Journal of Gorgan University of Medical Sciences

Vaccine adjuvants: past, current and future

Abolghasem Golian

Adjuvants are an essential component of modern vaccines. An adjuvant is an entity added to a vaccine formulation to ensure that robust immunity to the antigen is inoculcated. The adjuvant is typically vital for the efficacy of vaccines using subunit (pepdids, proteins and virus like particles) and DNA antigens. Furthermore, these components are used to reach the current new goals of preventing and/ or treating chronic infectious diseases and cancers. This review focuses on formulation aspects of adjuvants, safety considerations, progress in understanding their mechanisms of action and also their side effects with using 97 articles are acceceble in pubmed central and google scholar indexing which published during 1980-2016. Adjuvants can be broadly divided into two classes, based on their principal mechanisms of action; the first class are vaccine delivery systems that generally particulate and mainly function to target associated antigens into antigen presenting cells. The others are immunostimulatory adjuvants that predominantly derived from pathogens and often represent pathogen associated molecular patterns which activate cells of the innate immune system. Adjuvants induce cellular and humoral responses, in particular neutralizing antibodies that able to inhibit the binding of pathogens to their cellular receptors. Efficient Th1-immunity-inducing adjuvants are highly in demand. The adjuvants promote good cell-mediated immunity against subunit vaccines that have low immunogenicity themselves. However, attempts to develop a new generation of adjuvants, which are essential for new vaccines, is important, but their use is limited because, little is known about their mechanisms of action and health risks.

Effect of exercise on aging cardiac hypertrophy, role of oxidative pressure and some of the mitogen-activated protein kinases

Marefat Siahkouhian

Aging is an inevitable process, which is associated with the development of various diseases such as cardiac hypertrophy. Hypertrophy can occur in both pathological and physiological form. Both types can be divided into a variety of eccentric and concentric types. In the present review, we present the effects of aging and exercise on patological and physioligac cardiac hypertrophy, oxidative stress and some of the mitogen-activated protein kinases with using 79 articles which acceable in pubmed and SID indexing which published during 1976-2016. If the age is associated with inactivity, leads to pathological heart hypertrophy. Meanwhile, the role of the protein family of kinases activated with mitogen and oxidative stress is important. Adolescence, if accompanied by low activity, can lead to increase oxidative stress through mitochondrial dysfunction. Oxidative stress can affect the activity of MAPKs. MAPKs have important role in wide variety of biological events, such as proliferation, differentiation, metabolism, mobility, survival and apoptosis. The tipping point of signal transduction and the regulation of these biological events bigin initially by the four MAPK subunits, including extracellular signal regulated kinase (ERK1 / 2), c-Jun NH2-terminal kinase (JNK1, -2.3) kinase P38 (A, B, y, S) and large MAPKs (BMKs or ERK5s). This paper focuses on two types of ERK1 / 2 and P38 that play an important role in the development of cardiac hypertrophy. ERK1 / 2 and P38 amounts change with aging. These changes are associated with the development of pathological hypertrophy. Sports activities can control the pathological pathway of hypertrophy and can lead to physiological hypertrophy. Exercise can control or reduce oxidative stress, ERK1 / 2 and P38 and ultimately can affect cardiac hypothyroidism.

Effect of foot reflexology massage on feeling of comfort in open heart surgery patients: A clinical trial study

Shahnaz Tabiee

Background and Objective: Patients experience full stress condition after open heart surgery. Foot reflexology massage has a potential impact on the comfort of patients with special care. This study was done to evaluate the effect of soles of feet reflexology massage on feeling of comfort in open heart surgery patients.
Methods: This clinical trial study was done on 70 patients who were divided into intervention and control groups using permutable blocking method. 35 patients in interventional group were received Soles of feet Reflexology Massage after mesearment of vital sigins for six days. 35 patients in the control group did not receive any intervention received routine care. Data gathering tools were demographic items and HCQ questionnaire, which was completed in two stages, 24 hours after surgery, before massage and the 6th day after massage.
Results: The mean total comfort score in the intervention group was 103.1±9.04 and 110.63±7.6 before and after the intervention, respectively. This differnce was not significant. The mean total comfort score in control group was 105.14±10.37 and 111.29±7.56 perior and the end of study, respectively, this difernce was not significant. Also, there was no significant difference between considering the mean scors of comfort between the tow in the intervention and control groups.
Conclusion: Reflexotherapy massage had no effect on feeling of comfort in open heart surgery patients.

