Journal of Gorgan University of Medical Sciences

Effect of Endurance Training and Spirulina Supplementation on Inflammatory Cytokines Level in Overweight Men: A Clinical Trial Study

Ahmad Abdi

Background and Objective: Aging and old age are associated with an increase in inflammatory cytokines. Due to their anti-inflammatory properties, constituents of spirulina may be able to reduce or even improve this process. This study was performed to determine the effects of endurance training and spirulina supplementation on the level of inflammatory cytokines in overweight men.
Methods: In this clinical trial, 40 overweight, middle-aged and elderly men were randomly selected and divided into 5 groups: control-normal, control-overweight, overweight + training, overweight + supplement, and overweight + training + supplement. The training program consisting of an hour of walking on a treadmill, stationary bike workout, and climbing stairs was performed at an intensity of 65% of the maximum heart rate, 3 sessions a week, for 8 weeks. Individuals in the supplement groups received a spirulina tablet (500 mg) twice daily in the morning and evening. Blood sampling was performed after 12 hours of fasting at baseline and 48 hours after the last training session. The level of inflammatory cytokines including transforming growth factor-beta (TGF-β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) was measured by enzyme-linked immunosorbent assay.
Results: The levels of TGF-β, IL-6, and TNF-α were higher in the control-overweight group than in the healthy control-normal group (P<0.05). Training and supplementation significantly reduced the inflammatory markers in overweight men (P<0.05). Moreover, the level of inflammatory markers was significantly lower in the training + supplement group compared with the training group and the supplement group (P<0.05).
Conclusion: Endurance training combined with spirulina supplementation can significantly reduce inflammatory factors in overweight individuals.

Effect of Curcumin on Cortisol, Catalase and Nerve Growth Factor Expression Level in Animal Model of Induced Multiple Sclerosis

Shiva Khezri

Background and Objective: Multiple sclerosis (MS) is a common neurological disease that increases oxidative stress and causes immune system disorders. Curcumin is the active component of turmeric with anti-inflammatory properties. This study was conducted to determine the effects of curcumin on cortisol, catalase, and nerve growth factor (NGF) expression in an animal model of MS.
Methods: This experimental study was conducted on 30 female Wistar rats. Experimental autoimmune encephalomyelitis (EAE) was chosen as an experimental model of MS. The rats were divided into 3 groups of 10, including a healthy control group, an affected group, and a group treated with curcumin. The disease was induced by immunization of rats with homogenized guinea pig spinal cord and Freund's complete adjuvant. Then, the immunized animals were allocated into two equal groups. Treatment with curcumin (100 mg/kg daily) was started 12 days after the immunization when the rats showed the first symptoms of neurologic disability. The treatment was continued until day 24 post-immunization. Simultaneously, the EAE group received the medicine solvent (distilled water). Finally, the rats' weights as well as cortisol, catalase, and NGF levels were measured in the study groups.
Results: Curcumin significantly increased the level of cortisol to a level equal to that of healthy rats (P<0.05). It also significantly increased the expression of NGF and reduced the amount of catalase in the affected rats (P<0.05). The curcumin administration significantly increased the overall weight of rats with MS but had no significant effect on the spleen weight of the treated rats.
Conclusion: Curcumin can be beneficial for treating EAE by reducing the destructive effects of oxidative damage and increasing NGF.

Comparative Effects of Ginseng Extract and Green Tea with Pomeol Bruler on C-Reactive Protein and Liver Enzymes of Rats Fed a High-Fat Diet

