نشریه پژوهش در پزشکی
سال چهل و هفتم شماره 2 (پیاپی 186، تابستان 1402)

Osteoarthritis (OA) is a very common painful disease of the musculoskeletal system. The limitation of the effectiveness of current analgesics had been proven and better analgesics are needed. Duloxetine is one of the drugs that has been observed to have analgesic effects, but there are few studies about it. The aim of this study was to compare the effect of duloxetine and glucosamine sulfate as pain relievers in reducing knee osteoarthritis pain.

We performed a single-blind, trial of 60 mg of duloxetine and 500mg of glucoeamine in 60 subjects with osteoarthritis pain. Patients were divided into two groups and received 6 weeks of duloxetine orglucoeamine. The measured outcome was a reduction in average pain intensity after 6 months for subjects completing the trial. Symptoms were scored by the WOMAC Index. Data analysis was performed using Fisher's, t-test, and Mann-Whitney tests by a person who was unaware of the results.

28 patients in the duloxetine group and 29 patients in the glucosamine sulfate group completed the study. No statistically significant difference was found between the two groups before the intervention (P-value > 0.5). The mean age of patients in the Deloxetine group was 65.47 ± 0.3 years and in the Glucosamine group, it was 65.55 ± 0.4 years (P-value = 0.384). There was no difference in gender distribution between the two groups (P-value = 0.91). The WOMAC score was significantly decreased in the duloxetine group compared to glucosamine (p < 0.05). It was also found that the pain indices were significantly reduced in the Deloxetine group.

Duloxetine significantly reduce pain intensity on the WOMAC and could be considered as a suggested treatment for osteoarthritis pain.

Cytokine levels increase in response to air pollution. Air pollution is one of the most important factors affecting the general health of society and has become a concern in large and industrial cities. One of the        air- polluting components is sulfur dioxide (SO2). Based on epidemiological studies, SO2 aggravates various diseases such as cardio- pulmonary, cancer, progressive neurological diseases such as Alzheimer's, etc. The purpose of this study was to investigate the effects of sulfur dioxide gas on the level of pro- inflammatory cytokines IL-6 and TNF-α and hippocampal cell changes in mice.

This research was based on an experimental-laboratory study. Twenty- Four mice were randomly divided into 4 groups (control, Experimental (a) once with a high dose, Experimental (b) one week every day for 5 minutes with a low dose, Experimental (c) 3 weeks every day for 5 minutes with a low dose). In order to expose the animals to SO2 gas, a chamber was used. After the period, the mice were anesthetized and blood samples weretaken from the heart to analyze the inflammatory factors. After the perfusion, the brain was removed from the skull and entered the passage stages. Then cutting and staining the tissue slices, the neuronal density of different hippocampus regions was examined by the dissector method, and the data were analyzed by one- way ANOVA and Tukey's supplementary test.

The results showed that the amount of IL-6 in the experimental group b (P < 0.05) and c (P < 0.001) increased significantly compared to the control group. In addition, the amount of TNF-α also increased significantly in experimental group B (P < 0.05) and C (P < 0.001) compared to the control group. Also, the neuronal density of different areas of the hippocampus decreased in all groups compared to the control group, which is more significant in the experimental group (c) (P < 0.05).

It seems that the amount of IL-6, TNF-α increased in the experimental groups that were exposed to gas. Also, the neuronal density in all areas of the hippocampus of rats in the experimental groups was lower than in the control group.

Testicular torsion leads the a disorder of contralateral testicular function in addition to destructive effects on the ipsilateral testicle through the impairment of the blood- testis barrier, release of sperm into the blood, activation of immune responses, and production of anti-sperm antibody. Detorsion surgery also resulted in inflammatory reactions and the production of reactive oxygen species (ROS), which was finally accompanied by the destruction of the contralateral testicular tissue and infertility. The application of mesenchymal stem cells conditioned medium recently has been considered in the treatment of male infertility due to the presence of various growth factors and anti-inflammatory properties. The aim of this study was to evaluate the effect of conditioned medium derived from human amniotic membrane mesenchymal stem cells on the promotion of spermatogenesis and sperm chromatin structure in the contralateral testis following the torsion of the unilateral spermatic cord.

