نشریه پژوهش در پزشکی
سال چهل و سوم شماره 4 (پیاپی 172، زمستان 1398)

The cause of pain when using a tourniquet is not yet verified. If there is an acknowledgment of the role of ischemia in this connection, it can be suggested by the intervention of oxygen supply that the pain be reduced. The purpose of this study was to investigate the effect of oxygenation on the amount of pain when using the tourniquet for patients with hand surgery in an achademic hospital between the beginning of 1394 and the end of 1395.

This study was a double-blind, randomized, controlled trial of patient with hand truma. Participants received either 50% inhaled oxygen or air placebo via a face mask for 3 minutes before and up to 30 minutes after upper arm tourniquet inflation to 250 mmHg. Pain scores were recorded at 2-minute intervals using a validated 100-mm visual analogue scale. Data analysis was performed using SPSS software.

385 participants enrolled and, after exclusion criteria were applied, 200 were analyzed (oxygen, n = 100; air, n = 100). On average, at all points in the intervention, oxygen decreased the relative number of pain in the oxygen group compared to the placebo group to 10 mm difference in the pain visual analogue scale. Oxygen also significantly extended the time to reach visual analogue scale score of 40 mm (p=0.008).

It seems that Oxygen is a readily available, low-risk, low-cost treatment that significantly reduced tourniquet-associated pain in this study and significantly increased the time taken to reach visual analogue scale score of 40 or more. The authors recommend oxygen to facilitate hand surgery under a tourniquet.

In order to accurately deliver a prescribed dose to the treatment target volume, electronic portal images are widely used. However, the use of megavoltage beam leads to low tissue contrast. The inherently poor quality of portal images makes it difficult to interpret them. In this regard, a wavelet-based processing is performed to improve their visual quality. 

In the present experimental study, 150 pelvis portal images of 30 patients were obtained. To prepare the images for implementation of the enhancement algorithm, the pre-processing was performed in terms of noise reduction and intensity adjustment. Then, the local details enhancement and sharpening the bone edges were done on the approximation and detail subbands of the wavelet decomposition. Afterwards, in the case of non-periodic pattern and non-uniform background in the noisy images, two quality measures of images, including Edge Content (EC) and Measure of Enhancement (EME), were evaluated. Finally, the given results were analyzed using the statistical paired t-test.

The higher values of these two measures proved the superior quality of processed images relative to the original one (ECoriginal=0.0046±0.008, ECenhanced=0.0790±0.001, and EMEoriginal=0.3950±0.180, EMEenhanced=13.875±1.227).

A wavelet-based enhancement algorithm for portal image enhancement can be an effective approach to reveal more anatomical information, which results in more precise setup verification. In future studies, the evaluation of this algorithm is recommended for the enhancement of the other organs portal images.

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Considering the importance of core muscles hypertrophy and possible effects of core strengthening cycles in Cyclic Yoga, the aim of the present study was to investigate the effect of 20 weeks of Cyclic Yoga selected exercises on core muscles hypertrophy in adult women. The study was conducted in 1396 at international institute of Yoga Payam Mehr.

In the present semi-experimental study, 24 female participants were assigned as yoga group with at least 3 months of experience of yoga practice (N=15; 34.66± 6.68 y) and control group (N=9; 34.66 ± 5.09 y). Initially, an ultrasound sonography device was used to evaluate muscles thickness including Erector spine, Psoas and abdominal including Rectus, Transversus, Internal oblique, and External oblique. The Yoga group spent 20 weeks of selected Cyclic Yoga exercises, three times per week, one hour per session, and the control group did not have regular exercise during this period. At the end of 20 weeks of treatmnet, muscle thickness was recorded again using ultrasound sonography. Then, the percentage of the post-test changes, compared to the pretest changes within group and between group, was calculated and data were analyzed using independent t-test and Paired t-test, respectively. 

The thickness of the abdominal muscles were increased significantly for Rectus (19.1%), Transversus (16.8%), Internal oblique (9/9%), external oblique (15/2%) and Psoas (9.3%), and Erector Spine Muscles (5/1%) in Yoga group compared with those of the control group. (P<0.001)

It seems that two core strengthening Cyclic Yoga style cycles have positive effects on hypertrophy of these groups of muscles.