Kahin Shahanipour

Background and Objective: Many studies have been done on the effects of ginseng and green tea on inflammatory factors and liver enzymes, but no research has yet studied the comparative effects of ginseng and green tea extracts with Pomeol Breuler on C-reactive protein (CRP) and liver enzymes in hyperlipidemic rats. This study was done to evaluate the effects of ginseng and green tea extracts in comparison with Pomeol Bruler on CRP and liver enzymes in hyperlipidemic rats.
Methods: In this experimental study, 42 male Wistar rats were randomly allocated into 7 groups. Animals in group 1 (control group) received a normal diet. The experimental groups 2-7 received a high-fat diet for a month. The groups were treated with the extract for 8 weeks and by intraperitoneal injection. Groups 1 and 2 received 77.5 mg/kg/day and 155 mg/kg/day green tea extract, respectively. Groups 3 and 4 received 103.3 mg/kg/day and 206.6 mg/kg/day ginseng extract, respectively. Group 5 received 0.16 g/kg/day of Pomeol Bruler, and group 6 received green tea extract (155 mg/kg/day) and ginseng extract (206.6 mg/kg/day). At the end of the treatment, the level of CRP and liver enzymes including aspartate transaminase (AST) and alanine transaminase (ALT) were measured.
Results: The level of CRP was significantly reduced in the rats treated with ginseng, green tea, and Pomeol Bruler compared with the control group (P<0.05). The level of AST and ALT did not differ significantly between the ginseng, green tea, Pomeol Bruler, and control groups.
Conclusion: The combined use of ginseng and green tea with Pomeol Breuler for 8 weeks may reduce inflammatory factors but does not affect liver enzymes.

Effect of Simple and Sensor Thoracolumbosacral Braces on Electromyography Activity of Selected Muscles in Patients with Kyphosis during Running

Amir Ali Jafarnezhadgero

Background and Objective: The use of lumbar braces affects kinetics and kinematics. This study evaluated the effects of two types of simple and sensor thoracolumbosacral braces on electromyography activity of selected muscles in patients with kyphosis during running.
Methods: This quasi-experimental study was performed on 15 males with kyphosis. The subjects performed a running task in three conditions: without braces, with simple braces, and with sensor braces. An 8-channel wireless electromyography system was used to record the activity of the muscles of the lower back and lower limbs during running.
Results: There was no significant difference between the tested conditions in response to loading, middle support and swing; however, during push-off, the median frequency of the gastrocnemius muscle was greater when running with a simple brace compared with running without brace (P<0.05). In addition, the median frequency of the semitendinosus muscle was significantly higher while running with sensor brace compared with simple brace (P<0.05).
Conclusion: Using brace, especially sensor brace, can improve muscle activities in patients with kyphosis.

A Comprehensive Evaluation of Executive Functions Using the Cambridge Neuropsychological Test Automated Battery in People with Major Depressive Disorder

Roshanak Khodabakhsh Pirkalani

Background and Objective: Major depression is a common disease in the world, which is associated with cognitive impairment. Executive functions are among the cognitive functions that are influenced by major depression. This study was conducted to comprehensively evaluate the executive functions of people with major depressive disorder and normal people using the Cambridge Neuropsychological Test Automated Battery (CANTAB).
Methods: This case-control study was conducted on 13 patients with major depressive disorder and 13 normal individuals aged 21 to 35 years who were referred to psychology and psychiatry centers in Tehran (Iran) in 2019. The subjects were randomly selected from six centers in four districts of Tehran and then divided into an experimental group and a healthy control group. Both groups were subjected to cognitive assessment using the CANTAB, n-back test as well as Daneman and Carpenter's working memory sentences.
Results: The mean of executive functions was significantly lower in people with major depressive disorder compared to their healthy counterparts (P<0.05). When examining the components of executive functions in both the experimental and control groups, there was a significant increase in the shifting in the total number of errors and the inhibition component in direction errors. In addition, there was a statistically significant decrease in the updating component in errors 1 and error 2 and an increase in time 2. Furthermore, there was a significant increase in the component of working memory maintenance in error as well as the planning component in the average delay (response speed) to the first choice, to correct the error and a decrease in working memory manipulation (P<0.05).
Conclusion: Our findings indicate that the executive functions of people with major depressive disorder are lower than healthy counterparts according to the CANTAB.

