مجله علمی پزشکی جندی شاپور
سال بیست و یکم شماره 4 (پیاپی 139، مهر و آبان 1401)

Acanthamoeba is a free-living amoeba that can be found in various environments. It is found in ear, nose and pharyngeal mucosa of patients with respiratory problems .This is the most common protozoan found in the environment. The antibodies against Acanthamoeba antigens have been found in the serum of more than 80% of people with complete immunity, which indicates high human contact with this amoeba. Acanthamoeba is the cause of human diseases such as amoebic keratitis and granulomatous amebic encephalitis, which is mostly seen in immunocompromised people.Skin wounds and nasopharyngeal infections caused by this amoeba have also been observed, mostly in people with AIDS. Based on rRNA gene sequence determination, Acanthamoeba genus is divided into 12 different genotypes (T1 to T12). Most human Acanthamoeba infections are related to the T4 genotype.Studies have shown that the number of amoebic keratitis is increasing worldwide due to use of contact lenses. Acanthamoeba genotyping is a useful tool for taxonomic and epidemiological studies. It explains the relationships between infectious isolates and the phenotype of the disease. Since different strains show different pathogenic power, determining the strains with high pathogenic power can have more therapeutic importance. More studies to identify pathogenic features and genetic markers are needed to clarify this matter. The present study aims to determine the genotype of Acanthamoeba strains isolated from the oral cavity of people with immunodeficiency.

This cross-sectional descriptive study was conducted for 18 months.
The samples were collected with a sterile swab from pharyngeal or nasal secretions of 179 eligible patients in Golestan and Shafa hospitals in Ahvaz, Iran in 2019. The patients who had immunodeficiency with various underlying diseases including diabetes, AIDS, those who were under treatment with chemotherapy drugs and steroids, as well as dialysis patients were included in the study. In the university laboratory, the swab soaked in secretions was cultured on basic agar medium. Before closing the environment, it was autoclaved for 15 minutes at 121°C and divided into plates under the hood. The plates were fixed with parafilm and kept in refrigerator at 4°C. To detect Acanthamoeba, all samples were cultured separately in a non-nutrient medium (1.5% Bacto agar) along with an old medium of Escherichia coli. Then, bacteria were added to the medium to provide a good source of food for amoeba. The media were incubated at a room temperature and microscopic observation was done on days 2-14 to identify the samples positive for Acanthamoeba. All positive amoebae isolates can be cloned by subculturing method to produce pure culture for extracting pure DNA. Therefore, the existing parasites were transferred to new plates. To determine the genotype of the target sample, after cultivation using the primers presented in Table 1, polymerase chain reaction (PCR) was performed under the conditions shown in Table 2.The primers were diluted. For this purpose, 180 µL of distilled water and 20 µL of primer were added to two micro-tubes named as diluted G₁ and diluted G₂.To determine the genotype of Acanthamoeba isolated from patients, the PCR product was finally determined and the information related to sequencing of the fragment for each sample was compared with the information available in the gene bank, and the genotype of the amoeba was finally determined. Statistical analysis was done using SPSS software, version 22.

In this study, 110 men and 69 women participated. Most of them (n=48, 26.8%) were at the age group of 60-69 years, and the mean age of participants was 48±1 years. As shown in Table 4, 99 samples were taken from the throat and 80 samples were taken from the nose of patients.Among the samples examined by PCR, 6(3.4%) were positive to Acanthamoeba, collected from the oral (n=4) and nasal (n=2) cavities of patients. Acanthamoeba was identified in the medium by observing star-shaped cysts. The PCR analysis was successfully performed on these samples and the nucleotide sequence was determined for them. All positive samples of T4 genotype were obtained. The PCR analysis was confirmed by observing the 500-bp band on agarose gel (Figure 1).

The prevalence of infection with Acanthamoeba parasite in patients with immunodeficiency is higher. The Acanthamoeba positive samples identified in these people belong to the T4 genotype.

The patients undergoing lower limb fracture surgery face with severalcomplications and problems. One of these complications is related to use of urinary catheters and theirindwelling which may affect the patients’ satisfaction. This study aims to determine the effect of urinarycatheter removal time on the satisfaction of patients undergoing lower limb fracture surgery.

