فصلنامه کومش
سال بیست و سوم شماره 3 (پیاپی 83، خرداد و تیر 1400)

Evidence is supported the hypothesis that any changes in the composition and function of the gut microbiota play a fundamental role in a number of chronic inflammatory diseases including celiac disease (CD). In the last decade, several culture-independent methods have been developed to identify the components of the human microbiome. The study of microbiota based on nucleic acid analysis found in feces or other biological samples allows the characterization of non-cultivable microbes. Current evidence on the composition and role of the intestinal microbiota as triggers for CD is highly variable and sometimes contradictory. However, emerging evidence suggested that gut microbiota may be associated with development of several gastrointestinal diseases such as CD. The microbiota plays a key role in function and modulation of both innate and adaptive immunity. Recent studies have shown noticeable reduction in beneficial bacteria and increase in those potentially harmful microbes in patients with CD as compared to healthy controls. Thus, in this review we tried to discuss the relationship between the intestinal microbiome and CD.

Emerging COVID-19 disease has affected various aspects of people’s life. The psychological effects of this disease, especially in children and adolescents, include a wide range of disorders such as anxiety, depression, post-traumatic stress disorder, the possibility of domestic violence, addiction and substance use, dependence on cyberspace and related complications, change in patterns and daily lifestyles such as sleep, physical activity and mobility pattern disorders. The reasons for these disorders also include various aspects, such as economic reasons, school closures, being away from friends, and lack of privacy at home and lack of access to support resources. Due to the importance of these disorders in children and adolescents, measures and suggestions have been presented in this field, some of which are psychological measures and treatments and others are related to schools, teachers and counselors.

The aim of this study was to investigate the effect of one-session transcranial direct current stimulation  (tDCS) of cerebral cortex with and without step practice on foot function in patients with chronic stroke.

It was an interventional and clinical trial study. Forty patients with chronic stroke were randomly assigned into four groups, Sham tDCS, tDCS, tDCS + Step exercise, and Step exercise. Timed up and go test was carried out with asymmetrical position of feet, affected leg behind of the unaffected leg before and after of intervention. In this way, anodal tDCS (2 mA) was applied over the primary motor cortex for 20 minutes.

The interactive effect between time and groups has been significant (P=0.002, effect size=0.36). The follow-up test showed that the Timed up and go test time did not show a significant difference between the other groups after the intervention (P<0.05).

The use of anodal electrical stimulation of the brain with and without a step training was both effective in reducing Timed up and go test time, but no difference was observed between the two interventions

Sleep disorders and fatigue are common problems in patients with acute myocardial infarction (AMI) which can lead to an increased incidence of recurrent myocardial infarction and arrhythmias. The aim of this study was to determine the effect of foot reflexology on sleep quality and fatigue severity in the AMI patients.

In this double-blind randomized clinical trial, 90 AMI patients who had inclusion criteria were evaluated from cardiac care unit of Shahid Rajaee Hospital in Karaj, Iran from 30 may 2015 to 20 August 2016,  and were randomly assigned to 3 groups: Treatment (n=30), placebo (n=30), and control (n=30). Left foot reflexology in the treatment group and right foot reflexology were performed in the placebo group.The control group did not receive any intervention. Foot reflexology intervention was performed for 3 consecutive day’s for 20 minutes. The severity of fatigue was assessed in 3 groups of above, before, immediately and 20 minutes later of intervention by VAS. Sleep quality was assessed by Pittsburgh questionnaires and VAS, the day before and two consecutive days after intervention.

The fatigue intensity score of the treatment group immediately after intervention was not significantly different from the control (P=0.233) and placebo groups (P=0.903). Remarkably, the control group was not significantly different from placebo (P=1.00). The fatigue severity score in 20 minutes after intervention was significantly lower than the control group (P=0.003), but did not differ significantly from the placebo group (P=0.355). Also, fatigue severity score of the control group did not differ significantly from the placebo group (P=0.218). Sleep quality with VAS and Pittsburgh on first and second day after intervention wasn’t significantly different in the treatment  groups compared with the control and the placebo groups and in the control group than the placebo group (P>0.05).

Findings showed that foot reflex massage 20minutes after intervention induced of significant reduction in fatigue severity in the AMI patients. Therefore, nurses can use this easy, non-pharmacological, non-invasive and low-cost method to improve severity of fatigue.

Low back pain is one of the most common causes of daily activity limitation and functional disabilities that affect a large number of people in the community. Due to the ineffectiveness of oral analgesics in relieving this type of pain and the need for their long-term use, which has its own side effects, the present study investigated the supplementary effect of acupuncture on pain in patients with acute back pain referred to the emergency department.