Effect of Sport Shoe Aging on General and Directed Co-contraction in Ankle Joint Muscles during Running in Normal and Genu Varum Females

Amir Ali Jafarnezhadgero

Background and Objective: Genu varum is a lower limb deformity. This study was done to evaluate the effects of shoe aging on the general and directional contraction of ankle muscles during running in females with genu varum.
Methods: This case-control study was done on 30 female students (15 individuals with genu varum degree 2 and 15 healthy individuals) using new and old sneakers for 6 months in the sports biomechanics laboratory of the University of Mohaghegh Ardabili, Iran. Each subject was given a new pair of sneakers, and after the initial data collection, the subjects were asked to use them in their daily activities for at least an hour a day for 6 months. Electrical muscle activity was recorded using surface electromyography.
Results: There was no significant difference in the general and directional contractions if ankle muscles during the running phases.
Conclusion: Shoe aging has no effect on ankle joint co-contractions.

Frequency of Different Vascular Access Types Used in Hemodialysis Centers of Gorgan, Iran (2020-21)

Roozbeh Cheraghali

Background and Objective: Hemodialysis is an important replacement therapy for 70-90% of patients with end-stage renal disease (ESRD). Arteriovenous fistula (AVF) is the vascular access of choice in these patients due to its higher efficiency and lower risk of mortality compared to arteriovenous grafts. This study was conducted to determine the frequency of vascular access types used in hemodialysis centers of Gorgan, Iran.
Methods: This descriptive-analytical study was done on 200 hemodialysis patients (101 men and 99 women) at 5 Azar and Sayyad Shirazi hospitals in Gorgan, north of Iran, during April 2020 to July 2021. The subjects were selected by the census method. Information including age, sex, education level, duration of dialysis, the initial and current types of vascular access, site of vascular access, history of diabetes or hypertension, race, and history of smoking were recorded in a checklist.
Results: The mean age of women and men was 58.34±4.71 and 57.95±13.76 years, respectively. In addition, 61.5% of the patients were under 3 years old. The most commonly used vascular access to initiate dialysis was non-cuffed temporary catheters (69%) and AVF (24%). Smoking, ethnicity, diabetes, hypertension, and gender had no significant association with the type of vascular access used. In addition, there was no significant relationship between the duration of dialysis and the type of vascular access.
Conclusion: Considering the diversity of catheters and fistulas, it is necessary to emphasize that the use of AVF in patients undergoing dialysis for the first time and the timely placement of AVF in ESRD patients can improve the quality of life of the patients. It is also recommended to use jugular catheters instead of subclavian catheters when required.

Synergistic Effect of Dexamethasone and Diclofenac on Viability of K562 Cells

Yaghub Pazhang

Background and Objective: Chronic myeloid leukemia is one of the most well-known types of leukemia. Inflammation is one of the leading causes of cancer; therefore, anti-inflammatory agents are used for reducing and suppressing the growth of cancer cells. Dexamethasone, a cortisol agonist, has anti-inflammatory, anti-tumor, and apoptotic effects. Diclofenac is a cyclooxygenase enzyme inhibitor with anti-inflammatory properties. This study was performed to determine the synergistic effect of diclofenac and dexamethasone on the growth of K562 cancer cells.
Methods: In this descriptive-analytical study, K562 cell line was cultured in RPMI-1640 medium enriched with glutamine, penicillin, and streptomycin. The cytotoxic effects of dexamethasone, diclofenac and their combination (multi-target tracking) were evaluated using MTT assay. Hoechst staining and DNA electrophoresis were carried out to evaluate the occurrence of apoptosis.
Results: Diclofenac, dexamethasone and their combination had cytotoxic effects on the cells at concentrations of 20, 40, 60, and 80 µmol/ml. A significant cytotoxic effect was observed after 72 hours of treatment with different concentrations of the drugs (P<0.05). Hoechst staining showed that DNA fragmentation was increased in the treated cells. DNA electrophoresis also showed induction of apoptosis by diclofenac, dexamethasone, and their combination.
Conclusion: The combination of diclofenac and dexamethasone at concentration of 20 µmol/ml is more effective in inducing apoptosis in K562 cells compared with each drug alone.