In this experimental study 40 adult male NMRI mice were randomly divided into 4 groups. Control group without surgical intervention. Left spermatic cord torsion / detorsion group. Negative control group: torsion / detorsion surgery and injection of culture medium into the left testis. Treatment group: torsion / detorsion surgery and injection of conditioned medium derived from human amniotic membrane mesenchymal stem cells into the left testis. The Histomorphometric evaluation of the right testicle was done by preparation of tissue sections and hematoxylin and eosin (H&E) staining. This evaluation included counting different cells of testicular tissue, the number of seminiferous tubules per field, measurement of outer diameter and epithelium thickness of tubules, Johnson's score, and tubules spermatogenic criteria by Image J software. Also, semen samples were prepared from the cauda epididymis and toluidine blue staining was performed for evaluation of sperm chromatin integrity. One- way analysis of variance (ANOVA) and Tukey's test were performed for comparisons between groups, p-value less than 0.05 (P ≤ 0.05) is statistically significant.

The number of spermatogonial cells, primary spermatocyte, spermatid, Sertoli, Leydig, Johnson's score, outer diameter and thickness of seminiferous tubules germinal epithelium, TDI, SPI, MI, and the diameter of the spermatogonial cell nucleus in right testis significantly decreased in the torsion / detorsion group (P < 0.01). A remarkable improvement in the above parameters was observed after treatment with the conditioned medium in comparison with the torsion / detorsion group, although there was a significant difference as compared to the control group (P < 0.01). The percentage of sperms with abnormal chromatin in the spermatic cord torsion / detorsion group increased significantly compared to the control group (19.6 ± 8.54) (P < 0.001). A significant improvement in the sperm chromatin structure was observed compared to the torsion/ detorsion group after treatment (14.4± 3.6) (P< 0.05).

It seems that Conditioned medium derived from human amniotic membrane mesenchymal stem cells leadsto a relative improvement in sperm chromatin and spermatogenic indices of the contralateral testicular tissue after unilateral ischemia / reperfusion injury of the spermatic cord.

Stragol drops and Aerobic exercise may have additional positive effect on Liver hurt Indices after myocardial infarction. Thisstudy is aimed to analyze the effect of Aerobic exercises and stragol consumption on Serum AST, ALT and ALP following a Myocardial Infraction in male Wistar rats.

The present research was conducted experimentally. For this purpose, male Wistar rats were subjected to coronary artery occlusion surgery and then MI was confirmed by electrocardiography. 32 male rats aged 8-10 weeks were randomly divided into 4 groups (control, stragol, aerobic and combined exercise) and the aerobic exercise protocol for 6 weeks and 3 sessions every week was performed. The stragol group and the combined group received 9.58 microliters of straggle per day. Data were analyzed by one-way ANOVA test and Bonferroni test. The results have shown that the level of AST had a significant decrease in the groups of aerobic exercise (11.53 ± 0.206), consumption of straggle (11.56 ± 0.207) and the combined intervention (10.54 ± 0.217). The level of ALT also decreased significantly in the groups of aerobic exercise (20.405 ± 0.420), Stragal consumption (20.662 ± 0.419) and the combined intervention (18.669 ± 0.418). Meanwhile, the combined intervention had the greatest effect on reducing AST (10.54 ± 0.217) (P < 0.01). The Stragal consumption had no significant effect on the ALP level (227.747 ± 0.208). However, the ALP level decreased significantly in the aerobic training group (226.830 ± 0.207) and the combined intervention group (226.035 ± 0.209) (P < 0.01), while there was no significant difference between the effect of aerobic exercise and combined intervention (P < 0.01).