The present study is a randomized clinical trial that was performed on 80 patients with acute low back pain. Patients were randomly assigned to acupuncture and ibuprofen groups (n =40 in each group). The rate of pain reduction of these two treatments was measured with the pain numeric rating scale at the time of arrival, 2 and 24 hours later in the acupuncture group and the moment of arrival and two weeks later in the control group.

The mean age of patients in the acupuncture group was 35.61±9.13 years and in the ibuprofen group was 37.55±7.96 years. The mean change of pain in the two groups of acupuncture and ibuprofen was statistically significant. The mean pain reduction in the acupuncture group was 6.95 ± 0.21 and in the ibuprofen group was 1.37±0.21 (P=0.001). The mean trend of pain change in the acupuncture group at the beginning of the study and two hours and one day after acupuncture was statistically significant (P=0.001). The mean trend of pain change in ibuprofen group was statistically significant at the beginning of the study and two weeks after taking the drug. The mean pain decreased after two weeks of drug administration compared to the before drug administration (P=0.001).

Acupuncture along with ibuprofen drug therapy has been more effective than ibuprofen therapy alone and has resulted in a better response to treatment and reduced pain in the studied patients. Therefore, acupuncture is a simple and uncomplicated procedure and also effective in reducing pain in patients with acute low back pain, which can be suggested as a complementary treatment for low back pain, after confirmation by further studies.

The assessment of pain in critically ill patients requires careful examination, especially in intubated and traumatic head patients due to the impossibility of using verbal pain scales and changes in non-verbal communication due to the type of injury sustained .The purpose of this study was to compare the psychometric properties of the Persian version of Behavioral Pain Scale (BPS) and Critical-Care Pain Observation Tool (CPOT) in patients with head trauma.

The psychometrics (research methodology) was done on 60 intubated head trauma patients in Shahid Rahnemoon Hospital in Yazd (Iran) in 2018-19. Considerably, the pain was measured using two BPS and CPOT scales by two evaluators independently and simultaneously in both painful and non-painful procedures. Then, convergent validity, differential validity, evaluator reliability, stability, internal consistency, sensitivity and feasibility of the two tools were evaluated and compared.

Based on 2160 evaluations; in convergent validity strong correlation was observed between the two tools, (r>0.7). Differential validity, BPS and CPOT scores during painful procedures were significantly higher than painless procedures. The Cronbachchr('39')s alpha coefficient for the two scales was 0.722 and 0.865, respectively. The reliability of the stability of both instruments in all evaluations was more than 0.7 and significant. Also sensitivity and feasibility were confirmed for BPS tools 0.8 and 75% and CPOT tools 0.7 and 55%.

The use of BPS and CPOT tools to measure pain in intubated head trauma patients are associated with validity, reliability, and sensitivity. However, BPS was feasible for nurses to use.

Proper marital relationship is an important factor in success and continuity of the couplechr('39')s live together. So, this study was conducted to evaluate and improve of sexual function and marital satisfaction in Semnan’s women through educational interventions.

This interventional study was conducted in selected health centers of Semnan city (Iran) in 2019. The sample size was 200, which was determined using similar studies; and participants were divided between case and control groups, randomly. Therefore, the study tools included two questionnaires which their validity and reliability were confirmed in previous studies. The participants were surveyed in two phases, before and after the educational interventions, and the effectiveness of the interventions was determined by comparing obtained results in the case and control groups in the two phases.

Assessing the interventions impacts showed that the performed interventions had positive and significant impacts in all dimensions of sexual function aspect (except sexual pain) as well as total sexual function (P<0.05). In marital satisfaction aspect; the interventions had significant and positive impact on dimensions of “communication” and “satisfaction” (P<0.05), and had not any impact on dimensions of “idealistic distortion” and “conflict resolution” (P>0.05).

The study results showed that the implementation of educational interventions and the establishment of counseling mechanisms could lead to promotion of sexual function and marital satisfaction in women. Undoubtedly, the integration of these educational interventions in provided services from health system can promise the strength of the family foundation.

Forward head posture, which occurs often in conjunction with increased curvature in the upper body and rounded shoulder, is one of the most common postural deviations. Over time, this poor posture can contribute to the development of neck pain and shoulder dysfunction. Therefore, the purpose of this study is to design and develop a forward head rounded shoulder posture corrective orthosis (FHRSO) and its immediate effect on craniovertebral and protraction-retraction angles in people with postural deviations in the upper body.

Thirty men aged between 18 and 60 years with a forward head posture disorder (craniovertebral angle less than 42.5 degrees) participated in this study. Correspondingly, the immediate effect of the newly designed orthosis, namely FHRSO was investigated via measuring two variables, craniovertebral and protraction-retraction angles in the standing position by taking lateral view photographs.

