Journal of Iranian Medical Council
Volume:2 Issue: 6, Autumn 2019

In spite of large resources that have been allocated to manage the obesity, growing obesity trend is still a warning. Some investigators have mentioned global trade liberalization, economic growth and rapid urbanization as factors that may be responsible for this. It seems that lack of using managerial techniques in obesity control programs may be the reason for unsuccessful attempts to stop growing obesity trends. Thus, a systematic review was performed in the field of obesity control programs and management in various databases and a commonly used management approach was explained which seems to be overlooked in the field of obesity management. In the end, an example of an obesity management model was given based on this approach and obesity issue was investigated through a new perspective.

Breast cancer is a chronic disease that leads to many psychological problems that are involved in treatment and adherence to treatment. The aim of this study was to evaluate the effect of psychoeducational group intervention on psychological factors that help the patients in the treatment process. In this study, 80 patients were selected by using convenience sampling at Imam Khomeini Hospital. They were randomly allocated either to the intervention group or to the control group. All participants completed the questionnaires of post-traumatic growth, quality of life, subjective well-being, adherence to treatment and social support. The results were analyzed by SPSS-18 software using univariate and multivariate analysis. According to the results, the applied intervention had a significant effect on post-traumatic growth as a primary outcome, and also on subjective well-being and adherence to treatment as secondary outcomes. Psychoeducational group intervention in women with breast cancer can affect the treatment and provide better response to treatment through the improvement of post-traumatic growth, subjective well-being and adherence to treatment.

Circadian rhythm affects individual body function and health. Although it can regulate many biological processes in the body such as hormone release and eating habits, little is known about the relationship between circadian rhythm and metabolic disorders. Therefore, the purpose of the present research was to examine the association between Circadian Rhythm Chronotypes (CRC) and metabolic health status components, in patients with overweight and obesity. A cross-sectional study was conducted at the healthcare centres of Tehran. Patients with Overweight and Obesity (OW/OB) (n 374) aged 18 to 56 years were rectruited. All participants were assessed for metabolic health status components based on Karelis criteria (HDL, LDL, TG, hs-CRP and HOMA-IR). Morningness - Eveningness Questionnaire (MEQ) was used for chronotype categorizing. Also, bioelectrical impedance analysis (BIA) was applied to evaluate body composition. Regression model in crude and adjusted model was used to assess the relation between CRC and metabolic status. The differences in CRC were not significant in terms of Karelis criteria components except hs-CRP (p=0.02). Results had shown that the trend of hs-CRP tends to decrease from eveningness chronotype to morningness chronotype and it significantly increased in crude model (p=0.007) and adjusted model (p=0.03). In addition, hs-CRP had decreased significantly in morningness chronotype in comparison with eveningness chronotype in crude model [OR (95% CI): 0.28 (0.10 to 0.79), p=0.01]. This study indicated an association between hs-CRP and CRC in women patients with overweight and obesity, which indicates that inflammation may have a relation to the CRC and metabolic status.

Turner Syndrome (TS) is caused by the complete or partial absence/abnormality of the second X chromosome in some or all cells.The purpose of this study was to assess the correlation between clinical presentation and karyotype variations of X chromosome in TS.

In a retrospective case-series using medical records (2001-17) for our pediatric-endocrinology TS patients, additional data were collected using a questionnaire and detailed physical examination, including demographics, initial presentation, clinical characteristics at diagnosis, height, puberty stage, cardiovascular and renal malformations, uterus and ovary status, and hormonal profile. Three patient-groups of monosomy X (45,X) cases, 45,X/46,XX or 45,X/46,XY mosaicism cases, and cases with other aberrations of X chromosome were compared in this study.

In 57 TS patients (Age range 6 months to 25 years (Mean 11.85±5.1 yrs.)), 3.5% were diagnosed in infancy because of lymphedema and congenital heart disease. Short stature was the initial presentation in 78.9%. On presentation, 94.7% were short. Other referrals included cases with primary amenorrhea (12%), delayed puberty (5.3%), leg edema (1.8%) and congenital heart disease (1.8%). Mean height standard deviation score was 3.7±1.8 SD below mean for age and sex. Overall, 50.9% of cases had all clinical features consistent with TS and 21.1% had no symptoms of TS other than short stature. Of 39 patients in pubertal age, 31.6% had degrees of breast maturity. Most of them had X structural abnormalities (40.3%). However, 33.3% had classic TS. Still, 5.3% had Y-chromosome material. Among three karyotype groups, clinical symptoms and phenotypes were not significantly different.

The study found no correlation between the clinical presentation and karyotype variations of TS.

Symptomatic recurrent mitral valve stenosis develops in some patients after Percutaneous Mitral Valvuloplasty (PMV). This study assessed the immediate and early outcomes of redo PMV in patients with recurrent mitral valve stenosis after prior PMV.

