مجله پزشکی دانشگاه علوم پزشکی تبریز
سال چهل و ششم شماره 1 (پیاپی 169، فروردین و اردیبهشت 1403)

Diabetes is one of the most common chronic and metabolic diseases. This systematic review and meta-analysis study aimed to compare the effects of multiple daily insulin injections against permanent subcutaneous insulin injections on glycated hemoglobin (HbA1C) levels in type 2 diabetic patients.

Studies that compared the impacts of multiple daily insulin injections against permanent subcutaneous insulin injections on HbA1C levels and were published until the end of 2022 in international databases were searched and retrieved (nine randomized clinical trial studies). The Chi-squared test and I2 were used to determine the presence and size of heterogeneity.

The results of the analysis demonstrated that compared to the group of multiple daily insulin injections, HbA1C was significantly reduced in the group of permanent subcutaneous insulin injections, so that the standardized mean difference was equal to -0.26 (95% confidence interval: -0.46– -0.06 P=0.025). According to the results of Egger’s (P=0.333) and Begg’s (P=0.667) tests, publication bias was not observed in this study.

Based on the available evidence, permanent subcutaneous injection of insulin could be significantly successful in reducing and controlling the level of HbA1C because the patients in the permanent subcutaneous injection group had lower levels of HbA1C.

Recurrent pregnancy loss is defined as at least two consecutive clinical pregnancy losses before 20th week of gestation. In this study, we investigated microRNA-1 and microRNA-1229 in recurrent miscarriage patients before and after lymphocyte therapy in comparison to control group.

First, a written and informed consent will be obtained from the target population of this study, who are people with RPL referring to Waliasr International Hospital. According to the standard protocol, the number of 2×107 is injected subcutaneously to patients. Real-time PCR technique will be used to check the expression level of microRNA-1 and microRNA-1229.

The gene expression level of micro-RNA 1 in RPL women before of lymphocyte therapy was 2.030±1.445 and the gene expression level of the same micro-RNA after the lymphocyte therapy of the mother was 1.101±0.4780. Also, the expression level of micro-RNA 1229 in these women was reported to be 2.100±0.6296 before treatment and 1.247±0.9631 after treatment with lymphocytes. This level of gene expression in control group, for micro-RNA 1 and micro-RNA 1229 genes is 1.000±0.08334 and 1.000±0.08091, respectively.

The results of our study showed a noticeable decrease in the gene expression of microRNAs under study, both microRNAs 1 and 1229, in women with a history of three consecutive injections of the father's subcutaneous lymphocytes.

Various methods have been proposed to treat plantar fasciitis. Among these, autologous blood transfusion has been discussed and investigated in the past few years, the findings indicate its effects in the medium term, and in some studies, better results were observed compared to corticosteroids. This study was conducted with the aim of comparing the effect of two therapeutic methods of local injection of autologous blood and corticosteroid with the control group in the treatment of plantar fasciitis.

In this prospective study that took place in Shahid Beheshti Hospital, Babol, during 2020–2021, 90 plantar fasciitis patients were examined in two treatment groups by corticosteroid injection or autologous blood. Their levels of pain and satisfaction were recorded during three and six months by the visual analog scale (VAS) and the Roles and Maudsley Scale (RMS). The data were described and analyzed by SPSS-22 using descriptive indices and statistical analysis tests at a significance level of 0.05.

There was no significant difference in pain and satisfaction during the third month of steroid and autologous blood transfusions. However, in the sixth month, the patients in the autologous blood group had significantly less pain than those in the steroid group (P= 0.001), and their level of satisfaction was significantly higher than that of patients in the steroid injection group (P= 0.018). The mean pain intensity based on VAS in six months was 5.40 ± 1.37 and 3.76 ± 1.87 in the steroid and autologous blood groups, respectively (P< 0.001). Based on the Wilcoxon test, the VAS score increased significantly in the steroid group in the sixth month compared to the third month (P= 0.011), while it decreased in the autologous blood group (P< 0.001).

Based on the findings, autologous blood injection in plantar fasciitis over six months had significant pain-reducing effects and satisfaction versus corticosteroid injection. However, after three months, these effects were not significant compared to corticosteroids.