Both craniovertebral and protraction-retraction angles were significantly increased following the FHRSO wearing in comparison with no orthosis condition (P<0.001).

Our findings indicate that a FHRSO orthosis can be effective for correcting the forward head and rounded shoulder posture in persons with postural deviations in the upper body.

According to the world health organization the prevalence of type 2 diabetes in our country and world will increase sharply by 2030. Because improving glycemic control delays the onset and progression of diabetes complications, recognizing related factors is key step in the effective treatment of these patients. Therefore, this study was performed to determine the predictors of poor glycemic control.

This study was a cross sectional study performed on 388 diabetic patients referring to the diabetes clinic in year 2019 (Semnan, Iran). The mean glycosylated hemoglobin was used as glycemic control index, and Hb A1C >7% was considered as poor glycemic control. Exclusion criteria were pregnancy, use of corticosteroid or cytotoxic drugs, malignancy, hemoglobinopathy, anemia, uremia, secondary diabetes, history of GI bleeding, surgery and blood transfusion in the last 3 month. All patients with type 2 diabetes who did not meet the exclusion criteria were included in the study.

The mean Hb A1C was 8.044 ± 1.46 and 74 % of the patients had poor glycemic control. 44.5% of the patients had BMI> 30 kg/m² and 89.9 % of them had abdominal obesity. There was an association between poor glycemic control and gender, type of treatment and duration of diabetes. Women, individuals treated with injectable insulin, and patients with the duration of diabetes less than 5 year had better control.

Our study showed that duration of diabetes and type of treatment are independently associated factors of glycemic control.

Vitamin D has anti-inflammatory and immunomodulatory function. The role of vitamin D deficiency has been established in the development of many types of cancers and autoimmune diseases. Oral lichen planus (OLP) is a common chronic autoimmune in oral cavity. This study aimed to evaluate the serum and salivary levels of total vitamin 25 (OH) D3 in patients with the OLP and to assess the relationship between vitamin levels and salivary flow rate.

The blood samples, unstimulated and stimulated saliva were collected from 64 patients with the OLP and 45 healthy subjects. The 25(OH) D3 levels measured by ELISA technique. The salivary flow rate was also measured in milliliters per minute.

The level of vitamin D3 in unstimulated and stimulated saliva of the OLP patients significantly decreased compared to the control group (p<0.001, p = 0.01 respectively). There was no significant relationship between the serum level of vitamin D3 in the OLP and control groups (p = 0.11). No significant relationship was found between serum and salivary vitamin D levels with salivary flow rate. No significant correlation was found between salivary and serum levels of vitamin D, but the severity and pain score were negatively correlated with vitamin D levels.

Lower levels of salivary 25 (OH) D3 in the OLP patients than the healthy subjects can be an effective factor in the development of this disease. Conspicuously, saliva seems to be a more accurate tool for measuring vitamin D than serum.

Low back pain is one of the most common disorders in modern society. Disturbed properioception can be a possible cause of low back pain and can cause recurrence of low back pain. Previous studies have shown that low back pain reduces proprioception due to instability in the low back. Since the degenerative process of disc herniation is one of the important factors in exacerbating the known low back pain process, it is not clear whether the degeneration of the lumbar disc exacerbates the deficits of proprioception or the proprioception reduction is resulted from the low back pain itself. The aim of this study was to dertimine whether disk degeneration is the cause of proprioception reduction or not?

This observation study was performed on 70 patients with low back pain (35 people with chronic non-specific low back pain and 35 people with discopathic low back pain). Remarkably, the repositioning error of the forward bending angles at 30% and 60% of the total lumbar flexion angle and the neutral angle was measured by a digital electrogoniometer.

Based on the measurements of absolute error in 30% of the total range of motion (1.97±2.02 in patients with chronic nonspecific low back pain versus 1.92±1.04 in discopathic individuals, P=0.892) and 60% of the total range of motion (2.30±1.96 vs. 2.01±1.09, P=0.450) and neutral angle (1.74±1.36 vs. 1.44±1.41, P=0.370), there was no significant difference between these two groups.

Patients with low back pain may have altered proprioception, but due to the lack of significant differences in proprioception between chronic nonspecific low back pain patients and discopathic patients, other factors appear to be involved in the exacerbation of low back pain disorder.

Noise is one of the most harmful physical factors in the workplace that can cause annoyance. Therefore, the aim of this study was to investigate the effect of annoyance caused by occupational noise on employee’s mental distress.

