مجله دانشگاه علوم پزشکی گرگان
سال بیست و یکم شماره 4 (پیاپی 72، زمستان 1398)

Autosomal recessive primary microcephaly; MCPH is a rare neurologically condition observed in new born at the birth. Most patients suffer from moderate to severe intellectual disability. In this review article, we introduce MCPH disorder; include all of the chromosomal locations, kind of MCPH genes and numbers of mutations, functional efficacy, how to identify the genes separately and diagnostic algorithm of articles and data base such as OMIM, HGMD. 23 locations genes (MCPH1-23) have been recognized causes primary microcephaly in different population, so far. Function of them is to correct orientation of mitosis spindles, duplication of DNA, organization and function of centrosome, transfer of vesicles, transcription regulation, response to DNA lesion, etc. According to investigations, MCPH in Iran and Pakistan population is common because of more consanguinity marriage. MCPH1 and MCPH5 genes are more common in Iran. Recent advances in molecular biological techniques and animal models have helped to identify the genetic cause of microcephaly and open up the horizons for researchers in the field, and also elucidating of the underlying molecular mechanisms will improve our understanding of the structure and function of the brain.

Todays, coronary artery disease is one of the most important health issues. Antioxidants are the agents that can play important role in reducing cardiovascular diseases. The present study was done to determine the effect of resveratrol supplementation during rehabilitation exercises training on systemic inflammation factors in patients after coronary artery bypass surgery.

This clinical trial study was done on 40 patients after coronary artery bypass surgery in the heart rehabilitation center of Farshchian cardiovascular specialist hospital in Hamadan, Iran during 2016. Patients randomly assigned into four groups including control (Con; n=10), resveratrol supplementation (RS; n=10), rehabilitation exercise training (RXT; n=10), and resveratrol supplements-cardiac rehabilitation exercise training (REX; n=10). Rehabilitation exercise training was done in nonconsecutive three sessions for eight weeks in the form of endurance training at 50-70% HRmax for 15-20 min, and resistance training at 20-50 one-repetition maximum (1RM). The number of repetitions was 8-15 reps, where done based on the capacity and ability of the subject, while the subjects in supplement groups consumed daily 400 mg of resveratrol. Blood sample was done before and 48 hours after exercise training and supplementation, and concentrations of Tumor necrosis factor alpha (TNFα), Interleukin- 6 (IL-6), Interleukin 1 beta (IL-1β) and C-reactive protein (CRP) were measured in the plasma.

CRP, TNF-alpha and IL-1beta and IL-6 were significantly reduced in resveratrol supplements-cardiac rehabilitation exercise training group in compared to control, resveratrol supplementation and rehabilitation exercise training groups (P˂0.05).

This study showed that combination of consuming resveratrol with rehabilitation exercise training in reducing some inflammatory factors was evaluated selectively, more effective than rehabilitation exercise training and resveratrol supplementation alone.

The mental health of cancer patients impaired by suffering, future worriness, and fear of death. This study was conducted to determine the effect of acceptance and commitment based training on the difficulty of emotion regulation and mental health in women with breast cancer.

In this clinical trial study, 30 female patients with breast cancer were randomly divided into control and intervention groups (n=15). The intervention group received 8 sessions of 90 minutes of acceptance and commitment procedures. Before and after the treatment and two months there after, all participants were evaluated and compared with the Gratz-Romer 2004 and General Health Questionnaire (GHQ-28).

Emotion regulation score in the intervention group was singnificantly reduced from 113.52±4.16 to 104.67±3.96 (P<0.05). Emotion regulation score remained low in the intervention group in the follow up period (104.17±3.58); but the mean in the control group did not show any significant reduction. In the intervention group after the treatment, the total score of mental health reduced from (46.81±4.21) to (33.18±3.39) (P<0.05). This score was 33.12±3.33 in the follow-up period in the intervention group; but no significant reduction was observed in the control group.

Acceptance and commitment technique training can improves mental health and emotion regulation in women with breast cancer.