Effect of exogenous estrogen treatment on hippocampal neurogenesis in ovariectomized mice

Mohammad Taghi Ghorbanian

Background and Objective: Adult neurogenesis occurs in most mammalian species in two main areas of brain: 1- subventricular zone 2- the dentate gyrus of the hippocampus. Many factors such as 17-B estradiol affect neurogenesis in the hippocampus. The aim of this study was to investigate the effect of exogenous 17-B estradiol on neurogenesis and astrocyte functions in the ovariectomized mice.
Methods: In this experimental study; NMRI mice were allocated into five experimental groups including Sham, Control, Treatment with single dose of 17-B estradiol two weeks after ovariectomy (OVX) and were sacrificed 24 hours later, Treatment with single dose of 17-B estradiol two weeks after Ovx and were sacrificed 48 hours later and Treatment with single dose of Seasame Oil 2 weeks after OVX and were sacrificed after 24 hours. Animals were transcardially perfused with paraformaldehyde. Brains were removed and its sections for cresyl fast violet staining and GFAP immunohistochemistry were prepared. Cells were counted and investigated.
Results: Neuronal density and Proliferation of hippocampal progenitor cells in the CA1 region of 17-B estradiol treated mice significantly increased up to 24 hours (P<0.05). Density of glia and particularly astrocytes in different regions of the hippocampus significantly reduced after treatment with 17-B estradiol (P<0.05).
Conclusion: Density of hippocampal CA1 neurons are influenced by 17-B estradiol. Also, density and morphology of glia cells, especially astrocytes in different regions of the hippocampus are affected by 17-B estradiol.

Analgesic and anti-inflammatory effects of ethanolic extract of Hyssopus officinalis in mice

Mahbubeh Setorki

Background and Objective: Finding the pain relieving substances is one of the important aims of biological researches. This study was done to evaluate the antinociceptive, anti-inflammatory effects of Hyssopus officinalis extract in mice.
Methods: In this experimental study, 100 male adult mice were allocated into 5 experimental groups including control group receiving only normal saline and groups that received extract of Hyssopus officinalis at doses of 25, 50 and 75 mg/kg/bw, and positive control group in formalin test received morphine in acute and chronic phase of experiment and positive control group in anti-inflammatory test received dexamethasone. Formalin-induced paw licking was used to determine the anti-nociceptive activity of Hyssopus officinalis extract. The anti-inflammatory activity was determined by Xylene test.
Results: In the acute phase of pain (the first 5 minutes), doses of 50 and 75 mg/kg/bw (7.75±2.3, 8.75±2.1) of the Hyssopus officinalis extract significantly reduced the number of feet raised (P<0.05). Also, in the chronic phase of pain (20 min second), 25, 50 and 75 mg/kg/bw of doses (17.25±2.3, 11.75±2.9, 2.7±10.75) and morphine significantly reduced the duration of foot lift (P<0.05). The extract of Hyssopus officinalis with three doses of 25, 50 and 75 mg/kg/bw (13.33±3.1, 20±3.1, 19.83±2.8) showed high anti-inflammatory activity against Xylene induced ear edema (P<0.05).
Conclusion: This study showed that Hyssopus officinalis extract can inhibit pain and inflammation in animal model.

