نشریه پژوهش در پزشکی
سال چهل و هشتم شماره 1 (پیاپی 189، بهار 1403)

The effectiveness of stabilizing core muscles of the trunk and pelvis has been studied more in osteoarthritis (OA) of the hip and less in knee. Performing these exercises while standing, removes the limitation of performing them in different environments. The current study examines the effectiveness of standing core exercises on pain and performance of patients with knee OA, who have no strenuous activity and often have sedentary jobs. On the one hand, by reducing the social restrictions of doing these exercises and on the other hand, by reducing the occupational interfering factors that cause knee arthrosis, we have tried to get a purer and more accurate conclusion from these therapeutic exercises.

This is a randomized, controlled trial. Patients with knee osteoarthritis were invited to enter the study and if they met the criteria and received the consent, they were randomly divided into two groups. The control group, which only received the program of performing conventional exercises of knee OA, and the intervention group, which received the program of standing core exercises in addition to conventional exercises. The primary outcome of this study was visual analytic score (VAS) of pain and the secondary outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne and 6-minute walking test (6WMT) at 6 and 12 weeks.

In this study, 38 patients completed the study per-protocol. The baseline characteristics and outcome measurements did not differ significantly before the intervention. Within-group analysis showed that there is a significant difference in VAS, WOMAC pain, discomfort and maximum distance of Lequesne and 6MWT indices in both groups (P<0.05). Also, within-group analysis showed that there was a significant difference in WOMAC physical performance and Lequesne daily activity only in the intervention group (P<0.05). The results of the between-group analysis showed a significant difference between the two groups in all outcomes in 12 weeks (P<0.0001), and in the VAS and Lequesne index, a significant difference can be seen between the two groups even in 6 weeks (P<0.005). The effect size on the primary outcome of VAS is 0.68 in the core exercise group compared to the control group.

The results of this study show that standing core exercises, after 12 weeks, causes a significant reduction of pain, improvement of function and activity in patients with knee osteoarthritis compared to conventional exercises, and its positive effect on pain or discomfort, ‘maximum distance walked’, and ‘activities of daily living’ after 6 weeks, also observed. Although previous studies showed the positive effect of core exercise on the pain index and activity of knee osteoarthritis patients, the results of this study showed that even standing core exercises may be effective.

One of the most common health problems in the elderly population is frailty syndrome. Recent studies indicate that multi- component exercises can significantly improve physical performance of elderly people. The main purpose of this study was to investigate the effect of a selected multi- component exercise protocol (VIVIFRAIL) on balance, flexibility and functional capacity of elders with frailty syndrome.

This is an experimental and applied study with a pre- post- tests design that performed on 20 elderly men with frailty syndrome. Participants selected from one of the elderly rehabilitation centers in Isfahan city and were randomly divided into two exercise (n=10) and control (n=10) groups. For the exercise group, 12 sessions of multi- component exercises were prescribed and control group had no physical activity. The Fried's frailty syndrome index, short physical performance battery, manual dynamometer, sit & reach flexibility, and get-up and go tests were used to assessment of subjects. Statistical analysis and comparison of the mean of groups was performed by the analysis of covariance statistic.

The mean age of participations was 71.7 ± 9 years. Following the implementation of multi-component exercises, there were significant improvements in the mean score of frailty factors such as static balance (34.1%), flexibility (34.4%), Gait speed (%-17.2), hand grip strength (23.5%), risk of falling (-25.6%), and functional capacity (24.6%) of exercise intervention group. Also, no significant difference was observed in the weight of subjects.

The results showed that selected multi-component exercises have improved functional capacity, balance, flexibility, gait speed, hand grip strength, and fall risks in frail elderly persons.

The miR-302/367 cluster plays a critical role in reprogramming of somatic cells into pluripotent stem cells and in maintaining pluripotency. Until now, several studies have been conducted on the mechanism of miR-302/367 cluster in reprogramming, while little research has been done specifically on the effect of this cluster on mTOR signaling pathway. The mTOR pathway not only controls various cellular processes, such as proliferation, differentiation and autophagy, but also plays a significant role in the reprogramming process. Therefore, the present study was designed to identify the effect of miR-302/367 cluster on the mTOR pathway in adipose tissue-derived stem cells (ADSCs).

