مجله علمی دانشگاه علوم پزشکی کردستان
سال بیست و هشتم شماره 5 (پیاپی 128، آذر و دی 1402)

Diabetes mellitus is a metabolic disorder with an increasing global prevalence that can lead to premature death. High blood glucose is the main lab. abnormality in diabetes mellitus which occurs as a consequence of disorder in pancreatic insulin secretion or function. L -Serine supplementation regarded as safe by the FDA can improve glucose homeostasis and reduce homeostasis model assessment-estimated insulin resistance (HOMA-IR) and oxidative stress. The aim of this study was to investigate the effects of L-serine intake on oxidative stress indices and histopathologic changes in the pancreas of diabetic mice.

In order to conduct this study, 18 c57bl/6 male mice were purchased and divided into 3 groups (control, diabetic control and diabetic mice treated by L-serine(. Diabetes induced by chemical method (streptozotocin, 200 mg/kg). After four weeks of oral administration of L-Serine (approximately 280 mg/day/mouse), animals were euthanized by guillotine and blood samples and pancreas tissues were obtained to determine biochemical parameters, oxidative stress indices and pathological changes.

The results of this study showed that oral administration of the supplement of L-Serine in diabetic mice could help to lower blood sugar levels and could lead to increased catalase enzyme activity (P<0.05) but had no significant effect on the levels of MDA, cholesterol, and triglyceride. On the other hand, histopathological changes showed a slight reduction in diabetes-induced pancreas damage in mice treated with L-serine.

These findings showed that the supplement of L-Serine may have a protective effect against diabetes-induced pancreas damage by lowering blood sugar and improving oxidative stress status.

Doxorubicin is an effective chemotherapeutic agent. However, use of this drug is limited due to its dose-dependent cardiotoxicity. Activation of apoptotic pathways in myocardial tissue plays an important role in doxorubicin- induced cardiotoxicity. Minocycline is an antibiotic that has anti-apoptotic effects. In this study, we investigated the protective effects of minocycline against doxorubicin-induced cardiac toxicity in male rats.

Forty two adult male rats were divided into control (normal saline), doxorubicin (2.5 mg / kg), minocycline (45 and 90 mg / kg) and treatment (doxorubicin + minocycline 45 and 90 mg / kg) groups. Minocycline was injected intraperitoneally, once a day for 3 weeks. Ejection fraction (EF) and fractional shortening (FS) were measured using echocardiography. The activity of caspase 3/7 and the expression of Bax and Bcli were measured by biochemical methods. Bax and Bcl-2 genes expression levels were estimated by real-time PCR.

In the minocycline-treated groups (45 and 90 mg / kg) the activity of caspase 7/3 and the expression of Bax gene were significantly lower and the levels of EF, FS and Bcl-2 expression were significantly higher than those in the doxorubicin group.

Minocycline reduces doxorubicin-induced cardiotoxicity. The anti-apoptotic effects of minocycline may play an important role in its protective effects.

Oxidative stress and inflammatory response play an important role in the development of lipopolysaccharide (LPS)-induced acute liver dysfunction. The purpose of this study was to investigate the effect of hydroalcoholic extract of dill seed on liver damage induced by LPS.

In this study, 32 rats weighing between 200 and 250 g were divided into four groups: control, control treated with dill hydroalcoholic extract, rats with liver damage، and rats with liver damage treated with dill hydroalcoholic extract. Dill hydroalcoholic extract was administered at a dose of 200 mg/kg. LPS was used to induce liver damage. Activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), superoxide dismutase (SOD), and catalase level of malondialdehyde (MDA) and tumor necrosis factor a (TNF-α) were measured. The differences between groups were analyzed using one-way ANOVA and Tukey's tests.

The levels of ALT, AST, ALP, TNF-α and MDA significantly increased and activities of SOD and catalase significantly decreased in the LPS group compared to those in the control group. Treatment with hydroalcoholic extract of dill significantly decreased ALT, AST, ALP, TNF-α and MDA and significantly increased SOD activity compared to those in the LPS group.

Hydroalcoholic extract of dill showed a protective effect against liver dysfunction caused by LPS which is due to its anti-inflammatory and antioxidant properties.

This study aimed to investigate the protective effects of aqueous and ethanolic extracts of Caryophyllus aromaticus on DNA damage in mononuclear white cells of human blood using the COMET method.