Protective effect of hydro-alcoholic extract of Aloe Vera gel on enzymes and liver tissue structure of high-fat diet rats

Seyyed Ebrahim Hosseini

Background and Objective: Aloe Vera is considered as one of herbs causes oxidative indexes modification due to antioxidant properties. On the other hands, High-fat diets (HFD) cause liver disorders prevalence. This study was done to evaluate the protective effect of hydro-alcoholic extract of Aloe Vera gel on enzymes and liver tissue structure of high-fat diet rats.
Methods: In this experimental study, 40 adult male rats were allocated in five groups including control, sham (HFD 10 ml/kg) and three experimental groups receiving HFD with doses of 150, 300 and 600 mg/kg/bw of Aloe Vera gel extract. Prescriptions were conducted by gavage and for 60 days. Blood samples were collected to measure AST, ALT and ALP enzymes. Liver removed subsequently and following preparing tissue sections liver cells were counted.
Results: High-fat diet significantly increased ALP and ALT enzymes (P<0.05). High-fat diet significantly increased the number of Kupffer cells and reduced of hepatocytes in compared to control group (P<0.05). High-fat diet caused liver tissue alterations including blood congestion, inflmation; Vacuole breakdown, apoptosis, and ballooning of hepatocytes. On the other hand, the consumption of Aloe Vera with high-fat diet caused reduction in tissue changes and a significant decrease in the serum levels of ALP and ALT enzymes in compared to control group (P<0.05).
Conclusion: High-fat diet by damaging the liver tissue increased the serum levels of ALP and ALT enzymes and Aloe Vera extract with its anti-oxidant characteristic prevent the effect of a high-fat diet on the liver tissue and reduced the ALP and ALT enzymes.

Regeneration effect of Saffron on the liver damaged with paraquat in male mice

Farah Farokhi

Background and Objective: Paraquat is a common agricultural herbicide that is a strong stimulus in superoxide anions foundation. Due to the adverse effects of the free radicals, the anti oxidant compounds such as Saffron seem necessary as antioxidants and removing the free radicals. The aim of this study was to evaluate the regeneration effect of Saffron on the liver damaged with paraquat in male mice.
Methods: In this experimental study, 36 male mice were randomly allocated into 6 groups. Animals in group one were received normal food, water and corn oil. Secound and third groups of mice were treated at a dose of 20, 40 mg/kg/bw paraquat, respectively. Animals in the fourth group were received Saffron at a dose of 80 mg/kg/bw. Animals in fifth and sixth two groups were treated with paraquat treated at a dose of 20, 40 mg/kg/bw and Saffron (80 mg/kg/bw), orally, per day. At the end of 30 days the mice were anesthesia and blood samples were prepared for measurement of AST and ALT in sera and livers were removed for measurment of MDA, FRAP, katalaze concentration and half of liver was transfer to formaline for histopathological study.
Results: Cell necrosis and inflammation was found in the liver of mice treated with paraquat, also the level of AST, ALT and MDA was significantly increased in compared to controls (P<0.05). Also the level of AST, ALT and MDA and histopathological alterations of liver in animals treated with paraquat at a dose of 20, 40 mg/kg/bw and Saffron (80mg/kg/bw) were significantly reduced in compared to paraquat group.
Conclusion: Saffron (80 mg/kg/bw, orally) improves liver dysfunction in mice exposed with paraquat.

Effect of aerobic training on total antioxidant capacity and pulmonary function in asmatic men

Mojtaba Eizadi

Background and Objective: Several studies suggest the corelation between antioxidant capacities and pulmonary function and severity of pulmonary asthma. This study was done to evaluate the effect of aerobic training on total antioxidant capacity (TAC) and pulmonary function in asthmatic men.
Methods: In this quasi - experimental study, thirty inactive and overweight adult males with mild to moderate asthma were divided into intervention (aerobic training) and control (no training) groups. The anthropometric and spirometry indeces (FVC, FEV1, FEV1/FVC) and fasting TAC before and after aerobic training program (12 weeks, 3 time/weekly at 60-75% of HRmax) were measered.
Results: After aerobic training program, TAC was significantly increased in interventional group in comparision with before of training (P<0.05). FVC, FEV1 and FEV1/FVC were significantly increased in interventional subjects in compared to controls (P<0.05).
Conclusion: This study indicated that aerobic training improves antioxidant capacity and pulmonary function in asthma patients. Improved pulmonary function can be attributed to increase in antioxidant capacity induced by aerobic intervention.