Fifty-four patients (40 women and 14 men, mean age of 38±8.2 years) underwent a redo (second) PMV for symptomatic restenosis of mitral valve [with Mitral Valve Area (MVA) < 1.5 cm2]. Redo PMV was performed at 5.8±1.2 years after the initial PMV.

In this study, 48 hours after the procedure, there was a substantial increase in MVA by 2-dimensional Echocardiography (GE, Vivid 7) from 1.0±0.2 to 2.2±0.4 cm2 (p<0.001) and a decrease in mean left atrial pressure from 27 ± 5 to 15 ± 4 mmHg (p<0.001) and in mean transmitral valve gradient from 15±4 to 2±1 mmHg (p

Redo PMV can be performed successfully in patients with recurrent mitral valve stenosis following previous percutaneous valvuloplasty.

Single Nucleotide Polymorphisms (SNPs) in the IL-4 promoter and receptor genes have been proposed to alter the individual’s susceptibility to HIV infection and the rate of progression to AIDS. IL-4 -589 C/T and IL-4Rα I50V polymorphisms have been studied in different populations and were linked to differences in disease progression. No study has assessed the frequency of these polymorphisms in Iranian population.

In a cross-sectional study, after obtaining written informed consent, blood samples were collected from 120 HIV-seropositive individuals (91 males, 12 females) visiting a tertiary referral HIV center. All patients were primarily screened with the fourth-generation ELISA HIV test for the HIV-1 markers and subsequently with polymerase chain reaction (PCR). CD4+ cell count of the patients was recorded by using fresh EDTA-whole blood samples. The genomic DNA was extracted from peripheral blood mononuclear cells (PBMC) using the standard extraction kit. Then, PCR-RFLP technique was used to analyze IL-4 -589 C/T, and IL-4Rα I50V SNPs.

A frequency of 0.08 was found for IL-4 -589 T allele and 0.055 for IL-4Rα V allele. There was no significant difference between these polymorphisms regarding CD4 cell counts (p = 0.44 and p = 0.08 for IL-4 -589 and IL-4RαI50V, respectively).

This is the first study to assess the frequency of IL-4 promoter and receptor polymorphisms in the Iranian HIV-seropositive population. No significant association was found between IL-4 promoter and receptor polymorphisms and CD4 cell counts.

Dry Needling (DN) is a procedure to treat neuromusculoskeletal disorders. This study aimed to examine the effects of DN on quadriceps muscle fatigue in healthy young adults.

Fifteen healthy young subjects (13 male, 2 female; mean±standard deviation 26.1±5.9 years) participated in a pretest-posttest study. Subjects received one session of DN for a total of 3 minutes with one minute each for the vastus medialis, vastus lateralis, and rectus femoris muscles. The Isometric Peak Torque (IPT), Single Leg Hop (SLH) test, and Y Balance Test (YBT) were measured at baseline, immediately after completion of the fatigue protocol, and after DN.

Repeated measures ANOVA demonstrated significant improvements in the IPT, SLH, and YBT scores after DN. Effects sizes were medium for IPT (d =0.61) and SLH test (d=0.57), and large for YBT (d=0.7).

Dry needling had a significant effect on recovery of quadriceps muscle fatigue, functional performance, and dynamic balance. These findings suggest that DN can be utilized as a novel recovery strategy to manage muscle fatigue. Further research is warranted.

The purpose of this study was evaluating the medical students’ knowledge of Primary Eye Care (PEC) for determining the level of Eye Care Programs (ECPs) in Iran. In this cross-sectional study, a self-administered questionnaire was applied to collect the data from 504 medical students at Mazandaran University of Medical Sciences. The participants answered a total of 60 questions in 4 sections. The knowledge of medical students about the PEC and the importance of developing the ECPs in Iran were evaluated. Chi-square and Fisher’s exact test were used to assess the association between variables. The majority of the participants were under 30 years old and about half of them were undergraduate students and 49.4% were graduate students. About 54.4% of the subjects wore glasses and only 13.3% of them knew about the ECPs (p=0.028). Thirty-two and a half percent of subjects with glasses rarely had regular eye visits (at least once a year), and 42% of subjects without glasses also had blurred vision (p<0.001). Only 14.5% of contact lens wearers knew about the ECPs and 47.6% of them rarely had regular eye visits (p=0.013). About 90% of electronic device users didn’t know about the PEC and related educational programs for reducing computer vision syndrome (p=0.018). A considerable number of participants had weak knowledge about PEC and regular eye visits, and paid more attention to treatment than prevention. Preparation and implementation of educational ECPs are recommended to raise the level of PEC knowledge for improving eye health.