Mononuclear white blood cells were isolated from blood samples taken from 15 healthy volunteers. Cells were treated with H2O2 (25, 50, 100, and 200 μM), as well as with aqueous and ethanolic extracts of aerial parts of cloves (0.05, 0.1, 0.5, 1, and 2.5 mg/ml). Finally, to induce DNA damage the cells were incubated in a combination of 100 μM H2O2 with each of the two aqueous and alcoholic extracts at a concentration of 2.5 mg/ml at 4°C for 30 minutes. The extent of DNA migration was measured using the alkaline single cell gel electrophoresis approach assay, and DNA damage was expressed as tail length (µm), percentage of tail DNA, and tail moment (µm).

DNA damage in the mononuclear white blood cells exposed to the combination of hydrogen peroxide with aqueous extract of clove plant was significantly less than that in the mononuclear white blood cells treated with H2O2 alone. Tail length (µm) was 5.30±1.21 versus 21.84±3.91, percentage of tail DNA (%) was 4.29±1.21 versus 16.21±4.18, and tail movement (µm) was 0.24±0.08 versus 2.35±0.72, respectively (p < 0.001).

The results showed that the aqueous extract of clove plant (2.5 mg/ml) can prevent oxidative DNA damage in human mononuclear white blood cells, which is probably due to the presence of antioxidant compounds in the extract.

The aim of this study was to compare the analgesic effects of I.V. ondansetron and I.V. metoclopramide in combination with morphine in relieving pain in the patients with acute renal colic receiving morphine in the emergency department.

Patients were randomly divided into three groups of A, B and C. Group A patients were treated with 0.1 mg/kg intravenous morphine and 0.075 mg/kg I.V. ondansetron (maximum 4 mg), group B patients were treated with the same dose of intravenous morphine and 0.15 mg/kg metoclopramide (maximum 10 mg) and group C patients received the same dose of intravenous morphine and 5 cc normal saline. Pain intensity was assessed at the beginning of the study and 15, 30, 60 and 120 minutes after receiving the drug by Visual Analog Scale (VAS).

In this study, 150 patients were divided into three groups. The mean age of patients was 34.51 ± 7.84. There was no significant difference between the three groups in terms of gender distribution (P = 0.737) and mean age (P = 0.57). The mean VAS score was not significantly different in the three groups at the beginning of the study (P=0.338). But at the 15th minute VAS scores in the metoclopramide and ondansetron groups were significantly less than that of the control group (P=0.044). At the 30th minute, the difference in the pain intensity among the three groups was again insignificant (P=0.164). But at the 60th and 120th minutes, the VAS score in the metoclopramide group was significantly less than those of the other two groups. (P=0.033 and P=0.009). Also, intragroup analysis showed a significant decreasing trend in the VAS scores in the three groups during the study (P <0.001). Patient’s average length of stay in emergency department was 53±18 minutes in the metoclopramide group, 72±31 minutes in the ondansetron group and 80±31 minutes in the control group (P <0.001). In the metoclopramide group, 2 patients developed extrapyramidal complications.

Our findings indicated that metoclopramide and ondansetron in addition to their antiemetic effects, have analgesic effects. The analgesic and antiemetic effects of metoclopramide and its effect on reducing the length of hospital stay were greater than those of ondansetron

A variety of factors, such as age and underlying diseases, affect the severity of covid-19 and its mortality rate. Identification of these factors is important to manage the disease in vulnerable people. The purpose of this study was to examine the association of outcome of covid-19 with demographic characteristics, underlying diseases, serum biomarkers, and level of care for inpatients.

This retrospective cohort study was conducted in Sina Hospital in Hamadan in 1400. All adult hospitalized patients with definite diagnosis of COVID-19 were included in the study by convenience sampling method during a three-month period. Demographic and clinical status data were collected using a designed questionnaire. Using SPSS software the data were analyzed by independent t, Mann-Whitney, and multivariate logistic regression analysis tests.

A total of 283 hospitalized patients with a mean age of 57.22 years participated in this study, of which 67 (23.7%) died. Among the deceased patients, 92.4% were over 50 years of age which showed a significant difference compared to the deceased patients under 50 years of age (P<0.001). People who died with any documented history of underlying diseases accounted for 83.3% of the deceased patients, and their proportion was statistically significant compared to the patients without any underlying disease (P 0.0005). Prevalence of severe acute respiratory distress syndrome (ARDS) was significantly different in the deceased patients (28.8%) compared to that in the survivors (3.9%) (P<0.001). According to the results of our study age, gender, history of underlying diseases, serum BUN level and severity of acute respiratory distress syndrome are predictors of death in the patients with Covid-19.