Effect of three resistance training programs with different intensities on pulmonary function, physical function and body composition in overweight females

Amirhossein Haghighi

Background and Objective: Obesity and overwight affects on respiratory phyological indeces including pulmonary voulume, spirometery function, mechanical function of air ways neuro-muscular functions and capacity of exchange of gases. The obese and overwight subjects have high risk in reduction respiratory valume syndrome. This study was done to compare the effects of three resistance training programs with different intensities on pulmonary function, physical function and body composition in overweight girls.
Methods: In this quasi - experimental study, thirty overweight inactive girls were non-randomly divided into 3 equal groups (n=10) of resistance training with different intensity based on their 1 RM (light, 55-65%, moderate, 65-75%, and heavy, 75-85%, repsctively). The training progams were done for 9 weeks (3 sessions per week). Each session consists of 5 stations with 3 sets while rest intervals between the repetiotions and stations were 60-90 seconds and 90-120 seconds, respectively. Before and after the end of the training programs, spirometry, body composition, muscular strength and endurance of the upper body and VO2max were measured.
Results: 9 weeks resistance training program with 55-65%, 65-75%, and 75-85% 1RM intensities had no significant effect in the spirometry parameters, body weight, body mass index, upper body muscular endurance and VO2max. Fat percentage in 55-65% group significantly reduced in compared to those of 65-75%, and 75-85% 1RM groups (P<0.05). The upper body muscular strength in group with 75-85% 1RM significantly increased in compared to groups with 55-65% and 65-75% 1RM (P<0.05).
Conclusion: Overweight girls can apply resistance training with 55-65% 1RM to reduce the percent of body fat, and enhance the upper body strength through trainings with 75-85% 1RM. In relation to pulmonary function indices and indices of physical function and body composition, there was no dference between three training programs.

Comparision of satiety index in low-fat yogurt and bread regiments in healthy adults

Seyyed Morteza Safavi

Background and Objective: Obesity is a major healthy problem wordwide. The incidence and severity of obesity is incrased in recent years. Satiety is described as a blocker of receiving more food after the end of eating. Satiety index (SI) is considered as index for measerment of ablity of food for losing of hungry and making satiety for more than 2 houres. This study was done to determine satiety index of low-fat yogurt (1.5%) and white bread in healthy adults with normal body mass index.
Methods: This quasi - experimental study was conducted on 30 healthy adults with normal body mass index for two consecutive days. In the first day, each subject was consumed 90 grams white bread and in the second day, each subject was consumed 526 grams of 1.5% low-fat yogurt within 15 minutes. The satiety of low-fat yogurt and white bread based on VAS and LIKERT scales was measeared. Cronbach's alpha was determined 0.98 for satiety of white bread and 0.947 for low-fat yogurt
Results: Satiety index of low-fat yogurt was 136.66±1.46 in compared to white bread (SI=100). The level of satiety after 120 minutes of consumption of white bread and low-fat yogurt were not significant based on the VAS scale, but according to the LIKERT scale, low-fat yogurt (1.60±0.43) significantly increased the Satiety index (P<0.05).
Conclusion: The satiety index of low-fat yogurt in adults with normal body weight was 136.66% compared to white bread that showed higher satiety of low-fat yogurt compared to white bread.

Comparison of quantitative electroencephalography between normal and children with anxiety disorder

