مجله دانشگاه علوم پزشکی اردبیل
پیاپی 71 (بهار 1398)

Nuclear Factor kappa B (NF-κB), a master switch transcription factor, plays a critical role in the progression and development of hyperglycemia-induced microangiopathy. Hyperglycemia activates NF-κB, and subsequently increases pro-inflammatory cytokines such as TNF-α, IL-6 and IL-1β leading to development of inflammation. Some new studies have revealed the involvement of microRNA-146a (miR-146a) in the pathogenesis of diabetic complications through an NF-κB-dependent negative feedback loop manner. Despite numerous reports indicating changes of plasma miR-146a during hyperglycemia, the origin of this change remains unclear. This study was designed to evaluate the role of NF-κB on the miR-146a gene expression level in human umbilical vein endothelial cells (HUVECs) during a hyperglycemic condition. HUVECs were cultured in normal glucose (5 mmol/L), and hyperglycemic (25 mmol/L) endothelial cell growth medium in the six well plates for 24 h. JSH-23 (30 μmol/L), as an inhibitor of NF-κB translocation to the nucleus, was added to the culture medium, 30 min before induction of hyperglycemia. Quantitative Real Time PCR was performed to measure the expression levels of miR-146a and mRNA NF-κB. NF-κB activity was measured by Elisa. Hyperglycemia markedly increased the NF-κB activity and mRNA level in HUVECs. The expression of miR-146a significantly increased in hyperglycemic group compared to the normoglycemic group. On the other hand, JSH-23 prevented from miR-146a increment in hyperglycemic group and also it increased the mRNA expression level of NF-κB in this group. This result shows that NF-κB increases the gene expression of miRNA-146a in the early phase of hyperglycemia in HUVECs.

  with Regard to the increasing prevalence of nonalcoholic fatty liver disease (NAFLD), focusing on various strategies for its prevention and management seem necessary. The purpose of this study was to investigate the effect of running on treadmill and low calorie diet on visfatin and hs-CRP values in people with NAFLD. In this quasi-experimental Study, 55 NAFLD patients were selected and randomly assigned to one of four groups: training (n=14), diet (n=14), training plus diet (n=14) and control (n=13). The training program included eight weeks running on a treadmill with maximum heart rate intensity of 55-75% for 45 minutes three times a week. A low calorie diet with an energy deficit of 500 calories of daily energy intake was calculated from 3-day food records of the patients. Combined group subjects also used both types of intervention. Data were analyzed using covariance analysis and Bonferron's post hoc test at a significance level of p<0.05. Visfatin values in the training group (p=0.01), in the combined group (p=0.001) and also hs-CRP values in the training group (p=0.003) and the combined group (p=0.008) decreased significantly. The body mass index of subjects was significantly decreased by training (p=0.003) and combined intervention (p=0.001). Running on treadmill and a low calorie diet simultaneously reduce the plasma levels of visfatin and hs-CRP in male patients with NAFLD. Therefore, these therapeutic interventions are beneficial in reducing NAFLD inflammatory factors.

In recent years, Acinetobacter baumannii has been shown to be associated with several nosocomial infections, including pneumonia, bacteraemia, urinary tract infections, wound infection and meningitis. This organism can survive in the hospital environment and rapidly develops resistance to many antibiotics. The molecular genotyping can increase our knowledge about the spread of A. baumannii strains from one hospital to another and their drug resistance. Therefore, this study aimed to determine the prevalence of antibiotic resistance profile as well as phylogenetic relationships of A. baumannii strains in Shahrekord teaching hospitals. In this study, antibacterial susceptibility patterns of A. baumannii strains isolated from different clinical specimens (urine, blood, sputum) to amikacin, ampicillin/sulbactam, aztreonam, cefepime, ceftazidime, ciprofloxacin, gentamycin, imipenem, meropenem, norfloxacin, ofloxacin, piperacillin/tazobactam, tobramycin were tested using disk diffusion )Kirby-Bauer( method. Finally, genotyping of A. baumannii strains was performed using REP-PCR method. During this study, 50 samples of patients were identified as A. baumannii) 71%(, and their drug resistance rates were assessed. All A. baumannii strains were resistant to ceftazidime and cefepime and also a high rate of resistance to aztreonam, norfloxacin, ciprofloxacin, amikacin, imipenem, gentamycin, and ampicillin-sulbactam were observed. On the other hand, our results demonstrated nine genotype groups among A. baumannii strains based on REP-PCR method. Due to the high prevalence of antibiotic resistance among isolated A. baumannii strains, similarities between different genotypes and the dispersion of these genotypes in different parts of Shahrekord hospitals, the implementation of infection control programs in different parts of the hospital is necessary.