Menopause is associated with an increase in blood sugar and an increase in inflammatory cytokines. Exercise and genistein have biological activities, including anti-inflammatory and antidiabetic activity. This study examined the combined effects of regular swimming exercise and genistein as a preventive strategy against inflammation and pancreatic cell damage in ovariectomized diabetic rats.

A total of 42 female Wistar rats were divided into six groups: Sham, ovariectomy (OVX), diabetic ovariectomy (OVX.D), diabetic ovariectomy + exercise (OVX.D.E), diabetic ovariectomy + genistein (OVX.D.G), and diabetic ovariectomy + exercise + genistein (OVX.D.E.G). Animals underwent swimming training or received genistein or a combination of both for eight weeks. At the end of this period, the levels of TNF-α, Nf-κB, IL-1β, and SIRT1 proteins were evaluated using western blot in pancreatic tissue.

Ovariectomy increased the expression of TNF-α, Nf-κB, and IL-1β and decreased the expression of SIRT1, and these effects were more significant in ovariectomized diabetic rats. Treatment with genistein and swimming exercise individually reversed these changes in the level of proteins and improved the inflammation, but the combined effect of these two interventions exhibited more effect.

The combination of genistein and regular swimming exercise provides enhanced protection for pancreatic tissue and effectively prevents damage to it. Therefore, performing appropriate physical activities and consuming compounds containing phytoestrogens can prevent the occurrence of disorders such as diabetes during menopause.

Migraine disease is the second most common cause of headaches. Despite the high prevalence, the exact etiology of migraine is yet unknown. In this study, to evaluate the behavior change of electroencephalography (EEG) signals in migraine patients, various features of the EEG signals of migraine patients and healthy controls (HCs) were extracted and compared.

This cross-sectional analytical study was conducted on 21 HCs and 18 migraine patients. Various features, such as fractal dimension (FD), approximate entropy (ApEn), and largest Lyapunov exponent (LLE), were calculated from the EEG signals of migraine patients and HCs. Then different frequency sub-bands of delta, theta, alpha, beta, and gamma were extracted using the wavelet transform, and the energy of these sub-bands was computed. By calculating the mean and variance of the features and applying statistical tests, the feature changes were compared between two groups, and channels with significant differences were identified.

The mean of ApEn, FD and energy of all frequency sub-bands in most of the analyzed channels was higher in migraine patients than in HCs. The mean LLE was mostly lower in migraine patients than in healthy controls. According to the statistical tests, the energy of theta and delta frequency sub-bands with 36 and 35 channels was the feature with the highest number of channels, with a significant difference. In this study, P values less than 0.05 were considered statistically significant.

Migraine patients may have a less sophisticated brain dynamic system due to an increase in irregularity and randomness, as indicated by an increase in ApEn and a decrease in FD in their EEG signals compared to HCs. Anxiety, tension, and other intense sentiments and emotions, as well as the creation of new neural circuits in the brain, can all contribute to an overall increase in energy across all frequency sub-bands in migraine patients.

The present study examined the relationship between latent toxoplasmosis and mental disorders.

The sample included 117 toxoplasma-positive volunteers on Facebook, Twitter, and Instagram. Data were collected online using the 71-item abbreviated form of the Minnesota Multiphasic Personality Inventory (MMPI).

According to the results, a) the psychological profile of latent toxoplasmosis patients in the eight clinical scales of MMPI was within the normal range; b) in the male group, ‘duration of infection’ significantly predicted the scores for the four clinical scales of depression, psychopathic deviate, psychasthenia, and schizophrenia; also, ‘age’ predicted the scores for hypochondriasis and schizophrenia in men; c) in the female group, only ‘age’ was able to predict the scores for the scales of hysteria, paranoia, mental weakness, and social deviance; and d) there was no significant difference between male and female groups in any of the clinical scales.

Duration of infection with latent toxoplasmosis was associated with depression, psychopathtic deviation, psychasthenia, and schizophrenia in infected males, but this was not the case for the infected females in any of the clinical scales of the 71-item abbreviated form of MMPI.

Kawasaki disease is an acute and rare febrile disease that affects children and is characterized by conjunctivitis, redness of the lips and mouth, diffuse skin lesions, edema and redness of the hands and feet, and cervical lymphadenopathy. Since the start of the COVID-19 pandemic, Kawasaki disease has become much more prevalent and has more diverse manifestations.

