical activity, reducing muscle tension, restoring energy reserves through increasing blood flow, and as a result, improving performance in the next race [8, 9, 10]. Therefore, the recovery method can affect the success of athletes by reducing cell or muscle damage indicators [8, 9, 10]. Because intense and long-term training can disrupt an athlete’s performance by increasing oxidative stress and its effects on hematology indicators and antioxidant defense [19, 20], using different methods of recovery after an acute training session can be useful. Accordingly, the aim of this research was to compare the effects of active recovery methods and massage on recovery speed in female runners.

In this quasi-experimental research, 30 semi-endurance semi-professional female runner volunteers were selected by the simple random method as the research sample, and in a crossover design, they were divided into three groups of ten cases: 1) running active recovery, 2) sports massage, and 3) passive recovery groups. In order to homogenize the training plan of all runners, a training protocol with the following details of two weeks, three training sessions per week, and each training session about 2 hours of athletic training was created, and after each session, a cooling exercise was performed for 10-15 minutes, including light aerobic exercises and stretching exercises. After a week of rest, pre-test measurements and blood sampling were performed on an empty stomach. Two hours after the test, subjects had breakfast (including 70% carbohydrates, 15% protein, and 15% fat), and a 1500-meter running race was performed. After receiving recovery results based on grouping, blood sampling was done again. Active recovery consisted of 15 minutes of light running and then 5 minutes of static stretching movements. In the sports massage group, the sports massage therapist performed massage on the lower limbs. In the passive recovery group, runners sat for 30 minutes after doing the activity. Immediately after completion of the 1500-meter running race and subsequently various recovery methods, blood sampling was done. The one-way analysis of variance (ANOVA) was used for statistical analysis. Statistical analysis was carried out using SPSS software, version 22 and the significance level was considered at P<0.05.

Results :

In this study, the age range of female runners was 18-24 years old (mean: 21.34±2.32 years). The height range was 161 to 175 cm (mean: 169.126±4.112 cm), and the weight range of runners was 54-68 kg (mean: 62.113±4.217 kg). After a 1500-meters run, there was no significant difference in subjects regarding hematocrit (P=0.25, F=1.44), iron (P=0.23, F=1.52), red blood cells (P=0.41, F=0.92), hemoglobin (P=0.39, F=0.97), aspartate aminotransferase (P=0.80, F=0.21), total antioxidant capacity (P=0.43, F=0.87) and malondialdehyde levels (P=0.036), F=0.21). But there was a significant difference in the number of white blood cells (P=0.03, F=3.75). Also, a significant difference was observed between the effects of three recovery methods on changes in hematocrit (P=0.02, F=4.10), white blood cells (P=0.04, F=3.70), and hemoglobin (P=0.02, F=4.52) of semi-professional female runners. The results of the LSD post hoc test revealed that there was a significant difference in hematocrit (P=0.009), white blood cells (P=0.01), and hemoglobin (P=0.01) between the three groups. However, no significant difference was observed between the three recovery methods in changes in iron, red blood cells, and aspartate aminotransferase (P>0.05). Also, regarding the effects of recovery methods on total antioxidant capacity and malondialdehyde levels, there was no significant difference in total antioxidant capacity between the three recovery methods (P=0.12, F=1.83). However, a significant difference was observed in malondialdehyde levels (P=0.036, F=1.14). In further investigations, the results of the LSD post hoc test showed that a reduction in malondialdehyde levels in the active recovery group was higher than in the massage and passive groups (P=0.031 and P=0.038, respectively)

In general, a 1500-meter half-endurance running race increases oxidative stress and affects some hematological factors in female runners. Many body organs and systems, including the liver, cardio-respiratory system, muscle system - active muscles - nervous system, hormonal system, muscle glycogen, and triglyceride, and energy systems are under pressure during a race or a training session [28, 29, 30]. Fatiguing running exercises generate excessive free radicals and reactive oxygen and nitrogen species, which leads to damage caused by muscle oxidative stress and impaired contractility, and can affect an athlete’s sports performance or health. Also after different recovery methods, a significant decrease in malondialdehyde levels was observed compared to the massage and passive groups. It can be said that in the active recovery group, considering that light aerobic activities bring more blood flow to the muscles, as a result, it can improve mitochondrial respiration and improve recovery and reduce oxidative stress in muscles after exercises. However, in the passive and massage groups, the blood flow does not reach the muscles properly. Using active recovery can increase the supply of oxygen and nutrients with improved blood flow to the muscles, and improve the removal of metabolites caused by an aerobic activity, thus reducing oxidative stress, which can prevent muscle injuries in runners.