Infertility is an active disability. Male factors account for 50% of infertility cases. Disruption of sperm function and damage to spermatogenesis are among of the most common causes of male infertility. Anatomical trauma or anatomical defects in the reproductive system and the use of drugs to treat diseases can disrupt the production of sperm and infertility in men. The purpose of the present study was to evaluate the effect of diazepam on fertility in men.

A total of 30 male Wistar rats, weighing 200-250 g, were selected and randomly divided into 5 groups of 6: control and treatment groups with injectable doses of 2 mg/kg, 3 mg/kg, 4 mg/kg, and 1 mg/kg5, and the injections were proportional to the weight of the rats, in the amount of 0.18 ml / 0, 1.0 ml / ml, 0.16 ml / ml, and 0.2 ml / ml. Serum physiology was injected for the control group. Then, the anesthetized rats, testicular, vas deferens, and epididymis were examined for examination, testis, sperm motility, and live sperm count. The results were analyzed using Minitab and Anova tests with significance level set at P <0.05.

The results of weight control showed that large and small testicles, percentage of sperm, and sperm count with forward mobility, compared with those of control group decreases in injectable groups at a dose of 3 mg / kg in all factors other than the number of sperm with forward mobility. In other groups, only testicular weight decreased significantly in mg / kg2 (P <0.01).

According to the results, it seems that diazepam with injectable dose of 3 mg / kg had a decreasing effect on the effective parameters on fertility.

ABCG5 and ABCG8 are two membrane cholesterol transporters involved in transportation of this substance across the membranes of hepatocytes and enterocytes. The aim of the present study was to investigate the effects of continuous and interval trainings on gene expression of these substances in hepatocytes of male wistar rats.
Methods and Materials: In the current experimental study, 15 rats were assigned into groups of control with high fat diet (group 1, N=5), interval training with high fat diet (group 2, N=5), and continuous training with high fat diet (group 3, N=5). Duration of trainings was 12 weeks (5 days/week). Mann-Whitney U test was used for statistical analysis of data. 

The results showed that ABCG5 and ABCG8 genes expression after trainings were higher in groups of 2, 3, and 1, respectively. As for ABCG5, differences between groups 1 vs 2, 1 vs 3, and 2 vs 3 and for ABCG8, differences between groups 1 vs 2 and 2 vs 3 were significant (P=0.008) and only the difference between  groups 1 vs 3 regarding ABCG8 was non-significant (P=0.841).

It seems that exercise trainings are more effective on ABCG5, as compared with ABCG8 gene expression, and HIT is more effective compared with continuous trainings, on liver cholesterol excretion during reverse cholesterol transport.

Ginger has anti-inflammatory properties. The purpose of the present study was to determine the response of pro-inflammatory cytokines, interleukin-6 (IL-6), and interleukin-8 (IL-8) to short-term supplementation with ginger and exhaustive exercise in male athletes.

In a semi-experimental study, 40 male athletes were divided into 4 groups of control, supplementation, exercise, and supplementation with exercise (10 individuals each). Groups of supplementation and supplementation with exercise took two 500 mg capsules of powdered ginger per day for one week. Participants in exercise and supplementation with exercise groups performed Bruce test. Plasma levels of IL-6 and IL-8 were collected and measured before and immediately after the test. Data was analyzed using paired sample t-test and one-way analysis of variance.

No significant difference was found between plasma IL-6 and IL-8 in control group between pretest and posttest (P<0.05); however, plasma IL-6 and IL-8 increased significantly in exercise group and decreased significantly in supplementation and supplementation with exercise groups )P<0.05(. In addition, a significant difference was found between plasma IL-6 and IL-8 in the four groups (P<0.05), so that plasma IL-6 and IL-8 decreased significantly in supplementation and supplementation with exercise groups compared with control group, in supplementation group compared with exercise group, and in supplementation with exercise group compared with exercise group (P<0.05).

It appears that the consumption of ginger, as an anti-inflammatory supplement can have positive effect on the reduction of pro-inflammatory cytokines, IL-6, and IL-8, and thus the improvement of the immune system of male athletes.