Schizophrenia is a chronic disease associated with considerable impairments to personal life and social functions. Since exercise plays an important role in these problems, this study was done to compare the effect of high-intensity interval training (HIIT) and futsal training on body composition, physical fitness, life quality, and negative symptoms in schizophrenics.

This clinical trial was performed on 42 male patients with paranoid schizophrenia in Rasht Medical Center in north of Iran during 2017. Patients were randomly assigned into three groups of HIIT (n=15), futsal (n=12) and control (n=15) groups. Data were collected before and after 8 weeks of training using quality of life questionnaire, negative symptoms assessment and some factors of physical fitness tests. HIIT program (high-intensity interval training: HIIT) was held three sessions a week with 70 to 85% of maximal heart rate and futsal training lasted three sessions a week for 40 minutes.

Anaerobic power was significantly more in HIIT and futsal groups in compatre to controls (P<0.05), but anaerobic power was not significantly different between HIIT and futsal groups. Lower limb muscle power was significantly higher in the HIIT and futsal groups compared to control group (P<0.05). Lower limb muscle power was higher in the HIIT group compared to the futsal group (P<0.05). Negative symptoms were significantly lower in HIIT and futsal groups in comparison with control group (P<0.05). The quality of life difference in futsal and HIIT groups was not significant in compared to the controls.

It seems that HIIT is more efficient than futsal exercises, but both types of training improve some factors of physical fitness and alleviate the negative symptoms among schizophrenics.

Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic hepatic diseases which may be associated with cardiovascular disease. This study aimed to consider the effect of combined therapy with resveratrol supplementation and interval exercise training on heart cells apoptosis in rats with NAFLD using TUNEL assay.

This experimental study was done on 35 Wistar rats. Animals were randomly allocated into five groups including control (healthy) and four NAFLD groups, including patient, resveratrol, interval exercise, and resveratrol + interval exercise. A TUNEL assay kit was applied for the detection of apoptosis in heart tissue.

The patient group had significantly higher percentage of heart apoptotic cells (24.38±0.69%) compared to the other groups (P<0.05), while the resveratrol + interval exercise (9.02±0.49%) and resveratrol (9.47±0.83%) groups showed significantly lower mean levels of heart apoptotic cells compared to the patient and interval exercise (P<0.05) groups. There was no significant difference in mean of apoptotic cells between resveratrol and resveratrol + interval exercise groups. The mean of apoptotic cells in interval exercise group was 11.39±0.28%.

Nonalcoholic fatty liver disease is considerably associated with heart cells apoptosis. Resveratrol supplementation especially combined with interval exercise significantly reduces apoptotic cells in heart tissue.

Due to the properties of herbal remedies and their lesser side effects than chemical drugs, much attention has now beeing paid to herbal treatments. The aim of this study was done to evaluate the antinociceptive and anti-inflammatory effects of hydroalcoholic extract of aerial parts of Ruscus aculeatus.

This experimental study was performed on 80 male NMRI mice (6-8 weeks) weighing 23-25 gr. Animals were randomly allocated into 5 groups including: control group (distilled water), positive control group (morphine 10 mg/kg/bw in pain test and dexamethasone 15 mg/kg/bw in inflammatory test) and three groups receiving 75, 150 and 300 mg/kg/bw Hydroalcoholic extract of Ruscus aculeatus L. The pain was evaluated by formalin test and an investigation of inflammation conducted by xylene induced ear-edema.

The hydroalcoholic extract of Ruscus aculeatus L significantly reduced acute pain at 300 mg/kg/bw in compared to control group (P<0.05). Inhibition percent was 60% for acute pain and 85% in morphine group. Also, this plant caused significant reduction of formalin induced chronic pain at 150 and 300 mg/kg/bw doses in compared to the control group (P<0.05). At 150 and 300 mg/kg doses of Ruscus aculeatus L, inhibition of chronic pain was 71%, and 94%, respectively in compared with 97% inhibition in morphine group.

Hydroalcoholic extract of Ruscus aculeatus L at the dose of 300 mg/kg/bw reduces acute and chronic pain and at the dose of 150 mg/kg/bw reduces acute pain in laboratory animals.

