مجله دانشگاه علوم پزشکی گرگان
سال بیست و پنجم شماره 4 (پیاپی 88، زمستان 1402)

Foot pronation, as one of the prevalent foot abnormalities, can influence the biomechanics of the lower limbs. The use of various foot orthoses, including insoles and braces, is very common in eliminating this problem. The results obtained regarding the effect of orthoses on pain and biomechanics of individuals with foot pronation are different. The present review study was conducted to evaluate the effects of foot orthoses and shoes on the biomechanics of the lower limbs and balance in individuals with foot pronation. The articles were searched in Persian and Latin languages during 2004-22 in the databases of PubMed, Web of Science (WOS), Scopus, Islamic Science Citation (ISC), and Google Scholar search engine. Moreover, the types of the searched studies were original research, review studies, and clinical trials. Using keywords of Foot pronation, Foot orthoses, Medical soles, and Motion-control shoes, 52 relevant articles were selected, and 22 articles regarding the effects of orthoses and shoes on foot pronation were finally analyzed. Eight articles also reported that reducing forces imposed on the joints, absorbing shock, preventing pronation-related running injuries, and improving muscle activity occurred when using orthosis. Furthermore, 4 articles reported improving sports performance in athletes, reducing the ground reaction forces, and changing the frequency of muscle activity. Finally, 2 articles showed that motion-control shoes prevented intensifying the injury due to increased fatigue and subsequently increased mechanical loading during running. The results of the present study demonstrated that foot orthoses and motion-control shoes could have positive effects on balance, improving the activities of the lower limbs and reducing foot pronation and force imposed on the foot and lower limb joints.

Silver nanoparticles are produced in large quantities in the industry and have estrogenic activities and toxic effects on different organs. This study was conducted to determine the effect of silver nanoparticles on the ovarian tissue of NMRI rats treated with alpha lipoic acid.

In this experimental study, 24 female NMRI rats were randomly divided into 4 groups of 6. The groups included the control group, oral silver nanoparticles (500 mg/kg of body weight), injected alpha lipoic acid (100 mg/kg of body weight), and silver nanoparticles (500 mg/kg of body weight) plus alpha lipoic acid (100 mg/kg body weight). The treatment was performed for 28 days. After the treatment period, blood sampling was performed from the rats’ hearts to analyze biochemical parameters (malondialdehyde, estrogen, progesterone, and total antioxidant capacity using the ferric reducing ability of plasma (FRAP) method). By dissecting the rats, the left ovaries were removed, fixed, molded, and cut, tissue passaging was performed, and the ovaries were stained using the hematoxylin-eosin method. Then, the ovarian tissue was evaluated by different stereological methods.

The total mean ovarian volume, the cortex volume, the medulla volume, and the corpus luteum volume, and the total number of primordial, primary, secondary, and Graafian follicles were significantly reduced in the silver nanoparticles group compared to the control group (P<0.05). The simultaneous administration of alpha lipoic acid and silver nanoparticles compensated for the adverse effects of silver nanoparticles on the above parameters. On the other hand, the mean number of different types of follicles in the rats treated with alpha lipoic acid significantly increased compared to the control group (P<0.05). A statistically significant reduction was observed in the measurement of estrogen and progesterone hormones in the serum of the silver nanoparticles group compared to the control group (P<0.05). Moreover, in assessing the antioxidant capacity of the serum of the group treated simultaneously with silver nanoparticles + alpha lipoic acid, a statistically significant increase was observed compared to the group treated with silver nanoparticles (P<0.05).

Silver nanoparticles can have adverse effects on the structure of the ovary and its components, and alpha lipoic acid can largely compensate for these detrimental effects.

The application of different nanoparticles using green synthesis is increasing due to fewer complications. This study was conducted to identify the effect of cobalt ferrite nanoparticles synthesized with sumac extract on changes in biochemical and histological factors in rats.

In this experimental study, 30 five-month-old male Wistar rats with an approximate weight of 250-300 mg/kg of body weight were divided into three groups: The control group (saline receiving), the experimental groups receiving intraperitoneal cobalt ferrite nanoparticles synthesized with sumac extract at a dose of 10 and 20 mg/kg of body weight. Serum and tissue samples (liver, kidney, and spleen) were isolated. Serum concentrations of urea, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and creatinine were determined. The photometric method was used to measure liver enzymes, the calorimetric method without omitting proteins based on the Jaffe method was used to measure creatinine, and the urease-glutamate dehydrogenase (GLDH) method was used to measure urea. Tissue samples were assessed by hematoxylin-eosin staining. Transmission electron microscopy (TEM) and scanning electron microscope (SEM) microscopic studies were used for microscopic investigations.