Chronic obstructive pulmonary disease (COPD) is characterized by irreversible airflow limitation and systemic inflammation which is also associated with pulmonary and extra-pulmonary complications. COPD Diagnostic Questionnaire (CDQ) is a valid questionnaire that is used to identify patients with COPD. The purpose of this study was to determine the relationship between the severity of airflow limitation and the CDQ score in COPD patients. In this study, 100 patients with COPD and smoking history were included. The diagnosis of COPD was established based on American Thoracic Society (ATS) guidelines: cough and expulsion of phlegm, chronic dyspnea, obstructive spirometric pattern (forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) <70%). Disease severity was classified according to GOLD criteria. After obtaining consent, demographic data, history of smoking, the exacerbation rate in the past year, arterial oxygen saturation (Spo2) and spirometer variables were recorded. Then, CDQ and Modified Medical Research Council (MMRC) dyspnea score were completed. Also, the associations of the CDQ score with FEV1% predicted and clinical parameters of patients were tested. All studied patients were male. There was a significant relationship between CDQ score with FEV1% (p<0.001), GOLD stage (p<0.01), Spo2 (p<0.01), exacerbation rate (p<0.01) and severity of dyspnea according to MMRC dyspnea scale (p<0.01). The CDQ can be used to determine airflow limitation, severity of dyspnea and exacerbation rate in COPD patients. Therefore, it is recommended that this questionnaire can be used in primary health centers for identifying and referring of COPD patients.

Chronic Obstructive Pulmonary Disease (COPD) is accompanied by systemic inflammations and is characterized by irreversible airflow limitations. Leptin is a cytokine with pre-inflammatory effect. However, there have been no studies on the effect of conjugated linoleic acid (CLA) on the serum leptin concentration in COPD patients. Therefore, the present study aimed to explore the effect of CLA on the serum leptin level, lung function and quality of life in COPD patients. This interventional study was conducted on 90 COPD patients. The patients were randomly divided into two groups (supplement and placebo) with 45 patients per group. After obtaining written consent from the patients and recording their demographic characteristics, the spirometry was performed and COPD assessment test (CAT) score was calculated. Moreover, a fasting blood sample was collected from each of them in order to analyze their serum leptin concentration. After that, the patients in the supplement group were administered with 3.2 g/day of CLA for 6 weeks. The patients in another group received placebo. After the intervention, spirometry, CAT score calculation and blood sampling were repeated for all of the patients and the obtained results were analyzed. after the intervention, a significant decrease both in the serum leptin level and in CAT score as a quality life marker  was observed in the supplement group (p<0.05). Moreover, the FEV1 levels as a lung function test, increased significantly in the supplement group after the intervention (p<0.05). Although, the difference between the two groups was not significant. The use of CLA supplement can improve COPD patients’ quality of life through decreasing the serum level of leptin in their blood.

