Journal of Advances in Medical and Biomedical Research
Volume:20 Issue: 83, 2013

Dietary carbohydrate restriction is one of the most effective approaches in the management of metabolic syndrome. However، there is little information available on the role of inflammatory processes.

In a randomized cross-over clinical trial، thirty overweight or obese (BMI>25 kg/m2) women with metabolic syndrome were randomly allocated into two groups، to follow either a high-carbohydrate (HC) (60-65% carbohydrates، 20-25% fats) or a moderately-restricted carbohydrate (MRC) (43-47% carbohydrate، 36-40% fats) diet for 6 weeks. After a 2-week washout period، individuals were switched to the alternate diet for an additional 6 week period. At the beginning and the bend of each period، markers of inflammation (hs-CRP، hs IL-6، hs TNF-α and SAA)، endothelial function (E-selectin، sICAM-1 and sVCAM-1)، and adipocytokines (leptin and adiponectin) were measured in both study groups at baselines (i. e.، fasting state).

Consumption of the HC diet was associated with increased levels of SAA (3. 27 ±1. 22 μg/ml)، while consumption of MRC diet did not result in such unfavorable effects (P=0. 04). Serum concentrations of leptin and adiponectin were reduced by the HC diet (P<0. 02)، but these changes were not significant between the two diets (P>0. 05). Serum concentrations of hs-CRP، hs TNF-α and IL-6 were not influenced by either diet. There were also no significant differences observed between the two diets in terms of their effects on serum sICAM-1، sVCAM-1، and E-selectin concentrations.

Short-term substitution of dietary carbohydrates by unsaturated fats seems to have no significant effects on serum levels of adipocytokines، biomarkers of inflammation، and endothelial function except for SAA.

Insulin resistance is one of the key components of metabolic syndrome and a major risk factor for diabetes and cardio-vascular diseases، especially among obese people. The aim of this study was to evaluate the effects of L-carnitine supplementation either with or without moderate aerobic training on insulin resistance and anthropometric indices in obese women. In this clinical trial، 44 obese women (BMI≥30 kg/m2) were randomly assigned into 4 groups (n=11 each) as follows: 1، L-carnitine supplementation (2 g/day) (group CAR); 2، aerobic training + placebo (group EXR+PLA); 3، L-carnitine supplementation + aerobic training (group CAR+EXR); and 4، placebo alone (group PLA). The intervention periods were eight-week long، and the subjects of aerobic training groups went through 3 training sessions a week. The weight، waist and hip circumferences، waist to hip ratios، body mass indeces، daily dietary intakes and serum fasting free L-carnitine levels، glucose and insulin levels، and HOMA-IR were measured before and after the interventions. Significant decreases in the waist and hip circumferences were observed in the EXR+PLA and CAR+EXR groups. The serum glucose fasting levels، as well as insulin and HOMA-IR (homeostasis model assessment-estimated insulin resistance) values decreased significantly in the CAR، EXR+PLA، and CAR+EXR groups. The results indicate beneficial effect of aerobic training on insulin resistance and anthropometric measurements including waist and hip circumferences in comparison with L-carnitine alone supplementation. L-carnitine decreased the insulin resistance and was more effective along with aerobic training for improvement of insulin resistance. The aerobic training could be considered as an effective way of weight loss and insulin resistance improvement.

Spinal cord injury (SCI) has a high incidence rate in the world. However، until recently، there has been no reliable treatment available for its sensory and motor complications. Utilization of stem cells has opened new insights for treatment of SCI. Hair follicle stem cells (HFSCs) are multipotent، have high proliferative potential، and easily accessible. Here، we isolated HFSCs and transplanted them to Rats with spinal cord injury by compression model. HFSCs were isolated from the bulge area of Wistar rat whisker follicles. The SCI model was induced in 14 rats، and cultivated HFSCs were transplanted to the spinal cord lesion sites. Functional recovery was assessed by Basso–Beattie–Bresnahan (BBB) scale and muscular activity changes were evaluated with electromyography (EMG) 8 weeks following the transplantation. Behavioral assessments with BBB test showed that scores in transplanted animals were higher than the control group. Functional recovery in the transplanted group were better eight weeks after transplantation (p=0. 023) and BBB scores were 15. 64 ±0. 32 compared to 12. 8 ±0. 45 in the sham group. Moreover، the signal amplitude of the needle EMG records of the lower extremity muscles increased in transplanted rats. Our results show that transplantation of HFSCs to the site of SCI could be useful for repair and replacement of degenerated neuronal and glial cells.