No statistical significance was observed in blood samples and factors (urea, creatinine, ALT, and AST) in the experimental groups compared to the control group. Similarly, in the morphological investigation, the size of the liver, kidney, and spleen of the groups receiving cobalt ferrite nanoparticles synthesized with sumac extract was normal compared to the control group.

Cobalt ferrite nanoparticles synthesized with sumac had no toxic effect on the rats’ liver, spleen, and kidney tissues.

Considering the increasing use of silver nanoparticles in various products, including industrial and medical products, serious worries have been created regarding the potential dangers of silver nanoparticles. This study was conducted to determine the effect of silver nanoparticles on the kidney tissues of quercetin-treated NMRI rats.

In this experimental study, 24 adult male NMRI rats were randomly divided into 4 groups of 6. The groups included the control group, the silver nanoparticles group (500 mg/kg/bw), the quercetin group (50 mg/kg/bw), and the silver nanoparticles (500 mg/kg/bw) + quercetin (50 mg/kg/bw) group. Silver nanoparticles were fed orally on a daily basis for 35 days. Quercetin was injected intraperitoneally on a daily basis for 42 days. At the end of the study, after taking blood from the rats, the dissection, tissue passaging, and Heidenhain’s Azan staining stages were carried out. The total volumes of the kidney, cortex and medulla, renal corpuscle, and glomerulus were evaluated by a stereological method. A qualitative assessment of apoptotic cells was performed using the tunnel method. The amount of malondialdehyde (MDA) in blood serum was specified as an indicator of lipid peroxidation by the Buege and Aust method.

Comparing the body weight and kidneys, and the total kidney, cortex, and medulla volumes showed no statistically significant difference between the silver nanoparticles group and the control group. The silver nanoparticles group showed a significant increase in the total mean renal corpuscle volume, glomerular volume, tuft volume, Bowman’s capsule membrane volume, and the amount of MDA compared to the control group (P<0.05). Also, a statistically significant reduction was observed in the silver nanoparticles group in the total mean volume of Bowman’s capsule and capillary spaces compared to the control group (P<0.05). Quercetin could reduce the detrimental effects of silver nanoparticles on kidney cells as much as the control group; however, apoptosis was not shown in kidney cells in the group treated with quercetin. Assessing the cells in the silver nanoparticles group indicated the creation of apoptosis. The amount of serum MDA in the silver nanoparticles group showed a statistically significant increase compared to other groups (P<0.05).

The results of this study demonstrated that quercetin could reduce the detrimental effects of silver nanoparticles on kidney cells as much as the control group.

Obesity and overweight, one of which symptoms is chronic inflammation, is associated with changes in tryptophan metabolism, culminating in numerous diseases. Sport training is among the ways to control obesity and overweight. This study was conducted to determine the effect of eight weeks of endurance training on amino acid tryptophan serum levels and body mass of overweight women.

This quasi-experimental study was conducted on 24 overweight women in two groups of 12 people, including the control and experimental groups. The mean age and standard deviation of the control and experimental groups were 41.16±3.45 and 41.08±2.93 years, respectively. The body mass was measured using the anthropometric device, and blood samples were taken in the pre-test and post-test in a 12-hour fasting condition. The subjects of the experimental group underwent endurance training 3 sessions a week for 8 weeks with an intensity of 60% to 75% of the maximal heart rate reserve. Serum tryptophan level was measured by enzyme-linked immunosorbent assay (ELISA) method.

Eight weeks of endurance training led to enhancing serum tryptophan levels, reducing fat mass, and reducing body mass index (BMI) (P<0.05), and also resulted in a statistically insignificant increase in fat-free mass in overweight women.

Eight weeks of endurance training could be effective in improving the physiological status and body composition of overweight women.

The outbreak of coronavirus disease 2019 (COVID-19) has had many psychological impacts on the relatives of patients with COVID-19, which can influence their physical health. This study was conducted to determine Obsessive-Compulsive Disorder (OCD) and its link to the physical health of relatives of patients with COVID-19.

This case-control study was conducted on 98 relatives of patients with COVID-19 (the case group) with a mean age of 38.56±9.09 years and 98 family members without patients (the control group) with a mean age of 35.79±9.88 years referring to health centers in Gorgan, Iran during 2022. The subjects were selected by a simple random sampling method after extracting the list of patients with COVID-19 from the Health Information Software (NAB) system of health centers. For each selected case, according to the list of families in the NAB system, a family confirmed with a lack of COVID-19 infection was selected as the control group using the simple random sampling method. The data collection tools included the Yale-Brown obsessive-compulsive scale (Y-BOCS) and the patient health questionnaire-15 (PHQ-15).

