نشریه دانشگاه علوم پزشکی بیرجند
سال سی‌ام شماره 3 (پیاپی 96، پاییز 1402)

Hemophilia is an inherited bleeding disorder caused by malfunctioning or lacking blood coagulation factor VIII (hemophilia A) or IX (hemophilia B). Currently, the main treatments for these X-linked diseases are replacement therapy using periodic and regular injections of plasma-derived coagulation factors or their recombinant products. The use of recombinant coagulation factors is due to the need for periodic and regular injections to prevent bleeding in the acute type of hemophilia and in turn imposing a financial burden on patients. On the other hand, this treatment method is not available to all patients, especially those in developing countries. Recently, gene therapy has been proposed as a suitable, cost-effective, and permanent treatment option for hemophilia. This method is expected to solve the problems we currently face in treating hemophilia. Hemophilia is suitable for gene therapy since an abnormal gene is responsible for the disease. During the last two years, successful clinical trials for gene therapy using vectors derived from adeno-associated virus for both hemophilia A and hemophilia B have been conducted and approved for administration. Moreover, new methods based on gene-cell therapy and genome editing are under investigation for the treatment of hemophilia. This review article deals with different approaches for hemophilia treatments from the past to the present, particularly gene therapy methods.

In stem cells, the activation of specific powerful factors, such as OCT4, NANOG, KLF4, and SOX2, in conjunction with transcriptional control, triggers potency in both sperm-producing and cancerous stem cells. In the present study, we not only construct a protein-protein network and examine the roles of these factors in the development and advancement of testicular germ cell cancer but also explore the immunohistochemistry of the mentioned genes in pseudo-embryonic stem cells (ESC-like cells).

In this experimental study, the String database was used along with software tools, such as Cytoscape and Gephi, to examine the strength and interaction between these genes and construct functional networks. Following this, spermatogonial stem cells were isolated from mice, and after culture, ESC-like cells were manually generated from them. Subsequently, the expression of OCT4, NANOG, KLF4, and SOX2 in these ESC-like cells was investigated using immunocytochemistry (ICC).

According to the bioinformatics results, the target genes exhibit very strong interactions with each other, leading to the enhancement of their functionality and the enrichment of signaling pathways, particularly in cancer. Furthermore, the permanent expression of the OCT4 gene and the expression of the NANOG, SOX2, and KLF4 genes were demonstrated in ESC-like cells.

These data provide further insights into the potential of ESC-like cells. Given the highly interconnected network among these mentioned genes, their roles in enriching cancer pathways, and their key role in advancing spermatogenesis for male infertility treatment and cancer diagnosis, they have significant importance. These findings contribute to a better understanding of the potential therapeutic applications of these genes and open avenues for further research in these areas.

 Curcumin has potential anti-inflammatory effects. The aim of this study was to investigate the protective effect of curcumin against cardiac ischemia -reperfusion injury in rats fed a high-fat diet.

 In this experimental study, male Wistar rats were divided into four groups: control (C), high-fat diet (H), curcumin 100 (HyperC100, 100 mg/kg) and curcumin 200 (HyperC200), with the last two groups receiving oral curcumin daily for 3 weeks.
The rats were fed a high-fat diet for 7 weeks to induce obesity. After anesthesia, hearts were removed and placed on the Langendorff perfusion system andbegan beating. After 20 minutes of stabilization, 35 minutes of ischemia and 60 minutes of nutrient fluid reflux were performed. During this interval, ventricular (LV) functional indices including LVSP, LVDP, LVEDP and +dp/dt were recorded. The relative size of the infarction was measured by using 2,3,5-triphenyltetrazolium chloride staining.

 Hyperlipidemia caused dysfunction with changes in ventricular parameters, but curcumin could to improve some LV contractile parameters such as systolic pressure and increase diastolic pressure (P≤0.05). Curcumin could not significantly reduce the infarct size.

 Curcumin may have an cardio protection effects against ischemia/reperfusion injury in normal and hyperlipidemic rats.

Due to various antioxidant and antimicrobial compounds, plants are considered valuable sources. Ferula gummosa Boiss plant is one of the most important species of the Apiaceae family and is scattered in the eastern and western regions of Iran. This study aimed to investigate the antioxidant and antimicrobial properties of aqueous and hydroalcoholic extracts of Ferula gummosa Boiss plant gum.

The levels of phenolic and flavonoid compounds and the antioxidant capacity (by the iron reduction and 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging methods) were determined in this laboratory study. The antimicrobial activity of the extracts was evaluated using the disc diffusion method, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration were determined for some bacteria. Data analysis was performed using a factorial experiment within a completely randomized design, and Duncan's multiple range test was used to compare the means.

The highest content of phenolic compounds and flavonoids in methanol extract were (53.21±2.43 mg GAE/g dw) and (38.42±1.78 mg QE/g dw), respectively. The highest percentage of free radical scavenging and iron reduction power related to the methanolic extract was 96.43±3.56% and 1.963±0.012 µg/ml, respectively. Antimicrobial activity using the disk diffusion method and the MIC of Bacillus subtilis bacteria in all three extracts showed the most sensitivity compared to other bacteria.

The results of this study showed that the methanolic extract of the Ferula gummosa Boiss plant had antimicrobial activity, antioxidant potential, and higher phenolic and flavonoid content than the ethanolic and aqueous extracts.