The findings of this study indicated the need to pay more attention to preventive measures in old people with underlying diseases. It can also help healthcare professionals to consider designing programs for prevention, appropriate care and treatment in relation to the predictors of mortality.

Chronic low back pain is one of the most common debilitating occupational diseases. It seems that the frequency of this type of back pain is increasing, especially among young military staff. The aim of this study was to evaluate the causes of chronic low back pain according to interpretation of MRI reports in military personnel of army land forces of the Islamic Republic of Iran.

In this descriptive cross-sectional study, the data of military personnel with chronic low back pain, referring to the Neurosurgery Council of Khanevadeh Hospital, Tehran in 2016 were extracted. The information included demographic and occupational characteristics of the patients, clinical findings, and MRI reports. We used chi-square and Fischer exact tests for data analysis at the significance level of 95%.

326 male military personnel with chronic low back pain were evaluated. The mean age of the subjects was 37.3 ± 0.6 years. The most common MRI finding was disc herniation which was detected in 174 cases (53.3%). low back pain was most frequent in the combat branch, which included 114 cases (34.9%). There was no statistically significant correlation between MRI findings and types of military branches (P=0.071). The highest frequency of disc herniation belonged to the patients between 20 and 29 years of age (p=0.002) and the highest frequency of degenerative changes was seen in the patients over 50 years of age (p=0.005).

The most important finding of this study was the low mean age of the patients with chronic low back pain who were in their active working years. We suggest revision of the trend of periodic examinations of military personnel, ergonomics of the work environment and military training.

Dentists should be aware of the position and anatomical path of the inferior alveolar canal (IAC). The aim of this study was to investigate the position and anatomical path of the IAC on cone-beam computed tomography (CBCT) images in an Iranian population.

This retrospective study included 150 CBCT images. The distance of the IAC from the buccal and lingual cortex in the alignment of teeth 4 to 7 and the emerging pattern of the inferior alveolar nerve (IAN) from the mental foramen were assessed. Using SPSS version 22 software, the role of age, gender, and side of the jaw in the investigated parameters were evaluated by Pearson correlation, independent and paired samples t test, and chi-square test.

The most frequent emerging pattern of the IAN was "sharp turn with 90° angle" (44.7%). The average distance of the IAC from the buccal cortex of the mandible, unlike the lingual cortex, increased in the alignment of teeth 4 to 7 in both genders (P<0.001). The distance of the IAC from the buccal cortex of the mandible in the alignment of teeth 4 to 7 and the lingual cortex in the alignment of tooth 4 and distal of tooth 6 was greater in the men than those in the women (P<0.05). Furthermore, there was no statistically significant difference between the two sides of the jaw (P>0.05).

Although the distance of the IAC from cortex was not related to age, it was greater in the men than women. Considering the variations in the IAC path and the IAN emerging patterns, CBCT radiography is suggested in doubtful cases.

Cancer patients experience severe pain for which adaptation is excruciating. The aim of this study was to design a structural model of pain acceptance based on mindfulness and difficulty of emotional regulation with a mediating role of resilience in cancer patients.

This study was based on structural equations and descriptive-correlational research. The statistical population consisted of all people with cancer referring to health centers and clinics in Sanandaj in 2019. Based on Hair's rule for sampling in structural equations, 200 patients were selected by available methods. Data collection tools included the Pain Resilience Questionnaire, Emotional Regulation Difficulty Scale, Five-Dimensional Mindfulness Questionnaire, and Chronic Pain Adaptation Questionnaire. Data were analyzed using Amos - SEM.

The findings of this study indicated that the variables of difficulty in emotional regulation and mindfulness in interaction with the mediating role of resilience were effective in explaining the acceptance of pain in cancer patients. The direct effects of emotional regulation difficulty (-0.57), mindfulness (0.78) and resilience (0.22) on estimating pain acceptance of cancer patients were significant (P <0.05). The indirect effects of emotional regulation difficulty and mindfulness on pain acceptance through resilience were significant (P<0.05). The total direct and indirect effects of the difficulty of emotional regulation and mindfulness on pain acceptance were (β = 0.747 and β = 0.870), respectively, which indicated the significance of the total effect of these two pathways.

