Journal of Gorgan University of Medical Sciences

Effect of Injectable Ketamine on Histopathological Changes in the Liver in Neonates Born to Pregnant Rats Subjected to Short-Term and Long-Term Anesthesia

Behrooz Yahyaei

Background and Objective: Ketamine, a derivative of phencyclidine, is utilized as an anesthetic agent in surgical procedures. Like other medications, it can be associated with various adverse effects on different organs in the body. This study was conducted to determine the effect of injectable ketamine on the histopathological changes in the liver in neonates born to pregnant rats subjected to short-term and long-term anesthesia.
Methods: In this experimental study, 15 pregnant female Wistar rats were randomly divided into 3 groups of 5 each: A control group, a short-term anesthesia group (receiving an intraperitoneal injection of ketamine at a dosage of 25 mg/kg/bw), three times per week for 4 weeks), and a long-term anesthesia group (receiving an intraperitoneal injection of ketamine at a dosage of 75 mg/kg/bw, once per week for 4 weeks). Following parturition and during the lactation period, when the neonatal rats reached two weeks of age, they were initially anesthetized and sacrificed for tissue sampling via intraperitoneal injection of 7 units of ketamine and 3 units of xylazine. Tissue samples, with a thickness of 5 to 6 microns, were sectioned and examined using light microscope after fixation in formalin.
Results: In the short-term anesthesia group, dilation of the centrilobular veins and fluid accumulation were observed, with an intensity score of 2. Additionally, some hepatocytes exhibited degenerative-necrotic changes, characterized by acidophilic and dark cytoplasm, with an intensity score of 1. In the long-term anesthesia group, the liver tissue showed hyperemic changes in the portal space with a score of 1, as well as increased dilation of sinusoidal spaces and centrilobular veins of varying sizes and irregularities, also with an intensity score of 1. Fluid and blood accumulation were also noted in some of these structures. In the control group, cellular structures were maintained with complete regularity, and the intensity score of changes was determined to be zero.
Conclusion: Ketamine administration to pregnant rats can induce histopathological changes in the liver tissue of their offspring. These detrimental changes were more pronounced in the long-term group compared to both the short-term and control group.

Effect of Resveratrol on Sodium Valproate-Induced Oxidative Stress in the Hippocampal Tissue of BALB/c Mouse Fetuses

Gholamhassan Vaezi

Background and Objective: Sodium valproate (SV) is a commonly used antiepileptic drug; however, its therapeutic application is limited due to its potential to induce oxidative stress. Resveratrol, a natural polyphenol, possesses antioxidant properties. This study was conducted to determine the effect of resveratrol on SV-induced oxidative stress in the hippocampal tissue of BALB/c mouse fetal brains.
Methods: In this experimental study, 40 pregnant female BALB/c mice were randomly assigned to 5 groups of 8, including control, SV at 40 mg/kg/bw, SV at 40 mg/kg/bw + resveratrol at 0.6 mg/kg/bw, SV at 40 mg/kg/bw + resveratrol at 0.35 mg/kg bw, and SV at 40 mg/kg/bw + resveratrol at 0.225 mg/kg/bw. SV was administered orally per day, and resveratrol was administered daily via intraperitoneal injection. From gestational day 8 to 18, pharmacological interventions were initiated and continued until the birth of the neonates. On gestational day 18, the maternal mice were anesthetized, and 8 fetuses from each group were separated. Following the anesthesia of the fetuses, the brain tissue was dissected. Subsequently, oxidative stress parameters, including the malondialdehyde (MDA) level in nmol/mg as an index of lipid peroxidation, glutathione (GSH) level alterations in µg/mg, and protein carbonyl (PC) level alterations in nmol/mg, were evaluated in the hippocampal tissue.
Results: SV induced oxidative stress by increasing MDA (4.8 nmol/mg) and PC (51.4 nmol/mg protein), and also decreasing GSH (31.86 μg/mg) in the brain tissue compared to the control group (P<0.05). In a concentration-dependent manner, resveratrol reduced oxidative stress by decreasing MDA and PC to 3.02 and 37.21 nmol/mg, respectively, and also by increasing GSH to 49.76 μg/mg in the brain tissue. The most significant effect was observed at a concentration of 0.6 mg/kg/bw, which was statistically significant compared to the SV group (P<0.05).
Conclusion: The combined administration of SV and resveratrol culminates in a reduction in inflammation and oxidative stress-related factors in mouse fetuses.