Streptococcal pharyngitis is one of the most common bacterial infections that its improper treatment could lead to complications such as heart and kidney problems. Although streptococcal pharyngitis makes up a low percentage of pharyngitis etiology، penicillin derivatives are prescribed for many of the patients with pharyngitis. The aim of this study was to determine the prevalence of streptococcal infection in pharyngitis patients treated with penicillin derivatives as well as their drug resistance patterns. This cross-sectional trial was performed on 437 patients aged between 1-90 years with pharyngitis admitted to the emergency ward and treated with penicillin derivatives. A throat swab for culture and smear preparation for group A beta hemolytic streptococus was done for each patient، followed by evaluation of antibiotic resistance to group A hemolytic streptococci. From a total of 437 patients diagnosed with streptoccocal pharyngitis، only 31 patients (7. 09%) turned up positive for group A beta hemolytic streptococci. Drug resistancy to Erythromycin 38. 2%، Gentamicin 58. 8% and Penicillin 2. 9% were reported. Considering the fact that 7. 09% of the patients required antibiotic therapy، the irrational consumption of antibiotics likely leads to an increased likelihood of drug resistance or allergy. This issue deserves special attention in the continuing educational programs for physicians.

Glucose Challenge Test (GCT) is done for pregnant women during the week 24-28 of gestation to screen gestational diabetes. In patients with abnormal GCT، a glucose tolerance test (GTT) is performed، and if GTT is impaired، the patient is diagnosed with gestational diabetes. There is some evidence suggesting that abnormal GCT alone is associated with adverse pregnancy outcomes. The aim of this study was to determine the pregnancy outcomes in patients with abnormal GCTs but normal GTT scores. In this cohort study، GCT was carried out on 190 pregnant women during the 24th to 28th weeks of gestation. Ninety-five pregnant women with abnormal GCT and normal GTT (study group) and 95 cases with normal GCT (control group) scores entered the study and were compared regarding adverse pregnancy outcomes. The average birth weight in the study and control groups were3397±524gr and 3234±384 gr respectively (P=0. 015). Fourteen neonates (14. 7%) in the study group and 4 (4. 2%) in the control group had macrosomia (P=0. 013). Frequency of preterm labor was 8 (8. 4%) in the cases and 1 (1%) in the controls (P=0. 03). Frequency of preeclampsia was 8 (8. 4%) in the cases and 1 (1%) in the controls (P=0. 03). There was positive family history of diabetes mellitus in 20 (21%) of the cases and 1 (1%) in the controls (P<0. 001). Mean BMI changes was 5+1. 7 in the study group and 4. 3+4. 3 in the controls (P<0. 004). The prevalence of macrosomia، preterm labor، preeclampsia، family history of diabetes، increasing maternal BMI، and average birth weight were all higher in the pregnant women with abnormal GCT. Thus، due to the high incidence of some unfavorable outcomes، careful follow up women with abnormal GCT but normal GTT appears necessary during pregnancy.

Patients with lower back pain prefer to get treated by noninvasive techniques. The goal of this study was to examine the impact of foot reflexology on reducing lower back pain caused by discopathy. This semi-empirical study was conducted on 30 men suffering from back pain diagnosed with discopathy with a mean age of 30 ±5 years and BMI scores of 18-25. The subjects were randomly divided into two groups of 15 and classified as test and control. The pain intensity was measured both prior to and after the procedure using VAS. The reflexology protocol during fifteen 30-minute sessions (one every other day for a month) was performed on the test subjects. During this period، the control group received no treatment. Data was analyzed by descriptive and inferential statistics، especially paired t-test، using the SPSS software. Our findings show a significant effectiveness of foot reflexology on the reduction of lower back pain in discopathy (P< 0. 05) and also indicate a significant difference between the mean pain intensities between the test and control groups before and after the procedure (P< 0. 05). Foot reflexology appears to be an effective technique for reducing the lower back pain caused by discopathy.