In this experimental study, the third to fifth- passaged ADSCs were transfected with TDH101PA- GP vector expressing mir-302/367 cluster and the mock vector using a Neon Transfection Kit and Neon Transfection System. One week after transfection, the expression of some mTOR signaling molecules in the ADSCs was assessed by comparative Real- Time PCR. Relative gene expression between the miR-302/367 and mock groups (4 replicates) was calculated by REST 2009 software based on Pair Wise Reallocation Randomization Test. Also, the expression of some mTOR pathway proteins was assessed by western blot analysis.

The overexpression of miR-302/367 cluster significantly reduced the expression of AKT, MTOR, RAPTOR, and RICTOR genes; the expression of these genes in the miR-302/367 transfection group compared to the mock group decreased to 0.44, 0.51, 0.56 and 0.6, respectively (P< 0.05). The expression of genes in the mock group was assumed as one. Also, as revealed by western blot analysis, the expression of phosphorylated AKT and phosphorylated MTOR proteins decreased in the ADSCs transfected with miR- 302/367 cluster compared to the mock group.

Overexpression of the miR-302/367 cluster appears to inhibit the activity of the mTOR signaling pathway in ADSCs and affect the cell reprogramming through this mechanism.

The dysfunction of pancreatic islets plays a crucial role in the development of diabetes. Considering the positive effects of aerobic training and the protective role of vitamin D3 in reducing metabolic disorders, including diabetes, this study aimed to investigate the impact of aerobic training and vitamin D3 supplementation and their interactions on pancreatic islet morphology and insulin resistance index in type 2 diabetes rat model induced by high-fat diet (HFD) and low-dose streptozotocin (STZ).

In this experimental study, 40 male Wistar rats were randomly assigned to non-diabetic included in this experiment. Eight rats were assigned to the normal control group (C) and fed a standard diet. To induce type 2 diabetes, the remaining rats (n = 32) were fed a HFD for 6 weeks, followed by a single intraperitoneal (i.p.) injection of streptozotocin (STZ) at a dose of 40 mg per kilogram of body weight. Diabetic rats were divided into four equal groups: diabetic (DC), aerobic training (DE), vitamin D3 supplementation (DD3), and aerobic training combined with vitamin D3 supplementation (DD3E). Aerobic training consisted of treadmill running five times a week. Vitamin D3 supplementation involved a weekly i.p. injection of 10,000 units. Plasma insulin and fasting glucose levels were measured. Statistical analyses were performed using One-way ANOVA followed by Bonferroni's post-hoc comparisons tests. Values are reported as mean ± SD and the level of significance has been considered at (p < 0.05).

Type 2 diabetes resulted in a reduction in the number and size of pancreatic islets. Both aerobic training and vitamin D3 supplementation increased the level and number of pancreatic islets, compared with the diabetic group (8.48 ± 0.16) insulin resistance in all three groups of DE (3.99 ± 0.51), DD3 (5.15 ± 0.32) and DD3E (3.80 ± 0.30) showed a significant reduction (p˂0.0001). Additionally, in the intervention group DD3E, the fasting plasma insulin (0.25 ± 0.03) and glucose (277 ± 26.58) levels were significantly lower compared to the DC group (p ˂ 0.0001).

It seems that based on the results of this study, aerobic training and vitamin D3 supplementation, as well as Their Interaction, led to a reduction in insulin resistance index and an increase in the size and number of pancreatic islets in type 2 diabetic rats induced by high- fat diet and streptozotocin.