A Comparison of the Efficacy of Non-Surgical and Arthroscopic Treatments on Shoulder Function and Pain in Diabetic Patients with Adhesive Capsulitis

Saeed Kokly

Background and Objective: Adhesive capsulitis is one of the most common shoulder disorders, particularly in diabetic patients, and its treatment has been challenging. Adhesive capsulitis begins with a gradual increase in shoulder pain, spontaneous onset, and limitation of active and passive movements of the glenohumeral joint in all directions. In 90% of cases, it responds to conservative treatment; however, if there is no symptomatic improvement after 3-6 months of conservative treatment, surgical treatment, including arthroscopic or open capsular release, should be considered. The current study aimed to compare the efficacy of non-surgical and arthroscopic treatments on shoulder function and pain in diabetic patients with adhesive capsulitis.
Methods: This quasi-experimental study was conducted on 48 diabetic patients (16 males and 32 females; mean age: 53.56±15.93 years) with adhesive capsulitis referring to the orthopedics clinic of 5th Azar Educational and Therapeutic Center in Gorgan, Iran during 2021-2022. Initially, patients were placed under the supervision of shoulder fellowship for conservative treatment for 3 months, and patients without any clinical improvement and with resistant to conservative treatments after 6 months were included in the study. Patients were voluntarily decided to be assigned to one of two treatment groups: Non-surgical (conservative treatment) and arthroscopic surgical (arthroscopic shoulder release). The functional outcomes and limitations of shoulder movement of patients were compared based on the disabilities of the arm, shoulder, and hand (DASH) score in the pre-test and after 3 and 6 months of intervention. The data were presented using descriptive statistical indices. Then, the functional outcomes and limitations of shoulder movement were evaluated.
Results: The mean shoulder function score 3 and 6 months after the intervention was lower in the arthroscopic release surgery group (45.80±19.32 and 43.10±14.12) than in the conservative treatment group (67.89±17.46 and 72.10±15.16) (P<0.05). The mean and standard deviation of symptom scores, such as pain, burning, weakness, and stiffness of the shoulder, 3 and 6 months after the intervention were lower in the arthroscopic release surgery group (12.70±5.66 and 10.02±4.06) than in the conservative treatment group (19.83±8.17 and 21.14±9.37) (P<0.05).
Conclusion: The decreased shoulder function and symptom severity at 3 and 6 months after the intervention was more effective in the arthroscopic release surgery group than in the conservative treatment group.

Effect of Closed Kinetic Chain Exercises on Plantar Foot Pressure Dynamics in Women with Patellofemoral Pain Syndrome

Abbas Meamarbashi

Background and Objective: Patellofemoral pain syndrome (PFPS) is among the common causes of anterior knee pain in adolescents and individuals under 60 years of age. This study was conducted to determine the effect of closed kinetic chain exercises on changes in plantar foot pressure dynamics in women with PFPS.
Methods: This quasi-experimental study was conducted on 30 female university students aged 20 to 35 divided into two groups of 15 (one group diagnosed with PFPS and a healthy control group) at Mohaghegh Ardabili University in 2023. The PFPS group had a pain history of at least two months to a maximum of one year. The experimental group performed closed kinetic chain exercises three times a week for eight weeks. Plantar foot pressure variables were measured using a pressure foot scanner (sampling rate of 300 Hz).
Results: The peak forces in the first toe during slow-speed running exhibited a statistically significant decrease in both the healthy group (64.91 ± 28.69) and the PFPS group (215.19 ± 60.28). Furthermore, the time to reach the peak ground reaction force in the PFPS group (49.65 ± 44.332) showed a statistically significant increase during the post-test at slow-speed running (P<0.05). The external heel force (153.97±3.62) and the fifth metatarsal bone (65.19±19.77) in the healthy group demonstrated a statistically significant reduction in the post-test compared to the PFPS group during fast-speed running (P<0.05). In both the healthy and PFPS groups, statistically significant decreases were observed in the post-test for center of pressure (COP) displacement variables in the mediolateral and anteroposterior directions during both slow-speed and fast-speed running (P<0.05). Additionally, in the healthy group, a statistically significant reduction was found in the post-test for COP displacement at the first toe (64.5±51.08) during fast-speed running (P<0.05).
Conclusion: Closed kinetic chain exercises lead to a statistically significant reduction in plantar foot pressure variables in women with PFPS and healthy women.