QTc distance fluctuations are related to resting and exercise with ventricular arrhythmias and sudden cardiac death. Therefore, the aim of the present study was to investigate the changes of functional parameters of the heart and QTc interval in active and inactive men in one of the most isometric and isotonic exercise activities.

An experimental study was conducted at Shahid Rajaee Teacher Training University in 2018 with a pre-test and post-test. A total of 20 healthy active and inactive volunteers (n = 10) were randomly selected and hand-grip exercise protocol with maximal intentional contraction was performed as isometric with a longer stroke in the Fullext elbow mode by pressing the dynamometer knob for 30 seconds. After 60 minutes of rest, the isotonic protocol was run at the 90 degree Flex elbow angle of 15 sts. The change in QTc interval was corrected using the Bazett formula for heart rate. Systolic and diastolic blood pressures were recorded using a gyro barometer. Data were analyzed using repeated measures analysis (P≤0.05) in  SPSS, version 21.

The statistical findings showed a significant increase in cardiac performance indices of systolic blood pressure (1166.±6.74), heart rate (112.60±10.81), and the result of a doubling of pulse-pressure (RPP)(13.53±1.31) after isometric activity in active and inactive patients. But QTc (420.3± 36) distance and R-Rdistance (512.20± 64.36) after isotonic activity increased significantly. There was a significant difference in QTc changes, heart rate, R-Rspacing, and RPP between the three stages (p<0.05); however, there was no significant difference between the diastolic and diastolic blood pressure variables.

It seems that QTc after isotonic exercises can be screened for cardiovascular disease and assessing the cardiovascular status. It is also useful in predicting cardiovascular events.

Air pollution is one of the main causes of escalating allergies, especially in children. Genetic factors, along with environmental factors, affect the development and maturity of the immune system during the fetal period in the uterus and the early stages of life. Regulatory T cells play an essential role in maintaining the balance for the immune system when exposed to environmental pollutants.

Cord blood sampling was performed on 10 neonates born from mothers living in pollutant areas of Tehran and 10 neonates born from mothers living in Damavand city. Cord Blood Monomorphonuclear Cells were separated via density gradient centrifugation. Flow cytometric staining of CD4, CD25, CD127, and FoxP3 cell markers, as well as intracellular staining of regulatory T cell cytokines IL-10 and TGF-β1 were performed. Isolation and purification of CD4 +, CD25 + Tcells with MACS were done and culture of regulatory T cells in the presence of anti-CD3/CD28 coated beads in 1/1 bead-to-cell ratio were performed. T-cell suppression assay was evaluated through Measurement of Teff proliferation.

In the present study, the percentages of T-regulatory IL-10 + and TGF-b1 + in infants born in clean air regions were higher than those in contaminated air. The T-cell suppressory function in in vitro Teff / Treg ratio (1. 1) was significantly lower in infants born in airborne contamination than in newborns born in clean air. The rate of proliferation of Treg cells in the presence of IL-2 and anti-CD3 / CD28 mice was higher in two-week cultures in newborns born in clean air than those born in contaminated air.

The results of the present study showed that the contractile function of T cells in umbilical cord blood in newborns born of mothers living in infected areas of Tehran was lower than those born to mothers living in Damavand. Overall, the chronic exposure of mothers to airborne particulate matter before pregnancy and during pregnancy may reduce the function of the regulatory T cells and increase the risk of an increased allergy to newborns throughout life.

Epilepsy is the second leading cause of central nervous system diseases. Patients with epilepsy are exposed to various types of trauma during seizure. The aim of the current study was to evaluate the epidemiology of epileptic patients compared to patients without epilepsy.

In the present prospective study, among the total of 2119 patients admitted to the Imam Reza Hospital during 2015-2017, 44 were epileptic (2%). Demographic data, pattern, percentage, burn depth, and final outcome was evaluated and compared with non-epileptic patients using SPSS, version 24.