The mean OCD score in the case group (6.46±5.87) was significantly higher than that in the control group (2.04±3.76) (P<0.05). The mean physical health disorder of the case group (7.60±4.32) was significantly higher than that in the control group (3.43±3.98) (P<0.05). A significant direct linear correlation was found between OCD and physical health in both groups (r=0.39, P<0.001).

The levels of OCD and physical health disorders were significantly higher in family members with a COVID-19 patient than in family members without a COVID-19 patient.

Helicobacter pylori infection is a chronic bacterial infection in humans, and its link to epilepsy has been reported in some studies. This study was conducted to compare the frequency of Helicobacter pylori infection in patients with and without epilepsy.

This case-control study was conducted on 234 patients with focal and generalized epilepsy (the case group consisted of 88 males and 146 females) referring to Alavi Hospital in Ardabil, Iran and 234 individuals without epilepsy (the control group consisted of 88 males and 146 females) during 2019. Stool samples were taken from the subjects to assess the Helicobacter pylori stool antigen. Demographic information, including age, gender, place of residence, a history of alcohol, cigarette, hookah, and opium use, and the test result of the Helicobacter pylori stool antigen, were collected in a checklist.

The frequency of Helicobacter pylori infection was determined to be 67.2% in the case group and 71.1% in the control group, and no statistically significant difference was found between the case and control groups. Cigarette and opium use had statistically significant relationships with epilepsy (P<0.05). Moreover, opium users had a 6.92 times higher odds rate (OR) of contracting Helicobacter pylori infection than other individuals (CI 95%=1.05-45, OR=6.92, P<0.04).

No difference was observed in Helicobacter pylori infection between individuals with and without epilepsy.

In recent years, studies have been conducted to determine the prevalence rate of congenital abnormalities in different regions of Iran, most of which were conducted on live births. This study was conducted to determine fetal abnormalities in pregnancies leading to legal abortion in Golestan province.

This descriptive-analytical study was conducted on 199 pregnant women with a gestational age of less than 20 weeks with abortion licenses from the Forensic Medicine Center of Golestan province over 9 months during 2018-19. Demographic characteristics, including parents’ age, ethnicity, and family relationship, and the type of fetal abnormalities were recorded.

Given 29,460 births in Golestan province over a 9-month period, the prevalence of fetal abnormalities was determined to be 6.75 per thousand births. The incidence rates of fetal abnormalities were determined to be 6.78, 6.68, 7.69, and 5.65 per thousand births in native Fars (80 cases), Turkmen (65 cases), Sistani (34 cases), and other (20 cases) ethnic groups, respectively. Since the gender of 80 fetuses was unknown, the incidence rates of abnormality were determined to be 4.36 and 3.72 per thousand births in female (63 cases) and male (56 cases) fetuses, respectively. The most common fetal abnormalities included central nervous system (n=49, 24.62%), chromosomal abnormalities (n=47, 23.61%), and cardiovascular impairments (n=26, 13.06%). The incidence of fetal abnormalities was not found to have a statistically significant relationship with parents' age, ethnicity, and family relationship.

The most prevalent fetal abnormality was related to central nervous system disorders. The incidence of fetal abnormalities had no relationship with the parents’ age, ethnicity, and family relationship.

Coronavirus disease 2019 (COVID-19) can lead to organ failure by the occurrence of mechanisms such as increased thrombosis and, subsequently, increased lactate dehydrogenase (LDH). This study was conducted to determine LDH serum levels in COVID-19 patients and the factors affecting their mortality.

This descriptive-analytical study was conducted on 212 patients (57 males and 155 females) with COVID-19 with a mean age of 49.19±10.6 referring to Imam Ali Hospital in Chabahar, Iran during 2021. After obtaining patients’ informed consent and demographic information, the heparinized peripheral blood sample was taken from them. The LHD levels were determined using an autoanalyzer.