Immobility has unfavorable effects on our body physiology، including the respiratory system. The aim of this study was to investigate the effect of physical training course on pulmonary function during the course of one semester، using respiratory function indices by the spirometric test in female students at Zanjan University of Medical Sciences (ZUMS). This study was conducted on 141 ZUMS female students who had entered the university and took the first physical training course in September 2009. All participants underwent a systematic exercise training program during the full course of the semester. In the last session of the physical training course and prior to any physical activity، the spirometric test based on FEF25-75%، FEV1/FVC، FVC، PEFR، and FEV1 indices was carried out three times per capita in the same manner as it was done at beginning of the semester. Finally، the spirometric test results of the beginning and end periods were compared by paired t-test. Passing a course of physical training led to a significant increase in all of the pulmonary function indices (P<0. 0001). The maximum and minimum mean differences among indices were attributed to PEF/PPEF and FEV1/FCV، respectively. Considering the prolonged periods of immobility due to intensive study for the university entrance exam، a course of physical training had a remarkably positive impact on the outcome of pulmonary function in female students of ZUMS.

The survival rate of newborns not only depends on birth weight and gestational age، but also on other factors including physiological conditions and especially disease severity during the first hours of life. This study was designed to assess different variables and particularly the score for Neonatal Acute Physiology-II (SNAP-II)، and their impact on the fate of the admitted neonates at the neonatal intensive care unit of Imam Reza Hospital in Kermanshah province of Iran. This descriptive analytical study was conducted on all newborns admitted to the Imam Reza Hospital NICU between October 2009 and March 2010. Demographic data، APGAR scores at minutes 1 and 5، referral center، previous hospitalization history، and the initial and final diagnosis were evaluated and recorded for each neonate. The SNAP-II scores، based on collected data within the first 12 hours of admission، were also calculated. All neonates were followed up until discharge or death. Data were analyzed by chi-square and independent t-test. A total of 287 newborns were entered into the study. The neonatal mortality rate was 13. 6% (39 neonates). There were significant correlations between the mortality rate and birth weight (P<0. 0001)، gestational age (P<0. 003)، APGAR scores in minutes 1 and 5، and SNAP-II score higher than 40 (P<0. 0001). There were no statistically significant differences found between the mortality rate، sex، referral center، and previous hospitalization history. It seems that an SNAP-II score of more than 40 and the mean birth weight have the highest diagnostic value in predicting the mortality rate for the neonates. The APGAR scores in the first and fifth minutes of birth، and also the gestational age could be used as additional useful predictors for the mortality rate in neonates.

Diabetes mellitus is a complicated metabolic disorder that can impair both spatial learning and memory. The aim of this study was to evaluate the effect of zinc and melatonin supplements on spatial learning and memory in diabetic rats.

This experimental study was carried out on 5 groups of male Wistar rats (n=10 for each): the control animals (C); diabetic adult rats with a normal diet (D); diabetic animals receiving 227 mg/l zinc in their water (D+Z); diabetic rats receiving 150 mg/l melatonin in their water (D+M); and diabetic rats receiving both supplements (D+ZM). Supplementation was started 5 days before induction of diabetes with streptozocin (60 mg/kg، single dose). Twenty days later، the spatial learning was evaluated by Morris water maze (MWM) for 5 consecutive days (4 trials per day). The spatial memory retrieval was estimated on the last day. The serum levels of glucose and insulin were also measured.

Diabetic rats spent more time and traveled more distance to find the hidden platform than the controls in the learning stage (P<0. 0001). They also spent less time (P=0. 004) and passed a shorter distance in the target quadrant over the probe trial. Supplementation with zinc and melatonin inhibits the spatial learning and memory impairment in diabetic animals.

Zinc and melatonin Supplementation seem to reverse the induced impaired spatial learning and memory in diabetic rats.