Hormone and genetic disorders are the most important causes of hyperglycemia in obese and diabetes patients. This study was done to determine the effect of the resistance training program on FOXO1 gene expression in subcutaneous adipose tissue as an effective transcription factor in insulin signaling pathways, fasting glucose and insulin resistance in type 2 diabetic rats.

In this experimental study, type 2 diabetes induced by high fat diet and Streptozotocin (STZ, 30 mg/kg/bw) intraperitoneal injection in 14 male wistar rats (220±20 g) .Animals were randomly allocated into exercise (n=7) and control (n=7) groups. Exercise group were participated in resistance training program (6 weeks, 5 days/weekly). Fasting blood glucose and insulin as well FOXO1 gene expression in subcutaneous adipose tissue were measured lasted exercise session in the two geoups.

Resistance training  significantly reduces in fasting glucose, insulin resistance and FOXO1 gene expression in subcutaneous adipose tissue in exercise group in compared to control group (P<0.05).

Resistance training lead to decrease of insulin resistance and blood glucose by inhibiting FOXO1 gene expression in subcutaneous adipose tissue in diabetic rats.

There are few studies that highlighted the effectiveness of exercise on unstable surfaces in eldely subjects. This study was done to evaluate the effect of training on stable and unstable surfaces on walking kinematic and timed-up-and go (TUG) test variables in elderly wemon.

In this quasi-experimental study, 75 elderly women were non-randomly assigned to exercises and control groups. Cadence, step length, stride length, step width, walking speed, and TUG were measured. Gait kinematics (cadence, stride length, walking speed, step width) was recorded by an image recording camera. Gait kinematics variables were measured. The average of three repetitions was recorded for analysis for each subject.

Exercise training had a significant effect on the step length, stride length, step width, walking speed, and time of TUG (P<0.05). Although, there was a significant difference in gait kinematics after exercise training, training on foam with (9cm height) created the highest mean difference in TUG, cadence, step length, and training on sand resulted in the greatest mean difference in step length and walking speed variables.

Training on stable and unstable surfaces improves walking kinematic and TUG time variables in elderly wemon.

Parents of children with cancer are more susceptible to psychological problems such as anxiety, depression, stress, and generally, mental health risks. This study was done to determine the effectiveness of group acceptance and commitment therapy on self-efficacy among mothers of children with cancer.

This quasi-experimental study was conducted on 30 mothers of children with cancer referring to Children’s Medical Center in Tehran, Iran during 2017. Mothers were non-randomly assigned into intervention and control groups. For gathering the data, the parental self agency measure of Dumka and colleagues (PSAM; 1996) was used. The group acceptance and commitment therapy was offered to subjects in the interventional group for 2-hour in 10 sessions, but the control group's mothers did not receive any intervention.

Mean scores of self-efficacy among mothers of children with cancer were 31.40±6.40 and 53.87±13.35 in pre-test and post-test, respectively (P<0.05). Mean scores of self-efficacies among mothers in the control group were 30.07±5.73 and 29±7.58 in pre-test and post-test, respectively. This difference was not significant.

Acceptance and commitment therapy significantly improves parental self-efficacy among mothers of children with cancer.

Trauma is the most important causes of lossing effective life in human comunities, and it is the second leading cause of death in Iran. This study was done to determine the pattern of penetrating injuries and intrathoracic organ damage in Gorgan, north of Iran.

In this descriptive study, data of 107 patients with penetrating injuries whom referred to
5th Azar hospital in Gorgan-Iran during 2016-17 were collected. Age, gender, job, type, location and cause of injury were recorded for eacgh subject.

The mean age of patients was 26.13 years. The most frequent job was related to unemployed group (39.25%). The most freqent causes of trauma were quarrel with 78.5%. The most divice were knife with 66.35%. Lung was the most injured organ with 11.21%. The least damage was to the large vessels with one case (0.93%). The two patients died due to heart and subclavin vessels injuries.

This study showed that injury due to knife was the most prevalent of penetrating trauma in street strife in northern Iran.