Non-alcoholic fatty liver disease is the accumulation of triglycerides in the liver. Modifying lifestyle, especially exercise and nutrition, are ways to control this disease. The present study aimed to investigate the effect of high-intensity interval training (HIIT) and consumption of Portulaca Oleracea extract on Selenoprotein P gene expression and insulin resistance in rats with non-alcoholic fatty liver disease.

In this experimental study, 25 Wistar male rats with a weight range of 160-185 g were prepared and randomly divided into five groups of (n=5) (1. Control, 2. Control fatty liver, 3. HIIT, 4. Portulaca Oleracea extract, and 5. HIIT+Portulaca Oleracea extract). The non-alcoholic fatty liver model was induced in rats by following a high-fat diet for weeks. The training protocol consisted of 8 weeks of HIIT training and consumption of Portulaca Oleracea extract. Data analysis was performed using SPSS software (version 24) and one-way analysis of variance. Moreover, Tukey's post hoc tests were used to compare differences between groups.

The obtained results showed that eight weeks of HIIT and consumption of Portulaca Oleracea extract significantly affected the level of Selenoprotein P and insulin resistance in a way that the level of both factors Selenoprotein P and insulin resistance after HIIT and consumption of Portulaca Oleracea extract was lower than the fatty liver control group (P=0.001).

Based on the findings, HIIT alone and accompanied by the consumption of Portulaca Oleracea extract positively affected the amount of Selenoprotein P and insulin resistance in rats with fatty liver. The HIIT alone and accompanied by the consumption of Portulaca Oleracea extract can reduce the disease complications.

Obesity leads to impaired secretion and expression of adipokines in humans and causes the onset of type 2 diabetes. Although the role of regular exercise in the prevention of metabolic diseases has been reported, the mechanism of high-intensity exercise is still not well understood. Therefore, the aim of the present study was to investigate the effects of 8 weeks of high-intensity interval training on the changes in insulin, leptin and adiponectin levels in male Wistar rats with type 2 diabetes.

In this experimental study 20 male Wistar rats aged 8-10 weeks were randomly divided into four groups: Control, type 2 diabetes, exercise, and diabetes-exercise. Type 2 diabetes was induced by a high-fat diet and a single dose of streptozotocin (STZ). The rats in the exercise and diabetes-exercise groups completed 8 weeks of HIIT training (running at an intensity of 85-95% of maximum speed, intervals of 4-10). Insulin, adiponectin and leptin levels were measured in serum. Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), the Homeostasis Model Assessment for Insulin Resistance-beta (HOMA-β) and the Quantitative Assessment of Insulin Sensitivity Index (QUICKI) were calculated to assess insulin resistance and sensitivity.

Diabetes decreased the level of insulin, adiponectin and leptin in serum. HIIT reversed the impairments caused by diabetes. HOMA-IR, HOMA-β and QUICKI also improved in the diabetes-exercise groups.

Overall, our results confirmed that diabetes has detrimental effects on serum leptin, adiponectin and insulin indices and that HIIT training can improve these disorders.

Carpal tunnel syndrome (CTS) is the most common peripheral nerve compression neuropathy that causes many social and occupational problems for individuals. The epidemiology of the disease has not been investigated in South Khorasan province; therefore, this study aimed to investigate the epidemiological and clinical symptoms and the relationship between the nerve and muscle findings of patients with CTS referred to the physical medicine clinic of Birjand University of Medical Sciences, Birjand, Iran, in 2023. In this descriptive and analytical study, 159 hands with CTS referred to the Physical Medicine Clinic of Imam Reza Birjand Hospital were examined in 2023. Demographic information, body mass index, history of previous diseases, dominant hand, affected hand, duration of involvement, and clinical symptoms, including night pain or pain during activity, numbness and tingling, and muscle atrophy of the thenar region were investigated, and recorded in the checklist. The severity of median nerve involvement in CTS syndrome was recorded using nerve conduction study and electromyography (NCS-EMG) with nemous electromyography divice and classifieds according to last guideline in Electrodiagnostic Medicine (2nd edition) book. The mean age of patients was 51.01±13.5 years, which was more common in women. It was more prevalent in the age group of 50-60 years. Numbness was the most common symptom. Frequency distribution of CTS severity had a significant relationship with age group, pain during sleep and work, paresthesia, and muscle atrophy (P<0.05). Necessary information should be given to health centers and housewives so that suspected patients can be referred to the centers for early treatment and prevention from the disease progression and additional burden on the health system.

The changes in the causes of death in South Khorasan province, Iran, during 2002-2022 were examined in the present research. According to the data available in the “Mortality Data Registery” during these 20 years, cardiovascular diseases (CVD) was the most common cause of death, and its rate has increased from 20% in 2002 to about 37.8% in 2022. Even during the COVID pandemic, CVD was the first cause of death in the province. In 2022, the most common causes of death were CVD (37.8%), respiratory diseases (15.2%), cancers (14%), and accidents (9.2%). One of the most effective factors in preventing CVD is paying attention to"Life’s essential 8 Cardiovascular Health", i.e., having normal blood glucose, blood pressure, serum lipids, body mass index, sufficient physical activity, healthy diet, sufficient night sleep, and being a non-smoker. In addition to individuals’ attention to these factors, it is necessary for healthcare system decision-makers to have systematic and continuous planning to enhance people's awareness and attitude regarding these eight factors.