Pentavalent antimonials are the first-line drugs for treatment of leishmaniasis, which have multiple side effects such as drug toxicity. Moreover, parasite resistance to these drugs is rising around the world. Second-line drugs, including Amphotericin B and pantamidine have also side effects and expensive for patients. According to the cytotoxic effects of paraquat, this study was conducted to evaluate the effect of paraquat on Leishmania major promastigotes and HUVECs viability. A number of 2.5×106 of Leishmania major promastigotes were treated in each well of 96 well plates with different concentrations of paraquat. Cells were incubated for 48 hours in 24 °C. MTT test was performed for evaluating paraquat impact on promastigotes. The absorbance was measured using a microplate reader at 570 nm.  The trypan blue staining assay was performed to evaluate the number of viable Leishmania major promastigotes following paraquat treatment. Furthermore, the effect of paraquat concentrations on HUVECs viability was evaluated under the cell culture condition. The results of the MTT test showed that increasing concentrations of paraquat could significantly reduce the viability and the number of Leishmania major promastigotes in comparison to control group (p<0.05). In this study, the IC50 for Leishmania major promastigotes was calculated as 272.46 µg/ml. Trypan blue results were in line with the finding of MTT assay. Moreover, we found that HUVECs were susceptible to paraquat (IC50=188.99 µg/ml). Paraquat has a strong inhibitory effect on Leishmania major promastigotes and human endothelial cells. Although more comprehensive studies on the effects of the topical use of paraquat on Leishmania major lesions in animal model and its side effects are necessary.

Chronic illnesses are one of the most important causes of mortality. The purpose of this study was to investigate the relationship between perfectionism and stress with life satisfaction in cardiovascular patients. The research method is descriptive correlational. The statistical population of this study included patients who came to receive the services in Ardabil in the first half of 1396. The sample consisted of 60 cardiovascular patients who were selected by simple random sampling. Data was collected using questionnaires of perfectionism scale, stress scale and life satisfaction scale. Data were analyzed by descriptive statistics and multiple regression analysis using spss-19 software. The results showed that there is a significant negative relationship between perfectionism and life satisfaction. Also, there was a significant negative relationship between stress and life Satisfaction (p<0.01). In other words, with increasing stress, life satisfaction decreases. There is a multiplicity relationship between perfectionism and stress with life satisfaction (p<0.01). The results of this study showed that reducing the perfectionism and stress of individuals helps to increase the satisfaction of people from life and also effective in the process of treatment.

Background & objectives: Chlamydia trachomatis is a gram negative bacterium and chlamydia infection, as a curable infection, is one of the most common sexually transmitted diseases (STD). With regard to the essential role of chlamydia in infertility, the study of the prevalence of asymptomatic cases is precious. The aim of this study was to determine of the prevalence of chlamydia trachomatis in endocervical samples in infertile women with PCR method. In this cross sectional descriptive-analytical study, a total of 135 women between 20-40 years old with chief complaint of infertility that referred to Alzahra-Rasht hospital and private clinics were randomly selected. The endocervical specimen was prepared using a sterile swab and was transferred to the laboratory in PBS for performing PCR. . The results of PCR and collected data from checklists were statistically analyzed using SPSS16. Chlamydia trachomatis was detected in 19.3% of infertile women. There were no statistically significant differences between PCR results and the patient's age, type of infertility, obstruction in salpingography, family history and duration of infertility. The results of this study revealed that chlamydia infection has a high prevalence and in order to reduce the complications of this disease, screening tests can be used as a part of the country's health programs.

Background & objectives: This study was conducted to compare the basic psychological needs and different levels of Theory of mind between mothers of oppositional defiant disorder and hyperactivity / attention deficit disorder children The statistical population of the study included all mothers of childern with oppositional defiant disorder and hyperactivity/attention deficit disorder in psychiatric clinics of Fatemi hospital of Ardabil in 1396-1397. These mothers were randomly assigned in to two groups (35 people in group ODD & 35 people in group ADHD). The instruments used in this study were: Theory of mind, basic psychological needs and Children's Symptoms Questionnaire (CSI-4 Parent Form). The collected data were entered into SPSS-21 software and analyzed by data analysis method. Multivariate variance (MANOVA) was used. The results of the analysis of variance finding show that is no significant difference between mental theory (p>0.407, F=0.697) of basic psychological needs such as competency (p>0.336, F=0.393) self-determination (p>0.597, F=0.283) and communication (p>03.387, F=0.760) between two groups of mothers of children with oppositional defiant disorder and hyperactivity disorder/attention deficit. These results show that the importance of paying attention to the basic psychological needs and the theory of the minds of mothers of these children in improving the educational status of social communication and emotional assessments and cognitive development of the child.