Staphylococcus aureus (S. aureus) is the most common cause of nosocomial infections. Treatment of Staphylococcal infections has become more complicated due to the emergence of methicillin-resistant S.aureus (MRSA) strains. This study was done to determine the frequency of methicillin resistance encoding gene (mecA) and β-lactamase resistance encoding gene (blaZ) in S. aureus isolates from clinical samples using Polymerase Chain Reaction (PCR) method.

This descriptive-analytic study was carried out on 59 S. aureus isolates from clinical samples in Gorgan hospitals from January-February 2017 to June-July 2017. All the isolates were identified using gram staining, catalase test, tube coagulase test, growth on Mannitol salt agar medium and the DNase test in the Microbiology Laboratory .Antibiotic resistance was evaluated using the standard disk diffusion.  Iodometric method was used to detect β-lactamase production / activity in this bacterium. PCR test was done to detect mecA and blaZ genes.

All S. aureus isolates (100%) clinical samples possessed blaZ gene, followed by 27 isolates (45.8%) possessed mecA gene (MRSA), which these isolates possessed mecA gene were concurrently positive for blaZ gene. 5% of oxacillin-resistant strains and 3% of cefoxitin-resistant strains possessed mecA gene and 47 isolates (79.4%) carrying blaZ gene were β-lactamase-positive in phenotypic method.

This study showed that in all clinical samples isolated S. aureus isolates which these isolates possessed mecA gene were concurrently positive for blaZ gene.

The ever-increasing resistance to beta-lactame antibiotic in opportunistic Pseudomonas aeruginosa bacteria considered as one of the important factors of death of hospital-acquired infections. This study was performed for determine the antibiotic resistance and prevalence of IMP-1 and VIM-1 metallo-beta-lactamase and integron class I genes in clinical isolates of Pseudomonas aeruginosa.

In this descriptive-analytical study, 200 Pseudomonas spp. isolates from blood, urine, ulcer, eye and sputum infections were collected from Arsanjan hospital in Fars province in south –west of Iran during April-September 2016. After confirmation genus of bacterial by biochemical and 16S rRNA tests, and isolation of Pseudomonas aeruginosa by specific primer of lasI Gene, antibiotic susceptibility was done according to diffusion disk assay and CLSI procedure, the presence of blaVIM, blaIMP and Int-1 genes were determined by PCR.

The results of phenotypic and genotypic tests led to the isolation of 107 isolates of Pseudomonas aeruginosa that the highest resistance with (79.38%) for cefepime and the lowest resistance with (13.08%) for tobramycin. Out of 107 isolates, 10 (9.35%) isolates were carrying class1 Integron,19 (17/76%) isolates carrying IMP gene, 23 (21.5%) isolates carrying VIM gene, 4 (3.74%) isolates carrying IMP gene and integron class1, 11 (10.28%) isolates carrying VIM gene, and class1 intgron, 15 (14.02%) isolates carrying both IMP, VIM and 12 (11.22%) isolates simultaneously were carrying each three genes, VIM, IMP and class1 integron. 13 (12.15%) isolates did not have none of these three genes, VIM, IMP, class1 integron.

The results showed increased multidrug resistance and simultaneous presence of one or two IMP, VIM and Int-1 genes in Pseudomonas aeruginosa strains. Int-1 has the ability to transduce resistance genes and create resistant populations.

Cancer can cause many problems in all aspects of the physical, mental, social, economic and family life of the elderly patients. This study was done to determine the supportive care needs of the elderly people with cancer in north of Iran.

This descriptive- analytical study was carried out on 248 elderly patients with cancer whom referred to governmental and private medical centers in Gorgan, Northern Iran during 2018. Data were collected by a valid and reliable questionnaire "Supportive Care Needs Survey-SCNS" consisted of five domains of physical needs and daily functioning, health system and information, supportive and care, mental, and sexual chracteristics.

There was a significant relationship between physical activity and daily functioning, sexual domain, support and care, health and information system with gender (P<0.05). Female seniors were more in need of assistance in the areas of physical and daily functioning, and male seniors in the areas of sex, support and care, health systems, and information.