This analytical-descriptive study was performed on 325 employees of the parts manufacturing industry in seven groups and the noise dose received for each group was measured by a dosimeter using ISO9612 standard. Then, psychosis was determined using the Kessler psychosis scale and the degree of annoyance in the face of noise in the face of noise by the standard method of ISO15666 as an individual evaluation with a one-question scale of 11 Likert options.

The results indicated that there was a positive and significant relationship between the received sound dose and noise annoyance (P <0.05). In addition, the dose received from the sound can justify 72.2% of the variable response changes, i.e. the amount of voice annoyance alone. Also, the results of the simultaneous study of four variables of age, work experience, voice exposure and voice annoyance on the state of mental distress using multiple regression indicated that these 4 variables predicted 42% of changes in mental distress. And the main variable influencing psychological distress is voice annoyance (P <0.05).

Occupational noise through noise annoyance harassment can affect the mental health of people working in industry and harassment can act as a mediator due to job noise causing mental distress in people working in industry.

Diabetes is a chronic disease, non-epidemic disease that costs a lot of money in each year. One of the diagnostic criteria for diabetes is Glycosylated Hemoglobin (HBA1C), which in this study the effective factors on it examined by additive regression model.

In this cross-sectional study, 130 patients with diabetes type-2 were selected based on simple random sampling in Ilam city (Iran). Several variables were examined such as gender, age, weight, height, systolic and diastolic blood pressure, hypertension, smoking, family history of diabetes, daily walking for at least 30 minutes, waist and hip circumferences, HbA1c, fasting blood sugar (FBS), RBC mean corpuscular volume (MCV) and BMI. The data were collected based on Canadian diabetes checklist questionnaire.

In simple linear regression, waist and hip circumferences and in multiple regression, hip circumference and BMI had a significant effect on HBA1C (P<0.05). Importantly, in simple additive regression waist, hip circumferences and fasting blood Sugar as well as in multiple additive regression waist, hip circumferences, fasting blood sugar and BMI had significant effects on HbA1C (P<0.05).

Additive regression model with 0.878 adjusted R-squared and AIC equal to 603.464 was better model for examining the influential factors on HbA1C compared with the multiple regression model with adjusted R-squared and AIC equal to 0.386 and 844.730, respectively.

Cardiac tissue is one of the organs affected by thyroid hormones imbalances. Apolipoprotein D is a multifunctional glycoprotein that is expressed in various tissues including heart tissue. The aim of this study was to evaluate the effect of both hypothyroidism and hyperthyroidism on the level of apolipoprotein D protein in the heart tissue.

In order to induce hypothyroidism and hyperthyroidism in white mice, propylthiouracil (PTU, 100 ppm) and levothyroxine (L-T4, 8 ppm) dissolved in water  and were used for 6 weeks, respectively. ELISA method was used to measure the total T3 hormone in rat serum. After confirming the model, the mice were anesthetized and the heart tissue was removed and the ventricle and apex of the heart were used for histological examination. Immunohistochemistry was used to evaluate the expression level of apolipoprotein D.

We showed for the first time that the expression of apolipoprotein D in the hearts of hypothyroid (P<0.05) and hyperthyroid (P<0.001) rats increased significantly compared to the control group.

It is suggested that the increase in cardiac apolipoprotein D levels due to thyroid disorders may be part of an inherent system to protect the heart against damage caused by oxidative stress and inflammation in these disorders.

Development of new medicines with fewer adverse effects and more efficacies is needed for the treatment of psychiatric disorders. The present study aimed to investigate the putative antidepressant and anxiolytic effects of methanolic extract of Salvia spinosa L. (SS) in mice.

Elevated plus-maze (EPM) and open field tests (OFT) were conducted to evaluate anti-anxiety and locomotor activity of animals treated with the methanolic extract of SS [12.5, 25, 50, and 100 mg/kg, intraperitoneal (IP)], respectively. Antidepressant-like activity of the extract was evaluated using forced swim test (FST) and tail suspension test (TST). Total phenol and flavonoid contents were measured using spectrophotometric methods.

IP administration of SS (25, 50, and 100 mg/kg) significantly increased the percentage of time spent and the percentage of arm entries into the open arms of EPM and decreased locomotor activity (100 mg/kg), compared with the control group. Furthermore, the immobility time of animals significantly decreased in both FST and TST with doses of 25, 50, and 100 mg/kg of the extract, as compared to the control group. The total phenolic content of methanolic extract was 55.17 mg of gallic acid equivalents (GAE) per gram of dry extract and total flavonoid content was 53.07 mg of quercetin as equivalents (QE)/ g of extract.

Salvia spinosa L. has antidepressant- and anxiolytic-like effects in animal models of psychiatric disorders.