Comparing the Effects of Patient-Centered and Family-Centered Empowerment Model-Based Training on Perceived Self-Efficacy and Fasting Blood Glucose in Patients with Type 2 Diabetes

Seyyed Kamaladdin Mirkarimi

Background and Objective: Family-centered empowerment involves engaging clients and their families in decision-making processes to improve health outcomes, thereby enabling them to exert control over their health status through informed choices. Self-efficacy is considered the most crucial component of empowerment and holds significant importance in the management of chronic diseases and the enhancement of self-efficacy. This study was conducted to compare the effects of patient-centered and family-centered empowerment model-based training on perceived self-efficacy and fasting blood glucose levels in patients with type 2 diabetes mellitus.
Methods: This quasi-experimental study was conducted on 120 patients with type 2 diabetes who attended rural comprehensive health centers in Gorgan, Iran, during 2023. Patients were enrolled in the study using a multi-stage cluster sampling method and were divided into three groups of 40: A control group, a family-centered empowerment group, and a patient-centered empowerment group. The interventions in the patient-centered and family-centered groups were delivered in 6-8 people groups based on a four-stage model. These stages included threat perception, problem-solving, educational participation, and evaluation. Patients in the control group received only the routine health center training. Data collection instruments included the standard Perceived Self-Efficacy Questionnaire in middle-aged diabetic patients and a checklist for recording clinical characteristics.
Results: The fasting blood glucose levels decreased in all three groups after the intervention; however, this difference was not statistically significant among the groups in either the pre-test or the post-test. In the post-test, a statistically significant increase in perceived self-efficacy was observed between the patient-centered group and the family-centered group, as well as between the patient-centered group and the control group (P<0.05).
Conclusion: The patient-centered and family-centered empowerment model-based training on patients’ perceived self-efficacy was evaluated as effective; however, it had no effect on the fasting blood glucose levels of patients with type 2 diabetes.

Effectiveness of Group Schema Therapy on Aggressive Behaviors in Individuals with Substance Use Disorder

Kazem Shariatnia

Background and Objective: Substance use disorder is recognized as one of the most significant issues impacting the youth population both globally and within our country, leading to psychological consequences alongside physical problems. Aggressive behaviors are among the behavioral complications resulting from substance abuse. This study was conducted to determine the effect of group schema therapy on aggressive behaviors in individuals with substance use disorder.
Methods: This quasi-experimental study was conducted on 42 male participants with substance use disorder at the Hirkanian Comprehensive Addiction Treatment Centerin Gorgan, Iran during 2021. An 8-session integrated schema therapy protocol was implemented in the experimental group. The schema therapy protocol included cognitive techniques (schema validity testing), assessment of the advantages and disadvantages of coping styles, experiential strategies, such as mental imagery and role-playing in the group, mindset dialogue, and identification and practice of healthy behaviors as alternative solutions to the most significant problematic behaviors. Scores on the Buss-Perry Aggression Questionnaire (1992) were compared between the control and intervention groups in the pre-test and post-test phases.
Results: The mean and standard deviation of post-test aggression scores in the experimental group (79.619±12.212) significantly decreased compared to the control group (107.476±7.890) (P<0.05).
Conclusion: Schema therapy was found to be effective in reducing aggressive behaviors in individuals with substance use disorder.

Evaluation of the Correlation among Screen Time, Sleep Quality, and Overweight in Preschool Children in the City of Qazvin, Iran during 2019-2020

Abbas Allami

Background and Objective: The widespread use of digital devices by children has become a significant threat to global health. This study was conducted to evaluate the correlation among screen time, sleep quality, and overweight in preschool children.
Methods: This descriptive-analytical study was conducted on 100 preschool children (46 boys and 54 girls) aged 3 to 6 years and their parents in the city of Qazvin, Iran during 2019-2020. Data were collected using interviews and the Factors Associated with Screen Time in Iranian Children and Adolescents Questionnaire (Mozafarian et al., 2017).
Results: Seventy-six percent of the children were the firstborn in their families. The mean cumulative screen time for the children was four hours per day. Fifty percent of the parents did not adequately supervise their child’s television screen time at home. A statistically significant positive correlation was found between body mass index (BMI) and television screen time duration (r=0.24, P=0.01). With an increase in the children’s cumulative screen time, a statistically significant decrease was observed in the child’s sleep duration (r=−0.21, P=0.04). Although mothers had a significantly higher mean screen time compared to fathers (P<0.001), children’s television screen time exhibited a statistically significant correlation with their fathers’ television screen time (r=0.23, P=0.002).
Conclusion: The mean screen time for preschool children is high. Furthermore, the mean screen time is associated with children’s decreased sleep duration and increased BMI.