This study showed that unmet needs in the elderly with cancer are particularly high in physical and functional areas.

One of the health indices in human is normality of the number and size of blood cells. The purpose of this study was to screen for bleeding and coagulation disorders among the patients in oral medicine department of Yazd dental school.

This descriptive - analytic study was performed on 273 patients referred to the oral medicine department of dental school in Yazd, Iran during 2015-16. Data of age, sex, systemic diseases and their type, medical history, patient’s clinical examinations and also the cause and type of requested laboratory tests were recorded for each sujects.

Bleeding and coagulation lab tests were ordered for 63 persons (23.4%) and complete blood count (CBC) for 210 persons (76.9%). The CBC of most patients with systemic diseases (53 cases, 25.2%) was normal. The most frequent systemic disorders were cardiovascular diseases (56%) and followed by bleeding disorders (19%). The most frequent abnormality of CBC components was seen in the distribution of neutrophils (84.9%). There was no significant correlation between CBC results and its components and also PT, BT and PTT with the age of the patients. Platelet counts, Hb and INR results showed a significant correlation with the age of the patients (in age range of 6-83 years) (P<0.05). Platelet counts, WBC, PT, lymphocyte, neutrophil and RBC, Hb, MCV and MCH results were significantly different between females than males (P<0.05).

The majority of bleeding and coagulation labratory test results of patients were normal, which can indicate the readiness of the patients to tolerate dental treatments. The results of this study help to reduce the unnecessary laboratory test orders and patient costs with a thorough medical history and careful consideration of clinical findings.

Echinococcosis garnulosus is a major zoonotic disease, and surgery is the best treatment for it. So far, several chemical scolicidals have been used to prevent protoscolices leakage during surgery, but due to their adverse effects were not well-received. Therefore, using medicinal plants or compounds driven from them as alternatives were taken into consideration. This study was conducted to compare the in vitro effect of Cannabis sativa essential oil with albendazole on protoscolices of hydatid cyst.

In this descriptive-analytic study, essential oil of C. sativa was prepared from aerial parts of the plant in flowering season in university of Camerino, Italy, and Gas chromatography – mass spectrometry (GC-MS) analysis was performed. Protoscolices were extracted from the livers infected with hydatid cyst and were exposed to different concentrations of C. sativa (1, 2, 5 and 10 μg/ml) for 10, 30, 60 and 120 minutes. The viability of protoscolices was measured by 0.1% eosin staining. Albendazole was used as a standard medicinal drug.

Essential oil of C. sativa at all tested concentrations led to significant mortality in protoscolices which showed a direct relation with increase in concentration (P<0.05). The highest concentration of albendazole after 2 h led to 13.24% mortality rate while, this amount with C. sativa essential oil at 2µg/ml reached to 20.9%, and at 10µg/ml reached to 26.08%.

This study showed that C. sativa essential oil has promising scolicidal effect compared to albendazole and can be suggested as a natural protoscolicidal agent.

Salmonellosis is a gastroentritidis which caused by the different serovars of Salmonella genus, and responsible for morbidity and mortality worldwide. Food born disease is one of the growing problems of human societies especially in developing countries. The aim of this study was to evaluate and serogroup determination of Salmonella isolates from food along with antibiotic resistance pattern.

This descriptive study was performed on total of 400 in equal of 200 packed and 200 unpacked  samples of (red meat, chicken meat, egg, vegetable) collected in random from distributed in Tehran ,Iran during nine months in 2018. Microbial, biochemical and serological test was performed according to protocol number of 1800 of national standard. Antimicrobial susceptibility test was done by disk diffusion (MAST, Co, UK) method.

Out of 400 samples 8 (2%) was identified as Salmonella. The unpacked foods were more contaminated (75%) compared to packed foods (25%). The most isolated serogrouping were belonging to especially D. Salmonella. The chicken samples were more contaminated (37.5%) than other samples. The isolated Salmonella were mostly resistance to nalidixic acid (75%).

The Salmonella isolated particularly from group 1 showed higher antimicrobial resistance, additional care should be taken in preparation, packaging and supplying the food samples.