مجله پزشکی دانشگاه علوم پزشکی تبریز
سال چهل و پنجم شماره 5 (پیاپی 167، آذر و دی 1402)

Feeling loneliness is a prevalent phenomenon, affecting 25-50% of the population over 65 years old. The present study aimed to investigate feeling lonely in the elderly in Iran.

This review study was conducted by searching the keywords elderly, loneliness, isolation, elderly, old age, older people, and feeling loneliness. We retrieved all published cross-sectional articles in Persian and English languages from 2006 to 2021. Evaluation of the quality of the studies and data extraction was done by reading the full texts of the selected articles, using the STROBE Checklists for cross-sectional studies. Articles that had the required quality were included in the study.

In this research, 128 articles were found in the initial review. A total of 26 articles were included in the study after preliminary reviews. According to the studies, the average score of loneliness in the elderly was high. Also, due to the lack of social relations, the average score of loneliness in the elderly staying in nursing homes and far from their families was higher than the elderly living in the family. Conclusion. The average loneliness score among the elderly, especially those living in nursing homes, was relatively high. Creating the necessary conditions to maintain social relationships among the elderly can reduce their level of loneliness and prevent the adverse consequences of loneliness in them.

Practical Implications: 

Considering the importance of improving the mental health of the elderly, it is recommended to strengthen the counseling of the elderly, reduce treatment costs, and also involve the elderly in daily activities and talk with a group of friends to reduce their loneliness. The results of this research can be used to improve the level of awareness of policymakers, people, and families and increase the mental health of the elderly.

 High-fat diet (HFD) intake is linked to ectopic fat deposition in the pancreas. It also causes pancreatic inflammatory lesions. trans-Chalcone is a simple chalcone with protective effects against HFD-induced metabolic disorders. This study, for the first time, explored the possible effects of this chalcone on high-fat emulsion-induced pancreatic abnormalities in rats.

 Twenty-one male rats were randomly assigned into three groups: control (received 10% tween 80); HFD (received high-fat emulsion + 10% tween 80); and HFD + chalcone (received high-fat emulsion + trans-chalcone). Real-time PCR was used to assess pancreatic mRNA expression levels of monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor α (TNF-α) in the pancreas of all rats.

 High-fat emulsion increased the mRNA expression levels of inflammatory biomarkers, including TNF-α and MCP-1 in the pancreas of rats, and treatment with trans-chalcone prevented these high-fat emulsion-induced changes.

 trans-Chalcone can protect the pancreas of male rats against HFD-induced abnormalities through its anti-inflammatory effects.

Practical Implications: 

It seems that consumption of HFD up-regulates the production of inflammatory mediators in the pancreas. On the other hand, trans-chalcone can ameliorate HFD-related pancreatic inflammation.

 Sertraline is one of the most commonly used selective serotonin-reuptake inhibitors for patients with major depressive disorder. The prevalence of sexual dysfunction among patients who use selective serotonin-reuptake inhibitors is 40%–45% for women and 20%–30% for men. A strategy to prevent this side effect is combination therapy with medications such as buspiron and Ritalin. The aim of this study was to compare the effects of bupropion and Ritalin on sexual dysfunction among patients who use sertraline.

 This single-blind randomized controlled trial was conducted in 2018. Fifty eligible women aged 20–45 years old were purposefully selected from the psychiatric clinics of Yahyanejad and Ruhani hospitals, Babol, Iran. Structured interview was used to screen participants for major depressive disorder, sertraline use, and sexual dysfunction. All participants completed the Arizona Sexual Experience Scale and were randomly allocated to the bupropion and the Ritalin group through block randomization. All participants re-completed the Scale one month after the intervention. Data were analyzed through SPSS software by repeated measure analysis of variance.

 All fifty participants (25 in each group) completed the study. The mean of participants’ age was 36.38±5.64 years and the mean score of their sexual dysfunction was 23.44±3.14 at pretest and 19.52±4.92 at posttest. Between-group differences respecting the mean scores of sexual dysfunction and all its items were insignificant both at pretest (P= 0.886) and posttest (P= 0.872). However, within-group comparisons revealed that the mean score of sexual dysfunction significantly decreased in both groups (P<0.001).

 This study concludes the same efficacy of sustained release bupropion and Ritalin in significantly reducing sexual dysfunction among patients who used sertraline.

Practical Implications: 

 According to the results of the present study and the similar efficacy of slow-release bupropion and Ritalin in improving sexual dysfunction caused by sertraline, it seems that Ritalin, due to its effectiveness in treatment, is an easier drug to use. It is more cost-effective and a better alternative to bupropion in improving sexual dysfunction in patients who are candidates for treatment with serotonin- reuptake inhibitors.

Cardiotoxicity caused by fluoropyrimidines is an uncommon but potentially fatal complication. Its frequency has been 1.6 to 19% in previous studies. But there are no accurate statistics in Iran. The aim of this study was to determine the rate of cardiac complications of 5-fluorouracil (5-FU) infusion.

This prospective study was conducted in patients with gastrointestinal cancers who underwent chemotherapy with regimens containing 24-hour infusion of 5-FU at Rohani Hospital of Babol. Patients with a history of radiation therapy to the chest or epigastrium or suffering from COVID-19 disease in the last 6 weeks were excluded from the study. Each patient was examined in 2 cycles of chemotherapy. In case of complications, cardiac examinations including examination, electrocardiogram, echocardiography and if necessary, coronary angiography were done. Data analysis was done with SPSS 26 software using descriptive indices and Fisher exact test (significance≤0.05).