The mean age of epileptic patients was 38.3±12.9 years and 27 (61.4%) of the patients were male. About half of the patients (47.7%) did not use their medications regularly. More than one-third of the patients (n=15, 34.1%) had a history of burns and more than one third of them had a history of injury other than burns during seizure. The most common burn site was upper limb (61.4%) and the most common causes of burn were flame (59.1%) and hot liquids (26.7%). The rate of death was 4% (3 cases). In addition, the prevalence of grade 4 burns in epileptic patients was 18 times higher than that of non-epileptic patients.

Our study showed a high prevalence, depth, and repeatability of burns in epileptic patients. Considering that improper use of the drug and incomplete management of epilepsy are the predisposing factors for trauma, and on the other hand, flame and hot liquid were the most common causes of burns, it is essential that appropriate preventive measures be considered especially at homes. 
Funding: The present study was supported by Vice Chancellor for research of Mashhad University of Medical Sciences.

Arteriovenous Malformations are one of the most common cerebrovascular diseases that can affect various parts of the brain. AVMs cause complications such as cerebral hemorrhage, epilepsy, and neurological lesions that can be prevented by different therapeutic procedures such as microsurgery, endovascular intervention, radiosurgery with gamma-knife, and non-surgical treatment. The current study aimed to evaluate the demographic features and clinical outcomes of patients with AVM who referred to Loghman Hakim Hospital.

A descriptive study was performed using medical records of patients with AVM who had referred to our center betwen 2011-2018. The demographic data and treatment outcome and complications were collected and interviews with patients were conducted. Data were analyzed using SPSS, version 18.

Out of 47 cases, 70.2% were men and 29.8% women. A total of 25 patients were treated via microsurgery, while 14 patients received radiosurgery therapy, and 8 patients received non-surgical treatment. Treatment complications were observed in 40% of the patients who had surgically been treated (10 patients), the most common complication in patients with transient motor disorder.

Appropriate treatment approaches can improve initial symptoms of patients. However, decisions must be made to select the best treatment option based on the clinical conditions of the patients as well as the assessment of the possible effects of the complications to improve their quality of life.

Recent years of research show high prevalence and high risk of ADHD in adults. Students are at high risk of mental disorders. Also, the study of the risk factors of this disorder is less known among students. Thus, the present study addresses the problems associated with attention- deficit hyperactivity disorder in this group.

In this cross-sectional study, 90 students of attention- deficit hyperactivity disorder(ADHD) and 90 non-ADHD students selected through convenience sampling. Beck Depression Inventory, Beck Anxiety inventory, Inhaled Carbon Monoxide Concentration Measurement to investigate smoking and Iowa gambling task‏ for risky decision making, this study conducted. The results analyzed by SPSS software version 16 and descriptive tests, Independent Sample T-test and Chi-square.

The results showed that smoking, depression, anxiety and risky decision making in students with this disorder were higher than the group without this disorder (P <0.05).

Based on the results, students with attention -deficit hyperactivity disorder should be considered at the beginning of university entrance and referred to specialist psychologists and psychiatrists for treatment and recovery.

During pregnancy, each of the couples may experience various changes and problems. In some circumstances like  history of infertility, previous abortions or unwanted pregnancies, that couples pay special attention to pregnancy, the amount of these problems may also increase. The aim of this study was determination  of pregnancy problems in couples with a history of infertility, abortion and unwanted pregnancy.

In this descriptive study, 120 pregnant couples were examined. Gestational age of women was 28-41 weeks. The couples were divided into 4 groups: history of infertility, abortion, unwanted pregnancy and control group. Then they were compared by using a special questionnaire for the common problems of pregnancy. Also, in each of these groups, correlation between couples’ problems was calculated. The significance level was considered to be 0.05.

In all four groups, women experienced more physical problems than men (p <0.001). In groups with history of infertility (p <0.001) and abortion (p <0.001), each of the couples experienced more physical and mental problems than the control group. There was a positive and significant correlation between couples’ physical problems in all three groups (p <0.05). While in the control group the couples did not correlate

In conditions such as history of infertility, abortion or unwanted pregnancy, due to the importance or stress that pregnancy produce for couples, they may experience more problems during pregnancy. In providing care to this group of people, attention to such records makes it possible, if necessary, we  help these couples to experience better pregnancy