Journal of Kerman University of Medical Sciences
Volume:28 Issue: 1, Jan-Feb 2021

pulmonary hypertension is a serious problem in newborns, which is associated with increased pulmonary vascular resistance, leading to right-to-left extrapulmonary shunt and impaired lung oxygenation and severe hypoxemia in the neonatal period. The purpose of this study was to evaluate the effect of oral Sildenafil with intravenous Milrinone on the treatment of pulmonary hypertension in newborns.

The statistical population of this study consisted of all term and late preterm neonates admitted to NICU wards of Afzalipour Hospital in Kerman. A total of 80 neonates were included and divided into the intervention group (intravenous Milrinone with oral Sildenafil), and control group (intravenous Milrinone alone). The related criteria for increasing pulmonary artery pressure, including mean pulmonary artery pressure (mean PAP), Tricuspid valve regurgitation (TR), pulmonary artery diameter (PAD) and right ventricular systolic function by measuring TAPSE (Tricuspid annular presystolic excursion) were assessed by echocardiography in the first 24hours after birth and 72 hours after the intervention in all patients. Data analysis was done through SPSS24 software.

The mechanical ventilation time in the group treated with oral Sildenafil (2.5 days) was significantly (p <0.0001) shorter than that in the control group (10.5 days). Also, the hospital stay in NICU in the intervention group (11.3 days) was significantly (p <0.0001) shorter than that in the control group (20.2 days). Pulmonary artery pressure showed a significant decrease in the intervention group 72 hours after adding Sildenafil compared to the control group. The mean difference of TR gradient was significantly (P<0.0001) higher in the intervention group (59) than in the control group (22). The mean PAP difference was also significantly (P= 0.005) higher in the intervention group (47.7 mmHg) compared to the control group (33.3 mmHg). Besides the TAPSE difference was significantly (P = 0.009) lower in the intervention group (33.7) than in the control group (47.2). There was no significant difference in the PAD (Pulmonary artery diameter) between the two groups (P = 0.312). Also, there was no significant difference in mortality rate between the intervention group (3.7%) and control group (5%).

The results of our study showed that the addition of oral Sildenafil to intravenous Milrinone was associated with better therapeutic outcomes in the treatment of neonatal pulmonary hypertension. Conducting similar studies is necessary for the final proof of this issue.

Diabetes is a chronic and metabolic disease with a steadily increasing prevalence. Patients’ higher level of health information has positive effect on self-care and control of conditions. The aim of this study was to investigate the information seeking behavior of patients with diabetes in Kerman through applying a grounded theory approach.
This qualitative study was conducted through applying a grounded theory approach using Corbin and Strauss (2008) method. To ensure of the accuracy and reliability of the qualitative data, Corbin and Strauss (2008) criteria were used. Eighteen diabetic patients were included in the study based on a purposive sampling. Semi-structured interviews were done in diabetes and healthcare centers in June 2019.
The analysis of the data resulted in 45 primary categories, 17 subcategories and 5 major categories. The five main categories were: 1) recognizing the information needs to live well with disease, 2) acquiring health information literacy (the core variable), 3) information seeking barriers, 4).supportive information directing factors 5) empowerment. The main concern of the patients was “disease management and healthcare”. The main strategy to overcome it was health information acquisition. Information seeking obstacles had caused insufficient information, distrust, and information evasion; while, supportive information directing factors had facilitated the process and increased the patients’ health literacy. Finally, the interaction between these variables had led to the patients’ empowerment.
This study showed that there are various interactive factors centered on “health information acquisition” that influence health information seeking behavior of diabetic patients. The policy-makers can design optimal health information systems and effectively transmit health information to patients to increase their health information literacy, self-care, disease control and healthcare costs reduction. The findings can help diabetic patients to have access to the more proper information they need.