Effect of Food Support on the Treatment Outcomes of Tuberculosis Patients in Golestan Province, during 2017

Mohammad Reza Honarvar

Background and Objective: Malnutrition is a significant factor contributing to delays in recovery or failure of tuberculosis (TB) treatment. One nutritional support strategy involves providing food baskets to TB patients during their treatment course. This study was conducted in Golestan Province to determine the effect of food support on the treatment outcomes of TB patients.
Methods: This descriptive-analytical observational study, supported by the Community Nutrition Improvement Office of the Ministry of Health, was conducted longitudinally in two parallel groups in Golestan Province, during 2017. The first group consisted of 129 TB patients under treatment who had received two supportive food baskets and had completed their treatment course. The second group comprised 399 TB patients who did not receive any supportive food baskets. The outcomes, including mortality, treatment non-adherence, treatment failure, and recovery, were tracked for both patient groups by the healthcare system, and the necessary information was recorded in the patients’ records and compared.
Results: During an 8-month follow-up period, commencing from the second month of treatment, the increase in the mean weight of patients receiving the supportive food basket was statistically significant (P<0.05). Recovery rates in patients receiving the supportive food basket were determined to be 94.6%, while in patients not receiving the supportive food basket, it was 88.7% (P<0.05). The relative risk of non-recovery in the group not receiving the supportive food basket was 2.078 times that of the group receiving the supportive food basket (95% confidence interval [CI]: 0.961-4.494).
Conclusion: Receiving a supportive food basket is effective in the treatment of TB patients in Golestan Province.

Comparison of Certain Risk Factors Associated with Mortality Due to Coronavirus Disease 2019 in Patients at Shohadaye Kargar Hospital in Yazd, Iran (2019-2020)

Sareh Rafatmagham

Background and Objective: The coronavirus disease 2019 (COVID-19) has shown an increasingly rapid progression in individuals with underlying diseases or comorbidities, frequently culminating in mortality. This study was conducted to compare certain risk factors associated with mortality due to COVID-19 in patients at Shohadaye Kargar Hospital in Yazd.
Methods: This descriptive study was conducted on 120 surviving (recovered) polymerase chain reaction (PCR)-positive COVID-19 patients (55 males and 65 females) with a mean age of 52.8 ± 18.88 years and 60 deceased PCR-positive COVID-19 patients (34 males and 26 females) with a mean age of 75.4 ± 15.4 years at Shohadaye Kargar Hospital in Yazd, Iran during 2019-2020. Census sampling was performed on all confirmed positive cases of COVID-19. Variables including age, gender, cigarette use, presence of diabetes, hypertension, pulmonary and cardiovascular diseases, and malignancies, which were collected in Yazd Province by the Provincial Coronavirus Committee, were evaluated.
Results: The variables of gender, cancer, cigarette use, asthma, and deep venous thrombosis (DVT) did not show any statistically significant differences between the recovered and deceased groups. The variables of diabetes, hypertension, ischemic heart disease, chronic obstructive pulmonary disease (COPD), and age showed statistically significant differences between the two groups (P<0.05).
Conclusion: Advanced age and the presence of hypertension and diabetes are considered risk factors in COVID-19 patients.

Effect of the Parent-Implemented Early Start Denver Model Interventions in Improving Communication Skills and Reducing Severity of Symptoms in Children with Autism: A Case Report of Four Patients

Parvin Ehteshmzadeh

Autism is a neurodevelopmental disorder characterized by deficits in communication skills as one of its most prominent diagnostic criteria, and the initiation of intensive early interventions is a critical determinant in the prognosis of this disorder and the reduction of its severity. This study was conducted to determine the effect of the Parent-Implemented Early Start Denver Model (P-ESDM) interventions in improving communication skills and reducing the severity of symptoms in children with autism. This experimental case report with an A-B design was conducted on 4 children (3 boys and 1 girl) under the age of 60 months diagnosed with autism, who were referred to the Shekoufeha Autism Center in the city of Mahshahr, Iran during 2021. Initially, their parents received training in the P-ESDM interventions through 12 individual, one-hour, weekly sessions. The Autism Treatment Evaluation Checklist (ATEC) was used to assess communication skills, and the Gilliam Autism Rating Scale-Second Edition (GARS-2) was employed to assess autism severity. Assessments were conducted in 7 phases (2 baseline assessments, 3 assessments during the intervention, and 2 follow-up assessments). Data analysis involved descriptive statistics, within-condition and between-condition analyses, and an examination of the percentage of overlapping data (POD) and the percentage of non-overlapping data (PND). The implementation of the P-ESDM training culminated in the decreased mean scores, improved communication challenges, and decreased autism severity scores across all 4 subjects. In the within-condition analysis, the subjects’ communication challenges and autism severity scores exhibited a descending and stable trend. Moreover, in the between-condition analysis, the PND at the baseline and intervention phases was at its maximum (100%), and the POD was at its minimum (0%). The observed changes persisted until the follow-up stage. The findings of this study demonstrated that the implementation of the P-ESDM interventions could significantly reduce communication challenges and the severity of symptoms in children with autism, leading to improvements in their communicative skills.