The enzymatic defense system includes the enzymes glutathione peroxidase, catalase, and superoxide dismutase, which are responsible for intracellular protection [1]. One of the most important products of lipid peroxidation is malondialdehyde, which has been of great interest and is considered the main indicator of oxidative stress [4, 5]. Aerobic and endurance exercises can improve tissue resistance against harmful stimuli that improve intracellular oxidative stress and apoptosis [7, 8]. Following intense physical activities, with an increase in reactive oxygen species and lipid peroxidation, including malondialdehyde, and an imbalance between oxidative stress and antioxidant defense, a decrease in total antioxidant capacity occurs [11]. Caffeine increases heart protection by negatively regulating inflammatory and apoptotic pathways in rats [13]. Songstad et al. showed that performing six weeks of intense interval training caused no significant difference in the amount of total antioxidant capacity and malondialdehyde in the liver and heart tissue of pregnant rats [12]. According to the conflicting results of the research regarding the effect of intense intermittent exercise on cardiac oxidative stress indicators and/or the use of caffeine supplements on oxidative stress indicators, it is necessary to conduct a study in order to find an effective non-pharmacological solution to reduce these indicators on the heart of rats. Therefore, the present research was done to investigate the effect of eight weeks of intense intermittent exercise and caffeine supplementation on the levels of malondialdehyde and the activity of superoxide dismutase and catalase enzymes in the heart tissue of male rats.

Methods :

In this experimental study, 40 male Wistar rats with an average age of 8 weeks and an average weight of 200-220 grams were purchased from the Center for Research and Breeding of Laboratory Animals at Pasteur Institute, Tehran. After two weeks of familiarization with the environment and how to perform the activity, the rats after weight matching were randomly divided into four groups (n=8) including 1- healthy control (C), 2- exercise, 3- caffeine supplement, and 4- caffeine supplement. The training program included running on a treadmill in two-minute intervals for eight weeks and every week for five days. The warm-up and cool-down phase at the beginning and end of the main phase of the exercise was performed with an intensity of 40-50% of the maximum speed (16-20 m/min) for 5 minutes on the treadmill. Animals performed high-intensity interval training (5 to 12 2-minute bursts with an intensity of 90-85% of the maximum running speed and a minute of rest between bursts and 10 meters per minute equivalent to 30-40% intensity of the maximum oxygen consumption) at 19-20 pm, on a treadmill [9]. The control groups did not participate in any activity program. Then, 48 hours after the last training session. a part of the left ventricular tissue of the heart was carefully removed and frozen in nitrogen at -80°C. Pure anhydrous caffeine powder (dry) prepared from Merck, German was administrated according to the body weight of the animals (70 mg per kilogram of body weight) by intraperitoneal injection from 15:00 to 17:00 for eight weeks and five days per week [14]. Each 100 mg of tissue was homogenized in 1 ml of saline phosphate buffer containing antiprotease cocktail by a homogenizer, and then the tissue was homogenized in Rcf 10,000 for 15 minutes at 4 °C and the supernatant was collected and used to measure the biochemical indices of the research. 

Statistical Analysis:

The Kolmogorov-Smirnov test was used to check the normal distribution of the data. To investigate the difference between groups, a one-way analysis of variance and Tukey's post hoc test were performed at a significance level of less than 0.05 using SPSS software.

The results of the one-way analysis of variance showed a significant difference in the levels of malondialdehyde (P<0.001 and F=508.808) and the activity of superoxide dismutase (P<0.001 and F=115.266) and catalase (P<0.05) between groups. The results of Tukey's test showed that the level of malondialdehyde in the caffeine group (P=0.081) did not change significantly compared to the control group, but it decreased significantly in the training group (P=0.01). Following high-intensity interval training and caffeine consumption, the level of malondialdehyde decreased significantly (P=0.0078) compared to the control group, although the decrease in malondialdehyde levels in the caffeine+training group was not significant compared to the caffeine and training groups (P=0.07). The levels of superoxide dismutase in the caffeine (P=0.02), training (P=0.012), and training+caffeine (P=0.0083) groups had a significant increase compared to the control group and the simultaneous effect of exercise and caffeine was not significant compared to the caffeine and training groups (P=0.14). Also, catalase levels increased significantly in the research groups compared to the control group (P=0.019 in the caffeine group, P=0.001 in the training group, and P=0.0094 in the training+caffeine group).

Discussion :

In this study, there was a significant decrease in the levels of the oxidative index, malondialdehyde, and a significant increase in the activity of the antioxidant enzymes superoxide dismutase and catalase in the heart tissue of the caffeine+training group in comparison with the healthy control group. In the present study, an increase in the levels of superoxide dismutase was observed following caffeine consumption, which was associated with a decrease in the levels of malondialdehyde. This result is inconsistent with the findings of Ashrafi et al. [16] and Saker et al. [15], possibly due to the amount of caffeine consumed. In line with the results of this research, Bafghi et al. showed that eight weeks of interval training in 3-minute intervals with an intensity of 80% oxygen consumption and for 20 minutes in each session, along with curcumin supplementation, significantly increased the activity levels of superoxide dismutase and catalase enzymes [22].