Diabetes mellitus is a widespread disease disrupting cognitive function. We investigated the effect of eight-week high-intensity interval training (HIIT) and caffeine supplementation on Brain-derived neurotrophic factor (BDNF) and glial line-derived neurotrophic factor (GDNF) in a rat diabetic model.
In this experimental study, streptozotocin-induced diabetic rats were randomly divided into: control (C), diabetic (D), diabetic+caffeine (D+CA), diabetic+training (D+T) and diabetic+training+caffeine (D+T+CA) groups. Training groups underwent a high-intensity interval training program (5 sessions a week over 8 weeks). The supplement groups were administered with 7mg caffeine/100gr body weight for 5 days a week before each exercise session throughout the experimental period. The rat hippocampus and brainstem were removed 48 h after the last training session and blood samples were taken from left ventricle. The levels of glucose, BDNF and GDNF were measured by ELISA assay. Data were analyzed using two-way ANOVA test.
Streptozotocin-induced diabetes increased blood glucose (P<0.01) whereas decreased BDNF and GDNF levels (P=0.002). The results showed that HIIT decreased blood glucose (P=0.002) but increased BDNF and GDNF levels in diabetic rats (P=0.003 and P=0.001, respectively). Even though caffeine supplementation significantly reduced blood glucose concentration (P=0.0001), it had no significant effect on BDNF and GDNF levels in diabetic rats (P>0.05). We also observed a significant interaction between treatments regarding GDNF changes (P=0.024); yet, the interaction between caffeine and HIIT on BDNF did not reach the significance level (P=0.074).
Based on the findings, HIIT increased BDNF and GDNF levels in rat diabetic model, but caffeine ingestion had no significant effect on neurotrophic factors. However, caffeine seems to blunt HIIT-induced increase in neurotrophic factors which remains to be further investigated.

Type 2 diabetes mellitus (T2DM) has several complications such as hyperlipidemia and hepatotoxicity. Myricitrin has an antidiabetic action along with low bioavailability. So, the aim of the present study was to investigate hypolipidemic and hepatoprotective effects of myricitrin and solid lipid nanoparticle (SLN) containing myricitrin on the T2DM mouse model induced by Streptozotocin-nicotinamide (STZ-NA).

In this experimental study, 90 Naval Medical Research Institute (NMRI) adult male mice were divided into 9 groups (n=10 per group): control, vehicle, diabetic, diabetic + myricitrin, or SLN containing myricitrin 1, 3, and 10 mg/kg groups. The cold homogenization method was used to prepare SLN containing myricitrin. The diabetic model was induced by one injection of STZ-NA (65-120 mg/kg) with a 15-min interval. Animals' treatment was done for 4 weeks. At the end of the experiment, plasma samples were taken for experimental assessments.

Plasma level of triglyceride (TG), low-density lipoprotein (LDL-C), very-low-density lipoprotein (VLDL), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) increased and high-density lipoprotein cholesterol (HDL-C) decreased in diabetic mice compared to the control group (P<0.05). Administration of myricitrin or SLN containing myricitrin decreased plasma levels of TG, LDL-C, VLDL, AST, and ALT and increased HDL-C in the treated diabetic groups compared to the untreated groups (P<0.05).

According to the results, myricitrin and SLN containing myricitrin showed hypolipidemic and hepatoprotective effects in T2DM mice. Also, SLN containing myricitrin was more potent than myricitrin especially in a low dose of administration.

Panoramic radiographs are among diagnostic tools used by dentists. Because of the relatively large area covered by panoramic radiographs, incidental findings are possible. This study aimed to evaluate the incidental findings in digital panoramic radiographs of patients referred to the Oral and Maxillofacial Radiology Department of Mashhad Dental School.
In this cross-sectional study, panoramic radiographs of 1987 patients over one year were evaluated, and any finding that was not related to the reason of panoramic radiography request was recorded as an incidental finding. These findings were grouped into five categories: intraosseous findings, dental abnormalities, soft tissue calcifications, maxillary sinus findings, and TMJ findings. The obtained data were analyzed using descriptive statistics and through SPSS18.0.
A total of 3990 findings in 1987 patients, including 795 men and 1192 women aged 4 to 84 years old, were identified. The overall rate of incidental findings was 85%. The highest rate of incidental findings was related to intraosseous findings (53.8%), followed by dental anomalies (34.7%), soft tissue calcifications (21.2%), maxillary sinus (17.3%), and TMJ findings (3.2%). The most prevalent intraosseous incidental finding was rarefying osteitis. The most common dental abnormalities were impaction and missing. Half of the soft tissue calcifications were elongated calcified styloid ligament. The most common sinus and TMJ incidental findings were mucosal thickenings and articular eminence pneumatization, respectively.
Incidental findings in panoramic radiographs are common. Although most of the findings do not require treatment, early diagnosis of some of these findings is beneficial in preventing subsequent complications in patients.