Twenty-nine (13.67%) patients died. The mean LDH serum level of 29 deceased patients (708.420±96.25 U/L) was not statistically significant compared to survivors (640.360±96.80 U/L in 183). The comparison between the surviving and deceased groups showed that 25% of the deceased patients were hospitalized in the intensive care unit (ICU), and 90.90% of the survivors were hospitalized in the internal ward (P<0.05). All the deceased and 85.85% of the survivors were 40 years old and above, and this difference was not statistically significant. Furthermore, 24.56% of the deceased were male, 90.32% of the survivors were female (P<0.05), 22.72% of the deceased had a university education, and 88.69% of the survivors had a diploma or under-diploma education (P<0.05), and 71.42% of the deceased patients had thin, and 91.37% of the survivors were overweight (P<0.05).

There was no difference in the LDH serum levels of the COVID-19 survivors and deceased. The age of 40 years and above, lean and morbidly obese body mass indices, male gender, and the need for hospitalization in the ICU were determined as risk factors.

Sinus extension is a physiological process that occurs in the growth cells of the paranasal sinuses and leads to increasing their volume over time, causing challenges in the dental implant process. This study was conducted to evaluate maxillary sinus morphometrics by cone-beam computed tomography (CBCT).

This descriptive-analytical study was conducted on the CBCT images of 100 people (52 male and 48 female) with a mean age of 45.32 ± 17.41 and the age range of 27 to 63 years referring to an oral and maxillofacial specialized radiology clinic in Babol, Iran during 2019. The amount of maxillary sinus extension in the panoramic-like view was recorded based on the amount of its extension in terms of the first anterior tooth and the last posterior tooth. In the new net technologies (NNT) software, in the section related to creating panoramic-like views, first, in the axial sections, the starting point of the maxillary sinus was specified from the occlusal side, and the mediolateral dimensions were measured at distances of 3 mm above and 3 mm below.

The highest amount of maxillary sinus progress in the right anterior side was related to the mesial of tooth 5 (15%), and the highest amount of sinus progress in the left anterior side was related to the distal of tooth 3 (15%) and the mesial of tooth 4 (15%), which had no statistically significant differences. The most progress in the anterior area was related to the distal of the canine tooth and the mesial of the first premolar. The mean mediolateral sinus progress at 3 mm above the right nasal floor was higher in females than in males (P<0.05). Gender and age had no statistically significant relationship with maxillary sinus progress.

The maxillary sinus progress was almost equal in the left and right sides and also in males and females.

The visual processing disorder is broadly observed among individuals with autism. This study was conducted to develop an integrated rehabilitation program based on vibroacoustics and virtual reality and to assess its effectiveness on the visual processing of autistic children. This experimental case report was conducted using an Aberrant Behavior Checklist (ABC) design on 5 children with autism referred to Zehnara Rehabilitation Clinic in the second half months of 2021. First, the integrated program was implemented for ten 30-minute sessions on 2 subjects randomly selected from among the samples. After determining the program validity, 3 more subjects were entered into the study. The sensory profile questionnaire-2 was used. The questionnaires were filled out at the baseline stage, at the end of each intervention session, and at the one-month follow-up stage. The visual analysis, the percentage of recovery, the percentage of non-overlapping data (PND), and the percentage of overlapping data (POD) were used for data analysis. The implemented intervention was evaluated to be effective for all five subjects so that for Subjects No. 1, 2, 3, 4, and 5, the PND rates were obtained to be 90%, 90%, 70%, 100%, and 90%, respectively. The results of this study demonstrated that the integrated sensory rehabilitation program could be used to improve the visual processing of children with autism.

Unusual chest pain is often observed in older women with diabetes, high blood pressure, and heart disease. Some unusual manifestations of myocardial infarction have so far been reported, including earache, flank pain, fatigue, neck pain, nausea and vomiting, shortness of breath, and shoulder pain. In this article, we report a case of rare symptoms of cardiovascular disease with referral symptoms, including abdominal colic pain. The patient was a 55-year-old man with a history of diabetes under treatment with insulin who had abdominal colic pain, periodic epigastric tenderness, and frequent nausea and vomiting for 2 days. At first, he was suspected of pancreatitis, but considering that his amylase and lipase enzymes were normal and no evidence of the existence of free abdominal and pelvic fluid was observed according to ultrasound results, the hypothesis of pancreatitis was rejected. Despite the normality of the initial ECG until the night before the visit by the cardiologist, the patient experienced more severe pain and, as a result, was referred to the cardiac internal ward until the end of the same night, after angiography, it was found that the obtuse marginal (OM1) branch of coronary arteries had severe narrowing (90-99%). Abdominal tenderness and colic pain are among the unusual manifestations of myocardial infarction. In patients with cardiac risk factors, such as diabetes and chronic kidney disease, despite the existence of a normal ECG, uncommon manifestations should be checked.