The research results show that all three interventions of aerobic training, consumption of Stragol and combined intervention have a significant effect on the level of AST and ALT and reduce the level of AST and ALT(P ≥ 0.05). This is while; combined intervention has the greatest effect on reducing AST (P < 0.01). Consumption of Stragal has no significant effect on ALP level. However, aerobic exercise and combined intervention significantly reduced ALP (P < 0.01), while there was no significant difference between the effect of aerobic exercise and combined intervention (P < 0.01).

Taking Stragol and performing aerobic exercises at the same time can have an effect on improving the condition of the liver tissue caused by MI due to the significant reduction of liver enzymes.

Bacteria create biofilms as a mechanism to increase survival. The use of antibiotics to fight against them causes antibiotic resistance. Therefore, there is a need to produce strong anti- biofilm substances to fight biofilms. This experimental study was conducted with the aim of investigating the effects of malachite / zinc oxide / chitosan nanocomposites on the expression of pathogenic genes in Pseudomonas aeruginosa and Staphylococcus aureus.

Experimental, malachite, malachite / zinc oxide and malachite / zinc oxide / chitosan nanocomposites were prepared. The amount of biofilm formation of bacteria was checked with the help of crystal violet dye and TTC. The Minimum Biofilm Inhibitory Concentration and the Minimum Biofilm Eradication Concentration were investigated to measure the anti- biofilm activity of nanocomposites. The extent of cell survival in the vicinity of nanocomposites was evaluated by calcein-AM staining. The expression of rhlI and lasI genes in Pseudomonas aeruginosa and fnbA and fnbB genes in Staphylococcus aureus were investigated using Real- Time PCR technique. Data were analyzed using ANOVA test.

Based on the results of this study, the highest amount of anti- biofilm activity was observed in malachite / zinc oxide / chitosan, malachite / zinc oxide, and malachite nanocomposites, respectively. The results showed that the final malachite / zinc oxide / chitosan nanocomposite with a concentration of 7.81 μg/ml could inhibit the biofilm formation of two bacteria by about 50 ± 10% (MBIC50) and with a concentration of 15.62 μg/ml, the biofilm formed by both bacteria were remove about 50 ± 10% (MBEC50). Malachite / zinc oxide and malachite / zinc oxide / chitosan nanocomposites reduced the expression of rhlI and lasI genes of Pseudomonas aeruginosa and fnbA and fnbB genes of Staphylococcus aureus bacteria (P < 0.001). The use of malachite / zinc oxide / chitosan final nanocomposite reduced rhlI gene expression by 166.66 times, lasI gene expression by 30.30 times, fnbA expression by 20.70 times, and fnbB expression by 100 times compared to the control group (P < 0.001).

Malachite / zinc oxide and malachite / zinc oxide / chitosan nanocomposites probably have anti- biofilm activity on Pseudomonas aeruginosa and Staphylococcus aureus bacteria.

The distribution of multiple-drug resistance among pathogenic bacteria is an increasing serious problem for medicine and the pharmaceutical industry. The aim of this study was to evaluate the antibacterial effects of green synthesized Cadmium Sulfide Quantum dots (CdS QDs) using Nerium oleander leaves extract,due to its anti- cancer and  anti- inflammatoryeffects, on some gram negative and gram positive bacteria.

In this experimental study, the green synthesis of Cadmium Sulfide quantum dots was carried out using Nerium oleander leaves extract, which were collected from mountains around Ilam city, using three different methods including: ultrasonic (15 minutes at 37°C), microwave (15 minutes under 300W radiation), and flotation (soaking in water 3 days in Balloon packed. Then, dehydrated Cadmium acetate and Sulfide sodium were added. After that, the antibacterial effect of supernatant of different synthetic QDs wereevaluated on E.coli ATCC 25922, Salmonella enterica ATCC 14028, S.aureus ATCC 25923, and clinical isolates of Bacillus cereus using disc diffusion method on Muller Hinton agar, and those were compared with ceftazidime (30µg), chloramphenicol (30µg), penicillin (10µg), and imipenem (10µg). Also, Mean and standard deviation were used for descriptive analysis, and U- mann- whitney test was used to comparevariables.