Inflammation is characterized by interactions between cytokines and inflammatory pathogens. Cytokines are glycoproteins involved in inflammation. Exercise training and physical activity are associated with a healthy lifestyle. In the current study, we aimed to determine the effects of high intensity interval training (HIIT) and L-Carnitine (LCAR) on the expression of genes involved in inflammation and inflammatory pathways in the liver and heart of rats.

Thirty-two male Wistar rats were randomly divided into the four groups (n = 8): 1. Untreated control group, 2. LCAR group (received 200 mg/kg LCAR daily), 3. HIIT group (performed high intensity interval training), 4. Exercise training + LCAR.

The results of our study showed that HIIT + LCAR significantly reduced the expression of IL-1β in the liver compared to the HIIT group (p = 0.038). The combination of HIIT and LCAR decreased IL-6 expression in the liver tissue compared to the control (p <0.001), LCAR (p <0.001), and HIIT (p = 0.002) groups. The HIIT + LCAR group decreased Cox 2 gene expression in the liver tissue compared to the untreated control group (p <0.001), and LCAR group (p = 0.007). The combination of HIIT and LCAR reduced IL-1β expression in the cardiac tissue compared to the untreated control (p <0.001), LCAR (p = 0.034), and HIIT (p = 0.041) groups. The combination of HIIT and LCAR increased IL-6 expression in the cardiac tissue compared to the other three groups (p <0.001).

According to the obtained results, HIIT combined with LCAR administration is very useful in reducing the expression of pro-inflammatory genes in the heart and liver tissues.

The aim of the present study was to examine the association between hemoglobin A1C (HbA1C( and eGFR in patients with type 2 diabetes (T2D).

This cross-sectional study was conducted on 802 patients with T2D visiting Abu Reyhan Clinic of Shahid Mohammadi Hospital in Bandar Abbas, Iran. eGFR was determined using MDRD and EPI methods. The association between two levels of HbA1C (≤8% and >8%) and two levels of GFR (≤60% and >60%) were assessed in total population, and separately, in men and women using linear regression model.

The mean ± SD age of the study population (27.7% male) was 53.5 ± 5.5 years. Based on the multivariable adjusted model, in subjects with HbA1C >8%, there was a negative association between HbA1C and eGFR-EPI (β = -0.14) and eGFR-MDRD (β = -0.12), (P<0.05). However, there was no significant relationship between HbA1C and eGFR in individuals with HbA1C ≤8%. Also, no significant association was found between HbA1C and eGFR as categorical variables (based on the two categories of eGFR ≤60 and >60). An inverse association was observed between GFR ≤60 and HbA1C >8% in women based on the Hb classification. This inverse association was found between HbA1C >8% and eGFR-EPI (β = -0.76) and eGFR-MDRD (β = -0.78) in women with Hb >12 mg/dl (P<0.01).

According to the results, the higher level of HbA1C can be associated with decreased eGFR level. This negative association was mostly observed between HbA1C >8% and GFR ≤60 in T2DM female patients without anemia (Hb>12). It seems that monitoring kidney function by eGFR estimation is a necessary action in patients with T2D with high HbA1C levels.

Methamphetamine (METH) is a widely addictive and abused psychostimulant drug that affects organs of body. In this study, the effects of METH administration for 7, 14, and 28 days on the histological and functional changes of the liver and pancreas of adult male rats were investigated.