Mohammad Reza Shaeiri

Background and Objective: Anxiety disorder (AD) is one of the most common children disorders. In last two decades, several studies conducted to determine the mechanisms of child anxiety disorder specifically in base of neural mechanisms. However, studies about the electrophysiology of child anxiety disorder particularly in the quantitative electroencephalography (QEEG) are less than imaging studies. This study was performed to compare the quantitative EEG between children with anxiety disorder and normal subjects.
Methods: This case- control study was done on 30 children with anxiety disorder and 30 normal healthy children with 6-7 years old. Electroencephalography was recorded for each subject. Power of 19 channel and 5 frequency bands delta, theta, alpha, beta and high beta (25-30 Hz) in the frontal, central and occipital area were recorded, respectively.
Results: There was significant difference in delta absolute power in frontal lobe, theta and beta2 absolute power in central and high beta wave in occipital area between AD and normal children (P<0.05). In other words, the delta absolute power in frontal lobe and theta and beta2 absolute power in central area of brain was less in AD children in compared to normals. Also, the high beta absolute power in occipital lobe was more in AD children in compared to normals.
Conclusion: Recorded QEEG in relax time is a proper index of brain cortex metabolic activity. Therefore, low metabolic activity in particular parts of brain is determined by increasing slow waves power (delta and theta) or decreasing fast waves power (alpha and beta).

Application of multilevel zero-inflated Poisson regression for assessing the risk factors of excess hospitalization among patients undergoing abdominal surgeries in Shiraz, Iran

Zahra Bagheri

Background and Objective: Prolonged hospitalization lead to considerable financial burden for patients as well as health care system. This study aimed to identifying important factors resulting in excess hospitalization days in patients undergoing abdominal surgeries using the multilevel zero-inflated Poisson regression model.
Methods: In this descriptive - analytic study, 485 patients from five teaching and private hospitals in Shiraz (southern Iran) were selected based on convince sampling method. Multilevel zero-inflated Poisson regression model was used to determine the risk factors of excess hospitalization day. Maximum likelihood method was used to estimate parameters of the model. Moreover, Akaike Information Criterion (AIC) and Bayes Information Criterion (BIC) indices were applied to assess the goodness of fit of the model.
Results: The primary analysis of data showed that 81.2% of the patients did not undergo excess hospitalization days. Based on findings, age, respiration rate, blood infusion, fever, smoking and drug abuse did not affect excess hospitalization days. In contrast, gender, renal diseases, operation history, laparoscopic gallbladder removal, prostate surgery and ileus significantly led to excess hospitalization days (P<0.05). Laparoscopic gallbladder removal, prostate surgery increased the chance of excess of hospitalization days to 4.64 and 9 times, respectively (P<0.05).
Conclusion: Geder, renal diseases, operation history, laparoscopic gallbladder removal, prostate surgery and ileus significantly led to excess hospitalization days.

Effect of methanolic extract of Nasturtium officinale on growth and biofilm formation of Pseudomonas aeruginosa

Asghar Sharifi

Background and Objective: Biofilms caused by pathogenic microorganisms that plays an important role against human health. Due to their resistance to detergents and antimicrobial agent, treatment response of affected patients with these bacteria is difficult. This study was done to evaluate the effect of methanol extract of Nasturtium officinale plant on growth and biofilm formation of Pseudomonas aeruginosa.
Methods: In this descriptive - laboratory study, the extraction was done by Maceration in 80% methanol and by rotary evaporator. The minimum inhibitory concentration (MIC) of Nasturtium officinale extracts were determined by broth microdilution method. Biofilm formation was investigated using the microtiter plate and stained with crystal violet.
Results: The minimum inhibitory concentration of Nasturtium officinale against Pseudomonas aeruginosa was 0.625 mg/ml and the Minimum bactericidal concentration of this extract was 1.25 mg/ml. PAO1 strain and 5 clinical strains were able to biofilm formation. Inhibition of biofilm formation by extract of Nasturtium officinale plant was dependent to concentration. The highest percentage of inhibition of biofilm formation was in the concentration of 7.5 mg/ml and the lowest percentage of inhibition of biofilm formation was in the concentration of 0.11 mg/ml. The mean of Pseudomonas aeruginosa biofilm inhibition by Nasturtium officinale extracts was 72.69±22.27 %. In the concentrations of 7.5, 0.93, 0.46, 0.23 and 0.11 mg/ml, there was a significant difference between clinical strains and PAO1 strain (P<0.05).
Conclusion: Methanolic extracts of Nasturtium officinale plant has anti-bacterial and anti-biofilm effect against Pseudomonas aeruginosa.