This is a non-randomized clinical trial that was conducted during 2018-2019 inTehran, Iran. By using a convenience sampling method, 84 patients undergoing lower limb fracturesurgery in the orthopedic department of Imam Khomeini and Bank Melli hospitals were selected anddivided into three groups of 28: Catheter removal after 24 hours, catheter removal after 48 hours,and catheter removal after 72 hours. The data were collected through self-reporting and interview. 72hours after catheterization and voluntary urination, they completed a demographic form and a patientsatisfaction questionnaire. The gathered data were analyzed by using descriptive and inferential statisticsin SPSS software, version 16.

All three groups showed high satisfaction with their urination and there was no significantdifference among the groups (P=0.86). Regarding overall satisfaction, there was a significant differenceamong three groups (P=0.031), where the overall satisfaction was higher in patients with 24-hourcatheterization.

Early removal of urinary catheters in patients undergoing lower limb fracture surgery isassociated with their higher overall satisfaction.

Angiography is a common and invasive method in diagnosing cardiovasculardiseases. Some patients refuse to perform angiography due to reasons such as fear, high cost, and lackof confidence in the decision of physician for angiography. This study aims to determine the factorspredicting coronary artery occlusion to predict the outcome of angiography.

In this cross-sectional study, participants were 1187 patients received angiographyin Ghaem Hospital in Mashhad, Iran. Demographic data, lipid profile, blood sugar level, and history ofunderlying disorders were used in two prediction models of logistic regression and zero-inflated negativebinomial (NB), fitted using R3.6.1 software. Then, their sensitivity and specificity were compared.

Of 1187 patients, 404 (34%) had negative angiography. The results of both models showed thatthe risk of positive angiography was significantly higher in male and diabetic patients. The risk increasedwith the increase of age. The area under the ROC curve (sensitivity and specificity) for logistic regressionand zero-inflated NB models were 78.4(70.4%, 70.5%) and 78.2(71.4%, 71.5%).

Age, gender, smoking, and history of diabetes are significant predictors of the angiographyoutcome. There is no significant difference between logistic regression and zero-inflated NB models inpredicting the outcome of angiography. Due to the ease of use of logistic regression model, it can beused to predict the results of angiography.

Transfer of antibiotic resistance genes by integrons is the main cause ofdrug-resistant bacteria. This study aims to evaluate the prevalence of class I, II, and III integrons amonguropathogenic Escherichia Coli (UPEC) strains isolated from patients with Urinary tract infection (UTI).

This cross-sectional study was carried out on 50 UPEC strains isolated from patientswith UTI referred to hospitals in Shiraz, Iran in 2020. Antibiotic susceptibility pattern was evaluated bythe disk diffusion susceptibility test. Then, the prevalence of class 1 to 3 integrons in the isolates wasinvestigated by the polymerase chain reaction test. Data were statistically analyzed in SPSS softwareusing chi-square test. P≤0.05 was statistically significant.

42% of isolates had multi-drug resistance. The highest antibiotic resistance and sensitivitywere related to trimethoprim/sulfamethoxazole (52%) and gentamicin (90%), respectively. Therewas a significant relationship between the presence of class I integron and resistance to amikacin andciprofloxacin, between the presence of class II integron and resistance to gentamicin, and between thepresence of class III integron and resistance to trimethoprim/sulfamethoxazole and nalidixic acid (P<0.05).

There is a significant association between the presence of class I, II and III integrons andantibiotic resistance in UPEC strains isolated from patients with UTI. Infection control measures andsuitable treatment methods are needed for preventing the spread of these isolates in the hospitals andhealth centers in Shiraz city.

In this study, we aim to investigate the relationship of the numbers of daysuntil blood expiration and pre-transfusion hemoglobin level with mortality rate in patients admitted tothe intensive care unit (ICU) and received packed red blood cell (PRBC) transfusion.

This is a retrospective cross-sectional study that was performed in 2020 on 205patients admitted to the ICU of Al-Zahra Hospital in Isfahan, Iran in the past year and received PRBCtransfusion. Their demographic information as well as information about related to the blood such asthe number of days until PRBC expiration and pre-transfusion hemoglobin level were extracted from thepatient’s medical records.