 In sixty one patients, 122 courses of chemotherapy were evaluated. Underlying cancer was colorectal cancer in 32 patients, stomach cancer in people. Eight patients (13.11%) had cardiac complication, in eleven chemotherapy cycles, included 7 cases of chest pain and one case of each of complications of myocardial infarction, pulmonary edema and pericarditis. Four out of 8 patients suffered from complications only in the first round, one only in the second round and three patients in both rounds of chemotherapy (P=0.004).The incidence rate of complications in patients without a history of heart disease was 8.7% and in patients with a history of heart disease 26.7%(P=0.073), in non-smokers 10% and in smokers 30%(P=0.084). It was 10.6% in non-diabetic patients and 21.4% in diabetic patients (P=0.294).

 Cardiac complications are common in 24-hour injection of 5-fluorouracil. A patient who has a heart complication once, might have a higher probability of having a complication in the next cycles.

Practical Implications:

Due to the high prevalence of cardiac complications of 24-hour floururacil infusion, especially in patients with a history of heart disease, careful cardiac monitoring during hospitalization is recommended.

  Resistance exercise is a method designed to increase muscle strength and endurance, leading to beneficial physiological changes in various tissues. The aim of this study is to investigate the pathological and structural effects of short-term and long-term resistance training on various tissues of male rats, including cardiac striatum, quadriceps, liver, kidney, and lung tissue.

 Forty male Wistar rats were randomly divided into four groups: one-month control, four-month control, one-month exercise, and four-month exercise. After the exercise period, the animals were anesthetized and dissected to separate various tissues, which were then treated with formalin and prepared for analysis.

  The study findings showed that liver tissue did not show significant histopathological changes in response to exercise. However, in the heart tissue, mild hyperemia and hypertrophy of muscle cells were observed in the exercise groups compared to the control groups. In the quadriceps muscle, hypertrophy was observed to a lesser extent in the one-month exercise group and to a greater extent in the four-month exercise group. There was a significant difference in the diameter of the muscle cells of the quadriceps muscle between the one-month and four-month exercise groups, indicating the beneficial effects of long-term exercise. Additionally, an increase in the size of the epithelial tissue of the urinary tubes was observed in both exercise groups, which indicates an increase in kidney function due to exercise.

 Overall, the results of this study show that resistance exercise can lead to beneficial physiological changes in various tissues, especially with long-term exercise. Understanding these changes can increase our knowledge about the benefits of exercise.

Practical Implications:

Resistance exercises, through actions such as hyperemia, hypertrophy of muscle cells, and hypertrophy of the epithelial tissue of urinary tubes, improve the efficiency of the heart, kidneys and muscles during sports exercises, especially with long-term exercise.

Using personal protective equipment, including masks, is one of the most important ways to prevent coronavirus disease 2019 (COVID-19). The aim of this study was to estimate the prevalence and pattern of mask use and its association with COVID-19-related morbidity and mortality in different areas of Tabriz, Iran.

In this population-based study, 6,600 pedestrians were selected by multi-stage proportional sampling method in nine areas of Tabriz in 2021. The data was collected using the observation method. For each participant, we recorded gender, approximate age, mask usage, type of mask, and correct or incorrect use. The data of COVID-19-related morbidity and mortality for six months (from 21 March 2021 to 22 September 2021) were obtained from the Integrated Syndromic Surveillance System (ISSS).

The overall prevalence of facial mask use was 56.8% (95% CI: 55.56 – 57.95). Out of 3,421 men, 1,599 (46.7%; 95% CI: 45.1-48.4) and out of 3,179 women, 2,147 (67.5%; 95% CI: 65.9-69.2) were used face mask (P<0.001). The correlations between mask use and morbidity (r=0.375, P=0.320) and mortality (r=0.219, P=0.571) rates were not statistically significant.

The percentage of using face masks in Tabriz was relatively low, especially among males and young people. Also, there was no significant relationship between COVID-19 morbidity and mortality and mask use.

Practical Implications:

The results of the present study showed that the percentage of mask use in men and the youth was relatively low. In times of disease epidemics, it is necessary to create the necessary sensitivity in these groups and to carry out the necessary training and interventions to increase the use of masks and protective measures.

Different shoe weights affect walking mechanics. Therefore, the purpose of this study was to determine the effect of sport shoe weight on lower extremity muscle activities in athletes with anterior cruciate ligament reconstruction during walking. It was hypothesized that reduced shoe weight results in decreased frequency content of selected muscles during walking.

Twenty healthy males and athletes with ACL reconstruction volunteered and gave their written informed consent to participate in this study. Participants were male and physically active. Each participant performed three walking trials in each of the light (mass per shoe: 150 ± 18 g), medium (300 ± 18 g), and heavy (450 ± 18 g) conditions in a randomized order and electromyography were analyzed during shod walking.

EMG results showed that the increase in shoe weight was directly related to the increase in electrical activity of the muscles, but only in the swing phase was the electrical activity of the TA muscle decreased.

  Different shoe weights affect the electrical activity of the muscles and the walking speed. Therefore, lighter weight shoes are recommended for patients with ACL.

Practical Implications: 

The results of this study show that light shoes are useful for patients with anterior cruciate ligament rupture and the use of lightweight shoes is recommended for people with anterior cruciate ligament rupture.

The three primary differential diagnoses for a patient with systemic and hematological involvements (fever, lymphadenopathy, and hepatosplenomegaly), skin rashes, and sore pharynx are infections, connective tissue diseases, and malignancies. In this case report, we discuss possible illusory similarities between these categories that can aid in the diagnostic workup of primary care physicians.

Practical Implications:

The clinical course of (Infections mononncleosis, MI) patients with and their histopathological data rarely differ; Therefore, early testing for IM caused by EBV is recommended. This article will help physicians face similar cases