Frequently of Hemoptysis Causes and some Associated Risk Factors in Patients Admitted to Sayyad Shirazi Hospital in Gorgan, Iran (2014-16)

Roghieh Golsha

Background and Objective: Hemoptysis is defined as the expectoration of blood from the lower respiratory tract. Bronchiolitis, bronchogenic carcinoma, and bronchiectasis are the most common causes of hemoptysis in developed countries, while infections caused by Mycobacterium tuberculosis are the most common cause in endemic countries. This study was conducted to determine the frequency of causes of hemoptysis and some related factors.
Methods: This descriptive-analytical study was done on 68 patients (37 men and 31 women, average age 56.85±17.27 years) who were referred to the Shahid Sayyad Shirazi Hospital in Gorgan, north of Iran during 2014-16 with the complaint of hemoptysis. Demographic information, cause of hemoptysis and history of illness or drug abuse were extracted from the patients’ records.
Results: Based on the results, 42.6%, 45.6%, and 17.6% of the patients had a history of smoking, drug abuse, and diabetes, respectively. The most frequent causes of hemoptysis were bronchiectasis (25%), pneumonia (20.6%), tuberculosis, and lung cancer (16.4%). Gender was determined as an independent risk factor for hemoptysis (P<0.05). The most common causes of hemoptysis were bronchiectasis, lung cancer and pneumonia in men, and tuberculosis and bronchiectasis in women. Age, drug abuse, smoking, and diabetes had no significant association with the occurrence of hemoptysis.
Conclusion: Bronchiectasis, tuberculosis, and lung cancer are the main causes of hemoptysis, and gender is an independent risk factor for hemoptysis in the study area.

Prevalence of Suicidal Ideation and its Relationship with Depression and General Health Status of Patients Referred to Addiction Treatment Centers in Iran (2017)

Afshin Naghizadeh

Background and Objective: Most people who commit suicide suffer from psychiatric disorders, especially depression and substance-related disorders. However, major psychiatric disorders are not the sole risk factor for suicide, and other reasons, such as physical illness, may also be considered as an important factor for suicide ideation. This study was conducted to investigate the prevalence of suicidal ideation and its relationship with depression and the general health status of patients referred to addiction treatment centers in Iran.
Methods: This descriptive-analytical study was conducted on 689 patients referred to addiction treatment centers in Yazd, Khorasan Razavi, Mazandaran, Sistan and Baluchistan, Fars, East Azarbaijan, and Kermanshah Provinces who were undergoing maintenance treatment with methadone in 2017. In this multicenter study, the subjects were selected by two-stage sampling; in the first stage, seven provinces (clusters) were randomly selected, and in the second stage, the patients from the selected provinces were enrolled via convenience sampling. The instruments used in this study included the General Health Questionnaire, the Beck Depression Inventory, and the Beck Suicide Idea Scale.
Results: Of 689 patients, 218 (31.6%) had suicidal ideation. 21.91% (151 cases) of subjects had history of attempted to suicide. There was a significant relationship between suicidal ideation, depression, and general health status and its dimensions including physical symptoms, anxiety and sleep disorders, social functioning, and depression (P<0.05).
Conclusion: Suicidal ideation is present in one-third of the people who refer to addiction treatment centers in Iran. Depression and poor general health are major contributors to suicidal ideation.

Evaluation of Spiritual Health and Social Support in Family Caregivers of Cancer Patients in North of Iran

Afsaneh Arzani

Background and Objective: Today, the role of family members in caring for cancer patients is becoming more important. Numerous cancer-associated problems affect both the patients and their caregivers. Little information is available about the social support and spiritual health of caregivers of cancer patients; therefore, this study was conducted to investigate the spiritual health and social support status of family caregivers of cancer patients in northeastern Iran.
Methods: This descriptive-analytical study was performed on 265 family caregivers of cancer patients. The subjects were selected by convenience sampling from inpatient wards and outpatient clinics of Babol University of Medical Sciences in 2019. Data were collected using the Social Support Questionnaire (by Vaux), the Spiritual Well-Being Scale (by Paloutzian and Ellison), and a socio-demographic questionnaire.
Results: The mean scores of social support and spiritual health of family caregivers of cancer patients were 98.86±14.58 and 91.32±11.97, respectively, which are at a desirable level. The age of caregivers and the duration of cancer had no significant relationship with the score of spiritual health and social support.
Conclusion: According to our findings, family caregivers of cancer patients have a desirable level of social support and spiritual health.