Angiogenesis is the biological process of sprouting new vessels from existing vessels in the tissue. The main factor in the molecular guidance of this process is vascular endothelial growth factors (VEGF) and fibroblast growth factor (FGF). Considering the importance of plant medicine sciences and also, the role of angiogenesis in the processes such as wound healing, menstrual cycles, placental growth, and ovulation, the aim of this study was to investigate the effect of hydroalcoholic extract of the root and shoot of Ferula assa- foetida plant (as one of the prominent medicinal plants in traditional medicine) on changes in the gene  expression of VEGF and FGF in the angiogenesis pathway of the chorioallantoic membrane (CAM) of chick embryos.

In this experimental research, 80 Ross fertilized eggs of the were randomly divided into 8 groups including the control group, laboratory control (pbs), and 6 experimental groups. On the eighth day of incubation, the laboratory control group was treated with normal saline and the experimental groups were treated with doses of 100, 200 and 300 µg/ml of the hydroalcoholic extract of the shoot and root of Ferula assa- foetida plant. On the twelfth day, a photo was taken of the chorioallantoic membrane to count the number of vessels and measure the length of the vessels. CAM samples were prepared for RNA extraction and cDNA production. The collected data were analyzed by t-test and ANOVA.

The average number of vessels (26.1 ± 3.45) and vessel length (31.1 ± 0.78) in the treated group showed a significant decrease (P < 0.05) compared to the control group. Also, the gene expression level of VEGF and FGF in the treated group was significantly (P < 0.05) lower than the control group.

It seems that the hydroalcoholic extract of Ferula assa- foetida plant can affect the gene expression level of VEGF and FGF and the process of angiogenesis of the chorioallantoic membrane of chick embryos.

Pharmacology, as a major field in medical education, significantly shapes the competency of future healthcare professionals. The necessity of familiarizing with new teaching methods in pharmacology and evaluating their outcomes can be a good idea for their implementation. This article investigated the teaching of pharmacology in many medical universities worldwide with geographical diversity and international rankings to determine the reasons for using specific methods in those universities and to identify the results of the evaluations of their implementation.

In this descriptive study, universities were selected from all international rankings and geographical diversity to have more diverse data. Several countries and universities from each continent were chosen, and among neighboring countries, universities with social and cultural conditions closer to Iran were selected. The teaching method of each university was examined by visiting the university's website or studying an article about that method in the university or by contacting the head of the pharmacology department to review and summarize its advantages and disadvantages.

The methods of teaching pharmacology and their evolution in the examined faculties have been categorized.

It seems that a change in the traditional method is inevitable, and while teaching basic pharmacology may still require a traditional approach, clinical pharmacology discussions require the use of different methods. It also appears necessary for pharmacology to be taught both in the basics and in clinical settings, applying a different approach to teaching these two aspects.

Today, the treatment of prostate cancer and endocrine cancer by means of radiopharmaceuticals derived from lutetium-177 is the focus of many radionuclide therapy centers. One of the reasons for turning to lutetium radiopharmaceuticals is its favorable dosimetry and stability. Excreting the urine of these patients into the hospital's sewage and consequently into the city's sewage and finally into the agricultural fields causes indirect radiation exposure of the people. The aim of this study is to investigate the radiation exposure of people due to the presence of this radioactive material in urban areas.

In this cross- sectional study, the estimation of radioactivity in sewage has been done. In the first method, 18 wastewater samples were prepared in a standard volume from specific places at different times. The samples were counted using the gamma spectrometry method and the amount of radioactive substances in them was determined. In the second method, the concentration of radioactive substances in the wastewater was estimated using a mathematical model, and then the dose received by the people was calculated.

The dose received by the people from lutetium the wastewater of Shahada Tajrish Hospital is estimated to be 0.00052 nanosieverts per year, so this amount is equal to 1.73E-9 of the annual permissible dose and is equivalent to 0.0000003 days of natural radiation exposure.

The amount of dose received by people from lutetium in the wastewater of Shohada Tajrish Hospital is very small and is much less than the annual limit. Therefore, the direct discharge of the urine of patients treated with lutetium into the sewage of the nuclear medicine department of the mentioned hospital during the quarantine period of the patient undergoing radiation treatment does not cause significant radiation to the public.