The antibacterial effects of Cadmium sulfide quantum dots prepared by ultrasonic, microwave and flotation methods were stronger than ceftazidime, chloramphenicol and penicillin, while their antimicrobial effects were less than imipenem. The means effects and standard deviation of ceftazidime were respectively attained 11.50 ± 1.9, for chloramphenicol and for imipenem attained 13.2±1.5, 27.75 ± 2.2, respectively (P < 0.05).

It seems that the aqueous and methanolic extracts of cadmium sulfide quantum dots have had strong antibacterial effects and this effect had a direct relation with the concentrations of aqueous and methanolic extract of QDs, so if they won’t have any side effects, they can be usedas alternatives for antibiotics.

Colorectal cancer (CRC) is the third most deadly and fourth most commonly diagnosed cancer in the world. Although many interventions such as surgery, radiation therapy and chemotherapy are used nowadays, researchon other methods is being carried out too. The use of tumor antigens against the tumor is a kind of treatment that in combination with the virus can better stimulate the immune system against the tumor. The use of oncolytic viruses with natural characteristics in destroying cancer cells has provided a wide field for further studies. The aim of this study was to investigate the effect of MAGE-A3 tumor antigen on the oncolytic activity of Reovirus in colorectal cancer cell lines.

In this experimental study L929, a type of mouse fibroblast cell line, was used as a host cell for Reovirus propagation. Reovirus titer was determined by CCID50 method and the appropriate titer was selected for the study. The MAGEA3- expressing plasmid was transfected into colorectal cancer cells of the mouse (CT26) and human (Caco2) origin and infected with Reovirus (MOI = 1 and MOI = 0.01). 24 hours after Reovirus inoculation and observing CPE, the cells were collected to investigate apoptosis and measured by flow cytometry.

The apoptosis rate in CT26 cells in the presence of MAGE-A3 expressing vector and inoculated with Reovirus was higher (MOI=1, 38.5 ± 3.8% / p-value < 0.02 and in MOI=0.01, 30±  2.1% / p-value < 0.005) in comparison to the absence of MAGE-A3 expressing vector (MOI=1, 22.4±  0.9 and MOI=0.01, 15.8 ± 0.3). On the other hand, the rate of apoptosis in Caco2 cells in the presence of MAGE-A3 expressing vector and inoculated with Reovirus (MOI=1, 22.5±  1.8% / p-value=ns and in MOI=0.01, 11 ± 2% / p-value=ns) was lower than in the absence of vector expressing MAGE-A3 (MOI=1, 45.5±  2.7 and MOI=0.01, 11.5±  0.9). It can be stated that according to the results of this study, the cytolysis effect of Reovirus in Caco2 cell line is higher than that of CT26 cell and also the rate of cell cytolysis in the presence of MAGE expressing vector is almost twice more than that of this vector in Caco2 cells.

Given the higher cytolysis of the virus in Caco2 cells and the status of P53 and Ras genes in these two cells, in which P53 is mutant but Ras is active, the virus has more activity and MAGE-A3 presence reduces virus activity by reducing Ras activity.

Periodontitis is one of the periodontal inflammatory diseases ‎and is the most ‎common cause of tooth loss. Although bacterial infections play a major role in the ‎pathobiology of periodontitis, the severity of these diseases is determined by the severity of the ‎host's immune response to these infections. Human leukocyte antigens (HLAs) play roles in various ‎biological processes, including histocompatibility, inflammation, regulation of immune response, and ‎the complement cascade. In the following study, we investigated the difference in the frequency of HLA ‎locus alleles in patients with periodontitis compared to healthy controls.