In this experimental study, 58 adult male Wistar rats were randomly divided into seven groups including control (received no treatment), vehicle (received saline for 7, 14, and 28 days), and METH (received METH with a dose of 5 ml/kg, IP for 7, 14 or 28 days). Sampling from the liver and pancreas tissues was done after the above-mentioned times for each group, then, tissue samples were stained by H&E technique and evaluated for structural changes, as well as the evaluation of biochemical factors including SGPT, SGOT, and amylase enzymes. Data were analyzed by one-way ANOVA, using SPSS software version 20. Statistical significant level was considered at p <0.05.

In this study, METH caused a significant structural change in the liver and pancreas in the METH-treated groups compared with the control group. Functional changes depended on the length of treatment, with the 7-day treatment group having less damage than the 14- and 28-day periods.

According to the results of the present study, methamphetamine administration for 7, 14, and 28 days had adverse effects on the rats liver and pancreas structure and their enzymes (SGPT, SGOT, and amylase). Therefore, underlying mechanism need further investigation.

Pyodermatitis-pyostomatitis vegetans (PD-PSV) is an uncommon inflammatory mucocutaneous disease with unknown etiology. It is characterized by pustular and vegetating plaques on the skin and oral mucosa. When the oral mucosa is involved alone, it is called pyostomatitis vegetans. This disease is considered as an oral manifestation of inflammatory bowel diseases. In the present paper, we report a case of pyostomatitis vegetans in a 23-year-old female patient with swelling of the lips and oral lesions. Our patient had simultaneously three important clinical symptoms, including the presence of intra-oral lesions, lip swelling, and gastrointestinal manifestations that may be suggestive of inflammatory bowel disease. Her oral manifestations improved with topical antifungal drug and local and systemic corticosteroids. In addition, the results of our extensive search in reliable scientific databases including Google and PubMed for articles (case reports and literature reviews) containing the keywords: ”pyostomatitis vegetans” and "pemphigus vegetans” in recent years are presented.

Nocardiosis is an uncommon infection caused by Nocardia species, a group of aerobic actinomycetes. Nocardiosis may affect immunocompromised or immunocompetent patients and as this case was affected by a rare disorder, we describe it in this study. This paper describes a case of nocardial mycetoma from a hospital affiliated to Shiraz University of Medical Sciences. The case was a 52-year-old man with diabetes mellitus, who was admitted to our institution with a 5-year history of right lower extremity swelling with multiple discharging sinuses localized in distal part of the leg and dorsum of the foot following a penetrating injury to the affected foot. The wound culture yielded the growth of Nocardia species after incubation. Nocardiosis should be considered in the differential diagnosis of skin lesions, especially if patients have a history of trauma or contact with soil-contaminated materials. Our reported case increases knowledge about this rare, sporadic infection in our country.

The aim of the present study was to evaluate the inhibition of α-glucosidase and antioxidant properties of different tissues of sea urchin Echinometra mathaei.

α-glucosidase inhibition was determined using p-Nitrophenyl-a-D-glucopyranoside as a substrate, and the antioxidant properties were evaluated by 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS),1,1-diphenyl-2-picrylhydrazyl (DPPH), and nitric oxide radicals scavenging. Also, antioxidant potential was evaluated by the ferric reducing antioxidant power (FRAP) method.

Among the studied tissues, the highest α-glucosidase inhibition was revealed by the ethyl acetate extract of the shell and Aristotle’s lantern (IC50 = 3.7 and 4 mg/mL, respectively). Shell had the highest ABTS (IC50 = 183) and DPPH (IC50 = 208 μg/mL) radicals scavenging, respectively. And, gonad had the highest antioxidant potential by the FRAP method (1140 μg ASA/mg) and NO radical scavenging (70.68%), respectively.

Antidiabetic potentials of the ethyl acetate extracts of sea urchin tissues suggest that these extracts can be used as antidiabetic drugs.