This retrospective cohort study included patients diagnosed with Kawasaki symptoms between January and October 2021 at the Tabriz Children's Education and Therapeutic Center. The diagnosis was made using the guidelines of the American Heart Association (2017) and the American College of Rheumatology.

All referred patients had fever, and additional symptoms may include skin involvement (93%), mucosal involvement (87%), end changes in the peripheral exterimities in the form of erythema and scaling (75%), gastrointestinal manifestations (51%), cardiac manifestations (42%), followed by respiratory (27%), and finally cervical lymphadenopathy (18%).

Manifestations of Kawasaki disease during the COVID-19 pandemic can be much more diverse and severe. Knowing the variety of clinical symptoms and uncommon findings of Kawasaki disease in these patients can help to early distinguishing between Kawasaki and Kawasaki like disease and prevent the progression of the disease.

 Having problems in regulating the emotions is considered as the main core of depression disorder and rumination is one of the cognitive components in individuals with depression disorder. The objective of this study was to consider the effect of mindfulness training on rumination and cognitive regulation of emotion in students with depressive symptoms.

 This study was a semi-experimental method with a pre-test-post-test design with a control group. The statistical population included all 350 students of the Faculty of Nursing of Tabriz University of Medical Sciences in 2023-2022, among whom the Beck Depression Questionnaire was administered. Among them, 30 students with symptoms of depression (15 as experimental and 15 as control) were selected by purposive sampling method. The emotion regulation scale and rumination questionnaire were used to collect data.

 The findings showed a significant difference between the experimental and control groups in terms of rumination and cognitive regulation of emotion (P<0.001). The mean of rumination in the experimental group was significantly reduced compared to the pre-test and the control group, and the mean of the cognitive regulation of emotion was significantly increased.

 The results of the research showed that mindfulness training has an effect on rumination and cognitive regulation of emotion in students with depressive symptoms.

 Muscle weakness and low muscle tone may cause chewing and swallowing disorders in people with Down syndrome. This study investigated the electromyography of the masseter and temporal muscles in children with Down syndrome, aged 2 to 12, during maximal voluntary isometric contraction and rest.

 The current descriptive-analytical and case-control study investigated the electromyography frequency indicators of the masseter and temporal muscles at maximum voluntary contraction and resting states in 15 children aged 2 to 12 with Down syndrome and 15 normal children of the same age.

 The average frequency of the mean and median in the electrical signal of the masseter and temporal muscles on the left and right sides and in two different positions in children with Down syndrome is lower than in normal children. In comparing the average frequency of the mean, except for the left and right temporal muscles in the maximum voluntary isometric contraction and the left master muscle during rest, there is a significant difference in the rest. Also, in comparing the average frequency of the median, except for the left and right temporal muscles in the resting state, there are non-significant differences in the rest of the cases.

 The average frequency of the electrical signal of the masseter and temporal muscles in children with Down syndrome is lower than that of normal children. Unlike typically developing children, those with Down syndrome struggle with chewing and swallowing.  

 Since prenatal care may have been affected during the COVID-19 pandemic, this study aimed to compare the content of prenatal care during the COVID-19 pandemic with one year before the pandemic in Qazvin, Iran.

 This cross-sectional-analytical study included 722 pregnant mothers (361 before and 361 during the COVID-19 pandemic) referring to Qazvin health centers in 2018 and 2019. The "Evaluation of Care during Pregnancy" checklist was used to collect information. The information was extracted from the Integrated Health System (known as SIB), reporting offices of health centers. SPSS version 25 software was used to analyze the data.

The results showed a decrease in the number of prenatal care in all care times during the COVID-19 pandemic compared to the pre-pandemic period (P<0.001). The rate of preterm pregnancies increased during the pandemic period (P<0.001). Performing the first round of screening, the first and second rounds of ultrasound and the second round of laboratory tests, respectively decreased by 23.8%, 11.1%, 13.3% (P<0.001), and 7% (P=0.004) in the pandemic period (P<0.001). The follow-up rate of referrals also decreased during the pandemic period (P<0.001).

 The results showed a decrease in the number and content of prenatal care during the COVID-19 pandemic.