This is a case- control study. Tissue samples were taken from 40 patients with periodontitis and 40 healthy controls. Case and control samples were collected based on the inclusion and exclusion criteria of the study. HLA-A, HLA-B, and HLA-DRB1 loci were genotyped by the SSP method and Olerup company kit. Allelic frequency was determined by the direct counting method, and multinomial regression models were used for statistical analysis between the two groups. Arlequin software package, version 3.5.2.2 (Excoffier and Lischer, 2010), and R software, version 3.6.1, were used to perform statistical analyses. Chi-square and OR statistical tests were also calculated.

This study was conducted on 40 cases and 40 controls. The two ‎groups were similar. The frequency of the DRB1*04 allele in the cases (28 cases) was significantly higher than the controls (16 controls) (P < 0.01). The odd ratio for this allele was equal to 2.3 (OR = 2.3). The frequency of other alleles had no statistically significant difference between the case and control groups (P > 0.05).

HLA- DRB1 locus could play a role in the pathogenesis of periodontitis. Conducting similar studies with a larger population and high-resolution HLA typing methods could help to clarify the mechanisms involved in the pathogenesis of periodontitis.

Multidrug- resistant (MDR) tuberculosis (TB) is caused by a strain of Mycobacterium tuberculosis (MTB) that was at least resistant to isoniazid (INH) and rifampicin (RIF). World Health Organization reported 399,000-501,000 cases of RIF resistance and they reported this case without knowing about this situation in Tehran. So, it is an important concern.

Descriptive method and research was done on 1000 clinical samples of people suspected of tuberculosis. All the samples were studied in the TB center of the province for microscopic examination and culture. Using the ratio method, the drug sensitivity test to the first- line anti- tuberculosis drug was performed for positive MTB cultures on Löwenstein- Jensen (LJ) culture medium. All isolates resistant and sensitive to RIF were identified by GeneXpert and the prevalence of resistance in the samples was determined and its actual level in the community was estimated. Then, using SPSS software, the level of resistance and factors affecting it were checked.

According to theprevalence in these samples in this research, out of 440 positive samples, 3 positive samples, or 0.07% were resistant.

It seems that resistance to rifampin is not a big problem and is not a cause for concern. As a result, the prevalence of drug resistance in this study area was relatively low. Our suggestion is to conduct more studies in different regions of this country to evaluate the efficiency of GeneXpert and whether it can be useful and effective in Iran.

Fever leads to transient changes in the urine analysis of children and the would confuse the physicians in the diagnosis of urinary tract infection and antibiotic prescription.

The study was a descriptive study. Urine analysis of 400 children aged 3 months to 14 years who were referred to Loghman Hakim hospital with fever complaints in 1396-1397 was investigated. The Urine cultures were also performed for all patients in the blood agar medium. If the patient's urine culture was positive, the sample was excluded and other diagnostic and therapeutic measures were performed. In case of changes in urine analysis, in addition to following urine culture to rule out urinary tract infection, the second and third urine tests were performed 24 and 48 hours after complete fever resection, and the results of both tests were recorded in a questionnaire and software. Analysis by SPSS24 was performed and compared. If abnormalities persist in urine tests after fever is stopped, the patient is referred to a pediatric nephrologist for other diagnostic measures that may be necessary.

In this study, 400 febrile children, 164 (41%), girls and 236 (59%) boys with an average age of 46.5 ± 36.9 were included. 53 Children (13.3%) had urine analysis abnormalities. Urine analysis became normal after 24 hours of fever in12.3% of patients and after 48 hours in and 4 patients (1%) The most common findings in urine analysis were sterile pyuria (9.3%) and microscopic hematuria (8.8%).

In this study fever was a reason for urine analysis abnormalities, such as pyuria or microscopic hematuria, they were becoming normal 48 hours after stopping the fever.