Anticancer Activity of Copolymeric Nanoparticles Loaded by Plumbagin on Breast Cancer cells

Hossein Danafar

Background and Objective: In medical sciences, identifying the anticancer properties of plumbagin is of special importance. For this reason, this study investigated the anticancer activity of polymeric nanoparticles loaded by plumbagin against breast cancer cells.
Methods: In this descriptive study, the diblock copolymer mPEG–PCL was synthesized by ring-opening polymerization of caprolactone in the presence of mPEG as the initiator and Sn(oct)2 as the catalyst. The synthesized copolymers were characterized by Fourier-transform infrared spectroscopy, proton nuclear magnetic resonance, gel permeation chromatography, and differential scanning calorimetry. The nanoprecipitation method was used for preparing nanoparticles loaded with plumbagin. The characteristics of these nanoparticles were investigated by various techniques including dynamic light scattering. The cytotoxicity of plumbagin, copolymer, and the nanoparticles loaded with plumbagin on MCF7 and HFF2 cells was evaluated by MTT assay.
Results: The average diameter of the nanoparticles was less than 115 nm. The loading capacity and encapsulation efficiencies were 15.4±0.13% and 79.1±0.65%, respectively. Drug release was slow, controlled, and almost dependent on pH. The results of the MTT assay showed strong and dose-dependent inhibition of cell growth by the plumbagin-loaded micelles compared with plumbagin alone in a way that the half maximal inhibitory concentration of this nanoparticle against MCF7 cells after 48 and 72 hours was 10.78 and 24.03 μM, respectively.
Conclusion: The mPEG-PCL nanoparticles can be an efficient carrier for plumbagin, and plumbagin can be an effective drug on breast cancer cells, without toxicity on healthy cells.

Isolation, Cloning, and Expression of Streptococcus dysgalactiae Subspecies Superantigen by SDS-PAGE in Psoriasis Patients

Kumarss Amini

Background and Objective: Streptococci are Gram-positive and anaerobic bacteria that are isolated from different sources. These bacteria are capable of producing superantigens, toxins, and biologically-active substances and are therefore very important in the field of infectious disease. Streptococcal pyrogenic exotoxins A (speA) is produced by various bacteria, including Streptococcus dysgalactiae. This study aimed at the isolation, cloning, and production of speA from streptococci from the skin of psoriasis patients.
Methods: In this descriptive-laboratory study, samples were taken from 60 psoriasis patients. S. dysgalactiae isolated were identified by different tests. The speA gene was cloned by the TA cloning method using PTG-19 vector into the Escherichia coli X11 blue as host. Expression of the cloned gene in recombinant colonies was evaluated by SDS-PAGE.
Results: Screening of white recombinant colonies confirmed the presence of speA genes. Expression of the speA gene in E. coli X11 blue was confirmed by SDS-PAGE.
Conclusion: Streptococcus superantigens can be considered as a rich source of vaccine production for different infections caused by these bacteria. By utilizing different cloning hosts and investigating optimal production conditions, S. dysgalactiae could be a candidate for future studies on vaccine production.

Acute Myocardial Infarction in 22-Year-Old Male: A Case Report

Mojtaba Fazel

Myocardial infarction is characterized by the interruption of blood supply to part of the myocardium, leading to tissue damage. Acute myocardial infarction rarely affects young adults. However, considering the possibility of its occurrence, particularly in the presence of risk factors such as obesity and smoking, can help provide appropriate and timely diagnostic and therapeutic measures. Herein, were present a case of acute myocardial infarction in a young adult male.