The mean pre-transfusion hemoglobin level of patients was 10.53±2.8 g/dL. Male patients hadsignificantly higher hemoglobin level than female patients (P<0.05). Of 205 patients, 55(26.8%) hada death outcome. The mortality rate was significantly higher in males than in females (P<0.05). Thenumber of days until PRBC expiration was 11.52±3.71 days. It was not significantly different betweenthe deceased and surviving patients (P>0.05). Also, the hemoglobin level of the deceased patients wassignificantly lower than that of surviving patients (P<0.05). The patients with underlying diseases hadsignificantly lower pre-transfusion hemoglobin level and higher mortality.

The mortality rate among ICU patients received PRBC transfusion in the study hospitalis 26.8%.

Supplementation with amino acids for muscle recovery can be effective onoxidative stress and muscle damage. This study aims to compare the effects of pea protein and wheyprotein supplements on muscle damage, delayed onset muscle soreness (DOMS), and functionalperformance after high-intensity functional training (HIFT) bout in untrained overweight young men.

In this randomized, double-blind, placebo-controlled clinical trial, 30 untrainedoverweight young men were selected by a purposive sampling method and divided randomly into threedifferent groups of pea protein (n=10), Whey Protein (n=10), and placebo (n=10). Variables relatedto muscle damage and DOMS were measured 24 hours after HIFT. Repeated measures ANOVA andBonferroni post hoc test were used to compare the differences between groups.

There was a significant difference between the two evaluation stages. There was a significantdifference between the Whey protein and pea protein groups compared to the placebo group (P<0.05),but no significant difference was found between the Whey protein and pea protein groups (P<0.05).

The use of Whey protein, compared to pea protein, can reduce muscle damage and DOMSfollowing HIFT

The digital radiography offers a variety of image processing techniques. Dueto the importance of the accuracy of this method and its widespread applications, in this study we aimto investigate the diagnose of vertical root fracture (VRF) by conventional digital radiography with andwithout unsharp masking (UM) filter.

Radiographs were taken from 24 extracted anterior teeth before and afterVRF induction. The root canal was prepared with passive step-back technique, and then the teethwere divided into two halves buccolingually with a very thin disk. The two halves were re-attached toeach other and mounted in a mixture of gypsum and sawdust. After processing by the UM filter, theradiographs were evaluated by two observers to detect the presence or absence of VRF.

For the first observer, the sensitivity of both methods was the same, while the specificity of theUM filtering mode was higher. For the second observer, the sensitivity of the unfiltered mode was higher,while the specificity of the two methods was the same.

There is no significant difference between digital radiography with and without the UM filterin diagnosing VRF. Due to the high sensivity and specifity of the UM filtering method, the specialist canuse this filter based on personal preferences.

Cancer is one of the most important diseases of the century. It is the secondleading cause of death after cardiovascular diseases. Diagnosis of cancer followed by long treatmentprocess is a stressful experience. This study aims to evaluate the effect of mindfulness-based stressreduction (MBSR) therapy on illness perception and rumination in patients with cancer.

This quasi-experimental study was conducted with a pre-test, post-test, follow-updesign. The statistical population consists of all patients (males and females) with cancer in Ahvaz, Iranin 2021. Using a purposive sampling method, 40 were selected and divide into the experimental andcontrol groups (20 in each group). To collect data, the illness perception questionnaire of Moss-Morriset al. (2003) and the ruminative response scale of Nolen-Hoeksema and Morrow (1991) were used.The experimental group underwent MBSR (8 sessions 60 minutes), while the control group received notreatments. Data were analyzed using analysis of covariance.

The MBSR was effective in improving illness perception and reducing rumination in patients(P<0.001).

MBSR can be used to improve illness perception and reduce rumination in patients withcancer.

Reduced ability to control balance is one of the disorders affecting the qualityof life and daily activities of people with diabetic polyneuropathy (DPN), which can lead to dangerousconsequences such as falling. By identifying the causes of balance disorders, we can better understandthis condition to provide effective and evidence-based treatments for these patients. This study aimsto investigate and compare the use of motor strategies in people with and without impaired sensoryorganization suffering from DPN.

In this cross-sectional study, 40 people with DPN participated. Their demographicinformation were recorded and then underwent balance performance test using the sensory organizationtest. Based on the results, they were divided into two groups: Control group without impaired sensoryorganization (n=18) and Patient group with impaired sensory organization (n=22).