Background & Nowadays, bacterial resistance and the increase in the therapeutic costs are considered as the most important global concerns of medical care system regarding complicated infections. Imipenem is a member of the carbapenem class of beta-lactam antibiotics prescribed mostly in our hospitals because of its broad activity against bacterial infections. Drug Utilization Evaluation (DUE) process is an official, ongoing and systemic program that collects information in order to identify and improve the adverse effect of drugs and the cost of medicalization. The objective of this study was to evaluate the administration and use of imipenem in the educational Imam Khomeini hospital in Ardabil in 2018. In this prospective, descriptive, cross- sectional study, 110 hospitalized patients, who received imipenem from September to December of 2018, were included in this study. Patient's demographic data, dosing, dosage adjustment in renal failure and other co-prescribed antimicrobial drugs were extracted from current medical file of hospitalized patients and evaluated with medical guidelines. 64% of patients received imipenem in the first day of hospitalization and 75.5% of patients were empirically received imipenem while antibiogram test was ordered for only 24.5% of patients. Serum creatinine were ordered for most of the patients, but correct dose regimens for patients who get non-empiric antibiotic therapy were only 25.5%. High rate of empiric prescription without considering the result of antibiogram test and immediate initiation of antimicrobial therapy at the time of admission were the most important aspects of irrational use of imipenem observed in this study. Paying more attention to sampling, culturing and sensitivity test and prescription of imipenem based on specific guidelines are recommended.

MEFV gene has a major role in Familial Mediterranean Fever (FMF) as an auto-inflammatory disorder. FMF is most often seen in the people of the Mediterranean area. Considering the significant role of the MEFV gene in many rheumatologic diseases and even non-rheumatologic disorders, it is necessary to identify different variations of these mutations in the healthy and normal population of this area. 224 healthy people entered into this study. The blood samples were screened for the 12 most common MEFV gene variants according to manufacturer’s instructions. (FMF Strip Assay, Vienna lab, Vienna, Austria)
They filled a questionnaire containing the required information. All patients were initially evaluated for the FMF symptoms and signs in themselves and their first-degree relatives based on clinical criteria. Chi-squared test and t-test were employed for statistical analysis using SPSS ver.24. Among 224 cases, 113 cases (50.4%) were male, and 111 cases (49.6%) were female. MEFV mutations were detected in 57 patients (25%) of them, 28 cases were male (49.1%) and 29 cases were female (50.9%). The most frequent mutations were E148Q (18.3%, 41cases), followed by P369S (3.1%, 7 cases), V726A (2.2%, 5cases), A744S (1.3%, 3cases), F479L, M694V and R761H (0.8%, each 2 cases), and eventually K695R (0.4%) respectively. Some mutations such as M694I, M680I (G/C), M680I (G/A), I692del were not seen in these samples. There were compound heterozygous mutations of E148Q/P369S, E148Q/V726A, E148Q/P369S, and P369S / F479L in normal population without any findings in favor of FMF. Twenty-five percent of the normal population of the northwest of Iran carrying a heterozygous variant of the MEFV gene, E148Q (18.3%) as a most common mutation, which can be considered as a normal variant in the healthy population. The presence of M694I, M680I (G/C), M680I (G/A) and I692del mutations in the normal population can be interpreted with cautiously, while particular compound heterozygous mutations can be considered as normal variants.