Antibiotic resistance of Salmonella enterica producing Extended-spectrum B-lactamases (ESBLs) type CMY-2, in poultry

Pejvak Khaki

Background and Objective: Salmonella is one of the most important zoonotic pathogens responsible for food-borne infections all over the world. Poultry products are widely acknowledged to be a significant reservoir for Salmonella. This study was done to evaluate the antibiotic resistant of Salmonella enterica producer of beta lactamase spectrum in poultry.
Methods: In this descriptive – laboratort study 70 Salmonella enterica serotypes were collected from poultry. All Salmonella isolates were tested to antimicrobial susceptibility testing by the Kirby-Bauer disk diffusion according to Clinical Laboratory Standards Institute (CLSI). Twenty-nine antibiotics were used in this study. Klebsiella pneumoniae; ATCC 700603 was used as quality control strains. The isolates were determined to be ESBL-producing Salmonella by the conventional double-disk synergy and genotypic method.
Results: Among 70 salmonella isolates, the most prevalent serotypes were S.typhimurium and S.enteritidis. All serotypes were susceptible to gentamicin, ciprofloxacin, oflaxacin, imipenem, enrofloxacin. The common resistance was observed to cephalexin (96%), cefazolin (96%) and cephalotin (65%). Among the 70 Salmonella isolates studied, multi-drug resistance was observed in 59 (84%) isolates. Forty-seven (67%) isolates were found to be ESBL-producing isolates. PCR assay of all isolates showed that 17 isolates (33.3%) carried bala CMY2 gene.
Conclusion: This study showed that antibiotic resistance to Salmonella enterica serotypes is due to beta lactamase enzyme in this strain is considerably increased in poultry.

Intracranial arachnoid cyst without common clinical symptoms in a 10 years old child: A case report

Majid Karimi

Arachnoid cysts have primary and secondary types. The prevalence of Arachnoid cysts is about 1% of all tumors in cranial cavity. Based on anatomic position, arachnoid cyst can cause different clinical manifestations including hemiparesis, increase intracranial pressure, macrocephaly and isolated headache and stop body growth. The natural course of the disease is not exactly clear. Some of patients have no symptoms during life and some of them may show some symptoms after a while. This case report is about a 10 years boy who had no sign except generalized headache. Anatomic position of the cyst was in right temporal lobe of the brain on the temporal, parietal and the great wing of sphenoid bones. Arachnoid cyst diagnosed through MRI and CT-Scan. Patient treated with ibuprofen for three days and then patient followed up to treat with surgery method when other clinical symptoms appeare in the patient.

Trazodone induced urinary incontinence in woman at menopause period: A case report

Seyyed Hamzeh Hosseini

Trazodone is a weak inhibitor of serotonin reuptake and a potent antagonist of serotonin 5HT2A and 5HT2C receptors. Urinary incontinence is a rare side effect of anti-depressant drugs. Side effects of antidepressants can cause delay in treatment of patient and ultimately non-compliance in patients who take this medicinal drug. Here we present a case of trazodone induced urinary incontinence in a woman at menopause period. The patient was a retired woman with 63 years old. She reported a history of bladder prolapsuse and history of consumption of quetiapine and propranolol. But the patient had no history of other somatic illnesses, drug and urinary incontinence before administering the medicinal drug. Psychiatrist prescrided trazodone with dose of 50 mg, orally per day when appearence of the depression, anxiety and insomnia. But, the patient suddenly suffered from urinary incontinence, despite this situation the patient had continued taking the drug for three days. Due to the uncertainty of the above complications patient, was forced to discontinue the drug and follwoing drug discontinuation the side effect disappeard. After the improvement of the urine incontinence and full recovery, re-treatment was began with the same dose of 50 mg trazodone for the patient, but immediately after drug administration to the patient, urinary incontinence appeared once again. Trazodone can be considered as important factor to cause urinary incontinence. Therefore, this issue should be considered whenever this pharmaceutical drug is prescribed.