The prevalence of inappropriate use of motor strategies to restore balance in DPN patients withimpaired sensory organization was higher than in the control group. The adopted inappropriate strategywas mostly in using ankle strategy, where the somatosensory and visual perturbations were higher.

Patients with DPN use ankle strategy, instead of hip strategy, to restore balance. This non-useof hip strategy is more common in patients with impaired sensory organization.

Antihistamine drugs for acute upper respiratory tract infection treatment inchildren have many side effects. In this study, a anti-cough syrup was prepared from Cordia (Sepestanin Persian) extract and its effect was compared to that of diphenhydramine syrup on cough relief of childrenwith upper respiratory tract infection.

This double-blind randomized clinical trial was conducted on 124 children withupper respiratory tract infection aged 6-12 years referred to Abouzar Hospital in Ahvaz, Iran during 2019-2021 in two treatment groups. The first group was given Sepestan syrup at a dose of 20 mg/kg/day andthe second group received diphenhydramine syrup at a dose of 5 mg/kg/day in four dosages. For threedays, the number and severity of day-time and night-time coughs were examined and the data wereanalyzed with independent t-test and chi-square test in SPSS software, version 24.

The number and severity of day-time and night-time coughs in the group received Sepestan syrupsignificantly decreased compared to the diphenhydramine group, without any side effects (P<0.001).

High polysaccharides, strong antioxidants, and anti-inflammatory compounds of Sepestan canreduce throat irritation and soften the chest. The mucilage in the Sepestan extract can dissolve in waterand produce a viscous substance such as gelatin that cause softening of the breast and expectoration.

Obesity is one of the most important concerns and problems that threatenhealth all over the world, and sports activity and healthy diet are the most important ways to treat andprevent it. so, this study aims to evaluate the effect of 12 weeks of high-intensity interval training (HIIT)and Ellagic Acid (EA) supplementation on oxidative/antioxidant markers in obese women.

In this randomized clinical trial, 56 inactive obese women were randomly dividedinto four groups of HIIT, EA, EA+HIIT, and Control. The HIIT groups performed the training for 12 weeksincluding four 4-minute interval running at 85-95% HRpeak, 3 minutes of running at 50-60% HRpeak and7 minutes of rest interval. EA supplement was administered at a dose of 50 mg/day for 12 weeks. Bloodsamples were collected from the subjects before and 48 hours after the last session to assess serumlevels of glutathione peroxidase (GPx), Malondialdehyde (MDA), and total antioxidant capacity (TAC).

There was a significant difference between EA+HIIT and HIIT groups in MDA (P=0.005), TAC(P=0.003) and GPx (P=0.0001) after intervention. There was a significant difference between the MDAand TAC values of the subjects in the studied groups after 12 weeks of HIIT with EA supplementation(P=0.0001). And this was the difference between the combined group (EA+HIIT) and other groups.

Twelve weeks of HIIT and EA supplementation can significantly improve antioxidant and oxidantfactors in obese women.

Hypochondriasis (Illness anxiety disorder) is one of somatic disorders wherea person has a fear of having a serious disease for at least 6 months, despite having physical health. Itsprevalence is higher in people aged 20-30 years. This study aims to determine the prevalence of hypochondriasisand its related factors during the COVID-19 pandemic in medical students of MazandaranUniversity of Medical Sciences (MUMS).

This descriptive study with a cross-sectional design was conducted in 2021. Thestudy population consists of all students of MUMS. Of these, 125 students participated in the study,including 75 females (60%) and 50 males (40%) aged 19-27 years (mean age=22.80±2.54 years). Thedata collection tool was a questionnaire adapted from a hypochondriasis awareness questionnaire developedby Evans in 1980. The collected data were analyzed in SPSS software, version 26.

It was found that 36.8% had no hypochondriasis, 28% were at risk of hypochondriasis, 18.2% hadmild hypochondriasis, 13.6% had moderate hypochondriasis, and 3.2% had severe hypochondriasis. Therelationship between age and hypochondriasis was statistically significant (P=0.025).

Due to the COVID-19 pandemic and being in quarantine, most of the MUMS students hashypochondriasis, where older students have higher level of hypochondriasis.