Esophageal variceal bleeding is associated with a high mortality rate and expensive hospitalization costs. By diagnosing predicting factors of rebleeding at admission، and proper course of action، we can minimize the rates of mortality rebleeding. The aim of this study was to determine the predicting factors of rebleeding in patients hospitalized because of variceal hemorrhage by Child Turcotte Pugh Classification. In this case-control study، 100 patients with variceal bleeding، whom were admitted to the Tabriz Imam Khomeini Hospital from June 2007 to May 2008، were recruited. The demographic characteristics including age، gender، etiology، CTP classification، and also various clinical، laboratory، and endoscopic data were recorded for each patient. Patients were divided into case and control groups (with or without variceal bleeding) and predictive factors of rebleeding were determined. A total of 68 patients with mean age of 49. 88±16. 42 were in non-bleeding and 32 patients with mean age of 54. 2 ±19. 8 were in rebleeding groups، respectively. The size of varices (P=0. 046)، encephalopathy (P<0. 05)، ascites (P<0. 005)، and CTP classification (P<0. 0001) had predictive effects on rebleeding. Overall، 12 were CTP class A، 59 CTP class B، and 29 CTP class C. The level of sensitivity to CTP and bilirubin with the aid of ROC evaluation was found to be higher than 85% and 62%، respectively. Determination of the CTP class and grade at admission، in patients with variceal bleeding can provide useful prognostic information. In this study، patients with CTP class B were strongly susceptible to rebleeding. The risk of rebleeding increases significantly in patients with higher levels of bilirubin، or severe ascites or encephalopathy، and they require prophylactic measures.

Acinetobacter baumannii is an important human pathogen that has been a focus of attention in recent years. These bacteria are a leading cause of therapeutic resistant nosocomial infections especially in burned or hospitalized patients in intensive care Units. The aim of this study was to isolate the Acinetobacter baumannii species from the wounds of burned patients and to determine antimicrobial resistance pattern of these bacteria for selection of appropriate antibiotics. Samples were collected from patients and transferred to the laboratory under standard conditions. Bacteria were isolated and purified by conventional culture methods. Identification of bacterial species was performed by standard biochemical tests. The isolates that were identified as Acinetobacter baumannii were subsequently tested for antibiotic resistance by the disk diffusion agar method for 17 different antibiotics. The tests were carried out on Muller Hinton agar (MHA) plates and incubated at 35˚C for 18 hrs. The minimum inhibition concentrations were determined for 5 common therapeutic antibiotics. Out of the 65 clinical Acinetobacter baumannii isolates collected، 61 (94%) were multi drug resistant (MDR). Ceftazidime and aztronam (98%) were the most effective antibiotics against Acinetobacter baumannii. To determine the MIC، the highest levels of antibiotic resistance were seen against ceftazidime، cefepime، and ciprofloxacin. Our results confirm the high prevalence of Acinetobacter baumannii resistant isolates and the ensuing therapeutic problems in Iran. Determination of the resistance patterns of these bacteria according to MIC is necessary، and it can be especially helpful in treatment of burned patients.

Axillary artery، the continuation of the Subclavian artery، initiates at the lateral border of the first rib and normally ends at the lower border of teres major، where it obtains the name of brachial artery. Variations in the branching pattern of the axillary artery are common. During a routine dissection of a 25-30-year-old man cadaver، based on the classic Grant’s method، in the Department of Anatomy at Zanjan University of Medical Sciences، we observed an unusual branching in the second part of the left axillary artery. In spite of the existence of thoracoacromial trunk، the second part of the axillary artery had a common trunk for lateral thoracic and thoracodorsal arteries. The thoracodorsal artery accompanying the thoracodorsal vein and nerve entered lattissimus dorsi muscle. The axillary artery has the highest rate of rupture and damage after the popliteal artery، and it can get damaged in an attempt to either reduce old shoulder dislocations or remove axillary lymph nodes. Therefore، a full awareness of the axillary artery variations could prove very useful and essential for medical specialists، especially vascular surgeons، orthopedic surgeons، radiologists، and anatomists.