Enhancing resilience and mindfulness and reducing the difficulty of emotional regulation can lead to better acceptance of chronic pain in cancer patients.

Transferring a patient from the intensive care unit to the general ward is an anxiety-inducing process that is associated with feelings of insecurity, discomfort, dependency, and increased need. The most important goal of any care program is to satisfy the patient's needs and create a feeling of comfort. The aim of this study was to determine the effect of designed transitional care program on anxiety and general comfort of the patients undergoing coronary artery bypass graft during transfer from open-heart surgery intensive care unit to general ward.

This study was a non-randomized clinical trial with a control group which included 62 patients who were candidates for transfer from the open-heart surgery intensive care unit of Imam Khomeini Hospital in Tehran to the general ward in 2021. The patients were selected by convenient method. The control group received the routine care and were followed up. The experimental group pursued the designed transitional care program in addition to routine care. This program had 4 dimensions: 1-waiting for transfer, 2-support, gradually reducing dependence and increasing independence, 3-communication and strengthening the care triad, and 4-continuity of integrated and need-based care which was implemented by selected and trained nurses in cooperation with the researcher, physician, patients and families for 5-7 days.  Spielberger's anxiety Questionnaires and general comfort scale were completed before the transfer and on the day of the patient's discharge. Using SPSS version 26, the results were analyzed by Fisher's exact, Chi-square, paired and independent t-tests at a significance level of 0.05.

The results showed that the designed transitional care program could significantly reduce anxiety and increase the general comfort of the patients undergoing coronary artery bypass graft (p≤0.000).

Considering the impact of the intervention on the variables under study, use of the designed program as a suitable care program during patient transfer can be suggested.

Recently, nanostructured drug delivery systems have been investigated as delivery systems for chemotherapeutic agents in cancer treatment. The aim of this study was to review nanostructured carriers for targeted drug delivery of chemotherapeutic agents.

Data of this review article were collected by searching PubMed and WOS (Web of Science) using the keywords of cancer, nanomedicine, nanoparticles, liposome and solubility.

Among the various nanostructured drug delivery systems, liposomes, solid lipid nanoparticles (SLNs), nanostructured lipid carriers (NLCs), polymeric nanoparticles, micelles, albumin nanoparticles and drug-polymer conjugates have been used to develop the efficient delivery systems of chemotherapeutics for cancer treatment. Many chemotherapeutic drugs are highly hydrophobic with low aqueous solubility. Furthermore, non-specificity, toxicity and drug resistance are the main drawbacks of cancer treatment with chemotherapeutic drugs. Use of nanostructured delivery systems is the main approach to overcome drug resistance, reduce side effects and improve treatment efficacy. Additionally nanostructures containing two or more drugs for combination therapy of cancer are challenging issues that can increase the treatment efficiency by synergistic effects and decreasing drug resistance.

Although the development of various nanostructured drug delivery systems for chemotherapeutics are under investigation, few number of these systems have been used in clinical studies and entered the pharmaceutical market as approved nanomedicines

Food insecurity and poor quality of diet are among risk factors of cardiovascular diseases (CVD). The main objective of this study was to assess the association of food insecurity with atherogenic glucose and lipid profile in women.

In this cross-sectional study, 630 women between 18 and 50 years of age were selected by cluster sampling and interviewed face-to-face. To assess the household’s food security status, we used a household food insecurity access scale (HFIAS) questionnaire, which its validity and reliability had been determined in the Iranian population. The serum levels of glucose (FBS), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were measured and LDL/HDL, TC/HDL, and TG/HDL ratios were calculated.

The mean serum concentrations of TG and TG/HDL ratio were significantly higher in the women suffering from moderate and severe food insecurity compared to those in the food-secure women (p=0.002). Compared with the food secure group, women with moderate and severe food security were more likely to develop hypertriglyceridemia (adjusted OR, 1.63; p=0.018) and a high TG/HDL ratio (adjusted OR, 1.52; p=0.030). However, food security status showed no significant associations with the probability of having the impaired fasting glucose, hypercholesterolemia, high LDL, low HDL, and abnormal ratios of LDL/HDL and TC/HDL.

Food insecurity may be associated with increased risk of hypertriglyceridemia and high TG/HDL in women.